Wendy Briggs (00:08):
One of the most commonly requested topics that we get currently is in today's climate is how are we dealing with all of these changes that are creating some difficulties in our practices on the hygiene side? So I'm delighted that you've taken some time out of your busy schedules to join us, and it should be a great conversation. Along my journey trying to figure things out, I realized a few really critical lessons that was why did I want to share some of those critical lessons that I learned with those in my profession? I learned that I wasn't the only one that was having some of these struggles with how do I fit as a hygiene provider in the context of my growing practice. I was also with a younger provider, and as the sole wage earner for my growing family, I learned some really critical lessons.
Wendy Briggs (00:56):
And now I'm not practicing clinical hygiene anymore, even though I still love the profession now, I feel a higher purpose, and that is to share those important lessons that I learned early on. My family's continued to grow. So again, as I learned some of these valuable lessons, it really helped me create a bigger future for my own family. And certainly in the past few years as a part of the team training institute, one of the co-founders of that, the knowledge that I learned early on that dentistry changes lives and that our mission now with TTI is to really empower dental professionals to improve the dental health of the world. It's really amazing and humbling to me how far this mission has grown. We literally do work with practices the best and the brightest all across the United States, Canada, uk, Australia. We work with some of the best people all over the world, and what I'm bringing here to you tonight is the collective knowledge that I've learned from the past 25 years in the trenches in dentistry, as well as in the trenches in your practices, being able to see outside of my own four walls.
Wendy Briggs (01:56):
Dentistry can be a very isolating profession sometimes, and sometimes we don't know what other practices are doing to solve the very frustrations that we're currently having. That's really what tonight is all about. So some of the important lessons I learned that really have become part of what we teach is that for me as a new provider, even though I found myself in a very young practice that desperately needed to increase production, I realized early on that my personal ethics and core values would not allow me, I would not permit myself to look at adding a change or adding a service simply for the goal of increasing production. Instead, what I realized is that I took really great care of my patients and did what was best for the patient first. Every time production would naturally follow that. So for many of you, I know that that's an important thing for you as well, is that we recognize that our patients deserve the very best that we can give them.
Wendy Briggs (02:49):
And if we can all agree on that, let's do a high five or a clap or some kind of reaction. You can type yes in the chat if you like, but I just want to make sure we all agree that patients absolutely do deserve the very best care we can provide. And in spite of today's challenges, hopefully tonight you leave inspired with new ideas and a fresh vision of how we can overcome the most challenging conditions that I've faced in my career, but still do the very best thing for the patient. Okay? So that's going to be the goal here tonight. It isn't about the money. We will talk about money tonight. I'm going to share some case studies and some success stories with you because it's important to know that what I'm teaching tonight, what we're talking about are proven strategies. These are real world solutions.
Wendy Briggs (03:39):
This is not just theory. These are not ideas that sound good in principle, but when we go to apply them, don't really have an impact in our practice. That's not how we operate. For us, it isn't about the money, but we recognize that dollars currently or how we measure how well we're caring for patients in dentistry. I wish there was another way to measure it, but that's how we measure it. We look at production collections, we look at those things as a part of how well we're providing dentistry. So we look at our day sheet. At the end of the day, it's loaded with all the services that we provided throughout the day. So just keep that in mind that for me, production was never really the goal, but it is how we measure how well we're caring for patients. So that's enough about the intro.
Wendy Briggs (04:22):
Let's dig in, right? I've got a lot prepared to share with you about these challenges and how we're seeing other practices succeed in spite of them. Okay? So many of you have joined tonight because we want to have a bigger future than what we've been able to accomplish in the past. And I would say that patients want the same thing, but in recent months, we've had some pretty unique challenges. So I would be curious to know from some of you, what are the biggest hygiene struggles in your practice? I know what we often hear, the common struggles, not enough hygienists, cancellations, difficulty hiring and retaining and attracting people into our amazing profession, which is quite sad, honestly. Retention, retaining our providers, insurance, there we go. Insurance is a big one. Dentists only wanting to do surgery. So dentists being highly specialized, even though they have a GP practice creates some challenges for some of us.
Wendy Briggs (05:14):
I get that. Okay. True knowledge of what a talented hygienist does. Okay, that's fair. I think there's a lot of different opinions about what that looks like. And I'm going to share with you my definition as we go. Convincing patients to do services they need. The example used here was fluoride, but what about all preventive services or even restorative services that they really would benefit from under utilizing codes growth, being able to fuel growth. We hear from practices that they have been growing at a rapid clip, but then all of a sudden they hit a road bump and maybe they've become stagnant or they're starting to see a slow decline. That's a very common thing that we hear. So thank you guys for sharing those challenges with us as we go. Again, it's important to me that you get good value out of your time here on this webinar tonight.
Wendy Briggs (06:02):
So good news is I already have a lot of those common struggles built in. Okay? So I can tell you that in all my career, in all of the history since the late eighties, if you can believe it, working in a dental practice, I have never seen a greater divide between doctors and the teams, between hygienists and the team, between the doctors and the hygienists than I have seen right here right now. In the last few years, it's been really, really challenging, and I'm going to not hold back from addressing some of the reasons that I see. Looking over data and talking with thousands of practices. Every year we get a really well-rounded view of the current state in dentistry. So if I were to ask you, what are we all looking to accomplish in hygiene, almost always we're going to say we would like to have a profitable hygiene department.
Wendy Briggs (06:55):
Again, keeping in mind the lessons of we're not going to do it for the production only. We're going to do the very best care for the patient that we can. What does that actually look like? And then we also say, okay, what are the reasons we're struggling there? And the most common challenges that we hear is we end up with a prophy palace, and I'm going to explain that to you. What that means is we're seeing a trend in dentistry where the appointment times are being shortened down and the expectations that the hygiene team are ever growing. So we're seeing a high rate of burnout. So that's the common challenge that comes. So we end up with a prophy palace. Another common frustration that we hear, a common challenge is that the wages and hygiene have grown significantly in a short amount of time. Now, in some markets, that was a necessary wage adjustment, but in other areas, it's becoming a little bit unsustainable for many of these practices.
Wendy Briggs (07:47):
And I think it's important that we discuss that because that leads to our difficulty hiring. It leads to our difficulty with retention. Okay, so we're going to talk about that as well. Another challenge that was mentioned was insurance. Insurance. A lot of insurance fees are really low, and even though we've seen record pace with inflation and costs are through the roof, unlike many businesses, we can't just raise our fees if we're participating with insurance. And so it creates a real challenge for us on profitability. So these are the most common challenges that we hear about, and certainly we're going to expand those challenges because there's several that are kind of tied together. You mentioned retention. You mentioned attracting hygienists and retaining hygienists. You mentioned insurance. There's a lot of the challenges that you expressed that we will be covering in greater detail as we go throughout our time together.
Wendy Briggs (08:40):
So let's talk about the prophy palace first. And I mentioned that this trend is about shorting appointments down, and I think it requires some brutal honesty about how we got to this place. So I love to share real world scenarios with you. We talk about these a lot. So here's an example. Just got a new job, 50 minute recare, imperial maintenance appointments, 50 minute new patient appointments. Here's all the things that we need to do in that 50 minutes of scaling and replanning for two quads. I've been a hygienist for nine years and never had such short appointments. I see about six patients in five hours. I'm feeling worked to death and always rushed. There's all these other things that we have to do as well. That is in my world, the definition of a proppy palace where we're expecting our hygiene team to be on a hamster wheel and really get patients in, get patients out, shortening those appointment times.
Wendy Briggs (09:36):
Here's another example. I need your best response to the office manager telling you to do a perio maintenance in 30 minutes, as in the patient is scheduled for 30 minutes, still have to do blood pressure, health history, update, reappoint, scale, all those teeth. How do we do that? What's our response there? Some examples of Proppy palace scenarios walked out of my job today. I work assisted hygiene with two other hygienists altogether. We worked six columns. We had one assistant that we had to share. I brought this up to management, begging for more assistance and was told no work environment was toxic. Life is too short. This is one of the things that we're seeing. The prophy palace mindset, the thinking that we have to shorten appointments down and cram more patients through is part of why we have a shortage, hygienists. It's part of why we can't retain and attract hygienists. It's part of why hiring a hygienist becomes so difficult.
Dr. John Meis (10:32):
Hey, podcast listeners. One of the things that The Team Training Institute is best known for is improving hygiene performance. And we have a course that helps practice do that. We call it hygiene explosion. And Wendy, this is your brainchild and it is the most effective thing that we do in our company. Tell us more about it.
Wendy Briggs (10:53):
Yeah, it's so interesting the timing. The challenges that practices are having with hygiene have never been more frustrating. We hear from doctors all the time that wages are high, performance is low insurance reimbursement rates are low, and they know that a third of their practice production should be coming from the hygiene department, but many just don't think it's possible. For decades, people have said it doesn't matter what hygiene produces. Hygiene's a loss leader in the business. So what really matters is what we do with the patients once they come from hygiene. And we understand that 75% of all restorative production comes from the hygiene department, but many practices don't understand how hygiene can be run effectively, and it can be a profit center in your practice. And that's exactly what we do in hygiene explosion. We help them know how to maximize the impact of their hygiene department.
Wendy Briggs (11:46):
We help hygienists know not only what to do differently, but why they should. So we address the most important roles that hygienists should be maximizing in today's world, and that's the role of a preventive therapist, a periodontal therapist, and a patient treatment advocate. And the GIE explosion is all about enhancing the role of preventive care. And we do this in such a powerful way. We have coaches that are the best in the business, and we go and help the team understand not only why patients deserve the very best care, but how to do that consistently. And the goal is to give patients all of their options and make recommendations based on things that would help them. And what we see is when practice is the best in hygiene explosion, the impact is immediate. The very next day they see results. And I think the main reason for this is hygienists often, personally, I always wanted to do what was best for my patients. I wanted to increase my own productivity, but I just didn't know how to do that and do it in a way that I could feel good about.
Dr. John Meis (12:52):
Yeah. What I love about this training is you start out by going through the science of what is the science showing? What is the recommendations of the groups in dentistry that are advocating for their particular thing, for instance, pediatrics and radiology and restorative as well. And so it's really talking about what is recommended, what the science is behind those recommendations. And that's all good. Well and good, but it really gets into the how you get it done. And so when he goes through and the coaches go through the anatomy of an appointment and how much time do you spend on each thing, which helps hygienists know where they need to speed up and where they might be not taking as much time as they need to. And once they understand that and once they understand why it's best for the patients, and we make sure that there's a way that it's best for the hygienists, and also obviously the most important is that it's better care for the patients.
Wendy Briggs (13:57):
Yeah, we love that Dr. John. We lead with the whole concept, like you said, is the science providing better care? And one of the things that we hear from doctors and hygienists alike is we're already busy. We're rushed. We don't have enough time. So that's why we went into the anatomy of an appointment. The other thing we hear from doctors and hygienists is they don't want their patients to feel pushed or oversold on unnecessary services. And that's why we leave with the science. We teach the process of a risk assessment so that any recommendations we make to the patient are based on their individual risk status. So a lot of these very common concerns we've overcome, which is why I think it has been such a wildly successful program. And we're honored to have worked with more than probably 3000 practices at this point in helping them understand how to be more effective, to be more efficient, and how to really maximize the opportunity that exists in hygiene. And I think one of the things that we've also found that's so transformative about this is that practices have everything they need to get started. So that's why we see the results the very next day. We're not changing the appointment structure, we're not changing. They don't need to buy anything in the way of fancy new equipment. They have everything they need to get started. And so that's why we come in and our goal is to have the biggest amount of impact with least amount of disruption or chaos. And that's what happens with hygiene explosion.
Dr. John Meis (15:19):
And it's like Wendy said, a day one effect. So if you'd like to learn more about that, go to the team training institute.com/hygiene team, the team training institute.com/hygiene.
Wendy Briggs (15:36):
We love that. We'd hope to hear from you again, take those hygiene headaches and turn them into opportunities. That's what hygiene explosion is all about.
Wendy Briggs (15:53):
So how did we get to this place? Why are we seeing this response? Why are we seeing practices go down this path? And to me, I think we need a greater understanding of how profitability is calculated in dental practice. Now, some of you might be thinking, I'm a hygiene provider. I'm a dentist. We don't really get a lot of education training on the business side. We understand that, and that's why this profitability formula shared with us by our friends at dental Intel is so brilliant because of its simplicity. We take the number of visits times the production per visit, times the collection percentage minus the overhead, and that's how we come to profit in a dental practice. So practices that end up focusing on shortening the appointments down, they've instead chosen to focus on the visits component of that profitability formula. That's why we see things like today, I had an interview with a corporate company.
Wendy Briggs (16:54):
They said, I'm going to work eight to five in two different offices and I'm going to see 10 to 11 patients in a day without an assistant. That's the focus. That's where they're choosing to play in that profitability formula. And I can tell you in the short term, you will see profitability rise. You'll see production rise. However, in the long run, it's actually more harmful to the practice. We not only have difficulty retaining our team, but we have difficulty retaining patients, and this is, in my opinion, a damaging strategy. Instead, we choose to focus here on the production per visit. Now, we still focus on the number of visits by minimizing the churn in the schedule. Somebody mentioned that cancellations is a problem. We're going to talk more about that in a bit. But instead, we focus on the production per visit. And what I love about this as a hygiene provider and someone who's fiercely committed to my patients is that in this part of the formula, we can still provide quality of care.
Wendy Briggs (17:54):
We're choosing to focus on the quality of care we provide rather than the quantity of care we provide. Now, efficiency still matters. Utilizing a schedule, schedule effectiveness still matters, and we'll talk more about that. But when we focus on production per visit, what that means is we can actually expand the care we provide in the time that we have. So solutions for the common challenges of prophy, palace burnout, difficulty retaining providers, some of the things that we've learned, one of the core solutions that we teach is to improve our effectiveness. Okay? Now, you might be thinking that's pretty vague. How do we improve effectiveness? We have a variety of systems that we have created and we help practices that implement that help us improve our effectiveness. One of those systems is to implement a risk assessment process as a part of every hygiene visit. Okay?
Wendy Briggs (18:43):
Another system is we maximize three roles of hygiene world-class hygienists, one of you said it's difficult for hygienists. That was one of the challenges to know what makes an excellent clinician, what makes an excellent hygienist? This is a solution to that frustration maximizing three roles of hygiene, and then a very key and strong focus on patient experience that is also an important part of the equation. Okay, so let me dig into each one of these briefly. Okay. When we talk about risk assessment, how important is this? Well, this is the World Health Organization, and they say that chronic diseases and injuries are the leading health problems in all, but a few parts of the world, the rapidly changing disease patterns throughout the world are closely linked to changing lifestyles, which include diets, rich in sugars, widespread use of tobacco, increased consumption of alcohol, and they go on to say that oral disease is highly related to these lifestyle factors.
Wendy Briggs (19:37):
So for any of us that have been in the trenches for a number of years, and I see a few people that probably have maybe similar to or a longer time spent in the trenches than myself, we know who we are. I can tell you that over the years, the risk profiles of our patients have changed dramatically. Patients up today have a lot of risk. They don't come in saying, Hey, Wendy, I need a higher level of focus on preventive therapy. But they do come in saying, no matter what I do, I brush eye floss. I always tend to have a problem. Bad teeth are in my family. I do everything you tell me and I still have a struggle. These are the patients that need risk assessment desperately. They have products and services, products and beverages and habits, if you will, that are taking them backwards.
Wendy Briggs (20:28):
If we can, we need to help them balance the scales of risk in their favor. How do we outweigh all of those highly damaging risk factors in patient's lifestyles? Well, we do that by a stronger focus on preventive therapy, which is what dental hygiene is all about. So why a systematic process for risk assessment is so critical? Here's an example, a part of a tool that we use and we help hygienists employ. It's a risk assessment survey, and this is adapted from the A DA. It's a very quick and easy tool. We say 90 seconds or less is a part of your appointment is what it's going to take you to actually fill out this tool, and it helps patients understand why they need the services they need. Somebody mentioned one of the challenges was having patients to accept care like fluoride. Once we do risk assessment, guess what happens?
Wendy Briggs (21:17):
They understand not only why they should have those procedures, but they really appreciate our attentiveness and our care that we're providing them. I've had patients tell me, no one has ever helped me understand why I always had a struggle with cavities, right? They really appreciate that insight. Then we move on to three roles of world-class hygiene. Now, I could teach an entire webinar on just these three roles, but tonight we have so much more to talk about. But when we work with hygienists and we help them understand what is a world-class hygienist, what are the roles that we need to be embracing? How do we do this in the limited amount of time that we have? It always comes down to these three critical roles, preventive therapist, periodontal therapist, and then dentists. Get really excited about this one because very rarely do we see much training on this at all.
Wendy Briggs (22:11):
But the role of a hygienist is a patient treatment advocate, really in supporting our doctor's restorative philosophy. How many times do we have patients that once the doctor leaves the room looks at us and says, what do you think? Do I really need to do that? How long can I wait? If we're truly maximizing our role as a patient treatment advocate, patients no longer ask those questions. It's a systematic process that we're employing throughout the practice. Everyone's on the same page, speaking the same language, and helping patients understand why they need what they need. Those are all really critical, important roles. Now, when it comes to patient experience, this is probably one of my favorite things to speak about and to talk about, and that is, patient experiences need to be world-class, right? I love this book by will G. It's called Unreasonable Hospitality, and we have an entire training, a full day training that we do based on some of the principles in this book.
Wendy Briggs (23:07):
And if I had to summarize it, I love this quote. The way you do one thing is the way you do everything, and we found that precision in the smallest of details translated to precision in the bigger ones. So when it comes to a world-class patient experience, we created a list. We have 65 touchpoints in a world-class patient experience, and we encourage you to rate your practice on how you're performing in each one of those touchpoints. Precision in the smallest details can make up for it. It translates to precision in the bigger details. So when we talk about patient experience, we talk about increasing performance, all of these things add up to make a big impact right away. Now, again, I love to provide proof of some of the things that I'm sharing with you this evening. So I'm going to share with you some case studies as we go.
Wendy Briggs (23:55):
This is Dr. Wynn and his hygiene team, an amazing hygiene team. He knew he had untapped potential, and you can see in the first 30 days, they've already seen a significant improvement, and it's because they focused on risk assessment, having higher level conversations with patients about fluoride and some of the other preventive services that would really benefit them, right? It is because they understand they need to maximize their three roles. Then they really focused in on providing a world-class patient experience. It doesn't take long to see a pretty powerful impact with some of the strategies that I'm sharing with you here tonight. So we're very proud of his progress and his hygienist progress. They're doing amazing things, and it doesn't take very long again, to see that level of impact again, almost a $30,000 bump in the first 30 days. We'd love that. Let's move on to the next challenge.
Wendy Briggs (24:50):
Okay? Again, I want to make sure that we have time to answer questions for you. So let's talk about the elephant in the room. Let's talk about the high hygiene wages. Let's talk about what that means to our own profitability. Difficulty with hiring is also a challenge that comes from that. So I would love to see you rate yourselves, rate your practice in your area, in your practice. How big of a challenge is high hygiene wages, difficulty attracting hygienists? If you wouldn't mind, rate yourselves in the chat. Red, yellow or green? Red means it's a struggle. It's a serious problem. We have been trying to hire, our wages are out of control. Yellow, we're probably in the middle of the pack. We've been hiring. We've been able to find people, but we're not sure. Sometimes we end up hiring the least worst out of all the applicants that apply. Green, fully staffed, rockstar team. Not much of a challenge. Wages are comfortable. Okay, so let's just get a quick sense of where everybody rates themselves in this issue. I'm seeing red. I love the honesty. Red, red, red. That wasn't just one red, that was a triple red red to the third power. Okay. I'm so glad you're here because we're going to be talking about some ways beyond that.
Dr. John Meis (26:09):
Hey, podcast listeners, many of our listeners have asked where they can learn more about what we do, the philosophies that we have, and get some materials that they can read. And one of the best way to do that is our books. Today, we want to focus on the ultimate guidebook, so the ultimate guide to doubling or tripling your Practice production. So Wendy and I, co-wrote this. It is an Amazon number one bestseller, and what I love about this book is that it's the core of some of the systems that we teach, and it's some of the very first systems that we teach to help practices improve their production dramatically.
Wendy Briggs (26:46):
Yeah, this book goes step by step through our process for optimizing and growing dental practices. And many have discovered how to double or even triple their practice production by the principles in the book. And we long have taught that it's not about the production. It really is about providing the best possible care to the patient, and then the production will naturally follow. But there are systems that can help us increase our production and profitability. There are systems that help us raise the standard of care and create an engaging self-managed team and exceptional patient experience. And this book highlights what those systems are. Another thing that I want to note is every practice is different. So these systems are customizable to your unique practice shape, structure, size, goals, whether you're fee for service, whether you accept PPOs or participate with insurance plans. These systems can be customized to suit what you are trying to build in your practice.
Dr. John Meis (27:40):
And it's a very easy read. It's a good read for every role in the office. This isn't just for doctors. It's a good role. It's a good book for every role. And so if you want to get a copy of this, we'll give you the book. We just ask that you pay for the shipping. And to get this, go to the team training institute.com/books, the team training institute.com/books.
Wendy Briggs (28:15):
Okay, a couple more. Reds, yellows, reds, yellows, yellows, yellows, lot of reds, caps, reds, all caps. So we know that's a serious issue yet again. Okay, some more yellows. So not one green, which is really interesting. And of course you joined the call tonight knowing we're going to be talking about some of these challenges. So I guess it stands to, one could reason that that's why you're on the call, and I'm so glad you're here.
