Going Up?

Oct. 1, 1999
In Part I of this series on "Taking Your Practice to the Next Level" (found in September`s issue of Dental Economics), I introduced you to the first five "Steps of Elevation," which were:

It`s Part II of "Taking Your Practice to the Next Level."

Cathy Jameson, MA

In Part I of this series on "Taking Your Practice to the Next Level" (found in September`s issue of Dental Economics), I introduced you to the first five "Steps of Elevation," which were:

(1) Establishing or Revisiting the Practice Vision

(2) Analyzing and Improving All of Your Manage-ment Systems

(3) Uplifting Customer Service

(4) Improving Communication Skills

(5) Developing the Role of Treatment Coordinator

I hope your office has held a team meeting and discussed each of these areas and has begun its path of "continuous improvement." This path will, indeed, elevate you and your practice to the level that you are seeking.

Now, let`s look at the next five "Steps of Elevation."

(6) External promotion

According to the American Dental Association, the main reason that people avoid the dentist and do not accept dental recommendations is "no perceived need" or a "lack of dental education." Therefore, one of the most important things the dental professional can do is to educate people about what is going on in dentistry.

I talked about patient education, which is a must for any practice, in Part I. Once a person comes to your office, helping him/her see the benefits of proceeding with recommended treatment is critical, not only for the health and well-being of the patient, but also for the health and well-being of your practice. However, there is another side to patient education that must be addressed proactively: educating your community about the latest trends in dentistry. This knowledge will help motivate them to seek your services.

There are hundreds of ways to educate your community about the "latest and greatest" in dentistry. There are five external education methodologies that I have found particularly effective in practices across the country. Remember that there are hundreds of methodologies. I am only listing a few, but they are a powerful few!

(a) Media exposure: Reach the public through the media. Hold a media day where you invite the editors of newspapers, magazines, and reporters or producers from radio and television. Invite these media experts to come to your office to view something that is unique to your practice and is relevant to the public, such as your intraoral camera or digital radiography.

Have a packet of information ready for these members of the media. The packet should include a letter of introduction and welcome, brochures about your office or about a particular procedure you offer (such as cosmetic opportunities), and any written information that you may want published. Give them a tour of the office. Show them a slide presentation of before-and-after photography. Get excited about what you are doing in your office, and your enthusiasm will cross over to them. Make the presentation nonself-serving. It needs to be educational and something that would be interesting and beneficial to their readers, viewers, and/or listeners.

(b) Work with a public relations company or a publicist: Write or become a part of an article. This type of exposure is priceless. Open most any magazine today. You will find some article related to some facet of dentistry, such as cosmetic, periodontal, implants, prevention. Start paying attention to the magazines.

(c) Community presentations: Develop a 20-30 minute slide or PowerPoint presentation about one or two subjects. You might focus on topics such as "Smile Makeovers," "Smile for Success," or "Keep Your Teeth for a Lifetime." Send a letter to the program chairpersons of your local civic groups, letting them know that you are available for a nonself-serving, educational program using visual aids. In the letter, tell them that a member of your organization will be calling in a couple of weeks to see about scheduling a time to present your program.

Remember, these people have to put on about 50 programs per year. They will love to include you. You have to be ready, have interesting visual aids, keep it entertaining and short and to the point.

The doctor does not need to give the presentation. Members of the team can make these presentations, as long as they are well-prepared and excited about the subject!

(d) Press releases: Anytime you or a member of your team does something that is noteworthy, send a press release, along with a photograph, to your local newspaper. This could be a press release stating that you have attended a special course or that someone on your team has done something special in the community. Always be aware of these opportunities. The key to good marketing is repetition of exposure. Get your name and face out there. Build your credibility by letting people know that you are going to continue education, participate in the community, or present a course. The public`s confidence in you goes a long way toward giving them the strength to pick up that phone and call you.

(e) Lunches with specialists or other personal-appearance specialists: As a team, brainstorm about specialists who may be interested in networking with you: peridontists, orthodontists, oral surgeons, plastic surgeons, fitness experts, hair and makeup artists, etc. Invite them to your office for a catered lunch, a tour of the office, and a brief slide presentation about cosmetic opportunities. Have a packet of material ready for them to take back to their offices.

There is something magical about seeing the people with whom you network. One of the very best ways to build a business is to network. Brainstorm ways to do this effectively. Be sure to make this a win-win situation for both you and your guests. Explain to them how you can support each other. Be sure to let them know that you are interested in reciprocal referrals. Make sure that you invite people with whom you truly want to interact.

Exercise: Review the preceding external educational strategies. Choose one that you think would work effectively for you. Determine a specific plan of action: What are you going to do? (Be sure to be detailed.) Who is going to do what? When will each aspect of your plan be implemented?

Once you have initiated the program, be sure to evaluate your progress. How is it working? Are you on course? Do you need to make some adaptations? Don`t let procrastination get in the way of your progress. Stay focused.

Once you have implemented one strategy, begin work on another, and so on.

(7) Scheduling and financing

In Part I, I recommended that you look at all 25 of your management systems and focus on making each one better. That is a powerful and necessary suggestion if you are going to elevate your practice. However, there are two systems that I want to focus on specifically in Part II: scheduling and financing. These are two of the most challenging systems in your practice, and they can literally make or break you.

Scheduling: You must refine your schedule. You must learn to schedule for productivity, profitability, and stress control. So many times in practices, the appointment book controls the practice rather than the practice controlling the appointment book. In order to "go to the next level," you have to make some tough decisions about scheduling. You need to realize that reaping more patients is not the answer to profitability. It doesn`t matter how many people you see each day. It`s how much dentistry you are doing in a day.

Many practitioners are "driven" by how many names are in the appointment book. However, if you look at the bottom-line profits of practices, the ones that are scheduling succinctly for a predetermined production goal - have patients for fewer visits, see fewer patients per day and perform more procedures per patient - are much more profitable.

If you are interested in building the cosmetic aspect of a practice, you simply can`t see huge numbers of patients. You must focus on one patient at a time. If this isn`t your current strategy, the way you schedule must change. You need to preblock certain times of your day or certain times of your week for cosmetic procedures. Then, during other times of the day or week, you can orchestrate other procedures. Let your patients know that you reserve certain times of the week for cosmetic procedures, emphasizing to them that they will have your undivided attention. Certainly, you can vary these reserved times throughout your weeks in order to meet the scheduling needs of your patients, but continue to honor your commitment to be totally focused on these demanding procedures.

Financing: Get involved with and learn to present and promote one or more health-care-financing programs. These programs have been on the market for nearly 15 years, and yet a very small percentage of dental offices have them in place and are using them fully and effectively.

Look at the advertisements in this magazine. Call the companies. Get information. Organize a conference call so that you can hear the details of the company. Each company will be similar to yet different from its competition. Pay close attention to both the similarities and the differences. In today`s market, there are some programs that focus on cosmetic, implant, or full-mouth reconstruction cases. They are able to lend as much as $25,000 for a case. Remember, most people don`t pay cash for their car; they finance it. If someone wants the dentistry badly enough because you have fully educated him or her on the procedure, then make the financing comfortable.

If you are not already involved with a health-care-financing program, you should make that a priority. If you are involved, work at promoting the program to the fullest. If one patient per week goes ahead with treatment who might not have been able to do so without financial assistance, your practice can grow 10-30 percent. And wouldn`t you agree that`s one patient per week who is healthier or more attractive because of your financial service?

Exercise: Evaluate your schedule. Determine whether a fee increase is in order. If so, just do it!

Identify aspects of your scheduling system that are challenging. Get advice on how to improve this system, and make adjustments when and where necessary. Do not be complacent in this area. Know that scheduling always needs improvement.

Get involved with a health-care-financing program. Access training on the program. Determine specific ways that you are going to build your practice with this program. Set a goal of helping one person per week finance his or her procedure, which might not have been possible otherwise.

(8) Improve your case-presentation skills

Here is the "fulcrum" of your practice: diagnosis, complete treatment planning, and beautiful case presentations. You may have heard me say, "There is more dentistry sitting in the charts of most dentists than he or she has ever done." Most dentists will agree with me on this fact.

No one would come to you unless he or she needed or wanted something. Therefore, your greatest challenge is to help such a person make the decision to "go ahead."

I continue to be surprised by poor or incomplete treatment planning. Simply writing "next visit" and then listing treatment for a tooth or two is not comprehensive treatment planning. Develop a fabulous new-patient experience that gives you a chance to determine not only the physical needs of the patient, but also his or her perceived needs.

Each of your new-patient experiences should be the same. Everyone on the team needs to know his or her role and carry that out with exceptional care. Once the new-patient experience has been completed, develop a treatment plan. (Remember the role of the treatment coordinator outlined in Part I?) When the treatment plan has been developed, prepare for the consultation by selecting appropriate visual aids, having all the financial information ready, and having the consultation area prepared before the patient arrives.

Involve the patient with the case presentation by using visual aids (83 percent of learning takes place visually) and by including him or her in all discussions. Don`t just tell your client what is needed, include and involve him or her.

Know that there are two parts to the case presentation: the clinical presentation and the financial presentation. Both are challenging and need much attention and coaching. Don`t think that you were born knowing how to present successfully. This is a skill and an art form. It needs special coaching and a great deal of work.

There will never be a day when you or anyone else cannot improve on communication skills and, in particular, the communication skills that go along with case presentation. Make the case presentation the focus of your practice rather than an aside. With this, you can take the lid off of your practice.

Exercise: Outline your present system of the new-patient experience and the case presentation (including the financial presentation). As a team, discuss ways to improve these two critical appointments. Develop a specific protocol for both, identifying everyone`s role.

Practice both appointments. Then ask what felt good and what needs further refinement. Dedicate yourselves to solidifying the parts that are going well, but also dedicate yourselves to asking, "How can we do this better?" Then, do so.

Track the amount of dentistry diagnosed on new patients and the amount of dentistry being accepted. These numbers should be very close to the same. If they aren`t, you have identified a "glitch" in your systems. This will give you the validation to work on improvement.

If your acceptance rate is too low, begin identifying the reasons why people are not going ahead. If the main reason is money, then work harder at developing your use of the health-care-financing system.

(9) Associates

If you have a busy practice, but you want to focus on a particular type of treatment, then developing a position for an associate may be appropriate for you.

You may see the need to reserve time for cosmetic cases, and then wonder what to do with all the other patients. In addition, you are already scheduled out a few weeks and, if you reserve the time necessary for the cosmetic cases, you fear that you will be pushing the other patients too far away. So what should you do?

(a) If you are scheduled three weeks or more and can`t see another patient before that, you need to look carefully at the way you are scheduling. There are probably many refinements that will help alleviate this scheduling blockage. Step one is refining your scheduling methodology.

(b) Go up on your fees. If you are booked out so far that you can`t see another patient for three or more weeks, the laws of supply and demand give you the support for a fee increase. Plus, if you really want to do more cosmetic dentistry, you must charge enough so that you can reserve special times for these patients, be paid well for your time, and not have to worry whether you can "afford" to give them the necessary time allotment.

(c) Get involved with a health-care-financing program so that you can do a quadrant or a half-mouth at a time. The patients will be thrilled to get as much done as possible in the fewest number of appointments. They want to miss as little time at work as possible. Therefore, both of you benefit. You will be able to see a patient for fewer visits, and the time management will free up other appointment times for people who have had to wait too long to see you.

However, if you have done all of these things and you still can`t see patients expediently, or if you want to reduce the types of treatment you are offering, an associate may be appropriate.

Develop this role, just like you would a hygiene role. Nurture your associate. Market to build his or her practice within your practice. Decide which procedures you are no longer going to be providing, and schedule all of those types of appointments with the associate.

However, unless you are going to encourage a future "buy in" and develop the associate into a partner, you can probably count on this person changing from time to time. Do not be discouraged. If you have a hygienist leave for some reason, you don`t give up the role of hygiene in your practice. The same needs to be true of your associate role.

You will need to do careful hiring, making sure that there is a consistency of philosophy and that the dentistry is good. You should include your team in the hiring decision. They will have to work with this person as much or more than you will. Maximize the position, but know that the person filling that position may change.

Exercise: Answer the first three questions in this area. This will help you determine whether it is the right time for this addition to your practice. If the answer emerges as "yes," then seek professional help on not only determining how to access an associate, but also on how to integrate this person into your practice.

(10) Team selection and development

I could have put this first, but I am placing this last because "10" seems to be a good way to describe your team. In addition, I am placing this at the end of the article to make sure you see this as a big exclamation point!

Indeed, the secret to your success lies within the quality of your team. Hire carefully. Train with commitment. Continue the educational process for all of your team members. Involve them with decision-making. Work continuously on improving the communication between and among all team members, including the communication with the doctor.

Honor and respect your team members as professionals. Share the rewards for work well done. Determine incentive programs that are appropriate for you, your practice, and your team. Motivate team members with trusted delegation of responsibility, acknowledgement for work well done and rewards. As Michael LeBoeuf says, "That which is rewarded is repeated."

Do not allow anyone on your team to be a "de-motivator." Do not allow negativity to be a part of your life. Do not give anyone permission to pull you off your course of success. If someone is so resistant to change and development that he or she "slam dunks" any new ideas, or if someone is unwilling to work toward a life of continuous improvement, or if someone is not focused on the vision of your practice, make a change. If someone is so unhappy that he or she gripes all the time, give him or her permission to find happiness somewhere else. But don`t let yourself or other members of your team get dragged down by the most powerful attitude of all - negativity.

A productive, dynamic dental team is one that is focused on the same vision and committed to pursuing a common set of goals. This team is cooperative, enthusiastic, and willing to pitch in and help do whatever it takes. Team members in this situation are good communicators, committed to continuous education and improvement. They respect each other. They are willing to make statements of sincere appreciation to each other. They love dentistry and each other. They look forward to each day and bring themselves totally and completely to the practice every day.

Is that type of team a reality? Yes. You can create it, develop it, nurture it, and thrive as a result of it. Life is too short not to surround yourself with people who believe in you and what you are doing. And, once you gather the right people together, then the real work begins. Teamwork is dynamic, not static. It requires constant care, but, as in all of life, what you put into it will be exactly what you get out of it.

Exercise: Give yourself permission to surround yourself with a team of positive, constructive professionals. Then study and work at becoming a great leader/manager of these people. They are your greatest resource and asset. Their value is immeasurable. Honor yourself and each team member by becoming a great dental team and a group of leaders working together toward a common set of goals.

In summary, these are the 10 ways to take your practice to the next level. It will take all 10 to succeed in the next millennium. Don`t think you can "pick and choose" and receive excellent results. It just doesn`t work that way. It takes the entire process for success to become a reality. The difference between average and fantastic is miniscule. It is those tiny differences that make the ultimate difference.

The Do`s and Do Not`s of Building a Team


x Hire carefully

x Train with commitment

x Continue the educational process for all of your team members

x Involve them with decision making

x Work continuously on improving the communication between and among all team members, including the communication with the doctor

x Honor and respect your team members as professionals

x Share the rewards for work well done

x Determine incentive programs that are appropriate for you, your practice and for your team

x Motivate team members with trusted delegation of responsibility, acknowledgement for work well done and rewards

Do Not

x Allow anyone on your team to be a "de-motivator"

x Allow negativity to be a part of your life

x Give anyone permission to pull you off your course of success

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