EP71: Strategies to Maximize Change In Your Practice Tomorrow

Podcast

Wendy and Dr. John analyze case studies with offices who are implementing change and having tremendous success. During this episode you will find tips and tricks that will help you now while recovering from the COVID-19 pandemic as well as strategies that will continue to improve your patient care and practice production for years to come. You can’t afford to miss this one!

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“EP71: Strategies to Maximize Change In Your Practice Tomorrow” Transcript:

00:00:01.930 Welcome to the Double Your Production Podcast with The Team Training Institute, the one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it or in the trenches who know exactly what you’re going through. And now your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs. [music]

00:00:28.870 Welcome everybody to this Double Your Production presentation. I’m Dr. John Meis and I’m here with Wendy Briggs. How are you doing, Wendy?

00:00:36.780 I’m great, Dr. John. Always good to be here.

00:00:39.690 It is. So we had an interesting challenge among our coaches this week, didn’t we?

00:00:46.670 We did.

00:00:47.210 They were sharing results and the coaches were really excited that we have an internal Slack channel that we share the tremendous progress that our clients make. And everybody makes really good progress. Some make amazing progress. And so their challenge to us was, “All right. You need to go out and tell the world what the difference is between the ones that are doing really, really well, and the ones that make less progress.” So that’s really kind of the theme of our show today.

00:01:20.370 Right. And we really wanted to talk about what inspires some practices to have really amazing, amazing results. So we’re going to get these slides on here. And I’m not sure if– there we go. So we wanted to discuss how we can help our coaching clients or dentists in general, maximize the return on investment when they have made an investment for coaching or for some element of change within their practice. So the questions that we wanted to answer today. And we’re going to answer these questions in kind of a unique way. We’re going to talk through some case studies on practices that have seen incredible results. And then we’ll talk through as well why we think that happens and what are some potential roadblocks to inspiring teams to practice. Dr. John, one of the things that I think is so interesting is we often hear from dentists that say, “I’ve tried to get my hygienist to do X, Y, or Z for years. And it just has never really taken off.” Or we have the hygienists say, “Hey, we go program after program after program. And we just keep going back to the way we’ve always done things. And then, of course, we love hearing from those same clients six months into our program and celebrating the impact that they’ve achieved with what we teach and how we teach it. So we wanted to talk through what’s the difference? Why do some practices or some programs tend to inspire a much higher level of utilization and impact?

00:02:50.290 Yeah, sounds good. And the other thing that we’ll talk about is so we’ll show you some cases. We’ll talk through some specific case studies. But then we’re going to talk about really what we see as some of the roadblocks for people getting the full benefit of some kind of change initiative.

00:03:07.030 Love that. So here we go with the first example. This is a general dentist with three hygienists, and these were his numbers in January, I believe, so before any of the shutdown, any craziness with the virus and any of that occurred. This is kind of what they were doing. One doctor, three hygienists production.

00:03:30.860 Typically, the most productive month of the year. It’s a long month. We’ve got people past the holidays and people are focusing back on their health again. So typically, that’s a great model.

00:03:42.300 Yeah. Patients have a new insurance maximum, right? So some that had maxed out their insurance the year before are ready to get going again and practices that have certain systems in place really do tend to take off in January. So here we have a partial month after they started our program. So we’re able to see a uptick, a slight bump on doctors’ production. But before we could really get going, this was only a partial month, right? And then that partial month, the hygienists produced what they had done in the previous full month. So we can see the beginning of impact here.

00:04:17.310 So this is the month of March. And if they’re like most practices, they probably began going to emergency only treatment probably somewhere between the 16th and the 21st, somewhere in there. So this is maybe at best three quarters of a month.

00:04:35.110 Right. And then we have the first full month after they began the program. And let’s see if we can get that to build here. Here we go. Boom. This is June.

00:04:47.200 Wow. Now everybody’s going to be looking at it and saying, there is no way that a hygienist can produce $62,000 in a month. And it is an aberration. It’s an aberration for a couple of things. Number one, tremendous pent up demand. When their practices were closed, pent up demand. So our guidance all along [inaudible] must be ready for this. Have your office open, have everybody there and hit it. Another piece of guidance that we gave was to add extra hours. So extra hours, extra days. Take advantage of this period of time when there’s all this excess to demand. We know the economy is slowing down. We know that the unemployment is still a problem and it looks like it will continue to be longer than any of us hoped. So take advantage of this opportunity right now. That’s exactly what they did, didn’t they?

00:05:39.450 Yeah. And it’s really amazing to go from $24,000 a month of production to $62,000 a month in production in hygiene, to go from 23 to 61,000, to go from 21,000 to 48,000. All of the hygienists made tremendous progress. And like you said, because there were extra hours, this number may be somewhat artificially inflated. But isn’t that kind of the point? Here we are trying to recover from this incredible shutdown, really unique circumstances, unprecedented for our profession, and practices are trying to get cashflow back up and to be able to recover from those weeks that they were closed. So here we’ve got a practice that had a tremendous jumpstart. And of course, the hygienist numbers are super impressive. But I also love the doctor, right? The doctor went from 72,000 to 137,000. So one thing we’ve always said is that when we have the right systems in place, hygiene drives the practice. So as hygiene goes, the rest of the practice goes. And some doctors are a little bit fearful, right? I don’t want to– if my hygienists get too good at prevention, it’s going to impact my ability to do dentistry. And we somewhat chuckle at that because we’ve just never seen it happen. It doesn’t happen. There’s always so much dentistry to do. But we’re just delighted to celebrate the tremendous progress this practice has made.

00:07:06.490 When hygiene goes up, it goes up because quality of care goes up. When quality of care goes up, now you now your patient referrals go up and now there’s more flow in the practice. Now your retention is better. And so it doesn’t interfere with restorative dentistry. It supports restorative dentistry. And if you look at this, the dentist almost doubled his production from January to, I think this was may or maybe June.

00:07:33.170 June. It’s June.

00:07:34.140 Okay. So I mean that’s absolutely incredible. And another thing to point out here is that production number is while checking, it looks like too two and a half or two and three quarters hygienists. We always say that once you get past two hygienists, any more than a doctor trying to check above that will reduce the doctor’s productivity just because there’s so many interruptions to check hygiene. So that’s an amazing job. We rarely see somebody get to that level. But this is what’s possible when you put up systems place and you have everybody go in the same direction. Now they’re not going to do this month after month after month. This was a surge, right? They were trying to do as much as we could before the economy dropped down. And so these numbers will back off. But in this one month, they more than made up for the loss of profitability in the month and a half they were closed, in one month. So that’s pretty incredible.

00:08:32.320 It is. And I’m so glad you mentioned, Dr. John, that the level of care, the quality of care goes up because there may be listeners that don’t know us very well, right? And so we always teach that production isn’t the goal. Instead, production is the result that we see when we do the right things for our patients. And sometimes I think people misunderstand that, right? They may see us celebrating a record production day and not understand that that’s not necessarily the goal. Instead, our goal is to provide world-class care. And we just know that when we provide that world-class care, we’re going to see a reflection in revenue. It just happens, right? The production takes care of itself, and that’s an exciting part of our program [crosstalk].

00:09:14.820 So jump in hygiene production comes from providing a higher level of preventive services and a higher level of periodontal care, mainly preventive, right? So those are all quality of care indicators. And so that’s the only way it goes up is providing better care.

00:09:34.870 Right. We love that. All right. So here’s another case study that I want talk to. This is really exciting for us. This is a Blue Diamond member who had just had their hygiene coach come in and work with their entire team on case acceptance, right? We teach things like tribal language, utilizing technology as a part of the experience, helping the patients see what we see. We talk all the way through those things. And right before the practice shut down, they had that case acceptance training. So during the months they were closed or the weeks that they were closed, they were able to really dial in on those systems and work to make sure that when they came back, they had those things implemented. So this is another unique example because it’s a multi-doctor, multi hygienist practice. And we do deal with a lot of larger locations or practices that have multiple locations. So for you solo doctors, solo hygienist practices, you might be a little bit overwhelmed and [inaudible] by this number. So keep those things in mind, right? Multi doctor, multi hygienist, a large facility. And in June, they were able to produce $964,000 in production. And you can see here that their annual goal, their goal for the year is about 4 million. So here they were able to do 25%, just about 25% of their annual goal in one month.

00:11:02.370 Incredible.

00:11:03.120 Incredible. Incredible.

00:11:05.650 So another thing to really look at here was when you have enough capacity, so that means enough chairs, enough doctors, enough hygienists, enough assistance, if you have all the elements of capacity, you can really take advantage of surge demand, right?So look at those same day production on this, 77%. That means 70% of what produce was not on the books at the beginning of the day. So this was seeing new patients and doing treatment that day. This was seeing emergencies, doing the treatment that day. This is anything diagnosed in hygiene being done that day. Anything on the restorative schedule that’s due for hygiene or due for preventative services being done that day. So they did a tremendous job of taking advantage of their capacity and the surge in demand that happened after offices were closed for a period of time.

00:11:59.440 Yeah really incredible work. And we’re so delighted to celebrate with them. They couldn’t wait to tell their coach how they had done and share the impact because it is remarkable, right? And they worked hard to make that happen. And we always say dentistry is a team sport. So this is an incredible team effort and I would say a really, really commendable result. All right. Here’s our next example. Now this is someone looking at just hygiene production, not overall practice production. And this is a multi hygienist location. And comparing where they were when they started, this group in June alone was at $47,000. Now I wanted to share, their total increase in six and a half months in our program has been over 200,000, 222,000 and some change. So when things are in line, when there are certain elements that happen as a part of the effort to inspire change, the impact should be immediate, measurable, and powerful, right? So that’s something we’re really proud of. With our program, there’s an impact right right away, especially those that apply the principles that we teach. And we’re going to talk a little bit more about the practices that perform really, really well and some of the things that we noticed, some common denominators, if you will, on practices that have an impact. So this is just six and a half months later, $222,000 impact. Dr. John, we often joke the first month paid for their whole year. December paid for the following year. January paid for the following year. February paid for the– they have paid for this program in just six and a half months for many, many years. And that’s exciting.

00:13:47.150 Two doctor practice already doing extremely well, extremely well-managed practice, really dialed in and look at the increase they got. It’s absolutely incredible.

00:13:57.150 Love it. Absolutely love it. Okay. So here’s another example. This practice we got to celebrate. This is, again, a two doctor practice, soon to be three. They had a record hygiene production month. So if you look just at the total revenue between their three full-time hygienists, wow, right? To have hygienists doing 47,000, that was a record for that provider. We’re super proud of her. Great job, Kathy. But Krista and Shannon also knocking it out of the park. A lot of same day preventive happening, a lot of effort. I know they’re working hard to get patients in that needed to get in since the shutdown, working through lunches and all those types of things to do whatever they can to take care of their patients. And they really have done an amazing job.

00:14:43.970 Another example of one of our clients that added extra hours, added extra days in order to take care of the surge on demand that was there. So really, really well done.

00:14:55.470 And you can also see too, just so you all know, this practice started with hygiene, quickly moved into our blue diamond program, which involves more systems to support the hygiene growth. And now these doctors involved in our CEO program, which is an invitation-only high-level CEOs strategic group, more than anything, right, Dr. John? I mean, these are the cream of the crop that ended up joining that group, doctors that want to build an enterprise, if you will.

00:15:25.640 Yep. They’re the smartest guys in the room. They don’t say a lot. But they’re the smartest guys in the room. They implement well. And that’s why this particular practice, a two doctor practice going to a three doctor practice, one location, expanding that location, almost doubling the size of that location, adding another location, all in a very short amount of time. And you can imagine with these big jumps in productivity, there’s big jumps in profitability, which is able to fund that growth. So now this dock provider will go from four days a week practicing to three days a week maybe two and a half. And he’s well on his way to having an amazing enterprise.

00:16:08.030 Right. Love that. Great. Here’s a brand newbie, right? We showed some case studies on longtime clients, but also, this brand newbie, right? They went through our eight-week, 100-day recovery program, practice recovery program. And they joined Blue Diamond halfway through. So after four weeks in that program, they recognized, “Hey, we’ve actually got some other needs that we’d like your help with, joined the blue diamond, had their hygiene coach come in and do hygiene explosion. And here’s where they were before. So two doctors, one hygienist. One doctor was at 46,000. Another doctor was at 25,000. The hygienist was about 18,000. The very next month, the full month that they were open, we had a huge impact on all three providers, right? One doctor went to 69,000. The other doctor had a $6,000 increase, well, almost $7,000 increase. No, sorry. I’m reading the hygienist. The hygienist went from $18,000 to 31,000. So that was tremendous. The doctor as well, some impact. So everybody’s doing better. So this is really remarkable because, Dr. John, when did we launch that 100-day recovery program?

00:17:20.840 Gosh, it was–

00:17:22.250 It was in May. It was May.

00:17:23.520 It was May. Yeah. And I think so, yeah. So between a few weeks into that, middle of May, made this decision. They were decisive. They recognized a need. They joined the program. And here’s what they are today. So a few short months later, already doubled their production. So we have the Double Your Production podcast, right? We have our Double Your Production show. We do Double Your Production events. And it’s not just a catchy title. This is literally what we do. We help practices do it, right? Now, granted, we always say hats off to the team and the doctors and the hygienists themselves for implementing it at such a high level. And that’s really what we want to explore, right? So why do some practices see such incredible results? And why do other practices struggle to have lasting change in the practice? Really great question. So we’re going to dig in a little bit. And I think the first thing that we often talk about is getting the compensation figured out, especially when it comes to hygienists. And certainly, we’re not going to go into all the nooks and crannies of that. That’s a potential landmine for any practice, right? But one of the things that we know is that if we are compensating hygienists with a strictly hourly rate, what we often have is a producer with the mindset of a wage employee, so an hourly employee. And so to really harness our unique capabilities as producers, we’ve got to have some type of production based compensation incentive for our producers and just like we do with associate doctors. There’s no associates out there. Very few associates out there that are just paid a strict, hourly wage. You want the–

00:19:07.960 And if they are getting hourly wage, they’re highly underproductive.

00:19:11.860 Right. Right. So we know that compensation is part of this puzzle, right? And so usually, our most effective program is a hybrid of some sort, an hourly with an incentive once the practice hits the threshold of profitability. So everybody wins when we’re taking better care of the patients. Patients win because they’re offered a higher standard of care, a better quality of care. And the practice wins because profitability jumps. We’ve seen it time and time again. And then also the providers themselves win because they have an opportunity to create a bigger future for themselves. So compensation’s a big, big part of it. The next thing that we talk about is culture. And that’s why I love this picture here because it really does show how fun it can be, right, when we have a team working together. This is a newer practice with Julie, one of our amazing hygiene coaches. And you can just see from the expressions on their face that they were having a great time, right? So Dr. John, we have seen practices with truly exceptional culture. And we have seen practices with completely toxic culture. And it really is interesting when we look at the impact of culture on results. Some might think it has nothing to do with the results. But we know it does.

00:20:34.150 It has everything to do with the results and having a firm culture where everybody understands the mission and the why of the practice, everybody understands the values and included in those values are some way that we’re going to support each other and work as a team. When you have those pieces in place and people are trying to support each other to get better, that’s when really great stuff happens. But if you have a culture where everybody’s thinking about what’s in it for me and having that me, me, me only, you have the assistants who won’t slide over and help the hygienists with a probe or with a suction or with turning over a room, you have hygienists that don’t do the same back to the assistants or feel like they’re too good to sterilize their own– it’s all that kind of stuff. When you’ve got that stuff in a practice, you’ve got a sick culture. And there’s no way you’re going to make progress that you see on some of these case studies that we went through.

00:21:34.550 Right. Too often, I mentioned there’s practices for the doctors. I’ve tried to get my hygienist to do this for years, right, a feeling of, “Okay, here we go again, another thing, yet another change, another consultant,” right? And one of the things that I think really can be different about our approach is that we always start with the why? Your members need to know why preventive services matter. They need to know when it’s appropriate to talk about these things. We’re not doing sealants just for the sake of doing sealants. We’re doing a risk assessment on every patient. And when we gain consensus, can we all agree that a high risk patient needs a different approach? And when we lead with the science, everybody understands the why. But what often is missing, John, is how, right?

00:22:24.200 So hygienists often are like, “Hey, I’ve tried. The doctor says I’ve tried. We believe in these things. We just don’t understand how to get patients to accept the care.” And that’s a very important component that is often missing. And what we hear from our clients and our members is that we bring the how in a very strong way. For example, when our coaches go to a day training, we leave behind what we call a chairside toolkit. And those tools really help guide conversations, elevate the conversation with patients. Patients understand why they need fluoride, what’s in it for them. They understand why they always get cavities. Now we have patients say all day long, “Bad teeth run in my family. I brush. I floss. I do everything you tell me, and it doesn’t have much of an impact.” Those patients also need the why. So we bring the why, but we also bring a very strong how, here’s how you implement. Here’s how you help patients understand what’s in it for them. Here’s how you actually fit those sealants in same day for the patients that need them. That piece is often missing. And when we bring that, that’s how you see hygiene double from one month to the next. They understand why they need to offer these services, but they also understand how to get it done, right? So that’s such a big part of it. And when we have teamwork and a culture of supporting one another and working together– and we hear from some teams, we just do whatever it takes and the magic happens. That’s where we see really tremendous results.

00:23:56.300 Very good.

00:23:58.470 The next thing is consistency and this is so critical for long-term success as well, right? The doctors that say, “Oh, here we go. This is the bright, shiny object.” But before we can fully implement these strategies, they’re onto the next thing. That’s where there’s a lack of consistency. And it can be really damaging to long-term lasting change.

00:24:19.540 Yeah. It really destroys the motivation of the team if you have that. And one of the things that we really help our clients do is focus, stick with one thing until you get it perfected, right? And then move onto the next thing. Trying to make progress in a thousand different directions never goes anywhere. So really getting focused. Another advantage of consistency is when patients have a very consistent good experience, your referrals go up. And so having the ability for everybody on the team to do things in a similar manner. Now everybody has a different personality. So the experience is in some ways refreshing. But also there’s that consistency of, “This is how we do things here,” and making sure that you do it at a very high level. One of the things that we see over big organizations, groups with hundreds of practices, is that when we look at profitability, the practices, they go up-down, up-down, up-down. Their profitability level is lower than those that are consistently chugging along. Now as an example of where maybe that doesn’t make sense in the short term is when you’re closed. And so now you’re down. The only thing you can do is work your butt off to get it back up. But that’s not the way you want to move on forever. The more consistency that you have the better off you are.

00:25:43.650 And the last place, I think, consistency has an effect is when doctors and teams understand the case that the dental philosophy is the same. And so when patients are talking to– when team members are talking to patients, they’re saying things in a certain way. They’re saying things. They’re preheating the patient for recommendations that they know the doctor’s going to make because they understand the doctor’s philosophy. And when the team shares that, and the doctor has it, now, the trust that is built in patients goes up. If they’re talking different languages and they’re disagreeing and they’re being disagreeable about how they disagree, the patient trust goes down. And I’ve long believed that case acceptance is more related to trust than it is to patient’s financial ability to pay. Patients will find a way if they really want it and if they trust the providers to do it.

00:26:38.840 I [inaudible] agree, Dr. John. So when we look at practices that don’t see tremendous results versus ones that do, they’re often missing a few of those things. The compensation isn’t quite right. The culture isn’t quite right. There’s some disconnect there. And also consistency, the team knows that they don’t have to continue the focus because next month it’s going to be a new thing or something different. We see this occasionally with people who hire us to do like an à la carte one day. They will come in and they’ll see a nice bump the month right after the second month. But then it kind of wanes because they don’t have someone checking in with them, holding them accountable, helping them overcome the roadblocks. The consistency isn’t there. So I find that to be one of the things that really does help as well.

00:27:23.240 Another thing that’s really interesting that we see long-term, we look back. More often than not, the practices that we work with that have really great results are practices that are already doing a lot of things well, right? But they just don’t know how to break through to the next level or they feel that they’ve hit a ceiling of some sort. And they don’t know what they don’t know. And so one of the things that we often see is practices have a lot of experience with other consultants that have built a really great practice but just want to become truly excellent. Those are the practices that usually we were like, “Boom.” They already have a lot of things in place. It’s like lighting that fire. And they just ignite. And that’s really, really fun to see.

00:28:06.530 Yeah, it sure is. We got a fun gig, Wendy.

00:28:10.470 Yeah, we love it. We love celebrating with our members. And again, truly exceptional people that want to do the right things for their patients. And it’s just fun when they get it. When the whole team is on board and they get it, it’s really fun to see what can happen. Now, that doesn’t mean that if you feel okay, you take a step back and you look at your practice, do you feel like, “Oh, we got a culture problem. We really don’t have a lot of systems.” That doesn’t mean that you’re not going to have results or an impact. But really that’s where we start, right? We focus on culture, focus on getting the compensation thing sorted out. And it may take a little bit longer for you to get where you want to be. But we often say progress, not perfection. And so we want to be able to make measurable progress, one step at a time, one step at a time, and pretty soon, you’ll get there.

00:29:02.750 Yup. Awesome. Well, well done, Wendy. Thanks, everybody, for being with us on this Double Your Production discussion. And we’ll see you next time. Thanks, [crosstalk] everybody.


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