If you're working on solutions without a very clear definition of the problem you're trying to solve, you're doing it wrong.

Is the solution you're working on solving a real problem? Is the problem based on your existing patients needs? If you're successful with the project you're working on, would it change anything for your patients? And in turn, would it change anything for your clinic? These are the fundamental questions you need to answer to make sure that you're investing your time and effort working on worthwhile opportunities.

If you put yourself in a position where your clinic is running on autopilot and give yourself a chance to get off of the constant production treadmill you'll have a chance to work ON your business, not just IN your business.

Process is critical here.

My guess is that you don't have any real way to prioritize what you're working on at any one time. If you're like the vast majority of clinics who are physician-owned, you're not running a business as much as you are running a communal job, where nothing's addressed until there is enough pain that you have to actually do something.

• We don't have enough patients; so I need to try and figure out how to get some. I guess I'll call that local ___ rep who was in here last week promising that she could help grow my practice. Maybe my nephew can help me out with some Facebook ads.
• We're getting a lot of returns and some negative reviews online; Oh well, what can you do. Some people will always be unhappy. Nothing really you can do about that. (If this is you, get your ass a Podium account now.)
• I know that we're over-promising on what the results are with this old IPL that I've had forever but it's still working and it's not worth much so I can't afford to upgrade. (Get a certified quote on your used laser or IPL)

I could go on forever.

Features and solutions are easy to imagine and talk about with other people, and coming up with a 'solution' is rewarding, it makes us feel like we're making progress and are figuring things out.

This is not the way that successful clinics operate.

Successful clinics have systems, and one of those systems is some kind of process to prioritize what to work on, and it's not the low hanging fruit.

It's the hard things that will kill you.

No one cares if you add a Facebook widget to you website so that patients can join up and be ignored in your I-don't-have-time-to-do-it Facebook group.

But if your staff is fighting over commissions your patients will see that and you'll have less word-of-mouth.

Who gives a shit if your using a credit card processor that charges you 5% more than someone else.

But if your consultations aren't perfect you're cutting your own throat.

You need to be working on the hard things; building systems into your business, an obsessive focus on patient satisfaction, a team that is all working in unison, and a real business.

It's the hard things that you have to get right- the foundations of your business- not the bullshit on the surface.

Here's a simple process to identify and prioritize what you should be working on. (Note: I use this but I stole it from Amazon.

Prioritizing What To Work On

Here's a simple method to ensure that you're working on problems that can actually affect your business.

Note: This is a physical process, not a thought exercise. I suggest that you use post-it notes and do this first with yourself, but then with your team. (If you're doing it with your team DO NOT hog the meeting and deliver the answer. Let your team help you with all of it.)

1. Write down the BIG problems that are facing your clinic. These are the problems that, if they're not fixed immediately, can put you out of business. 
2. Prioritize those problems according to risk, with the biggest problem at the top and the least risky one at the bottom.
3. Pick the problem right at the top. The one that poses the biggest risk to your clinic.
4. Break it apart into smaller constituent parts. For example; "We don't make enough revenue to cover our costs" can be broken down into, "We don't make enough revenue" and "our cost's are too high".
5. Keep breaking it down into smaller segments.
6. Pick a segment or a challenge. 
7. Use this technique of the 5 Why's to uncover the root cause.
8. Use these root causes to build a plan of action that you can be sure are contributing to drive value and work on your most pressing problems.

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