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Medical Practice Business And Marketing Articles

Article #36 (part 2)-- August 2012         

“How to See More Medical Patients, Make More Money, And Do It The Hard Way”

(Part 2)

 If you must work harder rather than smarter in your medical
practice, you will find strategies here that will work for you.

(Part 1--Discussed what working harder means for a physician who is
left no other choice for increasing practice revenue.)

Some medical patient recruiting and income strategies that will help you increase your medical practice income, while working harder...

  • Learn how to manage your medical practice business
    more efficiently

  • Run your practice and patient schedules by the clock

  • Have deadlines for completion of any office or practice
    projects and keep them

  • Create a series of goals and steps to be accomplished
    as you move along

  • Have a system for measurement of progress that’s
    made monthly

  • Necessary to avoid external obligations such as hospital
    committee work

  • Accept that there will be a degree of neglect of CME and
    increased skill training

  • Create outside income separate from medical practice

1. You must create a business system for your practice to make the money you expect and need. 

In case you have no idea what that is, or what it means, your medical practice business must be run exactly like a McDonald’s Fast Food Franchise business. Every single step, every job, every function of every employee is scripted out in detail.

Every job is done exactly the same way no matter which employee is assigned to that particular job. And, that job is done exactly the same way in every McDonald’s Franchise in China, Alaska, and Russia. It’s exactly like an automobile assembly line job... no deviations.

It means that you have to personally create what has to be done for each job in your office. You’re the only one who can do that because no one else knows what you want done in the way you would like it done to match your business objectives.

It’s a written step-by-step process that an employee is placed in that position can follow almost instantly. You have to do the same for every job position in your medical office and place all the data in a 3-ring binder organized and labeled so when changes are made, only one page has to be replaced.

A practical example how organization works...

Ophthalmologists seem to have a great talent for such a business system when working in a group or partner practice. The Shepherd Eye Center is Las Vegas employs twelve ophthalmologists at one of their three clinics here where I recently had my vision checked.

Every step of the process was exactly choreographed down to the last detail. At no time did the 50 or so patients there have to go ask the desk receptionist what to do next, at least none that I witnessed... the exception was to ask where the bathrooms were located. 

I wasn't told what was going to happen next, but I was moved from one technician to another with less than 10 minutes waiting time. Quite obvious to me was the fact that the two screening sessions, each lasting no more than 5 to 7 minutes, were to record the generic baselines of my visual functions so that when I finally got to the doctor, all she had to do was check for visual and eye pathology, offer results and options, even allowing 2 or 3 minutes out of those 8 minutes to shoot the bull.

The most successful businesses in the world are using business systems structured such as these, because they bring overall efficiency to the top level possible, confusion is eliminated, and conflicts about what an employee in any job position is expected to do are eliminated.

In addition, patients and customers are not overly confused, patients wait less time to see the doctor, and patients receive more thorough medical care (not necessarily better care, but usually results in reliable care).

Not only is a medical office, or any business, able to run at peak efficiency all the time, but also provides the additional medical practice business attributes of peak productivity of every employee, time saving management issues, peak profitability, and becomes a perpetual well-greased money making machine like no other.

Your official medical office business system, even in a solo medical practice, needs to be  composed of a series of smaller business systems appropriate for each job position. Each segment of the business system is composed of efficient step-by-step “processes” each employee follows to complete each part of their job assignment exactly like you expect it to be done. You can be lenient about how they get it done as long as they include all the steps you have dictated. 

Lesson: You will be able to see about 10 to 20% more patients per day than you do now during the same time period. To have that kind of efficiency, you should have more office space available than you normally use... suggesting to you that it would be smart to select office space at the start that appears to be more than you need in your practice.

Also, if you choose to employ a nurse practitioner or certified nurse midwife (if you are an OBG) later on, you will already be ready for that addition.

Like for a receptionist... what to say to a patient calling in and how best to say it, what to tell patients when answering their questions, how to make appointments that fit a particular medical problem they have, how to create a chart or electronic medical record for that patient prior to their upcoming appointment, and etc.

·    Sure it’s a big job to create your system, only you can do it!

Because, if you don’t create a system to use to increase your practice revenue, the time wasted on explaining and re-explaining to employees what they are expected to do and how to do it your way—not theirs—
will frustrate you much more than the government fee restrictions.

The inefficiency of employees doing the same job a different way each time plus using their own ideas from former jobs mixed in to do it, will terrorize a well meaning boss.  

Lack of a coordinated team effort working towards a single practice goal will lead to business chaos every single time.

Business chaos leads to total inefficiency, significant loss of productivity and income, inability to handle the increased patient load, and the inability to correct the problems already present in your medical office.

These factors account for increased patient attrition resulting in insufficient revenue to cover all business and family obligations.

·      Once the system is created on paper, it’s good for a hundred years and you don’t ever have to do it again (just alter bits of it occasionally).

You can hire someone to do it for you. Even then, you will need to be persistently involved in modifying it to fit your needs. Probably the process will take as much or more time to complete than it would for
you to do it all yourself.

In addition, you’d have the job of educating the writer who will have
no idea about how to manage a medical practice in the first place, let alone understand your way of thinking.


2. You can create a good degree of efficiency by running everything in your business by the clock. (Called time management)

Since medical office practice is so often taking the brunt of hospital or other committee meetings that run overtime, hospital patient rounds that require unexpected time to complete, patients with medical emergencies that suddenly appear in your office unannounced, and other unpredictable interruptions of practice flow, it’s a miracle if any doctor can remain in full control of how he or she spends their practice time.  

It doesn't mean it won't help, but every inch of improvement counts. Even so, the use of establishing a tight time schedule for everyone to follow daily for what you intend to get accomplished is well worthwhile.  

If you are the kind of doctor who doesn’t have the discipline for sticking to a time limitation on all you do, then forget all this and enjoy your freedom and your less than sufficient practice income. Does that thought bother you?

If you allow a fixed length of time for each patient visit or for each job you have in your medical practice business, you will discover that your efficiency increases dramatically. Of course there’s a downside to that.  

It means leaving meetings before they are over, having to severely restrict you time and attention to patients, shortchanging patients in their medical care, interrupting peer conversations in order to get back to the office to meet patient appointment times, and other such anti-social behavior required by the clock process. It’s what you have to do to win. 

There is a secret to the clock discipline and setting deadlines for completion of projects that less than 1% of all business owners, managers, and business consultants know or talk about. 

The reason it is such a close held secret and business advantage is that so few professionals have never used the work-by-the-clock system of time management themselves.

They don’t use or even want to try such a system for many reasons... 

  1. Most professionals who are business people refuse to permit a
    clock to dictate to them when and how fast they do their thing.

  2. The entrepreneurial attitude of successful business people,
    including doctors, runs contrary to time limitations and lack
    of freedom of creative expression inherent to their personalities.

  3. They don’t believe that a clock discipline is any more efficient
    or productive than their own conscious mental distribution of
    their time.

  4. No one is able to demonstrate to them enough factual data
    and studies to convince them of the superior effectiveness
    of a clock discipline in a business environment. It’s like
    trying to explain the existence of God to an atheist.

  5. The “herd” effect---where one quickly adapts to the standards
    and disciplines that almost all people in a professional business
    setting are already doing... “So why should I choose a different
    approach to my business when almost all others are doing quite
    well without using a clock discipline in their own businesses?”

    It's very apparent that one doctor has no honest idea how
    another doctor really runs his medical office business, so beware of being a copy cat.

This brings us to the truth and the secret you will be unable to forget… ever!

First, only the individuals who use a clock discipline for running their small business management, experience the dramatic improvement and increase in their productivity. Are they able to explain how it works to others? … Rarely, if ever! 

Second, and most important, is what happens to us once we are fully functional in the clock discipline routine. Your mind snaps into high gear. It sorts information faster. It’s able to prioritize facts and data at lightning speed, and it organizes materials that are needed for the completion of the project. It all happens at an unbelievable speed.

Over two generations of the neuro-scientific community explain this effect by the innate ability of the subconscious mind, under these conditions, to actively participate in the conscious mind’s arena. Try and explain that one, to anyone! 

The activation of the subconscious memory banks, its selection of all relative information and facts essential to the work being done are instantly sent into our conscious mind.  

The persistence of this remarkable capacity of the mind that goes into overdrive without asking it to, is not all that unusual when you consider the common examples of that mental capacity in other areas of our society that are seen every day.  

Think of any situation when we are mentally challenged, threatened, in sports dodging a tackler, in survival circumstances, and many other triggering situations when suddenly you must make immediate decisions about the circumstance you’re in at the time.  

After it’s all over, you begin to wonder how you miraculously came up with doing the right thing at the right time.  

In spite of the downside of a fixed clock discipline, sticking to that rigid commitment will certainly increase your income, allow for more patients to be seen, and maybe guarantee you will get home in time for supper every night with the family… don’t laugh… it might happen... occasionally.

3. Deadlines and speed are well known to increase efficiency and results

For those who aren’t able to tolerate sticking to rigid time blocks for completing business tasks, using deadlines and speed as a means of implementing your medical practice income can be a
reliable strategy.  

 Some daring tactics being used by doctors to earn more today

·     Hiring midlevel healthcare providers so more patients
can be seen daily... increasing income

·     Joining a group practice where your overhead is decreased
and patient flow is the same or increased

·     Adding new skills and procedures to your repertoire...
working harder

·     Moving your practice to an affluent area of a city

·     Implementing telemedicine to your practice... care for
more patients without doing examinations in the office

·     Concierge (cash only) method of medical practice

How could newspapers survive without having deadlines to stick to? Knowing that you have a deadline, creates a chain of events that permits you to meet the deadline.  

Most people who never set deadlines for work being done either procrastinate or never do what they intended. Setting goals for yourself follows the same path. It’s why so many people and professionals spend their lives bouncing from one job to the next.  

For medical doctors who avoid deadlines and goals, their medical practices evolve independent of the doctor’s intentions and desires, leaving them in financial quicksand they can’t escape from down the road. 

Just having the intestinal fortitude to set deadlines for accomplishing various steps in improvements in your medical practice is the first step towards your ability and motivation to do even more. You can’t take action standing still.  

You’ll never improve by repeating the same stuff over and over again and expect the results to be different. Those who can't or won't keep up with the changes that are rapidly occurring throughout the medical profession and healthcare industry will become slaves to their environment.

How about a test effort to see how you stand relative to deadlines

You might consider a test run on something you believe will make a difference. Say, you decide that you’d be ecstatic about recruiting 5 or even 10 new patients next month. How would you approach that goal? You’ve made a mental commitment to do it, somehow. Such a promise to yourself creates a new flame inside that burns with enthusiasm.  

It’s exactly the same feeling you get when you are facing a medical patient with a complicated health problem, have no idea what is causing their symptoms nor the diagnosis, nor how you’re going to treat that patient. Immediately, your mind kicks into high gear, you are anxious to get to the cause, and it becomes a puzzle and challenge that excites you to solve. 

Most doctors face that situation at least once a week. You have to admit that it certainly brings your mind into focus on the most common possibilities almost immediately. How does that happen? Maybe you haven't treated such a problem for over 10 years and your memory about it seems vague at first. 

In the next several minutes you likely will have a plan for diagnosing the cause, a strong idea of what you will be looking for in the test results, and have thought about a treatment plan for that if it turns out to be correct.  

That patient actually presented you with a virtual deadline. “Doctor, get your shit together, find out what is causing these medical problems, and get it cured ASAP!” It may not be said out loud, but you know what the patient
is thinking. 

A deadline triggers the action needed to accomplish the job. You also understand, or should, that associated with the deadline is the insinuation that you are also working under an obligation for speed and urgency.

The fact that you have created some sort of a mental deadline for getting to the solution means that you have consciously agreed with yourself to reach that diagnosis and treatment stage at a much faster speed than you would have otherwise. A patient in excruciating pain can't wait a week for you to figure out the cause and treat them.

With the rapidly changing and advancing world in health care delivery today, patients expect doctors to do everything quickly and make no mistakes.

The urgency for using deadlines to earn more money in medical practice is overwhelming, especially for doctors in private practice.  

It may not be the best way to do it, but, for a percentage of medical doctors it offers better possibilities for increasing income than doing nothing at all (the worst practice destroying position of all).  

My views about the “work harder” mindset

In 1957 as a young college student age 20 working my summer in the chemical research lab at the General Electric company about 25 miles from my home, I joined a car pool of other GE employees.  

All were blue and white collar employees still recovering from the WWII war effort, but professionals of one type or another. I was intrigued by the job category one of those men worked in and proceeded to question him about what he did at this huge GE plant that manufactured locomotives, primarily.  

He was a time management consultant; something I had never heard of nor knew existed. His job consisted of watching a segment of the working employees go about their manufacturing chores for a period of time, then analyzing areas where workers were wasting time, and figuring out a way to avoid those situations and improve productivity of the workers. 

From conversations with him I learned in haphazard fashion lessons about productivity from a grass roots mentor walking the walk. That car pool education stored in my memory banks for 50 years now gives me an inside edge for understanding about wasting time and loss of productivity right in my own profession. 

I am repeatedly amazed by what the lack of good business practice management I find in medical practices today does to the income levels of those medical practices. It saddens me to see how even small adjustments or improvements can significantly raise the profitability of any practice today, yet are never done for lack of the knowledge needed by the physicians to know what to do, and how to do it. 

The following factors so commonly found in medical practices account for the million dollars left on the table during a doctor’s medical career that they never recognized was there to stuff in their pockets full with.

Medical practice management landmines 

·   Wasted work time

·   Lack of business systems being used

·   Absence of prioritizing office work and functions

·   Never had or disintegration of any real teamwork

·   Employee envy and competition

·   Lack of a boss who gives direction and instruction
but lacks leadership

·   Incompetence in employee hiring and firing

·   Lack of measurements for practice growth or decay

·   Doctors who delegate management to employees
having less knowledge and education than themselves

·   Doctors who spend less than 10% of their time
managing their own offices

One or more of these factors has the explosive power to wound an office medical practice so severely that it can never recover. Fortunately, most physicians are able to intermittently work at management and business problems when the problems become severe enough to affect the financial stability of the practice. Sometimes that doesn’t happen, or comes too late to do much about it. 

When these problems are recognized early, it usually means that the doctor in that situation has been attentive to the business side of his or
her practice. 

From my perspective, there’s not a single medical practice in our country that needs to close because of financial failure. There are multiple methods for avoiding that catastrophe using well known proven business and marketing strategies. These have to be already implemented prior to the serious financial problems because these tools are not engineered to operate on overnight notice and implementation. 

Among the many causes for financial failure, the two blatant causes that prevent any form of rescue are...  

1. Discovering the financial problem too late when all
    the discretionary practice income is long gone, and
    the unpaid overhead costs are months behind.

2. When the doctor sees the financial problems starting
    and figures he or she is smart enough to bring the
    practice out of the hole themselves.

    This mistake will postpone the problem but inevitably
    leads to the practice’s financial failure due to the same
    issues mentioned in #1.  

The amazing thing to me is that a physician with no MBA, no formal business education, and no marketing experience or significant business knowledge (perfect description of a graduating medical student) is so arrogant as to assume they can accomplish something that has taken business experts years of experience and education to do successfully.   

Bottom line: Ev ery business disadvantage found in medical practice today can be rapidly and permanently resolved with the implementation of sound business knowledge and essential marketing strategies that other successful businesses use and the medical profession ignores.   

The crime:
When a doctor reaches the stage of reasoning where the known cure of a disease is used properly or where the known cure of medical practice business sickness is ignored, it’s time for an injection of common sense and reality for those few who will take the bait.

The lesson:
Working harder should always be the last resort for physicians. Working smarter by using the tools available brings a medical practice success to its highest level and dignifies the intelligence of every medical professional who trusts the concept. 

The author, Curt Graham, M.D., an experienced physician, author, marketer and expert in medical practice business and marketing strategies, is an expert author and motivator for professionals in the business world. He is a platinum expert author with and has been published in Modern Physician and Medical Economics Magazines. His 3 books are available online.
Discover how to make your medical practice flourish and exceed all expectations with simple business and marketing strategies.
Click the link now for learning the effective ways to do it.

©Copyright 2004-2012, Curtis Graham, M.D., All Rights Reserved.



Professional Prods

man on bike loaded with 10 foot 
	wide and 8 feet wide blocks of spoonge blocks

You may believe that the work required for you to reach your maximum income potential is more than you can personally handle.

The point here is that each step in this loading process was done one package at a time. Similarly, your efforts to accomplish better results are not difficult if you accomplish one step at a time.

It's called inspiration at the start. It's called persistence in the middle. It's called celebration at the end. Better than that, it's called satisfaction.


ARTICLE---DAN KENNEDY Aug 2012     The Renegade Miphoto Dan Kennedy 
    sitting on a bull llionaire Way

by Dan S. Kennedy

"On Achievement, Prosperity, and Envy"

Oscar Wilde said: “It is better to have a permanent income than to be fascinating.” There’s nothing wrong with both, of course. Those who insist that money doesn’t buy happiness are usually short on money, ignorant of means of getting any, and selling their philosophy hard because misery loves company. Mark Twain wrote that, actually, no one can stand prosperity – another man’s. Money can’t buy happiness, but absence of money, endless worry about it, and envy and resentment of those who have it most certainly buys unhappiness.

There are reasonably happy, almost poor people. I know some. But they are rare. The lack of financial security wears a person down. I’d also note, making a great deal of money by honest means does not guarantee unhappiness. I know quite a few 7-figure earners and rich folks who are quite happy. And it shouldn’t just be about personal happiness anyway – such a childish pursuit.

There is some ethical obligation for being here, to be constructive, productive and contribute, whether by creating magnificent art, or writing an influential book, or building a company and creating jobs, or amassing and being a good steward of wealth, or being the best schoolteacher, nurse, cop, taxi driver or whatever you can be, and being willing to do tasks and bear responsibilities that don’t necessarily produce happiness-as-you-go in order to accomplish significant things.

Money is not the only measurement of such accomplishment, but it is certainly a valid measurement; money is a mirror reflection of commercial value created. Those who resent the rich are often, truly, resentful of their own failure to create such value. It’s not a constructive emotion, and others’ having and expressing it ought not influence you in the least.

One of the great benefits of my work is the up-close relationships I have with people I categorize as Renegade Millionaires, and beyond that, getting paid to be keen observer of many others similarly striped. An interesting thing I find about them is, compared to most, little time or thought or angst given to the question of happiness; and compared to most, much more time and thought and energy and, yes, angst given to achievement.

It’s easy to lose sight of the central question-- are you choosing goals for yourself that are significant and rewarding to you, and progressively achieving them?

If you went to Harvard Law School and now choose not to practice law and instead live as an itinerant cowboy, sleeping under the stars and drinking campfire coffee from a rusty tin cup, and you’re honestly, authentically happy about that, more power to ya – unless you have unpaid loans and debts to family, or institutions for your education, or other responsibilities that must be honored
and discharged.

If you make millions and wish to spend much of it on wine, women and wine, and it’s your money, and you do no harm to others, have at it. It’s unlikely, though, that such things absent achievement and contribution will long sustain happiness, but you’re welcome to try. The trick in it all is honesty
with self.

Earl Nightingale observed, that when it’s all said and done, each person is about as happy or unhappy as they choose to be. That’s true as far as it goes. Happiness is amazingly subjective, but not entirely subjective. For one person, never even having to think about money makes for happiness. For another, with no economic necessity, still, redeeming a coupon and getting a good deal makes them happy. But there is fact: achievement contributes to happiness; lack of achievement contributes to unhappiness. Envy contributes only to unhappiness. And much criticism masks envy.

Your business is YOUR business. Never forget it. That’s the core philosophy behind so much of my work, including books I hereby self-servingly but also sincerely suggest you get and read: NO B.S. RUTHLESS MANAGEMENT OF PEOPLE AND PROFITS; NO B.S. TIME MANAGEMENT FOR ENTREPRENEURS; and NO B.S. WEALTH ATTRACTION IN THE NEW ECONOMY. As arrogant as it is to say, they just may change your life.

So, by all means, seek out role models, inspiring examples, teachers, mentors, advisors, experts – validated by relevant, successful opinion – and learn from and sift and sort and consider all they have to offer. But ultimately know that The Renegade Millionaire Way is by very definition
the finding of one’s own way.

DAN S. KENNEDY is a serial, multi-millionaire entrepreneur; highly paid and sought after marketing and business strategist; advisor to countless first-generation, from-scratch multi-millionaire and 7-figure income entrepreneurs and professionals; and, in his personal practice, one of the very highest paid direct-response copywriters in America. As a speaker, he has delivered over 2,000 compensated presentations, appearing repeatedly on programs with the likes of Donald Trump, Gene Simmons (KISS), Debbi Fields (Mrs. Fields Cookies), and many other celebrity-entrepreneurs, for former U.S. Presidents and other world leaders, and other leading business speakers like Zig Ziglar, Brian Tracy and Tom Hopkins, often addressing audiences of 1,000 to 10,000 and up. His popular books have been favorably recognized by Forbes, Business Week, Inc. and Entrepreneur Magazine. His NO B.S. MARKETING LETTER, one of the business newsletters published for Members of Glazer-Kennedy Insider’s Circle, is the largest paid subscription newsletter in its genre in the world.


masonic emblem bright colored American flag   Curt Graham, M.D.
   2404 Mason Ave.  Las Vegas, NV 89102
    E-mail = cgmdrx(at)
      © 2004 - 2015 Curtis Graham, M.D.,  All Rights Reserved.