Congratulations. You have put in your time as a student, as an almost volunteer in that low-pay, no perks, no frills job at the clinic, and as a lowly associate in somebody else’s office. Now you have joined the big leagues – your first solo practice. It wasn’t easy and it wasn’t always fun, but the months of searching for the ideal location, demographics, patient flow, and facility have finally paid off. Even your accountant is happy.
Having cleared the search hurdle, it is time to take a long hard look at what you need to do to make it all gel. Old Dr. Brown’s decision to retire was the best thing that ever happened to you because it provided you with an opportunity. But old Dr. Brown’s decision to retire has also placed an awesome burden on your shoulders and the sooner you recognize that the independence you have acquired comes with a price, the better.
Consider where you stand. Dr. Brown’s healthy and lucrative practice did not materialize overnight. It took years of hard work and excellent dentistry for him to establish that wonderful patient flow. Taking over his practice is no guarantee that Dr. Brown’s loyal and happy patients will be loyal and happy with you. Loyalty is earned and happy patients must be wooed. The courting process should begin as soon as possible, preferably before you hang your shingle on the gate or nail you nameplate to the door.
The first thing you must remember is that your predecessor, respected and well-liked, is going to be missed by many of his patients. You will not fill his shoes, but there are many things that you can do that will make your own shoes more comfortable. The best place to begin is with Dr. Brown himself.
Assuming you and the good Dr. Brown are on good terms, you should take advantage of all the assistance that he is willing to give you. If at all possible, become a visible presence in his practice before he disappears to go fishing in the Florida Keys. Patients who see you working with him will see two colleagues working together for their benefit. They will accept the transition far more readily than if you are a totally unknown entity who suddenly appears out of the blue. An open house for patients, hosted by Dr. Brown for the purpose of announcing his retirement and introducing you, is also a good idea. Meeting you at a social event rather than chairside may make them less apprehensive when they do show up for that first appointment because it allows them to meet a person, not a dentist.
While “joint appearances” are an excellent way to meet the patients you will inherit, they are not always feasible. In olden days, before telephones and faxes and email, no self-respecting person could or would present himself to polite company without a formal and complimentary letter of introduction from a respected patron or mutual acquaintance. This custom made entry into a town or a group or an association or a community easy and painless. If the writer was known and trusted, the newcomer presenting such credentials was assured a welcome. It may seem old-fashioned to resurrect this custom, but the concept is sound and the results may
Dr. Brown, the respected and trusted dentist, writes to all of his patients to inform them of his
impending retirement. In the letter, he introduces the person who will be taking over the
practice once he retires. He provides a little biographical information about you, a little praise
for your professional and academic achievements, and a request to his loyal patients to make
you feel welcome. Because the source of the letter is well known, well liked and trusted, you
are no longer a total stranger. You can be trusted because you have entered the community of
patients with the proper credentials.
Such a letter, worth its weight in gold, needs to be followed with a letter from you as soon as
you have settled into the practice long enough to get your own letterhead and business cards.
The letter should be personable, but not pleading. It should begin with your recognition of Dr.
Brown’s importance to his patients, your respect for him as a professional and your
appreciation of his trust in you. Do not promise to be Dr. Brown. Promise instead that you
will continue his tradition of excellent dentistry. Do not welcome the patients to your practice
with an apology. Welcome them with optimism and enthusiasm and with a positive attitude
that says you are eager to work with them.
Once you have officially opened the door to your practice, recognize that every patient is a
new patient, even if most of them have come to the same address for many years. Be aware
that your presence here makes it a new practice for them. The proper protocol for introducing
yourself to them must be in place. Every patient who comes for an appointment should be
presented with a practice portfolio. It should include a page outlining your philosophy of
practice and a friendly welcome letter. It should also include a biographical sketch outlining
your education, experience, published work, research activities, and professional
organizations with which you are affiliated. Make the biographical information friendlier by
providing some personal information about yourself – something about your family or about
your non-dental hobbies or activities.
One of the things you need to look at very carefully is staffing issues. Hiring and firing the
day you begin life in your new practice is not recommended. You will have enough on your
hands without having to go through the grueling process of interviewing potential assistants,
receptionists, and hygienists. A trial period of three months should let everyone know whether
you can work with these team members comfortable or if there are insurmountable
incompatibilities. At that point you will be in a better position to decide whether you need
replacements or substitutions.
Especially during the first few weeks, you may find the staff members you inherited a useful
source of information about patients, suppliers, and a host of other variables. Treat them with
respect and be willing to listen to their recommendations. Be careful not to give in to the
temptation of allowing them to mold you into the image and likeness of Dr. Brown. Assert
yourself and your identity. Do this politely, but firmly.
Review very carefully the staff’s input on how they view recare, treatment plans, scheduling,
collections, and the hygiene department. Listen well. Think back on your previous experience
as an associate in other practices. Which policies and plans for productivity and profitability
did you admire or approve of? What fresh, new and unique ideas do you have? Decide what
you want changed and what should remain in place. Decide how you will implement the
changes and how soon. Let the staff know as they will be playing an important role in making
your proposed changes a reality.
One of the things you should do immediately is review your predecessor’s office manual.
Read it thoroughly and determine whether it reflects your practice philosophy, your business
plan, your ideas about productivity and profitability, and your vision of the direction you want
your practice to take. Keep what is good and replace those sections that do not conform to
your vision and your goals. Set new rules because they are good rules, not because doing this
will make feel like a boss. Change things because they need changing, not because you want
to make it clear that you are the new authority figure. Make the manual a top priority. It
should be printed and distributed as quickly as possible.
Changes to the facility should be made in the same spirit. Make changes that will enhance the
appearance of your practice and changes that will make it a more comfortable and safer place
A final word of advice is to enjoy being the master of your own house. The process of making
the practice what you want it to be may take you on some bumpy rides through unfamiliar
territory. Now and again, you may be waylaid by the occasional bandit hiding in the bushes.
Now and again, you will ask yourself what possessed you to think you could make it solo.
That is the time to remind yourself that you took the risk for a reason and that you had the
confidence to try. And that alone should give you the courage to vanquish the bandits and go
for the gold.
©Cindy McKane-Wagester, RDH, MBA