Managing and Marketing a Successful Practice

• Managing a Practice is a journey not a destination

• Profit is a reward for taking a risk

Chris Swaffin- Smith B.Sc. M.Phil.

www.privatepracticereflections.com

Common Errors

• INVESTING IN TOO HIGH A LEVEL OF FIXED COSTS TOO EARLY

• POOR PRICE STRUCTURE• NOT SORTING OUT A LEASE PROPERLY• NOT WORKING OUT HOW MUCH YOU NEED TO EARN TO

LIVE• NOT PLANNING• IGNORING SUPPORT AND HELP THAT MAY BE AVAILABLE

Why do businesses fail ?

• CASH• CASH• CASH• LACK OF ENERGY AND VISION• PLANNING• UNREASITIC VIEW OF COSTS AND REVENUE

What do successful People Do?

• RESEARCH THE MARKET AND KEEP CLOSE TO POTENTIAL PATIENTS

• NETWORK• CLEARLY UNDERSTAND THE FINANCES OF THE BUSINESS• WORK HARD,BE PERSISTENT,AND BELIEF IN WHAT YOU

ARE DOING• THINK OUTSIDE OF THE BOX BUT STICK TO YOUR

KNITTING

SWOT

• Opportunities and Threats External

• Strengths and Weaknesses Internal

Which of these financial techniques do you use?

• Cash Flow Forecasting

• Profit Forecasting

• Breakeven Analysis

SWOT Analysis Opportunities

• Are their opportunities for new forms of treatment in the area?

• What is happening demographically• Are there opportunities for multi discipliniary

treatment centres

What is my Practice Good at

• What do we do well in our practice• What do your patients see as your strengths

and why do they come to us.• In what ways are your staff an asset• What clinical specialisms do we offer• In what ways are accessibility and location

important to our patients

What are we not so good at within our Practice

• Making the best uses of our resources. Associates and treatment rooms

• Are you working the number of hours that you want in order to achieve a sensible work /life balance?

• Are you treating the type of patients you want to? • Are you making an adequate financial return?• Are the treatments that you offer up to date? Do our patients

know all they about what we do• Is your Surgery up to date and in good decorative order?

Options in relation to SWOT

• Match Strengths to Opportunities• Focus on Strengths to Reduce Threats• Work on Weaknesses to combat Threats• Work on Weaknesses to be more able to take

advantage of opportunities

HOW DO I KNOW HOW WELL I AM DOING ?

FINANCIAL PERFORMANCE

• CASH FLOW • PROFIT • GEARING

SOME TRUISMS

• Profit is an opinion, cash is a fact

• Turnover is vanity, profit is sanity

Price

• Cost Plus Pricing• Market Led Pricing• Time Based • Fee Based• Fee per Item• Fee per time of week• Fee per professional

Factors that impact on Financial Health (Revenue )

• Number of Treatments Per Year• Average length of Treatment• Number of weeks worked in a Year• Capacity ( either per chiropodist or per treatment

room )• Type of pricing structure• Proportion/ mix of different types of treatment• Percentage of no shows or non payers

Factors that Impact on Financial Health (Costs )

• Level of Fixed Costs.• Earnings of Principal.• Percentage of fee taken by associates.• Proportion of treatments completed by Principal and

by Associates.• Other variable costs ( such as credit card fees )• The time the Principal spends on managing in rather

than on the Practice

Breakeven

• This occurs at the point in the year when you completed the number of treatments at which;

Total Revenue = Total Costs. (Price x No treatments ) ( Fixed + Variable Costs)

What would happen if you…..

• Increased your fee per treatment by £2 ?• Increased the number of treatments per week by 10?• Changed the percentage that you offered your associates

from 50;50 to 60;40 in the Practices favour• Increased your income from the Practice by 10%• Reduced the number of treatments you did by 10 per week

and allocated these to an associate

I could not possibly put my prices up because……..

• Some of my patients could not afford it .• I will lose patients and I would feel hurt about that• I would be charging more than the other Practices in the area.• I earn far more money than I know what to do with now.• I am simply not good enough to charge more• Why charge more when I am so happy doing what I do and treating the

patients I am.• Could not possibly charge more as it would mean that I was earning more

than my partner and they would not like that

Pricing as a Strategy

• Deciding how much to charge your patients should not be looked at in isolation.

• Fees charged should be part of your strategy in terms of what you are trying to achieve.

• Balancing ,how much you personally want to earn, with the hours you want to work ,and the type of work you want to do

Pricing Options

Low Price High Price

Low Value Economy Skimming

High Value Penetration Premium

HOW WELL AM I DOING?

FINANCIAL PERFORMANCE

WHAT WOULD BE THE IMPACT IF I:

• Increased my prices by £2 per patient

• Reduced my fixed costs by 5%

• Charged a premium for patients attending during out of normal working hours

HOW WELL AM I DOING?

PATIENT ACCEPTABILITY

• PERCENTAGE OF REFERRALS.

• NUMBER OF REFERRALS

• NEW PATIENTS

• NUMBER OF RETURN PATIENTS

• PATIENT FEEDBACK

HOW WELL AM I DOING?

INTERNAL MEASUREMENT

• PERCENTAGE OF PATIENTS TREATED ON TIME

• THE % OF AVAILABLE APPOINTMENTS BOOKED

• THE AVERAGE TIME BEFORE SOMEONE CAN BOOK AN APOINTMENT

• THE PERCENTAGE OF PATIENTS WHO ARE FOLLOWED UP WITHIN A TIMESCALE

So how can I survive and continue to prosper ?

• Financial plan and identify the potential impact of alternatives.

• Look for ways of using your resources more effectively.

• Clarify what you do and what you are good at and make sure your patients know this

• Remain flexible but focused

So what can I do to survive and prosper ?

• Hold on to your patients.• Remain confident but realistic.• Look for ways in which you may be able to

work together.• Ask the questions about what you are

doing ,that you have never asked before• Keep selling

Marketing Strategy

Existing

Patients

New

Patients

Existing

Services

Market

Penetration

Product

Development

New

Services

Market

Development

Diversification

Benefits of Marketing

• Increased patient satisfaction• Increased team motivation• Enhanced sense of purpose and direction• Greater likelihood of professional development• Increased awareness of market opportunities

MARKETING MIX

• PRODUCT/SERVICE

• PRICE

• PROMOTION

• PLACE

Factors that impact on Perceived Value

• Location – convenience ,appearance ,car parking ,ease of finding etc. Also appearance inside ,cleanliness, appropriateness of décor etc.

• Service- reception ,promptness ,timely and relevant information ,times available , length of time before appointment.

BENEFITS NOT SERVICE FEATURES

Product/Service

• Benefits vs Service Features• Benefits generally Psychological• Processes for Delighting the Patient

Place- Internal Environment

• Do the Pictures on the Walls appeal to your patients or do they reflect your tastes?

• Are magazines relevant ,tidy and up to date?• Flowers etc?• What other messages are you trying to get across?

Place considerations the elderly

• Access must be easy and uncomplicated• If you have parking who should spaces be

allocated for • Seating must be comfortable and not too low• Visitors cards must be appropriate and

readable

Promotion

• PERSONAL SELLING

• SALES PROMOTION

• DIRECT MAIL

• TRADE FAIRS

• ADVERTISING

• SPONSORSHIP

WHAT ARE YOU GOING TO DO NEXT?

• Key actions to take

• Key things that you have learned