The first year was definitely difficult. Given that revenue was expectedly low and operating expenses were high, I suffered on both the top line and the bottom line. Your startup costs don't end as soon as you open doors. Throughout the first 2 years, you will encounter additional upfront costs that you initially didn't know you needed. In addition, you'll be paying for things that are wasteful and unnecessary, but you won't realize it until later. Only after the first few years, will you grasp which areas of fat you can further trim. Because I have constantly reviewed and fine tuned my expenses, I'm running a much leaner and more efficient practice today. Most of my current expenditures are absolutely necessary, yet at a competitive cost.
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