Business Planning as a Tool for Medical Centres Cranstoun & Hussein Chartered Accountants & Business Advisors

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1 Business Planning as a Tool for Medical Centres Cranstoun & Hussein Chartered Accountants & Business Advisors Presented by: Paul Copeland C.A. Principal

2 Introduction Cranstoun & Hussein working with medical practitioners since 1961 Wealth Creation Asset Protection Accessibility - Advice AMAQ preferred firm for accounting Work with network of other advisors

3 Professional Advice Disclaimer The information presented tonight is general in nature and should not be relied upon without seeking professional advice either from the presenter or other suitably qualified persons to ensure that the information and concepts contained in this presentation are appropriate for your individual circumstances.

4 Issues Covered Tonight Business Planning for a Medical Centre Planning towards selling the practice Strategies to accommodate the loss of a partner What practice managers should know and might not. Review the topics then discuss

5 Business Planning in Medical Centres A Business Plan is tool in the form of a document which outlines the goals, philosophy and direction which the business principals wish the business to take. Two elements of medical business medical and service provider. Business Planning for just recruitment or finance is limiting the use of the Plan.

6 Business Plan for Medical Centres (cont) Hardly any business have a current written plan which outlines; - The short and long term business goals - The goals of the business owners The elements of a business plan include; * Operating Plan * Marketing Plan * Financial Plan * Contingency Plan * Identification of key staff and responsibilities Consistent elements but different for each business

7 Starting the Business Plan Can not plan for the business without having your own personal life plan. Ask yourself, Am I Happy with; The contribution I make to the business? The contributions of my partners? My financial return from the business? Would I like a higher financial return? How much longer will I work or my partners work? What would I change if I could?

8 The Importance of the Business Plan Consider Business Planning in relation to; The financial performance of the business And Recruitment of Doctors

9 Business Planning Financial and Profitability Profitability does not mean the chasing of dollars at the expense of a reduction in patient care. Important tools in reviewing profitability are: Undertake a financial benchmark of the practice Prepare a budget for the practice Review the budget against actual results

10 Financial Benchmark of a Practice The benchmark is a guide to use as part of the planning process not ideal in isolation. Great tool when used in conjunction with a valuation. Consider 5 FTE practice some benchmark guidelines are; 65% of patient fees to doctors 13% to 17% for overhead wages 6% to 8% for rent and outgoings 1.5% for medical supplies 5% to 7% for general overheads

11 Financial Benchmark of the Practice The net profit margin of the practice is typically in the range of 2% to 7.5% The PIP and other subsidies can help to increase this Benchmark does not take into account finance repayments. Highly geared practice can make a loss.

12 Potential Issues when not operating efficiently You may set remuneration levels too high for doctors smaller practices paying 70% will struggle to make any money Financing growth may become an issue Owners remuneration may reduce

13 After the Benchmarking Prepare a Budget Once you have reviewed the practices performance prepare a budget of where you would like to be. Without a budget you have nothing to compare against there is no reference to expectations. Monitor the budget no good if it is not used and made reference to.

14 Benefits of Benchmarking and Creating a Budget Good financial management of the business makes it more attractive to investors Improved financial performance higher profits means better return and higher sale price Knowing profit levels you can design salary packages while still remaining profitable.

15 Business Plans and Recruitment What are doctors looking for? A variety of patients, interesting work, strong numbers A high percentage of patient fee as their income Good conditions, equipment and work space The location in relation to their families needs Reliability of payment and security of position An organised and professional operation

16 Recruitment and the Business Plan Knowing what doctors are looking for, could you provide: A review of patient numbers over 3 years, patient growth to show a need for their services; A marketing plan to grow the practice, copies of flyers and advertising material, policies and plans; A summary of existing doctors, their experience, qualifications and expertise;

17 Recruitment and the Business Plan (cont) Knowing what doctors are looking for, could you provide: A copy of their agreement, percentage, incentives Clear information on remuneration, draft invoice template, how the service fee is calculated Overview of the area showing schools, services, shops and housing. Discuss

18 Planning To Sell the Practice Some might think they do not need a Business Plan as the practice is older and they are looking to retire. Consider then: Would you like to sell or simply close the doors? Do you want to maximise a sale price? Who is your intended buyer? How will you sell? Do you have real plan or some vague ideas? If you have this covered you have a business plan.

19 Planning to Sell your Practice When planning to sell your practice, consider the type of retirement you might want. Will you stop work? Work part time? Travel? Ideally plan your exit so as you can work in the practice for some time before stopping work there. This will increase your sale price.

20 Planning to Sell your Practice (cont) Have a five year exit plan: Might seem long but consider Maximum value comes from having three years of financial statements; Allow the 4 th year to sell the practice; and One year to work in the practice after the sale.

21 Planning the Sale of Your Practice (cont) Identify your who you will sell to Don t put your eggs all in the one basket Neglecting options can prove costly Prepare the business as best you can this will only maximise your sale price

22 Planning the Sale of Your Practice (cont) Review your expected sale price Obtain a valuation to ensure your expectations are realistic. Use the valuation to assist in preparing the practice for sale. Tidy up financials for private expenses, motor vehicle costs, insurances, incentives and revenue by doctor. Discuss

23 Strategies to Accommodate the Loss of a Partner How do you lose a partner? Understand the reasons to plan for the risk and then to minimise impact. Partnership break down Death of a Partner Medium term absences (say 6 month holiday) or reduced hours Retirement of a Doctor Resignation of a Doctor Chronic illness with a Doctor or their family

24 Strategies to Accommodate the loss of a Partner Partnership Break Down Due to divergence of goals business plan Partnership agreement Formal meetings Death of a Partner Cross over insurance to cover equity, lost revenue and recruitment

25 Strategies to Accommodate the loss of a Partner Medium Term Absences Six month leave or 4 day week Budget and plan for this and it can extend the doctor s working life Retirement of a Partner Partnership agreement to cover the period of notice hopefully 12 months.

26 Strategies to Accommodate the loss of a Partner Resignation of a Doctor Partnership agreement with a notice period noncompete clause Understand why they are leaving to see if the reasons are reasonable Illness or Trauma to Doctor or Family Cross over insurance to cover equity, lost revenue and recruitment Discuss

27 What Practice Managers Might Not Know. Specialist advisors reviewed and checked by the AMAQ. Contact them for details. Starting the process is one of the hardest things to do There is a cost to doing things properly specialist advice is an investment not a cost Document Plan Budget: Do documents no defence

28 Summary and Conclusion Cranstoun & Hussein have almost 50 years experience in advising clients within the medical industry on issues relating to taxation, accounting and business planning.