EP56: How Your Team Can Help Case Acceptance Today (Part 2)

In this episode of the Double Your Production Podcast, we’re sharing a segment of Dr. John Meis LIVE answering common case acceptance questions.

If you pull the dreaded report of unscheduled or uncompleted treatment and the list keeps getting longer and longer, this podcast is for you.

Dr. John shares in-the-trenches strategies that you can use immediately in your practice to increase your case acceptance.

Listen now:

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, who are in the trenches, who know exactly what you're going through. And now, your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs.

Hey, listeners. We are here for round two of Dr. John's incredible case acceptance lecture. So I won't stand in your way too much. I know that our episode 52, the part one of this presentation, ended on a cliffhanger. So if you want to find out any more information about the Team Training Institute, just find us at www.theteamtraininginstitue.com/podcast. We've got all sorts of things there including where you can find us live, where you can see Dr. John speak in real life.

So again, this presentation last time ended with Dr. John asking the question, "What does this have to do with your case acceptance?" So we'll go ahead and start the track there with his case acceptance lecture.

You're going to ask, "What does that have to do with your case acceptance?" Well, let me talk about it. So I'm pretty happy to share with you my blunders so that you all don't have the same blunders. So I've done a lot of things right for sure, but I've done a lot wrong, too. And because of my position in consulting and managing all these practices, I get to see the breadth of what's going on and I get to see the outliers.

I get to see the ones that are doing extremely well. I get to see the ones that are doing not so well and doing bad. And I get to learn from both because it's interesting lessons from both, right? So I learned the hard way and you guys get to learn the easy way. So I want to tell you about what happened in my own practice. So we knew our case acceptance was low. We didn't have a good way to measure it. The best way I had to measure it was I would run what I would call the dreaded report.

The dreaded report from practice management software that gives you all of the diagnosed and undone treatment. And in my practice, it was millions and millions and millions of dollars, right? We had a big practice, millions of dollars. So I knew my case acceptance wasn't that great because every time I ran that report, guess what? It was a little longer. It was a little more money.

So I knew my case acceptance wasn't great. And so I began to experiment with things. And so one of the practices that I was watching, they had the treatment coordinator that you guys heard about from one of the practices on the blue diamond day. And the treatment coordinator, the idea was really good. So we put somebody in that position. And we did a little better, but not much better.

She was an assistant. She was very nice. She was very smart, very knowledgeable, capable about dentistry, but it really didn't make a big improvement. And then she got pregnant and so she left. And so one of our hygienists said, "Hey, I'd really like to give that a crack. And I think it'd be better because all the new patients go on my column and I can do all of the stuff and then, if they want their teeth cleaned, too, I can do that, too."

So in our office, we had always had the thing, if people asked to have their teeth cleaned on their first visit, they got their teeth cleaned on the first-- if they didn't, they went on the doctor's schedule, right? So this, we would be able to accomplish both if we had a hygienist do it. And this hygienist was very knowledgeable about restorative treatment. How much training, hygienists, did you get about restorative treatment in hygiene school? Zero. right?

So the only way your hygienists learn about restorative treatment is what you teach them, but I didn't know any practices that had a way to do that, that had a system to do that. I didn't know any. And so, what happens when we don't have a system to do that, is that the only way they learn restorative treatment, and particularly your philosophy about restorative treatment, is to be with you a very long time, right? Is that smart? No.

So because she had been with me for a long time, she was dialed in, she was ready to go. And when she took over this position, our case acceptance went up, and this was awesome, right? So now, we had to hire more doctors. This is great. It was a perfect, perfect setup. Perfect setup.

And I made a leadership mistake. The leadership mistake I made was she was doing really, really well, right? So I was giving her plenty of support, but what's the other thing people need? They need challenge, and I was not giving her challenge. And so, she was feeling like a superstar, and she was, but she wasn't being challenged.

And her ability to work with the team declined because she got the feeling that she was better than everybody else because I didn't challenge her. I didn't show her the way she wasn't being a good teammate. I didn't show her the way that her attitude affected everybody else. I didn't show her. I didn't challenge her to be better. I made a mistake, and guess what happened? The relationships started to fracture. The team started to go down. Resentment started to go up.

By this time, too late, I've created a monster, I can't fix it. Tried, but I couldn't fix it, and she had to go. So because I hadn't created a system, because I had no one else trained, I had no one else that had the period time of left, I didn't have anybody to put in that position, and guess what happened to our case acceptance? It was just like a plane in a stall. My case acceptance went down.

It's a survivable thing, but remember, I hired additional doctors, so I've got more mouths to feed now, and I got less treatment to feed all those people. Got the same number of patients. You see the leverage? So what I did, was I said, "We're going to do a postmortem on this just like the NTSB. We're going to sit down. We're going to put a team of people together, and we're going to spend whatever time it takes to figure out how we have this screwed up and how we fix it."

So it took weeks. There was some gnashing of teeth. There was some big egos that had to be tamed, including mine. But here's what we learned. We looked at it just like a NTSB investigation. We wanted to find the cause, and we wanted to fix it permanently. We got to work. We learned some things, some things that I kind of knew, some things that I didn't know, and some things that I needed to know.

Now, do we have a people problem or do we have a system problem? We got a system problem, but what do we all tend to do? We always tend to blame the people, right? And so we got a new treatment coordinator and is that we're not getting the results. It's her fault. No, it's not her fault. We didn't create the system, we didn't create the training, we didn't have it all done.

She was doing her best. There's a system problem. So here's some things I discovered. Number one, I discovered that the other doctors in my practice had different diagnostic criteria and different treatment philosophy on certain things than I did, all right? Is that good? That's not good. Team why is that not good? Confusing. It's confusing the patients, it's confusing the team, and it's like having multiple teams within the same team which doesn't work, all right?

So I learned that the doctors had different diagnostic criteria from me. Not a people problem, system problem. This one I discovered all the doctors including me were wildly inconsistent in our diagnosis, okay? So the letter from the hygienist on Facebook, he doesn't diagnose things on his friend. That's what I'm talking about diagnostic inconsistency, okay. Now, you all have these doctors.

Let me demonstrate it for you. I didn't think I had it. I really didn't. They pointed it out to me and I denied it like an idiot because I wasn't being coachable. I denied it, they showed it to me, they showed me the data, they pointed it out when it happened.

Here's some of the ways that I was being diagnostically inconsistent. If I was running behind schedule and I went in to do a hygiene exam there were times when there was something I needed to tell the patient about but I didn't because I didn't want to take-- I knew it was going to be okay till the next time they were in and I didn't want to take the time and get further behind to explain it to them.

Doctors, anyone else do this? Okay, some hands go up. Here's another way I was diagnostically inconsistent. Was that I had a tendency to judge someone by their appearance. I didn't think I did. I'm embarrassed to say that I did but I did. So is that a people problem? I believe it's a process problem.

Because if we have our processes in place the fatigue or the time of the doctor doesn't matter because when the doctor walks in it's already set up for them, all right? So that if the hygienist or the assistant who's ever seen that patient, if they're behind or if they're tired, we still have the doctor to save it, right? If we get off base just a little bit, we can still save it. But if it's the doctors coming in to do all that, and the doctor does his thing leaves, yeah, it's over, game over. Okay, let's see. If I go back.

So it turned out when I looked at our financial process they were incomprehensible. We were giving patients information that there was no way in the world they could understand. And there was no way we were giving them the information that would help them make a decision about how they wanted to move forward with treatment. It was about as incomprehensible as could be.

So we were handing our patients a piece of paper, right? And it's got 88 codes on it and clinical descriptions of the treatment and dollars and insurance, and then people are kind of looking at it. They had no-- we confused the living daylights out of them. So what happened next was kind of difficult to have imagined, but it really had a profound effect for me.

So what we did was we put together a system. And the system was what we do when, how do we talk about it to each other, how we talk about it to our patients, and how do we talk about the financial end of it? Sounds really simple. I later learned-- how do we document it so that we can teach new team members so that when someone comes into our practice, we can sit them down in their first two weeks of training.

They can go through our training manual on treatment philosophy-- what we do what, how we talk about it, how we talk to each other-- right? I wasn't smart enough to put that together when I was still practicing. I learned that from somebody else. So my question to you guys is do you have this? Do you have this all dialed in? And I know the answer because I asked this question at the last Blue Diamond retreat.

And I asked how many people had it all put together, and nobody's hand went up-- nobody's. And I've talked about components of this in the past, but I've never really kind of put it all together for everybody. And several people at that last Blue Diamond retreat said, "Boy, we need help with that." So that's why for our summer event we're going to do the case acceptance breakthrough.

This is an event-- two days to engineer a rapid increase in case acceptance. So in my office, when we got this dialed in as well as I knew how to do it then-- and I know a lot better how to do it now. Our case acceptance went up 20%. So I believe anybody can improve their case acceptance by 10% or more. So this is for dentists and certain team members - and we'll talk about that in a little bit - led by me, and Wendy will be there. And others will be there.

So let's walk through it. The idea is to put this all together so that your whole staff knows your philosophy, knows how to talk about it, and buys into it. And because you have some of your team members there helping to create it, we all know that people support what they help create.

So by having some of the team there, you're able to have already-- have you ever gone to a meeting and you go back and you got all these great ideas, but your team wasn't there, they're not excited; you're excited, and they go, "Just let him go. He'll calm down in a week or two. We'll just keep doing what we're always doing. He'll be fine." Right? But when your team comes back as excited as you are, that's why when people come to our annual summit, the ones that bring the most team are the ones that have the most progress. So because the team comes back excited.

So with this, you will have a team-- some of your team members come back in order to help you be on fire and make it happen. So there is hidden wealth in your practice. We all know it. Just run the dreaded report, right? And you will find that it's millions. We know that as our practices grow, the ability to scale and to scale efficiently so that we can bring people on board and get them up to speed very, very quickly is so critical, right?

Anybody have a problem with team turnover? Who has the exact same team that they did one year ago? Two people in the-- three people in the entire room have the same team. That means there is team turnover which means, did we have a process to bring them up to speed? Probably not. And probably you're using the method that I used until I figured this out. And that was just have them be around long enough, and they'll figure it out. Not very bright. But I did it for many years.

It's a two-day event. We're going to do it at our conference center in Phoenix so that we have a very, very consistent experience because we hold a lot of conferences there. The two days will be personally led by me, and we're only going to do 20 because I can only do 20. So the reason I can only do 20 is that you are going to develop your own philosophy; you're going to document it, right? You're going to decide how you talk about it.

Now when you have 20 people in the room, and they're looking at cases and saying, "Oh, with that I would do this." It allows you to dial in kind of where you are on that diagnostic assertiveness scale. So diagnostic assertiveness, I talked about it yesterday. Bring a patient in here. Have 10 dentists look at it, you'd get probably 10 treatment plans, maybe 9, maybe 8, but you'd get multiple treatment plans, right?

And when you practice by yourself, it's hard to dial it in. Am I assertive? Am I too passive? Am I letting things go too long? Am I hurting my patients without knowing it, right? This allows you to dial that in. Then we figure out how we talk to each other, all right? So we create our hand-off system. And by having that figured out, we now know how to talk to each other. And when you got 20 people in the room and two days, you have time for everybody. It's a rapid-fire, "Go down. This is how we're going to do it." So you get to learn from what everybody else does. And that's why we can only take 20. Same thing with how we talk to patients, same thing.

So what you're going to get from attending this is you're going to get a case acceptance bump of, I believe, 10% more. If you bring it back, it's going to be laid out to train your entire team. If you bring it back, and you train the entire team, I would expect a 10% bump. And think of the potential long-term value if you keep this up, you can bring people on faster. And in a time of almost absent, almost zero unemployment. Right?

Has it gotten easier to find team members to replace anybody who leaves? Are there more opportunities out there for people to go? Absolutely. So we're in kind of a bind, right now. All right? So beyond that, you can expect freedom. And when I say freedom, the freedom to and the freedom from. Right?

The freedom to had better case acceptance on the type of dentistry that you like to do. Right? And the freedom from patients that are confused and don't buy and move on. Freedom from, the "one and dones" where they come in for an exam and you never see them again. And definitely would create more profitability wouldn't it? Think of what this difference makes. Think of the next dollar phenomena has a big impact on freedom.

So your income goes up, you get to live in the house you want, drive the car you want, send your kids to the school that you want. You'd be able to pay your team better. Be able to have benefits better. You'll be able to take your team to-- gosh you guys went where? You guys went to, some Playa del Carmo Palm-- I don't know what it was. But damn, it sounded nice. I want to get a job there.

Freedom to hire the people that you like. Freedom to attract the kind of people that you like. Because you can afford to pay a premium. So after you attend what can you expect? You can obviously expect that freedom. But here's what you get by being in the program. The Case Acceptance Breakthrough, it's the two-day event. And we're going to build a custom set of treatment, diagnosis, planning, presentation systems, the four big things that I found were missing in my own practice. We're going to fill all those blanks in and give you what you need to go back and train the entire team.

It's perfect for practices that have associates, whose case acceptance or diagnosis is not as strong. Right? When teams kind of go through this breakthrough process obviously, 10% bump doesn't take much to repay the investment. I'll actually tell you how much of a bump it will take. So you will get the Treatment Plan Made Predictable script book. Right? Because we're going to develop those scripts. We're going to do it as a group. And we're going to use the wisdom of crowds to make sure that we use the best words for our patients to understand and for us to understand each other.

Next thing is the handoffs. How we talk to each other? Hygienist to doctor? Doctor to financial coordinator. Financial coordinator, treatment coordinator, the front desk. Whatever your system is. That's why I can't do one and just give it to you. Because every office does this slightly differently. So let's customize it so that you have a customized system for your office and how you do it. And then you'll get the Annual Training Pack.

I've talked about this for a long time. I mentioned it at the last Blue Diamond. I was surprised people didn't have it done. But I've got it done for you. And that's 52 images that you can show once a week at a morning huddle or an office meeting that you can show the picture and you can say to your team, "What do we do here?" So they will learn over time to get better and better at diagnosis and at treatment planning and at understanding in those conversations you can be talking about the why. So you'll get that, the Power Pack.

We'll be doing hot seats and role-playing, kind of like I described. And you'll get via recording, Mitch and his team are going to be there to videotape this, so you'll get the video recordings. So, if we stop right here, what's the value of this? So, because yesterday, remember I put up the slide with the one practice, two practice, three practice, and the 384,000 in and the 4.6 million out, whatever it was? It got you kind of thinking like finance people think. So, let me give you a few numbers to broaden that thinking.

So, who here wants to have their future bigger than their past? We started with this, everybody had their hands up. Who wants to have more impact on their teammates, and their patients and their communities? Everybody had their hand up, right? Who wanted to have greater teamwork? Everybody had their hand up. So, all of those things would happen, so that's a value, but now we get back to the people part. It's the best care for patients, right?

The team has the opportunity to do the best care, so it's great for the team, you end up doing more of the treatment that you love. So let's look at some of the math here. I took a practice doing 100,000 a month, so a $1.2 million annual practice. Okay? And I took, I looked into my database and saw what the average amount of treatment diagnosed in those practices were, and it was-- I looked as many hundred, and it was about $145,000 per month. Okay?

So we have this pool of hygiene income flowing through, and then we have restorative that we're diagnosing. And so, of this hundred, probably 80 of that is hygiene. So the rest of the restorative-- so you've got to do kind of two, at least, times diagnosis, as what you're actually going to do. So in this case, when we looked at it, on average, there were 29% case acceptance. Now, if we just tweak these two things by 10%, that's why this is so powerful, and it's why it's like a magical tool of float, or the next-dollar phenomenon. Right?

We're going to tweak two numbers, we're going to increase the amount that we diagnose because we're going to have a system in place that doesn't rely on any single person's personal energy, any person's relationship, we are going to have a system, and we're going to treat everybody exactly the same way. Who here doesn't think that that could create a 10% increase? We all know it could, right? So 10%, that brings that number to that, and we're going to increase case acceptance, not 10% to 39%, no, that's not what I mean. I mean 10% of the 20%, right, to 32%.

So look what happens, 32 times 159, we have an increase of $50,000 a month, and $610,000 per year. Two little things and look what a huge impact it has. Okay? Now here's where you're going to have to stay with me, because this one is a concept that most dentists don't know anything about. So, but we do know about this.

If we win the lottery, we get to take the money one of two ways, right? One is we get a lump sum now, or the other, we get paid out over a long period of time. So if you take the getting paid out over a long period of time, is it more or less? It's more and it's way more, right? So what they did was they did a calculation. They took out this series of payments, and they said, "Okay, let's do a calculation to determine what the value of all those payments are right today, if we were to pay it out."

So they did this calculation, it's called a time-value-of-money calculation speculation. So that additional revenue we had on the other page because we've improved revenue, we will improve profitability percentage, right? So profitability percentage, let's say it's 20% so that's the annual profit amount. And if we take a term of 10 years, and we look at that value, $122,000 yearly for 10 years. And do that same calculation they do for lotteries, the current value of that income stream is 1.3 million dollars. Okay?

So remember we're thinking finance, and we're thinking ownership of an asset, our dental practices. Okay? What's the value increase to the practice? Well, 1.2 million practice before 10% which is doing pretty decent, right? Current profit, 120. So if we use a multiple of earnings, that practice is worth $480,000. Okay? After the course we added that 600 and sum, so that's collections. Because we have more collections going through the same funnel, The profitability is going to rise, I used 16 here which is a little conservative.

But profitability is going to rise so the current profit then is this. Four times that, is this. This minus this, is this. So the practice value increases by $678,000. You see what I mean by it being a financial explosion tool, life float?

So let's just say that we're going to charge $150,000 for this. I want the reasonable test, now where's my-- here we go. Would you like to play a game again today? It was fun yesterday, wasn't it? Yeah. So, all right. You give me $150,000. Ah, thank you. Here's what I'm going to give you, I'm going to give you 1.3 million dollars. So that's the time value of money calculation. There you go, there's 1.3 million, right? Okay. And 678,000. So you gave me 150, and I'm giving you back about 2 million, okay? Game over.

Thank you.

Was that fun?


Yeah. That was fun, wasn't it? So it passes a reasonable test, but I'm a people pleaser. And I want everybody to do this. I want to fill this with 20 great practices and I want to have a bigger impact on everybody. So I'm not going to put that kind of a price tag on it. So this is the price tag I put on it, 2499.

So if just with what I showed you, that would be a good deal. But we're going to add some things in. So next thing is, that I will do a key constraint release exercise with you to determine what the number one thing in your practice is that's holding you back. I can do that with data, I can do it by showing you-- I can do that by interviewing you too. There's lots of different ways I can do it.

So I will do an exercise with you to identify what the key constraint that you have is. And how to fix it. Next one, is I'm going to do a special additional savings of $5,000 today, and here's why. If I sell it out today it saves me a ton of time and effort, okay? So I don't have to hire the copywriters, I don't have to mail the letters, I don't have to build up the web landing page. I don't have to do any of that kind of stuff. We just get done nice and simple.

So I'm going to take $5,000 off. Okay? So that's just before today because if we don't sell it out today, Monday, Darcy and I have to start putting all that together. And I've got to do it in a short period of time because I'm leaving for Europe. I'm going to be home this week and then I'm leaving for Europe for two weeks. So it's worth it to me to give you the $5,000 off so that we get it done today.

So how do you qualify? As a doctor and in this room, you qualify. You're already a good fit with our culture, most of you are already blue diamond members, already understand our double your production systems and methods and already are bought in. We don't have to cover a lot of extra ground. We can move really, really fast and light. So the ones that can expect the greatest success are really those that are living, or want to live what James was talking about this morning. To be teachable, open to new concepts, willing to participate.

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