Day-by-day, hour-by-hour, minute-by-minute. . .how often do you gauge the success of your practice??
I have hit an unexpected challenge as a business owner; what is the end-goal. Remember, I started this practice 3 1/2 years ago, from scratch. My first patient was 9/11/2006 - a denture patient. My second patient was on 9/12/2006 - a comprehensive new patient exam (the 1st of many in that first 6 months) on an old friend. On 9/13/2006 I had 3 patients including the first of many emergency patients. I had 2 employees and 3 chairs. My goals were simple, see at least 1 patient a day - everyday we were open. Every month was a new record and my goals were pure survival goals (make payroll, pay the bank, find some money to bring home when you can).
That survival mindset is a powerful thing. It forces you into a constant evaluation of the practice systems. I could tell you at any given moment where every dime of the money was coming from and exactly where it was going. Often times the money that was coming in had gone out the day before.
So where are we 40 months later?
On 2/18/10 we saw 18 patients and produced as much in that day as we did in the entire month of September 2006. Instead of seeing 50 - 60 new patients a month we are seeing 25 - 35. I have 5 employees (including 2 hygienists). We have grown, by any economic measure, we are a success. We grew in 2009 even in the midst of the "Great Recession". All of that is awesome in the abstract.
So why am I still in survival mode?
I have never, ever worked in another general dental office. My dad is an Orthodontist so I have lots of experience with their schedule and the ups and down of that occupation. But nothing in the generalist arena. Now that is great in one sense, I have no "brain damage", I have no prejudices about how something should or shouldn't be done. At the same time, I don't have anything to gauge the health of the practice by. Yes, I can look at the numbers and compare them, I can look at overhead percentages and see that we are within the appropriate ranges. But what about the down time?
A business owner in survival mode is looking at the patients scheduled in the next hour, the next day, the next week. A business owner with time to sit in his office on Monday morning has time to watch the schedule open up as the messages are played at the front desk. And that business owner who is in survival mode starts to stress, yea verily, to panic because his day dropped $600 (even though it would have been in the top 20 best days for 2008).
Do you catch the irony? A business owner in survival mode doesn't recognize when basic survival is no longer the goal. I am no longer a hunter-gatherer. I have a pantry at home full of food that I can choose not to eat. I don't have to concentrate solely on where my next meal is coming from - I can look longer term.
But I can't!!
It is time to move my practice analysis out 1 level. It is time to move to a month-by-month analysis, isn't it?
This year, I finally set out some goals for each month and the year that I felt were statistically valid. I had a couple of "real years" (2008 & 2009) which I could use to gauge some trends in the practice and felt like I could realistically set a goal that is reachable with an expected growth (my practice is not done growing, I don't know when it will be but that is another blog altogether).
So we set these goals and then in January blew right by the 1st one, we beat the goal by 10%. Great! But hold on, that doesn't mean my goals have changed for the rest of the year. Each month still has its own independent goal that I have set. I am not changing those goals just because we had 1 good month. But it is in the back of your head now; not only should be seek to reach these monthly goals, we should seek to surpass them by 10% or MORE.
That is survival mode kicking in. Gather, gather, gather, more, more, more. I should be excited when we hit our monthly goal - and we did again in February. But today, instead of being 10% over our goal, we have had some patients reschedule into March, so we are only 5% over our goal - and I'm stressed.
That is INSANITY!!! I AM 5% OVER MY GOAL FOR THE MONTH (12% OVER MY GOAL 2 MONTHS INTO 2010) AND I AM STRESSED???? As my 5-year-old said one time, "what the heck is going on in there."
I am past the point of being stressed over having some open time on my schedule - aren't I? Is this normal? In 2020 will I still be fretting over whether I can pay a bill that is due March 15th - yeah, I have a bill due in 3 weeks that is consuming my thoughts because it is a biggie. Yes, we have had the cash flow to pay that bill for the past couple of months, but will it last? Do I need to go back into survival mode? The survivalist business owner would put everything else on hold to make sure the vital bills are paid. I don't want to do that. I have all my bills paid as of today. Do you know how rare that is for me? I have no past due bills of any sort. I am bringing money home on a schedule for the past 6 weeks (and that is the 1st time I have done that in 40 m0nths). So why the difficulty sleeping? Why the hesitation to pay a bill before its actual due date?
When does the confidence kick in?
What do you use to evaluate your month?
What do you do when you have downtime? Is is stressful for you? If not, why?
Ahh, the voices are asking so many questions today. I must get them quiet, hopefully it is a good NYT Crossword puzzle today [well while waiting on approval to post the blog I finished the NYT puzzle good one today and my first sub-4 minute solve, now I just have to do payroll].
Have a great day.