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You Got What You Deserved

Suppose we stopped pretending the corpse is breathing.  Suppose we recognized that putting makeup on a body doesn’t bring it back to life.  Hey, it’s already another year.  Another opportunity missed.  You didn’t lower your overhead, produce more, or finally free up the future of that staff member that has made your life miserable.  You probably have made a couple of New Year’s resolutions that you won’t keep either.  Isn’t it about time to actually start a year, not just with lip service to some unobtainable goal, but actually start this year off to make it the best year that you’ve ever had.   Bottom line:  You get what you deserve.  For most of you, you get what you expect.  I’m here to tell you that you need to expect more.

These are the facts you must deal with in order to make a shift in direction.  The following are the fundamental truths you must embrace.

Every practice is a “General Practice”.   Forget about labels such as boutique, managed care, or family practices.  Think of your practice as a small consumer driven business that we label a “General Practice”.  At the very lowest common denominator we all work the same number of hours, deal with the same staff issues, use the same dental materials and instruments, have the same patient challenges, and have the same amount of time to produce dentistry.  As we age we go from a “whatever it takes” attitude, to almost a feeling of entitlement.  We get soft.  We forget what got us here in the beginning, and are not willing to do what it takes now to change or maintain momentum.  We fail to compensate and plan for demographic changes, economic challenges, or lack of commitment on our part.  If you are looking at ever diminishing margins and ever increasing challenges, understand you are exactly where you want to be.  If not, you would change.  I hear it every day:  “Just tell me what to do and I will do it”.  With an unknown commitment from the doctor and staff we forge ahead to outline how to produce more, collect all, and keep half.  It is about this time that the truth comes out.  “We’re willing to do anything, but that”, or they agree and never launch.  They never follow thru on their commitment.   Time is short, and practices fail.  Look at how long you have been in practice.  At a minimum, you should be saving your age, each year, in one thousand dollar increments (30 years old = $30,000 that year in savings, next year it will be $31,000).   This is a minimal financial commitment, and you will need even more.  Time passes and we get a call from you when you are 55.  You’ve successfully ended two marriages, have 4 or 5 kids, just remarried your perfect help mate who, by the way, is 15 years your junior, you have saved nothing, hate dentistry and have finally come to the realization that you will only need to put away three million dollars over the next 5-10 years while also paying off a million dollars worth of debt in order to retire.  Bad plan.  Call me now.

Every practice is working at Capacity.  Look at how many new patients you get, the hours you work, the production and overhead, and the net profit.  That profile is you.  You are a practice that does those statistics and your staff is that type of staff.  You are getting exactly what you deserve, and exactly what your practice is set up to produce.  You never see a million dollar a year doctor producing $30,000/month.  Just like you never see a $30,000/month doctor and staff producing at $83,000/month or million a year.  They are a distinct, separate breed.  So let’s agree: Everything you do, every system, staff members, your hours, fees, and practice personality create the environment to produce what you currently produce.  Your practice as it sits today will never produce any more new patients, productivity, or profit than it does right now.  If you want more, you need to be more.  This may not be possible doing what you are doing today.  Doing what you currently do longer or harder will only dig a deeper hole.  You need to make a 180 degree change.  It will require a shift in attitude, staff, systems, hours, fees, marketing….  In other words, most of us need the “Complete Practice Makeover”.  It’s not going to be one large change, but rather 50-60 small changes top to bottom that create an entire shift in momentum and direction.  You should think of it like the TV shows that do a complete makeover on an individual or home.  In most cases you will not even recognize the old house or person because of the drastic shift in appearance.  Capacity is delivering a service that patients want, at a time they will show up and at a price that will fit their budget.  If your new patients are not growing every month, if you production has gone down, you are no longer meeting your patient’s needs.  Remember the mantra:  You can’t get better at giving patients what they don’t want.

Each practice has a range of patients it can inspire.   We need to realign our thinking to understand that our job is not prepping a tooth, or sucking spit, checking someone out, or cleaning teeth.  These are just the things we do while we are doing our real jobs:  Inspiring our patients.  Walt Disney said it best:  “You need to do what you do so well, that people can’t help but tell everyone they know about us”.  Look at the number of new patients you are currently getting.  Now look at how many come from direct referrals.  If you are not getting at least 50% from your current patients, you are not doing your job of inspiring everyone who comes in contact with your practice.  Next, count up the number of new patients you average per month.  The average is about 25 for most small practices.  Realize that for every 600 new patients that come thru your door, you will need to hire another hygienist.  A hygienist can see about 600 or fewer patients a year if seen twice.  If you look back and find that after 5, 10, 15, 20 years you still just have one hygienist, you must face the fact that you are running off as many patients as you attract.  If you were not, you would be adding a new hygienist every couple of years like the example above.   More often if you had more new patients.  If you are not growing, you’re not meeting your patient’sneeds.  If you are not inspiring your patients, your practice will die.

The strength of your practice systems determines the range of patients that you can inspire.   Do me a favor and go to and plug in your zip code.  Take a look at the description of people that live in your area.  If you look, you will determine their educational level, median household income, how often they move, their race, and ages.  Now look at the profile of the patients you currently attract, and the staff you have working for you.  To grow a practice, your staff, marketing, and systems should reflect the demographics of your area.  Don’t make the mistake of setting these facts aside and plod along doing what you are currently doing but expecting a different result.  Not having your practice and staff reflect your audience or potential patients is a death sentence.  Basically you are a dead practice walking.  Everything you do, each staff person, and every system should be designed to take advantage of your area demographics.  Take a hard look this year at what you are doing and why it isn’t working.  Make the change, start the shift, begin to get what you deserve.

The only limits to your practice growth are those you have consciously or unconsciously imposed on yourself.  This is the 800 pound gorilla in the corner of the room.  This is the uncertain unknown that makes helping you difficult.  As Pogo said:  “We have met the enemy, and he is us.”  You are the ultimate reason for change or a lack of it.  Change is the only constant in business.  If you are done with change, you are done.  It happens most often when we accept a limiting belief.  It can be something small like:  “I can’t do endo or work on kids”.  It can start early in life.  The earlier the worse it is.   If you hold a limiting belief long enough, it becomes truth to you.  Most of these limiting beliefs are lies appearing as fact.  They can be stronger than any chain man can create.  They will limit your growth and success in life.  If I could be anything, I would love to have the power to break limiting beliefs for each of you.  Hopefully, a good coach and mentor can show you the foolishness in your belief as well as a pathway to move away from it.

The first step is to decide it is time for a change.  The most important step is to give me a call on my cell at 972-523-4660.  Let me create a free customized “Growth Strategy Analysis” of your practice along with specific strategies to break capacity problems.  All it takes is contacting me by phone or email me at [email protected]  Don’t wait.  This year, like last, will be gone and you will have missed another opportunity to make a shift by expecting and getting more out of your practice and life.

Michael Abernathy DDS