Doctor, we need more help!

March 1, 2010
After an especially busy day, your first response might be “Go ahead; put the help wanted ad in.

For more on this topic, go to and search using the following key words: leadership, team management, overhead, salary, bonus, Dr. Bill Blatchford.

After an especially busy day, your first response might be “Go ahead; put the help wanted ad in.” But don't cave so quickly. When your staff asks for more help, they probably have not had access to or learned what numbers in your practice make a difference. Do you know your numbers? How is your leadership? How can you move from having a “staff” to a team without offering solid leadership?

As a leader, be smart in assessing whether you currently have the right team members. If your employees are asking for help, sometimes it is the incompetent ones who are asking for a helper. Do you have efficient systems for scheduling, collections, and treatment planning? Does your team have training and cross–training? Are they fully engaged in what you are attempting to accomplish? Do they accept the bigger picture as their own?

What are the financial consequences for you when you allow someone else to raise your overhead? How much additional treatment will you need to produce to support a new person? At Blatchford, we coach doctors to keep team costs at 20%. Salary might be $35,000 a year including additional employer costs, so you need to increase your yearly production by $175,000. Team costs should be one–fifth, or 20% of your collection/production average.

Knowing that number, what exactly will the new person be doing that will help increase your production? Do you know why your team is asking for help? Have both you and your team done a task analysis to determine where you are spending your time doing each type of task? Why do we do these tasks anyway? Could someone else outside the office do them? Are they necessary in the present form? Who could be trained to do them?

These questions are critical. (For a copy of our Task Analysis, send an e–mail to [email protected].) It is possible that if we reorganize the tasks and the time it takes to perform them, including the skills we use, we may not need another person.

If your team knew the percentage for staff costs correlated to your collections, they would know what your production and collection is per month. I am amazed in speaking with staff members across the country how many do not have a clue as to their doctor's production/collection. How can your team be accountable for production/collection if they do not know or understand the numbers?

We have found that an equitable bonus system for the team creates accountability, curiosity, and results. They start owning production and collection when they can see the system of sharing in the profits.

They also become very selective in who they are willing to accept on the team. They need a dedicated team member who sees the opportunity. Team members are just like all of us. They continually ask themselves, “Why should I step up and be responsible if there is no reward?” Money doesn't motivate everyone, but it motivates most people. A team with a bonus plan would never ask for an additional staff member to share the bonus. They would figure out how they could be more efficient and effective on their own.

Real leadership is about understanding the difference between capacity and demand. How will hiring an additional staff member increase your demand? Are you currently turning patients away? Most dentists have more capacity than demand. Have you shared this concept with your present team?

There is also an emotional consequence in adding an additional team member. There is another personality, another set of needs and wants, as well as skills to be shared and learned. There also can be a subtle lowering of efforts now that we have a buffer.

A practice that produces $90,000 to $125,000 a month can operate nicely with three team members when the leader shares the numbers, hires the right people, has strong systems and continuous training in sales, in addition to an incentive of shared profits.

Think about it — do you really need another team member? Will the leader step up?

Dr. Blatchford's book, “Blatchford BLUEPRINTS — the Art of Creating Practice Success,” is available at for $39. Profits go to the Juvenile Diabetic Research Foundation. For more information, visit

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