Berning & Affiliates

Avoid Over Confidence

In a recent email a doctor of a larger group practice shared with me that no matter what happens in the economy his practice will always be fine. Looking at his local area demographics and being aware of his new and current patient statistics I could see why he made the statement. I usually encourage Doctor CEOs to be confident and act accordingly and this doctor knew my position. And yet, nothing in our recent economic history is quite like what we are experiencing in this current time. We have all levels of the economic strata effected and consumers tightening their purse strings seemingly across the board, health care expenditures included. So a word of caution for all Doctor CEO’s that may be acting or talking like they or their practice will go untouched. At this time, It is far better to be cautious, to budget carefully, to treat financial arrangements with patients and suppliers with attention to detail than at any time in the recent past. Coming across as over confident, indicating treatment plans or starts without empathy for your patients situation may be exactly the wrong behavior.

AAO Orthodontist As CEO NYC

Five hundred very attentive orthodontists gathered in NYC November 14-15. I was the kick off speaker sharing a perspective on "Performance Based Leadership" with attention to sharing how to achieve consistent high performance leadership for their practices. We explored how practice environment, expectations and vision, when tied to business plan execution can lead to significant advancement of the practice. A key aspect was asserting that doctors given the present financial condition of the country be tougher in controlling overhead and seeking to lead with increased attention to timeline implementation. Other speakers were Paul Zuelke on expenses and overhead, John McGill on accounting and financial concepts and management and Bo Elliot on financing options. To me the format provided for good audience interaction and a panel discussion allowed the attendees to hear each speaker comment on any question asked. My compliments to AAO and COOP for a very good meeting! Two photos from the AAO web site are included below.

 

Sad Downfall of Dentist

Most of my readers anticipate that I comment on doctor CEO leadership, practice transition approaches, valuation and related topics. Today, I write to share with you the downfall of a dentist. This excerpt is so sad for me because I have worked with association presidents, both ADA and AAO among them, and many board members, chairs and many wonderful members in the great volunteer ranks of dentistry. I know the potential for dentists and their practices, the wonderful life they can lead in their community and with their family. This dentist turned his back on all that and for what? Now it is prison. The article in the Chicago Tribune, Nov 21st is titled Dentist-landlord for pimps gets prison, subtitle, Prostitution ring was run from his apartments in Marina Towers by David Heinzmann. Here is an excerpt, for the complete article see the Chicago Tribune.

Chicago dentist Gary Kimmel told a federal judge Thursday that he didn't know at first that he was doing business with pimps who trafficked in women and underage girls.

And by the time he realized that he was laundering money for criminals, he was up to his neck in a financial mess he couldn't get out of it.

But U.S. District Judge Blanche Manning sentenced Kimmel to 3 years in federal prison, saying plenty of evidence showed he knew for a long time what was going on.

In addition to renting apartments to pimps, Kimmel also bought them flashy luxury cars, using prostitution money to make the payments. And in one instance, he did dental work on a prostitute after her pimp knocked out her teeth. Kimmel's payment for the work was sex from another prostitute for an elderly friend, prosecutors alleged.
Defense lawyer Joseph Lopez described Kimmel as a naive "teddy bear" of a man.

But Assistant U.S. Atty. Julie Ruder said that over several years of doing business with the pimps, Kimmel regularly saw evidence of violence against the prostitutes. And many of the prostitutes with whom he had contact were clearly minors, she said.

Kimmel apologized, saying: "I'm terribly sorry for what I've done. I've ruined my life, and I've ruined my children's lives."

Time to Innovate Your Practice Business Model

Recently I discussed the status of a practice with a doctor who was a client 8 years ago. All has proceeded well for the practice, the doctor and the new partner of 7 years since my last work for them as they went through their practice transition. Why the discussion then if all was going well? Because some of the practice’s competitors were apparently doing very well. They apparently had very focused market develop campaigns and seemed to have the cream of the crop of local staff. The competitors seemed to always be referred to as being "ahead of "other practices or as being the "best", a position they had enjoyed for years but did not now seem to be apparent to the market. We discussed that no practice or business stands still. It must continue to execute based on its vision and its marketing message. One way to give dimension and movement to a practice is to review performance and based on the review to innovate the practice business model seeking to advance the practice. It is a timely message for any doctor CEO today

Understanding Doctor CEO Consistent Performance.

My experience has been that the environment of most healthcare practices works against top level performance by the Doctor CEO. The reason, in my view, is that the doctors attention is fully engaged for most of the day in providing patient care (this may not be the case where the doctor CEO is an administrator, which is not the case with the practices I generally work with. Of course, there can be breaks for lunch and calls, but for the most part the day speeds by and is gone. Unlike most other CEO’s who spend their day focused on leading and managing the enterprise the doctor is in this respect clearly at a disadvantage. Yet, my experience has also been that when the Doctor CEO sets out a written vision, creates a linked in mission to the vision and sets performance objectives and does not waiver, staff and other doctors in the practice will act to move the practice forward. The key seems to be to have the structure set, the reinforcement in place and the commitment to consistent leadership.

Its Embarrassing!

This weekend I’ll be presenting No YouTube Moments, Transitioning Your Practice at the AAO Annual Meeting in Denver. This program got started with a prospective associate employee being considered for a progression to partner position. At the end of an interview I attended with the younger doctor and the practice owner, the younger doctor turned to me in the parking lot and said, "That was so awkward, it was funny, it could have been on YOUTUBE!" It really started me thinking! On YouTube you can search for all kinds of topics. One of those is searching on ‘employee’ or ‘unhappy employee’ or ‘embarrassing moments’, you get the idea. Wow! There is a lot of wacky / happy/ unhappy embarrassed people out there! You can do the same with words like dentist, orthodontist and others. But as I have thought about it, it is not what their logo says, video yourself - INSTEAD it is video yourself or someone else doing something that is embarrassing! It is also not only what is embracing, but also what NOT to do in many ways. It is that aspect in part that I’ll be sharing at the AAO meeting, how in the transitioning area to avoid being ill prepared and potentially embarrassing yourself as a practice owner or younger professional.

Leverage Your Strengths

Very interesting recent conversation with a doctor CEO who has had the good fortune to discern the areas that he is very good at and then leverage them. How? He related that through some trial and error and discussions with family and staff he had arrived at a list of his core strengths. For him this included his very warm and friendly personality and when talking with anyone an authenticity that with great frequency translated into a trusting relationship. This particularly helped to build his new patient flow. But his practice skills in the areas of financial management, personnel and regulatory compliance were poor. He for some time has focused on being in the community actively, on charitable boards, on local government panels etc. In his office his accountant and key staff coordinate the financial policies and "run the numbers". He has an outside personnel firm help find staff and administer periodic personnel reviews. He is so pleased and confident of the powerful approach being used that I thought it would be beneficial to share this success story with you! By the way, his "numbers" are impressive.

Overconfident Doctor CEOs

Observing and probing the actions of doctor CEO’s can be instructive as it relates to nailing down abilities that help predict success. One of the most interesting came up again this past week in a consultation. A doctor for the past 4-5 years had been focused on practice building. As most of you know, developing a practice to a pre-designated patient level can involve sequentially tackling facility, equipment, staffing and marketing items with, in many cases, considerable overlap. This doctor was very effective and so her confidence grew with each milestone accomplished. Now, staff and partner doctors report that she is crossing from confident to overbearing. It seems to be a case of only she knows what is best, after all, look what has been accomplished in the past few years. A good discussion raised the need for understanding how to develop a buy-in from the now larger group of doctors and staff, tactics for arriving at joint outcomes drawn from many viewpoints and how to reconcile underlying interests. With a new goal, running what has been built, and having the practice team positive and engaged in the practice the Doctor CEO will continue to be confident but not over confident to the point of overbearing and divisive in the practice

Are You Rich?

It depends, is the answer. Apparently, lots of personal and family aspects as well age and lifestyle all get added in when a person answers whether they consider themselves rich. As you know some people consider themselves rich because they have good health, or have the house mortgage paid off. But, a more definitive answer as it related to money was posted as a result of a small survey by Spectrum Group. It was recently reported in the Wall Street Journal as part of their Money Blog. The writer, Robert Frank, notes that "Having a net worth of $1.4 million will put you in the top 5% of Americans, according to the Federal Reserve." Which is true. Of course many doctors know that in certain areas of the country that $1.4 is just what the house costs!

"Do I Need Professional Help?"

In a consultation this week with a doctor evaluating numerous options for a practice transition strategy he wondered about the following: his investments and their performance, his insurance coverage and whether it was adequate, the documents being prepared (for nearly 2 years) for his estate plan and whether the firm preparing them should take into account his potential practice transfer plans, the marketing and management of the office and how it would be best developed when he brought in an associate or partner. There was more than that which gives you an idea of the number of questions and unmet needs being discussed. All of this discussion was prompted by his wife asking "when are you going to have a plan in place to transition the practice?" And his response to her was, "Do I need professional help to develop the plan?" The answer became obvious the more they talked! If you end up in a similar discussion don't wait -- in this case the doctor and his wife had their discussion 3.5 years earlier and he was just getting around to calling yours truly!