A top 10 list of mistakes in practice management

Borrowing from talk-show host David Letterman, the author presents his own top 10 list of common mistakes dentists make.

Borrowing from talk-show host David Letterman, the author presents his own top 10 list of common mistakes dentists make.

Larry Rosenthal, DDS

I often am asked about my formula for success in my dental practice, and I have a checklist that I frequently share during my lectures and seminars. The first step on the way to a successful practice is for the dentist to set goals and then implement systems to meet those goals. The hardest part is sticking to the action plan. The dentist must have a clear vision for the practice and must be able to share that vision. The dentist must be the leader in the practice.

As I speak with dentists , I hear some recurring themes. I have combined the mistakes I have made, along with the problems dentists are sharing with me, and come up with my own "Top 10 Practice-Management Mistakes." Here they are, in reverse order, ala David Letterman:

Mistake #10:

Failure to take control of your office ... and your life.

I truly believe that your dental practice is a large part of your life. Taking control of your office domain can be directly related to your personal happiness.

Many dentists have taken one or more of my seminars and hands-on courses at meetings and universities around the country. These courses are geared to help develop both the clinical and diagnostic skills, as well as the management skills necessary to create the "Ultimate Aesthetic Practice." The doctors become very excited at the possibilities they see for changing their practices; however, some of the dentists have not made the total commitment necessary to develop a cosmetic practice.

Many of them are in an uncomfortable state. The office is running smoothly, but there is a critical dilemma. The staff is not ready or supportive of making the necessary changes; therefore nothing really happens. Unless staff members participate in the program and the resulting new philosophy, they do not understand the dedication and commitment necessary to reach another level in their practice.

If a dentist truly wants to make changes in his or her life, then he/she must step up and pay the price. The price begins with setting goals, implementing those goals by means of action plans and measuring the results. We also have tools in the office that accomplish the "measuring" process.

Talk to your marriage partner or your significant other. Tell that person about your goals and ask for his/her support. Then, tell your dental team members what you want to do and ask for their support. They need to carry you on their shoulders and become partners in the practice! You may not get a unanimous vote of support and, as a result, may need to make some changes in your staff. Take control of your destiny. Break out of your comfort zone. Remember, your office is a large part of your life and only you and your new "partners" can create the environment necessary for change and growth. Be assertive! Take control; it`s your life! Live it to its fullest!

Mistake # 9:

Office image.

We call our office, "The Ultimate Aesthetic Practice." We provide the very best product available in dentistry today, and we always are seeking new ways to improve our office. Patients who come to our office perceive the value they will get from any treatment they will receive. From the first impression, they usually understand our philosophy. That philosophy is to provide our patients with a "Five Star Service" and a "Five Star Product." This is the type of product and service associated with other consumer winners such as the Four Seasons Hotel and Nordstrom`s Department Store. We make every patient feel truly special, and we treat everyone as a VIP, regardless of who they are or where they come from.

If you want to have an aesthetic practice that you can take pride in, you must do the same. You must have the active, not tacit, support of your staff because you cannot do all of this alone. Begin to build that new-office image today. Actively solicit suggestions from your staff. Be proactive!

Mistake # 8:

Underutilization of hi-tech equipment.

Hi-tech equipment is proliferating today in dentistry and is essential to optimal performance and patient perception of your office as state-of-the-art. I cannot complete a cosmetic consultation without my computer- imaging system. It is used every day to help people understand what I can do for them.

Don`t try to take away my intraoral camera either; it does a great job of education. I love my CD educational system, also. The digital X-ray lets me have instant pictures. I can`t work without my soft-tissue laser or my argon-curing light. I need them as much as I need my handpiece.

A much underappreciated tehnology is the telephone-message system in our office.

You understand you must plan for the purchase of new equipment in your office. You do not necessarily need to get everything at the same time, but you will never get anything unless you plan for it. This goes back to my point about goal-setting and an implementation plan. Invest in yourself!

Mistake # 7:

Office environment and decor does not project a positive image.

The office image that you want to portray must show in the design of your working environment and the overall office decor. Many dentists feel that they can successfully integrate cosmetic procedures in an office that does not project a possitive, aesthetically pleasing image. If the furniture is old, chipped and uncomfortable, and if the paint is peeling and the wallpaper is fading right down to your orange, shag carpeting, you need to make some changes!

The patient should be able to step into your reception area and know he or she is in the right place. It should just "feel right" to the patient. In my office, we have three types of books in the reception area: one consists of patients` letters thanking us for what we have done for them, and the other two books consist of "before" and "after" photos. The "thank-you book" is highly complimentary of staff members, since they are the ones who deserve it.

Your office must exude a "successful" look. Be professionals - both the staff and the dentist must look the part. Take a cue from Walt Disney, who always told his staff (down to the sweepers) that they were not employees; they were actors. You are on the stage every day and your performances must be great every day. Your excellent results reverberate throughout the community. Word of mouth will spread and help you build your dream practice!

Mistake # 6:

Staff members are not partners.

I will keep saying this over and over. I have not seen a highly productive and successful dental office without an extremely strong group of support people. Treat your co-workers with respect and make them partners in the dentistry and the dental office.

Initiate an incentive bonus plan to make them partners today! If necessary, hire a practice-management consultant to help you develop the appropriate plan.

Mistake # 5:

No control of the consultation visit.

This is "Show Time!" How do you make a good initial impression? Let`s go back to Walt Disney. Did you know that a Disney employee is not allowed to have any unreplaced missing teeth? By the way, how are your teeth? Does your staff portray what you want for your patients? The only way to be in control of this critical visit is to be prepared. You must do your presentation-planning ahead of time and know the features and benefits - and you must know your patients and how to approach them. What type of personality are you dealing with?

There are many forms available to help you through this interview process. Our office has developed specific action forms to systemize this process. Be confident! Be strong! It is your practice and you are in control.

Mistake # 4:

Failure to understand and emphasize the new-patient experience.

"Show Time," again! Do you understand the monetary value of each new patient to your practice? Have you calculated what this means to your practice? In my practice, we have a very useful tool for monitoring our new-patient value.

The new-patient experience begins with the first phone call. How is the patient handled? I know of practices that ask for so much information during the first phone call that they actually drive patients away. Be positive; tell prospective patients how happy you are that they called your office!

Marietta, my new-patient coordinator; Anne, my office manager; Jackie, my business manager; and Dawn, the office concierge, have developed a wonderful new-patient experience. Dawn greets the new patients. Marietta shows the new patient our books in the reception room, emphasizing the before and after books that illustrate the quality and artistry of our work. She also offers them a book of letters our patients have written in appreciation for the excellent treatment they have received in our office. She then begins the new-patient tour. This creates an opportunity to explain to the new patient our philosophy of treatment and our dedication to excellence! Make that patient feel special! Develop the relationship!

Mistake # 3:

Failure to utilize and cultivate the "proper team."

I have been mentioning this throughout this article. You must have the support of talented, dedicated people who believe in you and your goals. It takes time and effort to develop a group of people like this, but when the team functions together, it certainly is worth it.

The team members must be convinced that their doctor is the greatest and that he/she can deliver great dentistry. You must take your team members with you to continuing-education courses, so they can learn along with you. They must be able to see other dentists` work and be able to say, "Wow, our dentist is first class!"

Then, the attitude and self-esteem of the "practice" goes way up. Dentistry becomes fun, exciting and fulfilling. Practice what you preach! Quality without compromise!

Mistake # 2:

Lack of a strong "attitude."

Dentists must learn to believe in themselves and develop a strong attitude about themselves. They all have a tendency to become comfortable in their present environment and become hesitant to make the paradigm shift that is required. They are reluctant to step out and change things.

But the problem is that the world around them is changing. Procedures and materials that were good 20 years ago may not be the best today. They must look at their practices as a service and as a business. They must charge fees that reflect the amount of time it takes them to do quality dentistry, because to provide a superior product and a superior service takes time.

So, they have to learn to believe in themselves; they have to understand that there is a lot to learn out there and that life is a continuous, learning experience. They must understand that learning can be fun. Learn to enjoy your profession!

Mistake # 1:

Lack of self-esteem.

The number one failure dentists have today is a lack of self-esteem. Some dentists don`t feel that they are good enough or confident enough to do the things in dentistry that they would like to do. Additionally, they often have difficulty in gaining the trust of their patients. Their lack of confidence in the technique and/or results is too often conveyed to their patients. When they quote a procedure or a fee and the patient asks a question, they become defensive and consequently begin to justify their treatment plan. This problem often is attributed to their dental school education. The constant negative pressure takes its toll on self-esteem. It engenders in the graduate a feeling of inadequacy. Dental school graduates have learned a marketable, quality and respected skill, but in many cases, dentists have not developed the necessary communication skills.

The dentist must be able to communicate confidently the features, benefits and value of the treatment he/she is recommending. If you feel confident in what you do, patients will perceive the value of your service. They will accept the fee as appropriate and will find the time to undergo treatment. Therefore, if you believe in yourself, your patients will believe in you. For this to happen, you must communicate honestly with your patients and properly prepare them for quality treatment.

A key to becoming successful is to have a positive approach to the dentistry you enjoy doing. Our courses are structured towards building quality technique and personal self-esteem. Seek support from your family, staff and patients. Strive for excellence and never stop learning!

Enjoy yourself! It`s a wonderful time to practice the art of aesthetic dentistry! ... Go for it!

For information regarding Dr. Rosenthal`s aesthetic programs and products, please call (212) 794-3552 or fax (212) 794-3644.

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