The excitement has been building for months. The whole family has been packing, reviewing brochures, talking about the spectacular scenery and preparing for what they expect to be the vacation of a lifetime. The day of departure arrives and the whole family loads into the packed station wagon for the fun-filled, two-week adventure. Starting down the road, you have a general idea of the direction of your destination but nothing more. Who needs a map? Just head south and ask at convenience stores along the way. The locals are always helpful.
Would you embark on an otherwise well-planned family vacation under these circumstances? Will a cursory knowledge of direction to your desired location get you there in a reasonable timeframe? Probably not. Yet most of us go through our professional and personal lives with the same lack of direction because we failed to set goals. We have no road map to our destination, no landmarks or mileposts, and no timeframe in which we expect to arrive.
After years of postgraduate education and training, we believe we are ready to practice and be successful. Then, 10 years later, we wonder what happened. You will blame closed panels, competition, low reimbursement and geographic location. However, most of the time, it was simply a lack of planning, specifically a failure to set measurable goals. We do not plan to fail. We just fail to plan.
Do you have a five-year plan for the growth and development of your podiatric practice? Do you have a one-year plan? If the answers to these questions are no, your practice is among the majority of practices that are functioning without a road map. Goals that are in harmony with your core values as a practitioner will carry your practice further than you ever imagined.
Goals need to be what you want and not what you need. You need to feel personally drawn to a goal and obtain inspiration from it. It is this want or inspiration that drives the attainment and fuels, as you define it, your future success.
It is important to identify and prioritize goals. One should write a clear, concise description of each goal with a timeline for achieving these goals. The annual timeline requires some simple planning. Typically, Jan. 1 to Dec. 31 is your timeframe with the planning process starting on Oct. 1 for the next year. Set aside time weekly to discuss each defined parameter of the goals for your practice. Have written objectives for each area of your practice in place by the end of December.
You should establish goal parameters in all areas of the practice including but not limited to: financial goals, organizational goals, goals with the services and products you provide, marketing goals, compliance goals, goals with the physical plant (or office) and personal goals.
Financial. Financial goals usually stem from your annual income. While this parameter is necessary, one must address other financial areas in order to obtain a given salary. Specifically, these areas include gross collections, patient per visit value (PVV) and overhead expenses. Gross collections are simply all practice income in a one-year period. This number will act as the common denominator for all other calculations. Calculate the PVV by dividing the number of patients you see within the one-year period by gross collections.
Calculate overhead expenses by dividing the sum of all owners’ income by gross collections. The fraction you obtain is your overhead percentage. Therefore, the obvious goals are increasing gross collections and PVV while decreasing overhead. Your job is defining exactly what you expect to see with those numbers. Accordingly, you can set and prioritize goals in other areas that directly influence these numbers.
Organizational. Organizational goals include managerial structure improvements, regular meetings, employee manual additions and new job descriptions. Improvement of your bottom line comes with noticeable growing pains that one needs to address. Making those changes in this area is critical. Carefully review this area with your practice manager as he or she will execute most of the changes. A goal lacking in most practices is a weekly partners meeting. Even solo practitioners should meet with their key staff person for one hour a week to check the progress of your organizational goals.
Services and products. Goals for services and products are the fuel that runs the engine of your practice. Set goals that allow for vertical integration of new products and services as well as improvement of the old ones. A perfect example here is the integration of an in-office dispensing program or the expansion of your existing durable medical equipment program.
Physical plant. Your physical plant needs constant evaluation and it is incumbent upon you to have tangible goals in this area. Consider setting parameters for renovations and expansion of your existing space. This may range from simple cosmetic improvements to relocation. New computer hardware or clinical equipment such as digital X-ray or ultrasound would fall in this area. If you are thinking about adding a satellite office, this will require some research as this additional office will be part of your growing physical plant as well.
Marketing. Marketing goals grow from your target audiences that are internal (current patients) and external (new patients and referral base) to your practice. These include primary care provider meetings, presentations, recall programs, mailings, gifts and entertainment. A patient newsletter is an excellent way of communicating with and educating patients.
Choose marketing goals that fit your style and core competencies. You will need several goals in marketing. One or two by themselves will not constitute enough “poles in the water” to make a difference. Consistency is important in this area since one marketing attempt will bring minimal return. Always track your efforts so you can modify next year’s goals.
Compliance. Compliance goals are usually set for areas that involve state and federal regulations. While we all have existing programs, regular updates are required. Set your goals for HIPAA, Medicare Part B, DMERC, OSHA, radiation safety and labor laws.
Personal. Personal goals will keep you happy and healthy. On every flight, you will hear the attendant reviewing safety precautions. At one point, he or she will remind us to “ … securely fasten your oxygen mask and then assist the person next to you.” If we are to help our patients and properly run our practices, then we must think of ourselves as an important factor and set goals accordingly. These can include vacation, a day off during the week and retirement planning.
When making goals initially, make a decision with an endpoint in mind. From that endpoint, work backward and focus on daily activity. We all need daily reminders of what we are trying to achieve. Therefore, we write down the goals in the present tense, allowing us to visualize goals as though we have already achieved them. An excellent tool for goal attainment is a laminated pocket card with your annual goals written for daily examination. Track progress with charts and graphs, which are excellent visual reminders as well.
Goal setting and attainment is an exact science. Without goals, you may or may not get to your destination. With goals, you will not fail. In fact, while you may not reach your goal in the desired timeframe, you can reset the clock and leave the goal as it was. As with any skill, you will develop your ability to set a goal and achieve it in the planned time. Doing so will carry your practice to new heights you previously thought unrealistic and your daily work will become more stimulating.
Dr. McCann is the President of the American Academy of Podiatric Practice Management. He practices at Affiliates in Podiatry in Concord, N.H.