I know what to say, but I can’t say it. One of our Summit Coaches
I know what I need to say, but you can’t handle it. Michael Abernathy
I know what you need to hear, but you won’t listen. Max Gotcher
You can’t handle the truth. Jack Nicholson (A Few Good Men – 1992)
Often times, doctors find themselves underwater and need help quickly. Sometimes it isn’t that drastic, but some doctors just wake up one day and realize that what they have been doing won’t get them to where they want to go. Finally, we run into doctors that, from the very beginning, have decided to invest in the best help they can find. These are the doctors that would never be satisfied being “average”. Regardless of where you find yourself, there is always room for improvement. In fact, if you are not embracing change, constantly re-evaluating where you are and how you are doing, you will find that your practice life will drift off course. You could say that change is a constant in dentistry and business in general. Those who adapt, win. Those that procrastinate are writing their future that will never be the practice they always thought they would have. It will be the default setting for not acting now. Have you ever noticed that when people tell you what you want to hear, they are trying to sell you something, and that’s not good. The mentors, coaches, and friends that tell you what you need to hear are trying to help. I hope you consider what I write as the latter, because my goal in life is to set a standard of caring about how we help others.
Part of me hopes that Max will never put this in the newsletter. Max Gotcher and I were talking on the phone the other day, when he related a call he had received earlier in the day. A fiftyish doctor had called and was ruminating about how poorly his practice was doing, and how few (7-9/month) new patients he was attracting. After listening for some time, Max asked him (he was really thinking one of the 4 statements that began this rant) if his area had a lot of managed care or potential clients on various types of insurance plans. The answer was yes (it is always yes with most doctors we speak to) but then he added: “You can’t do quality dentistry with managed care fees”. This response was tantamount to: “I would never take managed care”. It could have easily been an answer like: Marketing is unethical, I’ll never work a Friday or a Saturday, I need four personal assistants, I’d rather kill myself than see kids, do ortho, do fillings, etc. You get the idea. There Max was: Stuck between telling him the truth or losing the potential client. He knew what the caller needed to hear, but he also knew the doctor wouldn’t listen. Should he tell him the truth up front, where it would make the most difference? Or slowly, over time, let him come to the realization that certain things change and if you don’t change with them you are destined for mediocrity. In other words, if you are done with change, you’re done. After all, shift happens.
I actually own the domain name: www.dentaltruth.com. I just never had the testicular fortitude to use it. I want to use it without anyone knowing where the advice and answers come from. A sort of dental Dear Abby, Ann Landers, Carolyn Hax’s Tell Me About It, and Slate.com’s Dear Prudence. A hard edged, nothing but meat answer to every challenge dentists face day to day. So let me take you into the dark side of consulting, the truth that we struggle with each day. Coaches, mentors, consultants, authors, and speakers walk a very thin line. How do we help someone understand their predicament without insulting them? How do we approach giving advice in such a way as to have the recipient embrace it? They can’t afford to stop listening, nor can they continue on the path they have chosen. Can a doctor who asks for help actually accept the best advice we can give in order to extricate themselves from their challenge? If you tell them the truth (it is always the doctors fault) will they continue to work with you, or will you alienate them to the point they stop searching for help? I would have to say the answer is NO! Most can’t handle the truth and, yes, we need to eventually tell them the truth at the tipping point of a relationship where they trust us enough to know that we have their best interest at heart (kind of like case presentations in your office). In most cases, we could fix a practice in a matter of days, if we didn’t have to convince a doctor and their team to embrace the change and leave most of what they are currently doing behind. Most of what we find practices doing is the result of a little study, a lot of trial and error, and sometimes resignation that this is as good as it gets. We’re here to tell you that any practice can become profitable, fun, and predictably successful. Any office can become the practice you always thought you would have.
Remember when you were young and some old guy or one of your parents told you it was impossible to do something or you would get hurt, or blah, blah, blah. You get the idea. You’re thinking: They’re just old and set in their ways, they’ll never change. You guys are soooooo stupid. Well, we’re the old guys and all the dentists we talk to are the young ones. I guess some of us are just too close to the forest to see the trees.
One of my favorite comedians was George Carlin. He would use everyday situations and words to compare and contrast things in order for you to think about the absurdity of a particular situation. Consider these things that make you go hmmmm?
- Why is “quality” and clinical speed mutually exclusive? So, I guess going above a certain speed means you can’t do “quality” work? Probably doing a crown, buildup, and impressions in one hour would cross the line. Only crowns done in 90 minutes are quality.
- Why is “quality” and fee related? So, you can only do “quality” work if you charge above the going rate? Is the quality zone 20% higher or some other percentage?
- Why is “quality” and type of procedure related? Is the only quality dentistry sedation, implants, crown and bridge, or “cosmetic” dentistry? I guess there are no quality fillings or extractions, or adjustments on dentures.
- Is every restoration performed in the US on managed care or Medicaid patients always just crap dentistry?
- If you provide health insurance for yourself, your family, staff and their families, etc., is it a managed care plan (PPO) and therefore of poor quality?
- If you go to a “plan” MD or hospital, are you automatically receiving low-quality, substandard care?
- Do you know the meaning of “double standard”?
I feel a little like the news commentator Andy Rooney. I loved his segment at the end of a broadcast. Bushy eyebrows, stoic dry humor, telling it like it is. His ranting and opinions mirror most of ours at some point but we’re too polite to actually say it. He always starts out: “I don’t understand ________.” Or “I don’t really like _________.” And then he goes on a 3-minute diatribe that really makes perfect sense. Excuse my Rooney-esque article, but every one of you need to see your practice as it really is. Forget the justifications, excuses, and little games of blame shifting or lack of accountability. Just become the leader and businessperson you need to be.
Every day I have the privilege to hear your challenges and share our experiences in order to help you minimize your mistakes and flourish in your practice. If truth be known, I wouldn’t have it any other way. I love helping other doctors become the doctor they always wanted to be. It’s equally frustrating and fulfilling.
Much of the frustration stems from trying to throttle back on our natural tendency to just fix the problem. Do this and the client is destined to make the same mistake again. We need to have you participate in the process, understand the reasons behind the systems and strategies, and at some point, become self-managing. Maybe, just maybe, when you hire a coach, you’re thinking that you “hired” them to “fix” your practice, when in reality, a coach is someone whom you partner with to take you to that new level of practice. They can give you systems, train you and your team, but it is still your problem, and at the end of the day, if you don’t own it, you are guaranteed to repeat it in the near future. When you lose your excuses and admit that you have a problem or challenge, the answer will magically appear. Lose your excuses and find your results.
Max and I are a little surprised at where you go to seek coaching. The worst is taking social media posts as gospel and answers from some unknown poster with unknown history or knowledge as if they were an expert. Say it isn’t so. There is a literal explosion of management groups headed by some very successful dentists with little or no experience in coaching or teaching others. We were surprised because just two, five, or ten years earlier we taught many of these same doctors how to get to the next level for their struggling practices. It was our systems; marketing; leadership training; and staff team building that doubled and tripled their practices. I was asked after giving a lecture at a well-known multi-speaker seminar, how we differed from some other management group in attendance. They were trying to decide between the new kid on the block and our 30-plus years of experience group. As it usually turns out, we had trained the other consultant. We originated the material they were using. We were proud to help them, and proud of their success, but now they were touting their track record, but forgetting to give credit where credit was due. Kind of reminds me of a story from my past. I have taken and taught various forms of karate and self- defense for almost 40 years. I was sparing with an instructor that was particularly aggressive and had a cruel streak. He basically would take any opportunity to hurt you. He took me down, then took his shin and, with all his weight, ran it across my calf. Done properly it will easily tear the calf muscle and if done poorly, you will wish it had torn the muscle. It made me so made that I immediately took my free leg and placed a heal kick to his chest and jumped up ready to take him on. It was game on for both of us. I was tired of his bullying and intentional cheap shots and was ready to challenge my teacher. It only took about 8 seconds for him to drop me with a flourish of kicks and punches ending with him standing with his right foot across my throat. I will never forget what he said: “Before you take me on again, don’t forget, I taught you everything you know. I didn’t teach you everything I know”. I made the fatal mistake of thinking that I was ready to take on someone who had 20 years of experience over me in a one-on-one fight. Great lesson, painful lesson, but I will never forget to pick my fights and give credit where credit is due. In fact, in life, if you embrace change you will be able to say that sometimes you win, and sometimes you “learn”. You never fail if you learn something and get back up.
Back to the subject at hand. I guess I am writing this to encourage each and every practice owner that reads this to give us a call or seek help from a trusted friend or competent coach. Anyone who has ever spoken with me can testify that I have never tried to sell them anything. I have always felt that sharing with other doctors has its own reward. I want to help those that not only need help, but want help. People fail because they give up on what they want most, so they can have what they want now. Don’t give up on having the practice you always thought you would have only to settle on a mediocre, average practice. Embrace change and seek guidance.
Michael Abernathy DDS
972-523-4660 cell
[email protected]