Howard Speaks: Hard Times Mean Hard Changes by Dr. Howard Farran

Dentaltown Magazine

You’ll need to make sometimes-difficult decisions to thrive in an era of increased competition

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

If you don’t practice in a rural area, chances are you’ve seen an increase in competition over the past 10 years. More and more dental schools are opening up across the country; I live and practice in the fifth-largest city in the country, where there is literally a dentist on every corner. Plus, Phoenix is home to two dental schools that graduate dentists every year. Those dentists, of course, love the weather and all Phoenix has to offer, and decide to stay, when what they should be doing is opening up a practice in a rural area where there is a shortage of dentists. But they don’t.

Do you have what it takes to make the tough decisions and the changes necessary to be successful if you’re experiencing the same situation that we are in Phoenix? It’s not easy, because no one likes to change.

Take a look at the team
When you’re busy and profitable, it’s so easy to let things slide, but it’s a different story when the schedule isn’t full and each day is a struggle. You should be using that downtime to, first, take a serious look at your staff—their abilities and their attitudes. One person with a negative attitude can bring down the entire team and cause new patients or existing patients to go to the dentist across the street.

In a small, tight-knit environment like a dental practice, you need everyone to be team players—your employees should be able to almost read each other’s minds and one should be able to pick up where another left off. When you tell a story with your notes, someone else should be able to come in and seamlessly take over—but if staffers aren’t getting along and don’t want anything to do with each other, communication gets dropped. Patients notice that—even if they don’t hear it outright, they can pick up on the tension.

If you have someone who’s not a team player, you need to address this right away. I know a lot of dentists don’t feel like they want to bother with personnel issues—it’ll all blow over eventually, right?, and if it gets to the point where you need to let someone go, the hiring process to find a replacement is such a pain—but addressing this is essential.

Even if you practice in a right-to-work state like I do, it’s best to start with a verbal warning, followed by a written warning and, only then, dismissal. Always give your employees a chance to change—but sadly, about 80 percent of the time it’s a personality thing and it’s just not going to work long term.

Luckily, bringing in a new person with new energy often invigorates everyone around them—especially after working for such a long time in a fraught or toxic environment. They may bring new ideas, different ways of doing things, such as possible ways of saving money they’ve learned from other practices that also could result in new patients coming and existing ones returning.

Office Highlights

Supplies and demands
Lean times are a good opportunity to look at supplies and materials.

• Labs. We have a CAD/CAM machine at our practice, which can be a money-saver because we don’t have to send all our crowns out to labs. That’s not a do-all, end-all situation, of course—certain teeth and materials work better with in-office milling than others—but overall it saves our practice some money.

• Supplies. Shop your supplies—especially disposables that you use once and throw away, such as bibs and saliva ejectors. Those can be costly; you often can save money by going for less-expensive versions—you’re literally throwing away money!

• Staffing. You have to have the right people in the right positions. If the person who orders your supplies just picks up the catalog and orders, that’s not optimal: You need someone whose mindset is about saving money—will they negotiate with your vendors to price-match a competitor’s product? Will they research options that are available online? When we switched who was ordering our supplies to someone who loved to search and find the best deals, our practice made huge headway.

Put your processes under examination
When you’re slow, start looking at things like how many people are walking out the door without scheduling treatment: What could you do differently to get them to schedule before they leave? Continuously ask for referrals. Put things like the phones under a microscope: Why do you have a low amount of new patients calling in, or a larger number who call but don’t schedule an appointment? Do you use phone software that records all incoming phone calls? What is your staff saying—is there too much “verbal vomit” that turns off callers and stops them from scheduling an appointment?

New practices especially can benefit from bringing in a consultant, who can provide great nuggets of information and advice after observing the staff at work. The only real alternative is to hit the books and try to develop your management skills and recommendations.

In established practices, though, your office manager or senior staff should know best practices about elements like taking control of calls. You should be able to look at your numbers and see who’s unscheduled, who’s been sent predeterminations and needs to be called, and the like. Do you have phone scripts ready to go for the most common scenarios? Are you or an office manager listening to transcripts of calls to check for opportunities to improve service?

Take another look at your office
This is also an opportunity to really look at your practice: Go outside and walk in your front door to see your office from the patient perspective. What does your waiting room look like? Is it dirty? Has it not been painted in 10 years? Is the upholstery ripped? These are all things that you just get used to looking at because you’re in the practice all the time, so you have to look at it with fresh eyes.

Because, as much as you would like to think that people don’t care about that—they only care about the dentistry you do—that is entirely wrong. You live in an era of competition. You’re out of tune with what the public is looking for today—especially if they’re new patients who are coming in blind to your services and want to be confident in their choices.

Sometimes my office manager goes out and sits in the waiting room and just looks around to see what a patient sees—are there visible wires to be tucked away? Paint chips to be covered? Clutter to be cleared? It’s crazy how much a coat of paint can do, and easy things like furniture, décor, pictures on the wall—all those bring up the vibe and atmosphere instantly.

You can’t be resting on your laurels at any moment, because the competition is out there constantly trying to be better than you. It may be different if you’re in a rural town and you’re the only dentist. But if you live in a city where there’s a dentist on every corner, a patient is going to go right across the street to somebody else if you don’t have that wow factor and give them a great experience.


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