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a blog by Chris Barrow

Growing pains in business – symptoms and causes

If you are running a three-chair practice with £500,000 in sales and 10 people, you can “wing it” 80% of the time and hold semi-formal meetings to create structures and protocols 20% of the time.

If you are running a 6-chair practice with £2m in sales and 20 people, you can “wing it” it 20% of the time but 80% of the time there has to be structure, protocol, systems.

The journey from one to the other reaches a point at which “winging it” no longer works.

That’s when the growing pains become apparent.


  1. Irritating mistakes start to happen;

  2. Patient complaints are heard;

  3. Team members begin to express frustration;

  4. Stuff doesn’t get done;

  5. Everything takes longer;

  6. Worst of all – gossip begins because the chain of command isn’t well established and communications flow sideways instead of top down.

The challenge when a small business becomes large is that many of the successful habits you learned when you were small become bad habits – they have to be replaced by a different set of habits when you become bigger.

It’s a very good idea to keep an eye out for the symptoms, so that you can identify the cause early on – and do something about it.

Almost always, what you have to do is create the protected time for formal management meetings (3 hours per month) and regular weekly reviews (1 hour).

Once more – here is the agenda for that monthly management meeting – I’ve been using a version of this for over 20 years. I’m still getting paid to remind clients to use it.

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