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Answer to a Young Doctor

I probably spend 50% of my time answering emails and phone calls from students and doctors I may never meet. I consider their trust in contacting me very seriously and I want to make sure that they get the answers they need. I thought you might want to see a question and an answer. To set the stage, this young graduate is in his first job. This is probably the fourth email that we have exchanged but what I want you to see is that the senior doctor seems to deflect a very serious observation the young doctor has made by basically just dismissing him without really considering the implications of his attitude or answer.

This is very common when I speak with doctors that are struggling in their business. It’s as if they just don’t really want to know the answer. It’s as if my explanation was correct, they would then be faced with actually fixing the problem rather than ignoring it. Before you read the email exchange, please go to and search for “It’s not about the nail”. This will set the stage. Here’s a link:


Dr. Abernathy

I spent the week going through the staff meeting notes for the past 12 years. They have followed new patients (not comp. care vs. emergency), crowns, and hygiene exams. For the past three years they have also started keeping track of the number of patients that requested records to be transferred and the reason. I charted the patterns out. I discussed this with the owner doc and he did not seem to be concerned about the lack of growth stating that no dentist he talks to has had constant growth.

I would love to hear your thoughts. I now have a copy of the 2013 P&L but need to scan it tonight.

Dr. Concerned


Dr. Concerned,

Every business either continues to grow or it dies. Inflation, overhead, and a lack of growth momentum, conspires to either take us the next level or condemn us to a career of mediocrity. An attitude of indifference to business growth is generally caused by ignorance or an inability to adapt to varying business climates. It is possible, and desirable, to have constant growth. The first time you see a slowing in your business, you react and modify your business strategy to maintain or alter its direction and momentum. It is common to see this poor attitude with many dentists and their businesses. It’s almost like the average dentist embraces failure or fears to actually go for it out of fear of failure. They just hunker down and wait for the poor times to blow over. This has never worked and in the current economic climate in which we find ourselves, it will probably mean a slow unrecoverable death spiral for your business. Statistically, a dentist at age 65 will be dead or dead broke. Only 2-3% of dentists are financially independent at age 65. Poor personal and business finance is the cause. The funny thing is that I don’t believe anybody graduated from dental school, ready to start their career, with the mantra of: “I can’t wait to finish my career as “average”. But then, there they are: Financially handicapped with failed marriages, alcohol and drug problems, and worthless kids, faced with working until they die. You are just starting out and if you do what the others before you did, you will end up just like them. It is important whom you choose as a mentor or model because the expectations and business models you form today will shape your tomorrow.


Bottom line: It is about the nail. The obvious symptoms point to the obvious cause. Give me a call and let me help you fix what you should have fixed years ago.

Mike Abernathy, DDS
972-523-4660 cell
[email protected]