"Where there is no vision, the people perish." - Proverbs 29:18
What is your vision? Do you want to improve your practice or business? What about becoming debt-free or improving your health? You need to develop a clear plan and put steps in place to carry that plan out.
It's not enough to simply have an idea in your head. If you really want to bring it to fruition, you must write it down and develop a time line to make it happen.
If you want to improve your business, how will you do it? Will you focus on a marketing aspect? What will you do? When will you launch it ?
Focus on the long-term when planning and then pull out the short-term things that you really need to do right now.