Plan for Things to not go as Planned (Private Practice Tips)

I spend much of my time working with persons starting counseling practices. Their first year is difficult, to say the least. New entrepreneurs have a steep learning curve and a mountain of tasks to complete (especially when they’re building a group practice). Also, they’re scared; they’re invested both emotionally and financially, and even though they’ve seen others succeed, they don’t know if the process is “going to work” for them.
Moreover, what surprises new entrepreneurs most isn’t the hard work of learning, and of completing a mountain of tasks. It’s that while they’re trying to do that, things rarely go as planned.

Not as Planned

Imagine purchasing the biggest Lego set, the Taj Mahal (5,922 pieces). You open the box and see that the instruction booklet is for the Lego’s smallest set, Scurvy Dog and Crocodile (4 pieces). Someone swapped the booklets. So, you go back to the store and exchange it for the right one. You get back home and find another problem: Some of the pieces are missing! The store is sold out of your set, so this time you call Lego customer service and they mail you the missing parts. You have a tracking number, and you watch your pieces travel all the way to…Phoenix, Arizona where the trail goes cold. A few days later the they’re deemed officially lost in transit. Someone locally says he can help you in a pinch, and you finally get the pieces but they’re the wrong color. Oh, by the way, this Lego set cost $30,000 and if you don’t get it built ASAP you’ll need to tell your kids you can’t pay for college. This sounds like a perfect nightmare, but with entrepreneurship it’s business as usual.

The Founder of Whole Foods, John Mackey, spoke in an interview about how his first store lost money, his second store was destroyed in its first month by a 100-year flood, and after rebuilding it he accidentally cannibalized it by opening one of his next stores too close-by (oops). These stories are as common as dirt. For Whole Foods, the path to success wasn’t just about climbing a mountain (that is, building a high-end grocery store with quality foods and then educating potential customers about why they should pay a premium for them), it was about climbing a mountain fraught with things that did not go smoothly.

Why is it like this?

1)The companies you work with aren’t perfect

You’re underwhelmed by the service you’re getting from your attorney, your realtor, your bank, your EMR provider, your…you name it. Nobody seems to deliver quite what they promise, when they promise it. It makes you want to yell “You have one job!”

Here’s the thing; new entrepreneurs expect everyone else to have their stuff together. In reality, most of the companies you’ll work with–from the person who does your printing to the guy who delivers your lunch–will be small companies struggling iron out their operations and make things work, just like you. Or, they’re huge companies that don’t need to get their acts together–you’ll take what they offer and you’ll thank them for it, because you are a tiny customer and there’s no better option.

Real Examples:

• You try to rent an office but the lease doesn’t come back from the landlord for a month
• Comcast arrived again, and the internet still doesn’t work
• The brand-new computers you bought freeze and crash
• Your printer ships you someone else’s rack cards, and vice versa
• You give your graphic designer exact text for a brochure, and it comes back with typos

Encountering problems like these doesn’t mean that “things are going wrong.” It’s part of the process. Have patience.

2) The people you work with aren’t perfect

You hire your first team members and you’re shocked to learn that working for you isn’t the most important thing in their lives. They care more about their families, their friends, even their hobbies. In addition, when they are focused on work, they want to do things “their way,” not your way. In fact, sometimes there are serious performance issues.

There are probably a few things going on here. First, when you start hiring, you’re not good at it. So maybe your first hires don’t have the characteristics or skills you thought they did–and that you need. Second, nobody is going to care about your company as much as you, or work as hard as you. Third, an established company culture helps to get people moving in the right direction. It’s hard to have such a culture when you’re new, or when you have just a couple team members.

Real Examples:

• You get lots of applicants, but no one you feel is qualified
• A clinician won’t complete his notes on time, or no-shows for an appointment
• An office assistant keeps arriving late, or calling in sick
• Your “social media expert” can’t seem to amplify your online exposure

When you encounter these things, don’t panic. Keep moving forward. Building a team takes time.

3) You aren’t perfect

Arg, that painful look in the mirror. You realize you’ve screwed up some stuff. You avoided some things you really didn’t want to do; like, spending enough time training your team, or learning how to budget with QuickBooks.

Real Examples:

• Your P&L shows that you’re making money, but there’s no cash in the bank. You don’t understand why.
• A team member quits, citing that you haven’t been providing the support you promised.
• New referrals are low, and there’s a stack of unopened rack cards you told yourself you were going to distribute to potential referral sources.
• Your website goes down because you forgot to pay the bill.

It’s okay. Just like everyone else, you don’t need to be perfect. In fact, I recommend not trying. Instead of trying to be the smartest person in the room, the person who can fix everything, the person with all the answers, it’s much better to just be you. Be the most curious, and the most willing to learn and improve. That’s the best anyone can do, and the best example you can set.

Soon, You’ll Look Back and be Amazed
You might be scared in your first year. You might not know if you’re going to make it. Let me tell you: I know that if you stay the course your chances of success are very good. I know that in time you’re going to work with vendors that get you what you need, you’re going to hire excellent team members, and you’re going to rise to the challenge of whatever life and business throws your way.

You try to launch a practice and things don’t go as planned. But at the end of the year, you look back and you don’t think about that. You look back and think “Wow, we accomplished a lot.”