4 Leaky Holes in Your Practice Revenue Bucket with Linda Miles

[0:00] You are listening to the Dental Practice Owner's Podcast brought to you by Prosperident. From our unique perspective as dentistry's embezzlement experts, Prosperident's team can bring you the information that is important to practice owners. The Dental Practice Owner's Podcast brings you strategies, tools and tips that you can use and dentistry's thought leaders as guests. So sit back, relax and listen to Prosperident's Amber Weber, Wendy Askins and David Harris

[0:31] talk about the issues that matter to you. Ladies and gentlemen, it gives me tremendous pleasure to welcome the incomparable Linda Miles to our webinar. We're going to hear briefly from Samir Basin. Care Credit has generously provided financial support for this project and I'd like to introduce Samir Basin from Care Credit who's going to introduce Linda Miles.

[1:09] Samir is actually traveling right now and he was kind enough to record the video in advance. Let's hear from Samir. On your end.

[1:27] Great, right. Can you see that on your end? Yes, it says recording, so we are alive. That's great. So isn't Zoom wonderful? It just makes all this so effortless, doesn't it?

[1:40] It has, it does. Yeah. So just imagine that David has sort of started things off and that he's introducing you and then after you, the spotlight will be on Linda. Okay, so I thank David and then I pass the baton directly to Linda. Okay, but I also think you can say hi, I'm Samir Basin and my role at Care Credit, we're

[2:13] happy to, you know, whatever is made sense. But ultimately I'm just passing it over to Linda is what I was trying to, or am I passing it back to David and then he's going to bring Linda in? No. Okay. Okay.

[2:30] So I think I know what I want to say. And we can take two or three shots at it. I mean, if it's three minutes or if it's 30 seconds, it doesn't have to be perfect is what I'm saying. Okay. All right.

[2:47] Well, good because perfection, I've been chasing it, I've stopped chasing perfection. Okay. All right. So, but you can hear me okay and you can see me okay. Everything is good there. I'm just going to say, you have a monitor behind you on your right.

[3:07] Yeah. Or I guess it's on your left. Is it possible to move it just so that we look kind of balanced or is it, is it solid right there? So you want me to just move it out of there. Just.

[3:24] Yeah, perfect. Yeah, that's good. Oh, and I see that you're standing all the time. I'm just wondering about that. Yeah. Because you look like you're standing. Yeah.

[3:34] Yeah. It looks good. It looks great. Okay. So I think we're, we're good to go. We're good to go. Okay.

[3:43] Thank you, David. For the kind intro and hello everyone. A very good evening to you. My name is Samir Basin. I'm the, my title is actually vice president of alliances for care credit. I'm going to take a stab at it.

[3:57] And I'm quite sure I'm pretty confident that I'm right on it. That over the last 20, 30 years, our profession of dentistry has seen some remarkable. Advances in technology advances in the clinical skills, advances in how we go and approach our patients. But in all those advances,

[4:17] what has not changed is the core of why we do this. It's the core of you wanting to take care of your patients. Similarly for care credit in the last almost 35 years, we have changed the ease of use, the technology, the innovations have been fantastic. But at the core of.

[4:35] Well, thank you, Samir. And wow. He said it so well. Linda, to start us off, the question that I have for you is, I know you've been in dentistry for an incredibly long time.

[4:50] And I don't necessarily want to tip somebody's age, but you know, it's 60 years, I think is the number that has been kicked around more or less. And the change over 60 years has been breathtaking, but I know that some things haven't changed. Tell us about that.

[5:12] Well, technology as Samir said, has changed and revolutionized our profession of dentistry. However, the one fact remains, and I've spoken about this for the last 35 years, and that is communicating effectively with your patients and your team.

[5:32] That is also building relationships on high degrees of trust and trust breeds lore. You'll never have a loyal team member nor a loyal patient until the doctor trusts both of these people. And when the doctor trusts the team member, the patient trusts the entire practice.

[5:52] So it's really, really important to build that relationship within the practice, the culture. And most of all, for that to spread to every single patient. Deliberation is important. Most of all, for that to spread to every single patient.

[6:10] Delivering the best care in the best possible way. That hasn't changed. And our first topic this evening is, there are many leaky holes in the practice revenue basket. And looking at the Prospera Dent team, I can tell you that one of the biggest leaky holes

[6:32] in the bucket is what they are so good about fixing, which is fraud and embezzlement. We're not going to talk about fraud and embezzlement tonight, but put that down as number one leaky hole in the bucket in many practices, way too many. The first one on my list is the scheduling concepts.

[6:52] I hope that every dentist who is listening, if you are working out of two operatories and still have only one clinical assistant, do yourself a favor and be properly staffed chair side. You will absolutely burn out good clinical assistants if you're understaffed.

[7:13] And when you have two ideal dental assistants working out of two operatories, you will make sure that both of them are not only clinically outstanding, but they are also outstanding in their communication skills. When that happens in your practice,

[7:32] you have a dynamic duo that is the other set of hands and eyes of the doctor. And so the first tip I can give you on scheduling is this. I want you to write down three numbers. I use this as an illustration, 60, 30, 10. And when I was put in front of a dental practice

[7:58] at the administrative position, I was a clinical assistant for a long time. And I had no idea how to engineer the doctor's day to maximize our productivity. And then I learned very quickly that I had to learn where the doctor was at all times.

[8:16] And I figured out that our doctor was in his primary treatment room, 60% of the day. That's Operatory One with Assistant Number One. Our secondary assistant, who was outstanding in not only clinical but communication skills, was our new patient coordinator.

[8:38] All adult new patients were scheduled with our second dental assistant, and those became filler appointments because the first 30 minutes of a new patient adult visit was done by our new patient coordinator. And the doctor came in to do a thorough

[8:57] complete mouth examination, but everything was prepared. Existing restorations were down, and now in the computer. Back in the day they were charted. All of the health history was gone over.

[9:10] The doctor was notified of anything specific, health history or medication-wise. And the blood pressure was taken. The X-rays were taken. The photographs were taken. Every time the doctor walked in to do a complete mouth exam

[9:26] on a new patient, I can assure you when my clients started changing from the hygienist seeing the new patient first, their case acceptance doubled, and so did ours. And that is because if you see a new patient

[9:42] in the hygiene appointment schedule, first of all, you have no idea whether they're a clean, healthy mouth or whether they're a totally bombed-out, dental-wise patient. So seeing the new patient in the doctor's second care was the best change any practice can make.

[10:01] So the 60-30, our doctor was in the second operatory 30% of his day, and he was in the hygiene room doing exams 10% of the day. So if you keep that thought in mind, knowing where your doctor is at all times

[10:17] and knowing that the two dental assistants that work with that doctor are ideally trained, you're going to see, well, maybe an $800 increase per day in productivity. So talk about a big productivity leak, not knowing how to engineer your time is the biggest leak.

[10:38] And the second tip I can share with you is to have zero defects in your doctor's schedule. One of the things that I created way back in the 70s before computers were in dentistry was my pending appointment system. And every patient that left my desk

[10:57] left with their next appointment, and if they said, Linda, I work shift work, I can't schedule until I look at my work schedule, I'll call you. That becomes a potential lost patient.

[11:08] They never left my desk without their N.A., their next appointment, or they were placed in my pending appointment file, their name, their phone number, how much chair time and the procedure that was going to be done.

[11:22] And then when we had an opening, I had a list of people that I could phone and bring into the practice. So zero defects in the schedule. That's another big leak. And the last but not least is that

[11:38] I hope that your hygienist is pre-appointing their appointment's chair side. I cannot tell you how important it is because when the commitment is made with the hygienist and their patient, I can assure you your broken appointment rate

[11:58] in that department goes completely down. So these are just a few tips. There are hundreds of tips and there are hundreds of ways to increase your productivity, reduce your stress, and that's just a few. Do we have any questions about scheduling Amber?

[12:19] Oh, Amber, you're muted. No, we do not have any questions from our audience yet at this time, Alinda, but I would like to add something that is my experience as a hygienist. So how you're saying the key thing is as a hygienist,

[12:38] you pre-appoint your patient. That is such a key, one of the most important things that I see from that aspect because you're building that relationship of trust and you're helping your team also to have their day flow and you're not telling your purse,

[12:53] your business team member at the front, oh, that's your job. So I love that you say that and I think that's really an important role right now as understanding the importance of that. I'm glad you understand that and agree, Amber,

[13:05] and I can honestly tell you that your administrative team will hug you at the end of the day because all they have to do is come to the front, present the fee, collect the fee, take care of the insurance, and bid the patient farewell, which saves them

[13:24] and the phones are always ringing. So yes, it's not only a time saver, it's a practice builder. Right, and I have a little fun saying that I tell hygienists who are nervous about that. I always say, I know you went to school

[13:38] and you learned how to scale, but realistically, we're here to serve, serve our patients and their needs, and that's that relationship. So just don't be here to scale, be here to serve also.

[13:48] That's right. And, you know, I was blessed to work with so many wonderful dental clients and their teams, and it was just amazing how sometimes the doctors would say to me,

[14:00] I don't know how you get them to want to do what you said. I told them the same thing, and they think you walk on water and I don't. So I think sometimes having someone who has walked a mile in their moccasins,

[14:14] talk to them about these issues, then they grasp those issues and go with it. So Linda, we do have a question that does kind of relate to that about the current staff shortage that's happening. So how do you think that relates to the scheduling right now?

[14:33] What was the question again? How do you comment about like the current staff shortage? How do you handle that? The team shortage is an absolute, a huge problem right now. And I still believe that

[14:48] if you're understaffed, you're going to have a big leaky bucket. So finding perhaps, sometimes I never put an ad out that said, wonderful job, great benefits. Not mentioning the benefits

[15:05] because you attract people who are looking for benefits, but my ads always read differently. Would you like to be part of a patient-centered practice that truly respects patients and team members? That'll get a lot of people right there

[15:21] because what's the number one missing link for most employees? Appreciation, respect. Would you like to be part of a patient-centered practice? And so that leads us to our second one, which is case acceptance.

[15:39] And I hope I'm not stepping on toes tonight. I'm pretty good at it, but in the South we learn that you tell people to go to hell and they thank you. So I'm going to go right into what I've gathered from 800 practices over 35 years.

[15:55] My next topic is a leaky hole is the case acceptance. And I want you to know that case acceptance begins with a mindset. And only 20% of the dentist I've met have the perfect mindset.

[16:13] And the mindset is selling is actually serving. And there's a very strong, strong, strong correlation between case acceptance and how a dentist or anyone in any profession,

[16:31] how they feel about the selling process. I left industry for six years and was with a sales company when my two children were small. And I will tell you that I learned a lot about selling and the selling mindset.

[16:48] And I learned that selling is serving. And so doctors, if you can't connect your patients with the dentistry they deserve, you are not doing your job. And my question to you to know on a scale of one to 10,

[17:06] how positive your mindset is about the selling process. Ask yourself this question. It would be fun to ask your team what is the score on where they think you are on this scale. One to five would even be good. And that is how do you treat salespeople

[17:22] who try to sell to you? How do you talk to sales reps who call or come by your office? Do you avoid salespeople like the plague? We all get sick and tired of spams and scams and all of those types of robo

[17:41] calls, but I will tell you this. Having respect for people who are in the selling profession will increase your case acceptance dramatically. So I want you to really think about how you are as a customer when you go to buy anything. Are you respectful or are you a tire kicker

[18:03] and are you actually rude and abrupt to people who educate you about a product or a service that will make your practice better? So take a look at that. That's the number one thing on case acceptance. Next on case acceptance,

[18:21] I believe that case acceptance doubles when your dental team is involved in setting the stage for case acceptance. My doctor that I learned all of this from, my last employer in Richmond, Virginia, Dr. Wilson was a master at hiring

[18:39] and training his team. And he knew the important role that the team played from the person at the desk, which was me, to his two assistants and his hygienists. He knew that we had more conversations with his patients than he actually did.

[18:58] And I used to do a seminar on the eight phases of patients visits and eight patients of communication. Number one is the telephone. Number two is greeting the patient warmly when they walk through the front door.

[19:13] Number three is registering the patient, which is most often done online. Number four is seating the patient. Number five is doctor or treatment time. Number six is patient education, post-treatment patient ed.

[19:30] Number seven is reappoint and present fee. And number eight, how do you greet your patients farewell? Do they just walk out or do you greet them warmly as they leave and thank them for being your patient and asking them if they have family, friends,

[19:47] or neighbors who don't have a personal dentist, remind them we'd love to see you, see them. And so there's so many little touch points and believe it or not, doctors, you are responsible for one of those. Only one, the assistants and hygienists

[20:06] are responsible for three, four, five, and six, seating during treatment and post-treatment patient education. The administrative team is in charge of five and you say, well, that adds up to more than eight. Well, there's some double there

[20:23] as far as doctor and assistants and hygienists, but you have one opportunity and eight doctor to build your own practice through communication. So when I say your team makes or breaks your practice and especially the administrative team who has five opportunities in eight

[20:41] to make or break the practice. And so one of the ways that let's go back to the number six, post-treatment patient education. I proved to my clients over the years and it didn't take many of them long to say, wow, that was the best change we made

[21:00] is to allow their very well-trained dental assistants to do pre-treatment explanations and post-treatment reassurances, home care instructions and explaining what we've done today, what we're going to do on the next visit. And the most important thing

[21:18] a dental assistant or hygienist can say to a patient post-treatment, you should never say, if you have a problem, give us a call. They're going to think that people have problems with what you just finished doing.

[21:32] So please do say, Mrs. Miles, we don't expect any problems with those composite restorations, but if you have any questions, give me a call. So it's all about communication. Case acceptance starts with communication and trust

[21:52] and I believe in ideal dentistry. I do not believe in patch and go. I believe that not all patients can afford to have ideal dentistry when it's first presented to them. We all know that, but the word phase dentistry

[22:11] is such an important word and letting patients know that they do have a lot of treatment needs, but if it takes us two years to do this right, let's do it right, not over. And there's so many phrases

[22:28] that I learned from my last doctor in the way in which he communicated. And I was so thankful for those four years because I learned so very much from him. One of the things that I will also mention is that 70% or thereabouts

[22:47] of large treatment plans fall apart at the front desk. They fall apart when the fee is presented and I'll go through how I've heard it 85% of the time and I'll go through how I feel it would be enhanced if it was done differently. And so let's pretend that I'm the patient

[23:10] and let's pretend that I have sort of neglected my follow-up care and I've kind of been busy. And let's say that I come in for a complete new patient exam, come back for the full consultation, the clinical, the doctor or the treatment coordinator

[23:28] presents my clinical after the doctor finishes his or her review of findings and the patient has now heard from the doctor or the hygienist or the assistant treatment coordinator and now they're coming up front and they have no clue about the fee.

[23:49] They came in or I came in thinking, I bet I need hundreds of dollars worth of treatment. It's been a while. And when I hear that my treatment is $4,500, I'm in shock and I'm really kind of at a loss of words. And so when the fee is presented,

[24:12] your total investment, Mrs. Miles, as far as time, the doctor will need to see you X number of visits over a period of X number of weeks and your total investment as far as the fee will be $4,500. And the patient, as I said, is shocked

[24:30] and they normally say, oh my gosh, I knew I needed a lot of treatment but I had no idea it was going to be that much and what is the normal response Well, give us a call when you get ready. We're here for you and the patient leaves

[24:48] and guess what? You never see them again. So doctors, if you're awake at night wondering about the woman in the red dress or the man in the camouflage pants that never came back again,

[25:04] I can assure you that it was the breakdown in the fee presentation. So here's what I would much rather hear and I learned to do this by probably losing a few patients when I was learning how to communicate effectively. One of the other things that I must say is

[25:23] if you are a person like I was at the time living from paycheck to paycheck you may be astounded by presenting larger fees. You have to realize that you are doing your patients a favor and there are ways that make it affordable for patients. So one of the phrases that I would use is

[25:47] if the patient said there's no way I can afford this I'm going to have to talk to my husband about this. The normal, the better response would be Mrs. Miles, if I were making this type of an investment in my total health I'd certainly need to talk to my husband as well

[26:06] and be sure and tell your husband our practice offers care credit which makes ideal dentistry affordable to every family in our community because you can make small monthly payments over an extended period of time.

[26:24] So mentioning, it just disturbs me how many practices have care credit and they don't offer it. And I always tell my audience I know that it's because the doctor has to pay a fee to have it in his or her practice

[26:41] but guess what 90% of a lot of cases is more than 100% of no cases. So I think it's the best thing since sliced bread and I'll have to tell Samir that privately since he's traveling tonight but anyway, getting back to case acceptance

[27:01] I also believe that the dentist has to feel really good about his or her dentistry so being clinically the best and providing the best administrative help and insurance and maximizing patients benefit plans

[27:23] they all think it's 100% no deductible and no maximum allowable benefit and we then have to break the news that that's not exactly what it's like. So any questions at all from the audience now Amber? No, nothing about case acceptance

[27:44] maybe we just have one coming here. Do you have any other do not say examples? Oh, I have thousands of them. Like for instance, when you answer the telephone and can I share a true story that happened to me that fits right in with what we're talking about Amber?

[28:03] Okay, I moved here four years ago in August to Florida and I was busy unpacking and all of that and realized I was past due for my preventive care appointment. I didn't know a dentist in my area so I called a dentist that I had seen on emergency to replace a lower anterior,

[28:24] I came and think of a word, not a crown but a veneer, I lost a veneer and he put it on so beautifully and Dr. Thomas Stone was the dentist and he's 90 miles from me and I said I would come to you, your practice

[28:46] because I loved meeting your team and being there as a patient as an emergency and I said, but I need somebody close by and he referred me to one of his buddies and a very, very prominent, wonderful doctor I'm sure and the front desk handled my call so poorly

[29:05] that I actually thought she knows who I am and she's just saying everything wrong as a joke. It was so bad I thought it was a joke. So here's the conversation. Hello, my name is Linda Miles and I recently moved here

[29:21] and I would like to make an appointment, I heard your doctor's wonderful, I'd like to make a new patient appointment. Do you have dental insurance? No, I don't have dental insurance, I would be a fee for service patient.

[29:35] Well, our new patient visit is two hours long and it's gonna take us three to four months before we can see you and I said, you're kidding really? And I said, don't you leave flex time in your schedule for new patients?

[29:52] No, we don't do that. I said, well, can you put me on a short notice, call list, I live very nearby and I could come with a one hour notice. No, but you can call in from time to time and see if we've had any change.

[30:06] It was so bad, I honest to goodness thought she was spoofing me. Needless to say, I did not make an appointment there. Needless to say, I went to another wonderful office and I also will say that she did call me back about two or three months later

[30:26] and I said, well, thank you so much but I am going somewhere else and she said, well, good luck. I don't know how much money that woman is, talk about a leaky hole in a bucket. It's very, very sad.

[30:44] But that was my personal. So to give you one, when you answer the telephone, thank you for calling Dr. Wilson's office. This is Linda, how may I help you? They wouldn't be calling if they didn't need help. How may I help you?

[31:00] And if it was a new patient, I always ask this question, who may we thank for referring you to our practice? Oh, I didn't get referred by anyone or they might say, oh, Heather Davis referred me, she's been a patient of Dr. Wilson's

[31:16] since he opened his practice. Oh, Heather is one of our favorite patients. I can't wait to meet you. She sends us the best patients. You see that compliment is going back to Heather. So you have to learn people skills

[31:31] if you're going to answer the phone. This is not just a wham, bam, thank you, ma'am call. This is a very important practice building, patient helping call. Perfect. Linda, what do you say to patients who call and ask

[31:47] if the office accepts their insurance and that they do not? What's a good thing? Oh, I love that question. Well, another story. I was early for my medical appointment.

[32:01] I had my times mixed up and there was a nice dentist who had hired me to speak in Williamsburg years and years ago. One of my first speaking assignments, as a matter of fact. And so I thought, well, I'll just pop in and say hi to him. His office is across the street.

[32:17] And I walked in and the dental assistant was at the front desk that day filling in for, I guess it might have been even lunchtime. I don't know, don't remember. And she was at the front desk and a patient called and she had the speakerphone on

[32:35] and the patient said, do you take Blue Cross Blue Shield? And she said, no ma'am, we don't, but we do take Delta Dental. And I thought, well, that's not really helpful at all. So I didn't want to embarrass this young woman

[32:51] when she finished her conversation and the patient of course was lost. And I said, do you mind if I give you a little bit of advice because I used to answer the phone all wrong. And she said, well, I'm not even the regular person

[33:08] that sits up here, I'm an assistant and I'm just filling in for an hour. And I said, well, do you mind if I share with you a better way? And she said, oh, I wish you would. And I said, well, the worst thing you can say is no.

[33:22] And just please remember to say, even though you may not be taking any of the PPO's or whatever, you should say, in our practice, we see patients with all types of benefit plans. We do not however, participate.

[33:42] You see, there's a difference between the word participate and provider. We provide dental care to all patients with a lot of different benefit plans. We do not however, participate with any plans that would require Dr. Harris to reduce the level of care

[34:03] to the degree that those plans require. And so what you're saying is, but we also went on to say, we are happy to see you. We are happy to file your claim form. But the only difference is the way in which

[34:20] we handle your account. Our patients with that plan pay us directly. We use electronic claims processing and your reimbursement should be there within nine to 12 days. And when they see that pitiful reimbursement, they're going to know why this doctor

[34:38] is not on that particular plan. But open the doors to every plan because, I mean, don't open the floodgates. What I meant to say was open your doors to every patient, but you don't have to be on their plan, especially the plans that are giving 50% reimbursement or less.

[35:01] Linda, I would like to comment here in that when I first, I have a praise and then I have a question. Okay. When I first got into orthodontics, it was probably in the early 90s that I heard you speak and I really got into following your methods

[35:24] and your phraseology. And believe it or not, I was a very shy person then and I'm actually still a very shy person now, although David often calls me a liar for saying that, but I really am. Anyway, when I first started working in the office

[35:45] as a treatment coordinator, I was paralyzed with fear. And I literally did not know how to say anything or get the words out. And so I went to one of your meetings and I came home with a stack of notes about this high and I just started practicing them over and over and over again.

[36:05] And it helped me to be more comfortable addressing the issue of investments with patients. And you know, really, you're exactly right. We are in their service. And I still sign my emails till this very day. And that comes from you also.

[36:24] I sign it in your service because that is what I am. Oh, I forgot where I was going with that. You forgot your question. I forgot. Well, I didn't forget my question, but I forgot. Oh, I know what I was going to tell you.

[36:39] Also, so I was a treatment coordinator in a practice when I an orthodontic practice when I first started in orthodontics. But do you know, I have also worked for a manufacturing company as a dental sales rep and an orthodontic sales rep. And do you know, I still use those same phrases

[36:59] or I use those same phrases that I learned from you. So it's amazing to me how gentle and kind they are. And it doesn't matter if you're using them at your work, selling dentistry to a patient, or if you're selling dental products to a dentist or even in your personal life.

[37:18] Those phrases are just consistently wonderful and kind and confident all the way through those different genres. But I'm glad you mentioned that because really and truly, Wendy, it's all about our tone of voice because we can say the same phrase in a mean tone, a caring tone.

[37:42] They can tell by the tone of our voice sincerity and whether they should trust us. It's all about the tone. So here is my question in the chat from Robin, which this kind of intrigues me as well. And I'd like to know the answer.

[37:58] It says, how do you let the dentist know about conversations like this? They need to know. So just like make up a scenario like if I'm trying to improve my communication skills and I overhear someone at the front desk having conversations

[38:16] like what you're talking about that aren't very positive and they're very harsh. How do you address that to the business owner or even maybe to that person that's speaking? Well, I think that people basically all the dental team members I've ever met, maybe I could count on five

[38:35] fingers, those that just were just adamantly, you know, rock walls to talk to. But I think basically all team members really want to be the best they can be. And I don't believe they have the proper training and training is everything.

[38:52] And as a consultant, when I first started consulting, my boss was bragging about how well his practice was doing. And a lot of his buddies thought it was me. It was actually him. But I took a little bit of credit for it with my little

[39:06] rinky-dink three-ring binder systems that I created and the verbal skills. And when I went into a practice early on and laid on, I didn't say, oh, that's the dumbest thing I've ever heard. You're ruining it. I just said, you know, I used to say things exactly

[39:24] the way you're saying them. And I've learned a smoother and more positive way. Do you mind if I share that with you? So I think asking permission to correct them is a positive way to get them to want to and to actually thank you. That's good.

[39:45] And then if it's the dentist, may I tell you the worst case presentation I've ever heard in my life? I was working with another consultant in training at the time. And we were in this wonderful practice. It was a southern, southern practice.

[40:06] And the dentist, I was a dental assistant. So I can look at x-rays and see rampant dental problems. I mean, crowns with evidently decay and leaky margins and all sorts of problems in this woman's mouth. And she was a physician. And anyway, the doctor was standing in the hallway

[40:30] and I'm looking at this as, wow, this is going to be a big treatment discussion. And he says, well, Dr. Mary, you've got a lot of problems there, but they're not too bad. And so when you get around to it, will you give us a call? We'll get started.

[40:50] I couldn't believe my ears. I think it was the worst fee presentation. And then one of my consultants was in a practice. And this is what she heard on the telephone. It was an implant practice and a brand new person. You know, a lot of dentists think if you're new,

[41:07] you can do the phone, which is the most important instrument in the whole office, the phone. Because if it isn't used properly, the handpiece doesn't go around. So anyway, Shar said she was standing in the back in a brand new front desk

[41:23] person answered the phone and had seen one of their ads for implant dentistry. And the new person on the phone turns to the other person and said, do we do implants here? Yes. That's what we specialize in.

[41:38] Yes, ma'am, we do implants. And the patient must have said, and how much are they? And she turns around and asked the person who should have answered the phone. And she gave her a very lovely definition of a fee range. Yes, ma'am, there about 3,500 is screw.

[41:57] So talk about bloopers that we consultants have heard. We could write a book on them. That kind of leads me to another question that I was going to hold until the end of our meeting. But maybe you can address it now or later in your presentation in that I heard someone speaking the other day

[42:23] about the positive correlation between onboarding processes and employee retention. And I think it goes up like 30% or 60% or something like that employee retention does. Because in the chats, we have all these comments of people talking about how we can't even get a warm body to show up.

[42:50] We need help on how do you hire and different things like that. So somewhere in our conversation, can we talk a little bit about onboarding? And with the example that you just gave, that person was thrown onto the phone and had no knowledge about what they were training whatsoever.

[43:12] And completely embarrassed the doctor's office, probably lost that patient and definitely lost the service. So can you speak to a little bit about onboarding and training of initial employees? I sure can. I wasn't planning to talk about the DIY,

[43:28] the digital dental consulting program that Nancy Crossin has created and is still absolutely smoothing and making it better every time we talk and meet. But it's a complete in-office training program. It's all digital. And anybody that's interested can look it up,

[43:51] DIYdentalconsulting.com. And to me, it's the best thing I've seen in my 60 years in dentistry because it's a lot of things that we're talking about tonight. But it's a complete and it's not replacing an in-office consultant.

[44:08] That is the best thing to do for your practice is to work with a consultant. I was a consultant. I know the results that we have. And so that's the very best. But only 20%, 15%, 20% can afford in-office coaching

[44:25] and in-office consulting. And what can they use before they can get to that point to bring in a consultant? And many times they get the DIY program and look at it and it's completeness and they still have their consultant come in and do four workshops to do it in chunks, the training.

[44:46] So it's a fabulous tool and it's all downloadable. It's audio. They can listen to it anytime. It's just a phenomenal, well-done program. And there's a lot of others out there, I'm sure. But that one is near and dear to my heart.

[45:02] And onboarding is so important because we're thrown to the wolves if we're a team member. I do want to talk about team and the advantage of having a well-trained team. But I want to talk about a motivated team. What causes team members to be motivated or burned out

[45:23] or demotivated? First of all, I'm going to probably get in trouble again because I firmly believe as a business owner that we business owners set the stage for the rest of the team. Happy dentist equals happy team members equals happy referring patients. So my question to the doctors that might be watching this,

[45:48] how happy are you? How enthusiastic are you? Are you the first one that arrives at the office to have coffee making and chilled orange juice for the morning huddle? Or do you come in late and do you have a scowl on your face and do you look worried and unimpressed?

[46:06] Please mark this down, doctors. Happy motivated team members come from happy motivated employers. So that's your assignment to start realizing that's one of the big leaky holes in your bucket is not having highly skilled and highly motivated employees. I always say motivation is a gift that we give ourselves

[46:31] and it's also contagious. I want to go over the signs of being motivated. Number one, we're always on time. If we're motivated, we can't wait for the day to start. We don't walk in and say, is it Friday yet? We walk in and say, I had a wonderful weekend

[46:48] and now I'm looking forward to a great week. I really believe this. When you wake up in the morning, look in the mirror and say, today's going to be a great day. Something wonderful is going to happen and guess what? It will.

[47:03] But if you wake up in the morning and you have, you are setting the stage for your whole day by the first 10 minutes of your waking day. So start your day off with motivation. You're always on time. You're helpful to coworkers.

[47:18] You use gap time in your practice productively, productively to help other coworkers who may have some other chores that are piling up. You also are interested in continuing education. You love going to dental conferences and learning and coming back and implementing that information that you learn.

[47:40] And you love being a mentor to new hires in the practice. One of the biggest problems dentists have is having a long-term team member. And I honestly believe in long-term team members. I think the longer my people were with me, the more valuable they became.

[47:59] But I also have met those team members who feel totally threatened by new hires who are sharp. And one such practice that I can share this story. A dental assistant was dynamic. She was good. But I said to the doctor, you have two busy treatment rooms.

[48:20] You need to hire a second assistant. Pardon me. In his rural area, he had a difficult time finding a certified dental assistant. So he hired one with the ad that I said, would you like to be part of a patient-centered practice

[48:37] that truly appreciates and respects patients and team members? And he hired this young lady with no experience. I get a call from the dental assistant at night after work. Linda, you're not going to believe this. When you came in our office, he hired somebody, but she has no clue.

[48:55] She doesn't know a tooth from a toenail. And he expects me to train her. And I said, Grace, if doctor had two of you, wouldn't it serve your patients better, your doctor better, and your production better? Well, yes, I guess it would, but it's not fair.

[49:15] I paid for my dental assistant program with my own money, and now I have to give it away. And I shared with her that evening that the greatest gift we have in life is sharing what we've been given, knowledge-wise especially. Do you know that her brother was in the Navy?

[49:37] She came to visit him in the Navy with her mother, took me to lunch, and thanked me for giving her that. And she said she was so proud of her mentee. So building dynamic teams is what it's all about. And the more opportunities for growth, I think that the better the atmosphere.

[50:01] And I also believe that there is no better marketing tool in a dental practice than having your team members brag about their doctor, his or her dentistry, in and out of the practice. And when patients used to say things like, oh, I heard your doctor's really good,

[50:23] but I heard he's also expensive. My favorite thing to say was we're very proud of our fees and our practice. They reflect the quality of care our patients receive. And so again, you have to believe in your doctor, believe in their dentistry, believe in their fees,

[50:45] and believe that they are the best boss in the whole wide world. And guess what? As soon as the doctor learns these four little words, and let's write those down if you have a pencil, H-T-T-P. H-T-T-P.

[51:04] You have to hire them, train them, trust them, and praise them. It's that simple. That's how you get highly motivated, highly accountable, well-trained dental team members. And so are there any questions about anything,

[51:26] actually, any questions at all? Well, Linda, we are just getting a master class in verbal skills here. I just love listening to the way that you talk to patients or encourage people to talk to patients. It's just so warm and welcoming

[51:49] and puts the doctor's best foot forward every time. I learned that because I had been a dental auxiliary for 14 years before I worked for my last doctor. I never had a dentist and talk about somebody that can take an ordinary. I was ordinary when I went to work there.

[52:10] Maybe he would even laugh and say, below ordinary, I couldn't cut every x-ray. But anyway, he would say to all four of us, I know that you ladies have a better solution than I'll ever come up with. Let's bring it to the meeting on Thursday.

[52:28] And he asked for our input. We would walk on hot coals for that man. He expected a lot, but he also gave a lot. And there were a lot of people that worked for him that actually went on to do bigger and better things. I mean, I was making 165 a week

[52:47] when I took my job in that office. And he always says that, well, a dentist in town wanted to come and work for him. And he said, well, you have a practice. Why do you want to come to work for me? She said, because everybody that works in your office

[53:03] becomes famous. That was 25 years later after. But anyway, I never had a boss that believed in the employees. And that's what made us all want to do so much better. He believed in us, we believed in him.

[53:20] It's that simple. And that works in any business, right, Amber? Not just dentistry. Yeah, definitely. Whether you're riding horses or doing teeth or, I mean, at all, it all goes back to, you know,

[53:38] the relationship and confidence. Any other questions? Last but not least. How much time do we have, David? We've got about another 15 minutes and people, you know, we've been kind of taking questions as we go.

[53:58] So we don't really have a huge backlog of questions. So it's, I think it's going to work out fine. And I can't wait to hear about systems. Oh, okay. Well, organized systems. We've already talked about our main system,

[54:10] which is engineering the schedule to utilize the team and maximize the doctor's time. That's the key. And I know for a fact that number six on my eight phases of patient communication, which is post-treatment patient education and pretreatment explanations,

[54:28] that will save a dentist seven minutes per day per patient. So I want every dentist listening to this to multiply seven minutes times the number of patients he or she sees daily and then figure out what that time is worth to them. It's a no-brainer that delegating a lot of the communication to the well-trained, verbally trained staff is going to save

[54:58] the doctor a lot of time. It doesn't mean that we don't want the doctor to talk. It just means that there's a lot of double talk. You know, the doctor will say it and then the dental assistant will reiterate it. And then the doctor will say, you know,

[55:13] I'm not going to talk about the patient's thing. I've heard this before. I've got to go, you know, so deciding who's going to say what is like working in an office is like that's well-organized and everybody knows at what point it's your turn to take over and finish the treatment of this patient.

[55:30] It's like a well-defined orchestra. And so the doctor shouldn't have to do all the heavy, heavy pulling and communication. And so that's what I'm going to talk about. The re-care system, we did mention pre-appointing in hygiene and have a set time blocked off each week.

[55:48] I always ask my audience to X off two hours a week of non-patient time to do the behind the scenes work like reactivating phone calls and so forth. And one doctor was sitting there, you know, doctors are quite analytical. Oh my gosh, did she say two hours a week?

[56:07] No, it's a 30% increase in production because all of our behind the scenes work is done effectively. And that is reactivating all the floating recalls. And one of the phrases that I taught when you're reactivating a patient, you would call and say, Mrs. Jones, this is Linda from Dr. Wilson's office.

[56:29] We're just going through our files and realized it's been more than eight months since you saw our hygienist or your preventive care appointment. I'm calling you today to reserve a time with Amber before all of her appointments are gone for this month. And we left flex time in our schedule for scaling and root

[56:54] planning. We left new patient flex time because when a new patient calls your office, they want to be seen in five or six days. They don't want to be seen in 10 days or 20 days or three months or whatever.

[57:10] So having the schedule with flex time and having your team with gap time on the schedule, even the doctor needs two hours a week of nonpatient time to return nonurgent phone calls to write up treatment plans to clean off their desk and go through their mail. I mean, there's a lot of down.

[57:32] There's a lot of behind the scenes work and I can assure you your practice will increase dramatically with with set downtime. And then we want to talk about there's so many systems now insurance and collections. I had a collection system that if a patient was

[57:50] past due, I called them every 30 days without fail. And when I talked to them, I said, and Mrs. Jones, when do you think I can expect a check on the account? They might say by the 50 I'm going to send a check on

[58:06] the 15th. Well, on the 18th, if it wasn't there, I called back. I even had a patient say to me once, I told George that nice lady from Dr. Wilson's office is going to call again. And so I made friends making collection calls.

[58:23] I didn't. I just really feel like that the money has to be in the bank and not on the books. And so I didn't mind making those calls. We also have marketing and we had a complete marketing system.

[58:39] No one is better at setting up a marketing program than a marketing expert. But I will also tell you that we had a marketing program in our practices that the team, it was led by the team and that is I'm plugging in my computer.

[58:58] I noticed my battery is getting a little bit low. Sorry about that. And so the marketing system that I had set up is you should have three people plus the doctor on the marketing committee. So the three team members, one hygienist, one

[59:18] admin, one assistant, and you asked them who would like to serve on the committee. And they know what our marketing budget is. If it's going to be five or six percent of our collections, we believe that two thirds of marketing should be internal, one third external.

[59:36] And thanks to technology today, there's a lot more external marketing and it doesn't cost money like postcards and letters and things we did back in the olden days. But in office marketing program is that the team members came up with how we would spend our

[59:57] marketing dollars. The doctor had to approve because everything needs to go by the doctor owner. And so I find that when people in the office are in charge of knowing how much money we're going to be spending this month on marketing,

[1:00:14] they can come up with some pretty creative ways to bring patients in that don't cost a lot of money. And there's no better marketing tool in your whole office than having patients that are happy.

[1:00:28] And when they leave your office, if you have any friends, relatives, neighbors, or co-workers who don't have a personal dentist, remind them to always invite, invite, invite others to refer to your practice. And patients would often turn around and see all

[1:00:45] the charts and say, thank goodness now we have digital charts, but back in the day we had piles of charts behind me. And they, oh, is he taking new patients? You know, when they see all those charts and especially in a practice that keeps patients

[1:01:01] waiting, they think, well, I'm not sending anybody here. It looks like you can't keep on schedule as it is. You don't need any new patients. So being on time is a marketing tool when

[1:01:12] you think about it. Also, there's HR. I highly recommend Tim Twig with Bent Erickson and Associates as far as HR, risk management, compliance, and on and on and on. There's just so many systems out there.

[1:01:30] But the main thing to remember is that with any system, it has to be worked. And when a system isn't being worked religiously, it starts to break down. Any other questions? I have a question about marketing for, I

[1:01:56] don't think so much general dentist's office, but specialty offices. They'll have a person that is in charge of reaching out to general dentist's office or marketing special delivery care packages and different things like that

[1:02:15] to their referring offices. How do you think the best way to go about doing that is, I mean, is one person the right person to have or do you vary it between different other employees? I think having a team effort is actually

[1:02:33] better. You might have a committee chair, but having other input with, you know, from the other team members, I think it's real important to do that. And one of the things that was asked on

[1:02:48] the Academy of Dental Management Consultants this evening is, Katherine and I tell ask how, does anybody have any tips on communicating with, if you're a specialist to referring doctors? And I shared with them something that I

[1:03:05] saw in one of my endodontic practices years ago in Nashville, Tennessee, fabulous practice. Every general dentist wanted to be there, wanted them to be their endodontist. And I usually said the doctor should

[1:03:19] never go near the front desk during office hours that the team members should escort patients back and forth. But in that practice, I didn't say that because all three doctors escorted their patient to the checkout person

[1:03:35] and said, Ann, I've already discussed with Mrs. Jones. She definitely wants to preserve her investment of the root canal therapy. I want you to get on the phone right now and call her dentist office and schedule

[1:03:51] her full coverage crown. So talk about a cross referral. It's the best thing that a specialist can do. You know, the food baskets, the food baskets, one doctor said to me, why don't specialists stop sending carbohydrates?

[1:04:09] I have to buy new uniforms every year because they all gain weight. So food is love. And I used to tell my specialist that the best two holidays are Halloween and Valentine's Day to surprise

[1:04:25] the team members of the referring doctors to the hospital. And then on Christmas, you're overwhelmed with gifts. And so, yeah, just remembering that all year long, what can we do

[1:04:42] to help Dr. GP's office? What can we do? It's not a one-way street. You know, I talked to an orthodontist about this once, and he was telling me a wonderful story.

[1:04:59] So instead of taking goodie baskets or care baskets or something, the marketing person was also trained in the clinical aspect and treatment. And so she knew exactly which offices,

[1:05:17] which GP offices she was going to go to that day, and she actually printed the patient had a new appliance in place. She would print out parts of their treatment card, of course, so she could help remind herself of exactly the points to talk about.

[1:05:35] And she would go into the GP's office and she would sit down with the doctor or an assistant if available and would actually say, we have a mutual patient, Jenny Smith. I wanted to update you on what we're doing with her treatment now.

[1:05:52] I'm going to update you on that. I'm going to update you on this when she comes in for her cleaning, which we're going to recommend every three months instead of every six months. And he said it was just absolutely working.

[1:06:09] Absolutely. Well, folks, I'm just speechless at the amount of wisdom and value that Linda has given me so much. This has been just wonderful. And I've heard you speak many times.

[1:06:26] In fact, every time I can and every time I come away and say, wow, where is the bottom of this knowledge pit? And I'm not sure it exists. Well, I was worried, David, because I had 10 pages of notes in one hour. I kept condensing all day today.

[1:06:43] Well, you did a marvelous job. I can't thank you enough. It's like a conversation over coffee. Well, that's exactly what I was hoping we could have. And my expectations were high and you managed to exceed them by

[1:07:02] a considerable margin. So we've a couple of quick announcements. We're hoping to have Linda back probably in October. And also, we've got a great guest for next month. Dr. Rich Maddow is going to be with us.

[1:07:19] We'll let everybody know in the next week or so the date and that kind of thing. But he's a very interesting guy and he has a lot of things to say that I think the audience will find valuable as well. So Linda, thank you from the bottom of my heart.

[1:07:37] Thank you all very much. And this was, wow, definitely one of our best. We look forward to seeing everybody again at the end of next month. Thank you all and good night. Thank you. Bye. Thanks for listening to the Dental Practice Owners Podcast

[1:07:55] brought to you by Prosperident. You can contact Prosperident through its website www.prosperident.com or by calling 888-398-2327. If you have questions about this podcast, if you would like to discuss your practice

[1:08:13] or there is a topic you would like to see in a future podcast, we would love to hear from you. Amber, Wendy and David will be back soon with another episode.