The Best Practices Show with Kirk Behrendt

Are You Billing Your Full Fee?

Episode #510 with Ariel Juday

You think you're billing your full fee — but you're not! So, to help you get the pay you deserve, Kirk Behrendt brings back Ariel Juday, an amazing ACT coach, to explain why billing your full fee is crucial, how to train your team members to do it, and ways to not be the limiting factor to collecting your full fee. Stop working one out of every three days for free! To start collecting your full fees today, listen to Episode 510 of The Best Practices Show!

Episode Resources:

• Ariel’s email: [email protected] 
• Ariel’s social media: @actdental  
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

AADOM: https://aadomconference.com

Main Takeaways:

Understand the consequences of not billing your full fee.

Train your team members to always bill your full fee.

Involve your admin team and ask for their input.

Show patients the true cost of your dentistry.

Check your fees annually to be up to date.

Don't assume patients can or can't pay.

Quotes:

“The most important part is you want to show the patients the value of dentistry. If we’re not showing them what it costs, they're not going to know. So, we’re giving discounts, or we’re showing our PPO fee. They're going to think, ‘Oh, this is normal. This is what it is.’ So, we’re not showing them the true value, and they're going to make up their own numbers in their head based off of what they're seeing.” (3:21—3:46) -Ariel

“You can't make decisions off of your practice if you're not seeing the real numbers. So, if we’re billing our PPO fees because we think that it simplifies our processes, we can't make true decisions because we don't really know what the fee is, what is our overhead for that procedure. We really can't make decisions, and we don't know if we’re keeping up with our PPO fees. So, the easiest is to bill our fee and let the PPOs keep up with us.” (3:50—4:23) -Ariel

“Your practice management software is going to try and tell you to put in the PPO fee and bill it. Because that way, when insurance pays, you don't have to do the individual write-offs, and your team doesn't have to focus on anything. So, they make it sound like it’s super easy. A lot of practice managers and team members who don't really know the unintended consequences of not billing your full fee, they also think it’s easier. They think it’s saving them time. But really, the unintended consequences are they could be making mistakes.” (4:50—5:25) -Ariel

“I've seen lots of dentists give back refunds to patients that were never deserved because we’re doing multiple write-offs, because we don't know how to read the EOB and the ledger. So, that's why to keep it simple is actually to bill the full fee. When the insurance check comes in, then we can make the appropriate write-off. We know everything is correct right there. And people say, ‘Oh, that takes me more time.’ In the end, it really doesn't. Because now, you're not auditing accounts later. You're touching it, you're one and done.” (5:26—5:57) -Ariel

“Make sure that our claims are being sent with the full fee. And usually, it’s in your settings. It’s a little checkbox for setting up those claims. You want to make sure your insurance claims are sending your full fee. That's the most important part, because that's so easy you can do that change tomorrow without affecting anything in your software.” (7:22—7:43) -Ariel

“What about the ledger? What are we showing on the ledger? This is one that if you're not showing your full fee on the ledger, I don't recommend doing it right when you get off because it’s going to be a change in the way people are seeing it, the way your patients are seeing it. So, you want to make sure you communicate with the team of the change. But it is a simple change. You go in, and it’s another checkbox showing your full fee on the ledger. Now, this means you have to do a little bit of work, which becomes software-specific of, ‘Okay, but I want to give accurate estimates.’” (7:47—8:21) -Ariel

“That's the important part, is giving patients the accurate treatment estimates. Each software is designed that you can still do that based off of the PPO fee schedule. And this is where the hard work comes in, is you have to still have those PPO schedules put in. But if you've been billing your PPOs, then you definitely have the fee schedules. And you can still do this even when you're out-of-network, is giving them an estimate as well based off of this fee schedule. Your software knows whether to give a discount or not based off of how you input it.” (8:21—8:54) -Ariel

“At least [check your fees] every year. At least check to make sure, ‘Am I up to date?’ And then, throughout the year, spot-check. See some of those big codes, your top 20 codes that you're billing. And we always say if it is a code that a patient is going to see a lot, so their prophys, their bitewings, things that they may be paying out of pocket for or they see more often because they get them done more often, those, we don't want to make a huge increase right away, because then patients are going to think we’ve been deceiving them. But ones that they don't see all the time, the extractions, the crowns, the root canals, those, you can make a bigger increase if you are behind.” (9:13—9:54) -Ariel

“If you are in-network with PPOs and you increase all of your fees, just know you're not going to get a huge check tomorrow. It takes time. But we need to let the insurance companies know as well, ‘Hey, this is how much it costs.’ And if all of us are billing a higher fee for a crown, the hope is, eventually, the insurance company will reimburse a little bit more.” (10:07—10:30) -Ariel

“I know people are like, ‘Oh. Now, you want me to audit.’ But if we’re billing our full fee, we’re looking at every EOB to make sure the payment is correct. And so, you can start catching those things right away.” (12:02—12:14) -Ariel

“You also want to audit your EOBs because insurance companies, they're a business. And they hope that you take what they paid and what they said as fact. And you'll see that they’ll deny some things. Cores are denied a lot because they say, ‘Well, you didn't show proof.’ And all you have to do is send in either the seat date or send in an appeal. But they don't want you to do that so that they don't have to pay. But if you have that process in place that you're reading each EOB and seeing and fighting for what you deserve and what your patient deserves, you can catch those. It does take a little bit of extra work. But insurance is hoping that you're going to roll over and take their fee that they give you.” (13:07—13:53) -Ariel

“The team members aren't the ones setting the fee, so they should not feel bad about it. It’s, ‘This is the fee.’ And for doctors who say, ‘Oh, that's too much,’ no, that's your fee. That's what you should be paid. Value what you do. We don't question the value when we go to the grocery store, ‘Ah, that's too much. I should get a discount.’ No, that is the value. And that's why we want to start showing the patients now. Because as you get out-of-network and now you have to start showing them, at least patients saw, ‘Oh, okay. My crown cost $1,500. But because of my insurance plan, I was getting a discount.’ They already know that, so they don't think, ‘Oh, you've just now tripled the price of your crown.’ So, that's why I want everyone to start showing it now and saying, ‘Hey, this is the value of a crown.’ That way, later on, they say, ‘Yup, I've seen that number before. That's not a shock to me.’” (15:28—16:27) -Ariel

“From my perspective, it’s the team members that project their own feelings that get the results of the hesitancy from the patients. So, we cannot judge any patient on what they can pay. And I always make a joke, we don't know what they have behind their walls or in their couch. Make it fun. Like, we don't know where they're hiding their money. And if they want to pay for it, they will. But I'm not going to assume that they can't pay for it. Assume that everyone can and will pay for it, and they will tell us differently.” (17:17—17:52) -Ariel

“If [patients] say, ‘Oh, I can't afford that,’ okay. Well, now, I go back to my financial agreements and my system within my practice of, okay, what options can I offer? Do we have a payment plan? Or do I say, ‘Okay. What is your paycheck schedule? Are we able to push you out two weeks so that it falls on a paycheck period?’ That's when you start letting the patient decide of when they can pay for it and how they can pay for it. My job is to tell them the value and tell them the investment, and then let them tell me yes or no. And if it’s a no, okay. Now, I'm going to come back with some solutions for you to help you start thinking, ‘How can we make this work?’” (17:53—18:35) -Ariel

“Some team members say, ‘I can't afford that.’ You can if we have the right agreement in place. Same with patients. They may not be able to pay for it today, or they maybe can. We don't know. We have to let them decide that, not us.” (18:39—18:54) -Ariel

“Admin team members are not given excellent training on verbal skills and fees. And when they are, they shine. They can shine. It’s the dentists that becomes the limiting factor on full fees.” (19:28—19:40) -Kirk

“I've had so many dentists say, ‘Oh, Ariel. Let's give them a discount.’ And my first question is, ‘Why?’ And they're like, ‘Well . . .’ And then, it’s, ‘Oh, they can't afford it.’ I'm like, ‘Did they tell you that, or are we assuming that?’ We can't assume, and then I go in and present the value and say, ‘Hey, this is your investment,’ and they tell me, ‘Okay,’ and then I come back, and I'm like, ‘Oh, hey. You owe me that discount you wanted to give because they're willing to pay your full fee.’ It’s in our mind, and the dentist starts thinking like, ‘Oh, maybe this one will be easier.’ But maybe it won't. You can't charge that. The value of a crown is a value of a crown, and you just have to go with it. And once again, you have to value your own work. You're the one doing it. Stop giving out discounts just to hand them out.” (19:44—20:36) -Ariel

“I tell [patients] the value, and they look at me, and I just smile. I'm great with the awkward silence because it’s like, okay, I'm going to let you process. I'm just here smiling, letting you know. I'm not backing down from it. ‘This is what it is. This is what you need.’ And then, they come with a solution and they say, ‘Oh, okay. How about I pay this? Do you take credit card?’ ‘Absolutely.’ So, it takes time.” (21:49—22:16) -Ariel

“Make it fun for the front, because talking about money is not fun for everyone. And that's where it goes to right people, right seats. You have to have someone who’s okay with talking about money. But I say one KPI that they can track is the over-the-counter collections. And each day, they can say, ‘Hey, guys. Guess what? I collected 100% of what I was supposed to.’ And it makes it fun because it’s an easy accomplishment for them. Or they can celebrate those hard balances. They're like, ‘Augh! I've been chasing Ms. Mary down for months. And today, she paid!’ That's a celebration. And we know it’s not all about the money. But if we’re not collecting the money, it doesn't matter what you're producing.” (22:17—22:58) -Ariel

“You have to take it step by step. You can't go tomorrow and say, ‘Okay, I'm going to bill my full fee. I'm going to drop all my networks, and then I'm going to be a millionaire.’ It doesn't work that way. We have to take it one step at a time and get your team involved, especially the dentists that don't know what's going on at the administrative level. Ask them and get them involved in the process. See how it may affect their day and their processes. And some of it, they may come back and say, ‘Oh, we can't do that.’ Ask them why, and ask them why again, and say, ‘Well, can we try this? Can we try it for three to six months and see what happens?’ Very rarely, will they go back to the old way.” (23:49—24:29) -Ariel

Snippets:

0:00 Introduction.

2:09 Ariel’s background.

3:06 Why it’s important to always bill your full fee.

4:23 Unintended consequences of not billing your full fee.  

6:55 What team members should pay attention to in the software.

8:54 How to systematically update your fees.

11:22 Irregularities in auditing and shared agreements, explained.

14:42 Start showing patients your full fees now.

16:43 Let patients tell you what they can afford to pay.

18:54 Dentists are the limiting factor on full fees.

22:16 Make collections fun for the admin team.

23:01 What to expect by billing your full fee.

25:04 Last thoughts.

Ariel Juday Bio:

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

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

The Power of Self-Care & Rituals

Episode #509 with Courtney Dalton & Gina Diakonov

Dentistry is draining. And to recover physically and emotionally, you need to practice self-care. There are different ways to do it, and Kirk Behrendt brings back two amazing ACT coaches, Courtney Dalton and Gina Diakonov, to talk about their self-care rituals, why having one is important, and how you can start your own. Care for yourself so you can keep caring for others! To learn how to get started, listen to Episode 509 of The Best Practices Show!

Episode Resources:

• Courtney’s email: [email protected] 
• Courtney’s Facebook: https://www.facebook.com/courtney.dalton.739
• Courtney’s social media: @courtney.hannig
• Gina’s email: [email protected] 
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

Atomic Habits by James Clear: https://jamesclear.com/atomic-habits

Main Takeaways:

Self-care is what refills your tank.

Make time for self-care and make it a ritual.

Don't feel guilty about taking time for self-care.

Your self-care ritual will set the tone for your day.

Hold yourself accountable for creating self-care time.

Quotes:

“Gender plays a big part in this. A working mom dentist has some added responsibilities — dads do too. Those dad docs do too. But let's talk about the mom side. It takes so much out of us to be a parent. It’s amazing, it’s fulfilling, and it’s the best job in the world. But it’s exhausting. And then, when you wake up to go to work and you spend your day there, I hear those mom docs say to me, ‘I've got nothing left. I still have to prep the dinner when I get home because I didn't do it on Sunday. How do I have the energy from having a long day of work and still have the energy to give my best to my family? Because I want to show up. I'm just really tired, and I don't know where to go from there.’” (5:35—6:22) -Gina

“Our teams and our doctors that we work with, they feel so pulled and so dictated by the needs of the practice that they get caught up in it and get overwhelmed by it. And rightfully so. It’s hard to be a business owner. It’s hard to have people with you that you trust to help fuel your business forward. But to Gina’s point, at the end of the day, when you go home, if there's nothing left in the tank, you don't have the energy for your family. You definitely don't have the energy for self-care, for doing the things that you want to do. So, one thing that we do, as coaches, is help them find the balance.” (6:58—7:35) -Courtney

“If you're not present for yourself, you can't show up in either facet of business or personal.” (7:42—7:48) -Courtney

“I find that what makes me feel great in self-care is fitness. I feel 100% guilty when I do anything after my working hours. Because the kids are gone, I'm work, work, working all day, now, I'm done and they're home, and I feel compelled to give them all of my energy. Whatever I have left, I want to be present for them. But there are nights when I leave and I have to go teach a fitness class, or I sometimes leave to go take one. And I will tell you, the guilt is real. But I love it. If I don't do that for me, I am not there for them. I need a little me to give more to them, to my career, and to the people that matter.” (8:10—9:05) -Courtney

“We recently purchased a Tonal. It’s a workout equipment that's in my house. So, the time that I now have to not worry about changing and driving to the gym and dealing with traffic, I've inherited back. It’s more time for me to get into the room with a Tonal and get out. But what does that mean? I'm feeling guilty that I'm in my own home making the babysitter, my husband, somebody else watch the kids so I can get that me time. So, I feel that guilt as well. I totally need it. I get that endorphin release and I'm a happy person. And my kids and my family feel it too.” (9:20—10:08) -Gina

“Everybody’s got to find their thing, whether it be at night, whether it be a yoga class — something. You've got to find the time and carve it out.” (11:41—11:47) -Kirk

“When I don't have the exercise, I have to take two or three deep breaths when there's something stressful. [When I take time to exercise], I'm like, ‘Ah, whatever. It’s all good.’ So, you've got to find the time.” (12:45—12:57) -Kirk

“You don't find [the time], you make it. You have to carve it out. And I'm an early bird. Maybe because I'm in the season with the kids and they’re seven and four, and I have to. And I have the guilt afterward. So, I carve the time out before.” (13:02—13:19) -Courtney

“It’s important enough to me that I don't mind that early wakeup call. I don't mind it at all because I feel so good after [the workout]. And it sets the tone for my whole day. I can tackle the big team meetings. I can tackle the really hard client issue that's been festering in my brain for a few days. I'm good. I've got it. But if I don't get that time in the morning, I set myself up for a tough day.” (14:02—14:27) -Courtney

“Your spouse, your partner, or your significant other, whoever is your companion and is helping you day in, day out, tap into that person to find the balance. And it goes back to E minus R. Have the conversation out loud. I know that one of the things that I do if someone sends me a text message, I respond in my brain, but I forget to hit send. And then, I think I hit send, and I think that we’re clear, but we’re not clear because that wasn’t actually an external conversation. Have the conversation out loud, ‘You do dinner because I'm going to go here,’ or, ‘Get everybody ready for school, and I'll pack lunches. And then, I'll do this.’ If you don't clearly outline who’s going to do what, it goes right to communication, then you're going to have a really bumpy day or a bumpy week.” (18:37—19:29) -Courtney

“My husband, when it’s the summertime, he works very long and late hours. So, it’s a little bit dicey depending on when we are in the year based on his career. He’s a tennis pro, so he works when people are outside playing and having fun. So, I already know that division of labor is not going to be equal, and that's just a part of our relationship. So, in the summertime when he does have an evening off, I know that he actually needs that time to go and clear his mind because he has been working so hard.” (20:02—20:39) -Gina

“I can't even imagine how difficult [it is to be a single parent]. But I would say this, even in that environment, clarity and communication and division of labor is really important. I know a lot of single mothers that are dentists, and they get help. And they're not afraid to get help. They have parents helping them out. They have a nanny helping them out. They have somebody helping them out . . . I'm not ashamed to pay for help.” (22:02—22:26) -Kirk

“You've got to find out what you're happy to pay for.” (23:10—23:12) -Kirk

“How about a babysitter so that you can go out on a date, to have that self-care with your significant other, or your girlfriend, or your buddies? Bring it in. That's a good use of money, in my household.” (23:24—23:37) -Gina

“Babysitters are cheaper than divorce attorneys and psychiatrists.” (23:40—23:43) Kirk

“It’s the power of rituals, finding rituals in a week, whether it be exercise, whether it be when you start work. You're going to see all of this goes back to one thing: we’ve got to get some rituals down. And what rituals do is they create neuropathways.” (25:17—25:33) -Kirk

“That conversation [at the dinner table] — there's no phone. No phone at the table. TV, off. Be connected with each other. Now, we’re imperfect. Sometimes, the TV is on, I won't lie, in my house. But we don't do phones at the table. We are connected to each other. And the sense of harmony that that gives us is so invaluable. I don't think that we could function without that time together to check in and to talk and connect.” (26:50—27:26) -Courtney

“How do we connect? We do roses and thorns at the dinner table . . . We all take turns. Usually the youngest, it’s her idea, and she says, ‘Roses and thorns, everybody!’ And she’ll start us off. Her rose that she shares with us is the best part of her day. And the thorn is the part of the day that maybe didn't go so great. Not the worst part, necessarily, but something that maybe sparks a discussion. So, we go all around the table. We all share it. It’s the best ritual.” (27:35—28:10) -Gina

“If you're a dentist listening right now, you never bargained for how physically, emotionally stressful dentistry was going to be at this point in your career. You're 15 years in. You never thought, ‘Yeah, I knew it was going to be this stressful.’ No. It is a physical sport that's emotionally and spiritually draining at times, and you've got to find a way to refill the bucket. And a lot of it is going to have to be with your personal rituals, whether it be exercise, whether they be dinner, whether they be when you finish, when you start.” (31:05—31:32) -Kirk

“Self-care, in whatever form that looks like for you, if it’s reading, if it’s walking, if it’s fitness, if it’s family time, whatever that looks like, make time for it. If you can't figure that out, we can help you figure out how to put that as a priority so that you can be present in what you do, be present for those who depend on you, and be present for yourself. It’s so important to carve the time out. Make it a ritual. Make it a habit. Make it repeatable so that your days are better and better.” (32:32—33:09) -Courtney

“The dentists in this world, and team members, that have control of their time are the wealthiest people anywhere.” (33:23—33:29) -Kirk

“My biggest piece, which I always have to work on, is holding myself accountable to that ritual. Carve out the time. And if it’s really hard, do a little bit of those Atomic Habits style. Plug it in here. Plug it in there. But keep yourself accountable to whatever it is that you're passionate about for your self-care, and it'll get easier. You're going to keep stacking that habit and you're going to be able to organize your life to hold yourself accountable and prioritize yourself. You're going to love yourself for it.” (33:59—34:34) -Gina

“We have dentists come in here and go, ‘Oh, I see patients until 6:00.’ Then, we make them not do that anymore, and they go, ‘Gosh, my practice didn't die at all. I got busier.’ I'm like, ‘You've got three more hours a day. You could do a lot with three more hours a day. You could be a better person. You could sleep better. You could feel better.’ So, make sure you get control of your time. And when you don't feel like you can, that's when you reach out to somebody to help you be accountable.” (34:41—35:06) -Kirk

Snippets:

0:00 Introduction.

2:10 Courtney and Gina’s backgrounds.

4:32 Why self-care is important in dentistry.

7:48 The guilt that comes with self-care.

11:41 Make the time for self-care.

14:28 Advice for dentists who want a great life.

17:08 Division of labor and communication in the household.

21:16 It’s okay to ask for help.

23:58 The power of rituals and patterns.

32:24 Last thoughts on self-care.

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.

Gina Diakonov, MHSA, RDH Bio:

Gina Diakonov has been involved in dentistry since 2000. She has held multiple roles in the industry such as dental assistant and hygienist, faculty member at the University of Detroit Mercy School of Dentistry, and Director of Development and Training. She advanced her education earning a Master of Health Service Administration from the University of Detroit Mercy. She has a passion for community dentistry and volunteers regularly in Metro Detroit.

Gina enjoys spending time with her husband and two daughters, their dog Suge Bite, traveling, amateur gardening, and playing tennis. 

Say This, Not That for Scheduling

Episode #508 with Ariel Juday, Adriana Booth, & Andy Konkle

Patients should fit into your schedule — not the other way around. For that to happen, you need to guide them with your language. And to teach you the words to say and avoid, Kirk Behrendt brings back his amazing ACT team for their insight into scheduling success. Master what to say for late, no-show, or canceling patients! To learn the secrets to protect your schedule, listen to Episode 508 of The Best Practices Show!

Episode Resources:

• Ariel Juday’s email: [email protected] 
• Adriana Booth’s email: [email protected] 
• Andy’s email: [email protected] 
• The ACT Team’s social media: @actdental
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

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

Main Takeaways:

Don't ask patients when they want to schedule.

Know which questions to never ask your patients.

Eliminate words like “cancel” from your vocabulary. 

Tell patients what you can do, not what you can't do.

Learn how to tell patients no without saying the word no.

Take time to practice and audit yourself after each interaction.

Quotes:

“[Scheduling] is extremely important. It helps us to manage our time and have predictability.”  (2:44—2:50) -Adriana

“No one wants a root canal, a crown, a filling. There are only a select few of us that choose to schedule to go to the dentist. So, my first thought [to asking, ‘When do you want to schedule?’] is no. Second thought is, ‘Okay. Well, if I have to come in, I'm going to pick a specific hour. And most likely, they're not open. So, now, they're going to have to tell me no.’ So, that's why you don't want to ask.” (4:16—4:39) -Ariel

“[By asking patients when they want to schedule,] you're setting yourself up for having a bad experience for that patient. Or you're having to get into a conversation, and we’ve created a barrier — an unintentional barrier, but we’ve created a barrier for that patient.” (4:48—5:02) -Ariel

“You should never try to fit into anyone’s schedule. They should try to fit into yours.” (5:12—5:17) -Kirk

“You have a schedule to protect. And your ability to guide patients into the right spot is critical, not only to the overall flow of the day, but there are procedures you should be doing certain times of the day. So, I think the first part is, let's think better about our schedule. Now, we can support it with verbal skills.” (5:28—5:46) -Kirk

“If the doctor does that procedure in the morning and in the afternoon and I have both of those options, then I would [ask, ‘Do you like mornings or afternoons?’] because now I'm guiding them and letting them feel in control. But if the doctor only does that procedure in the mornings, then I'd say, ‘Would you prefer Tuesday at 8:00 a.m., or Thursday at 8:00 a.m.?’ So, to me, it depends if the doctor has that availability or the office has that availability.” (5:59—6:25) -Ariel

“It depends on the practice. I have some practices that may have wide-open schedules. And say we do give the option of morning or afternoon to an office that is super limited in time. If I say afternoon and the doctor does do the procedure in the afternoon, but now we’re four weeks out for an afternoon, that's going to give a bad impression to the patient also. Like, ‘Wow, they're so busy they can't see me for four weeks. Wow. Is this the right place for me?’” (6:36—7:03) -Adriana

“When it comes to Say This, Not That, you don't always have to know exactly what to say. You've got to have an idea of what to say. And one of the things that we teach that's been taught forever is, don't tell people what you can't do. Always be focused on what you can do.” (7:33—7:48) -Kirk

“I'm looking back on some of my best experiences as a patient. And when I needed a procedure done, they would guide me. Like, technically, I would come in at 3:30. But luckily, my practice was open until 5:00. So, they're like, ‘Are afternoons still the best for you?’ ‘Yes, they are.’ ‘Okay, great. Next Tuesday at 3:30. That's the next opening. Can you make it?’ ‘Yes.’ ‘If not, it’s going to be this much longer out.’ So, guiding that patient to the best possible way that still fits in the open schedule, I think, is the best way to go.” (7:58—8:36) -Andy

“No one likes to hear the word no. But we all know when we’re being told no without actually being told no. So, they say, ‘Oh, I can only make it here at 4:00.’ ‘Oh. Well, doctor actually does these procedures in the morning for the best results.’ Well, why would I want to come in at 4:00 if I'm going to get bad results? So, I’ve told them no, they can't come in at 4:00, without saying, ‘Nope. Too bad.’ I said, ‘Well, actually, doctor can see you on Tuesday at 8:30.’ And the same thing is, ‘Are you open on Saturdays?’ ‘We’re open Monday through Friday. We do have early morning appointments available, and right around lunch time, if that works for you.’ You can guide them to, ‘What works for your schedule?’ in there as well.” (9:08—9:58) -Ariel

“I'm thinking back to some of the other times guiding to needing procedures. The hygienist would ask me if my job was still the same and what schedule I work. So, they had an idea of what worked for me and could look at what was open as it was going on, knowing that afternoons worked best for me and that I was busy in the morning. So, getting that information from your patient is a good idea as well.” (10:12—10:41) -Andy

“As a hygienist, I would always preschedule my patients as they were leaving. I didn't ask them what time they preferred. I didn't ask them what day. I went from where we were, right now, and moved six months and a week out. And I would say, ‘Your appointment card is in your bag. When we get closer, you'll get reminders. And we can adjust, if necessary,’ and left it at that.” (10:48—11:12) Adriana

“The bib is the seatbelt. You don't get out of the car until you take your seatbelt off. So, when you have that bib on, it is holding you down. It’s holding you back. I'm not quite finished. I'll take your bib off once you're finished here in our appointment. So, it’s a signal to the patient that they are still in treatment.” (11:36—11:55) -Adriana

“The biggest gift you can give your admin team is setting the expectation for what they are coming back for and how much time they are going to be in the office. That way, on that walk from your operatory to the front area, they can think, ‘Oh, wait. I have to be here two hours, and then I come back two weeks later for an hour. Okay. Let me start managing, in my brain, my time, my schedule.’ And I can have already told them the next visit we have available is going to be next Wednesday at 9:00. Ariel will help you with that on your way out.’ That way, we've already set that in their brain, and they can start rolling it around. Because some people aren't processors. They can't make appointments on the fly. So, we want to respect that. But I also, when I get up there to Ariel, I don't want Ariel to look at the patient and think, ‘What do you need scheduled for?’ And then, the patient says, ‘What? Two hours? She just said I had a crown. Two hours? That's crazy!’ So, we really want to give that gift of this beautiful handoff.” (13:34—14:39) -Adriana

“I love the handoff. Because not only, one, it helps you make sure that I'm scheduling correctly for your clinical schedule, but it also — that walk of amnesia. I don't know why it’s real, but it’s real. So, the patient needs to hear it again so that when the patient goes to tell me, ‘Oh, no. I don't need to come in in two weeks,’ ‘Well, actually, they just told us together. So, we’ll see you at that 7:00 a.m. time.’ It helps and makes sure, and they all know that, ‘Oh, they're on the same page.’ I can't play mom versus dad, or aunt versus uncle. Can't play good cop, bad cop because they know we’re in communication. We’re on the same page as a team.” (14:41—15:23) -Ariel

“You have to say something eight times for someone to hear it one time.” (15:57—16:00) -Ariel

“Naturally, we don't process things or hear things until we’ve heard it over and over and over. We need to hear it seven times. So, on that eighth time that you've said something, now it sinks in, ‘Oh, okay. I got it. I know this now.’” (16:06—16:23) -Ariel

“‘I know I have an appointment at noon. It’s 9:00, and I'm going to have to cancel.’ ‘You know what? Let me get your provider. I'm going to let you go ahead and talk to her. I'm going to place you on a brief hold.’ I'm going to give them a little bit of time to think about, can they really not make that appointment, or could they squeeze it in today.” (18:38—19:00) -Adriana

“It’s okay to say, ‘Augh, this was a really long appointment scheduled in doctor’s time. We scheduled it specifically for you. Is there any way that you can make it?’ It’s okay to make sure that they understand that they're really putting you at a disadvantage by doing this. Or even telling them that this is such last-minute, there's no way that you can get another patient in that appointment slot. So, now, they're like, ‘Oh, okay. Not only am I hurting the doctor, but now another patient that could've been in.’” (20:01—20:37) -Ariel

“The worst thing you could say when it comes to Say This, Not That is, ‘That's okay.’” (21:04—21:07) -Kirk

“I can tell you from my evil hygienist days, ‘Oh, 20 minutes [late]. Oh, goodness. Well, I had you for 45. You've missed half of your appointment.’ And then, they're staring at me. I'm like, ‘Ugh, I mean, we can see what we can do. But you're going to have to come back. Now, we’re going to have to have two visits to make up for one. Let me see if that's okay with the doctor.’” (21:28—21:53) -Adriana

“You tell them, ‘Well, we had you scheduled. I don't know if we’re even going to be able to do everything today. Unfortunately, I'll have to go check with your provider and see if they're okay with the amount of time we have left.’ And as an administrative team member, I always left it up to the provider because they're the ones that know, can they get it done, can they not get it done. Or sometimes, they would say, ‘Yup. Well, we can do diagnostics and the exam today, and then they can come back.’ So, I would tell them, and then the patient would get upset. And, ‘I'm sorry, but we had you scheduled at 4:00, and it’s now 4:20. So, next time, we’ll need you to show up at 4:00.’” (22:00—22:41) -Ariel

“The important thing is, number one, letting them know this is not okay. Don't say, ‘No problem.’ Because when you say, ‘No problem,’ and they're 10 minutes late, what do you think is going to happen next time? They're going to be 15 minutes late.” (22:43—22:53) -Kirk

“If it’s their first time, I always say, ‘Try to see them.’ Of course, I'm coming from the administrative side of it too. But try to see them because they did make an effort. They did show up. And do I really want to schedule them out for the chance of them being late again if I can go ahead and get it done today, while still telling them that they're late, ‘It’s not okay. We’re going to do what we can. Next time, I really need you to show up on time,’ but then, they're at least appreciative of it as well?” (23:14—23:42) -Ariel

“Now, if it’s the second, third, fourth time [they're late], well, I don't know why they're in your schedule. But if they are showing up, that's when I would say, ‘You know, we talked about this, Mrs. Smith. We really cannot keep doing this. We’re going to have to reschedule, and we’re going to need you to show up on time for that appointment.’” (23:44—24:02) -Ariel

“It reminds me a little bit of my parents — a little bit of tough love. They want the best for you, just like your provider does. But some of it is teaching them tough love and a lesson. They have to understand. They might learn your value. You're more than happy to provide the service, but you guys have to learn that our time matters too. And if you're coming to see us, you need to respect that and do everything you can to be on time.” (24:15—24:40) -Andy

“We’re teaching people how to treat us. In a business, you teach people how to behave. You teach them how to treat you. If they constantly are late and constantly don't show, basically . . . we’ve let this happen over time.” (25:01—25:23) -Kirk

“I've always been the one to call and say, ‘We had you scheduled at 3:00. I hope there's no emergency keeping you from us. Please give us a call back.’ That way, they know that we care, and the only reason that they didn't show up for their appointment that's okay, in my mind, was an emergency. And then, if they do call, and hopefully they do, that's when I would bring it back to, ‘Oh, was there an emergency? Is everyone okay?’ Making sure that, one, they are okay because they no-showed. But if they have to make up an excuse, it goes back to making them sweat a little bit of, ‘Oh, no.’ Well, now, I also know I'm not going to give you those prime-time slots if you admitted to no-showing for a nonemergency.” (25:40—26:25) -Ariel

“The no-shows are tough. I had this discussion with a team, ‘What do you do about a new patient that no-shows?’ And I was like, ‘Oh, you're asking the wrong person because I'd say they do not get another try.’ It’s really challenging. For someone that you know that has never no-showed before, you give them some grace. Something could've slipped. But for someone who you scheduled, you had extended time for, they were confirmed, and then they blew you off — you don't know them, so you don't have a relationship. That's a tough one.” (26:31—27:09) -Adriana

“There are things we can do to improve the relationship before we see [patients]. And so, one of the steps that we crossed over is calling patients in advance before their appointments. I'm a big fan . . . If you're a restorative doc and you only have 1,200 patients active in your practice and you get 20 new patients, it’s worth your time to do a small pre-phone call and say, ‘Hey, Adriana. This is doctor so-and-so. I'm looking forward to seeing you tomorrow. I wanted to reach out and say hi.’” (27:29—28:00) -Kirk

“I have several office managers that [call patients in advance]. And they will, ‘I'm the office manager here. I want to make sure you have a great experience. I will be your contact. Once you come into the office, you will meet the rest of our team. They're amazing.’ And then, it goes from there. But they know they have a point person, and that's helpful.” (28:17—28:37)

“The [confirmation] call, in general, if you can get the doctor to do it, that's the best. And then, secondary, definitely a team member, especially as the world is moving to online scheduling, because online appointments have literally no connection. They haven’t even spoken to any team member to make this appointment, so it’s very easy to cancel because they have no commitment. They have not talked to anyone. So, especially with online appointments, I would say make the phone call to reach out to them and welcome them. Even if they’ve already filled out all their forms, they’ve already got all the information, it’s still nice to welcome them and say, ‘We’re looking forward to seeing you,’ making sure they know where to park, whatever it may be.” (29:02—29:44) -Ariel

“There are ways to be nice without saying some of the key trigger words. Don't say, ‘If you need to cancel.’ Well, I wasn't even thinking of cancelling. And now, you put that word out in the universe and in their mind. Or, ‘If you need to reschedule, please give us a call.’ In our minds, as administrative team members, we want to know ahead of time. We want to avoid the no-show. But now, we've put it out there. Where if I never tell you, ‘It’s okay to cancel,’ or I never even say the word cancel, it’s not in your mind. You're not thinking, ‘Oh, yeah. She told me to call her if I needed to cancel.’ So, keep those words out of your vocabulary when you're scheduling, when you're making phone calls, if you're confirming. Don't give them the option.” (29:51—30:39) -Ariel

“I would say get rid of the word “cancel” completely. Nobody ever cancels on you. The new phrase is, ‘There's a change in schedule.’ Because if you're ever calling a patient going, ‘We had a cancellation today,’ you could probably trade that out for “violated”. ‘Hey. We had a patient violate us today and totally blew us off. You want to come in?’ No. In a great business, in a great dental practice, they don't have cancellations. They might have a change in schedule, which is a nicer way to say it.” (30:42—31:08) -Kirk

“Remember, at the end of the day, this is always about trust and relationships, always. So, you've got to make sure that your practice screams that.” (31:37—31:44) -Kirk

“Figure out what your pain points are in your own practice and come up with some things that are comfortable and natural for you to say in your own way. You don't want to sound like a script, but we can always be here to help too, to give you pointers and tips.” (33:23—33:39) -Adriana

“Outside of roleplaying, because no one likes roleplaying, when you hang up the phone or when a patient leaves, take 30 seconds and audit yourself and say, ‘Augh, dang it! I said cancellation. Ugh. Next time, I won't.’ And that makes you aware of what you're saying. And soon, you will see it gets less, and less, and less. And then, eventually, it'll become pretty much extinct. And sometimes, you'll catch yourself. But then, it'll be like a trigger in your mind of, ‘Oh, I said that,’ and you won't say it again. Keep auditing yourself.” (33:47—34:18) -Ariel

Snippets:

0:00 Introduction.

2:32 The importance of scheduling and why it’s a problem.

2:53 Questions to never ask your patients.

7:30 Tell people what you can do, not what you can't.

11:20 Why the bib is important when prescheduling patients.

12:33 Tips for preconditioning your patients at the chair.

15:37 Be okay with repeating yourself.

17:19 Guide patients as a team.

18:03 What to say for cancellations.

21:14 What to say to late patients.

22:53 Should you reschedule late patients?

24:03 Give patients some tough love.

25:25 What to say for no-shows.

27:09 Confirming patients with verbal skills.

28:49 Other trigger words to eliminate.

31:52 Last thoughts on Say This,...

Finding Your Path to Financial Freedom

Episode #507 with Dr. David Phelps

How do you gain more freedom in your life? It’s all about cash flow, cash flow, cash flow — and you can create it outside of Wall Street! And to help you find your path to financial freedom, Kirk Behrendt brings in Dr. David Phelps, creator and CEO of Freedom Founders, to share those alternative investment strategies. While it’s not for everyone, you can supplement and even start replacing active practice income with real estate. To learn how with Freedom Founders, listen to Episode 507 of The Best Practices Show!

Episode Resources:

• Dr. Phelps’s social media: @DrDavidPhelps
• Freedom Founders: https://www.freedomfounders.com
• Freedom Founders Facebook: https://www.facebook.com/FreedomFoundersGroup
• Dentist Freedom Blueprint Podcast: https://dentistfreedomblueprint.com
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

Books by Dr. David Phelps: https://www.amazon.com/David-Phelps-DDS/e/B00RPCHD42  

Main Takeaways:

You can diversify your portfolio with real estate.

Don't invest all of your wealth into 401(k)s and stocks.  

Understand your “freedom number” and lifestyle burn rate.

Get your passive or asset-based income higher than your burn rate.

Be proactive with your finances to finally step off the financial treadmill.

Quotes:

“What I learned in life is in order to really have financial freedom, the real focus has to be on cash flow.” (16:06—16:14)

“I'm not saying investing in 401(k)s, the stock market, index funds, and mutual funds is a bad thing for people to do. But I found, in my experience — and now we’re hundreds of members of Freedom Founders — that the curation of real estate alternative investments, and particularly, the inefficiency of that market, allows for a lot more ability to navigate like we’re doing right now in the markets where we have a lot of downside risk protection. So, my philosophy, overall, is to really gain financial freedom, which is what we’re all after, at some point.” (16:17—16:51)

“How about practicing on your own terms where you can ditch some of the PPO managed care contracts you've got, or just practicing because you like to do it? You need to replace a certain amount of your active income. Maybe not all of it. So, it’s asset-based income. When you focus on the cash flow, there's also value-add inflation hedge to real estate.” (16:54—17:15)

“It’s the cash flow, it’s the cash flow, it’s the cash flow. That's where we differ from Wall Street, which is all about accumulation. You'll build up an estate, build up as big as you can. And then, when you “retire,” you're going to start to deplete it 3%, 4% a year. And they have these algorithms, over time, you'll deplete it. And hopefully, by the time you expire, about that time is about the time your accounts will expire. We look at it completely differently. We never want to kill the golden goose. The golden goose continues to produce. In fact, that's what gets to be passed on to heirs and beneficiaries in this way. So, that's the overriding philosophy.” (17:16—17:49)

“The first milestone is getting to a point where your passive or asset-based income, that cash flow, is equal or a little bit more than your lifestyle burn rate. So, your burn rate is different than your income. Most of the time, your income is going to be up here, and you pay taxes. And then, you get down to your lifestyle, and you put money in savings or investments. So, I want to show people that if you can get to whatever your burn rate is, that's going to give you a lot of margin for peace of mind. It doesn't mean you're ready to retire, but it means you've got peace of mind to actually change the model under which you're currently living your career path, your practice, whatever it might be, that you could even take some pressure off. Because when you know you've got something there that's giving you a safety net, everything changes.” (18:24—19:12)

“The first step is figure out your freedom number, which is your lifestyle burn rate, and reverse engineer. We look at, what do you need in actual capital that you could invest in the right kind of assets to produce that income? And so, we’re very diversified in real estate. Some people say, ‘Well, if you're in real estate, that’s not very diversified.’ But I say, ‘Well, actually, you can diversify a whole lot in real estate.’ I'm not saying that needs to be the end-all for all people. It is for me. But I've been doing this for over four decades, so I'm very comfortable with it. But when people first come to Freedom Founders, we let them take baby steps because most of them have had money in the markets and 401(k)s. And look, I get it. So, we, little by little, encourage them to test-drive another model. And before long, most people have moved a significant amount of their capital from the stock market Wall Street into alternatives.” (19:25—20:15)

“Wherever people are, whether it’s in business or investing in assets, it’s a time to realize that the markets are changing a lot. And whatever people thought they knew or experienced in the last several years is changing. It doesn't mean you quit. It doesn't mean you put your head in the sand. But you have to realize that you have to be very prudent about your next moves. And there are good moves and not-good moves. It depends upon where you are in your life, and what assets you have, and the skillsets.” (22:37—23:03)

“Probably the greatest thing . . . it’s about relationships. Who do you know? Who do you know that you can trust for insights about anything in life?” (23:03—23:14)

“Realize your own time value, what's important. If your time is better expended in your practice — which, for most doctors, it is — and with your family, then probably trying to have a few rental properties on the side until you get to a certain run rate of those kinds of properties, you can't really scale it — scaling it to get over the hump where you could actually afford to pay a manager, or be more passive in investing into real estate syndications or funds, which is more passive. But then again, you've got to know, ‘Who am I investing with, and what's their track record? What do I know about them?’ That's a whole other level of due diligence that you don't necessarily have to do so much when you're in control. Now, you're giving up control to buy your time back. There's always a trade. There's always a trade.” (24:11—24:56)

“The freedom number is your lifestyle burn rate. If you can keep that down — I don't mean to live like a pauper. I don't mean to live in austerity like you did when you were a student. But don't go for the, ‘Let's get the big house in the big neighborhood, and let's get the big cars.’ If you can keep things down and truly learn how to get invested in assets that will produce some kind of a dividend or rent or interest off of assets, and see that number start to climb, and don't let your lifestyle elevate faster, and if you can get it even close within a few years by keeping your lifestyle down to a decent modicum of living, that changes everything. And it’s hard to do. It is so hard to do because we go to school for all these years, and we've invested time, and we’ve got student loan debt. Of course, that has to be paid back. And that is a real anchor to people. But still, you've got to build the stuff in. Because if you don't, you get on a treadmill. You get on this treadmill. And it’s like, ‘When do I get off this treadmill?’” (27:27—28:36)

“In your mid-to-late 40s, your 50s, for sure, mentally and physically, the work that we do in dentistry, it’s exhausting. It takes its toll. And so, if you're going to want to practice for longer-term — and I'm not saying that people are going to have to. Again, if you watch your finances, you're not going to have to. But let's say you want to. You want to have longevity. Just like a prime athlete, particularly in athletics that are very physical like football, well, those athletes don't usually last very long because it’s so physical. They get pummeled and beat down. And if they get three, four, or maybe five years, that's a career. Well, dentistry could be, relatively speaking, the same thing. I mean, three or four years is small. But let's say you go really, really hard early on and bust it for 15, 20 years. Your body is not going to be able to take it.” (28:43—29:31)

“If you have a little bit lighter run rate and don't feel compelled to have to play the societal expectations of, well, you're not successful unless your practice is doing this, or you're having a run rate of this, or this many ops, or you don't have multiple practices, or you're not doing this or this — I mean, the comparison factor today, not just in our industry but in society, overall, I think, is very, very bad. And I think people need to say, ‘Look, I'm going to live my life.’ A lot of our young people are looking at it that way. We see it with the generations coming up. Not so many are as compelled as maybe we were about, ‘We’ve got to get out there and hit it, and crank it, and take it while we can get it.’ There's a whole lot of life for you to live if you take a little bit more of your time and don't feel compelled to have to keep up with everybody else.” (29:31—30:16)

“Geography plays a big part. There are places in the country where it definitely makes more sense to rent or to lease. Realize, when you buy and you own, that real estate — again, I'm very much a fan of real estate. So, you might say, ‘Well, sometimes it makes sense to rent.’ But you tie up a certain amount of capital. Typically, on a commercial building of any kind, the bank, today, is going to require you to put probably about 30% down. Well, if you're talking about, let's say, a $1 million building, which that could be the case in many places, that's $300,000. That $300,000 is tied up in real estate, which is good. But when you're in a business building mode, having access to cash, and not having to borrow everything you do to expand or add to, your biggest engine is your business, your practice. Don't start putting too much money out into investments until you've really optimized your business strategy or model. I think too many people start thinking, ‘Well, I need to go out there and get all this money invested in other stuff.’ Even though I'm a big believer in real estate, I still tell people, ‘Look, stay focused on where you're going to get the biggest return on investment.’ In business, if you do it well, your return on those dollars invested, it’s going to be at least 50% to 100%. That's your return on well-placed invested money back in your business.” (31:09—32:25)

“As soon as people start making money in their business, they’ll start complaining to their CPA, who tells them, ‘You'd better write this big check, Dr. Jones. Get ready. Coming up in April, you're going to owe $75,000.’ Dr. Jones has barely written a $75,000 check in over four or five years, and all of a sudden, he’s profitable. And he’s going, ‘Oh. What can we do about this?’ And the CPA or the financial planner goes, ‘I've got exactly the thing for you. It’s a 401(k).’ ‘Oh. How does that work?’ ‘You put money into this vehicle. It’s going to compound. And you get a tax deduction, so it’s going to lower your taxes.’ ‘Great! Sign me up. Sign me up.’ There's, in Wall Street, a great marker of this. It’s really a construct that's been oversold.” (32:49—33:31)

“I'm not against the discipline of people putting money in anything where they are actually doing it on a regular basis. That's not the worst thing that could happen. But what I don't like is the fact that when you put money in tax-deferred retirement accounts, that money is locked up until you're 59-and-a-half. You can't take it out without paying a penalty in tax. So, even though people say, ‘Well, it’s compounding,’ yeah — but you know what? In your hands, your ability to use that money in other opportunities can far more make up for these — it’s not even savings in tax. It’s a tax deferral because you will pay that tax someday. So, it’s not tax savings. You're putting it off.” (33:32—34:06)

“Your tax rates are likely to be higher down the road when you “retire” or start taking money out than they are today. It’s just, I think, a fact of life. We can all say taxes are not going to go back down. They're going to go up. So, is it better to pay taxes on the acorn, that is, the money down here, versus the oak tree up here? Well, it makes more sense to pay it here, be done with it, and have what I call unfettered money that you could put in anything. You could put it in your business, your practice, real estate, or even stocks and bonds. I'm just not a fan of locking that money up where you can't get to it.” (34:07—34:37)

“I can't tell you how many people come to Freedom Founders where the majority of their wealth outside their practice is in 401(k) type vehicles. I'm talking about significant, seven figures or more. And yet, they're 42, 45, 49 years old. They're a decade or more from being able to access that money. Yet, if they have that money that they can actually put in viable investments today that can get the cash flow, they could cut back on their practice time immensely, if not sell. But it’s locked up. And I go, ‘You know, we can help you self-direct that money, at least get it out of the stock market, if you wish. But you still can't touch it until you're 59-and-a-half.’ And they just drop their head and go, ‘Ah, I wish I would've known.’ It’s not for everybody. Some people, if that's all they do and they make a regular contribution, then that's better than doing nothing at all. So, I'm not trying to bash it. But for people who really want to be on the forefront of their finances and their future freedom, I’d say it’s better to keep that money close to the nest and use it appropriately for your means.” (34:38—35:40)

“Being a landlord, it’s not all fun and joy. There are things that you have to take care of, even if you have a “manager”. And so, it depends on your personality, it depends on the market, it depends on where this building might be. So, I'm not saying you do it or you don't do it. It’s really got to be an assessment that somebody helps you look at it, scrutinize it from all the angles, and then make a decision. It could be a really good decision, or it could be a really bad decision.” (37:42—38:08)

“I think it’s time to go back to quality and say, ‘How can I get more freedom in my life?’” (41:34—41:38)

“As long as you keep escalating your lifestyle as fast as your income goes up, you really never get free.” (41:44—41:50)

“If you get to that [freedom] number quickly with investments replacing your lifestyle burn rate, it changes everything. And that's what I try to sow into everybody I talk to, especially young people who are starting out, because I think they look ahead and go, ‘I should be doing this and this by this age to have this kind of house.’ It’s like, stop that. You're going to be a lot freer a lot sooner if you change that model a little bit.” (42:00—42:20)

Snippets:

0:00 Introduction.

1:55 Dr. Phelps’s background.

4:03 The important call that changed his life.

10:11 The genesis of Freedom Founders.

15:08 Why this topic is important in dentistry.

17:50 Financial freedom, explained.

20:20 What most people get wrong about real estate.

25:33 Advice for getting started.

30:26 Should I own, or should I rent?

32:38 Tax-deferred retirement accounts, explained.

35:48 The landlord market.

38:26 Books by Dr. Phelps and more about his podcast.

40:56 Last thoughts.

Dr. David Phelps Bio:

Dr. David Phelps owned and managed a private dental practice for over 21 years. While still in dental school, he began his investment in real estate by joint-venturing with his father on their first rental property. Three years later, they sold the property and Dr. Phelps took his $25,000 capital gain share and leveraged it into 31 properties that produced $15,000 monthly net cash flow.

Multiple health crises suffered by his daughter, Jenna (leukemia, epilepsy, and a liver transplant at age 12), caused Dr. Phelps to create the freedom to leave practice and make time for what mattered most.

Today, Dr. Phelps is a nationally recognized speaker on creating freedom, building real businesses, and investing in real estate. He authors a monthly newsletter, Path to Freedom, and hosts The Dentist Freedom Blueprint podcast. He is also the CEO of Freedom Founders, through which he provides hundreds of professional practice owners a blueprint to create Freedom in their own lives. 

How to Help Your Patients Take Treatment Seriously

Episode #506 with Christina Byrne, Angela Heathman, & Heather Crockett

Do you ever tell your patients it’s “just a little cavity” or “only a quick screening”? If you want them to take treatment more seriously, you need to change your language! And to help you shift your thinking, Kirk Behrendt brings back three of his amazing ACT coaches to explain what minimizing language is, how it’s affecting your treatment planning, and ways to eliminate them from your practice. Minimize your minimizing language! To learn how, listen to Episode 506 of The Best Practices Show!

Episode Resources:

• Christina’s email: [email protected] 
• Christina’s social media: @actdental
• Angela’s Facebook: https://www.facebook.com/angeheathman
• Angela’s social media: @angeheathman
• Heather’s email: [email protected] 
• Heather’s Facebook: https://www.facebook.com/heather.r.crockett
• Heather’s social media: @actdental
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

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

Main Takeaways:

Your language matters!

Stop devaluing your work with your words.

Don't downplay patients’ diseases with what you say.

Roleplay with your team and practice saying the right phrases.

Your entire team needs to be aligned and calibrated on language.

Quotes:

“The problem that we’re talking about is using minimizing words when we’re explaining treatment to our patients. Why is this so big? Because if you're going to the doctor’s office and they tell you that you have cancer, they're going to tell you what stage of cancer it is. And then, you understand at what level, what degree that cancer is at. We need to use the same outline in dentistry in order for our patients to understand the diagnosis that we’re recommending.” (4:45—5:14) -Heather

“[Minimizing language] is any phrase or word that you use that makes . . . what you're doing, what you're seeing, what they're experiencing less than what it actually is. So, an example of that might be using, ‘You have a little bleeding. You have a little cavity.’” (5:30—5:53) -Angela

“I hated when the doctor would say we were going to “watch” something. Because from [the hygienists’ perspective], we got to see the patient when they sat down in the chair from what they have done or not done in the last six months. And so, I know that this patient doesn't live in the same household with his toothbrush. The doctor doesn't know that when he or she comes in because I've done such a great job of making them look good and removing that plaque and calculus and stain. So, from the hygienists’ perspective, we tend to be a little bit more on the aggressive side because we know what that patient looks like and what their home care is.” (6:25—7:03) -Christina

“Start with listening to yourselves. I can remember going into practices and talking about this same exact thing and having the teams practice it. So, literally, sitting in the operatory and have one of the team members pretend to be the patient and the doctor talk about what he or she is saying. And one practice I was observing, and it wasn’t a real patient, it was one of the team members, but the doctor was saying, ‘A little cavity,’ or, ‘A little bit of bleeding.’ And I would pipe in and say, ‘How much bleeding? How much cavity?’ Because it’s so ingrained. We feel like we have to wear our patients’ diseases.” (8:27—9:11) -Christina

“I worked with a doctor years ago, and I won't say who, but that doctor would apologize when they would see something. So, they might find a cavity, ‘I'm so sorry. You have a cavity.’ Like, no! You're not sorry. They did this on their own! You had nothing to do with it. We’re so ingrained to want to help our patients so much. But we’re not helping them if we’re not being honest with them.” (9:12—9:44) -Christina

“It isn't ours. The patient needs to own that this is their diagnosis. They have periodontal disease — not “we found”. You have periodontal disease. And that takes the onus off of the doctor and the team members too, to say, “you have”. And to Chris’s point, backing up all of your recommendations and diagnoses with some kind of data, especially when it comes to periodontal disease. If we’re not perio charting our patients, what information do we have to back up that diagnosis?” (9:48—10:27) -Heather

“It’s not always about minimizing the treatment. Sometimes, we’re minimizing what we’re doing. Like, we might be doing an oral cancer screening, and instead of saying that we’re doing an oral cancer screening, we might say something like, ‘I'm just going to check for anything that looks abnormal,’ or something like that. And no — you're doing a very important screening for the patient. And they need to know that part of it too. The same thing when you're doing X-rays or taking a pan. You're checking for very specific things, and you can mention that. You don't have to say like, ‘Oh, I'm just looking for this.’ Make sure the patients understand the value of what your exam or your diagnostics are too.” (12:04—12:54) -Angela

“Patients value [exams and diagnostics]. They’ll value it more and ask. If it’s been a couple of years and they haven't had that pan, and you explain to them the reasons why you take a panoramic X-ray, they're going to ask. The good patients that you want there in your practice, they're going to ask and say, ‘We haven't taken that big X-ray. You know the one that goes around my head? We haven't done that in a while. When do we need to do that again?’” (12:55—13:17) -Heather

“The reason to take bitewings is not because you're due.” (13:19—13:21) -Christina

“When it comes to talking about scaling and root planing — and when I was a clinical hygienist, and this is what I also talk to my teams about — is using the same verbiage that the insurance company is going to use when they get the explanation of benefits. So, oftentimes, we’ll say deep cleaning or periodontal therapy. If we say scaling and root planing, that's the exact same thing that's going to show up on that patient’s explanation of benefits. So, they're going to connect the dots and know that we did what we said we were going to do. Not only that, but then you can explain to the patient what that procedure looks like and tell them, without minimizing words but in layman’s terms, exactly what that is.” (14:25—15:07) -Heather

“I would usually say something to the effect of, ‘I need to go below the gum tissue where you cannot clean yourself at home with a toothbrush or floss. I'm going to use special instrumentation to make sure I remove as much of that plaque and calculus as I possibly can. And we’re going to, in some cases, smooth that surface so that bacteria cannot attach itself and wreak havoc again.’” (15:10—15:38) -Heather

“What Chris was talking about before, it’s very uncomfortable to start using language that you haven't been using. But I love, Kirk, what you say all the time, and we took it from Rachel Wall, tell me your feelings, your philosophy on periodontal disease. Now, tell me, what are you doing to support what you just said? And if you're still feeling uncomfortable with it, have a roleplay session and practice during a team meeting so that you can get used to it and get comfortable.” (16:56—17:25) -Heather

“I have a team who is really struggling with this. It’s hard, right? It’s really, really hard to change your language. And so, they have a jar. It’s the minimizing language jar. Every time somebody says “little” or “just”, they have to put their name in the jar. And their team helps them to, ‘Oh! Doctor, you said “little decay” again! You've got to stick it in the jar!’ And so, then, at their team meeting, they pull it out and they read about it and, ‘Okay, how can we make this better?’ And every week, it seems to be less and less, which is good. But it’s a good reminder for the entire team to help each other out and to keep each other accountable to that language.” (17:30—18:09) -Heather

“If it’s “just a little,” why bother?” (18:43—18:44) -Christina

“We would see patients in hygiene. And then, if the doctor happened to have time in their schedule, they would do the restoration that day. And oftentimes, the doctor would minimize it and say like, ‘Oh, this little cavity. I can do a little filling. We might not even have to use anesthetics,’ and he would totally minimize it. And then, guess what would happen when they went up front to pay? Well, they didn't have “a little” fee. They had the same fee as they’ve always been charged. And so, what we did at my office is any time the doctor said a minimizing word during an exam, the hygienist or the assistant would lightly tap the dentist on the top of his shoe. And at first, he would look up like, ‘What?’ And then, he realized like, ‘Oh, yeah. I'm doing it.’ And that would be a chance to recover on the spot and say, ‘And I'm so glad we caught it early, because this is going to get bigger.’ And so, that was a nice on-the-spot thing to do.” (18:49—20:04) -Angela

“Any time you're actively working on something with a coach or with your team and everybody knows about it, it’s something that's much easier to talk about. So, if you're trying to get better at scanning, or you're trying to get better at communication or your PIT Stop, if you can acknowledge that you're working on it, then it’s much easier later to talk about it.” (21:31—21:57) -Angela

“The entire team needs to be calibrated on this too, because that patient is going to go to the front desk and schedule, and you don't want your admin team member to say, ‘Okay, let's get that little cavity scheduled for you.’ You can't say, ‘Oh, that's a clinical thing.’ So, we have to do this across the board. Every single person on the team has to be aligned and calibrated on what to say.” (22:58—23:24) -Christina

“The more confident your team gets in these verbal skills, the more you'll see your treatment plan acceptance numbers go up and your schedules are full.” (24:34—24:42) -Heather

“It doesn't happen overnight. This is something that definitely has to be practiced . . . Think about yourself as a football team. When you're in practice, you're practicing against your teammates. You're practicing with each other so that when it’s time for the real game, you know what to do in front of the other team. And so, we could think about it the same way.” (25:12—25:38) -Christina

“Roleplay in the operatory, at the front desk, so that your brain has the muscle memory of having these conversations so that when it is “game time” and you're with the patient, you'll remember that you had this conversation already, even though it was with your team. And it gives you the ability to make mistakes with your team.” (25:40—26:00) -Christina

“I heard something really good the other day. Dr. Richard Short sent it to me, one of our members. It was a video of someone saying, ‘Practice makes, what?’ And the audience came back and said, ‘Perfect.’ And he said, ‘No. Practice makes progress.’ And I thought that was so great because we think about this ideal of perfect. You're not going to be perfect. Get that out of your brain right now. Even if you've been doing it great for a year, you're going to slip up. There's going to be a day when you're sitting with a patient and you're going to say, ‘Oh, there's a little bit of bleeding here. Augh! How did I do that!’” (26:01—26:36) -Christina

“Eliminate the [minimizing] word. You have bleeding. You have an infection. You have decay. Get rid of a little.” (27:10—27:23) -Heather

“One of our coaches, Courtney, recommends to her clients that they say action words like, ‘Your gums are bleeding. Your tooth is cracking. Your tooth is decaying.’ And I really love that.” (27:52—28:07) -Angela

“Grant yourself grace. You've been doing it one way for so long. Grant yourself grace. Start small, even if you eliminate one word. Focus on one of the words that we talked about and getting rid of that. And like Chris said, progress, not perfection, in the beginning.” (29:21—29:36) -Heather

“Think about it as a mindset shift or a mind shift. So, don't start your morning huddle and say, ‘Okay, we’re never going to say the word “little” anymore.’ Let's have a team meeting. Let's talk about the mind shift. Let's talk about the pitfalls that might be there. Acknowledge that, yes, we have done it this way for a long time, and we’re going to make a shift. And talk about it. Talk about why it’s important. And then, start the process.” (29:38—30:10) -Christina

“In the end, this is all about patients’ health. And if they understand what's going on in their mouth, we can get them closer to health. I think that's the most important thing.” (30:27—30:37) -Angela

Snippets:

0:00 Introduction.

2:10 What ACT coaches do and why they're amazing.

4:29 The problem, and why it’s so big in dentistry.

5:15 Minimizing language, explained.

8:19 Where to start.

10:49 Don't minimize exams and diagnostics.

13:54 Other words and phrases to be aware of.

16:26 The minimizing language jar.

18:10 Patients will devalue what you minimize.

20:50 Celebrate your successes.

21:59 Have a place to document your language.

22:52 Your entire team needs to be calibrated.

23:24 Unintentional benefits of changing your language.

25:12 Practice makes progress.

26:48 Eliminate the minimizing words.

28:31 Make it black and white.

29:08 Last thoughts.

Christina Byrne Bio:  

Christina Byrne has been involved in dentistry since 1985. Over the years, she has held many positions on the dental team, including dental assistant, business office, and dental hygienist. Christina’s extensive knowledge of the front office and clinical procedures is a great asset, and she loves to impart her knowledge to guide dental teams do the best they can to achieve a Better Practice, Better Life!

Angela Heathman Bio:

Angela Heathman is a Lead Practice Coach who works with dentists and their teams to help them accomplish their goals. She believes the hard work you do on your practice is just as important as the work you do in your practice!

Angela has over 20 years of clinical dental hygiene, dental sales, and practice coaching experience. When she transitioned from her role as a clinician to her role as a sales account manager, she realized both her passion for education and practice development. Angela holds a master's degree in dental hygiene education from the University of Missouri-Kansas City.

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. 

Different Mindset vs. Dangerous Mindset

Episode #505 with Dr. Tracey Nguyễn

For an isolating and difficult profession like dentistry, you need a strong and positive mindset. But how do you begin to develop it? One way is through community. And to help you find yours, Kirk Behrendt brings back Dr. Tracey Nguyễn from ASAP Pathway to share tips on where to go, who to seek out, and things to focus on early in your career. Your mindset shapes your life — so have the right one! To learn how, listen to Episode 505 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 the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Main Takeaways:

Find a purpose early in your career.

Seek out friends, mentors, and a community.

Think about the legacy you want to leave behind.

To become good at something, learn from the very best.

Work with people you respect, and whose work you respect.

Quotes:

“Early in your career, find a purpose. And once you find a purpose, and you find a goal, and you find what makes you happy, grab the people that will help you in that journey. I don't think that a lot of young dentists have that, but I think it’s important for us to seek that. And it’s also important for older dentists to mentor other dentists because we represent each other. At the end of the day, we represent each other. So, if one person isn't doing something right, it’s a reflection of the whole community.” (5:51—6:25)

“I don't think I grew as a dentist, as a person, until I joined the Kois Center, until I had that network of people to support me. When I look back, up until that 15-year [point], I was just working to get paid, working to pay the bills — and working to get paid really well. But I didn't really have a purpose.” (7:37—8:02)

“In the first track course, [Dr. John Kois] has a good 30 minutes to an hour discussion on tribe and the meaning of community and taking care of each other. And I think because he instills that in his students, the students do that for the other students. And I've never had that kind of relationship.” (8:30—8:51)

“The first Symposium after COVID-19, [Dr. Kois] ended it with, ‘Who’s got your back?’ And I thought this was so powerful that he said after COVID-19, he realized how many people had the Center’s back. And then, he said, ‘For as long as I'm alive, we will always have yours.’ And that was so powerful for everybody. And I took that, and I was like, ‘I want to do that for somebody else.’” (8:54—9:23)

“At the top of your career, it’s about your legacy. What do you want to leave back? And it’s interesting because you don't think about your legacy until you're doing well. But I think we should think about that right when you start, like with treatment planning, with the end in mind. How do you want to be remembered? What kind of life, what kind of journey do you want to have? And I feel like you should have that guidance in the beginning.” (9:39—10:06)

“I think what people don't understand is airway dentistry is doing dentistry with respect to the airway. So, it’s not like its own discipline. It’s really just straight dentistry but understanding how your dentistry can impact airway. I think that's where people are a little bit confused. But also, with airway management, the core of airway management is understanding the patient’s medical history, how they feel, what's going on in their life. And if you can connect with a patient on that level, it’s a different type of relationship. You will see the practice will grow.” (12:03—12:51)

“If you're looking at airway dentistry as, ‘How many full-mouth rehabs can I do?’ that's not what airway dentistry is about. Airway dentistry is about connecting with your patients, understanding the medical history, and guiding them throughout their entire treatment, their health treatment, and then including dentistry.” (12:51—13:10)

“When I introduce airway dentistry or that whole oral systemic connection, helping patients navigate through their whole medical history, they took it as, ‘Okay. You're not just someone that's going to fix my tooth. You're sitting here and you really care about me and care about how I sleep, how I feel, how I breathe. And, by the way, this is how my family is.’ And that's how my practice has grown. But airway dentistry isn't like, ‘I'm going to take an occlusion course and I'm going to do five rehabs.’ It’s a different philosophy.” (13:15—13:49)

“When you choose the practice that you work for, you should ask yourself, do you want to be like this person? When you pick a job and you're working for a boss, you should always be looking up to your boss. And so, when you pick a dentist, you're like, ‘Okay, would I want this dentist working in my mouth? Is this someone I really want to work for?’ And then, that person can also guide and mentor you in your cases, in your work, in your life.” (17:07—17:37)

“There's no growth in it if you're in a practice where you don't respect your boss, or you don't respect his or her work. And I think that “dangerous” is where you're just trying to chase the money. You're like, ‘This is a job. I need this job right now.’ But it’s not fulfilling if you don't like the door that you walk through.” (17:46—18:08)

“The worst thing that could happen is you fail, and you try it again. What's so bad about failing? You have to learn. Some of the best athletes in the world failed miserably before they got to where they are.” (19:37—19:52)

“I think we’re too focused on the quick and easy fix. The quick and easy fix is the money. And even when we talk about failure, not understanding why and self-acknowledgment, that's a big thing, not even recognizing what you're good and not good at and what to do about it.” (21:22—21:46)

“I was listening to Tony Robbins, and he said if you want to be good at something, find the person that's the best at it and go learn from them.” (21:48—21:56)

“We’re so focused on our skill. But how you communicate is almost more powerful than your skill.” (23:45—23:53)

“Find friends, find mentors, because I think this profession can be really hard on us, mentally.” (29:40—29:46)

“As dentists, we’re such perfectionists. So, when we have a patient that complains, it really takes us into a dark place. And you really need to find that support to get you out of it.” (29:55—30:06)

Snippets:

0:00 Introduction.

2:15 Dr. Nguyễn’s background.

4:50 Things to do early in your career.

6:27 The importance of a support network.

8:03 How the Kois Center creates community.

10:11 Airway dentistry requires a different mindset.

14:52 Find an office that will mentor you.

16:33 Don't just chase the money.

18:08 Failure is growth.

20:53 Learn from the best.

22:23 Learn how to connect and communicate.

24:58 About ASAP Pathway and how to get involved.

29:11 Last thoughts.

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.

Dr. Nguyễn 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.

Dr. Nguyễn 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 expertise by completing thousands of hours of advanced training at the most prestigious dental institutions across the country. 

Dentures Need Suction but They Don't Have to Suck

Episode #504 with Dr. Wendy Clark

Dentures get lost and broken — and that sucks. But your duplication process doesn't have to! And to convince you that dentures can be fun, Kirk Behrendt brings back Dr. Wendy Clark, an expert prosthodontist from UNC-Chapel Hill, to share what dentists get wrong and the advancements that have been made in the digital space. Digital dentures don't suck! To learn more about why they're great for you and your patients, listen to Episode 504 of The Best Practices Show!

Episode Resources:

• Dr. Clark’s Facebook: https://www.facebook.com/wendy.a.clark.9
• Dr. Clark’s social media: @drwendysworld
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

Carbon: https://www.carbon3d.com

Mission of Mercy: https://www.amissionofmercy.org

The Cupcake Technique by Valerie Cooper: https://www.youtube.com/watch?v=bl34KCyC5Yo

Main Takeaways:

3D printing is the future.

Digital makes dentures predictable.

You don't need a scanner to get started.

Digitizing is better for you and your patients.

Don't underestimate the value of record preservation.

Quotes:

“You really can't underestimate, in all of your practice, being kind to staff. It takes you to the next level.” (4:58—5:04)

“A lot of people don't like dentures, which I've never understood. But I always like to get in the psyche. And I think it’s because they're not very predictable. I tell my students you can do every single step correctly, every single step perfectly, and then it goes through processing, and there's an error. And that insertion appointment, your denture doesn't fit. And in practice, that's no fun. When you're a dental student and it takes you like 18 appointments to make a denture, and then you don't get to insert it at that appointment, it’s the worst sinking feeling.” (6:33—7:04)

“How can we make [dentures] more predictable? And digital dentistry is why it’s there, so you can get that predictable fit, support, stability, and retention, that suction. But dentures don't have to suck. They can be fun.” (7:07—7:19)

“Digital dentures have gotten such a bad rap . . . The first lecture I did on digital dentures was actually 2013, so I hope I'm starting to learn my stuff. And from that first lecture I did in 2013 to the last lecture I did last week, I always get the question of, ‘I don't have a scanner. I can't do this workflow. How can I do this workflow?’ And the great thing is, you don't have to have a digital scanner. You can jump into the workflow by digitizing your impressions.” (8:52—9:30)

“By now, most full-service laboratories will have a benchtop scanner of some sort. They can put your denture impressions in that the same way they put your crown and bridge impressions or your models for crown and bridge. So, truly, if you can partner with a dental laboratory that has that technology benchtop, you can send whatever impression material you're already using to your lab. So, take your PVS, take your alginate, and pour it in stone. Send a cast. The cast can get digitized. You can jump into the workflow at any point. So, don't be hesitant to try this new workflow and this more predictable denture technology because you haven't invested in a scanner yet.” (9:31—10:10)

“The first time I touched a CEREC was the CEREC 3 with the rollerball. And so, I think anybody that's been in the CEREC world knows the pain of using the spray and trying to keep everything isolated and trying to use the rollerball as a mouse instead of a touchscreen or a keyboard. And it was a process to try to trace that margin with a rollerball. And now, as technology has gotten better and started to catch up and become more affordable, the workflows have really opened up.” (10:19—10:49)

“When I was in practice, I remember everybody had the bad connotation of those first CEREC crowns. They were like, ‘Augh, they're not pretty. The margins are bulky. They're not polished right. Labs will always do better.’ . . . But CEREC crowns, now, are pretty. And if you follow the protocols right and you know what you're doing, you'll get a good crown. And the same thing with digital dentures. The first cases we did with the first 3D printed resins, when they first FDA-cleared, were not as strong as the PMMA that we used to use. And it didn't look the same. It didn't feel the same. It didn't polish the same. And so, it was hard to jump into that workflow where you're saying, ‘Well, digital dentures all suck.’” (10:50—11:49)

“I think that the value of record preservation is totally underestimated. Even if you have a conventionally made denture and you scan it and keep that in your records, now you have a digital preservation of what this patient always has. So, in a week, they lose their denture, they go on a cruise, and it falls overboard — I had a patient scuba diving and their denture fell out — rather than start at the beginning, and again, I work in a dental school where dentures are not necessarily two or three appointments. It can be a long process, start to finish.” (12:28—13:05)

“I had a patient last week whose denture was lost in the hospital. And I had to start from scratch because it was not done digitally. And so, you think about just the opportunity to save the patient’s time and to save your chair time by maintaining these digital records, is huge.” (13:06—13:21)

“We have to shift our lens. When you think about access to care, to me, that's one of the most underestimated aspects of 3D printing. We’re always comparing apples to oranges where, yeah, if you have a master ceramist like I had in my practice design me and handcraft this crown on number eight that they're custom staining chairside — it’s not going to look as good if I'm in my office printing something out on my printer that I'd done myself. But if I am at a service clinic and a patient can get a root canal for free, but they can't get anything but an amalgam to restore it with — and yes, we’re still using amalgam — then what service are we really doing for this patient? We’re stopping the service at an incomplete point.” (13:23—14:08)

“3D printing is our future. I think conventional hand-processing will always exist. And it always needs that human touch, so I don't think we’re going to be replaced by robots. But I think robots are going to make our lives more predictable.” (16:14—16:28)

“I'm going to appeal to all my denture technicians out there where the patient loves their dentures, and they want it duplicated. Man, it is so much harder than you would think to put those teeth in the same spot. You're working on all these putty matrices and trying to reposition everything. And you can get so close. And then, the patient is like, ‘Uh, I think this one’s a little shorter.’ When you scan it and duplicate it, you're like, ‘Nope, it’s a 1:1 copy! I have the digital file to prove it!’ And it helps with that predictability.” (19:42—20:11)

“If you have not ever done a digital denture in your life and you're still on that fence like, ‘I don't know if I want to do it. It’s a little bit intimidating. I don't know what the product is going to be like,’ immediate dentures are the way to go. And if you've ever made an immediate denture, they're the worst dentures.” (20:14—20:31)

“With digital, you have that preservation of record. I know that the incisal edge on my immediate is exact to where the incisal edge was of the patient’s pre-treatment, pre-extraction records. And then, you can always go back to the pre-extraction records. If the patient says, ‘Ah, you made my teeth too big,’ you can look and see if the teeth you chose are bigger than the pre-extraction records. You could never do that with conventional, and it unlocks so much possibility to eliminate that unpredictability. And so, they make immediate dentures not suck.” (21:03—21:37)

Snippets:

0:00 Introduction.

1:52 Dr. Clark’s background.

5:16 Dentures need suction, but they don't have to suck.

7:20 The Carbon printer.

8:25 Myths about dentures.

10:10 CEREC of old versus the CEREC of new.

12:08 What dentists get wrong about digital dentures and 3D printing.

15:02 The future of dentures and 3D printing.

17:20 Learning from her students.

18:27 Favorite tips and tricks for dentures.

21:49 Last thoughts.

25:32 How to get in touch with Dr. Clark.

Dr. Wendy Clark Bio: 

Dr. Wendy Clark completed her undergraduate training at the University of Georgia in Athens, Georgia, then earned her doctoral degree from the Marquette University School of Dentistry in Milwaukee, Wisconsin. She then earned her master’s degree in clinical dentistry and certificate in post-graduate prosthodontics from the University of Alabama at Birmingham School of Dentistry. She practiced prosthodontics for seven years with Team Atlanta (Goldstein, Garber & Salama). Throughout this time, she lectured nationally on a variety of topics ranging from smoking cessation to dental implants. She was named a “Leader in Continuing Education” by Dentistry Today in 2017 and 2019. Currently, she is full-time faculty at the University of North Carolina Chapel Hill in the Department of Prosthodontics.

Dr. Clark is a board-eligible prosthodontist, currently pursuing certification from the American Board of Prosthodontics. In addition to poster presentations at national meetings, she has co-authored articles published in the Journal of Prosthetic Dentistry, the Journal of Prosthodontics, Compendium, and the Journal of The American Dental Association. Current research and lecture topics include digital dentures, curriculum innovation, and bioactive restorative materials. 

10 Steps to Better Implementation

Episode #503 with Dr. John Cranham & Lee Culp, CDT

You have a ton of great ideas, and you're excited about all of them. But how do you put them into play? If you're struggling with implementation, don't miss today’s episode! Kirk Behrendt brings back Dr. John Cranham and Lee Culp, founders of Cranham Culp Digital Dental, with 10 steps to help you create a process for better implementation. Don't let your vision go to waste! To learn how to overcome the challenges of implementing your ideas, listen to Episode 503 of The Best Practices Show!

Episode Resources:

• Dr. Cranham’s Facebook: https://www.facebook.com/john.c.cranham
• Dr. Cranham’s social media: @johnccranhamdds
• Lee’s Facebook: https://www.facebook.com/lee.culp.cdt
• Lee’s social media: @leeculpcdt
• Cranham Culp Digital Dental: www.ccdigitaldental.com
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Links Mentioned in This Episode:

Episode 372 of The Best Practices Show with Dr. John Cranham: https://www.youtube.com/watch?v=V89AbeNNJHY

Kolbe: https://www.kolbe.com

DiSC: https://www.thediscpersonalitytest.com

Main Takeaways:

First, formulate your vision.

Sell your vision to your team.

Identify key players in your practice.

Block out enough time to train your team.

Always have open lines of communication.

Set benchmarks so the team can self-assess.

Encourage continuous, never-ending improvement.

Quotes:

“Every doctor that is trying to be better has to hone this skill. They’ve got to be able to decide they want to do something, get excited about it, and then have some steps that they can follow. And understand that whatever you're doing, whether you're learning scanning, or you've gone and taken a class from Frank Spear and you're changing your prep design, whatever it is, you have to go through this process. And there are going to be some bumps and bruises and a little bit of frustration. And the last thing that's really important is you can't go it alone. You've got to get the people around you excited about it and make them feel that they're a part of it.” (6:24—7:00) -Dr. Cranham

“Getting excited is one thing . . . But then, it’s really committing to, ‘Is this what you want to do?’ That's the first question you've got to ask yourself, ‘Is this really what you want to do?’ Understand the responsibility that you're putting onto yourself to do it, and then go do it.” (10:55—11:15) -Lee

“Step one is, you have to formulate a vision, a really specific vision, about what it is you're going to do. And the thing that I always asked myself was, if I wanted to implement a scanner, or I'm implementing a new protocol, or whatever it is, I want to know specifically, regarding predictability, efficiency, and profitability, ‘How is my practice going to be different at the end?’” (13:32—13:58) -Dr. Cranham

“I think that for most people, the difference between excitement and really having a vision is that excitement sort of wanes.” (14:22—14:31) -Dr. Cranham

“When you're implementing something new, you have to think less about the ROI and more about what it’s going to be like when you reach that destination, because the ROI will come then.” (15:22—15:32) -Dr. Cranham

“[Step] number two is to share. And I would even say sell the vision to the team. And what I didn't do for a long time is I never really — I would say, ‘This is what we’re doing.’ And that certainly works if you're authoritarian. But what works better is if you can share or sell the vision to the team and really explain to them what is in it for them, whether it’s a time-saving thing or something that's more profitable that can lead to bonuses. Whatever it is, you have to get them to understand that this culture of growth, this culture of implementation, this culture of continuing and never-ending improving, is going to be something that is good for them.” (18:31—19:18) -Dr. Cranham

“[If you don't sell your vision to your team,] it’s very easy for them to just say, ‘So, I've got to now do something else in front of a patient for the first time, and I'm going to feel awkward and stupid, and they're not going to like it.’ And that's what goes through their heads. That's real. That's real the first time they do those things. And so, scanning is a great example because, initially, it’s kind of like, ‘Why? We get good impressions this way.’ But then, if you can imagine selling them on what it could be, there's no question the experience is better for the patient. They like it better, it’s faster, all those things. But if you can first get really clear in your brain and get excited about it, and then have the ability to sell it to the team, I think there's another part of that in the process of being prepared to share and sell the vision to the team. I think it further solidifies the vision into your brain too, because now you're pulling other people along with you that if you're having a little bit of a down day, they're going to be the ones to say, ‘Hey, we said this. This is what we’re doing.’ There needs to be a level of accountability for the culture of the organization.” (19:18—20:31) -Dr. Cranham

“I like to lump [steps] three and four together. Three is, identify the key players in the practice. But also, in my mind, I'm thinking about, ‘Where am I going to get the best information, or what's the person out there that's getting the results that I would like that I can copy that can potentially be a trainer?’ And the reason I like to do that is because I want to make sure that the people that I'm thinking about also are going to fit with who I think is going to be training.” (22:51—23:23) -Dr. Cranham

“People under 35, they get digital. Like, they think digital. A lot of us old guys, we learned analog, so it’s kind of like learning a new language where you're thinking analog. You're looking at digital but translating back to what you know — analog. And so, sometimes, if you're implementing digital, maybe the most experienced person on your staff isn't the best person. They may really struggle digitally. There might be a younger person in your practice that potentially could grab a hold of this and become a star. So, that's one of the things I was going to say, is that my strategy would be to find the trainer, maybe talk to the trainer and get opinions from them about who I should be looking at as a key player, depending on what it is.” (23:46—24:40) -Dr. Cranham

“You've got to identify those key players. And then, at the same time, you also have to be thinking about, ‘Where am I going to get the best information?’ I found out a long time ago, it doesn't make sense to just recreate the wheel. The best way to get good at something is to find somebody who’s getting the results that you want, and then copy that behavior. That's why I hung out with Lee when I went down this road.” (24:53—25:16) -Dr. Cranham

“When we get to [steps] five and six, now we’re starting to execute. And this is where I stumble a lot because I'm more of a visionary. I like coming up with the idea. I get excited about it. I can see crystal clear where I'm going. And I don't always think about all the little baby steps. I just want it to happen. And so, that's why these are the important steps, for me, to really make sure I set it up so that we can block that training time.” (26:27—27:04) -Dr. Cranham

“As we train, [make] sure that we’re not going to just dive into it. We’ve got to get the front desk involved so that when we start scheduling procedures for the first time that they understand, ‘We’re going to need a little more time. As we start doing this on live patients, we’re going to need a little more time.’ Because the last thing you want to do is throw it in there, not have enough time, and create tons of stress on the person that's doing it, and maybe get a bad scan that the lab has got to kick back. So, [steps] five and six become extremely important, blocking the time for training, and then also when you start bringing it in, making sure you've got a little more time.” (27:06—27:47) -Dr. Cranham

“What's interesting about the team we have here at the laboratory is most of them are a whole lot smarter than I am. So, it’s kind of fun to, ‘Here’s the vision.’ Implementation is just me pushing. But I tend to hand off the responsibility of, a lot of times, figuring out how to do it because they know how to do it better than I do.” (28:03—28:30) -Lee

“It becomes a little bit more freeing when you have some people that understand that that's their job. When I hit about 40 and it started to become where I couldn't keep it all in my head, I went through a very stressful time until I started to put some layer in place that could help me with that. And you need that as a businessperson, for sure.” (31:35—31:57) -Dr. Cranham

“[Sometimes, my team is] worried about disappointing me. And culturally, we have to understand, as doctors, we may have that effect on people. And if they're implementing something new and they don't feel comfortable telling you that they're not comfortable, that's a problem. They have to be able to talk about that they're struggling with this. And so, that's why [steps] seven and eight become important.” (33:21—33:48) -Dr. Cranham

“[Step] eight is you establish benchmarks to assess success. And it might be time, it might be quality, it might be the outcome or results. But if you can establish, like if you're scanning, ‘All right. We should be able to scan an upper arch at the end of this month in about two minutes. We ought to be able to do a two-minute scan. We ought to be able to get the palate,’ just have some basic benchmarks so that they can self-assess what they're doing. And they need to understand that if they're not able to do that, nobody is in trouble. Let's just figure out why.” (33:49—34:22) -Dr. Cranham

“[Steps] seven, eight, and nine really go together, establishing those open lines of communication so the team can tell you what's going on, having those benchmarks to self-assess success. And then, based on those two things, knowing that there's going to be some additional training and follow-up so that they don't feel like they have to do it perfect. And again, if you think about implementation, most dental practices, it’s more like you get the scanner, the dude comes one day, and they go, ‘Okay, have at it.’ That's it. And then, the dentist is yelling if something is getting kicked back from the lab. I mean, it’s just not that simple. You've got to have this process that they know, as the leader, you're going to be supporting them to be successful.” (34:36—35:23) -Dr. Cranham

“If you look at this list and you can practice implementing something and going through those nine steps, you're going to find the first time, it’s kind of difficult. But then, the second time, if you follow this programmed approach, it’s not going to be quite as difficult, and the team will be a little more trusting that they're not going to be left off on an island somewhere to figure this stuff out.” (38:52—39:15) -Dr. Cranham

“Putting a procedure in place for implementation will become, I think, a defining cultural thing for your practice, if you do it. Because the best practices are always getting better.” (39:45—39:58) -Dr. Cranham

“I would hate dentistry, I think, if it wasn't for the ability to continue to learn. And learning can be extremely fun and rewarding if you have a process in place where you have help.” (40:58—41:11) -Dr. Cranham

“Continuous improvement is something I base my life around. I mean, it’s everything we do.” (41:28—41:34) -Lee

“My job is to make the person’s life that's next in line easier. He is my customer. So, whoever is doing anything in our business, in our lab, in our practice, if it affects another person or a group of people, your job is to make them happy, no matter what it takes. And their job is to make the next person in line happy.” (42:27—42:53) -Lee

“We tend to think of each other in our business, in our laboratory, as we are customers of each other. How do we make the next person happy and have their job easier? So, if we think like that, if you think of your team like that and we’re not separate, we’ve got a vision — my vision is not always shared. They have no problem telling me it’s a bad idea. I'm like, ‘Oh. Okay.’ But at least we've got a shared vision and we’re trying to keep our internal customers, which is our team, happy with what everybody else is doing.” (43:03—43:40) -Lee

“If you can commit to developing a process and surrounding yourself with great people that want to help you, part of this process, and Lee said it, is helping them succeed with what they're doing. And when you do that, it lightens the load tremendously and it makes the implementation process fun and not stressful.” (44:30—44:52) -Dr. Cranham

“Let everybody know what we’re going to do and figure out what they need to be able to do it so they're comfortable.” (45:35—45:40) -Lee

Snippets:

0:00 Introduction.

2:36 Dr. Cranham and Lee’s backgrounds.

4:33 Why implementation is a big challenge in dentistry.

7:39 Lee’s “why” for implementation.

11:34 Step one: formulate a vision.

17:57 Step two: share your vision with your team.

22:44 Steps three and four: identify key players in the practice.

26:11 Steps five and six: block time for training.

29:28 You can't have two visionaries.

32:29 Steps seven, eight, and nine: have benchmarks and open lines of communication.  

38:36 Step ten: encourage continuous and never-ending improvement.

43:42 Last thoughts on implementation.

45:55 More about Cranham Culp Digital Dental and how to get involved.

Dr. John Cranham Bio:

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

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

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

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

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

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

Lee Culp, CDT Bio:

Lee Culp, CDT, is the CEO of Sculpture Studios, a dental laboratory, education, and research and product development center for new and innovative digital dental technologies and their applied applications to diagnostic, restorative, and surgical dentistry. He is a pioneer in digital dentistry and a leading resource/inventor for many of the materials, products, and techniques used in dentistry today, and holds numerous patents for his ideas and products. Lee writes many articles per year, and his writing, photography, and teaching style have brought him international recognition as one of today’s most exciting lecturers and innovative artisans in the specialty of digital dentistry, dental ceramics, and functional esthetics.

Lee is the 2007 recipient of the Kenneth Rudd Award from the American Society of Prosthodontics, the 2007 recipient of the AACD Presidents Award for Excellence in Dental Education, the 2003 recipient of the National Association of Dental Laboratories, Excellence in Education Award, the 2013 American College of Prosthodontics-Dental Technician Leadership Award, the 2014 Spectrum Publishing-Lifetime Achievement award, and the Dr. Peter Dawson-Dawson Academy 2016 – Dentistry Distinguished Service Award. 

How to Improve Results and Automate More with Less Work

Episode #502 with Dave Monahan – CEO of Kleer

How do you get more people into your practice without the extra work? You can do it with automation! And to share the best software for automating your processes, Kirk Behrendt brings back Dave Monahan, founder and CEO of Kleer, to introduce three new Kleer features that will help you automate more so you and your team can focus more on your patients. To learn more about Kleer and how to get started, listen to Episode 502 of The Best Practices Show!

Episode Resources:

• Dave’s email: [email protected] 
• Mention ACT Dental for a discount! https://www.kleer.com
• Kleer’s Facebook: https://www.facebook.com/KleerLLC
• Kleer’s social media: @kleerllc
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
• Get the Best Practices Magazine for Free!
• Write a Review on iTunes

Main Takeaways:

Automation will help increase your collections.

More automation means more time with your patients.

Automate the renewal process with Kleer. It will pay for itself!

Kleer Intelligence Automation will eliminate many time-consuming tasks.

Automated marketing with Kleer Intelligence Growth will grow your membership.

Quotes:

“You have patients who come in all the time but are very hard to make any profit off of. Then, you have other patients that are profitable that don't come in. So, what does a membership plan do? It gives the patient coverage. It gives them access to some discounts. Most importantly, though, they're paying a subscription for access to their hygiene visits. And so, on average, on our platform, a patient pays $30 a month. That goes directly to the practice. That's not given to Kleer. That goes to the practice. It doesn't go to the insurer. It doesn't go to a third party. It goes straight to the practice.” (7:02—7:33)

“For $30 a month — again, it'll range. It’ll range from $20 to $50 a month, depending on the type of plan and where you are from an economic standpoint, like where you're located. But the net is, that patient paying that subscription gets their two cleanings or two exams, their X-rays, typically, an emergency exam. We’ll design this with the practice and customize for the practice, depending on what their treatment protocol is. But since they're paying a subscription, they come in. They come into your office for their hygiene visits. So, it goes from a fee-for-service patient who comes in once every two years, to a membership plan patient who comes in one-and-a-half times a year. Those are the numbers. So, they come in three times more often.” (7:33—8:09)

“What happens when somebody is in hygiene? They accept treatment. 75% of all treatment is accepted in the hygiene chair. So, it creates this cycle where they come in, they get their hygiene, and they accept treatment.” (8:11—8:22)

“When you measure a Kleer patient who is using a membership plan versus a fee-for-service patient, they come in twice as often. They accept 142% more treatment, production is about 172% more, and collections are 182% more.” (8:43—9:00)

“One of the things we’re going to automate is the posting of the subscription payments. So, if you have monthly payment plans, or annual payment plans, or some mix of the two, when that payment gets processed, we’ll also write it back into the Practice Management System and nobody needs to enter that data into the Practice Management System. So, that's one automation feature that comes with Kleer Intelligence.” (12:06—12:24)

“Another one that sounds small but it’s one that office managers really appreciate is, now that we have access to the patient data in the Practice Management System, if a patient walks up and wants to join your membership plan, all you have to do is query the name of that patient, select that patient, and we’ll autofill all their information — name, address, phone number, email, all that good stuff that we need on our side — so you don't need to do that and practices don't need to do that anymore.” (12:25—12:49)

“Benefit tracking status. So, we’ll have access to the Practice Management System. If they have, let's say, two cleanings included in their subscription and they’ve used one and we know there's one remaining, it’ll be easy for us to let the office manager and also the patient know there's one cleaning left. And so, if they come in for their cleaning, ‘This one is part of the subscription,’ versus having to charge them. So, there's tracking things like that and automating things like that.” (12:49—13:12)

“The research said [patients are] worried about cost. They don't want to negotiate. They want more care. So, they're sort of stuck and exposed. That's the net of it. And so, what the membership plan does for them is, let's say it’s $30 a month. They're like, ‘Wow.’ The feedback we had is, ‘That's very affordable. I could do that. Can I do $250 in one visit? No. But I can do $30 a month for access to the care I need.’ So, it enables them to get access to the care they want, in a way that they can afford, in a way that makes it easy for them to pay.” (14:42—15:14)

“We have another set of features that we call Kleer Intelligence Growth. And this helps a practice grow their membership. So, the first feature that practices have asked for around that is, ‘Can you market to my patients? Can you automatically market to them, and I don't have to do anything?’ So, what we’ve done is we've built an infrastructure where we can now identify different patient sets inside your data that are a good fit for your membership plan.” (17:14—17:40)

“Any patient that's over 65 years old, who is uninsured, who has outstanding treatment, who has not been in the office for 18 months — sounds like a pretty good patient, right? If you can get them back. We’re learning that they do like the idea of membership plans. They don't have access to insurance. Once somebody retires, a lot of these patients end up dropping off because they don't think they can afford care. So, we run a series of emails over the course of four weeks to these patients and get them interested in the practice and book a visit. And then, hopefully, when they're in for their visit, they actually purchase a membership plan. And we’re having success with that.” (18:12—18:47)

“PPO optimization is, we can look at all your PPOs that you are either in-network or out-of-network with. And, by the way, we can analyze and understand if you're in-network or out-of-network with them, and we can tell you exactly what your level of discounting is by PPO. And what we’ve done, we do this on the side for practices that are on our platform. The difference is, we’re going to build it into the platform for everybody. But when we do it on the side, practices typically know, ‘If I'm collecting a certain percentage of my fee, then it’s profitable for me. If I'm not, then it’s probably not profitable for me.’ So, we can very easily say, ‘Okay, production for Delta Dental is $1 million a year, and you're collecting 65% of your full fee.” (20:54—21:33)

“What's really cool is when you stack [the PPO optimization data] up against each other, you can see which ones are producing for you, from a total revenue perspective, and then which ones are producing for you from a collections perspective. And if you want to move away from PPOs, where do you want to start? You want to start with the ones that are small production and low collections. We can identify that PPO for you right away. It’s, bam, you see this graphic we pull up, and we’re like, ‘There it is. There's the one to start with.’ And it also tells you how all your PPOs are behaving. And then, you can branch off of that and say, ‘Okay, maybe a PPO is large, and I can't just walk away from them anytime soon.’ So, why don't we try to renegotiate that? Or maybe I try to not bring any new patients into that . . . It provides the insight you need to start making those decisions.” (21:34—22:27)

“Our best customers come from people who've had in-house plans. And so, the in-house plans, people — I'm not saying it’s always done perfectly — typically will understand there's a lot of value in this. But they start to break down when you get to 25, 30, 40 patients, using it, because you don't know who signed up, when they signed up. You've got to track credit cards. You've got to track renewals. You don't know what type of benefits when they signed up. Things like your fee schedule sometimes change, and you're not sure which fee schedule they're under. So, it just becomes a mess. We hear that over and over again, ‘The front desk team goes nuts over managing the in-house plans.’ And you're leaving a ton of money on the table.” (24:24—25:00)

“One feature will pay for Kleer on its own, which is autorenewal. So, our membership plans just renew. You don't have to do anything. Nobody needs to call anybody. If there's an issue with a credit card, we use a backend payment processer that gets flagged right away. When it happens, it gets flagged. The patient is notified, and your team is notified. So, you just keep all that leakage out of your subscription. And not only is it good for you from a revenue perspective that those renewals just happen, and your subscription revenue builds up over time on its own, but if you are going to, at some point, exit and you want to sell your practice, you want to be able to prove that. You want to show an investor that, ‘My renewal rate is 80% on these subscriptions.’ You will get five times the value for that revenue than you will one off-revenue.” (25:02—25:48)

“Investors love to see this automated revenue stream. That, to them, is gold. And, obviously, for yourself, we have practices that are generating $1 million of subscription revenue a year. Wouldn't that be nice? And, like I said, that's going to be valued, if you do it right, when you're going to exit. You should get — the average, outside of dentistry, is 5x. You'll get 5x the multiple on subscription revenue than you'll get on one off-revenue. So, it’s one of these things that becomes a really valuable tool for you, not just from the cash flow perspective here and now, but also once you exit.” (26:28—27:01)

“On average, you have 2,500 dormant patients in your practice. From a conversion standpoint, we can't measure that too well right now because we don't have access to the data and we’re not doing the marketing to them. As we build Kleer Intelligence, we’ll be able to tell you what's happening there and give you an idea of what of that 2,500 can be moved over. We’re assuming, right now, we can move 10% of it over to a membership plan. I just don't have the data that proves it. So, roughly, if you can get to about 500 per dentist in your practice onto the platform, that's basically what we’re looking at. At $30 a month or $360 a year, that's your subscription revenue.” (28:26—29:03)

“Production more than doubles. It almost triples. So, at 170%, if you translate that — 172%, if you translate that to a multiple — it’s about 2.5 times more revenue from treatment than you would get normally. So, you take that subscription, plus more than double the treatment — fillings, crowns, and so on — in order to really get what the real impact of your membership plan is. So, it has a significant impact even outside the subscription.” (29:29—29:57)

Snippets:

0:00 Introduction.

3:01 Dave’s background and why he created Kleer.

5:12 Findings from Kleer’s market research.

10:30 Core automation features with Kleer Intelligence.

13:44 How membership plans benefit patients.

15:30 Kleer’s rollout plan and Kleer Intelligence Growth.

19:04 Optimize with Kleer Intelligence Performance.

22:28 When these features will be available.

23:52 Can I test Kleer’s membership plan?

25:50 Other values of this built-in business model.

27:20 What success could look like when using Kleer.

29:22 The impact of a membership plan outside of subscriptions.

30:54 Other benefits that Kleer can provide.

33:15 How to find out more about Kleer and get in touch.

Dave Monahan Bio:

Dave Monahan is the CEO of Kleer, an advanced, cloud-based platform that enables dentists to easily design and manage their own Membership Plan and offer it directly to their patients. Kleer is turn-key and free to implement. Kleer’s mission is simple: partner with dentists to increase the value of their practices by making dental care accessible and affordable to everyone. 

Setting Up Your Team for Success with Clearly Defined Roles and Job Descriptions

Episode #501 with Adriana Booth

Don't “waterboard” your team — onboard them. And the best place to start is before you even hire them. You need clearly defined roles and job descriptions, and Kirk Behrendt brings back Adriana Booth, an amazing coach at ACT, to reveal a few simple ways to ensure clarity and to break down the onboarding process. Your team wants to be successful in your office. So, help them! To learn how, listen to Episode 501 of The Best Practices Show!

Episode Resources:

• Adriana’s email: [email protected] 
• Adriana’s Facebook: https://www.facebook.com/adriana.booth  
• Adriana’s social media: @adrimarieb
• Email Kirk or an ACT Dental coach: [email protected] 
• Subscribe to the Best Practices Show Podcast
• Join the To The Top Study Club
• See our Live Events Schedule here
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• Write a Review on iTunes

Links Mentioned in This Episode:

Brené Brown: https://brenebrown.com

Loom: https://www.loom.com

Main Takeaways:

Learn and implement the 3-3-3 rule.

If your standards aren't in writing, they don't exist.

Your job descriptions don't need to be 10 pages long.

Remember that specific is terrific, and vague is the plague.

Have your team members weigh in on their job descriptions.

Quotes:

“It is so important to clearly define our expectations, our roles, and our duties for our team members so that they can feel successful. At the end of the day, we all want to be the best we can be. And as a team member, knowing what our manager, our boss, our owner or doctors want from us so that we can hit those marks makes us feel like a success.” (2:43—3:13) -Adriana

“A lot of times, dentists get so upset because, ‘So-and-so is not doing their job.’ Well, the truth of it is, as team members, you're not given a clear line of sight on how to succeed in a dental practice.” (3:19—3:32) -Kirk

“When you do find the right people, you want to onboard them, not waterboard them.” (3:37—3:43) -Kirk

“Of all the teams I've worked with in the six-and-a-half years I've been lucky to work with Kirk, I would say going into coaching, maybe five percent of them even had a rough outline of clear job duties and descriptions. And I would say zero percent of them had an onboarding plan.” (4:31—4:49) -Adriana

“Depending on who you listen to, it takes the average team member — employee in any company in the United States — about 12 weeks to fully be stepping into the role. Now, think about it — 12 weeks. That is a long time. And so, I would say it’s probably longer in dental offices because they don't fully understand the role at all, if ever. So, one of the things is creating a countermeasure for that, helping people succeed right away. And we have what’s called our 3-3-3 onboarding.” (5:13—5:46) -Kirk

“Another statistic that I read recently is it takes the average business about six months to unwind the wrong team member for your practice. Think about how costly that is. So, number one is finding the right person. Number two, give them the rules. And helping them adopt the system right away is one of your biggest keys to success.” (5:48—6:08) -Kirk

“As a team member . . . I want to succeed if I'm coming to work in your office. I also don't want to come in and fix everything. I want to come in, know the rules, work the rules, and get really good at this whole process so that I can help and be the right type of team member.” (6:09—6:27) -Kirk

“I want to give our listeners a tiny bit of homework. Now that you've heard the stats, think of the last person that you hired and how long until you basically pushed them off the deep end and made them swim. It wasn't 12 weeks. It probably wasn't even 12 hours. And think about when did you follow up with them, ‘How is it going? What can we help you with? Is there anything we missed?’ It’s probably a small percent of you. So, these are just two small opportunities to start thinking, ‘How could I do a little bit better?’” (6:32—7:08) -Adriana

“When we think about the 3-3-3 rule, we want to break down our onboarding. What do they need to know in three days? What do they need to know in three weeks? And what do they need to know in three months? And I don't mean “need to know” like we’re just going to dole out little bits of information, but to be proficient at, to be aware of, to be able to do in that role.” (7:09—7:33) -Adriana

“At the end of the day, we are all people pleasers. Maybe not outwardly, but we all want to make someone else happy, whether it’s a patient, our coworker, our boss. So, think about that when we’re onboarding also, is, ‘How could I serve this person, and how can they serve someone else?’” (7:35—7:57) -Adriana

“Clear is kind. Brené Brown said that, and I think that's absolutely true. Don't try to be overly nice, but be super, super clear. We like saying specific is terrific, vague is the plague. It helps people succeed.” (8:04—8:17) -Kirk

“As a dentist, when you're hiring people, you have to evaluate them against the standards that were established at the beginning. And if they're not in writing, they don't exist. So, a lot of this is emotionally charged.” (8:19—8:32) -Kirk

“It’s funny because I've had some teams that’ll say, ‘Oh, we have our job descriptions.’ And I look in our shared Google Drive — and they're so awesome at putting all these things in there so that myself or their coach can see it — and it'll just look like an ad that they would throw up on Indeed. And I'm like, ‘Oh, I'm so sorry. Let's restart this.’ I want to see what's expected from that team member in their duties, their tasks, what they're responsible for, what we can hold them accountable to, not just, ‘You're a hygienist, so you scale and polish.’ They already know that. What else? What are the other things that we do here at Kirk Behrendt Dentistry? What are our standards? That's what we want to have outlined in a job duty and descriptions.” (10:14—11:03) -Adriana

“When you're designing this, you have to do two things. You have to create a Function Accountability Chart of what your future practice would look like. That's really important. Don't take what you have and mold it to what it might be a little bit better. That's not a good way to look at it because you're going to slow down your progress. When you can take a 30,000-foot view at your practice and say to yourself, ‘How do I get where we need to go, and what does that structure look like?’ now, you can start moving towards it . . . The second thing is to do exactly that in those roles that you see in a Function Accountability Chart. What would each person have to be responsible for in each one of those spots? And then, outlining them as specifically as you can. And then, collaborating on them as a team to make sure that your sentences make sense to another human being.” (11:55—12:52) -Kirk

“When you find the right people, be super clear about where we’re headed and what are you responsible for as we move forward.” (13:18—13:27) -Kirk

“Most dental practices operate on a few simple things that have to be done by each team member in each one of the critical zones in a dental practice. So, don't think that in a dental practice a job description is eight, nine pages long. It’s not. If it’s longer than a page, email it to me and I'll make it a page. There are a few things that make a big difference here, and if you can get people locked in on the few things, they can make a big difference in each one of those roles and collectively create a greater good.” (13:43—14:21) -Kirk

“Right person, right seat. How do you set that up for success? Functional Accountability Chart, job duties, and descriptions. Also, it goes back to leadership. How can we create leaders within the practice? The one way we can is to set them up for success. Give them the tools to excel, and to get better, and to be a leader inside your organization.” (14:35—15:00) -Adriana

“If you have a big practice, it’s often a good exercise to have everybody write down what they do. That's a good place to start — but don't stay there. Then, week over week, you can upgrade them, improve them, clarify them. And I promise you, if you stay focused on that process, over the period of eight, nine weeks, you'll have locked-in job descriptions that everyone can agree on. And that's the cool part. When you have them weigh in on this, your team members, they can buy in instead of just delivering it.” (15:29—16:03) -Kirk

“When I ask my teams to start this, you're right, I want to hear from their viewpoint what are their job duties and descriptions. It tells us a lot. Of course, I can come in as your coach, I can hand you some examples that have been created by awesome clients in our community. But I want to know your viewpoint because I also want to know, what are your primary, secondary, tertiary responsibilities. And that's a really easy way for us to see, what does that team member see as the most important parts of their role. And if we have a little bit of a miss there, it’s a great way to have a conversation as, ‘Let's reverse this a little bit.’ And this is where a lot of our systems are born. We see maybe someone thinks that recare is a primary. ‘Well, what's our recare protocol?’ ‘Hmm, we don't have that.’ ‘Awesome. Let's add it to our list.’ And we can create so many great things for the practice out of a job duties and descriptions list.” (16:20—17:19) -Adriana

“The easiest way to look at this is, ‘What have I done recently?’ And then, adding a couple layers of what we covered today and, ‘How could I do this a little bit better?’ We’re just asking you to take incremental changes, and it will make a really big impact on your practice and for your team members.” (21:40—21:57) -Adriana

Snippets:

0:00 Introduction.

2:04 Adriana’s background.

2:34 Why this is so important.

4:17 Statistics on the onboarding process.

6:28 The 3-3-3 rule.

7:59 Standards need to be established.

10:05 What does a job description look like?

11:51 Things you need to do to set your team up for success.

21:33 Last thoughts and how to get in touch with an ACT coach.

Adriana Booth, BS, RDH Bio:

Adriana Booth is a Lead Practice Coach who partners with dentists and their teams to cultivate leadership skills, build practice growth, and streamline business practices. After spending nearly two decades in the dental industry working with top-notch dental teams, Adriana came to ACT to share her passion for professional growth, high-level training, and systems creation with our clients.

As a dental hygienist with a love for continuing education and personal growth, helping a practice become successful is at the heart of her passion for dentistry.

Adriana has a B.S. in Dental Hygiene from West Liberty University/O’Hehir University. By being involved in several Columbus, Ohio, study clubs, Adriana maintains strong relationships within her local dental community. She enjoys a variety of fitness activities, family time, good books, and at the top of her list, her fur babies.