Why Systems, Not Goals, Build a Practice Worth Staying For

Transcript YouTube English auto-captions. Hey guys, welcome to another edition of Bootstrap MD, the podcast for physician and healthcare entrepreneurs. This is for doctors who are tired of being told what they can and can't do, and they're ready to take control of their income, time, and freedom. My name is Dr. Michael Ming. I'm a 20 plus year physician entrepreneur, and today I'm going to tell you something. It might tee you up a little bit. So, what if I told you that your goals may actually be sabotaging your business? Yeah, I know you're probably thinking, Mike, what are you talking about? Goals are everything. I know you've had goals your whole entire life. Goals to get into medical school, goals to match into residency, to pass your medical boards. But here's the thing, and stick with me on this. The most successful companies and the most fulfilled entrepreneurs I know don't obsess over hitting their goals. What they do obsess over is building systems. So, let me give an example. This happened early in my clinic days. We set a revenue goal and it seemed reasonable at the time. We hit it one month and we were super pumped. We celebrated. We felt like we figured it out. The next month, completely different story. So, I'm sitting there going like, "What happened? We hit our goal, but we had no idea how to repeat it." Felt like we're just throwing stuff at the wall and hoping it's stuck. Does this sound familiar? That's when I realized something that completely changed how I think about business. And that's what I want to share with you today. Because here's what I see happening with physician entrepreneurs that I counsel all the time. They'll have a killer month and then they'll spend the next three months trying to figure out what they did right. Meanwhile, they're stressed. They find out their revenue is now unpredictable and they start questioning even whether they're cut out for business. I don't want that to happen to you. So, that's what we're going to dive in today is systems because I know what you're already thinking. You're going, Mike, you've lost it. Goals are important. Look, I'm not anti- goal. I'm not on an anti-goal obsession here. There is a huge difference. And what I want understand is what separates successful physician entrepreneurs for the ones who burn out after 6 months. So let's break it down for you. A goal is a result you want. Goal could be I want to see 50 cash pay patients a month. I want to hit six figures in my tele medicine practice. I want to launch my first coaching program. Sounds reasonable, but a system is the repeatable process you follow to get yourself there. It's your weekly lead generation routine that you do whether you feel like it or not. It's that patient consultation pipeline that you've built that works the same way every time. It's that sk content creation schedule that you've built that doesn't depend on inspiration or motivation. So, think of it this way and this analogy really changed everything for me. A goal is the destination. A system is the vehicle that gets you there. So you see it before you, the most beautiful destination in the world. But if your vehicle breaks down every miles or you don't know how to drive it consistently, you're never going to get there. You're just going to be stuck on the side of the road trying to figure out what went wrong. One of my favorite authors is James Clear. He's the author of the Atomic Habits, which I'm sure you know very well. And here's what he says. He says, 'You do not rise to the level of your goals. You fall to the level of your systems. So here's why this matters specifically to us as physicians. In medical training, we were conditioned to focus on outcomes, right? Test scores, board certifications, how many procedures we completed. You hit the number and then what do you do next? You move on to the next number. You study for the test, pass the test, and guess what? immediately start studying for the next test. This outcome focused thinking served us very well in medical school and in residency. But when it comes time to entrepreneurship, it actually is working against us because here's what they don't teach you in business school. And I didn't go to business school, but outcomes are often outside your control. Market conditions can change overnight. Patterns behave unpredictably. Staff turnover happens at the worst possible times. Regulations shift without warning. But your process, your system, that's what you can control every single day, rain or shine, good mood or bad mood, whether you feel motivated or not. And the most successful physician entrepreneurs I know are the ones who build sustainable, profitable practices. They're not ones with the best lofty goals. They're the ones with the most reliable systems. So, let's talk about why goal only thinking backfires so spectacularly for entrepreneurs. I'm sure you heard of Scott Adams. He's the cartoonist who created Dilbert. He said something that sounded harsh, but is actually true. Losers have goals. Winners have systems. Now, before you go on and throw your phone out across the room, hear me out. I'm not calling you a loser if you have goals. I'm saying if you only have goals without the systems to support them, you're setting yourself up for a world of frustration. So here's the first problem I see with goals is they create feast or famine cycles. So this is huge in healthcare businesses. You hit your goal, you celebrate, and then you coast or worse, you hit your goal and you don't know how you did it, so you can't repeat it. I see this pattern constantly with my clients. A physician will have an amazing quarter. Maybe they got lucky with referrals or they had a social media post that took off or they launched something just at the right time. They hit the revenue goal and they think they got it figured out. Then what happens? The exporter tanks. Their referrals dry up. The social media algorithm changes. The market shifts. And guess what? They're back to square one. Scrambling to figure out what happened. So this feast or famine cycle can be brutal on your mental health, your financial planning, and your confidence as an entrepreneur. Second problem, you feel like a failure every day. You haven't hit the goal yet. Let's say your goal is to make 20K a month from your site practice. Sounds reasonable enough, but every day you're not at 20K. You feel behind. Every week you're under that number. You feel like you're failing. This can be psychologically devastating. You start questioning your abilities, your business model, your decision to become an entrepreneur in the first place. And the irony is that you might actually be making some great progress building systems, growing your patient base, improving your processes, but because you're kind of tied to that arbitrary goal number, you feel like crap. Third problem, goals don't account for realworld variables. In healthcare, this is especially brutal. You might plan to see 40 patients this week, but guess what? Staff shortage errors occurs or insurance companies change the reimbursement rates or there's a seasonal dip in elective procedures or your biggest referral source leaves town. Goals assume a perfect world when everything goes according to plan. But as physicians, we know better. Anyone thinks that things rarely go according to plan. Now you have systems on the other hand assume chaos and plan for it. They're designed to work even when everything else is falling apart. I'm a big fan of Leela Horoszi, Alex Horsey's wife and her approach. She runs a portfolio of companies worth over $100 million. So I think she knows what she's talking about. And what she says is instead of saying we want 20 new patients a month, her team built systems are the inputs that they can control. What can you control? I ran X number of ads per week. X number of ads generates Y number of consultations. Y number of consultations converts to a Z number of new patients. So they know the math. They know that if they do X and Y consistently, they're going to get Z. There's no guessing, no hoping, no praying to the marketing gods. And that's when I started implementing this mindset in my own practice. It everything changed. We stopped chasing numbers and started perfecting processes because here's what can happen. We built a patient on boarding and reactivation system. It's not a goal. It's a system. We had specific days for specific activities, specific scripts for specific situations, specific metrics that we track every week. The result is our monthly revenue didn't just stabilize, it became predictable. And this is that psychological shift that I've been hinting at. This really made all the difference. I stopped living from milestone to milestone, started building a business that I could actually trust. Because when you have reliable systems, believe me, you're going to sleep better at night. You can plan for the future. you can take time off without everything falling apart. All right, I want to give you guys theory. I want to give you practical information that you can use. So, how do you actually build a systems that works for your physician practice or your side business? So, I'm going to give you a four-step framework and I've used this to help build seven figure businesses and more importantly, I've taught it to hundreds of doctors who are using it to transform their own practices. So, step one, define the desired outcome, but do it right. This isn't make more money. You want to be specific enough that you know what you've achieved it, but not so specific you're micromanaging every detail. So here's a good example. You want to launch a program and have 10 ping clients within 60 days at $10,000 a monthly recurring revenue from tele medicine consultations. I want to hire and train a nurse practitioner who can see 20 patients per day independently of me. So these are goals that I talked about specific, measurable, and time bound, but they're not so detailed that they become rigid constraints. Okay, let's talk about step two. You want to identify the repeatable inputs. Now, this is where most people kind of screw up. You need to think about what needs to happen every single week consistently to move towards the outcome. So if you want to launch that coaching program with 10 clients in 60 days, what do you need to happen to do every week? Maybe it's write two email sequences for your launch funnel. Record one training video for your program. Reach out to five warm leads who might be interested. Create that one piece of social media content that demonstrates your expertise. Those are your inputs. Those are what you can control. The key insight is that inputs are predictable and controllable. Outcomes are not. You can't control whether someone buys your program this week, but you can control whether you reach out to five potential clients. Step three is you block time and delegate ruthlessly. This is where the rubber meets the road. If you don't block specific time for these inputs, they're not going to happen. Your day jobs can eat up all your time and you keep pushing your business activities to someday when I have time. News flash, you're never going to have time. You have to make time. One thing you can help is batching. So, I'm a huge believer in batching similar activities. Don't record one piece of content at a time. Block two hours and record everything you need for that week or month. Don't write one email. Sit down and write your entire email sequence at once. So, this serves two purposes. First, it's going to make you more efficient because you're not constantly switching between different kinds of tasks. Your brain can get into a rhythm and stay there. Second, it protects your own time. When someone asks if you can jump on a random call, you can say no without feeling guilty because you know you have your dedicated business development time blocked later in the week. And here's something that's really crucial for doctors. If you can afford it, delegate everything that doesn't require your medical expertise or strategic thinking. A VA can help with social media scheduling, calendar management, initial patient screening, billing follow-up. This stuff doesn't need your 200 plus hour brain. Step four, track the input, not just the results. This is the secret sauce that most entrepreneurs miss completely. Instead of obsessing over how many sales you made this month, track how many discovery calls you booked. Instead of stressing about your YouTube subscriber count, track how many videos you published. We keep a simple spreadsheet where we track our weekly inputs. Did I reach out to my target number of potential clients? Check. Did I create my planned content? Check. Did I follow with pending leads? Check. When you win the day with your inputs, the months take care of itself. And something interesting I've also noticed is when you focus on inputs instead of outcomes, the actual outcomes actually improve because you're not stressed about the results. you perform better in the activities that created the result. So I want to give you some physician specific examples. These are real systems that work in the real world. Let's say you've got a cash clinic. You want to patient acquisition system. Something that I love to talk about. Instead of this vehicle, I need more patients. You want to build a predictable system. So let's plan out a week. Every Monday, review what you have to do for the week and then set your marketing budget accordingly. If you have 15 open appointment slots, you spend enough on ads to fill those slots plus the buffer. Tuesday, you respond to all the inquiries from the previous day. Now, when you get around to it, Tuesday at specific time using your standard response templates. Wednesday, conduct phone consultations using your proven script. Same questions every time, same process, same follow-up sequence. Every Thursday, you want to send up follow-up messages to people who inquired but haven't booked yet. You have templates for all this stuff. Would you personalize each one based upon their specific situation or concerns? And Friday, analyze your numbers. What are the ads that really perform best? Which consultation approaches led to the highest conversion rates? What objections are you hearing most often? Again, this is work. This isn't exciting. It's not invasion, but it works week after week, month after month. The beautiful thing is once you have a system dialed in, you can predict with pretty remarkable accuracy how many new patients you're going to get each month based upon your advertising spend. So, okay, let's focus on another thing. Let's say you're trying to build for authority. You need a content marketing system. So, I see positions say, "I need to post more in social media." Okay, but then they stress about what do I share? So, create a system. Pick one day of a week, let's say Friday mornings, and batch create all your content for the following week month. You know, have a running list. I have a running list of 50 plus topics related to my specialty that I can reference. Every time a patient asks a great question, I add it to the list. Every time you see an interesting study, add it to the list. During your matching sessions, create multiple pieces of content at once. Record three short videos answering common patient questions. Write five social media posts about recent developments in your field. Draft two email newsletters for your patient list. Then use a scheduling tool to space this content out over the coming weeks. One batching session feeds your content pipeline for weeks. The key is consistency over perfection. A steady stream of good content beats sporadic burst of great content every time. Third, a hiring and training system that actually works. Let's give an example. If you want to scale your practice, you can't just wing the hiring process. Too many docs post a job ad and hope for the best. Then they wonder why they keep getting mediocre candidates. We recently just went through this whole thing. We create interview templates with the same core questions for every candidate plus role specific questions. I use behavioral interviewing. You know, I say describe a time when you had to handle a difficult situation with the patient, walk me through exactly what you did. You want to build a comprehensive onboarding checklist. New hire should know exactly how to access your EMR system. I'll handle common patient questions, what your policies are for various situations, and what metrics they'll be measured on. You want to create a 30-day scorecard with specific measurable expectations. So by day 30 they should be able to handle X type of patient interactions independently. They process Y type of insurance claims, maintain Z level of patient satisfaction scores. The system ensures every new hireer gets the same quality training and then you can identify potential problems early instead of six months down the road. Fourth example, I know you guys want to build wealth. Have an investment due diligence system. So physicians, I know you want to get into early stage or investment and you should be building wealth outside your practice. Don't make emotional decisions, but you have system block the same time each week. I'm going to review potential investments. Maybe it's Sunday mornings, Washington day evening. It doesn't matter. Whatever it is, just make it consistent. And then use the same checklist for every potential investment. You're going to look at projected cash flow, risk assessment, market analysis, exit strategy. Check, check, check. Every deal gets the same level scrutiny. No exceptions. even if from someone you trust or a limited time opportunity. This systematic approach helps you avoid the emotional investments mistakes that can destroy your wealth buildinging efforts. Okay, now I know what you're thinking. This sounds great in theory, but I'm already drowning. I barely have time to see my patients, let alone building labor systems. So that response tells me you need systems. The reason you're drowning because you don't have systems. You're really reinventing the wheel every time you do something. You're making decisions that should be automatic. You're doing work that could be delegated or eliminated entirely. Because here's the truth. If you're too busy to spend 30 minutes a week documenting what you do, you're going to stay busy forever. And busy isn't the same as profitable or fulfilling. I know Dr. say, "Hey, I'm not good at technology." You don't need to be a system could be as simple as a checklist in Google Docs, a template email. You copy and paste a recurring calendar here to do specific tasks. I'm not telling you to build some complex software platform with AI and automated workflows. I'm just talking about documenting your current processes so you can improve them, delegate them, and eventually eliminate them. If you don't know what to systemize first, start with anything you're doing more than three times. This could be patient intake calls, insurance verification, posting on social media, following with leads, scheduling appointments. So, here's a simple exercise that I want you guys to do. I want to leave for you for one week. Write down every business related task you do and how long does it take? And then at the end of the week, ask yourself, what did I do multiple times? What took longer than it should have? What could someone else do if they had clear instructions? These tasks are your candidates for systemization. The tools don't have to be fancy. You can use Loom. I love Loom for recording quick training videos, Google Docs for checklists and procedures, your phone's voice recorder capturing ideas when you're driving between appointments. And so, here's the beautiful thing about systems. Once you build them, they compound. Every system you create makes the next one easier to build. Each process you document saves you time every week going forward. This goal is to become kind of efficiency robot. The goal is to free up your time and your mental energy for the work that actually matters, seeing patients, growing your practice, spending time with your friends and family. All right, let's wrap this up with something you can use. If you want long-term success as a physician entrepreneur, I want you to stop obsessing over hitting numbers. Start obsessing over building the machine that produces those numbers consistently. Goals are important. They give you direction, but they're destinations. They're not road maps. Systems, what we said, is what actually gets you there week after week, month after month, whether you're motivated or not. So, I challenge you this week. I want you to choose one area of practice or your business to systemize. just one. Maybe it's how you handle new patient inquiries. Maybe it's about your approach to creating new content. Maybe it's your process for following up with potential coaching clients. Pick something specific that you do repeatedly. Document your current process, even if it's messy and inconsistent. Block time in your calendar to work on the system. Create a simple way to track whether you're following the system or not. I don't want you to systematize everything at once, but start small. Get one system work smoothly, then move to the next area. I hope you found this helpful. If you like talking about this stuff, we've got a group. It's in school, doctor's online success. You can go find it. It's free. And myself and Dr. Ann Trong will share with you our knowledge of building and scaling uh businesses for physicians. I hope you like this. Remember, as a physician entrepreneur, you're going to have your ups and your downs. Do something a little each day to get you closer to your goals and keep moving forward.