Alice J. Gish, Ed.D.
When my husband was in school at The State Univ-ersity of New York at Buffalo School of Dental Medicine, the students' wives were invited to attend a quarter-semester course that was designed to teach us how we could assist our spouses in their dental practices. At the time, as a teacher, I saw little value in what the professors were presenting so I spent the class session socializing rather than learning. Now, as an integral part of his dental practice for the past five years, the "opportunity lost" forms the impetus for writing this article.
Although I had established my own career path, my husband and I came to realize that he could not successfully expand his practice while he was chair-side, treating patients. The demands of a large practice where the gold-standard of patient care is the rule requires a manager who shares the same vision as the practitioner. Too often, dentists hire office managers whose sole credential is prior experience as a dental assistant or who have been the office manager of a small company. Because these employees, although well-meaning, do not have a clear understanding of the doctor's goals and aspirations, the doctor is forced to take one of three approaches: 1) spend precious time continually redirecting the staff; 2) hold time-consuming meetings that often result in little or no change; 3) relinquish control.
The frustration dentists encounter when trying to oversee their businesses while practicing their craft too often results in the staff making key business decisions. I can't tell you how many dentists we meet who cannot answer questions regarding the daily routines in place in their own offices and, not surprisingly, how many have supply cabinets that are overstocked with expensive medicaments they rarely use. Some dentists are forthright and clearly articulate that they have lost too much control of their practices; others sheepishly realize that they don't have the time or the skills to deal with these issues.
While one group of dentists is resigned to this situation, others are frustrated that the rising gross incomes of their practices are not resulting in concomitant salary increases. Sadly, within the group of dentists who clearly know they could and should be achieving more, many remain stagnant. Our realization that the dentist cannot take the time to oversee and monitor the implementation of new procedures that will result in practice growth became the foundation of our business relationship. With a working knowledge of the Total Quality Management, or TQM, business model and the lessons learned from helping schools implement and sustain innovations, I became the implementer of our mutually agreed-upon vision.
Since joining the practice, we have hired seven associates and opened two other dental offices in noncontiguous locations (three in total). I travel to each office to ensure that the corporation policies and procedures are followed. Employee concerns and issues as well as input into more efficient practice-management techniques also are within my domain of work. In addition, meetings with staff, lunch-and-learn sessions, outings, and social events also are my job responsibilities.
I frankly admit that the first hurdle I had to overcome was to not take business issues personally. The second area of contention arose when I felt that my "toes were being stepped on" which occurred less frequently as we both gained confidence in one another's abilities. There is a natural, well-documented progression that occurs as a business relationship matures, but knowing that we had a vivid and oftentimes repeated shared vision brought us to the realization that our "partnership" would work.
My husband and I subscribe to the notion of kaizan — continuous improvement. We are constantly discussing the design of new systems or paradigm-challenging practices. By engaging in the continual assessment of how we conduct the business and the level of patient care we provide, we are assured achievement of our goal: reaching the gold standard of dental care. Since we have no other competing agenda when it comes to the practice, our discussions are frank and multidimensional. In addition, with our individual strengths and weaknesses clear in our minds, new business ideas are often implemented successfully because they have been the source of rich discussions and long hours of action research.
If you are experiencing the frustration of sporadic, non-sustainable change, if your well-meaning employees are running your dental practice, if you are working harder and wondering where the income is going, perhaps it's time to consider taking on a business partner — your spouse. Who more than you and your wife or husband wants your dental practice to be increasingly successful? Remember — you and your spouse already have established shared values and visions, so agreeing on business goals requires you to simply add to the existing commonalities.
The old paradigm of the dentist's wife who comes into the office, pays some bills, and flits out to the store to deservedly use the charge card as compensation for her two hours of work is long over. I suggest that it is these capable women who can be the successful implementers of dental-practice expansion.
Similarly, the male spouse often is overlooked as the perfect business partner. Today, many men have been forced into second careers because of corporate downsizing. Some are floundering as they try to adjust, or have taken jobs that are less than satisfying. Here again, I suggest that it is these men who can be the successful implementers of dental-practice expansion.
As a real-world-oriented consultant, I cannot stress enough the need to consider the internal capacity of your practice before you implement new initiatives. If you can entice and invite your spouse to join you as a productive, integral co-leader of the dental team, then you have a loyal partner who shares your dedication to the practice's success. Tonight is a good time to initiate the discussion — perhaps you can begin with "Honey, have I got a proposition for youU!"
Dr. Alice J. Gish has been a consultant for 10 years. Her success is grounded in her ability to design plans for change that are goal-oriented and sustainable. Using her well-honed technique of carefully listening to the client, accurately assessing the environment, and helping to build the internal capacity to sustain the new initiatives, she provides the business expertise that allows dentists to remain chair-side throughout the day. Gish manages three dental offices — Danbury, Fairfield, and West Hartford, Conn. — that comprise the practice. Dr. Gish can be reached via email at [email protected] or by phone at (203) 743-4770.