Academy of Doctors of Audiology

Author: Jennifer Gryska, Au.D.

Do you have what it takes? There have been lots of articles and lectures on “what you need to know to go into private practice,” but how do you really know that you have what it takes? Why do two equally knowledgeable people open offices, one is very successful while the other struggles? We often only look at what money it takes or the ‘knowledge’ we need to open an office, but what about the characteristics—the entrepreneur aspect of owning a business?

Most of us recognize that we need to be able to raise start-up capital, create a business plan and plan for taxes, operations and billing. However, these are not the main or only reasons why a clinic will be successful or not. What we are talking about is the entrepreneur mindset of a business owner.

The phrase ‘going into private practice’ may invoke thoughts of doing exactly what you are currently doing only doing it in your own clinic. There is a big misconception about what it is like to be a business owner. Anyone who has owned their own business knows that the clinic portion of their business becomes only a part of what they do, think and dream about. As a consultant for Audiologists Helping Audiologists, I find myself spending a significant amount of time trying to get audiologists to ‘think outside the box,’ which in our case means to ‘Think outside the CLINIC’.

We must squash the common, Scarlett O’Hara management mentality that fosters an ‘I’ll worry about it tomorrow’ way of thinking. The truth is that we need to address the uncomfortable questions about or capabilities before taking the plunge into private practice. We spend so much time trying to present ourselves as medical professionals that we often end up hurting ourselves by brushing aside necessary personal business skills. Many audiologists also inaccurately equate possessing a strong business acumen to being perceived as a ‘used car salesman,’ and spend little time talking about or cultivating those skills.

It is important to ask some key questions before committing to private practice ownership—questions that you can use to identify your strengths and weaknesses. Here’s the trick, you have to be honest and don’t feel bad if you don’t ace all of them. Like all preparations, these are here to point out areas of which you might need to get some advice or training.

How do you handle stress? Do you feel the need for control all of the time?

Take a minute and think of a couple of examples of stressful situations you have encountered. On a scale of 1-10, how stressful was it? Now think about how you think you handled it. The past is a nasty truth-teller of whether we confront, internalize, lash out or choose any other way to handle stress. Remember to include uncomfortable confrontations, money and managing situations. This is something that is very important not to breeze over. Remember that BELIEVING you can handle stress isn’t as good of a predictor as looking at your track record.

I know, the next thing usually said is that the past is the past and when the time comes, you will handle things better. The question is, do you know how? Now here is the kicker, (and you have to do this if you are serious) ask someone who was close to you during the stressful times how they saw you handle and react to the stress. Tell them to be honest, even if it hurts a little. Owning a business is probably not going to be the most stressful situation in your life (at least it shouldn’t be). However, it does result in some daily stress that can build over time. Look at your track record and see if it is an area where you may need advice. If you don’t feel that you have ever experienced a really stressful situation- that is not a good thing in this context. Having little to no experience with stress makes you less able to determine how you might handle it.

Are you totally responsible and can you handle accountability (legally too)? Whether we like it or not, it is ultimately your responsibility to oversee all aspects of your business. I recognize that this is almost impossible on a daily basis, which is why knowing how to find the answers can be just as important. The key is that you have to be tough enough to be the place where the buck stops when it comes to oversight. Have you ever had to stand up and take responsibility for the actions of another? When something bad happens, do you look to blame others? Remember that even if it was the receptionist who forgot to call a patient (or any similar situation), ultimately it is your business and you have to be the one to take responsibility to the patient. The same is true with taxes and other legal requirements as well as vendor and employee relationships To take this one step further, you must be prepared for every situation- even the bad ones. Having a plan and a script for both positive and negative situations, this will greatly lower your stress.

Architect- can you (or have you ever) create, change, and adjust the business model to design where you want your company to go in 6, 12, 24 months or longer? An example of this would be designing the future of your business in terms of numbers of employees, pay, bundling vs unbundling etc. Even if you haven’t before now, do you think this way? Are you constantly planning?

Engineer-can you (or have you ever) improve, create and implement systems and processes, efficiently? Some examples would be to create an efficient scheduling system without bumping into people or sharing equipment in different rooms. Have you ever trained anyone? Can you tell the difference between frivolous complaints and a real need? It is your job as owner to address the components of the systems and processes of how the business is run. Most business owners have little experience in this area, but having an engineer mindset makes some a natural at this. If you don’t have this mindset, get assistance.

Coach- It is your job to work with employees to encourage the best outcomes, develop talent and recognize needs. It can be difficult to hire and fire, but there is also a definite middle ground where employees require coaching. Sometimes, someone has a talent that can be used elsewhere in the office, or has an interest in doing more than what they are currently doing. This can be a great thing or a real challenge. Learning how to interact positively with employees is crucial in keeping a productive office. What experience do you have? How did you do? This is another great time to ask someone that was around to see how you were perceived.

Player-It’s amazing how so many of us get a complex about coming to the front office and pitching in and helping with a task or project. Knowing all jobs is essential to be an effective leader. Do you have a reputation for this? Ask around. Educator- It’s your job to keep your business, employees, products/services and all aspects of of the business updated. I know this sounds overwhelming, but the point is that you have to have the innate quality of leading and managing. You have to want to be the educator, not the follower.

4. Do You Love What You Do and Are You Good At It?

You must have drive. Successful business owners don’t concentrate on a personal encounter or daily clinical procedures as much as loving the aspect of business ownership! Believe it or not, the clinic is the easy part of the business. You have to work and love the expansions, designs marketing etc. of the business. Can you talk for hours about the business of Audiology? Can you go beyond worrying about daily patient issues and concentrate on the bigger picture? This is a key component of becoming a successful business owner versus a clinician that owns her own practice.

5. Do You Play Well with Others?

This last question usually hits a nerve. How are your current relationships? The reason this is so important is because this has wounded many businesses (some mortally). You will need support, away from the office from family and/or friends. Owners need someone to bounce ideas off of, laugh at funny things at the office etc. Remember, you can’t do this with staff! Small offices make it tough to not be friends outside the office. But you have to remember that when times get tough, it is you that has to lay down the law.

Another aspect of this uncomfortable question is, “How you get along with others?” This directly effects the office mojo on a daily basis. Look at your life. Ask someone close. Don’t ‘Scarlett O’Hara’ this either. What kind of relationships do you have? The last aspect of this reflects you as a sales person. Yes, you are a sales person whether you like it or not. When you alone are responsible for hitting your bottom line each month, things change. Typically you change too. Are you comfortable in a sales position? Look into this honestly. Ask someone close to you about a time where you might have had to convince them to do something they were hesitant to do. Your track record is always the best way to predict the future. If you need advice or help, get it.

The reoccurring theme here is to go through these questions yourself, site some examples of times you have handled situations and ask someone close to you during that time how you did. This should get you thinking outside your ‘clinic box’. Oh and remember that if you are considering a business partner (of ANY sort) you need to know ALL this stuff about them too.

If you don’t feel like you have a lot of experience in a certain area or have a weakness in one of these areas, get help. (Audiologists Helping Audiologists is a great resource) The stronger you are and the more you prepare before you run into a situation, the better your response will be, and the closer you are to being ready to be a business owner.    

Dr. Jennifer Gryska is the owner and Executive Director of Smart Hearing and Balance in Overland Park, Kansas. She has been in private practice for nearly 10 years and is committed to helping other audiologists start their own practices with her franchise model. She is an active member of ADA, serving on the Professional Leadership Training Development and Practice Advisory committees. Dr. Gryska earned her Au.D. degree from A.T. Still University and her undergraduate and Master’s degrees from the University of Kansas. She can be contacted at [email protected]