Howard Speaks: Drive-Thrus and Dentistry by Howard Farran, DDS, MBA, publisher, Dentaltown Magazine

Fast-food restaurants and dentistry have a lot in common. Pull up to order at a McDonald's drive-thru, and your first encounter will be via speakerphone with someone who often couldn't get the order right if his life depended on it. He can't see there are four people in the car, so he repeats the order summary after each person finishes … only to have to do it again after the next person orders. It's a joke! Then you pull up to the first window to pay, and that guy is now taking the next order while you're paying—or, if you're at a franchise that has two drive-thru lanes that converge into one with a single cashier, there's an added layer of "which order did you have again?" Guess how that works out. No worries—it's just the money!

If you drive across the street to In-N-Out Burger, the difference is all-encompassing. You give your order, face to face, to a human who can see that there will be several orders from several people, and doesn't waste time repeating each order after each person's turn. Who would've thought that it'd be best for an employee to be able to see you with her eyeballs? That concept must be mind-blowing for the senior management team at McDonald's, who can't seem to realize how many wrong orders—and lost sales—are placed daily in their 36,899 restaurants, in 128 countries, serving 68 million people per day.

You've got to pay attention to sales
Here's the dental equivalent: I could sit on the phone for an hour calling dental offices, and half of the time my calls go to voicemail. If the phone is answered in person—by someone whose job title was named after a piece of furniture, the "front desk person"—chances are I'll hear, "Can you please hold?" (That's not an actual question most of the time, by the way—it's just a phrase they say perfunctorily, without listening for a response, before they put you on hold.)

I've watched dentists talk to each other on the Dentaltown message boards several hours a day, every day, since we started in 1999. They'll talk about the best bonding agents, implants or composites until 3 in the morning—but if I ask them how many new customers have to call their offices before their front desk staff manages to convert one to an appointment, many of these superdentist clinicians have no idea. They're confused because they don't know what a "customer" is; they say, "You mean a new patient?" (The national average answer to that question, by the way, is 3.5—that's how many people your staff will need to speak to before one converts to a new patient who comes to your office.)

Then I'll ask dentists what their "close rate" is on sales—and they reply, "What? Do you mean my treatment plan acceptance rate?" They can't even use business terms. Health care and government are too sacred to be bothered with efficiency and profitability, but doctors need to have an idea—the success of their practice relies on that knowledge!

Think macro, not micro
I laugh when dentists can't tell me sales-related numbers but can rattle off the fact that their bonding agent bonds at 27 megapascals. Like that's supposed to matter, as if billion-dollar dental companies would sell glue that doesn't work! I don't need to take CE to see if their glue works; I'm thinking if they sell a billion dollars a year in glue, it's probably real damn gluey! But some dentists would rather spend their time double-checking the strength of that bonding agent by watching a lecture (given by a dentist who doesn't even remember organic chemistry) because that feels like a better use of their time than recording all of their incoming calls and going over missed opportunities that could've led to new patients.

Similarly, why are dentists so focused on composite glues if only one person out of three accepts their treatment plan? Why aren't dentists wondering why the nation drills, fills and bills only 38 percent of the cavities diagnosed, let alone everything else? If I said, "The country would be better off if we just removed 100 percent of all the decay and then filled the resulting holes with butter," I already can imagine the Townie conversations online:

• "Does Gordon recommend butter, or margarine?"
• "Which instrument does Dr. Kois use to spread his butter?"

It's so important to rethink how we do business, and which metrics are important when it comes to success. Between 1955 and 2014, a full 88 percent of what had been Fortune 500 companies either dropped off the list or disappeared entirely. Nine out of every 10 Fortune 500 companies in 1955 are gone today, because of market disruption and creative destruction, and that churn is getting even faster in our modern society. The companies that survive and thrive are the ones that can provide customers with low prices, high-quality products and services, and great service. Is your practice on track for success?

Check out Howard Farran's podcasts!
Listen to free Dentistry Uncensored with Howard Farran podcasts about staffing and motivation—and pretty much anything under the sun!—by downloading them from iTunes.

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