Our thoughts . . . 12-11-08
EVOLUTION, NOT REVOLUTION
Those of you who know me very well know that I'm a Car Guy. This disorder usually sets in very young (sneaking Rod & Custom Magazine under the covers at age 13 – sick!), and continues until they have your graveside service. Naturally, I was excited when my son Jeff gave me a book last Christmas entitled "The Toyota Way" by Jeffrey Liker. My immediate assumption was that all of the intimate details of the Toyota models, from those first produced in the 30s up to the current high-tech Prius would be revealed. After all, who could forget their first glance at a 1958 Toyopet? Turns out though that this is a management textbook and although you might not think the auto industry has many similarities to dental practice, you are in for a surprise. The book explores at great length the well-know Japanese concept of KAIZEN, meaning continuous improvement, and is precisely the attitude operators of dental practices should embrace. Never is this more important than at the time of an acquisition and transition.
Every dentist brings their own perspective on offices and practice style. I have seen and owned enough offices that I can quickly create a list of things I would change in every office I visit. To relapse briefly to the "Car Guy" thing, it is not unusual for a guy to spend $100,000+ building the car of his dreams only to sell it and move on to the next dream. It is also no surprise that the buyer of that car will spend another $25,000 having the color changed from Screamin' Yellow to Purple Passion just to satisfy his personal tastes. Such is the case with dental practices and it is very temping for the new owner to begin immediately to fulfill their vision of what a dental practice should look and feel like.
In almost every case our advice is just the opposite. We will usually advise the new owner to just show up with their lab coat and briefcase and ask the staff where they are supposed to go and what are they supposed to do. As they begin to get comfortable with the office staff and patients, they can embrace that KAIZEN mentality and begin to plan and implement gradual changes to the facility, its systems and culture. Consider evolution, not revolution. We believe that productivity, staff and patient retention will best be maintained and subsequently improved by taking it slow and easy. Certainly dangerous issues of infection control and standard of care should be addressed immediately, but one would wonder why a new owner would find themselves in this situation in the first place. Unless you are there with the specific intent of rehabbing a distressed practice, maybe you should look for a better opportunity.
Some opportunities could be classified as the "don't screw it up" variety. If the office is up to date, profitable, has great staff and treatment systems, we would suggest a new owner move very slowly in making any significant changes. Change just for the sake of change may well have a negative effect on the bottom line.
Some offices will ultimately need to be moved. When I speak to students, one of the few guarantees I offer them is the fact that they will not finish their careers in the same location they began. Time, demographics and practice philosophies will cause the need for offices to be moved and redesigned. Even in those cases where relocation is inevitable, we suggest you stay in the original location for a long enough period of time for the practice to become "yours". It may take anywhere from 6 months to several years, but you will know when the time is right to make the change.
Lastly, read the book. While the Toyota Production System (TPS) may not be a perfect model for dental practices, you will be amazed at how well the concepts can be used to improve the productivity and profitability of your office. The fact that Toyota is now one of the ten largest businesses in the world and soon will become the undisputed leader in auto production is reason enough to give it your attention.
Steve Wolff, DDS
UMKC Class of 1977
For further evidence of the "Car Guy" syndrome, check the ongoing restoration of our '68 Firebird in the Just for Fun - Boys and Their Toys section of this website.