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Six steps to create the ideal practice

Oct. 1, 2005
I have met thousands of dentists who have had great dreams of achieving clinical excellence and profitability, as well as a quality experience for their patients.
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I have met thousands of dentists who have had great dreams of achieving clinical excellence and profitability, as well as a quality experience for their patients. However, many of these dentists lacked the skills to turn their dreams into reality. As a result, they settled for achieving less than what they really wanted. This is unfortunate because every dentist can create an ideal practice. If you have a dream of what you would like to achieve, but your actual practice falls short of your aspirations, you can change that. It’s just a question of clearly defining the kind of practice you want and then taking the steps to achieve it. This essentially involves following six simple guidelines. It requires work, but dentists who have implemented these steps tell us that the rewards have been well worth the effort.

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Let’s describe each step in more detail.

Step 1- Define the kind of practice you want to have.

This is the starting line, the point you must pass before you can run the course. It is amazing how many dentists are completely consumed with handling the day-to-day operation, and they do not stop to ask themselves where they would like to be and what they would like to do and have in one year, five years, or 10 years down the road. These dentists cannot achieve their ideal practice because they have not defined what it is. To move in a meaningful direction toward your ideal practice, you need to create a vision of exactly what you want; then, develop a strategy for attaining it.

In clarifying your vision and goals, ask yourself some basic questions, including:

1) Am I practicing in the location I really want to be in?
2) What kind of dentistry do I want to do?
3) What type of patients do I want to have to do the kind of dentistryI want to do?
4) What qualities do I want my staff to possess?
5) What kind of customer service do I want to provide that will complement the kind of dentistry I want to be doing?

Your answers will provide you with the vision for your ideal practice. Now, make it happen!

Step 2- Communicate your goals effectively to your staff and patients.

Once you complete the daunting task of deciding in some detail the objectives you want to achieve for your practice, the next step is to make others aware of it. In the book, “The Leader’s Voice,” authors Clarke and Crossland note, “The difference between a hallucination and a vision lies in how many people see it.” Your goal is to communicate persuasively with patients and staff so they will understand and embrace your vision.

When was the last time you strategized with your team about what all of you could do in the next 12 months to improve efficiency, profitability, balance of life, patient care and service, clinical skills, and staff motivation and satisfaction? Most dentists are reluctant to have such a discussion with their teams because they fear:

getting that horrible vacant stare that says, “Doctor’s gone crazy.”

being a failure if the stated goals are not met.

having to deal with change should the team suggest different ways of doing things.

encountering obstacles that have yet to be invented.

Our challenge to you is to put your fears aside and take the risk.

The task of the leader is to turn those vacant stares into light-bulb looks of understanding and commitment. One of the key ways to communicate the clinical and operational goals of your practice is through a powerful document called your practice philosophy.

Your practice philosophy describes your ideal practice. It is the place to indicate your goals and outcomes in all key areas of your practice, such as staff performance, patient profile, clinical care, customer service, and operational systems. Will you want state-of-the-art technology? Will you offer dental solutions that work for your patients’ lifestyles, specialize in esthetics, or handle a wide range of dental problems? Do you want to attract families, business professionals, esthetically minded patients, or anyone who values long-term oral health? What role will your team play? Will you assemble a staff that is well-educated, skilled in the art of influencing, clinically and managerially experienced, or capable of being trained in any of these areas? Will you create a practice that is unique in your area because you provide service that exceeds expectations? Your philosophy describes the standards and results you want to achieve in your practice.

Besides having a practice philosophy with which to communicate your objectives, you also need to be sure that your message successfully reaches your audience. Guard against making the following four fatal assumptions in your communications:

1) Assuming your patients and your team understand what was communicated,
2) Assuming your patients and your team agree with what was communicated,
3) Assuming your patients and your team care about what was communicated, and
4) Assuming your patients and your team will take appropriate action based on what was communicated.

In their book, “The Leadership Challenge,” authors Kouzes and Posner say, “No matter how grand the dream, if others do not see in it the possibility of realizing their own hopes and desires, they will not follow it.” For your communication to be truly effective, you must provide your staff and patients with a personal motivation to care. This means you must address the benefits to these individuals, and not just the practice. Doing what is best for your practice should always lead to fulfillment and satisfaction for you, your team, and your patients.

Step 3 - Cultivate loyal, committed patients who want the same kind of treatment that you have the passion to give.

Once you identify the kind of dental care you want to give, you need to find patients who will value, appreciate, and accept your treatment. Determine what kind of patients match your vision and where to find them. The biggest mistake dentists make with marketing is what I call “spray and pray,” which means hurling their message to the world at large, and then seeing who walks through the door.

I recommend doing everything you can to find your targeted patients. Are patients of a certain age group especially in need of the kind of dentistry that you want to do? Are you looking for patients interested in urgent care who seek you only in an emergency and who want short-term solutions, or are you seeking patients who want long-term comfort, functionality, and appearance, and who will either commit to it immediately or over time? Obviously, you would prefer that the majority of patients match your practice vision. Many may not enter the practice with a full understanding and appreciation of what you have to offer, but they can be influenced to rise to that level in time. Once you find patients whose vision for their own care matches your vision, then you need to create an environment in which you and your patient “co-discover” the ideal treatment for that person’s oral health.

The process of co-discovery involves communicating your diagnostic methods and findings during the initial examination (and also during the consultation), so that the patient is learning about his or her oral condition at the same time you are. The goal of co-discovery is to help patients to:

1) Understand the process they are going through,
2) Have a greater awareness of what they need and want,
3) Recognize the benefits of treatment, and
4) Develop an increased level of commitment to treatment.

Ultimately, the goal of co-discovery is to make patients feel that they are being worked with and not worked on, possibly for the first time. This sets the foundation for a partnership based on a mutual vision that promotes lasting relationships.

Step 4 - Set fees and financial guidelines that allow patients to accept treatment and also allow the practice to achieve profitability.

Your fees should reflect the nature of your practice - the vision and values that you have implemented, including the level of clinical care and customer service you offer.

Patients will pay your fee if:

1) They like and trust you,
2) They are committed to the treatment, and
3) You can make it affordable for them.

The way to make it easy for the patient to accept treatment is by creating a co-discovery financial system in the same way you established the co-discovery diagnostic system. Have your financial administrator hold a financial discussion with each patient as a courtesy and service to that person. Extending this respect reinforces the quality experience of the examination and consultation. The discussion consists of matching a payment option to the patient’s needs, while adhering to the practice’s internal financial guidelines. A suitable arrangement may mean full payment in advance, outside financing, or a payment schedule. An arrangement which benefits both the patient and the practice is an excellent financial arrangement.

Step 5 - Create a blueprint for the clinical skills, operational systems, and staff development to exemplify and support the vision of your ideal practice.

You cannot arrive at a new level of practice by means of the same blueprint that created your past practice. (Insanity is repeating the same behavior, but expecting different results.) You need to re-examine all of your systems, some of which we touched on above, to be sure the mechanics are in place to support your ideal practice. Develop formal goals for your own clinical advancement and the staff’s training and problem-solving so that you are consistently increasing skills in the practice. Too often, we see practices rest on their laurels. Are you willing to take your practice up a notch? Whether that means attending an advanced clinical institute for extensive training or a CE course on the latest customer-service techniques, are you truly committed to enhancing your skills and your team’s?

According to “The Fifth Discipline: The Art and Practice of the Learning Organization,” written by the respected author, Peter Senge, “Personal mastery goes beyond competence and skills, though it is grounded in competence and skills. It means approaching one’s life as a creative work, living life from a creative as opposed to a reactive viewpoint.” A leader is a perpetual student and a perpetual student is impassioned with the constant drive to upgrade systems. Senge goes on to say, “Team learning is vital because teams, not individuals, are the fundamental learning unit in modern organizations. This is where the rubber meets the road. Unless teams canlearn, the organization cannot learn.”

Continuously training and developing your team is essential if you are going to be a learning organization and not just a doctor who learns without including the team in the experience (thereby inviting those cold, blank stares when something new and wonderful is proposed).

Step 6- Statistically interpret your successes and challenges to ensure your vision is met.

When business management is “intuitive” (read: seat-of-the-pants), it can be wrong 90 to 100 percent of the time. That’s because decisions are based on subjective judgment and emotions. The only way to tell if you are succeeding in accomplishing your goals is to create black and white benchmarks so you can measure success objectively.

In addition to measuring production per day, do you also collect statistics about your patients? Do you know your new patient counts? Your treatment presentation and acceptance rates? The average fees for the first phase of diagnosis for a new patient? Your rate of continuing-care compliance? Your average cancellation percentage? Knowledge is power, and power equals control.

When a practice statistically interprets its successes, it can repeat the feats. When it statistically identifies its weaker areas, it can strengthen them. The statistics measure the behavior patterns of you and your dental team, so that you know which ones lead to success and should be repeated, and which fall short of expectations and need to be modified. Ken Blanchard, author of the book, “Heart of a Leader,” aptly states the proper guidelines to follow when dealing with your practice statistics. He says: “Do not only look at profit in and of itself, because managing only for profit is like playing tennis with your eye on the scoreboard and not on the ball.” The best definition of profit is the applause you get for satisfying your patients and the long-term excellent oral health that results from comprehensively serving these patients with ideal clinical skills and care. Your practice’s statistics are useful because they indicate how well you are succeeding in accomplishing these goals.

As a professional who has invested so much time and resources into a noble profession, do not settle for less than the kind of practice you most ardently wish to have. It’s your life and your career, so be sure it is as fulfilling as it possibly can be for you. As Pride Institute founder, Dr. Jim Pride, used to say: “This ain’t no dress rehearsal.”

It’s show time, so give it your all! Start creating the vision of your ideal practice today, and then enjoy the tremendous satisfaction of making it a reality!

Amy Morganis chief executive officer and lead trainer of Pride Institute, a dental management-consulting firm serving dentists nationally and internationally. Working with renowned management experts, such as Bob Nelson and the Ken Blanchard group, Morgan brings the latest leadership teachings of corporate America to dentistry. For more information, call Pride Institute toll-free at (800) 925-2600 or visit

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