64. Behind the Scenes: What Your Clinic Needs First

What does a business consultant actually do when you hire one?

That’s usually the part people are curious about. Do we start with your numbers? Your marketing? Your schedule? The team issue that’s been slowly driving you nuts?

A big part of my job is figuring out what’s actually keeping your clinic from moving forward, because the thing you think is the problem isn’t always the thing we need to tackle first.

Here, I’m taking you behind the scenes of how I work with physician business owners: how I decide what to tackle first, the five areas that tend to come up again and again, and why our first priority might be very different from the problem you thought you hired me to solve.

First, we figure out what’s really getting in the way

When I start working with someone one-on-one, I don’t have a standard Week 1, Week 2, Week 3 curriculum that I pull off the shelf.

I ask a lot of questions.

What does your clinic look like right now? What are you trying to build? What feels hard? What keeps getting pushed to next week? What’s taking up an unreasonable amount of space in your brain?

Then we look for the biggest boulder in the road.

And sometimes, that boulder has very little to do with what you thought we were going to talk about.

I once worked with a physician who wanted to grow her clinic enough to leave her part-time job. On the surface, that sounds like a straightforward business problem.

Except as we talked, childcare kept coming up.

If one of her kids got sick, she felt she needed to be the parent who dropped everything. She was hesitant to commit to more clinic hours because she didn’t feel she could reliably protect that time.

So before we spent much time digging into the clinic itself, we talked about what being a “good mother” meant to her, how responsibilities were shared at home, and whether getting additional childcare support was something she could give herself permission to do.

Eventually, she did. And suddenly this obstacle that had been hanging over her business was gone.

That’s a good example of why I don’t automatically start with marketing or spreadsheets just because I’m a business coach.

We start with the thing that’s actually keeping you stuck.

From there, though, there are a few areas I find myself coming back to again and again.

1. What do you actually want your clinic (and your life) to look like?

A lot of physicians leave corporate medicine because they want more autonomy.

Then they open their own clinic… and recreate the exact schedule they just left.

Monday through Friday, nine to five, with patients packed into the calendar because that’s what a clinic is “supposed” to look like.

Except now you’re the one making the rules.

One of the first conversations I often have with clients is about work-life integration and clinic design. Not what you could build. What do you actually want to build?

Would you like Fridays off? Two half-days for patients? A day with no clinical work at all? Longer visits? Space in the middle of the day to exercise or pick up your kids?

When you’ve spent years working inside someone else’s system, a blank sheet of paper can feel surprisingly uncomfortable.

Sometimes we have to spend a little time giving you permission to want what you want before we ever get into the mechanics of making it happen.

2. Do you understand what your numbers are telling you?

Then there are the less glamorous parts of owning a business. Hello, accounting.

I’ve had clients bring me their chart of accounts, billing reports, expenses and financial statements, and we’ve gone through them line by line.

I’m certainly not trying to turn every physician into an accountant.

But I do want you to be able to look at your numbers without getting a knot in your stomach.

You should understand where your money is going and whether your reports are accurate. And ideally, you should be able to look at the numbers and tell me the story of what’s happening in your business.

Because once you can do that, the numbers stop being this scary pile of financial information and start becoming something you can actually use to make decisions.

And yes, sometimes this work is nitpicky, but we baby-step our way through it anyway.

3. Is your team making your life easier… or harder?

Nobody hires me because they’re excited to talk about HR. (Truly, nobody.)

Usually, they opened a clinic because they wanted to take care of patients. Then the clinic grew, they hired a few people and… surprise! They discovered they were now also a manager.

That’s when the issues start appearing.

One team member isn’t performing well. Someone else isn’t following instructions. Nobody is completely clear on who owns what. A job description exists somewhere, but it may or may not bear any resemblance to what that person is actually doing.

And suddenly you’re spending a huge amount of mental energy managing people instead of running the business you wanted to build.

When there’s a real staff issue, it often jumps straight to the top of our list because team problems don’t tend to stay neatly contained. They affect operations, your own attention and potentially even the patient experience.

4. Do the right patients know you exist?

Once the clinic itself is on solid footing, we may turn our attention to visibility.

In other words: how are patients going to find you?

You can build an incredible clinic, offer exactly the kind of care you’ve always wanted to provide and create a wonderful patient experience.

But if the people who need that care have no idea you exist, we have a problem.

So we look at who you’re trying to reach and how you can get in front of them.

That might mean thinking about marketing, referrals, partnerships, content, local visibility or other ways of helping your target patients discover your clinic.

But the important part is that visibility isn’t automatically where we start.

If your pricing doesn’t work, your team is imploding or you’re not even sure exactly what you’re offering yet, pouring more patients into the clinic isn’t necessarily going to help.

5. Does your business model actually make sense for the clinic you want?

This is a big one, especially for physicians coming out of insurance-based corporate medicine.

You’ve spent years inside a system that was designed around a particular business model. So it’s natural to bring some of those assumptions with you.

But your new clinic doesn’t have to work that way.

We might talk about:

• how much you charge
• whether you want a membership model or fee-for-visit model
• what patients are actually receiving for that price

And perhaps most importantly, what makes the experience at your clinic different from what they could get somewhere else

This is where we start defining the value you’re creating, which matters far beyond pricing.

Once you’re clear on who you serve, what you offer and why it’s valuable, your marketing gets easier too.

Sometimes the business problem isn’t just a business problem

Owning a clinic is highly personal.

You don’t suddenly stop being a parent, spouse, partner, daughter, friend or human being because you formed an LLC.

Building a business changes how you think about your time. It can also change responsibilities at home and bring up uncomfortable feelings about money, ambition, identity and what you think you’re “allowed” to want.

Ignoring all of that doesn’t make it disappear.

Sometimes the most useful conversation we can have is highly technical. We’re building a pro forma, estimating revenue and expenses or digging through a spreadsheet.

Other times, we’re talking about childcare or what it really means to be a mom.

Both can be business consulting.

My goal isn’t to force you through a predetermined list of business tasks.

It’s to figure out what’s standing between you and the clinic you want to build, and then work on that.

Not sure what's standing between you and the clinic you want to build?

My discovery calls are really more like brainstorming sessions. You tell me what's going on, I ask a lot of questions, and together we start figuring out what actually needs your attention first.

Book a free discovery call and let's see what comes up.