Last week I met a doctor from New York State who sold his practice in January. He stated that finding a buyer had been very difficult. He tried marketing the practice on his own with no success and finally ended up using a practice broker. In the end he had to discount his sale price and carry a portion of the debt for three years. Much as we do not like to admit it, this is the current trend in practice sales in much of the country as discussed in a white paper by Charles Blair[1]. Although he is no longer an owner he has concerns about the practice viability as he is at risk for a portion of the debt. He has a good relationship with the new owner and is trying to maintain a mentor relationship with him. He has noticed that the accounts receivable has moved up significantly since the sale and asked for ideas about how to address the matter.
We believe that there are probably several issues that need to be addressed – 1. The new doctor fears rejection. 2. Staff not 100% committed to new provider’s success. 3. Accountability issues.
A new provider has two issues to address even when they have been introduced to the client base and have a reasonable level of experience. The new provider subconsciously does not want to be rejected when treatment is proposed. Even though this feeling is unspoken clients may feel it. This may lead to a lack of clarity about treatment proposed or fees involved. When this happens staff will sense the change and be less assertive in setting up treatment and fee arrangements. The new provider and old provider will naturally have different styles and differing trust levels with clients. In some cases it may take several years before clients trust grows to the prior level. In some cases clients will depart. The key to managing this aspect goes back to the principles expressed by Sandy Roth of ProSynergy[2]. Before any treatment takes place: All parties must be clear about the outcomes desired, All parties must agree on the means to achieve the outcomes, All parties must agree on the prices involved. The doctor and every team member must use this model exclusively in discussing treatment of any sort with clients. This is not a script it is a philosophy. Dentistry is optional and the patient is the final authority on whether to move forward with treatment or not.
The team must be 100% committed to the success of the practice. The practice is their reason for existence. No practice equals no job. The team must be committed to helping deliver the highest standard of health care that they are capable of and supporting one another in that goal. As the new team leader the doctor must address this issue openly. In a practice transition there will be a period of chaos where some staff yearn for the “old ways”, fear new leadership and test the boundaries of accepted behavior.
The new provider would be wise to set aside several hours for a mandatory team meeting to review and clarify the philosophy of the practice and set goals and objectives that the team can agree on. If that is not part of the skill set of the provider, bringing in a consultant would be money well spent. Rest assured that a practice transition where there are staff mergers and/or a new provider moving into an office with long-term staff there will be emotional turmoil. Staff turnover may be necessary to develop a loyal team. The only way to address this is to meet the issue head on and allow open and honest discussion. Triangulation, back room talk or negative attitudes cannot be tolerated.
The new provider must demonstrate that he/she is accountable and require accountability from every member of the team. Mike Scott[3] has some excellent material on this topic on his website and is an excellent lecturer and consultant in this area. The doctor must demonstrate absolute accountability as the team leader. Only then is it possible to expect accountability from the team. Team members who are not accountable must go. Everyone in the office team knows who the “bad apples” are. Eliminating these bad influencers improves moral and frees up significant time and energy that was being wasted on gossip and excuses that can now be used to address A/R issues. Carefully developing trust through the Outcomes, Means, Prices model, clarifying philosophy, goals and objectives and creating an atmosphere of accountability should move the accounts receivable in the proper direction.
Blg032816
[1] Blair, Charles, Eight Game changers in Dentistry, White Paper, Charles Blair.com
[2] Roth, Sandy, Personal Communication, Prosynergy.com
[3] Scott, Mike, Lecture Material, Totally Accountable.com
We believe that there are probably several issues that need to be addressed – 1. The new doctor fears rejection. 2. Staff not 100% committed to new provider’s success. 3. Accountability issues.
A new provider has two issues to address even when they have been introduced to the client base and have a reasonable level of experience. The new provider subconsciously does not want to be rejected when treatment is proposed. Even though this feeling is unspoken clients may feel it. This may lead to a lack of clarity about treatment proposed or fees involved. When this happens staff will sense the change and be less assertive in setting up treatment and fee arrangements. The new provider and old provider will naturally have different styles and differing trust levels with clients. In some cases it may take several years before clients trust grows to the prior level. In some cases clients will depart. The key to managing this aspect goes back to the principles expressed by Sandy Roth of ProSynergy[2]. Before any treatment takes place: All parties must be clear about the outcomes desired, All parties must agree on the means to achieve the outcomes, All parties must agree on the prices involved. The doctor and every team member must use this model exclusively in discussing treatment of any sort with clients. This is not a script it is a philosophy. Dentistry is optional and the patient is the final authority on whether to move forward with treatment or not.
The team must be 100% committed to the success of the practice. The practice is their reason for existence. No practice equals no job. The team must be committed to helping deliver the highest standard of health care that they are capable of and supporting one another in that goal. As the new team leader the doctor must address this issue openly. In a practice transition there will be a period of chaos where some staff yearn for the “old ways”, fear new leadership and test the boundaries of accepted behavior.
The new provider would be wise to set aside several hours for a mandatory team meeting to review and clarify the philosophy of the practice and set goals and objectives that the team can agree on. If that is not part of the skill set of the provider, bringing in a consultant would be money well spent. Rest assured that a practice transition where there are staff mergers and/or a new provider moving into an office with long-term staff there will be emotional turmoil. Staff turnover may be necessary to develop a loyal team. The only way to address this is to meet the issue head on and allow open and honest discussion. Triangulation, back room talk or negative attitudes cannot be tolerated.
The new provider must demonstrate that he/she is accountable and require accountability from every member of the team. Mike Scott[3] has some excellent material on this topic on his website and is an excellent lecturer and consultant in this area. The doctor must demonstrate absolute accountability as the team leader. Only then is it possible to expect accountability from the team. Team members who are not accountable must go. Everyone in the office team knows who the “bad apples” are. Eliminating these bad influencers improves moral and frees up significant time and energy that was being wasted on gossip and excuses that can now be used to address A/R issues. Carefully developing trust through the Outcomes, Means, Prices model, clarifying philosophy, goals and objectives and creating an atmosphere of accountability should move the accounts receivable in the proper direction.
Blg032816
[1] Blair, Charles, Eight Game changers in Dentistry, White Paper, Charles Blair.com
[2] Roth, Sandy, Personal Communication, Prosynergy.com
[3] Scott, Mike, Lecture Material, Totally Accountable.com
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