A mission to manage

March 1, 2000
Reading dental-management journals is a lot like picking up the Sports Illustrated swimsuit edition. We may see some dental practices that are absolutely stunning, but to imagine ourselves in the picture requires a stretch of reality.

When you start the great journey of transforming your practice, you`d better have a road map!

Michael R. Gradeless, DDS

Reading dental-management journals is a lot like picking up the Sports Illustrated swimsuit edition. We may see some dental practices that are absolutely stunning, but to imagine ourselves in the picture requires a stretch of reality.

The truth is you already have a practice that can be everything you would like it to be. Being a great dentist is only one part of the equation that results in a great practice. Management of our practice is as much a part of our success as managing our crown and bridge techniques. Unfortunately, while we were taught a lot of crown and bridge in dental school, we were taught next to nothing about management.

Studying management principles can be far more profitable for your practice than taking continuing-education courses in any technical procedures. The main problem is that management of a business is a cohesive process that is built from attention to detail in many areas that are irrevocably intertwined and cannot be separated or "cherry picked." You can add one new procedure code to your billing list and see a measurable difference in your practice, but there are no "practice-management" procedure codes.

When we look at the great practices featured in magazines, we may think we have so far to go that we`re not able to make those changes in our practice. The question is: Where do you start if you want to study dental-management principles and transform your practice?

The absolute foundation of managing your practice comes from your mission and philosophy statements. Starting anywhere else would be like building a beautiful sailboat without a rudder. You do, of course, have a mission statement and a philosophy statement, don`t you? If you don`t, it is time to develop them. It took me most of a weekend to develop my mission and philosophy statements and I have found the time I spent to be one of the best investments I`ve ever made. A few hours of work on a weekend yielded a document that I have used over and over again. Can a simple piece of paper be that valuable? Of course! When you start on the great journey of transforming your practice, you`d better have a road map.

Words like "absolute foundation of your practice" and "sailboat without a rudder" sound pretty compelling, but what are mission and philosophy statements, how do you get them, and how do they work for you?

The mission statement

The mission statement and the philosophy statement are two separate documents. Your mission statement is something you want everyone to read. Every publicly traded corporation has a mission statement. You will find it printed word for word in every annual report. When you are waiting for a table in your favorite restaurant, you may see a framed mission statement prominently displayed.

A mission statement is a document of one paragraph describing exactly why you are a dentist. Your mission statement should be framed and prominently displayed in your reception room. This is a way to let your patients know how important dental health is to you and why you come to work every day. The philosophy statement is your road map of how you will achieve your mission. You must share your philosophy statement with your staff and you must motivate them to agree with your philosophy if you ever expect to have a successful practice.

To develop a mission statement and a philosophy statement only takes a little time. To write your own statements, start with a mission statement. Remember that a mission statement is only one paragraph long. This means it must be packed with powerful thoughts and expressed in powerful words. Of course, you have experienced these powerful thoughts; you probably just have forgotten them! To recall these thoughts, you need to think back to the reasons why you applied to dental school. You also should think about the patients you have treated as a dentist that have given you the most satisfaction. Your mission statement is a summary of your greatest aspirations and accomplishments as a dentist. It is OK. if your mission statement sounds a little pretentious. It is better to attempt great works and to fail than to attempt nothing and succeed.

If you want to be a cosmetic dentist, your mission will be to help people by creating beautiful smiles. In some areas of our country, your mission may be to provide dental care to underserved populations. Your mission may be to provide quality dentistry while expanding dental care through the use of new technology. If you consider that dentistry is the health profession most associated with preventive care and you recognize that periodontal disease and dental caries are the two most prevalent diseases in our society, there may be some thoughts on that issue worthy of inclusion in a mission statement. Think about the issues in dentistry that you find to be most significant. When you have a good thought, write it down. That is all it takes to write a mission statement.

The philosophy statement

The philosophy statement is longer and more detailed than the mission statement. It is your road map that details how you expect to achieve all of the great goals in your mission statement. Your philosophy statement must be shared with anyone who will play a part in the success of your practice. This includes your spouse, your staff, and any specialists on your referral list. My philosophy statement has sections on how we will perform dental care, how we will work as a team, our promotional philosophy, our profitability goals, our requirements for continuing education, and finally our expectations for leadership.

Start with these parameters and develop your own topics. Set the standards for performance in each area of your practice that must be met if you are to achieve your mission. Not only do you share this philosophy with your existing staff, each new hire, and any associate dentist, you must require your staff to embody this philosophy if they expect to be employed in your practice. Think about this as you write your philosophy statement and realize that you are setting your expectations for your employees.

Most dentists will discover as they write their philosophy statement that they have one or more employees who will not be able to meet the new standards. You must not allow this to deter you from your goals. Your mission and philosophy statements will take hours to think about, only minutes to write, and provide years of satisfaction when your practice embodies your philosophy.

A demonstration of leadership

Writing these documents is one of your most visible demonstrations of leadership. Using these documents is a fundamental precept of management. Your first act of management is to manage yourself. Place a small copy of your mission statement in your wallet, in front of your driver`s license, where you will see it every time you open your wallet. The lack of a commitment to a mission is one of the greatest factors in the backlog of uncompleted dentistry in this country today. Most uncompleted dentistry has nothing to do with financial considerations. Every management consultant will tell you that there is a gold mine of uncompleted dentistry in the active files of every dental practice.

How many patients do you have in your practice that suffer from early periodontitis, that have not been informed of the disease, the possible treatment of this disease, and have not been presented with a treatment plan? How many patients in your practice have failing restorations and have not been offered treatment? How many patients do you have that have just a tiny amount of decay, either incipient or around an existing restoration, that you are "watching"? Do you have patients that are receiving substandard care because they are very difficult to educate, they are contentious about every proposed treatment, or simply because you are too busy to perform a quality examination during the preventive-maintenance visit? This is one of the first paybacks for your management efforts. When you have internalized your philosophy of providing a higher quality of dental care, you will find yourself proposing more dentistry to your patients. When you propose more care, you also will achieve more acceptance. While this will improve your profits, this is not profit-motivated. More dental care is needed in this country than can possibly be performed by the existing number of practicing dentists. It is time to improve the dental health in your particular corner of the world. This will benefit your patients, as well as your bottom line.

This is an endless job that only can be accomplished if you are driven by an important mission. Attempting to live up to your mission and philosophy statements every day will make you a better dentist. This is the first step of practice management that will make you a more profitable dentist.

Improve your staff

After using your mission and philosophy statements as a standard to improve yourself, it will be time to improve your staff. While we all like to be dentists, very few of us like to be the boss. Most of us are so poor at confronting staff issues that we no longer even try. We simply hope that our problem staff members will correct themselves by magic or they will quit and go to work for someone else. If you are living up to your mission and philosophy statements, it is not asking too much to expect your staff to do the same. These documents can suddenly make it easy to confront the behavior of a member of your staff.

If, for example, you have an assistant that always is just a little late, and your philosophy statement contains a section on teamwork and patient care, then you have a totally objective way of confronting this issue. It certainly doesn`t matter how good this assistant may be in other areas, she also is expected to fulfill your philosophy about teamwork by being on time. Your employees should expect to be fired if they cannot perform their duties in a way that embodies your philosophy.

Having the statements written down will allow you to address an employee`s behavior on a nonpersonal level. This not only allows you to be objective about employees` performance, but allows your employees to be objective about their jobs.

When we ask our employees to be on time because we want them to be on time, they really don`t care very much. When we ask our staff members to improve their performance to improve teamwork with their coworkers or to improve the quality of care their patients receive, then we are more likely to achieve results. Your staff members may not care about gross production or practice profitability, but they certainly can relate to a patient-centered practice philosophy. When you and your staff strive on a daily basis to embody your mission and philosophy statements, the production and profitability of your practice will increase while your patients receive a higher quality of service at the same time. This improvement of your services will be compounded on a daily basis and will ultimately return a profit far in excess of the effort required to create the documents.

Focus on your goals

The greatest value of your mission and philosophy statements will accrue from focusing on your own goals as a dentist. Today, our profession is gradually being invaded by corporate interests. You are being offered contracts on a daily basis from insurance companies that want your services and from management-service organizations that want your entire practice. This is not inherently bad, but, at this point, the results are mixed. Some dentists are profiting under these arrangements, while others regret the contracts they have signed. Obviously, these contracts are very complex and profit is only one factor in your ultimate happiness with the deal you have made.

Possibly the most important factor is how well your mission and philosophy will fit in within these corporate identities. If the corporate mission is at odds with your own, you ultimately will be unhappy, regardless of profit. Your mission and philosophy statements can provide you with a method for visualizing your future, as well as a primary means of determining if a corporate future is right for you. This is more important than any "pie in the sky" numbers, such as numbers of new patients or the future value of any stock in an initial public offering. If your philosophy of practice cannot be matched with the philosophy of a management-service organization or the insurance company that is offering the PPO or managed-care contract, you should not join. It won`t matter how much money you make if you cannot fulfill your philosophy on a daily basis.

A first step

Developing a mission and philosophy statement is the first step to practice management. A mission statement is valuable as a marketing tool that lets your patients know what your dental practice is about. Your philosophy statement is a leadership tool that will motivate you and your staff. Your mission and philosophy statements will most importantly remind you of your own fundamental goals as a dentist whenever you are considering new opportunities in your practice.

Every well-managed corporation has a mission statement. If you wish to have a well-managed dental practice, you need to start with a mission and philosophy statement of your own. This will serve as a roadmap to success that will that become more and more valuable to you as your new management skills expand.

Use the study-guide questions to clarify your thoughts and to help you develop ideas for your own mission and philosophy statements. Write your statements today, present them to your staff tomorrow, and strive to live up to them every day you go to the office!

For more information about this article, contact the author at (317) 841-3130.

Study guide questions for developing mission and philosophy statements

(1) What are the ways in which a dentist most benefits his or her patients and why is this important? What are the activities that you engage in on a daily basis that expand these benefits for your patients?

(2) How has your practice of dentistry changed since you graduated from dental school? What do you foresee as the dental practice of the future? How are you personally preparing yourself to practice dentistry in the 21st century?

(3) A great team will always achieve more than a less organized group of individuals. List the ways your staff will demonstrate teamwork? What are the qualities an individual must possess if he or she expects to be a part of your dental team? How will your practice foster and promote teamwork?

(4) Any business must be promoted in order to grow. What do you feel are the ethical ways in which your practice can be promoted and how will your team promote the profession of dentistry?

(5) What are your goals for profitability? How will increased profits benefit your team, the profession of dentistry, and your patients?

(6) What are your standards for continuing education for yourself and every member of your team? What level of education will be necessary to enable your practice to fulfill its mission? How are individual team members expected to get this education?

(7) How will you provide the leadership necessary for your practice to embody this philosophy? Who are the most effective leaders you know? Can you model the leadership behavior they demonstrate?

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