Friday, 14 February 2020

Jane, you are like Nanny Mc Phee


I have just had an end of coaching conversation with a client with whom I have worked for several years. They have given me permission to share their feedback and requested that I don’t share their name or practice details.

Jane                 As you reflect on our coaching journey what do you notice?

Client             It is like you taught me to sail

Jane                 What do you mean by that?

Client             The picture that come to mind is, before we were working together I was single handed trying to sail a yacht. I was in the middle of a large ocean, sails flapping in the wind, being buffeted by the wind and tide. I was going nowhere and if I was, I had no control over the direction, I was exhausted, lonely, at a desperation point

After coaching with you, I see the boat in full sail, my hand on the tiller, going in the direction of my choice. You have taught me how to harness the winds and waves of adversity and use them to my advantage. I can now get to the destination I want in the direction I choose.

Image result for yacht FULL SAIL 

Jane                 Anything else?

Client             Your BPE was genius. I know , initially, I did everything I could to avoid it. When I did it was a revelation, like looking in the mirror and seeing my practice warts and all.  Only then was I able to stop denying that there were cracks, acknowledge the dysfunctions, accept that the responsibility to put things right was mine and get on with it.

You were so patient with me, now I look back I wish I had done the BPE when you first suggested it, I would have saved myself so much heartache.

Jane                 What do you mean by that?

Client              It took me so long to commit to working with you, I think from the first e- mail I sent, to our first session was 2 or even 3 years. At first I knew things were not right in the practice and something had to change, deep down I knew you had the answers. I then kidded myself that it wasn’t that bad, other dentists I knew had similar stories, so I thought problems with staff, associates, money, never having enough time was all normal. I told myself that what you suggested was to expensive in time and money and dentists did not need coaches.  I was scared of the truth.
Time went on and you kept in touch and little by little things deteriorated, money got tighter, staff more difficult, and then my wife said I had to get the practice under control, or she was leaving.

Jane                 So your practice was affecting your home life?

Client              Yes, and I was in denial about that too. It was like I was a frog being boiled alive and I was not aware the water was getting hotter.

Jane                 So what changed?

Client              My wife offered and ultimatum, and I knew now was the time I had to bite the bullet. The really annoying thing was, by now the finances were even tighter and I had even less time, I had brought it all on myself. If only I had taken the decision earlier, to quote you, I would have saved myself, time money as stress. With my wife’s’ ultimatum ringing in my ears, I knew that now I could not afford not to work with you.

Jane                 What stands out about how we worked together?

Client             What didn’t stand out?  Your workshops me taught me so much. I had no idea how much I didn’t know about being a practice owner. I thought because I knew about how to be a dentist, how to be a principal was easy, how wrong was I?
The 1-2-1 sessions were essential. I seemed to lurch from crisis to crisis and each and each session you helped me refocus, find solutions and held me accountable for implementing the changes. I don’t know what I would have done without having you there at the end of the phone when I needed you.
The team sessions, the staff loved them, you were motivational and somehow managed to take on ideas that when I suggested them, they didn’t want to know. With them onboard it made my life so much easier.

Now my practice is nothing like the one you visited years ago. Now we get along, really support one another rather than paying lip service to team-work. The patients have noticed the difference, they keep returning bringing others, I have put my fees up, I have time off with my family and my wife and I now date again. I have fallen back in love with my wife, my family, my practice and dentistry.

Jane                 As you think back, what else do you notice?

Client             I remember our first few conversations and I was banging on about, the numbers, the patients, what I will get to show from paying for your coaching, would it be worth it, what would be the ROI. All those things that you call the tangibles. As I think back, yes, all those things have improved massively and it has been the intangibles that have been the most important outcome from coaching with you.

Jane                 What do you mean by that?

Client             The money and the hard, measurable numbers are important and don’t get me wrong working with you has turned around the practice. The intangibles, the things I can’t quantify, or measure have been the most valuable and useful outcome.

Jane                 Tell me more?

Client             KPI’s and performance plans are one thing. What you gave me was the confidence and skills to do things my way. Until we spoke I had no idea what my values were or any idea about the importance of designing a practice culture, these things are never spoken about in dentistry.  On reflection, the work that we did on values, culture, confidence, leadership etc formed the foundations that enabled me to build my ‘new practice’

Jane                 New practice?

Client             Yes, we may be in the same location and the same name, and that is about it. I feel like my practice is like a phoenix that has come out of the ashes.

Jane                 What would you say to someone else in your position?

Client             You are like Nanny McPhee?

Jane                 Nanny McPhee?

Client             When a dentist needs you and do not want you they must engage you and when they want you and no longer need you, they they must let you go. You have taught them to sail on their own

Jane                 How will a client know they need me and don’t want me.

Client             They will use all the displacement activities I did.

Jane                 Such as?

Client             Well that is a list, and I suppose you want me to be really honest?

Jane                 Yes please

Client             Here goes then
·      Deny there is a problem and pretend everything is ok.
·      Avoid anything that might make me face reality, like your BPE.
·      Work longer and longer hours.
·      Blame failings on others in the practice, using disciplinary procedures for things that were ultimately of my making.
·      Blame the system of the NHS, the BDA, GDC anyone I could to avoid taking responsibility.
·      Avoid any conversations with staff, no staff meetings, cursory appraisals, avoid any socials, stay in my surgery wherever possible.
·      Not reply to your emails or return your calls
·      Using the excuses of not enough time or money to avoid making a start.
Now for some real honesty, I distracted myself from the truth about the practice by drinking too much, obsessive attendance at the gym and many late nights on the internet, anything I could do to avoid facing the truth.

Jane                 Thank you for your honesty. There may be others who are in the situation you were. With your 20-20 hindsight what would you do if you had your time again?

Client             Knowing what I know now. The best thing I could have done is responded to your initial contact, done your BPE when you first offered it, worked out a way to it make coaching fit into my schedule. I should have prioritised my wife and myself by prioritising the fitness of the practice. I was working for the practice rather than learn how to get the practice to work for me.

Now I  know the excuses I made about not being able to afford it were that just excuses, I spent about £650 a year on Costa and probably almost 4K on takeaways. If I was prepared to make some minor changes in my spending affordability would have been easy, after all your fees are all tax deductible.

Whilst I was in denial I also did not calculate the real costs of not making the decision. the costs of lost treatment plans, lost patients, staff leaving and recruitment, mistakes, stress, fall outs with my wife, the list goes on. I made a very expensive mistake, not taking you on 2-3 years earlier than I did.

I was the last to realise what was happening, all my team knew there were problems in the practice, my wife certainly knew, my lab, suppliers, friends, everyone, they were just all to polite to say anything. Back then, I am not sure I would have listened if they did, I had my time again I would like to think I would.

I hope that others have greater wisdom than me and rather than fabricating excuses, like I did, they work through it with you and find a way to make it possible. If my experience is anything to go by, it will only get worse not better.

Image result for nanny mcphee emma thompson 

Jane                 Any final comments?

Client             It has been an awesome journey working with you, and I could not have achieved what I have without knowing you are there believing in me, showing me all the incredible things, I had no idea, that I had no idea about. Thank you so much.

Jane                 It is my pleasure, as I say, your success is my business and together we make your good practice great. I am always here for you. Once a client always a client.


If any aspect of this conversation sounds or feels familiar to you, get in touch.

If  you would like to do the BPE, it is here.



Tuesday, 11 February 2020

Is comparing your prices damaging your practice?


I have recently started working with a new client who asked me to work with them because they were struggling financially. It was not so bad that bills could not be paid on time, there was insufficient cashflow to give them the freedom to make decisions about investments, courses, training, team development etc.



Before the client invited me to work with them they had introduced an hygienist to the practice for the first time The hygienist made a big impact on the dental health of the patients and within a short period of time her book had become very full, and additional hygiene support was required.
One of the triggers to engaging me was that the principal had been led to believe that the hygienist as well as freeing up dentist clinical time, should also have been a profit centre and they did not understand why the practice finances felt tighter.

Image result for comparing to others

My client had acquired the practice 12 months previously, it was beautiful, the type of practice associates dream to work in. Full private list, exceptionally well equipped, digital scanners, well trained dentists who have done post grad training all over the world, quality materials, in a spacious clean and attractive building, with a long serving support team who share the vision of the practice.

During our sessions together I discovered that the principal had set the hygienist, and other fees, by comparing against local practices. The principal did not have their finger on the pulse of the practice finances The budget had been created to raise finance,  once the purchase was complete, they had not been looked at again. The principal was unaware of the income, costs, working hours, target gross incomes, target hourly rates, what being achieved. KPI’s were a mystery.

I asked my client to create a 12-month budget, making it as easy as possible by supplying personal and business budget templates. Unfortunately, for several weeks, despite setting their own accountability targets for creating budgets they were not completed; lack of time, distraction by other pressing matters and clinical demands were most often cited.

With my help, the budget was completed based on the previous years’ figures and the future development plans. I then helped the principal calculate the fixed hourly costs of running each surgery. At this point the principal understood why they were feeling a financial squeeze and we were able to change the hygienist packages to a value based service rather than a commodity, altering the language used by all team members especially clinicians regarding hygiene care and set the fees correctly.


Now the hygienists pay their way, generate profit, improve and maintain the dental health of the patients.

More importantly my clients’ budgets are a live document that is referred to frequently, especially at Monthly Financial Review Meetings (MFR), is consulted before any decisions are made. The budgets have become part of the navigation system for the short and long-term pans for the practice, giving the principal the confidence, freedom and control they were looking for.

My top tips
  • Reassure yourself you are not alone, many dentists have financial challenges and they can be overcome.
  • Prioritise and protect the time you need to care for your business
  • Create a budget, refer to it frequently
  • Know and share the figures, income, costs, etc with all your team
  • Ask for help early and accept it when offered
  • Never use comparison with other practices when setting your fees
  • Make treatments a valuable service not commodities.



If you would like to know more about the support we offer principals contact us Jane@IODB.co.uk or 07989 757 884.

Your success is my business



Friday, 7 February 2020

Are you using marketing as a cover up?


Image result for tattoos cover up


The has been a massive boom in marketing services for dentists and in many practices, marketing is being used as a sticking plaster to cover up underlying problems.

Underlying problems are like a damp patch; irrespective of how many times you paint over it, the damp still comes through. Painting over the damp is not the solution, eliminating the cause of the damp is.

Damp on living room wall 


When it comes to money there is a saying

“Income is vanity
Profit is sanity
Cash is king”

For patients we could also say

“Enquiries are vanity
Consultations are sanity
Conversion and retention is king”

There may be really valid reasons that you want to market your practice and I am sure that you are aware the only the 3 reasons are,
  • Brand awareness
  • List building
  • Conversion


What is you reason for considering marketing?

For many practices marketing is a knee jerk reaction when there are white spaces in the appointment book or insufficient money to pay the bills or to invest in new.

White spaces in appointment books and insufficient money are signs and symptoms of other problems  that are not resolved by marketing.

The situations that result in you looking to market for new patients will usually prevent your marketing from working, making any marketing campaign and expensive failure. Can you afford that cost?

Before you invest in marketing whether it be online, off-line, internal or external, please make sure that you are building on solid foundations.

Image result for appointment book exact soe 
Common reasons why practices are short of patients and money include;
  • Ill-defined and poorly executed patient journey
  • Poor customer service
  • Not delivering what the patient wants, needs, expectations
  • Perceived indifference
  • Inadequate conversation structure to deliver patient Centred Sales and BEST CHOICES treatment plan discussions
  • Patients being confused / talked out of treatment
  • Not following up treatment plans
  • Dentists and other team members not listening to the patients
  • Poor time keeping, rushed, running late, long waiting times for appointments, inconvenient appointment availability etc
  • Incorrect pricing structures, especially plans, and free consultations
  • Principals and team not understanding the finances of the practice
  • Errors in invoicing and claims
  • Discounts and freebies
  • Mistakes in taking payments
  • Wastage of time and materials
  • Poor quality poor equipment, breakdowns
  • Inconsistent service



None of these problems will be resolved by marketing. Moreover, until these situations have been addressed your marketing won’t deliver the results you are hoping for.

Before you are frivolous with your time and money trying to attract new patients, invest time and money getting your practice organised performing well and look after your existing loyal patients.


When you practice is healthy, with a fresh pair of eyes there is much more profit and far fewer marketing costs in your existing list that already knows, you, likes you and trusts you.



If you would like to avoid wasting time and money on ill-timed marketing, you can use our online Brilliant Practice Evaluation   and check that you are building on solid foundations.

https://www.surveymonkey.co.uk/r/Brilliant-Practice-Evaluation-BPE

Invest your time and money wisely, don’t waste it