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June 13, 2008

By Linda Zdanowicz, CDA, CDPMA

I was recently involved in a practice transition, and here's my story.

My former boss is an amazing dentist and nice person. I had been with him for nine years when he sat me down and broke the news--he just couldn't do it anymore. I was stunned. I knew he was looking for an associate, but I didn't anticipate the end of our working relationship.

He had been in pain for a long time. He'd been in a bike accident 11 years ago and had broken his collarbone. He knew then that his injuries would end his clinical career early. At 52, his prediction came true. He also suffered from degenerative disc disease and arthritis in his hands, a deadly combination for a clinical dental career.

I went through several stages. First, I had a strong sense of loss. He was losing the career he loves, and I was losing the person who had given me so many opportunities for professional and personal growth. For the next two weeks I tried to find ways to change his mind. I thought about ways for him to work differently so that he'd have less stress on his shoulders, back and hands. I presented these ideas with great excitement, and expected him to respond with equal enthusiasm. I was, after all, giving him back the career he loves.

As with all misguided yet well-meaning efforts, it didn't have the desired result. Instead, I found myself faced with his breaking point. I wasn't thinking about what he needed, I was motivated by my own desire and delusion. He stopped me in my tracks when he said, "Stop trying to find ways for me to stay. If you really want to help me, help me leave."

What I didn't realize was that I was making him feel like a quitter when he needed understanding and support. He felt like he was causing a lot of unwanted change and pain for the people he cared about. He was trying to do what was right for his patients, himself, his family, and staff. He needed to be able to make his decision, make peace with it, and not be required to explain or justify it. He had enough pain and stress to deal with without having to handle someone else's. The last service I could do for him as his practice manager was help him find someone to continue his legacy. He needed me to leave him alone to find his way to his future.

Once I finally figured that out, I had direction and purpose. I started with myself. I needed to stop seeing his departure as an end and look forward to what would come next. Yes, I'd miss my boss. He's been an integral part in my professional life and accomplishments. I would find out later that all of that would still be of service to this practice that I'm so devoted to. First, we had to find the right person to buy the practice. We hoped to find a dentist who would continue the legacy of compassionate care. My boss believed in meeting people where they are, understanding who they are, and discovering what they need from us.

We wanted to find someone with similar philosophies. When a dentist starts a practice, he is birthing the dreams he nurtured through the years of preparation in dental school. Once the practice is born, its future is determined by what the dentist puts into it. It's much like raising a child. If it's nurtured and surrounded with people who care about its welfare and future, it will most likely mature into someone to be proud of and who will serve others well. A dentist parents a practice and goes through the terrible two's with it. The practice is on its feet, but not completely stable yet.

He worries as it stumbles through staff changes, economic ups and downs, and the demands of a growing patient base. As time goes on, he finds himself delegating some control to others so that he can concentrate on providing dental care so that the practice can keep growing and improving.

My boss was just through the "teenage years" and right at the point where he could relax and enjoy the rewards of a mature practice when he realized that the best thing he could do for the practice he'd nurtured was turn it over to someone else. What a difficult realization, and what strength it took to acknowledge and act on it. Only the best guardian is capable of such an unselfish decision.

The courtship began, and like a father who finds that most suitors are not worthy of what he holds dear, most of the dentists interested in the practice just didn't seem like the right one. We needed someone who would care for and nurture what had been so carefully developed for so many years. And then, the right one came along. We recognized this and felt equal parts relief and regret--relief that the one we had envisioned had finally arrived, and regret that the one who had made it all possible would step aside.

Finally, my boss wearily but hopefully handed what he treasured over to one who was anxious to make it his own. He may have thought, "Is he the right one? Will he care like I cared?" And perhaps the new dentist thought, "Can I care for what he loved as well as he did? Will I ever be as good as him?"

As with all good people, each man saw what was vulnerable in the other and reached out to make what was weak, strong and what was uncertain, sure. They set an example of generosity and cooperation, and together they put the future of the practice and its patients before their own concerns.

Now, imagine what it was like for the new doctor to walk into the practice that had flourished before he arrived and assume the seat at the head of the table. How did he present a picture of confidence on legs that must have felt shaky, when he appeared before the group that would depend on him to make their way? How would it feel to realize that the people before him were determined to help him succeed?

People have choices in every situation, and we chose to help him. He didn't have to win us over; we were with him and ready to walk into the future with him. His future is ours, as well. We believe in him and spread the word, and soon the patients did, too. He's a lucky doctor to have a staff that feels fortunate to have him with us.

I remember my first meeting with my new boss. I felt as nervous as if I were interviewing for my position. I was worried that he wouldn't want someone else's office manager or that he wouldn't want me to keep the same responsibilities. I was afraid of losing something. I never even considered the possibility that I'd gain anything with this transition. It didn't take long for me to feel really good about this new young dentist. I found myself wanting to help him and see what he would make of the practice. I lost my fear and began to see a bright and happy future. It would be different, but it would be good.

What have I gained? I'm involved in the rebirth of the practice I thought had reached a healthy, but predictable maturity. Everything old is new and exciting again, and it's fun. I get to work with a young dentist who goes home at night and tells his wife that he loves his job. I'm part of that and it's an honor to be so trusted. As a group we're going in new directions and exploring new ways of doing things. Some will be good and some will be mistakes, but we'll enjoy the journey.

Advice I share with someone facing a practice transition is: It can be heaven or hell, but whatever it becomes is the result of the dominant force in the practice. We all wanted our transition to go well. We talk and think positively about what is happening. We give unconditional support to our boss and each other.

Patients ask us what we really think of him and we say we think he's great. He does his part by being a great guy to work with, expressing appreciation to his staff, and really caring about patients. He does his homework and looks over charts the night before. He comes into the operatory and knows what happened two years ago, not just two appointments ago. He calls all operative patients every night to see how they are. He's warm and personable and easy to like. As a result, we've seen very little attrition in our patient base. Not a very complicated recipe for success.

Do you think this is the stuff fairy tales are made of? Well, I can tell you. It's a dream come true, yet it's real life. We found the right person to carry on what was started by my boss. All that I had learned from him could now be used to usher in a new legacy. It's not the end of the road, the path has just diverged. We all hope for the best for each other and wait for what's next. With the wisdom of experience and the anticipation of youth, we continue to nurture this dream that began when a young man walked into town and said, "I'll start my future here."

Bio
Linda Zdanowicz is the practice administrator for Nigel R. Morgan, DDS. She has been involved in dentistry since 1978. Linda will be a presenter at the 2009 Florida National Dental Convention. She lives in Hendersonville, N.C., with her husband, Mark. They have raised three children. Zdanowicz writes the Exceptional Dental Management Web log. The URL is Dental Practice Management.

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