Why Isn’t Your Practice Growing?

Have you ever wondered why your practice has stayed roughly the same size for the last five years? Think about it, do you have: approximately the same number of clinician days, about the same number of active patients, the same turnover, give or take 5%? And yet, in the Nineties and the early Noughties, you grew your practice, effortlessly, year on year? Well, it’s easy to grow a practice when demand for dentistry outstrips supply as it did back then. These days, there is (depending on your location) a greater supply of dental services than patient demand, a situation which is likely to get worse.

Despite this, some practices we work with are growing. Growing their clinician days, growing their active patient list and growing their turnover despite having plenty of competitors. So, how do they do it? Well,  I can confidently tell you that practices that are growing are all over these three tactics:

  1. They have created an effective Management Team (including the Principal) who are focussed on growing the business.
  2. They have a strategic Marketing plan which they are in the process of implementing and (importantly) they are willing to pay (the right price) for effective Marketing.
  3. They have a Team of gifted communicators lead by a Principal who understands the value of communicating with his team and with their clients.

Take a three surgery practice, with two (full time equivalent) Dentists and a (full time equivalent) Hygienist, turnover circa £600k.  It has three thousand active patients and an attrition rate of 10% (probably average for this type of practice. You do know your attrition rate?) 300 patients leave the practice per annum for reasons such as: moving away, dying, have found an alternative practice with: cheaper fees, better parking, nicer people, more convenient hours etc.  However, a delighted 25 new patients book consultations every month and most of them take up treatment. Net growth of active patients for this practice?

A big fat Zero.

300 new patients arrive every year whist 300 quietly leave. The practice is in a steady state. (Many practices are actually shrinking in terms of active patients, their attrition rate being higher than their new patient count.)

So, if this is your practice, how can you move from this steady state into net growth? Well, you can focus on reducing your patient attrition rate, particularly if it is more than 10% (unless you practice in Central London).  However, although this is possible, it isn’t easy. Patients are becoming more promiscuous with their service suppliers, willingly and easily changing Doctors, Banks, Opticians etc when they see an opportunity to spend less and/or get a better service. In this market, your attrition rate is more likely to increase rather than decrease. You can, of course, rescue and reactivate some of your leavers if you know how to do it,  but by far the best place to focus is on both new patient acquisition as well as existing patient satisfaction.

This is not about putting an ad in your local paper or tinkering with your web site. The first tactic you need to deploy is to

1. Improve Your Management Team. 

It’s likely that your current management resource is:

  • About right or even slightly inadequate to support the size of the Practice you already have, particularly if it’s mostly You doing the key management tasks! (You don’t have any more time right?)
  • The old model, a Principal, a Practice Manager who has come up through the ranks, A Senior Receptionist and a Senior Nurse, may not have sufficient of the management skills you need to grow your practice. You might make some progress with a team like this, then inevitably slip back.
  • A Practice Manager who is spending his/her time administrating and looking after the daily operations.
  • You as leader, leading sporadically/ineffectively, complaining a lot that things aren’t getting done.

This management resource (sort of) works for practices up to circa £500-600k turnover and then it really falls over.  One of the primary slowers of Practice growth is likely to be the Principal because he/she is trying to do some management, some leadership and too much dentistry.  Meanwhile, his/her PM is busy sorting out the team who (on a daily basis) find reasons why they can’t do what they are being asked to do as well as going off sick or doing a bit of sabotage.

You cannot break through this glass ceiling unless you improve your management team. You might already know this but you have backed away from hiring people with a greater skill set because you are (rightly) worried about the cost.  However, you will have to spend more before you can grow. It’s true for all businesses, think of it as an investment and track your return in £.

Your Management Team needs:

A Leader who looks after The Team by:

  • Providing and communicating his/her vision and turning this into bite sized strategic objectives for the practice Team.
  • Inspiring the Team to want to deploy tactics to achieve the strategic objectives.
  • Providing the direction for the Team and the individual Team Members.
  • Involving all of the team in achieving the strategic objectives.
  • Helping induct new team members by introducing them to the values of the practice and the required behaviours

A Business Manager who is focussed on getting the tasks done by:

1. Taking care of planning and getting tasks completed
2. Setting Targets
3. Reviewing progress against targets
4. Understanding the problems and providing solutions
5. Communicating to get the tasks done.

The irony is that in most Practices, the management is organised the other way around! The Principal is task focussed and the Manager is people focussed. No wonder progress and growth is slow or even non-existent…

The second tactic is to;

2. Implement Effective Marketing.

I find that most practices have yet to get even the basics of effective marketing in place. That is, these three essential tactics:

1. An effective and measurable “Patient Get Patient” system.
2. Sufficient and clear signage that succinctly conveys your proposition to interested passers by.
3. A functional Web Site which clearly differentiates your practice from your competitors, attracts sufficient traffic and delivers enquirers to your front desk.

These are the pillars of dental practice marketing and until all three work well in your practice, don’t get distracted by putting last minute ads in the paper, sponsoring the local school football team or dropping thousands of leaflets through local letterboxes, however persuasive the salesman sounds…

And the third tactic is to;

3. Create A Team Who Can Communicate Effectively To Patients The Many Benefits Your Practice Can Offer.

The best communicator in the practice has to be the leader as the team will take their lead from him/her. We often get involved with communication skills training for practice owners and their teams in order to create these essential outcomes:

A Reception and Nursing Team Who have:

  1. Good listening Skills
  2. A confident communication style
  3. Good knowledge of all the practice services
  4. Knowledge of how to close/ask for the business
  5. Practised their skills (Role Play) and are willing to use Scripts.

A Clinical Team who are:

  1. Willing to treatment plan more than one unit of dentistry per course of treatment.
  2. Capable of presenting sophisticated Treatment Plans and having 70% of patients say yes.
  3. Willing to refer patient within the team to the clinician with the appropriate skill set.
  4. Working closely with the Hygienists to treat periodontal disease effectively for their patients.
  5. Able to phone patients who need to return to complete unfinished treatment plans.

In summary, if you are serious about moving your practice into growth, I believe that: first you have to improve the capability of your management team, then you have to get your marketing basics in place and right on the tail of this you need a team that has the capability to communicate clearly and comfortably with your patients (and prospective patients).  These three tactics will, I  promise, you move your practice into growth.

How Breathe can help.

  1. We can assess your Management Team and help you improve it.
  2. We can improve your Leadership Skills.
  3. We can help you implement effective Marketing.
  4. We can train you and your team in effective communications.
  5. We can help you reduce your attrition rate.

If you would like to chat about any of this.
Contact Simon Hocken on:
e. simon.hocken@breathebusiness.co.uk
m. 07770 430576

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