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In a recent issue of the Harvard Business Review, the Editor offered a profound thought. He said, "Management can be learned, but it cannot be directly taught". This is what makes management difficult. It is not entirely a set of principles, procedures, and ploys. Knowledge of these may form a basis for understanding and performing management, but does not assure good, successful management. Absence of that knowledge may most often result in non-management or poor management. One of the key lessons to be learned from the current installment of the JCO Orthodontic Practice Study report is the role of management in orthodontic practice and its importance to an orthodontist's financial success.

There is ample evidence from the Study that the more successful orthodontists, as measured by their high net income, pay more attention to record-keeping and to in-depth analysis of their practice activity. They keep their fingers on the pulse of their practice. They know how many observations, diagnostic studies, case presentations, case starts, and case finishes they have had in a given month. They know the sources of their referral. They know what their income for the month has been, what their delinquencies are, what their contracts written amounts to. They know what their case load is, and they know who is lagging in treatment. They know what their expenses amount to in all categories of expense. They know how they spend their time and how their employees spend theirs.

There is also ample evidence from the Study that the more successful orthodontists are thoughtful planners. They prepare a written practice philosophy, written practice objectives, a written practice budget, a written office manual, and written job descriptions. You can be sure that these are not written in stone, but are constantly re-evaluated and up-dated in the most successful practices. Chances are that you could take all the written materials from a more successful practice and give them to a less successful practitioner and he would not produce the same results. He has not gone through the mental processes that produced them, and that is probably more important than the documents themselves. The beauty of the JCO Orthodontic Practice Study is that it can point you in the right direction, but there are not many shortcuts to better practice management and greater financial success after that. The price is the devotion of a great deal more time and attention to total practice management. The rewards will include much more than higher net income.

Orthodontists, by selection and education, are "how-to-do-it" people. But, management of an enterprise such as an orthodontic practice is not a mechanical operation. People are involved--other dentists, staff, patients and parents. Orthodontists can acquire knowledge about management and make up that deficiency in their education; but then the learning process begins in using the knowledge in the individual practice environment, in applying it to things and especially to people.

If there is one thing that becomes clear in reading this month's installment of the JCO Orthodontic Practice Study report, it is the importance of a sensitivity to people management in the most successful orthodontic practices. It is a thread that runs through the entire fabric of the report.

The more successful practices have more staff; more delegation of tasks to staff; more appreciation of the importance of staff management and patient management; more attention to dentist referrers; more use of all practice building methods and more belief in their effectiveness.

The report also points to some glaring deficiencies in all practices, whose correction should be beneficial to practices at all levels. The vast majority of orthodontists do not have a practice budget. The vast majority of orthodontists do not solicit patient feedback. The vast majority of orthodontists do not raise their fees enough to keep up with inflation. The vast majority of orthodontists do not have an adult case fee sufficiently larger than their child case fee. The vast majority of orthodontists have not built a large enough adult case load.

There is a great amount of direction in this Study report and it should spur a great many orthodontists on to the study of basic management, which can be learned. Applying it to the individual practice is what the Editor of the Harvard Business Review was talking about when he said, "Management can be learned, but it cannot be taught directly". Because, when one has reached that point, management becomes chemistry, or even alchemy--occasionally turning lead into gold.



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