79 Ways to Fail in Dentistry – Chapter 2: Business, Burnout and Buying a Practice
In my experience as not only an experienced dental professional but also a business coach, I see a wide range of challenges and considerations that present themselves in each and every practice.
My second chaper focuses on the top three queries which start with 'B' in my A to Z of getting it wrong in Dental Practice.
When someone wants to buy a McDonald’s franchise, they need a minimum of £100,000 cash plus a willingness to be inducted through a six month training programme in order to make a return on their investment and maintain the reputation of the McDonald’s brand. To own a dental practice, you need a lot more money plus the enthusiasm to endure a learning process that lasts for a working lifetime or longer.
My point is this, until and unless you accept that just like McDonald’s, Cathay Pacific and Mandarin Oriental Hotels you are in a business then you will fail.
The business of dentistry is challenging at best and crushing at worst. The best way to fail at any business of dentistry is to presume that it is as easy as the successful businesses make it look.
Seven ways to ensure failure:
1. Vision: Have no plan, dream or idea of the direction you are going to take. Don’t bother to set goals, wait for things to happen and react to them. Assume that everything will work without making detailed arrangements for every thing large and small.
2. Finance: Everyone knows, outside dentistry that is, dentists are always successful. In the same way that “nobody ever sees a poor bookie” dentists are amongst the wealthiest of professions. All you must do is open your doors and then keep taking your bucket to the well without regard for costs, prices or controls. Cashflow is for accountants.
3. Sales: You’re a highly trained professional and you know far more than the people who are lucky enough to have you treat them. Any problems they have are their fault or have been caused by other dentists. You know best and you’re the boss, they will always do as you say.
4. Marketing: As you are so good, there is no need to have a system for attracting, pleasing and retaining patients. The word will get round magically that you are the best in town.
5. People: Because you are so skilled at dentistry your team will be as good. By osmosis, it’s simple. There is no need to nurture, train, support and encourage team members. If they don’t like working for you it’s their loss.
6. Systems: Dentistry is simple; everyone knows that, patient, dentist support staff, and perhaps a practice administrator to take care of all the non-clinical things. You can do all your paperwork at the weekend. No problem.
7. Environment: You love winter sports and MMA so Sky Sports on the big screen in reception what’s not to like? As for the smells, sights and sounds of uncovered instruments that’s just the way dentistry is.
5. Buying a Practice
Thirteen top tips to fail when buying a dental practice:
- Fall in love at first sight with a practice or become so desperate to buy that you lose your sense of perspective.
- Take everything at face value. The seller seems like a nice person; any differences between what you can see and what is claimed are merely small glitches that can be sorted out between you.
- Only view the practice in the dark and/or on a Sunday. Why take time away from your busy job to travel during the working day? What’s to be gained by walking around the local streets, watching the footfall, looking at the neighbouring businesses and houses?
- Convince yourself that there isn’t a real need for accurate accounts going back three years and that up to date ones are so difficult to arrange with such busy accountants.
- Accept a handshake over re-negotiating the terms of the lease as adequate security for your future. Everyone says that solicitors only complicate things to increase their fees.
- The regular problems with the back-ups leading to a loss of some data isn’t really important in the grand scheme of things, it will soon be under control and anyway new computer systems aren’t very expensive.
- Of course the commute from home will be a bit longer during the rush hour, but 100 miles isn’t that far, it’s only the M25, and it will give you a chance to get ready for the day and to unwind at its end.
- Your mate Dave the builder is pretty upbeat and he reckons that the surveyor is being over the top about the damp and that cracks are just due to the old building settling, you always get that in listed buildings that age. As for the rumours of asbestos and corroded wall ties, they are just scaremongering.
- The private price list needs updating but as son as you get settled you can put your prices up to level with the NHS fees.
- There has been a bit of a turnover of “girls” (as the seller described them) but once you get going with your new management style and bonding exercises that won’t be a problem. You can redo all the contracts as a priority, and get rid of the dead wood.
- Use solicitors and accountants who have never handled a dental sale before, let alone one with an NHS contract involved. They’re cheaper and should be OK.
- Your (life) partner doesn’t think it’s a good idea for you to buy, so you have both stopped talking about it. Their job is stressful enough at the moment as it is, what with them facing a promotion and a possible move.
- Don’t listen to your gut instinct when it’s telling you “No, don’t do it” and throw caution to the winds.
Problems with burnout are frequent in dentistry and it’s a topic that must be taken seriously. I have experienced burnout personally and also by helping clients to sort out their professional (and personal) lives in the wake of their own challenges.
Here are some of the things that I know about burnout:
- You don’t see it coming until it has hit you.
- Once it has hit, you take longer than you think to get better.
- You don’t realise how ill, and without doubt burnout is a form of mental illness, you have been until you are back to form.
- The lessons it brings are often overlooked because we all think we are invulnerable.
- Bouncing back is fine in theory but few return to exactly the same shape after burnout.
- Prevention is better than cure.
The definition of burnout is relatively straightforward, “a state of emotional, mental, and often physical exhaustion brought on by prolonged or repeated
Stress, in some form, is a necessary stimulant for life. Since Hans Selye published his initial work we are aware of there being a number of stresses, which, in small amounts, stimulate us to give our best. Selye described this type as good stress or “eustress”, however when we pass a certain point the stress becomes a negative and “distress”.
Burnout happens for a number of reasons, which often act synergistically. An extended period of stress feeling as if it cannot be improved or from which there is no break. It is often associated with a sense of having no control over circumstances, feeling unsupported or trying to achieve a goal that does not resonate with you.
The key signs of burnout are physical and mental exhaustion, a feeling of dread about work and often a sense of cynicism, anger or irritability. These can frequently manifest themselves as a slowing in accomplishments, procrastination and a lack of effectiveness.
It is not always related to work, parents, carers and those with relationship problems can also suffer.
Treatment requires rest, realisation and acceptance that you are unwell plus renewal and re-evaluation of the way that you are living. Experts can help to treat, or to assist to find other ways of living that do not manifest themselves in crisis.
The worst thing that you can do is to ignore the signs and symptoms in yourself or anybody else, it will not go away easily on its own, and it can return.
Alun Rees - The Dental Business Coach
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