I don't think I have EVER gone this long without posting. It's been almost (but not quite) a full month since I last wrote about our practice start up and the busyness associated with that. Well, the busyness continued well beyond that entry and The Hazard Chronicles sort of "fell by the wayside." The good news is that each week has been less busy than the one before it, and that life is slowly returning back to it's normal pace (which, for us, is at a dead run). And I'm back.
So, what's new you might ask? Well, let me take this one subject at a time.
First of all, there is the practice. I am starting with this because even though things have become a lot less stressful in recent weeks, this is still the topic that consumes most of my time/thoughts/energy. I promise that I won't talk to much about my work in future posts, but I ask you to indulge me during this start-up period.
In short, the practice is doing well- better, in fact, than we had been planning. There have been a few surprises and setbacks along the way, but overall things are moving forward. Here is a shortened list of what we have run into (shortened is a relative term).
THE GOOD:
Immediate Growth! Rachel has been the driving force behind our advertising efforts and she has done a totally phenomenal job at it. When we walked into this practice they were seeing, on average, 4-6 new patients per month. Last month (the first month we were open), due to Rachel's intense marketing push, we saw twenty nine new patients! What's more, we are starting to become known in the community- and in a good way. Rachel is good at not only putting out advertisements, but also at getting us positive press coverage. In the last month we have had four newspaper articles written about our practice, one community group developing a partnership with us, and a bunch of sponsorships in the works for local events, causes, sports, and celebrations. She's not slowing down either- her advertising budget is only going to grow from here on out. People will know Heartwood Family Dental.
The Team! When I arrived I made a lot of changes. A LOT. This sort of flies in the face of conventional wisdom as far as practice transitions go. I thought long an hard about this, but the fact is that I had little choice. Before I walked into the practice it was hardly profitable enough to support itself, let alone the growth that I wanted and expected out of it. Change was a necessity, and if it didn't happen soon I was afraid we would not be able to build the momentum that would be so necessary to get us started. So I went in and changed how the office looked, how it ran, how records were kept, how our scheduling was done, how we used our computers, how we accepted payment, and how people did their jobs. Really, there's not much that I didn't change. It was a lot, and I was very aware of the fact that it would be a strain for the people who were used to doing things their way. I was also aware that I was working with people who didn't know me, had no reason to trust me, and would probably not be so enthusiastic about these changes as I was. Well, let me say that the team has totally taken the bull by the horns and has made this happen in a way that has surpassed my highest expectations and has put all my fears to rest. We're building this practice together, and it seems like everyone is headed in the same direction. That's saying something after just one month. Patients are noticing too. Hardly a day goes by that someone doesn't go out of their way to let us know how comfortable and taken care of they felt while in our care.
The Patients! Like I just said, people are having good experiences with us. That is good because sometimes I feel like behind the curtains we are running on complete chaos, putting out fires at every turn. On center stage, however, the team, the practice, and the patients are all coming together to create an experience worth talking about. We need that, and patients are giving it. Right now, with our new patients, we have a 75% reschedule rate. Now, to some that might not sound like something to brag about, but I'm telling you that I'm ecstatic about this. Let's put this in context. First of all, we have some pretty good offers out right now (as we always will) that draw people into our practice. One thing about good offers- you get shoppers. You know- the people who come in and take advantage of whatever deals you have, and then move on to the next place. Also, on top of our offers, we have an "Open Door Policy" stating that exams, x-rays, and consultations are always completely free to new patients. Sweet, huh? Yea. It also means that people can come in without making any commitment whatsoever, take advantage of our offers, and then just walk out the back door without passing go or even stopping to say hello. It's a real risk that we take in our approach. So why do open ourselves up to this possibility? Because we believe that once patients come into our practice and see what we are all about they will want to continue receiving treatment with us. And the numbers show that 75% of them do. I'll take 75% any day. And what's more, they are referring their friends. Now that's cool.
THE BAD
Immediate Revenue: For obvious reasons I won't go too into depth here. Let's just say that the pool of existing patients that I purchased doesn't have a whole lot of work left to do. What that means for us is that, even more than we were expecting, we are having to run this financially more like a start-up than as an acquisition. This would be a hard hit except for three facts: First is that the existing patients (what few there are) are pretty regular on their hygiene appointments. That means that Deb, our hygienist, is able to carry us through for a while until we build up a new patient base. Second is that our existing patient base is building fairly rapidly (see above). And third is that our initial costs ended up being a lot less than what we had projected, giving us funds to see us through the next several months while we are becoming established. These three things have taken what could have been a devastating blow and turned it into a minor setback.
Supplies and Equipment: Most of the materials that were being used in this practice prior to my entry had expired over 5 years ago. Also, some of the basic equipment that is required (legally and ethically) to run a dental practice was either non-functional or missing altogether. Honestly, I'm not sure how the place stayed in business. It's a good thing they never had a government audit or inspection because I may not have had a practice to buy. Anyway, most of these issues were foreseen and accounted for before the purchase, so it hasn't been too much of a financial strain to get things up to par, but it has taken a lot of time and has caused its share of stress. There have also been a few other issues that have "popped up" and sort of taken us by surprise forcing us to scramble and then regroup as soon as possible to keep things going. In hindsight I have spent more time worrying about these things than I should have, since we already had the budget written into the plan. It just gets tiring, and sometimes overwhelming, when it seems like the only thing you do all day is write checks for new stuff. I can definitely say that I've learned a few things, and that the next time I buy a practice (hopefully not too far in the future) I will be more aware of what to look for.
The Books: I don't know if I should put this down as a challenge or a conquest, but whatever it is I have spent a good deal of time with my new best friend, Quickbooks. Running a business by the numbers, while something I understand pretty well in theory, is something I have not yet had the opportunity to do. Well, like most things I do I have decided to take the David Farragut approach ("Damn the torpedoes, full speed ahead!") and jump right in. Let me just say that I have spent at least as much time this past month trying to figure out payroll/taxes/bookkeeping/random pointless forms as I have over patient treatment. And I have come away the champion- I now have it down to a system where I go in on Friday mornings to do all this stuff for the whole prior week, and am still usually able to be home for breakfast. Take that, Quickbooks! Also, I know it sounds nerdy, but there is some sick derisive pleasure that comes from seeing all the numbers line up. I guess I can't make fun of the accountants any more- I'm one of them!
THE UGLY
The Cars- While not directly related to the practice, it sort of ties in. See, a few weeks ago I drove my trusty 1990 Prizm down to Seattle to get my training and certificate in Sedation Dentistry (That's the tie-in). Everything went great until on my way home I saw the "battery" light start blinking on my dashboard, signaling to me that something was wrong with the electrical system. Like a fool, I thought I'd just let it go and check it out the next time I stopped for gas. Well, it wasn't too long after that when the "check engine" light came on, followed by a very impressive display of steam leaking out from under my hood. Here I was, driving down the freeway at 90 miles per hour, and I couldn't see a single thing in front of me including the front of my car. It was cool. Luckily I was in the middle of the Washington desert and the only thing I hit was a errant tumbleweed with unfortunate timing. Anyway, I got over to the side of the road and it turns out that my alternator belt had broken (thus the electrical problem). Unfortunately, this same belt drove my water pump, so a bunch of pressure started building up in the radiator causing it to literally blow its top (thus the steam). These two things together did not constitute a huge problem, but the fact that I was in the middle of the desert, two hours away from home, did.
Well, the car still ran, and by keeping a close eye on the temperature gauge I was able to make it (finally) to a Chevy dealer before my battery went totally dead (which would have forced me to call in a tow truck since the alternator was MIA). It was also around this time that Rachel called me and told me that she had discovered that the husband of a friend of a friend of a friend was actually on his drive home from Yakima and would be passing my very location in less than 20 minutes. Talk about luck! So, I left my car at the dealer (keys in the after-hours drop box), jumped in with "Robert," and made my way home so I could go to work the next day.
Well, I wish the story ended there, but it doesn't. Before I go on with it, however, I need to mention my rekindled enthusiasm for bicycle commutes. It's too bad that winter is around just around the corner, since I am only a fair-weather bicycle commuter. Come spring, however, I will definitely be leaving the car in the garage in favor of spokes and a chain.
Okay- back to the story. The next weekend we put all the kids in the van and headed out on a rescue mission to get my car. Well, we were about an hour away when suddenly our van started sounding an obnoxious alarm notifying us that we were overheating. What!? We had just had the cooling system worked on less than two weeks before! We checked the coolant levels and our radiator was nearly completely empty. We put more coolant in which allowed us to make it back to my car. The dealer had put a new belt on it for me, and we drove to a nearby church parking lot where we had a picnic lunch while I repaired my radiator. All was well with the Prizm.
The van, however, was having issues of its own. As we were eating our lunch I notice a steady leak of coolant coming from underneath the car. Great. Well, we couldn't do anything about that here, so we topped off the radiator and carpooled home, making sure we could always see each other in case we ran into more problems along the way. We stopped every now and then to make sure the coolant levels in the van stayed where they should be, and somehow made it home without further drama.
Since then, our van has overheated twice though. We believe that we need to replace the coolant lines. Instead, we are now in the market for a new van. We'll do what we can to patch things up, but with 235,000 miles on it, the van is about ready to retire anyway.
IT'S AUTUMN TIME!
Alright- let's move on to another subject. Autumn! As most of you know by now, Autumn is my favorite time of year. I surprise myself every year how it never seems to get old- I simply love the season and it always makes me feel energized. Here are some of the "Autumny" things we have been doing.
Leaf collecting- pretty self explanatory.
Apple picking- our annual tradition. This year we came home and made an amazing apple crisp. Mmmmm.
Pumpkin carving- due to limitations of time and gumption, this year we did not go all out with our pumpkins. It was the first year, however, that our kids have been really into it, and that made it fun for a different set of reasons. I think Halloween is just fun- it's impossible to make it any different.
KIDS!
With Fall time comes back-to-school time. This year, Evelyn is a part of a real preschool, and Addy and Jack are part of a co-op group that Rachel organized (similar to the ones she has done in the past for Evelyn). Evelyn's preschool, by the way, is absolutely amazing- Unfortunately, I think that means she is going to be in for a real letdown when she goes to kindergarten next year. Her teacher is super creative and I am always a little bit surprised (although I shouldn't be) by how much Evelyn is learning. It's fun that Evelyn is so enthusiastic about it too, and between Rachel's co-ops and this I feel like she is getting a really good introduction to structured education.
Watch out world- Maren is mobile! This means that we have to keep a closer eye on her- last week Rachel called me up at work after getting off the phone with the poison control center- Maren had eaten a dead hobo spider. Now don't worry, because while that is really creepy and absolutely disgusting, apparently there are no ill side effects from eating poisonous spiders. Who knew?
