Wednesday, December 30, 2009

Finding An Associate- We're Your Tipping Point

Not news: There is a shortage of qualified Associates or potential Partners.

News: Strap yourself in, because we haven’t seen anything yet.

During the past 12 months, the ETS Dental team has made 107,000 calls and had more than 115,000 individual email correspondences with Dentist Candidates and Dental Practice Owners.

The result? While many industries were slogging through the “Great Recession,” we’ve found that outside of a few saturated Dental School cities, there are really no unemployed Dentists. From 1975 through 1986, Dental Schools graduated literally thousands of Dentists more than they have graduated over the past twelve years. Good economy or bad, this simply means that, over the next decade, there will be a steadily decreasing population of dentists per capita.

Certainly, there are those Dentists who would like to earn more money or find a better opportunity. However, as a group, Dentists are at full employment, and less are willing to make a change than in the past. In fact, we’re making 60% more recruiting contacts to generate the same number of applicants than just one year ago.

So, what does that mean to you? If you plan on looking for an Associate or potential Partner/ Buyer in the coming years, start you search sooner, rather than later. In the very near future, we will see a spike in demand and competition for Associates in the following groups:

Deferred Retirment Dentists: We’ve spoken with hundreds of Dentists who have deferred retirement for a few more years simply because their retirement funds shrank with the reversals in the stock and real estate markets.

Two things will happen with this group. As the stock market returns to where it was a few years ago, many will be in a position to transition out once they find a qualified heir apparent. A second group of “fire sale” practices will come available from Dentists who decided to continue practicing but had a sudden medical condition that forced them into retirement. Our team fields at least one call like this per week. If you currently have an Associate and have not worked out a buy-in/ out arrangement, do it now. Don’t lose a great Associate to an emergency practice sale in his/her spouse’s hometown.

Deferred Growth Plans- (2009 Dental Economics/ Levin Group Practice Survey, 10/09 Issue): We’ve spoken with hundreds of Practice Owners who reported they are planning to hire an Associate “when the news gets better.”

The truth is, that for many practices, the news is getting better. Although median annual gross practice production declined by 3.5% since last year, many practices are reporting that production is on the rise, but they are still standing on the sidelines. In the Dental Economics/ Levin Group practice survey, 39.5% of respondents
reported they increased their production over the past six months. More importantly, 43.9% said they are confident they will increase production over 2008.

Practice Management Companies- (Forbes, Susan Adams, 11/19/09): This week, Forbes published an article about accelerating growth of the National Dental chains. the author cited Aspen Dental, which opened 50 new offices this year and plans on opening another 50 in 2010. Practice management companies like Heartland, DentalOne and AllCare can also be expected to act aggressively.

Not-for-Profits: An unprecedented amount of funding is making its way to not-for-profit clinics around the country. Many not-for-profits that previously could not offer Dental services are taking advantage of grants to add Dental Clinics, and those with Dental services are expanding. Loan reimbursement funding for early career dentists (and other medical professionals) will grow dramatically. Many not-for-profits offer guaranteed salary plus eligibility for Dentists to qualify for Federal tuition loan reimbursement. This is especially appealing to recent Dental School Graduates with a huge student loan burden (often $200-$300k or more).

Summary: There currently is not a pool of unemployed Dentists to draw from when you are ready to hire. In the next year, practice owners will see a dramatic increase in the demand for new Associates from Deferred Retirement Dentists, Deferred Growth Practices, Practice Management Companies, and Not-for-Profit Clinics with newfound funding and huge patient demand. If you like your current Associate, take proactive steps to keep him/her today. If you plan on hiring an Associate, be ready to put your best foot forward.

Written by Mark Kennedy, Owner/ Director of ETS Dental,

Wednesday, December 23, 2009

Dental Staff- Making a Good First Impression

As a Dental Staff Recruiter, I have the privilege of speaking to hygienists, assistants, and office staff around the company and at various points in their career. It is my job to make a positive match, finding the perfect fit for both the candidate and the hiring practice. However, after five years in the recruiting field, I have learned that the best possible candidate is not always the most educated, experienced, or decorated within the field. Sometimes, it just comes down personality and who makes the best impression. I know that sounds trivial, but we are in the people business-ETS, as recruiters, and you, as a dental professional-that being said, the old adage “You never get a second chance to make a first impression” really holds true.

Remember your phone screenings are part of the interview process; this holds true with your conversations with the recruiter and with the practice. Give the phone call your undivided attention! Move away from the screaming children. Find a spot in the house with decent reception. Sell yourself-elaborate on your resume! Tell us why YOU are the candidate we have been looking for! However, there is a fine line between confident and cocky, so don’t overdo it!
Also, early on in your search, take a look at how the outside world views you. Google your name and see what “pops up”. Those blog entries from high school may still be out there! Take a minute to review your social networking sites-do you want your prospective employer to see what is posted? You will also want to consider your phone’s ring back tone-my personal pet peeve. Do you want their first impression of you to be a Nickelback or Buckcherry song? I think not. Also, listen to your voicemail! When you are searching for a position, it is not the best time to place a commentary on last night’s game on your message nor is it professional to have a “You know what to do” message-be professional.

Now is an exciting time to be a job seeker and the market only continues to get stronger. It is time to put the years of education and preparation to work. By putting your best foot forward, hopefully you will land that position you are looking for!

Posted by Tiffany Worstell, Dental Staff Recruiter at ETS Dental. You can reach Tiffany at (540) 491-9112 or

Wednesday, December 9, 2009

Resources for those entering the dentist job market

Here are a few helpful resources for graduating dental students, residents or dentist ending their military commission. For more up to date tips and helpful information follow up on our facebook fan page, twitter, or on our blog.

How much will I make: Data from 2009 Levin Group/Dental Economic Survey (.pdf)

Where do I look for a job: ETS Dental Position Search, job listing aggregator,, DentalTown Classifieds

What should I know going into my job search: Job seeker tips

Traditional Practice or Group Practice: Which is right for you?

Where do I want to live: Area reports and comparisons

How do I write a CV: CV writing tips or email for a link to ETS Dental’s CV wizard (beta).

What should a dentist cover letter contain: Cover letter sample, Writing a Cover letter

How should I prepare for an interview: Interview tips and questions and What hiring practices are looking for in a candidate

What should I look for in a dental contract: Questions to answer before accepting a job, Employment Contracts - What a New Dentist Should Know and considering an associate position leading to partnership.

Considering starting a practice-

Friday, December 4, 2009

Analysis of Today's Bureau of Labor Statistics (BLS) Report

An Analysis of Today's Bureau of Labor Statistics (BLS) Report

The full report can be seen here:

In January of 2008--24 months ago--the U.S. labor market began losing jobs, which by January of this year was happening at a rate of nearly 800,000 per month. According to the Bureau of Labor Statistics as of this morning, that hemorrhaging has slowed to just 11,000 jobs in November or essentially nil. The unemployment rate also declined from 10.2 percent to 10 percent. The numbers for September and October were also revised to show a loss of 139,000 jobs in September from the previously reported 219,000, and October to 111,000 instead of 190,000. Since the start of the Great Recession in December 2007, the unemployment rate has risen from 4.9 percent and the total number of unemployed has swelled from 7.5 to 15.4 million people.
The unemployment rate for management, professional and related occupations has now fallen nearly a full point from its 5.5 percent peak four months ago, to 4.6 percent in November. The total number of unemployed professionals topped out then at just over 3 million people and has since dropped to 2.5 million. One of the top gaining job categories in November was administrative and support services which, after having been decimated over the last two years, added 86,900 jobs during the month, with 52,400 of those coming from temporary help services. Overall, professional and business services added 86,000 jobs, and for the first time in years, beat out education and health services (+40,000) as the top jobs gainer.
After two years of job losses, today's virtually flat numbers are good, but they are still tempered by the 15 million people who remain unemployed and the millions more under-employed. Should the current number of people out of work continue for an extended period of time, there will remain the threat of a double-dip recession dragged down by sluggish consumer spending. However, many signs show that both job creation and underemployment are at last on the mend. The total number of part-time workers fell in November by 104,000, while the number of full-time workers rose by 140,000. The average workweek also added two-tenths of an hour after having lost eight-tenths since the beginning of the recession. Average weekly earnings surged to a high of $630.14, $10.18 more than in October and $10.06 more than the figure's last peak one year ago.

Thursday, December 3, 2009

Questions To Answer Before Accepting a Job Offer

The New Year is an excellent time to start looking for positions whether you are finishing dental school, a residency or after ending your commission as a military dentist. After you write an impressive CV, line up interviews and begin to field offers, it is important to know what questions you need to be asking. Here is a compilation of questions from job seekers that I have worked with over the years. I hope that you find it helpful.

-Employee or Independent Contractor?
-Employee at will?
-Is the doctor open to restrictive covenant in case of future ownership?
-Is the doctor going to stay on PT for some time or can he, if needed (After purchase)?

-Days, hours, on call, etc.
-How many office hours and days per week is the office open?

Type of Practice
-How the practice is set up (family, Pedo, or dentures)? Pedo: what age?
-Age of the practice?
-When/what do you refer out?
-Place or Restore Implants? Which system?
-# of operatories
-# of Hygienists. Hrs of operation?
-# assistants
-Will the associate have their own assistant?
-How much is the practice overhead?
-How long has each employee been there?
-What does the practice do to market itself?
-How many FT and PT staff?

-What is the patient pool like?
-Have the number of active patient records been reviewed?
-Is the practice growing or declining in number of patients seen, new patients -attracted, and young patients?
-Average number of cancellations per week?
-Average number of patients seen by associate per day?
-How far ahead is the doctor book filled?
-How far ahead is the associate book filled?
-How far ahead is the hygienist’s book filled?

-Job description (separate document) or general description
-Is the associate expected to check hygiene of other doctor’s patients? If yes, will the associate be compensated for it?
-Will the associate be expected to perform hygiene/prophy?
-Does the doctor do any procedures other than regular general dentistry?
-What were the most of the cases being done by the associate?
-Will the associate be placing Implants for the practice?

-Supplies, equipment, support. Etc
-What type of PMS (Software) is used?
-Implant surgical set up? Who finance to get that set up if NOT already have?
-What is the square footage of the office? Can it be expanded?
-Average age of equipment?
-Is the practice left-handed, right-handed, or ambidextrous?

Fees for service
-Appropriate/assign billing?
-Discounts/Bartering/payment plans
-PPO type of insurance? Insurances: accept all kinds or just selected ones?
-How much is the discounted price of the PPO compared to the fee schedule?
-Medicare or Medicaid acceptance?
-How much of the practice relies upon capitation programs, PPOs, HMOs, Medicare or Medicaid?
-What percent is FFS, cash and discounted PPO?
-When was the last fee increase?
-Are the fees low, high or average for the immediate area?
-Do you offer patients credit?

Term of contract
-How long?

-Salary, Hourly, Draw, Minimum, Commission, Percentage, Bonus, When, How,
-Taxes withheld?
-What percent of production or collection will be the compensation?
-How will the associate be paid? (Weekly/bi-weekly/monthly)
-How much on average was the associate making?

-What is the % of collection for the practice?
-What was the average associate production per day?
-Does the associate production include hygiene exams and x-rays?
-Can I get a fee schedule of the practice?

-Medical Insurance: health and dental?
-Malpractice insurance?
-Disabilities insurance?
-Required CE courses? How much and for how many hours a year? Are they paid for/reimbursed,? Is there a stipend?
-Sick days…….. # allow per yr…..
-Personal days/vacations…..# per yr allow……
-What benefits are given to the staff?

-Define, list, when paid, lab, etc…..
-What Lab do you use? Use different lab for different lab orders??
-Is the associate responsible for my own lab fees and expenses?
-Will the practice support the acquisition loan (in case of future ownership), pay the overhead expenses and afford a reasonable income?

Other Questions and Notes:
-What is your practice Philosophy and Goals? For the Practice and with new pt’s tx?
-% of implant surgeries
-Have you had associate before? How many? How long they stayed? What was the reason for the associate resignation?
-Do you have a confirmation system for apts?
-How do you deal with NO Show?
-Digital X-ray?
-Intraoral Digital Camera?
-How do you advertise?
-Will most dental insurance dictate pt’s Tx plan??
-Do you deal a lot with EMERGENCY pt? Separate operatories for that?
-Average number of emergencies per week?
-Will I be doing hygiene/prophy when I don’t have pt?
-Who determine how long I have when spending with new pt/initial exam and record?
-Do I have an apt separate to do comprehensive exams and record…. Or do I do the TP when pt come in for cleaning?
-How long does a hygienist spend on their recalls?
-Is there a particular doctor in the area who is your main competitor?
-Who sees the patient first (Doctor, hygienist, associate)?
-Why was the partnership offer turned down by an associate (if applicable)?
-Will I be able to visit the office during regular working hours?
-Does the doctor have a report showing how much treatment is treatment planned?

Partnership/Buy in/Sale
-What will be the time frame for associate position before we can talk about partnership/buy in/buy out?
-Is there an option for future ownership? Are you considering a move out of state?

-State, specialty

Confidential Information

Covenant not to compete

Termination of agreement

-Define, temporary, permanent, etc…..

Binding Effect


-Verbal, written, witness?

Benefit and Assignability

Alternate Dispute Resolution
-Included? Define


Professional Conduct:
-Standards or ADA, MDA? Other
-Emphasis on Dr. name or practice name?

Provided by Morgan Pace, ETS Dental

Tags: Job Interview Questions What To Ask Associate Position Job Search Job

Tuesday, December 1, 2009

Dental Economics-Dental News - Part 2, 2009 Dental Economics®/Levin Group Practice Survey

Dental Economics-Dental News - Part 2, 2009 Dental Economics®/Levin Group Practice Survey

November 23, 2009
For more on this topic, go to and search using the following key words: Dr. Roger Levin, annual practice survey, procedure mix, practice overhead, staff wages, practice production, stress, doctor satisfaction, economy.
As 2009 draws to a close, it's time to look back at the year's successes and challenges. How did your practice fare in this tough economic environment? Were you able to adapt and discover new opportunities? Or were you playing “catch–up” for most of the year?


Thursday, November 5, 2009

Dental Economics-Dental News - 2009 Dental Economics®/Levin Group Practice Survey

Dental Economics-Dental News - 2009 Dental Economics®/Levin Group Practice Survey

November 2, 2009

For more on this topic, go to and search using the following key words: Dr. Roger Levin, annual practice survey, practice overview, practice production, collections, billings, overhead, wages, benefits, doctor satisfaction.

Editor's Note: This is Part I of a two–part series discussing the results of the most recent practice survey, conducted by Dental Economics® and Levin Group. Part II of the series will appear in the November issue of DE.

How is dentistry doing? In light of the economic downturn experienced throughout the country since last fall, many of you might expect the answer to be “bad,” “awful” or “terrible.” Fortunately, that is not the case. The results of the Dental Economics®/Levin Group 2009 Annual Practice Survey show dentistry to be holding its own, with relatively modest dips in practice production and new patient visits.

Although it was not a great year by any means, dentistry remains a resilient profession as dentists continue to prove themselves as resourceful entrepreneurs who can adapt to changing times. Some recent trends include:


Click here to view survey results...

Dental Economics-Dental News - Tips for practice growth in difficult times

Dental Economics-Dental News - Tips for practice growth in difficult times

November 2, 2009

by Carol Tekavec, CDA, RDH

For more on this topic, go to and search using the following key words: practice growth, marketing, advertising, patient education, communications, treatment-planning, patient financing, Carol Tekavec.

Most business leaders agree that at times of market stress, marketing should increase. Rather than cutting back on “promotional” activities, putting your practice out in the forefront of your community is recommended. Advertising, per se, can be helpful, depending on how ads are designed. Advertising can also be expensive. Here are a few ideas for promoting a practice that are not expensive, and in some cases, free: ....


Monday, November 2, 2009

Confessions of a Dental Recruiter

Written by Mark Kennedy, Managing Director of ETS Dental.

Sooner or later, every practice is faced with seeking a new Associate, Partner or Owner. In the past twelve months ETS Dental has recruited and placed more than 200 Dentists with independent practices and clinics around the country and some of the lessons we’ve learned may be beneficial to you when it comes time to bring a new dentist into your practice.

The best candidate already has a job
As a whole, the population of Dentists is truly at full-employment. Most great candidates are employed, but passively seeking a better long-term opportunity. In fact, only one out of every 20 Dentists we place come as a direct result of an ad…the rest come from networking.

There’s a reason the best opportunities aren’t advertised
The best associate or partnership opportunities are rarely advertised. If a practice is losing a key associate it is typically in the best interest of the practice NOT to advertise this fact until a replacement is found. Some patients and key staff will certainly leave if they know their Dentist is leaving the practice.

The best time to start looking is early
There is an old Chinese saying, “The best time to plant a tree was 20 years ago. The second best time is today.”
Very few good candidates are desperate for change. The vast majority are willing to wait a few months or a few years. Likewise, no one practices forever…there is usually an identifiable window of opportunity when a partner would like to step back or retire…the closer a practice waits until that time, the more they limit their options.

Practice Owners with a plan hire the best Associates
Interview preparation is a two-way street. While much has been written to help the potential hire prepare for an interview, we have found it equally essential for interviewers to have specific communication goals to achieve through the interview process. Let’s face it, most dental practices conduct comparatively few interviews.
If you found the “perfect associate candidate,” I can guarantee you that your perfect candidate probably has multiple options. Have a plan in place. Do you have a sample contract? How will the associate be compensated? Would he or she be offered a buy-in? If you can’t answer these questions, you will lose the best candidates.

Relocation, relocation, relocation
More that 60 percent of the dentists we recruit and place relocate. Many are looking for the opportunity. Many are looking to get closer to the people or places they love. Dentists coming out of a residency or the military are nearly always located in a different city or state. When you are looking for a new associate, you probably won’t find them in your own back yard.

Whether you are a practice owner looking for a candidate or a Dentist seeking a long-term practice opportunity, the moral of the story is the same:
• Start looking far in advance.
• Work hard to find multiple options.
• Be prepared if the right opportunity or candidate comes available.
The best candidate or practice for you may be somewhere you don’t expect
Carl Guthrie is a Account Executive for ETS Dental. ETS Dental is an excutive recruiting firm specializing in finding and placing dentists, dental specialists, and dental staff across the United States.
Connect with Carl Guthrie at:

Thursday, October 22, 2009

12 Reasons to Hire a Boomer

The following list highlights a generation’s strong points and was created by Cindy Cooke, executive Director of Boomerz in Scottsdale, AZ.

1. Boomers eyesight may be changing, but they still know how to read a clock, so they show up to work. ON TIME.

2. Boomers are unlikely to take the week off because someone broke their heart.3. Boomers don't think of ear buds as required jewelry.

4. Boomers know how to spell "customer service". Better yet, they know how to deliver it.

5. Since they aren't looking to climb the corporate ladder Boomers make great mentors.

6. Boomers don't expect to be complimented for breathing. They expect praise for a good job and correction for a bad one.
7. You'll get points in heaven if you protect an endangered species. Boomers are the last generation of workaholics.

8. They REALLY need the job. Boomers can't move in with Mom and Dad. (Mom and Dad are more likely to move in with them!)

9. Boomers have an attention span greater then the life of a flea.

10. Boomers don't have their cell phones glued to their texting fingers.

11. Boomers may not be as physically agile as they were at 20, but they are still really flexible. They work different shifts, work from home, change their plans and work on contract or projects without complaining. They remember the old adage: Work before pleasure.

12. Boomers are not going to leave just because they are overqualified. They are looking for balance in their lives and are willing to sacrifice to get it.

(Source: The Arizona Republic)

Monday, October 5, 2009

Dental Economics-Dental News - Motivation: How it shapes your future

Dental Economics-Dental News - Motivation: How it shapes your future

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Motivation: How it shapes your future
Michael Schuster
September 30, 2009
by Michael Schuster, DDS

For more on this topic, go to and search using the following key words: recession, four levels of dentists, creating wealth, motivation, procrastination, low value awareness, Dr. Michael Schuster, the Schuster Center.

“All behavior is shaped by the reward we believe and expect the behavior will produce.” — Thorndike

There are distinctly different types of motivation that work in distinctly different directions with different results. Individuals and organizations are either moving toward what they want or away from what they don't want. We have all developed a toward motivation and an away from motivation: toward fun, comfort, satisfaction, and peace of mind, and away from pain, problems, distress, and complications.

Both motivations are useful in different situations, and we all use both motivations. But for most people, one predominates.

It's vital to understand the predominate motivational direction of each team member and patient with whom we work. We've all met people who get up early and are excited about life and need little or no guidance or prodding. We have also worked with people who need the threat of job loss to motivate them.

Both types of motivation work. However, when anyone primarily uses away from motivation, once they are away from danger, they have no more desire to move onward and upward. Generally those who use away from motivation do so because they are experiencing discomfort. In my experience, away from individuals lose money when they invest and are rarely very healthy individuals. Let me explain.

In away from motivated people, the pain must be really severe before they take action. They feel the “threat” and see the value of their investments going down, but they usually don't act until they've lost a great deal of money.

Another example is health and disease. I talked with a dentist who was procrastinating about how to improve his practice. He was in the hospital, more than 100 pounds overweight, diagnosed with diabetes, with a blood clot in his leg so severe he might lose his leg. He actually told me, “I never thought this would happen to me. I thought I was invincible.”

This is an amazing true story of away from motivation. How bad does it have to get before he becomes serious about his life and practice? Individuals with away from motivation often lose their desire to improve the further away from threat they are.

The problem with procrastination
Since away from individuals are moving away from the truth, they generally end up in a place they don't like. When your mind is preoccupied with what you don't want rather than what you do want, you continue to repeat your past and make no long–term progress. Rather than focusing on the desired future, people are so busy running away from what they don't want that they run right into it.

Procrastination is the sneak thief of life. Procrastinators (generally people with an away from orientation) live in a great deal of anxiety and pain and have built up a resistance to it. So it takes a great deal of pain, anxiety, and discomfort for them to overcome their fear and move forward. For many, the first attention they pay to diet, exercise, proper eating habits, and stress reduction is after a near fatal heart attack.

I am not sure what percentage of the population is away from versus toward motivated, but my guess is that 80% to 90% are away from motivated rather than toward motivated. To show how predominate the away from motivation is in our culture, let me share my experience of many years in working with dentists regarding money and investments.

Every week I talk with one or more dentists who have lost 50% of the investment value of their retirement, 401K, or college planning accounts. Several times a month I lecture to small groups of dentists, and when I ask why they are there, invariably someone responds, “My 401K is now a 201K or 101K.” This absolutely mystifies me, but it helps prove that away from motivation predominates.

The top of the S&P was around 1565, and the bottom was 677. That's a decline of more than half. Every time we have a recession, which is about every eight to nine years, the majority looks for new investment managers. Why?

They look because they have lost so much money. Away from investment advisors and investors ACT when they experience great pain or discomfort. After every major drop in the value of securities is a rise. It always comes back, but what you own may not come back. The companies in which you invested may have experienced “creative destruction” and may never return to their former value.

Since away from motivators have to experience extreme pain before they act, it's easy to see how they can let their investments slip to great depths before they do anything. These same people could wake up and understand themselves and then realize that they must protect themselves, rather than wait to act under severe and serious distress.

Make a plan and have a strategy
A toward motivator is always looking forward to specific goals and objectives. Both should have a specific strategy rather than simply relying on emotions. Since the value of any investment is determined by the emotions of the masses, it is critical to have a plan to protect health and wealth. Toward motivated people are creators; away from motivated people are reactors. To be effective, both types must understand their motivational direction, because it impacts every aspect of their lives and businesses.

Click here to enlarge image All success requires a plan and a strategy. I tell my investment advisor that no matter what, I never want to lose more than 10% in any year, ever. So I personally invest 33% in cash–like instruments, 33% in municipal bonds, and 33% in stocks, mutual funds, and real estate.

I realize that I won't make as much money when the market goes up, but I also won't lose nearly as much when the market goes down. Every three months I have the entire portfolio rebalanced to minimize my risk and optimize my gains.

Here is an interesting piece of data that proves my point. An S&P of 1565 to 677 is a 56.74% drop. At 677, I would have to gain 131% to get back to where I was. This explains the vital strategy of stop losses or conservative management of your investments. How many years does it take to get 131% back?

I would say the same toward motivation works with your health, relationships, and practice. Planning is the key. On the other hand, the majority of people I meet don't have a clue as to what they really want. How can this be?

It's because they are away from motivated. They have learned this style of motivation and are so busy running away from what they don't want that they don't have time to focus on what they really, really want.

It's critical to realize that we always make the best choices available to us. Whereas I do believe this is true, I also believe that my responsibility is to help people find better options, and that if they're doing what they have always done, they are going to get what they have always gotten. So what's the key to all of this?

Values are the single most important factor. Values enable you to break through the fog and center your decisions and actions on what matters most to you. Individuals with strong values are less likely to waste time and are more strongly motivated. Individuals in an away from motivation nearly always lose their desire and find it difficult to stay focused, on track, and inspired.

Individuals with low value awareness easily go off track, procrastinate, and wait until the pain gets so bad they can't stand it and react. They end up in the hospital with a heart attack, diabetes, or stroke. Or they end up losing 50% of their investments. Or they spend their lives reacting to other people's problems, or they wait so long they lose their business or practice.
Human behavior is fascinating, if not humbling. Watch your patients' procrastination, watch your investments go down the tubes, even watch your practice go downhill. Or you can rise up and take control of your health, money, time, and practice. You can either react or create. You can spend your life moving away from pain, discomfort, and distress, or you can move toward what you really want to create in your life.

A practicing dentist, Dr. Michael Schuster founded the Schuster Center in 1978. Guiding more than 3,500 graduates to achieve wealth and freedom, the Schuster Center is the first business school created exclusively for dentists. It celebrated 30 years in 2008. Dr. Schuster is a cadre and former director at the Pankey Institute, adjunct faculty at the Dawson Center, OBI, and LSU Cosmetic Continuum. Dr. Schuster can be reached at or

Sunday, July 12, 2009

Career Planning

Are you where you want to be?

When you decide to take your next career step, write out your personal and professional goals to see if they align with your current situation. The following questions can help you clarify your objectives:

  • Why are you a Dentist?
  • Are your talents and personality traits being fully utilized in your current practice?
  • Do your clinical and personal philosophies fit with those of your current practice?
  • Are you living and working in a community where you want to spend the rest of your career?
  • Are you doing the type of dentistry you would like to do?
  • Are continuing education, current technology, and training high priorities where you work?
  • Will you ever become an owner or partner in your current practice? Will this happen when you are ready? Or, will you have to wait until someone else retires or decides to cut back?

After you have answered these questions, take the following next steps:

  • Support - Be sure that your family endorses your choices. You’ll be able to move faster when an offer is tendered.
  • Skills - Make sure your clinical skills are up-to-date. Dentistry is constantly evolving. Do you have unique set of clinical skills that increases your marketability?
  • Career Management - Take control of your life by taking positive steps to achieve your objectives.

Carl Guthrie is a Account Executive for ETS Dental. ETS Dental is an excutive recruiting firm specializing in finding and placing dentists, dental specialists, and dental staff across the United States.
Connect with Carl Guthrie at:

Saturday, June 27, 2009

Offer Assessment

You’ve had the interview and the practice makes an offer. Now what do you do? Is it a good offer, great offer, or a time bomb ready to blow up in your face? Maybe you are trying to choose between more than one offer. Perhaps you are trying to determine whether you should take the first job you’ve been offered.

Before you accept an offer, you need to be able to answer the following questions:
  • Will you be paid a percentage of collections or production?
  • What is included in these numbers?
  • Would most of your patients be Fee-for-Service, PPO, Traditional Insurance, Medicaid, HMO?
  • Will you have a full schedule from day one or will there be a ramp-up period?
  • Is there a guarantee? (Hourly, Daily, Weekly, Monthly)
  • What is the restrictive covenant? What is a reasonable distance?
  • How much notice needs to be given if things don’t work out?
  • Is there a clear documented path to practice partnership or ownership?
  • What are the practices fees?
Is it better to get 25% of production, with a full schedule in a fee-for-service, high-end practice or 40% of collections in a discounted fee-schedule, insurance-driven practice?

Is it better to make less during the first year in a practice that you could own in two years or make more in a practice where you will always be an employee?

Would it be smarter to accept an offer near my friends and my Dental school making a salary of $8,000 a month or move 50 minutes away and make between $150,000 and $200,000 my first year?

Thursday, June 25, 2009

Cost of Not Having an Associate Dentist

Of course not every practice needs an associate, but if your practice is growing there will come a time when this will need to be considered. Below are just a few things to consider regarding the cost of not have an associate.

Cost of your time – As a practicing Dentist your time is probably worth some where between $150 to $350 an hour. At an average of $225 an hour it would cost $18,000 if you personally invested 80 hours in a search. Considering your chances of success, most find this is neither time nor money well spent.

Lost Opportunity Cost – Most successful practices are booked up for at least three or four months. Think how much new patient/referral revenue is lost everyday from not being able to readily accommodate new patients. What would it mean to you to bring on an associate six months sooner. (Example: $1000 Net collections per Associate per day – Less $350-$400 for Associate Pay = $625 x 104 days (4 days a week for 26 weeks) = $65,000.

Cost of Not Being Open Five or Six Days a Week – What would it mean to your practice if you could stay open one or two additional days a week? One would expect your net collections to increase any where from 10% to 40%. Most of this money would go directly to your bottom line since your fixed cost would remain relatively stable. (Example: Your Current Weekly Net Collections x (10% to 40%) = $???,???.

Cost of Your Vacation Time – What would it mean to your practice if you could keep it open when you take a vacation. One Dentist told us it costs him at least $30,000 for him to take a one-week vacation. How much does it cost you? ??,???.

Carl Guthrie is a Account Executive for ETS Dental. ETS Dental is an excutive recruiting firm specializing in finding and placing dentists, dental specialists, and dental staff across the United States.

Connect with Carl Guthrie at:

Wednesday, June 17, 2009

The Manager's Cheat Sheet: 101 Common-Sense Rules for Leaders

By Inside CRM Editors

Management is all about connecting with the people on your team. So how do you effectively manage a team? With common knowledge, of course. These are a few back-to-basics rules that will help you develop management skills that really matter.

Body Language
Like it or not, your body speaks volumes, even when you are silent. Here's how to express an attitude that's appropriate for a leader.

1. Stand tall. Keeping your shoulders back and holding yourself up to your full height will give you an air of confidence.
2. Take your hands out of your pockets. Putting your hands in your pockets is often seen as a sign that you have something to hide.
3. Stand with your arms crossed behind your back. This will help you adjust your posture, and it leaves your hands in a position that is open and not intimidating.
4. Make eye contact. Always look directly into the eyes of the people you are speaking with. This shows you're interested and also gives you a sense of confidence.
5. Sit up straight. Even if you're at an 8 a.m. meeting and feeling tired, it's important to sit up straight in your chair. Slouching makes you look disinterested and can give off an unwanted air of laziness.
6. Face the person you're talking to. This shows you are interested and engaged in the conversation.
7. Shake hands firmly. For many, a handshake is a reflection of the person you're shaking hands with. You don't want to come across as unsure or overbearing, so make sure yours is professional and confident.
8. Always smile. Smiles are contagious and will make others feel positive when you're around.
9. Look your best. You don't have to be model perfect every day, but you should dress appropriately and neatly. Clothes can have a big impact on the way you're perceived.
10. Walk confidently. Keep your head up and take even strides.

Meeting Deadlines
No one will be happy if your team has to rush around at the last minute to complete a project. Follow these tips to make deadlines less stressful for everyone.

11. Only promise what you can realistically deliver. Don't create deadlines that you know you can't meet. By only promising what you know you can do, you'll be able to finish on time.
12. Set clear goals. Once you know what you need to accomplish, it helps to know how and when you want to do it. Put your goals down on paper and make sure everyone on your team gets a copy.
13. Organize a team. Many of your employees will have unique strengths and training that can make them great assets to certain projects. Pick a team that has the right skills to carry out the job.
14. Delegate tasks. Spread work among your employees in a way that doesn't leave anyone overburdened while also allowing the project work smoothly.
15. Create milestones. Creating milestones for you and your team will help you keep track of your progress and also give you a sense of accomplishment as you reach each milestone.
16. Keep communication open. Keeping everyone in touch with the status of the project is key to making sure it's completed on time.
17. Do it right the first time. Planning ahead will help prevent you from delivering a substandard product. Having to redo something for a client costs money, and, more than likely, future business opportunities.
18. Stay organized. Staying organized will help keep you from wasting time chasing down important documents and information.
19. Make sure expectations are clear. Be sure that each member of your team knows what their specific responsibilities are. This will save time and prevent tasks from being overlooked.
20. Create a plan. Compile your goals and milestones into a comprehensive plan for attacking any project you are given. This way, you can make sure you're staying on schedule and that all of your employees will be clear about how and when things should be done.

Getting Along with Employees
A happy office is a productive one. Everyone will be more cheerful if you follow these simple rules.

21. Don't make your employees come in on days they're normally not scheduled to work or call them while they're on vacation. A surefire way to make employees resent you is to invade their personal time for nonpressing work. Unless you have something that absolutely has to be done, let time away from work stay that way.
22. Don't play favorites. Playing favorites can bias your judgment and impair your leadership abilities. Treat your employees equally.
23. Give credit when it's due. Don't take credit for your employees' ideas or hog their limelight. This action not only fosters resentment but also makes you seem untrustworthy.
24. Don't micromanage. While it's fine to keep up with what your employees are working on, don't constantly look over their shoulders.
25. Never discuss employee matters with their co-workers. This kind of gossip always gets back to the person and will make you look unprofessional.
26. Don't interfere with employees' work. If your employees are getting work done, don't stress about how it gets done. Even if it's not being done they way you'd do it, it's best to let employees use their best judgment.
27. Don't push unreasonable deadlines. You don't want to spend all of your time at the office, and neither do your employees.
28. Keep your promises. Barring some catastrophic event, you should always keep promises you make to employees, especially about pay and benefits.
29. Keep work about work. Don't require employees to run your personal errands. Take care of your own personal business or hire an assistant.
30. Reward hard work. Make sure your employees feel valued for the work that they do. Employees will be more willing to put in extra effort if they know it's noted and appreciated.
31. Provide motivation. Sometimes employees need a morale boost. Provide them with encouragement to get a project rolling.

Manage Yourself
Being a good manager isn't just about what you can encourage other people to do, it's also about managing your own performance.

32. Be accessible. Don't hole up in your office all day — come out and visit with your employees. Let them know that they can always come to you with problems and concerns.
33. Be open to constructive criticism. It may not always be what you want to hear, but listening to constructive criticism gives you the chance to learn and grow from your mistakes.
34. Accept responsibility. Part of being the boss is accepting responsibility for the mistakes of all that you manage, not just your own.
35. Know there's always room for improvement. No matter how good you think you are, your job can always be done better. Always be willing to learn.
36. Improve your skills. Learning is a lifelong process. You're never too old to take a class or ask a co-worker to help you improve your knowledge.
37. Explain things simply. Don't use big words or technical jargon just to sound smart and impress others. Your employees will understand and perform better if you explain simply and clearly what you need.
38. Instruct rather than order. You may be the boss, but you don't have to be bossy. You'll have more success if your requests are more tactfully delivered.
39. Include your staff in your plans. Don't make your work top secret; let your employees know what's going on and how they are expected to contribute.
40. Know your subordinates' jobs. You don't want to be caught with inferior job knowledge.
41. Be flexible. It's fine to be firm in what you expect, but allow for flexibility in how it gets done.
42. Get regular feedback. Your employees and superiors can give you valuable feedback on how to improve your performance. Use this to your advantage.
43. Know your limitations. You can't be everywhere doing everything all at once. Know the limits of your time and abilities and say no to things you know you can't do.

Boosting Productivity
Getting the most out of your day can be difficult with a busy schedule, but you can use these tips to help you maximize your time in order to be better available to employees.

44. Get the most out of meetings. Be organized and prepared for meetings to increase effectiveness and time savings.
45. Focus your energy on things that matter. Don't let trivial tasks take time away from things that are really important.
46. Identify your time-stealers. Everyone has little things that detract their attention and make them lose focus. Figure out what these are and work to eliminate them, if only for a few hours a day.
47. Be punctual. Being on time is a big deal. Never keep people waiting for appointments or meetings if you can help it.
48. Respond to your correspondence within a reasonable amount of time. You don't have to be chained to your inbox, but make sure you respond to emails within a few hours whenever possible.
49. Do only what is necessary. There are times when going above and beyond works, but doing so on a daily basis can derail your progress on more important issues. Get the key things done first, then see if you have time for additional things.
50. Stick to schedules and routines. While they may not be the most exciting things, schedules and routines can help streamline and improve your productivity.
51. Organize and manage your schedule. Use any tools and utilities you have at your disposal to prioritize your day and keep track of what you need to get done.
52. Plan more than you think you can do. While this may sound stressful, it can actually be a great motivator. If you manage to get everything done, you'll enjoy a great sense of achievement.
53. Get to work early on occasion. Sometimes an uninterrupted half hour in an unoccupied office can help you get key things done or allow you to plan your day before there are any distractions to slow you down.
54. Know that sometimes stress is good. While too much of anything, especially stress, can be bad, sometimes a little stress can be the motivation to get you moving, allowing you to get more done.
55. Do your least favorite tasks first. Get your most tedious and least desirable tasks out of the way earlier in the day. After that, everything else will be a breeze.

Managing Finances and Resources
Whether you're a business owner or a manager, staying on top of tangible items is vital to success. These tips can help you keep track.

56. Set up a realistic budget. While it's good to be optimistic, don't plan for more spending than you know you can afford. Make sure you plan for emergencies and contingencies as well.
57. Save costs where they matter the most. Don't just pinch pennies for the present. Make sure your savings will pay off in the long run. Compromising on quality might cost you later on in repairs and replacements.
58. Spend only when it's necessary. Don't spend if you don't need to. Every bit you save goes toward your profit.
59. Find alternative sources of finance. Sometimes even successful businesses need a little help. Business loans and investors can help you through leaner times.
60. Stay true to your contracts. Not only will you gain the respect of your clients, you'll also avoid legal battles that can be a serious financial drain.
61. Make sure employees are well compensated. Employees deserve to be rewarded for hard work. Make sure yours are well compensated for their time and they'll be more productive and happier to come to work.
62. Learn to do more with less. Quality is much more important than quantity, so make what you have count.
63. Assign equipment wisely. While it might be nice for every employee to have a PDA, budgets often don't allow for such conveniences. Make sure the employees that need tools the most have access to them.
64. Invest in solid technology. This doesn't always mean the latest technology, but what your office needs to do work effectively.
65. Update when necessary. Using obsolete equipment and programs can really slow you down. Update when it makes sense so you won't get left behind by competitors.
66. Don't be wasteful. Every sheet of paper, paper clip and pen is a cost on your budget. Use materials wisely and don't waste them out of haste or carelessness.

Communicating with Clients
Whether you're a business owner or a manager carrying out a project, one thing is always the same: The client is dominant voice in decision-making. Learn to communicate with them effectively and you'll set a good example for the people you supervise.

67. Remember that the customer is the boss. At the end of the day, your job is to make the customer happy. Act accordingly.
68. Differentiate your products. Don't get lost in a sea of products and services like yours. Make sure you stand out from your competitors.
69. Retain customers as much as you recruit new ones. While you always want to bring in new business, it's very important to maintain relationships with loyal customers.
70. Provide effective channels of communication. Make sure your clients can contact you easily and quickly if they have a problem, concern or question. They can also provide a valuable source of feedback.
71. Maintain customer data. Use this data to make your customers feel special by remembering occasions like birthdays and anniversaries. It's also helpful for keeping track of purchasing preferences.
72. Segment your customers. Not all customers are alike. Divide your customers into groups that allow you to provide attention and services that meet each customer's unique needs.
73. Provide effective after-sales services. Don't let contact fall off after the work is complete. Make sure your client stays happy.
74. Listen attentively. Pay attention to exactly what clients are asking for to help you better meet their needs.
75. Don't be afraid to say you don't know. It's OK not to know the answer to every question. It's better to say you don't know and get back to a customer than to try to bluff your way through a conversation and have to backtrack later.

Keep Up with Change
There is no way to stop the world from changing, so follow these tips to keep up and ahead of the game.

76. Don't fight change. You can't stop markets, trends and technology from changing, so learn to go with the flow.
77. Adopt a predictive managerial style. Don't wait for things to happen to make a move. Anticipate problems and provide contingency plans.
78. Test your contingency plans. Waiting for disaster to strike is a dangerous way to find out if your emergency plans will hold. Test them out from time to time to fine-tune them and make sure they're still relevant.
79. Identify the positives. Even the most negative changes can have positive aspects to them. Being able to identify and maximize them can help make adapting less painful.
80. Be quick to adapt. Learn to adapt to changing situations quickly and be able to change plans on the spur of the moment if the situation requires it.
81. Stay tuned to external factors. Your business is affected in many ways by outside factors. Keep abreast of these so you can anticipate any sudden market changes that would affect how you need to manage.
82. Put in place a Research and Development plan. Encourage innovation and creativity to stay ahead of the demand for newer and better products and services.
83. Keep an eye on the competition. Don't let the competition get the best of you. Keep up-to-date with what they're doing and use it to your advantage in managing your business.

Resolving Problems
Whether problems are internal or external, they can make your management duties a nightmare if you don't handle them correctly. Here's how to stay on top of them.

84. Stand up for employees. If other departments or managers are bearing down hard on your employees, stand up for them.
85. Fix what's broken. Don't waste time placing blame. Take care of fixing the problem before dealing with any possible repercussions.
86. Manage and control your emotions. Don't let anger or frustration affect your problem resolution. If you are emotionally invested in a situation, cool down before discussing it or bring in an outside mediator.
87. Learn when to step in. Some problems might resolve themselves if you just let them be, but you need to be aware of times where you'll need to step in and take control of a situation.
88. Take the blame. If you've made a mistake, fess up. It'll give you more time to work on fixing the problem instead of talking your way out of taking the rap.
89. Get the facts first. Before you pass judgment on a situation, make sure you have the whole story. Listen to employees and refrain from questioning anyone's integrity without first ensuring that you've gathered all the data.
90. Rise above the crisis. Learn to separate yourself from the problem and rise above the fray. You'll be able to think more clearly and make a better decision on how to rectify the issue.
91. Don't ignore problems. A small problem can easily snowball and become something much more difficult to fix.
92. Try to depersonalize problems. Let employees know that the problem isn't with them but with their actions. Don't make it personal.

Go Above and Beyond
Managing people isn't just about getting the job done. To truly be a great leader, sometimes you need to go above and beyond what the job calls for.

93. Lead by example. You can talk until you're blue in the face, but the best way to get a point across is to be the model to emulate. Let employees follow your lead.
94. Get your hands dirty. Sometimes you need to show your employees that no one's above doing unattractive tasks.
95. Make a difference to your employees. Don't just be a generic manager — stand out as a leader and role model for your employees.
96. Gain your employees' trust and respect. You'll have a much easier time managing employees when they respect your rules and boundaries and trust your leadership.
97. Be empathetic to personal problems. Whether it should or not, what happens outside of work can have a big affect on the quality of work produced. Be sensitive if employees have personal issues that keep them from concentrating on work.
98. Be unique as a manager. Every position demands something different and you should be proud to be adept at your particular role rather than trying to emulate other managers.
99. Remember that ethics matter above all. Be honest and reliable in all of your business and personal relationships.
100. Be on the lookout for new ideas. You never know where your next great inspiration will come from.
101. Get to know your employees. Learn more than just their names. Get to know your employees' family backgrounds, likes and dislikes. Doing so will make you more personable.

The original source of this article is , part of the Focus network of sites.

Tuesday, June 16, 2009


Article from the WSJ
June 2, 2009

Melissa & Doug LLC, a fast-growing toy maker in Wilton, Conn., puts applicants through an interview process so grueling that one job seeker says she left in tears and felt psychologically traumatized.

Candidates must bring their lunch -- plus three years of W-2 statements. They spend hours on simulated work tasks, several with tight deadlines. They complete a lengthy survey, where they rank their interest in chores such as fixing a leaky faucet and changing the fax machine's toner. Some prospects walk out right after the all-day screening starts.

The process "is sometimes a little rough around the edges," but Melissa & Doug hires only individuals "who will love it here," says co-CEO Doug Bernstein. He and his wife founded a firm where sales staffers often interrupt work to belt out songs using the office karaoke machine. Melissa & Doug can afford to be picky. About 50 people now apply for every position the company fills, 10 times as many as two years ago, according to Mr. Bernstein.

As the downturn persists, U.S. employers flooded with résumés increasingly insist that job hunters jump through unusual hoops. An investment bank ordered an experienced female marketer to come dressed in fancy evening wear suitable for entertaining wealthy clients. Certain businesses force contenders to interview each other and tout their rival's prowess. Others demand protracted unpaid tryouts.

"Job seekers frequently face a process that makes the Spanish Inquisition seem tame" because management sees the sour economy as a golden opportunity "for upgrading talent," says Jennifer Berman, a Chicago human-resources consultant.

Anyone craving employment these days "should expect just about anything," says Tom Carter, president of LeaderFinder Consulting Inc., a New York executive recruiter. He recently began requiring prospects to ace a role-playing exercise before recommending them to clients.
However, there are ways to anticipate and handle unorthodox screening tactics so you don't get knocked out of the running while jogging that extra mile.

You may avoid surprises by digging deeper than usual. Ask present and prior staffers about a company's hiring regimen, before checking online chatrooms and the corporate Web site for extra clues.

Capital One Financial Corp. alerts potential professionals and managers that many will tackle a business case study during interviews. The big bank's Web site offers a sample case study and acceptable analysis. Candidates believe "it's extremely helpful to have that case-study preparation," says Tonya L. Swatzyna, senior director of recruiting.

Rehearsals also get you ready for curveball interview requests. Act out responses to standard queries with friends, and then "have them ask you crazy questions to catch you off guard," says Townley Paton, owner of InterviewClips. The small San Francisco concern produces multimedia résumés for job hunters. You will appear even more self-confident if you practice your breathing, eye contact and smile, Mr. Patton adds.

Thinking fast on your feet helps, too. That's how a candidate became the frontrunner for a vice presidency at a midsize biotechnology company. During the prospect's interview with the company's chief executive last month, the CEO insisted the woman attend a corporate meeting about pitching for a contract research assignment.

Her participation "was totally unplanned," says Jay Meschke, president of CBIZ Executive Search, a CBIZ Inc. unit that helped the biotech concern field candidates. The woman offered impressive ideas about how the biotech business might craft the client pitch, according to Mr. Meschke. The firm will likely decide this month whether she will be its next VP of sales and marketing.
Daunting Hurdles

Some employers create hiring hurdles so daunting that their reputations suffer. A jobless executive sought to manage a large training department for a West Coast bank last year. The executive and seven fellow candidates were ushered into a crowded boardroom, where officials gave them each five minutes to interview the applicant next to them and offer a presentation on "why that person would be the best person for the job," he recalls.

The assignment infuriated the HR executive. "It's a total no win. You're put in a position of failure from the beginning," he says. The bank didn't hire him, but "never told me why I wasn't chosen," the spurned candidate adds.

Since then, the executive repeatedly has discouraged acquaintances from applying there. He hopes the bank hears about his criticism. "Why would I care about burning employment bridges at a place I don't want to work?" he asks.

Making the Most of It

Rather than retaliate, other job hunters take advantage of unconventional hurdles. Consider William "Tommy" Rollins, a digital marketing analyst laid off when Circuit City Stores Inc. liquidated in January. He soon met Brent Peterson, founder of InterviewAngel, a professional guide and toolkit offering interviewing tips in a binder. Mr. Peterson offered an unpaid tryout.
Mr. Rollins agreed to design free of charge an online sweepstakes where winners will receive a free copy of the guide, a résumé overhaul and a month of career coaching. He figured the start-up experience might lead to a paid gig there or elsewhere.

Mr. Rollins has provided 60 hours of free labor so far. The sweepstakes, launched May 13, proved immediately popular, according to Mr. Peterson. To make sure pro bono work opens doors for Mr. Rollins, Mr. Peterson serves as a job reference. "It is the least I can do," he notes

Sunday, June 7, 2009

Patience in the Dental Job Market

I have been speaking with a lot of doctors lately who are becoming more impatient and frustrated with the current availability of jobs in their particular geographies.  My advice to these dentists is to be patient if you can afford to be otherwise it is time to look at opportunities that they may feel are not "ideal."  As a whole, dentistry is short on doctors.  The ADA  states that we are retiring more dentist than are graduating dental school.  

Think outside the box.  Talk to everybody you can.  Even if someone cannot help you find a position in the exact location or practice type, they may be able to give you insight that will help.  Talk to other doctors, the dental societies, suppliers, dental recruiters, classmates, faculty, etc.  We are here to help, and advice is usually free.  Never pay someone to find you a job.  You pay brokers or transition companies to find practice buy-in/buy-out opportunities, but not associate positions.  

Options for job seekers when the going is tough:

  1. Part-time positions in multiple offices
  2. Locums tenens work. Be willing to travel and stay overnight in different areas in the state.
  3. Teach
  4. Community/public health clinics
  5. Federal Dental careers. Typically federal clinics only required that you have a license, not necessarily a license for the particular state.
  6. Volunteering in local clinics or public dental events.  These things help you keep up with your skills, and provide great networking opportunities.

Dental schools and residencies are letting out thousands of new dentists into the market right now.  Keep your options open. Competition for jobs is high, and you need to set yourself apart from the rest of the pack.

Carl Guthrie is a Account Executive for ETS Dental.  ETS Dental is an excutive recruiting firm specializing in finding and placing dentists, dental specialists, and dental staff across the United States.

Connect with Carl Guthrie at:

Wednesday, May 27, 2009

Dental Economics-Dental News - What a great time to be a dentist!

Original article found at: Dental Economics-Dental News - What a great time to be a dentist!

First, the demand for dental care has never been higher. Our aging population's dental needs will continue to grow. Simultaneously, the number of experienced, quality practitioners continues to decline, even as the total number of dentists increases. In fact, many doctors who have been pondering the decision to retire will take this opportunity to discontinue the expense of running a marginal practice. Others will limp along hoping to recover lost savings by extending the life of an obsolete practice, while refusing to invest in what they hope will be a relatively short extension of their career in dentistry.

Second, 90% of our working population is likely to remain employed. While this may vary by region, the fact is that the vast majority of working people will remain just that — working. These people will continue to break teeth, get decay ... and need attractive smiles even if it is for the purpose of interviewing for a new job. Yes, some patients will want to give up on teeth and get dentures. We don't control this, but we certainly can be ready to provide the best possible outcome when they make this decision. The reality is that it doesn't really matter what type of teeth patients choose, but rather that they choose us as their dental care providers.

Third, the failure of an economy based on consumer spending is likely to be followed by a return to fundamentals. One of the most basic of these fundamentals is health care. During the Internet boom, we observed a phenomenon in which young, healthy, working adult patients became so obsessed with the fortunes they were making on paper that it was almost impossible to get their attention to pursue even the most obvious investment in dental care. In their minds, every dollar that was being poured into IPOs was surely the one that was going to ensure an early retirement. After the bubble burst, it was remarkable how rapidly these individuals returned to an appreciation of what was really important — family, community, and health.

Fourth, the dental care which will be deferred by some will inevitably result in far more extensive and costly procedures. As a profession that has relentlessly pursued prevention, it is certainly not our desire to have patients increase the level of required care. However, this is an unavoidable result of the current situation. Even those who can afford care may be delaying or deferring treatment until their sense of panic has abated. The 80% to 90% of the population with reasonable job security will not delay long, and most people with dental insurance are rushing to pursue care.

Fifth, market leaders in any industry consolidate their leadership positions during times of contraction. This is simple business reality. Those practices that are the most organized, highly motivated, and best trained are positioning themselves for the inevitable growth ahead. Will America be the great single superpower that it was in previous years? That is largely irrelevant. Witness countries such as France and England, long in decline in a leadership role. World power status does not significantly affect one's ability to pursue dental health.

Sixth, now perhaps the best part of this story. Never in the history of my 25 years in dental practice have I seen the pool of highly skilled and highly motivated employees as large as we see at this moment. This is a tremendous opportunity to build a superstar team! Team members have, perhaps, for the first time in a generation, come to understand the value of a secure occupation and position. The level of satisfaction at work and appreciation for work has never been higher. We have seen a steady stream of applicants, some with decades of experience, for all positions in the dental practice. In addition, a number of highly skilled people from outside the profession are making every effort to enter into our secure, satisfying, and rewarding occupation. Imagine a practice alongside such a skilled group. I personally cannot wait!

Seventh, quality real estate has never been more available. Leasing opportunities that were never available to health-care practices suddenly are being freed up at rental rates that were previously unimaginable. Land is often available at distress sale prices. It has suddenly become possible in many areas of the country to build a new office in a location that will provide a sustainable competitive advantage for decades. As the years go by, late movers will simply be unable to capture these premier sites.

If you are willing to consider this reality — the reality of those fortunate enough to have chosen dentistry as their life's work — how do you respond to this level of opportunity?

1) Grow! You have got to make room for those who want your services. One way to do it is to consider spreading hours to accommodate patients who are reluctant to take time away from the office or factory for their dental care. An expanded schedule does produce a certain amount of inconvenience in many offices. However, the primary purpose is to obtain economic security and expand the practice's market position. For those who are timid about the opportunities at hand, this might be a good place to start.

2) Accept the new economic reality as the opportunity that it is.The increase in needs-based care — and shift away from or delays in accepting cosmetic procedures for some patients — will inevitably lower the case average for practices. In order to accommodate a lower case average, greater capacity is a requirement. Some offices merely need to optimize poorly utilized space in their existing facility. Many offices will find that by increasing room count, they can easily overcome the reduction in case average. The economics of room count are compelling, if counterintuitive. Expansion when possible clearly shows great benefit. At even the extremely low case average rate of $1,000, you would only need to treat an additional 50 to 75 new patients to offset the cost of a new room using simplified systems. Offices with higher throughput are able to easily handle significant increases in new patients. When the economy returns to a more stable balance, there will be opportunity for a return to higher case averages.

3) Consider expanding or building that new office you've always wanted now! With rates as low as they are, land costs plummeting, the availability of high quality contractors who are highly motivated to complete projects, and the decrease in construction material costs, this is unquestionably the best opportunity in our lifetime to create a new office. Patients have choices, and they are more confident than ever about their abilities to choose wisely. Outdated, inefficient, noisy — and I must say — ugly offices do not achieve the new patient referral counts that their clean, private, comfortable, and efficient counterparts do. You have the ability to create patient demand. You want to prevent the erosion of patient loyalty, and you want to lock in the lowest cost for a new office. From our vantage point, from coast to coast, the time is now!

In my next article, I will discuss proactive steps that you can take to increase profits, even as case averages decline. I will discuss the very important concepts behind the relationship of quality and productivity ... and it's not what you think! The future is ours to make. For dentistry, it has never looked brighter!

David J. Ahearn, DDS, is a full-time practicing general dentist. His office consistently ranks in the top 1% nationwide. The president of Design/Ergonomics, he lectures on cost-effective office design, design for performance, and making it easier to get dentistry done. Reach him at (800) 275-2547 or at

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Sunday, May 17, 2009

Dental Practice Owners or Hiring Authorities Interview Preparation

When interviewing for jobs, associate candidates need to ensure they are prepared as much as possible. See The Interview for All Dentists. But what about the hiring practice? If you are interviewing prospective associates you should know the answers prior to the interview, as well as the questions you want to ask.

This is not a comprehensive list, but it surely provides some insight and foundation on what candidates are expecting. Also, some of these questions go beyond a typical associate arrangement and describe things related to partnership/ownership transition. Remember, candidates are interviewing you as much as you are interview them.

First things first
  • Why is your practice opportunity better, more desirable, and lucrative than another opportunity down the street?
  • Employee or Independent Contractor
  • Employee at will?
  • Is the doctor open to restrictive covenant in case of future ownership?
  • Is the owner doctor going to stay on PT for some time or can he if needed (After purchase)?
  • Days, hours, on call, etc
  • Office hours and days per week is the office open?
  • What is the new associate's schedule expected to be?
Type of Practice
  • How is the practice set up (family, Pedo, or dentures)? Pedo: what age?
  • Age of the practice?
  • When/what do you refer out?
  • Place or Restore Implant? Which system?
  • # of operatories
  • # of Hygienists. How many days/hours of hygiene
  • # assistants
  • Will the associate have their own assistant?
  • How much is the practice overhead?
  • How long has each employee been there?
  • What does the practice do to market itself?
  • How many FT and PT staff?
  • What is the patient pool like?
  • Have the number of active patient records been reviewed?
  • Is the practice growing or declining in number of patients seen, new patients attracted, and young patients?
  • Average number of cancellations per week?
  • Average number of patients seen by associate per day?
  • How far ahead is the doctor book filled?
  • How far ahead is the associate book filled?
  • How far ahead is the hygienist’s book filled?
  • Job description or general description
  • Is the associate expected to check hygiene of other doctor’s patients?? If yes, will the associate be compensated for it?
  • Will the associate be expected to perform hygiene/prophy?
  • Does the doctor do any procedures other than regular general dentistry?
  • What were the most of the cases being done by the associate?
  • Supplies, equipment, support. Etc
  • What type of PMS (Software) is used?
  • Implant surgical set up? Who finances to get that set up if NOT already have?
  • What is the square footage of the office? Can it be expanded?
  • Average age of equipment?
  • Is the practice left handed, right handed, or ambidextrous?
Fees for service
  • Appropriate/assign billing?
  • Discounts/Bartering/payment plans
  • PPO type of insurance?
  • Insurances: accept all kinds or just selected ones?
  • How much is the discounted price of the PPO compared to the fee schedule?
  • Medicare or Medicaid acceptance?
  • How much of the practice relies upon capitation programs, PPOs, HMOs, Medicare or Medicaid?
  • What percent is FFS, cash and discounted PPO?
  • When was the last fee increase?
  • Are the fees low, High or average for the immediate area?
  • Do you offer patients credit?
Term of contract
  • How long?
  • Salary, Hourly, Draw, Minimum, Commission, Percentage, Bonus, When, How,
  • Taxes withheld?
  • What percent of production or collection will be the compensation?
  • How will the associate be paid? (Weekly/bi-weekly/monthly)
  • How much on average was the associate making?
  • What is the % of collection for the practice
  • What was the average associate production per day?
  • Does the associate production include hygiene exams and x-rays?
  • Can I get a fee schedule of the practice?
  • Medical Insurance: health and dental?
  • Malpractice insurance?
  • Disabilities insurance?
  • Required CE courses? How much and for how many hours a year? Are they paid for/reimbursed,? Is there a stipend?
  • Retirement?
  • Sick days…….. # allow per yr…..
  • Personal days/vacations…..# per yr allow……
  • Holidays?
  • What benefits are given to the staff?
  • Define, list, when paid, lab, etc…..
  • What Lab do you use? Use different lab for different lab orders??
  • Is the associate responsible for my own lab fees and expenses?
  • Will the practice support the acquisition loan (in case of future ownership), pay the overhead expenses and afford a reasonable income?
Other Questions and Notes:
  • What is your practice Philosophy and Goals? For the Practice and with new pt’s tx?
  • % of implant surgeries
  • Have you had associate before? How many? How long they stayed? What was the reason for the associate resignation?
  • Do you have a confirmation system for apts?
  • How do you deal with NO Show?
  • Digital X-ray?
  • Intraoral Digital Camera?
  • How do you advertise?
  • Will most dental insurance dictate pt’s Tx plan??
  • Do you deal a lot with EMERGENCY pt? Separate operatories for that?
  • Average number of emergencies per week?
  • Will I be doing hygiene/prophy when I don’t have pt?
  • Who determine how long I have when spending with new pt/initial exam and record?
  • Do I have an apt separate to do comprehensive exams and record…. Or do I do the TP when pt come in for cleaning?
  • How long does a hygienist spend on their recalls?
  • Is there a particular doctor in the area who is your main competitor?
  • Who sees the patient first (Doctor, hygienist, associate)
  • Why was the partnership offer turned down by an associate?
  • Will I be able to visit the office during regular working hours?
  • Does the doctor have a report showing how much treatment is treatment planned?