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The four-step postrecession growth plan
PERSPECTIVES
A
BETTER
PRACTICE
The four-step postrecession growth plan What steps should Q I take to increase productivity as quickly as possible?
A
Dentists, who are always dedicated to providing excellent patient care, may be realizing that the Great Recession changed the business of operating a practice. In its most recent survey of economic confidence, the ADA reports that 52.0 percent of responding dentists had negative perceptions about overall economic conditions in the fourth quarter of 2012 (an increase from 45.3 percent in the third quarter), and 52.0 percent had negative views about net income (compared with 45.1 percent in the third quarter).1 Practice owners want to know what step-by-step procedures they can take to restore growth. By taking the four steps discussed below, the typical dentist will see tangible improvements in practice performance in three to four months.
Conduct a thorough, objective situation analysis
Dentists generally have neither education nor experience regarding how to use standard analytical methods commonly employed in the business world. However, it is possible for dentists to develop a clear picture of where their dental practices stand today. There are two primary challenges to overcome. The first is to maintain objectivity. When a person’s entire professional life is tied up in an enterprise, it can be difficult to view the practice impartially. Dentists must make the effort to eliminate personal bias from the analytical process, avoiding wishful thinking, excuses and blind spots, while acknowledging the difference between intentions and actual results. The second challenge for dentists analyzing their practices is in identifying which figures to evaluate. I recommend creating a list of 25 key metrics or targets to initially analyze and
R o g e r P. L e v i n , D D S
continue tracking. Although all of these performance targets are important, several will be essential for increasing production rapidly. For the general practice, the top five targets are dkeeping 98 percent of patients scheduled at all times; dreducing no-show and lastminute cancellation rates to 1 percent or less; dreactivating 80 percent of inactive patients; dachieving a 90 percent acceptance rate for all treatment; densuring that hygiene care accounts for 25 percent of total production. Any steps taken to move the practice toward reaching these specific targets will increase production. Metrics that relate to higher collection rates, reducing overhead, presenting comprehensive treatment plans, generating more referrals and dentist’s income also should be analyzed to give dentists a clear picture of the state of their practices. In the simplest terms, the first step determines where the practice is today, and the sec-
1062 JADA 144(9) http://jada.ada.org September 2013 Copyright © 2013 American Dental Association. All Rights Reserved.
PERSPECTIVES
ond step identifies and visualizes where it should be in three years. Together, they define the trajectory a dentist and staff members must take if the practice is to progress from point A to point B.
part of the dentist and team must occur? dWhat deadlines should be set throughout the transformative process? dWhat numerical targets should be emphasized, and how will progress toward them Project a vision of be measured? where the practice Working out the answers to should be in three years these questions will generate A practice vision has the power a set of specific growth stratto motivate the dentist and egies. Once strategies have transform the practice if these been established, systems rules are followed: must be implemented to supduse a three-year time frame; port them within 90 days. The dcommit the vision to writing, aim is to bring about dramatic typically a few paragraphs; changes in the practice’s outdaccompany the vision statecomes as a business, so the ment with 10 major goals that dentist must be sure that all will signify success in fulfillsystem protocols will enable ing the vision when they are the practice to reach its growth reached; targets more effectively—and dshare the practice vision rapidly. These systems should statement with all team be spelled out in detail, step by members. step, and documented fully in The vision statement can writing. help the dentist see the destinaThe vision driving the protion. Next comes the roadmap cess is a long-term goal, but for reaching it, with increased taking these steps toward it production along the way. can generate positive results within 90 days. Use the vision to develop innovative growth strategies and the systems to implement them
Evaluate all practice systems and training and update as needed
This third step demands a combination of creative thinking and results-oriented action. The dentist must concentrate on his or her vision of the future state of the practice and figure out exactly how to reach the 10 major goals. This process requires strategic thinking, which involves the following questions: dHow can the dentist and team members provide excellent care to more patients? dWhat specific actions on the
To help the practice reach its full capacity for growth while also providing superior patient care, the dentist must have systems in place that work in concert and operate at peak efficiency to move the practice steadily toward its goals to achieve its vision within six months. Some systems may already be functioning at or near optimal levels. Others may be outdated or lapsing into inefficiency and in need of upgrading.
A
BETTER
PRACTICE
For the dentist and team members, this is not the end of the process. Rather, it marks the beginning of a new pattern in which systems are reviewed regularly, problems are identified and solutions are implemented whenever necessary. Following these steps can help the team adapt quickly to new market conditions, eliminate accumulated system bottlenecks and make adjustments to accommodate practice growth. The dentist also should have a robust training program in place. In addition to script-based training for the use of new systems, a proper training program can be designed to hone the skills, attitudes and day-to-day performance of all team members. This is best accomplished with a combination of on-site and off-site components that address both practice and personal professional objectives. Conclusion
By applying proven business methodologies, dentists can ensure consistent, high-quality patient care while capitalizing on the potential for greater productivity in the practice. Equally important, dentists will transform their practices in other essential ways. Stress will be replaced by energy, and dentists will derive more satisfaction than ever from their work. n Dr. Levin is founder and chief executive officer, Levin Group, 10 New Plant Court, Owings Mills, Md. 21117, e-mail rlevin@levingroup. com. Address reprint requests to Dr. Levin. The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the American Dental Association. 1. American Dental Association. Dentists’ Economic Confidence, Fourth Quarter of 2012. Chicago: American Dental Association; 2012:4.
JADA 144(9) http://jada.ada.org September 2013 1063 Copyright © 2013 American Dental Association. All Rights Reserved.
A
BETTER
PRACTICE
The four-step postrecession growth plan What steps should Q I take to increase productivity as quickly as possible?
A
Dentists, who are always dedicated to providing excellent patient care, may be realizing that the Great Recession changed the business of operating a practice. In its most recent survey of economic confidence, the ADA reports that 52.0 percent of responding dentists had negative perceptions about overall economic conditions in the fourth quarter of 2012 (an increase from 45.3 percent in the third quarter), and 52.0 percent had negative views about net income (compared with 45.1 percent in the third quarter).1 Practice owners want to know what step-by-step procedures they can take to restore growth. By taking the four steps discussed below, the typical dentist will see tangible improvements in practice performance in three to four months.
Conduct a thorough, objective situation analysis
Dentists generally have neither education nor experience regarding how to use standard analytical methods commonly employed in the business world. However, it is possible for dentists to develop a clear picture of where their dental practices stand today. There are two primary challenges to overcome. The first is to maintain objectivity. When a person’s entire professional life is tied up in an enterprise, it can be difficult to view the practice impartially. Dentists must make the effort to eliminate personal bias from the analytical process, avoiding wishful thinking, excuses and blind spots, while acknowledging the difference between intentions and actual results. The second challenge for dentists analyzing their practices is in identifying which figures to evaluate. I recommend creating a list of 25 key metrics or targets to initially analyze and
R o g e r P. L e v i n , D D S
continue tracking. Although all of these performance targets are important, several will be essential for increasing production rapidly. For the general practice, the top five targets are dkeeping 98 percent of patients scheduled at all times; dreducing no-show and lastminute cancellation rates to 1 percent or less; dreactivating 80 percent of inactive patients; dachieving a 90 percent acceptance rate for all treatment; densuring that hygiene care accounts for 25 percent of total production. Any steps taken to move the practice toward reaching these specific targets will increase production. Metrics that relate to higher collection rates, reducing overhead, presenting comprehensive treatment plans, generating more referrals and dentist’s income also should be analyzed to give dentists a clear picture of the state of their practices. In the simplest terms, the first step determines where the practice is today, and the sec-
1062 JADA 144(9) http://jada.ada.org September 2013 Copyright © 2013 American Dental Association. All Rights Reserved.
PERSPECTIVES
ond step identifies and visualizes where it should be in three years. Together, they define the trajectory a dentist and staff members must take if the practice is to progress from point A to point B.
part of the dentist and team must occur? dWhat deadlines should be set throughout the transformative process? dWhat numerical targets should be emphasized, and how will progress toward them Project a vision of be measured? where the practice Working out the answers to should be in three years these questions will generate A practice vision has the power a set of specific growth stratto motivate the dentist and egies. Once strategies have transform the practice if these been established, systems rules are followed: must be implemented to supduse a three-year time frame; port them within 90 days. The dcommit the vision to writing, aim is to bring about dramatic typically a few paragraphs; changes in the practice’s outdaccompany the vision statecomes as a business, so the ment with 10 major goals that dentist must be sure that all will signify success in fulfillsystem protocols will enable ing the vision when they are the practice to reach its growth reached; targets more effectively—and dshare the practice vision rapidly. These systems should statement with all team be spelled out in detail, step by members. step, and documented fully in The vision statement can writing. help the dentist see the destinaThe vision driving the protion. Next comes the roadmap cess is a long-term goal, but for reaching it, with increased taking these steps toward it production along the way. can generate positive results within 90 days. Use the vision to develop innovative growth strategies and the systems to implement them
Evaluate all practice systems and training and update as needed
This third step demands a combination of creative thinking and results-oriented action. The dentist must concentrate on his or her vision of the future state of the practice and figure out exactly how to reach the 10 major goals. This process requires strategic thinking, which involves the following questions: dHow can the dentist and team members provide excellent care to more patients? dWhat specific actions on the
To help the practice reach its full capacity for growth while also providing superior patient care, the dentist must have systems in place that work in concert and operate at peak efficiency to move the practice steadily toward its goals to achieve its vision within six months. Some systems may already be functioning at or near optimal levels. Others may be outdated or lapsing into inefficiency and in need of upgrading.
A
BETTER
PRACTICE
For the dentist and team members, this is not the end of the process. Rather, it marks the beginning of a new pattern in which systems are reviewed regularly, problems are identified and solutions are implemented whenever necessary. Following these steps can help the team adapt quickly to new market conditions, eliminate accumulated system bottlenecks and make adjustments to accommodate practice growth. The dentist also should have a robust training program in place. In addition to script-based training for the use of new systems, a proper training program can be designed to hone the skills, attitudes and day-to-day performance of all team members. This is best accomplished with a combination of on-site and off-site components that address both practice and personal professional objectives. Conclusion
By applying proven business methodologies, dentists can ensure consistent, high-quality patient care while capitalizing on the potential for greater productivity in the practice. Equally important, dentists will transform their practices in other essential ways. Stress will be replaced by energy, and dentists will derive more satisfaction than ever from their work. n Dr. Levin is founder and chief executive officer, Levin Group, 10 New Plant Court, Owings Mills, Md. 21117, e-mail rlevin@levingroup. com. Address reprint requests to Dr. Levin. The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the American Dental Association. 1. American Dental Association. Dentists’ Economic Confidence, Fourth Quarter of 2012. Chicago: American Dental Association; 2012:4.
JADA 144(9) http://jada.ada.org September 2013 1063 Copyright © 2013 American Dental Association. All Rights Reserved.