The Best Practices Show with Kirk Behrendt

Solutions to the Hygiene Crisis

Episode #600 with Dr. Sam Low

We’re all asking how to attract hygienists. But there's another question you should be asking. How do you keep the ones you've got? To help you motivate the right hygienists who are already in your practice, Kirk Behrendt brings back Dr. Sam Low, associate faculty member of The Pankey Institute, with his insight into what hygienists truly want and the best ways to provide it. To learn how to keep your hygienists happy, listen to Episode 600 of The Best Practices Show!

Episode Resources:

• Send Dr. Low an email
• Learn more on Dr. Low’s website
• 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

Main Takeaways:

Don't wait to give your great hygienists a raise.

Empower hygienists with CE and provide opportunities.

Add technologies that can decrease your hygienists’ stress.

Understand what your hygienists actually want from your practice.

Hire hygienists for their people-person personality, not just their skill sets.

A huddle is not an option. Do morning huddles with your team every morning.

Quotes:

“I know that dentists have always appreciated a hygienist. But I'm sure they never appreciated them till they didn't have one.” (2:07—2:20)

“When we go to any kind of service, we like to see the same people. We don't like somebody different. Like likes like. And so, our patients, who are used to Sally being their hygienist for 20 years — now, Sally's gone. Now, Martha's there. ‘Who's Martha? I don't know. Martha's going to be in my mouth. Is she the same as Sally?’ And then, they say, ‘Well, maybe I don't want to go back there.’ Especially if you have, what? Constant turnover. How many times have you heard patients say, ‘I don't know what's going on over there. Every time I go over there, there's somebody different’?” (3:44—4:28)

“The most frequent, perfunctory appointment in a dental office is a dental hygiene prophylaxis. Nothing else repeats itself like that. It’s predictable. You kind of know what's going to happen. So, if that's the situation, to me, it would be like a process. First of all, how much time do you want for each one of those perfunctory appointments to occur? Now, here's going to be your problem. There is no way, with third-party reimbursement, that you can pay for a dental hygienist and the operatory with what you're going to get off of a prophylaxis in one hour. We've worked the numbers. It's impossible. In fact, if you're not careful, it'll be kind of like Medicaid — you're going to be paying them.” (7:14—8:16)

“Dental hygienists spend 50% of their time scraping on teeth — 50% of their time at that one hour — with antiquated scalers and curettes that they will not let go of because that's the way they were taught, and they were taught that, ‘If I ever give them up, I will die.’ And yet, power-driven instrumentation has been around since 1956. And now, we have the science to demonstrate that we can do the same prophylaxis 50% faster with technology. And now, I'm going to add the next one, and that is this thing called Air-Flow, air medicament erythritol — not a Prophy Jet, but these high-tech air medicinal delivery systems where you can do a prophylaxis on a normal patient with a little bit of calculus in seven to ten minutes with the sciences there. So, I'm not about, at this point, to tell a dental hygienist, ‘Hey, by the way, we're going from 60 minutes to 50 minutes, even though I know you're in the driver's seat and you're going to go bolt to somebody else's practice.’ But if I give them something ergonomically to where they can do these procedures with less chair time and spend more time doing, what? Head and neck exam, blood pressure, talking to the patients, have relationships with the patients, and selling my dentistry. I've looked at this every possible way, and the only way we can pull this off is to decrease the chair time of the mechanical debridement that has no scientific base, at this point.” (10:03—12:25)

“I am talking to practices that are actually saying this to me: they're moving towards a hygiene-centric practice. Isn't that interesting? Now, I'm not sure I want to go so far over because, in my mind, a dental practice is comprehensive care. But isn't that interesting that they're moving towards something called a hygiene-centric practice? And there are some philosophies out there that a little bit of the core of a dental practice is that dental hygiene segment. Why? Because, first of all, they see the patient more than anybody else. Actually, they see a patient more than anybody in healthcare. So, with that, let's take an opportunity.” (14:36—15:23)

“Something is very interesting. Dental hygienists are going to courses where the topics are about them. Now, it may say about their patients. But they're going to courses that are on nutrition, yoga, exercise, and stress. Isn't that interesting? Millennial hygienists, especially, they're going to courses, ‘What about me?’ And when I pick up RDH, because I read everything, you know what I'm seeing? And I'm starting to see it now with us, ‘Are you stressed? How do you feel? Are you taking time?’ When you talk to a baby boomer dentist and you say, ‘Are you stressed?’ ‘What is that? I get up in the morning. I go to work. I do my stuff. I come home.’ But when you talk to a millennial dentist, they say, ‘I need time for my family. I need time. A five-day week? Are you crazy?’ So, hygienists are the same way.” (16:35—17:45)

“Start looking at the possibility of adding some technology into the practice to decrease [your hygienists’] stress. Assist with their ergonomics. Provide them with the time. I always say, what does the hygienist do at lunch? Catch up. And I've tested this in large audiences. They don't take lunch.” (17:54—18:18)

“I think there are only three mission statements — in this order: quality of care, be happy doing it, and make money . . . It's in that order. And I always have to do a small preface in that I have spent a lot of years in Key Biscayne at Pankey. The reason I say that is that I don't want anyone to get the idea that we're talking about money, money, money, money. Dr. Pankey always said, ‘Do what you do best, and the money will come.’ So, in that order. When I say quality of care, I don't mean some altruistic, amorphous thing. I mean that they have the right equipment to do what they need to do, that they have the right amount of time to do what they need to do. To me, it's tangible things; it's metrics. It's not like, ‘Okay, kumbaya. Everybody, quality.’ No, no, no. Show me what you mean by quality.” (18:53—19:59)

“Number two [of your mission statement is], be happy. What does that mean? Economically, mentally, and physically. When a hygienist can't wait to leave the office because they're so taxed — on a Sunday evening, if they don't want to go in, you might say, ‘Well, that's just them.’ It doesn't matter. Dentists out there, you're not in the bargaining position right now. But that doesn't mean that you should be bending down to allow them to do whatever they want. No — there are positive solutions.” (20:24—20:55)

“Number three [of your mission statement is], there has to be an ROI in hygiene. But here's where some people do not think about it. If my hygienist is so taxed that she has no opportunity to talk about my treatment planning, who I am, and what I can do — the word on the street is 50% of a dentist’s production comes out of the hygiene operatory. That's the word on the street. But if she is so taxed, and so timed out, and so stressed, do you think that she's going to have a meaningful conversation about the fact that you place implants, about the fact that you are into sleep dentistry, the fact that you are doing these incredible veneers? No. I'll tell you what she's thinking about, just like you and I would be thinking about. ‘When can I get out of here?’ And I'll tell you what they do — sometimes they'll deny it. They pray for a cancellation. They pray for a cancellation just to catch up. And guess what happens? There goes my ROI.” (20:56— 22:11)

“[Hygienists are] being compressed at a time where we can't let them go. So, you see where I'm aiming at? Almost like a perfect storm. We have got to pay attention to this. I was reading this article. They were saying, ‘How to keep your team.’ One of the things was to take them bowling once a month, or to have a party once a year. And I must tell you, I said to myself, ‘Are you kidding me?’ No — what they want is every day, hour by hour, ‘I want to be there. It's a great place to work.’ Giving those kinds of things, perks, that's not what they want. In fact, a survey was just done. They truly do think about money, as they should. Maybe these people are single parents. They should. But do you know what was number two? Positive workplace environment.” (23:21—24:22)

“Hire an associate dentist to be a hygienist . . . You're laughing, but I can tell you there are DSOs out there that are doing that. And there are dentists in Southern California that are new graduates that are making as much money being a dental hygienist as they would be doing restorative as an associate.” (25:43—26:09)

“There actually is not an answer [to attracting and hiring great hygienists] when there's no pool.”  (26:20—26:23)

“If you feel that your hygienist should be making more money, and the value that they can provide to you — especially if you have meetings with them and see what more can happen within that time frame — go ahead and raise them now. Do not let them talk to each other, go out and talk to a dentist down the street, and then come back and say, ‘Well, she's going to offer me ten more dollars,’ and then, you say, ‘Oh, okay. Well, then I'll increase you by $10,’ because what that says to her is that if she hadn't come back with a competing hourly wage, you wouldn't have raised her.” (27:00—27:50)

“I understand about overhead. I know the overhead is increasing. The production, to a certain degree, is decreasing. I've got it. I said advice is cheap. It's a lot easier, you and I talking, than you and I owning a small business. But you may find that increasing their salary by X, potentially, will make your life so much less stressful, but also make more money if they're doing the procedures that actually make money.” (27:56—28:30)

“There are many, many dentists out there that are doing everything perfectly. But I will tell you something. I don't care who you are out there. You are not immune from a dental hygienist walking in and leaving. No one. So, in my mind, I would much rather you try to retain and have positive conversations than be in the position to where you're trying out there with ads and circling the wagons because, also, hygienists know good practices are not.” (30:11—30:52)

“[If you want to keep hygienists long-term], treat them as a nurse practitioner. Empower them. Give them the opportunity and the time to be able to do what they need. Even though there may be a little bit of pushback, decrease the amount of time they are mechanically doing things at the chair. We forget that over a career life span, dentistry is very taxing on the body. We ignore that. And so, I'm suggesting, bring in the technology. Bring in the ultrasonics. Send them to continuing education courses. Let them be CE junkies. Give them time off to do CE. Every now and then, I'll talk to a dentist who says, ‘Well, if I let them go there, I'm going to lose production.’ Well, you and I both know how shortsighted that would be. Give them continuing education.”  (31:41—32:38)

“Friends, you’ve got to do a huddle every morning. A huddle is not an option. It is something you have to do every single morning. So, you give them technology. That gives them the opportunity to have the time to be able — they're going to appreciate that you've invested in them, for the most part. And you have to be a good listener. You have to be a good listener. The days of a prophy goddess is over if you want to create what we're discussing.” (32:41—33:18)

“I believe you need commission and salary. I've worked with enough practices — I'm going to do a very simple formula. It won't be best for everybody, but in my mind, this is the formula. It's going to be quick. You tell me what you want your hygienist to make a day, a quota. You do know most practices don't have that. You’ve got to have that. And you can tell what that is. Those are the procedures that your hygienist does. Any other procedures, they're not going to get credit for. So, let's say it's $1,100 a day. Anything they make over $1,100, they get one-third of every month. Straightforward, transparent, and open. This is the way it is. If your quota is $1,500 dollars — I don't care. But please don't make your quotas so high that they can never achieve it.” (33:26—34:38)

“[Sally McKenzie] always said one-third goes to the dentist, one-third goes to the hygienist, one-third goes to the practice.’ She's always talked about the third, the third, the third. I'm very concerned that hygienists are going to want to move towards practices that have some type of commission base. Now, I'm going to reinforce something. The dentist is still the CEO. We are not subservient. We are not at the mercy. If you feel you're in that position, then we've got to have another conversation.” (35:14—35:55)

“I go to these meetings where they do teambuilding. It goes in one ear and out the other because they don't practice it.” (36:00—36:08)

“There are only two kinds of days. There's a “cardiac” day, and a “nirvana” day. Most cardiac days are caused by a process. Most nirvana days are caused by a process.” (36:17—36:31)

“I like to hire hygienists that know how to sell themselves. I like to hire hygienists who have been professionally trained in sales. I was with a hygienist, and she had been trained in selling shoes at Macy's. She had been through sales training. She knew how to close. She knew how to develop relationships. She knew how to be eye-to-eye. In an interview, if a hygienist can't look me in the eye and be eye-to-eye, I can tell you they're not going to be hired because I can't change that. I can show them how to do debridement. I can show them how to find calculus. I can show them how to do periodontal charting. But I can't show them how to create a personality that is a people person. So, on your interview, don't just think about their skill sets. You can send them to one of our CE courses and get that. You've got to think about, ‘Are they a people person?’ to have the kind of practice you're describing that you want to be in.” (37:39—39:00)

“We always say in the business, ‘A dentist is quick to hire, slow to fire.’ . . . Now, let's turn that around. First of all, there's not a lot of “quick to hire”. But guess what? You don't have to worry about “slow to fire” — they're gone.” (39:15—39:31)

“I never understand why a practice would not have voice-activated periodontal charting. I mean, that is a slam dunk because that is one of the primary things that hygienists will tell you, ‘I have to do periodontal charting by myself. When I look out to find someone to help me, the rats have left the ship. There's no one to help me.’ And then basically, as a periodontist, I'll tell you what happens. ‘We'll do it next time. We’ll do it next time.’” (40:20—40:59)

“Some global data just came out. We thought 47% have bone loss periodontitis. We now think about 62% to 64% of the population has periodontitis. And then, with the oral systemic link, everything else, I think we're in the — it's not going away.” (48:25—48:42)

Snippets:

0:00 Introduction.

1:15 Dentists’ number-one issue today.

6:38 The anatomy of a great hygiene department.

9:58 A Total Perio Solution you need to incorporate.

12:28 The role of a hygienist.

18:23 Three mission statements.

22:41 What your hygienists truly want.

24:23 How to attract a hygienist.

30:54 Ways to keep great hygienists long-term.

33:18 Think about the one-third.

35:59 It comes down to processes.

37:30 What kind of hygienist to hire.

42:44 What Dr. Low teaches in Total Perio Solution.

49:03 How to get in touch with Dr. Low.

Dr. Sam Low Bio:

Dr. Sam Low provides dentists and dental hygienists with the tools needed for successfully managing the periodontal patient in general and periodontal practices. As an associate faculty member of the L.D. Pankey Institute for 25 years and Professor Emeritus, University of Florida, College of Dentistry, Dr. Low’s many years of experience training dental professionals is evident in his straight-forward, informative, and entertaining teaching style. Dr. Low’s presentations focus on creating positive interactions between dentists, periodontists, and dental hygienists through communication skills and continuous quality improvement to enhance esthetics, tooth retention, and implant placement.

Dr. Low’s achievements and awards include:

• Certificate in Periodontology

• 35 years of private practice experience in periodontics and implant placement

• Graduate of University of Texas Dental Branch at Houston

• Diplomate of the American Board of Periodontology

• Past President of the American Academy of Periodontology

• Past President of the Florida Dental Association

• Former Trustee to the ADA

• Selected “Dentist of the Year” by the Florida Dental Association

• Selected Distinguished Alumnus by the University of Texas Dental School

• Recipient of the Gordon Christensen Lecturer Recognition Award 

Team “Never Sell” Your Practice

Episode #599 with Dr. Craig Spodak

Do you ever feel like selling your practice? Whatever your reason — stop! There is probably a better option. To explain the pressure you're feeling to sell, important things to consider, and different options that are available, Kirk Behrendt brings back Dr. Craig Spodak, co-founder of Bulletproof Dental Practice and author of The Bulletproof Practice. Create a business you never want to sell! To learn how, and to learn more about the upcoming Bulletproof Summit, listen to Episode 599 of The Best Practices Show!

Episode Resources:

• Join Dr. Spodak on Facebook
• Follow Dr. Spodak on 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:

Learn more about Bulletproof Dental Practice

Register for Bulletproof Summit (August 11-12, 2023)

Read or listen to The Bulletproof Practice by Dr. Peter Boulden and Dr. Craig Spodak

Listen to Bulletproof Dental Practice podcast on Apple Podcasts, Spotify, Stitcher

Watch Bulletproof Dental Practice videos on YouTube

Main Takeaways:

Dentistry is whatever you want it to be.

Never forget the “why” behind your dentistry.

Ignore the FOMO you feel about selling your practice.

Identify exactly what you want in your life and your practice.

Don't make long-term decisions based on temporary emotions.

Quotes:

“Right now, we're all aware of this pervasive narrative of, ‘This DSO bubble is going to burst. Money is flooding in, but it's going to dry up. You don't want to be the last guy standing, not cashing in on the value of your practice.’ So, there's a lot of dental FOMO out there. I think that the narrative is strong and widely held by different parties. Whether those be different portions of the industry, there's a force to push us to consolidate. And I think it's fine if that's what you want to do because you want to exit your career, you want to exit dentistry. But I think there are a lot of people that are caught in the crosshairs of this narrative that just need to work on their businesses a little bit and make the business work for them, and they don't know how to do that, so they pull the F-it card and wind up selling.” (7:52—8:44)

“I am a big proponent of the team “never sell” concept where you learn how to make your business work for you, that you're not a prisoner of your business, that it can actually run like a business if you want that to be the case, and that you would then never want to sell.” (8:44—8:58)

“When you sell your business, you have to take that money and invest in another business. So, you never really exit business — you just exit yours and then go put the money somewhere else. And one thing that we as dentists that are operators know, we know our dental businesses. So, when you sell and you take that money and dump it in a mutual fund, I guarantee you don't know as much about that mutual fund as you do your own practice. So, the team “never sell” approach is to get the business working, and then make sure it provides the cash flow that a business of that character deserves, and then ride off with it.” (9:27—10:01)

“Everybody's situation is unique, and there are people that at the right time and the right place, it might not be a bad idea to transact their business. What I'm fearful of is that the message is so pervasive, and the net is cast so broadly, it's catching everybody. So, whether 10% of the population needs to hear that, ‘Hey, sell now,’ or 20%, or 5% — it's not 99%, is all I'm saying.” (11:13—11:40)

“You don't become a dentist because you're ready to be an entrepreneur. I've had portions of my life that are entrepreneurial, as you have as well. It's literally scary as shit. It's like, ‘Am I going to make it?’ And I think part of the reason why we all became dentists, number one, we want to help people. Number two, we're like, it's pretty recession-proof. It's pretty risk-averse. So, by nature, the act of becoming a dentist puts you in a small category of people who don't like to take chances. So, that's why it's a powerful narrative between like, ‘Hey, Dr. Jones, it's going to dry up. You're going to be totally high and dry.’ So, it catches us in a very opportunistic way.” (11:46—12:25)

“There's a lot of what you should do in dentistry. There are a million coaches. They all tell you that you should, ‘Do these four easy steps.’ Dentistry is beautiful in that it can provide exactly what you want. Each practice I ever visit is like a complete snowflake. They're totally, totally different. The way they maximize for either profitability, experience, legacy, charity — they all have their own vibe, or at least they should have something they stand for beyond fixing the teeth. So, the first thing I'd say to the 31-year-old is, what do you really want from your life? Because dentistry can provide that for you. You might just want to be a softball coach and do the dentistry three days a week for 5 hours. Or you may be an entrepreneur, ‘I want to scale a business.’ Or you may practice in a rural area and want to take care of the farmers, and two of your days are philanthropic and three of the days are for-profit. But you have to build what suits you.” (12:56—13:47)

“You have to do this if you're going to be fulfilled and successful in your life. You have to sit down and get intentional on what your future life is going to look like. So, 31-year-old dentist, he or she, sit down, describe exactly what your future practice looks like. It's not like this hopian bullshit thing where you try to come up with all this crazy stuff. Start the writing exercise. And as you write it, you'll have an authenticity filter. As you write something that doesn't resonate, you'll erase it. It'll be a cathartic and constructive process where you can describe your future life. Three ops, five ops, $500,000 production, $1.5 million production — get it all out. And then, from there, that's when I would start advising you. Because anything less than that, or without that step, I'm telling you what I would do.” (13:52—14:39)

“You're successful in life when you know what you want, and you get what you want, but you decided what you wanted, and you put some time into it. The worst thing is to get what you want and realize you never really wanted it. That's where you have no fulfillment and you're really miserable.” (14:59—15:15)

“We are our own worst enemies. It's the dialog that we have, the constant dialog, what we whisper to ourselves — it’s the most destructive force in our lives.” (15:55—16:04)

“If you believe that your area is not going to support the practice, and you tell yourself — and more importantly, you tell your team that — you will never be able to do it because you are the leader, and the psychology and skill set of the leader makes everything impossible or possible.” (16:52—17:08)

“We all create greater leverage for people that we care about than for our own selves. We all want to take care of other people sometimes more than we take care of ourselves. So, as you, the leader of the business, the doctor in the practice, if not for you, give your team the power to believe that is possible. Because if the psychology of a leader is not a fit for growth, you will never grow.” (17:14—17:40)

“There are people who are artists. There are people who are manager-leaders. There are people who are entrepreneurs. There are distinctions that people need to figure out who they really are.” (18:39—18:49)

“I don't have to be in the office today. There's no other reason that I need to be in my office today. I could handle everything from outside my office, but I chose to be here because I love it. I built something that I love. I'm an extrovert. I'm talking to different people. I'm engaging with them. But if you're an introvert and you want to build something like this, and if you don't put some really good operators in place, it's going to be really hard on you. So, I think it's like the first quote of the Stoics, ‘Know thyself.’ And I think the second quote, ‘Don't bullshit yourself.’” (20:52—21:24)

“People sell a business that is either not performing or they don't like. And then, when you have a business that you like and is not performing, you don't want to sell it, and everybody wants to buy it. So, if you are this person, you're listening to this and saying, ‘I pretty much decided I want to sell,’ but you're probably thinking, ‘I've got to get my business fit to sell. I want to get it better. I want to refine the process to then sell it,’ my suggestion is, go through the training to get it to work for you, and then reevaluate it. Because once you turn it passive — and I think all businesses, if left long enough with proper care and stewardship, should turn into a passive investment. That's the natural progression.” (23:00—23:45)

“I don't believe in this FOMO, ‘You're going to be left high and dry and never have any options.’ But let's face it. If you have a solo practice and you are the business, a DSO or a company that's going to be buying you is going to be buying you and paying you with your own money. So, you don't get to be Dr. Kirk and show up one day, get a big fat check, and walk out a year from now. If you do, they're going to have a replacement strategy, and there are going to be claw-backs. If you don't produce adequately, you could get the money clawed back. So, for those guys, it might even be compelling for them to work for four or five years, and then just throw the damn thing away. Because when you look at the money that they're going to give you, and then the taxable portion of it, and all the other components of it, it might not be as sexy as the letter of intent that slides across the table looks.” (25:34—26:27)

“If you're a team “never sell” person and your business is passive and you enjoy it, that's the most important thing. I think people work so hard in dentistry for so long that they can't bear the thought of another day, another month, or another year of doing it. If you get to that point — if you're at that point right now — I would suggest you take off a couple weeks. Your practice will survive. Never make a long-term decision on a momentary emotional feeling. I see a lot of people do that. So, what I would recommend is, get some clarity. Take some time off. I know you think you can't, but it will be okay. I'd rather you do that than flick the switch and sell when you didn't really want to.” (26:28—27:12)

“For those that have a business that exists, and it gives them some purpose and fulfillment, I don't see the need to ever sell it so long as the return on your investment of owning the business is as good as what it would be in the market. And what do I mean by that? If your business is worth $1 million and you're making at least, whatever you want to call it, five, six, eight, 10% on that money, then why sell it? Because if you sold it as a $1 million business, you're going to get hit with taxes. You're going to put it on the market and be lucky to get five percent. So, you've got to think about your assets.” (27:13—27:46)

“There have been enough DSO transactions where they've seen the pitfalls, where people get all their money and be like, ‘Okay, I'm not going to show up the next day.’ So, there is a hold-back. There's typically 60% to 80% up front, and the rest is in a hold-back. And the problem with the hold-back is some DSOs may actually tell you, ‘We're going to fire Sally because we have a Sally in our main office in Washington, D.C.’ ‘Well, I'm in Florida.’ ‘Yeah, but we have a Sally.’ ‘But Sally has a lot of brand equity and relationship with the patients. You fire Sally, the hygienist is upset.’ And, ‘By the way, it's no longer this composite. It’s this composite. No longer this lab. It's no longer this clear aligner, it's that.’ So, in many ways, you're handcuffed to be able to do the clinical dentistry and have the team around you that you always had. So, if they trim costs to benefit their P&L, they may affect your ability to produce. And guess what? You'll be responsible for that. So, there's a claw-back. What does that mean? It literally means that the money that they were given, the provisions, that they can claw it back and ask for it back. Very normal, usual, and customary. Something for you to know about. And that's usually not in the LOI.” (29:44— 30:55)

“Dentistry is a beautiful profession. It can be exactly what you want it to be. You're not stuck. If you hate your practice right now and you hate everything, what you've chosen, you listened to some people and you got in a place you don't like, don't worry. There are options for you. You can completely pivot your practice. You could be doing patchwork dentistry, and go to Kois or Spear, any of those great organizations, and start doing FMRs and comprehensive dentistry. You could be doing comprehensive dentistry, but it hurts your back, and you want to just do clear aligners. You can get an associate and give that to them. There are so many choices. When I talk to burnt-out dentists — and I talk to them all the time — they're so stuck with those blinders on. I was that guy too. And as soon as you start talking about this, like, ‘You're right. You're right,’ you see this weight lifting off of them like, ‘Oh my God, it's not that hard.’” (33:28—34:18)

“Dentistry is golden. It's a beautiful profession. You can pivot, you can reinvest — you can reinvent, rather — or you can actually take your practice and sell it, move to wherever you want. Anywhere you want in the United States that you love, you can go there and be okay. If you're a restaurateur and you fail, you're in deep doo-doo. As a dentist, if you have a license in good standing and a good skill set, pick any spot in the country that you want to live, and you can get a job as an associate. Maybe the pressure of owning a practice is not for you, and you realize that as well, and you're like, ‘Screw it. I just want to show up and do the dentistry.’ There are a lot of guys like me out there that would love to hire a seasoned dentist that's a good person and does good dentistry. There's so much optionality and we fail to recognize it. That's the big problem. That's why we're leading in divorce, and drug abuse, and all this stuff. We're leading in those kinds of categories because we don't understand what's really available to us.” (34:38— 35:38)

“We don't get burned out because of what we do. We get burned out because we forgot the why behind it. Dentistry is really beautiful. You get to be paid to help people. Never forget the privilege to be able to serve other people. When you make it about yourself and you start over-obsessing about yourself, you lose fulfillment and purpose. So, if you're in a burn-out stage, focus on everything around you. If you feel less appreciated, give appreciation. Whatever you want more of in life, give it away first.” (36:16—36:47)

“If you work with a team of dedicated people — or even if they're mildly dedicated but they've been there a long time — find new ways to appreciate them. If you're listening to this podcast on the way to work, go to work and tell everybody how much you appreciate them. ‘Sally, you're my hygienist. You've been here for four years. I'm not good at this stuff, but I want to let you know how much I appreciate the fact that you come here every day and help me with our patients.’ Diane, Johnny — do the same thing with all of them. Figure out a way, like a hack, to go out and appreciate everybody.” (36:47— 37:16)

“Realize that everyone suffers. In the Mastermind at Bulletproof, one of the great things that happens is they see people like me and Pete who are “successful”, got everything, they want it all, and they start realizing, ‘Oh, shit. They have major drama. They have huge troubles. They have upset team members. They have marital problems. They have problems with their kids.’ So, there's a realization that everybody is suffering, and everybody is coping. No one has it all figured out. Anybody who tells you everything is going perfectly is bullshitting.” (37:21—37:52)

Snippets:

0:00 Introduction.

2:06 Dr. Spodak’s background.

3:31 How he started Savin Ranch.

5:44 Failing forward.

7:40 Team “never sell”, explained.

10:02 Why dentists respond most to fear.

12:30 Create a vision for your future.

15:15 Get rid of self-limiting beliefs.

17:43 Figure out who you are.

19:52 Bigger isn't always better.

22:49 The “never sell” framework.

24:16 Don't make decisions based on emotions.

28:25 Hold-backs and claw-backs, explained.

32:14 Recognize the options and choices you have.

35:39 Why dentists get burn-out.

38:26 About Bulletproof Summit 2023.

Dr. Craig Spodak Bio:

Excellence in the practice of Dental Medicine is a proud tradition in the Spodak family. Dr. Craig Spodak is a third-generation dentist who earned his Doctor of Dental Medicine degree from the acclaimed Tufts University, graduating with highest honors. He joined his father, Dr. Myles Spodak, in his practice in Delray Beach, Florida, in 1998 with a dream to change the way patients experience dental care.

He inherited the practice in 2006, and immediately began to develop a new vision for the modern dental practice with a goal to deliver comprehensive dental care from a team of general and specialty dentists in one, convenient, 13,000-square-foot, state-of-the-art, LEED Gold Certified facility. His dream was to change the way patients experience dental care, and he worked tirelessly to...

The Truth Behind Happy Dentists

Episode #598 with Dr. Gary DeWood

There is one thing even the best dentists can't help you with in your practice. That one thing is your happiness. To bring you closer to it, Kirk Behrendt brings back Dr. Gary DeWood, executive vice president of Spear Education, to reveal the secrets to becoming a happier practicing dentist. By identifying three simple things for yourself and your business, you will experience more joy in this profession. To find out what they are, listen to Episode 598 of The Best Practices Show!

Episode Resources:

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

Learn more about Spear Education

Upcoming seminars at Spear Education

Main Takeaways:

Identify how much time, money, and patients is enough.

Have a clear vision of what you want for your practice.

Make a plan for your goals to make them happen.

Only you can know what makes you happy.

Don't try to be everyone’s dentist.

Quotes:

“Aristotle said — and I don't know that anybody has really changed anybody's mind if they disagree with this — that the whole purpose of life is to be happy. That's what everybody is seeking. In fact, the more I have thought about that, read about it, and talked about it to people, the more I believe that to be true. The difficulty is no one can define what it is that will make you happy, or what things you need for you to be happy. That's when you get into the whole thing about, you have to decide for yourself what it is you're after. What do you want? How are you going to decide? That is not something anybody can help you with.” (4:13—4:54)

“It's impossible to feel successful at the end and say, ‘I did that all myself.’” (7:28— 7:33)

“There's a time in your life when you should have a consultant. I believe this. That's why I said I don't think anybody does it all themselves. There's a time when somebody has to tell you what to do, ‘Do this.’ Well, first of all, I would offer this, for what it's worth, from my own personal experience. If you say to somebody, ‘I don't know what to do,’ because you trust them, and they don't immediately ask you, ‘What do you want?’ it doesn't matter what they say — don't listen, because that's going to be about them. If you know this person and they say, ‘Well, what are you after?’ — because I honestly believe unless you have some sort of an outcome in sight, any advice you get is going to be, ‘So, what?’” (8:45—9:32)

“What is your vision? What do you have as a vision? For me, it's, ‘What do you want? What are you hoping to get?’ And, by the way, it's going to change throughout life. It changes all the time. It's like looking at the horizon. It's out there. I see it. By the way, every step you take toward it, it moves a step away because that's where it is. That's where it exists. So, I think that what we have to think about doing is asking people to spend some time in their head before we can begin to answer those other questions and be advisors for them. And unfortunately, sometimes that gets in the way for some of the people who are looking. Because I remember being, ‘What do you think I should do?’ And what I really meant was, ‘Tell me what you think I should do so I can make up my own mind anyway.’” (10:19— 11:11)

“If somebody asks me, ‘What should I do?’ I will tell you my first response. You've heard me use this before because I use it with dentistry all the time. ‘I would love to talk about what you could do, because should is a power word and I don't want the power in this. I'm not the person looking to decide.’ And now, I can answer your question, ‘Based on what I know, this is what makes the most sense to me.’ And that works for everything in life, I think, not just talking to patients. It works for your own life. What do you want out of a practice?” (11:20— 11:56)

“Sometimes, the best thing you can do is find someone who gets your story out of you so you can hear it for the first time.” (12:29—12:39)

“Part of the problem is that we were all taught to sell people dentistry. And unfortunately, nobody wants to buy dentistry. No one alive, no human being alive, wants to buy dentistry. They want to buy something that dentistry will get them. And so, when we try to sell them dentistry, we're existing in our logical mind because it's how we were taught, and we're scientists. Of course, we would go there. Unfortunately, that doesn't move the needle.” (14:31—15:00)

“What I love to tell people, I say, ‘Go back. And this time, don't talk about the dentistry. Don't talk about the dentistry.’ We were taught this way: ‘Here's a list of what's wrong with you. I have this list I made of everything that's wrong with you. I have this list I made of everything I'm going to do to fix it. Here's how much that costs.’ And then, if they said, ‘No, thank you,’ you're supposed to now educate them. I said, ‘Why don't we educate them first, and then just stop? So, try this next time. Next time you're talking to somebody who has a bunch of things they didn't know about and they're receptive, they're asking some questions, they're in, go over everything that you've discovered, and then stop talking. After a few seconds, if there is not something coming from the patient, say something like this. ‘Kirk, based on everything we've discovered and saw together, which of those things do you believe is the number-one priority that we should be acting on immediately?’ And look them in the eye. Now, if they say something like this, ‘Well, could you tell me again?’ don't be hurt. Don't be surprised. Remember that almost all of the population on the planet, for sure in the U.S., has been conditioned not to listen to our lecture because it might make them buy something they don't think they want, because that’s been their experience in the past. And if you don't go there, it'll be different for them. I promise you they will hear you the second time because they know you're not going to ask them to buy anything.” (16:07—18:05)

“[Someone who came to our occlusion workshop] came up and said, ‘I have to share a story with you. I went home, and I did what you talked about. I cannot tell you how many people have asked me to do their dentistry.’ And I said, ‘Well, tell me more about that.’ He had a whole story. He said, ‘You know what? I just stopped telling them the treatment plan until they asked. And all of a sudden, when they asked, it was very different.’ That's what lights me up, because the truth is this — it's exactly the same treatment plan. Nothing changed with what you knew to do or didn't know to do. What changed was your ability to allow the patient to have a reason to want to hear that. And unfortunately, that's not how we were trained.” (18:32— 19:14)

“At some point, you’ve got to decide, what are you willing to sacrifice to be able to do something for a patient? And, by the way, I think it's noble. I don't see this as a negative, somebody who tries to figure out a way to do good stuff at a lower fee. I love you. Good. That's wonderful. But what are you willing to do to make the fee low? And unfortunately, that's going to be an endless cycle. I mean, the cheaper you do it, the more cheaply someone will ask you to do it. At some point, it's this race to the bottom. And don't hear this wrong. Some of the best dentistry that I have ever seen came out of places that lots of dentists badmouth every day as being mills and stuff. I've seen some beautiful dentistry out of places like that. I've seen some really crummy dentistry out of places that had incredible reputations. What I mean is, that's not what it's about. Obviously, it's easier to not make the bad stuff happen if you're being paid enough to do stuff.” (19:40— 21:31)

“Let me tell you the first step to, ‘How much is enough?’ Claim it, ‘I want more money.’ Money is about choice. Money is not what I thought I heard when I was in dental school at Case, which was, ‘Gary, if you think about money, you’ve just prostituted yourself to the dollar at the expense of those people you're supposed to be serving.’ Somehow, I heard that. And it stuck with me a little bit because it got in the way for some things until I could finally claim, ‘Well, no. Actually, it's one of the tools I need to use to be able to figure out a way to do the best stuff for all those people.’” (29:21— 30:03)

“If you want to know how to answer, ‘How much?’ you have to say, ‘What would I do with more money?’ For yourself, what would you do with it? If you don't have enough money and you say to me, ‘I want more,’ and I say, ‘How much?’ and you say, ‘Well, I don't know,’ my answer is going to be, ‘Well, I'm sorry. You'll never get there because you haven't established why you want the money. Tell me what you're going to do with it. What are you going to do with it?’” (30:34— 31:03)

“People always want more time. And so, then I say, ‘How much?’ And they go, ‘Umm . . .’ I say, ‘Can I ask you another question?’ This just happened the week before last. ‘What would you do with that time?’ The answer was immediate. They said, ‘I have a four-year-old son. I would love to find a way to spend more time with him. That would be important to me.’ I said, ‘Okay. In a normal week, how much more time do you want to spend with him?’ Now, he got into a whole discussion about, ‘Well, I don't even know if it had to be in one week. Maybe it's taking some more days off here and there.’ I said, ‘Okay. How many do you want to take off in a year?’ ‘I'd love to have an extra ten working days that I could do anywhere in the year.’ I said, ‘Excellent. Why don't we sit down and make a plan to make sure that you have the income that's appropriate to be able to do that? Because once you have a plan, you know exactly what you're shooting for.’ And do you know what I've discovered? Most people who make a plan make it happen.” (31:06—32:11)

“It's hard to see when you just know you need more. When you're frustrated about time, and you feel totally stressed out, and you don't have time for anything, I say, ‘How much more time do you need?’ If they can't answer that, it doesn't matter because it doesn't work. And this is the most important part. You can change your mind whenever it's appropriate. And sometimes, it's appropriate as soon as you said what you think you want. You say, ‘Well, I think I want this.’ And then, you go, ‘You know what, though?’ I'm serious — that's what happens. As soon as you begin to establish a claim — just show me the target so that you can see it yourself. As soon as you can see the target, I can say, ‘What ways do you see would be possible to get you there?’ I hear often, ‘I don't know.’ And I say, ‘Well, why don't we investigate some possibilities? Because now, we can talk about what might be possible. What could be possible? What could you do to make that happen?’ You’ve got to say, ‘What are you going to do with more time, more money, more patients? What are you going to do with them?’” (32:34— 33:43)

“One of the best realizations that you can have is that you can't be everybody's dentist. As soon as I realized I couldn't be everybody's dentist — I don't want everybody to come to me. And what I've learned in the years since is this. First of all, if I have more time than patients in my life, I have to say, ‘What is getting in the way of more patients coming here?’ If I had more patients than time, I have to say, ‘Who am I letting in?’” (35:51—36:32)

“Life is way too short for me to spend time with people that don't want to be happy when I'm with them. It just ain't worth it.” (36:48— 36:56)

“If you haven't clearly identified who those people are that you would choose to spend your time with, who are you looking for? It's going to be hard to say, ‘What would be the best thing we could do to recognize those people, and then find a way to have more of them and get them here sooner?’ Now, the number-one thing for patients is this. I believe this. First of all, you have to know what you want. When people say, ‘You know what? If they call, make them an appointment,’ I say, ‘Is that how you plan your life? How's that working out for you?’ Because usually, it's chaos. Put them in the schedule.” (38:23—39:10)

“One of our clients decided they wanted to grow the practice, thinking about maybe adding somebody, and all this stuff. They wanted 100 new patients a month — solo practitioner. I said, ‘Okay, perfect.’ I tore off four sheets of the giant paper that I had their schedule on and drew a week in each one. I said, ‘Put 100 people in that schedule, and then go ahead and block in your rocks for me.’ They came back to me after about an hour and they said, ‘We decided 35 is a great number.’ So, step one, identify what you want. I got what you meant when you said 100. And that's just because 100 is like, ‘I want a high flow of new patients.’ But the first thing you’ve got to figure out is, what is it, really? What do you really want? And then, I say, ‘Then commit to it. Put them on the schedule. Schedule them.’ It's amazing. You will do things you don't even know that you're doing to have those people in those blocks. Seriously, that's what happens. This sounds totally crazy, but anybody who has experienced it knows this. If you can't identify what it is you want, it's harder to hit it. As soon as you identify it, you do things that you don't even know will have an impact on that because you already know what you're after.” (39:13—40:29)

“If you want to change the mindset around dental benefit plans in your practice, whose minds have to change first? It ain't your patients. It's you and everybody in your practice.” (41:00— 41:09)

“I know I've used this one before, so people have probably heard this one, where somebody walks in and says, ‘I have this dental insurance, but it sucks.’ And then, I say, ‘Yeah, they all suck.’ And then, you and I both now are whining. It's like, tell me what good that does anybody. They really don't suck until you tell me what you're basing that on. They're exactly what they're supposed to be. When that mindset can change in your practice, now we can go to the real thing about this.” (43:10—43:36)

“If my mindset is that [insurance sucks], then a patient is going to pick up on that. And now, we're both righteously indignant, and patients don't do anything. People will do whatever is in their best interest in any way they can.” (45:00—45:14)

“The number-one question I think that every dentist can answer for themselves is, ‘How much is enough?’ It doesn't matter where you are in your career. It doesn't have to be, ‘That's in stone, and that's all I get.’ It has to be, ‘Right now, at this point in my life, to the horizon as far as I can see it, how much is enough? What would make me be able to go home at night and say I'm okay?’ Answer that for yourself. Answer it. And then, say, ‘Is there a way for me to get that?’ Because sometimes, what you find is you need to identify it and say it to yourself so you can hear it for the first time.” (50:37— 51:12)

Snippets:

0:00 Introduction.

2:37 Dr. DeWood’s background.

3:53 How do you define happiness and success?

6:00 You can't do it alone.

13:06 Don't talk to patients about the dentistry.

19:40 What are you willing to sacrifice?

21:32 Do you truly want to do big cases?

24:29 What a great schedule could look like.

28:04 How much is enough?

34:44 You can't be everyone’s dentist.

39:12 Identify what you want first.

40:42 Change the mindset around dental benefit plans.

49:09 Last thoughts for happiness in dentistry.

51:49 More about Spear Education.

Dr. Gary DeWood Bio:

Dr. Gary DeWood is the Executive Vice President of Spear Education. As one of the founding members of Spear, he directed Curriculum and Clinical Education for nearly a decade prior to joining in the launch of Spear Practice Solutions. Today, he splits time between teaching and consulting.

Dr. DeWood serves as an instructor in multiple Spear Workshops, including Facially Generated Treatment Planning, Occlusion in Clinical Practice, Advanced Occlusion, Sleep Medicine in the Dental Practice, and a special focus workshop on temporomandibular disorder. He also maintains a limited private practice on the Spear Campus in Scottsdale, Arizona, and lectures nationally and internationally on practice management, treatment planning, case management, case acceptance, TMD diagnosis, appliance therapy, occlusion, and esthetics.

Prior to his contributions at Spear, Dr. DeWood maintained a private restorative general practice with his wife and fellow Spear Resident Faculty member, Dr. Cheryl DeWood, in Pemberville, Ohio, before dedicating most of his time to teaching full-time. With 40 years in general dentistry, he provides a unique perspective on the application of the dental principles taught at Spear. He has spent years focused on diagnosing and treating functional occlusal problems and TMD, and as part of that focus completed the craniofacial pain mini residency at the University of Florida College of Dentistry in the early 1990s.

Dr. DeWood served as clinical director at The Pankey Institute from 2003 to 2008. He has held appointments as associate professor at the University of Tennessee College of Dentistry and assistant professor at the University of Toledo College of Medicine. He earned his D.D.S. from Case Western Reserve University in 1980, and an M.S. degree in biomedical sciences from the University of Toledo College of Medicine in 2004. 

How to Safely Reduce PPO Write-Offs Without Leaving PPOs

Episode #597 with Dr. Tom Orent

It’s impossible to reduce PPOs. That's what your friends and colleagues tell you. But it is possible — they just don't know how to do it right! To teach you how to do it safely, Kirk Behrendt brings in Dr. Tom Orent, “The Gems Guy” and CEO of Freedom Summit, to reveal his proven strategies that will free you from your “PPO hell”. To learn more about how Dr. Orent can help you and your practice, listen to Episode 597 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
• 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:

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:

Understand the true cost of PPOs to you and your patients. 

Don't go fee-for-service just to go fee-for-service. 

Remember that some PPOs will not negotiate. 

Learn how to reduce PPOs the right way. 

You don't need to leave all PPOs. 

Quotes:

“We get out of school, and we make the assumption that, ‘If I can be the best dentist I can be clinically, everything else will fall into place.’ Well, the truth is, if that's all you're focused on, everything else will fall — but not into place.” (3:38—3:50)

“One of the things I did was I went 100% fee-for-service. I decided that PPOs — that was the end of that . . . You don't want to do it haphazardly, as I mentioned a moment ago. So many docs make that emotional decision, and they say, ‘I hate,’ name any PPO you want, whatever it is, ‘I'm just going to pull out of it.’ And then, they end up getting hurt, financially, and patients leave in droves, and they're not prepared to do it. They're not prepared financially. They haven't prepared their team on how you speak to these patients, when should you speak to them, what should you say, how should you say it, and who should say it. There are so many pieces to that puzzle of doing it well.” (6:04—6:45)

“[I realized] we don't need to be 100% fee-for-service when there are two plans that are actually paying us well, treating our staff well, and the patients are great. So, I would never go fee-for-service just to be fee-for-service. I would do it because I'm being mistreated by the PPOs, if your fees are terrible, if the treatment they're giving you is terrible, if they're leaving your staff on hold for 30 minutes and then hanging up and pretending it didn't happen. One of our favorite people is a PPO expert with us, and his name is Ben. Ben told me that approximately 35% of all claims are denied or downgraded, not by a clerk, even — by an algorithm that just downgrades. Now, of course, the insurance industry will say, ‘We don't do that.’ But he said about 35% are downgraded or denied as an initial swipe just to get rid of half of the money.” (11:05—11:55)

“The average GP is losing anywhere from, low end, 25% write-offs, high end, 45%, even 50%, which is absurd. Just absurd. Now, where are we seeing 45% to 50%? Typically, that's in California, some parts of the Mid-South, and the Mid-Atlantic. But California is the worst offender. It's not at all unusual for a doctor to be writing off 43%, 45%, 48%, some 50%. We've run into a couple who are over 50%. So, you're working half a year for free.” (12:59—13:32)

“The more typical dentist is losing 30% [write-offs]. So, if it's a $1 million practice, $1 million production, which is a decent amount of production for one doc, it's a $300,000 write-off — $300,000. That's like a small practice. I mean, it's a small practice, but it's a small practice. It's $300,000. So, that's the surface cost. For a $1 million practice, it might be $300,000, $350,000, or $400,000. What about the hidden cost? Well, I've never yet spoken to a dentist who said, ‘Oh, I've already taken that into account. I realize that.’ And here's the hidden cost, financially. Let's say you're doing $300,000 worth of free dentistry — which, you are. It costs you 12% to 15% to produce it because you've got variable expenses. Variable expenses are lab and supply. On the low end, it's 12%. More typically, it's about 15%. That's $45,000, call it $50,000, that it's costing you out-of-pocket to give away $300,000 worth of dentistry. So, now, we're getting a little bit deeper. We've got $300,000 that you knew you were writing off. We've got $50,000 that you didn't know you were spending to write it off. So, the hard cost, financially, is $350,000. But it gets worse. There's not a practice out there that isn't spending a lot of money on staff to manage the insurance.” (13:36—14:59)

“Adjusted production is collectible production. [Dentists] always get mixed up, ‘Well, I don't know. We're doing $1 million.’ ‘Well, is that $1 million top line, or is that after write-offs?’ ‘Well, we don't do write-offs in our practice. We just put in the fee of the insurance company because it's too confusing, and it's quicker and easier.’ ‘You do, what?’ ‘Well, we have our staff just enter the network fees.’ That could be an episode in itself, but that is killing yourself. It’s killing every other doctor in your zip code, and it's blinding you to how much you're losing. I actually wrote a reverse formula. So, when we're working with a doctor trying to figure out what's going on, if they don't have their top line, we can figure it out for them in order to help them with a really close guesstimate to see what they're losing. And usually, that's the fuel that gets them started in the right direction.” (16:32—17:20)

“This is one of the seldom-spoken-about dirty little secrets within our profession. Nobody is proud of it, and it doesn't exist in every practice. There are doctors listening who can, rightfully so, say, ‘That's not happening in my practice,’ and I respect that 100%. However, what does happen in most practices is the doctors are painfully aware of what insurance will cover, what they won't, what they'll cover well, what they won't, and what they'll deny. And I've had many doctors tell me they won't offer certain services because they can't afford to, literally.” (18:24—19:01)

“I call it the devil and the angel effect. You walk in, and you're doing your assessment. You're looking at the radiographs, you're looking at photos, you're doing your probing, you're looking at all the teeth, trying to figure out what would be best for this patient. The angel is on one shoulder saying, ‘Tom, make sure that you offer the very best dentistry on each and every patient — no bias, no exception.’ That, by the way, is what we train our coaching members to do, and give them the ammunition to be able to do that, and get paid for it, and get the patients to say yes, even though a lot of it is out-of-pocket. So, angel, offer the very best. Offer what you would want done for yourself, your mother, your brother, your sister, your kids. The Devil is there saying, ‘Be serious. It's the real world. You're not going to get reimbursed for it, and the patient is not going to pay for it. Even if the patient would pay part of it, the insurance is going to downgrade it. And in the particular plan, you've signed a contract which says you can't balance the bill.’” (20:22—21:11)

“There are 43 different states, I believe, maybe 44 now, that have the Non-Covered Services Act. The Non-Covered Services Act says, ‘Hey, insurance companies. You have no right to dictate.’ The insurance commissioners were part of this, and the state, the dental societies, were really good for pushing on this as well to the legislators, and they finally got it passed in most of the states, this Non-Covered Services Act, which basically says if you deny this insurance company, then we can charge our patient the full fee, even though we're in-network. So, that's good. What's not good, and most dentists don't know, is 50% of the time, if you do that, even in a state that has that legislation, you will be committing insurance fraud at a federal level, not state. It's the state insurance commissioner that has the ability to say, ‘You can't do that, insurance company.’ And the legislation gave the insurance commissioner the teeth to say that. But there's about 50% of all plans that don't answer to your state insurance commissioner because they're federally funded.” (21:15—22:27)

“There are a lot of patients not getting the quality [of care] that they otherwise could get, just because we — when I say we, the dentist who is in a PPO — may make a decision not to offer certain things. But let's talk about the emotional cost on the doctor. I speak with so many docs who are so fed up, anxiety ridden, and frustrated that they know how to do the quality care, but they can't offer it, or don't offer it, or they do offer it and the patients aren't accepting it because they're just looking at their insurance. So, the emotional cost of PPOs — ultimately, it's a cost to the patient's health.” (22:37— 23:12)

“Ultimately, if you want to get out of PPOs, I would urge you to do it. If you don't want to get out, if things are fine, then don't change a thing. If you're doing well, financially, and you're doing great dentistry, and you've got great patients, and they're accepting of that care, and they're paying for it out-of-pocket, then — as I said in my dad's office, we didn't leave the last two plans. Thirteen, we did because they were terrible. Two of them were good, and we kept those.” (23:32—23:55)

“That's one of the biggest problems that we see, is somebody pulls out, they go fee-for-service, they destroy their practice, and then they rebuild by adding PPOs. And those PPOs give them the worst possible fees because now they’ve got them under their thumb. So, as far as moving forward, you mentioned that most practice management people see that practices will need to be some sort of hybrid in the future. I thoroughly disagree. It's going to be no different down the road than it is today.” (25:44—26:16)

“The vast majority of dentists will tell you that, ‘Even today, you can't go 100% fee-for-service. You just can't do it. You’d kill your practice, especially in our area. Tom, you don't understand. I'm in the deep bayou of Louisiana, and the people are poor. They don't have any money. They all have network insurance, and you can't do it here.’ Well, one of my favorite docs, Kurtis Zeringue, who's been with us for years and years and years, turned his practice 1,000% around, put away a big retirement — and all of this in one of the poorer areas, the deep bayou of Louisiana. I had a young lady in Socorro, New Mexico, Ginger Bratzel. Ginger said, ‘I'm thinking of maybe closing this practice, and then reopening somewhere else that would be more economically advantageous, and then maybe doing your program.’ I said, ‘Well, would you stay there if we can make it work where you are?’ She said, ‘Yeah. This is where I grew up. This is the indigenous [American] Indian population of the mountains of Socorro, New Mexico. These are my people. I don't want to leave, but I don't think you can do it here.’ I said, ‘Well, if we could?’ ‘Yeah.’ ‘Okay.’ She did great. She never moved. She stayed where she was.” (26:20—27:26)

“It doesn't matter where you are, and it doesn't matter how many dentists are in-network and tell you [reducing PPOs] can't be done. The reason that your friends and colleagues tell you it can't be done is because they don't know how to do it. That's the only reason they're telling you it can't be done. So, for somebody to tell you there will always — yeah, there will be a lot of hybrid practices. But that's because they don't know how to get out safely.” (27:44—28:06)

“The bottom line is, no matter what you negotiate, they're not going to give you a good deal. They're just not. So, if you think that, ‘Okay. Right now, my crown,’ and we're not supposed to discuss fees — FTC violations. So, let's say my crown fee is X, my whole crown fee, and I'm losing 35%. I'm losing 35% of my crown because that's my write-off. It's not like they're going to give you a 17% increase and, ‘Wow, that's not so bad. Now, I'm only losing close to 20%.’ That would still be terrible, but they're not even going to do that. They're going to come back with, ‘Yeah, we can give you 2%. We can give you 4%. We can give you 4.5%. Well, we’ll give you 4.75%’. Even if it's 5%, 6%, or 8%, or maybe you hire a PPO expert — and we've got a PPO expert with us — I'll tell you that negotiations is one of the services we don't recommend as often because it's a lot of money. Or you can try to do it yourself, and you're not going to get anywhere. But it can be done, and you can get better fees.” (29:03—30:10)

“I'm going to give you a little strategy that I used in my dad's office that worked like a charm. It'll work like a charm today, but it doesn't work very often. It only works occasionally. But when it does work, it's amazing. Which insurance company, and not by name, but what type of insurance company would absolutely negotiate before they would let you go? The answer to that is one that needs you. I think this is such common sense. Think about it. The only insurance company that will negotiate and give you better fees is one that needs you. Why would they need you? Because the ratio of number of employers and employees. So, they contracted with 200 employers, or 800 employees, whatever it is, in your area and they've got 10,000 patients, or 20,000 patients, or 100,000. It depends on whether you're rural, suburban, or urban. But the point is, they've got X number of patients under contract, and they've only got Y number of dentists, and the ratio is messed up for them and they don't have enough dentists. Why are some of the 800-pound gorillas refusing to negotiate? Because they don't need you. They simply do not need you. They never will negotiate. They just don't. They don't need you.” (30:51—32:06)

“How did I find out which [PPOs] will negotiate and which ones wouldn't in the Worcester office? Real simple. I never left a PPO until I could do it financially and it didn't matter if I lost every one of those patients. That's number one. We talked about that a little bit earlier. You want to get yourself in a position first. Then, when I was ready to leave, I sent them a certified letter, return receipt requested, saying — it was a very positive letter, by the way. It wasn't a negative letter. ‘I've appreciated working with ABC PPO. You guys have been great, and I love the patients, and it's all been good. However, unfortunately, at this point, I can no longer afford to offer uncompromised care.’ And this is the key. This is what we tell our patients as well. ‘I can no longer afford to offer the uncompromised care that we deliver with the compromised fees that we're getting. And so, please see addendum A. Addendum A is our new fee schedule.’ You’ve got to play hardball, but you can only do it if you're willing to cut and run completely.” (32:07—33:12)

“As I was cutting and running, I sent this [letter] out as a shot over the bow. At the end of the letter, it said, ‘If you are unable or unwilling to work with us on the new fee schedule, then please consider this.’ Let's say it was a 90-day notice for that company. ‘Please consider this our 90-day notice.’ It was return receipt requested, and we had the date that they had signed for it. So, we had proof that we had given our notice. About half of them, maybe 40% of them — and today, it might be only 20%. So, that's the biggest difference, is there are fewer who need you now. Back then, not as many dentists were tied into PPOs. But the same strategy will work to figure out who. But don't use this strategy unless you can financially afford to walk away. Having said that, many of them said, ‘Yeah, we don't want to lose you.’ What they're saying is, ‘We don't have enough dentists in your area.’ And so, they either gave me that schedule, or they gave me a little bit of a compromise, ‘Well, we can't do schedule A, but we could do 10% less than that. Would you take that?’ I said, ‘Sure, let's do that.’ Eventually, we left all but two. But for a while, on the way out, we were collecting way more money. You follow that? So, I still left. I didn't promise them I was going to stay. I just said, ‘Pay us this, or we're leaving now.’” (33:13—34:28)

“Unfortunately, only about half of the dentists out there that we speak to have a sufficient understanding of the umbrella networks. For those who've never heard it called an umbrella, you can also hear it called shared or leased networks. Leased, shared networks, or umbrella networks. So, there are three different names that these evil things go by, and they're terrible.” (34:44—35:06)

“Mrs. Jones shows up at the front door — a super nice lady. Shows her insurance card. She's in some insurance plan, but it's not one of yours. So, you're not in-network with her. She's going to be full fee. She broke a couple of teeth. She's got some decay. She agrees to do the care at full fee. You prep the two crowns, and maybe did some build-ups, and maybe a little bit of whatever. You submit, say it’s $5,000. I don't know how many different services we're bundling into that, but let's say it was $5,000 worth of services that you assume are full fee, and she was fine with full fee. You submit for her, and the EOB comes back, and it says you are required, by contract, to write off not $500 of that $5,000, not $1,000, but $1,500 or $1,800. It depends on what your insurance is. You could lose $1,800 of what you thought was a full paying patient because you're not in-network with her plan.” (35:20—36:15)

“If you read the fine print — the little five-point or seven-point pica print of your contracts, what you're going to find is this phrase that says something to the effect of, ‘Oh, and, by the way, we may be in a behind-the-scenes arrangement.’ It’s like the airlines. You get onto a flight. You're sitting at the gate, and it says American Airlines Flight 456. That's what you have a ticket for. And then, the marquee changes, and it says some other name of some other company...

3 Best Practices to Prevent Embezzlement

Episode #596 with Matthew Nelson

Three in five dentists experience embezzlement. Don't let it happen to you! To prevent this from happening in your practice, Kirk Behrendt brings in Matthew Nelson, a practice management analyst from the California Dental Association, with three best practices that will keep embezzlers at bay. Know the red flags and do your due diligence before it’s too late! To learn what they are and what you can do, listen to Episode 596 of The Best Practices Show!

Episode Resources:

• Send Matthew an email
• Follow Matthew on 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
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• Write a Review on iTunes

Links Mentioned in This Episode:

Learn more about the California Dental Association

Protect your practice with LastPass

Main Takeaways:

Recognize the red flags of embezzlers.

Be involved with spot-checks and audits.

Make it known to your team that you audit.

Always do background checks on applicants.

Call references at the official business number.

Remember that embezzlers steal in multiple ways.

Quotes:

“There is a survey from the ADA from 2018. In the survey, about 49% of the dentists that responded said they had experienced some type of embezzlement or employee theft. What we're finding now, Dentistry IQ had an article, they said three in five. And with COVID-19, and with people furloughed and laid off, doctors started to open more of their own mail and finding weird things. Three in five, that's 60%. That's a pretty big impact.” (6:04—6:35)

“[The reason why dentists may be more susceptible to embezzlement is because] I don't think there's a lot of training. A lot of dentists don't think it will happen to them because it's their staff that they hired and brought in. Third-party payments are hard to track. Things like consultants, bookkeepers, CPAs, the second set of eyes, all of these things are usually the first to go when things aren't going how they're supposed to. There is, in healthcare more than any other industry, this sense of entitlement that the staff feels. Like, ‘If I didn't book this appointment, or if I didn't do this treatment coordination, or if I didn't get this person to say yes to doing this treatment, the doctor wouldn't even have this.’ More in healthcare than anywhere else, we see this amongst staff.” (6:52—7:41)

“Circling back to the impact, obviously there's financial loss, but there's turnover. And listening to a lot of your shows, obviously, you are a big proponent of time and having time back. When there's turnover, you're recruiting and staffing and training, and there goes some of your time. And studies right now are showing that hiring and training someone is $8,000 to $15,000. But then, how do you not have low trust and morale in the office after having someone you trust steal from you? How do you not feel betrayed, and how do you not project that onto the rest of the staff? It's going to take a conscious effort.” (7:45—8:22)

“I think back to this story in Las Vegas that I was telling you about. This employee had stolen $249,000 from one office. Then, they applied for another office while they were, I don't know, waiting to go to jail or whatever, and worked for that office. Exactly a year later, they were caught stealing about $10,000. And then, three months later, in January of 2022, another $3,600. And so, I think there's this thing where we see experience, and we get really excited, and maybe don't do our best practices of a background check or reference checks to make sure that this person is someone you want to bring into the practice.” (9:54—10:40)

“Be involved. You don't have to do everything, but you do have to be involved. Ask questions. Closely review what you're signing. The team should know that you're checking, that you're spot-checking or that you're auditing. Have all your logins and passwords. There was someone that didn't want to go on vacation, and they kept all their logins and passwords, and wouldn't share them. When they finally went on vacation, the doctor had to reset the logins and passwords to help with some billing questions, and they unearthed all sorts of stuff. So, make sure that you have access to that, that it's not all entrusted to one person.” (11:48—12:25)

“If you can, have a system of checks and balances. If you talk to any of the big remote billing companies, they'll have one person that does the billing and one person that does the posting of the checks. So, if you can have that, I recommend that. Know your deposits and your adjustments. Your software company, your practice management software, should have people that can help you identify what reports to run, or to put controls in place so adjustments are limited. Make sure everybody has their own sign-on password so that you can track who did what. Those are some of the involvement parts. But after that, have your controls and best practices in place. So, like we talked about, access, segregation of duty. Make sure your staff takes vacations. That is one of the big red flags, is staff that doesn't take vacations or never wants to leave.” (12:26—13:19)

“Something else that I've heard an office do as a best practice that I love was that, obviously, they're using carbon copy deposit slips, and they're taking the deposit slips home with them. They're having the banking statement actually mailed to their house instead of to the office. That way, it triggers them like, ‘I need to go back and double-check these carbon copies with the deposit to make sure everything is in line.” (15:32—15:52)

“When we're talking about $100 for a background check, this study that I was looking at — it’s the Association of Certified Fraud Examiners, and this was multiple industries — what they found is the average loss from a manager is about $150,000. From a non-manager is $60,000. So, in comparison to a $100 background check, I think it's pretty smart to do them.” (18:31—18:57)

“We recommend offices sign up for the EFTs and get the electronic funds transfers. That is your safest bet. We're starting to see a lot of calls from people about checks getting misdelivered, misplaced, stolen, whatever it may be. There is still a lot of check fraud out there, and that's not easy money to get back from the plan. There are virtual credit cards, which are easily stolen. On top of that, they cost you two to three percent to process them.” (19:06—19:33)

“We highly recommend that you turn down those virtual credit cards and you try to get EFTs. But I'll tell you, you have to be involved in the setup of the EFTs. There was an office we did consulting and remote billing for, and this doctor called us and said, ‘Hey, I don't understand why my office manager is going on nicer vacations and drives a nicer car than me.’ And so, we started digging in and found out that several of the EFT accounts were set up to go to the office manager's bank account. And that had been several years and close to $500,000 by the time it was all unearthed.” (19:33—20:08)

“Establish your control. So, the first part is being involved. The second one, controls on best practices. So, controlling your access, segregation of duties, take vacations. Do you know your deposits? Do you know how much your deposits were? There was an office that, if you're familiar with HMOs, this office took HMOs, and they have a planned visit fee where you can charge a $5 or $10 co-pay. Every time that person paid with cash, they would delete the planned visit fee and just pocket the cash. So, make sure you know those. And there's a lot of practice management software out there that will show you how to run deleted payments or deleted postings that you can check. So, check with your practice management software.” (22:36—23:21)

“This was an office manager in Vancouver, Washington, [that embezzled] $123,000. And so, this is why you need to be involved in a little bit of everything, because they didn't just steal one way. So, $15,000 in cash; over $77,000 with checks with the check stamper. So, if you have one of those automatic stamps, please get rid of that; $25,000 in payroll. And so, when I talk about payroll, I don't usually talk about clocking in ten minutes late or something, stuff that's time theft. This is actually creating a fictitious employee, putting them on the payroll, and then sending the check to their house. So, $25,000 in payroll; $2,500 on Amazon — which, Amazon has great business controls, so I do recommend you look into those. But $2,500 in Amazon deliveries. But here's the kicker. Because of the fraudulent payroll, the doctor had to pay an extra $2,200 in payroll tax. So, this was $123,000 over multiple different levels. It doesn't happen just one way, and they're not only doing it just one way. So, we really recommend being involved in everything, not just one aspect.” (23:31—24:45)

“Make [team members] take [vacations]. You go back to the trust piece that you were talking about earlier, and I hear this again and again, that the broken trust hurts more than the financial loss. And it's the best employee that never takes their vacations, never calls out sick, never misses work, has a super clean area, won't let anybody touch any of their stuff. It can be a red flag. If they're there and they don't want to take time off, sometimes it's because they don't want people to find what they're doing. So, if you do provide vacation and time off, make sure that your staff takes that time.” (24:55—25:32)

“Be involved. Establish controls and best practices. And the last one is, your best people practices. So, like we talked about, the background checks, reference checks. Make sure you report misconduct. That same ADA survey — you're going to be surprised. What percentage of people do you think got fired after the doctor found embezzlement? . . . They did turn in 65%. But 35% of people got to keep their job after stealing from the doctor.” (25:43—26:24)

“[When something doesn't feel right], use your partners. You have a lot of partners out there. You have your risk management team. You have, hopefully, a CPA or a payroll company. There are forensic accountants. There are third-party billers. I would even be happy to refer you out to anybody if you have questions. But really, start the investigation process. Start trying to build the story. If something looks weird, dig into it and find out why, or start looking for patterns. Is this just one employee, or is this one family? Is it multiple families? Really start trying to dig in and peel back the onion and see how deep this goes.” (27:41—28:22)

“Have an employment manual and have that outlined in your employment manual that embezzlement is not tolerated, that it leads to termination and prosecution. If you don't prosecute, the likelihood of you recouping any lost money from your insurance claims is minimal. They might require prosecution to recoup that.” (29:39—30:00)

“One thing I did want to bring up that I heard another office did is, they periodically ran a background check on themselves, or a financial credit check on themselves or on their business. It doesn't hurt to do that. But really, as long as you start building your best practices, have your employment manual, do your background checks and your reference checks, have your controls in place, you're involved so people know that you're looking and touching things, I think you can prevent a lot of this from happening.” (30:12—30:41)

Snippets:

0:00 Introduction.

2:08 Matthew’s background.

3:10 Have the proper controls in place.

5:40 Statistics on embezzlement in dentistry.

6:38 Why dentists are susceptible and the toll it takes.

9:08 Patterns of serial embezzlers.

11:37 Tip 1) Be involved and show that you're involved.

13:20 Use LastPass and two-factor authentication.

15:20 Have banking statements mailed to your home.

15:56 Keep a monthly discrepancy graph.

16:43 Great team members like accountability.

17:31 Always do background checks.

20:40 Don't call the number applicants give you.

22:20 Tip 2) Establish your control.

24:46 Make team members take their vacations.

25:37 Tip 3) Do your due diligence.

27:30 What to do when something feels off.

28:36 Outline your embezzlement policy in the employment manual.

30:03 Last thoughts.

Matthew Nelson Bio:

Matthew Nelson is a practice analyst with the California Dental Association. With over seven years of experience as an office manager, dental consultant, and CDA analyst, Matt specializes in all areas of practice management, including leadership, practice systems, dental billing, dental insurance plan analysis, human resources, practice transitions, and embezzlement. He has been in the dental field since 2015 as an office manager of a large group practice and in private consulting.

3 Tips for Writing a Hiring Ad That Stands Out

Episode #595 with Miranda Beeson

An ad won't fix your practice, but it can attract the right people. To draw in those awesome, future team members, your ad needs to stand out! To help you craft an eye-catching post, Kirk Behrendt brings back one of ACT’s amazing coaches, Miranda Beeson, to share three tips to write the best ad that applicants will find. Let the right people come to you! To learn how, listen to Episode 595 of The Best Practices Show!

Episode Resources:

• Send Miranda an email
• Follow Miranda on 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:

Register for ACT’s To The Top Study Club (July 28, 2023)

Register for ACT’s To The Top Study Club (August 11, 2023)

Watch How Should a Company Share Its Values? by Simon Sinek

Listen or watch The Best Practices Show Episode 572 with Heather Crockett

Main Takeaways:

Be crystal clear about your core values in your ad.

Utilize photos and videos to illustrate core values.

Share testimonials from current team members.

Use a call to action to weed certain people out.

Know which words and phrases to avoid.

Post your ad on social media.

Quotes:

“[The hiring challenge is] not just in dentistry, it's everywhere. But we're feeling it really hard in dentistry, especially a smaller practice when you're not part of a larger corporation that has recruiters out there constantly interviewing. When you're a private practice and you have a smaller team, or even 20 team members, and you're responsible for filling those seats with the right people, we're in a challenging place right now. I don't think I have a single team that I coach that isn't looking for at least one new team member. It's a problem across the board in every industry, but it hits dentistry really hard and it's ongoing. I don't think it's changing any time soon.” (1:51—2:27)

“One day, we're going to stop talking about pre-COVID and post-COVID. But this is really a post-COVID problem. I really think it stems from that era of people being at home for a period of time and really starting to reflect on what they value, work-life balance, and where they want to put the effort in their life. There are a lot of people who stepped away and said, ‘I don't think I'm going to step back in that game.’ And now, we have a lot of the newer generation — millennials, Gen Z. Those are the team members that are coming in and looking for new jobs and looking at these ads. We have to speak a little differently to those people than we've had to do traditionally in the past.” (2:29—3:07)

“We have to take a little bit of responsibility and look in the mirror at, traditionally, in dentistry, the auxiliary team members, business team members, hygienists, assistants, they were the workforce behind this game that we're playing. We really rely on the auxiliary team members, and there was a different approach to how we managed. We didn't really lead as much. We managed a little bit more. Those team members were hustling and bustling, and hustling and bustling. And there's been this shift in work-life balance. There's so much talk around work-life balance, toxic cultures, and nontoxic cultures. I think that a lot of auxiliary team members — and this doesn't apply to every dentist and every dental office. So, I say that out loud first — they got run ragged. They got burned out. And when they sat at home for eight weeks, they were able to reflect on that. And so, coming back to the office, they're looking for more flexibility. They're looking for more work-life balance. They're looking for stability. They really want to be a part of something and not just a cog in the wheel.” (3:53—4:59)

“I've heard dentists say to team members that, ‘I could work with a robot. You're just a cog in the wheel.’ No one wants to feel like that. And so, really having to wrap our mind around the accountability of what traditionally we may have created within our industry and make a shift so that team members truly feel valued and that they're a part of something bigger than just punching the clock.” (4:59—5:24)

“You don't find the right people. The right people find you. I think that's a Kirk-ism. And it's so true. When I was a hygienist, I was that way. I knew I was an exceptional hygienist. When I was sifting through ads, which back then there weren't that many to choose from, I was kind of like, ‘Ugh, no. No, no, no. Oh, golden nugget. They talked about core values. They talked about their team.’ It wasn't just about the hours and how much they could get out of me. I knew I wasn't going to be just a cog in the wheel, just a number, within that practice. I was going to mean something there. That was the office that I was going to reach out to. If you're looking for a rock-star team member, you have to put out there something to let them know what they're going to get, the intangibles out of working in your practice, and stand out from the crowd of ads that are all over Indeed, dental posts, and everywhere else that they're living right now.” (8:02—8:55)

“Number one is building in your core values. We talk about core values all the time at ACT, but we don't talk about them in jest. Legitimately, they're the most important thing in your practice. If you're looking for the right people to find you, you want to be really clear about what your core values are within that ad. It's going to speak to applicants who are familiar with similar values or have similar values to what you have who are looking for that in a practice, and they're going to be pulled and gravitate towards responding to that ad if they also believe in the same things that you believe in.” (9:03—9:39)

“When I talk with clients and if there are issues around certain team members, I go back to, ‘When was the last time you looked at that particular person, their behaviors, and how they relate to your core values?’ Because if an action or a person is consistently creating frustration for you, like you were saying, and you look back and say, ‘You know why? It's because I can't trust them, and “always tell the truth” is one of the most important values we have in this practice.’ And it's like, ding, ding, ding, ding, ding. So, if you put those in your ad and you start with that, you're going to set clear expectations of what characteristics and behaviors are expected of team members in this practice. If you're really clear about that in your ad, team members who don't believe in those things who might create frustration for you in the future are so much less likely to even apply. Great. You keep looking for the practice that fits you, because I want to find that person who believes in the same things that I believe in.” (11:25—12:26)

“If you have people on your team who are all-in, they are all about your core values, they fit, they're the right people, they're in the right seats, they get it, they want it — ask them who they may know that also fits those core values that could come work here. Before you even place an ad, start there.” (13:25—13:43)

“If you've reached all the resources within your team, they've asked everyone they know, you've already gotten as many great friends as they could possibly bring on board, we have to put an ad out, at this point. You can still make that feel very personal and very word-of-mouth. That's part of building in your core values. You take out that transactional view of what the ad looks like when someone is perusing Indeed, and it gives this more personable approach as if you're on the phone with a friend learning about what this practice values. So, again, it gives it that personal touch versus a transactional touch of, ‘We're a great practice. We work Monday through Thursday from 9:00 to 5:00. We expect you to do these things by this time. Call me now.’ It's a completely different approach to putting your business out there.” (15:05—15:52)

“Step number two is, share current team members’ testimonials in your ad. I think this is underutilized. I don't see this very often at all, but I think it's a huge, huge hit because just like patient testimonials help to provide that personal perspective from the inside out, you can have the same influence coming from existing team members who are sharing why they love working here.” (15:59—16:22)

“Let's be honest. There are people, when they read these ads, that get a little skeptical. Right? Maybe you've had an ad out for three months because you haven't found the right person yet, and someone has seen it over and over again, and they're going to start thinking like, ‘Man, they can't find someone to work there to save their lives. They must have a lot of turnover. This ad has been on here for like six months.’ No, we're just being really careful about who we're bringing on board and making sure we find the right person. So, if we can debunk some of that skepticism that maybe it's a toxic place or, again, I mentioned people worry about work-life balance and, ‘Are they going to appreciate me? Am I going to be valued?’ Who better to shout that from the rooftops than the people that already feel valued working on your team? In quotes, ‘Here's what Michelle, our hygienist of eight years, has to say about working here.’ And then, Michelle has in quotes, ‘I love working here because we're valued as autonomous colleagues and partners in the hygiene department,’ whatever it may be. If you have someone from the actual team putting a quote into that ad and someone can read that, there's automatically this shift in trust.” (16:23—17:30)

“[Sharing team members’ testimonials] also shows potential team members that you value your team. This isn't just about me. This is about our whole team. We're bringing someone into our family over here, and we value them so much that we ask them to be a part of writing this ad, to be a part of bringing someone on to the team and being a part of it. That way, they also know in the future, if there's ever another team member that comes on board, they get to have a say in that. And a lot of people have worked at places where they're like, ‘Oh my gosh, I can't believe they hired Suzy.’ Well, wouldn't it have been great if the team had had a voice and had felt value in any part of bringing someone new on board?” (19:01—19:37)

“[Step three is], use photos and videos whenever you can. If the platform that you're posting an ad on allows for images or video content, use it. What do they say? A picture paints a thousand words. So much emotion is evoked from photos and videos. Being able to see someone's eyes, seeing this group of individuals having fun together inside and outside of the office, it's so important to demonstrate as much as you can the emotional buy-in of what it's like to work here. So, if you can evoke emotion through adding team member photos, maybe photos of the work that you do too, if you do a different type of work, comprehensive approach, something that's not typical and you want to show that off, awesome, because you're going to want people who are eager to learn innovative new things to be able to keep up with what you're doing.” (20:41—21:35)

“The people that are looking for jobs right now are primarily looking for being a part of something, feeling valued, some work-life balance. It's not just about punching the clock. It's about being a part of a group or a family that really means something and does something for the community. So, if you have pictures of your team with patients, if you have pictures of your team at a team-building event together out and about, if you have pictures of your team doing CPR training or iTero training, those types of things speak much louder than words can in an ad — and not many people are doing it. It will stand out amongst the crowd.” (21:40—22:18)

“[Sharing team photos of taking out trash] has actually got some subliminal messaging in there too. Like, ‘We're going to expect you to do things even as simple as taking out the trash here. We need a little humility in whoever comes on board. But we're going to support each other and have fun while we're doing it.’ I actually love the idea . . . [of] showing team members taking out the trash. That's actually a big topic when you hop in Facebook forums and groups online, people complaining about, ‘I just started at this new office, and they expect us to empty the trash in our operatory every night and take it out to the dumpster. Can you believe that?’ And you're like, ‘Okay, teamwork makes the dream work. Pull out your trash bag and take five steps outside.’ Could you imagine if that person had seen a photo like that in the ad before they came on board, to say like, ‘Oh, but we can do it. And it's a team expected activity. We can still have fun doing the things that we have to do to keep the business running.’ I think that's a cool concept.” (22:50—23:47)

“If you had somebody who had a, ‘That's not my job,’ mentality, they're not applying for the job for that ad that had that picture [of taking out the trash] there. But if you had someone who doesn't mind teamwork, pushing up their sleeves and doing what they have to do to get the job done, and if that's what you want on your team, they're going to apply for that job because they're not going to be deterred by something like that.” (24:13—24:32)

“[Videos don't] have to be doctored up and edited. It can be the doctor saying what they love about being in the practice, or what they love about dentistry, and a couple of team members doing the same thing, and then, ‘Come work with us!’ Something fun. Just the energy — show who you are. That's what people want to know. That's what's hard about even applying and going in for the interview, is you're sitting there across the table — everyone is on their best behavior. We're asking what your strengths and weaknesses are . . . You're asking these questions, and it's this very formal environment. You can't really get a feel for what this practice is about. You may or may not even get to see any of the other team members while you're there for that initial interview. So, if you can have some little insight about the vibe of the practice and what people are all about, what the energy is through photos or videos beforehand, that's a win already.” (24:40—25:45)

“If you have something like that in your ad where you are showing that you take CE, you're automatically going to attract — the right people find you — people who are like, ‘Oh my gosh, they do CE together? I want to be part of a practice that is putting CE in front of me.’ It's going to make your life easier, weeding out the people who don't fit, because the ones who don't want to learn something new aren't going to apply for your ad.” (26:24—26:48)

“After interviewing hundreds and hundreds of team members over the last several years as a practice administrator, when you mentioned resumes, even before AI, I don't really trust the resume too much. I also don't trust calling references very much. You don't know who's on the other end of the line. They're only going to add people on their reference list that are going to give a positive recommendation. No one's dumb enough to put people on there who might say they're not a good candidate. Right? So, the most important part of bringing someone on board is meeting them face to face.” (27:52—28:24)

“Here are a few things maybe not to do, stand-outs from being in this profession for a long time and knowing a lot of people who are in this profession. Avoid using things like, ‘Busy practice looking for . . .’ Like, how stressful. I read that and I think, ‘Oh my gosh, I'm going to be so stressed out working in a busy, fast-paced practice.’ That is not what someone wants to read. It's not screaming, ‘We have a healthy work-life balance,’ when you hear busy and fast-paced. Another one is multitasking, ‘We need a good multitasker.’ We actually learned together at our last To The Top Study Club event about switch tasking and when you're trying to multitask, how you're not nearly as productive. But what that means to a reader of an ad is, ‘They're short- staffed, and I'm going to be doing more than one person’s job,’ or, ‘They don't have good systems, so it's crazy and chaotic in there. It doesn't sound like solid work-life balance, structure, clear roles and responsibilities. It sounds like, ‘This is going to be a little crazy, and I'm going to be running around on roller skates every day.’ So, I'm probably not going to apply for that ad.” (29:47— 31:03)

“We have to be careful about what we're putting out. Certain words will start to push people away instead of pull people in.” (31:25—31:31)

“Clinical roles, listing out every role and responsibility of, ‘I need a hygienist. You need to be able to do cleanings and provide fluoride applications.’ Like, yeah, duh. I know that. That's what I have a bachelor’s degree in. Right? So, we don't need to have so much focus on the tasks that we’ll be responsible for. Maybe for a business team role, because if you're specifically looking for a hygiene coordinator, you want to make sure that someone who loves insurance doesn't apply for the role. But when it comes to the clinical roles in particular, that trade is what it is. Most of the skills that we need to have to apply for that are built in. So, instead, let's take the time and space on that page focusing on some of these other things we've talked about, like team member testimonials, some photos, or building in our core values, and less of the task list.” (31:33—32:24)

“I love adding in an extra step. So, having a survey, ‘Please don't send your resumé. Instead, click this link and fill out a quick survey about what you would love about working here,’ and having something that's built in that's that one extra step that the person has to follow to see, how eager are they? Are they going to follow directions well? Are they a robot? Are they AI? Same thing...

The Untapped Energy Goldmine Inside Every Dentist: Boost Your Life and Practice!

Episode #594 with Dr. Uche Odiatu

Do you want to enjoy more of your day, but don't have the energy? Get ready to bring it back with this episode! Today, Kirk Behrendt returns with Dr. Uche Odiatu, one of ACT’s favorite health and wellness gurus, with tips for tapping into your energy reserve through simple, actionable steps and mindset changes. If you're ready to boost your life and practice, listen to Episode 594 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
• 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:

Register for SmileCon (October 5-7, 2023)

Listen to Bulletproof Hygiene

Read Sapiens by Yuval Noah Harari

Read Die Broke by Stephen Pollan and Mark Levine

Read The 7 Habits of Highly Effective People by Sean Covey and Stephen R. Covey

Read The Brain that Changes Itself by Norman Doidge

Read What the Bleep Do We Know? by William Arntz

Buy the Hooga Health Book Light

Main Takeaways:

Energy is currency.

Stay physically active for brain health.

Take the time for self-care and relaxation.

Pay attention to messages from your body.

Celebrate the people you respect and admire.

Quotes:

“You get paid for energy. People remember your energy. You can't hide your energy. When you walk into a room, you either have high energy or low energy. If you're in a dark or sad place, it's low energy. That's why a lot of dentists know you’ve got to have more energy than the patient. You can't have a patient with more energy than you. You, as a healer — if you want to heal, if you want to influence, if you want to convince, you need to have high energy. It's impossible for a low energy person to be convincing. So, when people wonder why certain people are good at closing case presentations, you wonder why some hygienists are better than others at getting patients from six-month recare to three and four-month, why are they more convincing? It’s the energy that goes into the whole talk. And it's not just words. A lot of times, people memorize words. Like, if you had a speech to give, people spend all the time on the words. But I think it's your body language, the tonality — what you put into the words is way more important.” (2:18—3:12)

“We're drained cognitively. We're drained emotionally. We're drained physically. We're drained mentally. Then, we wonder why we can't put more into our treatment. You wonder why, at the end of the day, you've given your 60% during the 8:00 to 5:00 or the 10:00 to 6:00, and your family, your friends are starving for you after, and you come home, you just have fumes left. It's like you're trying to squeeze out moisture and dust comes out, like a cactus. So, energy is important, not only for your patients, but your personal life.” (4:06—4:37)

“Margins are going to be forgotten. How you made people feel during a talk, or what did you remind people of, that can't be quantified. That's why they call it intangible. It's beyond the physical. It's metaphysical, and that's where energy lies. That's where energy lies. And you can boost it by doing certain lifestyle habits. So, it's very mechanical. The body responds if you infuse it with certain things.” (5:21—5:46)

“Adrenal fatigue is something — we have two glands, one on top of each kidney. They pump out adrenaline. They pump out cortisol. They do it mainly for an emergency. They also pump it out first thing in the morning to get you up. That's why the neuroscientist, Andrew Huberman, says you hijack that natural system of adrenaline and cortisol when you have coffee first thing in the morning. It's like your tanks are already full, and you're putting a little bit more gasoline in. The body goes, ‘What the heck are you doing?’ These neurotransmitters aren't happy with more caffeine in the morning. You already have the energy to leave the cave, the proverbial cave, and now you're putting more gas in the tank.” (5:56—6:29)

“Your liver releases glucose, and your body, your adrenal glands, release adrenaline and cortisol to get you up and moving, enough energy to get out of the cave. That's why that book called Sapiens by Harari, he said we are more caveman than modern man. We might look like modern men, but there are more cavemen cells and memories in our body than not. And we're meant to leave the cave, first thing. If every caveman and cavewoman had to eat breakfast before they left the cave, we'd all be dead. We're only alive because, boom, the sun came up, out looking for food. Hunt or be hunted. So, lingering inside in the dark, sipping more gasoline when the body gives us enough energy to leave. And that's never going to be programed out. It takes hundreds of thousands of years to change the genome. So, we are sabotaging it by having a big, strong cup of coffee first thing in the morning. Apple cider vinegar, maybe. Green tea, a lighter form, or just plain water, and then get going.” (6:30—7:31)

“We have energy for things we think are really important. But the team, the family, the friends —a busy dentist with two offices, ten offices, or a large team, 40, 50 people — everyone knows you're a busy dentist, and you’ve got to put your two phones — you know you're busy when you have two phones and you’ve got to put them face up when you're out with friends. And they brag about you, but they never have your full, undivided attention. You just don't have the energy. You don't have the bandwidth to give 100% to the team, the office, your ongoing learning, your CE, the next phase of your implant talk, your friends, your family, your spirit, and your community. We have so much energy. And many people, because of poor physical lifestyle habits, they're really 60% at all of them.” (8:29—9:12)

“Energy is currency. It's coin. What would I rather have, a strong credit line, or energy? Energy will get me another credit line. Energy will get you through a recession. It'll get you through family tragedy. Energy will give you that second wind when you get home. Energy will allow you to work through lunch for a kid that's been hit with a puck and his teeth are broken. Energy will get you through lunch working on an emergency. Energy will get you to enjoy — but many dentists, when they go on vacation, the first two days they're decompressing because they're so adrenally fatigued. They can't even enjoy the first two days of a seven-day vacation because the body is so exhausted. So, energy is the thing. It's ATP. This is really cool stuff.” (9:34—10:18)

“Many dentists are discovering sciatica, reflux, ankylosing spondylitis, bulging discs, knee issues, or chronic pain. This is the body, and the body is always telling you messages of comfort or discomfort. So, reflux, not comfortable. If someone is living with reflux, the body is telling them, ‘I'm not comfortable. I'm putting this acid in your mouth to tell you something is not sitting quite right right now.’ Reflux is a message. You don't have reflux on your honeymoon. But why is my stomach spitting up acid into my esophagus, into my mouth? Why is this acid, which digests food and kills parasites and viruses, in my mouth? It's trying to kill you — or it’s trying to give you a message, ‘Keep it up. I'm going to dissolve that sphincter. Keep it up. I'll have you on meds in the next 20 years.’ So, the body is always giving us messages of comfort or discomfort, comfort or discomfort, ease or disease.” (16:54—17:46)

“We need time off. People think going to the gym is important. You only grow in the days you don't go to the gym. People spend all their time on how to work out, how to work out, how to work out quicker, better, with more intensity. No one asks, ‘How do you relax? How do you rest between the sets?’” (18:48—19:02)

“If you want to biologically turn back time, we've got to learn how to rest, replenish, and take care of the machine.” (19:54—20:01)

“[Your] iTero is important. Your CEREC is important. It’s all important. But your number-one tool as a dentist, as a hygienist, as an assistant, is your body.” (20:07—20:13)

“If someone wants to get rich, they’ve got to get rich mentally first.” (20:56—20:59)

“The average North American, 95% of meals eaten outside of the home is fast food. So, you need to nip that in the bud. One way to do that is to bring nuts with you. Almonds — I try and mix mine up with pistachios, sunflower seeds, Brazil nuts, walnuts. All kinds of different benefits, having a variety.” (21:19—21:36)

“[Nuts are] something you can snack on either on the way to work — if you have this on the way home from work, what happens is you don't attack that fridge like a long-lost lover. You will actually get home and have time for the dog. You might get home to give yourself 10, 15 minutes to chat with your significant other about the day and his day or her day if you have something to cut your hunger off at the knees. So, travelling with a bag of nuts, this might cost $18. You keep it in your car, it'll last six months. It could be frozen. It could be hot. Keep it in the glove compartment. On the way to a study club — I would say focus on the conversation, not the food. A lot of people get to a study club famished, sucking back the free food, sucking back the alcohol. If you have food in your belly, I can now focus on talking to Kirk, or talking to Kois, or talking to Christensen instead of jamming down the food because I'm starving when I got there. So, this is an easy car hack that gets people focusing on the conversation, not the food.”  (21:45—22:42)

“I have unconscious competence when it comes to lifestyle habits. What dentists are thinking about is called conscious competence. It takes energy to count your macros, look at your app, look at your fiber app, and work out. The ideal sweet spot is unconscious competence. It’s the highest level of attainment, whether as a dentist, or as a mom or a dad. Whatever you do, if you're really good at what you do unconsciously, it's become part of your cerebellum. It's part of your habitual pattern without thinking about it. That's the perfect place — Michael Jordan doesn't have to think about his three-point throw. Automatic. Stops, plants, and it's up. That's unconscious competence. That's where you want to be with health, family, reading, money. Wherever you have unconscious competence, that's where you have supreme joy in life.” (25:42—26:24)

“Being physically active is one way to keep your brain like a Chia Pet. People who are sedentary, your brain is not as good as someone who is physically active. You have a youthful brain if you exercise. These are neuroscientists [making these claims]. The one way to [get] neurons to last longer and grow longer is to have a continuously curious environment, continuously stimulating. So, I liken that even to cars. If you've driven Volvos your whole life, get a Ford F-150. If you’ve had four-door cars your whole life, get a two-door coupe. Don't go to your favorite restaurant. Every now and then, go to Thai. If you like going to Cabo San Lucas, go to Maui. Have an active vacation. Change your vegetables. To be curious and having a stimulating environment is one way to keep your neurons living a long time.” (30:01—30:44)

“Energy is youth. It's curiosity. It's enthusiasm. It's the sizzle. People want to know how it's done. They want to spend time with you. Usually, friends that we like to spend time with are high energy people. And we do have low energy people that we need to nurture and bring along. You can't ignore your cousin and your uncle. But somehow, there are certain people, when you leave the conversation, you feel physically tired. You get emotionally drained. Jim Rohn used to say spend less time with them — still love them. Return their call. But make sure you spend time with high energy people because it's contagious.” (31:00—31:31)

“Read outside of dentistry. Don't just read your journals from Kois or Pankey. Pankey and Kois are amazing. But read something else.” (35:55—36:03)

“The space between you and what you want, you can close that space by meditation, prayer, and celebrating another person's success. They say any time you cut someone else down or we're critical, we lengthen the space between us and what we want. But admiration, or you admire someone, you close the gap.” (36:35—36:54)

Snippets:

0:00 Introduction.

2:03 Energy is coin.

3:43 Don't stay at 60% energy capacity.

5:46 Adrenal fatigue, explained.

7:33 Listen to the warning signs.

9:23 The value of energy.

11:44 Work versus a calling.

14:37 Balance family and business.

17:47 Working all the time is not productive.

20:33 Ways to build more energy.

23:26 Build unconscious competence.

26:25 Embrace self-care.

31:57 Earn your dessert.

34:09 A tip for night readers.

35:36 Last thoughts.

Dr. Uche Odiatu Bio: 

Dr. Uche Odiatu has a DMD (Doctor of Dental Medicine). He is a professional member of the ACSM (American College of Sports Medicine), a Certified Personal Trainer (National Strength & Conditioning Association) NSCA, and the Canadian Association of Fitness Professionals (canfitpro). He is the co-author of The Miracle of Health (c) 2009 John Wiley (hardcover) & (c) 2015 Harper Collins, and has lectured in Canada, the USA, the Caribbean, the UK, and Europe. He is an invited guest on over 400 TV and radio shows, from ABC 20/20, Canada CTV AM, Breakfast TV, to Magic Sunday Drum FM in Texas. This high-energy healthcare professional has done over 450 lectures in seven countries over the last 15 years.

Elevate Your Dental Practice! Learn 4 Ways to Communicate and 3 Skills to Listen Better

Episode #593 with Dr. Steve Carstensen

Listening is the most important skill, in and out of your practice. How you listen and communicate will drive your success as a dentist and as a human being. To help you provide the best care for your patients, Kirk Behrendt brings back Dr. Steve Carstensen, co-founder of Premier Sleep Associates, with advice for improving your listening and communication skills while in the chair. To start getting more engagement from your patients, listen to Episode 593 of The Best Practices Show!

Episode Resources:

• Learn more on Dr. Carstensen’s website
• Join Dr. Carstensen on Facebook
• Follow Dr. Carstensen on 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 The Clinician’s Handbook for Dental Sleep Medicine by Dr. Ken Berley and Dr. Carstensen

Learn more about World Sleep Society and World Sleep Academy

Read articles in Dental Sleep Practice

Read Books by Alan Alda

Read Fascinate by Sally Hogshead

Learn more about Mary Osborne’s listening exercise

Register for the ADA Children’s Airway Event (July 27-29, 2023)

Main Takeaways:

Know your patients, yourself, your work, and how to apply your knowledge.

Don't tell patients what they need. Start with a benefit statement.

Understand the benefits that patients are looking for.

Get good at questions, not answers.

Listen more, talk less.

Quotes:

“Communication touches everything we do. If we have a great idea, fantastic. But if it doesn't get out of our head into somebody else's head, well, then it's not communication. And if we sit there and we need to hear from somebody what their story is, what's important to them, what it is that we can do to make their life better, we have to listen carefully. And so, we have to communicate that way too.” (6:52—7:16)

“Ultimately, the only thing that matters is, does somebody smile better? Does somebody chew better? Does somebody feel better? Does somebody breathe better? The ultimate rubber hitting the road is when our community health gets better.” (7:39—7:52)

“The masters, Aristotle and others, through the years have given us a better way to communicate where we get to four important points, which is knowing your patient, knowing yourself, knowing your work, and then applying your knowledge. Now, the knowing your patient part is where we get into real interpersonal communications. And that means little things like, ‘What can I do for you today?’ but also, ‘How did you get to where you are today? What's your health history like, and details? What is it that you've had as an experience before? How has it been for you going to the dentist’s office? How has it been struggling with solving a snoring or sleepiness problem, given solutions that don't really work for you, and dismissive attitudes by some of the medical colleagues that we work with, and really helpful attitudes by others? How is it you've gotten to this chair, in this place, with this set of attitudes, with this expectation? And by the way, patient, what are those expectations?’ If you draw those out of your patient really well as a dentist, now you can start to match up better what it is that you can offer to meet those. And if you learn that somebody has unrealistic expectations, wouldn't you like to know that before you start your treatment?” (10:12—11:36)

“Knowing your work, knowing what you're comfortable with, and really getting to know your patient, that gives you all the tools you need, all the crayons you need to make the right picture for applying your knowledge. Because applying your knowledge is not simply taking a new skill of fixing a composite a certain way or being able to use that CEREC machine. It's really about how you can put it all together to make sure your patients are healthier on the other side. That's the key. Because there are a lot of easy ways to be a great dentist. But if your patient isn't ready for it, or it's not the right time for them, or if you're not the right person to do that particular treatment, then it may not be as successful as you want. Or they have expectations that you think, ‘My margin is great, the color is fantastic, and the bite is perfect,’ but their expectation was different than that. Now, we have a failure there.” (12:36—13:30)

“[It’s] all communications. It's all really talking to yourself, talking to your team, talking to the patient, and then putting it all together. So, a treatment plan is way more than just putting the tooth list together and what you're going to do.” (13:36—13:48)

“Another thing that you need to be able to do is to use the data that you gain from getting to know the patient to help them make decisions. Now, you have to be really careful there because we can gain skills to manipulate people pretty easily. That's not the endpoint because that violates expectations. And so, you can manipulate somebody into saying yes. It's not hard to do that. But if, at the other end, they feel that manipulation — and they will — that's buyer's remorse. And then, they'll come back, and they won't be your champion anymore. Like Dr. Pankey says, I want people to pay with appreciation.” (15:46—16:26)

“Scientists have told us that if you're saying something to somebody, you have a microsecond to keep their brain engaged with what you're talking about. If you don't start with something that engages their brain, they're thinking of something else by the time you're in your third or fourth word in the sentence. Well, if our job is to communicate, then we have to keep them engaged. And the way to do that is to come up with a benefit statement. So, you start your sentence with what's good for them, or their name. Their name works too. A classic example, somebody walks into your office, and they have a broken off cusp on number 30. You look at that and you might think, ‘I'm going to do a crown on that tooth.’ Define crown any way you want these days, but, ‘I'm going to do a crown on that tooth.’ And so, you look at that and go, ‘Well, patient, we need to do a crown on that tooth to put it all back together. It's going to be gorgeous. It’s going to look pretty on your teeth. It'll be great.’ Well, what did you start with? You started with what the dentist needed, and you ended up saying what the dentist could do.” (17:21—18:26)

“[Instead of telling the patient what they need], if you sit down and go, ‘Huh. I see that cusp is broken. Tell me more about that,’ and they tell you the history of that one, and how long the filling has been there, and whether another tooth has had a broken cusp. ‘Okay. Now, what is it you'd like to make sure we do for you about that broken off cusp?’ And they may say, ‘Well, I'm worried that another piece will break. I'm worried that I can't chew my food.’ Whatever it is that they say right there, you listen carefully to. And say they are worried about another tooth breaking. ‘Well, patient, in order to make sure that your other teeth are strong, I'm going to do a thorough exam. In order to make sure this tooth won't break down some more, there's a procedure we can make called a bonded porcelain restoration.’ Whatever it is, the thing you have to do for that tooth, start with the thing that they told you is the benefit that they're looking for.” (18:27—19:19)

“We like to talk about features. We like to talk about color match. We like to talk about shape, flossing ability, close margins, and all these fun things about crowns. But we don't lead with that because patients don't care. Right? They care a little bit, but that's not their primary. They didn't walk in saying, ‘I really want some better margins here.’ They walk in and say, ‘I have a broken tooth, and I'm worried about it.’ ‘Okay. Tell me what you're worried about.’ And they tell you. Then, you follow up with a benefit statement first. So, it's like talking with their first name. ‘John, in order for your tooth to be strong,’ bang. Now, they're listening. Their brain is engaged. And so, you can carry on that way. So, there's another way of approaching your communications, is to think, what is their benefit, and how do we support what they want with what we can do?” (19:57—20:49)

“[Patients] have a picture of what they want. And they also might have a picture of what they don't want. Say, for example, you have this broken off cusp on number 30. Easy for a dentist to treatment plan. Then, you look across the mouth and number 19 has a crown on it. And number 19’s crown has a hole in the top of it with a filling. So, we all know what the history there was. They had a crown, and the tooth kept hurting, kept hurting. So, now they had a root canal.  Maybe that's their only experience before. And if you lead with “crown”, well, guess what their brain is remembering? So, get to know your patient. Get their history. Notice that other tooth and say, ‘Tell me more about that other tooth and your experience over there,’ so you get a little bit of their history.” (21:51—22:37)

“Think about our dental practices. If somebody sits in your chair and says, ‘Well, I have this concern,’ and your first response is, ‘Well, no. That's not really a thing. We can do this other thing.’ Well, you’ve stopped communication right there. But if they say, ‘I have this concern,’ and you say, ‘Oh, I hear that. Yeah, I’m concerned about that too. Let me help you understand that a little bit more,’ now, you've engaged your patient with that. And so, the first rule is to listen. The second rule is, ‘Yes, and,’ which means you always have to add to the information. And the third rule is that you have to give more information.” (32:04—32:39)

“The last rule of improvisation is, when it's over, it's over. When the story is run out, when the patient shared with you the right things, when you feel it's time that they've said yes, they understand what it is that they're making a decision about, shut up. It's time to finish the story. Stop talking because we can overdo it, and that doesn't apply our knowledge very well. It doesn't provide a benefit. It doesn't stay in their question. It starts to add yours, and you won't be as successful in getting your patient comfortable with making the decision to move forward on the health issues that you've talked about.” (33:02—33:38)

“Part of applying your knowledge is to be able to know when the patient is ready to make a decision. Because on a simple example, a broken off cusp, and you really do think a crown is right for that person, and you overcome the history of number 19, so they say, ‘Yeah, I guess I need to do that,’ that's it. Done. Let's get it scheduled. Let's do it right now, whatever it is that works for you at that point. Stop talking because they don't need any more information about the margins, the color, the bonding system, or whatever it is you're going to do.” (34:13—34:50)

“When you are sure that the patient is giving you all the signs that they're comfortable, stop talking. Ask for the close, if you want to be salesy about it. The close is, ‘Well, shall we get started? Are you ready to make an appointment? Would you like to talk to our financial coordinator?’ Whatever it is that gets them to say yes. Because if they don't say yes to whatever it is that you have in your wheelhouse, they're not going to get healthier. And we have to not manipulate people into saying yes — that doesn't work. But if we apply all that teaching, and if we provide a benefit so they stay with us and we stay with them, and then we listen carefully and add to the question, don't shut down communications, they're going to get to the point where they're going to make a decision that's in their favor or their best interest. They're going to say yes to something. And that's when we get out of the way and do whatever it is they told us to do.” (35:42—36:39)

Snippets:

0:00 Introduction.

1:50 Dr. Carstensen’s background.

5:01 Why communication is important.

7:53 Treatment planning starts with communication.

13:48 Start by knowing yourself.

16:58 The benefit statement, explained.

21:36 Mary Osborne’s listening exercise, explained.

26:12 Build trust through questions.

29:15 The improv approach.

33:38 Know when to stop talking.

36:56 Last thoughts.

39:39 More about Dr. Carstensen’s work and how to get in touch.

Dr. Steve Carstensen Bio:

After Dr. Stephen Carstensen graduated from Baylor College of Dentistry in 1983, he and his wife, Midge, a dental hygienist, started a private practice of general dentistry in Texas before moving to native Seattle in 1990.

In 1996, he achieved a Fellowship in the Academy of General Dentists in recognition of over 3,000 hours of advanced education in dentistry, with an increasing amount of time in both practice and classwork devoted to sleep medicine. A lifelong educator himself, Dr. Carstensen is currently the Sleep Education Director for both The Pankey Institute and Spear Education, recognized as among the finest places for dentists to further their education. As a volunteer leader for the American Dental Association, he was a Program Chairman and General Chairman for the Annual Session, the biggest educational event the Association sponsors.

He is a Consultant to the American Dental Association for sleep-related breathing disorders and co-author of a textbook for dentists treating the disease.

For the American Academy of Dental Sleep Medicine, he’s been a Board Member, Secretary-Treasurer, and President-Elect. In 2006, he achieved Certification by the American Board of Dental Sleep Medicine.

Why You Need a Clinical Coach

Episode #592 with Dr. John Cranham & Dr. Noemi Cruz-Orcutt

In the words of Brené Brown, we weren't designed to do everything alone. We all need a little help, whether it’s from a mentor, a coach, or a teacher. To explain the differences between the three types of guidance, why you need it, and how to find the right person for you, Kirk Behrendt brings in Dr. John Cranham and Dr. Noemi Cruz-Orcutt to share their mentor-mentee relationship and how it continues to grow. To hear more about how a coach can change your practice, listen to Episode 592 of The Best Practices Show!

Episode Resources:

• Send Dr. Cranham an email
• Join Dr. Cranham on Facebook
• Follow Dr. Cranham on Instagram
• Learn more at Cranham Culp Digital Dental
• Join Dr. Cruz-Orcutt on Facebook
• Follow Dr. Cruz-Orcutt on 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

Main Takeaways:

Understand the differences between a teacher, mentor, and coach.

Find someone you respect, admire, and is the right fit for you.

Coaching or mentorship can help speed up your progress.

A coach will help you gain the confidence you need.

Don't just choose anyone to be your coach.

Quotes:

“[Coaching is] one of those things in dentistry that is way underutilized. With the technology today, like virtual articulation and the ability to treatment plan on a computer, we can use technologies or software like TeamViewer, or Zoom, or any of these things to be able to share a screen, and it's like you're sitting right next to one another. I think it can really help connect dentists — whether you're a mentor, a coach, or even an interdisciplinary team — maybe better than we've ever seen it before.” (5:09—5:44) -Dr. Cranham

“If you have somebody that you trust, and you know if you put in the time that you're going to get a result, that's way different than putting time in when you're not sure you're going to get a result. That's called reinventing the wheel. And if I hadn't had those people, Pete [Dawson] and all those people early in my career, there's no way my career would have gone where it ended up, because by the time I had been practicing 10 years, I probably had the experience and knowledge of a dentist doing it 30 years. And so, you can get to a [higher] level much faster. You hear the old adage, standing on the shoulders of the people before you. That's what you're basically doing. You're eliminating the trial-and-error process, eliminating mistakes, and being able to drive right into workflows that work.” (10:16—11:11) -Dr. Cranham

“A mentor is often somebody that is in your community, somebody that you're close with. That might be a periodontist. It might be an older dentist that you spend a little time with. But I think it's a little less formal [than a teacher or a coach]. It's a little less organized, where I think as a coach, it's a little bit more of a professional relationship. There's usually a curriculum. There's usually something involved, very specific, that you're doing. A teacher is usually not so much in a one-on-one setting. You might be in a classroom with 20 or 25 people. I think mentorship and coaching often is one-on-one. But I think the coach is usually something that you're committing some time and finances to that you're going to lock in. That's certainly how it was with my coach, with Jerry. I was committing to certain things, and time that he would assign to me. Whereas I think with a mentor, it's often somebody that you might have dinner with occasionally, or swing by the office, and it's a little looser. That's the way I think about it.” (21:34—22:51) -Dr. Cranham

“I think with mentorship, it’s maybe less official, someone that you might communicate with once in a while and ask questions. It's not as structured as coaching. With coaching, what has been great for me from the beginning is I would schedule that time. And many times, I would be like, ‘Okay, I need to get this case ready for that time,’ so it kept me accountable in terms of getting my stuff ready before I met with John because we had that time set up.” (22:57—23:34) -Dr. Cruz-Orcutt

“There's also a difference from the standpoint of the person on the other side of it. So, from the student perspective is one thing. But if you're a mentor, ‘Yeah, I'll mentor you,’ and that means, ‘I'll give you some time when I'm free and our schedules connect.’ When you coach, you are committing time. So, like with my calendar, I have about 10 hours a week that my clients can sign up for. I'm there for 45 minutes, locked in, to whatever they're doing. I think that's the biggest difference, is there's a bigger level of commitment on the coaching side versus the mentor side.” (23:39—24:19) -Dr. Cranham

“For me, before starting the coaching, I didn't want to bother as much — or, I don't want to say bother, but take his time without having the structure because I'm like, ‘Well, I don't know how much is too much,’ in terms of taking the person's time. When you set up with the coaching and you're compensating the other person, then you feel like, ‘Okay, this is my time with this person,’ and I don't feel bad, or that I'm bothering. So that, for me, felt better.” (24:26—25:05) -Dr. Cruz-Orcutt

“To be honest, I think I had the knowledge on how to do these cases. But trusting that — like John said, we're changing the occlusion of our patients. When we're doing bigger cases, I wanted to make sure that before I did it, I had someone with experience looking over it and saying, ‘Yeah, we're in the right place,’ because you don't want to do any harm to the patient or put them in a worse position than they had come in. And John, I'm always happy because he will look at my case in five minutes and tell me. I'm like, ‘Okay, you just looked at it, and you gave me the answers, and it makes total sense.’ I would always feel better after talking to him about the case. I'm like, ’Okay, I've got this. I feel better.’ He gave me the confidence that I — to be honest, I never did a full-mouth reconstruction until I had John as a coach.” (29:24—30:27) -Dr. Cruz-Orcutt

“I think the biggest thing [dentists get wrong], and I don't necessarily think it's wrong because everybody is a little bit different, but usually we'll find out pretty quickly where their holes are. That's one of the things that's so interesting to me, is that we've got a lot of people that have been through either Dawson, Pankey, or these curriculums — and I understand the philosophy, and I can coach accordingly. But it's interesting that a lot of times people will go through things and miss a concept like envelope of function, or something along those lines, and are not thinking about it. And sometimes, we’ll have a clarification discussion of what something like that means, and you'll see them go to a higher level of understanding, just being able to talk through it, but not seeing that in their design of like a diagnostic wax-up. If you miss something like that, it's catastrophic. And the permanent restorations — like, you can't miss that. So, I think having these little check points of being able to go through things is really, really important.” (32:01—33:14) -Dr. Cranham

“Dentists that I'm around, or some colleagues that I know, they're in the same boat trying to do good dentistry, and taking continuing education, and trying to do the best they can. I feel that sometimes, if you're taking a lot of different courses and trying to implement it all at once, it could get confusing without having one specific path or philosophy. And so, what I notice, that's one thing, that it’s hard to implement. So, my advice would be to find one of those philosophies, it could be Pankey, Dawson, Kois, Spear, and just focus on that. Then, from there, branch out and start learning how to do the techniques. But then also, for me, finding a mentor or a coach that's ideal — and unfortunately, I don't think everyone has the chance or an opportunity to have one. And in that case, it can limit how quickly you can progress or implement all that you're learning into your practice and be able to do those bigger cases or more complex cases that you're wanting to do.” (34:25—35:57) -Dr. Cruz-Orcutt

“Whatever you're learning from, whatever institution or different courses, if you continue to see many of the professors or teachers that are providing the knowledge, just approach them. For me, I'm lucky to have John in terms of what I look for in a mentor was someone that was approachable that I still look up to, someone that I respected. And maybe a little scary at first, but now we’re past that. I wanted someone that I admire and that I'm like, ‘That's the type of dentistry I want to do.’ But then, that person also has to be approachable, and that you don't feel that you can't even ask them a question, or when they answer, you don't feel bad about their response. It's good communication, and you feel like you're growing with that person. As you get more comfortable, you're like, ‘Okay, I'm more comfortable with my dentistry, and I also feel like I'm more comfortable with the mentor,’ and that relationship continues to grow. So, I would say in order to do that, it's not as easy as just, ‘I'm going to pick this person.’ You have to develop that relationship somehow. Many teachers or instructors that are giving courses out there are willing to teach and take students under their arms to help them grow. But you have to find that person that fits their personality as well.” (36:20—38:13) -Dr. Cruz-Orcutt

“Where I got really lucky with Pete is that he not only had the clinical things that I wanted, but we had a very similar value system. For him, doing great dentistry was 100% about being more predictive so that he could leave his office at 5:00 and go be a dad. His values for family and faith — he was somebody I wanted to be, not just as a dentist, but as a person. And so, I think when you're picking a coach or a mentor, you can separate it out. There are short-term relationships you can have. Like, if you want to do better endo, you can probably find an endodontist that you're going to spend a little time with, and you don't need that. But if you are looking for somebody to shape your practice — and I feel like that's what we're doing. It's not just about the dentistry, but we're really shaping how they practice, how they set their hours, and how they manage their time. Those are all hugely tied to your value system and who you are.” (38:25—39:37) -Dr. Cranham

“When you start getting a little bit along in years, you start thinking about what has your life in dentistry, your life, and what you practice, what has it meant. And it is directly tied to the people that you touch. Pete called it the ripple effect, as a drop of water hits a calm lake, how that ripple goes across all the way. And that's where we're at right now.” (41:24—41:55) -Dr. Cranham

“I can speak more about my practice, as a leader with my team, and also giving them the opportunity to learn from me, and also to have the independence, of them taking pride in being able to do certain things themselves within the office. And the digital portion of it has been a huge part of it, that they have learned some of these techniques that we're doing now, and then they take ownership and do it themselves. So, that gives me some pride that they are also embracing that portion. And as I look to the future, I would love to help other dentists benefit from what I have benefited from in this process. I feel like in a short period of time, I have gained the confidence to — when I look back two years ago, where I was at and where I am now. So, being able to share that knowledge and opportunity for them to do the same in their practice, and as I continue in my career, being able to help and lead others do the same.” (43:13—44:31) -Dr. Cruz-Orcutt

“I think for doctors that are used to being taught things, that are going to CE and accustomed to having a teacher, definitely look for a mentor, and maybe even a coach. One of the things that Noemi mentioned, the word that I really like was accountability. When you're being taught by a teacher, there's zero accountability. When you have a coach that you've signed up time for and you're going to go online one-on-one, that coach knows instantly whether you've done the work or not. I've been on the side of seeing people that are prepared, and the ones that aren't prepared are embarrassed and apologizing because they wasted their time, and they're wasting my time. I'm nice about it, but if it's happening a lot, you’ve got to go, ‘We've got to help you. How can we help you organize your time so that we can get more out of this?’ And so, there are lessons in that too. I think that it may not be 100% for everybody. But I think understanding the teaching/coaching/mentor spectrum — think about who you are. If you're somebody that can benefit from that, go ahead and start working in that direction.” (45:44—46:59) -Dr. Cranham

“[Having a coach is] a no-brainer in terms of how quickly you can get to where you want to be if you find the right mentor. You could have taken countless hours of continuing education. But implementing it, I have to say, even since I started — I tell this to other colleagues. Since I started having John as my mentor, it completely changed the way I practice. And maybe that's why I can take so much blue time, John.” (47:06—47:35) -Dr. Cruz-Orcutt

“[It’s about] finding the right person that fits you, and knowing how you want to practice, and observing, ‘Who do I look up to? Who do I want to learn more from? Because I want to practice that way.’ That's the key. I would say if you don't have that clear vision, just getting anyone, it might not be as helpful because you might not have the same vision, or you might not have that connection that you feel comfortable talking to each other and learning from. So, you have to have that vision of, who is that person you want to learn from? And then, from there, grow.” (47:41—48:23) -Dr. Cruz-Orcutt

Snippets:

0:00 Introduction.

1:28 Dr. Orcutt’s background.

2:51 Dr. Cranham’s background.

5:46 Why you need a coach.

12:08 Dr. Orcutt’s journey with mentorship.

21:12 The difference between a mentor, coach, and teacher.

25:07 Clinical coaching, explained.

28:58 Increase your confidence with a coach.

31:52 Things dentists get wrong.

35:57 Advice for finding mentors.

40:51 Being a great leader.

45:31 Last thoughts on getting a clinical coach.

48:30 More about Cranham Culp Digital Dental and how to get in touch.

Dr. John Cranham Bio:

Dr. John C. Cranham is a highly respected and renowned dentist in Chesapeake, Virginia. At his state-of-the-art office, he delivers unsurpassed general dentistry, cosmetic dentistry, and restorative dentistry, including TMJ THERAPY and DENTAL IMPLANT SERVICES. He uses his vast experience and expansive knowledge to create healthy, natural-looking smiles. 

Dr. Cranham was an honors graduate of the Medical College of Virginia in 1988. He’s an internationally recognized speaker on the esthetic principles of smile design, contemporary occlusal concepts, treatment planning, restoration selection, digital photography, laboratory communication, and happiness and fulfillment in dentistry. 

Dr. Cranham founded Cranham Dental Seminars, which provides lectures, mobile programs, and intensive hands-on experiences to dentists around the world. In 2008, Cranham Dental Seminars merged with THE DAWSON ACADEMY, a world-famous continuing education facility based in St. Petersburg, Florida. 

As The Dawson Academy’s acting Clinical Director, Dr. Cranham is involved with many of the courses and provides continuing education to dental professionals across the globe. He spends approximately two-thirds of his time in private practice and the other third as an educator. He believes this balance keeps him on the leading edge of both disciplines. 

A published author, Dr. Cranham is committed to providing the highest quality patient care, as well as developing sound educational programs that exceed the needs of today’s dental professional. 

Dr. Cranham is an active member of numerous professional organizations, including the American Dental Association, American Academy of Cosmetic Dentistry, American Academy of Fixed Prosthodontics, and American Equilibration Society. 

Dr. Noemi Cruz-Orcutt Bio:

Dr. Noemi Cruz-Orcutt was born and raised in Puerto Rico. She completed a Bachelor of Science degree in Natural Sciences as a Valedictorian at the University of Puerto Rico and earned her Doctor of Dental Surgery degree from the University of Iowa College of Dentistry.  While receiving her dental education, she was involved in dental research and was an active leader in various dental organizations. Due to her academic performance and commitment to patient care, she was selected by her faculty to be a member of dentistry’s most prestigious honor society, Omicron Kappa Upsilon (OKU), in addition to receiving other dental awards. She furthered her education by completing a residency in Advanced Education in General Dentistry at Virginia Commonwealth University in Richmond, Virginia, and practiced as an Associate Dentist in Charlottesville, Virginia, prior to moving to Mason City.

Dr. Cruz-Orcutt is committed to lifelong learning and providing the best comprehensive dental care to her patients. She is an Alumni of The Dawson Academy and is also a member of the Academy of General Dentistry, American Dental Association, Iowa Dental Association, American Academy of Cosmetic Dentistry, Seattle Study Club, Spear Study Club, and American Academy of Clear Aligners.

Dr. Cruz-Orcutt entered the field of dentistry because of her desire to help others achieve the best oral health possible. She believes that everyone should enjoy life to the fullest with the benefit that good oral health provides. She loves the joy and satisfaction that she receives from each patient interaction and strives to individualize treatment to meet her patients’ unique oral...

3 Ways to Foster Team Loyalty and Retention

Episode #591 with Heather Crockett

Are you tired of high turnover in your practice? If you want to know how to retain the best people you can find, listen to this episode! Kirk Behrendt brings back Heather Crockett, one of ACT’s amazing coaches, with three ways to help you attract the right people, earn their trust, and gain their loyalty. If you truly care about your team, show them! To learn the three things you can do to keep your team in your office, listen to Episode 591 of The Best Practices Show!

Episode Resources:

• Heather’s email: [email protected] 
• Heather’s Facebook: https://www.facebook.com/heather.r.crockett
• Heather’s social media: @actdental
• 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:

ACT’s To The Top Study Club (July 28, 2023)

ACT’s To The Top Study Club (August 11, 2023) https://www.actdental.com/event/members-only-climb-with-us-register-for-august-11-2023-ttt-study-club

ACT’s check-in form

The 5 Languages of Appreciation in the Workplace by Paul White and Gary Chapman

“Wise-up Wednesday from Zane Benefits: Employee retention strategies for dentists; real costs of losing an employee”

Main Takeaways:

Team first, patients second.

Have great weekly team meetings.

Get the right people in the right seats.

Schedule frequent, consistent check-ins.

Appreciate and show appreciation to your team.

Quotes:

“Turnover is expensive. It's painful. It hurts. I pulled this stat up. The cost of employee turnover in dentistry — think about this — for a dental hygienist making $60,000 a year, that's $30,000 to $45,000 in recruiting and training expenses. Others predict the cost is even more than that, that losing a salaried employee can cost as much as two times their annual salary, especially for a high earner. So, the important lesson here is when you find somebody great, find a way to foster team loyalty, trust, and retention. It's important to your future.” (2:49—3:37) -Kirk

“[Turnover expense is] a painful stat. And that only speaks to the money side of it, your cash. Think of all the time that it takes you also to train a new team member, to get them up to date on all of your systems and your agreements and your protocols. It can be a lot of work to onboard a new team member.” (3:40—4:01) -Heather

“When I was in search of a job, whether it was as a dental assistant, an admin team member, or a dental hygienist, which is where I experienced the majority of this, when you go on and you are seeking out information of the practice that you are looking to apply for and they're also hiring for other areas in the practice, that throws up a red flag like, ‘Maybe this dental practice has a lot of turnover. I'm not sure I want to be part of a practice that has a lot of turnover.’”  (4:50—5:20) -Heather

“People that are applying for jobs in your practice are doing way more homework on you than you're ever doing on them. So, they know a lot. They know so-and-so that used to work there. The second thing to remember is that no dental team member ever leaves a practice. They usually leave a person. It's somebody they left. So, I think we've got to call it out. Your ability to attract, keep, and retain the right type of people is highly dependent on how you behave and who you become as a leader.” (5:29—6:02) -Kirk

“Number one, hold and have great weekly team meetings.” (6:30—6:35) -Heather

“The song comes to mind, “Everybody's working for the weekend.” They don't care. Their brain is already halfway into their plans of what they're going to do Saturday night. Forget about late in the week and in the afternoon. That is the wrong time to have a team meeting. We're having team meetings earlier in the week. Maybe not on a Monday, because we know that Mondays are very Monday. Tuesdays, Wednesdays, early in the morning. And the reason why I say that this is so important to foster that loyalty and to retain team members is because our weekly team meetings are for the team. It's for us to really better the practice. It's going to give us that time and say, ‘Look, our team is first. Our team comes number one.’ Oftentimes, we have clients and community members that come in and say, ‘No, patients first. Patients first.’ Absolutely not. It is team first. So, when we put our weekly team meeting first in the schedule before we add any other patients, that screams that you care about, who? The team.” (6:59—7:58) -Heather

“What you do screams you either care or you don't care. And if you're a dentist who says, ‘Oh, weekly team meetings, they're not very much fun. We recycle garbage,’ you have to change that. In order to have a great team, you've got to land the plane, and you’ve got to do airplane maintenance on the ground. You would never fly with me if I was your pilot and I said, ‘I don't do any maintenance. I don't do any check-ins. I don't do any of that. We just fly, and we fix it in the air.’ That is crazy.” (8:10—8:36) -Kirk

“Your team members can't guess what you're thinking. They have no idea what you're thinking. And when you take scheduled production time — and yes, I did say scheduled production time — out of your schedule, you go from 32 hours to 30 clinical hours, here's my promise to you. If those two hours are used really well, your production will go up. You will truly start seeing the benefits of producing more by working less, and your team members will appreciate the fact that they're not racing from room to room to room. You're going to fix so many problems. You're going to improve communication, and you're going to feel connected to the people you work with, which is a huge piece of this. And so, we encourage people to do this all the time.” (8:40—9:26) -Kirk

“If you say, ‘No, I want to do [team meetings] over lunch,’ and all that kind of stuff, you're inviting natural challenges, which means I'm hangry at mid-part of the day. That is a very unpredictable time because you're going to run over with patience, and you make the judgment in your brain, ‘Well, we already take four hours of lunch. Why don't we combine that with the team meeting?’ You're setting it up to be compromised. There are very few people that can pull that off. That's why we encourage you to do it during production time and make that commitment that happens when you guys all get together. Weekly team meetings are huge.” (9:27—10:02) -Kirk

“That's very dangerous, entering into that lunch time, end of day. That's a dangerous time to have a team meeting. That may be why you don't like your team meetings. When are you the freshest? When can you give your best energy? Do you want to give your best energy to your team? Then what are you doing to support that?” (10:06—10:23) -Heather

“Not having a weekly team meeting is like saying, ‘I don't need to have dinner with my family. We're pretty locked in. We know each other.’ Or saying, ‘I'm married, and I don't have to go to date night because we're good.’ That's silly. This is a time and age where you’ve got to go all-chips-in. You've got to double down on your investment to grow and develop and connect with the people around you, and your habits determine all of that. So, the weekly team meeting is absolutely critical. If it isn't done really well, that's symptomatic of other things. You've got to change that around and make sure everyone's connected.” (10:36—11:14) -Kirk

“Number two, you have to have frequent and consistent check-ins with each individual team member in your practice.” (11:17—11:24) -Heather

“A check-in is intentional carved out time where you get to sit down as the doctor, practice owner, and/or a leadership team member and give space to that team member to allow them to share what's happening with them personally and professionally, and what the leadership team can help them with. This is one of the ways that you can help to prevent burnout with your team members as well. We all have burnout that ebbs and flows. We have to be really proactive about getting ahead of it. Check-ins are one of those ways that we can do that, is that we can catch things before they become a crisis. You often talk about conflict. If it's not addressed, it's going to become a crisis. This gives us the space and allows us to be able to share what it is that we're experiencing. Is our plate too full, or are we dealing with something at home that you weren't aware of until the check-in? The check-in gives us the space for that.” (11:28—12:30) -Heather

“One of our church leaders, years and years ago, coined this term — and I don't know if he got it from somewhere else. Love is really spelled T-I-M-E. When you give these check-ins your energy, your team will see that you really care.” (12:33—12:52) -Heather

“Unresolved conflict always becomes a crisis. We just don't know when. And so, what you want to do is mitigate some of that conflict. You're never going to get rid of all of it, but you've got to leave space for how we can proactively mitigate some of this.” (12:59—13:18) -Kirk

“[If you stop check-ins], your team can't trust you to follow through on this, or much else. If you say that you're going to implement this, then do it. Let's do it. The other part of [being] consistent is, I wouldn't let the team member fill out the entire form until they say when their next check-in is. We do that at ACT as well. I can't fill out anything in my check-in form until I have scheduled my next check-in. That forces both parties to hold each other accountable to continue keeping up that cadence.” (16:30—17:00) -Heather

“Once you start doing check-ins for most every single person and you start to realize how important this is, you'll never go back to the way you did it before because your team will feel very connected to you, the purpose, the process, and they'll start to trust you.” (17:11—17:26) -Kirk

“When you first start this, the personal high, personal low, it's always really easy to get the professional high, professional low type of thing. But what you'll find when you do the personal high, personal low is that team members really aren't going to tell you a whole lot. All you want to do is leave space. You're not requiring them to say anything personally or professionally. But the more you do it and the more you listen, the more they'll trust you and the more they'll be vulnerable with information. They'll share some stuff that you're like, ‘Okay, I didn't really have to know that.’ That's the sign that they're trusting you with their vulnerability. There's a world of people out there that talk about trust, and trust, and trust. My question to you is, what systems have you built in your practice that helps foster that trust? I'll answer it for you. A check-in creates and fosters that trust.” (17:34—18:26) -Kirk

“Step number three, you've got to show appreciation. You have to. This is a nonnegotiable if you want to retain amazing team members. You have to show appreciation. Now, appreciation looks a little bit different for every single team member. I like using the five appreciation languages at work. And here they are: acts of service, quality time, words of affirmation, tangible gifts, and appropriate physical touch — and I'm talking about high-fives, pat on the back, kind of a thing.” (18:31—19:01) -Heather

“According to the U.S. Department of Labor and Statistics, the number-one reason why people quit their jobs is they don't feel appreciated. They feel like, ‘I'm working my tail off here. Nobody notices.’ I love our friends in the South. They always say, ‘I appreciate you.’ I love that. It sounds so great when they say that. But I think the bottom line is, these people work very hard for you all day long. And maybe you're not built with the appreciation gene or node in your brain. That's where you need some help to be able to say, ‘Hey, listen,’ and pause every once in a while. People can live on a thank you. Here's one thing. Practice a thank you. Practice a hello and practice a thank you. At the end of your day, don't look at your computer, check out Facebook, go back to your office and close the door. It might be powerful to your practice to say, ‘Hey, I really appreciate you guys. I don't know what you did at 1:00 today, but that was magical. Thank you. Enjoy your evening.’” (19:38—20:43) -Kirk

“Be as specific as possible, also. Point out specific points throughout the day that made a difference for your practice, for you, and for the patients. That's really where your team members are going to take that to the next level because they love that appreciation, and that you showed that, and that you brought that up and you said it out loud. They're going to want that again, so they're going to do it over, and over, and over for you.” (20:45—21:09) -Heather

“Your team members have a built-in BS meter. This has got to come from the heart. It's got to be very sincere. You have to want to appreciate your team member. If you're just doing it to make them feel better, that's short-sighted. So, put your heart in the right place. And remember, there are so many things that feed into this. Great leaders don't speak to people's heads, they speak to people's hearts. A manager speaks to your head about what you can do better. Speak to people's hearts. That's powerful. Things start to take off and transform.” (21:12—21:45) -Kirk

“A great team member who's a chairside assistant changes your life in 60 seconds. Having an amazing team member at the front who protects your life, the schedule, and the financial well-being of your practice changes the financial landscape of your entire life in 30 days. Having the right hygienist in your practice changes the oxygen everywhere. Having the right office manager, having the right accountant — having the right people — makes your life so much better. And the greatest of all time, Peter Dawson, said, ‘When you have the right people, you can produce twice as much, in half the time, with a quarter of the stress.’” (21:55—22:33) -Kirk

“So many doctors and practice owners want [team loyalty and retention], and they care about their team. But I want you to have some reflection. What is it that you're doing to support that? If you really, truly love and care about your team, what actionable things are you doing to show your team the way that you feel?” (23:11—23:27) -Heather

“These three things, don't be overwhelmed and start all of them at once. Take one thing and start that one thing, and then get some re-evaluations and feedback from your team. After a month or two of doing check-ins, after doing team meetings, let's get some feedback from the team to see how they're showing up with the five languages of appreciation as well. Ask your team during those check-ins, ‘How do you like to be appreciated?’” (23:30—23:58) -Heather

“We spend 30% of our lives on this planet going to work. Thirty percent of the breaths you take while you're alive on this planet are at work. Wouldn't you want to enjoy work? Well, your ability to enjoy work is greatly dependent on who's around you at work.” (25:34—25:56) -Kirk

“In the spirit of talking about Brené Brown, she says we weren't meant to do it all alone. We need people around us to do everything together.” (26:00—26:09) -Heather

Snippets:

0:00 Introduction.

2:25 Team loyalty and retention is important for your future.

4:01 Other implications of high turnover.

6:21 1) Have great weekly team meetings.

11:15 2) Have frequent and consistent check-ins.

13:18 How to do check-ins with your team.

15:30 Consistency is key.

18:28 3) Show appreciation.

21:45 Get the right people in the right seats.

22:59 Last thoughts on improving team loyalty and retention.

24:01 More about To The Top Study Club.

Heather Crockett Bio:

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

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

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