You’ve Got Skills—to Write a Business Plan If you can execute a treatment plan, you can also craft (and tweak) a business plan for your practice. In Private Practice
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In Private Practice  |   January 01, 2018
You’ve Got Skills—to Write a Business Plan
Author Notes
  • Gregg J. Altobella, MS, CCC-SLP, is president and CEO of the Indiana-based Synapse Health Group, LLC, which provides consulting services to health care organizations. He is an affiliate of ASHA Special Interest Groups 11, Administration and Supervision; and 17, Global Issues in Communication Sciences and Related Disorders. gregg@synapsehealthgroup.com
    Gregg J. Altobella, MS, CCC-SLP, is president and CEO of the Indiana-based Synapse Health Group, LLC, which provides consulting services to health care organizations. He is an affiliate of ASHA Special Interest Groups 11, Administration and Supervision; and 17, Global Issues in Communication Sciences and Related Disorders. gregg@synapsehealthgroup.com×
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Research Issues, Methods & Evidence-Based Practice / In Private Practice
In Private Practice   |   January 01, 2018
You’ve Got Skills—to Write a Business Plan
The ASHA Leader, January 2018, Vol. 23, 40-41. doi:10.1044/leader.IPP.23012018.40
The ASHA Leader, January 2018, Vol. 23, 40-41. doi:10.1044/leader.IPP.23012018.40
I fondly recall beginning my clinical fellowship in a Catholic hospital in a small Midwest town. On my first day of orientation, one of the nuns commented, “If there is no money, there can be no mission.”
I wasn’t quite sure what to think about what she said, as I had just spent my college years obsessing about properly assessing and treating communication disorders, without really thinking about whether my services would be profitable for a hospital.
Fast-forward 27 years—to last week—when I visited a well-established and reputable private health care provider. They were considering hiring me as a consultant to help them remedy their sluggish cash flow, which was stressing their business. Nostalgically, I found myself referencing what I heard during my fellowship orientation. It was a comment that expanded my thinking about effectively treating patients and operating and leading health care organizations.
It continues to surprise me how health care providers, including audiologists and speech-language pathologists, miss the opportunity to apply our training in planning, measuring and articulating care plans to defining business models and approaches. With the ever-changing health care landscape and the related economics, many clinicians face challenges in aligning clinical care with business initiatives and models.
But we can apply that specialized care-plan training to our practices and businesses. Why? Because developing a business plan is not unlike developing a care plan. As many of my fellow Little League parents shout as they cheer on our young players stepping up to the plate: “You’ve got this!”
Throughout my career as a business owner/operator and, more recently, a business consultant, I’ve had the privilege of working with large and small corporations—hospitals, outpatient therapy providers, physician offices, skilled nursing facilities and home care agencies. Regardless of the size and type of health care provider, I’ve found that the following simple strategies have been useful.

It continues to surprise me how health care providers miss the opportunity to apply our training in planning, measuring and articulating care plans to defining business models and approaches.

Understand, plan and define
Think about and describe what type of business you have or want to develop, and what business outcome you seek. These goals may be in terms of either direct patient care to specific populations in specific environments, and/or consultative services to different types of programs, services and providers. A couple of examples of business outcomes may include:
  • “Develop a comprehensive pediatric speech therapy model that provides direct services via outpatient therapy and contract services to educational systems within the greater Baltimore area.”

  • “Collaborate with local northeast Indiana hospitals to establish an outsourcing model of speech-language pathology services that reduces expenses without sacrificing the quality of clinical care.”

Further, think about and articulate how your business differs from others. Describe your business as if it is a person, entity or mission. After all, it is hard to develop goals around something that isn’t defined. For example, “XYZ Speech Pathology Company will be the provider of choice for outpatient speech-language services in southeast Nebraska, as characterized by its ability to treat a wide range of patient populations via proven clinical protocols administered by a comprehensive and innovative team of professionals.”
After you’ve thought about and considered what you would like to achieve with your practice—similar to when you begin treating a client—you should outline a plan that includes goals.

Describe your business as if it is a person, entity or mission. After all, it is hard to develop goals around something that isn’t defined.

Align
There is a business aspect to everything that you do. More specifically, there is a value or revenue accompanied by an expected outcome from your services. Your services require resources and ultimately a cost to you or your business. Many providers seem to be challenged by achieving clinical results while also being mindful of business aspects. Again, “You’ve got this!”
Think of your business plan in terms of a care plan for your patients. In my experience in working with tens of thousands of health care professionals, they often feel conflicted about or unable to balance clinical goals with business goals. Understandably, we’ve been conditioned to think primarily in terms of providing the best clinical care to our patients—but sometimes at the risk of overlooking the associated financial aspects of doing so.
When I plan, develop and advocate for clinical programs and services (or help others do so), I justify these programs by thinking in terms of associated revenues and expenses. Doing so allows me to better implement and successfully grow these programs and services because I have specific benchmarks to hold myself accountable to.
Also, in writing business goals or plans, I have accidentally discovered that the key elements of setting business goals align with the key elements of clinical delivery models. In the chart below, the left column is a generally accepted outline of a business plan that is eventually built out through specific goals.
Writing a business goal consists of identifying an objective and stating the actions needed to achieve the objective by a specific time frame. Does this sound familiar to you? Of course it does, as you’ve been trained to develop and measure applicable and obtainable goals for your patients. So why would you hesitate to do so for a business?
Also, as indicated in the right column of the chart, the key components of a business plan align with key components of a plan for a clinical program, such as outpatient services for Medicare and Medicaid beneficiaries.
Thinking and writing goals in this format helps me—and my business clients—feel less conflicted in balancing both business and clinical aspects, while also ensuring that service delivery is sustainable and successful.

You’ve been trained to develop and measure applicable and obtainable goals for your patients. So why would you hesitate to do so for a business?

Quantify
You can achieve what you can measure if you measure what you define. Successful businesses set goals, then measure and review those goals routinely (I suggest at least monthly). Just like with patient care plans, when you aren’t achieving a goal as measured, you may adjust your strategies or interventions, or perhaps the goal itself.
Nevertheless, most failing practices/businesses that I see lack defined business strategies, budgets and other infrastructure elements that support the clinical programs—and the ones that do have these elements usually lack the discipline to routinely measure, review and act on the results.
Here are examples of goals that are both clinical and business in nature:
  • Business growth. “The Example SLP Company will receive two referrals for service to every discharge from service, by or before July 2018.”

  • Revenue and resources. “The Example SLP Company’s total cost of employee time and resources allocated to each patient visit will not exceed 85 percent of the revenue from each visit.”

Finally, as an SLP who does not have an MBA, I can tell you that you already have the training and skills to be successful. You know how to think, plan, define and measure goals. Simply think about and plan out your practice as a treatment plan, and don’t ever forget, “You’ve got this!”
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January 2018
Volume 23, Issue 1