Practice Management

Sometimes We Don’t Know Enough to Know What We Dont’ Know


Ron Weintraub


November 10, 2013

November 10, 2013

The complex role of being an owner/operator of a modern dental office exposes many challenges other professional practitioners don’t have.

Clinical ResponsibilitiesAmong the myriad of demands for our attention typically include those related to clinical and financial decisions. Primarily, our focus is on providing optimal clinical care that our patient base expects and deserves; while doing so, we devote attention to the following:

1. Staying current with an ever expanding knowledge base that a contemporary practice demands

2. Consistently diagnosing and adequately explaining the treatment regimen advised for a specific patient at a particular time

3. Liaising with specialists to whom we have referred patients to ensure proper interface

4. Discussing completion of comprehensive dentistry with laboratory professionals for a number of patients for whom work is in progress.

Financial ResponsibilitiesSuccessful practices have to be financially viable. Therefore, owners/operators need to provide oversight in operating the business side of a dental practice in addition to their daily clinical responsibilities. Some of those tasks, but not limited to, may include the following:

1. Dealing with landlords

2. Satisfying banking demands

3. Being involved in purchasing sundries andequipment

4. Agreeing to service contracts

5. Making decisions regarding upgrading the high tech component of the practice

6. Considering the possibility of significant input on website and electronic marketing

7. Providing the necessary follow-up with patients and pharmacists regarding prescriptions for supporting pre- and post-operative therapy.

To complicate matters, sometimes these tasks demand the attention of clinicians while they are engaged in focused operating procedures. Although nothing in our formal training adequately prepared us to be expert other than in the clinical demands legitimately expected of us, the reality is owners/operators should be minimally involved in routine decision-making about diverse demands. To deal with these issues constantly on our own is an extremely daunting task. Some would say in these areas: “We don’t know enough to know what we don’t know.”

Finding solutions to the growing problems are dependent upon the recognition and acceptance of the existence of the complexity of the practice. What often occurs are those of us with perhaps limited business acumen accepting the roles thrust upon us and doing our best to solve daily problems. 

Since our knowledge of business problem solving skills is likely to be somewhat inadequate to get optimal solutions for the challenges we face, a good starting point to problem resolution is to admit that we don’t have the necessary expertise to deal with these issues successfully. However, a solution begins once we are able to identify the problem. For many, one of the answers is “responsible delegation” in-house and, in some areas, to outside specialists who are focused on and knowledgeable about dental practices in order to avail ourselves of their expertise.

Internal DelegationWhen delegating a task internally, accountability to the dentist/owner should be clearly stated before the process begins. Some examples of internal delegation are the following:

1. Dealing with dental sales representatives for the reordering function can be downloaded to a knowledgeable staff member. Unless a new product requires a demonstration to the clinical department, training a current staff person to assume the responsibility frees the practitioner.

2. Empowering the office manager/receptionist to be aware of the banking arrangements, such as overdraft arrangements, day-to-day control of accounts receivable, and general management of cash-flow.

Dentists/owners are often relieved with their perception that their choices of office manager, receptionist, and treatment coordinator can fulfill their roles independently and enhance them. We sometimes overlook the potential of their ability to apply the skills needed of an administrative staff, but evaluating and pairing those skills with our needs raises our expectation level of staff. This solution serves a two-fold benefit: it satisfies dentists’ requirements while giving greater responsibility to competent staff. Such a strategy promotes job retention and employee satisfaction.

Problem RecognitionSo you are thinking, “Where is the problem?” The problem is that most of us do not have the proper frame of reference to know if we are getting optimal results from some very capable people. This issue is compounded in the increasing instances where dentists are operating in more than one location; therefore, they have a diminished ability to oversee this crucial area. We dentists “don’t know enough to know what we don’t know.” We are not certain whether we are getting the best possible results from these very skilled people who also may not know enough to know what they don’t know about their own roles.

It is a case of double jeopardy when owners /operators and their valued team members are unaware of their potential. It is to our mutual detriment. Owners/operators often compliment team members when they think they are getting value from them. If practice performance slips, however, compliments may reinforce the team’s feelings of invincibility and create a possible resistance to improvement.

Without adequate comparison by means of an objective overview of our operation to accepted industry standards, we run the risk of unintentional underperformance. The complexity of running a contemporary office invites the insight of a lawyer, accountant, and perhaps, one of the fine practice management organizations.PA