For years I’ve given this topic a lot of thought. It’s a subject that, not until now, I had any answer to. First, let’s define the word “dichotomy”.

noun: a division or contrast between two things that are or are represented as being opposed or entirely different.
synonyms: contrast, difference, polarity, conflict;  gulf, chasm, division, separation, split; “the great dichotomy between theory and practice”

Now let’s discuss the typical background of the dental office personnel:

The Doctor: This person has typically gone through four years of undergraduate school, and four years of doctoral training at an accredited dental school. Very few dentists have received any formal or practical business courses or training. However, they do get to see some of the business side of dentistry in dental school, but not enough. Hmm.

The Hygienist: This person has typically gone through two years of prerequisite classes to be accepted in an accredited hygiene program, which is another two years of education. So, four years of educational experience is where the hygienist ends up before working in a dental office. Business experience? Almost always none.

The Dental Assistant: Some are trained and accredited through a dental assisting school, and others are educated with on-the-job training in the office. Some offices would rather train in-house because many dental assisting programs are too basic, or simply lack in clinical training. However, the dental assistant is constantly learning dental procedures from who? The dentist! That’s right, the dentist, master teacher, experienced guru of everything dental is the one who is training the dental assistant. So literally, the dental assistant, after a year or two, can become a highly trained individual by the same way the dentist was trained, that is by another dentist. Fantastic!

The Office Manager: This is the position where the dichotomy of the office typically rests. Dental office managers rarely receive any formal college training. Very few have undergraduate degrees in business, and it’s a rare find to see a person with an MBA running a dental office. What we typically see is the current office manager was trained by the previous office manager, who was officially trained by the previous office manager, who happened to be trained by the Sunday school teacher in the church. Right?

My personal favorite is when the dentist hires someone to run the office without doing a background check to see how well they did in their previous employment, and then they just tell them to do the job. What if they were problematic in their last office? What if they constantly took advantage of their last doctor with time-clock theft? Or worse, flat out embezzled from their last doctor. And then, who trains these office managers? The dentist? Heaven forbid…please!

Now what happens? Typically, the power struggle, whether seen or unseen, whether spoken or unspoken. We see the self-anointed office manager begin to exercise his or her lack of commensurate achievement by using the “title” of the position. Pretty soon the doc, hygienist, and assistants hide from them. Often times the power struggle exists between the doctor and the office manager. The docs expectations can simply be unfair with the office managers current training and the office manager overstated ability to effectively do the job. In defense of the office manager, how can they possibly be on the same page?

As the office manager begins dealing with those crazy insurance providers, and a few even crazier patients, they become frustrated and threaten to leave if not paid more. Needless to say, if they had better training their jobs would be easier. But where, who, and how do they get that training? Who of us honestly has the office manager’s back – like we do everyone else in the office, especially when we, the docs, honestly have no more business training than they do?

Until office managers have proper training to do their jobs, they really should be defined as “office administrators.” Many would probably prefer that title just to reduce the stress. How can any office manager make key business decisions without the training to do so?

So, we send our office managers off to “how to run a dental practice” courses at the dental convention, or sometimes to a training course taught by a self-appointed consultant that was trained the very same way they were. Ouch! However, they do come back with some pretty good ideas they want to try and implement, only to be shot down by the doc, and even the staff members. Why? Because they still are not grounded in good business practices.

Then the doc goes to a CE course and comes back with some good business ideas he or she wants to implement, only to be attacked by team members who suffer from what we call the YNINDI Syndrome, which stands for, “Yah, no, I’m not doing it.”

Office Managers, you need and must be vested in your practice. How can you be rewarded if you’re not? If you’re not invaluable, you are replaceable. So how do you get to that position of an office manager, a true dental office manager?

  1. Start by taking the Professional Office Manager Training at My Practice My Business. It’s one of the best office manager course in the industry. (Those are our client’s words, not mine.)
  2. Enroll in school to get an Associate Degree in Business. Ask your doc to pay for it in return for your loyalty and dedication to the practice.
  3. After that Associates Degree, consider finishing up with an on-line Bachelors Degree. Sure, these things take time, but they will only benefit you in the long run.

When the front office members have the commensurate training equal to the rest of the team, they truly become equal to all team members involved, and the dichotomy of the office no longer exists.

An Office Administrator is really about a $15-$18 per hour position, and that is honestly where most office managers should be with their knowledge base. But an office manager who continues empowering him or herself with knowledge is worth more. The office managers who go through our training become so valuable to the practices they serve, they typically make bonuses placing them where hygienists are paid. How you might ask? They typically bring in $5K to $10K more per month into their practice with the knowledge and training we bring to them – and receive bonuses off of the increase!

Everyone on your team has significant financial and educational investment with their jobs, except the office manager. I hope that has become obvious. It’s time to invest in that person whose primary responsibility is making the practice profitable. Invest in them and watch your profits significantly increase as you reclaim forgotten revenue in dentistry again.

Rob Thorup, DDS
Clinical Director
My Practice My Business

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