If you have read the last two articles, you should be pumped up and ready for the next step in scoring. Don’t miss the opportunity of seeing the whole strategy. You can easily go to www.summitpracticesolutions.com/blog, and there will be a search block to about 700 articles, as well as the last two for you to catch up. Don’t forget to get your free copy of the Super General Dental Practice by going to www.supergeneralpractice.com and read chapters 16 and 17 on benchmarks and overhead or, for our purpose, how to keep score.
“Life is tough… but it’s much tougher if you’re stupid.” John Wayne
I really don’t like the word “stupid”. I remember that as a third grader it was the worst possible insult on the playground. Its use is not very sophisticated in communicating your angst. You run into someone by accident, and the response from the aggrieved is: “You’re stupid”. It was the go-to adjective for putting someone in their place. With that said, I do believe that intelligent people can be “stupid”, if we define stupid as lacking common sense or as being foolish enough to do or believe something. Some of the most intelligent people in the world could be considered stupid in some areas of their lives. In fact, in dentistry it is common place to see doctors do “stupid things”. With some reflection and a little research, these common place actions are not common sense. I want to talk about how the dental climate has changed and how so few people have made the adjustment in their strategies and practice of dentistry to compensate for a constantly changing dental environment. It is this lack of recognition, and not taking the appropriate actions, that will doom most average practices to a mediocre financial future. Basically, you could be like a hair circling the bathtub drain, totally unaware that the current is drawing you down a deep, dark hole.
If we take a look at the statistical score card of an average dental practice:
- Overhead of 67%-74%,
- Collections of 94%-97%.
- New Patients of 20-30 per month.
- Less than a 60% case acceptance.
- One hygienist producing about 20%-25% of collections each month.
- Higher staff turnover than is ideal.
- Total collections of $650,000-$738,000 per year.
- Net take home before taxes of $190,000 or less.
- Average debt including school, practice, home, car, credit cards, etc., approaching $1,000,000.
This score card is the result of average engagement and below average understanding of the business of dentistry, and a lack of commitment to improving their score. They have a tendency to accept their position in dentistry along with the mediocre results and less than stellar effect on their life.
My prediction is that the dentists that are most invested in the old traditional practice model of dentistry will be the last to change, and the most likely to be disenchanted with dentistry. Mainstream dental practices, the average practices, are at greatest risk of not surviving in the new dental economy we find ourselves in. Every plan and action will ultimately have a cost or overhead attached to executing it. The successful are willing to pay the price. They are willing to look at others and adjust their own trajectory to go beyond those that have gone before.
About every third post on dental social media web sites concerns stress, burnout, money, and upset patients. A literal hailstorm of catastrophe. On the other hand, there are those that are claiming to be killing it based on their own comments but seem to fall far short when we take a deeper dive into their results. They have great self-images for no apparent reason. These same people seem to be the ones with the most to say on Facebook, and the least to offer. This creates a “Barbie” mentality of some mystical idea of perfection in the dental arena. All these comments come from some of the most intelligent people in world; dental school graduates. It seems that the “current” (like a river) of advice ebbs and flows but tends to move in the same direction from different perspectives. The solution is to be an employee, don’t be an employee, be an owner, don’t take insurance, be a fee-for-service office, etc. You get the idea: a pendulum of opinion that tends to stress the idea of totally opposed strategies for success. Each group passionately defends their perspective all the while falling short in the business arena of great dental successes. I think I can make a strong argument for a score card that will define success regardless of whether you work as an employee, an owner, have an insurance driven practice, fee-for-service practice, or specialty practice.
When we discuss how to keep score, there is an obvious assumption. In any competition or game, there are winners and there are losers. You get to define what is a win, but by definition, winning is not just a participation ribbon. Going through the motions is not even committing to the game itself. No one wins by just showing up.
Let’s talk about how you got to where you are now. Good grades, competitive attitude, good schools, and consistent performance got you into college, and you persisted. THEN YOU GOT INTO DENTAL SCHOOL! Getting in is easier than getting out and making things work for you. Grades got you in, but what got you there will not ensure your success in the dental field. Real success in business is not about grades (that was high school and college), and it’s not about being more intelligent than the next dentist. People skills, leadership, some depth of business management knowledge, and an entirely different way of pursuing your goals will ensure your success.
We should take a brief moment and try to define a couple of terms and categories on our “score” sheet that will continue to pop up. This will help make sure we are all on the same page and that the words we use are actually understood completely.
Last time I left you with a few challenges in the form of a list of questions:
- What game am I playing?
- What are the rules?
- Where am I now?
- How do I keep score?
- What numbers are important to track?
- Define winning for yourself.
So, we now understand that everything has a cost to doing it, and that cost is “overhead”. We also agree that anything really worth doing and committing more time and money to will be difficult to accomplish because anything worth striving for always seems to be uphill. You could summarize this by admitting that “there ain’t nothing for free”.
Each of us gets to define “success”. For our purpose we are looking at how to keep score, and how to win. Now, “win” and “winning” are two different things.
Win: Is defined as being successful or victorious, acquired or secured as a result of a contest, conflict, bet, or other endeavor.
Winning: One that is successful especially through praiseworthy ability and hard work.
I feel that used as a noun or adjective, these definitions fall short of what we need to agree on. I see a “win” as not being determined until the final score pops up. You don’t win after the second set in a 5-set tennis match. You don’t win when you complete the first inning in baseball. So, lets agree that few of you reading this have won. You may have some wins in life, you may even be winning by your limited understanding of what is possible, but from a practice perspective the game is not over and you have not won yet.
On the other hand, on the way to a win, each of us will stumble, struggle, regain our momentum, then start winning again, only to fall short. An endless graph of ups and downs. The final score is not yet determined. On Facebook, many dentists seem to think they have won, but are only winning right now. This may or may not be the case in a month or five years. You are happily married today (you are winning now), yet we all know that you have over a 50% chance statistically of not being married to that person for the rest of your life. In that contest you may not win. It is true when it comes to dental practices.
You need to accept that you might stumble, be winning sometimes, and at other times, not so much. It is the breadth of your career that will define the title of “Winner”. We need to agree that we don’t need another generation of participant trophy takers. If you are a dentist reading this, you have been a winner your entire life. You won in school and you now have graduated. How is it possible that so many dentists decide after graduation that average is OK? When was the last time anyone stood in line for an OK dentist? What potential client would say they want their dentistry performed by any dentist, that is just “OK”?
The rest of the articles in this series will not be about settling for less. They will challenge your expectations, reality, and benchmarks that you use to set goals. You will soon find that life and success will be what you make of it. No one gives you this. You earn it, and it is a challenge for everyone. The neat thing about this journey is that far too many experts tend to insinuate that this is incredibly difficult to obtain or reach. Success is elusive and fraught with challenges that most of you will not be able to overcome. I believe this is nonsense and in the next discussion I will cover the absolute black and white definition of a successful dental practice. It will be so obvious, that many of you will have that “aha” moment of clarity. It will be so simple and doable, that anyone reading this should be able to take the information and double their practice in a matter of months.
Michael Abernathy DDS