Parkinson's Law Applied to Dentistry (Follow-up)
Last week my Weekly Tidbit essay was about how Parkinson’s Law is applicable in dental offices. A very commonly asked question is represented by the following exchange between Dr. R and me.
OK Hurston,
What is the proper production of a hygienist and is that part of your ratio? I have always heard that a hygienist should produce 3x her salary. If that is the case, contemplate this. Suppose I have an office in which the staff is properly compensated at 20%. Now I decide to add another hygienist. She costs 33% of her production and accordingly raises my staff costs above 20%. I would play this game all day assuming (minus increase in variable expense) she is going to be 40 to 50% pure profit. IMHO hygienists can throw this ratio off and should be considered outside other staffing ratios as they are producers. What say you?
K. R., DDS
Dear Dr. R,
One of the dangers of my writing these weekly essays trying always to include something of real value while maintaining some degree of brevity is that clarifications by necessity are brief or not included at all. In this case I think that can lead to some confusion, which might cause logically thinking dentists to assume there are flaws in the monitors.
When I first saw these monitors being used more than twelve years ago my background was not internal operations in dental offices. I had been a business manager/owner with experience in accounting who watched statistics and daily/weekly results regularly. The company's technical staff was preparing presentation slides for one of the many seminars given by Dr. D who owned the company. When I saw them this same issue immediately sprung out at me. I was told that I was just pulling one element from an entire formula and that would not work. The slides and Dr. D went off for a weekend seminar, but I was convinced that there was a flaw. On Monday, armed with my calculations I met with the practice management consulting staff and the General Manager. Their explanation partially convinced me, but it was many years of data collection and modeling since then that has absolutely convinced me that there is no conflict
As they explained, "When production in hygiene increases it is because there are more patients being seen. Even in America, with the best dental health in the world it is impossible to see more patients without diagnosing additional required dentistry. Measuring this over time and in numerous dental offices statistics show that the amount of dentistry generated from additional hygiene production is roughly equivalent to the hygiene production." There were data sources available for me to study, but I was never totally convinced. Now, having owned our own practice management company for more than ten years my wife (the former General Manager of the company mentioned above) has absolutely proved this to me. That is why I constantly write that hygiene drives the growth of a general dental office. There is no way in a real world situation to increase hygiene production while not also increasing doctor production. There are not that many perfectly healthy mouths in any practice, and if there were they should be spread among hygienists.
In the real world the situation would follow a scenario like this example. A dental practice is producing $50,000 per month and salaries are $10,000 per month. A full-time hygienist is added who is paid $250 per day. Her production is $750 per day. (Minimally accepted amount. Less and practice is losing on her at this salary.) In a 16-day month her hygiene production is $12,000. However, an additional $12,000 in doctor production results from all these exams on additional patients. This means production is now $74,000 per month. The additional salary expense is $250 per day for 16 days, or $4,000 per month. Total salary cost is now $14,000 per month for $74,000 production. In fact, now our salary cost as a percentage of production is 18.9% meaning that there is $800 per month, which should be designated as bonuses (or part-time help) for the non-production staff. The Hygienist has been paid her one-third already. What if hygiene does not produce nor generate the designated production for the doctor? That flaw must be rectified in the Hygiene Protocol, which is proved to be malfunctioning.
When we analyze a dental practice we look first at the major monitors. If there is something amiss in one or more of these monitors, we then perform a much more in-depth analysis to uncover the real issues. It is somewhat like looking through the lens of a camera (or possibly intra-oral camera) to take a picture and then zooming in for close-up views of particular areas. It is necessary to get the entire view first, but almost inevitably that will dictate a closer look at one or more other areas.
Gross Production.
There is one other area that can cause confusion in dental offices when calculating monitoring percentages. That confusion involves an understanding of what is meant by gross production. Very often monitors are misread because either collections or net production are used as the basis. Gross production is the absolute total of all dentistry that is performed utilizing the supplies, facilities, personnel, etc. regardless of what payment may be received. Gross production is not calculated using any discounted fees whether for family, staff, professional courtesy, barter, insurance write-off, capitation, etc. Gross production is the pure undiluted total of all dentistry performed in the practice. Many, many dental practices do not count everything due to concerns about taxes, etc. If the true gross production is not available it must be ascertained as best possible before monitors will be correct.
An example of how this can skew monitoring results would be as follows: A dentist pays $10,700 in salaries monthly on recorded production of $50,000. It seems as if the salaries are too high at 21.4%. However, in this example the dentist actually performs discounted dentistry such as for employee benefits, for family members, for barter, and for professional courtesies totaling the national average of 7%. This means that there is really $53,500 in dentistry being performed from this overhead. Salaries are not too high in this case. It is wrong to penalize the staff for this unrecorded dentistry. The practice owner, not the staff, makes those decisions. The dentist must bear any cost associated with this unrecorded production personally. In this example, the additional salary cost of $700 must be paid from doctor's portion for it is the doctor who gets the benefit of providing this unrecorded production. This benefit may be in staff retention, community relations, etc., but it is entirely the responsibility of the dentist.
Great question. Thanks. I hope this clarifies a couple of apparently confusing issues associated with calculating total salary cost at 20% of gross production.
Have a great week,
Hurston
813-963-7228
Hundreds have taken advantage of our free practice evaluation service. The procedure is simple. I email a simple 14-question form, and you email it back to me completed. Then, I have your responses to the questionnaire input into our computer model representing the thousands of dental practices across North American with which we have worked. From that analysis we can make recommendations about the potential that the practice should be able to achieve including some ideas of how to precede toward realizing this potential.
Our management workbooks are terrific based on the real world. They can help to reach potential, and if more information is needed about them, email.
There are two really valuable ways we can assist, however. First, we can do an in-depth analysis of the practice. It is the next step after the 14-question analysis, it requires that we visit your office for one or two days, and there is a fee to cover the extensive analysis and travel costs. I make as many of those as possible, and I personally direct all these In-depth Analysis Studies. The product is a bound report of the status of the practice, its historic progress, and its future potential with very specific suggestions.
Also, we are still accepting a few more consulting clients for in-office management consulting. This is a yearlong relationship in your office, which implements the actions necessary to realize the practice’s potential. Our references are excellent nationwide.
Parkinson’s Law Applied to Dental Offices
C. Northcote Parkinson in his 1957 book, Parkinson’s Law and Other Studies in Administration, wrote, “In any public administration department not actually at war, the staff increase (per year) will invariably prove to be between 5.17 % and 6.56%, irrespective of any variation in the amount of work (if any) to be done.”
The point is that increase in staff will progress regardless of whether the work increases or decreases. While Parkinson’s research and statistics were taken from bureaucratic governmental organizations, the same is true in dental offices. It is much harder to offer a percentage of growth because individual organizations are smaller. However, I believe that the range he suggests averaging 5.865% is about right. That means that, if left unchecked it will require twice as many staff members to perform the same tasks ten years from today as today. The amazing part is that the dedication of the staff members, their hours worked, their general attitude, and other factors or generally irrelevant. The size of staff will grow. Below, I will list some of the reasons.
In dentistry it is even worse than in general administrative areas. The reason is that staffs are already smaller, and must inevitably grow in a stair-step manner. That is, we start with one staff member and grow by adding individuals one at a time. This means that as we grow it is only for a split second that we are actually properly staffed. For the majority of the time we are either overstaffed or understaffed. My experience is that overstaffing is ten times more frequent than understaffing.
This stair-step staffing approach has the effect that in most dental practices the second person is added when the work exceeds 100% of the first person’s capacity (in a perfect world, much less in the real world). Two people must split between them the 101% of a full-time job. Consequently, almost half the time of both staff members is wasted with make-up work from the doctor, looking busy, personal calls, gossip, needless repetitive activities, etc. As the practice grows, there is less and less time for the needless tasks which have by now often become institutionalized because essential tasks begin to consume more and more time. The problem is that it becomes difficult to differentiate between tasks that are essential and those that are not essential but have become institutionalized during overstaffing periods. This means that staff members often honestly feel they are overworked when in fact much of what they are doing has been the result of developing bad habits during the times that overstaffing existed.
How can a dentist ever keep the staff properly productive during times of overstaffing due to stair-step hiring? (see end)
Overstaffing is an epidemic in dentistry. Frankly, we seem unaware of the fact that dentistry is an industry with enormous wasted potential. In the real world, the doctor often cannot recognize it because he/she has become part of causing it to happen. Owners of overstaffed offices are not necessarily pinching pennies, however. A well-managed dental office in North America in the 21st century is a fantastic business. Any dental office should be able to return to the dentist/owner between 40% and 55% of net production. This should be the case whether the gross annual production is $250,000 or $2,500,000. Certainly, staffing to maximum potential is only part of the answer, but it is a vital key.
Raising production can cover any number of overstaffing inefficiencies. A well-managed general dental practice can operate at peak performance while paying only 20% of gross production for all staff salary costs (including all taxes, uniforms, retirement, bonuses, hygienists, etc.) while still paying the staff extremely competitively…anywhere in North America. This is true, absolutely, and I can prove it in any instance. How do I compensate for the stair-step staffing issue, then? It is simple. There is a production potential from that staff that is not being reached. Until production reaches potential for the staffing level we are overstaffed.
Parkinson’s Law of ever expanding staff size is true. There is only one way to prevent it. On a regular basis it is essential to get back in shape…to clean out the excess poundage that has accumulated over the years. Get an outside look at the size of the staff and the size of the tasks to be certain that no added poundage has been gained during times of overstaffing. It starts with a simple arithmetic problem. Add up all costs for salaries and other compensation for staff during 2001 (not including doctors, of course). Divide by gross production. If the percentage is more than 20%, it is time either to increase production to the proper level, reduce staff to the proper level, or (more probably) adjust in your situation appropriately.
I know that I will receive many, many emails form those who will be offended and contend that my 20% figure is impossible. Some will be so incensed as to ask me to discontinue sending these tidbits. It happens every time I write this. However, I do not enjoy this so much as to tell dentists only what they want to hear. Sure, I love to write these weekly (almost) letters, but only because I can tell the truth. I have personally looked at more than two thousand dental offices’ individual financial results, and our company combined can multiply that number several times. The reason that we have never, ever failed to help our clients increase production in their practices by $10,000 per month is that unrealized potential is always there…always, in the most efficient of practices, even. However, it is the dentist himself/herself who suffers from not achieving potential, so I suppose it is as it should be.
Okay, I reread that and I sound like an obnoxious, know-it-all jerk. Sorry. It is just that we have a unique perspective on this issue. My nature is to soft-pedal, but I would be doing a disservice to those who read this faithfully.
Who will win the Super Bowl? Probably, St. Louis or Pittsburgh, but we here in Tampa Bay have our dreams and remote chances.
Have a great week,
Hurston Anderson
813-963-7228
Hundreds have taken advantage of our free practice evaluation service. The procedure is simple. I email a simple 14-question form, and you email it back to me completed. Then, I have your responses to the questionnaire input into our computer model representing the thousands of dental practices across North American with which we have worked. From that analysis we can make recommendations about the potential that the practice should be able to achieve including some ideas of how to proceed toward realizing this potential.
Our management workbooks are terrific based on the real world. They can help to reach potential, and if more information is needed about them, email.
There are two really valuable ways we can assist, however. First, we can do an in-depth analysis of the practice. It is the next step after the 14-question analysis, it requires that we visit your office for one or two days, and there is a fee to cover the extensive analysis and travel costs. I make as many of those as possible, and I personally direct all these In-depth Analysis Studies. The product is a bound report of the status of the practice, its historic progress, and its future potential with very specific suggestions.
Also, we are still accepting a few more consulting clients for in-office management consulting. This is a year-long relationship in your office which implements the actions necessary to realize the practice’s potential. Our references are excellent nationwide.
During times of overstaffing as a result of the stair-step hiring issue the excess time should be productively spent on marketing activities.
Confessions of a Chronic Canceller
One of the toughest things in some practices is dealing with a rash of patients who either call at the last moment to cancel or who simply do not show for appointments. In only hours a really healthy schedule for a doctor or hygienist can turn into a disaster. The fact is that it is not necessary to suffer with disrupted schedules given a strict adherence to appropriate procedures.
First, no patient should be considered to have an appointment unless there has been a positive verification one or two days beforehand by telephone. Leaving a message does not qualify. When I traveled a lot internationally, I once came back from a business trip to find a message left after my departure reminding me of an imminent dental appointment. The practice thought I had been confirmed and were actually annoyed with me when their schedule was disrupted. In fact, I was in Africa on urgent business. Positive verification is the patient (or parent) actually speaking with the designated confirmer. If a message is left, it should request a call to confirm. If a confirmation call does not come, an additional call must be placed. Often, this means there must be a dedicated staff member who makes a few calls from home each evening. Maybe she comes in a little later or leaves a little earlier. There are many working moms who would appreciate the opportunity to make calls from home in exchange for this sort of flexibility.
Second, know your patients. Never schedule patients who do not have a good record for keeping appointments on Monday morning, and leave room for emergencies as are typical for the practice. While sometimes it is necessary to sacrifice an appointment time for a patient with a spotty record, never sacrifice several appointment times at or near the same time.
There are some consultants around suggesting not pre-booking hygiene. This is coming from people who have been out of direct involvement with dental offices too long or who are willing to “burn through” too many patients to fill a hygiene schedule. To maximize the hygiene production from active patients, forego the computer capabilities that will automatically send cards. There is no substitute for a patient receiving a card addressed by the patient personally. With all the junk mail we get it is essential to be unique. Nothing gets a patient’s attention like a card in his/her own handwriting. About a week after the card should have arrived call the patient to confirm the card’s arrival and the appointment. Also, call to confirm again no more than two days prior to the appointment. Using this method will allow a hygienist to produce about $1,000 per day from only 750 active patients. Yes, there is some work involved, but it is well worth the effort, and it works.
Keep a large VIP list for hygiene and doctor patients. Depending upon many factors including specialty and demographics this list will be larger or smaller than average. This list should include people like me. No matter how hard I try, I cannot control my schedule, as I would like. Just as I am ready to leave the office for a dental appointment, I always get a call. In my case, now, it is usually a client and sometimes I can simply return the call afterwards…but, not always. Frankly, a client’s problem is sometimes more urgent than my semiannual prophy at that specific time. Previously, I had stockholders and/or bosses whose need to speak with me was also more important. Does this mean I lack respect for my dentist or hygienist? Absolutely not. However, my clients or someone’s stockholders/bosses provide the income that feeds the family. They must come first. For me, being on a quick call list is the absolutely perfect solution. I am only five minutes away, and a quick call has at least a 50-50 chance of getting me in for my cleaning or other non-emergency need. When presented to me as a preferred service I am even honored. The problem is that most practices see these patients as a nuisance and treat them that way. These patients are the “quick patch” for the “flat tire” schedule. Again, it may take a dozen calls and an attitude change, but that is better than a gap in the schedule.
Since the average dental practice loses between 10% and 15% of scheduled production due to cancellations and no-shows, this is a very important area. Simply sticking to a solid Scheduling protocol including effective cancellation and no-show procedures can increase a $500,000 dental practice’s income by $50,000 to $75,000 per year. This can be done without additional staff or hours in the office. Also, it can remove a lot of guilt from chronic cancellers like me who are really good patients but who do not have a job with a predictable schedule.
Well, the good-natured competition for best (or most) lighted house here in our neighborhood here in North Tampa has really heated up this Christmas season. Just a few years ago stringing a few icicle lights would do the trick. This year we have escalated to animated reindeer and angels. It seems like every night someone slips out and adds something new. When do these guys sleep? I quit. Well, then again, there is this 7’ animated Santa on sale downtown that might fit on the roof next to the chimney.
All kidding aside, I think the possibility of returning to some semblance of normalcy given the events of the past few months is welcome to all. Prayers and thoughts for all those who suffered great personal loss on 9-11 or are enduring the absence of and the fear for of loved ones directly involved in the conflict. And personally, I feel great sorrow for those innocent Afghani casualties. It seems they have suffered so much for so long. It is the same in all wars. Wars are not fought between democracies that have chosen their leaders. Autocrats seize control and then put their controlled citizens in peril by their egotistical actions. Maybe the aftermath of this conflict will give the Afghani people a chance for a better future as has been realized by Germany and Japan a couple of generations after WW2. God willing, and I think He is.
Have a great, though probably hectic week,
Hurston Anderson
813-963-7228
If scheduling is a problem in your office, we offer a special protocol workbook in our Protocol Series on scheduling. Like those on the other four critical areas, the Science of Scheduling can be purchased by faxing cc#, etc. to 813-963-5974, calling above, or emailing (no cc#’s by email. Not secure). Much of scheduling as well as general recipes to solve all internal operational problems in dental offices are available with Practice Management Cookbook. Protocols are 179.95 each plus shipping/handling of 12.50. Cookbook is 199.95 plus s/h.
We cannot take additional consulting clients to begin in January, but there are a couple of openings for February and March. If interested, contact me ASAP.
Retiring to “The Life of Riley”
I grew up on the outskirts of Dallas in what my father always called the “rural-burbs”, small towns close enough to the city for the fathers to drive to work yet far enough away to have a few acres for horses, chickens, and other 4-H projects. Most of our neighbors were like my parents. They had been raised on family farms, but they had moved to the better opportunities of the city. We lived near Forney, the town where we went to school that was twenty miles (and twenty years) east of Dallas. And no, our high school mascot was not the “Gators”.
Just north some twenty or so miles was a similarly sized town where we often went to play Little League baseball and football games. As you rode into town after driving past miles of hay pastures, cattle ranches, and cotton fields, just to the right there was an old faded sign with a picture of a man lounging on a hammock. The caption below read, “You’ll live the life of Riley in wide awake Wylie”. I have no idea if that sign still exists. It has probably been thirty-five years since I was in the area and it was pretty old then, but I remember thinking that was what it probably meant to retire, enough money to pay for a hammock strung between two trees and a tall glass of iced tea to keep you cool. (The “Life of Riley” was to a black and white television program of the mid-fifties starring William Bendix.)
There are times when the pressures we face daily seem particularly heavy. The staff is in revolt, patients are complaining, the kids are hellions, and our wife/husband seems to be pushing those buttons that only spouses know. A hammock and a big glass of iced tea with a sprig of mint sound pretty good then. Here in the 21st century though, I don’t know very many professionals who would really want to spend the last decades of their lives idly. We are likely to seek a more active lifestyle.
That is an important consideration when it comes to planning for retirement. Independent professionals, like dentists or writers/speakers/consultants, do not have a particular age for retirement, like 60 or 65. Without a particular target date planning for retirement sometimes gets delayed time after time. While it is not necessary that we actually retire at a certain time, it is necessary that we be prepared to do so. Personally, I cannot see myself spending all my time in leisure. I just do not have that many hobbies I enjoy more than the work I do. Still, it is important to know that I could quit, if I felt compelled to head another direction with the remainder of my life.
There are specialists with big titles and big expensive offices who charge tens of thousands a year to help dentists plan for retirement and to monitor their financial progress. My guess is that those who engage them certainly feel that the cost is far outweighed by the value of the advice, so my point is not to criticize these professionals. However, it really is not all that complicated to plan for retirement.
Let’s look at an example that does not consider inflation and taxes. While these considerations are important they can be calculated after the basic plan is in place. (If you aren’t interested in the details, skip to the *****.)
Suppose there were a 40-year-old dentist who owns a dental practice producing and collecting $500,000 per year. In addition, the practice has about $50,000 in equipment and supplies, but there is also a $50,000 debt on the practice. This dentist and his family live in a home worth $400,000 and owe $250,000 on the mortgage. All personal assets are worth $150,000, but there is $100,000 in personal debt. So far, he has $75,000 in his retirement account.
Net value of dental practice = $250,000 (1/2 annual production/collections + equipment – loans)
Net value of personal property = $200,000 (Home value – mortgage + personal property – debt)
Retirement account = $75,000
Total net worth = $525,000
This dentist wants a plan to be able to retire at the age of 55. All three children should be through college, but they are realistic enough to know that they will need about $30,000 each year for expenses related to their children and grandchildren. All other expenses for a rather active lifestyle and some travel mean that they will need another $10,000 a month in cash flow. So, he needs about $150,000 per year in passive income to retire rather comfortably. Since he does not know how long he will live, he needs to have this income without touching his assets. Assuming a 5% annual income on his assets, he will need $3,000,000 in assets to retire at age 55. At present he has $525,000. So, he needs to increase his assets by $2,475,000 over the next 15 years. How can he do this?
First, we look at the practice value. Assuming a 5% growth per year his practice should be worth about $520,000 plus equipment. Let’s say about $600,000.
His home will be paid off and will have increased in value about 3% per year. That creates a value in the home of about $625,000. Personal property will increase at about 3% as well increasing that value to about $312,500.
Practice value = $600,000
Home value = $625,000
Personal Property = $312,500 (cannot be used to create cash flow)
Property Value that can be used to create cash flow = $1,225,000
Additional assets required to produce a cash flow of $150,000 per month at 5% = $1,775,000
Annual contribution needed to reach $3,000,000 assuming 5% earnings on contributions. = $80,000
While this may seem difficult for those dentists who are already striving to makes ends meet, it is important to know where you stand. Several things should be noted. This is a very conservative approach with no need for risky investments. Heirs would stand to inherit the entire $3,000,000 ultimately, so no other provision for them should be needed.
*****Since the average dental practice in North America is operating at about 55% of potential, it is only necessary to become efficient enough to operate at 63.8% of potential to earn the additional amount for a very comfortable, early retirement given this sample. This can be accomplished with better internal protocols and procedures and a bit more proactive attitude among the entire team. There is no need to make risky investments, etc.
Admittedly, this can look pretty confusing especially when you calculate taxes and inflation, but it really all boils down to putting together a plan and meeting that plan through internal efficiencies. Every situation is different. Some are rosier and some are much bleaker, but the issue does not disappear simply because it is ignored. Certainly, the sooner a plan is established the better, and there will be unexpected circumstances that may vary the plan through the years. Still, whatever the actual situation is must be considered, and a plan must be formulated from there. Also, I think it is wise to plan to completely retire at a particular age even though many of us will never do so. It gives you the flexibility to live a much better later life.
I missed sending a message at Thanksgiving for several reasons including family visiting, computer virus problems (Watch out for Badtrans.), and a short case of the flu. But, I still have a lot for which I am thankful. For one thing, I wanted to thank everyone who reads these messages and comments. I know sometimes I get a little slow in answering, but I really enjoy getting to know you and gaining the wisdom of your individual experiences. All of us seem to be so busy that your taking your precious time to send comments can be a great sacrifice. My thanks to you.
Have a great week,
Hurston Anderson
813-963-5974
PS: Call above # or email me for information about special internal operational workbooks including the Financial Management Workbook that contains a form to create retirement plans. Also, you pretty much know by now how this year will end financially. If you need to do better next year, we have openings for a few new consulting clients beginning next year. Among the things you can expect are an increase of at least $10,000 per month in practice income and our professional assistance in all your financial planning needs including retirement planning.
REMEMBER! Your rewards in life are determined by the kinds of problems you are willing to solve for others. Your income depends on the complexity of the problems you solve. If you solve problems that many others can also solve, your income will be lower than if you solve problems that very few others can solve. (paraphrasing author Mike Murdock)
October Production Results
I was anxious to see the monthly results from our clients around the country for October, the first full month since 9-11. Weeklies had been rather good, in general, but the last week was going to tell the tale. There had been a softness in the last half of September especially in hygiene recall that suggested a bothersome trend. After getting all the monthlies for October I was amazed. A solid 40% of our clients had all-time record high production in October. There seemed to be no specific regional factors, and there were other dynamics involved, but it was a surprising discovery for me given the conversations and emails during the month.
Admittedly, this should not be considered a good statistical survey because we are hired for this very purpose and most of these clients were at that critical second to fourth month of our time together when the new techniques are taking affect. Still, the feedback from emails that I had received from non-clients around the country during October had not been very encouraging. There is an interesting phenomenon, though. Very often dentists think things are worse (or better) than they are in production based on their overall mood. Many are still feeling uncomfortable since 9-11, so the monthly results were a moderate shock to me. Few predicted setting new records.
Why did this occur? As I stated before, partly it was due to our involvement. We encouraged them to become very proactive after the concern we felt in September. Newsletters were part of that pro-activity, but also there was a lot more telephone contact with patients who had cancelled in September. Some of October was simply the September patients rescheduling after being called. Another thing that seemed to help was the heightened awareness, the increased focus. I believe the doctors and staffs in these practices were just a little more diligent than they had been before 9-11, a bit more serious about their jobs. November will tell us if that will continue, but October was a genuinely pleasant surprise for me. Even the 60% who did not break records performed better than they had expected even several who had turnover, vacations, illness, etc. All in all October was a great bounce back month in most of the practices we monitor.
There is a lesson to be learned, I think. Even under duress we control our own destinies. Too often, businesspeople blame circumstances supposedly out of their control for their difficulties. In reality, our success or failure is completely up to us and how we deal with the situation. A little remembered fact is that many of today’s largest companies were founded and grew during the Great Depression. Alternatively, many purportedly great companies failed during the same period. In each case it was due to the attitudes and efforts of the owners/managers/employees of the respective companies. Seminal events like 9-11 can shake us into new paradigms, cause us to look at the world around us differently. For some, this will be a new birth. For others, it will have a very negative effect.
I have been worried that too many dental practices have become complacent during the past ten years. The 1990’s were a time of incredible prosperity in the US, the best in our history. Tens of thousands of dental offices were created or changed ownership during this period. Almost no dentist or staff member can remember when there were difficult financial times nationwide. Sloppy, inefficient, ineffective habits were formed. Concentration on superior customer service slipped. Scheduling became too often a matter filling blank slots from telephone calls or at the front desk. It seemed not to matter what was done the practices did pretty well. Creativity and hard work seemed unnecessary. This was not the case for all practices, of course. Some maintained good habits and discipline, and these practices soared with the economy. It is sort of like an airplane catching a tail wind and maintaining speed by cutting back the engines. Keeping the engines running only increasing the success. There is no reason that any dentist should not excel during those types of conditions. Yet, many, many dentists did fail, and many others struggled.
Unless there are additional cataclysmic events this Recession will be over by early summer. (I have just heard the news of the Queens AA crash as I am getting ready to send this out. At the time of this writing it seems to be unrelated to terrorism and an incredible coincidence which should have only a few days effect on consumer confidence. I do feel so terribly sorrow for all our fellow Americans in NY, though. It seems to just keep coming for them.) Those dentists who refocus and stay proactive for the next few months eschewing complacency will see no negative effects whatsoever. Others will keep on in the same way as before and lose tens of thousands of dollars in income placing themselves in financial stress for years to come. Some, will even be forced to declare bankruptcy. There is a simple solution. Watch your business very, very carefully. Look every day at your pertinent monitors compared to goals. Refocus your efforts and those of the entire staff toward more efficient and effective activities. Eliminate deadwood quickly, but humanely. Remember that doing the same old thing as before during strained conditions will not work. Just as in everything else in life, modify your approach to the changing circumstances. Do not let circumstances control your life and business. In short, avoid lethargy and run a tighter ship.
Baseball is now becoming a worldwide sport, but it retains a lot of the American personality. This year’s World Series was one of the most exciting I have ever witnessed. On the one side is the powerhouse NY Yankees who have won so many championships that it boggles the mind, including the last three in a row. They are not only great athletes, but they are individually great role models for youngsters. Examples would include Derek Jeter, Paul O’Neill, Bernie Williams, etc. Besides NYC had just been attacked by hateful maniacs. How could anyone not root for them? On the other side is one of the newest teams in the league. A team which chose to sign many older players who have never been in a World Series and who were getting possibly their only chance. Examples would be Mark Grace, Matt Williams, Randy Johnson, Curt Schilling, etc. How could you not want to see these future Hall of Famers in the twilight of their careers get what they had hoped and prayed for since Little League days? Then the Yankees went down 2-0 due to masterful pitching. They looked beaten. Then, they came back in NYC three nights in a row with some great pitching and timely hitting. The President even threw out the first pitch, a strike to any umpire, to a thundering applause in a city where he received very few votes a year ago. But then, back in Arizona the old gamers Schilling and Johnson made their statement rather emphatically, and somehow it helped this country recover. I believe it was an example of America at its best, a gift from the National Pastime to a hurting people.
Have a great week,
Hurston Anderson
813-963-7228
PS: If you need to run a tighter ship to steer through these troubled waters, you must get better organized. Our workbooks on Scheduling, Hygiene, Finance, and Personnel from the Protocol Series are 179.95 each plus shipping and handling, and that is their purpose. Consider also the Practice Management Cookbook, our most widely used reference book at 199.95 plus s/h. I will admit that some have purchased these books and put them on the shelves, as if that alone would help. However, those who have actually used the books have had incredibly positive improvements in their practices. Fax cc#, etc. to 813 963-5974.
Also, we are able to handle a few more consulting clients. We have references from coast-to-coast. Call or email wisdom@wisedentist.com to discuss.
The website for the SMILE, America! Campaign is http://www.SmileAmericaCampaign.com. If you are looking for a great way to get your practice involved in raising the spirits and moods of the country, take a look. It is just starting in most offices, but the initial reaction has been quite positive.
