Berning & Affiliates

Are You Challenged By Confrontation?

Many doctor CEO's direct substantial practice enterprises with literally dozens of employees, vendors and outside service professionals. Yet, size seems to make no difference in one of the all-time management difficulties: avoiding a confrontation. In smaller practices generally either there is a resolution with a discussion / confrontation or the employee, vendor or professional firm is terminated if the matter can not be resolved. In contrast, in larger environments, it can be easy to avoid the discussion altogether by hiding or delegating. In some cases we are familiar with the CEO has raised to an art form the avoidance of resolving with direct conversation the irritating or problematic situation. What is often not accounted for is the emotional cost of not resolving the situation. From a practice administration and emotional standpoint, we find that it is always better to resolve the difficult situation or personnel matter than to let it fester.

The Roar Gets Louder

It is common to come across doctor CEO's who have loved their practices and invested themselves totally. To the point that whole decades go by. One recent client email stated, "I cannot believe I have been in practice for over 28 years. Where did the years go?" The unusual aspect is the doctor CEO who plans early enough, though late in their career, to effect a beneficial transition. Although most doctor CEO's are pressed with day to day practice and personal activity to the point there can be little time left, the roar of the coming end of practice gets louder. Today, as never before with larger and more sophisticated practices it is imperative for doctors to plan sooner rather than later for a potential transition. What combination of transition/succession options fits best for the practice and doctor? Is it an associate and then a sale? Is it a partner with a planned buyout? Is it an immediate sale? Any hire back period for a founder? All of these aspects and others need to be reflected on to design the optimum approach for each doctor CEO.

Doctor CEO's Net Is What You Want!

Recently I discussed with our practice valuation firms their perspective on current practices. Here's what one said. "I see practices with lots of patients, great facilitates, major marketing efforts but outrageous overhead and little profit." Wow! What an indictment! If you have a practice with lots of patients, big payments for facilitates, equipment, staff and marketing but i.e., big overhead and little profit, STOP. It is time for a review. Consider our Doctor CEO day examination and review to re-calibrate your practice and achieve more net!

The Advanced Practice

Some of the most challenging practices for me to work with are those that have moved beyond getting administrative systems nailed down, staff entry/performance and exit under control, regular repeating marketing and vision/transition set. These practices aspire to more. But the 'more' requires careful decisions. In a complex practice tinkering with success can have big consequences - some of them not desired. So we find that adequate time must be spent to evaluate a course of action before implementation. Some doctors that have grown a practice based on intuition and their own hard work find taking time to think through a planned objective and implementation constraining. Until, that is, they realize that the current practice has many staff, many many patients and lots of dollars on the line. Then the sobering reality hits that more care and attention is required not less to make sure a good result is achieved. I particularly like the great results that occur when larger practices plan well for their continued evolution!

Harvard Graduation Speech By Dr. Charlie Ruff

I received the following audio file from my good friend and client, Dr. Charlie Ruff. You will hear him reference in the first couple of minutes that his lawyer (me) suggested he record it so it could be posted. Well, here it is! It is a wonderful, humorous and thoughtful set of reflections for future CEO's that current doctor CEO's can benefit from.

Change Before You Must

Can you sense the practice is not advancing? Have you lost a sense of excitement. Has staff lost the expectation that it will be a great day, week, month and year? You could dig deeper. Find what's going on. But it is easier to let it slide. It is summer, and you are enjoying the summer activities. Why get into it now? Here's why, because the lackluster practice usually does not float for long. It heads down. It can sometimes, with the loss of key people or a poorly handled series of patients take a real dive. Sorry, doctor CEO's, there is no break. You have to check and change what needs attention before it is a major problem. Act now and decisively before you have no options and you must change.