It’s that time of year. Traditionally we set goals and make resolutions for the new year and that is a fine thing. We all know that setting goals gives us something to shoot for and provides focus for what we want to accomplish. We can think of goals like being in a high-rise building and trying to climb from the floor we are on to the next one or even a higher level. In this model, in order to set a goal we have to understand what floor we currently occupy then decide how many floors we want to ascend in a given period of time. Though this type of goal setting is almost universally accepted, I’d like to point out a couple issues:

1. When you pick a floor, you also pick a ceiling – Think about it. Sure goals push you to excel and grow but they also place limitations on what you do. Almost every time I’ve set a goal in the past I’ve wished I’d set it higher once the goal was reached. We tend to find what we are looking for and we tend to accomplish what we set out to do. Also, we orthodontists tend to be failure averse so we are generally careful to set goals we know we can achieve. That doesn’t make sense. As Dr. Dick Barnes used to say, “It is far better to shoot for the moon and barely miss than to shoot for a cow pie and hit it dead center.”
2. You might be in the wrong building – While focusing so hard on reaching the floors above you, you likely will be oblivious to other options. Setting and chasing goals too often is like putting on a pair of blinders. This narrowing of vision and reduction of awareness is not a good thing. If you become too focused on what you think the goal is then you can be blindsided by something you never saw coming or totally miss an opportunity to excel in an area or way you never considered.

“Everyone knows that goal setting is a time tested and age honored way of doing business Burris. If you’re saying we shouldn’t set goals, what the hell are we supposed to do?” I can hear you saying. Well, I’m glad you asked

Look, goals are fine if you’re a rookie at this whole personal growth thing or if you’ve never tried to go from where you are to where you want to be. I mean, you have to start somewhere. But if you’re an orthodontist or orthodontic resident, I’d be shocked if you’re a rookie! It’s almost impossible given what you’ve gone through to get where you are. Goal setting is safe and socially acceptable and it feels good to have a concrete action plan.  I’ll readily admit that goal setting is better than nothing but let’s talk about what the next level looks like. If you want to elevate your game and plan to grow and succeed without the self-imposed ceilings and barriers that come along with setting goals, then consider this:

• Think about what you want in the broadest possible way – Let’s say, for example, you decide you want to become an  Invisalign Elite Provider in 2017. What would the goal you set look like? For most it would be, “I want to do X number of Invisalign cases in 2017 so I get Elite status and am listed on the Doc Locator as such”. That’s a fine goal and very doable in most practices but if you set your goal in this way, you’re missing out on so much. Let me explain. Here is what this goal looks like when broken down to its elements.
  • Do more Invisalign-> Elite status-> Doc Locator-> More new patients-> Practice growth
• Again, this is wonderful but if we would just think more broadly we could improve ourselves in so many ways that we had not considered. When I decided to do Invisalign again in late 2015, here is what my “goal” looked like.
  • Understand marketplace on large scale-> Understand patient desires-> Understand patient motivations-> Understand local market and pricing/financing-> Give patients what they desire on terms they will accept by reshaping my practice model-> Practice growth and stability

Honestly, I didn’t start out wanting to do more Invisalign. Bridget and I could tell the market was changing and that our business was changing so we knew we had to reexamine what we did and how. As a result of this broad based assessment and planning directionally, we discovered several things:

1. We were getting 20 odd calls a week from people asking for Invisalign that we turned away. Patients want Invisalign.
2. We were no longer a traditional owner/operator orthodontic practice and that meant we didn’t have all the bells and whistles we used to but we were still charging the same high fee and our numbers were suffering because of that.
3. Orthodontics was becoming more populist and many now consider ortho a rite of passage. Increased desirability created increased opportunity for orthodontists who could make orthodontics affordable.
4. We had been offering liberally extended financing in Arkansas for over a decade and that alone was not enough to be considered affordable any longer.
5. Most if not all local competitors demanded a high down payment for Invisalign treatment.
6. We were paying far less for brackets and wires and equipment and supplies than we used to and our capacity was much greater than it used to be because we had learned a great deal. We could get much lower per case pricing from Invisalign if we did substantial volume.
7. There was no need to have an elaborate TC process – comparable businesses do not do that. Changing this could save a massive amount of time and money.
8. In the processes of growing dental we lost focus on what got us where we were – orthodontics – and we needed to refocus on what we do best and what patients want.

So what did we do?

• We lowered our fee for orthodontics sustainably across the board and went to “one price” and one financing plan and marketed the hell out of it. Our pricing was strategic based on the local marketplace and designed to self promote via word of mouth in our target demographic. After a while we no longer had to market to get orthodontic new patients because everyone likes to share a deal they discover with their friends.
• We became far more efficient in our new patient process (much of that facilitated by the new, simple fee and financing plan) and this increased our capacity massively.
• We went all in on Invisalign, partnered with Invisalign in a substantial way and marketed the heck out of our Invisalign offering.
• We modulated our services to match our fee.

So what happened?

• We were shocked that we didn’t get an immediate response to our pricing on braces. It was foolish to think things would change immediately and it took a few months for people to believe our pricing wasn’t too good to be true. However our “Invisalign Deal” got traction immediately and the influx of new patients certainly helped bridge the gap.
• After about 2 months our new patient numbers and starts skyrocketed.
• Our conversion rate decreased (got worse) but our number of starts jumped. Because of our pricing, we get a lot more new patients these days – many who had never considered the possibility of orthodontics before. Logically, some patients have not had regular dental care and need dental work and this delays them starting ortho. Luckily for us we happen to have dentists in house (marketing ortho was a big part of the plan to attract new dental patients). We measure our conversion rate monthly so any delay in starting hurts our conversion rate but that doesn’t matter. Conversion rate is not nearly as important as starts!
• By focusing on orthodontics, giving people what they want with terms they find attractive and marketing our most desirable product, the entire practice is growing like never before and we are practicing/operating/marketing in ways we had never considered before.

So what’s the point of all this?

If we had set a traditional goal of “we want to do more Invisalign” or “I want to be an Invisalign Elite Provider” in response to our declining ortho numbers, then we certainly would have done more Invisalign but we would have missed out on all the rest. By deciding to understand what was going on around us and in patients’ heads we were able to make a much better plan (the plan actually created itself as we became aware of our reality) and the business is thriving because we left our pre-conceived notions at the door. Goal setting is a fine thing and much better than wandering aimlessly but I would suggest you consider deciding, instead, what you really want in the broadest possible terms then and then set about discovering everything about your desired outcome. If you start down that path and leave what you think you know behind, you’ll be surprised what you find and amazed by the plan of action that materializes. Setting goals harnesses what we think we know and locks us into a path without regard for reality. Choosing a direction and researching options with an open mind allows our plan of action to develop outside the constraints of “the known”. Which sounds better to you? Happy New Year!

“It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.”

Mark Twain