The new economy and dentistry

Dr Michael Sernik, October 2008 - The current economic meltdown will affect all businesses to varying degrees. What will this economic climate mean for you as a dentist? How is this going to affect your practice? And what can you do and what should you not do to prepare for the range of possibilities that could result? We need to put aside some ideas that worked before and take a fresh look at today’s realities.

Communication skills
When people do not have money, or are faced with an uncertain economic future, their first step is to reduce non-essential discretionary spending. The question for dentists today then becomes, how do your patients view the treatments that you are proposing? If they view the treatment you propose as discretionary, they are more likely to postpone or decline the treatment.

You might need to re-phrase your proposals. Adjust your communications message from discretionary to essential. A patient with bleeding gums may regard their chronic condition as ‘normal’. After all, in the patient’s mind, it’s been like that for years and it has not really been a problem. Yet in the dentist’s eyes it is seen as a very serious problem. We now know more about the link between periodontal disease and general health. If the patient does not view their condition with appropriate concern, then they are unlikely to be motivated to want treatment. The same disparity of concern applies in many clinical situations …abfractions, abrasion, cracks in teeth, loss of vertical dimension etc. The dentists that will do best are the ones who have the ability to have their patients view their genuinely urgent condition as such without any sales pressure. If you sound like you are trying to convince or talk the patient into something, this is sales pressure. The ability to communicate without this sales pressure is beyond the scope of this article and requires training to explain.

An interesting consideration regarding lack of communications skills is that the deficiency is invisible to the dentist. The same patient in another dentist’s hands might have chosen full comprehensive treatment. Luckily, a dentists communication skill level is something that can be learned and trained.

Niche vs general practice
In boom times, the most outstanding practices tended to be highly niched practices that offer one product. In the non-dental world, businesses that have survived multiple booms and busts offer a mix of basic and premium services. This way they can do well in any economy. Some dental gurus with niched practices will continue to shine no matter what happens to the economy, but by definition, gurus are rare. For mortals, this might be the wrong time to turn away patients and it might be prudent to take a slower road to ‘nichedom’.

Clinical training
Most dentists don’t really have enough premium services - they only offer basic dentistry. Don’t delay getting up-skilled clinically. When you have the clinical skills to treat all manner of complex conditions, you will actually see those conditions. Two hundred years ago, a dentist only recognized grossly overt problems; massive decay and broken teeth, because they only saw what they could treat. Today we recognize a wider range of problems, partly because we can treat them. The unskilled dentist will often claim the skilled clinician is over-servicing the patient. The dentist from 200 years ago might say the same things about modern dentistry.

Consider emphasising your other services like preventive dentistry (with the emphasis on saving money) or new techniques that promote painless treatment (lasers, wand etc). Any treatment that has a deleterious consequence if left too long, like sleep apnoea, TMD, abrasion, loss of vertical dimension, can be powerful because there is the threat of future cost and risk if left untreated

An advertising campaign can only be viewed as successful if it leads to increased business. The advertising itself is merely the vehicle that gets the phone to ring. It cannot lead to increased business on its own. The communication skills of your whole practice coupled with your clinical skills is what is going to convert the phone call enquiry into new business.

Without strong communications skills in your practice, you might be wasting expensive advertising dollars on an inefficient revolving door scenario – paying to get potential patients to phone and losing them along the way.

Well-run businesses of all descriptions use key performance indicators (K.P.Is) to tell them where they are now and where the business is heading. They are invaluable to tell the business owner where the weaknesses are and so help to plug leaks before terminal haemorrhage sets in. You can’t run a business successfully on only gut feel. Ideally, the comparison of your practices KPIs with those from previous (comparable) periods and the interpretation of the results should show if there is a skills deficiency or a system deficiency.

The final point to consider is the concept of leadership. A dental practice, like a country can prosper or fail depending on its leadership. Most dentists have little understanding of the practical significance of leadership in their world. The best leaders know that they have a lot to learn about it and the poor leaders don’t even know that they don’t know. In boom times businesses could afford to have mediocre leadership. The times carried them along and perhaps gave them a false sense of security. The good thing about adversity is that it can spur us to higher levels of excellence.

Disruption always creates new opportunities. There is a lot dentists can do. People today will still find the money for a hearing aid instead of an ear trumpet. They still will buy glasses to see with. They still will get knee surgery instead of a walking stick if at all possible and they will choose an implant if it means avoiding the discomfort and loss of libido of a plastic denture. It’s all about communication. The dentist with hard core communications and clinical skills will always outperform the less skilled. Hopefully, the current downturn will reverse quickly, but if not, face reality calmly and logically. I would suggest that if you want to ride the next economic waves and come out on top, investing in yourself will always be your best long term investment.

{Published in late 2008}

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