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One Pivot Can Change Your Game by Jay Geier

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Categories: Practice Management, HR and Accounting;
One Pivot Can Change Your Game 

If a dental practice is set up to satisfy its patients’ needs—not just the owner’s— the chances for success skyrocket

by Jay Geier

When’s the last time a patient asked to see your credentials or continuing education certificates, or got excited about the equipment you use? Probably never— they just assume you’re good. Yet most doctors go into private practice with the notion that really good clinical skills alone will bring success and the practice will automatically attract patients, grow and be forever profitable. Throughout their careers, they continuously invest time, effort and money in CE credits well beyond what’s required and learn new techniques they think will impress patients. They also habitually overspend on new equipment and gadgets, believing the sales pitch about it being a great investment that will bring a profitable return.

If that’s the game you want to play—one that’s more about you becoming a better clinician than building a patient-centric practice—you really should just work for someone else instead of being a practice owner. Then you could focus entirely on your skills and not worry about business matters or growing the practice.

As a consequence, though, you’ll need to accept your income will max out at a certain level no matter how much you learn: You can see only so many patients in a week and drive average purchase up only so far, which means your earnings have a definitive ceiling. And don’t forget to factor in your age. Dentistry is hard on the body; the longer you’ve been practicing and the older you get, the fewer hours you’ll be able to work.

The same scenario applies if, as an independent practice owner, you refuse to have associates. Your business and personal incomes will max out, then decrease over the years as you find it necessary to cut back on the hours you’re willing and able to work.

Given these facts, why do so many practice owners continue to play the game of insisting on being the only provider and focusing heavily on clinical skills instead of patient-focused, business-building strategies? The two most admitted reasons:

“I CAN’T AFFORD ASSOCIATES.”
That’s an oxymoron because the whole point of hiring associates is to profitably raise the production and net income of the practice through clinical duplication. If your investment in an associate doesn’t bring a net positive return, you have a poorly structured contract or your associate is underperforming against the agreement and needs to either improve or be replaced. Get coaching on how to correctly implement the strategy, and learn why you can’t afford not to have associates if you expect to remain a profitable practice in the long term.

“I DON’T WANT TO DEAL WITH THE PROBLEMS THAT GO WITH HAVING ASSOCIATES.”
Maybe you’ve had a bad experience hiring or managing an associate, or heard others talk about their difficulties. But look around. There are plenty of independent practice owners—and I emphasize, independent—who have thriving practices, a balanced life and happy patients because they’ve learned to hire and manage associates successfully. Again, it’s a matter of doing it right by learning from others who know what works and what doesn’t. Don’t give up on an excellent business-building strategy just because you lack coaching on how to implement it well!

Those are really just excuses when the underlying reason is often egotism. Many doctors simply can’t accept that someone else could care for their patients as well as they do, so they refuse to allow another provider into the practice. That’s nonsense! Do you really believe that if you got hit by a bus tomorrow, nobody else would be able to care for your patients? No matter how much you may love your own doctor, chiropractor or personal trainer, do you believe there is nobody else in your community who could possibly take as good care of you as they do? Of course there is.


Pivot, shoot, score!
You worked hard to earn your credentials and gain your experience, but so did many others. Once you accept that fact, you can start playing a different game— one that’s patient-centric instead of clinician-centric— and learn to pivot in ways that position your practice to score bigger by making better shots, especially these:

Become patient-centric.
Your most lucrative pivot is to begin making every decision about how you run the office with the patient in mind. Every practice owner thinks they’re patient-centric, but if you’re not already doing these things you’re kidding yourself:
  • Put patient convenience ahead of yours by offering extended hours and being open six days a week (with the help of associates, of course), so patients can be seen when they want to be seen. If you see patients only three or four days a week, you’re leaving a huge chunk of potential revenue on the table each week. You’re also annoying your existing patients—and driving away new patients—with lengthy wait times to book appointments and by making them work around your limited schedule. Patients don’t care that you and your staff don’t want to work Fridays and Saturdays if that’s when it is best for them or their kids. Instead of assuming they wouldn’t want to be seen by any other doctor, pivot your thinking; your patients will be impressed that you care enough about their convenience to hire more providers.
  • Answer the phones when patients want to call, not just when it’s convenient for the staff.
  • Take the phones off the front desk altogether, so potential new patients calling in get undivided attention at the same time as your valued patients in the office.
  • Train the team on how to capture new patients and deliver an excellent experience, which leads to patient retention, referrals and a reputation that attracts patients—leading to practice growth and profitability.
  • Provide growth and development opportunities that attract and retain talent to a growing business.

Maximize ROI on your space and equipment.
Do you know practice owners who brag about working only three days a week? If their story includes that they have associates and the office sees patients five to six days a week, then kudos to them! They’ve learned how to have a successful business along with the freedom of time and money. If, however, their office is closed four days a week, that’s an absurd business model and they deserve the financial woes they undoubtedly have but are definitely not bragging about. They are also likely to be price-gouging patients to get as much as they can in those three days—an equally lousy business strategy.

Obviously, no office sees patients 24/7, but when you consider how much more ROI you could be getting on your investments in space and equipment by not letting it sit idle so much of the time, you’ll see the value in pivoting to score with more patients across more hours.

Let’s say your office is open 8 a.m. to 4 p.m. four days a week and closed one hour for lunch. That’s 28 hours of seeing patients per week, which is a mere 17% of the time you’re paying rent on your space and making payments on equipment and other capital investments. Associates make it possible for your practice— not you personally—to offer extended hours, stagger staff lunches so you don’t have to close, and even offer Saturday hours so you’re getting much higher return on your space and equipment investments.


Invest in clinical duplication.
Business Economics 101 teaches the inevitable life cycle of any decent business: After an initial rapid growth period, every business reaches a plateau when revenue slows, and then profits begin to decline because of inflation.

That’s because X number of employees can only work so many hours to serve X number of customers or produce X number of widgets in any given period of time. Even with continuous productivity improvements, unless the company figures out how to scale its products and services, the plateau and eventual decline are inevitable.

Clinical duplication is about scaling your business. Learn how to grow your practice with associates by connecting with colleagues who have done it and are willing to share their experiences so you don’t have to reinvent the wheel or learn the hard way. Their bottom lines are benefiting with higher production, and their businesses are earning even when they’re not there. This allows them greater freedom of time and money and a more balanced life, and also positions the practice to remain thriving over the long term as they age.


Play the right game
Is your game about you—your clinical skills, your convenience and your team’s convenience? Or is your game about the patient—their convenience and overall end-to-end experience? If you’re a young practice owner, the sooner you start playing the right game in the right way, the better. But you’re never too old to start playing a different game and to learn to pivot in ways that position your practice to score big. 

Author Bio
Author Jay Geier is an advocate for independent dentists and a world authority on growing independent practices. He is the founder and CEO of Scheduling Institute, a firm that specializes in team training and development, coaching doctors, and helping those around him reach their full potential by uncovering blind spots that are holding them back. Subscribe to his "Private Practice Playbook" podcast at podcastfordoctors.com/dtown.
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