do you have a leaky bucket?

Episode 112
Do You Have A Leaky Bucket?

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Podcast Transcription - Do You Have A Leaky Bucket?

Hello and welcome along to my favorite titled podcast ever given my absolute teenager maturity, I'm not a teenager. I'm just mentally a teenager. I think all men are, right? I think about 16 or at least in my instance, I've just not matured since then. I still draw willys and anyway, this podcast title is called do you have a leaky bucket? And the answer to that is, you certainly do and what I'm talking about is the areas right now where things are falling between the cracks because we don't have processes in place. Many clinics are always striving for more, more and more growth on the top line.  Yet let's look at the ways that you can protect that bottom line and ensure that you're bolstering all the areas that need bolstering in order to ensure that as you put more in the top, it's actually turning into revenue and profitability. Let's get started.   

Welcome to the Business of Hearing podcast with me, Oli Luke, the podcast for entrepreneurial private practice hearing care clinic leaders, the ones who set benchmarks of excellence, build wildly successful businesses, grow their impact and navigate the choppy waters to spearhead the future of private practice hearing care. Thank you so much for joining us. Pour yourself a cup of tea and let's get stuck into this week's episode. 

So welcome along and I've got six big things that I want to talk about today. All about areas where there's leaks in the bucket and what I'm talking about is, if you put so many phone calls, so many leads, so many opportunities in the top, where are the opportunity? Where are the situations where things are falling between the cracks and we're losing out on revenue and profitability, not intentionally but often unintentionally, in the shadows, where many of us do not look or either choose to ignore so I've got a lot to work through but first things 1st, February the 22nd, I'm hosting a webinar that I think you should definitely attend. The title of the webinar is the baby boomer blueprint, how to attract younger patients, play offense against manufacturer owned competitors and escape third party toxicity. Now, there's a lot that I'm going to be covering in this webinar, from the changing of the guards and what I mean by that is why 2024 is such a pivotal year with the baby boomers coming into the market and taking over the silent generation and why over the next ten years, the market size is going to more than treble as a result but the key things that you need to do to be on the right side of that wave. I'll give you a full walkthrough of the framework that you can use to attract younger patients and future proof your practice and that will include the marketing strategy that some of the best performing practices are doing in 2024. That isn't super expensive, which isn't throw money ads but doing the foundations to a gold standard consistently.  I'll be sharing how you can play David versus Goliath and utilize your competitive advantages to take patients and opportunities away from manufacturer owned chains.  And I'll share the simplest and quickest way to find hidden revenue in your practice.  And that is on top of what I'm going to be talking about today and finally on that, I will be sharing how you can escape the toxicity of third-party relationships and drive more private pay options to your patients so there's going to be a lot in there. If you want to learn more about that, then the link is in the show notes or easy go to join Orange webinar so that's join Orange webinar so there's a lot in there. I'm looking forward to sharing that with you. It's an hour. It's going to be limited to 100 attendees and there's a few rules to it. If you're part of a manufacturer owned chain, you're not allowed to attend. I will spit tea in your face which is the ultimate British insult. I want this to be private practices that want to make a meaningful difference and protect themselves for decades to come but let me jump into what we're talking about today because there's a fair amount in this, right? The six key areas where currently you have a leaky bucket and the first one starts at your front desk and it's simply your front desk not converting. What do I mean by that? Well, let's look, how many phone calls does your front desk get and how many of them actually turn to successful appointments? And there is opportunity here because I am very, very sure that front desk are not trained that well.  They're thrown into the role, they're told the basics, they're told how the systems work, but are they actually told how to deal with objections, how to answer those difficult questions and how to turn them maybes into shores? I'm very confident that they don't and it's not the case in many, many practices and I know that if you will go to ask your front desk, and I'm sure they're lovelier, they're only trained as well as they're trained, right? But if you were to ask them, how's everything going today? What's the answer you're going to get? It's probably, yeah, it's going great. How many phone calls are converted? Like, yeah, they're all converting to appointments. Perfect and I'd be very sure that if they did not convert, the result would be wrong lead, wrong fit.  It was for the right reasons and I believe right now I could call up many practices including yours, and purposely be on the fence and say, hey, just looking for more information.  I'm concerned about my Dad. I don't really know the best process here. Looking for some feedback, that type of conversation. How many of them would get to a consult, especially if I started saying, I'm just concerned how much it would be. Finances are tight. What would be the best way to move forward with this?  If we can get more of them? Converting to an appointment? There's magic there because all the work's being done in order to position yourself to have that phone call and if you're not converting them then that is a leaky bucket. How leaky is it? Well, let's just run the math’s on this, right? If it's one phone call a day, and that's what, let's say you're a small practice, one phone call a day, that's five a week. That's what? 23 on an average of a 4.3 week month.  So 23 appointments that you're missing out on, which should be on your schedule, convert them however you wish to convert them and turn that into revenue and compound that over the year and that is pretty significant right now. Consider you're a larger practice. Let's say it's five to ten. All of a sudden, there's hundreds upon hundreds, if not thousands, of missed opportunities every single year. That is a prime example of a big, big leak in many, many practices and what's the solution to that? Well, it's better training for your front desk. Now, where is that training? What does it look like? As far as I've seen, there isn't a huge amount of great training out there, especially when it comes to objections, sales, et cetera. We help our inner circle members with a few trainings, a few exactly what to say, master classes that have been put together and things like that but beyond that, there's nothing too deep and I think this is where you've got to take responsibility of. This isn't somebody else's responsibility to train your front desk. This is where you need to step in because these are some of the most valuable conversations that are happening in your practice and right now, unless you're listening to all your phone calls, you have little to no transparency on and you've just got to go off the trust that the right person is doing the right thing and unless they're trained to do the right thing, then it's a very, very difficult ask. I have no doubt that you've hired a great person who's trying their best, who's doing exactly what you've asked them to do and doing it with trust and elegance and everything else but unless you've trained them to overcome these objections, meet people where they're at and guide them towards scheduling appointment being the right answer to that conversation, then unfortunately, this is your responsibility, not theirs. That is the first big leaky bucket. Let me talk about the second and this is cancellations. How many patients did not turn up for an appointment? It's a gap, right. You've done all the work to get them confirmed for an appointment. Why did they not turn up? Well, there's a couple of reasons why most people don't turn up.  

Number one is they agreed to this appointment. Maybe they called your front desk and they were spoken into getting an appointment or maybe they felt too awkward to say, I don't actually want it and it's easy to cancel.   

Number two is between the time that they scheduled the appointment and the time it actually turns up, they've had time to think about it. They think, actually my hearing is okay, or they've spoke to somebody else or had a recommendation that they should just go to Costco.   

Number three is naturally, this is an uncomfortable thing for many people to step into and although it's just another day for you, this is a lifetime event for many of your patients. Now, them turning up for an appointment is psychologically a big, big step. Right.  It's them coming to the conclusion that I'm a little broken, my hearing isn't working as well as it should. Am I getting old? What are people going to think? There's so many things that would keep people awake the night before this appointment you can understand and I do it right. I consider myself quite a disciplined guy but if I'm about to step into a really uncomfortable situation, could I pull out the situation before?  Like the day before, could I go, actually, I'm going to do something else? Absolutely. If I've made a commitment to go and run ten K with a friend and then the night before, I'm like, I'm not in the mood for that. Could I make an excuse and get out of it? Could I find better things to do? Absolutely and your patience are very much the same with creatures of habit. We avoid uncomfortable situations and we've got to accept that.  Now, what can you do in order to be in better control of that?  Well, consider what happens between somebody schedule an appointment and their actual appointment.  This is the big thing where you should be considering what you should do. What do the emails look like? Is there a direct mail piece? How is it set up to them on that phone call to let them know what happens next, what's going to happen at their appointment?  Nullify and minimize any of the concerns, objections or fears that they may have. This is where the consideration needs to be. As I shared in the 23 of the smartest and most original ideas of 2023 piece and the four part podcast episode, I believe it was in the first part one is I shared the process that quite a few of our inner circle members have put into place, which is prior to somebody's first ever appointment, they're sent an email that directs them to a page. On that page it has a video that introduces the provider.  It shares what's going to happen on the day. It answers all the FAQs. It uses case studies of other people that have been in their situation that are thankful that they visited for that first appointment. That's where I'd be giving key, key, key consideration to get that step right because once again, how many people is it per week? How many people is it per month that compounds? There's tens of thousands of dollars there for getting these things right. Let me share the third that I think is a big, big leaky bucket and it's not charging enough.  Like, has your pricing increased since COVID? Question like 2019 pricing to 2024 pricing, how much has your pricing increased? Because unless it's significantly then it's wrong, right? Because your costs have gone up like manufacturer costs. Every time you get an email from a manufacturer, it's about price increases. Your wage for your team like 20% minimum, it's gone up and that's based on, if we believe the government's inflation numbers, I believe they're significantly more but like 20% minimum, more like 25, 30%. Since 2019, all your costs have gone up and unless your prices have gone up as well, then what's been sacrificed? And it's your profitability. Now, why do many practices not put their prices up? I think there's a combination of reasons, but it could be a case of times are tight for patients we want to keep our prices as low as possible. It could be competitors are lower so therefore I need to be lower or it could be just a reflection of confidence, right? And this happens a lot with smaller practices that haven't done the work on their pricing is unless they're feeling super confident in their offering, then naturally the easy thing to do is minimize our prices. I feel undercharged because of low self-esteem. I'm in a competitive area. It's a very easy thing to do but giving consideration to your pricing and ensuring your margins are there and you're proud of what you're offering and what you're packaging, that's one of the biggest ways to grow any practice right now is do that literally, there's three ways to grow any business, any private practice, and it's get more patients. It's get patients to pay more, and it's get them to pay more often. Now, the biggest lever you can pull is increase how much patients pay like it's something you could implement today and all of a sudden feel a benefit. If you can collect an extra $300 per transaction right now, based on the same infrastructure and system, it's pretty much all profit.  It's money that goes into your pocket to pay for vacations, pay for good times, pay for fun stuff. It's your money that you can spend on Reese's bar, Reese's chocolate at the end of the month, whatever you want to spend it on, right? That's where the magic happens and it's probably one of the biggest areas where there's leverage for opportunity, where right now it's a leaky bucket because it's just money that is being left on the table. Let me share the fourth area where there's opportunity right now, where there's extra profitability and revenues available mand this will be a little controversial, potentially but this is not converting enough patients to premium. Now, I know what you're saying. Like well, not all our patients need Premium and very, very true, right? I think this is very circumstantial but here's what I see where I'm sat, right.  I believe many practices, and especially when you hire providers to do this, and if they're not trained correctly with great pricing structures, is they leverage their buying habits, fears and concerns and put that on the patient. They're like well, I wouldn't spend, I wouldn't buy premium. I buy mid-range so therefore I'm going to make this recommendation for mid-range and justify why this is actually the smartest option like I believe any provider or you. If you're seeing patients, your job is to not make a buying decision for the patient. Your job is to make the best recommendation to get them the best outcome and I think setting this up at your appointment to be like look, my job here is to get you the best outcome. I want you to hear better. I want you to have the most success so I'm going to introduce the best option available and then you help me understand if it fits your budget or not. I think that is the right way to approach this. If you can get more patients towards premium, not only are you going to grow revenues, grow profitability, et cetera, you're probably going to get the better solution for your patients. Yet, I think borrowing buying habits from elsewhere and it typically happens through a not a well-structured pricing process, then I think you're leaving money on the table and once again, it's another leaky bucket.  If you're getting 100 patients through your door, if you're charging correctly, moving them to premium, you're getting a lot more profitability as a result of that process.  Let me give you the next one. This is number five of six, and this is having no process for upgrading patients like, what is the expectation you set to patients on how long technology should last before they step into something new? Is it three years? Is it seven years? Is it five years? Is it four years? There's such a diverse range there and keep in mind, many people don't know the process. Many people have never bought a set of hearing aids before and you're guiding that journey now.  You can do it ethically, of course and you should do it ethically, of course but you've got opportunity to guide this and I think as a result of guiding it, you can make the best set of recommendations to ensure patients can upgrade to new technology at the right time.  But I think the big opportunity here is what is your process when it comes time for a patient to explore upgrades for example, let's say they come to the end of year four, their service plan and warranty is expiring. What happens then in order to get them to either explore new technology or step into some form of service plan? This is the one thing I'd be looking into so much if you don't have this process in place, because I think it's absolutely key in order to drive more revenue into your practice and I'll give you an example because here's how I'd structure this. Let's say they're coming towards the end of that service plan. They're at year four. Then I'd be looking to write to them and say, almost a dear patient, I'm writing to you today as our records indicate that your warranty is set to expire on this date. It means you'll no longer be covered for XYZ and any further appointments will require an out-of-pocket expense with the average out of pocket expense running into the hundreds, if not thousands of dollars per year. Many of our patients make one of the following two choices at this stage. Number one is they step into an extended service plan, a continued care and coverage plan.  If you want to keep hold of your devices and want to continue to access our support care, then this is for you.  It's this annual rate or you can pay monthly. Secondly, you can explore new technology. At this stage, many of our patients decide to step into new technology and start a brand-new manufacturer, warranty and service plan. You'll benefit from Xxx and as a result we'll make it as easy as possible for you. You can come and trial some new technology. We'll explore your insurance benefits, et cetera but with your warranty soon to expire, please let us know which of the above options are right for you by calling us and scheduling a visit. You need a process in place in order to ensure that patients don't just fall out of warranty, don't hear from you, and then potentially upgrade next time they come in, or whenever the time's right or whether when the wind is blowing in the right direction. You need to get this bit right because it's once again one of those foundations. Let's go back to the free ways to grow a business. More customers, more patients, increase average spend, increase how much patient spends on that initial visit and then increase frequency of purchase like increase how often they upgrade like if you can get two and three right by charge correctly and have a process in place in order to make upgrades congruent and align to some form of four year or five year plan then you're going to be set up significantly better and once again, you're not going to have a leaky bucket and then I'll give you the final one and I'd say this is one of the hardest ones to implement in our industry but once again, I think many of the biggest lessons that we've implemented for inner circle members have come from taking ideas from external industries and applying  them to private practice, hearing care and this is not selling patients anything else. I've got a bit of a rant about this that I'll come on to in a moment but look at any other industry. Look at Starbucks. Starbucks don't make the majority of their money through coffee. They make it through cakes and water and soft drinks and all the additional things, You look at Amazon, started as a bookstore, now sells everything but you can look at any successful brand. Very, very few businesses have one offering and that is it. Yet, in the world of hearing care, typically the only thing we sell is a service plan or a set of hearing aids, a treatment plan, etc. and the thing that I'd be considering right now and I don't come to you with all the answers but the thing I'd be considering is, what else can you sell your patients? They buy a set of hearing devices and a service plan. There's a transaction. What can you sell them after six months, twelve months, 18 months? Now, is this accessories? Is this also to go through a cognivue view assessment? Is this an additional complementary service? And I don't know is the answer. Is this an affiliate relationship with an eyeglasses place? And I'm just throwing silly ideas out here but finding additional ways that you can sell things to your patients that trust you like you know you, I think is incredibly smart thing to do from a business perspective and once again, let's and this is going to be the rant now, but let me just.  I suppose let's address the elephant in the room, the word sell. Now, this industry and healthcare as a whole has a big, big issue with the word sell and I think it's frankly ridiculous and I think the reason that there's this challenge is mainly through to some old people who've been in the industry for a long time that are very much stuck in their ways.  Like healthcare in the course, it was very, very different to what it is now and if you think the sun shines out of your ass and because you're in healthcare, then you shouldn't have to sell and people should just flock to you in this super competitive marketplace, then I think you're loopy like that is a 30-year-old view of what this world looks like and maybe you wish it was like that and maybe that would be easier, right?  But it's not and you either accept that and move with the times that right now healthcare has changed and it's super competitive, especially in our industry and yeah, if you want a successful enterprise business, et cetera, you do need to sell now. Sell has negative connotations like, you're selling people, you're selling things to people they don't like. We think of used car salespeople like selling some beaten up old car to try and maximize profitability. That's not what this is. This is essentially introducing options that the patient agrees is the right thing for them and you helping them make their mind up about it. That's what sales is in the modern world but if you think you should just have patients just flock to you because you're a healthcare provider, hate to break the news to you but the 1980s is calling and it's wondering where you've gone, right?  It's very, very different right now but I think those six key areas, so let me just recap them to you because I think they're super, super key. 

Number one, how well is your front desk converting and how can you get them to turn as many conversations into appointments as possible? 

Number two, patients that don't show up for appointments or cancellations. What is your process?   

Number three, you're probably not charging enough and leaving money on the table. 

Number four, not converting enough patients to premium. 

Number five, you have no process to upgrade patients routinely and number six, there's probably no attempt to sell anything else. It's always hardest to make the first sale and it's easiest to make the second so considerations of accessories, additions, additional services, that's what I would be considering right now and as I've said many times before, many of these ideas are things taken from external industries and then we analyze them on how they can be applied to private practice. It's not direct answers of exactly do this but yeah, I think there's a lot in that to unpack. I will say again, February the 22nd, I'm running a webinar where I'm going super, super in depth on a lot of big, big topics about how you can be ahead of the big curve, the big wave that is coming, that is either going to wash you off that surfboard and dump a load of water on your head or are going to allow you to ride it at super, super speed so if you want to join us, February the 22nd, 03:00 p.m. Eastern 02:00 p.m. Central twelve noon Pacific and that is join orange-gray webinar or the link is in the show notes on my LinkedIn. If you go to the orange-gray website, you'll find the link to the webinar. It's going to be a big one so be awesome to see you there but yeah, hopefully this was helpful and yeah, if I got your knickers in a twist by having a little rant about healthcare, then I kind of don't apologize but I'm not here to suck up to you and tell you the things you want to hear. I'm here to tell you what I see as the truth right now in our industry and where it's going over the next five to ten years which I feel is unbelievably significant so hopefully that was helpful. As always, greatly, greatly appreciate your beautiful, beautiful ears and I'll speak to you again soon. 

And there we have it but before you head off to skip to the next episode or eagerly await for next week's, I have three things for you. First of all, if you've enjoyed what you've heard today and want to learn more about our exclusive inner circle to discover how 60 plus clinics are setting benchmarks of excellence in private practice, benefitting from a mastermind of North America's most successful practice owners and having an industry leading marketing team driving gold standard implementation, then go to That's orange-gray. There's not only a video there detailing how you can win in the next two decades in private practice but it also shares a downloadable PDF with no ask for email address or anything like that, that will explain exactly what becoming a member looks like. Second of all, I strongly feel that private practice is in a very challenging spot right now, where we're the David fighting against Goliaths, made up of large groups, manufacturer owned chains, Costco's and whatever the next heavily funded Whizbang online direct response consumer model will be. I'm a strong believer in a rising tide lifts all boats and the more private practice can fight back at scale, the bigger impact will make so please consider a friend, a colleague, or even a Facebook group, a LinkedIn group, etc. where you can spread the word about this podcast and third and finally, it may be a little thing but a five-star review hitting subscribe will ensure you automatically download all future episodes and help the algorithm to grow the impact of this podcast and at the very least, it will certainly put a smile on my face when I go and look at the numbers so I look forward to talking to you again next week. Thank you for your ears and I'll speak to you soon. 

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Drip… Drip… Drip… I’m no plumber, but I know a leak when I see one!

The leaky bucket analogy, one of my favourites.

The water inside the bucket represents all of your current patients and existing customers, when you think of the holes in the bucket, they represent the reasons why people leave or decide not to convert…

In this episode, I share the six big areas where most practices are losing money and/or leaving cash on the table, and how addressing these areas can result in significant growth (without having to attract more patients).

Whereas many clinic owners are focused on driving more phone calls, more appointments and more patients, unless you have these six areas optimally performing, you’re putting water into a leaky bucket.


Are you eager to learn more?

You can find some amazing tips and tricks of our members in 2023, head over to 👈🏼 to find out more.

Want to learn more? 👀 ⬇️

If you want to learn more about the Inner Circle to discover how 60+ clinics are setting benchmarks of excellence in private practice, benefiting from a mastermind of North America’s most successful practice owners, and having an industry-leading marketing team driving gold-standard implementation, then visit

Listen To More:

Free (No Opt-In) PDF Download:
23 of The Best (and Most Original) Ideas Implemented by Private Practice Hearing Care Clinics in 2023


📈 A clinic that has launched a premium monthly subscription program that includes community perks, benefits and annual upgrades (yes, ANNUAL upgrades) ... yet earns them industry-high margins!

📹 How one clinic has bought themselves 6+ hours back on the schedule each week by implementing a series of helpful patient videos (that is also winning them patients from competitors

🔎 How two clinics have built industry-first programs to attract existing hearing aid wearers that are either unsatisfied with their existing provider, or new to the area (and turn this into a profit-center for their business)

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