If you’re in Dublin on March 2nd

My maternal grandparents would be proud of me being selected for Croke Park. I’ll not be gracing the hallowed turf with my prowess with sliotar and hurley. Instead I’ll be up on level 5 in the Hogan suite on the 5th Floor with a Taster session of “The 101 Things They Didn’t Teach You At Dental School”.

Herb Kelleher – Cheap can be cheerful

Herb Kelleher was the co-founder of Southwest Airlines, he died earlier this month. He had many attributes that I admire, not least of which was introducing a culture to the company where Southwest’s employees took themselves lightly but their jobs seriously.

 

Kelleher had a simple philosophy, “A motivated employee treats the customer well. The customer is happy, so they keep coming back. It’s not one of the enduring mysteries of all time; it is just the way it works.”

An article in the FT Michael Skapinker which celebrated Herb, contrasted his outlook with a recent email from a disappointed British Airways passenger. Skapinker concluded with this statement, “few people come to work intending to be unhelpful. If they are horrible, it is usually because their bosses are horrible to them, or they prioritise sticking to the rules, or cutting costs, over keeping customers happy.”

In 1987 Michael O’Leary (of RyanAir) visited Southwest Airlines and Herb Kelleher to learn about the airline industry. Although there were plans for them to meet again, O’Leary never went back to complete his tuition.

Read more about Southwest’s business model here.

 

 

The Monday Morning Quote #515

“It’s easy to make it lousy.

It’s difficult to make it right.”

Ben & Jerry.

What to do when…..a Corporate Opens Nearby – Part 2

What to do when a corporate opens nearby. First Published in Private Dentistry…2 of 2

6 Expand your offering.

What is the corporate doing that you could be doing – and be doing better? Now is the time to take those course that you have been postponing. Invest in yourself, your skills and those of everyone in the practice. Where are your “blind spots”? What skills are you, your associates and support team lacking? Get out there and get refreshed, it will do everybody good.

 

7 Up your business game.

Get out of any business comfort zone you may have been enjoying. Set personal and business goals. Make sure your financial controls and monitoring are as good as they can be. Brush up your sales process by ensuring everybody understands the importance of every stage of the patient journey. Refresh your internal marketing.

8 Ride with, and learn to avoid, the punches.

People will leave, the unexpected ones, the ones that you have moved heaven and earth to help. That will hurt; you’re a human being, of course it will hurt. There is a possibility that there will be a fall in new patients calling. Accept it, use it as a chance to look backwards at patients who you haven’t seen for a couple of years and reactivate them.

Beware of getting dragged into a price war with the new business who will be using loss leaders and offers to attract new patients. There’s no such thing as a “free” examination, just a consultation with someone who isn’t qualified to give a full opinion. A price war is a race to the bottom, keep your eyes upwards, make quality your mantra in everything that you do.

9 Wave goodbye / Welcome back

Let patients “leave” with your blessing, they’ll be back. Be understanding, be helpful, offer to share notes and radiographs. Keep them on your database (with permission) so that they get the regular newsletter, the news of the people, the offers, the inside track.

In my experience the best way to drive business to a private practice is an NHS corporate opening across the road. When they come back, and if they don’t return you really do need to take a long hard look at yourself, welcome them, listen to what their experiences have been and what they have learned. Then learn from them. Delight in their return, welcome them home.

 

10 Celebrate your independent success on your terms.

The patients who attend are coming to see you and your colleagues. The help you give is what you think is appropriate not set down and governed by a spreadsheet. The targets you set are your targets, flexible enough to be realistic for your patients.

The history of post-war Britain is for successful small firms to be swallowed up by large ones and for the intrepid owners to move on and start again. You cannot take on the “big boys” on their terms so don’t try to do it. Discover your niche, work at it, celebrate it.

Look at the big picture, you aren’t competing with the corporate you’re competing for the discretionary spend with holidays, cars, gym membership and consumer goods. Put health and individuals at the heart of your business, be honest with yourself, your team and your patients and you will resist this and other challenges.

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.

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

 

GDPR = Got Desperate People Rich(er)

Chicken Licken says the sky has fallen – #94

Lee Gilbert’s thoughts on GDPR,

“It seems every type of company from Accountants, HR Advisory firms, Law Practices, IT companies, Greengrocers and Candle Stick makers… have been jumping on the band wagon of running seminar’s on the subject without truly understanding (or having read in some cases!) the Regulation and its subsequent Recitals.”

It’s Regulation 2016/679. It’s 88 pages long and there are 173 Recitals…. by the way.

Some people say complying with GDPR requires extensive planning and in some cases, a complete change in processes and procedures.

The reality, for most, is the change is minuscule.

It should not be ignored but the changes and updates required are so small you could argue they merely constitute the best practice many organisations have been applying for some time.

Put simply, GDPR is designed to clean up some poor practices conducted by the few. It is the many though who are feeling the brunt.

Cynical? Moi?

Link to the full post

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