Dr. John and Wendy get into the detail of challenges that doctors face every day. They discuss how-to create an office that runs on its own, and doesn’t depend on one single person, recognize your need for new patients and emphasize value to your patients for the procedures you are performing. Also included: WHY these common mistakes are happening to doctors everywhere and how YOU can avoid making these mistakes or correct them within your office. You don’t want to miss this!
"EP49: 3 Common Frustrations and How to Handle Them" Transcript:
Hey, everybody. Welcome to this episode of the Double Your Dental Production Podcast. I'm Dr. John Meis, and with me is the amazing Wendy Briggs. How are you doing, Wendy?
I'm awesome. How are you?
I'm doing fantastic as well.
So our topic today is just to kind of review some of the challenges that we hear from doctors practically on a daily basis. There just seems to be certain places where doctors get kind of caught. And so we'll just talk through those, Wendy, so this is going to be fun.
Yeah, you bet. We always hear from amazing dentists across the country, and many of them are already very, very successful in their practices. But occasionally, we have a very specific question or challenge that's brought to us, and there's doctors that are seeking help for their practice. So we thought it would be interesting to talk about a few of those. You want me to just kick off with the first one?
Sure. Yup, you go first. I'll go second.
Okay. Well, I got an interesting call from a practice that I've worked with, actually, as a high dentist in another life, right, in years gone past, and this doctor was concerned because of a high rate of turnover. Pretty much everyone on the team was new. In fact, he was seeking two or three new assistants to hire and was in a state of panic because he didn't have what he needs to do what he does every day. And so when we were having the conversation, we discussed the fact that he really is not tigerproof. So this is a principle that we teach. We wrote about it in our book, The Ultimate Guide to Doubling or Tripling Your Dental Practice Production. And we had a little bit of a conversation about what that meant and the different ways that we find dentists are not tigerproof.
Sure. So for those of you who aren't familiar with the tigerproof concept, it goes back to two Las Vegas shows. You've got Siegfried and Roy and Blue Man Group. So on Siegfried and Roy, the most profitable Las Vegas show ever by orders of magnitude, hundreds of millions of dollars in revenue, hundreds of team members, a theater that was built just for the amazing things they had, they had a fire-breathing dragon that's on their set, just a very, very elaborate set, very elaborate theater. And one night, one of the tigers got spooked and injured Roy. And what happened the next night? Well?
Nothing. Or the next night or the next night or the next night. It was done. The show was completely done. And if you look at the Blue Man Group set, so if a tiger gets spooked there and injures a blue man, what would they do the next night? Well, they'd paint another guy blue and on they go. So the idea being tigerproof is that you over time create a practice that is not dependent upon any one person. And there's a variety of ways to do that, and so I think that's what we can talk a little bit about.
You bet. In this doctor's particular case, it wasn't himself that he was struggling with. We got another scenario where we had a doctor miss four months of production this year because of a variety of surgeries that were needed. So we do see occasions where it's the doctor themselves that is out. But in this situation, this practice wasn't tiger-proof with team members. So not only did they lose a few, but when they have new assistants to hire, they don't have assistants in place for quickly onboarding and training those team members and getting them up to speed. So they are, again, at risk, as if the tiger took them out.
So if you work with three assistants, and generally two of them are really great, one of them still learning, if you lose the two that are really great-- it's one thing if you lose one, because the one that's left can train everybody else. But if you lose both, the ones that know what's going on, you are in deep doo-doo because that is super tough for doctors to train assistants. Because, first of all, you don't know everything they know. And second of all, you don't have time to do it because you're trying to be productive. So it's a great example of not being tiger-proof. And if the elements that are missing is, are we able to recruit assistants? Are we able to recruit them? Are we able to hire them? Is our offering to a potential employee attractive enough to bring them in? Next, what's our onboarding process? What's our training process? What are the systems that we're going to train? And so, in this particular office, the systems work well this documented, and the key people who had the knowledge were gone. It's a very painful situation.
Very painful. So this is one of the things that we talked about. And I mentioned the book earlier, and it's interesting because we went through five strategies in the book. And it's interesting because as we look at a variety of these interesting situations, the strategies tend to run together. Right? And they create almost a success loop of how things should go practice. And one of the other strategies that we talk about in the book is our systems. So that comes down to the systems in place for onboarding, recruiting and hiring, onboarding, training, developing any team member, not just assistants, but any team member that provides a greater level of stability through the practice as a whole right down to the dentist. Right? Because in a situation when it's the dentist who's the sole producer, when they go out, the same thing can happen. And we've seen it happen time and time again where the entire show stops. And there isn't another show until another producer can be found and onboarded and trained and hired and all of that if we're lucky to be able to [inaudible] from that disaster. So the systems is what protects and helps create a more tiger-proof practice, not just on the doctor side, but also on the team side.
Yup. All right. Are you good with that one?
Yeah, for sure. Yup. That's [crosstalk].
I've got one.
Okay. So here it is. It goes something like this. I've got this marketing piece that I'm going to send out, maybe a Facebook ad, maybe a direct mail piece. And I'm wondering if I should use red letters or blue letters. And should I put a box in the upper right or lower left? It's something like that. And so it's very easy to just jump at-- it doesn't matter. Send the damn thing out. But it's what I [laughter] sometimes want to say, but even that's not a good answer. So going back to well, why are you sending this out?" "I want more new patients." "Okay. Can you see more new patients?" And we start going through our demand algorithm. Do you need more demand? And so I ask him, "Well, how well are you [at?] answering phones?" "Well, I don't really know. I think we're answering them pretty good." Which means they're not measuring it. "And if someone calls for an appointment, what percentage of those are we converting to an appointment?" "Well, I think it's 100%." That's what I always hear. "Oh, it's 100%. They're really good. Those ladies at the front, yeah, they are really good." 100% tells me that they're not measuring it, because nobody's 100%. And I can guarantee you, having seen now many, many, many, many, many people who are measuring it carefully. So the conversation goes on further, "Well, how many new patients are you seeing?" "Well, I'm a one-doctor practice and I'm only seeing like 75 new patients a month." And I'm thinking, "Oh, really. Wow. My goodness. That is a lot of new patients for one doctor." "How's your profitability?" "Oh, not that great." Well, duh. You're spending all this time processing new patients, which is a heavy load for the team, heavy load for the doctor. You don't have time to be developing cases, to be doing more complex and high-value dentistry for clients. You just don't have the time because you're rushing to get through all these new patients. So that one, it just-- over and over again people don't think about, "Do I have a capacity problem or a demand problem?" And they go about fixing the wrong one.
Right. And they spend all their mental energy worrying about the color or the size of the text on the postcard instead of developing [new?] cases and making the most of the patients that they currently have.
Yeah. Doing what they can with what they already have.
Yup. Such a good one. Capacity is so huge. There're so many practices that we visit with-- we ran into one just a few weeks ago that is doing zero recall. They make zero effort in recall because they have no place to put anybody. But then the day of, or the day before, the schedule will fall apart and they have swiss cheese. And [it isn't much?] of a schedule. So we see it time and time again. These systems that are necessary may not be what is required for today's practice. We may be using outdated systems that worked well in years gone by but haven't been updated. Or we may have team members that aren't following the system. That's very, very common as well. Or we really just haven't done a very good job of letting the team members know what those systems are and what the expectations are.
Yep. [I know?]. Exactly right.
So I've got one more.
Okay. Let's hear it.
So this one's really interesting. We've had this more than once in recent months. And that is practices that have bought in-- dentists that have bought into the thinking that no one should ever have to pay out of pocket for anything. So especially on the hygiene side. They want to do fluoride, but they want to do it for free on everybody, because if they really need it they should just have it for free. They want to do sealants if patients need them, but again, if the insurance doesn't cover it, they're just going to do it for free. Because it's so important to them that everyone has these services, they're not going to charge for these services. So talk us through the thinking on that, Dr. John, because I think in some ways it's noble thinking, but I find that it's also flawed thinking.
So, yeah. So there's a couple reasons in my mind why this happens. So one of the things that I have noticed is that practices that do this will put in the full fee and doing adjustment back to zero so when they look at their production, there's this inflated number, right, because they're not going to collect that. They're going to collect zero on it. And I think when you read in all of the business-minded dental journals, there is a hyperfocus on production and a largely absent focus on profitability. And so everybody's trying to drive up those production numbers because that's what they're reading and that's what they're seeing, and Lord knows there's a lot of consulting groups that are suggesting this. And I can't take and spend production. I can spend profit dollars, but I can't spend production, and if I'm going to work, I want to provide great value for my patients and I want to be rewarded for doing that. So that's one of the reasons why I think there's this disconnect among many in our profession between effort and profitability. Another one-- and maybe we saw this when we were doing the tour and speaking to large groups, a large DSO. And they found that many people were just not feeling that confident of the value or how to talk about it. They didn't know how to talk about it with patients, and so they just-- they knew it was important. They knew it was valuable, but they didn't really know how to talk about it with patients. They were afraid that patients were going to say no, so they just did it for free.
And then that really was what I was going to say, Dr. Don, is, the acceptance rate when something is free is always really high, and so it takes a lot less work and effort and courage. When it's free, everyone's willing to do it, but I think we've done our setting the stage where we're building an expectation within our patients that anything of value or anything we do for them should be free. And that's not fair. That's not fair to the doctors. It's not fair to the teams. And really, it's not fair to the families involved.
And then it's certainly not a sustainable strategy because it not only drastically reduces the income of a dentist, but now we don't have the resources that we need to upgrade technology, to keep our facility up to date, to spend on the development of our team, to be able to save adequately for retirement. Only 3% of dentists do that successfully. So there's just no way in that scenario where they're giving everything away that they'll be able to do that. And it's one of those strategies that will catch up to people, so it really doesn't make sense. And I just listened not that long ago to a podcast from a consulting group, and they were leaning towards this. Not completely, nothing out of pocket, but for a significant portion of the procedures, they were suggesting no out-of-pocket cost.
Right. I remember when we did that with this other organization, they actually printed a report for each practice on how much they were giving away. I'm just saying a handful of services. It certainly wasn't a complete report. And I can remember-- then they took that money that they had written off in the last month and calculated what it would what they would give away over the year, and it was sometimes shocking for them to see that number, how quickly it can grow and the fact that they have given away over $100,000 in one area of oral cancer screenings, for example. It sums up so quickly.
And in most practices I know are very generous with their patients. They do treatment for free for people. They do dentistry from the heart. They're great, community-minded, and service-minded. That's not what we're talking about here. Those kind of things that they get, almost every single practice does something like that. We're talking about a situation where a certain procedure, they're just not going to charge. And when we had that experience at this large DSO, we saw that the doctor was often disconnected. The doctor didn't know that we weren't even charging for this, right? He didn't even know. And so it was kind of interesting to see the discussion that happened once everyone understood what each other was doing because the communication and the organization and the processes and the accountability were clearly not there.
And we've seen practices that have, I guess, charted a different course, that had had some struggles with these things in the past, and certainly, in every aspect that we talked about, all the challenges we talked about today, practices that weren't very tiger proof really worked on systems and revolutionize their practice, practices that were out of capacity and didn't understand they were out of capacity. When they add additional capacity, amazing things happen. Practices that were including all fluoride varnish at no charge for every patient every time. And once they understood the language and the confidence and the value of risk assessment, they were able to optimize hygiene and dramatically see an impact. So all of these strategies, interesting challenges. Very, very common. We hear them quite frequently. And the good news is with the right mindset, with right focus and with the right systems and strategies in place, they're very easy, in my opinion, very easily and sometimes quickly. Can we turn that around?
Yeah, for sure. That that kind of issue, once a process is identified, once the team is trained on it, once they've had a chance to role-play it and get good at it. And once they're set loose on patients, it's amazing how quickly you can have a dramatic impact.
Yeah, I love that. One of the things that we haven't done Dr. John is we really haven't shared with our podcast listeners some of the amazing opportunities we have for them to attend live events. And that is another question that we get all the time, "When is your next event in my area? When can we come see you? What's on the agenda? What's on the calendar." So why don't we take just a minute and go over our two most common events that dentists and their teams attend to hear us live?
Why don't we talk first about the W production workshops that we do?
Awesome. So the W production workshops are really taking a few of the strategies from our book and getting into the detail of why, first of all, and really showing how they work, allowing you to see the impact of making these very, very simple changes. And some of these changes can can have a profound impact on profitability. So it's always a really super event just watching people leave with all these notes because they have all this information. or how they're going to go back and implement the changes in their practice. So that would be the [first one?].
Yeah. You bet. And one of the things that we love is when people that ordered our book on Amazon or read the book, and they reach out and say, "Loved the book." I do think the natural next step would be attending a Double Your Production workshop. And what we're going to do is you can certainly find where our workshops are. You can go to theteamtraininginstitute.com/2xworkshop, and that will pull up a page that lists all of the upcoming dates and venues for you. We'll also post it here. We'll post a link - just to make it easy - on our Double Your Production Podcast homepage, so you'll have access to that. Those are generally one day. We have them in a variety of cities around the country. We have - I don't know; what do you think? - four to six a year depending on our schedule and how crazy things are. So I know we generally have some coming up here very soon. Usually, we have four to six of those a year. And it's a one-day event and great next step for those who've read the book and would like to have more information about how to apply some of those principles.
You know, we should probably do this, Wendy. Why don't we go ahead and offer for people to-- why don't we buy the book for folks that are listening on the podcast?
Oh, that's great. Yeah.
Well, to do that, you can just go to ultimateguidebook.com, and you pay the postage, we'll buy the book for you, so you won't even have to pay for the book. You can get it on Amazon if you like. It is an Amazon number-one bestseller, but you can get it by going to the ultimateguidebook.com and get [inaudible].
Awesome. So, if you haven't read the book, that's where you start. If you already have read the book, and you want to learn more about the principle we wrote about, the 2X event is a very good next step for you as well.
So, [Wendy?], tell the listeners about the hygiene explosion events that you hold.
Yeah. So we hold these around the country as well. The hygiene explosion workshops really are an amazing way for you to get, I guess, a more affordable opportunity to have a hygiene coach work with your team. So we do this in small groups. We generally sell it out at 10 practices. So, if this is something that sounds interesting to you, we recommend that you register early because they often do sell out. What you would do is you would bring your hygienist, your practice team leader, and then, of course, the doctor would attend this hygiene workshop. And when we have a coach come to your office, we're very proud of the fact that our return on investment is nine to one. So every dollar you invest [inaudible], you get nine of those dollars back. For some practices, they're ready to jump in and have a coach come in right away. Other practices want to dip their toe in the water and give us a little bit of a test run before they go all in. Those practices, it's great to attend a hygiene explosion workshop. So the same amazing content the practices have used to double, even triple their hygiene productivity. We focus again, just like the Double Your Production event, on why these changes make sense. We talk about what to do differently and how to do it. And at the end of that day, your hygiene team has a chairside toolkit. They have very specific verbal skills on strategies that are tested. And again, very important for us to know this. We talked a lot about productivity, but [Dr. Tom?] and I both hope our listeners understand that, for us, production is never the goal. Instead, we view production as the result that comes when you do the right thing to the patient. So everything that we teach at the hygiene workshop is all about elevating patient care and hygiene, doing the right thing for the patient. And the production just naturally follows when we do that. So hygiene explosion workshops are way for you to get all the amazing content, things that can truly revolutionize your hygiene department at a much lower price point because it's done in a group format.
Very good. That is an awesome experience. And practices really take off after that, so that's awesome.
They do. So, for those that want information on that coming dates for that, we'll also have the link posted on our homepage for the podcast. The link for that one is not quite as easy as the 2X workshop link. So just visit the podcast homepage, and you can find information about those workshops.
All right. Very good. Well, thanks, Wendy, what a great episode we had. And thanks, everybody, for listening. And we'll see you on the next Double Your Production podcast. [music] Bye-bye