Howard Speaks: Is Your Practice Poised for Growth? by Dr. Howard Farran

Dentaltown Magazine

by Howard Farran, DDS, MBA, publisher, Dentaltown magazine

Any 30-year-old football team can have a great roster some years—one that makes the playoffs and wins the Super Bowl—but in other years lose a player here or there and end up being much less successful. (The Arizona Cardinals made it to the Super Bowl in 2008, for example, but this year they’re already 0–3 and didn’t manage to score a single point in the first half of their second game.)

The same principle applies to 30-year-old dental offices, too: Sometimes you’ll have a strong team; other times, it will be less successful. Human resources will be the No. 1 problem in your office until the end. One of the things we’ve noticed in HR over the years is that people who come in and talk mostly about money have always been the biggest underperformers.

When I look at the two greatest managerial moves we’ve made in the past few years, both involved promoting current employees who were hesitant to take the positions. They knew what the jobs entailed and how they really wanted to deliver—and they wanted to exceed our expectations, not disappoint us. But the ones who talked only about money-money-money clearly had the wrong focus, and were serious disappointments.

Getting online referrals
Every practice management consultant I talk to says that on Day 1, when she observes the office, she never hears a single staffer ask for a referral.

Does it “feel weird” suggesting that patients fill out an online review? Get over that! Your patients walk into that all day long, when they blurt something out like, “Oh, my God—it looks awesome!” or even “I didn’t even feel that shot.” Whenever you hear a patient say something that you’d love to see associated with your name in print, or online reviews, follow up and say, “Would you please say that on my Facebook page?”

Many people don’t know how to make online reviews — I bet you’re reading this right now and you’ve never made one. Walk your patients through it! Do you have an instruction sheet? Can you help them do it on their phones, right then and there, to get it done?

These online referrals are social confirmation, which is imperative in our industry because we’re selling the invisible, and that requires trust. In urban and rural locations alike, there’s a correlation between places that have the most online generated referrals and those that show the highest increase in new patients.

Office Highlights

Get your whole house in order
So many dentists who are trying to solve problems in their office act like failing steakhouse owners who say, “Well, if we just added lasagna, that would make the difference.” Your restaurant is going under, and you think what will solve that is a menu change? These dentists are spending time and effort to learn and offer specialties that their customers don’t need and aren’t asking for. Your dental office is struggling, and you really think that the answer is to leave town every weekend and go learn how to do another dental procedure? Get your house in order!

And when we look at a house that’s not in order, it’s usually related to HR. You spend 10 minutes explaining to a patient how he needs four fillings, but when you walk out of the room, he turns to the hygienist and asks, “Do I really need to get all four?” If the hygienist rolls her eyes, or says, “I don’t know” or “I’d at least do the big one,” your acceptance rate just went to zero—or dropped by 75 percent if she suggested tackling only one.

If I fell off my bicycle and broke my leg, the ambulance would pick me up and take me to a hospital, which is fully staffed. If I fell off that bike and broke off my two front teeth, I couldn’t find many dentists in Phoenix who would be able to treat me quickly. A staffer often says, “We can’t do that today,” and if I ask, “Are you open at lunch?” the reply is, “Oh, we all take lunch—we’re all entitled to lunch.”

I’ve never seen a firetruck pull up to a house on fire and say, “Let’s not get out the hose; we’re going to go to lunch in about five minutes.” The police car never stops a chase to go take a break or to lunch.

You’re a doctor, and one of the nine specialties by the American Dental Association is public health. It’s a huge public health problem that 8 percent of all emergency room visits are odontogenic in origin. Why? They had a toothache, they couldn’t leave work until 5 p.m., and now every dental office they call goes straight to an answering machine. By Saturday or Sunday, they’re in the emergency room all swollen up and it’s a huge deal. Why were you not answering the phones during lunch or after 5 p.m.? You need to act like a public health dentist.

Find out what patients are asking for
It’s amazing how crazy-fanatic dentists get about things like their bonding agents, or occlusion, or how they place an implant. They’re obsessed! But they can’t tell me how many incoming calls their office gets, or how many of those calls came in when the practice was closed, how many of those calls went to voicemail, and how many of those voicemails were opened. Are you recording your calls?

Why do you have two receptionists, who both come in at 8 a.m., take lunch from noon to 1 p.m., and leave at 5? If the software on your phones shows that the calls start coming in at 6 a.m., you need a receptionist who can answer them. She could start at 6 to 11, have lunch at 11, and work from noon to 3 p.m. The other receptionist comes in at 9:30 a.m., takes a lunch break at 1:30 p.m. and stays until 6:30 for the evening calls.

I asked a dentist in Ohio why he didn’t offer any clear corrector treatments and he said that no patients ever asked him about it. I had trouble believing that, so I asked him to prank-call his office and ask if they offered Invisalign. When we did, the woman who answered the phone told him, “We don’t do Invisalign.” How many people had she told that to? And keep in mind that most clear corrector cases are worth about $6,500.

A lot of dentists ask me if they should learn how to place implants, but I can’t answer that without knowing what their supply and demand is. They should record all their incoming phone calls and tally the times the team had a “get to yes” mindset but had to say no to someone. If, after one month, they discovered that eight people asked about clear correctors, or nine people asked if the practice accepted a certain insurance plan, or a dozen asked if the practice takes Saturday appointments, that’s what they should be changing. Conversely, they shouldn’t spend time and money learning how to do “all-on-fours” if everyone in their market wants and can only afford an all-on-none denture. That’s like opening up a Mercedes-Benz dealership in Childress, Texas. That’s Ford country! I’d want to open a dealership that sells only F150 pickup trucks.

Think about supply and demand
There’s so much misguidedness in dentistry. It seems like most of the tools that dentists are using to build their offices are actually tools that are destroying their offices. They’re raising their overhead because they’re investing in CE courses to learn procedures their own patients aren’t demanding. They need to create a supply of what patients are demanding.


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