Sudden Impact Solutions:
Avoiding the Monsters Under the Bed - Your Strategic Plan for 2007

In previous columns, I discussed the merits and impact of creating an annual plan by which you indicate the goals for your practice and forecast them numerically for the upcoming 12 months. If you do only this much, you’ll discover that the numbers by themselves—such as the forecast of a 20-percent increase in production, or a 30-percent rise in new patients—do not insure success. The rubber only hits the road when you create a solid strategy for achieving your goals and numbers, which is the purpose of a strategic plan.

The planning process reminds me of one of my favorite business quotations. It begins with: “A task without a vision is a drudgery.” For those of you who feel overwhelmed with practice activities from morning to night, with no future desired outcome in mind, your labors will seem like the ultimate eat-your-spinach moments. The quotation continues: “A vision without a task is but a vacant hope.” I know many dentists with illusions of great outcomes; however, they fail to develop realistic strategies to support the changes. This leads to a lack of credibility in the leader’s words, frustration, and failed efforts for the team, as well as a continuation of the status quo. The last line of the quotation is: “A vision combined with a task is a dream fulfilled.” Success comes from identifying a future that you passionately want, and then creating actions that focus you and your team on achieving that vision.

I recommend that dentists begin their strategic planning by considering worst-case scenarios and developing methods to deal with them. Why? Because my definition of optimism includes preparing for the worst by having a plan. When you are strategizing with your team on how to attain the objectives, the most courageous thing you can do is to ask the question: “What possible obstacles or barriers can prevent us from accomplishing our goal?” Most dentists shy away from asking this because they’re uncomfortable with confrontation. However, it is the obstacles—such as systems breakdowns, outside economic factors, or staff behavioral or training issues—that can become the monsters under the bed if not addressed and handled. Unexpressed misgivings (real or imagined) can be amazingly powerful in blocking the accomplishment of the goals.

For example, let’s assume you intend to give yourself and your staff members a significant salary increase and to invest in new technology that reinforces your vision of excellence in patient service. You forecast a 20-percent increase in production to pay for these proposed improvements. The wrinkle is that for the past six months, due to job layoffs and an economic slowdown in your area, your number of new patients has decreased. So, at a time when there are valid concerns about maintaining the status quo, you are proposing a significant increase in production. If this issue isn’t confronted head-on, your strategic plan is flawed and your goals unattainable.

When you provide a safe outlet to examine all potential obstacles to your strategic plan, from the ridiculous to the sublime, people feel much more comfortable following their leader into an uncertain but desirable future. I recommend having what we at Pride call a “vomit and spew session.” (Disgusting, yes, but the name does aptly describe the process.) Use a flip chart or dry-erase board to list all of the team’s qualms, fears, misgivings, and hesitations (as well as the potential benefits) in achieving the objectives.

There is a tremendous relief in pulling the monsters out from hiding. Once you’ve done that, ask each staff member to choose the three obstacles most likely to interfere with accomplishing the objectives. Once you have consensus on the most serious obstacles, prioritize the issues and create possible solutions.

Focus the staff on systems and behaviors that are in their control to change. For example, if the obstacles include: “What if the Homeland Security alert goes to red?” and “What if our patients begin to say no to discretionary cosmetic dentistry due to our economic slowdown?” direct the team’s efforts to the latter concern. Your practice has no way to monitor national security, but has every way to adjust financial arrangements to make cosmetic dentistry more affordable. You may think I’m exaggerating, but we often see practices fretting over situations beyond anyone’s control. A solid plan addresses the controllables, focuses everyone’s knowledge, skills, abilities, and attitudes on issues they can influence, and supports achievement of the new goals.

Once you have chosen your three major obstacles, which should you tackle first? For example, if your key issues involve a scheduling, marketing, and treatment presentation problem, ask yourself and your team: Which of the three key issues will provide us with enough productivity and efficiency to be able to tackle the other two? Almost always scheduling is the first system to address because improvements to this system often create the efficiency and profitability to support the more difficult to implement, longer term, comprehensive changes, such as in treatment presentation and marketing plans.

A useful tool we use to help set priorities is called force field analysis. A force field analysis allows you and your team to analyze all of the forces, or reasons, why a situation should be addressed versus all of the forces, or reasons, why the situation should not be addressed. For example, let’s say you want to implement digital charting. If you can cite ten specific reasons to move forward in the implementation and only three reasons against doing so, then you have strong justification for making the improvement a key part of your strategy.

I also recommend that a strategic plan be a combination of short-term and long-term implementation steps, with a limitation on the long-term ones so that your strategy provides you and your team with ample immediate results to keep spirits high and give everyone a sense of real accomplishment. Most practices attempt to solve all of their problems at once, which invariably results in nothing ever changing. So, chose your battles wisely, then single-mindedly follow your plan to completion without letting new issues distract you.

The main resource needed to develop and implement a strategy for success is the hardest commodity to find in a dental office: time. All too often we encounter dentists and teams who feel they do not have enough time for analysis, prioritization, and implementation. My question is: Do you have enough time not to begin implementing your most impassioned goals today? What better way to ring in the New Year than with an effective strategy to realize your dreams?

Amy Morgan is CEO and lead trainer of Pride Institute.

Originally published in Dental Economics, December 2006