Kiera is joined by Mike and Stephanie Walton of Walton Family Dentistry in Bardstown, Kentucky. For the past almost year, the Waltons have not had a hygienist in their office. They talk with Kiera about why they were struggling to keep one staffed, what led them to stop having one in the first place, and how they efficiently and profitably operate to this day without a hygienist.
Episode resources:
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Leave us a review
Transcript:
Kiera Dent (00:05.844)
Hello, Dental A Team listeners, this is Kiera and today is such a special episode. I am so excited. I am being joined by our incredible clients. I've got Mike and Stephanie Walton. They are running such an incredible practice. They are doing something so different, so unique, and I just wanted them to come on and share just about themselves. I think they're just a great example for so many offices out there. So Stephanie and Mike, welcome to the show. How are you today?
Mike Walton (00:30.602)
Doing great, doing great. Thanks for having us on.
Stephanie (00:33.948)
Thank you so much.
Kiera Dent (00:35.114)
Yes, absolutely. And I'll do better. I'll ask like Mike this, Stephanie that, because I know when there's three of us on here, can get a little funny, I'll just have Mike, I'll have you kind of kick this off. You two are incredible. I finally met you for the first time. We've worked together for so long. Tiffanie's your main consultant, but it was really dreamy when I got to meet you in June at the Dennis Money Show with Dennis Advisors.
Stephanie (00:39.209)
.
Kiera Dent (00:59.07)
So super fun, I'm excited to see you guys in person really soon too, but Mike, I'll have you just kick us off, kind of tell us a little bit about your practice, where you guys are at, kind of the dynamics of what you guys do in your practice. So the audience gets to know Mike and Stephanie Walton's office.
Mike Walton (01:11.809)
Great. So we are central Kentucky, little south of Louisville. So we're in a town called Bardstown. That's the bourbon capital of the world and the most beautiful small town award that we've received as well.
Stephanie (01:27.244)
In America.
Kiera Dent (01:28.69)
I agree. And you also bring the best candies and treats with you. Like they loaded us up when they came and met us. Bourbon Central, it was amazing. It was great. I was so like, it was so, the Carmel Stephanie, top notch, incredible. That was my favorite. So thank you.
Mike Walton (01:43.318)
Well, and Kara, have to say, you know, when I first saw you there, you know, of course we've seen each other on the think tank and, I saw you across the room and I was like, Hey, there's Kara. And I was like, she probably don't know who I am. We've never met before officially.
Stephanie (01:44.759)
You're welcome. Majestics.
Kiera Dent (01:46.961)
Exactly.
Kiera Dent (02:01.086)
I did it. Well, cause you know, you guys can see Mike, like there's video of him, Mike always, so we have, meant in think tank, which is our doctor mastermind every the first Tuesday of every month that we have. And Mike always wears his Yankees hat. Always. He always has a hat on. So even tonight I'm like, Mike, what are you doing? I'm not even going to recognize you. And you're right. I was like, where's your Yankees hat? That's fair. All right. So you guys are in Kentucky.
Mike Walton (02:19.4)
I'm saving it for next season.
Kiera Dent (02:27.103)
Tell us kind of the dynamics of your practice. How long have you been practicing? What does this practice look like?
Mike Walton (02:30.026)
So I've been practicing, it'll be 22 years in June. Started out in partnerships and then went out on my own about six years ago. So we are a small office where you are about five operatories. It's one doctor. And then right now it's four assistants, two front desk and then office manager.
Stephanie (02:35.246)
you
Kiera Dent (02:56.552)
And did you hear there's no hygienist, which is what we're going to lead into of how Mike went from a hygiene practice where he had hygienist to the shortage. was crunch time. Like he couldn't figure out how to, like it was so hard to hire. And so that's what I'm super excited to talk about. There was literally four assistants, no hygienist. Stephanie, tell us about your place. How are you in the practice? How did you get involved? I mean, you must really love Mike to be working there. You're even like scrubbed up over there, girl. It's not like you just shop. Tell us kind of how you.
Stephanie (03:07.129)
you
So I could tell that he was kind of unhappy at the last place and I was like, you know, it doesn't have to be that way. And so we started doing some research about how to open an office because they don't tell you a lot of business in dental school. And I had my own career and we had three little kids, but I wanted him to be happy. And we found ideal practices and they helped us open the office up and it was well worth the money.
And so that's how I got in there with him. And it was just he and I and an assistant and a hygienist when we started. And now we have two wonderful girls at the front desk. And so they do the majority of running the day-to-day stuff and I get to do the stuff that expands the practice and things like that. So we've come a long way, especially with your all's help.
Kiera Dent (04:16.54)
amazing. Tiffanie loves you. She raves about you. guys, every time you're on her coaching call schedule, Tiffanie is like, I get to talk to the Waltons today. Like truly, it has been such an incredible relationship. She adores you. And Stephanie, I love that you love Mike so much. And I think that that's just so telling of who you two are as a couple, what your practice is, the vibe you have, really just coming together as a couple. So now everyone is wondering and I'm wondering, like, how did you guys even come to this decision to have no hygiene? And how is that even like
operating. Like I need to know this because when you mentioned it on think tank, I didn't realize because I'm not on all of your calls that you literally had zero hygienist in your practice and it's been that way for a little while. So whomever wants to like take this on, I don't know whose brainy idea it was, like how did you guys even come to this decision and how is it going and give me all the things.
Mike Walton (05:04.002)
Well, I think what kind of led to, know, after COVID came through, you know, the number of hygienists went way down and, you know, it was constant turnover. It was, you know, they were in such demand and every office needed them that it was constantly training and getting them adapted to how we like things done. And then
Stephanie (05:19.492)
Okay.
Mike Walton (05:30.66)
somebody else would make a better offer and then they would go. And you know, their schedule would be booked out six to eight months and they'd give you a two week notice. And it was super stressful because you know, then we're faced with, well, we're running an ad, there's no way we're gonna get somebody to replace you in two weeks. And it got to the point where it was like, do we reschedule all these people or do we squeeze them in? And we were squeezing them in.
Kiera Dent (05:34.666)
Mm.
Kiera Dent (05:42.377)
Yep.
Mike Walton (06:00.778)
And it was stress and stress and stress and more stress. And then we got to the point where we're like, we can't do this anymore. and you know, you'd go through the cycle where you'd finally get somebody to bite on your ad, you'd get them in the office. And then, you know, I think about every maybe three or four months, it was turnover. And we were going through the same thing again. And we finally got, we're like, how do we, how do we get out of this terrible cycle of.
Stephanie (06:19.136)
you
Mike Walton (06:30.441)
of one, having to train, and two, having to deal with a six month schedule that's booked out for a two week notice. And the team was feeling that too. It wasn't just us because they were picking up a lot of the slack. And so we were like, gosh, if we keep doing this, they're going to get frustrated. We're going to lose the whole team. And then what are we going to do?
Stephanie (06:53.736)
And we have a wonderful team. The assistants are wonderful and the two at the front desk, shout out to Haley and Jessica. They are great.
Kiera Dent (07:03.346)
Yeah. Stephanie, how did you feel going through this? Did you agree with Mike? Were you like, let's just cut bait and try and see if we can figure this out? Or were you like, let's not do that. I mean, the traditional model is we need hygienists. We know we need two hygienists for every doctor. Like, Stephanie, what was your take? Because I think if I was in your shoes, I have a reasonable level of risk, but I'm also very risk adverse. And so how is it for you? I mean, this is your livelihood. You two are a couple in this. You went away. You've given up your career. You're in this now. Stephanie, how is that for you?
making this decision to go hygiene-less in a practice.
Stephanie (07:36.508)
you end up with kind of your opposite when you marry you know and so I'm the kind of like let's don't miss the boat and he's like that let's not rock the boat kind of person so so this was my idea like I was like
Kiera Dent (07:48.042)
Okay. I love it. I knew it was. I didn't even know, but I was like, I bet it was Stephanie's. Just knowing you two, I'm like, I bet.
Mike Walton (07:54.627)
But that's what I was gonna say is that I think you're directing this question to the wrong person.
Kiera Dent (08:02.612)
Yeah
Stephanie (08:03.274)
So I'm always like, well, what about this? And what about this? And what about this? And they're like, you're wearing us out. And so I try not to change too many things. But at the same time, I'm like, if anybody has any ideas, that's the great thing about small business and not having anybody to be your boss. You can try it. And if it doesn't work, you try something else.
Kiera Dent (08:26.47)
Exactly. Stephanie, what was your career prior to joining the dental practice? Where did you come from? What were you doing? I know you had three littles. So what did you do beforehand?
Stephanie (08:34.462)
was an occupational therapist. So I did, you know, worked at the hospital post, you know, rehab for strokes and hip replacements and things like that. So it comes in handy telling him about ergonomics and protecting that because I had patients that were former dentists. And so I can help the assistants and hygienists. We had one when we switched to this model and assistant
that was having some ulnar nerve impingement because she was doing so much of the same task. And so I was teaching her about ulnar nerve glides and ergonomics and stuff. So that's what I did before.
Kiera Dent (09:13.564)
I love it. And so what's fun about that is I wanted to highlight that because I think so often having a fresh perspective like you'd have Stephanie of we're running a ragged race and Mike, I think we're in dental. We're so ingrained in dental. That's why it's really fun to have consultants or have other business people or have someone else's perspective. So Stephanie, how did you pitch this and what was your reasoning? Like walk me through, how did you even say like we're getting rid of the hygienist? Like forget it, Mike. We're going to go for this. Walk me through kind of your thought process of even how you
thought to do this and then I'm excited to hear Mike how you guys actually ended up doing it.
Stephanie (09:46.832)
You know, I don't even know if I'm on a lot of different forums and a lot of just to learn podcasts, consume, you know, and I don't know if somebody else was doing it or if it was like a hybrid from like accelerated hygiene or if it was just the fact that can we entertain the idea of not having that position in the office.
and then boost the wonderful people that we do have, you know, could we make that work? Because I'm kind of like, you know, out of the box, you know, well, have we ever tried this before? And, you know, I watch a lot of Simon Sinek, you know, you can have anything you want as long as you don't hurt anybody else in the process, you know? So.
Kiera Dent (10:29.224)
Yep, yep.
Kiera Dent (10:33.13)
Mm hmm. All right. So Mike, she pitches this to you. Let's get rid of hygiene. I can only imagine a dentist's worst nightmare is, hey, you want to start scaling teeth again? So I'm just dying to know, Mike, how did this pitch go? I'm imagining Shark Tank. Stephanie's got the like white boards. Like we could do this. We can think outside the box. And Mike, you're like, but this means I have to scale again. So Mike, how did this go for you? Give me come because I guarantee you dentists listening are like
I'm hanging up. Like I'm not even gonna listen. How did this dentist even say yes to wanting to do hygiene again? Because I imagine that that's how it's rolling in your practice right now. Well.
Mike Walton (11:04.144)
Well, you know, we've been married. We've been married for it'll be 24 years this year and together for 31 years. And I learned a long time ago that I say, you're right. you know, it doesn't take a lot of fight anymore to kind of get me to go along because
Kiera Dent (11:13.374)
Wow, congrats.
Kiera Dent (11:22.942)
Yeah
Mike Walton (11:28.956)
She does a lot of that research and a lot of that background. You know, I've always been more of the technician and she kind of says, hey, if you think about this, you think about that. And she's got a good way of presenting it to where it makes all the sense in the world. You know, I think there were some logistical things that were kind of popping in both of our heads of how does this work? But also from her background as an occupational therapist, she is...
Stephanie (11:38.526)
.
Mike Walton (11:57.744)
incredibly structured and organized. And so it, you know, she took a lot of that on and kind of said, Hey, what if we do this? What if we do that? And I was like, I couldn't find anything to argue with other than, you know, in dental school, I remember graduating dental school thinking, well, that's the last prophy I'm ever going to do. and you know, I kind of dreaded it going into it at first, but you know, it's not, it's not bad. know, right now I'm still like, you know,
Stephanie (12:02.157)
.
Mike Walton (12:25.787)
I'm not gonna do any scaling and root planing. you know, I say we're hygienist-less. We do have one of our old hygienists that does come in and do our scaling and root planing for us. And we set her up every couple of weeks and with a full schedule and she's fantastic. And she comes in and takes care of us with that. But we do all the paramedinance and all the pro fees. you know, it took a little time to kind of get into that groove because we were trying to figure out, we do it all?
all hygiene in one day and all restorative in another day or do we mix and match it? And we decided and figured out that it was more efficient and profitable to kind of break it up and do it day by day. we got one day or I guess we work four days a week. So in a two week span, we got eight work days and we'll do several days of just hygiene and several days of restorative.
Stephanie (13:22.5)
Three.
Mike Walton (13:24.859)
and we kind of alternate those doors. So yeah, so like today was a full day of hygiene for me. So we had three operatories of hygiene just back to back to back and ran all day like that.
Kiera Dent (13:27.316)
So you do a full day. It's a full day. Go ahead.
Stephanie (13:27.383)
you
Kiera Dent (13:40.668)
Amazing. And so you basically are doing triple accelerated hygiene. You've got your assistants who are over a column and then you basically just go in scale. You can do the exam at the same time. So that is convenient. Is that how it operates? Now I'm dying to know the logistics. All right, so we've got three columns of hygiene that we're doing, which is why we have our assistants. How does that work for you, Mike? Are you just scaling, they're polishing, they're taking the x-rays?
Mike Walton (13:42.594)
Thank
Kiera Dent (14:07.282)
and do you stagger your schedule so that way you're able to get to all of them or are they blocked on the hour just like a regular hygiene schedule?
Mike Walton (14:12.26)
So good question. We do not stagger them. We kind of have them on our appointments. I'm trying to think of what's the best way to start here.
Stephanie (14:29.31)
The front desk does a really good job of mixing patients that need x-rays with patients that don't need x-rays. So that's kind of the substitute for staggering and the DAs do too, looking forward.
Mike Walton (14:33.186)
Yes.
Kiera Dent (14:35.978)
Amazing.
Mike Walton (14:37.518)
Yeah. So yeah, we'll have somebody that needs x-rays and two that don't. And so what happens is I'll start out and I'll just scale. As soon as they get the first three patients back, I'll scale one. The other assistant is getting all the data and profi. And then the other one's doing the x-rays. And so they're a little bit behind that second one. And then it kind of staggers when I need to go into each room, if that makes sense.
Kiera Dent (15:07.614)
Mm-hmm, it does.
Mike Walton (15:08.043)
And then, you know, that's what it is. It's just kind of a bounce, room to room to room, and then they got time to turn over, and then we bounce room to room to room again.
Stephanie (15:20.476)
And we're real fortunate in the state of Kentucky because the dental assistants can do everything but the scaling. With the certification, they can do the coronal polishing. They can do, we trained them to do period charting. We trained them to do everything but the scaling and of course the diagnosing. And that has worked out tremendously well as far as that. But they can do everything. They can do sealants, can do flora, they can do polishing.
Kiera Dent (15:20.659)
Amazing.
Stephanie (15:48.785)
They can establish rapport and so they fill that time with what we call how's your mama experience, you know, because that's what it is when people come in, we say how, you know, how are you doing? How's your mom? And we know that good.
Kiera Dent (15:54.984)
Yeah.
Kiera Dent (16:00.095)
Mm-hmm.
Right. And in the state of Kentucky, because I don't know all the laws, are they, when we go to the restorative side, can they act as like F does in others or are they, they do fillings? Can they do crown preps? Like you obviously prep. that, does that work for you? Because I'm just trying to figure out logistics on restorative day, because I'm guessing you've got quite a few columns of restorative. Is that how your, your assistants work?
Mike Walton (16:22.74)
Right, right, exactly. yeah, anything that is reversible they can do. And so they are all extended duty certified.
And that's kind of how we run. Whatever they can do, they are allowed to do, they do, and they do it well. You know, that was one of the...
Kiera Dent (16:46.473)
Right?
Stephanie (16:47.311)
And the great part about that is, is they understand the restorative part when it comes to treatment planning during a hygiene appointment. And the hygienists always struggled with that. They knew hygiene inside and out, everything about that. But when it came to treatment planning, the process of extractions and dentures or whatever it may be, they didn't understand that. And these dental assistants understand it forwards and backwards. And so they're his right hand in the restorative. And so when it comes to treatment planning,
Kiera Dent (16:55.156)
Totally.
Kiera Dent (17:09.258)
right.
Stephanie (17:17.147)
They already know how he likes it, the procedure process, the steps of it. And so even the treatment planning is so much better because they understand the restorative part where the hygienist really didn't.
Mike Walton (17:21.558)
All right.
Kiera Dent (17:30.394)
That's a good point Stephanie and I hadn't actually not thought about that. Like you're right. They're probably teeing up treatments so much better. They don't even need to know what would doctor do because they know they've assisted you and as an assistant, I'm like, I know what my doctor is going to do. You're so intimate with your doctor that you really do know. That's actually like a plug for people that want to go fully hygiene, hygiene less like you guys have. If you're looking at assisted hygiene, that assistant really can tee up a lot of treatment if they've worked with a doctor and they are an experienced assistant.
Stephanie (17:36.078)
Yes.
Mike Walton (17:36.469)
you
Stephanie (17:39.856)
Yes.
Mike Walton (17:42.101)
Okay.
Kiera Dent (17:58.346)
That's a really big pro that I had not thought of. So Mike, is it for you as a dentist, like scaling all day long? Are you okay with it? Do you like the piezo? Walk me through, how many months has this been since you guys have gone to this model?
Mike Walton (18:06.516)
It was probably May when we started doing this. Yeah, yeah. And so it was tough at first because it's a whole different positioning. know, it was, I would end the day and could hardly, you know, stand up straight. you know, it's taken a long time to try to figure out
Kiera Dent (18:15.754)
Okay, so we're like nine months, 10 months in.
Kiera Dent (18:27.145)
Yeah.
Stephanie (18:29.765)
It's.
Mike Walton (18:35.858)
where proper position was, you know, cause it had been so long since I'd done it. But you know, the last, probably the last month or two, month and a half, it's gotten to where I found that groove and I get in. it's not, you know, it's not that strenuous on me as it was in the beginning. You know, I think that was one of the things early on that we thought, gosh, we might not be able to pull this off because it was so hard, you know, physically, but.
Kiera Dent (18:41.833)
Right?
Stephanie (18:58.051)
Okay.
Mike Walton (19:05.363)
I think we just kept working and of course, know, Stephanie's got a lot of good input on how to do things with the ergonomics and, you know, if I was complaining about something bothering me, she's like, try this, try that. And so, you know, that all kind of panned out and, you know, I think with the assistants learning new skills and taking on more responsibility, they really like, they've run with it, you know, it's pushing there.
Stephanie (19:27.051)
Okay.
Mike Walton (19:35.388)
their level of importance up in the office and they appreciate that and I appreciate that. It kind of makes their job more fulfilling and it allows us to get through the day. We tend to on time a lot better than we did before. I think one of the nicest things is that there's no interruption. When you had a hygienist, was no matter what you were doing, was constantly, I'm ready for a check.
Stephanie (19:53.614)
Okay.
Kiera Dent (19:54.834)
I bet.
Kiera Dent (20:01.279)
Mm-hmm.
Mike Walton (20:04.518)
and you'd have to stop and get up and go check and then you come back and then it seemed like as soon as you sat down and put your gloves on and got your fingers wet, it was time for a check again. And so we don't have that anymore. And so that's like a huge stress reliever. And because you're not having to get up and down all the time, it allows you to schedule more efficiently. know, it...
Kiera Dent (20:14.461)
Right.
Kiera Dent (20:26.856)
I was going to say, I bet on restorative, can actually do a lot more restorative faster and more efficiently and actually get more done than you were prior. Have you noticed that to be true?
Mike Walton (20:37.027)
It has because and you know just kind of jumping a little bit into probably what you would ask down the road, but you know I think our our overall production has gone down a little bit just because we Yeah So like it's it's gone down a little bit just because we can't see as many patients anymore
Stephanie (20:50.092)
Okay.
Kiera Dent (20:52.262)
Yep, you knew, you know me. Of course I want to know like what are the numbers?
Mike Walton (21:01.584)
So we had to scale back just a little bit to make it work with the amount of appointments that we had possibly available. But with how efficient we are now with the scheduling, the profitability has gone up. And I had those numbers and I did that on a presentation with another mastermind group and I don't have it right in front of me, but I don't know, do you remember what those were Stephanie or no?
Kiera Dent (21:02.634)
Mm-hmm.
Stephanie (21:26.668)
Not exactly, we took home more is what it came down to and our team did. Like we were able to give raises, we were able to share that because we didn't have that hygiene overhead. But another good point is that we had to set aside specific time in the schedule, make appointments, make events.
Kiera Dent (21:33.353)
Mm-hmm.
Stephanie (21:45.75)
to formalize their training with how to do period charting to his standards, how to do these skills to his standards. It's like everything else you had to put it on the schedule so that everybody could check it off. And so it's kind of like a loss in the beginning, but it pays off in spades down the road because they feel confident about it. And it's like they're their patients, you know, and they're, you know, in charge of it.
Kiera Dent (21:48.383)
Yeah.
Stephanie (22:11.335)
and responsible for it and they're very proud of how many skills they have now and you know so they were kind of hesitant at first because it's just like it's unknown and you know I don't know if I can do that and but you know by checking off and feeling confident you know it's made the biggest difference.
Kiera Dent (22:30.75)
That's amazing. And as an assistant myself, and I know tips and assistant as well, it actually is really fun to think of elevating assistants to give them more skill sets, things that they can do giving them that autonomy. It actually kind of comes down to an ortho assistant model where they're able to do so much more while still being able to have the the general side where we get to do all the fun, like I call it the blood and guts of dentistry, like ortho is so clean, which hygiene is so clean with air quotes around it.
Mike Walton (22:45.23)
you
Kiera Dent (22:58.538)
And so I think you've actually blended for assistance because I was always envious of the ortho assistance. I'm like, gosh, they get to do so much. They get to do so much more than I do. So I think like really incredible work agreed. think I'd be nervous to take this on and be like, if we're doing hygiene, but I think also way to give them a huge elevation piece. So, and it's also fun to hear about your numbers. I would imagine without that hygiene expense that you will be more profitable. So you run
When you run restorative days, you run three columns of restorative on that, or how many columns of restorative do you normally do?
Mike Walton (23:30.189)
three and then. We'll have a foot. We've got a fourth room that if we have kids we can squeeze in a fourth. Yeah, yeah.
Stephanie (23:42.692)
that are assistant only.
Kiera Dent (23:44.842)
Sure. Okay, so we're running three columns of hygiene on one day, then three columns of restorative, which you can. Now you can have them shorter appointments. You can get in and out. You can utilize your assistants more. So they're having fun too. They have a hygiene day, then restorative day, hygiene. So it breaks up their model too. They're not running all the time. But I'm curious. I always think like long-term, like, do you guys wanna go back to hygiene and or would you hire another dentist?
So then Mike, you and another dentist are doing this hygiene model. can see, cause I'm thinking, well shoot, you're seeing three columns of hygiene. You're probably only seeing two before, but we're seeing three columns, but just not consistently across the time. So what are your kind of your long-term pieces? You took home more, you had a little drop in production. I'm super curious like to see a full year of this. Like will the numbers come back up now that everybody's trained? We kind of have this whole model, but what's kind of in the long-term scope? Are you thinking of another doctor or maybe looking for hygienists?
or like, no, we're gonna just ride this out for a little while.
Mike Walton (24:41.671)
I think the plan is gonna be to kind of ride it out. We kind of talked about if you brought on another doctor, are they gonna buy into doing hygiene like we have? I think that's a hard pill to swallow until you've had the heartache and the upset that we had with maintaining a hygienist. So I think it's gonna be kind of ride it out and see how things go.
Stephanie (25:00.407)
.
Kiera Dent (25:03.486)
Right.
Mike Walton (25:12.317)
Is there ever a time where you'd have a hygienist back in? Absolutely. I think there's some things that have to change market-wise and availability-wise and knowing that security because I think that's one of the biggest things that the patients have noticed is they're getting consistency with the same person. And we're...
Stephanie (25:34.233)
They love seeing the doctor. There's no pushback to not having a hygienist. They are very excited to have more time with him.
Kiera Dent (25:34.495)
Right.
Mike Walton (25:41.29)
And, you know, and I think we're getting into that cycle where from when we started, we're seeing the six month, you know, group coming back through and they're like, you know, we had so much turnover that every time they came, it was a different person. And now there, there's like, I get to the same person again. And, and so, you know, that's a, that's a good feeling for them too. And, you know, I think that that would be the limitation on a hygienist is one, no one, you know,
Kiera Dent (25:42.889)
I believe it.
Stephanie (25:59.533)
you
Mike Walton (26:09.994)
If I could guarantee that they would be here long term, absolutely. Or if the market were to change to where there was a surplus that you felt like that was gonna drive them to stay for a long time, I think that's where the change would come in that perspective.
Kiera Dent (26:31.582)
Wow. I'm so intrigued and I'm sure listeners are just beyond intrigued by this. It is fun to know about the numbers. It's fun to hear. And I remember Mike in our mastermind that we were chatting, you literally said like, I wouldn't go back. You're like, it was the best thing we ever did. And I'm like, we're getting on the podcast because it's such a anomaly. think it's, it shows your guys's grit. It shows your determination. I love Stephanie, you pushing to think outside the box. So I'm just curious, like with this.
Stephanie (26:52.164)
.
Kiera Dent (27:00.202)
What would you say are like the best benefits? mean, Mike, I've heard a few come through from you benefits and Stephanie, you just said them. So I'll list a few and see if there's anything I might have missed was something I love that you said they get consistency with the, with the doctor, like they're seeing Mike, they're seeing him more often. Um, I think Mike, for you not having to get the, we're ready for a check. We're ready for a check. Like you feel like you can just get in and almost like do your thing every single day. I also heard the assistants have been able to rise up. You've been able to
probably pay them more than they would normally make, which also then retains your assistance and makes them more sticky to you, I would presume. But any other things that you've seen that have been positives of moving to a hygiene-less model?
Stephanie (27:38.747)
Well, I want to speak to that because the team is so much more unified because and they're candid with us because everybody feels like they're on the same level.
Kiera Dent (27:44.681)
Interesting.
Stephanie (27:48.192)
Like there's no hierarchy in the office. The back office people are candid with the front office people and telling us how we can schedule more efficiently. The front office people are telling the back office people you need to document this so we're getting paid quicker. It's like the barriers have been broken down. Like everybody's on the same level and that has unified the team, I think, like we didn't anticipate.
Kiera Dent (28:17.574)
I wouldn't have thought that either. I could see like some divides, but I also think when you go through quote unquote hard times, which you were, you were losing hygienists consistently. We're having to pick up the slack. That's stressful. We've got all these columns of hygiene. It does bring people together when they go through that. And I bet this team is pretty rock solid sticky with you for quite some time going through this, which I think is awesome. Mike, anything you've seen that you want to add to that or Stephanie, either one of you.
Mike Walton (28:40.738)
you know, I think those are the big highlights. you know, it's, it's, it seemed like there was always tension before and we don't have that. Like Stephanie said, it's, you know, that, that unifying of the team and it's because everybody's, you know, pulling, you know, a very important role in the office and making it work and everybody's establishing that relationship and
Stephanie (29:09.907)
All right.
Mike Walton (29:10.817)
It's kind of like not your right hand talking to your left hand. It's like having one big hand and it's all just working together. And I did look up while you all were talking a minute ago, I pulled up the other presentation I had with the profitability. So this was when we were four months into it. Our payroll overhead was falling between 15 and 18%.
Stephanie (29:18.016)
Okay.
Kiera Dent (29:18.58)
Yeah.
Stephanie (29:25.633)
Okay.
Kiera Dent (29:26.89)
Oh yeah, I wanna know these. I love numbers.
Mike Walton (29:37.284)
because we lost the payroll for the hygienist. Our average overhead for that four months was 48%. And then our overall production was steady, but our profitability was up 27 % over the same four month period the year before. So.
Kiera Dent (29:38.504)
Wow.
Kiera Dent (29:47.306)
amazing.
Kiera Dent (29:56.854)
That's insane. And to hear payroll numbers coming in at, you know, 15, 18 % when right now people are struggling to keep it at 30, 34, 35%. Everything's rising up. And so that had to just feel good to, I mean, I don't know, Mike, I saw both, I saw you for many months. And I just remember the stress, like so many think tanks, you're like, can't find a hygienist, we just lost a hygienist. And I feel like the stress and the
angst that you are going through and watching you two tonight, you just seem like, yep, we have a plan and I'm wondering if there's now, do you feel more certainty? And I think Stephanie will come to you on this one. Is there more certainty that like your success, your future's in your hands or does it feel like there's more stress because now it's all on you? has it, has it freed you up? Has it created more stress? What do you feel Stephanie from your perspective?
Stephanie (30:46.206)
think making this change has recreated more stress at all. I enjoy this. I worry about it being physically hard on him, but I enjoy the team being a lot happier when they come in and them feeling fulfilled. And I think that decreases our worry. And I think a lot of people that own practices are worried that people, if you rub them the wrong way, they're just going to leave.
If you ask them to do one more thing, they're just going to leave. And that was a constant stress for us. And I don't feel like that with this group. So, you know, I don't know if it's going to be a long-term option because, you know, I worry about the wear and tear on him, but they seem to really care about each other. it's...
Kiera Dent (31:15.604)
Right?
Mike Walton (31:15.811)
Thank
Kiera Dent (31:18.442)
Mm-hmm.
Stephanie (31:39.249)
Yeah, it's working for now and we just need to watch trends and see if it's going to continue to work or if we need to pivot.
Kiera Dent (31:48.212)
Sure, I love that. Mike, what about for you?
Mike Walton (31:49.637)
you know, I think, I think the excess of stress is kind of what pushed us to make the change. And I would say that definitely the, you know, since we've made it just with the demeanor and the whole office and, and the, the lack of the headache of constantly replacing somebody is, I mean, that's taken mountains of stress away. And, and, you know, I mean,
I think that was the most valuable thing that we've done is relieving that stress because it was taken as toll. It was pretty hard on us.
Kiera Dent (32:31.006)
believe it. How does it feel Mike for you being like Stephanie was saying you are now the hygienist and the dentist and so like those two hands I always told my dentist every night I'm like hey keep those hands good because that's my job I tell him like when you walk through the crosswalk put your hands up so in case like the car hits you like they just take your body out but your hands are still good but truly I was like you are my job Mike how is that for you like you are the hygienist you are the dentist it is you in that practice
Stephanie (32:35.292)
.
Kiera Dent (32:58.524)
Is there stress on you feeling that or is like, well, I'm to do what I can do. And Hey, worst case scenario, I'm going to find someone to replace me if I have to. What, does that feel?
Stephanie (33:05.843)
So I think that was something that was really eating at him. And then we sat down with Matt at the dental advisors. And once we got the disability insurance in place and everything was, we have a contingency plan. So if the works were to happen, for whatever that the team is provided for for a little while, and then we have.
Kiera Dent (33:16.446)
Mm.
Kiera Dent (33:21.712)
Tell
Stephanie (33:30.649)
And I think that's, and Mike, you need to speak to this. I think that made him feel a whole lot better because there was a lot of responsibility on his shoulders is just having those contingency plans if something bad were to happen.
Mike Walton (33:44.404)
Right and like what she was saying, you you kind of carry that load of everything is dependent on me and what happens and You know, I think that's just seeing the numbers, you know once you see the numbers just like anything that it Relieves you a little bit and you know that hey, you know, you don't want the worst to happen but if it does you know things are provided for you know, as far as
Kiera Dent (33:45.224)
For sure.
Stephanie (34:10.606)
you
Mike Walton (34:11.42)
you know, hands and things go, you know, I see lots of people that go through years of work and I think if anything, my hands are good. It was my back that I was worried about, but you know, I think just repositioning and kind of paying attention and listening to your body too that, you know, I, I've had hygienists that only hand scale and you know, and I'm like, use the use of ultrasonic, you know, that's what it's there for. It's meant to save your hands. And so
Kiera Dent (34:22.472)
you
Kiera Dent (34:38.833)
Exactly.
Stephanie (34:40.133)
.
Mike Walton (34:40.315)
You know, I do most everything ultrasonic and if I can't get to ultrasonic, I hand scale and like I said, it's not, you know, I don't pay a whole lot of attention to that wear and tear, you know, because it's so minimal. But, you know, it's one of those things that, you know, at first I thought I wasn't going to like, but I've always been the talker with the patients too. And it's like, now I've got a little extra time to talk, you know?
Kiera Dent (35:07.751)
Yeah.
Mike Walton (35:10.746)
I think it's been a good change.
Kiera Dent (35:11.058)
I bet.
Kiera Dent (35:14.842)
It's such a fun thing and I'm so grateful you guys were willing to come on and share and definitely love you guys as clients, love seeing your success, love seeing the change. love just you sharing your experience. It's really fun. So just super appreciative of you coming on. And of course my mind's thinking like, well, if you guys are gonna stay this model, you might as well go fee for service. Like you've already got a huge tether to these patients, make more, it can do less.
bring on another doctor that could swap you out. Hi Jenna. So really fun past for you in the future. I'm just curious as we wrap up tonight, like so appreciative. Any last thoughts, maybe things I didn't ask that I should have asked or things that you're like, Kiera, this would be really helpful for practice thinking about doing this. Stephanie, I'll pivot to you first and then we'll wrap with you, Mike. Anything I maybe didn't ask or something you want to add as we wrap up tonight.
Stephanie (36:00.993)
So it probably helps us tremendously that we do not have contracts with any insurance. So we're not straight up fee for service, but we do get full fee now. So that probably makes it a little bit more doable for us, but it also adds a little bit of stress on our wonderful front desk people because they're having those hard conversations.
Kiera Dent (36:10.398)
Yes.
Stephanie (36:20.951)
And then another barrier was there are only so many hygiene spots that we could fit in a calendar year. So we could literally with only one doctor see probably 2300 hygiene appointments in a year. And so we had probably 4,000 active patients when this was going on. And so we were like, what do we do? And Mike said, you know, a little bit of health issues. And so we wanted to decrease the stress. We're at a point where we could do that. And so
Kiera Dent (36:38.376)
Yeah, the big cut.
Stephanie (36:50.006)
we had to like downsize some patients and I bet every office would like to downsize some patients. And we just started with the people that gave him the highest stress or didn't value keeping their appointments. And we enacted a super strict cancellation policy, which is a little bit of a hard conversation for the front desk, but it's a little work upfront that pays off in spades and...
Kiera Dent (36:55.946)
Hahaha
Stephanie (37:17.353)
And it's kind of like people are coming to the understanding that this more of a specialist type office. If they truly value coming to see Dr. Walton, which they love seeing him because of that relationship, you know, they're going to keep that appointment. They're going to book it far out. And so we got to kind of let some people go that didn't respect, you know, his time or we didn't enjoy seeing necessarily. So, you know, I think that was, you know,
something that was hard that we didn't anticipate. But I think it's kind of a good thing in the long run.
Kiera Dent (37:53.596)
Yeah, no, and you're right, that is a big downsize, but it's also an upgrade in life and fulfillment and happiness. And I tell a lot of offices, like the best gift, there was one dentist I worked with and they said every year for the holidays, the gift they gave was like, the employees could go through the list of patients of which ones give us the heartache, which ones are the ones that like we just grown, and we're going to dismiss them and we're going to actually like fire them as patients in a very respectful way, send them to another office.
But elevating that, like it's crazy how much that can do for your morale. I only work with clients that I like. That's part of the Dental A Teams model. Like, yes, I understand that there'll be some tricky ones, but we really only, we like to work with our clients. love, and I love the name, my day is full of all the clients that I love working with. And I know Tip feels the same way. So I can only imagine giving yourself that life upgrade was incredible. So thanks for that. That's a, that's also a good, think, key point, cause you're right. Limited space. What do we do with that? And based on where you are in your career path,
It makes sense to possibly downsize. Who knows how much longer we want to practice, but I think if you're really early on in your practice, that'd be something to really consider because downsizing a practice and then if you ever bring in doctors, you're going to need to re-increase that. think that's something that was a wise decision based on where you are. So Mike, anything for you you wanted to add or highlight?
Mike Walton (39:07.389)
Well, I think the only thing that Stephanie didn't mention, I'm going blank here now, but it was... What was I going to say?
Kiera Dent (39:23.624)
I chatted too long for you, Mike.
Mike Walton (39:23.896)
Caught me off guard there. Oh, I know, was when we made that change, one of the other difficult things was, you had six months of hygiene people that you had to reschedule to the days that you were seeing hygiene. And so that was a tremendous load on the front desk as well to move all of those patients and get them lined up on the days that we deemed as the hygiene days. But that was for...
six months and we've made it through that and you know that's a huge load off of their shoulders now and yeah yeah.
Stephanie (39:58.002)
.
Shout out to Jessica.
Kiera Dent (40:01.93)
Right. It is something where I think you guys have really painted a picture of it's short-term pain for long-term gain. Yes, those are annoying. Yes, those things are just obnoxious. And I think a lot of people aren't willing to do the short-term pain. So they stay in long-term pain thinking that that's easier. And so it is annoying as a front office to move patients, but it's what the benefit going to be. Like we have a pediatric practice that I worked with and we got the doctor where she has
We work just ops in the morning and then we do all hygiene in the afternoon. So it's a similar, it's just split days for them. And she's so much happier, but they had to move. I mean, we're talking pediatrics. That's just like so many little appointments in a day. But that team, hunkered in just like your team did. And it's amazing at how happy this team has become, how much happier the patients are, how much more efficient they are with their time. So mad kudos to you and your team. Yes.
Stephanie (40:55.583)
And add those hard conversations about that. that's what people, a lot of people don't want to do is have those hard conversations to have the long-term benefit.
Mike Walton (40:57.526)
All
Stephanie (41:06.927)
That's what we've experienced is they just, even the doctors, they just avoid those hard conversations, tell them what they want to hear and just get out and.
Kiera Dent (41:16.604)
Yeah, and then here we are. So I'm so proud of you. I know Tiff has been proud of you. I know she's been a huge instrumental part to help you guys navigate through this and just work with it and just like really I think the tenacity, the grit and the love that you have is just so incredible. So thank you. I know it's late for you. You guys are East Coast. I'm West Coast. So thank you for taking time. You had a full day today. But really, just thanks for sharing your experience. And I think for offices listening, I think think outside the box like Stephanie and I Mike and go through those
the pains, you will, it's the pain, the pain of holding on and like having that constant replacement, or is the pain of let's figure this out so we're not there. And I'm so excited, like, thanks for letting me, you know, eat my popcorn on the sideline of your life and watch to see how this unfolds. I think you have so many fun things to see how does this year shake out? Is this something we want to do long term? Or is it something where no, maybe we might go back to a more traditional, maybe we do a hybrid of what we've done and what we used to do. I'm really excited to see the future and I think it's bright and
Mike Walton (42:03.859)
Yes, thanks.
Kiera Dent (42:13.588)
hallelujah, you're not in the hygiene debacle anymore for now. We'll see what changes in the future, but mad appreciation to both of you.
Stephanie (42:20.239)
Thank you for letting us share our story.
Kiera Dent (42:23.58)
Of course. All right, you guys, that wraps it up. And for all of you listening, thank you for listening and I'll catch you next time on the Dental A Team Podcast.
