The Best Practices Show with Kirk Behrendt

670: Part 1 - Top 10 Phone Skills for Tackling the Toughest Patient Questions! - Miranda Beeson

Join us with our resident expert Miranda Beeson in this 2 part series on improving phone skills to improve a consumer experience and ultimately improve your business. Learn how to provide the kind of experience that makes people feel safe, secure and excited to visit you. It’s all here in Episode 670 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Main Takeaways:

Enhancing phone skills enhances the practice. 

If you’re answering the phones, you are just part of the practice, you ARE the practice. 

Provide the kind of experience on the phone that makes people feel safe, secure and excited to visit. 

Trust is one of the most important things in dentistry. 

Sympathy is great, but Empathy with patients is what makes the difference. 

Your attitude should be “Yes, we do!”

Mirror a patient’s communication style. 

Quotes:

“It’s the first piece of interaction that someone has with our organization. So enhancing phone skills is just going to enhance our customer service level. New patients, really important. In the first moments they’re learning about who we are. Continuing to grow and trust with our existing patients, building loyalty and then slowly practice growth over time. To be equipped to deliver excellent phone skills, we have to have tools…You’re only going to get better if you have the tools.” - Miranda (1:31—2:20)

“If you answer the phone in the dental practice, you don’t represent the practice. You are the practice….Admin team members…they are the most under trained segment in all of dentistry” - Kirk (2:43—3:10)

“The administrative roles are sometimes the only roles where someone could have no dental experience and come into the office. So it is really important for us to support them. And a big piece of it is feeling confident. If we aren’t confident then we aren’t going to guide that patient properly and deliver that experience that takes our care to another level…There is a statistic that 60% of new patient calls don’t convert to appointments and a lot of that comes down to the receptionist or the administrative team member on the other end of the phone not having the confidence or tools to know how to close that call.” - Miranda (3:47—4:27)

“Patient perception begins with ‘Hello’ . It's in the first instant. If you said no other word than hello, they can tell on the other end if you’re smiling, if you’re happy, if you’re frustrated. And let’s be honest, there are 17 million things going on in the front office at all times and sometimes we are a little frustrated that we see the phone ringing and we have to pick it up. So we have to know, foundationally, from a mindset perspective it is the most important thing you’re doing because within fractions of time you’re creating an experience for that patient that’s going to live on forever in terms of the lifespan of them in your practice.” - Miranda (8:10—8:48)

“You should be getting regular compliments. People should be reaching out to you. Talking to you. Texting you going ‘Hey, I just want to let you know that person, they’re good.” - Kirk (11:59—12:12)

“If we think about the majority of the people who come to the dentist, most of them are not super duper excited about it…but if we can provide an experience or an environment that starts on the phone with them feeling comfortable, confident, safe, secure. ‘These people sound like they’re going to take care of me. They sound so nice. Ok I’m not quite as scared as I was before.”  - Miranda (13:02—13:38)

“Imagine, just for a moment, what it would be like to be on the other side of your phone call. And think about what it is you're trying to create as an experience for the caller and for the patient and are you delivering that?”  - Miranda (15:49—16:01)

“Trust is one of the most important things in dentistry. We know that without trust we will not maintain patient loyalty, we’re not going to have case or treatment acceptance, we’re not going to have referrals…in general, everything is based off of trust. Like we said before, it’s a vulnerable place to be. It’s not everyone’s favorite place to be…Trust starts way before the patient gets in the chair. So one of the key phrases that helps someone feel welcomed and builds rapport right off the jump is ‘That is such a great question. Thank you for asking.’ Because it allows for them to go ‘oh ok.’ A lot of people are nervous about getting on the phone…so if the first thing you respond with is ‘I’m so glad you called. How can I help you today?’ and they ask a question and you respond ‘That is a great question. Thank you for asking,’ they’re going to be so much more willing to trust in you and open up to provide you with more information.” - Miranda (16:38—17:58)

“Active listening is when you’re listening to truly understand what is going on. So you’ll hear people say ‘You heard me, but did you listen?’ Sometimes we are going through the motions. We’re just checking the boxes…we’re not focused on active listening with the patient that’s calling us. There are 3 A’s to active listening that are a nice, easy go to. The first one is attention. You have to give your full focused, undivided attention to the caller. They can tell when you don’t. If we are dividing our attention they can tell. They can feel it. They can hear it. And that’s going to be a fail immediately, in terms of rapport. It’s going to be the first break in that link of trust. So finding a way to give your full and individual focused attention to the caller. A quick tip from my own experience: have a little notebook that sits right next to and when that phone rings you write down what you were doing and then when the call is done you can come back.”  - Miranda (19:00—20:36)

“You have to be able to adapt or shift gears to meet the patient where they are. It’s not about our agenda…this call is going to sound different with every patient. Now you might hit the same high notes through that call with that patient, but if we are actively listening to where that patient is wanting to go on the call and what their needs are, we’re adjusting our attitude to make sure we are there to serve them. Then we need to also be able to shift gears and go down the path that we need to go down to get them where they need to go.” - Miranda (24:16—24:59)

“We are there to serve. We are in the health care service industry. So ultimately when they call us they’re looking for support. They’re looking to hear I am so sorry you’re in this situation but I’ve got you. We’re going to take care of this. And again, when we talk about sympathy and empathy: sympathy is looking down in the hole and saying ‘I’m so sorry you’re in that hole.’ But empathy is like climbing down in the hole and giving them a hug and going ‘Dude it really sucks that we’re in this hole. But you know what? I know how i got down here so I can help us climb back out.’ So if you climb down in that hole and you really put yourself in their shoes for a moment to understand where they are coming from, not to create bias with how you move forward later to help them, but to say ‘I get it and don’t worry we’ve got you. You can lean on me. Let’s do this.’ - Miranda (26:46—27:42)

“Most of the time what I hear with teams is ‘Sure. Let me get your insurance. When was the last time you had a visit? It looks like you were in in October…All of that stuff is great information to have before someone comes in but the most important information you’re going to gather from someone is what is their concern? What are they needed and wanting and how can we support that? Again, it’s not about my agenda. It’s about theirs. They have something in mind when they’re calling and we have to identify it.” - Miranda (28:00—28:39)

“I talk a lot about the buying cycle. We are selling a service. We are selling our practice and our doctor’s skills and abilities. In any service, before a purchase, it starts with the consideration phase. And so there is an awareness that happens first. Before anyone goes into consideration, if I’m going to buy a new washing machine I don’t just say I think I should buy a new washing machine. My old one had to have broken…or something that created this awareness in me that I needed to start investigating and finding a new washing machine. People don’t wake up excited to make a dental appointment…usually there is an awareness that has occurred, so I often use the example, because I’ve heard it so many times from patients ‘I’m out to dinner with my friends last week and it was really tough because they were all looking at the menu and they were so excited about what they were ordering and I was actually getting a little nervous because I didn’t see anything I could eat on that menu without having discomfort…and I decided in that moment that I needed to do something.’ And that awareness is the trigger. And if we don’t find out that awareness piece, that emotional buy in from our patient and what their concern is.”  - Miranda (29:50—31:29)

“The key phrase here is ‘Yes We Do.’ We want to try to say yes as much as possible. Sometimes you can say yes even when it’s no. We have to figure out how to get around that but we want to say yes we do. ‘Are you taking new patients?’ ‘Yes’ ‘Do you work with my insurance?’ ‘Yes and I’d love to explain to you how that works here in our practice.’...’Yes we do’ in an immediate phrase that’s going to help build confidence. And if you say it with confidence, it’s not just what you’re saying, it’s how you’re saying it.” - Miranda (31:48—32:40)

“So maybe someone is calling you and telling you they’re looking for a new practice. They were with their last provider for 40 years. He was the nicest person…and you are going to go ‘You are going to love Doctor Awesome. He has such a strong relationship with all of our patients here. He even attended a patient’s son’s wedding last year.’ You want to tie it in to what it is that they’re looking for in a provider.”  - Miranda (37:31—38:04)

“The top 3 things when you’re on the phone with a caller. I often relate this to a new patient call, but ultimately it can be any call: I need to know who I’m talking to, so first off ‘What’s your name?’...Get their name, so you can use it, get their number because things to do happen. You get busy, you get going with your call…and then the key is going right into knowledge. Not knowledge about their dental history or knowledge about their X-ray history or about their insurance plan. Knowledge about who they are and what their expectations are for a visit with you…just something open ended that helps you identify that concern. What was the awareness? What’s the motivation for their call? Something aside from those logistical components that we usually jump right into. It’s that emotional buy in piece that we are looking for here.” - Miranda (39:27—41:16)

”We need to use clear, concise language. Really important to mirror their communication style and speed. I talk about this often and love incorporating DISC and personality styles into how we communicate with patients. But if you aren’t trained in DISC, if you don’t even know what I’m talking about right now when I say DISC, one of the easiest things to do modify how you communicate to your patients in their style is just listen to how they’re communicating with you.” - Miranda (43:27—43:55)

“[Using someone’s name repeatedly] Part of what ties into number 1, where the name comes in first, introducing yourself so they know your name and then learning their name and using it throughout the conversation, it customizes and makes them feel so important and so special. You don’t want to do it so excessively that it feels awkward but we do want to say again, ‘Joe, as I shared such and such,’...The more we use that name and customize, they don’t feel like just a number.” - Miranda (46:35—47:20)

”An open-ended question is something that cannot result in a yes or no answer. So it’s going to start with something like ‘What’ or ‘How’ or ‘Why’. ‘Tell me more’ is such an easy phrase that leaves an open end for them to extend the paragraph of whatever it is that they’re telling you. So it’s really important to have. As I mentioned earlier, the first question you may ask ‘What are you expecting out of your first visit with us?’ THat is a wide open question that can go pretty much anywhere. And they’re going to say something and you’re going to say ‘Tell me more.’  - Miranda (49:22—50:00)

Snippets:

0:00 Introduction.

1:13 Improving phone skills.

3:45 The administrative role. 

7:40 #1 First Impressions.

16:35 #2 Building Rapport.

19:00 Active Listening.

24:16 Adapt. 

25:58 Empathy and Sympathy. 

31:48 #3 “Yes We Do”

37:12 You are going to love…

39:27 #4 Top 3 Things to Say on a Call

48:45 Ask the right questions.

Miranda Beeson, MS, BSDH Bio:

Miranda Beeson, MS, BSDH, has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.

Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach. 

Send Miranda an email [email protected]

Follow Miranda on ACT’s Instagram https://www.instagram.com/actdental/

669: The Best Way to Recession Proof Your Practice - Dr. Leonard Hess

When business slows down, it can be worrisome for your practice. Take control back by learning to think bigger, investing in yourself and treatment planning for your patients, not the insurance companies. Dr. Leonard Hess of the Dawson academy joins us to show you how. Learn more in Episode 669 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

The Dawson Academy https://thedawsonacademy.com/

Main Takeaways:

Too many dentists are treatment planning for the insurance companies and not their patients. 

Most people over their lifetime are undertreated when it comes to dentistry. 

Learn to solve bigger problems. 

If you want change, stop acting like every other dentist. 

Invest in yourself. Invest in your team. 

If you’re a dentist, you’re in the people business. 

Quotes:

“Right now the best thing to do is educate yourself. Right now you should be investing in yourself to put yourself in a position where you can come out of this little slow down ready to rock and roll more than ever. The biggest change that has to happen is…the insurance industry is impacting dentistry now more than ever…it’s getting worse for the dentists. It’s not getting better. A lot of practices are starting to move towards DSOs and now DSOs are negotiating…The trap that almost every dentist falls into these days, and especially younger dentist, the problem in dentistry is that too many dentists are treatment planning what is best for the insurance company and they’re not doing what’s best for the patient.” - Lenny (7:52—9:04)

“The paradigm shift when you can educate yourself and put yourself in a position where you can diagnose better and you can educate your patients better, people inherently always want to do what’s best for themselves. They just need that choice. We’ve got a great standard of care of dentistry in the United States, but most people over their lifetime are actually undertreated.” - Lenny (9:08—9:32)

“People are getting a veil lifted and they see things differently. Because in dental school you were really only taught to diagnose problems related bacteria: causing decay or periodontal disease. But the biggest threat to whether or not people keep their teeth long term has very little to do with bacteria and has everything to do with force and occlusion and how everything is being managed. Most people who want a dental makeover, they don’t want it because they want whiter teeth. They want it because their teeth are worn and chipped. They have teeth of a 70 year old when they’re 40 and that’s not just a good combination. So in dental school we weren’t taught how to treat those types of cases. And they’re everywhere.” - Lenny (11:20—12:08)

“If you diagnose right, if you build a relationship with your patients you just need a dozen new patients a month. Or even less than that. Because if you can diagnose, if you can educate and if you can get patients to own their problems…the only way they can own it is by you explaining. Then people, a lot of times, will choose to do the best thing. And insurance doesn’t matter..”  - Lenny (13:07—13:27)

“You have to be willing and knowingly put yourself in a position where it’s going to be uncomfortable. And put yourself in a position where you can get over that hump and then great things can happen. You gotta be a problem solver.”  - Lenny (13:49—14:00)

“If you want to make more money and you want to work less days a year and you want to have more production per hour then you need to learn to solve bigger problems.” - Lenny (14:52—15:00)

“If you want to change your practice, stop acting like every other dentist.” - Lenny (16:03—16:06)

“[Forces are] the biggest thing that causes restorations to break and if you start replacing your dentistry because it’s not holding up, you’ve lost money. The profitability that you got from doing that case is now out the window. The key to having a really happy dental life is predictability, because predictability leads to profitability. Profitability means you’re happy. When your dentistry is predictable, that means your patients are happy and everything can be great that way. But dentistry, if it’s not predictable and then if it’s not profitable - if you feel like you’re working way too hard for the money you’re getting - dentistry can start to be a real drag.” - Lenny (16:35—17:14)

“All it takes is improving your clinical skills until you get to the point where you can do cases that you couldn’t before. And all it takes is one good case to pay for your entire curriculum.” - Lenny (20:56—21:24)

“The most important thing to realize in being a dentist is that you’re in the people business. Because if people don’t like you, if they don’t trust you. Who do you write big checks to who you don’t like or you don’t trust? Just the IRS. And if you’re going to act like every other dentist and you’re going to behave just like every other dentist, then people are going to put their trust in you to do major things or write you a big check.” - Lenny (24:15—24:42)

“People are always going to invest in their health, no matter what. People wanting to take care of themselves is recession-proof in and of itself. People are always going to have money, but when things get tight or when people are feeling less wealthy then they’re going to choose where to spend their money. They’re going to make a little more of a narrow choice. They’re going to be a little more careful about what they’re investing in. So most people will invest in their health because they care about how their teeth are going to look. They care about how healthy they look. People don’t want to lose their dentition. So if you are in a position where you can offer people options, choosing to do the right thing has nothing to do with the recession. There are always going to be that percentage of patients who want to do the right thing.” - Lenny (25:36—26:24)

“Invest in yourself. Invest in your staff. Train your team. Team training is so important. If you walk out the door, we all know, that a lot of times a patient is sitting in that dental chair and they are waiting for you to walk out so they ask your assistant or whatever do I really need this? If the vision of health and the philosophy of the practice walks out with you, you got a big problem….And when you start to see a slow down like this, it’s the best time to do it. More than ever.” - Lenny (31:02—31:40)

Snippets:

0:00 Introduction.

7:52 Insurance companies and dentistry. 

11:20 Seeing dentistry differently. 

13:49 Think bigger. 

16:35 The importance of predictability.  

20:45 No time for CE. 

22:50 Dawson curriculum. 

22:45 Being steady with comprehensives. 

31:02 Final Thoughts. 

Dr. Leonard Hess Bio:

Dr. Leonard Hess, D.D.S., is a Co-Clinical Director at The Dawson Academy, joining the Dawson faculty in 2009. He owns Union County Center for Comprehensive Dentistry in Charlotte, North Carolina, and he practices full-time in addition to teaching continuing education courses. He is a member of the editorial board for Inside Dentistry and has had over 17 articles published in peer-reviewed journals. He is also a member of the American Academy of Restorative Dentistry, AACD, ADA, AES, and NCDS.

Dr. Hess began teaching continuing education courses in 2005, and the topics include occlusion, smile design, treatment planning, preparation design, and practice integration of complete dentistry. He has taught full-day continuing education courses at the American Academy of Cosmetic Dentistry’s national meeting, The Greater New York Dental Meeting, AACD National Meeting, Pacific Dental Conference, Ontario Dental Association meeting, and The Yankee Dental Conference. Dr. Hess also has taught courses in Japan, Germany, Poland, China, and Canada. 

Join Dr. Hess on Facebook: https://www.facebook.com/leonard.hess.7 

Follow Dr. Hess on Instagram: https://www.instagram.com/drlennyhess

668: Your Practice Within Your Practice – Dr. Brent Bush

Do you want to better serve your patients, but don't feel like you have the time? One solution is to create a practice within your practice. To help you get started, Kirk Behrendt brings in Dr. Brent Bush from The Pankey Institute to share his journey and experiences that changed his practice. You can slow down and still get busy! To hear how you can be a better dentist for your patients — no matter where you are — listen to Episode 668 of The Best Practices Show!

Episode Resources:

• Send Dr. Bush an email: [email protected] 
• Join Dr. Bush on Facebook: https://www.facebook.com/bushfamilydental
• Follow Dr. Bush on Instagram: https://www.instagram.com/bushfamilydental
• Subscribe to The Best Practices Show podcast: https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club: https://www.actdental.com/ttt
• See ACT’s Live Events Schedule: https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes: https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Main Takeaways:

You can't afford not to do CE.

Go and seek the people who will help you.

Do the legwork of going to CE and workshops.

Choose to do the work that brings you the most joy.

Bring your team along with you on your learning journey.

Block out time to help your team implement your learnings.

Quotes:

“I had another buddy of ours from dental school, David Hedgecoe in Fayetteville. He was one of those practices where I was like, ‘How is he so busy? What is he doing different than I'm doing? I feel like I'm so busy and I'm going to burn out here. Why is he so busy doing cool stuff?’ I was busy and good. But, oh, boy, it was hard. And no joy, really, after you do your thousandth MOD. So, I realized that there was more to [dentistry], and I asked Todd [Davis], ‘What do I do?’ He said, ‘Well, you need to go learn.’ And so, I started to get on the CE train and do some workshops and seminars, and I hit it hard. That's that thing where if you are going to bet on anybody, bet on yourself. I invested a bunch of money and a bunch of time — I didn't think twice about it — to go learn how to be a better dentist for my patients.” (7:26—8:25)

“I think as a young dentist out there — and I was this way too. I'm no different than you are. If you're the young one out there listening, I'm no different than you are. I just saw that there is a different way and maybe a more comprehensive way. To me, [having a practice within your practice] meant that there's the everyday, bread and butter, do the fillings and crowns, but there's also this niche that you can work for yourself, whether it's orthodontics, or placing implants — for me, I became the bite guy — where you have an interest that inherently shows up, and you do more of it. The more you do it, the more it shows up, and you don't really need to even market it anymore, where people refer you for that reason, they refer their friends for that reason. So, you become maybe a second opinion person, and things like that. It becomes this little thing where you have these moments in your schedule, daily or weekly, where you set aside time to focus on what you really, really like to do.” (8:43—9:43)

“[As you become known for something, it becomes less about insurance] because patients become more and more invested and interested in the best thing for themselves. I don't think those two things are congruent, that you can give the patient what's best for them, and at the same time have somebody else tell you how much you should charge for that.” (10:10—10:27)

“You go to these CE classes, and you hear people talk, and that's all they do all day long — it's just this big dentistry, full-mouth cases. And it's not that. We don't have these people show up and say, ‘I want this. Here's my money.’ You need to walk them through the process of their dental journey themselves, find out how aware they are of what they have going on with their mouth and their dental health. And then, as you educate them, they become more engaged. As they become more engaged, then you have a patient who wants the best for themselves.” (11:50—12:25)

“The more I learned, the more I wanted to learn. The more I knew, the more fun it became and the more I enjoyed dentistry, this second career, if you will.” (12:52—13:01)

“It's funny how you meet these great people, and they're there to help you. You have to go to these places [like Spear and Pankey]. You have to get yourself out there. You can't just look at things online. You have to get out there, and meet the people, and experience it for yourself to see what you really want to do and know how much they want to help you. These older dentists want to be your mentor. They want to help you.” (14:24—14:48)

“Having done this side of it for 10 years now, the real joy in it is to see somebody else grow. I heard Gary [DeWood] say when I was in Arizona one time, he was talking to another person who had been around him a lot. He said, ‘One of the real joys is for you to become bigger and better than me at doing what we do.’ I thought, ‘Wow. From Gary DeWood, that's crazy.’ . . . But you don't get to meet them if you just hover around the office, and stay there, and watch things online. I think when you look for things online, you find what you want. But when you go to a workshop, you find what you want, but you also find things that you didn't know you needed, which are relationships, community, more knowledge, and the chance to ask questions to professors or whoever is leading it. It's special. A lot of times, I hear, ‘It's so expensive. I can't afford to do that.’ I say, ‘You can't afford to not do it, really.’” (15:35—16:33)

“When you schedule out a two-hour appointment and you charge for that about the same that you would charge for a few fillings and you get paid for that, it’s an aha moment like, ‘Wow, this practice philosophy, as far as a business sense, can work.’ So, that's, on the practice management side, an eye-opener like, ‘Oh. I did this, and it worked.’ So, it's feasible and viable to build your practice within the practice around your time, your expertise, and your talent.” (17:53—18:35)

“It's funny because you come back [from CE] and you are so energized. You're so ready to go, and [your team is] like — they didn't have the same experience that you did. You get back, and you're like, ‘All right, this is what we're going to do. We're going to change this, and we're going to buy this, and we're going to use this, and you're going to take pictures just like I learned how to, but I didn't teach you how to.’ And so, here is the bump in the road, that they didn't have the same experience you did. Imagine going to the Grand Canyon. You go out there, and I look at a postcard of it. You come back from the Grand Canyon. I see the postcard, and I'm like, ‘Wow, that looks cool.’ And you're like, ‘No, you don't know. It was super cool. I saw it. I saw the sunrise.’ I just have a postcard. Like, that's their perspective of my trip to learn more. They didn't experience it. So, you double down, and you take them out there, and they get to experience it also.” (21:09—22:07)

“We block time on our schedule to learn how to implement what we just learned, what I just learned. That's a key thing. Like, you're in control of your schedule, no matter what. You can do whatever you want to do with your schedule. You can work on Saturdays if you want to. You can work till 7:00 or 8:00 at night if you want to. But if you set aside time to train your staff, and get on the same page, and make sure everybody knows what's going on and technically can do it, can take photos the way they need to be taken, it's huge. It's a game-changer to have your staff on board with what's going on. So, you’ve got to invest the time in your office with your staff.” (22:37—23:21)

“If you can carve out an hour a week and designate that [time] to somebody that I know you saw during the week before that needs special attention, just one hour, and talk to them — don't even put gloves on — that's the best way to start.” (25:33—25:54)

“Our new patients were scheduled in hygiene for the hour. So, they got their teeth cleaned, and we would do the 10-minute new patient exam within that hour. We're like, ‘Well, that's not enough,’ so we did an hour and 10. We thought, ‘Well, let's give it 10 minutes extra. Well, that's not enough. So, then, we bring them in 30 minutes before their cleaning. And they all got cleanings. So, we bring them in 30 minutes beforehand to get them in a separate room. Now, we've transitioned to an hour-and-a-half, new patient exam. Photo is uploaded so they can see them right there, and we talk to them for a good 30 minutes, trying to find out where they're at, what their goals are. And that's my first question, ‘How can I help you best as your dentist? What do you want from your dentist?’ It's amazing what people will tell you if you've given them the opportunity to tell you.” (26:00—26:58)

“Take an hour, find a patient that you see something that you want to address with them, or maybe they're going down a bad path and they don't know it, or maybe they do know it and you don't have time. Take that hour and talk to them. Get them back, talk to them, take some photos. Get a camera, for sure. If you don't have a camera, get a camera and use it. Show the patients their pictures. It's unbelievable. That's the first step, is for a patient to see their own mouth. That's a game-changer.” (27:01—27:32)

“I've done a talk that's titled “Slow Down to Get Busy”. It's a matter of understanding and helping the patient understand where they are — and you cannot do that in hygiene. Anything more than three or four minutes of a conversation needs to happen in your own chair at a different time.” (28:03—28:22)

“Don't be afraid to go learn more, to go approach an older dentist that you look up to and ask them for help. It may be an instance in time — one of the most impactful dentists that I've been in touch with, I was with him for five days at Pankey, and that's it. He said some things to me that opened my eyes. So, you don't know how long you need to be in their life, if you will, for them to have an impact on you. And so, you’ve got to get yourself out there. Then, when you get back to the practice, take your time to implement what you just learned, and lean on somebody for help.” (28:50—29:32)

Snippets:

0:00 Introduction.

1:42 Dr. Bush’s background.

3:09 The study club that changed Dr. Bush’s practice.

6:52 Gain a new set of eyes.

8:26 A practice within your practice, explained.

12:30 Seek people who will help you.

17:10 Put your flag in the ground.

18:36 Choose the work that brings you joy.

20:48 Bring your team along on the journey.

23:43 The future for Dr. Bush.

25:02 How to start having a practice within your practice.

27:38 Take time to talk to patients.

28:32 Last thoughts.

30:37 More about Dr. Bush’s study club and how to get in touch.

Dr. Brent Bush Bio:

Dr. Brent Bush graduated from UNC School of Dentistry in 1998. He is a member of the American Dental Association, North Carolina Dental Society, and is a past president of the Wilmington Tri-County Dental Society. He was born and raised in California and moved to North Carolina to attend dental school at the University of North Carolina in Chapel Hill. In his spare time, he enjoys family, friends, and triathlons — including completing two Ironman triathlons. He has three boys, who keep him busy with their baseball and swimming schedules. You will also find his photography decorating the office. 

667: Scaling with the Right Culture - Dr. Brett Levin & Dr. Jennifer Derse

Growing a practice is more than acquiring or opening new offices. And it’s hard! Dr. Brett Levin & Dr. Jennifer Derse have done it with their Espire practice. And have the secrets to scale your business and keep the culture you want. Learn more in Episode 667 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

Learn more about Espire Dental https://espiredental.com/

Main Takeaways:

Make a discussion of your culture part of your daily stand-up meetings. 

You have to have a structure to the culture. 

A one-size-fits-all all blueprint might not work for expansion. You may be leaving great ideas on the table for each unique practice. 

It’s hard to maintain consistency when you try to grow a practice on your own. 

Quotes:

“We had a lot of people asking us how you did this? How did you create an amazing culture? How are you fee for service? How are you getting all of these referrals? How are people traveling? We saw 5+ years ago that the dental industry on the precipice of change. We wanted to try to control our destiny in that change. And really create a private practice DSO model. And that means something different for every person. But we didn’t want to do it where someone comes in and buys your practice and now you’re part of a bigger conglomerate and you don’t have to do any type of change. That’s not really pushing yourself to grow or become collaborative. We also saw that a lot of younger dentists really craved mentorship and growth but didn’t have the time or the means for someone to nurture and support them. I think Jennifer really had that vision and was spurred on to help create it and that was the genesis of how this fire started. We have 28 practices and 352 team members” - Brett (14:16—15:41)

“We have been really fortunate to have met a lot of wonderful people…within dentistry but also others who share our entrepreneurial mindset. And through the McKinsey course we met some entrepreneurs who we picked their brains, one of whom had done something in eye care and we said how did you do [grow and keep your culture]?...We started Espire with 4 essentials. It’s our playbook. It’s our credo. It’s our mission. It’s our values. And we weave this into our daily huddle. And every day not only do we talk about the procedures we’re going to do and the patients we are going to see, but some dynamic of our cultural playbook gets put in it so we can all encourage and put supportive of one another. So that was the foundational start of the Espire. And I think culture is a big buzzword but I think that’s something people talk about but don’t really put words and conviction to. And when we would talk similarly-minded doctors about what we are doing and then show that we are talking about this but we actually have something like a beacon to hold. It was easy to get the right doctors to work for us. ” - Brett (16:41—19:12)

“If your culture doesn't have some type of structure, then you don’t have a culture. You have to have a structure to the culture. ” - Jennifer (19:47—19:54)

“We thought our office could be the blueprint for every office and you carbon copy it. I think what I learned is that every doctor, every office, every location, has unique qualities to it that might be different from ours. So what I think we learned is instead of saying do everything like us, it was what core things where we found success do we think you could apply and then still be independent and unique for whatever location you’re going to be in and use the best of what we found to work, but also use the best of what you’ve found to be working and if it works better in your office, let’s take that idea and have it go throughout Espire.” - Brett (20:36—21:26)

“Some pitfalls were…it’s harder than it looks. Sometimes in finding cultural alignment you…it’s like dating…In our first year we reno’d this practice, we did all these things and we learned it wasn’t a good cultural fit and we divested it.” - Jennifer (21:58—22:30)

“We have learned to ask better questions to make sure the person in the deal is a right fit and is ok being uncomfortable. Because you come into Espire and there are a lot of things we can do to support you but we are also going to challenge you and ask you to do a few little different things that you maybe you wouldn’t have to do if you joined another type of company.” - Brett (22:58—23:26)

“There are a lot of other DSOs that are really hands off. That is not us…We are all partners at the top level. So you are now part of a real group where every doctor who is an owner owns all of the company. So it’s in all of our best interests to help elevate each other and life each other up. You’re not on this island. THe culture is so different that way. And if you want that direct line of mentorship…I don’t know if some of those other organizations do that. I didn’t experience that in my 6 months of [somewhere else]. But here, when our young doctors are in first smile designs, I’m in there with them coaching them like this is what you do. But I’ve never placed an implant in my life and they need mentorship there, I who to call in the company who is going to go over and mentor them through that process. I think we are so much more integrated and aligned with each other that you really do feel like you’re part of a team.” - Jennifer (28:04—29:24)

“For me, a land grab…if someone said ‘I primarily want to be paid top dollar for my practice and I don’t care’…that may not be someone that we want. We can pay top dollar but we want you to bring more to the table than just saying ‘Pay me and I’m not going to do anything different or I’m not going to work anymore.’ A land grab is just where these companies grab whatever they want. They don’t care the quality. They don’t care to have consistency within them because they’re searching for a certain number of practices, a certain financial number that gets on to the next cap event or whatever it is. We want more than that. We want to have those opportunities but we want to have it in a much more choreographed and deliberate manner than a lot of other places to.”- Brett (30:00—30:56)

“We have a CEO, CFO, COO, CMO, Regionals, Practice Managers. We have all of that in place. And every Wednesday our leadership gets together from 9-12…and that’s where we have the opportunity to bring up ‘Hey I need support over here. Hey this doctor is struggling and I haven’t told you about it. Can you go and help them, Jennifer?’ We go through all of that process.”- Jennifer (31:29—32:11)

“That is seems easier than it is. You think it’s going to be a lot easier than it is. And a lot of dentists might start the process on their own thinking I got this. I can do this. As doctors we get a lot of positive reinforcement all day every day…but when you go into this other side of things you think that’s going to be really easy too and most dentists max out what they’re able to do. I just think about what we put into our practice. We have the 12 treatment rooms and it was like we had two jobs. I would go home at night and pass out for a few minutes and then I’d wake up and get started on some kind of marketing project.”- Jennifer (36:49—37:39)

“When you define your culture and your way early on, it’s much easier to say ‘I don’t think this is working.’ Jennifer said ‘Fail fast.’ I don’t think we have gone through this. We can find when people are becoming uncomfortable with some of the accountability. I don’t mean that in a bad way…It’s not the perfect scenario for everyone.” - Brett (40:27—40:48)

“If you buy another practice and you’re working less, you’re probably ruining that practice. What are you driving there?”- Jennifer (40:27—40:48)

“[A year from now] I hope we have created enough awareness in the community of we are doing. That we are real people behind this trying to do something. Do the right thing. And do something well. That we are more than just a group. And I hope by then we’ll start to have this reputation in the community.” - Jennifer (43:25—44:12)

“[A year from now] I want us to be an agent of change for good in dentistry. There are so many things that the DSO corporate world…people interpret that as this big negative and I want to be a place where people want to come work for us because we know they’re going to have an exceptional experience, exceptional support and be able to do great things because we are going to want to push them to do great things. I don’t want someone who is going to sit and coast. And I hope that people look at Espire as a place that you can do great things from top to bottom.” -Brett (44:20—45:07)

Snippets:

0:00 Introduction.

14:00 Creating culture.

20:36 What worked and what didn’t. 

23:28 Change is hard. 

28:04 The Espire Difference.  

29:36 A land grab. 

31:15 Leadership. 

36:42 What others are getting wrong.

43:20 What’s on the road ahead.

Dr. Brett Levin Bio:

After obtaining his dental degree at the University of Pennsylvania School of Dental Medicine, Dr. Levin returned home to Denver to practice with his father, Dr. Alan Levin. Having served the Glendale/Cherry Creek area for over 20 years, he values the “idyllic” relationships he has created with his patients. He is committed to upholding the traditions of Espire Dental while incorporating the best of modern dental practice technologies.

Dr. Levin is one of a select few clinical instructors at the prestigious Kois Center, a clinical program designed to integrate the latest advances in esthetic, implant, and restorative dentistry. As a leading Denver cosmetic dentist specializing in dental veneers, same-day crowns, and clear aligners, he is uniquely qualified to give patients the smile of their dreams.

Dr. Levin is a respected member of the Denver dental community, having served on the board of the Metro Denver Dental Society (twice) and being awarded 5280 Magazine’s Top Dentist every year since 2008. He has also traveled on medical mission trips, providing dental care to communities in need. 

Follow Dr. Levin on Instagram https://www.instagram.com/brettrlevindmd/

Dr. Jennifer Derse:

After dental school at Marquette University School of Dentistry, Dr. Derse focused her practice on cosmetic dentistry in Scottsdale, Arizona, and taught at the Arizona School of Dentistry. In 2010, she moved to Denver to join Espire Dental, formerly Levin Family Dental, where she has maintained a Top Dentist award by 5280 Magazine every year since.

Dr. Derse completed the Kois Continuum and focuses her dental practice on esthetic and restorative dentistry. She is actively involved in the Denver community, serving on local non-profit boards and fundraising with Smiles for Life. She has also gone on numerous medical missions to the Dominican Republic and Guatemala to provide dental care in needy communities. To build upon her service in non-profits, she started the Derse Levin Foundation, Espire’s philanthropic arm that funds humanitarian work along with local charities.

Dr. Derse loves puppies, traveling, cycling, and spinning (you can ask how she fell off the spin bike). Fun fact: as a leading cosmetic dentist specializing in dental veneers, same-day crowns, and Invisalign, she is often called up as an expert witness for dental cases presented to the Colorado Dental Board. 

Follow Dr. Derse on Instagram https://www.instagram.com/espiredental/

666: AR is a Team Sport - Dayna Johnson

Collecting money isn’t always an easy conversation, but it’s critical to the business. And it’s not just an admin task. The whole team should be learning how to get involved and support the profitability of the business. Listen to expert Dayna Johnson share her systematic approach. Learn more in Episode 666 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

Dayna Johnson’s Website: https://novonee.com/

Dayna’s Podcast: https://novonee.com/podcast/

Main Takeaways:

Accounts receivable is not just an admin task. It’s the responsibility of the team. 

Your money is worth the most today. You have to collect the patient portion on the date of service.

It’s not just about collecting money, but being proactive about preserving the relationship when an honest conversation is had about the patient’s financial responsibility. 

Use a systematic daily, weekly and monthly approach to getting insurance claims paid. 

Make sure your team understands how critical profitability is and how they personally can influence the collections in the practice.

Quotes:

“Your accounts receivable is the money that’s sitting on the books. So you produce $1000 today and you only collect $500 then you still have $500 of accounts receivable. You still have money that’s sitting on the books. The accounts receivable, some of it might be coming from dental insurance companies, some of the money might be coming from patients. And so there are those two buckets of money that needs to be collected. And the reason why I say it’s a team sport because collections is not just an admin task. It doesn’t just belong at the front desk at the check out. Everyone on that team needs to understand what the patients out of pocket is today and how much do we have to collect today? And if someone on the admin team or someone at the front desk is not available to collect that money, how do I jump in as a dental assistant or doctor. How do I jump in and run the credit card through the machine and collect that money that is due today?” - Dayna (3:57—5:11)

“Your money is worth the most today. You have to collect the patient portion on the date of service. This is so critical to the profitability of the practice. Once your accounts receivable goes past even 30 days, you’ve already lost about 15% of the value of that money.” - Dayna (5:22—5:48)

“Most dental teams really don’t think about profitability…Why should I care? I work in the back. Profitability doesn’t affect me. Well it sure does because profitability is where raises come from. It’s where bonuses come from. Your new scrubs that you want to wear. Your instruments. Your team CE. All of that comes from profitability.” - Dayna (6:19—6:49)

“Being more proactive on the front end so you’re not chasing money on the back end. And it helps preserve the relationship [with the client] because you’re being open, honest and transparent with your patient about their financial out of pocket expense on the date of service.” - Dayna (9:00—9:18)

“Job descriptions and what is my primary role within the practice is huge with you understanding what your tasks are. How do I master my skills at this primary role? And then you know walking in the door every day what am I accomplishing today? What is the outcome that I want?...I see not only are admin team members not trained well, but they’re also also just a little bit confused as to what’s my primary role here?” - Dayna (10:40—11:38)

“I want you to be more proactive. It really starts from the treatment planning side because the treatment that you are going to be scheduling for the patient needs to be accurate and comprehensive and so the clinical team they treatment plan, and if they need a crown, a build up and maybe a couple of fillings and someone on the team needs to prepare that treatment plan. And of course we want to be as accurate as possible with our estimates. If the patient has insurance, we want to be able to prepare the patient for what their out of pocket investment is going to be in their next visit. My rule is a patient does not get scheduled for treatment without a financial arrangement…Because what will happen is the patient will get scheduled and they don’t know what their out of pocket investment is and then the day of the appointment comes and the patient still doesn’t know what their out of pocket is so the patient really thinks it could be $50. It could be $5,000. They just don’t know. So that’s when you’re going to have that uncomfortable situation.” - Dayna (12:14—13:32)

“Now it’s a team sport because the whole team needs to be informed of what is that patient’s copay for today. So this might happen in your morning huddle. You might make an appointment note on the appointment…the patient is informed. They might have a signed agreement already. But then the whole entire team knows from that appointment that the patient has been informed about their out of pocket. They know they owe $500 today. And so anyone on the team that is available to collect that $500 should know how to run the credit card.” - Dayna (14:30—15:25)

“So I have a pretty systematic approach when it comes to your daily, weekly and monthly systems when it comes to accounts receivable….On a daily basis, of course you balance your day so what did we produce? What did we collect? What did we adjust off? And we balance that every day. Insurance claims go out within 24 hours of the date of service. Billing statements are going out every day…When you send statements every day you’re catching those overdue balances a lot quicker…Weekly is you have a team member at your practice where their primary role managing accounts receivable. You have an accounts receivable report…and you have an insurance claims manager report you’re looking up past due claims. If the claim is over 30 days then I’m checking on the status of that claim. If that claim gets to 60 days past due I’m involving the patient and that’s really hard for a lot of offices…At 90 days if the account is not paid up, I’m sending my first collection letter. And then at 4 months, I’m sending them to collections.” - Dayna (17:30—19:45)

“With accounts receivable a lot of times it is putting the emotion aside because you are running a small business. Sometimes we have to take things to that level and send that patient to a collection agency. I know it’s hard, but if we did it the right way and collect on the day of service we wouldn’t get to that point anyway.” - Dayna (21:04—21:30)

“With the accounts receivable ratio, which is the total accounts receivable on the books compared to the monthly production number, I still like to see that below 1.0. So probably between 0.5-1.0 which means you have about only a month of production on the books. Over 90 days past due I want to see that less than 10%. And collection percentage, I feel like 98% is still the gold standard.” - Dayna (22:17—23:00)

“I think the number one thing that they get wrong about AR is that it’s only an admin task. That it only belongs at the front desk…Identifying that everyone can be involved in accounts receivable. You can help the profitability of your own practice just by not dismissing that patient from their crown prep appointment without collecting that $500.” - Dayna (28:27—29:00)

“Another thing I see doctors getting wrong is not understanding what their accounts receivable is. Just taking that important system, the most important piece of their practice and not looking at it. And just trusting someone on the team to manage it and not looking at the adjustments. And not looking at what their accounts receivable percentage is or their collection percentage is. And I think that’s another place where doctors put their head in the sand.” - Dayna (29:23—30:01)

“Why is accounts receivable so important? I think when the team understands that accounts receivable and getting the money in the bank effects them personally with them asking for a raise or wanting to get a bonus, start wanting new scrubs, going to a conference. Any of those extra benefits that they want from their practice, all of that comes from collections and the profitability of the practice. I think when the team understands how critical profitability is and how they personally can influence the collections in the practice I think you can get everyone on board.” - Dayna (34:08—34:54)

Snippets:

0:00 Introduction.

3:57 About accounts receivable. 

5:22 Your money is worth the most today. 

7:40 Be more proactive about the financials.

11:45 How to make AR a team sport. 

16:30 Past due balances. 

20:00 Working with a collections company. 

22:00 The standard for ratios. 

28:20 What people get wrong about AR.  

33:58 Final thoughts. 

Dayna Johnson Bio:

Dayna Johnson has helped dental offices from around the country easily transition down the path to paperless using her years of experience as a dental office manager and Certified Dentrix Trainer. As one of the Pacific Northwest’s most trusted consultants, she gives a straightforward and complete assessment for each of her clients. No two dental offices are alike, and Dayna channels her passion for going chartless to help each of her clients fulfill their goals and increase their profitability.

Dayna’s expertise has helped her earn prestigious honors such as:

• Spirit Award for Independent Certified Dentrix Trainers for her loyalty and dedication to the Henry Schein brand.
• Teaching Dentrix seminars for Henry Schein throughout the United States.
• Authors the national blog for dental office managers for Dentrix users.
• Featured speaker at the Business of Dentistry Conference in Las Vegas.

“Going chartless” is an often-used and often-misunderstood term in the dental world. Dayna’s expertise will allow practices to see benefits such as automated systems that give team members more time to spend on patient care, integrated electronic services to ensure your patients know your practice is keeping up with the latest technology, making the patient chart more accessible, and allowing the clinical team to treatment plan while the front office can be working ahead on payment plans and insurance issues, raising the level of office security to comply with new HIPAA requirements, and much more.

With 18 years of experience in the business and technical sides of dental offices, Dayna’s passion for efficient systems is grounded in personal understanding and professional expertise. Dayna knows firsthand the problems that occur when collections are down and a schedule is full of holes. She has also lived the frustration of too many hours spent hunting for misplaced patient information and mishandled recordkeeping. 

Join Dayna on Facebook https://www.facebook.com/DentalConsultantConnection/

665: Treatment Planning & Digital Are Not the Same Thing! – Dr. Jeff Rouse

If you're new in the digital space, there's one thing you should know: digital smile design and treatment planning are not the same thing! To explain how they're different and why the confusion is one of his biggest pet peeves, Kirk Behrendt brings back Dr. Jeff Rouse from Spear Education with advice for using digital and analog in your treatment planning process. Analog isn't outdated just yet! To learn why the best dentists still use analog, listen to Episode 665 of The Best Practices Show!

Episode Resources:

• Join Dr. Rouse on Facebook: https://www.facebook.com/jeff.rouse.58
• Follow Dr. Rouse on Instagram: https://www.instagram.com/jeffreyrouse
• Subscribe to The Best Practices Show podcast: https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club: https://www.actdental.com/ttt
• See ACT’s Live Events Schedule: https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes: https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

Register for Facially Generated Treatment Planning at Spear Education (December 2-4, 2023): https://campus.speareducation.com/workshops/facially-generated-treatment-planning/details/syllabus

Main Takeaways:

Understand the difference between treatment planning and digital design.

Digital still has some limitations for certain kinds of cases.

Smile design software is not a treatment planning tool.

Don't go fully digital until you master analog.

Using software can lead you to overtreat.

Quotes:

“I love the idea behind [digital] of creating a motivational mock-up. So, when DSD or Dr. Christian [Coachman] talks about doing that, I think that's perfect. I absolutely agree with the whole concept of being able to motivate a patient to continue on and create the desire to do dentistry. Got it. The problem comes when you believe that is treatment planning — because it's not. It’s a motivational mock-up to get people interested in doing something, but it tells you nothing about how to actually do the dentistry.” (4:46—5:34)

“Digital designing doesn't show you how to treatment plan the case. It simply is a way of giving an illusion to a patient to create a desire to act, but it doesn't treatment plan the case. In fact, I would argue, in some cases, it actually does quite a bit of harm because unless you're skilled at treatment planning, you don't know what can and can't be accomplished. You just simply pick out the perfect place for a smile, and it doesn't matter if the teeth are going to actually work with that final smile at all, and it ends up creating the need for more dentistry, some dentistry that doesn't really need to be done. There are tons of problems because people conflate one with the other, treatment planning with smile design.” (6:54—7:53)

“Treatment planning is, if you start in the Spear world, figuring out where the incisal edge of the central incisor belongs in a three-dimensional plane. So, it's not only in a vertical, horizontal fashion but also in an AP fashion. So, you have to figure out exactly where it belongs, and then you work your way around the rest of the arch. That is where the teeth belong. Treatment planning is, how do I actually get the teeth into that position and, more importantly, in the Global Diagnosis system, how do I get the gingival architecture into the position that it needs to be for me to actually accomplish the dentistry that I'm describing? So, that could be, ‘Everything is fine. It works perfectly. Let's rock and roll. All we need to do is make the teeth prettier than what they are. They just have a bunch of restorations in them.’ Unfortunately, the majority of the cases that people are using smile design concepts on are cases with significant amount of wear, significant amount of erosion, teeth that are malpositioned, teeth that are twisted, turned, or something is off in the totality of the smile. Well, in those cases, the gingival architecture is off, the positioning of the tooth is off — everything is off. And so, you have to, in treatment planning, figure out how I can get the teeth and the gingiva to work within this framework or idea of where the perfect smile is.” (8:38—10:16)

“Smile design, on the other hand [of treatment planning], simply limits it to, ‘Let me show you a pretty picture of where the teeth would look better on you.’ It has nothing to do with the reality of the case behind what you've drawn. It's just, ‘This is where the teeth would look really good, and here's a model of a tooth that would look pretty on this particular patient.’ That's great. I love it. But I love it for what it's intended for, which is selling the patient on the design. Unfortunately, when you confuse it and call that treatment planning, then you run into real problems with the overall case.” (10:40—11:26)

“You have to learn how to treatment plan to make [the design] software work to your advantage. If you don't know how to treatment plan, you will get frustrated by that software because it's going to require you to do more dentistry than your patient base probably can do, because most people that are doing this don't have a lot of patients that can do full-mouth rehabilitation — that's me included. I don't have a lot of people walking through the door all the time that say, ‘Design the most perfect smile for me.’ And, by the way, now that you've designed the smile, all the teeth are in the wrong location, which means I have to do the lower teeth as well to get the function that I'm after. I don't have a lot of those people, and design software would lead you to believe that that's the treatment plan.” (12:47—13:47)

“At the current moment, digital has some limitations that if you want to do [certain] types of cases, you've either got to be very invested in expensive software and very time-consuming effort in order to transfer information correctly to your virtual articulator — which, I found very few people do. Now, the ones that do it, that's great. But the majority of practices are not invested that deeply into digital. They scan for a crown. They scan for a nightguard. They may print the nightguard in the office. They may make casts in the office. They may store digital files in the office. But they're not so invested in the case so as to have the ability to put a virtual facebow to it and a face on it. And so, if the patient is canted like in the case that I was referencing, if you try to send that off to the laboratory, or even something as simple as send it to Invisalign or some sort of orthodontic system — I mean, if they're canted and you level that cant virtually, your wax-up is going to be completely off. Your orthodontic movement is going to be completely off. Everything is going to be off. And so, the idea that a facebow is gone, to me, it has not reached that point in time.” (16:59—18:36)

“While I have a 3Shape scanner in my office, I choose not to use it because I can get things done more efficiently by simply staying in the analog world at this point in time.” (18:42—18:55)

“It is very limiting to throw everything into the digital world unless you're really willing to live in that world completely.” (19:16—19:24)

“It's amazing, some of the things that they're able to accomplish [with digital], and workarounds and such when I say, ‘Well, this is a problem.’ ‘No, I can do it this way, that way, or the other.’ I think it's phenomenal that they can do it. That's just not the regular dentist. Too many of the regular dentists give up on analog because they . . . I don't know why, honestly. I think they want to seem progressive, but it just makes their life harder.” (19:55—20:24)

“If I was a young dentist today, I would do everything in my power to get really, really good at analog with a little smattering of digital. But remember, digital — I can do everything analog. I can do everything. I can exit my practice having never practiced digitally and be just fine. It's just learning to work within that world. And, by the way, I would note that . . . for the most part, if you put together all the big names in dentistry right now and said, ‘Tell me how they practice,’ they're analog.” (22:11—22:58)

“Anybody that you're like, ‘Oh, yeah. They're really good,’ when it comes right down to the difficult cases, they're all analog. Bigger cases, cases that are off somehow, all the hard cases they do, they're always doing it in analog. So, if that's true — which, I know it is — why do you think that you have to be digital just to keep up with people?” (23:05—23:35)

“If I was a new dentist and going out and trying to get continuing education, I would go somewhere and learn how to do things in an analog fashion. Learn how to make a facebow. Learn what an articulator does. Learn how to use stone on an articulator. Learn the proper way of doing all these things. If you want to print a cast, that's fine. But the cast doesn't, today, have the detail that stone does. It's not even close. A printed cast is not close to a stone cast, and there are reviews all the time in the literature to tell us that. So, are there cool things that can be done digitally? Yes. But with the background of analog and knowing how to work analog, you know what the deficiencies are as well to digital. So, you can then pick out the strengths of the digital and use it. That's how I work with it in my practice, is when I have something that I know digital does really well, that's when I use it. When I know there's something that analog does better, that's when I use it.” (24:05—25:15)

“So long as a young dentist is going into the smile design world knowing that that's not treatment planning, that it’s a way of motivating a patient — if all they do is say, ‘This is a motivational mock-up,’ that's what I get from it, then it's a wonderful tool.” (25:44—26:05)

“The frustration a young dentist is going to get [with digital smile design] is they're going to look at it and go, ‘Now, what do I do? How do I actually make this happen?’ If you don't have a background in treatment planning, you are going to do crown lengthening to mimic the gingival contours on the mock-up. And if a tooth is in the wrong place, you're going to cut the bejesus out of the tooth in order to make it happen, or you're going to not cut so aggressively and you're going to have to warp your crowns around, which won't mimic the mock-up anymore. So, if you want to get digital smile design, go learn how to treatment plan so that you know how to actually make it happen and marry those two technologies, or marry the technology of smile design with the intelligence of treatment planning so that they can work the way they're supposed to work, which is to the benefit of the patient, and that you're not just crowning or veneering everything you see there, that you actually get their teeth in the right location, you get the tissue in the right location, but you do it the correct way. You don't force the case once you get to that point in time because you know what needs to be done.” (26:25—27:48)

“Some of the best dentists in the world don't actually treatment plan very well. They do really beautiful dentistry, but their treatment planning is not that well done.” (28:23—28:33)

“I honestly do understand what digital can do for you and the benefits that digital can have for you. And the way I understand that is I know how to do analog, and I know what analog can do better than digital — because this discussion a few years ago would be completely different. Three, four, five years ago, digital couldn't do a lot of the things that it can today. And so, I trust it more than I would have in the past. In the smile design world, it's always been the same problem, though, since its introduction. People are taking it as a treatment planning tool, and it absolutely is not — and it's never been marketed as that. It's always been marketed as a way of creating a vision for the patient as to what can be done so that you get this motivational mock-up.” (33:06—34:00)

“All the people involved, from Christian [Coachman] on out to all the other different people that have done this and are talking about it, never say, ‘This is how you treatment plan the case,’ by somehow magically making the teeth go to that spot. They always say it's much more in-depth than that. Now that you know where you want the teeth, you have to figure out how to get them there and get them there correctly. But people miss that over, and over, and over again, and they think that learning the treatment plan is old-school, and the old way, and we need to do digital, and in order to be up to date, you've got to show digital. And that's not right. That's simply incorrect. They are two completely different issues, and there will never be a digital version of how to treatment plan. It will never exist because it's a way of thinking. Maybe AI can someday treatment plan for us. But it isn't now, and it's not for the foreseeable future because there are too many different variables that are involved at the present time.” (34:01—35:15)

Snippets:

0:00 Introduction.

1:47 The problem with digital.

8:19 Treatment planning and smile design, defined.

11:27 The problem with design software.

15:28 Don't give up on analog.

20:24 The best dentists still use analog.

27:51 Things dentists get wrong.

29:32 Have a systematic approach to treatment planning.

32:31 Last thoughts.

35:17 About Dr. Rouse’s Facially Generated Treatment Planning course.

Dr. Jeff Rouse Bio:

Dr. Jeff Rouse is recognized as a pioneer in the field of airway prosthodontics — the impact that a compromised airway has on the stomatognathic system. Along with fellow Spear Resident Faculty member, Dr. Greggory Kinzer, he developed the "Seattle Protocol" to recognize, control, and direct resolution of airway distress in a restorative dental practice.

After graduating from dental school in San Antonio, Dr. Rouse completed a two-year general practice residency at the University of Connecticut Health Science Center. He practiced family dentistry for 12 years before returning to school to earn his specialty certificate in prosthodontics from The University of Texas Health Science Center at San Antonio in 2004. He is a member of the American Academy of Restorative Dentistry and American College of Prosthodontists, and past president of the Southwest Academy of Restorative Dentistry.

Dr. Rouse maintains a private practice in San Antonio, Texas, and practices with Dr. Kinzer and Dr. Frank Spear in Seattle. He is also an adjunct assistant professor in the Department of Prosthodontics at The University of Texas Health Science Center at San Antonio. Among his dental accolades, he has written numerous journal articles, including a portion of the “Annual Review of Selected Dental Literature” published each summer in the Journal of Prosthetic Dentistry. Most recently, he co-wrote a textbook by Quintessence titled, Global Diagnosis: A New Vision of Dental Diagnosis and Treatment Planning. 

664: Winning with Data - 7 Practice KPIs to Illuminate Practice Health - Robyn Theisen

It’s not just about tracking any numbers. You have to know which numbers are the best to make a real impact. When you track these 7 KPIs you can make a treatment plan to illuminate your practice health. Learn more in Episode 664 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

To the Top Session: Data to Dollars https://www.actdental.com/event/members-only-climb-with-us-register-for-april-19-2024-ttt-study-club

Contact Gina: [email protected]

Main Takeaways:

Numbers don’t lie and it gives us a place to look to either celebrate our wins or look for opportunities.

Tracking makes you accountable. 

Never charge $0.

Knowing the numbers tells you so much. And you can improve them. 

7 KPIs to know: gross production, write off percentage, net production, collection percentage, new patient re-appointment percentage, diagnostic percentage, treatment acceptance percentage

Quotes:

“We need to know what our goals are. It gives us an idea of the standard of care, the things that we have in place, the beliefs that we have about who we say we are and are we doing them. And the way that we know is through numbers. Numbers don’t lie and it gives us a place to look to either celebrate our wins or look for opportunities.” - Robyn (2:03—2:30)

“Numbers are not emotional and team members often associate them with a negative or a positive and I really view them as they are. This is where we are starting and we have an opportunity to change that. If we think it’s a negative then what are we going to do to make it different? So that we look at it and we are happy about what the number shows us.” - Robyn (3:15—3:33)

“The first one is gross production…So the production is measuring your output potential or it is looking at everything that is posted to your ledger. What did we actually produce in a day. And so that is the first number to look at. And when I say charge the full fee, the other option would be to charge what your insurance…put on the ledger what your insurance fee is. And I think we miss a lot of information by not charging the full fee to really give us an idea of what our gross production or what our output potential is” - Robyn (4:25—4:56)

“There are inherent challenges with gross production. #1 not charging your master fee. A lot of people don’t know that means. Even if you’re 100% PPO and you’re listening to this podcast right now, you should be billing out your full master fee. Which in some cases might be twice what the PPO will allow and that’s ok because there may be a day where you’re not on the PPO and you don’t want your patients to say ‘Wow your fee when up 100% and now you don’t take my insurance.’ You don’t want that to be the narrative. The other inherent challenge with gross production…is you’re a dentist who is a really nice person and you don’t charge any fee at all because you have your sister in and she’s in for 2 days while you prep the uppers. Well she’s my sister. I’m not gonna bill that hour and charge that out. And at the end of the month you’re like we didn’t make any money…When you put it in the computer it shows you how you utilize your time. It shows us how you utilize your time and you can start to be elective with your write offs” - Kirk (5:00—6:15)

“Never charge $0. What you have to do from this point forward is do it very intentionally.” - Kirk (7:15—7:19)

“The second one is your write off percentage. For this one particularly, I think being the most specific you can be about your write off categories the better. So just to your point of the different insurance companies, I see a lot of offices that will have insurance company write offs. What I recommend is to have a Delta write off, a MetLife write off, a Cigna write off. It gives us information about what fees you’re receiving from our insurance. What the write offs are. And as you’re making decisions about whether you’re in or out of what network, how you want to have that relationship with PPOs going forward, knowing specifics about each insurance company is really important. In addition you’re going to have different write off categories. The elective write offs, it’s important to know what percentage that is. If you’re having to do warranty work, what percentage is that for the year. So being specific and really knowing where those write-offs come in is important to make some decisions around.” - Robyn (7:24—8:23)

“If you’re at 42% write-offs or you’re at 33% write offs that means you’re working 1 out of every 3 days for free for sure. Possibly more.” - Kirk (10:29—10:39)

“KPI #3 is your net production. So your gross production minus your write-off equals the net production and that is your revenue potential. So that is what you’d base the collections off of, is your net production. It’s the revenue potential you have within the practice. That’s important number. I know there are some that would say the only number. Gross production isn’t as important as net production. I disagree. Gross production is where you start. You need to know what the potential is and be able to evaluate the write-offs. Know where we want to continue to do that. Where we need to make some tweaks to get to the net production or what we can collect on.” - Robyn (11:50—12:26)

“[KPI #4 is] your collection percentage. So that’s looking at the percentage in your practice of your net production that you actually collect. And this is a number I see often that when I’m initially talking with teams or doctors, that they say we collect 100%. And this is one that is lower than they expect it to be, which makes it a really great reason to have it as one of the KPIs that you’re looking at to make sure you’re collecting 100% of what your potential is.” - Robyn (14:20—14:55)

“[Collections] is a team one. It’s a team opportunity. So if there is not a proper hand off at the front desk or you’re not having the PIT conversation, the PIT stop, those all impact our collection percentage. So it’s not just the responsibility of the business team or a reflection on them or what they are or are not doing. It’s really an opportunity to look at our whole system.” - Robyn (16:23—16:45)

“[KPI #5] is the new patient re-appoint percentage…We’re not tracking how many people we are re-appointing. So we talk about that number [of new patients] and that number means not a whole lot unless you know how many people are coming back. And so looking at the re-appoint percentage. And I like to be more specific and know how many patients are coming back into hygiene. The hygiene is where we are not going to lose them. They’re going to be part of our re-care process. We know they’re going to be coming back in. And it is an opportunity with a new patient to talk about how important hygiene is and build that value in hygiene so that they know when they come back how important that is within our practice.” - Robyn (18:20—19:16)

“Where is see the most new patients leave is through the Doctor’s schedule. And I get assistants and Doctors that say they’re here for an emergency. Those are the people who need you as a hygienist. They need your hygiene team to not have those emergencies. It’s that opportunity. It’s something that they don’t always think about. Those emergency patients are opportunities to get them into your hygiene program…We talk a lot about value and I believe with cancellations and no shows that it’s a value problem. Not a cancellation problem. And so if a new patient comes in and we don’t talk them at all about hygiene at that first appointment, how important is that appointment. So now when we’re trying to talk you 2 or 3 appointments later about hygiene you’ve lost an opportunity to really talk about the value.” - Robyn (21:35—22:27)

“You as a dentist don’t need every patient. You don’t want to be a dentist for every patient. All you need is the right number of patients to build your practice. And depending on practice style, a hygienist that works full time only needs 750 patients if they’re seeing them twice a year. If your team is locked in on making sure the right new patients are calling and they’re going through hygiene, over time, two decades, I could filter this process so we’re inviting back the right people and in no time…you’ve got..If you’re a one doctor practice and two hygienists, you’ve got 1300 of the right type of patients, where you’re annual patient value is north of $1000 and now you’re killing it…instead of trying to capture everything because if your new patient numbers are through the roof and your new patient re-appointment are below the floor, you’re filing the practice with terrible patients and wondering when can I sell?” - Kirk (22:40—23:54)

“KPI #6 is the diagnostic percentage and I’m speaking in dental intel. So the way that dental intel measures that is it takes the number exams a doctor does in a month and of those exams how many are something new diagnosed at. So the patient could have an existing treatment plan and this is looking at what new is diagnosed. So that diagnostic percentage is really important to take a look at to have a good barometer of how many of your patients are leaving with good treatment plans and how many are you diagnosing on. One thing I’m seeing with this diagnostic percentage is how busy our hygiene programs are the need for that mix of patients within program to keep the doctors busy.” - Robyn (24:11—25:14)

“[Number 7] is treatment acceptance percentage. In dental intel it measures it in 2 ways. One of them is measuring the people. It’s looking at the number of treatment plans that were presented and then how treatment plans something was accepted. So it’s looking at people. And the other one is looking at treatment dollars. So of those treatment plans there were X amount of dollars and this was the dollar amount that was accepted. So it’s a way to look at both of those numbers and determine are there areas of opportunity there? Is the treatment getting accepted to the percentage that we want it to be?”  - Robyn (27:05—27:39)

“I hope you’re seeing through this, when you use these 7 KPIs to illuminate your practice health what you can do is diagnose your business. It’s not just about tracking random numbers or seeing how much money we can make. But when you start with gross production, write off percentage, net production, collection percentage, new patient re-appointment percentage, diagnostic percentage, treatment acceptance percentage, you can literally say this quarter let’s work on this number…and by doing that you create compound effects on the overall health and result of the business.”  - Kirk (28:47—29:27)

“These are 7 great KPIs to really take a look at, that gives you a bird’s eye view to what’s going on in the practice and areas of opportunity. And I think numbers too are a great way to celebrate with your team. When you get the numbers to where they are, it’s an awesome place to celebrate and look back on where you were and where you are today and the efficiencies you’ve created through it.”  - Robyn (30:50—31:11)

Snippets:

0:00 Introduction.

2:00 Why are KPIs important?

4:12 How to start.

7:24 Writing Off.

11:50 Calculating the business potential. 

14:20 Your collection percentage. 

18:20 It’s not just about the new patient percentage. 

24:11 The diagnostic percentage. 

27:05 Treatment percentages accepted. 

30:45 Final thoughts. 

Robyn Theisen Bio:

Robyn Theisen brings an entire life and legacy of dental experience to the team and every team with which she works as the daughter and sister of dentists. With almost 20 years of experience in dentistry, her roles ranged from practice management to operations at Patterson Dental to coaching teams. Robyn’s passion is empowering teams to realize that they can dramatically impact the lives of the people they serve by implementing skills and systems to remove barriers to life-changing dental treatment. She has done it for decades and does it every day with dental teams.

Outside of coaching, she enjoys time with her husband, Rob, and two daughters, Emerson and Ruby. She loves traveling, music, fitness, and cheering on the Michigan State Spartans.  

Send Robyn an email [email protected]

Follow Robyn on ACT’s Instagram https://www.instagram.com/actdental/

663: How to Make Clear Aligners Profitable - Allison Lacoursiere

Whether you offer clear aligners in your practice or you’ve been thinking about it, Allison Lacoursiere has tips on how to bring them into your practice efficiently, get your patients to overcome cost barriers and how to make it profitable. Learn more in Episode 663 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

Aligner Bootcamp: domoreclearalignercases.com

Clear Aligner Coaching: https://www.yourclearalignercoach.com/coaching

Main Takeaways:

Dentistry went through a big shift during the pandemic. 

Patients are more educated about clear aligners. You, as a dentist, need to be as well. 

Don’t “kind of” do aligners. Go all in or it can be a big waste of your time. 

Partner with your orthodontist and you will both benefit. 

Educate your patients on the importance of teeth retention. 

Attach a value along with the cost of the aligners, so patients can overcome cost barriers. 

Clear aligners should be a team effort with minimal support from the doctor. 

Quotes:

“Dentistry has continued to change and evolve and partially during the pandemic I think we saw a big shift. But there is something that’s happening, especially as it relates to social media, to marketing, to digital technology where patients are getting almost an inside perspective of our practices. They get to see more. They get to understand dentistry better because we are talking about it in different ways on social media, online, YouTube, all of these places. And so first of all patients want clear aligners. They want that beautiful smile. They can see it as an option now…Patients are knowing more now and they know they want clear aligners. Partially because the aligner companies have done such a good job making it understandable to the modern day consumer. So that’s reason #1. Reason #2 comprehensive treatment planning. If we can put the teeth in the right position before we place implants, bridges, crowns, we are doing better for our patients…The third one: it can be highly profitable.” - Allison (3:05—4:10)

“[Aligners are] something that [patients] want, so as a general dentist being able to offer something like this to them is really really powerful.” - Allison (4:55—5:00)

“If you want to do clear aligners, don’t dip your toe in. Don’t kind of do it….otherwise it can be a big waste of your time. Go all in. Know how to use the software, whatever software you choose to know. Know how to use the treatment planning and implement it across your entire team so that your team knows why you’re doing this. Go all in. The second thing is clear aligners are a team drive procedure meaning they don’t go in your productive chair. They don’t need a lot of doctor time. And so if you’re here sitting here listening to this podcast and you’re like ‘wait a minute, clear aligners are taking up a lot of my chair time’, that’s a problem. So get them out of your chair and into your team’s chair and get your team to run the system.” - Allison (5:18—6:07)

“Your orthodontist will be excited because when you start screening every single one of your patients for orthodontic treatment you’re going to refer more because you’ll see more…and you’ll want to refer…be open and honest with your Orthodontist. “Hey we’re offering clear aligners in our practice. I may need your help on a couple of cases, but I’m still going to be referring the cases I’m not confident doing to you.” - Allison (7:39—8:30)

“I think the language around retention needs to change. And we’re going to have it. Patients are not compliant with their retainers. They’re going to be super disciplined for a couple of years and maybe drop off…we don’t take that on. We are educating them on your teeth are going to constantly move over the course of your life…we want to be able to protect your arch with arch height and holding it in place with a retainer. That’s your job for the rest of your life to have a retainer and then they still don’t do it? We don’t have to feel guilty about that. We have done the process.” - Allison (9:12—9:43)

“I think we have to remember our patients are going to pay for what they want…We have to do what we do best which is treatment plan and educate and offer a reasonable, flexible payment option for our patients…One of the biggest mistakes I see practices make is the assumption is that patients are not going to want it or pay for it…It’s our job to educate patients on the consequences, the risk, the factors over time. ‘If we leave your teeth like this, what is going to happen? If we move your teeth into the right position, what is going to happen?’ And that’s our job. It’s not our job to assume what our patients are going to pay. How much they rely on their insurance or not. We have to let that go and just do dentistry.” - Allison (11:47—12:47)

“[The confidence of the person discussing the money] is make or break when it comes to the success of clear aligners in your practice. And what many practices do is they take it on as if they decide if the patients are the ones that are going to choose to start or not. Assume they are going to. Assume they will start. Assume that they find this valuable and important. When I ask people ‘Why do you think patients say no?’ They say ‘Money’ That’s a part of it for sure, but the other two factors are trust in you and your entire practice and value. Do they value what you just gave them? There is a reason you said yes and so when we can attach the money to the value that is when patients will be like “I totally understand. I’m going to do this.’” - Allison (13:30—14:13)

“Our relationship with the patient starts online and more and more than ever our patients are looking into us. They are researching us. They are trying to see who we are. How we can help them. So we must have [what we offer] on our website. We must have it on our social media. And not just one time. Many times. Marketing is not doing something different each day. It’s saying the same thing in different ways. So don’t be afraid to be repetitive. Make sure it’s in your waiting room. Make sure its in the operatory. Be so obvious with the fact that you do clear aligners. You’re not being pushy. You’re not being salesy. You’re just showing them it’s an option in your practice.” - Allison (15:33—16:09)

“Digital technology is changing dentistry. It’s changing what patients know could be true for them and seeing is believing. So if you have a digital scanner and you feel like maybe you’re not utilizing it enough or you don’t have a digital scanner. When I was in clinic it was the one tool that completely changed the game for our practice. We started scanning every single new patient and we’d literally be like ‘Look, what do you see? Let’s look at this.’ And it creates this buy in that I’ve never seen with patients before…and especially with the millennial population which is the largest cohort of purchasers and decision-makers the world has ever seen, coming into your practice. They’re constantly looking at themselves on camera. So if you can show them this is what your teeth will look like using the digital software on your scanner, you’re 10 steps ahead.” - Allison (16:53—17:49)

“Get super efficient with the Clincheck technology. And you get to do the same thing again and again with every case, there are ways to make it super super simple and streamlined. The second thing is your are spending too much time, you as a dentist, on the case. You must have your team be an ortho-assistant for you. So they’re doing the scanning. They’re doing the treatment case presentation. They’re doing the aligner checks. They’re doing the bonding and debonding. This is not a doctor procedure and it’s the one procedure that we can add to our practice that won’t take up more time. And then I would say inefficiency in the systems. With clear aligners, everyone needs to know who is doing what when and how more than a lot of other procedures because it can touch a lot of hands and so you have to be very very systemized with it. And then also just look at your pricing. We know what the average bill is. We know the average cost of chair time. We know what our marketing budget is. Run a P&L just on your clear aligners and see how much this is actually costing me. What do I need to charge? What is my average profit per case? And it will give you an idea of when you’re running promotions or you’re doing more, what that actually looks like.” - Allison (18:30—19:46)

“It’s just going to continue to grow and I think one of the things that really motivates me about this is just our ability to set up our cases better. So if we are placing an implant, if we are placing anything permanent in our patient’s mouth, the question we ask ourselves is could we put our teeth in a better position first? And the reality is, with more information that our patients are getting they can understand more about dentistry, they’re going to expect more from you…I can see this trend where straight, white teeth is the norm. People want that. It’s all over social media.” - Allison (22:28—23:13)

“If this feels daunting to you to add this entire procedure, I know a lot of times general dentists say ‘You know we didn’t get enough coursework in school for me to be confident about this.’ There are so many opportunities for education online. You can figure this out very quickly and easily and it can be a really beautiful part of your practice.” - Allison (23:46—24:06)

Snippets:

0:00 Introduction.

3:00 Why clear aligners are becoming more popular. 

5:00 How to start integrating aligners into your practice. 

7:30 Work with your orthodontist.

11:15 Making it profitable. 

13:00 Overcoming cost barriers. 

16:50 Using digital technology to recruit more patients. 

18:00 Get more efficient with how you’re using clear aligners in your practice. 

22:28 The future of the industry. 

23:40 Final thoughts. 

Allison Lacoursiere, RDA, OA, CPC, ELI-MP Bio:

Innovator Allison Lacoursiere, RDA, OA, CPC, ELI-MP, is the creator of the Clear Aligner Systemization methodology. Allison helps dentists and teams streamline efficiencies to increase both patient and practice satisfaction and health.

A native Canadian, Allison moved to Bermuda at the age of 19 to work as a dental assistant and to seek adventure and try something new. She incorporated a system in that practice which generated $80K a month in clear aligner production.

With over a decade of dental practice experience, Allison is a sought-after mentor and speaker. She helps dental teams improve culture, increase production, and grow into their full potential. She is certified through International Professional Excellence in Coaching and is a member of the International Coaches Federation. Allison is a member of Toastmasters International and has trained with Dale Carnegie Speaking Institution. She is a Certified Transformational Trainer through LionSpeak.

Allison is passionate about fitness and wellness. She is an active team member and competitor on the Bermuda National Beach Volleyball Team. Allison is also a certified personal trainer and yoga instructor. Her passion lies in empowering individuals to achieve their ultimate potential and life satisfaction. 

Send Allison an email [email protected]

Follow Allison on Instagram https://www.instagram.com/yourclearalignercoach/?hl=en

Follow Clearly IG on Instagram https://www.instagram.com/clearlyig/?hl=en

662: Work Less, Earn More: The Dentist’s Blueprint to a Dream Practice & Life – Dr. Barrett Straub

Do you find yourself working harder and harder, but earning less and less? If you're feeling overworked and overwhelmed, don't miss this episode! Kirk Behrendt brings back Dr. Barrett Straub, ACT’s CEO, to share their blueprint for working less and earning more. Don't become a statistic — create your dream practice! To start writing off less and enjoying dentistry more, listen to Episode 662 of The Best Practices Show!

Episode Resources:

• Send Dr. Straub an email: [email protected] 
• Join Dr. Straub on Facebook: https://www.facebook.com/barrett.d.straub
• Follow Dr. Straub on ACT’s Instagram: https://www.instagram.com/actdental
• Subscribe to The Best Practices Show podcast: https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club: https://www.actdental.com/ttt
• See ACT’s Live Events Schedule: https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes: https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

Get your Golden Ticket to ACT’s To The Top Study Club: https://info.actdental.com/golden-ticket 

Get your free copy of ACT’s PPO Roadmap: https://www.actdental.com/free-resources/ppo-roadmap/

Get ACT’s Say This, Not That resource: https://form.jotform.com/221665137804153

Main Takeaways:

Working more hours does not equal more revenue.

Understand the different gaps in your practice.

Be proactive with your dental accountants.

Invest in differentiating your practice.

Create a plan for dropping PPOs.

Quotes:

“Some dentists that we're finding right now are writing off as much as 42% — and write-offs are climbing. Typically, we wouldn't find dentists that are writing off 42%. It might be normal to find a dentist that was writing off 20% or 22%. But the thing that's important right now is that write-offs are skyrocketing, and dentists aren't even aware of that. So, that's something very important to pay attention to.” (6:50—7:18) -Kirk

“It's not unusual for us to coach a practice and a dentist will say, ‘Well, I only participate with one insurance.’ I'll pull [the data], and I'm like, ‘Not really. There are a lot of other insurances you're not even aware of that are slowly filtering into your practice.’ So, we have to take a look at that.” (7:28—7:48) -Kirk

“I'm sure you're watching this going, ‘I'm busier than ever.’ We don't find one dental practice in the world that says, ‘I'm not busy.’ Everybody is too busy, too busy, too crazy, too many patients. The data reflects that. Here's what the data shows. The data shows that patient appointment wait times are up significantly in 2022. Now, the ADA points to this is likely a result of staffing shortages — I don't like the word staff. It's “team” — in dental offices. I kind of agree with that, but not wholeheartedly agree with that. I mean, more and more patients are going to the dental offices through PPO measures that everybody is incredibly busy. The data shows that.” (7:57—8:43) -Kirk

“Dentists across the United States are feeling overworked. This shows the percent indicating too busy to treat all people requesting appointments, or provided care to all who requested appointments but was overworked. The thing that [the ADA points] out is that it's at an all-time high. We're way too busy and we're way overworked. That's what the data shows. The bottom line is dentists are busier than ever.” (8:49—9:21) -Kirk

“Dentists are working more hours than ever. On average, right now, GP dentists worked 4.5% more hours in 2022 than the average from 2000 to 2019. The increase in 2022 is roughly equivalent to an extra 1.5 hours per week. Now, what this doesn't show you, we like to think of it in terms of days. There are people out there that work 12-hour days. Knock yourself out. That's crazy. But in real simple terms, 1,758 hours a year is the equivalent to 225 days a year — assuming you work eight hours in one day. That's a lot of days. That's way higher than the previous research that we had. The bottom line is dentists are working more hours, making less money. They perceive busyness is way up. The crunch is biting in terms of capacity, which is a whole other thing that we'll talk about. Wait times are up significantly for patients, and team member shortages are severe.” (9:39—10:51) -Kirk

“Usually, when we work more, our assumption is, ‘I will work more, and therefore my revenue will go up a corresponding amount.’ But the graphs and the numbers show that we are working more, working harder, expending more energy, and making less. So, no longer is working more actually benefiting you financially. There are other reasons you may feel the need to do it. The math isn't working anymore. We've got to understand the math and then apply the learning to our own practices because, ultimately, why do we practice dentistry? We're going to encourage you that the answer should be so you can live the life you want. When you're too busy and making less than you should, it affects your life. That's why we've got to reverse this equation here, do some math, and figure out some different strategies going forward based on this new knowledge that we have.” (11:03—11:59) -Dr. Straub

“If you come to anything that we do, you're going to hear us talk about gaps. Gaps will work like this. You've got a couple of gaps in your financial statements. The first gap is the effort gap. You’ve got what you produce, your gross production, your percentage of write-offs, your net production as a result of those write-offs, how many days that you actually gave to produce that much, and then gross production per day. We call that the effort gap, and that's an important gap that you have to pay attention to because you can't keep working more, and more, and more, and more, and more. There's a limit to that. We see some dentists giving blood, and they can't give anymore. And so, the effort gap is really important. As you tighten up each one of these gaps, you're going to see one more dollar falls to the bottom line.” (12:15—13:11) -Kirk

“The second gap is the collections gap. You've got your net collections number, and it comes as a result. It's your collectible production. Well, what percentage of those dollars did you actually collect? If your net collections is 94%, you're leaving six percent on the table. So, that's an important gap. You might be thinking, ‘Well, I've got Sally. Sally works at the front. She's so nice. She's been here for 20 years. We collect 92%.’ You have to collect 100% of your collectible production. That is money left on the table.” (13:13—13:50) -Kirk

“The third gap is your overhead gap. Costs are increasing. Costs are rising just to do business, and you have to know what percentage your overhead is. We see practices that have 75% overheads — some even higher than that. We're going to show you how you can get your arms around it. It's not about cutting costs. It's about, first of all, knowing what the percentage is. It's amazing how many dentists go, ‘My overhead is this number.’ I'm like, ‘It's not even close.’ That's a gap that you can trim up.” (13:53—14:23) -Kirk

“The last gap is your cash flow gap. Now, let me explain this . . . You're a dentist. You go to your accountant every year, and your accountant goes, ‘Man, look at your profit and loss statement.’ At the bottom of your profit and loss statement, it says, ‘Wow, I made $300,000!’ Your accountant goes, ‘You're doing so good compared to all my other clients!’ And then, you go, ‘Yeah . . . I don't have any money.’ Well, your P&L statement doesn't show what you paid in taxes. It doesn't show your loan payments. It doesn't show any of that stuff. And so, you go home to your spouse or significant other, and you're like, ‘We have no money. Yet, I keep working harder, and harder, and harder.’” (14:25—15:04) -Kirk

“To totally simplify it, every gap is where a portion of your production leaves your practice. So, if you do $1 of production, a portion of that leaves in the case of write-offs. On the screen, you're going to see a 14% write-off — 14%, gone. Of that remaining money, if you're not collecting 100% — so, let's say you collect 92%, per your example. You have an eight percent collections gap. So, eight percent of that dollar now has left again. Now, we have overhead expense. So, another big chunk of that dollar leaves. And then, we have this cash flow expense. So, really, what we're talking about is margin. The true profit margin on every dollar of production of that dollar produced, what I want to know as a small business owner and a dentist is, how much of that dollar do I actually get to put in my wallet? What we're seeing is the P&L statement is only a small part of this whole equation. When you put it all together and you work to shrink these gaps, your margin increases and, therefore, you get to put more money in your pocket.” (15:08—16:18) -Dr. Straub

“There's never been a business owner in the history of the United States that ran a business on a P&L. It’s just never happened. Anyone who's ever had a successful business will go, ‘A P&L is important, yeah. It shows me where cash went out.’ But that's half the story about what's going on in a business. You need cash. You need to pay taxes. You need to know the implications of all of this and how it's reflected in a P&L. So, don't let the P&L be your driving decision-maker. It's part of the story, but it's half of the story.” (17:48—18:24) -Kirk

“Every successful change process, no matter what it is in the world, starts with the first same step. You have to tell the truth. If you're in AA, Alcoholics Anonymous, the first step is you have to admit you're an alcoholic. If you go to a weight loss program, you have to first weigh in and find out what your weight is. Anything that you're doing, you have to start with, ‘Where are we right now?’ so that I can start to improve where we are — and it starts with data.” (18:34—19:05) -Kirk

“Here's the other thing you have to pay attention to. You probably have to educate your dental accountant. Now, I love dental accountants — don't get me wrong. But you can't be passive with a dental accountant. You have to be proactive with a dental accountant.” (28:02—28:14) -Kirk

“If you want to be happy as a dentist, you only need two things. You need progress — I call them the two P’s. And this is what we're showing. Year over year, you don't have to have the most amazing, brilliant everything. But if you're making progress every year, your soul is good. The second thing is you need predictability. By using this method we're showing you, you can predictably determine where your income is going to be and how hard you're going to work within very few dollars. It's really quite predictable when you can embrace progress and predictability.” (30:53—31:29) -Kirk

“Here is an important point to the math that you can't see. Nothing is more disheartening than when you feel PPOs run your practice. This is the critical point where you say, ‘I make the rules.’ And it's true — you make the rules. This is more powerful than the money.” (32:45—33:02) -Kirk

“There is nothing better than paying all of your bills and having money in the bank.” (34:28—34:31) -Kirk

“As you grow, growth sucks cash. Your business needs cash on hand in order to do anything in the future.” (34:34—34:43) -Kirk

“Every dentist watching knows this scenario. You're at CE. You're eating lunch with dentists, and they're like, ‘I produced $1.2 million. I produced $1.2 million.’ Now, I think we're starting to see that producing dentistry means very little. There's a big difference between the dentist at year one that says, ‘I produced $1.2 million,’ and the year three, ‘I produced $1.2 million.’ Those are very different practices. One has got $30,000 sitting in the bank with 20 more days, or five weeks more of vacation. They have $30,000 to take their family to Disney and spend some of that. The other one is stressed, scraping, and borrowing money from family members to pay the tax bill — but they both produced $1.2 million. And so, our point is, we as dentists have to stop focusing on production and know that production is just one small KPI in a much bigger, more complex story.” (35:55—36:47) -Dr. Straub

“Time is the new rich. I don't care what people produce. Gross production means absolutely nothing anymore in dentistry. I care about like, what kind of days do you work? I can't waste a day for anything. Yet, we see dentists wasting days. I mean, if you're writing off 42%, that means more than one out of every three days you're working, you're working for free. And that's not fun either.” (36:55—37:17) -Kirk

“This is not a joke. Anyone can do this. All you have to do is know the numbers. If you're not looking at the numbers and you're letting PPOs flood your practice, you have no idea what's going on, and you're a victim of circumstance. You now don't control your practice anymore. We want you to control your practice and enjoy your life.” (42:05—42:24) -Kirk

“There are three scenarios where we coach dentists, and they benefit from this gaps method. The first is, year one, ‘I don't know where my money is. I'm in financial hardship,’ and the gaps can help them strategize how to get out of financial hardship. That's scenario one. Scenario two is the doctors that are like, ‘Okay, I'm going to be practicing in my practice for many more years. I want to maximize my profitability for my effort, and I'm going to use the gaps, and I'm going to use these levers, and I'm going to use the production per day and how many days, and I'm going to find the right better life, better practice mix that works for me and my life and my family.’ That's phase two, and that's a bulk of the career. And then, we also coach dentists who are like, ‘Okay, I'm really good. I'm on the back nine of my career. I still love dentistry. I'm going to use this calculator to see how few days I can actually work and still make what I'm making. That will allow me to practice maybe longer than if I were just pounding it out.’ So, this isn't a young doctor, middle-aged doctor, or old doctor tool. It's for every phase of the professional career, and we can use this to make each phase as successful as we possibly can.” (44:01—45:21) -Dr. Straub

“Many people think they're going to lose all their patients [when they drop PPOs]. You might lose a few. But don't listen to the pundits who are like, ‘Oh, you're going to lose 20% across the board.’ That is absolutely not true. There are so many people that are like, ‘I dropped X, Y, Z insurance. No one is going away.’ I can't tell you the number of people that have dropped insurance, and they're like, ‘I am still way too busy.’ Here's the real issue. There isn't a dentist in the world that we get that isn't busy. Most practices we get, we'll get a single GP doc, and I'm like, ‘You have 3,500 patients.’ They go, ‘I know.’ I'm like, ‘You don't need 3,500 patients.’ The great restorative practices, if we're talking about GPs, they know exactly how many they need. They need 1,200 patients, probably about 750 per full-time hygienist in a practice. They know what to charge. They know how many days they work. So, I would be so quick to not say, ‘Oh, we're going to lose a bunch of patients.’ Now, if you don't have people paying your full fee and you're 100% PPO, that is true. If you get off PPOs, you're going to lose patients because you haven't created enough value. Here's the bottom line. I want people to come to you because of you — not because you're cheap, and not because you're easy. The real mark of a true professional is that people come to you, and they trust you, and they pay you because you're my person and my team is so well-trained.” (47:19—48:45) -Kirk

“Our practices that have gone fee-for-service, they'll be the first to tell you, ‘We get the insurance question all day long.’ Once you go fee-for-service, it's not like people come in and go, ‘I've got all this cash. Can you just prep all these?’ No, you still have the question every day from almost every other patient, ‘Do you take my insurance? Why aren't you on my plan? How come you cost so much?’ That's the game you have to play as an entrepreneur. You have to train your team. Verbal skills matter. Your team has to be so good that when somebody says, ‘Why aren't you on my plan?’ they go, ‘I love that question. Bring it.’” (48:48—49:19) -Kirk

“We never coach someone to just drop a PPO. There's a method and a right way to do it. We have a whole PPO Roadmap that we walk our coaching clients through, and it starts with data. It starts with identifying the low-hanging fruit insurance plans that make sense to get out of. It identifies the one that we should stay on for a little while. It doesn't mean you drop all your PPOs. So, there's a method and a strategy to doing it the right way. When done correctly, after making the right decisions, knowing the right data, and training the team for the right verbal skills, it's very successful. You will lose some, but much less than you can. Once you know the numbers, we can even do a calculation where you know how many of those patients you can lose and still break even. It's often like, ‘Oh my gosh, I can lose a ton and still break even financially.’ So, when it's done right, when we see dentists do it right — meaning, follow the roadmap, take our time, do it the right way — very successful. When dentists say, ‘Hey, guess what? I just dropped all my PPOs yesterday,’ and they didn't do the steps, it's not good. And so, there are some things that we need to ask ourselves. There are some strategies we need to employ before we [drop PPOs so we] can become successful. Part of it is this thing called differentiation. We coach all our dentists that the patient has to have a reason to go to you before you dump all your PPOs.” (49:28—51:07) -Dr. Straub

“We see people chase volume in the search for profit without really knowing the equation. ‘If I add more capacity, if I add a hygienist, if I add a chair, if I add a building, if I add three doctors, I should be making more.’ Not necessarily, because this margin goes with it. Sometimes, we actually make less. And so, the gaps also help people say, ‘I think I should hire

661: 5 Quick and Easy Ways to End the Year Strong - Ariel Juday

Looking to ensure you finish the year strong and have a great December? We have the treatment plan for you! Find out how to wrap up 2023 and use this 5 step process well into 2024 too. Learn more in Episode 661 of The Best Practices Show!

Episode Resources:

• Subscribe to The Best Practices Show podcast https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club https://www.actdental.com/ttt
• See ACT’s Live Events Schedule https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine
• Write a review on iTunes https://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218

Links Mentioned in This Episode:

To the Top study club:  https://www.actdental.com/ttt

Main Takeaways:

Tip #1: Fill the schedule with patients who are already scheduled.

Tip #2: Remind patients to use their FSA or HSA and how they can use the funds. 

Tip #3: Think outside the box and be flexible as a team. 

Create a holiday call list. 

Tip #4: Take time to celebrate with your team. 

Tip #5: Take time to care for yourself and your health.

Quotes:

“I like to just say what are some quick easy ways that we can do…because we all know momentum is easier than motivation. So we if we can get the momentum going into the new year, the energy is even better and stronger when our team is excited.” - Ariel (1:50—2:10)

“#1…Fill [the schedule] with patients that are already scheduled. You have lots of opportunity in the schedule already. You just have to look for it. For example, how many hygiene patients are in the schedule that have unscheduled treatment? Can we go ahead and get them done on the same day? Or vice versa. Is there someone coming in for an emergency and they haven’t had a cleaning in a while? Is that something that we can go ahead and just utilize those patients that are already walking in the door.” - Ariel (3:15—3:46)

“Same day dentistry does not mean right now. So if they have a hygiene service and they need to go and do something for an hour, a lot of patients will come back…So don’t think it has to be done right now because you don’t ever want to hinder the schedule of currently scheduled patients, but there are lots of opportunities, you just have to be open to looking for it.” - Ariel (5:53—6:20)

“#2…We all know there are a lot of insurance and flexible spending accounts that at the end of the year, those funds expire…That is money your patients have put aside and put away for that they’re just going to lose, so we want to remind them. And sometimes they don’t even know they can use it at their office.” - Ariel (6:35—7:07)

“#3…The easiest way [to think outside the box and be flexible as a team] is just set the expectation. Tell the team ‘Hey, for this month we’re going to be a little flexible. We are going to think of solutions.’...You get that deadline of December 31st. You know that your office is closed that week. I hear a lot of admin team members answer the phone and say ‘Sorry. We’re booked.’ …These patients are currently motivated and they are wanting to come in, so at the very least can we put them on a short call list? A priority list? Is there a way utilize a different column or chair? How can we get them in while they are motivated to get their dental care done.” - Ariel (8:50—9:53)

“A team work column…you take the name -  teamwork - and you know that if a patient is in this column it's going to be…we don’t have a specific provider assigned to them and it’s going to take a team effort to get this patient taken care of.” - Ariel (10:16—10:31)

“It’s not an open [team work] column that we can just fill whomever in. It’s very strategic. A couple per day, maybe 2 in the morning. And everyone knows and the patient knows as well that we are working you in and it might take a little longer, but as long as you’re flexible with us we’ll go ahead and get you taken care of.” - Ariel (11:56—12:16)

“[A holiday call list] is very similar to a priority or an ASAP list or a cancellation list but this one is very specific to days in the calendar. So we know that the middle school in your area, you know what week they’re off. You know what breaks they have…even other industries have different days that they’re off. So if we know about those days…it’s the only time I’d say go away from your normal priority list - people who are just get in sooner - but use those patients’ motivation…and the chance is very likely that they’re going to rearrange their schedule because they don’t know if there is going to be another opening that comes up.” - Ariel (12:29—13:35)

“#4”..The end of the year can be chaotic and sometimes the last thing we think about is celebrating with our team and I hear a lot of people say because the end of the year is so chaotic they do their holiday party in january and that is fine, however there are plenty of opportunities to still celebrate and keep the energy high. Especially if we’re thinking outside the box…your team is working really hard that there is no reason we can’t have a random pot luck or lunch as a team. Just do things that are different. And the doctor isn’t the one who has to lead it and probably shouldn’t” - Ariel (14:40—15:29)

“The whole theme of this podcast is to finish the year strong. It isn’t always financial. Sometimes it’s emotional. Sometimes it’s the connectedness. Sometimes it’s just…I want to feel better this month. So it’s not all about money.” - Kirk (16:39—16:54)

“This is 100% all year round, however as we are talking about no letting life and things just happen, is you have to be intentional about taking care of your health…We all know we have higher energy and we feel better when we’re getting enough sleep, we are eating healthy, we are exercising right, we are moving our body. You are doing something to fill your cup, because if you’re just letting things happen and you’re…your energy is going to plummet. And your team’s energy is going to plummet. And your patients are going to feel it. So really an extra reminder to take care of yourself so that way you can take care of your team and your patients.” - Ariel (17:26—18:10)

“Because when you feel bad, you think bad, you perform bad” - Kirk (19:00—19:05)

“Remember that the end of the year is not the time to slow down. It’s really a time where we need to be taking care of ourselves, our team and our patients…Momentum is easier than motivation. So if we can end it and get on a roll going in the new year is going to be so much easier for yourself and your team members.” - Ariel (19:17—19:42)

“You have to get into this pattern of thinking next year is going to be better than this year. And when you start to do that it’s called a future pull. And it can be your behaviors, your thinking, it can be your team being engaged. Our goal with this podcast is just to give you a little bit of information…so that you can go back to your team to become a better leader and create a better practice and a better life.” - Kirk (20:18—20:43)

Snippets:

0:00 Introduction.

3:00 #1 

6:35 #2

8:34 #3

10:00 A teamwork column 

12:22 Making a holiday call list

14:33 #4

17:24 #5

19:10 Final Thoughts.

Ariel Juday Bio:

Ariel has a master’s in healthcare administration and several years of dental experience in all aspects of the administrative roles within the dental office. Her passion is to work with dental teams to empower team members to realize their full potential in order to better serve patients, improve office systems to ensure a well-functioning team/office, and to help everyone have fun in the process! 

Send Ariel an email [email protected]

Follow Ariel on ACT’s Instagram https://www.instagram.com/actdental/