The most innovative, unique way to grow your practice: Part 1

Today, numerous dentists are still asking the big question, “What does it really take to have a highly successful dental practice in this new economy?” Recently I interviewed Eric Nuss, Director of the Henry Schein Dental Business Institute.

Eric is the most astute, innovative, entrepreneurial and caring educator it has been my privilege to meet. After a two-hour interview, I was able to grasp and understand his unique method of teaching dentists a completely one-of-a-kind method to excel in business. Unfortunately most dentists think the correct path to success is to become a “clinical superstar.” Sadly, the result will be a failed administrative system due to a lack of business knowledge.

How did your idea of the Dental Business Institute come about?

The idea came as a result of building the Henry Schein Dental Business Solutions Portfolio. We’ve always recognized that doctors are business owners and must treat their practices as business enterprises. We discovered that they needed coaching and/or consulting because they wanted to be more efficient and profitable. And that’s exactly what we can do with an array of coaching and consulting resources, service provider or business education.

When I went to get my MBA, it wasn’t just with the intent of learning about business. I also went in with the secondary intent of understanding how adults learn. What I discovered was that whether you’re a sixth grader or an adult professional, you learn pretty much the same way. Everybody learns from doing things. That really was the crux of the idea: Presenting business education for dentists, but in a way that they never experienced it before.

What ignited the spark for you to start the Dental Business Institute venture?

The idea itself was inspired by Stanley Bergman our CEO, who often talks to our sales force about “intrepreneurism rather than entrepreneurism.” Intrepreneurism focuses on working within a company and coming up with creative ideas to help our customers or our business. So it’s within that spirit and that we have the opportunity to create something that would help our dentists in a new meaningful way was a business education achievement. That was definitely the start.

In the beginning, what was your mission for the Institute?

Our goal with the whole program, and the goal for me personally, are for the doctor to recognize that he/she is a small business owner. Their job is to manage and build that business into something that is amazing. Their small business is selling a product and that product is oral health.

What is the teaching strategy at the Institute?

At the Henry Schein Dental Business Institute, we really believe that participant doctors working together on ideas will learn that much better. When we give them a concept, they have to play with it. Quite literally they play with these ideas, because business ideas and challenges are presented every day in their practice, and it’s about how they handle these ideas, isn’t it? We have Legos in the middle of the table, and there is a box of toys to help provoke thought and action.

This approach to learning challenges the orthodoxy of traditional business education. And that is our goal. People are set up in pods rather than in rows, because they work in teams. We are teaching people how to work collaboratively and effectively. That only works when you can see your partner and you are working in conjunction with each other.

What are the essentials that make up your educational process for the Institute?

I use a scientific method, because I was a science teacher. With science you have to always be curious. Ask yourself the following questions. If you are not looking for the answer to the problem, why are you here?  What are you really seeking to accomplish?  Scientific method is the first part of a sixth grade education. It is the first time that a student starts to understand the process to develop their own curiosity. Of course kids are always curious. But if we reinforce the scientific method in a classroom environment for professionals, and peel back all of the layers of junk they have accumulated over time, so that they can just go back into learning mode, and learn what they want to learn, rather than subscribe to a process or philosophy, the education is theirs. Like I said before, they are brilliant instructors, they will learn more from each other because they are experiencing and experimenting and asking questions and being curious about what’s working and what’s not working.

How would you refine this system and how would you do this differently?   

A doctor states, “I’m ready to hire a new associate… how do you think I should pay them?  We can stand at the front of the room and say you should do it this way, and you should cross this “T”, and you should dot that “I”, and here’s my philosophy. No doctor, here’s a list of 10 different things you should consider. However, at the end of the day, it’s your decision to make. You need to understand what would be the outcome of every one of those decisions. That’s the purpose of the simulation, is to understand what happens when, where and how. Along the way if I am setting goals, what is the next point that I need to cross in order to take the next endeavor?  Is there another practice? Is there another doctor? Is there a revenue number? Is it a patient count? Is it I’m booked out so many weeks? It’s a different number for different people. And it’s a different metric for different scenarios, and it’s in the eye of the beholder. What we are trying to teach them, is that there is the framework, here’s the process, rather than, we want you to do dentistry this way.

What is the basic structure of the program?

During the first two days of class, which are always Thursday and Friday, there’s a little bit of lecture and then additional activities related to the session theme. In the first class for example, the planning class, we have a workshop on building a mission and purpose statements. Then we do communications training to teach them about how to communicate that mission and purpose. The next day we cover the business plan with an Academy Of Dental Certified Public Accountants (ADCPA) member who coaches them.

On the third day, we have marketing experts come in and talk to them about marketing plans and how that fits in the overall business plan. But at the very last day of every session, always on a Saturday, we do a full day of computer-based business simulation.

During the first session they have a competitive business simulation to create and refine the best, most optimal, practice. They make over 140 decisions as a team, over the course of several years in simulation. They determine insurance participation and fee schedules, the number of employees, payroll and marketing. Simulation is an invaluable component of the program, so they can return home and implement what they have learned. I know it’s exhaustive, but they received a complete understanding how a business operates.

During the subsequent time period between sessions, I have a one-on-one, one-hour meeting with each one of the participants to touch base and make sure they are following up with what they learned at the Institute and connecting the material to their real-world practice. Incidentally, the positive feedback from attendees has been incredible.

What topics do you tackle in the classes?

In the second class, we discuss building a physical building. We talk about four elements of infrastructure: Brick and mortar, technology, money and people. The most important of these is the people. So when we talk about metrics and building, it again is a matter of weight points. When we are connecting the dots with the plan, and on an individual basis, you might say that you wanted to accomplish this in this time period, with this amount of resources and this amount of patient and this amount staff. But how are we getting there?  And when we get there, then what? 

The building concept is more centered around, “So, we have created the plan and we crossed the threshold. Now what?” The metrics here are, how do we buy a practice or should we build a practice from scratch?  The metrics become, again on a financial trajectory, where do I see cash flow generated in that expansion? 

In the third class we talk about HR and leadership. These are different to quantify, but from an HR perspective, it’s more of a yes/no, do you have HR or not? Do you document? Do you have a paper trail? Are the people compliant? Do you know if it’s legal or not for them to prescribe, diagnose, deliver, etc.?

On the leadership, it is very intangible and unquantifiable. I would argue unquantifiable metrics is about whether people are happy? There are tons of examples across the country of different companies that put people at the center: Southwest airlines and Disney are great examples For Ritz Carlton, it’s all about the people. When the people that work for you are happy, they inevitably carry that on to the customer experience they create. What do they say about California cows? When they are happier they produce more milk?

In the fourth session, we talk about lean management. This subject is very quantifiable because now we are measuring the efficiency of the systems, and success is always measured by the doctor. If the practice’s goal is to be efficient to a certain capacity, or certain ratio, then we need to refine that system to make that possible. We are here to give guidance on the process. It’s less about a number and more about a step and a sequence. Valuing the system, measuring the system, creating control, improving the system and eliminating waste. We also then teach about negotiation.

 In negotiation training we teach that when you’re in negotiation, you should always be thinking in the back of your mind, “what’s the alternative?” If I am negotiating with a bank for a deal to fund another practice, I should have in mind what the going rate is at another location. Or if it’s not about necessarily getting a loan, but it’s about bringing on an employee or expanding the build out space in my lease, having that best alternative to negotiating agreement in the back of your mind.

What happens at the end of each session?

At the end of every session, they do a business simulation to develop their thoughts on where they think they are, and a roadmap to where they want to go from a business perspective. The business simulations are conducted with help from our program partner, Simulation Studios. During the simulations, attendees apply what they have learned in three steps. First, they take the scenario and make it bigger by asking themselves, "Who am I going to employ?," "how will I attract and retain patients?" and "what investments will I make?"

Second, they ask themselves, "Which practices will I consider adding to my portfolio?" and "how will I develop the infrastructure?" The third simulation is all about delegation and leadership. Here they are asked, "how can you expand, yet stay true to the original mission once you have added more practices?" This is an important step in the process as they are taught how to delegate without giving up the business model.

Be sure to watch for part two of this series to learn even more about the opportunities provided at Henry Schein Dental Business Institute. 

About Eric Nuss

Eric Nuss leads the Business Solutions Department at Henry Schein Dental. He developed and leads an educational program for dentists, the Dental Business Institute, for the entrepreneurial dentist. Eric has a degree in Education and an MBA in Business, in addition to almost 15 years of industry experience in leadership, sales and education. Prior to his current position, he was the regional manager with sales and operations responsibility in Iowa, Nebraska and South Dakota.

About Dr. Hugh Doherty

Dr. Hugh Doherty is a Certified Financial Planner, national speaker, author and business and financial coach to the dental profession. He is the founder and CEO of Business of Dental Practice LLC, a company dedicated to coaching only dentists to develop and implement cutting edge business strategies. His varied background in the field of dentistry, years of research and study at Harvard University Graduate School of Business and the College of Financial Planning, make him uniquely qualified to educate in all aspects of the business and financial world. He can be contacted by email at hughdohertydds@comcast.net.