Pay Now or Pay Later…Expanding into Three Clinics and the Cost!

growthaheadsign:dropcap_open:G:dropcap_close:ood staff will do. Imagine you were planning on building a health care empire.  Would you have time to be so picky about hiring new staff that you would delay months just to find that perfect staff member?  Would you have time to constantly turn over your staff? This process is costly, decreases morale, and ultimately slows you down from achieving your goal.  Hire people who have the basic qualities that any employee should possess.  Beyond that, it is your responsibility to see to it that they are trained properly to serve their purpose.  Great companies tend to create a noticeable culture amongst their employees, and the company’s expectations and standards are built into that culture.  A new employee working with such a company should quickly understand what is expected of them regarding work ethic, punctuality, detail, and customer service.  Once these basics are in place, training on their job specifics is simply a function of planning and time.  Be patient, have fun with them, encourage and guide them, and redirect when necessary.  Remember, you are building an empire and you don’t have time to lose them and start the process over.  A word of caution:  If your hiring standards are too high, and so few will do in order for your company to be successful, you should reconsider your practice model.  Subway was recently named the most profitable fast food chain, with locations in 85 countries, 150,000 employees, and total annual sales of 9 billion dollars 1.  The simplicity of Subway’s business model has been the key to their success.  If they relied on only hiring that one-in-a-million staff member, they never would have grown to the top so quickly.
Slow down to speed up.  Commit early to training an associate D.C. as a future clinic director.  Most clinic owners resist this step, since it usually decreases profits in the short term.  Of course the associate D.C. isn’t as good as the owner, and they make more errors.  However, if you are patient and dedicated to the training process, the return is substantial because it allows you to replace yourself in the business.  It frees you up to spend the bulk of your time working on the business, not in the business.  Is it more important that you perform the hands-on care yourself, or would you rather be responsible for exponentially more patients receiving care because of the practice you have created?  Not only are extra patients receiving care, expansion also creates more jobs, and more opportunities for advancement within your company.  You win, your employees win, and the patients win.  Have you ever heard that learning how to play golf and tennis is a good idea, since both sports can be played into your elder years?  Well, learning how to train and manage another doctor to run your clinic successfully follows the same concept.  The sooner you learn this vital skill set, the sooner you will be positioned to expand more successfully.  Pay for this experience now, and not later.  Who knows what can happen later.  You have the opportunity to do it now, so get started. 
:dropcap_open:Quick response ads and spinal screenings are nothing but short-term solutions.:quoteleft_close:
Branding works, and prostituting does not.  Many D.C.s that fancy themselves as marketing savvy will tell you that long-term branding is ineffective and a waste of money.  This couldn’t be further from the truth.  Quick response ads and spinal screenings are nothing but short-term solutions.  They will not positively contribute to your company’s reputation.  Think about it:  You are sending the message that you need patients, and are willing to give away or discount services in order to get them.  Instead, focus on developing the qualities that make your business different.  Determine the best platform to send that message.  Then, begin establishing relationships with as many community members as possible.  Start with the most obvious sources, and go from there.  Once you have reached a critical level of branding, multiple sources of referrals will consistently show up.  Everything gets easier.  Just as more patients attract more patients, more professional referrals attract more professional referrals.  How we did it: Our branding started with informational television commercials, none of which offered discounted or free services. In addition, we began building relationships with the primary care providers and specialists in our community.  As our frequency of calls increased, we had to form a separate call center which allowed all incoming calls to be funneled to a separate location.  Next, we began tracking the calls, and the information that process gave us was priceless.  We discovered that many patients were coming from other towns, and when it was time to open a second clinic we already had supporting data to decide on which location made the most sense.
The two step satellite process:  We subleased the space of our second clinic, and began a part-time schedule there. We shared staff between the two clinics in order to minimize the transition costs.  After maximizing our part-time schedule with services, we then moved to step two:  Expanding into our own space within the same building, and offering a full-time schedule.  This two-step plan for a satellite clinic allows you to test a new area before committing to a long-term lease, and the expenses that come with staffing and supplying a full-time clinic.  
Make a strategic plan.  Start with a practice model that allows for a large profit margin.  For us, it was the integrated health model.  Determine the best fit for you.  
  1. The Editors of Publications International, Ltd.  How Stuff Works [Internet].  [2007 Sep 15; cited 2013 Feb 7]. Available from:
Tim Gober, D.C. is the President and CEO of The Integration Group, a consulting company specializing in multidisciplinary integration for D.C.s. He is also the owner and founder of The Baltimore Pain Relief Centers. Dr. Gober can be contacted at [email protected]

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