Many offices provide dental care for the entire dental team. This system can cause problems within the team if one team member has had some significant neglect. A team member who is not at a very high level of oral health will receive a lot of care and a large benefit.  While a team member who has taken great care of their mouth may only require minimal dental treatment and not use this benefit.

Consider providing the same amount of benefit for all of the employees. You can provide a consistent dollar amount each year to be used by your team. For example, you could stipulate that you will provide them with $2000.00 of dental treatment each year. They can use those dollars for their care or for their immediate family. Once they use up the thousand dollars, they will be responsible for paying the remaining portion in cash.

Part time employees are typically not entitled to any benefits. You will need to determine what you would like to provide for them, if anything.

Please know that we are not discouraging benefits to your team. In fact, we encourage them! We simply encourage you to put systems and structures in place that are equitable for all of your team members.

Don’t forget the compensation benefits that don’t show up on your employee’s paycheck. These items are called “Hidden Paycheck” items and your dental care benefits are only one example of this.

Employees may overlook the benefits provided to them by their employers. By incorporating these items into your compensation review, it allows the employee to see the whole compensation picture for what it really is. Many times the hidden paycheck items can add up to 35 percent of their earnings, and most of it is tax-free.

Example of a Compensation Review – Preliminary Offer

Annual Base Salary Offered                 $__________________

Employer Matching FICA                    $__________________

Profitability Pay when Available      $___________________

Medical Premium Contribution         $ ___________________

Pension Plan Contribution                   $ ___________________

Total Salary                                                 $___________________

 The items listed below will not show up on your paycheck. But they are additional benefits provided to you by the doctor.

Uniform Allowance                             $ ___________________

Dental Care Allowance                       $ ___________________

Jury Duty – Bereavement Pay        $ ___________________

Parking Garage Fees                            $ ___________________

Continuing Education                         $ ___________________

Total Compensation $____________________________

Pension Participation Date ___________________

Coaching Department; The Schuster Center

The objective of the fiscal responsibility is to teach you how to manage your professional and personal monies. Budgeting can give you a map of expenses that are known and help you plan for expenses that cannot be anticipated.

Once you have all of your figures together, you have to start asking questions such as: How much control do I place on my spending each month to achieve the desired profit? What purchases are coming up for me in the future? Can I afford to take my vacation this year?

Once you have completed you budget you will have one of the most effective personal management tools of all – something that you can use each month to check your progress in achieving your personal dreams.

In its simplest form, a budget is a detailed plan of future receipts and expenditures. Right from the start you can validate the activities that you have planned for the coming year. Knowing what your personal activities cost and when such expenses will occur will help prevent any unexpected surprises that could lead to financial problems.

Once the period for which you have budgeted is completed, you can compare actual results with anticipated goals. Get into the habit of making this a regular part of your personal routine. You may find it takes discipline at first, but the rewards are high. You don’t have to do anything elaborate, just a simple comparison of your budgeted figures to your actual results. Then begin by asking yourself “why” they are different. Were your expenses higher than you anticipated? If so, do you need to look for ways to cut costs? Don’t blame the budget, use the information constructively and improve your budget the next time around.

The next step in preparing a budget is to determine whether you can achieve your personal profit goals. To do this, you must project your fixed costs and your variable costs. From these three figures, targeted profit, fixed expenses, and variable expenses you can determine your required level of income.

Fixed expenses are those costs that regardless of personal income generally stay the same. Several examples are mortgage payment, insurance, car payments etc.

Variable expenses vary with income. Several examples would be entertainment, travel, groceries, and clothing.

During the year the budget provides you with one of the most important personal financial management tools. For example, by looking at the year you can anticipate peak periods and months where personal profits may be restricted. It helps you anticipate your schedule better so you can make good decisions about special personal purchases or activities.

Through the process of budgeting, you will gain greater self-awareness by developing a deeper understanding of your cash flow needs. This will lead to improved personal performance and an enhanced quality of life. Through this process you will become more self-aware and committed to take action in route to your personal financial success.

There is a marketing life cycle that all businesses go through if they want to be successful. First, the business has to know there is a line. Then, they need to know where the line starts and how to get in the line. Much of the effort goes into staying in line and holding that position. Sometimes a practice decides it wants to move up in the line and, perhaps, get to the head of the line.
Marketing is about this entire process.
But when an organization stops marketing and takes it’s position for granted, it is the same as getting out of line and having to start over or, if not from ground zero, then certainly from a more disadvantaged position.

Unfortunately, it is a cliché that when times are rough, the first expense to cut is marketing and advertising. This happens time and again, despite the many case studies and statistics that strongly demonstrate how companies, products and practices that marketed (e.g. maintained their visibility) throughout down times gained greater market share when the good times turned around.  And for a lot less money! Those organizations that silence their marketing voices have to spend more, work harder and play catch up to their more marketing savvy competitors. Often, in spite of their efforts, they never again really catch up to where they were.

Healthcare advertising has a lot to learn. Unfortunately, many organizations learned the wrong lessons, from the wrong people. During the 80s, it became fashionable to talk about “product line advertising” as opposed to image/brand advertising. Large hospital systems thought it would be a good idea to apply consumer packaged goods approaches to healthcare and hired MBAs out of Proctor and Gamble to direct their strategies. Lectures and seminars were developed that had these marketing gurus telling hospital folk how to do it, and the first to be sacrificed was the image (or brand) of a facility. The new hero was the product. Ads had to be measurable. Marketing had to be accountable. The brand stewards were hushed in favor of short term returns.

Lamentably, abandoning the brand took its toll and turned healthcare into a commodity.

Commodities do not have bargaining power.

Commodities do not inspire loyalty. People will not pay a premium to use their services. But organizations (and practices) who maintained their belief in the power of their brands ultimately thrived and out-performed their competitors. For example, Mayo Clinic remains the “poster child” for this concept. The Mayo Clinic “brand” is protected at every turn. They do not market individual programs and services as much as they market them under the aegis of Mayo’s programs and services.

The safe default position to which many healthcare advertisers fall prey is to tout facilities, technology, and sometimes its doctors. Add to that some testimonials from satisfied patients whose lives have been saved, mixed with smiling family shots of arms draped over loved one’s shoulders, or couples walking on the beach holding hands, and you have the typical clichés of healthcare.

Ads that provide a concept that hits a nerve, that engages us on a deeper level of desire, fear, hope and longing are ads that we remember. That is the point of doing ads at all: to plant in the minds of our target clients (patients and referral sources) the message about who we are, what we do, and what we can do for them that is better than what they could get elsewhere.

That is when advertising goes from being an expense to becoming an investment.

Great advertising, effective advertising, is like shoulders from which to drape a garment. It flows. It fits. It makes an impression that lasts long after the person leaves the room.

There are plenty of opinions as to what makes for good, if not great, advertising. Yet the truth rests with some very simple concepts. Do you remember the advertiser and the product? Do you get what the advertiser’s key benefit is to you for the product or service? Do you understand the product’s attributes and promises long after the ad has run its course? Do you like the ad and look forward to seeing it again? Does the ad make you feel inclined to ever use the product? Do you come away from the ad with a positive perception about the advertiser?

If you are going to hold your place in line and improve your position, create an impact. Make your advertising memorable. In Hollywood, people often use the expression “I laughed, I cried, it became part of me” to describe with flair how a performance affected them. Advertising, to be effective, must affect people as well. If it doesn’t, it is an expensive exercise. If it does, it is the best investment you can make in marketing your practice and becoming “brand visible.” The better you are perceived, the more choices you have in creating the practice you desire, with the patients you choose, on your own terms. That’s why you market, and why being in line matters.

If you enjoyed this article and would like more information, contact The Schuster Center at 1-800-288-9393 or www.SchusterCenter.com

1. Know Yourself  – Having your own practice is more than just creating a job for yourself. Your basic roles are in delivering dentistry, marketing, finance, administration, and the responsibility of personnel. To get the best results, it is rare for one doctor to play all these roles equally well. You must know which parts you can handle yourself and which parts you’re going to need help with. As the technician in the practice your time is leveraged best when you are concentrating on activities that ensure future revenue for your practice. Empower your team to run your management systems and stay focused on what you do best.

2. Plan Ahead – well-intended team members but who don’t have all the information they need to do their job run most practices. This includes a clear idea of market segment, target markets, customer service, marketing mix and promotional activities. If you want to succeed you need a well thought out business plan that helps you make the right decisions? If you don’t have a business plan, consider enrolling in The Schuster Center’s Strategic Planning program.

3. Know Your Industry – You can gain the greatest competitive edge if you have an intimate knowledge of your business. Unfortunately dentistry is a very isolated profession. Exposure to your colleagues and their practices is very limited.  To thrive and prosper, you must be committed to learn and have the desire and energy to accomplish your goals. These are five main reasons why most practices don’t prosper.

1. Lack of Industry Knowledge
2. Lack of Vision
3. Poor Market Strategy
4. Failure to Establish Goals
5. Inadequate Cash Flow

4. Understand Your Clients – Make it your business to give your clients what they want, and they will continue to buy from you. The services you provide should reflect your client’s needs and wants.  Many doctors position themselves as a commodity-based practice and focus on selling Crowns, Veneers, and Restorative.  Think in your client’s terms; buy, show, sell, and say things that interest them, not just what interests you. Remember, they want NO dentistry. Sell yourself!! Focus on your services such as trust, being on time for their appointments, and your attention to patient comfort.

5. Keep Good Financial Records – If you don’t know where your money is going, it will soon be gone. Good financial records are like the instruments on an airplane, they keep you posted of your height, direction, and speed. Without them you’re flying blind with no controls to guide you to your destination. If you are not tracking your statistics get back into the routine of this with your staff. If you need assistance contact your support coach for a review.

6. Use Sound Management Practices – As a practice owner, you are also a manager. You have to make decisions, offer client service, manage time and resources, and know how to run the practice better than anyone working for you.  Your team not only includes your immediate staff, but surrounding yourself with a professional advisory team is also critical. Remember the concept of a level one dentist vs. level two dentist. This same concept can apply to your accountants, insurance agents etc. Are you working with a level one accountant or a level four? Are they simply organizing your money on a P & L or are they coaching you towards future goals?

7. Develop A Distinctive Image – Your image is important and is a function of your marketing efforts and materials.  Clients create their perceptions of your practice from your name, web site appearance, practice location, displays, business cards, newsletters, and anything else that relates to your business.

8. Learn From The Pros – In today’s explosive markets, making the right moves is absolutely essential; there is little room for error.  Stay connected with The Center so you can interact with dentists from all over the United States.  The support department is also a terrific resource for your practice. Each year we have the privilege to communicate with literally hundreds of doctors.  Because of the emotional and sometimes difficult decisions that must be made, the crucial difference is having fresh ideas with an impartial business position. This is one the primary reasons we use statistics in our coaching calls. Our job is to minimize the emotion and give you guidance based off of objective data.

Case presentation skill development is a critical component to your success. You will need to constantly improve and refine your skills. If your case acceptance is less than 85%, then consider attending an Advanced Case Presentation Seminar with Dr. Schuster.

1. Case Studies - Many of our clients have told us how much they have benefited by reviewing a completed case as a team. Questions such as, “What could we have done better relative to the patient’s treatment”, and “Clinically, what could we have done to improve the outcome?” are great customer service questions.

2. Recare Review - Once a month, the hygienist should report on the patients who were due for hygiene this month, who is accounted for and who is now missing in action. What is their strategy for contacting those patients and more importantly, why did they not respond to the retention efforts?

3. Structured Messages - This should be an ongoing project. You created a number of messages during your Management Program but your practice has an enormous opportunity to refine and create more as a team. Many offices only use structured messages for phone conversations but you can use these for virtually any face-to-face interaction. The format can be used to help with your pre-clinical interviews, chair-side education, and financial arrangement conversations.

4. Communication – Your ability to communicate your thoughts, feelings, ideas, values and beliefs are determined by how well your practice runs. We often limit ourselves by only thinking about how we communicate person to person. However, you might consider reviewing all of your printed materials to check for the consistency of the appearance and the message you are sending. Your web site, yellow page ad, signage, phone messages, collection calls, etc. should be evaluated on a consistent interval.

5. Career Development - The best practices hire and retain the best people as employees and are responding quickly to changing market conditions. The doctors are not satisfied with the status quo. They continually upgrade facilities, processes, and the skill of their employees. Many of my doctors lament about not having enough time to get trained on power point or digital photography. Why not send a team member?? Don’t forget to invest in talent and keep them intellectually challenged. Many of my best clients have mismanaged very talented team members by not investing in their development. Take time to plan out your employee’s career path so they continue to be renewed and recommitted to your practice.

The opportunities for creating the practice of your dreams are unprecedented. But so are the difficulties, for competition is more intense than ever. The critical success factor for your practice is the quality of your team. Authentic team members who are mature and committed will make your vision become a reality. However without meaningful staff meetings in place, your opportunities for success will be limited.

Peter Drucker says that, “to make a decision is the specific task of an executive; effective executives, therefore, make effective decisions.”  People decisions are not only the most important and difficult decisions a leader will make, they are time consuming and complex.

People, not plans or products, are the wellspring of organizational success. Individuals are the basic building blocks of any group or organizational effort. Your success will ultimately be determined by the quality of people you recruit.

The objective of any placement decision is to obtain the best possible fit between the person and the position. The better the match, the greater the potential to succeed. To achieve the greatest match, the decision maker must know the demands of the task as well as the gifts, skills and temperament of the people being considered for the position.

The selection process may appear straightforward, yet we tend to blow it for a few reasons:

• FIRST, the selection process involves many more unknowns than knowns. Jobs are difficult to define, and the people who fill them are infinitely complex and their behavior somewhat inconsistent. People decisions are frought with subjectivity, uncertainty and risk.
• SECOND, the selection process is hard work, the complexity of which prompts many leaders to unfortunately make too QUICK decisions, leaving the results to chance.
• And FINALLY, making good people decisions is a skill. It involves knowledge of human nature and proficient application of certain processes and principles. Not knowing the process and how to apply it causes us to fall back on the old standbys of intuition and gut feeling

Generally, mistakes in people decisions aren’t immediately obvious. But when they do become apparent, we invariably go through a long, drawn out expensive process of analysis and attempted solutions. Instead of taking fast action to solve problems, we often delay, hoping the problems will solve themselves. They seldom do. When the basic fit between the person and the position is flawed, things usually become worse over time, not better. Often, another cause of delay is some feeling of guilt on the part of the person who did the hiring – usually the doctor.

Cost of Mismatches

Poor hiring decisions are the costliest mistakes practices make. The doctor too frequently finds that a newly hired employee performs unsatisfactorily on the job. Both the doctor and the hiree suffer the consequences. A poor hiring decision effects productivity and morale and can have grave economic consequences.

By definition, the selection process means choosing one applicant in preference to others. This decision is based on a set of characteristics which the doctor believes must be present in order for the job to be performed satisfactorily. The question is whether or not an applicant’s suitability for a job can be predicted with any measure of success. The answer is YES!

These statements we know to be true:

• Exceptional people are less accessible and are difficult to find.
• Finding exceptional people is hard work, but worth the effort.
• We are often too quick to settle for acceptable versus exceptional ones.

Steps in the Selection Process:

• Determine critical or essential job requirements
• Screen resumes
• Interview candidates
• Check references
• Evaluate all data
• Make the offer 

There is no guarantee that by using these suggested practices you will hire only winners or avoid personnel problems. However, by considering the issues presented here, you will be improving your abilities, as a professional, to hire effective performers.

–If you’ve enjoyed this article, visit our website for more free practice success tools. www.SchusterCenter.com

Insubordination may be described as “resistance to” or “defiance of” authority, disobedience, refusal or failure to obey reasonable and lawful instructions, rudeness, rebelliousness, disobedient gestures, dismissive gestures, walking away, abusive language or other negative behaviors that result in an actual work stoppage.

Disciplinary sanctions can include written warning, final written warning or even dismissal depending on the severity of the offense. In our experience, most of our dentists have weak or non-existent systems when it comes to implementing disciplinary systems. Every employee not only has the responsibility to come to work and be on time and so on, but also the duty to obey all reasonable and lawful instructions. In other words, to do as he/she is told, within the parameters of what is accepted as being a reasonable and lawful instruction is at the heart of “insubordination”.

Obviously, any instruction that can be carried out without breaking any statute, common law or practice policy is regarded as “a lawful instruction.” This would also be the first requirement of a “reasonable” instruction.

But for the instruction to be reasonable, there are other elements required. An instruction can quite easily be lawful, but at the same time it can be unreasonable. For example, it would be appropriate for a dentist to instruct an employee to clean her operatory at the end of the day. But it would be unreasonable if you telephoned her late at night to return to work to do this.

It is a simple matter to determine whether an instruction is lawful or not. But defining “reasonable” simply means that the employee must have the necessary knowledge, skill, capability and ability to carry out the instruction. Instructing an employee to do something that she cannot do is not only unfair and unreasonable, but it is also unlawful.

It is not always clear whether or not a particular task falls within the parameters of an employee’s job description, when not specifically stated in writing.  So it is a question of reasonable and rational judgment that must be applied here. Also worth consideration is whether the task in question is merely a “one time” thing, or is it likely to become a permanent element of that employee’s job description? An example may be asking a team member to arrange personal travel plans for the dentist.

Perhaps the best approach in those “one-time” situations is to use a bit of the old psychology, “Don’t assume, simply ask..”  However, if the task would now become a permanent part of the employee’s job, then you would have to consult and reach agreement on the matter.

Please note, providing there is no dispute about whether or not the task falls within the parameters of the existing job description, that the consultation with the employee is purely to discuss the new task, the reasons for it, how it must be done, what standards must be met and any problems or difficulties the employee may wish to discuss. The consultation is NOT a negotiation during which you have to offer an increase in salary or improved benefits because of the extra work.

A Job Description, by definition, is a written description of those tasks that the employee is expected to do. Therefore, the fact that a specific task is not mentioned in writing in the Job Description, does not give the employee the right to refuse to do it now or in the future. If the employee and/or others doing the same job have performed the task in the past, and it is lawful and reasonable, then the employee(s) must continue doing it now even if she has suddenly discovered that it is not written in her Job Description.

Resistance should be brought to the employee’s attention, and she should be warned, that her continued unreasonable refusal may lead to disciplinary action, and the dental office should proceed accordingly.

–For help with dental practice management, dental case presentation, hygiene as a profit center, business plans for the dental practice, dental continuing education seminars and more, go to www.SchusterCenter.com or call 1-800-288-9393

Many dentists believe that if they just increase the number of patients seen they will have financial success. Dentists have been told that bigger dental practices will produce more money for them. But this production model assumes that the dentist’s fixed costs are indeed “fixed” and quality time spent with patients will not become a problem.

Fixed costs aren’t really fixed, just constant. Dentists soon realize that they must add staff, increase office space, or keep more materials on hand to handle a larger practice. But when fixed costs increase, the overhead percentage increases and net profit decreases.

Most dentists are not aware that their introduction to marketing and management of their practice was influenced by research of manufacturing. This manufacturing/production model doesn’t apply to dentistry or other service industries.

Those dentists who believed in this model now find themselves spending more time managing the business side of the practice and less time with their patients. As the pressure increases to produce more business, neglected patients go to another dentist who cares about them. Eventually, dentists realize that they can’t produce their way out of the “bigger is better” trap.

What do they do then? Some dentists sell their businesses to a management firm and become a paid employee of “their” practice. Others file bankruptcy or use consultants for a “quick fix.” Most continue to struggle day to day, looking for a way out. Let’s look at a model that does reflect what actually happens in a dental practice.

Costs are very high at the start up of a new practice and decrease as the practice grows. At some point, the dentist will be faced with a decision to hire more staff, increase office space and buy more materials. When this happens, “fixed costs” per unit and the overhead will increase.

Revenue per patient seen is very low at the beginning of a new practice and increases significantly as the practice grows. At some point, however, the dentists will see less return on investment with every additional patient. Efficiency is lost due to the limitation of the dental practice. As the practice grows larger, dentists are forced to spend more time in managing the business of the practice or pay someone to control the practice. There is a point where more patients means more money, but a diminishing profit margin.

What this means to you…since 1978, The Schuster Center has helped thousands of dentists identify and reach their optimal profit zone. In fact, 97% of the dentists who have learned and applied Schuster strategies and methods have achieved or exceeded their practice goals within the first year. If you’d like to learn where your optimal Profit Zone is, contact us to schedule a complimentary assessment. Call 1-800-288-9393.