Smashing the barriers of success

Aim for the sky and you’ll reach the ceiling. Aim for the ceiling and you’ll stay on the floor.

Bill Shankly


Each month I meet a handful of practice owners for the first time. I travel to their practices and help them analyse their business. Then we look at many ways that they can improve their practice.

Most Principals want to grow their patient numbers and with that their top and bottom lines. However, before I open my practice grow kit of proven strategies and tactics, I must first identity the roadblocks to growth that are often already well entrenched.

Most of the private practices I analyse are shrinking, but shrinking in a way that isn’t immediately obvious. Most good dentists attract around 10 new patients a month by word of mouth recommendation, yet their active patient list size remains about the same and their hygienist books fail to get any busier. So, what’s going on? Here are my explanations:

  1. A significant number of patients are leaving the practice. It’s just that they do so quietly, without any fuss or giving a reason. They simply cancel their check up or treatment appointments, fail to remake them and ignore any follow-ups made by the practice reception team…
  2. A significant number of patients are delaying their check ups and treatment. They are down the rabbit hole and they’ll come back out when the country looks like it’s in better shape and the newspapers start writing about something other than the recession.

However you measure it – active patient numbers, top line sales, bottom line profit – it’s clear that many practices have hit an invisible barrier to success. Through the work I have done with hundreds of practice owners, I have learnt that there are a few key barriers preventing business success. In this article, I want to describe the most common obstacles and how to get around them.

So, what (or who) creates these obstacles, and what you can you do to remove them?

Here are some possible barriers to your success:

  1. The Practice Manager Many Principals have delegated a number of critical responsibilities to their practice manager and then left them to get on with it. This suits the owner and the manager until either the practice starts to shrink or the Business Coach comes along and asks some pertinent questions such as: * How many enquiries do you get on average a month and how many of them agree to a new patient consultation?
* How do you decide which dentist to allocate these new patients to?
* What is the active list size (not the number of patients on the data base) for each dentist?
* How many patients regularly see the Hygienist? * What happens to the ones that don’t?
* What are your fixed costs per surgery per day? The problem is that not knowing the answers to these questions hasn’t really impacted on the growth of your practice until now. And very often the attitude of the PM or their receptionists is, Why are you asking me to do this all of a sudden?
  2. The Principal is Unwilling to Invest Enough in Making Changes Making changes takes time and cash.The rewards are seldom instant, rarely guaranteed and usually show up a bit/lot further down the track! Some Principals want an instant, cheap fix and preferably someone else to implement it.
  3. There are Saboteurs on the Team Sometimes, skilled team members will quietly find ways to resist changing their working practices. They know that there will be little in the way of sanctions if they don’t embrace what the principal has asked them to do.
  4. The Building/Facility Needs Updating. Have a proper look at your facility with a fresh pair of eyes. Does it need freshening up, cleaning? De-cluttering? A complete refurbishment? How about booking a skip and getting rid of everything from the practice that you haven’t used in the last 12 months. Either bin it, recycle it or store it off site.
  5. The Team Don’t Know What Is Going On! Because the Principal doesn’t meet often enough with the team to discuss plans for the future.  Or possibly, when they do meet, the team doesn’t show much interest in the development of the practice!
  6. The Team Are Inflexible. For example, they are unwilling to: 
Cover new/extended opening hours.
Work a shift pattern to keep the practice open at lunchtime.
Come in early so as to offer patients early appointments.
Call patients out of hours to reactivate them.
  7. The Principal Is Waiting To See What The Others Will Do. Many dentists like the safety of the herd and are unwilling to try something without the confidence of someone else pioneering the idea (most well-trodden paths lead nowhere). I suspect the supermarkets will have no such nervousness. Tesco are already planning to have a dentist available in their stores for 78 hours a week!
  8. Fear, We’ve Always Done It This Way And It Has Worked… For many years changes in dentistry happened very slowly. Now changes come thick and fast. Running the practice in the same way, year after year, is no longer going to work.
  9. Poor Advice From Suppliers of Professional Services. Unfortunately, I meet principals every week whose: web site doesn’t bring in new patients, marketing collateral is inappropriate, computer software back-up hasn’t worked, don’t know how much tax they are due to pay etc.
  10. Principal Spends All His Time Doing Dentistry. With little time or energy left by the end of the week to make any changes to the way the practice is run!

Growing a practice means making changes, sometimes a lot of changes and it’s worth revisiting an old saying in coaching: “Keep on doing what you’re doing, keep on getting what you’re getting.”  Or, in the case of Dental Practices: 
“Keep on doing what you’re doing and get even less of what you have been getting!”

So, to summarise, don’t let barriers stand in your way. Stop focusing on the external factors that are inhibiting your success (politics, economics, the competition); things that are largely outside of your control. If you are serious about breaking through your invisible ceiling, have a close look at either the things or people around you who could be holding you back.

Make no mistake, removing barriers takes guts. It takes a strong commitment from the top, but it also requires participation and support from your entire team.

Removing these internal blockages won’t guarantee success if you have misjudged your market, pricing or demand. However, the exciting news is that recognising and tackling these barriers will set you back on the path of long-term, sustainable growth.


Simon Hocken Director of Coaching, Breathe Business


If you would like your practice analysed by Simon Hocken, or you’re looking for additional information and advicecontact the Breathe team on 0845 299 7209 or


This entry was posted in News, Uncategorized. Bookmark the permalink.

Leave a Reply

Your email address will not be published. Required fields are marked *