New Dentist Fall 2009

THE #1 JOURNAL FOR NEW DENTISTS

A Few

WORDS from the CHAIR

What Patients Want You to Know

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FROM THE PUBLISHER’S DESK FA L L 2 0 0 9

Dear Readers,

O

PUBLISHER

n the Discovery Channel, the popular show MythBusters routinely debunks various myths and urban legends – everything from exploring if cigarette lighters really do pack the power of a dynamite stick to determining if sonic booms are capable of shattering glass. The hosts use modern science to separate reality from fiction. By definition, a myth is a belief that has little or no basis in fact. But that simple description doesn’t begin to explain the power that myths have over our decisions.

Take the myth that the majority of dentists buy or build their first practice when they are five to 10 years into their careers. This myth influences the decisions of hundreds, if not thousands, of companies in the dental industry. Many of you will be stunned to learn that longstanding myth is completely false. In fact, the majority of dentists – 52% to be exact – securing loans for startup practices either from scratch or new purchases are in the first FIVE years of practice. Dentists early in their careers are not the small, silent, and insignificant minority that many misguided companies think you are.

Speaking of myths, if you’re building your first practice, don’t succumb to the myth that you have to spend a fortune and incur huge debt to create a beautiful space. I sat down and talked with Dr. Jarom Lamoreaux of Colorado recently about his experience and the lessons he learned on his first startup practice. You can read more on page 18.

Another myth that many dentists, both those new to practice and those well into their careers, believe is that patients will speak up if they have a concern or problem with the doctor or the practice. That too could not be further from the truth. As David Clow explains in the excerpt from his book A Few Words from the Chair; A Patient Speaks to Dentists (P12), dentists and patients may see each other regularly, but they rarely develop the kinds of relationships that enable them to work effectively as a team to accomplish desired results.

David is a patient who felt so strongly about his experiences in the dental chair and the opportunity that dentists have to make profound and positive changes in people’s lives through dentistry, that he felt compelled to pen his experiences and perspectives. This book is a must read for every dental team.

Also in this issue, I am pleased to introduce Dr. Joshua Austin who will be a regular contributor both in the magazine and at his New Dentist Clinical Buzz/Blog at www. thenewdentist.net/clinicalblog.php. Dr. Austin is a new dentist practicing in Texas. He’ll be sharing clinical perspectives and candid insights about his personal experiences and challenges as a new dentist.

I hope you enjoy this issue of The New Dentist™. In addition to the information you find here, there is a wealth of material at www.thenewdentist.net to help you dispel any number of myths that you encounter throughout your career.

Fondly,

Sally McKenzie, Publisher

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Sally McKenzie Sally@thenewdentist.net DESIGN AND PRODUCTION

Picante Creative picantecreative.com Managing Editor

Tess Fyalka Tess@thenewdentist.net Consulting Editors

Tom Snyder, DMD MBA Jim Stehman, DMD Keith W. Dickey, BS, DDS, MBA, SIU, School of Dental Medicine SALES AND MARKETING

For display advertising information contact ads@thenewdentist.net or visit our digital media book at www.thenewdentist.net/ mediabook.htm The New Dentist™ Magazine is published quarterly by The McKenzie Company (3252 Holiday Court, Suite 110, La Jolla, CA 92037) on a controlled/complimentary basis to dentists in the first 5 years of practice in the United States. Single copies may be purchased for $5.00 U.S., $8.00 international (prepaid US dollars only).

Copyright ©2009 The McKenzie Company. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical without permission in writing from the publisher.

Authorization to photocopy items for internal or personal use is granted by The McKenzie Company for libraries and other users registered with the Copyright Clearance Center.

Disclaimer – The New Dentist™ does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses or other damages incurred by readers’ reliance on such content. The New Dentist™ cannot be held responsible for the safekeeping or return of solicited or unsolicited articles, manuscripts, photographs, illustrations, or other materials. The opinions, beliefs and viewpoints expressed by the various authors and contributors in this magazine or on the companion website, www. thenewdentist.net, do not necessarily reflect the opinions, beliefs, and viewpoints of The New Dentist™ Magazine or The McKenzie Company.

Contact Us - Questions, comments, and letters to the editor should be sent to Tess@thenewdentist.net. For advertising information contact ads@thenewdentist.net or visit our website at www.thenewdentist. net to download a media kit.

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TABLE OF CONTENTS

FALL 2009

F E AT U R ES

6 New Practice, Old Technology

By Lorne Lavine, DMD What do you replace first?

10 Steer Clear of Bad Habits

By Josh Austin, DMD Avoid the clinical compromise.

11 Students: What’s on Your Mind?

12 A Few Words from the Chair

Patient and book author David Clow has some advice for dentists.

18 5 Lessons for Start-up Survival

By Sally McKenzie, Publisher Avoid the start-up pitfalls that nearly sank this doctor.

a Successful 20 Becoming Associate

By Tom Snyder, DMD, MBA 10 steps to make the most of your opportunity.

24 Debt Driven

By Ralph Sardell, Ph.D. The psychological toll of ‘owing.’

28 Financing Options for Your Practice Purchase

By Keith Merklin and Jim Baum You can still obtain funds to purchase a practice.

6 DEPARTMENTS 2 Publisher’s Desk 16 The Buzz | Hire Me. Please!

22 The Not-So Simple Human | Your Strengths are Also Your Weaknesses

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16

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New Practice, Old Technology — Where to Start?

F

By Lorne Lavine, DMD

or the new dentist who is graduating, there are plenty of options for starting your new practice. Many will choose to associate with an established dentist to “learn the ropes.” Others may pursue an opportunity to purchase a practice from a retiring dentist. In both of these situations, though, the new dentist is often left with the challenge of bringing the practice into the 21st century, at least from a technology standpoint. While some of the newest technology like cone beam and CAD-CAM are very exciting, the truth of the matter is that many new dentists are already saddled with significant debt from their education, and these types of purchases are often not in the budget. The purpose of this article is to examine where a new dentist should start, with a focus on getting the most bang for the buck.

Practice Management Software I continue to be amazed at the number of practices that are not using modern practice management software to run the practice. The practice management software is far and away the most critical decision that a practice owner can make.

This is the “glue” that holds everything together, and all the other decisions, like computers and image software (more on this shortly), will be tied into the practice management software decision.

The choices that face the dentist are almost overwhelming. Recent consolidations have reduced the “major players” in this area. The “Big Four,” as they are often referred to in online forums like Dentaltown and the IDF, consist of Dentrix, Eaglesoft, PracticeWorks, and Softdent.

Combined, these four programs account for at least 80% of the market by my estimation.

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However, there are certainly many smaller companies that have been around a long time and continue to produce excellent products. One program that I highly recommend for new dentists is Open Dental (www.open-dent.com). Not only is this a great program, but there are no upfront costs.

You pay $149/month for the software, service, and support (it drops down to $99/month after the first year)…that’s it.

The trick, however, is to find the program that best meets your specific needs. As different systems are compared, you will see how certain features are handled better on one program than another, while another feature is better on a different program. When comparing products, there are a few things I recommend that you keep in mind: 1. You must involve your staff in this decision. As most dentists know, the staff are the ones who interact daily with the software. Many dentists have admitted to me that they barely know how to turn the computers on, let alone understand a CONTINUED ON PAGE 8 >>

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Technology continued from page 6

complex dental program. It is your staff that will be handling all of the administrative functions that the software handles.

If they find the program difficult to use, it will be disastrous to your practice. Many dentists are fortunate enough to have an office manager who has experience with dental software; someone like this can be an invaluable resource for determining the advantages of a particular program.

2. Every program has numerous bells and whistles, but most dentists end up using only a very small portion of these “features.” There are certain areas of practice management programs that almost all offices use. These include but are not limited to patient registration, scheduling, treatment planning, insurance estimation and processing, recall patient management, and reports of practice parameters, such as production and collections. Every dentist and every practice is unique. It’s essential that you make a list of what’s important to you and compare every program you evaluate using your list.

One method that I have found effective is to take either an existing patient or create an imaginary patient and see how the software tracks this patient. In other words, create the patient record, schedule them, create a treatment plan, post treatment to their account, create an insurance form, re-schedule the patient, etc. In this case, you can compare “apples-to-apples” when evaluating how software handles this. Keep in mind that you should see how well the software can adapt to how you prefer to see and treat patients. Poorly designed software will force you to change how you practice and process patients and you should avoid this at all costs.

Computers in the Ops Many older or outdated practices will not have computers in the operatories, and I think this is one of the biggest “no-brainer” decisions you can make when upgrading the practice’s technology. Computer prices continue to drop and for around $1000, you can have a very powerful computer that will run all modern dental software for three-to-four years. If the practice plans to add digital x-rays at some point in the future, computers in the ops are mandatory to both take and view these images.

Many practices find that they are more efficient if they decentralize the practice…remove some of the duties of the front desk and have those duties completed in other areas of the practice. For example, there’s no reason that hygienists cannot schedule their recall patients for their next visit while they are still in the chair and many hygienists I work with are

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also comfortable collecting payment and/or printing walkout statements. You’ll also need computers in the ops for functions such as charting, treatment planning, and patient education.

Marketing As any good practice management consultant will tell you, in tough economic times, it’s critical that dentists market their services both internally and externally. The good news for new dentists is that this can often be done effectively even if you have limited funds. In the last issue of The New Dentist™, I talked about software like Demandforce that can help get the practice better Google rankings, and software like that runs under $300/month. New dentists will find that creating a website and marketing it can be done with even limited funds.

There are numerous social media systems, such as Facebook and Twitter, which don’t cost a penny but can still be used to effectively market a practice.

As new dentists start to upgrade the older practices they are acquiring, they need to be smart about how they spend their limited funds. By investing in the proper infrastructure first as well as cost-effective marketing, the practice can be allowed to flourish and eventually have funds for other high-tech purchases.

Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provide dentists a full range of services relating to the implementation of technology. Dr. Lavine can be reached at drlavine@thedigitaldentist.com or at 866.204.3398.

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Steer Clear of

Bad Habits

Editor’s Note: “The New Dentist™” magazine is pleased to introduce Dr. Josh Austin. Dr. Austin is a 2006 graduate of the University of Texas Health Science Center San Antonio Dental School. After working as an associate for two years, Dr. Austin opened his own practice this fall. As a regular columnist for “The New Dentist™” magazine and Clinical Director of the New Dentist Clinical Buzz/Blog, Dr. Austin hopes to help new and young dentists to feel connected and learn from each other. “There are so many voices out there trying to tell new dentists what to do and how to do things that many get lost. I am just an average new dentist experiencing the same challenges as thousands of others. I hope that I can offer some new dentists a pearl here and there that might help them get through their day.” BY Josh Austin, DMD

A

bout eight weeks ago, like many of you, I received my copy of The New Dentist™ magazine. I had read the publication before, but it seemed that there was something different this time around. As I flipped through the pages, I noticed a new publisher had taken over the publication, Sally McKenzie. The McKenzie name is certainly familiar to those in the dental profession.

By this time, I had been writing my New Dentist Blog for around eight months. I saw some similarities in the audience that Sally and I are trying to reach. I decided to contact her in an effort to combine resources and provide new dentists with clinical and non-clinical Josh Austin, DMD information both online and in print. That’s the process that led me to The New Dentist™ magazine and website (www.thenewdentist.net).

I look forward to being able to offer some clinical insights to other new dentists. As I have stated in my Clinical Buzz/ Blog at www.thenewdentist.net/clinicalblog.php, I am just an average new dentist working through the same troubles many of you are. New dentists are in a unique position in dentistry. Dental student debt is currently at the highest level in history. Because of this, many graduating dental students feel pressured to begin producing at high levels very quickly.

Unfortunately, this oftentimes leads to compromising the principles and values new dentists learned in dental school. From a clinical perspective, this can mean abandoning the rubber dam and performing procedures that the new dentist doesn’t feel completely comfortable with.

There is no magic bullet to fix the average new dentist’s situation. As time proceeds and production increases, this pressure can subside. However, at that point, the bad habits adopted during those earlier years may already be ingrained.

I have seen this happen to colleagues and even experienced it myself. As a part-time faculty member, I see both sides of the 10 WWW.THENEWDENTIST.NET

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situation. On Friday afternoons, I am back in the dental school ivory tower where every occlusal amalgam gets rubber dam isolation to the contralateral canine. During the week, I am in private practice where sometimes even root canals are done without a rubber dam. Staying true to the fundamentals taught to us in dental school has made me a better dentist.

This is not to say that I am telling the dental world to do things exactly as they were taught in dental school, to quote college football analyst Lee Corso “Not so fast, my friend.”

In some regards, dental school educators are traditionalists entrenched in aging technology, methods, and materials. There is a happy medium between being progressive and forward thinking but also being rooted in some of the fundamentals we learned during our education.

My plea to the new dentist is simple. We all understand the pressures of being a new dentist. As time goes on, and you find yourself more comfortable in your practice situation, keep an open mind. Don’t forget about your operative instructor who was a stickler for a rubber dam. Think about that pros faculty who would ask you to smooth your margins more. Keep those voices in the back of your head. They are the voices that will guide you when you are lost or uncertain.

Dr. Austin can be reached at jaustindds@thenewdentist.net or www.thenewdentist.net/clinicalblog.php.

DENTAL STUDENTS: What’s on Your Mind?

These days, Michael Babston, president of the senior class at University of Alabama School of Dentistry, is focused on Part II of the National Board Exam and passing the CITA exam in February. He is very happy to be pursuing a career in dentistry. “I look forward to implementing the skills and techniques I have acquired over the past four years to start a successful lifestyle as a practicing doctor.” But he acknowledges that he is worried about the future as well. “My chief concern is how quickly I will be able to repay loans I used to finance dental school. The economic recession is not a concern of mine; I strongly believe dentistry will survive, even thrive, in times of economic hardship. This is primarily because I believe there is/will be a relative shortage of dentists in the south due to the number of retiring ‘baby boomer’ dentists.” In the near-term, Michael is applying for a residency in Oral & Maxillofacial Surgery. After that, he plans to practice in central Alabama.

Dental students, tell us what’s on your mind. Email Managing Editor Tess Fyalka at tess@thenewdentist.net. We want to hear from you.

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A Few Words from the Chair Editor’s Note: A Few Words from the Chair by David Clow, the first book written for dental professionals and students by a patient, offers a new perspective on the opportunities and challenges facing dental practices.

An excerpt from A Few Words from the Chair: Not long ago, I had a chance to give one of the best dentists in the country some comments about the ways in which he was marketing his services. This dentist owns one of the most prestigious and lucrative practices in the United States.

It’s not unusual for patients to fly halfway around the world to see him for a six-figure course of treatment, so his concern wasn’t gaining more work or increasing his income. He wanted qualitative improvement. Although he had a beautiful office in a great location, dedicated staff and the finest equipment, he recognized that something was missing.

We visited together for over two hours, and he used part of the time to give me the talk he gives to prospective patients. He showed me slides of his beautiful clinic. He told me about his fastidious sterilization procedures and the purified water at every station. He took well-deserved satisfaction in the before-and-after shots of his work. His craftsmanship was breathtaking. Some cases started with severe damage.

All of them ended beautifully. I felt deep admiration for his passion and his skill as he delved into the finer points of porcelain veneers. He makes his own, and he’s an artist.

As he wrapped up his presentation, he looked to me with pride and waited for my feedback. He was right: something was indeed missing. “Doctor ___,” I told him, “With all due respect, I don’t care about anything you just said.”

He wasn’t pleased.

Here’s the problem: dentists and patients have extended interactions, but hardly any conversations. I assume the ones like this one with my dentist acquaintance are quite rare.

That’s too bad for us all, because I need your expertise, and you need to understand me better as well. Someone like you could be the most important health-care practitioner I know; 12 WWW.THENEWDENTIST.NET

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people like me, typical dental patients, are the most important people in your professional life. When you and I don’t communicate, we’re both missing out.

With me, you have a chance to practice health care at a higher level, and for greater rewards, than you might ever have imagined. Speaking practically, you need more effective patient recruitment and better retention. You need to spend less time and money in areas that don’t produce for you, and more where they deliver a return, so you need to invest as effectively as you possibly can at marketing, and more delivering paid services. Speaking at a higher level, you need the satisfaction of knowing that the work of your hands is making a difference, and that what you sow today is reaped in better lives for the people you treat. You want to enjoy the hours of your labor and you want to look back with deep satisfaction over what you accomplished. You want the respect of your professional community. You want to be appreciated by your patients while CONTINUED ON PAGE 14 >>

On behalf of McKenzie Management, David Clow consults with dental professionals on practice culture, case acceptance, and patient expectations.

He can be reached at davidclow@ mckenziemgmt.com.

Mr. Clow is also a writer/consultant for Fortune 100 companies. His book, A Few Words from the Chair, is the first book written by a patient for dental professionals and students. It can be purchased at www.thenewdentist.net.

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Making a difference is a daily bonus.

To learn more, call 888-262-4069 or visit healthcare.goarmy.com/info/e920.

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A Few Words from the Chair continued from page 12

you’re here and missed when you retire. For all that, you need me.

What about me? Speaking practically, I need excellent health. I need pain-free, sound, strong teeth that permit me to eat the healthiest diet. I need to know the best mental wellbeing and the best physical fitness and the deepest emotional satisfaction a person can know. I need a trusted independent healthcare practitioner who delivers front-line prevention before my problems become serious, and even more—at a higher level—a chance to fulfill hopes and to find happiness of which I scarcely dare to dream. I need love, respect, joy and satisfaction in my life.

For all that, I need you.

Pretty ambitious, I know, and a lot for people to ask of each other. Does it surprise you that I should expect dentists to talk in these terms? It shouldn’t. Your goals are the same as mine, and we can help each other to

make them all real. For either of us, getting less than everything we hope for is foolish. Looking for less, and settling for too little, has had tragic consequences for every dentist and every patient in the nation. This unmet potential isn’t a matter just of your income and my teeth.

It underlies billions of dollars in poorly invested healthcare spending, millions of serious illnesses, and countless lives endured, but never truly fulfilled, by people who know neither how healthy they can be, nor the transformative possibilities of a smile.

I believe there is a great crisis in health care in the United States, and a great opportunity in prevention, and thus an essential contribution for dentists to make. I believe you are artists and healers with unique capabilities to do it. I believe there is a great deal we do not know about each other, and that it serves us both to talk.

The Gap What an opportunity patients have! Dentistry offers people so much they want and need. Why don’t people get it? What would permit someone to have this resource available and fail to use it? What would cause them to misunderstand it so thoroughly that they fear it more than they fear the consequences of not collaborating with a dentist?

There are gaps here, and like the gaps you work on in your practice, they’re problems. The obvious one is between us, between dentist and patient. There’s another between what I really need and what I think I need. Yet another divides what you think you do and what I think you do. And there’s a serious one between the value most dentists have and the value they feel they can discuss. Until these gaps are bridged, you and I will continue denying each other the benefit of a collaboration that could make both of our lives better. And the potential worth to you and to me of those miracles I mentioned will go unfulfilled.

Somehow dentistry isn’t where it belongs. Despite its credibility being beyond any doubt, a tidal wave of attention CONTINUED ON PAGE 27 >>

Drowning In Overhead?

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Realize Your True Potential The New Dentist Practice Enrichment Program is specifically designed for dentists in the first five years of practice.

“I hired McKenzie Management to help me with my practice year one into a scratch start. I would definitely do it again.

McKenzie Management helped me increase efficiency and productivity and helped to implement successful systems.

I had a gut feeling I could benefit from a practice consultant, but I was reluctant to hire one for my practice. I thought a business degree and corporate experience was all I needed for success. I’m glad I went with my instinct and called McKenzie Management. I had heard they were the best, and now I know it. My investment in McKenzie not only paid for itself by the second month, the systems put in place continue to pay dividends. I can recommend them without hesitation.

I am happy to speak to any dentist about McKenzie Management.”

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THEBuzz

Struggles and Challenges Facing Today’s New Dentists

“I recently graduated from dental school in Nevada. I moved to California and have a California dental license, but I cannot find a job. I am looking for a position either part-time or full-time as an employee or associate. I have searched for a job in virtually every California city for almost two months. I’ve looked at CareerBuilder. com, Craigslist, The Dental Trader, and other websites, but I can’t find anything.

At this point, I’ll work as a hygienist if I have to, can you help?”

• Newly graduated DMD

Dear New Dentist, Thank you for reaching out to The Buzz. Please do not give up hope even though this has been a very frustrating start to what will become a very rewarding career. What you and thousands of graduates from the class of 2009 are facing is the aftermath of a horrible economic downturn. Yes, there is hope on the horizon. But dental practice revenues have been down in recent months, so the need to bring on an associate dentist is not as high as it was before the recession. However, this is temporary. So what can you do to take charge of your destiny? Plenty, read on.

Inside Dentistry, Dentaltown, or Dental Products Report to purchase mailing list addresses of dentists in the zip codes where you would be willing to work. You can also request the names and addresses of general dentists that

“Please do not give up hope even though this has been a very frustrating start to what will become a very rewarding career. “ First, register and check out www.dentalopportunities. com. Next, if you are a member of the California Dental Association, contact them and ask if they can help you link up with any member dentists seeking associates.

Prepare your resume. Include your experience, education, honors, awards, and references. Also include a photo of yourself. Your resume should look very professional. Prepare a well-written cover letter. Next provide several copies of your resume and cover letter to the local dental supply company representatives, including Henry Schein, Patterson Dental, and others. Ask them to give these to clients that they believe are considering retiring, trying to cut back, or looking for an associate.

The most aggressive technique is to contact some of the dental trade magazines such as Dental Economics, 16 WWW.THENEWDENTIST.NET

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graduated between 1974 - 1984. Those dentists would be approximately age 55 to 65. You would then mail to them your cover letter, resume, and contact information. You also might offer to work for them FREE for 2 days so they can observe your skills. It’s something to consider to set yourself apart and prove that you are worth far more than just a passing consideration.

I hope that is enough to get you started. Best of luck to you and let The Buzz know how this works out.

Can you help Nevada DMD? Visit the Buzz/Blog at www.thenewdentist.net and click on the Management Buzz/Blog. Want to read more answers to questions from dentists like you? Visit The New Dentist Buzz/Blog at www.thenewdentist.net.

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5 Lessons for Start-up SURVIVAL

By SALLY M c Ken z ie , publish er

Dr. Jarom Lamoreaux, 31, received his DMD from University of Nevada Las Vegas School of Dental Medicine and his MBA, he jokes, from the “School of Hard Knocks.” He readily acknowledges that earning the second “degree” was much more costly and not nearly as much fun as dental school. He can look back on the experience now with a little levity, but the first couple of years out of school were rough. In fact, at times, the struggles were so great he seriously questioned his decision to go into dentistry.

O

n a whim, Jarom and his wife, Kelly, who is also a dentist, went to work for a company in Arizona, but they quickly realized their hard work was paying off nicely for the company, but doing little for them.

The couple wanted to build their own practice. They chose an area in Colorado where they believed the market was better for new dentists. Colorado may be known for its spectacular mountain views, but, for the Lamoreauxs, it is here that they walked through some very deep professional valleys. They also learned their share of serious life-lessons.

Lesson #1 – Ask Lots of Questions, and then Ask More Questions Armed with an undergraduate degree in small business and entrepreneurship as well as considerable research that he and his wife did on their own time, Dr. Lamoreaux believed he knew enough to build his new practice on his own. “I had been planning on opening a dental office for years. In undergraduate school, when I was majoring in business, I always geared it toward dental business, such as writing a business plan for starting a dental office. Even in dental school, I was reading business books, accounting books, and other dental business stuff. I researched as much as I could, but even that wasn’t enough. The problem was that I didn’t ask enough questions, and I trusted too much. There’s just so much to look out for.”

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on equipment and tenant improvements on the space he was leasing. Additionally, as a first time owner, Dr. Lamoreaux says that he also made mistakes in how he handled the lease agreement. “We just let people take advantage of us.”

Lesson #2 – Big Firm = Big Money Dr. Lamoreaux chose a large, expensive architectural firm, but he wound up with an architect who had never designed a dental office before. “We kept having these project meetings with the contractors, engineers, and architect. I felt really important, but I didn’t realize how much I was being charged for those meetings. The architect for our first office kept trying to ‘sex up’ the place. Those were his actual words. All of his little accent items increased the cost per square foot to build out, thus increasing my monthly fixed costs.”

At last, the office was built, and Jarom and Kelly were ready to put the frustrations aside, chalk the negative experience up to “lessons learned” and move on. In January 2008, the doors opened and the couple had $55,000 in working capital, within five weeks it was nearly gone.

Lesson #3 – Be Very Selective in Hiring Staff Dr. Lamoreaux discovered that the office manager he and his wife hired, someone who came across as truly excellent, was incompetent. “We found out that she never submitted

a single claim to insurance. We hired people to do jobs, but we didn’t hold them accountable, and that got us into big trouble.” He urges dentists not to hire an employee for a job that the dentist does not understand him/herself. In other words, dentists should be at least somewhat familiar with every system in the practice. “Get with a practice consultant who fully understands the business of dentistry – but not just any practice consultant, a reputable one with a solid track record and references. Learn how the business systems are supposed to work. Otherwise, the employees can tell you anything, and you’ll believe it because you don’t know otherwise,” warns Dr. Lamoreaux.

The couple was facing exorbitant lease costs and high fixed costs. Overhead was swallowing them, and Dr. Lamoreaux found himself regretting his decision to become a dentist. “We were under so much stress to produce and that’s just not good when you spend your days knowing that you have to produce this much just to break even.” Thankfully, the couple were wellreceived in the community and together were able to average about 80 new patients a month in the practice.

Nearly two years later, Dr. Lamoreaux says their practice is doing well and they’ve since built a satellite office, which he says, with the benefit of lessons learned, cost less than half the price of the first and fixed costs are thousands of dollars lower in the second office. The second time he went with a very small architecture firm that cost less than half the price of the large company. “My architect did a great job.” And, most importantly, the second architect had dental office design experience. “Any architect can design something beautiful. But it takes a true master to create something beautiful and within budget.”

Dr. Lamoreaux realized in building the second office, which was a completely different experience from the first, that the frustration, anxiety, and expense could be significantly reduced, if not eliminated. “Now I want to help other dentists avoid that. My goal is to get the message out – I’m tired of people taking advantage of dentists,” says Dr. Lamoreaux. And to help other dentists through the process he started simplifiedstartups.com; the site is a testament to what Jarom and Kelly went through, and a roadmap for how to avoid the same traps that they fell into.

The site provides information on managing overhead from the very beginning, creating the business model that will work for your practice, developing and defending a realistic but conservative budget, as well as other essential information. Currently, Dr. Lamoreaux is creating a step-by-

step plan for new dentists to walk them through the process and guide them away from the many minefields that threaten the viability of any start-up practice. For more information, visit his website at www.simplifiedstartups.com.

Lesson #4 – Business Model First In talking to his friends, colleagues, and other dentists that he tries to help, Dr. Lamoreaux finds that dentists usually make a mistake of building an office and then trying to figure out what type of business model they want to implement. “The opposite should be true. Office design should be a reflection of the type of business model you want to run. A master architect understands these differences and helps you design accordingly.”

Lesson #5 - Caveat Emptor “So many dentists say, ‘That won’t happen to me. I’ll make smart choices and not overspend.’ If you don’t have experience and know what a fair price/deal is, how can you know if you haven’t just overspent? Additionally, most of the advice out there is garbage. People mix business models together and talk about things they have no expertise in. But in the end, we found a way to reduce our fixed costs on our second practice by $7,314.41 a month, and the second practice is just as beautiful.”

Want to learn more about Simplified Startups? Contact Jarom Lamoreaux at (719) 488-5981 or consult@simplifiedstartups.com

Drs. Jarom and Kelly Lamoreaux

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THE TOP 10 STEPS TO

Becoming a SUCCESSFUL Associate Many of you are now considering becoming an associate. Some of you will be on a “partner track,” others may consider purchasing the practice of your new employer in a few years.

Below are 10 steps that you should consider taking to ensure you will have a productive and successful relationship with your employer.

• Tom Snyder DMD, MBA 1. Reactivate Patients Busy practices that may be the right fit for you to join usually have a patient retention problem. We recommend that a patient reactivation program be implemented to coincide with your joining the practice. This allows the practice to reactivate patients that have not been seen on a regular basis in hygiene. This is often the case in practices that have more than enough patients; however, there is not enough capacity for one doctor to handle the entire patient base.

Your joining the practice is the perfect opportunity to solve that problem.

When patients are reactivated, we recommend that they be scheduled for a hygiene appointment with the associate. The hygiene appointment is probably the most nonthreatening appointment in the dental practice, making it the ideal way for you, the associate, to get to know several of the patients. It also allows patients an opportunity to get to know you, and hopefully you will form a long-term dentist/patient bond with all of them!

That being said, we do not recommend that you always see the patient as a hygiene patient. Rather, once you’ve completed their reactivation recare appointment, future recare appointments should be scheduled with the practice’s hygienists. We also suggest that your employer schedule you for no more than four reactivation patients a day so that you have time to perform other clinical procedures. The number of scheduled hygiene reactivation patients per day is directly related to the number of patients that can be reactivated.

Many associates are scheduled with the identical time units as their employer. This is totally unrealistic, particularly if you are a recent graduate. Therefore, you should carefully review your time unit allocations. If you are uncomfortable with them, add more units. You do not want to keep your patients waiting unnecessarily because you’ve underestimated your time requirements.

2.

4. “Over-the-Shoulder” Training

Determine Your Clinical Supply Requirements For those of you who are graduating this year or are completing your residency program, your first real job 20 WWW.THENEWDENTIST.NET

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in a private practice may hold some surprises for you.

Therefore, it’s important that you sit down with your employer and head assistant to determine what clinical supplies you may need that may not be readily available in the practice. Rather than join a practice and be unable to perform at the level you feel you’re capable of because you do not have specific supplies, instruments, or burs, for that matter, discuss what you need up front. If your employer does not agree with your requests, now is the time to discuss it before you begin treating patients.

3. Determine Realistic Time Units

As new practitioners, you need to continue your clinical learning process. We recommend that “over-the-shoulder”

training be implemented in the practice, if not on a weekly basis, at least on a bi-weekly basis. By serving as the “dental assistant” for more complicated or clinical procedures that you are unfamiliar with, you, as the associate, will learn from your employer and gain confidence and experience to perform them yourself one day.

5. Assess Your Strengths and Weaknesses As a recent graduate, obviously, there are certain clinical procedures you are more adept at performing.

We recommend that you analyze your employer’s production report to determine those services that are being referred to area specialists. Usually, at the top of this list is endodontics. So, if you’ve had limited experience in endo, we suggest that your employer enroll you in an endo clinical program. There are a multitude of clinical programs available encompassing all facets of dentistry.

The important thing is to be realistic in your clinical self-assessment and make sure that what you learn can contribute to the practice’s growth as well as your own.

CONTINUED ON PAGE 31 >>

Dr. Thomas L. Snyder is Managing Partner of The Snyder Group, LLC, a nationwide practice transition and financial management consulting firm. With more than 75 years of experience in the field, The Snyder Group provides a full range of services for new dentists considering purchasing a practice, practice valuation services, associate/partner agreements, practice transition matters, and retirement planning. They can be reached directly at 1.800.988.5674. TSnyder@snydergroup. net, www.Snydergroup.net

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WWW.THENEWDENTIST.NET 21

THE NOT-SO

Simple Human

Your Strengths Are Also Your Weaknesses

Y

ou had what it took to make it through dental school.

You’re goal oriented, perfectionistic, focused, and driven – all essential to surviving the academic rigor of your chosen career. But those same qualities that served you so well as a student, may be your Achilles heel as a professional.

As the dentist, the success or failure of your practice falls primarily on your shoulders. It’s essential that you have a very clear understanding of your temperament or personality type as it is often referred. It will have a profound and powerful impact on your ability to build and maintain an effective staff, attract and keep patients, achieve production and collection goals, and manage stress throughout your career.

Dentistry requires certain characteristics to be successful such as being a good communicator, excellent listening skills, warmth and compassion for your patients and employees, creating a motivating environment for staff, not being too autocratic or too lax, a willingness to experiment and take risks, forward thinking, organized, patient, able to reprimand or fire people when necessary, and the ability to make decisions just to name a few.

It’s fair to say that few newer dentists bring all of those to the table from day one. But what is essential to your success is a willingness to understand your temperament type, improve your shortcomings, and hire staff whose temperaments are not the same as yours but complement yours.

Perhaps you went into dentistry because you loved the sciences? You had the skills and the discipline, but then you got into the patient side of it and realized that dealing with people all day is utterly exhausting. It’s entirely possible that you are an introvert, and forcing yourself to be extroverted all day drains your energy. Introverted dentists can also have low case acceptance and generally do not have flourishing practices because they struggle to communicate with patients and staff and often come across as uncaring or aloof. While the natural tendency is to hire people that are like you, the dental practice needs a good mix of strengths and different personalities. Extroverts, for example, are often better at communicating with people.

You may be a “thinking type” person. Thinking types are “bottom-line” people who “call it as they see it.” As a result, they can hurt a person’s feelings but are totally unaware they

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have done so. They are able to step back from a situation, analyze it for what it is, and apply an impersonal solution.

Thinking types can come across as heartless, insensitive, and very uncaring because they naturally see all the flaws in situations and are very critical. Thinking types are usually motivated by a desire to achieve goals. They also feel it is more important to tell the truth than be tactful.

While you may be more “thinking” in nature, your staff may be more “feeling,” as dental auxiliaries often are.

Feeling types like harmony and will work very hard to make this happen. They need plenty of feedback and praise from employers. They consider it important to be tactful as well as truthful. They dislike telling people unpleasant things and will procrastinate doing so. They have an inner desire to please everybody. They can come across to others as weak because they are too emotional.

Thinking type dentists can unwittingly alienate their entire team if they are not aware of how they come across when they come out “shooting” over something they don’t like or are not happy with. They will fire off nasty comments and accusations before gathering all of the necessary information leaving even the tougher staff bristling in anger and the feeling staff ready to quit on the spot.

Feeling type dentists can experience serious financial difficulty if they are afraid to give patients “bad news.”

They may be inclined to minimize treatment – recommending a filling when a crown would be a better longCONTINUED ON PAGE 32 >>

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Debt Driven

The Psychological Toll of ‘Owing’

A

By Ralph Sardell, Ph.D

s we watched the financial systems collapse over the last 12 months, many of us have been struck by the sheer greed of those involved. Wall Street risk takers abused the system yet stood in line for their share of the federal bailout, as many of us watched in disbelief and suffered the consequences of their actions. I don’t need to tell you that should you make such catastrophic financial decisions in your life, there will be no federal bailout monies to save you. You, doctor, are essentially on your own.

Manage your debt well and you’ll reap the benefits many times over. Manage it poorly and you’ll pay an even greater price. But successfully handling debt involves far more than simply making financial payments in a timely manner. It is a reflection of how you will handle virtually every aspect of your future success … or failure. Read on.

Starting out in business, many young dentists enter the profession with sizeable school debt and then must take on additional financial liability in one form or another.

As financial debt grows, so too does “emotional debt” and both must be managed for their risk implications. If you fail to manage your financial debt, you can develop a bad credit rating. If you fail to manage your emotional debt, you can stress out in your 20s, deny the stress, get married, have children, acquire a mortgage, and rationalize that you are stressing for a good cause: the family. Eventually, as you approach your 40s, burnout, a sudden illness, or a diagnosis of impending heart disease will give you pause about the feasibility of out-running your debt. While there is always risk when you accept any kind of debt, working excessively to stay ahead of the bank or partner can destroy more than your credit rating; namely, your personal health, family harmony, and your self image.

For the new dentist, defaulting financially will consume few aggressive entrepreneurs, but what causes the most damage to many young professionals is the stress of managing their emotional debt by focusing on the financial debt. Yet how you manage your emotional or financial debt is a func-

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tion of how successfully you managed your “personal investment” decisions while growing up.

From a historical perspective, look over your life and you will gain some insight into how you handled various forms of “debt,” financial or emotional, in the past.

This tells you a lot about how you will handle debt in the future. Did you try out for a team and accept the investment of hard work or did you pass on the tough training? Did you take the Advanced Placement courses and accept the challenge or did you feel they required too much effort? Did you ask out the girl/boy of your dreams or were you too afraid to put in the effort to impress her/him? Do you accumulate debt on your credit cards, pay them off regularly, or do you just make the minimum payments? Your personality and ability to manage emotional and financial debt manifests in the history of your lifestyle and your personality and temperament determines your capacity to handle debt in the future.

CONTINUED ON PAGE 26 >>

Ralph Sardell, Ph.D, Clinical Psychologist, is in private practice in La Jolla, California. He works exclusively with business executives and dentists.

As the Business Coach for McKenzie Management, he works with his clients on personal issues that affect business profitability. He can be reached at 858-454-2828 or peaks@adnc.com. Call for a free consultation.

Debt Driven continued from page 24

Impact of Choices As you start out in the business of dentistry, you have choices.

You can build a new practice and accept 100% risk. You can work for someone, hone your skills, and work for a salary or percentage. You can buy in as a partner. Or you can borrow a lump sum, purchase an existing practice, and go it alone, or any combination of these. Each option carries its own emotional issues, in particular the isolation you can experience when you become financially responsible for not only yourself, but for others, i.e. family, mortgages, partners, and building your 401K. While all of the business options are viable, the ultimate/best choice is to make a decision based on your personality and history for managing your emotions and your money.

How risk averse or success driven are you?

It is not unusual for many dentists to become overwhelmed by their sense of obligation, not only to their families, but to staff, patients, and most of all their partners or competitive colleagues. This sense of social obligation is instinctive and biological. Their sense of pride demands that they succeed.

However, many young dentists find themselves driven to satisfy the expectations of others, while often being driven to surpass their traditional expectations of themselves. This is unnatural and sows the seeds for an eventual burnout.

Many young dentists find themselves driven to satisfy the expectations of others.

Logic and Reasoning Not Enough It is a psychological fact that emotion will always overcome reason, and, for that reason, understanding which emotions guide or drive you is important. Fear will always trump logic.

Your logic may be perfectly sound and sound perfect to you when you listen to yourself. But in all likelihood, your logic will lead you to an outcome that is very typical of what you experienced in the past. Do not be fooled by the sheepskin on your wall. The temptation or pressure to increase production can be overwhelming, but you will fail at this leap of faith if you are not accustomed to driving yourself for 10 or 15 years without a safety net. Yes, without a safety net, and that’s the point.

When you were a child and you drove yourself to incredible feats of academic superiority, mom and dad were there to take care of all the essentials. Today, as a young entrepreneurial professional, there is no safety net only 26 WWW.THENEWDENTIST.NET

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increasing expectations as your family and financial obligations grow. It is important to appreciate that the fact that fearful emotions incapacitate reason and logic is actually a good thing from an evolutionary standpoint. We make emotional determinations quickly and instinctively; this capacity saved our lives on the Serengeti.

Listening to one’s logic can be nothing but a 10, 20, or 25-year fantasy that we are surviving and winning, when we are, in fact, dying slowly from misinformation.

Yes, reasoning and thinking got you through organic chemistry, and hand-eye coordination and working in small spaces got you through dental school; but logic and reasoning will not help you when it comes to managing staff, selling treatment plans to patients, raising children, nurturing a marriage, and managing debt. Managing your financial risk requires a bit more awareness of your emotional disposition and a bit more honesty. While your academic temperament determined your standing in graduate school, your emotional temperament will determine your ability to survive the business of dentistry, and my message is that it would be wise to accept the facts and reality of your personal history and make your financial debt decisions accordingly.

What Can You Truly Handle?

If you were a fearful adolescent, then calm your fears by accepting a more conservative entrepreneurial path so that you can learn to manage your money, your emotions, and make good business sense. If you are accustomed to financial and emotional risk then push forward with your full potential and take large steps in that direction knowing

that the outcome is basically certain based on your past behavior. And, if you are somewhere in-between, then trust your feelings as to what kind of risk would be prudent. Taking big chances can be healthy and fun when you are coming into the business without any emotional negativity. If you carry emotionally negative baggage, taking smaller steps can be healthy and fun as well. Your past successes will materialize again, just as your tendency for failure will materialize.

In the end, it is your emotions and your fear of risk that controls the whole picture. If you have spent your life visualizing your success, you will eventually be successful, but at what price? Taking on debt is not about dollars and cents. It is about the danger of unbalancing the equilibrium of your daily emotionally comfortable routine in an effort to materialize a fantasy of yourself that you are familiar with but may not be practical in the long-run.

From the Chair

But the patient who rose from that chair, even after a brief course of treatment, was a different person, with a different outlook on life, with new hopes and possibilities, with courage and hope they’d never felt. That patient had been looking for that smile, or that relief from inexplicable pain, or the simple ability to eat comfortably, for their whole lives, and they found it in a matter of hours, in a place that once made them afraid, with a person they once avoided.

Miraculous, I’d say.

It’s a humbling thing, I guess, to be told that you have miracles waiting to happen in your fingers, but please, don’t argue with me about this. I’m not flattering you, and I’m not exaggerating. It’s simply true. I need you to believe it every day. Your training and technology have never been

continued from page 14

and money has flowed past the health care professionals whose services might deliver the greatest return of all. I’m not saying dentists are going broke, or that there are too many of you. Nevertheless, I’m struck again and again by the absence from both the patient side and the professional side of a big, factual, splendid declaration of the dental profession’s real purposes and real significance, a statement so simple and truthful that nobody can deny it or get it wrong.

I was surprised recently when I opened a best-selling anthology about healers and healing.

It contained contributions by M.D.s and Ph.D.s, counselors, several different kinds of mainstream and alternative providers, but none—none—by dentists.

Not a word. How is that possible? Were the editors suggesting that you don’t have a place among such company, that you aren’t “healers,” while metaphy-

sicians are? Is the dental profession suggesting that?

Maybe the editors were asking, “What do dentists have to do with the health care crisis in America?” I’d hate to think that dentists are asking it too.

There’s that gap again between the need and the solution. Frankly, I don’t care who’s responsible for it, but one way or another, it needs to be bridged.

Whatever is standing in our way needs to be overcome by us both, together, because our goals here are the same and our effective collaboration is essential.

What an opportunity you have! Great dentists perform wonders for their patients. Many of you hesitate to believe that, it seems, but I know you understand what I’m saying. I’ve spoken with dentists who were so moved by the effects of their own work they were almost reluctant to talk about it.

They didn’t want to seem full of themselves, or unprofessional, I guess. From their modest perspective, they just fixed a problem.

better. My understanding of what great dentistry can do for me has never been greater. We’ve never needed each other more, nor ever have we been able to do so much practical good for one another. So if the billions of dollars patients are spending in pursuit of miracles aren’t going at least in part to every dentist in the nation, we’re both squandering an opportunity.

What an opportunity we have! I want our collaboration to reach that level where my highest hopes meet with the best of your abilities. That’s why it‘s important for me to be as candid with you as I was with him. For your good and my own, I need you to think again about who dentists are, about what you do and why you do it. And I need to offer you some thoughts from the person in your chair.

5M’s of a Successful Practice FREE Download www.thenewdentist.net/5M

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WWW.THENEWDENTIST.NET 27

FINANCING OPTIONS

for Your Practice Purchase

W

By Keith Merklin and Jim Baum

hile today’s economic environment is certainly challenging, there are still a number of financing options available for dentists transitioning to ownership.

Whether you’re purchasing an existing dental practice or starting up a practice in a lease space, you most likely need financing that gives you maximum flexibility and resources to meet your immediate needs and ensure long-term success. But prior to starting the loan process, you’ll want to know the financing options available to you and the answers to questions you’ll get from the lender.

Loan options are based on the type of project you pursue. If you are purchasing a practice or starting a practice in a lease space, your loan is considered Practice Financing and can be structured as either a conventional practice loan or Small Business Administration (SBA) loan.

Lower fees and less paperwork.

Flexible and customized repayment plans.

Up to 100% financing options available.

Quick turn around.

Lenders may accept the business and business assets as collateral rather than personal property and personal assets.

But conventional loans have their disadvantages as well, particularly if you’re not working with a specialty lender.

• Conventional loans through a local or regional bank can require a larger down payment.

• Loans can be based on existing assets rather than future performance, making it difficult for new business start-ups to obtain financing.

• There may be limited creative repayment options for borrowers with special circumstances.

Conventional Practice Loans

SBA Practice Loans

A conventional practice loan is typically financed over five-to-10 years, and can range from variable and fixed-rate loan packages with standard repayment terms and possible down payment requirements, to customized fixed-rate loans with up to 100% financing and flexible terms.

Conventional practice term loans are often used for practice acquisitions and start-ups in lease spaces. These offer a number of advantages to new business borrowers:

SBA Practice loans are term loans obtained through a bank or commercial lending institution and guaranteed by the Small Business Administration.

SBA practice loans are typically financed over seven to 10 years, with SBA lenders offering 85% to 90% financing. The loan typically commands a 2% to 4% SBA guaranty fee and other closing costs, most of which can be financed into the loan. However, as part of the 2009 Economic Stimulus Package

• • • • •

CONTINUED ON PAGE 30 >>

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• Custom financing to meet your needs • Planning tools to manage your progress • Practice expertise to support your success

Contact us today for your complimentary practice transitions newsletter:

www.matsco.com/DQ209TND If you have immediate financing needs, call your Financing Officer at 888.937.2321 Matsco is the only practice lender selected especially for ADA® members and endorsed by ADA Business Resources.

ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association.

ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. ©2009 Wells Fargo Bank N.A. All rights reserved. Matsco is a registered trademark of Wells Fargo Bank N.A. All practice financing is subject to credit approval.

Financing Options continued from page 28 signed by President Barack Obama, many of these fees have the size of your payment gradually increases over time as been temporarily reduced or even eliminated for certain loan your business becomes established and grows. Be sure you’re programs, making SBA financing even more attractive. provided with a specific timetable showing exactly when and SBA practice loans offer some key advantages over how much you will be paying month-by-month. conventional practice loans: What will you do if you experience a revenue or • A lower variable rate option. income shortfall? It’s critical to be prepared with an alternative plan. This could either be cutting • No prepayment penalties. expenses, working outside your practice, • More flexible credit underwriting or tapping into working capital, lines of guidelines. credit, or personal savings.

But SBA practice loans also have their limitations: Advantages of Using a • SBA loans almost always require at Specialized Lender least a 10% down payment.

• The loan fees and closing costs Using a specialized health care lender traditionally range from 2-4% for your practice acquisition, start-up, or depending on the size of the loan. expansion saves you both time and money.

However, due to the 2009 Economic Unlike most local banks, a specialized Stimulus Plan, many of these fees have lender can combine your practice, equipEven in a tight been temporarily waived. ment or property purchases into one loan economic • The loan program may require personal package, providing a streamlined process environment like assets and property as collateral. with one credit application, one set of fees we’re experiencing and one closing. A specialized lender can • The loans typically require more today, you can still also provide a broader range of loan options, paperwork. obtain the funds from short-term fixed rate loans to low you need to make variable rate mortgages. Many specialized Be Prepared for the transition Lender Questions lenders also use a consultative approach and to new practice To ensure the loan process goes well, be can provide additional resources to help ownership. prepared to answer these five basic questions make the process easier. that all lenders ask potential borrowers: Even in a tight economic environment How much money will you need? The like we’re experiencing today, you can still lender needs to know the precise amount of funding that obtain the funds you need to make the transition to new you need for your project, which means you’ll need to do practice ownership. With a little homework and preparayour homework in advance by obtaining estimates for your tion, you’ll be well on your way to obtaining the funds that practice purchase or start-up. will help get your dental practice off the ground!

How will you use the money you will borrow? For a Want to learn more? Visit www.matsco.com/ practice acquisition, be prepared to provide the negotiated dentalstrategies to read the full article on “Financing purchase price plus the working capital needed. For start-up Options for Practice and Real Estate Purchases.” or expansion projects, lenders will be looking for detailed costs for the project with a specific amount for working capital, Keith Merklin has been a commercial lending officer for 10 years and is currently Director of Commercial Real Estate equipment, construction costs, as well as a contingency fee.

Financing for Matsco. He can be reached at 510.450.3230 or How will you pay back your lender? Provide a busikeith.merklin@matsco.com. ness plan with a detailed pro forma that shows your monthly Jim Baum, Mid-Atlantic Regional Manager for Matsco, helps dentists nationwide finance their practice acquisitions and start-up cash flow and ability to make payments to the bank.

When can you start to make payments on your loan?

You may want to request a graduated payment plan where 30 WWW.THENEWDENTIST.NET

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projects. Jim also speaks at seminars and dental schools throughout the year. He can be reached at: 800.897.2208 or jim.baum@ matsco.com.

Top 10 Steps for Associate continued from page 21

6. Schedule Weekly Meetings It is important for the employer to serve as your “mentor,” particularly during the first six-to-12-months of your affiliation. This frequent communication can prevent problems from occurring, particularly in the early phase of your employment. These meetings should be scheduled for one hour and the topics of discussion should include treatment planning, case presentations, challenging cases, and scheduling problems.

9. Request an Experienced Assistant Chances are that you have not had the opportunity to spend many hours with a chair side dental assistant in dental school or sometimes in a residency program. It is critical for you to work with an experienced assistant, particularly during the first three-to-six months of your employment. You can learn a great deal from an experienced assistant. Learning clinical routines, instrument transfer, as well as practice record keeping protocol are all important to your success.

7. Schedule Monthly Meetings Monthly meetings should be held to review the business aspects of the practice. You should review your production reports, collection reports, accounts receivable reports (if applicable) as well as other reports that may be relevant. The employer gets the opportunity here to begin coaching you in developing analytical skills that are needed to become a successful manager.

8. Get to Know Your Practice’s Software Program We recommend that you become familiar with various features so that you are able to run specific management reports, understand scheduling, etc. Developing this skill becomes more important if you assume ownership or become a partner. This allows you to become more involved in the overall management process of the practice. For example, running a detailed production report shows you how you are spending your time in various clinical areas.

Running an incomplete dentistry report may give you insight into how successful you have been with your case presentation skills.

10. Marketing, Marketing, Marketing It goes without saying that if you join a busy practice, you may believe there will always be an infinite supply of patients.

We often find that the new associate fails to engage in any meaningful marketing activities. To avoid this problem, get involved in activities that can generate new patient referrals. Whether it’s coaching sports teams, joining community service clubs, or participating in church and civic activities, these opportunities place you in a position to meet many new people who may become future patients as well as increase your profile in the community.

In summary, there are many practical tasks you can accomplish, particularly in the early stages of your employment. There is usually extra down time for you to follow these ten steps, so become a proactive participant and the outcome will be a successful associateship!

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Strengths and Weaknesses continued from page 22 term solution. But they cannot say “No” to staff who request raises, bonuses, and other special perks that send overhead skyward.

It is essential that you understand not only your own temperament type but your staff’s as well. Moreover, certain personality types are not suited for some dental office positions. In other words, Emily may be great with people and absolutely horrible at collecting payments.

Placing staff in positions that they are not suited for can result in high accounts receivable, holes in the schedule, poor patient retention, ineffective recall systems, poor case acceptance, and low hygiene production, to name just a few.

Understanding your temperament type and the types of your employees is crucial for practice success. One of the best books on the subject is Please Understand Me,

by David Keirsey. Making the effort to better understand yourself, as well as those you work with, will save you and your team many wasted hours dealing with conflict, anger, and reduced productivity in the years to come.

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