Berning & Affiliates

"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!

No Matter How Many Times, Say Thank You Again

Recently I had a doctor relate to me how fortune he had been over the years with wonderful referral relationships, both from other practitioners and patients. He said in passing that it had been going on for so many years with some of the referrals, he just didn’t make a big deal about it anymore. I suggested he rethink his position. The act of referring, of saying to another person, you can trust and be well treated by the doctor I am sending you to is a major act for any person, professional or not. The same day of our discussion I received a thank you note from the UCLA Pediatric Dentistry and Orthodontics Postdoc Student Course coordinators, Dr. Scott Jacks and Dr. Michael McCartney. After more than two decades of speaking to all kinds of groups, do you think I just tossed it off as one more thank you for speaking to our group? No way! The reason is that they took the time to express genuine appreciation. With your referrals, I encourage you to do the same. Keep saying a genuine thank, you no matter how many times! Whether with a written note, a telephone call, an in person visit saying you appreciate the referral is always important. Here’s what they said:

Dear Randy:

We want to thank you for helping to make the practice administration course given to the UCLA postgraduate students a success! We believe the students are better able to move forward with a commitment to learn more about the specialties of pediatric dentistry and orthodontics within their lifetime and perform better as a result of the great start you have helped to give them. They are most appreciative, as you probably felt, and at the very least each of the students appears sincerely motivated to learn more about each of the subjects presented.

Presenting practice administration material to post doc students in both pediatric dentistry and orthodontics is both an honor and a challenge. Your contributions are not only significant to the students but very much appreciated by both of us.

Scott T. Jacks, DDS

Michael J. McCartney, DDS

The Power of Visual Impact

One of the most interesting large group practices I have worked with is that of Dr. Larry Kawa & Dr. George Nicholas, located in Boca Raton, Florida. Larry is the founder of the practice. He is a master at driving the practice to meet new goals. Most recently he has undertaken a major expansion. In his practice prior to the remodel were several larger fish tanks that the patients just loved. He also had top art talent add an ocean and fish creatures theme to the office. Well, with the remodel he expanded on the theme with a total of 21 aquariums, including literally a walk through one! The office is just dynamic and the new art work ties it all together. The visual impact of this office is a tremendous marketing advantage. Local school groups actually reserve time to come and tour the office!

Are You Delivering What Is Expected?

When you think about it, there is an important fundamental criteria that can be used to judge you and your staff. Namely, are you delivering what is expected by your patients? I have found that carefully evaluating the promise you and your practice make for excellent care and the approach taken to deliver on the promise can tell volumes about a practice. There are many levels to such an analysis. But, basically it involves asking and confirming whether or not each patient interaction is consistent and efficient. For example, consistent means that a patient calling the practice results in the same warm greeting and efficient resolution of the call. Same for other routine areas such as making an appointment, whether by telephone, e-mail or in person, or handling a financial arrangement. By meeting expectations, especially the ones you have created by your marketing and prior treatment effectiveness, you strengthen your ability to deliver in all areas of the practice. By the way, this can make a great staff meeting discussion topic: "Are we delivering what is expected by our patients at each interaction?"