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Core Principles of the Successful Implant Practice

Sean Crabtree

In coaching peak dental practices all across North America for nearly a decade, I have found the principles of success to be the same regardless of the clinician’s area of focus. However, the specifics of creating the peak performing implant practice of your dreams require that implementation of these principles be combined with a strong business model perhaps in the most traditional sense. For some this can be a stretch, as most dental schools have no significant curriculum focus on business.

While the success of any business is certainly beyond the scope of a few pages, my intent is to share, principally from a business standpoint, that which I have found to be at the core of any successful implant practice. This core model can then become the foundation on which all areas of the practice rest. A similar outcome of the following pages is to provoke thought that may challenge current beliefs that can sabotage your success.

VISION, TEAM, SYSTEMS, SALES, MARKETING

Core Belief: My Practice Is an Entrepreneurial Business.

My first challenge to you is to see your practice as not a practice at all. Instead see it as I see it—an entrepreneurial business. As such, it can become an asset that can be invested in, bought, sold, and even transitioned to new ownership. As you’ll see, this view serves your patients, your team, and your bottom-line profitability.

With that in mind, consider that an overall picture of your business might look much like a spinning saucer. The business is divided into four segments that spin around a central point—your vision. Your vision gives direction, meaning, purpose and clarity to each of the four segments (Figure 17.1).

Center Point VISION

Defining and communicating your identity.

In his book The 21 Indispensable Qualities of a Leader, John Maxwell titles one of the chapters, “VISION: You Can Seize Only What You Can See.” The word “vision” has become a buzzword in referring to business and desired outcomes, perhaps causing it to lose some of its original meaning. However, your vision of exactly who it is, how it is, and what it is that you and your team want to be for yourselves, each other, and your patients must be at the heart of your business. It must incorporate your beliefs, values, and attitude about business and indeed life in general. Once clearly defined, it must be at the very center of everything that you do, everything you are, and how your patients perceive you. Any and all decisions must be filtered through this vision so that it becomes your identity and creates the culture of your practice. Great questions to get you started include:

FIGURE 17.1.

• How much do I want to earn in the next twelve months?
• How many days am I willing to work to earn it?
• How many patients am I willing to see to earn it?
• How do I want my practice to look?
• How do I want my team to look?
• How do I want my patients to look?

Once answering these questions with your team, you’ll then begin to shape a single paragraph that will become your identity and indeed the culture of your practice. It must be the higher purpose that motivates everyone on your team. This identity you’ve created will become the brand that separates you from others in the marketplace and will be communicated in all forms of marketing.

Organizational Model/Systems

• People VISION Marketing
• Identity/brand
• Sales
• Organization and systems
• Creating a better mousetrap!

For your entrepreneurial business to be a solid asset, two components must be in place. First, it must have a model that allows it to be self sustaining. That is, while the people you have in place can bring their own strengths to support the systems within the model, the model itself drives success and must be the continual focus. Secondly, with this focus in mind, every single person, including the doctor, must be replaceable. In other words, if decision-making and progress lie at the feet of any one person, the saucer slows its spin and that person becomes the bottleneck. Similarly, when that person is no longer there, the business can cease to exist. So the model, by design, must bring success, and this will be accomplished in part by empowering the people inside it to make decisions.

Without a successful model in place, the owner of a small business must be the human resources manager, the sales manager, the manufacturing supervisor, the collection manager, the president of marketing and even the bookkeeper. In addition to these roles, the owner of an implant practice is the only one in the office who can actually perform the production. Again, add all this to the fact that most dental schools spend little or no time on business management, and the whole thing can begin to seem overwhelming. The organizational model that follows is what I call the front line management concept. It directly addresses this and the previously mentioned components, when applied with key system strategies (Figure 17.2).

FIGURE 17.2.

Based loosely on what I learned as an undergraduate in the school of business and with my own additions and twists, this model allows for the doctor to make a staff person directly responsible and accountable for a respective front line area. This is not to divide duties, as you’ll see in the system layout. Instead it is to have a person responsible for game plans in a particular area and accountable for the results in that area. In the example, a typical implant practice could be divided into five departments: marketing, administration, operative, hygiene, and reactivation. The front line reports directly to the doctor, and both report to the coach. From the bottom up the coach supports the doctor in a leadership role and supports the team to ensure that these areas are getting results. The doctor supports the team from an informational and emotional standpoint. The model is customized depending on the circumstances of the practice. If, for example, a doctor had a full-time, in-house lab that made dentures, there would be a sixth front line box labeled “lab” added to the mix.

This model supports the doctor by freeing him to produce implant dentistry as well as focus on long-term directional business issues. The staff is then enabled to take on more of a partnership role by being empowered to create and implement game plans. In order to support them, decision-making criteria must be in place. Four possible questions for decision-making criteria include:

The final piece of this model is the system layout that supports it. It is based on five questions that front line staff will use to manage each area. The intent is to ensure constant growth by being proactive rather than reactive in your management style. Weekly use of this system at staff meetings will support this focus.

Front Line Accountability System

In his book Leadership, Rudolph Giuliani explains how, by using a model of accountability and a system he dubbed Compstat, he reduced crime by 70 percent in New York in just a few years. Similarly, I see amazing boosts in production and collection in practices that implement the above model and system.

People

Creating your best asset!

As mentioned earlier, all four of these segments will be driven by and filtered through your vision. When it comes to the people who will eventually make up your team, it is most important to use your vision as a hiring tool. My belief is that choosing the right people on the front end is paramount to a successful implant practice. A few things to consider when assembling a team:

• Make sure they will fit with who it is, how it is, and what it is (your vision) that you want your business to be.
  It may sound like a given, but it is a big challenge that I see throughout the profession. People are chosen without giving thought to the broader vision. You have incorporated your beliefs, attitude, and values into your vision. It is imperative that this person fits with those fundamentals. Otherwise, he or she will be at odds with everything your team and your business represents. How do you find out what this person’s beliefs, attitude, and values are? One way is simply to ask, keeping two things in mind. First, make sure you are within the boundaries of labor law and fair hiring practices for your state and country. Second, if interviewing is part of your process, remember that this person will display their best “game face” in answering questions. Another way is to share your beliefs and values and how that fits into your business. Then gauge their responses.
• When talking to a prospective team member, picture the person talking about you to a patient.
  When this person communicates, what are they saying to you outside of the words? Studies show that human beings communicate with tonality and physiology much more than with words. When you picture this person communicating with a prospective patient or a prospective referral source about you, do you see that as a fit for your vision?
• Is this someone you can see yourself spending time with outside the office?
  This does not mean that you will. However, what better way to gauge whether or not this person is a good fit? My assertion is that any staff member you have that you would not spend time with outside the office is probably not currently “fitting in.” That person may do a wonderful “job.” You and your team, however, need more than that.
• When it’s time to add a team member, let the team decide who that person will be.
  When this is handled properly, it will not only result in a great team member, but it will also promote unity and cohesion with the others, which, in turn, will save you much grief later. Have the team conduct the search through interviews and other processes, and then narrow the list to three people they really like and think will be a great fit. The doctor will then conduct his or her own interviews of the three and make the final choice. If none of the prospects seems to work for the doctor, the team continues the search.
• Hire for the right reason.
  The most significant mistake I see consistently is basing the decision to hire on experience only. Training is certainly an issue, and training will be required regardless of the level of experience. Instead, place more emphasis on beliefs, attitude, and values. Experience can be acquired, especially if these principles are in place. In the long run, it will serve your patients, your team, and your bottom line to hire based on these principles rather than experience.
• Analyze your strengths and weaknesses and those of your team.
  In finding the best person for the job, make sure the strengths they bring to the table not only support the position, but that they complement the weaknesses that exist, as well. This will require a serious look at yourself and your team. The team will perform best when each member brings different strengths and contributions to support the overall outcome.
• Have the courage to remove staff members who are not a good fit with your beliefs, attitude, and values.
  This seems to be common sense, yet I see different teams encounter this challenge on a continuing basis. Let’s face it. There is no easy way to ask a team member to leave. However, it is possible to look at the situation in an empowering way. It is not a personal attack on the person’s character or work ethic. It is simply a question of proper fit. If this is the case, then the employee is probably also not happy with the situation. I remember a particular instance with a periodontist who had a team member who needed to go. He and I brainstormed all the strengths and weaknesses he saw in her and then he spoke with colleagues who he knew that needed staff members. He found a general dentist who was looking for someone with her strengths and qualifications. The colleague called her the next day for an interview. She left and has been there four years. She never missed a paycheck. While I am not suggesting this will work for everyone, or even that you try it, the principle of making sure it is not personal and is sincerely helping your staff, even if it means helping them be somewhere else, will serve all involved. As the old saying goes, a bad apple will ruin the bunch.

Hiring good people is only part of the process. Once the “right people” are on board, you must take several steps to keep them. While the list is long and varied as to what it takes to keep good people, following are a few key points:

• Give your team members something to work towards beyond a paycheck.
  Most studies show that money is not a sole motivator for anyone in the long term. However, bonuses are great incentives to exceed set goals. Take care to ensure the goals are set high enough so the bonuses do not become expected. Expected bonuses can be perceived as paychecks and lose their value as incentives. Bonuses can also take the form of trips or gift certificates, for example. In addition, make the team a part of your “grand scheme.” In other words, put the vision out in front; it’s this higher purpose that they are there for, not just the paycheck.
• Invest in their growth and consistently acknowledge it.
  Ray Crock said that when we are green, we grow, when we are ripe, we rot. Most people may justify, even to themselves, that they leave a position for better hours and pay. Studies show that people leave because of lack of acknowledgements and/or because they felt as though they were going nowhere. Make continuing education a part of who you are and take staff along consistently. Then find reasons to acknowledge them. Some business owners are naturally gifted at acknowledging team members. If you are not, start a good habit by beginning each day with ten quarters in your left pocket and challenge yourself to have them in your right pocket by the end of the day by moving one at a time when you give a heartfelt acknowledgement.
• Become a leader.

Leadership can be learned. While this subject is beyond the scope of these pages, it is one of the most important aspects of keeping great people. Read and learn all you can about becoming an effective leader. John Maxwell has written many books on the subject, as have many others. My belief is that leadership begins with the way you think and the first step is always to see things as better than they are. Additionally:

• Make motivation a part of who you are.
• Never see things as worse than they actually are.
• Become a great influencer.
• Acknowledge, acknowledge, acknowledge.
• Do what you say, when you say.
• Begin all corrections with what is working.
• Acknowledge, acknowledge, acknowledge.

While strong clinical skills lay the foundation for your trade, the success of your business depends on how well you master the relationships with your team, referral sources, and patients.

Sales

Embrace the concept.

Use the word “sales” in a roomful of healthcare practitioners, and you can observe all variations of facial contortions. Many equate negative connotations to the word and think in terms of used car salesmen, or vacuum cleaner salesmen. While there are certainly professionals in both these areas, they don’t immediately come to mind for some. I have addressed this issue from coast to coast for nearly 10 years and continue to do so. Consider the following:

Fiction: I am healthcare professional, sales is beneath me.

Fact: You are the healthcare professional; it is your responsibility to influence your patients’ decision-making to help them choose the treatment plan that will give them what they want.

Fiction: You cannot sell healthcare, you can only offer solutions to the patient’s problems. It is up to the patient to do whatever she or he think, is best.

Fact: Again, you are the healthcare professional; you know all the benefits of the treatment you provide. You owe it to your patients to find out not only what is happening clinically, but indeed to find out what they want. Then, show them how what you have to offer will get them what they want.

Fiction: I am competing with other general and implant dentists for market share.

Fact: Your competition is the professional salesperson who sells the big screen plasma TVs, the vacation travel packages, the home audio components, new cars, or anything else that goes after the same discretionary dollars you are. Patients see what you offer as a luxury item; therefore, you are offering a product and service in the same category as the things just mentioned. The only solution is to embrace the idea of becoming a professional salesperson to compete.

Fiction: Salespeople are pushy and I would have to become that to be good at sales.

Fact: Some salespeople in the world give sales a bad name, just as some dentists, specialists, and attorneys give their respective careers a bad name. The truth is that sales is a respected profession and those who master it are paid very well. If your intent is to have a successful implant practice, it is imperative that you make a conscious decision to embrace sales and master it.

Very simply put, sales is the art of making friends. It is finding out what people want and giving it to them. If you do not master this concept, you are destined to hear one inevitable sentence from each patient, “How much does it cost?” My challenge to you is that from this point forward, any time you hear that question, see these words in your mind’s eye:

THE PATIENT SEES NO VALUE.

Hygienists see this concept in action nearly daily. They can show a patient how to floss, talk about what flossing accomplishes, put the mirror in the patient’s hand so they see flossing, and in general spend lots of time “educating” patients on flossing. This is a free service to the patients and yet many will simply never do it because even though they were educated, they weren’t sold. So they did not see the value.

The doctor sees it when he has a patient in the chair, perhaps someone he knows, who obviously has money. He talks of how many implants are needed, spends time educating the patient on how the procedure will go, the time involved, and all the care that will go into making sure the patient is taken care of, but when the patient learns the price, she says she just can’t afford that. On the way out the door, she changes her hygie/>

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