Key Takeaways

• Sustainable practice growth often requires the owner to grow as a leader along with the business.
• Strong cultures are built intentionally through clear expectations, consistent communication, training, and reinforcement.
• Documented systems make it easier to create consistency, develop employees, delegate, and scale.
• When a practice feels financially stuck, understanding the numbers behind the results can help identify where attention is really needed.
• Growth rarely comes from one big change; leadership, culture, systems, and financial insight work together to build a stronger practice.

When Dr. Corey Malnikof opened his first clinic in 2005, he was confident in his clinical abilities and assumed patients would follow. The reality was very different.

He had signed a lease before his space was ready, bills were piling up, and he knew very little about running a business. At his lowest point, he was working evenings at the Dallas Expo Center to help pay his office expenses and had his credit card declined trying to buy a $4 sandwich. 

That experience forced him to rethink his approach. He began studying successful businesses, working with mentors and focusing as much on developing himself as on developing his practice. He eventually grew from that struggling first clinic to an organization encompassing 24 locations.

On a recent episode of Beyond Bitewings, Dr. Malnikof joined us to talk about what that experience taught him about leadership, culture, systems and sustainable practice growth.

Growth Starts with the Leader

One of Dr. Malnikof’s central lessons is that business growth often requires personal growth first. As his organization expanded from one location to several and ultimately to 24, he recognized that he couldn’t lead each stage of the business in the same way. The skills and mindset needed to operate one practice weren’t necessarily those required to lead a much larger organization. 

That also changed how he approached problems. Rather than automatically blaming the market, pricing, employees or other external factors when something wasn’t working, he learned to look first at his own leadership.

For practice owners, it’s an important question to consider: What does the next stage of the practice require from you that the current one doesn’t?

Build Culture Intentionally

Dr. Malnikof also looked well beyond healthcare for ideas about how to build a better business. He studied Starbucks for its approach to culture, Ritz-Carlton for service, Nordstrom for training, and Amazon for innovation and growth. He then adapted what he learned to his own organization. 

One example was his “little yellow book,” inspired by Starbucks, which documented scripts, procedures, and core values so employees understood not just what to do, but how the organization expected them to approach patients and one another.

But documenting values isn’t enough. Dr. Malnikof emphasized the importance of continually reinforcing them through training, meetings, employee reviews and strategic planning. His organization also uses regular employee check-ins to identify problems and training needs before they become larger issues. 

The larger lesson is simple: culture doesn’t become part of a practice because it’s written on the wall. It becomes part of the practice when it’s consistently reflected in how people work.

Systems Make Growth Repeatable

As a practice grows, relying on the owner to remember, oversee, or explain everything becomes increasingly difficult. That’s where systems become critical. Dr. Malnikof recommends starting small rather than becoming overwhelmed by trying to document every process at once. Identify the procedures that should be standardized, choose one, and write down how it should work. Have the team review it, improve it, and then move to the next.

He also discussed how AI can help practices identify missing processes, organize information, and improve procedures that teams have already documented.  The goal isn’t to build the perfect operating manual overnight. It’s to create enough consistency that the practice isn’t reinventing the way work gets done every day.

Know Which Number Needs to Move

For practice owners who feel financially stuck, Dr. Malnikof offered one particularly practical piece of advice: know your numbers.

If collections aren’t growing, simply knowing that they’re flat doesn’t tell you what to do next. You need to understand the numbers underneath them. How many new patients are coming in? How many accept treatment? How long do patients remain with the practice? What is their lifetime value? What does it cost to acquire a new patient? Which procedures are driving revenue?

Once you understand the underlying metrics, you can identify where the constraint may be and focus on changing it rather than trying to change everything at once. 

That’s an idea we believe strongly at Edwards & Associates as well: financial information becomes far more valuable when you use it to make decisions rather than simply record what has already happened.

Building a Stronger Practice

Dr. Malnikof’s experience demonstrates that sustainable practice growth rarely comes from one big idea. It’s the result of consistently developing as a leader, creating a culture people understand, establishing systems that can support growth and paying attention to the numbers that reveal where the business needs attention.

In the full episode, we also discuss mentorship, employee development, handling stress, discipline and consistency, and learning from people and businesses outside your own profession.

Listen to or watch the full episode of Beyond Bitewings for our complete conversation with Dr. Corey Malnikof.