Let’s be honest, shift happens. It happens to me and it happens to you. Sometimes the world can be pretty shifty. Shift is defined as a slight change in position, direction, or tendency. We’ve been talking about climate change in the new Dental Economy and the ultimate demise of the independent dental practice. What’s it going to take to thrive when everything around us is changing? How can we adjust our actions and vision to take advantage of this change? Having your practice strategies just a little off of target can mean disaster in the long haul. Keep in mind that even a 2-degree shift in trajectory today might mean you miss your financial goals in the future by decades or millions of dollars. The bottom line is this: What are you willing to do when you are hit with a face full of shift?
I believe that the widespread basic assumption that our dental destination in life (obtaining a successful solo practice) is flawed. If this very same solo practice were truly successful (more new patients every year, profits of 40%+, low staff turnover, etc.), you couldn’t help but grow past a solo doctor practice. Let’s begin with the end in mind and look at where we should be focusing.
Last week was our first BEST for Dentistry Summit meeting in Scottsdale, Arizona. A few select members and most of our Alliance partners met to master mind how BEST (Building Everyone Success Together) could radically change the way dentists do business and how each of our partners in BEST could cross pollinate one another to accelerate the growth of what is already the largest group of dentists dedicated to the survival of the independent practice of dentistry. (NOTE: Watch for announcements of future meetings and plan to attend.)
I wanted to take this week’s blog and give you another quick peak at the evolution of where we have been and what we face. In the coming weeks I will lay out an action plan for steering your practice in the direction of continued improvement.
In 1975, when I graduated from dental school, dentistry had been a “needs” based business. Lots of decayed, missing and filled teeth out there (12.1/adult). There were far fewer dentists so with high demand and limited competition anyone could make a great living in dentistry. Insurance was not a factor and school costs and debt were minimal. Even then dentistry was a small consumer driven business. People came in when they needed something fixed. Preventative and hygiene driven practices were few and far between. At this time, dentistry was the 3rd most respected profession, falling just slightly below a pastor and a medical doctor. Even the least talented doctor could still do OK because of the huge demand. We did not have to sell. The baby boomers drove the decision making in the marketplace. We also lived to work, where today, graduates work to live. This constitutes a huge change in culture for dentistry.
The 80’s brought seminars about business, insurance, and marketing. The 90’s brought cosmetic dentistry and managed care became the reality that no one wanted. This is the point where technology, invention, and competition pushed us to selling dentistry. By the year 2000 we were number 24 in the most respected professions, just one tier above a used car salesman. The 2000’s brought consumerism and three recessions in a row ending in 2009. From this point until today, the average school debt for dental graduates has continued to climb and is between $300K-$500K. We are also graduating over 6,000 dentists a year into a consumer pool with little or no demand compared to 4 decades ago. By 2010 we saw the growth of insurance at 9% a year and the resurgence of national corporate dentistry while the costs of goods and services have risen. Our national dental distributors have continued to profit from solo practices while deeply discounting their products to these same corporate entities. Consumerism and commoditization of healthcare has created a “wants” based business model for dentistry today. Patients vote with their feet and they are educated consumers who decide with whom they want to spend their money.
Today, we have the largest number of graduates from dental school that we have ever had and this will only increase. The average decayed, missing and filled teeth in the Gen X and Millennial groups is the lowest we have ever seen. This is where we are about to see the oversupply of dentists outstrip the demand for what we have to offer. Multi-doctor offices are increasing 20% a year while the solo practice of dentistry is dropping 7% a year. 50% of our current and future graduates will never own a dental practice. The baby boomer generation is becoming a non-entity in the market as they age out of driving the economy to not being able to afford what they could during their productive years.
If trends continue, the average dentist will suffer without a foundational shift in how they look and act in their businesses. Being a “good clinician” will not be enough. In fact, good is merely the cost of entry into our field. To stand out we have to be remarkable and memorable.
Doctors from the old school taught us dentistry. Great people with good intentions that couldn’t really thrive in a private practice environment or were ill suited to be a dentist at this time of dental evolution (business of dentistry) turned to teaching. This passed on the proclivity of misunderstanding regarding a viable business model. This has created curriculums in dental schools that have ended up being more idealistic in an old dental model, while not even trying to get their students to understand the numbers and the business of dentistry. Practice management and real-world wisdom has taken a back seat to getting the students out the front door with a clinical education that makes them just barely not dangerous.
The decisions you make today will define the future you will have tomorrow. If trends continue, the average dentist will suffer without a foundational shift in how they look at and act in their businesses. It is time for a change. It is time for a better outcome. It is time for you to step up and be accountable for your own future. This is how you Summit: Practice management done right.
I am not afraid of failure. I am fearful of being successful at things that don’t matter. Your success is what I think matters. BEST has just added more resources for our members. Please take the time and check out www.bestfordentistry.com. Become a member. Do it today! With the year-end fast approaching, also consider what a 15-20% increase in business and lowering your overhead would have meant if you had called Summit Practice Solutions at the first of this year and started re-engaging in your business for success.
Michael Abernathy, DDS
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