Bert Triche, a hygiene coach, discusses with Dr. John & Wendy a common mistake that practice owners make that leaves them missing out on hundreds of thousands of dollars in the long run for a little short-term gain. She shares a common scenario that happens when doctors think about performance-based incentives for hygienists.
- How To Turn $600 to $6000 with your hygiene team
- How a practice’s hygienist was able to blow past their production goal of $180 per hour.
- How to incentivize your team to give world-class patient care.
- How practices are achieving 50- 60% increases in fluoride acceptance.
- A huge mistake dentist makes after setting goals for their team
- Why doctors give up $1 million dollars in retirement or lifestyle funds because of a decision made on how they feel.
Bert has over 32 years experience in dentistry. She is a practicing hygienist and is currently coaching and training for The Team Training Institute, focused on increasing practice profitability and improving hygiene systems.
She is a proven top producer in the field and has coached many hygienists to more productive hygiene days. She has worked in all aspects of the dental practice…hygienist, chairside assistant, front desk manager, treatment coordinator, marketing director and most recently office manager.
She has a really unique delivery style which is quite entertaining and infused with her passion and enthusiasm for the profession. Bert has been a coach with The Team Training Institute for 2 years now and currently lives in Reserve, LA just outside of New Orleans with her husband and 3 children.
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Dr. John: [00:00:00] Hey, everybody. Welcome to this episode of the double your production podcast. I am Dr. John Meis here with Wendy Briggs and Bert Triche. How are you doing ladies?
Bert Triche: [00:00:10] Great.
Dr. John: [00:00:12] Fantastic.
We've got a case study today and this case is unfortunately a very common one. And so I want everyone to listen through, what happened and then think about the emotions and why somebody would have made some decisions that they did. And why necessarily those weren't the best way from a business perspective and from a team perspective and from a patient perspective. Bert, do you want to, lead us through the situation that you, are dealing with one of our clients?
Bert Triche: [00:00:47] Yes, I'd be happy to do that. So let me get this, Oh, I can choose the keynote.
That's what you said, Wendy.
Wendy Briggs: [00:00:56] And while you're getting that set for, let's tell our listeners who Bert is. Right? So Bert Triche is one of our amazingly talented hygiene coaches. For some of you, her face will probably be a little familiar. Her story is really powerful because she was one of our clients.
For a long time. She attended a program that I did, took back what she learns, doubled her personal production by providing elevated patient care and then had some direct coaching. And didn't you come close.. did you triple your former production?
Bert Triche: [00:01:27] Oh, yeah, we tripled in the practice, as well as my own.
Yes, we trippled.
Wendy Briggs: [00:01:32] So rock star staff, world-class hygiene, really excellent patient care. And what we found is when we do that, then the production will naturally follow that. So Bert story's powerful. And now she's spent, gosh, what eight years? Traveling the country for us traveling the world and coaching others.
Bert Triche: [00:01:50] Nine and a half. I'm about to have ten next April. Can you believe it? I can't believe it either. It's been a quick 10 years. It really has. Thanks Wendy for that introduction. And, how lucky am I right to work for this great company and, support, what Wendy has taught for so many years.
Here's the scenario, and this happens a lot with clients, with production based incentive. This was the pre-visit numbers before I went in three hygienists. We're doing about 54K a month. You can see, fluoride production was not great. No sealants, no sealant protect. Very few x-rays were happening.
Perio was very slim. And then we trained. I did, a hygiene explosion day with them, which is our initial preventive role. And then we did perio, in May, post COVID and here's where they are now. So up about $10,000 for the month. And you can see the difference in fluoride, the number of sealants have gone up.
And the, x-rays have really gone up, probably a hundred fold with PAs and their perio is up about 3%. So doing really well, the girls are earning an incentive, And we originally...
Dr. John: [00:03:09] Just to, backtrack a little bit, one of the strategies that we use to improve the quality of patient care, is to have incentives on certain things for providers, and certain things for non-providers to make the office run more smoothly.
So this particular incentive was a production-based incentive for the hygiene team. So we have a formula that we have to gather a bunch of data, do some analysis, but then we come up with a formula that works for everybody. So go ahead. I didn't mean to interrupt you. I just wanted to bring people up to, up to speed.
Bert Triche: [00:03:43] So the original goal was set at $1440 a day, about $180 an hour, for the hygienist, which is really great. Wendy. I know, you know this too, , and then post COVID the practice, dropped some insurances Dr. John. I wanted to let you know that. And now they're pretty much fee for service except for one. Okay. One big one and they had a 14% increase in fees. and one of the hygienists got an hourly raise.
So they recalculated right? The, goal, because you never moved the carrot unless right, there's a fee increase or we, we, the, hourly goes up and they recalculate it to $192 an hour and they're still beating that. Okay. So they're beating that goal. One of them's doing $2000 a day, the other women, $1586 on average, I'm sure there are higher days.
So here are some of the concerns, that the doctor has. and, the OM, they have not changed it yet. Dr. John, but this was, they were asking us about it, if they should change because doctors feeling it ought to change and go up. So in, incentives are sometimes as much as $600 a month for a hygienist. Doctor doesn't feel hygienists are doing enough to warrant that with what he's seeing, feels it needs to be raised again. And looking at what's going on, going out instead of what's, they're bringing in to generate that. The office manager was she's on board, with keeping it, where it is because she understands, but she, knows every time the doctor gives out those checks, he has a conversation with her about this. So she wanted to make sure she was prepared to have this conversation within this month because they were especially high in September. So there we are.
Dr. John: [00:05:33] I can, tell you, this is a completely logical thought process. For most dentists. They're going to say $600 a month?!
My hygienists are making more than everybody else in the place. I'm overpaying them. That's the logic and you can see it, it does make sense. On a, "I'm only going to pay my team, what everybody else makes" logic basis. It makes sense that's your standard. One of the things that we know when we see people who have incentives, their team earns the incentives and then they jerk the incentives away.
What we see is performance doesn't stay up. In fact, often the people are so disillusioned and maybe a little upset and maybe a little passive aggressive. We actually see the productivity go down below what it was before. So what I would want all the doctors to hear is that is one set of logic that I only want to pay my people, what everybody else is making.
That's one, one logic. I, get that. Another logic is I want to have better patient care. I want to incentivize my team to give better patient care. If they do more and have better patient care, I want to incentivize them to do that. And I want to come out ahead too. So that's another set of logic.
It's different. Is it also not logical? And isn't that attractive as well? So what this doctor didn't understand was that he had $6,000 additional dollars coming in every month and he was paying out $600 in added incentives. So the hygienists went up by $600 a month, but the practice went up by $5,400 a month.
So the question that I always ask doctors is would you like to buy, would, you like to lose, I should say $5,400 in order to gain $600. When they look at it that way, their logic starts to shift. And so that's really what they're expecting. Now. I know there are some doctors who think, I could pull away the incentive and they'll continue to perform at that level.
Okay. Is that, have you ever, either one of you ever experienced in the thousands and thousands of hygienists you've coached and the, and we've seen this happen, what did it's about one and, one and 11, maybe dentists that we've worked with that have come to this same point where they realize, geez, these people make a lot of money earning a lot of money, right?
Earning is different than isn't it. They didn't just ask for a $600 a month raise. They're performing at a higher level. And the, greatest beneficiary of them performing at a higher level of who?
Bert Triche: [00:08:27] The patients
Dr. John: [00:08:28] Exactly.
Wendy Briggs: [00:08:32] Which a common scenario that we see, which is why we're doing a, another show about this issue, because it's such a common thing that we see doctors, we're not used to compensating, hygienists as producers and as providers.
And so when we make that shift, it's a shift for everyone, We all have to think differently about every situation. Really almost every scenario in the practice. And, I always caution, us to really focus on expectations. what is our expectation for the, comment that stuck with me is the doctor doesn't feel the hygienists are doing enough to warrant that.
The doctor sometimes we're really not even aware. maybe he's looking at different things or she's looking at different things. She doesn't see, the home products going out of the door. But what they didn't see is, some of them had a 50 to 60% increase in fluoride acceptance.
So give us time. We always say progress, not perfection, and this is a journey and we focus on all the positive steps that are happening along the way. So give us a year and I bet the doctor will feel differently. I bet the doctor will then see all of the things that the hygienists are doing to warrant that additional incentive and prepare yourselves because that number is going to grow.
The number being paid as the incentive to the hygienists, as they embrace everything that we teach and become better at everything we teach, that's going to grow. But Dr. John says, when that does happen, the patient wins. So I think we've got to be careful with our expectations and don't expect everything to be firing on all cylinders all at once. It does take some time for us as producers and providers to really implement at the highest possible level. So don't be impatient, and recognize the positive, the good that's happening.
Bert Triche: [00:10:24] And let me talk as, a hygienist, right at the moment, who was in a situation that was similar to this and, I always called it moving the carrot.
So the carrot would be placed, right? The goal would be set. And then when I got the carrot, it would, be, Oh, no, that's not where the carrot was. So in essence, if you change the goal, you're moving the carrot, which kills the morale. And we all want to go. What's the point, right? Because the carrot keeps moving and that is so frustrating as a team member, to not have clear expectations about where that carrot is and know, now I've got it. But then it gets yanked out of your hand, right? Because the doctor doesn't like what, where the carrot is.
Wendy Briggs: [00:11:14] So it's very much as a team member who experienced that
Worst, if you have complete clarity on where the carrot is, you hit the carrot and all, and after the fact that the carrot gets moved, that's even worse because now that's a matter of integrity.
for the doctor. That was, this is our deal. This is, how we're moving forward. And now I'm going to change it because you hit it. That doesn't show a high level of integrity. And, another thought that I had this particular, doctor, and it's the common one that they folk, they think of hygiene services and hygiene production being majorly influenced by product sales.
Bert Triche: [00:11:57] Yeah.
Dr. John: [00:11:58] So my experience with that is that while there is, product sales, is patient, it gives great patient convenience, so it's great, but now we've got inventory now we've got shrinkage, and the amount of extra dollars there. And when it comes to profitability is, only a fraction of what these hygienists are doing with what they're doing.
And this one decision could be a $60,000 a year, 60 some thousand dollars a year loss. And of course that loss continues forever. So if you have 10 years left in your career, you just lost three or, two thirds of a million dollars,
Wendy Briggs: [00:12:44] Right? And that's just one hygienist Dr. John, because together the hygienists have impacted $10,000 a month in dollar mistake, right?
Dr. John: [00:12:54] $1 million $2 have retirement funds or lifestyle funds gone because of a decision that was made based on how it feels. Let's look at the data. This make decisions based on data and not on feelings, and that it'll help us become much better leaders, much better managers. and have in this case, a higher level of quality of care for our patients.
You love that, we always say productions, never the goal production. Instead as a result that follows me do the right thing for the patients we serve. And again, Bert, I'm so glad you brought this to our attention. And like I said, at the beginning, we see this often is the very common scenario because we all have to shift our thinking.
When we start doing some type of production based compensation protocol with our hygiene team is producers. And so these are just common mistakes and that's why we thought, this would be a great conversation for one of our shows so that our listeners could, have all perspectives on how we think through this, especially hear from Dr. John, because he's so good at it, helping shift doctor's thinking, in a way that makes sense, right? So that everybody can understand a different, approach, a different strategy, and, then have the opportunity to experience the end result, which can be powerful.
Bert Triche: [00:14:14] The other thing I would say is just, this particular office was a one day with a 30 day call.
And, the reality is that it's really tough, right. To get the great result in, a 30 day period, a lot of hygienists are superstars. They come out the gate, they run, they do really well, and they serve patients right away at a high level, but not everybody's like that. And it takes a lot of hand-holding right.
Wendy. We know that because we hold their hands the whole way and a lot of follow-up and accountability, to make sure that the standard of care right, is raised and then, maintained. And so the incentive is part of that, right? Cause it gives them a reason. It gives them a win. along with the patient and along with the practice, but it does take some handholding in, a lot of coaching, to make this happen.
So sometimes just a onetime, one day coaching doesn't create that. But they're doing extremely well. considering, I've probably had four or five calls with them, not a whole lot. Yep. So wanting to make that point because the year, or six months is so much better.
Dr. John: [00:15:25] Yeah.
Bert Triche: [00:15:26] Good. Good point.
Wendy Briggs: [00:15:28] That's fantastic.
Dr. John: [00:15:30] Bert, thank you so much for bringing this case to us because it's, such a common thing and really, it shows a mind shift for the doctor to think about it differently. Look at the data, think about it differently in a way that's, that is a win for everybody.
So thank you so much for bringing this. It was a great example. So thanks everybody. Okay. Yeah. Thanks everybody for being on this episode of the, double your production podcast. We'll see, on the next episode.
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