Episode 7: Understanding Profit & Loss

Do you really understand your P&L (profit and loss) statements? Are you running your business by only looking at the P&L? If so, you may be doing yourself a disservice. Financial tools shape our business and the direction we move our businesses.

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You're listening to the Functional Medicine Business Podcast featuring Dr. Deb, one of the most creative functional medicine business practitioners in her industry. She shares the wisdom and knowledge that she has gained over 25 years of functional medicine, a pioneer in functional medicine, scheduling, leadership and Practice Management. Dr. Deb has a wealth of knowledge and is eager to share to help functional medicine become more productive, and for the practitioners and patients to live better lives. Our podcast shares the good and the bad of our industry, because Dr.Deb knows the pain you live every day building a functional medicine practice with practical tools on how to manage money, taxes and patient care. She will discuss it all with you. 

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And I want to talk to you today about the dreaded mastering your books. Yes, we're going to talk about finances today. You know, one of the scariest things that business owners have is to look at their books, understanding the dreaded profit and loss statement. Understanding where your money is going, understanding where it's coming from, and of course, balancing it, and then talking to your accountant about what you're doing. So what I want to talk to you about this is because when I started a business, the profit and loss statement meant absolutely nothing to me. I really had no clue what the hell was on it, how to read it, or what it meant. And interestingly enough, the first practice that I owned, we would meet with our accountant every month, and he'd hand us the profit and loss statement. And then we'd have lunch. And we talk about everyone's personal life. We never talked about the profit and loss statement. We never discussed, were we in the red, were we in the black, were we overspending in one area or not? We never looked at it from year to year to see if our practice was growing. So I never had a clue what to do with this profit and loss statement. When I went out on my own, I was determined to understand the profit and loss, I was determined to be able to answer the question, Am I profitable? Or am I not? And I want to set my business up from the beginning to be worth selling when I was ready to exit. Now I didn't have an exit strategy in mind. None of us usually do until we're ready to walk away, which I'm telling you is too late the day you should start planning your exit strategy is the day you open your practice, you should have your end in sight. Whether it's five years or 25 years or 55 years, it really doesn't matter. Have your exit strategy in mind. No one can change over time for sure. But you have to have that long term goal. What do you want your practice to be worth? What do you need to get out of it? What do you want to get out of it? How many days do you want to work? And for how long? How old? Do you want to retire with owning the business but not running it? You don't just want the business? Are you just going to close the door and walk away and not sell at all? All of these are questions that should be answered. When you're looking at having the end in mind. It's really important to do that sooner than later. Because trust me 20 years goes by very quickly. And if you didn't plan what you are going to do, you're going to work for a lot longer than you wanted to simply because you didn't plan. Okay, now that's my tangent on exit strategy. I just think it's super important. 

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Let's get back at looking at your books. Looking at your books is so important. Like I said, Where does your income from? How much is insurance paying you? How much are you getting from your cash patients? How much are you getting from your online dispensaries or your supplement sales or virtual medicine? How much are you getting from programs it's really great to be able to dissect your practice with this much information for a couple of reasons. You know where your revenue is coming from, you know where to double down on your marketing. For me if there's a loss in my business, I want to know why we have this loss. It's easier to find when you know how much income you're making from all of these different categories. And it's super important to know whether or not somebody is embezzling from you. When we started adding different venues to our business besides insurance, we started looking at cash and we did telemedicine and we're just starting to do programs. All of these things online online dispensaries. We immediately broke out our books before we decided to do these things. So we knew what our books said. And let me tell you when we looked at them one year, and we were like, Oh my gosh, our supplement sales are down $50,000. This year, what the heck is going on? Well, I went over to our online dispensary, and saw that what we were doing in their online dispensary was up more than $50,000. So we knew it was just a transition to our online dispensary versus what we were selling in our brick and mortar. But if your online dispensary is down, and your in store, sales are down, you're not selling enough supplements, something's going on. And then you need to look at how many patients you're getting. Your patient numbers are down. Or maybe your patient numbers are up, but your supplement sales are down. You have to have this information to be able to go through and really look at what's happening in your practice. So you can make good business decisions. Are people not buying supplements from you? Is your front desk not using their script? Are they not checking people out encouraging them to get their supplements? Are they deterring them from getting supplements from you. And sometimes that happens, sometimes they tell them to go someplace else, you need to be able to problem solve this issue. But you need objective data to do that. And it's much easier with a month at a glance to be able to do this than to look back six months and figure out something is wrong. So what I want to encourage you to do right now is look at your books at least once a month, glance over your books every week, because I'm kind of a control freak, I still pay my own bills. It's one of the things that makes me feel like I have a pulse on the business. And it's something I've discussed with my accountant. And we both agree that I know what everything is being purchased. I know how much those bills should be I know where they should come from. And I could teach somebody to do this. But in the time that it would teach me, the time it would take me to teach them would take longer than me doing it and I still have oversight. So it's trust and verify. You don't just hand over your bookkeeping to someone, unless you trust them 100% that they're doing things the way you want them to. Because they won't. And then you're going to be mad. And so for me, this works. And at this point, right now it's okay. But it may not work for me going in the future. And then I'm going to have to trust somebody, and I'm going to have to verify and I'm going to have to teach them. And I'm going to have to set things up so that they can be successful with it. Everyone needs to do what works best for them. But if you're not doing your books, you need to be looking at them at least once a month, you need to be analyzing them from month to month so you can see the changes that are happening. 

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Now at 15k. Doc (Functional MBI), we offer a free financial tracker that you can get. And this allows you to track all your services in dollar amounts and number of visits or patients seen per month per quarter. How much did Suzy Jones bill? How much did Johnny bill? How much did Casey bill? and you can track it. So you can see from month to month where things are at. This also makes it a lot easier than just looking at QuickBooks files because you can oftentimes see that there are trends that happen, and you can really break your numbers down. But sometimes it's hard to do that with your EHR as well. And it's easier in some EHRs to get those numbers. But for me, it was much harder to put those numbers into QuickBooks. So we broke it out into our financial tracker system to help us. And that way I can print this off, I can give it to each of my providers individually share with them what's going on. I can tell them that I noticed your numbers are up or they're down from the last month. Or you can say hey, you're doing amazing job. You're killing it this month. You're $60,000 up from last month, girl, what's going on? What are you doing? How are you doing this? I'm so proud of you. This is amazing. And hey, by the way, I want to kick a little bonus into you because you've been doing so well. You've been killing it here. And these are the things that you need to be able to track in your business. Or maybe all of a sudden your lab expenses jump from 10,000 a month to 15,000 a month and you go to your ordering person and say "hey, Susie, what's going on here? How did we spend $10,000 in laboratory fees this month? Did you have to buy a lot of supply? Did something go bad? What's going on? Are we having a lot more people using our lab and we're going through supplies faster?" You need to have a finger on this pulse. What if all of a sudden something weird goes on? Like you get really high numbers in your practice and office expenses. I had somebody ordering supplies for me and my office supply costs doubled while she was doing it. And I went and said, "What's going on here?" Well, lo and behold, she was ordering things we didn't need in large volumes. She wasn't checking the prices from different vendors like Costco versus Office Max or Office Depot, or didn't even look at who we always bought from, she was just going to one place instead of buying them where we normally used to, and buying a three or four months supply. And some of those things we wouldn't use in a five year timeframe. So there were other things she was ordering that we use a lot of and we were running out of. But if you don't know that, you don't know what the cost should be, you're not going to find that sooner than later. And you're going to see money going out the window. I see this all the time with practitioners, and they wonder why they don't have a profit. They wonder why they can't take a salary, why they can't take dividend income? Well, sometimes it's because you're spending money in places you shouldn't be spending money in, and you don't know what you are not tracking. And guess what, you could have a bonus, you could have a staff bonus. Because you didn't look at this, it's just out the window. So I think it's really important. 

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I think it's really important for you to know this, sit down with your office manager and your person who does your orders. If it's not your office manager, explain what you're doing. And set some time aside to create a budget, I really don't have a budget. In my practice, we've been really good about having people that are doing their ordering, and knowing what to look for. But now we've had times where I've had to tell my staff, hey, you really need to order more supplies we're running off to the shelves are bare, and people are having to go someplace else for supplements, we want to keep those supplements sales in house. So we created a form and all of our practitioners look at it. And all of them say, I use these supplements, I'm not using this anymore, I've changed to that. So that it's always up to date. And then we come up with an average of how much of those supplements we should keep on hand, and how much we want to keep in stock every month. And then every quarter, we look at this sheet to decide whether or not our practitioners are continuing to use that product anymore. And then we adjust the ordering sheet. So our staff know, our front desk is really amazing as well. They can tell when we're ordering new things or changing things and they'll come in, they'll ask us, Hey, are you guys not using this anymore? We still have x number on the shelves, and they're getting ready to expire". They know these kinds of things. But if you don't communicate these things with your staff, they don't know. And they can't possibly read our minds. They don't learn these things. It's you know, it's what we teach them on our check in checkout process. It's what we teach them in how to do their job. So it's really important for us to look at all of these changes that are happening in our practice management, pull a report quarterly, or monthly on your supplement sales so you can see how much product you're selling quarter to quarter year to year, and then work backwards at developing how much you want in inventory. So I always compare our EHR numbers to our quick book numbers. I pull both reports and I compare them. Because sometimes what's in my EHR doesn't match what's in my QuickBooks. And sometimes it's simply because we're shifting and insurance, we're waiting for payment. But if all of a sudden, there's a big discrepancy, I want to know where that money is missing from, where's that loss coming from? Did somebody overbill at some point is somebody not giving proper change? Is there a glitch in our system is something not calculating properly? God knows what I've had seen problems that happen before by pulling the wrong report, and you just about had a heart attack, seeing what you did in finances for a month, right. So pull the same reports sit down, take a look at them every time compare year to year, year to date. And if you're doing the first quarter this year, look at the first quarter of last year and compare the two. And then you'll see your trends. You'll see how much your billing, you'll see how much you're spending, where's your money going. And then I would encourage you to look at where you could have potentially cut costs. Maybe you're running as lean as possible already, and you can't cut costs anymore. That's fabulous. But I would encourage you that there's probably some subscription things you've signed up for, that you don't even use anymore, or don't even remember you signed up for them. Go looking for those. Let's eliminate those extra costs because they all add up. At the end of the day. We want to look at places where we can increase revenue, increase income and decrease our expenses. So you want to look at this every quarter Don't spend time putting in numbers that don't matter. Let someone else do this for you. So you just look at the report each month. And then you can look it over and see where you're at and ask questions, that's a better use of your time. Then if you're pulling all these reports, putting these numbers in the financial tracker, it's just going to be a waste of time for you. But this would be worth your waiting gold, I promise you down the road if you understand the profit and loss statement. We're going to talk in the future about accounting and taxes. And I'm going to tell you why it's important to know these numbers. So really start learning these things, digging in and understanding them comparing them looking for discrepancies. have open conversations with people on your team so you can start to find out where these discrepancies are coming from. That's your homework for today. Get those reports. Take a look at them. If you have any questions about them. Join our private Facebook group 15k A day doc (now Functional MBI), post your question in there. Let somebody who's has more knowledge help you figure this out. Don't try to figure it out on your own. Your own takes too much time. It's not worth it. post some questions, let us help you. We want to help you figure it out so you can be financially sound and successful sooner than later in your business.

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Thanks for listening. If you enjoyed this episode, and you'd like to help support the podcast, please share it with others. post about it on social media, or leave a rating and review. To catch all the latest for me. You can follow me on Facebook at FM bi, join our free group where we support one another and share our struggles. Thanks again and I'll see you next time