Kiera and Kristy break down a few reasons why your practice might not seem (or might not be, period) to have any money. They touch on how to find your profit point, knowing your debt, staying on top of collections and AR, and more.

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Transcript:

The Dental A Team (00:00)

Hello, Dental A Team listeners, this is Kiera. And today I have Kristy with me and I'm super excited because today is one of my favorite things to do as consultants and I call it office autopsy. ⁓ Don't worry offices, this is a mix of a few offices because believe it or not, offices think that they're on individual islands and believe it or not, you're not. ⁓ Multi-practices actually struggle, they actually do the same things that you struggle with. And so we just wanna make sure that we bring, we're not going to ever disclose who this office is.

 

We will mix a few offices together, but I think for people to see what the office's pain point was and then what as consultants were able to do. Kristy, we have some really fun ones. so Kristy and I decided we wanted to podcast today about some office autopsies of what, hopes to help more offices. So Kristy, welcome to the show today. How are you?

 

DAT Kristy (00:48)

Good, thank you. Pleasure to be here.

 

The Dental A Team (00:50)

Of course. Well, I'm super happy because I think the one that we run into a lot ⁓ is we call it cash flow row or cash flow woes, like whatever you want to talk about. But it's really when an office comes to us and they seem to not be able to figure out what's going on. ⁓ They feel like they're producing. Sometimes they're producing, sometimes they're not. So we'll kind of discuss like how to know if you're producing enough or not. But then they feel like they just like have no cash. And so giving some background.

 

Like I said, I'm going to blend a couple of practices together, but we have kind of going to do like two simultaneous ones. One practice was producing really, really well, but literally the owner felt like they had no money. We're talking like flat broke, felt like they were completely going to go under, had no money, but yet their production numbers were really good and their P &L looked really good. And we're just like, it showed on the P &L. I think, Kristy, you'll find this too, offices get so frustrated.

 

I got so frustrated and angry with my CPA when they said, well, Kiera, like according to the numbers, you have money. And I'm like, great, high five, jerk. I have no money in my bank account. Like it's the most infuriating feeling in the world of my CPA tells me I should have money, but there's no money. Flip that too on the other side when a practice isn't quite producing what they need to be producing to pay for their expenses. And they feel like they have no money and they are flat broke, which in reality that practice is flat broke because they need to produce more or they need to cut.

 

So we're gonna kind of dig on both sides of these with office autopsies of what we see, what we've been able to do. And let's start, Kristy, on the side of what do we do? Like, okay, first step, how do we find like the profit point? Like, how do we figure out what should an office be producing? Because I think that's also infuriating when doctors are like, but I'm just producing. I feel like I'm trying to out-produce my problems. Like, I don't know how to produce more. ⁓

 

how do you, Kristy, as a consultant, come in and help offices just gain that clarity? Because I think sometimes when we know the North Star and we know what we should be targeting, it actually becomes a lot easier to then build block schedules and then figure out what our overhead should be. But how do you help offices even dig into that? As point one to figure out, let's autopsy both of these practices, I think this is step one to really getting clarity.

 

DAT Kristy (03:00)

Absolutely. I agree with you, Kiera. ⁓ The first step is to understand how much we're paying for things. What is the cost to keep the doors open? You know, we talk about overhead, right? But what is overhead? It's everything that we have to pay within a month. Rent, utilities, staffing, right? The other thing that I want to point out is many doctors don't include themselves in that. And I definitely want to pay them

 

The Dental A Team (03:16)

you

 

DAT Kristy (03:30)

Just like if they were an associate in the practice and so we want to include that in that overhead cost if you will and find that What I like to call profit point so we know where we're what's our? BAM right

 

The Dental A Team (03:48)

bam, that bare ace minimum, like what do we have to

 

do? It's kind of like in real life. I mean, I think all of us have a bam in real life. You know what your mortgage or your rent is. You know how much it costs you to like do your groceries. You know how much daycare is, you know how much it costs you for like your Amazon spending. And some of those are fixed costs. So fixed are like your mortgage or your rent. You can't really change those. Those are fixed for you. Yes, like I get it. The semantics, we're not CPAs here. We're not like, that's not our world.

 

The semantics are can you change your rent? Potentially you could go find somewhere else. That is an option you could do. But most of the time those are pretty fixed. Just like our utilities are pretty fixed. You can be like my husband where literally our AC goes off at 6 p.m. at night. He freaking freezes us until 6 o'clock to save on these utilities until 9 o'clock. It drives me wild. I'm like in a hoodie freezing, shivering. And then the AC goes off and I'm like roasting. It's really entertaining because he wants to save the $3.

 

But genuinely speaking, like you're not really going to be saving on those fixed costs. are some fixed ones. Staffing is usually pretty fixed. However, we could add team members or take team members away. So therefore it's not as fixed. But like you said, Kristy, I think it's figuring out in a practice and agreed, doctors should be paid. Like nobody, think that that actually causes more stress for owners. If you don't even know what your paycheck is or you're just taking draws, because then how do you budget your life on a up and down volatile paycheck?

 

I think that creates a lot of stress versus like, okay, great. Let's just put you at a hundred grand or let's put you at whatever is a reasonable salary. Talk to your CPA. They'll be able to give you that. ⁓ And that can be agreed with Kristy. I like to pay you as an associate, but if right now the practice can't support that minimum should be a reasonable salary of say a hundred grand. So that way you can at least bank on that of getting that paycheck in your practice. Sometimes you have to adjust that, but generally speaking, if we at least give you some type of certainty and clarity,

 

that's going to help you then be able to budget your life around that too, in addition to budgeting your practice.

 

DAT Kristy (05:49)

Absolutely. In fact, Kiera, sometimes even with startup doctors, I like them to even keep a spreadsheet of their production as if they were paying them as an associate. And then when they start to get profitable, we can back pay those wages. But definitely they have to take care of themselves first. ⁓ I've even seen where they get a little bit of animosity if not, right? Like, staff's driving these cars and they're getting their nails done and they're doing

 

The Dental A Team (06:00)

Agreed.

 

Mm-hmm.

 

DAT Kristy (06:19)

and I can't even pay myself. So I think it's very important that we understand what that is and work toward that, number one, if we're not there. And then if we are there, adding additional ⁓ percentage to that, which us as consultants can help guide that depending on your goals. If it's paying down debt, paying you as an owner doctor.

 

⁓ And you know, we follow the EOS system, so adding those buckets for taxes and those sort of things that come up and we can be prepared for.

 

The Dental A Team (06:55)

Yeah, no, I think it's brilliant, Kristy. And when you said that, I agree. You don't want to not be paid in your practice, because that gets, A, it's stressful, and B, it's annoying, and C, you've got all this debt on you. ⁓ But I also think when we're looking at our practices, there are pieces, so when doctors are like, I'm not getting paid, I just want to remind that sometimes we're being paid through things running through our practices. And so we've got to be careful, because that is,

 

Like if you didn't have your practice, you'd be paying for that out of pocket. And so that is technically part of your salary, doctors. And I don't want to be the like balloon pop girl over here. I do want to be realistic because a lot of times doctors are like, I'm not making money. And I'm like, but you forgot that these things are running through your practice. So you are being paid for those or those things are no longer coming to you, which is totally fine and legal. Talk to your CPA. Like we want you to do that. There's nothing wrong with it.

 

But when we're looking and we're like stomping our foot saying we're not being paid, sometimes I even have to remind myself of like, yes, but Kiera, if you didn't have the business, all those costs would be coming out of your W2 paycheck, not your business right off. So agreed with Kristy, when we're looking at this, step one is let's find that BAM, let's find that profit point, let's find out what you have to produce. And then from there, what we need to find out is also in addition to that, how much is our debt?

 

Because a practice should not have to be covering your debt, but you as a human needs to be covering your debt. So if your student loans, your practice loans, things like that, the practice isn't necessarily a poor performing practice. You just have all this excess of like, my gosh, I have to pay this off, which that's real life for you. And I think that's the difference of a CPA's bookkeeping for you versus your real life living through it. And I can tell you from personal experience, like this is very hard. Sometimes practice loans do go through your

 

your practice profitability. Again, this is pending on your CPA and how they recommend you do it. But most of the time your student loans and different things like that don't run through the practice. So, but you as a human need to have enough money to be able to pay for all those things. So I think it's finding out the practices, BAM, like Kristy said, finding out your personal BAM, because that might be different. And then from there, let's tack on 10 to 20 % beyond that. So let's say you know you've got to produce 50,000. Well, awesome. 10 % of that would be 55, adding

 

20 % excuse me, so 10 % of that is going to be an additional $5,000. To do 20 % of that's going to be an extra $10,000. So if I know I've got to do 50, I've either got to produce 55 or 60. Now that becomes much easier and I know beyond that I'm going to have 10 to 20 % leftover of the practice after everything's spent. Our ideal is to get it to where your 50,000 is 50 % of your practice and there's 50 % quote unquote profit beyond that. Now again,

 

that profit is a little bit funny because if we're doing a 50 % overhead and 50 % profit, doctor salaries usually are not included in that. If doctor salaries are included in that, then usually it's a 20 % profit at the end of that. So I know those two numbers feel a little like disjointed. They've been very disjointed for me. So if you're doing true overhead, we want it at 50%, 30 % doctor pay, 20 % profit. If you want to combine it all together, then it would be 80 % quote unquote overhead, 20 % profit. Now that 20 % profit though,

 

does technically pay for debt services. So watch that. You might need to scale down our 50 % down a little bit more or 80 % to then be able to offset that. So hopefully that wasn't too confusing for everybody. This is why we're consultants. This is why we help you. But I think when you understand like either need a 50 or an 80 % ultimate goals, we're trying to get 20 % cashflow at the end of the month. think for me, that's like the easiest thing. Like, okay, if I'm producing a hundred grand a month,

 

I want 20 % of that, so that's 20 grand. So like I'm trying to do easy numbers for all of you. I want 20 grand after everything's paid to still be remaining. Now, one other kicker as a business owner is that 20 % is also taxed. So don't forget that that gets taxed. So if you're at a 30 % tax bracket, well, you gotta take 30 % of 20 grand and then the rest of that you can spend. And this is why I think owners get so frustrated, because it's like, oh my gosh.

 

Like just tell me how much money I can have. And when I talked to a CPA and Kristy, I think you come across this, like our whole lives up until owning businesses, we've been paid at the W-2. So everything we got paid, we were able to use. Well, now as business owners, everything we're paid, we don't get to use. That's not the way the game works. ⁓ And it's due to write-offs and different pieces like that. So I think just knowing the rules of the game, I remember being so fresh with my CPA and I said, I like you're playing Monopoly with me. Like just tell me the dang rules.

 

So, and like, don't tell me like, no, you can't pass go, but you can pass go if you do X, Y, Z, but then like, no. So it's really, you've got to have a profitable practice of overhead. That's what we as consultants are really obsessed with. You also as an owner need to be responsible of how you spend. That's not to say you can't spend, but you do need to spend responsibly and you do need to set aside your taxes. And I think when you have all those pieces set up, then you can have guilt free spending because you're paying yourself.

 

Plus, you know what your true profit is. You've saved for taxes, you've saved for a rainy day, like Kristy was saying. We can put buckets into place to pay down more debt. You can put buckets in place for emergencies in your practice. You can put buckets in place for ⁓ vacations. I have a doctor I was just talking to on Alaska cruise and I was like, how's that bucket working out for you? And he's like, I love it, Kiera, you set it up for me. And I know how much I can spend on vacations. I know how much of my paycheck goes into that portion. He also used to spend an absurd amount on CE. So we set a true budget of how much CE money he could use.

 

But that's kind of where you then as owners aren't just trying to waffle through this and actually can figure out those profit points. And I do think, Kristy, like as much as we've belabored this so much at the beginning of this podcast, I feel this foundational piece is what makes owners crazy because they don't know the rules of the game. So they start spending all the money. Then you get this huge tax bill. Then you feel mad. Then you feel like you have no money when it's like, no, you did have money. just we accidentally spent it. So now we got to make up for it later because we didn't put these rules of the game into play.

 

Kristy, you might have a simpler way to do that. What are your thoughts around that?

 

DAT Kristy (12:49)

No, I agree with you 100%. Otherwise, what I find is, you know, business owners, doctors, they just come up with this arbitrary number that they want to hit. But again, just because we're producing something doesn't mean we're profitable. And so they go together, but we have to understand the difference.

 

The Dental A Team (13:12)

I agree. And I love that you said that because production feeds the ego and profit feeds the family. And so it does not matter what you're producing. And I agree with Kristy. It's like, I want to produce a hundred grand. I want to produce 200 grand. Well, high five. Let's help you do that. But on the flip side, let's make sure your expenses are there. And there's another practice I'm thinking of right now where they're like, we have no money. And I'm like, all right, if we have no money, truly it's let's do the checklist. Number one. Like, do you see me even scratch my head? I'm like, if you're not watching the video,

 

Just know when I hear people say, don't have money. I'm like, all right, it's either a production issue or a spending issue. It's one of the two. So just know those are the only two levers for when you're saying, I don't have money. It's either actually there's a third. There's technically a third. And that is a collection issue too, because we're either not producing enough. And if we are producing enough, we might not be collecting enough. And if we're doing both of those two things, then it's a spending issue. So let's break it down to this office autopsy. Kristy, let's go for a practice that is producing enough.

 

they don't have money, how did you fix or how did you find out that this practice had a collections issue?

 

DAT Kristy (14:14)

Yeah, well number one we would look at.

 

How much was their net production and how much are they currently collecting? My minimum benchmark is always to be at 98 % or higher. Obviously, if we can get reservation fees to pre-collect on things, we may see that up a little bit higher. But if they're not at that 98%, what can we do to get them there? What's getting in the way? Is it patient? Is it insurance? Are we not submitting clean claims and getting them back in a timely fashion?

 

The Dental A Team (14:26)

Agreed.

 

DAT Kristy (14:47)

⁓ But definitely that would be the first place to look.

 

The Dental A Team (14:51)

Yeah. And so Kristy just said the benchmark. If you're not at 98 % collections, then there's a problem. Second piece is look at your AR and if you have more than one month's worth of production in your AR, we also know it's a collection problem. So when we diagnose on this practice, I remember we talked to a doctor and they're like, Kiera, I have no money. Kristy, I have no money. And I remember we're like, so actually you do have money. Believe it or not, the money is there. It's just sitting in uncollected amounts. So Kristy, you even went with another office and like they didn't have money and you just straight up called.

 

You like went with the office manager and you guys just picked up the phone and started calling on balances to get the money. And I really want doctors to know, and Kristy, I think this is the infuriating part as a consultant where I'm like, no, like you're producing well, you just have to collect the money that you're producing and don't like, don't even feel bad about it. So what do you do for teams that don't want to collect, that have these big ARs? Like what are a few simple steps? Like if that's my practice, I'm-

 

Hi, Kristy. I'm the doctor today. My team, this does not want to collect money and I feel like I can't pay any bills. What do you do in that scenario as a consultant, Kristy?

 

DAT Kristy (15:53)

Yeah, well, I think we have to dig deeper into their own, like the team members own biases and what's getting in the way and get them comfortable to realize that we're not doing good by our practice and or patients if we're not collecting those balances. So, you know, really seeing what's the roadblock and let's work through it to overcome it because people deserve the care. Patients deserve to be healthy and

 

And part of that is also paying for the treatment, right? So just digging deeper, figure out what's getting in the way and helping them to overcome, create some verbiage for them to feel confident in being able to collect.

 

The Dental A Team (16:39)

Yeah. And Kristy, I think you do an amazing job as a consultant. think this is where I love being consultants is like, you will actually help them sometimes call on accounts and help them see how easy it is. And ⁓ I also think when we're looking at AR, let's get our best bang for our buck. like, let's sort it to biggest balances and let's call on those first. Like, let's figure out different pieces. And like you said, there might be a myriad of reasons why your team members don't want to collect. don't think typically it's due to the fact that they don't want to collect. I think they're just scared. There's fear.

 

They're afraid of a patient being mad. They're afraid of not being able to explain the balance on the account. They might not understand why insurance is denying claims. Billing is a whole black hole, just so doctors understand, like there are a lot of nuances there. But I think on that side, if you are producing, like I remember this practice, they are producing like 150 to 200. And I was like, what do mean you don't have money? And we looked at the P &L and we're like, no, according to your P &L, you have money here. And we just realized it was a lack of collection process.

 

We implemented that Kristy, you helped this practice. They implement, they started collecting and now the doctor's like, wow, like two months later, I feel like I'm like happy as a clown because they literally have money now, but the money was there all along. And that's really like, I think a myth to dispel on this office autopsy is a lot of times the money is actually there. We're just not collecting. We don't have the correct processes in play to do correct insurance verification, to have better estimates, to collect in practice, to then have better ways that we are posting payments.

 

We don't have a process for how we're calling patients and insurance. And if you don't have that whole process dialed in, that can actually get really daunting for a practice. But Kristy, let's flip sides to the other dark side of this coin where they might not be producing enough. So like we said, it's either a production process, a collection process or a spending process. What do we do on the dark side where they're not producing enough? Like that's scary to me. So what do you do on that? I think there's like two zones here.

 

DAT Kristy (18:33)

Yeah, absolutely. Well.

 

Number one, once we figure out that benchmark, typically, Kiera, we go and look at how much are they diagnosing, right? If we're looking to hit 100,000, we typically need to be diagnosing minimum three times that number ⁓ if we want to hit it, right? So where are we with diagnostics? And then where are we in case acceptance? how, if we are diagnosing that much, how much are we

 

actually getting patients to say yes to that treatment if you will.

 

The Dental A Team (19:09)

Mm-hmm. And I think, Kristy, great point on that because it's twofold on this dark side of the coin of if we're not producing, are we diagnosing enough? And if we're diagnosing enough, are we closing enough? And those are two different people actually in this scenario. So doctors, have to diagnose. And if you're a doctor who's scared of diagnosing a couple tools, it's OK. I always tell doctors, it's your moral obligation to diagnose. As a patient, if you were to go in and there was someone who saw

 

Let's say you did a scan, I've had multiple MRI scans on my brain. Do you know how mad I would be at a doctor if they chose, because like they don't know if I can afford it, if I don't wanna hear the bad news or like whatever it is, they choose not to tell me what's on my brain or a broken bone or if I've got something in my blood work, I would be livid. And yet doctors, you're diagnosing, you're taking x-rays and if you're not telling these patients what's going on, ⁓ that's your moral obligation to do that. So if you're nervous about it, that's okay, I'm not here to tell you.

 

there's anything wrong with it. I just want to remind you that this is your moral obligation as a healthcare provider. So there's Pearl or Overjet of an AI solution that might be a solution for you ⁓ or just diagnosing one more thing than you normally would. If you're used to like watching, ⁓ that's okay. Maybe like just watch 75 % of it, but diagnose one of those things that you would normally watch and just notice patients don't get mad. They don't get angry. ⁓ Remember when you do get that frustration, it's just due to their expectations not being met.

 

So if you can even help them co-diagnose with you. So having your hygienist call out their perio numbers and let the patient know before they do it, like, hey, we're looking for the health of your gums, anything above a four, that's something that we need to watch if there's bleeding. And I'm gonna show you, so listen with me, you're gonna hear, ⁓ and then you'll be able to hear. Well, now that patient's listening actively with you of, wow, I heard like seven fours, or I heard like a six in there, now you don't have to try and teach them and say like, you've got perio.

 

They actually heard it and they co-diagnosed with you. You can show them x-rays of here's a healthy tooth. This is what a healthy tooth should look like. Now look at this tooth and what do you see? You guys, if there's decay in there, even the untrained eye usually can see that pretty big chunk of decay taken out of there or use intraoral photos to where that patient's co-diagnosing with you to gain the trust. And that actually makes it easier for you doctors, because then you're not teaching them. Or if you're like really nervous about it.

 

AI teaches them. Like it literally just puts the puts it up on there and you don't even have to hardly do anything other than just presenting it to them and educating them. So something simple there. And then if your team's not closing cases, amazing simple things like an NDT our handoff. next visit date, time, recare that can help tremendously. ⁓ having your team members track their treatment plans, having a consultant help them. Like we literally help listen to treatment plans, guide and give coaching on different ways that they can do it. So there's two ways if you're not diagnosing or producing enough.

 

that we can easily do that. And the next one would be a block schedule. Kristy, any other thoughts on that? Because I'm sure you've got pieces working with so many team members too.

 

DAT Kristy (22:06)

Yeah, listening to you talk about the case acceptance, it's just hitting me that sometimes I think our fear is in telling them, but really if we take a step back and just include them in the process and figure out what are their long-term goals for their mouth and being able to speak to them in a relational way that...

 

The Dental A Team (22:23)

Thank

 

DAT Kristy (22:29)

really is flipping it to what is their goals and getting them what they want. I think that takes the pressure off of us telling the patient, right? And so, ⁓ truly, I think when we master this, it's a beautiful thing and you get patients to stick for very long time because they feel heard, right? And they still are in control of their care. So.

 

The Dental A Team (22:53)

Totally, I agree with you, Kristy, and I love that you talked about like, they're part of the solution with you. And I agree, like, I can't as a treatment coordinator want this more than they do. It really has to be something that they're a part of. ⁓ And also just helping your team see, similar to doctors, when we're watching so many things, team members can accidentally be saying one or two words that's guiding a patient the wrong direction. We might be highlighting insurance more than we're highlighting total treatment. We might be putting emphasis on like your max on insurance or

 

Like we could just start with one thing because we're afraid of presenting total dollar amounts. All of those things are normal. That's like very normal. Your team's not struggling, team members listening. You're not doing anything wrong. Just highlighting that there are different ways that you can present it. And I call it like the sequence. So think about when you're back in high school and you had your locker combination. If your combination code was 321, you could put in the number 213 and your lock wouldn't open. You could also do 123 and it wouldn't open. You could also do 32...

 

three and it won't open. You can have the exact same numbers and just do them in the wrong combination and it won't open versus if we have the right pieces in the right combination, we actually get more case acceptance. So just realizing like what are my tools that I'm using? Am I putting them in the right sequence? Am I using the tools like insurance is a tool? It's a coupon. So let's maximize that, but it's not going to guide my treatment. Let's maximize getting full case acceptance. Let's maximize like Kristy said, knowing their ultimate goals and tying my treatment back to those ultimate goals.

 

just using the tools in the right sequence can also help with that case acceptance. Now, if you are a practice that's not diagnosing enough, I think that this becomes like a little bit of an ego check and I'm sorry to be the ego check day today, but it might be something where if we're not diagnosing enough and we are collecting and we're not producing enough, it might be time for us to look to see about cutting costs. And this is something where I don't love to have this conversation. However, bottom line is the practice has to thrive.

 

Otherwise we all will fail. And doctors like you won't be able to help your team. You won't be able to help patients. And ultimately your livelihood is on the line too. Nobody is happy in this scenario. So when an office is like, don't have money, great. We've looked to see, you diagnosing? We've looked to see, are we collecting? We've looked to see our case acceptance. Like let's check all the boxes. Flip side is what are we spending money on? Immediately I'm gonna go to anything that you no longer need in the practice. So I know we might have been in the glory days.

 

doing all these ITero scans. Well, guess what? Glory days are gone. We're no longer there. And I hate to be Debbie Downer, but the reality is we need to sell that. We need to get out of that contract. Anything we are not using in the practice, we need to cut those debts off of us. And this is just a yucky moment. And I'm sorry, but you've got to do it. And as a business owner, this is your job as a CEO is to watch the profitability of the business. Like you have to, and you have to make those hard cuts. And I will tell you, you do it one time. You're a lot more cautious on things you'll purchase in the future.

 

So we start cutting costs of things that are not paying for themselves. So if we've got extra equipment in the practice, if we've got other things that we can sell. Also, team members, we might have bulked. I've done this as a CEO, so I'm just gonna tell you, like, it was a really, really, really bad day when I realized I over-bulked anticipating something to happen in the practice, and I actually had to scale back and cut. That does not feel good, and it's something that we want to avoid. However, if we have ultimate, like, more team members than are necessary, or we could outsource to things,

 

I'm not here to say, determinate team members. Like we said, like we went through all the different scenarios, everything we possibly could do. But the reality is you may have bulked too much in a practice and you need to scale back and cut. And that's just a zone where you walk the walk of shame and you commit you're never going to do it again. But ultimately you have to get yourself to a profitable zone. You've got to look at your own spending. A doctor was like really struggling on spending and they had multiple credit cards. Consolidate those credit cards down to where you only have one. We pay it off every single time.

 

We look to see what other things we like work out deals with the lab or different people. ⁓ But you've got to be realistic. You might have to get a line of credit to get yourself out of it. You might have to take equity out of your home or your practice. Those are things I hate doing, but I also feel sometimes the pain of discipline is better than the pain of regret. And I would rather go through the pain of discipline and learning to like cut my costs and watch my costs and not hire. Like I might extra hire.

 

a hygienist. I might extra hire a treatment coordinator. Those are two players on my team that will actually generate revenue for me. And not to say assistants don't because assistants can, but I could get by with a Mr. Thurshy. Now, dentists, I know I'm going to get a lot of flak for that. The reality is you can do that for a short amount of time. And I just want to highlight like it's inconvenient, but it's also inconvenient not to have money to pay your bills. So like choose our heart on this. But this is a zone where like I heard a doctor and they were struggling and they

 

They spent like 10 grand on something unnecessary. And I'm like, that's a spending issue. That's a you issue. That's not a practice issue. And it's not a diagnosis issue. If you cannot produce what you have for your costs, it's like the person has to accept the fact that they bought too big of a house. Like you've got to scale down. You got to size down. And as much as that's an ego blow, that's also smart business ownership. So Kristy, that's my like soapbox. So doctors, like we said, it's first, let's make sure we're producing. Like, let's figure out our amount. have to, then we're going to check our production. Then we're going to check our collections.

 

Then we're going to check our diagnosis. We're going to check our case acceptance. We're going to check our block scheduling. Then we're going to go into any unnecessary costs that are on our PNL. ⁓ Look to see, there anything we could do to reduce costs? And then it's going to be, we've got to cut. And like, you've got to make that decision before you go under. ⁓ You owe that to your patients. You owe that to yourself and you owe that to your team. And it's a sad, crummy day, but it's part of business. Kristy, what are your thoughts?

 

DAT Kristy (28:27)

Yeah, I think you nailed it. The only area we didn't uncover was you usually do have some unscheduled treatment that you may be able to tap into. And I would definitely explore that resource. But you nailed it, Kiera. I mean, you hit all of the boxes for sure.

 

The Dental A Team (28:46)

So those are kind of like looking at a practice that says, I don't have cash. These are some of the ways to diagnose that we do within practices. And notice the very last thing that we went to was cutting. That's not our mission. That's not our process. And we're never going to tell you to cut somebody. That's going to be ultimately your decision. We're just going to remind you that as a CEO, that's part of your job. And I remember going through COVID, had a coach and she said, Kiera, you've got to have a list. You've got to have a list in your mind of like when things get tight, if they get there.

 

What are you going to do to make sure your business thrives and survives? And that has stuck with me when I realized like, that's why I'm paid a CEO salary. That's why I'm paid to make these hard decisions. That's why I ⁓ signed up to be a business owner. Like that's the hard side of success. Success has two parts of that coin too. There's the light side and the amazing side. And then there's the dark side that a lot of people don't talk about. So if you're looking at your practice and you're saying, I don't have cash, go through the checklist, Kristy and I just gave you. ⁓

 

And sometimes it does help to have a buddy in it with you, a consultant, somebody who's in it with you. Like Kristy, I think about the night that you picked up the phone with that office manager and you guys started calling, you called on accounts with them. I think sometimes not feeling alone in the process. think somebody pushing your team, because you're like, I don't know how to say this to my team. ⁓ Someone who can help guide them, someone who can help look at your diagnosis and help you diagnose maybe one more thing, ⁓ really can be an asset. And I call Kristy our money bloodhound.

 

If I have a practice on cashflow row, I'm like, all right, Kristy, I don't what you're gonna do, but girl, go to work and go start looking. And I think having an outside set of eyes, it's not sitting in there floundering with you, but can have a cool, calm, collected head, sometimes can be the most beneficial. So if you're struggling, reach out, we're here to help you. And it comes with no judgment. Kristy, don't think I've ever once heard you judge a single practice. You come with love, you come with open arms, and you come with solutions quickly.

 

to make sure they get there. So Kristy, any last thoughts you have for these practices who might be struggling, who are hearing this office autopsy being like, my gosh, that's been me, or my gosh, I feel like I'm headed that way. Any other thoughts you might have for them?

 

DAT Kristy (30:43)

⁓ Just again that you're not in it alone and having us to help ⁓ guide mentor and just make sure you have you know daily weekly monthly Systems in place and balance, you know a checklist balance. We got ya we can help

 

The Dental A Team (31:00)

We do. do. Well, Kristy,

 

thanks for being on the office autopsy with me. Thanks for just loving our clients so much and helping them. I think that client who two years after you started helping say to us, I like have never been this free or like, my gosh, like this is what ownership should feel like. I think those are the wins that we live for as consultants of hearing you thrive, hearing your successes, hearing you have your dream life and not being so stressed, ⁓ even in possible situations that are stressful. So Kristy, thanks for being that consultant with us.

 

DAT Kristy (31:30)

It's a pleasure. Thanks.

 

The Dental A Team (31:32)

Of course, for all of you listening, don't be on cashflow row. Don't be struggling about these things. If you are part of any of the scenario, if you're like, my gosh, any of those things resonated, reach out. [email protected]. Go to our website, click on TheDentalATeam.com book a call. Like truly it's a no judgment, just clarity, just momentum. Even if we can't help you, we've got resources. Even if you're not quite the right fit, that's okay. Like we will be there to support you. ⁓ but I think it takes courage to book the call. It takes courage to admit you need help. but there's so much freedom.

 

to know that you're not alone, that you're not having to do this alone and that there's somebody who truly can help you get out of the scenario and that's been there, done that and done it successfully many times. So reach out and as always, thanks for listening. I'll catch you next time on The Dental A Team Podcast.