John Meis (00:02.858)
All right. Hey everybody, welcome to this episode of The Double Your Production Podcast. I'm Dr. John Meis here with my partner, the lovely and talented Wendy Briggs. Hey Wendy, how are you?
Wendy Briggs (00:12.238)
Good morning, I'm well, how are you?
John Meis (00:14.25)
Fantastic. So what's on our plate for today, Wendy?
Wendy Briggs (00:18.702)
Yeah, so I am so excited about today. Today we're going to kick off a series. And it's interesting because somebody asked me a question the other day that got me thinking. Somebody said, what is it that you do to help practices grow? And I thought, well, that's a really interesting question that could take us quite a while to answer. But then I realized we actually do have a way to answer that question. And I don't believe we've ever really talked about it or shared the answer to that question on our podcast. I thought this would be a really great series for us to do. So let's tell everyone, all of our listeners, about our practice growth model and really how we use that to help practices grow. Because I think there's really great gems in there for all practices, right? Any shape, size, level of complexity. There's takeaways that I think all of our listeners could gain.
from us walking through that.
John Meis (01:18.346)
Yeah, it's kind of our secret sauce, Wendy. Do you really think we should let this out?
Wendy Briggs (01:21.966)
Well, I think it makes sense just to talk through, certainly, there's no way we're ever going to be able to share all of the things that we do, but at least can give listeners an idea of what we have found can really drive practice success. And I think there's so many elements in each one. I think each segment of that, so really it's 12 basic principles that we walk practices through.
So if we do a series of one through 12, I think it'll be a great way for people to really get a deeper understanding of how they can be more successful given all of the challenges that we have today.
John Meis (01:57.578)
Yeah, sounds great. Our listeners deserve the best. So let's give it to them. So go ahead.
Wendy Briggs (02:03.502)
Yeah, you bet. So often we hear from practices that there's too many reasons, there's all the reasons that they can't be successful, right? All of the main obstacles. And too often we hear all of these market conditions or complications that they're having in their practices and they feel like because of that there's no way for them to continue to grow. You know, practices reach out and say we're stuck, we're plateaued or we've even declined over where we were a few short years ago. And to me that's, it's disheartening certainly, but also I feel like, you know, if people only knew how to look at things a little bit differently or how to address those challenges, then they could realize a higher level of success. And certainly that's what we help our clients do is work on these one segment at a time. But I think it's a really great conversation for us to have.
John Meis (03:07.722)
Yeah, it really is. Each of us struggles with the same thing, and that is we tend to focus on the things that we can't change instead of the things that we can. And so this model helps create a discipline and a very, it's really an algorithm. It's a very thoughtful way of thinking through the various things that might hold a practice back. And so we call them the profit choke points, really. And so identifying where it is and then, using our systems in order to fix those is how we help clients. So this would be a really, really great conversation.
Wendy Briggs (03:43.662)
Yeah, I love it. We could talk about maybe some of the top challenges that we hear real quick first, all the reasons why people think they can't grow. Probably the one we hear about the most in my circles anyway is hygiene wages, costs have grown. Some people say their staff salaries are up just crazy numbers. I actually looked at a graphic today that was comparing grocery prices from today to four years ago. And some of the grocery prices, just the costs for things that people need every day have gone up by more than 50%. So I think costs everywhere have gone up. But certainly in our world, the high cost of hygiene wages, for example, the high cost of even assistant wages, business team members, everyone's feeling the squeeze on that.
John Meis (04:30.154)
Yeah. And we know from our friends at the ADA that dental team salaries have not kept up with inflation in real dollars. And as dentists, we often would like to be able to do that, but at the same time, dentist earnings have gone down significantly in real dollars. And so there definitely is a squeeze on profitability in the dental industry. And there are various ways to overcome that squeeze, and we think the best way is to follow the very simple set of steps that we're going to walk through during this podcast series.
Wendy Briggs (05:11.278)
Right. I think that brings us to the next reason that people think they can't be growing or profitable is that as the costs have risen, reimbursements have not and reimbursements have somewhat fallen. And so, you know, we hear a lot of chatter in dental circles that the only way to be successful is to go strictly fee-for-service, drop all the plans, don't participate. And, you know, frankly, we do work with some people for service practices that are very effective and very successful. But I would say those are becoming more and more rare. And it's somewhat alarming to see the prevailing message out there to dentists in that the only way you're going to be able to succeed is to drop the plans, drop the plans, drop the plans, because we've seen that have disastrous consequences and actually take practices in the opposite direction of where they're wanting to go.
John Meis (05:59.178)
Yeah, that's absolutely right. And so the days of fee-for-service, particularly in the group practice setting, there are fewer and fewer that are able to be successful with that. Also gone are the days, or they're coming to a close. It's dying, the trend has changed, of everybody taking everything. People are now dropping, more people are dropping plans and adding plans. And we're starting to see the low payers, the bad actors starting to struggle finding providers. And that will, over time, raise reimbursement. But it's going to take a while. It's not going to be, and nobody wants to wait for that because it's beyond our control. Let's focus on the things that we can control. And that is becoming more effective, having a better patient experience, et cetera.
Wendy Briggs (06:49.166)
Yeah, love that. The other reason that I hear more commonly, I guess, is a struggle or frustration is patients, right? We always hear from doctors, patients don't accept the care they need. They only want what insurance covers. Patients just don't have the money. That's a very common, I guess, reason that practices feel like they're not growing. And we actually, you know, there's certainly some truth to that in some circumstances, but more often than not, in our world, when patients really understand the problem they're having, the consequences of doing nothing about that, and the solution that we're proposing, many times patients become very invested in moving forward with their care. So sometimes I think we throw that up as a reason that we feel patients aren't accepting the care, but we don't recognize that that really is a symptom instead, that there's something missing with our case acceptance process. So.
So that sometimes I think it's a false flag. If you will, you know, us always wanting to say, patients just don't have the money or they only want what insurance covers. It's really not, I think, what what we think it is. It's something else that's happening.
John Meis (07:46.762)
Yeah.
John Meis (07:56.97)
Yeah, it's an easy excuse because again, it's beyond our control. But if we do all the things that we can control well, we can't solve everybody's money problems and we can't solve everybody's values when it relates to dentistry. But we can improve it. We can change it. We can get better. And if we focus on that, we'll have a lot more success than if we'd focus on the fact that, just be frustrated with the facts.
The patients may not have the same values that we have about teeth. They don't have the same knowledge and education. If we do a better job helping them with both of those, I think, and we've seen over and over again, that case acceptance rises and the quality of care rises and the general dental health of a patient pool gets better over time.
Wendy Briggs (08:43.758)
Yeah, love it. So in our practice growth model, Dr. John, we have three main areas of focus. And then for each of these three main areas, we have three systems, three, I guess, principles that we work with practices on to strengthen that core fundamental principle. So let's talk through today. Let's share what those three areas are. And then one at a time, we're going to break down those areas, but also the systems that we teach that can help practices improve on these vital vital pieces.
John Meis (09:18.666)
Awesome. Sounds great. So the first segment of three is practices in order to reach their maximum success have to have an adequate patient flow. And so that means there's enough patients coming through that we can successfully maintain from a financial standpoint can maintain a profitable practice. So that's a main principle. And I remember very frequently hearing, oh, we need more new patients. And some of the experts in our field have said that all you need is more new patients, or another one is more new patients solves every problem in the dental practice, et cetera, et cetera. We've learned that that is definitely not true. And so having the right amount of patient flow is really the key.
Wendy Briggs (10:14.318)
Yeah, it's fascinating to me that practices often are making decisions, well -intentioned decisions, but misguided ones because they don't really evaluate where they are from a standpoint of capacity versus demand. And for example, a classic example of this is a practice, you probably remember this moment, I remember it, I'll never forget it, a practice that said, we've got several locations, we're actively growing, we don't have time to see new patients for five months, but we're still spending about $20 ,000 a month on marketing.
John Meis (10:45.194)
Yeah, what a waste. Both of us just groaned. Oh no. Yeah.
Wendy Briggs (10:49.678)
Yes, we're like, oh gosh. And in the same breath, you know, probably there's people in the practice that think, gosh, we can't ever order new instruments or we don't get the materials and supplies that we need to get our job done effectively. Or, you know, that that's probably happening too, right? So it's so frustrating and really shocking that more voices or more people don't talk about that. You know, I think just about every decision we make in a practice on what's next should be guided by, are we seeking?
John Meis (10:58.282)
Yeah. Right.
Wendy Briggs (11:19.438)
Do we need more demand or are we out of capacity? I took a couple screenshots just this week of really incredible circumstances where practices are severely out of capacity and they don't recognize it. One example was practice saying, their patients are getting frustrated. They don't have any time to do scaling and route planing for about nine months. So they're recommending scaling and root planning. They're talking with patients about it and they don't have time to get them in. So the patients are wanting the hygienist to do a prophy today because they're waiting for nine months and they're asking, you know, is that a problem? Well, we're focusing on the wrong problem, right? You know, there's a much bigger problem going on right now. Yes, yes. And so it's incredible, you know, and I could share probably five more examples just like that from this week alone from practices that are severely out of capacity. And chances are those same practices still want more new patients.
John Meis (12:03.434)
Multiple problems there, yeah.
John Meis (12:18.282)
Yeah, no, it's really true. So understanding what your level of capacity is and matching, growing that capacity to the degree that you can, at the same time growing more demand so that you fill the capacity that you're creating. And so most practices have a very, very difficult time identifying where they are on that demand and capacity scale. And it's one of the things that a third party advisor can spot very, very simply because we don't have the same blinders on, as you do when you're actually in the practice every day.
So as you said, this is really the first of the key things that we look into when we're looking at patient flow is where is a practice on this demand capacity scale? And most frequently, people think that they are out of demand or don't have enough demand. And what we find when we do the analysis is most practices are out of capacity. And if we increase capacity, it naturally fills with the demand that's already wanting to get in, such as the patients who want scaling and root planing and don't want to wait nine months after they've learned that the disease is going to make them more likely to have a heart attack, a stroke, diabetes, et cetera, et cetera, et cetera. No one wants to wait around nine months when they understand the seriousness of their condition.
Wendy Briggs (13:37.71)
And really we shouldn't be asking that of our patients, right? It's just not the right thing to do. And one of the things that we often talk about is how critical it is in dentistry to do the right thing for the patient every time, all the time. And how can we be doing that? If our operations aren't supporting that vision, well, I would be looking at that first. So that's just one of the things that we'll talk about when we dig into the three key systems that we help practices understand about patient flow. And so that'll be really the first part of our series is digging into that core fundamental principle. So today, Dr. John, let's introduce them to the other two. And then on our next podcast, we'll dig into the more specifics on each one.
John Meis (14:22.794)
Sounds good. So the second thing that we need to have is case acceptance. And when I mean case acceptance, I mean that pretty broadly. That means doctors have to diagnose. And when they diagnose, then patients have to, we have to bring patients to the point where they want the care. And then lastly, we have to find a way for them to fit care into their budget so that we don't have money as an obstacle for patients receiving the care that they want.
So that's kind of a broad category and there's lots of systems within that category. But that's a really important piece because if you have tremendous patient flow and low case acceptance, you're not going to be very effective. I'd much rather have a lower patient flow and have really great acceptance because then we're getting off the hamster wheel. That high patient flow, low case acceptance is the most miserable way to practice, in my opinion.
because you're on the hamster wheel, you're doing small cases, you're doing single tooth dentistry, et cetera.
Wendy Briggs (15:26.99)
Yeah, I think also we overlook how much those two are connected. And as you mentioned before, we've seen practices that have way too many new patients and they're out of capacity. And one thing that suffers is their case acceptance, right? Their diagnostic percentage, their case acceptance percentage will actually suffer, it declines. And the other thing that we often see with case acceptance is the doctors driving everything there. And that's exhausting as well. You talk about the way that people don't like to practice. We often find that when the doctor's the one carrying all of the heavy lifting for case acceptance, it's also a struggle. It's exhausting. You often talk about how doctors run out of mental energy long before the physical energy, and that's a very easy way to drain doctors' mental energy.
So we love talking about case acceptance as a team -driven concept. And I think what I see, especially in hygienists that have been in the field for a long time, I think this provides for many providers, it's the recipe for burnout, right? We're helping the entire team become engaged in providing patients with a higher level of care. And many hygienists will tell me, once they really embrace this role and step into this role and recognize the impact they can have, that they've never had as much fun. They feel a new life in their career. And they really become much more, I guess, satisfied or empowered by what they're doing every day because it is making a difference for patients.
John Meis (16:58.218)
Yeah, it's making their role even more important in improving the dental health of your patient pool. So, Hygienists really love it. I've seen as you have Hygienists become, you know, passionate again about their profession and become passionate again about the purpose that brought them into the field in the first place. And it's really fun to see that transformation as you see people's excitement level grow and the practice grow and all from just better patient care.
Wendy Briggs (17:32.078)
Yeah, I love that. Well, the third piece that is so critically important in our practice growth model is that of efficient delivery. And this is a really, I guess, critical element. We've seen completely radically inefficient practices, and we've seen practices that are at the top level of efficient delivery. And certainly, we want the practices that we work with to understand what drives efficiency in how they deliver care and be able to do that to provide it and replicate it amongst all of their providers.
And this is another area that I think doesn't get a whole lot of attention in dentistry, at least from the main stages around the world is how important efficient delivery is. In fact, one of the things that we often hear from practices is my hygienists are asking for an hour and a half for every patient appointment. Well, that just doesn't make a whole lot of sense when we look at those three fundamental principles together. So this is an area that I think once practices really dig in and understand the mechanics behind it, how to improve it, we have certain partners that we work with that really help drive this in a powerful way. Again, it's an amazing component, so critically important, but often overlooked.
John Meis (18:49.866)
Yeah. And once you understand the principles of efficient delivery, now all of a sudden, we only have so much time and we can only provide so much care in that time. But some peep dentists can provide $1 ,600 worth of care in that hour and some struggle to do $300. I mean, there's a huge range in clinical efficiency. And so if we understand the simple processes to fix that.
Because everybody who's at $300 an hour thinks to get to $1 ,600 an hour, they have to drill faster and they have to run from place to place. And they'll be running around with their hair on fire when the exact opposite is the truth. But it's really hard for people to see until they see it.
Wendy Briggs (19:35.982)
Right. Same thing on hygiene. We have people all the time reach out and say, how is it possible to get all of these things done in my fairly limited hygiene appointment time? And that's what we talk about. We talk about the anatomy of an appointment, how we break it down, and we look piece by piece. What can be delegated when necessary? What can't be delegated? How can we accomplish all of the really critical elements that provide a world-class patient experience in such a way that we can do it in a timely manner, in the constraints of the time that we have.
And it's fascinating because we'll have hygienists say, it's just not possible, we can't do it. We're already doing so much as it is. And then a few months later, once they really understand the principles of it, they're the ones reaching out saying, you wouldn't believe what we did. We had a record production day. We protected X amount of teeth. We've never done that before. And they're just delighted with the impact that they're able to have. So again, really critical component that marries with the other two, you know, patient flow, case acceptance, and efficient delivery all support and feed into one another, which is why there are such critical elements that we teach in this model.
John Meis (20:42.282)
Yeah, absolutely. So those are the three big pieces of a practice growth model. And over the next 10 or so podcasts, we're going to be going through all of those systems, one focusing just on the high -gene growth model alone. And so it's going to be absolutely fantastic. And I think these will be the most impactful podcasts we've ever done.
Wendy Briggs (21:09.326)
I agree. I can't wait to dig in. And like I said, all it came was from a simple question. How do you help practices grow? And I thought, you know what? We've actually figured out what that looks like, but I don't believe we've really shared that with our listeners. So we're excited to bring you along on this journey and get this series started.
John Meis (21:27.562)
Very good. Well, that's it, everybody, for this episode of The Double Your Production podcast. We'll see you next time and we'll be talking about capacity and demand and where you might be on that scale.
Wendy Briggs (21:40.462)
Thanks everybody.
