I am convinced there is a reason that a small practice stays small - And it does not usually have anything to to with the economy or the market environment.
It usually has to to with the seriousness of the marketing program. The surgeon is either not willing or unable to grow his practice.
You may say that I am pushing this because it feeds into my business. Maybe it colors my view, but, I found a quote lately, that I have experienced to be true in almost every instance of growing a business. Even when I was not making a living out of growing others' businesses, but was working on my own:
"What we wonder and what we think about sets the course of growth. Any day we wish; we can discipline ourselves to change it all. Any day we wish, we can open the book that will open our mind to new knowledge. Any day we wish, we can start a new activity. Any day we wish, we can start the process of change. We can do it immediately, or next week, or next month, or next year! Remember - An opportunity is never lost, just found by someone else. Äú
I have experienced this: The surgeon that is serious about growing his business will start today. There is a reason why you are reading this. What is holding you back in your practice?