The Search for the
Holy Grail of Dentistry
David Woods
This year another set of fresh faces will obtain diplomas certifying them qualified and competent to practice dentistry. To this new phase of their journey they bring energy and enthusiasm, hopes and dreams. Most have high expectations of earning substantial incomes, working four day weeks, being their own boss, and finding joy and satisfaction from their service to others; something we like to call the Holy Grail of Dentistry. All of them arrive in the wet finger world of private practice with certain expectations about what it will take to achieve their goals and obtain the Holy Grail. But sadly, as with the fabled knights of King Arthur's court, many of them are soon disillusioned, and only a few will actually obtain the prize.
If we survey graduates in the same class from any dental school in the country we find this same phenomenon. Seventy-five or eighty dentists with the same degree, from the same school, doing much the same clinical work, working about the same amount of hours, yet some are earning over $250,000 per year while others are barely making $75,000. As early as three or four years out, some of these young dentists will already own substantial practices with plenty of fee-for-service patients. Their incomes will be well into six figures, and they will have time to travel, to explore their personal interest and to spend with their children. They will already be setting aside significant amounts of money for their future, and by the time their incomes and interest in dentistry peak out in their mid to late 40's, they will be financially free to pursue a wide variety of options. But they will be the minority.
The ADA reports that only about five percent (5%) of dentists are able to retire comfortably by age 65. Years after graduation, most dentists from your class will still be wondering how the others do it. Four or five years out, many will still be gutting it out in startup practices, hoping patients will show up before their bank line runs out. Most will still be associates, hanging on and waiting until their host decides to let them own a piece of the pie; waiting for their turn to get back as much as they have put into their career.
Why does this happen? Why are some dentists so much more successful than others? After almost twenty-five years of first hand experience, we can summarize it in just two words, willingness and knowledge, and in that order.
Willingness is an attitude. It is what we call an enabling or empowering attitude. It is that quality which allows for everything else to happen. Willingness is being willing to accept the possibility that you don't really know what to do. It is being willing to accept guidance from others. It is being willing to accept and take risks. It is being willing to make and keep commitments. Yes, willingness is an attitude. It is the attitude of success.
Contrast that with the young doctors that come out of school thinking that somehow their dental diploma has someway imbued them with the answers to life's great questions; who inwardly believe that they are different than their predecessors; that the business part is easy or just plain common sense; that their particular abilities will allow them to beat the odds. They really believe that their associateship will actually work, because they alone know the secret to structuring the world's greatest associateship; they know how to build the perfect practice from scratch in less than three years; they know just where to go for financing; and finally, they know the secret to attracting and keeping vast numbers of quality fee-for-service patients. They, of course, know so much that they don't need anyone else to show them.
Let's suppose for a moment you are willing to do whatever it takes to make your career in dentistry the very best it can be. The question now becomes, "What does it take?" We know from experience that there is virtually no correlation between clinical perfection and practice success. Some of the best clinical dentists we know experience high stress, continual staff turnover, and low productivity. When they get together at the dental society meetings they stand around bemoaning the difficulties and pressures of private practice, and the fact that they can't make any real money in dentistry. Listen closely to what they are saying: "there are just too many dentists, too many cut-rate dental plans, too much advertising, too few patients who appreciate their work, too few patients willing to accept treatment, too many whining staff members, too many government regulations, too few hygienists, blah, blah, blah.", poor fellows.
Down the street, their colleague (who graduated in the bottom half of his or her class) is experiencing something much different. Their same staff has been with them for years; ever since they bought the practice from Dr. Smith (or Dr. Jones or Dr. Whomever). They are friendly, motivated, and extremely good at what they do. They really enjoy working together and share a common vision of why they are there and what they need to do to meet the needs of their patients. Last year each staff member received just under $5,000 in bonus income, placing each one's individual compensation well above the industry norms. Nevertheless, the doctor took home over 45% of his practice collections. That came out to just under $250,000 working the same 32 hour week as his or her neighbors up the street. This doctor earns enough to set aside a significant amount toward savings and investments. By the time his or her practice earnings peak out in their mid to late 40's they will be financially free.
Let's see, here we have a clinically average dentist who somehow has plenty of fee-for-service patients, a motivated and happy staff, works a four day week, earns a net income in the top 4% of all dentists, and will be set for retirement before he or she turns 50. If there really is a Holy Grail in dentistry, this person has found it. Sounds like a very successful dental practice, wouldn't you say? Does it sound like yours? Does it sound like something you would like to have? You can have it, if you are willing, and if you know what to do to get it!
What kind of knowledge is required? First, you need to know how to acquire and retain large numbers of fee-for-service patients. Second, need to know how to acquire and train a motivated, topnotch staff. And finally, you need to know how to treat and serve your patients so well that they will never leave; not for a PPO, not for another dentist, not for anything. That's it.
That's it? Yes, that's it. Are you surprised? It sounds awfully simple, doesn't it? And in a lot of ways it is simple. Simple stuff that anybody ought to be able to do - right? So why then don't more dentists have practices overflowing with happy staff members serving loads of fee-for-service patients? Maybe it's not so easy after all. Maybe things get confused in the vast gulf of reality between talking about it and actually doing it.
So what is the first key to any successful practice? It all starts with patients. Without patients you have nothing but equipment and a lease on some real estate. I am always amazed at how many young dentists think that because they have a location and some equipment they have a practice. Wrong. Those things can be had just about anywhere. They are commodities which can be acquired anywhere, at any time, from any vendor or leasing agent. In a way, patients are also commodities, only they are not so plentiful, and are much more precious, as any practicing dentist will tell you. Nevertheless, fairly large groups of quality patients can be acquired. Sometimes they come with equipment, a location, and a staff. Sometimes they even come with a doctor willing to do some of the production. Sometimes they come with only their charts and a letter of endorsement from the one guy they have trusted for thirty years or more. Amazingly, if the proper steps are taken, over 95% of them will typically show up to let the new doctor treat them.
All you have to do is be willing to make the journey with someone who knows the way. Just remember that most of your colleagues will seek dentistry's sacred Holy Grail, yet few will ever find it. Now you know why.
Remember, for the noble Knights of the Round Table, the requirements of success were virtue, humility and the sinless life. ■
David Wood's academic background is in Business with an emphasis on Marketing. He is a graduate of Mississippi College. David has managed and acquired multiple businesses in the Mid South prior to joining PARAGON. Over the past ten years he has assisted many PARAGON clients across the nation with their transition needs. He has been involved in the development of many of PARAGON's current transition programs including presales, mergers, consolidations as well as co-ownership arrangements. David currently serves as PARAGON's Vice President overseeing operations in the Southern United States. His primary duties with PARAGON include the recruitment, training, and daily transition support of PARAGON consultants. © Paragon, Inc. All rights reserved.