Case Study

Case Study

Case Study

Skye Andersen

Skye Andersen

Skye Andersen

Osteopath

Osteopath

Osteopath

“We thought we had a business. We didn’t.“

As a Clinic Owner, you’re probably used to doing a case study for a patient or condition, but have you ever done it with your business owner hat on?!

You’re probably interested to know what other clinic owners are doing to grow their clinic!

It’s pretty common for us to see a clinic owner that is lost for direction, not sure what the next step is for their business journey.

You’re either in a position of pain, struggle or overwhelm and need some urgent help, or you’re happy, content and potentially complacent, meaning you’re missing a lot of the upside.

In any case, it’s great to learn from other health professionals in business because it highlights the opportunities for you to grow.

In this case study with Skye, we’re going to share a detailed insight into her journey as an Osteopath and Private Practice owner (Pakenham Osteopathy).

As you can appreciate, everyone’s journey is different, so, take what you see here and filter it through your current position and ask yourself, how could this work for you?

You’ll notice that we’ve included a lot of detail in this case study. We’ve been able to do that because of our 103 point self assessment business audit that we do at the beginning of every new member’s journey.

We are also constantly reviewing our progress with members and on a quarterly basis we do a business audit to review our progress so that Clinic Mastery can stay accountable to the clinic owner getting a return on their investment.

You’ll see in the answers below we have included Skye’s feedback throughout her time with us.

Why did you start your clinic?

To be able to be our own bosses.  

My dad always encouraged me to do something where I could “hang a shingle out” and not be at the mercy of other people.   

Being able to have flexibility of days and times was also a big attraction.

Tell us about your clinic

Shane and I studied together at University and 6 months after finishing uni our student plans to open our own practice was realised  in April 2004.

Our R&D began with the purchase of a suburban map of Melbourne.

Armed with sticky dots, a Yellow Pages printout of all the osteopaths in Melbourne and our map we set about identifying our opportunities.  

Our sticky dots clearly identified Pakenham as the perfect fit, having a close friend in Pakenham I was familiar with the area so the decision was made.

Office space was short so we built a room in the back of a local health food shop and made it our home for our first 12 months.

Originally we worked half a week each in our business – the other half was spent at a busy South Gippsland clinic about 1 hr away so we had an income.  

It was similar to a job-share. Our original idea was to create a health care business where we cared about our patients more than the rest!

In 2005 we departed the health food store and sublet a room in the back of an allied health clinic joining a local acupuncturist and massage business.  

As opportunities unfolded we grew to 2 rooms and eventually the entire office space.

We engaged subcontract osteopaths, essentially all running their own business (treating and managing patients) under our banner.  

We were oblivious to formulating systems and procedures that streamlined our patients’ experience.

We had almost no control over (and honestly weren’t even aware) how the other practitioners were managing patients.  

We were naive and thought that as long as we hired good people, the rest would manage itself.

For a few years our attentions were elsewhere – marriage, home renovations and arrival of  children – but thankfully the business continued to tick over.

In 2008 I enrolled in business coaching as an initiative offered from the local council.  

From this I got Shane on board and we engaged a professional coach on a month-by-month agreement starting with a clinic audit and “systems” review.

We started to find out what we didn’t know.  We got a lot out of this process but took what we needed at the time and went off on our own again to implement.

Our 3rd coach was a 12 month commitment.  

Our coach stated our goal as a minimum should be to be a $1M business (we were doing less than $400k at that time).  

We had the capability so why weren’t we delivering.

We thought he had lost his mind, in reality we needed to adjust our mindset.  

The benefits an impartial coach could offer became further cemented in our minds.

We quickly realised an open mind was needed and if not willing to get a little uncomfortable (even after running through our own filter Shane Davis) then a coach was a waste of time and money.  

“When the student is ready the teacher will appear” – Fake Buddha.  

We were now coaching advocates.  All our coaches to date have improved our business acumen.

In 2015 as we emerged from the fog of small children Shane announced the clinic was dated and an embarrassment.  

Rather than spend money on a fitout to continue dealing with an unreasonable landlord, he had formulated an idea of how we could acquire a commercial property.  

He had done the sums and challenged me to have my independent Financial Advisors review it, which I did, and we were away!

We engaged a Buyer’s Advocate to retain our anonymity and commenced negotiations.  

After some exciting times with council and vendors we got the business done at the 11th hour over a protracted 6 month negotiation purchasing a building across the road.

The old renovator gang was mobilised in to action  (those ideal tradie patients, who we will forever treat as no gap clients) working 7 days per week over the xmas/NY period, delaying holidays, and in 7 weeks gutted and transformed the tired 1970’s space into a modern, purpose-built clinic.

The previous owners, also patients, could barely recognise the new space and surrounding grounds.

We changed our name, re-branded and re-launched in January 2016.

We made a few big changes – moving from subcontractor to employee structure and hiring 2 more osteopaths (one new grad, one with 10+ years experience) taking our osteopath count to six including Shane and myself.  

An exercise physiologist was added for the gym and reformer pilates space we’d created.

With the excitement of the new surrounds, there was great energy about the clinic and we continued to grow month on month for about 6-7 months.  

Then we noticed a slight slip in patient numbers and team morale.

Almost overnight complacency had set in and grabbed hold, TIGHT!

I happened to come across Clinic Mastery on my Facebook feed and a Melbourne seminar was coming up.  

We went along, signed up on the day and haven’t looked back.

In addition to Shane and myself, we now employ 11 staff (clinical and admin).  We have 6 treatment rooms that are utilised well but there is still room to grow – and we now have a clear plan in place to do that.

We have made some tough changes in the last 8 months – transitioning out a very experienced osteopath who was reluctant to change with us, dismantling the gym/pilates space and re-configuring it into 2 more treatment rooms (One currently used for admin), but we now have a clear vision of what we’re about, where we are going, and how we are going to get there.

Why did You Join the Clinic Mastery Business Academy?

Complacency had set in.  

We were doing basic & uninspired KPI’s (individual info only, not completely transparent with everyone’s performance on show).  

Our regular meetings had lost their original effect and impact, they had become very dry, predictable and ho-hum.

The impact was lost, we were trying different methods to inspire and reinvigorate but not realising change.  

The KPI’s stopped, the meetings became less and we disengaged blaming the EOFY, the start of the financial year, the weather, the credit squeeze, the 2nd year blues or anything else that seemed to soothe us.

We were too reliant on our own personal exertion income.  We thought we had a business. We didn’t.

The biggest challenges so far has been people management.  

Changing the landscape of how we ran the clinic (eg. the setting of KPIs, technology implementation, non-negotiables like management plans) created push back from staff.  

There was a lot of changes in the first few months as Shane and I really wanted to implement this stuff sooner rather than later.

It led to one practitioner moving on as they could not embrace any of the changes and this was a really bitter pill to swallow.  

He was consistently >90% utilised but was not the ideal fit for the culture we were trying to establish.

What Results Have You Achieved With The Business Academy?

You’ll see some real figures below…

What you need to know is that the comparison spans between October 2017 – May 2018 (~9m)

Remember, Skye runs an Osteopathy clinic and your numbers are likely to be different if you are in another industry.

Over that period, these numbers reflect how Skye has been able to engage and align her team, with the help of Clinic Mastery to be able to implement many of the (64+) practical systems (we give you in the business academy) to create a sustainable business.

You’ll also need to appreciate that these are sustained average numbers over a 9m period.

Monthly Revenue

  • Increase Sept (mth prior to signing up) revenue = $81K. May revenue just under $126K

  • Key system (s) we implemented to help create this change:

    • Putting culture first

    • Induction process – we were hiring new staff early on and so on-boarded them with clear expectations, clear job descriptions and outlined KPIs that would be managed

    • Focused on exceptional client experience (drink/food station, cliniko template management plans)

    • Appropriate rebooking done by practitioner in the treatment room

    • Transparent KPIs across the team so everyone can see how they’re performing compared to the rest of the team

    • Regular clinic meetings and 1:1 meetings – accountability

    • Cliniqapps reactivations

    • Rewarded performance.  Admin staff were filling the books of the quiet practitioners preferentially.  A team meeting was called and explained to the team that a smaller PVA meant that effectively a lazy practitioner could benefit from the hard work of others by picking up the overflow of their reputation and their NP referrals.  We agreed to reward star performance by identifying the outstanding performance each week. We directed admin to fill the star performers appt books preferentially. This was a lightbulb moment with significant immediate impact. We stopped this with the onboarding of 3 practitioners with a combined 12/12 experience but will become a focus again soon

    • Unwound Pilates, mobilised reno team, decommissioned gym/pilates and added consult room and admin office

    • Added Saturday appointments

    • Re-employed our Digital Marketing Expert with greater engagement

    • Drift chat on website

    • Updated web page photos

    • Added 3D tour and videos

    • Added welcome video to home page

    • Made our online business presence more about our employees and less about us

Monthly New Clients

  • Increase from Sept 2017 (prior to signing up) = 107 per month to 131 May 2018

  • Key system (s) we implemented to help create this change:

    • Enforcing the need for management plans

    • Social media presence – regular posting on FB and insta

    • Referral Network Teams Collaboration

    • Facebook Ads Campaign

Monthly Appointment Numbers

  • Sept 2017 (prior to CM) = 1007 monthly appts, May 2018 = 1428 monthly appts  

  • Key system (s) we implemented to help create this change:

    • Introducing management plans

    • Follow up calls from admin and practitioners

    • Increasing networking, including presentations to the other health care professional and gymnasiums

    • Reactivation and support contact by utilising Cliniqapps

Patient Visit Average

  • Sept 2017 (prior to CM) = 13.3, May 2018 = 13.6 however we employed 3 new grads only 4 months ago and have included their figures which skews us down.  To maintain the clinic PVA, let alone grow the clinic PVA, with the addition of 3 osteos with a combined 12 months experience provides great satisfaction.  A Shane Davis warm & fuzzies every day of the week

  • Key system (s) we implemented to help create this change:

    • Using slicker management plans through Cliniko

    • Follow up calls within 3 days to all New patients

    • Weekly 1:1s on top of weekly PD with our new practitioners to accelerate their learning, confidence and creating better care and health outcomes for clients

    • Belief/Mindset/Goal setting and identification.  Ownership of performance. Earl Nightingale Strangest Secret and other similar content.  If cannot achieve PVA, why not? If cannot achieve utilisation percentage, why not? Identify roadblocks, obstacles and aim to break them down

Average Revenue Per Client

  • Increase from approx $80 to $85

  • Key system (s) we implemented to help create this change:

    • Have implemented scheduled price increase bi-annually

    • Removed low value, low compliance, high traffic pilates clientele with increased osteo clientele

    • DNA procedure

More Freedom

  • Clinical hours have halved from approx 14 to 6 (Shane’s consulting time has also almost halved)

    • Im working 25 hr on the business each week

  • Key system(s) we implemented to help create this change:

    • Hired more like-minded practitioners with clearly defined expectations

    • Big focus on team member 1:1 meetings and Professional Development to ensure same quality throughout the clinic

What Other Changes Have You Experienced in Your Clinic?

Our business finished in the top 25% of all businesses that entered the 2018 Telstra Business Awards.

This is a huge result for us, we entered on a whim of “why not?” and viewed the exercise as a learning experience.

We went conservative with our numbers as our application was last minute and rushed. Next year?

  • We’ve added new Team Members

    • We employed 3 more Osteopaths

    • We employed 1 extra Admin Team Members

    • We sacked our accountants

    • We removed Ex Phys & Pilates

 

  • We’ve transitioned to better Operating Systems

    • Using existing software better.  

      • Xero now has budgets and forecasts with purpose built P&L sheets separating info out in to logical groupings to easily track percentage of revenue spend

    • Using Cliniko reports to generate relevant KPI dashboards

    • From nothing or texting on my phone to cloud based client communication system Cliniq Apps

    • From written to-do lists, to Asana Project Management Software

    • We use weekly, monthly and quarterly dashboards to monitor practitioner and clinic performance

    • Slack

    • G-suite replaced MS Office

 

  • We are much more Structured in our Growth

    • All of my plans used to be in losely in my head, now we have a clear structure because we have created detailed 90 day and 12 month plans.

    • We are regularly marketing to our database

    • Spreadsheets and graphs forecasting when targets should be hit, new staff employed and the timetableing of rooms to maximise utilisation.  

    • A clear pathway from graduate employee osteopath to senior osteopath over 4 years detailing wage growth commensurate with experience and targets has been established.

 

  • We are more delivering a better Client Experience

    • We have a written and clarity on the touch points in our new clients journey

    • We survey our clients using the NPS to find out how their experience was after their first visit and subsequent visits going forward

    • We offer chilled water, glasses (not plastic cups), fresh fruit

    • We have defined our consult structure, using scripts to help practitioners run on time and deliver a high quality, consistent service experience

 

  • We’re getting paid what we’re worth because we Add More Value

    • We have decreased the amount of discounted consults overall

    • We have increased our consult fees

    • We have a fee adjustment strategy that is sustainable and profitable

 

  • We are transforming our Team Culture by;

    • We’re still improving, however, our team now have helped craft our core purpose and values.

    • We regularly celebrate our team wins

  • We have structured team meetings, reviews and social catch ups that align our teams personal/professional goals with the business objectives

    • We have weekly team meetings, monthly team check-ins and quarterly performance reviews

    • We have a structured team induction training

 

  • We are Marketing better by;

    • We have clearly defined our ideal client and we are consistently marketing to them

    • We measure the effectiveness of our marketing activities to know the success of our campaigns and the total acquisition cost of a new client

    • We have a website that ranks in the top 2 of google

    • We have a Content Marketing Plan guided by Google Analytics

    • We have a client database that is up to date, segmented and use regularly to connect with our community

How Would You Describe Your Business Academy Experience

 

Virtual Classroom

  • Kajabi = Informative & Valuable

    • Loved that at any time we could easily log in and find the videos that corresponded with what we wanted to focus on at the time (We revisited modules on hiring team members when we on-boarded 3 new osteos at the start of 2018!)

 

Study Buddies

  • Coaching & Community = amazing

    • Shane was our personal coach – as well as the odd cameo from Jack regarding FB ads etc.  Shane is such great fun, something that we value highly. He needs to learn a little restraint and control of laughter at his own jokes.  Let the audience enjoy it first we say. He was always a level head in situations that sometimes, as a clinic owner, can be quite emotive.  With Shane we navigated push back from existing staff with system implementation, transition out of an experienced practitioner.  Big stuff made so much easier with Shane’s help.

    • The larger community was also great for information sharing.  To be able to put a question or query out there to other health practitioners, knowing that someone else may have done the leg work was a great time-saver, and equally made us want to readily share information that we had come across.

 

Business in a Box

  • Google site = great structure

    • We had basic policies and procedures prior to joining CM.  Having a central hub to put everything in an orderly manner made it very easy. Its still a work in progress for us but slowly but surely we’re chipping away.  We had a surprise visit from WorkSafe and the Hub was a saviour!

 

How Would You Describe Your Experience with the Clinic Mastery Team?

  • “Fabulous! Shane in particular has been super helpful and kept us accountable as well as giving us a few laughs along the way!  CM have played a huge role in the success and growth of our clinic.“

What Advice Do You Have For a Clinic Owner Contemplating the Business Academy?

  1. Definitely worth the investment if you are prepared to change.  You will make your money back and then some!!

Applications for the next Business Academy enrolment are now open (only 4 per year), claim your strategy session now to see if we have what you need and find out if you’d be a good fit.

Conclusion

So, the question i have for you is this, do you want to grow your clinic?!

Unfortunately, you don’t get any extra rewards for doing it yourself…

If you want to take control of your clinic growth, just like Skye, you might as well take advantage of the entire done-for-you systems, policies, procedures and structures we’ve created and use in our clinics today…

There is no need to re-invent the wheel!

If you’re serious about taking the next step, then we should talk. If you’re on the fence, this is not for you. Just like Skye said, you have to immerse yourself to get the best results.