PracticalDermatology

Running a successful practice is hard work and requires skills that are not routinely taught in medical school. Shani Francis, MD, MBA, Chief Corporate Strategy Officer of Shani Francis, LLC, President and Principal Investigator at Ashira Industries, and Chief Wellness Officer at Ashira Dermatology in Los Angeles, earned her MBA before her medical degree, and it has served her well. Dr. Francis spoke to Practical Dermatology® magazine about her journey and offered tips on how to make solid business decisions for a practice.

How is a business background helpful in a practice?

Shani Francis MD, MBA: I have always believed that one can benefit from more education if only to provide an enhanced perspective. Medicine is a team sport, and while it is not necessary to play every position, often during startups you do not have the luxury of a fully staffed team. The biggest advantage of having a business background is being able to effectively quarterback your team and identify those strategic gaps that you can temporarily fill when necessary.

What are some solid fundamentals, and how do they help run a practice?

Dr. Francis: The most important fundamental tool is understanding the language and structure of your business. Accounting is the language of business and with a great grasp of this language, our business templates can be as formulaic as our subjective, objective, assessment, and plan (SOAP) notes. Understanding basic accounting principles will allow you to zoom out of the day-to-day operations and maintain a more strategic vantage point of the overall business structure. Instead of being overwhelmed or lost in the details, you can manage daily decisions and understand how they will contribute to overall performance.

Any tips on utilizing business advisors effectively?

Dr. Francis: Having a solid understanding of your financials, including your income statement, balance sheet, and overall goals, will allow you to partner with the right people. Think of using your business advisors as “calling a consult” for a patient. The communication skillset is nearly identical. The business advisor is the consultant, and the patient is your business.

How do you decide what aspects to outsource?

Dr. Francis: My father always reminded me of his simple equation: Time + Energy = Cost. You want to make sure that this equation stays balanced or to your advantage. Sometimes the time and energy that it takes you to do something is worth the cost, other times, it is not. These three levers help me decide when to outsource to achieve consistent high-quality patient care.

What classes or programs would you recommend for a dermatologist looking to start or grow a practice?

Dr. Francis: The demand for dermatology is great, and there are many strategies to fulfill unmet patient needs. When growing or starting your practice, the initial decision is what problem your practice is solving, and more importantly, how you want to solve it. How you want to work should be married to how you actually work so patient safety never compromises your quality of life (a main driver of physician burnout). With a little creativity, we can achieve the ultimate balance of life and not sacrifice our personal wellbeing in the process. I have learned through trial and error that there is no “best practice” in providing outstanding patient care, as this looks different for everyone but is achievable by all.

Billing is one of the most dynamic and impactful aspects of a medical practice so it is important to understand your revenue cycle and how to manage it. Availity.com offers great free and low-cost training on how to navigate insurance.

Accounting is the language of business. Understanding basic accounting terms and how they relate to your practice will also optimize your communication with your business advisors. The online education platform Coursera has a diverse offering of four- to five-week business classes, and I will also cover these concepts during a session at the annual meeting in Boston!

I also would encourage anyone who wants to expand their practice to first expand themselves. Prioritize at least one of those hobbies that you may have given up during medical training. Bringing what you love into your practice and patient encounters builds trust and ultimately, this intangible asset is the secret sauce of success. If you are not having fun going to work, you are doing it wrong.

Speaking of which, what is your secret sauce?

Dr. Francis: Authenticity. I love what I do, and I love how I do it, which for me is being as authentic as possible to my patients, staff, colleagues, and myself. My definition of success may also be different. For me, creating flexible opportunities to enhance the quality of life for my family, patients, teams, and myself is the ultimate goal of how I prioritize my time. Wayne Dyer said this best: “Remind yourself that you cannot fail at being yourself.”