Woe is “WE”

January 22, 2023
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This past Thursday, I was granted the privilege of asking a question of Dan Kennedy on our monthly Diamond Membercall.  I took the opportunity to ask about an issue that is facing many of my personal coaching/consulting clients and dental practices across the country.

The question was; “In light of the recent employment situation, what are the best marketing tactics to use to find and retain great employees?”

His answer was simple and profound, if not a bit depressing.

“Make the economics of your business so profitable that you can spend the most to attract and retain good talent.”

By the way, this is a take on his philosophy about marketing and generating new business (patients), which is, The business that can spend the most to acquire a customer wins.”

While I somewhat disagree with the latter (that’s a whole other topic), I appreciate the validity of the former.

Our employees and potential employees are being exposed to marketing that promote salaries and bonus amounts that are not advantageous for dental practice owners.  They know that they are ‘in demand’ and if they want more money, they can easily find it elsewhere.  Inflation just aggravates the matter, as it makes their need for more money more acute.

It just makes sense that being able to pay your employees well and offering them exceptional benefits can help attract and retain the best talent.  Some people might work for “passion, purpose and praise”, but those won’t put food on their table and a roof over their head.

INFLATION has made that painfully clear.

The unfortunate part of this formula is that many dental practices have built a business system whose economic structure is inflexible.  Reliance on Insurance results in a limitation on the revenue from most services rendered and on top of that, the discounted amounts received come months after the serviceshave been delivered and all costs incurred.

What a great model for the Insurance Company.  It’s abundantly unfair for dentists.  But it’s not new!

Sam Walton (founder of Walmart) exploited such a model.  His vendors, my father in-law was one, had to ship goods (ladiesunderwear), give 90-to-120-day terms for collection, and if the goods didn’t sell, they were shipped back for a credit.  Because they were so big, they could dictate the terms to smaller suppliers who needed their business.

Similarly, dental practices are dictated terms by the Insurance companies who hold sway over their subscribers and a practice’s patients.

Walmart is just one example of how such an exploitationalmodel works.  What’s happening today is not new.  It’s just another version of the economically powerful controlling the economically weak.  But the ‘weak’ eagerly comply, just as my father-in-law did.

I once asked my father-in-law why he put up with it.   He said that Walmart’s business kept the factory (in lower Manhattan) busy (expensive machines and workers) so that they could afford to make more profitable (sexy panties), that had a smaller market.

In fact, my father-in-law, who I loved dearly, admired Sam Walton.  I thought that was unusual, given that he was exploited.  I finally understood this phenomenon in 2012 after reading a book.

Michael Drew and Roy Williams described such a model in their book “PENDULUM”, which theorizes that cultures move in 80-year cycles between “WE” and “ME”. In their model 2023 is 18 years into a “WE” cycle, that will last until 2045.  As I grew up in a “ME” cycle in the 60’s, it was difficult to understand anything that limited personal liberty.

The last “WE” cycle started in 1925.  Look at what happened 18 years into that cycle, and you can get a sense of the power of such a trend.  Hitler, Stalin and Mussolini were able to get millions to comply with the most heinous activities in the name of “WE”.  Think of the socialistic ideologies commonly discussed today for the sake of “WE”!

Today, Insurance companies can get away with such exploitation in the name of “WE, or “The Public Good”.  And altruistic physicians and dentists have complied because they too want what’s good for the masses.  And while they have, until recently,been able to sustain an admirable lifestyle, everything seemed to be just fine.

Until it wasn’t.

Look at some recent headlines.  Things are starting to get a little rank.


New survey shows troubling trend in physicians’ income

Our Covid response in another example of a “WE” cultural trend.  WE (many) were willing to be locked down and forced to get vaccinations because we’re in such a “WE” cycle.  During a “WE” cycle, society as a whole is compliant with what’s best for the most.

Drew and Williams, who are marketers, understand the macrotrends that govern humanity and societies.  Their thesis is based on the premise that humans as a species always take a good thing too far.

It takes 20 years for WE-cycle behaviors and policies to begin to reach their zenith. And then another 20 years to undo them.  Then, a “ME” cycle begins (1965-2005, with the next one 2045-65).

“Medicare for all” was a little early.  And perhaps he wasn’t the right messenger.  Or perhaps the Insurance Industry too powerful?

We will increasingly see promotion of the “single-payer” system, which was recently mentioned in California.  Surprise!  Leave it to the left coast to be the leading edge of a “WE”movement.

Don’t discount this as crazy.  It’s coming, because it’s an acknowledgment that Insurance Companies have exploited the WE.  In a relentless pursuit of profit, they’ve gone too far. Another system must therefore be developed to replace them, while still promoting the “WE” goal of healthcare for everyone, or as it has been rebranded; “Healthcare as a RIGHT”.

The stench from the current exploitative insurance model will be accelerated by employment shortages and inflation.  Healthcare has been hit hard by these socio-economic trends, resulting in acute shortages, increased burnout rates and significantly reduced profitability.

Here’s a prediction:  The Candidate of either party in the next Presidential election who promotes a kinder, gentler, less exploitative “WE” program, will win.  It’s all about the messaging from the right messenger.

As a dentist. What can YOU do?

My mother taught me to never bring up a problem unless I had thought about a potential solution.

Next week, I will present a controversial strategy, which willhelp protect your practice from the onslaught of profit-ravaging programs that are on their way.

In the meantime, you can help protect yourself and your team by subscribing to The Liberated Practice program, formerly known as Coffee With The Coach.

Stay tuned for the antidote for the “WE” symptoms of shrinking profits and employment woes.

Towards a better “WE” and a happier “ME” (YOU),


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Dr. Michael Goldberg is one of the leading educators on dental practice management in the United States.

Michael ran and sold a prestigious group practice in Manhattan and has been on Faculty at Columbia University and New York-Presbyterian Medical Center for 30 years including Director of the GPR program and Director of the course on Practice Management.

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