...hit the ground running Issue 1 / April 2013
Chris Barrow has been active as a consultant, trainer and coach to the UK dental profession for over 15 years.
Why dental businesses fail Business isn’t that complicated.
Dental businesses fail because: 1. there are not enough sales 2. the operating costs are too high 3. the owner’s drawings are too high
A new company is born….
Understanding social media
Winning when you are winning is bloody easy.
I’m worried that we are losing money on the work of our hygienist
Please allow me to introduce you to our new arrival. 7connections
how many people are you connected to? how many people are they connected to?
Letter From The Editor
hen did I start writing? Thinking back, it started as a result of two circumstances of my childhood:
being an only child - I always seem to have had plenty of time on my hands, during which I read profusely - books and comics (can anyone remember Illustrated Classics?) - and my preferred learning style at school - which (bizarrely perhaps) was to handwrite the contents of my text books and set them out in a certain format.
I realised later that I have a partially photographic memory and can remember facts by visualising the way they are set out on the page. So back in the 1960’s I was converting academic text into lists, bullet points and mind-maps (before any of us knew what they were). There was a challenge, however. My handwriting is awful - I wrote then and still write today in a minuscule spidery fashion that is so bad that I often cannot read it back (perhaps I should have been a medic?). So not only did I face the challenge of transcribing huge amounts of text - but also to do so in small block capitals, which became my favoured “font”, almost always with a good quality fountain pen (an early sign of my OCD with tidiness and smart technology). Hence, by my early teens, my second finger, right hand, sported a patch of hard skin that remains to this day, even though its a keyboard that has become the 21st century methodology.
During those teen years I have no recollection of “composing” anything original - I was just the modern-day equivalent of a medieval scribe, relentlessly copying religious scripture for distribution to the masses. It eventually worked, because after a disastrous year in which I fell off the rails and flunked all my “O” levels (I’ll tell you about 1968 another time), I did eventually leave school with 6 “O’s” and a decent job at £550 a year. That may not sound much to the graduates but the context is an evening meal with my parents, during which I announced my desire to attend Salford University to study maths (my top subject), greeted by an announcement from my mother (the boss) “don’t be so bloody stupid - go and get a job and bring some money into the house.” Thus are futures determined. So began 7 happy years in a Central Manchester office, commuting by bus twice a day (oh - how many books I read) and studying in the Manchester Local History Library most evenings, where my first wife worked as a librarian. I was acquiring a qualification to suit my job - Associate of the Chartered Insurance Institute - and that took me 5 years. Again, transcribing text books by hand, visualising the layout of the pages, taking and passing exams that were essay based.
I then moved, at age 24 (and beginning to suffer from vaulting ambition), from my comfortable desk job, to a sales rep’s position with the same firm, working in Derbyshire/Nottinghamshire and then, 2 years later, over to Blackburn as assistant to a consulting actuary, running a portfolio of self-administered pension plans. My first wife still worked Saturdays and so I had time on my hands (no kids) at the weekend. Time that was invested in my first attempts at distance running (here I am, training for my 17th marathon, over 30 years later) and time to continue to study (an Open University Science Foundation Course), as well as to begin journalling. Why journalling? I actually think I was lonely, missed the comforts of home and missed my roots in Manchester. So writing about how I was feeling and what was happening to me became a catharsis. I suspect that I was becoming my very own pen friend. The “bug” soon infected me and the journal entries became a daily, rather than weekly events. As far as I can recall, there were a series of “page a day” diaries that were dutifully completed most evenings (remember the days of 3 TV channels and no internet?) with a blow by blow record of events and some reflections.
Writing about how I was feeling and what was happening to me became a catharsis.
I have no idea where all those journals now are. My first wife and I separated in the early 80’s and when I drove away they stayed behind. Life can be ironic - my second wife recently sent through a box full of page a day diaries full of my scribbles from the 90’s, as we coparented 5 children and I won, lost and won again in business. I do seem to leave a trail.... To add to the “when did it start?” question, I now add “when did I start expressing an opinion to be read by others, rather than just record events?” I’m still journalling after a fashion - but its called Facebook and last September they announced that over 1 billion people are using the site every month to record what they do, where they go, who they meet, what they eat, drink, watch, listen to. Connecting with each other but (IMHO) really connecting with themselves. My first “opinions” came in the early 90’s when, as an independent financial advisor (IFA) I began to issue a monthly newsletter to my business-owner clients, giving my views on financial services but also beginning to observe and speculate on the habits of successful entrepreneurs. Take your mind back to 1993, an office in Cheadle Hulme (South Manchester) and yours truly typing a newsletter in Microsoft Word, printing off about 100 copies, printing labels and sticking stamps on envelopes to get the news out.
Here - it began - having an opinion and not being afraid to express it. Building an audience of clients and also prospects. Asking people who didn’t buy there and then, “would you have any objection to me including you on my mailing list for a regular newsletter?” The start of a journey that progressed from word-processing in 1993, to my first email newsletter around 1998, my first blog post in September 2004 and my first Facebook entry goodness knows when. I don’t consider myself as a writer - there are no novels inside me, bursting to get out. I do consider myself a journalist and a commentator. Contents 03 - Hygienists Pay 05 - Understanding Social Media 06 - Stuff 07 - A New Company Is Born 08 - Ownership – Really? 09 - Winning 10 - Journaling
seems to be about every 2 weeks now that I get a call from a Principal to say:
“I’m worried that we are losing money on the work of our hygienist – I’m paying her to sit on Facebook during the day – what should I say and do to avoid a war but mind the pennies?” I’ve realised that this “profit warning” is usually based on a hunch rather than any scientific analysis of cash flow – but even so, it is clear that pressure is mounting across the UK and Ireland as books get gappier and belts are tightened.
I’m paying her to sit on Facebook during the day.
A recent example demonstrates. Lets take the fictional case of John Smith of J S Dental and their hygienist Mary Jones. First things first – quantify the problem. An examination of the practice management software and management information systems revealed the following over the last 6 months:
• • • • • • • •
Mary is paid £32.50 an hour the patients pay £45.00 for a 30-minute appointment, some pay £97 for an hour (especially new patients) number of hours worked and paid for = 300 number of hours unbooked = 38 number of hours failed = 11
So John has called a meeting with Mary to “discuss the changes that need to be made to stop us losing all this money.” That meeting, of course, will go down with Mary and her nearest and dearest like a bacon butty at a Bar Mitzvah – especially when Mary reflects on the lovely house the Smiths live in, the lovely car they drive, the lovely school their kids go to and the lovely holidays they plan this year – oh – and the clinical courses John is attending, the dental doodads he will be buying at trade shows, the 50% he pays to his associate who rarely refers to Mary (and keeps a scaler in his surgery) and the nurses who tell Mary all the “secrets” in the staff room at lunchtime.
number of hours cancelled by patients = 30
= 26% of billable time paid for by the practice but not charged to patients
Over my 20 years in the business of dentistry, I reckon that a 10% overall FTA rate is acceptable just because “shit happens”. Wrong kind of weather, kids with poxes, pets pining, traffic jams – stuff.
Quite apart from the operating costs per surgery per day (which I have not included in this analysis), the mind-set of John Smith is:
Which John, of course, calculates to be a grand total of £2567.00 down the drain – or c.£5,000 in a full year.
What is a “normal” failure rate for a hygienist?
So, in actual fact, in the case of Mary I think we are dealing with a 16% problem and not a 26% problem.
so total “lost hours” = 79
“so I’m paying £32.50 an hour for 79 hours when Mary is either on social media or sat around doing nothing.”
16% of 300 hours = 48 hours @ £32.50 an hour = £1,560 in the period measured and c.£3,000 in a full year. Not much love in the room I suspect. So lets break this down a bit and see if we can come up with a strategy that might avoid deadly silences and “that look” that women give men.
So lets be clear that, until JS Dental are on their game, we are having a £3,000 conversation here with Mary. £3,000 is £3,000 but it probably means a lot more to Mary (c.£16,000 a year income) than it does to JS Dental.
written by Chris Barrow Point 2 If the book isn’t full – is it Mary’s fault? I would say there is an 80/20 here. 80% of the responsibility for attracting new patients, selling hygiene treatment and encouraging existing patients to attend rests with the practice. 20% is about Mary’s ability to communicate effectively the benefits of attendance and continued treatment, as well as spotting new business opportunities that she can refer to John. As an important aside, there is no excuse for the associate having a scaler in his room – it should be removed immediately. Point 3 Is Mary “on brand”? I always ask clients a few quick questions about hygienists (please change gender as appropriate):
• • • • • •
Point 5 The conversation.
Don’t expect your hygienist or any other team member to change, if you or any other team member will not.
do you love her? is she an ambassador for your brand? does she attend meetings and make a positive contribution? as far as is possible, does she avoid gossip and always support you?
If the answers above are “no” then I’m afraid that no amount of scientific calculation will help. If the answers above are “yes” then I will always want to work with John and Mary to broker a win:win.
What I like best about what you do around here is your attitude – you are a valued member of the team, the patients love you, we love you and we want you to be with us for a long time to come. We have a problem with lost billable hours at the moment and I’d like to go through the numbers with you and show you what effect that is having. SHARE NUMBERS
do the patients love her? do the staff love her?
“Mary, I’ve been analysing your contribution to the practice over the last 6 months – do I have permission to give you some feedback please?
Point 4 Are John and the JS Dental team on brand? None of this will work if there is a single member of the team who has a face like a slapped arse, who gossips, who bitches, moans and whines about everything all the time (associate included). Well poisoners have to go. These are the days of zero tolerance, of Genghis Khan leadership. Don’t expect your hygienist or any other team member to change, if you or any other team member will not change.
So you can see that, in a full year, the practice is losing about £3,000 in revenues because as a team we are not as tight as we could be. What I would like to ask is that you work with us over the next three months, to do everything we can to tighten our belts and get the attendance back to 90%. As a practice we will focus through our marketing and through our patient journey on making sure that every encouragement is given to patients to attend their hygiene appointments in a timely fashion. I would like you to be a part of that process. We plan to meet weekly to review cancellations and other FTA’s and decide in real time how we are going to improve. Can I ask for your support on that please? In three months, I sincerely hope that we will have closed that gap – if not, we may have to review your hours or the basis of your pay – but I genuinely want that to be a last resort, so lets pull together and work up a much better solution for us all.”
Understanding Social Media
written by Chris Barrow
onnection is simple:
How many people are you connected to? How many people are they connected to? Its about degrees of separation. If we believe that the average number of Facebook friends is 150, then:
• • • • •
you are connected to 150 people through them you connect to 22,500 people who connect you to 3,375,000 people who connect you to 506 Million people who connect you to 7.6 Billion people
So social media has created 4 degrees of separation between you and every human on Earth.
Content without connection is talking to yourself. The places you express your big idea are
your web site – a 4-minute movie trailer that convinces people to see the main feature
The places you describe what you are doing/ seeing are:
• Facebook • Twitter • Linkedin • Google+ • Pinterest/Instagram • You Tube • Foursquare
Step 1 – What am I thinking at this time?
• • • • •
It is necessary to have an opinion – for your clients/patients to know:
Here – you imagine, express and evolve your beliefs.
what you believe and
You are a thought leader.
how your belief differs from your competition
Step 2 – What am I doing and seeing today?
Content There are two ways in which the content that you create is distributed to your audience.
In the “noise” of the connected world – your opinion must be Bold, Outrageous and Provocative (BOP) for you to engender a response. Your opinion must be relevant – there is no point in having an opinion about Betamax video players or the virtues of amalgam fillings.
your printed or virtual newsletters your public speaking your articles in magazines your broadcasts/podcasts your webinars, video blogs and streaming tutorials
Although people might “get” your big idea – they still need guidance in understanding how it applies in the world and how it applies to them.
and other social media channels. Here, you tell today’s stories:
• • •
I had a thought today about my belief I did this today, congruent with my belief I witnessed this today, which proves my belief This is happening today because of my belief I heard about somebody else’s story today which is an example of my belief
The application of connection and content All effective social media has two essential elements:
This is where your belief becomes a parable.
Try 3D television or Cad-Cam dentistry.
A story of how your belief made you or someone else perform and behave in a certain way.
Your opinion has to move the debate forward. It must call for action. It has to motivate your audience do something.
The simplicity of content creation here is that EVERY event is a metaphor that can be used to demonstrate your belief.
Connection without content is trivia, Content without connection is talking to yourself.
written by Chris Barrow
a day when I’m looking at a load of “stuff” I need to get done.
There is always “stuff”. It is a symptom of 21st Century life. I used to read 36 books a year – then along came the internet and now I read 12 if I’m lucky. I used to dictate into a tape or digital recorder – then along came the internet and now I type. I used to finish work on weekday evenings and at weekend – and do other things, like raise a family, play sport, watch TV, read books – then along came the internet and I’m “connected” 7 days a week. A few years ago we took our first sailing holiday in the British Virgin Islands and spent 10 days on a catamaran, away from the “stuff”. Now the charter crews dock in a paradise bay at 16:00 each day, the crews pile into the dinghies and head for a beach bar run by a Rastafarian, because he has wifi and they can check “stuff” on their iPads. We used to leave our “stuff” at work – on the desk, in a drawer, in the office. Now we carry our “stuff” everywhere we go – we check “stuff”
• • • • • • •
before the movie starts before the game whilst we are queueing on trains, boats and planes between patients between children at either end of the sofa
Will we look back at all the “stuff” we got done? In the last three months:
• • • •
how many times did you check your “stuff” how many times did you take a long walk with a close friend and just talk? how many times did you make love? how many times did you just stop?
The “stuff” will never end – but we will. When we do face our end – will we look back at all the “stuff” we got done? All the check ins we made, posts we read, follows? Or will we reflect on the moments of pause – when we connected with each other and not with the “stuff”?
A New Company Is Born
written by Chris Barrow
lease allow me to introduce you to our new arrival.
7connections - passionate about business.
www.7connections.com We are 7 passionate people: Chris Barrow Tim Thackrah Tim Caudrelier Nikki Berryman
Passionate about 7 core values for our company:
Jon Barrow Phillippa Goodwin Passionate about 7 areas of business: strategic planning finances branding and marketing the patient experience
the ability to show others that you care about them through kindness, generosity, sharing and compassion. COURAGE the attitude or response of facing and dealing with anything recognized as dangerous, difficult, or painful, instead of withdrawing from it.
treatment co-ordination and presentation
operations and compliance
Passionate about 7 methods of delivery:
the willingness to be truthful and sincere without deceiving or misleading others or withholding important information in relationships of trust.
the ability to stand up for your own beliefs about right and wrong and show commitment, courage, and self-discipline in everyday interactions.
mentoring partnership Passionate about delivering 7 results for you: an enthralling vision a clear plan a commitment to core values agreed goals time-activated tasks realistic deadlines a finish line 07
the ability to think before you act, giving consideration to the possible consequences of your interactions as well as exercising selfcontrol and self-discipline. LOYALTY the willingness to stand by and support your team without talking behind people’s backs, spreading rumors, or engaging in gossip. FAIRNESS the ability to treat all people alike without prejudgment and to make decisions only on appropriate considerations.
We have much to do A brand to agree upon (nearly there). A web site and social media platform to build (first meeting today). A marketing plan to construct (in progress). Systems to build for ourselves and our clients. All 7 of us want to express our appreciation to the clients who have already promised to take this journey with us – without you we could not have come so far, so quickly – thank you – it will never be forgotten. You are going to hear more and more from us as we evolve and grow this “tribe with a cause”. We begin as a consultancy business – but our vision is to become equity partners in our clients’ businesses – and to be a “dragon’s den” in UK dentistry for those with great ideas and good plans. Today is our first day – thank you for the ground-swell of support in the last three weeks that has given us the passion and confidence to make this happen. www.7connections.com
Ownership – Really?
written by Chris Barrow
he fact of the matter is that business ownership is a pain in the neck.
It must be – the evidence is irrefutable. What evidence? Your evidence.
Do you have confidence about the value of your business?
I’ve had the good fortune to work with the owners of many “Champions League” as well as “Premier League” dental practices over 20+ years. You have one thing in common. You NEVER stop complaining about:
• • • • • • • • •
other people’s performance and behaviour – suppliers, team, associates, partners, patients – even consultants! making a living but not an abundance not enough new patients not selling enough of the right products, services and procedures lack of initiative from your team poor work/life balance lack of a clear strategy/direction /exit route bouncing up against a glass ceiling simply struggling to make ends meet and hold it all together
Your complaining has been consistent. So why do you bother? Because you want:
• • •
Question: “how much of those three benefits do you have right now?”
• • •
are other people/organisations telling you what to do? are you earning what you think you are worth? do you have a clear exit route and confidence about the value of your business?
Coaching is NOT about removing the things, situations and people that you complain about – I’ve tried for 20 years without success. Coaching is about making it all worth your while because you DO have freedom, you ARE earning what you think you are worth and you do HAVE a clear exit route and a business value that will be attractive enough for you to sell and for someone else to buy. Settle for anything less and I’m afraid you are letting yourself and your family down – and you need a coach.
freedom – nobody able to tell you what to do the ability to earn what you think you are worth to build a goodwill value that can be sold at some future date
written by Chris Barrow
inning when you are winning is bloody easy.
Its winning when you are losing that requires special character and fortitude. I wonder whether, like me, there have been times in your life where you felt you were on a losing streak? Times when, no matter how hard you try to make something (or someone) better – it (or they) just keeps on getting worse? There have been times in my life when I have genuinely wondered whether I have been called by some Superior Being to suffer setbacks, misfortunes and let-downs – hardened in the fire of experience – SO THAT I CAN THEN BE OF MORE USE TO THOSE I SERVE? Since the 90′s, I have regarded consultancy, coaching and mentoring as a CALLING and not as a career. OK – I may have been “called to serve” by my mortgage company, my kid’s schools or my love of great holidays – and not by The Many-Breasted Paleo Goddess of Human Endeavour – but, let’s face it – I could have made a living doing some easier stuff than this. It is somewhat similar with marathons. I have long held the view that some 6 stone bloke running like buggery for 2 hours 10 minutes because he lived his whole life at 2,000 metres and grew up on macronutrients – is no big deal.
These guys run 20k in the morning, 10k in the afternoon and spend the rest of the day doing nothing – I wish… The real winners medal at a marathon should go to the person who finished last – in 7 hours, after the worse day of their life to date, on top of holding down a 50-hour a week job and/or raising a family – but who kept on staggering around the course because they were raising money for a worthy cause. I’d love to see just one emaciated elite professional runner attempt London dressed as a rhino or in full Royal Marine combat gear. The winners in my world are the people who are carrying the weight of the world on their shoulders – but who still get up when that alarm clock calls, get dressed, get on stage and, as the curtains rise, the band strikes up and the lights blaze, whisper “its showtime” to themselves – and do it all over again.
written by Chris Barrow
sometimes asked how long I’ve been journaling?
The answer is way back in the mid-1970′s when I lived and worked in East Lancashire and invested many weekend and weekday hours in writing thoughts down, especially as my first wife worked at weekends and I found myself with lots of spare time on a Saturday. The habit continued throughout my adult life and, recently, some of my journals from the early 90′s came to light during a property move. Looking back, I wonder how I found the time – but nowadays I’m still journaling – except its called social media and I type rather than hand-write. That’s just as well as my hand-writing to this day is indecipherable and you might notice from the photo that even in 1990 I was laboriously writing in block capitals – thank goodness for the keyboard.
Its a funny old world – we are fascinated by each other.
Journaling is cathartic – a release for tensions, worries and stress. Journaling is a way to connect with yourself and “check in” that you are OK. Journaling is a way to evolve ideas. When journaling becomes social media it changes – perhaps there are some subjects that are taboo – or too personal to share. My experience has been that the social media audience are often far more interested in the writer than the subject. When I blog about business – I attract readers and comments. When I blog about my life – the number of readers and comments peaks. Its a funny old world – we are fascinated by each other.
With thanks to: Matt Cox - Graphic Design firstname.lastname@example.org Photography: 3 Flickr
4 Flickr 5 Anna Tesar - Flickr 6 Phantom Menace - Flickr
7 David Diode - Flickr
8 Gnuru - Flickr 9 Oh-Barcelona.com - Flickr 10 Macitioner - Flickr
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