Now is the time to plan for 2020.   Have a staff meeting and plan for the next 12 months  Go to seminars quarterly and plan 2-4 weeks off next year.  Plan to share what know on social media and get your staff involved in the process.   Plan any renovations you may want to do to make the clinic more attractive and efficient.  And you may want to add professional or administrative staff to your team in 2020.