The vast majority of ophthalmologists prefer to think of themselves as physicians and surgeons first and businesspeople second. While reasonable, perhaps it is time to look at our roles differently. I am enrolled in a Business Growth Programme at Cranfield University, in the United Kingdom. I have found the experience to be tremendously beneficial as I work to make our practice a better business. In this and future issues, David Molian, of the Business Growth & Development Programme at the Cranfield School of Management, will be sharing his expertise on how we can all better focus on the business of medicine.
— Sheraz M. Daya, MD, FRCS(Ed), Section Editor

Many aspire. Few achieve. Although this sounds cliché, based on our experience of studying over 15,000 independent UK businesses, we know that 2% consistently grow their businesses by 25% annually. The question becomes: What do these top 2% do differently to grow? Here are 10 pieces of advice we have learned that you can apply to your own medical practice.

1. You have to really want to grow. Growth does not happen to the half-hearted. It is the difference between involvement and commitment. If you have ever consumed bacon and eggs for breakfast, reflect on the respective contributions of the pig and the chicken. The chicken was involved, but the pig was definitely committed!

2. Successful businesses know where they are going and write it down (and not just on the back of an envelope). Successful businesspeople have clear plans and well-articulated goals. Creating a business plan is not as complicated as you may think. Start by writing down the goals you may have in your mind for your practice over the next 1, 5 or 10 years. Then, think about the steps you need to take to achieve those goals.

3. Do not diversify too early. Instead of looking for ways to attract new patients, start by getting more from your existing patient base. Do they order their contact lenses or purchase their spectacles through your practice? Do you provide refractive surgery patients with referral cards for their friends and family? Most successful businesses achieve success through selling more of what they currently do to their existing customers and others who are like them.

4. Be a profit in your own land. Too many businesses think only in terms of growing sales and do so at the expense of margins. Look at your practice expenses and your operating margins. A reasonable rule of thumb is that your expenses, including staff time and consumables, should be no more than 40% of your income.

5. Grow up as an organization. Just as people mature, so must organizations. Managing growth means implementing the necessary changes to systems, structures and processes. You are constantly working to improve your surgical skills and you should take the same approach with your practice.

6. Stop solving other people's problems and/or meddling in jobs you pay others to do. It is hard to change one's behavior, but often the boss is the biggest impediment preventing the organization from moving forward.
7. Become a strategist. A business leader has three basic tasks: Run today's business; make today's business better; and create a better business for a new tomorrow. Most owner-managers spend nearly all their time running today's business. The top performers spend most of their time improving today's business and creating the business they aspire to become. That is strategy.

8. Focus on your staff. Your team will deliver the results for you if you explain to them what you want, allow them to get on with it and invest in their future!

9. Develop yourself. Who is the single person in the business who can have the most impact? The owner-manager. Whose development as manager and leader do most owner-mangers never invest in? You have got it.

10. Work smarter. Working longer hours is most owner-managers' recipe for success. It may be a good recipe — but only for working yourself into the ground. If anything, our top performers work fewer hours than the average. They take more time off and get more fun out of their businesses.

In the articles that follow, we will take each of these issues in turn, to see what practical steps you can take that will make a positive impact on your business's performance.

For more information on the Business Growth Programme and Cranfield's other programs for owner-managers, visit www.som.cranfield.ac.uk/som/groups/enterprise/credo/index.asp.

David Molian is codirector of Credo at the Cranfield School of Management. He may be reached at d.molian@Cranfield.ac.uk; +44 01234 751122 (phone); or 0788 079 3849 (mobile).