The Best Practices Show with Kirk Behrendt

Preventing Embezzlement in Your Dental Practice: What Every Dentist Should Know

Episode #560 with Amber Weber-Gonzales

Almost half of all dentists will experience embezzlement in their careers. What's worse, it can happen more than once! You need safeguards in place, and Kirk Behrendt brings in Amber Weber-Gonzales, head of Prosperident’s Proactive Services Group, to share their best practices to help you protect your business. Your practice is like your patients’ oral health — be proactive and preventative to keep it healthy! To learn more about deterring embezzlement and catching it early, listen to Episode 560 of The Best Practices Show!

Episode Resources:

• Amber’s email: [email protected] 
• David Harris, CEO of Prosperident: (888) 398-2327
• 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:

Prosperident: https://www.prosperident.com

LastPass: https://www.lastpass.com

Main Takeaways:

Trust and verify.

Create a process of transparency.

Know which key reports to focus on.

Implement a solid end-of-day process.

Do your due diligence before hiring anyone.

Learn the common red flags of an embezzler.

Practice good habits with passwords and emails.

Quotes:

“Almost 50% of dentists, at least one time in their profession, their career, will have embezzlement occur. It’s a large number. And it doesn't usually occur just one time. In our experience at Prosperident, of those 50% that have embezzlement occur, 11% of dentists who had it occur, it happens twice. Four or more times, we see about 8% of repeat clients of the ones who've already had it occur. So, it’s not a one-and-done type scenario. It’s a recurring, revolving door, especially with the change in staff and things like that. So, there's a 50% chance it’s going to happen to you. We’re seeing those statistics come up from what they used to be, sometimes in the 60, 70 percentiles.” (4:16—5:07)

“The majority of cases where we find theft or embezzlement is from a long-term, trusted employee. And part of that is you build a relationship, the psychology behind it. It’s almost like your work-marriage type scenario. And so, yes, Sally’s been there for 25 years. You trust, but sometimes forget the verification part. That's one of the things that I oversee with Prosperident, is we really want to teach practice owners how to have transparency with their team members, whether they’ve been there for 20 years, or two years, or two months.” (6:06—6:44)

“Trust but verify. That's one of the biggest sayings that has been instilled in me. I think that comes from my ranching background in Wyoming. You're out there and you're like, ‘I think those are my animals over there.’ But you still have to verify because there are other people that are doing the same thing as you, livestock. I know that's an interesting analogy, but that's where that comes from. What you see sometimes is not always what you're going to get.” (7:28—7:53)

“In the dental world, we’re all about documentation and attention is in the details. When you go enter a clinical note, you make sure all the details are there, no different from the business aspect of your practice. So, where’s the verification for you to ask questions to have that transparency with your team? If you were to ask a question, can they easily and readily not just give you the answer but also show you how they have verified and have the documentation to stand behind what's happened with a patient’s account?” (8:11—8:41)

“One of the main things that I really want to focus on when I interact with clients is having really specific and clearly outlined methods and documentation on end-of-day closing. What that means is, at the end of the day, after seeing ten patients and done 22 hygiene exams or whatever, are you going to have the time to put on a different hat and say, ‘I'm going to print off all these reports 100% on my own through the software’? In a perfect world, you would say, ‘I'm going to go ahead and put on my business hat. I'm going to print off all my reports at the end of the day, and I'm going to make sure everything lines up.’ But sometimes, my saying to a lot of practice owners is you have to delegate to elevate.” (9:21—10:02)

“One of the most important things that I try to help doctors instill is a really good end-of-day process. Make sure there's true separation of responsibilities. You have an active team that is going to help you obtain daily reports of what occurred in your practice, and it’s not just one individual team member like Sally, the office manager. So, there's true separation of responsibilities, and there's that verification that everybody is participating. So, the verification and the trust process of how that is being completed is better, and that they also know that, ‘This doctor or the person that I'm working for or working with, they want to know what's happened. While they’ve been working on patients, they want to understand what's happened in the business. And at the end of the day, they want that documentation put together, and we have to provide that to them in a regular manner.’” (10:06—11:01)

“One of the main things we see with people who embezzle is they're very territorial. So, if their co-worker wants to take over helping them with part of their job, or, ‘Hey, I'm going to go ahead and run these reports for the day,’ they don't want anybody touching that. The same thing happens when a doctor starts to take over some of their territorial duties. ‘Hey, I want to go ahead and run that report today,’ or, ‘Hey, I want to look at that.’ That transparency starts to disappear because they don't want to be transparent. They don't want to give you the answers or be able to say, ‘Yeah, sure. Go ahead. Let me help you do that. Do you need help?’ And so, that's one of the reasons that we’re so about transparency. You should be able to ask a question at any moment, ask for a document at any moment, and there should be no hesitation.” (14:13—15:01)

“We’re all about protecting the financial integrity of your practice. So, for me, the main reports [to focus on] is, I want to see exactly the revenue details that occur so that you have something to reference to where your revenue actually goes, meaning your bank account. So, let's make sure what is recorded in the software is actually what has occurred financially for your business. That's one of the main key reports I always tell practices to focus on, is understanding the details of daily revenue so that you can track that on a monthly basis.” (15:13—15:45)

“You need to randomly check and make sure that the passwords and email that you have on file, for example, insurance, different things like that, truly work. And in my experience, what I've seen happen is Sally, that front desk manager — you have it in a spreadsheet. Let's say you don't use LastPass or those other programs that store that and help you make sure it’s safeguarded. I've seen this a lot where it’s spreadsheets or written in a notebook. When Sally leaves and you go to access things, what you have on your file, you can't access it. And we’ve experienced that so many times at Prosperident where even to complete employee payroll, you can't do that. Or you go to log in to order stuff off Amazon for the business, and it’s locked down because it was changed at some point, and you weren't aware of that.” (16:21—17:15)

“One of my top silly things right now [that dentists do] is Amazon, where we order everything for the practice through Amazon, but there's no true verification and everybody can get on Amazon and have a free-for-all. So, that's one of my things, is Amazon. I'm pretty big on that. Another thing is business credit cards where the business credit card is on file and used for a lot of stuff, and they keep a copy of it up at the front. And if they need to order lunch, or they need to do different stuff, everybody can have access to that.” (19:39—20:14)

“I recommend [having individual credit cards], especially if you're going to have an office manager or somebody that is your business team leader — obviously, she needs to be able to take care of business and the needs sometimes daily. I do recommend that that person have their own individual card. That allows accountability with that person too because they know it’s easier for him to look at everything that I am completing versus what the doctor is completing. So, it gives that separation of oversight. So, your own individual credit card for you, as a practice owner, and then the team would have their own different card with different numbers. It allows for oversight and accountability.” (20:50—21:30)

“Obviously, everything is in a digital world. So, your team will be responsible for deposits. But what I want to reiterate about that is it should not just be one individual person that's responsible for that. If you are physically taking deposits to the bank, at Prosperident, we've always recommended that the doctor be in charge of that so that there's a little bit more safeguarding in physical type payments such as cash, checks, things like that. So, making sure that no one individual person is in control of not just revenue received but how that revenue is being entered into your bank, making sure there's true separation and oversight.” (23:17—24:03)

“We’ve come across practices like that [that don't collect cash]. But I still think, sometimes, that's just not going to happen. I mean, depending on the practice. And that's where, as an owner, okay, you say that you're not collecting any cash; it’s zero. The oversight on that to see if you actually were would take a lot of understanding the software and details and where to double-check for that. So, that's something you'd want to contact us for so we could teach you how to make sure, if you say you're not collecting cash, that you aren't collecting cash and it’s being misappropriated somewhere.” (24:18—24:56)

“One of the main best practices, in my experience, we see a lot of change right now happening with staff members. So, I think really doing thorough checks on who you're hiring, and smart hiring, making sure you're doing reference calls and double-checking who’s walking through the door so that you're not bringing somebody in that maybe has a history of embezzlement, but they were able to hide it pretty easily. And I know that's difficult right now because everybody is struggling to find staff. But I think, for me, one of the most important things right now from a preventative aspect is really screening who you're hiring so you don't bring somebody in that maybe is not going to align with protecting that financial integrity of your practice.” (25:47—26:33)

“One of the main things I've seen lately is change of timeline. Meaning, somebody turned their resume in to you, they say they were the office manager, they oversaw accounts payable, managed all the insurance. I mean, they are super qualified. And they maybe stayed at a job, let's say, seven years. And when you get on your good friend Google, and you make sure that their reference numbers are true, and you contact these previous people, sometimes, what is on that resume, just like David [Harris] said, is not always true. They maybe didn't have that actual duty — maybe for the last three months of their job. Or they didn't work there the entire time. They changed the numbers a little bit to not show a small area of unemployment, or things like that.” (28:05—28:54)

“If somebody wants to embezzle, say you hire somebody new, and everything checks out perfect. If they truly want to embezzle, we’re not going to 100% stop them. But with a system of oversight, we’re going to deter it. And hopefully, if you're following protocol, you can catch it earlier rather than later.” (32:49—33:07)

“Part of the service that we offer, if a doctor chooses, is we will have interaction with some of your key team members to teach them and help them understand the system and help implement it. It’s not just about protecting the practice owner. As a former team member, it’s about protecting my safeguards too. I want to make sure everything is in place so that if somebody were embezzling that was a co-worker, number one, I'll catch it early. And number two, there are safeguards in place so that the software is set up or things are set up correctly to where I'm not taking the fall. Somebody is not coming to me and saying, ‘Amber, you were supposed to oversee all of the insurance. What happened? This is messed up,’ and I don't have a good system of transparency to provide. So, I tell team members this isn't just about protecting the owner of the practice. This is about protecting you, also, and your integrity and abilities in the practice.” (35:20—36:22)

“This really relates to what our purpose is in oral health. We want to be as preventative and keep things as healthy as possible. And so, I think at Prosperident we feel the same way. We want to help doctors keep things as healthy as possible. And while we’re always going to probably be doing investigations for some practices, if we can prevent a doctor from having a huge loss in the practice because we helped them have a great system of oversight and implementation, that's the reward in itself.” (36:43—37:14)

Snippets:

0:00 Introduction.

1:53 Amber’s background.

4:00 Why this is an important subject in dentistry.

5:10 Embezzlement is not clear-cut.

7:06 Trust and verify.

9:08 Have a good end-of-day process.

11:21 Three heads are better than two.

13:19 Create a process of transparency.

15:04 Key reports to focus on.

15:46 Best practices for passwords and emails.

17:15 Why you need to use LastPass.

19:07 Top things to not do.

20:22 Suggestions for credit cards.

23:12 Suggestions for deposits.

24:03 Are you truly not collecting cash?

24:57 Disable credit card sharing.

25:33 Do your homework before hiring.

26:34 Look for what you can't see on a resume.

28:55 Things to ask previous employers.

30:48 More about Prosperident and how they can help you.

36:23 Last thoughts.

37:20 How to get in touch with Amber or David Harris.

Amber Weber-Gonzales Bio:

Amber Weber-Gonzales began working in the dental field as a Registered Dental Hygienist in 2005. With a background in accounting and her interest in the business side of dentistry, she moved into office management roles and, ultimately, into dental consulting. Before joining the Prosperident team, Amber discovered embezzlement taking place in one of her client’s offices, bringing to light her aptitude for the kind of investigative and preventative work she now performs for our clients. Amber was recently the runner-up in the prestigious Spotlight on Speaking competition, featuring dentistry’s best-emerging speakers, and has been published in Dentistry Today magazine. In June 2022, Amber was appointed the head of Prosperident’s Proactive Services Group, which provides embezzlement prevention services to individual practices, groups, and DSOs. 

7 Steps to Reduce Cancellations

Episode #559 with Robyn Theisen

One secret to a better practice is better scheduling. When you can reduce your cancellations, you will have better days, a happier team, and become more profitable. You can do exactly that with seven essential steps, and Kirk Behrendt brings back Robyn Theisen, an amazing ACT coach, to share how to incorporate them into your office. With a few changes to your verbal skills and mindset, you can start saving more appointments! To learn how, listen to Episode 559 of The Best Practices Show!

Episode Resources:

• Robyn’s email: [email protected] 
• Robyn’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:

Previous Best Practices episodes with Miranda Beeson: https://www.youtube.com/results?search_query=act+dental+miranda+beeson

Dental Intel: https://www.dentalintel.com

ACT’s Capacity Tracker: https://drive.google.com/file/d/1MdN96fVhau8tcP10kW2_cU-Tv91K8r7l/view?_hsmi=241651107&_hsenc=p2ANqtz-98AjmJ7LkC2HvkK9uuY8l577tbOQ_8dHgEv1V_RVjByeE1xTLRFEYlHJVqxNmOsEBjwFPH-Cjr7iCbb4p-dJiLdKWb7A

Main Takeaways:

Remember that all of your cancellations start at the chair.

Value your dentistry and communicate that to patients.

Track your cancellation and no-show percentages.

Appointments are confirmed once they’re made.

Never tell your patients it’s okay to cancel.

Code and track your patients’ behavior.

Get rid of your cancellation fees.

Quotes:

“Cancellations become something that’s acceptable in the practice. And with practices today that are busy, hygiene is overflowing, they tend to become, as soon as someone has cancelled, it’s filled. So, they overlook the problem and how much time is spent on keeping the schedules full. If we could keep more patients in the schedule, there is more time for your business team and your whole team to be spending with patients and creating those relationships.” (2:04—2:33)

“We must value what we do and speak to patients in that way. Patients place as much importance on an appointment as we do. So, when we talk about, ‘It’s just a cleaning,’ or we brush over that appointment when we’re walking a patient out for PIT Stop, or we don't talk to them about how important those appointments are, creating urgency, any of those things, it devalues the appointment, and it becomes very routine to them, and it becomes no big deal.” (3:30—3:54)

“It starts with our belief system. And what you believe is leadership and how you talk about dentistry. So, the clinical team and the dentist himself or herself and how they talk about it, that's really important. It isn't “just” a cleaning. I like to tell people too, when [they] don't want to schedule ahead and they say, ‘I don't know what I'm doing six months from now,’ I'll say, ‘Well, great. Let's get this scheduled, and then you'll know so when something else comes up, you can tell them, I can't do that. I've got to be at my dentist at that time.’” (5:40—6:10)

“Seeing a hygienist twice a year, that’s sometimes the only doctor’s appointment that people have in a year. And the mouth is the gateway to so many things. It’s a really important appointment. It’s not “just” a cleaning.” (7:08—7:20)

“All cancellations start at the chair. I think the business team carries the weight of the cancellations and no-shows. And really, the clinical team has such an impact on this as well with the language and how many times they talk about the cleaning, how many times they talk about returning for the appointment, the urgency the doctor puts on the treatment that they're recommending. All of those things start at the chair.” (8:00—8:26)

“[We want] the patient to hear it over, and over, and over again with the PIT Stops and the handoffs. I know we tire of doing them in dentistry, and it’s really not about us. It’s about the patients, and they can't hear it enough.” (8:29—8:40)

“Know the cancellation and no-show percentages. You cannot impact what you don't know. And most often, I think people believe that their cancellation or no-shows are low, and it’s oftentimes higher than they believe that it is. So, knowing what it is — you can't impact it without knowing where you're starting from.” (9:55—10:13)

“We use, and many of our practices use, Dental Intel. That's a great source. Now, in Dental Intel, it has to be done correctly. For each software, there are nuances to how you break or cancel an appointment so that it falls into the right bucket with cancellations and no-shows. The other ways are capacity trackers. So, having each clinician keep track of how many hours they saw patients for that day, and how many hours they did actually see them. So, that's a manual way to do it as well.” (11:25—11:53)

“I would like for [cancellation and no-show percentages] to be under 10%, combined. I do believe that having some openings in your schedule is good because it allows for growth. It allows for new patients to come in. It allows for us to have scaling and root planing. We need to have some ability to have openings in the schedule — emergencies that call, some of those things. But I want them to be controlled, and I want to be able to refill them. So, having that under 10% is my goal.” (13:11—13:45)

“Consider your appointments confirmed when they are made and use language that supports that. So, telling your patients that you have the time “reserved” for them, ‘It’s on our calendar. Go ahead and put it on yours so that you also have reserved that time.’ Eliminate “confirm” and “remind”. If we continue to call and confirm appointments, it means it wasn't firm in the first place. When we've “reserved” time for them, that's the language that we want to use. And when you're calling those patients as a courtesy reminder between appointments, using it more as an assumptive close of, ‘We’ve got this time reserved. We’re all set to see you tomorrow, and we’re looking forward to it,’ rather than, ‘If you can't make it, call us,’ or giving patients a bunch of outs of ways to not come in, or it’s okay to cancel or no-show for the appointment.” (16:23—17:15)

“Having a 48-hour cancellation notice, you've just told patients when it’s okay to cancel with you. So, eliminate the 48-hour cancellation. The appointment is reserved. Let's go on the assumption that the patient is going to be there.” (18:44—18:57)

“[Instead of “cancellation”, say], ‘We’ve had a change in the schedule.’” (19:53—19:55)

“Start coding patients’ behavior. So, creating codes in your practice management software to track cancellations, changes in schedule, no-shows, and late arrivals so that we can track a patient’s behavior. Someone once told me, ‘When a patient shows you or a person shows you who they are, believe them.’ And so, if there is this trend in how they are treating you, it’s on us to respect our schedule and to train the patients how to respect it as well.” (20:26—20:56)

“I like to create my own [patient behavior] codes so that it’s a way for us to track it and it keeps it separate from any ADA code. It’s another code, and it’s unique to our practice. So, create a code that works for you.” (21:48—21:58)

“At two [cancellations], I'm going to have a conversation about it . . . You recommended having the conversation about putting them on a call list. I would add another option to that. I would allow them to be on a call list, or they could go ahead and prepay to reserve the time with us. So, ‘Either one of those will work. Which is going to be best for you?’” (23:19—23:48)

“I also say to patients, ‘Gosh, it looks like we’re having a hard time getting our schedules to line up. What recommendations do you have, or what suggestions do you have that could make it easy for this to work for the both of us?’ So, putting it back on the patient too, to understand from them like, ‘What can we do with this system that's going to work for you to be here when you need to be?’ So, it’s not just about me. It’s about them too.” (24:50—25:15)

“I hear from teams all the time that it’s customer service to allow patients to behave this way. I push back on that in that this is a relationship business. And in a relationship, there are two sides, and each person is responsible for their behavior. So, it’s having boundaries and teaching them to respect my time, and I will absolutely do the same for yours.” (25:58—26:17)

“I hear a lot of team members, and I used to do it myself too, when patients would call to say that they needed to cancel their appointment, I would tell them that, ‘Oh, that's okay.’ And really, it’s not okay. So, remove that piece of it. I believe when patients call in and they are, ‘I'm so sorry. I can't be there,’ they're expecting for us to make it very easy. They're expecting for us to say, ‘It’s okay. No problem. We’ll take care of it.’ And so, I like to tell them, ‘Let me put you on hold for one minute. Let me take a look at your account, and I'll be right back with you.’ And by putting them on hold, the pausing, collecting yourself — because I know that these can be hard conversations for team members to have. It’s a change for them. It’s different, and confrontation or having a tough conversation can be hard for them. So, putting them on hold, having the patients wait for a moment and collecting your thoughts, and really being able to understand how many times this patient has cancelled, or they have not shown up, or they have been late helps you to frame what you're going to say next.” (28:01—29:03)

“Many of our practices right now, hygiene is overflowing. They're not going to get in for six months. So, how about saying, ‘Gosh. I'm concerned because my next appointment that I have available is six months from now. That is a long time between your hygiene visits, and I'm concerned about your health. Is there any way that you can keep that appointment today?’ Or what are their health goals? Like, ‘I'm really concerned. I can't get you in to see the doctor for another month or so. I'm concerned about the crown that you were needing. Is there any way that you can keep that appointment?’ So, build value into it, and go back to what's important to them rather than scolding them. It’s really about, let's build value into this and see what they can do to make it.” (31:57—32:37)

“Get rid of your cancellation fees. I believe that verbal skills outweigh a cancellation fee, hands down. And cancellation fees are generally a threat. They don't really get used. When they do, they get reversed. And the fee that is charged is never enough to cover the appointment time. So, instead, use the other things we've talked about. Create a bulletproof no-show cancellation policy and get rid of the fee. Keep more patients in your schedule.” (33:22—33:59)

“As the business team, when you put these into place and you save appointments, celebrate it. Let your team know that you saved an appointment. It’s a big deal. So, when you actually put these things into place, celebrate the wins and celebrate the decrease in that no-show cancellation percentage.” (35:54—36:11)

Snippets:

0:00 Introduction.

1:49 Why cancellations are a problem in dental offices.

3:23 Step 1) Value what you do and communicate that to patients.

5:29 How to get the team to think better and create value.

7:57 Step 2) All cancellations start at the chair.

9:51 Step 3) Know your cancellation and no-show percentages.

10:13 Where to get the data for broken appointment percentages.

12:55 Good and bad cancellation and no-show numbers.

14:24 Breaking and dragging appointments.

15:11 The Capacity Tracker.

16:20 Step 4) Consider your appointments confirmed when they are made.

18:41 What to say instead of “cancellation”.

20:22 Step 5) Start coding patients’ behavior.

21:32 Should I use the ADA’s patient behavior codes or create unique codes?

22:25 How many strikes for cancellations?

23:50 Teach patients how to behave in your practice.

27:57 Step 6) Don't say, “That's okay.”

31:06 Advocate for your patients.

33:18 Step 7) Get rid of your cancellation fees.

35:46 Last thoughts on cancellations.

Robyn Theisen Bio:

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

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

Difficulties in Digital Dentistry

Episode #558 with Dr. Marcos Vargas

If you're wondering when to jump into digital — now is the best time! It’s been proven to work, the technology keeps improving, and your labs are already using it. So, why are dentists still hesitant to change? To explain some of the hurdles in digital dentistry and ways to overcome them, Kirk Behrendt brings back Dr. Marcos Vargas, Professor of Family Dentistry at the University of Iowa. Start using digital to improve your patients’ experience! To learn how to get started, and to sign up for his free webinar, listen to Episode 558 of The Best Practices Show!

Episode Resources:

• Dr. Vargas’s email: [email protected] 
• Dr. Vargas’s Facebook: https://www.facebook.com/marcos.vargas.1963
• Dr. Vargas’s social media: @marcosvargas999
• Hands-OnLine: https://www.handsonlinelive.com
• 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:

Composite Mastery Webinar with Dr. Bob Margeas, Dr. Marcos Vargas, and Dr. Stephen Phelan: https://phelandentalseminars.com/cmo-webinar-wj 

Main Takeaways:

Don't be afraid of change.

Now is the best time to jump into digital.

Your world will open up with digital dentistry.

Start slow, get your team’s buy-in, and practice often.

Keep an open mind and continue learning for the rest of your life.

Quotes:

“I think, more and more, dentistry is moving towards digital. I think there's more interest, not only from the younger generation, but the older generations are jumping in there too. This is a subject that moves so fast, and there are so many components. The implementation, when we’re thinking about why it is difficult and you think about economics, one of the difficulties is, where do you jump into it? It’s kind of like buying something new. When do I jump into it? Do I [get] the model of this car now? Do I wait a couple of years with more features? So, it’s a little difficult to know where to jump [in].” (4:12—5:01)

“There's no right or wrong when you jump. The sooner you jump, the sooner you are going to get into digital, obviously. I would say, looking at the market and looking at what I know [about] digital, I would jump right now. I think the technology has been proven. There is a lot of research behind the scanners we have right now, to the point that I will say, yes, you can jump right now and immediately get good results.” (6:05—6:34)

“Now, how do you jump into it, and what areas? Is it aligners? Restorative dentistry? I think, in general, most dentists will do restorative dentistry. So, jump into buying yourself an intraoral scanner. I will say that is the entry point. Buy yourself a digital scanner. With that, you are going to scan upper and lower arches, bites, crown preparations. Maybe start with a crown preparation that is supragingival, something relatively simple. And then, communicate with your lab that you are jumping in. And the labs, surprisingly — it’s not everyone, but the grand majority — they already are digital. So, dentists, we haven't jumped into digital when laboratories already are way far ahead than the dentists in digital technology.” (6:35—7:32)

“We still, in some cases, do analog impressions with impression material. The laboratory is going to scan those impressions and work everything digital. So, what I think is much easier, faster is if we scan and send that data to the laboratory. The communication is faster. You don't have to wait for the impression to get to the laboratory. It’s immediate. I send it now, and in two seconds they’ve already got it, so they can start your case.” (7:34—8:04)

“It’s a parallel. We’re teaching the principles of, let's say a crown preparation. And then, there is a [fork in the road], and we say, ‘Now, we have to take an impression. You can do it either way, digital or analog.’ And then, we start talking a little bit about the advantages and disadvantages of maybe one over the other. But also, we need to be conscious that some of those students are going to be practices where they don't have digital yet. So, we need to teach them both. I will say more and more people are jumping, but not everybody is digital. So, in academics, it’s a little difficult to make that complete change, or maybe what percentage says digital and what percentage says analog. So, that’s why we teach them both, parallel.” (8:35—9:29)

“We think about AI as something that can do everything. ‘Artificial intelligence, that's everything. I don't have to even touch it.’ But artificial intelligence has different degrees. We already have artificial intelligence in these machines. So, some of this equipment, you scan for a crown, you're telling it what crown you're looking at, and the AI in the machine immediately finds your margin. So, there's already something incorporated in these systems to help you design what you're doing. A lot of the digital process is driven by AI; we just don't realize it. A lot of things are already going into modern dentistry with AI.” (10:10—10:54)

“This is one of the difficulties when we talk about implementation, is that sometimes, as a dentist, you want to jump into something. You go to a meeting, and you go talk to a rep, or go to the exhibit floor, and you get excited about implementing something in your practice. You come back, and your staff is like, ‘Well, just settle down a little bit. We need to talk about it. We need to think about it.’ So, it’s important to have the people in your team buying into the concept of digital.” (11:38—12:06)

“In restorative, you're doing a crown. And when you do analog, you might not get a margin. What does it mean? You have to retake the impression. In digital, it means you delete that area you didn't get, do an [area of] isolation, rescan, and you get the margin. So, speed and comfort for the patients are things that when I talk to my team, I discuss it and say, ‘Think about the advantages. We don't have to have the material for five minutes in the mouth. The patient is going to be more comfortable because there is not that — they call it “goo”. ‘I hate that goo,’ people will say. And the first time you do digital with those, it’s like, ‘Oh my god. I love it, doc! I hate that goo. I feel like salivating, saliva all over.’ And they love it. So, again, bring the team in that way. I found out that is a very good way.” (12:23—13:15)

“The benefit [of digital for team members] is that there's less cleanup because you don't have all that impression material going around and you have to clean it. It’s faster. Patients like it. They're happier with your system, happier with the dentist. And some of the assistants get excited about this. So, they can scan. Instead of taking alginate models, you can take scans. And then, you can print them. That's probably the next step into digital, maybe getting a printer in your office. I think that's the second step, once you are comfortable with the scanning. So, I think the team realizes the advantages. And once you explain the advantages to your team, I think most teams are excited with the technology and improving patient service.” (13:17—14:06)

“We think, ‘I am happy with what I'm doing. Why change? Why modernize myself if I'm already happy with what I am [doing]?’ I wouldn't say that that's not right. But I think we produce fear in ourselves because we are afraid of change. Moving from analog to digital is change, by itself. So, people are like, ‘No, it’s working fine. Why do I have to change? And then, the expense.’ They make more excuses than there really are to not jump into digital.” (15:05—15:51)

“I don't believe that [digital decreases traditional skill and craftsmanship]. I really do not believe that. Because what do we know? We know that the better dentistry we do, the easier for technology to follow up on that. Like my margins. The better margins, the smoother margins I give to digital, the better the fit is going to be on my crown. So, the craftmanship, I see it’s still there. When we try to teach somebody digital, I tell them digital is just a different way to get an impression. Instead of analog, it’s digital. But the quality of the work should be good for both. It should be the highest quality you can put out there. So, I will never equate loss of quality, loss of craftsmanship, to digital. I will say that it should be maintained. We need to maintain that quality of dentistry.” (16:20—17:16)

“Once you [start doing digital dentistry], maybe start designing your cases [digitally]. Move a little further along to digital smile design or bridges. Scan your restorative and mix it with esthetic. Meaning, you can take photos of the face, the smile, at repose, and then get your scans, put them in the computer, and you can design. You can start showing the patient, ‘If you do veneers, you will close the diastema.’ So, all of a sudden, it becomes a diagnostic tool at the same time. Not only tools for the restorative dentist, but also for the diagnostic portion of the dentist. You can incorporate CBCTs in that. That's maybe another step, incorporating in their designs, CBCT. You can plan your implants.” (17:34—18:26)

“The world opens up after you go step by step. I think the first one is the scanner. The second one is the printer. And the third is design into the computer. Now, does every dentist want to get in there? Maybe not. Maybe some would like to get in there from a diagnostic point of view. Some of them like to go diagnosis plus treatment. You start combining things in the digital world, and that's very doable. Some people already do it that way. We try to teach it that way. At least from the esthetic point of view, the senior students will take photographs, scan CBCTs. And then sometimes, for an esthetic case, now with the CBCT, I know where the bone is. I know where the gingiva is, where the CEJ is. We can plan to the detail how the surgeon, the periodontist, is going to trim the tissue for me to have the ideal length of the crown. And then all that planning, maybe I have a missing tooth, I have an implant, how everything fits. So, digital also brings multidisciplinary dentistry together, I would say.” (18:28—19:32)

“Stage number one, getting the scanner and to start scanning, it should be maybe a week or a couple of weeks. Because again, if you're going to start scanning for models, things like that, you scan and send it to the lab. They print it, you get it back. Or for a crown, you send it, they send your crown back with a model and everything. So, that's one or two weeks, I think, there. My suggestion to everybody getting into scanners, don't start with five, six-unit bridge, or even a three-unit bridge. Start with a single crown because I think that's the easiest that you learn.” (19:54—20:35)

“Practice. The more you practice ahead of the patient, the better you're going to be at scanning. For a long time, once we started getting the scanners, like probably ten years ago, I would come in the morning and then fire up the scanner. We had the 3M scanner. I don't remember the name nowadays. But you had the powder and everything. So, I would go and practice on my model. Because your patient comes in, and every time, it becomes faster, and faster, and faster. So, practice. Don't think that, immediately, you're going to run with it. You need to start slow with easy dentistry. You don't want to start with very complicated dentistry. So, be patient. Be patient because, eventually, that piece of equipment will pay for itself.” (20:36—21:25)

“I don't have any doubt that a lot of the things that we’re doing is going to get even more mainstream, digital. I might even say, now, it seems like it’s mainstream. You go and talk to a group of people, and the idea of impressions is kind of foreign to some people. Some people have gone completely digital. So, whether it’s mainstream or not is kind of difficult. But every time I try to foresee the future, it’s like, oh my god. I think it’s bigger, bigger, and better. Faster scanners. Eventually, the scanners are going to become cheaper, scanners that can see through blood, through saliva. Wouldn't it be great that you prepare the tooth, and it’s bleeding because you nicked the gingiva, and all of a sudden, the scanner with doppler radar or whatever, they get you the margins, get you everything? And AI will give you warnings, ‘Oh, there is a rough margin here, a J margin.’ Things like that, I think, eventually, is going to happen. That is going to make the life of the dentist much easier. It just has to be.” (21:42—22:50)

“With the explosion of knowledge over the last 10, 20, 30 years, if I look back on myself, when I went to dental school 35, 40 years ago, the dentistry that I knew in that time is dentistry that I don't practice anymore. It’s completely changed over the years. That dentistry that I learned is not the dentistry that I practice now. So, to students, I will say dental school is boot camp, to give you the basics to go and pass the board and start practicing dentistry. But learning about dentistry doesn't stop that day. The next day, you need to keep learning, learning, learning, and learning. Because if you drop the ball in learning, you are going to fall behind your colleagues that are learning, learning, and learning.” (23:57—24:46)

“Keep learning throughout your life. Expect that everything is going to change that you learn. And with the explosion of knowledge, cramming basic information in four years is so difficult for us. And then pushing to do three years — I don't think three years is enough to get you the boot camp. Now, I call it boot camp because so much knowledge is out there. So, is it easy? No. I would never say that getting through dentistry is easy. But it’s exciting. It’s fun. It’s a very rewarding profession in a lot of aspects. So, go do dentistry.” (24:53—25:35)

“This is as good a time as any to jump into digital. Start slow. Involve your team. Reach out to educators or people that teach a little bit of the tips and tricks of digital dentistry. Keep an open mind. Be patient. Practice. Those are the things that I will say are the initial hurdles to go into digital dentistry. But I will say jump in now because it’s exciting. It’s going to get better and better.” (29:14—29:46)

Snippets:

0:00 Introduction.

1:44 Dr. Vargas’s background.

3:52 Where we are with digital dentistry.

5:34 When is the best time to jump into digital?

8:17 Are students today learning both analog and digital?

9:49 AI's role in digital dentistry.

11:19 How to get your team to buy in.

14:45 What dentists get wrong about digital.

16:03 Is digital linked to a lack of skill and craftsmanship?

17:17 Digital smile design.

19:34 Practice, practice, practice.

21:26 The future of digital dentistry.

22:52 What to expect in dental school.

26:18 More about Dr. Vargas and his future courses.

29:05 Last thoughts on digital dentistry.

Dr. Marcos Vargas Bio:

Dr. Marcos Vargas attended Cayetano Heredia University School of Dentistry in Lima, Peru, and graduated in 1985. He spent two years, 1990 to 1992, in the AEGD program at the Eastman Dental Center in Rochester, New York. He received his Certificate and Master’s Degree in Operative Dentistry in 1994 at the University of Iowa, where he is currently a Professor in the Department of Family Dentistry. His primary research interests are in the areas of dental materials, including glass ionomers, dentin bonding, composite resins, and esthetic dentistry.

Dr. Vargas is also recognized for his expertise of Direct Restorative Treatment Procedures and conducts numerous lectures and hands-on seminars in the U.S. and internationally. Dr. Vargas has published extensively in the areas of dental adhesion and resin composites for over 25 years. He maintains a private practice limited to operative dentistry with an emphasis on esthetic dentistry. 

8 Advantages to Numbers

Episode #557 with Heather Crockett & Courtney Dalton

Numbers can be awkward and uncomfortable, but you need to talk about them with your team. There are many advantages to doing it, and Kirk Behrendt brings back two amazing ACT coaches, Heather Crockett and Courtney Dalton, to highlight eight of them that you need to know. If you want results, it starts with numbers! To learn the benefits of knowing, tracking, and reporting on your numbers, listen to Episode 557 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 
• Courtney’s email: [email protected] 
• Courtney’s Facebook: https://www.facebook.com/courtney.dalton.739 
• Courtney’s social media: @courtney.hannig 
• 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 Capacity Tracker: https://drive.google.com/file/d/1MdN96fVhau8tcP10kW2_cU-Tv91K8r7l/view?_hsmi=241651107&_hsenc=p2ANqtz-98AjmJ7LkC2HvkK9uuY8l577tbOQ_8dHgEv1V_RVjByeE1xTLRFEYlHJVqxNmOsEBjwFPH-Cjr7iCbb4p-dJiLdKWb7A

Traction by Gino Wickman: https://benbellabooks.com/shop/traction  

Episode 552 of The Best Practices Show with Miranda Beeson: https://www.youtube.com/watch?v=oBHDC4fOXHc

Main Takeaways:

Numbers produce results. 

Numbers create accountability. 

Numbers help create teamwork. 

Numbers eliminate the subjective. 

Numbers quickly lead to solutions. 

Numbers attract accountable people.

Numbers lead to healthy competition.

Numbers build clarity and commitment.

Quotes:

“It’s crazy important. Without numbers, we don't have any data. And without that data, we can't make any changes to what really matters to the practice and to our lives.” (2:42—2:51) -Heather

“[Talking about numbers] gets better over time, absolutely. But in the beginning, it can feel really icky and awkward. That's why I'm saying it kind of feels worse in the beginning, because it does feel weird. It feels sticky because we may not have much experience with it. So, it feels kind of wonky. Do things get better? Yes — as long as we are talking about the numbers and putting some countermeasures in place to continue making them better so that we reach our goals.” (3:11—3:35) -Heather

“To answer the question, why do we struggle with tracking, if a team has never been asked to do that and then they're asked, suddenly, they're aware of the disconnect between what they didn't know and what they now know. And usually, the first issue is, ‘Well, what do we do? What do we do, now that we know what we didn't know before?’ It feels overwhelming. And to echo Heather, it’s super sticky because it’s unknown territory. So, now, we’ve pointed out where the disconnect is. And now, the next question is, where do we go from here?” (3:40—4:08) -Courtney

“Numbers cut through murky, subjective communication between manager and direct reports. It’s data. It’s not emotional. It’s not anything except what it is. It’s a number. It tells us if we’re on track or off track. Are we moving this way, or are we moving that way? It’s not, ‘I think you're doing a bad job,’ it’s, ‘Well, this was the goal, and this is where we fell,’ whether it’s below or above. So, it’s not murky at all. It’s crystal clear.” (4:55—5:23) -Courtney

“There's that time and effort, ‘We’re busy, we’re busy, we’re busy.’ We feel like we’re doing all the things. Well, what do we have to show for our effort? And that is results. So, we can be busy, or we can be focused and actually get some things done. That speaks to advantage number one in a huge way.” (6:47—7:04) -Heather

“[Accountability] requires accounting. We’re going to make sure that we have set clear expectations and clear goals. And the numbers that are in there, that's what we’re using to keep track of that. And then, we can hold each other accountable to what we said we’re going to do.” (7:47—8:02) -Heather

“If you know what the goal is, and if you're someone who’s responsible for bringing a certain set of those data points with you to your weekly team meeting — which, if you're not having it, you should be — then you can't ask someone to do anything. You have to know what that data point is or what the goal is and be accountable to it, to reporting on it, to understanding what it really means and how it benefits the practice, overall.” (8:06—8:30) -Courtney

“[Accountable people appreciating numbers] means that they understand what that number means and what it reflects on. These are also the people who are objective. They're not subjective. They understand that the number is related to the process, and they appreciate what it means for the practice, overall. So, there are numbers people and there are non-numbers people. And that's okay. But essentially, you still have to dig through all of it to really understand where that number came from and what the point of it really is. What are we tracking? Why are we tracking it? And now that we know, what do we do with it?” (9:40—10:16) -Courtney

“[Numbers] also light a fire. When you have the right person and they own a number, they really want that number to be in the green. They want to reach their goal every week because you have the right person on the right number.” (10:29—10:42) -Heather

“As soon as you start asking them — again, you don't know what you don't know. Now, we know all this information and it’s going to make some people feel a little bit uncomfortable. But once you know, and you have an appreciation and an understanding, now we can go somewhere. Now, we can really be open and vulnerable, and have a great discussion about how to get from A to B together.” (11:22—11:44) -Courtney

“The clarity piece, we need to have a number. And every team member, they don't know what it is that we’re expecting of them. ‘You need to make sure that you have great capacity.’ Well, we need to have butts in the chair in order to produce what we need to produce. We’re a business. So, what does that look like? Back to what Courtney said, we need to understand why. If we understand why we’re tracking it and what the result is going to be when that number is in the green and we are hitting our goals, then we have that commitment and that layer of clarity because then I know, as a hygienist, why I'm tracking my capacity. And that piece alone helps me to take away some of that sticky awkwardness and uncomfortableness from it.” (11:57—12:44) -Heather

“It’s an E – R = C. If you're not setting up their lane, ‘This is what's expected of you. This is what I want you to know and to understand,’ if you don't do that, conflict. And that's where you're back to sticky. You're back to murky. You're back to bad feelings. And it’s data. It’s not bad. It just tells us where we are.” (12:48—13:09) -Courtney

“If you're the right person in the right seat, you're seeing that goal or that number, you’re thinking, ‘I'm going to do one better next week. I'm going to do five better.’ So, if I'm a hygienist, I'm thinking, ‘I want to identify some opportunities to help my patients.’ And inherently, that's going to increase my production per hour. And inherently, I've now crushed last week’s goal. So, for me, it goes back to right person, right seat. That person is going to adopt that number as their own, and see the value in it, and continue to be competitive — even with themselves — to get a better number, week after week.” (14:44—15:21) -Courtney

“If you have the right people, they're going to care enough about that number. They're going to get competitive. And like Courtney said, they're going to try to one-up themselves to produce a great number for the practice.” (16:08—16:19) -Heather

“What gets measured get improved. But what gets measured and reported on exponentially improves. And I'd one-up it to say what gets measured gets monitored. What gets monitored gets attention. What gets attention gets action. And what gets action gets results. There are a couple of different layers that go into that. So, you have to report on that. So, yes, they produce results because, again, reiterating what we've already said, as long as we’re reporting on it, you have the right person reporting on that number, they care, so they're competitive, and they're going to one-up themselves. Of course that number is going to get you the results that you want.” (18:33—19:08) -Heather

“There's a difference between just putting the number down and glossing over it, and recording your number and talking about it, truly reporting on it, measuring, understanding what you're measuring, and then taking action on it. So, yes, numbers do produce results. And I love how Heather said there are a few extra steps in between there that are so equally important.” (19:15—19:39) -Courtney

“When you're talking about these numbers, you're having that collective discussion around countermeasures. So, maybe we didn't hit the goal. What can we do? What are some ways that each of us can contribute towards next week towards greening the red? It’s not just a hygienist problem if they don't hit their goal. It’s also scheduling. It’s also the doctor talking about treatment. It’s also language skills. It’s so much everyone in the practice that every issue bears everyone talking about it. It has to come from the entire team because it’s their collective thoughts that get the wheels in motion towards the solution, and not just one person saying, ‘This is what we should do.’” (21:23—22:11) -Courtney

“Back to the word, accountable, we’re holding each other accountable to these numbers too. It allows for us to say, ‘What can I do to help you?’ when it’s somebody’s number. And we may be unsure of how to get that number where it needs to be. But the other individual team member does know. They just need help from the team. So, it gives the space for us to ask for help and to ask if somebody needs help with something as well. So, I do think that it fosters that teamwork aspect hugely.” (22:18—22:48) -Heather

“When you're in the red, your problem is right there. So, the “identify” is really easy. It makes it so much easier to talk about it when you know, ‘What is the problem?’ ‘Well, we’re not hitting this goal.’ Well, stop and, to Heather’s point, IDS (identify, discuss, solve) it. Let's talk about why. And again, get the collective effort of your team to pour in their thoughts and opinions and facts and come up with a solution. So, you're absolutely going to solve problems faster because the problems are right in front of you. If you're tracking them every week, you know what the goal is. You know what's above. You know what's below. If it’s below, let's talk about it. That’s the true problem that you want to attack that week. And with the attention of the team, you can do it really quickly. And if they're the right people, you're going to get there extra, extra speedy.” (25:48—26:43) -Courtney

“We need to start with the why. Why are we going to track numbers? If the team and the doctor understands and knows the why, then the how gets so much easier. And there won't be as many questions that come up with that. So, I would say understand the why in the beginning. Before you bring it to your team, you have to have a why statement prepared.” (27:32—27:57) -Heather

“The team will not care if they don't understand the why behind it. And if you give them a couple, at first — don't hit them with 87. Just give them a few. They know the why, but they have to believe in the why. And then, you can expand. And then, you can give a little bit more. And then, just like Heather said in the beginning, now, it’s really taken off. And now, we’re achieving our goals, and we’re setting new ones, and we’re achieving those too.” (28:02—28:32) -Courtney

“It’s okay to admit to your team, ‘This is new to me too. I've never done this before. It’s going to be hard. It’s time to get a little bit uncomfortable.’ And that's okay. It’s okay to say, as a leader, ‘I'm new to this too. Let's grow into this together.’” (29:49—30:03) -Heather

“Just do it. If you want to be in a better spot, whatever “better” looks like to you, you have to start somewhere. Just jump in. This can be a little intimidating, but it’s going to show you how to get to where you want to go. And you have to be ready to embrace it and be really excited when you finally have your team that's on board, tracking numbers, having conversations, and getting results. Just do it.” (30:08—30:38) -Courtney

Snippets:

0:00 Introduction.

1:36 Why dentists struggle with talking about numbers.

4:42 Advantage 1) Numbers eliminate the subjective.

7:37 Advantage 2) Numbers create accountability.

9:29 Advantage 3) Numbers attract accountable people.

11:45 Advantage 4) Numbers create clarity and commitment.

14:20 Advantage 5) Numbers create competition.

18:21 Advantage 6) Numbers produce results.

21:13 Advantage 7) Numbers create teamwork.

24:16 Advantage 8) Numbers help you solve problems faster.

26:56 Know your why and your core values.  

29:36 Last thoughts on the advantages of numbers.

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.

Courtney Dalton, BS, RDH Bio:

Courtney Dalton is a Lead Practice Coach who focuses on establishing a solid foundation in order for a practice to thrive. With over 15 years of experience in the dental industry, she is as passionate about patient care as she is about those who are providing it.

Courtney has an A.S. in Dental Hygiene from Manor College and a B.S. in Exercise Physiology from West Virginia University. Outside of coaching, she enjoys teaching group exercise classes and spending time with her husband, Dan, and children, Lola and Levi. 

Current Trends in PPOs You Need to Know

Episode #556 with Sandi Hudson

Insurance is all so confusing — and it’s not the dentist’s fault! To provide guidance and help you figure out the PPO landscape, Kirk Behrendt brings in Sandi Hudson, founder of Unlock the PPO, to demystify PPO trends and explain what you need to know about insurance participation. More practices than ever are dropping their plans. Maybe it’s time for you! To do it with the help of an expert, listen to Episode 556 of The Best Practices Show!

Episode Resources:

• Unlock the PPO: https://unlocktheppo.com
• Unlock the PPO Facebook: https://www.facebook.com/UnlockThePPO
• Unlock the PPO social media: @unlocktheppo
• 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:

Always do your homework. Don't start randomly dropping insurances.

Understand direct contract versus shared network agreements.

Know the difference between an opt-out and a termination.

Make a habit of auditing your EOBs regularly.

Don't try to figure this out on your own!

Quotes:

“Whatever you signed ten years ago is no longer what you're getting. It’s a completely different thing that you're getting with all of your participation than what you originally agreed to. So, you need to be the one to take control of that instead of letting the insurance companies make those decisions for you.” (5:00—5:19)

“Until recently, I'd say the last couple years, most offices complained about their PPO fees, but they didn't necessarily make drastic changes with them. Even if it was a crappy fee schedule, it seemed hard for them to completely let go of them, a lot of times. And now, I'm seeing far more offices dropping plans. My partner, Lisa, on the startup side, is seeing startups become a lot more selective about what they take to start with. So, it used to be that even if you didn't take very many PPOs, you always took Delta. That was kind of the given. Lots of her startups are not even taking Delta now to open a brand-new practice. So, we’re starting to see new practices be more selective.” (5:47—6:33)

“After COVID-19, we saw things start rebounding in terms of your patients coming back, offices getting busier. But now, all of a sudden, they're dealing with higher supplies. Everything has gone up in price. Even more so, the staffing issue right now is huge. If you can find staff at all, if you have good staff, you're having to pay more to keep them. If you're trying to find new staff, that's impossible in a lot of areas, particularly with hygienists. We had so many hygienists exit the industry with COVID-19 and choose not to come back at all. There's a real shortage, so it can be months, sometimes, to find a hygienist to work. So, you've got that whole side. Expenses are going up. And then, now, on the flip side, you've got PPO fees that are staying very stagnant. So, most of the doctors I talk with are really in a place where they're like, ‘Now is the time. If I'm going to be changing my insurance contracting, whether I like it or not, there's not a choice anymore. I'm not able to pay more to a hygienist than I'm getting from the insurance company for a prophy.” (6:44—7:56)

“A lot of dentists are telling me they're supplementing. They're lowering their income in order to offset higher staff expenses that they need to pay for just to keep things going. So, that's a tough deal. At some point, something’s got to give with that. And so, I'm seeing a lot more offices saying, at least these bottom ones, ‘We’ve got to start somewhere. Let's start looking at these bottom payers, and let's figure out how we can get a game plan and at least start chipping away little by little.’ If you're not going to do anything drastic, which is often not the best case, going from a heavy PPO practice to a fee-for-service practice overnight is not necessarily the recommended action for most offices. But how can we at least look to see what's working, what's not, and get some kind of game plan to get some action?” (7:57—8:48)

“The difference between a direct contract and a shared network agreement . . . a direct contract means you sign directly with the insurance company. So, if you sign directly with Aetna or MetLife or Guardian, or whoever it is, the upside to that is that it’s going to be an easier way to participate. You sign directly with the insurance company. You know what you're getting. It will put you in-network faster than if you go through a shared network agreement.” (14:07—14:35)

“There are some definite advantages to direct contracts. All things being equal, I prefer direct contracts. If we can get a good direct contract, that's always our goal. But where the big dilemma has come in is all of these insurance companies now have made multiple shared network agreements with other companies. So, really, Delta is the only one left that has no shared network agreements with anybody. If you want to be in-network with Delta, you've got one choice. You sign directly with Delta, or you stay out-of-network. There are no other avenues to participate with Delta. Pretty much everybody else has at least some of their networks that can come in through shared network agreements with other companies.” (14:36—15:18)

“A shared network agreement is essentially that you're in-network with that insurance company, but you're using somebody else’s fee schedule. So, as these insurance companies have continued to make more and more of these agreements — I mean, there are a lot of them now that could have eight or ten different shared network agreements. So, one thing you have to be really careful about is understanding, of your contracts, who has shared network agreements with who. Otherwise, here’s what happens. I talked to somebody this week who said, ‘Yup, I already bit the bullet. I already sent in my termination for company A.’ I said, ‘Well, that's great. But the problem is, as soon as you get out of that contract with company A, company A has seven other shared network agreements with companies that you're in-network with. So, as soon as you drop that, you're going to get picked back up again by somebody else. You're going to be back in-network, and you're going to get paid on somebody else’s fee schedule.’” (15:19—16:14)

“We can all guess how this works. If you drop a direct contract, because in most cases, not all, a direct contract is going to override everybody else. So, as long as you have that direct contract in place, they take priority. But as soon as you get out of that direct contract, that's when the insurance company can attach to any other shared network agreement that you have in place. Now, the way this should've worked is it should've all been set up so that if there's a shared network agreement, they have to ask your permission to be added. Well, we can all laugh about that now because we know that's not the way it works. You can opt out of most of those agreements, but the burden is on you to opt out. You automatically get opted in, and you have to be the one to figure out how to opt out of those agreements.” (16:20—17:08)

“If you have a direct contract and you terminate it, you want that company to be picked back up again by the highest paying option. Or maybe you want to stay completely out-of-network. Well, the insurance company has no interest at all in paying you the highest option. If there are five contract options that they have to choose from, why do they want to attach to the highest option? They're going to want to attach to the lowest option.” (17:11—17:35)

“If you start randomly dropping things thinking, ‘It’s finally time to get out of some of these bottom ones,’ where you can have a really unpleasant surprise is, all of a sudden, you're back in-network, and now you're getting paid worse than you were originally because there's a lower paying shared network agreement that attached back on for you. So, if you're not careful, you can actually go the wrong direction with some of this. That's why, before you actually make any changes, you want to go, ‘If I get out of this, what, of my other contracts, could pick that company back up again? And do I want them to pick up, or not?’ And if not, then opt out of those agreements. Most of them, you can.” (17:36—18:17)

“When we say opt out, just to clarify, an opt-out is different than a termination. A termination means you're terminating the whole contract. An opt-out means you're keeping that contract in place, but you're saying, like if you opt out of Aetna’s agreement with Ameritas, what you're saying is, ‘Hey, Aetna. I want to keep my contract in place with you. I still want to be a contracted provider with Aetna, but I don't want you to allow Ameritas to attach to your fees.’ So, those are two different pieces of this whole puzzle.” (18:18—18:50)

“You want to step back, map out everything ahead of time, and decide where you want to move things. Get all that paperwork in place proactively before you start randomly dropping things. Otherwise, it’s six months down the road, and you're like, ‘I dropped all this stuff and I'm not making any more money. What happened?’ We don't want that happening either.” (18:51—19:12)

“Every six months or so, pull a handful of EOBs and look to see, ‘Am I getting paid the way I'm supposed to be getting paid?’ Because what will happen is, a lot of times when these shared agreements are created, either you don't get a notice, or you got a notice, but nobody caught it. Nobody realizes, ‘Does it mean anything to us?’ And so, pretty soon, they start automatically downgrading, and you don't even know that it’s happening. So, you definitely want to be spot-checking EOBs on occasion and going, ‘Is this actually paying me the way I thought I was supposed to be paid, or has something happened here that we weren't aware of? How do we jump in and rectify that?’” (19:52—20:35)

“In the market right now, if an insurance company negotiates, you're probably looking at 3% to 5%. This is not going to be something that overwhelms you with crazy high increases. There are a couple of companies that have done pretty major decreases across the country in the past couple of years. So, keep an eye on that . . . You've really got to keep requesting every two or three years. They're not going to do a request or look at it more than once every two years, sometimes once every three years now. So, honestly, don't waste your time every year going back. But if it’s been two or three years, go back and ask. All they can say is no, so it’s certainly not going to hurt you to ask.” (21:48—22:41)

“We used to work with some amazing reps with the insurance companies. And we still do work with some amazing reps. But their ability to have the same kind of discretion to make big increases is not as much there as it used to be. This is kind of a different game now. It used to be if you had a really low fee schedule for your area, then the insurance company reps would go, ‘Yeah, this is pretty low. Let's get you up into a more reasonable range.’ And we would see some that would be bigger increases. There's not as much of that now. So, if they do anything, you're going to see a little bit more of almost a cost-of-living kind of range. You're not going to be looking at huge increases in a lot of areas.” (22:47—23:32)

“There's always a case to be made, if you are in an underserved area where they need providers — a lot of this is timing. Sometimes, an insurance company last year did not negotiate. This year, they are. So, it’s still good to continue to keep that in a rotation with your practice where every couple years you're checking back, because you just don't know. In your area, things can change. There's not necessarily a lot that you're going to be able to do to make that increase bigger outside of, how badly do they need you? That's the big thing.” (23:34—24:09)

“I remember having three little kids and being a couple years into a new practice. I remember a lot of sleepless nights, laying there, thinking, ‘Okay. We’ve got the supply bill due in three days. We’ve got payroll in five days.’ That's a real thing. With the cost of dental school now compared to where it used to be, dental practice owners have to be more business-oriented than they did 20 or 30 years ago. There's a lot more at play here. So, then you get that end trend where you go, ‘I don't have to worry about that as much, and I have the ability to get out of some things that maybe I wouldn't have done five years ago.’ So, the trends I see tend to be more geared toward where that dentist is at in their life as opposed to their practice.” (26:05—26:59)

“I do think COVID-19 was a gamechanger for dentists in some other ways where — I mean, nobody liked the whole, let's be forced to shut down our offices outside of our control. Nobody likes feeling out of control. But there are a lot of dentists who came out of that and said, ‘I was able to reprioritize a few things in my personal life — by force, maybe, but I still did it. And now, I want my practice to look a little bit different.’ And so, I'm definitely seeing more dentists say, ‘My end plan that I thought was going to happen when I was 55, now I'm 48, and I'm doing it now instead.’” (27:03—27:43)

“If you've got a new patient calling and you can't get them in, then that's a problem. And if you're saying, ‘Well, we can get you in, but my next opening is July 17th,’ well, that doesn't do you any good. Because when you think about it, you've only got eight hours a day, or however many hours a day you see patients, to see patients. If you're booking out six months instead of two weeks, what is that gaining you? You can only see one patient at a time. So, continuing to book farther and farther and farther out, that doesn't get you anything other than

Surgically Facilitated Orthodontic Therapy (SFOT)

Episode #555 with Dr. Drew McDonald

With new technology and advanced procedures, you can give patients better results faster than ever. Dentistry is evolving, and to highlight the importance of 3D imaging and surgically facilitated orthodontic therapy, Kirk Behrendt brings back Dr. Drew McDonald with his best practices for maximizing case outcomes and preventing the results that you and your patients don't want to see. Stop hiding in the past with 2D! To learn how 3D and SFOT will increase your patients’ quality of life, listen to Episode 555 of The Best Practices Show!

Episode Resources:

• Dr. McDonald’s website: https://www.mcdonaldortho.com
• Dr. McDonald’s Facebook: https://www.facebook.com/drew.mcdonald.984
• Dr. McDonald’s social media: @drdrewmcdonald
• Email Kirk for Dr. McDonald’s Master Classes: [email protected] 
• 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:

CBS News story about AGGA: https://www.cbsnews.com/news/agga-dental-device-lawsuits-teeth-damage

Surgically Facilitated Orthodontic Therapy (available April 2023) by Dr. George Mandelaris and Dr. Brian S. Vence: https://link.springer.com/book/9783030900984

SureSmile: https://www.suresmile.com/en-us

Chicago Study Club: https://chicagostudyclub.com

Stay tuned for Dr. McDonald and Dr. Courtney Lavigne’s courses, fall of 2023!

Main Takeaways:

Learn from the mistakes of AGGA.

Embrace 3D. 2D imaging is no longer enough.

Never expand without proper teeth and bone assessments.

Slow down. You can't analyze everything in a limited amount of time.

Thoroughly understand what you're working with before starting treatment.

Quotes:

“There's a lot of controversy going on right now, especially because of the CBS News story that came out about the AGGA appliance, which is an Anterior Growth Guidance Appliance. It’s an orthodontic appliance that's trying to move teeth. But what was happening to these cases that are being shown on TV is that the patients’ bone levels, in terms of their alveolar bone, was very likely not assessed before that patient got into treatment. And so, what happens is, you can only move teeth so far because there's an envelope around bone, around the roots, that keeps the teeth stable. If you push those teeth beyond what the capacity of that bone has to handle that, then you can push teeth right out of bone. You can expose roots. You can cause teeth to die. You can cause severe recession. And I can't tell you how many times I see adult patients in my office that have been through some sort of orthodontic treatment in their life, and a lot of times, they have significant bone issues where you're trying to move teeth and that bone is thinner. And you're at a high risk getting into this orthodontic case if you try and move those teeth in that thinner bone.” (5:33—6:42)

“What surgically facilitated orthodontics is is that we can utilize our periodontist colleagues a lot in these situations. And if we’re able to diagnose that patient’s bone conditions — or their alveolar phenotype is the fancy word for that — before we start our orthodontic treatment, a lot of times, these patients, we can work together with our periodontists to do bone grafting or soft tissue grafting along with the orthodontic tooth movement. And what ends up happening is a much more stable result. We’re preventing things like recession from happening along the way.” (6:44—7:17)

“One of the other big benefits [of surgically facilitated orthodontics] is that teeth move about 50% of the pace faster than they would without utilizing the surgical techniques. And so, a lot of times, patients, especially adult patients who really don't want to be in treatment very long, this becomes a bonus for them because they get in and out of treatment faster. And they're happy because they're not having unforeseen recession. They're not having trouble with their teeth. They’re not having loose teeth that are about to fall out at the end of treatment. But it really all comes back to, we need to be diagnosing at a higher level before we get into these orthodontic cases. And that involves, as a minimum standard of care in orthodontics, utilizing a CBCT. And that is 100% where the profession needs to go.” (7:18—8:07)

“Whenever you start diagnosing cases of ortho, there are really four regions that are very important that you need to look at, one of which is the upper anterior bone around the front teeth. Why would that be important? Well, if you're going to move those teeth and flare them, or retract them, or whatever tooth movement that you're going to do, it’s a good idea to know if there's adequate bone to handle that type of move. On the other side, in the lower anterior, that is the highest frequency area to have thin bone. And we know from certain types of growth patterns, especially people with jaw joint issues that have thinner bone in the lower anterior, a lot of times, or open bite cases. And so, if you're trying to correct that bite issue and we don't have great bone, we’re asking for trouble. And so, again, those are two of the most important areas.” (9:44—10:35)

“The other areas that are very important are in the back, our posterior teeth. Especially in today’s world where we’re doing a lot of expansion and trying to help expand the maxilla for breathing issues and all of that, if we’re doing an expander that bases off of the teeth and has the potential to tip those teeth or push those teeth out, then we need to know, does that bone in that area have enough thickness to handle that movement as well? And also, if we’re going to expand the maxilla, the mandible has to go with it, and we have to upright those lower teeth. If we don't have great bone around those lower back teeth to upright into, we’re going to see a ton of recession. And very likely, we’re going to see an unstable result.” (10:36—11:21)

“Traditionally, in ortho, we've thought of utilizing periodontists and all these surgically facilitated techniques as maybe a little bit of overkill because, ‘Oh my gosh. We’re asking a patient to go do this surgery along with orthodontics. And if all we were telling them was that it might speed up your treatment,’ which, we’ve known that for a long time. That's been since the ‘80s with the Wilcko brothers. Dr. Frost had also pioneered that. In general, that was our only excuse to get someone to go to a periodontist back in the day. And so, a lot of patients would go, ‘Eh, I don't really care that much about that.’ And what would end up happening is that we'd see recession when we thought we weren't going to. So, again, this is where the 3D world and CBCTs have changed how we execute plans, is it allows us to see the enemy before we get in on the treatment plan. If we see that bone has areas of concern, then we should get them to our periodontist before treatment so that they understand, ‘If I do this procedure, I'm going to have less likelihood of having recession and problems later.’ And so, that's really where the 3D world is changing the way that we interdisciplinarily work together, if that's a word. Essentially, it opens up our world.” (11:47—13:03)

“If our patients see they’ve got that thinner bone, a lot of times, they ask me, ‘Okay. What do I do? I don't want that recession. I don't want problems with my teeth. I can see how thin that bone is.’ And that's where, again, it opens up the conversation that you need more involved treatment. And patients say yes to that more involved treatment.” (13:04—13:21)

“A lot of the older — in any profession, not just ortho — they say, ‘Hey, we've always done it with this set of imaging. Why do we have to move into this?’ And oh, by the way, there's so much fear about a 3D image possibly adding more radiation to the patient . . . And they base a lot of decisions on old material. And what I mean by that is that today’s 3D X-ray machines, cone beam CTs, when we do a light scan on an orthodontic patient, we’re doing less radiation in one 3D image than we are from a panoramic X-ray and a ceph X-ray, which are two-dimensional images. And so, if you're going to sit there and say 3D is overkill because of radiation purposes, I think that that argument is by the wayside, at this point. Again, that's based off of old CT images, which are heavy radiation. Cone beam CT is much different. And so, we have to start changing that narrative that we’re over-irradiating our patients when we have these newer tools to be able to have a much better radiation level for them than what our old images used to provide.” (14:02—15:18)

“The way we’ve always done it needs change.” (15:36—15:38)

“You can't see joints or airway issues on patients without 3D, in a lot of these cases. And I should clarify that airway issues, especially pharyngeal airway issues, they're visualized. They're not diagnosed on an X-ray. The X-ray is a helpful tool. However, what orthodontics really needs to be is so much more than teeth. Because what puts a patient in our chair and creates malocclusions are airway issues, tongue issues, TMJ issues. And to execute how we correct those, we have to see all of these things. Otherwise, if we overlook them diagnostically, they're going to come back to haunt us. And what's dead will never die. We are going to be chasing and chasing a malocclusion because we didn't get to the root of the problem. We can only see that with imaging. And 2D imaging is not enough anymore.” (15:48—16:43)

“When we come out of ortho school, we know that there are certain things that we don't want to stress with tooth movement. One of those is if we have thin tissue. That was always the traditional thought is, ‘Oh, look at the gum tissue,’ because we could see it at the surface. It’s right there in front of us. And so, a lot of times, there are adult patients, and it’s been well-established that a patient needs to be periodontally stable before going into orthodontics. I don't know that everybody who starts orthodontic cases observes that, sometimes, because I've seen a lot of problems after ortho that come up.” (17:22—18:00)

“In general, I think every orthodontist and every periodontist out there understand, in common, that there's a risk for periodontal issues when you get into ortho. But we’ve always looked at it as, ‘Is there already recession, or is the gum tissue thin?’ What we need to wrap our heads around is, where is the bone? So, back to playing together, this is where the imaging facilitates conversation. Basically, in my world, we do our diagnostics with our CBCT, MRI, whatever else we do. But with that, I put together a whole presentation that shows those levels of bone to the patient. And then, with my referral to the periodontist, it has those same pictures of...

How to Make Airway Dentistry Profitable

Episode #554 with Dr. Tracey Nguyễn

Airway is profitable. So, why aren't more dentists adding it to their practice? To reveal the common reasons why dentists don't succeed and what you can do differently, Kirk Behrendt brings back Dr. Tracey Nguyễn, co-founder of ASAP Pathway, with advice for overcoming the challenges in this space. Adding airway will help your practice grow — as long as you do it right! To learn how to make airway profitable in your dental practice, listen to Episode 554 of The Best Practices Show!

Episode Resources:

• Dr. Nguyễn’s Facebook: https://www.facebook.com/tracey.nguyen.9085  
• Dr. Nguyễn’s social media: @drtraceynguyen
• ASAP Pathway: https://www.asappathway.com/pediatric-airway-training-events
• 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 overcomplicate airway dentistry.

You need your team’s support to do airway.

If you can't find your dream team, create it yourself.

Giving patients “homework” will undermine your expertise.

Expect the worst but know that things will eventually work out.

Quotes:

“I think the big thing that people don't get is that airway dentistry is not — you don't take a course, and you're going to come out making a lot of money from that one course. It’s not like implant dentistry or a composite course where you're learning an actual skill, and then you're going to practice it Monday morning. Airway dentistry is more of, think about it like an occlusion course, or more of like a philosophy course. And just like occlusion, there are several different camps. You have to decide what you jive with more, what fits your philosophy. So, I always tell people that comprehensive dentistry is airway dentistry. It’s not different.” (5:10—5:52)

“People try to overcomplicate airway dentistry. You're still doing dentistry. If someone has an airway problem, and they don't believe you, and there's all this dentistry to be done, don't spend two hours convincing them they have an airway problem. Just do the dentistry. I think that's the big thing that a lot of dentists forget. We forget to be dentists first. The whole thing with airway dentistry is, understand that there's an airway component, and understand that your dentistry could potentially make it worse. So, don't make it worse. It seems so simple. We definitely overcomplicate what airway dentistry is.” (5:54—6:37)

“One of the things I mentioned in my How to Make Airway Profitable is you're not going to do it without your team’s blessing. We all know this. We go to a course, we come back, and they think that, ‘Okay, they took a weekend course. My dentist is going to be gung-ho for two weeks, and then it’s going to trickle away.’ The thing with airway dentistry, it’s such an emotional impact for you, your significant other, your children, that your team needs to see that. And most likely, someone in your team is suffering from it, or someone in your team knows someone that's suffering from it. So, once the team has a “why” for themselves, then they can support your why.” (6:49—7:30)

“I remember being with Rick Roblee at a meeting, and he said, ‘If you can't find your team, make it yourself. If you can't find these people, then you develop your team.’ So, basically, as a restorative doctor, I'm one of those doctors that I don't spread the wealth. I have a very strong referral network. That specialist basically gets all of my patients. I have two periodontists and two oral surgeons. And those people, we have a really great connection with. So, my referrals, common sense, you don't bite off the hand that feeds you. Right? And so, those are the ones that are going to listen to you more and respect you a little bit more. The ones that aren't buying in, don't waste your time. They’ll come when they're ready. I think that's the thing that we struggle with. Like, we want certain people on our team. But if they're not ready, they're not ready. So, then you find someone else that's willing to listen, and then you grow them. You grow together as a team. That's how I pretty much developed my network.” (7:52—9:01)

“I have a love-hate with social media. But social media has pretty much built my entire platform. When I think about when I was discovering myself and discovering my why, I was like, ‘Wow, there's not that much information about this.’ And so, I decided to, ‘Well, I'm going to put it out there.’ I made all my social media pages public. I started blogging about literature reviews. I would basically post a literature blog, post a case blog on social media, and I started to get known. People were messaging me, ‘Hey, I just read this.’ And then, they started connecting with me as the airway specialist or airway dentist. And then, just being real on social media, most of my patients do find me from that. I get a lot of referrals, actually, from other dentists and other medical colleagues. I get referrals from other medical colleagues because I developed my own group, locally. And like I said, you grow it yourself.” (9:45—10:52)

“I'm still learning how to structure it. Because while I am a heavy restorative practice, the new patient worth for a restorative practice is, you get this patient as a new patient, and you get X amount every year. That's the cost of this new patient because you're going to see them every year. As a specialist, you’ve got one treatment, and then they go back. So, I'm still learning that. With my team, it’s like, ‘All right, guys. I need more new patients than a GP because I've got one shot with one treatment.’ It’s a learning curve. I'm learning things differently and how to communicate with patients.” (11:43—12:22)

“What I will tell anybody, if they're doing airway, is do not give your patients homework. This is what I did, and I realized, ‘Why am I doing that? I'm supposed to be the expert in this.’ So, do not have all these books in your waiting area and say, ‘You should read this book.’ Do not give your patients books. Do not give your patients things to read because you're supposed to be the expert. You look in their mouth. You're supposed to know what's going on, or suspect what's going on, and direct them to the right care.” (12:37—13:14)

“As a restorative doctor, we ultimately decide the restorative material we want to use. But we don't go, ‘I just came from an Ivoclar lecture, and I'm going to use this type of composite. I'm going to give you the MSDS on these three types of composites. Can you go home and research which one you want me to use Monday morning?’ It makes no sense. Right? But we do that with airway. We’re like, ‘You know what? We think you have a breathing problem. We think you have this. Here are some articles that you can read, and here are some literature reviews that you can read.’ No! Patients don't want that. And so, my number-one thing is, do not give the patient homework. You have to be very confident in what you are seeing and how you think that this patient should be treated.” (13:18—14:11)

“If you're going to make recommendations in treatment, know what you're recommending. If you are giving people homework, then you don't know what you're recommending. That makes you look like less of an authority, and there's going to be lack of confidence from a patient standpoint.” (15:35—15:53)

“I do like social media. I think that you have to decide who is going to do that social media for you. I definitely think that you want to be careful about oversharing. But I think that patients do look for social media for content. That's pretty much how I got started with it, finding me. They search for you based on that.” (16:05—16:32)

“I do [social media] myself, and it’s very exhausting. But I think when you do it yourself, it’s very real and it’s very organic, and patients connect with that. Patients know when it’s not you.” (16:44—16:57)

“I think social media can be good and bad. Bad, in the sense that it can really mess with your psyche with the whole likes, ‘Do they like me?’ The more popular you get, you're also going to get people that don't like you. Every once in a while, I'll come across a negative review or a negative post, and it hits you to the core. So, you have to remember that when you put yourself out there, you're going to take the good and the bad.” (17:34—18:07)

“I got accredited in 2015, and that was my first drop. It probably took me about two to three years to get back up again. So, I will say, with anyone that’s debating on dropping insurances, just expect the worst. But it’s going to be fine. Tough it out. Figure out your why and make sure the entire office understands your why, because that's going to keep you going.” (19:26—20:03)

“The office that I worked with when I came out [of school], what I loved about them is, there were three doctors in there, and one of them was a prosthodontist. So, while I was getting paid pennies, I learned a lot as a dentist. And I think that's very valuable, that growth and having that mentorship, someone teaching me a little bit about the business, and then discovering what kind of dentist you want to be. Because I don't think you really know until you start diving into it and you're like, ‘Okay, I don't know if I like this. I like this.’ And then, you figure it out.” (25:44—26:13)

“From an airway dentistry component, you're doing more dentistry. So, it’s not really an increase of fee, you're just doing more dentistry. You're looking at these arches. You're rounding out the arches. You're doing more bonding. You're doing comprehensive dentistry to try to not make the airway worse. So, that, as a whole, you're doing more dentistry.” (26:49—27:12)

“There are other procedures that you can add in your wheelhouse. One of the things is orthodontics, Invisalign. Most people are already doing Invisalign. Well, now, you're setting it up for restorative. Now, you're setting it up to make the airway better. You're increasing the oral volume space for the tongue. I'm doing Invisalign on younger kids, so we're catching them a lot younger. So, that's an extra tool that I'm doing. Laser therapy treatments. I was already doing lasers, crown lengthening in soft tissue, hard tissue. Now, I'm looking at frenectomies, tongue-ties. I'm looking at the soft palate like NightLase. So, there are definitely extra procedures that you can do that pertain to airway to add into your wheelhouse.” (27:14—28:03)

“You're going away from single-tooth dentistry and being overall comprehensive care. I think that's the goal with occlusion courses, and that's the goal with airway. It’s comprehensive care. Get away from single-tooth dentistry. Even get away from quadrant dentistry.” (28:46—29:01)

“When we take any of these large comprehensive classes at Kois or Spear, we’re trying to take a step back from single-tooth dentistry and then go into comprehensive care, because that's where the money is. It’s how much you treatment plan. And you're not doing it, obviously, for the money, but you're being more comprehensive in your care.” (29:26—29:46)

“Like any occlusion course, the profitability comes. It’s more about the dentistry that you start treatment planning. So, don't think of it as, ‘I just took an implant course. I'm going to place five implants.’ It’s not an immediate relief like that. It’s basically changing your mindset. Think of it as an occlusion course. As you start to see more of it, as you start treatment planning these cases, the profit comes. The key is knowing how to treatment plan these cases.” (32:20—32:54)

“We have to make dentistry practical because that's the only way we’re going to do it. We’re overcomplicating everything. Just make it practical and make it fun.” (34:25—34:37)

Snippets:

0:00 Introduction.

2:06 Dr. Nguyễn’s background.

4:39 Don't overcomplicate airway dentistry.

6:39 You can't do it without your team.

7:33 Build your core team and network.

9:17 Building your network with social media.

12:23 Don't give your patients homework.

15:56 Do your own social media and don't overshare.

19:09 How long will it take to start making a profit?

22:13 Dr. Nguyễn’s insurance journey.

25:13 Figure out who you are.

26:14 Airway means doing more dentistry.

28:04 Go back to the principles.

29:48 The future for Dr. Nguyễn.

32:06 Last thoughts on profitability in airway.

33:22 More about Dr. Nguyễn’s courses and how to get in touch.

Dr. Tracey Nguyễn, DDS, FAGD, AAACD Bio:

Dr. Tracey Nguyễn, a.k.a., “Dr. Tracey,” received her DDS, Magna Cum Laude at the Virginia Commonwealth University, Medical College of Virginia. She pledges to treat each patient with the highest standard of oral health care.

Dr. Nguyễn is very involved in the local, state, and regional organizations, i.e., Loudoun County Dental Study Group, Northern Virginia Dental Association, Virginia Dental Association, and the American Dental Association. She is a member of the American Academy of Laser Dentistry, the World Clinical Laser Institute, and the International Congress of Implantologists (ICOI). She understands the importance of lasers in dentistry and was one of the first doctors that introduced the hard tissue laser dentistry in Loudoun County. She is also a Fellow of the American Academy of General Dentistry. She thus understands that providing great smiles and excellent oral health are the result of going above and beyond basic requirements.

Dr. Nguyễn serves as an editor for the AGD peer-reviewed research manuscripts. She also has continued to advance her dental and clinical...

How to Motivate My Team to Use Technology

Episode #553 with Dr. Kelly Tanner

Your team is averse to technology. They're intimidated, overwhelmed, and not motivated to learn. But is that actually true? Technology might be what your practice needs, and today’s guest explains why. Kirk Behrendt brings back Dr. Kelly Tanner from Next Level Dental Hygiene to reveal how your team may be craving new technology and how you can help them learn. For the naysayers in your practice, she also shares advice for encouraging and motivating them to learn. To hear more about technology and getting your team to use it, listen to Episode 553 of the Best Practices Show!

Episode Resources:

• Dr. Tanner’s website: https://drkellytanner.com  
• Dr. Tanner’s Facebook: https://www.facebook.com/kelly.g.tanner
• Next Level Dental Hygiene: https://www.nextleveldentalhygiene.com
• Next Level Dental Hygiene Facebook: https://www.facebook.com/Nextleveldh
• Next Level Dental Hygiene social media: @nextleveldh 
• 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:

The Dental Handoff podcast on Spotify: https://open.spotify.com/show/3afYSFs5POJlcMmS0zsjh0

The Dental Handoff podcast on YouTube: https://www.youtube.com/@thedentalhandoff

Books by John Maxwell: https://store.maxwellleadership.com/All-Books_c_237.html

Books by Jim Collins: https://www.harpercollins.com/collections/books-by-jim-collins

Main Takeaways:

Your team might actually want to learn how to use new technology.

Help team members understand how technology will help patients.

Give team members reasonable expectations for learning.

Train your team and provide real-time feedback.

Technology can bring your team together.

Ask your team how you can help them.

Quotes:

“Technology is 3D scanning devices, it’s CBCT, it’s digital cameras, it’s lasers, it’s digital censors. It’s anything new. Sometimes, for some offices, it’s technology for AI. It’s reading the radiographs, sending them over the interwebs into the global outer space system where there's a space modulator . . . and sending it out somewhere to have it read, to have your team be supported by these technologies so they can best serve the patient. And so, that's what I mean by technology.” (4:32—5:15)

“You have to help that team member go back to their original answer about why they're there to begin with and why they're showing up every day. I would bet you, because most people answer yes to this, that it’s about serving people. So, can we, with this technology — with this procedure protocol, whatever, fill in the blanks, CBCT, 3D scanner — serve the patient at a different level to help them understand and to help them get the best health outcome from this? If you can relate that and translate that back to that dental professional, that dental team member, they're more likely to be able to figure out how to put it in their workflow.” (11:22—11:58)

“Docs will go out to a convention, and they come back with the shiny thing. They roll it back in, and it’s like, ‘Oh, this is the best thing that I've ever purchased! Okay, let's use it on Monday.’ Everybody is going, ‘What is this about? What do we even do with this?’ So, one, you've got to train your team. Some of the best companies I've worked for and worked with have the best trainers and support around that tech. And then, also, where do those procedure’s protocols fit in around that individual schedule? So, for instance, I love, love, love teaching offices about how to integrate 3D scanning in their hygiene operatory. So, agnostic to any type of scanner, just using it, putting it in play to educate. It is not about selling, because educating is serving. So, when you make time, one three-minute scan that you can do compresses that visit down. You gain back 10 minutes of time.” (12:26—13:25)

“A picture can be worth a thousand words. What is a scan, or an X-ray, or something else that you're showing them visually that is worth even more than a thousand words? Because it’s about a visual, an emotional experience for the patient. That's how we all make decisions. So, if we can integrate something, a CBCT scanner, a 3D scan, show them what it is, they can see what you see, they go, ‘Whoa. I didn't know that that was there. I now want to take action on that.’ Don't you think, dental professional, that saved you time? Because now, you don't have to try to explain it, from this very complex thing that they can now see for themselves.” (13:26—14:09)

“It’s practice, just like anything else. Holding a high speed, doing a certain procedure, it took you a little while to get there. We all have to remember that the first time that we held a mirror, it took a minute to not feel like we were going to drop it down someone’s throat. So, it’s going to take that muscle memory, that repetition, that repetitive nature of putting it into your workflow, having the doctor and team be also giving you some grace to do that. I'm not saying give you 10 extra minutes. That's not what I mean. But be intentional about practicing that. So, with the scan, scan yourself. Sit down with teammates. If you're waiting on a patient, or a patient cancels, or during lunch time, or whatever, sit someone down in the chair. Practice on them. Get better. Get that feedback from team members.” (15:00—15:48)

“I always start with, ‘How can I support you?’ The best words, ever. ‘How can I support you with this?’ Listen for more than five seconds, pause, and let them fill in the air space. Because they’ll tell you if you listen. And say, ‘How can I support you? Do you need more time?’ And don't give them the answer. ‘What are you having the most challenge with? What do you think would be most beneficial for you?’ And then, once they tell you if they need a little more time, or they need a little more coaching, bring that other trainer back in during a lunch-and-learn, whatever that looks like. Or people hire me to come in to consult and watch their workflow.” (17:51—18:33)

“My dentist has a new team. And the team member, this is her third scan for this intraoral scanning device. And so, I'm a trainer, just not paid by anyone. But because I'm a consultant, she’s like, ‘Okay. I know who you are, and I know you train. Give me any feedback.’ I'm like, ‘I want you to be confident. I want you to know that you have got this.’ She starts to do it, and she’s like, ‘Tell me if I can do anything.’ So, I reached up gently, and I held her arm, and I went, twist. She goes, ‘Oh.’ And I said, ‘Parallel.’ All it needs, sometimes, is one word for her to see that difference on the screen and how it’s turning up. And she goes, ‘Oh, I didn't know that!’ It just takes one flick of a wrist, and here it is. It’s filled in all the spots where it was missing before. I said, ‘You see, it’s like a camera. If you hold it too far away with this particular scanner, it’s trying to fill in the information from what it thinks it needs.’ And she’s like, ‘Oh. Just like a real camera.’ ‘Exactly. It’s going to be blurry, so it’s trying to make sense of it.’ ‘Oh.’ So, it’s that real-time feedback, just like coaching.” (18:49—19:54)

“[AI and radiographs are] so important because it’s the appointment where everyone is rushed, and the doctor is rushed. Sometimes, doctors and hygienists are rushed. We’re all thinking that we’re looking at the same X-ray. We’re looking for the same things, we think. But then, it’s just sitting there. This pathology is just sitting there because it’s not jumping off the screen at you. But then, these AI technologies are already prescreening this and somewhat giving you a second opinion — not taking you out of the equation but helping you. They're supporting you to say, ‘Hey, I'm over here. Look at this. Look at this,’ with a percentage of confidence that that may be what you're looking for or looking at. And then, you could say, ‘Nah, I don't agree with that,’ or, ‘Whoa, I almost missed that.’” (21:44—22:31)

“These AI systems, they're constantly taking in information, as we all know. The more information you feed it, the smarter it gets. And the more cases you put in, it’s going to give you more output based on different patients all over the world. And so, you're sitting there in the op, and all of a sudden, these boxes come up around the teeth or at the bone level saying, ‘Hey, there's bone loss here. There's loss of lamina dura. There's potential pathology here.’ And I'm going, ‘Whoa, I never would've otherwise seen that. I would've thought maybe it was something else.’ I think that it’s easy in any part of our lives, if we’re experiencing something, to try to explain it away of, ‘My stomach is upset. Oh, it’s probably that thing that I ate,’ or, ‘It’s probably this.’ ‘Well, how long has this been going on?’ ‘A week now.’ ‘No, it’s not that, then. It’s probably something else.’ But we can look at it and say, ‘No, that's probably just cervical burnout on the X-ray.’ ‘No, it’s caries because this also thinks that it’s caries. Should we look a little bit closer?’ It truly gives you that second opinion to be able to give you the best predictable outcome for that patient. And to catch things when they are small is always the goal, because dentistry only gets more expensive.” (22:32—23:47)

“Training by many companies and manufacturers, we need to take advantage of this. With doctors who have purchased technology, please take advantage of this training. It...

The 3 Reasons You Should Share Your Numbers With Your Team!

Episode #552 with Miranda Beeson

There is a cost to running a business, and your team should know those numbers. Once they understand it, they will become more committed, more accountable, and more trusting. To help you build that team, Kirk Behrendt brings back Miranda Beeson, one of ACT’s amazing coaches, to reveal the ten key numbers every dentist should be sharing. To learn how to create a smarter, healthier team for your practice, listen to Episode 552 of the Best Practices Show!

Episode Resources:

• Miranda’s email: [email protected] 
• Miranda’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 Capacity Tracker: https://drive.google.com/file/d/1MdN96fVhau8tcP10kW2_cU-Tv91K8r7l/view?_hsmi=241651107&_hsenc=p2ANqtz-98AjmJ7LkC2HvkK9uuY8l577tbOQ_8dHgEv1V_RVjByeE1xTLRFEYlHJVqxNmOsEBjwFPH-Cjr7iCbb4p-dJiLdKWb7A

Main Takeaways:

Numbers lead to accountability.

Sharing numbers will create more commitment.  

If you are transparent with your numbers, you will create trust.

Know the top ten numbers you should be sharing with your team.

Determine whether you're sharing too much or not sharing enough.

Quotes:

“Most of the time, the question stems around either, ‘Have I shared too much?’ or, ‘Am I not sharing enough?’ And the why behind it is really simple. It’s really three things. You want to create accountability. The numbers and sharing the numbers helps with commitment with your team. It also helps to build trust, to help you guys move forward. So, it’s really accountability, commitment, and trust. There's a whole lot more, but it really sums it up into those three reasons why sharing the numbers can be helpful.” (2:53—3:24)

“Accountable people appreciate numbers. I've always been someone who’s a very accountable team member. Nothing brought me more joy than knowing, where did you need me to go? Where’s the goal? What's the target? How can I get there? It’s the people who want to be held accountable, who want to grow within your practice, they're all-in, they love having numbers to help drive them there. It also holds the team accountable to applying countermeasures when needed.” (4:27—4:51)

“[A countermeasure is], what is something we need to do — start, stop, or pause? What is something we’re doing well that we need to keep doing? What is something that is obviously not working that’s resulting in this data point or this number that we need to stop doing, and maybe we need to think about starting something different instead?” (5:30—5:48)

“If we’re committing, as healthcare providers, that we’re going to be giving the best level of care that we possibly can, providing the best options, treating their health optimally, treating their disease optimally, the numbers are going to help us to know, are we giving the best care we can give to our patients?” (12:38—12:54)

“When I was an early hygienist, I was top of my class. I did all the things right. I was that employee from day one that was all-in. But I didn't understand the numbers. I didn't understand tracking, KPIs, what they were, overhead — nothing. So, when I got a hole in my schedule, you best bet I was going to protect that hole. I wanted that cancellation to stay in there. I wanted it to be first thing in the morning, our last thing in the day, or maybe right after my lunch. And I was so excited because I got a break, for goodness sake. Once I learned what that meant to the practice, what that meant financially, overall, what it meant to my paycheck, in the end, and everybody else’s, I didn't want holes in the schedule anymore. I realized how impactful it was in a negative way, and I was so committed, I would go in the hygiene re-care room and call to try to fill that hole myself.” (15:01—15:54)

“Once your team knows the numbers, what they mean, and how they benefit the practice, as well as themselves, they're going to be more committed to maintaining a full schedule and keeping that capacity up where it needs to be.” (15:55—16:06)

“When practice owners are transparent around the numbers, team members don't have to guess. They don't have to guess about the security of the practice. We’ve heard about practices where, ‘I didn't make payroll this month.’ A team member doesn't ever want to have to experience something like that. So, when you're open and transparent around the numbers — now, I'm not saying tell them what's in your bank account, but enough to know that, ‘Our practice is healthy. We’re in the green quite often. When we’re in the red on these KPIs, we’re doing things to change it to get back on track.’ It helps the team to feel more confident and more secure. It limits the skepticism that might be created in their mind, the storytelling that comes up in their mind around the practice, when we’re open and honest. It builds trust between the team and leadership and the doctors.” (16:51—17:40)

“[Trust] goes both ways. As a team member, you can trust the doctor more. But the doctor can start to trust the team. When the team understands what's going on and they can work together to put those countermeasures in place, and you as the practice owner start seeing that happening without you having to — it’s kind of like with your kids. They're going to start cleaning their room without you begging them, and yelling at them, and asking them to clean their room. All of a sudden, I'm going to trust that they're going to clean their room. And so, you can start, as a practice owner, really trusting your team as well because it goes both ways.” (18:32—19:06)

“We talk all the time at ACT about E – R = C. So, expectations minus reality equal conflict. And we know that trust and conflict really are hand-in-hand. If we can create expectations around these numbers with our team and expectations around what we’re going to be doing to implement changes to those numbers over time, the reality can then match and reflect that and will limit the amount of conflict that we have between team members, between departments, between leadership and team members, sometimes even between leaders, when we have multiple leaders on a team. And so, that's going to lead to less conflict, and that's going to mean stronger trust, overall, within the team as a whole.” (19:32—20:14)

“I've worked with doctors where they're sitting in their office during the day, and they're like, ‘What does Jodi even do up there? Every time I walk up front, it doesn't seem like she’s doing anything.’ We talked about micromanaging for just a minute, but it really comes back to trust. If you can see that these are the key performance indicators, these are the numbers that Jodi is primarily responsible for, and they're killing it, Jodi is probably doing some pretty awesome things up there and we really don't need to sit in our office and stress and worry. We can trust that she’s on top of it because we can see it in the data. Now, if it’s the other way around, it might be worthy of a conversation. But it’s going to help you have that trust.” (21:16—21:59)

“Most team members don't even know that [gross production and net production] are two different numbers.” (24:13—24:18)

“If you are someone who is considering transitioning to more insurance-independence, the team understanding those numbers — again, we go back to trust. They will trust in the security because that can feel scary to a team member. Just like most doctors, most of us lean into insurance participation. You go on any other forum, we talk about this all the time, blogs and forums online, they're going to tell you, ‘Participate with every insurance because you'll get more patients. You'll get more patients.’ But what we know through our process is, that's not the way to become more profitable, really, and live a better life and have that better practice. So, we know that. We have to help our team members to understand that too. We’re seeing that from our bookkeeper on a monthly basis, those adjustments, and what we thought we made versus what's really going in the bank. We have to help our team members to understand that there's a shift, and there's a write-off, and there's that difference there between gross and net production.” (25:57—26:53)

“Collections is super important to know. Obviously, we need to know what we’re producing. But does that even matter if we’re not collecting the money around what we’re producing? And that really feeds right into our AR percentages and knowing where we stand on accounts receivable. It’s really important for your team, as a whole, to know, what's our collections percentage this month? Did we get 100% of what we produced, or did we get 75% of what we produced in the bank? That matters. And it falls right into accounts receivable. If we didn't get all of that money, it’s just money owed to us that's going to keep going on down the line. Old money, as they say. But it’s still technically money that we have to try to figure out how to get back in the bank.” (28:22—29:06)

“Our hygiene reappointment percentage [is another important number to share]. Of the number of hygiene patients that come through the practice, how many of them are we prescheduling and reappointing right then and there for their next visit? Because that's going to maintain our schedule, over time.” (30:06—30:19)

“[Your hygiene reappointment percentage should be] in the 90s. I say 92% would be a minimum. I shoot high. I have high expectations. I would like to see 94%, maybe, or more be reappointed. There are always going to be some patients who are moving, or they just cannot preschedule because they're around my neck of the woods, in the military, maybe. They might be deployed on their next visit. But certainly, in the high 90s. Otherwise, how much manpower and effort are we going to be spending four months from now, six months from now, trying to track that person down and getting them back into the schedule?” (30:38—31:12)

“A little healthy competition can go a long way. You could build bonus structures into this type of thing as well, if you really want to build competition when you're in a really healthy, financial place. Even just that, those numbers are hanging in the break room on your boards, month to month, and that one person consistently is in the red when everyone else is in the green, they're going to want to bring that number up. They don't want to be the odd man out. A little healthy competition goes a long way.” (32:27—32:54)

“I have worked within a couple of practices where we started around two percent, and they were able to build that periodontal percentage up into the 20s and 30s within a year to two years of time. So, what that is is, how many patients are coming through the hygiene room? If I'm a hygienist and I'm tracking this, how many patients did I see this month, in general? And of those patients, how many were periodontal codes? So, our full-mouth debridement code, our gingivitis therapy code, quadrants or localized periodontal therapy, and periodontal maintenance. Of the number of patients I saw, what percentage of them were periodontal patients? And really, a healthy number is going to be somewhere between probably 35% and 45%.” (33:08—33:52)

“I think fluoride is one of those things that — actually, I was working with a coaching team recently, and they switched from foam to varnish. And they had a predisposed notion that the patients were not going to like the varnish. Like, ‘They're used to this. They're not going to like that. It’s also a little bit more expensive.’ So, when we were chatting about it, they're like, ‘Well, we have noticed that the acceptance has gone down since we started with the varnish.’ And I said, ‘Tell me a little bit about how your hygiene team is bringing that up, chairside.’ And so, when she roleplayed that out to me, it was, ‘We wrap up with a patient, and we say, ‘Would you like to have your fluoride treatment today?’ And then, the patient says, ‘Well, I don't know. How much is it?’ And then, we’re telling them, and then they're like, ‘Oh, maybe not.’’ And so, it’s a little bit around, how do we use the verbal skills to build that value, ‘So that we can protect your root surfaces that are exposed from a higher risk of cavities and sensitivity, we’re going to apply a fluoride varnish for you today. How does that sound? Great.’ So, it’s all about how you're delivering the value behind that.” (35:41—36:53)

“[Capacity] is, how much open time do we have in our chair? How much availability do we have of our providers? And of that availability, how much of it is currently scheduled? So, we want to know, if I have eight hours a day as a hygienist, am I consistently having eight hours of that day filled with patients, or am I at five one day, and six the next, and seven the next? And we’re busy. We’re so busy, and we’re booked out until August, and we have nowhere to put patients. But consistently, when we’re tracking capacity, we’re seeing that there is space in the schedule. There are holes. And so, now, we know, if we’re booked out six months, that must be the last-minute cancellations. That’s short notice changes in the schedule. How can we do something different to try to combat that? So, that's what that number is able to tell us, is how successful are we being with keeping the schedule full.” (38:03—38:56)

“A lot of people start considering bringing on an associate. But we need to look at capacity, and is our schedule truly full, and can we really support someone else, or do we have some holes going on?” (40:00—40:10)

“Treatment acceptance can be measured in two different ways. We can measure, of the number of patients who were presented with a restorative or elective option today, what percentage of those patients accepted? So, if we presented to two people and one of them moved forward with something, we’re at 50%. The other way that can be measured is based on the dollar amount presented. So, we can look at, out of the dollar amounts of treatment presented today, what dollar amount percentage was accepted? You can track it either way, and it’s really important to know that the data is being entered in correctly to be able to track that information correctly on the back end. But both of those basically tell us, how much value are we building in what we’re recommending? Are our recommendations working? Is our communication working? What's happening up front when that treatment is being presented by our front office? Do we have the right financial policies in place to help our patients be able to afford the treatment? If we’re not doing well in treatment acceptance or patient acceptance and treatment, we have to look at each step in that treatment presentation process and see, where is the kink in the chain, and how can we create some countermeasures there?” (40:22—41:32)

“You might not even need to share the [overhead] percentage. It’s going to depend on the team, to a degree. But they need to know what overhead is. Here’s why. I worked on a lot of dental teams, and this is what I hear: ‘I can't believe the doctor is on another trip to Cancun on a private plane. And did you see that they had a $700 bottle of wine on the table? I can't even get new Cavitron tips.’ So, that's the imaging. That's our storytelling that our team members are often creating . . . But when team members understand what overhead is, they don't look at gross production at $500,000 last month and assume that the doctor is getting $500,000. They will understand that there's a cost of doing business. We have to keep the lights on. We have to have someone clean the office. We have to buy trash bags — down to the most minute detail that it takes to run a business.” (42:26—43:33)

“Dentists and leaders, they assume that people know [the cost of running a business]. I'm telling you — team members do not know that overhead is a thing, or what it is, or how it impacts the practice. So, even just the concept of overhead is important to share. And it’s really, in my opinion, dependent upon the culture and the health of your team if you're going to share the percentages or any numbers around that overhead.” (43:39—44:05)

“There are a couple of numbers within overhead that I think are important for the team, supply budget and laboratory, because those, the team can impact. When they're getting those lab invoices, they can have a system for double-checking charges and making sure that duplicate charges aren't on those invoices. And they can monitor for things around your lab overhead. Supply is huge. What we see a lot of times, coming into coaching, is we can reduce overhead percentage for doctors pretty quickly just by initially getting on top of managing supplies. So many teams don't track and budget for supplies. They order what they need when they need it. They don't look first to see if there's a hidden stockpile in an operatory that they forgot about. So, when we start bringing the team into overhead, those are two components that I feel the team can have some control over, if your team members are the ones responsible for ordering.” (47:16—48:18)

“If you want to build a smarter and healthier team, the numbers are a part of it.” (49:42—49:46)

Snippets:

0:00 Introduction.

2:01 Miranda’s background.

2:41 Why sharing numbers is important for your practice.

4:19 Numbers mean accountability.

10:43 Numbers mean commitment.

16:44 Transparency creates trust.

19:29 E – R = C.

23:25 Gross production and net production.

28:20 Collections.

30:01 Hygiene reappointment percentage.

32:56 Perio percentage.

35:38 Fluoride.

37:51 Capacity.

40:11 Treatment acceptance.

42:02 Overhead.

47:06 Two important overhead numbers: supply budget and laboratory.

49:24 Last thoughts on sharing numbers.

Miranda Beeson, MS, BSDH Bio:

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

Miranda...

Video Confidence on Social Media

Episode #551 with Allison Lacoursiere

Your millennial audience is the largest consumer group. If you want to reach and connect with this generation, you need to be online! To help you build that familiarity and connection, Kirk Behrendt brings in Allison Lacoursiere, owner of Clear Coaching and Clearly IG, to explain video confidence on social media, why it’s critical for your practice, and how to do it. With a few simple systems and a lot of practice, you can be more confident in the online space. Start changing your digital reputation today! To learn how, and to hear more about Allison’s courses, listen to Episode 551 of The Best Practices Show!

Episode Resources:

Allison’s website: https://www.yourclearalignercoach.com

Allison’s email: [email protected]

Allison’s social media: @yourclearalignercoach

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Links Mentioned in This Episode:

Instagram University: https://www.yourclearalignercoach.com/instagram-university

Main Takeaways:

Improve your digital reputation by using video.

Stay relevant by using video in your social media.

Be intentional about the videos you create for patients.

Video is the best way to connect with your millennial audience.

Using videos can increase your case acceptance and conversion rates.

Quotes:

“When we think about video content, it’s actually becoming the norm for how people are interpreting, understanding, and learning about anything on the internet. And so, for a dental practice who, we’re business owners, we want to make sure that we’re representing ourselves well, in an authentic way, and helping people capture their attention to understand who we are faster. If we’re not using video content, we’re becoming irrelevant.” (3:50—4:14)

“[Video] has an 80% higher conversion than anything else on the internet. And so, if we think about that, if we want the best website, if we want the best SEO, if we want the best of anything for our own business, we have to use video to be competitive.” (5:13—5:27)

“I know in dentistry we never like to say that we’re selling. We’re educators. We’re educating our patients. But the reality is, when we’re selling something, it really is just helping somebody make a decision to say yes. And so, really, it is still sales. As much as we don't like to admit it, we’re still selling in dentistry. And when we’re selling anything, there are about seven to eight touch points for somebody to say yes. One of those touch points can be even before the patient gets into the practice. And when you have a video of the doctor or of a team member of a trusted person explaining the consequences, the risk, why something is necessary, even just explaining orthodontic procedures, it helps the patients have that one touch point already to say yes. When they come into the practice, already, they know you. They like you, and they’ve started to trust you, which is one of the ways that patients will say yes to whatever you're telling them that they need for their overall health.” (5:49—6:48)

“Familiarity allows people to trust you more. So, even though, not consciously, they're like, ‘Oh, you're familiar to me,’ subconsciously, you're familiar to them [from watching your videos]. So, their anxiety decreases, and they feel more comfortable when they get into the practice.” (7:07—7:20)

“A lot of times, my docs are like, ‘I am too afraid,’ or, ‘This is so uncomfortable.’ It’s kind of like listening to your own voice on the phone. But as soon as you start doing it again and again, you become better at it. You become more confident. And that is 100% what I would suggest, is to be the best beginner there ever was. Be the best beginner at creating video, and you will become great.” (8:37—8:58)

“When we think about the millennial audience, that millennial cohort is the largest cohort of purchasers and decision-makers that are coming into our world. They are our consumers. And so, we have to talk to them in a language that they understand. And oftentimes, now, if we don't have video content, if we don't have a social media presence, if our millennials can't connect to us in the way that makes sense to them, then we feel or seem outdated to them.” (9:42—10:09)

“There’s a lot of misinformation on the internet about dentistry. There's a lot of bad information. There are a lot of people out there scamming our patients on the internet because they're putting things out there, they're making social media content, and they're creating videos. And so, my hope and wish is that great clinicians and providers will also create videos and will also educate their patients so that our millennial consumer can have that true and real information that combats the rest of the noise and the misinformation out there.” (10:17—10:46)

“Let's say somebody has recommended your dental practice to go to. The next thing a millennial audience is going to do is look you up online. And when they see you online, they're going to notice what your website looks like, if you have a YouTube channel, if you have an Instagram, a Facebook, what your photos look like. Your digital reputation is a way that you represent yourself on everything online. I know amazing clinicians who I would trust my mom to go to, who if I look them up online, I wouldn't know that about them. I wouldn't know that they're a great clinician. And so, it’s taking it from being unknown in your values, in your excellence, in your professionalism, internally to be externally known in your digital reputation. It’s more important than ever, and it’s not going away.” (12:06—12:53)

“Google yourself right now. Search everything that you can find about your practice, about you as a clinician, online. If there's anything that you'd want to change, then go ahead and change it because you have other people looking this up right now.” (12:56—13:07)

“If this is going to be the video that's going to be popping up immediately on your website, then it needs to be a bit more polished. You don't want it to be low quality. You want it to look really professional and nice. But if you're on social media or any of those platforms that is about authenticity, then show up as yourself. What I always say is, remind yourself that you know yourself. If you are a dentist and you are explaining a crown, or explaining your practice, or explaining why you love dentistry, this stuff is so known to you that you don't even have to think about it. So, I would say that's my first step for the confidence, is trust that you know what you're talking about — because you do. In fact, you probably talk about it a hundred times a day. So, trust that element. You know your stuff. You know what you're talking about. You do it all the time.” (13:37—14:24)

“I want to give you a hack or a tool. If you're just starting out, this is one of my favorite ways to do it because it helps you save time and you can repurpose your content across multiple different channels. The goal would be to take a higher quality video. You can use your MacBook camera, or you can use the camera on your computer, and film as much as you possibly can. And then, chop that up and put it wherever you have a presence. That's another conversation we can have about what presence should I have. But let's say you have a YouTube channel. Use that longer video on your YouTube channel, and then chop up the little pieces and use it for your Instagram. So, repurpose your video content as much as you can. And even in that, you can take quotes, you can take clips, you can take certain segments, and you can actually put that into a little writing and put that onto your social as a quote from you. So, repurpose your content as much as you can. As you are starting out, you want to make this time valuable.” (14:39—15:39)

“Get really intentional about it. As a coach, I love to talk about the values of an organization, the things that matter the most to you. When you can film videos intentionally, talking about these things that really, really matter to you, the more people will get to know you before they come into the practice, or before they even decide to book with you. So, what you really want is to decide, internally, who are we, what do we do, what makes us different, and film videos on those topics.” (16:14—16:44)

“Whenever I'm coaching a practice, we write out the values, and then we create video examples about each of those values. So, let's say a value was service. Amazing. What are some video examples that we could film around service? That might be capturing somebody walking an elderly patient out to the car. It might be a home visit that you're doing. It’s evidence that this is your value, and [you] live it. You can be intentional about that, and people get to know you even before they meet you.” (16:45—17:13)

“If you are starting video and you feel unconfident, that is okay. Most people start there. Just be the best beginner there ever was. The first thing you need to know is that no one is going to be as critical about you as yourself. And so, make a promise and a pact to yourself that you're not going to criticize your appearance. You're not going to notice that your left eye is a little bigger than the right, that maybe your right ear is a little bit lower than your left. No one will notice that. And the fact that you notice that — it’s okay. But no one is going to criticize these things about you. So, first and foremost, leave that aside. Don't become perfectionistic about your appearance.” (18:22—19:08)

“This is not about you. This is about the people that you're meant to serve. And so, as soon as you can switch the focus from me to all of the people that might need to hear my message, or might be helped by hearing my message, or might come to my dental practice because I'm a great dentist — it’s 100% about them. It’s not about you. And so, think about the one person. If [even] only one person watches this video and makes a decision to be healthier because of it, then your work here is done.” (19:28—20:02)

“If we’re in dentistry, we care about helping people. And so, ground yourself into that. Align yourself to that like, ‘I'm here to help more people.’ That really is what marketing is. How do we help more people? How do more people get to know about us? And when you can really sit into that intention before you film, that's when you're going to feel less self-conscious and uncomfortable.” (20:38—21:02)

“What gets scheduled gets done. If we can schedule this into our marketing strategy for the year, it will get done. And so, what I would say is be prepared for the videos that you're going to film ahead of time. Make sure that you wear the clothes that you want, your hair looks the way that you want it to look, and then film as many as you can. Don't try to get on camera every single day in a different way. Just get ready and film as many as you can. Repurpose them across multiple platforms and schedule it so it will get done.” (21:24—21:56)

“A lot of people are like, ‘Well, what videos do I create? What do I even talk about?’ Think about the questions that your patients are asking you on a day-to-day basis and answer those questions on video. Those are ways that you know you're connecting right to your audience. They're already asking these questions, so go ahead and answer them on video and put them online.” (22:54—23:13)

“[Social media and video is] something that's worth getting comfortable with. If the reason why you're not on video and social media is because you're not confident, then we can fix that.” (24:20—24:27)

“You're the only one, as a business owner, as a clinician, that knows what's in your head and your heart, why you're there, why you do what you do. No one else is going to really be able to say it as well as you're going to be able to say it for yourself. As much as marketers love to create messaging, the best one is going to come from your heart and your head and from your voice. And so, if you can do that, you're going to be able to connect with people in a different way, in a more powerful way, so that they're ready to start dentistry when they walk into your practice.” (24:35—25:04)

“Just try it. Start today. If you're listening to this podcast and you're like, ‘Wow, this is one of the reasons why I don't get on video. I don't feel confident,’ my suggestion is to go home and film a video. And then, film another one tomorrow. And another one tomorrow. Because it will help you be that beginner and to get confident with this skill and this tool. It’s not going away, and we need to connect with our patients where they are, which is on social media, online, and on video.” (25:20—25:47)

Snippets:

0:00 Introduction.

2:05 Allison’s background.

2:49 Why video confidence is important for your practice.

4:15 Use video to be competitive.

5:28 How video helps increase conversion and treatment acceptance.

7:35 Be the best beginner to become great.

9:24 Connect with your millennial audience.

11:43 Digital reputation, defined.

13:08 How authentic should you present yourself?

14:25 Repurpose your content as much as possible.

16:04 Have your reputation precede you.

18:03 How to gain more confidence.

20:03 Focus on how you can help others.

21:03 What gets scheduled gets done.

22:11 Is audio quality important when getting started?

22:42 What kind of videos should you create?

23:15 More about Clear Coaching and Clearly IG.

25:14 Last thoughts on social media confidence.

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

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

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

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

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