https://www.youtube.com/watch?v=9y8GKSDy354

Questions to Ask Before Seeking Financing for Dental Startup or Acquisition

Carrie:

Welcome to the Jameson Files. I'm your host, Carrie Weber, and it's so great to have all of you back in the Jameson Files community today. We're excited. We have a very special guest who has come to the Jameson offices to be in person with us for this interview. This is Tom Angeloni, the National Sales Director of Bank of America. We were talking earlier, Tom, we've both been in the industry for about the same amount of time. It's been over 20 years for you. 

Tom Angeloni:

Like a quarter century. I have to date myself.

The Future of Dentistry

Carrie:

Well, a lot has come and gone. I'm really excited and very grateful that you've come by to spend some time with us because, for those of you out there, whether you are a young dentist starting out, looking to get footing into your own practice ownership situation or whether you're a practicing dentist and have been practicing for some time and are looking for opportunities to expand, you may have a lot of questions about financing and what things you need to be considering. What is the environment like today and what things can you plan for? So, Tom, I'd really love to have a conversation about that. I’d love to start out with just giving your perspective on where things have come, after all of this time. From your perspective, where do you see things right now in the dental industry? In the dental environment? 

Tom Angeloni:

Honestly, it's driven demographically.  There have been a lot of states, different territories that were heavily driven by startups. Over the years, depending on where you're at, that has moved more towards acquisitions. Overall, we still find that the dental economy is still very strong. Dental spend is up year over year.  The last stat I saw from the ADA is that between 2021 and 22, there was an increase, not a huge increase, but about 1.2% increase in graduates. And then over a five year span, there's been about a 7% increase in graduates. So you still have a lot of graduates coming out. And the trick is to keep pace with who's retiring, right? That's always the trick. So the projections, again, ADA and some different consultants are really looking at it and say that over the next eight to 10 years, so 2031, they say that there's going to be a shortage of about 30,000 dental professionals. So you can look at that as, you know, very optimistic and an opportunity. There are still, as it stands right now, about level or a little bit more graduates compared to those that are retiring.

Starting a Dental Practice from Scratch or Acquisition

Carrie:

Wow.  And I don't know why that feels surprising to me, but, you know, that gives a lot of opportunity to these young dental graduates. You do a lot with dental students and with those new dentists in trying to educate them on what their options are. And they think they know the direction, but I don't know that they've done a lot of due diligence in terms of how to make the best decisions for the start of their professional career. Some of you have, but some of you may still be really unclear about how you get from here to there. What are some of the questions that you get asked a lot from these dentists starting to explore purchasing or even starting up a practice from scratch?

Tom Angeloni:

I'll tell you the most common question in all the lecturing that we do at different dental schools across the country.  Almost 80% of the time we do this, the question comes up, should I start a practice from scratch, or should I do an acquisition? 

And a lot of people have different opinions, right? Obviously, when you acquire a practice, you have a built-in patient base, you have a staff, you have equipment. It's almost like you flick the switch and get going. But what I've always seen is that it really has so much to do with what the transition plan is, right? 

So if you're going to walk in and do what we call a walkaway acquisition where a dentist has been there for 30 years and he leaves on a Friday, and you come in on a Monday and take over that practice, with no transition plan in place, it's hard, right? You see a lot of attrition from that, because a lot of people have been driving past three or four dentists to go to that dentist, because that is what they have done their whole life and they leave. They say, well, there's no reason for me to pass up. I don't know the new person anymore. 

So, a walkaway transition doesn’t work well.  I'm not saying there's not opportunities for that, but it is much more difficult. And sometimes, as you know, when you buy a dental practice, you pay a percentage of the revenues. So if you pay it and then all of a sudden you lose 10% from an attrition standpoint, you've just lost that, right? So in my experience the key is to have a very good transition plan where the existing dentist is going to stay. You don't want them there for a long time, but at least six months. So you get one rotation for everybody coming through for hygiene. Then you slowly transition.

And when you do that, you don't have as much attrition, because every time a new patient comes in, they're introducing you as an associate. And all of a sudden, they don't even realize it, now you're the owner, right? When you do it that way, and you have a good transition strategy, there is much less attrition, and that might be a better situation than a scratch startup. 

Now, the flip side of it is that when you do an acquisition, you're basically taking over a practice that already has character to it.  It's already been doing things a certain way. The staff has been doing things a certain way, and as we all know, people are just naturally adverse to change. So you come in, and again, you think that you have a staff, and then you start changing things and you realize that the staff doesn't like that and they leave. So in that scenario, it may be better to go ahead and do a scratch startup. You can do things the way you want with your equipment and build your staff how you'd like. So I'm really not for or against either one. 

Carrie:

You do a lot of both.

Tom Angeloni:

A lot of both, right. It's really just the transition and, and where you're at. And if the transition strategy is done right, then maybe an acquisition is best.

Carrie:

I think this is really great. I'm glad you brought it up, Tom, because as I think about doctors that we've talked to, practices that we've worked with, and conversations that we've had, this is so true, and it's interesting coming from your perspective to also be recommending that. This is something for anyone listening, if you're the doctor looking to acquire, think really clearly about it before the purchase is made. How are you going to enter into that practice and have that be as successful as possible? But also if you are looking to sell, if you want that practice to be successful long after you're gone, what are you willing to do? What intentional processes are you willing to partner with the buying doctor to help that be that successful transition? I think from both sides, that's a really important thing to consider for the success of the practice, and for the patients, and the team. So that’s a great point that you make there. 

The Key to Making Wise Financial Decisions when Acquiring

When you think about the financial investment that these doctors are going to make, whether purchasing or starting up from scratch, what would you say is important for them to consider, long before, in preparation for taking these leaps in this next step of their careers?

Tom Angeloni:

I think what you just said there, preparation, that's the key. I always say it's vital that you surround yourself with industry specific people that can advise you. We talked a little earlier about how so many say, I want to buy a million dollar practice. And you're like, well, maybe you do, but maybe you don't, because there's a big difference between a million dollar practice and a profitable practice. Right?

Carrie:

Wow. Say that again. 

Tom Angeloni:

There’s a huge difference between a million dollar practice, a million dollars being produced in the practice and a profitable practice. So many get it locked in their head that production is important. I want to buy a practice, or I want to start a practice and get it up to a million dollars or 1.5 or 2 million dollars. And if it's not a profitable practice, you don't want that. So yes, having a team of advisors that can come in and look at it and say, okay, well this practice is doing a million or 1,000,005, but overhead is up here. It's not the most profitable practice, so maybe you don't, and you can take that analogy across to all different aspects of starting a practice or growing a practice and say, look, you really have to have the right people around you to advise you.

And that would be from the right dental specific lenders to CPAs, to financial analysts, to contractors, to equipment providers. You really have to take your time and prepare, as you said. And that's whether you're starting or whether you're growing.If you're doing a second or a third practice, you need people that can come in and advise you on whether this the right time to go from one to two or two to three, or is my infrastructure set up correctly to go from three to five? 

We were making jokes earlier that you would think just like when you have children, right? You have one child, and two wasn't hard. So you figure, how much harder could three be? And then you have the third and you move from man-to-man defense to zone defense. It's very similar when you buy practices, right? Going from one to two isn't all that difficult. You can hire an associate, you spend some time there, I'll spend some time here, but then you go to three, then you go to four,

https://www.youtube.com/watch?v=fBSxnl4wTvk

How EndoConnect Can Improve Endodontic Care for Both Practices and Patients

Carrie:

Welcome back to the Jameson Files. I'm your host, Carrie Weber. Dr. Randy Middleton, of Dallas, Texas, thank you so much for joining me today. 

Dr. Randy Middleton is an endodontist in the Dallas Fort Worth area, and he has started a new company called EndoConnect. He is on a mission to help make the referral process of the endo needs in a general practice as easy as possible by providing a service that makes that in-house for general practices. Dr. Middleton, I'd love to learn a little bit more about your services through EndoConnect, but before we do that, let's back up a little bit and would you mind telling the listeners and viewers a little bit about your backstory? What led you to endodontics and what ultimately led you to the path that you're on today in your professional career?

The Beginning of EndoConnect

Dr. Middleton:

So I found endodontics actually in dental school. It was something I was drawn to– the actual work itself, the meticulous nature of doing the actual procedures attracted me. So I just ran with it from there. That was probably my second or third year in dental school, so I had a lot of time to reflect on what practice life looks like. It never seemed right to me to duplicate everything that a general dentist has, an office, the chairs, the staff. Everything is literally a carbon copy, but down the street, and it just didn't seem right. I thought there's a better way for this. Patients don't like traveling. It's hard to collaborate on cases when you're down the street. So I always thought this would be something I did, and it's slowly building, so I'm excited for the future. 

Carrie:

So exciting! For some time, you've been doing this on your own. You’ve been going into the practices, you bring your assistance, you bring all of the equipment that you need, and you basically are collaborating and partnering with these practices, providing your endodontic services however many days a month that they need you there, correct?

Dr. Middleton:

That's right. It's interesting that it can grow organically, you know, just vendors and assistants and dentists. Everybody you know knows 10 more people, and it's really grown bigger than I thought it would without a whole lot of advertising, at least so far.

Carrie:

Yes. What's interesting to me is when this started taking off, had you known about this model before or is this something that you took the lead on and said, why don't I just come to you? How did this really begin?

Dr. Middleton:

Well, I kind of conceptualized it loosely in dental school and then residency. Then I was actually connected with a DSO, which had the same model. And I thought that I would just link up with them. And then as I got my footing there and learned the business side of it– things that I like and things that I can do better. And then it grew in parallel. It started with vendors, and I've found connections through hygienists that I've met. Word of mouth is very powerful.

The Advantages of Formal Marketing Over Word-of-Mouth

Carrie:

That leads me to something interesting. You said just a minute ago that this has really started pretty organically. You made one connection, and then the word got out about you and that this was something that you would provide. You had mentioned that to this point it's been organic, but you are definitely a forward thinker in terms of all aspects of marketing your business. You really do put your own effort forward to help that word-of-mouth marketing grow. But also you're investing in your own marketing efforts and you've been trying to do that since I've met you. So how do you see marketing in terms of its role that it plays in your career in this particular approach to endodontics that you're taking?

Dr. Middleton:

Word of mouth isn't direct. You can't control where that goes. And I like that I can control where I'm marketing the practice. That's really the onus of, number one, to scale the practice, but also, to be able to direct it geographically in certain areas. That's a lot more easily controlled with formal marketing, so that's what drove me to the formal marketing campaigns.

Carrie:

It's really a matter of being able to direct the message that you want to get out there, because it is a very specific process of how you work with these practices. So I'm sure you want to make sure that they understand what this is all about and what we do. Would you agree?

Dr. Middleton:

It's a different practice type. A lot of practices have never heard of it. And formal marketing is not my area of expertise. I'm not a marketer, right? I have a loose vision, but I don't know the psychology of what a flyer needs to look like. How does my website need to flow? And so that's what led me to find a professional that does this. So yes, I don't pretend to be an expert in marketing, so I'll just stay in my lane.

The Role of Endodontists in Patient Care

Carrie:

You have your expertise, right? You know what your expertise is. So let's talk about your expertise– endodontics. Interestingly, in 2024, I've been doing some work more specifically in specialties. Something that's very unique about Endo is there's not very many of you out there. You are one of the lowest represented specialties nationwide which could lead to definitely the demand of what you provide. What do you see in terms of what you all bring to the profession and bring to patient care? Why do you think there's so few people that choose the Endo path?

Dr. Middleton:

I don't know if too few people choose it. I think there's just not a lot of programs. It's highly competitive, so I don't think there's any programs that aren't full. I think the interest is there. I think it's an attractive specialty to a lot of dentists. I don't know why we don't have enough specialists, but I don't think it's a lack of interest.

Carrie:

Well, and it's interesting because it seems as if this is one of those pieces, especially complex endo cases, that the GPs want to pass off to somebody else. And that's what brings you to the table. So for those that are considering endodontics or those younger doctors that are just getting started in Endo, what kind of advice would you give them that you've learned at this point in your career as an endodontist that would really help them thrive in this specialty?

Dr. Middleton:

I think just viewing the specialist as a partner to the practice. It doesn't have to be in my model, it can be in the traditional model, but the goal is partnering with them to take care of this patient. So whatever that means or whatever that looks like for that practice and you know, specialist and dentist together. But the more that I lean into the partnership aspect, the better we collaborate together. And I think the patient feels that seamless transition when the care is passed from the general dentist to the specialist. We all know what's going on, and so that makes everybody look competent and the patient feels even that much more comfortable with us.

How EndoConnect Partners with GPs

Carrie:

The ideal piece about what you're doing is it really puts the emphasis on a partnership, a true collaborative relationship for the sake of the patient. This feels like a good time to share a little bit more specifically. Endo Connect is your company that's creating this community of partnership with GPs and Endodontists, yourself included. You’re going into the general practices and providing that Endodontic care, Can you give a little bit more of a deep dive description of what that looks like? What is the relationship between the partnership with the practice and with you and your company? How is that realized? What's that look like?

Dr. Middleton:

So an office would traditionally send their patients to the office down the street. They don't do that anymore. They schedule them in their own office on a day of their choosing, and based on their volume. We'll come in and we'll see their patients, morning and afternoon, all day, however many they need seen and at whatever frequency is good for them. So the patient never really knows of this relationship behind the scenes, but all they know is they go to the same office, they have a procedure done by a new dentist, but one that their dentist is endorsing because it's in their office. And most of them will get their final restorations right after the endodontic procedure. So they're not running around in a temporary crown. They're not driving across town.

EndoConnect Benefits Both GPs and Patients

From the patient's perspective, it's seamless, and the relationship on the backside is not complex. They bring us in, we charge them a fee for every procedure that we do, and then they bill their patients as they normally would. So it really works well. I think that the idea seems intimidating, but in practice the offices seem to be able to integrate it quickly and easily. The front desk staff don't change much of what they're doing. They just add a new column, you know, for the Endo day. It seems to be pretty smooth once we get past the mental hurdles of having a new provider in the office.

Carrie:

Yes. To me, it’s brilliant. It answers such a high level of customer service for the patient, Time is one of the biggest obstacles for care for patients. So to me, the convenience and the time saving is so huge. Plus for the patient, they don't have to go somewhere new and strange. They can go to the place that they're most familiar and comfortable with. And then also in terms of the comfort level for the actual practices: they get to schedule, they get to do the financial arrangements, they get to care for that patient and lead that patient through treatment like they would any patient in any treatment.

https://youtu.be/3er-1SUZwHg?si=c6mP1B689NNeEtDo

Carrie and Jess Webber Talk about the Most Commonly Asked Questions

This transcript with our Jameson Files host Carrie Webber has been lightly edited for flow. To enjoy the audio, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Carrie Webber:

Welcome to the Jameson Files. I'm your host, Carrie Weber, and I am very happy today because I have coerced my partner in crime and all things in life, Jameson CEO, and my partner in business, Jess Webber. Yes. He's also my husband.

Jess Webber:

That's how it works.

Carrie Webber:

So this is probably the first time you have joined me on a Jameson Files episode, which is kind of amazing considering how long we've been doing the podcast, but we finally have lured him in. Today I'm excited because we're going to talk about trends we see– the questions we are getting asked the most from doctors across the country when we're having conversations with them. So thank you for agreeing to join me and being a guest.

Jess Webber:

You're welcome. Since 2020, we've started to see a lot of different questions come up in the industry, and I think it's great that we're going to discuss this with you.

Carrie Webber:

Absolutely.

Jess Webber:

Not at the dinner table.

Carrie Webber:

Not at the dinner table, not in the car. Our kids will be so happy we found a different place to have this conversation. 

How to Determine the Profitability of Your Practice

Most of the doctors that reach out wanting to know about Jameson services start the conversation with me. And often once they are clients of Jameson, for one reason or another, they'll find themselves having a conversation with both of us or with you, when it's about specific things. So that's what I really want to tap into. When we're having conversations with clients, we're certainly seeing some themes in what those conversations are about. Number one being the pain point of the cost of running the practice. That is something that most of you may have experienced in the big jump in inflation, or costs of salaries and so on, that we've experienced over the last 12 to 18 months especially. Let's talk a little bit about what those conversations are, how we're exploring ways that we can help them, and what you're finding as you're looking at P&L’s and talking through this with doctors.

Jess Webber:

Sure. So that's right. Since 2020, the team costs have risen with inflation. We have different types of pressures on costs including salaries and supplies and lab and all the things that it takes to run a practice. So we continue to see those, probably not as much this year as we did last year, but it's still definitely there. And we're not going to kid ourselves, costs have always been an issue and a question in a dental practice. Just now, people are really hypersensitive to it for all of the reasons that we're seeing. 

Carrie Webber:

Well, and what I hear a lot is it's not necessarily that there's a specific area of cost that they're struggling with. But sometimes the question is, I want to know if I'm even in the right realm in terms of my benchmarks and what we call the key performance indicators of cash flow, of the overhead of the practice, and so on. That's a question that we get a lot. I don't know if those of you that are watching have those questions yourself, but a lot of times doctors just want to know if they’re even in the right range. 

Jess Webber:

Anybody, any specialty, GP, it doesn't matter. If you want to know those specific ranges, you can just ask us. We'll tell you it's a lot easier. 

And if you don't know how to figure that out, we can obviously do a little lesson in that math too. But you do need a great P&L. It's easier if you have an accountant do it, because it breaks it down a little bit by percentages and puts it into a normalized type of profit and loss or P&L. So what we do is we obviously gather our clients and we work with a great company called Cain Watters. They are a financial accounting firm out of Dallas that works specifically with dentists, and they work with like 3000. I don't know the exact number but it’s a lot. So it's a big enough sample size that we can get some good solid numbers. So like I said, just ask us and we can help you evaluate if that's something that you're in need of. 

The absolute top cost in any practice is your team. And that's what we've seen going up over the last year, I would say. The other area is supply and lab. Those two in general are the two top areas.

Carrie Webber:

Well, and I think something that you're experiencing more and more, especially those that are in network with a large number of PPOs and insurance plans, is that those plans are cutting into your profit because of the write-offs, obviously. So as you start to see this swell in the costs of running the practice, or rather the investment of running the practice. I hate to say team is a cost, but it's an investment that must be made to keep the practice up and running. As you see these things happen, you need to be very aware of the relationships that you are in, what your write-offs are, how many of your patients are in these different plans, and what's the cost of participating. I've had Lois on the podcast, and she's done a pathway on our Grow platform about this topic specifically because it's not a matter of us telling you to be a network or not, it's really for you to understand what you are a part of.

And that all plays a part in what your bottom line and what your profit is. The way that you are going to become more profitable is by becoming more productive, increasing your fees of the dentistry that you provide, or reducing the cost of running the practice. Those are the ways. When you're in network with PPOs, that definitely has an impact that's worth exploring. So are there ways that you can be more productive? Are there opportunities in the practice for growth to help you cover the costs of running the business? And also are you in relationship with the right kinds of plans that benefit your patients, but also are most beneficial for you as a business?

Jess Webber:

Yeah, it's definitely worth an evaluation. If you're in network with PPOs, you really need to take some time– work with somebody or do it yourself– but you need to evaluate what those fees are and how many PPOs you're associated with. Because if you're involved in one, I bet you don't know you're involved with a lot. So it's definitely worth evaluating what you're getting reimbursed for, procedure by procedure. Because sometimes you might be losing money every time a patient shows up. So it's worth that evaluation. I highly recommend it. Like I said, you can do it yourself. It's not rocket science. You know what it costs and you can see what you get reimbursed for. So it's the alligator mouth, one of them is greater than the other one. Figure it out.

Carrie Webber:

The alligator mouth?

Jess Webber:

Greater than, less than.

Carrie Webber:

Oh, the Pac-Man. 

Jess Webber:

I’m from Florida. It's the alligator.

Carrie Webber:

Oh, geez. We're going off the rails. 

Understanding of the Profitability of Your Practice is Valuable when Transitioning

Something that we find ourselves engaging in perhaps not as much as the topics of the cost and managing your practice appropriately, but some practices are starting to go on the path of considering that they want to sell, or wanting to affiliate or perhaps even wanting to expand themselves into multiple locations or services and so on. So there's definitely a lot of consideration in terms of what we need to do in our practice to either be ready to sell, or be able to expand, or do things in a different way. 

Jess Webber:

This is actually probably one of the biggest topics right now because we see it at all ages of practicing dentists. We have young people wanting to sell. We've got people who are more experienced who are wanting to sell. And it's interesting because historically how you got out of your practice was you worked a long time, and then you found somebody that wanted to work a long time, and then you brought them in and they associated, and then you eventually sold out to them. So there's a lot of variations to how you can do that. 

But now we're in an age of DSO and affiliations and non-captive models that you can get involved with where you maximize your practice right now and continue to work and then maximize it again. So it's a very, very, very great opportunity. I can't encourage you enough to start learning about the different ways that you can maximize your practice right now, whether that's, like I said, a DSO, or a non-captive type model.

Carrie Webber:

And the magnet to your practice – whatever stage or whatever approach you're wanting to take is going to be– is the profitability of your practice. It’s what we were talking about at the beginning, having a really clear understanding of your overhead, your profit margin, working to streamline systems, and your cash flow so that you become more profitable. It’s getting your overhead in check as best as you possibly can, and then having systems in place so that anybody can see new patient flow is coming in. You are a healthy, growing, thriving practice. You run well. You are up to date; your facility is up to date. All of those pieces of the puzzle are considerations on whether or not you’re the right fit for what somebody's looking for. And so if affiliating, if being bought out, if any kind of transition of your role is something that you are wanting to look toward in the not so distant future, it's important to do your work now to make sure your practice is attractive to an outside entity.

How EBIDTA Affects the Value of Your Practice

Jess Webber:

https://youtu.be/mTXoI6XeQp4?si=W4SGsE1A5ejqjDp1

This transcript with our Jameson Files host Carrie Webber has been lightly edited for flow. To enjoy the audio, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Dr. Kahn's Dental Successes and Challenge

Carrie:

Welcome to the Jameson Files. I'm your host, Carrie Webber, and it's such a pleasure to be back with all of you for another episode. I am so happy today to be joined by a longtime friend and client of the Jameson Group, Dr. Donald Kahn from Long Island, New York. We had the pleasure of meeting with his partner, Dr. Angela Ferrari, and she's a part of a previous episode. But today we're going to talk about a new perspective from their amazing practice– Dr. Kahn as the founding owner of Kahn, Ferrari And Aldieri and his amazing story in his journey through dentistry. You know, for me it's really about his amazing intentional approach to building a culture that matters in his practice for patient care, and to provide the type of dentistry and the way that he wanted to provide it. And that involved amazing partnerships that also led to a very successful transition as Dr. Kahn is now enjoying retirement after retiring this year. I'm so thrilled to have you with me, Dr. Kahn. Thank you so much for being a guest.

Jameson’s Influence on Dr. Kahn’s Professional Career

Dr. Kahn:

Thank you, Carrie. I really appreciate you asking me to join you for the podcast. Your organization, Jameson, has been a part of my professional career. It has been 34 years since I met Kathy at a study club meeting, and as other people can attest, she just blew me away. I realized at that point what my practice was really missing. So once again, I just want to thank you for having me on because you, and your mom and your dad, and the whole organization, and all the people that I've come in contact with through 34 years of practice management have been just wonderful. It's made all the difference in the world, and it is the number one thing I can put my finger on in terms of why we were and are as successful as we are today

Carrie:

That is so kind of you to say. And I hope that you know that the feeling's mutual. It is such a joy to have been part of your professional career. And I love that we are continuing on to be able to share so much about what you have learned, and the successes, and even the challenges that you've had over the years. What a gift to the dental community! So, as we start, you know that I really feel passionate about talking about building that thriving practice culture, and being so intentional about the evolution of your practice, and finding the right people to be a part of your journey with you. So I'd love for you to share with us, Dr. Kahn, a little bit of your story, a little bit of how your practice evolved over time, and some of those lessons that you've learned, and the things that you felt like helped you be so successful.

Dr. Kahn:

Oh, how long do we have for this project?

Carrie:

I'll try to keep you under control. 

Keys to Successful Practice Management

Dr. Kahn:

I retired this year after 46 years of practicing. I just have one practice. I always focused on just the one practice. I always was in wonder of how people with multiple locations run their practices. It's hard enough to run one practice correctly. And every single time I saw that, that was really what was missing. The one thing I always say, and I've talked about this, and I know that Dr. Hyman, who I know and I've spoken with, talks about the fact that when we come out of dental school, we barely know how to do dentistry, let alone how to run a business. They had one course for 30 minutes, and that was it.

Nobody even told us even how to balance a checkbook. And I'm being facetious, of course, but I mean, there was nothing about practice management. That's it. So when I came out, I was lucky enough to buy into a practice that was existing. And, may he rest in peace, Stuart Glassman was a great mentor. He taught me a lot about dentistry. But, once again, he taught me about business, but not practice management. 

And then I saw a lecture that Kathy lectured. It was a study club. It was an hour-long lecture in a restaurant. And I said, that's it. That's the missing link. We really don't know anything about practice management. So I spoke to her that day. She gave me a card. She was coming in to speak at the midwinter meeting– New York Greater Dental meeting.

And I met her there and we talked. And that's when we decided that we were going to start utilizing her service. That's the part that I think is important that people understand, especially today. I made a decision back when I first started that I was going to have a fee-for-service dental practice. I worked in a couple of clinics. I didn't like the environment. I didn't like the pressure. I didn't like having to overwork and spend so much time on so many patients. I felt it was impossible to develop a relationship with these people. 

Being Committed to Patient Relationships 

So in doing a fee-for-service, yes, it's very difficult in today's world. I have lived through the seventies, and 1987, and 2007, and all the times the market changed, and dental practices always take the first hit because they're on the bottom of the totem pole when it comes to importance when patients are struggling. But I decided that you don't have to have volume if you have quality dental care. That is the most important thing. And I've said that for so many years. And then I realized that, yes, you have to be a good dentist; you have to practice well. You have to treat and do the things to the best of your ability, but successful dental practices have very little to do with that. And I've seen it all the time. And with your mom's help, and Drew's help, and the other people that came to the practice, we learned how to manage people. We learned how to treat people. We learned how to love. We learned how to touch. We learned how to connect with people.

That's why the practice was successful. If people don't have pain and their teeth look good, that's really all they care about. When they come in and you have that connection with them, and then they send in a close friend, and then you have a connection with them–making that connection with them, putting your hand on their shoulder, asking them how they are. If they tell you something important about what's going on in their life, make sure you make a note of that. Because the next time they come in, if you say, “Mrs. Jones, how's your mom? The last time you were here she wasn't well.” These are the kinds of things that patients really remember. 

I never appreciated that during the 46 years before I retired– the outpouring of love, and cards, and letters, and gifts about how I touched them. They talked about the dental care and how I took good care of them, but they talked more about the connection that I had with these people. 

And my staff will say, “You hug everybody.” “Yeah, I guess I do.” “Don't you worry about that in today's world?” No, I don't. That's just me. I've always been that way, and the patients appreciate that. You know, my last patient that was in the office when I retired, she came into the operatory and she said, “Dr. Kahn, can I give you a hug?” And I said, “Of course.” She comes over, gives me a hug, and she's crying on my shoulder. 

Carrie:

I love that. 

Dr. Kahn:

And I go, oh, boy. And I turned to my head assistant Angelica, and I looked to her for help. And the tears are coming down her face. It wasn't very, very helpful. Those are the kinds of things that we led by example. But anybody who is doing dentistry today that is not involved with practice management to make sure that the most important person in your office is the person who answers the phone. That first person can make or break you if they don't know how to talk to people. If they don't know how to turn people who call up and say, “You accept my insurance?” You have to be able to take that patient and turn them and explain to them why they should come in and see the office, and speak to the doctors, and see that what we do is different than the other 10 dentists down the street. I lived and died by those basic rules that you have to make that connection because those people will stay with you for life. And they have.

Carrie:

You know, it's interesting, Dr. Kahn, that you say that you never really realized the impact of focusing on the patient and patient care until you retired. I find that interesting because from my perspective, the way patients are handled on that first telephone call is such a pivotal moment. And seeking out practice management and coaching support, it feels like you always knew that that focused intention on elevated patient care and building those relationships was the pillar that you wanted to build your practice on. So how did you make those decisions? How did you find team, and how did you instill that kind of mindset of that patient-centered, relationship-centered care throughout your practice, even in your partnerships, so that you could be a fee-for-service practice throughout your career, and so that you could build a patient family that was committed to you in your practice throughout all your 45-plus years of practice. How do you feel like that was centered in your decision making?

Building a Community of Like-minded Team Members and Partners

Dr. Kahn:

The hardest thing that we do is get good people to work for us. There's just no doubt this was true on Long Island; I'm not sure if it's the same in Oklahoma or in Dallas. I think finding the right people and starting off with the right people is important. Now, I got very lucky. I made a decision a long time ago that I did not want to practice by myself. I wanted to practice with somebody else.

https://youtu.be/og1NMmWJqv8?si=lraDnkhbc-mIHVag

This transcript with our Jameson Files host Carrie Webber has been lightly edited for flow. To enjoy the audio, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Setting our Team up for Success Regarding New Team Members

Welcome to the Jameson Files. I'm your host, Carrie Webber, and I'm so glad to be with you once again for another episode. As we roll into the end of 2023, something that we're finding in the seasons of our dental practices is perhaps some of you are overcoming that challenge of finding new employees and getting people hired. Today I want to talk about setting your team up for success when you are bringing a new employee or a new member of your team on board whether that is now or in the very near future. We're going to talk about things to consider and ways to successfully and effectively onboard new employees. And then the big question that is often asked is, how do we retain superstar team members? 

I recently did a presentation on recruiting, onboarding, and retaining new employees, rockstar dental team members. When we asked the group what the most important pieces of this topic were that they were hoping that we would cover, the large majority of the requests and the goals and objectives for our time together were how do I retain, how do I build accountability, how do I build engagement in my team? So it really has come full circle to not finding team, but now that I've found somebody great, how do I keep them? So again, today on the Jameson files, we're going to talk about how to set our team up for success, especially when we're talking about hiring, onboarding, and those new employees that are so valuable. Of course all of our team members are valuable, but how do we keep these valuable team members onboard and have them be as successful as possible in their new role? So let's get started.

Have a Clear Structure in Place When Onboarding a New Employee

When I think about the successful onboarding process of a new employee, it's important that we have clear structure and intention in place on that onboarding process and timeframe. We're looking at those 30, 60, 90 days of how to make this successful. We're measuring from all of that time as we're training, is this person the right fit? Can this person do the job that I have hired them to do? Am I training them successfully and clearly? Am I giving clear expectations of the role so that the person that's coming on board fully understands their responsibilities in this position in my practice? And do they have the desire and the willingness to do the job to the level of expectation that I have clearly set? So this is the thing that we want our pro training programs in our dental practices to do. We want them to help a new team member get fully invested into the practice and into your practice's culture, get fully productive in their role so they are as productive as possible and meeting or exceeding the expectations that you have set for that employee, and get interested in being successful.

We want them to be bought in and interested in experiencing full success and excellence in their role in our practice. So remember, we want our new team members to get fully invested, fully productive, and get interested in being successful. That's what a great onboarding and training program is going to do in your practice. So when you think about effective training, I want you to start thinking about what the plan is that we have in place to help this person be successful. We want clarity and consistency in training and onboarding. So as you are preparing for this new employee that's coming on board in your practice or that will be in the future, think about these things and make sure that we have all of these items in place in that training and onboarding window of time. 

Have Clear Roles and Responsibilities Lined Out For the New Team Member

Number one, have clear roles and responsibilities lined out for that team member for whatever role they're coming in on. Something that I find, especially if you have multiple business team members, is that we're hiring a lot of people to fulfill specific elements of the business systems of the practice, but often there is confusion in practices about who's ultimately responsible for what. So bringing on a new employee is probably a great opportunity for you and your practice to review the roles and responsibilities of the team you have in place, get those streamlined and clear, and then make sure that the roles and responsibilities are lined out clearly for this new person that's stepping into this new role. So make sure clear roles and responsibilities are lined out and that we are able to review that with that team member so they truly know, understand, and are up for the job they're stepping into.

Have a Clear Documentation Process

We need to make sure we have a way of documenting all of the things that person gets trained in, and that we're checking those boxes when those items are completed. We do that when we have that documentation process, and we can check the boxes and say, we've trained on this, we've trained on that, we've trained on that. That prevents things falling through the cracks and those accidental executions of systems. So what we want to do is protect the systems you've worked so hard to create in your practice. We want to protect that which is working really well for you. The only way we can do that is make sure we're training up successfully the person that's stepping in to help execute those systems now. So document the items that need to be done, and make sure we're keeping track of that.

Have a Schedule in Place for the Training Process

We want to schedule training. We don't want to just throw them out off the cliff and say, good luck. You said you had dental experience, so let's see what you're made of.

We want to have a schedule in place. We want to have a training plan so that that person knows when to expect this training to occur and you have a clear process to follow. That makes it much less stressful and a much clearer line toward the end result, which is a fully trained, fully engaged new employee. 

Delegate Different Aspects of the Training Plan to Appropriate Team Members

We want to delegate to appropriate team members different pieces of the training plan. It doesn't have to be one person training a new employee on all the elements of their role in a practice. In fact, I want the person training that employee on different elements to be the one that does that step the most or has the most experience or understanding of what “right” looks like in that process. So if you are hiring a clinical assistant, I'd love to have another assistant leading them through some of the training. If you are hiring a hygienist, if possible, have another hygienist do some training. If it's a business team member, I want to be sharing that training process with any other business team.

Doctors, you can delegate this out to different members of your team. Office managers, you can do the same. In fact, the more people that are involved, the more likely we have cohesiveness across the board, and the more invested everyone's going to be in making sure this team member is successful. 

Block Time for Progress Review

So delegate to appropriate team members, the different aspects of that training plan, and then make sure you're blocking time for progress review. If you are an office manager that's ultimately responsible for the training of a new team member, or if you, as a doctor, are the one that's leading this process along, we want to make sure we're blocking time regularly in those first 30, 60, 90 days to sit with that new employee, review what has been trained up to this point, give time for questions and for review, and answer those questions or do some continuous training or course correction.

That's going to be important, especially if early on you're getting lots and lots of questions from new employees. We want to give them time to batch those questions and ask those questions so that we build up their confidence and their competence in their role. So again, make sure you have clear roles and responsibilities lined out and that we're clearly setting expectations of what “right" looks like in this position. We wanna make sure we have some kind of document in a sheet where we can do documentation of training progress. 

We want to have a training plan and schedule in place. We're going to work on X, Y, and Z this week, and next week we're gonna work on A, B and C and so on. We want to delegate to appropriate team members different elements of that training process and training plan so that we're all sharing the responsibility of helping this new employee, new teammate be successful.

And we want to block time for progress review so that we can reduce the amount of distractions that those of you that are in the training positions may be experiencing and you can fully support that employee in their work and their training and their progress. So remember, clarity and consistency is important. 

Train to the Standards that you Want to See Executed

We need to train to what “right" looks like. A lot of you that listen to the podcast or have seen me speak, ask this question all the time. In your processes, in your ideal dental days, what does “right" look like? So we need to make sure we're training these new employees on the answer to that question. Something that we always put ourselves at risk at when we hire someone, especially when we hire someone with dental experience, we're so relieved to have someone in that position that we just assume they know how to do things the way we would want them done.

Do not assume that they're going to do things the way you prefer them to be done or the way that works great for your practice.

https://youtu.be/BYqBZ89Jtd4?si=QlFSJspjQ2wmxA0v

How Authenticity Can Help Your Marketing Efforts

The following podcast has been lightly edited for flow. To enjoy the audio conversation, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Carrie Webber:

Welcome back to the Jameson Files. I'm your host, Carrie Weber, and so excited to be coming back. While we're recording this, we are entering into the fourth quarter of 2023. And why I wanted to bring that up is because today's topic is going to be all about the trends in marketing, what we see happening, because what I hope that all of you are doing is preparing yourself now for the year you want to have in 2024. I'm thrilled to be joined with my guest friend and teammate, Nate Porter, who is the chief marketing officer of the Jameson Group. Nate, thank you so much for joining me today.

Nate Porter:

Yeah, thank you for having me. Excited to talk about this topic.

Carrie Webber:

Yeah, and my hope is that in this episode we can share with you what the Jameson marketing team has been seeing, as of late, in terms of what's getting results in marketing or what's happening that dental practices or dental business owners need to be aware of. And also, like I said, how to plan for this upcoming year–what you need to review and what you need to strategize for so that we can help you grow your practices or your businesses, whatever the case may be. So, Nate, I want to pass it over to you for a little bit. Tell me what you're seeing and what your recommendations would be at this point in the year.

Authenticity Breaks through the Noise in Marketing

Nate Porter:

It's interesting to watch trends and see what's happening with marketing in general. One of the things that we see a lot of is a really widening gap in terms of what people are doing for marketing. Things have evolved and some people are still looking back at their 2015, 2016 strategy, and they think that it’s going to continue to work, and it may in some markets. But what we are seeing is that there's a lot more people who are really advancing in their marketing, and they're really putting a lot of effort, a lot of resources behind their marketing. And so what that looks like is, as we've been talking about over the last number of years, is a trend towards more authenticity.

And so they’re moving away from this templated, very static, very generic feel to online marketing, to social media, all of that sort of thing, to a much more genuine approach. And, I think, as you look at the marketing industry as a whole, and you listen to leaders in the industry, what you hear is the importance of understanding the signal-to-noise ratio. So as you have more demands on attention, more demands on people's time, more competition, frankly, in the marketing space, including dentistry, you have a harder time breaking through that noise. And so what can break through is not shouting louder about your list of services that you offer, or being more pushy about your message, but being more authentic.

And so what we see as tools for that are creating a conversation with your potential patients or even with your patients online. That conversation needs to start online.You can't wait for it to start in your practice. And so that can be things like video, like what we're doing here today, where we're having a conversation about topics that are relevant. It can be authentic photography of your team, and your practice, of you interacting with patients. Dentistry can be something that creates anxiety. This feels warm, it feels welcoming, it feels like something that you want to engage with. The contrast has gotten so much clearer between what was common in the early 20-teens to today. It’s night and day from people who have kept up and kept moving their marketing forward.

Carrie Webber:

I love this point. I think the hangup, especially in dentistry, is historically it felt like you could have this set-it-and-forget-it mentality.  I am there, I'm online, I have a website, I have a logo. (Whether it's a good one or not is for another conversation.) We just don't put enough emphasis on the “why” behind marketing in the first place. 

I love your point about the authenticity and the use of video. People feel like they don't even know where to start with that. Start with the people and the products and the brands and the businesses that you really enjoy seeing online. I guarantee that almost every time, the social media influencers or businesses that you follow have some kind of fantastic video piece that's included, because of your point, Nate, the authenticity of it. We get to see a little bit more of the “who” behind the “what” and to see that type of connection.

I always tell people in lectures that marketing evolves quickly, and it evolves because of how the consumer is gathering information, how the consumer is using online resources, and how the consumer is finding what they're looking for. So marketing isn't continuously changing just to make your life harder. Marketing's actually changing to make the consumer's life easier. And so that was something that I wanted to share concerning what you're talking about. Sorry to interrupt, but I love the point that you're talking about in terms of authenticity.

Authenticity Helps Businesses with Smaller Budgets Compete

Nate Porter:

I think it's a really, really important point. The other thing too, I think is, you can probably get a little bit discouraged if you see some of the big corporate entities coming in. Some of them look really polished, and a lot of them are spending a lot of money on marketing– TV and otherwise– and you wonder how you are ever going to compete with a $12 to $15,000 a month budget per practice. The thing is that they are taking a shotgun or sledgehammer approach to it. So there are a lot of ineffective dollars being put towards marketing in those situations. And you can compete if you're authentic and you're strategic with a much, much more affordable plan. Just the fact that you are personal, that you do care, and that you are focused on the patient is a big differentiator if you can frame that message in a way that breaks through.

Carrie Webber:

Absolutely. And just to answer the question for yourselves as businesses– how can I be more present in my efforts? How can I really show up more? It doesn't have to be perfect. To your point, Nate, it doesn't have to be this shiny thing. It's really about that authentic presence in your message, and repeatedly doing that. You have to be continuously putting effort into it. Some of our favorite clients use a combination of the services that we provide for them, and they bring in their own mix to the recipe, using their own team and skills and time and efforts. And I think that's really a secret sauce–using professional services to give you some really high level great content, great video, a great website–all of those pieces. Then combine that with your own personal efforts as a team to be continuously posting and reaching out and connecting with your community, your patients, your online reach, and so on. Would you agree with that?

Nate Porter:

Yeah, a hundred percent. I think it’s really important. One of the things that can be overwhelming for practices is understanding what tools to use for what purposes. And so you try this, and try that, and do a little bit of everything, and you can probably feel overwhelmed and discouraged pretty quickly. One of the things that we look at when we look at practices is their goals and the outcomes that they’re hoping for, and then we identify what tools meet those needs.If you're looking to build referrals and engage with your current patient base, we really recommend strengthening your social media efforts, and maybe even personal email campaigns, because that really connects with your existing patient family and it helps create some buzz around your practice.

Improving Your Business’s Appearance on Google

If you're looking to grow new patients and build traffic in that way, your focus really needs to be on your website, and it needs to be on the ways that you can leverage your website to grow traffic from Google. We know that 85 to 90% of that traffic comes from a Google search to your website, so that's everything. It can be as simple as making sure that you're asking for reviews verbally when you have patients in your practice, not just putting a sign out there that says, give us a review. The other thing that you might want to look at is what the patient sees when they are searching for dentistry in your area. If your listing comes up on Google, and there's a picture on your Google listing that looks dark and uninviting, or maybe just a picture of the street view of your building, you can change that really easily and give a more welcoming feel.

And often for people that's the first, and sometimes the last, impression of your practice. Things like that are things that would be easily updated and changed. I really like what Gary Vee says, putting it in dental terms, “You no longer have the luxury of being a dentist who does marketing, you're a marketer who does dentistry.” You have to think about how you incorporate storytelling throughout your process and your day.

Carrie Webber:

Oh, I love that. And you can see it online. You can see it with the people that just get it– that recognize they need to be continuously on top of what's working and staying relevant. I was just talking about this the other day. Your online presence is not only building a type of perception for potential patients and your existing patients, but it's also building perception for potential employees of whether or not you are a practice that they would want to work at and be a part of. So it's important to keep in mind that this needs to be a priority, not just once,

https://www.youtube.com/watch?v=fFBFU64O-TU

Dr. Dimple Desai and Her Career in Cosmetic Dentistry

The following podcast has been lightly edited for flow. To enjoy the audio conversation, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Video Link: https://drive.google.com/file/d/11pxopvZ9Fq2Tk2OrGS96Ttyo7XfndvHC/view?usp=sharing

Carrie Webber:

Welcome to the Jameson Files. I'm your host, Carrie Webber, and we are back recording live episodes at the AACD annual meeting in Grapevine in Texas. I am so thrilled to have with us today our Jameson marketing client, Dr. Dimple Desai from Newport Beach, California. Dr. Desai, thank you so much for joining me. 

Dr. Dimple Desai:

Thank you for having me. 

Carrie Webber:

Now, I can't wait for this conversation because we have just met. You've been working with my team, but I haven't had the privilege of getting to know you, so this is going to be my opportunity to learn just as much about your story as everybody else. 

Dr. Desai’s Beginnings in Dentistry

Dr. Desai practices extraordinary aesthetic dentistry in Newport Beach, California. When you're walking around the AACD meeting, she's on videos, she's in the magazines. Your work is incredible. I would love to know how this all started for you. Tell me a little bit about your story in dentistry. What led you to dentistry, and especially what led you to this specific focus in dentistry?

Dr. Dimple Desai:

So when I was, I believe 13 or 14, my mom's local dentist needed an assistant. So my mom said, “Hey, Dimple, do you want to go help out?” I said, “Sure.” So that was my first real exposure. Thereafter, I knew I wanted to do something in healthcare. At 17, I started school at USC, and I didn't know what to do. I was like a lost puppy. Mind you, I'm also the first female who ever went to college in my family. So I didn't really have any guidance or support. I just had to figure it out and take it from there. So I went to the counselor and I said, “I need help. What do I do? This is where I want to be, but I just don't know which avenue to take.” So she said, “Well, why don't you look into dentistry? The dental school is on campus. Go on over there.”

So next thing you know, I was there every single week, and they would hear my footsteps and the admissions director's name was Mark Mitchell. He would hear me, “Is it Dimple? Is that you again? Oh my God, You're too much.”  I said, “Mark, you know, I'm 17. I don't know what to do. I need help. I think I'm going to be a dentist.” He said, “Okay, so let's help you out here.” 

So they had a program where you can go through dental hygiene school and then move on to dental school so you can shave off a year from dental school. At that time, that's what sounded good. And he said the same. You can learn great chairside manners, practice dental hygiene, which is a great career in itself, and build your skills to that level.

So I did everything he told me to and started dental hygiene school at USC my third and fourth year. I did all the prerequisites and so forth. Thereafter I finished, and I decided to work six days a week and make a little bit of money. So I practiced dental hygiene for two years and then went back to dental school and the rest is history. Then obviously I got married, I had my children, and so I was just an associate, but I would always go to continuing education courses. I never stopped and I'd come back Monday morning super hyped like everybody else from learning and ready to implement. However, it's different when you're an associate and you're not able to implement right away because you have an employer who's not always on board.

Desai Opens Luminous Smiles and Focuses in on Cosmetic Dentistry

So finally I decided that I need to practice dentistry the way I want to, and I opened Luminous Smiles.  I call it my third child. It's five years old now, and I can't tell you how much joy it's brought me. It's not easy, it's not an easy path, but at the same time I'm able to practice dentistry the way I want to. 

Thereafter I finished my Kois education and I got into AACD.  I remember my first meeting was in 2018 and I saw what it was doing for people and the high end aesthetics. So that put me on another mission of getting accredited. Now you have five years to complete accreditation, but I felt as though I needed to catch up because I lost so many years from being an associate. So I finished accreditation in one year. I just put my head down and went to work. I can't tell you the journey, the people I've met, the mentors, the friends–  you're surrounded by like-minded individuals to practice this quality of cosmetic care and deliver the best to your patients. I'm forever grateful. And now I'm onto the next pursuit.

Carrie Webber:

When you started honing by obviously getting some extraordinary advanced clinical training, how were you able to start to establish yourself in your area, in your community, as offering that type of dental care that patients might be seeking out? What were your starting points there? 

Dr. Dimple Desai:

That’s a great question. So in Newport Beach, everybody's a cosmetic dentist; however, there isn't really accredited cosmetic dentistry and it really distinguishes you from the rest. In addition to just the label, it's the way you perceive dentistry, how you practice it. So for me, I had to build my reputation, and at the same time I would publish articles. I would get myself out there and just work with individuals who can hone in on my skills and help me improve. For me, it wasn't a mission to be known. It's just as long as you provide quality and do the right thing, you will get the referrals you need and get to be known out there.

Carrie Webber:

I love that point. It wasn't your mission to be known, and yet here you are, you are known, because you committed very early on, from actually the very beginning, to whatever you were going to do, you were going to do it really well. 

Tell me what that continuous development looks like for you now. You've reached so many great way points in terms of becoming accredited and starting to be known for those types of patients that are looking for that type of care– that advanced level of care. But for you, what does that 

continuous development look like?

Dr. Dimple Desai:

So for the next chapter of my life, I want to provide education, and help those who want to learn these skills, and start lecturing, and doing some hands-on training. I have some gigs set up already. Dentistry's so amazing; there's so many avenues you can take, and if a person wants to take a different avenue or pursue, say, cosmetic dentistry, you have to improve your skills. It takes practice, it takes repetition, and I would love to help somebody. Even while I was here, I've had a few individuals come up to me who've seen my Instagram, seen my work, and comment that they've read my journal. I can't tell you how humbled I am just for them to say that to me. So my next step is just providing education and helping those who want to be helped.

How Quality Marketing has Helped Desai Become Known in Cosmetic Dentistry

Carrie Webber:

I love that you want to help others and that you're now in a phase of mentorship, but I also keep thinking about the “being known” aspect. I keep going back to that because I think you do put forth effort. You see the value. You're a marketing client of ours, and so you see the value of the message. And you've mentioned your Instagram and putting really quality content out for people to find that reflects who you are and your practice as a brand. There are a lot of practices that are basically checking boxes. They have a website done, but they're not really and truly invested in making sure that everything that is out there represents who they want to be. Why do you see the value in that? You've seen it from the beginning. You can tell by the way your

messages are, and how you are found, your social media, and everything. Why do you think that that resonated with you and you saw that important so early on?

Dr. Dimple Desai:

I'm just very detail oriented. Every little bit matters. And it's exactly what you said. It's just representing you. So how do you want to be represented out there? I want to show you what I can do and what I can provide. At the same time, my pictures have to be perfect. The alignment has to be perfect. How much should I drive you guys crazy with the website and with the development?  I still look at it and I'll say, “Hey, we need to change this, or let's fix this.”

Carrie Webber:

But that's also what makes you such a tremendous clinician– that attention to detail.

Dr. Dimple Desai:

I have been super detail oriented from day one. I can do the same procedure every single day, but yet to me it's a different procedure. And I'll check and triple check just to make sure everything's perfect before we move on. And my team or whoever works with me, they know too.

How to Find a Focus for Your Dental Practice 

Carrie Webber:

They know. For those that are at this meeting for the first time, or are exploring and wanting to pursue a specific area of focus, or bring new services or procedures into their practice, how would you prepare them for that? What advice would you give or are you giving to these people that want to be doing more or want to be doing things at your level?

Dr. Dimple Desai:

I would say invest in continuing education. Nobody can take away what you've learned. Practice. For instance, I love doing composite bonding, and that is not an easy procedure, especially aesthetic composite bonding. During Covid, obviously we were all shut down. I set up my entire dining room table into a laboratory and all I did was bonding on my table. I bought my hearing light home. I bought a waxing unit off eBay and, I think,

https://www.youtube.com/watch?v=RagPVYRK1w0

Dr. Cappy Sinclair Shares About the Power of Vision in Dentistry

The following podcast has been lightly edited for flow. To enjoy the audio conversation, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Video: https://drive.google.com/file/d/1zsfYdt8jDBr6H-lmkSWfcjxdjG7znpfw/view?usp=share_link

Carrie Webber:

Welcome to the Jameson Files. I'm your host, Carrie Webber. Thanks for joining us for another episode. We are really excited to be joining you today from Grapevine, Texas at the American Academy of Cosmetic Dentistry's annual meeting. We're thrilled to be back at the AACD meeting. It's been some time and we’re so happy to be here with the Jameson team. I'm especially thrilled that we're spending some time today with our client, a great friend, Dr. Cappy Sinclair. 

Dr. Cappy Sinclair: 

Thank you. 

Carrie Webber:

Dr. Sinclair, thank you so much for being with us. 

Dr. Cappy Sinclair: 

Glad to be here.

Carrie Webber:

Before we started this episode, we were reminiscing that Dr. Sinclair was the Jameson Files’ very first podcast guest when we launched the podcast in 2019. 

Dr. Cappy Sinclair:

And I got invited back.

Carrie Webber:

I know. It was a success. So we'll see how you do this time. No pressure. I’m thrilled that you’re  here. There are two episodes with Dr. Sinclair from very early on in the podcast, and I invite and encourage you to go find those episodes because I still feel like they're very powerful, and you shared some great information and insights in those episodes. 

Dr. Cappy Sinclair:

I talk about that probably at least once a week to someone that reaches out and wants to know how I got to where I am and what was the most important thing that I did.  I still feel like one of the most important things was setting up where I wanted my practice to be. Without that vision, I would not be where I am today. 

Dr. Sinclair’s Beginnings with the AACD

Carrie Webber:

I love that. I love that. And speaking of establishing that vision of where you are, not only in how your practice runs, but in the clinical skills that you do, you have chosen to become deeply involved with the AACD and have been for several years now. Would you tell us a little bit about how you chose to be a part of this organization and a little bit of how you started within this, because now you are an accredited member? For those of you that aren't familiar with that process, boy, that is a feat. That's a lot of work and effort.

Dr. Cappy Sinclair:

Besides starting my practice, I would say that's probably the one thing that I've learned more about anything else in dentistry– making myself a better dentist, seeing what education I should take, where I direct my attention– all of those things were because of trying to become accredited. Now being on the other side, we're starting to mentor other people that are going  through this process. Having the insight of going through it myself, I can give them experiences that I learned along the way that hopefully will help them out. 

Carrie Webber:

I love that. I love the story of the beginning of your relationship with this organization. I think it's pretty special for young doctors that are just getting started and really trying to find their way. Will you share that with the audience?

Dr. Cappy Sinclair:

This meeting's special in particular for me in Grapevine because this location was the first AACD meeting that I came to in 2010. I was actually working close by. I worked in Oklahoma City. I actually did not know you guys at that time, which is crazy.

Carrie Webber:

That's a strange connection.

Dr. Cappy Sinclair:

I worked for a group practice there and I just wasn't happy. And so long story short, I ended up quitting that job in May or April. And I knew this was going on in Dallas, so I tried to time my leaving that job with coming down to this meeting. So I think I left on Friday from Oklahoma City, packed up my stuff, and then drove down here to the Gaylord. The problem was I had just quit my job. I was in tons of credit card debt from traveling back and forth all over the country, and I didn't know what to do, so I couldn't stay at the Gaylord, which was probably $600 a night or something crazy, so I ended up camping. There's a campground actually a mile and a half away from here, so I ended up staying there for about four or five nights.

It was beautiful. There's a lake there. I got to watch the sunrise and the sunset every day. I would ride my bike every morning from the campground over here. I didn't know a soul, but the dentistry that I saw here changed my life. I knew that one day I wanted to do what these people are doing here. I think that drive and ambition really fueled me continuously over the years. So it was an experience I'll never forget. I drove the rest of the way across the country, back home, and then two years later ended up starting my practice with the vision of knowing that I wanted to be on the stage accredited someday. 

Carrie Webber:

Wow! And where are you staying this year?

Dr. Cappy Sinclair:

I'm actually staying in the hotel, which is great. 

Choosing Resources that will Aid you in Your Dental Vision

Carrie Webber:

It's a true success story. I think that's so amazing and I love that this was one of those pivotal moments for you that really started to create the framework of your vision for how you practice. Something that I really appreciate about you is that as long as we've known you, you have truly and intentionally sought out resources and training–both clinically and for the business side of your practice. You’ve taken your vision and sought out the right resources for you. Because you're also very involved in other things, not just AACD. So would you share a little bit for those that are trying to find their resources, their training, their people or organizations? What do you go through when you’ve decided that this is what you’re going to explore at this time? 

Dr. Cappy Sinclair:

I think the hardest part for being a dentist, and especially if you're a solo practice owner, is there's only so much time for you to leave the office. And if you're going to be doing that, how do you make it count? If I leave the office, it's for a vacation– I love to travel– or I'm going to go to do some educational event. 

For me, when I was trying to establish again where I wanted to go in my dentistry, I considered who are the clinical leaders in the world that are going to be the best dentists for me to learn from, and how do I get there? What's my path and how do I start at some of the more basic things and move forward? I think one of the biggest challenges is that with social media today, a younger dentist graduating is just barraged with clinical photos on Instagram of “before and afters”, but they don't see the journey that the dentist went through to get there.

A lot of people, unfortunately, want a really quick fix. What's the one course that I can go to to make the difference? And there's not one course. It's going to Kois; it's going to a functional occlusion, learning how the teeth work, how function masters and creates the proper aesthetics, business training courses... Once you do the dentistry, how do you sell the dentistry to your patients? How do you motivate your team to sell the dentistry to your patients? All of those courses, I think, compound into your education, and if you're just going to take a course on the weekend because you like the location, then is that really the best place to go?  So just because it's a course on implants and you want to place implants, is that the best place for you to start or do you need to learn how to take teeth out first? So, if you're a dentist learning or wanting to expand your horizons, I would actually say figure out where the baseline is first. It might not be the sexiest place to start, but it's probably the best place from a foundational aspect, and then build from there.

Carrie Webber:

My father, John Jameson, had an identical mindset and mentality to yours. If he were here, he would say to doctors that are looking to expand the way they practice or even just the depth of their skills, that one of the greatest investments he made for himself was continuing his clinical training and education. He chose his people, his resources, his organizations to be a part of and never stopped as long as he was practicing until he retired. I don't know if this is good news or bad news for a younger dentist, but it's not over at graduation. It’s just starting, because at that point, there's a lot of work to be done for your own self and your own skillset, your own efficiency, your own level of success, whatever that is. So the vision is so important. Where do you see yourself in the foreseeable future? What do you want that to look like for you? I love your point of starting at the very beginning. Where am I right now with my skills or with my business or whatever? Where do I just need to start?

Dr. Cappy Sinclair:

Yes. Mastering the basics is really important. Most great athletes practice the fundamentals before they become great. So again, it's the same process of just practice, practice, practice, but practice the basics and get good with that.

Carrie Webber:

Yes. A lot has happened since the last time we were sitting across from each other like this in 2019. You now have a business partner, Dr. Mark Reichley. You now have taken two locations between the two of you, and you have combined them into the most extraordinary facility.

Dr. Cappy Sinclair:

Yes. It's awesome.

Carrie Webber:

It's gorgeous. You both have continued to invest together in clinical training,

https://www.youtube.com/watch?v=gEcKkM2Qcn4

Our transcript of the discussion between Lois Banta and Jameson Files host Carrie Webber has been lightly edited for flow. To enjoy the audio conversation, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Utilizing Your Dental Practice’s “Why” to Help Navigate Relationships with PPOs

Carrie :

Welcome to the Jameson Files. I'm your host, Carrie Webber. Thank you so much for joining us once again for another episode, or perhaps for the first time. We are certainly so glad to have you with us as we continue to bring information and resources and experts to you to help you be as productive, as profitable, and as fulfilled in your dental practicing life as you can possibly be. Today, I am so excited. We are coming to you from the Jamon offices in Oklahoma City, and look who I have here, our dear friend and colleague in the dental realm, Lois Banta. 

Lois Banta:

So excited to be here and doing this with you for the first time. A real honor, and I'm sure we'll share a few giggles.

Carrie :

Maybe so. We just need to try and keep ourselves under control. We'll see.There are no rules in this. I'm just so glad to see you face-to-face and to have you in the room with me. This surprised us because we have collaborated together, and we have Lois as a guest educator and presenter on the Grow pathway that is launching as we speak on the very popular and needed topic of how to navigate PPO relationships in your practice. It’s going to be a phenomenal resource for all of you that are on Jameson's Grow learning platform. We’re very excited to share your knowledge with the members of Grow. 

How to Make Healthy Decisions about Your Relationship with PPOs in Your Practice

Today we're going to dip our toe into that topic a little bit because it only seems right to keep carrying forward the conversation that we've started here about PPOs. How do you navigate those relationships? How do you make healthy decisions about your relationship with PPOs in your practice? Do you have one? Do we need to perhaps step out of one? Do we need to do something different in the months and the years to come to help you in your pursuit of your ideal practice vision? Really, that's what it all comes down to.

Lois Banta:

It's such an important decision to make, and it’s one of the most difficult decisions that practices in our industry make. It’s scary. There's a lot of thought that has to go into it, and if you don't do it the right way, you could lose all your patients. So it's a pretty serious topic right now, especially with the insurance reimbursements being lowered across the board with many of the plans. Practices are taking a really big financial hit. It's really time to consider where you are in that relationship and where you want to go.

Carrie :

It's interesting because you've been educating dentists and teams for a long time, 23 years now. Jameson has been in the industry as a company for 32 years, and over those years, the landscape has really, really changed. We're seeing this continuous shift, and truly two paths diverged in a woods, and you need to decide what path to take. As you’ve said, it really has to align with your “why”.

Lois Banta:

Yes. You have to be very passionate about why you're making the decision. As soon as you can wrap your heart around your “why", the decision becomes fairly easy, but you still have to pay very close attention to the process in making that decision. But ultimately, back in the day when insurance was even invented, I think in the seventies, there really weren't a lot of in-network plans. It was just insurance coverage, and it typically covered most of the patient's dental care for a 12 month period. And now those maximums haven't changed, not because of the insurance industry, but because of employers' budgets not wanting to pay high premiums for those benefits. So the maximums don't change, but the cost of that dentistry has changed greatly. So somewhere along the line there became this process of, if you become an in-network provider and you make a contractual deal with us to lower your fee-for-service fee, you'll be able to get more patients.

So it was used as an avenue to acquire more patients, but it became the beast. It was a really great idea, and maybe it is still a great idea for some practices. Some practices can manage it very well, but the ones who are really getting caught off guard and caught by surprise with the insurance industry lowering reimbursements and increasing adjustments, have really taken a hit in the pocketbook. And that's when it becomes a really important decision. Where's your tolerance level? When is it time? And once you've made the decision, it's time, how do you do it?

Myths that Prevent Practices from Making Healthy Decisions about PPOs

Carrie :

I know that you work with a lot of teams in retreats and in your mastermind sessions on how to do this and on how to make these decisions. At Jameson, we help practices step out of relationships in PPOs all the time. But I think you and I both know that sometimes that process and releasing the fear of the “what if” with practices can be very difficult. What's some of the pushback that you see and experience that you've overcome with practices? Let's bust some myths here that may be preventing practices from making really healthy decisions about this.

Lois Banta:

It's the noise that plays in your team's heads where they're very, very sensitive to what they feel the patients want and need. So it's a perception. You're going to get the pushback when the team has a general perception that it's going to cost the patient a lot more money. So one of the myths is that it’s going to cost the patient a lot more money. Insurance reimbursement typically increases when a dentist changes the relationship with how they work with them. So they're no longer in-network, so they've removed the barrier of having to charge a lower fee. They charged the fee-for-service fee. Typically, the reimbursement will catch up to that fee-for-service fee. So one of the myths is that your patient's out-of-pocket expense isn't going to go up by the amount that the practice is writing off. The practice is writing off those dollars because the dentist signed a contractual relationship with that insurance company to lower their fees, therefore increasing adjustments

Carrie :

I think you're going to have to go on the Grow pathway to get all the details, or go see Lois in lecture, or bring her in for a retreat. Something that really resonated with me was the reality of the write-offs. A lot of decisions are being made, or not being made, in dental practices without the practices doing the due diligence to understand really what your relationship with these plans are.Some of the most painful realizations are when a practice is meeting their production goals, high-fiving each other, thinking this has been a great month, and then bam, you're cut up at the knees because you just wrote off 50% of what you produced that month. You worked your rear end off for that. You had some really “aha” moments in that part of your presentation.

Understanding the True Cost of PPO Relationships in Your Practice

Lois Banta:

Yeah. The twofold analysis is analyzing all the data of production, collections, and adjustments. Then if you're going to dig a little deeper in it and really analyze the “by code” adjustment percentage, most practices realize that they're struggling when the doctor goes to pay the bills at the end of the month and suddenly, “Hey, we've produced all this money. How come I don't have enough money in my bank account?” Because they haven't really gone in and done a deep dive as to which plans they're adjusting the most dollars off, which ones are not allowing the benefit when the benefit should be there. It puts the practice in a hypothetical position that the team tends to adopt, so the thing causing how to react to everything is based on inaccurate data.

Then the team starts having these conversations with the patients telling them that they can't do this or that because their insurance doesn't allow it. Then the practice is at risk for diagnosis and treatment plan discussions based on what the insurance does and doesn't cover, which of course is not in the patient's benefit. It's almost like a scare tactic that then drives the mindset. And that's where you're going to get a lot of pushback from the team with that mindset, because they're so entrenched in what insurance will and won't cover, what maximums are going to happen, and when they're maxed out or whether there's a deductible. It drives the conversation instead of letting the practice drive the conversation with what is truly in the patient's best interest.

Carrie :

It’s interesting. I was just kind of reminiscing back to the last AADOM conference. I was on a panel, and you were the moderator of the panel. And I always say: why don't they just put all the insurance speakers and experts on the panel, because the questions are always about reimbursements or being in-network, or changes that are being made to the agreements? And you know, you found yourself working a little harder.

Lois Banta:

I did. I found myself being on the panel and being the moderator. 

Carrie :

Again, the point always is that your practice vision can be whatever you want it to be, and if being in-network is important to you and how you want to care for patients, that's great. You do you, but understanding what that means and what that's going to have to mean in terms of how you run your practice is important. 

Lois Banta:

You're going to have to make financial decisions on your expenses. A lot of practices make these decisions based on where their overhead starts or stops.

https://youtu.be/aybdFJs9nig

Our transcript of the discussion between Dr. Angela Ferrari and Jameson Files host Carrie Webber has been lightly edited for flow. To enjoy the audio conversation, you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Dr. Angela Ferrari Speaks about the Importance of Team Development

Carrie Webber:

Welcome to the Jameson Files. I'm your host, Carrie Webber, and we are so excited to be presenting to you this episode live from the AACD annual meeting in Grapevine, Texas. I am very excited that in this episode we are with a client of Jameson. I don't even know how long; you might have to tell me– Dr. Angela Ferrari of Long Island.

Dr. Angela Ferrari:

Oh, it's such a pleasure being here.

The Beginnings of her Dental Journey and Their Involvement with Jameson

Carrie Webber:

I feel like we are kindred spirits. We are just so happy to be together. And I'm so thrilled that you said yes to being on this episode because I feel like a lot of pieces of your dental story and your dental practice is going to resonate very deeply with listeners or viewers of the podcast. And so, to start with, I'd love for you to share a little bit about your dental story. What has led you into dentistry to where you find yourself today? Then we’ll go from there. Would that be all right? 

Dr. Angela Ferrari:

First of all, I just love you. Thank you so much for having me here. This is just an honor. Thank you so much. As for my story, I figured out that I wanted to be a dentist when I was in high school. And actually my own dentist, Dr. Donald Conn, became my partner, but that's getting ahead of ourselves. I shadowed him as a high school student, and it was one of those Oprah “aha” moments, where I was interested in science, I was interested in medicine, but that didn't quite fit the bill. I watched, I shadowed for a summer and I felt like, “This is it”. This is exactly what I want to do. The patient care, how he was with his patients, the work he was doing, working with his hands, the artistry, I realized this is for me. From that point on, I knew that this is what I wanted to do. It was just like eyes on the prize– focus all the way to the end.

Carrie Webber:

Wow! I love that. And today you have quite a significant practice. You all have really built something wonderful. Share a little bit about what the practice is today, your size, what you  focus on, and the energy that your practice is for you.

Dr. Angela Ferrari:

I want to start from that history. When I graduated dental school, I went to Donald's and I said, “I'm done. Do you have a place for me?” And he said, “Come on in.” So we started working together and I said that I have one more person to bring into the group. And it was my husband who I met in dental school. So Dr. Aldi and I were like a pair and…

Carrie Webber:

He is in the wings as we speak right here. So I feel like you need to lean in and wave. Come into the camera. I love it. 

Dr. Angela Ferrari:

So our practice became a real family. Donald was definitely a mentor to us. I joined in 2001. We became partners in 2005. So it was all history after that. It was the three of us. Donald actually introduced us to Jameson, and that was in 2003. So it's been a really long time that we've had Jameson to help us grow as providers.

Carrie Webber:

And we continue to work with you. You still have Cathy at your practice.

Recognizing Each Member of Your Dental Team as Important

Dr. Angela Ferrari:

It became the fabric of how we work. It really resonated with us with how we want to practice– the methodology and being there for your patient, not only with your skills and your clinical excellence, but with how you treat people and how you treat your team. Your team is everything. And I feel like that is what Jameson brought to us, and that's why we continuously have Jameson back. It refreshes us and fills the bucket. It's awesome. Our team is special to us, and I feel that that's what makes us excellent providers to help bring this excellence to our patients. 

Carrie Webber:

Yes. I love that. And you know, something that we had talked about before we started this

episode was how your team and how you all have been very committed, and not just with Jameson, but in overall development, training, and education. That seems to me, as a person watching you, that that's been a big priority for you over time. Share a little bit about the decisions that you make as business partners, as the leaders of the practice, of how you choose to do that and invest in your team, and what you get back from that, from the team in terms of performance or commitment or the culture of the practice.

Dr. Angela Ferrari:

We are so proud of our team and how highly trained they are. They bring an energy that makes them easy to train, and we want to share knowledge with them. It's so important to have them be on the same page as us. I always say I cannot do what I do without my assistants, without my entire team, my front desk team, my office manager, everyone. They are amazing. It's really not just about you the doctor; it's about how every interaction that your patient has– from the minute they get that phone call, from the minute at the desk when they're welcomed to bring Brooke back into the chair. Then, you know, I'm the 10th person they see.

Carrie Webber:

Absolutely. 

Dr. Angela Ferrari:

I want my patients to have a stellar experience and that's all from my team. And I think going through continuing ed is what helps them grow. They want to provide that. My team wants to give that, and I'm happy to help them get there. It just helps everyone. So it's very, very important for us to stay up on their education just like here at AACD, and that is why we're super excited to be here learning new techniques. My assistant already texts me. She's asked, “What are you buying? What are you bringing home? I want to get trained. Tell me everything.” And that's awesome. I love hearing that. And I don't just work with one assistant. I have a team of seven assistants, and we rotate through. So everyone has a chance to work with every provider and get a feel for what we're doing. It's a real integrated team. 

Carrie Webber:

I love that. And it's obvious that you have instilled into the culture of your practice that genuine curiosity and passionate enthusiasm for continuously developing and learning, and that your team is wanting to know what are you bringing back? What are you learning or doing, what's, the new thing we're going to be working on? Instead of the mindset of, oh boy, here they go again. Instead there's this passionate enthusiasm for what you all continuously do and work on. I love that so much. And I love what you were saying about how each member of the team is (you know we believe this), each member of the team is such a key component to the patient's relationship to you, with you, the relationship to their own dental health and that journey. You're building those building blocks of value and trust with every interaction before they've ever even set eyes on you.

Dr. Angela Ferrari:

Yes.

Carrie Webber:

And so I just want to reiterate how much I love what you share about that and your mindset on that because it's so true.

Staying Relevant as a Private Practice

Dr. Angela Ferrari: 

I feel like it's a very interesting time in dentistry. As far as a private practice goes, staying private and not changing that. And what sets you apart from all these other offices that are popping up- corporate offices- all down the street. 

Dr. Angela Ferrari:

I just think it's an experience. The patient, they know that. They feel it; they tell us; they tell my

assistants; they tell my team. I love hearing that. But honestly, that's what I think is the future. There will be corporate dentistry, but I think that we still have a niche. There are patients to still value the kind of service we want to give - the personalized service. That I know you, Carrie, and you're coming in to see me today, and my time is devoted to you, and only you, for that time period. I'm not going to be pulled in 85 different directions seeing different people. I am here for you. And I only hope that continues- that people still value that. But I know it's what we value and we're staying strong.

Carrie Webber:

And you obviously know that all three of you have had a very unique relationship in every way- that you are aligned in that and that you are that united front for your team to say, “This is important to us.” And also that you recognize and pursue that there is a place for your practice even in the changing environment and the changing tides of our profession, but it takes effort. It takes intentional effort to carve that place out for yourself, but it exists because there are patients, I bet, that are coming to you every single day because they know your names. They know your reputation. You're known in your area and community, and you worked hard for that to be the case.

Dr. Angela Ferrari:

I definitely think that it's never ending. It's constant. It's also staying up with the changes that are happening. You know, like getting your name out there. In years past, you'd put an ad out in the paper. And then there was a period of time where I did radio and I was on radio, and that was like a period. Nobody listens to the radio anymore. They have an iPod or whatever, so they're not listening to that anymore. So how do you catch people's attention? How do you become relevant to them? Social media? I'm not a dancing dentist, I'm not going to be TikTok dancing, so don't look for me.. But how do you stay relevant to your patients on a social media platform, which is where people are getting a lot of critical information and a lot of it isn't correct?