“You can’t outwork a problem.”

That’s what Dr. Ian Fontenot’s wife, Kim, said to him three years into his start-up practice. A second-generation dentist, Dr. Fontenot built his practice in Carencro, Louisiana from the ground up.

In 2013, after he couldn’t find a practice to buy, he opened his own practice in a new retail center while continuing to work three days a week at a health center. With one front desk and an assistant in the back, Dr. Fontenot performed the hygiene services himself.

By his third month, he was seeing 116 patients a month–by himself–practicing only three days a week. “By month four, I was turning a profit,” Dr. Fontenot said. “A few times I took off work at the health center so I could see all the patients coming in.”

At the same time, he was attempting to learn everything about how to run his practice. He had no systems in place, and even basic things were new to him. “I didn’t even know how to file insurance,” Dr. Fontenot said. By month five, Dr. Fontenot could no longer handle all the business coming in. “I quit working at the center cold turkey and hired my first hygienist full-time right off the bat,” he said.

Growing 30% year over year, business was good. But he was working so hard that he threw his back out. He was just three years into the practice and only 33 years old. “It was insane,” Dr. Fontenot said. “I didn’t know what to do. I was working over 40 hours a week. When everyone would leave on Fridays, I’d keep one assistant with me just to keep up. When I threw my back out, my wife, said, ‘You have to do something, you can’t keep practicing like this.’”

To try to get things under control, he sought advice from consultants who all told him to stop taking insurance and raise his fees. After dropping some of his insurance, he quickly realized this would not solve his problem. “The practice became more dependent on me because patients were paying a higher fee to see me,” Dr. Fontenot explained. “And that’s not at all what I wanted.”

Still searching for an answer, he met Wendy Briggs at a Break-Away Practice Seminar.

“What struck me was when Wendy said, ‘You can make your practice whatever you want, and you DO NOT have to stop taking insurance.’ This was different from every other consultant out there. Previously, every consultant told me the only way they could fix my problem was to charge more for my services and get off insurance.”

Not wanting to go that route, he had a long discussion with TTI hygiene coach Bert Triche. “TTI just felt like it would be a great fit,” Dr. Fontenot said. “I did a hygiene training with them and we just clicked. We had the same philosophy. TTI was dealing with organizations with massive growth. They weren’t telling people to get off of insurance. They were looking at what the patient, as a buyer in the market, wanted and trying to pivot the practice towards that, as opposed to pivoting the practice towards what the dentist wants. That was extremely appealing to me because I want to create a business as well as be a dentist. I felt that what consultants out there push you to do is naïve. They push you to do the opposite of what the patient wants. The patient wants fast, easy, reproducible, and cost-effective care. And every other business is going that way except dentistry.”

When TTI’s hygiene training doubled production, Dr. Fontenot signed up for the Blue Diamond Coaching program. “I didn’t know how I was going to pay for it, but then again I don’t know anything that I’ve ever invested in that doubled my money within six weeks the way the hygiene training had,” Dr. Fontenot said.

His Practice Has Doubled Twice in Three Years

The first year with TTI, working out of 3 to 4 chairs, Dr. Fontenot cut the number of patients he was seeing in half and still produced the most revenue he’d ever produced, exceeding seven figures. Last year, he was just shy of doubling his revenue again, working out of just 6 chairs in only 1800 square feet. Plus, he reduced his clinical hours from 40 hours a week down to 26 hours a week, while doubling production.

The Patient Experience Improved

Patients repeatedly praise him for the customer service they receive. “I have multiple patients who work in management in organizations where customer service is big, such as the hospitality industry,” Dr. Fontenot said. “They tell me things like, ‘I’ve been going to the dentist for 50 years and I’ve NEVER received customer service like this.’”

The number of reviews his practice receives exceeds the other practices in the area too, even the big practices such as Heartland. “Before TTI, I had 4 Google Reviews,” Dr. Fontenot said. “Now I have 268 Google Reviews with a 4.9-star rating, and over 800 reviews on the internet.”

He’s made huge leaps forward in protecting teeth and preventative care too. “We’re not a poster child for protecting teeth,” he said. “But prior to TTI we were at a 5% acceptance rate for fluoride, whereas today we are at around 80% acceptance.” He’s also tripled the number of preventative services he provides.

Dr. Fontenot says TTI has helped him see the many options of how he can design his practice to make it exactly the way HE wants. “We just continue to grow with what TTI teaches us,” Dr. Fontenot said. “The biggest challenge is to continue to grow and keep the same culture and the same core values and still provide quality care as we grow. But being involved with TTI, you see it’s possible. Going into this, you’re an island with preconceived notions of what you can and can’t do. Then you start meeting all these other dentists... people practicing one day a week, another practicing six days a week but only working three hours, so you can see all the possibilities.”

Here are 5 ways Dr. Fontenot has applied lessons from TTI to grow while delivering quality customer service and make his life sane again:

#1: Solve the Problem with Profitability and Hygiene

Prior to TTI, Dr. Fontenot was losing money on hygiene and it was only producing about a third or half of what it should be producing. To cover the cost, Dr. Fontenot was over- producing on restorative so he could pay his hygienists. “I knew I wanted a hygiene- centered practice and to have preventative be a big part of my practice, but that wasn’t happening,” Dr. Fontenot said. “It wasn’t the hygienist’s fault. It was mine for not knowing what a hygienist should be doing. It’s something you aren’t taught in dental school. They don’t teach you anything about profitability, much less what a hygienist should do day in and day out to deliver a high level of care beyond just cleaning.”

Within thirty days of doing hygiene training, his hygiene department was crushing it, more than doubling production. “Bert transformed my whole hygiene program within a month and showed me how to be profitable on insurance with my hygiene,” Dr. Fontenot said.

#2: Reduce the Workload

Within three months, he’d hired a second dentist and put in another operatory room after TTI advised him to. “I hired him full time right away,” Dr. Fontenot said. “I told him, I don’t know how we’re going to do this, but I have so many patients that I can’t see that as long as you come in and see patients, there’s no reason you can’t make money.”

Initially, production slowed down for Dr. Fontenot because of giving patients to the new dentist, but within four months, his production was back up again. “It was scary,” Dr. Fontenot said. “But he’s become extremely productive. Plus, he’s only working out of one room because we don’t have the space. Once I can build out, I know his production will jump up more.”

Since starting with TTI, Dr. Fontenot has built a team to help manage the practice too, adding another hygienist, two more assistants, another dentist, and another front desk person. He also created an office manager position. “I now have a full-time office manager position,” he said. “She is 100% focused on managing. This has allowed me to totally clear my plate. Before I had an office manager, people were coming in while I was doing a procedure to ask for time off and all kinds of things. Even the small things make it difficult to practice with those distractions. My production jumped up.” Spending only $500 a month on marketing, he still sees between 70 to 80 new patients a month, without taking Medicaid.

With the systems and a management team in place, he can focus on scaling production. “Now I focus where my time is more valuable,” Dr. Fontenot said. “For example, by having time to work with my other dentist, he’s tripled his production.”

#3: Use a Specialty to Increase Referrals

There are approximately 100 dentists in the surrounding area of Lafayette where Dr. Fontenot pulls patients from, yet he’s one of only five that do IV-sedation in a family practice. “IV-sedation exploded my practice,” Dr. Fontenot said. “Because most specialties don’t sedate, we end up doing all of the work ourselves rather than referring out to other dentists.”

While this is only part of his practice, it has been both personally and financially rewarding. His goal is to develop his people to be top-notch clinicians, top-notch sedation people, and top-notch in treatment and discipline. Although difficult, he loves the challenge. “The patients are hard because they’re coming in tremendously emotional, so you have to learn how to deal with that,” Dr. Fontenot said. “And because you can’t refer out, as a dentist you have to step outside of what your bread and butter is and learn how to do a lot of different types of dentistry. It’s extremely rewarding, though. Plus, once you help a patient with fear like that, they will refer you to five or six patients. Money isn’t an issue to them either, especially because it is difficult to find someone who does sedation and does it well.”

As a result of this focus and putting systems in place for his team, his staff says, “we’ve become a well-oiled machine” and “the patients love us.”

#4: Expand Hours to Increase Free Time for Everyone

Changing the hours was at first a hard sell to some of his team, however, now they see the benefits and are enjoying more free time. “I do split shifts and keep the office open from 8 AM to 7 PM two days a week,” Dr. Fontenot said. “This allows my staff more time off... one of my assistants often gets to enjoy drinking coffee and spending time with her husband in the morning, something she didn’t get to do previously. I spend afternoons and time off with my kids, 8 and 4 years old. I’m spending 30% more time with my kids than before.”

In addition to more free time outside of work, his hygienists aren’t under high pressure at work either. “One of my hygienists came from a corporate practice, and we run the hygiene department exactly opposite of the way they run it,” Dr. Fontenot said. “She sees half the patients, she produces the same amount of money, and my profitability is still there.”

#5: Run Your Practice Like a Business

“What TTI does differently is that they are teaching me how to run and scale a business,” Dr. Fontenot said. “How to actually systematize. In other dental practices, I feel the dentist is crazy integral, and while I still feel integral, it’s not in the same way as I was before TTI.”

Dr. Fontenot says the biggest discovery he’s made with TTI is understanding that it’s okay to grow and that you don’t have to sacrifice being an amazing dentist. “Growth doesn’t have to mean less quality and care,” Dr. Fontenot said. “Because our quality of care increased, and we’ve seen it get better while we’re continuously growing.”

Life is better for Dr. Fontenot, too. “Before TTI, all I had time for was to work on the business,” Dr. Fontenot said. “If you asked me a couple of years ago if I thought that at year six in a startup practice, in a town that I would never have gone to, that I’d be able to take off ten hours a week during normal clinical practicing hours, I would have said that you were insane. At year six, you just hope to be profitable. But because of TTI, the value of my practice has doubled, profitability has gone way up AND I’m working fewer hours. The pain in my back has totally gone down. I can do things. I feel like my life doesn’t revolve around me being a dentist and owning a business. It’s not all that I have to offer.”

Dr. Ian Fontenot has also been featured on The Team Training Institute's podcast. Click below to listen to his episode:

Ep 23: How to Enjoy the Business of Dentistry with Dr. Ian Fontenot

UPDATE: Dr. Fontenot has been with The Team Training Institute for several years and he recently sat down for an interview to give our community an update. Click here to read about his practice's big expansion.