ARE YOU Prey to the Failure Patterns of Women Dentists? Four Management Mysteries Revealed

Being a professional woman, I know how we are often expected to be all things to all people at all times. As the head of a company, mother of teenage daughters, and semi-decent wife when I'm not asleep, I can tell you, it's a tall task to be superwoman. This is particularly true for the woman dentist, who often takes on the roles of mother, wife, business owner, caregiver, patient's counselor, staff's nurturer, etc. There are four "management mysteries" that keep professional women down; once we unlock them, we can shed the lead weights from our feet and soar toward success in all areas of our lives. The mysteries lie in staff management, patient management, cash-flow management, and, most importantly, life management.

Staff management entails setting your vision and priorities, and learning how to be friendly but still professional. Patient management involves attracting the kind of patients you want to your practice, and then inspiring them to embrace your vision for ideal care. Cash-flow management means achieving the lifestyle you desire from your practice while funding your retirement, whether it be five, 10, 20, or more years away. Life management means getting what you want without having to be a super hero. Let's look at each of these mysteries.

Staff Management

One of the biggest challenges for women in dentistry is to summon their knowledge, intention, and self-esteem to design their dental practices from the very beginning to match their needs and desires. Too many women set Miss America, politically-correct visions ("I want to help the children of the world."), or old-world martyr-mother visions ("It's okay. I'm here to serve everyone else. I don't need anything."). When we follow the Miss America vision, we're speaking rhetoric to make people think we're good; but in truth, this vision doesn't really meet our needs. The martyr-mother vision, similarly, means designing our business to suit everyone else's needs except our own. Neither of these approaches is going to last for long without our feeling resentment, discouragement, stress, and frustration at not getting what we really want, ultimately leading to burn-out. Women dentists in particular are vulnerable to this mindset because they somehow think that being a professional caregiver means they have to be "Mother Teresa." There is no reason why a woman dentist can't trust her vision and values enough to want to be a huge financial success and to accomplish that in a way that also benefits her staff, patients, family, and everyone she touches.

Your practice, which is your life's work , must aim for goals that serve you , the owner-leader. How do you set a vision that meets your needs? Look 12 months ahead and ask yourself: What do I really want from my practice? Examine the areas of profitability, treatment and outcomes, service and quality of care, staff performance, schedules, and a balance of professional and personal life that makes you happy and productive. If you fail to begin each year with a specific vision of tangible outcomes that you want to accomplish and a roadmap to achieve them, you will end up serving other people's goals-like the martyr-mother who sits alone in the dark eating crumbs.

Once you find the courage to create a vision that supports you, the next challenge is to drop the restrictive leadership roles that women dentists in particular can adopt. Too many run a practice like a sorority. The intense desire to be liked and supported by your staff can make you soft on standards, creating a chaotic work environment that leads to frustration and dissatisfaction for you and the team. Be supportive of your staff; but don't let yourself be held hostage by them. You can achieve this balance when staff members desire to be in their jobs just a little more than you desire them to be. True freedom and self-direction for the staff come from the leader's setting black-and-white expectations for job performance, then communicating clearly when that performance exceeds or falls short of the standards set. It isn't always easy for the woman dentist to pull back on the nurturing; however, true security for your staff does not come from coddling them, but from giving them directions and goals with the freedom to choose to meet them or not. The most liberating leadership stand you can take-for yourself and your team-is to tell them frankly: "This is what I need. This is what I'm getting. You are at a choice point." For example: "I need all staff to arrive on time every day for the morning huddle. Last month there was consistent lateness, which violates our practice vision of maintaining a daily exchange of information among us for a seamless delivery of service. Therefore, I need your commitment to arrive on time." The latecomers are at a choice point.

Patient Management

Once you influence and inspire the staff (your internal customers) to want to do what you want them to do, the next management mystery lies in doing the same thing with patients (your external customers). Again, it can be difficult for a female dentist in particular to act assertively-especially if she has been conditioned by the culture around her to adopt the more traditionally feminine traits of being congenial, and accommodating. Can you look directly into your patient's eyes, whether male or female, and tell the person: "Even though your insurance doesn't cover a three-month hygiene visit, it's necessary that you have this, or we will compromise your clinical care." Many female doctors cannot do this for the same reasons they falter in managing staff-they want to be liked, to be approved of, to avoid conflict. But patients deserve a dentist who is a strong advocate for their long-term oral health. Ultimate respect and popularity come from serving your patients' needs well.

Part of achieving your vision lies in identifying clearly the type of patient you want to invite into your practice. Women dentists need to guard against assuming the traditional female role of being mother to all. We've been conditioned not to favor one of our children over another; but in our professional lives, of course, we can and should favor those customers that best match our business philosophy. Do you know who your ideal patient is? What kind of person fulfills your vision, values, and goals? Do you have the courage to say no to being all things to all people? Do you want to attract people of a certain age or gender? Or those with certain kinds of dental needs and desires? Families? Young professionals? Think about the patients you really enjoy treating because their needs and desires match your vision. It is the leader's job to define the characteristics of her ideal patient and to gear all marketing efforts toward attracting them. For example, if you really enjoy working with the entire family, then your Yellow Page ad, if you use one, should feature a family and carry a message that speaks to them.

Once you attract patients that match your ideal profile, you again need the verbal skills of influencing. By engaging patients in co-diagnosing their condition during the clinical exam and by presenting treatment in a way that lets them partner with you in discussing and choosing the best care, you can influence them to make the best choices for their oral health. However, influencing patients requires that you give them direction and not fall prey to the more traditional feminine behavior patterns of congeniality and unassertiveness, which can lead to compromise your standards of care.

Cash-Flow Management

Now that we discussed how to create an environment where staff and patients align with your vision and values, let's turn to the third management mystery. Unfortunately, this one is sometimes perceived as the "unwholesome" mystery: cash-flow management. Are you truly comfortable with being hugely profitable? Or do you feel that a concern for profit conflicts with your goals as a caregiver? An entrepreneur is someone who takes the risk of investing and expects a return, so it's necessary for the woman dentist to feel comfortable with being extremely profitable and financially successful.

One of my favorite teaching examples, which can strike fear in my clients, compares the financial picture of a dentist straight out of dental school with that of a telephone installer who immediately starts working for the phone company at age 18. I found that it would take the dentist 20 years of grossing $150,000 a year in salary to catch up to the telephone installer in wealth accumulation. What are the factors that create this rather dismal statistic? The cost of schooling for the dentist, the lost years of revenue, the expense of a practice purchase or start-up, the higher tax bracket of the dentist, and most importantly the head-start that the telephone worker has in accumulating retirement savings, as a company benefit, from the moment he or she begins work. Dentists-male or female-are amazed at the cost of the investment they make in their career. We at Pride consider dentistry a noble profession and think it is okay for a dentist not only to catch up with telephone employees, but to surpass them. Because women have traditionally made less money than their male counterparts in many professions, female dentists need to feel comfortable knowing that a DDS or DMD degree brings with it the permission to make as much money as their male colleagues-or more.

Some women dentists who have a spouse contributing to their income demand less of a return from their practice investment than they should. This may be due to a reluctance to make more money than a spouse or a complacency with having just what is needed and no more. As a professional, your practice should be able to meet all your needs. It should fund your cash-flow requirements and give you the lifestyle you deserve in the present, as well as provide insurance coverage, savings for retirement, college and weddings for the kids, and funds to reinvest in new technology and education to remain state-of-the-art. Your practice should fund all of this without your needing a partner or spouse's helping hand.

How do you accomplish that? Each year, along with creating a vision for what you want to accomplish in your practice, it is essential to compose what I call a "holiday wish list." This is an itemized list of the personal and business expenses that you forecast for the next 12 months-e.g., staff salary increases, new equipment purchases, retirement savings, and of course a raise for the doctor (don't forget: you need to catch up to the telephone company employee). Back-track from this list to identify the production and collection goals that will net you the cash flow to pay for these expenses. Then you can design a strategy with your team to meet those goals. This process absolutely works. In consulting with hundreds of dental practices, we discovered that just having a goal-be it production per hour, per day, or per year-can increase your returns by up to 25 percent. Why? Because what gets focused on, gets done. Of course, if you incorporate systems, staff, and other operational improvements in attaining your goals, the results are ever much more spectacular.

Life Management

Now that we've solved the mysteries of staff, patient, and cash-flow management, we're left with the biggest and most dramatic one of all: life management. Unfortunately, I too often see the female dentist burdened with the myth of the superwoman. Who remembers the jingle: "I can bring home the bacon/fry it up in a pan/and never let you forget that you're a man/'cause I'm a wo-man . . . " How many women attempt to be a super-dentist, super-mom, and super-wife-only to burn out? When a woman dentist asks me how she can be superwoman-how she can care for three children under age five, increase her production by 50 percent, transform her practice into a digital office, and do it all at once-my answer is simple: take off the cape. Don't try to be superwoman. As is the case with any entrepreneur, you can't do everything perfectly at the same time. Different stages of your life will bring different priorities. You cannot make everything a priority, because then you will fail in something.

For example, when raising a family, it is perfectly okay to make your personal life your top priority and to adjust your practice to accommodate that. The years when your children are young may not be the same years that you will see a 50-percent growth in your practice. This may be the time when you are working less and producing at a more modest level, but still meeting your basic needs. The impulse to do everything at once can result in your being mediocre at all of the things that matter to you.

I counsel female dentists who, during their child raising years, adopt space-sharing arrangements with another dentist or take on an associate in order to limit their time in the office to two or three days a week. With maximum efficiency of systems, they can make all the money they need at that life stage. Then when their children are older, they significantly increase their office schedule and production. (Trust me, as a mother of teenagers, I now look forward to leaving the house to go to work.) The most important lesson to learn in balancing your life is that there is no one cookie-cutter solution for all women. You need to decide what schedule works for you.

Incidentally, we find that an ideal schedule for a well-managed, solo practice in peak performance is no more than 172 days a year of work and with a spectacular production of $1 million or more. How many days are you working this year? If more than 172, you may still be wearing your cape. Take it off. As a dental professional, you're a hero already. Increase the return from your practice by working smarter, not harder.

As a businesswoman who lives with these issues every day and who helps women dentists to realize their vision, I can tell you with certainty that it is absolutely feasible to have the practice of your dreams that supports your personal goals and lifestyle. It's possible if you're courageous enough to solve the four mysteries. This means coming to grips with your relationships with others, your business and financial needs, and your priorities. You are the architect of your own future. So, why not build the most beautiful

Amy Morgan is CEO and lead trainer of Pride Institute.

Originally published in Woman Dentist Journal, May 2006