Start and Grow a Profitable Botox®, Aesthetic Medicine or Medical Weight Management Practice

Using Awesomely Simple Tools for Practice Success

For over 22 years, author, John Spence, has traveled worldwide helping people and businesses be more successful. 

At 26, John was the CEO of an international Rockefeller foundation, overseeing projects in 20 countries. 

I, personally, read about 70 business books a year, but since 1989, John has been reading over 100 business books a year. 

Two men in business suits looking at a book

The benefit of his combined hands-on experience and thirst for knowledge resulted in an amazing book, ahead of its time really, called “Awesomely Simple: Essential Business Strategies for Turning Ideas into Actions.”

I first read this book years ago, and since there is such a gold mine of great strategies, I created this book summary to remind me of the valuable tips that are found throughout the book. 

The tips are very much applicable to a medical practice, in fact, they are critical if you want a profitable and successful aesthetic practice.

John bases the book on “The Six Strategies of Business Success,” which are:

  • Vivid vision
  • Best People
  • Robust communication
  • Sense of Urgency
  • Disciplined execution
  • Extreme customer focus
Awesomely Simple Book Cover

The purpose of this summary is to act as a supplement to the book.  The book is filled with detailed real life examples which will help you better understand the principles he is teaching. 

The book also includes workshop examples which you can get your team working on right away. 

John’s website also has a free downloadable “toolbox” to help you with the concepts.

Before you start implementing any of the following strategies, its important to understand the table stakes, which is what you should currently have in place in your practice:

  • A high quality product or service which provides real value to your customer
  • Solid understanding of financials (I like “Accounting for the Numberphobic: A Survival Guide for Small Business Owners” – it’s a $2 Kindle download, which gives you the basics of business financials)
  • Be prepared for constant change. Markets shift, consumer preferences change, new competitors appear, technology changes faster than ever before.

Vivid Vision

The first strategy is “vivid vision.” Having an inspiring vision for both you and your team to focus on is a critical first step of any successful practice. 

This book, written many years before Simon Sinek’s “Start with Why,”  is a great reminder on the importance of having a compelling vision to keep everyone going in the right direction.

To give you some examples, for my cosmetic medical practice, our purpose or vision is to “put a smile on every patients face.” 

For the IAPAM, it is “to help practices succeed.” Every team member knows our vision, it’s the “why” of our existence!

John also gives his interpretation of mission, vision and values. “A mission says why the company exists, the vision says where we want to go, and values declare how we will act and behave along the way. “ 

He goes on to say “The biggest problem in most organizations is not that they lack vision, but that the vision is poorly communicated throughout the organization. 

A great vision statement is like a mantra—a few key words that inspire and direct your people. “

John also covers off some things to watch out for, “the four biggest issues for many business leaders are a lack of well-communicated vision, lack of courageous communication, toleration of mediocrity, and poor execution of key plans and ideas.” 

If anyone has read Patrick Lencioni’s book, “The Five Dysfunctions of a Team”  you will be aware that lack of trust and accountability will certainly erode a team.

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Best People

The next strategy, “best people,” is critical for any business success. I find it amazing how little time people take when hiring.  

If you don’t have a thorough hiring process, you will spend much more time and energy removing those “bad hires.” My tip is spend the time up front, and hire only the best.  

Look for those who have a natural desire to provide exceptional customer service, and have a history of being accountable for their actions. This is critical for a successful practice.

If the importance of hiring only the best is not clear yet, keep this in mind “find your lowest-performing employee. 

Then realize that this is the person who sets the standard of acceptable performance for your entire organization.”  You should look at your existing team at your practice, and if you would not hire them again, then really think if they should be there.

Once you have hired a great team, you want to keep in mind that “talented people want to be respected for the work they do, treated fairly, and made to feel that their voices will be heard and their opinions valued.” 

So have a regular rhythm of team and 1-to-1 meetings of each team member.

Spence goes on to cover The Five C’s of talent: competence, character, collaboration, communication, and commitment.  

Competent is pretty self-explanatory, you have to be able to do the job. Character is all about trust, if they are not trustworthy, you certainly don’t want them working for you! 

Collaboration covers their ability to work on a team, very few jobs are “lone wolf” jobs and if they can’t work well with others, than they are not a fit. 

Communication entails having the ability to ask great questions, listen and connect emotionally. 

One needs to be committed to the company, the job, and they must want to succeed.  These are all great attributes to highly successful team players.

The following pretty much sums up this strategy: “You need to be obsessed with discovering highly competent people of impeccable character who work really well with others, are great communicators and have a driving commitment to excellence.” 

Well, I think we all have our work cut out for us!

Robust Communication

According to John, the single biggest problem facing organizations today is the lack of open, honest, robust, and courageous communication. 

One of the challenges of growing businesses is the complexity of communication, the more people involved, the more likely of a breakdown or miscommunication.

Do you, or your employees, know the vision or direction of the practice? If you are like most practices, you do not.

The key skills for superior interpersonal communications are:

  • effective use of body language
  • focused listening
  • expert questioning
  • flexing to sensory modes
  • providing both logical and emotional arguments
  • and listening for ambiguous or emotionally loaded hot words

One of the most serious blocks to effective practice communication is the inability of people throughout the company to deal with difficult, stressful, or confrontational conversations. 

There are five stages for handling a confrontation: empathetic listening: I- statements, finding common ground, positive redirection, and no alternative. 

The five stages and tools for handling them are beyond the scope of this summary, but suffice it say John gives some great examples and techniques that you can use for your company.

The fact is, the key to improving practice communication is to work on improving your own interpersonal communication skills and then model positive communication skills and behaviors for others in the practice to learn from.

Sense of Urgency

This chapter covers how to create an organizational culture that reflects a strong desire to get the most important things done quickly and never to waste time on the trivial. 

Greg Mckeon’s book, Essentialism, came to mind as I thought of this concept.  Sense of urgency is fourth in the list, and you can see that without a vivid vision, having a team of the best people, in an organization with robust communication, it would be hard to create a clear line of sight of what you want to accomplish.

I love this quote “You don’t always get what you ask for from employees, but you almost certainly get what you reward for.” Make sure you are rewarding the right behaviors.

John discovered early in his career that the best way to keep a company moving forward was to give people as much independent decision-making authority as possible. 

He created a framework called “four-level decision making” to delegate decisions effectively across the organization. 

A “level 1” decision is one that you own completely as the employee. The employee should be comfortable making this decision, quickly and confidently, without any input from others. 

A “level 2” decision is one in which you get some advice from the appropriate person(s) in the organization. 

The example given was that of a marketing person who needed some feedback from sales before completing a marketing campaign. 

A “level 3” decision is a team decision. This is when you get all of the stakeholders together, get their input and make a decision based on the team’s feedback. 

The final level, “level 4” is when the leader makes the decision on their own, often with the advice from various members of their team.

Having a decision framework in place expedites decision making in a practice, which is where urgency usually gets derailed.

Disciplined Execution

Since my focus word of the year is “execution,” I paid particular attention to this strategy.  

John’s definition of discipline execution was “a performance-oriented culture that demands flawless operational execution, encourages continuous innovation, and refuses to tolerate mediocrity. “

If there is one thing that stops good practices from becoming great, it is allowing mediocrity to flourish.

John goes on to say, “businesses that fail might have the best of intentions, good people, great products, and a solid plan for success, but they cannot deliver results because they are not disciplined in executing on their most important goals day in and day out.” 

This cannot be under estimated, the failure of most companies is their lack of their ability to execute.

Spence created the “Nine Steps to Ensure Disciplined Execution” to address the issue of lack of consistent execution. 

Again, the book goes into much more detail than I’m going to cover here, but here is a summary of the nine steps:

Diagram - 9 steps for ensuring effective execution

The first step in creating an organization that is superb at disciplined execution is to set the context by clearly communicating (actually over-communicating) the vision and the values of the organization and strongly emphasizing that only through the effective execution can the vision be attained. 

This step is important to help people remember why they are working so hard on the business and the way you expect them to act within the organization as they pursue aggressive goals on tight time lines.

Step two is strategy. The entire organization must be focused on the handful of key strategies that drive the success of the business. 

I know this is a challenge for me, but it’s important to remember that not everything can be a priority. 

Another reason for creating a clear, intended outcome—a focused strategy—is also to tell people what to say NO to.  

The most successful organizations only focus on a few critical areas that will yield the highest return.  

This ties into Greg Keller’s book, “The One Thing,” where he talks about focusing on the one domino which when completed, will knock down the most dominoes and accomplish the most for your business.

The third step is commitment. You need to have everyone committed to the goals of the company. 

It’s important to ensure everyone is onboard with the decisions and direction of the company. 

They all need to know the “why” and be prepared to work towards it. This often starts at the top meaning if you are not excited, then they will most likely not be either.

Step four is alignment with all the other strategies, goals, plans and actions of the organization. 

You want everyone to be able to see how what they do impacts the vision and goals of the organization. 

John goes on to explain his variant of SMART goal setting: Specific, Measureable, Agreed, Realistic, Time-bound.

Step five is to have well-thought-out “systems” in place to achieve your goals. It’s important to have a document system of process and procedures to reference as you execute on your goals. 

This may include: checklists, step-by-step procedures, and/or detailed protocols.  The key here is that you don’t want everyone going in a different direction; you need to keep everyone focused on how things should be done.

Step six is communication of priorities. In fact you will relentlessly over-communicate to everyone the vision, why you are doing what you are doing, the overall strategy, and the importance of everyone to follow the current systems. 

This is not only done during the launch, but must be maintained and nourished continually. 

According to John, any major change will take eight to eighteen months of continuous, relentless, consistent communication to keep it on track and moving toward success.

Step seven involves giving people lots of “training and support” so they can learn new skills and accomplish challenging tasks. 

Make sure you review everyone’s level of expertise, and be prepared to give them any additional training to ensure they, and the organization, are successful.

Step eight covers the fact that you will need to be prepared to “adjust and innovate” your plan as you go. 

Rarely, do plans go without the need to update and change.  You will need the ability to measure the key elements that actually drive success. 

John goes on to explain Toyota’s famous “kaizen” philosophy of always looking for a better way to do things. 

The goal is to get everyone looking for a 1% way of doing everything better. This 1% drive for improvement will not feel overwhelming to your team, and will help them change their mindset to always look for a better way do doing everything.

The last step, nine, covers rewards and punish.  What gets measured and rewarded gets done. 

According to John, the number one way to get people to effectively execute is to lavishly reward those who do. 

He goes on to say lavish is not necessarily monetary, but praise, celebration, recognition, small rewards, and sometimes large rewards. 

Even more important is to create a culture that refuses to tolerate mediocrity. 

An important part of determining whose fault the mediocre performance is to look in the mirror, did you really do everything to help and support them? 

Have you given clear direction? 

Does this person have all of the tools and equipment he or she needs? 

Have you given enough time and help to be successful? 

Have you communicated very clearly that his or her performance needs improvement? 

If you have done everything to set this person up for success and they failed, you need to see which of the “three T’s” are needed: Training, Transfer or Termination.  

John also has some great exercises to help you to get the most out of your employees.

In summary, the four biggest roadblocks that almost nine hundred executives identified to moving their businesses forward are lack of a well-communicated vision, lack of courageous communication, lack of disciplined execution, and tolerating mediocrity.

Extreme Customer Focus

If you take everything else you have learned so far in this book—well-communicated vision for the future, best people, courageous communication and transparency, a culture of urgency, and disciplined execution—and focus all of it intensely on listening to your customers, delivering superior customer service, and building strong relationships with your customers, you will dominate your market.  

John also talks about an eighty dollar book he purchased in the past that was only twenty-eight pages long, but had the following four key principles for business success:

  1. Show up on time
  2. Keep your promises
  3. Be extremely polite
  4. Give a little bit more than is expected

These principles make me think about the Four Agreements: Be impeccable with your word, don’t take things personally, don’t make assumptions and always do your best!

John mentions that a broad array of national surveys demonstrates that these are the most important customer expectations for great service:

Reliability: The ability to provide what was promised, on time, dependably, and accurately

Professionalism: Highly knowledgeable, ethical, and honest employees who instill a sense of trust and confidence in the customer

Empathy: Genuine care and concern for the complete satisfaction of the customer

Responsiveness: Not just delivering prompt service but being proactive in anticipating the needs and concerns of the customer

Ambience: The design and comfort of the physical facilities, cleanliness of the facilities and equipment, and appearance of the personnel

I love this quote “hire for attitude and train for skills.

John goes on to talk about a customers “moment of truth.” The goal is to identify the short list of your company’s key moments of truth—that is, your most critical customer touch points—and design processes and systems to ensure they are done absolutely flawlessly every time. 

The aim here is to make it as easy as possible for your people to provide stunning service by removing opportunities for mistakes or failures.

John emphasizes the importance of owning the voice of your customer, “the only way to find out what your customers want is to ask them, listen to them, and do everything you can to own their voice. 

Through surveys, customer panels, focus groups, help lines, expert users’ groups, new users’ groups, discussion boards, blogs, special events, trade shows, open houses, visiting customer locations, taking key customers to lunch, and a hundred more ways, it is essential that you spend the time, energy, and money necessary to find out as much as you can about the likes and dislikes of your customers and precisely how they define great customer service.”

John wraps up this last strategy with a listing of factors that lead to strong employee engagement:

  • A vivid and compelling vision for the future of the organization and a clear customer service excellence vision that is meaningful and motivating
  • A culture of respect, encouragement, recognition, and praise
  • All of the training, tools, and resources necessary to perform their jobs superbly
  • A fair compensation system that is at least equal to what they would be paid to do a similar job at any other company
  • Setting high standards of performance and then holding people throughout the organization 100 percent accountable for meeting or exceeding the standards at all times
  • A culture of empowerment that supports prudent risk taking, innovation, and doing whatever it takes to deliver consistently superior customer service

In the end if your employees aren’t on board, then success may not be an option. 

I hope this summary of John Spence’s brilliant book, “Awesomely Simple: Essential Business Strategies for Turning Ideas into Actions,” has helped you either overhaul or fine tune your practice’s culture of getting things done. 

Over the years, I’ve used many of these tools successfully in my practice. Many of which you will find incorporated in the IAPAM’s Secrets to a Successful Practice Workshop.

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