If you're not doing anything other than what every other plastic surgeon, dermatologist, and medical spa is doing you're stuck competing on only one thing; price.

And that's a straight shot to the bottom.

There can only be one lowest price in a market and the second-lowest price will always lose. Just ask Kay-Mart and Sears who lost long ago to Walmart. Worse, a patient who comes to you based on price will leave you just as fast for someone who's offering IPL, Botox or cosmetic injectables for less.

To get unstuck and find some area where you can distinguish yourself you'll first need to identify the orthodoxies and assumptions that you're already using. The most common assumptions revolve around what others are doing and especially the "we've always done it that way" lazy way of thinking.

Here's a way to tackle this. Start by actually writing down the assumptions that you have that - if they are true - would prevent you from achieving your goals. Your clinic is filled with assumptions: patients won't pay for ___, my staff can't sell, they're not motivated, I'm not good at business, everyone is doing it better than I am, I have to work 60 hours a week... you're looking to root out orthodoxies by identifying existing assumptions and overturning them to illuminate blind spots or limiting beliefs to look at your problem in a new way. By articulating these assumptions you can then attempt to test them - which is key - in order to make better decisions that actually improve  your business and lifestyle. Y

Example: Alan Robinson (co-author of Corporate Creativity) writes in his book how KC Fine Furniture trained their delivery drivers in basic interior decoration so that when they deliver furniture to the customer, they help arrange the room, and accessorize. As a result, their rejection rate dropped from 10% (the industry standard) to 1%. That simple change decreased their returns by an order of magnitude. Nice.

Assumption Reversal

Here's an example based on a process from the book Orchestrating Collaboration At Work.

Procedure

1. List all the assumptions you have about a particular topic, even the most obvious ones. Remember, not all assumptions are wrong. You just want to be explicit about them because they may hold the key to achieving a breakthrough idea. (Aim for 10-20 assumptions
2. Write down the opposite or a modification of each assumption.
3. Use each assumption as a trigger for new ideas, write each idea on a Post-it® Note, and place them on flip-chart paper for evaluation.

An example: Assume you are a dermatologist with a new medical spa and want to attract new patients. You might list the following assumptions:

• My existing patients are going to competitors who are charging less for filler injections.
• I should lower my filler injection prices to compete.
• I will make up the loss on other treatments.

Next, reverse these assumptions as shown in the following examples:

• My existing patients are not going to competitors who are charging less for filler injections.
• I should not lower my filler injection prices to compete.
• I will not make up the loss on other treatments.

Finally, use these reversals to suggest ideas:

• Emphasize that that you're not the "Walmart" of filler injections.
• Stress the high cost of my treatments and "you get what you pay for".
• Give patients who recruit their friends an "insider friends and family" deal.

Source 101 Activities for Teaching Creativity and Problem Solving. (VanGundy 2005)

What assumptions do you need to question?

You're always going to see competitors as the person just down the road, but the truth is that you're competing with much more than that. The path to success is paved with broken assumptions and you need to question - and test - all of yours. If you're relying on the wrong assumptions about your market, your patient population and your business, you're driving with the breaks on at best.