Build the practice around your goals so that your business becomes what you want it to be. Many physicians open their practice without planning out how the practice will serve THEM. Whether the goal is to grow, scale, and sell a multiple 8 figure chain of clinics or open one clinic that offers the opportunity to enjoy a balanced life with time to spend with family (while earning the income that will allow this), you need to plan the clinic around your goals.
As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Jessica Jones.
Jessica Jones, CEO of Build Your Cash Practice, is a born entrepreneur who helps doctors find the time and financial freedom they deserve. Having helped open more than 70 cash medical practices while building, scaling, and selling her own medical clinics, Jessica knows first-hand what it takes to open successful practices and achieve financial and growth goals, all while enjoying the ever-important work/life balance. Her award-winning work as an advertising agency owner, lead generation expert, and medical clinic owner, gives her the unique expertise to be the ideal guide to help doctors leave the frustration and burn out and turn their medical expertise into their own private practice.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?
My background is actually in advertising sales, and I became highly sought after to help clients when they couldn’t make their advertising produce much ROI. Advertising led me to working with pharmaceutical companies finding it difficult to fill clinical trials. From there, I was referred to doctors who owned cash medical practices that simply were not thriving. After I “fixed” the issues surrounding getting patients to call, it was evident that the business end of the practices needed help. So, I became an integral part of the success by helping with all facets of the business and eventually became a partner in starting, scaling, and ultimately selling medical clinics. Now, I’m surrounded by medical practitioners — my clients, friends, and family members — and I’m keenly aware that many doctors are frustrated and want to move into their own practice but need both the business knowledge and expertise to take them from idea to open and seeing patients. Now doctors hire me as a consultant to help them open new practices and struggling medical practices hire me to pinpoint the issues and make the changes necessary to thrive.
I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
I like to think that I learn something from every interaction, whether it’s with the cashier at the grocery store or the brilliant medical practitioners that I get to work with. However, my “biggest” mentor would be Dr. Gerald Bell, the Founder and CEO of Bell Leadership Institute. Early in my career, I was lucky to work for a company that recognized entrepreneurial spirit and rewarded it. Within that company, I became the lead corporate trainer in sales, brainstorming, and leadership.
The company supported me while I earned my Master’s Degree, sent me to training retreats surrounding entrepreneurship, had me become a train the trainer in numerous sales and leadership programs, and they sent me to the Bell Leadership Leader’s Roundtable, all of this while I was in my early 20’s. The ability to interact at that level so early in my career was life shaping. I cannot say enough about Dr. Bell and that year-long opportunity to work 1:1 with him and learn from his mastery of leadership. I learned about myself, interacting with others, building successful teams and organizations. His teachings and philosophies have been adopted as major influences on my daily life.
What made you want to start your own practice? Can you tell us the story of how you started it?
Well, I can’t say that I sought to own or start a practice. In fact, for some time I resisted clients’ requests to partner with them and insisted on maintaining my role as consultant. However, a long-term client convinced me to come on board as equal partner and CEO because he lacked the skillset to handle the business facets of practice ownership. I was able to oversee the tasks of building the compensation packages, the financial oversight, the sales protocols, training, HR, and management — all of the business skills needed for a practice to thrive. While I was passionate about the work and started my own clinics, my real passion is helping doctors build their own thriving practice. I love supporting clients as they build their unique programs and, in many ways, feel as though I’m a small part of making the world better by helping the doctors bring their vision to fruition.
Can you share the most interesting story that happened to you since you began your career?
Honestly, I probably can’t share the most interesting stories in practice ownership simply because of privacy.
One thing that I can share that I think readers will relate to is a recent conversation I had with one of my clients. They found me after already leasing their space and planning their opening. This is a husband-and-wife team, and the doctor was still working in the ER while working hard to build their cash practice. I see this over and over again. There’s a fear of leaving the so-called security of what they know and taking the leap, yet there’s also such frustration, anxiety, and unhappiness in the day-to-day. More hours, less time with patients, less reward, less time with loved ones, and more. What I see once a physician commits to their practice is a renewed sense of self, restored passion about their work, and the ability to be in control of time and the way that they are practicing medicine. Whether your goal is to stop trading your time for money, to simply be in control of your time or how you practice medicine, or to take your treatment protocol and become a nationally or internationally known expert in your niche, you can’t get there without taking the first step into practice ownership. There is absolutely no better way to reach those goals. I’m in no way suggesting that it is the easy path, but it is a rewarding one.
Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?
This is absolutely true and something that I work with from a mindset perspective with my clients. That said, of course when starting a cash practice, there’s fear of leaving a stable contract that needs to be overcome, and there’s the reality that there is a strong income that needs to be replaced and ideally improved upon. I help build the sales packages and focus on ensuring that every patient leaves the practice with an answer and resolution that fits their budget. However, I also work through a proforma with each client to simplify and clarify what it really will mean to earn the desired income. By looking at the set expenses and estimating miscellaneous expenses, it helps to create a very clear understanding — I need to see this many patients at this price to achieve my desired income from the business. It’s no secret that the system is broken. Most of the doctors I work with realize that they are venturing into ownership to earn an income that helps them achieve their goals, but they also need some support to see how to build their practice around profitability.
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
Although I’m not a provider, I understand the balancing act. I’ve employed providers and I help clients hire providers within their practice. I encourage maintaining oversight of all the key functions of the clinic, but also emphasize how essential it is that you surround yourself with competent staff at all levels. Every person who interacts with the potential patient impacts the business’s success or failure. In addition, the staff impacts morale internally. That idea that you’re only as strong as your weakest link is proven time and time again. If you’re a provider who employs providers, PA’s, or locum tenens, you have to learn to delegate and encourage others to grow while maintaining oversight so that you have your finger on the pulse of every facet of the organization. Outsourcing where possible can be an invaluable asset. For example, I recommend outsourcing payroll to a company that can also support you with your HR requirements. I also suggest an outsourced financial person to ensure that there is no one inside who is controlling the books, but I also develop and show easy spreadsheets to be used daily to ensure that the doctors have a clear idea of daily/weekly cashflow.
From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?
I entered practice ownership as the business partner to build a chain of clinics that could be scaled to sell. I work with many physicians who are brilliant and have a passion to bring a valuable service to patients, but they simply were never prepared nor taught how to run a business, hire, lead, bill for services, and all of the details that go into managing a business. I think that there are two main challenges that are consistent across all clinics that I work with: patient flow and staffing. Staffing is, regardless of clinic niche, region, or length of time in business, a constant frustration. As an example, I can highlight one very successful clinic. In this clinic, the owner kept rewarding the staff for success, but not directly addressing areas that needed improvement. In fact, when the owner would mention concerns, the staff would point to reasons why things were not working properly, and it was never the fault of the staff.
So, I worked with the owner to get to the bottom of things. We added a weekly staff meeting where positives were highlighted, but then each week, the physician also pointed out three things that could have been handled better. I worked to ensure he was not discussing how things could have been handled better, but rather, he would review the situation and ask the clinic staff how the situation could have been handled better. This meeting, over time, reduced the excuses because the staff now realized that the owner was reviewing all of the processes in the clinic each week. In addition, they realized that they didn’t want something they were handling to be highlighted as something that could be improved. By setting up a consistent review and directly addressing processes, the staff improved and did so for the reward of being highlighted as a job well done in the weekly meeting.
Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)
- Plan — Build the practice around your goals so that your business becomes what you want it to be. Many physicians open their practice without planning out how the practice will serve THEM. Whether the goal is to grow, scale, and sell a multiple 8 figure chain of clinics or open one clinic that offers the opportunity to enjoy a balanced life with time to spend with family (while earning the income that will allow this), you need to plan the clinic around your goals. So many medical practitioners are unhappy and frustrated in the current system, but opening a cash clinic that isn’t planned around your ultimate goal can be like jumping out of the frying pan and into the fire. You can replace the frustration of administration and lack of control with clinic ownership that offers even less balance and more stress if you aren’t building the clinic around your goals.
– When I am able to work with a physician to help them build a plan, they are able to clearly identify what they really want their life to look like. In doing so, they are able to build their clinic around that goal. In one such clinic, the physician had worked in the ER and was burned out. He wanted more time with his family, he wanted to spend time fishing, and he really wanted to be in control of his time while earning enough money to enjoy a nice quality of life. We were able to build a plan that allowed him to hire a P.A. who handles the bulk of the workload and allowed him to be inside the clinic only one day a week. He is paying out a lot of money to the PA, but it’s ok because he’s still earning enough profit to provide the lifestyle he enjoys, and he has the quality of life that he desires. Because he planned the clinic around his goals, he was able to build the clinic that served his needs instead of having to make changes to the clinic. I also work with many who reach out to me once they are already open and struggling. If you are reading this and find yourself struggling, as C.S. Lewis said, “You can’t go back and change the beginning, but you can start where you are and change the ending.” Your clinic is always evolving and your plans will always steer that evolution.
- Advertising and Tracking — You need to have a strong advertising strategy in place. You must have all of the areas of marketing in place: Product, place, price, and promotion, but a practice that isn’t promoting their service is one that is empty and soon to go out of business. Advertising is the 4th “P” in marketing — the part where you promote your clinic to the public to attract your ideal patient. Of course, with my background, this is how I have been brought into many practices, to help solve the issue of getting the message to patients in a way that breaks through the noise and brings response. Working with many struggling clinics, when a medical practice does not find a resource or determine how to get their advertising to work, they go under because they don’t get enough patient flow. There are ways to learn how to develop lead flow. I teach this to my practices. Once you are at the advertising stage, you must test, get feedback, make appropriate changes, and repeat. It’s very strategic and data driven. If you change everything, you won’t be able to tell what is working. If you change nothing and just keep doing the same thing, well, we all know that making no change will bring the same result. It’s about getting the right message and putting it in front of your patients in the right combination of distribution (TV, Radio, Print, Social Media, Digital, Outdoor). Therefore, you have to have a strategic and data driven method in place when you start to advertise. When you use data, you can test one change at a time to measure what it is that brings the best response. Then, you can build on results. Once you get the method that works, you can scale it, continue to add new elements, and build a plan that can be used to ensure a continuous patient flow to your clinic. Ideally, you’ll also have patients who are thrilled with their results and happy to give testimonials and referrals, but depending on your goals, that is typically not enough to drive the response needed. I can give so many examples of failures and successes. I’ve had many clients referred to me who were truly struggling and ready to go out of business. One such client believed that they had strong lead generation skills. They were not tracking patient response by any method other than asking over the phone or during the appointment how a patient heard about their clinic. Because people do not self-report accurately, the information they were tracking was completely inaccurate, leading them to continue to spend money with media sources that were not actually pulling in response. I put tracking phone numbers in place to accurately monitor phone calls, analytics for digital response, and was able to provide a real cost per patient call and cost per appointment set. In doing so, it became clear that what the client had been doing was leading them down a path to ruin. We were able to make changes, follow lead flow, and grow the clinic. In addition, we were able to use the tracking to start testing messages that brought in greater response. Once you are tracking, you can make changes confidently because you will have a clear view of how that change impacts results. Frankly, it’s a never-ending process. Things are always evolving, and your message and media mix need to be ready to be modified to continue to achieve the same results on a continuous basis.
- Communication — You can bring patients into the clinic, build a wonderful rapport, offer appropriate pricing and excellent service, but if you have anyone on your staff who drops communication or who communicates ineffectively, you can lose even the most loyal clientele. It’s important to always be monitoring each week to listen into how your staff is communicating with patients. This is all interaction, including fielding initial calls and converting them to appointments, confirming appointments, rescheduling, welcoming a patient to the clinic, following up with patients when they call with concerns — every interaction is an opportunity to build or break down your patient satisfaction. Each week, monitor a sampling of calls and use this as an opportunity to review examples of excellence and highlight some areas that need improvement. When you review the calls that need improvement, ask the staff how the call could have been handled better and then you have an opportunity to see how they problem solve, show a new way of improving, and ensuring that you are always aware of potential breakdown. If you notice that the same staff member is constantly highlighted as a communication that could have been handled better, you need to work with them to improve and if they cannot improve, they need to be replaced. In addition, many clinics don’t follow-up and stay in communication with patients. It’s essential that you stay in touch to build your relationship and give opportunities to retain a patient (in a concierge or membership model) or to enable reorders (in a cash for services model). Continuous communication builds relationship. In contrast, if you only reach out to patients when you have something new to offer (aka sell), you damage the relationship and limit the ability to have a patient continue to work with you to purchase programs that will resolve the issue your niche serves. I can give a number of examples here as well. In many examples, I have worked with medical practitioners who are not looking at and responding to positive and negative reviews on social media platforms. This can be time consuming, but responding to reviews, both positive and negative, shows that you care about patient satisfaction. Responding to negative reviews can help potential patients overlook the negative review. Similarly, clinics should be monitoring their BBB rating and responding to any concerns that are brought to the BBB. Simply responding makes all the difference. It is also surprising to me that clinics frequently miss the importance of simply calling a patient within a day or two of their visit to see how they are doing, answer their questions or concerns, and ensure that they are satisfied with their visit. Relationship is essential and this is a key step to building rapport. After advising one clinic to add this step to their protocols, they found that they were able to resolve patient concerns that could have escalated to poor reviews or complaints and instead solidified the patient as a satisfied loyal patient. In addition, they were able to have patients who did not purchase a treatment program make a decision to buy because the follow-up call put them at ease, allowed them to address concerns, and made them comfortable ordering. Essentially, adding this step made the clinic money immediately and also saved them time and effort by resolving concerns before they became a problematic complaint.
- Evolve — It is essential that a physician-owner stay on top of their industry and outside impacts. You always need to listen, keep your eyes open, and be aware. There are always going to be changes to what you’re offering and there will always be new regulations. It’s so essential that you educate yourself on new treatment methods, therapies, technologies and ensure that you’re prepared to make changes to stay at the top of your field and at the forefront of your area of practice. You should be working in an area that you’re passionate about — continue to research, publish, and speak on the topic. Listen to what patients wish for and try to implement it in your practice. I see doctors open a clinic, become successful, and then get stuck. That’s because they become resistant to change. It is essential that you be willing to add new treatment options (aka revenue streams), remove treatment therapies that are outdated, and evolve to grow your practice. This doesn’t even have to be complex or surrounding protocols and regulations. In many clinics, I have had owners conduct exercises where they listen to patient feedback and search for opportunities. In more than one clinic, there was feedback about offering appointments at different times than the current schedule. We were able to work with staff and, as an example, have the clinic open for a few hours one Saturday each month and one evening each week. This was a small change, but it made a massive impact on the number of appointments set because so many patients could not come during the traditional 9–5 hours. If you aren’t listening to patients and taking the time to step back from the practice to ensure you’re paying attention to the competition, regulations, and other factors in the outside world that impact patient mindset, the niche, and the environment around you — you will fail to see opportunities and threats.
- Systems — Just like your therapies have a protocol to be followed, so should your practice. Every member of the team should be following systems to ensure that patients have an experience when they visit the practice that is repeated with each visit. Systems allow you to create quality assurance. When you go to a restaurant and the experience is different each time you eat there, you find another restaurant. Especially when they are entrusting their health, people want to have confidence that they can have the same or very similar experience when they are coming to your practice. They want the receptionist to offer the same check-in experience, the same quality of care while in the clinic, and the same quality follow-up. It’s security for them, and it is assurance for you that they will remain a patient of the clinic. The way to do this is to have systems for each employee to follow. No business can scale without a repeatable user experience and medical practices are no different.
As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?
For me, it’s a bit different because I’m not a physician. I entered into practice ownership as the business partner needed to bring success to the practice. However, I’ve hired and managed physicians and I work with physicians to help them manage the challenges of being the medical director while also running the practice. I always recommend maintaining oversight of all elements of the business, but I also recommend doing so while delegating those tasks that don’t come naturally to the individual owner. As the practice grows, I also recommend that a solo practitioner consider hiring a P.A. or other medical support staff to allow them to have time to devote to the business. I also recommend block scheduling so that there is a time set aside very day to look at cashflow, review quality of care and review each employee to ensure they are following protocols. Many of the physicians I work with are building a practice with the intent to gain more time. With this in mind, it is essential that there be a clear plan in place to grow and then add staff to allow the owner to step back and spend more time on the business and on themselves. To be the best leader as a clinic owner, it is essential that you be healthy, practice self-care, and invest in learning and growing your business and leadership skills. This can be done through classes, retreats, and hiring appropriate consultants.
I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?
Especially in my recent work with medical practitioners, there can definitely be a lot of stress and most definitely some different pressures and anxiety since the COVID pandemic began. Throughout the pandemic, even in niche practices, the doctors and staff persevered and continued to interact with patients. However, the stress of worrying about catching COVID and bringing it home to family was constant. Every business owner needs a ritual — whether it’s a morning walk, a yoga practice, running — the thing that you enjoy that clears your mind is unique to each individual. If you don’t have that one thing that promotes your physical health while also allowing your mind to clear, you need to find one. For me, I enjoy yoga and I take our rescue dogs for an hour long walk each morning before the day begins for most of the household. During this time, I’m getting physical exercise. I’m also clearing my mind and by stepping outside of my business, I get a lot of my best ideas, epiphanies, and solutions to challenges often come more freely to me. When you are able to take yourself away from the business, you gain clarity and productivity. If you don’t find a way to step away, you often become less productive, more stressed, and that impacts every level of your practice because the staff feeds off of your energy and the patients do as well. One of the most essential investments you make in your business is your health and wellbeing!
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
“My mantra is, “You will lose what you don’t maintain.” — Unknown. This has daily applications as a clinic owner and as a consultant to owners. I think of this quote every time that I think of things as simple as “skipping” a workout, making an exception to my diet, or avoiding a call that I’m not looking forward to. This has major implications on the bigger things so it comes up often in my day to day with practices that I consult, and I can point to an experience with the clinics that I owned. When you’re entrusting staff, you believe in them. I had set protocols and systems for staff to reach out to all patients at specific intervals. You cannot maintain a relationship with a patient if you aren’t actively communicating with them. However, I started to hear patient complaints. As these grew in frequency and I had the opportunity to talk with patients to address concerns, it was evident that they simply didn’t have the follow-up needed to answer concerns after their initial visit. A simple call one to three days after their initial treatment would have made the difference between winning back a dissatisfied patient and instead, building relationship and ensuring a thrilled patient.
By skipping the follow-up phone call, patients were left without contact and no one to address minor concerns about bruising following a procedure, aches, pains, questions about using their medication, etc. By nature, people hesitate to call the doctor’s office back. That makes it all the more essential that practice owners ensure that staff is reaching out to patients. Each week, I worked with staff to do a review of things working and things that can be done better. When we built in a follow-up protocol that was documented in the patient files, patient satisfaction improved greatly, patient complaints became rare, and patient re-orders grew. Patient acquisition is challenging — but retention is simple. Put systems in place to ensure that you are maintaining contact with patients to ensure you don’t lose them. If you think that patient acquisition is difficult, it pales in comparison to re-building trust with a patient you’ve lost by not taking the simple steps to build and retain your relationship after their visit.
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Thank you for these great insights! We wish you continued success and good health!