Practice management advice from John Marvin

Improv might work in comedy, but your business deserves a script (starting with a strong ending)

This article originally appeared in the June 2015 edition of INVISION.


When was the last time that you went to the doctor? What was your experience like? Did it feel like organized chaos — or worse: disorganized chaos?

A recent study of 50 Texas-based optometry practices revealed that 82 percent of patients felt that office staff were distant, not friendly and not organized. Wow! That’s a big number. I guarantee, if you were to ask the staff members if they were friendly and organized, you’d get a completely different answer.

So why the difference? The fact is, if you do not intentionally design your practice and make sure it consistently follows that design, chaos will seem normal after a while. This month and next, let’s talk about how developing a story for your practice can dramatically improve patient care and your bottom line.

Think about what would happen if a Broadway production opened without a script or a director. Some nights, the audience would rave about the play. Some nights, people would discourage others from wasting their money. Some nights, the play would conclude on time; other nights, it wouldn’t. But long-term success would be unlikely without the right story, script and direction.

Recently, I spoke with a doctor whose life and practice had changed dramatically while his annual sales grew from mid $800K to well over $1.5 million. He shared with me that as the practice grew, he felt completely out of control. He knew patients were not getting the level of service they deserved and he wasn’t sure if he was making the money he should. He described it as controlled chaos. He decided to run his business more intentionally, be confident in his team’s service and effectively manage the practice revenues.

Here are five important steps that my doctor friend used to write the script for the story he wanted to tell. It’s a simple approach, but you need to be disciplined to follow through with each step and manage the direction of your “production.”

Reflect on the practice and your professional self. It takes intention to create a successful career. Set aside a few hours and think about your past few years of work. List the things that make you proud and areas that are problems. Make this a routine: Set aside time for reflection each quarter. I suggest at least four hours and preferably an entire day.

If you do not
intentionally design
your practice, chaos
will seem normal.

Write the ending first. In Stephen Covey’s book The 7 Habits Of Highly Effective People, the second habit is “Begin with the end in mind.” First decide the story you want your practice to tell. What do you want people to think about your practice? What do you want them to feel about your practice?

Identify key players in your story. Explain the ending and empower them to define their part. Chances are they will be much more thorough and effective when they take responsibility for their own part in the story. Don’t make it complicated. Each player simply identifies important key activities that must be consistently performed in order to deliver the desired ending.

Write it down. I can’t overstate this: If each of your players writes down how he contributes to the ending, it helps him consistently perform and improve his part. Think of our Broadway production again: The actors have memorized the script, but sometimes scenes are rewritten to help the players connect better with the audience and advance the end of the story.

Rehearse, rehearse, rehearse. Joe Frazier, former heavyweight champion of the world said, “You can map out a fight plan or a business plan but when the action starts, it has to come down to reflexes.” This is true in your practice. Give your staff the opportunity to role play and practice, and your story (including its happy ending) will be told in the day-to-day delivery of care.

Broadway productions face reviews — and so do you, whether via word of mouth, online sites or surveys like the one I mentioned above. Next issue, I’ll talk about simple but concrete ways to measure your business’s performance.


With more than 25 years of experience in the ophthalmic and optometric practice industry, JOHN D. MARVIN writes about marketing, management and education at the practiceprinciples.net blog. He is president of Texas State Optical, a member-owned cooperative of 120 independent, professional optometry practices. Contact him at This email address is being protected from spambots. You need JavaScript enabled to view it..

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