Some Questions (And their answers)
Here's a question that might actually be your answer. Next time you're working on your practice-building strategy, ask yourself this:
If I ran a competing practice, how would I beat mine?
Which weakness would I attack? What would I do to distinguish my new practice from my current practice?
Then --- eliminate that weakness from your practice. Either augment your activities, your location, your service, your support systems, etc. or outsource them. Your weakness is your soft underbelly, and probably the reason you are losing some business.
Next --- build on your distinguishing strength before someone else starts doing it.
Always ask yourself, "How would I beat me?"
Another good question to ask.
Whenever you consider your business's next steps, ask, "if we were starting this business from scratch, what would we do differently?"
Then do that. Every now and then it's good to start from scratch.