In this episode, Dr. John sits down with dentist Dr. Charles and his wife Sylvia Betts, owners of a dental practice in Decatur, AL. Like most dental practices, they were shut down for several weeks due to COVID-19, but are now busier than ever and are still getting new patients, even though they are a fee for service practice (a rare phenomenon these days). Dr. Charles and Sylvia share their journey during the pandemic, the challenges they've faced, and how they've pushed through and are doing better than ever.
- Why they hired 2 new staff members before they even opened back up again.
- How they made the team (and patients) feel safe coming back to the office.
- Why they double booked hygiene and how they were able to keep up with the wave of demand when they reopened.
- What they started doing that was a massive turning point for their practice.
- How they created a culture where their team solves the problems (not them).
- The strategies they are using now that the pent up demand is starting to subside, to keep their schedules full.
Dr. Charles Betts grew up mostly in Alabama. He is a husband, father, and grandfather who has been practicing dentistry in Decatur for 30 years. Sylvia began her career in health care and received her bachelor’s degree in nursing education and management from Emory University in 1979. She has held nursing positions in several hospitals and home health agencies and now is the office manager at the practice. Sylvia is married to Dr. Betts. They have three children, two of whom are married, and three grandchildren.
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Ep 74 Transcript
EP 74- Charles and Sylvia Betts
Dr John: [00:00:00] Hey everybody. Welcome to this session, the double your production podcast. I'm dr. John Meis, and I'm here with one of my favorite practices, the practice of Dr. Betts and his wife, Sylvia. How are you guys?
Dr Betts: [00:00:14] We’re good. I'm great. Thanks.
Dr John: [00:00:16] Good. So you guys are, are one of my favorite clients. And I say that about all my clients.
You guys are favorite clients because I just love the spirit and heart that you bring to your patients and your practice and to our events. Every time you just have such a, a calm and caring spirit that, that it's, you're just really special. Thank you all.
Dr Betts: [00:00:39] Thank you very much.
Dr John: [00:00:41] So I wondered if you'd kind of give our listeners a history with your practice, kind of where you, where you are, where you come from and, and, how things are going now.
Dr Betts: [00:00:53] Well, now we've had a lot of changes. Of course. we've had some staff changes. We've had changes due to COVID, and, what is amazing is that we've been extremely busy. I know, there's some practices around. who are not doing very well. some are closing down and rather than putting up with the current situation, but we've actually thrived and done better than ever, under the circumstances where a fee for service practice, which I realize is a rare, a rare thing these days.
but, but we still are. And, and we're still getting new patients and. That's going to go on really well.
Dr John: [00:01:36] Yeah, that's fantastic. So, you know, people keep talking about fee for service, diet practices, dying, or as a non workable model anymore, but that's not true, right? it is a workable model.
but it's really hard to do it and do it successfully. Like you guys have it, it is really. Some of the reasons why it's hard is that number one, patients like to use their insurance. Sure. and so, When they, when they have to pay the patient's portion and there's no discount for the PPO, it's a net for patients.
And so you have to be able to make up that, that if you know, and you make up that negative with great customer service with the warmth and empathy, empathy that you guys have that I already talked about, you have to make it up. You can't just be semi-good and think that you're going to survive in a fee for service world.
You're not, you've gotta be really good. And on your game. So, where is your office physically located?
Dr Betts: [00:02:42]It’s in the, it's in the Southwest part of Decatur. I'm
Dr Betts: [00:02:48] Not in North Alabama, I'm sorry, Decatur, Alabama and North on the Tennessee river.
Sylvia Betts: [00:02:53] not far from full,
Dr Betts: [00:02:54] which is where Redstone arsenal and the space center are.
we have a lot of incinerators in our town too. but then we have large businesses here, 3m and, ULA, which is a rocket producing facility. so that's the kind of place we are
Dr John: [00:03:14] kind of a mix of
Sylvia Betts: [00:03:15] blue collar workers. Really?
Dr John: [00:03:17] Yeah. Insurance dominated community. It sounds like though. Really? Yeah. So, so that makes it even, even a little bit tougher.
And so just kind of give us an idea of your office, kind of the, the layout, how many ops, how many team members, that kind of thing.
Sylvia Betts: [00:03:41] what sticks we have. we're we have 10 person team, 10 team members counting the two of us. We added two. Really after, when, after COVID, that was one of the things we did was add two additional assistance when we opened back up for COVID so that we had an additional doctor assistant and added a hygiene assistant so that, so we actually, took the plunge and expanded our staff before we opened back up.
Dr John: [00:04:07] And aren't you glad you did? Yes. Oh yes. Yes. You know, when, and I predicted the rush of patients coming in and how there was going to be this big wave of demand and. W, you know, we counseled, everyone to make sure that they were, were prepared to capture that demand because the demand was going to wane, given a little time and it may be starting to wane in some practice.
Okay. Yeah. And so you, you, you did the exact right move because, with that big demand and expanding your capacity, you probably had a pretty good month in June or July or both.
Dr Betts: [00:04:51] We did well. And the last in the last three weeks of may, that we were open. Very good there too.
Dr John: [00:04:58] Yeah.
Sylvia Betts: [00:04:59] We hit the ground running.
He didn't say no to any treatment. Pretty much whatever we could find a chair for. He did. And same thing with the, with the hygienists. We, we had a good call list. So the hygienists were booked solid all the time. The hygienists worked extra days. Yeah, they were, they did, they, they double booked a lot.
We had a lot of double booked hygiene where we were doing assisted hygiene and the Hodges would go back and forth. And, and I mean, I would say most of July and August as quick as we could turn a room around, it was, it was used again the whole time.
Dr John: [00:05:32] Yeah. And, and that, that is absolutely awesome. And that takes a lot of teamwork to, to do that.
So you have these new two clinical team members all at once. And so tell me how you got everybody up to speed and got everybody onto the philosophies here because assisted hygiene is a whole different ball game. And you know, you really start to do same day dentistry to a degree that you hadn't done in the past.
So how'd you get everybody on, on board?
Sylvia Betts: [00:06:01] Well, we, at the first thing we did was we tried to keep in contact with everybody. We were closed and because they were, some of our team were hesitant to come back. And so we went above and beyond and did more, to protect them. And that's what it started with when we brought them back was here's how we're protecting you.
And we, we put in air filters and, and all those kinds of things, but went through all that and got them on board with their own safety. Before we started talking about anything else. And we took the, we didn't spend much time talking about the next dollar phenomenon, but we talked about the cost of turning the room around.
And when, when they understood that they bought into like, just overnight, they bought into same day dentistry and they started working out systems and parts and such to figure out because we were. Operative on one side hygiene on the other side. And so they turned that around themselves. We didn't have to do that.
So they took the ownership for that. And, and I think that was a, a massive turning point for our practice when they decided that this was important. And that just made all the difference in the way, the
Dr Betts: [00:07:09] Fact is that they came up with a system made them own it.
Dr John: [00:07:13] Absolutely. Yeah. Yeah. That was an absolute, brilliant move.
People support what they help create and what you did was laid out out an important why for them, right. You know, we're doing all of this for you to keep you safe. You know, here's, here's how we make it up for the practice and gave, you know, show them financially how that worked and I'd let them figure it out.
That is awesome.
Sylvia Betts: [00:07:39] Yeah, it works better than we thought it would.
Dr John: [00:07:44] Yeah. There's always that little bit of fear that they're not going to buy in, or that they're going to pick a, you know, some system that's unworkable or unreasonable or, or as times happens, They'll want to use capital meeting dollars before using their creativity.
And so when we hand over projects, we always use the phrase creative before capital, you know, we don't mind spending money, but we want to figure out how we can do it without spending money first. Let's get it as good as we can. Yeah. So fantastic. So, so you had, so probably a record month in July.
Dr Betts: [00:08:21] Yeah.
Sylvia Betts: [00:08:23] Yeah. And Sherry said it was the most gross she'd seen and if any of her
constantly looking at it. So that felt really good.
Dr John: [00:08:35] Yeah, absolutely. So what are some of the other things that you did to, to drive that while you talked about assisted hygiene, and the, how did your hygienists, respond to the idea of assisted hygiene. Oh,
Sylvia Betts: [00:08:49] well, one had already one had expressed an interest in, in any way, because a few weeks before we everything's shut down, we had listened to, Burt, or when do you wanna talk about assisted hygiene?
And she she's a real innovator and always wanting to try something new. And she said, I'd like to try some of that, that, you know, assisted hygiene. And she's interested in driving her numbers up. I mean, you know, she she's. You know, like taking home a bigger paycheck. So she had said something about it. And so, they had kind of begin to talk about it before we shut down.
And I think that helped another thing that was fun about it though, was we thought, Oh, we'll rotate the assistants through. And one assistant who, I would say it was a little weaker and a little bit less dependable. when we put her over there, she thrived. She loved it. They loved it. And, I mean, today, I even said, no, I need you to use another assistant for one patient this morning.
And they're like, no, I need, I need Casey. You know? So that was a great, you know, sometimes you just get a person in the right spot and then, and they just blocked them. I had it yeah. With the assistant yesterday and she's like, I'm so happy. I love what I'm doing. You know, so, so it's just interesting, the most surprises you get along the way.
So, and they've really become a team. They've formed a team, but it's the three of them right now. And they, they problem solve together. That's a, that's a new culture. Sure. For us is, is groups of people, problem solving together. Everything used to be, and we, you know, Well, you know, we've had some staff changes, so there's a different, you know, it doesn't take much to change up the whole dynamics,
Dr John: [00:10:25] the truth to people.
So some keys were. Number one that you have some type of production based compensation for your hygienists. So their hygienists, when they do more, they get paid more. and so there are people, there are hygienists that really, you know, want to do more, want to earn more. there's a lot that want to just get paid more.
Right, but there's a, there's there's, you know, many of them also want to earn it. and so you're lucky to have the furniture types. Okay. and, yeah, so you put the people in place and again, you let them figure out how to do it. You know, often the, Often practices struggle with assisted hygiene because they intentionally put or weakest assistant with the hygiene, which I've always said is a bad idea.
You know, you really want one of your best communicators. One of the people who understands. Restorative dentistry. Well, can talk about restorative dentistry. Well, you really want a strong person in that position. but so often in office, as it ends up not being that way. So you got a double whammy and that someone was maybe not as strong on the restorative side, but good communicator and good relator and good teammate to teammate, and really made it work.
Sylvia Betts: [00:11:46] I really have, she loves to teach. And so she has the opportunity to do a lot of teaching now.
Dr John: [00:11:52] Very good. Very good. So speaking of hygiene, we have the Tober black bull coming up. And for those of you who weren't paying attention to it because of when we were closed before we have no appointments in hygiene, you know, in October and November is where we're gonna feel the most.
and. Of course 70% restorative dentistry comes out of hygiene. So we're going to feel this, this isn't just the hygiene problem. A lot of people are confusing that, that that's just a hygiene problem. No, it's going to be both and it's going to be rough. And so some of the things that you're doing in order to get those spots filled as many of them as you possibly can and hygiene,
Sylvia Betts: [00:12:33] well, right now, one thing we're, we've got a call list, but we're keeping a list.
There are quite a few people that don't want to come in until. the virus settles down and right now we've, we're on, I think week five of being in the green zone. So it's looking like the virus just going down. So we're hoping to contact those people. I've got those on a ready list and dental Intel. So I can pull that up.
We're also talking about sending out a letter. to those patients and talking about the relationship between, especially the perio patients, the, the relationship between the disease processes and, you know, your body can't fight two things than just taking care, you know, correcting them and that sort of thing.
So hopefully we can title them and get them in that way. See if a letter from the doctor will help a little bit.
Dr John: [00:13:18] Yeah. I think that's a really, really, yeah. Nope. I think it's a really good idea. are you tracking where you are a number of, appointments you're shy? Here's a tip. Okay, good. So, our offices that are really, really hitting this hard, they have, they figured out what their total hygiene is.
Minutes were for October last year. they added the growth rate that they were expecting from year over year as a budget. And they're using that as the number. And then they're seeing how many appointments they actually have. So they're, they're tracking the deficit and they're reporting it in their morning huddle every morning.
Right, so that you start to see it decreasing and decreasing and decreasing. And, and you know, some of them have, offered a bonus. if they get the deficit down to zero. And it's absolutely crunch time. Cause we've got about 20 days to get this in place. So it's gotta be, are you putting any more team time onto
Sylvia Betts: [00:14:22] it?
Not yet, but I think we're about to what the hygiene assistant has done a little bit. we have pretty much until this week just been patient care, patient care, patient care, and nobody has done anything to take care of patients. except us coming in on the weekend to clean up the mess. But, but, but now we should, we should be able to do that.
And I hope another thing we're gonna do in October is we're going to take a week off. This is a solo practice.
Dr John: [00:14:47] Great idea.
Sylvia Betts: [00:14:48] We did a break it's time to take a vacation and taking a week off. The whole County is going to take a week, fall break. So we're going to do that so that there, so that'll factor in and.
Yeah. It cost us money to take off. Yeah, we can do that too. So
Dr John: [00:15:04] yeah. So you can reduce, you know, because you're not going to be there. You can reduce that number of appointments to get to zero because of that. So that's, that's a very good idea and it has to take a vacation now and then anyway, so, that's a great idea.
do you have a in house dental discount plan?
Dr Betts: [00:15:22] Yes. Yes. We have a dental savings plan and we've done quite
Sylvia Betts: [00:15:28] a lot since, since that new staff up front, it's growing a lot. So
Dr John: [00:15:33] there's no time, you know, on those, they're not limited to six month insurance time. So other practices are hitting that group hard to try to get them in.
So, another, another thought, yeah,
Sylvia Betts: [00:15:46] we've looked at that. We've looked at the perio patients, and just all the past to, you know, trying to see where we can get people from.
Dr John: [00:15:53] Yeah. Awesome. So what are you looking forward to? So we've, we've survived this, COVID. The both the downswing and the ups swing, and now things are, are gonna, it's going to be a little tougher as the economy is a general economy sinks, right?
So we mow that some of the businesses that are closed are not going to open back up. We know the government, unemployment support. the $600 a week is gone. there was kind of a $300 a week thing going that's. I think that's ending here very shortly and Congress doesn't appear to be willing to do anything, in the future.
So all these folks that have been out of work, but still able to spend money are not going to be able to, because they're not going to have anything coming in or very, very little. So it's going to become a little bit. Yeah, they have a tougher slog. So tell me what you're going to be doing to prepare for that.
Dr Betts: [00:16:52] Well, one thing we've done is try to just stockpile cash you had advised, because we know there can be some really fleeting days ahead. we're going to try to maximize appointments. We're going to, to maximize dental, Intel, to find, people to put in slots or going to be as efficient as possible with, employee time.
Okay. we actually have some who have been one to cut back. on numbers of days. So that will happen. just trimmed hair, a little trim there, I guess you might say on some things,
Sylvia Betts: [00:17:30] that's the way we train the new ones too.
Dr Betts: [00:17:35] Well, the available, we're not talking like cut cut days or anything like that.
Dr John: [00:17:42] So we first do everything we can to fill the days we have. And so if we can't fill them, then adjusting slightly our cost structure so that we can maintain the practice income. and so, you know, the things that you're doing, As far as making sure that you're hitting a schedule as well as you can.
And we also talked a little bit about, about increasing case acceptance for, for your patients. And that, that is such a huge variable. And we look at practices who swing from, from, kind of meat, Yoker performance, too. Good performance or even great performance case acceptances, almost always one of the big levers.
They use it, believe it or not. It's answering the phones and case acceptance. If a person were to focus on just those two things alone would make a dramatic impact on any practice. And
Dr Betts: [00:18:40] that's why we want to improve that improve handoffs, that communication thing. So that the whole process from clinical to front desk is the same message.
Repeated. So people get it and understand why they're having something done. Not just. That we want them to do something, so. Right.
Dr John: [00:19:01] Awesome. Awesome. So I'm looking forward to seeing you at our case acceptance course, coming up in December. It's an awesome course. I'm glad you're already signed up. Cause it always fills up.
We can all take so many because it's such a hands on integrated experience to get entire teams on the same page. So I'm glad you're already signed up. Yep. All right. Well, I w. Go ahead, Charles.
Dr Betts: [00:19:26] I'd just say that that's something we're really looking forward to because we've talked about trying to have continuity of message.
And we've done things, but it. It hasn't been what we wanted. So we're hoping this is what we want.
Dr John: [00:19:42] You will, you will leave with that messaging done. You will leave with your hand offs. Then you will leave with all of it done packaged. All you have to do is go back and implement it and you can implement it on Monday.
And by the end of a day, maybe seven or eight in a practice, your size. the course will have paid for itself, in growth. So, super excited for that. Well, I want to thank you too for being on our double your production podcast. Thanks for all the, the, great ideas and creativity that you shared today.
And thanks for being such wonderful clients. And I, I really passionately enjoy working with you guys. Well,
Dr Betts: [00:20:21] we appreciate TTI also because we felt like they were. You all were holding our hands through,
Dr John: [00:20:29] through the
Sylvia Betts: [00:20:30] shot.
Dr John: [00:20:32] Very good. So that's it for this w reduction podcast. We'll see you all next time.
Sylvia Betts: [00:20:39] Hold on.