Work — Life Balance

A recent article in the Harvard Business Review shows that technology is making it harder and harder for individuals to step away from work.[1] Balancing work with other commitments and passions can be a daunting task in our ever increasingly connected world. Sometimes emergencies from work cannot be avoided — the same goes for personal, communal, religious and familial responsibilities — not to mention trying to squeeze in exercise, recreation and other hobbies. Nigel Marsh, author of several best-selling books and renowned public speaker, emphasizes this point in his famous Ted Talk. After taking a year off from work to rebalance his life he “found it quite easy to balance work and life when I didn’t have any work.”[2] A reality that is not available to most of us in the world today.

The dental world knows this all too well and this reality is exacerbated by those who own and operate their own practices where you find yourself trying to balance the workload of a practitioner and a business owner. Finding ways to reduce work and keep it from intruding into all aspects of a dentist’s life is key to work-life balance. Imbalance in one area directly impacts others. Creating an equitable balance is necessary to the focus required for transitioning towards the next balancing act, whether it be family, volunteer work, quality time with friends, etc. This balance is especially difficult for those strapped with college debt and/or a large monthly practice payment. Finding ways to reduce workload and increase savings seems to be a goal that drifts farther with each day.

Time is largely a monetary matter — as one expands so does the other, as one decreases, the other follows suit. There are limited ways for creating cost side savings within a dental practice, but there are some proven methods. The three most common are:

  1. Raise prices on your services
  2. Reduce staff and/or staff hours
  3. Reduce your supply costs

Studies have shown that increasing your pricing menu is not a viable option for dental offices looking to increase patronage. Similarly, it becomes problematic for retaining existing clientele.[3] The former puts the value of becoming a client into question and the latter increases the probability of clients leaving for a more affordable option. Decrease in dental visits has been shown to be directly tied to the cost, not availability of dentists.[4] There are a lot of dentists on the market and some areas are oversaturated; this makes it even more important for dentists to do all they can to maintain loyal customers and build that base. This brings us to the second approach: reducing hours and/or staff.

Your practice is a business and needs to be managed as such. Employees should know the underlying goals that drive your practice and the role that they play in accomplishing them. Too often employees are not performing at their peak because they do not understand their role or they are being distracted from their primary purpose. Surrounding yourself with experts and well trained staff is a major time and stress reducer for dentists. Loading personnel with additional responsibilities that take them away from their primary responsibilities reduces their value and increases work-related anxiety and stress; not only for them, but your customers too. Reducing hours and/or personnel in an already overloaded environment is a gamble that is often not worth the risk.

The third method where a practice can make real gains in time and money is with supplies. Some would have you believe that it is in your best interest to search out a sales rep from one of the large dental suppliers (the Big 4) and let them handle the work of supply management for you. A recent article in Dental Economics stated as much and suggested that “supplies should total no more than 5 to 6 percent of your collections,” and therefore are not an area where you can save a lot of money—they are wrong. The article goes on to support adherence to the traditional supply rep route because saddling your employees (or you, the dentist) with lots of extra work isn’t worth it. “Even if you were to save 20 percent, that still will result in only a 1 percent overhead reduction.” They make a good argument that you will spend a lot of time, effort and stress shopping the best prices. Besides, you didn’t hire the receptionist to be an online shopper, nor do you want her negotiating with various reps all day playing the price matching game. In their view, using a traditional dental supplier will allow you to “concentrate on more important areas.”[5] (View Article)

They are correct in their defense of keeping your people focused, but they err in their methodology. The average dental office brings in $650,000/yr and spend closer to 7-9% on supplies with yearly averages hovering around $58,000 on supplies. Any reduction in that number is pure profit unencumbered by tax, overhead, etc. that can be put towards any number of incentive programs, wage increases, office improvements…the list goes on.

Many recent dental podcasts have been addressing the need for dentists to shift the existing paradigm when it comes to purchasing supplies. Dental Town founder and podcaster Howard Farran spent an entire episode discussing the need for dentists to try other brands and products that are available. His guest, Supply Clinic founder Scott Drucker, DMD spoke directly to this issue and pointed out that many dentists never take time to test alternative brands — they stick to the brands they are accustomed to. Similarly, most dentists never explore lower cost alternatives that are just as good or better. The emphasis around new approaches to purchasing supplies is growing, see recent discussions on The Dental Guys and The DentalPrenuer.

Now think of the savings if you could reduce the amount you spend each month AND outsource the supply ordering altogether. Why spend time and money on something someone else can do better? That something is supply management. The market for supplies is only growing larger and that is lowering the overall costs of supplies — this is a positive for dentists — but the dentists need to weigh their available options. Savings on supplies can put a lot of money back into a dentist’s pocket, but be mindful of what is required. Some options may save you some money, but require a lot of extra work by the dentists and his/her staff.

Reducing supply costs is paramount because it results in cost side savings. Cost side savings are coveted within the business world as they result in direct reduction of capital expenditure (i.e. pure passive income). For example, if I am spending $1,800 a week on supplies and I reduce that by $400, that is a 22% undiluted profit gain for my business. If you are spending closer to $6000 a month on supplies and can achieve 25% savings, that is $1,500 back in your pocket every month. It is true that it is a tiny savings when compared with the $650,000 gross income — but that is not the comparison that should be made. The correlation should be against the monthly supply spend, not the company’s gross income. If you can cut your current spend in half, from $6,000 to $3000, that is only half a percent savings of the gross income, but that small amount means $36,000 in cost side savings back into your pocket on a yearly basis.

Trying to achieve the same return rate via price increases on procedures or hourly reduction of staff is difficult and can have a negative impact in various areas of your business from employee morale to customer satisfaction.[6] However, as the discussion on The DentalPrenuer podcast showed, keeping track of the fluctuations in supply costs can be a daunting task for any office, let alone a dentist or office manager. They aren’t paid or professional supply shoppers. No one in the office went to school to play the dental supply price matching game and — aside from the dentist — it is not worth it for anyone in the office to be that person. Meaning, it is a huge gamble for a receptionist, assistant or manager in the dental office to try and take the necessary time to understand the products, read the professional reviews and make informed purchasing decisions.

The time that an office can end up spending in their search to save on supplies is phenomenal. The fluctuation in market pricing is outrageous. A single item can change a dozen times in a 24hr period. Tasking a receptionist, dental hygienist or other employee to handle shopping during down time is not realistic and setting aside dedicated time to search, price match, order, track, etc. distracts them from the goals of your office and their primary tasks. Imagine the time you could save by having your ordering handled by a trusted ally in the dental market.

A recent podcast discussion by The Dental Guys mulled over several pros and cons of the traditional dental supply rep; but one of their main points was the need for dentists to be more involved with their supply ordering. This is not a bad idea. But this requires creating and managing a massive spreadsheet each week and spending countless hours outside work searching sources, signing up, tracking info, etc. A better use of the dentist’s knowledge, expertise and time could be spent working with a company that will handle all the supply ordering entirely. This will save you money and time.

Nigel Marsh identified the massive benefit that can be achieved when we are willing to make the “smallest investment in the right places.” Taking time to understand your actual monthly supply spend isn’t a huge project. Invest the time necessary to know the numbers and be willing to analyze the data with the intent on making some changes. Whether it is simply shopping a few items, trying different brands, moving away from a traditional supply rep or outsourcing your supply purchasing altogether — make the move that helps you best achieve your balance and your goals.

[1] Sarah Green Carmichael, “Millennials Are Actually Workaholics, According to Research,” Harvard Business Review (17 August 2016). Accessed online 30 May 2017. Available at: https://hbr.org/2016/08/millennials-are-actually-workaholics-according-to-research).

[2] The comment was made during his talk, “How to make your work-life balance work”, TED Talk given February 2011. This is the most viewed talk TED Talk given outside of America. Accessed 30 May 2017 at: https://www.ted.com/talks/nigel_marsh_how_to_make_work_life_balance_work/transcript?language=en

[3] Cassandra Yarbrough, Kamyar Nasseh and Marko Vujicic, “Why Adults Forgo Dental Care: Evidence from A New National Survey, Health Policy Institute Research Brief (American Dental Association, November 2014); accessed 12 April 2017 at: http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1114_1.ashx

[4] Thomas Wall, Kamyar Nasseh and Marko Vujicic, “Most Important Barriers to Dental Care Are Financial, Not Supply Related,” Health Policy Institute Research Brief (American Dental Association, October 2014); accessed 13 April 2017 at: http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_2.ashx

[5] Thomas Wall and Albert Guay, “The Per-Patient Cost of Dental Care, 2013: A Look Under the Hood,” Health Policy Institute Research Brief (American Dental Association, March 2016); accessed 13 April 2017. Available at: http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0316_4.pdf

[6] Bill Blatchford, “You choose your overhead,” Dental Economics. Accessed 20 April 2017. at http://www.dentaleconomics.com/articles/print/volume-94/issue-2/departments/flourishing-in-changing-times/you-choose-your-overhead.html

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