Achieving the reality of your dream practice: Personnel policy manual

Feb. 1, 2005
A doctor developed his own personnel policy manual. Referencing the "at-will" language in his manual, he terminated an employee.

(Part 1 of 2)

Dr. Scott Bolding
Dr. Randy Lais
Dr. Susan B. McBeth

All dentists have thought about the practice of their dreams. Some, like Drs. Scott Bolding, Randy Lais, and Susan B. McBeth, have mustered enough courage to make their dreams a daily reality. In the first of two parts, join me to learn from them as you muster that same courage to have the practice of your dreams, in the location of your dreams, performing the dentistry of your dreams.

Dr. Jameson: When did you first begin to think about formulating this type of practice that I’ve referred to as “your dream practice”?

Dr. Lais: The dream of my practice is something that evolved over the years as I continued to study not only the technical aspects of dentistry, but also the business and the personal growth areas of communications, leadership, and relationships. I guess, from Day 1, I had some kind of dream for my practice. It was pretty simple at first. I wanted a place where people could know that their dentistry was going to be done right, where they could trust what we were telling them, and where we were continuously up to date. So, at that point, it was mostly clinically oriented. I didn’t really clarify it or focus on the other aspects as much as I would learn to do later. This type of practice first began to form in my mind in the mid-1980s while studying with Dr. Pete Dawson, Dr. Alvin Fillastre, and while taking my first courses at the Pankey Institute.

Dr. McBeth: I was an orthodontic patient in high school when I first started thinking about what that type of life would be like and began taking action toward that plan. I knew dentistry was the career path for me. I am a native of Arkansas, as is my husband. We took a trip to this part of the state and felt it was beautiful. We decided early in our formal education that we would live and raise our family here in northwest Arkansas. It has met all the expectations that we dreamed of in those early days.

Dr. Jameson: Dr. Bolding, when you first began in your specialty practice of oral surgery, and you began thinking about what kind of a dream practice you would have, when did you start thinking that you were going to be an oral surgeon, and about what practice life ideally could be like?

Dr. Bolding: Initially, I began to dream of becoming an oral surgeon in college and went to dental school with the intention of going into oral surgery. During my oral surgery training, I began to decide what type of practice I wanted.

Dr. Jameson: So, when you went through the educational process, you knew where you wanted to go and what you wanted to do? Still, I’m sure at some point you had to take some steps in achieving the practice of your dreams. What steps do you think you went through that were beneficial in making this happen and what would you suggest for other doctors?

Dr. Bolding: I believe that there is an inherent spiritual sense of what we’re about and why we are here. That is why I’ve always felt strongly about offering an extremely high quality of care. In order to provide high-quality dentistry, you must have a sense of the type of practice it would take to achieve optimal results. Many would assume that living in Arkansas would limit one’s ability to have a high-level practice in oral and maxillofacial surgery. That was just the opposite of what I believed. When I moved to northwest Arkansas, the local dentist had recently started a study club called the Interdisciplinary Therapy Study Club. It was an accumulation of multi-specialists and multi-restorative dentists who met on a regular basis. On a weekly basis, we would discuss cases. Then, on a monthly basis, we would have a comprehensive meeting where we closed our practices in the afternoon. Four times a year, we would hire high-powered speakers and teachers from around the world to come to our community and offer full-day teaching programs. It was the interdisciplinary approach to care that helped us develop our high-end practices. We’ve always tried to set up a system within the practice where the patients come first. We have three mottos that we always have used in our practices: “It’s the little things that make the difference,” “Pay attention to detail,” and “Communication is the key to success.” We’ve tried to take all three of these mottos and apply them to every facet of our practice. We apply them on the patient side, we apply them on the colleague side when working with referrals, and we apply them with our organization and team. I would put my financial interest aside and provide education through the community, but also within our practice, I would spend more money on the highest and the latest quality that we could have in terms of imaging and instrumentation and these types of things. The investment in my practice helps it grow.

Dr. Jameson: Some dentists describe as somewhat traumatic this feeling of “should I or shouldn’t I take the steps to move this practice on to that dream level?” In your case, Dr. Lais, you were going to leave a successful practice in one community and move to another area and begin a new practice. Obviously, that’s a time of potential apprehension. What were some of your feelings?

Dr. Lais: As I was going through all of this, there were times I would wonder what I was doing. After taking the effort and time to build a very successful practice, planning to start over from scratch did bring a myriad of feelings into play. There were feelings of loss in leaving patients and staff who were friends, and a community where I had built a good professional reputation. There was a time of evaluation. Is the price to be paid in balance with the value to be received? And the value I was looking for was in the personal and lifestyle area more than in the financial area. There was considerable apprehension until the vision was focused, and the commitment made; then it became more anticipation. While the practice I was leaving did have value, I came to realize that who I had become professionally and personally through continual learning was of more importance. I knew I could take that and create a new, even better, practice in a place that improved the overall quality of my life.

Dr. Jameson: So, what you’re saying is that, for you, building your dream practice started with finding a mindset and a standard for the quality of life you were looking for. That was the primary driving force to enable you to relocate and basically start again?

Dr. Lais: Yes, that mindset for me has always been about an appreciation for quality. Our decision to move was primarily for lifestyle and family reasons, but the move to northwest Arkansas did offer a very significant advantage to me professionally. I have been involved with the Academy of Interdisciplinary Dentofacial Therapy in northwest Arkansas for 10 years. It’s a group of like-minded professionals who are dedicated to providing comprehensive dentistry on the highest levels. We get our mutual support and a lot of quality continuing education. To me, that was just a great natural fit for helping me build my dream practice. I don’t know that I would have changed communities only for the sake of the practice. But isn’t it great when you can add positive things to other areas of your life and develop the practice of your dreams? I think that is a good point to make. Don’t let your pursuit of a dream practice take over your life. The practice of your dreams has to be a congruent part of your whole life.

Dr. Bolding: That’s correct. And, as you know, we have a company called MaxSurg that is in business development and management for physicians and oral surgeons. What we teach - or try to emphasize to our colleagues - is that they, first of all, need to decide where they want to live. In deciding where you want to live, there are some parameters. You can’t go to the middle of the Mojave Desert and practice dentistry because there are no patients there. So, you have to make sure that, at least, there is a subset of patients from which you can draw. If you choose an area that has a lower standard of care, or there’s less ability for you to generate an income than you may desire - as long as you understand that trade-off - that’s fine. First, choose where you and your family want to live. Then, if you live where you want to live, you have that part covered so you may then use these other steps to really boost the practice by developing relationships, and working with colleagues, patients and staff. Finding the place is the initial recommendation that I would have. Most of the time, this is an emotional thing for individuals no matter whether they want to be close to the ocean, in the mountains, or maybe in a large city. Where they want to be is the first consideration. Then, once that is established, make sure it will meet your goals from a financial standpoint. As long as you have realistic goals there, and the community can serve that, then that’s your first step.

Dr. McBeth: The first consideration for choosing a practice location is simply deciding where you want to live. Where do you want to raise your family? Then, opportunities are narrowed, utilizing demographics and economic information. The professional atmosphere that is in place is also important. Here in northwest Arkansas, we are so fortunate to have bright and enthusiastic professionals who succeed in comprehensive, quality dentistry.

Dr. Jameson: When you were mentioning the three mottos that you have for the practices you’ve been in and that you have now, I noticed that one of them emphasized communication. I think that, as a management company (Jameson Management, Inc.), we’ve always felt this is one of the most important areas of the practice and probably one of the most frequently overlooked. Of all the system development factors in a practice, what do you think are the different aspects of the average practice that need to be focused on and what’s most important?

Dr. Bolding: I think the most important thing, whether with a general practice or a specialty practice - either in medicine or dentistry - is leadership. Developing leadership skills for communication is probably the most important thing. Especially in the dental setting, if the leader is a poor leader, it doesn’t mean that he or she can’t have a great practice. It just means the person needs to make sure to put someone in the practice who has some of those leadership skills. The team feeds off the leadership in the practice. So many times I see that where there’s a weak leader, the practice is never as strong as it could be. The leader does communicate to the staff his or her goals and the way the person wants the practice to be. If he or she is wanting it to be very high end, highly successful, very communication-oriented, then he or she has to have those communication skills and develop those skills for the team.

See the March issue of DE for the conclusion of this interview.

Dr. John Jameson is chairman of the board of Jameson Management, Inc., an international dental consulting firm. Representing JMI, he writes for numerous dental publications and provides research for manufacturers and marketing companies, as well as lectures worldwide on the integration of technology into the dental practice, and leadership. He also manages the technology phase of the consulting program carried out by JMI consultants in the United States, Canada, and Europe. He may be reached at (877) 369-5558 or by visiting

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