Dear RDH:
Heidi Emmerling paints a pretty bad picture of management consultants. They encourage dentists to force unnecessary dentistry on their patients. They cut staff pay. They force staff to attend meetings without pay. They want the practice to cut corners in delivering quality care. They try to intimidate dentists to thinking they are not successful unless they have a million dollar practice.
I have been a practice management consultant for 16 years, and I disagree with much (but not all) of what she wrote.
Although I`m a firm believer in setting goals as a way of focusing the team`s efforts and challenging everyone to be their best, I shudder at the thought of oversell. I would not like it if my wife went to an OBGYN where they had a quota of doing six hysterectomies per month and they were one short when my wife came walking in. Ms. Emmerling`s essay is representative of the sort of backlash we may be hearing in the coming months and years regarding these kinds of approaches. Every patient should be presented the same treatment options as you would for a close family member ... no more and no less.
Ms. Emmerling also says "To increase production, the doctor needs to do more work. This means either doing more work on the patients already in the practice or getting more new patients." Right! And, what`s wrong with that? The purpose of management is to get the best outcome for your patients and for the practice, given your time, talents, and resources. The better organized your team, the better the recall response, the better the case acceptance, the better the care you deliver.
To take Ms. Emmerling`s argument to the extreme, probably the best thing you can do in a dental practice would be to not open up at all ... that way no hygienist is inconvenienced and no patient ever has to pay for dentistry. But, the plain fact is that, in a dental office, production is quite literally a measurement of care delivered. If a consultant helps production go up ... that`s a good thing!
However, a consultant`s role should be to help a dentist and staff attain the kind of practice they want ... and not everybody wants or should want to have a "Million dollar practice."
Ms. Emmerling states that she has never seen a hygienist retire early because of management consulting. Maybe so ... but I have seen many staff people get a retirement plan because of increased prosperity of the practice. I can`t remember the last time I ever suggested to a doctor that he/she cut someone`s pay ... but I can think of countless times that staff pay has increased because of incentives or practice growth ... not to mention the creation of jobs as a practice expands. And, I would not suggest that staff attend management consultant meetings on their own time. Taking time to manage the office is every bit as much work and as important as any other duty.
Most people hate hype, oversell, greed, and insincerity. Our profession, like any other, has its share of sinners. However, labeling all consultants "blood sucking leaches" is the kind of prejudiced hostility that never does any good for anyone.
Bill Rossi
Edina, Minnesota
Editor`s note: Thank you for writing. You raised some good points. We don`t think Ms. Emmerling was knocking retirement plans for staff members, for example. The column merely raised questions about some absurdities, as she sees them.
