Build a Practice You’ll Love, and Get a Life, Too.
“You get what you intend, not what you hope for.”
by Chuck Blakeman
Too many practice owners and managers think their purpose in business is to make money. Surprisingly, it’s not. The practice owner’s purpose is to build a business that makes money. Making money, and building a practice that makes money are worlds apart. Almost every practice owner or manager I know is absolutely buried in trying to make money, which keeps them from ever making a lot of it.
From the beginning Diane and I thought of all three of our kids as adults in the making. We looked forward to being adults together, where we could all invest in each other, help each other find significance with our lives, and simply enjoy each other for decades.
Dental Practices Should Grow Up, Too
I think dental practices should grow up, too. I don’t mean “it would be nice if it happened.” I mean we should all, every one of us, expect our businesses to grow up and start giving back to us and to the world around us.
Nobody would argue with me that we should intend for our children to grow up and become adults we could enjoy for decades. It’s normal for children to grow up, so why isn’t it normal for dental practices to do the same?
Most practices never grow up. We spend decades changing the diapers in our business. Twenty years later we’re still spending as much time, emotion, and money on our business as we did the day it was born. Why would we so eagerly anticipate the maturity of our children and never expect the same for our business?
I believe the root of the problem is a conventional view of business. The very thing you think will make your business successful, a focus on trying to make money, is the very thing keeping keeps it from happening You’re too busy making money. No business can survive that. It’s not a play on words—it’s a serious problem. You’re simply too busy making money, and most likely it is stopping you from building a practice that will ever grow up.
Two Opposing Realities
There is a good explanation for why we get stuck trying to make money. Dentists, like all business owners, are constantly fighting to balance two opposing daily realities:
The Tyranny of the Urgent vs. The Priority of the Important,
It’s a daily battle. Almost universally we let the Tyranny of the Urgent keep us from paying attention to the Priority of the Important. I haven’t met anyone who doesn’t struggle to properly balance these two realities.
The Tyranny of the Urgent
The Urgent things fly at us all day, every day, causing us to be reactive and defensive as we hold the practice together as best we can. The Urgent things are tyrannical—they want to rule over us. Like small unruly kids, they scream and yell, poke and prod, and are relentlessly in front of us.
One of the most Urgent things pulling at us daily is the need to make money to cover today’s bills. Think about it. That great-looking clinical space, those shiny instruments, and that great location very quickly turned into a relentless liability screaming, “I need money!”
We don’t have to find the Urgent things—they come and find us. Over time we resign ourselves to the notion that this is normal. And besides, all the dental practices around us seem to be doing the same thing. Welcome to the Dental Practice Treadmill.
The Priority of the Important
In stark contrast is the Priority of the Important, which sits patiently in the corner, whispering, “I can help you solve the Urgent stuff? But you’re right; taking care of me today won’t make you more money right now. I’ll try to nudge you again next week as you go flying by.”
The Important things require us to be proactive because they almost never seem Urgent—planning, processes, training, patient experience, and leading. We don’t make money right away doing those kinds of things, and they’re definitely not as Urgent as paying the bills.
I know plenty of people making millions who are totally focused on the Tyranny of the Urgent. But they’re on a treadmill. Attending to the Urgent can only bring us Riches, which I define as money. But attending to the Important things will bring us true Wealth, the freedom and the ability to choose what to do with my time and my money.
Which do you want? Riches you don’t have time to use, or Wealth, the freedom that allows you to go on vacation while your practice makes money for you? Freedom is the best evidence I can come up with that you have paid attention to the Important things and now have a mature practice.
You Get What You Intend, Not What You Hope For
Shelley ran her husband’s very successful dental practice in upstate New York full time as the practice manager. For years she had always hoped to figure out how to gain the freedom to start her own consulting business, but the Urgent things kept her on the treadmill. As we worked with her, Shelley developed real clarity on what the practice should look like at maturity, just like we had done with our kids.
With Utter Clarity on where she and her husband wanted the practice to end up, they were no longer relying on the Random Hope strategy of business—working really hard and hoping something good happens. Instead, they were now focusing on a few Important things that would solve a lot of the Urgent things, like planning ahead, developing and writing down simple processes, training people, delegating decision-making, and building a great culture.
In well less than a year Shelley had gone from manager to leader, and was down to investing two hours a week in the practice, not managing, but leading – creating vision and guidance, supporting, training, and asking clarifying questions to keep everyone on track. All the things she thought she could never delegate were now in the hands of the front and back office teams.
She gained freedom without hiring an office manager to replace herself, simply by moving all those management functions to the teams. And the teams were thrilled to take on the responsibilities because it allowed them to begin to make decisions that had always been made for them. Shelley’s consulting business is now booming. Everybody wins.
Failing or Getting Tired
Statistics say fifty percent of businesses fail in the first five years and eighty percent within ten years. But what actually happens is the business owner gets tired because they are focused on the Tyranny of the Urgent, reacting to their business and living on a treadmill. When you’re tired, you stop paying attention to Important things, and that will result in failure.
A treadmill is very exhausting and demoralizing if you don’t know how to get off of it. The way off that treadmill is not easy, but it is simple. The profound things are always simple.
Time and Money
The key to getting off the treadmill is time, not just money. A law practice in Denver was stuck at $9 million a year, and the two founders had only taken one week’s vacation in eighteen years. One day they changed their intention. They start requiring that the practice give them back time, not just money.
Four years later the practice is thriving, with $25 million in revenue, exponentially higher income for the partners, and no end in sight for the growth. More importantly, the two founders now take almost two weeks a month off, and a month in the summers. After his first month off teaching his daughter to surf, one of the founders said, “My first thought was that I could have gone my entire life and never had this kind of time, and then secondly, I realized I’m only in my forties and now I get to do this the rest of my life.” You get what you intend, not what you hope for.
Dental practices should be built like this, so they produce both time and money. We focus a lot on how the practice could provide us money but rarely think of how it could produce time. And it is this separation of these two that keeps us from having enough of either.
Thinking Differently About the Result
I regularly get the following response: “This makes such great sense, why haven’t we heard this before?” The Industrial Age taught us that if you make enough money, you would somehow magically be happy. But money is only a resource, a means to an end, not the end itself. By pursuing money alone, all we’ve done is bought ourselves a job and an immature business requiring constant supervision. Why not build a practice someone would love to buy, but then keep it and enjoy it? If you built a practice that got you off the treadmill, that gives you both time and money, and you wouldn’t want to sell it.
A successful Washington state practice is now doing just that. After years of micro-management, they decided to build what we call a Participation Age practice around self-managed teams, and it’s working. One of the doctors wrote this note recently:
“Today was a great day even though we were down one doctor, two treatment coordinators and three assistants. Now that the teams are self-managed, they are taking the initiative to cross-train their respective Stakeholders. To make ten columns work there was a collective playing of musical chairs today and it worked almost flawlessly. It was truly amazing. Tanya (the office leader, not manager) and I spoke after work and we think what happened today was a direct reflection of our people taking the initiative and working as a team from hiring to training to implementing.”
Be Intentional About What You Want
Your expectations for your practice should be no less than those we have for children. Expect your practice to grow up, or you’ll still be changing its diapers decades later. It’s not rocket science, and it’s not a matter of talent or luck, but simply focused intentionality.
Are you in? You get what you intend, not what you hope for. Let’s figure out what it takes to get off the moneymaking treadmill and build a mature dental practice you can enjoy for decades, that produces both time and money, and gets you off the treadmill.