Insights From Our Editors

7 Biggest Mistakes Small Business Owners Make

By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD

Dec. 12, 2018

There are mistakes that small business owners often make. Many optometric practice owners have made the same mistakes. Here’s how to avoid falling into these traps, and what you should do instead.

Trying to be a Jack-of-all-Trades
You cannot be an expert at everything. The two lessons that must be learned – and are often learned the hard way – are to delegate and outsource.

Let’s start with delegate. If you are doing the majority of the eye exam yourself, then you are not functioning at your highest level of education and training. And you are seeing fewer patients per day, which results in keeping patients who need your services out of your chair.

Here’s what to do.
• Make a list of everything you need for your examination.
• Identify everything that can be delegated in your exam.
• Create an examination flow map that identifies who does what and what “end product” you want from each “step.” (To really make this effective, time flow each step as well to enhance patient flow.)
• Train and proficiency-test staff.
• Implement your plan.
• Work out the bugs.
• Finalize the plan.

Now to outsourcing. It makes no sense for you to be doing the practice taxes. Hire an expert to do this for you. We talked to a doctor this past week that missed a $56,000 tax exemption that could have been taken every year over the last decade, but didn’t happen because he just didn’t know.

Here’s what to do.
• Make a list of everything that you are doing that is not directly the patient examination or treatment.
• Identify how many of the things on your list can be delegated out to someone else.
• Prioritize your delegation list.
• Delegate the most important thing on your list this week.
• Keep working down your list.
• Redo this list every six months to make sure you are functioning at peak efficiency.

Picking the Wrong Staff
Hiring the wrong people is a killer. The wrong people negatively impacts both your patient care and your practice culture. So, how do you pick the right staff? There’s a great article in Forbes that gives these suggestions.

• Look for Someone With a Commitment to Their Career
• Test for Excellent Learning and Analytical Skills
• Check Compatibility
• Keep Improving Your Hiring Process
• Don’t Forget to Hire Interns
• Get Social With the Candidates

Misreading the Market
There are two negative things that can happen when you misread the market: you jump into something that patients do not want, or you don’t provide something patients do want.

Fads come and go all the time in eyecare. This is where market research with your own patient population is important. Always survey your own patients before making a move. This is true for everything you do in the practice. If you are going to move your practice, survey your patients to make sure the move is supported by them. If you are going to add a service or a product to your practice, make sure it is something they want and would purchase from you.

Marketing 101 is to survey your patients to find out what they want, then provide it to them. Make sure you are surveying your patient population at least once a year to find out what they want and need.

Assuming Patients Will Come to You
“If you build it, they will come” only works in the movies. If you want new patients, then there is work you must do.

Here’s what to do.
• Start with your internal processes. Have you refined your internal systems, so every patient visit is like a spa experience? Most practices we’ve seen are built for the doctor and not built for the patient. Take a fresh look at the patient experience in your office.
• Then, the most powerful thing you can do is to ask your current patients for new patients.
• In today’s world, you must have an active social media program. You can outsource this.
• You must actively manage review sites for both positive and negative reviews. You can outsource this.

Not Understanding You Need Cash
Bankers have an interesting mantra they live by: Cash is king. You can look great on a P&L – even have a nice profit – but have no money in the bank to meet payroll or pay lab bills. Effectively managing cashflow is one of the top issues in every practice.

Here’s what to do.
• Create a budget. Use last year’s income and expenses to predict this year’s budget. Revisit the budget every month and adjust your budget based on performance – always with the year’s goals in mind.
• Annually, have your local banker review your internal cashflow systems to see where they can be improved. As an example, do you have a check reader that saves your staff from having to go to the bank to deposit checks? Are you paying the lowest credit card processing fees for the service you want?
• Make sure your internal cashflow management systems have been theft-proofed. You can work with your banker or CPA to help you put systems in your practice to prevent money from “disappearing” in your practice.
• Randomly audit your practice. Just having staff know that you are looking is a great deterrent to theft.

Not Having a Plan
This is a major miss that we see in a lot of practices. You should have a written 3-year plan for your practice. If you don’t have one, then take today to make one.

Here’s what to do – Build your plan around these four areas:
• Business overview – what changes do you want to make in the practice?
• Marketing plan – how are you going to get patients to buy your changes?
• Financial plan – how will the money flow?
• Daily operational plan – what has to change in the daily operations of the practice?

Thinking You Are Your Business
Michael Gerber has several quotes that relate directly to this problem:

• “Organize around business functions, not people. Build systems within each business function. Let systems run the business and people run the systems. People come and go, but the systems remain constant.”
• “If your business requires your presence, you don’t have a business, you have a job.”
• “Systems permit ordinary people to achieve extraordinary results predictably.”
• “Most entrepreneurs fail because they are working IN their business rather than ON their business.”

Here’s what to do.
• Spend at least half-day per week working ON your practice instead of IN your practice.
• While you are working ON your practice, build systems within each business function of the practice.
• Whenever a practice problem occurs, fix the problem, then fix the underlying system that broke down permitting the problem to occur.


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