Am I Ready to Launch a Satellite Practice?

The word "satellite" has many inspiring connotations of exploration, adventure, and new frontiers. For the entrepreneurial chiropractor, the seduction of cloning yourself and your practice model into multiple locations can be compelling. A common refrain is. "Ill work on my practice and not in my practice." In reality, successfully executing a multiple-location practice can be a significantly more complex journey. The satellite practice model is one tliat can be fraught with false starts, pitfalls, and dead ends for the inexperienced yet optimistic practitioner. However daunting the task, successfully expanding your practice and your influence on the health of your community can be one of the most satisfying adventures that a seasoned practitioner can undertake. The annals of chiropractic are filled with pioneers who made their mark on our profession by extending their reach beyond the four walls of their practices. Once you have decided that you have the mettle and finan­cial wherewithal to embark on a multilocation expansion, take some time to access your reasons for expansion. In addition to the passion and desire to expand your legacy, you first must accept that satellite practices are a financial decision—one that is a double-edged sword. Your decision can result in inspiring returns when done correctly or could erase all of the gains you have made in your successful single-location practice. This is a major business decision that should not be undertaken lightly. Satellite Start-Up Strategies The financial upside to operating a business successfully in multiple locations can be significant. The number of Mc­Donald's and Starbucks in every community confirms that. The economics of scale, in particular the leveraging of your marketing budget across locations, can mean that bigger is indeed better. However, the financial commitment required to fund a second location is considerable. Think about the expense required to open your current location. You had to purchase or build your office space, equip it. and then staff it with your team of employees. You most likely did all of that before you had any financial return. You must be an expert at delegation in your current location before you attempt to open a satellite. You will need to delegate every task you currently perform—including patient care—so that you can be free to manage the increased personnel and overhead that come with multiple locations. This means finding the right associate chiropractor to assume your responsibilities for patient care. If you arc unwilling to step out of the role of carcgiver and into the role of practice manager, you will need a highh- competent outside consultant or administrative-level staff member who will keep an eye on the business ball for you. The financial commitment for your second location will be equally significant. When you add the salary of an associate chiropractor to it. the stakes are even higher. Be sure to find out if the associate is crcdcntialed on third-party insurance panels. In today's climate of associates becoming crcdcntialed. it could take six months or more to get on mam panels. Take a moment to assess your current practice. Is it running like a Swiss clock—well oiled, streamlined, and at the peak of per­formance? Now step back and contemplate. How well would your practice run without you in it? If your answer isn't a resounding "perfectly!" and your goal is multiple practices, it is time to systematize your practice so that it is reproducible. You also need to begin stepping out of the role of hands-on chiropractor and into the role of chiropractic-entrepreneur. Without disconnecting from hands-on patient care, managing a satellite practice will be draining. Satellite Sustainability Strategies A common mistake that main' chiropractors make is to think that the systems responsible for their success in a single loca­tion will easily scale up to multiple locations. What works in one location with a single set of staff members can quickly turn one location with a single set of staff members can quickly turn into chaos without the right systems in place. Your operating systems must be independent of the personalities of the indi­viduals performing them—including yours. This is the only way to produce a consistent level of sen ice. With well thought-out systems in place, you should be able to pluck a staff member from one practice and drop him or her into the same position in your satellite location without that person missing a beat. Without successful systems, rather than working smarter, you will find yourself bouncing from location to location and working harder without achieving any significant financial gain. It is not easy to step off such a treadmill. Begin by clarifying and codifying your current systems for case management, patient financial procedures, compliance, team training, office communication, and all of the other key areas of your practice. You must have written job descriptions, daily routines, and procedural manuals for every member on your practice team if you arc going to replicate them successfully in a second loca­tion. In the end. your second and third locations are only going to be as good as your first. Satellite Success Strategies Congratulations, you"vc taken the quantum leap and have decided to open a satellite practice. The mantra for successful satellites is the same for successful real estate transactions— "location, location, location." Be sure that you select your second location carefully. Sustainability in satellite practices comes from effective management. You will spend a number of hours physically in each location ensuring that all on staff are doing the job that they arc supposed to be doing. You cannot do this task remotely. Facc-to-facc training and management is the best way to protect your investment. For this reason, your second location should be a reasonable drive from your home. A drive that is longer than an hour will require you to spend an unreasonable amount of time behind the wheel. It has been said. "What gets measured gets managed." Without proper metrics, it will be impossible to monitor and track the success of your satellite. You must be able to readily track everything from the new patient pipeline to the patient visit average. This requires a great software solution. Choose a software system that allows you to access the data you require remotely and in a "dashboard" format that is customizable to your preferences. You should review the metrics of all of your locations on a daily basis. This will help you spot negative trends before they become irreversible and costly. Be prepared to manage your marketing budget. Practice expansion into multiple locations will require you to generate a larger number of new patients. Only the rare associate chiro- praetor can generate the same number of new patients as the practice owner. This means that you will most likely expand your marketing budget to include mass media vehicles such as print, radio, and television. Once your satellite is up and running, your role will be both practice manager and chief team builder. One of your primary areas of focus will be to maintain a con­sistent culture of continuous improvement in each of your locations. Keeping your practice team success-oriented requires your active engagement. Hold regular team meetings and train your team by bringing them to seminars where they can interact with other successful practices. With the right systems, team members, metrics, and management, you will have a recipe for satellite success that you can replicate time after time. Dr. Mark Sanaa is a mem­ber of the Chiropractic Sum­mit, the ACA Governor's Advisory Board and a board member of the Foundation for Chiropractic Progress. He is the president and ("EO of Breakthrough Coaching (www. myhreakthrough.com 1-800-723-8423).