Are you being honest with yourself?

It was July of 1997. I had been out of school for 5 years and it was my first meeting with a man who would later become of my greatest teachers and mentors. He asked me: “So, how do you think you’re doing right now? Where do you think you are?” My answer, about which I still hang my head in shame, is all too common. “I think I’m becoming a pretty good clinician. I feel like I know most of what I need to know to run a business and give patients a great outcome and I just need to round out my knowledge base.”
Sound familiar? It should because it’s almost exactly what I hear and read online from most younger clinicians. I’m not blaming or trying to embarrass you. Just come to grips with the fact that this is what most of you sound like because right now you’re like “that’s not me”. Bullsh*t. We’ve all been there and then 25 years later we laugh about how cocky and how utterly unknowledgeable we really were for our first decade or so. It’s the exception (and to be lauded) when a young clinician realizes that they should keep their ears open and their mouths shut, other than to ask questions. And if you’re like me and you just can’t help but talk a lot, you better listen twice as much and twice as intently.
I’ve owned non-orthodontic businesses and I spend a lot of time with experienced clinicians and non-healthcare providers discussing business topics and “picking their brains”. If nothing else, my 25 years of being in business has taught me that there are way smarter business minds out there and most of them aren’t in healthcare. With a combined couple of hundred years between my mentors, their opinions matter to me and I’ve asked them what they see in today’s young entrepreneurs. Some common themes:

  1. Many younger clinicians seem to believe that the flood and access of information from the internet means that the process of gathering information isn’t as important.
    It’s almost as if there’s a race to get the information and that once obtained, it’s now time to get onto something else, instead of just being with it, taking it into a written business plan and then working with it and changing it. Yes, the internet is a far easier way to get information about running a successful business, but hundreds of clinicians have asked me what they should do and I ask them how it fits into their business plan. They want a quick answer and not homework, but they tell me they’re going to write one up and get back to me. I’m yet to see one…
    Fast access to information doesn’t mean complete information and you can see posts online where people will ask (and humorously get answers to) several questions about their businesses where each one alone could be a topic in a textbook. “How should I be a better leader?” “How should I market my practice?” “What about real estate as an investment vehicle?”
    Note that there’s nothing wrong with these questions being starters, but after getting an answer , go out and so some seriously legwork and due diligence rather than simply accepting someone else’s answer and moving forward. You need to work on your business, which leads me to the next one…
  2. There isn’t an eagerness to work on the business after hours.
    It’s as if there’s an equality between the associateship and practice ownership and that owning a business is only a 9-5 job. Every single successful business owner I’ve ever known has woken up early, stayed up late and spent their weekends working on their business, taking years to get out of survival mode. My recent post “Eat Sh*t” explained that pretty well. I get it. You’re young and finally out of school, but if you want to own a practice, you’re gonna have to work. Hard.
  3. Do you understand that we are now in one of the longest economic growth periods of our nations’s history?
    Nobody knows when or how much, but it’s going to correct. There are people out there less than 10 years with 3, 4 or even more practices all built in an economic growth period. This isn’t meant to be a scare tactic, so just listen when I ask you for your plan of how you are going to respond when the markets correct.
    In a fantastic article in the Harvard Business Review, Bill Taylor cites uber-successful venture capitalist Ben Horowitz’ blog about wartime vs. peacetime CEO’s. Speaking about himself, and Alan Webber, with whom he built a huge company in an economic boom, Taylor wrote:”We weren’t Wartime CEOs. We were better at building than  retrenching, better at expanding the vision than hunkering down, better at getting people fired up than keeping them focused.”
    Keeping a business afloat in tough economic times is a lot different than running a business in great times. And please, please, please don’t tell me how tough it’s been in your neck of the woods and how you’ve had to struggle with it because of some local economic factors, blah, blah, blah. Until you see the stock market drop 30%, currency corrections and many major corporations laying off hundreds of thousands of people, you haven’t experienced the effects of a national recession. I’ve been there, especially after 2001, when all of my GP friends said to me: “Where has all the dentistry gone.” If you can’t remember a time when GPs weren’t doing implants, wisdom tooth removal and tons of endo for financial reasons, then you have no idea what I’m talking about. Every recession has significantly changed the delivery of care in dentistry and you would be wise to keep that in mind. Older docs continue to work in your area? Maybe they weren’t prepared when 2008 came along…
    Gary Vaynerchuck (owner of Vaynermedia and one of the top business consultants today) repeatedly says that he can’t wait to see all of these “big time” entrepreneurs who will be working at Bank of America when the market collapses. He’s in his 40’s and has seen a recession in his business life. I’ve been there twice (2001 and 2008). How about you?
    So you’ve had some success running a practice the last 5 or 10 years. Whoop-dee-doo. You would have to be completely inept not to. When the market corrects, it is my sincerest hope that you’ve spent the time getting ready for it because those of us who’ve been there know that not all businesses or practice make it through to the other side.  Best of all, if you’re prepared, you can actually take advantage of it and boost your financial life. Big time. Go read Unshakeable by Tony Robbins.
  4. Where is your advice coming from?
    There’s no transparency on the web and everyone assumes that all advice sources are equal. How many times have you seen someone online offer serious business advice having owned a business for shy of a decade or dispensing life experience to someone only 3 years younger than them? The online community is self-selecting because many times, those who have owned a practice for several decades aren’t online, which is the primary place that most young clinicians seek advice. Many of the best clinicians and practice owners I know never go online, so I seek them out and visit their practices and try to bring them to those around me.
  5. “Everyone has a plan until they’re punched in the mouth.” -Mike Tyson
    How many of your mentors have gotten punched and gotten back up, or have they danced around the ring in a way that’s prevented them from ever seeing any serious problems? I don’t harbor any anger or hostility to anyone who went into the family practice (remember that I walked away from my dad’s 5 practices because they didn’t suit my style) or has a best friend or spouse who is their number one referral, but how can their advice on how to grow a practice possibly be relevant to the solo practitioner fresh out of school on their own with $500,000 in debt and no referral sources? Always question your sources of advice and if they are relevant to your situation.
  6. Decisions are made on “gut” or “emotions” with minimal experience to help guide those decisions.
    Lots of clinicians say they “don’t need numbers” or books to learn what they need to know. Why do we hear so many clinicians say that they don’t have time to read the books or attend the business courses that are so relevant to running a business? Why are they so hesitant to spend the money on proven consultants or courses, when many before them have shown that these methods can shorten the learning curve? Mind you, I’m not talking about charlatans or “fringe” courses, but great books and great speakers who can teach you how to run a more productive practice?  Sure, my dad taught me a lot about running a dental practice and dealing with people, but the world has changed and I’ve learned way more about how to be successful from authors like Carnegie, Collins, Vaynerchuck, Godin, Feriss, Gerber, Hill, Sinek, Lencioni, Horowitz and many, many more. They are experts in their fields. Why can’t you find time to read or listen to them or worse yet, how can you ignore them altogether?

Notice that in all of my blog posts I challenge you to think differently. I ask you to push yourself for knowledge, to look for mentors and to work as hard as you can on your practice. I don’t give or accept excuses and will challenge you to work as hard as you can to achieve your dreams. If you want it, you can have it. If you think all of this is just BS and you already know what you need to know, nobody is going to stop you.  The best part of the free market economy is that fair or unfair, good or bad, it’s going to decide who lasts and who doesn’t.
Are you doing everything you can? Be honest with yourself.
All the best,
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