It's become increasingly common to meet a dentist who has several practices. It's also common to see them having to scale back because they got into trouble.
Large dental conglomerates go out of business because they make the same fatal mistake: they don't understand the basic idea of first developing a qualitative model in each practice. If you bought practices that were successful because the principal dentist was always dealing with recurring inefficiencies and you then duplicate all these inefficiencies, you will be multiplying mistakes and the problems will hit the fan when there is a dip in the economy.
Just as the McDonalds franchise started with one location, it makes sense to get one model working smoothly before you start duplicating that model.
There are two ways to achieve growth. One way is very expensive and can send you broke and the other is free.
- Quantitative growth - add more patients. Typically, you grow the practice via external marketing, which requires capital.
- Qualitative growth happens when more patients make better treatment choices. That's the hidden gold inside every practice because you've already got the patients. This type of growth doesn't cost anything; the patients tend to be loyal and they refer more new patients.
Ideally, you should first develop a qualitative model and then add the marketing - the quantitative model. That's being smart.
The key factor in all business development is leverage: The ability to gain more benefits with less effort. There are several types of leverage in dentistry.
Clinical leverage
This involves employing more clinicians. The starting point is the hygiene department. Hygienists typically earn 33% of their production. Assuming the dentist is already covering the fixed costs of the practice and assuming the consumables are roughly the same, whether it's the dentist or the hygienist doing the work, the dentist is pocketing almost 66% of whatever the hygienist produces. Furthermore, with the right training, an hygienist will increase the amount of high value work that the patients select. Since an hygienist's hourly rate is lower than a dentist's rate, if the principal dentist is employing dentists to do hygiene work, this is lowering that employee dentist's income. When a dentist is being their own dental hygienist, they are willfully lowering their own hourly rate and lowering their income. Not smart.
From a business perspective, the only rational reason for not employing an hygienist is not being able to find one.
For dentists who have a practice manager and an hygienist, the next stage of leverage is to implement a system of extended team leverage.
Extended team leverage
This is still rare in Australia. It's better understood in the USA and it really is the future.
The clinical coordinator brings the patient through; takes x-rays, photos and digital scans, then has detailed clinical discussions with the patient. Finally, the dentist appears, examines the patient and leaves. The clinical coordinator discusses the treatment options. Sometimes, the clinician will spend some more time chatting, but the bulk of the important communication is with the clinical coordinator.
The whole idea is to have moved the role of "great communicator" to team members. If all the communications and clinical skills are in the hands of an employee dentist - that's dangerous. Your star dentist is probably looking to build their own empire!
It's much easier to train lots of team members than trying to find the one perfect dentist. This leverage system significantly increases production and your employee dentists will earn more in your efficient practice than elsewhere... so they are more likely to stay.
Communications is the invisible foundation of every successful practice
Teaching technical skills, such as taking a scan or photos is relatively simple. But soft skills (communications skills) are the ultimate challenge. Normally, the team inherits their soft skills via passive absorption and by emulating a dentist. This is not ideal because replicating information in an unstructured way guarantees that the information gets degraded. As the enterprise grows, you'll have the equivalent of the blind leading the blind.
Most dentists are poorly prepared to teach communications. Dentists typically have developed their communications techniques via an ad hoc, reactive process - dealing with problems only as they arise. This system guarantees the recurrence of problems. When a dentist tries to analyse how their communications fared, it can easily become a confusing blur. That's because there was no real structure to their model. Their communications didn't follow any clear rules and are essentially a gut-feel process. It's also difficult to distinguish excellent communications from average.
When communications fails, there's stress; the team is exhausted; patients make poorer choices; they don't return; and they don't refer. But the mere avoidance of open conflict is a crude measure of success. Like being a chess master, the advanced communicator is thinking multiple steps ahead, always preventing problems and leading the patients to make the best treatment choices.
Training
The success of any dental enterprise is wholly dependent on the quality of training.
In general, there are 2 common complaints regarding training:
- Most training, today, is online, however, online team training sessions are usually done in groups and this often interferes with production.
- Attending a course will deliver flashes of clarity but after a few days, that clarity dims. Studies that measure the Ebbinghaus Forgetting Curves show that 50-80% of new information will be forgotten within 24 hours and 98% in 30 days. This is the most significant flaw in training models.
Problem solved
I have created an entirely new online program that is designed specifically to create a system that takes Extended Team Leverage to its highest point. Importantly, it corrects the two flaws just mentioned.
It's designed to be used as a standalone training tool for all clinicians and all team members. It thoroughly covers all front office and clinical scenarios imaginable.
The entire training is possible without the need to halt production because:
- Each participant's training is personalised.
- The videos are very short... often as short as 5 minutes so they can be viewed in short natural breaks during the day. They can be viewed by each individual or in small or large team settings when appropriate.
- Each team member's competencies are tracked and visible to the managers and participants.
Training is only as good as how much is being used
Unlike other systems, the information will not be forgotten. The problem of the Forgetting Curve has been solved using 30-second puzzles that can be completed on each team member's phone at prescribed intervals. The system has been configured to be a non-intrusive, on-demand process. This intelligent algorithm reinforces the knowledge, based on each team member's scores.
We've designed the system to be fun, non-intrusive and genuinely helpful.
Instead of the harried practice owner multi-tasking in the role of clinician, being the main communicator and in some practices, the practice manager and the hygienist... clinicians can focus just on the most important role - being a great dentist!
Whether your ambition is to create an empire or not, it makes perfect sense to first develop a strong, self-sustaining business model with a well-trained team. The Sernik System will give you and your team the skills and tools you'll need to grow as big as you want.
Dr Michael Sernik is the CEO and creator of Channel D, dental videos designed to trigger conversations that will grow your practice. Simplicity in patient communications matters. Channel D is also perfect for treatment rooms. It plays silently and will trigger conversations on Dental topics that matter to you. Visit www.ChannelD.com and use Code MA56 to start your trial.
SernikSpeak is a new program offering online communications training for dental practices.
Wednesday, 11 December, 2024