Dental Practice: Training Tools for the Clueless

Abdicating Knowledge

I have to admit that there are certain things in the office I am totally clueless about. Actually, I don’t even know the right questions to ask when it comes to some of the front office tasks. Re-filing problem claims, insurance questions, basically all the billing and AR stuff that goes on outside of my clinical wheelhouse. I don’t know the first thing of tactically how to do it- and actually, when I coach other dentists- I suggest they also avoid spending many hours to learn these skills.

Why do I suggest abdicating this knowledge? Simple math- you should be doing dentistry, not billing. Now, to achieve this, I have two tools at my disposal if it ever occurs that my front office disappears from the face of the earth. (Young employees these days have been known to ‘ghost’ employers more and more.)


Tools of the Trade

First tool: My Operations Manual – I consistently and thoroughly push my team to have a killer operations manual to help train new employees, as well as document what they do everyday. Our operations manual is soo detailed it goes through their daily task lists, all the way down to ‘How to Submit a Claim’. These instruction pages are simple, even I could do it if I had to. Actually, that’s what I tell the team to achieve…instructions soo simple you could teach a newbie in 15 minutes. (Remember DSN Members can download the example Operations Manual)

Second Tool: I don’t have time to teach my employees all the most detailed aspects of billing, AR, insurance, and front office skills. I do have time to just enter their email, assign courses, and follow along as these employees complete the coursework to become billing rockstars. You can even track how well they complete these tests as they progress through the courses. It’s crazy simple, for $49 a month for DSN members, it pays for itself in minutes. If the team member has questions or needs further assistance- there’s even weekly webinars and office hours to ask specific questions of or amazing contributors

Once again I think our time is valuable, and learning to do front office duties and tasks are not the best use of our time. Make sure as you grow your team, you’re doing it right- and with the right help.


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Dental Practice: Wisdom of the Tao Te Ching

Expanding Your Mind  

I was reading the Tao Te Ching the other day, and of the small percentage of it that I can comprehend, I enjoyed it. Chapter 14 reads:

Which is more important, your honor or your life?

Which is more valuable, your possessions or your person?

Which is more destructive, success or failure?

Because of this, great love extracts a great cost and true wealth requires greater loss.

As it often goes, we get successful, and that might actually be destructive because it allows us to chase shiny objects, while neglecting something powerful that just needed a little more energy.  When we get distracted by ‘shiny objects’, sometimes we need to go back to our goals, and re-focus on what we are actually doing here.

In my experience, these questions describe the constant struggle for high-performing people to describe their goals. It’s easy to set a monetary goal. Sometimes it’s easy to say, “I want 3 clinics with 6 doctors.”  However, finding the complete vision of their goals is much harder. (Also- who do you have to become to achieve that goal?)


Setting Apart Mastermind Practices

Dr. Mark Costes and the Elite Practice Mastermind often go through goal-setting exercises, including very specific visionary activities that encompass 16 different parts of the future. These include where you will donate your skills and money, what your family looks like, and what your relationships look like.

If you want to dig a little deeper into these questions and work towards a more fulfilled life, we encourage you to sign up for Mark’s 16-Day 4 Futures Challenge HERE. Or, if you just want to buy the book, you can buy it on Amazon HERE.

Not a DSN member? Get 45 days free Here.

Dental Practice: Thief of Joy

The Road Less Traveled

The road that we travel as dental practice owners and clinicians varies individually while holding many of the same benchmarks and similarities.

It can be challenging not to compare yourself to classmates and colleagues and assume that you are falling behind. However, in coaching our members I regularly remind them of one of my favorite quotes: 


“Comparison is the thief of joy.” –Theodore Roosevelt 


It can be easy to fall into the trap of assuming that you are behind the curve in your professional career if you are constantly holding yourself to the standards of someone who may be on a different trajectory. 

You could be weighing your chapter 1 against their chapter 10 or viewing their highlight reel and assuming that is what everyday life should look like. 


The Path to Success

In today’s clip from the Dental Success Summit 2021 I share with you a case study of a dentist who was well into their ownership journey, but ready to make a change and launch into a 3 year transformative path to profitability and success.


If you haven’t signed up yet seats are now limited for our 9th Annual Dental Success Summit in beautiful Scottsdale, Arizona.

Join us June 10th and 11th where I share more case studies, systems, and tactics to accelerate your practice ownership journey.

Not a DSN member? Get 45 days free Here.

Dental Practice: 30X Rule of Delegation

A Wider Perspective

We have all said the following to ourselves in some capacity:

“I would delegate this, but no one can do it as well as I can.”

What if the above perspective was wrong? What if you are not thinking it through clearly and deeply enough?

“How could we as leaders create situations where everything could be delegated with the understanding that the task would be done even better than we are currently doing it, while at the same time creating time for us in the future?”


Giving Time, to Make Time

Over the last few weeks, I was exposed to the wisdom of Rory Vaden and his time management principles. One of the principles is to delegate everything possible to people around you. Before you jump to conclusions on how that’s not possible because the tasks you do are just too important, too complicated, or no one can do them to your level… hear me out. Perhaps you have that mindset because you have tried to train someone to take over your tasks, but I would argue you did not spend enough time training the delegation of that task.

Enter the 30X rule

The 30x Rule from Rory Vaden dictates that you, as the leader of a team of people, should spend 30x the amount of time training someone to do a specific task—precisely as though you were doing it yourself. So, for example, if a particular process takes you 10 minutes to complete, you should be able to comfortably train someone for 300 minutes (5 hours) to complete that process, as the 30x rule suggests.

5 hours? Are you F*&%!ng kidding me? I don’t have 5 hours to train someone on something I can do in 10 minutes.

Let’s see if that’s, in fact, true.

It would help if you did not get stuck focusing on what this time will cost you in one or 2 or 3 days of training—instead, think about what this will mean for you in the long run. By taking this time to train someone to do this task, you save yourself way more than five hours in the future. In addition, you are delegating this task, ensuring that it will be done well, and giving yourself MORE TIME to focus on other aspects of your business that only YOU can do.


I Save How Much Time?

How does the time-saving math actually work? Let’s say you need to take 10 minutes per day doing this specific task, and there are 250 working days in a year; that’s 2500 minutes in the year (10 minutes x 250 days = 2500 minutes) that you spend working on that task! That’s over 45 hours a year! YOU ARE SPENDING 45 HOURS A YEAR DOING THIS 10 MINUTE DAILY TASK . . . .IN PERPETUITY

So can you spend 300 minutes (5 hours) training someone to become excellent at this 10-minute task? I would argue that if you cannot train the right person on how to perform a 10-minute task with excellence in 5 hours, we have other issues to figure out.

Does the extra 2200 minutes per year (36 hours in year one, 45 hours a year from thereon after) of “free” time sound attractive to you?

That’s a 700% return on your investment of time.

I hope this is making you think. What could you get off your daily, weekly, and monthly task list and create time for yourself in the future?

Dental Practice: Changing Seasons

A Clear Understanding

As the seasons change, I’m reminded of a quote from James Clear that really spoke to me last year:

“Good advice at the wrong time is bad advice. Life is full of seasons and each season has different requirements. Know what season you are in, and you can better identify which ideas to utilize.”

This quote stuck with me because it spoke to how my life has gone.

Sometimes I have to be a clinical thoroughbred. I have to work 48 hrs clinically a week to keep the practice afloat.

Sometimes I have to deep dive into the practice to find those pearls and leverage the team to get the results I know are possible.

Sometimes I have to focus on family and our new baby, battling sleep deprivation and handling the daily stresses of parenting around sports and activities.

We each have seasons. Sometimes those seasons match our optimal energy output and we get to put our positive, best selves in a place and time where our output is best-suited for the season. Sometimes we are prepared for being a killer clinician and utilizing our newfound skills, when family duties take all our energy and time. To be honest, it sucks.

When this happens, I go back to this quote. It reminds me that I need to be intensely aware of what season we’re in, and match my energy accordingly.

Know what season you’re in, and move to accept it and make the most of it.


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Dental Practice: Implanting Success into Your Practice

Revisiting the Past

As clinicians it serves us to revisit and consider previous cases and determine what we can learn from them. I wanted to share this case I did several years ago that shows inadequate reduction, which is one of the major issues we see in full arch procedures. Nowadays, the fp1 and fp2 approach is working much better than the significant reduction needed to do an fp3 design.

I used a guide to place the implants, and to do the bone reduction. You can see where the guide didn’t extend back far enough. The guide didn’t fit on the bottom properly, so I had to go free hand in the posterior after that anterior osteotomies were done.

The sleeping implant didn’t have any torque, so I placed implants at 19 and 30, however, I didn’t revisit the reduction after the guide was removed, and ran into prosthetic space issues. I also didn’t flap the maxilla far enough back to reduce enough bone, and you can clearly see the excess present on the pano with red lines that is creating some distal extension issues from a zirconia thickness and VDO perspective.

The implants are BSB and now I use Neodent. I believe it is a superior product to many implant systems for multiple reasons.

Please let me know if you have any questions, and I’m more than happy to discuss the numerous appointments needed to correct this VDO issues and muscle pain she felt due to opening her VDO too much.

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Dental Practice: “Do You Think I Should Sell My Practice?”

At our 2021 Dental Success Summit I shared with you the story of Dr. M. A case study of a DSI client who started the mastermind program with us in 2017.

Dr. M faced a medical condition that was forcing her to step away from the chair, but retirement was not an option at her young age.


What next?

Sell the practice and pivot with the profit? Transition to a CEO role and grow the organization with more offices and providers?

Check out the video below where I share the game plan we put together for Dr. M and the crucial details of step one to execute the plan.


If you missed the announcement before, we are thrilled to share that registration for the 2022 Dental Success Summit is open June 10-11 in gorgeous Scottsdale, AZ.

Click Here for more information.

Not a DSN member? Schedule your consultation Here to get 45 days free!

Dental Practice: The Sorites Paradox

Small Changes, Huge Results

I Spent the last week going through all my notes on habit formation and came across this principle which I had completely forgotten about.

The Sorites Paradox is an ancient parable that teaches the lesson of how very small changes over time can lead to huge results (positive or negative). The lesson trying to be taught, at least from my perspective, is that it’s impossible to identify which of these little specific behaviors actually lead to the result. Instead it was a combination of all of them repeated over time.


Two Sides of  the Same Coin

Can one coin make a person rich? If you give a person a pile of ten coins, you wouldn’t claim that he or she is rich. But what if you add another? And another? And another? At some point, you will have to admit that no one can be rich unless one coin can make him or her so.

Another classic example is water boiling. Water boils at 100 degrees Celsius. Does that mean the the temperature increase from 89 to 90 is less important that the change from 99 to 100? No. each incremental temperature change needed to occur in order to get water to boil.


What Makes Habits Difficult

The same is true with habits and our repeated behavior, no matter how small the behavior. Does one burger and fries for lunch cause you to be fat? No. Just like one garden salad with grilled chicken on it for lunch doesn’t make someone healthy. The consistent repeated behavior over time is what has the huge effect. Using the above example, a few years later you are either 15 pounds overweight or you are a lean and mean healthy individual.

For this reason, it’s so hard to start new habits like eating healthy because it takes a while to see any benefit to performing that habit.

For the same reason it’s so hard to stop a bad habit because in the moment the bad habit feels good but it takes a long time for the detrimental effects of that habit to rear its ugly head. The classic example is a cigarette that can reduce your stress in the short term moment but cause lung cancer in the long term.


Staying Hungry

We can say the same thing about habits. Can one tiny change transform your life? Not in the short term. But what if you made another? And another? And another? At some point, you will have to admit that your life was transformed by one small change.

The secret of getting results that last is to never stop making improvements. It’s remarkable what you can build if you just don’t stop. Small habits don’t add up. They compound.

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Dental Practice Anesthesia: It’s Simple…’Till It’s Not

Anesthesia Can’t Numb All Nerves

We’ve all been there. It’s your big case for the day. Maybe, you’re part way through the procedure and your anesthesia starts failing. Or it’s the patient that needs to be completed so the rest of the day’s schedule doesn’t fall apart. Maybe the patient is scared to death and you’re trying to win them over with this first procedure. Or it’s the new procedure that you’re trying for the very first time.

And now… the patient isn’t getting numb. Time is ticking away. Even though you allowed enough time (even a little extra), now it’s all gone. The staff have started cruising by the operatory like sharks that smell blood in the water.

They’re looking at their watches, tapping their feet and wondering what’s going on. And so are you. Can you tell I’ve been here before?

If you have as well, stay with me. I’ll tell you what my biggest game changer was.


The Game Changer

It’s the PDL injection given a little differently. Adjusted slightly so that my success rate is 100%! Now, I’m certain that at some point I’ve given this injection and not gotten profound anesthesia but, I honestly can’t remember when.



This is my second injection if the patient isn’t numb with the primary anesthesia. Like a missed IAN block. Rather than blocking again and then waiting another 5-10 minutes (can you hear the clock ticking?), you can give this injection and start work immediately. Onset of anesthesia is immediate. Or how about, when you’ve placed a rubber dam and now discover that the patient isn’t numb? You won’t need to remove the rubber dam. Just inject between the clamp and the tooth or mesial to the clamp.

It can be used as a primary injection if an infiltration is unwanted or impractical (mostly mandibular molars)



I use a “pistol-style” PDL syringe that “clicks” as the plunger is advanced. It lets me know how many “clicks” I’m giving so I have a feel for how much anesthetic the patient has received.

The “non-click” syringes are just fine. They work great. I just don’t get the feedback.

Could you use a regular syringe or a pencil-style PDL syringe?

Yes, but…

So, what is the Vibraject?

It’s that little grey and green thing attached to the barrel of the syringe. And all it does is vibrate.

It’s the secret to success because it helps to better seat the needle at the tooth/alveolus interface. This is the critical step to getting anesthetic where it needs to go.

While the injection can be given at any of the tooth/bone interfaces, I’m usually giving it as far into the mesial interproximal space as possible or in the furcation area. The distal and lingual are harder to access but will also work just as well.


Which Anesthetic?

I like Septocaine with 1/200k Epi. But then again, I like Septocaine everywhere and for every injection. But especially for this injection, Septocaine is my “go to”.

It diffuses better and seems to give more profound anesthesia when compared to Lidocaine.

How about patients that are “allergic” to the epinephrine? First off, if that were true, they’d be dead because their body produces way more epinephrine than is found in a few carpules of anesthetic. However, I get that many patients don’t like the feeling of the epinephrine rush.

Unless they are VERY sensitive to epinephrine most patients won’t feel any effects of the few drops of anesthetic that is administered with the PDL injection. (Again, I’m sure it’s happened but, I honestly can’t remember when). Just be sure you’re only administering a few “clicks”. Maybe 1/5 to 1/4 carpule of anesthetic at most.


Which Needle?

30 guage and super short. You’re placing pressure down the long axis of this needle. Long needles bend and won’t allow delivery of the anesthetic.



      You should feel significant back pressure




Final Thoughts

“All in” the syringe and the Vibraject will probably cost $400 or so. It sounds a little pricey until it saves the day a time or two. Then you won’t be able to live without it.

In my office, we lay out the syringe every time we treat a mandibular molar. Most of the time it isn’t needed but, when it is, this saves the inevitable wait for the assistant to run to the lab, find it and bring it back.

So now re-imagine our starting scenario…

It’s that critical appointment of the day.

We’re trying to do a great job of treating the patient and winning them over. Also, for the first time we’re trying a new more productive procedure that we want to introduce into the office.

So, we need to win over the staff as well.

We have enough time but after waiting for anesthesia to take effect the patient isn’t getting numb. However, in this scenario, we know that we can pull out the PDL syringe with the Vibraject attached, give an injection and in two minutes have a numb patient and be ready to start the procedure.

How much calmer and at ease do you think your procedure and the rest of your day will be now? How much more will the patient trust you because you weren’t like all the other dentists that hurt them? How much more likely will they be to get the rest of their work done in YOUR office? How much more confidence will your staff have when recommending you as the doc that the patients should trust?

All from spending $400 and learning an anesthetic technique that truly was a game changer in my office.


Feel free to message me with any questions about this or any other topic about efficiency, productivity or any of our courses.


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Dental Practice: What’s the Rallying Cry?

Leading to Greatness

In many situations, great people that make up great teams can still struggle to accomplish great things. Why is that?

There are many reasons for this but the #1 by far is lack of clarity from the leader about what the most important goal is NOW.


What’s the priority?

When leadership is not crystal clear about W.I.N. (what’s important now) leadership teams are left to try and figure it out for themselves. When this is the case most team members will simply do what is specific to their own teams and their own skill sets. Patrick Lencioni uses the term “silos” to define this. Silos are groups of people in an organization, many times great people, not all working towards the same goal due to lack of clarity on what is the most important goal NOW.


What is the rallying cry?

The idea of a rallying cry is critical. Without it, team members at all levels, especially the leadership team, can easily get lost, moving in different directions, not rowing the boat towards the same point.

Most organizations have too many top priorities to achieve the level of focus they need to succeed. Wanting to cover all of their bases, they establish a long list of objectives and spread their scarce time, energy, and resources across all of them. The result is almost always a lot of initiatives being done in a mediocre way and a failure to accomplish what matters most.

It is so easy to get lost in the day-to-day tactical minutiae when you don’t have a common rallying cry. Pulled in many directions without a compass, team members pursue seemingly worthwhile agendas under the assumption that their efforts will be in the best interest of the organization as a whole. Unfortunately, what happens is great work being performed by great people that ultimately doesn’t lead to a unified result. Different team members working in different directions and not making nearly the progress as an organization that could have, or should have occurred.

It’s human nature to have a genuine interest in working well with other team members. We need to give our teams a unified direction in which to row the boat. It’s one of our primary responsibilities as leaders of our organizations.

There is a simple and powerful way to create a common sense of purpose, they must establish a rallying cry.


What are the four components to a rallying cry?

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2022 Dental Success Summit

Friday, June 10th – Saturday, June 11th
JW Marriott Scottsdale
Tickets 40% Off!

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