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Poison Patterns

An article I wrote entitled “Donor and Recipient Practices” was published in The Profitable Dentist Newsletter.  We have had hundreds of doctors responding to the article and our offer to send information to reverse this trend in many offices around the US.  (I suggest you read that article before reading this one — just click Quick Link #3 to the left).  This follow up article entitled “Poison Patterns” is a response to the new graduates and those of us who are aging not so gracefully.  While these two age groups seem to exhibit poison pattern traits more often than not, I would have to say that any age is susceptible.

These patterns will almost guarantee failure 100% of the time in any business venture.  I would have to say that Dentists and their staffs seem to be the most susceptible and therefore the most likely to fall victim to these poison patterns.  These patterns or characteristics highlight the personalities and operating traits of every marginal dental practice I have ever encountered.  So common are these patterns that once identified and corrected, we can almost assure an increase in profitability, new patients, and satisfaction in practicing dentistry for the doctor and staff.  Read and study the list carefully.  Understand that infected parties are the last ones to know their own symptoms.  These patterns are so devious and sinister as to seem illogical and of little importance to the infected doctor and staff.  Often times the worst offenders feel like they are symptom free, when in fact they infect everyone they know.  In order for you not to miss the significance of even a couple of symptoms from the list, we have included a form at the end of the articlethat will allow us to diagnose any blockages and patterns that may be holding you back.  Fill it out, fax it back in, and I or Max will spend an hour or so with you on the phone diagnosing why you are not having a banner year.  Correct the areas we diagnose and you will be on your way to at least a 15% increase in productivity, a lower overhead, and decreased stress and frustration.


  1. Entitlement:  Feeling like you have put in the time and effort throughyears of practice should guarantee you low overhead, limitless number of new patients, and a 50% overhead.  I even see new graduates exhibiting entitlement by thinking that they are owed an income level or cushy job because they graduated from dental school.  As you know, a new graduate is “just barely not dangerous”.  The fact is, if you have been in the same location more than 10-15 years you are probably in the wrong place.  If you have been practicing pretty much the same way for more than ten years, you are probably not even in touch with the reality of running a small consumer driven practice. Demographics, competition, median household incomes, race, and educational levels always change with time.  Failure to meet thesechanges creates a plateau, increases in cancelations and no-shows, lower productivity, and fewer new patients.  It is time to get back to the mantra we all used when we first started practicing:  Whatever it takes.  Gone are the times of no competition, work whenever we want, and charge whatever we think we can get away with.  Welcome to the new economy.  Change or die.  If you are thinking that you can coast or just stick it out until the economy turns around, you are guilty of entitlement.  When you are done with change, you are DONE.
  2. Fear of setting prosperity goals (fear of failure):  We all know that goal setting works, yet most of us are guilty of spending more time planning a vacation than engineering goals for our practices.  If you are too tired, worn out, or your giddy-up has gotten up and gone, you need to remember that the doctor down the street still has something to prove and he or she is willing to do whatever it takes to  survive and become a success.  To set a goal, you need a benchmark, a target at which to aim.  Fill out the included form and fax, email, or snail mail it back and let us help you set those goals.  We will give you direction along with a reason to challenge yourself with prosperity goals.  Waiting to see what happens is over-rated.  Start today, find out where you are, create some challenging goals and begin moving forward to that next prosperous stage of practice.
  3. No Promotional Consistency:  Doing marketing on a hit or miss basis only guarantees a miss in results.  Marketing grows throughconsistency of a well engineered marketing plan.  It requires dedicating at least 5% of your income to a systematic outreach program that is dictated by your area demographics with a significant offer and urgency to act in order to meet our benchmark of 50-75 new patients per doctor per month.  A result like this is predictable and will assure a steady growth rate of at least 15% along with the cushion of knowing that you are recession proof.  Add to this consumer hours, a great telephone strategy, and comparable fees and you can’t miss.  Don’t settle for just getting by while blaming a poor economy that might or might not correct.  Recessions separate the marginal from the great.  Business failures are nature’s way of saying:  You are doing it wrong.   Give us a call and let us put you on the path of strategic marketing with a predictable return on your investment.
  4. Capacity:  Capacity is the ability to deliver dental services when the patient wants them at a price they are willing to pay.  How do you know that you have the perfect capacity?  You are growing.  Lack of capacity could include poor consumer hours or convenience (not being there when the patient wants the work done).  Poor pricing by not keeping comparables comparable will insure a lack of growth and few internal referrals.  Not having enough chairs or staff or even too many (your staff should be producing about $20,000 – 25,000/staff person/month, and produce about $25,000 – 30,000/month/operatory).  Typically, inadequate capacity can be diagnosed and fixed in a matter of days by changing systems or purchasing equipment at the right time.  Excess staff or chairs means having too high an overhead (facility costs goal would be 7 – 9% of collections, and staff overhead should be 25% of collections, including associates and any other expenses dedicated to staff).  You must have peak demand times (7am to 10am, and 3pm to 6pm each day, plus Saturdays) in order to grow.  Being overbooked or not having sufficient peak demand times open for productive cases and new patients is a killer of growth (you must be able to get a patient in for a cleaning in within 5 days, for an exam within 48 hours, for an emergency the same day, and for hygiene follow through on soft tissue within 10 days).  Capacity is time and efficiency in motion.  If you have and use capacity properly you will maximize effectiveness and efficiency.
  5. Target fixation:  Dwelling on a single problem like the economy is “negative goal setting”.  The Bible says:  Worry about nothing, pray about everything.  I am not saying to not be aware of your circumstances, but when you get fixated to the point of blaming everything on the poor economy, you are wasting your personal resources.  You have become like a deer caught in the headlights of an on-coming car.  Acknowledge your circumstances but then make a conscious decision to not have your circumstances dictate your response, and certainly not your outcome.  We see practices that are having a twenty to thirty percent increase in business this year over last.  Are they working harder?  Yes.  Are they doing the practice of dentistry  differently?  Yes.  Are they succeeding in spite of what others wallow in?  Absolutely.  From now on, decide you are not participating in negative talk or think.  You will set prosperity goals and act in such a way as to not be drawn into a marginal practice.  Your goal is a 15% increase for the rest of the year.
  6. Financial Captivity:  Not learning how to balance your life and your money will only bring stress and disappointment.  A couple of months back Max wrote an article about the “Fulfillment Curve”.  You need to go back and reread it.  With every copy of our newsletter, you have the ability to go back and read or reread a past article.  It will change your life.  I practiced with a great dentist as a partner for 15 years.  He was great with the patients, a great clinician, and good producer.  His dark side was his complete inability to plan and hold on to his money.  He always found a way to spend more than he made.  He has always struggled to spend less and plan for the future.  Too often, we find this trait in Dentists that we mentor.  It seems to be tied to a type of entitlement that they feel when stressed.  They work hard and feel that they are justified in spending to offset the stress associated with their practice.  This is a self-destructive habit that will drag you down.
  7. Lack of Consumerism:  We have touched on this in the previous 6 categories or poison patterns.  In today’s economy, potential patients vote with their feet.  If you have an increased no-show ratio, fewer new patients, and even fewer direct referrals, and even when they actually come in you keep seeing the back of their neck as they walk out the door to get a second opinion (donor vs. recipient practice), you are not taking into consideration that nothing happens until the patient (consumer) says yes.  Fail to meet the expectation of the consumer (being caring, compassionate, comparable in  pricing, competent, confident, convenient, and able to do what they “want” rather than just what you think they “need”), and you are destined to have your practice  fail.  Never, never be caught trying to sell the consumer something they do not want.  If you are not growing, you are not inspiring the patient and are not meeting their needs.  Stop.  Look.  Listen.  What type of relationship do you search out in small consumer businesses that you frequent?  This is what your patients and the public want from you.  Stop practicing like you are doing them a favor by being there.  The patient is not the problem.  The patient is your job.


If anything resonated here both about poison patterns and donor vs. recipient practices, you have your work cut out for you. The problem is that next month turns into next year and your career ends up never really being what you always wanted.  Give me a call today and find out how your practice can be more than you ever thought possible.