scal·a·bil·i·ty
/ˌskāləˈbilədē/
noun
  1. the capacity to be changed in size or scale.
    “scalability of the service has not been an issue”*

I remember the first several months after starting my practice. I’d listen to my single employee answer the phone, hoping it was a new patient scheduling a consult. I remember getting excited when I actually had multiple new patients in a single day. I wanted my practice to grow and was willing to work hard to help it happen.

My practice has grown and I’ve learned a lot. I can see what has worked, what hasn’t and where I would have acted differently. If there was one thing I could do over, it would have been handling by scaling in a better way. We seemed to go from a “small” practice to a busier one in a short time, and I didn’t see it coming. By the time I recognized it, my team was stressed, our systems overworked, our technology inadequate, our team too small and we weren’t poised to properly handle the growth we were experiencing.

What went wrong?

I was always proud of how we were so productive in terms of collections per team member. However, as we grew, the amount of work that needed to be accomplished increased and I was too late to realize it. The phones rang more, the Facebook inquiries were growing, the number of patients coming through the door was greater and so on and so on. But I didn’t realize it until the people in my practice were working in their redline and feeling stressed. I came to a very important conclusion.

I would never be understaffed ever again. It was worth an extra 2-3% per year to always have that extra team member so that everyone could focus on being the best they could at less systems, rather than asking fewer people to master a ton of stuff while handling an increased workload.

Yeah, we’ve all read about the practice owners who declare: “My team members are amazing. They work so hard and I stay understaffed because they get their bonus and kill themselves and we all come together as a team. Yeah, we work really hard and while we’re stressed,  it’s worth it.”

Not me anymore.

I realized that being understaffed is like trying to save a nickel and end up losing a quarter. With a larger team to handle more tasks more effectively, sure my overhead goes up a bit but my stress goes down and my patient experience goes up. Note that a $40,000 increase in employment overhead (roughly 1 extra employee at $19/hr, 40 hrs/week) is a 2.2% increase in overhead for a hypothetical $1.75 million dollar practice. But that 2.2% investment just might help you grow your practice a lot more and deliver better outcomes.

The consulting firm “Superteam” suggests: “You can maintain a healthy pace by focusing on understanding existing customers before reaching new ones…”

Develop your systems when you’re not overly busy, build your team to handle appropriate growth and look to the future as your practice grows. Lack of foresight in handling growth can really hurt a practice and you should focus not just on your customers of today, but the ones who will be knocking down your door as you continue to grow. How will you serve their needs? Anticipate where you will need help and fix the problems before they occur.

Wishing you all the best!!!

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GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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*Google.com

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