Behind the Book: The 9 Secrets of Successful Health Practices

JESSICA:

Hi everyone and welcome. I'm Jessica, the Chief Buzz Officer here at Zanda. I'm really excited to be here with Damien Adler. Damien is a registered psychologist, business owner, and co-founder of Zanda, a practice management platform used by health professionals around the world, and he is now an author. This webinar is a chance to celebrate the launch of Damien's new book, The Nine Secrets of Successful Health Practices: learn how to create a thriving business without an MBA. It covers a lot of pain points. We'll be talking about things like burnout, systems that don't work, and how to build a practice that actually works for you and supports you. But don't worry, today is not a lecture. It's a relaxed conversation about what's working, what we've learned from others, and how this book might give you some ideas you can use right away. So let's dive in. Damien, I have a couple of questions for you, but first I'd like to dive into why this book, and why now. You've supported thousands of practitioners and run your own practice. What pushed you to finally write this?

DAMIEN:

I think we saw a lot of recurring themes. Like you said, my wife and I started a private practice, we grew it, scaled it, and sold it along the same sort of timeline. Along with my co-founder Paul, we also started Zanda and grew that. So I've been in this space for a long time. We saw recurring themes both within our own practice and talking to lots of colleagues who own their own practices, and then as we started Zanda and worked with lots of different practice owners, we kept seeing these same themes over and over again. We thought, let's try to condense what we've learned over that journey, which is 15 plus years now, into something that's actionable and really breaks down what matters when it comes to running successful practices. And hopefully give people some tips and tricks so they can learn the easy way, not always the hard way like we sometimes did.

JESSICA:

Nice. My second question to you is, what do you wish someone had told you when you were just starting out?

DAMIEN:

I think, like many things, the truth is that no one really knows what they're doing. We talk about imposter syndrome a lot these days, which I think is a good thing, but it is a real thing. A lot of people fake that they know what they're doing, but internally it's really trial and error. And it's okay to feel out of your depth when you're starting out, or to feel like other people have it more figured out than you. That's the norm, not the exception. So completely okay. If we understand that, hey, no one truly knows what they're doing, everyone is just learning, and those that appear to know what they're doing have often just been trialing and erroring for longer, then really, just have a go. Don't feel like you're the only one experiencing that.

JESSICA:

That's very true. What advice would you give to viewers today? I think it leads into your number one secret in the book.

DAMIEN:

All of them are important, I'll say that. But really it's about starting out with an idea of where you want to go, right from the beginning. We got some initial legal advice, accounting advice, and business coaching advice in the very early days of starting our practice, which really helped us frame what we wanted to do, where we wanted to go, and what we wanted it to deliver both to the community and to us personally, professionally, and financially. So I guess it's starting with the end in mind. We call it the rocking chair test, if you're later in your life and reflecting back, what would you want to be able to say about your time as a practice owner? What would that period ideally look like? What would you have achieved? When you've got that, it really shifts the way you think and allows you to make decisions that are always aligned with it. People often describe decision making as one of the hardest things to do, but when you've got a clear idea of where you want to go, it makes those decisions easier. Does this take me further towards that goal, or further away? And it's amazing how much simpler everything else becomes when you have that vision. This doesn't mean you can't change it, you start with it and modify it as you get more data and find what you like and don't like. It's not about locking in, but having some guiding principles and direction.

JESSICA:

That's great. The "end in mind" is a great mindset, I feel like even as a personal goal, it's good to think about your rocking chair moment.

DAMIEN:

Yeah, absolutely. And it applies to relationships, raising kids, sporting achievements, fitness goals, whatever it might be. If you have an idea of what you want things to look like, a lot of other decisions naturally follow. You're looking at everything through a particular lens, and that makes decision making a lot easier.

JESSICA:

I love that. Now let's move into the next topic, the tasks that really drain practitioners and clinicians. So many practitioners tell us they're drowning in admin. What is one small system that made a big difference for you, and for others as well?

DAMIEN:

Yeah, I think this is super true and most people can relate to it. Admin tasks don't just grow proportionally with the size of your practice, they grow exponentially. If you move from one practitioner to two, you might think that's just double the admin. But no, because you get an interaction effect between practitioners and all the activity that occurs, you're now managing room bookings, coordinating after-hours cover for more practitioners, and so forth. Admin tends to grow disproportionately if left unchecked, if we're not focused on it. So moving as quickly as possible toward automating things, and having the mindset of efficiency, is key. We have this concept of "once-ifying." Once-ifying means do it once, but make sure you don't have to keep repeating that same thing. It gets you efficiencies as you scale. Thinking back on our practice, the things that made the biggest difference were streamlining new bookings and onboarding processes. New patients are the lifeblood of a practice, so streamlining that is great for everyone, great for the practice, great for the patient. It helps get the admin under control because you get it organized from the start, and that makes everything else easier.

JESSICA:

And actually, I do case studies here at Zanda and interview a lot of our users. One thing that really aligns with what you're saying, one of our users, Katherine Turner, she's based out of Australia. She says, don't underestimate the power of small efficiencies. When you're on your own, having one system that does it all, calendar, communications, notes, and reports, means you can focus on the care, not just the admin. It's like once-ifying on one platform, making you more efficient.

DAMIEN:

Music to our ears, of course, that's what we're trying to build with the system. I remember once doing a live in-person presentation, and people came up afterwards from different practices making very similar observations. They were giving practical examples of how they used to do things, and then what they were doing since they'd had Zanda, and it was just so much more efficient. There's a financial side to that too, less admin overhead, but also from a headspace point of view, having things more automated just makes life a lot easier. You get less encroachment of admin work into your personal life, which is really important for people staying engaged and motivated in the health space. And I think the other thing about once-ifying is that you don't need to approach it all at once, that's overwhelming. You can just start small and do little things, and those little things add up really quickly. Think about what steals most of your time, what you don't like doing, what's really inefficient, and start there. Do it bit by bit. It doesn't need to be a big overwhelming task.

JESSICA:

She also mentioned that it grows with you. As you start small the tasks are smaller, and as you grow and bring more people into your practice, it scales with you. She noticed that with Zanda it grew with her from start to finish as she built her private practice.

DAMIEN:

Yes, and that's actually been one of our challenges as we've grown Zanda, we really do want to cater for both small practices that are relatively simple and solo practitioners all the way through to multi-location franchise practices. We have the full spectrum. We actively think about each of the different positions people are in and the types of practices they run. It's really good to hear feedback from both ends of the spectrum. Having a solo practice can be hugely rewarding and keeps things simplified. Other people want to grow and scale, so we've really focused on making sure that if you're just starting out it's easy to pick up and go, but if you want to run multiple teams, multiple locations, and multiple disciplines, you can do a lot without having to switch platforms.

JESSICA:

Awesome. Let's move on to the next question, let's talk money. I know it can feel uncomfortable, but Damien, why is financial clarity such a struggle for clinicians and what helps them change that perspective?

DAMIEN:

I think, look, if we think about where health practitioners come from, their streams of study are all focused on, and rightly so, the clinical element, the delivery of services, the patient experience, making sure that as a professional you're doing a great job, using current thinking, being evidence-based. But what that means by default is that people typically don't get into private practice with the view of being business owners as their primary driver. So sometimes it's just not a natural skill to think about money, or to think about business as a system that generates money. It does need to generate a profit to be sustainable. And then when it comes to the more detailed money conversations with patients, that's another level of awkwardness that people sometimes struggle to overcome. It takes a bit of a mindset shift to feel confident seeing your practice as something that does good in the community and provides services, but also as a business that generates more profit than it costs to run. It really does boil down to that. And what we see in education is that there isn't a lot of that built into the courses. I've done guest lecturing at universities with healthcare education sequences, and it's interesting, students who are close to going into the field often have questions about the realities of running a practice. You can tell they're hungry for that information. There's a hint there that it's probably not being taught enough in school. So in the book, we've tried to look at some common mistakes and common traps, and help people think about it in a way that leads to them achieving their financial goals, because it's important.

JESSICA:

It definitely is. My next question is, let's talk team culture, even for solo providers. What is one tip from the book that can improve that experience for practice owners?

DAMIEN:

Yeah, I think when it comes to teams, hiring the right people is really important, but how do you hire the right people? That's the real question. I think most people would say, yes, of course we want to hire the right people. But understanding who the right people are for you goes back to that idea about values, what you're trying to set up as a practice, what you want it to stand for, what values align with your own view of the world. There's a very large variety of valid views about what you want your practice to be, I'm certainly not here to preach what your values should be. But the key thing when building a team is to make sure there's alignment between that and who you're recruiting. When you get people who align with your values and how you're approaching the work, you get a very positive cycle. There's a sense of teamwork, shared goals, alignment. Those people are happier, you get a happier workplace, you can add more people who are also similar, different personalities, but aligned on the key things. You retain people for longer. Where we see issues is when there's misalignment, you get churn, dissatisfaction, and conflict of values. Often it comes down to that missing foundation. So understanding what your values are and knowing how to detect that alignment in candidates, that's why we put it in the book. That culture piece is so important. We have lots of conversations with people in Zanda because they're adding and removing practitioners, and they often talk to us about these things. We can see the themes, why someone is churning out of their practice, what led to it. It's a common theme: alignment of values makes a huge difference.

JESSICA:

I bet. Now, what helps avoid burnout when growing from a solo practice to leading others? How can you share your experience with viewers today?

DAMIEN:

I think you look at where your natural energy and enthusiasm is, what energizes you versus what drains you. If you're aligned and focused on something that is energizing and meaningful to you, it's kind of self-sustaining, giving you energy and enthusiasm. If people find their practice is getting out of control, going in directions they don't want, they're spending a lot of time on frustrating HR-type issues because some of those other foundations we've touched on aren't in place, that tends to lead to burnout. We also see that sometimes practitioners struggle with organizational skills, it comes up quite a bit that people struggle to stay on top of everything, or feel highly stressed when things aren't up to date. So getting those systems in place to reduce, automate, or delegate work really helps reduce burnout. We talk in our practice about trying to create the ideal environment, thinking back to when we were first studying, what did we dream our practice would look like? Try to make your reality as close to that as possible. It becomes energizing, a positive cycle.

JESSICA:

That's true! So to wrap up, I want to do a couple of rapid-fire reflection questions. These are ones you weren't expecting, so just go off what you can share. First, the one thing you used to overthink about in a practice. What was that?

DAMIEN:

Pricing. Yeah, pricing. Just to be transparent, we ran that practice for about 15 years and I don't think we ever truly nailed down our pricing strategy. We did some things really well, but we used to really overthink price rises. The advice, and what we learned and can see with other practices, is that there's a strategy to price rises, there should be a consistency to it. We were reluctant sometimes to increase prices even when everything told us we should. And 99% of the things we worried about with price rises never actually played out. They lived in our heads. And the other thing with pricing, you're just delaying the inevitable anyway. So don't overthink it, do it on a regular schedule, and it will be fine. One of our recent case study interviewees, Marizel from South Africa, said the worst mistake she made was comparing her pricing to other clinicians in her area. She said, everybody's different, you offer different things, never compare yourself to somebody else. Absolutely right. And there's also a race to the bottom that you see sometimes, do you really want to be competing at the lowest end of the market, cutting corners? That came up for us too. We did a fair bit of corporate and government work, picking up contracts and tenders, and if we didn't like the terms, if they were clearly inviting the bottom end of the market by opening eligibility to providers with very low qualifications or no registration requirements, we'd just not participate. And the funny thing is, very often we'd end up with that business anyway, because they'd go with the cheapest provider, the cheapest provider would turn out to be a disaster, and they'd come back to us. And now we're negotiating on our terms. So be clear about your pricing strategy, base it on the right things, look at the market but don't let it define you.

JESSICA:

Very true. My next question, favorite piece of feedback you've received from others in the industry.

DAMIEN:

I'm going to say it was about the chocolates, but I'll leave that, people can read the book to find out why the chocolates feature. The other one though, which is probably my favorite, is about correspondence with referrers. In our context, family physicians and general practitioners would refer to our practice, and we had a standardized template and format for responding, providing acknowledgment of the referral and updates. Obviously the content was different for each patient, but we had a tight, short structure. One of my favorite bits of feedback was from a referring doctor who pulled me aside and said: I really like your practice. You do this, all the information, succinctly, in a structured way. We know how to read it. It's efficient. It's predictable. We're not wading through pages of paragraphs. I really liked that because that was the intent. To get that validated in an unprompted way, the fact that I still remember it years later is a sign it was a real win.

JESSICA:

Huge win! Now, what would you say to your past self about this book?

DAMIEN:

I would hope my past self would read it and say, I can learn without making a lot of the same errors. That there was a shortcut, people would probably arrive at the same destination, but end up having to do a lot of trial and error along the way. So I think the past self would say, oh good, that saved me a lot of time, some money, and some heartache. And look, I'm not expecting every page to be a new idea, I think people will relate from their own experience to some things. But if it shifts their thinking in some small or larger ways, or they take away a few key things, I'll be happy with that.

JESSICA:

That's great. Really keying back to mindset and aligning with their goals. And the last question, do you have a secret number 10 in the book? A 10th secret that you wish had made it in?

DAMIEN:

I'm tempted to say the secret I held back is that you should always hold back something for the second book, but let's see whether people read that! Outside of that, I would say: success builds on success. With anything, it can be overwhelming when you look at something and think about where to start. If I was going to add another secret, it would be: just start with something and get a small win. That small win becomes fuel and motivation for the next thing. If you've got lots of things you think you need to change in your practice or your life, just focus on something that gives you a small win, and use that to motivate the next step. It becomes self-sustaining. Whether it's yourself or people you're working with, mentoring a team, keeping that in mind is key. Otherwise things get really overwhelming. The more we learn, the more we realize what we have to do, and it can become anxiety-provoking. But yeah, learn about it, then just focus your energy on one thing, get a win, and move to whatever the next thing is that makes sense for you.

JESSICA:

Nice. Thank you for answering those questions, I know they were a little unexpected.

DAMIEN:

That's good. It keeps it surprising!

JESSICA:

Yeah. And some of the tips in the book are surprisingly simple, little things that really get people talking about your practice, how to greet clients from the moment they walk in, the vibe, the office space, even something small waiting in the waiting room. Like the chocolates, but you can learn about that in the book! The secrets we've shared today aren't just rules, they're more reflections. Some might click with you, some may not, and that's totally okay, as Damien said. We'd love to hear what resonates with you, what you liked, what your rocking chair moment was, what really stuck with you, and something you felt like you could add to your practice. Damien, did you want to say anything else to the audience?

DAMIEN:

No, look, just really hope you enjoy the book and find it helpful. I'd really love to hear your feedback and the things that resonated. Thanks very much for talking today, Jessica. It was good fun going over everything. Really exciting to have this out there and in the hands of people, hopefully making a difference.

JESSICA:

Yes! Thank you again, everyone, for joining. We'll see you next time. Bye!

DAMIEN:

See you. Bye!