Berning & Affiliates

"You Are So Different - In a Good Way"

During a recent practice meeting both the Doctor CEO and key staff reported on a new patient that was very enthusiastic with the care provided. The patient had transferred to the practice from out of the area due to a job change. The direct quote of the patient is the headline for this blog entry. When pressed for more detail the patient wanted to answer but mainly provided broad responses, "you are so friendly", "you seem to care a lot". But then came the specifics, "you helped me to understand what my options were in plain English and educated me", "you gave me the time I needed to make a good decision". Several additional patients were interviewed prior to our development meeting. During our meeting we seized on the various patient stated specifics and explored them. As a result of our discussion it clear that the Doctor CEO had set the tone for the practice and it dramatically influenced this staff. The attributes of the practice were then listed by the group, we are patient, we explain everything, we want the patient to understand why they are making a certain decision and what it means. From these attributes emerged a picture of the strengths of the practice, and just how different they are from what some patients have experienced in other practices. It is these now written and detailed strengths that will help guide this practice’s interaction and verbal discussion with any prospective patient that asks, "tell me about your practice".

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.

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

"To A Degree"

In a recent discussion with a specialist who had just opened a new practice location, I asked if he had studied pertinent demographic information prior to choosing the location. His answer was, "To a degree". I found this a surprising answer given the nearly $500,000 spent to open the practice in leased space. He said that he had been in the area for 5 years prior to opening the practice and so he knew about the location. Of course now a great deal was dependent on attracting patients and making the practice viable. We talked about his marketing challenges and lack of patients and, given his limited study of demographics, his answers were lacking in detailed prospective resident and business information. In my view, it is critical to secure detailed area specific demographics when considering any practice related initiative. Just a cursory look or thinking that as a doctor CEO in a local area for a number of years means that you know everything about the area can be costly and just plain wrong. Whether for a new practice or established practices, ordering a demographics study for your practice patient drawing area is a prudent step prior to any transition, marketing or expansion initiative. See how at:  http://www.berningaffiliates.com/demographics.htm

"From Nordstrom to Wal Mart"

A long established doctor recently sold his practice to an energetic younger practitioner. The seller had an established reputation based on the care provided, personalized attention to patients and a business format provided by the excellent front desk staff. It is approximately two months since the practice transfer. Despite the seller providing suggestions, a guide to policies and procedures that have helped the success of the practice over the years as well as and daily experienced based perspectives to the purchaser, the practice is in upheaval. The seller received a call from a long time employee at home recently that was shared with me. The employee related that almost all systems are being changed, the schedule compacted and many other changes. The employee noted that one adult patient stated "the practice is being changed from a personal Nordstrom type caring environment to a more performance based Wal Mart type" environment. Every doctor has a right to develop and present their practice as they see fit. In CEO parlance this can be seen as a part of branding and also of course marketing. In the health care context it also relates to the subtle indicators of more or less doctor attention and care. One of the things this purchaser bought was the goodwill of the patients, a portion of which as the expectation that patients would return for care as needed. But care can be secured in many places today and big changes are often not welcome by patients. My view is that it is too drastic for this new owner and CEO to switch the practice to a very different brand so soon after the transaction and he will pay a price in lost patients and production.

Losing Sight of What Made Practice and The Doctor CEO Great

I often work with very large and complex practice settings. The doctors that have built these practices are generally driven to have the growth oriented practice. In some cases the growth has happened just by virtue of the practice and doctor being in the right place. As growth occurs, as more staff, larger premises and additional doctors are added trouble can brew. In one practice this month the brew reached boiling. In short, the current doctor CEO has lost sight of what had made the practice prized by patients and made staff want to work at the practice. Size, it came to be seen, was not the end all and be all. All of this was determined after surveying doctors, staff and selected patients. Doctor CEO's, take this lesson to heart: in health care the core attributes that are sought after for a given practice must be carefully maintained throughout the growth and development of the practice or it will be crippled. Patients and staff can and will flee a practice they deem, in the words of one patient, "just an impersonal machine".

Harness Your Magic

Do you think your patients understand how you do what you do? They no doubt see the result. But very few have even a basic conversational ability to explain all the considerations that go into your practice, staff and doctor delivery of care. To a point that's OK. Our world is increasingly complex and most of have little understanding what the next person really does. But when it comes to health care many people want the reassurance that the doctor and staff understand them, their needs and will give at least a basic explanation of what is being provided and why. In one practice they are providing the patient explanation geared to the level of interest shown by the patient (they find the mechanical engineer generally gets a more detailed response than the sales clerk in the department store) but then adds as a wind up "and the rest is our magic in making it all meet your health care needs". This phrase has itself been magic! Patients reportedly now say, "tell me a bit about the magic you'll be providing today". The doctor recently went to a local community function and at the lunch counter one person, not a patient, came up and said, "I understand you do magic, and I need some!" Maybe that's what it takes, a short upbeat and friendly way for all CEO's and their staff to sum up the often very difficult and involved procedures that are provided to patients every day.

Great Visit Dr. Ruff

Very enjoyable time visiting and meeting with Dr. Charlie Ruff of Waterville, ME this past weekend. We had time not only to see some of the local Naples sites but also time for a fair amount of discussion on orthodontics and his perspective. Our time together reminded me of the suggestion I've often provided over the years to orthodontists visiting with general dentists or others in their community. Sure it is nice to set a time for a lunch, dinner or practice visit. But having enough time to really "be" with another person to share comments and perspectives and not rush after the time together is much more satisfying and enjoyable. If your time and circumstance permits, allow more time, not less, to visit and meet with those important to your practice and gain a good exchange with them that is something to be remembered by both parties, not quickly forgotten.

Our Mission Is...

As part of our ongoing coaching of doctor CEO’s to help fine-tune and grow their practices we discuss stating the practice mission. This discussion is not the tired old format that many doctors think of, namely, ‘our mission is to be good dentists and do good dentistry for our patients’. Rather we encourage doctor CEO’s to clearly state their vision for the defined period of time under discussion and then produce their "marching orders" i.e., the statement of mission that helps achieve the vision. Here’s one excerpt of a recent mission statement that helped to transform an organization. "Our Mission is to be a practice that provides dental care carefully matched to the patients needs, providing a thorough explanation of the benefits that will inure to the future health of each patient...." In this portion of the statement you can feel the whole dental team joining together to focus on the dental health of their patients. It stresses matching care, not just scheduling another procedure, to improve the patient’s health. My view is that powerful mission statements are one of the best initiatives a CEO can take to lead and unify any team.

Calling All Oral Surgeons New CE Course

Are you interested in advancing your practice growth and development? It all starts with stating your practice strategy. A well developed strategy is built on the dynamic of your practice, your referral sources and your patient population. Now you can learn and understand the development and then application of strategy to your practice. The American Association of Oral and Maxillofacial Surgeons is offering my course "The OMS as CEO", Saturday, April 21, 2007 in Chicago. To learn more and see the course brochure, click here. Http://www.aaoms.org/docs/events/oms_as_ceo.pdf See you there!