Question: How many hours per week should I work to be successful?

Answer: It still depends.

Maybe the best way to arrange your schedule is to block out the time on a weekly basis to work both on your practice and in your practice.  You might start by estimating the number of hours you spend with direct patient care and charting - that is in the practice work.  Then you could allocate a number of hours more per week to work on your practice – planning, organizing, marketing, reviewing  financials, talking with your banker and your CPA, applying for loans, recruiting other providers to work in your practice, developing business contacts, and so on. 

The weekly number of on the practice hours should reflect how ambitious you are.  If you are really lazy, it will be zero.  That’s OK, but outside circumstances are more likely to dictate the number of in the practice hours you spend.

Block out your time for each, as though it were a scheduled meeting and don’t deviate from your scheduled times.  Respect the boundaries of your time and don’t let people encroach on it.  On the practice time is not meant to be “play time” or “get in touch with your feelings time” or ”complain about life in general time”.  This is work time dedicated to ensuring that your practice is retaining and attracting patients and earning money efficiently and consistently. 

The real reason to spend hours working on the practice is to be able to control the hours spent in the practice.  The first goal of this exercise should be to optimize the ratio of hours spent on the practice to in the practice.

The most common mistake to make is to get excited about a new task or tactic and let that project dominate your time and impinge on the rest of your world.  Better to do fewer things well and keep building a stronger and stronger business infrastructure into your practice.  Doing fewer things will make you more strategic in the long run and therefore more successful.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at http://www.ultimatepracticebuilder.com/.

Question: How many hours per week should you work to be successful?

Answer: It depends.

It really depends on how you define success in the first place.  Like any other question in life, it is much easier to answer if you know yourself.  If your goal is to prove yourself to yourself or anyone else, the answer is there will be no peace and no rest for you.  Give up on sleep.  Stock up on Tums and PeptoBismol.  It’s going to be a bumpy ride.

If you really look at the big picture of life, most of what we need we already have and we may have had from birth.  We only need to find a good mate, a handful of worthy friends and a decent job or business.  Once we have these people and situations in our life we only have to be loyal to them and esteem them enough for them to want to stay around.  That’s it, after that you can take it easy.

http://www.bobparsons.me/index.php?ci=14968&id=-1&isc=goaf2001ab&targetGuid=6b8d214b-87e3-4cc6-9c47-9a5920831355

The only problem is I have to stop watching because I’m getting mezmerized by Leeann.  I now listen to them without looking at the video.

Anyway Tanya is thinking about starting a business.  She is great at making cakes and the people who have bought her cakes absolutely rave about them.  So she reached out to good ol’ Uncle Dave for some advice on starting a business.  We looked at her projections and I’m asking her to adjust her course – not to give up, but to proceed ahead more cautiously and strategically.  Here is the meat of the email I recently sent her.  (Hey Tanya, it’s free consulting – don’t expect the same level of confidentiality and privacy that paying clients get!)

Albert Einstein

“We can’t solve problems by using the same kind of thinking we used when we created them.”

“Logic will get you from A to B. Imagination will take you everywhere.”

Jay Leno

Don’t forget Mother’s Day.  Or as they call it in Beverly Hills, Dad’s Third Wife Day.”

Lily Tomlin

“I always wanted to be somebody, but now I realize I should have been more specific.”

Melanie Griffith

“There is a place you can touch a woman that will drive her crazy.  Her heart.”

Steven Wright

“A lot of people are afraid of heights.  Not me, I’m afraid of widths.”

 Woody Allen

“I’ve often said, the only thing standing between me and greatness is me”

“I don’t want to achieve immortality through my work. I want to achieve it through not dying.”

Goals are an underused resource in most doctor’s lives.  Why?  Because we  often set them without a lot of thought (see part III of this series), and then we feel bad when we find ourselves not progressing to that goal.  Eventually we become less and less likely to want to set other goals because the ones we have actually demotivate us.   We end up viewing those who do set goals as overcaffeinated Tony Robbins types who live in an unrealistic world of dreams and fantasies.  But isn’t the belief that goal setting doesn’t work as much a fantasy (albeit a negative one) as the belief that goal setting does indeed work?

The most important key to using goals is to realize they are a tool.  They are  a tool to focus your mind (all parts – conscious and subconscious) on achieving a specific outcome and to guide the management of your time.  Like any tool or instrument, the results you get from it have a lot to do with who is using it.  You can give me the greatest, most finely crafted accordion in the world but I can’t produce any worthwhile music from it because I have no talent or training for playing the accordion.

Find three people in your sphere of influence that are highly successful or otherwise appear to be good at goal setting or time management.  Ask them how they use goals and how they prioritize and organize the use of their time.  Ask them how they choose their goals.  Ask them how they became skilled in using goal setting effectively.  There are people all around you who have the skills you need.  See what they know.

The next posts on this topic will focus on what to focus on when you are setting your goals and how to most effectively use the goals you’ve set. 

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Michael Gerber, author of The EMyth Revisited, talks about the shift from working in your practice to on your practice.  Michael is a genius and he is completely correct.  Unless you get out of your own way, you will never develop a vision for your practice and then turn that vision into reality.  You have to stop focusing on the minutia, the day-to-day details that are important yet just as obstructive to progress, and gaze into your future long enough to invent it.  If and when you do that, you will soon realize that you are the biggest problem your practice has because you are basically in the way, slowing things down, keeping life slow, small, safe and predictable.  (My apologies if you are an outlier – I’m talking to the average doctor who is struggling, not those in the top 10%.)

But there is  a second ratio shift:  When you move from working on your practice to working on yourself.   If you become self-aware enough to see that you are indeed the problem, it only make sense that you might want to start changing some of your maladaptive hard-wiring.  That’s a hard pill for most to swallow but a success secret for the fortunate few who share that insight.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Here are a few questions I would like you to think about…

1. Who does your management team consist of? 

2. What are their relative competencies and weaknesses?

3. What is your process for decision making in your practice?

4. How often does the team meet?  What do they talk about?

5. Do you have a one-year and five-year written plan for the practice, complete with timelines for implementation, assignment of roles and resources, costs and metrics for success?  How often do you review that plan to ensure course correction?

6. How are policies set in your practice.  How often are exsiting policies reviewed?

7. Do you have a manual of protocols and procedures?  Who made it?

8. What are the best three decisions made in your practice in the last five years?  What circumstances led to those decisions?  Who made them?  What were the results of those decisions?

9. What are the worst three decisions made in your practice in the last five years?  What circumstances led to those decisions?  Who made them?  What were the results of those decisions?

10. What is the one major decision that your practice is currently procrastinating on?  Who is responsible for that decison?  What are the possible reasons why a decison is not being made?  Is it about not knowing what to do, or not wanting to do it and accept the consequences?  How can you help?  What is likely to happen as a result of that decision?

The quality of your practice is the quality of the decion-making that goes on in your practice.  Teams generally make better decisions than individuals.  Teams generally get more done consistently than individuals.  Hire the best people you can and start with your management team.  You might have to get bigger to get better people, either by growing your own practice or forming alliances with strategic partners.

Here is a different way to think of your management team.  Imagine a venture capital firm gave you $1 billion to franchise your practice.  Your mission would be to develop a total of 1000 offices that all ran at top level efficiency starting from where you are right now.  All venture capitalists will insist that they have control of the management team – usually by putting their own CEO or COO in charge.   Otherwise they would lose all their capital by trying to build up a small brand using a weak management and process infrastructure.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.