When do I change my daily office routine to have the practice of my dreams? First, you must take careful inventory of where you are at, and where you want to go next. You should be always looking at least a quarter, if not a year down the road. Right now, you should be putting the finishing touches on your 07 Game Plan. 
Never do this during office hours. Only while relaxed, completely focused, hopefully after a couple days away from the office. The next step is to look at your past 6-12 mos. statistics (hopefully you have at least a basic array) and see what’s missing VS where you want to go next.  
For example, if retention is poor, your Second Visit needs a makeover. If NPs are not where they should be, a careful analysis of your marketing is in order. But also, take a look at what’s really doing well, say Former Patients returning, and don’t change what’s driving that, such as your current patient newsletter. 
Take the very same step by step process in determining which staff or positions need change, makeover, or maybe deletion.  A good example in our clinic was x-ray. My last 2 years, I broke even once, lost a little the second year, then sold it all, outsourced x-ray, and converted the space to revenue generating, adding at least 50k the very next year! 
In this day and age, you must approach your business decisions with precision, and that’s where great coaching comes in. A good coach won’t make your decisions for you, but will help you see things as they are, not necessarily as you are.  This is when the really big breakthroughs in life and practice happen. It’s also why all exceptional pros in sports and business have coaches at several key positions. 

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