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Avoid running a unsustainable dental practice

Dentists love to be in control.

I am a trained dentist myself. I have been practising dentistry for 18 years and know the feeling of having to know every detail of my business. The challenge is that the desire for control often gets in the way of the desired goals of the practice.


This blog post is about how you can achieve more freedom, less stress and higher profitability by working with the feeling of control.


Female hand holding a reminder with the text: "Don't forget"

Inhuman working conditions

Over the past few weeks, I have helped dental practices in 4 different countries find ways to optimise their practices. Here I was reminded of how we as practice owners and general dentists, time and time again get placed in a hamster wheel that just goes round faster without us moving forward.


People with no relationship to the dental industry who are introduced to the way we work describe the typical working conditions in a dental office as inhumane. The workload is simply so extreme and persistent that it causes head shaking.


Healthcare has a "zero error culture", our work processes require an extreme degree of precision. All procedures are so time-optimised that even 3 minutes of delay can haunt us for hours. Just as we have virtually no time to exhale or recover mentally during a working day. This is crazy!

Just imagine how it feels when the dental assistant has to go and get some missing materials or instruments for the third time in one morning.

The pressure on dentists

Although all professionals in a dental practice work under extreme pressure, dentists are often the hardest hit. Not because we do most of the work in the office, or because we carry all the responsibility, but because we never take time off.


When dentists are not sitting at the dental chair, we are reading professional literature, taking courses, preparing treatment plans, filling out insurance paperwork, talking to sales reps or other colleagues about teeth, thinking about teeth and the responsibilities associated with treating teeth.... More of us are dreaming about teeth!


This extreme and persistent mental pressure takes the focus off the dental practice as a business. It becomes a workplace where we exchange hours for money (also called salary). We work and work and work.... With everything that is right in front of us. It takes the focus away from our management tasks and therefore we loose track the practice as a business.


Practice management

As leaders, our job is to complete tasks and achieve goals through others.

This means that we must constantly ask ourselves the question: "Does it make sense that I am the one doing this task? Should it be done again? If so, should I do it going forward? If not - who will do the job and how do we get this person to do the job better than me?"

En mand står og dirigerer en masse mennesker, der trækker i nogle reb

I know there are several colleagues who do not believe others can take over tasks and perform them better than themselves. That is also absolutely correct, if you maintain that view it will become a self-fulfilling prophecy. But if you train your staff, encourage them to keep going - even when they (obviously) fail at first, take responsibility for the mistakes they make and praise them for everything that goes well. Then there is actually some likelihood that the team can become better at any task than the dentist.


As a leader, there is almost no better feeling than watching your team grow, become happier and better versions of themselves. Among the team members this leads to pride and ownership of the tasks and of the practice. This in turn will lead to greater freedom for the practice owner - and this is exactly what I hear the majority of dentists asking for: Freedom.


The stress-free and profitable everyday life

Over time, many tasks have been delegated to others. I have written about this in the blog post "Winners of the future" In the future, even more tasks will have to be delegated if we are to have a profitable and stress-free everyday life in our dental practice.

Almost all dentists tend to work IN their practice, rather than working ON their practice.

If we don't stop and think about how we run the practice as a business, many dentists will have to admit that they don't have a business. They have a job. Because when we work in our practice, we make teeth. Here, we trade our time for money.


When we work ON our practice, we work with leadership and management. Here we get others to work for the company on activities that generate more value than we are able to produce on our own.


Delegation

Is the key to success.


Internally

We may delegate tasks to our staff or to external partners.

As we do so. Our staff grows, has a more enjoyable day and becomes more attached to the practice. The dentist gets more mental freedom or can perform more tasks in less time.


Examples of tasks you can delegate internally:

  • Cleaning of teeth

  • X-rays

  • Intraoral photos

  • Clinical photos

  • Preparation of temporary restorations

  • Temporary cementation

  • Alginate/IO scans

  • Fabricating stone models and Inserting them in the articulator

  • Bite splint fabrication

  • Bonding of attachments/engagers (clear aligners)

  • Control of clear aligner treatment process

  • Patient instruction (prophylaxis, pre- & postoperative, etc.)

  • Teeth whitening

  • Presentation of treatment plans

  • Financial discussions with patients

  • Denture repairs

  • Management of emergency patients

  • etc.

The prerequisite for delegating tasks is that we accept the mistakes of others.

We have to accept that nobody becomes a top professional by seeing a given task done once. It requires lots of practice and support along the way.

Just think how long you spent doing your first filling yourself and how bad the result was compared to what you are able to do today.


So praise your staff for taking on the challenges. Accept their mistakes, praise them for ALL that is good and help them with the stuff that is difficult for them. Most people know when they make a mistake. No people think it's super cool to have their mistakes pointed out over and over again. If we fall into the trap and start pointing out the mistakes of our employees, they are sure to stop practicing.


External

It is also possible to delegate tasks to external collaborators.

You certainly already delegate highly confidential and very essential tasks to an external collaborator. In any case, I assume that you have your accounts are being reviewed by an accountant once a year?


The need for control

It is the perceived need for control that is stunting the growth of many dental practices, stealing dentists' freedom and stressing the team. In other words, the cost of maintaining a strong focus on control is unsustainable.

ooden doll controlled by strings

I have seen dentists in Belgium working in solo practice - quite literally.

Here we still find dentists working alone, without any assistance! No dental assistant, no dental hygienist, no receptionist, just the dentist!!! Just imagine how unproductive your everyday life would be if you had to work all alone like that.

Can we agree that this is not exactly a dream scenario?


I once heard of a dentist who allegedly terminated all his staff because none of them could find a way to do the tasks that were within their scope of work. At least not to the standards of the owner dentist..... Let's leave that one for a moment.


Certainly the example is extreme. But it also speaks to a challenge most dental practices and practice owners face. In any case, I have lost count of the number of times I have seen practice owners and employed dentists express the wish for more skilled I have written before about how we have the staff we deserve.You can read about what that means and what you can do about it here.


It becomes a vicious circle.

When we take over more and more tasks ourselves, we also lose focus on the tasks that are most important for the practice. No human being can handle an infinite number of tasks, not even a highly trained academic like you and I. Especially when we are working in an environment so time-optimised that a two-minute delay can haunt us for a whole day.


One is to know the feeling of lack of control.

Another is how we react to it.

All people have feelings.

Emotions cannot be controlled.

But the way we react to the feelings determines what we get back.

  • Think about what you dream about.

  • Set some specific goals that will bring you closer to your dream.

  • Make a plan for how you will achieve the goals.

  • Share the plan with your team and let them keep you on track.

  • Follow up again and again.


Observations in dental practices

Typically, the staff is not trained to perform their tasks as the manager wants. Or the staff do not know what the manager wants to achieve with the dental practice. Which causes the staff to either quit or they define the direction themselves. Which often frustrates the manager, as it is most often a different direction than the one the manager wants the clinic to go.


When we experience something like this, it is tempting to take over tasks ourselves. Especially the tasks we consider important. Because then we at least gain control of the task. It gives us a feeling that the task is being solved in a way we want it to be solved.


I hope the above has given you the courage to work with delegation.


But it takes time!

Yes, that is absolutely correct.

The more time you invest in training your team, the easier your day will become.

But it costs money!

This is also correct.

Most dental practices today are under financial pressure.

That's why it's important to lay out a plan to begin implementing lasting changes with maximum value. Here, it is important to start with the changes that will give you the most benefit with the least effort.

  • What if my team get trained to be super awesome and then they change jobs?

  • What if you don't train your staff and they stay?

If you find it difficult to get started, you are always welcome to contact me. It costs nothing to have a no-obligation chat.


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Tandlæge Jesper Hatt med blazer og hvid skjorte

I hope to see you in the next posting


Many kind regards

Jesper Hatt DDS




P: +41 78 268 00 78


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