gott-episode-7 Stages

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Begin with the end in mind.”

Stephen Covey

Seven Stages of Practice Ownership

There are seven stages in the maturity cycle of practice ownership. Why seven? Okay, there might be five or twelve, but I’ve found seven that seem clearly different enough to call stages of a practice.

In this podcast, we take a good look at the first four stages, because these are the four that teach us how we got on the treadmill. Stages Five through Seven are the ones that get us off the treadmill, so we’ll walk through them in Part II of this podcast next week.

Stage One: Concept & Startup

This is the stage everyone dreams about. We envision the future with bustling streams of patients coming in and out of our practice, creating rosy spreadsheet projections. The operative emotion in Stage One is a sense of euphoria for having pushed your dream to reality: “What fun!” It’s a great stage and should be relished, but not for long. Startup isn’t something you want to drag out. Get through it as quickly as possible.

Stage Two: Survival

Why should you get moving fast in Stage One? To avoid as much of Stage Two as possible! The problem right out of the gate here is that Stage Two is where you begin to train yourself to spend thirty years on the treadmill as a hostage to your practice. Already at this early stage, your practice is training you in a very bad habit: making money. As you focus on patient acquisition, you get patients and money starts to come in. It’s working, or so you think.

Three: Subsistence

In Stage Three, your accountant comes to you and says, “Good news – you’ve broken even for the last 3-4 months.” The first time this happens you slump in the chair and stare at the wall with a mixture of disbelief, exhaustion, and growing excitement. This practice might be viable after all. The euphoria you had in Stage One but lost in Stage Two is back!

But the euphoria doesn’t last long. Subsistence looks great having just emerged from the Survival stage. The practice is too fragile. It seems that if you even sneeze, you might lose patients.

So in Stage Three, your lifestyle is still on hold, but at least you’re breathing easier. It’s all about the basics, but the basics look great because they’re finally paid for.

Stage Four: Stability

Your marketing, your reputation and referrals finally start to kick in. For the first time you have money left over at the end of the month—actual profit. A new and wonderful question forms in the practice. What will you do with that “extra” $2500 this month? 

Stage Four is the “American Dream”, isn’t it? But something is missing. You keep thinking about that one practice owner you know who seems to have a light heart and a quick step, who can get away from work regularly. And when she does, she seems to enjoy the time rather than spending it trying to recover from work. You keep dismissing her as an exception—that’s exactly what she is, but that doesn’t make her a freak. She’s actually quite normal, and the overwhelming majority of practice owners who have stalled in Stage Four are not normal at all. They are just average. She is normal.

Let’s become Freedom Doc. You can escape the Tyranny of your practice and become normal too, if you’ll just change the question in your head. That’s what the Part II of this podcast next week is all about.