People don’t buy what you do. They buy WHY you do it.

Dr. Halligan

Dr. Halligan

Oddly enough it was the collapse of a tree—or rather, a couple of trees—during the Farmer’s Insurance Open PGA tournament held at Torrey Pines this year that started me thinking about strategies that are commonly applied to practice growth.


The eucalyptus tree is one of the fastest growing trees in the world. But the height and girth of the big tree often outstrips the development of a firm foundation, its root structure.


The fastest growing tree in the world may be the first to fall during a decent rain storm.


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A couple of eucalyptus trees fell during a PGA tournament at Torrey Pines Golf course.

A couple of eucalyptus trees that fell during a PGA tournament at Torrey Pines Golf course. The biggest one shown here next to the leaderboard.

The biggest one is shown here next to the leaderboard.

This one landed on a car that was owned by one of the golfers in the tourney. Yep, that's a Bentley.

This one landed on a car that was owned by one of the golfers in the tourney.

The ancient bristle cone pine in contrast, lays down it’s rings slowly and certainly; its roots form a widespread foundation for growth in the harsh climate of the White Mountains on the east side of California’s Owens Valley.


These trees are the oldest living things on earth. They were already ancient when the Pharaohs ruled Egypt.  The ring structure is so tightly formed that dendochronologists, those who make a study of tree rings, look at the cross sections of bristle cone pine samples under a microscope. The roots of the bristle cone pine form a wide and solid foundation. And nothing gets to the bristle cone, not burrowing insects nor bitter ice and snow storms or summer heat and drought. There are living trees in the White Mountains that are nearly 5,000 years old.


This bristlecone pine could be as much as 4500 years old.

This bristlecone pine could be as much as 4500 years old.

Want to build a practice really fast? Send out a few thousand 4 color postcards on nice quality stock with an offer so good it’s hard to pass up. A guy I know very well tried that approach once years ago. The postcards offered deeply discounted x-rays, cleanings, and exams.


The approach seemed to work pretty well. New patient numbers went up, gross collections went up, but the dentist owner’s income hardly budged. Why?


Well, while the hygiene department was so busy that the practice actually had 9 days of hygiene booked per week, 2 full time hygienists 4 days per week plus one newly hired hygienist one day per week, those hygienists were being paid their normal salary while the practice was collecting half fee for many of those cleanings. In addition there were so many appointments being made and so many insurance claims being sent, that another front office staff person was hired.


Staff salaries as a percentage of gross receipts went from a reasonable 22% to an unsustainable 29%.


Is a practice like a tree? Well, this one was a eucalyptus in the wind and it was going to fall. As I said, I know this practitioner really well. I had to put a stop to sending out those darn cards.


Another approach, seemingly difficult to impossible to avoid in today’s economy, is to join a preferred provider type discount insurance plan. I was once a Delta DPO provider and I can tell you that’s a tough road as well.


If you’re taking a discount of as much as 30% and your expenses are around 70% (about average for most dental practices), you might enjoy good new patient numbers but you’d better have some awfully good systems in place so that the office is a streamlined jet fighter not a Piper Cub.


And so some ideas on marketing.  For a good number of years I’ve agreed with Dr. Omer Reed who said marketing should be word of mouth and internal only. “No outhouse marketing!” he said.


He says, “People come to a dental office for the relationship, not for the tooth fixing.”


I believe that for a practice to grow a solid foundation that has to be an absolute. You can grow a practice on 4 color postcards and discounted plans, but it won’t have the kind of longevity that I believe most of us crave.


Dr. Reed reminds us that dental school teaches to the test, that is it emphasizes teaching students how to pass the state board exams in order to become licensed. “And then suddenly, this young person could become the CEO of his or her own small company with no knowledge of the behavioral sciences and no knowledge of economics.”


Back to the title: People don’t buy what you do, they buy why you do it.


“Don’t tell people about venereal crowns and root channels.” (Omer Reed)


A week or so ago I came across a 4 color postcard from a dentist. It didn’t make any particular offer but did state that he accepted almost all insurances. It featured a large picture of a dental mirror next to a white plastic maxillary molar, I guess representing an extracted tooth. Why he used that picture I don’t have a clue. It also listed all the services he provides: fillings, crowns, root canals, cleaning, fixing broken teeth, and so on.


My zip code is quite some distance from his office, so I figure that if I received the card he must have mailed a boatload of them. I’d guess the cost of this mailing campaign at over $10,000.


Why would any dentist pay $10,000 to tell people he does dentistry? He must have been the victim of some very bad marketing advice. I know the mailing was of no help in expanding his practice because the practice failed. Closed its doors.


Within days of seeing that card, I watched a terrific TED Talk that in many ways brings this all together. It is titled, “How great leaders inspire action,” by Simon Simak. The point he emphasizes repeatedly is, “People don’t buy what you do, they buy why you do it!”


The better dental practices seem to know this, perhaps intuitively. Read the web sites of the best practices in your town. I doubt you’ll read that they do fillings and crowns. Of course they do, but why would they bother saying so?


Instead you’ll read things like, “Come experience how we build relationships with our patients.”


Or, “We strive to provide the best care in a fun, enjoyable environment. Our goal is to make patients happy.”


And, “Our goal is to treat patients with the same standards that we would want for ourselves, to treat every patient as though they were part of our family.”


What is your Why? It’s not to make a profit, that is just a result. There has to be more.


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The roots of the bristle cone pine form a wide and solid foundation.

Chris Guillebeau is one of the authors I enjoy (“The Art of Non-conformity: Set your own rules, live the life you want,” and others). One of his precepts is, if you’re going to have a goal, it might as well be to change the world. That’s his Why. I figured it might as well be mine as well.


And so in whatever way I can, and beyond trying to make a positive difference in the lives of our patients, that’s my own objective. I’d like to change the world of dentistry, to make it somehow more than it presently is for dentists and their patients.


I’m not alone in this endeavor of course. Many have the same goal, even if it isn’t stated quite that way. Frank Spear, John Kois, Pete Dawson, William Dickerson, Mark Piper, among others must all have a vision of what is better for the world of dentistry. I’m just trying to help my team.



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