The Daily Grind offers readers a glimpse into the life of general dentists practicing today. Each post offers a perspective on managing a dental practice or balancing a life outside of the practice. The Daily Grind is written by several general dentist and student members of AGD. All content published on The Daily Grind is property of the Academy of General Dentistry and cannot be reposted or reprinted without permission.

Part 2: What Defines a Successful Practice?

  • by John Gammichia, DMD, FAGD
  • Jun 6, 2017, 09:36 AM
IMG_6359This is my second blog post in which I strive to define success through my eyes. In my previous blog post, I talked about how I feel like success is always measured in dollars. (If you haven’t yet read it, I recommend you do. It is a must-read. I mean: Pulitzer Prize-type stuff.) I also discussed that while making money is important, regardless of how much money you make, it will never be enough. With this in mind, I have changed my definition of success, and I now measure success in the intensity of my happiness. 

I love coming to work every day. I actually like and enjoy all of my staff members (most of the time). I love doing dentistry, and I like most of my patients. Now, I don’t know about you, but I feel pretty successful in light of these things. 

Today, I want to tell you about my practice. Now, it is probably going to seem different from yours and even different from some of the other bloggers’ practices. (I know Dr. Murry has multiple offices, but the funny thing is that when I read his blog posts, I feel like I could have written them because we think the so much alike.) I have a relatively small practice. This is how it started: I joined my father’s practice about 22 years ago, two days a week. I began working full-time in a little more than 2½ years later. (Joining your father’s practice has its good and its bad components. This is a story for a different blog post series.) 

My father allowed me to buy 25 percent of the practice after eight years of being an associate. Four years after this, he allowed me to buy another 25 percent. At this time, my father was about 60 years old. It took a couple more years, but he started to allow me to start making decisions. 

And it took a couple of more years before he was coming into the office less. Then, a natural evolution of the office was starting ... and it was starting to look a lot like my practice, the product of my vision — after 15 years of working there. 

I bought 100 percent of the office six years later. That’s right: I was 42 years old before I owned the practice. (See, I told you that there were both good and bad components that go along with working with your dad.) My father was my associate for a year and a half before he fully retired. 

As an aside: When my father retired, I brought in an associate, and after about a year, he bought his own practice and left. (Again: This could be the topic of another blog post series.) This is when I decided that I was just going to work by myself for some time. (I probably will never hire another associate until one of my kids becomes a dentist or before I am about to retire.) 

I have eight rooms in my office. In my practice, I work with three hygienists, but I only have nine hygiene days. I have a four-day, a three-day and a two-day hygienist. Every day, I work with two hygienists, and one day, I work with three. I work four days a week, so that means on the days I am in the office, there are at least three empty rooms, and three days a week, there are four empty rooms. And I have no desire to fill them with patients or staff. (I did work something out with an orthodontist, and he is now working one day a month and is trying to build a practice out here.) 

I take only traditional dental insurance. These are the insurances that involve you picking your own dentist, and you go, and they pay a certain percentage. I am not on any PPO or HMO networks. 

I am not on any lists, and if the patients have one of the above and they want to come here, we will take the out-of-network benefit, and they will be responsible for the rest. We know that this means that a lot of people are going to be paying out-of-pocket to come to our office. So we have to make a practice that is worth visiting. 

For this reason, there has to be a perceived difference between us and the dentist down the street who is within their insurance network. This is how I try to make my office stand out from the others. Our office has to be warmer. We have to have perceived technology, whether this means monitors mounted on the ceiling, an intraoral camera or digital X-rays. The people who work here have to be nicer and friendlier, and they have to be “service above self” people. We are a service profession, after all! How many offices don’t serve patients well? In how many offices is it about the dentist and not about the patient? I think when you go above and beyond, people are going to notice. And it is not that expensive to do so. 

Pictured is my reception area. I bought at least four of the chairs on clearance. The massage chair was $300, and I recently reupholstered it. A patient made me the armoire. I bought the little fridge on clearance. And so on.

And the only other thing I think is important is me and remembering to always put the patient and the practice first. It’s important for me to be all of the above: warm, nice, friendly and all about service. Look, to me, this profession is about building and maintaining relationships. I have always said, “Patients don’t care how much you know until they know how much you care.” 

You have to get be able to talk with the kids. You have to be able to relate to Grandma. You have to be able to have a conversation with Mom — not your assistant, but you. Yes, it’s important for you, not your assistant, to go out into the reception area, sit next to Mom and have a discussion. You have to remember that your patient’s 50th birthday is next year and that your 65-year-old patient is retiring in April (so that you can send him or her a birthday card and a congratulatory gift card, respectively). You have to notice someone driving into the practice parking lot in a new car — go out to the parking lot and tell the patient how awesome it is. Talk their language; ask them, “How many miles do you have on that baby?” Are you starting to see a theme? It is about them, my patients — not me. I have learned that people just want to feel known and special. 

Yes, this is a lot to do. And if you are thinking that you have a schedule that is so packed that you have no room to talk with patients, well, then I would think about changing that. I know some of you are not good at this. Chit-chatting with patients may not come naturally for you. I get that. Some dentists are introverts. My advice is to “fake it until you make it,” as they say. Give talking with patients a try. Or enlist the help of your staff members. Remember: People just want to feel special.
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