If you grew up in the 1950s, you might remember the popular television game show "20 Questions," in which one player chose a subject and the others had to try to guess what it was by asking up to 20 yes-or-no questions. Today, the 21st century equivalent of the game is simply called 20Q and, like many activities, is available to be played online.
Besides being entertaining, the 20Q concept encourages creativity and deductive reasoning. The 20 questions posed below are intended to get you more engaged in the nuts and bolts of running a practice and enable you to think more strategically about your business. Implement the tactics suggested for each question, and you have an excellent chance to "win" in your practice.
1. Do you know what you want your practice to be known for? This question allows you to determine your unique selling proposition (USP)-that distinct, appealing idea that sets your practice apart from your competitors as well as other related businesses where customers can choose to spend their hard-earned dollars. For example, as a potential customer is deciding how to spend discretionary income, cosmetic surgery or hiring a personal trainer may be competing with the idea of getting hearing aids.
Your USP is likely to revolve around just five possibilities: price, product, technology, customer service, or memorable patient experience. It's up to you to determine which of these five dimensions is your USP and to design your practice's goals, objectives and marketing tactics around the dimension for which you want to be known.
2. Do you have specific business goals? Many practice managers are so busy taking care of their patients that they don't have the time to plan. In short, planning means you are setting some clear performance goals for your practice. These goals typically revolve around raising the bar on either productivity (seeing more patients, dispensing more hearing aids) or quality (taking better care of patients or operating more efficiently).
3. Do you have a long-range plan for growth? If you have not planned or thought about your long-range plans for success, you could be moving in the wrong direction and not know it until it is too late. Opportunities to generate profits may be lost.
Develop a long-range planning procedure and review this plan periodically. You may need to modify it as the economy or your competitive landscape changes. Long-range planning often starts with a strengths, weaknesses, opportunities, and threats (SWOT) analysis. Brainstorming with your staff and identifying the strengths, weaknesses, opportunities, and threats to your business is a proven way to get started on long-range planning.
4. Do you have a plan with specific, measureable objectives? Once you have established a long-range plan and set goals, you need to make sure your staff understands their job assignments with enough detail so there are no misunderstandings as to what is expected of them each day. The key to this point is to provide clear communication and coaching in order for each employee to know how their efforts contribute to the success of the organization. Conducting weekly one-on-one meetings with each member of your staff to review their projects and tasks is a great way to build a personal relationship with them as well as ensure things are getting done.
5. Do you set clear expectations? Based on years of experience we know that owners and managers who take the time to plan and set goals often have a far greater chance of being successful. After setting goals, be sure to clearly communicate your expectations for accomplishing your goals.
6. Do you have an office management system? In addition to either a web-based or stand-alone office management system, you need a process in which you book appointments, schedule recall visits and mine your existing database as part of a systematic patient retention program. Paying attention to your patient pipeline through diligent management of it will ensure you have a steady supply of patients coming through your doors.
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Figure 1. Adding value in the margin will ensure loyal patients.
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7. Are you relying on the tests and procedures you learned in graduate school to make clinical decisions? Based on MarkeTrak VIII data, there is a relationship between pre-fitting test protocol execution and patient satisfaction. Taking the time to implement more engaging pre-fitting tests like the Quick SIN, Acceptable Noise Level and TELEGRAM will allow you to foster a deeper bond with patients. In addition, taking the time to incorporate these tests as well as other more cutting-edge procedures, like speech mapping and computer-based auditory training, add value to your offerings. As Figure 1 suggests, there is no better way to feel good about the retail prices you charge than adding value by providing innovative services and tests during your interaction with patients.
8. Do you have a selling process? It's surprising how many clinicians leave the consultation with the patient up to chance. Taking the time to develop a formal consultation process will make it likely that you move the patient from one point to the next and that you ask them to do business with you.
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Figure 2. The various patient points of contact, along with optimum time of appointment. Those listed on the bottom of the line are in-direct points of contact with your practice, such as visits to your website.
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9. Do you add value to the patient's experience in your office? One way to add value is to bundle warranties, batteries and office visits into the price of the hearing aids. Any time you are bundling goods and services into the price, it enables the customer to look at the long-term value of your offering.
You also can conduct a patient experience audit. Start by recording all the points of contact you have with a typical patient, such as shown in Figure 2. Once you have recorded all these points of contact, ask yourself, "What does my staff need to do in order to make the experience for the patient memorable and engaging?"
10. Do you generate and track word-of-mouth referrals? Because word-of-mouth referrals add virtually no extra cost to your bottom line, it makes perfect sense to try and get as many of them as possible. There are several ways you can generate more word-of-mouth referrals; all of them rely on your ability to work your patient retention plan.
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Figure 3. All staff need know how they contribute to at least one of these three variables. Weekly meetings, feedback and coaching all revolve around striving to improve these three dimensions of practice productivity.
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11. Does your staff have a clear understanding of what is expected of them? What seems obvious to you may not be so for your staff. Employees have a strong desire to know how their time and efforts contribute to the success of the practice. You can start by asking members of your staff how they create value and how they rank their daily priorities. Once you gain agreement on what their priorities should be, you can discuss exactly how their efforts are intended to contribute to the practice's success, such as shown in Figure 3. If you're not sure of the answer, ask your staff to answer this question.
12. Do you have weekly one-on-one meetings with your staff? In order to build an effective business relationship with each member of your staff, it's important to get to know them as a person. During your weekly, one-on-one meetings (Question 4), letting your staff set at least part of the agenda is a great way to build mutual trust. After all, it is largely trust that allows you to focus on what you do best while your staff completes other important daily tasks. During your weekly sessions, be sure to set aside time for each member of your staff to bring up items they want to discuss.
13. Do you provide your staff with constant feedback? As the practice owner or manager, one of your primary responsibilities is to lead your staff and to expect them to be continually improving at their job. One way to let them know how they are performing, both what they are doing well and what needs improvement, is to bathe them in constant feedback about their performance.
14. Do you provide coaching to your staff? Beyond providing feedback, you need to make sure your staff is continually improving or taking on greater responsibilities. By directing them to the appropriate resources you can be sure they continue to fine-tune or improve their skills.
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Figure 4. The 3 Es of quality
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15. Do you have an obsession with quality? Quality is that difficult-to-define term that can be a huge competitive advantage and ensure that you command an above-average selling price for your products and services. In short, customers rave about quality when they experience it. As shown in Figure 4, there are three dimensions to quality: effectiveness, which is your ability to execute evidence-based clinical procedures; efficiency, which is your ability to work patients through your process in a thorough manner; and emphasis on results. By taking the time to measure hearing aid outcome as well as several aspects of your interaction with the patient, you are more likely to become the provider of choice in your area.
16. Do you have a passion for the mundane details, such as fixed costs and margins? It's not enough to look at the final results on a monthly basis. Successful business managers know the details of their business. Knowing about your variable and fixed costs, cash flow and accounts payable and receivable on a daily basis is important to success. For example, fixed costs are those that you accrue even when you are not dispensing hearing aids. When left unchecked, fixed costs can have a devastating consequence to the bottom line of your practice. Review this data often and update your budget as needed.
17. Do you have an annualized budget with revenue and product mix objectives? In order to maintain a vision for your company (Question 1) you need to align costs, revenue and margins with your vision. A budget serves as a template for your monthly revenue and unit targets.
18. Do you have a retail pricing strategy? There are a couple of reasons it is absolutely critical to have a clear pricing strategy. Without one, it's easy to fall into the trap of providing discounts (cutting a deal) with every customer that comes through your door. A pricing strategy also helps you build a budget. If you are able to maintain a precise retail price, you can plug that number into a monthly or annual unit forecast that will enable you to project revenue over the course of a year. You simply cannot do this without stable pricing. Start by knowing how you want to price products; do you want to be the low-end or high-end player in your market, or do you want to play in the middle ground?
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Figure 5. The Pyramid of Success shows the things it takes to be successful in a hearing aid dispensing practice.
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19. Do you have a marketing strategy? Most business owners agree that at least 10 percent of annual revenue needs to be reinvested into marketing. Once you have established a marketing budget, the next step is to create a plan. Typically, owners like to devise a monthly calendar that plans out the entire year. In addition to pre-planning an entire year, it's important to use a wide range of marketing tactics and measure the return on investment for each.
20. Do you get a sense of accomplishment from managing your business? In today's incredibly hectic world of business, the ability to simplify and find small, incremental areas to improve in your practice is the key to finding long-term success. In his long and very successful career, John Wooden, the coach of the UCLA men's basketball team, won 14 national championships. Much of Wooden's unprecedented success was not the direct result of his ability to recruit top talent or coach during the game. Rather, he attributed his success to being an effective teacher and leader. During his tenure, he created the "Pyramid of Success" (Figure 5), which schematically shows the essential characteristics and behaviors needed to be successful.
The concept of the Pyramid of Success has great utility for managers and owners of audiology practices and can provide a foundation for long-term success. As you move up your pyramid, the skills required to be successful become more complex and finally culminate in your ability to identify areas of improvement and simplify essential processes. Asking yourself and your staff the 20 questions posed above will help you get to the top.
Brian Taylor, AuD, is director of practice development and clinical affairs for Unitron US.