Healthspan Blog

This guy should be the poster boy for why “Not to Abuse Steriods”.

In many ways, the practical aspects of leaving your practice for a sabbatical – locums, money management, etc. – are, believe it or not, the easiest. What can be incredibly challenging is the emotional roller coaster ride of walking away from something you’ve worked so hard to build, and then trying to remain sane while you’re gone. Given our recent transition, here are a few tips for you:

Stay Big Picture
From 40,000 feet, the big picture of leaving your practice (assuming you don’t shut your doors) looks like this: patients show up, consume products and services, and happily pay. It’s a system for exchanging services for money. In the past, you may have been the main engine of that service, but now it’s time to pass the torch.

Certainly leaving your practice for any length of time – even a short vacation – can result in the world’s longest to-do list. Resist the temptation, though, to get caught up in the details. Yes, they’ll all have to be taken care of, but not at one time. Start a list right away, and just jot down all the little things as you go so you don’t have to think about them until it’s time.

While you’re away, continue to focus on the larger picture. One slow day at the office doesn’t mean your practice is going down the tubes – each day’s going to be a little different. Remember that you have slower days when you’re there, too – one bad day doesn’t make a trend. Micro-management isn’t going to work when you’re gone.

Practice Before You Go
The best way to iron out the kinks of the no-you practice is to…well, leave. Do a test run before you go. Get your locum started a few days before you leave, turn off your cell phone, and see how things go. You’ll be surprised at how many kinks you’ll work out in one day.

While there’s clearly a practical side to this, there’s also a huge emotional benefit to a trial run, particularly if you’re leaving the country. Traveling or relocating can be stressful enough without wondering how things are working at home. A trial run is the best stress-reliever there is. Most of the kinks are little things that are easy to fix while you’re in the office, but far more emotionally draining when you’re halfway around the world. In our case, the trial run made a huge difference during the week or two it took to get email access and a phone.

Accept the Worst-Case Scenario
Calculate the worst possible financial outcome for your practice in your absence. What will you have to pay out if not one single patient shows up the entire time you’re gone? This is likely the sum of all your fixed costs for your practice, give or take.

It’s also extremely unlikely to happen, and the objective is not to focus on it. The purpose of this is to be able to say, “the worst thing that can happen is I’ll lose $X, and I can live with that,” and then get on with your planning. In reality, your clients will show up. The worst-case scenario is just that, and it lies in the very fringes of probability – it just ain’t gonna happen.

Ask yourself, “is it worth $X to be home with my new baby/travel/do volunteer work/etc.?” If the answer is yes, then move on.

Focus on What’s Real
Once you’ve accepted the worst possible outcome, focus on what’s real. Don’t speculate on problems that aren’t there (and likely won’t be). Feel free to do a little disaster planning – data backups, staff changes, illness, fire, etc. - but don’t obsess on issues that don’t exist.

Obsessing over the possibility of declining patient visits is not productive. If that happens, start generating positive solutions to the situation, but not until then. Learn to understand the difference between brainstorming solutions to possible outcomes, and obsessing over problems.

Give Up Your Ego
Small businesses tend to operate in an “owner is everything” environment. You may be used to doing everything yourself. Over time, that can evolve into believing you have to do everything yourself. That in turn, evolves into believing you’re the only one who can do the job at all.

Let it go. The truth is that we’re all dispensable. What’s led you to believing that no one else can do your job is the subconscious feeling that no one else cares about your practice as much as you. Instead of focusing on how no one else can do it, focus on finding ways to motivate your staff to care as much as you do.

Maybe it’s not Supposed to Be Easy
Leaving your practice is hard. It’s a whole new skill set. For most practitioners, what’s really going on is a transition from owning a job to truly running a business, and that’s a tough change. Don’t expect it to be simple, but at the same time, don’t expect it to be impossible or painful. Just expect it to be a challenge that you’re well equipped for.

If you’re thinking of taking some time away, feel free to email any questions you may have: dan@alternativehealthpractice.com

Related Posts
How To Take Time Off From Your Practice Part 1
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This guy sure is lucky to be alive.  I hope they can re-construct his skull.

Whether it’s a sabbatical, an illness, a new baby or just a break, there are times in your practice where you may need to be away for an extended period of time. We’ve just arrived in Paraguay for a five month medical mission, so I thought I’d share some ideas on how you can take time away, and still return to a thriving practice.

Find a Locum
You’ll need someone with your qualifications and skill set to fill at least part of your shoes. Start early, and don’t take the first thing that comes along – the right person can take time to find.

Try to discover what makes you popular with your patients. You may not be able to find a clone, but you can do your best to get someone with similar values and personality.

I’ll write a longer piece on locums later, but make sure you have a contract, and it includes a non-competition clause.

Diversify
If you haven’t done so already, start thinking about other ways of generating income in your practice that aren’t specifically tied to you.

Are there other types of practitioners you can add to your practice? Additional products and services? Someone to rent a portion of your office space? More importantly, is there a “sub-doctor” (to use an Emyth Physician term) who could do some of what you already do? Some type of assistant, nurse, or technician?

The reason for diversification is twofold. First of all, adding new products and services to the mix reduces your risk. If all your revenue is generated by selling your time by the hour, then you rely entirely on you for your income. Let’s say, for example, you find a locum, but in your absence, the locum turns out to be a little less than ideal. When patient visits drop off as a result, your practice starts to slide. If you have other revenue generating plans in place, the “bad” locum will hurt a lot less.

Secondly, diversifying is critical to staying profitable. Locum agreements are often based on a revenue sharing plan. If your locum takes 50% of every patient visit, you may find that your practice has a tough time making money even if it’s booked solid in your absence – after all, you now have half as much money to pay the bills. It’s the equivalent of cutting your fees in half.

When you diversify, however, the other revenue generating parts of your practice don’t have to be included in your locum agreement. The revenue from associates, products, technicians, etc., can be 100% yours to keep.

Review Your Costs
It’s something many holistic practitioners avoid, but there’s no better time than before a sabbatical to cut your costs. Go through every expense in your practice, line by line, and ask yourself these questions:

• What would happen if I stopped this?
• Can I get this cheaper from the same source?
• Can I get this cheaper from another source?

Continue Your Marketing
Just because you’re not at your practice, doesn’t mean you should stop marketing. When you go through the cost-cutting process above, it’s tempting to cut all your marketing expenditures, but consider carefully before you do.

If you continue what marketing you can during your time away – yellow pages and other advertising, for example –awareness of your practice will remain higher. If your practice is going to be less profitable while you’re away (meaning you get to keep fewer cents of every dollar) then you’re going to want to do as much business as possible during that time in order to pay the bills. Keeping a presence in your community will be a part of that.

Stay in Touch With Your Patients
I’ve separated this out from marketing (even though it falls squarely in that category) because it’s important on many levels. In the case of alternative medicine, the relationship between doctor and patient is often more intimate than what you might normally find in an MD’s office. As a result, not only will your patients want the comfort of hearing from you in your absence, but they’ll actually be genuinely interested in how you’re doing. If you’re volunteering in another country, or having a baby, your patients will love hearing about it.

If you haven’t got a system for email marketing, try Intellicontact. There’s no easier way to stay in touch with your patients while you’re away. You can grab a free 15 day trial here, or read my post on it here. It’s the most inexpensive and easiest to use of all the email newsletter and marketing packages that I’ve tried. We're using it right now to keep in touch with existing patients, and as an automated way for new patients to sign up for newsletters online.

Build Systems
When you boil it down, what you and your staff do on a day-to-day basis is usually a series of repeatable steps – a process. While some things are difficult to capture in a process – bedside manner, for example – much of daily operations can be distilled and written down.

Capturing this stuff on paper will make your life a great deal easier, both when you leave and when you get back.

You’ll also find that staff who are best suited for process-driven work – repetitive administrative tasks, for example – will appreciate a clear system for doing their job.

Keep an Open Mind
The biggest thing we’ve learned so far is to abandon your pre-conceived notions of what it means to leave your practice. Thinking in terms of “losing as little money as possible while I’m away”, or “maybe breaking even” are sure ways to do exactly that.

It may seem impossible but you can make money while on sabbatical. In fact, you can make more money on sabbatical than you do at work.

Leaving your practice running without you there forces you to find other ways to generate revenue without simply selling your time. You’ll be surprised at what you can accomplish – and how much you can earn – when you have to.

In planning for your time off, ask yourself questions like, “How could I make more money without being at my office than I could while I’m there?” If you allow yourself to freely brainstorm without judging, you’ll be surprised at what you’ll come up with.

One thing that most of the concepts above have in common is starting early. If you can’t, fine, but if you’re planning some time away, plan as far in advance as possible. It’s hard to think in the big picture when you’re buried in the last minute details of leaving your office, but that big picture is exactly where you need to be. Start planning as soon as possible. I’ve found that committing to doing one sabbatical related task per day is an easy and effective habit that gets the job done.

Related Posts:

Email Marketing for Your Alternative Health Practice

The Integrator Blog has an update on the Working Class Acupuncture story, including several interviews and comments. Worth a look - there's a larger picture here that goes beyond acupuncture.

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