Are you tired of chasing your tail?

Every day, I am beseeched with questions from doctors about things like where they should practice, how many assistants they should hire, what kind of lease they should sign, should they hire an associate and so on.

I’m always happy to help, but I ask a simple question almost every time and then I listen for the sound of crickets because that’s usually what I hear. The question is, “How does this decision fit into your business plan?

After the long awkward pause, I am usually told: “Pretty well. I mean it seems to make sense.

You see, most clinicians never develop a business plan. They come out of school and just go to practice, eager to start making some money. The idea of a plan never comes into play and they run from decision to decision like the proverbial dog chasing its tail. But, as the old adage states…

If you don’t know where you’re going, any path will take you there.

Here’s my advice for anyone, irrespective of where you are in your practice life: Go to a quiet place like a library, don’t bring your phone, and turn off wifi on your computer. Start typing (or writing) your business plan. Compose, in as much detail as you can, how you view your dream practice in 1 and 3 years from now.

What does it look like? How many chairs? What does your schedule look like? What does the decor look like? What kind of overhead do you have? How does patient flow work? How are new patients handled in terms of their experience?

Work it out to the smallest detail and do not compromise in any way. This is YOUR plan, your dream practice and you get to write whatever you want.

At first, it’ll be tough. It will take you some time to get going. Don’t stop writing, but rather, keep going no matter what’s coming out of your brain. In time your creative juices will start flowing and you simply can’t imagine how good this will turn out. The ideas of your dream practice will start getting you really excited about things to come and you’ll start picking up speed.

The first time I did this in 1996, it was 17 written pages.

Then, let it sit for about a week. Come back and revisit it and make sure that it’s correct. Fix anything you don’t agree with and then print it and bind it. Keep it somewhere you’ll always see it.

Every future decision you make needs to be measured against your plan. If it doesn’t fit into your plan, don’t do it without significant consideration and then, rewrite your plan.

If your plan is to practice in a suburban setting on lots of kids, don’t buy a practice in an urban setting where it’ll mostly be adults. If you want a small, low overhead practice to work 3 days a week, don’t buy a 2 million dollar practice with an astronomical advertising budget.  

If you want a huge practice with 2 associates, don’t buy a practice with 1500 square feet, unless your plan has a way of working it all out.  If your future life is a building, your business plan is your architectural drawing.

Now, here’s the hard part. 95% of you are going to read this post, agree and do nothing. Yep, nothing. The other 5% will actually do what I’m suggesting and take a first important step towards building the life you’ve always imagined and will understand how every decision can play a role in setting you on the right path.

For the rest of you, I’m here, ready to answer the same questions I get every day. Just be ready for my question back at you…

All the best,

If you’re not a member of our geographically exclusive OrthoPreneursRD Facebook page there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at to learn more and to see if your region is available.