The Monday Morning Quote #512

“Any company designed for success in the 20th century is doomed to failure in the 21st.”

David S Rose

It’s always the small that get squeezed the most…

Over the past few years I have seen a few dentists who are being forced into financial situations that are making survival harder with relatively short-term loans that were taken out at “tight” times and their banks declining to support them further by rescheduling the debts over a longer term. Instead of being able to breathe and grow their businesses they are constantly having act in the short term, thus significantly increasing the stress in their lives. Mike Cherry’s words struck a chord, as it isn’t only Dentists who have these problems.

“Despite being a decade on from the crash, we still have this dangerous combination of weak appetite for, and low awareness of, alternative finance options, high borrowing costs and inadequate support for small firms that are turned down by banks.”

Mike Cherry, National Chairman of the Federation of Small Businesses, commenting on research which suggests that UK economic growth is being ‘restricted’ by limited access to alternative finance options for small firms.

via PG&T

As one of the founders of PG&T, that wonderful true gentleman, Ted Price (may he rest in peace) said when he dressed down the Area Director of my bankers in 1992 after they threatened to bankrupt me when my debts ran as high as £42K (less than the cheapest one bedroom flat on the local housing development), “you lot (ie Bankers) can’t lend money to the likes of Robert Maxwell and expect this young man (sic) to bale you out!”

The Monday Morning Quote #506

“Doing the right thing is aways difficult. Very few worthwhile things are achieved easily. If you believe that you are doing the right thing, you must find the resilience and staying power to keep trying.”

Ken Jarrold (from Other People’s Shoes)

Hours down. Productivity up. Nothing new.

Sculpture of a Ford car in his father’s village in West Cork.

“Reduce your hours and watch your productivity increase.” I tell my clients that they need to focus on the the three Es by becoming, “Efficient, Effective and Economic.” This does not mean cutting corners or scrimping to save, rather ensuring that you are doing the best you can for only as long as you need – and no longer. Most dentists spend far too much time doing work that is undervalued, under rewarded and ineffective.

When my team & I stopped working 5 clinical days per week, our income and profits rose and team morale increased. Unfortunately there is still a macho thing about being booked “X” weeks ahead, it’s more likely to kill you than make you happy.

My daily calendar tells me that today in 1926 Henry Ford introduced the 5 day, 40 hour working week. I have an interest in Ford, not least because his father was born a few miles from where I am writing this in West Cork and my grandfather had some involvement with the Ford factory in Cork. I wondered how the hours change came about and why we seem to have stuck there or, in some cases, moved backwards in 94 years.

It seemed that Ford’s decision was one of several that put the company’s workers first. In 1914 with a background of unemployment he increased wages from $2.34 to $5 for a nine hour day. This move, doubling the industry norm, shocked many who said it would not succeed. Instead it was “a stroke of brilliance”, it boosted productivity and helped build a sense of company loyalty and pride.

Then came the reduction from 6 to 5 working days, a decision originally made four years earlier, justified by Henry’s son, Edsel Ford, “Every man needs more than one day a week for rest and recreation….The Ford Company always has sought to promote an ideal home life for its employees. We believe that in order to live properly every man should have more time to spend with his family.”

Henry said, “It is high time to rid ourselves of the notion that leisure for workmen is either ‘lost time’ or a class privilege.”

Ford also saw a bigger picture. Give people Saturday off and they can shop and have leisure, thus spending the money they are earning.

…and we think the “gig economy” is progress?

Yerkes-Dodson is still relevant – if you want to enjoy your clinical career

Why should a “law” described first in 1908 be relevant to everyday Dentistry (and more)?

Robert Yerkes and John Dillingham Dodson described their tests with rats that could be encouraged to complete a maze when stimulated with slight electrical shocks. When the strength of the shocks was increased however the rats just ran about looking for an escape. They concluded that arousal levels helped to focus attention and motivation on the task at hand but only up to an optimum point and after that point fatigue appeared and performance declined.

Research has found that different tasks require different levels of arousal for optimal performance. For example, difficult or intellectually demanding tasks may require a lower level of arousal (to facilitate concentration), whereas tasks demanding stamina or persistence may be performed better with higher levels of arousal (to increase motivation).

The first image shows the classic inverted ‘U’ shape of a difficult task (placing implants, molar endo, treating some children are examples that come to mind). It also shows a continuation without decline of more simple tasks which can be maintained for longer without reaching a point influenced by fatigue (examinations, routine restorations on well adjusted patients).

 

 

The second image shows the typical “stress curve” where performance takes a while to peak if we are under too little stress, then goes through a short period of optimum stress before reaching too much and heading down through exhaustion to burn out.

The reason that I have written about this is that we need to look at the time periods that these curves represent from the short (an hour say) to long (months or even years). There are different challenges that dentists face with differing solutions.

Firstly of course there is the fatigue that comes from trying to do too much challenging work in a short period of time. This results in high stress levels and possibly poor performance on a daily basis. Often there are time management issues where we are obliged to match our performance to the patients availability. This can see a clinician “coasting” by dealing with the relatively straightforward whilst at their peak in terms of readiness and responsiveness but then having to find reserves of energy when the patient “demands” treatment at later times in the day. I have never understood why dentists are reluctant to tell the patient exactly when and why they would like to see them. My own experience in a practice with large numbers of children was to insist on seeing under 11s for any treatment (examinations excepted) first thing in the morning. For the most part when people have reasons explained to them and can understand that it is for their benefit then they will comply with your wishes.

Also to consider are the long term problems of fatigue that arise from the day after day, just doing it without time off. Even in the best time managed (at a relatively micro level) practice if there is often not enough time spent away to unwind, recharge the batteries and recover, then burn out will creep up on you. The prodromal signs are a lack of efficiency and, more importantly, effectiveness.

Dentistry is still a macho occupation for many who seem to get a perverse enjoyment from overwork. It’s sad but true that for many there is an opportunity to build the life they want but put obstacles in their own way as if frightened of taking control.

Time management on both micro and macro levels is hugely important, ignore it at your peril. Get help if you need it.

Ten things you should know about Instagram’s terms of use

It’s the current “big thing” in social media (for my clients anyway). But before you throw yourself into the pool, I doubt if you have read the terms and conditions fully, and most of us don’t because we don’t have time or aren’t sufficiently educated, just consider this list from “The Conversation”.

  1. The terms are confusing

  2. You own your own photos, right?

  3. Instagram can give away or sell your content

  4. It can use your content for its own purposes

  5. Instagram can also give away these rights

  6. It can do this anywhere

  7. It’s a one-way street

  8. Instagram makes money from ‘sharing’

  9. You could be sued for copyright infringement

  10. Instagram should do better

The full article is available HERE

Remind me, who owns Instagram???

Time to review your associate contract?

A couple of years ago I asked a specialist dental lawyer friend of mine why her firm suggested using the BDA associate contract rather than writing one of their own, she replied that as the BDA contracts are the the mostly widely used they are regarded as the industry standard. She went on to say that the longer and more complicated the contract the more likely it was that there could be challenges and disputes both of which cost money to resolve. (Simplify, simplify)

Times change, bringing changes in the context of contracts, therefore the content needs to evolve.

The BDA has updated their template dental associate contract to reflect these changes; the amendments include clarification around:

  • Practice hours.
  • Time away from the practice.
  • Locum cover.
  • Provision of equipment.
  • Hygienist services.
  • NHS contract requirements.
  • Private fees.
  • Confidentiality and data processing.

I am still surprised by how many associates and principals do not have a formal agreement in place or, where they do, there is no regular formal review of working arrangements. When I visit a practice to carry out a Practice Business Health Check I ask about not only “if” but also “when” contracts are in place and reviewed.

With the self-employed status of associates coming under increasing scrutiny it is important for both parties their contracts are contemporary. 

BDA members can access the relevant updated contracts on the website here: New Contracts

 

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