Are orthodontic education and
licensure ripe for disruption?
Fig. 1: The words “Speedee Service System” appeared on McDonald’s signs for years.
“It’s the system!”
Where have you heard that before? If you’re a baby boomer or younger, the ubiquitous proclamation was a part of the golden arches (Fig. 1) for years. We probably never even noticed—but then again, that’s the idea!—that at the time it was called the Speedee Service System. Right up there with how many million hamburgers had been sold was posted a reminder that the entire reason for Micky D’s existence was the underlying system that made it all possible.
They did away with the system reference years ago, but any student of business or franchising understands that McDonald’s was probably one of the first mass systems recognizable throughout the country.
Michael Gerber makes constant reference to Ray Kroc, McDonald’s and systems in many of his E-Myth business books. As the keynote speaker at an Orthodontist as CEO conference sponsored by the AAO several years ago, Gerber closed his talk by encouraging the orthodontists present to “change the world of orthodontics.” I’m sure we agree that a few in attendance, and some outside of the field, have taken note! (Gerber’s lectures and motivational speeches are online to a limited degree and worth a look.)
A system, which is an organized scheme or method, is the basis for Gerber’s business— which, by the way, is established to develop small businesses into larger ones.
Checking off the boxes
During a recent CE trip to Miami, I had the opportunity to stay at a luxury Marriott resort. When I entered the lobby, I was presented with a sleek, upscale reception desk. Upon check-in, I couldn’t help but notice a list on an old-fashioned clipboard (Fig. 2) sitting next to the keyboard and mouse. I inquired about it and, lo and behold, it was a very basic checklist of tasks and duties to be performed by the front staff. My local bank uses a similar system: On paper and a clipboard, also sitting right in front of the safety deposit boxes, was a checklist outlining duties for the local branch office.
Marriott hotels and Chase Bank have achieved world-class stature and are known for their impeccable attention to detail, and on these checklists were trivial, seemingly mundane and easily repeatable duties such as “unlock this and that room” and “turn on the computers.” The lists weren’t digital—there was no pad or monitor. That’s not to say that they’re not recorded, scanned or updated in the cloud, but the implementation of these lists is done the old-fashioned way: paper and pen (or pencil).
Performing in that manner allows for:
• Ease from which to check.
• Review at a glance of the progress.
• The ability to add and subtract items in an easy manner.
These systems may be easy to talk about, but putting them into place can be a different story. Arguments against such systems or routines can be plentiful, starting with the most common: “Our office is too small for big corporate systems, and everyone already knows what they have to do.” Another frequent opposition expressed is that of time or lack of staff.
My argument against these challenges is that organization is what allows a person or practice to increase or improve, and that not adopting organizational systems forces you to stay small. Your staff will have more time if they’re working in a coordinated fashion, seamlessly, quietly and without distraction, focusing on their duties and patients.
Provide training—and references
An additional doctor and office have recently been added to my “semi-retirement practice.” Nothing exposes your weaknesses like new staff, new doctors or new office locations; I’ve been exposed on all three, and am paying the price for not having my game on to the letter in the list, script and procedure department.
They say, “Hire the personality and then train the skill!” But when you opt for personality and there’s no training manual, procedure or expectations written down, you run the risk of losing the personality for lack of fulfillment, structure or meeting the employees’ expectations.
One of my children, a millennial, has a hospitality management degree. Out of college he was hired by a local restaurant chain where he was exposed to hiring, firing, overhead and procedures. (Sounds like a dental office!) Needing to expand his horizons, and with an opportunity to move to the West Coast, he landed a job with one of the country’s premier restaurant groups—after several interviews with the corporate office, personality tests and background checks. (Should we be doing this also?) He was placed in sunny California managing a restaurant that had plans to expand across the United States. This large corporation had purchased what was then a local chain, the Yard House, after evaluating its business plan, model and success. They paid handsomely!
Everything was systematized: The playlist for music on a rotating basis, the menu, how the servers approached the customer … all were specifically written down and in an online training manual. There were pictures of each menu item, showing the cooks, servers and managers how the food should be arranged on the plate for presentation to customers. Could we not do that for our drawers, tray setups and procedures?
My son has since returned to the Midwest, but in the same capacity. He now works for a different startup food group, but just like before his job is to enforce and implement systems that have been put into place to help grow the group into a chain that—you guessed it—can be sold to a larger group. (See a pattern here!)
Make systems—and enforce them
Without an enforcer or implementer, systems fail. This is the issue in my practice, and some of yours as well. None of us wants to start off the day on a “bad note,” criticizing mistakes from the previous day. Office managers need to maintain a healthy contact and relationship with the rest of the team, so, quite honestly, they have many other duties besides reviewing staff and lists.
My suggestion is that a compliance officer or position should be created and delegated to one of the trustworthy staff for their input on a daily, weekly and monthly basis in front of the team. When the other team members understand that compliance and implementation of the business systems is in the interest of everyone—get home on time!—they’ll embrace the challenge.
Just a suggestion as I continue to grow.?