The Challenge of Running a Small Business

In his latest editorial, Randolph Waldman, MD, discusses the challenges of running an independent medical practice, including cybercrime, employee deficits, and the threat of escalating tax burden.

All signs and data point to the fact that we are finally turning the corner on this horrible pandemic. Our practices have not only weathered the storm but most ultimately thrived. Stimulus money, vacation time, Zoom dysphoria, and other factors have certainly played a role. However, is this sustainable long term? Will there be new challenges ahead?

Most of our practices are small businesses, and the small business environment in our country is challenging for many reasons, such as COVID-19 compliance; difficulty in keeping and finding employees, given enhanced unemployment benefits; rising health care costs; rising material and supply costs; and the threat of an escalating tax burden.

Now it is time to be wise and prudent and consider many dilemmas:

  1. How do we ramp up staffing without a significant effect on our bottom line?
  2. How can we be wise and prudent in future buying decisions without exceeding our cash flow?
  3. How do we change our message regarding team safety?
  4. Are there new services we should consider?
  5. Should we be focusing on our younger patients, people of color, or people of diverse gender?
  6. Will we be working more and taking home less?

Just as many of our colleagues in other fields were acquired by hospital groups, we are finding that many of our own practices are being courted by private equity. Some practitioners are coming to the conclusion that the advantages of independence are not as clear as they once were.

How will that affect our industry, our societies, our conferences, and the way we practice in this new decade?

In the end, however, the strong will survive. Those that work the hardest and spend the most time will be rewarded. We have come to understand that the number of providers will continue to escalate, but we must also believe that the cream rises to the top. Those who offer patients the best care and the most consistent result will succeed. In today’s world, this is measured empirically rather than by clever marketing. Reviews are now perhaps the No. 1 reason many patients choose to come to us.

Practice management and effective marketing have risen to a new level of importance. The premier meetings spend as much time on teaching these topics as on making clinical presentations. It is crucial that we include our staff members in this new awakening.

We must also be mindful of the increasing threat of cybersecurity breaches and related issues. I hear of more and more practitioners who have been affected by these criminals, and some have even been forced to pay large ransoms to secure their data and photos. To combat this, we must learn from experts and help one another. We must inform and train our respective staff members. That is why Global Aesthetics Conference will make this an area of focus in November.

We must insist that our societies be proactive rather than reactive. Societies must expand their role and provide tangible member benefits or they, too, will continue to lose momentum and strength.