John Meis:
Hey everybody, welcome to this episode of the W Production Podcast. I'm Dr. John Meis with my partner, Wendy Briggs. How you doing, Wendy?
Wendy Briggs:
I'm doing great, Dr. John, good to see you.
John Meis:
Good to see you too. Amazing things happening in dentistry right now. It's fun to watch all the developments both on the scientific end, the technology end and in operations. And so we're going to focus a little bit on operations today. And you've done a great job of learning from all different sources and applying it to dentistry. And so you coming from a baseball fan family. You've studied the book Moneyball and really have some really interesting things about how we can apply the principles from that book to dental practice.
Wendy Briggs:
Absolutely. And there's a lot of things, you know, over the years that I find interesting. I think I get, probably have a little ADD and I get bored of, you know, the same topics in dentistry over and over again. And we do a popcorn box book for our highest level members where we will actually send a book and focus on the teachings within that book for the quarter. And this quarter, our book was Measure What Matters. And as a part of that book, they were really talking about measuring and, and setting objectives and key results and being willing to challenge our thinking and they happened to mention Moneyball as a part of that. And so I took that and kind of ran with that piece of it because as you mentioned, our history, our baseball family on my husband's side. Clear back in the early 1900s, his ancestors were coaching baseball teams. And that legacy continues still today. My father-in-law actually coached a little league team to the World Series, and they won it in the 1980s. And so that legacy is super fun. So today, when we.
John Meis:
I'll let everybody in on a little secret. And that is that Wendy speaks generally to only two big groups, big meetings, just because her and my calendar are so full now, we don't get to do the small ones. However, if there is a small one in a city that you haven't been to the baseball park, right? You've made it to almost all of them. There's only a handful left, right?
Wendy Briggs:
There's only one left.
John Meis:
Oh, really, only one? Okay, which one?
Wendy Briggs:
It's actually Toronto Blue Jays in Canada.
John Meis:
Okay, well,
Wendy Briggs:
We've
John Meis:
gosh.
Wendy Briggs:
done this many times in Toronto, but the ODA, all those meetings are in the winter, which I don't
John Meis:
Yes.
Wendy Briggs:
understand that.
John Meis:
Yeah.
Wendy Briggs:
Certainly probably because it's cheaper to hold meetings in Toronto in the winter is my assumption.
John Meis:
Yeah, people go out to their colleges in the summer too. So dentists are, you know, when they're not in their practices, they're often in Toronto, they're often out in the colleges. So
Wendy Briggs:
Yeah.
John Meis:
very cool.
Wendy Briggs:
So yes, one to go, but there's some valuable lessons that we can learn in dentistry, especially as we're looking at measuring what matters and key objectives and being willing to challenge our thinking on what we are measuring and how we measure it and how we're performing in key areas. So we thought today's topic would be kind of fun to dig into some of the lessons that we can learn in dentistry from Moneyball. And the first lesson is really interesting. I think this has been a struggle recently. And the first lesson is hiring and developing the right talent. I think it's been a really interesting thing to watch over the last few years. We had a really tremendous shortage after COVID. We're still struggling with that in some geographical areas. I'm delighted to report it is getting better for some.
John Meis:
Yep.
Wendy Briggs:
It's just the hiring piece though, right? Developing the right talent is the rest of the story. And that's often something we don't do well. in dentistry. You know, we don't have great processes for hiring and onboarding and developing our team. And, and often Dr. John, we get people reach out that say, I'm just so tired. I can't find good people. I just need to find some rock stars. And that's probably the biggest mistake that we see dentists make.
John Meis:
For sure. You don't hire rock stars, you develop rock stars. There just aren't that many rock stars out there. And somebody who might be a rock star in one practice would come to your practice and really be an also-ran because practices are all a little bit different. And so the fact that we don't have great onboarding systems and great training systems, that's why we start to look outside our practices to hire these special people. And that almost always leads to disappointment. Probably everybody's hired someone that really turned out. fantastic from day one. But that's the exception. That's certainly not the rule, and that's certainly not predictable.
Wendy Briggs:
Right. So we obviously have multiple resources for that. Not too long ago, I was asked to work with Dr. David Gowler, who runs the American Academy of Clear Aligners. And he was developing a series for office managers. And he said, you know, what would you come and share with these office managers? And I thought, you know, given the struggles of the day, I think We walk them through our eight C's for hiring and developing a world-class team. These are some principles that actually people listening to the podcast can go and buy in our book on Amazon on hiring and developing a world-class team. These are areas that when you fill these gaps, it not only fixes your development of your next hire, but it establishes you to create and utilize these systems forever in your practice. It is something really worth... your time and energy to work on developing these tools. And certainly our business coaches help practices do that as well.
John Meis:
Yeah, and really if we look at a simple way to break it down is to look at what do they need to know after three days, three weeks and three months, our 333 system, and really identifying what those are with your current team, and then developing a process of how a new team member can come into your practice and take responsibility for their own development in order to go through the 333 process.
Wendy Briggs:
And then I would add to that, one of our top clients, long-term OG members, Dr. Nate Lester from Bear River Dental in Wyoming, he took that principle and developed an assistant training program. And so he took our three concept and added an entire, I guess, really deep and intensive assistant development program. So you can hire somebody who doesn't have very experience and they've just finished their 10-week program, and as quickly as they want to develop. they can turn into a tier three highest level assistant that can assist the doctor with any procedure and do it incredibly well. So there's so much opportunity here and I think that's a really fun topic for those, especially those who are struggling with hiring and developing the right talent. You don't have to have a struggle. There are some solutions that can really help you improve on.
John Meis:
There are a lot of resources. We have a lot of resources for people that want to up their game when it comes to this. And I really think of it as one of the core competencies of a dental practice, that if you don't have this, you are really at the mercy of which direction the wind is going and who's available at any given time. But if you can take someone off the street, which many rural practices in the United States are kind of used to, where you take somebody literally off the street, and you help them develop into a really high quality business assistant or dental assistant.
Wendy Briggs:
Right. Well, perfect. Dr. John, that leads us to the second lesson. And this is ask the right questions. So if you've ever seen the movie Moneyball, you probably remember the first scene where Billy Bean meets, oh gosh, what was his name? Peter. I think his name was Peter. Pete. Calls him Pete. And the first time he meets him, he was like, basically, who are you? Where did you graduate from? Because he challenged the way he thought on certain things. He was asking him questions. It didn't make sense to the manager of a baseball team based on how people had always looked at baseball. And when he started asking him the questions in return, there's a scene where Pete says, baseball looks at their players entirely wrong. These are the questions we should be asking. So I think that lesson is important for us to learn in dentistry as well. We need to ask the right questions. I've seen a lot of people asking a lot of questions on Facebook groups and things like that. And I love Facebook for the ability that it enables us to connect with people outside of our usual circles. I think there's a lot of positive things that happen there. But sometimes the answers that you might get to a question you ask on Facebook, the answers are cringe worthy for those of us who've been around for a long while and really know what the truly excellent practices are doing different than the masses. Because you get a lot of group think. average answers. And most people, when they are working to develop their practice in their team, they don't want to be average, right? We're working to create something better than average. And so sometimes the advice that people get, they may be asking the right questions, but I would also add to that, be careful of the answers. Really know who you're getting feedback from. And a lot of the armchair experts that... have a lot of time to be involved in these groups, have a lot of time because, well, they have a lot of time for a reason. Let me just say that.
John Meis:
Yeah, we recently ran into one, Wendy, that made us both cringe a little bit. And it was simply a matter of the question was, what should I do to lower my overhead? And he gave his kind of his some of his stats. And the answer was, you're highly efficient right now. That it was it was a reasonable question. But given his current status, he was asking, it's a good example of asking the wrong question. His question should have been, what can I do? to drive my top line because I'm already very efficient from the expense standpoint. But because he didn't know that, and so then there was all this crush of answers to the wrong question. And really, we see that so frequently on Facebook groups. So it's helpful to take a step back when you're asking a question and look at is this, if it's a tactical question, are we really needing a tactic? or are we really lacking a strategy?
Wendy Briggs:
so frequently something that we see, right? And even the same thing holds true on the hygiene forums and the office manager forums and things like that. Sometimes people are asking a question because they don't know what else to do, but we've got to make sure it's the right question. And then when we see the answers, when we see the answers coming in, really be able to vet the expert opinions and hopefully find some people that you trust so that as you're asking the questions and you're getting the answers, you're moving forward instead
John Meis:
Yeah.
Wendy Briggs:
of backwards. We
John Meis:
Yep.
Wendy Briggs:
hate to see people go backwards. lesson is to challenge the status quo. And I think that's one thing that we learned again, from Moneyball is Billy Bean was willing to ask the right questions, get some answers that were completely different than what anybody else was doing. And as a result of his willingness to challenge the status quo, everything changed in baseball going forward. And now you see many, many teams employing these similar strategies, right? So If we're not willing to challenge the status quo, we've got another thing coming. Now, Dr. John, a few months ago, we used the book by Adam Grant called Think Again for our popcorn book for the quarter. And that book was excellent in helping us realize, there's so many great books on this, right? What got you here won't get you there. Think Again, another great example that we just referenced on being willing to think differently. and accepting that sometimes doing it the way we've always done it may not be the best strategy going forward.
John Meis:
Yeah, it's so true. And looking at the process of challenging the status quo is not looking at how it's always been done, but looking at the results that you want to get and redesigning how you get from where you are to those results. And so frequently, there's the group thing that you mentioned earlier that people do it. That's the way we've always done it. That's the way a professional always does it. And then you see somebody comes along that has an innovative idea, and their results come faster. easier, better, simpler. It's amazing how many things that I've seen over the years that are that way.
Wendy Briggs:
Right. I think that's something that's a little bit daunting for us as practice leaders or practice owners is there's change management required. Right. The reason the team wants to continue doing it the way we've always done it is because that's often where they are comfortable. Right. You don't have to step outside their comfort zone. They don't have to learn anything new. They have to try anything new. And that's the fastest place that we see people get stuck. Right. Good to great. Another example of how You know, to move from good to great, it takes a different strategy, a different approach, willingness to challenge the status quo. And that's not always easy. So I think sometimes we see great leaders with great ideas and a new strategy become defeated very quickly because they don't have the support of the team. And so that's something that can be demoralizing for many of us.
John Meis:
And you use the word I was going to bring up, and that's leadership. The better leaders are able to manage these things. But it can be so frustrating when you're trying to move your team, and they're resistant to the ideas. And you've gone to a course, or you've gone to a meeting, or you've gone to one of our retreats, and you come back, and you just went by yourself, and you have all these great stuff that you're going to try to implement very, very hard. But you bring a team to those things. And now that team understands the what, and the why, and the how. and they can support that. So it's really a challenge of leadership. And if you follow the same things that you've always done, you'll get the results you've always gotten. And we're about improving results and decreasing effort.
Wendy Briggs:
Right, that brings us to our next lesson, which fits so perfectly after this one, and that is connect with the team. So when we look at, you know, how they implemented these strategies, and when they were talking with their players about, hey, you wanna go deep in the count every time. It's not about hitting that home run. It's about wearing out their starting pitchers. It's about taking the walks. It's about getting on base. The players are like, wait a second, that's, you know, antithetical to the way I've always been taught. to approach my at bat, right? And so they had to really sell these changes. And the way they did that was they would go and have one-on-ones with each team member. And you see Pete going over with each team member, what they're doing well and where they need to improve. Even down to when they throw this pitch, this is the outcome and the result that you're getting. Connecting with the team and helping them become aligned to the vision is how. you're going to achieve a higher level of performance, no matter what the strategy is.
John Meis:
Yep. One of our great team members, Heather Driscoll has a phrase that she uses and that's people support what they help create and getting the team's idea, helping them understand what they could do to do better as a team and getting them involved in the process of designing it is such an important leadership tool.
Wendy Briggs:
It absolutely is. Awesome. Our next lesson is adapt or die. And this again, I think leads to one of the most iconic scenes in the movie, certainly, where Billy Bean is around the table with all of these scouts and they're having a meeting on which players they should go after. And of course we all know, maybe we know, but. Let's remind our listeners of the history, right? The reason he had to adapt was because he didn't have the same big budgets that other markets and other teams had. And he knew that in order to remain competitive or stay competitive or become competitive, they had to radically change what they were doing. And I see some of the struggles that we hear from doctors today. It seems there's a lot of doom and gloom, right? Overhead is high, the cost of supplies has never been higher. Our salary costs are high. We've had some obviously challenges attracting talent period. So we've had to do some crazy things. I've never in my history seen signing bonuses offered for hygienists, for example. So I think there's some practices that are having to adapt and it's putting an enormous amount of stress onto doctors and their office managers as well, who are trying to keep their operations, budgets. into a normal level, we see practices that are saying, hey, we're producing, but we're not profitable because of all of these other conditions that we feel we have no control over, right? So we might find ourselves in that adapt or die moment at various points throughout our career. And some of the practices that we see doing well in this area are the ones that are willing to challenge the status quo and think differently. We have our coaches and practices every single week, and I've been impressed with how many lately We'll call and say, listen, I've been watching you guys for a long time. This is the biggest challenge I'm having. It's time for me to move. Are they ready to move? We talked with one practice last week that was like, I want a trainer in my office next week. That is awesome to see because they've recognized, hey, this is an unprecedented challenge for them in their practice. they're ready to take action and they've realized adapt or die, right? It's time to do something different today to accomplish the things that we know we can do.
John Meis:
Yeah, you know, dental industry is in a profit squeeze. Dental practices are in a profit squeeze. As supplies costs go up, lab costs go up, all the costs around us are going up, you know, reimbursement is going down. And so, you know, two ways to manage that, to adapt. One is to become more efficient. And the other is to be more picky about the payers that you have a relationship with. And we see the practices right now, there's really kind of a rapid adaptation in that. According to the Health Policy Institute, the ADA 40% of practices are dropping a PPO relationship this year. I think we're gonna see that continue as practices struggle to have enough team to take care of all the patients. Well, if you don't have enough team, why are you taking discounted care to bring more patients in when we can't take care of the patients that we have? So it's really an interesting time to see the adaptation and the ones that are moving quickly. on both of those on becoming more efficient, being able to provide more care in a shorter period of time, as well as being pickier about payer relationships are really the ones that are getting hit fast.
Wendy Briggs:
Right. And we often see, sadly, again, this comes back to asking the right questions and challenging the status quo. We often see practices make a decision in the moment, a knee-jerk reaction, but they haven't really thought through all of the elements there. So for example, they get angry with a particular payer, they drop it all, not realizing that 60% of their practice patient base actually had that insurance. And so then they're scrambling to repair the damage and plug the holes. save the ships, if you will, in that category. So all of these things feed together. And that leads us to our next lesson, Dr. John, which is to identify the right metrics. And before you make any type of decision in that way, we've got to identify which metrics can guide some of those decisions. And again, looking at collections, production, and new patients doesn't cut it in today's world. Historically, those are the numbers that practices will look at. And for a lot of different areas, depending on the question, once we figure out what the right question is, then we have to look at the right metrics that can help us identify maybe how best to proceed with answering that question.
John Meis:
Yeah, one of the things about this topic just recently, I spoke one day in Vegas, the next day in Salt Lake, probably a couple hundred people in both rooms. And we were going over the metrics on capacity. You know, how can you tell if you have enough capacity to take care of all the patient demand? And there's a very small set of numbers that can help you dial in on where you are with that. Well, after going through that with these two groups, two completely separate groups, different cities, different organizations going through that, there wasn't a single practice in either room that had excess capacity. I was stunned. And so if you understand those metrics and understand exactly what you're measuring, you can answer the questions that you have. We have such wonderful ways to get data from our practice management softwares. There's such good analytic software out there that we can figure out pretty easily from the data, what are the things that, how we can make decisions based on the data. Most dentists only measure three things, right? They have three KPIs, it's production, collection, new patients. But those really don't give you enough information by any means to manage a practice.
Wendy Briggs:
And going back to the lessons from Moneyball, this is where they learned by asking the right questions and challenging the status quo, they learned that they didn't want the home run hitters. The baseball valued home run hitters at a very high, high threshold. And what they learned was they needed the people that could get on base. And I think this is very true in our practices. When people say, I want to hire the rock stars. Well, rock stars are amazing. And it's great to have a few of those because they can drive the rest of the team to a higher level of performance. Get the singles, take the at bats, get on base. We want consistency. Consistency and performance over the long run is far more impactful than a home run every once in a while, right? So when we look at that, when we're looking at identifying the right metrics, we see this in hygiene all the time. What we want hygienists to do, having a record production day is amazing, that's awesome, but we really wanna focus on the production per visit. What does that look like? How can we influence and change that? Because a 10 or 20% bump there consistently provides a much bigger payoff than a record production day once in a while.
John Meis:
Absolutely. Yeah. And the, you know, you can see that in, you know, sports is a great analogy because it applies, because it is teamwork as well. And you see teams that have a really great day one day and a really crappy game the next, you know, they don't end up very, they don't end up in the Superbowl or the World Series. It's those that are consistent, play well, day in and day out, are the ones that become the champions.
Wendy Briggs:
Absolutely. And I think, you know, knowing the right metrics and being able to measure those is what leads us to the final lesson, which is accountability and ownership. Right. And I should mention for those that may be new to us, you know, when we talk about having a record production day or increasing the production per visit, we're always talking about doing the right thing for the patient. You know, production isn't the goal necessarily. It's the result that comes from doing the right thing. And that's where the accountability and ownership comes in, right? Because if we're having those record production days, or if we're focusing on increasing productivity, we want to make sure we're doing it in the right way. You know, there's certainly people who can become hyper-focused on the numbers and driving the numbers can supersede patient care. And that's not who we are. And in our experience, it's really a relief to know we don't have to practice that way
John Meis:
That's right.
Wendy Briggs:
able to still exceed, you know, our... the average, if you will, and really do great things for our patients. But you're not going to have a team willing to do those things without accountability, without creating some ownership, which is why we do things like evaluate production-based compensation for our providers. We look at what incentives do we have in place for the team because we want to drive that mindset away from the hourly-minded employee into a team member who has ownership in the success of the practice.
John Meis:
Yeah, every fall we have a case acceptance course. And when we talk to people about the case acceptance course, they're all concerned that it's gonna be about sales techniques. Well, sales techniques, I'm not sure they have any place in healthcare. For us, the whole process is really using education, giving the patients the information in a way they can understand it, and the way they can make a decision that's best for them. There's no sales needed, right? And so you don't have to be pushy. You don't have to try everything. You don't have to, like you said, focus on pushing care in order to hit the numbers. You just have to have to help inform patients of the care that they need and make sure you understand what they want. And somewhere between the two magic happens.
Wendy Briggs:
Right. And I think that's another thing that we hear from time to time is a fear that the team will become hyper-focused on the numbers or driving, you know, doing 15 sites of arrest in Perttu, for example, to jack up the productivity. Without accountability and ownership, maybe some of those things can happen. But under our program, usually we don't see those things happen because we have a very values-driven... focus, we're creating a culture of champions by doing it the right way, focusing on services that our patients desperately need and helping the patient understand, like you said, why they should want the services that they need. And that's where the magic happens. So accountability is key, ownership is key. And we absolutely love when we see those elements click in. And like you said, magic happens and we're seeing that. We absolutely, even though we're seeing. many, many practices with challenges. We also see many, many practices that are far exceeding their own expectations for what they're capable of accomplishing, and that's really fun to celebrate.
John Meis:
Yeah, it sure is. All right, Wendy, well, good job. Another great episode. Thanks, everybody for being on this episode of the Double Your Production podcast. Wendy and I would love to see you at one of our events soon.
Wendy Briggs:
Thanks everybody.
John Meis:
Thanks everybody.
