When Key Employees Leave It Needn’t Be Disastrous.

It seems like just when the staff is finally clicking together as a great cohesive unit someone's husband gets transferred or they get pregnant or...you name it.  Then it is back to the drawing board while we try to get someone who fits in.  Our plans have gone astray.  In a forty year career a dentist will see this as many as ten to twenty times, and some dentists never know anything else.  Clearly, it can have a devastating effect on the success or struggles we see in different practices.  There are some antidotes which can help to cushion the blow of turnover and reduce turnover.

1) Don't ever become too dependent upon a single individual regardless of her dedication and loyalty.  No matter how much you treasure her she is not the one whose name is on the line with the IRS, dental board, patients, other staff members, your family, or your creditors.  Treat her with respect and pay her value, but always know what you will do when she leaves.

2) Make certain that the practice is totally organized with its own internal protocols in key areas such as hygiene, finance, scheduling, personnel, and marketing.  These should be documented and understood by all.  If these procedures and systems are in the heads of key staff members, they walk out the door when these individuals leave.

3) Provide proper leadership and team management to allow individuals to air grievances, display superior performance, and receive appropriate kudos and rewards.  An employee should not be asked to work a single day without a written Job Description which has been discussed and signed by both employee and doctor.  Also, each and every employee should have a copy of the Employee Handbook (Practice Policies and Procedures), and the doctor should have a signed statement that it is read, understood, and will be followed.

4) An employee review is more important than a crown, bridge, root canal, etc.  Try not to sacrifice production for these reviews, but do them anyway.  The review is NOT for discussion of salary...that is another meeting.  NO salary adjustment should ever result from a review.  Reviews should be written and signed by both parties.

5) Hire carefully and fire carefully, but do both when needed.  Keeping an employee who is not working in your office is a disservice to her.  She has unique skills which should be used in the right place.  If it is a mismatch, it is the doctor's responsibility to solve it, quickly, and humanely.

6) Employees are directly responsible for your success.  They are to be treated with the dignity they deserve...without emotional tirades, without sexual intimidation and harassment, and with open communication.  However, you cannot maintain an appropriate boss to employee relationship with someone, if you are on too close a personal relationship.  Your friendships are to be found elsewhere...and definitely your romantic involvements.  (If a relationship begins in the office it will destroy the morale.  It must be ended or your practice will suffer enormous damage. Don't kid yourself.  Everyone knows.)

7) The doctor is the boss.  It is his/her responsibility to solve morale and other personnel problems.  Don't expect the employee to come to you.  Be fair and active in solving YOUR problem.  Whatever the source it is YOUR problem.

All these including Job Descriptions and Employee Handbooks can be purchased for many sources including our company (see below). It is not rocket science or brain surgery to maintain a productive and caring staff, but you must work at it.  It will not happen by itself.

The best time to prepare for future difficulties is when things are going well.  However, it is a rare individual indeed who will do so.  It’s like the leaky roof in the Snuffy Smith comic strip.  He only thinks of fixing it when it is leaking and making him uncomfortable, a time when it is too late.  I think there are parallels in the US now with such a healthy economy, but there are also parallels in our businesses.  Crises may direct our attention more pointedly, but it can be awfully hard on the blood pressure and heart.  Most crises can be avoided if we simply spend a little time anticipating their possibility and taking preventative measures. 

We get our “monsoon” rains here in Florida this time of year sort of as a lead-in to hurricane season.  Lightning shooting like fireworks with ear-splitting thunder while it rains about three inches in less than an hour.  Then it stops, the sun comes out and the sky is a beautiful blue with white puffy clouds.  This is not really the height of the tourist season because it can be pretty muggy with the combined heat and humidity, but the rain/lightning/thunder show alone is worth the trip.  I am told that this area has the highest number of people being struck by lightning per capital in the world.  Watching the show is best done from a safe place.

Have a great week,

Hurston Anderson

(813) 963-7228

PS: The Practice Management Cookbook and Protocol Series are excellent sources for reorganizing your office and for solving the dilemmas from this weeks tidbit.  Fax Amex/Visa/MC#, exp date to 813 963-5974 (Cookbook is $199.95 plus s/h, and Protocol Series {Hygiene, Financial Management, Scheduling, Team Building, and Marketing} are $199.95 each plus s/h. Order on line at our store. 

Where Has This Summer Gone?

Or going, anyway.  High school actually starts here in about a week.  What I can’t understand is, “If the school year is getting longer for these kids, how come the test grades are still far behind where they were when summer vacation was three full months some thirty or so years ago?”  My hope is that our U.S. public school system doesn’t crumble completely.  My father, mother, sister, great grandfather, and many other family members have been public school teachers.  Of all the things government does to serve the governed, it seems to me that providing excellent schooling should be the most important.  Well, after defending the shores, anyway.  This is really not a political statement, but I can’t see that we have done well federalizing the educational process because it is too far from those most concerned, the parents.  But, the genie seems to be out of the bottle, so some sort of federal action is expected by the electorate.  I think I would vote for the person who would stand up and say, “I don’t have a clue how to solve this.  Why don’t you folks back home work it out for yourselves?”  I wonder what the odds of that are?

My point is that when school starts, even if the dentist’s children have already graduated, practices seem to begin to get seriously down to business again.  We monitor quite a few practices on a weekly basis, and most have had an excellent summer, so not too much momentum seems to have been lost in dental offices in North America.  However, the focus will leave the beach, the mountains, the barbeque, and other summer diversions to return to the office.  We have five full months to go before the year ends.  It is a great time to look at your results for the first six, or even seven months soon.  Incidentally, in the year 2000, if you do not have the ability to see your production and collections by procedure and producer immediately at the end of the month, get a new computer system.  This is vital to the management of your practice, and even poorer systems have this capability.  Also, if you cannot get your overhead expenses by category and percentage within two days of the month’s end, fire the bookkeeper/accountant, or get it done on your computer with Quicken, QuickBooks, PeachTree, etc.  These are basic data elements for you, and you cannot properly plan for you practice without them. 

WHAT DO YOU LOOK FOR?

a)  What is the total production for the practice averaged by month?  Are there months which are greater or less than the average by 10% or more?  This is a problem of consistency, that indicates scheduling inefficiencies and/or  excessive cancellations/no .

b)  In your general practice, is the doctor’s production more than twice that of hygiene?  If so, you are probably losing money on hygiene and work needs to be done there.  Likely problems are either too full a pre-booked schedule for the hygienist, cancellations/no shows out of hand, or hygiene protocol in disarray.  You must have a hygiene department that produces close to a third of total production,  not only to keep from losing money but to funnel dentistry into the doctor’s schedule. 

***NOTE***

There is a natural conflict here.  Hygienists generally consider the healthy-mouth hygiene patients as their patients.  They see them regularly, they know their names, and they want to take great care of them.  Can this be bad?  Actually, it can.  In many cases, the hygiene schedule gets too full of pre-booked “good” hygiene patients to see patients who need dentistry.   Healthy mouth prophies produce for the practice less income than do new patients and soft tissue maintenance patients.  The dentist is, in effect, supporting a “Hygiene Practice” for the hygienists because overhead allocation and salaries will exceed hygiene income when accurately measured.  Admittedly, we want to see these patients because they are good sources of referrals.  However, we should never let a hygienist fill her schedule all day long with these patients.  Half is all that is allowable.  If more time is needed to treat these patients, more hygiene hours are needed.  The dentist opened a “Dental Practice” to serve all the dental needs of his/her patients, not a “Hygiene Practice” so that hygienists can just clean the healthy mouths of  THEIR patients all day long.  A hygienist can and should be able to produce $1,000 to $1,250 per day without excessive treatment or fees.  It means cancellations/no shows must be virtually eliminated and the Hygiene Department must be operating effectively from scheduling through treatment.  Almost every practice we see can increase their overall practice production by 10%, or more, simply by getting control of this area.  (There is magic in initiating incentives based upon production for hygienists.)

c)  Is your overhead total more than 60% of your production (not collections)?  If so, you are cheating the doctor of his proper portion.  Probably, it will not be possible to reduce expenses quickly, so there must be an increase in production high enough to make the percentage work.  Look first at total salaries including hygienists.  Count everything.  It should be around 20% of production (not collections).  Fudge to 23% by taking money from your pocket, if you have such a great team that your life is less stressful by keeping staff that is paid 15% over the appropriate amount.  And, if the total is too high, don’t think about who can be let go, but how can this team be molded and directed in a way to produce 5 times their cost to the practice?  You probably have great people or you wouldn’t have hired them.  Find a way for them to shine.  Contrarily, if there are personnel changes you know in your heart you must make, do this quickly, decisively, and humanely.  Too many dentists drag out the inevitable so long that everyone becomes miserable, and angry.  Nobody will ever thank you for asking them “to let their light shine elsewhere”, but it needn’t turn into some sort of distracting soap opera.  How much productivity is lost while we pussyfoot around?  Now, if you are a mean sadistic person who enjoys torturing people emotionally, go ahead and let it drag, but that will come back to haunt you, too.

d)  What was your production for the first six months.  If you double it, would you have the type of year you want, or need?  If so, keep the course steady and true and sail through the rest of the year.  If not, something has to change.  You have to change course.  Too many are just waiting around hoping for a strong tail wind.  Chances are that your chances of doing better in the last six months than you did in the first without some changes are not good.  (Huh). 

Looking at these three areas will not even consume as much time as going to Walgreens, or wherever, with the kids for school supplies, and it will be a lot more profitable. 

I am rededicating myself to staying more consistent with these Weekly Tidbits.  I have been spotty, admittedly.  This has been a very distracting summer with a lot of time and money spent to initiate a new web site with some incredible new free services for dentists, stuff not available anywhere else.  Programming is now almost two months behind, and I don’t yet like the results, but we are close.  When it is acceptable, I will dedicate an entire week to explaining how this can be helpful.  I’ve been around dentistry now for about 12 years and my wife (and partner) for twice that.  There are just some things that dentists should be able to do that are not available without a needless charge.  We plan to rectify that in a few days.  Even then we will be tweaking the site, but it will be innovative.  That I guarantee.

In the next few months the US Presidential election rhetoric will heat up intensely.  As a bit of a student of the presidency, I can’t help but notice that the residual effects of our Civil War are apparently over so far as voting for President.  9 of the first 12 US Presidents came from what became Confederate states (two Adam’s and a Van Buren and a lot of Virginians).  Then there was the War.  For more than 100 years after the War no President came from a state that had seceded.  That’s about 4 or so generations, as people lived in those days.  This year both major candidates are from formerly Confederate states.  Everyone better practice their ”y’alls” (just simply plural you).  Actually, one is from a long time New England family and the other never lived very long in the South, but they claim southern states as home.  Now, if we want to start looking for a really scary trend, count the Presidents from Ivy League schools, especially Yale and Harvard.  I would do that, but I have to talk with the web site developers some more, then take a nap.

Have a great week,

Hurston Anderson

(813) 963-7228

www.(I’m not saying until it’s better).com

PS:  Our Practice Management Cookbook (@ 249.95 plus 19.95 s/h) can help with the above analysis and provide some good recipes for solutions.  More in depth effort in hygiene, scheduling, and finance would direct you to our Protocol Series of protocols (@ 199.95 each plus s/h).   Incidentally, we now take American Express and Discover as well as MasterCard and Visa.  Just fax number, exp date, and address to 813 963-5974.  This will all be on-line soon, I am assured. Order on line at our store. 

Win, win, win.

The scarcity philosophy is based on the concept that there is only a limited supply of any particular commodity...or service.  That means if one is to win another must lose.  It has become so prevalent in our thinking that we hardly even realize that is our belief.  Yet, it is no longer true, and...in retrospect never was.

We have a real-life example from three dentists with whom we have been working. 

Dr. A.

Dr. A was in a great location in a large Midwest city but had not felt the type of growth and income increases that seemed appropriate. Truth is, he was sorta bored.  For Dr. A our task seemed to be typical for us.  That is, establish solid protocols in all areas so that the staff and doctor are functioning nearer maximum efficiency, increase production about $10,000-15,000/month by concentrating initially on the hygiene scheduling, ensure that the team is acting professionally and as a TEAM, and help build new habits so that gains are permanent.  His average had been about $40,000/month for two years running. Within a few months he was averaging more than $50,000/month.  (This increase was key to his practice valuation.)

However, we always want to know what the dream is of the dentists we assist.  Dr. A had built an incredible new home in a rural suburb where he felt that raising his family would better match his own upbringing on the farm. His dream in five years was to practice within five minutes of home instead of losing an hour and half each day driving. He wanted to spend time with his young children as they grew.

Dr. B.

Dr. B had built a nice solid, but not exceptional practice for the past thirty years in this same rural suburb.  Dr. B needed to accumulate some wealth in anticipation of retirement.  He does not like to manage, and was really ready to ease off just a bit on hours.  He wanted to move to the lake house permanently and to work in his woodworking shop.  All the children had graduated from college and married.  His problem was that the practice had  provided a good income, but there was not enough for retirement.  In fact, retirement planning had not been done.  A stock broker friend was having him buy a few stocks, but that was about all. This practice had been averaging about $35,000/mo. for the past five years, and had fallen to about $33,000/month.  His lack of enthusiasm for the business of the practice was beginning to take a toll, and Mrs. B was very concerned about their future.

Dr. B had a dream to "just spend time doing dentistry" for a few years before retiring to the lake to make duck hunting decoys.

Dr. C.

Dr. C is an aggressive young practitioner who had purchased a good, but not excellent practice in the city closer to downtown.  He comes from a family rather prominent politically in the city. He has been in practice only a few years, and the older dentist from whom he purchased the practice is still seeing patients two days. The area had been terrific in the past, but demographics were beginning to concern him, justifiably.  In addition, there was not enough room to expand in the building.  He loved the city and he and his wife are very active socially.  He was anxious for a much larger practice with higher income to match his social position, but couldn't see how to do it under his circumstances.  This practice had never exceeded $30,000/month since it's inception.  It was not growing, and he was struggling to maintain that level.

His dream was to own and manage a million dollar practice...a showplace in the booming part of the city where all his friends would feel comfortable.

..................................................................................................…………...........................................

It is now fourteen months later and they are all experiencing their dreams from a single transaction.  There are two practices instead of three.  In general, Dr. C purchased Dr. B's practice and traded it to Dr. A for his practice (tax reasons).

Dr. A has just completed a huge new building that is just three long blocks from his home.  He's coaching his daughter's soccer team.  Dr. B works in the new facility as an associate treating his patients without the need to manage.  We have his retirement well in hand, so Mrs. B is contented.

Dr. B's retirement plan includes monthly rental income from the original building, monthly practice sale income from Dr. C, and 40% of his production while working in the new location.  Their third month together Dr. A and Dr. B  exceeded $100,000 in the new location.  Dr. B made more as an associate last month than he had ever made as a practice owner in a single month.  The new location and all the marketing (professional, subtle) has dramatically increased new patient flow.  He is expecting to retire within two years without reducing his lifestyle at all....three years early.

Dr. C merged into the location and acquired the growing practice from Dr. A.  He just opened an additional three treatment rooms by expanding into the space next door.  In March his production was $75,000 and growing.  He seems destined to exceed his million dollar goal this year.

Summary.

Three practices (Dr A -$40,000, Dr. B-$33,000, Dr. C-$28,000) became two (Dr. A/Dr B-$100,000 and Dr. C-$75,000)  and the result was an increase of 75% in monthly production (collections are at 98% in both).  There were no broker fees, no rancor, and no complicated negotiations (each practice was evaluated at half production plus appraised value of equipment).  We did use a tax attorney for the transaction.

These are not typical results maybe, but it isn't really all that difficult either. The Dr. A/Dr. B practice produces 30% in hygiene, 30% by Dr. B (3.5 days)  and 40% by Dr. A.  The Dr. C practice produces 32% by hygiene, 12% by the older dentist (2 days), and 54% by Dr. C himself.

These practices are well-organized with motivated teams, but the expansions and excitement of the changes were also essential.  Each office is shining new with the latest of everything.  There was some debt required, but it is many times surpassed by the increases in each practice. In fact, the entire debt will be eliminated in eighteen months.  In this case it is a WIN-WIN-WIN.

When we are beginning to think everything is hopeless we often need to step back and be creative...maybe, bounce some ideas off an expert or knowledgeable friend.  Not one of the above dentists would have believed that they would be where they are today, and without the right mixture of elements they  would all still be just "dreaming the seemingly impossible dream". Instead, they are now living their dreams.

I hope your weather is as good as ours right now.  

Have a great weekend, and week.

Hurston Anderson

(813) 963-7228

PS:  Our Practice Management Cookbook  is a reference manual for handling day to day operational challenges in dental offices..  It is available for $249.95 plus 19.95 shipping/handling.  Also available are the workbooks in our Protocol Series on hygiene, scheduling, finance, team creation/retention, and marketing in dentistry.  Each is 199.95 plus s/h.   FAX Visa/MC/AmEx/Disc#, exp date, and address to 813 963-5974, call, or email to order.  It is probably not a good idea to email cc information, however. We’ll call you for the cc#, if you will give us your phone # by email. Order on line at our store. 

Why Have We Americans Forgotten George Washington?

We in the US will be celebrating our Independence Day this next Tuesday on the Fourth.  It is ironic, actually.  July 2^nd should have been the day for ratification of the Declaration of Independence, but some stalling due to political intrigue, procrastination, and even possible carousing delayed the signing for two days.  John Adams, 2^nd President, predicted that July 2^nd would be the greatest most festive of all holidays for centuries throughout a land that would ultimately stretch from sea to sea.  Right he was, and wrong he was. 

I exaggerate somewhat in the title about Washington.  He still shares a holiday with Lincoln, always celebrated on a Monday so that we can have a three day weekend.  But, it seems to be “politically correct” to debunk the stories and hero worshipping that was so prevalent in the past concerning the Father of His Country.  Among the cries that “everyone does it” of the past few years, even unproved allegations against Washington were trotted out again.  Washington, the man, will not suffer.  He was never one for excess fanfare, anyway.  The man who was urged to become the first King of America was so incensed at the notion that he reacted with anger.   No, the country suffers and every small child who grows up hearing that George Washington did not really chop down the cherry tree and fess up, nor throw a dollar across the Potomac, nor show great military prowess, nor honor his marriage vows.  Do we really make ourselves bigger by bringing down the “giants” of the past.  Was the American Revolution really a grab for economic gain by greedy opportunists?  Choose your historian, but choose well.

George Washington was nothing less than the key to the success of the Revolution.  In addition, he was by all accounts a poster child for poor dental home care.  His teeth were so bad even as a young man he is never  shown smiling with his mouth open.  Somehow, that has probably contributed to the impression that he was somewhat somber which is completely contrary to the facts.  Washington was extremely warm with his fellow Colonialists both civilian and military unless agitated when he could light up the room or field of battle with a string of profanities that were unparalleled in the times.  At about 6’2” in height he was a mountain of a man for the times.  If you have ever toured his home in Virginia, Mount Vernon, it is amazing that he could even get around inside.  It is rather small by today’s standards, but people were smaller then.  No wonder he liked the outdoors so much.. 

Here was a man who persisted and persevered, but who was a sponge for new ideas and advise.  Our entire government is a result of his presidency of the Constitutional Convention and his personal creation of the Executive Branch as the first President of the US.  To some extent the American Revolution to Great Britain became what the Vietnam War was to the US some two hundred years later.  Then, when Washington was able to deliver a small non-defeat against the British for Benjamin Franklin to use as proof of American potential, the French monarch decided to become more active.  There is strong evidence that the King Louis XVI’s financial support of the American Revolution brought on the economic crisis that ultimately led to his beheading.  But, certainly the French entry into the war raised the stakes very high for the British who now had to protect their more lucrative holdings in the West Indies and defend their own homeland.  So, Washington’s victory at Yorktown, Va. was the only real American victory in the entire 8 years of insurrection, and this one only due to the French Fleet blocking the port.  Be this as it may, claiming this proves Washington’s ineptitude as a military leader ignores the fact that the small ragtag army should have been easily annihilated many times for 8 years. 

Leadership is not always about how big or how financially successful the enterprise becomes.  Sometimes, simply staying afloat is an example of tremendous hard work and leadership.  How would Washington have fared had he been a General in modern times (with a big toothy smile like Jimmy Carter, maybe)?  Dentists sometimes become discouraged because the struggle seems so difficult day in and day out with staff difficulties, low case acceptance, and financial stress.  Amazingly, these same dentists may be highly successful given a new environment.  So often, a dental practice operates in a manner almost as archaic as Washington’s America compared to today.  Internal systems need revamping, staff needs unifying, and everyone needs a paradigm change.

The limitations on the practice may not be the doctor and his/her leadership but out-dated operational procedures and protocols.  The greatest oarsman cannot win a race in an old leaky canoes.  At lot of success is the leadership, but part of that leadership may be taking action to change things.

Have a great Independence Day in the US,

Hurston Anderson

813 963-7228

PS:  Our Practice Management Cookbook  is a reference manual for handling day to day operational challenges in dental offices..  It is available for $249.95 plus 19.95 shipping/handling.  Also available are the workbooks in our Protocol Series on hygiene, scheduling, finance, team creation/retention, and marketing in dentistry.  Each is 199.95 plus s/h.   FAX Visa/MC#, exp date, and address to 813 963-5974, call, or email to order.  It is probably not a good idea to email cc information, however. We’ll call you for the cc#, if you will give us your phone # by email.

Dentistry in Moscow.

There’s something unique about the nightlife in Moscow.  A sort of desperation to be  the same as the west.  I liked it. Even with the gangsters who seem to have all decided their characterization from old movies of the Chicago Mob.  It is raw, and yet it is real.  Russia is an emerging economy.  Will it join the Free World today?  I don’t think so.  Probably, Putin will take Russia back to her roots for awhile in order to bring her into the 21^st century, or maybe he is just another opportunist, like so many before him.  I love Russia with it obsession with chess, it interminable gab fest lasting into the morning, and its melancholia.  These are real people who need only a spark of genius to join our world.  I understand Russia now has an economy equal to that of Illinois.  What a shame, because the have the natural resources to best us all.  I get amused when I hear Communism defended as a great place to send a young orphan.  Communism destroyed a great nation.  It has no redeeming characteristics, yet we seem to be enamored by its philosophies.  I was also in this group.  Never a Communist, but a believer in the basic philosophy of fairness.  Thomas Jefferson stated that Democracy is a horrible form of government, almost impossible to maintain, but so superior to others, that there is no close second.

I do not know how to bring my beloved Russian friends into our world, but I insist that we never romanticize the charlatanism that distracted the wonderful people for almost 75 years.  They may actually be more educated than we, but education is no substitution for common sense.  It is too bad that every human born is not good by nature, but basic religious training including Christian, Jewish, and Islamic warns us otherwise.  We lucked into our circumstances.  We must defend it with our lives.

How does this relate to dentistry.  Only, that dentists in capitalists countries are well-paid and well-respected, while dentists in socialists countries are merely a part of the oligarchic whole.  Do you really think your training and skill are equal to that of a ditch digger. Move to Cuba or North Korea or China, and you will discover the truth of capitalism.  Man should have been created equal, but he was not.  Why can’t I dunk the basketball? Why can’t I hold the note that Luciano Pavarotti can hold?  We are different, and God (of natural selection if you need this for your psyche) meant it this way.  We are fortunate in this country of freedom.  Never take it for granted.  When you mismanage your dental practice you might as well be in the USSR.  It is not necessary, and it wastes resources.  May we help?  Order on line at our store. 

TEAM (Together Everyone Accomplishes More)

From my office window I watched a drama unfold this morning that shows the strength of teamwork to overcome superior odds.  There is a Mockingbird nest in the chimney of the house next door.  I had noticed two adult Mockingbirds feeding the nestlings for several days.  In fact, the Mockingbirds had discovered my tomatoes and claimed several ripe ones as their meal of choice.  I had even surrendered a few to them hoping to protect the rest.  While fried green tomatoes may be a delicacy in some parts of the South, I can personally attest to the fact that Mockingbirds like theirs only after they are nearly ripe.

This morning my attention was drawn to the window at the sound of a crow’s distinctive call.  It seems Mr. Crow had decided to invade this Mockingbird families’ tranquility. He was edging his way up the eave toward the chimney and the young Mockingbird family.  My suspicion, and that of the adult Mockingbirds, was that Mr. Crow had foul play in mind.  Almost immediately, the two adult Mockingbirds began dive bombing the crow, but he edged closer and closer.  Suddenly, out of nowhere a third Mockingbird flew toward him.  He retreated a few feet, but did not leave the roof.   The three Mockingbirds kept up their continuous diving missions.  It was methodical in that when one finished another buzzed the huge crow.  The crow began flapping his wings and complaining, but they kept up their defensive activities.  Then the bigger bird started inching again up the eave toward the nest.  From nowhere again there appeared a fourth Mockingbird.  Now, they had two defenders high near the nest and one on either side all intermittently diving toward the invader delivering small pecks as they flew by.  Mr. Crow is not easily dissuaded, though.  He stood his ground, and once more began the slow assault.  A fifth Mockingbird joined the team.  I was tempted to go assist, but I’m glad I didn’t.

It took the sixth Mockingbird joining in the attack to finally drive the crow away.  Five escorted the enemy out of my view toward a clump of trees, and one stayed near the nest.  Eventually, a second Mockingbird returned to the area near the nest.  I suspect these are the parents, but I cannot really tell them apart.  During this entire episode there was one Mockingbird who was the most active.  Each time he flew closer and closer always returning to the highest perch near the nest.  He was diving twice to three times as often as the others.  No doubt the crow which was many times larger could have harmed him, but he was relentless and fearless.

A dentist can be the best clinician ever and the best administrator ever, but if he/she is surrounded by employees who are simply staffers (don’t like that word) doing the least they can to get by, the practice will not prosper.  It takes a team to create a successful dental practice.  I know the word team is getting a bit overused, but I persist because it is so effective symbolically.  Sure, a team and an office staff are about the same thing, but a true leader should be part of the team not just the boss of the staff.  This is particularly important in dentistry where the team leader is busy all day long performing his/her technical duties while the rest of the team must work without supervision. 

Team chemistry is important, and that means that a lot of thought must go into the personality traits of the existing team members when a new employee is brought into the group.  Several things should be done.  First, use a personality profiling test with existing team members to discover who everyone is, personality wise.  Then, use this for prospective new hires to make sure they will complement the team.  For instance, if a person is a strong, even domineering person and also negative, they can destroy the entire team, all alone.  Do not hire this person!!  If you already married her, send her home.  A positive domineering personality can be okay, or a negative personality that is more meek can be overcome.  If everyone is a talker, nothing will get done.  If there isn’t a detail personality involved, the Day Sheets may never balance, and other administrative requirements may be overlooked.  Every new employee should meet the existing team at lunch or another comfortable setting before beginning work.  A working interview may solve this.  And, everyone should be on a 90-day probation for the sake of the team as well as the person.

Remember always that we are on the same  team.  Too often, in our haste we forget to treat other team members as we would want to be treated.  This hampers the entire team.  If you were playing doubles in tennis, you would not want to whack your partner’s knees with your racket before the next serve.  Berating, belittling, or otherwise abusing employees serves about the same purpose.  Certainly, the patient is important, but we can intensely concentrate on patients without mistreating our teammates.  It is not an either/or issue.

Keys to Retaining Staff

1.Mutual respect and trust

2.Personal interest in fellow teammates (professional only, not too personal)

3.Regular evaluations where salary is not discussed

4.Fair salary based upon accomplishments

5.Match personalities to jobs and TEAM

6.Reprimand, if necessary, privately, swiftly and allowing personal dignity to TEAM member

7.Do not overstaff

8.Reward for excellence not mediocrity

9. Don’t do stupid stuff, and we all really know what is stupid.

I just looked out and there are two Mockingbirds back atop the chimney next door.  One is fluffing his feathers and looks as if his chest has expanded twice its normal size.  From my angle he is at the highest point possible with a beautiful blue sky and white fluffy clouds in the background.  There can be no doubt who this proud Mockingbird is.  He is the father, and no better example can be seen of fatherhood.  I have too many tomatoes anyway, dad, go ahead and feed your kids.

Happy Father’s Day in the US.  Sometimes it seems the most thankless and frustrating job there is, but sometimes we get to sit on top of the world with our chest heaved out in pride.  All in all, the good far outweighs the bad.  I miss my dad every day in some way or the other.  Spend as much quality time with yours as possible while you can.

Have a great week,

Hurston Anderson

813 963-7228

PS:  I will be in Mobile this next few days speaking at the Alabama Dental Association meeting on the business of dentistry.  If I have gotten a bit behind in correspondence, please forgive me.

Our Practice Management Cookbook  contains an enormous section on team creation and retention.  It is available for $249.95 plus 19.95 shipping/handling.  Also available are the workbooks in our Protocol Series on hygiene, scheduling, finance, team creation/retention, and marketing in dentistry.  Each is 199.95 plus s/h.  We have not made the last two available yet because there is still a good deal of editing to do on the manuscripts.  If interested, email and I will make sure you get one from the original printing. FAX Visa/MC#, exp date, and address to 813 963-5974, call, or email to order.  It is probably not a good idea to email cc information, however. We’ll call you for the cc#, if you will give us your phone #. Order on line at our store. 

Two Periodontists, an Endodontist, Four General Dentists, and an Oral Surgeon

I spent most of this past week in the offices of our clients listed in the title who are all located in one of the most gorgeous parts of the US – the Great Smoky Mountains and nearby areas.  The truth is I am not sure where the Smokies begin and end exactly.  The whole area is mountainous, or at least hilly, at least to me having grown up around Dallas where it is so flat that rivers and creeks sometimes are confused about which direction to flow.

We are indeed fortunate to have a number of terrific clients in the area and a great location for our office there in Asheville, NC.  If you want to drive through some of the Creator’s most beautiful landscapes, fish rather than just wet the bait, golf beautiful courses in magnificent settings, take a great picture every time you point the camera, enjoy top-notch family entertainment, hike through magnificent trees and beside pristine streams and lakes, eat well from Continental cuisine to Lancaster-style barbecue, shop in so many stores and outlet malls you wouldn’t believe it, and much more, this area cannot be beaten.  Next time, I’ll try to take a lot more extra time because we had a pretty busy schedule this time.  Here in a part of Florida which is a very attractive tourist destination and part-year residence for North American and European “snow birds” we are often asked where in the world Floridians go on vacation.  Take a visit to the area about where the Georgia, South Carolina, and North Carolina borders meet, just east southeast of Asheville.  In that area, say around Highlands or Cashiers, during the months of July and August when it is a bit muggy and hot in Florida you’ll see more Florida license plates on cars than local ones.  Beautiful area, but not my main subject, actually.

I go into our clients’ offices usually for a specific purpose associated with some sort of transition rather than day to day coaching and advising.  That is done more than adequately by our Partners and Associates who all have many, many years experience working in dental offices each in both clinical and administrative positions.  It is our believe that advisors to staff members should have more than theoretical knowledge of the work being done.  How can you honestly advise someone about scheduling, or whatever if you haven’t done it yourself?  A good sound theoretical basis is essential for any type or education, but practical experience is also essential.  My undergraduate degree is split between theoretical math and accounting.  Graduate degrees are in linguistics and international business. During all these eight plus years the best instruction came from those who had or were still practicing their discipline.  For instance, my Statistics and Probability professor had been a professional gambler in Las Vegas, a card counter who had been banned from several casinos.  When he talked about the probability of certain things happening he spoke with experienced passion. 

Sometimes, staff members feel that the doctor does not understand the problems of their job, and sometimes they are absolutely correct.  Management is always best done by a manager who has been successful at the discipline he/she is managing.  As a former Sales Manager, I can assure you that telling a salesman how to close a sale when you haven’t done so yourself is wasted breath.  No matter how many books, seminars, courses, role playing sessions, etc. you have experienced, that is still theory.  In sales there is no substitute for the feeling of losing a commission and the emotional rejection you experience when being told “NO!”.  One very good Salesman I managed years ago described selling as asking 100 women each of whom you love dearly at the time to marry you and being rejected by the first 99.  To succeed, he said, is to be able to ask the 100^th with enthusiasm and expectation.

Certainly, theory is essential or you don’t have the requisite knowledge to do the job, but some practical experience rounds out the skill set.  I have heard many who have been through dental school describe instructors who could not successfully be in private practice but who were excellent at clinical instruction.  This instructor has probably found his/her perfect fit in the profession, and he/she is an essential cog in the overall dental industry.  However, I would not want to see Practice Management 101 taught by the same Instructor.

I suggest that a dentist who wants to communicate effectively with his/her entire staff should spend enough time with them and their jobs that he is able to speak from some level of experience about their daily activities.  This is an easy task with the clinical staff, of course, but it is a bit more difficult with the administrative staff.  Typically, and logically, the doctor spends almost all of his/her day in patient treatment not in scheduling, collecting, filing insurance, daily closing, etc.  Understanding and managing these activities with authority is easiest, if you are able to relate not only to the theoretical functions but the emotional realities. 

For instance, the best and most effective scheduling is done to an Ideal Schedule created by the doctor or hygienists and discussed in detail with the persons responsible to see that the schedule is filled in an ideal manner.  Yet, there is still a lot more to the job of scheduling than simply understanding which and how many procedures we would like to schedule at a particular time of the day.  Scheduling Mrs. Jones, a very important patient who volunteers at the church every morning and meets with her bridge club for lunch Tuesdays and Thursdays, next Tuesday morning at 9 am for an intricate procedure the doctor prefers to perform only in the mornings is not assisted by theoretical discussions of how important it is to keep to protect the doctor’s Ideal Schedule.  This is a time for some practical experience.  Yet, it is seldom even as clear cut as this example.  Mrs. Jones may be someone for whom the doctor will make an exception gladly, but what about other examples which are less obvious? 

Most dentists cannot have extensive experience in all the jobs in their offices, but they can spend enough time communicating with staff members about their jobs to feel the emotion as well as understand the theory.  This may mean that it is necessary to spend an entire day simply checking hygiene patients and sitting side by side with the administrative staff.  She will be uncomfortable if you listen in while she is trying to communicate with Mrs. Jones, or collect from the insurance companies, or call to fill the hygiene schedule, or collect from patients at the counter, or any number of other activities.  However, the dentist will get a better understanding of the dynamics of the job…as well as, an added respect for the people performing the jobs.

As good an experience as this is though, it can be rather expensive and somewhat limited because the dentist can never really get the feeling for how things are done when he/she is in the back with patients.  The atmosphere in the front changes automatically when the doctor is there, so even my above suggestion will have only limited success.  Hiring experienced, well-recommended and vetted staff members is one approach.  Even though their experience may not be in exactly the same personality of practice it will help tremendously.  There are times when this is difficult or impossible, and you have to bring in an employee with potential but little or no experience.  The only approach is to fill them with as much theoretical knowledge as possible and hope they are good at learning on the job.  In truth, this is how a vast number of dental offices in the world operate.  Obviously, it can and does work, but when the doctor/manager has good two-way communication with his staff and truly empathizes with their difficulties, he/she can better understand how to assist them in their difficulties.  Even if a lot of his/her help is still really theoretical, two heads are better than one.

There is no doubt that some employees when confronted with failures or miscues will make excuses which imply that you really don’t understand their problems.  But, you learn pretty quickly who is a complainer and excuse maker and who is not.  Try not to treat every defense by employees as a self-serving excuse.  There are many, many things to know and experience in each and every job in a dental office.  Certainly, the theoretical objectives must be met, but they can only be met by applying practical solutions.

I began thinking about theory versus practical experience on the plane back to Tampa yesterday.  The fact is that it happens to me.  In a typical week I will see production, collection, and expenses numbers from dozens of dental practices throughout the world.  They are mainly from North America, of course, because that is where our offices are, and all the data from all our offices funnels to me  ultimately.  We have developed our theories from all these data as well as the practical experience of all our Partners and Associates who are actually in offices every day.  Further, we apply our practical knowledge, educations, and experiences in other industries.  With all this data available though, there is still the need to go out to the offices and sit in with the doctors and their staffs as they solve real problems.  For instance, I know without a doubt that $1,000/day production by a hygienist is not impossible regardless of the protestations I hear.  There are just too many examples in our data from throughout North America for me to be dissuaded.  However, sitting with hygienists and administrative staff as they attempt to accomplish the task I know to be possible is an altogether different experience.  I have a great deal of knowledge about consultants and speakers in dentistry, and I know too many of them no longer practice their professions whether that be dentistry or business management.  I think this makes their messages somewhat tainted.  It does not take long to lose the emotion of the office even though you may still remember the most of the facts and theories.

A lot of folks seem to be giving Shaq and the Lakers the pro championship in basketball by default almost it seems, and they are certainly extremely good, but Portland plays a style that could be very difficult for them.  Plus, both Miami and New York are very great.  This next few weeks could be very entertaining, if you like to see gigantic sweaty men running back and forth every twenty seconds poking a rubber ball in a metal hole.  Ah! Professional sports, ya gotta luv it, the actions of super-humans doing things that have little or no practical use in society for outrageous amounts of money.  We are indeed a blessed society.

Have a great week,

Hurston Anderson

813 963-7228

PS: WiseDentist.com is coming soon.  It will be a free source for dentists on more subjects than you will believe.  Programmers are still working, and billing.  They tell me mid-June, so that I can announce at the Alabama Dental Association meeting in Mobile, but programmers sometimes are a bit optimistic.  I’ll keep you informed.

Our practice management consultants travel throughout North America applying practical knowledge and sound theory to dental offices with extensive hands-on assistance by those who have been there themselves.  Call for info.

Practice Management Cookbook  is $249.95 plus s/h 19.95.  Protocol Series workbooks can help keep your office organized for your sanity and your patient's comfort. The series includes Hygiene, Scheduling, and Finance now with Team Building and Marketing released soon.  They are $199.95 each plus s/h.  Fax Visa/MC#, exp. date, and address to 813 963-5974.

Free Practice Production Potential Analysis and Practice Evaluation by email.  Email for form, if interested. Order on line at our store. 

Analyzing a great practice.

As you probably remember we offer a free evaluation of the production potential and overall performance by email.  We supply a form which is completed and emailed back to us.  Then we input the data into a computer model which contains a data base collected from hundreds of practices throughout North America.  We then report by email the optimum potential and the practice’s progress toward that potential, and we offer suggestions of how reach closer to potential (if possible).  It has been an interesting exercise which we will continue for a bit longer, if you are interested.   Hundreds have availed themselves so far, and be assured there are no strings attached.

I thought it might be interesting to include a typical response to a good practice which was delivered this past week.  Certainly, the name, location, etc. are confidential as is always the case, but it could be anywhere north to south, east to west.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Dear Dr.  B,

Obviously, yours is a really nice practice.  So, although there will be suggests for doing better, we do not want to appear too critical.  You can take great pride in your accomplishments in this practice.

Our analysis does several things.  It estimates a maximum production from your facility based on information you have supplied, and it then compares your present production to optimum.  Additionally, we will  suggest how we think you might reach closer (if      possible) to maximum potential.

Under existing staffing and facility space your practice has a maximum sustainable potential of $127,000 per month.  At the present level of $60,775 per month you are producing at about 48% of optimum potential.  We really want to see practices at 60% to 80% of potential.

In addition it is better for your dental office's financial health if overall overhead does not exceed 60% with 40%+ left for doctor's portion.  20% of production can be allowed for salaries, etc. for all staff members including hygiene.  It appears likely that your salaries are from 26%-28% of production.  This is a little high, of course.

The ratio of hygiene to doctor income is good at about 1 to 3, but the hygiene production for 312 hours per month is only $63.30 per hour.  That means the total per hygiene day is less than $500.  Hygiene compensation should not exceed (or fall below) 33% of her production.  That means your hygienists cannot cost you more than $167/day or you are paying out of your own pocket.  Preferably, your hygienist would produce $1,000-$1,250 per day with income of $333- $375 per month.  In your case this would almost double
hygiene production to about $39,000 per month while producing some very big grins on hygienists' faces.  Overall practice income would shoot to about $80,000 per month with not a single additional dollar being produced by you. The reality is that you will increase your production as well, however.

How do you increase production in a hectic office without increasing stress?  First, you analyze the reasons for the stress.  Is it the period while the doctor and hygienists are actually performing clinical procedures or during other parts of the day?  It is highly probable that you would say that non-clinical distractions like cancellations, no shows, scheduling miscues, etc.  are the greatest drain on energy in your office like in most others.  The key is to schedule more scientifically and to eliminate cancellations and no shows.  This is verifiably possible in all practices, but it will require new paradigms and new habits.

The precise technique for scheduling in a practice differs based upon the demographics, staff personalities, doctor's personality, and practice philosophy.  One size does not fit all, but there is a special size that will work for each.

I would like to see your practice set a new goal to reach 60% of potential in 2000.  This means a monthly production of $76,200 or about $4,500 per day.  Salaries would then be about right, too.  At least $1,500 must come from better scheduling and reducing cancellations/no shows in hygiene.  Actually, this still assumes your personal production will increase by about $10,000 per month.  That can be done during a four day week because added hygiene especially with new patients produces higher per hour doctor
production.  This also assumes working on your personal schedule and cancellation./no show situation.

In 2001, you should expect to exceed $1,000,000, and go from there, if you want.  Assuming all this growth there will be a critical strain on your internal systems, procedures, and protocols, so you should expect to rework all protocols.

Frankly, it may require some outside assistance to reach these new levels (especially to change paradigms and habits) smoothly, but it is possible to reach even 80% of potential, as many offices have, and maintain that.  In your case that would be an annual production of $1,219,200.  Doctor's portion at 40% would total an income of $487,680.  That would cause some personal tax problems, but those are problems anyone can endure. 

This can be, and is being done, in all geographic areas of North America.  We have seen it too many times to say otherwise.  Certainly, the journey may have a few bumps along the way, but probably no more than you already experience, and the dentistry does not suffer, but improve.  With additional funds for equipment, supplies, and material, as well as continuing education the quality should increase.

Once more, you have built an exceptional practice, but do not feel that you have max-ed your potential.  Your practice has even greater potential. 

Let me know if you have further questions or comments.

Have a great day,

Hurston Anderson

Original data from Dr. B

Age of practice (10 years)

Years under present management (How long have you been there?)  (10 years)
Type of dental practice (eg. general, periodontics, etc.) (general)
# of active patients of record  (have been treated at least once in the past 2 years) (2000+)
# of new fee for service (including insured) patients per month (average last 6 months) (30)
# of new HMO/PPO/Medicaid/Medicare/etc. patients per month (average last 6 mos.) (10)
# of Hygienist hours available per month (312)
# of Hygienist Assistant hours available per month (0)
# of Dentist hours available per month (135)
# of Dental Assistant hours available per month (270)

# of Administrative hours available per month (270)

# of fully equipped Treatment Rooms available at all times (2 extra)

% of practice that is fee for service (including insured) (100%)
Average Total Production per month for last year (or as long as possible) ($60,775)
Average Hygiene Production per month for last year (or as long as possible) ($19,750)
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

I will be in our office in Asheville next week, but receiving messages from our primary number should anyone wish to reach me.

Well, the Aggie (my nineteen year old son at Texas A&M) is going to struggle through his freshman year, barely, it appears. As he comes to Tampa for a few weeks next weekend, I think he returns with a bit more humility than he had as a senior in high school this time last year.  Also, I think his sudden interest in taking a couple of summer courses are more an interest in making amends for a bit of excessive leisure and low GPA than burning intellectual curiosity.  College has changed his attitude a little toward study and leisure I think, and fortunately not too late.  I remember through the mist of time the sobering effect of realizing that there were a lot of people out there who are a lot smarter than I.  That may be one of the best lessons we learned in our first year of college. 

It’s beginning to get the high humidity muggy feeling here in Tampa Bay.  This has not, however, led to our horizontal summer rains yet, so the drought and water rationing continue.

Have a great week,

Hurston

813 963-7228

PS: Practice Management Cookbook  is $249.95 plus s/h 19.95.  Protocol Series workbooks can help keep your office organized for your sanity and your patient's comfort. The series includes Hygiene, Scheduling, and Finance now with Team Building and Marketing released soon.  They are $199.95 each plus s/h.  Fax Visa/MC#, exp. date, and address to 813 963-5974.

Free Practice Production Potential Analysis and Practice Evaluation by email.  Email for form, if interested. Order on line at our store. 

Take This Job And Shove It...OOPS!, I Own The Company.

For most of us there are some days when we are less enthusiastic about our businesses than others.   In fact, sometimes it lasts more than just a day.   This ennui can last a week, or a month, or even several months.  When this goes on for an extended time it is a dangerous time for the CEO of a small business like a dental practice just as it is for the CEO of a major Fortune 500 corporation.  

In a large corporation with many ambitious and capable individuals available there is always a bit of a "love-hate" relationship among the CEO
and his/her immediate reports (usually VP's, some capable of replacing him/her) anyway.  Visualize a shark tank with one shark just slightly
larger than dozens of others all swimming in circles close together.  The leader is constantly being watched by the others for weakness, and the
leader is cautiously eyeing his loyal teammates for tests to his leadership.  When the CEO in a publicly traded corporation is strong and
vibrant the VP's are loyal and appropriately supportive, but when the CEO appears weakened it threatens the organization, the stockholders, and all employees' livelihoods.  This is when the "sharks" begin to circle the wounded CEO.  As heartless as this sounds, it must be this way because a major corporation must be effectively led to succeed. The families of thousands of employees depend upon the success of the organization which can be swamped by competition in a capitalistic society if it begins to falter.  Obviously, when the CEO controls the stock he/she can survive a Putsch, but his/her ennui will cause the organization to weaken and possibly even fail.  Recently, I read that of the top 100 U.S. corporations in the year 1900, only one remains as a viable independent entity one hundred years later.

There is a different dynamic in a smaller organization like a dental practice (or consulting firm), but some of the same pressures exist.  This
owner/manager may not be surrounded by subordinates who are capable of replacing him/her, but a diminished CEO will see his/her business begin to falter.  Certainly, a dental practice needs the dentist to lead.  Leadership by any other person becomes a problem.  Very often we are called into an office where the dentist has lost leadership to a strong-willed office manager or other employee.  Too many bad things can happen in this situation including embezzlement, marital infidelity, high turnover, vulnerability to virtual blackmail by the employee, etc.  It is true that
there are some practices where the spouse or a close relative provides more leadership than does the dentist, but even this is a difficult situation
because it diminishes the authority of the dentist and depends too heavily on the relationship between the dentist and spouse/relative.  As we all
know, mixing our business and personal relationships is tricky.  My wife and I work together in our consulting business rather well, I think, but it
does take a toll on our personal life.  Even though we have clearly delineated functions, we clash from time to time.  Also, we tend to wander
quite frequently into business discussions night and day, weekends, holidays, and vacations.  Our clients, Partners, and Associates can better
answer whether it affects our business life.  I believe that in our case the positives outweigh the negatives, but not all relationships can survive
a twenty-four hour togetherness, and frankly we travel apart a good deal of the time, too.   Also, of course there is a difference between our business and a dental practice.

What can we do when we just develop a case of the donwanna's?  Any number of things can bring this on including physical and mental. impairments, relationship issues, financial strain, mid-life doubts, and fatigue.  No matter, the employees must be managed, the patients must be treated, and the bills must be paid.  So, what is a dentist to do when he/she just wants to be somewhere else, but can't?

#1. Face the issue.  It is so easy to let things slide and simply go through the motions day in and day out.  That is going to solve nothing. 
One or two days of lackluster performance will not destroy the practice, just the week.  When it stretches into a longer time some action must be
taken.  Usually, you can detect this in dental offices by a slippage in production and collections, a reduction in new patient flow, and/or too
many reworks and cancellations/no shows.  When things start to go the wrong direction it is time to discover the problem.  Quite often it is not just the leader's  mood and performance, but sometimes it is.

#2. You can't soar with the eagles if you surround yourself with turkeys (sparrows).  The best antidote to a down day is a positive team.  All jobs
in dentistry are hectic, but the dentist must produce and lead.  If the dentist is surrounded by positive, hard-working staff, he/she will
inevitably catch the positive fever.  Avoid those who tend to mope around themselves, constantly.  Misery feeds on misery and grows.  Certainly, the leader's attitude is the prevailing attitude, but smiling faces tend to smother frowns.

#3.  Make sure that internal operational procedures are sound.  When the dentist is not at his/her best it is usually the management and staff
relation area that suffers most.  We all force ourselves to present our most positive face to our patients/clients.  It is our involvement with
others in our office that suffers.  When each person clearly understands her responsibilities, when there is an all inclusive written protocol for
all major areas in the office, when there are few daily decisions that must be made by the dentist, and when there are no overlapping areas of
responsibility the practice can hum along for days without the dentist being at his/her best.  Leadership in this case is not ceded to another
person but to the SYSTEM which all understand and can follow without supervision.  Some practices can overcome rather long periods of a
leadership vacuum simply because the office operates like a well-oiled machine.

#4. Take personal action.  Every single successful person I know spends some time reading, attending, or listening to others whose message is
inspirational.  I can just imagine a good number of you saying to yourself, "Oh no, not another rah-rah Zig Ziglar advocate!"  Yes, and no.  A normal day for most people is to surround themselves with negative input.  At home there are personal relationship issues, children with their problems, demands on our time, etc.  Then we get in the car to go to the office and face angry commuters while listening to negative radio personalities and songs.  All day long we deal with problems at the office, and then drive home while listening to more negative radio.  Just in time to watch Tom Brokaw or Peter Jennings tell us about all the problems in the world today.   The question isn't, "Why is there so much depression in the world?", but "Why isn't everyone depressed?".  Somewhere along the line we have to find positive stimuli to counter all this negativity simply to break even.   There are times when the things in our lives are more positive than negative and we're just fine, but sometimes we get inundated by the negativity, and need an uplift.  My dad had a habit of reading the Bible each night before bed and getting up early each morning and reading a chapter or two of Zane Grey or Louis L'Amour each morning.  That would not work for everyone, but it is best to end your day and begin your day with positive input.  That could be calming music, poetry, inspirational novels, special time with loved ones, sitting on the pier with a fishing pole in your hand, walking on the beach or in the woods, or listening to tapes by Anthony Robbins or Zig Ziglar or Stephen Covey or your choice.  I can assure you, though, if you go to bed watching Howard Stern and wake up listening to Don Imus you will not be adding a lot of positive input to your life.

#5.  Go to a seminar or hire someone to come in to bolster your leadership.   If all you need is shock treatment to jar you back, then a good positive seminar with a positive message can be effective.  In that case the purpose is to change a negative paradigm.   However, if you have slipped for some time and the practice is beginning to suffer, it may be necessary to hire an outside person or persons to come into the practice to change the overall mood.  The added adrenalin of the right specialist can get the staff back in a positive direction and also redirect the doctor.  The continuing presence of a coach who loves what she does and helps to reorganize, redirect, and refocus may be the only thing that can get your practice back on the steady climb.  The great thing is that it can be effective even if you are still in a funk yourself.  The energized staff
can bring you back , too.  This does not mean that all the negativity which got you down in the first place will magically disappear, but you are the
only one who can solve these things anyway, and when you are at your best it is amazing how rapidly everything else turns around.

For several years now I have decided not to accept any speaking invitations.  We have been rather busy expanding our consulting practice
across North America, creating our Practice Management Cookbook and Protocol Series of workbooks, opening offices in five cities, working on a
soon to be announced Internet project, traveling, etc., and as anyone knows who speaks frequently, it is very time-consuming to prepare a good, well illustrated presentation to keep an audience properly enrapt for several hours.  However, an invitation some time ago to speak at the Alabama Dental Association meeting next month in Mobile inspired me to update my presentation "A Businessman Looks at the Business of Dentistry" for the 21st century.  As has been pointed out by a good friend, the picture in the brochure is a few years old because I kept putting off going to the
photographer for a new press photo, and the ALDA ran out of time.  Yes, that really is me JDH, or was.  The meeting is the weekend of June 16-18, and my slot is Saturday from 9-12. If anyone is in the area but not a  member of the ALDA, I can find out what arrangements are necessary to attend.  Just email me.

It's generally a tough time for pro sports fans in my native Dallas area.  The Cowboys are aging and still over the salary cap.  There is a pro basketball team there named the Mavericks, but they stir no fear in opponents and haven't for some time. The Rangers I already lamented last
week.  But there is one bright spot.  Now, there is a hockey team that is really good and in the playoffs for their second straight Stanley Cup. 
Amazingly enough, hot, hot Dallas there seems to be pretty good local support.  It can't be from knowledgeable former little league players like
in Canada or in northern cities of the U.S.  My guess is most of the fans have never skated on ice except in their cars during the icy storms of most early Januarys.  In fact, the last time I was in Dallas for a hockey game a big tall lanky guy with boots and a Stetson stood up and shouted, "Hit him with that stick thang, pard."   I think he is a season ticket holder.  Although it would seem that the closest most of the fans have come to that much ice was in a tall glass of iced tea during the hot afternoons, there seems to be a growing number of rabid hockey fans that fill up the stadium every game.  I suppose the real test will be when the Stars are not vying for the championship.

Have a great week,

Hurston Anderson
813 963-7228

PS:  Our Practice Management Cookbook has been used on five continents to assist dentists and their staffs with day to day dental questions for four years.  It is available for $249.95 plus shipping/handling of $19.95.  In addition, we created the Protocol Series to assist dental offices to
establish written protocols in critical areas of the office like Hygiene, Scheduling, Finance, Personnel Management, and Marketing.  The first three
are available at $199.95 plus s/h, and the last two will be finished, I promise, when we get past this new Internet project this summer.  Fax 813
963-5974 with Visa/MC#, exp. date, and address; or call above number.

We will continue to assist dentists at no charge by providing a Practice Production Potential Analysis and Practice Progress Evaluation.  Just email for a form and we can handle the whole thing by email.  We have been a bit behind, but we will catch up this week.  Too much travel and time with programmers.  Order on line at our store. 

In dentistry, you must make your patients comfortable that you are the expert (as you are, of course) in this area of their lives whom they can trust.  An apprehensive patient will not be comfortable in a messy, disorganized practice.  Attracting new patients is essential, but no amount of marketing will provide enough patients to build a solid practice unless you provide an environment in which patients can feel that they are in the hands of professionals.  Fees cannot be low enough, staff members pretty enough (sorry about the sexism, but there are still consultants out there telling dentist to hire 10's only), offices expensive enough, equipment modern enough, etc. to build a prosperous practice unless the patients feel that they can trust the dentist and his team.

Well, it is springtime pretty much across North America now.  Brown has been replaced or is being replaced by green and various blo