Blind Spots in Dentistry™: Part 1 of 3:  You’re a new dentist who just bought an existing practice. Now what?

You’ve done it, bought your own, previously-established practice. You feel exhilarated, excited, and of course, more than a little nervous. After all, you’ve not only acquired debt, a building and hopefully a bunch of patients, but an existing team as well. Will they like you? Will you like them? What now?

If you find yourself in this position, here is a checklist of things you should do right away:

1. Assemble your own team of advisors – CPA, Dental Consultant, Banker, Lawyer, Dental Sales Rep, for instance. While there may already be a good team in place, you face the risk of being seen by them as an Associate rather than an Owner. It’s important to choose people who understand and agree with your philosophy and vision for your practice, as well as to get independent and unbiased advice.
2. Have a team meeting to review the philosophy of the previous practice and owner, and how your philosophy may be different. Explain your vision and where you want to go. Get feedback from team members – how do they view the practice as it is now? Questions to ask:

• • Do they have the systems and tools in place they need to not only do their job, but enjoy their job?
  • What if anything, would they like to see changed or modified?
  • Do they feel the practice is growing or stagnant, and why?
  • What personal goals do they have for the next year?

3. Review your expectations for each team member and each system in the practice, for instance:

• • What are your expectations when it comes to negotiating payments arrangements?
  • What questions/conversations do you want the clinical team to have with patients?
  • How do you want the hand-off between you and the hygiene department to look and sound?
  • How does the hand-off look like/sound when moving patients from the clinical area to the admin area to handle future appointments, as well as financial and insurance issues?
  • What questions do you want your Assistants to ask prior to onset of treatment, and upon completion of treatment?

If you have been an Associate and are now buying an existing practice, most likely you have some ideas you want to implement that you have not had the authority or approval to act on before now. Ultimately, you must decide early on what you want to see your practice look like and operate, and take steps to put that vision into place immediately.

Part 2 of 3: Blind Spots in Dentistry™ – How to lead and work with an inherited team

For the new doctor who is inheriting an existing team, open and honest dialogue is imperative. Your first priority is to meet with team members individually and encourage them to speak freely and openly about their opinion of the practice as it operated under the previous owner, and what they would like to see happen in the future. This is your opportunity to get to know them better, and find out more about them.

For instance, ask questions like:

• • Do you need help with anything, and if so, what?
  • What tasks are most comfortable for you, and why?
  • What tasks are least comfortable, and why?
  • What is the most frustrating aspect of your job and why? Can you give me examples?
  • What are the biggest distractions you encounter?
  • What aspect of dentistry would you like to learn more about?
  • What can I do to help?
  • What do you need to help you grow your role in my practice?
  • What can your team mates do to better assist you in your role?
  • How do you feel about my vision for this practice?

Allow them time to think about their answers, without rushing them. Think of this process as similar to presenting treatment and payment options. Silence does not necessarily mean ‘no’, it just means they are collecting their thoughts. Be courteous and give them time to consider the question and respond.

Once you have met with all your team members, the following are important next steps to implement:  

Lay the groundwork for handling gossip and communication issues.

Ensure you have a policy manual that has been audited and is current and up-to-date with state and federal laws.

Review job descriptions and make any modifications to adapt them to your expectations. Review the current performance evaluation used. If none exists, create one and implement it.

Establish a schedule for regular team meetings. Stick to this schedule! Leave each meeting with an Action Plan in place – who will do what, by when?

Have measures for accountability purposes to know if your hygiene team is profitable.

Generate reports that will help you understand how the team is working. (This is vital when considering bonuses and raises. It’s hard to know what and how to reward if you don’t know what you are measuring.)

Explain when and why bonuses and raises will be considered.

Discuss the number of patient contacts made and appointments scheduled each month to reactivate reluctant, overdue patients.

Discuss how you will handle cancellations and no-shows, eg:

1. How many of each on a daily basis?
2. How many are filled?
3. Who is taking and making the calls?
4. How are they putting the last-minute or re-scheduled patient into the schedule?

Make a plan for tracking how much treatment was recommended in the previous month versus how much is scheduled.

Remember, your team is as anxious for your new practice to be a success as you are. It’s your job to give them the tools, the rules and the leadership they need to make this happen.

Part 3 of 3: Blind Spots in Dentistry™ – How to transition patients in your newly-purchased dental practice

The practice is now yours, and so are the bills. Now is the time to “start out as you mean to go on.” For instance, have you:

• • Made sure your website and social media reflect your vision and philosophy?
  • Updated or created your “About the Doctor” page? Remember, the first page patients will look at and read on your website is the page about you. Make sure yours is current and well-written. Include appropriate personal information so patients have the opportunity to see you as a person, not just a dentist. Include a good and recent photo.
  • Updated your “About the Team” page, especially if they are new to the practice as well. Include good photos and short bios.
  • Considered holding an Open House, or “Get to Know Us” event?
  • Promoted any new procedures or equipment you are implementing into the practice?
  • Instructed your team to discuss, with enthusiasm, all of the above with the patient, whether on the phone or in person?

And finally, have you:

• • Made sure that you and your team are demonstrating ‘value’ at every patient visit? (This is the part that will help the most with those pesky bills.)

Demonstrating value is vital to the success of any long-term doctor-patient relationship. If a patient leaves your office thinking, “Wow, that’s a lot of money just to look around in my mouth for a few minutes!”, you clearly need to re-think how to better communicate what value you are truly providing that patient.

Here is a common scenario: At Mrs. Smith’s first appointment with Dr. Green, he and his team:

• • Perform an oral exam, including an oral cancer screening.
  • Do a caries risk assessment.
  • Provide a treatment plan, and explain the consequences of delaying or declining that treatment.
  • Provide oral hygiene instructions.
  • Take x-rays or intra-oral pictures.
  • Explained why they need to come back, if sooner or more frequently than normal.

The patient, however, leaves with walkout papers showing only a charge of $$$ for XYZ, let’s say the doctor’s exam.

If the patient does not have a visual record of the procedures that were performed, even though the service may have been included in the cost of XYZ, they have no way of placing a value on that service.

Fast forward a year or so and now Dr. Green is recommending to this same patient that they go ahead with treatment for extensive restorative work. Unfortunately, it is much harder for them to see ‘value’ in his treatment plan because he and his team have not shown them, visit by visit, what they are actually doing to protect their oral health, and why they should trust him now with significantly more expensive treatment. (Intra-oral pictures speak volumes, and should be shown to patients at every visit, especially when restorative work is recommended.)

As a new owner, you and your team need to recognize that your new patients are used to being treated in a certain way, and now the rules are changing. The tendency for a new doctor can be to overwhelm the patient with treatment recommendations before getting to know them. (Maybe the previous owner was lax in certain areas, or maybe Dr. Green’s new diagnostic equipment has uncovered something new.) Either way, it’s imperative for you not to frighten patients away with excessive and enthusiastic treatment planning. Spend time with them. Build relationships. Gain trust. Most patients will proceed with dentistry if they are not hit over the head with it. Make sure your team is on the same page, especially as patients will naturally look to Hygienists and Assistants for verification if they worked for the former doctor.

Consideration must also be given to payment options. Will there be a change in the way you expect patients to pay at the time of service, or will you continue to balance bill them after insurance, a service offered by the former doctor? (As a consultant I do not recommend this. The downside far outweighs any benefit to the practice.)

And finally, will you have the patient sign a consent form, or a declination of consent form, which basically states that they will not hold you liable for their choice not to proceed with treatment?

A well-thought out transition plan is vital if you hope to keep patients you have inherited from a previous owner active and invested in their oral health and in your practice. From their point of view, a change in ownership might be the perfect time to go elsewhere, without worrying about hurt feelings. Don’t let this happen to you. Make sure your patients know who you are, what changes, if any, you plan to make, and finally, how important they, and their oral health, are to your practice.