Time, People and Money: The Ultimate Juggling Act
“It’s quite straightforward really, Alun” the old sage said, “you only need to get a grasp of three fundamentals for business success and they are Time, People and Money. Once you understand these, everything else is straightforward.” He was right of course, but what he failed to say was how hard the lessons would be.
I think of the three as primary coloured juggling balls. When you learn to juggle you start by practicing with one ball to get used to its weight and the action of your arms. You then proceed to moving two balls from hand to hand and eventually you progress to keeping three balls in motion. As anyone knows who has learned or attempted to learn the skill it’s a lot easier to write about, or to imagine, than to do. Yet once you have mastered it the time spent learning was well worth the effort.
There are hundreds, info thousands of books, talks, courses and techniques around the topic of time management, indeed one of the first self-help books, “How to live on 24 hours a day”, was published in 1908. Its author, Arnold Bennett, said, “we shall never have more time, we have all the time that there is”. The challenges faced then are exactly the same ones we face today; they are primarily ones of choice.
Many new clients complain that their appointment book is “out of control”. Every small business depends upon its owner’s production and every small business owner’s sanity relies on them using their time to be most effective. We all acknowledge that the diary, book or schedule can make or break a business or individual yet rarely is everyone happy with the way their time is organised.
The most common problems arise when there is an acceptance that the appointment book just happens without any thought of the concept of Flow, which is defined by Mihaly Csikszentmihaly as “the feeling of optimal experience”.
By starting with the end in mind it is possible to design a work schedule that attends to the patient's needs and runs at a profit without burning out the clinician. My experience in my own and other practices have shown me that practices that appear calm and quiet are actually more profitable and better run than those that seem busy.
This is the point in our imaginary Venn diagram where time and people overlap. People come in two groups, the team and the patients. Let’s examine the team first as it is they who will be responsible for managing your time. It is imperative that they all grasp the values that you embrace as a clinician and business owner. Knowing your values will lead to the “why” of your practice, which they must understand. You have to be able to explain your purpose in life to them so that they can reflect that in their actions and, especially, their interactions with patients. This requires regular two-way conversations where challenges can be discussed, feedback heard and any necessary amendments to processes made. An open, learning environment will lead to a patient focussed culture.
Whoever manages your appointment book is in a position to influence or even control the practice income. If they understand the importance of the role, accept that it can be a force for good and know that they are appreciated for their work then you have a vital functioning cog in your business engine.
Start well every day. A morning huddle gives everyone an opportunity to learn from challenges in the previous 24 hours and to anticipate any difficulties coming up. Get the day off on a high point.
“Dentists should only do what only dentists can do, and they should delegate the rest - where possible”. This means utilising the skills of dental therapists and hygienists, care co-ordinators, nurses and educators to the maximum wherever you and they are able. Delegate but don’t abdicate, there is a clear line between responsibility and accountability, stay on the right side of it.
Very few dentists enjoy and excel at every element of dentistry, either learn to say no to procedures that feel like life shortening exercises or take some serious time to increase your skills. True professionals don’t dabble at anything.
The other group of people are your patients, the reason that gives you a business in the first place. They are your greatest source of feedback, your best ever sales force and your unpaid marketing team. Patients, clients, customers call them what you will, I believe that in healthcare they are patients, who deserve the highest quality of customer care.
It can be very easy to become blasé especially with long established patients. Unfortunately with the high focus placed on marketing and finding new patients it can be very easy to lose sight of the existing ones, their wants and needs. Never forget that every visit is a big deal for them, it’s something special, there’s no “just a” check up or “only a” scale & polish when you are a patient. Every patient carries the memories of anything sub-optimal from the past. Their trust is hard earned; ensure that you never lose it.
The days of “doctor knows best” are, quite rightly, long gone. Patients are growing in sophistication. They search for practices that suit them and cater for their requirements and they recognise a lack of authenticity and clunky sales techniques when they see them.
There are two sorts of patient transactional and relationship. (That might be said of many dental team members also.)
The transactional patient is primarily interested in price; they will shop around for the best deal and are committed to you making as little money as possible. If they find what they think is a better deal or a better perk they will disappear. They are the most likely to complain make demands and seem unreasonable.
The other type is the relationship patient and they search for, and appreciate, trust, familiarity and authenticity. They want to know who their professional team are and that you are the “go-to” place for all things dental. They will pay more for the trust factor. They are profitable over the long term, are forgiving, and the bond should last a lifetime.
Your antennae and those of your team will learn to tell the difference between the two patients and behave accordingly.
The late Jim Rohn wrote, “Time is a lot more valuable than money, you can get more money but you can’t get more time.” That is why I have left money to the last section. A business exists to make a profit, to give a return on time, money and effort (if you don’t agree, stop reading now). It is also there to provide employment and, ideally, to deliver the best possible care in a pleasant, relaxed atmosphere where everyone can give of their best.
There are certain rules that must be observed for happiness and success. The fundamental one is that income must exceed expenditure. However there is far more to it than that, and requires asking basic questions which many self-employed people are slow to do because they fear falling short of their hopes and expectations and feeling as if they have failed.
The biggest questions are:
How much do you want to earn to have the life that you desire and to invest in yourself, your team and your business?
How many clinical hours will you work per week? How many weeks a year?
The calculations are easy and your desired daily income or yield can be obtained. Unfortunately the subsequent planning and implementation doesn’t always happen. Too often dentists know what they should charge but what has been described as the mental - oral fiscal gap stops them, this is where the mouth overrides the knowledge and you quote a lower fee than you should. Every element of your business is based on knowledge, research and proven systems, don’t let a wobble in asking for the appropriate fee get in the way of your success.
In this brief article I have been able to skim across the surface of each of these subjects. I know that giving time regularly to consider the relationship between each member of the triad in your business life will repay itself ten or a hundred fold.
To your success,
Alun Rees - The Dental Business Coach
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