I got stumped on a telephone call. I was blindsided with a question I could not answer. A new client asked me: “What makes the difference between a great client and a doctor who doesn’t really perform?” He had already signed up for coaching, but I still would have liked to have said: “Every doctor does well when they hire Summit.” He actually just wanted to be one of our best clients, and wanted a list of things to benchmark against. I would have to say that there are differences in the results each office attains. Every doctor gets customized coaching based on a consistent formula of systems, information, one on one training done in their office, 24/7 access to Max and I and their individual consultant, but we do see different levels of success with each practice. So why do consulting companies get different results with each client. After a little thought and consultation with the coaches, we came up with these top 10 reasons that results may vary depending on the client.
1. The Doctor (and Staff) fails to own the process of learning and application of what he and the office is taught. When asked, most doctors would say that they don’t want to manage the office, deal with the staff, or worry about financial strategies. All they want to do is just do the dentistry and not have to deal with the staff or patients. I wish we could cull this type of applicant for our services, but sometimes they slip through. If you feel this way, don’t even go down the road to improve you practice and bottom line. It will never work. I hate to say it but every problem in your practice is your fault. Either by omission or commission you created the problems that exist in your practice. You hired the staff, set up the hours, bought the location, marketed or failed to market, fell short inspiring your patients, you were responsible for everything. The opposite is also true: If you want a different result, you have to make the decisions, set the course, and start the process. You are the valve that every action goes through prior to implementation. As your coach, we need your attention and participation. The act of leadership cannot be delegate or ignored. Leadership can be taught and we can help, but you must consistently act to implement.
2. Poor Demographics. Believe it or not, there are many areas in the country that make growth almost impossible. Once you drop below the doctor to population ratio of 1:2000, you have entered an area of diminishing returns. You have gone over to the “dark side”. Marketing is more difficult because every doctor is doing it, and every person is exposed to it. Fees are more competitive. Patients have more choices in the dentist they go to. Everything has to be at the top of your game. There is very little wiggle room. You must have the location, hours, take their insurance, and offer services at a price they can afford six days a week. Differentiating your practice from everyone else is difficult if not impossible. If this is the case, your expectations on growth, new patients, production, and overhead need to be realistic. Without an out right move, you will struggle for the remainder of your careers. This is a difficult fact to accept. Make sure you can handle the truth.
3. Location. Even if the demographics seem right in your town or zip code, they tend to degrade and change. If you have been practicing in the same location for more than 10 years, you may now be in the wrong location in your city or county. Every neighborhood degrades; it changes demographics, race, and income levels. As it does, you will often find that your practice does not reflect these changes. You will have lost touch with your audience. The patients today are looking for something altogether different than what you have to offer. Your practice, staff, and overall systems must reflect the community you practice in.
4. The wrong practice strategy. There are all types of successful practices: Boutique, general, family, managed care, fee for service, Medicare….. Any strategy can work somewhere. Many strategies are doomed to fail where you are. The problem is that many strategies are fraught with challenges. While the idea of a cosmetic or boutique practice appeals to most doctors, your practice location, your personality, charisma, and clinical skills may not be able to support it. Each form of practice is dictated by the demographics of the area you serve. Don’t be fooled by some slick speaker or “institute of higher learning” into thinking that a boutique practice is the only stress free, high profit, low overhead, and higher quality, higher calling type of practice. Often times it is the most stressful, least profitable practice that you could start. It is certainly the least valuable when it comes time to sell and retire. All this to say: Make sure your choice of practice styles is supported by your circumstances. Deciding to try and give patients what they do not want is a sure fire way to financial and practice failure. Look at what your patients want, and give it to them.
5. Not being poised for growth. This is a very broad topic. Many practices seeking a consulting firm are plagued with burned out doctors, marginal staff, and have entered the practice mode of coasting till retirement or have a “barely strategy”. If you are about to invest your hard earned dollars in a full court assault on practice growth, you need to be poised for growth: Right staff, great location, healthy benchmarked numbers, good overhead, growing practice, and fully engaged doctor who is looking to make things happen. The entire office needs to be wearing Tashirts saying “Whatever It Takes” or as we like to say in the South: “Git ‘er Done”. It takes an overwhelming commitment to growth, excellence, time, money, and energy to make this happen. A practice management company cannot motivate you, it can only train and guide you.
6. Paralysis by analysis. Our best clients operate on the premise of “ready, fire, aim”. They are not frozen by fear of failure. They realize that if everything has to be perfect before they act, nothing will ever get done. Part of a healthy practice/coach relationship hinges on trust that what is brought to the table is a tried and true strategy that will work with their situation. We have seen thousands of practices, and believe me, yours is not the worst situation we have seen. The worst thing a doctor and staff could do is agree on a strategy with their coach, have an assigned job for each staff member and doctor, and then fail to follow thru. Max likes to refer to this as “Idea Overload with Execution Failure”. Failure to act has doomed many practices. Procrastination is overrated. Plan and execute the plan.
7. Thinking your job is doing Dentistry. Successful practices realize that crowns, cleaning teeth, sucking spit, making phone calls, dealing with insurance companies….are just things that you do while you’re doing your real job. The key to a successful practice is and always will be your ability to “inspire” your patients. It is counter intuitive, but the best practices, most productive practices, practices with the lowest overhead, and greatest number of new patients hire for people skills and motivation and train them to do everything else. People skills come with the person chosen for the job. It cannot be taught or trained. You either have it or you don’t. Bonus systems will not motivate your staff. You need to hire motivated staff. Keep in mind that Job #1 is INSPIRING your patients and staff.
8. Failure to incorporate “Consumerism” in all you do. Dentistry is a small consumer driven business. It is not just a science, a calling, or art form, it is foremost a business driven by the whims of a fickle public. Today there is a dentist on every corner. Patients vote with their feet, and if you are not getting your share, it is the consumer telling you that you cannot compete in dentistry. You are not viable with the business model you are currently using. You either change or struggle. Capitalism at its essence is the ability for anyone to sell anything anytime. The fit survive. The noncompetitive practices that have no relevance with their clients will fail to exist. Not coming to accept the truth of consumerism will hold you back and drag you down. If there is one thing that has been a constant in dentistry it is change. To do well in coaching and in life, you must embrace it.
9. Financial Captivity. I would have to say that putting off a change or seeking help until the last minute is a common situation. By waiting, many doctors approach us in financial captivity. In other words the margins are so close that there is little or no money to invest in coaching, marketing, or capital expenditures to correct blockages. Profit, and a lot of it, allows you more choices in executing a strategy. Lack of it often limits the options, scale of change, and speed at which it can take place. Learning to handle money is an essential skill that we try to teach each of our clients. One of the most common causes for financial captivity is “The Shiny Object Syndrome”: Where the doctor believes that buying every piece of new technology is the path to practice success. Nothing could be further from the truth, and nothing will sink you financially faster than over spending. This could be true of “seminar addiction” where doctors attend every new clinical course only to bring it back home and never use it. It is not unusual to see these same doctors spending $30,000 in a year for clinical courses but fail to produce $40,000/month. If you find that you are in this category, we will encourage you to create a 100% moratorium on going to courses and buying toys. Let us show you how a profitable practice invests their profits.
10.Holding a Limiting Belief. I could spend 50 pages discussing this. I see it in myself and especially with doctors who find that they are struggling with the many facets of practice and life. A limiting belief is a thought or process that you have held or performed so long that it has become truth to you. Most often the belief is patently untrue, but because it is the only thing you have experienced, you hold it as truth. It creates a filter through which you view and take action on all things. Consider this: If you are given false information, how can you possibly make the correct change or take the right action. This begins when you are young and it builds a stronger hold on you as you age. This is the hardest bond to break. A consultant cannot usually correct this problem. This is where Max and I will spend time creating strategic decisions with you and offer a correction in your course of action until you lose the limiting affect of this belief. Imagine the effect of believing that: I’m terrible with finances, I can’t be a good leader, patients just can’t afford my dentistry, there are no good staff around here, I have never been able to save, Dentistry is stressful, I’m not lovable …… It can go on and on. None of these are truths. If you hold the wrong limiting belief long enough to make it truth for you, your ability to be coachable, implement new ideas, and embrace change will fall by the wayside and limit your practice success.
As I write this I keep thinking of number 11 and 12 but I hope you get the idea. A coaching relationship is a partnership. It requires effort, understanding, action, and knowledge to get a superior result. Regardless of the level of success you have in coaching, you will always be better off than the practice that has failed to try. If you have any questions, or would just like to discuss an area of your practice that you are currently struggling with, give me a call on my cell at 972-523-4660.
Michael Abernathy DDS