So here's the thing: I LOVE Halloween. I love watching scary movies (through my fingers, because I'm 35 going on 3-5). I love the several hours of under 80 degree weather we get in North Texas that constitutes "fall". I love seeing the creative ways my neighbors decorate for Halloween, and most of all I love dressing up in costumes (see below...yes, that's me. And yes, I did my own makeup #eyelinerspider).
Today's topic is the glaringly obvious (to me) mistakes that folks often make when setting up their business. Not that I'm some kind of super genius (well, I am...I'm almost as smart as I am humble), it's just that when you're in the trenches of operating a business at the admin/support level, you tend to feel the impact of bad decisions pretty intensely.
I'm going to focus primarily on private practices today since the extensive (and very focused) training that folks have to complete to become licensed professionals often leaves a lot out of 'how to set up/run/manage a business'.
Much Ado About Everything
Picture this: you've completed your 80 billion years of school. You've finished your 11 trillion hours of supervised hours or residency or whatever. YOU DID IT!!!!!
Now fly, my pretty! Fly out into the world and do what you've been training for years to do! All the sacrifices have paid off and everything is gonna be super easy now!!!!.........right?
HA! Now you get to deal with managing student loans and either taking a job under someone else's shingle (not a bad option when you're new in town and just starting out), or going out on your own and being your own boss. That second option sounds kinda nice. Not having to deal with other people's rules. Setting your own schedule. Doing things your way...
Your Way...Or The Highway
Well crap. Did you just realize that you know essentially nothing about actually running a business? You know so much about how to be the best therapist/chiropractor/dentist you could write a book about it. You don't, however, know poop about fluff when it comes to setting up a billing system, getting credentialed, onboarding new clients, creating social media content to attract new clients, maintaining a functional website, keeping up with client balances, and most importantly...you have yet to figure out how to schmooze that crotchety practice manager from your most vital referral source. Btw, her name is Geraldine, she's 700 years young, and she Does. Not. Find. You. Amusing.
I've said it before, and I'll say it again, be good at what you're good at, and let other people pick up the rest. Of course that's easier said than done when you're first starting out, and your startup expenses may be scaring you more than my spiderface. Those are reasonable and realistic concerns! Getting started can be expensive, and stressful, and time consuming. But you know what is even more expensive and stressful and time consuming? Nickel and diming yourself into paying 3x more to dig yourself out of a hole that it would have cost to pay someone to get you up and running in the first place.
Fool Me Once...
One trap that a lot (like....a LOT lot) of folks I've worked with have fallen into is not looking at the big picture. To get through an intense education, you've had to focus on one exam, one paper, one class at a time. Now that you're in the real world you have to focus on each individual tree AND keep an eye on the rest of the forest. Wait..what? You can't be in the thick of things and flying above it all? No wayyyyyyy (that was sarcasm, in case I wasn't clear).
Let's say you've signed up with an EHR or scheduling system that is integrated with Stripe to collect credit/debit card payments. Ok, that's cool, but omg those Stripe fees are like .3 percent more than this other company that has a cool desktop card reader thingy!! Obviously the best move is to use the cheaper card processing company. You'll save like .04 cents for every dollar, you smugly think to yourself. You're a tycoon in the making. You'll have your swimming pool full of cash full by the end of the year.
Shame On You
Maybe you're starting to get nervous by the tone I was using, but if you didn't, please check out my magic bean emporium...have I got a deal for you!!!!!
Seriously though, on paper, saving a dollar here/there per transaction can add up, that's just math. Unfortunately, forgetting to collect payments from clients and not remembering who has paid and who hasn't, and therefore collecting no money costs way more than a few dollars. Having to either take time out of your schedule to manually update payments so that you can process claims (or pay someone else to do it) costs more than a few dollars. Paying your accountant to laugh at you as they make you write off hundreds of dollars you didn't actually collect at the end of the year costs WAY more than a few dollars, cuz you know that damn bean counter has figured out that it doesn't matter if a card fee is 2.6% or 2.9% or 4,000% if you collect $0 from someone.
I don't mean to be insensitive, this is a real issues that folks struggle with. It takes experience to be able to see an entire business as a whole, and know what pieces connect now, and what will have an impact down the road. Having integrated systems that flow and communicate is how you scale your business. You can't build a practice using spreadsheets to tie your scheduling and billing systems together. It's not sustainable, and all that money you 'saved' on those transaction fees are just a drop in the bucket on what it will cost you in lost revenue and future admin fees.
Help Me Help You
You don't have to hire me. You really don't, seriously. Just please be realistic with yourself about how you're setting up your business. Reach out to friends in the industry. Ask them what they wish they'd known starting out. Ask for referrals for software that they love. Ask about software they hate with a fiery passion that didn't do what was promised and had a big ol' fee for breaking the contract they signed 'to secure a great rate!'
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