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HELP! My dental ship is sinking… – How To Fix A Practice

By January 22, 2018October 18th, 2021Madow Blog
wood cut in the shape of a house with stacks of coins behind it

Here is a question we received about how to fix a practice:

Dear Madow Brothers Coaches,

Things are so bad in my practice I don’t even know where to begin. I am producing close to a million dollars a year and collecting around $750K. This is considered really good for my mid-sized Midwestern town. But I am earning practically nothing. My hygienist and my associate are both earning more take-home than me.

Our new patient flow has collapsed, and we are losing patients to two new practices that have opened nearby. It gets worse.

My lab just cut me off because I owe them over $50,000. I owe money on two credit cards, and am still paying off a practice construction loan (when I can). Sometimes I feel like I am the captain of the Titanic and my staff is the orchestra, just blindly playing as the ship sinks. Can you help?

Dr. Jay
Somewhere in Ohio

How To Fix A Practice

Dr. Jay-

Wow – you sure have a lot of things going on there. So first of all, let’s make this clear. There are no coaches or consultants in dentistry who can wave a magic wand and fix your practice. Not us, not Roger, not Cathy, not Lois, not Mayer, and certainly not those people who call you every day, belittle you, and scare the shit out of you until you sign up. But the good news is, based on our years of experience, there is light at the end of the tunnel and it can be found. 

There is an old saying – “How do you eat an elephant?” “One bite at a time.” And while we are certainly not recommending or condoning eating elephants, this will be the way you need to approach things. That said, here are a few questions and starting points for you.

When you say that you produce close to a million and collect 750K, does that mean you are writing off a ton of PPO stuff? That is not necessarily bad, but the fact is, if you agreed to a PPO fee schedule you never actually produced at full fee. So that figure is a fantasy. If you are not talking about write-offs, you have a seriously bad collection problem that is adding considerably to your overhead.

If your associate is out-earning you, what is the point? Not every practice needs associates.

Why are you being beaten by those new practices? Our guess is that you are doing little about this, trying to depend on your reputation and word-of-mouth, Hint: It’s 2018. 

We can guess (and we are right) that you do not have an effective system to reconnect with your patients who have not been in for a while, do not have a hygiene appointment scheduled, or have diagnosed but untreated dental needs. And remember, any old system is not necessarily an effective one. 

Has an outside expert (such as an accountant who specializes in dental practices) reviewed your expenses and debt issues? It is pretty safe to say you are missing a lot here.  

Just a guess here (again based on experience) that if we called your practice posing as a new patient your front desk team would not make the appointment. We cannot even tell you how many times we have heard “Oh – my front desk person is fantastic!” only to call and be connected with Clueless Claire. 

And here is where it gets a little deeper. We have found that when we work with someone with a practice similar to yours (and we have done that lots of times) the problems are not just with the dental office. To fix a practice, we always start with a pretty intense interview process, and nine times out of ten when someone has a similar situation there are factors that go WAY beyond new patients, collections, etc.

Yes – that means that there are some screwed-up things going on in their lives that are negatively affecting their practice. (Not to brag here, but we are the only dental coaches that go deep like that!) Of course that is not always the case, and we are glad to work with “just the practice.” But again, experience shows that outside factors typically contribute to this kind of stuff.

Bottom line – you need some help! This is not a situation you can fix yourself. Keep doing what you are doing and it is just a matter of time before there is a padlock on your door and a “For Rent” sign in the window. Let’s make sure that doesn’t happen!!
Coach Rich
Coach Dav

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Dr. David Madow

Influencer, Speaker, Author & Coach at The David Madow Lifestyle Show + Co-founder of The Madow Center for Dental Practice Success.

Dr. Richard Madow

International Keynote Speaker, Author, Award Winning Musician & Composer, Coach and Co-founder of The Madow Center for Dental Practice Success.

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