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Business Awareness: How to Grow Yourself to Grow Your Business
Episode 183rd November 2022 • Align Your Practice • Dr. Clifford Fisher
00:00:00 00:23:29

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Dr. Cliff and co-host, Dr. Joseph Esposito as Align Your Practice helps you understand and create clarity on your business awareness. You wear two hats; one as a clinician and one as a business owner. There is a distinct difference to those roles and today we will help create clarity for you, your team and practice! Let’s dive in and see how creating this business awareness can help you understand and build the aligned life.

Do you feel like you have struggles or challenges in these areas, this episode will help you understand and fill in the gaps and create the life and practice of your dreams. 

About the Host:

Dr Clifford J Fisher

Dr Cliff Fisher – Owns several offices all over the US and has a coaching business Dream Leadership Institute to help people find the greatest version of themselves. He will help you get to a foundational understanding to create the business and life that align with your being.  

 

Dr. Joseph Esposito, CEO

Dr. Joseph Esposito, D.C., C.C.N. C.N.S., C.C.S.P., D.A.B.C.N., F.A.A.I.M. C.T.N., is the Founder and Chief Executive Officer of AlignLife. As such, he is responsible for the direction of AlignLife as it expands further across a dynamic and rapidly changing health care landscape. Dr. Esposito has more than 20 years of experience in a broad range of businesses, including chiropractic, nutrition, technology and internet marketing.

Dr. Esposito has extensive post-graduate academic accomplishments, as well as 15 years of experience managing successful chiropractic clinics in multiple states. He also is founder and CEO of Aceva LLC, a service-based nutritional company providing products and services to the AlignLife clinics. As the former CFO of an internet publishing company, Dr. Esposito understands the power of leveraging the internet to impact the lives of millions of Americans.

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Transcripts

AYP Intro/Outro:

Align Your Practice podcast with Dr. Cliff Fisher where your best practice and life awaits you. Are you tired of running a practice on your own. We want to come alongside you with experts to help you create your dream practice in your dream life. Here is your host

Dr. Cliff Fisher:

Alright, tribe Welcome back to align your practice with Dr. Cliff and Dr. Joe brought to you by line life, where we want to give you the tools to find and create your line life. I am so excited, we have been just going nuts with this topic of business awareness. And so we're going to be talking about awareness. And we're going to kind of jump back a little bit into the four seasons of practice. So if you don't remember those, go back to those four seasons of practice. But today, we really want to talk to you about business awareness and how that impacts I'm on with Joe. And Joe, we've had a great conversation about this. And I've seen like my whole perspective of business has changed in the hour and a half or so.

Dr. Joseph Esposito:

Yeah, so I think it's it's a great conversation chiropractic and business. And I think we, we have a sometimes we feel like we have dual personalities because we're a business owner and a practitioner. And I think we have to quantify the difference between these and help and edify the practitioner and also create awareness around the business person, that is also the practitioner. So let's get into that conversation first, I think because if they're a student in school, right now, they went to school to be a practitioner. That's why they went to school, they didn't go to school necessarily to have a business, although some did, most are going because they're intrigued about this amazing profession of how we can serve, you know, their communities to better health. And they buy not by mistake, but by they just gravitate to owning the business without much awareness, intention, focus on the actual entity of creating the business and to me, Cliff, and I know we can go down a rabbit hole here. But it's to me, it's the same thing of creating a relationship, you end up dating, and all of a sudden you're engaged, and then you're married. And then it's just like, I don't really know where I'm at, like you didn't, you didn't intentionally create this third entity, which has a relationship that needs energy, focus time respect, planning, to create this relationship that we have to now auto respect as a third component in business, people think they are their business. And I think that's where I'd like to dive in with you is, you are not your business. You aren't just the owner of the business. But let's let's dive into that a bit. What do you think?

Dr. Cliff Fisher:

Yeah, I would love that. I think as you were speaking, I think one of the things is that we are both of those people like just like at home, like you're talking about that personal. We're a husband and a dad, who are a husband and a man or a wife and a woman. And so and then I think what's happened in chiropractic, at least I feel like is we've classified one as being good or one is being bad. So it's like, oh, the good persons that caregiver, the or the, you know, the doctor, and then the bad ones, the business one, because they're greedy. And I think really, basically being able to accept both of those that they're both good and bad. There's good and bad to both.

Dr. Joseph Esposito:

Well, there's two components to that you're talking about the people and then the entity. So let's break that down. Because you're right, you haven't you're the caregiver, and you're the business person. Yeah, but business is not you, in your personal, intimate relationship. If you're married, the relationship is not you it's a separate entity. Correct? You gotta you gotta respect these things as separate entities, like the business is not the person. Does that make sense? So we're talking about two identities, a caregiver and a business person, but then I'm talking about the entity of the business. First, you have to realize you are not the business. It's a living, breathing entity on its own. And my mindset on that is, if you respect the business as it is, then there's multiple people that deliver respect, provide service and outcome for this entity. If you are the business, then you're in charge of everything, you're the energy of everything, you're the focus of everything. And many people they think through the business and when they step out for a day, the business doesn't run. So that's the separation of it, even to the point cliff that people are running on personal finances is like it's one account. And the business and the personal account is one, there's like, arrows that I knew, actually keep that as one entity, and that further that was them on that they are the business. Right,

Dr. Cliff Fisher:

right. And that's not like wow. Blows my mind a little bit on that space as far as like not having that separation, but it's Oh true. Like, we just become that. And, you know, I know for me, like when I was in practice, I felt like, you know, I was the business. And then when we started to get more doctors and started to have more locations, I wanted to be a smaller part of that. And it was hard to pull away, it was definitely, like, some of it was my own ego. Some of it was like, patients were like, oh, no, I only want to see you. And then so then I felt obligated, and then I had to be there. And so and I think that awareness is critical. Now. It's like, it's a different space.

Dr. Joseph Esposito:

And some of the literature that you and I read, you know, they talk about, you're always going to reach a ceiling. And if you are the business, that ceiling has reached really quickly. So you have to realize that you have only so much capacity to do what you're trying to do, that the only way to do it is growing a team that has creativity and accountability, that they're looking at KPIs, and they're creatively changing behaviors in order to create outcomes, and they're accountable to things versus you being accountable to everything. So that's a cultural move for, you know, a new business owner to think about the business as its own entity. And it'll allow you to grow a more effective team and build a team that honors the business that honors the doc of the person. Yeah, you see it click, when you go into an office and you walk in and the doctors, the owner is a participant in Office meeting, but the office manager is running the whole thing. And they just are participant verse, you walk in the office meeting, the doctors running that the team, the huddle, the doctors running, that the finance, the doctors pulling the reports, it's like, that's the clinic that the doctor is the business and scale that way.

Dr. Cliff Fisher:

And I think, you know, just a retouch on the seasons, if everybody doesn't remember, but there's launch, build, scale and exit. And so launch is that, you know, first year opening up getting things build is like when you're single doctor, and, you know, a couple of team members. And then the next one is scale, where it's multiple doctors are multiple locations, and then exit is up when you're passing that legacy on.

Dr. Joseph Esposito:

So let's talk about the the seasons. First off, most doctors don't know there's four seasons. Secondly, most doctors don't prepare to go to the next season. So let's spend a moment on that real quick is like, launch, how many people what percentage you say doctors go from launch? To build anyone that makes it through the first year? Right? So 70 to 80%. Don't go bankrupt the first year, bankruptcy rates in five years is like ridiculously high in the first year. It's higher than people want to realize. But I'll say most chiropractors go from launch to build right? Would you say? Yeah, I would say that. So and align life, one of our really strong asset value is mastery launch to get you solidified locked in on systems, process protocols, KPIs marketing, right to get you to build after that first year. I think we're masterful in that regard.

Dr. Cliff Fisher:

And even the steps before that, I think the steps before that the planning and prep, I think like we asked those questions like, we have systems and processes to ask those questions. So that you know, and the ability that we have with our leverage of being able to get people financed and have resources and know the direction they're headed. I think that's just as critical as actually opening the door.

Dr. Joseph Esposito:

Because then you can open the door. Yeah, that's it. Yeah. So then we go from, then we go into build, and then the preparation of build to get into scale. That's where a lot of people fall down. Will you talk about that a little bit? What do you have to do and build to get ready for scale.

Dr. Cliff Fisher:

So one of the biggest things is actually having a team driven practice, like going from build, I think everybody thinks it's like a numbers thing. But it's actually it's a personal growth and personal development issue, like the leader has to be able to delegate instead of abdicate. One of the mistakes I think I was making up until I honestly, our conversation earlier, was like to bring on an office manager before you bring on an associate doctor, because you want somebody who can run that. So then you can focus on clinical with that new doctor when you bring them on, because it's a heavy lifting, training a doctor. And if you're trying to train a doctor run the office, like that's one of the reasons people fall down. And what I see is people will try and associate, it'll be a train wreck, and they'll be like, Oh, I'm never doing that. Again, that was a disaster, not recognizing they weren't the leader, they needed to beat and move to that next iteration.

Dr. Joseph Esposito:

So you're saying the maturity of the team has to happen before the additional doctor comes on? And then you're saying the office managers beforehand because the associate doctor is going to report to the office manager. Yeah, you hire the doctor, and he reports to you then you start throwing a manager in place goes Oh, no. Now you got a report to them, that doesn't usually work very well for the average person. Because their their respect or their, their connection is with that doctor. So I think that saves a lot of pain is you mature the team, you mature your business mindset, and you don't wait for scale for that happened. Because people think and build, it's just build, build, build, build more visits, more visits, and then now we're gonna hire a doctor. Now preparation for scale is probably the biggest drop in this profession. Because you would also say the biggest drop in the seasons is going from build to scale, right? That's where most chiropractors don't gain benefit.

Dr. Cliff Fisher:

Yeah, 100%, like one of my favorite people on the planet, Brian Willie. She was telling me like he was stuck in build for five years, he brought on his office manager. And you know, he's just rock solid. He's like, she is like the best office manager on the planet. And that's what's allowed him to grow to where he's gone to. And so that was one of the realizations for me, because I never really had an office manager. I played that until like, probably 15 years into practice. So

Dr. Joseph Esposito:

well, people don't want to pay for an office manager. And if they pay, they want to pay someone that doesn't have experienced they pay cheaper, but when you hire an office manager with experience and has the energy and the fortitude to to run the business, yeah. Now I thought I was your favorite person. But

Dr. Cliff Fisher:

I said one of my favorites here on the list.

Dr. Joseph Esposito:

But no, I love you bring it up, Brian, he is one of my favorite people, too. So now he can watch his podcast and get his ego really lifted. But it's it's it's not his brilliance is his brilliance and realizing there was a gap, right? And he solved that gap. And too often, I think doctors or students look at a clinic and say, Wow, that's he or she is just a different world. But then you look at a team around the person and say, Wow, what a smart build of a team, right? I mean, if we really look at these really stable, durable practices, it's not the doctor alone, it's the team.

Dr. Cliff Fisher:

Yeah. And the skill and you're spot on, because there's an people can be in different stages of scale, and build and development. And you know, sometimes when you grow too fast, you don't have the skills to be able to sustain that. So then you kind of burn out, or you have a breakdown, and you have to reset, and that slows down momentum. And so there is a process and one of the things that I love about a lot of life is we've created this 10 steps on, you know, how do we what's the developmental processes in each of those? And we'll be going over that in the future podcast. But how do we shift? What are the things that we talked, we talked about it in the ceilings, when we did those when we talked about the four seasons, but now we're gonna break it down more into that doctor space, and the clinic space? And what are the skills and business awareness and more that business acumen will be more these conversations?

Dr. Joseph Esposito:

Yeah, as we move on, I like that, we're gonna go through the exact steps of building an enterprise chiropractic business. So stay tuned as these podcasts continue. And we're gonna give you the exact process of what you should be focused on right now. Wherever you are in the cycle, whatever season you're in, we can give those steps so you know exactly where you're at. So that the key to this session, Cliff, I think, is awareness. Like, yeah, how are you wired? What do you want to do? You know, the four seasons, we mentioned, most people get to build in scale, I'd say as low as 20% of of offices get to scale, which is bringing on other practitioners and leveraging what you built, you deserve it, you've built the business, you own it, you took the risk. But so you should appreciate the value of build, which is leveraging awesome teammates, and practitioners to help you scale the business.

Dr. Cliff Fisher:

That's a different muscle, like the building is like you're working out, you're taking care of yourself, when you're scaling. It's like you're leading a workout class with a with a group. And so I think that's the difference. It's just a different muscle group. It's a different skill set. And people just think I'll just keep doing what I'm doing. But ultimately, what happens is the strength of the leader becomes the weakness of the business. And so and I think that shows up on exit, which, you know, we've talked about, there's four ways to exit are five ways to exit. And so I'd love for you to

Dr. Joseph Esposito:

exit we said most people, probably 90% of people go from launch to build from build to scale, probably 20, maybe 30% of the perfect AV scale, maybe that is like usually it's a one doctor, one staff or two staff for the rest of the career. Yeah, so scale is where the gap is. And that's where the mastery of align life is, is we we focus on scale. And that's the UD bone into business, and then exit what percent exit,

Dr. Cliff Fisher:

I'm gonna say 100%.

Dr. Joseph Esposito:

They all, you're all eventually got business, whether it's alive or not, you aren't going to leave that business at some point. So we can around with a clip. But let's let's break the exit for two minutes of the different ways of exiting. Because if you're a student, I want you to be aware of all four seasons, because you're going to navigate through them whether you like it or not, you may skip scale, which is a shame for a business owner. But you're going to do at least three, whether you like it or not.

Dr. Cliff Fisher:

Yeah. So the first couple, like, you know, some people, they just like, the worst one, I think, is they just closed the doors, right? Like, they just leave, they're like, Well, I'm done. I don't have anything valuable to sell here. Nobody wants to buy it, or they sell it pennies on the dollar there, or they sell out their equipment. The next one is they honestly kind of die by the table. Like they're just like, they just work their life. And they're like, I don't know what else to do. I don't, I can't sell it. So they leave that way. And then the other one is, you know, to, if you're in scale, you have a doctor, buy your portion out or buy you out. And then the next one is you get to that in space you like you created this great business, it's scalable, it's something that's sellable, it's durable, it's transferable, so then they sell that for a great exit, or like what we've talked about with a line life is you can be part of a group and increase your multiples substantially. And so those are the five exits that we came up with.

Dr. Joseph Esposito:

So let's spend two minutes on that to finish out this session. Because we went through the different seasons, closing the doors, because the doctor doesn't feel there's value. I was talking to my partner about her photography business. And she says, Well, it's not sellable. I'm like, does it have revenue? Yes. Okay, it's sellable. You can yes, you can, you can sell lollipops, if there's value, and there's revenue, it's sellable. So Chiropractors may not think their business is sellable. So first off, you got to know as a student, you have an asset, you own it, be proud of it, it has value, it can be sold, that's number one, we die and by the table side. And the reason that happens is because if you don't have scale, and you don't have practitioners in the business, it's not worth much money. So you can only get about one year's income, when you sell your business maybe one and a half times, if you're the sole practitioner, someone's going to come and take over your role as the doctor. So if you're making 200,000 a year, when you sell it, you get 200,000 pay your tax on that you left 130 grand and that's all you got. And there's no more money coming in. Most people say you know what, I'll just go part time. Yeah, let's keep working. And the average Cairo's working at 7075 years old, 1015 hours a week just to make a little bit of money. That's really true. I've seen it in this profession. rampid. The third way is when you hit scale means that the business operates on its own without needing the owner. Now you've doubled your value. Now, exit for two times whatever one year's income is, they'd say you're making 200,000. Now this thing's worth $400,000. That's a little bit better money. And someone's going to come and scoop that up. Maybe maybe three times, maybe you get as crazy as 600, which I don't think you will, but you get somewhere between two and three. Yep. So hopefully that makes sense to people. The last way is align life has systems that we've put into place that we're going to be building a private equity exit, where we team up align life clinics, to a certain level, where you now have value at six 810 12 times one year's income, which is a different game, that's a nest egg, that's a retirement, that's a beautiful exit. So you are going to exit anyway. Right? So it's not we want to focus on exit as a student just have awareness and realize you want to build a business that is transferable over time. So

Dr. Cliff Fisher:

just want to double click on that. So we're not talking about selling a different business, even though you're creating different businesses, but one business is worth one times another business is worth two or three. And then the same business, if you build it right from the beginning. So if you start with the end in mind is worth anywhere from six 812 to 15 times and the same business. So if the business is collecting 100,000 You can either get 100,000 300,000 or 1.5 million.

Dr. Joseph Esposito:

The same business. Yeah, so in business. That's the crazy thing about it, because you can pull your clinic with other line like clinics, and you could take that same two 300,000 and profit and that thing could be worth 3 million that one clinic or worse or 200,000. So it's just it's how you frame it out. So we have to educate the profession a little bit as to valuations and how these things work. and have the Cairo that's listening to this podcast know what stage am I? What do I do to prepare to get to the next stage? That's the two questions I would ask Where am I? Yeah. Okay, I'm in like, I mean, first year, I'm six months at what do we have to do prepare prepare for build? That's the question I want you to ask. And we're going to be dissecting that on this podcast and knowing where you are. Well, first, who you are, where you are, what are you have to prepare to get to the next level? Three questions not to. So you want to end this this for this podcast may be on how they're wired, because we talked also with a gap is in the planning that Elaine life does. I don't know if we want to go into that on the next podcast or now about that, because

Dr. Cliff Fisher:

let's pick up on the next one with X, I think it's a great place, because so the next two are going to be on structure, and then the architecture. So one will be like, Okay, what's the structure this or the structure? This will be the first part, it'll be sitting down, like, Where does each person want to go and build? And where do you want to go and grow because everybody has a different definition of success. So we want to honor that I know and align life, we went on to that. And honestly, in this podcast, same thing, we want to honor where you're at. And then we want to give you the tools to go exactly where you want to go. If I want to take my family to Florida, and we want to go have a great trip. And I have a choice between this force car and a minivan, I'm going to take a minivan. So I just want to make sure we give you the right tools and align life has the right tools. We have both, you know, we have the vehicles available. She was like, Okay, let's take my car. For that trip. If I want to go on a date with my wife, I want to take her car because it's this, you know, let's say she has a sports car convertible, like that's a better date car than a minivan.

Dr. Joseph Esposito:

And that's a great scenario analogy. Because in practice, you can take this career and his business wherever you want to take it. So you could fly to Florida, or say I don't, I don't want the expense. I want to spend quality time with my family in the car, because it's only eight hours, or you can walk there, which wouldn't be smart. There's many ways to get there. Some people go into practice, in a sense, walking versus flying, because they don't have the plan. So the next podcast will lay out what is the plan? Like where do you want to go with your career? And they're all the right answer whatever it is that you want. If you want to be just the sole practitioner, if you want to build a clinic with multiple doctors, if you want to build multiple clinics, there always is the desire for scale because you're not sustainable. Your body hour, or just your energy is not sustainable to be the only one for your entire career. And you have to frame that out by understanding the seasons, preparing for the next one, and having the resources and tools to get there. Yeah,

Dr. Cliff Fisher:

awesome. What a great wrap up. And so I think next time we'll we'll talk about plan and structure. So that'll be our next podcast. We'll spend some time on that to help you guys give you guys a tool to be able to continue to grow in the direction you want to grow, and go. And so thank you guys for jumping on this. We're super excited for this one and then the next series. So thank you very much for joining us, Joe. Thanks for your time and your insights. Awesome, thanks. Have an awesome day.

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