Practice management: A balancing act between being a doctor and business owner

October 3, 2016

Terri Lively

Article

DPR Spoke to Dr. Jason Goodchild, DMD, about how to provide excellent patient care and run a successful practice.

DPR Spoke to Dr. Jason Goodchild, DMD, about how to provide excellent patient care and run a successful practice. For Dr. Goodchild, it’s all comes down to rapport-building skills and putting the patient experience first.

He believes that when the patient believes that you are there to help them achieve their best possible oral health, you have a culture of trust that builds a foundation for a successful practice.

Why do you think your practice has been successful?

I have a practice; I work in education, and I work in industry. So I have all three perspectives. But I’ll put on my business owner hat for you today and talk about the things that have made me successful in my dental practice. Doing dentistry might not be the most important aspect to running a successful dental business. Of course we should know how to do dentistry effectively, but we’re not technicians; we’re doctors and business owners. Balancing those two things is difficult sometimes, but is the key.

My practice has been successful because I’ve tried hard to develop a culture of communication, trust and rapport. I encourage patients to call me by my first name. They have my cell phone number. The secret of my success has been creating a culture where patients feel like I’m always working to make their lives and oral health better. They trust me and hopefully feel that I’m not just another doctor. They can talk to me or reach out to me or just get advice from me. It’s a culture thing in my office.

What comprises practice management and why is it important?

When I think of practice management, I think about the tools that you can give a young dentist who has very little or no business training to help them be successful. Because if they believe that doing good dentistry is the only thing that matters, they’re unfortunately mistaken.

Why do patients come to you? Do they come to you because you do excellent dentistry? Maybe. But do they also come to you because you have a nice person answering the phone? Or a nice hygienist? Or a welcoming office? Or easy parking? Or you give painless injections? There are so many answers out there for why people come to you. It’s all these peripheral things that can make or break your business, and differentiate it from competitors.

The overarching theme for all of practice management is that dentists have to remember that we are in a service business. We have to work toward better patient experience and by doing that, we will be able to attract new patients and take care of them better. We are taking care of people, not only taking care of teeth.

People have a lot of choices when it comes to dentistry. What differentiates you isn’t necessarily your dentistry. It’s all those other things.

What do you think is the number-one practice management tip every clinician should remember?

It’s the idea of trust and rapport. The philosophy of building a practice is that patients believe you are there to help them. They trust you and that they can’t envision themselves going anywhere else.

Dentistry is an interesting business. When you tell people they have a cavity or have something wrong with their mouth, sometimes they feel it. They can feel a sharp edge or a broken tooth, or they’re in pain. But in a lot of cases, if we're proactive, we’re telling them that they need to fix things that they can’t see or feel. So there needs to be some level of trust that I’m not just making something up out or out to treat their wallet. There needs to be effective and open communication, and this sometimes involves visual aids.

So trust, empathy and education are my three big factors. If I’ve done those things correctly, patients will be able to have an open and honest conversation with me, and I’ll feel like I’m looking out for their best interests.

Continue to page two for the most vital practice management tips...

What other practice management tips do you think are vital?

Work on your rapport-building skills. Get out of your comfort zone if you have to, but work toward treating the patients. There’s a saying, “It’s not about you. It’s about the person in front of you,” or “They don’t know how much you know until they know how much you care.” It’s the idea of getting to know your patients and breaking down that doctor-patient relationship until it’s just two people working toward a common goal, which is making the mouth healthier and looking better.

Your success in dentistry is in large part due to the people around you. I mean your front desk people, your assistant, your hygienists and all of your team members. Because the time patients see the dentist during their whole dental visit could be small, but they spend more time with those other people. Your team members can make or break the entire patient experience.

Remember these three things: empathy, confidence and education. Some people call that the trust triangle: empathy, confidence and education. By doing these things, displaying empathy and confidence, and educating patients on what is going on their mouth and what they can do to treat it, you can develop rapport and trust with your patients. I’ll give you one crazy example of this:

One particular patient came in for a simple filling. We started chatting like two friends who hadn’t seen each other in a long time. My dental assistant gave me this sideways glance, and so I said: “Alright, we’ll put you back in the chair, and we’ll get started.” Five minutes in, she looks up at me and says “Jason, do you think I need Novocain today or do I need local anesthesia for this?” I was horrified. I sat her up and said, “I’m so sorry. We were just chatting away, and I completely forgot.” And she said “No big deal. That’s fine. Don’t worry about it. I trust you, so I just figured you didn’t think I needed it.”

I always tell that story because in most cases, if a dentist starts working without local anesthesia, that can be a deal breaker. But she just laughed it off. That could have been the last time I saw that patient, but I see her and her husband all the time. When you screw up, having that trust and rapport saves you and can help preserve the relationship.

Have a great team who shares your philosophy.The whole team, not just the dentist, should believe that dentistry changes lives. If everybody is on board with that, then you have a working team.

Get back to basics.The first contact is important. You want someone who is warm and helpful on the telephone. Also, a lot of patients make their judgments very quickly, so I insist on a clean and spotless office. It doesn’t have to be the most up-to-date and modern office, but if it’s sparkly clean, that makes a huge difference. One of the things I encourage each of my team members to do – hygienist, assistant, front-desk people – I ask them to sit in all the dental chairs and look around as if they were a patient. Do we have too much clutter in an area? Under one of our light shades, do we have some dust and dirt? Just look around from the patient’s perspective just to make sure that we are putting our best foot forward.

Systems are important, but they have to be sincere. I just don’t want my team members acting like robots. Systems are good because everybody knows what to do, but, at the end of the day, systems only work when they’re sincere.

Continue to page three for the most common practice management mistakes...

Is there a common area that clinicians make mistakes as it pertains to practice management?

It’s all about customer service. It’s doing the little things. It’s taking the bib off of the patient. It’s about sitting them up and thanking them for being there that day and saying ‘You did great.’ Little personal touches that can make that patient experience better. Those little touches are what differentiate your office and make people want to come back.

I had an associate who was just out of dental school, and when he was done with the procedure, he’d hang up the handpiece and walk out of the room. He wouldn’t even sit the patient up. He wouldn’t take the bib off. He wouldn’t say thanks. He wouldn’t say “This is what to expect after the procedure.” He would just walk out. His feeling was “I’m there to do dentistry. That’s why I’m there.” But that’s just a small part of it. It’s the patient management side of things, the soft skills as I call them, that can make or break your practice.

What can someone do to get better at that? How do they train themselves on soft skills?

Some dentists have those soft skills inherently. They have the gift of gab. They’re personable and warm. And others not so much. The truth of a service business is you have to put on your game face when you walk into the office. Patients don’t want to hear about my bad day. Patients are paying for my best hour of the day, so I need to give them my best hour of the day. Because that’s what I would want if I were the patient.

Unfortunately, these soft skills don’t get much attention in dental school. I’m trying to change that. In my role as department chair of diagnostic sciences at Creighton University School of Dentistry, I’m in charge of treatment planning and soft skills. Yes, it’s important to get all the other aspects of dentistry right, but those soft skills are so important. Develop those trusting relationships and the rapport so that patients will want to follow you. Communicate with them. Educate them. Motivate them to come back and see you. Unfortunately, some young dentists fail at that. Those are important skills, just as much as giving a good injection or doing a nice filling or crown.

Any other advice for young clinicians just starting out?

Find a good mentor. Watch what they do so you learn how to do it. Along the way, you’ll find things that work for you, but you cannot work in a vacuum. The idea of a dentist graduating from dental school and jumping in to start a new practice is concerning. The best way to do it after your training is to associate. Find someone that will be helpful in showing you what’s worked and what hasn’t worked, pitfalls to stay away from and that sort of thing.

Be a sponge.Keep your eyes open in this profession because things are moving so quickly. From practice management to software to equipment to materials to the roles of the team members to insurances to technology, it’s unbelievable. Once you finish dental school, your training is not finished. There are so many other things to learn in the profession. The end of dental school is just the beginning of your experience. Now it’s about learning how to make it a business and keep it profitable.

It’s not all about money; it’s about the patients. Coming out of dental school with $350,000 in student loans should not impact your treatment plan. Does a young dentist with $350,000 in student loans suggest treatments that are more expensive to make more money or do the best thing for the patient? I don’t want dentists to think that way. Treat your patients how you would want to be treated. If you do that, the money will come-and you’ll be able to sleep at night because you have upheld the nobility of our fantastic profession!

Find the tools that work the way you want to practice. There’s just so much out there. And because all those things cost money, and you have to be careful about what you buy. You can end up with a drawer of stuff you thought you needed, but end up not using.

Efficiency is about working fast but also getting it right the first time.Find the procedures, materials, and technology that work for you. Because if you do a filling fast, but the patient is having problems and they have to come back so you can fix it, you haven’t really done anything. The patient experience was poor, you didn’t make any money, and your profit margin was erased. So if you can make people happy, work quickly and get it right the first time, then everybody stands to gain.