June 26, 2010  
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August 2009
University of Memphis Alumni Magazine

http://www.memphis.edu/magazine/issues/summer09/smile.php

September 2009

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NO DENTAL PRACTICE SHOULD WASTE A PERFECTLY GOOD RECESSION!

Concepts to Prosper During the Economic Downturn

By

Mickey Bernstein, DDS

Bernstein Consulting

421 Falling Creek Lane

Eads, Tennessee 38028

901 497 3508

www.bernsteindentalconsulting.com

DENTISTRY IS A GREAT PROFESSION - There will always be a need for your services. Some patients may have to postpone treatment during a time of economic crisis, but most will be back when the time is right. Others are in pain or dire need and will find the money; therefore, we have no need to panic. Your community holds you in high esteem by virtue of your profession and the degree you have earned. Do not take that fact for granted. Credit lending institutions find you a good credit risk do to the high profit margin of dentistry and the regular supply of customers. Compared to other work environments, a dental office is a Great place to spend your working hours for the Doctor and Team.

EVERYONE IS DIFFERENT – In discussing the concepts that follow, we must acknowledge that each person brings a different set of circumstances to the table. The new practitioner with no patients can only go up. The recession will hardly be noticed. The mature practice with thousands of active patients may notice they appointments are booked a few days out instead of weeks ahead and only minor adjustments are necessary. Those Doctors close to retirement may find themselves planning to work more years to meet the demands of their economic needs. One must also consider your personal Values, family needs, and the demographics of your community. Certainly, the effects are more significant in Michigan than in a farming community.

MINDSET OF ABUNDANCE – You are encouraged to view the world through the lens of abundance. As of this printing, the U S Government says unemployment stands at 10.2%. I feel a more accurate number is 30% if you include those that have fallen off the unemployment roles, teenagers out of work that are ineligible for unemployment compensation and illegal aliens who no longer work (may have left the country), but did contribute to the production of goods and services. Another large group of workers are underemployed ( example: previously making $120,000 and now making $20,000 but ineligible for unemployment) are not counted in the total numbers. All that being said, if the proposed number of 30% is accurate, then 70% are still gainfully employed with decay, periodontal disease, and missing teeth. Our goal is to create an atmosphere to say YES to needed dentistry.

ECONOMIC CYCLES AS THEY RELATE TO DENTISTRY – In the book Conquer the Crash by Robert Prector, Jr., many economic indicators are compiled which show 4 major deflationary cycles since 1700, the most notable being in 1929. Each deflationary period was preceded by 5 waves and followed by long periods of prosperity. When Mr. Prector wrote this book in 2002, he predicted the current deflationary trend defined as a slowing of the velocity of money, tightening of credit, foreclosures, and general fear to spend money. This deflation will be deep and powerful, but will begin a period of long prosperity and a slow resurgence of confidence in the economic system. Our patients are making wise personal decisions to postpone non-essential dentistry. When this cycle changes direction in 6-12 months, it will take consumers some time to regain their confidence. Savvy dental offices will be poised to take advantage of the many dental consumers with stored up needs and wants.

THE NEW FACE OF DENTISTRY – Others and I predict a new landscape to models of dental practices after the economic crisis.

• The typical dental office will disappear. Dental insurance as we know it will cease to exist. That middle class of dental offices that all appear and function in a similar manner will have few or no patients in their marketplace.

• There will be an abundance of clinics providing basic care, government affiliated dentistry, and managed care.

• A smaller group of high end practices will flourish that cater to the affluent and the health conscious. A number of these offices are already positioned to cater to this niche market.

STEPS TO SURVIVE AND PROSPER – Most of the concepts that follow are sound principles in any economy with a few exceptions, which will be noted.

DON’T RUN WITH THE HERD – Do not be afraid to define yourself as different than all the other practices. If an idea is legal, ethical, and fits your value system – create an experiment and explore the possibilities. In the book, Tribes, Seth Godin, the idea is explored that all brown cows look the same, but purple cows stand out. How can you create purple cows in your dental practice? The status quo is comfortable, but change is uncomfortable and creates fear. Innovative leaders reach outside the norm recognizing the marketplace has changed.

MAKE GOOD USE OF OPEN TIME – Should you have open time on your schedule, move some patients and create significant time for Team meetings, training, cleaning, painting, reactivating old charts and all the projects you have not had time to accomplish. Whatever you do, don’t go home early. If you work 36 hours per week most weeks, commit to 36 hours every week even during slow times.

LOVE YOUR PATIENTS THROUGH THE RECESSION – These are hard times for many of our patients financially or emotionally. Be patient; be understanding. Seek temporary alternative treatments, such as a build up until the time is right for the crown or a full mouth of provisional restorations until the patient feels secure in their job. These patients will still be in your practice when the upswing comes and will feel very loyal to you.

KEEP GREAT TEAM MEMBERS EMPLOYED – If times are slow, keep in mind that it is temporary. It takes many years to find and train a good team member. Use this opportunity to seek new team members while there is an abundance of highly qualified individuals seeking employment. ”Depressions don’t last forever. When the next upswing comes, you will want a loyal and trained staff to help you prosper in it; and they will want a healthy company to prosper in it….pay what you need to the talent you require.” Robert Prector, Jr. You may also like to read The Gifted Boss by Dale Dauten, a powerful leadership book on creating the magnetic workplace.

STEVEN COVEY’S HABIT # 7 – SHARPEN THE SAW – Train yourself and your team on a reasonable budget. Now is the time to invest in the intensive courses you have always intended to enroll in. Refine and document all business systems. Test new techniques on team members, family, and friends.

REACCESS YOUR PATIENT FINANCING – Consider discounts for patients in need. If you can reschedule some patients and create a half-day to perform a $15,000 case, would you not gladly do the work for $12,000 rather than waste the time. The team must use well-prepared verbal skills to maintain posture. Also, consider extending payments for those patients you trust. Allowing a third down payment and the balance over 12 months will help fill an empty appointment book. Many businesses are using private money to finance their needs with tightening banking policies. You or someone you know may have money on the side to loan to a patient with dental needs for 12%, which would be a big win/win for both parties. These concepts would never be recommended in a booming economy or to a busy practice.

DEVELOP AND OPERATE ON A STRICT BUDGET  - The best way to manage expenses has always been to know your expense benchmarks and set goals to achieve or undercut them. Renegotiate all repeatable expenses, such as telephone, Internet service, and insurance. Consider allowing a staff member to clean the office for a reduced price.

Take advantage of the economic environment by asking your dental lab and dental supplier for preferred pricing to help you through these times. They appreciate and depend on your business and want to keep you as a customer. Refinance your mortgage for a lower rate or renegotiate a lower rent. Again, the economy is working in your favor.

MAXIMIZE ALL FREE AND LOW COST MARKETING OPTIONS BEFORE INVESTING IN EXTERNAL MARKETING – The exception is Internet Marketing, which has proven worth the investment if executed properly and followed with good business systems. The best marketing program you can possibly have is having highly refined business systems in place. Patients talking about your kind and knowledgeable staff, efficient operation, thorough exam, and expert patient education are worth more than any other perk available.

Other low cost marketing includes staff business cards and incentives, systematically asking patients to refer their friends and family, sending notes of sympathy and concern, and sending articles or e mailing links to additional information of concern to that patient. Develop a high style book of before and after cases and testimonials that you can place in salons, fitness centers, and offices of other health care practitioners. This can easily be done today over the Internet at low cost per book. ( i-publisher ).

Write an article for your hometown newspaper each week. Smaller newspapers are desperate for newsworthy information. It might be a topic of interest to the public or simply answering questions to the readers. You will become the expert in town to the public.

CONSIDER ADDING TO YOUR MIX OF SERVICES – If you are so inclined, Sedation Dentistry will add business and revenue to your practice in any economy. There is still an abundance of anxious people who need an avenue to complete much needed dentistry. If they trust you and your sedation abilities, they will find the funds to complete a mouthful of dental care in one or two appointments. There will be an initial investment in equipment, training, and state certification. Find out more at www.docseducation.com.

Orthodontics, implant surgery, and esthetic injectables are all procedures you are capable of performing with proper training.

SPONSOR CHARIBLE EVENTS – With your heart in the right place, you can help the community, your favorite charity, and your dental practice by using some energy to sponsor charitable events with no cost to you.

ADD NEW TECHNOLOGY – You may now have some spare time to properly investigate new technology and learn to use it properly. Manufacturers are anxious to meet their goals and will work with you on price and financing.  Your dental lab may be willing to help you pay for some equipment, such as digital impression systems, that reduces their remakes and time.

Most of all, MAINTAIN ENTHUSIASM! – A positive attitude starts at the top and you are the leader of the team. Walk in the office every day planning to make the most of any eventuality.  Enjoy yourself and get ready for the future.

By Diane and Mickey Bernstein, DDS

We, as dental professionals, have some compelling, practical reasons to build trust with our patients.  As Dentists and Team members, we are there to help by changing the structure and appearance of our patient’s smile and occlusion to improve their lives and health.  Change requires risk taking. Risk taking requires trust for both parties.

Patients worry about working with us.  They worry about pain, cost, time, outcome and deeper subconscious anxieties. They often give us powers that are usually reserved for themselves and a few trusted others. They ask themselves whether they really want to enter this relationship, with all its uncertainties. The patients that show up in our offices want to be willing to take risks with us; they want to be able to trust us.

Consider the junior high school dance. The girls are talking along one wall and the boys along another wall. The music begins and a boy moves into that long space between the two groups to ask a girl to dance. He (the patient) holds all the power to choose. As he approaches and asks the chosen girl the balance of power has shifted. She (the doctor) can say yes or no.

In the dance between new patient and dental office, trust and risk are key elements in creating a good fit. A patient’s unwillingness to risk can be related to their degree of trust in the doctor and team based on a number of valid reasons. Some patients risk out of proportion to the early trust relationship established. No relationship has been established, but they are ready to commence a large case. This should be a warning sign.

Others show a pattern of resisting the size of the case, the costs, timing, or the details of the dentistry. This behavior could be a clue that they lack the trust necessary to take the needed risk. Some suggestions to build trust to make risking more acceptable might include:

.

-Be more open about yourself and your work.

-Reveal your concerns and your real self.

-Discuss other cases that you have completed with stories that made a difference in the patient’s life.

- Learn about and respect the individual. Give them hope.

- Follow through on all your commitments.

-If you want them to listen, listen more yourself. Ask compelling questions.

-Share responsibility for getting the work done. Dictating all the decision making, encourages the opposite of trusting and risking.

You will learn more about how to build trust and the willingness to risk when you approach clients knowing that your partnership must include both elements in order to work.

Diane Bernstein has worked in healthcare management for 18 years. She lectures on Developing the Cosmetic Practice and the Role of the Patient Coordinator.

Mickey Bernstein is Past President and an Accredited Member of the Amercian Academy of Cosmetic Dentistry. He has practiced Cosmetic Dentistry for 34 years and lectures on the Psychology of Cosmetic Dentistry.

Together they operate Bernstein Consulting.  mbernst1@comcast.net

1. BY ROBERT SILKEY AND MICKEY BERNSTEIN