The Best Practices Show with Kirk Behrendt

Uche’s Top 10 Favorite Books of All Time

Episode #630 with Dr. Uche Odiatu

When you read more, you know more. With more knowledge, you can help patients beyond their dental needs. To get you started on your learning journey, Kirk Behrendt brings back Dr. Uche Odiatu, one of ACT’s favorite health and wellness gurus, to share his ten favorite books that have kept his mind open, challenged, and engaged. Readers become leaders! To learn from some of the best minds in the world, listen to Episode 630 of The Best Practices Show!

Episode Resources:

• Join Dr. Odiatu on Facebook
• Follow Dr. Odiatu on Instagram
• Learn more on Dr. Odiatu’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:

Read The Diet Myth by Tim Spector

Read Exercised by Daniel E. Lieberman

Read Outlive by Peter Attia

Read Spark by John J. Ratey

Read The Clever Gut Diet by Dr. Michael Mosley

Read Clean by James Hamblin

Read Younger Next Year by Chris Crowley and Henry S. Lodge

Read Aging Well by George E. Vaillant

Read The 48 Laws of Power by Robert Greene

Read The Body Keeps Score by Bessel Van Der Kolk

Read Think Again by Adam Grant

Read Traction by Gino Wickman

Read The E-Myth by Christopher Barrow and Michael G. Gerber

Read 

The Dental Hygiene Shortages & The Challenges Within

Episode #629 with Katrina Sanders

There isn't a shortage of hygienists. There's something else in short supply. Back to share her provocative thoughts, Kirk Behrendt brings back Katrina Sanders, The Dental WINEgenist, to explain the factors that contributed to this “shortage”, common barriers and pain points hygienists experience, and ways for you to navigate these challenges. Invest in the people who carry and represent your practice! To learn how, listen to Episode 629 of The Best Practices Show!

Episode Resources:

• Send Katrina an email
• Join Katrina on Facebook
• Follow Katrina on Instagram
• Learn more on Katrina’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 Katrina’s next Disease Prevention & Wine Tasting course (October 5-6, 2023)

Learn more about Katrina’s wine

Main Takeaways:

It’s not hygienists that are in short supply — it’s dentists who value them.

Know what your hygienists truly want from you and your practice.

Understand your hygienists’ pain points and create solutions.

Evaluate whether you're attracting the hygienists you want.

Offer new hygienists more than just a sign-on bonus.

Quotes:

“One interesting trend that I still don't understand today is around how dentistry looks at who the employable hygienists are. It seems as though you're not considered an “employable hygienist” until you have two years of experience. Well, that's really hard. Right? Because it's like, how am I supposed to get experience if nobody is going to hire me because I'm a brand-new grad fresh out of hygiene school?” (5:14—5:37)

“I had this viral post go out. I posted this a few months ago and I said, ‘Just a heads up, there's no shortage of employable hygienists. We are there. We have the skills. We've gone to hygiene school. We've passed the boards. We have the licensure — we're there. We are licensed and we are ready to work. There's no shortage of hygienists. There's a shortage of appreciation of what hygienists bring.’ And so, inside of that, it makes it a lot easier if I show up every day and I'm in a toxic environment, or I'm being treated like garbage, or the skills that I spent all of this time not just going to school but getting continuing education credits for, that all of that is being squandered inside of, ‘Just do what's on the Dentrix appointment book column for today,’ well, you know what? Opening that Etsy store where I'm making stickers and bookmarks and making the same amount of money working from home sounds really yummy and juicy right now for me.” (6:07—7:03)

“Hygienists, for a long time, have not felt the level or layer of importance around the value and worth of what it is they bring to their practice. As a hygienist, I am consistently told — I will go into practices. I see them all the time where their morning huddle begins with, ‘Here's what Katrina produced yesterday.’ That's a hard pill for me to swallow because what you're doing is you are quantifying, ‘This is the value of what you brought to our practice yesterday. Here's how much money you brought in.’ What you're not talking about is the patient who cried in my arms because she's going through a divorce and she's scared, and she's looking to me not only as her healthcare provider but as somebody who cares about her as a human being. What you're not taking into consideration is the patient who maybe did want to start scaling and root planing today but couldn't because they had to pick up their special needs son from school. And so, as a human, instead of driving home the bottom line of the business of the practice, I'm treating my patients from a humanistic standpoint.” (7:09—8:25)

“It really moved into this model where hygienists were seen as, ‘Here's how much production you're bringing into the practice, so here's the value of what you bring.’ It has created this really toxic narrative where hygienists truly only believe that what they bring to the practice is around money. Hence, where you start to see the sign-on bonuses and the, ‘Here's how much I'm going to pay you.’ It really started to create that narrative. And it's interesting because I've asked hygienists, ‘Has your doctor ever asked you, what do you need in order to remain happy here in this practice? Is that a question?’ That's where we have to start changing that narrative.” (8:26—9:11)

“You have a provider, or a series of providers, who are showing up every day, clocking in, putting on your branded scrubs, representing you, the core values of your practice. They are the mid-level provider of the practice. They are gathering, at a minimum, a dental hygiene co-diagnosis. They're taking intraoral photos. They're taking radiographs. They are single-handedly maintaining open relationships with the patients who trust you and have to come in every three, four, or six months — and you can't prioritize a chunk of time to sit down with that person and to make sure that they're happy. And here's the thing. Doctors will say, ‘I'm giving them everything.’ Well, that's everything to you. What do they want?” (12:07—12:53)

“I find, as many times as I ask a hygienist, ‘Has your doctor ever asked you,’ or not even doctor, has your practice owner, whomever that may be, ‘Has your practice owner asked you, what do you need?’ or, ‘What can I offer you? What are your professional goals? What are your clinical goals? How can I support that?’ Are these the conversations you're having? Or is it, your doctor is so afraid, we're in this fear base where it's like, ‘Here's how much more money I'll pay you if you continue to stay and don't go to the practice across the street’? So, the first piece I'll say is, the fear brain, the scarcity mindset, goes, ‘I don't have any more money to pay these people. I'm doing my best. I'm giving them everything.’ That's the fear, the scarcity mindset. The love is, ‘These individuals are representing me. They are bringing their clinical excellence every day.’” (12:57—13:49)

“One major piece that I don't think practice owners fully understand is, as much as they are working because they own the practice, and if we close a bunch of porcelain crowns, or cosmetic work, or whatever that may be, that they as the business owner are going to benefit from the bottom line of what that is. What I don't know if they fully understand is that you also have team members who are dying to pee but don't so that they can bring that next patient back on time. They are starving. Their stomachs are growling in their patient's ears because they are just dying for a handful of almonds. And they're not going to do it because they're going to make sure that they bring your patient back. They are going to wipe down all of the pieces of equipment in the operatory. At the end of the day, they're going to take the trash out. They're going to make sure that their instruments are wiped down. They are going to help you by anesthetizing that patient when you're running behind. These are people who really do care about you, about your patient population, about your practice.” (13:50—14:46)

“The fear base is, ‘Oh, they only want more money, and they only want this, and they only want that.’ The love space, I think, really carves open the space to have a conversation about, ‘What does this look like? What does your dream practice look like? What does your dream job look like? What does your dream patient experience look like? How can I help facilitate that for you? Because here's the thing. When you facilitate that for your hygienist, what you're doing is you are facilitating clinical excellence for your patient population. Does that not matter to a practice owner? Of course, it does, because clinical excellence gives clinical outcomes. And clinical outcomes mean you have a happy patient population. That's marketing you simply cannot pay for.” (17:02—17:45)

“Are you a magnet attracting people in which their motivator or their core values are perhaps not in alignment with what you want?” (18:57—19:07)

“Let's say you don't have a hygienist or a hygiene team, and you're putting ads out there because you want to bring in a hygienist or hygiene team into your practice, and [your mindset is], ‘Nobody in my town wants to work. You don't understand.’ Well, take a look at what bait you're putting on that fishing hook before you're throwing it out there.” (19:54—20:12)

“If you're saying things like, ‘We pay the top amount of money. We give bonuses,’ what you're going to attract is a hygienist in which money is their motivator. So, there's where that fear base — if you're a practice where you can't pay top-dollar, you can't just throw a $10,000 sign-on bonus or whatever that might be, if you can't do that, what can you offer? What can you offer to a hygienist? Are you a practice where you, as the doctor, are going to support your hygienist when they sit down and they say, ‘I'm concerned about this area. I want Dr. Jones to come in and take a look at this. Dr. Jones, come on in,’ and Dr. Jones says, ‘Wow, Katrina. Thank you so much for pointing that out. That was excellent.’ That may be a terrific motivator for somebody. Do you offer continuing dental education as a team? Do you create opportunities for your hygiene team to select the products, the equipment, the protocols that they're using? What type of an experience is a clinician going to have inside of your practice?” (20:30—21:41)

“If you can't think of anything that gets you excited to write about in an ad, then I think we found the problem. You know what I mean? I promised we're going to get provocative here, so here it is. Start getting creative. Think about other ways to help people.” (21:42—22:01)

“If you can't write about something that you're excited about, that makes people get excited to potentially be a member of your team, then we've got some work to do in what that culture looks like in your practice, what you are offering to a team to help them understand the value and worth of what it is they bring to your organization.” (22:43—23:02)

“There are four major reasons, barriers, challenges, or pain points that nearly every hygienist — definitely in the country. I won't say around the world, but I'll say, at a minimum, in the country — will say or call out as major pain points or challenges that interrupt them or get in the way of them being able to do the level of care they want to. My first inclination or thought, if I'm a practice owner or doctor and I want to either attract a hygienist or I want my hygienist to be happier, I'm going to look at these four things and I'm going to think, what are ways that I can really trap or corral those four pain points into different segments so that I can start addressing how those things are showing up for my hygienist? If I can solve those four major barriers, then I am a delightful, wonderful, joyful place to work, and I'm going to be able to be a wonderful attractant for future clinicians to want to come and work with me . . . Those four barriers are time, fear, lack of support, and cost.” (24:40—25:54)

“Time is a big [pain point for hygienists]. I want you to start thinking, for practices where it's, ‘This is as much as I can pay my hygienist,’ can we get creative with time? So, this was interesting. There's a research study that was done by the American Dental Hygienists Association that looked at how often dental hygienists take and record blood pressure readings on their patients. In this research study, the most frequent reason why dental hygienists do not take blood pressure and record — which, by the way, this is starting to become a standardized protocol in dental practices across the United States. The most frequently cited reason why hygienists do not do this is because of insufficient time and minimal value given to this procedure by their employers. So, let's put the doctor hat on. Let's put the practice owner hat on. ‘I'm giving them everything they want. I bought them the little wrist cuff thing. I don't know what else they want.’ Well, we might need more...

How Dental Marketing Will Completely Change in the Years Ahead

Episode #628 with Dr. Christian Coachman & Brendon Macdonald

You're told you should outsource marketing. But in the near future, insourcing will be more advantageous. To reveal why, Kirk Behrendt brings in Dr. Christian Coachman and Brendon Macdonald from Digital Smile Design to talk about the upcoming revolution in marketing and how to get ahead of the curve. AI is changing the landscape of marketing — be an early adopter! For everything you need to know about leveraging AI tools, listen to Episode 628 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:

Listen to Episode 627 with Dr. Coachman

Register for Brendon’s DSD course (November 2023)

Main Takeaways:

Trust is currency.

Start to insource your marketing.

Your website is your number-one asset.

Word-of-mouth is the strongest form of marketing.

Generative AI will become the gold standard. Leverage it now!

Quotes:

“The clock model is a decision framework used when building brand. So, as we know, brand is not any one thing. It's not a logo. It's not a design. It's actually every interaction with your patient or your prospective patient. That's brand-building. As Christian has mentioned many times, it's about how you greet somebody. It's how quickly or how friendly you answer the phone. It's the waiting room. It's your social media. It's everything all together. Basically, it's a gut emotion that your patient has with an interaction with the brand. And so, the challenge you have is you don't have one brand — you have a brand every patient has. That's why the clock model really helps you understand which brand-building activities to tackle first, because it's about understanding which activities will give you the fastest return on investment. We all have finite resources. We don't have unlimited resources. So, for my $1,000, I need to look at the clock model and say, ‘Where will I invest my money to build my brand the most efficient and effective way?’” (8:25—9:37) -Brendon

“The most effective and efficient use of your money, initially, is going to be in the purchase moment. If you master that moment, you'll get great return and you'll build amazing brand with that. Then, the second moment to invest in is the post-purchase moment, after case acceptance, the treatment, how the treatment goes, the referral program . . . And then, finally, when you've mastered those two moments and everything is covered, then we can look at . . . the pre-purchase moment.” (9:44—10:21) -Brendon

“The clock concept shows that before you invest in marketing, you need to invest on that in-person moment where you are starting the relationship, starting the trust, building your plan, and presenting your plan. It’s in DSD what we call the first and second appointment. In Apple, they call it the Apple Store experience. That is our number-one inspiration.” (11:15—11:42) -Dr. Coachman

“Samsung, it costs $400,000 to build a store, whereas an Apple Store, it’s $18 million. That's how much they invest in that moment . . . That's the difference in how much they value the Apple Store experience. The idea of the Apple Store experience originated from Steve Jobs. He saw his initial iPod and iPhone inside Best Buy, I think it was. He said, ‘Oh my gosh, my beautiful products. I can't control the environment. It's being put next to other products. It's being devalued.’ He realized in that moment that, ‘I need to build my own experience, my own environment, so that I can position my product in the right light,’ which is what DSD does. It's about positioning yourself to the patient so that you can get the positive case acceptance. That's the key.” (11:44—12:33) -Brendon

“There are many people out there that can master the purchase moment and do bad dentistry. That's the reason why I always say, to deserve to benefit from the purchase moment, you need to be a good dentist first. Because if you have a great purchase experience, you're going to convince almost anybody to do anything. That's how powerful it is, and that's why I call it the magic . . . So, the first moment of the clock is marketing. The second moment is the magic. And the third moment is the treatment.” (12:47—13:25) -Dr. Coachman

“When we talk about the pre-purchase moments, there is actually a moment inside the pre-purchase moment that we aim for as businesses, and it's what we call the zero moment of truth. It's that moment when somebody who is anonymous who's been researching you, they’ve been trying to find out if they can trust you, whether you're the right individual and business to go and give their money to to have the treatment, they give us their information either in the form of an email, telephone number, or a message. That's the moment in the pre-purchase segment of the clock we are aiming for. That's the goal.” (13:55—14:34) -Brendon

“Everything you do in terms of communication, marketing, PR, social media, charity, word of mouth, anything that you do in this pre-purchase moment, your one goal should be to get information from people that you don't have information from — a contact.” (14:35—14:57) -Dr. Coachman

“Everything is about stages of intimacy. You have to earn trust to move one step further along the intimacy journey. The ultimate intimacy is that they come and schedule an appointment and they come into your office. But there are steps before that. The first major win for you in a pre-purchase moment is the individual makes themselves known to you in the form of an email address, telephone number, or something like that.” (14:58—15:25) -Brendon

“I think we are going to live through the biggest revolution of our time as individuals. It's going to be the most impactful thing that's ever happened. It's not just a technology innovation — it's an entire platform shift. It's going to produce so much economic value. It's going to produce so many changes in our lives because generative AI, which is what the hype — and what you guys might be feeling a little bit overwhelmed with, or that everybody is talking about, is this idea of large language models. Which, if we explain it in easy-to-understand language, is basically a very smart robot that has a brain that helps and speaks to us and understands how to answer our questions. It's basically going to be smarter, quicker, and faster than a human brain. So, anything relating to communication, computation, and creativity, generative AI is going to permeate, and it's going to basically influence everything. Technology is no longer going to be technology. It's going to be our interface to our lives. It's going to touch everything that we do in our life.” (16:27—17:40) -Brendon

“If you think about generative AI, it does language, it does computation, it does creativity, and it empowers individuals who use it to basically process, consume, and output content ten times faster, a hundred times faster. And so, the possibilities are huge, and the impact is huge.” (18:34—18:56) -Brendon

“As a small business owner, as a dental clinic owner, there are three truths that Kirk mentioned that we have to accept to move forward. The first truth, when it comes to our brand and promoting ourselves, is that we are going to have to insource our marketing. We're going to have to find a system where our own team generates all our pre-purchase marketing activities. So, I'm talking about blogs, social media updates, video content, production, creation, etc. You will not be competitive or sustainable if you continue to pay your agency to do those activities because your competitor or your office next door or down the road, if they insource, they have a huge advantage over you.” (19:30—20:18) -Brendon

“You need to find your stories. You need to develop your stories. You need to produce your stories. You need to edit your stories. And you need to share and spread your stories with your own team.” (20:19—20:33) -Dr. Coachman

“If I still had an agency, I would be finding a way to teach clinic owners how to leverage AI and coach them how to insource models. That's what I would be doing because that's the only future for you.” (20:40—20:53) -Brendon

“If we were to break down the practical marketing activities, if you're currently doing marketing and you're paying an agency, if you list what you should start to insource and what you should keep outsourced, I think the solutions at the moment aren't — some activities, you still need to outsource. Mainly, it's going to be paid media. So, if you pay Meta — so, Instagram, Facebook, TikTok, as well as Google Ads — then keep outsourcing that. Because, at the moment, the solutions aren't there yet for your team to manage that successfully.” (21:12—21:46) -Brendon

“I do think that, in the future, you will be able to tell Google, ‘I want this type of patient,’ and it will do it automatically. That's coming — 100%, it's coming.” (22:03—22:13) -Brendon

“The other one [to keep outsourcing] is setting up websites. At the moment, I would still pay someone who has know-how because of the technical aspects of the domain, getting the template up and ready, all that sort of stuff. Don't get your team to learn that, because you do it once, and then you optimize your website afterwards. But the rest needs to be insourced. SEO, local SEO, social media updates, blog post writing, video creation, email marketing, all the tactics that you might be aware of, that is done by an in-house individual leveraging the AI tools that are there, as well as the system. So, that's truth number one — insource. You have to insource your marketing.” (22:24—23:08) -Brendon

“The third truth is to leverage the AI tools that are available to you, because generative AI is about automation, augmentation, and acceleration, those three things. If you use them correctly, you accelerate your output, you accelerate your consumption, and reasoning and processing. And it's not hard, because that's what I've been learning, is trying to understand how to bring across this complex field to dental office team members in an easy-to-understand way, not because I'm smart, but because I understand the realities of running a practice. They're not agencies, and they can't sit down and write code, and be complex in the way that they process stuff. So, there is a way to make it super simple, and the tools are evolving so quickly that it's becoming easier, easier, and easier to do. So, I think those two truths match each other. You need to develop a resource dedicated to doing your content marketing, and leveraging it, and then you need to leverage the AI tools. You need to accept, adopt, and be excited by them, not fight them and put your head in the sand, which is the favorite form of marketing, right? Ostrich marketing. You put your head in the sand and pretend there's nothing that's wrong.” (23:18—24:36) -Brendon

“With the advent of cheap content creation, and the ease of the output that you're going to be able to do this with, and the tools that are going to help you do it, you need to have a sales and marketing strategy that, at its fundamentals, outperforms tactics. Your strategy always outperforms tactics. And so, the strategy you need to focus on from a sales and marketing perspective is this idea of becoming the most trusted voice in your space. You have to obsess about educating your patients. You have to obsess about transparently sharing the good, the bad, and the ugly of everything that you do. You have to compare. You have to talk about prices. You need to talk about the things that dentists don't want to talk about. You need to show the things that dentists don't want to show. And you need to sell like you've never sold before, which is just education.” (24:58—25:52) -Brendon

“Trust is going to become so important because of the volume that you're going to have. Everybody is going to be able to create stories. You press buttons, and there are stories. There are pictures, content, and millions and millions of things that you're exposed to.” (25:58—26:14) -Dr. Coachman

“Every interaction, you either earn a positive credit or a negative credit. Earning trust is about earning as many positive credits as you can. If you're answering questions, key questions you know that I have, an anonymous person, on every step of my journey, I'm getting more green, positive emotional credits so that zero moment of truth is much more likely to happen than if not. And so, you in your pre-purchase moment, you have to obsess about all the activities and tactics that you know will earn trust.” (26:21—26:55) -Brendon

“Eighty percent of the buying decision is made when they've filled in that form. So, the final 20% is just about understanding the details that you can share on the website, the specifics about my problem, my situation. It's, ‘I can trust you. You've shown me that you can solve my problem. You've shown me that I'm the right fit for you.’ Now, it's just about the specifics of what needs to happen, the next steps. And normally, it goes very quickly. And so, if that is the case that 80% of a buying decision is made before we even know them or they contact us, then how important do you think that pre-purchase marketing activities about earning trust is? It’s huge.” (28:06—28:48) -Brendon

“That is the currency of all business, is trust. Every business trades on trust. If I don't trust you, I'm not coming to see you, and I'm not going to give you money. Regardless of AI or anything, the currency of business is trust. And so, in the advent of this wall of information that's going to potentially flood us, yes, we need to demonstrate trust. Actually, our most important entity is going to be our website now. Your website is going to be your number-one salesperson.” (31:05—32:37) -Brendon

“It's about trust. I think that's the best marketing possible.” (34:31—34:36) -Dr. Coachman

“On the pre-purchase moment, you need to look at your website as your number-one asset because it's actually an employee that never sleeps, doesn't take vacation, and works for you 24/7. That's the reality. And so, how do I develop this website to become a really trusted advisor? Because that's what you want that person to feel when they go to the website. So, how do I do that on my website? What are the practical tips? Talk about the five topics that no one wants to talk about: cost, comparisons, the best of, problems with. Even though I sign up for orthodontic treatment, what could happen? This is what people want to know. They want to understand these things. Talk about those topics. No one ever wants to talk about the topics, and there are multiple topics on treatments that you can talk about.” (34:52—35:38) -Brendon

“You need to do a “culture of” video. You need to create video — more video than ever before. Ninety percent of all internet users, the only content they consume is video. In a week, 90% of the content they consume is video. So, as a business, you have to learn how to insource your video production because that's the way to win. It's about trust. I hear and see the team, and I start to earn a little bit more trust.” (35:39—36:07) -Brendon

“You need to build your website and think of a human, not think of search engines. And so, it's a bit of a challenge because everybody says, ‘What are the SEO tactics? What are the key words that I need to create?’ And it's like, no. Think about your patient. Think about what they want to know the answers to. And guess what? You will be rewarded by the platforms because, guess what? They're looking for trust indicators. Trust indicators are, I come back to your website multiple times. I stay on your web page, and I read for a very long time. I watch website videos. I share. I do all these things. And that's not an SEO tactic. That is, ‘I think about my patients. I think about all the questions that they will have in the journey to becoming my patients, and I answer those questions.’” (36:17—37:03) -Brendon

“It's funny because it's making us more human as we think about digital marketing, connecting to the things that really matter.” (37:03—37:11) -Dr. Coachman

“We get asked questions every single day by our clients and our patients. We're just not listening.” (37:21—37:26) -Brendon

“Learn how to listen. Learn how to understand which part of the journey the person is in, because it's not only about pre-purchase and purchase, but each moment has moments in that journey that people are asking different questions in different ways in each part of the journey. So, you need to feed the funnel with trust, with transparency, straight to the point, but differentiating the content according to the moment of the journey. And on top of that, customize this for your buyer persona that you and your team decide is the type of people that you want to attract.” (37:55—38:41) -Dr. Coachman

“If you write the blog posts, or you let AI write the blog posts for you, you in the future — this is what's going to happen probably within the next six to 12 months. Every website is going to have an agent or a chatbot that my patient — it’s not going to look for information. It's going to ask the chatbot a question. And then, that chatbot is going to reference my answers, not ChatGPT, and it's going to interact with me like a human. And so, it will be either like dental clinic assistants or front office assistants, and you'll be confident that the answers it gives are the right answers because the answers it's reading and processing are your content. So, that's why you need to start to develop the content because you want your chatbot to be very specific to you and give the right information.” (39:44—40:31) -Brendon

“There are three AI business modes that you look at when you say, ‘Where do I start?’ or, ‘What should I use?’ The first one is, ‘How do I improve my efficiency, my internal efficiencies?’ So, I'm looking to understand that, in my business, what are the ways and the workflows that will improve my internal efficiencies? The second way is to improve your service. So, you're looking at your product or your service, and you're going to augment it with a bit of...

The Clock Concept: 3 Moments of Every Client Experience

Episode #627 with Dr. Christian Coachman

If you want to grow your practice, you need to do more than be a great dentist. You need to know how to sell! To reveal the shortcut to successful selling, Kirk Behrendt brings back Dr. Christian Coachman, founder of Digital Smile Design, to explain the three moments in your client experience that you should invest in and master. To learn the marketing strategies of tech giants like Apple, listen to Episode 627 of The Best Practices Show!

Episode Resources:

• Join Dr. Coachman on Facebook 
• Follow Dr. Coachman on Instagram 
• Learn more about Digital Smile Design 
• Register for DSD Residency 1
• 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

Main Takeaways:

Master the pre-purchase, purchase, and post-purchase moments.

Investing in your purchase moment is the shortcut to growth.

Increase efficiency and comfort of the clinical experience.

Build the best comprehensive treatment plan.

Have a strategy for handling objections.

Don't just be good — be the best!

Quotes:

“The clock concept is a concept that comes from business, from marketing. The definition of this concept is pretty obvious. It says that every company should focus on three moments of their client experience to grow and sell more. They call the three moments pre-purchase, purchase, and post-purchase. As I said, pretty obvious. It means that a company, to succeed, needs to have a good pre-purchase strategy, meaning conventional marketing, spreading the word, telling the world what you do, and hoping that people like the message. So, that is the pre-purchase. Then comes the purchase moment where some of these people that are listening to your story are actually saying, ‘Oh, maybe. Perhaps,’ or they're just walking by your store, and they decide, consciously or unconsciously, linked to the pre-purchase story, to walk in and check you out, maybe try your product, maybe do a test drive, maybe compare, talk to your salespeople or your experts, and everything that involves that moment of decision-making. So, that is the purchase moment. And then, you have the third moment. That is the post-purchase, obviously. For the ones that actually buy your product or buy your service, they're going to experience your product or your service, that's called the post-purchase moment.” (2:02—3:54)

“We, as dentists, were never into marketing, naturally — in sales. Now, less, but for many years when I was talking about communication, persuasion, storytelling, case acceptance, I would say the word “marketing” and I could see in the crowd, discomfort. When I would say “selling dentistry”, even worse. Some people would even walk away and leave. ‘We don't sell. We are in the medical environment. We are healthcare providers.’ I actually looked in the dictionary for the meaning of the word “selling”. Basically, it’s exchanging services for money. So, yes, we are dentists. We sell every single day — we have to sell. But, of course, we want to sell with ethics. We want to sell in an elegant way. And above all, we want to sell something that we know is the best for the patient so that we are comfortable selling that. But we are selling.” (5:08—6:14)

“As I was reading this article about the clock concept, they explained pre-purchase, purchase, post-purchase, and then they mentioned that companies that are more successful are biased towards the second and third part of the clock. So, purchase and post-purchase, and they use the example of Apple. So, what they say is that, again, pre-purchase is conventional marketing. Any type of marketing is pre-purchase. Purchase is the experience at your store. Post-purchase is the experience with your service and product. What they showed is that companies that are putting their major focus on the purchase moment are the ones that are really finding the magical formula.” (8:31—9:25)

“For some reason, Steve Jobs decided that instead of doing what every company was doing at that time, that is investing in marketing to grow conversion, he decided to take most of his marketing budget and invest in the purchase moment. That's when the Apple Store concept was created. We can recognize this in the old days of Apple. And I'm talking about the 2000s, 2010, when they really exploded. They did very little conventional marketing. So, if we compare with Samsung, the competitor, Samsung was doing it the conventional way — marketing, marketing, marketing. Billboards, radio, TV, beautiful ads, the whole thing. Apple took their money and said, ‘We're going to invest in this new concept called Apple Store that is going to be revolutionary in terms of experiencing the products in the store. Because of that, we believe we can transform clients into fans. And because of that, we're going to grow more than the others. And because of that, we're going to create a community of people that love us beyond the product. And because of that, we're going to generate loyalty. And because of that, we're going to become the number-one company in the world.” (9:57—11:25)

“How many times have you walked into an Apple Store even when you didn't need an Apple product just because you were walking by? This is the power of exceeding expectations and fascinating you in the purchase moment. It's not the ad. It’s not the billboard. It’s not the conventional marketing. It’s your experience in that store. And there are so many things that [Apple] did. Nowadays, we take it for granted because it became normal, and because every other company started to try to copy it. And now, Samsung has their store. But, of course, there's no first-mover advantage, and it's not as sexy, and everybody is just trying to copy that.” (13:00—13:47)

“You have three moments that you need to master. The shortcut to success is the purchase moment. The success story that proves this concept is the Apple Store that made us all fans of this brand and their product — regardless of if their product is the best in the market. The iPhone is not the best phone, and people that are experts on technology try to convince me to move from iPhone to Samsung. Good luck with that. There's something stronger that connects me to Apple, and I can tell you it started in the Apple Store experience, year after year, making me a fan. So, it shows that, of course, having a great product is key. But when you invest in your purchase moment, it's like you gain so many credits with your possible client that your product can even be slightly worse or equal to others, and you're going to have a competitive advantage above all the people around you.” (13:52—14:54)

“In dentistry, you also need to go through three moments. You need to attract people, you need to convert people, and you need to treat people. Dentists are obviously focused on treating — and we should. That's what we do. We need to be very good clinicians. But since 10, 20 years, dentistry started to go heavy into marketing, and you see dentists spending a lot of money on marketing. So, that is pre-purchase. We are forgetting that the magic is in the purchase moment. It means that in dentistry we are leaving the magic moment in third place. We are putting the least energy where the magic happens the most.” (15:34—16:35)

“If you want a shortcut to grow, there are so many things you can do. Yes, you can become an even better dentist. Yes, you can grow. You can buy new technology. Yes, you can improve your associate. Yes, you can better train your assistant. Yes, you can follow up better with your treatments. You can have a better orthodontist, a better periodontist. Yes, you can also invest more in marketing, lead generation. You can hire a better agency. You can improve your social media. Yes, yes, yes, and yes. But if you really want the shortcut to grow immediately, more than anything else, you need to invest in your first and second appointment — period.” (16:51—17:41)

“My iPhone can be worse than the Samsung. It can have a worse screen or camera, or it can break earlier than the Samsung. But if Apple got so many emotional credits with me in the Apple Store experience, then I'm still a fan and I will assimilate. I will absorb this problem, and I will stay with the company, stay with the brand. I will give a second chance, and a third chance, and so on. It means that if I would change to Samsung today, for any reason, if somebody would force me or convince me, and for any technicality Samsung would have one little mistake, I would change back to Apple. This is what I call emotional credits. So, what I'm saying is that if you master the process of the first and second appointment, you're going to gain so many emotional credits that even if you make mistakes later on, you're going to be able to take advantage of these credits. You can leverage these credits. That's how the human brain works.” (18:00—19:10)

“The clock concept just works. The purchase moment is the shortcut for success and for growth. That's where you transform clients into fans, more than just users or consumers. So, when you realize that, you need to ask yourself, ‘Okay, the translation to dentistry is the first and second appointment. The purchase moment is the first and second appointment.’ It means that you need to master this. What does that mean? It means that whatever you do to have the best first and second appointment in the world is worth investing time and energy, whatever it is. The funny thing is that nobody asked this question. You don't see people talking about it. People take the first and second appointment for granted, as practice owners. I ask a dentist, ‘Do you have a good first appointment?’ ‘Yeah, of course. I have a great first appointment.’ ‘Why?’ ‘Why? Uh, I don't know.’ I say, ‘Yes, you don't know because you're so focused on the treatment and marketing that you're not focused on the magic.” (20:14—21:26)

“The definition of the first and second appointment — the timeline is this. Whenever somebody calls you to book that appointment, whenever somebody walks through your door, that's the beginning of the magic. That's the beginning of your purchase moment. If they're walking in by chance, if they're referred, if they saw you on social media — it doesn't matter. The story starts when they make a decision to come to you. That's when the purchase moment starts. And the purchase moment ends when they sign the check and they say, ‘I'm going to do this treatment, and I'm going to do it with you.’” (21:47—22:34)

“The challenge to you listening is, why not have the best first appointment in the world? Why not? I ask you, as a dentist, why not? ‘Oh, I have a good first appointment.’ No, no, no, no. I'm not talking about good. I'm talking about the best in the world. How can you have the best? This is the best investment you can make for your career, by far, is having the best first appointment in the world. Now, the problem is that we don't even know what it means to have the best first appointment in the world because we never asked that question to ourselves. We're not focused on that. It just happens. We take that moment for granted. We just do the obvious. We do what everybody does, etc. So, I need you to think outside the box. I need you to be creative. I need you to put energy into this and reinvent your first and second appointment. Why? Because it's worth it. Why? Because Apple Store proved it.” (23:51—24:48)

“The first and second appointment, it's not only for new patients. The interpretation of the first and second appointment is the beginning of a story. It can be a patient that’s been with you for ten years in hygiene, and you're bringing them back into a new approach, a new perspective, a new story. It can be a patient that already did a treatment with you in the past and you're reactivating them. It can be a new patient. It can be a referred patient. It can be a patient that is coming back from your orthodontist back to you. It doesn't matter. It's the beginning of a story with another human being.” (25:19—25:59)

“Marketing can be important, but it’s not even as close as reaching out to the people that are already coming to you or already came to you in the past. And we know how underexplored the practice database of patients is. The goldmine is there on your computer, that list. Imagine that you did your homework, and you reinvented your first appointment. Imagine your excitement — the excitement of your staff saying, ‘Holy cow, this is so much cooler than the old first and second appointment that we had. I wish every patient would come back to us. Everybody that came to us in the last few years, if they could come back and experience this again, this would be amazing.’ So, first, you need to do the homework. But once you do the homework, you're going to be reactivating these patients. Zero investment in marketing. Zero in marketing. You're taking advantage of the people that already gave you a...

Kids Getting Hurt: Consequences on Facial Growth

Episode #626 with Dr. Drew McDonald

Kids get hurt — a lot. But even when they “seem fine”, those facial traumas can have severe consequences on their growth and development. To help you detect those issues early, Kirk Behrendt brings back Dr. Drew McDonald, instructor from the Chicago Study Club, with advice for seeing the signs and asking parents the right questions about their child’s injuries. You can save children from a lifetime of pain and suffering! To learn how, listen to Episode 626 of The Best Practices Show!

Episode Resources:

• Send Kirk an email for Dr. McDonald’s Master Classes!
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• Learn more on Dr. McDonald’s website
• Subscribe to The Best Practices Show Podcast
• Join ACT’s To The Top Study Club
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Links Mentioned in This Episode:

Register for Chicago Study Club

Follow Kids Getting Hurt

Main Takeaways:

Problems with growth and occlusion start early in life.

You need 3D and CBCTs to see and diagnose joint issues.

Even seemingly benign injuries can lead to severe growth issues.

Know where to look so you can get children the help that they need.

Ask parents good and thorough questions about their child’s injuries.

Quotes:

“One of the biggest issues that we run into as orthodontists is relapse. Why did everything we tried to accomplish — why are we watching it unravel? The topic we're going to talk about today is one of the most important issues that I see, which is that a lot of things under the surface, especially joints, airway issues, issues with kids’ necks or adults’ necks, can really be the undoing of their bite, of their occlusion, of their growth — and they start early in life.” (3:16—3:45)

“I saw a little four-year-old guy yesterday. He's not growing well. His lower jaw is extremely retrognathic. He's very Class II. He also has a bilateral crossbite. He has extremely narrow development. This little kid’s jaws also click and pop. And as I'm doing my exam, I'm asking his parents, ‘Does he ever mention this to you?’ They go, ‘We thought that was normal. We thought everyone’s jaws click and pop. We didn't know he was hurting, but he said it right here.’ My next question immediately is, ‘Do you recall any head or neck trauma? Any falls? Falls down the stairs? Normal, typical, kid stuff?’ And to a tee, a lot of parents go, ‘Well, we never had a car accident. He never had to go to the hospital or anything. But we do remember normal kid stuff.’ Well, “normal kid stuff” is pretty rough. I see it all the time.” (4:00—5:10)

“If you've ever been to a cheerleading camp, if you've ever watched kids in any summer camps right now in terms of how they play with each other, if you've ever been to a trampoline park, if you've ever literally just hung out, you've probably seen kids get whacked in the head, face, fall down, whatever it is. And those injuries, although they're not needing to go to the ER, or they're not bleeding, they're not having a big issue where you think you have to take them to see somebody, those types of injuries can very often have effects on our facial growth, especially if there's a whiplash type of incident. The biggest structures that get affected by this are our TMJ joints. Our nasal airway very often gets affected too.” (5:14—6:01)

“I see so many young kids with deviated septums and their parents go, ‘Yeah, he did actually break his nose. He got hit in the face with a bat. We didn't take him in, though, because we just figured, nah, we’re not going to make this a bigger issue.’ But ultimately, that affects how our child breathes, which can affect growth. You hear this all the time from my friends, Becca Bockow, and other people. We talk about how we breathe and growth all the time. The other hidden gem — or hidden nightmare, I should say — is what happens when they have neck injuries to their upper cervical spine. These are super common, and they're injuries that we think are benign: kids running into each other, kids bumping heads, hitting their chin on the swimming pool.” (6:02—6:50)

“There's a really great Instagram account that I would urge everyone that's listening to follow. It's called Kids Getting Hurt. I would say that every dentist needs to follow this because these types of injuries you see on this, they all affect us, especially orthodontists and anyone trying to deal with facial growth and helping kids grow properly. These types of injuries, they look like everyday stuff. They create havoc on our facial growth, which creates orthodontic issues. We need to know how we got here to know how to treat it.” (6:53—7:27)

“On my intake for any new patient, there is a whole section that is, ‘Have you had any head or neck trauma? Have you had any injuries that affect that area?’ Most often, people skip over that and think they didn't have a major injury or a cannon injury that they can go back on and go, ‘Oh, yeah. We had this car accident. He had to go see this guy.’ Ultimately, that leads to some gray area or more questions that I need to ask. As I do my exam, if I start to see signs of joint injuries, airway problems, neck issues, or kids holding their head asymmetrically and all of that, essentially, I need to ask more questions as to, were there any incidents that came along here? I really think that us as dentists need to be really good diagnosticians and ask really good questions about trauma because it's there for most kids, whether the parents realize it or not.” (8:58—9:58)

“If a young child has a joint injury early in life, falls on their chin, has to have stitches, or hits their head on the bathtub, that can compress their TMJ. A lot of times, I see young kids as young as six years old, seven years old, when we do their MRI of their joints because they're clicking and popping, they've got completely displaced discs. They've got really bad architecture within their joint because of those injuries. Essentially, what that does is it starts to stunt the growth of their jaw joints. If we have one jaw joint that's not growing properly because of an injury, then we start to see facial asymmetry ensue. We also see a lot of kids with very retrognathic Class II mandibles. When I do their MRIs, which is a huge part of my practice — we've done close to 2,000 MRIs to this day on orthodontic kids, mostly — they don't have discs in place when they have Class II growth, when they have asymmetries, when they have open bites. Those are the three big things that all point towards a joint injury. So, when you're doing your exam — and even before I see that patient, I've got a good idea just from looking at facial photos, there's probably something up with this patient's joints . . . You can see signs of airway. You can see signs of neck injuries before you ever say hello to that patient in person. Those are things that show very easily with even photos, or watching the kid walk by on the way to your exam room.” (10:15—11:50)

“The growth center of the mandible or the lower jaw, one of the principle growth centers is our condyles, which is our jaw joints. If that growth center is injured, we see repercussions on growth of the face. And it's not just the lower jaw. What I see over and over again is that if a patient has a displaced disc on one side versus the other, it doesn't just disrupt their mandibular growth, but their maxillary growth on the same side of that joint injury gets affected too. If the mandible is not growing properly and it's not interacting with the maxilla in the way it normally would on one side versus the other, I see this all the time where the maxilla is also asymmetric towards that side. We also get underdevelopment of the maxilla in a unilateral way. So, what does that look like in terms of the patient? That looks like a canted smile. Their smile is going up towards that shorter side. I see it all the time.” (12:11—13:09)

“Kids are much more active from younger ages and they're playing a lot of competitive sports, or dance, or cheerleading, and things like that. And I don't want anyone to misconstrue what I'm saying. Kids need to live their lives. They need to play sports. They need to get out there and be active. But sometimes, things that happen in those sports can have repercussions.” (15:00—15:20)

“In orthodontics, there's this common term that comes up where, especially a teenage female, after their orthodontics, we're watching them have a joint issue. We commonly allude to it as “cheerleading syndrome”. ‘Oh, that's cheerleader syndrome. Pretty classic.’ That's the verbiage that people use. Well, what is it, really? That's not just, ‘It happened because they were a cheerleader,’ or a female, or they're a teenage female — it just happens idiopathically. No. There is 100% correlation. If you watch some of these sports, or dance, or stunt routines, there are a lot of times where things have jarring impact or whiplash type movements that happen in the head and neck region. That can [cause] a lot of problems during ortho or afterwards and start to have jaw joint meltdown and problems because we're displacing a disc.” (16:50—17:44)

“There are two parts to our airway. I think that we very often construe, ‘The airway world does only OSA,’ obstructive sleep apnea. What I find so often, or what I allude to is the two parts of airway, which is, one, the nasal airway, and two, the pharyngeal airway. So, why would an injury to the face affect either of these? I see a lot of kids that say they play football, play sports, a pretty common thing — back to soccer, they get hit in the face with a soccer ball. Basically, I've had several parents lately, I don't know if it's just me, say, ‘Oh, yeah. We knew he broke his nose. They told us at the doctor’s he broke his nose. But they're not going to do anything at this point because he's just a kid. So, we’re just going to watch.’ Well, then my next question is, ‘Can he breathe through his nose now?’ And a lot of times, what parents say is, ‘Well, he does sound pretty nasally after the accident, and he does breathe with his mouth open more. Yeah, I kind of see that.’ Well, that is the kid, orthodontically, that has the narrow maxilla, because when you breathe through your mouth, your tongue can't live in the roof of your mouth. That can't drive that maxillary growth the way it needs to, and we end up with narrow maxillas. We end up with a lot of crowding of our teeth, and we end up with what looks like just an orthodontic issue. But if we don't look under the surface and ask questions, then we miss the point.” (18:16—19:43)

“How do we actually look at these injuries? We need 3D imaging. We need CBCT, at minimum, to see noses. We need CBCT, at minimum, to see joints. We need it to see necks. And so, ultimately, that's a big consequence of facial injuries, is that if the nose gets involved in some sort of injury, that's going to affect their breathing. And if they're not breathing through their nose, that's going to affect their growth, especially in the maxillary region.” (19:46—20:10)

“The other side of our airway, which is the pharyngeal side, doesn't get talked about a lot. Which is that if we have a joint injury and we're stunting our mandibular growth because of that, then if the mandible doesn't grow forward, then it really hangs back, and our pharyngeal airway starts to get really impacted. There's lots of research, lots of papers, that have looked at Class II or retrognathic patients, especially adults, that have very significant OSA type of issues because their pharyngeal airway is very collapsible because their mandible is not forward, it's back. So, what if we could have caught this early rather than letting them get to 20, 30, 40 years old and having this significant pharyngeal airway issue? If we could have caught the joint injury early enough and been able to support that joint and the growth, and understood how to do that based off of the MRI imaging that we take, then we could have given this kid a shot at having a normal projected mandible and growing normally, which allows their pharyngeal airway to develop properly.” (20:11—21:18)

“Back to the two parts of the airway, injuries to our nose, injuries to our joints, they affect those two parts of the airway, especially. If we catch that early in life, we give this kid the best chance of growing properly, breathing properly, sleeping properly, having better attention at school. All the consequences of not breathing well and how they often begin is if we have a facial injury or a head or neck injury. So, if we know what to look for early, we're going to give a better shot.” (21:19—21:50)

“Active kids — these are football-playing kids. We think of them as being in pretty good shape. We're not really worried about them from a health consequence right now. But I can tell you, I see so many kids that are wrecked because they're not sleeping well. I mean, how many of our professional athletes do we see or read about now that are sleeping in hyperbaric chambers, basically maximizing their oxygen while they're sleeping because they know it affects their performance? Well, high school kids that aren't sleeping well, they're probably not getting the best rest. They're probably not feeling that great whenever they go into school that day. And then, back to their football field performance, stuff like that, what could they have been?” (22:41—23:20)

“We think, often, of the airway people as adults that are sleep apnea, overweight, out of shape, whatever you want to call it. It's quite the opposite. There are so many kids that don't present that way at all, or adults that don't present as overweight and with issues, that have the worst sleep. And when we look at their nose, their pharyngeal airway, their jaw structure, their retrognathic jaw structure, they are set up for this pretty early in life to have these problems. And again, if we could have caught that earlier, we could have made a difference in the trajectory of that kid's life from a health standpoint, from a growth standpoint — all of it.” (23:23—23:58)

“Back to getting hit in the nose, or having a jaw joint injury, what's connected to that? Our neck. And the upper cervical spine, especially the C1-C2 issues, it’s super common in kids — it's frightening. And again, they're not in pain, so we don't sit there and go, ‘We take him to the chiropractor because his neck is hurting.’ Often, young kids don't present with pain. But what I see on my CBCT images — and I always go through the slices of the upper cervicals because I see all the time C1 rotated posteriorly towards one side. C-2, very often, also rotated. And if those two in particular are rotated posteriorly on one side, the nerves in that area namely are ansa cervicalis, which those nerves exit between C-1 and C-4 . . . Those nerves control the sympathetic nervous system tone to our head, our neck, and our shoulder on each side of our body. And so, if we are rotated on our upper cervicals back because of an injury and that is compressing those nerves, what we see over and over again is that those nerves over-fire. If our sympathetic nervous system is over-firing, that means blood vessels are constricted. If our blood vessels are constricted, that means less oxygen to growing tissues. And so, if we think about these patients that have facial asymmetries, I often see neck issues that are rotated back towards that side, especially C1-C2 issues. And again, it comes from an injury.” (24:14—25:58)

“The other thing is that if our sympathetic nervous system is over-firing on one side more than the other, we see muscle tightness. This is the kid that if you're a myofunctional therapist listening — which, I work with myofunctional therapists all the time — when you take your pictures, this is the kid that has one shoulder higher than the other side. They kind of lean their head towards that side. Sometimes, they have tighter facial musculature on that side of their body. And again, the dynamics of growth, if we see those things happening in a young growing kid and their muscles are tighter, they're not getting oxygen. We see that side, especially, not grow properly and we get more and more facial asymmetries, more torsion. Cranial strain is another word that gets thrown out there. I see it. And again, we can dive back to a lot of neck injuries in these young, young kids. It's sad to think about. And so, if we know where to look, we can get these kids help.” (26:39—27:38)

“I work all the time with what's called an Atlas Orthogonal chiropractor. We're fortunate to have one here in Albuquerque. She tells me all the time, ‘Thank you for sending the young kids,’ because she knows what these young kids become when they get older. If you have increased sympathetics on one or both sides, as you're getting older, that starts to also present itself in other weird ways. People that have ringing in their ear, or tinnitus, people that have hearing or sensory loss on one side, or have headaches, very often have upper cervical issues driving that. I can't tell you how common this is, and it's frightening. I never thought about this before I met Mark Piper a few years ago. He said, ‘Sympathetics are it. Everything is driving sympathetics in the wrong way.’ If we're not breathing well, sympathetics are bad. If we have a joint injury and we have neck injury things that are driving sympathetics, this is a problem, and we have to unwind these things as early as possible.” (27:38—28:37)

“We need to give our patients the best chance of having longevity that's healthy and productive. Our job, really, we operate in this head and neck region all the time. We catch so many issues before they ever create a bigger problem — or we have the opportunity to catch them, I should say. But we have to know where to look.” (29:05—29:25)

“We have to have the tools to look at this stuff. You need 3D imaging. You need CBCT. You need an MRI to be able to see the joints and the injury of that disc and the displacement. You can't go in blind. And sadly, especially in these areas, looking at under-the-surface things with the nasal airway, pharyngeal airway, neck, also our joints, we’ve traditionally gone in blind because we've said, ‘We don't want to take X-rays whenever there's not a big problem.’ But I'm going, ‘Every single orthodontic patient that walks in my

How to Significantly Increase Your Revenue Without Getting Off of PPOs

Episode #625 with Dr. Tom Orent

To drop or not drop PPOs — that is the question. If you're frustrated and don't know what to do, don't miss this episode! Kirk Behrendt brings back Dr. Tom Orent, CEO of Freedom Summit, to reveal what you can do to safely reduce your dependence on PPOs. If you do it right, you can increase your revenue while staying in! To learn how, when, and which PPOs you should drop, listen to Episode 625 of The Best Practices Show!

Episode Resources:

• Send Dr. Orent an email 
• Join Dr. Orent on Facebook 
• Follow Dr. Orent 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:

Learn more about Dr. Orent’s Free 4-Step System

Learn more about Dr. Orent’s 1,000 Gems

Book a call with Dr. Orent today!

Main Takeaways:

If you're not in PPOs yet, don't go there.

Know which PPOs to strategically drop first.

You will lose patients by sending “the PPO letter”.

Your goal doesn't need to be 100% fee-for-service.

The majority of your patients could afford dentistry.

Quotes:

“I wish I could say in my first year or two, but in my first 15 years of practice, I made the same mistake over and over, year after year. It's a mistake that's very common to a lot of dentists, and the mistake was I was under the assumption that if I focused on becoming the very, very best dentist, clinically, that I could be, that would be enough to build an amazing practice and a livelihood for my family and a future.” (2:16—2:39)

“I became a good dentist. It wasn't enough. Twenty-seven years ago, I found myself in the office of a bankruptcy attorney. Who sent me there? My divorce attorney sent me there because my wife was fed up with the fact that we had no money. I was never with the kids. We had two little kids. I get chills at how many people — how many dentists — can relate to this. I get chills at thinking about the fact that there are a lot of us still out there, a lot of our colleagues — maybe some of you guys listening. I'm sure a lot of you are past it and you're already really successful, financially, and that's awesome. I'm going to give you some stuff too. But for those of you who are struggling, or maybe you're just starting out, becoming a great clinical dentist is important, but it's not the answer to building a great practice.” (4:25—5:08)

“Dropping PPOs is the last thing I would recommend. Now, it's half tongue in cheek. Not 100%. The reason I say it's half tongue in cheek is it's true. But it is the last step that I would recommend. So, I'm not saying don't leave them. But if you start cutting the cord, if people just dropped all their PPOs, it would be a major financial risk for the practice. If it were that easy, if you could just drop them and everything would be fine, if we were all confident that that would work, PPOs could not and would not exist.” (9:45—10:22)

“If you're a solo doc, I would figure out a way to increase my revenue by $100,000, $150,000, $200,000. I'm not talking about production. I'm talking about revenue. What's the difference? For you listening, the difference is somewhere around 35%. Why? Well, because you're writing off somewhere around 30% to 35% of the PPOs. It's sad, but years ago, I thought I was losing my shirt writing 20% off. Today, there are dentists who would kill to be down at 20% loss. We have members in California who are writing off 40%, 45%, 48%. It’s just nuts. Almost 50% in parts of California, Texas, and a couple of areas. But 30% to 35% is pretty much the norm.” (11:01—11:49)

“One of the biggest mistakes I see dentists making today — and about half of us are doing it — is when a patient comes in and we perform a service, a crown, or whatever it is, we post not the full fee, but we post the fee that we know insurance will allow. So, we have those all loaded in. We think that's really cool that we already have all these numbers loaded in because it makes it really easy to do the math. Well, that's true. It makes it easy. But it's also killing you on two fronts. When you're posting, instead of putting in full fee, if you're putting in the PPO fee, the allowed fee by contract, it's costing you in two ways. Number one is you have absolutely no way to figure out what you're losing.” (12:01—12:41)

“So, Dr. Smith says to you, ‘I'm losing $400,000 a year, and I'm only a one-doc office. One doc, one hygienist, and I'm writing off $400,000.’ So, in the future, your answer will be, ‘That's not true. That's not what you're losing.’ You're losing close to half a million. Why? Because variable expenses to treat the $400,000 that you're giving away for free — you're not collecting on that $400,000. The variable expenses are somewhere between 12% and 15%. So, there's $60,000. I get the $60,000. It cost me to produce that. So, I'm at $460,000. What's the other $40,000? It’s the other team member who's doing all that insurance work that they wouldn’t need to do if you weren't in the PPOs. Almost every practice today has anywhere from a half-time to a full-time employee just dealing with the crap.” (13:33—14:26)

“For the listeners who are younger and maybe not in PPOs yet, maybe don't even have your practice yet, going to have a practice soon, I often hear them say, young docs and early-in-practice docs, ‘I'm going to add one or two PPOs just right now while I have some open chair time because wouldn't that make sense? I'm not losing anything. I'm actually gaining something because that chair time is open.’ Adding a couple of PPOs is like taking a malignant cancer cell and putting it in and saying it's only a few cells. It will grow until it kills you. So, if you're not there yet, don't go there. If you're not in PPOs, don't go there.” (17:42—18:18)

“Sometimes, dentists feel forced into cutting certain corners. I'll give you a simple one . . . A significant percentage of dentists choose not to offer certain services that they might have otherwise offered if it was full fee because they can't afford to based on a certain contract, or whatever. Patients don't know that. Patients think they're getting the deal of the century. ‘I have a PPO that gives me the best fees. This dentist is really good.’ Well, the dentist may be really good, but he or she is not always offering you the same thing they're offering a full-fee patient because they can't afford to.” (21:03—21:36)

“One of my colleagues, many years ago, told a funny story. I'm sure he was joking, but he said, ‘I'll go into hygiene, and I'll do a check. I'll see that they need composite, whatever it is. Sometimes, you can't afford to do that. What I'll do is I'll write the patient a check for $100, and I'll say, here. I don't want to do that for you. I want you to go down the street and pay somebody else to do it because I can't afford to do that.’ Of course, he was joking. He never wrote the check. But that was the point.” (21:38—22:04)

“[When I turned my dad’s practice around], did I make it 100% fee-for-service? No, I did not. Here's why. I removed 13 of the 15 plans . . . The two that Elizabeth and I decided to keep, we kept because the fees were actually really good. They were close enough to my dad's fees and our fees that we didn't want to rock that boat. They were pretty good, a small write-off. The other thing was, they were decent. They were respectful with my team. They didn't put them on hold for 30 minutes, and then hang up on them and say, ‘I'm sorry. I didn't realize I got you disconnected.’ They didn't deny stuff by an algorithm. Doctors think that these denials are happening by a $15-an-hour clerk. They are not. The first denial is by an algorithm that denies a certain percentage. This is the truth, guys. The first downgrades in denials are not done by a cheap clerk. They're done by an algorithm that removes about 30% to 32% of all claims by just rejecting them.” (22:07—23:08)

“Did you know that only 35% of claims that are denied are ever appealed? They are depending on that, that you will not appeal anything.” (23:09—23:21)

“Sending a letter and saying, ‘We're getting out of Delta,’ or Blue Cross, or Cigna, or whatever your plan is — there are all sorts of plans. I'm not choosing anyone. If you send a letter to those patients, you will lose most of those patients.” (23:47—24:00)

“If you send a letter instead [of talking to your patients], if you try to shortcut this, Mrs. Jones gets home at 5:00 after work and the full day. The kids are back from school. She's back. Everybody's running in. They know dad's coming home in about a half hour. She tries to put something together because he wants a hot meal. Doesn't realize she just worked the whole day. Or maybe he realizes but doesn't care. Whatever. He wants a hot meal. And so, she's fussing to make that meal. The kids are scurrying around. She gets them at the table. He comes in. Everybody sits down, and they're looking at some mail. He says to her, ‘What's that from Dr. Smith?’ She says, ‘I don't know. I didn't open it.’ He says, ‘Open it up. Find out what it is. Is it a bill? What is it?’ She glances through it. She says, ‘Oh, no. He's dropping our insurance. We need to find another provider.’ That's all they're going to do, especially if she had a bad day, or he had a bad day, or the kids are screaming. They're not going to say, ‘Kids, quiet down for a second. Bill, I know you had a hard day, and I'm making a hot meal, but I just want to address this for a minute. He's one of the finest dentists, finest human beings we've ever met. He never compromises on our —’ they don't care. They get the letter. They're just going to switch providers.” (25:04—26:15)

“Do not send a letter saying, ‘We're leaving.’ Now, what does that mean? That means the timing of telling a PPO that you are leaving should be six months after you make the decision, and you begin speaking with your patients. Because I don't want to allow any of those PPOs to send that poisoned letter that they will. Within 24 hours of your telling them that you're leaving, they will auto-generate a terrible letter talking about how you are no longer considered a preferred provider. What does that mean? All that means is that you've dumped their contract. But what it sounds like to the patient is you did something wrong. And then, they give a list of ten other competitors who are within two blocks of you, or whatever the distance might be.” (26:15—27:03)

“Once you're up a couple hundred thousand dollars, let's say $150,000, $200,000, let's say you have eight plans, and your smallest plan is $150,000 a year. So, if you went up $150,000 and you drop a plan that's $150,000, even if you lost half, three-quarters — you won't if you do it right. But even if you did, you're still in a nice financial position. So, which one would I drop? A lot of docs drop the one that they hate the worst, whichever one that is. And they hate it because it has the worst write-off. So, let's say, on average, I'm writing off about 30% to 32%, which is typical. But let's say my worst one is 38% or 40%. I'm getting torn apart by that plan. The emotional decision is to drop that plan first. Do not do that. You want to drop the smallest plan first, the one where you have the fewest patients. Maybe it's not a big write-off. I don't care. Let's say the plan with the worst write-offs is 20% or 30% of your patient base. That's scary. Let's say a plan with a reasonable write-off is only eight percent of your patient base. That's a good test case scenario for you where it's pretty much a no-lose situation.” (27:10—28:27)

“The knee to knee, eye to eye, toe to toe conversation, one at a time, it's either done by one of the GPs in your office, or by the hygienist, or both, depending on who has the patient first. You only have to do it one time. And, by the way, at the end of six months, you will not have seen everybody because not everybody comes in. What do you do now? What you do now is you pull a computer report of the ones that you never saw in the last six months. Maybe that's 50 people, eight, whatever. The doctor and the hygienist split those people up, and you call them, and you have the same conversation. Now, the phone is not as good as knee to knee, eye to eye, toe to toe. But the phone is way better than sending them a letter that they're not going to read. They're just going to, ‘You know what? This has been a terrible day. Just add that to the pile, and we'll find another provider tomorrow.’ So, you make calls to the ones you couldn't see physically. If you do this right, you're going to keep a lot of patients. I retained a high percentage of my patients in both practices. But you should always, like Harvey McKay said, dig your well before you're thirsty. You should always add that revenue before you need it.” (28:36—29:49)

“If you're in practice and you're getting crushed by overhead, in addition to working with the PPOs and getting them out of the way, one of the things I'd be doing is figuring out any way I can to increase revenue with my fixed costs as they are without adding more staff or more equipment.” (36:04—36:17)

“I would urge everybody to get out [of PPOs] if you can. Which, you can if you choose to. It's a choice. It's not an “if”.” (37:17—37:23)

“It is my understanding that there is a law that they cannot use the words preferred provider organization, PPO, unless they are willing to allow the patient to go to any provider and still pay. And again, that's not something I would just take, ‘Oh, Tom or Kirk said it.’ No. Check with your attorney. Read the contracts. Check with your state and federal law on it. But having said that, I am quite certain that that is accurate. Now, that means the good news is when you leave a PPO, you can say to Mrs. Jones, ‘The great thing is that we can still not only send in the information and take care of the claims and all that so you don't have to do a thing — it's all done for you — but the better news is, we can not only continue to see you and take care of the claims, but we can also continue to get you benefit from the PPO,’ because that PPO, they won't tell you this, but they allow you to go to anybody you want. That's the good news. The bad news — and a lot of dentists already know the bad news. The bad news is the percentage will be different for an in-network versus an out-of-network provider. So, OON, which is out-of-network, versus in-network. But you know what? If you do it right, if you speak to the patients right — I'm sure you guys have great relationships with your patients. That's why they're going to you. They're going to stay if you do it right.” (37:37—38:53)

“Front end targeted marketing is the first thing I would be doing if I wanted to get out of PPOs. Why? Because targeted marketing means you are only targeting a specific demographic and or service, and specifically the treatment or service, and you're only going to target stuff that you want to do more of. And if you're really sharp, you're only going to target things that aren't covered by insurance.” (39:48—40:14)

“Ninety-five percent of the patients in a general practice are asymptomatic. So, even if that patient just moved to your area, and even if they do have some work to do, you have two bars you have to hit in order to get them to say yes to your treatment when it's asymptomatic. The first part is easy. The first part is that they recognize, appreciate, and agree that there is a problem. That's an easy bar. We've got so much technology today. Every dentist listening to this has the technology and the verbal skills to make it pretty clear that there's a problem. They're still not going to schedule. They won't schedule. That's only bar number one. Bar number two is way harder. And it's not something that I can teach in any situation quickly because it's something that we take a year to teach. But the second bar, I can tell you what it is so you can focus on it, because you can still do it yourself. There's a do-it-yourself component to this . . . Patients, even if they, ‘Yeah, I guess that is an issue. I didn't realize it. My last dentist didn't tell me about it,’ or, ‘It doesn't hurt,’ or whatever, to get them to appreciate that they have a problem, that's easy. But they still won't schedule unless they sense an immediate or urgent need to schedule and do the treatment.” (41:04—42:31)

“Patients will not schedule unless they sense an immediate or urgent need to do that treatment, with the exception of elective care like esthetics. So, we're not talking about a smile makeover. We're talking about, they need a root canal, a crown, an onlay, an implant — all these other things — extraction, phase one perio. Whatever it is, the moment they sense that there's an immediate and urgent need, you're going to see something disappear which you have been hoping and hoping would disappear forever. And that is patients telling you, ‘I just can't afford that right now.’” (42:33—43:05)

[Patients will] give you these sob stories about money. It's not the money. Write these five words out. It's not about the money. They'll tell you it's about the money 99% of the time. Now, this doesn't make any sense. Tom is saying that it's not about the money, but they tell us it’s about the money every time. Why? The reason is because it's way more comfortable for a patient to say, ‘Oh, the twins just started school. I'm going to need to think about that. We'll put that off for a bit. We’ll definitely get that done, but not right now. Now is not a good time, financially.’ I said that in 10 seconds, and it was comfortable. What's not comfortable is for me to say to you, ‘I don't really think that I need to get that done right now,’ because you're basically conflicting with the dentist who just gave his professional opinion or her professional opinion that this is very necessary, and you should do this. So, they don't want to argue with you. They'll just tell you it's the money. You can't argue with the money. If they tell you, ‘Our family cannot afford this right now,’ you can't argue with that.” (43:17—44:29)

“Five percent of the time, it is the money. [Patients are] living hand-to-mouth, literally, and they don't have any money. Those patients typically don't go in on any regular basis to a general practice. They'll go...

The Difference in Teaching & Presenting a Beautiful Case in Dentistry

Episode #624 with Dr. Christian Coachman and Dr. Bill Robbins

In the second half of this two-part episode, Kirk Behrendt and Dr. Christian Coachman return with Dr. Bill Robbins, one of dentistry’s brilliant teachers, to share what it takes to master the art of teaching and the difference in teaching versus presenting a beautiful dental case. Great teachers aren't made overnight! To learn the secrets to becoming an effective and inspirational teacher, listen to Episode 624 of The Best Practices Show!

Episode Resources:

• Join Dr. Coachman on Facebook
• Follow Dr. Coachman on Instagram
• Learn more about Digital Smile Design
• Register for DSD Residency 1
• Send Dr. Robbins an email
• Join Dr. Robbins on Facebook
• Learn more on Dr. Robbins’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 the Global Diagnosis Education Symposium (September 7-9, 2023)

Read Global Diagnosis by Dr. J. William Robbins and Dr. Jeffrey S. Rouse

Main Takeaways:

Teaching requires a lot of work and effort.

Master the art of storytelling to be a good teacher.

Take photographs of failures — especially your own.

Surround yourself with people who are smarter than you.

Remember that this is the best time, ever, to be a dentist.

Quotes:

“One of my mentors, many years ago, said, ‘Always photograph your failures — especially yours, but any failure — because someday you'll be able to use them and learn from them.’ It's very difficult to take photographs the day you fail. If something happens — you break a file, or the patient swallows a crown, something terrible in your practice — it's hard to make yourself photograph it. But I've always done it. And so, I assume I've got one of the largest caches of failures of any clinical dentist on earth. When I started this lecture, it started out with only four subjects. Now, it's up to 21.” (3:37—4:16) -Dr. Robbins

“Being a good teacher, I think it's got to be done very methodically. It has to be systematic. The lecture has to be created based on an outline. The second really important part is just the opposite, and I think that's telling a story. I think that's something I do well. The more you can tell a story when you're teaching, the more you connect with your audience. I would say those are the two primary areas that I've tried to work on through my career as a teacher, and that is being methodical and systematic in the creation of my presentation, but to attempt to tell a story throughout the presentation from beginning to end.” (4:35—5:20) -Dr. Robbins

“Surround yourself with really smart people — people that are smarter than you are.” (6:44—6:49) -Dr. Robbins

“The mistake that we make in dentistry — and we still make it today, for sure. In medicine, our physician colleagues gather data, number one. Number two, they make a diagnosis. Number three, they make a treatment plan. In dentistry, we gather data, and we go straight to the treatment plan. We leave out the diagnosis. In my mind, that is one of the biggest problems in dental education today. That is, we don't make a diagnosis before we make a treatment plan. And that was the systematic approach that Jeff and I created. That is, you must make a diagnosis. If you have a diagnosis, then there's only a limited number of ways you can treat each given diagnosis, and then it makes it much more objective. So, I think treatment planning needs to become more objective and less subjective by making a diagnosis before we make a treatment plan.” (9:53—10:51) -Dr. Robbins

“One thing that I realized is that to do the dentistry that we dream of, to do the dentistry that we love, to do the dentistry that we get inspired by from our mentors, first and foremost, we need to inspire our patients to pay for it. We need to convince our patients about it. We need to onboard them on these crazy ideas. Global Diagnosis — if we want people to use it on every first, second diagnosis appointment, we need to show people how to sell this idea, how to make patients fall in love with Global Diagnosis. You need to make your patients fans of Global Diagnosis. You need to make your patients fans of facially generated treatment planning because they need to pay for it.” (14:50—15:45) -Dr. Coachman

“People say that they don't think about money. This is BS — that they are doing it all for the patient. BS. At the end of the day, people will implement technologies, concepts, and philosophies when they see that the return on investment is happening. And so, we need to master the process of helping people become storytellers about these concepts. How can you tell this story in a non-dental way so people will embrace it? When people start knocking the doors off of your students, ‘I came here because I want Global Diagnosis,’ people will be like, ‘Goddamn it, where's that book? I need to do this right now, and I need to do it over and over again.’ And then, another patient says, ‘Oh, I only came because of Global Diagnosis. Do you do that? Do you do Global Diagnosis?’ We need to learn with Invisalign. Regardless of if you like it or not, they did it. They made patients love it, and they told a story, and they started to make patients knock at our doors and say, ‘I want to do Invisalign. Do you do Invisalign?’ ‘No, no, no. I do something better.’ ‘Goodbye. Ciao, ciao. I'm going to look for somebody else.’ And then, suddenly, everybody is like, ‘Oh my God, I need to do Invisalign.’ Now, people are doing Invisalign even when you don't need to do Invisalign. So, we need a company like Invisalign embracing Rick Roblee’s book. Imagine if Invisalign would study Global Diagnosis and say, ‘This is our next mission. We're going to make the world love Global Diagnosis. We're going to push this world, and we're going to make patients understand the value of it, and we're going to make patients ask for it.’ Then, the magic happens. That's my opinion.” (15:48—17:41) -Dr. Coachman

“We all are bemoaning the way dentistry is moving in the world, certainly the United States, and that is to the corporate mob. People commonly ask me, ‘Is it going to ultimately be all corporate? Is dentistry eventually going to become all corporate?’ I don't think so. I do believe there's always going to be a place at the top. I don't know if that's because that's where I am, and I believe there will be a place for me. But I do say that there's always going to be a place for this.” (21:37—22:08) -Dr. Robbins

“It's like being the three-star Michelin restaurant. All these principles that we are talking about are shortcuts for a doctor to be the three-star Michelin restaurant and not be inside corporate dentistry, if that's not what you want. I don't think that in the future corporate dentistry will be bad, in the same way that medical hospitals are not necessarily bad. Physicians are not running their hospitals. They are working for hospitals. We are going to be very similar. Dentistry will evolve to that, but you will always have space for the very good private practice delivering high-quality, unique experiences. But you need to learn these principles. You need to differentiate yourself. But the corporate world will learn these principles as well. That's another path that is going to happen very fast, because the moment that the corporate world understands that this will generate predictability, that this will improve quality in a more consistent way, that this will differentiate themselves, I see corporations already looking at these principles and thinking, ‘Hmm, there's very smart business there,’ and you're going to see chains of clinics starting to incorporate this technology, starting to incorporate these principles, of course with the business mindset, but bringing this more mainstream.” (22:17—23:48) -Dr. Coachman

“I always use Ferrari and Fiat. You're never going to have on Fiat everything that you have on Ferrari. They are the same company, but Fiat handpicks the amazing things that were developed on Formula 1 Ferrari, they dumb it down a little bit, and they choose the things that can be used mainstream that makes the Fiat a better car. Definitely makes it a better car. So, corporate dentistry will start to learn all these things and start to bring things that can be scaled. That will help dentistry get better for the masses, for sure.” (24:20— 24:59) -Dr. Coachman

“This is the most exciting time to be a dentist, ever, on earth. There is no question about it. When I look at my son and what lies ahead for him, there's certainly a part of me that wants to remain young and viable for as long as I can to share a little bit of this journey that he's going through at the beginning and I'm going through at the end. But I never — and you know I'm being honest when I say this — I've never been more enthused about dentistry than I am today. I've got a patient in about 15 minutes. I'm going to get to do an esthetic crown lengthening on this patient. Life is awesome as a dentist, for me. It's never been better. And so, I don't know who is listening today. I don't know if it's young dentists, or old dentists, or no dentists at all. But the young dentists, you are well-placed in the best profession on earth. There is clearly no other medical profession that compares with what we get to do. This is the best time, ever, to be a dentist.” (25:56—27:06) -Dr. Robbins

“Dentistry is getting even stronger with all this advancement, and more vital, because you cannot substitute that easily what we do. Technology will always support us, but will never, at least for 100 years, be able to do what we do.” (27:33—27:52) -Dr. Coachman

“Young dentists that are still struggling with, ‘Did I choose the right profession? Oh my God, this is tough. Oh my God, right or wrong?’ you made a great decision....

See Inside the Mind of One of the Most Brilliant Teachers in Dentistry

Episode #623 with Dr. Christian Coachman & Dr. Bill Robbins

Every great mind is taught by brilliant teachers. In this two-part episode, Kirk Behrendt and Dr. Christian Coachman brings back one of those brilliant teachers, Dr. Bill Robbins, to share his thoughts on building a successful and happy career in dentistry. To hear about what brought him in and keeps him in this amazing profession, listen to Episode 623 of The Best Practices Show!

Episode Resources:

• Join Dr. Coachman on Facebook
•  Follow Dr. Coachman on Instagram
• Learn more about Digital Smile Design
• Register for DSD Residency 1
• Send Dr. Robbins an email 
• Join Dr. Robbins on Facebook
• Learn more on Dr. Robbins’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 the Global Diagnosis Education Symposium (September 7-9, 2023)

Read Global Diagnosis by Dr. J. William Robbins and Dr. Jeffrey S. Rouse

Main Takeaways:

Success will take a lot of hard work.

You can't become successful by yourself.

Cultivating relationships is critical in dentistry.

Discover ways to maintain the “beginner’s mind”.

Find people who will support you in your journey.

Quotes:

“That which makes dentistry so fun, so enjoyable, is the relationship part of it. My father was not a great clinician. He was actually a farmer who loved to farm, and dentistry just supported his bad habit of farming. He didn't have the passion for dentistry that I have. So, it was the relationship part that I first learned about when I hung out with him, and how he related to his patients, and how much they loved it. So, what drew me into dentistry, I think, was the relationship, not the technical part. I mean, from the clinical part, obviously, dentistry is so much better [today] in so many ways. Back in his day, what he would do — I would stand there and watch him — he would extract 28 teeth on a patient and put in an immediate denture. That was a normal day for him. Well, that's not a normal day anymore. We don't do that anymore. But the relationship part of it, I think, is what drew me into it. And I would say, at this stage, it's what still is the most rewarding for me because I'm still practicing.” (9:03—10:15)

“I [sold my] practice to a young prosthodontist three years ago, and she's been a wonderful friend and boss. What brings me to the office these days — what I continue to enjoy doing here — is primarily seeing my old patients. So, I'm still doing dentistry, and I do some sophisticated dentistry. I don't work nearly as hard as I used to, but I see my old patients that are really her patients now, and I have time. I'm not rushed anymore, so I have time to sit and talk with them. And so, it's interesting. What brought me to dentistry was the relationship part of it, and what's going to usher me out at the end is the same. And then, there was a lot of technical dentistry in between.” (10:16—10:59)

“We all go through many different passages in our lives. I went to the Pankey Institute many years ago, and I learned about the Cross of Life and the four arms of the cross and happiness in the center. I've come to believe that it's a very difficult and perhaps even a false thing that we're trying to attain with this goal of living our life in balance.” (11:13—11:41)

“The idea of living your life in balance is impossible. If you're building a practice, it's going to take more of your effort than the play side of your life. So, I'm not demeaning play and family and work. I think those things are incredibly important. But certainly, there are times in your life passages when you're going to have to commit more to one of those four arms than the other. So, I think that the success of a young dentist is going to take a lot of work, and there's no way around it. And I think the next part of it is, you can't do it by yourself. Clearly, you have to have people taking this walk with you. I've had so many people along the way that have helped me from the business side, the professional side, the emotional side, the behavioral side. Dental school is literally just dipping your toe into the pool.” (12:03—13:01)

“What I've loved in my career is watching the light bulb go on. I know that Christian and [Kirk] also have experienced that a lot. That's when you're working with a younger dentist, student, or resident and, all of a sudden, they get it. There's some concept that they get. That feeling, I think, transcends almost any for me as a teacher, when I see a light bulb go on in the mind of a young dentist, and they get either a vision, or at least they get an idea of what we were talking about, what the goal was for the discussion we were having. And so, the thing I love is being around young dentists. I love dental students and young dentists and residents because they make me feel young. They energize me. When the light bulb goes on in one of their heads — and less now, in all honesty, but occasionally the light bulb goes on in my head also. So, there's still clearly a give and take.” (13:21—14:29)

“I've always been so grateful to my father for many, many reasons. But one of the reasons is that he had a vision for me that I didn't have for myself. He essentially gave me the freedom to go off and pursue this other career — and he would’ve loved to have practiced with me. We would’ve had fun together. It would’ve been a successful practice. But he knew the type of dentistry he was practicing wasn't going to be rewarding to me, and I think he knew that there was more there for me than a career pulling teeth in Little Rock. And so, he gave me the freedom and pushed me out of the nest to do the academic thing first. And I never returned. I never went back into practice with my father. But I think he was very proud of the academic career that I had. He never saw me in private practice because he died. I was in academics for 25 years, and he died before I went into private practice. So, that was the front end, the freedom that my father gave me to spread my wings.” (19:25—20:36)

“[Digital Smile Design] has been one of the most important and relevant things to have happened to me in the last decade for a couple of reasons. First of all, it's really fun. It really helps with this whole issue of patient communication. That is, for me, the crux of DSD, and that is the patient communication part. But it's also, I think, helped me to remain relevant because as I age and stand in front of groups, people know I'm getting older. And in order to be relevant to a younger group of dentists, you can't be talking about gold restorations. I mean, I still do gold in my practice. But you can't lecture about that because it's not relevant anymore to them. And so, DSD has brought a lot of pleasure to me in my clinical practice, but it's also helped me to remain relevant, I think, in the eyes of younger dentists.” (23:17—24:13)

Snippets:

0:00 Introduction.

5:44 Why Dr. Robbins chose dentistry.

7:54 The importance of relationships in dentistry.

11:01 Keys to a successful and happy career.

14:40 The pillars for success.

15:26 Light-bulb moments in Dr. Robbins’s career.

20:36 How DSD keeps Dr. Robbins relevant.

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.

Dr. Bill Robbins Bio:

Dr. J. William Robbins, D.D.S., M.A., practices part-time and is an Adjunct Clinical Professor in the Department of Comprehensive Dentistry at the University of Texas Health Science Center at San Antonio Dental School. He graduated from the University of Tennessee Dental School in 1973. He completed a rotating internship at the Veterans Administration Hospital in Leavenworth, Kansas, and a two-year General Practice Residency at the V.A. Hospital in San Diego, California.

Dr. Robbins has published over 80 articles, abstracts, and chapters on a wide range of dental subjects and has lectured in the United States, Canada, Mexico, South America, Europe, the Middle East, and Africa. He co-authored a textbook, Fundamentals of Operative Dentistry – A Contemporary Approach, which is published by Quintessence, and is in its 4th edition. He recently co-authored a new textbook, Global Diagnosis – A New Vision of Dental Diagnosis and Treatment Planning, which is also published by Quintessence.

Dr. Robbins has won several awards, including the Presidential Teaching Award at the University of Texas Health Science Center, the 2002 Texas Dentist of the Year Award, the 2003 Honorary Thaddeus V. Weclew Fellowship Award from the Academy of General Dentistry, the 2010 Saul Schluger Award given by the Seattle Study Club, the Southwest Academy of Restorative Dentistry 2015 President’s Award, and the 2016 Academy of Operative Dentistry Award of Excellence. He is a diplomate of the American Board of General Dentistry. He is past president of the American Board of General Dentistry, the Academy of Operative Dentistry, the Southwest Academy of Restorative Dentistry, and the American Academy of Restorative Dentistry. 

How AI Could Be Better in Dentistry Than in Healthcare

Episode #622 with Florian Hillen

Do you want to elevate patient care? AI is your answer! To introduce the next big thing in dentistry, Kirk Behrendt brings in Florian Hillen, founder and CEO of VideaHealth, to showcase their AI software used by thousands of dentists and practices. Using it will increase trust with your patients, improve treatment acceptance, and optimize scheduling. To learn more about VideaHealth so you can start using it today, listen to Episode 622 of The Best Practices Show!

Episode Resources:

• Join Florian on Facebook
• Learn more about VideaHealth
• Subscribe to the Best Practices Show Podcast
• Join ACT’s To The Top Study Club
• Join ACT’s Master Class
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

Watch Florian’s TEDx

Read more about VideaHealth’s FDA clearing

Read about VideaHealth and Henry Schein’s partnership

Main Takeaways:

Using AI can optimize scheduling.

AI will help increase your case acceptance.

You will be able to identify more treatment options with AI.

Building trust and increasing patient education is easier with AI.

It’s not AI versus clinicians. AI working with clinicians is a win-win.

Quotes:

“I believe that [AI] is an industry-wide disruption. Similar to when we had industrialization, or every time we have very new technology, a lot of things are changing. But I truly believe it will change for the better. In dentistry, in particular, I think it will enable clinicians to finally spend more time with their patients to build this patient-provider relationship and trust, and also make the job much more fun while it helps them on diagnostics, as well as automate a lot of administrative tasks. I think there's a huge opportunity.” (5:13—5:50)

“I think there are problems pre-office visit, during the office visit, and maybe post-office visit. Pre-office visit is all about patient engagement, scheduling appointments, etc. I think, there, we would see AI relatively quickly being introduced where you can have a natural feeling discussion with the office of when you should schedule or reschedule your appointments. It helps the provider because you can be super responsive also on the weekend, but you don't need to be online all the time. Also, it optimizes your schedule and I, as a patient, don't feel that I'm getting all of these cancellations. So, that's huge.” (6:30—7:13)

“One of the biggest challenges we've been seeing is that there's a huge information asymmetry between the dentist as well as the hygienist and the patient. The dentist knows exactly, ‘This cavity is all the way through the enamel and into the dentin, and it needs a filling.’ But the patient [doesn't] understand that. So, there's a huge suspicion from the patient if they really need this treatment. And to be honest with you, the suspicion towards the provider is, in dentistry, larger than in any other healthcare domain. One of the reasons is because in healthcare, where I was before, if you have a radiologist who does a diagnosis, but then the surgeon confirms it — so, we have a lot of confirmations vertically and horizontally, which you do not have in dentistry. You only have this one provider who does everything, from diagnosis to treatment. So, there's this mistrust, unfortunately, to some extent.” (7:17—8:09)

“We have FDA-[cleared] algorithms. So, you can imagine you are a dentist, and you are taking the X-rays, or the hygienist takes the X-rays, or the assistant. We automatically source this into our AI-powered X-ray viewer, which we call Videa AI, and it points out all the potential cavities. It points out radiographic bone loss. It points out the calculus, etc. It then visualizes it to the provider to [help] make a more informed treatment decision, but most of all also to the patient so they see an ad hoc second opinion. So, where we've seen this is it helps tremendously with treatment acceptance. Treatment acceptance increased by over 20% of our customers because they are communicating with this AI the treatment plan. That's why it helps. It helps with transparency and treatment communication.” (8:15—9:04)

“Post visit and administratively, in terms of treatment planning, charting, claim submission — all of these front office tasks which take a lot of time, and are not fun, and take away time from the entire staff to spend it with the patient — all of that, I think, will be automated to a large extent in the next two years.” (9:06—9:28)

“We already have tons of people adopting [AI], and we have great success stories of patients converting treatment. And patients want to go to the dentist who uses AI because they want the second opinion. We also have dentists who are reaching out all the time to give us more product feedback and what else they want, which, from a software perspective, that's the most amazing thing that can happen because that's how we can build an even better product.” (12:14—12:38)

“This is based on product feedback. We are now sourcing automatically to pass X-rays of a patient. So, you are coming in, and you were there last year. You are coming in this [year] again. We are diagnosing both of your X-rays. We are taking the past X-ray and we’re identifying the same decay, and then we can show you how much your decay grew in the last 12 months to explain the progression of disease, because the progression of disease is much more relevant than the stage of disease. So, those are things which we are building together with our clients, and that's incredible.” (12:50—13:21)

“I think the problem in radiology is AI, to some extent, did threaten the jobs of radiologists because that's what radiologists do. They sit in a dark chamber, and all day they diagnose different X-rays or CT scans or MRI scans. Now, in dentistry, it's a bit different. A dentist has a lot of jobs. They are a businessman or woman. They are diagnosticians. They are primary care physicians. They are surgeons. It's four jobs in one, which is honestly phenomenal that they can do it. We are only supporting them in the diagnostic part, at this point, as we automate a lot of processes. It's not competitive at all because what we want them to do is to save time as well as be able to communicate it to the patient clearly. And so, what we are predicting is that the adoption of diagnostic AI will, in the next two years, significantly surpass the adoption of AI in healthcare, meaning in radiology. I think we are absolutely on track of that. We are already used, as I mentioned, by over a thousand dentists. We diagnose over, I think, a couple of million patients per year now. So, the adoption is rapid and I'm very excited about it.” (19:05—20:28)

“I do believe that in the next two years, AI-supported diagnostics in dentistry will become, to some extent, a standard of care. And patients will also request that. I can speak from my own experience yesterday, being at the dentist’s and seeing our AI. I would like to have that. And then, number two, I do believe it will elevate or it will enable dentistry, in the long run, to get to medical-dental integration. And that is also what our company — that's why it's called VideaHealth, by the way. Videa means to improve overall health — is about. I do believe, with massive amounts of data, we can do studies with AI machine learning where we can actually show if you have certain age, gender, diabetic, etc., certain other medical conditions, and then you have this bone loss, this calculus, and all of that, you have a very high risk of being diabetic, or have hypertension. And then, we can flag that, and we can request to send them to a primary care physician. I think that's how actually — not healthcare will go into dentistry. I think dentistry will go into healthcare. That's our vision for the company, that we enable medical-dental integration in the long run.” (20:40—21:56)

“Experienced dentists think it's AI versus them, and they think, ‘I don't need AI.’ I totally understand where that's coming from. But at the end of the day, we see AI similar to digital radiography. Like, when we had phosphor plates, everyone was like, ‘I don't need digital radiographs.’ But at the end of the day, it's another [tool in the] toolbox which makes things easier, faster, better. I think it is a tool which supports the dentist in making their treatment plan, as well as converting it. But it should not, in any way or form, cut the autonomy of the dentist. That will always stay. And I think that is what we are facing, not in young dentists and not in hygienists, but especially in experienced dentists, is that they see it as challenging them.” (22:27—23:21)

“Where AI is really good, the dentist is not so great at. And that is being consistent. Like, not being sleepy, haven't slept well, or you are already in your office for nine hours, and now comes new patients, like being impatient, or whatnot. That just happens. We are humans. AI is always on point. It never sleeps, and so on. Now, the dentist is much better at taking the input from the AI and then forming a holistic treatment plan. Like, know the patient, know the history of the patient, sees the patient, sees the skin color, understands how they are feeling, understands fears, and all of that. AI is terrible at that. So, bringing the strength of a dental clinician with lots of experience and being human, together with AI, it's a win-win. It's really a partnership. It's nothing against. It's like, together they are better, if that makes sense. It's pretty magical, to be honest.” (23:42—24:44)

“We are helping our clients right now to save time, as well as get higher treatment acceptance by improving patient communication. I also believe that this is the future, and in two years it will become the standard of care, and patients will demand it. I'm very excited about it because there will be more and more stuff around automation of strenuous tasks. And so, I would encourage your listeners — obviously very innovative. I mean, listening to your podcast, innovative clinicians — to reach out and give it a try and see for themselves if it helps them. I'm convinced it would be.” (25:48—26:26)

Snippets:

0:00 Introduction.

1:45 AI, explained.

6:05 The problems that AI can solve.

9:42 The impact of AI on treatment planning.

13:47 Why FDA approval is important for the AI process.

16:47 How AI helps with patient communication.

22:12 What dentists get wrong about AI.

25:24 Last thoughts on AI in dentistry.

26:48 More about VideaHealth and how to get started.

Florian Hillen Bio:

Florian Hillen is the founder and CEO of VideaHealth, an MIT spinout and leading dental-AI company working with leading DSOs, insurers, and other companies in the dental industry. Previously, he conducted research at the intersection of engineering and social science at MIT’s Institute for Data, Systems, and Society and at Harvard Business School. He also worked for McKinsey & Company and founded Ninu, a digital healthtech startup. He holds two master’s degrees from MIT in computer science and technology policy, and a bachelor’s in management and technology. He has also completed the first German State Exam in medicine. 

Overfunctioning and its Unintentional Consequences

Episode #621 with Ariel Juday

Your team is smart and capable. Step back and let them be successful! To reveal how, Kirk Behrendt brings back Ariel Juday, one of ACT’s amazing coaches, so you can stop overfunctioning and feeling overworked. You can't and shouldn't do everything on your own! Empower your team to find purpose in their roles. To start delegating more and stressing less, listen to Episode 621 of The Best Practices Show!

Episode Resources:

• Send Ariel an email
• Follow Ariel on ACT’s Instagram
• Subscribe to the Best Practices Show Podcast
• Join ACT’s To The Top Study Club
• Join ACT’s Master Class
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

Read Scaling Up by Verne Harnish

Read Traction by Gino Wickman

Main Takeaways:

If the leader overfunctions, it causes the team to underfunction.

Sift through the untrue and unhelpful beliefs you have.

Get rid of the limiting beliefs about your team.

Empower your team by stepping back.

Your team is smart and capable.

Quotes:

“[Overfunctioning is] when as a person, as a leader, or as an individual, we're taking on too much responsibility. That means we're trying to either control things that we can't control, or we're trying to fix it. We're trying to [solve] the problem. And common for business owners, and I think as you probably have experienced, is when we're doing too many things that aren't essential all the time. We may feel that they're essential, but they're not necessarily essential at this moment, and they're maybe not necessary. So, we're taking on way too many responsibilities. As you can imagine, that leads to a lot of burnout.” (2:30—3:07)

“There are a lot of examples [of overfunctioning] within the office of, they're doing things that they feel — it's out of our own anxiety, our own insecurity that it needs to be done, or maybe someone else can't do it as well. I see a lot of dentists and a lot of my clients involved in a lot of the basic administrative tasks. They're daily execution tasks that — that's what your team is for. That's what they can do. Like photography — there are lots of team members that would love to do it and love to learn about it. I have one client, she checks the notes at the end of the day. Every single patient, she's checking their notes. So, it's constantly doing things that team members are happy to do. But as you mentioned, we're training them to underfunction. Maybe those team members no longer do it because, why would they? The doctor has done it for them for years.” (4:17—5:12)

“[Constant reminders to your team] demotivates them. It's now, you're constantly on them about something that they're not doing right, or you're doing it for them. Then, I think that becomes a disconnect. Now, you have this goal. You have this idea of where we should go as a team. But the team doesn't feel that because they're not engaged. They're not engaged in the process, either because they don't feel the need to, or you've trained them that way. Maybe they used to do it, or maybe we never gave them the chance to. So, I feel like as dentists and as leaders, we take that on and we start working on it, and we say, ‘Well, I'll just do it because it needs to be done, and it's easier if I do it,’ because we all know the process of training is tough. It's not easy and it takes time. It's slower than if I were to do it myself. But that's a short-term fix. What's the long-term goal? And that's where we start beating ourselves up, because then we start feeling like we're not doing enough because we're not getting to the big things. We're never being productive enough. But you ultimately can't when you have too many things on your plate at one time.” (5:48—6:56)

“One thing you see is a lot of resentment. As a leader, when you do start doing all of this and you feel like you are working harder than everyone else, or you're putting in more energy, you're working longer hours, you start resenting your team members because you feel like they aren't giving the same amount of energy to the same situations.” (8:35—8:58)

“[When we overfunction], we start creating a different reality and perceiving what our team members are thinking. ‘Oh, they don't care,’ or, ‘They're not trying.’ And that's not true. Then, as team members, they start saying, ‘Well, all they ever do is correct what I'm doing,’ or, ‘They're always looking behind my back,’ or, ‘They're always fixing it.’ So, then they get frustrated and start perceiving that as their leader or their dentist doesn't trust them. And I say to my teams, ‘As a team member, why would I put the effort in if you're going to go behind me and correct it? And then, it gets to the point of, I'm just not going to do it because I know you're going to do it anyways. So what if you're upset with me?’” (9:39—10:26)

“We know that perfection is never going to happen. You can't get there. You always have to worry about progress. If you're working for perfection, you're not going to be able to stop and celebrate the successes of where you've come from. If you're looking at, ‘Okay, I'm going to get a little bit better. I'm going to do one thing better today,’ it may not be perfect, but I improved. I went golfing last night, and I didn't do as well as I would have liked. But when I texted my family, I was like, ‘You know what? Overall, last night was not as good, but I'm still getting better.’ If I'm worried about beating everyone else on the course, well, that's not going to happen. I just started. You can't compare yourself because you don't know where they’ve been. I'm on day two. They're on day 102.” (11:32—12:22)

“[When you overfunction, the team starts] seeing that you're stressed. They start feeling it. And as we've already mentioned, there's a dynamic of, now, the team is underfunctioning. So, not only has the dentist created more stress because they're overfunctioning, which is going to lead to them to continue that process, the team is now underfunctioning. Now, we have an even bigger divide. Now, the dentist is like, ‘Well, now, I really need to fix this and rescue it,’ so they start overfunctioning again. That's where they get into that vicious circle. I think they really need to stop and say, ‘Okay, hold on. What is causing this?’ Because a lot of the time, if you're disengaged or you feel your team is disengaged, what has caused that? It's not just, all of a sudden, the team doesn't care. We've probably done something to get them to that point. So, it really comes down to self-awareness.” (13:21—14:15)

“What are some of those untrue or unhelpful beliefs that you're telling yourself? Maybe you're saying, ‘Well, I have to do it, or it won't get done.’ First, is that true, or is it not true? Maybe it's true. Or sometimes, it's not true. Then, it's like, ‘Okay. Well, if it's not true, why am I telling myself this?’ And then, you have to say, ‘Maybe it is true. But is it unhelpful for me to be thinking of it in a negative way? How can I change it?’ Because we start thinking of the way the team should be functioning, or the responsibilities. I think that's when we start looking for that perfection, and we start telling ourselves negative consequences and untrue and unhelpful beliefs of the situation.” (14:19—15:02)

“Start respecting your time and energy. What are we putting our energy to? You always say put your energy into the things that only you can do and that you enjoy. So, if I enjoy doing a particular task and that's something that I am the best person for the job, well, I'm going to do that. Let's start delegating and helping team members do the tasks that they enjoy. You have to start honoring your boundaries, because if you don't honor your own boundaries, how are you going to expect team members to honor those boundaries?” (16:39—17:15)

“When teams say, ‘These are your responsibilities. These are your daily tasks,’ do they align with that team member’s strengths? Because if not, we're really sucking a lot of their energy out. And then, that could cause me as a leader to say, ‘Okay. Well, they're not doing it,’ or, ‘They're not doing it very well.’ So, now, I'm going to start doing it. I feel that responsibility. I think we have to evaluate, does everyone have the appropriate tasks? And then, you can start evaluating right people, right seats.” (18:26—19:00)

“Delegation is not just handing over tasks. I could say, ‘Well, I don't want to do that, so I'm going to give it to someone else.’ That's not actually what delegation is. Delegation is looking at a team member’s skills and strengths and saying, ‘You know what? Honestly, they would be really good at this. I really trust that they would get this done.’ So, when I'm delegating something to a team member, that's what I'm telling them, is, ‘Hey, you have a skill set that I do not have. You have the ability to do something better than I can do, or faster, or more efficient, and I would really like your help with this.’ So, if you approach it in that way of, I'm not just handing over tasks. I'm actually giving them opportunities to show their success and to prove to themselves and to the team that they really are an important part of the team, that's what delegation is. It's looking for opportunities and helping them see that.” (22:17—23:17)

“It has to be a slow process because we have to make sure that we're setting them up for success. You can't delegate ten tasks in a row. We have to make sure that they have the tools, the training, and support, and that they're comfortable with that task before moving on. Because if you do just throw it all on them, now, it does feel like, ‘Oh, they just don't want to do that anymore, so now I need to pick up that slack.” (23:29—23:53)

“What limiting beliefs are you telling yourself? Become self-aware, and then trust the process. You'll be surprised how well your team responds and how empowered they feel once you step back. You will realize that, ‘Oh, I do have a really good team around me. I was the one that was being their ceiling. I was capping their abilities.’ Once you take a step back, you'll really see that teams become empowered, they become enthusiastic, they become more engaged the more that you give them, the more opportunities that you allow for them to have during their day-to-day work.” (25:26—26:08)

Snippets:

0:00 Introduction.

2:22 Overfunctioning, defined.

4:05 Overfunctioning causes underfunctioning.

6:59 Goals don't motivate your team.

8:29 Overfunctioning leads to resentment.

11:07 Avoid perfectionism and comparison.

12:22 Get rid of untrue and unhelpful beliefs.

16:26 The treatment plan for overfunctioning.

19:01 Why you need a Function Accountability Chart.

21:30 Delegation, explained.

25:18 Last thoughts on overfunctioning.

Ariel Juday Bio:

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

Outside of work, she can be found by the beach or the pool reading a good book, enjoying sporting events with her husband, Alex, or exploring the outdoors with her Bluetick Coonhound, Maddux.