Sustaining Momentum During Sleep Integration

Five Behaviors Can Keep Bad Habits From Reasserting Themselves

In recent years, dental practitioners in North America have begun realize that status quo earnings have placed the financial health of their practice at risk. Office staff have become restive, and the principals are pushing to set a new growth trajectories. The introduction of sleep medicine presents a logical and determined way to embark on what often proves to be a Herculean and seemingly successful effort to create business within the practice. In the average dental sleep practice, earnings before interest, taxes, depreciation, and amortization (EBITDA) often increase by more than $600k annually, significantly improving cash position of the depressed dental office.

The story can be a salutary one for any practice failing to embrace proper introduction and integration of any new treatment modality. But thankfully, on the face it, and by the grace of the sheer force of will, a successful sleep medicine integration will unleash the hidden potential of most general dentistries and almost always sends financial performance into a measurable upward trajectory.

However, due to the recent creation of model upon model, many tough and painful decisions must be made before most dental practices’ pull the trigger. There are a litany of “sleep consultants” offering success models that are little more than illusion. Selling and promoting use of impressive looking, high-tech equipment and providing “cash-reimbursed” diagnostic scenarios often place the dental professional in harms way. As a result, going into 2017 dental sleep medicine finds itself under close scrutiny by state, federal and private, third party insurance regulators, and charging cash will no longer protect dentists from the guidelines they are currently working to circumvent with these practice models.

Aside from operating outside of regulatory guidelines, many “sleep consultants” fail to recognize the important functions of sustaining a successful sleep medicine program, which may sound obvious—and the actions required straightforward. But they’re not. “Consultants” routinely neglect regulations with their “ways to get around guidelines” because, understandably, they’re obsessed by their short-term gains. But, equally important to operating within regulations, and key to sustaining a successful sleep medicine program is to embed an “execution engine" - replicable processes that fundamentally change performance rhythms and decision making in the practice - raising sights beyond the strategic choices and daily initiatives to change how the sleep practice functions.

Building this engine requires five distinct behaviors:

1. Take independent perspective.

Challenge everything! It can be exhausting, but a practice that can sustain change will never be satisfied with the status quo. Continually looking for fresh facts rather than accepting the status quo and constantly guard against falling back on negotiated targets that staff may accept easily.

2. View the practice like an investor.

This is not always a mind-set that is popular inside the dental practice, and should not bejust for the management team. Passive employees kill the dynamism of a practice. Employees in a successful practice sustain their ownership by constantly challenging colleagues, not just getting along. They refuse to settle back into a leisurely pace of decision making. And they pursue new sources of value.

3. Ensure ownership down the line.

During the integration phase, there is an inevitable tendency for management and outside advisers to set the targets. We suggest this model be resisted. Practices’ with large front and back office teams that own centrally imposed initiatives, embedded in budgets without buy-in from managers, are most at risk of falling back into their old ways.

4. Execute relentlessly.

As with the incorrect bonus program, it’s all too easy for dental practices’ to allow the pace to let up once the initial improvement targets are achieved. After all, it’s simpler to delegate. But when the practice managers go back to high-level target setting and avoid immersing themselves in the details—perhaps on the dubious pretext that they don’t want to micromanage—the red flags should begin to raise.

5. Address underlying mind-sets.

Inspired employees make all the difference in a practice and in our experience conspicuously outperform those imprisoned by traditional command-and-control culture. Managers should not just challenge; they must instill meaning…recognize extra effort. And they should not assume that employees necessarily understand why the practice has to operate in a different way in the future.

Sleep practices’ that sustain integration continue to bring these five disciplines to their monthly operating meetings, to their annual budget discussions, and to their everyday management routines.

Sleep medicine success, they realize, ultimately is not about the scoreboard and whether the practice can deliver 20 or 20 appliances at the end of the month. It is whether the integration has ingrained a repeatable, replicable process that will drive better and better results long after integration is over.

Thinking about sleep medicine #weshouldtalk