Building a Solid Foundation: The Importance of Systems and Procedures in Running a Clinic

One of the biggest stressors that exist for clinicians who operate a growing clinic, is the chaos that may ensue when transitioning from being a single clinician operation - being the individual wearing all of the hats within the business, to taking off one of these hats and handing the reins over to another.

It's a common trap, a stressful trap, and an incredibly avoidable trap.

I say this from having fallen into the trap in the first years of running my (now sold) clinical practice.

From DAY 1 run your business like you're going to sell your business.

ie: Document, document, document!

As allied health practitioners progress through their careers, one of the most common progressions in private clinical practice is for a clinician to move into opening their own practice.

For many, their venture into business ownership starts out as a single-practitioner operation and they instantly move from wearing the hat of a clinician to wearing multiple hats - clinician, accountant, practice manager, marketer, and more...

For many in single clinic operations, they are able to strike the balance of wearing multiple hats and learn to balance the tasks with their clinical roles.
For others, the clinic grows and the demands of each role increases, leading to an often inevitable (and daunting) decision of making a hire.

Your first hire may be for administrative support, a clinician to share the clinical load, or something else - it will vary depending on the demands of your clinic and where you feel you personally need to share the load (there's no right or wrong answer as to what your first hire is for).

Whilst the primary focus of practitioners should (hopefully) remain as striving to provide exceptional care to their patients, it's crucial to recognise that an essential element that will ensure quality care remains as your clinic grows, is understanding the importance of developing & implementing robust systems & procedures.

No, I am not talking about cookie-cutter treatment approaches.

It's the systems that exist outside of the specific treatments we provide individual patients, based on their individual needs, that I am referring to.

This article aims to share some insights as to why many single operators may fail to document their procedures, the benefits of creating efficient systems as your clinic grows, and the significance of policies and procedures for new staff.

By understanding these principles, clinicians may lay a strong foundation for their clinic's success.

The Unrecorded Expertise 

One common reason why single operators neglect to document their procedures is that they have an intimate knowledge of their clinic's operations.
Since they are the sole practitioners responsible for every task, they often carry the information in their heads.

However, relying solely on personal expertise can become a significant obstacle as the clinic expands. Documenting procedures not only preserves crucial knowledge but also ensures consistency and reliability in the face of changing circumstances, such as staff turnover or unexpected events.

A word of warning: If you are waiting until your clinic is expanding to document your procedures, you may be adding to your stress. Often when we're at the point of needing to make a new hire, we are typically recognising this due to our capacity being somewhat stretched.

Tip: Finding a mentor early on in the piece can very much help you plan ahead, make future-based decisions and grow your clinic in a less stressful, considered way.

Embracing Growth and Focus

As clinics grow, practitioners need to shift their focus from trying to do everything themselves to strategically automating, delegating, or eliminating tasks.
By developing efficient systems and procedures, clinicians can free up their time and focus their energy on their areas of expertise and passion.

This enables them to deliver higher-quality care and improves overall clinic performance. It is crucial to recognise that relinquishing control over certain tasks is not a sign of weakness but rather a wise decision to optimise efficiency and enhance patient outcomes.

What you choose to automate, delegate or eliminate will vary depending on your interests, your goals and a myriad of other factors. Some clinicians wish to remain purely in a clinical role, therefore their hires may be in relation to practice management & administrative tasks. Others may wish to move towards more managerial tasks, therefore their hire may be bringing another clinician onboard to share the clinical load.

The Power of Policies and Procedures

When new staff members join a clinic, policies and procedures become essential tools for integrating them into the practice smoothly. It's not just about them following our way of doing things, the on-boarding process can very much impact how long your employee may remain within the organisation (more on this soon).

Poor on-boarding (or none at all!) delivers uncertainty and sets the stage for a clinic that lacks focus and is disorganised. Often a reason that contributes to low levels of work satisfaction.

Well-documented policies and guidelines establish a systematic framework for employees to follow, ensuring consistency in service delivery, quality of care, and patient safety.

Furthermore, having clear protocols in place minimises confusion, empowers employees to perform their duties effectively, and fosters a positive working environment. It also enhances accountability and facilitates continuous improvement as feedback and revisions can be incorporated into the established procedures.

Remember: we're not talking about cookie-cutter treatment protocols - patient care should always be individualised. We're talking about the operational elements of our clinical practice.

Treatment Frameworks > Protocols.

Ensuring Compliance and Standardisation

Compliance with legal, ethical, and regulatory requirements is paramount in any healthcare setting.

By implementing documented policies and procedures, clinics can establish a framework that ensures adherence to these standards. This not only protects the public from adverse or sub-standard treatment, it protects the clinic from potential legal and reputational risks, and also reinforces patient trust and confidence in the practice. Standardisation through well-defined procedures also facilitates training and allows for seamless coordination among staff members, regardless of their roles or levels of experience.

Continuous Improvement and Adaptability

The creation of systems and procedures should not be seen as a one-time task but rather an ongoing process of continuous improvement.

Clinical practice continues to evolve - as should we.

Regular audits, reviews and refinements of existing procedures, enables clinics to adapt to changing circumstances, embrace new available literature & best-practice, evolve with emerging technologies, and address any shortcomings that may exist. Encouraging staff members to provide feedback and suggest improvements cultivates a culture of collaboration and innovation, leading to enhanced patient care and overall clinic efficiency.

In Summary...

Clinicians embarking on the journey of opening and running their own clinics must recognise the significance of creating systems and procedures from the outset.

From the minute you decide to open a business, anything that you need to do more than ONCE - Document, document, document!

Documenting procedures, embracing growth and focus, and implementing policies and guidelines are essential steps for sustainable growth & success.

Ultimately, the investment of time and effort into building a solid foundation of documented policies & procedures will pay dividends as your clinic expands and evolves.

Hard Lessons Learnt

As I mentioned at the start of the article, I learnt this lesson the hard way.

Whilst there were a number of policies and procedures I developed along the way, it often came at the point when I was bringing on new staff or delegating to an external provider. Saving things until this point to develop the procedures only added to existing stressors of operating the clinic. Over time, I did get better at developing policies and procedures before it got to a crisis point many of us have experienced.

However, when it came time to sell the clinic it was very much seen favourably for the buyer having so many policies, procedures and systems in place (and staff working within the business in all roles).

The more you document, the more your clinic can develop into a turnkey business - that is, a business the new owner may only need to turn the key to unlock the front door to begin operations. Keep in mind, the level of turnkey we are able to sell will very much depend on how reliant the clinic is on the owner working IN the business versus working ON the business (more on this another time...)

As always, I'd love to hear your thoughts.

Please leave a comment or email me at [email protected]