The disaster caused by "extra hours and extra days"

I want to take you back, for a moment, to around August/September of last year.

It what was we came to know as the first "return to work" phase.

Many practice owners felt the need to either catch up with cash flow and/or patient demand after lockdown.

Thus developed the idea of extra hours and extra days:

• Let's open "eight till eight" - shift #1 from 08:00 to 14:00; shift #2 from 14:00 to 20:00, with appropriate re-allocation of existing team and maybe a touch of recruitment;

• Let's open Saturday as well (maybe even Sunday?).

By Christmas 2020 the consequences of this started to become apparent.

Previously happy and talented team members:

• Resigning to take "9 to 5" jobs in dentistry at lower hourly rates;

• Resigning to take jobs outside of dentistry;

• Resigning to start or grow side hustles - dog-walking businesses, artisan coffee shops et al.

Oh - and by the way:

• Clinicians taking alternative opportunities with better hours;

• Owners totally burned out and unable to think clearly;

• Patients no happier because they still had to wait and, when they arrived, the team were frazzled.

I found myself, over Christmas and New Year, trying my level best to offer therapy to the burned out - respectfully suggesting that they needed to get their lives back and limit whatever damage had already been caused to the team. Most returned to "9 to 5" at the start of this year.

So - the reason I'm creating this post, this morning, is that "here we go again".

To start with - trying to solve similar problems:

• Too many new patient enquiries;

• Waiting lists extending in some cases to January;

• The need to maximise cash flow in the face of impending increases in costs and wages;

• New NHS thresholds;

• Keeping up with plan patients;

• A desire to make hay before the impact of rising prices and inflation hits consumer confidence;

• Here's a new one - the desire to maximise a potential sale value.

In the overwhelming majority of examples I've seen, "extra hours and extra days" is a VERY short-term gain that creates long-term pain.

There is, however, a big difference this year.

When, three months after you implement extra hours and extra days, your team breaks - this time around it isn't going to so easy to replace them, because as you well know, recruitment at the moment is a nightmare.

Which means even higher wages to attract the replacements and so it all becomes a vicious downward spiral.

I have a simple request (and I might be creating this post so that I can just share a link when people ask).

Don't do extra hours and extra days.

I know - you are asking "so what do I do in the face of this increased demand and desire?"

• Put your prices up;

• Become a "plan-only" practice;

• Create better virtual pre-clinical consultation systems, delegated to your FOH and TCO team, so that you can robustly triage new patient enquiries

• Embrace the TCO/IOS new patient journey;

• Zone your diary even more rigorously;

• Delegate more of your clinical work;

• Cross your fingers that new IP&C measures will speed things up soon;

• Learn to say "no" to new and existing patients and ask them to wait or move on.

All of which are better than watching your team disintegrate and yourself lose the plot.

Just saying....

Have a great weekend (at home).