EP47: Design Dental Success with Angie Bachman

In today’s episode of the Double Your Production Podcast, Dr. John Meis is sitting down with Angie Bachman, one of the trainers for Design Ergonomics. Angie is sharing how to create a more optimized, efficient dental practice through a process called Reboot Practice Productivity.

Increasing productivity by $50 an hour is no small feat, but the team at Design Ergonomics knows the systems necessary to make it happen. Listen to learn some ground-breaking wisdom from Angie that is sure to transform the way your practice operates each day.

Hey Double Your Production Listeners, Kati here! Thanks so much for tuning in! We’ve got an awesome show for you today with one of our favorites, Angie Bachman, from design Ergonomics. During this episode, Angie gives us an awesome opportunity for some deals from their company. We took a little longer getting her show on the air and so Dental Ergonomics have graciously extended the deadline on those offers! So If any of our listeners are sparked by her conversation with Dr. John and would like to get more information and participate in those deals, the deadline will be August 31— which is approaching quickly so listen in, and the head to our website, www.theteamtraininginstitute.com/podcast, click on todays episode (Episode #47) and there in the resources section will be the links to both the book and the coaching that are mentioned today. If you head over to the design ergonomics website which is desergo.com, you can also just use the promo code ‘team training podcast’ to claim these offers. Can’t wait to have you hear a little more from Angie about the cutting-edge thinking offered by this amazing company that we have had great experience with! I’ll turn the time over to Dr. John, Thanks for listening! 

hey, everybody. Welcome to this episode of the W Production Podcast. I'm John Meis, and I am super excited to have with my Angie Bachman. Angie is one of the trainers for Design Ergonomics, and they have a process that I thought everybody would really like to learn about. It's Reboot Practice Productivity. So Angie, tell us a little bit about yourself and how you came to be doing what you're doing.

Great question. Thank you, Dr. Meis, for having me. I really enjoyed meeting you at your Champions of Dentistry event in Orlando in April, and you had a great turnout. So I was happy to be a part of that. But--

Well, we were sure glad to have you.

I am--

[inaudible] super fun, wasn't it?

Yeah. It was a blast. I had a great time. So I have been in this crazy dental business for about 27 years, and I was just explaining to Dr. Meis a few minutes ago that my daughter was born 27 years ago today. And literally at the time we started this discussion, that was the exact time that she was born. So I think it's a lucky day. But I got started a couple months after she was born. Landed a job as a dental assistant making $4.25 an hour--

Ah, the good old [days?].

--believe it or not [laughter]. Yeah, right. I worked with a couple of doctors who-- I mean, one of which who'd smoke cigarettes in the lab, you know?


Between patients. And it's like, "Whoa." You think about that now and you're like, "No. That can't happen." I mean, gloves were optional, for goodness sake.


I think. So I was a dental assistant for a number of years in the state of Ohio and landed a sales job at Nextel Communications. So I was kind of worked in the competitive wireless industry. I wanted to make more money. More than $4.25 an hour. So I landed this job and did an okay job. Thought I wanted to get back into dentistry and sold Trophy RVG sensors, eventually, before they were Kodak. I was actually there during the merger and sold SoftDent and PracticeWorks. And then now, of course, they're Carestream. I was there for a couple of years and then consulted for a period of time, and met Dr. David Ahearn at a dental convention in 2006. So kind of skipping ahead. But he said a few things that resonated with me, a lot of which had to do with clinical operations. And of course, I had all this back experience with clinical experience that I really wanted to learn more. Still consulting, still consulting. I reached out to him several years later, and I said, "You know what? I really want to learn more about what you're doing." And in 2011, I accepted a position with Ergonomic Products. I know I'm kind of skipping a few years, but just in a nutshell. Making a quick start out of this whole thing. In 2011, I started to sell this dental equipment. And I didn't want to sell something I didn't actually believe in. And although he is very persuasive and enthusiastic about what he did, I really needed to work with it myself. So I worked in his practice chairside with him, which was difficult. He's kind of we kind of had to pick things up, but the best part of it was I was able to pick it up quickly. And actually, as I was working with it, I thought, "Where in the heck has this stuff been the past 20 years I've been working in this industry?" And I believed in it from right then and there. So I sold dental equipment for him, and worked [chair side?], attended a bunch of lectures with him and our team. So we thought that this stuff needed to be shared. And one of the fun things about selling dental equipment is like, "Hey, this is kind of outside the box stuff." And they'd buy the equipment, the equipment would show up, and the docs would call and say, "Okay, Angie. Now what?" And it was, man, we've got to help these guys. So Dr. [Ahearn?] wrote a book called The Guide To Maximizing Productivity Book. And it was basically just an easy read pictorial nuts and bolts explanation on how to set your practice up for success and make it the most efficient as it can be. So they [inaudible]. Go ahead.

Most of our listeners will remember Dr. [Ahearn?]. He was on episode 36 of the Double Your Production Podcast. So you can go back and reference that and reference some of the things on how he began to make a very innovative set of changes to what is so typical in dental practices. And because these innovations were all driven by efficiency, by proper body posture and position, it also improved clinical speed. So you can learn more about that on episode 36. All right. So now you decided, "Okay. Now, we've got the equipment, but doctors don't know how to maximize the effect of the innovations."

We've got to train them. We have to go on-site and actually implement this stuff. And we started that soon after the launch of the book. And for the last, heck what is it? Almost five years now. I am in a new city almost every week anywhere in North America implementing the systems in that Guide To Maximizing Productivity Book. And it's implementing these [lean?] principles that there are a billion books on [lean?] principles, but implementing them in a dental practice, it's so simple that docs who I work with tend to overcomplicate it. And it doesn't have to be that complicated. So we're there to simplify it and standardize their processes and help them duplicate it and sustain it.

So Dr. [Ahearn?] and I went about a study of the most productive doctors that we could find. And he and I looked at production slightly differently. In fact, we looked at almost everything slightly differently. So we have great conversations because he helps me learn another way to think about it, which just makes me a little bit smarter. He's one of those guys that you can't be with without being a little bit smarter. So one of the things that was very, very obvious in the ones that were hyperproductive, in the doctors and offices that were hyperproductive, is really very strong systems. And ones that are highly-- I'm going to say highly efficient, but I'm also going to say highly team-friendly.


Yeah. So that's one of the things that you do is you help people understand those systems.

I do. It is important to have that [inaudible]. Now, you hire somebody from outside to come into your practice and say, "Okay. what you've been doing is completely wrong. I'm going to make you more efficient." Actually, don't approach us like that. I approach it as, "I want you to tell me what's working right for you. What's going great? What keeps you motivated?" And I'm asking the staff this because they're the ones who feel it. I'm a clinician who-- I experience a lot of bottlenecks in private practice. And it man-like. I didn't know there was another way. And sometimes it takes an outside eye, somebody to come in from the outside and say, "Hey. have you considered maybe this could work?" And q1, "Oh. No. No, [inaudible]. I haven't considered that." All right. Well, I'm going to show you how it can work for you. And let's work on that. let's write a system that is most efficient, completely designed for your practice. It's not me taking some pamphlet and throwing it out on a desk and saying, "Okay, guys. We're going to follow this." It's, "You tell me what you're, and I'm going to help you be more efficient at it." The study of efficiency is ergonomics. And I'm going to help you not have to get up a lot. I don't want you to bend over. I don't want you to reach and go through a drawer that materials aren't there that you need. I joke with practices sometimes. And I said, "You know where I spent a lot of my free time? In the bar, because I'd be so frustrated during the day that I got to stop at the bar o the way home in order to--" And then they go, "Oh. Yeah. We've been there." They're giving me that affirmative nod. And that's just what it feels like. I don't drink like that, just kidding. But I mean, you get the drift.


You just feel frustrated. You left the office. And you're like, "Oh. My God. Nothing was done today." So having that staff line is a big, hairy deal. And the processes don't run by just the doctor ordering it. It has to be understood by the team who's implementing it. And I have to make sure that they are going to implement it moving forward because I've got two days with you. And I've got to make sure that I convey a message so that you can duplicate moving forward.

Yeah. Well, that is so awesome. And your company designed an addition to my dental office. And we put the systems in at the time of that addition. Some of them were already in place. But the rest of them we put in place at the time that we did this addition because we remodeled about two-thirds of the office when we did the addition. And one of the things that noticed was that first of all my productivity did rise. And the second thing that I noticed was on days where I was doing a lot of patients [inaudible]. There was a lit of patients going by. And you're doing little things. Usually, days like that I would go home. And I didn't stop by the bar. But I love to stop by someplace to get an [laughter] [inaudible] because my body would just feel beat up. And so that's kind of one of the ways that I think people could look at  whether they should consider having somebody help them with efficiency or not. But what are some of the other ways a doctor would know?

Well, I asked doctor when was the last time you actually went home feeling like you didn't have to go that extra mile or overexert yourself and get to your goal that day or when was the last time you actually had everything you needed when you needed it without getting up, without asking somebody to get up and go? When was the last time? And I'll tell you I've never come across anybody who I've personally talked to has said, "Oh, Angie. Every day we are perfect." Even Dr. Hern can say, "Hey, you know what? There's always room for improvement." And he's exactly right. So there's always ways to improve. But docs sometimes just don't know when it's time to ask for help. And that's what we're here to do. No matter if you're-- whatever your design, no matter what your equipment selections are, whatever you have in your practice, we originally thought that this whole thing would be for docs who just equipped and designed with us.

But then we found that we can implement this anywhere. We can implement this with any practice. The system [in and?] itself are-- we can duplicate those. And they can sustain in a practice. And it's all customizable to your practice. The secret is to get everything out of drawers, to make your inventory visible, to be able to start an endo when you've exposed the nerve in a matter of 30, 45 seconds rather than 10 minutes. That time is a valuable commodity that if I can save you-- if I can save you a minute here or if I could save you a minute there, imagine if I could save you five minutes for every appointment. That's another appointment at the end of the day. That's a whole nother appointment that you can treat patients who deserve dental care. You don't have to turn anybody away. And the docs that I talk to can relate to that and it's-- oh, yeah. Man. If the process was simpler, yeah. There's no question.

Yeah. And that additional procedure is very, very profitable because your fixed overhead is already done. The most you're going to have-- you might have supplies and a lab bill. But other than that, there aren't any other additional expenses. So that one extra doesn't sound like a lot. But its impact on profitability is really high. So one extra is huge. So now, your job's got to be kind of tough because offices have all kinds of interesting design issues. I've been in 313 practices now in the United States. Well, I guess I've been in six different countries and three continents.

Oh, wow.

And no two dental offices are the same. And some of them--

[That's true?].

--are converted spaces from other things and I guess some really challenging floor plan things. You've seen it all I bet. So what is kind of a real common system that you can put in place that makes a big difference on efficiency, body wear and tear, and essentially more productivity?

Get rid of your drawers in your operatories. Not physically get rid of them but get rid of what's inside of them and I mean with a bin and a tub that sits in front of you that's reachable that you can see. I could do that in 99% of the offices that I've worked with. I can do that. "Oh, Angie. What am I going to do with all these drawers?" I go, "They're pretty. Just let them sit there. They're going to look nice but they're not usable to me. They're not usable in your practice. I'm going to keep all of your supplies and 90% supplies is supplies you use for a week-- I need a week's worth of supplies for 90% of the dentistry you do. And 99% of the time, it's crown and bridge and it's filling, right? I need to have that stuff accessible to me. I need to be able to see it all the time. Anything else, it's going to be easily deployed. I don't want anybody having to get up, bending over, reaching. I don't need dentists grabbing instruments. Use your assistants. Delegate." A lot of doctors, "Huh. I can't train." Which brings me to one of the other components of the reboot training which is reinvigorate training. It's training your staff for success. It's creating [heart charts?], which we trademarked. In addition to having visible inventory, we also want a visible growth chart, and we publicize those. And the staff knows what it takes to get to that next level. A lot of offices don't have any type of training program, and we help implement a training program, as well. So as long as we're able to simplify your products. I can't tell you how many times I go into a practice and I've got six doctors, let's just say, that use six different bonding agents.

[Ay yi yi?]

Yeah. And I need [inaudible]-- "Hey, pick one, any one. Here's what Gordon Christensen said is the best one. I'm going to give you this [CRA?]. You can pick this one or pick another one, but we're not going to move forward in this training without having that simplified." Because training staff members to come in on board and understanding what doctor uses what bonding agent is mass confusion.

Complexity, for sure.

Yep. How do you feel about that? Do you agree with that?

Oh, totally. Not only in the ease of training staff and the flexibility of staff being able to work with whatever doctor because they're all using the same materials, but it actually reduces your supply cost, as well. And so it actually drives profitability, because if you're using multiple products, you're going to have waste. And when we studied the practices that were the most efficient on supply ordering and supply cost, all of them did exactly what you're describing. None of them had multiple of the same products. They picked one and they stuck with it, and they all used.

Amen. And it is a tough discussion. I'll never forget the group of hygienists that had 14-- or 15 different prophy pastes in two grits. Say what? A, I've got to find a place to put it in a central location, B, I've got to find a place to put it in all the operatories, and C, man, the time it would take to ask that patient what flavor they want. And I say to them, "I've never lost a patient by not having cookies and cream prophy paste. Never." But they just-- it's sometimes a difficult conversation. It's like, "Mint or fruit?" You go, "Mint or fruit?"


So they're interesting conversations. But you have to respect that they like what they like, but maybe they just don't know any different. And, "Hey, here's the best of the best. And this isn't just [schmucky?], and Dr. Nobody who tests this stuff out. These are 100 docs who work with the best products and say, 'Here's the best. This is best in class. Choose this one.'" And now I've simplified your bonding agents, and it's going to be much easier for me to standardize it.

Yeah. That's awesome. So when we took stuff out of our drawers it was very enlightening, because what I found was that there was stuff that I knew were in the drawers, but there was all kinds of stuff that I didn't know were in the drawers. So what happens-- if you ever run out of anything, then people start to squirrel away stuff. They put it in the very back of their drawers. "Just in case we ever run out of it again, I'm going to have some." And so, of course, when you get back to the or [inaudible] look at the expiration date. We have a garbage pale full of stuff that was expired and wasted. And I was so frustrated. I'd actually brought this garbage pale to a staff meeting just to point out, "This is why we're no longer going to use drawers." And I think it made the point. I think people were embarrassed when they saw-- I was certainly embarrassed that I hadn't noticed that all the stuff was being [crosstalk] away. I think they were embarrassed because it all got wasted.

Well, it's funny that you say that. And I have this discussion a lot. And I can go in there and say, "Hey--" Just as, "Hi Jannis and [inaudible]. We're kind of hoarders by nature. Maybe we'd experienced running out of things. And you tend to just accumulate a whole slew of things and [inaudible] you dedicated yourself to and you taken ownership of. And you don't have to borrow from Peter to pay Paul which someone who's not connected to the practice might do that. "Oh. I'm just going to go to so and so's [inaudible] and take and put in mine. I mean, that's not teamwork. But it's funny that you talk about removing stuff out of drawers. [inaudible] condo is-- she's on Netflix. Right? Okay [laughter].

Oh. Yeah. Yeah.

You know who I mean?

Oh. I do. Yeah, I read the book. And I did the whole exercise. So yeah. I know [what you're talking about?].

Well, it's funny because I hadn't the first time I heard her name. I didn't know who she was. [inaudible], "Do you know who that is?" Well, you would probably be considered the Marie condo of dentistry. And [inaudible] after I learned who that was I go and without introducing myself on my hands and knees to your practice I'm going to help organize [inaudible] and to get you on a right, efficient path. So it was funny that [inaudible] talking about listing things out. If I may discover what you've got and how you can be a little leaner and strategic in your organization.

So Marie Condo--

It's been a blast. I mean, this is-- yeah.

The book The Magic of Tidying Up or something like that.


[inaudible] Magic of Tidying Up is what it was called. And she has a show on Netflix, tidying up. And her principle is, "You don't need any more than you need. Simplify it. Organize it. And get rid of all the excess." And super easy read and harder to do the exercises. But I love the fact that [crosstalk] and help people with that.

I mean, I don't like the term professional organizer. But I should probably embrace that and say, "Well. If I can't implement lean principles in some of those things like [inaudible], and if I can't set your [space?] and standardize it, simplify it I need to be able to sustain it-- I need to do those things. And I talked to dentists and their staff. And I say, "This isn't stuff I'm making up. This isn't pretend. This is something that you can implement at home." Fortune 500 manufacturing companies do it as well. I joke, and I talk about my husband. I'm a newlywed. And my husband likes to help out around the house. And he can't get my drawers straight. Right? So he he'll put my shorts and a t-shirt. And it takes me 20 minutes to find what I need. So I thought we're arguing, I'm telling him [inaudible], and I'm [thinking?], "Well, how can I make this any better?" So why am I not implementing these same principles that I talk to [inaudible] about at home? I took a picture of my dresser and I labeled what goes in each drawer. And I printed it. I put it under the dresser and I said to my husband, "Chris, if you ever doubt what goes where, you can pull this little guide out from underneath this dresser [laughter] and you'll know where everything goes." Now no more fights and everything's fine and dandy. It's funny.

Yeah. Most--

It's good. I mean it does work.

Most couples would have said, "Well, if want it done a certain way, you do it yourself [laughter]," right?

Yeah. Right [laughter].

Great relationship skills, Angie. You got right past that. All right. So--


Go ahead. I'm sorry.

No. You're good. You're good.

If I'm a dentist and I see some signs of disorganization, of lack of consistency, if I see my team stooping, reaching, turning around. If I think that your processes could help me, how does it work? What should somebody do?

Well, they could first go to our website and find out a little bit more about us. We are at www dot desergo, D-E-S-E-R-G-O, dot com. That is our design website. We have www.dental-reboot.com and that will go right through our training website and you can inquire about more information. We have, I would say, arguably the best team in any sales organization in the industry. And I happen to work remotely so I need an airport. So I have my little office here but I don't work at the home office in Fall River, Massachusetts. I live in Central Florida. So because I travel every week I just need an airport. But I'm happy to have a discussion with you, schedule some time, and we can go over some of those things, find out what it is that you want to accomplish, find out if we can offer something for you that is going to change the way you do dentistry. And hopefully, it will increase your productivity, which something that we do guarantee by the way. So we base our practice growth on production per hour. I think you have a little experience with this Dr. Meis, right?

I do.

We got to value every minute and if I can save you a minute, that's a big number. So we want to determine what your production per hour number is. And in four months we guarantee that that production number increases $50 or we will give you your money back for the training. And in three years of doing this and it's about every week. So I did 40 trainings last year. I'm slotted to do about 50 this year and I've done it two a week so I don't have a lot of time off but I have only had two practices in-- we've only refunded two practices in that entire time.

Which is amazing because in any group of--

It's amazing.

--there are knuckleheads that aren't going to apply what they learned or are going to let it go back to chaos because they're just more comfortable with that. So 50 bucks an hour. If Dennis works 2,000 hours a year, that's $100,000. And of that profitability, remember, these are extra dollars. So this is marginal profit. So that means the overhead on this is low, maybe 10 to 12 percent. So this is a huge increase in earnings. And at the same time, it's making our team's life a whole lot easier. And it's making our treatment more efficient, which makes it better for our patients because they aren't [dealing?] with complexity and their treatment is moving forward more quickly. And every patient I know, speed matters when it comes to treatment. The more efficiently and quickly you can get it done, the more they like it. So that's--

But it's all about adding value. All about adding value to that patient's appointment. Value is whatever that patient's willing to pay for. So not willing to pay for waiting for you to go grab something that isn't there. They're not willing to pay for a complicated sterilization process, or setting up for an endo, or not having your lab case on site. Man, how about that checklist. It's being prepared and always adding value to that patient's appointment. It's incredible. I'm having the time of my life doing this. I enjoy it. I am super passionate about it. My personal mission in this whole thing is to keep private practice alive. And I see a lot of these-- some corporations trying-- they kind of get in there a little, and what about the mom and pop shop down the street or what about these private practices? They just want to exist and be relevant. I want to help them. And whatever I can do to help that process, that's my personal mission-- that's my personal mission. That's why I do what I do. And there always has to be a why. And I hope that I can convey your why when I show up at your practice.

So what is the website they should use to contact you again?

That would be www.dental-reboot.com.

dental-reboot.com. Awesome. And Angie, you said that you were going to be willing to make a book available to our listeners. You want to tell everybody--

I am. Sure. So you know that bible I was talking about early on? I didn't call it a bible, but in my world, it's a bible. But we are going to go ahead and give you the guide to maximizing productivity book at no cost. In addition to that, if you schedule reboot training with us, we will honor a 20% discount on reboot training until July 4th, 2019. It's a small window.

All right. Very good. That's awesome. So, extro to this video will be the directions on how to get that book, but that is super generous, and I really appreciate you guys doing that.

Oh, it's our pleasure. We're happy to do it. Again, it's the tools that you need in order to get the job done. And you're going to get the bible. And you just need reboot training to implement it. You asked me a question early on before I think we started this, and you said, "What value do you bring?" And the value is in the implementation. It's maybe you coached your team for a number of years, and some things just didn't stick. Sometimes an outside source kind of puts the nail on the coffin, kind of just hones it in and takes it to that next level. And this is all I do, guys. This is my passion. This is the difference-maker in practices.

Well, that's terrific. Well, Angie, I want to thank you so much for being on our Double Your Production Podcast today. And if anyone has interest--

Thank you for having me.

Oh, it's my pleasure. That is dental-reboot.com. And listen to the extro to the podcast to know how that you can pick up your copy of the dental efficiency bible. All right. Very good. Thanks, Angie.

Thank you, Dr. Meis

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