Perhaps one of the most frustrating experiences is the lack of correlation between the above standards of excellence, and the productivity and profitability of your practice. Worse yet is the fact that declining profitability directly and adversely affects your ability to deliver excellent care!

"My patients have no choice -- and I therefore have no choice -- but to succumb to the inevitable of invasion of big brother (HMO, PPO, DMO) into my dental practice. As more and more patients leave my practice, and fewer new ones call to replace them, I realize the sad reality of the current state of dentistry." If you believe this to be true, then it is. However, learn to recognize the fallacies, and you and your patients may be rewarded beyond your wildest dreams.

I recently attended a dental practice management lecture at which the following statement was made by the lecturer: "Keep doing what you've always done, and you'll keep getting what you've always gotten." It scared me to death. Not because it's true. Rather, because it is no longer true! If we practiced in a vacuum, it might be the case. However, external forces significantly affect and alter our ability to achieve the same outcome from consistent management routine. Tom Peters (the best-selling business author in the United States) said, "Quote me in five years and you'll be entirely wrong." (My window of opportunity to use even that quote is running out.) That's how fast business is changing. Dentistry is a business -- and it's changing a whole lot faster than that!

Why did the dental lecturer's message scare me? Because if her message were true, consistent management of a thriving practice would continue to yield a thriving practice. Sadly, this is no longer the case. Whether highly successful or underutilized, we all need to constantly re-evaluate our management style and dental practice business plan. Where should we look for guidance? Perhaps it's time to look outside.

Since dentistry is a business, perhaps then we should look toward the business world. Your journey may even be an enjoyable learning experience -- a fulfilling one which reaps rewards of plenty for all. Dru Lebby delivered a key-note message last year that we were perhaps not yet ready to hear: Invest time, effort and money in whatever's worked really well for you in the past, and you may be headed for disaster. No different than Peters' quote warning us not to depend on five-year old wisdom!

Microsoft's Bill Gates took one of the most dominant companies in the history of the planet and purposely tried to destroy it! Gates walked into the think tank of Microsoft's multi-million dollar research brain trust. He closed and locked the door behind him. He demanded of his R & D teams that they wipe out all memory and record of every project in process! He purposely tried to destroy Microsoft as we know it! He told them of a one hundred and eighty degree about-face. From that moment on, every research dollar would be thrust into the Internet. Peters' comment on Gates' move was one of awe and respect. "Bill Gates attempted turn-around of a fiscally healthy, thriving giant is nothing short of spectacular. Awesome!"

But why? Why would Gates take such an incredible risk? Why mess with the ultimate success? Because no computer giant has ever survived the first decade of flaming success. Digital. Wang. IBM. In their time, all were thought to be invincible. None looked around the corner, much less over the horizon.

Tom Peters' and Dru Lebby's messages were almost identical. Each and every organization (large and small) has a pattern through which all growth areas must cycle. From small businesses to civilizations, we all make the same mistake -- when things are gang-busters we invest more and more into perpetuating that growth. Our limited long-term vision blinds us to potentially catastrophic failure, as outside environmental influences take their toll. Translation: If your practice is doing well, don't passively sit by until some factor beyond our current horizons takes you down. If your practice has already felt the pressures of dentistry's current challenging business environment, it's time to react, yesterday!

Peters said that he was in awe of Gates' foresight and fortitude (pulling the plug on what's working, in search of the next giant star). When asked whether or not the gamble would work out for Microsoft, Peters replied that it was an incredible move -- but it could as easily take the company down, as catapult it into its second decade of glory.

Look outside of dentistry for insight into the business future of your practice. Read Peters and Drucker and Gates. Seek out the writings of Ted Nicholas, Dan Kennedy and Jay Abraham. Listen to tapes from Jo Sugarman, and Steven Covey -- just for starters. We spend so much time perfecting our clinical skills that we lose sight of our declining ability to fiscally protect the "hand that feeds us."

Recently, the Madow Group had the insight to enlist the help of Hiram Smith (of Franklin-Covey) and Ken Glickman (of the Greenwich Institute for American Education) to enlighten a group of 1000 dentists and dental team members. Mr. Smith's company is responsible for the Franklin Planner. He spoke about principles we all place upon a window through which we view our world. A window which alters behavior and can predictably determine future outcome. Useful for personal and professional relationships, as well as internal growth and success. Mr. Glickman spoke of "I-Power," a system for constant incremental improvement. So eloquently described, one could hardly leave without a plan for predictably successful implementation into dental practice. Well beyond the scope of this article, each of these gentlemen's messages could help us to build and sustain growth beyond our present limited visions.