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'If I knew then . . .' Asking the right questions in today's evolving dental market

Feb. 8, 2017
This dentist was overworked, stressed, frustrated, and scared. He was angry that the quality of his care and cheerful bedside manner weren't enough to create success. He wants to share what he learned on the path to success with his peers.

This dentist was overworked, stressed, frustrated, and scared. He was angry that the quality of his care and cheerful bedside manner weren't enough to create success. He wants to share what he learned on the path to success with his peers.

When I started my practice almost 20 years ago, my goal was simple-provide great dental care to the people in my community. If the dentistry was great and I treated people nicely, then everything else would fall into place. Patients would happily and eagerly buy the treatment that I recommended, regardless of cost, and they would tell all of their friends and family about my practice. We would grow and flourish, and I would make a great living. After enough years had passed I would be able to coast, living happily and comfortably until I decided to retire and sell my practice to an eager new graduate hoping for the same good fortune that I had experienced.

'If I knew then . . .' At first the dentistry was the challenge. Thanks to some amazing continuing education and supportive mentors and colleagues, I was able to handle the demands of clinical practice. It turns out the real challenge was running a small business. When I went into dentistry the thought of being an entrepreneur owning and running a company was the furthest thing from my mind. I was taught that dentistry was health care, and I assumed that I would be a health-care provider. I could never have anticipated how the changes that came along in dentistry would change my future and send me down a path I could not have seen coming.

Initially my practice was successful (at least to me it was). But when just being a good dentist wasn't enough, and the business of running a business became key, everything went downhill. I was overworked, stressed, frustrated, and scared. I was angry that the quality of my care and my cheerful bedside manner weren't enough to create success. I knew that I was missing something, but I didn't know what it was.

I sat hour after hour in CE classrooms and study clubs looking for answers. I knew that something was changing in dentistry. The 2008 crash created a panic, and every industry was talking about change. I wanted answers, but I didn't know what questions to ask. It seemed as though there were plenty of experts selling solutions, but none of them seemed to really understand my problems. They talked about spa dentistry and office tours and avoiding insurance and wowing your patients, with all the bells and whistles. I tried it all.

Then everything changed. I had lunch with a friend who was very successful in retail. I was, of course, complaining to him about my business and how challenging it was. I described my issues and he said something that changed my life and was the catalyst for Million Dollar PPO Coaching and Consulting. He said, "I've dealt with so many of these same issues." Really? In retail? Then everything clicked. I wasn't in health care, at least not the way that I thought I was. I was in the business of providing a health-care service on a retail platform. I was asking all of the wrong questions.

The wrong questions were, "How do I get more new patients?" "How do I get insurance companies to pay more?" "How can I find the right people to work for me?" "Why do I seem so busy but make less than ever?" These are all great questions. However, they're not the questions we need to ask if we as a profession want to be able to respond to the challenges we face in the modern era of dental business management.

As costs rise, consolidation and competition increase, and insurance companies continue to squeeze fees, it is critical to find new ways to streamline processes, innovate, and automate in order to grow, profit, and flourish.

Dentists provide amazing, impactful, and life-changing services. We can all agree on that. However, most of our colleagues are confused about the businesses they own and the industry they're in. This isn't simply health care anymore. This is a new world, a new economy, and a new market. The lines have become much less clear, and while we may be saving lives, or at least teeth, we find ourselves at the crossroads between the retail, sales, and services industries.

Corporate dentistry has been looking toward these ideas and using them for over a decade to grow and expand. Now, with Wall Street and private equity firms at an all-time level of excitement over the opportunities in the dental consolidation space, there is more pressure than ever on solo practitioners to innovate and expand!

By looking outside of the dental industry, we can see new, fresh, and innovative ways to remain profitable and relevant. Toyota used the concepts of efficiency, waste, and value to help the company become a top automobile manufacturer. Starbucks, Apple, Google, and Amazon are all great examples of culture versus strategy. Ricardo Semler (who wrote Maverick) helped Semco create a stakeholder mentality that elevated his manufacturing company. The time has come (and almost gone) for individual dentists to ask new questions.

We need to be asking:

• What is lean manufacturing, and how can I incorporate it into my practice?

• Am I (are we) vertically integrated?

• Does culture or strategy guide my company?

• Do I have employees or stakeholders running my practice?

• Do I care more about price than I do about margin?

• Who is helping guide my vision?

When I founded Million Dollar PPO Coaching and Consulting, it was to help my fellow dentists run better practices. Over the years, my company and its purpose have evolved. I now focus more on teaching dentists how to be leaders, visionaries, and entrepreneurs.

It's time for all of us to look to the businesses and leaders outside of dentistry for guidance. The status quo, along with its antiquated philosophies and limited scope of vision, has done all of us a great disservice. As a profession, we need to learn to adapt and respond to the shift in how people in the 21st century shop for, experience, and buy dentistry.

Stay tuned for the answers to all of these questions and more in my new column. For now, make the following calculation. Determine how many doctor hours are worked in your practice per year. Take the total number of hours worked and divide it by your annual collections. The answer to this equation is your doctor hourly collections rate (DHCR). This number is the key to all of the answers, and where we will begin our next conversation.

Matthew Krieger, DMD, is the founder and CEO of Million Dollar PPO, an advisory and consulting group that helps dental practices throughout the United States transform their practices into efficient and profitable businesses while delivering exceptional care to their patients.

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