April 15, 2014

Achieving Success in the Practice of Dentistry – Part 10

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 1:46 am

As I conclude this series on how to achieve success in the practice of dentistry, I have one more observation for you to consider. I consistently find that successful doctors have figured out a way to take a little bit more time away from their practice. That may seem counter intuitive – how can working less equal greater success? We all know that we are in what I like to call the “widget” business. You do one crown, you get paid for one crown. You do two crowns, you get paid for two crowns. You do no crowns, you don’t get paid anything.

But dentistry is not an easy profession. There is a lot of stress. We are working in a very small confined area. Our patients many times don’t really want to be there, and that can really get to you. So as a way to become rejuvenated  and combat burnout, I am suggesting to everybody that they try to take more time out of the practice. Studies show that time away from the practice will rekindle energy, and the business will actually become more productive because the doctor is in a better frame of mind. We also have to remember that we only go this way once–that our kids are only going to be young once, and that it is important to spend time with family.

So here is an amazing statistic: the worst two weeks in a dental practice for production and collection are the first two weeks of September. I see this year in and year out. More dentists want to jump off bridges in September than any other month of the year! I think it is a combination of the summer doldrums and kids getting back into the school year with their schedules not being set. So these two weeks of September routinely and consistently have the highest number of last-minute cancellations and no-shows. Don’t try and fight it. If it’s  at all possible, those two weeks might be a great time for you to take a vacation, and the practice will suffer the least.

Over the past three months, I have shared my thoughts in a series of nine posts – garnered from seventeen plus years of full time coaching – as to what I see as the commonalities of successful dental practices. Now it is time to sum things up, to  put everything in proper perspective, and to tie the loose ends together. At the risk of sounding pretentious, I would encourage you to print out the posts and read them again. See what you agree with, and what you may not agree with. See what you have already instituted in your practice, and what you haven’t. Take a look at what could be improved – or added – and then decide on a detailed plan of action.

Achieving success is not easy. If it were, we would all be there. You have to take it one day at a time. It is a marathon and not a sprint. Slow and steady wins most races. A recent Chinese fortune cookie message just might say it all: things turn out best for the people who make the best of the way things turn out.

I wish you all good luck in your pursuit of success.



April 1, 2014

Achieving Success in the Practice of Dentistry – Part Nine

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 5:13 am

After writing eight posts in this series on my observations over the years of why certain doctors achieve success in the practice of dentistry – none of which relate to clinical expertise – it is finally time to discuss something related to teeth and the oral cavity! In truth, there really is no substitute for great hands and great confidence and great diagnostic ability. Some of that is God given, and those people are very lucky. But I see so many doctors who really grow into  becoming excellent clinicians with some serious commitment to continuing education that can increase their productivity. All states, of course, have minimum requirements for continuing education. I am talking about going way beyond that.

• Spending time with world class clinicians and educators like Frank Spears and Ross Nash or David Hornbrook gives a doctor  confidence and the ability to visualize cases. I hear only good things about these guys, and I see wonderful results from my clients. A major additional benefit to the learning process in formalized lectures is the socialization and rubbing elbows with other doctor attendees who are as serious as you are about improving. Often the idea sharing among the participants at the conference is just as beneficial as what is presented on stage.

• Participating in study clubs. In just about every successful practice I have been involved with, the doctor is an active participant in a well organized study club. Again, you learn not only from the lectures but from the involvement with other doctors in the club who are serious about upgrading their skills and knowledge.

• Learning new procedures like short-term orthodontics with Six Month Smiles enables a doctor to create opportunities for much more restorative dentistry. In the past two years, I have had fifteen different clients attend the Six Month Smiles  course – and they are all happy. I actually attended the course two years ago just to see what this was all about, and I can honestly tell you it was the first time in all these years that I wished I was back doing clinical dentistry. It is really pretty amazing. The room was filled with frustrated Invisalign providers!

• Promoting aesthetics. I see a lot of good results from practices that continually talk about whiter teeth. I think people in general want to look better. I think they feel it will help their life both personally and professionally. But if a doctor wants to be successful promoting aesthetics to the patient base, he or she better be very sure that their own smile looks great as well as the smiles of their staff members.

So challenge yourself to be the best clinician you can be. It is a privilege to be a “doctor” and to be held in high esteem by your patients and your community. You have earned this by hard work and perseverance over many years – but the quest for excellence is never ending. So continue on this path, and success is almost guaranteed.

March 18, 2014

Achieving Success in the Practice of Dentistry – Part Eight

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 6:56 am

Successful doctors, as I’ve said in an earlier post, do a great job of offering treatment choices and have a high level of case acceptance with a focus on quadrant and arch dentistry. These successful doctors then know how to schedule treatment in a way that maximizes productivity and profitability.

Productive doctor scheduling is actually a topic where I feel that I have more expertise  than just about any other area in dentistry. I started consulting full-time 18 years ago, but prior to that–for the last seven or eight years that I was in clinical practice–I was doing some part-time consulting in a very niche area -showing  busy dental practices how they could be more productive and more profitable through scheduling techniques developed in my own practice. This would involve an analysis of current production per hour in a practice that was pretty busy, followed by a six hour seminar with their entire  team, teaching them how to increase their production. There is, you know, a big difference between being busy and being profitable. Obviously it would be beyond the scope of a blog post to give all the specifics of how to do this. But here are some basic principles of scheduling that I frequently see in a successful dental practice:

• Realize – as simple as it seems – that there are only so many available hours in the day, and so many days in a week. Once the time goes by, you never get it back. So you have to try to maximize every hour of every day.

• Have a consistent 12 to 15 minute morning huddle at the beginning of the day. I really do believe that practices that have a morning huddle do 15% better than those that don’t.

• Do not save designated time blocks for emergencies. Emergency time can be determined at the morning huddle every day. At the huddle, identify the three best times based on the doctor’s schedule that day as to where an emergency could be seen. Those are the times that are offered to an emergency patient who calls. That emergency is always side booked.

• Do not do definitive therapy for emergency patients.  That is the surest way to get behind.  Palliative treatment is what is indicated.

• Do not place a procedure in the primary schedule unless it has been diagnosed by a doctor exam  and financial arrangements have been made with the patient.

• Seat every patient requiring local anesthesia  in a room 20 minutes before the doctor  will be starting that actual procedure. The doctor leaves the patient he or she was treating,  takes a quick few minutes to deliver the anesthesia to the patient who was just seated, and  then returns  to the original treatment room to finish the dental procedure.

• Stop scheduling defensively. I see a lot of sloppy scheduling where much too much time is allocated to a procedure. This of course may be a defense mechanism by the front desk if the doctor is always running late.

• Delegate delegate delegate–where ever possible to highly  trained dental assistants.

• Stay on time–the best schedule in the world can be blown up by the doctor. The doctor absolutely has to know  when to “punt”.  In a football game, if it’s the first quarter and you have 4th down on your own 30 yard line and three yards to go, the obvious move is to punt the ball away. There is plenty of time left in the game to score. With that same yardage situation and only a few minutes left in the game, you don’t punt. You go for the first down or else the game is over. Metaphorically, when there is a pulp exposure in the middle of a prep temp impression visit for a crown, or when your impression fails because of gingival bleeding – this is the time to punt. Finish up what you can in the allotted time period, and re-schedule the patient for another day to finish the procedure. Cut your losses. Don’t be tempted to extend that appointment and get 30 to 45 minutes behind for every other scheduled appointment and keep those patients waiting.

Running  late and behind schedule on a consistent basis is just not acceptable. Working into the lunch hour and past the normal end of the day gets pretty old. Clearly the doctor must be aware of the time. Productive doctor scheduling is an absolute must to insure a successful dental practice.


March 6, 2014

Achieving Success in the Practice of Dentistry – Part Seven

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 6:21 pm

I routinely see the correlation between state-of-the-art technology and successful dental practices. There is no question in my mind that the latest in technology is hugely influential for promoting practice growth. Two true stories.  I am playing golf in Florida with a friend of mine from the Boston area. He tells me that he has found this wonderful dentist in Naples, and is leaving his dentist up North. When I asked him why, he said ” this guy in Florida took an x-ray that immediately showed up on a computer in his treatment room, and he was able to make a crown for me in one visit.  My dentist in Boston is a nice guy, but he is clearly behind the times.” A few months later I was at a cocktail party and I hear someone whom I didn’t know describing how amazing her dentist was (actually one of my former clients), and talking about how this dentist used “a laser to check for cavities”. Someone in the group listening to this conversation then asked ” do you know if she is accepting new patients?”

The overall message to take away is that there is a wow factor and a marketing factor to technology that definitely needs to be understood and evaluated when decisions are being made from an investment point of view regarding the affordability of the technology itself. The old adage of having to spend money to make money is so true. And there is so much great technology out there – digital impression systems like iTero that completely eliminate goop and gagging, cone beam three dimensional diagnostic imaging for implant placement, CAD/CAM systems such as Cerec and E4D that create all ceramic restorations in a single appointment, digital radiography that allows instant viewing and manipulation of images, various hard and soft tissue lasers, iPads where you can download intra-oral high resolution photographs for intimate case presentations–the list goes on and on.

I believe that the idea here is to promote new technology to your patient base not only for being cool, but also as something that is going to be beneficial to their health. I feel strongly that you want to cultivate an image of being state-of-the-art and certainly the most up-to-date practitioner in your area. I also feel another important benefit is that new technology keeps the doctor challenged–keeps the doctor from getting burned out–same old same old can get pretty tired.

Since any dentist can avail themselves of this opportunity, what on earth is holding you back?


February 24, 2014

Achieving Success in the Practice of Dentistry – Part Six

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 8:24 am

Successful dental practices make marketing a top priority. In this day and age, you certainly need to spend money to make money. I am advocating to my clients that they spend up to 3 to 4% of annual collections on marketing strategies to attract new patients. I also don’t believe that there is one magic bullet that will apply to every practice and every situation. And beware of people selling you on that concept. You need trackable data to justify every marketing plan, and you can’t be married to a plan forever. You have to be flexible –sometimes have the courage to abandon something that you thought was a good idea–and possibly invest more in strategies that seem to be working. Here are some possibilities to consider.

Internal Marketing – I have always been a huge fan of internal marketing because it is very inexpensive, but it can be very effective as long as it is done consistently. Internal marketing is defined as marketing to your existing patient base. I am big on rewarding patients in all kinds of ways for their referrals. Have fun with this–leave your comfort zone and do something different or unexpected. A key component of an effective internal marketing program is hand written notes from the doctor. I suggest there is the opportunity for at least two or three of these to be written everyday. Patients feel so very important when they receive a note from the doctor.

Internet Marketing – I have seen enormous benefits from Internet marketing that begins with the development of a great website,  that through various and clever SEO techniques, positions well on the local Google business map. It is hard for me to believe that something like 40% of all dentists still do not even have a website. They must be living under a rock! You simply have to play in the Internet world. Everyone these days searches for everything on Google–I mean why would you go anywhere else?

Google Adwords – Targeted campaigns are effective for specific services like same day crowns, implants, invisible braces, etc. These are the kind of popular services that are often searched. When people click on these campaigns, they can be directed to a very nicely designed landing page within your website. You can start to get into spending some serious money here, but you will definitely drive traffic. Again–in  competitive metropolitan areas where it is more difficult to get organic rankings of your website on the Google map–Adwords campaigns can level the playing field.

Facebook Advertising – I am starting to see more successful practices getting involved with Facebook advertising. It is much less expensive than Google Adwords. But in order to be successful with Facebook, you have to make a commitment to be responsive and reactive with posts on your Page. Successful practices have one or two staff members who  take this on as a project spending dedicated time every day creating new content and responding to comments. Most doctors do not have the time for this, or even more to the point, don’t understand it.

Direct mail–I recently wrote a post about this. I am feeling more positive about this marketing medium, and it is definitely something to consider.

Marketing and advertising is a business apart from dentistry, and there are experts out there that you can hire to help you. It really helps to have an objective advisor in this area.

In conclusion, I would like to make one very important point regarding patient retention. It is futile to try to attract a continual source of new patients–and absorb all of that cost–if you don’t continue to take good care of these people forever. It is critically important that you retain and please these patients on an ongoing basis. Having an inviting front door that is wide open will not help if the back door is open as well.

February 13, 2014

Achieving Success in the Practice of Dentistry – Part Five

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 10:03 pm

Providing exquisite customer service to your patient base is another important ingredient of successful dental practices. Customer service is absolutely a skill that can be learned. And it really is not that hard to be good at this when so many others are so bad. But I believe you need to be better than just good. Your practice needs to be extraordinary in order to separate yourself from the competition. Everyone in the practice–doctor and staff–needs to buy into the process. The commitment to maintaining and improving an exceptional customer service experience must be an integral part of the DNA of the practice. Here are some ideas for you that really work well.

• Emergencies should always be seen on the date of the call.

• Never say NO. This is a simple rule, but often hard to implement. Eight words that work well are ” the best way that I can help you is…”

• The key to great customer service is making people feel special. Nothing is too difficult. Nothing is a problem. Leave it to us to take good care of you.

• The telephone is the entrance to every dental practice. Great customer service is especially important when any new patient contacts the office. The new patient call is your first opportunity to build a relationship. That telephone call, if done well, could routinely be a 15 minute conversation. That patient should get off the phone and say “WOW – I never had that kind of experience with any office that I ever called!” The person answering your telephone just might be the most important person in your office. If anyone is interested, I have a great new patient telephone intake slip that I am happy to share.

• I’ve said it before, and I’ll say it again. You just can’t overestimate the importance of post-treatment telephone calls by the doctor at the end of every day to patients that have had extensive dental procedures.

My very first post in this series on successful doctors discussed the importance of having a great staff. Providing an exceptional customer service experience for your patients is obviously a lot easier to deliver when you have the right team in place. Having patients all over town raving about how well they are treated  in your office creates a huge funnel for attracting new patients. And new patients equal success.

February 3, 2014

Achieving Success in the Practice of Dentistry – Part Four

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 2:47 am

I have always felt that the ultimate key to success in any business–more important than skills–more important than your grades in school–certainly more important than clinical acumen in a dental practice –is the ability to communicate well and to get your ideas understood and accepted. Unfortunately, communication skills are tough to teach. Superb communications skills are really a gift–and you either have them naturally or you don’t. But I do believe that communication skills can be improved, and since they are so important to success, I feel it is definitely worth the effort.

Successful doctors are passionate about dentistry and the benefits of quality restorative and cosmetic care. When you truly have that passion, it is infinitely easier to sell dentistry. There’s nothing illegal about selling. It is what we need to do well in order to be successful. So don’t be afraid of selling. I love Fred Joyal’s definition of selling: selling is communication with a purpose!

There is an old saying that says people like to buy, but they don’t like to be sold. But before you can expect someone to buy something from you, they must trust you. Nothing gains trust more than making that person feel special and taking the time to truly listen to their concerns. Then – using great communication skills which include proper body language and certainly eye contact – you explain your goals and your treatment choices (offering choices is a must) in language that a ten year old can understand. And good old-fashioned honesty and sincerity will win out every time.

In an increasingly insurance dependant environment, communication skills are more important then ever before. Confidant, articulate treatment presentations using understated laid back conversational techniques are what is necessary to let your patients understand that dental insurance is only a stipend towards quadrant and arch dentistry.

Part of the art of communication is also the ability to recognize when a patient might not be ready to make the decision to go forward with one of your recommended treatment options. It is so important to know how to back away and not be perceived  as being pushy. Allowing the patient to feel comfortable with their decision to delay for a while will more often than not eventually work to your benefit. Remember that the ultimate mission is to have people do dentistry in your office and not somewhere else down the street.


January 22, 2014

Achieving Success in the Practice of Dentistry – Part Three

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 6:42 pm

How can you expect your staff to support you in your mission if it has not been clearly articulated to them? They are not mind readers. I find that what successful practices all have in common is a doctor who is a leader. That doesn’t mean that you have to be Tom Brady or Peyton Manning. You just need to be your own person and lead by example.

Successful doctors are aware of  performance numbers for their practice. They review day sheets at the end of every day. They are looking at collections and production and accounts receivables and numbers of new patients and where these new patients are coming from. These doctors  are pretty knowledgeable about their management software, and can print out reports when needed.  They usually have an accountant who understands dentistry and has other dental clients.  These successful doctors will request and review quarterly expense reports.  You would think that this is pretty basic stuff, but you would be surprised at how many docs are not paying attention to this, and, more importantly,  not sharing this valuable information with their staff.

Here are some other attributes of leadership that I see in the practices of successful doctors.

• Being on time. How about even being the first one in the office. every morning?  It may be a little much to be handing your staff  coffee on their way in–just the way they like it – but you get the idea.

• Being generous and caring to your patients. When staff see the doctor exhibiting this behavior, it is not that difficult for them to follow suit.

• Being involved with your community. People can’t measure or evaluate your clinical skills, but they can certainly assess and observe your willingness to volunteer your time to worthy causes. They then make the connection that if you are a good person, then you must be a good doctor. Presto – lots of new patients come your way. I cannot overemphasize the importance of this.

• Being concerned about your patients. Post treatment telephone calls to patients every evening is a must.

• Being willing to take the time to really listen to your patients. We all know  that listening is very different from hearing. Force yourself to build  a relationship and make that person feel – for the short period of time that you are interacting – that they are the most important person in the world and that they truly have your undivided attention. This kind of personalized attention by a doctor is what gets talked about and shared at cocktail parties.

What seems very apparent to me – and I see it a lot – is that some of the most successful doctors I know are just not all that impressed with their own importance. They are quite humble and low key. Clearly in life, some people are  natural leaders. But the foremost thing for you to try to do is just to be a good leader of your own team. This is definitely a requirement for success and an area where we can all improve.


January 12, 2014

Achieving Success in the Practice of Dentistry – Part Two

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 11:37 pm

Knowledge of human resources (HR) goes hand in hand with my last blog post on staff development. The doctor or the office manager needs to understand the intricacies of hiring and firing. If you are determined to build this great team, you will need to understand employment law. I believe that part of the reason for keeping some of these dysfunctional or inept or under performing staff members around is because the doctor is fearful of being sued for improper firing.

Courses on this topic are readily available, but here are some basics:

• Keep an employment file on every employee. This file is where you document your continuous assessment of the performance of a staff member. Proper documentation gives the doctor the courage and the confidence to make the decision to terminate the services of an employee, if necessary.

• Conduct performance reviews for every staff member two or three times each year. Lead off with what the employee is doing well. Then suggest improvements to performance that you would like to see. Then ask if there is anything that you can do to help the employee achieve success. Write down what you discussed  and keep the notes in the employee’s file – otherwise you will never remember. At the next performance review, you will be prepared to continue the discussion.

• Write out clearly defined and detailed job descriptions for all staff members. These need to be continuously updated to be relevant.

• Spend the money to have a professional create a well written, current office policy manual that meets legal standards. In today’s litigious society, you will be living dangerously without this manual.

• Be sure to purchase EPLI insurance. This is an essential but relatively inexpensive insurance policy that will cover your legal costs to defend a lawsuit relating to improper firing or sexual harassment. It will–in the unlikely event of a judgment against you- also cover that cost up to–depending on the limit of the policy–250 to 500K.

• Stay current with OSHA regulations and get certified annually. It seems like the only time that OSHA even gets involved with a dental practice anymore is when there is a complaint from a disgruntled staff member.

The bottom line is that it is very expensive to stumble  and realize that you have hired the wrong person. Training is a big investment of time and effort. So it is important to do everything you can to be successful the first time around. But when you do make a mistake- and of course it is bound to happen – it is imperative to know the rules of hiring and firing. Bite the bullet. Take your medicine.  Move on and take the appropriate action. You owe this to yourself and to your other staff members.

January 2, 2014

Achieving Success in the Practice of Dentistry – Part One

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 7:51 am

As promised in my last post, I want to share what I have found to be the ten major reasons certain dental practices are more successful than others. The surprising thing to me is that only two are related to clinical excellence. So what better time than now, at the beginning of a new year – “resolution season” as they say – to decide to make some changes and improvements to the way you run your business.

I haven’t made an attempt to rank these ingredients for success, except for today’s topic. In my opinion, the number one biggest challenge in any business today, dentistry or otherwise, is to assemble and keep–over long periods of time–a dedicated, talented, business savvy, customer service oriented group of individuals who function well as a team.  Building this team has to be the number one priority if you want to be successful.

Now I know that many staff members read my blog posts, so I don’t want any of them to misunderstand or misconstrue the comments I am about to offer. They should know – unequivocally – that they will never find anyone more staff friendly than I am. In the course of my work, I interact with literally hundreds of staff personnel every month – and the large majority do a great job.

I feel quite strongly that it is the responsibility of the doctor to create an environment where staff truly love to come to work. Your patients will absolutely feel this karma. You need this kind of staff because it is impossible for a doctor to achieve success on his or her own. It is hard enough just to try to get through each clinical day. You need to surround yourself with people who can do their jobs extraordinarily well. These people in fact want to be held accountable for their performance. They do not need or want to be micromanaged.

I sometimes  see situations where one or two staff people hold back everyone else. They poison the atmosphere. I’ve had doctors tell me they hate coming to work knowing they have to deal with this toxic environment. And often these offending staff members have been employed for years and years. They feel empowered. They truly feel that the practice would crash and burn without them, when in fact, when they are let go or dismissed, a huge weight is lifted off everyone else’s back, and the practice begins to grow again.

I also see many instances of talented staff members leaving because the doctor just will not get rid of the bad apples. It is really interesting to realize–and this is one of my favorite sayings–that the way you feel about someone is usually the way that most people do. Patients, as well as staff, will vote with their feet. They may not tell you why they leave – they often just disappear –but a lot of times it is because of the behavior or attitude of a staff member. Repeatedly I will hear that when a staff member is finally let go, so many patients now say to the doctor, “why did it take you so long to take this action.”

To summarize, I feel your number one resolution as you enter 2014 is to commit to building a great team one person at a time. You should hire for attitude and train for skills. Pay them well. Compliment them often. Tell them how much you appreciate their efforts, and that you couldn’t do what you do without them. This process of team building could take months, but the effort will be so incredibly worth it.


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