Still running a covered market? 27 reasons you shouldn’t

Many years ago I used to write and speak about the phenomenon of the covered market in dental practice. It was the situation prevalent in many practices I visited, where the principal shared their practice with a bunch of clinicians who behaved like stall holders in a covered market. In return for rent (50% of fees earned) they got to treat the practice’s patients, any which way they chose.

In reality, I suppose the principal took the view that all dentists were professionally qualified and that (hopefully) the ones they were sharing with would have a similar approach to themselves when treating patients.

Then in the middle of the noughties we became part of an expanded EU, opening the UK to dentists who would add to the existing variety of good and bad dentist behaviours. So now we have many practices where the associates (and hygienists) are free to do their own thing, setting out their stalls and offering varying qualities, skills, behaviours and solutions at different fee rates. This leads to chaotic organisations where a patient’s experience varies depending on who they are lucky (or unlucky) enough to be booked in with.

These experiences populate the many one-star reviews on Google and savvy principals and those who want to maintain the good reputation of their practice realise that they need their clinical team to offer a unified approach to treating patients. These days a typical practice’s marketing will often make promises such as “a relaxing environment” or “painless treatment” or “long lasting solutions” and therefore the principal needs a clinical team that is willing and able to deliver on these promises. Because naturally, when the new patients roll in, they assume that all the practice’s clinicians are operating to the same standards and charging the same fees.

These days some principals are more aware of the need to have a set of common behaviours (for a consistent patient journey) within their practice and so they try to round up their clinicians and get them all pointing in the same customer-facing direction. At Breathe we find that there is still considerable resistance to doing things ‘the practice way’ from some associates and hygienists however, and within our client base some clinicians have been replaced for being inflexible, stubborn and even obstinate about cooperating with defined practice standards and behaviours.

The best opportunity you will have to create some on-brand behaviours is when a new clinician or team member joins your practice. This is where many principals miss a trick. Imagine starting work for Virgin Atlantic and turning up for your first day’s work. You would be surprised if they put you on a plane to New York and waved you goodbye with, “Don’t forget to do the safety demo when you’ve got a mo…” Virgin Atlantic, like all serious consumer-facing businesses, inducts and trains its people.

So when you take on new clinicians or other team members, have them inducted into the standards of behaviour that your practice strives to deliver. Here’s the formula that we run for a new dentist induction. As you can see there is a lot more to it than, “Let me know if there is anything you need.” But in return you get an on-brand, compliant associate. (Or one who has just left!)

Associate induction

  1. A walk through of the complete patient journey by the principal including language and phrases that should be used
  2. The new associate to sit in with the principal for a couple of half-day sessions (minimum) to observe the way the principal and the support team handles patients, particularly during check ups and new patient consultations
  3. Then have the new recruit role play both these deliverables
  4. Treatment planning. Is the practice a get-it-all-fixed-and-maintain practice or a slowly-slowly-fix-it practice? Show the way
  5. How and who do you refer to the hygienist, and for what?
  6. Referring in-house
  7. Referring out of house
  8. Preferred labs
  9. Preferred materials
  10. Preferred clinical protocols
  11. Computer software training and familiarity
  12. Day book keeping
  13. ADY collection and reporting and discussion RE targets
  14. Brand standards, particularly “what we always do” and “what we never do”
  15. Preferred speed of follow through and standards of performance (the practice expectations)
  16. Practice communications style (formal/informal/mixture)
  17. Importance and content of morning huddles
  18. Uniform/dress code, including arriving and leaving work
  19. Punctuality
  20. Meetings (expected attendance at)
  21. Practice complaints procedure
  22. Name policy (how team members refer to each other) and Paddi Lund’s Courtesy System
  23. Required behaviour towards nurses and receptionists, and forbidden behaviours
  24. Treatment planning protocols
  25. Care of equipment and facility
  26. Emergency treatment and emergency cover protocols
  27. Appraisals and reviews procedures

It’s a lot to talk about and it takes more than half an hour. However, like any investment, the rewards will keep showing up if you get this right and you will start to build a team of clinicians who are working towards a minimum quality standard, both clinically and in the way that they handle YOUR patients!

If you would like some help with sorting out your team’s behaviours, contact me for a chat:

m. 07770 430576



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