Nothing is new:

•     Keep your operating costs per surgery per day below £700, preferably below £600. If it’s over £700, you are going to struggle.
•     Keep your associates on no more than 45%. More than that and you will struggle.
•     Keep your associates grossing over £1500 per day, preferably over £2000 per day. Below this you will struggle.
•     Deliver 160 days of surgery yourself every year. Below this you will struggle.
•     Use TCOs to eliminate poor salespeople amongst your clinicians. If you don’t, you will struggle.
•     Invest 5% of gross in effective marketing. Below this you will struggle. By “effective” I mean first, word of mouth, second, web  and social media, third, networking (B2B and B2P), fourth, selected direct marketing (radio, signage, adverts)
•     Insist on building a team who are ‘on brand’ at all times – any non-believers must go. If you tolerate them, you will struggle.
•     20 new patient appointments per surgery per month. Below this you will struggle.
•     A web and social media presence that is constantly updated with content and engagement. Short on this and you will struggle.
•     Simply the best ‘word of mouth’ conversations as part of your Patient Journey. Without this you will struggle

and then, hold your nerve.
I am still working with a few practices that are enjoying a “best ever” year in 2012 – they have the above characteristics in common.
Those who cannot tick ALL of the above boxes, struggle to some extent or other.