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Inside Dentistry
Jul/Aug 2009
Volume 5, Issue 7

Enjoy Your Time Off: A Survivor's Story

Laura Jamison; Jamison Consulting

Millions of Americans are hooked on reality television, while some of us wonder why. Yet I admit I was at least intrigued when in 2001, a dentist named Carl Bilancione, DMD from Orlando , Florida appeared on Survivor Africa . After all, how could a practicing dentist afford to take months off from his practice? Most dentists I know fret about taking one week at a time for vacation or continuing education.

Let's explore Carl's story and how we can learn from his experience.

Carl admits that prior to the show he was typical of the aforementioned dentist. The very most he allowed himself to take off was two consecutive weeks. In January, 2001, he was challenged by his office manager to participate on Survivor . She was a fan of the show and downloaded the application form for him, but the paperwork remained on his desk until three days before the deadline. Finally, Carl recorded an audition video, submitted the package, and after several auditions, he was selected and sent to Africa . While participating on the show, he was unable to inform anyone of where he was. He was also disconnected from the practice for three long months.

I approached Dr. Bilancione at a dental meeting to inquire if I might tell his story for an article because I believe that dentists benefit from taking time off. By enjoying time away from the practice, the dentist returns to the office more rejuvenated. Patients, employees, and even the dentist's family all benefit from this. Carl agreed.

How can the dentist enjoy time away? The reason that most dentists do not is because they fear what will happen to their practices when they are gone. Will patients leave? Will new patients schedule somewhere else? Can bills be paid? What will the employees do unsupervised?

Let's start with solid information: a plan is 90% of the preparation. What is done in advance of a vacation will affect how much the dentist can truly enjoy time away from the office.

  1. At the end of every year, usually in the final quarter, an annual planning session with the team should be scheduled. This retreat is for the purpose of plotting out the calendar for time off in the new year. There are several benefits to this type of planning session. When the team is involved in the planning, they know in advance that the doctor wishes to take time off from the practice. Many employees will consider taking their time off at the same time as the doctor if they are given ample notice. During this meeting, a production goal for the year should be established. In a seminar called Beyond Your Bottom Line © , we teach a system for setting goals that considers taking the best average production per day figures from the last twelve months. The philosophy is that if you have accomplished that average production per day in three months over the last twelve, then by the end of the next year expect to achieve that three month average as a new average daily goal. For example, take the average of the best three months for each producer and multiply the figure by the number of days the doctor plans to work next year. Then calculate the monthly goal based on the number of days that each income producer will be working. Team members appreciate knowing how the goal is set and having a voice in the decision. Because the year end production goal is then divided by the number of days the doctor plans to work, if there are fewer working days, the daily goal for the days in the office is going to be slightly higher all year. See Table 1 for sample calculations.
  2. Preblocking is very important to the planning process. Prior to extended time off, it is essential to preblock for new patients. Treatment presented before vacation may end up on the doctor's schedule for the weeks after his or her return. The day after a doctor returns should be scheduled with time set aside for emergency patients of record. Although it is difficult to do, this day should be scheduled lightly, allowing the flexibility to see those patients with immediate needs.
  3. Budgeting must also be considered. When setting the annual production goals, create a budget for expenses in the office. The process is fairly simple: take the profit and loss statement and a blank sheet of paper. If the expenses are fixed, consider if the expense is going to remain the same or if it will be adjusted in the following year. Add the expenses that can be incurred by taking time off. Dr. Bilancione hired a dentist he trusted to work several days per week: that additional expense needs to be included in a budget. If an expense is variable, such as lab or dental supplies, set the goal higher or lower accordingly. When the expenses are totaled, compare to your original production goal. If the budget can be managed during the time away, then it is a matter of saving some income for the months in which production may be less.
  4. Trust the team to manage the patients' needs. The Bilancione team understood how important it was to keep patients in the preventive maintenance system coming in for appointments. Train employees to be at their best at all times. Reward people with appreciation, feedback, a good work environment where they feel valued, with fair salaries and fringe benefits. Dr. Bilancione's team was exceptionally responsive, and this was a direct result of his commitment to them over time.

When these four pieces of the plan are complete, get away from the practice and rejuvenate. Learn something new that will benefit the practice. Plan for next year. Carl Bilancione had this to say in retrospect, "Do not be afraid of losing patients or destroying your practice. If you put all the right pieces together the patients will stay loyal. In fact, I did not lose one family or patient. I learned that I can take more time away from my practice without suffering a great hardship. We actually reduced our income by 25%-35% and rebounded the next year with an increase of 18%. Patients were excited that I did what I did. I think people admire people who take a chance and follow their dreams. I live life to the fullest; always remembering that life is not a dress rehearsal. So seize the moments!"

The doctor plans to work 170 days in the next twelve months. $ 3,956 x 170 = $ 675,520. If the doctor were to generate the same level of income from last year, the average production per day was $ 3,504. Multiply that by 170 days and no increase to the goals would be equal to $ 595,750. Using this method of calculating goals suggests a 13.4% increase in revenue.

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