EP 72: How to Weather the Storm with Curtis Marshall

In this episode, Wendy Briggs discusses the current crisis from both a practice and data standpoint with Curtis Marshall from Dental Intel.

Together, they lay out strategies on how to move forward now and weather the storm that is coming. They discuss how to take advantage of this time and come out with some of your best production months yet, all while creating a higher level of patient care and attracting even more patients.

For more video updates from Wendy and Dr. John, follow us on Facebook.

Welcome to the Double Your Production podcast with the Team Training Institute, the one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it or in the trenches know exactly what you're going through. And now your leaders, the stars of the broadcast, Dr. John Meis and Wendy Briggs.

00:00:24.070 Hey, everybody. This is Wendy Briggs with the Team Training Institute. And I am delighted to introduce my special guest friend and neighbor actually for those who don't know and a longtime client member friend, Curtis Marshall from Dental Intelligence here with us today. Curtis.

00:00:46.870 Hey, thanks for having me on live. I'm not sure what to do with my hands, but I'm really glad to be here today.

00:00:54.540 It's going to be awesome. Yeah. So a couple of weeks ago, we had this conversation about a storm that is common. And so I said we should really get on there and talk about it based on some of the things that you see from the data side and some things that we're seeing from the practical clinical side. And I'm delighted to report that you're gracious enough to be willing to do that. So I'm going to go ahead and share some slides that we can dig in run a short time frame. I know everybody that's listening today and of course, those who will listen afterwards always appreciate when we are direct and to the point, right?

00:01:31.250 Yep. That's the truth. That's what's so good about Wendy and her team. I love working with you guys. And so thank you so much for having me on today.

00:01:39.090 Oh, you're awesome. You always bring such value. Clear back when all of this craziness and this shutdown happened, we got together and we had a virtual retreat planned for some of our members. And one of the first things we talked about early May was schedule forecasting about how a storm is coming and if we're not paying attention, it's going to hit us hard. And like the graphic on the right, we don't want our members to be saying, "Oh my gosh! What is going on?" We've got all of these problems to the point that we're so overwhelmed we just ultimately say, whatever, whatever. So I--

00:02:14.600 Over here, you got this--

00:02:17.790 That's right. So I wanted you to talk with us a little bit about what you're seeing from the data side. We always said this is the Chinese word for crisis. And I thought it was so fitting that these images, these characters mean danger and opportunity put together. So we've always been very upfront and honest about the danger that is existing in this crisis. And then of course, then strategizing for the opportunities that also exist. Whenever there's a crisis, there's danger and opportunity put together. So let's kind of talk about what you're seeing on the data that you have from thousands of practices across the country.

00:02:51.640 And just for everyone out there, I mean, I know of course this is your group and not every one is a member of TTI, but I just want everybody to know how wonderful John and Wendy and their whole team-- everyone is. Because I called you guys up in about June and said, "Oh my goodness, there is such a storm coming, get ready". And the answer I got back is, "Yeah, we're talking about that in May to our patients, to our clients". And just like you mentioned. So this is something that-- which is awesome that you guys se-e-- that you're really good at seeing and that you already have an outcome for it. But this is the data. So what we want to look at now and this is why I wanted to show you earlier and what we're now showing everybody here is the data. This is an average of the hygiene dollars and hygiene visits. So as we can see in the past, it was pretty much a flat line. I mean and you can see visually, you squint your eyes and make it blurry, you can see COVID. There's not a question of where COVID is, right. The big dip. The question here now is what is the results or what going to happen from that. When we look at weather, right, if we have a really hot something come up then we know that there's got to be cold air going somewhere else. There's an exchange that happens. Well same thing in dental offices. When we reschedule-- so back when I was flatlined, this blue line right here is where we rescheduled to. That portion is where we reached-- all the future visits should be at. But it's not. This is something that we're not seeing and this is what you announced back in May, what I reached out to you in June about, is that divot right here. This divot is what's concerning because we're all really good in dental offices. Wendy, when you used to be a hygienist and when I was running a practice, we would do what's on with the pink area. We would fill up from the regular line and fill up the hygiene schedule and the hygiene dollars right there. But now we have this divot. Think if you had your regular responsibilities of everything else in a-- back 20, I know you were practicing probably in 2018, right? That's when you stopped practicing is-- just kidding.

00:05:21.950 Yeah [laughter].

00:05:24.210 So I think if you had all your regular responsibilities and then you had this huge divot on top to fill up the schedule it would be difficult. That's what's coming. This is the worry, the divot. We're all going to do what's in the pink, that's given. That's what we've always done. This divot is going to be very difficult. Does that explanation of this data help?

00:05:49.980 Yeah. So obviously we were worried because six months ago we didn't have any patients, right? So the schedules and scheduled visits and production looks awful come October, right? And for some even into November. And so the concern is, what are we going to do on that? As you mentioned, usually we take where we start and we add it, add additional patients on top of what's already scheduled to make up the difference, right? And to have a really full hygiene schedule and have successful productivity and everything else. And right now it's really concerning that we're seeing across the board with data from thousands of practices, that Grand Canyon looking thing that means we are not on track with the schedule. We knew it would be a concern, right? So here's what we're looking at. We don't want to get to the point we're caught off guard and here comes October and we only have 200 patients in the hygiene schedule when we really need 400 or 600 to be effective in what we do. And certainly none of us wants to be caught in a situation where we have to lay off team members again because we don't have enough demand when it comes to patients. And that might be hard for us to imagine now because many practices are reporting way too much demand right now. So we're going to kind of talk through some of the strategies that we shared back the end of April with all of our members about recall strategies given where we are and you feel free to chime in at any point, Curtis. So here's some of what we talked about. Schedule forecasting. We've got to be looking ahead. We encourage them to check with insurance companies right away about their stance on previous restrictions. So we know that some companies will say, hey you can have two visits in a calendar year, the dates don't matter. Other companies are six months plus a day. And if we get it any earlier there are no benefits. So those of us that accept insurance, those of us that are providers to specific companies need to be very, very clear about checking on those restrictions. Some companies have chosen to ease those restrictions and some companies have chosen not to be flexible at all, all right? So if there are patients in our schedule that we know can add two cleanings a year, those patients can come in a few weeks earlier or even a month earlier without any struggles. Without any insurance limitations, problems getting paid.

00:08:06.430 Wendy, are you saying that some insurance companies are being flexible because of COVID with the six months plus one day?

00:08:15.100 Yes.

00:08:15.220 So they should be calling--

00:08:17.110 The patients we see now-- really, the patients we were seeing at the beginning of the opening were the ones that we needed to be calling on, which is why we recommended this to our clients months ago. Because the ones that are due to come in soon, if they're due in November or December, if their insurance companies have chosen to be flexible, guess what? We can call them in six weeks early at no detriment to them. Right? It's not going to harm them one way or another. We often joke about the fact that the recommendation for a cleaning every six months came from a toothpaste commercial in the 50s. Many patients have need to be cleaned more frequently than that, right? Especially given oral-systemic link and keeping their immune health solid and sound in this time. So, getting them in six to eight weeks earlier is not a problem at all, except if they have insurance limitations, because they do depend on those benefits.

00:09:12.940 As a patient, if I can come in more or get my two cleanings in because I miss my COVID, I want to take care of those benefits because I'm paying for them. So, that's something that I would love to know and I'm not going to think about that. Our team members here, this is something for you to take care of your patients with.

00:09:34.770 Exactly so. So, we've been recommending that. Many of our members have done that to the extent that they could. Okay so, if so, you can schedule some patients several weeks earlier than that six-month timeframe hygienist. We know there are patients who build up deposit quickly, who have a lot of excess abstain. These are ideal candidates. So even when you see these patients now, if you feel like it would be appropriate to recommend a three or four month interval for those people, there has never been a better time to do that. Give them the opportunity to have an additional visit this year especially if there are no insurance limitations. If not, if they are not going to be flexible on insurance, make sure we make a note, right? So that we're carefully watching those dates and don't end up scheduling someone sooner than their benefit will allow, because nobody likes that, right? Those surprises are never fun. So, Curtis, real quick, some of the resources that Dental Intel put together for the shutdown, for practices to use as they [inaudible] for our practices. Right here, I would say, when you look at this list, two things stand out to me that I'm going to ask your opinion. But obviously, anybody who's in need of a perio maintenance, ideal to get it in that timeframe. Right? Because typically, insurance companies may or may not have a benefit for that anyway. Sometimes they pay two cleanings a year and two of those maintenance visits are on the patient anyway. So, those are people we should call. I love this list as well, and that is people who, during COVID, had to be postponed; those appointments. So, this is the list of people who are due now and need treatment. Now, many of us have made some good progress on this list, but if we haven't, because we haven't had available time in the schedule. We'll talk a little bit more about that in a second. Here is your time. Start working this list now for October. What else would you add?

00:11:21.980 Now, there's also another list that we created called the abandoned COVID list. The abandoned COVID list means that they haven't-- because oftentimes, in offices, if we're not in the office for a week or a month or two months, unfortunately like COVID, right? We leave appointments on and we don't go in and break those appointments. So, the abandoned COVID-19 list is saying, "Are there any appointments during that time frame that didn't get completed or broken but they're just in the past, they're just hanging out?" So, we give you that list as well. That's another great one to be looking at. And you can customize and say, "I only want to see patients who are due, who have two insurances, who also have $500-plus in treatment, and also their first name starts with a C because I want to see-- Curtis, just come in. Whatever list you want, you can make it super quick. So that's what I would suggest.

00:12:16.400 Yeah. Love that. So this data has been invaluable, if I could just say. We're so glad that Dental Intel had the foresight to create some of these resources for our practices because we hear from the people in the trenches, and they have loved them. They have become incredibly important and invaluable in helping them rebound more quickly. So with that, here's somebody out in the shadows that we've long thought that can help us in this time where we're having to basically catch up, right? So having a dedicated recall coordinator especially if there's more than one hygienist being scheduled, we find that this is such an important component in a practice because hygiene feeds the restorative. So as hygiene goes, the rest of the practice goes. So having somebody who's dedicated, especially if there's multiple hygienists, it's really necessary in this time, maybe challenging because we are hearing from some practices that they're short-staffed, right? You may have some people that are a higher risk. You may be in an area that's been hit super hard with community spread, and there are people that have chosen not to come back. So some of this may need to be outsourced in this time. We want to pre-schedule especially during their current hygiene appointment. We need to be super vigilant. We always have taught that. But now, more than ever, make sure every patient that leaves the practice has their next visit scheduled. That's new patients too. This is something we often miss. And we want to check the restorative schedule [crosstalk] of patients. Yeah?

00:13:39.000 Sorry, Wendy. I'll just say, don't forget this recall, it gets worse because of that divot going back to that section. Yeah. You have team members who are staying all because they're worried about COVID or whatnot or the pandemic. You're now having less staff. Well, not only do you have to do that pink section that we talked about earlier, but we also had that huge divot. And I don't know if you're going to go over it or not, but there's another software too to get those patients in quicker we can go over later.

00:14:10.960 Sure. Yeah. Would love that.

00:14:12.060 [inaudible].

00:14:12.850 Yeah. You're exactly right. So we not only are working harder because we have fewer team members. We are out of capacity with team, but we have more to do, right? So we recognize that. We're hearing that from teams all around the country. And frankly, now that we've been open for a month or two in some areas, we're getting burned out, right? So we've got to be smarter about how we spend our time. That's why we always talk about the morning huddle tool that Dental Intel has created as well. And I know this may seem like a commercial for one another, but here's the thing. Dr. John and I, the team training institute, focuses on helping practices maximize their potential. And we want to make sure that we're providing you with the path of least resistance. The biggest our ally, with the effort that you're expending, and that's why all of our Blue Diamond members, we have on Dental Intel because it dramatically helps. You will be more effective. So again, these strategies that we've talked for a long time have never been more important, okay? We want to utilize programs, Dental Intel, all these things are super important. And when we go back to non-negotiable standards, these are our five hours of profitable hygiene. We've got to be hyper-vigilant and make sure that these non-negotiable standards are not being relaxed because we're overwhelmed, right? So we've got to make sure that all of these systems are on point because it's so important. Now here's the other thing, Curtis. I don't know if you're hearing this from people in the trenches, but we are seeing so many practices sincerely struggling because there's no space in the schedules. So we have all of these abandoned COVID appointments. Well, we already had a full schedule that is full because six months ago, we were on point then. So this has been a challenge. Are you hearing the same thing?

00:15:56.230 For right now, yes. And I love how you said earlier we're kind of sitting fat and heavy-- well, fat and happy right now, meaning, "Oh we're having best months ever. We're full schedule," blah blah blah. Well come October, because of the pandemic, then we're gonna have a big-- it's going to be completely different. But yeah, we were already full. We rescheduled. We did really well. What was six months from right now? December, January of last year, right? We were really good at getting people rescheduled, so we had it full. And then we got all these COVID patients that want to come in. Yeah of course, we don't have space right now for them. But yeah this is definitely something and it's a false sense of what the future is going to hold.

00:16:45.010 Exactly. So this is an example of what schedules look like. This is a one doctor, one hygienist schedule. You see any open spaces? I mean, we are filling everything we can, right? And this is what we're seeing. Of course this is multiple hygienists, so we get it. Your schedules may look amazing at the beginning of the day and you're like, "There's no where to put anybody." But then we we start getting the phone calls. Somebody has symptoms. We're taking temperatures. Maybe someone has a fever that's elevated and they can't be seen today. So we need to make sure all of our recovery strategies are in point. We'll talk about that in a second. But we've been talking about creative solutions for capacity blockages. We've taught them how to do hygiene blitzes, which is an assisted model of hygiene during peak demand times. Practices are doing kid's days, where they're they're using all of their team more effectively, right? So some of these creative solutions have really provided amazing results for our members. And we are really delighted with what we're seeing. I have to give Dr. Marcel Lambrecht's team a shout-out, Kathy, April. He's got such an amazing team. Dr. John's doing amazing, as well. But look it. The first two are doctor production, doctor and associate. The last three are hygienists. So amazing production, which of course we know, right? In our world that translates to amazing patient care because you focus on doing the right thing for the patient and production actually follows. The first year with working with us in our program, he was up about $380,000. The second year, about $800,000. Year three's still in progress, but they just had a record month. I had to give them a shout-out. They took such great care of their patients in June. They had an amazing month. But when we dug in, we noticed that the trend that you're seeing is still happening with them. So of course, their current clients were going to be alerting them to what's going on here.

00:18:32.700 And too, Wendy, before you jump into this, I just want everybody else to know, too, because they're with your group? This office right now has more production today than they did last year at the same time. Even with COVID, they're $50,000 higher right now than they were on this exact same day last year. And that, my friend-- that is why having such a great team member in your corner is really important. But yeah, let's go ahead and see-- even though a great office, let's see what they still have coming up in the future.

00:19:08.520 And I appreciate you calling my attention to this too, right? Because we're like, "Oh my gosh, record months. Our clients are killing it." They really worked hard during the close, the shutdown, to position themselves to really come back strong. Some people wanted a slow ramp back up. Uh-uh. We were like, "Here's what we're gonna do. We're going to hit the ground running." And you can see that this is January. They were scheduled with 430 visits in hygiene.

00:19:33.860 This is actually-- this is December, I think.

00:19:38.440 This is December. Okay, perfect.

00:19:40.420 This is December. Yep. So they were in the office in June and they rescheduled for December. This is what their six-month future should always look like; six months or even three, four-- at least bare minimum. If it's under six months away. it should at least have 430 visits in hygiene got it. So then what they're actually scheduled for in October is 197. So we are concerned about that because just like the graphs that you showed there is that Grand Canyon that exists between where they should be and where they actually are. And this is with them making some significant efforts to keep those schedules full. I know you mentioned before most practices are up about 20% of where they should be. Dr. Marcel and his team is about 50%, so that's great but I'm still concerned about October, we've got some things to do, right? So regardless of how you're performing now we've got to be mindful of what's coming. There's still that storm coming. So that's why recovery is so important. Recoveries how we handle last-minute changes, right? The stiffest tree is most easily cracked where the bamboo survives by bending in the wind. We've got to be flexible, right? Flexibility makes us stronger and so when we look at what we've been talking about with recovery post-COVID especially, as we schedule every patient better ask permission to call them in earlier if an opportunity arises. Having a deep ASAP list or as sooner possible list will be critical. Again if we have people start falling out of this amazing schedule we need to know where to go, right? So that's another thing like we were saying using the tools being vigilant in communication confirmation. If they don't feel safe to be out yet you want to know sooner rather than later. Be careful what you say and how you say it, that's so critical. And as we confirmed communicate our safety protocols and arrival process to streamline. But Curtis there's also some things when we talk about strategies. And these are some things that we teach but certainly utilizing programs for opening today and tomorrow and utilizing Dental Intel tools. So walk everybody through real quick because I know we're almost out of time. What you have to help team members still their schedule in the moment.

00:21:54.620 Great question. So there are quite a few ways that you could do this. You could either do more on the family members who are coming in. So for example, if I was taking my family to your practice and my three daughters don't have an appointment, guess what? You should tell me and you'll be able to see that in a Dental Intel tool in the morning huddle, right? But another big one especially for right now because we need to fill up that divot. We need to really take care of those-- get those patients in. If we make phone calls that's just going be a whole-- we could give you a list. I could give you the coolest list ever and it's 100 people. You still have to make those phone calls. So a new product that we just released is a thing called online scheduling or local med where you can send a text to your patients and they schedule just like when they schedule to pick up their groceries at Walmart, right? They don't have to talk to anybody. With Walmart you schedule you say I'll be there at 10:00 o'clock you're there at 10:00 and they have their groceries, same thing with local med for the first time ever you can send your patients a link so that they can schedule in October for without you making any phone calls. So there's quite a few others but those are the two big ones. Go ahead.

00:23:11.710 Yeah, how important is that right now as we talked about being short-staffed and not having enough team to be able to use tools and resources to help us be more effective with our time like that is a no brainer. We've got to be utilizing some of these tools. And again we could go through like you said there's so many, there's the unscheduled treatment plants list. There's the recall list, the patients that are due for [inaudible]. There's the abandoned COVID list. All of those people, it should be all hands on deck right now working those lists to fill October and November and maybe even for some end of September. Right. So take a look at where you are.

00:23:42.100 Some September.

00:23:43.540 Yeah. We got to get on it people. There's a crisis coming. So one last thing and a big part of what we teach is same-day dentistry and you mentioned this in your morning huddle tool, it's going to tell you who had treatment plans, treatment recommended previously that's not yet completed, family members that are due, same dentistry is critical. I have to give this practice a shout out as well. They had just done case acceptance training right before COVID hit with us with their amazing coaches, and look at their same-day production post-COVID 77%--

00:24:14.530 For June.

00:24:15.110 --are serious. This is just June. Now, this is obviously a multi-doctor, multi-[inaudible] practice. But oh my goodness, how amazing is this. Their annual goal is 4 million and they did almost all of that in one month because they were focused on it, they trained on it, they were ready to go. So this is why these things are so important, right? I mean, I can't tell you how important these things are. It's so much easier for me to show you. Champions of dentistry that are doing it that are living it, right? So critical.

00:24:49.450 That's amazing.

00:24:49.860 So Curtis, I just want to tell everybody thank you so much for listening today. If you're listening to this as a W production podcast we'll have a link on the page for you to contact Curtis. What I want to do, I know we went through some of this a little bit fast feel free to send me an email, wendy@theteamtraininginstitute.com if you want a copy of some of those slides that we rarely do that we rarely share that content. But I think this is so important that I want to make sure that if you want the additional resources and the help send me an email my team will get you to PDF so that you can review this in a staff meeting, talk about it with your team members because it is such critically important information and of course if you have any questions for Curtis you're free to reach out to me as well in this email and I'll connect you. But Curtis will also put a link maybe even our QR code where people can contact you on the podcast home page.

00:25:43.050 Absolutely. Hey, Wendy, do you think your--would this be a too much of an ask, that if anybody reaches out to you that isn't working with you, would you give them as a gift from me, but will you give them the COVID list, that abandoned COVID list at no charge? Would you give that to them for me?

00:26:02.710 Of course, I'd love that.

00:26:04.690 I'll show you how to do-- we'll get it up. So please reach out to Wendy no matter what. Or if you have a question or anything like that or you'd like to learn more on how she's able to get offices at this amazing level. But if nothing else, reach out tell her we'd love to-- from a gift from Dental Intel and TTI, The Team Training Institute like to give you that COVID list, abandoned COVID list at no charge.

00:26:29.270 Love it. All the resources, right? All the tools and that's how we avoid that feeling of being in the thick of a storm. What the heck. What's happening here. That's how we avoid it. We've got to work now to avoid that coming storm. So Curtis thanks again so much for being with us, you're always such a great guest to have on our show. And we just love all of the great tools and tidbits that you bring to the table. So we love our friends at Dental Intel. Thanks so much, Curtis, [crosstalk]--

00:26:54.660 Thanks, Wendy. We appreciate it.

00:26:56.040 [crosstalk] today. Have a great week. [music].

00:26:59.590 You too

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