Episode : How to Stay Sane With Multi-Practice Ownership

Podcast Description

Dear listener, it is possible to scale your practice and keep your sanity! Kiera discusses three overall pieces of advice for those who have expanded/want to expand to multi-practice ownership, including centralizing atmosphere and tactics, establishing leadership infrastructure, and keeping your communication fluid.

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Transcript:

Kiera Dent- Dental A Team (00:00)

Hello, Dental A Team listeners, this is Kiera. And today I wanted to dig into multi-practice management and how this can be something so fun. I know several of you have multiple practices. I had multiple offices and I just think that this is a space of like, all right, here we go. How can we make this amazing? And how can we lead, scale and stay sane? I think is a big spot because I think that when we go from one practice to two practices, I know I went.

insane and it was not fun. And so for you, I just wanted to break this down because I really think this is a popular thing. And also if you’re sitting on the fence of should I grow, should I not grow, I think it’s going to be a fun discussion for us today. And I just wanted to say, welcome to the Dental A Team podcast. I’m Kiera Dent and I’m so happy you’re here. I love all things dentistry. I love everything that we’re about. I love helping you have the best day. I love positively infusing you and your practice with goodness. I love reminding you that you are in the absolute best profession.

And this podcast is made free because you guys share, review, like, and you’re able to bring in more and more listeners for us. So I just want to say thank you. And if you haven’t done that today, please share this, like this, review this. That’s how we’re able to stay at the top of the list for more offices to be positively impacted, to grow their practices with ease, and to realize dentistry should be fun again. So with that, I want to talk about like, when we go into multi-practice ownership, it can get really freaking thrilling. So.

I want you to look at like, okay, things that we need to do are as we grow and evolve. Number one, I want you just to ask why are you doing this for ego? Are you doing it for impact? Are you doing it for fun? Are you doing it to be acquired by a DSO? Knowing your why and then putting that up on the mirror so you never miss it is going to help you tremendously. Like genuinely a hundred percent just have that why because then it gets really, really thrilling. And so for you then it’s going to be, okay, great. Once we have that,

I look at like, what can we centralize? So when we brought our second practice, it was make everything very, very simple and very easy for us. Meaning I want it to be all of our software is going to be the exact same. So we have the same software, the same colors. So from practice to look like the different locations when doctors go multi offices, it actually is very easy. Also, we had billing. So we had one person who was over the billing of all the practices. What about our reporting? Can we have the same reporting? So different scorecards that are reporting the same thing.

over the location that we have at centralized so we can quickly look and see how is each location doing. And then also making sure like our handbook, our SOPs, our operations manual is the same. So we set up the operatories the same. We do the same thing for hygiene. Everything is the same. So again, think about McDonald’s. Could you imagine McDonald’s or Chick-fil-A or any fast food restaurant opening multi-locations if the experience isn’t the same that actually gets hard. Now there can be some nuances but the core infrastructure should be very, very similar.

Then after that, you also want to make sure that you have the same culture, team culture and patient experience. So again, go back to Chick-fil-A, the employees all have about the same, the culture is the same, we have the same experience every time we go in, no matter where I’m going across the nation or the globe, it’s the same experience. And so for you, how can we make sure that we’ve got same team culture, same patient experience? You want to make sure your leadership team is really, really solid. And then you’ve got to have like shared tools. So the KPI dashboards, we’ve got to have low

specific views. So if you’re having things that are on a ⁓ software, so like if Open Dental, you’ve got to have it to where I can access every single practice easily or if it’s in the cloud and there are pros and cons between cloud software versus none. I have found that a lot of cloud softwares are awesome for ease of access at home. I will say Dentrix Ascend is my least favorite even though know they’re coming back and they’re popular. What happens is like I have a practice that switched to curve and they love it.

but there’s nothing that can really integrate oftentimes. So you can’t get analytic reports. You can’t get other things. They’re not as open source for you. And so if you ever want something outside of that software, that’s usually cheaper, more affordable, helps you. That tends to be an issue with the cloud-based softwares. But when we got multi-practices, it becomes much easier because then we can sink in. We can look at it. We can have centralized billing, centralized, re-care, centralized phone systems, but you can also do this with a server. So when we look at this,

I think it’s really great because we have practices and when we standardize how we schedule, we standardize our software, we standardize our billing procedures, the practices actually grow 10X. So I have a location, there’s five practices and when we standardize these items, I kid you not, we add about a million per practice per year. So when you go across this, five million growth and you get 10 million growth and you get 15 million growth and you get 20 million and consistently every single year we’re typically adding, but it’s because things are standardized, things are centralized. We’re able to say, right,

All offices, this is how we’re now gonna block schedule. All offices, here are your goals. All offices, the billing is processing. All offices, this is how we do new patients. And it really is able to help you. So you’ve got to centralize what you can across the board and then have it localized at certain levels. But then it means like each office manager does the same thing, but they’re making sure team spirit and team culture is the same. Patient experience is the same of what we do as an overarching multi-location area. So that’s step one.

Step two is we wanna build a leadership infrastructure. So what this is, is we’ve gotta make sure that we’ve got regional managers, office managers, department leads. Sometimes multi-office locations are gonna have a hygienist that’s over all hygienists of all practices. Other times it’s at the practice level. But regardless across the board, there are set standards and set processes that are going to be there for you. So I really wanna make sure that you have that. And then we also need to clarify like who has ownership of this, who’s entering scorecards, who’s entering KPIs.

I like it to be that each office manager is responsible for their practice. So that way their office needs to be profitable, hitting the KPIs, the metrics, all the different pieces in the organization total org. Now I understand some practices, like I’ve got two locations. One’s a very expensive location, one’s a less expensive location. But across the board, you need to have leaders at both locations, because we’re really struggling with these two locations. We have a regional that’s bouncing back and forth between the two, but no one owns the accountability of these practices. And as it gets larger and larger and larger,

Guess what? Capacity struggling. So now we’re having to put into place office leads in both location, office scorecards in both location, office hygiene departments. So looking at this and you’ve got to train the leaders how to lead, not just do. So I can’t just be like, okay, you do this X, Y, Z. It’s gotta be, how do I grow the practice? How do I make sure everybody’s engaged? How do I really get people very talented, very excited about this? Like making sure they know how to hire and fire and have the one-on-one conversations. And what do the scorecard numbers mean?

And what are we looking at? And what is a healthy practice? What isn’t a healthy practice? Usually my regional is meeting with my office managers weekly to make sure that they’re successful. And what I found is when we track and measure all the locations, the practices increase. So typically as we’re tracking and measuring, we’re then able to grow them, elevate them and make them so much stronger because we’re truly leading. So you’ve got to make sure you’ve got a strong leadership infrastructure. And if you don’t have that, you don’t have the pieces, multi-ownership gets really hard. If you’re in multi-ownership right now.

You need to start appointing these people, having KPIs that they’re reporting on, helping them see like how we run leadership meetings, how we run these meetings that are very successful, what your ownership piece is, what are you responsible for, how are you winning? And I think if you think about it, imagine a DSO, they’re going to come in and they’re going to take over your practice. Well, you better believe that they’re gonna have KPIs scorecards for every location. They’re going to have leaders at every location. They’re going to have regionals. They’re going to train.

So if that’s what a DSO is going to do, why not do that yourself of multi-locations and learn from them because they’re smart. They have these systems in place. You can do this as well. And then the third step on here just to help you guys is we’ve got to make sure that we’ve got like communication that’s fluid rather than it just sitting there. weekly leadership calls are non-negotiable. We’re talking run them on traction style, whatever your style is.

but we review where we’re at, like where are headed as an organization? What are the numbers tell us? And then what needs to get accomplished? What are the blockers? What are the issues? What are the problems? And having that. Now, some offices, depending upon how large they are, some have a regional. So like we’re gonna have a board that talks about the whole organization as a whole. Other times I have it where we’re talking about each practice and we run individual ones for the practice, or there’s maybe a hybrid of both. I recommend the hybrid of both. I think as an organization, we need to make sure we’re healthy.

And then each practice is individual time where they’re having these weekly meetings. They’re also having ⁓ our KPIs by location. And we also are making sure that everybody’s aligned. Then in addition to that, I’m very big on quarterly calibration and quarterly meetings of where are we going for the quarter? What are the rocks, if you will, with air quotes? What are the big objectives that we’re accomplishing for this department, for this practice at this time? And what needs to get done?

So it can be different. Each location might run a little bit differently. And that’s where it’s really great because across the board, all of us quarterly know, and then we roll that down to the full teams. So as an org wide, where are headed quarterly? As practices, where are we headed quarterly? And then also making sure quarterly we’re doing some type of team bonding or engagement, because as you get larger and larger and larger, the team culture really can drift. And I know we talked about that at the beginning of like centralizing that and localizing. the OMS are responsible for patient experience and team culture.

But at the same time, you’ve got to make sure that quarterly, like it’s an all team alignment. We send out updated handbooks or protocols across the board, but we also get them like excited. So I’m really big on your communication and your metrics need to be solid. So I’m talking weekly L10s. They usually run for an hour, hour and a half at each office. You also should probably be having department meetings every single week as well to make sure the departments are growing. And then quarterly for sure having amazing like

incredible quarterly meetings that are going to really, really help people drive to those quarterly results, the quarterly pieces and make it to where it’s just fun and then do something fun. You don’t need to run this as a leadership team, but it is a way for you guys to all start leveling up, have fun together. Remember why we all went into this and it’s not just like the drudge of quarterlies. It is truly something fun and exciting. And I have a practice in New York. I’ve got eight locations over there.

And I’m not joking every three to six months, we are meeting with every single practice, setting up goals, setting up pieces, having the full teams bought in and engaged. think I meet like 250 people in about four days. And the goal is to get team alignment, to get buy-in, but we know as an organization what each of the practices need to do, but we’re getting team buy-in from them. And I think when you do that, what happens is the KPIs, when we start tracking them, when we get the quarterly buy-in,

the whole organization rises up because a big pitfall that people don’t realize is multi offices. You’ve got so many team members. You’ve got so many offices. You got so many places that you can actually let KPI slip profitability slip. And what happens usually in multi offices is one practice is actually draining. It’s not as profitable and all the other practices are doing well, but yet all the other practices are having to take care of our draining practice. And it’s how do get all the offices leveled up?

Do all offices need hygiene? Do all offices need block scheduling? Do offices need to be reporting on what we’re doing for the doctors? And I think when you’re able to have that and establish that, you’re able to have much, much, much easier multi-practice management, how to lead it, scale it, and grow it. So when we look at it, just a quick recap is we’ve got to centralize across the board. So our softwares are centralized, our billing is centralized, how we do our patient experience, centralized.

Then we need to make sure we’ve got leaders in place. So regional managers, office managers, having that go through to where we’ve got that whole infrastructure, they’ve got their KPIs, they’ve got their ownership, they know. And then we also are going to make sure that we are going to have tight communication. So we’re running those weekly meetings, we’re running those quarterly meetings. Everything is running and driving really, really well. And this is just one of those things of like, we’re not doing more. As you see, we’ve got directed people in their seats, having ownership. So we’re able to mass scale across the board.

and make sure all the practices are humming in the right direction. Yes, sometimes personable pieces aren’t as common, but you don’t have to lose that because you can set that as this is part of our culture and we put in every single practice. The OMS do it, the departments do it, we have fun. I have multi-offices that compete with each other, that have fun with each other, but this is something and I really feel like if you were trying to scale, your sanity is going to be number one. When we scaled, I started working

double time and I was already working about 14 hours a day. So I know there’s not 28 hours in a day. It’s close. And I was literally sleeping about four hours a night and I was trying to manage all the practices, but it was because I didn’t do these things. I did not put into place centralized across the board. Like didn’t have it. We then hired a biller that did all the billing for it. We then had our office managers and we set up the software that were the same. We then had it to where here are the like protocols of how we set up the rooms.

but it took me so long and I was already in it rather than having this built before I did it. I did not have leaders of both. I was trying to be the leader to both locations and I was running myself ragged and it was exhausting. Like literally burnout to the nth degree, but you’re just in it. And so you’re like, there’s no way to get out of it versus realizing like, no, we can have a regional, we can have managers, we can have scorecards, we can have KPIs. And if you have this really dialed in at location one before you open up,

Great. If you’re already in the location for let’s get these things into place and make sure that they’re all profitable and then make sure we’re weekly, monthly, quarterly team meetings, calibrating them and driving for those results using the numbers, using the culture, using the team. But this is where we’re headed over the next quarter. And then we track and measure for that. I promise you, if you do this, you will be able to have multi-practices grow with ease. You will keep your sanity.

And then you’re tracking and keeping tabs without having to be the doer of all of it. This is what we do. We build scalable systems for practices. We grow leadership for practices. We train you. We coach your multi practices. We train your office managers how to do it. Our consultants have managed hundreds of employees at one time. They’ve done this. They’ve done it successfully. So this is the time for you to truly jump in, call, make your life easier. So reach out. [email protected]. This is something and if you guys want more tips on this,

send this to your regional or send this to a COO or send this to your leadership team. If you’re thinking about growing a practice and you want to scale, like let’s talk about it. Let’s help you and your office manager know what’s going to happen or get you and your regional managers or help out. do multiple, multiple, multiple multi-office locations that we consult on. So reach [email protected]. And as always, your sanity is your gift. This is something that you owe yourself, your practice, your patients. And these are three quick, easy ways to be able to scale, sustain and grow.

and keep your sanity. So reach out if we can help you. And as always, thanks for listening. We’ll catch you next time on the Dental A Team Podcast.