In this episode, Brad and Michael are joined by medical practice management consultants Amy Anderson and Mara Shorr of BrinsonAnderson Consulting. Tune in as they share practical tips to optimize your practice and support ongoing growth. Learn about the importance of establishing solid processes, effective lead management, and adapting to industry changes. They also discuss the impact of culture on a practice’s growth and how to maintain a strong foundation amid expansion. Listen for valuable insights on building and growing a successful medical practice in today’s competitive landscape.
Listen to the full episode using the player below, or by visiting one of the links below. If you have any questions or would like to learn more, email us at info@byrdadatto.com.
Transcript
*The below transcript has been edited for readability.
Intro: [00:00:00] Welcome to Legal 123s with ByrdAdatto. Legal issues simplified through real client stories and real world experiences, creating simplicity in 3, 2, 1.
Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host Brad Adatto with my co-host Michael Byrd.
Michael: Thanks, Brad. As a business and health care law firm, we meet a lot of interesting people and learn their amazing stories. This season we are talking about businesses who decide to double down on their business. They’re going to scale their business. Our theme this season is Growing a Business.
Brad: And Michael, for those that know growing a business is just a season. What are the four seasons?
Michael: Yeah. So we have kind of walked that journey this year. We have the starting a business, then we have the operating a business, and now we’re growing a business, and then we will end this year with buying and selling a business.
Brad: Oh man. That sounds like fun. And I’m excited. We have guests [00:01:00] today, yes, we have two of them.
Michael: Yes. Our guests today are our friends. We’ve been working with them for probably a little over a decade now it feels like.
Brad: Yeah, time flies when you’re having fun. Yeah. But before we bring them on today, I was wondering if I could get paid more right now since I’m really feeling like I’m crushing it today.
Michael: No.
Brad: Well, that was real direct. What if I told you I was working off hours, could I get paid more?
Michael: No, you are making fun of me today, so you’re not getting paid anything more. No matter how you ask you’re not getting more, but why are you asking me this?
Brad: Well, I was reading an article about a fast food chain, Wendy’s, was thinking about adding dynamic pricing, which is like Uber-like surge pricing for the menu at certain times of the day.
Michael: So now I understand where you’re going, and I have a counterpoint for you. You do realize that if you instituted surge pricing for your compensation, that you’d get paid less all the other times you weren’t working.
Brad: Sir, I am [00:02:00] always working. Even when I’m not working I am working.
Michael: Spoken like a true lawyer. So tell me more about Wendy’s. What’s going on there?
Brad: Yeah, so Wendy’s is planning to spend about $20 million through the end of 2025 to install digital menu boards all over the US locations. And that will help facilitate surge pricing during busy periods like lunch hours. And I know we both have used Uber and other ride shares and have been shocked about some of these price surges.
Michael: The ride hailing apps and the ticketing companies like Live Nation have all caught flack in the news for introducing these markups to their price during certain hot times. But other than this customer pushback, I think, the report shot of that, these companies are continuing to thrive and even dominate their fields. I think we may be stuck with it.
Brad: Well, right. And if Wendy’s adopts this price surging it could spread across to these other fast food chains [00:03:00] and restaurants, but we might start seeing more of these digital marking and options. I guess it started getting ready for that because I think it’s going to creep into other things. And obviously, like you said earlier, it’s already crept into like bowling or finding the good seat at the movie theater. But do you recall a time when there was a surge price that was so high that you tried to use another app, or you didn’t use the service at all?
Michael: Well, the first time I ever experienced it, I remember it clearly because I was at a Dallas Mavericks game, pre-Covid and wanted to Uber home. I was stunned at the price that showed up. And so I ended up waiting and this was back in the day, Brad, so I went to the bar next door…
Brad: Audience members, that meant he went to go drink more.
Michael: And so, that was the first time I became aware of this. I think the answer of why people are willing to do it is, something happened during Covid, like pre-Covid, this isn’t surge pricing, but I would never do like DoorDash [00:04:00] and all that stuff because I was like, I’m not paying $20 for Chick-fil-A and then something happened during Covid where you just like, give up and you just accept it. And I think that’s why we’re about to pay a premium if we want Wendy’s lunchtime.
Brad: Yeah. I think for me, it’s funny, I can remember and I can’t remember if it was with you or with my cousin, but I was in Chicago at a Cubs game. The Cubs game let out and I started trying to find an Uber to get back to my hotel. It was the same thing where I was like, holy moly, this is so high, and someone goes, it was my cousin, he goes, “Yeah, you got to walk five blocks.” I go, “what do you mean?” He goes, “If you walk five blocks, the prices change because you’re outside of the zone. So we ended up walking like five blocks away and then we looked it up again and it was completely different, like drastically different just by walking five blocks from it. So, interesting times out there.
Michael: Okay. Well just plan ahead when you want your next frosty. [00:05:00] Let’s bring our guests on. So joining us today are our friends, Amy Anderson and Mara Shorr with BrinsonAnderson Consulting. [00:09:00] I’ll do a little intro for both of them. They both have been on our podcast before but not together. Amy is one of the lucky few who found her calling at 18 when she started to work part-time in a plastic surgeon’s office as a pre-med student. In the 20 plus years since Amy has worn virtually every hat at a medical practice, and so she intimately understands the business side of a practice. She, from a school perspective, earned her bachelor’s in MBA from Indiana University. Moving on to Mara, Mara’s a seasoned professional when it comes to aesthetic practice management. She has spent nearly 15 years guiding practices across North America toward [00:06:00] their strongest operational, administrative and financial health. Mara graduated from Central Michigan University where she studied journalism, public relations and advertising. And she also worked for the student newspaper. And like I said, they’ve joined us before, but not together. And we’re so excited to have you. Welcome guys!
Amy: Hello.
Mara: I forgot that that’s in there. I need to take a look at my bio – the student newspaper? It might be time to take that out, but maybe not. I don’t know.
Brad: I mean, I think it’s important that you were their writer. Did you have like a little hat that you wore when you were working at the student newspaper?
Mara: You know, I don’t know that I did, but maybe instead of taking that out, I’ll add in there my blue ribbon from milk carton balancing during field day in middle school. So maybe instead of removing, I’ll just add to it.
Michael: Double down. Brad talks about my typing skills still all the time from high school.
Mara: Amy, can I add that in?
Amy: Sure.
Mara: [00:07:00] On the website?
Amy: I think almost every day, Mara and I find something else we share in common. So I was actually editor in chief of the student newspaper in high school. So there we go.
Mara: Me too. I was too.
Brad: Now we’re getting the dets, people. Well, I guess, you know –
Mara: In case you want in a consultant.
Brad: Exactly. And I guess before we really jump in there, I’m going to hit you with a, a very important question. Have either one of you ever been a victim of that surge pricing? And if so, what did you do?
Mara: Absolutely. And I’m about to fly into the Chicago airport today and take a ride share of whichever brand, and I really hope I don’t hit it tonight. We’re not even putting that into the universe, but Amy –
Amy: You know what, if I can just dive in here. As you were talking about the surge pricing with Wendy’s, I had to think, it’s not all that different than what we do sometimes in plastic surgery and aesthetics. [00:08:00] We’re increasing our charges, but we often talk, like right now at summer, surgery schedules tend to be a little bit slower. And so it’s when we might lower our prices, offer special pricing for a limited time. So, when I think about it that way, I’m not that mad. I’m mad about it because I don’t want to pay more for my frosty. Do you understand it from a business perspective? And for me, I think it’s less about increasing the charge during the busy time. It’s more about maybe having special pricing during a less busy time of day.
Brad: Like happy hours…I mean, so I heard. Well, that’s such an interesting point right there. Yeah.
Michael: And I’m thankful that you brought us out of our banter and back into reality. Thank you. So why don’t we – I’d love to hear a little bit from both of you, kind of talk a little bit about BrinsonAnderson Consulting and [00:09:00] kind of how you guys work together.
Amy: Absolutely. So I co-founded BrinsonAnderson back in 2020 with my business partner, Cheyenne Brinson. Both of us had worked in practice management consulting for a decade or more at that time. Our focus is really on working with private practices and specifically surgeons. So part of our firm works closely with orthopedic surgeons and otolaryngologists, ENT docs, and kind of the other half of us is very focused on plastic surgery and aesthetics, and that’s the end that Mara and I team up on. And so Mara joined us last year, and if you can’t tell already, it’s kind of a match made in heaven. We’ve known each other professionally for quite a while. And just the stars aligned and it really made sense for us to align forces and start working together, and [00:10:00] we’re quite happy about that.
Mara: We really are.
Brad: That’s awesome. Well, as you guys had heard in the beginning, this season we’re really focused on growing a business. Talk to us about how you help your clients scale their businesses.
Mara: Sure. I would say we fit in beautifully at the other stages as well as far as launching a practice. I can’t tell you how many new practice startups we’ve done this year and just this year alone, but obviously for the past few years. But the beautiful part is that once we help the practice launch, we continue to stay with that practice and we continue to help them run the practice and scale the practice and grow the practice. And so for us, what we see is that just because that initial checklist of the doors are open, just because those boxes are checked doesn’t mean that, okay, smooth sailing from here.. And so, we help them establish processes and protocols [00:11:00] and look at their KPIs, both establishing their KPIs and then helping them really, not just establish them, but helping them conquer them as well, and helping them help their team to conquer them. So, we work very closely with the majority of the staff/team as well.
Michael: Brad’s not very smart, so could you tell him what a KPI is?
Mara: Oh, Brad.
Brad: Is that a football team, a basketball team?
Mara: Oh, here we go again.
Brad: Keeping people informed, is that what KPI is?
Mara: For my journalism background, I’d go with that. But for us, and I have to say, we do, do a lot of keeping people informed through all the different communication channels with our clients, but “Key Performance Indicators”.
Brad: Oh, thank you.
Michael: Awesome.
Mara: I got you, Brad. I got you.
Brad: And Amy, did you have anything to add to that?
Amy: Yeah, I think just to tag onto what Mara said, I mean, we love a good process. [00:12:00] So we are all about looking at processes in a practice. Like what she said, it’s one thing to get the doors open. It’s quite another to really create a fine tuned machine and to get protocols in place so that you can grow. And growth could be additional services being offered. It could be adding more staff, it could be additional locations. It goes in a lot of different directions, but it has to start with a very solid foundation. We really look at workflows that make sense when the practice is small, and then looking at what needs to adapt and change as we add additional services or locations to the practice. So that foundation is so core, and I would be remiss if I didn’t also talk about the culture, such a big, big piece of it. And so, it’s kind of the part we don’t maybe broadcast or talk about a lot, but with all of this, starting a practice, growing [00:13:00] a practice, we should label ourselves consultants/part-time therapist, or unlicensed therapist maybe, because there’s a lot of handholding and just emotional support that goes into growing a practice. There’s a lot of things that come your way and we’re there to help them just deal with those challenges and struggles.
Brad: Great points.
Mara: And I will say too, just to tag onto all of what we’ve said is that it really should be noted that what your practice looks like at day one is not what your practice will look like six months in or one year in. And what it looks like at one year in is not what it looks like at three years in, which isn’t what it looks like at five or 10 years in. And so, not just keeping up with what’s going on in the rest of the world, but the growth. And if you’re running a practice the same way that you did on day one, and not keeping up with, whether that’s rules and regulations and changes in the industry, or just the growth [00:14:00] model, then you’re really going to do a disservice to yourself and it’s going to become just exponentially more difficult within your practice on all aspects.
Michael: Yeah. So I have a double click, and I’ll play consultant for a second, at least my perception, so don’t yeah.
Mara: Michael, I’m not allowed to play lawyer, so you’re not allowed to play consultant.
Michael: I’m not a consultant, but – so I just want to get a little bit more clarity on the processes that you guys help with. So I think of processes like you have your clinical processes that are the this is how we’re going to do the various treatments and the standards that on how procedures are delegated. And then you might have employment processes like handbooks and this is how our team is going to behave. And then, maybe generically operational processes of this is how we do things to run the business. Where are the areas that you guys focus [00:15:00] out of that kind of menu? And if I miss something, please add, because I’m not actually a consultant.
Amy: Well, you identified several of them. I think probably a great example that we’ve focused on a lot lately is the whole leads management and aesthetics. So this is that whole timeframe from when somebody out there raises their hand and says, I’m interested in the services you provide, whether that’s, they filled out the contact form on your website, they called the office, perhaps there’s an opportunity to text the office, but what are we doing with that lead? And so, we’re really honing into how quickly is the team responding. What is the quality of the response if we actually get that person on the phone? Are we engaging them, asking really good, meaningful questions to not just, the goal we say is not just to schedule the appointment. It’s to start the relationship. And it’s really to start building rapport. And then of [00:16:00] course there’s the people who filled in the, the web form at 11:00 PM when they’re scrolling on their couch and they don’t answer when you call them in the morning.
So what’s our follow up cadence? How many times are we reaching out? Are we using multiple channels, phone, text, email, to reach them? So, I bring that up because leads is such a hot topic and almost every practice can improve what they’re doing. And this kind of falls into, we talk about let’s work smarter and not harder. The goal is we don’t need to keep throwing money at Google Ads to get more and more leads. Most of the time, if we just do a better job with the leads that are coming in, we’re going to see more consultations and better qualified consultations that are more likely to book surgery or book treatment. And then I think tying into that, Mara has been doing a lot of teaching of patient coordinators kind of that next stage of what [00:17:00] happens from the consultation to the book surgery. Do you want to talk about that a little bit, Mara?
Mara: Yeah. So I think that that is such a really a process that’s missed and not really well established. We talk about once that lead lands and that lead turns into an appointment, then we look at what is that process and protocol? How are we screening for external medical factors, right? So how are we making sure that that patient is a candidate for that particular procedure? And what kind of conversations are we having with that patient prior to them coming in for their consult? We then really look at, once they come in for their consult, what is the flow? Because we want that to be a really well-oiled machine, from the time that that patient walks through the door, who is greeting them? Who is checking them in? What does the check-in process look like? Who is guiding them back and rooming the patient? When is their before photo taken? What do [00:18:00] the consents look like? And making sure that the consents are all consents that would be blessed by actual lawyers. So, we want to make sure that that’s the factor as well.
And then we look at what does that entire flow look like for the consult, and not just when the consult happens, but how are we getting that patient on the books for their surgery? And then what does that process look like? Because we have seen what happens when it goes wrong. And I will say that Amy and I, on any given day could say, here is what is today as of this very moment, the most beautifully laid out plan and process. And then we will go into a practice and realize that there’s been two key steps that have been missed that we thought maybe were common sense.
Amy: Yeah. We thought that those were common sense and realized that maybe to us who have been doing this for a combined, I don’t know how many decades, they’re common sense, but to somebody that is brand new to a practice [00:19:00] and running their own practice and running their own bus business, it’s not something that they knew right off the bat. And we may have neglected to tell them IE, making sure that the person that is taking a patient home after their surgery needs to be a responsible adult with a valid driver’s license. An adult means that they are 18 years of age or older with a valid driver’s license that you have met prior to surgery. They come in, they physically come in and pick the patient up. After the procedure, they have signed all the paperwork, not just that they’ve signed the paperwork, but that you have a copy of the signed paperwork. I know that maybe this sounds obvious, but it isn’t always obvious, because I’ve seen paperwork walk out the door. I’ve seen someone’s teenager drive their parent home after a surgical procedure. I’ve seen a patient think that they will fool us and get in that car and drive themselves home. And we run into some very [00:20:00] uncomfortable conversations. That run into very quick texts to Brad and or Michael.
Brad: Well, I mean, all really good points. And hopefully our audience is realizing those details do matter. So now that you’ve established that these protocols and processes are really important, what are some of the struggles that you typically see with your clients when they’re ready to start scaling then?
Michael: And when you say that you’re talking like either adding a location or adding a service line or some other?
Mara: I would say that the number one that I see is that they think that because they’ve gotten it down to a science with one location, and that team at that one location is like coming along, and it is being done beautifully, but everything is – it’s historical knowledge at that point, right? So everything is in that current team’s head. So when you go to open that new location, it feels like starting from scratch, and there is no process and protocol or like SOP [00:21:00] standard operating procedure. There’s no manual that we’re able to give that next team. And so, it remains in that first team’s head, right? And I’ve said before, “Okay, well tell me about the wait list.” So I’ve had somebody that’s been in an office for years in the reception position say, “Oh, well it’s… I keep it in my head. I just know.” But what happens when that person is out sick for the day? Or if they win the lottery and they leave, then the wait list just walked out the door with them.
So I think if you, I wouldn’t even say if you’re planning to scale on a larger level, but if you plan on getting to be any bigger than like two people at your office, and even if you just plan on being those two people, have all of your processes and protocols of things that you do day in and day out, keep them somewhere. Either keep it in an internal YouTube drive where as long as there’s not HIPAA data in there, but where somebody’s able to see a three minute video here, a five minute video here, [00:22:00] keep everything documented as well so that we’re able to pull these virtual documents out. I don’t think you need to have everything printed out because things change so quickly. But start by creating a process for everything you do, including who turns on the TV in the reception area and whose job it is to make sure that the Keurig coffee maker and the reception area is filled.
Brad: That’s Michael’s job, by the way. He turns the TV on and he has to make the coffee in the morning.
Mara: Oh, see. When Amy and I travel, we share that duty. It’s part of a healthy relationship. What can I say?
Brad: Amy, what are your thoughts?
Amy: I would say to add into that, like Mara said, it’s not just making sure we have it out of that person’s head, but that person is probably not going to stay with your business for a long time. And so I think one of the biggest challenges is, it really truly is staffing. It’s turnover of your current staff and or finding good quality people to add to [00:23:00] your team to help you grow. I didn’t set out to really offer HR services, and yet somehow we probably spend 70% of our time on HR issues, because your business is nothing if you don’t have good people. And so because of that, we get heavily involved in the hiring process. I say involved, we lead the entire hiring process for most of our clients, doing those initial screening interviews and finding good candidates because it’s so much more than just a skillset. It’s hiring a person, a personality, a work ethic all of those things that go into it. And so I think most of the surgeons we work with, and med spas would say the hardest part of it that they never expected was managing people. And I don’t want to be doom and gloom. We work with some amazing practices that have been very intentional, built of [00:24:00] great culture, have a very solid team, but it’s not easy, and it doesn’t just happen. It absolutely takes time and intention and focus to get your team there.
Michael: We’re kind of on the, the wrap up. So this’ll be a little bit of a speed round. And you may have covered this, and if you have something different to add, I’d love to hear, but talk about some lessons you guys have learned, kind of helping through clients grow their business over the years. And we have probably a minute or so left. So speed round.
Mara: Amy, you first.
Amy: I was just going to say, I mean, change is hard. Be prepared for it. Staff really need to be walked through it. You joked earlier, keep people informed. I actually kind of love it, because as you’re implementing a new change, whether it’s adding a service, that’s probably the easiest thing to do. Adding a service to your practice, it’s communicating it multiple times in multiple ways. People don’t [00:25:00] hear it always the first time, so we need to talk about it regularly, give written instructions be very, very focused on communicating changes to your team. You cannot over communicate.
Michael: Awesome.
Mara: Can I include a tip that I learned.
Michael: Yes, absolutely.
Mara: Okay. So tagging onto what Amy has said about change is hard and communicating. One of the tips that I give every practice that I set foot in, either literally or virtually, keep in contact with your tech vendors. So everything from your phone system, if you have a separate texting system, your EMR, your photo software, every single piece of technology that you have, request a meeting maybe 30, no more than 45 minutes once a quarter and have them walk you through any changes in the technology. Because there are changes are constant, you are going to miss the updates that come out. You’re just inevitably going to, even if they send you 52 emails in the meantime. And the technology that you’re already [00:26:00] paying for is going to help your practice regress and keep up with the times. And it’s going to keep you from spending additional money to do additional things. It’s going to help you move faster and harder. So I really say – and you’re going to have to proactively request that; they’re not just going to come to you typically and ask you for it, but it’s so important. Have one person on your team that that’s their role, and that we add that to a job description is quarterly updates.
Michael: Amazing.
Brad: And you can use my KPI, keeping people informed, because that’s what you just said. You may use it all the time now. Just hashtag, thank you Brad Adatto.
Michael: Yeah. Well, with that, we have reached the end of our episode. It’s been so awesome having you both on here. What we’ll do is go into a commercial and on the other side do a little quick legal wrap up. Thank you, guys.
Brad: Thanks y’all. Thanks
Mara: Thanks for having us.
Amy: Thank you.
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Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host Brad Adatto. I’m still here with my co-host, Michael Byrd. Now, Michael, this season, our theme is Growing a Business, and we are scaling and we had two rock stars on with us, Amy and Mara. They had a lot of amazing aspects about scaling. And one of the things I was thinking about while they were talking about the processes is, leads are huge, right? Especially in the aesthetic world. And a lot of people have a whole process they build about how they onboard [00:28:00] a potential patient, but then they start getting confused. There’s a good faith exam and part of it. Can you kind of talk about the difference between the tire kicker part and then the good faith exam?
Michael: It’s a great question. And Kennedy, strike that so Brad doesn’t hear it. And one we get, it can be really confusing. And what it really comes down to, I think is, is there a physician patient relationship established at that point? Because if so, a lot of things start happening, like the good faith exam. And the reason it gets confusing is you have leads coming in through social media, coming in through website and at that moment in time, it is ,what are your obligations? And really, it’s just to intake it. They’re not a patient yet. And so, there is a lot more flexibility on what you can do up until the moment in time where it’s time to start [00:29:00] rendering care. And that starts with the good faith exam, and that’s the physical examination of the patient by the doctor sometimes over Zoom or they have the patient history and all the processes in place.
Brad: So, final thoughts, Michael?
Michael: You’ve got me stumped for the first time. I don’t have a final thought.
Brad: My final thought was that I thought Amy had a good point that even with the windy surge pricing, there could be surge pricing in your business, but take it from that perspective is that, as your business slows down, maybe you have nice discounts and other things like that. Well, that was awesome, Michael. Guess what, audience? We’ll be back next Wednesday with a super rockstar, a physician, Sacha Obaid will be joining us and really talking about how to scale a medical practice. Thanks again for joining us today. And remember, if you like this episode, please subscribe, make sure to give us a five star rating and share with your friends. [00:30:00]
Michael: You can also sign up for the ByrdAdatto newsletter by going to our website byrdadatto.com.
Outro: ByrdAdatto is providing this podcast as a public service. This podcast is for educational purposes only. This podcast does not constitute legal advice, nor does it establish an attorney-client relationship. Reference to any specific product or entity does not constitute an endorsement or recommendation by ByrdAdatto. The views expressed by guests are their own, and their appearance on the program does not imply an endorsement of them or any entity they represent. Please consult with an attorney on your legal issues.
