Table of Contents
Definition of Business Foundation
Before defining the Business Foundation, first, define what foundation means because it might mean something different to you than me or whatnot. So let’s explain it. According to Merriam-Webster:
The act of founding is the foundation.
A basis upon which something stands or is supported.
An underlying base or support.
A body or ground upon which something is built up or overlaid.
You get the point, think of your house. What if you built a house on mud that was sinking. Will the house last? No, so you’re going to invest your life’s work, money, and everything into this business. But my recommendation is that you build a solid foundation so that no matter how high that house gets, no matter how wide that house gets, no matter all the people you fit in, it can hold it. So don’t just build a foundation for today, but create a foundation for tomorrow.
When I started my Private Practice, it was just about me. I had nothing to worry about. And over the last ten years, I went from me to ten employees, but the house is starting to sink a little bit, and I don’t know what to do. So then what we have to do is we have to come in, and we have to reassess the foundation and build a whole infrastructure. So that not just supporting your nine employees of today, but a big enough foundation so that you can pivot as time changes because change is part of the business process.
The Startup Equation
So I like to show a diagram taken from The Startup Equation. Great book, lots of visuals. I recommend getting it. Stephen Fisher is one of the writers of it. What Stephen Fisher put together was this equation, that Foundation plus Experience plus Growth. That’s so important.
I want you to think about building the foundation. What’s the foundation starting point:
You all are here today because you have a solution. So that’s your foundation. We want to craft the experience, your team, culture, customer experience, and brand.
Let’s take one of the most famous businesses to do it this way. Do you know who I’m talking about? It’s an icon. That’s in the shape of a fruit. Yes. Apple, that’s correct.
Apple started with the foundation of an idea and a solution and entrepreneur. And they failed at first for those who don’t know Apple; it wasn’t until they crafted the experience. When everything came about, team, culture, customer experience, brand, suddenly that little iPad, iPhone, whatever you want iPod. It was about the Experience.
When I met my wife, funny enough, her father had a rule that they weren’t allowed to have Apple products. He was all about the old MP3, and this was way back when Apple was getting there. But he was a PC guy. He built PCs for a living. So he was a No Apple Man. And I remember my wife; she never had an iPad. iPod was not allowed to, and she had one of those old, clunky MP4 players.
I remember that I would break the mold with her family by proposing to her on an iPod. And sure enough, I did. I engraved, and my wife got her first iPod, her first Apple product ever cut to today. His daughter-in-law works for Apple. His whole family has Apple products.
But I get back to this, and I share this with you because what did Apple do? They crafted the experience. What it feels like, what it tastes, what the team is like when you walk into an Apple store, tell me that there’s another, a company that has an experienced. They don’t.
When I survey Apple employees, which I’ve been so fortunate to be able to do, they tell me that there’s no other company they want to work for. Why? Because what Apple’s creating as an experience is not available anywhere else is what they tell me. So we build the foundation, we craft the experience, and then we grow the dream.
The dream is about taking the time, foundation, and experience and bringing about funding, sales, marketing, scale, x-factor, and innovation. Yes, in healthcare today, we have to be innovators. Look at a practice that you’ve been to recently and ask yourself what makes them successful. And the two things that I find, usually the experience and the innovation.
Brandon's Four Core Components for an Optimal Business Foundation
So as we build your startup, as we remodel your startup, focus on, get the foundation set up, let’s craft your experience, and let’s grow the dream.
So I have four components for an optimal business foundation. This is where I come about when I am remodeling or building a new business or an existing business that needs remodeling. I need:
If your clients aren’t willing, you won’t win. Bottom line, have these four things, and nothing can stop you.
Tapping into your "Fear Factor" in Building your Business Foundation
So I want to talk a little bit about this fear factor in building business foundation because every Private Practice I have ever met has fear. Most of them come to me because they are not achieving the success they want to. Not that they’re not successful, but that there’s more success. That they feel they’ve reached a roadblock. And when I look at the roadblock, I often find that they are blocked by fear, which is the roadblock.
So one of the things we do is break down that fear and explain to them that fear can be your biggest asset when channeled appropriately. Those that don’t have fear often fail. That’s something that gets missed.
They’re like, what do you mean those who don’t have fear, fail?
Those who don’t have fear make wrong mistakes. They are that car going 200 miles an hour with no safety precautions or anything. So I want you to channel fear as a tool for success by confronting it.
First of all, what is the fear that is stopping you from doing something? Or what is the fear in the back of your head saying, you can’t do this? You may fail. Whatever that fear looks like. I want you to look straight in the eyes of fear, and then I want you to research:
Develop your worst-case scenario list, and I do this with my clients all the time. What’s the worst that can have happened. So depending, you know, the worst that I’ve seen so far is I may have a client die on my watch; that’s a critical fear. That is a level 20 out of 10 fear. So then I say, what are you doing about it? Is the fear going to keep them alive? No. So we need to utilize it. Develop your worst-case scenario list. Utilize your fear as fuel because fear is what fuels my hustle.
Every day I get asked, how do you do what you do? And I say, I hustle, and the fear is what keeps pushing me to push myself to the next level. Don’t get it complacent. What’s my fear. The fear that all of it will disappear tomorrow. Keep creating; keep going.
Every successful entrepreneur that I’ve ever met has utilized fear as the form to hustle. Push yourself to be great. Don’t settle. Mediocrity is what kills businesses. Be great, not good. And don’t let fear be the barrier to success. Use the fear to motivate success.
So I’m going to talk about two tools right now that I think are just really important in the self-discovery phase.
One is a SWOT analysis. It’s something that is used in every business. It’s Business 101, but it’s beneficial. And what I want you to do is I want you to break down the strengths. I want you to provide everything internally that you have going for you and your business as a strength.
Strength is about your internal measures, team, education, experience, funding, and everything internal about you. That’s strong and a strength. Please write it down in your business model.
Then I want you to keep looking internal. And I want you to look at your weaknesses. Where are you weak? Is it your system? Is it your IQ? Is it not knowing what you don’t know? What are the things internally that you evaluate your business as weak, all internal.
Now we’re going to switch. So the next item we’re looking at as opportunities step out that door of your business. What are the possibilities? What lies at the horizon that you can achieve, whether it be: service model, technology model, delivery model, quality model, what’s the opportunity that’s at that horizon, name it and seize it.
And then the last crucial thing. You’re outside your business right now. Look around scan left to right.
Now you’ve achieved your SWOT analysis.
So the next thing I want you to do is I want you to name some goals. And this is one that you probably have seen before. I call them smart goals. And not me, but out there, it’s been coined as Smart goals.
I always say something in the middle to start. Your long-term goals can be more challenging, but you want to have some short-term success. Measuring the attainability of that goal is very important. The next thing sounds funny, but it’s relevant.
So put these all on your little paper, and you should now have your SWOT analysis and your Smart goals, ready to go, ready to work. And you’ll continue to build on that.
Secrets to Success in the 21st Century
So secrets to success in the 21st century, I have to tell you that besides business foundation, there’s one thing that is changing the landscape of business and Private Practice in today’s environment. And that’s efficiency. That is the key.
When I go into businesses, I measure efficiency. Now people look at efficiency in different ways. I’m not telling you, you have to have robots operating your business. No, but you have to evaluate how long something takes and the return on investment. And if it can be done as effective, if not better and in a faster unit of time.
So efficiency and operations can empower quality effectiveness via time management and prioritization of patient care. Efficiency saves private practice owners money and streamlines the best bottom line while increasing the quality of time.
I’m not trying to free up your time. So you can go to your private Island. I’m trying to free up your time so you can do what you do well. So efficiency often increases consistency and continuity from an operational standpoint.
Brandon's Efficiency Nightmares
I’ll give you a couple, and I’ve seen a lot. I never say I’ve seen them all because I’m sure there’s one I have not seen yet, but here’s just a couple. So I would say 40 to 50% of the Private practices that I come in. They’ve been established and have been around for five to 10 years.
We have what I call the binder. I go into the company owner, or I go into the office manager, or whoever’s running the operations. And I say, show me your data, show me how you do things? And what they do is they pull out this three-ring binder. That’s like a thousand pages, boom. And they slap it on the desk. And being honest, I almost faint at first.
I go, what’s that?
And they go, it’s everything.
I go, what?
They go, it’s everything.
What do you mean?
It’s our ledger. It’s our patient ledger. It’s everything that we need is right here. Brandon, I have one big binder organized, filed, ready to go for you.
And I start laughing,
and they go, what’s so funny.
I go, how confident are you with the computer?
And they go, Oh…
I go, you’re going to become confident because now I’m going to start giving you the fierce scenarios.
The binders are no longer valid in today’s environment. We’ve got all the different kinds:
You can take a picture of your check tomorrow. And it’s in your account. There are solutions to get out of the binder.
So the next story I tell you about the same Practice is what I call the credit card machine. I went into evaluate the finance person’s job and everything they did. They logged in a binder in that ledger.
I said, well, how are you charging credit cards? Are you taking credit cards?
She said, yeah, that’s probably 90% of our payment.
So I said, okay, tell me how you do it.
She said, this little baby right here.
I said, really? And it was one of those old fashioned credit card machines.
I asked her; I said, you get many people who just want to swipe their card.
She said, never.
I said, so you’re telling me you type in every credit card into that machine.
And she said, yeah.
I said, so tell me that flow, where do you get the info?
And she’s like, well, I kind of have it in this chart.
I’m like, well, that’s illegal.
You can’t store credit cards in a binder. You can’t store credit cards in that you must keep them either on an approved electronic system, which is a merchant services system that has proper encryption for it. Or you must get that credit card every time, no photocopies and binders people. I hate to be the bearer of bad news. And I see this a lot, but then what shocked me was:
I said, so then what?
She said, okay, so I type in the number. I don’t even swipe it, I type in the number, and I get the receipt. I then get my superbill in my invoice. I put it in an envelope, and I nail it.
And I say, how many of these are you doing a week?
She said hundreds.
And I said, how would you like to save 75 to 80% of your time?
And she said, what are you talking about?
So then I implemented a merchant services system where we went all-digital, everything was e-mailed, and everything was HIPAA compliant. And now she pushes buttons where she said, Brandon, you just took 75% of my day away. I said, great, what’s next? What can we put on?
Let’s use your brain instead of your body. You’re going to hear this a lot. Use your brain instead of your body. Otherwise, you’re going to end up getting replaced by computers. I hate to tell you that that’s what’s happening. Go to the United terminal at New York airport. And you will see what I’m talking about.
So the piles of filing the credit card machines, the binders, the old school scheduling books, it’s all going away. People are going electronic. It is the solution. Whether you love it or hate it, embrace it. It is a necessity in today’s environment.
Selecting your Systems to Build Business Foundation
So we need to select the right systems for you to build business foundation and each client’s different. I’ve implemented:
I’ve done it all, and not everyone is right for everyone. So we have to look at what are the pieces that are essential to you. So the key to selecting the suitable systems and ensuring it saves you time, just because it’s got all the bells and whistles, doesn’t mean that it’s right for you.
So it’s interesting. My father-in-law called me, and he just got this brand new car, and he was all excited. It’s been about three weeks.
I said to him, I said, how’s the car?
And he said, Oh, it’s okay.
I said, what do you mean? It’s okay. Like, it sounds impressive. It’s got everything.
He’s like, that’s the problem. I don’t know how to use all the bells and whistles.
And my statement to him is either you have to learn it or not have bought all the bells and whistles. So you’re only as good as your ability to utilize your system. So I find that the world of operating and picking the polarizing pieces is not the right fit. I want the value, or I want the bells and whistles.
Sometimes you’ve got to find the happy medium, and the keys to effective systems are understanding the following factors.
So first of all, what’s the problem that you’re trying to solve. What’s the frequency of the problem? This is important. So I get all the time, or if you’re like, well, you know, once in a while this happens, I go, I don’t want to know once in a while. I want to know how quickly it occurs because the more frequent the occurrence, the more valuable the system is if it happens once in a blue moon, we’re not buying systems for that right now. What’s the return on investment of that solution. And then what’s the scalability.
Based on the idea, I just implemented a new electronic medical records program in my Practice. The reason why I picked it was the scalability. It was able to support and growth without it costing too much money. And that initial investment was worthwhile where some people need a different system because they don’t need that same scalability.
These are the things that I can help you decide, but you need to be looking at these pieces when you’re evaluating your systems.
Samples of Private Practice Systems / Solutions
So samples of private practice systems and solutions, we’ve got electronic medical records, EMR, and practice management platforms, which can be different, or they can be all-inclusive. We’ve got cloud-based storage servers, patient portal platforms for all of your forms that go to the patients. All of that’s important.
We’ve automated marketing tools, telehealth platforms, automated communication tools. Are you using MailChimp? I am. Those are the tools that we want to start looking at and building your suite of solutions. It’s only as good as the problem it’s solving for you and the time that it’s saving.
Understanding the Mind, Body & Spirit Phenomena in Building your Staff
In this next section, I want to talk a little bit about is understanding the mind, the body, the spirit phenomenon, and building our staff. And I bring this up because just earlier, I said that we need to replace the body with the mind.
And it’s something that I eat, sleep and breathe daily. It’s the role that our mind, body, and spirit play. And I don’t mean it from a spiritual standpoint. What I mean is that it’s often telling on efficiency.
So I have found that the more body and spirit I have, the more efficient I begin to become because I’m creating solutions to make my mind or my body more effective.
The mistakes I find in today’s environment is we have a lot of people that just a body, for example, and I’m going to go into this in greater detail, but ultimately it’s someone that you have to tell to pick up that paper, file it this way, do this, do that.
Signs that your Employee Falls Under the "Body" Category
That’s where the New York airport piece comes into play. We have to replace the bodies with systems with solutions and save time. So let’s talk about this body. The employees follow directions, but there’s no proactive effort in identifying problems. It’s like I did what you said
Sorry. If I have to think for you, we have a problem. The employee would literally walk off a bridge into the deep end of the ocean if you told them to because they’re not thinking about the job.
Every day, I challenged my people. You are a decision-maker. You might not be the business-owner but come to me with the solution. If you’re just sitting back and documenting your clinical notes the same way, and you’re not coming to me saying, Brandon, this doesn’t feel right, Brandon. I feel like I’m taking too much time. Brandon. I want to cut. I have an idea that is essential in today’s success.
I find that bodies usually have the least amount of buy-in. When I even asked them. I’ll go into a practice, and I’ll identify in Practice on an onsite visit. I will audit. And I’ll say you have three bodies who work for you. You have five minds. You have ten minds, body, spirit. And when I share this with these private practice owners, like you are so right, Brandon, the reason why I’m hitting my head against the wall is I have to do everything for them. I have to tie their shoes.
And they’re like, but what about what I’m paying for? And my statement is this; we will no longer be paying for bodies. Bodies will be replaced by technology. If you go into a McDonald’s, you no longer have that person for minimum wage say, can I take your order?
Nope, it’s a computer system. People have to think and contribute beyond just following directions in today’s environment. So the solution either you empower the employee to be the mind or the spirit or the mind, body, spirit, or you think with the position to contribute on a greater level. Otherwise, we need to replace them with a computer. Filing should go away, and Faxing has to be much more streamlined. Merchant services should be much more streamlined. Your person should be operating on a more basis than you just telling them what to do.
Signs that your Employee Falls Under the "Mind" Category
So the mind is essential. This is an employee that’s proactive in identifying problems, researching solutions, making recommendations to ownership. They take responsibility for the role that they contribute to your company. They’re an ambassador of the idea that I’m going to work smarter, not harder. I’m going to free up time and bring more value because I offer more financial opportunity to myself and the company.
The employee is consistently and continuously seeking ways to add value to the company. And they buy-in to the better business. My core team is all mind, body, spirit, and we’ll go into the spirit part, but mind, at the very least, is someone thinking on their toes for me.
Signs that your Employee Falls Under the "Spirit" Category
These are signs when someone falls into the mind, body, and spirit; these are unique because spirit, what is spirit? Spirit is energy; it is just like beyond the job. They eat, sleep, and breathe what we’re doing. They have bought in almost an ownership level, regardless of their position.
I have receptionists that are mind, body, spirits, and their viewpoint is. Every day I answer that phone to transform someone else’s life on the other end. They’re not just doing it because it’s part of the job. They’re doing it because they see results and invest both in thinking with the job and genuinely transforming how they do the job.
So the employee has the highest level of ownership in this stake. The employee is continuously seeking ways to contribute, and they ultimately are that superhero next to you, doing everything they can. They’re able to confront recommendations and corrections. Their viewpoint is that if they contribute to the company’s greatest level, they will contribute to their life. And the overall exchange will be at the highest level, both beyond just compensation, but job satisfaction, being part of something, purpose in life, et cetera.
The Tale of Three Employees
So I have three employees that I’ll quickly tell you the tale of so that you know. And, I will tell you that two are unfortunately no longer with the company. And the reason for it is just they didn’t grow in the way we needed, and they fell into that mind body spirit.
So the first is I actually had a front desk person at our clinic, and first of all, she fell asleep on the job. How do you fall asleep on the job? It was a 30-minute break, in terms of like till the next clients came through, and she literally fell asleep in her seat. And the problem with this employee was that she would be motivated when I was looking over her shoulder, but she was off the minute I turned around.
I found that she put on what I call this image, this valence, this idea that I am your dream employee, and I buy-in. But at the end of the day, she was a body. She only worked as hard as someone watching her. She only did what she was told. She contributed nothing beyond, and her ownership was, well, you didn’t tell me to do that. So ultimately, that position got eliminated. I utilized technology to replace many aspects of her job and bring in the next level person at a higher level to contribute greater.
Tale number two was someone that came in and started thinking with the job. She was defined, and I would classify her under the mind role. But she would think with it. She was a little disconnected, but she was able to bring solutions, and that was important.
But ultimately, what I found was that she never was able to get entirely behind and invested. And it just still kind of felt this, like she thought with the job, but it was really about clocking in and clocking out. And I get that some people are in that game, but their job security will go down when you can streamline things to afford what I call the mind, body, spirit.
So now I have the last employee, the mind, body spirit. We transformed our company. She brings me ideas; she critiques me. She tells me, Brandon, I think you could do this better, and I can have it from her because she has my best interest at hand. Now, the idea that she can critique her box is so empowered that I value her input.
She has grown in eight years with me to be one of my right hands now. And it’s because I can call on her. I can trust her. And I have eyes, ears, mind, body, spirit with me in this March. And it comes down to the team at the end of the day. So as you build your workforce, realize that workforce and that investment in the workforce are only as good as your weakest link. And the more you can streamline your operations and bringing effectiveness, the more you can afford to bring in the mind, body, and spirit.
At the end of how to build business foundation for your private therapy practice, don’t forget to sign up for a free 30-minute video consult. We will make it happen. We will push you to the finish line. We can thrive, not just survive.