Who is Dr. Smith?

In a 1960 interview with Hollywood gossip columnist Mike Connolly, actor Hugh O’Brian explained that there are 5 stages to every Hollywood actor’s career. Pay attention because they parallel the lives of our practices. They are:
(1) “Who is Hugh O’Brian?”
(2) “Get me Hugh O’Brian as the star of our next picture!”
(3) “Get me somebody who’s a Hugh O’Brian type.”
(4) “Get me a young Hugh O’Brian.” 
(5) “Who is Hugh O’Brian?”
For many reading this post, you’re starting out your career and your potential patients and referrers may be asking: “Who is Dr. Smith and why should I go there?” You’re in the early stages of your career known as either the “seed” stage (you just have an idea) or “survival” when you’ve just started and are hanging on, just hoping you’ll grow. This is where a written business plan should be developed, being used as a template for the next 5-10 years of growth. How do you plan on growing and what steps do you need for this to happen? Create a plan and follow it and enlist the help of others when you don’t know what to do. Join groups where others can help you grow.
As your practice grows and you achieve some success, you might hear referrers and patients say: “You’ve gotta go to Dr. Smith”. It in this stage that you’ll be making strategic decisions about how to move forward. You’re making a profit and probably having managers take over certain duties that you were able to perform when you were smaller. As the Harvard Business Review discusses ( https://hbr.org/1983/05/the-five-stages-of-small-business-growth) you can choose to stay small and enjoy this model or figure out a way to grow and become bigger. The choice is yours but the hope is that you’ll get to the “take off” phase where your profit grows because of all the hard work you put in (keeping it small or growing large). Either way, your hope is to almost become so busy that you hear referrers and patients say: “You need to see someone like Dr. Smith because the practice is booked too long for new patients.” (Note the word “almost”. You never want this to actually happen.)
If you’re like some more experienced clinicians without an exit strategy or investment of technology, you’ll eventually start hearing folks say: “Dr. Smith’s practice used to be great”.  We all know these practices and many of us have even purchased one. It’s the doctor who used to be at the “top of their game” but took more time with their lifestyle and enjoying the fruits of their labors than actually developing a way out of the practice, or greed kept them from hiring an associate or selling at the right time. As my friend once told me, “They’re riding their dinosaurs into extinction.” Be smart when you’ve hit takeoff phase and develop a written plan of where you expect the practice to be in 5 or 10 years and follow it. Be as diligent and motivated with the tail end of your career as you were with the start.
The final stage, which I personally hope to never achieve, is when a clinician has clearly stayed on way too long. Their skill levels have waned, their physical plant is outdated and the practice has gotten much smaller. It’s at this stage when referrers and patients say : “Dr. Smith used to be great, but I wouldn’t suggest you go there anymore.” The value of the practice is gone and there isn’t much left to sell. Unfortunately, a lot of clinicians wait until this time to sell their practice, but are surprised to learn that it simply doesn’t have any substantial value. I can’t imagine the feeling of working my whole life, only to find that the practice I nurtured from nothing 25 or 30 years earlier, is now worthless. Don’t let this happen to you and be diligent in the earlier stages of your career, making sure you develop an exit strategy, even if it’s 20 years away…and discuss it with a professional with a practice transition company to make sure it’s logical.
I’m a third generation dentist and have been around the profession since I first started walking. I’ve seen many dentists and specialists retire when they wanted to and I’ve watched many struggle to make ends meet well after starting to collect social security. The latter breaks my heart which is one of the major reasons I write this blog; Every single one of the aforementioned clinicians started out as a bright eyed new clinician (like may of you) and made choices that got them where they ended up.
Be smart with understanding what you need to do during each stage of your practice life and treat each one differently. Develop an exit strategy and enlist the help of professionals along the way. For those of you just starting out or in survival mode, just work hard, ask questions of experienced peers and develop and follow your business plan because you will get to where you want. Just remember that like actors,  your career is going to have distinct stages and you need to be prepared for each one.
All the best,
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