by: Ivan Delman, DC
As always, practice management
is as much an art as a science. As such, it must always be practiced
and worked on.
I took the liberty of pulling
a section out of my up-coming book. This section addresses the
three areas a doctor might want to look when first trying to figure out how to start to really manage his or
Here's the section called,
"Try Managing These First"
TRY MANAGING THESE FIRST
Below are three critical
areas of your practice requiring close management:
Planning then directing
the operation of your business...You already know your business
and are aware of what you want to accomplish. It's not enough, however, just to plan your business expecting it to
operate your personal direction. This principle applies even if
you have competent office staff. As sure as the sun will rise tomorrow,
sans proper supervision, your staff will wander off the road leading
to your goals and objectives. You mustn't remain nailed to your desk
playing executive especially during the operating hours of your office. You have to be aware of every operating detail in yourpractice.
This includes following up on assigned staff responsibilities.
I call this Mobile Management. Here's how it works.
During patient hours and
whenever staff worked in my office, I would make it a point to
"do rounds". I walked through every part of the office, checking areas for cleanliness, machine maintenance and
supplies. I also observed staff interaction with patients, how
they handled scheduling and so on. This was done in an obvious, not
sneaky. fashion. I wanted to be seen walking around the office. I wanted
staff to know I consistently check on procedures and protocols.
If I didn't totally understand
a working area of my office, I would spend extra time there until
I felt comfortable with it's functions.
The majority of my desk
time was during off hours. Until you are of sufficient size to
warrant hiring an office manager who will then utilize Mobile Management", the doctor's place is out in
his office, not behind his desk. Even when I had an office manager,
I made "Rounds." Just not as often.
Cash-flow simply is the
moneys coming and going in your business. It is essential to know
your future cash requirements as well as current cash expenditures. Most successful companies use some
form of cash flow projection. The extraordinary manager can carry
the information in his or her head, however, that's an exception.
A cash flow budget and projection can be as simple or complex as you want to make it. Normally, a cash
flow budget will list all possible anticipated and actual income
/ expense items in your practice. Gathering the cash flow data
is as simple as looking back to your prior basic income and expense
items, setting them down on paper anticipating similar numbers
in the future. Then, after you reach the anticipated time period, you write the
actual numbers in a column next to your budget. You then analyze
and adjust your budget for any differences. The answers will give you the
details regarding the life's blood of your practice, your cash
I used an informal system
which included charting all income and expenses over the years.
That cyclical information allowed me to plan for low cash periods (See sample cash flow chart). I also kept
a separate cash reserve for unforeseen expenditures such as emergency equipment repair. If additional funds were needed, they were obtained
via short-term bank loans at negotiated interest rates. The business axiom, "The best time to borrow money is when you don't need
it" holds true. It's to your advantage to predict low cash
periods then borrow when you're in a strong cash position. Some of my colleagues use
their credit cards in lieu of bank loans. This is not a smart
business practice. Credit card financing is very expensive and should be
utilized only if that loan can be paid off within thirty days
or less thus avoiding their high interest charges.
How much money do you want
to tie up in vitamins, appliances, literature and equipment? You'll
be shocked to find how much capital you have sitting on your shelves.
Take the time to see what moves and what gathers dust while sitting
on your shelves.