This blog is the sixth in the series of Private Practice Mastery. Here’s the recap so far:

  1. Letting go of control
  2. Managing your finances
  3. Marketing and Sales
  4. Operations
  5. Managing YOU

… and now we have now arrived at Measures that Matter. (This one’s for all the clinicians who feel STUCK on a hamster wheel right now.)

To illustrate what the heck I mean by this, I want you to take a minute and remember how it felt to be a new grad. A newly-minted health professional.

Do you remember how scared and totally inadequate you felt?

If you were anything like you me, you were always terrified that you would somehow manage to “break” one of your clients. I couldn’t believe that people actually left me alone with my clients, because somehow I had clearly managed to fool people into thinking I was competent and somehow in a position to help people get their lives back.

Sure, I had 4 years of education. Field experience. A supervisor (or three)…

But a real life human? They were hurting and scared and I just wanted to help them.

You probably remember this feeling. And you probably also remember how badly you wished for a script or rulebook that would tell you what to do, what to say and how to make it work.

Do you remember that feeling of desperately wanting to know that everything was going to be OK? And the certainty and the promise that you would be fine and know exactly what to do and when?

By now, we know that this isn’t how the world of counselling and client-facing work actually goes.  And that as prepared as we might feel, nothing compares to having real- life people, in their messiness of life in front of you, and having to get used to calling on your own skills and capabilities.

So what does this have to do with mastery? And what does this have to do with growing a business?

In the book Outliers, author Malcolm Gladwell says that it takes roughly 10 000 hours of practice to reach mastery in a field.  So, if I was on average seeing clients for, say, 20 hours per week, for 48 weeks a year, for 20 years… then I will have completed over 19 thousand hours of clinical work. And this is probably why it feels so easy for me to see a client.

I no longer need a script, in fact I resent the script.  Scripts get in the way of the work that needs to be done. I don’t resent the scripts for others in my practice, or for people who use them – I just don’t need them anymore.  I know what needs to happen, but I will allow the client and my MASTERY of my process guide us through how this weird, messy process is going to work.

Do I always get it right? NOPE, but I know what to do when things don’t go well because I have that nailed too.  This is mastery and this feels right. You’ll know that you’ve achieved mastery when what you do each day feels normal and you can’t understand why other people find it so hard.

But here’s where it starts to get funky: we ASSUME this level of mastery from our clinical practice will automatically roll over into our private practice and business building.

Well guess what folks, that’s a GIANT NO WAY. For many of us, going into private practice has made us feel like a novice again.

This is why we want to stay where it is so safe  – where the clients are and doing the client work.  And there is nothing wrong with this, but please understand that you must give your private practice building skills the opportunity to grow up too.

I’ve been in my own private practice since 2008.  That’s 9 years.  And I was building practices  for other people as an employee for around 5 years too – although I’m  not going to do the math here, because although it will tell me that I have the 10 thousand hours, there is no way on earth I’m going to say I have mastered this thing called Private Practice.

However, I do know this: my fallback is my client work, because it’s where I feel safe and in control. Client work is my “happy place” to immerse myself in when I need to feel good.  Because after dealing with financial management, taxes, payroll, marketing, sales, people who malign me, people who don’t do the right thing, insurance, legal issues, supervising team members, recruitment (oh my god why is that so darn hard)  I just wanted to go back to something I knew I could do, and do well.

How does this story relate to measures that matter in your private practice?

Well, you see we have a massive problem.  We have a bunch of clinicians who have well and truly obtained mastery over their clinical skills. But they DON’T have mastery over their practice, and in particular they aren’t tracking how, if and when they’re actually making progress in the first place.

This is where metrics that matter come into play.

If you knew with out any doubt at all that I could tell you exactly what you should  be measuring in your private practice would that be helpful?  Damn right it would be – so are you ready?

Here’s the list of all the things YOU COULD be measuring when it comes to your practice:

Metrics related to Finances:

  • You have your categories sorted for your expenses so that year upon year you can compare apples to apples to know what you are spending on what to be in business.
  • You have a spending plan (aka budget) to know how much it costs you to be in practice  with all of your expenses clearly identified including your payments to yourself!
  • You have all of your insurances up to date relevant and doing their job
  • You have your Balance sheet at the ready; your P&L available and you know how to read these
  • You are planning your taxes every quarter or every year.  In this day and age there really isn’t  an excuse for a tax bill blow out – there is so much  information available that we smart clinicians should be able to ask the questions of the right people to help us plan for our own taxes.
  • You know how much you can spend, you do spend and what you want to spend on specific  tools and resources.  Please note that “free and cheap” is not a business building growth strategy.
  • How does your metrics for Finances relate to your metrics for Letting go of control, Marketing, sales, for operational management, to your own self care?

Metrics related to letting go of control (aka delegation) and operations

  • You have KPI’s or something similar created for every role (not person but role) in your business, every person whether they are employed or contracted knows exactly what to do and have the tools and resources to do what they are contracted to do
  • You measure your own performance
  • You have revisions of performance scheduled and you have scales, ratings systems and processes ready to help you make informed decisions about how people and services are adding to your practice.
  • You have clear boundaries of what you will do and what you will not do both personally and in your business
  • You have policies and procedures that the right people know when to use them and how to use them.

Metrics related to marketing

  • How much are you spending on advertising and how many paying clients are you getting as a result
  • Word of mouth and networking: how much time are you investing in this and for what type of result?
  • Speaking engagements and other leveraged marketing opportunities, how much time do you spend preparing, travelling , attending, delivering?  What do you spend per person in the room and how many of these people do you then convert into paying clients?
  • Your website: is it generating traffic, the right type of traffic, and are you converting this traffic to paying clients?
  • Your opt-in, your free awesome thing that you provide prospective clients; how are you attracting people to your list?  What do you do when they are on your list?  Ad how many of these are you converting to paying clients?
  • How much marketing are you doing to new clients as opposed to previous or  current clients?  What works better for you?  And how do you know – is it a measure of simply conversations, or is there more than a conversation rate to measure?

Metrics related to Sales:

  • How much does it cost for you to convert a cold person into a new paying client?
  • How much does it cost for you to convert a warm person into a new paying client, and how did they become warm and when did you decide they were warm?
  • How much time, energy and money does it take for you to upsell or cross sell a previous client or a current client?
  • Do you pay someone to close sales for you?  If you have someone answer the phone and take client bookings then yes, you are paying someone to close sales for you.  Therefore are you measuring how many conversations they have with prospective clients, and compare this to how many conversations become bookings, and from those bookings how many of these people actually turn up and give you money in exchange for your expertise?

Metrics related to Managing you:

  • You know exactly how much work, the type of work you will do and when
  • You know how to determine when you need downtime and take it
  • You have people you can call on to ask for help
  • You have people who will hold you accountable
  • You have people who will kick your butt
  • You have a quasi Board of Advisors who give you advice and make sure that this business of you is in a position to thrive
  • You measure your energy levels and adjust your workload accordingly
  • You factor your family and significant others into your energy levels

Hey, you made it – I am actually impressed.  Although I do wonder how many of you read all the words above, or if you are like me and would have skipped down to this part??? (I know you…..)

If you are overwhelmed by all of the measures the metrics I have listed above then congratulations. SO AM I!  They are but a small, teeny tiny drop in the information ocean that I found when I started researching for this post.  There are so many different things we could measure in our businesses.  SO. MANY. THINGS.

However many of these metrics are not useful, nor are they helpful. And they are totally meaningless outside of the context that really matters: our goals. 

I don’t produce widgets, therefore I don’t  need to have metrics around production targets.  (Although some business advisors would tell me that I need to be measuring the output of my team and the success of my “products”, but I digress.)

What I do know is that I need to see progress on my journey.

PROGRESS! We all want to know that we’re making progress.

I want to see how what I do on a daily, weekly, monthly basis is leading me towards my bigger overarching goal.

I want to see if something isn’t working quickly so I can fix it, or stop doing it.

I need to see if I’m about to say YES to something that I need to say NO to.

I need to be aware of how my energy is being affected by what I’m working on and WHO I’m working with.

Don’t you want the same thing?

In order to feel like you’re really making progress, you need to be finding and then tracking meaningful metrics and measures that matter for you in your business.

If you want your goals to work, then they need to be tied to meaning. And they need to be tied that metrics that matter…

Because how is another Facebook like, another person on your email list, another call from a client who isn’t the type of person you actually WANT to work with actually going to help you reach a meaningful goal? Serious question. Because tracking pointless stuff like that, if you are even tracking in the first place, is exactly why you’re feeling so stuck and frustrated right now.

So how do you stop that cycle? Well, you start with the end in mind (thank you, Steven Covey) and then work backwards.

If you want a practice that generates $250K PA working 4 days a week, having 6 weeks off a year  then what do you need to make that happen? What do you need per month, per week, per day?  Who do you need to help bring that goal to reality?

Or if you want a practice of 10 clinicians each doing awesome work while you are speaking, writing and seeing a handful of cherry picked clients, then what do you need to do to make that happen?

The measures that matter are aligned to the GOALS you have set for yourself, and the goals you have set have to be aligned to the person you want to be. No amount of goal setting, business planning, advice, coaching, training can  get you where you want to go when you are not working towards who you want to be.

And this is why so much goal setting doesn’t work.

So, dear clinician in private practice, I ask you to share with us in the comments below – what metrics matter to you? What will your metrics actually help you move towards, and create in your life and practice? And what can you start tracking now to make sure you stay on track?

Here’s to your success,


3PS – you know I wrote an awesome workbook about this right? 

I know that traditional goal-setting rarely works, so I want to share with you how I’ve learnt to set goals and to make them work to build a plan around my whole life, not just my business goals. This is a workbook that I’ve been working on over the past two years to bring to fruition exclusively for private practice owners who want to set meaningful goals and – dare I say it – actually reach them.

If you’d like to learn more about it or purchase yourself a copy, all you need to do is click here.

Feature photo credit: sualk61 via / CC BY-NC-ND

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