6 Low-Growth Ortho Practice Mistakes (& How to Fix Them)

You know how water tastes unrealistically good when you’re thirsty?

Or how food tastes like a little slice of heaven when you haven’t eaten all day?

That’s what 30% growth felt like.

But it really shouldn’t have.

This is the thing.

I had the pleasure of managing my mother’s orthodontic practice over the last few years. After 10 years of relatively flat growth before I came onboard, we changed the systems, changed our mindset, and ultimately, created and sustained a 30% annual growth. Later we even made the Inc. 5000 list for successive years.

I’d be lying if I said we weren’t happy.

We were very proud of our success.

But here’s the thing.

30% growth isn’t impressive.

It doesn’t have to be, anyway.

Over the last 19 months as the owner of OrthoChats, I’ve learned that 30% annual growth can and should be normal.

We work for a handful of doctors that are growing by more than 200% annually (we track their traffic volume and leads generated through chat). These are the best and brightest business owners in the industry, and most of them aren’t nationally recognized as leaders.

When I ask these doctors about their success, they’re not interested in talking about their results.

It’s the every-day implementation that gets them riled up.

They’ve invested metaphorical blood, sweat, tears and a whole heck-of-alot of time into developing these systems. They’ve poured consistent, daily effort into grinding out new processes and refining existing systems.

Interestingly, most of these doctors have a refreshing level of humility that sticks out in an almost glaring juxtaposition against the typical academic arrogance that plagues our industry. It’s like a cold mountain spring bursting from the cracking sands of the desert. It throws you off balance a little. In a good way.

Anyway, these high-growth practice owners are humble and eager students of business. They regularly acknowledge that they can learn something from anyone. I don’t know about you, but that makes me respect them that much more.

But let’s talk about contrasts some more. The most important of which is, why do most practices fail to create stellar practice growth?

What do stagnant practices do that keeps them in the low-growth bracket?

And on the same coin:

What do 200%+ growth practices NOT do?

Here’s six common characteristics of low-growth practices and how to NOT take on these toxic traits.

1. Most orthodontists do not surround themselves with other business owners who possess high-growth mindsets.

I’ve been blessed with exposure to great businesses minds in the ortho industry and beyond. Our original OrthoChats client, Dr. Ben Fishbein, one of the kindest and most humble people I have met, owns a practice that blows away (!!!) 30% annual growth. He encouraged me to surround myself with other growth-minded practices. To respond, our practice joined ProOrtho FE. In this group, 30% growth is celebrated, but almost expected.

Contrast this to most practices. They sit back and complain about how the market is beating them. They continue to do the exact same things while corporate dentistry closes in and mail order ortho is becoming more popular.

Solution: Surround yourself with other growth-minded business owners. Join ProOrtho FE or find another group of orthodontists that are killin’ it. Additionally, find business owners in different industries that are successful and growing! You’d be surprised at the practice-growing insights you can collect from a rich plumber.

By the way, Dr. Fishbein is hosting this in-office, practice management and marketing event that you really shouldn’t miss.

2. Most orthodontists do not make sales and marketing the primary focus.

We’re in the business of sales and marketing. There’s thousands of other orthodontists who can straighten teeth as good as you or better. But patients don’t choose an orthodontist based on clinical results. That’s why clinical excellence is an ethical threshold standard, but not the primary business focus to grow your practice.

Solution: Focus consolidated effort on developing a scalable sales and marketing model. Oh, and TCs should sell. Period. We sit on mountains of patient files of people who never started treatment. Your TC should be making outbound sales calls to those contacts every day. Don’t distract your TC with tertiary responsibilities, no matter how busy or tempting it is.

3. In most orthodontic practices, high-growth is not an internal cultural expectation.

If the practice owner thinks that 10% annual growth is a stretch, so will the team. High-growth practices have a team of people who expect fast growth. The growth is celebrated and everyone is a participant in moving the business forward.

Solution: Talk about your business goals. Every. Single. Day. Celebrate success. Use failure as a learning opportunity. Get your practice into “startup” mode to kick-start your growth. Then, design your systems to scale up quickly.

4. Too many orthodontists consolidate control and decision-making at the top.

Most ultra-successful business owners do not make many day-to-day decisions. These decisions are delegated down and team members are held accountable. Making every decision in a high-growth practice is the recipe for a heart attack at age 40.

Solution: Hire smart people. Pay them fairly. Then, expect excellence. You’ll get significantly more done with a team of likeminded, motivated, and smart professionals than you will with an entire team of clock-punchers who could care less about your practice growth.

Also, require your team members to think about scaling the business. Have them consistently asking questions like,“Will this process support a team that’s 4x larger than it is today?”

5. Most orthodontists are penny wise and pound foolish.

In our practice, we had a skimpy marketing budget. To be fair, I did a lot of the marketing work myself. But we still spent relatively little on marketing. We were focused on how we could save a few thousand here and a few thousand there. Honestly, we were scared to spend money.

I failed the practice here.

My tightwad mentality was not growth-minded. And it’s a special sort of crazy for orthodontic practices running 50% margins.

Solution: Spend more money on practice growth. Growth begets growth. As you spend wisely on marketing, your practice grows. As your practice grows you can spend more, the stronger your brand becomes, etc. It’s an amazing business growth loop! A few thousand dollars is NOT a big risk, especially if you have the opportunity to produce a great return. Remember – you only have to be right 51% of the time.

6. Most doctors use emotion-based decision-making.

When I first started managing our ortho practice, I was faced with several “commonly known facts.”

November and December are tough months…

… and so are March, April and May.

Spring Break is hard because our target demo is on vacation. They’re not looking for an orthodontist.

July is the slowest summer month because families are on vacation.

Etc.

We’re all guilty of this in different ways. We tell ourselves an ugly story about our business and we look for ways to prove that it’s true.

How does this play out? Well, just look at the AAO meeting month. Aren’t April and May supposed to be slow ortho months? That’s why they hold the AAO in the spring, right? Well, when we go to the AAO, don’t we lose a week of productivity and exam time? Yes!! Do you think this might contribute to our story about spring being a difficult time? Absolutely!

Solution: Make your decisions based upon data, not stories. Stories are fun. They can be useful. But ugly stories are subconscious belief systems that bubble up into excuses and create self-fulfilled prophecies. Because what you believe is what you take action on, and sometimes, fear is the belief that gets in the way. That’s where we have to use reason to harness and guide our emotion. Use the cold, hard facts; logic. Data.

Ways to spot ugly story telling:
1. The words, “always, never, can’t, don’t, and forever” are used when describing a strategic decision.
2. The presence of lots of emotion in a conversation.
3. Someone acting offended when asked, “why?”

Final Thoughts

Let’s bring this thing full circle.

30% growth tastes good, and it should. It’s a good cause for celebration.

But if you’re like me, and you’re getting those kinds of gains, you may be tempted to fall into the laurels-resting trap.

That’s when we have to self evaluate. Are we hitting our practice-growth goals consistently? Perfect. Time to bump up the standards.

Spend more and more time with mentors and winners – the people who have the highest, growth-oriented standards, and a winning mindset. Their wisdom, ethics, and energy is what you should be feeding on and emulating, until you have what they do. Then, give back. It feels good because it is.

That’s all I have for you today. I hope you have an outstanding week!

As always, feel free to shoot me your opinions and feedback at Scott@OrthoChats.com.