The team at Denco Medical Construction Specialists, LLC has almost 100 years of combined experience in commercial construction. We specialize in medical, optical and dental office construction, but we have done and seen it all. However, we do not want to just be your general contractor when it comes to building your office. We want to be your partner. We want to help in anyway we can to build your business. Whether it is simply spreading the word about your new practice to our friends, or putting you in front of a great marketing team, we want to help. One of the ways I think we can help is by summarizing ideas from different books on building your practice.
I've started with books primarily focused on dental practices, but the lessons are somewhat universal. I will work on putting summaries up bi-weekly. If there is a book you think I should address here, please email me at bwarren@dencomedicalcs.com.
Also, I am not an English Professor. I am sure there are some grammatical errors in this, so please forgive me. This is also a summary of the ideas this book has to offer. Obviously, there is much more detail in the book itself, so if something sparks your interest, please grab the book and learn from it.
By Peter Boulden, DMD and Craig Spodak, DMD
I started with BPP because I've listened to their podcast for awhile. They are honest and straightforward, so I figured they would have the same approach to their book.
Here is the Table of Contents:
Chapter 1: A Tale of Two Dentists
Chapter 2: Visioneering: Leadership Gets People Aligned and Excited
Chapter 3: Lay Down the Law, but Make It Pearson's Law
Chapter 4: Your Culture Can Make or Break You
Chapter 5: Corporate Dentistry: The Disruption Is Way Overrated
Chapter 6: Social Media is a Daily Grind, and That's Just Great
Chapter 7: Value-Based Marketing and the Law of Reciprocity
Chapter 8: What You Do Speaks So Loudly, the Patient Can't Hear a Word you're Saying
Chapter 9: Double Down: Redefining Success and Failure
Chapter 10: What the Practice of Tomorrow Will Look Like
Chapter 1: A Tale of Two Dentists
Dr. Craig Spodak is a third generation dentist that has a 13,000 square foot practice that "looks more like an Apple Store than a dentist's office."
Dr. Peter Boulden has a multiple-location practice throughout Atlanta called Atlanta Dental Spa "with an experience level that rivals that of any elite spa."
They have built two very different, but very successful practices and they are putting what they've learned into this book. Besides telling you about their businesses and relationship, there are a few things to take away from this chapter:
Craig's idea of building a bulletproof practice means, "to provide the best possible care for your patients, promote a culture that enables your team to thrive, build superior marketing and systems that drive patients in the door, and finally, to leave room for the constant evolution inherent in running a successful business.
This book will help you build your own definition of a bulletproof practice.
Focus on dentistry as a business
"To have a next-level practice you always have to be thinking, What's Next? Who could put me out of business? Why are they doing it better than us?"
Working on your business, and not just working in it, is extremely important, but rarely pressing - they are the necessary actions that can help take your practice to the next level.
Embrace and Improve Your Problems - This is one of the hardest things for people to get and it is so important. Most people think "If I can get to this point, my problems will go away. When the problems go away, then I'll be happy." Problems do not go away. If you can embrace that, then the quality of your problems will improve. You'll go from "Can I pay my mortgage this month?" to "Should I work three days a week or two?"
"This book is meant to help you see that there are many different factors - and likely ones you've never considered - involved in creating your ideal practice."
This is a strategic book, not a step-by-step book. It addresses mission, vision, culture and fulfillment. It does have very good methods of improving all of these aspects.
Chapter 2: Visioneering: Leadership Gets People Aligned and Excited
"If you want to build a ship, don't drum up people to collect wood and don't assign them tasks and work, but rather teach them to long for the endless immensity of the sea."
- Antoine de Saint-Exupery
You need to be able to guide your practice. You need something bigger fueling your work rather than just making money. You need Vision. "Without a strong vision, you're almost guaranteed to be heading in the wrong direction." Basically, any vision is more powerful than no vision at all.
"The process of creating a bulletproof dental practice requires setting an intention before doing anything logistical." You should get quiet time alone and document, sketch, and visualize everything. And "your vision can't be cut-and-paste." you need to craft
your unique vision. "As long as it's what you want and what will bring you fulfillment, it's valid. Happiness comes from authentic expression."
Your next steps need to be to write it down and answer these questions:
- What does your ideal practice look like?
- What does it feel like?
- Who are you working with?
- Who are you serving?
Make sure you get it as detailed as possible. "Getting Crystal clear on where you want to go is the first step in getting there."
Now that you have an idea of your ideal practice, know that it will change. Your team, environment and even life will change - be ready and able to adapt. Your vision my change 100 times. It is "a living, breathing organism; it needs nourishment and attention."
Getting people aligned to your vision is how you take it from the intangible to the concrete. This is where you need to be a good leader "and the key to good leadership is flexibility." Leading your vision is "a constantly evolving organism with room for team insights and contributions. When you let others be part of what you're building and seek their ideas and insights, you create an environment that people are excited to be a part of." Do this right and not only do you start to get your vision concrete, you also get to step back and work on your business and not in it.
Guidelines to meaningful, vision driven leadership
1. Believe Your Own Hype - Don't BS - If you don't believe it, people will know.
2. Find Your First Stakeholder - Vital - "A committed stakeholder creates a domino effect, attracting a community who will buy into and help bring your vision to life."
3. Communicate Your Vision - Talk about it all the time.
"You need to describe your vision so many times to your team that the thought of saying it one more time makes you want to vomit. Then you'll know you're halfway done."
4. Making It Big is About Baby Steps - Make it part of your daily tasks. Always ask:
- "What will I do today to align with the master vision of the practice?"
- "How will I set my team in motion through inspiration, confidence and leadership?"
5. Your Dental Education Does Not Make You Uniquely Skilled to Run a Practice.
- "99 percent of the things that help a dental office run smoothly don't require a DMD or a DDS."
Let Your Team Take the Lead
- Make it bigger than yourself.
- Let your team lead and delegate.
- Remain open to possibilities that seem crazy.
- Do this and you can gain freedom.
Chapter 3: Lay Down The Law, But Make It Pearson's Law
Pearson's Law: "That which is measured improves. That which is measured and reported improves exponentially."
"Metrics matter. They're the only way to know whether what you're doing is working."
Key Performance Indicators (KPIs) need to be actionable to be useful. You also need to know what they really mean. You can measure the amount of money you charge for production of a particular service and how often you are performing that service, but if you aren't measuring what you are actually collecting, you have no idea what is actually hitting your bank account.
Questions to ask to keep you on track:
1. Do you have a handle on your data? - Both authors use Dental Intelligence, a.k.a. Dental Intel, a patient management software tool.
Provides a unified platform, enabling every member of your team to view and share.
Links to your financial software to breakdown performance.
Highlights areas of exceptional provider and areas for improvement.
Analyzes data to recommend growth strategies.
Supplies expert data analysts and coaching.
2. Are you retaining the patients you already have?
i. Existing patients accept 50% of the treatment plan you present.
ii. New customers only take 10%.
iii. Onboarding a new patients is far more costly than retaining existing patients.
iv. "Keeping patients who know and love you in your chair is not just smarter financially; it's also more fulfilling.
v. "If you're just a commodity, you can easily be swapped out for convenience or value."
3. Is your pre-appointment rate watertight?
-93-95% pre-appointment rate is solid and Dental Intel makes it easy to track.
4. How well can you make your case?
i. After you tell your patient what you want to do, make sure your team inputs and tracks what was accepted.
ii. Aim for 70% acceptance.
iii. If you are enrolling 95%, be wary. You could be under-diagnosing.
iv. Enrollment has a lot to do with how you talk to the patient. Don't just spout your plan and go. People are different. Handhold if they need handholding; be straightforward if they are a driver personality.
v. A good way to think of this, "Would every member of your team be your patient?"
5. How much money does each patient spend per visit?
- This is simple. Make sure you track the average number spent per patient that walks through your door.
6. Is your Overhead on point?
- Your O/H goal should be 60%. If you get it as low as 45%, your patients will probably be suffering and no one will be talking positively.
7. Are you social enough?
- Check number of reviews, page views, likes, etcetera.
8. Is your team tuned in?
- Your team needs to know what's important to track and make sure they are in the loop.
9. Can you keep people onboard?
i. Your largest overhead chunk is your people: 30%.
ii. Lead your people, Appreciate your people. Manage your stuff, not people.
iii. "When employees leave it actually costs 3 times their salaries to replace."
iv. "What you appreciate, appreciates in value."
10. Are you your own best advertiser?
- Spend 1/2 your budget on external ads and 1/2 on things to set your practice apart (internal ad).
This chapter can be a little overwhelming. That's why they pushed Dental Intel so much. It does help to have it all in one place designed how you want it. Also understand that knowing these numbers, along with general KPIs is a must to have a successful practice. Although, ignorance is bliss, "taking a hard look at what's working and what isn't and acknowledge that you are probably at fault for the things that aren't;" that self-awareness is imperative.
Chapter 4: Your Culture Can Make Or Break You
If you want to go fast, go alone. If you want to go far, go together. - African Proverb
"Your culture has a tremendous impact, not just on your team and the feel of your office, but also on patient care, so it's essential that you get it right."
Firstly, you need to identify your current culture. You can use Survey Monkey and ask anonymously.
"How would you describe our current culture? How do you feel when you come to work? How do you think our patients feel when they arrive? When they leave?
Can you describe our belief system? Do you think it could be improved?
What are our values? Do you think they translate to our culture?"
If you get answers all over the place, you need to define your culture and start taking steps to get there.
Honest Feedback is Essential to Your Success
Maintain a novice mentality and an openness that allows you to advance.
Questions for feedback:
"What are three things I should never stop doing?
What are three things I should stop doing immediately?
What piece of advice would you give me to help me be a better leader?"
With negative feedback, a few moments of discomfort is definitely worth the outcome.
Check Yourself to Make Room for Community
- You have a Team, not a staff! And even moreso, not just a team but a Community!
- Teams can fracture into groups, but a community is a group of people organized around relationships and if something happens in the community, someone is there to help out and support. It's a win-win for everyone.
Maintain Your Culture or Watch It Turn Into Chaos
"You don't have to plant weeds in your garden; they just show up."
Your culture needs to be talked about daily, give kudos to each other, have a peer-to-peer reward system, praise buckets that lead to big gifts each month for the team member with the most praises, etc. This helps keep culture awesome day after day, week after week, month after month.
Don't Focus on Process; Focus on Results
- If you agree on the result, the process can be flexible.
- "If you encourage the idea that people are intelligent enough to make decisions on their own and your team members know that they have the creative power to do so, they'll usually do a great job - maybe an even better one than you would have."
- Even if it's not the decision you would've made, as long as it is in line with your vision and culture, that's great.
Make a Millenial Mindset Work For You.
- If millenials understand the "Why" then they're in.
- Millenials will soon make up the majority of dental practice owners and patients, so you've got to get on board.
Who Will Protect This House? The Beauty of Self-Managed Teams.
- "Who will protect this house?" Team says in unison, "I WILL!"
- The Team Hires, Not just you.
- Self-Management leads to solving problems without the tattle-telling.
- As the leader, you are more susceptible to the law, not above it.
Cultivate a Sense of Ownership
- Teammates with skins in the game have a huge ROI.
Leaving Millions On The Table
- Get your 401K right because you could literally be leaving millions on the table for you and your team.
- Look up America's Best 401K" and get Tony Robbin's book "Unshakeable" through www.freetonybook.com
Chapter 5: Corporate Dentistry: The Disruption is Way Overrated
"Entrepreneurs get distracted by productivity and miss profits. Corporate folks get distracted by efficiencies and miss effectiveness. But ballers? Ballers know the difference between a hack and a hoop every time. Take your shot." - Richie Norton
11 corporate offices open up every single day. As their number goes up, private practice ownership is going to go down. There's a few main reasons for this:
Industry interests from VCs - Dental practices are a good investment and VCs are putting billions of dollars in it.
Poorly managed private practices - This whole book is devoted to building a bullet proof practice. There are so many private practices out there that don't even realize they are running a business. They neglect metrics, culture, marketing opportunities and everything else this book is about. If they worked on their practice as a business, they could grab more share of the market.
Inordinate amount of student debt - It's getting out of hand and "with such a high price to pay upon graduation, it's hard to fathom borrowing even more money" to start a private practice. That, combined with corporate recruitment from day one of dental school, these students are corporate dentists from the beginning.
That Millenial mentality - Millenials want to "work to live not live to work," which makes the lifelong investment of a private practice unappealing.
But it's not all doom and gloom. If you aren't one of those poorly managed practices, there's still hope for you.
"Cottage-industry dentistry will always win if done correctly."
The Cottage-Industry Advantage
"Even if corporate dentistry can attract them with convenience, the patients will eventually wise up to the fact that the bottom line will always be profits, and they will take their business elsewhere." Elsewhere being your private practice, where you care more about culture and human capital than the bottom line profit.
You've got to step up your game. It's actually good for you. Do not let the fear of corporate crush you, but step up your game and rise to the occasion. Get motivated.
Don't copy corporate. You won't win at their own game. You need to utilize your distinct advantage - "The high-quality experience that comes from investing in patients, rather than just returns."
Use corporate as an early starting point. Learn the ins and outs of running a practice as a business on corporate's dime. Then get out in 2 years and start your own practice.
- Make the consumer the center of the universe.
- "The most important quality of a business is flexibility."
- Be open to change.
- "Dreams are free, but the hustle is sold separately."
- "You have to lead like a CEO and market like a marketer, in addition to being an awesome dentist."
- Embrace the startup reality.
Chapter 6: Social Media is a Daily Grind,And That's Just Great
Either pay someone to craft a compelling story for you or be remarkable enough that people are willing to tell it for free. - Dr. Craig Spodak
It's not the money/cost that matters, it's social credibility.
Step 1. Build the culture you want internally.
Step 2. Express that culture externally through Social Media.
Ground Rules of good social media.
Do It Yourself or Don't Do It at All. - Be authentic and utilize your team.
Choose Your Channels Wisely. - Keep it simple. Pick one and stick with it.
Add Value, Not Traffic - What works?
Think Visually - Doesn't have to be perfect, authentic is more important.
Go for Real - Celebrate birthday's, babies, long-time patients on social.
Encourage Interaction - Ask questions, Request Response
Consistency - Do not go dark. Get a schedule and stick to it.
Hashtags are your friends - Get a core group of hashtags you use regularly
Keep your personal accounts clean - Keep it clean, don't be political, etc.
Make patients part of your network
If you can get a patient to share on their own page - that's the holy grail.
Offer check-in incentives.
Ask for reviews.
Anyone of influence that walks through your doors needs to endorse you.
Social Media is Advertising; It's an extension of your brand and it will only magnify your current culture, so get Step 1 above right first.
Chapter 7: Value-Based Marketing And The Law of Reciprocity
The best marketing strategy ever: CARE. - Gary Vaynerchuk
Value-based marketing is not mechanical like traditional marketing. "It's about what you offer, not how you offer it."
Traditional marketing doesn't have any evidence it works.
Here's a few marketing strategies:
Spray and Pray - Expensive and not very effective. It's impossible to track and you cannot get it hyper-niched, so it's kinda pointless.
Paid Ads - Find people actually interested in what you have. Facebook Ads, Google Adwords. These are expensive.
Invest in your website - Don't just slap something up; be personal, have before and afters, in depth about page, etc. Your site introduces someone into your business, so introduce yourself. The more you can show, the better off you'll be.
The Art of Recapture - If someone is inactive for more than 18 months, send them a shirt with a reminder. Keeping your patients active increase's your practice's value.
The Law of Reciprocity - Give something of value, people are compelled to return the favor. New patient gifts are great and can lead to loyal patients, but do not give anything away with an expectation of reciprocity. That's inauthentic.
Don't fall in love with yourself; fall in love with your patient - Patients go with the person they bond and connect with the most, not the person who spouts off how much they know. If they know you care and see your team getting along, you are much more likely to have a loyal patient.
The "Thank You" Economy - Actually care about people. "Focusing on our existing patients, showing our appreciation for their loyalty, and making them feel like they're part of our family. And it's all part of our marketing budget." Go deep with your customer base.
"Value attracts value" - a customer who appreciates you is going to spend a lot more and follow the course of treatment you recommend, than someone who came in to get an exam for a dollar is."
"The new marketing is a compelling story, a meaningful gesture, paying it forward, and engaging in the thank-you economy."
"Add value, add value, add value, and then, after that, you've earned the right to ask for business - but not before." -my favorite sentence in the book.
Chapter 8: What You Do Speaks So Loudly, The Patient Can't Hear A Word You're Saying
The way we communicate with others and with ourselves ultimately determines the quality of our live. - Tony Robbins
- Dentists are engineers/technicians and they/you speak like it. If you do not feel like you're where you want to be, often communication is the missing link.
- "Recognize the vulnerable position you're putting someone in just by the very nature of your job. Dentistry is very intimate."
- Quality communication is what will set you apart. Always say, " We're in this together."
- "If you want to make it big, being able to adapt and communicate is not optional."
"Your verbiage, your approach, and your body language can all prohibit you from doing the dentistry you were trained to do."
- "People don't care how much you know until they know you care."
Even if you are socially awkward, this can be learned:
Depart from the script - One size does not fit all, read body language, get eye-to-eye, don't hover over them and tick off a list. Actually get their chair upright. On consults, don't stand and point, but get shoulder to shoulder with them
Basic Ways to Improve Presentation:
Don't fear silence - Pause is ok. Say what you need to say and let it sink in.
Do some public speaking - Toastmasters International is great. Forces you to get in front of people and make something happen.
Learn about body language - Read books, Youtube.
Record yourself in a consultation - Super useful. You hear how people perceive you.
Ask for advice - Your team will have boat loads, so don't get mad, get better.
Trifecta for Dental Success:
Manual Skills - People Skills - Drive!
Determine your weaknesses, and work on them!
Chapter 9: Double Down: Redefining Success and Failure
Where focus goes, energy flows. -Tony Robbins
A lot of dentist make their money through their practice and then cannot wait to invest in something crazy like a yogurt shop or burger franchise or even day trading. "You're missing the boat on a sea of opportunities that could actually be strengthening your unique value proposition as a dentist rather than diluting it."
Dentistry is one of the most lucrative things you can do!
Why do you care so much about your yogurt shop while neglecting your practice, which is far more lucrative?
These dentists don't actually consider their practice a business and they see it as an extension of themselves (compensation for their labor). They don't understand that patients care a ton more about the aesthetics, the culture and the personality of the practice, rather than their skillset alone.
Don't Fear Failure - It may seem like there's a ton of dentists to compete with, but it is so much smaller than that yogurt shop.
Don't look elsewhere to put your money - Double Down on your practice! "Don't forget that you're blessed with the opportunity you have. When you feel overwhelmed, double and triple down."
Where focus goes, energy flows - Don't blindly dump money into things we cannot control (Read Killing Sacred Cows: Overcoming the Financial Myths That Are Destroying Your Prosperity by Garrett B. Gunderson) - Focus on how to add real value for your patient.
Turn your Have To's into Get To's - It's a privilege to be in the profession you're in, but it's up to you to feel that way.
Winter is coming - economies are cyclical - Get excited about winter because you know the other guys are scared. That's when you buy real estate, buy practices, buy equipment, and leverage your relationships.
Business is constant innovation, so have a sense of urgency to get better.
Stay hungry and stay hyper-focused on adding value.
"You have to think abundantly. You can't ever shrink your way to greatness. Don't fear failure. Don't be scared of scarcity - or of competition. Who gives a shit if someone opens up a practice across the street? There's plenty for everybody as long as you are doing it right. Just be better and you'll do fine."
Audit yourself constantly.
This was a great chapter. Primarily, you need to invest in yourself and what you know, then double-down. Basically, you're an idiot if you think owning a yogurt shop is better, or can be more successful than what you are an expert at already.
Chapter 10: What The Practice Of Tomorrow Will Look Like
The future belongs to those who believe in the beauty of their dreams - Eleanor Roosevelt
Technology has arrived and it's not about if it works, it's about when .
The practice of the future:
a) Focuses on maximizing patients' time
b) Makes it super easy to get care
c) Creates the most value for patients while they're in the office
"If you focus on those three objectives and reverse engineer your practice from there, with those ideals as your guiding principles, you'll win."
Learn to set yourself apart. Technology can't negate that, it can only enhance it.
Start by developing a vision, tracking your goals, creating an inspiring culture for your team and patients alike - none of which requires a fancy machine.
Regardless of technology, human beings still value relationships, so smile.
The Bulletproof Practice is a great book for any dentist looking to raise his game, but it's for anyone who runs a private business and has to compete with corporate companies. Corporate box versions of whatever you do will always be there, but if you can set yourself apart, following the ideas in this book, you won't fear any competition. You will thrive in it.
Also, this can be overwhelming if you are someone that has been rolling with the status-quo practice for years now, but someone once told me that if you change by just 2% each week, that's over 100% within the year, so baby steps are ok. The main thing is to start doing something.
Comments