The Accelerator Program has been developed by the National Skin Cancer Centres (NSCC) to partner with selected skin cancer practices. Based on discussions with the owners, we have identified potential for growth which is not possible in the current state due to limited capacity or resources. The participating practice owners aim to exit their business in the near future and would like to optimise the practice’s valuation prior to sale.
The Accelerator Program allows the owners to leverage of and work with the NSCC team of experienced professionals who will focus on building the value of the practice over a two-year period and provide the owner with a better outcome when they exit from practice ownership.
Upon joining the program, the owner will be relieved of the administrative burden of day-to-day operations and will be able to focus on optimising their work as a clinician.
Upon agreement NSCC will conduct a thorough review of the practice in collaboration with the owner and practice manager to identify the opportunities for revenue growth, workflow optimisation and expense reductions. From our experience, 80% of the opportunity for net profit growth comes from revenue growth as there are generally few expense reductions.
We will collaborate to develop a two-year plan to optimise the practice and obtain the best result possible. Once the plan is developed, the operations team at NSCC will work directly with the practice manager to ensure execution while providing monthly updates to the owner on the improvements.
NSCC will also take on the following back office responsibilities:
NSCC have a proven track record of implementing value-enhancing growth initiatives via the following drivers:
There are various additional initiatives we deploy to optimise your practice which are detailed below, including case studies of practices where we deployed these strategies.
Upon agreement of working towards a mutually beneficial outcome, we will commence a review of your practice’s current performance and assess its growth potential under NSCC management. This will provide a benchmark for a fair market valuation for you to consider.
The sale of your practice would be structured so that 100% of the practice is sold to NSCC at settlement. NSCC would then also inherit all future legal and financial responsibilities, relieving the current owner of these obligations. NSCC will determine a valuation for your clinic and make a cash offer typically paid in two payments, with a substantial potion paid upfront.
The exact structure of valuing the practice needs to be agreed on a case-by-case basis in a way that best suits your business and personal preferences. We understand that everyone’s professional and personal circumstances are different so we remain flexible at all times and will develop an outcome that works for both parties.
We are so confident in our ability to grow your practice and provide you with increased returns over the two years that we guarantee a 20% improvement in your net profit from when we start. Most practices are fortunate to grow two to four per cent per year (industry average and compare against your three-year average) so your benefit will increase even if there are impediments to further growth.
While you will continue working with us as a doctor and receive a share of your billings, you could consider putting your new wealth to work. Please click the link below to view a short video with Property Investment Expert Chris Gray explaining just one of your many options.
The Accelerator Program is designed for practice owners who wish to work with an experienced team of skin cancer medicine professionals to scale their practice. We work with you, your doctors, and staff to help identify the areas that could be improved on, build a plan for execution, and monitor the results. The program also provides the owner and the NSCC team with the opportunity to get to know each other, understand how we all work and grow the practice together.
This is a win-win situation as the practice owner has a guaranteed exit strategy with a fair value. The doctors can grow their income without having to work more hours and have access to professional development in skin cancer medicine. Participating practices have seen a dramatic increase in the performance as other improved outcomes like practice culture. Please review the case studies to see how we have helped practices in the past and you are welcome to speak to the owners about their experience with NSCC.
We would appreciate the opportunity to help you achieve your goals – personally, professionally, and financially, and welcome your practice into our group of ‘centres of excellence in skin cancer medicine’.
The key focus for the Accelerator Program is to increase the profitability of your business, to optimise its value and to provide you the best return on your investment.
We work together to improve the practice’s performance over a two-year period. Many of the initiatives and tasks will be handled by our experienced team but as the owner (and practice manager) on the ground, many will need your help and support to ensure successful implementation.
To help achieve optimal performance, our focus will be in two key areas: revenue and expenses. From our 20 years of experience we have learned that 80% of the growth in a practice comes from revenue.
It is critical to understand what the bottleneck is for growing your revenue. Is it more patients, more doctor hours, more space or a combination of several factors? Identifying these challenges early will help us focus our resources in the right area.
If the practice is short on patients, we will implement initiatives to retain existing patients, attract new patients and increase the income per patient via fee increases and new services. If we are short on doctor hours, we will prioritise doctor recruitment or focus on workflow changes to increase the revenue per doctor.
If the practice is short on space, we will expand your current tenancy or relocate. Please keep in mind that often the cost of relocating is negligible compared to the potential revenue it could add to the business by relocating.
The simplest way to increase revenue is to increase your fees. Most patients do not shop around on the cost of medical services, but they do talk to their family and friends. Understanding the opportunity to increase the fees starts with a detailed competitor analysis and an understanding of what your patients are prepared to pay for your service. We will establish a pricing policy that will lead to regular fee increases that keeps the revenue in line or exceeds the increasing cost of running the business. If you are a bulk-billing practice, moving from bulk-billing to private fees can be challenging. We have proven strategies to navigate this complex challenge.
With many of the operating costs fixed, such as rent and a minimal level of staff, the first two or three doctors working in the business will only be contributing to the cost of running the business and deliver no bottom-line profit. We will help you understand at what level of FTE (full-time equivalent), the practice goes from covering costs to making a profit. Often the difference between a business breaking even and making a reasonable profit is simply one more doctor working in that practice.
As part of the Accelerator Program the practice will have the support from the NSCC doctor recruitment team, with direct access to over 11,000 skin cancer trained Australian GPs via our parent company HealthCert. We will help recruit experienced skin cancer doctors to work in your business.
Another way we can grow the revenue of the practice is to minimise onward referrals of more complex patients. We do this by providing free or heavily subsidised education and practical training for the practice’s doctors to equip them with the skills and confidence to manage more complex cases. Every doctor is different, and we will interview them to understand their limitation and how we can develop their skills in the most efficient way possible.
Utilisation is the term we use to track how efficiently doctors are being used in our practices. Any empty appointment slots represent missed revenue for the doctors and the practice. This is a key performance indicator for the front desk staff, and we will provide training to the staff to identify gaps and move patients to ensure that the doctors work at capacity every day. We will track utilisation weekly and we will train the staff to ensure the practice maximises the doctors’ available time.
If patient numbers are the bottleneck, we will focus on patient retention. Why chase new patients when the bulk of skin check patients should be returning annually for a regular skin check? Our target is to have at least 80% of the patients return each year. We have developed patient retention strategies that will double if not triple the patient retention and significantly reduce the dependency on new patients to grow the practice.
Our Appointment Centre will also be made available to the practice. The Appointment Centre, located in Brisbane, consists of trained medical receptionists and nurses who review the appointment book of the practice and actively call overdue annual skin check patients to rebook them. Our goal is to ensure the practice has a full appointment book for next 21 days. As most practices have minimal reception staff in the practice and their focus is to serve patients at the front desk, the Appointment Centre is an invaluable tool to reengage with past patients. We have also developed customised database searches to allow us to identify different patient groups (melanoma patients etc) which allows us to target patients with customised messages.
A unique feature of our business model is measuring patient satisfaction via a process called NPS. Every week, approximately 20% of our patients provide feedback on our service delivery which allows us to identify areas for improvement. It also allows us to identify dissatisfied patients within 12 hours of their visit and to remedy the situation. We supply training to the staff on how to manage disgruntled patients before they share their dissatisfaction with their family and friends.
Growing the practice through new patients can be challenging in the oversaturated world of marketing. Our dedicated marketing department has the ability and experience to build specific campaigns to attract new patients to your practice. Tools range from public presentations, including the use a dedicated UV camera to social media and much more.
The best source of new patients are referrals of family and friends from existing patients. We have developed a training program for staff in customer/patient service excellence which includes how to ask patients for referrals. We also provide printed materials and other resources to help us achieve our goals.
A doctor’s workflow can significantly improve or impede revenue. We understand that there is more than one way to approach skin cancer detection and treatment. As part of the Accelerator Program, we will work with you on the ideal workflow for your practice and identify potential improvements to increase the doctor’s dollar per hour and ultimately the business’s profitability.
Providing additional high-in-demand services in your skin cancer practice will increase revenue and profitability. A number of these initiatives do not require additional doctor hours and often do not require additional patients. As part of the Accelerator Program, we can integrate various services and the training to ensure you and your team are skilled at delivering them.
We will review whether your practice is over- or understaffed, and if all team members are being fully utilised. We will identify the cost of staff in comparison to the revenue, to the doctor hours and to industry standards.
As part of the Accelerator Program, we will improve staff utilisation to increase the doctors’ revenue and develop additional revenue streams driven by staff rather than doctors. We will also review the employment structures and compliance to state or federal regulations to ensure that we do not have a potential claim brought against the business in the future.
The ‘structure’ of a medical business is to provide a facility to a subcontracting medical practitioner to treat patients. In return, the medical practitioner pays the business a fee for the use of the facility as a percentage of their billings. Our unique “Power of an Hour” formula breaks down the fees paid by the doctors for the services the business is providing. It will also show how much each doctor contributes to the practice and deploy strategies to improve their performance.
Understanding the true cost of running the practice will enable us to negotiate current and future doctor percentages. As a matter of process, we will not change the percentages for existing doctors unless it is shown that they cost the practice money. We have a proven track record of being able to recruit doctors at realistic percentages which allows the practice to make a decent return.
We will review whether we have the right property for your practice, including size and capacity for growth. We may be paying for a premium location whereas we only require a functional location. We will review the property costs and propose a plan to minimise this expense.
As part of NSCC, you and one of your nominated doctors can join the Clinical Advisory Board (CAB), chaired by Prof David Wilkinson. The objective of the CAB is to discuss clinical matters and innovations within a group of like-minded skin cancer doctors. All clinical decisions within NSCC are evidence-based and guided by this group of clinicians. They meet via video call eight times a year.
One advantage of the Accelerator Program is that you, your doctors and staff receive access to additional learning opportunities and resources. Whether that be the specialised training programs we have custom-built for doctors and staff, a dedicated HR manager to help with ‘people challenges’, the opportunity for you your practice manager to connect to other experienced practice managers across the country or a dedicated marketing team to fill the appointment books – the benefits are numerous and of great value.
As the heritage of our business lies in GP skin cancer education with the world leaders like Professors Giuseppe Argenziano, Harald Kittler, Iris Zalaudek, Ash Marghoob, Luc Tomas and many more, we can facilitate clinic visits to their facilities overseas. This is an excellent way to combine a holiday with learning if you wish to expand your knowledge.
Our goal is to get engaged in the field of skin cancer medicine research. If you or your doctors have an interest in research, we can assist by connecting you to the chair of our CAB, Prof David Wilkinson, or one of the aforementioned leaders in this field.
Many doctors have the desire to give back and help upskill the next generation of doctors in skin cancer. Through HealthCert you may have the opportunity to teach other doctors and author or co-author books on this subject. Our goal is to help doctors transition from spending their ‘free time’ in running the business to teaching, which those already involved find very rewarding.
This practice was purchased in April 2017 and offered combined services of skin cancer and aesthetic medicine. It was owned and operated by two doctors who worked in the practice along with several other doctors. Both doctors aimed to remove the administrative burden and focus on clinical work.
Our initial strategy was to increase the number of doctors practising skin cancer medicine and utilise unused space. We then focused on growing the existing aesthetics side of the practice with the introduction of new services and a revised marketing strategy. Three years after NSCC took over the management of this centre, the skin cancer side of the business is operating at full capacity and the aesthetics business is experiencing strong growth.
There are current limitations to growth due to the size and configuration of the building that the practice is located in, with the centre running at capacity for the past 12 months. In addition, the room layout of the current tenancy has limited our ability to modify the workflow and potentially increase the doctors’ billings per hour by about 20%. In November 2020, the lease on this centre will expire and we will relocate to a new purpose-built facility.
Our new facility, currently under development, has been designed specifically for the treatment of skin cancer and other skin conditions. The facility includes:
Our second case study looks at a centre that joined the NSCC group in December 2016. The practice was owned and operated by two doctors. With high demand from patients and no success in recruiting new doctors to the centre, it had become apparent that both doctors would struggle to retire over the next few years.
Our initial strategy was to increase the number of doctors practising at the facility and shortly after we acquired the practice, we added another FTE doctor. Over the next two years, we increased the doctor levels until the practice was at full capacity.
In December 2018, we relocated the centre to a purpose-built facility within a short distance from its original location. The new location has allowed us to grow the practice to a four FTE practice.
Skin cancer practice before NSCC management
Skin cancer practice after NSCC management
Copyright © 2020 · National Skin Cancer Centres. All Rights Reserved