How to Institute Change

There’s times when we, as the owners and leaders, try to institute a new policy or system. Oftentimes we come back from a CE course all fired up and ready to take on the world only to face a wall of resistance to this new way of doing things.

Why do these fail so often?  

It’s often associated with the realization that we missed a step somewhere along the way. So, here’s my six step model of how change works and how we need to address each part of the process in order to get people to change.

If the team doesn’t have awareness – they will just end up in confusion.

If the team doesn’t have buy in – they will just end up in sabotage.

If the team doesn’t have the skills – they will just be stressed and filled with anxiety.

If the team doesn’t have the desire – they will be openly resistant.

If the team doesn’t have the resources – they will be frustrated with you.

If the team doesn’t have an action plan – they will be on a treadmill loop of aimless wandering.

So, how do we help avoid all these pitfalls? Remember that 70% of learning is on the job training. This training needs to be done in small steps, hand-in-hand, and with the resources for you to help them. You will be standing at their side as they learn this new idea. This is not done in a classroom, it’s done on the “battlefield” of the practice: at the front desk and operatory.

To recap, when we ask someone to change, we need to remember these big rules:

If you follow these rules, and follow up with the accountability, then you can institute change like a champ. Remember, the dental industry evolves all the time, from clinical to business practices, so your ability to change and implement change is going to lead to success. I hope you find this process helpful the next time you need to switch things up in your practice!

Getting Associates a Vested Interest in Your Practice

Our friends at Polaris have some great tips for you around attracting and bringing on a new associate. Check out the info below.

Building a successful group practice means creating stability among associates, and stability is often best achieved through ownership. Aside from a traditional buy-in scenario, there are two types of “earn-in” methodologies. Here’s a closer look at Restricted Stock Units:

If you are interested in using an exclusive discount between Polaris and Dental Success Network, apply to DSN today!

To your success,
The Dental Success Network Team

Who is Answering Your Calls?

Many people believe that they should use their weakest team members to answer the phones — this could not be farther from the truth. In fact, I believe that you should be leveraging the knowledge of your strongest team member. Active listening, active questioning, and emotional intelligence are paramount in converting those coveted new patient phone calls into patients in your clinic.

There are many coaches and consultants that can help you train your team on more effective phone skills; however, I have found the key to any training in the dental office is becoming a Chief Repeating Officer. You must harp on the things that matter forever and always never stop reminding. Another way to dramatically increase rate of implementation is to use Key Performance Indicators and report on those KPIs on a regular basis. The most useful KPIs are lead indicators; in other words, they are actions that can be counted that lead to reaching a goal. For example, if you want to increase fluoride acceptance to reach 100 fluoride varnishes per month, then you can create a lead measure KPI such as “how many times did you educate a patient on how they could personally benefit from fluoride.”

We can also create KPIs and lead measures with phone skills to help reach a new patient goal. I am going share my phone call answering score card. We will dive into what these things mean and the secret sauce behind the system.

Most of the items on the call scoring sheet are self-explanatory so I will unpack the less obvious ones. We always want to give our name, ask for the caller’s name, and then use the caller’s name as much as possible.  The next item is less obvious and is a form of active listening. It is apparent that the caller is looking for a new dentists, but we want to ask them “what is most important to you when choosing a dentist?” By asking this, we are able to assure the caller that our practice, team, and doctor is a perfect fit for them. A black belt level practice would put this in the patient’s chart so that we always meet the listed need to the patient.

Secondary compliments help us form opinions, so if we compliment “our gently hygienist” or “our doctor is great at getting people numb” then we are not only assuring the patient that they are making a great choice but then they will actually be influenced to believe their experience was as promised. We never want to answer with a “no” unless it has to do with Medicaid in my practice and when we answer yes we always want to follow that up with two positives. For instance, “Yes we do crowns and we also have a scanner and not awful goo impressions and we even make your crowns immediately and it will all be completed in one hour.”

Now, the real magic is not in having this phone call scoring sheet but in using it. Once your team is trained on the components of the perfect call, you can implement the use of the scoring sheet. I have hired a virtual assistant in the Philippines to listen to all of our calls. She skips all existing patient calls and listens to new patient calls in full. She fills out the score sheet. Each morning she emails us for our morning huddle our number of new patient calls. This is great info for your marketing team. She also gives us our average call score for the day and then the number of callers that scheduled. I have regularly scheduled meeting with my marketing team and some of the metrics that we are most interested in tracking is the number of new patient calls and then the scheduling percentage. All of these metrics are reported on month to date and year to date so that you can identify trends related to operations and marketing.

My treatment coordinators review their score cards daily and know how their previous day’s performance was. If they need further coaching, both of you will know exactly how to help them achieve their highest potential.

You can make sure your treatment coordinators are not only highly trained but also are implementing their knowledge regularly. Doing these simple things on a daily basis is guaranteed to increase the number of new patients you are seeing.

If you are interested in learning more implementable case acceptance strategies and marketing techniques, you can attend the Peak Dental Resources “Case Acceptance and Marketing Masterclass” held on Jan 11th in Scottsdale, AZ!

Start-Up Tips

Many of you are looking at doing a start-up or expansion right now. Inevitably, there comes a question of, “How do we build a break room that’s comfortable, but not obnoxiously large?”

Truthfully, this is an area of opportunity to save money on construction costs. With careful planning you can maximize resources and still make sure it is a comfortable place for the team to take a breather during the course of a busy and often stressful clinical day.

However, even in a small space, there are simple upgrades we can make to show our teams we care about providing them with a great work experience (it doesn’t require fancy sinks, faucets or cabinetry). Providing snacks (like Dr. Addison Killeen has talked about) or going a little further and buying a massage chair for the break room (like our buddy, Dr. Taher Dhoon did) can actually make a difference.

During any build out or renovation/expansion there is always a slow steady creep of additional expenses we didn’t plan for. I see too many dentists take the amount the bank approved them and mistaken this for their budget. When decision fatigue sets in during a construction project there are a couple common & costly narratives we might tell ourselves including: “It’s fine. I just have to get to opening day and I’ll figure out paying off the debt later.”

This is common in the dentist that is busy working as an associate trying to do a startup at the same time. They start to get overwhelmed with all the questions from the equipment rep, architect, contractor. They start making concessions to small addons that they “don’t have time to think about.” $1,900 here, $6,000 extra there, $900 somewhere else and before you know it they’ve conceded tens of thousands of dollars.

That quote above quickly becomes: “I should have taken some time to do a little more research and save a few more bucks along the way — I knew better, but I was too busy to pay attention”

As my buddy Dr. Mark Costes says, “Watch out for that dental tax my friends: IT ALL ADDS UP.”

Don’t let yourself become the doctor that is too busy to watch the costs.

Strategies to Boost Dental Practice Revenue: Beyond the Hygiene Chair

Many of the practices I work with have limited to no capacity for new patients through hygiene. When this occurs, it is important to ensure your operations and marketing are optimized in order to increase revenue. In the last 12 months, we tracked 29 practices who all had limited or no capacity for new patients through hygiene. Limited capacity is defined by not having a new patient hygiene appointment available for four weeks (excluding cancellations). These 29 practices averaged a 7.1% increase in new patients and a 26.4% increase in production over a 12-month period. They were able to increase production at a higher percentage by focusing on growth outside of hygiene.

Here are three tips to help increase revenue without increasing new patients through hygiene.

  1. Focus marketing on emergencies. This is a low-hanging fruit as emergency appointments often have a higher production per patient and fills a spot on the doctor’s schedule. Marketing to emergency patents is often overlooked by other practices and many markets has a lower cost per conversion. Some emergency patients may only want to get out of pain and not equal higher production, but overall we found an increase of over 20% in production compared to an average new patient.
  2. Increase marketing and awareness of services such as sedation, clear aligners/ortho, and wisdom teeth extractions. These are all services that many patients will need or want even during a downturn in the economy. You can create external marketing campaigns for all three of these but be sure to create an internal strategy as well. Many current patients do not know general practices offer these services.
  3. Look into dropping a low reimbursement insurance. If your demand is high enough and you choose the correct insurance to drop, you should see little to no impact on new patient flow. For example, if 15% of your active patients have insurance X and 12% of new patients over the past six months have insurance X, and you can use your marketing numbers, phone data, and how many days until next open hygiene to determine the potential impact of dropping insurance X.

Until next time,

Ryan Gross
Owner CMOShare

P.S. Join DSN to chat with Ryan Gross inside of the Marketing room in DSN’s exclusive Workplace!

Why You MUST Have Photos and Not JUST Screenshots

When it comes to your orthodontics and Invisalign cases, it’s hugely important to ensure you’re meeting standard of care for patients. Unfortunately, this isn’t always the case, often unknowingly. One such example is using JPG / JPEG screenshots of scans for intraoral images for Ortho Starts. But why is this? Well, we’ve outlined what you should and shouldn’t be doing for ortho.

You can find my full blog post here.

No More Dull Burs

The propensity for doctors to use dull instruments to achieve a highly technical and relatively intolerant outcomes never ceases to amuse me.

We are a highly skilled bunch. We cut precise preps in teeth, make incisions that avoid complications and follow teeny, tiny nerves down a root so that our patients can keep their teeth. Our instruments are literally on the cutting edge of what we do and can accomplish. So, why do we insist on working with dull instruments that are, quite literally where the rubber hits the road?

I know the answer! It’s the cost. We are a frugal (some would say cheap) bunch too! Give me a few moments of your time and I’ll try and disavow you of that particular reasoning.

But first, why should we even bother with fresh burs and diamonds?

Less Heat, More Comfort: Ever been prepping a tooth where you’re pushing that bur harder and harder, and it’s like trying to slice through a brick wall? Then, magically, you switch to a new one, and it’s like cutting through butter. The extra force needed with a dull instrument generates more heat, and that’s not great for the tooth. Plus, it’s uncomfortable for the patient.

Sharper = More Precision: Dull instruments not only make you work harder, but they also mess with your precision. You lose control because they’re just not doing the job.

Think about it this way: every boy scout knows that most accidents (or accidentally gouging the adjacent tooth) happens with a dull knife (or bur) not a sharp one.

“OK, but what about saving money?”

Yeah, I get it, we’re all trying to cut costs. Reusing burs and diamonds seems like a smart move. But there are some problems:

Hidden Costs: Sure, reusing these tools might save you a bit on supplies, but there’s a hidden cost: someone has to clean, sterilize, track, and store them. That takes time and slows things down.

Slowing Down Production: Dull instruments are like speed bumps in your workday. They slow you down which means you’re spending more time on procedures and reducing productivity.

Finally, let’s talk about the “bur bill.” If you’re running a well-managed dental practice, your supply costs should be around 4-5% of your revenue. So, for a $1 million practice, that’s $40,000 to $50,000.

While I can’t give you the exact breakdown, I’d bet that burs and diamonds aren’t eating up a huge chunk of that budget. The cost of your assistant’s time and the hit to your productivity likely outweigh any savings from reusing them.

Here’s the icing on the cake: it’s just plain nicer to work with instruments that actually do the job instead of fighting with them. Of course, this has all been just one doctor’s opinion. 

“You pays your money, you takes your choice.”

The Power of Emotional Regulation

Emotional regulation is a superpower that can transform your work environment, even in a high-pressure setting. It’s the ability to manage your emotions, leading to better decision-making, improved relationships, and increased overall workplace satisfaction.

As the practice leader, you’re naturally crowned with the ability to be all-knowing and knowing of all. In most cases, you hold the keys to the kingdom and only you know how the kingdom operates.

Most leaders are constantly interrupted to handle simple tasks such as: “Hey doc, this night guard isn’t fitting. What should I do?” Or “Hey, Office Manager, the computer will not load the x-rays. Can you fix it?” Every day could feel like an uphill battle and an unending list of decisions to make. Frustration boils over, and hiding your irritability and stress becomes impossible.

Let’s start with checking our emotions:

Emotional regulation isn’t a luxury: it’s a necessity for leaders in dental practices. By mastering this skill, you can navigate the daily challenges of your role with grace and resilience. Emotional regulation isn’t about suppressing emotions but channeling them constructively to foster a more positive and productive workplace environment.

P.S. Looking for more tips on leadership? Join me November 3rd-4th, 2023 for our 2-day OM Workshop: Unlocking Leadership Brilliance in Dental Practice Management as we discuss understanding the importance of protocols and system implementation, building a profitable insurance department and key marketing strategies and tracking tips in today’s market.

Success as You Age

Have you ever met those older retiring dentists and wonder how they got there? You think to yourself, “Boy, if I could just learn what they know, I’d be instantly successful.”

While this might appear to be true on the surface, there’s another thing at play.

It took decades for them to hone their skills to be good at extractions, decades to develop the best hand skills for cosmetics, and decades to be able to free-hand implants to within a millimeter of ideal. It also took decades to develop their leadership skills, learn the business, and systemize their practice enough that it looks easy.

And, what happens at the end once they become really good? They’re at the end of their career. This wisdom is wasted on people staring retirement in the face.

The graph above shows how the green line goes up (wisdom), but then the time left to use that wisdom drops precipitously. I fear that happens to all of us.

However, it doesn’t need to be. We can gain the knowledge, content, principles by learning – in order to get that wisdom earlier in our career.

Much of that is why Dental Success Network (DSN) was created. It’s “jumping the curve,” it’s “shrinking time.” It’s helping dentists gain wisdom and advice at a clip that is both faster than nature can teach and less expensive than anything out there in the marketplace.

What are the top resources people are saying help them crunch time?

Learning will help you avoid the trap where “wisdom is wasted on dead men”. Don’t wait, you don’t know how much your trajectory could change by gaining the resources earlier in your career.

P.S. If you want to share wisdom with other practicing dentists, join DSN today and get access to Workspace where you can talk with colleagues around the world!

“Doc, I Can’t Breathe!” (Why a Rubber Dam Might be the Answer)

The patient had been anesthetized (block for the lower left and infiltration for #8) and I was just starting to prep a very small lesion on #8. Every few seconds he would move to get out from under the handpiece. So, I asked, “What’s going on right now?”

“Doc, I can’t breathe!”

That is not exactly what you want to hear at the start of an appointment. Since the patient didn’t show any signs of distress, I asked him to take a deep breath. Problem solved.

It seems silly, but frequently when we lay patients back for their appointment they start to panic because they now have to actively maintain their airway. Usually, this is done by pushing their tongue forward or by dropping it below the occlusal plane of the mandibular teeth. Then, the dentist or assistant starts manipulating the tongue and the patient must push back to maintain the airway. Naturally, when this pushing contest starts the tongue expands as it pushes back, further obstructing the airway and complicating the problem.

Alternatively, lay a patient back and place a rubber dam. Frequently, the patient immediately becomes a “mouth breather” for the same reason; but, now there is something obstructing the flow of oxygen. Then you hear, “Doc I can’t use one of those things.”

We all know that the appointment is a completely different experience for the patient and the team. But, sometimes it can literally feel like life or death to our patients.

So, how do we make this a more comfortable experience for everyone involved?

I’ve tried handing the patient a mirror and coaching them on how to place their tongue so that they can breathe easier (this almost never works). Usually, I just try to gently hold the tongue away from where I’m working.

But for those extreme cases, a rubber dam can actually be your best friend. By placing it and cutting a breathing hole in the middle of the dam, it can keep the tongue out of the way and allow the patient a larger degree of freedom. With a hole placed like this, it allows the assistant to go to the corners of the mouth through the hole rather than trying to lift the rubber dam and possibly popping off the clamp.
So, the next time you’re having one of those appointments with one of those patients, try using a rubber dam to solve the problem. You might be surprised.

P.S. Join Dr. Aaron Nicholas October 13th in Las Vegas, Nevada for his One Hour Molar Root Canal Buildup and Crown course
(DSN members receive a $300 discount) or join DSN to chat with him inside of the Endo Simplified room.