Managing a Dental Practice
Whether you have a new startup dental practice, or a stale existing practice that isn't going anywhere, there are several core requirements for managing a dental practice. As a dental business consultant, I've had to enter practices to assess what's going right, what's going wrong, and what is missing. As is the case for every single business, location is extremely important in achieving success; but if your already established practice is in a less desirable location, no worries. Your practice can still improve on revenues and get patients walking in through the door, assuming you have built your practice in a location that has a significant accessible population.That said, you have to for your practice what I get paid to do: examine, eradicate, build, and change.
I've never seen a patient who commits to a practice because their dental chairs are comfortable. I've never seen a patient who is loyal to practice because they like the sample given after a visit. Why a patient comes and stays with a practice depends on a lot more than the dcor yet doctors nationwide spend tenfold (if not more) on equipment over marketing or employee training. This is a surefire way to build a stale practice that will plateau and start a slippery downhill slide.
Figuring Out Your Niche
Before you figure out the details of how your practice works, you have to figure out who your existing and potential patients are. The best practice in the world means very little if you don't have patients coming into your office.
Examine your patient records and see where the patients you have are coming from: which areas do they live in? Which demographics? What race? What language is their primary language? Especially when you are located in a large metropolitan city, and there's a dental office on every other block, you have to figure out the pattern of who has been opting to come to your practice. Also, look at which of these patients you have retained, and which have opted to have dental work done elsewhere.
Then, assess how much treatment these patients are receiving at your practice. How much revenue are these groups bringing into your office? Are they mostly one-time patients who receive a new patient exam and possibly a cleaning, but opt for nothing else? Or are they patients who get their dental work done at your office, albeit at a slow rate?
Finally, you have to decide whether these particular demographics are the ones you want for your practice. Just because you want a different type of clientele doesn't mean your location has access to that group, so be careful in what you decide. If your practice is located in a shady neighborhood, your wanting clientele from the most affluent neighborhood in your area won't be accomplished as those patients will not drive to your area, and will not want to park their cars in your area. On the flip-side, if you decide you want a minority clientele that uses more cash than insurance but your location is on the other side of town in the affluent area, the kind of clientele you are wanting often do not have reliable transportation; it also won't work.
Market, Market, Market!
Once you have figured out which niches in your area are the patients of choice (by location or history), you need to look at your budget and decide how much of your currently available funds you are willing to invest into marketing. Marketing is the brain of your practice and is not an area that where frugality works. Patient cannot come to your practice if they don't know about your practice. Spend as much as you can on marketing your practice!
Now that you have figured out your target niches, you have to do a lot of research to figure out what venues these demographics use. Are they the type to use the internet? If only a small percentage of this population uses computers at home, internet marketing won't work; it doesn't matter if it's the latest rage if they can't see your marketing advertisements! Does this population have television channels that they watch religiously? If it's a Chinese population, are there dedicated Chinese channels on television, or radio? What you use is irrelevant here; your belief that television ads are outdated is erroneous if that is the medium your potential patients use the most. The same applies to radio. Spanish-speaking communities still use the radio a lot, and savvy marketing through this medium can be very effective.
Consider newspapers. Are there local magazines and newspapers? Which has the highest readership from your niche?
Especially for patients for whom internet marketing will not work - the phonebook is an excellent place to market. What internet users look up on Google, they look up in the phonebook the old-fashioned way.
Once you figure out your budget and medium, you need to come up with savvy marketing tactics and incentives to place into your ad, along with visuals and placement within that medium. For television, which timeslot, and why? For phonebooks, is it worth dedicating a 2 page spread in the middle of the book, or under a certain heading, or do you want a more expensive one full-page layout in the beginning or end, and why? This requires time and a lot of planning, and a deep understanding of the market you want to target.
Service is Everything
Bringing in all the patients in the world means very little if you can't retain them and build loyalty to your practice. A "new patient exam", after all, brings in very little income without commitment to further treatment. If marketing is the brain of your practice, then the patients are the heart of the practice. A great determinant in whether or not a patient stays depends on the service your employees provide.
When I enter a practice, I will spend a full week just watching what the employees do with the patients who enter. This requires a keen eye and an ability to read people, especially the patients, and their reactions to your employees. I will take notes and see who does what, when, where, and my suspicion as to why.
I will then build a list of who gets to stay, and who must go - and be able to document exactly why. Some employees are trainable and have potential to change whereas other employees, especially long-term employees, are set in their ways and believe they know how to run the practice. In the latter case, it becomes a great obstacle in trying to revamp a stale practice if they should remain in the practice.
Once I have the array of patients that the practice will be targeting, it's imperative to build a practice that has the type of people who will best provide the desired service to those patients. If many of the patients will be families, having employees who excel with children is important. If many of the patients will be of a specific ethnicity, language is of the utmost importance. If you are in a business location, your employees must be of the type that appeal to business people; if you are in an blue-collar industrial location, the employees must be people that can communicate with industrial folks, and so forth. The process is long but must be precise.
Sometimes, I will find that I can work with all existing employees. At other times, I find that none of them are suitable; it all depends.
When I have the final list of employees to keep, I then reposition jobs. Sometimes, the dental assistant is less talented in the back office and more suited for front office tasks. Other times, a receptionist should be slated for the office manager position, if she's that good. Some people belong in a billing office or sterilization with no patient interaction. It's a trial and error process, and once in awhile, I will end up with an additional employee who becomes useless in the objectives of the practice in this process, and be relieved of their duties later on in the game.
At this point, I now know which positions are needed and unfilled as of yet and the hiring process must begin. Hiring the right people for these positions is crucial in building the successful practice.
It can take awhile to build a strong team, but it's not a step in which you can afford to settle. This applies from the receptionist all the way to the hygienist and each individual associate doctor that you hire. In some cases, the managing owner doctor doesn't fit the practice and I have hired associate dentists to see the patients with the owner overseeing the business, but minimizing patient contact. A doctor with good clinical skills is important, of course, but a doctor with good patient interaction is of equal importance. Every single person on your dental team counts and leaves a lasting impression on each individual patient.
Never forget that!
Summary
There is a lot more to consulting for a business than this.
Billing and collecting procedures must be established, since there is no point to getting patients if you can't collect money from them. Recall systems must be put into place and religiously followed. Management must be established as well as a hierarchy; styles must be dynamic and adjusted according to the needs of the employees and practice.
The above process will take me anywhere from 2-6 months to put into place, and the remaining 3-6 months are spent solely training and role playing. Every possible situation must be covered and employees have to understand their function precisely. Furthermore, it's also important to cross-train employees. While a receptionist may not assist a crown placement effectively, even a receptionist should understand the basics of how to assist a filling or extraction. Employees get sick or don't show up; if this happens, even if it's only required for a half-day, a good team knows how to function in one another's roles as to ensure continued efficiency no matter what unexpected event takes place.
Following these steps, you, too, can manage a strong practice. It may require a build from the ground-up, but it's a worthwhile change to implement. With the right marketing and excellent employees who provide the utmost in service, it becomes difficult to not succeed in dentistry.
