Step 4: Systems point the way

April 1, 2004
Those who read my newsletter, Private Practice, know I look to sports for metaphors for the many lessons we need to learn in creating a successful dental practice.

Barry Polansky, DMD

Those who read my newsletter, Private Practice, know I look to sports for metaphors for the many lessons we need to learn in creating a successful dental practice. One of the most admirable accomplishments of great football coaches such as Bill Parcells, Dick Vermeil, and Bill Walsh, is their ability to win championships with different teams over the course of their careers. Is it because they have great talent around them, or because they are great motivators, or because they are superb tacticians?

I believe all of these things are necessary to build winning teams. I also believe these coaches are unique innovators who develop winning systems that depend less on the talent of the players and more on the consistency, predictability, and low variability of their systems. To quote Michael Gerber, small-business guru and author of the best-selling book, "The E-Myth," "The system is the solution."

Systems are very visible in sports, but behind every great business model, there also is a network of systems that constitutes the story of that particular business. The story of last year's Super Bowl champions, the Tampa Bay Buccaneers, was good, solid defense with a strong but conservative offense. Every procedure (or play) in football is designed around the group of systems that helps define the team. Michael Gerber puts it succinctly when he says that every business should be able to answer the question, "How do you do it around here?" If your practice can't answer that question, then maybe it's time to create some good systems.

One of the first questions the practice needs to ask itself is, "What are we trying to accomplish?" Many years ago, I decided my practice would try to achieve comprehensive dentistry for every patient we treated. I felt that was the only way I could feel fulfilled in dentistry. That was my reason. Your reason could be totally different. For me, the one system that helped align every other system in my practice was the new-patient examination.

I was so convinced that this one system was the key to accomplishing what I wanted, I wrote a book called "The Art of the Examination." I realized the examination, which includes the initial contact, preclinical exam, co-diagnostic exam, records, treatment-planning, and case presentation, is the one system that demands excellence in every area of dentistry — technical, behavioral, and managerial. A well-thought-out, new-patient examination system can act as the spine of the central nervous system of a dental practice.

In my practice, we have been doing our new-patient examination for so long that we have reduced variability to practically zero. The success of a system depends on optimization or low variability. In football, it would be like running a play so often that it would be hard to make a mistake. It's been said that Vince Lombardi's legendary Green Bay Packers only had four plays, but they were so good at executing those plays that no defense could stop them with any consistancy. Once the staff is on board with the system, you can throw away the playbook — there is no longer a need for scripting or struggling to find the right words in a particular situation. Like those Packers, you just run the same play, and you will be scoring more than you ever thought whether your goal is comprehensive dentistry or high-level cosmetics.

What happens if you lose a staff member? Simply give new staff members your playbook. Tell them to study the system, and then throw them into the game. In time, they will learn what is expected of them and will be doing it like a veteran — saying all the right things at all the right times. Like clockwork, you will begin to see a consistency in your practice like you never dreamed of, and your biggest source of stress — that of reinventing yourself every day for every patient and the frustration it brings — will dissolve.

For me, the system became the solution to just about every fear and worry I had in dentistry. It was just that simple. But the real payoff is what occurs after the systems really take hold of the practice. Once everyone understands his or her role in the practice, a culture develops. Creating the practice culture is the real key to a successful long-term strategy for success. In the next issue, I will discuss the culture of excellence.

Barry Polansky, DMD, practices dentistry in Cherry Hill, N.J. He is a member of the Visiting Faculty of The Pankey Institute for Advanced Dental Education and author of the book The Art of the Examination: Why Patient Care Goes Beyond Clinical Correctness. Dr. Polansky also publishes a monthly newsletter titled Private Practice, and may be reached toll-free at (866) 428-4028, and also at

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