How to Survive the Next Five Years

Whenever you find yourself on the side of the majority, it is time to pause and reflect.

—Mark Twain

Predicting the demise of the private medical practice has become a favorite sport of pundits and so-called “experts” in the media and at many of the conferences you attend. With all of the changes occurring in so many parts of our medical system and with the increasing complexity of simply operating in that system, it is understandable and appropriate for anyone who is interested in the issue to be concerned. It is a system that is in flux, and it is changing.

Almost all of us recall living through and surviving the financial meltdown of 2008. The Dow Jones Industrial dropped to below 8,600, after having reached a high of 14,164. The “experts” were predicting depression. “We are in a free fall right now and fundamentals have been thrown out the window,” said Phil Orlando, chief equity market strategist at Federated Investors.(1)

It appeared that we were headed for a new reality; a very bad reality that could potentially take all of us down. It was scary.

At the time, experienced observers understood that our financial system, while flawed, was fundamentally sound and that the markets would recover, and eventually the Dow would cross 20,000. What we don’t know is when. On May 19, 2015, the Dow closed at 18,312. Not 20,000, but knocking on the door. At the time of this writing, uncertainty is shaking our markets again, but a deeper understanding helps us see that it is only a matter of when we get to 20,000, not if we get there.

It is very difficult to see what is truly going on when you are in the middle of something. The military calls this “the fog of war.” It’s messy on a battlefield. Everything is confusing.

The reports of my death have been greatly exaggerated.

—Mark Twain

You’ve heard the whispers. Private practitioners are going to have to band together in super groups just to be able to survive. Hospitals and other systems are buying up all the private practices. Small private small practices are doomed.

There is just one problem: it’s not true. Not only do the facts not bear this out, there are fundamentals—remember them?—that, if understood, guarantee it’s not true.

Your Future Can Be Bright—It’s Up to You

The next 5 to 10 years are positioned to be the second “golden era” of medical practice. I call it the “second era” because some doctors remember other periods very fondly as “the best of times.” For some it’s the 1970s, for many it’s the 1980s, and a couple of you really loved the 1960s. Just as the experts predicted disaster for the financial markets as we began one of the longest bull markets in history, the experts are predicting the demise of the small private practice just as it is poised to be one of the best times in history for small private practices.

It is true that it is becoming more complex and difficult to manage a private practice. The weight of paperwork and regulations can be overwhelming, to such an extent that it is causing many doctors to decide to exit their practices, often five or more years earlier than they really wanted to leave. They are contacting their colleagues and discussing acquisition or merger possibilities, or just closing their doors. This has caused a significant number of patients who still want to see a doctor in private practice to seek out other doctors who are continuing to practice in private practices.

At the same time, fewer doctors who finish residency are seeking private practice opportunities, because they have been told repeatedly that they should not even consider it. They are just looking for jobs. (To be sure, many excellent young doctors are still looking to join you and someday partner with you; there are just fewer than there used to be.)

This has created an opportunity for doctors who remained committed to private practice, because while the demand for your services will be increasing, the supply of private practitioners will decrease, a trend that is only going to accelerate in the foreseeable future. The stage is set for your second golden era.

There is Just One Catch

There is a catch, but it’s a good one—and it is your one outstanding competitive edge. You will have to market and manage your practice much better. The opportunity is there; the patients are there; and yes, the government and other forces, while really annoying, are going to make sure they don’t hurt our citizens by putting doctors out of business. The healthcare industry is one of the largest market sectors in our economy, and disrupting it too much is something no one can tolerate.

So in the end, it all comes down to you. That’s the good news for you. And it’s the bad news for everyone who doesn’t have this mindset.

Your Mindset Is Your Secret Weapon

It is up to you. No one except you can stop you if you understand the following points and take the appropriate actions.

It is no longer possible to manage your practice haphazardly. Two key strategies that will significantly support your success in this post–Affordable Care Act future are effective practice management and effective marketing.

Effective Practice Management

Institute clinical and nonclinical procedures (protocols). The efficiencies gained by practicing in a structured and streamlined approach are now as essential to profitability as they have always been to patient outcomes. When you practice by protocol, your quality of care goes up dramatically, because you are practicing more comprehensively and your per-visit value soars, thereby making it possible to earn more with every patient visit.

Consider adding appropriate ancillary services that are cash-based, or more services that can be delivered by your well-trained staff, such as nutrition programs or wellness services. Patients are interested in and open to these kinds of programs and often are seeking them out. As you integrate these healthy services, you’ll find your cash flow improving and your patient outcomes soaring.

Effective Marketing

Marketing your practice is now as important as your credentialing. You cannot operate in this highly competitive, complex, and confusing healthcare marketplace without effectively communicating to prospective patients and existing patients.

It is essential that you take marketing your practice seriously and commit resources to ensure that anyone in your market who needs your help can find you online, from medical and nonmedical referral sources in your local market, from your own patients, and from any promotional activities you are participating in with the larger community.

This means, first, having a website and a vigorous and engaging social media strategy. You must be sure your local search engine optimization is in excellent condition and you have multiple positive reviews. Second, this means having a well-trained staff member who is reaching out regularly to potential referral sources, both medical and nonmedical, in your community. Third, this mean communicating to your own internal database of patients monthly to nurture your relationship and build referrals and reactivations. And finally, it means fielding appropriate marketing and advertising strategies in the community to raise awareness of your brand and promote it.

This is all good news because your future is in your hands, not those of bureaucrats or insurance executives.

The next 5 to 10 years are under your control.

If you are thinking that since 2008, while the markets and the economy have rebounded, many people have been left behind, and it certainly doesn’t feel to them like things have improved—you would be right. As we move forward in this new reality of private medical practice, many of those people who are complaining in the hallways at your conferences will experience exactly what the experts are predicting because they don’t manage their practices well at all, and they don’t market them. People who are not able to adapt or innovate are being sidelined. This has always happened, and it always will. But at the same time, millions of people, including many reading this article, have experienced enormous growth and opportunity because they have adapted, grown, and prospered.

The next 5 to 10 years are under your control. No one except you can stop you. But it isn’t easy. The path to success is filled with challenges and frustrations and betrayals and disappointments. You’ve got to get over that. Deal with it. And find that abundance, joy, and prosperity is right before you—if your mindset allows you to see it and grasp it.

Is There One Thing That Can Guarantee Your Success?

Is there one thing that can guarantee your success? This is one of those questions that shouldn’t be asked but always is. It’s just like the question “What is the one thing I should be doing in my marketing?” There is no one thing—if there was, everyone would be doing it and everyone would be winning.

In marketing and in business there isn’t one specific thing you need to do to be successful. There are a number of strategies that, when added together, create far more than the single components can do alone.

Luckily, though, it turns out that there is answer to the question, “What’s the one thing I can do to guarantee my success?” Here it is:

Be here, one year from now, actively immersed in the process.

—Jeff Olson, The Slight Edge(2)

That’s the answer. That’s the only answer. The one thing that can guarantee you success is to keep going. Don’t quit. Commit to yourself that one year from now you will be here, actively involved in the process.

That process can be anything. It can be your health program. It can be your marketing program. It can be becoming an effective CEO for your practice. It can be becoming a better mother, brother, friend, and business partner. Whatever you want to succeed in, you must have a plan and you must commit to that plan. You must commit to:

• Be here. Being here means staying focused on your plan. In fact, it means getting a plan if you don’t have one. The biggest hurdle to your success is lack of a plan. We all have a lot of “want to” but very little in the form of a concrete plan. Your plan can be simple, and simple plans are usually much more effective. “Be here” means paying attention and being present.

• One year from now. “One year from now” is a clear way of understanding that change and growth take time. What you want will not happen overnight except in rare cases. Keep putting the red X’s on the calendar every day you follow through on your plan, no matter what happens that day.

• Actively immersed in the process. You can’t phone this in. If you want a healthy practice filled with a reception room of perfect clients, you must market your practice well.

If you want to guarantee your success and ensure that you don’t just survive the next five years, but thrive, then be here, one year from now, actively immersed in the process. That’s the answer, and it’s a heck of an answer.

Reference

1. Twin A. Dow tumbles 7%. CNN Money. October 9, 2008; http://money.cnn.com/2008/10/09/markets/markets_newyork/ . Accessed October 8, 2015.

2. Olson J. The Slight Edge: Turning Simple Disciplines into Massive Success and Happiness. Austin, TX: Greenleaf Book Group; 2013.