Solving endo’s Catch-22 lifestyle gap

Dr. Albert (Ace) Goerig discusses an effective method of providing essential care

The great advantage that endodontics has is that almost everything we do is classified as essential care. Regardless of the economy, insurance, or demographics, conditions requiring endodontic treatment occur with predictable frequency in any population. It’s an enduring clinical need, with associated pain often motivating patients to seek timely care.

The great disadvantage we have is that a significant portion of our patient flow is therefore driven by the need for prompt emergency care. By the time patients with escalating pain see their GP, it may be so severe that treatment is needed as quickly as possible … ideally the same day.

That is the source of our Catch-22 lifestyle gap. We can be a hero to patients and referrers alike for quickly providing essential care, but to do so requires that we are almost always available on short notice when the emergency referral call comes in. As a result, many endodontists end up working more days per week, more days per year, and fewer vacation weeks than any other dental specialty.

In fact, Endo Mastery had a new client last year whose biggest problem was its top referrer. The referrer insisted as an explicitly voiced condition for continued referrals that the endodontist be available every day (including weekends) without exception. While most referrers are not so exploitive, it is true that we implicitly worry about what our referrers will do if we’re not available. Will time off drive them to refer to someone else?

The solution to improved lifestyle

Schedule coverage is the fundamental issue that must be solved for endodontists to truly have time freedom. Therefore, a solo practitioner will always need to make trade-offs that balance time off with the needs of referrers and patients. However, two endodontists working together do not require compromises at all. It’s a lifestyle model for endodontics that creates flexibility for the lifestyle doctors want.

With two doctors, a practice can be open every week of the year (provided you plan your vacation weeks at separate times). That means you could take as many vacation weeks every year as you want, and in turn you cover the schedule for the weeks your partner takes off. At Endo Mastery, we think 10 weeks off per year is a good goal — great lifestyle with your family and lots of time to recharge and avoid burnout.

The lifestyle benefit also extends to the weeks you are working in the practice because you don’t have to be there (or on call) 5 days a week. You can work 4 or 3 days per week to your preference, with your partner providing schedule coverage on the other days. For example, you work Monday, Tuesday, Wednesday; and your partner works Wednesday, Thursday, Friday.

It might sound like reduced days means reduced revenues, but that is not true. The average endodontist completes three to four cases per day. With a properly designed schedule template and a highly trained team, you can complete six or seven cases per day easily and effortlessly without feeling rushed. In 3 days, you can complete as many cases as you previously did in 5 days. Plus, with more schedule coverage from two doctors, referrers learn they can rely on your practice even more, and your reputation and referrals actually increase.

An even smarter lifestyle coverage strategy for two doctors is to alternate weeks in which they start or end the week. For example, this week you work Monday, Tuesday, Wednesday; and next week you work Wednesday, Thursday, Friday. That results in working 3 days (at the same or higher revenues than 5 days), then a 2-day weekend, then 3 more workdays, then a 6-day weekend. Six days! It’s like another whole week off every two weeks!

Implementing the vision

In this scenario with perfect coverage, the total workdays for the year per doctor is 146 days (10 weeks x 5 days + 16 2-week cycles x 6 days) with no decrease in revenues. That’s a far cry from the 240 days (5 days per week x 48 weeks per year) that a solo doctor feels pressured to work.

Of course, forming that partnership can be a challenge. It might be difficult to bring two doctors with existing teams and practices together under one roof. When both doctors are closely aligned on the vision and goals, then it becomes possible.

However, in my view, the best way to achieve great lifestyle is by growing your practice to the point where you can add an associate. You can maintain control of your practice while developing a working relationship (and expanded profitability) with another doctor who meets your goals for lifestyle. Plus, the young endodontist benefits by joining a successful practice focused on long-term quality of life for doctors. It’s win-win for both doctors.

One of the most exciting things that I get to do as a practice coach is work with doctors to create a vision like this. Endo Mastery helps doctors grow their practices, become associate-ready, integrate a new associate, and transform the owner-doctor’s life with incredible financial success and time freedom.