The Best Practices Show with Kirk Behrendt

How to Properly Read Cone Beam Images

Episode #640 with Dr. Dania Tamimi 

Bones chronicle a person’s life, and imaging helps you to read it. Knowing how to properly read the imaging is critical, and Kirk Behrendt brings in Dr. Dania Tamimi, lead author of two textbooks, Specialty Imaging: Dental Implants and Specialty Imaging: Temporomandibular Joint and Sleep-Disordered Breathing, to encourage you to use imaging when diagnosing your patients. Imaging is like having a crystal ball! To learn how proper readings can change your patients’ lives, listen to Episode 640 of The Best Practices Show! 

Episode Resources:

• Send Dr. Tamimi an email
• Follow Dr. Tamimi on Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Read Specialty Imaging: Dental Implants and Specialty Imaging: Temporomandibular Joint and Sleep-Disordered Breathing

Read Specialty Imaging: Dental Implants  

Learn more about BeamReaders

Learn more about Modjaw  

Main Takeaways:

Imaging helps you see the past, present, and future of your patients’ dental health.

Understand the physical, emotional, and psychological causes of dental issues.  

Change the trajectory of your patients’ lives by understanding bone biology.

Be smart about who you irradiate and use imaging when it’s necessary.

Remember that bone is alive and “fluid”. 

Quotes:

“When we're looking the imaging, when we’re looking at cone beam CTs, or the panoramics, or whatever, we're really thinking about the process of how this person got to that point because your bones are the chronicle of your life. Your body is the chronicle of your life, in general. But when we're talking about cone beam CT and imaging, in general, in dentistry, what we see is the bones, the hard tissues, and whatnot, and these tissues basically will record your life instances, what you do with your body, how you hold yourself, how you carry yourself, how you function, how you chew. All that stuff will reflect on what your bones look like on imaging.” (4:23—5:05)

“I'm looking at people's skeletons and trying to figure out where they were in the past, what happened to them in the past that brought them to this point in terms of morphology and function, and then what do I see in the scan here that can change their morphology and function in the future. So, it's kind of looking into a crystal ball. You look into the past, you look into the future, and you try to figure out what's going to happen to this person.” (5:10—5:35)

“If you understand bone biology, if you understand how osteoclasts and osteoblasts interact with one another, and how bone remodels in response to function or parafunction or whatever, if you understand how the face changes when someone doesn't breathe properly through their noses, then it's easy for you to put all those pieces together and help change the projection of that person's life.” (6:56—7:21)

“If you ask me what the most misunderstood structure is in the craniofacial complex, and the most important to understand, is the TMJ. And all of us have gone through dental school. All of us have had some semblance of TMJ education in their background. But unfortunately, most of us have had a very poor introduction to TMJ, a very poor understanding of how those joints function, and when it falls into disrepair, parafunction, dysfunction, whatever it is, that's going to change the way your occlusion works. That's going to change the way your teeth fit together. It's going to change the way your face forms and growth. It's also going to affect the patency of your airway.” (7:53—8:41)

“There's someone who's coming to you, and they say their teeth don't fit together anymore. They basically have a gap in between their front teeth, an open bite. You're thinking to yourself, ‘All right, let me do some Invisalign to try to bring those teeth together.’ But no, that's not the way to approach these. If you see a bite change, you have to understand why. If you see crowding of the teeth, you have to understand why there's crowding of the teeth. It didn't just magically happen overnight. There's a process that led us to that point, and it's not just bad genes. It's a process of how the housing that held those teeth or holds those teeth is no longer where it should be. It has changed over time and created these bite changes. So, an open bite, like if you have a patient who had their front teeth together at some point, and then they came to you and say, ‘Hey, my teeth aren't together and the mamelons are worn off,’ then you know that there's something going on with the TMJ. So, that's going to be your first thing to think about.” (8:49—9:52)

“I try to make the TMJ relevant to the everyday dentist, to the general dentist, to the specialists. It's not just about, ‘All right. So, there's a clicking joint. All my joints hurt,’ whatever. There's a whole bunch of things to consider. A lot of our dental work needs to be proceeded with a good TMJ evaluation and airway evaluation as well, and my take on this is the radiographic evaluation of these patients so that, in the end, your dental treatment survives long term. You want something that's stable. You want something that's going to last for a good chunk of that person's life and not fail because you misdiagnosed your patient. And that right there is a point that I see, that we shouldn't be diagnosing our patient's teeth. We should be diagnosing our patients, a full comprehensive evaluation of their craniofacial complex that houses their teeth, so that when we render dental treatment, we should be able to do that in a fashion that we have stable results that hold with that patient for a good chunk of their lives.” (9:54—11:13)

“We have to come to a realization that bone is alive. We tend to think of hard tissue as something that's solid, that's unmovable, when in reality it's fluid — or, it's not liquid. It's fluid, meaning that it will move over time. It will change over time. And that's the homeostasis that we, when you understand how osteoblasts and osteoclasts work and the modeling and the remodeling and how these things can work together to suit the function and to suit the everyday habits and patterns of movement. Then, you understand that whatever you have right now, your morphology right now, it's not going to be the same in 10 years. There's going to be a turnover of the bone. There's going to be a turnover of the tissues and the structures and the soft tissues and hard tissues. All that are going to interact with one another as a result of how you use your body.” (11:57—12:53)

“Where were we like 25 years ago when you and I were in dental school? We were still doing panos and cephs. We're still doing these procedures, but now we have the ability to actually view our patients in 3D. You and I are three-dimensional structures. Our patients are three-dimensional structures. Their teeth inside their mouths are three-dimensional structures housed in three-dimensional structures. So, it makes sense for many of our procedures to be able to visualize those three-dimensional structures in their true dimension in 3D. And maybe in the future, we're also going to be able to see them in 4D moving with time. But definitely, there is movement towards improvement towards advancement. I don't have a crystal ball. I have 3D vision. I don't have ESP or anything like that, so I can't tell the future. But just by watching the progression of imaging over the past 20, 50 years, look at how far we've gone.” (14:31—15:42)

“Many of our dental friends, even though they work in 3D, they're not looking in 3D. And there are a lot of misconceptions or fear of the use of radiation — which is justified. Photons are bad. But the thing is, whenever we acquire an image or make a decision to acquire the image, there's a thought process that we need to be considering. The first is, can I get the diagnostic information I need without using X-rays. If I can do that, then I don't do that. I don't even go for a periapical if I don't need it. But if your diagnostic evaluation, clinically, is insufficient to render the correct diagnosis to your patient, then you need to bring out whatever big guns you have and do that judiciously. Screen your patients. See what they need. So, I guess the misconception here is, we are going to stay away from cone beam CT because it's such a bad thing because of the radiation. Yes, radiation is a force to be reckoned with. But the thing is, in my humble opinion, the harm that you do by not diagnosing your patient properly far outweighs and is far more prevalent than the harm that may occur with some random photon hitting a water molecule and ionizing it, or any of the other changes that we see with imaging.” (15:58—17:38)

“One misconception that I'd like to, or at least one fear that I'd like to quell, yes, we have to be very smart in who we irradiate, but we shouldn't be so scared to use imaging when we really need it. And many of the cases are the three-dimensional movement of teeth. In the case of orthodontics, surgery, if you're going to be removing a third molar and the canal on the pano is ambiguous, definitely, you're going to need to see where it is so that you can maneuver around it. Things like that. And, in general, I believe that most orthodontic patients should be seen in some way or the other in three-dimensions because the 2Ds are not sufficient to really represent that patient's morphology. There's also the magnification, the super imposition, lots of things. And because I see a lot of these patients, I see the resorptions, I see the pathology that would otherwise be missed on 2D. That's why I'm like, guys don't worry too much about it. Just be smart and use a good selection criteria when choosing who to acquire an image for, be it cone beam CT or other.” (17:40—19:06)

“[4D is] the dimension of time. I'm looking at you right now. I'm looking at you 10 years from now and I'm evaluating what's happening with your progression. And to be able to monitor that with time in a more fluid manner. You can also introduce another dimension, which is movement. Obviously, our jaws are not static. Our TMJs are not static, and they have a certain trajectory to how they work, and everybody is a little bit different because they have different conditions that may affect the way that they use their mouths, their jaws, their lips, or their musculature, or whatever it is, or even their head posture on their neck. All that changes how you move. So, watching the movement and the function, over time, those are the extra dimensions. 3D is just the image itself, the static image. The fourth and fifth dimension would be the time and the movement.” (19:20—20:30)

“AI is coming. We're not there yet where the software is going to replace the radiologist. It is an aid, at this point. Not in the oral maxillofacial radiology quite yet, but in medical radiology when the evaluation necessitates a static lesion. So, the variation in the gray scale of the units that make up the scan which are called voxels. The AI can pick up patterns of change that alert the radiologist, ‘Hey, there's something here. Take a look and tell us what you think.’ So, it's still done in conjunction with a human. It can't be that you just rely on the AI. It's a tool to help minimize things like errors that come with fatigue, for example. Someone who's been on call all night and doing scan, after scan, after scan and might miss a small one-millimeter change in the brain or something like that, and the AI helps direct that person's vision to that. So, that's where we are currently.” (21:57—23:03)

“When it comes to 2D, AI has been successfully used for two-dimensional imaging for our periapicals, panoramics, whatever, to help pick out things like caries and periapical disease, and that kind of thing. Currently, there is some software that is attempting to do that as well for the oral maxillofacial complex on 3D and on cone beam CT. The problem with that is that on cone beam CT, we have a lot of artifacts, and those artifacts could mimic periodontal disease and caries and that sort of thing. So, it's hard to hang your hat on that. The dream, I think, for a dentist, for many of our dental friends who have a cone beam CT, is to have the software plug in the scan, and have it read everything, and don't need to send it to a radiologist or anything like that. Well, you can't do that. You can't do that because the software is not intelligent enough to do the cause-and-effect thing that we do as dentists. So, remember the whole understanding the TMJ and understanding the airway stuff that I was talking about in my books? That understanding, the, ‘I understand that this phenotype, this patient, how this patient appears at this time point is a result of X, Y, Z happening that also was confounded by A, B, C.’ And putting all that stuff together, that's a very complex algebraic equation.” (23:04—24:37)

“A big part of our thinking as dentists, our own thinking towards ourselves, our own profession, as well as how the public views us, is that we have to step away from being tooth carpenters. We are not that. We are not smile makers. Yes, we are, but we're not just that. We're not tooth straighteners. We’re doctors, physicians of the oral and maxillofacial complex, and that encompasses an understanding of how those teeth that, of course, the aesthetic component, dental patients will see that as part of their cosmetic repertoire. But we know better. So, changing that mindset, not just within the general population, but also our medical colleagues who don't know what we're doing, who don't understand the importance of what we're doing.” (25:08—26:10)

“I speak at medical conferences, the head and neck radiology conferences, showing them — because they're always talking about noses and sinuses and things like that, but then I come and say, ‘Hey, but did you notice that this person who has that kind of blockage because of their chronic sinusitis also has a face that's very long, a mouth-breathing phenotype. His jaws are small, he's not sleeping, the kid, has ADHD, etc. Putting those pieces together is completely foreign for our medical colleagues. And then, there's us, as dentists where we need to step up to the plate and understand what a patient's phenotype means. Read between the lines. There's stuff they're not going to be able to articulate, and a big part of that isn't just the phenotype and the way the patient appears to you at this time point, but also what has happened in their past, and not just physically but also emotionally and psychologically. Because trauma, and you mentioned trauma. You probably meant macro trauma, but psychological trauma, PTSD, all that changes the way that you use your jaws. If you've ever heard of brux, just clench, these people with these huge masseters and temporalis because of all the stress that they're under. That is your body basically speaking your mind. That is your body translating your emotions into physical form. And if you don't deal with that, then no matter what you do dentally, no matter how many splits you put in, no matter how you change the occlusion, whatever it is, that's not going to get fixed if you don't change what's in their heads. They're going to keep breaking all those crowns.” (26:10—28:02)

“The bone is a chronicle of your life, and the ability to visualize the three-dimensional imaging — and I'm not just talking about looking for like when you get this cone beam CT and looking for pathology or whatever, but the actual creation of reformations of models of what that patient appears like and understanding how to analyze, and what that stuff means [is important]. What does it mean if I have that 3D skeleton of the patient's face, and I see that the gonial angles are flared out? I need to think about how the muscles are working there because bone is responding to muscle, and the battle between muscle and bone, the muscle always wins. So, the bone is going to respond to an excess of muscle function, whether it's pulling or pushing. And they're recreating whatever reformations, looking at the airway, looking at the TMJs, looking at the skeleton, looking at specific cross-sections of whatever area that you're interested in putting an implant in, for example, the root canals, and trying to find the MIST canal, or whatever it is, all that requires a little bit of thinking, three-dimensional thinking, which can be trained, but it's not intuitive. And this is a dental specialty. This oral maxillofacial radiology thing is a specialty, just like any specialty that we know, orthodontics, and perio, or whatever. So, you have to invest the time and the education to be able to do it effectively. You can't just be going straight to the thing that you want to do. There's a methodology. There is a sequential methodology to getting the scans read.” (28:30—30:09)

Snippets:

0:00 Introduction.

1:36 Dr. Tamimi’s background.

5:36 Why this is important in dentistry.

7:35 What clinicians get wrong or misunderstand most.

11:23 Bone is alive.

13:57 The future of imaging.

15:46 Don't be afraid to use imaging when necessary.

19:06 4D, explained.

21:21 AI's role in 3D imaging.

24:41 Change the perception of dentistry.

28:04 Last thoughts.

30:15 About Dr. Tamimi’s courses.

Dr. Dania Tamimi Bio:

Dr. Dania Tamimi graduated with a dental degree from King Saud University, Riyadh, Saudi Arabia. She trained at Harvard School of Dental Medicine and earned a Doctor of Medical Science (DMSc) and certificate of fellowship in Oral and Maxillofacial Radiology in 2005. She is board certified by the American Board of Oral and Maxillofacial Radiology (ABOMR) and is a Fellow of the Royal College of Physicians and Surgeons (Glasgow).

She is a...

Correct Oral Rest Posture & Nasal Breathing

Episode #639 with Brittny Sciarra-Murphy

We all know that mouth-breathing is bad. But do we truly know the importance of nasal breathing? It all starts with myofunctional therapy, and Kirk Behrendt brings in Brittny Sciarra-Murphy, owner of CT Orofacial Myology, to explain what it is and how it will help you re-educate patients on breathing properly through the nose. Stop the negative domino effect! To correct dysfunction early and help change your patients’ lives, listen to Episode 639 of The Best Practices Show!

Episode Resources:

• Join Brittny on Facebook
• Follow Brittny on Instagram
• Learn more about CT Orofacial Myology
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for Brittny’s and Karese Laguerre’s course at Airway Health Solutions

Listen to I Spy with My Myo Eye podcast

Learn more about CT Orofacial Myology on YouTube

Main Takeaways:

There is a place for myofunctional therapy in every dental treatment plan.

Know how to properly screen for airway and myofunctional disorders.

Educate patients about the importance of nasal breathing.

Start using the BROOMS screener in your practice.

Collaborate with other clinicians.

Quotes:

“The technical term for [myofunctional therapy] is the neuromuscular re-education of the oral and facial muscles. It's essentially like having a personal trainer for the muscles of the oral facial complex. We have common goals that we work on with our patients. Essentially, it's to restore proper oral rest posture, which, you might not know what that is. So, as you're listening to me, I want you to breathe, and I want you to think about where you feel your tongue inside your mouth. Weird question. All my patients, when they come in, they're like, ‘Well, I don't know. Nobody has ever asked me that before. My tongue is moving everywhere now that you brought so much attention to my tongue.’ But if you're having correct tongue posture, if you think about where you say the letter “N”, where the tip of your tongue hits up behind your upper front teeth, essentially, right on your incisive papilla, that is where the tip of your tongue should rest. That whole tongue should actually be resting up in the roof of the mouth. The lips should be closed, and we should be breathing through our nose. This is really what our goal is as a myofunctional therapist, is to restore this posture.” (4:00—5:07)

“Whoever you are listening, whether you're a pediatric dentist, general dentist, orthodontist, cosmetic dentist, sleep dentist, there's a place for myofunctional therapy in literally every single dental treatment plan.” (6:35—6:48)

“One of the things that I like to explain, whether it's other professionals that I'm lecturing to about myofunctional therapy or patients when they come in, it's really important to understand that structure and function go hand in hand. You can't really have one without the other. You can slap braces on somebody. You can get those teeth to move while they're actually physically in the braces. But what about when you take those braces off? What's going to happen if that soft tissue dysfunction was not corrected? We see a lot of patients with orthodontic relapse. So, patients that have tongue thrust — that can even impact cosmetic dentistry. I mean, how good is doing cosmetic dentistry on somebody that's always thrusting their tongue? What good is that cosmetic dentistry if we can't keep those teeth inside our mouth? Periodontal disease, there's a link between that. Think about the forces of clenching and grinding, bruxism, what that does to the periodontium. Mouth-breathing, we already know what that does to the health of our gums. So, there's a place for myofunctional therapy everywhere.” (6:54—7:56)

“I think one of the most important things is we want to understand, truly, the importance of nasal breathing and that it's not okay to breathe through our mouth. Yes, maybe when you're doing some high-intensity workouts, that's fine. Otherwise, those lips should always, always, always be closed during the day and at night. You hear patients come in and they're talking about maybe their children, and they might snore. They might snore a little bit. Or, ‘My husband is snoring. I have to sleep in the other room.’ Snoring is not okay no matter who you are, what age you are. We should be sleeping in our rooms, nice and quiet. I always tell my parents, ‘You want to go in your child's room and put your finger underneath their nose to make sure that they're breathing. That's how quiet we want our children to be when they're sleeping.’” (7:56—8:45)

“You could be the best myofunctional therapist in America, or to ever exist. But if your patient cannot breathe through their nose, it is very hard for us to be successful. So, we have to see, what is that root cause of mouth-breathing? Are there enlarged tonsils, enlarged adenoids, turbinates? Do they have a tongue-tie that's impacting their ability to get their tongue up in the roof of their mouth? There are so many things that we want to look at.” (9:45—10:08)

“There are so many kids out there that are truly suffering and that are getting mislabeled as ADHD, getting mislabeled with behavioral issues. Kids respond differently to not getting enough sleep than we do as adults. As adults, we're lethargic. We want to sit there, and we want to watch Netflix. Kids become hyperactive. They are trying to do everything they can to possibly keep themselves awake. And there's a big correlation — I want to say it's like 75% of patients — children that are diagnosed with ADHD actually have an underlying sleep-disordered breathing issue going on. That's the other thing I feel like in dentistry — there are not enough practices that are focusing on sleep, even though we should, because every dentist should be screening for sleep-disordered breathing. But we think about sleep apnea, and that's really all that anybody thinks about. But sleep apnea is that final destination we don't want to get to. Sleep-disordered breathing is really an umbrella term — mouth-breathing, snoring, upper airway resistance. Then, we get to full-blown sleep apnea. So, again, it's not normal to have any kind of snoring, no matter how old you are.” (11:45—12:57)

“[There are] simple questions that can be asked about sleep, sleep patterns, and behavior. I teach a course to other dental hygienists to become myofunctional therapists. I co-teach with my partner, Karese Laguerre. We came up with a screening that you can do in the op. The acronym is BROOMS . . . It's very quick to do in your intraoral and extraoral exam as a registered dental hygienist. You're not taking all this crazy time aside to do this. So, the “B” in BROOMS stands for bruxism. So, any signs of wear going on, any signs of clenching and grinding going on. Maybe your patient has massive tori in their mouth. Well, those grew from somewhere.” (13:45—14:35)

“The “R” [in BROOMS] stands for respiration. How are they breathing? Are they breathing through their mouth? When you're looking at your patients, even before you call your patient from the waiting room, observe them in their natural habitat. How are they sitting? Are they super slumped over? Is their mouth slumped over, open? When you watch them breathe, are you seeing a lot of chest movement, or are you seeing the movement come from their diaphragm? Because that's really that primary muscle that we want to be breathing from.” (14:37—15:06)

“The first “O” [in BROOMS stands for] open mouth. I think the first one is open mouth posture, technically. So, again, monitoring them. Is it typical that they have those lips apart, or are they together? And very simple, you can obviously see their teeth if their lips are apart. So, when parents are like, ‘Oh, I don't know if their lips are together or open,’ well, do you see their teeth? That's a big tail sign. Patients that have to use ChapStick. They might whip out the ChapStick while they're in your chair. There is a reason why your lips are chronically chapped. Aside from the fact that, yes, ChapSticks smell fabulous, and lipsticks and glosses, and things like that, if your lips are chronically chapped, that's a sure sign that you're probably doing some mouth-breathing and have your mouth slumped open.” (15:08—15:56)

“The “M” [in BROOMS] stands for maxillary transverse width. This is something that should be taken, I think, on every single patient and that can be easily done. Take a cotton roll. A cotton roll measures about 37 millimeters. I don't know if it differs from company to company, but generally it's about 37 millimeters. Stick that cotton roll up between three and 14, or the baby second molars, and see if it fits. If we're talking about an adult and you're squishing that cotton roll up between three and 14, they are deficient. There's probably some crowding going on, or they probably have that high narrow palate. For our children, depending on the age, of course, 37 millimeters might be a little bit too big. But by age five, we want to have a 30-millimeter transverse width. And there are not, unfortunately, a lot of five-year-olds walking out there with 30 millimeters. Think about your pediatric patients. We would love to see so much spacing between those primary teeth that you can take a nickel and slide it up there. We don't see that a lot. A lot of parents think, ‘Oh, their teeth are close together. This is great. They're not going to need braces.’ But we know that that's not true. What's going to happen when those exfoliate, and those adult teeth come in? So, it’s a very simple thing you can do.” (15:58—17:20)

“The “S” [in BROOMS stands for] strained mentalis. So, when you're looking at a patient and you ask them to close their lips, you might see some strain going on in this chin area, in that mentalis, having some activation. Even sometimes without them actually closing their lips, you end up seeing some strain here. That can be a sign of a vertical overgrowth. So, maybe that jaw is really growing down versus forward, like we want. A lot of those patients will have longer faces and gummier smiles. It's a lot more difficult for them to actually get that true lip competence. And how simple is that? That's something that can be done in a jiffy as an RDH. That's a good screener for if this patient needs a myofunctional referral.” (17:22—18:10)

“The second “O” [in BROOMS stands for] orally defensive. That's a big one because we see this a lot in the dental world. So, think about, for my hygienists that are listening, you're trying to scale those lower anteriors, and that lower lip is hooked so far over that you're almost standing up to fulcrum to be able to scale down there. There's a reason. Those patients that have severe gag reflex that you're dreading when you, unfortunately, see their name in the schedule and they're due for a full set of X-rays — there's a reason for that. They're trying to protect their airway. That tongue that constantly follows you around, everywhere your mirror goes, that tongue follows. Difficulty retracting the cheek — any kind of oral defensive sign, there's probably some kind of dysfunction going on there.” (18:22—19:05)

“A lot of us myofunctional therapists also do breathing re-education. The type of breathing re-education that I'm trained in is called Buteyko breathing . . . I'm going to give you guys a challenge. I would like for you to try to suction your tongue up to the roof of your mouth like this. And then, I want you to try to

4 Reasons People Don't Do What You Tell Them

Episode #638 with Katherine Eitel-Belt

You've told your team what you want done, and how you want them to do it. You’ve told them a hundred times — and they still don't do it! What do you do now? To give you some insight into why this happens, Kirk Behrendt brings back Katherine Eitel-Belt, founder of LionSpeak, to share four reasons why your team doesn't do what you ask, and what you can do as a leader for them to succeed. It’s easier than you think! To learn about the changes you need to make, listen to Episode 638 of The Best Practices Show!

Episode Resources:

• Join Katherine on Facebook
• Learn more on Katherine’s website
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Get the One Sheet, the Courageous Conversations framework, and Katherine’s article on her website

Learn more about AADOM

Main Takeaways:

Are your expectations clear to team members?

Can team members repeat your expectations back to you?

Do your team members have the intellectual or physical capacity?

Are your team members willing to do the things being asked of them?

Have you done everything you can as a leader to set them up to succeed?

Quotes:

“Most of us didn't get training. Most of us didn't have parents that modeled [leadership skills] for us. Some exceptions to that. We’re the lucky ones. But most of us didn't, and most of us didn't take a class in this. So, here we are, thrown into these leadership and management positions. And right now, we're seeing a huge trend as practices consolidate, especially. They are promoting or advancing someone who is maybe a great hygienist or a great assistant, but the skills that they need to be a great team leader are not the same skills as it takes to be a great clinical hygienist. They're different skills. Unless we empower them and train them to have these courageous conversations, these coaching conversations with their team, they will never know how to grow them. That's the whole point of having a leader of a team, is to grow that team into an aligned, capable, independent, self-sufficient, and successful team.” (4:39—5:45)

“I've seen a lot of people getting out of management and leadership positions because they are not enjoying it at all. I think some talented people are jumping ship because we haven't equipped them with the right tools and the right skills.” (5:54—6:14)

“Let's say someone, an employee of mine, a teammate of mine, has not performed part of a system that we've all agreed to, and I feel like they should do it, should know how to do it, and they're not. The first thing I ask myself is, ‘Are they clear?’ If we assume most people want to do well, want to do good, want to perform well — I am making that assumption that people want to do well. So, of the people that want to do well but they're not doing something, I ask myself, ‘Are they crystal clear about the actual expectation?’ Now, many times, we will say to ourselves, ‘Yes. My God, I've told them. We've talked about this thing in staff meetings ad nauseum. They're clear. They have to be clear. We've talked about it a hundred times.’ But I would tell you, you can never be sure they're clear until they can repeat that expectation and standard back to you in a way you would check the box.” (9:20—10:31)

“We often feel we've been clear. That is not the same as the recipient of that message actually being clear. The only way you know is that they can repeat it back to you. So, if they cannot repeat it back to you, then don't even go any further. Start here. Continue to clarify the expectation and potentially the why behind the expectation until they can repeat it back to you exactly. Once they can do that, you can check this box. They're clear. So, I've done my part as a manager in making sure they know what to do.” (10:33—11:09)

“Let's say that you have decided that you want people on your team to communicate at a more mature level. No more gossiping, no more complaining, no more blaming, no more low-level behavior. And so, you have made it a standard that we communicate with respect, we communicate with dignity, we communicate with non-judgment, we communicate effectively, and we do it first with the person we're in conflict with. And if that doesn't work, then we bring it to a manager. So, let's say that's the expectation. We talked about it in team meetings, we've read articles on it, whatever, and they're not doing it. You catch someone not doing it. Maybe they're gossiping or something. I would ask myself, ‘Are they clear?’ And the tendency for me would be to say yes because we've talked about it. But if they couldn't repeat that back to me, then I can't check the box. Let's say you either could check the box or you got it clear, and they're still not doing it. The next one, reason number two, is that they don't know how. In other words, they're not trained. So, someone could understand the expectation . . . of communicating at a high level or a mature level, but they don't know how to do it. No one has actually trained them on the framework of how to have that conversation. So, that's a good example of, someone could understand the expectation but not know how to do it.” (11:12—12:47)

“You could have thought you trained them. You could have watched a video. You could have sent them to a class. You could have talked to them about it. But until they can perform it for you in a demonstration in a way that you go, ‘Yep, they know what to do. They know what buttons on the computer to push. They know where to write that documentation. They know how to set that tray up that way. They know how to have this conversation because they just did it for me in a practice session,’ now, I can check the box. But for both of these first two, there is this feeling of, ‘I've said it a hundred times. How could they not be clear? I've shown them a hundred times. How could they not know how to do it?’ But the only real test is, can they tell you? Can they show you? If they can't, you can't check the box.” (12:52—13:42)

“The research is six times [that a person needs to hear something before it registers]. It's called the magic of six. I have a certification in adult learning theory, and the research shows that it's actually the repetition of six. It doesn't mean you necessarily verbally tell them six times, although that would count. But it's, I told them once. I showed them once. That's two. I demonstrated it. That's three. We maybe did an activity around it. That's four. I had them review it. That's five. So, six touches. What the research says is that it takes six touches to move a new idea or a new concept from short-term memory to long-term memory. So, that's what we're after.” (14:39—15:27)

“What we're frustrated with is they aren't making the changes. It's easy to do what we've done repetitively because we don't have to — if you want your team to answer the phone differently, or handle the price question on the phone with new patients, if you want them to handle that differently than they're doing it, they have to really stop and think about the new way, where the old way, they didn't have to think about it at all. It's what they've been doing. They were repetitive with it, and now it has become their norm. You're actually asking them to change the norm, and that doesn't happen by hearing it one time. And more importantly, having a coach to coach us through that. So, it's that tell, show, demonstrate, and then get them to do before we put them on the front lines to actually do this.” (15:35—16:30)

“The second one about, ‘Are they trained?’ really does require us to learn how to be good trainers and good educators in terms of these systems and skills. We can't assume that, ‘I showed you what buttons to push on the computer. Dang it, you're not doing it.’ It's a little bit more. We can dig our heels in the sand and say it shouldn't be that way. But guess what? It is. So, if you embrace that it takes more than one time for someone to actually get most things, then you can embrace it and figure out how to make that happen.” (16:34—17:07)

“If they've repeated it back and they've shown me they could do it, but they're still not doing it, my next question to myself is, ‘Are they capable?’ In other words, do we have the right person in the right seat? A lot of times, people aren't doing something because they have no capability to do it. I'll give you a great example. We recently had a young dentist who purchased a practice from an older retiring doctor. The older retiring doctor's pace was much slower than the pace of the new young doctor. He had an assistant that had been with him for almost 40 years, and she was coming with the transition. And she was amazing. She was clear about what needed to be done. She was definitely trained — highly trained. When we got to the capability question, the truth was she could not physically keep the pace of the new doctor. She just physically couldn't do it. And so, there was a capability issue there. And one of the reasons she couldn't do or wouldn't do all the things he was asking and requiring was it was a capability issue. Sometimes, we have people that we tap on the shoulder to bring financial reports or metrics to a team meeting, and they don't have a high math IQ. And so, they're bringing the wrong reports over and over. It isn't that they aren't clear. It isn't that they aren't trained. It's just that they don't have the capacity. So, do they have the intellectual capacity? Do they have the physical capacity to actually get this done?” (17:25—19:08)

“Let's say I've been clear. They're definitely trained, because they've shown me. They are definitely capable. They're still not doing it. Number four is, are they willing? Can you see now how many people in high levels of frustration go to, ‘They're not willing,’ before they check the first three boxes? The first three boxes are on us. Was I clear? So clear, in fact, they could repeat it back. Was I a good enough trainer that they could actually do it right before my eyes and show me that they know how? Do I have the right person set up for success in the right job? Those are on me. But if I check yes to all of those and they're still not doing it, now, my attention turns to them. Now, I say, ‘I've done all that I can do to set you up for success. You're still not doing it.’ This now becomes a willingness issue.” (20:21—21:20)

“[Identifying a willingness issue] is what engages our courageous conversations framework to make sure people understand what is negotiable and what is non-negotiable. It's non-negotiable that work starts at a particular time, right? Let's say work starts at 7:45 for the huddle. It's not 7:46, and it's not pulling in on two tires at 7:44. It's standing at the meeting, ready to go. You've already consumed your breakfast. You've already got your lab coat on. You are ready to go at 7:45. That's what on-time looks like. That's a non-negotiable piece. What is negotiable is whatever we can come up with to support you in being here at 7:45 or determining that it will never work for you at 7:45 and helping you transition to another place. And so, it's when the willingness piece comes into play that we now get to initiate a courageous conversation that helps people align one way or the other.” (21:21—22:26)

“People were going to the framework, but they hadn't gone down this hierarchy of, ‘Why aren't they doing what I'm asking them to do?’ and essentially, have I checked that I have set them up and done everything I could do as a manager and a leader to set them up for success? And then, at some point, it is up to them. That's that willingness piece. I do think they have some skin in this game, so this is their piece. But the first three are mine, and I think managers often don't check on their own responsibilities in the breakdown before we go to the other person.” (22:28—23:08)

“What would need to happen for you to go, ‘I now trust this person with this task’? So, if we, as a manager, do the work to say, ‘If I had 90 days of this, this, and this kind of result, then I would trust you.’ So, I would say to the person, ‘Thank you. Thank you for opening up the conversation to what I would need to trust you, because you clearly want to be trusted with this and feel you are capable and can be successful at it. And I 100% want you to be. So, here's what I would need in order to trust you. The non-negotiable is we need success at a particular level. The non-negotiable has nothing to do with whoever does this job. Here's the standard. Here's the result, the measurement that I need. Let's talk about, together, what needs to happen in order for me to trust you, and what the time period would be for that.’ And I would work on getting them clear and having very, very clear check-ins about whether or not those things are happening.” (24:26—25:40)

“By the time you get to the end of [the check-in], it either has happened — in which case we need to say, ‘Okay. You've done everything I've asked, and the results are what I was looking for. Why would I not trust you?’ Or it hasn't happened. In this case, we're off the hook to say it isn't for a lack of trying and I think we have our answer. And I love to say, ‘The last thing I would want for you is to continue to work in a job where you felt you weren't successful. What a terrible way to come to work every day. You are perfect for a particular position. We've answered the question that it isn't this one. So, let's talk about either another position in our practice, or helping you find a position somewhere else where every day you come to work, you feel like you can be successful, because that's what I want for you.’” (25:40—26:38)

“Imagine using this with a teenager. It doesn't matter. Have I been clear about the expectation? Have I given them all the tools, and the how, and how to do this chore, or do this homework, or whatever it is? Do we have them in the right class? Is this too advanced for them in where they are? Are they capable of doing this? And then, we get to, are they willing? And the willingness conversation is a very different conversation. But don't go there too soon — not before we've done our due diligence.” (29:05—29:40)

“They say that great communicators always accomplish two things: clarity and inspiration. You've got inspiration down in bagfuls, right? I mean, you don't have to think about being inspiring. But you have to think about, I have to think about, ‘Am I being clear?’ And other people get clarity — my mother got clarity, hands down. You never left a conversation with my mother and didn't understand what she was asking of you. But she wasn't always very inspirational. She often didn't encourage me to take a step in that direction. I think most of us are better at one than the other. The best communicators find a way to be good at both.”  (30:07—30:47)

“Don't wait until there's conflict. Don't wait until someone is falling down on the job to have a great conversation. We should be having ongoing conversations — especially when there is no conflict — to make sure people are growing into the professionals we want them to be.” (31:26—31:43)

Snippets:

0:00 Introduction.

2:10 Why this is important for your practice.

3:52 It’s easier than you think.

8:32 Is your team clear about your expectations?

11:10 Can your team repeat your expectations back to you?

14:18 The magic of six in learning.

17:09 Is your team capable?

19:55 Is your team willing?

23:13 How to verify that your team is capable.

26:39 Develop leadership skills and teach by example.

29:04 Don't ask the willingness question too soon.

29:41 Great communicators are clear and inspirational.

30:50 Last thoughts.

32:48 More about the One Sheet and AADOM.

Katherine Eitel-Belt Bio:

Katherine Eitel-Belt is considered The Unscripted Communication Expert in the U.S., Canada, and the UK. An international keynote speaker, author, and coach, Katherine is the creator of The Lioness Principle™, a unique leadership communication tool. This guiding principle, along with several other easily replicable tools, is what LionSpeak uses to help professionals communicate with more authenticity and effectiveness. The company specializes in a broad range of communication forums, including frontline telephone skills (including mystery shopper services), public speaking skills for executives and sales teams, media readiness, inter-team communications, adult learning techniques for trainers and educators, and personal leadership skills.

Using creative, non-traditional methods to help professionals break through barriers and achieve phenomenal results is something Katherine and the team at LionSpeak love to do! Through this transformative work, Katherine has become a mentor to other consultants, trainers, speakers, corporate executives, and managers. In response to that demand, Katherine created her Transformational Training and Inspirational Speaker’s Workshops, as well as her Lion Camp Leadership Experiences, which are annual sell-outs in San Diego, California, and are considered the premier team retreat for progressive, corporate, and healthcare teams.

Katherine is an SCN Spotlight-On-Speaking champion, National Speaker’s Association member, Speaking/Consulting Network board member, and past-president of the Academy of Dental Management Consultants. She was recently honored as the 2015 recipient of the prestigious Linda Miles Spirit Award for her contributions to the dental industry. 

New Thinking on How to Grow and Keep Great Team Members

Episode #637 with Dr. Rebecca Bockow

Your practice isn’t just your practice. It also belongs to the people who help you run it. Your team is the most valuable part of your business, and Kirk Behrendt brings back Dr. Rebecca Bockow, an instructor from Spear Education, to help make your practice the place they want to be. To learn how you can grow, nurture, and keep an amazing team, listen to Episode 637 of The Best Practices Show!

Episode Resources:

• Follow Dr. Bockow on Instagram
• Learn more on Dr. Bockow’s website
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for Dr. Bockow and Dr. Michael Gunson’s Healthy Growth, Healthy Faces workshop (October 26-28, 2023)

Main Takeaways:

Provide an amazing workplace where your team can grow.

Make your team feel appreciated, fulfilled, and safe.

Use the morning huddle to create a great culture.

Value, encourage, and celebrate learning.

Focus on having a positive mindset.

Quotes:

“One of my goals as a business owner, a practice owner, is to not only provide great care for our patients and for our community, but also to provide this wonderful, amazing workplace for everybody that gives so much of their lives to helping our patients and our practice and creating a place where everyone can grow.” (3:50—4:12)

“We are very intentional with our culture, and we really want to create a place where people feel fulfilled, where people feel like they're appreciated, like they're constantly learning, and they're constantly coming to a place where we've created safety.” (4:38—4:55)

“I love learning new things, and I'm constantly reevaluating what I do as a clinician every day. When I change the way I look at a patient, and when I change my patient processes, that changes clinic flow. It changes the way we schedule. It changes what we do chairside. And on top of that, especially in orthodontics but in all aspects of dentistry we do day to day, we might do a piece of something, but not any one person, except maybe the doctor, sees the whole thing. And so, we started incorporating a lot of CE, internally, everything from how to take a great impression, to how to take great photography, to big-picture stuff like why do we even consider jaw surgery and what is it doing, to what's the most current literature about skeletal growth and development and sleep. And so, once a month at each office, we do a one-hour CE, and we have built-in training time into our weekly schedules.” (5:23—6:29)

“Part of [attracting and retaining great team members] comes from constantly learning. It's learning big-picture stuff like, why does expansion help nasal breathing, and how does that help reduce airway collapsibility? But also, how do we incorporate text messaging into our systems? We now can offer 3D printed ceramic brackets that are computer designed. How does that work with our workflow? Do we have to change our bonding material? Do we have to change our protocols? How does that impact scheduling? And once we make those decisions, educating the team and helping that flow. So, we've introduced a lot of layers to help with personal growth, professional growth, and constantly looking for ways to not just train the team but celebrate learning. Value and celebrate learning.” (6:46—7:43)

“I've heard from our team that they enjoy being able to contribute to the bigger picture. They enjoy the opportunity to learn something new. They enjoy feeling like they're part of something that encourages and celebrates growth, and so creating opportunities for team members to grow individually, but also creating safe spaces for people to contribute their thoughts and ideas to ensure that they're heard and implemented — because it's not my practice anymore. It's our team's practice. Everything from how we answer the phones, to how we schedule, to how we template the schedule, we're constantly checking in on our systems and asking ourselves, ‘Do these systems still hold true? Do they need revision? How can we take what we've learned and implement it in a way that makes sense?’” (7:57—8:59)

“I want my team to feel safe to share with me anything that they're struggling with, and also share with me any of their suggestions. They're going to live a problem differently than I will, and I won't know how to make things better if they don't feel safe enough to come to me. Also, learning requires vulnerability, and the reality is we all make mistakes. I'd much rather any given mistake becomes a learning opportunity so that we all can grow from it. Because if one person makes a mistake, chances are three more people might make the same mistake. Is there something with our internal education or with our systems that maybe we need to refine? And so, that safety becomes really important because we all grow and benefit from learning from that.” (9:16—10:08)

“Once a week, we have designated admin time that we use for internal training. We also, on a daily basis, have different appointment types blocked off for different staff members who want to learn or improve different aspects of their clinical competencies. So, if someone says, ‘I'm not feeling comfortable with banding. Can we set aside some time so that I can sit with our clinic manager, and she can sit alongside me, and we can really delve into what does that entail to really find the right band fit, seat it, cement it’?” (10:30—11:09)

“[Onboarding is] something my team has taken upon themselves in the last two years. We had some gut-check moments where we said we don't really have a great onboarding program. And so, many, many team members came together and created onboarding programs, everything from shadowing different team members, to watching online courses, to sitting alongside team members so that even the person answering the phones has sat in the clinic floor and watched an adjustment, and watched what happens at an emergency appointment so that everybody has an understanding of what everybody else is doing. It's been phenomenal. But truly, truly, that was the team coming together to create this.” (12:06—12:54)

“Something else we've implemented — and Bent Ericksen was helpful. We work with Bent Erickson too — having 30, 60, 90-day check-ins and asking the team members, ‘How was your onboarding? How is your onboarding going? What areas do you feel like you still need some training and coaching in?’ We talk a lot about coaching. We have a lot of mentor/mentee roles within the practice. Any time someone is having a hard time with something, we look at it as a growth opportunity. How can we help you grow to a level where you feel more comfortable doing a procedure?” (13:27—14:08)

“Something we are piloting — this is new for us that we've thought a lot about for about six months to put into place. We're going to go live next month — is scheduled one-on-one time with a mentor/mentee within the practice. And it's the mentee that sets the goal with the help of the mentor. And then, we're hoping for about a ten-minute check-in once a week. ‘Where are you at with your goals? What struggles are you up against to hit your goals?’” (14:39—15:08)

“One thing that I can't imagine living without is our morning huddle. We've tried things over the years, and maybe many of the listeners have as well, everything from looking over every detail of the schedule, this and that. What we open with every day is, we call them shout-outs. It's kind of like a Quaker meeting. You speak when you're moved, so there's no order, and someone says something great or wonderful about someone else, something that someone else did the day prior. On Monday mornings, it can be a moment of gratitude. Often, it's a reflection on what happened the week prior, and these are the opportunities where we really get to celebrate someone's learning and achievements. So, if someone did their very first bonding, someone else will often recognize that, ‘I'm really proud of so-and-so because she did her first bonding yesterday.’ Or someone that finishes ahead of their appointment time, or someone that took the time to set up somebody else's chair, or ran someone's instruments because someone was running late. These small opportunities where we can really celebrate one another really has brought us much closer and really help celebrate the team.” (15:54—17:11)

“I cannot practice without [a morning huddle]. Cannot. It unifies the team. It helps us get organized for the day. It helps set our mindset for the day. And importantly, it recognizes people for doing great things. Even small things, like I mentioned, ‘Great job. Someone helped jump into sterilization to help me because I couldn't get it all done.’ How amazing is it that you're recognized for that small extra moment that you took? And then, we go through the schedule very quickly and highlight anything that is important to know. Couldn't imagine going through the day without it.” (17:30—18:11)

“Going back to mindset, I think if we focus on what we're grateful for, it makes the day so much better. You can walk through the day and say, ‘Oh, the schedule is too busy. Everybody is showing up late. Everything is broken. Ten broken brackets on the schedule.’ You can make a day bad, or you can make a day good based on your mindset.” (20:10—20:32)

“How amazing that we're in a profession where we can help people. And we have the power to create an office environment where people feel appreciated, and people feel good coming to work. That in and of itself is a privilege.” (21:06—21:19)

“I think that's where the internal training comes in [for managing expectations], especially if we have a new process or something that we're going to be introducing. Or take a big step back, ‘Does everyone understand the principles of bonding? Why do we place brackets while replacing them? How do we take great clinical photography?’ So, having those built-in systems allows for checkpoints for people who've been with us for a long time to really make sure they're mastering. And to that extent, if you can teach it, you really have mastered it. And so, having our more experienced team members teaching our newer team members — it's rewarding to be a teacher. It's rewarding to learn something new. And so, creating time in the schedule for those learning opportunities helps build in opportunities so that when we gain new information, new ways of doing things, we can incorporate it into our day-to-day practice.” (24:35—25:40)

“We all want to attract the right people to the practice. And I think focusing our hiring on the right type of person — so, some people that would be a good fit for our practice would be people that are excited to learn, people that have an open mind, and people with this mindset that we've talked about because we are constantly changing. I've had staff tell me that, ‘Gosh, we're never doing the same thing,’ and that might not be the right fit for everybody. Some people, that might drive them crazy that we're always changing just a little bit. And so, looking for mindset, and then having a really strong onboarding process, and making sure that people have training opportunities, check-in opportunities, creating that safety network for people to feel safe to learn from their mistakes, and to have the vulnerability as a leader to recognize that maybe I'm not always right. Maybe I make a decision, ‘Hey, the schedule should be this way,’ and if the team comes to me and says, ‘This is not working. We’re feeling burnt out,’ or, ‘We can't get our work done,’ or, ‘We can't do a good job,’ then I need to listen, and I need to say, ‘Whoa. Okay, let's talk about it. How can we make it better?’” (26:07—27:31)

“Having open communication and having opportunities for communication, growing leaders within the practice, that's something I'm so proud of. We have tiers of leaders within the practice that have grown. I have a handful of people who have been with me for six years, which I am so humbled by, so proud of. People have grown with me, grown alongside me, and they are excited about these initiatives. They're excited about creating onboarding manuals, and they're excited about the one-on-ones. It's not me meeting with everybody. It's our tiers of leaders that get to take new leadership roles on, and they will grow from that.” (28:19—29:07)

“I’m not the best person to teach someone how to take an iTero scan. I'm not the best person to teach our new scheduling coordinator how to manage the front desk. I'm not the best person to take on a lot of these tasks. My team is better at it than I am. I might think I'm pretty good at it, but the reality is, they're better. And to give them the trust, the psychological safety, the training, and the opportunities to grow, I get excited watching them grow, for sure — 100%.” (29:44—30:22)

“We focus so much on our patient care. But, at least for me, the mission and vision of our practice has evolved to create a wonderful place for our employees to come to work. Like we said at the beginning, I don't even want to say “employees”. This is our team, and they're family to me. I care so deeply about each person that's on our team. I love celebrating everyone's successes, and I love supporting learning and growth. That's really powerful.” (30:53—31:23)

Snippets:

0:00 Introduction.

1:05 Dr. Bockow’s background.

2:15 Why this is important for your practice.

4:22 Value and celebrate learning.

9:00 Why safe spaces are important.

10:10 Set aside time for internal education.

14:09 Schedule one-on-one mentor/mentee time.

15:38 Why you need a morning huddle and how to do it.

19:55 Make...

Data-Driven Clarity: 3 Steps to Turn Your Frustration into Informed Action

Episode #636 with Heather Crockett

Unresolved frustration turns into conflict, and unresolved conflict becomes a crisis. There's only one sure way to avoid catastrophe, and Kirk Behrendt brings back Heather Crockett, one of ACT’s amazing coaches, with three steps to turn your frustration into action and keep your practice healthy. Don't let frustration run your practice! To learn how data can prevent and solve needless frustration, listen to Episode 636 of The Best Practices Show!

Episode Resources:

• Send Heather an email
• Join Heather on Facebook
• Follow Heather on ACT’s Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Listen to Episode 557 of The Best Practices Show

Read Traction by Gino Wickman

Read Atomic Habits by James Clear

Main Takeaways:

Make decisions based on data, not emotions.

Start collecting and organizing your data.

Figure out how to report on the data.

Don't try to do this on your own.

Anything can become data.

Quotes:

“If you don't have any frustration in your practice, then you are not a normal practice because we all deal with issues and frustrations from time to time.” (2:59—3:07) -Heather

“Oftentimes, our clients are making decisions that are emotionally based and not data driven. So, that is my goal with this podcast, is to help our clients and our community, anybody that's listening to this podcast, to help you turn that frustration into that informed action because there's so much frustration. Oftentimes, we get to the brink of, ‘Okay, I'm just going to do this because it will help to take this off of my shoulders.’ It doesn't unless it's an informed decision.” (3:08—3:38) -Heather

“Frustration will continue to grow and fester like bacteria, and it will ultimately become something worse than that.” (3:46—3:53) -Kirk

“Unresolved conflict always becomes a crisis. We just don't know when. So, if you're a dentist and you have frustration, and it's happening day after day, something will break. You'll either explode on a team member, you'll get burned out, you'll give up, or you'll go, ‘All right, forget it.’ We don't want you to do that, so we're going to take this frustration and we're going to take it into informed action with a couple of steps.” (4:01—4:26) -Kirk

“Where we start, we have to make it data with a number. Oftentimes, we overthink things. Oftentimes, we think things are worse than they are, or we may believe that the situation is better than it really is. So, we have to give what it is that we're feeling a number.” (4:32—4:49) -Heather

“I get really excited about road trips. One of the reasons I get really excited about road trips is because I stop at the local gas station that knows me by name. I fill my cup, my 44-ounce mug, with my “fun drink”, is what my kids call it. It's a mixture of Diet Coke and Diet Dr. Pepper. Yes — I'm a dental hygienist. Yes, I am aware of the acidic nature of that drink, but I still do it. I have my water right next to it, so I've got both beverages to take on this road trip. Well, it's a long road trip, and there is a space of time on this road trip that there are not a whole lot of places, or good places, to stop to use the restroom. So, my husband and I are newlyweds. I've got my big drink. We're going along, and I'm like, ‘Honey, I think I need to use the restroom.’ ‘Okay. Well, how badly do you need to use it?’ ‘I need to use the restroom probably like 20 miles back.’ ‘Okay. Well, let's try to find a restroom.’ Well, it's for miles, and I'm unbuttoning my pants at this point. It's getting really uncomfortable. I can't breathe the right way because I don't want to have an accident in the car. So, after that trip, I said, ‘Wouldn't it be great if we had a way of communicating so that you knew and understood just how badly I had to use the restroom?’ And so, we came up with a scale of 1 to 10. If I need to really use the restroom and I need a restroom like 10 minutes ago, I'm at a 10. I'm dying, like hospital need. I need to go to the restroom now. I'm at a 10. If I just used the restroom, I'm at a 1. So, we have taken something that usually doesn't have any data and we have given it data so that it deepens our understanding.” (5:13—6:56) -Heather

“Not only yourself, but your team members too can feel some stress and anxiety when we're uncertain of where we are. We can't read each other's minds. That data absolutely gives us that clarity.” (8:48—8:58) -Heather

“I shared that story of having to go to the restroom with one of my teams a couple of months ago. And I asked for a few minutes — that I shared with the team — that we were going to take a break at 9:30 a.m. At 9:32 a.m., I have a team member raise her hand and say, ‘Heather, I'm at a 10! I'm seriously at a 10. Can we take a break right now?’ I said, ‘Oh my gosh, absolutely. We'll start right back here in five minutes.’ So, you can see how it does. It's like, ‘I need to use the restroom,’ versus, ‘I'm at a 10.’ I totally get that. It takes it and it makes it so much more clear. That stress and anxiety is gone because now I have a way of telling the other people around me exactly what's going on. So, yes, it helps to reduce that frustration, helps to reduce your anxiety, and that of your team as well.” (8:59—9:42) -Heather

“[Step] number two is you've got to collect and organize your data. So, once you determine what it is that needs data, now you can start collecting that data. Don't overcomplicate it either. Make it as simple as you possibly can. You can track it manually or you can track it digitally, but you need some form of a spreadsheet.” (10:23—10:42) Heather

“If you have people around you and you create a culture where people bring their data to you, they can't argue with their own data. ‘Okay, let me show you what I've got. Here are the numbers around this, and here's how I see it.’ Now, we've got a starting point.” (15:01—15:14) -Kirk

“Anything can become data. We just have to be really crafty in how we put that together. Then, from that data, we can take action. When we report on this data, the more frequently we report on it, the better. So, whether that's during your morning huddle on a daily basis, whether that's weekly during a team meeting — as we recommend you have weekly team meetings — the more frequently you do, the more aware you and the team are going to be of that gap. Once you have that data and you're armed with that information, now, you can make a more informed decision and you can take action on it.” (16:58—17:35) -Heather

“You can't do this as a reactionary measure whenever you're frustrated, ‘We're going to put data to it and we're going to have a meeting.’ It's got to be a regular interval. Here, at ACT Dental, we're big fans of Atomic Habits, which is, you create a week that works, and then you stack habits on the week. So, every week is the same. When you look at having your meetings, or you're gathering data, or you're having a huddle, or you're having a team meeting, this is the point where you introduce the data. If I was a personal trainer — my wife went through a program like this, and it was awesome. She loved it. She had to take a photo of her feet on the scale every day, before her day started, to her trainer. Now, that's forced accountability. You can do whatever you want to do, but here's what happens as a result. What gets measured gets improved, but what gets measured and reported on significantly improves. So, I would be the worst in a program like that. But if I put my feet on the scale and it's not what I want, I'm not sending that photo every day hoping it goes up. I'm hoping it goes down, and now the two of us are working on a treatment plan.” (17:38—18:45) -Kirk

“If you do it all, the team is not going to be bought in to the whole process. They're just not. If I have my name next to a number — and I do on our ACT Dental Scorecard. My name is next to several numbers. If I have to go in and report that it's below goal, there's a ping of guilt, almost. It's like, ‘Ugh! I really hate that I'm bringing this back to my team.’ My team is counting on me to be sure that this number is what it needs to be. So I, then, am going to put some actionable steps in place to make that number better the following week because I don't want to let my team down.” (19:19—19:52) -Heather

“At the end of the day, it's basically the leader that holds everybody back most. And it's not about money, but when you start to introduce numbers — and it's not always about numbers. Numbers help us get out of frustration. So, when you start to move to an accountable structure where people like numbers, you'll find your favorite people. They like numbers. They like feedback. They like it. If you're running into a dead end where people don't want feedback, you’ve got to change that. My first suggestion would be to find a coach because that's a hard thing to navigate on your own. Secondly, if you don't want to get a coach, you’ve got to create a system of accountability where we are all on the same page. We're all committed to making things better, and it's a healthy thing.” (20:49—21:32) -Kirk

“Any time my clients or a team member says, ‘I think,’ ‘I feel,’ ‘I assume,’ that's when I say, ‘Okay, it sounds like we need more data,’ or data, period. We need data on this. You can't think, feel, or assume. You can't run a successful practice on ‘I think,’ ‘I feel,’ and, ‘I assume.’ You need that data, for sure.” (23:09—23:29) -Heather

“Don't sit and stew in your frustration. Do something about it. Remember, anything can become data. Start tracking as soon as you possibly can, and delegate that tracking to your team as well so that you're not doing all of it. Allow time to collect your data. We can't just immediately say, ‘Okay, we collected data for today, and now we're going to report on it tomorrow.’ You need some time, whether it's a week’s worth of data, a month’s worth of data, a quarter's worth of data, a year's worth of data. But don't wait too long, because you need to start making those informed decisions as soon as possible. Collecting the data will mean nothing and will only increase your frustration unless you start making those informed, actionable decisions based off of that data.” (24:18—25:01) -Heather

Snippets:

0:00 Introduction.

2:06 Why addressing frustration is important.

4:26 Numbers give you clarity.

10:17 Collect and organize your data.

12:39 Start taking action on the data.

14:50 You can't argue with your own data.

16:17 Figure out how to report on the data.

18:45 Don't do it all on your own.

20:12 Numbers help you get out of frustration.

24:12 Last thoughts.

Heather Crockett Bio:

Heather Crockett is a Lead Practice Coach who finds joy in not only improving practices but improving the lives of those she coaches as well. With over 20 years of combined experience in assisting, office management, and clinical dental hygiene, her awareness supports many aspects of the practice setting.

Heather received her dental hygiene degree from the Utah College of Dental Hygiene in 2008. Networking in the dental community comes easy to her, and she loves to connect with like-minded colleagues on social media. Heather enjoys both attending and presenting continuing education to expand her knowledge and learn from her friends and colleagues.

She enjoys hanging out with her husband, three sons, and their dog, Moki, scrolling through social media, watching football, and traveling.

What To Do When Leaders Are Out of Alignment

Episode #635 with Courtney Dalton

Being conflict-free isn't the secret to success — it’s your ability to work through conflict with your leadership team. To help you move past disagreement and misalignment, Kirk Behrendt brings back Courtney Dalton, one of ACT’s amazing coaches, with a treatment plan for getting your leaders on the same page. You don't all need to agree, but you do need to align! To learn the steps to start moving forward, listen to Episode 635 of The Best Practices Show!

Episode Resources:

• Send Courtney an email
• Join Courtney on Facebook
• Follow Courtney on ACT’s Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Read Traction by Gino Wickman

Read books by Simon Sinek

Download ACT’s OGT Tool

Main Takeaways:

Establish your core values.

Create leadership agreements.

Have great leadership team meetings.

Know your outcomes, goals, and targets.

Be accountable to the plans you put in place.

Quotes:

“Leaders being out of alignment is something that, as coaches, we see all the time. It's why a lot of practices seek a little bit of help. There are several of us in our community right now that are going through some misalignment — and that's not a bad thing. It's just something that happens as time goes on, and it's so important to call it out and to address it so that you can move past it.” (1:59—2:24) -Courtney

“Agreement and alignment are not the same thing. You don't always have to agree as partners. Sarah and I don't always agree. But what we have to do for the health of everything else is we have to align. So, whether you're a one-doctor practice, a three-doctor practice, an 11-doctor practice, it's very important that — we may not agree, but we're going to be aligned before we leave this room so that people can see that we're aligned, because I've been on the other side of it. When you have leaders and they're not aligned, everyone else can feel it. It's palpable in your business. You don't have to say a word.” (3:39—4:15) -Kirk

“Just like your kids know when something is off, so does your team. They can feel it. We love to say this all the time — as goes the leader, so goes the team. If they see that something is out of place, they feel it. They'll pick up on it and they oftentimes will replicate it, or at least challenge the crack that they see.” (4:32—4:52) -Courtney

“First thing, right out of the gate, you have to be meeting as a leadership team. You have to have time — predictable, consistent, regular — set aside to meet as a leadership team. If you don't have that time set aside, the problems, the issues, stack. And now, you're in fire mode. You're just trying to put out all the fires. Whereas, if you have the time set aside every Wednesday at 8:00 a.m., every Tuesday at 10:00 a.m., whatever it might be, you have that time set aside to sit down together and go through your list of subjects that you need to touch on for the day. It’s so important. It’s absolutely where you have to start.” (5:47—6:31) -Courtney

“Do you have time for a successful practice? Do you want to have a great team, and a happy team, and a happy balance? Then you have to add [leadership team meetings] in. We know this to be true of our teams because our ACT teams are having weekly team meetings. You're not going to take a hit in your production if you do it the right way. Everything will be okay. Everything will be worse if you don't set this time aside.” (6:51—7:20) -Courtney

“The single most important meetings I have in any week are not client-facing. They are alignment meetings with leaders because we're going to go to work. We're going to go work hard on things. It's almost like not treatment planning for a very large case. Think about this. A case comes in your office, a lot of complex dentistry, and you're like, ‘We don't need to treatment plan this. I know what to do. I'm just going to start doing the dentistry.’ That's silly. It's like building a house without a blueprint. That's silly. The alignment meeting is the cornerstone.” (8:10—8:42) -Kirk

“You’ve got to run a really good leadership meeting. You might say, ‘We've tried that.’ And if it sucks, we need to call it out. You're just not doing it right. A great leadership meeting should energize you. You should be talking about metrics, issues, to-do lists. Boom, boom, boom, boom. It should be efficient, it should be fast, and you should say to yourself when they're done, ‘What an amazing investment of time.’” (8:49—9:10) -Kirk

“If you don't have an agenda, a template, something to follow, at ACT Dental, we could certainly help you with that. You have to have something that is predictable every week, somewhere that as a leader you can go in and write down your thoughts. If you're in between patients, if it pops into your head, put it in your agenda so that it doesn't get lost in the shuffle. We know you're busy. We know that you're providing amazing care to your patients. We don't want these problems, issues, questions, concerns, or any of that to get lost. Throw them into your agenda so that when the time comes in these weekly meetings that you're having, you can go through each of them and give them the time and the space that they deserve. You can either make time for the meetings, or you can make time for the problems. It’s about perspective now.” (9:15—10:08) -Courtney

“Hopefully, step number two puts the pieces into place towards being aligned, leadership agreements, standards of behavior, the ways that you want to treat each other, and the ways that you want to present a united front to your team. And if you're already having these regular weekly meetings like you know that you should be and you don't have leadership agreements, you have to get them now because we're imperfect. We're going to have great days, not so great days — and that's okay. We want to be sure that, as a leader, you're still presenting to your team united with your partner or partners because, again, your team sees it. They feel it and they understand what's happening even when you don't think they do. So, you have to have rules of engagement, rules of behavior, among your leadership team so that you can present that united front to the rest of your practice.” (11:01—11:58) -Courtney

“You can agree to disagree. And what's your solution to that? Do you choose what's right in the moment, and then say, ‘We're going to come back to this a month from now and reevaluate’? That's a perfect example of a leadership agreement. When we don't agree altogether, that's okay. But we have to agree on something to continue to move us forward.” (15:05—15:27) -Courtney

“You have to come together. You don't always have to give up on what you believe, but you do have to get together, and you do have to be aligned in order for things to be healthy around you. There's no great practice that we coach where everyone agrees all the time. No way. As a matter of fact, the better they are, the more they actually disagree.” (16:08—16:25) -Kirk

“Great teams aren't in the absence of conflict. They are really good at conflict resolution. They see it, they call it out, they get it done right away, and they move on, thus making them powerful leaders to follow.” (17:07—17:22) -Kirk

“All roads lead back to your core values. If, at the end of the day, you establish these leadership meetings and you have your leadership agreements, go back to your core values and make sure that that alignment piece is still in the same spot it was when you decided to start this partnership or this agreement together. If your values don't align, we might need to have a separate conversation. Your core values that you've set in place — and if you haven't, we will provide you with a resource to help you figure out exactly what those are — are so important. They guide every decision you make. So, if you are still having conflict, or there's still no time for leadership agreements, and there's still some misalignment, go back to your core values. It might feel complicated. That's okay. Work through it again.” (17:33—18:24) -Courtney

“Your core values are everything. You're going to use them in good decisions, and you're actually going to use them more in bad decisions. You're going to go, ‘Wow, this is really hard. What do our values say?’ They're non-negotiable verbs. I'm telling you, when you put the flag in the ground and you say, ‘This is how we behave, and this is who we are,’ everything gets better.” (18:29—18:46) -Kirk

“If two partners don't align on a value system, it never, ever, ever, ever, ever works. It only works if one of them gives up on who they are. They go, ‘I'm just not going to be the person I always wanted to be because I need money, and I don't want to address this conflict.’ And so, you have to give up on who you are in order to stay in that relationship.” (18:49—19:11)

“Step number four really has to do with, what do you want and how are we going to get there? At ACT, we call it our OGT Tool, our Outcomes, Goals, and Targets Tool. Broken down, you need to figure out what each of those three really important categories are and what they mean to you. So, your outcomes, when you sit down and say, ‘What do we want? How do we want to feel at the end of the day? What are we really searching for?’ write it down. Your goals are the steps that you're going to take to get there, and they have to be measurable and tangible. If we pick a certain outcome, how are you going to get there? What does that look like? And then, your targets are your KPIs. They are your data points that you're using to measure how you're achieving those goals and if you're achieving them. They're the tools that tell you what to do if you're not quite there yet. So, really sitting down and figuring out the feeling, what that outcome looks like — remember, together, because you're on a leadership team together — how you want to get there, and then the data that measures those steps are really, really important.” (20:29—21:36) -Courtney

“Make your plan, stick to it, and move forward together. So, you've established your weekly meetings. You've discussed what your agreements are going to be as your leadership team. You've measured your core values. You know what they are. You take them to heart, and they define who you are when you step into your practice. You've sat down together, you've worked on your outcomes, your goals, your targets, where you're going, how you're going to get there, and what's going to tell you if you're on track or off track. That's your plan. Stick to it. Then, the word I'll use here is accountability. Hold each other accountable to the plan that you've set and move forward. Don't stop having your weekly meetings because that is your time to be aligned. That's your time to talk about the bumps that come and how you're going to get over them. So, make your plan and keep going. Keep moving.” (26:33—27:30) -Courtney

“As goes the leader, so goes the team. We opened with it, and I think it's appropriate to close with it. Be united. Talk to each other. Call out the elephant in the room, whatever it may be. Establish your core values. Establish your leadership agreements. Present a united front to your team, and good things will happen. It is not the teams that have no conflict that succeed. It's the teams that do have conflict because they learn how to work through them. So, if you're in this place of misalignment and you're feeling a certain way internally, you're not alone. And this is actually a good thing because we can figure out how to get you moving forward to the next step. Go back to your core values. All roads lead to your core values, always.” (28:47—29:37) -Courtney

Snippets:

0:00 Introduction.

2:30 Why alignment is important.

5:38 Have great leadership team meetings.

10:55 Create leadership agreements.

17:28 Everything leads back to core values.

20:22 Know your outcomes, goals, and targets.

21:36 More about ACT’s OGT Tool.

26:28 Have accountability.

28:33 Last thoughts.

Courtney Dalton, BS, RDH Bio:

Courtney Dalton is a Lead Practice Coach who focuses on...

Primary Care Dentist: The Changing Role of Dentists in Healthcare

Episode #634 with Dr. Steven Carstensen

Dentists do more than clean and fix teeth. They are the entry point to healthcare for patients. To help you embrace your role in improving community health, Kirk Behrendt brings back Dr. Steven Carstensen, chief dental editor of Dental Sleep Practice Magazine, with advice for navigating the changing role of dentists in healthcare. Start giving patients the best care possible! To learn how, listen to Episode 634 of The Best Practices Show!

Episode Resources:

• Join Dr. Carstensen on Facebook
• Follow Dr. Carstensen on Instagram
• Learn more on Dr. Carstensen’s website
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Learn more at Dental Sleep Practice

Learn more about the American Academy of Physiological Medicine & Dentistry

Learn more about World Sleep Academy

Read Outlive by Peter Attia and Bill Gifford

Read Healthy Heart, Healthy Brain by Bradley Bale and Amy Doneen

Main Takeaways:

Practice the four Ps of medicine.

Dentists are the entry point to healthcare.

Be a curious, connected, resource-based dentist.

Reach out to physicians to collaborate on patient care.

Focus on whole-person health and evidence-informed care.

Quotes:

“I was reading something about P4 medicine. P4 medicine uses four different words. The four Ps are predictive, preventive, personalized, and participatory. Those are interesting words. What can I get from that? Well, I'll explain them a little bit. Predictive is using big data. Preventive is using some biomedical innovations that we have, some ways we can gather information from patients. Preventive is what we would think of — it's how do we use that data, and even different data like molecular data and blood data. And then, participatory is when we engage our patients. Well, great. How do you get across thoughts like that? You get across stuff like that and connect with people through story. So, when people tell you, ‘I'm concerned about this,’ or you notice something and you see it with new eyes, something that you learned at a recent course, something that you heard presented and you go, ‘Wow, how am I going to talk to that patient about these things?’ well, you can give them data. You can do a mini lecture there in the dental office. But really, what people listen to is story. What does it mean to them? What is their reality now? What's new for them? What could be different?” (3:09—4:34)

“The four elements [Dr. Pankey] came up with were know yourself, know your patients, know your work, and apply your knowledge. Well, we think about these things. If you know yourself, you know that you're not interested in being an average dentist. You want to be a curious dentist. You want to be a connected dentist. You want to be a resource-based dentist for your patients. You get to know your patients. Alone in medicine, dentists and dental hygienists and other dental professionals, we spend the time to get to know our patients better than anybody else. I was scheduled for a physician's visit later on today. Twenty minutes is what I'm given. Well, nobody gets to know me in 20 minutes. It’s a brand-new doctor for me, at that point. But we see our patients over, and over, and over again, so we get to know them really well and we get to be curious and learn more about our profession. We learn more new things. We learn more about what impact we can have. We learn some more materials, those kinds of things. And then, we wrap all of that up and we apply our knowledge. We can't just do that by a technique. We can't do that with new materials. We have to do that with the other bases.” (4:48—6:01)

“You think about primary care. Primary — first. Right? Well, by definition, the U.S. association of family practice says a primary care practice serves as a patient's entry point into the healthcare system. Okay. But how many people go to their primary care doctor as an entry point into the healthcare system? They really go there to complain about a problem. They come to the dentist because they want to enter into the healthcare system. So, we do that for them. And then, if we notice some issues, we can be another entry point.” (7:35—8:08)

“We are able to observe overall health. Now, we don't have training that physicians have. We can't listen to hearts or understand how the gut works. But we have some knowledge base about that, and when we see some things going south in the oral cavity, when we get the answers to curious questions on a health history and we pay attention to what they're actually saying, and we look at their list of medications, for example, and we're curious why they're having to take that medication, that gives us a chance to get a view into their overall health and offer up some observations, and let them share with us their story. Maybe they're frustrated with many undiagnosed problems or, ‘I don't like taking these pills,’ and they don't have a chance to share that with anybody else.” (8:13—9:03)

“There are really three ways to address the problem. If your patient has a problem and you want to help, you can do it. They can do it. If they can do self-care, then we can get them to breathe better. We can get them to exercise. We can get them to control the hole under their nose. Or someone else can do it. So, if we have a problem that we recognize, we get the patient engaged with that issue, they say, ‘I want a solution to this problem.’ Well, if we become a good community partner, then we are a resource of finding a connection for them to go somewhere else and get it done well with someone who thinks like us. Because if we send them to a narrow-based community health partner, a specialist of some type of primary care, and that narrow-based person can't see what's going on, then they're going to do their expertise, but nothing else. If we send them to a curious, engaged community health partner, then we're going to be able to have them reflect back the value of whole-person health. That way, you do it, they do it, somebody else does it. That concept helps create the best person possible because they don't have just one pathway for health. They have all three pathways for health.” (10:16—11:36)

“The Census Bureau says there are 393 million Americans. There are 300,000 physicians out there that identify themselves as some kind of family practice, and there are 160,000 dentists. So, that's not enough for what's in our population, I guess. But if we're going to address some things, then we have to add our skills to the overworked primary care doctors. We can't solve it as dentists — we need the 300,000 primary care doctors as well. They need us because together we have almost 500,000 people paying attention to health. And underneath us, what do we have? Three, four, five team members? So, if somebody comes and sees you, and you're curious about their blood pressure, you're curious about their medication, you're curious about supplements and lifestyle, well, you have to understand why you're curious. Don't just check a box on a health history and ignore it. Be wondering what's going on. Well, you may not have time, as the doctor, to be able to make that conversation happen. So, your team has to be just as curious and know why they're curious. So, it's a great opportunity to engage your team with whole-person health and expect in your culture, in your office, ‘In this office, we pay attention to whole-person health.’ I'm echoing Mary Osborne here. ‘In this office, we want to make sure that what we offer you is more than just a tooth cleaning. We offer you the connection between that and how your heart is doing these days, and I notice you're taking blood pressure medications. Can you tell me why you're doing that?’” (12:34—14:19)

“[Dr. Peter Attia] writes about medicine in three different phases. Medicine 1.0, he calls it, is back in the day when they didn't understand a lot of things — bloodletting and those kinds of days. Medicine 2.0 is what we all know. It's evidence-based. It's where we look at studies, and we look at research, and we think, ‘Okay, let's make decisions based on that,’ which is really good until we come to the limitations of the individual person in the chair. And this is where it gets exciting because he talks about medicine 3.0 as evidence-informed, which means we are able to take the good evidence but use our brains and use our clinical wisdom and use our curiosity to meet the patient in the chair where they are. That means if they tell us a story that's a little different than the evidence — you know, they weren't participants in that study, so we can't see them as that. But we can see them as the person who says, ‘Look, I tried that medication. I tried that treatment. I'm wondering what I'm going to do to not have a heart attack when I'm old.’ The things that are important to them, we can use the evidence to say, ‘Oh, let's try it this way. Let's go to this person. Have you thought about physical therapy? What about a myofunctional therapist? That might meet your needs,’ all the tools that we have available to us. And so, it's evidence-informed, not necessarily limited to evidence-based. Not bad, not ignoring the evidence, but thinking about it as well.” (14:45—16:17)

“What they're learning in science now is that what we have to do is a risk-based assessment. So, somebody can have a lot of apneas and hypopneas, but they don't have much cardiovascular effect at all. They don't have that gene that Bale and Doneen talk about. They don't have problems with their heart. So, their cardiovascular risk is really low. But somebody can have a few events and have a brittle heart health issue, and their risk assessment is really high. So, instead of counting the

Unlocking Achievement Mastery: Decoding Goals and Targets

Episode #633 with Heather Crockett

Setting goals is easy. So, why is it so hard to achieve them? It’s because you're not setting SMART goals! To decode what they are, Kirk Behrendt brings back Heather Crockett, one of ACT’s amazing coaches, to help you master the goal-setting process. Don't just set goals — make them happen! To learn everything you need to know about setting and achieving your goals, listen to Episode 633 of The Best Practices Show!

Episode Resources:

• Send Heather an email
• Join Heather on Facebook
• Follow Heather on ACT’s Instagram
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for ACT’s To The Top Study Club (October 20, 2023)

Register for ACT’s To The Top Study Club (October 27, 2023)

Read Atomic Habits by James Clear

Read Scaling Up by Verne Harnish

Main Takeaways:

Understand the difference between a goal and a target.

Reflect on why you have the goals that you have.

Know how to create SMART goals and targets.

You can measure, track, or rate anything.

What gets measured gets improved.

Quotes:

“Goals help us because goals are statements that are more tangible that are going to help us to achieve that outcome.” (5:20—5:27)

“It’s better if [your goals are] meaningful. So, if it's something that means something to you, or if you think it's something that you should do, there's a difference there. I ask a lot of my clients, my new clients, especially, when they come on with me, ‘Is this something that you think you should do just because it’s the status quo, or is this something that is meaningful to you and is going to ultimately bring you that better practice and that better life?’” (6:01—6:27)

“If you don't have that direction, and you don't have that vision, and you don't put words to it and write it down somewhere, you're going to end up somewhere else. And that somewhere else may be completely off track of where it is that you truly want to be.” (7:34—7:48)

“A goal is a statement, a specific statement, that moves you closer to a larger future outcome. Like I said before, an outcome is more intangible. An outcome is more of an emotional, ‘This is where I want to be.’ A goal is a statement that helps you to get there. And it could be multiple goals that help you to attain one specific outcome.” (9:00—9:25)

“Tangible results are something that's easier to achieve in a timely fashion, where an outcome, we're not sure exactly how long it's going to take us to get to that outcome. But by giving the goal that statement, that specific statement . . . that will give us a better time frame. And goals could take a quarter. They could take a year. They could take a little longer than a year. But I would say no more than two or three years, at most, for a specific goal.” (11:04—11:37)

“In the brainstorming exercise that I work my clients through, it asks them, ‘Are you doing this goal because you think you should do something like this, or are you doing this because this is what you really, truly want?’ Because you're going to have more motivation and inspiration from yourself and where you want to go, versus where you think you should go based off of the status quo.” (12:17—12:38)

“When you start with the why, you're going to get your team on board a lot quicker.” (14:04—14:08)

“A target, it's that hard data. It's going to take it and make it black and white. It takes the subjectivity out and makes everything objective. It gives us evidence and proves to us whether we are on track or off track with achieving that statement goal that we set.” (14:21—14:38)

“Whatever you're measuring gets monitored. What gets monitored gets attention. What gets attention gets action. And what gets action is going to get you the result that you need, which is achieving the goal that you set, that statement goal. Those targets help to take that emotion piece out of it to say, ‘Okay, if our goal is to have 100 patients, then we're going to report on that every single week.’ If we need to get 100 patients in three months, great. Then, we're going to break that down into a monthly number. And then, we're going to be able to have great discussions and conversations as a team. When that number is off track, we're going to put some countermeasures in place. What action could we take today, rather than waiting three months, then looking at the number to go, ‘Oh, okay. This hasn't changed at all.’ So, we need to have a system, a process in place, to report on where we are with our targets, and then give space for those countermeasure conversations to occur.” (15:45—16:43)

“We have a scorecard in Google Sheets. If our goal is 100 patients and we're not there when we need to be, then it's going to show up red. Red does something to me. That drives me crazy. I'm a competitive person. I want my number to be in the green. Green is comfortable. Green means that we're doing great. So, having those colors associated with it helps to give us that motivation as well.” (17:52—18:17)

“A SMART goal means that we're going to make it Specific, Measurable, Attainable, Relevant, and Time bound. That's what a SMART goal means. Now, we're talking about goals and targets. So, the smart piece of things does affect both your goals and your targets. As we dive into specific, what is it exactly that we want to do? We need to better define — for example, you said, ‘What I mean by a healthy culture, a healthy company,’ and then you started listing off core values, core purpose. You have to define what “better” looks like. So, that's the specific thing. For example, if you say, ‘I want to be a better runner,’ well, what does “better” mean to you? And that's where it's smart. If you take all of your goals and targets through this SMART process, you'll be able to get more specific. You'll be able to get to that measurable piece, and you'll be able to get to where it's attainable.” (20:29—21:29)

“Let's talk about the “M” now in [SMART goals]. “M” stands for measurable. This is where your target associated with your goal comes into play. So, this is how you're going to ask yourself, ‘How am I going to track my progress to achieving my statement goal?’ That's your measurable piece. This is your KPI. This is your number. For example, if you wanted to run a marathon three months from now, how fast do you want to be able to run that marathon? How much training are you going to do now? How many miles do you need to run every single day? That's your measurable piece.” (24:18—24:56)

“I have clients tell me all the time, ‘Well, that's not really something that we can measure or track.’ Yes, it is. You can measure, track, or rate anything.” (25:53—26:01)

“Don't give me any excuses or reasons why you can't track something — everything can be tracked.” (26:26—26:33)

“The next one, “A” [in SMART goals] is for attainable. So, is this really, truly realistic for me and my practice now? Do I have exactly what I need? Does my team have what they need in order to achieve it?’” (27:10—27:23)

“Now, this is where you could get into a little bit of a trap. If you did $1 million last year, you say, ‘Okay. Well, I'm just going to set my goal for $1 million this year because we've done it before.’ I would say, no, you've still got to push yourself. So, with this, attainable, you can end up in that trap. This is where a coach could really come in and help you to set that attainable goal, push yourself, and challenge yourself the right amount and not go too far that you fail so hard that then your team also loses trust in you because you set this wild, crazy goal as well. So, there is a happy medium in there, and a coach can really help you with that.” (28:25—29:01)

“[The “R” in SMART goals is] Relevance. Does this really, truly matter to me? Is this where I want to go? This goes back to setting those meaningful goals. Am I doing this for me and the practice, or am I doing this because I believe that society thinks that I should? So, this comes back to the “why” in your goal statements. Is it truly relevant to me, and who I am, and where the practice is going because this is who we are?” (30:50—31:17)

“If you want to achieve something within a certain time frame, you have to ask yourself the question, ‘What is it about my life that I need to change in order to get there?’ Because oftentimes, these goals and targets, they're going to require your time and your attention. So, what in your life do you need to remove, change, or modify in order to focus on these goals? Be smart and keep in mind just how realistic and attainable is it within that time frame.” (33:28—34:00)

“I have a client who, they have a target to do $1.5 million production for the entire year. Great. So, then we have to know that first quarter in, we need to be X amount. Second quarter, we need to be X amount. And I would bring out the math . . . We had a conversation just this past week to say, ‘Okay, we are not on track to reach this by the time frame that we have set. So, what countermeasures do we need to put in place to make that happen within this same time-bound time frame that we have put on us?’ And it is achievable. It is totally achievable. Because we are tracking that target in order to get to that goal, we will get there because we're having the right conversations, because we set SMART goals, SMART targets, in order to get there, and we're having the conversations around those countermeasures when we need to.” (34:32—35:31)

“Understanding the difference between the goal and the target will help you to achieve more because you'll be able to separate the two things, have your statements, and then have your KPIs and your metrics that you will report on weekly, monthly, and then be able to set great countermeasures in place for that. Make sure that you are making both your goals and your targets SMART goals and targets so that they are time-bound, they are realistic, and they are specific. This will help to give you and your team direction and purpose. If you have the right team members on your team, they're not going to want to just come in and punch a clock, punch in, and punch out. They're going to want to be part of something bigger than themselves. Setting those meaningful goals and targets will help you to get there. And by doing that, you will have mastered that process of achieving those goals and targets.” (35:54—36:43)

Snippets:

0:00 Introduction.

2:30 Why having goals and targets is important.

5:29 What to understand about achieving goals.

8:47 Goals, explained.

10:58 A good time frame for goals.

12:07 Reflect on why you have the goal.

14:11 Targets, defined.

14:40 What gets measured gets improved.

17:49 Use colors to simplify countermeasures.

20:09 SMART goals, explained.

35:50 Last thoughts.

37:53 More about ACT’s To The Top Study Club.

Heather Crockett Bio:

Heather Crockett is a Lead Practice Coach who finds joy in not only improving practices but improving the lives of those she coaches as well. With over 20 years of combined experience in assisting, office management, and clinical dental hygiene, her awareness supports many aspects of the practice setting.

Heather received her dental hygiene degree from the Utah College of Dental Hygiene in 2008. Networking in the dental community comes easy to her, and she loves to connect with like-minded colleagues on social media. Heather enjoys both attending and presenting continuing education to expand her knowledge and learn from her friends and colleagues.

She enjoys hanging out with her husband, three sons, and their dog, Moki, scrolling through social media, watching football, and traveling. 

6 Keys to Masterful Strategic Planning with the Better Practice Blueprint

Episode #632 with Miranda Beeson

You can have a better year by doing one simple thing: planning. There's an effective way to do it, and Kirk Behrendt brings back Miranda Beeson, one of ACT’s amazing coaches, with six best practices to set you and your team up for success. Don't wait until December or January! Now is always the time to plan. To learn the recipe for a better year, listen to Episode 632 of The Best Practices Show!

Episode Resources:

• Send Miranda an email 
• Follow Miranda on ACT’s Instagram 
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for ACT’s To The Top Study Club (October 20, 2023)

Register for ACT’s To The Top Study Club (October 27, 2023)

Get your free copy of ACT’s One-Page Strategic Plan

Read Start with Why by Simon Sinek

Read The One Thing by Gary Keller and Jay Papasan

Main Takeaways:

Don't wait until December to start planning for next year.

Take time to form your core purpose and core values.

Revisit your core values and core purpose often.

If you fail to plan, you're planning to fail.

Celebrate your achievements.

Quotes:

“If you don't have a plan and you're not intentional about how you're approaching this upcoming year or each year that you enter into, it's going to look just like the last — maybe even a little bit worse. So, this time of year is the perfect time to be looking at it because summer has come to a close and we're coming to fall. Why wait till December 31st to try to plan out what we're doing next year? Let's get a head start on it now so we have the time that we need to strategically and intentionally plan for what we want to do next year.” (2:29—2:59)

“If we don't reflect backwards into the year that we're in so far and see what's going on, we can't really provide clear direction for what we want to do next year. That's what our team needs from us as leaders. For the practice owners listening, that's what the team needs. They need to know what you want from us this year that's new or different from last year, and how we can help you get there. So, if you want to bring your practice to the next level, if you want to elevate, if you do want to grow — and who doesn't want to grow — you really can't wing it. You can't shoot from the hip if you want to be truly successful.” (3:00—3:31)

“Don't wait till January. Some people wait until it is the new year to start setting goals. They're like, ‘Let's just get through this year, and then we can get there.’ And now, it's January. Then, it's February. Then, it's March. And now, you've lost an entire quarter and haven't even had a good start. So, certainly, the time is now.” (4:39—4:58)

“Step number one is, if you don't have one, make a core purpose. What is your “why”? Now, if you already have a core purpose, like a lot of the clients within our coaching community might already have that in place because they've worked with a coach to develop one, then revisit it and make sure that your why is still true to the core of who you are.” (5:05—5:23)

“Distrust has become society's default emotion, which means as leaders, as business owners, in our strategic planning, we have to think about how to build trust with our team and with our clients intentionally in order to overcompensate for that default emotion that they're already feeling. And so, knowing your why, sharing your why, keeping it at the forefront, and making sure that you're using it to guide decisions so that your team doesn't flounder, they can help you drive forward to the mission that you're trying to accomplish.” (9:04—9:36)

“Step number two coincides a little bit with that first one, which is either making or revisiting your why or your core purpose, and that is revisiting your core values. So, again, if you don't have core values, you certainly need to establish them within your organization for a lot of the same reasons that we were talking about with our purpose. But if you have core values, you want to revisit them every year. Another great quote I picked up at Global Leadership Summit is, ‘They're not just hanging on the walls. They're alive in the halls.’ We want to make sure that the core values truly do speak to who we are, what we believe in, and how we behave in this practice. And so, if you already have a core purpose established, our number one, and if you already have core values established, part of your strategic plan, right from the jump, should be reflecting on what you already have and making sure that truly does fit where you are.” (10:44—11:36)

“If you're forming for the first time your core purpose or your core values, please take your time. Please do it thoughtfully and really think it through. Be reflective. Look in the mirror. We say that's the final test with all these things. Look in the mirror. Do you also model these behaviors? Do you truly believe in this why? So, if you're starting from scratch with your number one and your number two, that core purpose and core values, really take the time to thoughtfully think through these. Don't just go online and Google what someone else's core values are, or, ‘Hey, I like that practice. Let's see what their purpose is.’ This should be true to you and who you are as a business owner and what you want to leave as a legacy when you are all done here on this earth. So, looking at it thoughtfully and designing them uniquely to who you are, because then you're reflecting your true self to the team and you will find those people — or those people will find you — that believe in those same things, and you'll be off to a great start. So, modify them if you need to. If you're reflecting and you're going, ‘I don't know that this really is who we are anymore,’ okay. Stop and go through that process again, and thoughtfully modify what those core values are, and then share that with the team.” (13:37—14:50)

“Step number three is reflecting on, what do we do here? So, really getting clear around what your core competencies are in the practice. We have a differentiation tool that we work with for our teams, looking at what are our uniques, what are our unique abilities, and what differentiates us from the guy down the street.” (16:43—17:03)

“You have to stand out because there are a lot of dental offices as you drive down the road. Patients are driving down that road, and they're going to drive past you, or going to drive in your front door, and you have to know what it is that is unique and special about you. What do we do here, and how do we do it that sets us apart? And then, how do we make sure that that message is getting out to those patients so that they'll choose to come see us?” (17:29—17:53)

“Part of your strategic planning when you're stopping and you're sitting down and you're looking at, ‘What do I want next year to look like?’ you're looking at, ‘What do we do now really well? What could we maybe not do anymore? What else could we do? What could we introduce that would bring a new passion or innovation into the office?’ And then, again, not only are you setting yourself up to look attractive to potential patients, as long as your marketing coincides, which we just mentioned, but your team too. It's really great for your team to also be on board with, ‘You know what? This is what we do really, really well here.’” (19:39—20:13)

“If you aren't the implant king, that's fine. If you do really solid general dentistry, your one thing may just be the patient experience. It might be how we treat people here is the one thing. That's what we do. We have a different experience than what you're going to get down the street. So, it might be, ‘I do great crowns. I do great general dentistry. I refer out all my endo. I refer out all my oral surgery,’ the flashy stuff that gets talked about more often. But your thing that you do well that sets you apart could be how you treat people and how people feel when they leave your practice. It could be as simple as that. So, I wanted to put that out there. There doesn't have to be some flashy, new thing that's going on in dentistry. It can genuinely be just doing a really good job with some general dentistry but treating people exceptionally well so that that experience stands out.” (20:56—21:46)

“Step number four is, how do we know if we're successful? What are we going to measure? How are we going to measure it? You have to start by looking at where the data is coming from now, reflecting backwards. Now, the facts reflect the past, not the future. But if we don't look at the past, then how do we know? Like you said, you're just lofty goals, just throw them out there and see what happens, versus using the data that we do have and then seeing where we can grow from there. So, step number one for how we will succeed is, let's look at how successful we were within this calendar year. Now, if it's October and you're planning or starting your strategic planning, you're going to have three quarters. You're not going to have a full year. That's okay. We can make some predictions. But that's the first step, is really looking at what we've accomplished so far — SWOC. Strengths, weaknesses, opportunities, challenges. What can we look back at that went well or didn't go well so that we can start setting new goals and targets for the upcoming year?” (22:21—23:24)

“You have to stop and celebrate what you have accomplished. So, you have to measure progress by how far we have come from where we were. It can't just be, ‘But we're not here yet.’ Yeah. But we're here today, and it's not where we were two quarters ago, one quarter ago, three quarters ago. So, yes, there is something to be said about progress and being able to celebrate that along the way. If you aim for perfection all the time, you're going to be disappointed. So, you have to aim for small, incremental improvements.” (25:20—25:51)

“Something I heard recently at a presentation that I was at, they talked about the one percent rule. There was a graph, and it said over the course of the year, if every single day you improve by one percent, then you're going to end up 37.78% improved with that one percent each day, where the opposite was, if you aren't, then you're actually going to be like at zero to 0.3. You gain maybe three-tenths of a point of growth by not taking that — reading a book for ten minutes a day, every day. You don't have to read, say, 37 books. But if you read ten minutes a day, you're going to be that much further along.” (25:52—26:31)

“When you're setting goals, it is really, really important to think about progress. Look at where you were. Think of where you want to go, because you need to have that bar out there for where, ideally, you want to be.

The Role in a Marketeer’s Journey into the Age of AI

Episode #631 with Dr. Christian Coachman & Brendon Macdonald

AI is the future of marketing. To help you get ahead of the curve, Kirk Behrendt brings in Dr. Christian Coachman and Brendon Macdonald from Digital Smile Design with strategies for leveraging its power in your dental practice. Increase your literacy in the most exciting and transformational technology of the century! To learn how AI can boost and grow your business, listen to Episode 631 of The Best Practices Show!

Episode Resources:

• Join Dr. Coachman on Facebook 
• Follow Dr. Coachman on Instagram 
• Learn more about Digital Smile Design 
• Subscribe to The Best Practices Show podcast
• Join ACT’s To The Top Study Club
• See ACT’s Live Events Schedule
• Get The Best Practices Magazine for free!
• Write a review on iTunes

Links Mentioned in This Episode:

Register for Brendon’s DSD course (November 2023) 

Register for DSD courses

Main Takeaways:

Learn to leverage AI.

Have the beginner’s mind.

Focus on building your brand.

Master the strategies to earn trust.

It’s now possible to insource marketing.

Quotes:

“Right now, you will feel overwhelmed, and you will feel that it's too much, the AI movement that's coming towards us. But the reality is everybody is in the same position. If you're thinking about it, you're ahead of most people already.” (9:32—9:49) -Brendon

“Marketing is not medicine. Marketing is food. So, it’s a little every day, feeding, feeding. It's not a magical medicine, and people treat marketing as medicine. ‘I'm going to pay. I don't care about paying a lot right now. I'm going to take this, and I want a solution.’” (14:44—15:03) -Dr. Coachman

“Dentists do make good money. But there's a lot going out, and they only have a small percentage that they can allocate to their marketing budget in order to be sustainable. The good news is, now with AI and the right systems and processes, 100%, you can do everything that is needed to benefit. That's what I'm really excited about. I can say that with complete authority because the moment we're in right now is that no longer do we have to eat the fish — we can actually build the net. This is the problem that most dental offices have, is that they were just catching fish and eating the fish. They were paying fish by fish, which is their marketing tactics, whereas the net that you can build is the brand, the culture, and the trust.” (15:16—16:08) -Brendon

“The exciting position we're all in as small business owners, as dental clinic owners, is that it is completely possible now to do it on your own, to insource your marketing. That's my new message. That's the new thing I believe, is that you no longer have to outsource your marketing efforts. That's the key for me, and that's the exciting piece.” (18:12—18:33) -Brendon

“Insourcing your marketing, even before AI, was already the most powerful thing or the most efficient thing to do. It was financially not feasible for the huge majority. But if you see the doctors that are really killing it on marketing, they have a mini agency inside their practice — at least one person. They have a videographer. They have a schedule every week. They know how to generate content in a bunch so they can spread through six months. They have a system.” (18:34—19:10) -Dr. Coachman

“In order to insource your marketing, you need to have a full-time content manager. That's someone who takes control of the content creation, the writing, the social media updates, interviewing your subject matter experts, your patients. You, as the owner, or the manager, or the dentist cannot be doing that, and you shouldn't be bothered with that. That's why you pay that individual what you need to pay them, their full-time salary . . . And they need to be able to leverage [AI] because then it's going to make them much more effective. They're going to produce much more content, and they can keep the quality.” (19:18—20:04) -Brendon

“The reality is more and more people are going to learn, ‘Write me a blog post about smile makeovers. Write me a blog post about the cost of dental implants.’ And then, the machine is going to produce blogs, and maybe I can do one a day very, very easily, very quickly. The reality is the quality won't be that great.” (20:12—20:29) -Brendon

“If you had a choice, you would focus on the quality. So, you do the quality. But obviously, if you can do quality with quantity, then you're leaps ahead of the competition. I think we have about 12 to 18 months of first-mover advantage, especially in the dental industry. What I see is when I'm talking about it, people are completely overwhelmed, and then find reasons not to do it. So, they don't want to embrace it for bigger questions and bigger reasons. But you have to be pragmatic and realistic. I think we can't solve the big existential question — which, there is. But in the meantime, in my dental clinic, I need to get somebody who can leverage and take advantage of it while there is still the first-mover advantage.” (20:47—21:36) -Brendon

“Marketing agencies are almost like lawyers. Everybody always complains about them. People usually hate lawyers and marketeers because they always feel like they're paying too much and not getting the results.” (21:57—22:11) -Dr. Coachman

“What normally happens is because you have a problem, you go search for a provider. The provider presents a solution. And then, in your head, you mentally tick that off and you move on. ‘I bought the solution. All my problems have gone away.’ The reality is that the work has just begun. It’s a joint venture. It's a partnership. And then, the challenge is that the parties start to point fingers at each other, saying, ‘Hey, we need this information from you,’ and you're saying, ‘Well, I'm paying you. Why should I do extra work? You should know this.’ And so, we get into this balance, and it's a cycle that is constant.” (22:41—23:26) -Brendon

“Usually, people reach for marketing when they are feeling a problem. ‘Oh my God, things are not as easy as it used to be. I'm not getting as many patients as I used to. My word-of-mouth is not as good as it used to be. New practices with younger people are opening down the road. I feel the pressure. I feel the competition. DSOs, cool new practices with new architecture and new technology. I need new patients. I have a problem,’ when we should say, ‘I don't have a problem. I'm already doing very well. Let me find a marketing strategy to continue not having a problem, long term.’” (23:33—24:16) -Dr. Coachman

“I had a conversation with a doctor on the weekend, and that was the exact conversation I had. He's like, ‘I've never needed marketing. I am doing extremely well. We've been in business over 50 years. Word-of-mouth is strong. I'm so busy that I don't even want to think about adding more people.’ And I said to him, ‘This is the time you need to double down and find different strategies, different sources of patients, because you have the flexibility, the bandwidth, and the cash flow to be able to deal with it. When the cash flow is tight, then it's a vicious cycle because then you cut, you can't try, there's too much pressure on a situation. You don't give it enough time for it to play out, and so you stop things before they get started. And so, for anybody listening, I think if things are going really well, then I encourage you to double down on understanding how to insource your marketing and how to leverage the artificial intelligence. Now is your opportunity because you're best placed because you have the bandwidth.” (24:17—25:22) -Brendon

“The main currency of any business is trust — the ability to earn trust. I earn enough trust from you to give me your hard-earned money to do your service. In a digital world, we need to have signals, and entities, and environments that demonstrate and earn this trust without having met us in person because, obviously, it's easier for most dentists to earn the trust of the patient. But to get their attention, first of all, is a big thing. To then keep their attention and earn their trust to get them to walk through the door is many obstacles and hurdles to clear. And so, it comes down to answering the questions that everybody has, the very basic questions, the five topics that every prospective patient has that almost no dentist talks about online. That's the way you're going to get someone's attention.” (26:51—27:52) -Brendon

“When we're searching for information online, what happens when you get to a website, and you can't find the information quickly? What's the F-word of the internet? I always call it the F-word of the internet. It's frustration. You get frustrated. Do you think, ‘Oh, no. This is a value-based business. You know what I'm going to do? I'm going to fill in the contact form. I'm going to wait for them to email me back. I'm going to call them, and I'm going to let them explain to me all the things that I want to understand’? No, you're not going to do that. You're going to jump to the next place within a few seconds. And so, that's what we have to do. We have to develop that environment. And it's a very simple marketing strategy — just answer the questions. I wish it was more complicated than that, but you have to talk about the topics that no one wants to talk about.” (27:52—28:43) -Brendon

“It's very hard to find truthful reviews, truthful information about the considered purchase that I'm having, because everyone has a vested interest. Everyone has a horse in the race. So, you're always, when you're reading something, trying to understand how much of it is weighted towards the provider and how much is actually useful, truthful information. So, that's the challenge.” (31:03—31:29) -Brendon

“To earn trust, you have to talk about things that no one else wants to talk about. You have to show things that no one else wants to show. And you have to sell like no one else wants to sell. That's how you earn trust.” (31:33—31:47) -Brendon

“[How you earn trust is] admitting, ‘I'm here to sell to you, to convince you,’ admitting that and being straight to the point . . . It's not only being transparent but saying exactly what people want to know, not having a strategy behind — like in the past, saying, ‘Let's not mention the price right now so that people will be curious and enter a funnel, and then they're going to ask a second question, and then we're going to do this, and then we're going to twist everything around, upside down, because I'm scared to tell my price.’” (31:47—32:20) -Dr. Coachman

“How many dental websites have you come across that have a pricing page or talk about their competitors? None. And how many of your prospective patients want to know those two things, how you compare to your competitors and what your prices are? So, think about it. You have all these individuals who are trying to understand who they can trust. Two key things. There are three other topics, but we'll focus on that one. ‘How much will it cost me to get this dream smile or this treatment done with you?’ ‘Oh, it's very complicated. It depends. You need to come in. Because it's biology, it's impossible for me to tell.’ And I don't want to scare you away. I want to make sure that you're in my office so I can convince you that I'm the right person. That's not going to interest.” (32:24—33:14) -Brendon

“What's the most searched-for term on the internet in the dental industry? What would you guess is the most searched-for phrase in Google, at the moment, as a patient? If you had to guess, what would you think it would be? . . . ‘How much does a dental implant cost?’ . . . You need to understand why — because no one talks about it . . .  No dentist gives a clear answer. And they have a justified reason. They say, ‘Listen, everybody is different. We don't know what's going on in your mouth. We cannot give you a cost because we have no idea.’ But the reality is that me as a prospective patient, I can afford to have this treatment. But I do want to know the range. I don't want to be embarrassed. I don't want to go down this path where I am in front of you, and you tell me a price that if I had realized, I wouldn't have gone down this route. And then, you burn any opportunity in the future because I'm too embarrassed to come back to you . . . So, it might be, ‘I'm going to save this money, and then I'm going to come to you in two years’ time,’ which happens with DSD treatments.” (33:28—34:46) -Brendon

“We can easily defend the dentist and say, ‘Look, every treatment is customized.’ But it's very easy for you to take a few examples and say, ‘Look, I don't know exactly how much your treatment will cost because there are some variables. I can give you a range. But what I can say, and I already have it on my website, check this case from A to Z. This lady, Mary, came to us with this problem, this problem, and this problem. We did six implants, a full-implant arch on the top, some composite extractions on the lower, plus a bridge. Her treatment cost exactly this.’ Boom, you solve the problem.” (35:02—35:41) -Dr. Coachman

“You can talk about the variables that add cost — you don't have to talk about the exact treatment — so that when you are speaking to your patient about all the elements that you have, your website has already spoken about that. If you have this, it's X. If you had this, this is the range. They have an understanding, so it's not a big shock. You could say, like, ‘Your mouth means you need these three variables. As you know, these variables add costs.’” (35:43—36:05) -Brendon

“One of the reasons why aligners became a revolution in dentistry is this: because, suddenly, ortho had a very clear range that was actually promoted by the companies that, ‘This treatment costs from here to there.’ Everybody suddenly felt comfortable, ‘When I have this money, I'm going to do it.’ There's no embarrassment. There's no anxiety. There's no barrier. I have the information, and it's on my priority list, and I'm going to do it.” (36:09—36:38) -Dr. Coachman

“Trust is going to become the most precious thing. So, everything that you can learn about generating trust is going to be extremely precious and something really valuable to learn.” (54:04—54:20) -Dr. Coachman

“One of the things that I think is very powerful to generate trust that I always share is to express passion — true passion. It's not that easy to demonstrate true passion because you can sound fake, and you can sound arrogant. There are many mistakes that you can incur when trying to express passion. But this happens naturally when you're really passionate. When you practice your speech with passion, people immediately trust you because the brain works very simple. They see you demonstrating or explaining something with passion, or talking about dentistry with passion, talking about the reason why you do dentistry with passion. People listen to you and they say, ‘I don't understand what he's saying, but I can see that he's very passionate about it. That probably means that he does that a lot because he loves it. If he does it a lot, he probably does it very well. And if he does it very well, I probably should trust him.’ So, maybe that's a good way to start when you start generating content, or when you're starting to fine-tune the content that AI is giving to you. That is the one thing that AI cannot give you. Passion, zero. AI will give you great content with zero passion. So, you need to master the process of putting your touch and translating it into your passion with your passion.” (54:26—56:06) -Dr. Coachman

“There's one skill that you will need, and that's what served me in where I've got to, is this beginner's mind, this idea of being obsessed with learning, because I do think with the advent of the technology wave that's coming our way and everything that's changing, you need to have an ability to learn quickly. I think if you can master that skill, you have a skill that will take you as far as you need to go. And then, finally, to build your brand in your dental office, just be obsessed with the questions that your patients are asking. Just start there. It's not complicated. It's very simple. Every question you hear, ‘Let me answer it,’ and then you go from there. It will take you places that you'll be surprised.” (57:07—57:53) -Brendon

Snippets:

0:00 Introduction.

3:55 Brendon’s background.

7:02 Take advantage of being an early adopter.

13:14 Marketing is food, not medicine.

16:32 Be the most trusted voice in your space.

21:36 Mistakes to avoid in marketing.

25:42 Avoid the F-word of the internet.

36:39 Brendon and Dr. Coachman’s journey.

43:28 The three pillars of Digital Smile Design.

50:46 Last thoughts.

57:55 More about DSD.

Dr. Christian Coachman Bio:

Combining his advanced skills, experience, and technology solutions, Dr. Christian Coachman pioneered the Digital Smile Design methodology and founded Digital Smile Design company (DSD). Since its inception, thousands of dentists worldwide have attended DSD courses and workshops, such as the renowned DSD Residency program.

Dr. Coachman is the developer of worldwide, well-known concepts such as the Digital Smile Design, the Pink Hybrid Implant Restoration, the Digital Planning Center, Emotional Dentistry, Interdisciplinary Treatment Simulation, and Digital Smile Donator.

He regularly consults for dental industry companies, developing products, implementing concepts, and marketing strategies, such as the Facially Driven Digital Orthodontic Workflow developed in collaboration with Invisalign, Align Technology.

He has lectured and published internationally in the fields of esthetic and digital dentistry, dental photography, oral rehabilitation, dental ceramics, implants, and communication strategies and marketing in dentistry. 

Brendon Macdonald Bio:

Brendon Macdonald is the Founder and CEO of Yello Veedub Inbound Marketing Agency, a Gold Certified Hubspot Partner. Prior to starting Yello Veedub in 2015, Brendon was involved in several social media consulting and management businesses focusing and specializing in the global dental sector.

Brendon has extensive experience in digital marketing strategies in the B2B & B2C healthcare and e-commerce sectors. He has a Bachelor of...