Ok, maybe not the MOST enthralling topic this week.  We admit it.  We write to doctors, not corporate executives.  They’re doctors for a reason: they want to treat patients.  They didn’t go to school so they could be a manager–otherwise they probably would’ve gotten an MBA!  They are doctors because they want to see patients–not manage a business.

But what if we could give you one compelling reason that would absolutely persuade even the MOST management-averse doctors to try to learn about being an executive?

OK, here it is, get ready:

Because you have to.

That’s right–you have to.  Unfortunately every practice owner in America, so long as they’re going to continue to own and run a practice, has to know something about management.  If they don’t it’s an absolutely miserable experience.  In fact, the less you know the more miserable it is

The moment a person buys or starts a practice, he is no longer just a doctor.  Now he’s a business owner which means that he is, by default, an executive and a manager.  This has its own set of problems that are completely disrelated to being a doctor and require a totally different skill set.  And no matter how smart someone is, he won’t know what to do unless he’s been trained in management.  A person can try to run their practice on instinct, but often this flops.

Running a business can be counterintuitive at times.  Dealing with employees is different than dealing with patients.  A lot different.  Extremely intelligent people can fail at running their own business if they don’t learn the technology of management.  


Yes.  There is a technology to managing.

Running a business isn’t done off of feel, off of opinion or gut instinct.  Running a business is done according to certain laws, which invariably work in all situations.  There are right ways to do things and wrong ways to do things.  If you learn the laws and procedures you will succeed.  If you don’t learn them, you…won’t.

Note:  As an aside, because it’s relevant here, one point bears addressing.  When talking about practice management, many practice owners say that they don’t want to bother with it and they’ll just hire someone else to take care of it for them.  That almost never works.  The reason is because it’s the doctor’s money, credit and name on the line.  No one will ever be as interested in the survival of the practice as the practice owner.  At the end of the day, it will always fall on the practice owner to ensure the practice is running well and solvent.  Delegating to an office manager is good, and should be done–as long as the owner is also an expert at management.  The owner has to have their eyes open and be overseeing the direction of the practice.  He might not handle the day-to-day operations, but he’s still the “CEO.”  Delegating all managing to someone else while ignoring it personally is like taking your hands off the steering wheel and closing your eyes while driving.  The only doctor that doesn’t have to know about management is the one who works for someone else.

Here are five tips you can apply right now to become an expert manager in your practice:

1.  Decide to become a good manager or executive.

Most practice owners identify themselves as a doctor.  They have no problem with that role and when someone asks them who or what they are, they are likely to answer that they’re a dentist, a veterinarian, an ophthalmologist–whatever.  They normally don’t say that they’re a business owner.  The first step to becoming an expert manager is deciding to fully take on that role in addition to your role as a doctor.  It can’t be something that you do because you have to.  No one ever got good at anything that he did unwillingly or grudgingly.  You have to decide that you ARE a manager.  It has to be an identity that you want to have, that isn’t just thrust on you because you have no one else do to it.

2.  Decide to become an expert.

You are an expert at treating patients.  You’re good at it and people pay you good money for it.  Decide to become an expert at practice management.  It takes a decision and a commitment, but it’s the only way to win.  Don’t decide to half do it.  Do it all the way.  If you’re going to run a practice for the next 10, 20 or 30 years, you might as well do it well.  Decide that you’re going to become a professional executive and an expert in your own right.

3.  Study

No one ever became good at anything without a tremendous amount of study and practice.  Even the “natural talents” in any field still practiced a ton.  If you’re going to become an expert executive, you’ll need to actually study how to be one.  Devote time, energy and treasure to learning about it.  It will pay you back in spades every year that you practice.

4.  Don’t listen to opinion.

Management ideas are thrown around like political slogans.  The vast majority have absolutely no workability.  Remember that.  Just because someone says it’s the flavor of the month doesn’t mean it will work.  And just because a successful business owner says he does _______, doesn’t mean it will work for YOU.  It might just be that with his personality or his staff, it happened to turn out OK.  There is no guarantee it will work the same way for anyone else.  Go in for natural laws, broad general principles and basic fundamental truths.  Ignore fads.  Disregard things that worked in only one or two instances.

As you learn about management, you will encounter so many opinions that it can get extremely confusing.  Learn to ignore opinions and mere “theories” or you’ll get lost.  Stick to basic workable fundamentals and everything gets simple.

5.  Learn to become an executive the same way you learned to become a doctor.

Sir Francis Bacon revolutionized science with empiricism and the scientific method.  This method of thinking holds true even today.  All of science and its allied fields like medicine are based on it.  Every class you ever took to become a doctor had at its root the basics of the scientific method.  Don’t throw it away when studying how to become an executive.  It’s truly your most valuable asset.  The only test of a management principle is: does it work?  If it works, keep it.  If it doesn’t work, get rid of it.

Too many people in the fields of management and business are willing to throw the scientific method out the window and work for years on completely false ideas.  You see it all over the news, in government and in professional journals.  The only valid way to manage a practice is the same way that you treat patients–using observably workable procedures based firmly on fundamentals which are based in fact, not opinion.


Becoming an expert manager is the way to economic freedom and professional success for any practice owner.  If you can embrace it you will see steady expansion for your practice and financial freedom for yourself and your family.

There is no one-shot silver bullet to successfully managing a business, but if you really learn how to do it, the “management end of things” stops being a chore and actually becomes fun in its own right.


Hanses Management provides training in the fundamental laws of result-based practice management.  If you want to learn more about management based on natural law, contact us below.  We also recommend an excellent book on the subject, “Breaking the Code: The Mysteries of Modern Management Unlocked.”


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can.



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What if I told you there were a way to get more New Patients/Clients,  greatly increase Collections and Production and it is sitting under your nose waiting to be used right now?

Well, I am telling you that.  There is.  It’s in your existing files.

The problem is that many practices don’t take full advantage of their files because they don’t know what to do with them.

There are a couple things every practice has to know about using their existing patient/client files.

First let’s quickly go over the theory of marketing to existing files.  Another word for this is “reactivation.”  Some people call it “internal marketing.”  Whatever you call it, it means marketing to people who have already bought things from you–not just new patients or clients.  Over the period of a person’s life they will need your services over and over.

For a dentist, a person will continue to have a mouth their entire life.  So will their kids.  Thus they will need dental work for the rest of their life.  For a vet, a person will likely have many pets throughout their lifetime.  So will their family.  Thus they will need your services for years.  And so it goes for all sorts of professions.

That new patient who came into the practice is going to keep going to a doctor.  In fact, he’s probably already gone to many other doctors.  The trick is not how to GET a new patient.  It’s how to KEEP him.  This is where the practice really will see the bulk of its gain–from repeat regular business.  This is how a practice really develops into a juggernaut that grows and grows.  This is the subject of marketing to your existing files.

Below are five things every practice should be doing to market to their existing files.  If you’re not doing these right now, pick one that you know you can do and keep it going consistently while you work toward getting the others in one by one.

1.  Send out a monthly newsletter.

This is profoundly important.  A newsletter tells everyone that you still exist.  Without a monthly newsletter your practice starts to disappear from people’s minds.  The newsletter doesn’t have to be fancy–one page will do.  It doesn’t have to be clever.  It just has to be regular.  Every patient you have ever had should receive a newsletter once per month.  It may seem like a waste of money, but consider this: they will all need treatment in the future.  Where will they be going?  To you or someone else?

2.  Send out reminders.

This one is a no-brainer.  People forget to come back, they don’t come in for check-ups, they get tied up with life.  In the back of their minds they know they should be coming back in but are procrastinating or trying to put it off until the last minute, or maybe they’re just busy and plain forgetful.  The way to address this is to do two things: first always schedule their next visit before they leave the office and get their firm agreement to show up then.  Next, make sure they receive a reminder notice so that they don’t forget about it once they’ve scheduled.  It’s that simple.

3.  Reactivation calls

Each file in a practice should be called on a rotating basis to keep in touch with them and get them coming back in to complete their treatment or start new treatment.  It can be quite a project, but if it is kept in as a routine action, you’ll rapidly see results.  Reactivation calls require someone with a good phone presence–easygoing and nice to talk to, but at the same time interested in filling up the practice.  If they are afraid to tell people what to do, they’re not a good choice.

4.  Personal letters

This one is not as frequently done as it should be.  The concept here is just to regularly and routinely cycle through the files, writing to each former patient in order to get them back in touch with the practice.  This is very different from a newsletter, which is mailed in bulk.  These are actually personal letters from someone in the office–can be anyone.  It doesn’t matter whether they’re hand-written or typed.  The way it works is you just pull the file and write to them about whatever is relevant from the file.  If they completed a big restoration five years ago, you would just ask how it’s going for them now.  If they are mid treatment that they never finished, then ask them how they are doing with their problem and what happened on finishing their treatment.

Same as with reactivation calls, an office should regularly and repeatedly cycle through all of their files.  This is a flood of personal letters going out, for sure.  However, it really keeps the practice in touch.  These people end up coming in again and either finishing the treatment plans they started or getting started on new ones.

5.  Personal Notes and Cards

This takes some organization to do this one, but it really adds a nice touch to all your marketing efforts.  Work it out to send everyone in your files a holiday card in December.  Send them all birthday cards throughout the year.  Send them congratulations when a kid finishes college or someone has a baby.  These don’t have to be from the doctor; they can be from anyone and can be on behalf of the office as a whole.

Holiday cards are easy–you just send a card to every single person in your files as a bulk mail.  This is once a year.  Simple.

Birthday cards are a little harder.  It takes a regular action of the office to stay on top of these and requires a system of organization.  Still not too hard if you’ve got a good office manager.

Congratulatory cards really put the icing on the cake but you have to get pretty clever in order to stay on top of them.  One simple way to do this is just to have a supply of all different types of cards on hand and any time someone hears the good news, they personally sit down and write a card out and drop it in the mail.  Another way to do it is to keep a central database so all staff can jot down notes to a single staff member when they hear something.  This staff member is the one in charge of staying on top of it and they collect the information and send out the cards.  The best person for this is usually whoever does the marketing already.


The key to marketing to your existing files is organization.  You really have to stay on top of who should be getting what type of card or letter or call at what time.  This takes organization.  This is the main reason why offices can’t do it.  They simply don’t have the organizational systems in place.  Without ways to easily keep track of every patient or client you’ve ever had, without ways of easily mailing to them or calling them, it is nearly impossible.

The main reason this doesn’t get done is because there isn’t someone in charge of it.  One person needs to be assigned to marketing.  This person does whatever marketing is realistic for them–don’t bite off more than you can chew.  Really get one type of marketing worked out and organized so that it is smooth.  Then, as your practice expands you can put a full-time marketing person on and work out systems for each one of the different types of marketing we talked about–and more!


This is one of those fundamental actions it takes to run a practice and can be a real bear to sort it out.  The key is to figure out what you can do right now and have a plan to develop toward the ideal in the future.  This will, of course, require increased organization and resources which you will get along the way as you grow.

If you have any questions about this or want to know how to address something specific to your practice, write us.  We’ll do our best to point you in the right direction.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can.




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Now we did it.  We said the word collections.  No one is going to read this blog ever again.

This is sort of the dark underbelly of a practice…collecting money.  It’s the part no one wants to talk about.  Like taxes and OSHA, there are certain aspects of practicing that people could do without.

Everyone is in favor of getting paid–it’s just the collecting money part they wish they could skip.

However since it is a necessary evil, is there a way to clarify the subject or make it less painful in any way?

Clarify it?  Yes.  Less painful?  Ummm…

Ok, joking.  It’s not that bad really.

Let’s review the problem here.  Practices deliver treatment to all sorts of people.  They have expenses (payroll, supplies, insurance, rent, etc.)  They need to get paid.  However, people don’t always pay.  Insurance companies don’t always pay.

The secret of collections is actually really simple–ask for money.

No, seriously.  We see this all the time.  The number one problem that we see with collections is actually amazingly simple.  Practices simply don’t ask for money.

A person finishes up his treatment and goes to the front desk, fully expecting to pay.  The front desk thanks him for coming and sends him on his way, telling him he’ll get a bill in the mail.  Doesn’t even ASK him for money.

A person is told they need a treatment plan.  However, rather than waiting to see if the person can work out how to pay for it, they instantly assume that they don’t have money or won’t want to pay for dental work and so give him another, cheaper, option.  However, the funny thing is that the patient actually needs the first option.  That’s what would be what would be best for him and probably what he would be happiest with in the end.

Some practices don’t even send out bills sometimes.  It’s true!  We’ve seen it.

Doctors will sometimes just give away treatment.  The patient isn’t even a friend or family.  The doctor doesn’t even tell the patient that he’s doing it so that the patient understands what just happened.  The patient thinks he’s paying full fee because the doctor never even told him that he did two or three things for free.

This is one of the ways that a practice stays broke while working hard.

Let’s look at it this way: You do a lot of work–a lot of hard work.  You provide good service.  You went to school for years.  You studied and skipped out on other things you could have done.  Even today you don’t do things that you could be doing, taking time off for yourself or your own hobbies.

You work hard to provide the best treatment possible.

That’s valuable.

You deserve to be paid for it.

You and your office staff don’t have to be pushy or rude–but you do have to actually ask for the money that is owed.  This can be cheerful and friendly, but it can’t be overlooked.

Too often practice owners see this as dirty or greedy, but it’s a vital part of running a business.  Billing and collections are necessary to keep the lights on and provide future service to those who are counting on you.

The four most key points of collecting money are:

1.  Treatment plan presentation.

Present the treatment that the patient actually needs–not what you think he can afford.  Make sure that you are absolutely thorough in communicating why he needs it so that he can understand it himself and be able to weigh the options.  Many patients will just go with the cheaper option because they don’t even understand the difference between the two–even if the more expensive option would be much better in the long term.  People will often select the more expensive treatment with no persuasion at all–if they fully understand it and the ramifications of it.

2.  Free Service.

A doctor may feel bad that he is charging what he is, even though it is a fair price.  As a result, he’ll throw in extra services or products.  It’s sort of tricky way of not getting paid.  You see, he didn’t discount the services he billed for–he just did some other things for free.  Often the patient or client doesn’t even know this was done.  The doctor just subconsciously believes that all of his patients think his prices are too high and so does freebies to make them cost less.

There are two things wrong with this.  First, his prices aren’t too high.  His services are valuable and he deserves to be paid for them.  Secondly, he isn’t fully confronting HIS costs.  You see, the bank isn’t going to cut him any slack.  The suppliers aren’t going to give him free supplies.  The landlord isn’t going to give him a free month’s rent.  HE still has all the same expenses to stay in business, but now he’s making less.  He gets overworked and feels under pressure as a result.

Any doctor has to make money just to stay in business in order to help more patients.  You can’t treat anyone if your electricity is shut off.

3.  Front desk.

Make sure the front desk is trained on actually asking for payment whenever possible.  Don’t let them get into the habit of sending everyone on their way.  People expect to pay when they go to any restaurant or store in the world.  They won’t be shocked that you’re asking them to pay–and the best chance to catch someone is before they even walk out your door.

4.  Billing.

Make sure your billing is in good shape.  A practice has to send out regular bills that are very clear and easily understood.  They also have to be consistent.  If the practice doesn’t follow up, the patient or client very likely may not pay.  The same sometimes goes for insurance unfortunately.  Pushiness is not needed here–persistence is, however.

If you just focus on the four points that we listed above, you can raise your Collections Ratio almost without even trying.  Again, you don’t have to be mean or demanding or stingy.

But you do have to ask.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can and may even post our answer to your question (but not your name) for others to see in the future.



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The Lone Ranger had Tonto.  Batman had Robin.  Sherlock Holmes had Dr. Watson.  Johnny Carson had…well, you get the idea.

The owner of a practice has several different jobs: Doctor, Managing Executive, Practice Owner and sometimes Landlord.  This is important when you realize that the most common reason for lack of expansion of a practice is owner overwork.  Because who is going to come up with the Big Ideas and make sure that they get done if the owner is drowning?

Every hero needs a sidekick.  A practice owner is no different.

So, what do you call a practice owner’s sidekick?

An office manager.

The main reason for a practice owner to be overworked is an unstable office manager.  There is simply no way possible for one person to treat patients full time, be the building landlord, be the owner/CEO and also be the manager of the practice.  And even if a person could pull it all off in a small practice, how are they ever going to expand?

The solution is to hire an office manager that works well with you and turn over the “Managing Executive” job to them.  Get them trained up so they can take all of the day-to-day decisions, paperwork and staff problems off your plate.  That way you will have time to focus on the jobs that only you can do.

What To Look For In Hiring An Office Manager

In hiring an office manager, there are a couple of things to look for:

1.  What is their production record?  It is very important that your office manager be able to get a tremendous amount done in a short period of time and you have to be able to trust them to take care of it on their own without your constant oversight, so they really have to be competent.  The best way to judge this is to actually have a track record with the person.  Whoever has the best record of actual PRODUCTS will be the best person to promote.  This is why it is often best to promote from within.  That way you have a chance to see how they produce on their job.  Remember though, being busy isn’t the same as being productive.  Saying nice things to the owner isn’t the same as real-world productivity.

2.  Do you like them?  You will work best with people that you genuinely like.  After all, you’ll be spending a lot of time with this person and sharing in your hopes and dreams.  If you don’t actually like them, don’t make them your OM.

3.  Do you trust them?  This is extremely important.  If you’ve got a bad feeling about someone, NEVER put them in a position of power in your office.  The last thing you want is to be proven right that you shouldn’t have hired someone.  If your instincts tell you not to trust them…don’t.

4.  How quick are they at learning?  An office manager doesn’t need to be already trained to run a practice.  In fact, a lot of times this is a mistake an owner will make.  They hire an outside office manager at a high rate of pay because of some previous credentials or experience and then are unhappily surprised that they were all talk, or the person didn’t fit well in THEIR practice.  You can train up an OM yourself.  But they will need to be quick at learning.  Someone managing a whole practice has a lot to do and learn, so they need to be quick at picking up on how to do new things.

Ok, I Hired Them.  Now What?

Now you’ve got to train them.  Many a good office manager has gone bad simply because she wasn’t trained properly.  No one can do a job they weren’t trained for.  They will sit around and grumble and complain if they aren’t trained.  Don’t expect them to be telepathic.  They don’t know your office, your rules, your software or your patients.  Once you hire them you will have to set aside a substantial amount of time to actually get them up to speed, continually training them every week until they are actually able to do everything they are expected to in each part of the practice.

Use Them Or Lose Them

This is normally spelled D-E-L-E-G-A-T-E.  Everyone has heard of it and everyone knows that they need to do it.  However, this is extremely important to reiterate.  Remember that as the practice owner, it is still your job to provide the direction for the practice and do the long-term planning.  Don’t expect the OM to run on autopilot.

Make sure that she is correctly utilized, that she knows what direction you’re taking the practice and she has a plan that she is working off of.  Meet with her each week and help her sort out the priorities, making the best use of both hers and the staff’s time.  Ensure that your office staff are working on something productive and take responsibility for providing valuable work for them to do.

Don’t Give Up

The right office manager is out there.  Just keep looking.  Most of the time people get one office manager and then think that there aren’t anymore out there in the world.  Sometimes the best way to find the right office manager is not to actually make them the OM until they’ve worked in the office a while and you’re sure of who they are.  Just keep hiring and hiring office staff in a continual flow.  Let the ones go who don’t work out.  This will give you a chance to see how different people function in YOUR office.  Once you’ve got a winner, promote her to OM.

The main thing is just not to give up.  This is a key part of building a practice and any time you spend on this will be well spent.  As always, if you have any questions about hiring, training, personnel or anything else, just drop us a line.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can and may even post our answer to your question (but not your name) for others to see in the future.



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Whew.  This week’s topic is a a toughie.  What a loaded question.  I’m sure we’re going to get hate mail after this one.  😉

So many of our clients have this as a fundamental question.  It’s sort of a Hamlet proposition for many practice owners: “To market or not to market, that is the question.”  It isn’t that they can’t market.  They don’t know if they even should.

Is marketing yourself to the public unprofessional?  Greedy?  Unethical?  A necessary evil?

It’s an important question to answer for any practice owner.

What is Marketing?

Marketing is simply the promotion, advertising and selling of a product or service.  It includes the strategy behind conceiving of a product to sell, deciding how to promote it, getting it advertised and finally sold to the public.  As a subject, marketing really grew up in the late 1800s and early 1900s as the Industrial Revolution shifted the United States from a country of small craftsman to a national marketplace.  Whereas previously you would’ve bought shoes from a cobbler who made them in the back of his shop around the corner, now goods manufactured in Detroit were being advertised and sold in New York.  Marketing was a natural outgrowth of this and became a new skill and profession in its own right.

Is Marketing Inherently Manipulative?

Well, it depends on what you’re selling and how you’re selling it.  It’s like asking if lawyers are inherently manipulative.  They definitely can be, but they don’t have to be either.

In any economy, marketing fills a vital niche.  It lets people know what’s for sale so that they can then buy it.  If done honestly it is helpful.  If done wrong, it is unethical.  As an example, if a practice owner were desperately searching for a piece of new equipment, he would probably like to read a brochure or a website.  How else would he know about it?  That’s marketing.

Now if that brochure were filled with lies or misinformation designed to get him to buy something he really didn’t need…then that same practice owner would probably feel manipulated.

When used to manipulate people, marketing is manipulative.  When used to help people get the service that they need, marketing is not  manipulative–in fact, it is actually a valuable service.

But What About For a Doctor?  Isn’t That Tacky?

A matter of taste.

It is true that in some countries this is considered absolutely taboo.  I was talking to a South African friend and she was telling me about how advertising is heavily regulated for professionals there such as doctors, accountants and lawyers.  It is considered to be a conflict of interest or some such.  In the U.S. we have some regulations, but for the most part there are few restrictions.

But what about the question of it being tacky?

Well are blue jeans in the office tacky?  What about corduroys?  How about a doctor who doesn’t where a tie, or an Office Manager with a penchant for tchotchkes all over the waiting room?

Tacky is a matter of taste and what’s appropriate for your area.  Something “tacky” in downtown Chicago might not be in rural Kentucky.  For that matter, something completely acceptable in Chicago might be considered rude in Kentucky.  It’s the same for marketing and advertising.

The best way to judge what’s appropriate for your area is by checking out how marketing is used in your area.  If you can find even a couple of other doctors using a certain method of marketing, it’s a pretty sure bet that the public at large doesn’t object to it.

Remember Who You’re Marketing To

Remember one thing: you are not marketing to other practice owners.  You are marketing to the public at large.  What the doctor two blocks over thinks about your marketing isn’t important.  Whether it brings in new patients or new clients IS important.  You aren’t marketing to your competitors, your colleagues or your state association.

So Is Marketing Right Or Wrong?

The answer to this is that the ethics of marketing depends on one thing: Do you deliver good treatment or do you deliver destructive treatment?

If a practice delivers good treatment that is valuable to patients, then patients and clients DESERVE to know about it.  If a practice delivers poor-quality treatment that is destructive, then it is wrong to market that practice.  It literally is that simple.

If your treatment quality is high, then you are actually being helpful by marketing to your patients.  After all, they need services that you deliver and by reaching out to them, you’re helping them go to a practice where you know they’ll be taken care of (yours), instead of getting substandard treatment that they won’t be as happy with in the end.

By this logic, a constructive practice that does good treatment has a moral obligation to market so as to help others get the high quality of treatment they deliver!  It would be wrong for them not to market, or to do poor marketing which really doesn’t represent them well.

The Bottom Line

If a practice does good work and knows that they do good work, it is absolutely ethical to let people know about it.  If they plan to do poor work, then obviously they aren’t doing anyone a favor by marketing themselves.

Truthful marketing about a high-quality service that people actually need is not only acceptable, but helpful.  Done right and with the intention to actually help people get the service they deserve, you should promote yourself to the whole world.

Sometimes the RIGHT thing to do is market.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can.

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Your office is more than just a job to you.  You’re personally invested in it and it means a lot for your future.  Unfortunately, all of your staff may not feel the same way.

To many staff, their job in an office is just that: a job.  They are working there to get a paycheck and so don’t have the same drive to expand the practice.  They may not use their time to get the most done.

Is there a way to focus your staff on productivity instead punching a clock?  Is there a way to motivate the staff to take more ownership for the practice?  This is a key issue for any practice owner, and in many cases it can drastically change the bottom line.  To answer that, let’s go over the difference between productivity and “working.”

Every person doing a job will expend the same number of hours in a given day.  But they do different things during those hours.  One staff member adds value to the practice, while the other absorbs a paycheck.  What’s the difference between the two?


The first staff member actually gets things DONE.  He finishes things that don’t have to be re-done.  He starts on something valuable to the practice, gets it done, goes onto the next thing, gets that done, etc.  He achieves products.

The second staff member sits at the desk and starts on something…keeps working at it.  Hangs out.  Maybe talks to another staff member.  Finally asks a question about it.  He may even appear to be “busy” and working, but at the end of the day not as much was actually accomplished.

The final test of any staff member is always that staff member’s productivity: how much they accomplished for the office.  Therefore, the most efficient staff member will be the one who is most focused on products, not just “working”.  The way you can increase any staff member’s efficiency is to get them to focus on products.  How to do this?

The answer lies in production quotas.  

A lot of times when staff aren’t being productive and are just “working”, they aren’t malicious or even negligent.  They’re just distracted.  They don’t have their attention on achieving real products and so use their time inefficiently–maybe even distracting the other staff who ARE working.  The way to solve the problem is to help them focus their attention on getting products.  This is done by assigning production quotas.

A production quota isn’t just a quota for “Production” in the traditional sense (meaning the dollar value of all services rendered by a practice).  A production quota is a numerical quota of any type of work assigned to a staff member.  This could be the number of new patients scheduled in a day, an amount of money they’re supposed to collect in a week, the dollar value of treatment plans accepted, etc.  Production quotas are simply an amount of work assigned to a staff member to get done in a given period of time.  They’re like little goals for each staff member to hit in a given day or week.

How do you use quotas?

1.  Meet with the staff member and work out what their job is.  Decide with them what product they produce for the practice.  Perhaps it is Appointments Scheduled or Collections or New Patients (by the way, Hanses Management has all of this worked out for each job in an office and can help you if you have questions).

2.  Figure out a way to quantify that product, giving them some sort of way of tracking it.  This needs to be a real and meaningful system which actually results in real work done that adds value to the practice.

3.  Every week sit down with them (or have your office manager sit down with them) and assign them a production quota.  This is best done when you have their full agreement and it is something that they themselves are interested in achieving.  Always try to set it for a little higher than they got last week.

4.  Break down the weekly production quota by each day of the upcoming week.  Help them figure out where they’re going to have to be by Monday, then Tuesday, then Wednesday, etc.  Make sure that they have this written down and can see what figures they’re shooting for each day.

5.  See if they feel like they are going to run into trouble in achieving those those quotas and help them figure out how to overcome any barriers they may run into.

NOTE: Even if you only get this far, you will greatly increase office productivity, so long as every week you stay on top of the production quotas for each staff member.  Simply by gently putting their attention on how many products they’re going to produce, you will make them more efficient and productive.

However, if you really want to see things soar, take it one step further:

6.  Implement a bonus system in your office so that staff are rewarded based on how much they produce.  There is no better way to incentivize your staff than to reward them based on their personal productivity  There are many ways to set up a bonus system, but the keystone is just ensuring that the staff are rewarded for production and so are eager to get more done.  If you also want them to focus on the overall office as a team, you can bonus each staff member on the total office production in addition to their personal productivity.

The bonus system is where the ownership really kicks in.  All of the sudden, they start looking at the office the same way you do.  It isn’t just a job.  They aren’t just “keeping busy.”  Suddenly their attention is on productivity–how they can get more done and how they can be more efficient.  After all, you yourself operate based on a “bonus system” of sorts.  You only get paid if they practice makes money–regardless of how many hours you work.  Focusing your staff in a similar way puts everyone on the same page and gets everyone working toward the same thing: providing high quality and high quantity patient care and growing the practice.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can and may even post our answer to your question (but not your name) for others to see in the future.

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Visibility is key to getting new patients or clients.  However, when most people think of “visibility” they just envision a big sign on a busy road, which is only a tiny part of it.

So what is visibility?  Let’s look at it this way:

As you read this article, there are people in your immediate community (maybe less than a mile from you) who need services that you deliver and who are actively looking for a practice like yours.  Will they find you?  Will they find someone else?  Will they forget that they were looking?  This what we mean by “visibility.”

However, there’s a lot more to the subject than first meets the eye.

Let’s look at the big picture.  Every practice needs new patients.  Vast sums of money are spent by practice owners trying to solve this.  Newsletters are sent out, advertising is paid for and postcards are mailed.  This is marketing, which is fine.  However, many practices spend enormous amounts of time and money on marketing, when they aren’t even visible to the people in their neighborhood who are looking for them.  

This last part is key.  You have to understand that people are looking for you right now.  You provide a valuable service and people need it.  Regardless of whether or not you spend a dollar on marketing or not, all on their own they are going to be looking for you.  The trick is just: can they find you?

It isn’t about whether or not you can convince anyone to do anything.  It’s just about letting the people who are looking for you know that you’re there.  All too often this is completely missed by practice owners.  THEY know that they are there.  After all, they pay the mortgage and work there every day, so it seems completely foreign to them that people around the corner wouldn’t know they’re there.  In fact, they disbelieve it when you tell them.

So here is the trick of visibility: just make yourself present at every point where a person would look when trying to find your services. At this stage of the game, you don’t have to convince them you’re good or anything else.  You just have to be strikingly, obviously, glaringly…VISIBLE.

Patient Viewpoint

In order to do this you need to pretend to be a patient.  Actually be an actor and play a prospective patient or client who would be looking for a general dentist or a vet or an optometrist in your city.  Actually try to find a practice to get treatment for yourself and see what you end up finding.  Where do you look?  Google?  Yellow Pages?  Signs by the road?  Billboards?  Search online and see what comes up.  Which practices can you even find?

Each point YOU checked is also a place a potential patient or client would check.  The trick of visibility is just to make sure that you’re there.

Often it isn’t possible to find a practice when you’re looking for them!  In fact, the only way you can find 90% of practices would be if you knew their address and drove there, knew the doctor’s name and specifically looked him up, or happened to be driving down a certain road and looked at the right angle at the right time to catch the small sign above the door.


Here is a basic checklist of things you can look for with regard to visibility:

1.  Building Sign

Get in your car and drive down the road in front of your practice, pretending to be someone passing by.  Is your sign clearly visible from the street coming from multiple directions?  Is it obvious how to get into your parking lot and then get to your practice?  Is your sign so obvious that it is unmistakable what you do?  What you’re looking for in a building sign isn’t something flashy or gaudy.  We just want something that a passerby can see even when they’re not looking for it, regardless of which way they’re driving from, and which will clearly and unmistakably state to them: THIS IS A DENTAL OFFICE.  So many offices lose business on this one point: their signs are bad.

2.  Internet

Go online and type words into Google as though you’re searching for a practice like yours.  Include the name of your city or community and what you do.  Try specific services such as “emergency dentistry Buffalo NY” and also general terms like “Springfield veterinarian” and see how you rank.  If you don’t have a website, you need one.  Most people will go to the internet no matter what they’re looking for.  You need to hire a company to make sure that your website is optimized to show up when people search for your services in your local area.

3.  Google Places

When people search for a specific business in Google, a map shows up with little pins indicating all of the nearby businesses.  Try it yourself.  Type in “coffee shops Hopkinsville” or any other business type in your city.  You’ll see a ton of results show up.  Google has it set up to rank these very highly in searches and it’s a really easy way to be visible.  Make sure your listing represents you well.  Make sure that it links to your website.  Make sure that it has the correct contact information.  Make sure that you have decent reviews on there.  If you don’t know how to do this, there are many people out there who can help.

4.  Phone Book

This is the old standby.  Although it is getting used less and less, many people still use the phonebook instead of the internet.  You don’t have to take out a full-page ad.  We’re not talking massive advertising.  We’re just talking about being visible.  Check it out for yourself.  Flip through the yellow pages and see how easy it is to find you.  Are you a tiny entry that someone would have to specifically search for, or do you at least stick out enough that a person will see you when they’re scanning the page?

5.  Local Word of Mouth

Do your neighbors know you?  Do you know your neighbors?  Do the other businesses one block over know who you are?  When asked to recommend a practice, would they remember you well enough to send someone your way?  Word of mouth is the best form of public relations there is.  Give this a boost by making sure your neighbors remember who you are.

6.  Clearly Understood Contact Information

This last one is important.  People may find you, but not be able to quickly locate your phone number or address.  This applies to your website, to Google Places, to your sign outside, etc.  You will lose more business than you would believe, just because the person wasn’t easily able to call you on their cell phone as they were driving by, or because it took too long to find the practice address on your website.  The last step here is to review every place where people find you and ensure that your address and phone number are SUPER obvious, so that it takes no effort to find them.


There are many other examples like this, but they all come down to ensuring that you are at least VISIBLE to people who are actively searching for your services.  If you do this well, you’ll be surprised by the new patients you’ll generate.  The first step of any marketing effort should always be just making your practice VISIBLE.

As always, stay in touch.  If you have any questions about any of these points above, shoot us an email and we’ll try to help you out as best we can.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can and may even post our answer to your question (but not your name) for others to see in the future.

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There is no cookie-cutter approach to practice growth.  Each practice is individual.  Everyone has different goals, so the same approach won’t work for two different practices.

However there are certain basic principles which apply to a majority of practices.  This week we give five key steps anyone can take to grow their practice, no matter who they are.

These are so important that you can almost use these as a checklist of basic actions to grow your practice.  You may be doing some of them, or may be doing all of them partially.  Each of these five points below is a make-break for a smooth-running practice, and they give you a way to make your life saner and more productive.

1.  Make sure your practice is visible to your clientele.

This doesn’t just mean having good road frontage.  This means being “present” at all of the different points a person would check who is looking for your services.  It just means being able to be found.  People are looking for your services—sometimes they live right around the corner.  Make sure that you are letting them know you’re there.  This includes signage, web presence, phone book presence, etc.

2.  Market to your existing patients.

Your existing files are always your best source of future business.  Don’t ignore these when you’re focusing on new patients or clients.  The people in your files already know you and how you operate.  Continually market to them to remind them that you’re there.  Whether a newsletter, reminder cards or something else, all of your files should get mailed to at least once every two months.

3.  Actually ask for the money owed to you.

No, seriously.  We see this all the time.  Practices don’t even send out bills sometimes.  You do a lot of work–a lot of hard work.  You provide good service.  You deserve to be paid for it.  You don’t have to be pushy or demanding, however your office staff can’t be so timid that they don’t even ask to receive payment.  It’s just a mechanical fact—people pay when they are asked to.  If you don’t ask, often they won’t pay.

4.  Get an office manager that works well with you.

You need a right-hand man, a Friday, a Tonto.  If you don’t have a sidekick that you get along with and who you trust, then you won’t delegate.  If you don’t delegate you’ll become overwhelmed.  If you’re overwhelmed, your practice won’t grow—and might even shrink.  A good office manager handles all of the day-to-day decisions and tasks that will eat you alive.  Every practice needs one.  If you have an OM that you know and trust, do everything you can to keep them.  If you don’t have one, keep looking—you’ll find one.  They’re out there.

5. Learn about practice management.

You went to school for years to become a doctor.  You’re an expert.  You really are.  People pay good money for that expertise and value it.  However, the second you hang out a shingle, you become something else—a business owner and a manager.  Are you an expert manager?  Are you expert to the same level that you are as a doctor?  In fact, are you anywhere NEAR that level?  Most practices fail to grow, not because of poor patient care, but because the owner simply didn’t know how to be one.

Learn management.  It is a science.  Too many people throw opinions around as facts.  Francis Bacon had it right; apply the same Scientific Method you would use in studying physiology to studying management.  The test is: does it work?  If you’re going to run a business, don’t resist learning it.  Treat it as a serious endeavor and become good at it.  It will be well worth the effort and, in fact, will ensure that you’re well-paid for the effort you’re already expending.


Each of these points are a subject in their own right.  They aren’t necessarily easy or quick fixes.  But they are the basics and if you stay on them, you will be rewarded by a soundly expanding practice.

In future weeks we’ll have articles which explain more about each of these points, so if you saw something you had a question about, stay tuned—it might be answered next week.  As always, if you ever have a question that wasn’t specifically answered here, feel free to email us.  We’ll do our best to steer you in the right direction.


Have a question about your practice?  Try our free “Ask a Consultant” service.  Just send us your question in the form below.  We’ll email you back as soon as we can.

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Disclaimer: we do realize that this subject can be boring and very dry.  This particular area of practice management may remind you of accounting, taxes or something equally exciting.

We agree.

But bear with us.  It really does need to be said and it is a vital part of managing any business.

We haven’t been able to find any really good articles anywhere that explain which metrics a practice should keep track of, so we had to write one.  The subject is so important for a practice owner that you should probably not only read this, but keep it on file to refer back to in the future.

Ok, so now that you’ve been warned it’s technical, let’s move on.  We promise we’ll write more emotionally gripping and inspiring articles later.

Metrics, or a practice’s “numbers,” are just ways to measure how well a practice is doing compared to how well it was doing at an earlier time.  That’s fine.  But that’s a lot of work, and no one really defines how to keep track of them.  Which metrics should a practice use?  How do you find them?  How do you view them easily once you have located them?

Below, we tell you which metrics are most important for you to keep track of and give you a step-by-step procedure to stay on top of them:


Total Dr. Production

This is the total production of all the doctors added together; the total production of all doctors in the practice.  This is the gross number of services rendered by doctors, before write-offs or free service.

Total Hygiene Production

This is the total dollar value of service produced by all hygienists in the practice.  This would be calculated by adding the gross production of each hygienist together.  This is counted before write-offs or free service.  It includes anything done in the hygienist’s room—including the doctor’s exam and x-rays.

Total Gross Production

Calculated as Total Dr. Production + Total Hygiene Production—in short, the total production for the entire practice.  This is the total dollar amount produced in services and sales.  Another way of stating it is the total dollar value of services delivered, before write-offs or the value of free or discounted service is deducted (including such service provided to staff, families of staff, other professionals,–as well as pro bono work.)

Adjusted Production (Net Production, Collectible Production)

This is the Total Gross Production minus write-offs or adjustments of all types (except does not include bad debt write-offs).  This gives the production figure that is actually collectible.  Any amount of the “Production” statistic that is actually legally owed to you should count as part of the “Adjusted Production” stat.  Whether it is difficult or easy to collect the legally owed money is another matter.  Any components of “Production” which are monies that the practice cannot legally collect would not be counted as part of “Adjusted Production.”

Patient Visits

This is the total number of patients seen by the practice.  This includes all patient visits for all doctors and hygienists.

Average Production Per Patient Visit

This is the dollar amount produced on the average for each Patient Visit.  This is calculated by dividing Total Gross Production by Number of Patient Visits.  This gives you an idea of how efficient your practice is.  Are you really giving your patients all the care they need, or are you selling your services short?  A practice can be seeing an avalanche of people, but if they aren’t effectively getting compliance to their treatment plans, they won’t be doing as much production as a practice with a higher “Production Per Visit.”

Collections (Gross Collections)

The amount of money actually collected by the practice.

Net Collections

This is the collections minus refunds, repayments, bounced checks, etc.

Number of New Patients

This is the number of individual new patients paying for and receiving treatment in the practice for the first time.  Does not include reactivated patients who have bought anything in the past, regardless of how long ago it was.

Net Profit

This is the profit of the practice and is what the practice would make for the owner, as though he were not a service provider.  Does not include compensation for the owner as a doctor, as an executive or as a landlord.  This is figured by: Total Collections minus cost of sales, direct costs, taxes, overhead, all other expenses and payments to owner as a provider, manager and landlord.


Total Production

This is the total dollar amount produced in services and sales.  Another way of stating it is the total dollar value of services delivered, before write-offs or the value of free or discounted service is deducted (including such service provided to staff, families of staff, other professionals,–as well as pro bono work.)


A Transaction is simply an individual invoice for services rendered and/or products sold.

Collections (Gross Revenue)

Defined as total dollar amount that was actually collected from clients for services and products; gross revenue.

New Clients

This is the number of individual new clients who purchased a product or service from the practice for the first time.  Does not include reactivated clients who have bought anything in the past, regardless of how long ago it was.

Average Client Transaction

This is the average dollar amount for each transaction.  It is figured by dividing the Total Production by the number of Transactions for a given time period.  This shows how well you’re presenting and closing clients on recommended products and services.

Average Client Transaction

This is the profit of the practice in terms of what the practice makes for the owner, not considering any other service he may provide.  Does not include compensation for the owner as a doctor, as an executive or as a landlord.  This is figured by: Total Collections minus cost of sales, direct costs, taxes, overhead, all other expenses and payments to owner as a provider, manager and landlord.



Ok, so those are the metrics a practice should be keeping track of.  There are more, but the rundown above gives the basics.  Now that we know what they are, we should talk about how to keep track of them.  You’ll have to have these numbers in some sort of format where they can be viewed and updated.  What format is best for this?  A simple line graph.  The best method of viewing and comparing metrics is a simple line graph with each month running from left to right along the bottom and then the values of metric along the left-hand side running from top to bottom.

Now, how do we assemble such a graph?  There are a lot of different methods.  Below we will give you one way to do it–a step-by-step rundown of how you can find and track metrics.  There are other ways to do this with pen and paper, but this can be more time consuming.  The easiest way to approach this is to find someone who knows how to use the basic computer programs of your office and get their help setting all of this up.

1.  Finding The Numbers 

No matter which practice management software you use, you will be able to get these numbers out of there.  Export the numbers into an Excel spreadsheet.  If you need help on how to export these numbers, contact customer support for your software company.  This should be a relatively painless task for someone who is familiar with computers.

Depending on the exact software and how much you use of it, you may need to also get some other numbers from your accounting software, such as QuickBooks.  Again, this is a fairly simple matter of exporting numbers.

2.  Export Them By Month

The simplest way to approach it is just to export your numbers for each month.  That way you can see your Production for January, for February, for March, etc.  You want the total value for each metric for a given month.

3.  Keep Track Of Them In A Spreadsheet

Now that you have the numbers exported, arrange them into a spreadsheet, like Excel.  The easiest way to do it is just have all of the dates running along the left-hand side of the spreadsheet, and all of the different types of metrics running along the top.  This way you have a grid.  On the left-hand side of the grid you’ll have the earliest months at the top, with later months running down the side.  Looking across the top of the grid you’ll be able to see the different types of metrics.  In this way you’ll be able to see each of your metrics for any given month.

4.  Create Graphs

It is very easy in Excel to create graphs, or “charts.”  Create a line graph for each one of your metrics.  This way you can see how if your numbers are going up or down.  It is very easy to see what is happening with your practice, once you can see a visual representation of the numbers.  Your line graph should have the months along the bottom (x-axis) and the practice numbers along the left-hand side (y-axis).  This will be very frustrating for someone who doesn’t know how to use Excel, but will be a no-brainer for someone who can use the program.  If you don’t know how, get someone to help.


This can be complicated for someone who doesn’t know how to use computers.  However, there are many different ways to figure this out.  One simple way is just to get graph paper and use a pen to mark the lines monthly for each metric on their own sheet of graph paper.  Here we’ve just laid down a simple way to do it, using a computer program most people have.  The bottom line is that you just need to be able to see your practice’s metrics on a line graph, with the months running along the bottom.

We realize that this can be tricky for someone learning to do it the first time.  Therefore, if you have additional questions or want to see if you’re doing it right, feel free to write us.  We’ll do our best to point you in the right direction.

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Wait!  Before you decide this is just practice management mumbo-jumbo, read on.  This is a simple explanation you can use in the real world.

Management experts continually talk about metrics, statistics and Key Performance Indicators (KPIs).  These are all different names for the same thing.  They basically mean, “ways of measuring how well a business is doing.”

Is it healthy?  Is it growing?  Is it headed for collapse?

This is an important subject every business owner should understand, but it is often made overly complicated.  Here is a simple explanation of how metrics relate to YOUR practice:

First, what is a metric?

A metric is a way to measure your practice.  It is simply how many products or services were produced by a business, compared to how many of those same products or services were produced at an an earlier time.  For instance, a practice that sees 150 patients a week is doing better than it was last year, when it was only seeing 100 patients a week, all other things being equal.  A lot of times people just call metrics the practice’s “numbers.”  Ultimately “metric” comes from the Greek word metron which means “to measure.”  They’re just ways to measure a business.

Why are metrics valuable?

Diagnosis in medicine is important as it allows you to determine what is wrong and what to do about it.  In order to diagnose a patient, there must be some way to analyze or quantify the condition of the patient.  It is the same way with organizations.  In order to “treat” the organization, you first must diagnose it.  That requires measuring its condition.  That’s why metrics are important.

What do you do with metrics once you measure them?

The most fundamental use of metrics is to determine one thing: “Do I change what I’m doing or do I keep doing the same thing?”

There are a lot of very skilled ways to view a practice’s metrics that go beyond this, but at the core metrics are most useful simply in telling a practice owner whether he should just let things run or whether he should jump in and do something.  If things are gradually going up, obviously you should keep doing what you’re doing.  If things are gradually going down, you need to change something.  If they’re steeply going down, change something now!  Simple.

How often should I track my practice metrics?

You should minimally track your metrics once a month.  In this way you can see how you did compared to last month, or compared to the same month in previous years.  However, it’s best if you can get to the point where you’re keeping track of each metric on a weekly basis.  This gives you a very close monitor on the pulse of your practice.

What time periods should I be comparing when I look at metrics?

When you look at your practice metrics you are always comparing some time period to an earlier time period.  So which ones should you compare?

1.  Look at the month (or week) that just ended compared to the one right before.  If you just finished July, compare all your numbers to June.  See if you were up or down for the month.  This is where you will find the small tweaks that you need to make in order to keep things moving up.  You won’t see major big-picture shifts in your practice, but you will discover if what you’re doing is working, or if you need to adjust something for next month.

2.  Look at the past 12 months.  Check out the overall direction of the line.  Is the line gradually going up, staying the same or going down?  This is important.  This is where you’ll see long-term shifts in the practice.  If you have declining Collections for a whole year you will need to do something, or likely it will continue to go down the next year too.  A year-long view won’t tell you how to tweak your practice for next month, but it WILL tell you what broad strategy you need to be executing in order to move the practice in the right direction for the long haul.

3.  If your practice experiences heavy seasonal fluctuations, you will need to compare the month that just ended to the same month the previous year, and the same month the year before that.  This way you’ll be able to see changes in the overall growth of your practice.  You can even put these on a line graph showing something like, “Total Production For The Past 5 Julys.”  This method is only required for a practice with large seasonal fluctuations.

What do I DO with all of this?

Now that you have an idea of what’s happening with your numbers, you go look at your practice to find out WHY.  You see the New Patients have been declining ever since October.  Better go back and look at your promotion.  Did you stop sending out postcards?  Now that you have a scientific method of finding out what the state of your practice is (good or bad), you go find out WHY it’s in that state.  The statistical trend tells you that things are getting better or worse, but it doesn’t tell you why.  It’s up to you to go inspect the practice personally and find out what’s going on, so you can come up with a plan to fix it (or, if it’s good, strengthen it).

Why does all this matter?

Keeping metrics puts you in the driver’s seat in your practice.  Without metrics you’re going blind, guided by hunches and guesses.  Once you start regularly watching the practice’s metrics, you don’t have to guess at what’s happening in your practice–it’s right there in front of you plain as day.  Now you’re in control, not relying on fate to ensure your success.

Practice management can be pretty dry.  But it is often the difference between success and failure.  Learn how to use metrics and you’ll have a peace of mind that others only dream about.

Stay tuned next week for the answer to the question: “Which metrics should a practice keep?”

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