472: Is Your Practice Tracking the Right Numbers? Reaching Beyond New Patient Count | Brad Billings

Today we're going to introduce a game changer in the dental practice management software world...

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This is an innovative, all-in-one, cloud-based practice management software, and it offers an array of powerful features that are custom built for dentists by dentists ready to revolutionize the way you work. ‍If you are a start-up and decide to sign up with Oryx, they will NOT charge you a single dime, until you reached 200 active patients!⁠⁠They are partnering up with all startup practice owners and making sure you succeed, fast!⁠⁠ Click this link to schedule a FREE personalized demo and to see more on their exclusive deal!⁠‍‍Guest: Brad BillingsBusiness Name: Full ScheduleCheck out Brad's Media:Website: https://dentalbilling.com/full-schedule/Email: [email protected]‍‍Other Mentions and Links:Pacific Dental ServicesQSI AnalyticsDOSAbundant Dental CareDentrixDental IntelOpen DentaleAssistWeaveForbesAndrés Irlando Forbes top 40 under 40Fortune 500MicrosoftMicrosoft Leadership TrainingsPracticeWorksEaglesoftSQL databaseKois CenterCurve DentalDentrix AscendDentrix Enterprise‍‍Host: Michael Arias‍Website: The Dental Marketer Join my newsletter: https://thedentalmarketer.lpages.co/newsletter/‍Join this podcast's Facebook Group: The Dental Marketer Society‍‍My Key Takeaways:

Some of the core steps to an effective front office onboarding system are clinical and insurance fundamentals, understanding practice software, phone skills, and financial arrangements.Empowering your employees does not mean handing them a script. Give them some autonomy to make their own decisions under a certain dollar threshold.How should you handle mistakes by team members?Help team members be individually successful and they will make your practice successful.The top 4 metrics that contribute to high profitability are 1. continuing care growth, 2. open hours, 3. number of indirect restorations, and 4. percentage of firm financial arrangements.‍

Please don't forget to share with us on Instagram when you are listening to the podcast AND if you are really wanting to show us love, then please leave a 5 star review on iTunes! [Click here to leave a review on iTunes]‍p.s. Some links are affiliate links, which means that if you choose to make a purchase, I will earn a commission. This commission comes at no additional cost to you. Please understand that we have experience with these products/ company, and I recommend them because they are helpful and useful, not because of the small commissions we make if you decide to buy something. Please do not spend any money unless you feel you need them or that they will help you with your goals.‍Episode Transcript (Auto-Generated - Please Excuse Errors)

Michael: Alright, it's time to talk with our featured guest, Brad Billings. Brad, how's it going? Good. Brad: Thanks for asking. Michael: Awesome, man. We appreciate you coming on. If you can you kind of break it down to us? Tell us a little bit about your past, your present. How'd you get to where you are Brad: today? Oh, that's a, that's an interesting one.So actually worked at Verizon Wireless for a number of years. 15 years and made it to lower level executive status great leadership development program and I had a ton of really good leaders. think what was interesting there and probably what I'd translate into dental is, they just had every metric you could think of all the data that you'd ever want for any.Situation out of every store, every phone, everything, they just had all the data and we use that to, you know, gauge and monitor performance. I was in the sales channel, that's kind of where I started and I'll be brief on that 1. and then I moved to, uh, Pacific dental services and that was my foray into dentistry.And it's probably good that I went to a company like Pacific dental. Specifically because I didn't know anything about dentistry and they had a really good training program, which is obviously something that you need. If you're going to, if you're going to try to enter into a leadership role, within the dental industry, you have to know what you're talking about.So, pretty extensive training in a very successful region. and that kind of was my entrance into the dental world. And then the other thing about Pacific Dental is they also had an exorbitant amount of data. They worked out of a system called QSI. There might be a few people on the station that, that know of QSI.It's really archaic. It was written in DOS and, still running in DOS. You had to do. Manual um, command entries to get it to do anything. And, and then they had an overlay. I forget what the overlay was called for the doctors to enter their clinical notes charting and things like that. But the reason that they had such a hard time transitioning to anything modern, was because of the amount of data that they were getting out of that. And that really was the foundation, That I think helped kind of springboard me into success outside and into, small DSO and, and starting up a private practice.It was kind of that foundation and understanding that, metrics drive decisions. And, and if you're just making guesses about what you should do within the business, you're oftentimes going to, guess incorrectly without those metrics and data. Gotcha. Michael: And so right now, what are you doing? Brad: guess there's more background in all of that. I left for an opportunity to run a small DSO. In Utah, or to help run, I should say. So I got hired as the VP at Abundant Dental Care, a phenomenal DSO. I still have a great relationship with them. I entered in to that relationship.They had about, I think they had four practices, so very small. they were doing about, probably about 500, 000 a month. So a decent amount of money. They were like many small organizations that I saw. They were running they had a really good foundation. So they had like a really good team, really good processes, really good.Atmosphere. And this is kind of why I chose to go with them is because their foundation was so solid, really good clinical work. They had some of the best dentists out there with a really good clinical leader, which is stuff that I don't know. So I didn't want to try to tackle. solving clinical gaps along with solving operational gaps.So that's why I kind of decided to go with them. And then they, this is going to be the most boring podcast you ever.Anyway uh, they were operating off like, you know, sugar house dental care at gmail. com and they had, you know, four practices and they're just sharing documents across gmail platforms and, you know, they were careful not to share HIPAA information across those things, but that made communication super challenging.So, I initially came on, you know, as operations to help with the, case acceptance, closure and, you know, operational performance. And there were just so many gaps everywhere else that did do that. And then I also started to, work on automated reporting is where I started.They were doing these spreadsheets every night. It would take, you know, 45 minutes to an hour of. Office Manager's time. They tracked a lot. They tracked everything. How do they track everything? They, it just does a spreadsheet. And they would pull manual Dentrix reports. So they would, and I don't know if you've ever dealt with Dentrix at all, but say create this report, and then you can walk away.Like you can, Yeah. Go to the bathroom and, eat dinner and then come back and it might be done. And you do that, but you have to do, you know, four or five different ones, and then you take all the data manually off of those. And manually enter them in this spreadsheet. They had four different spreadsheets, which was also really weird, four different spreadsheets.And then they had another operator that would grab, from those four different spreadsheets that were filled out by office managers and manually enter them into this master spreadsheet that the owner would look at in the morning and decide what our day was like the previous day and try to take action, depending on that.Right. far as execution is concerned, like. They did a pretty good job with what they were doing. Like they always filled that out. They always, you know what I mean? There's a lot of people that try to do processes like that and can't execute on it because it takes a whole lot of accountability and follow up to make sure that those numbers are right.So they were doing a good job. But was manual and it took four hours at least each night, plus the hour that it took that other operator put it all together. So you're talking about five hours a day, you know, how many working hours a week. So it was an incredible amount of hours.And then it was, it was often wrong because, human error. So I just, I got a wild hair and I went to the owner. I said, look I, want to make this automated. This is ridiculous. We're doing it this way. and he was like no, I'm not going to give you any resources. You can't do that. I don't believe that you can do that.You don't have the skill set. I was like, sure. Yeah, I, okay. So I just went and did it on my own. Like at night I, I called a buddy of mine that I went to college with. And, at the time he was working for a data company, just basically doing what I was asking us to figure out. Right. And all the time I'm like researching all this stuff too.Cause I there's dental Intel out there and there's, there's a few others, but I researched probably three or four and I found out that bad data in, bad data out. And to get access to that back, that backend of Dentrix was, very expensive. And I don't remember the exact dollar amount, but I already didn't have any funding approval to do what I was trying to do.And so I'm trying to stand up on, this manual SQL backend. So what I did initially was I took this spreadsheet, put it into one, protected spreadsheet, and then had an auto pull from the spreadsheet into this database. so all I really did initially was remove That last hour of the combination from that other operator.And you know, but I worked and I was like, Oh, this is, this can be powerful, but I'm not going to, I don't have the means. We didn't have the means that this is company we weren't profitable enough to go pay the amount of money needed to get under the back end of denture. Yeah. I started to research open dental was the first one that, cause everybody researches up though they start there cause free, right.You have access to everything. You have access to all the tables. It's not an API. all the back end. So we just did like a demo account in this back end to Open Dental. And but I don't, I'm no longer employed by them. I, I ended up growing this big enough to contract with them and move on. Michael: So what is it exactly? Like, if you don't mind me asking the you're doing right now, Brad: I own two practices with a partner, a doctor, that's a partner in Utah. The laws don't make you you don't have to be a clinician to own. It's one of like three states in the US but we're set up as A D S O. So, I can own a portion of A D S O that owns practices. So we are set up legally for me to own in other states as well.But we, right now we just have two practices. And then, I also own a company called Full Schedule, which is, I'm in strategic partnership with eAssist. I'm not a partner of eAssist, so I have to make that very clear. We're a separate company, but I am in a strategic partnership with eAssist, the dental billing company, and we essentially Some of their clients I own a company that has employees that call and fill their schedule essentially.So instead of doing that automated faceless, nameless, kind of process with like the weaves of the world and whoever else we have, we put a face and a name to it, set targets to it and help them get treatment and hygiene scheduled and then, you know, we charge per office for Michael: that. So is it more like, that part, full schedule, is it more like front office services in the sense of like, Hey, I only have one front office right now, I need someone to answer phones and, take care of stuff whenever that person's doing other things. Brad: not yet. It is on the road map to have an answering service. so right now we just are filling schedule. So it's basically like, we're 2 years in our recare list is miles long, but for whatever reason, we're never full.And our treatment is still out there and it's not getting closed. So employ only, Currently, I would say stateside, so that we have, experience that we have hygienists that have been doing this for years and years, scheduling appointments, know what clinically they need to be doing all of these.So we have about 30 offices right now that we. Essentially, we just find out what they want to do, what they want scheduled how they want it scheduled, which operatories they want it scheduled in, what their treatment times are that they want scheduled. And then we follow those standard operating procedures for that office.And we fill the needs of that office, eventually, you know, fill the schedule. if we don't reach our commitments to the office, we reduce our price per each schedule not fulfilled to our commitment. Okay, Michael: man. That sounds legit. cause that is a humongous need, right?as far as when it comes to front office and answering services and things like that. So. That'd be really good. real quick, Brad, if we can rewind a little bit. You mentioned that you worked for Verizon and that they had a great leadership program. What to you, because it made it great, and what takeaways from that program would you recommend someone in a dental practice, your dental practice owner, utilize?Brad: That's a good question. think anytime you have a program at all no matter how good the curriculum is or anything else, it's dependent on the people that are in it. I was lucky. I, I had some of the, in my opinion, and granted, it's my humble opinion. I had some of the best leaders, even in Verizon.I had a. The president of my region that I was in, Oh, Andres Irlando, he was Forbes top 40 under 40, just a amazing guy. He's running another tech company now. then I had a couple of other really, some of the smartest men that I've ever met.I think that Fortune 5 companies draw those kinds of. And then I had another guy named DJ Leckwold and another guy named Shane Schwab. And these guys were just very focused on, you know, personal growth and leadership, what that actually looks like and how to communicate with your teams around performance.Cadence and meetings large workload organization, which was very challenging for me. and that's what I would probably say Verizon had is, and what these leaders did is Verizon has a ton of resources. They have classes going on around the country all the time. Either run even by teams of Microsoft employees to teach you how to use Microsoft more effectively.They have time management trainings. They have, communication trainings you know, trainings based on books like crucial conversations, and, they have all of these trainings going on. And what these leaders allowed their team to do, and a lot of leaders wouldn't because it would affect budgets.They don't understand the, uh, return on investment that you're receiving, but they would allow us to fly around the country all over. I remember flying to, you know, Massachusetts from Arizona so that I could take a time management class for Microsoft and they're not cheap, but, I still use large majority of those practices today, or I wouldn't be able to do what I do.and then on top of that, you know, obviously they modeled what a leader should, what a leader should do, what a leader should look like. So that's probably what I would say. I got, I got out of her eyes on this really good leader. Michael: Gotcha. But how are you implementing that into the practice or how would you, if you were to tell me like, this is what you got to do, Mike, for your practice?Brad: Around leadership specifically? Yeah. I think there's a Appropriate priority level leadership and leadership development. if you're an individual practice owner, we've purchased practices where there's this harsh separation between front hygiene and clinical, right? And your practice will never be successful if you're not running like you have a true leader to follow and that leader is engaged and helping the entire team be successful, and not just, the team being engaged to, make the practice successful, but also they need to feel like you're helping them be successful, whether that's in, you know, their goals and where they're headed, or.In their skill sets in the practice, but you have to be engaged and know what your employees want and what they're trying to do every single day and help them get their goals. And if you do that they'll give it back to you and help you be successful and be happy working for you. And that's, I think a lot of what leadership really is, especially on an individual practice level.From there, I mean, if you're going to go larger than that, then it, it comes to Having a an actual training process from soup to nuts. So from beginning to end, when you bring people on, you can't just assume they know exactly what you're going to talk about. And if you don't have defined training process, there's no way everybody's going to have that same training experience and everybody's going to deliver a different product to every patient that comes in and, and that creates uncontrollables that then create a lower performance.And, so yeah, that, that's kind of the difference between private and as you grow, I think private is you could really just be a leader by. Being engaged with your team and helping them be successful in who they are. And then outside of that you've really got to start formalizing and structuring a training program, leadership training and development.Michael: Do you have one of those for your, both of your practices, Brad: I've only left Abundant. think I've been outside of Abundant for three months. We just bought our second practice. In August. So, do I have one? No. And, have I felt the pain of not having one?Yes. Did I build one at Abundant? I did. We had a very robust training program with videos and tests and the onboarding processes. And I led that initiative and, and built that whole platform. And I also built a like a knowledge based platform so that, Yeah, after the training, they could go back and reference it.So, I desperately need one here. I just, as I'm sure many of your listeners know when you buy that second practice, You're first standing it up, making sure everybody's reducing turnover and, you know, keeping production as high as you can through that transition. Michael: Yeah.And we'll dive into that right now. But when it comes to the robust training, if you can, Brad, could you make us one right now? Meaning like this is what from beginning. The steps you should be in initializing, you know what I mean? Like the, I guess more like the title headline and then the headings and that's it, you know what I mean?Kind of thing. Like, how should it look? Brad: mean, that's a pretty tough question because it you want to. Michael: Could you give us like front office? Brad: Yeah. So like front desk. Yeah. Sure. And also this depends on your structure too, because different people have front desk, do different things. But, it starts with, dental knowledge. You have to have a foundation in dental knowledge and normally.When front desk, when you're hiring front desk because of the wages that they're in they really don't have foundational knowledge and I'm talking like, Keith numbers and surfaces and procedures and really just the basics because people are going to be talking to them about that stuff and they can't be just caught.Blindly in the headlights there. And from there, it would probably be to like foundational again, very basic knowledge of insurances and those sorts of things. So really just foundational knowledge between clinical and insurances. If you're taking insurances, I should say, they should know all the insurances that you take. They should know all the um, leased networks that you take and how to check to see if they're in that leased network, so that they can answer those questions appropriately. And then, the 3rd foundational piece for their job should be a complete understanding of the system they're using.So the PRM, that probably the first 3 foundational things, and then I would move very quickly to and I'm talking probably before they even have face to face interactions. They need to have those 3 things locked in and tested, or you're going to be every interaction that they have.You're going to be deteriorating the integrity of your of the perception of your business, right? And then even before again, still before the 1st face to face interaction, you should set some very clear expectations on. Communication to patients, how to answer the phone, empower them to solve problems without passing the buck all the way till the end, even if they're going to make mistakes doing it.And that takes some training too. We made a lot of videos at Abundant specifically how to answer questions when people say, I can't believe I'm on a 300 bill, let me say. You know, you very quickly say I'm, sorry that you're unaware of this bill. How can I help today? And then if they say, any anger at all, then it's okay, no problem.We'll take care of that for you. If it's under 500 bucks, it doesn't matter. We'll take care of it for you because the value of a patient is way more valuable than 500 that they didn't know about that you're trying to wrangle out of their hands. So. Anyway, so those, that's probably the foundational training for them and then it gets into more I'd say more detailed actually, you know, doing, insurance coordination and entering that into the systems and you're getting more into the details of making sure patients are set up for success while they're there, how to check copays and how to collect money at the front, things like that. Michael: So that's good, man. This is a good like process. And you mentioned something.A lot of great stuff, but one thing you mentioned is, you empower the team to handle problems on their own. It's super huge. So how do you do that? Like how do we, do we just provide them like with scripts of like, what if scenarios or? Brad: that's not empowerment enough you can't script everything.It's literally Hey, I want you to take care of the patients any way you can. Anything that you think is right probably is treat them how you'd want to be treated. If you go outside of the bounds, then we'll have a discussion, but you won't be in trouble. And then it's really you know, you got to hire well.you give them that, let them go. You can't micromanage true patient care. You really can't. And because every patient is going to be a bit, different and so you've got to have, the right front desk person with the right kind of empathy and communication skills to be able to make a lot of those decisions on their own.And yeah, I mean, there's absolutely times where like, Hey, you probably shouldn't have given that. 500 credit because they actually did owe that, but at the end of the day, if they did a very good job and that patient stayed, it's worth more than 500 bucks. So, again, it's, I guess, continual coaching.So that would be empowerment to me is you say, yeah go do it. You said very loose boundaries. Like if it goes over 500 bucks from grab us. But anything else you have full autonomy, just let us know when you're done and we'll talk about it. Yeah. Michael: Interesting. Okay. So like having almost like full confidence in them to, yeah, you made a mistake.And then almost to the point where it's like, well, let's just talk about the mistake. That way they're like, okay, it's cool to make mistakes. I mean, not huge ones, but I'll learn from them. You know what I mean? Brad: I mean, there's been big ones, man, but I still think it's more valuable for someone to have that empowerment and make One big mistake, but have corrected 20 mistakes that the patient was feeling. maybe we got 1 big mistake where they went out of bounds, you know, and they shouldn't have done that. You're still saving those other 20 patients their empowerment. And then you do that correction.And, and that is the attitude you take, like. We love mistakes you learn from it. That's great. I love that you did that. like that man. It's really good that's what empowerment is to me. Michael: Okay, and have you ever gotten like pushback from so you mentioned something about a PRM, right?So have you ever gotten people like hey, man We've been using Open Dental or practice works or Eagle software ever I know like the back of my hand like don't be switching it what happens Brad: And yes, I mean, every practice that I've been a part of acquiring and switched off of all the mainstream archaic PRMs that are out there, clinicians, especially they, they all have just challenges with that change and change is hard, doesn't matter what it is, change is hard.So I get it. And let me tell you the things that we can do after we make this change and why you're going to like this better. I mean, I think we mentioned it, but I use Oryx and all the practices that I've managed and that I own. I think that's the thing, as long as you are open about the challenges that are coming.And then understanding about the challenges that those people are going to be facing through the change. And then also you can express and make sense logically as to why the change is needed. Then most of the time you can get through those transitions relatively easy. We started really early with Oryx, and.It's a thousand times more robust than when we really, when we very first started. those first, you know, few months while I was learning and trying to teach it, I had to be the brand advocate and then I had to, get, one by one by one, these other to say, no, this is the PRM that we want to use and here's why.And, and with that one by one by one, they just kind of starts to spread. And now I mean, I still go back and ask like, Hey, if you had a chance, there's still hiccups in every PRM, but also in works. And occasionally we get a hiccup and they submit to their help team. And, And you say, Hey, would you switch?Like, even after this, would you switch? And every answer resoundingly, every time they'd never go back, there's no way to go back to a server based. Archaic DRM like that, there just isn't. Michael: Why did you decide to go with Oryx? Brad: So I was kind of getting into that before I stop, but it was that whole automated reporting thing.It started with Open Dental, and we spent a lot of money training on Open Dental on a single office. We switched one office over to Open Dental. It was on an, it was on an acquisition that we, so it was a new acquisition that we were doing at Abundant, and decided rather than, you know, Just paying for a year of, because Dentrix charges you a year up front, figured that practice, you have to re sign a contract.Rather than doing that, we were just like, let's just try Open Dental, see what happens. Super painful transition. They had good support. Open Dental was, good support, but just a painful transition. The conversion was rough. everything was pretty rough training. Everything was pretty rough.Posting was rough. Everything was rough. It was just new to me. And it was, and I'm the one training, so I'm trying to learn it and train it. And they had good support and all of that. And then we, we actually stood up automated reporting. So we pulled their backend just straight out of their database.Dumped it into a SQL database, and started running automated reports. And then I showed the owner and he was like, I want more of this. I want all of this. I want everything you can do with this. And so he was just fully body and like, when are we switching to open dental? So I started doing test conversions and all the other practices we had.And at that point, I think we had seven. So I started doing these tests conversions and open dental. I've got a lot of experience in conversions now, and I wouldn't have done it the same way that I was doing it in that first office. But anyway, I had probably 4 test conversions done. I was about to pull the trigger and I had a buddy call me from.Texas from PDS, a doctor buddy of mine. he had just got back from Coyce Institute. And he's like, just talk to me about his great experience with Coyce and comprehensive dentistry. And you know, his plan to make his practice just pop and dude, it was so exciting and he's a very engaging guy, just exciting guy to talk to.So I'm like, that's rad, man. What else, What else did you learn? Tell me everything. And he's like, Hey man, there's this software that he talked about at the end. It looked amazing. Have you ever heard of it? Oh man, I've been, I've been researching and I, I researched everything like curve, open dental, Eaglesoft, Dentrix, Dentrix Ascend, Dentrix Enterprise.you name it, I probably have done a test conversion during that time period for it. And I was still going with open dental after all of that. I was like, nah, man, I haven't heard of it, but. Man, I just don't see how anything this is. This has got to be the one I've looked at every other one.He's like, dude, just check it out. I called him up and yeah, I was blown away. Like, it's simple. It's intuitive. And this again was, this was four years ago. So it was much less robust than it is now. I don't know how to explain that any other way, but it did not have all the features that it has now.And so anyway I, it was really frustrating, but I remember calling the owner and I was like, Hey, look I, I hate more than anybody that I'm making this phone call right now. Like I've put months into this, I've put nights, evenings, weekends, just to even stand up our one office and open dental, but we got to do more.And he was like, no. And I was like, all right, well you, and we, Abundant was a comprehensive dental model. Which kind of, it very closely aligned, like Oryx and our model very closely aligned. was like, look, I understand. Like I said, I hate this too, but you just get on the phone. I'll get Ronnie on the phone, Ronnie and and our owner got on the phone and kind of talked through, they actually knew each other, which was small world.Yeah. But, yeah, it was very he eventually got, so he saw it and he was like, well, I could work. So we, you know, we decided to make the switch for all of them. So we switched all seven of our practices over to work. Michael: Nice man, that's good. And right now are you going to transition to Oryx 2 with your two practices or already?I do Brad: it. I do it on day one. Yeah, I don't take over a practice with that. Yeah, I've got so many systems built through this now that It just has to be done. Like rather than trying to figure out how to remote in to a server with RDPs and then manually track things I, I already have prewritten programs that pull from works as APIs.And so I, I've switched an office over day one and get API access and we're off to the races. So, man, Michael: all right, good stuff, man. So, cool. Oryx is the winner for you then. That's what you like. Oh, by Brad: far. Yeah. Yeah. and I would just, for anybody that's out there looking like, I am an Oryx fanboy, so I'll get that out of the way.But, at the very least, like, Just stay away from server based platforms. It creates complication and expense. You just don't need, just don't need it. You have to pay an it team any break that you have, like, I have an it degree and it takes me hours to figure out. These complicated setups.So, no, it's just not yeah, I would say stay away from those. Go online. Orcs is a great Michael: base. Yeah. Gotcha, man. Awesome. Awesome. So then I know you've been talking a lot about data and metrics and I feel like that's, that's your thing, right? So it is. Yeah. If you were telling me right now, I'm telling you like, Hey man, I can't, yeah.I'm struggling. struggling in the sense of like, Sometimes new patients are good. You know what I mean? looks like I'm growing, but my bottom line is also growing and all these things. What data or metrics would you say? Hey, these are the top metrics you need to hyper focus on.Brad: Yeah. All right. So this is what and this is A correlation I learned through my extensive training, top 3 most correlated metrics to practice profitability. There's actually more. We talked about 5 or 6. I'll give you top 3 and then we can. expand a little more, but top three, number one is is actually continuing care growth year over year.and it's super interesting because it tells you so many things, but care growth year over year is always the first place I focus. And the easiest way. To start that increase because you can't obviously that's you're waiting a year to see if so it's a very lag metric.It's, you look at it after the fact. So you've got to do something up front and track a metric to make sure that you are even approaching that attainable year over year growth. quickest 1 for that is just reappointment rate. them while they're in the practice? And if you're not anywhere between 85 and 95 percent, then you're actually deteriorating your practice growth year over year.And every practice that I've ever gone to is like, oh, we're killing that. We always reappoint our, then you go look at, they're always at 60 to 65 percent. I'm telling you, everybody right now on the things on your podcast is going to be saying, no dude, we're. We're at 80 percent easy if they had a number that actually pulled the data, I guarantee between 65 and 70, 60 to 70.It's always Michael: there. That causes it Brad: to decrease. And there's statistics and I don't want to butcher them, but there's essentially there's a certain. recare patients that return and a certain percentage of new patients that return. And so if you're below 30 new patients a month, which majority of practices are, I mean, both of these practices that we just got are well above that, but a lot of practices are at that 30 to 50 new patient range.If you're at 30 new patients are below and you're below I think it's 75 percent reappointment rate assuming they're going to come back, then you're going to have an actual deterioration of patients. unless you have obviously some sort of strategy to then reactivate them, but then you're doing double work on the backend rather than just doing it on the front end while they're in the practice.All of a sudden, now you're employing my company full schedule to reappoint your patients for you, which then is another added expense, right? Um, Rather than just doing that job up front and tracking performance of that job, making sure your people are doing it. Gotcha. Michael: Okay. So continuing care growth and then reappointment.Brad: Well, yeah, so really continuing care growth year over year, all that other stuff was just about continuing care growth, but that's where I would focus. Initially the 2nd most correlated is Dr. Days, Dr. Hours, call it whatever you'd like. It's a very easy one to think about, but I mean, the less days that you're open, the less money you'll make.and this is to profitability. I'm not talking revenue. So. There's a lot of practices that have this super concern of like, we don't have enough patients, so I'm not going to open another day. But the statistics show that you open another day, you're going to be more profitable. Even if you think you're not ready yet.If you open another day, you're going to be more profitable. And it's just, you know, open it up on, Google and you advertise for it and you put marketing out for it. You may be down for a couple of months, but for the year, you will be more profitable just to open the day and be there and your people will figure out how to fill it.That's number 2. Number 3 is, number of indirects, and this is a challenging one because you can't obviously set a quota on your doctors doing number of indirects, but it is just a very highly correlated metric. Doctors that do more indirects make more money. Michael: So more indirects. Brad: Yeah, indirect Michael: restorations.Yeah. Gotcha. Okay. The first one, reappointment rates. Man, that's pretty huge. So like when you come, when it goes to that, The system that you utilize that Brad utilizes for making sure reappointment rates happen is Hey, right when they're in the practice, we got to get them on the books for the next appointment Now what would happen and I'm sure you've experienced this many times, but like, you know how people complain like the no shows, right? What do you do for that? Brad: so there's going to be no shows. A good no show rate is actually 15%, which is still a ton. And that's a good no show rate, right? Traditionally, I'd say most practices are probably in between 20 and 25%. Which is a huge slide. And yes, you need to work your very best to capitalize on bringing those patients back in.doesn't really in my metric calculation, it doesn't go into reappointment rate. Because reappointment rate is if you came if you did a dollar of production, we counted as a completed appointment, and then we check for the next appointment schedule.So, we don't count that into reappointment rate. But yeah, we have strategies around and we actually do you know, heavy confirmation, and then. And so if they don't show, we usually know why and then if they're not there within 5 minutes, we call them and text them. And then if they're not there all day, we, you know, we reach out to again, try to reschedule appointment.But I think most practices do that. That's kind of like the easy low hanging fruit. you're not doing that as a practice, you've missed. That to me doesn't even have anything to do with metrics other than understanding your no show rate which brings me to my fourth metric, which is a percentage of firm financial arrangements, which is different than what I was taught historically, but in my data.Now, it has changed and from financial arrangements, this means collect in full for any appointments you put on the schedule with the exception of obviously like hygiene exams and be patient. You can't collect before they're there. But if you're going to put a root canal and a crown on your schedule, have it paid in full before you put it on there. Michael: Okay. Is there a specific script you kind of like mentioned when you're like, Hey, you got to pay us in full. Brad: You know, surprisingly, it's not super challenging. You just say we do collect in full for our procedures. Before we put you on the schedule and then you basically just say, how did you want to pay for that today?And then if they ask questions you just say well our doctor's time is valuable so we really have to make sure that the people are going to show up that say they're going to be here and usually when people pay that means they're going to be here and people really understand it They're not turned off by it at all. Like if they're really planning on being there They're going to pay for it. Anyway, the only thing that we do is If a patient's like, you know, I don't get paid till Friday can you collect for me on Friday? Then we'll say, yeah, and Norix has a great tool.You just send a text link. So you put a little reminder and, in a calendar, and then you send them a text link on that day and they pay over that. And if they don't, then you have to pull them off the schedule because. you can assume Michael: that they're not going to be there if they haven't paid. Yeah, that's true.So then these are like the four main metrics we want to keep looking at. What are, in your experience, what are the numbers or the data that you notice or you see like in the forums or on Facebook or something where practice owners are talking about it, they're looking at it, but in your mind, Brad's mind is like, man, that ain't even that important.Brad: Interestingly enough, new patient count, it is important. get me wrong. You have to have a new patient count to grow your business. But there's so many clinicians that come out of school that are, they don't even care. You're continuing care patient depth. They just care. Like if they're coming on as an associate in your practice, they want to know how many new patients. a crazy skewed metrics. 70 percent of practices established over two years. Their revenue comes from continuing care patients. 70 percent of the revenue. So 30 percent of your revenue only comes from your patients after two years. So if you're in your first two years, yeah, hit the marketing hard.Make sure you're doing your reappointment rate. But after that second year, you should be focusing very heavily on your exams what's going on there. Michael: then, Right now, one of the questions I wanted to ask you is what can a dentist do today, practice owner, to improve their marketing or their business? Brad: marketing honestly. Michael: Or their business, or their business in general. I'll Brad: give you, I'll give you my basic marketing rundown and we're, averaging about.Anywhere from 60 to 80 new patients a month at both of our practices, and it's super basic, and there's plenty of practice out there that can do much more than this, like Abundant was, really approaching 100 new patients a month, but they spent, you know, a ton of time on marketing. This is like me in my spare time while I'm also not managing operations.And helping, you know, look for new practices, but this is, it's super basic. You need, Google ads and you need a really high Google score. and that's it. If you have Google ads a low Google score, you're just torturing yourself. So make sure you have a ton of reviews. Make sure as many of them are as five stars.Don't do anything shady. Give them the experience that they want. And if you have those two things in place, patients just find you and they come. At least that's in my experience. And then we also have strategies that we're on, certain streets with 20, 000 cars passing with high visibility.Like obviously those things matter. But outside of that, that and sandwich boards and the new patient special, we don't do much. Michael: With your Google ads budget, what's the budget look like for there? Brad: 35 an office, we try to stay below 1. 5 percent of revenue. And really right now, we're at like, 0.8 percent of revenue because. We just don't need to keep spending it. So 3500 a month is what we. What we were doing and then we just never really upped it and we don't really have to Michael: you're doing pretty good like 60, new patients and everything like that. So that's really good, man.Awesome, Brad Thank you so much for your time, man I truly appreciate it But before we say goodbye if anybody wanted to reach out to you for questions or anything like that, where can they find you? Brad: man, I got I got a ton of email addresses. Let's do a Brad at MountainWest. Healthcare. Alright, Michael: Brad at MountainWest. Healthcare, you said? Alright, so that's going to be in the show notes below for anybody who wants to to Brad. And Brad, thank you so much for being with us, man. It's been a pleasure. Thanks for having me on. Brad: talk soon. Bye.‍