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It’s Your Economy by Joan Garbo

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The conversation in the public domain is awash with “the economy,” and there are only smatterings of good news amidst the doom and gloom. It’s understandable that people can get caught up in the negativity and start to believe they are next to succumb to the recession. And I am here to warn you to be careful what you buy into!

You don’t have to look far to find out our country is in a recession; however, orthodontists in particular, are not as affected as other industries. For instance, the AAO Bulletin reported that national statistics for 2010 reflected a four percent increase in case starts per member from statistics in 2008. In addition, there are many doctors reporting that 2011 showed a continued growth in their practices. Yet there are others who experienced a decline. The important question to ask is what differentiates those in growth from those in decline. Is it really the economy or is it how one responds to the conversation about the economy?

If it were true that the economy of a region is the source of decline in a practice, then it would follow that every practice in the region would be in decline. Yet, there are practices that thrive in the same region.

As motivational speaker W. Mitchell asserts: “It’s not what happens to you but what you do about it that counts!” How one responds to any circumstance is dependent on one’s interpretation of the circumstance. If you believe new patients are scarce there will not be enough new patients walking in the door, and rather than attending who is in the practice, you will notice who broke or changed an appointment!

When you are focused on the big picture, the day-to-day circumstances are put in a different perspective. The Big Picture was exquisitely expressed by the late Dr. Robert Ricketts (1920-2003):

Orthodontics may seem small and in the total scheme of things may appear insignificant; but we perform a unique function for humankind. We contribute to people’s comfort, to their happiness and to their sense of wellbeing. We touch the very heart of modern culture, for people are gregarious animals; they cluster together for security in groups for stimulation with all their fellows; their faces, eyes, mouths and teeth help them to relate to and communicate with others and, more important, to establish their own identities. This, in turn, leads to happiness, to love, and to a sense of accomplishment and purpose, which in the final analysis, is the very essence of our existence. Good orthodontics is a contribution to the welfare of another human being. It has an element of immortality. Its spirit is good and its purpose just.

When you lose sight of the vision of the practice and start focusing on the numbers, you risk moving into a survival management mode. Most successful and growthoriented practices have clearly articulated vision and mission statements and stay focused on their core values regardless of what the economy is doing. When a practice’s primary purpose is to make money, it risks being at the effect of the economy rather than being responsive to it. Of course you must attend to the money the practice generates if you want to stay in business, but think of it this way: you have to have gas for your car to run, but you don’t buy a car in order to put gas in the tank!

To illustrate this, consider that every practice has fluctuations in its production and collection figures. A practice that is oriented around these statistics will generate mood swings in the doctor and staff. When results are high, everyone is happy; when results are down, the doctor and staff go into a survival mode and tend to forget about the patients who are there and worry more about the patients who are not coming in. The sense of appreciation and gratitude for the patients who are in the practice, and for each other, is depleted. Stress goes up, tensions rise, tempers flare, gossip runs rampant and fault-finding and defensive responses become the basis for corrective conversations.

Dr. Ray McLendon of Kingwood, Texas, a suburb of Houston, opened his first practice in 1983 just in time for the Texas economy to crash, starting what would become a national recession. It was estimated that people were leaving Houston at the rate of more than 5,000 per month. Despite the fact that other practices and businesses were downsizing, within 18 months Ray’s practice had grown to a $500,000-a-year practice. When asked why he was so successful while others were struggling just to keep afloat, his answer was, “I choose not to participate in the recession.” He also attributed his success to never taking his eye off the ball (i.e. his vision) and his “attitude of gratitude.” He said, “When you have nothing, you’re grateful for whatever you get.” Thus, any patient who came in was warmly received, and was given the highest level of service. Every patient who enrolled in treatment was a validation of the vision becoming manifest. The patients also became an energetic volunteer sales force for the practice! Those doctors and business owners who were distracted by and enrolled in the failing economy stopped doing what works, i.e., creating an upbeat, fun-to-be-in practice that focuses on service to the patients. Other practices also failed to have value-based enrollment conversations with potential patients. Remember that it is not what you say that counts, but what is heard!

Case in point: a treatment coordinator, who will remain anonymous, was having personal financial problems and was deeply in debt. Struggling to make ends meet at home, she viewed her co-workers and doctor with envy, since they seemed to be financially fit. (Whether they were fiscally sound is not important; that she believed they were is the point.) She was relieved that her children were too young and didn’t need orthodontic treatment because she wouldn’t be able to pay for it, even with the employee discount. She also thought the doctor charged too much for braces. Her case acceptance was 50 percent in a good month. So while she followed the script something was off in her attitude and conveyance of the information, and patients went elsewhere for treatment. Essentially her attention was on her own survival and trying to get the numbers up, rather than on listening to and serving the needs of the prospects. When a patient did sign up for treatment, her joy was shortlived, knowing that “one is not enough.”

Now imagine the impact on the practice when the doctor is in a survival mode! Whether the doctor believes it, feels it or declares it, he/she is the leader! The old axiom applies: how goes the leader, so go the followers. Without a clearly articulated vision that is backed up with effective and consistent actions, the practice will be subject to the fluctuations of changing circumstances.

The vision operates like a lighthouse in a storm whose beacon leads ships to safe harbor. The circumstances still have to be dealt with, but the vision will strongly influence the actions that will be taken and will color the interpretation of those circumstances. Clarity of purpose and vision is what keeps the doctor centered and grounded in times of economic swings, when life throws a curve, when staff problems arise, when dealing with difficult patients. As many a coach has told their players “keep your eye on the ball!”

Here are some suggestions for things you can do to support you in staying focused:
  • Have a flip chart available and at every morning huddle have staff members write down one thing for which they are grateful. No duplications allowed for the week! So once someone writes down “family,” no one else can use that. Keep expanding everyone’s view of abundance.
  • Make a list of the core values of the practice that are embodied in the mission statement. Assign a color to each value (e.g., purple for integrity, red of excellence, green for compassion, etc.). Each week, pick a value to focus on and have team members, including the doctor wear a ribbon of that value’s color on their uniform. At the end of the week, have the team choose which teammate was a “demonstration in action” of that value.
  • At the end of the day clearing meeting, have each person acknowledge a “win” for the day, such as new patients committing to treatment, a difficult patient becoming cooperative, staying on time, or anything that they can be proud of either about themselves or about another teammate’s achievement.
  • At different times of the year, have your office be a repository for canned foods, schools supplies, etc., to be donated to a local charity.
These are but a few actions you can take. Have a passion for prosperity for yourself and all those around you, and you will find your economy will be a shining example to follow for anyone stuck in the economy!
Author's Bio
As a consultant, executive coach and professional speaker, Joan Garbo has led more than 2,000 seminars and has trained hundreds of dental professionals in effective communication, customer service, team-building, leadership skills and other topics that enable individuals to live life more fully and accomplish their goals. To quote one of her fans: “Joan says what every doctor wants the staff to hear, and what every staff want the doctor to hear.”
Orthotown Magazine
September 2025
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