If Your Practice is Failing, It’s Your Fault – Practice Perfect Podcast Episode #13

Nick Dumitru

"The one thing that'll kill your business is doing nothing, sitting there analyzing it to death, right? The paralysis of analysis will kill your practice."

Nick Dumitru: 00:23 Welcome back to another episode of Practice Perfect, the podcast for those running cosmetic aesthetic medical practices and anyone that's trying to improve their business and their lives. Alright, today's title is going to be, If Your Practice is Failing, It's Your Fault, and I want you to get a handle on your mindset and your limiting beliefs. So this podcast is going to be all about the way that you think, all about the way that you are holding yourself back, and ultimately it's going to be about accountability. I want to keep you accountable. I've seen too many doctors fall into the victim mentality where they'll start blaming everyone from their staff, to the marketing companies, to the economy, anything they can think of just to avoid taking responsibility for the fact that they are in charge of their own practice, they are the masters of their own destiny, and I want you to get that you are in charge of your future and it's your responsibility to move yourself forward.

Nick Dumitru: 01:28 No one else is going to do it for you. If you want your practice to succeed, the buck stops with you. And I'm telling you this, even if everyone poops the bed, if all of your suppliers, your marketing company, everybody soils the sheet, it's still your responsibility to fire them and course correct. Don't sit there wallowing in your own self pity about things not working. If something isn't working, figure out why and fix it, because at the end of the day, nobody should care about your practice more than you do. And I've seen this over and over. I've been doing this for 20 years and I got to tell you that one of the most damaging things that I've ever seen in medical practices is when the physician cares less about his or her practice than I do. When I care more that the phone is being picked up and that the emails are going out and that people are showing up for the procedures, then the doctor does, that practice isn't going to go very far because the reality is, you're the only one that's going to benefit longterm.

Nick Dumitru: 02:32 Your employees come and go, your marketing people come and go, your web suppliers, whoever it is, they come and go. You're the only one that's in this for life. You've made the commitment to it, and if you aren't taking responsibility for that commitment in your own practice and caring more than anybody that works for you, you're letting yourself down, your family down and your future down. And I know that may sound harsh, but I want it to be harsh. I want you to get it through your skull that you have to care. You can't just sit back wanting to do surgeries all day, not caring about how things are going. You are in charge of your practice and until you grow to such a state that you can start putting a CEO in place to run the day to day operations, the buck stops with you.

Nick Dumitru: 03:19 So let's examine where that comes from, because the thing is that the same instincts that make you a good doctor are killing your business. Your compassion and your loyalty to staff, your unrelenting analytical thinking, fear of making mistakes, thinking because you got through med school that you're qualified to do everything yourself, all of that is holding you back. And the only reason you think you can do everything is because you're arrogant, because society has put into your mind that just because you went to med school, you're qualified and intelligent enough to do everything. And I'm going to let you off the hook here because you don't have to know it all. Just because you're great at medicine doesn't mean that you're a great marketer. You know the funny thing is that I was speaking with a doctor just last week, someone wanted to sign up for services with us and where we go through an elaborate vetting process with them, we do a full interview and the thing is that even though he's never built an eight figure practice, he thought that he was qualified to have an opinion on my recommendations because he read a few books, or he went to some seminar, or he went to one of the big meetings and some guru on stage told them one thing or another.

Nick Dumitru: 04:31 He thought that he was qualified to have an opinion, and I'm not saying this out of arrogance, what I want you to understand is that there's a difference between arrogance and experience. There's a difference between reading about something and actually doing it. And if you're sitting there and you're arguing with your marketing people, with people that are hired to be experts with someone like me that's been added for 20 years and has built multiple practices, because you've read a book or heard something online or have gone to one of the meetings, or one of the seminars and somebody on stage told you the latest, greatest thing and then you're arguing with the professionals that you hire, you're making a huge mistake and that is just hubris. It's one thing to have data. It's one thing to try something and then have it not work based on the data that comes back, and it's another thing for you to handcuff your staff to tie their shoes together and then ask them to run before they even get going.

Nick Dumitru: 05:33 And here's the thing, most doctors, they are not great business people, they're not great marketers and that's okay because they're great doctors and that's the craft that you should focus on. In the years that I've been doing this, I've seen maybe less than 1% of doctors that can do medicine and business great at the same time and the ones that do it had to sacrifice a lot. They sacrificed their family time or their ethics. I've seen some guys that have done some very unethical things like walking into operating rooms with a full film crew without permission and stuff at hospitals. They've done all kinds of things. A lot of them will sacrifice their free time. They don't have a lot of time for golf and hanging out with people and their friends.

Nick Dumitru: 06:13 They're working like dogs every minute of the day. If they're not in surgery, if they're not in consults, they're doing their marketing, they're filming their videos, they're doing their podcast, whatever it might be, writing books, whatever it is, and they're really sacrificing their time, their free time. And whatever it is that they sacrifice, you have to understand that it doesn't come for free. It doesn't come easily. You have to put in the work and they work like crazy to get ahead, and you have to understand that working like crazy doesn't mean running around in a circle. You want to move forward, right? Running in a circle and running straight, expend the same amount of energy. You spend the same amount of calories, the same effort, you run out of breath the same way, whether you're making no progress or you're making great progress, and if you don't know what you need to know to move the needle forward, you're never going to get there, and thinking that you can do it yourself isn't going to do the trick.

Nick Dumitru: 07:11 And when I talked about those instincts, perfectionism. Perfectionism is a disease. Perfectionism is one of these things that you need to have in medicine. You need to have when you're doing your surgeries, you have to do things right. Business is not the same way. Perfectionism isn't progress. Analyzing something to death is another disease. The paralysis of analysis is a disease, where you get paralyzed just trying to think about which way you should go. Again, fantastic instincts for a physician. Excellent instincts. If you're doing surgery, you want to analyze it. You want to make sure that you're using the right tools and the right way at the right time. In business, being last and being perfect is the death toll because it means that you're doing nothing. When I see that in a business, a business that takes so long to make a decision that they make no decision, I know that that business isn't going to go far. And from an outsider in terms of a medical degree, because I'm not a physician, I find this really interesting.

Nick Dumitru: 08:11 I have a very unique perspective working with all these doctors and you know I've known guys that wouldn't think twice about cutting off five pounds of fat from someone's stomach while they've got the body opened up, the human body exposed, but those same doctors will take six months to make a decision about what toilet paper to use in the bathrooms practice. Even though they're taking these life and death, sometimes life and death decisions, even though I know cosmetic surgery is relatively shallow compared to deep surgery, but you're still opening up a human body. Think about that. You are willing to take that risk because well you've been trained, you've got the training, but what's making you afraid of moving your business forward is the fact that you're not trained and the fact that you think that you should know or you could know all of the things that someone that studied marketing for longer than you've studied medicine knows.

Nick Dumitru: 09:02 It's something that you should seriously re-examine because it's holding you back. The fact that you don't know what you don't know is very dangerous. The guy I told you about that I was talking to just last week, he knew just enough to be dangerous, just enough to cause him self harm in his marketing and his practice, and he's wasting time reading marketing books when what he should be doing is seeing consults, getting his lead gen going, getting people in the practice, staying on top of his staff to make sure that calls are happening and that the leads are coming in and that he's going to be able to perform surgery and make more money, and then grow his business by hiring other doctors instead of doing all that, he's stimulating his need for education, right? He's gone right back to school. He's going there and scratching that itch of knowledge, right?

Nick Dumitru: 09:50 That festering wound of knowledge, the infested, infected, disgusting need to keep learning things and not do anything in your practice. Right? Because a lot of people confuse doing something and learning something. Learning something, having learned something, even having understanding of something isn't doing something. You want to move your practice forward, you take action, you move forward. Don't sit there reading a book thinking that you learn the latest greatest marketing tactic, and then not use it thinking that that's progress in your practice. It's not. That just mental masturbation, you're just sitting there and intellectually masturbating to the latest knowledge that doesn't move the needle forward. I challenge you to go to the bank and try to deposit your knowledge. Go to the bank and just tell them, "Hey, you know what? I went to med school, I've got this degree, and then I also read these 700 books on marketing. I'd like to put them all in my bank account."

Nick Dumitru: 10:46 You'll get laughed out of the bank because the banks work on cash. They work on money, they work on success, and success is in knowing success is doing and if you don't know how to do, get someone to do it for you. And again, the fears are what are holding you back, right? The instincts, the great instincts as a physician, and let's get into the fears of making a mistake, right? The fear of making a mistake. I'm going to let you off the hook and let you know that in business, mistakes aren't fatal. You can make these mistakes. You can move your practice forward by adjustment, making a mistake, adjusting going the right way. They're not fatal, right? You're not puncturing a major organ by putting up an ad that maybe doesn't perform as well as it should, but you're learning right from your advertising you're learning.

Nick Dumitru: 11:36 You can move it forward. It's okay to make these mistakes because you're going to move your practice forward with every step. The one thing that'll kill your business is doing nothing, sitting there analyzing it to death. The paralysis of analysis will kill your practice and it's okay to look stupid. It's okay to do something and make that mistake and learn. You know? I'm going to let you off the hook on that because a lot of doctors are also afraid of what their peers will say, or what their spouse will say, or what their staff will say that, Oh, look at you. You screwed up. It's okay. Screwing up is okay. Making that mistake is okay. As long as you're moving your practice forward and you're learning from it. And even if you did it yourself, that's a kind of learning.

Nick Dumitru: 12:17 You Did it yourself, you know that you shouldn't do it yourself. You've learned something. You move forward because the reality is is that the cost of doing nothing, the opportunity cost of not moving your practice forward, is a lot higher than anything you're going to lose by trying something. You think you're going to lose a couple of thousand dollars or euros wherever you're located, I know we have a readership all over the place, you think you're going to lose a couple of grand? Well, guess what? By doing nothing, you could have lost $600,000 over the course of the next couple of years or more, maybe $6 million over the course of the next decade, or more depending on what you do now because it's exponential. It's the same as pointing a gun. If you move a gun slightly at the point of origin, if you move it by just a half an inch, a few millimeters where the bullet ends up could be meters a hundred meters miles apart depending on the range of the gun and the distance from the gun.

Nick Dumitru: 13:17 And these small adjustments that you make right now, can either make you or cost you millions over the course of your practice, tens hundreds of millions over the course of your life because you didn't do something. So you think you're going to lose a couple of thousand dollars by testing out an ad? guess what? You're going to lose a couple of million by not testing it out. And this fear of losing money, I see this paralyzed people more than anything. I see this paralyzed doctors in a considerable way and I don't understand why, because you've got a medical degree. You have money coming in, you're always going to have patients. There are always people out there looking for your services. As long as you can get in front of them, you're always going to have money. Money will always come back to you. Don't worry about spending it. But here's the thing about money, no amount of money that has ever existed has ever been able to buy a single second of time on this planet, not a second.

Nick Dumitru: 14:13 The wealthiest person couldn't pay for an extra 10 seconds of life at the end of their life, even if they gave all their wealth away. It's impossible to get, and I want you to have that urgency. I want you to understand that time is fleeting. Your potential is going past you as you're sitting there analyzing your spreadsheets, making decisions, fretting over minor expenses. If you want to move forward, take action, do something now. Because even going the wrong way and hitting a wall is better than not going at all, because at least you know you're going in the wrong direction. So stop fretting like a pansy and get some help. The people that don't know what to do, hire the people to do it for them. The wealthiest people, the most successful people in the world get help doing the things that they don't know how to do.

Nick Dumitru: 15:06 They hire the people to do it for them, and then they incentivize them to do it. And I don't want you to think that this sort of mindset, this limiting way of thinking stops with the business owner, it doesn't. It also comes from your staff. The mental disease isn't just reserved for you. Your staff comes into your business with their own mental baggage. How you have to understand that people's experiences shape them. People's beliefs from their parents, from when they were young, from things that they've done shapes the way that they act now, and they will bring this baggage and they'll carry it and they'll happily shove it into a corner into your business and clutter up the processes and the progress with everything that they've brought in from their life. So I want to go through some of these things. I want to go through some of the limiting beliefs so that you can talk to your staff about them, you can start addressing them with them.

Nick Dumitru: 16:01 And one of the biggest things that I see is that they're bothering your prospects too much. You get a lead, somebody fills out a form on your website, they don't get in touch with them, they leave a voicemail, they forget about it, because they think that they're being bothersome because maybe they don't like getting phone calls, or maybe they've got low self worth because when they were children, their parents told them to be quiet, to not interrupt, to not talk, don't be annoying, don't offend, right? All of these things, the politeness when translated to sales and business hold you back. And what I want you to talk to them about is this, that the world has changed, alright? This is in the 1950s or 60s when people love to get a phone call, right? And then if you left a message, then they will call you back right away because it was one of the two phone calls they got that week or something.

Nick Dumitru: 16:52 People these days are busy and you're not bothering your prospect, you're providing them a valuable service in their hectic lifestyle. Things have changed. People are busier than they've ever been, right? People say this every decade, but it's true. It's just getting more and more busy, more and more distracted, and they're calling your practice because they want to change their lives. The prospect is calling because she wants to change her life. There's something about her life that's making her unhappy and you're not bothering her, you're providing a valuable service because she may have been distracted. It's great customer service to call again to "bother them", because most women put themselves second. They call because they're unhappy. They finally had a minute to call you and then they've put themselves second, they weren't able to pick up the phone and they missed your call and then they dealt with whatever they were dealing with in their lives.

Nick Dumitru: 17:48 They put themselves second, second to their kids, second to their spouse, second to their job. All kinds of things get in the way and if you allow them to slip through the cracks because you thought you were bothering them, they'll resent you for it, because you didn't remind them and they'll appreciate you when you do. When you call that fifth, sixth, 10th, 15th time, 20th time that month, because she just couldn't pick up the phone because she had to deal with life and she forgot what form she filled out online even. She couldn't return the phone calls and you finally get her on the phone, it'll be a sigh of relief for her. So understand that you're not bothering them, but trying to get in touch and helping them achieve their dreams. You're providing invaluable customer service to a woman that's allowed her dreams to take the backseat for years.

Nick Dumitru: 18:37 So if your staff in a cosmetic medical practice do your job, stop letting your own baggage interfere, get it done. Call again and again and again and there's going to be a bad apple. There are going to be those that complain. You're going to hit some bad calls. You're going to get people that use their baggage to make you feel bad that you called them because they're angry about whatever bullshit is going on in their life. Understand that that's not the reality for most. Those are not the patients that you wanted anyway. Don't let those people dictate how you move things forward in the future. Get it done. Help this woman achieve her dreams because she didn't go on your website and fill out an online form or pick up the phone and call you because she didn't want to make a change. It's just that life got in the way and she put herself second once again.

Nick Dumitru: 19:27 Another limiting belief I come across, another piece of baggage that gets dragged into your practice is this idea that it's too expensive. This is a very big one. I see this all the time and it crosses over from staff to doctors as well as this is not reserved for staff because it's very tempting to think that, "Oh, they're getting paid less. They're not making the same money that I am as a physician." Also. They're obviously going to think that it's more expensive. No. I also see this in doctor. Some doctors are just cheap. They're just cheap. There's no other way to do it. Right. I'm not saying you know that it costs a little money to go with them. They are just stingy, they're misers. They don't want to spend their own money because their own background, whatever that is, it's contributing to their own inability to sell, because they are cheap. Maybe they were brought up with cheap parents, maybe they grew up poor, whatever it might be, they have a sense of low self worth where they feel that causing money pressure on somebody is burdening them, that it's their job to make sure that they save their money.

Nick Dumitru: 20:32 It's not, it's not your job to tell people how to spend their money. Your personal belief about money's probably standing in the way of you making more money. What someone's willing to pay is different than what you're willing to pay. Just because you think something's too expensive doesn't mean that the patient does. Now, your staff are particularly guilty of this and are afraid and often ashamed to charge more for your services. They invite discounts when no discounts are needed. A lot of times I see them discouraging you from raising your rates.

Nick Dumitru: 21:04 I've had this happen in practices. I've gone in. I've said, let's slap on an extra 500 or $1000 because you're providing a valuable service here. That $1000 goes directly to your profit margin. If you're making $1,000 profit and we can increase the overall sale, let's say it's a $5,000 sale, you're keeping 1000 if we can add an extra thousand and charge 6,000 instead of five, well, it's this proportionately larger on your profit margin because you went from 1000 to 2000 you've doubled your profits, and discounts work the same way. If you're discounting $500 you're having the profits, you're taking 50% less profit, and these people in your business are doing this. You may be doing this, not realizing how you're hurting yourself, giving these discounts uninvited oftentimes because you don't understand how to sell, you don't have a good selling process, you may be ashamed of selling, it may be a dirty word in your mind, because in medical school you are taught that, real doctors don't sell, real doctors provide service.

Nick Dumitru: 22:11 The other S word and all of these limiting beliefs are holding your practice back from doing more and being more and making more money. So just because you think something's too expensive, it doesn't mean that your patient does, and you may be thinking that, "Oh, have I give people a discount? It's doing them a favor." When in fact it could be harming their experience. Have you ever thought of that? Have you ever thought of how what somebody pays impacts how they experience the procedure that they're getting? I'm going to guess that you haven't, I want to let you in on something, there was actually a study done with this with wine. They did it with wine. They hooked up people to machines.

Nick Dumitru: 22:51 They started analyzing the brains to see what happens. And here's a quick rundown of the experiment. So volunteers were given wine to taste with clear labels, right? The wines were marked with prices ranging from $4 to $22 per bottle. Okay. So they anonymize the wine and then they labeled them with just the price of the wine. Okay, $4 to $22 per bottle. And here's what happened, the volunteers rated the allegedly higher priced wine as tasting better than the allegedly cheaper one, right? And they ran MRIs, magnetic resident imaging, they had them hooked up so that they could see what their brains are doing, so it wasn't just feedback data, it was actual measured data, not just opinion data. And the MRI scan showed that when those evaluations were made two parts of the volunteers' brains experience greater activity.

Nick Dumitru: 23:43 So they were evaluating the same wines, but during one of the evaluations versus the other, their brain was more active, so they're experiencing something different. Now here's the thing, in reality, all the wines were the same and they were all about $14 a bottle. So it's the same wine labeled with different prices causing higher levels of satisfaction and more enjoyment of activity in the brain. So think about that, think about how that applies to your procedure when you give that discount. What is that really doing? What's that doing for that patient's experience? How is that making them feel by the end of the surgery? Did you do them a favor? Did you do them a favor by saving them a few bucks and making their experience shitty? Did you do your practice a favor by having your profit margin, cutting it in half, hurting your practice and at the same time lowering the level of satisfaction for that patient because you gave them a discount?

Nick Dumitru: 24:43 Well, I'm going to answer that for you. It's pretty easy. No, you didn't. You screwed yourself and you made the experience worse for the patients. And let's dig a little bit deeper into what happened in that experiment, and what's that called. And that's called the marketing placebo effect. In medicine, you're very familiar with the placebo, body's ability to heal itself when suggestions are made through fake pills, whatever it might be, marketing's the same way. The way that your patient experiences the procedure isn't 100% tied to your surgical skill, and again, this that arrogance that I was talking about where you feel that your skill is 100% responsible for how things go in your practice. It's not. And if you're not taking advantage of this marketing placebo effect and thinking through how things are being used throughout your practice, you're holding yourself back. You're limiting beliefs and your mental baggage and your staff's mental baggage are hurting your practice. Even when you're think you're doing the patient a favor and after all, the goal at the end of the day is to have a great result with high satisfaction and happy patients.

Nick Dumitru: 25:47 If charging them more gives them a higher sense of satisfaction, you have a moral obligation to do so. You have a responsibility to your family, to yourself, to your staff, to your practice, to your future, to charge more for your services and to root out these limiting beliefs, to treat them like the disease that they are and use your medical instincts now to fix your practice, to get to the root of this disease and treat the problem, not the symptoms. Now, there are a lot more limiting beliefs. We're going to cut this short for the sake of the length of this podcast, but I hope that this has given you something to start examining. I hope that it's given you a lens through which to look at your practice and see where you're constraining it, where your beliefs are holding you back, where you as a physician care less about your practice than the people that you hire to work in your practice.

Nick Dumitru: 26:44 And I hope that you go out there and you start hiring for your weaknesses. I hope you start to identify what your weaknesses are, and instead of the solution being education, it's to hire professionals in your staff, contractors, consultants, whatever it might be that can give you the right answers where you are weak. And understand that weakness isn't something to be ashamed of. And when I say weakness, I mean that you are fantastic in certain areas of what you do, but nobody, and I mean nobody, no wealthy person ever has tried to do everything themselves because they hire for their deficiencies and they incentivize those people to get it done for them. And you should be thinking the same way, acknowledge what you don't know. Acknowledge where you're weak. Acknowledge where your practice is negligent, where they're failing, where your practice needs to help, and then get the right people in place to do that, measure them.

Nick Dumitru: 27:43 Take your instincts out of the way, right the same instincts that are making you a great doctor and really move your practice forward. Put the pieces in place on the back of this self-awareness to really move yourself forward. If you haven't subscribed to the podcast, I highly recommend that you do hit the subscribe button on iTunes or whatever podcast listening service or app that you've got. There's a lot more coming. We're going to be recording a lot more of these. I hope you're getting value out of this. If you've got any ideas, leave comments on iTunes, preferably go to our website or just write to [email protected] and just send me your ideas for shows. What are you struggling with? What are you having problems with? What's your staff struggling with? Let me know what you want to hear about and we will be happy to do our best to record. We're going to have some guests moving forward throughout the rest of this year as well, so stay tuned on that. Make sure you hit the subscribe and stay up to date with everything that we're going to be putting out there. All right, thanks and see you on the next episode.

Speaker 2: 00:13 Practice Perfect.

Speaker 3: 00:14 Actionable business information to take your medical practice to the next level.

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