What’s the difference between a Practice Manager and a Business Manager?

How would you describe the Manager in your practice?

Recently we conducted a survey amongst around 700 dentists and dental professionals. This, to help us assess the drivers of, and the road blocks to, successful Dental Practice in 2012.

One of (many) clear messages from this survey was that many practice owners felt that their Practice Managers were not able to support their practice as well as they wanted them to and that this problem was holding back the growth and development of their business.  When I meet with practice owners, a common complaint from them is that they are having to do tasks which should sit with their PM, or more commonly, that these tasks are simply not getting done.

Recently, I sat in on a meeting chaired by a Business Manager who I believe has exactly the right skill set and behaviours that the owners of a 2012 dental practice require.  Let me describe this meeting to you.  These two principals own a £870k turnover private dental practice and this meeting was their regular, monthly Director’s Meeting, for which they allocate 2 hours at the beginning of a clinical day.  Their meeting ran like this:

First off, they reviewed the minutes of the previous month’s meeting to check that all the agreed actions had been taken and quickly discussed how to accelerate the completion of any outstanding actions.

At times during this meeting they referred to their three year Business Objectives and to their 2012 Business Plan and it was clear that this was the main driver for the decisions they were being asked to make, by their BM.

Then, the Business Manager presented a summary of the previous calendar month’s financial performance.  He reviewed each fee earner’s monthly gross fees against their targets and they looked at graphs of the individual fee earner’s hourly rate to see how it was trending.  One associate and one hygienist had an hourly rate which had trended downwards for two consecutive months and this had already triggered a meeting with these two fee earners to discuss how they could reverse this trend.  Overall, the monthly gross was just over their budget forecast as one of the principal’s had over-performed and so the practice was still on track to make the budgeted profit.  They discussed how much profit to draw from the practice and how much to leave in a deposit account for future capital expenditure which they had planned for before the end of their tax year.  The BM had managed to keep the practice costs for the month below the budget and this had added to their profitability.

Next up was a review of the performance of their marketing. This practice has sophisticated and accurate data recording (by their front desk team) including the source of their leads and their lead conversion rates. They utilise a skilled “New Patient Coordinator” to talk to new Leads and this has created an average lead conversion rate of 68% across all their marketing channels.
In order of effectiveness, their marketing channels created:

  • 17 New Patients from their Patient Get Patient programme
  • 15 New Patients form their Web marketing and
  • 9 New Patients from their signage, banners and A Boards.

Their average cost of New Patient acquisition was £59.  They discussed their Autumn Marketing Campaign and in addition to this they decided to pilot a 12 month advertising campaign at a local commuter station.  They also decided to further support their web site with some more search engine optimisation and PPC to increase their monthly visitor numbers above 550/month.  Lastly, they initiated an email campaign to their existing patient data base to tell them more about the Orthodontic solutions that one of the partners was now able to offer.

During the second half of the meeting, they discussed interviewing for a new receptionist, the BM had recruited a short list of 3 possible candidates for the following week after receiving over 40 applications.  They were also looking torecruit a Therapist for 2 days/week to look after their private Children’s list and the BM had drawn up a list of skills and behaviours for them to review before he networked the vacancy. Most of their support team are on “Performance Pay” and the BM quickly reviewed their performance against their targets and the likelihood of them getting their bonuses at the end of the second quarter of the year. (5 would, 3 were unlikely to).

Lastly, they discussed changing their software from their current provider to a new, American developed Cloud system.  The BM had arranged a demonstration for a couple of weeks time and explained the system benefits and cost savings, (over 3 years, potentially circa £34k).

The meeting ended just ahead of time with a new set of actions which would be issued, with the Minutes, the next morning.

For me, this is simply playing the game at the right level.  The Principals are well briefed and well served by their BM.  They have accurate information that allows them to make good tactical decisions against a back drop of a set of strategic objectives.  The BM acted both in support and, when necessary, took an active part in decision making.  It was clear that the BM managed the practice on a day to day basis freeing up the owners to focus on their clinical roles and overall direction of the business.  Problems ended up at the feet of the BM, not at the feet of the Principals!

I wish I could report that effective monthly meetings run by skilful Business Managers happen across all the practices I come across.  They don’t.  However, many Breathe members have, or are, addressing this because they of their frustration at having to fire-fight operational problems on a daily basis.  They have also woken up to the folly of making strategic and tactical business decisions, (without sufficient data on the real performance of their practice) during the cracks in their diary, or worse, during family time in the evenings or at weekends.

Unfortunately, many Practice Managers don’t have sufficient skills or sufficient data to sit and discuss with their Principals: Financial Perfomance, KPI’s, Marketing. Sales process etc and instead, they spend nearly all their time focussing on Operations and Compliance.  This means that the Principals have to pick up what is not being done, or leave it undone.  The consequences  of this are many including:

  • Practices where the growth has stopped or where the turnover and profit is falling
  • Rising Overdrafts
  • Ineffective marketing with poor ROI
  • Poor Sales process
  • Too few new patients
  • Clinicians and support staff behaving badly.

We are currently building a six month programme to help turn Practice Managers into Business Managers!  We plan to run around 4 bespoke, one day workshops over 6 months, with phone and email one to one support, starting this September.  If you think this might be for your Practice Manager, please register your interest (places will be limited) by ~
emailing or telephoning Jane Chrispin at:
e. jason.currim@breathebusiness.co.uk
Office: 0845 299 7209

With All Good Wishes,

Simon Hocken BDS.
Director of Coaching

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