I had an online file folder from GoDaddy to store data, but I kept forgetting the password, which is another problem.  When I decided to stop using it, I had to transfer hundreds of files back to my computer, just to be sure I had them.  

The pluses of online applications:

1.  They are cheap.  Most are under $20 a month.
2.  They don’t require you to sign up forever. You can sign up month to month and cancel at any time.
3.  They store your information online, so you don’t have to worry about backing up your computer.
4.  They are very user-friendly, giving you lots of helpful information and easy tutorials.

What’s not good about these online applications:

1.  You are storing personal and company information online, which might not be secure.
2.  You have to remember your password and be able to go online to get the information.  If you have a bad day and forget your password, or if your Internet connection does, you’re SOL, if you know what I mean.
3.  Most are pretty limited in what they can do.  Some of the online programs I’ve used are very sophisticated, for the high end version, but many don’t have much power.  If your business grows you will need something more powerful.  Which leads to the last problem:
4.  If you stop using them, you have to manuallly pull off the information and manually load it onto another applicatoin.  This might not be so easy, if you’ve been using the app for a while.

In general, I would say if what you’re doing is very simple and doesn’t take much power (like a simple accounting system), consider the online version.  But if you think your practice will outgrow the system within six months to a year, bite the bullet and buy real software that you can load on your computer. 

I would welcome your comments on this subject.

Clients and patients love receiving lagnaippe.  For one thing, it makes them feel special.  That sucker you give the child as he leaves your office is lagnaippe.  Here are some other examples you might want to consider:

• When a new patient fills out paperwork, give him/her the pen to keep.  Of course, it has your name on it, but it is still a nice thought.
• I know a new doctor who gives each new patient a canvas bag to carry paperwork and directions on exercises in.  Great idea!
• Another professional gives a cookie to clients who fill out a satisfaction survey

Some tips for lagniappe:

1. Keep it small and simple.  You don’t need to spend a lot of money to make people feel special.

2.  Don’t do it all the time.  People take it for granted, and expected gifts aren’t valued.  Only give once in a while.

3.  Give unexpectedly.  Avoid the traditional holidays and occasions.  One doctor I know sends Thanksgiving cards instead of Christmas or Hanukkah cards, to express his gratitude to patients who have been with him for a year.

4.  Finally, the best present is a sincere “thank you,” which costs nothing and gives huge payback.

Happy Lagnaippe Day!

“Sell this new pillow”

“Get trained in this new technique”

“Become a distributor of these great new supplements.”

Wow!  Too much?  Absolutely.  Sure, when you have a new practice, you’re hungry.  You are afraid the patients won’t come in fast enough for you to pay your bills.  But, dividing your efforts, and spending money on new things that you don’t know will work is dangerous, for two reasons.  First, new possibilities (what my coach calls “bright shiny objects” or BSO’s) divert you from your primary purpose, your USP.  Second, they cause you to divert money that you need to pay your bills.

Remember, there’s no such thing as a “sure thing.”  If it sounds too good to be true, it probably is. 

Instead of jumping into new things that will cause you to lose focus, spend your time with the basics:  Get out there and talk to people.  Get new patients to come in, give them excellent service, and ask them to refer their friends.  Too simple?  No.  It’s what works, over and over and over.

Keep your focus, stay on the track you’ve chosen, and you will succeed. 

A:  Yes, an exit strategy is a plan to get out of the business.  When you’re starting into practice, you’re just worried about getting INTO the business, not getting OUT of it.  That is not something at the top of your mind these days. 
But some banks ask the question because they want to know your long-term plans.  Are you committed enough to this business to stay in it until you retire?  More likely, I would guess that the banker wants to know what you would do if the business were in trouble.  

Even though I don’t believe it’s a good idea  to focus on the negative, it might be illustrative to take a minute to think about what you would do if you needed to get out of the practice.  There are several reasons why you might want to do this:

1.  You decide you don’t really like the area and you want to move.
2.  A family emergency forces you to leave the area.
3.  You get divorced and need cash to settle up.
4.  You have an accident, injury, or health problem that forces you out of practice.

In these cases, you probably want to sell, which is a whole different strategy.  In that case, you would want to clean up the financials as quickly as possible, get your financial statements in order, and (depending on the urgency of the situation) call a practice broker.

Let’s take the most likely situation: You don’t have enough working capital to keep going.  What do you do in this case? 

1.  Sell your inventory and equipment.
2.  Tell your patients/clients you are leaving practice and give them enough time to find another provider (don’t just walk away from them; that’s abandonment).
3.  Pay your creditors off, starting with the bank, from the proceeds of the “fire sale”.
4.  Tell your employees you’re quitting practice, pay them, and let them go.
5.  Negotiate with your landlord to terminate the lease, or sell the building
5.  Finalize all financial and legal obligations
6.  Close out the checking account
7.  Close the doors
 And, move on.  Don’t look back.

Something bigger and better is out there waiting for you.  And you have all of this great experience behind you to help you figure out what NOT to do next time.
 

1. Concentration
2. Discrimination
3. Organization
4. Innovation
5. Communication.

In this article, I will discuss each of these skills and give you some tips for using them to make your practice more successful.
Concentration: To concentrate is to focus. If you aren’t focused on starting your practice, to the exclusion of just about everything else, it won’t get done. It’s easy to get distracted, by a current job, or financial worries, or fear, or just busyness. You must put all of your energy on getting your practice started and keeping it going. Taking your eyes off the ball causes you to waiver, and wavering means failure. Each day plan the three most important things you need to do that day. If a crisis comes up (personal or business), deal with it only if you determine it’s more important than those three things. Concentrating on getting your practice started or on keeping it moving forward will pay big dividends in creating a wildly successful business.

Discriminate. To discriminate, you must differentiate between the important and the unimportant. This is the 80/20 principle: 20 percent of anything will bring 80 percent of the results. For example, 20 percent of your clients will bring in 80 percent of your sales. sales. By looking at sales figures, you should be able to figure out which is the 20% in any situation; by discriminating between the 20 and the 80, you can concentrate your energies on the important, where they will be most productive. Here are some ways to apply this principle: If you have an employee who is in the 20 percent and causing problems, let the person go. If you have a client or patient who is just not productive and is draining your energy, let that person go. If you have a patient who is bringing in lots of referrals, focus on that person. In other words, discriminate, by focusing on the standouts. If the standout is positive, encourage this. If the standout is negative, ignore or dispense with it. Once you can do this, you will see a dramatic difference in your energy and in your practice growth.

Organize. Organizing is keeping track of all the tasks involved in managing your practice, and systematizing these tasks for efficiency. Here’s an example: Collecting money. Set up an organized systematic process for assuring that you collect the money owed to you by patients or clients. Determine how often you will bill (every two weeks). Determine how and when you will contact non-payers (by phone? by letter?). Determine how and when you will take someone to collections. To organize means to assure that you have a system. Otherwise, you will let events take control of you, instead of you taking control of them.

Innovate. Never stop thinking about how to make things better. This relates to areas like marketing and promotion. How can you promote your practice to gain new clients? Some people call this “thinking outside the box.” I’d call it “new ideas for changing times.” A wise doctor I know said, “You have to re-invent yourself every six months.” Your patient or client base never stops changing; you can’t rest on your past successes. You must keep changing and adapting. If you don’t think you’re clever, find people who can help you with these new ideas. Call an advertising agency and have them give you an hour to toss around new ideas. Or go to your local
Small Business Development Center and see if they have a marketing person who can help. Use your powers of creativity and innovation to adapt to changing times.

Communicate. This one is most important of all. To be a successful practitioner, you must be a great communicator - with your patients or clients, with your staff, with vendors, with everyone. This means you must be able to connect immediately with people one-on-one and in groups. If you don’t think you’re good at this, then you need to learn how. Take a Dale Carnegie course. Practice looking people in the eye. Go to Toastmasters to learn how to do public speaking. Join a networking group, like BNI. In other words, practice communicating and you’ll become a better communicator.

So, to be successful in your practice, you need to concentrate, discriminate, organize, innovate, and communicate. That’s all. Whoever said it was easy? That’s why they call it “practice.”

How about Parkinson’s Law:  The amount of work to be done expands to fill the time of the people available to do it.   My conclusion:  You can always cut back on employees, down to 1, of course.

Then there’s Hofstadter’s Law:  Things always take longer than you expect, even when you take into account Hofstadter’s Law.  Very true! Murray’s (my) corollary:  And things always cost twice as much as you expect.  This is why you plan for things taking longer and costing more.  Overestimate expenses and underestimate sales, and you might come out with a decent budget. 

Another famous principle that I have seen quite often is called the Pareto Principle, or the 80/20 rule: For many phenomena, 80% of consequences stem from 20% of the causes.   If you find the 20% of patients, for example, who provide the 80% of your income, you can concentrate on them and not worry about the rest.  Lots of other examples of this one:  For example, in marketing, 20% of your marketing effort produced 80% of the results.  Find the 20% that is working best and cut out the rest. 

Here are some great laws everyone should be pleased about: 

 Littlewood’s Law — Individuals can expect miracles to happen to them at the rate of about one per month. Coined by Professor John Edensor Littlewood.

Clarke’s Second law: The only way of discovering the limits of the possible is to venture a little ways past them into the impossible. Arthur C. Clarke, science fiction writer. 

Here are three steps you can take to assure that you are collecting everything you can:

1.  Set up the expectation of payment with new patients.  From the very first conversation you have with your clients, make certain they understand that they are responsible for paying all bills at the time of service.  Just having a sign in your office won’t do it.  Your staff must talk to the new patient and explain payment procedures.  Have the person sign a financial responsibility statement.  If there is insurance involved, explain that the patient is responsible for what insurance won’t pay, or that you will help with the insurance submission but they must pay you up front.

2.  Make it easy for people to pay and keep reminding them of their obligation.  Here are some suggestions:
     a.  Set up a script for all patients as they are leaving “How will you be paying today, by check or credit card?”
     b.  Offer credit and debit card payment options.  Many people expect this, and it’s worth the 3% or so to be assured of payment.
     c.   Offer payment plans for slow or no-payers.  Let them pay over time.  If you charge interest, make them sign a statement that they understand the interest charges.

3.  Review your Accounts Receivable Aging report monthly and set up a process to get payment from slow payers.  The cardinal rule of collections is “The longer the bill has been outstanding, the less likely you are to get paid.”  Don’t wait 30 days to send another reminder; send one every 2-3 weeks.  Make the reminders increasingly demanding, up to the ultimatum; then be prepared to follow up and send an account to a collections agency or take it to small claims court.

If you have other suggestions for receivables collection, let me know.

For example, let’s say you have selected a health insurance plan with a $1500 deductible and a monthly premium of $280.00.  Each month, you put $125.00 into the HSA bank account.  When you have medical bills that are not paid by insurance, you can pay them out of this bank account.  Of course, you have to have the money in the account to pay from the account.  If you had a $500 bill in January, you would have to use other money to pay it, or wait until you had $500 in the HSA.  For more information on HSA’s, go to this website:  http://sbinformation.about.com/od/insurance/a/ucHSA.htm

To look for an HSA health insurance account, the best place I’ve found is www.ehealthinsurance.com .  On this website, you don’t have to give all your personal information to see quotes, and you can see if your doctor is on one of the plans. 

Success secret:  Embrace unforseen opportunities and have the patience to ride the waves to see the vision realized

Advice: It’s important to develop and maintain business relationships.  Reputation is so important.

Advice:  1. Surround yourself with people who are smarter than you are; (2) hire talent and let them do their work; (3) always exceed customer (patient) expectations

Success Secret: Hard work, good people, and a little luck!

Success secret: Listen to your heart rather than your pocket.

Advice:  Don’t fear taking risks or making mistakes.

Success Secret:  Have an expert, talented, and dedicated team with common core values and the willingness to be flexible to meet market (patient) needs

Best advice:   Treat every customer (patient) as if he or she were the most important person in your business. (They are!)

Best advice:  Ask for input from consumers (patients), listen, and implement changes to meet their needs.