Let’s back out of details and take a 30,000-foot look at the diagram above. Michaelisms are never so true as when we look at the big picture. Decades ago, I noticed a consistent pattern in dental practices. In fact, there is a consistent pattern in life that follows the same stages as a practice. A predictable set of stages that mark “where you are” as well as the characteristics in each stage being remarkably consistent no matter where the practice is or how big or small it was. In our slide, you see “time” laid out on the horizontal line (X axis) and the vertical line (Y axis) representing money. For our discussion forget about the time integral, it is just an approximation representing an entire dental career. In fact, I have seen dentists reach the sellout stage in the first year of practice. These doctors were disillusioned, despondent, burned out individuals when they realized that dentistry was tough and their future was going to require an inordinate level of debt and poor that practices have always been around. On the other side of the coin, we have doctors who, at age 80, are taking ortho courses to add another level of service in their practice and they love every day. The rest of us fall between the survival and the sell-out stages.
The same goes for the vertical axis. The dollar amount is not important. At some point, you will plateau, and each stage will follow the next “unless” __________ occurs. That is the crux of the Michaelisms in this segment of articles. Where are you, and what are willing to do in order to move from where you are to where you always thought you would go? This is business 101 in chasing the “practice you always thought you would have”. As we run through each stage, try to be honest about where you find yourself now, and how long have you been there. Ask yourself, “Am I where I want to be, and will the next stage be where I want to be tomorrow”?
William Pollard, the long-time CEO of ServiceMaster said, “The arrogance of success is to think that what you did yesterday will be sufficient for tomorrow.” Shift happens, and the winners in life adapt and act quickly.
My wife loves to bake, and she loves making bread. She has the same starter yeast in our refrigerator that is over 15 years old. She adds to it weekly, so that it grows and is ready to form the foundation for the next loaf. It forms the foundation for every bread she makes today and will be making tomorrow. While the breads she makes all start with the same foundation, each and every one is different because she continues to learn new tricks and recipes in baking. Success is like bread. It has a short shelf life, so you’d better be making the next new batch, now. If you are reading this, you are already on the road to another better you, than you were yesterday.
Back to our diagram. Everyone begins at 0. We have our experiences and whatever education we have accumulated to this point. We begin with the mantra of the “whatever it takes” attitude because we must survive. Surely, you remember the start-up days when you were going to make it happen, no matter what. You expected setbacks but were determined to progress and ultimately win at the business of dentistry. This could translate into the day after you graduate from dental school. Pretty scary when you realize that dental school just gave you a learner’s permit. In actuality, you are just barely not dangerous. Let me rephrase that, I hope you are not dangerous. The schools today seem to turn you lose, but you didn’t get the education you paid for. You barely are competent at the clinical basics, if that. You know nothing about business, and now it’s time to get that first job. You are about to leave survival, I hope, and move on to growth. This is a pretty scary situation when you realize that your education didn’t supply a compass, training, or competence and confidence in actually earning a living from 4 years of dental school.
The next level, and hopefully the longest, is also the most fun, challenging, and brings the most fulfillment. The problem is that there are about 20% of the graduates that never leave survival. Instead of living their dream of owning a practice and securing financial success, they wallow in “average” or less. The pinnacle of their life already happened in high school, college, or dental school. They failed to factor in the need for another level of commitment to succeed in Dentistry. Making a living in dentistry is a whole new ballgame.
In this level of “Growth”, you initially get your first job, second one, perhaps marry, have kids, move to ownership, fight debt, make a profit, save, own a home, etc. You get the idea. The TV version of the 1950’s black and white, Leave it to Beaver show where June and Ward Cleaver raise their kids in an idyllic small-town culture. It would be nice to assume that we all find satisfaction in our endeavors and have nothing but success in our day-to-day routines. While growth is exhilarating, it is also challenging. It is a moving target where consumers are fickle, and systems, needs, and demographics change. What got your there, will not get you to the next level of practice. You must learn to embrace change. It is a constant. Or you plateau and “settle” for what life gives you. You move from control of your life if you plateau to just letting things happen. Following about 10 social media platforms on Facebook for dentists, it seems like the new generation of dentists is disillusioned with what dentistry will do for them, instead of deciding to be the one that makes dentistry a successful career. It is said that happiness occurs when reality exceeds our expectations rather than having our expectations exceeding reality. Is it just me or are we seeing a generation of young graduates who expected this to be easy? No matter where you are in your career, anything worthwhile is going to be uphill. Get ready to work for it.
If you are like me, during my times of growth, I found myself qualifying and quantifying my success. I look at my numbers and compare where I am to the benchmarks I chase. The successful doctor takes this analysis as a challenge and adapts to an ever-changing landscape and economic ups and downs. Instead of stopping at this plateau, they add a service, extend their hours, hire a doctor, increase new patients and team members. The successful understand that life is not about a destination but learning to enjoy the journey. In fact, if you are one of the few that continue to grow throughout your career, plateaus are just a way point where your adaptation to different changes means more growth and better results. You are the few that will never settle for average or just “OK”.
The takeaway in the twilight zone between growth and plateau, is never ever not realize where you are and as you begin to plateau, you react by expanding your business so as to not actually stay plateaued. It is possible to never leave the growth part of your practice, your marriage, anything you choose to do. If you don’t have the energy to grow, adapt, or embrace change, you will probably end up with unintended results in your life.
The slippery slope of diminished returns always happens quickly once you plateau. Timing is everything so you must act quickly. If you don’t, there will be a gentle decline in productivity, longevity of team members, profits slide away, and debt raises its ugly head again. Before you know it, instead of running your business, the business runs you. Burnout and mediocrity will destroy your self-worth. It will take a career that you dreamed about and drove you early on to be a heavy millstone around your neck dragging you down physically and emotionally.
Quickly following the Plateau stage, if you stay there for a while, is a turn to leisure pursuits. You lose your engagement in work, and you transfer your attention to golf, fishing, hunting, whatever. Anything other than work. The fulfilment you used to find in serving your patients and developing your culture and team will quickly be in the rear-view mirror of your life. Fulfilment is gone and life is a little boring. You finally realize that because you stopped caring, someone else is controlling your future. The bank, the Jones’s, TV, and consumerism is destroying your financial future.
The final step is Selling-out. Retiring. Moving towards your “next”. Don’t get me wrong, I believe there is life after dentistry. The trick is being in control as to when this takes place and where you ultimately end up. Your job is to create a financial future now so that when the time comes, you have more options.
The scary part of selling out is that too many do this early in their career but keep working as a dentist. They go through the movements, but their engagement and enthusiasm are gone. They are working to “settle” instead of adapting and continuing to strive for tomorrow. I can’t think of a worse fate than being stuck on a hamster wheel running as fast as you can, just to survive financially because you squandered the early years, not being proactive and engaged in growing your business. Now is not the time to sit down and rest. It will always be time to strategically work as if this is a marathon where you must run a smart race with the goal of finishing well.
Life after selling out will, for most, not be the nirvana you hoped for because hope is not acting. Those who own their performance today, get to rewrite their future for tomorrow. I refer to life after dentistry as my “next”. I spent decades engaged in work while also planning my “next”. If you are like me, a “next” has to be as challenging, engagement worthy, and rewarding as dentistry always was. I need to be able to use the few skills I have worked to perfect in my “next”. Helping others, leading followers to a worthy goal, and finding a way to leave a legacy should be a constant goal for each of you. I need to have a “next” that allows me an arena to compete, and the time to enjoy what I have worked for.
My prayer for you, is that you take a look in the mirror of today and decide that being in the moment and planning for the future are worth the striving. I want each of you to feel in your “next” that you played the game well and gave your best to whatever you did or will do in the future.
Michael Abernathy DDS
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