July 7, 2025 • 22 mins
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When your revenue tanks, it’s easy to panic. All successful entrepreneurs have been there at one point or another.
But what if I told you there is a calm, strategic approach to addressing revenue slumps that allows you to bounce back with confidence?
Today, I’ll walk you through my tried-and-tested three-step method for addressing (and fixing) revenue problems. From conducting a postmortem analysis to turning your business around in just 30 days, this method provides a clear pathway to sustainable growth. And the best part is it will give you the confidence you need to face problems head-on without panicking!
Tune in.
—
Key Takeaways:
- 00:00 Intro
- 01:52 Running a postmortem
- 07:17 Building a pathway
- 12:19 Executing the plan
- 18:10 Leaning on your community
- 20:12 Outro
—
Additional Resources:
- Learn more about my 12-month program.
- Interested in 1-on-1 coaching? Apply here.
- Grab a copy of the "The EntreMD Method" book.
When you are ready to work with us, here are three ways:
- EntreMD Business School Accelerator - If you are looking to make a 180 turnaround in your business in 90 days, this is the program for you.
- EntreMD Business School Grow - This is our year-long program with a track record of producing physician entrepreneurs who are building 6, 7 and 7+ figure businesses. They do this while building their dream lives!
- EntreMD Business School Scale - This is our high-level mastermind for physicians who have crossed the seven figure milestone and want to build their businesses to be well oiled machines that can run without them.
To get on a call with my team to determine your next best step, go here ...
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
How am I going to get out of this?
How am I going to turn thisaround?
And let me tell you you're aphysician CEO.
You can turn this around.
You can turn it around.
You started your business fromscratch, you got it to where it
was, and then the revenue taxyou could get it back up.
Hi docs, welcome to the EntreMDpodcast, where it's all about
helping amazing physicians, justlike you, embrace
(00:20):
entrepreneurship so you can havethe freedom to live life and
practice medicine on your terms.
I'm your host, dr Una.
I used to think that once Ifigured out how to create
revenue in my business, I wouldhave sorted out all my
confidence problems, right, like.
(00:40):
I would know how to do things,I'd be relaxed, I'd finally
arrived, and one of the thingsthat happened, you know, for
instance, the first year that wehit two million in revenue was,
all of a sudden, this fear cameover me Like, what if you can't
maintain this?
What if you can't grow this?
What if you drop back to amillion in revenue and you're
found out that you didn't reallyknow what you were doing and
all of that stuff.
And I addressed that, right,like.
(01:01):
So it was a very shockingdiscovery for me right, but the
thing is that you know theremight be seasons in your
business where it seems likeyour revenue tanks.
Your cashflow is not there.
Maybe you didn't get to payyourself even after you've done
really well and after you'vedone really well for a while.
And I want to show you on thisepisode what to do when your
(01:22):
revenue tanks, when yourcashflow tanks.
And having this way of thinkingputs you in a position where
you can grow, and you can growconfidently.
And when challenging times showup in your business or you
anticipate they're going to showup, you know exactly how to
handle them, so that consistentgrowth can be what your business
experiences.
Okay, and I'm going to walk youthrough three things.
(01:42):
This is something.
This is one of the episodes.
You probably want to have anotebook and a journal and all
of these things and really leaninto it.
It's going to be a total gamechanger.
So three things the first thinghere is going to be running a
postmortem, like getting thediagnosis what exactly is going
on here?
Because the fact that yourcashflow is less, it doesn't
(02:03):
mean maybe you didn't haveenough volume.
It doesn't mean you didn't haveenough new patients or new
clients that like.
We don't know what it meansuntil we look at the numbers.
Okay, and I want to give you afew examples of the things that
could be going on.
The first thing that could begoing on is it could be that you
made heavy investments in yourbusiness because you're
preparing for growth, okay, andso that could look like.
(02:24):
I've had clients who, you know,did additional locations to a
private practice.
Right, that's something that isa heavy investment, but it's
required for growth, right, andthe investment precedes the
growth.
Or it could be maybe you didn'tget a new location, but maybe
you moved into a new location, abigger location.
I've had clients who did that.
They had six exam rooms,whatever.
They had it for a few years,they had outgrown it and they
(02:46):
had to get more space.
That puts you in a place whereyou're going to make a lot of
investments.
Sometimes people findthemselves paying rent in two
locations as they're trying towork through it and all of that
stuff.
Right, that's a heavyinvestment.
Maybe you're in a specialty, youhave a private practice and
you're in a specialty where it'svery equipment heavy.
These are, you know, themachines and all of that stuff.
They're really expensive andall that.
(03:08):
Or maybe you invested in team.
You know, maybe you're a coachand you hired a high capacity
team member, maybe a businessmanager or something like that,
or you hired more coaches.
Or you're a physician and youhired another physician in your
private practice.
Right, you have a privatepractice and you hired another
physician.
Again, that is an investmentthat will precede the return on
investment.
(03:28):
Now, if that is the case, nowwhat you want to do is really
separate out the numbers, like.
What is the like?
If I took out the heavyinvestment that I needed to make
that hasn't started re-yieldingan ROI yet, what is my, what do
my numbers actually look like?
Right, and it's important to dothat because you want to see is
that the only problem?
Are we having multiple problems?
You won't know till you look atit.
(03:51):
So you take out, let's say youtake out the physician's salary
and maybe the support staff thatyou had to hire to support that
physician.
They haven't started pullingtheir weight yet and all of that
.
If I take all of that out, howare we doing?
Is it comparable to where we'vebeen?
Are we?
Maybe we're even growing, right, if you take that out, right?
So you want to take a look atthat first and then see, okay,
another reason why you know,when you run a postmortem,
(04:15):
another thing you may find isyou may find that there's low
volume of business, right, like,so the money coming in, the
revenue coming in period is justit's dropped like it's dropped
significantly, right?
So in the first instance wegave with a heavy investment.
Your revenue may even be more,but you had so much, you know
capital expense or you knowinvestments for growth, that it
(04:37):
looked like you didn't growRight and the cash flow is like
shot, right.
In this case you just didn'tbring in the revenue period,
right, and it could be a numberof things.
Maybe you didn't have, you know, enough new clients, or maybe
you didn't have enough repeatclients or repeat patients.
Or maybe you know you typicallyhave a lot of upsells or you
have you're a surgeon, so I'vehad, you know, surgeons in
(05:00):
private practice where they sawthe same volume of patients, but
now they have more medical andmore follow-up and less
surgeries, and they saw the samevolume of patients, but now
they have more medical and morefollow-up and less surgeries,
and so the revenue issignificantly less,
significantly.
So you want to take a look atthat Like is that what happened?
Or maybe it's just that youknow it's low team productivity.
This is the one you always wantto look for, and so maybe
there's somebody in charge ofreferrals they didn't do their
(05:22):
job.
And there's somebody in chargeof, you know, making sure
there's repeat clients or repeatpatients, and that person
didn't do their job.
Or you have somebody in chargeof marketing and they completely
dropped the ball like low teamproductivity, and the bigger
your team is, the more importantthis is.
So you want to take a look likedid everybody pull their weight
?
What are the levers that bringrevenue into my business?
(05:43):
Is everybody pulling theirweight?
Because if they're not pullingtheir weight, you still have
their expense, but you got noROI right.
And then now you know what tofix.
Why is this important?
Because until you do this, youdo not actually know what the
problem is and you can't fix itbecause you don't know.
When you do a postmark, whatelse could you discover?
You could just discover thatthere's a lot like increased
(06:04):
expenses.
Okay, so we just have a lotmore expenses so not quite
capital expenses, like the firstexample we gave, but you have
more, or you have unproductiveexpenses, and I'll explain what
I mean I mean by that.
You have expenses that are notcreating an ROI whatsoever in
your business.
Maybe they mattered in thebeginning of the business, they
don't matter anymore, but you'restill paying for them.
(06:26):
Now, notice that I put that asa lower example, because a lot
of times it's not quite that.
A lot of times it's the topnumber, but, yeah, that could be
one of the reasons, and then itcould be any combination, right
?
So, for instance, the personwho did the really heavy
investment they may have beentotally distracted by a new
location, or moving to a newlocation, or getting a new team
(06:47):
member onboarded and all ofthose things that they actually
stopped doing, all the thingsthat would normally bring in
revenue.
So now you have the heavyinvestment, now you have the low
volume of business.
You see what I'm saying.
So, again, this piece is socrucial.
Not doing this is like seeing apatient.
The patient is like you know,doc, what's wrong with me?
And you start telling themwhat's wrong with them without
(07:08):
doing a proper history, reviewof systems, exam and all of
those things.
You cannot make a diagnosiswithout doing this.
It is worth the time it willtake you to do it, okay, okay,
so that's the first thing is runa postmortem so you can get the
diagnosis.
The second thing is, now thatyou have a diagnosis, you want
to work on a solution.
(07:29):
You want to work on a pathway.
Okay, like, what is my path outof that stuff, plus overhead
and all of those things, and soyour cashflow is shot.
What is the pathway?
Well, the pathway is filling upthat person's schedule.
(07:51):
That's the pathway.
Now there are other pathways.
Right, we could ramp up otherproducers who can bring in
revenue while this person'sschedule is being built.
But again, that's a pathway.
Now, maybe you know how to fillup your schedule.
You have a good reputation inthe company, in the community
where you find yourself.
You've used ads before and youknow how your ads respond.
You have a referral base, areally good referral base that
(08:14):
you can talk to and they'll sendyou people.
You have a ton of patients whoare overdue for appointments.
You can reach out to say, hey,we can get you in this week and
all of those kinds of things,and all of those kinds of things
, like.
So you just map that out, like,okay, this is what we're going
to do to overcome that problemand when you're done, you look
at it like if we did thesethings, that we decided to do
these five things we decided todo, what are the chances it will
(08:34):
fill up this person's schedule?
Maybe, say, 80%.
It's like, boom, okay, let's goRight.
Maybe it's not that.
Maybe you know you moved in,you had a low volume, right.
It's kind of the same thing Ifwe had a low volume.
The question becomes what arethe top three things that filled
up our schedule in the past?
Like, wonderful, now let's godo those three things, let's go
(08:55):
all in on those three thingsagain, and maybe there's some
loaf hanging fruits you can addto it.
So then you build out thisstrategy, you build out this
pathway.
This is how we're going to getout of this.
Maybe you moved into a newlocation again, right, and
you're like, okay, what is thesolution to this?
Like our old location is doing,our first location is doing
fantastic.
Like after we did thepostmortem, we found out that's
(09:17):
not even the problem at all.
Like it actually grew.
The revenue for that locationgrew, the profits for that
location grew.
Is the second one that makes itlook like we have a cashflow
problem?
Okay, wonderful.
So then what are we going to do?
It means we need to fire on allcylinders to fill that place up
.
It means that if we have, forinstance, if we have more volume
(09:39):
than we can handle in the firstlocation, maybe we pull a dock
on the days they're not busy inthe second location to come to
the first location and seepatients and stuff.
So they're still bringing inrevenue because it's one pot.
Do you see what I'm saying?
So I can't give you the exactthing you would do, but once you
have a diagnosis, you can thenlook for the pathway.
So think about three to fivethings that you can do over a 30
(10:01):
day period, 60 day period thatwill really I like 30, which
will really rev everything upright, like you want to.
You want to create that pathwayand you may have this thought
like, oh, I don't know what thatpathway is and it's almost
never true, especially if you'reestablished.
You want to tap into your ownwisdom and say, knowing what I
know, like, what are the topthree things that would deliver
(10:22):
X results?
Okay, and what are the topthree things that are proven to
deliver X results?
And then you come up with yourown pathway.
So that's the second thing wedo, right, we build out a
pathway.
Maybe your expenses went way outof whack.
Maybe somebody else, who cannotfeel the pinch because they
don't make the money, isresponsible for spending the
(10:43):
money, right.
And you decide, okay, I'm gonnatake that, that back, or I'm
going to put parameters in placeand stuff like that.
I'm going to cut out the thingsthat don't have an ROI.
I want to say this you knowvery clearly when it comes to
cutting out things that don'thave an ROI, let me give you
three things not to cut.
I say this all the time on thepodcast.
The first thing you don't wantto cut is you don't want to.
Okay, now you want to make sureyour team is a profitable team,
(11:13):
right, you want to make surethey're all creating revenue and
things like that, but you don'twant to cut your team.
You train your team or youremove underperformers, but you
don't cut your team.
And then, third thing you don'twant to cut is your education.
Right.
Is your education when you findyourself in a position where
it's more challenging?
That's when you want to lean inmore, like I need to be in a
(11:34):
community where I'm getting mybusiness education, so I know
what to do, I know how torespond to circumstances and all
of those things.
I'm continually upgradingmyself as a physician CEO and
things like that.
Okay, so those are three thingsyou don't want to cut.
Okay, so we talked about runningthe postmortem Very important.
I keep saying this because ifthis is not done, none of the
other things matter.
Okay, so I run a postmortem.
(11:55):
Okay, I decide on a pathway.
How am I going to get out ofthis?
How am I going to turn thisaround?
And let me tell you, you're aphysician CEO, you can turn this
around.
Okay, you can turn it around.
You start your business fromscratch Most people, you start
your business from scratch,no-transcript.
(12:39):
And then our revenues tanked andstuff, and I said, okay, I
don't like what happened, Idon't like what's happening with
the revenue, I don't likewhat's happening with the
cashflow, and so what I found isthat there there are a lot of
you know, like what wasresponsible for the tanking is
how I had low volume of business.
So for a practice that may looklike you know, we got really
comfortable.
We're like oh yeah, everybodyjust finds us by word of mouth.
(12:59):
And here comes this competitorand we did not have the engine
in place to respond to thecompetitor because we had grown
fat and lazy, and we're justlike, oh yes, we're just, you
know, we're just leaning on ourword of mouth, we don't have to
do anything, right?
I got real humble real quick,okay.
So I'm just giving an example.
I got humble real quick and Isaid, okay, what is the
diagnosis?
(13:19):
Here?
We are doing nothing to bringin new people.
Nothing, nothing at all, okay.
And I'm like, okay, fantastic,we shouldn't have done that.
But we're here now.
What do we do?
We're like, okay, great, we canhit the recaller, because we
have a bunch of people who areoverdue for appointments.
We don't call them anymorebecause we're like, you know, we
don't have to do anything andwe just get all these patients.
So we're going to hit therecaller.
We're going to reestablish ourrelationships with our referral
(13:41):
sources, right, and we're goingto go back to posting on social
media.
We're going to go back toshowing up on a YouTube channel
where people are finding usanyway, and we're going to ask
for referrals from our patients,right, not just from other
doctors referring to us.
And we're going to do thesefive things, and we're going to
do it every single day for thenext 30 days.
And we're doing with intention.
What is the intention?
New appointments on the books,right, okay?
(14:03):
So that then becomes a sprintthat I run and in the beginning
it will look like it's notworking.
Okay, so let me tell you thatyou know real quick here, in the
beginning it will look likeit's not working and then the
more I do it, the more it willwork.
The more it starts to snowball,the more we create momentum and
then we begin to shift that.
Okay, so it's a little bit of along game, like not long, like
years or many months, but it's alittle bit of a long game.
(14:26):
You have to have the innerstrength to just stay and see it
through, right, okay, so thatmay be the thing.
Or let's say, I got anadditional location and I do the
postmortem and it's just likethere's just low volume of
business, right, for the newlocation.
First location, doing great, infact, it even grew Fantastic.
Okay, so what's the plan?
We'll keep the first location,as is Everything that's working.
(14:47):
We'll just keep that working.
And we come to the secondlocation.
We're like, okay, what could wedo?
(15:08):
All right, we have, you knowphysician in this new location
that's being underutilized, sothey work four days a week.
Maybe we'll have them workthree days a week in the new
location and then one day a weekin the old location.
Knowing that we we're like, okay, we make a database of all the
referral sources, potentialreferral sources there, and then
we just go at it.
We just go at it to build andour goal is okay, over the next
30 days, we want to have threeto six people who are who are
active referrers for us, right?
(15:29):
That's the next thing thatwe're going to do.
The third thing we're going todo is man, you know, maybe we
even have a YouTube channel, forinstance.
That's already going, but we'renow going to lean into it.
What are the hot topics?
What are the things that ourpatients really want to know?
What are the things that areevergreen People are always
asking about this stuff and thenmake our podcast, so our
(15:49):
YouTube channel, so relevantthat it's creating all this buzz
for us and stuff like that.
And we're going to look at ouronline reputation.
We're going to really go hard,hard, hard on the Google reviews
, right, and you can get Googlereviews from the first location.
It's the same, it's the samecompany and stuff like that.
Right, so we're going to goafter Google reviews and stuff
like that.
Go after social media, so we'reout there, so people can see us
(16:11):
, right?
Then for the patients who comeinto the office, we're asking
everyone to refer patients to usand stuff like that.
Like, I'm just making thisstuff up, right.
But think of it that way andwe're like, okay, boom, get the
whole team on board Next 30 days.
Boom, this is what we're doing.
But, guys, we not respond.
We cannot take decisive action.
We cannot respond casually tosomething as significant as our
(16:35):
revenue tanking.
Right, like so we, this is like, we're dealing with this with a
sense of urgency, not franticenergy, that's not what I mean
but urgency, right, which meansthis is important, this is
timely, this is time sensitiveand we're going to go all in,
right.
And so, when you think of thisis just a simple, like, quick
and dirty way to come up with aplan to respond to, that is just
a simple, like, quick and dirtyway to come up with a plan to
(16:56):
respond to that.
We have used this so many timesNow in my private practice.
We use it a lot in anticipation, right, like so in pediatrics,
we know, in the summer, peopletalk about the summer being dead
, nobody's coming in forappointments and all those
things Not our experience at all.
Because we anticipate it andthen we build a plan like this
and we put it in place toprevent that from happening.
Right, and so does it work?
A thousand percent, yes, itworks, and it works all the time
(17:19):
.
Right, but it's something thatwe need to do, and I do want to
say this, you know, becausesometimes you know, when things
like this happen, there's a lotof shame around it.
Right, like if I knew what I wasdoing, this wouldn't happen.
If I was on top I needed to bethis would have happened.
(17:41):
This happens to the best ofpeople, this happens to trillion
dollar companies, and I want toinvite you to not embrace the
shame, to not take the shame, tonot accept it at all.
Just go like huh, okay, we'regoing to learn a new thing,
we're going to learn how to runa sprint and we're going to
learn how to turn a machinearound, turn a business machine
around, which is what you'regoing to do, which will be so
exciting, and after you do it,and you do it with your team.
Guess what?
You guys now have another skillthat you can use, and now maybe
even use it more for prevention, right, and you know, okay, we
(18:02):
anticipate this will happen andwe know what to do, we know how
to respond to it.
Okay, so that's what I would do.
That's what I would do for that.
As far as you know the thejourney as an entrepreneur, as
you go through this, I will alsosay you definitely want to lean
on your community, right?
Like this is the reason why I'msuch a huge advocate for, you
(18:22):
know, physicians, being incommunity with physician
entrepreneurs who are thriving,who are pushing, who are trying
to become the best version ofthemselves, building their dream
businesses and their dreamlives, who believe in
collaboration over competitionlike, really lean into the
community and get the help thatyou need.
I say this a lot, that I'drather talk to somebody about a
(18:43):
challenge that I'm having andhave it done in five minutes
than have to deal with somethingfor five weeks or for five
months, right, so you want toreally lean into your community,
and I think the last thing I'llsay here is you know, when
you're in this season as thephysician CEO, one of the things
you want to do is make sureyou're an excellent steward of
your time.
Now, are you going to be anexcellent student steward of
(19:05):
your time?
A hundred percent of the time?
No, but that's what the intentneeds to be, which means, for
the times that you do show upfor your business, you want to
make sure you're in the 20%.
You want to make sure you'redoing the highest level
activities and stuff like that,because it's game time.
It's game time, we want to turnthis ship around.
We want to turn the machinearound right.
So I want to make sure you'redoing that.
So do this.
(19:26):
And even if you're like, okay,this was really great, someday
maybe, if I need it, I'll knowwhat to do, I want to invite you
to just practice it.
Like, even if everything isgoing fantastic, just practice a
30-day sprint, like, let mejumpstart my business right.
You can think of it that way.
Let me jumpstart my business,let me get it out of cruise
control.
You know, think of it that way.
(19:46):
Or maybe you need it, and ifyou need it, use it right.
And that's what I want you topractice doing.
If you feel like man, you know,I want to be in a community of
docs who are doing just this.
Of course, I will alwayswelcome you to come into the
Entremet Business School.
I believe it and actually it is.
It's the only.
It's the only business schoolof its kind for physicians, for
(20:07):
physician entrepreneurs who arecrushing it right, and so so do
that.
But regardless, this is the deal.
I want you to see yourself as akind of person who can
experience challenges inbusiness and you can just turn
it around.
You can flip it around.
You can just flip it around Now.
It will take a minute.
You're not going to flip itaround in two seconds.
That's not the way this works.
But you can create a strategicplan, you can execute on the
(20:30):
plan and you can blow your ownmind by the results that you
create.
I am rooting for you,relentlessly rooting for you.
If this helped you, just sendme a private message on Facebook
or Instagram.
Let me know that it did.
If you have follow-up questions, I'm so happy to answer them.
Okay, rooting for you always.
See you on the next episode.
How am I going to get out of this?
How am I going to turn thisaround?
And let me tell you you're aphysician CEO.
You can turn this around.
You can turn it around.
You started your business fromscratch, you got it to where it
was, and then the revenue taxyou could get it back up.
Hi docs, welcome to the EntreMDpodcast, where it's all about
helping amazing physicians, justlike you, embrace
(00:20):
entrepreneurship so you can havethe freedom to live life and
practice medicine on your terms.
I'm your host, dr Una.
I used to think that once Ifigured out how to create
revenue in my business, I wouldhave sorted out all my
confidence problems, right, like.
(00:40):
I would know how to do things,I'd be relaxed, I'd finally
arrived, and one of the thingsthat happened, you know, for
instance, the first year that wehit two million in revenue was,
all of a sudden, this fear cameover me Like, what if you can't
maintain this?
What if you can't grow this?
What if you drop back to amillion in revenue and you're
found out that you didn't reallyknow what you were doing and
all of that stuff.
And I addressed that, right,like.
(01:01):
So it was a very shockingdiscovery for me right, but the
thing is that you know theremight be seasons in your
business where it seems likeyour revenue tanks.
Your cashflow is not there.
Maybe you didn't get to payyourself even after you've done
really well and after you'vedone really well for a while.
And I want to show you on thisepisode what to do when your
(01:22):
revenue tanks, when yourcashflow tanks.
And having this way of thinkingputs you in a position where
you can grow, and you can growconfidently.
And when challenging times showup in your business or you
anticipate they're going to showup, you know exactly how to
handle them, so that consistentgrowth can be what your business
experiences.
Okay, and I'm going to walk youthrough three things.
(01:42):
This is something.
This is one of the episodes.
You probably want to have anotebook and a journal and all
of these things and really leaninto it.
It's going to be a total gamechanger.
So three things the first thinghere is going to be running a
postmortem, like getting thediagnosis what exactly is going
on here?
Because the fact that yourcashflow is less, it doesn't
(02:03):
mean maybe you didn't haveenough volume.
It doesn't mean you didn't haveenough new patients or new
clients that like.
We don't know what it meansuntil we look at the numbers.
Okay, and I want to give you afew examples of the things that
could be going on.
The first thing that could begoing on is it could be that you
made heavy investments in yourbusiness because you're
preparing for growth, okay, andso that could look like.
(02:24):
I've had clients who, you know,did additional locations to a
private practice.
Right, that's something that isa heavy investment, but it's
required for growth, right, andthe investment precedes the
growth.
Or it could be maybe you didn'tget a new location, but maybe
you moved into a new location, abigger location.
I've had clients who did that.
They had six exam rooms,whatever.
They had it for a few years,they had outgrown it and they
(02:46):
had to get more space.
That puts you in a place whereyou're going to make a lot of
investments.
Sometimes people findthemselves paying rent in two
locations as they're trying towork through it and all of that
stuff.
Right, that's a heavyinvestment.
Maybe you're in a specialty, youhave a private practice and
you're in a specialty where it'svery equipment heavy.
These are, you know, themachines and all of that stuff.
They're really expensive andall that.
(03:08):
Or maybe you invested in team.
You know, maybe you're a coachand you hired a high capacity
team member, maybe a businessmanager or something like that,
or you hired more coaches.
Or you're a physician and youhired another physician in your
private practice.
Right, you have a privatepractice and you hired another
physician.
Again, that is an investmentthat will precede the return on
investment.
(03:28):
Now, if that is the case, nowwhat you want to do is really
separate out the numbers, like.
What is the like?
If I took out the heavyinvestment that I needed to make
that hasn't started re-yieldingan ROI yet, what is my, what do
my numbers actually look like?
Right, and it's important to dothat because you want to see is
that the only problem?
Are we having multiple problems?
You won't know till you look atit.
(03:51):
So you take out, let's say youtake out the physician's salary
and maybe the support staff thatyou had to hire to support that
physician.
They haven't started pullingtheir weight yet and all of that
.
If I take all of that out, howare we doing?
Is it comparable to where we'vebeen?
Are we?
Maybe we're even growing, right, if you take that out, right?
So you want to take a look atthat first and then see, okay,
another reason why you know,when you run a postmortem,
(04:15):
another thing you may find isyou may find that there's low
volume of business, right, like,so the money coming in, the
revenue coming in period is justit's dropped like it's dropped
significantly, right?
So in the first instance wegave with a heavy investment.
Your revenue may even be more,but you had so much, you know
capital expense or you knowinvestments for growth, that it
(04:37):
looked like you didn't growRight and the cash flow is like
shot, right.
In this case you just didn'tbring in the revenue period,
right, and it could be a numberof things.
Maybe you didn't have, you know, enough new clients, or maybe
you didn't have enough repeatclients or repeat patients.
Or maybe you know you typicallyhave a lot of upsells or you
have you're a surgeon, so I'vehad, you know, surgeons in
(05:00):
private practice where they sawthe same volume of patients, but
now they have more medical andmore follow-up and less
surgeries, and they saw the samevolume of patients, but now
they have more medical and morefollow-up and less surgeries,
and so the revenue issignificantly less,
significantly.
So you want to take a look atthat Like is that what happened?
Or maybe it's just that youknow it's low team productivity.
This is the one you always wantto look for, and so maybe
there's somebody in charge ofreferrals they didn't do their
(05:22):
job.
And there's somebody in chargeof, you know, making sure
there's repeat clients or repeatpatients, and that person
didn't do their job.
Or you have somebody in chargeof marketing and they completely
dropped the ball like low teamproductivity, and the bigger
your team is, the more importantthis is.
So you want to take a look likedid everybody pull their weight
?
What are the levers that bringrevenue into my business?
(05:43):
Is everybody pulling theirweight?
Because if they're not pullingtheir weight, you still have
their expense, but you got noROI right.
And then now you know what tofix.
Why is this important?
Because until you do this, youdo not actually know what the
problem is and you can't fix itbecause you don't know.
When you do a postmark, whatelse could you discover?
You could just discover thatthere's a lot like increased
(06:04):
expenses.
Okay, so we just have a lotmore expenses so not quite
capital expenses, like the firstexample we gave, but you have
more, or you have unproductiveexpenses, and I'll explain what
I mean I mean by that.
You have expenses that are notcreating an ROI whatsoever in
your business.
Maybe they mattered in thebeginning of the business, they
don't matter anymore, but you'restill paying for them.
(06:26):
Now, notice that I put that asa lower example, because a lot
of times it's not quite that.
A lot of times it's the topnumber, but, yeah, that could be
one of the reasons, and then itcould be any combination, right
?
So, for instance, the personwho did the really heavy
investment they may have beentotally distracted by a new
location, or moving to a newlocation, or getting a new team
(06:47):
member onboarded and all ofthose things that they actually
stopped doing, all the thingsthat would normally bring in
revenue.
So now you have the heavyinvestment, now you have the low
volume of business.
You see what I'm saying.
So, again, this piece is socrucial.
Not doing this is like seeing apatient.
The patient is like you know,doc, what's wrong with me?
And you start telling themwhat's wrong with them without
(07:08):
doing a proper history, reviewof systems, exam and all of
those things.
You cannot make a diagnosiswithout doing this.
It is worth the time it willtake you to do it, okay, okay,
so that's the first thing is runa postmortem so you can get the
diagnosis.
The second thing is, now thatyou have a diagnosis, you want
to work on a solution.
(07:29):
You want to work on a pathway.
Okay, like, what is my path outof that stuff, plus overhead
and all of those things, and soyour cashflow is shot.
What is the pathway?
Well, the pathway is filling upthat person's schedule.
(07:51):
That's the pathway.
Now there are other pathways.
Right, we could ramp up otherproducers who can bring in
revenue while this person'sschedule is being built.
But again, that's a pathway.
Now, maybe you know how to fillup your schedule.
You have a good reputation inthe company, in the community
where you find yourself.
You've used ads before and youknow how your ads respond.
You have a referral base, areally good referral base that
(08:14):
you can talk to and they'll sendyou people.
You have a ton of patients whoare overdue for appointments.
You can reach out to say, hey,we can get you in this week and
all of those kinds of things,and all of those kinds of things
, like.
So you just map that out, like,okay, this is what we're going
to do to overcome that problemand when you're done, you look
at it like if we did thesethings, that we decided to do
these five things we decided todo, what are the chances it will
(08:34):
fill up this person's schedule?
Maybe, say, 80%.
It's like, boom, okay, let's goRight.
Maybe it's not that.
Maybe you know you moved in,you had a low volume, right.
It's kind of the same thing Ifwe had a low volume.
The question becomes what arethe top three things that filled
up our schedule in the past?
Like, wonderful, now let's godo those three things, let's go
(08:55):
all in on those three thingsagain, and maybe there's some
loaf hanging fruits you can addto it.
So then you build out thisstrategy, you build out this
pathway.
This is how we're going to getout of this.
Maybe you moved into a newlocation again, right, and
you're like, okay, what is thesolution to this?
Like our old location is doing,our first location is doing
fantastic.
Like after we did thepostmortem, we found out that's
(09:17):
not even the problem at all.
Like it actually grew.
The revenue for that locationgrew, the profits for that
location grew.
Is the second one that makes itlook like we have a cashflow
problem?
Okay, wonderful.
So then what are we going to do?
It means we need to fire on allcylinders to fill that place up
.
It means that if we have, forinstance, if we have more volume
(09:39):
than we can handle in the firstlocation, maybe we pull a dock
on the days they're not busy inthe second location to come to
the first location and seepatients and stuff.
So they're still bringing inrevenue because it's one pot.
Do you see what I'm saying?
So I can't give you the exactthing you would do, but once you
have a diagnosis, you can thenlook for the pathway.
So think about three to fivethings that you can do over a 30
(10:01):
day period, 60 day period thatwill really I like 30, which
will really rev everything upright, like you want to.
You want to create that pathwayand you may have this thought
like, oh, I don't know what thatpathway is and it's almost
never true, especially if you'reestablished.
You want to tap into your ownwisdom and say, knowing what I
know, like, what are the topthree things that would deliver
(10:22):
X results?
Okay, and what are the topthree things that are proven to
deliver X results?
And then you come up with yourown pathway.
So that's the second thing wedo, right, we build out a
pathway.
Maybe your expenses went way outof whack.
Maybe somebody else, who cannotfeel the pinch because they
don't make the money, isresponsible for spending the
(10:43):
money, right.
And you decide, okay, I'm gonnatake that, that back, or I'm
going to put parameters in placeand stuff like that.
I'm going to cut out the thingsthat don't have an ROI.
I want to say this you knowvery clearly when it comes to
cutting out things that don'thave an ROI, let me give you
three things not to cut.
I say this all the time on thepodcast.
The first thing you don't wantto cut is you don't want to.
Okay, now you want to make sureyour team is a profitable team,
(11:13):
right, you want to make surethey're all creating revenue and
things like that, but you don'twant to cut your team.
You train your team or youremove underperformers, but you
don't cut your team.
And then, third thing you don'twant to cut is your education.
Right.
Is your education when you findyourself in a position where
it's more challenging?
That's when you want to lean inmore, like I need to be in a
(11:34):
community where I'm getting mybusiness education, so I know
what to do, I know how torespond to circumstances and all
of those things.
I'm continually upgradingmyself as a physician CEO and
things like that.
Okay, so those are three thingsyou don't want to cut.
Okay, so we talked about runningthe postmortem Very important.
I keep saying this because ifthis is not done, none of the
other things matter.
Okay, so I run a postmortem.
(11:55):
Okay, I decide on a pathway.
How am I going to get out ofthis?
How am I going to turn thisaround?
And let me tell you, you're aphysician CEO, you can turn this
around.
Okay, you can turn it around.
You start your business fromscratch Most people, you start
your business from scratch,no-transcript.
(12:39):
And then our revenues tanked andstuff, and I said, okay, I
don't like what happened, Idon't like what's happening with
the revenue, I don't likewhat's happening with the
cashflow, and so what I found isthat there there are a lot of
you know, like what wasresponsible for the tanking is
how I had low volume of business.
So for a practice that may looklike you know, we got really
comfortable.
We're like oh yeah, everybodyjust finds us by word of mouth.
(12:59):
And here comes this competitorand we did not have the engine
in place to respond to thecompetitor because we had grown
fat and lazy, and we're justlike, oh yes, we're just, you
know, we're just leaning on ourword of mouth, we don't have to
do anything, right?
I got real humble real quick,okay.
So I'm just giving an example.
I got humble real quick and Isaid, okay, what is the
diagnosis?
(13:19):
Here?
We are doing nothing to bringin new people.
Nothing, nothing at all, okay.
And I'm like, okay, fantastic,we shouldn't have done that.
But we're here now.
What do we do?
We're like, okay, great, we canhit the recaller, because we
have a bunch of people who areoverdue for appointments.
We don't call them anymorebecause we're like, you know, we
don't have to do anything andwe just get all these patients.
So we're going to hit therecaller.
We're going to reestablish ourrelationships with our referral
(13:41):
sources, right, and we're goingto go back to posting on social
media.
We're going to go back toshowing up on a YouTube channel
where people are finding usanyway, and we're going to ask
for referrals from our patients,right, not just from other
doctors referring to us.
And we're going to do thesefive things, and we're going to
do it every single day for thenext 30 days.
And we're doing with intention.
What is the intention?
New appointments on the books,right, okay?
(14:03):
So that then becomes a sprintthat I run and in the beginning
it will look like it's notworking.
Okay, so let me tell you thatyou know real quick here, in the
beginning it will look likeit's not working and then the
more I do it, the more it willwork.
The more it starts to snowball,the more we create momentum and
then we begin to shift that.
Okay, so it's a little bit of along game, like not long, like
years or many months, but it's alittle bit of a long game.
(14:26):
You have to have the innerstrength to just stay and see it
through, right, okay, so thatmay be the thing.
Or let's say, I got anadditional location and I do the
postmortem and it's just likethere's just low volume of
business, right, for the newlocation.
First location, doing great, infact, it even grew Fantastic.
Okay, so what's the plan?
We'll keep the first location,as is Everything that's working.
(14:47):
We'll just keep that working.
And we come to the secondlocation.
We're like, okay, what could wedo?
(15:08):
All right, we have, you knowphysician in this new location
that's being underutilized, sothey work four days a week.
Maybe we'll have them workthree days a week in the new
location and then one day a weekin the old location.
Knowing that we we're like, okay, we make a database of all the
referral sources, potentialreferral sources there, and then
we just go at it.
We just go at it to build andour goal is okay, over the next
30 days, we want to have threeto six people who are who are
active referrers for us, right?
(15:29):
That's the next thing thatwe're going to do.
The third thing we're going todo is man, you know, maybe we
even have a YouTube channel, forinstance.
That's already going, but we'renow going to lean into it.
What are the hot topics?
What are the things that ourpatients really want to know?
What are the things that areevergreen People are always
asking about this stuff and thenmake our podcast, so our
(15:49):
YouTube channel, so relevantthat it's creating all this buzz
for us and stuff like that.
And we're going to look at ouronline reputation.
We're going to really go hard,hard, hard on the Google reviews
, right, and you can get Googlereviews from the first location.
It's the same, it's the samecompany and stuff like that.
Right, so we're going to goafter Google reviews and stuff
like that.
Go after social media, so we'reout there, so people can see us
(16:11):
, right?
Then for the patients who comeinto the office, we're asking
everyone to refer patients to usand stuff like that.
Like, I'm just making thisstuff up, right.
But think of it that way andwe're like, okay, boom, get the
whole team on board Next 30 days.
Boom, this is what we're doing.
But, guys, we not respond.
We cannot take decisive action.
We cannot respond casually tosomething as significant as our
(16:35):
revenue tanking.
Right, like so we, this is like, we're dealing with this with a
sense of urgency, not franticenergy, that's not what I mean
but urgency, right, which meansthis is important, this is
timely, this is time sensitiveand we're going to go all in,
right.
And so, when you think of thisis just a simple, like, quick
and dirty way to come up with aplan to respond to, that is just
a simple, like, quick and dirtyway to come up with a plan to
(16:56):
respond to that.
We have used this so many timesNow in my private practice.
We use it a lot in anticipation, right, like so in pediatrics,
we know, in the summer, peopletalk about the summer being dead
, nobody's coming in forappointments and all those
things Not our experience at all.
Because we anticipate it andthen we build a plan like this
and we put it in place toprevent that from happening.
Right, and so does it work?
A thousand percent, yes, itworks, and it works all the time
(17:19):
.
Right, but it's something thatwe need to do, and I do want to
say this, you know, becausesometimes you know, when things
like this happen, there's a lotof shame around it.
Right, like if I knew what I wasdoing, this wouldn't happen.
If I was on top I needed to bethis would have happened.
(17:41):
This happens to the best ofpeople, this happens to trillion
dollar companies, and I want toinvite you to not embrace the
shame, to not take the shame, tonot accept it at all.
Just go like huh, okay, we'regoing to learn a new thing,
we're going to learn how to runa sprint and we're going to
learn how to turn a machinearound, turn a business machine
around, which is what you'regoing to do, which will be so
exciting, and after you do it,and you do it with your team.
Guess what?
You guys now have another skillthat you can use, and now maybe
even use it more for prevention, right, and you know, okay, we
(18:02):
anticipate this will happen andwe know what to do, we know how
to respond to it.
Okay, so that's what I would do.
That's what I would do for that.
As far as you know the thejourney as an entrepreneur, as
you go through this, I will alsosay you definitely want to lean
on your community, right?
Like this is the reason why I'msuch a huge advocate for, you
(18:22):
know, physicians, being incommunity with physician
entrepreneurs who are thriving,who are pushing, who are trying
to become the best version ofthemselves, building their dream
businesses and their dreamlives, who believe in
collaboration over competitionlike, really lean into the
community and get the help thatyou need.
I say this a lot, that I'drather talk to somebody about a
(18:43):
challenge that I'm having andhave it done in five minutes
than have to deal with somethingfor five weeks or for five
months, right, so you want toreally lean into your community,
and I think the last thing I'llsay here is you know, when
you're in this season as thephysician CEO, one of the things
you want to do is make sureyou're an excellent steward of
your time.
Now, are you going to be anexcellent student steward of
(19:05):
your time?
A hundred percent of the time?
No, but that's what the intentneeds to be, which means, for
the times that you do show upfor your business, you want to
make sure you're in the 20%.
You want to make sure you'redoing the highest level
activities and stuff like that,because it's game time.
It's game time, we want to turnthis ship around.
We want to turn the machinearound right.
So I want to make sure you'redoing that.
So do this.
(19:26):
And even if you're like, okay,this was really great, someday
maybe, if I need it, I'll knowwhat to do, I want to invite you
to just practice it.
Like, even if everything isgoing fantastic, just practice a
30-day sprint, like, let mejumpstart my business right.
You can think of it that way.
Let me jumpstart my business,let me get it out of cruise
control.
You know, think of it that way.
(19:46):
Or maybe you need it, and ifyou need it, use it right.
And that's what I want you topractice doing.
If you feel like man, you know,I want to be in a community of
docs who are doing just this.
Of course, I will alwayswelcome you to come into the
Entremet Business School.
I believe it and actually it is.
It's the only.
It's the only business schoolof its kind for physicians, for
(20:07):
physician entrepreneurs who arecrushing it right, and so so do
that.
But regardless, this is the deal.
I want you to see yourself as akind of person who can
experience challenges inbusiness and you can just turn
it around.
You can flip it around.
You can just flip it around Now.
It will take a minute.
You're not going to flip itaround in two seconds.
That's not the way this works.
But you can create a strategicplan, you can execute on the
(20:30):
plan and you can blow your ownmind by the results that you
create.
I am rooting for you,relentlessly rooting for you.
If this helped you, just sendme a private message on Facebook
or Instagram.
Let me know that it did.
If you have follow-up questions, I'm so happy to answer them.
Okay, rooting for you always.
See you on the next episode.
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