“We cry to God Almighty, how can we escape this agony? Fool, don’t you have hands? Or could it be God forgot to give you a pair? Sit and pray your nose doesn’t run! Or, rather just wipe your nose and stop seeking a scapegoat.”

 -Epictetus, Discourses, 2.16.13


The world is unfair. The game is rigged. So-and-so has it out for you.   All of this might be true and is for many if not most of us.  But so what? What are YOU going to do about it? You, not someone else.

Ryan Holiday writes in “The Daily Stoic” in the reading for June 5th with the title of this article:

“We have a choice: Do we focus on the ways we have been wronged, or do we use what we’ve been given and get to work? Will we wait for someone to save us, or will we listen to Marcus Aurelius’s empowering call to “Get active in your own rescue -if you care for yourself at all- and do it while you can.” That’s better than just blowing your own nose (which is a step forward in itself.)”

Bad things happen. I’ve said now for years that we all get three stink-bombs a year. Three letters, audits, embezzlements, you name it. We all -everyone of us - get these. No one escapes them.  It is our job to build our lives and families, careers, and businesses (podiatry practices) to be strong, resilient, flexible, and profitable enough to withstand and deal with the stink bombs.

Covid-19 was a category 5 hurricane that hit the whole world at nearly the same time.  We should not be surprised that this happened.  When the next earthquake happens (it has to) the next actual hurricane, tornado, fire, flood, and embezzlement happens (they have to) we should not be surprised. We should be prepared. 

Podiatry practices (well-managed podiatry practices) are remarkably resilient. They are resilient in down economies and pandemics for instance. Most podiatric practices are now recovered to near 100% volume pre-mid-March. Not all, but most.  Some entire industries may never return and will be significantly changed in the future. This is actually an expected and normal part of the business cycle. And great strides and changes occur during periods like the one we are in now. There is a company we will all know and use in 5 years that is just getting launched right now.

Top Practices’ mission has is, and has been since 2007, to coach, guide, lead, and support you as you lead your own practice -your own business- to become a profitable, enjoyable, and rewarding business to own and operate.

As you begin to build your own resilient, strong, flexible practice focus on these three essential points of leverage:

The number and quality of the patients coming to your office every day. You need great marketing and exceptional customer service to do this.  If your office is filled with the kinds of patients you want to see you will become stronger and stronger

Your Per Visit Revenue. This is the amount of revenue generated by every patient visit in your practice. Knowing and working to improve this number increases your patient outcomes and profitability. This requires training, protocols, and efficiency.

The Dollars Generated Every Hour Your Practice is open and patients are in your clinic. By using your people, time, treatment rooms, and modalities that include cash efficiently, for instance, you can transform your practice from a stressful, cash-strapped, practice into a well-oiled machine that makes you able to effectively weather the next stink bomb.

No one is coming to save you. No one should. The system isn’t fair and it certainly isn’t what you signed up for. But you can beat it. You can be your own best ally. Through Top Practices your fellow doctors want to help you get there and they want to learn from you and what you can share.

Stop complaining online about how bad it all is. It’s bad. So what? It’s always been bad we just didn’t have 24-hour TV channels and social media platforms to remind us endlessly.  Don’t let anyone else do your thinking for you. You are more than capable of that yourself -you earned a DPM - you are a very sharp person.

The Future of private practice is brighter than ever. The status quo of the last 10 years just got upended. The labor market just improved. The number and quality of DPM’s you could bring into your practice just increased.

“If you think you can or you think you can’t, you’re right.”  -Henry Ford

I wish for you a realization of all the blessings that you have right now. And I wish for you to “blow your own nose” and build the practice that you deserve. One that provides for the emotional and financial stability of you and those you hold dear.


Rem Jackson
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Founder and CEO of Top Practices, LLC
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