By James R. Schroeder, DDS
One of the most overlooked aspects in the lifespan of a dentist's career is taking time to assess the various stages of his or her practice - then making strategic adjustments. For the purpose of today's article, let’s do an overview or “fly over” from graduation to retirement.
As a retired dentist and founder of a consulting firm that specializes in dental practice transitions, I’ve had the unique opportunity of seeing both the significant and subtle nuances that exist at each stage of a practice life cycle. The American Dental Association (ADA) compares the life cycle of a dentist’s career in private practice to that of a bell shaped curve. The “x” axis represents the years in practice from graduation to retirement, and the “Y” axis represents revenue produced. Nobody can escape the curve. Or, can they?
A modification of the curve does seem to exist by those with a sharp awareness of internal and external factors that impact the shape the curve. Through measurements and honest self-assessments it’s possible to discover more clearly where an individual dentist’s road map is trending. Depending on where he falls on the curve, it’s critical to ask important and sometimes difficult questions. According to a recent survey, the average dentist’s career tends to peak in the age range of 55, followed by a decline in earnings of approximately 5% per year.
Of course, please recognize there is a wide range of variables. But the real elephant in the room is the question about where we’re spending the majority of our time and energy. It’s easy to be driven by the tyranny of the urgent in dentistry. An average day is largely occupied by a focus on delivering exceptional patient care and clinical skills. Unless you have an appetite for business and leadership, those skills simply don’t get fully developed and the practice will never operate at maximum efficiency and productivity.
Dentistry is no longer about honing your technical skills alone. A generation ago that may have been acceptable - but today, the dental owner feels squeezed by corporate entities, large insurance companies, and government regulations - including very difficult HR regulations. Today, consult outside the dentists’ wheelhouse is often critical and saves a great deal stress and heartache.
As I look at our dental colleagues of all ages and stages of life, I see many different responses to our changing health care world. Many recent graduates have a degree in “fearodontics” which is an important discussion for another day. Further along in the dentist’s journey, many will acquire diversified skills and talents to make the necessary course corrections. Others will recognize a need to develop their business acumen and leadership skills. And others will remain in the comfortable circle – starting in graduation and holding steady for the next 40 years, unchanged yet very satisfied.
There is enormous diversity when it comes to the chosen path of our colleagues. But no matter where one is on that path, all can benefit from self-examination. Below are three areas of growth to consider reflecting on as you reach the various stages of the dental journey.
GROWING YOUR DENTAL SKILLS
General dentists have enormous opportunities to expand their skill base - from surgery to cosmetics to sleep apnea. Excellent resources are available, but require planning, energy and time commitment, followed by staff development. What were your top procedure codes 5 years ago? Is it time to challenge yourself and increase your technical skill base? Check with your colleagues who’ve developed new skills. I encourage a thorough engagement as opposed to a weekend course to learn these often complex procedures. There also has to be a commitment to skill application shortly after you return from your training. This can serve as an exciting addition to your day and boost your income by meeting an unmet need or demand in your market. It’s exciting to know that you’re meeting the needs of your patients and improving their health!
DEVELOPING YOUR BUSINESS SKILLS
My encouragement is to evaluate your relationship with your accountant. Many colleagues do not track expenses and revenue in a methodical manner. There are industry standards that provide you with a compass, allowing you to better discover if you are “off course”. Recently, a client told us that his staff salaries were at 48%, wondering why he had so little take home. Was he under producing or was he over paying? Another young client was producing $900,000 and collecting $500,000 due to the many insurance contracts that were taking away enormous revenue from his collections. Basic understanding of the numbers is important to know, but the more difficult road to take is developing the business skills to execute the changes necessary. Knowledge without application is useless.
I am sure I’m not telling you anything that you cannot find on the internet. The challenge is with the execution of the changes necessary to take within your office and with your staff. As a consultant, a common issue is resistance to change. This can be resolved in a positive manner by including the team in the plan. If significant changes are necessary, I strongly encourage a well laid out plan with outside guidance. Pain is often necessary before the doctor will seek outside consul, but it can be a game changer!
This is an absolute must to execute growth, change and enjoyment in today's world of health care. I encourage you to develop a continuous growth plan for yourself followed by learning skills to develop your diversified team. Most of us have discovered that simply “informing a team member” about a necessary behavior change that’s needed is not always the best strategy. The number one complaint that I hear from practice owners as they age is, "I am tired of people management!" The number one complaint I hear from the team members is, "I wish the doctor expressed a little more appreciation each day".
The truth of the matter is that if you are interested in business ownership, leadership is part of the package. You can’t expect to delegate everything without oversight.
In summary, consider taking time to check where you are in your journey. For those of you who fall in the beginning of the bell shaped curve, school provided you with a start. It is up to you develop your road map. For those of you who fall on the end of the bell shape curve, take the time to plan and look at your choices. There is an exciting next chapter that you can shape. Don't wait for a crisis. We have a great profession so enjoy the ride!