Sunday, October 28, 2012

Back to normal life

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?















Saturday, September 29, 2012

Our "modified start-up" dental practice is working!

We did it! We started our office, and things are going great! Things are also EXTREMELY busy, but they're starting to slow down, and all of our plans are working. Isn't it nice when things work out?

By the way- if you have no idea what I am referring to, then go back and read the last few posts on this blog. Here's a short recap- I just quit my job and bought my own dental practice. It is small, and in many ways it is like a start-up. In fact, a start up may have been easier, but we didn't have the time to do that. Also, the price we paid for this practice was less than we could have started one for, so that was nice.

Here's a brief timeline of the past couple of weeks:
September 12th: Sign the papers. The practice is officially ours. I am officially a Post Falls Dentist! (And yes, that is a shameless backlink to my web page).

September 13th: Painter starts tearing down the wall paper and getting things ready. I was still working with Loftus until the end of this week and it was hard to keep my head in the game. It was just as well though, since by this point they had pretty much transferred all of my patients over to one of the other doctors. I basically went to work and worked on my computer all day on stuff for my new practice. At lunch time I drove down to check on the progress. Also, we took the boy scouts rock climbing that night.

September 14th: I went to unlock the door for the painter in the morning. PROBLEM! The whole waiting room was a very bright shade of yellow. Like, put-on-your-sun-glasses bright. This would not do. That day during my lunch break we went down and got new paint. He would have to paint over everything he had just done. We had just wasted a day. Not good, since the painter needed to be completely finished on schedule in order for our floor guy to start working. Also, I hired another assistant.

September 15th: The office was looking much better after the new paint shade. I spent most of the day buried in my computer trying to get paperwork set up. At the same time, the paint guy and the computer guy were working around each other setting things up. I went in and helped where I could.

September 16th: The paint guy finished. Paint looks great. We allowed ourselves a quick sigh of relief so that floor guy could come in the next day.

September 17th: I went to open the door for the floor guy. He wasn't there. PROBLEM! An hour later he still wasn't there. Several phone calls later, he still wasn't there. He had completely stood us up. Even though I would like to give him the benefit of the doubt here (emergencies do happen), I can't say I wasn't frustrated at him. While I continued with my paperwork stuff, Rachel made all kinds of calls trying to get someone in. We finally found someone who looked, said he could do it, but then called an hour later and said that he didn't have enough time. She found someone else who did the same thing. We were starting to panic when the third guy came in to look. He said he would have to work long hours, but that he could get us up in time. This guy was awesome. He started ripping up carpet early the next morning. In the meantime, I built a wall.

September 18-20: These days went by in a blur. We had computer guy and floor guy doing cartwheels over each other while at the same time I was meeting with all kinds of people trying to get the business side of things set up. On the 19th our first ad went out in the newspaper, which is great except that we had nobody around to answer the phones. This was bad. Also, between paint guy, floor guy, computer guy, and myself, we had managed to put the office into an incredibly impressive state of disarray as we scrambled to complete our various tasks.

September 21: I had a big staff training day in our conference room. It went pretty well. Mostly. At lunch time the new assistant I had hired left and then sent me a TEXT MESSAGE that she was quitting before she even got started. I'm guessing she was scared away by all the work that needed to be done. We didn't want her anyway if she was going to be like that- but it did force us to open short-staffed. Also, our sign got installed.

September 22: We had another ad in the newspaper, and a feature article in the annual "family" magazine that the local press distributes. Our schedule still wasn't totally up by this time so we had a rough time handling phone calls. Also, our internet page was in a pretty sad state, although we did finish installation of all the computers in the office.

September 23: Carpet guy finally finished (kudos to him for working so hard) by mid-afternoon. The problem is that our office was in complete shambles. Stuff was EVERYWHERE and we were supposed to open tomorrow. A wonderful girl in our ward who knew what we were going through (she had done a LOT of babysitting for us this week) came up and volunteered, on her own accord, to watch our kids so that we could go finish things up. Also, her mom volunteered to come help. We stayed at the office pretty much all day, decorating and putting things back together. By the end, things actually looked pretty good. As far as advertising goes, we had yet another ad in the Sunday newspaper, as well as a feature article about us on the front page of the business section. We were ready to open the doors- or so we thought!

September 24: Opening day! I ran around the office like a mad man putting out fires as they came up. We quickly identified several glitches and other small items of business that required my attention. We had 5,000 mailers go out to the surrounding neighborhoods and we started receiving calls from those.

September 25: Day two- I was still wearing my "fireman" hat more than my "dentist" one, but we knew it would be this way. Last week I put in over 90 hours at the office, and this week was looking like more of the same. Basically, I go to work all day to identify the problems that I work on fixing all night, only to repeat it the next day. It's fun, but I am starting to get exhausted.

September 26: Day three: First day of new patients (never been to the practice before). Of course we identified a hundred ways that we could improve upon the new patient experience, and of course I stayed up all night again trying to make it happen. We are still looking for another assistant, and that will definitely help. The good news is that the team is starting to feel more comfortable with our systems.

September 27: Day four- I am beat. I slept for 3 hours the night before. We had 2,500 more mailers go out today, as well as another newspaper ad. It was all worth it though at the end of the day when I ran my weekly report. The results? We had scheduled more new patients in the past week than they had in the past 2 months combined! Our plan was working! All the work was paying off! Also, I sense that our team, who was a little bit hesitant in the beginning, is starting to come on board (mostly). They are beginning to trust me and to understand what we are trying to do. They are excited about it.

September 28: I ran the financial reports- the one saying how much this "modified start-up" actually cost us. Results? We are about $30,000 UNDER budget! Woo-Hoo! For this,  I think I have Rachel to thank more than anyone. She is the toughest negotiator I have seen when it comes to contracted work, and she finds amazing deals when it comes to stuff we have to buy. As an example, she did ALL the interior decorating (furniture, paint, floors,decorations, and labor) for under $3,000. If you have done much of this then you realize that this is absolutely incredible. She has also been the driving force behind our advertising, and she pretty much single-handedly designed the decor of our office. She is amazing.

September 29: I only worked for a few hours today- I was home by breakfast. I know it's Saturday, but when I'm used to working pretty much every waking hour this seems like a vacation. I think this is my first non-12-hour-workday for the past 3 weeks (actually, most days I've put in 16-18 hours). It also means that things are starting to fall into place. I'm looking forward to next week. We have 20,000 more mailers going out on Monday in little coupon packets, as well as another newspaper ad. It's hard work, but things are working, and in a little more time I think we will be able to cut back to a normal 40 hour work week. Also, this stuff is FUN! It's fun to see your plans turn out even better than you were expecting. It's fun to overhear you staff telling their friends on the phone how cool their new boss is. It's fun dealing with problems and coming up with innovative and creative solutions. It's fun being the guy in the driver's seat, for better or worse.

I've said it before, but it's even more true now than ever before- I love my job!

Here's a few pictures. Most of the "before" pictures are the ones that the practice broker used to sell the practice. We took the "after" ones on my phone- but I think it still shows the difference.


The outside of the office- not much changed here except for the signs on the door:

The sign- Before
 And After:


Waiting Room- Before:
 And After:
The big empty wall to the right of the door is reserved to be used as our "Real People" wall. We'll have a sign here across the top that says "Real People. Real Smiles." Then we'll showcase some of my work. The thought is that we'll have 2-3 8x10 studio quality photos (that we'll pay for, of course) of patients after they finish their work. We'll also have a small 2x2 inset in the photo of the "before" picture (which we take for all patients). These pictures will be in a nice, matted frame. On the matte will be a little bio about the patient, their testimonial about us, and a plug for whatever it is they do (free advertising for them). I like the message it sends. Real People. Real Smiles. That's what we're all about. For now, obviously, we don't have any work to show off- but we do have some in progress!


Front desk/reception area- Before:


 And After:




The Hallway- Before:
 And After:


Treatment rooms- Before:



 And After:






The journey:



(Dinner)





And finally, here's a little video tour:

Check out this video.  Look for the fun kids room wall that Rachel created.  We didn't get a picture of it, but it is worth looking at.  Also, the treatment rooms are decorated with winter, spring, summer, and fall themes.  They each feature photography (that Rachel painstakingly found) of Post Falls and Coeur d'Alene.  The coolest photos are in the winter room.  These pictures are all of Post Falls in the 1930's.  Pretty neat.

Sunday, September 16, 2012

First of all, a couple of random things:

Jackson totally just walked into the house grinning and giggling, followed by Evelyn and Adalie who are also beaming. As soon as he saw us he said "Mamma, Papa- look what we found!" We looked. He was holding a dead bird. By the neck.

The other day Rachel was just finishing her shopping at Walmart and was about to leave. Suddenly, a stranger politely asked her if she was missing one of her children. That's when she turned around just in time to see Jackson on one of the motorized shopping carts, cool as can be, zooming out the door.

About a week ago, Addy brought a toy to Rachel and said it was broken. It was one of those pop-up type toys where you have to either push a button, or pull a lever, or turn a key, or something to make the animal pop up. Anyway, the tiger wouldn't pop up. A while later, Evelyn came with the same toy to report the same problem. After some investigation into the matter Rachel declared the toy broken and said there was nothing she could do. Then Jack got up and said "look at me." He then performed a complicated set of maneuvers that involved pushing, turning, and pounding in a very deliberate pattern. Suddenly the tiger popped up. Jackson calmly said "I fixed it," set the toy down, and walked away.

Jack has a mechanical toy truck that was recently ripped apart in one of our kids' "sprees of destruction." Afterwords, Jackson and Evelyn went to assess the damage. It was in several small pieces. In a very loving voice, Evelyn told Jackson that it was unfixable. Jack tried to fix it anyway. Evelyn became a little bit upset and said "No Jack. It's broken. We have to throw it away," and walked away from him. Jack sat with his toy, tinkering for the next several minutes. Finally, he picked up his totally re-assembled toy, brought it to Evelyn, set it in her lap, and walked away. He did'n't say anything, but I swear I saw a little smirk on his face.

Jack, Evelyn, and Addy were finger painting at the table. Jackson started getting close to Evelyn and Evelyn warned him not to touch her with his dirty hands. Jack then proceeded to bring both hands as close to her as he could without touching her. Evelyn started freaking out and running away. Jack started chasing her, careful never to actually touch her. He was laughing. She was not. He is mastering the art of taunting his sisters.

We love our Jackson.

Oh- another random thing. About a month ago I got a "smart-phone." It is amazing! How did I ever live without this thing?  It has actually been REALLY helpful in the establishment of this new practice. Really.

Speaking of the new practice, things are moving forward at breakneck speed. Within the next 7 days we will have totally torn down all the wallpaper and repainted all the walls, ripped up all the carpet and installed new carpet in the waiting room, office, and hallways, and new "wood" floors in the treatment rooms, removed a large mounted robotic looking microscope from the ceiling and built a wall in its stead, built from scratch a totally awesome computer server, installed 8 new computers, and equipped them with all new software, gotten rid of all the film-based x-ray stuff they had and installed digital x-rays in all treatment areas, changed all the signs to reflect the new practice name, put brand new furniture and decorations in the office, printed business cards and other promotional materials, sent mailers to over 30,000 people, printed our ad in the paper, hired a new assistant, said goodbye to an office manager, trained a new team, and opened the doors to the public. And that's not even touching all the behind-the-scenes paperwork that's involved with taxes, bookkeeping,  accounting, regulations, systems, licenses, financing, etc. Oh, and we already have patients on the schedule for the following Monday, so let's hope this works. Woo Hoo!

Yesterday, Addy and Jack had their official birthday party. We did it in the backyard and had a decent turnout of parents and kids. We played games, decorated cupcakes, ate pizza, and opened presents. It's fun having three-year-olds. They are good kids.

By the way, the weather is becoming very crisp and "Fall-like." I LOVE IT! I love it, I love it, I love it. I love the smell of burning fields in the morning. I love that the trees are starting to change colors. I love the still, quiet feeling of potential energy that seems to resonate in the air. I love the wildlife that is busy getting ready for winter. I love it all. Earlier this week I drove myself to a nearby trailhead and just walked alone in the woods that surround our beautiful little town. While I was out I was thinking about everything that was happening and was just totally filled with hope and with energy and with optimism and I started to run on the trail and...well, it was just a good morning. Have I mentioned that I love this time of year?

Well, that's pretty much it for this week. Sorry it was all over the place, but that's also a pretty good representation of how we have been lately. Here are some pictures:

 Addy's Doctor Set.



 The Pirate Treasure Hunt


Addy, trying to get a peak at her next present.
Jackson got "power tools." He has been playing with these non-stop. That's my little man!