Two Step Decision-making is this simple:
Step One – Whoever has to execute/carry out the decision should make it.
Step Two – Whoever is affected/impacted by the decision should have input.
Yes, it is utterly simple, but we have found that in many companies steeped in Factory System hierarchy it takes a few months for people to actually work it out in daily life at work.
Understanding why you are doing what you are doing, and how to allow it to pull you through adversity are both essential to establishing your culture, and thus grow your practice. Your BIG “why” needs to be something that can never be checked off as completed. Once something is checked off, you are done with it, something like “having a million dollars in the bank” simply isn’t strong enough to keep you going. The importance of this often gets over looked due to the chaos of the immediate.
Most experts say fifty percent of businesses fail in the first five years and eighty percent within ten years. Don’t believe them. It’s not true. Very few businesses truly “fail,” probably fewer than five percent.
What really happens? The practice owner gets tired because they are focused on the Tyranny of the Urgent, reacting to their practice and living on a treadmill. They become hostages to their practices. When you’re a hostage and you’re tired, you stop paying attention to Important things, and that results in your failure.
A treadmill is very exhausting and demoralizing if you don’t know how to get off of it.
Time and Money
One of the fundamental mistakes we make is to measure our practice against itself instead of against what it provides to us as practice owners. We focus a lot on how it could provide us money but rarely think of how it could provide time for us as well. And it is this separation of the two that keeps us from having enough of either.
Building a Mature Practice
You get what you intend, not what you hope for. What are you intending? To get a lot of revenue? My definition of a “mature practice” is from the point of view of the people in the practice, not from the viewpoint of the practice itself. A mature practice has at minimum two attributes:
- The practice owner is not the major producer— the produce by choice.
- Because of number one, the practice regularly makes money when the owner is not there.
Thinking Differently about Business Maturity
Let’s change our intentions from creating revenue and/or profit, to building a practice that serves our Ideal Lifestyle, and then we can figure out how much revenue and profit we need to do that. It’s a very fine, but very important distinction.
You might be thinking, “But my practice is unique.” Listen to the podcast for the The 1000 to One Principle to get you started, and remember what Henry Ford said, “Whether you think you can or you think you can’t…
The host of the Dental Heroes Podcast, Paul Etchison, DDS joins us to help understand how important the Participation Age is to our practices. Ask yourself these questions:
1. Does everyone know what our values are, and could they describe them?
2. Do they talk about it? DO they bring them up to me, and others within the team?
Core values, mission statements, do they really matter?
This is the simplest, most impactful and practical principle in the quiver of Participation Age arrows.
The Mission Centered Organization
We should teach everyone that “The mission is the only boss we all have.”
Everything lines up when you fully embrace that simple, but powerful “rule”. To build a great practice and create a happy and loyal patient base, the Mission is the boss.
Following are a few implications of being a Mission-Centered Practice:
- To be Mission-Centered is to not be centered on other things.
The average Factory System dental practice is either Boss-Centered or Department-Centered, or a combination of both, many times with no connection to the practice’s objectives.
- To declare the Mission as the boss is to place ourselves under it.
If the Mission is now the boss, I’m not. I work for, and serve at the pleasure of the Mission Statement.
What Else is Affected By Becoming Mission-Centered?
Following are a few other implications of the power of being Mission-Centered:
- Functions vs. departments. In the Factory System hierarchy, departments and their boundaries are very important. In the Mission-Centered organization, functions can replace departments, both in your language and in a practical sense. Let’s stop guarding fiefdoms and work together to serve the Mission Statement.
- Roles and responsibilities Instead of Titles
We can also emphasize roles and responsibilities, instead of power titles (supervisor, manager, etc.). This helps keep us Mission-Centered; I’m not a supervisor in the marketing department, I’m a Creative Writer in the marketing function that only exists to serve the Mission.
- We must all know the Mission Statement intimately
If we all exist to serve the Mission Statement, that is now the one boss that can hire and fire anyone and everyone. We must all become as intimately acquainted with the Mission Statement, and spend as much time socializing with it as we did before with our human bosses.
When we all serve at the pleasure of the Mission, it levels the playing field in a way that nothing else can, and invites everyone to keep us focused on accomplishing the only thing that really matters, our Mission.
Getting to Know the Mission Statement
- The podcast suggest six extremely practical things you can do to get started.
Our Mission, the one result we want to get for our patients, should be the driving force behind everything and everyone in the practice. We all serve at the pleasure of the mission. We don’t build departmental fiefdoms, but we use our functions to serve and support each other to fulfill the mission.
Currently 8% of practice owners own multiple practices, and that is said to be moving to 38%. But, is this trend real, and is it the best way to reach the success you have your sights set on? We take a deep dive on this with Dr. Farran and explore all of the possibilities on the business side of Dentistry.
When our kids were born, we saw them as adults in the making, reminding us to make decisions that would help them both now and when they were adults. We need to have the same mindset toward our practice – it should grow up and start to give back to us at some point, and as fast as possible.
To get a practice to “mature”, we employ Dual Tracking – As we do things to satisfy the Tyranny of the Urgent, we must use that same activity to also satisfy the Priority of the Important.
As an example, I did the Business Leader’s Insight Lunch for five years in Denver. I could have just talked about business, but that would have been single-tracking, and would have only satisfied the urgent, tyrannical need to present a lunch topic. Instead, I knew I wanted others to learn how to do this in the future, so I put together a handout, expanded on that with a leader’s guide, and recorded each of them with a hand-held recorder. It took an extra 45 minutes for each lunch, but as a result, we have 120+ lunches in audio with handouts and leader’s guides. Now, when new Facilitators start one of our 3to5 Clubs anywhere in the world, they have these tools to support developing their business. These are used on three continents today.
I could have saved 45 minutes to an hour every time I put together a lunch, but that would have cost me hundreds of hours and greatly decreased effectiveness in the long run. I dual-track both the present (the Tyranny of the Urgent) and the future (the Priority of the Important), and got them done once and for all.
A doctor in Chicago has adopted the same idea from us:
- He is doing videos to train other dentists while doing the work ( with permission of the patient of course).
- The front desk is doing a recording of each process as it is performed, with added training comments about how this was handled well, why it worked, etc.
- We have worked with them to write down all their major processes (we call this Freedom Mapping).
In each instance, it would be easier to just do the work, but that is very short-sighted. Now that dentist’s amazing artistry is being reproduced by others that he hires, the front desk has an exponentially shorter training cycle and assurance they are all using the same process consistently, and each function in the practice has their Freedom Maps to accomplish the same thing.
These are just a couple examples of dual tracking. It’s not about being clever or creative, but simply being committed to finding ways to use every money-making activity in your practice to pay your bills and at the same time help you build a future practice that will make money when you’re away doing something else important to you.
It’s critical to ask yourself, “How can I use this task to build a practice while I’m not here?” Ask that every day of every activity in your practice, and your practice will change dramatically and begin to grow up. If you’re only focused on the Urgent, your practice will never get to maturity.
Today we do a deep dive into how to build out your practice in a way that allows you to live the life you want while delivering the service, and attention to your clients that you are passionate about. Dr. Costes takes us through his experience of growing his practice, and the creation of the Dental Success Institute which is designed to help you attain the success you want.
Most dental practices are unwittingly mimicking outdated Factory System organizational design and management practices. The emerging work world of the Participation Age is demanding a much different approach and great practices are racing to embrace the Participation Age.
The hallmarks of the Participation Age are: 1) participation – people want to participate WITH you in building a great practice, not FOR you, and 2) sharing – they want to share in the rewards of that participation. One without the other is hollow.
To get everyone to participate as “Stakeholders” (not share holders necessarily), we need to rehumanize dentistry by giving everyone their brain back. How do we do that? The central practice of the Participation Age is universally Distributed Decision-making (DDM) through universally Distributed Leadership – everyone is a leader.
Why does DDM work? Because Input=Ownership – the more input I have in a decision, the more I will own carrying it out and improving on it. There decisions should be made locally (universally distributed) whenever possible, and it’s almost always possible.
What do we do instead? We mimic a 19th century Factory System model borrowed from the military with its roots in slavery; the classic top-down “pyramid scheme” hierarchy of management. It’s emotionally satisfying – everyone knows exactly who has a bigger gun than whom, but it destroys engagement and participation at every level, and dehumanizes work like nothing that came before the factories other than slavery, serfdom, and indentured servitude.
What should we do instead? Become a Mission-Centered Practice, where we all work to get our patients the result we have committed to. We all serve the Mission, not our department, a human boss, or a job description. And we all make every decision by how it relates to our Mission. We also help each other stay focused on the Mission, and use functions, tools, methodologies, processes, equipment and relationships to accomplish that mission. The effectively flattens the organization in an extremely healthy way and makes us all accountable to the Mission itself.
How do we see the differences between Factory System Dentistry and Participation Age Dentistry worked out? The podcast goes deep on these; following are a few differences:
Classic Factory System Dentistry emphasizes command & control management, assuming people want to be codependent, childlike, task-oriented workers, centralized decision-making, time-based pay, and silos/fiefdoms that create competition and division between functions.
Participation Age Dentistry rehumanizes by emphasizing localized (but not independent) decision-making, inclusive leadership by everyone, adult Stakeholders who are self-managed adults, universally distributed decision-making, results-based pay and incentives, and being Mission-centered, not department or boss-centered.
There are nine practices outlined in the podcast that reflect the above emphasis on Distributed Decision-making; things like DDM Teams, turning Practice Managers into Practice Leaders, roles vs jobs, process mapping & metrics vs. frantic work, much higher standards for team members, hiring completely differently, and full transparency. These nine, along with some others provide the transition from Factory System Dentistry to Participation Age Dentistry.
There are a lot of myths about Participation Age Dentistry:
- Chaos & Anarchy w/out Management – Tighter processes, less chaos
- It’s different, not better – Higher profits & staff retention
- It’s a new fad – Return to pre-Ind. Age practice
- Will cause a dip in performance first – Better performance right away
Practices are racing to embrace the emerging work world of the Participation Age. What is the first thing you can to move your practice in that direction. Eat the elephant one bite at a time.
Should I open a 2nd practice? Why should I open that 2nd practice? How do you get to a place where you understand the TRUE inner workings of culture, team work, and really honing your leaderships skills? All of these are questions that you need to answer to successfully scale your practice. Each of these questions have unique answers to you, your practice, who you are, and where you want to take your practice. Are you ready for this?
Episodes featuring Chuck by himself (with no guest interviewed) will include the title along with, in the bottom of the episode image, the book that the content relates to:
MMIKYB (Making Money Is Killing Your Business)
WEAAABI (Why Employees Are ALWAYS A Bad Idea)