To Open or Close? That is the Question.
As we are now well into the new year, I would like to spend some time reflecting on the recent past and planning for the coming year.
Were you open for business between the Christmas and New Year holidays?
When I left the Canadian Forces and first worked in private practice as an associate, I was working in a shopping mall where the clinic was open during mall hours. For four years, I worked the week between Christmas and New Year’s Day.
Although there would be the occasional person who wanted to get dentistry completed to use up their benefits before the end of the year, I found this week to be very quiet. (Many dental benefit plans have since changed so that the benefit year does not coincide with the calendar year. This made fiscal sense to insurance companies so they would not take a massive hit to their cash flow at the end of December. It encouraged their clients not to pay attention to the benefit year and maximize their benefits. Insurance company profits rose after they made these changes.)
Generally, I found that week a great time to catch up on some reading, go for walks in the mall and see the odd emergency. Patients would make appointments with every intention to come in, but the reality of being off work and enjoying a holiday with family and friends resulted in consistently high cancellation and no-show rates. Thanks to computers and the ability to track production, I realized that the production of the dental clinic during this week was 75 percent lower than the rest of the year on a daily and hourly basis.
Then I purchased a private practice — not in a shopping mall — and, in the first winter, I opened the clinic between Christmas and New Year’s Day. With no walk-by traffic, I had even fewer emergencies and a lack of normal dental work. My production fell over 80 percent on a daily or hourly basis. It was then that I decided to close during that week and have not worked that time since (more than 20 years).
It is unethical to close your clinic and not provide emergency dental health care for your patients, so I made arrangements with the shopping mall clinic to look after my patient emergencies. Inevitably, there would be one or two people who needed care, and I was grateful that I knew someone competent would be there for my patients.
It was a win-win-win-win situation. My patients were happy they could see someone I trusted. I was happy to have the time off and not lose money paying my team to be at the office. My team was happy because they got to spend the holidays with their family. The mall clinic picked up a few extra patients.
So, did you open or close during the holidays? Did you track your income in that week? Does it make financial sense for you to be open then? Or would it be better to partner up with other clinics and clinicians to rotate being open in the future, giving everyone an opportunity to have time off while ensuring patients are looked after?
Just some things to think about as we head into 2018.