The Biggest Problem In Dentistry

With few exceptions, I'm in a practice somewhere in the U.S. almost every week of the year. When on sight, I interview all staff, study the practice KPIs (key performance indicators) and of course, talk to the doctor. The goal of the visit is to find and remove practice blockages to allow the office to express the doctor's personal vision for the practice.

Over time, this blog will detail a long list of the blockages and solutions for removing them. However, there's a great axiom that should be considered when the search for profitable practice growth is undertaken and it's this: all system upgrades are useless until the practice is under the control of the owner doctor.

In other words, it does you no good to identify growth blockages unless you have control of the team. With few exceptions, I hear a horror story daily from a doctor who unsuccessfully attempted to implement some improvement to his or her office, only to be quietly or openly ignored by the staff.

The doctor returns from a seminar or consultation with a practice guru only to find that his staff have a compelling rationale as to why this new idea won't work in this office or town. The put downs that the doctor endures fall into several predictable categories:

1. I've worked in dentistry for 21 years, and in offices bigger than this one, and we never had to... (Pulling rank).

2. Do you want me to implement your new internal marketing program or collect money from the patients? I'll do what ever you ask. (The fatal choice).

3. I don't think our patients will want to us to do... (Using patients or your image as a deal-killer).

4. I've talked to the other staff and I speak for everyone when I say that what you're asking us isn't going to help the office. (The majority rule)

5. When am I supposed to find time to organize and apply this program for our practice? (Probably when you're texting your boyfriend during office hours)

You, the doctor, are just one voice among many when it comes to implementing an improvement to the practice that requires staff to use their creativity and resourcefulness. In short, you are, at best, an influence on the practice when what you really need is "Control".

In offices where the doctor is in control, the staff are highly motivated to come up with permanent solutions to problems that limit practice growth. How is this control achieved? We'll get there but first you have to know control when you see it.

Are you now in control of your practice? Take this simple test: can you get your staff to learn and deliver a simple scripted patient encounter? What would happen if you asked your team to memorize a couple of paragraphs of scripted text and deliver it in a believable way to patients? If you'd like to know how this will end, just look at the 5 numbered excuses I just listed.

Having a lot of great practice building ideas with no control over how your team will behave is the equivalent of revving up the engine of a high performance race car that has no transmission, you're not going anywhere. And by the way it's impossible to gather enough great practice building information to overcome the fact that you're not in control of your practice.

Yes, I know that good staff are hard to find and training new ones is one of your least popular activities. Still, at the end of the day you have to ask yourself, is it better to have unmotivated, highly trained and experienced staff or to have highly motivated staff that don't know what they're doing? No, there's no easy answer to this problem but then that's why everyone's not rich.

You're daily enamel grind can be hard work, but, overcoming unwillingness and half-heartedness on the part of your uninspired staff can be down right exhausting if not overwhelming. You know the old saying, there's no such thing as the right answer to the wrong question. If your question is how do grow my practice, any answer that doesn't start with getting staff on fire for excellence is complete waste of your time.

I've watched hundreds of doctors spend over $5,000 a month for advertising, and this in hopes of generating a few phone calls from the weak, under committed prospects that usually respond to your best marketing efforts. And when these tentative callers finally do reach your mildly motivated receptionist, they are not reached out to and carefully connected to the practice. They are usually seen by staff as a lower grade of prospective patient, whose degrading questions about price or immediate schedule availability are answered with barely disguised contempt. Until you can change this situation should you be spending this kind of money on marketing?

For today, it's enough to simply acknowledge that you are NOT in control of your practice, your staff is. No, they don't have a sinister plan to guide your practice down to utter failure. They do however, have the simple goal of getting through the day and seeing that practice continues to earn just enough to insure their job, and unfortunately there's more of them than there are of you.

The title of this blog is "The Biggest Problem In Dentistry". Well, not being in control of the practice is indeed the biggest problem if profitable growth is the goal. At the root of this problem, that of not being in control of the office, are to following:

1. The doctor is outnumbered and out voted by "hard-to-replace-staff".

2. The doctor has become so close to some or all of the staff that they are seen as family. I don't have to tell you where you end up with a bunch of family members working in your office.

3. The doctor is so beaten down by having to offset the staff's lack of motivation with his super-motivation that exhaustion finally overtakes him and the practice settles into a dreary fight for survival.

If I had to sum up the biggest problem in dentistry I would say it's the relationship the doctor has with his or her existing staff and its resulting lack of practice control. I've found that from the time you acknowledge that you are not in control of your practice it will take between 6 - 12 months to correct that situation, and that's if you know what to do and have the courage to risk a full-on staff walkout. No wonder so few practices reach the great heights. Just decide now, is the vision of your ideal practice worth alienating some or all of your staff over?

While this is my first blog post, the good news is that it really is down hill from here. If you do get in control of your practice the possibilities for profitable growth and personal fulfillment are endless. Most of the doctors reading this blog are painfully attempting to offset their team's mediocrity with their own grim determination. If you've had enough and want a change, read the next installment on getting control of your office.