Guest Column — Chuck Blakeman — Build a Practice You’ll Love, and Get a Life, Too

The first time our CEO heard Chuck Blakeman speak, David’s thought was that “this guy truly understands the essential challenge of owning a small business”.  His book Making Money Is Killing Your Business (available on Amazon)is something that every dentist should read.

We are thrilled to have Chuck as a guest columnist!

Build a Practice You’ll Love, and Get a Life, Too.

Build a Practice You’ll Love, and Get a Life, Too.

“You get what you intend, not what you hope for.”

Chuck Blakeman

Too many practice owners and managers think their purpose in business is to make money. Surprisingly, it’s not. The practice owner’s purpose is to build a business that makes money. Making money, and building a practice that makes money are worlds apart. Almost every practice owner or manager I know is absolutely buried in trying to make money, which keeps them from ever making a lot of it.

From the beginning, Diane and I thought of all three of our kids as adults in the making. We looked forward to being adults together, where we could all invest in each other, help each other find significance with our lives, and simply enjoy each other for decades.

Dental Practices Should Grow Up, Too

I think dental practices should grow up, too. I don’t mean “it would be nice if it happened.” I mean we should all, every one of us, expect our businesses to grow up and start giving back to us and to the world around us.

Nobody would argue with me that we should intend for our children to grow up and become adults we could enjoy for decades. It’s normal for children to grow up, so why isn’t it normal for dental practices to do the same?

Most practices never grow up. We spend decades changing the diapers in our business. Twenty years later we’re still spending as much time, emotion, and money on our business as we did the day it was born. Why would we so eagerly anticipate the maturity of our children and never expect the same for our business?

I believe the root of the problem is a conventional view of business. The very thing you think will make your business successful, a focus on trying to make money, is the very thing keeping it from happening: You’re too busy making money. No business can survive that. It’s not a play on words—it’s a serious problem. You’re simply too busy making money, and most likely it is stopping you from building a practice that will ever grow up.

Two Opposing Realities

There is a good explanation for why we get stuck trying to make money. Dentists, like all business owners, are constantly fighting to balance two opposing daily realities:

The Tyranny of the Urgent vs. The Priority of the Important.

It’s a daily battle. Almost universally we let the Tyranny of the Urgent keep us from paying attention to the Priority of the Important. I haven’t met anyone who doesn’t struggle to properly balance these two realities.

The Tyranny of the Urgent

The Urgent things fly at us all day, every day, causing us to be reactive and defensive as we hold the practice together as best we can. The Urgent things are tyrannical—they want to rule over us. Like small unruly kids, they scream and yell, poke and prod, and are relentlessly in front of us.

One of the most Urgent things pulling at us daily is the need to make money to cover today’s bills. Think about it. That great-looking clinical space, those shiny instruments, and that great location very quickly turned into a relentless liability screaming, “I need money!”

We don’t have to find the Urgent things—they come and find us. Over time we resign ourselves to the notion that this is normal. And besides, all the dental practices around us seem to be doing the same thing. Welcome to the Dental Practice Treadmill.

The Priority of the Important

In stark contrast is the Priority of the Important, which sits patiently in the corner, whispering, “I can help you solve the Urgent stuff. But you’re right; taking care of me today won’t make you more money right now. I’ll try to nudge you again next week as you go flying by.”

The Important things require us to be proactive because they almost never seem Urgent—planning, processes, training, patient experience, and leading. We don’t make money right away doing those kinds of things, and they’re definitely not as Urgent as paying the bills.

I know plenty of people making millions who are totally focused on the Tyranny of the Urgent. But they’re on a treadmill. Attending to the Urgent can only bring us Riches, which I define as money. But attending to the important things will bring us true Wealth, the freedom and the ability to choose what to do with my time and my money.

Which do you want? Riches you don’t have time to use, or Wealth, the freedom that allows you to go on vacation while your practice makes money for you? Freedom is the best evidence I can come up with that you have paid attention to the important things and now have a mature practice.

You Get What You Intend, Not What You Hope For

Shelley ran her husband’s very successful dental practice in upstate New York full time as the practice manager. For years she had always hoped to figure out how to gain the freedom to start her own consulting business, but the Urgent things kept her on the treadmill. As we worked with her, Shelley developed real clarity on what the practice should look like at maturity, just like we had done with our kids.

With Utter Clarity on where she and her husband wanted the practice to end up, they were no longer relying on the Random Hope strategy of business—working really hard and hoping something good happens. Instead, they were now focusing on a few Important things that would solve a lot of the Urgent things, like planning ahead, developing and writing down simple processes, training people, delegating decision-making, and building a great culture.

In well less than a year Shelley had gone from manager to leader, and was down to investing two hours a week in the practice, not managing, but leading – creating vision and guidance, supporting, training, and asking clarifying questions to keep everyone on track. All the things she thought she could never delegate were now in the hands of the front and back office teams.

She gained freedom without hiring an office manager to replace herself, simply by moving all those management functions to the teams. And the teams were thrilled to take on the responsibilities because it allowed them to begin to make decisions that had always been made for them. Shelley’s consulting business is now booming. Everybody wins.

Failing or Getting Tired

Statistics say fifty percent of businesses fail in the first five years and eighty percent within ten years. But what actually happens is the business owner gets tired because they are focused on the Tyranny of the Urgent, reacting to their business and living on a treadmill. When you’re tired, you stop paying attention to important things, and that will result in failure.

A treadmill is very exhausting and demoralizing if you don’t know how to get off of it. The way off that treadmill is not easy, but it is simple. The profound things are always simple.

Time and Money

The key to getting off the treadmill is time, not just money. A law practice in Denver was stuck at $9 million a year, and the two founders had only taken one week’s vacation in eighteen years. One day they changed their intention. They started requiring that the practice give them back time, not just money.

Four years later the practice is thriving, with $25 million in revenue, exponentially higher income for the partners, and no end in sight for the growth. More importantly, the two founders now take almost two weeks a month off, and a month in the summers. After his first month off teaching his daughter to surf, one of the founders said, “My first thought was that I could have gone my entire life and never had this kind of time, and then secondly, I realized I’m only in my forties and now I get to do this the rest of my life.” You get what you intend, not what you hope for.

Dental practices should be built like this, so they produce both time and money. We focus a lot on how the practice could provide us money but rarely think of how it could produce time. And it is this separation of these two that keeps us from having enough of either.

Thinking Differently About the Result

I regularly get the following response: “This makes such great sense, why haven’t we heard this before?” The Industrial Age taught us that if you make enough money, you would somehow magically be happy. But money is only a resource, a means to an end, not the end itself.  By pursuing money alone, all we’ve done is bought ourselves a job and an immature business requiring constant supervision. Why not build a practice someone would love to buy, but then keep it and enjoy it? If you built a practice that got you off the treadmill, that gives you both time and money, you wouldn’t want to sell it.

A successful Washington state practice is now doing just that. After years of micro-management, they decided to build what we call a Participation Age practice around self-managed teams, and it’s working. One of the doctors wrote this note recently:

“Today was a great day even though we were down one doctor, two treatment coordinators and three assistants. Now that the teams are self-managed, they are taking the initiative to cross-train their respective Stakeholders. To make ten columns work there was a collective playing of musical chairs today and it worked almost flawlessly. It was truly amazing. Tanya (the office leader, not manager) and I spoke after work and we think what happened today was a direct reflection of our people taking the initiative and working as a team from hiring to training to implementing.”

Be Intentional About What You Want

Your expectations for your practice should be no less than those we have for children. Expect your business to grow up, or you’ll still be changing its diapers decades later. It’s not rocket science, and it’s not a matter of talent or luck, but simply focused intentionality.

Are you in? You get what you intend, not what you hope for. Let’s figure out what it takes to get off the moneymaking treadmill and build a mature dental practice you can enjoy for decades, that produces both time and money, and gets you off the treadmill.


Want to learn more?  You can contact Chuck through his website http://www.chuckblakeman.com/ or by phone at 303-669-2349

Essexville MI woman pleads guilty to stealing prescriptions for opiates from dental office

BAY CITY, MI — An Essexville woman police say stole prescription forms and used them to obtain controlled painkillers has accepted a plea offer.

Heather M. Malone, 32, on Wednesday, March 1, appeared in Bay County Circuit Court and pleaded guilty to two counts of obtaining a prescription by fraud. The charge is a four-year felony.

In exchange, the prosecution dismissed a charge of larceny in a building, also a four-year felony.

Circuit Judge Harry P. Gill is to sentence Malone at 1:30 p.m. on Monday, April 17.

Malone’s case dates to July 14, 2015. That day, a Bay County Sheriff’s deputy responded to a theft complaint placed by Dr. Raul Mosqueda, who has dental offices at 4181 Shrestha Driver in Bangor Township. Mosqueda said several prescription sheets had been stolen and he speculated Malone, a former employee who had quit a year and a half previously, was to blame, court records show.

Mosqueda told the deputy that he recently needed some painting done in his offices. He ran into Malone and she offered to do that job. Malone and another man in mid-June visited the offices to perform the task, the dentist told the deputy.

Though Mosqueda paid Malone $2,500, she never completed the task, he told the deputy.

On July 7, Mosqueda began receiving calls from several pharmacies asking if he had written prescriptions for Malone. He told them he had not.

Mosqueda provided the deputy with data recorded by the Michigan Automated Prescription System (or MAPS), showing multiple prescription requests in his name for Malone and others starting on June 18, court records show.

Between June 18 and July 2, Malone used the prescription forms in attempts to obtain 130 tablets of hydrocodone for herself, with seven others attempting to acquire 460 such tablets at pharmacies in Bay and Saginaw counties, court records show.

Hydrocodone is a semi-synthetic opioid. Brand names include Vicodin, Norco, and Lortab.

By July 27, Malone was lodged in the Bay County Jail on an unrelated matter (specifically, an armed robbery allegation). The next day, the initial deputy and a detective interviewed her.

During their conversation, Malone said she did steal the prescription sheets from Mosqueda’s desk. She and another man had used them to write numerous bogus prescriptions, though she said the pills obtained were used for personal use and never sold, court records show.

“Heather stated that she and (the man) would go to the various pharmacies with the individuals and wait for them to come out with the prescriptions for controlled substances,” states a police report contained in court files. “When the individuals came out of the pharmacy they would divide the pills three ways.”

Malone also claimed Mosqueda was aware of her addiction and had previously written her prescriptions for Vicodin. According to court records, between May 2014 and May 2015, Mosqueda had only written two prescriptions for Malone, one for tramadol and one for hydrocodone.

Do you have questions about embezzlement?  Give Prosperident a call at 888-398-2327 or send an email to requests@dentalembezzlement.com

 

Content retrieved from: http://www.mlive.com/news/bay-city/index.ssf/2017/03/essexville_woman_pleads_guilty_2.html

Former NC medical office administrator embezzles $900k; going to prison

Editor’s note — as you may know, we normally confine ourselves to investigating dental office embezzlement.  However, we do provide reporting on significant embezzlements in medical offices because the methodologies employed have considerable commonality.

Mallard embezzled almost $900,000 from women’s center

Correction

This story should have said she owed $697,714. Mallard paid $195,444 in restitution of the $893,157.41 she embezzled. The insurance company for Eastern Carolina Women’s Center paid about $100,000.

Original story

Betty Small Hurley Mallard, a 62-year-old accused of embezzling nearly $900,000 from a medical practice, pleaded guilty Monday in Craven County Superior Court and was sentenced to five to seven years in prison.

Mallard, a former administrator at Eastern Carolina Women’s Center, was facing six Class C felony embezzlement charges and up to 60 years in prison.

Judge John Nobles consolidated the charges and gave her the lesser sentence.

Nobles said the case was difficult in many ways and wasn’t like normal criminal court cases. Someone age 62 would be devastated going to prison, he said.

“I guess I could give her 30 years,” he said, “but I wonder how many in here think she would live 30 years.”

Nobles said after listening to the attorneys and doctors from Eastern Carolina Women’s Center, the crime was serious and Mallard needed to go to prison.

“I recognize we’re dealing with somebody with serious mental problems,” he said. “I recognize she has made some restitution, and I recognize the damage she has done to the practice.”

Before passing sentence, Nobles said, “I do hope you’re able to survive it.”

District Attorney Scott Thomas said while he would have liked to see more active prison time for Mallard, he understood the judge’s reasoning.

“The defendant came to court, pleaded guilty, and paid partial restitution,” Thomas said. “We asked for a higher level of an active sentence and the judge decided not to give the highest sentence. But 60 to 84 months in prison for a 62-year-old is still a significant amount of time in prison, especially for somebody with no criminal record, no prior charges or convictions.”

Michael Mills, Mallard’s attorney, said the embezzlement started in September 2005 and continued to November 2015. The aftermath cost Mallard her home, a lot she owned, a beach home, and her retirement savings, he said.

Mills said he saw the embezzlement as one crime instead of the six with which she was charged. But Tonya Montanye, a prosecutor working with Thomas, said when Mallard was working at Eastern Carolina Women’s Center, she was writing checks to herself and giving herself raises to which she was not entitled. When she left the center, she had a $150,000 annual salary.

Co-workers grew suspicious when they saw pictures of an extravagant cruise ship suite she stayed in and began wondering how she could afford it, Montanye said.

 Mallard’s large spending habit included taking $22,000 from the center to pay off one month of her personal credit card bills. In six years, from 2011 to 2015, she took $686,451 from the center to pay on her personal credit card that had monthly charges from $500 to $1,000. She made $35,230.13 in unauthorized purchases from the company credit card, Montanye said.

“She had a very extravagant lifestyle,” she said.

That lifestyle included spending $2,775 at Peacock Plume, making seven purchases one day buying shoes that cost up to $398, Montanye said.

Bill Faison, who was also representing Mallard, said she had a college education and liked working at the center and everyone there liked her.

“But plain and simple, Betty is mentally ill,” Faison said. “It is unfortunate. … it acted out on her job. She spent the money on such silly things: handbags … just nothing. Just threw her life away for nothing.”

But Mallard was not a threat to anyone, Faison said.

The person signing the checks shouldn’t be keeping the books, but that wasn’t the case, he said.

“Because of her mental illness, she has done a terrible thing,” Faison said. “She is now broke, destitute, has given it all up and now faces whatever your honor thinks should be done.”

Dr. Rob Patterson of Eastern Carolina Women’s Center said Mallard’s actions harmed the practice. Two doctors had to resign because they could not afford to pay themselves while trying to compensate for the embezzlement.

Fifty employees were also affected and morale was harmed, which possibly harmed patient care, Patterson said.

Mallard, wearing a blue dress, stood before the judge.

“I would like to express my deepest regret and remorse to Eastern Carolina Women’s Center,” Mallard said in a quiet voice. “I take full responsibility for my actions. … I have great respect for the practice, physicians and employees and felt a great sense of loyalty toward the group.”

Mallard said she realized she had mental health issues that cause her irrational behavior.

“I’m deeply saddened to have disappointed those who placed their faith and confidence in me,” she said.

As part of her sentencing, Nobles ordered Mallard to get a mental health assessment at the Department of Corrections and to reimburse Eastern Carolina Women’s Center the remaining balance of more than $600,000 owed in restitution.

Do you have questions about embezzlement?  Give Prosperident a call at 888-398-2327 or send an email to requests@dentalembezzlement.com

 

Content retrieved from: http://www.newbernsj.com/news/20170320/former-medical-office-administrator-going-to-prison

Stamford CT Dental Office Manager Pleads Guilty to $500k+ Fraud

The woman falsely billed insurance companies for work under a retired dentist’s name.

STAMFORD, CT — A former dentist officer manager pleaded guilty to defrauding private insurance companies after she used a retired dentist’s information to submit false claims.

Elene Ilizarov, 44, of Stamford pleaded guilty to wire fraud. She worked at Advanced Dentistry and between 2005 and 2016 she billed private dental insurance companies for services allegedly performed by an identity theft victim for patients of Advanced Dentistry, according to the U.S. Attorney District of Connecticut office.

The victim dentist was affiliated with Advanced Dentistry for a short time and retired fully in 2011.

Do you have questions about embezzlement?  Give Prosperident a call at 888-398-2327 or send an email to requests@dentalembezzlement.com

 

Content retrieved from: http://patch.com/connecticut/stamford/stamford-dental-office-manager-pleads-guilty-500k-fraud

IL woman makes it to Federal court for large embezzlement from medical office

Editor’s note — as you may know, we normally confine ourselves to investigating dental office embezzlement.  However, we do provide reporting on significant embezzlements in medical offices because the methodologies employed have considerable commonality.


LOOMNGTON — A Clinton woman accused of stealing more than $400,000 from the medical practice that employed her is in negotiations with federal prosecutors to resolve charges that carry a possible 20-year prison term.

In a court filing delaying her March 7 jury trial in U.S. District Court in Springfield, attorneys for the government and Veronica Luster disclosed that the two sides “have met on several occasions in an effort to resolve the factual disputes regarding the amounts in issue” and recently obtained information.

The lawyers “have discussed a resolution of this matter, but have not finalized a critical term of any agreement,” according to filings by Assistant U.S. Attorney Bryan David Freres and defense lawyer L. Lee Smith.

A March 17 hearing is set to discuss a change in Luster’s not guilty plea she entered shortly after her arrest on mail and wire fraud charges in 2015 related to the alleged embezzlement of more than $400,000 from Clinton Internal Medicine and Dr. Farrukh Kureishy.

Kureishy, who is now employed at the Family Medicine Clinic at Warner Hospital and Health Services in Clinton, filed a lawsuit in 2014 against his former office manager. The doctor accuses Luster of taking more than $600,000 from the medical practice for personal items, including books, clothing, home improvement items and electronics.

The pending lawsuit seeks repayment of the office funds and Luster’s salary.

Luster was employed at the medical practice from 2005 until her termination in 2014 after the alleged embezzlement was discovered.

Do you have questions about embezzlement?  Give Prosperident a call at 888-398-2327 or send an email to requests@dentalembezzlement.com

 

Embezzlement News #55 — March 2017

 

Prosperident’s Dental Embezzlement News
Issue #55 — March 2017
In This Issue:
  • Guest Column — Kevin Tighe
  • Upcoming speaking dates
  • A note from our CEO

Our most-requested presentation is called “How To Steal From A Dentist”. And it is never boring!

Mar 3 Dolphin Management User Meeting, Nashville TN
Mar 9 Greater Philadelphia Valley Forge Dental Society, Philadelphia PA
Mar 10 Pacific Dental Conference, Vancouver BC
Mar 17 Dr. Michelle Haddad Memorial Scholarship Lecture New Hartford, NY
Mar 21 Greater Woonsocket District Dental Society, Providence RI
Mar 24 Eaglesoft User Group Meeting, Houston TX
Apr 4 Texas Dental Meeting, San Antonio TX
Apr 4 Tri-County Dental Society, Wilmington NC
Apr 19 Lakeshore OMS, Lake Elsinore CA
Apr 20 San Diego AGD, San Diego CA
Apr 21 Upper Island Dental Society, Comox BC
Apr 25 GCO Orthodontics, Calgary AB
Apr 28 Keely Dental Society, Hamilton OH
May 4 Atlantic Canada Seattle Study Club, Halifax NS
May 10 Tax Matters For Dentists, Toronto ON
May 12 Tax Matters For Dentists, Ottawa ON
May 25 Patterson Dental, Nashville TN
Aug 25 Kentucky Dental Association, French Lick IN
Sep 19 Dentsply Sirona World, Las Vegas NV
Sep 22 Patterson Dental, Dallas TX
Oct 20 Thompson Okanagan Dental Society, Kelowna BC
Nov 14 Fresno Madera Dental Society, Fresno CA
To book us for your meeting or study club, click here or call us at 888-398-2327.

Senior Investigator Dr. Pat Little

Pat was once a happy, wet-fingered dentist when, as they say, he was “bitten by the investigation bug”.

After retiring from clinical practice, Pat returned to college to study accounting and then fraud investigation. His heritage gives the dentists who he works for instant comfort in dealing with “one of their own”.

Pat is also one of Prosperident’s busiest speakers, and he has entranced audiences at Hinman, ADA, and Chicago Midwinter meetings along with many other venues.

To request Pat’s speaker’s packet, or to see a video of him speaking at a conference, click here.


Guest Column — Kevin Tighe, Cambridge Dental Consultants

We consider Kevin to be both a friend and one of the smartest guys in dentistry. Let’s hear what he has to say about dealing with that costly phenomenon, cancellations.


Reducing cancellations and no-shows have similar but different protocols for:

  1. New patients
  2. Patients due for re-care
  3. Patients past due for re-care
  4. Patients scheduled for operative

Ten Point Checklist

  1. Patient communication: Despite amazing technology available to dental offices, the most important step to keep no-shows and cancellations low is talking to patients while they are in the practice to ensure they’re educated on the negative effects on their oral and overall health that can occur if they do not receive the needed treatment and on-going re-care.

READ MORE

Cambridge’s website is here, and the phone number is 800-595-2380.

Meet An Embezzler — Rosemary D’souza

Rosemary

Rosemary was the office manager and bookkeeper for a Georgia dentist for over 20 years. Rosemary and family were charged with embezzling $2 million from 2009 to 2013.

We profile Rosemary, and over 400 other embezzlers, in our Hall of Shame. Wondering if an embezzler is working for you? Check out www.prosperident.com/prosperidents-hall-shame-gallery/

A Note From Our CEO


I got a call last week from a friend of mine who is a long-time practice management consultant. I have known her for many years, and completely respect her judgment.

She is working in an office where the office manager seems to be overly resentful of my friend’s presence.

The consultant is used to encountering resistance from office staff, because consultants are often hired by dentists to make changes that the doctors have been unable to implement on their own. However, the pushback that my friend was receiving in this office was far stronger than what she was used to encountering, so she called me to discuss the ongoing antics of the office manager.

The embezzler’s perspective on a consultant is simple — embezzlers are pretty confident that they can fool their doctor, but a consultant represents a much bigger threat. Therefore he or she will do everything that they can to convince you that a consultant is not needed, or even actively sabotage the consultant’s work.

After listening to my friend, I agreed with her assertion that the office manager was acting out, and I arranged to have one of my investigators take a quiet look at transactions in the practice management software. He quickly reached a verdict of “suspicious”, finding hundreds of unusual transactions. Obviously our work is just starting, but I will try to update you in a future newsletter.

The moral of this story — if you are working with a consultant who develops embezzlement concerns about your office, take them seriously as their experience and outside perspective put them in an excellent place to identify this problem.

Thanks for reading.

David Harris CPA, CMA, MBA, CFE, CFF
Chief Executive Officer
Did you miss a previous Newsletter? We archive them here.
Prosperident is the world’s largest firm investigating financial crimes committed against dentists.