Make Building an Owner-Independent Practice Your Goal

If you don’t enjoy the medical practice you’ve built because you feel maxed out, here’s what you can do

Dr. Landon was a successful surgeon with a sterling reputation and a highly profitable practice. When he was in medical school, he learned how to care for patients and help them get the health outcomes they desired. But nowhere in his four years of medical school, six years of general surgery training, and two years of plastic surgery training did he ever learn how to best run a medical practice. So during the two decades after he first opened his surgical practice, he just figured it out as best he could

By all accounts, he was super successful at it, too. He enjoyed a great reputation and was making an excellent living. But he was tired—tired of the long days of surgery and tired of fitting in the practice administration on nights and weekends while missing out on time with his family. He was also tired of worrying that if he ever got hurt, his practice could very well fail

“There was a time, and it wasn’t that long ago,” Dr. Landon told us, “when, if you had asked if I could scale the practice, I would have been concerned that the only way to do that would be to work longer hours, perform more surgeries, and see more patients. I was already working sixty to seventy hours a week and didn’t want to work more

“More than just the hours, however, I didn’t like that I had all these people—from my family, to my staff, to my patients—counting on me. If I got hurt or wanted to take time away from the practice to compete in a triathlon, the practice would suffer. The business revenue was so dependent on me alone as the only operating surgeon. And I saw no end in sight.

To the world, Dr. Landon was a smiling, seven-figure surgeon who had it all under control, but inside he craved a way to reduce his practice’s reliance on him. He didn’t see how that would ever be possible, though, so he felt trapped

Does Dr. Landon’s story sound familiar

Maximum Capacity

According to the Physicians Foundation’s 2016 Survey of America’s Physicians, 80 percent of physicians are overextended or at maximum capacity. That survey also found that nearly half (49 percent) of all doctors say that they “always” or “often” experience feelings of burnout. The average number of hours worked by U.S. physicians has inched up to fifty-three a week, with many working seventy hours or more

How many hours a week on average do you work? The number may be far higher than you think when you add in the email messages handled from home at odd hours and calls taken on nights and weekends. That doesn’t include the time you spend thinking and worrying about your practice when you’re away from it

Are you enjoying the practice you’ve built? Or, somewhere along the way, did it turn into a grind? Have you been able to build a profitable practice that lets you take time away from the office to spend with your family

Yes, it’s one thing to earn a healthy six- or seven-figure income. But if your practice requires you to fuel that income through long hours and high pressure based on your personal medical production, then not only is your practice vulnerable to something happening to you, but its growth will also be limited. After all, you have only so many hours in the day, only so many patients you can see, and only so many procedures you can personally perform

Stated Goal: Make Your Practice Owner-Independent

This is why the first step to building the practice you dream of owning is to make building an owner-independent practice a stated goal of your practice

We know what you’re thinking: “It’s just not possible to build an owner-independent practice. My patients wouldn’t want to see anybody else. My staff would be upset.

When we first talk with physicians about the fact that they can actually build an owner-independent practice, they don’t believe it’s possible. Specifically, they don’t believe it’s possible for them

Often, they’ve seen other physicians do it. Sure, Dr. Singh can do it with his 177-provider family practice. Maybe they even know someone like Dr. Friedman who works six months a year and takes six months off, all while running a multimillion-dollar practice. But when doctors first consider the idea of turning their practice into one that’s owner-independent, they believe their circumstances make it impossible. And it’s this kind of automatic, conditioned thinking that keeps them trapped

We’ll be honest. There are important reasons why, from where you’re sitting, the idea of turning your practice into one that’s owner-independent looks and feels impossible. These reasons might be

• The stacked deck. The practice of medicine has become a treadmill. The entire economic model is built on the expectation that you will see patient after patient after patient from daybreak until after the sun sets. In some ways, your work has become a commodity, a numbers game that’s all about volume. There seems to be no way out. The more you work, the more patients you see, the more your practice is dependent on your personal production for its success. With that for a backdrop, it’s no wonder it’s hard to imagine your practice humming along nicely without you. In fact, your practice may be so dependent on your around-the-clock devotion that your staff may be terrified of something happening to you. If a bus hit you tomorrow, they’d be out of a job in an instant. It’s a scary scenario.
• The “competency trap.” Let’s be frank and acknowledge that you are exceedingly competent. In college, you posted the grades and board scores you needed to get into medical school, and in medical school you absorbed and mastered a staggering amount of information. All told, you’ve had the better part of a decade or more in professional training. After that, you went on to establish your own practice—which you built, one patient at a time, on the foundation of your competence as a physician. Such competence is normally something to celebrate, but in a sense, it’s now working against you. You’re so darn competent that it’s hard to let other people handle tasks you know you can perform better. You may well find it excruciating to watch a member of your staff do something less well than you know it can be done. You may feel constantly compelled to step in, handling every little job to make sure it’s executed properly. But the more you do, the more you have to keep doing. And over time, the accumulation of myriad responsibilities becomes a heavier and heavier burden to carry.
• Controlitis. Controlitis is the inflammation of your control gland—and, boy, do we understand! We’re a bunch of control freaks ourselves who run more than a dozen different companies with annual revenues of over $1 billion. At various times, we’ve found ourselves saying, “If you want something done right, you’ve got to do it yourself.” Business owners generally tend to be control freaks, and physicians who own their own practices tend to be control freaks twice over. We get it. But recognize the high price you are paying for your urge to control every detail of your practice. We won’t tell you to just abdicate responsibility but rather to build on a stable base of sound business systems, a talented and well-trained team, and a culture that helps ensure your team properly handles ambiguous situations that arise.
• Lack of business training. In all that professional training, they never taught you practice management. There’s yet another way the deck is stacked against you. In all your years of training—from medical school to residency to specialty training—you likely had around zero hours of instruction on the business of running a medical practice. This implicit bias in medical training—the bias of not talking about business or profit or anything related to it—probably didn’t seem like a problem at the time; after all, you weren’t expecting a curriculum in business management. You went to school to become a doctor, and that was precisely the education you received. But if you pause and think about it, this situation is absolutely crazy. A medical practice is a complex business; it sure won’t run itself. And yet doctors typically receive no training at all in how to build a practice that not only delivers great medical care but is also financially viable, never mind highly efficient and scalable.

20% Growth in Employed Physicians

Maybe that’s why more and more doctors are leaving private practice to become employed physicians. Over the past decade, the number of employed physicians has grown by a whopping 20 percent. Those doctors, like you, never had any training in business management, and they ultimately determined they couldn’t run a practice and practice medicine. Doing both is an impressive feat

Happily, we’re about to make that impressive feat a whole lot easier by helping you turn your practice into a successful business that’s owner-independent.

You’ll only regret that you didn’t do it sooner.

Stop building your practice in isolation and let our experienced team coach and guide you.