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Howard Speaks

It Takes Guts to Admit
We Don’t Have All the Answers

Howard Farran, DDS,
MBA, MAGD
Publisher,
Dentaltown Magazine

Every once in a while I find myself in a situation in which I’m listening to my dental colleagues, and I cannot understand why they so willingly put up with certain frustrations. Recently, I was sitting with a couple of dentists during the lunch break at a dental meeting and they were commiserating, sharing war stories from the “front.”

I figured these two were good friends because they were talking about some major problems they were having in their offices, and, as you know, we dentists don’t like to admit having problems. One of the dentists, I’d say he was probably 45, I’ll call him Doc #1, was asking the other dentist Doc #2, who was around 55, about how her office scheduled patients. Doc #1 said his days were a string of frustrations, stops and starts, frantically running until everything came to a screeching halt. There’s no rhyme or reason as to how his scheduling coordinator organized the day. His practice’s production was nowhere near where he thought it should be. One day it’s $5,000 the next it’s $1,000. Of course, Doc #2 asked him if he’s talked to his scheduling coordinator and Doc #1 said he has asked her to make sure he’s busy. Things would improve a little for a while, but then it would go back to the same erratic production.

Well, misery does love company because Doc #2 proceeded to open up about the staff conflict and collection nightmares she’d experienced for the past three years! Suffice it to say that Doc #1 was certainly feeling much better about his scheduling woes after hearing Doc #2’s blow-by-blow account of the turf wars and serious financial worries she’s facing.

All the while I was asking myself why these dentists were living their careers in such misery. I don’t get it. They desperately need the help of an outside management consultant. I should know. In my early years I brought Sally McKenzie in to my practice to help me get my management systems in order. It was the best decision I ever made.

But before I did it, I had to admit to myself and my staff that I didn’t have all the answers; that someone else needed to look at my practice and objectively assess what was working and what wasn’t. It took a lot of soul searching, but I knew it was the only way I was going to bring my practice to the point where I could not only reach my goals but to where I would absolutely love coming to work every day.

The reality is that, as dentists, most of us are committed to being truly excellent clinicians. That’s why I earned my FAGD, MAGD, DICOI, fellowship in the Misch Institute, LVI, Mercer, and spent five weeks at the Pankey Institute. We’re dedicated to our patients and to providing what is best for them. But we don’t come out of dental school with management degrees or human resources experience, which is why I went back to school and earned my MBA at Arizona State University.
If I learned one thing at all from getting my MBA it is that every Fortune 500 Company employs several thousand MBAs. Yet these same companies routinely have a train of outside consultants inside their companies tweaking every little aspect of their businesses. The inside MBAs know that the return on investment of the outside MBAs is always positive. If it wasn’t, the outside MBAs couldn’t stay in business. Yet the majority of dentists do not understand this. When you hear of a dental consultant like Sally McKenzie who has been in the biz for more than 30 years, do you really think she could have done it without very positive results?

Most of us dentists have never considered writing a business plan for our dental practices. We are not experts at guiding our collections coordinator in developing the best systems to finesse payments from our patients. We see conflict on the team and want to run in the opposite direction. We know we want to be busy, but we don’t consider the difference between being busy and being productive.

As committed as we might be to providing the best for our patients, we cannot do so effectively if our own systems are out of whack, if our teams are dysfunctional little fiefdoms, and if we’re stressed out from the worry of paying bills and dealing with staff problems.

Consider your own practice. Aside from simply feeling things should be better, there are a number of tangible indicators that your dental office could benefit from if you were to bring in a consultant, such as: You have holes in the schedule that go unfilled, yet patients must wait more than a week to get an appointment. You either don’t know what your patient retention is or it’s below 90 percent. Gross salaries are more than 25 percent of income. Overhead is more than 55 percent of practice income.

There are no performance measurements in place to evaluate your employees. Job descriptions are either non-existent or unclear. Staff conflict is a common distraction. Practice production has leveled off or declined. The list goes on, but the bottom line is that you’re not enjoying our great sovereign profession as much as you could and should be. It’s time to hire a professional dental management consultant.

There are many of them out there, I recommend Sally because I’ve had firsthand experience with her in my own office and seen what her team can do. No matter who you hire, be prepared to be completely honest with them. Just like when we work with patients, if they are not straight with us in terms of their wants and desires, we cannot meet their expectations. We cannot provide the level of care they need if we do not have all the information. The same is true with your dental management consultant. He or she cannot create the types of systems you need and address your individual practice desires unless he or she has a clear understanding of your situation, your vision, and your goals.

Next, look at the consulting companies. You want a dental consultant who has the expertise necessary to address the challenges that your specific practice is facing. You need a consultant who can help empower your team to implement systems that will ultimately benefit you, the patients, the team itself, and the total practice. You want a consultant who can effectively explain the recommendations as well as the “why” behind them and provide access to the training and the tools that will help the team effectively implement your vision.

Talk to the CEOs of these consulting firms and ask questions, seek references, and talk to those references. Do the consultants you’re considering have a reputable company behind them? Do they have the expertise necessary to address the challenges that your specific practice is facing? Will they customize their recommendations to address your needs? Will they be there for you after the consultant leaves to help you overcome hurdles that may arise along the way? Do they offer other services, training, and supplementary materials that can help specific members of the team? Can they explain to you exactly how they have helped other practices? Will they seek not only your input but that of your team as well?

And finally, will they tell you what you want to hear or will they tell you the truth? It is that last point that is the most difficult for all of us. You’re likely not going to want to hear everything the consultant needs to tell you. But it is in listening that you learn and it is in learning that you can take the steps necessary to build the practice that you thoroughly enjoy walking into every day of your career.
Dentaltown Magazine
September 2025
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