Dr Phillip Palmer, December 2007 - This year it will be ten years since I started teaching practice management and, as with all anniversaries, it has been a time for reflection. Practice management has come a long way in Australia in the last 10 years, both in terms of the size and sophistication of the industry! The more I think about it, the greater the chasm is between what existed in Australia ten years ago, and what exists here today.

I should know. A little over fifteen (15) years ago I was at the proverbial crossroads many dentists find themselves at. I was confident in my clinical skills, but realised that there were other skills that I needed in order to be a successful practice owner. I needed to learn how to be a better manager, leader and all-round businessman. I started to look for answers. I started the search for practice management skills.

The search for practice management in Australia in the early 90s
Back then, I would only ask for help as a last resort. I used to try to work things out for myself. The first thing I did was read all the books on small businesses that I could lay my hands on; (the 90s equivalents of the “rich dad, poor dad” books). Sure, I learned some general things, but it quickly became obvious to me that I wasn’t going to get what I needed. There are very broad-brush comparisons that you can make with a launderette or a video store but, at the end of the day, a dental practice is a very different animal to other businesses. I needed help from someone who knew my world. Who addressed issues like: how to project expenses or income, how to be a leader in a dental practice, how to manage your team.

I looked around for help, but back then the only thing that was available in Australia was the occasional visiting American guru, like Ken James, Jenny De St Georges or Linda Miles. After seeing them, I remember thinking that the content was probably only 70%-relevant to the Australian market. But it was more and better information than was being offered anywhere else, and I was happy for any help I could get. I would walk away from those seminars enthused and inspired, and come back to the practice with so many ideas about how we could do things better.
The light quickly faded though... bad habits are often deeply entrenched, and cannot simply be unlearned with some vaguely-remembered protocols and catchphrases from a one day visit to a seminar. Without regular maintenance and support, regression always set in.

At the time I couldn’t find any credible resources in Australia I could learn from, so I turned my attention overseas. First I went to Sweden, then to the US. Back then, in the early 1990’s, the US dental industry was an exciting place. Everywhere I looked, there seemed to be products, concepts and ideas that I’d never seen or heard about in Australia. The lectures, the technology, and the presentations I saw on my visits to the US then were all, (in my opinion at least), lightyears ahead of what I had seen in Australia.

The practice management courses I attended there, and the follow-up coaching I received, were exactly what I was looking for – sure, they needed some tweaking to get them ready for Australian staff and patients, but the comprehensive step-by-step courses about the business of dentistry were amazing.

It didn’t take long before my net income from my practice doubled. I found that, as my skills in communicating with my patients improved, they simultaneously improved in dealing with my employees. Instead of having constant staff retention problems, I started to learn how to ‘be’ with
my team.

In a small profession like dentistry, it didn’t take long before other dentists asked if I could help them bring the same changes I had implemented to their practices. I ended up bringing a few of the practice management concepts that I had seen in the US back here to teach to my friends and colleagues.

That was 10 years ago.

Practice management in Australia today
Today there is a vibrant dental practice management industry in Australia and New Zealand.

• Overseas gurus are still visiting our shores regularly.
• Dental industry publications regularly publish articles on practice management issues.
• Prime Practice and others regularly hold workshops in every major city tailored to Australian/ New Zealand practice issues.

In 2005, I went to the U.S. again, this time to the Mecca for dentists…the Chicago Midwinter Dental Meeting. As I planned my trip I was excitedly expecting the same inspiration, innovation and advanced thinking (in the business of dentistry) that I had seen 15 years earlier. I was hoping
to bring some new concepts and ideas back with me. When I arrived I realised that things were different this time. Sure, the larger market means that there is a greater choice in everything in the US dental world - materials, implant systems, software companies, but the technological and innovation gap that used to exist in practice management had disappeared.

The lectures and presentations by world-class names seemed just… ordinary and not that different from what you would see at an Australian Dental Association exhibition (actually, I’ve seen and heard better here). Dental businesses that I used to look at overseas and wish were in
Australia (like 3rd party patient financing and marketing companies specialising in dental practices) are now a well-established part of the Australian dental industry. I walked away from the visit unimpressed and uninspired. I don’t think I brought back one idea that was novel or new to me.

I recently started contemplating why the gap had closed. Why we have progressed so far and so quickly? One explanation that I have heard is that several traditional factors creating international innovation and knowledge chasms have been lessened or removed in the past ten years.

1. The advent and proliferation of email and the internet, and the drop in the relative price of telephone in the past decade, has made it much easier for knowledge, concepts andcorrespondence to move quickly and cheaply around the world.
2. The relative price of international travel has also fallen considerably over the past ten years giving people and businesses affordable access to markets (and ideas) that they would never have had before.

A new idea, or concept can travel across the globe faster now than ever before.

Far from being an isolated outpost, The Australian dental industry has actually begun exporting poduct around the world over the past ten years. Australasian Dental Practice magazine recently reported on a record number of stalls held by Australian and New Zealand companies at the Cologne IDS dental convention in 2007. Even in the world of practice management Australia has started exporting - Prime Practice now regularly holds seminars and workshops in the US (at the Las Vegas Institute). We get regular website enquiries from dentists from all around the world looking for advanced information on how to run their practice. Ten years ago if someone had told me that we would be exporting practice management to the US I’d have had them certified. I wonder what the next 10 years will bring….

[Published Australasian Dental Practice, December 2007]