Honing Your Practice Owner Skills

Auto-generated transcript: Honing Your Practice Owner Skills

You are listening to the dental practice owner's podcast. Brought to you by Prosperident. From our unique perspective as dentistry's and bezel-lit 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, talk about the issues that matter to you. He named into a family. So happy that you are able to join us this evening. And spend some time with us. I'm Wendy Askins, Prosperident, Superbizing Examiner. My co-host this evening, our Amber Weber,

a Superbizing Examiner at Prosperident. David Harrelitt Harris, our fearless leader at Prosperident and Dr. Wayne Kerr, is joining us as a special surprise tonight. Leaving. Hi Wayne. Hey Wayne, how are you? Great to be with you tonight. What a privilege.

Thank you. So good to have you. Awesome. And it's my pleasure to introduce a guy I've known for years. He is one of the finest men to ever walk the planet in my mind. His name is Wayne Kerr. He is a former practicing dentist. He's a master of the Academy of General Dentistry,

which is a pretty elite group. He's now a teacher and educator and speaker. Wayne is hands down the coolest senior citizen I know. He's got a lifetime of experience. And we were just delighted to have him share it with us. So Wayne, it's great to have you. And we look forward your contribution tonight. If you're a great pleasure and privilege to be here.

Thank you for your very time words. There's a challenge in being a practice learner. In addition to doing good clinical dentistry, because if that part doesn't happen, nothing else is really important. You wear a lot of hats as a practice learner. And you're stretched a lot of ways. And really what we're going to do tonight is try to give you a little bit of help and some tools in handling some of these areas.

And I'm going to quote a couple of people. I'll start with Harry Truman, who said the buck stops here. And I guess another way you could put that is that crap rolls downhill and as a dental practice learner, you're going to forever live in the valley. So how do you make it work? Well, there's a business strategist who does a lot of work within us. His name is Chuck Blakeman. And Chuck wrote kind of a seminal book a number of years ago.

And the title of the book is making money as killing your business. Now, this book is not specific to dentistry, but it certainly fits. And the temptation is always to, or the trade-off, that you always make is between, I spend the next 20 minutes doing something inside somebody's mouth, or I spend the next 20 minutes doing something that runs my business. And what I'll say is that most dental practice owners suffer from a predisposition to the first one. That's the happy place. That's where you want to be.

And that makes it easy to make the decision in terms of doing something billable in the next 20 minutes. David, can I explain to you a short story? Please. So it's my first week in my first practice in 1978. I have, this is my new dental supply rep. And I leave the app at the door. And I come out.

And I spend several minutes meeting him and getting to know him. And telling him I'm looking forward to working with him through the coming years. He says, you can't be here talking to me because you're not making any money. Unless you're back in the app at the right spin on the bird and grind it down. Somebody's tooth. And I said, no, I think I will learn a great deal from you through the years with regard to new products, new techniques, new pieces of equipment that can help me perform a higher level, provide a greater level of service, being more efficient, and therefore,

or productive, and therefore more possible. And that's my story that I learned early on in my career that you got to work on your business as much as you work in your business. And that's a very important point. Absolutely. And very theoretically, everybody who's here listening to us tonight could be doing the same thing tonight. Good night. I mean, they could be spin in the bird and treating people.

Some time investments that do not directly generate you revenue are, are still vitally important. And we're going to talk about a few of those tonight. We are going to talk about a few of this. And the first one starts with accountability. That's owners accountability by the way. In my entire career in dentistry in orthodonics, it's been heavy in delegation. And I've loved that because I've been able to do so many different things within different practices and different businesses. But delegation does not need application on the part of the business owner.

The business owner still has to follow up on that's delegated task to make sure that they're being completed accurately. The very first casualty of investment is transparency. And that's Amber's quote. Oh, Amber. Listen to that again. The very first casualty of investment is transparency. I'm often baffled about what sometimes when I speak with clients and I'll ask them questions and they'll just say, I don't know. You know, and of course they didn't know the investment was happening, but there's no follow up.

And then, you know, someone once told me, you know, I ask the same question. I ask for this employee to explain these transactions to me for over a year. And she just told me, don't worry about it. I haven't taken care of. You go back in the clinic and you do your thing and let me worry about it. So again, there we see there's no transparency in the transactions that are being completed. And also, you know, we often talk about our teams being families like our daytime family and she's my work BFF, however you want to call them. But I'm baffled also how it is that there are some people who get threatened if you try to make a suggestion to them or you offer advice to them

or you ask them to train another employee so that you can do cross-training. This is an issue because in best-lers don't like for anyone to be in their space. They want to be alone and they have to be secretive and they are not transparent. But accountability starts from the top. The greatest, what's the word I'm looking for Dave? Detection is the greatest what?

What's deterrent? Detirent. Oh my gosh I failed the test. What? Detection is the greatest deterrent to investment. So if an investor feels like you're on to them or you might be detecting some issues with that, just step up and ask them that question. Because accountability starts at the top. It starts with the business owner asking questions, making the staff members aware that the business owner is looking at certain reports or they are doing a reconciliation and they're looking at what goes in the bank. And it doesn't come naturally for healthcare givers because we want to trust each other with our full hearts. We want to give our hearts to our patients and our staff. But you have to start

that culture of accountability with your staff members. So Wendy, I want to jump in here because I have a fun story to share about this. This fun little name tag. When I was an office manager, I did a little workshop because I was having an issue with that transparency that we're talking about. I would ask, if they had completed their duties that I had delegated to them. So there I was doing that transparency. I was trying to check and do what you're saying. And nobody wanted to actively participate in that task. So I made name tags that were very similar to this. And for two days, everybody in the office, including the doctor, wore the name tag around that said, hello, I'm accountable. And it completely changed the office. So fun little experiment to try

in your office. Patients asked about it and we said we were doing a research project for our team culture environment and patient flood it. They thought it was great. Good answer. So if we were going to further for the benefit of the audience, Wendy, if we were going to define the difference between delegation and application, how do we do that? To me, delegation is when you assign a duty to a staff member, and you go back and you're accountable for following up with that staff member to ensure that it was done. For example, if I stay to a staff member, I want you to run the day and report, close out the day and report in the deposit, take the deposit to the bank, get a receipt from the bank, that the money has been deposited, staple it to the day sheet for that

day and put it on my desk. That's total delegation. The accountability comes when the next morning, if that day sheet is not done exactly that way and placed on your desk, you follow up with the employee and say, I've noticed that the day sheet is in on my desk, what happened last night. That's delegation and accountability. Application on the other hand would be to give this specific instructions to your team member and not check the next morning if the day sheet is on your desk or not. You're just assuming that they did it. You've advocated the responsibility of following through. When you think to yourself, I don't ever want to deal with this problem again. That's application. That's good way to say it.

Yeah. Well, yours was good too. I'm just rephrasing.

All right. We just talked about this at start in the details. The first thing you want to focus on is daily. What does me had a quote and he says, there's no magic and magic. It is all in the details. I found that quote really inspirational. I think about your practice that way. It's going to happen throughout the day is reviewed and in place before Disney opens the gate and starts selling tickets. Similar to starting your day off in your practice, that's where your morning meeting is. You're going everything. How do you want the data to plan out before you open the doors to your patients and allow them to come in for treatment? So think of it as that. You're setting that culture before you're open your gates and start selling your tickets.

The other thing that you want to talk about is that what we're talking about this accountability is that's where as a team you can say here's the duties that we delegated to you. What happened to those reports yesterday? This didn't get entered into the software completely or correctly. So that's the other thing where that morning meeting sets the tone and it also lets you help hold everyone including yourself accountable. So we talked about Walt Disney. They know the plan before they open the gate and sell the tickets. So let's say about it this way. On a Walt Disney ride you can go through the day and it's a great ride. Great experience. You go like here on space mountains. Everything went great, right? But Walt Disney has a plan

and a structure to make sure they know that the ride went good. Everybody gets off. They're safe. They're secure. So same with your end of day. You have to review the end of day of the details because you might have thought it was a great ride. But if you don't focus on those details, you're missing a huge huge part of the puzzle. So for instance, did you produce what you thought you did? Does your schedule match the reports that come from your software? The other providers in the office. Did they establish their daily goals? Are you guys meeting your target? Adjustments. This is a huge one. Are these being reviewed on a daily basis to make sure that they're verified? They're valid. Did they make sense? Who is your

then? Who on that seat on your seat is going to be accountable and have the discussion that everything is making that Walt Disney experience that you're trying to shoot for? Go the way it is. The payments that were collected. You have that standard in your office. You have a system and a structure. Are your team members following the system and structure that you guys have set place in the office? All about the safety, the security and the stability of your office that daily focus on the details. Go back to what Wendy said. This doesn't happen by accident. This is one of those places where if you... don't take five to 10 minutes at the end of your day to look at what happened today and

and look at all the things that Amber told you to look at. That's one of those cases where not spending that small amount of time can cost you a lot. I worked in an office years and years ago where just because of a little communication mix up, all of the radiography that hygienists were taking was not being built up. And when you think about how much money is involved in that year, this is a one-denist, two hygienist practice. It was probably $80 to $90,000 that was just vanishing into thin air. And that can happen, but what that told me was that the practice owner was not taking that 10 minutes because if he had, he certainly would have noticed that. So it's tempting to say, yeah, if I'm going to spend that extra 10 minutes, I'm going to spend it clinically.

You know, I need my turn a couple hundred dollars conceivably by doing that. This guy's time would have been far better spent on a little bit of review. What do you think, Wayne? Spot on for sure. You said a mouthful. All right. Well, I get to say one more. Part of your financial writing hurt on your practice happens at the end of each day. And the other thing I meant to mention, and I'll say it now, delaying that review to the next day or, or, you know, Monday, following a couple of days off is useless. That stuff really has to be done while everything's fresh in your mind.

You know, if you, if you, if you postpone that review, you know, I'm really tired. I'm going to go home, or I've got something on that I've got to get out of the office for. If you do any of those things, you, you greatly diminish the potential value. So there's a daily part, and there's a monthly part. And every practice on our needs to do a little bit of a monthly audit. Some of the stuff that needs to happen is delegatable. Some of it isn't. The delegatable part is tying what happened in your practice management software to what happened in your practice financially. In other words, your software keeps track of how much money should be deposited. And we have to ask a very simple question. Did that money make it into the bank? And again, this is not something you have to do

yourself. And, and if you're saying right now to yourself, you know, I didn't go to dental school to be an accountant. I get it. This can, this can be outsourced. And outsourced is different than delegated. Right? outsourced means to somebody who does not work in the practice. Like, for example, a bookkeeper. Or if you are one of those lucky people who has a spouse who is prepared to tackle something like this, then it can go to your spouse. It cannot go to somebody in the practice because that's like handing the fox the keys to the hand house. We have something called a monthly monitoring spreadsheet. And gosh, I forgot to put it on the end of session email that's coming out in about an hour. You know, I'll also note a separate email with a link to this for you. This is a

spreadsheet. A lot of practitioners use it. And what it does is it does they have a lifting in terms of math. So essentially what you do with this spreadsheet is you enter your day end results each day as they happen. And it will cross add them for you so that when you're looking at a monthly report, you can make sure that it lines up to the 20 daily reports that you have. It also does some ratios and stuff like that. It's, it's a very handy spreadsheet. I will send it a separate email probably tomorrow morning that we'll have a link to that because I, I meant to do it for tonight and I get any of our some reports to look at on a monthly basis. The first thing I want you to look at is the accounts receivable's report. But let's

print it two ways with credits included and also let's filter out the credits and look at the report without credits. Sometimes things will happen where for example patients will have offset offsetting debit credit balances. A place where this could happen is if a payment is posted to the wrong provider. So Dr. A does the work and when the money comes in, the payment is posted to Dr. B. If that's done, the patient will have a zero balance in total. But there's an offsetting debit balance with one doctor and a credit balance with the other. So when you filter the credits out, you tend to see that stuff much more handling. The second thing to look at is called the insurance aging. And I'm, I'm giving generic names for this stuff. They may be a little different in your

own practice management software. But I think from what I'm telling you, you can figure it out. Insurance aging and really what that tells us is which insurance claims are overdue. Which one's have been sent out and not paid by an insurance company somewhere. And fundamentally, there's a lot of money potentially sitting in those unpaid insurance claims. Are they things that are being bounced by insurance companies and your staff aren't assembling whatever needs to resumpt them or what's going on. It's a very illuminating report. And then a couple of things to look at. And again, most software has reports for these deleted modified transactions reports and adjustments report. A few other things to look at. One big one, and we've said this in a previous webinar,

but I'll repeat it now. You want to ask your alarm company to send you what they will refer to probably as the access log or the entry log. So this is the recording of when people are in disarm your alarm system. And the point of asking them to send this to you is it's a great chance to see if somebody is sneaking into the practice at times that you wouldn't expect anybody to be there. Let's remember that thieves want to be alone when they're doing their dirty work. And the access log is one of the best ways of finding out if somebody is doing that. Let's look at your payroll report. Does it make sense? Is there an hourly rate there that doesn't look right? Did somebody who's in charge of payroll, for example, you know, literally give them self-raise?

And one final report that I want you to look at now that in most practices, prescriptions are being sent in electronically, and generated through your practice management software. Let's look at the report for prescriptions. I got a call maybe a week ago from a doctor and he looked at this and he was just astounded at how many narcotics prescriptions were going out of his office. And he was pretty convinced that not all of them originated from him. So that's another one. We're worthy of a look. So that's your job on a monthly basis. To me, if you're a little bit organized, looking at all these things should take somewhere between half an hour and 45 minutes. Dave, I am about to come out of my skin over here. Oh, please.

I absolutely. love this list. And as you were going down them and reading them and talking about the importance of each of them, my mind was automatically triggered back to the cases that I've done even the payroll cases that bank reconciliation, the deleted modified payments. And this is truly, I mean, if you're looking for investment and not just investment, if you're looking for errors. Yeah. It's an error errors in the data. This is a wonderful comprehensive list, Dave. You know, when you, when you think of your practice like this, Bucking Bronco that wants to throw you off, this is how you grab the reins. Yeah.

And Amber's family race horses. You know, exactly what I'm talking about here. So that brings us to, you know, we talked about the audit. Now we want to talk about the analysis. As, as an owner, you also want to look at what is your goal and what have you accomplished. So as the overall office, what is your goal to produce as a team? And then what actually happened? What occurred? Review, what happened that allowed you to either go above the goal or below the goal? Because everybody's going to play a role in achieving that goal on a regular monthly basis. Aside from that, as the office as a whole, you also want to look at individual producers versus target.

So do you have any specialist that come into the office? Do you have high genesis at a part time? Do you have certain doctors that perform specialized procedures that may be that the other doctor does not. So this is where you want to really look at the analysis of what all of your team members and people who contribute to the success of your practice complete. Also basic key performance indicators. We will discuss this in advance and may. So definitely join us for that because we're going to really go into depth on this monthly analysis and what those key performance indicators are. But for me, the number one thing is new patients. So I look at this as who's excited to come see me that hasn't seen your face.

If you don't have that number growing, what can you do to increase that number? Because similar to growing a garden, we have to see it grow and flourish and get better. Just like you said Dave, I grew up on a ranch in Wyoming. So kind of a funny story here. When we used to raise hey, one of the key performance indicators was how much we couldn't each year make the hay improve per acre. So I was when I went into dentistry. I used to look at this as like, okay, I've got 30 acres of hay here. What can I do to make it better each year because the field is not going to get bigger. Your practices are going to grow, you know, as patients increase, you might be able to add a few opportunities here and there.

But realistically, what are the key things that are going to keep that producing more so little different analogy. As a hygienist for 15 years, one of the big things for me is okay, you got that garden to grow. But now we need it to come to come back each year. Be healthy, be fresh. So that's one of the key things that I really like to focus on is who's overdue. Why haven't we seen them as a team that delegation, how are we going to measure this in a metric and delegate those duties between a team and all be accountable for continuing to make this thrive and survive. And where you absolutely fascinate me, you're going to raise hey. I was like, how much pounds per acre did you produce and then you set that goal and next year you talk about, you know, what you're going to do to make that same pasture grow and be better.

Just to to step aside from the firm.

You know, which, which, you know, I know I know I'm talking to two gals from Texas when I say this. The thing about hygiene backlog is really this, do we need to add a hygienist. And, you know, one of the, one of the best ways to look at that is to look at how long the normal patient is spending between appointments. So if your cycle is built on six months. And patients are being seen every seven, a half months from hygiene. First of all, there's a revenue loss to that and secondly, then you have to ask the question, is it a, is it an inefficiency and getting them in the book or is there just nowhere to put them. And the decision that's going to come out of this is, do we need to add another hygienist or do we need to work on our. Our recall program because it's not working that that's the the outcome from what we're doing here.

And, but, but, but, comment, I think it's as a fairly well known standard, but in a general practice for every 200 active patients of record, you need one. Full day of hygiene each week and it's very easy for the attendees tonight to look at their practice management software. Look at their active patients of record, which is defined as anyone who's been seen in the office for any reason at all within the last 18 months. And divide that by 200 see how many days of hygiene you have each week. And if in fact, you have enough chairs and a high genesis and enough capacity, but you're you're still backlog. Then, as you said, a moment ago, that becomes more of an issue of maintaining that ninety ninety three percent level of. Prevent care efficiency, bringing those people back. So that's a practice management failure rather than a capacity failure. And it's important to understand the difference. It's also important to understand on that blue box production versus goals.

It's it's so important that a practice owner knows what his or her fixed annual costs are. And if you know that and you multiply that by 117 percent now, you know what basically your fixed and variable costs are for the year. Now, if you then add in the doctor's lifestyle needs to run his or her family. Then you have a goal. And then when you divide that goal by the number of days that you and your team have agreed to work next year, you know how to daily goal. So while this slide is about a monthly analysis. I know for me that part of the end of day review when you're checking production and collection and whether the deposit matches that it's certain part of it was. And then he go to day because if I'm following behind my financial goal, I want to know that on day eleven and not day twenty seven of a month because that gives me the opportunity to step in my hired year and do what I need to do to make certain. I meet the financial goals of the practice and keep the ship afloat.

Yeah, that's true. You know one thing one good thing you can ask your CPA to do for you is to work out what's called a break even calculation. In other words, how much do you know. be have to earn this month to cover all costs. And I think Wayne, you make an excellent point. One of the costs you have to consider is what you need to keep your family in shoes and football pads. Great.

OK. So yeah, I was a, I was a, a treatment coordinator in an orthodonic office for about 10 years. And I did the same thing. I followed its production numbers like crazy every single day, because we wanted to make sure we were making it to go.

And we knew exactly how many more new patients we needed to see or sign up until we could get to our goal at the end of the month. There's a lot of discussion when we talk about production about if we use gross production numbers or net production numbers. And bear with me just one moment. The difference between gross production and net production

is that gross production is the dollar value that you have on your ledgers, right? If you take any adjustments off of that number, so let's say you offer a family member discount or professional courtesy discount. Those come off of your gross production. Let's say you have a contracted rate with an insurance company.

So you have to take that money off. That comes off of your gross production as well. So those who you take your gross production, your adjustments off of that, and then you have your net production. I personally, I would love to hear what you have to say about this. In looking at actual production,

I always like the number of net production, because my net production is where I actually have a possibility of collecting some net production and collections go hand in hand whereas gross production, gross production, you know, I may run around saying I have a $10 million practice. Well, if I have $9 million of adjustments, what does that make me?

I'm gonna spend $9 million. If my money is on any, you sign to any contracts. Yeah, so let's be really speak about it when you're looking at those production creatures. So, wait, you're talking about how you're absolutely right. You're absolutely right. You can't collect what you've written off. And you have to be honest and realistic

about what it is that your net production is. So I was fee for service my entire career. So I never had my loss yet, I'm practically, when we need to take care of somebody, we just take care of them. I work through three recessions. And we had many families just like many of the offices listening tonight.

You know, if you had a family cancel their preventive appointments because they'd lost a job or lost their insurance, we said, that's not gonna happen. We've been carrying for you for five or six and seven years, you're part of our professional family. You're coming in and we're taking care of you. And that's just a dentistry. The most impassioned profession on the planet

and the human beings, we have the need to care for it and give to others. And that's why many of us have selected this profession that you can't collect what you've written off. So, slide on, Wendy. Absolutely. And when you're doing ratio type calculations and you can see some illustrations of those on the slide,

most of the time you should be using adjusted production as the denominator and not gross production. And you'll see an example at the bottom, collections ratio. So essentially what you're asking with collections ratio is how much of what we produced did we collect. If you use gross production as the denominator,

then you're kind of combingling to concepts, which is the efficiency of our front desk at collecting and the contractual arrangements that we've made with insurance companies. I mean, those two don't have a whole lot to do with each other, but they either a change in either one could cause a changing collection ratio if you were basing it on gross production instead of adjusted.

So, to me, the only ratio that has gross production as the denominator is production ratio, which is just looking at adjusted versus gross in other words, how much are we giving back in adjustments? After that, for anything else you do, related to adjusted production, because as Wendy says, the difference between gross and net is really affection.

The only other thing I'll say about collection ratio is this. I get a lot of calls from doctors who say, I'm looking at my monthly collection ratio, and it really fell last month or the last two months have been down. And as soon as somebody gets there, I say, I'm just gonna stop you. Monthly collection ratio is kind of a stupid ratio. Why?

Because a lot of what you collect this month is a function of what you produced last month. In other words, the causality isn't all that strong. So if you picture a month where you take two weeks off, in that month, your collection ratio looks fantastic. Why? Because you're collecting a full month from last month and you're applying it against a partial month of production.

So your ratio looks really good. And everybody passes themselves on the back. And if you have a bonus tied to this, people get checks from. And then the next month looks like crap. Because you're now looking at a month of collections that was impaired because you took two weeks off, going against a full month of production.

So I like collection ratio as a metric. But the only thing I'd say to you is that you need to link them at a time period that you're looking at. In other words, if you're statistically inclined, do a six month moving average. As opposed to looking at individual months, because it's very easy to either get artificially

congratulatory or artificially scared, simply because your measurement window is a bit too narrow on this. Definitely. Another thing I was like, oh sorry. That was me. Sorry. Another thing I really like to focus on from my experience

on a monthly analysis basis is your receivable turn over. So I always like to look at receivable as it should look like a waterfall when you print off this report. So if you look at each category, you're 30 day, you're 60 day, and you're 90 day, those percentages are those amounts should paper

and be smaller as each category ages. What I've seen in a lot of practices is sometimes the office is happening 30 days, you know, how? Because we just saw those patients, 60 days, it goes down a little bit, and then we start to see that climb, we don't see that waterfall effect.

So you definitely really want to look at your receivable turn over and make sure that you see that waterfall. processing your practice and each aging category. And you don't see a slow rise as each category ages. The only other thing I'll mention about receivables is I encourage people when they're doing what Amber just said to ignore this stuff that's over 120 days for purposes of calculations. And here's why practices follow different routines in when they write stuff off. And if you have a practice that is a little bit lacks, let's say it, writing off stuff that's

old and and cluttering up your receivables report. It's easy. If you think of it, if you were in practice for 20 years and you never wrote anything off, you're over 120 day receivables would be more than a year's production. On the other hand, if you write this stuff off, let's say monthly, you know, each month, you and your office managers sit down and decide what's uncollectable and take it off the books. Then your receivables over 120 days look very different, but it doesn't mean anything.

Whether you write that stuff or not, doesn't, doesn't really change anything in the practice. So I guess what I'm saying to you is that the 30, 60, 90 is stuff that is at least potentially collectible. The stuff that's over 90 is typically more or less dead. You know, you may be able to send stuff to a collection agency and get a little bit from it, but you just have to think of that as a repository where everything that doesn't get collected ends up eventually. And again, the speed of how quickly you recognize that it's not collectible and get rid of it, shouldn't really change anything about how you perceive your receivables are being collected. Let's talk about culture in the practice. And I put this slide up because once my wife made me go to opera.

And I was so proud of myself because I only fell asleep once. And after that, I told my wife, who loves opera, I said, you know what? I get my culture from yogurt. I think she thinks I'm a little bit of a filistine and she's probably right. But let's talk about corporate culture and where I'm going with this is the following. If the doctor bends the rules, the staff will do the same.

It can get worse than that. If the doctor bends the rules in a way that can get him or her in trouble, then that's like handing the staff a get out of jail free card. What am I talking about here? Things like if you condone or encourage or direct that corners be cut with insurance. If a patient gets tooth whitening in your practice and it gets build to their insurance company as a root canal. And you were behind that. You just gave your staff license to do just about anything to you and they know that they're immune. We run into this one a little bit. The people who play games with the IRS and they take the cash that comes into the practice and they put it in their pocket and they don't report it. If your staff know that that's going on, they have a huge lever

over you. And of course, the one that has has caused some peril sometimes is if the doctor is having an affair with a staff member. I remember distinctly years ago doing an investigation and I didn't know this one I got into things but eventually it came out. The doctor and the staff member who were stealing were doing a household I put at the mattress dance together.

And what the ambassador said to me was when Dr. Solanso was trying to decide what to do about my ceiling, he should just give a little bit of thought to what a divorce will cost him. And you know how this story ends. I mean, she walked away. So if you put yourself in a compromising position, bad things will happen to you and there's nothing you can do about it. So you've got to you've got to set the tone that conducting yourself with integrity is something that you do and you expect from others. And if you don't do that, we'll have a very unsatisfactory conversation in something. And talking about setting the cone, let's talk about an anti-fraud policy, which is actually a written policy, which defines what is fraud, what is acceptable behavior and what is not.

I find that in most employ policy manuals and anti-fraud policy is missing. So if you have one in your employ policy manual, good for you, way to go. If you do, guess what, we're going to give you one.

So the whole purpose of an anti-fraud policy is to define what is fraud, what is imbezlement, reporting of any suspicious activity, how to report it, when and who to report it, to conduct of an investigation and to make it clear that if imbezlement is found to be confirmed, that the person will be prosecuted to the full extent of the law. And one thing that I really love about an anti-fraud policies, I find a lot of my clients get trapped in between the, you know, oh, but she came to me and she asked me to forgive her and she said she would pay back half of it and she's so sorry. When I love about an anti-fraud policy is that it takes that decision out of the business owner's hands by saying an investigation will be conducted by outside sources and

outside counsel and if it is found to be confirmed, you will be prosecuted to the full extent of the law, in which case the business owner gets the white of their hands of having to make those types of decisions. That's really good, Wendy. I had that I'll confess that part hadn't occurred to me. Wow, yeah. The other thing too is that, you know, we all think that we understand what fraudulent conduct is, but there are a lot of gray areas and it's, you know, let's say, for example, that a member of your staff is offered by a dental supply company a cruise somewhere, you know, because because you guys bought a lot of supplies this year.

So they're doing continuing education and it's on a cruise. As a practice owner, I might have a little problem with that. But unless you define what is acceptable there and what is. And there's room to take different approaches, but unless you have a definition, you get into some really heated arguments with your team about what's acceptable for them to receive from third parties.

But let's talk about whistleblowing. And I'm going to give you an interesting statistic when we look at all businesses, so including ministry, but everything else as well. And we look at what's called occupational fraud, which talks about things like embezzlement, are detected, 43% of them are detected because of whistleblowers.

So this is somebody coming forward and saying, I'm a little concerned about what my co-workers doing. However, when we narrow our focus to dentistry, now this number falls to less than 10%. In other words, your employees are far less prepared to come forward on average than people working in most other businesses.

So a couple of things come out. We need to ask why, and secondly, there's a huge opportunity here. If we can make our people feel more comfortable about the concept of if you see something, say something, then your chances of catching embezzlement that's going on in your practice go way out. So let's ask what the barriers are,

and then think about what to do about them. Hey, Dave, I'm sorry to interrupt you. Can I ask your question real quick? You can. I'd be helpful to put this in context. If less than 10% of dental employees come forward to make it a way or to the business owner, what would you estimate is the amount of people

who come forward after the investigation has been completed? Just say, hey, I know with my cases, it's an awful lot. Almost every time someone knew something and just didn't say. Yeah, that's a really good point, Wendy. It's not that these people are unaware. It's that for whatever reason they don't feel comfortable,

going to the doctor or the practice owner and seeing, you know, my boss, the office manager, did something the other day that I'm a little bit concerned about. It's that conversation that's not happening. And Wendy, I don't have a number of statistics, but my perception is in certainly in more than half of our cases, somebody was unaware and or somebody was aware rather and chose not to say anything.

So to me, it's a disclosure problem, not an awareness one that's causing the gap between 43 and 10. So ask ourselves why? The first thing is of course, they've compared with most businesses, dental practices tend to be small places with relatively few employees and one of the concerns about somebody coming forward is, is it going to get back to my boss, the office manager,

that I went to the doctor with concerns. Of course, a lot of people have that question, you know, I don't want to cause trouble for somebody if I'm not right. I think in a lot of practices, the loyalty, the primary loyalty of staff is to each other and not to the person who signs their paycheck. And I think that's a significant problem.

And the final one, we see a lot of what we refer to as sugar mama syndrome. And sugar mama is the person who's stealing and coincidentally, they are also the person. And then I call it sugar mama, we really need to find ladies, we need to find some gender neutral term for that. But whoever is stealing tends to dispense largest to other staff members.

We see a lot of cases, for example, where if the office manager is stealing and also coincidentally in charge of the payroll, that there are at least a couple of other employees who are getting paid extra hours or there are already rates been increased without the doctors approval or something like that. You know, there's some quit pro quo going on.

And as you say in dentistry, you don't look at gift horse in the by-caspets. When you're a staff member who's getting paid for five extra hours a week because the office manager likes you. So those are, I think, the reasons why.

But yeah, if we can, in your office, if we can create a situation where your staff are more comfortable coming forward, there's a huge potential here to turn what otherwise would have been huge frauds into much smaller ones. So the question is, how do we facilitate that? How do we encourage people to come forward?

And the good news is Amber has the answer. Well, I will try to have the answer. But the main thing I think is we need to realize that a lot of staff members face fear of the unknown. So they even know that they have a safe place. Not just verbally, not just the owner that you say, oh, yes, you tell me any time you see Jane doing something that she should not be doing.

They need to have something concrete and in writing that says, here's the safe space, here's the policy, here's the procedure. The main thing is you have to have a plan. You have to have a protocol and come up with a way that you're going to handle employees coming forward and talking to you. As I said, it needs to be a policy,

as part of your employee handbook. So you need to have it in writing. The number to that anti-prime policy, so that everybody understands this is how we move forward if you feel like one of your colleagues or teammates are not keeping the practice best interests at heart. So the essential elements here

that I want to recommend to you is number one, it needs to be taken very seriously, very professionally and impartially investigated. So I want to talk about what the word whistleblower means on this. Loaded a whistle as known as the informer to bring an end to a thing, like a referee that blows a whistle.

They see something that should not be happening. So they blow the whistle to make it stop. So realistically you are a team member that still, like they're ready to blow the whistle. So this would be a no-ball situation that you are compassionate and appreciative that they've come forward. The other main thing here is it needs to be very confidential.

No conversation, nothing that talks about Jane that's sitting next to her, you, as your scheduling coordinator, needs to happen while any other team members I've heard them in the office. So there needs to be complete privacy, confidentiality, and it needs to be in writing that you as a practice owner will keep it that way. On the end note, there also needs to be, you know, we talked about it's a noble thing, your appreciative is that outside party has investigated, and it's confirmed that this person put an end to something that they felt felt was not good for the practice sooner, rather than later, you need to reward that staff member. But you have to have a plan and a policy in place to where people just don't, I'm going to tell this guy that I think, you know, Mary stole some money because I might get a reward for it. You have to have correct sets and make sure that, you know, in the data, there's details, there's evidence, there's not just a hearsay scenario.

You will receive a giveaway of this at the end of our webinar today, and email, we're going to send you a template so that in the future, you will have some guidelines and overview of how to implement and use this whistleblower policy and your practice to help reduce in development from a current long term. So something's happening, you may have a staff member who feel comfortable coming forward and keeping your practice, there workplace safe and secure. Here's the issue and I've asked a number of dentists over the years. Okay, hypothetically if somebody came forward to you and wanted to tell you about what was going on with another staff member, how would you handle it. And the overwhelming majority of the time when I asked that question, I get the right answer, you know, all the things Amber said, I'll be discrete, I'll you know, I'll take it seriously, I won't shoot the messenger, all that kind of stuff. It's my follow up question though, that kind of sets the dentist back on their heels, I say that you know, that's a good answer, my question though is do the staff know that now. In other words, the point of having a policy is to be able to reach people at the point in time when they're sitting there with a suspicion and trying to decide do I come forward or not. It's it's not enough to have thought out for yourself a good approach if somebody does that you have to reach them when they're wavering between doing between coming forward and not. And the reward is really to attack what I talked about on my slide with the misplaced loyalty, you know when when staff members predominant loyalty is to each other and not to you.

To get them out of that is to buy it to write them a check, so there should be a reward and the reward should be kind of formulaically based so that somebody can understand where you came up with a number and having sort of a discretionary award just makes not much sense to a staff member. Oh, I'm sorry. Well, I'm going to hit. I mean, they're they're also getting a reward for possibly saving the your business and other jobs. I mean, if you'll remember a long time ago, we had a large theft case in which they employed. I think about 10 employees and the business owner told me if we will figure out what's going on here, I'm going to have to lay off all my self members because I came forward to pay them. I've already you know took a second mortgage out of my house for the business and just throwing so much money after money after money because somebody had a hole in their pocket was stealing it from them. And that thief would have cost those people there jobs.

You're right, I'm just not sure anybody would you know I'm I'm not sure at the ground level Wendy and employee is going to see that way I personally I think the you know the direct benefit and the federal government does exactly the same thing by the way, I mean the the Fid's reward whistleblowers for example, who. You know who bring out Medicaid fraud. And it's it's the same logic, yeah, you know, sure you you saved our jobs, you saved the business, but. I think a personally a tangible reward for sort of what all call successful whistleblowing in other words, where it saves the doctor money is is something we really need to do. Yeah, I think it's a great idea. Awesome. All right, well then we're at that that part of the night where Amber Wendy and I get to sit back for a little bit and welcome Dr Wayne to the front again and I'll I'll mention again he is a guy who brings a lifetime experience in in dentistry with a whole lot of energy and enthusiasm and it's just such a such a lovable combination. Take it away Wayne.

Thank you David Amber and Wendy again, what a delight to be part of this evening. I've learned so much listening to each of you and I have the rethought some of my policies through the years and I'm just thrilled to be part of a panel that's providing such important information to our attendees tonight. You know, in an ideal world, we probably would not have a team comprised of employees, we would have a team comprised of stakeholders. Now, I first heard the word stakeholder from Chuck Blakeman and David mentioned that earlier Chuck had written a top selling business book several years ago called making money is killing your business. But Chuck also wrote a book called Why employees are always a bad idea. And in Chuck's mind employees even with adequate job descriptions have to be told what to do on a daily basis. Whereas a stakeholder takes the initiative they know what their responsibilities are every day. They live the practice purpose they understand the vision and they come together as one with a mindset of abundance or happy to do whatever it is it's necessary to take that practice to the next level because they understand that when the practice succeeds.

The patients succeed and everyone is is better off indeed they are practice leaders they own their work and the work that it creates. So we really want to try to create a culture where we have stakeholders rather than employees I will say that that is not easy to do it takes a lot of time and a lot of work. And there are those practices and practice owners that will never achieve that level of practice culture because not only does it take. Very strange and hiring and onboarding protocols and in prosperity has covered those topics wonderfully in previous podcasts and presentations but additionally a practice owner has to be a very very strong leader. So let's talk about leadership for just the moment. Looking at Dr. Jim Pride my mentor and leadership Dr. Jim was the founder and former CEO of the Pride Institute and pretty much everything I know about leaders of my learned from Dr. Pride and I love his. definition of leadership. Leadership is inspiring others to want to do that which you want them to do. I want to say that again, leadership is inspiring others to want to do that which you want

them to do. Signum cynics says that leadership is not about being in charge indeed is about taking care of people in our charge. Now let's assume you have two doctors. The graduate from the same dental school, the same year. The established practices in the same town and they're faced with the same economic and market conditions. The doctor with the stronger leadership skill will develop the more successful practice hands down every time guaranteed leadership is that important. And so if you look at some of the kind of intrigueds of a leader we know the leader is visionary because doctor, if you don't know where your practice is going to be in five years, how can you possibly expect your employees or stakeholders to know where the practice is going to go? Leaders are

goal-oriented. Based on what I said, if you don't know where you're going, how can you expect to get there? We're persistent leaders are persistent. An objectious progress is fall seven times, stand up eight. Well, Disney reminded us that leaders are courageous. All our dreams can come true. If we have the courage to pursue them. Leaders have to have high personal integrity. My own father told me when I was in junior high school said Wayne personal integrity and product integrity and success demands both. And we've talked about that tonight. I mean, the leadership starts at the very top with the doctor. I mean, here she sets the example for his or her routine. And that includes using quality materials providing excellence in patient care,

because if the doctor fails to do so, the doctor is at Billman, so the clinical outcome for the patient. Then his or her employees might anticipate that they're also rather at Billman and it's interested in management of the practice. And we've already mentioned about how the failure to review the daily production with the daily collection and the daily payroll deposit leads to just devastating loss. So it starts at the top. And in this practice culture of creating a team of stakeholders, you've got to practice with high personal and professional integrity. Leaders are self-confident, 10, 4, 1, 10, 10. I love this. If you believe you can, or believe you can't, you're right. And leaders obviously need to maintain a positive attitude. Norman Vincent Peel once said that

any fact facing us is not as important as our attitude toward it before that determines our success or our failure. And finally, we're in the service industry. We're compassionate people. We're care givers. We'll be serve others. Oddbanding on a wonderful quote, years ago that says the only certain means of success is to render more and better service than this expected of you. No matter what your task might be. Additionally, I think it's important. So for the team meeting, early on, and in fact anytime you have a new onboarded employee, have a team meeting, and discuss your big why, discuss who you are, what gets you out of the venue and what makes you go. And inadvertently talking about core values will bring up the

topics of integrity, both personal and professional. And I think it's important to have written agreements with your teams. I call them non-negotiables. But these are statements that we wrote together. We agree on this is part of our practice culture. We all sign off on this. We adhere to it. And one of those non-negotiables should be that we're all going to practice with transparency with an ethical behavior that will be honest and will have a professional integrity. I know that for example, some of our core values were very simple. My favorite was that our actions today create our future. Now what that means is we understand as a team that our success is dependent completely upon providing a mountain topic experience for every patient we see from start to finish.

And if we do that, guess what? We're a session proof. That's now I know. I went through three recessions. Patients didn't leave my practice. We were insurance proof. How I know? I was never a part of a PPO. We were insurance proof. How do I know? Because we never relied on insurance, because we never diagnosed patients' needs on the basis of their annual benefit. Another non-negotiable was that our choices are valued within. And again, very simply, we're going to use the best materials, the best devices. We're going to continue to get annual updated, continuing education so that we can practice at a higher level that we know what's out there to be more productive, more efficient, more profitable. But again, provide better dentistry for

our patients using better materials. It's part of your CE. And we learn from some of the best. We learn from Dr. Gordon Christensen, many of the science speakers from Henman, Chicago, and we're in the Georgia Delta Association, Lynn Amiles, you name it. We put a lot of money into CE and it paid off for us. And finally, the non-negotiable, we understood and agreed that life is a journey. It's not a destination. And we're waiting for some special event to happen on our life with missing life, life isn't a journey. And we should find joy every day. And there was laughter in my practice every day. I promise you, we laughed. And I would ask the attendees on this program tonight. When do you think your patient wants to see you, the doctor? And I would

say, I would say to you, it's when you're having a really good day. And when you're laughing at work, they hear that. They're like, ah, he's having a really good day. I'm happy to be here. So, I enjoy every day. And as we slipped on more slide, I want to just remind people that it's not easy to build a team of the overachievers and it does take strong leadership and a commitment to onboarding and good hiring. But as we mentioned tonight, part of building a team is having open communication and working with integrity. Now we've talked a great deal about integrity. And I'm going back and just highlight again the comments that Wendy and I have remade about open communication. And that's partly that yesterday begins each day with the morning huddle.

And yes, you continue throughout the day. So we all are on the same page with regard to what's happening in real time, in caring for our patients. But as has been so beautifully illustrated tonight, part of your office policy manual, I'm going to create a gift for giving out tonight to attendees with that template. wonderful because I promise you through my 35 years of practice I would have lost in the dark to wait what you're getting away tonight. So so thank you for that. But part of open communication is creating a clear policy that your employees or stakeholders can approach you at virtually any time, even if it's a phone call after hours at your home. And they can bring up anything about the

practice or patient but they can do it without a fear of a prideful. They can do it with complete confidence. And I think that that is such an important thing. Very quickly you can see on the screen if you have organized systems, your teammates know what it is, then it's expected of them and they know what to do. If you delegate appropriately, obviously, you're not only becoming more efficient and productive and more profitable in which case everyone wins, but the employee to which those tasks are delegated based upon the practice to stay practice act and training, booster self esteem because they know they're contributing to the practice at a higher level. Obviously, we're going to treat our employees and teammates with dignity and respect if we don't, we don't deserve them

period. To a great time to be a dentist, it's always been a great time to be a dentist. So show that. Be positive in your attitude. Start that morning, all with a with high energy, hey, gang, great to start another day, can't wait. And we know also that once you meet and the place basic financial needs and the benefits, I mean, if we look at Mazlo's hierarchy of needs we know that once the base level of security is met, as you go up that hierarchy, the next thing that's staff member most appreciates is this, is patient recognition. And if we give an employee or teammate praise in front of a patient, it goes a long way. You know, Mrs Smith, wow, what a great procedure. Everything went so well with, you know, Mary,

you had everything I needed, just when I needed it. This procedure couldn't have gone better. Thank you, Mary, you're amazing. Now, do you think Mary, your chair son, appreciate it? Yeah, I think so. Do you think Mr. The patient was impressed? Yeah, I think so. You know, she probably always figured the doctor was pretty good doctor, but now she knows Mary is an exceptional chair side. Just the of praise and recognition, the appreciative I never left the office without finding each employee and saying thanks for making today the great day that it was. And then we did some things outside the practice, just because part of our culture was contributing to our community. We, we were part of the community as an economic engine to contribute and drive and building

the community in which it's an economic better place in which to raise on families and practice. And I guess in wrapping up my comments tonight, I would say that when the entire team is unified by a common vision and it commits to non-agosable team agreements including practicing with integrity and having open communication. And understands it's success only comes from creating one that satisfying patient at a time then you will in that creative culture for practice excellence and you will go on way to honing your practice skills. Thank you so much for allowing me to contribute to this meeting tonight. What a joy. Well, thank you, Wayne. That was awesome. I want to consider next to you. What a wonderful positive message. I just love you, thank you.

So I love to turn shareholders, Wayne. That's a great term and I think you know all the things that we talked about this evening were an anti-frag policy and with the world and all the stuff that seems like it would be scary territory for your team members to talk about. I think if you have that type of team member, they will welcome that. I really care about the practice.

I get it back to creating a culture. Yeah definitely. So now we'd love to take some time to answer your questions. We're so appreciative that all of you guys attend our webinar. We're always happy to hear with you. Please feel free to give us a call at our toll free number or you can visit our website and there is a way to contact us directly through the website if you want to send a message. We're very excited. We hope all of you will join our spring session. How to outsmart and buzzwords. Our personal is going to be next month, April 22nd. So please register and as Wendy said at the beginning of our program tonight, please if you enjoy tonight's session, please give us a good positive Google review. We appreciate everybody participating and joining us to

the TV. Okay, well I have like three questions. Ryan, we're doing questions now? Let's do it. Okay, so here's a question from Grace and she said, I need to or she wrote, I need to start working on employee handbook but have no idea where to start. What would you recommend? Who wants to take that? Maybe I'll start in the others' can chime in. And Grace, if you're in the US in particular, then the best place to go for the starting point for an employee handbook is probably one of the three or four dental specific HR companies that operate. And I'll mention some names. I mean, there are others but I think of HR for health and California, Benterricks and Oregon, and Cedar, CEDR solutions in Arizona. Three excellent companies, we're privileged to work with all of them.

And they'll get you started. There's no cookie cutter here. I mean, there's nothing that will come off a word processor and you will look at it and say, yeah, that's exactly what I want. It's always a starting point and then you need to make it fit your situation and make it fit your preferences. Okay, and then the next one is kind of a two-quarter. Sorry, did we want? Did anybody have anything to add just before we drive on, Wendy? I would just comment that you're spying on with those three companies. When I established my practice, I would dare say that one of my weakest areas was my policy manual. I had to just know more complicated area in dentistry today, or I should say small business ownership than HR policies. The people you

named are complete professionals. They know what they're doing. And your advice was excellent. Yeah. And you can get in so much trouble if you don't have your employment policies kind of written down and cast in stone. The other part of this grace, just while we're on the screen. object. The other place that a lot of practices fall down is that employees do not have written contracts.

And that gets you in so much trouble. I mean, there's a contractual range with there, whether it's written down or not. In a legal sense, every employee has a contract. The question is, if it's not written down, what's the agreement? And it's open to a whole lot of interpretation. Where we get frustrated is we get somebody who calls us and says, you know, I think that one of my employees in fact, the call I took before we went live tonight was with an orthodontist. And he said, yeah, I think some of my employees are patting their payroll. And the first question I asked them, the first two questions were, do you have an employment? Do you have an employee handbook? Because I want to, I want to know what the rules are around things like entitlement to overtime in the practice.

And the second question I asked was, do the employees have written agreements? And the answer to both was, no, and I said to him, okay, so, you know, we're happy to do an investigation if there is payroll fraud going on. We will find it for you. The problem is, there's nothing you can do with it. Other than fire the employees, you know, they're not going to jail. Unless there's a written agreement that says X and they've done Y.

Even one other comment, if I may, for a really small business, let's face it, we've mentioned many dental practices are very small businesses with a handful of employees. One way to leverage services is through a practice employment organization or PEO, like Oasis, administer a text that comes to mind. Pikes might have been one, but when you contract, as the practice owner with the PEO, you gain access to all of those perks, including the employee manual through the HR department. That's a great suggestion. And yeah, good point ahead and to mention that. Thank you, Wayne. You bet?

Dave, I have a question that one of our participants asked, an employee with leaving determining the practice, no longer an employee, and found out that she wrote off her son's bill. So, that she paid it, that was still unpaid. What is the best way to handle it, really similar to what we're talking about? Well, first of all, that's a form of embellishment. If that's all that she did, you know, the dollar amounts on the swimming earned aren't massive. And certainly the person who asked that question, if they wanted to ask a follow up and just give us the amount involved, that might help with the answer. I mean, let's assume it was $700, just to have a number to talk about.

It's embellishment, but in most states, taking $700 is a misdemeanor. I mean, what I would tend to do is send them a bill. I just reverse the right off because I'm assuming it wasn't in accordance with your practice as policy. And when we talk about the need to have a policy manual just to tie this question to the last one, one important element in that employee handbook is, what's the policy for staffed industry? What's the policy for family members? I've seen a lot of family members get free dentistry. And if the manual addresses that, it's investment. If the manual is silent, it's a difference of opinion. So, assuming that you have an established policy and that that policy is not being followed,

the simple thing to do is just send them a bill. And they'll probably ignore it. And at that point, send it to your favorite collection agency and let their collection agency hassle them for a while. Hopefully, they see the logic in paying it. If not, again, if it was $700, you would go to the police, the police will say, look, it's just not enough for us to bother with. If it's $5,000, then you can get law enforcement interested if given the chance to pay this person doesn't. Here's what I'm going to say, though, and I'll probably get some affirmation on this from Amber and Wendy. When somebody does this, they're probably doing other things to you as well.

In other words, this is not likely to be all that they did to you. And I'd encourage you to give me a call, then numbers on the screen. And let's have a conversation about what else might have happened and what your options are. Amber, Wendy, I'm opening the floor to you to talk. If you've excuse me, if you've seen cases started with something like this and then something bigger happened.

Oh, yes, definitely. I have a case right now that I've seen this. I see this happening right now. Friends, family, neighborhood down the street. And so doctors unaware of it because we're talking about that daily end of day. He was not paying attention to that and it turned into a larger amount. So I would definitely call Dave and talk to them about the situation because like he said, there's probably more than just meets the eye on that one account. Yeah, this could be the tip of the iceberg. And as I say, no, no obligation to have the chat with me. Let's just explore the issue and see where it goes. But it's something to be concerned about for sure.

Okay, I have two other questions. I'm going to lump them together. Number one, in the financial huddle. I'm sorry, in the, in the AN funnel, what financial information should be shared? Like in the huddle and how deep should you go into that? And then number two is in the monthly monitoring that you do. How much of that information should you share with your staff members as far as finances of the business? You know, there's a really good philosophical question here. And I'll give my thoughts and I suspect Wayne will have some as well.

And I'll start by saying, I don't think there's a right answer. Some practitioners will freely share all kinds of financial information with staff and others keep that stuff pretty close to their chest and, you know, will sort of give staff the minimal financial information that they need in order to do their jobs. And I think where you sit on that continuum depends on first of all you're self and you're It's not exactly the people you're working with. I'll tell you a few things. Every staff member has a pretty good idea of what your revenue is.

Where they tend to get it wrong is when they think about how much money you take home. And most staff overestimate that by a pretty wide margin. So on the one hand, there's some logic in, you know, if my staff think that I'm taking home a million dollars a year and what I'm actually making is 275,000, and there's some logic in sort of helping them understand that I'm not quite rolling in money the way that they think I am. On the other hand, the reaction of a staff member who's paid 65,000 dollars

when they find out that their doctor makes 275,000 might be holding a shit. That seems like a lot of money. Again, I think you have to read the people involved, including yourself, to come up with what you're comfortable with. But a little bit of openness is never a bad idea. As I say, everybody knows you're revenue. That's not a big secret in anybody who has a user ID and password or do you practice management software can find it that way

if not any other way. So the real question is how you talk about expenses and my encouragement would be that you know, you make the staff aware that running a high quality dental practice is a very expensive undertaking and you do it that way because the staff and the patients are worth it. That's absolutely said. I think it is up to every doctor, every doctor feels differently

about it. I know some who have shared, I think, too much, and some who obviously have shared too little. It's a matter of, again, practice culture and mutual trust and respect for each other. First, in the morning level, I didn't talk money. I know that some of the big names in the practice management field

are talking about what we did yesterday, what we planned to do today and what we did in the arm. I didn't find that talking money in the morning level was the purpose of the morning level. I wanted to know, who we're seeing, why they're coming in. Are we prepared? Who's responsible? And are we seeing any patients of record and hygiene

within complete treatment? And if so, why? Is it a financial issue? Is it an insurance issue? We fail to properly impress upon the patient to need for the recommended treatment. If so, this is our opportunity to pull out the entire camera and remind the patient of why we've made the treatment recommendations

that we've made. Now, to me, the monthly meeting is when we got into the numbers and we had a monthly monitor. And I have shredded most of everything since 2012, but we tracked about 15 different KPIs, probably too many. But we tracked a lot of things for a number of reasons. One is that if we set a goal for new patients or a goal for units of chronic reds or a goal for full mouth

series of radiographs or a goal for quadrants of scanning and replaying, I would typically take $10. Every one of those units of chronic, let's say we have a goal to do 20 units of chronic reds in the months of March. And we did $34. 10 dollars came out of every one of those 34 chronic reds payments and they went into her CET account. And it was that CET account that my team built

by goal setting and meeting goals that paid for us to all go on the inside last year, and cruise with Gordon Gersings in for seven days. It paid for us to go to Hawaii for the 80 and the 1989. It paid for us to go to Sun Fund, some of the hours and wonderful him in the meeting, seeing downtown. And all those things. But specifically, the dollars that we would talk about

to answer your question is, I would use best practice averages that I obtained at the time from Pride Institute. And I would show the categories of best practices overhand. And here we are. And right now we're fighting that we're a little high in payroll. And it doesn't mean I've overpaying you. I think what it is is we're currently underproducing.

So let's talk about what procedures we can add to our regiment of procedures. Let's talk about what fees need to be adjusted. Let's talk about how we can be more efficient or whatever. But it wasn't about cutting anyone's salary or benefits. It was about determining why we weren't in that window of best practices. And that same went for for facility for supplies for minor. Costs like you know, postage and the bank discount credit cards.

That's what we were talking numbers. And yes, they would have an idea. Looking at best practices once once each month. That you know, our overhand might be, you know, $1.5% might be a 68% and if they want to, you know, calculate the difference and think well, you know, at least they get over 300,000. Well, you know, maybe I was guess what, you know,

the IRS going to chunk in that too. And, and my, my staff was well cared for and they got, you know, mostly generous benefits. And most of my employees were with me anywhere from 13 to 23 years. So I think we established a culture. We're pretty much a culture who practice when people want it to be part of our practice. I've talked in those. Great answer, Wayne.

Great, Wayne. Well, ladies and gentlemen, I'd like to thank you all for hanging out with us tonight. I, I'd very much like to thank our special and, and a steamed guest, Wayne Kerr. We knew you, you, you were everything. I thought you would be tonight and more. It was so nice to have you. And there's a, there's an email coming out to you right about now that, There's an email coming out to you right about now

that we'll have some links to the two template policies that we promised you. And I'm going to send a follow up in the morning as well with a downloadable spreadsheet that is the monthly monitoring spreadsheet that we talked about. Ladies and gentlemen, have a great night. And we would love to see you back on April 22nd. Bye, everyone.

And thanks. Bye. Bye. Thanks for listening to the dental practice on our spotcast. 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, 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.