John Meis
Hey everybody, welcome to this episode of the Double Your Production Podcast. I'm Dr. John Meis here with my partner, Wendy Briggs. Hey Wendy, how you doing?
Wendy Briggs
Hi, John. I'm so excited today is going to be a great topic for our podcast.
John Meis
Yeah, so tell everybody what we're going to be talking about today.
Wendy Briggs
we are really gonna be dialing in to practice profitability. I think it's such an interesting time in dentistry and we've had long time friends and really solid practices reach out and share with us that over the past couple years, their profitability has shrunk, their margins are more and more challenging. And I think it's time to have an open and honest conversation about why that is and what practices can do to turn things around.
John Meis
Yeah, it's great. It's a great, great topic and it's a concern for everybody. At one of our recent events, we went through an exercise for dentists and their teams to actually figure out what their profitability is because most dentists don't know. They look at their checkbook and they see how much is in there and that's how they calculate profitability. But that's not really the best way to calculate profitability. That's not profitability. That's just cash.
So we went through this exercise and everyone understood, I've never known. I've never known how to actually determine my profitability. But what they do know is that their expenses are rising and their revenue is being challenged. Reimbursements are continuing to go down. And so those that are playing the insurance game, reimbursements continue to go down. And now the insurance company is getting very clever at how to create partnerships in order to reduce reimbursement even
more than you think. And so it's a big challenge. And the other thing that's happened at the same time is our people costs have gone up significantly. And so it's a squeeze right now. And so we're getting squeezed. And if we do what we've always done, our profitability will shrink until there isn't any. We may still be taking home a paycheck, but there's not going to be any profitability in business.
Wendy Briggs
Right. And one of the best ways to overcome that certainly is looking at things differently. Like you said, if we do what we've always done, we're going to get what we've always got. Right. I mean, that expression's, I guess, stood the test of time for a reason because it is very, very true. And we also talk about how Steve Jobs was such a tremendous advocate at instigating change in the world, in the business world, certainly by talking about how we have to think about things differently. So
One of the things that we do well at the Team Training Institute is help dentists and their teams understand how to think differently and why they should. And certainly some of the things that we teach and we bring to practices can certainly help them have a better tomorrow than what they've done in the past by thinking differently, right? Change of human behavior is really, really difficult. And I wish I could have, you know, a dollar for every time I had a dentist say to me,
Gosh, I've been trying to get my hygienist to do X, and Z, but you guys came in and you're able to just do it like that. And I think the reason is, there's a lot of reasons we could dig into that, but one of the most compelling in my view and in our experience is that we really focus on why we should approach things differently first, and then we get into the tactical and more of how we do it. So let's talk about some of the whys with profitability and some of the things that we've seen, the easiest knobs to turn, to transform profitability in a practice. And again, you mentioned insurance. Let's talk about how that factors in because there's probably listeners that were thinking, well, gosh, you know, in my area, I have to take insurance. We have to take insurance. And they, in some instances, are listening to the voices of the crowd that say the only way to become profitable is to drop that. And we know that's not necessarily true.
John Meis
That's not true. Nope, that's not true. yeah, so there are a few really easy knobs and we think of the three pillars of profitability being patient flow, having an adequate and but not too many, too much patient flow, having really good case acceptance because if we have too much patient flow, sometimes case acceptance will go down and then have really efficient delivery. So those are the three, three general pieces, areas, and within each of those, there's different strategies on how to improve those. so a very simple one that we have really all of our clients do is really do an analysis of the capacity and demand balance in their practice. Do they have open time? Do they have enough patient flow, enough demand to keep their chairs full or not? And if not, then we need to increase demand. But very frequently we see that there's not enough capacity, they're missing something. And so if we don't have enough capacity, we are letting profitability dollars just fly out the window.
Wendy Briggs
100%. And I think as well, the next two pillars kind of partner up here. We look at case acceptance and efficient delivery. Another thing that we often find is we're not providing comprehensive enough care on the patients we do see. So we can do a quick analysis of a practice and we can say, okay, they saw, you know, 3,500 hygiene patients last year, but then we'll look at the complexity of care or the menu of services that they provided to those hygiene patients and they're really not offering ancillary services at the level that patients of today desperately need. So in my mind, that's a combination of case acceptance and efficient delivery. You we often hear from hygienists that are burned out. saying there's not enough time to do everything we need to do. But in reality, when we look at the day sheet or what they, the services they're providing on their patients, it might read something like, exam, right wing's prophy, exam, right wing's prophy, prophy, exam. BioWings Pro-Feed all day long. And in that instance, we know we probably are providing excellent care to that patient with the cleaning and the exam and the x-rays, but there's so many more services that we could be offering to those patients that they definitely desperately need. And if we were offering those services, our case acceptance would go up and our efficient delivery would also improve significantly. So it's interesting how those two partner up in a big way here.
John Meis
Yeah, they really do. And the ancillary services that you're talking about in hygiene, I was just in a really great group, spoke to a group, two locations, but big locations, very sophisticated, extended hours, extended days, just the very, very sophisticated practice. And this was not part of their strategy. And so when we did the math on how much they could improve, most importantly, the quality of care that they're giving. Because if we're not offering those services, then that would be fluoride, sealants, bond and protective agents, and curadonts. Those are the big four. There's others as well, but those are the big four. We started to calculate how much care wasn't being provided and how that really was a measure of quality, right? Of the quality of care because patients weren't being offered it.
Wendy Briggs
Yeah, and it's not uncommon. know, when we first go into a practice, that's one of the first assessments we do is, okay, you what did the opportunities look like based on the averages that we're able to attain very easily? And it's quite shocking how much opportunity is left on the table. Dr. John, you mentioned that group. I just got statistics from another group, fascinating, about 50 locations in this organization. And in the first four months on the program, first four months really looking beyond doing what they've always done, thinking differently about hygiene, understanding what to do, but why we should do it. know, patients of today and the risks that they have, it's fascinating to see the impact. And they're just getting started. In the first 16 weeks, so the first four months, their providers treated 1,900 early cavities with Curadont, more than 1,900. They did more than 820 bonded protective agents, which is protecting that very vulnerable classified cervical root exposed area. Many patients need that. They placed more than 2,300 sealants. interestingly enough, just the strategy on those top things that you mentioned, the four main menu for preventive services alone generated more than $1.2 million in growth. So these are very common examples of things practices can and should be offering patients. And when patients understand why they should do it, and they understand the financial impact, you know, the financial impact is a big thing for patients because they want to save money down the road. They don't want to have to wait until things get more complicated, more expensive to fix. But certainly they love investing in value. You know, they want to do something now that's going to make their lives easier down the road.
So we mentioned the financial impact, but certainly it's also, as you mentioned, the standard of care, the quality of care that we're providing goes up dramatically when we understand the connection between these services and patient care. It's also fascinating to me that so many hygienists want to be divorced from reality. And what I mean by that is they say, can't we just be providers? Why do we have to worry about?
Wendy Briggs
production numbers and all of these things, health care shouldn't have to worry about that at all. And I think in a way, I understand our desire to really focus on caring for patients, but the reality is the numbers tell us how well we're caring for patients. So if you don't know what your production is, or you say you don't care, what that really means to me in my world is that you really don't care about the quality of care we're delivering to patients. And I know that's not true. I know that doesn't make sense.
John Meis
Exactly right. Yep.
Wendy Briggs
dentists and high dentists went into dentistry because we wanted to care for people. So I think we have to recognize the reality of practicing in today's world is that we have to understand the connection between our own provider productivity and the care we provide to patients. And you can't have a high level of care and low production. It's not possible. So we have to understand that our new normal is paying attention to how we're performing in these areas.
And I understand the desire to be divorced from the dollars. I wish there was a way we could measure care without having to look at it in a dollars and cents. But the reality is we have to know what we're doing and we have to care what we're doing because that means we really do care about what's best for our patients.
John Meis
Yeah. And it's a grownup world. And there was a day where dentistry was so profitable that no one really needed to pay attention to the dollars. It just kind of worked out. Well, that day is gone. And so we got to live in reality of what's going on right now. that's a good example. I hear that sometimes too, that a practice focuses on the money. Well, I hope that we're focusing on the quality of care. I hope we're focusing on the quality of care and the way we measure that is our productivity. So yeah, it's fascinating. All right, so what's another knob we can turn, Wendy?
Wendy Briggs
Well, certainly, you we talk a lot about the next dollar phenomenon and you teach this principle so well. Really, it's about doing more with the time we have and focusing in on that efficient delivery. And so one of the things that we see practices make significant strides in is same day dentistry, you know, understanding that every procedure we do today that wasn't on the schedule makes today inherently, you know, more profitable by orders of magnitude. In some practices, we'll have a coach go in, And then they'll send us a photo and they're holding a piece of paper saying, hey, the day after our coach was here, you know, we produced 15,000 and extra same day services. And we want them to be celebrating that because again, that's harnessing that approach of really providing efficient delivery, giving patients what they want when they want it. We've seen same day dentistry really transform practices profitability in a powerful way.
John Meis
It is fascinating to me that we hold a course called the High Impact Dental Course. the design of it is to get people in the right mindset to be as productive and as efficient as they can to have the right skill set and the right tool set in order to do that. And so of the people that have gone through this course, one of the questions that we polled them on is,
how much of your time is spent doing treatment and how much of your time is underutilized. And the most, the best that anybody's ever said was that 80 % of their time was being used for the doctor doing doctor things, which means the very best had 20 % of their time that wasn't being utilized. And that's one of the things that...
focusing on same day dentistry. Same day dentistry means doing something that's not on the schedule. And a very easy way to think about it and a reasonable goal is that we don't reappoint single tooth dentistry. We're offering them the opportunity to do it right that day, the day it's diagnosed. And that's how we start filling in that 20%.
And so everyone's always concerned that, gosh, it's going to be hectic and it's going to be chaotic. And if you don't do it properly, yeah, it could be. But you can do it very, very well so that you're going through your day smoothly. You're never being rushed, but you're never having nothing to do. That's the gold standard.
Wendy Briggs
Yeah. Another thing too, doctors, I mentioned how hygienists can kind of get stuck in a rut. We see the same thing on the doctor's side as well. And we often hear from doctors, gosh, you know, we wish we could do more expanded services or what I really, really love to do is aligners or I really love to do, you know, full cosmetic cases or, or I love the TM, TMD problems and, and they want to do these more advanced cases.
John Meis
yeah.
Wendy Briggs
and they don't necessarily know how to do that. And so that's another thing that we focus on as well is focusing in on, know, what kind of dentistry does your doctor really enjoy doing? How do we do more of that? So expanding the menu in hygiene is one approach, but also expanding the menu on the restorative side, whether that's implants, whether that's aligners, whether that's TMJ or whatever, sleep, some practices of sleep. So whatever the doctors really enjoy doing, you how do we, as a team, drive awareness? and educate patients to increase case acceptance for some of these valuable services that again, can be wildly more profitable than just prepping teeth all day.
John Meis
Yep, yep, for sure. And when you do drive up those specific procedures, now the dentist's satisfaction goes up, productivity goes up, their mental energy is improved because they're doing the things they enjoy. And it just really has a great positive effect. So these are some of the tricks and tips of getting to be more efficient so that we can be more profitable.
Wendy Briggs
Yeah. Dr. John, I wanted to mention real quick, I'm sure our listeners know by now that our 20th annual Champions of Dentistry Summit is coming up. This year it's going to be in Austin, Texas, the end of April. We're super excited about that. And one of things I wanted to mention is at that event, we actually are going to be having some breakouts designed to help drive those ancillary services. It's all going to be focused on case acceptance for aligners and implants and, and perio, you know, things that, that we hear from our members that they need to improve and increase their profitability and their practices. So yet another reason, if you're not planning on joining us for our summit, we really encourage you to visit championsofdentistry.com, see what else is on the agenda. But those breakouts alone are going to be super powerful and very instrumental in helping patients practices and patients alike know how to make this year a better year than last year by far.
John Meis
Yeah, that's it. Very good. All right. That's it for this episode of the Double Your Production podcast. We'll see you next time. Thanks, everybody.
Wendy Briggs
Thanks, everybody.
John Meis
Okay.
