I find it extremely amusing how every dentist
knows what the politicians on Capitol Hill
should do to balance the budget and improve
things for the USA. You say they need to cut
overhead, scale back entitlements, raise taxes and
deregulate. But, here’s what you need to understand:
our government is paralyzed. They’ve seen
what happens to smart guys who made difficult
and calculated decisions that focused more on
our long-term sustainability – instead of shortterm,
ill-thought-out band-aids – and then lost
the next election because of them. The government
is not going to do what you know it needs
to do to right the ship; the funny thing about all
this is while the government isn’t making the
tough decisions you know it needs to make,
you’re not making any yourself. You all know
how difficult it is to do effective dentistry, run a
practice, keep paying your mortgage and keep
food on the table these days. Do you really even
need a reminder about this crappy economy?
Here are a few things I see going on in dental
practices around the country that make me
think some of you need a wake-up call.
Get Your Staff in Gear
When I attend an Arizona Cardinals or
Phoenix Suns game with certain dental colleagues
who rant and rave about how stupid the
team is for keeping certain players on the
roster and that they should trade this guy
for that guy, I get angry. While they’re
going on and on about pro sports, I’m
sitting there thinking to myself, “Are you
kidding me?! Your receptionist is quite
possibly the most slothful human being
on the planet and you are fully aware of
this, but even after 10 years she still
does the same awful job for you,
and you let it continue. You
really think you can run
the Arizona Cardinals?
You can’t even run
your own practice!”
Why is it some of you have the laziest,
most unmotivated, dysfunctional staff in the
world, but you hang onto them because of
some emotional connection or because they’ve
been with you for five years? Guys, listen up,
it’s time to make some tough decisions! You
need to evaluate your teams. What have they
done for you lately?!
It’s tough out there, so it’s time to get tough!
Some of you give your staff a dollar raise every
time the earth travels around the sun. Your entire
pay structure is based on the zodiac. Doctor, if
you work hard, you see more money because
you’re the dentist and you own the joint. Your
bottom line directly correlates with your performance.
Your staff doesn’t care if it works hard
or not because it keeps getting paid no matter
what. They are trading time for cash! It’s time to
knock that off. Staff incentives need to be based
on production. You need to make the decision
and say, “I used to provide a 401(k). I used to
provide health insurance. I used to give you a
dollar raise every year but I am not doing any of
that anymore until our collections reach this dollar
amount.” Get your team focused. Give them
the same incentives you chase. If the practice
does well, then everybody does well. Let your
staff know you are only collecting $50,000 a
month and until it gets up to $60,000 not a single
raise or bonus will be given. That’ll separate
the wheat from the chaff pretty damn quick.
Get Personal
I tire of the complaints from doctors who
say their practices are failing, but they drive a
wicked sports car and live in a high-falootin’
mansion in the ritzy part of town. If this is you,
take a good look at yourself in the mirror, doc.
Think you made some good decisions? Are you
not making tough decisions because you’re
afraid how your wife is going to take it when
you tell her it’s time to rein in your household
spending? Are you afraid of disappointing your
oversized ego by downsizing your house and trading in your BMW for a practical car? We
hear over and over how important it is to market
our practices to get more new patients, and
I know a handful of dentists who say they can’t
afford to undertake a marketing campaign, yet
they lease a Mercedes Benz at $1,000 a month!
Are you kidding me?!
Maybe putting your Rolex up for auction on
eBay is a good idea. Not just because you’ll pick
up a couple thousand dollars but because maybe
you’ll start to understand you’re personally
spending way too much. I’ll borrow a line from
the movie Fight Club: “the things you own end
up owning you.” You don’t need the boat. You
don’t need the vacation condo. You don’t need
the fancy cars. You don’t need a membership to
the country club. You can’t afford a stay-athome
spouse. You can’t afford to go out to eat
four nights a week. You need to sit down and
figure out how to cut your personal expenses
because they’re also eating into your practice’s
bottom line. Seriously, how good does it feel
that you bought your wife that Gucci purse?
That’s $5,000 that you could have reinvested in
your dental practice. You could have bought
two or three AMD Lasers for what you dropped
on a handbag.
You need to deploy some capital and do
some serious investing in your office. I have
written about investing in CAD/CAM until
my fingers bled. We’ve got continuing education
courses about cone beam computed
tomography (CBCT) and how nobody wants
to go back to using 2D X-rays like a pano or a
PA after using 3D CBCT. Why can’t you pull
the trigger on these new technologies? Because
you – just like your neutered congressmen –
feel more comfortable kicking the can down
the road another mile hoping things will
change. Nothing is going to change until you
start making some tough decisions.
Get Marketing
Every time you eat out for $100 that could
have been $100 worth of Internet ads on
Google or Facebook. My dental practice runs
advertising on Google and Facebook and they
cost us about a dollar a click. I would rather
have 100 clicks to my dental office’s Web site
than a fancy dinner. You need higher patient
flow, which equals more cash. Every time you
are supposed to go out to dinner, go to the grocery
store and buy a box of Kraft Mac & Cheese
for a dollar instead. Then go home and buy
$100 worth of advertising on Facebook. The
smaller your market the more effective your ads
will be. I live in an area of Phoenix, Arizona,
called “Ahwatukee,” and there are 3,600 people
on Facebook that have Ahwatukee in their profile.
Every time those 3,600 people log onto
Facebook they see my ad. Most of the activity
on Facebook is from women, and women make
about 89 percent of all dental appointments.
You can put two and two together…
Get Learning
We have 4,000 periodontists in the United
States and every single one of them does a
crown lengthening procedure every single day
and you don’t even know how to do it? Why
don’t you sell your Rolex watch, get on an airplane
and fly to some pig jaw course that
teaches you how to do crown lengthening especially
because insurance pays 80 percent of it.
Spend a little of your money wisely on new
technologies or CE courses that make you better
at dentistry in order to make more profit for
yourself and your practice!
Get a Move On
I recently had some long, over-the-phone
conversations with two despondent dentists.
They are both from a town of 5,000, and the
only factory in town – which employed all of
the townsfolk – closed down a year ago. The
town is drying up and 80 percent of their
insured patients were people who worked at
that factory. Now those people are not only unemployed but they are leaving the city
because there are no job opportunities in town,
they have no money and they need to downsize.
I listened to these two doctors tell me they were
born in that town, married in that town and
their kids were born in that town. I told them it
was time to make a tough decision. I told them
they needed to move, plain and simple. I said,
“Look at your ancestors. Damn near every
American immigrant made a tough decision 50,
100, 200 years ago when they were sick of living
in the country they were in. Maybe they hated
the king or the noble landlords. Maybe they
were squatter peasants and despised their lives.
They knew about the opportunity in America
and left everything they had behind. With just
the shirts on their backs they took a boat ride
for six weeks and landed on the shores of
America with nothing (if they survived the journey)
just for the mere opportunity for a better
life. And you are afraid to leave a ghost town
that used to have 5,000 people and move an
hour away or to a different state for better economic
stability?”
Get ’em Out of Your Pocketbook
Another thing I hear all the time that continues
to bother me is dentists telling me they
are about to literally go broke by putting their
kids through college. Here’s what I say, “Doctor,
did your dad pay for college? He didn’t? OK,
does your son in college even have a job? No?
Does he have an iPad and an iPhone? Does he
have a credit card? Are you paying his car insurance?
Why don’t you do your son a favor and
tell him after this semester he is on his own. I
was on my own, I made it, and I was a better
person for it!” I would put all of my eggs in the
basket of a self-made man any day over some
daddy-did-it who was born with a silver spoon
in his mouth.
Some of you have heard of the Five Ds.
Design your plan. What do you have to do?
What is your tough decision? Number two, drop
everything that doesn’t matter. This isn’t the
time to be in the Kiwanis Club, guys. This isn’t
the time to be coaching your kids’ little league
team. Get focused back on your business! Let’s
delay everything we can’t drop. Let’s delegate
everything that can be delegated so you can do
your plan. Guys, the feather in your cap is this
– unlike your government, you don’t have an
election to worry about every four years. You
can make the tough decisions to ensure your
personal and professional success. Stop trying to
make nice with everyone and start acting like a
boss. If you and your practice fail because you
didn’t make the tough decisions, do you think
they’re going to help you out? No, because your
staff is now out of a job and hates you for letting
the practice tank; you were your family’s bringer
of bacon, and they know nothing but “spend.”
It’s time to end this craziness. The buck starts
and stops with you.
I’d love to hear from those of you who were
recently faced with making a tough decision –
whether in your practice or on the home front –
and I want to know what the outcome was. Send
me an e-mail at howard@dentaltown.com, or
post your tough decision on the message boards
of Dentaltown.com or in the comments section
under this article on Dentaltown.com.
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