WRITTEN BY
Carolyn Flanary, DDS
Some were born to be wild. I was born to be an orthodontist. Wild and wacky maybe, but definitely an orthodontist. Every day I have the opportunity to make people beautiful and improve their self-esteem. I love it!
More than 20 years ago, at the Medical College of Virginia, I received a BS degree in dental hygiene, my DDS degree, and my orthodontic residency training. I was promptly recruited to join the faculty of the University of Texas Health Science Center at San Antonio, Texas, as the co-director of the Dentofacial Deformities Clinic in the Department of Oral & Maxillofacial Surgery. After four years of wonderful challenges and the intensity of the academic arena, I made the career change to private practice. While I had graduated with honors, I had much to learn about running a successful practice. And I must say, running a dental practice isn’t for sissies!
A little over three years ago, I realized I needed a new office. Becoming increasingly concerned about the cramped feeling in my leased 1,600 square feet, I decided that with the prevailing low interest rates it would make economic sense to consider building. I found a piece of land a half mile away, bought it, subdivided it, and began a three-year process of planning and construction of a larger office. At that time I also thought it might be time to consider bringing an associate into my practice. I attended every lecture I could find on practice transitions, knowing that choosing a business partner would be nearly as critical as the decision for a marriage partner. I wanted to be cautious. Each expert spelled out the importance of getting a formal baseline practice valuation before taking on an associate or partner. This was great advice. Although I have not yet chosen to take on an associate, I did pursue getting my practice valuated.
Many good consultants provide this service. They can be found through an Internet search or through national dental associations. I chose Jerry Clark’s Orthodontic Management Group. The valuation process was a huge turning point. I received valuable insights during an on-site visit from a consultant that really started the wheels turning. He gave me some great advice.
The information requested by the valuation company was not necessarily data that I was tracking. I had to go through an involved process of reconstructing data from previous years. It may have been the first time in my practice in which I had actually taken a good look at the statistics.
I have always believed that if you do great work and treat people fairly - the way you would want to be treated - good things will follow. For me, it’s not about money; it’s about people. What then is the best way to bless as many people as possible - patients, staff members, their families, as well as our own family? The answer, as small business owners, is to first be good stewards of our own practices. If our businesses are unhealthy, we will have trouble serving others.
I discovered that there were various practice indicators with which I was unfamiliar. I gained insight into the importance of understanding the simple things, like the percentage of revenues that should be allocated to payroll or laboratory expenses. While I knew clinical orthodontics backwards and forwards, I realized I was weak in the area of practice management.
A few months later, I was fortunate to have an on-site visit by a consultant from Peniche and Associates, who are affiliated with Align Technology. She inspired me to take a fresh look at what patients experienced when entering our office. Although I knew I would not be staying in my smaller leased office space, I decided to at least update the décor in the interim. I made simple changes involving pictures, furniture, and painting. Paint is one of the cheapest ways to get a new look fast. Using designer colors and accents can dramatically change the feel of an office. It was a great temporary solution! Don’t ever run from consultants.
During that same period, I felt that it was time for a Web site. The younger population relies heavily on the Internet and expects to have their doctor present online. I wanted to design a wacky Web site that would be consistent with the focus of our new office. It sounds a little crazy, but I told the site designers I wanted something that would be a cross between Italy and Alice in Wonderland. They did it: www.YourOrthoTeam.com! The practical thing is that patients can log on anytime to get their appointment times and account balances, as well as other helpful information.
Peacock's Parlor
In the meantime, I still felt the need for a hands-on management course. I needed to better understand what I perceived as voids in my practice management. I enrolled with the Levin Group and received valuable coaching in management and goal-setting. Although change can sometimes be a painful process, as the consultants had warned, the lessons are so worthwhile.
See the accompanying sidebars for a few pointers about employees and business that I have learned from consultants and my own observations. I hope you can apply some of these points to your own practice.
Now, let’s get back to the fun of planning the new office. Early on, I decided upon a Mediterranean-style exterior for a more classic and timeless look. Complimenting this idea I used high ceilings to create an Old World ambience and assigned a European theme for each room. I collected interesting and eclectic pieces from local auctions to develop each theme.
Outside view of Dr. Flanary's office in San Antonio
Our reception room is called “Peacock’s Parlor,” highlighted by a real stuffed peacock perched high above the lounging area. Our treatment bay is “The Veranda,” punctuated with nine-foot columns and large arched windows. The two exam rooms are named “The Vineyard” and “Knight’s Quest,” while the records and sterilization rooms are called “Venetian Library” and “Piazza Bella” respectively.
A former patient, who is a very talented graduate of the Chicago Art Institute, agreed to paint faux images on key walls to add dimension and intrigue. It was important to me that people feel like they had experienced something special and unusual while in our office.
I wanted to create a warm sense of home for patients and parents alike. To achieve this, I envisioned a spacious “living room” for lounging in comfy armchairs and leather couches, a big screen plasma TV, the latest magazines and cookbooks, and a selection of cookies, gourmet coffees, teas, hot chocolate, and lemonade ... just a great place to simply take a break in anyone’s day. I needed a couple of entertainment centers as well, where kiddos could sit on furry “LoveSacs” and play with Nintendo Game Cubes. And that’s what we did.
Finally, in February 2005, we moved into our “new home.” Sometimes the great thing can actually happen. The dream can come true. And it did! Now, we have adults and kids who don’t want to leave and joke about moving in. Kids bolt through the front door to get to the cookies and Game Cubes. Frequently, we have patients who bring family and friends by just for a tour. It’s very humbling. I’m so grateful when we can make someone else’s day better. Everyone needs to feel significant, safe, and recognized. We love creating that atmosphere.
"Vineyard"
In the meantime, as a team, we are busy improving our state-of-the-art orthodontic care. Our efficiency is improving through standard operating procedures and cross-training. We also are establishing an accountability system by tracking clinical processes. Through staff training and the streamlining of everyday procedures, our team can focus on making each patient’s orthodontic experience truly remarkable and memorable. That’s what it’s all about, isn’t it? ■
What I have learned ... regarding business ...
• Set a gracious tone for how each patient or guest will be treated in your office.
• Reiterate the mission statement and practice philosophy at each staff meeting.
• Attend management courses regularly. One “pearl” can be worth the cost of the course.
• Keep good practice statistics and set short-term and long-term goals.
• Tie staff bonuses to a measurable achievement.
• Regularly compare your practice statistics with national averages.
• Trim the fat. Start with black belt shopping for supplies and equipment.
• Regularly review the interest rates banks and credit card companies are charging you.
• Find efficient appliance systems in order to reduce chairtime and save money.
• Develop systems to track various clinical processes, employee production, and efficiency.
• Implement a system to track and audit your financial records. Ask your CPA for advice.
• Create standard operating procedures and written job descriptions for each staff position.
• Post written, step-by-step procedures where they can be conveniently referenced.
What I have learned ... regarding employees ...
• Employees need to share your value system and vision.
• Find ways to get staff members working in their areas of strength.
• Cross-training reduces stress, increases efficiency, and helps when someone is absent.
• An attitude of gratitude is good medicine. People love it and need to be recognized.
• Larger staffs can produce more areas of conflict. Bigger is not always better.
• A manipulative personality can be a great danger to office morale.
• Maintain a written Policy Manual and stick to it.
• Individuals who violate office policy should be counseled immediately.
• New employees need and deserve feedback. Use 30-day, 60-day, and 90-day reviews.
• Do not procrastinate in eliminating a problematic employee or your team morale may be jeopardized.
• “Be nice to folks and they’ll be nice back” does not work with all employees.
• Fairness, consistency, and discipline are needed for good staff morale.
• Being a female boss is different from being a male boss with an all-female staff.
• Respect from your employees is more important than being close friends.
Carolyn Flanary, DDS
Dr. Flanary maintains a progressive orthodontic practice in San Antonio, Texas, where she resides with her husband, Dr. Glen Fritz. For more information about her practice, visit her Web site at www.YourOrthoTeam.com or contact her at [email protected].
