Question: I have been in practice nine years in a suburban area of a large Northeastern city. I work hard, I take tremendous amounts of CE, I treat my patients like kings and queens, and I treat my staff like family. I hired the best interior designer to design my office. I hired a well-respected marketing firm to do my website, brochures, cards, and yellow pages. I’ve done everything and anything to create a top-end practice, but I am just barely making it.
My competition appears to be doing a lot better. I struggle every month for new patients and production. This whole thing is a struggle. I feel helpless. What can I do?
— Susan
Answer:
Susan,
You are not alone. I hear dentists all the time whine about how poorly their practices are performing in the area of revenue. Their complaints always come with a number of stories, explanations, rationalizations and excuses such as:
- I really take great care of my patients.
- I do excellent dentistry.
- Most of my patients don’t have money and can’t afford it.
- I live in a community that is insurance-driven.
- I have a lot of competition.
All these may be true, but so what? Your competition is kicking your butt and they practice in the same neighborhood. How do you explain that?
What’s missing is you are not running your practice as a business. You are running your practice as a non-profit clinic and you have become a poorly paid salaried employee.
Given you are in a for-profit business, when your practice is underperforming, the first place I’d suggest you look is at your integrity. Not moral integrity — I’m talking about business integrity. Those things that a business should do to give and keep its word as a business are just not being done.
I can promise you that it is invariant; the higher the business integrity, the greater volume of revenues. The formula is proven, valid, and unfailing — the greater the level of business integrity, the higher level of business revenues.
Here is a list of questions to assess your business integrity. You should be asking yourself:
MONEY
Do I have a budget and am I strict about spending — including staff salaries and benefits? Am I fully conscious about my money, not hoping it will somehow all work out? Am I making more than I am spending? Am I able to generate a surplus or margin? If not, what specific actions do I need to do to accomplish this? Am I able to cover my bills without concern?
STAFF MANAGEMENT
Do I have performance criteria for staff, and if they don’t deliver, are there clear and understood goals and consequences? Do I do performance reviews on a routine basis? Do I have a clear and fair raise policy? Do I recognize when I am acting like the benevolent parent, wanting to avoid conflicts or upsets? Do I have clearly defined job descriptions, and are these kept current?
GOALS & TARGETS
Do I have goals, not targets? What’s the difference? Targets are what you want. Goals are what you can promise. Do I operate with my goals and press as hard as I can to make them happen? Do I recognize when I am I resigned, and therefore surrender and say I did the best I could? Is my staff’s compensation tied to making these goals?
CORE VALUES
Have I clarified my core values? Do I make sure that the core values are adhered to and, if not, are there defined consequences? Am I willing to fire someone who does not adhere to the core values? Do I walk the talk?
HONOR
Do I have real pride of ownership and stand that the practice is a sacred institution? Do I immediately intervene when my staff treats the practice like it’s a “rental?” Do I speak about the practice with pride, admiration and deep respect?
VISION
Do I have a real vision? Do I see a future that I know is possible to achieve? Am I willing to be unconditionally committed to achieving this future vision? Do I know when I am pretending that doing good dentistry is not nearly enough?
GOVERNANCE
Do I have well-articulated governance policies and operational policies? Do I stick to these policies? If someone doesn’t follow policy are there real penalties? Do I stay alert not to make decisions based on the moment, but based on well thought-out policies? Do I avoid executing policy because I know it will cause a breakdown, and I’m scared to cause a breakdown?
MARKETING
Do I deliver effective word-of-mouth marketing, or is my marketing left up to some external sources, such as the yellow pages and the web? Do I realize when my basic marketing plan is just “hope and prayer?” Is marketing a daily activity? Do I have metrics for marketing activity?
OWNERSHIP
Do I talk straight to staff? Do I know when I am being nice — not direct? Do I know when I am windbagging? Do I make powerful and effective requests?
MISSION
Are you and your staff on a mission or is it business as usual? Is the mission real to you, to your staff, to your market? Are you converting staff into missionaries?
There you have it. If you answered “No” to any of these questions, you need to convert them to a “Yes” in order to raise your level of integrity — the integrity of your practice as a business.
If you want to make money, run your practice as a business. If you just want to do dentistry, you’re doing fine.
— Marc
