If you have ever heard me speak, you have heard me say that I am a lot closer to my “use before date” than my “born on date”. I’ve been around a long time and have owned more than one practice, and worked with thousands of dentists. With that said, and with over three and half decades in dentistry, I feel like I pretty much have a handle on what separates the superstars from the average (or maybe mediocre) dental practices. If we were to line up all of the attributes of a successful dental business, a really complete comprehensive list of those things that are necessary to guarantee success for the life time of our careers, we would next need to prioritize them as to importance. Think about this as a finite number of talents you must acquire during your career in order to maximize your results. Also consider that they are “time” and “order” sensitive. In other words, you don’t really have forever to get this right and if you waste most of your time on less important attributes while coasting on the really important ones, you will wake up one day to a disappointing future with few choices. You just don’t have the money or the time to learn from your mistakes. Consider also that your time is limited. We all have to sleep and balance other commitments of time against those required in our businesses. Regardless of what you put on that list, the most important aspect of any list is the order in which you would rate most important down to just nice to have but less important. If we face the fact that no one is good at everything, then we need to spend what time we have perfecting the most important things that will lead to the biggest increase in success. We are talking ROI: Return on Investment. Herein lies the dilemma: Each doctor has his or her own opinion of what is most important. But I would bet that nearly all of us would put the same overall attributes on our list, just not in the same order. Each doctor will gamble with the order of the list, only to discover the truth near the end of his or her career. It’s kind of like going through life gambling that eating everything you want, never exercising, smoking, and driving fast is the pathway to a long life. How about successfully ending four marriages as a wealth-building strategy? Statistics prove you’re wrong. It is this perspective of how you would organize your list that is a “key” to rapid, predictable, and sustainable growth. Think about it. If I asked a hundred doctors what they would put on this list and how they would rate a list of dental attributes as to order of importance, I would probably get a different opinion from each one. The problem with that is that most will be wrong. There is and always has been “the” order of attributes to guarantee a balanced, profitable, low overhead practice with no growth limits. This priority list will dictate your effectiveness with your patients and ultimately determine the success of your practice.
So let’s create a list. Just sit down and start writing. Don’t worry about the order. It’s not important if you repeat yourself or struggle with only getting 10, that’s OK too. Just make the list and let’s meet back here and try to organize them. Go. Start writing and don’t go any further until you have your own list. I will do the same thing and we can meet back here in just a few minutes.
- Clinical competence
- More services than are normally found in a general practice: Implants, orthodontics, kid outreach, sedation dentistry, TMJ treatment, dentures, complex bonding, same day services, Cad Cam crown and bridge, pain dentistry, and full mouth rehab.
- Overall confidence in my abilities.
- Great overhead: 50-60%
- Production: $20K-25K/Employee, $25K-30K/Operatory
- Great recall system: At least 80%+
- Convenience: Hours, services, affordability, no barriers, insurance friendly, awesome location, etc.
- Consistent marketing: Results based, multifaceted, consistent year round marketing strategies based on spending 3-5% of monthly collections and yielding at least a 3:1 return as a minimum.
- Superior hiring systems and strategies resulting in a selfmotivated team with an ownership mentality.
- Incredible policy manual as a foundational system to management that creates consequences for every team member.
- People skills that reflect a caring and compassionate outreach to every patient and every patient encounter from me and each staff member.
- Being in the right location (city, state) while considering competition and population demographics.
- Having the leadership skills to create a longevitybased ownership mentality in my team.
- Creating consequences based on results to enforce the strong systems and staff policies.
- World-class leadership skills.
- The ability to inspire my staff and patients.
- Goal setting, or even better would be goal-achieving skills.
- Management by statistics resulting in a results-based management system in every aspect of the practice.
- A servant’s view of “why” we do what we do. Serving our patients is our “purpose”.
- Commitment to continuing to educate myself and the entire team.
- Consumerism attitude in every system and decision made in the practice.
- Finding a coach and mentor from day one.
- Commitment to embracing change.
- Never stop learning.
- Doing whatever it takes to inspire our patients to follow through with treatment, pay for it, and refer everyone they know.
We’re back, and we both should have a list. It may not be complete but you have begun to formulate what attributes it will take to become a great dentist.
Let’s take a moment to define a great dentist and great practice in order to get each of us on the same page. For me it would be a doctor and practice that continues to grow through their entire career: A doctor who has learned that he must spend less than he makes and save at least a thousand dollars for each year of their age each year of their life. This great doctor has served his patients with compassion and caring while continuing to adapt to changing conditions and situations. They have joy in what they do and it shows. They balance their time in order to find balance in their lives. In the end, this doctor will have choices. They will retire on their own terms with dignity and with a legacy to leave their staff and family.
Now back to your list. Here is where it gets difficult. Take a look at the list you made. You might even look at mine. Get some input from your staff and family and come up with as complete a list as possible. Keep in mind that the list is never really complete if you consider that you can add to or take away from it from now on. Now it’s time to put them into order. This is where “perspective” comes in. When you look at the actual definition you realize the variables. Perspective depends on several things. Your dental perspective is shaped by: Age, experiences, and skill set. While these three distinct “lenses” focus your perspective, you need to realize that each is inseparable. Consider the story of the four men who were blindfolded and led into a room and given a moment to touch what was in the room and them based on their “perspective” describe what it was without actually seeing it. The first one said it was a “wall”. The second said it was a “tree trunk”. The other two said it was a “rope” and a “hose”. Each man was right from their perspective yet all were describing the same object: An Elephant. Its tail felt like a rope, it’s trunk like a hose, its side felt like a wall, and its leg like a tree trunk. Each man was right but they all missed the mark. None of them had the complete picture until their eyes were uncovered.
Your list is like the pieces of a jigsaw puzzle. Leave one piece out and you never finish and see the completed picture. Fail to organize and arrange the pieces in a particular order, and you will struggle. What if I just had you take all the pieces and put them upside down so you couldn’t see the picture? That would certainly handicap any result. Like the jigsaw puzzle, there is a very logical way in which really good puzzle workers proceed. With this in mind, there are puzzle pieces that are more important at the start than any others. Everyone who is good at putting the picture or puzzle together quickly goes for the edge and corner pieces. These frame the rest of the puzzle. We then look for distinct objects or colors and arrange those pieces. Then and only then do you begin to put together the other pieces.
Before you start arranging your list, consider that in a dental practice, the only person who will judge the list and directly validate your decision is the patient. So go ahead and look at your list and just put a number from 1 to whatever you got to in front of each attribute and I will do the same. Really take the time to especially consider the first 3 or 4.
- 20. Clinical competence
- 18. More services than you would normally find in a general practice: Implants, orthodontics, kid outreach, sedation, sleep dentistry, TMJ treatment, dentures, complex bonding, same day services, Cad Cam crown and bridge, pain dentistry, and full mouth rehab.
- 19. Overall confidence in my abilities.
- 21. Great overhead: 50-60%
- 22. Production: $20K-25K/Employee, $25K-30K/Operatory
- 23. Great recall system: At least 80%+
- 12. Convenience: Hours, services, affordability, no barriers, insurance friendly, location, etc.
- 13. Consistent marketing: Results based multifaceted consistent year round marketing strategies based on 3-5% of monthly collections yielding at least a 3:1 return as a minimum.
- 9. Superior hiring systems and strategies resulting in a selfmotivated team with an ownership mentality.
- 10. Incredible policy manual as a foundational system to management that creates consequences for every team member.
- 1. People skills that reflect a caring and compassionate outreach to every patient and every patient encounter from me and each staff member.
- 4. Being in the right location: City, State, while considering competition and population demographics.
- 8. Having worldclass leadership skills in order to create a longevitybased, ownership mentality in my team.
- 11. Creating consequences based on results to enforce the strong systems and staff policies.
- 7. The ability to inspire my staff and patients.
- 14. Goal setting, or even better would be goalachieving skills.
- 9. Management by statistics resulting in a resultsbased management system in every aspect of the practice.
- 6. A servant’s view of “why” we do what we do. Serving our patients is our “purpose”.
- 17. Commitment to continuing to educate myself and my staff.
- 5. Consumerism attitude in every system and decision made in the practice.
- 15. Finding a coach and mentor from day one.
- 3. Commitment to embracing change.
- 16. Never stop learning.
- 2. Doing whatever it takes to inspire our patients to follow through with treatment, pay for it, and refer everyone they know.
Now you should have your list organized and numbered in order of importance. I want you to now look at just the first 5. I have reproduced mine below.
1. People skills that reflect a caring and compassionate outreach to every patient and every patient encounter from me and each staff member.
2. Doing whatever it takes to inspire our patients to follow through with treatment, pay for it, and refer everyone they know.
3. Commitment to embracing change.
4. Being in the right location: City, State, while considering competition and population demographics.
5. Consumerism attitude in every system and decision made in the practice.
These five traits are what allowed our practice to consistently grow a minimum of 15% every year for over three decades.
Each of you will have organized your list in a different fashion, but let me address a few of the common limiting beliefs that almost guarantee a mediocre (or worse) result if followed.
1. Clinical Excellence above all else. Becoming the best clinical dentist would seem to be a very logical course of action. We all have heard the adage of “build a better mouse trap and people will flock to your door”. If clinical excellence is in the top 5 of your list it better be no higher than number 5. Dentistry is a small consumer based business where nothing happens until the customer (patient says yes. Far too many struggling practices have found out too late that patients define quality differently than the doctor. To a patient, quality is something that looks good, feels good, and lasts a long time. Add convenience, caring, and compassion and you can’t go wrong. The doctor that thinks that quality dentistry will sell itself is delusional. It’s as if he’s back at school where all that matters is the good grade. It doesn’t matter if the professor or their classmates like them. It is just the performance. It’s almost a joke when doctors of super successful practices get together and they all know the “A” students have all ended up working for them. You need to keep improving your skills. You need to strive for clinical excellence. You just need to keep it to yourself. The patient assumes you are competent or they wouldn’t even be in your office.
2. Marketing is everything. This is the poster child of the Donor practice. A practice that has their priorities so out of line that they depend on the marketing to bring in the patients. You never see a high referral rate in these practices because they just are not giving patients what they want. Marketing is important, but you should not look for an external solution for an internal problem. People skills, leadership, great staff and superior systems always come first, and then you market. Close the back door before you try and open the front.
3. Chasing the Dollar. This is the practice where profit is everything. They manage by the numbers, but always leave out the feedback they get from patients that no-show or don’t refer. It’s the corporate practice model with a sleazy commercial bent. Kind of like a dentist turned timeshare salesman. There will be high staff turnover, and few referrals. It may even be a high producing practice but it is not sustainable. We are looking for life choices and for career sustained growth. Not just the sale, rather it’s the lifetime value of a friend and raving fan that just happens to be your patient.
4. The all-adult, boutique practice. Choose this path and you’d better be good looking, charismatic, an excellent clinician in the exact right location with little competition surrounded by wealthy adults with crappy teeth. Statistics are against this strategy. Everyone is doing sedation, implants, orthodontics and cosmetic dentistry. Locations without an overabundance of dentists are almost nil. Add in managed care and the fact that 87% of the patients will change physicians for a $5 difference in fee, and you see a strategy that is leading to failure. What will replace it are general practices with a greater outreach while still supplying a lot of highend dentistry but taking into account the demographics of the area you practice in. Of course, there will be survivors and places where this type of practice will thrive. It will be rare and very competitive.
5. The never changing, same location, stoic practice that refuses to see that the world has changed and they haven’t. Kind of like the doctor with a great self image for no apparent reason. What can I say? It’s the telephone call from the clueless doctor who can’t understand why he only has 15 new patients a month and is making less each year. They haven’t saved anything and are faced with being in dentistry forever. Their position has always been: “I will just wait for things to turn around”. Guess what. It’s never going to happen. Change is the constant, and a very unforgiving master. Every potential client can see you are practicing in the 80’s.
Look at your lists, weight them, and place skills, inspiring patients and staff, embracing change, being in the right location, and consumerism in the prominent spots.
Successful people get better at this so that it takes less and less time to make the cycle. Their perspective gets sensitive to their experiences so that the learning process takes less time. If we learn more quickly and embrace change, we will see results accelerate.