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Almost Overnight, Things Began to Transform!

I have worked with a number of different consulting companies through my 10 years as a dentist.  Some are the “big practice, big spend” types and are very flashy.  Others are the “mom and pop shop” run by people who aren’t dentist and who have never been dentists.  The problems I kept running into were that promises were made that were never fulfilled, and the systems recommended just didn’t make sense from a dental business perspective.  In fact, we found that it’s possible to almost go bankrupt with 250 new patients a month producing almost $4 million a year if the systems aren’t balanced correctly and the spending is too high.  About a year ago I was on the hunt for a new practice consultant and was referred to the Brady group by my accountants.  I went in skeptical, wondering if they could really understand my practice.  Almost overnight, things began to transform.  We reduced our overhead by a very large percentage, and we began to be much more selective about the things we were and were not willing to do in dentistry.  We set new standards and completely re-vamped our process.  While not perfect, I feel that we’re coming along and are on the right track.  This year we only have a fraction of our new patients and our production is down, but our overhead is WAY down (so we no longer have to produce 4 million a year just to stay afloat), our net is WAY up, I’m taking 7 weeks of vacation time this year, my staff is happy and the practice just feels a lot more fun to work in.  In short, I’m making more than I have in years and the stress level is much lower.  I recommend these processes and systems to anyone looking to reduce stress and increase the “fun” level of dentistry again!

Build It, and They Will Come!

The way you schedule can make or break your practice.  We are often asked – which comes first?  The right systems for case acceptance, or blocking the schedule for the ‘ideal’ day?  Some want to put off block scheduling until they get better case acceptance, but it never really seems to happen.  That’s because ‘reactive’ scheduling actually gets in the way of the systems that will support better communication and case acceptance.

photo posted on http://www.post-gazette.com

I think of one of my favorite movies of all time when it comes to setting up your schedule for success – ‘Field of Dreams’ with Kevin Costner.  In the movie, Costner plays Ray, a farmer in Iowa.  One night Ray hears a voice coming from his corn field saying ‘Build it and they will come’. He interprets the message as a command to build a baseball diamond in his fields, despite ridicule from his neighbors and family.  Well, Ray builds it, and the Chicago White Sox come.

See, we often create a false sense  of security by filling the schedule with something. Anything. But if you make the commitment as a team to honor the blocks, something magical happens. Everyone is on the same page and is working toward creating the perfect day instead of just ‘filling’ the schedule.

Create the schedule you want, and they will come

How Many More Years do You Plan to Practice?

In our dental world of primarily ‘production-speak’, overheads continue to rise. At dental meetings it seems that the only numbers bantered around are production numbers. We all acknowledge that only net income matters, yet most of us don’t seem to remember that vital detail when it comes to running our practices and making overhead choices.

Latest research shows the average overhead in a general dental practice is hovering at 75%. WOW! In other words, you have to produce and collect 4 dollars for every dollar you get to claim as income. That’s before the tax man, etc. comes to visit. In effect, you work approximately 9 to 10 months for your overhead and taxes and 2 to 3 months for your spendable net. Sobering.

Obviously, decisions you make today profoundly affect your life for years to come. One such decision is the amount of overhead you choose to have in your practice. Yes, I said ‘choose’ to have, because every dentist chooses his/her overhead. Now, I understand that you may not intentionally choose high overhead, but the decisions you make today affect your overhead tomorrow. What choice have you made? High overhead model or low overhead model? It’s not too late to commit to a low overhead model.

Most dentists live by the rule that the best way to lower overhead and make more net income is to increase production which usually means working harder/faster/longer. Or, we often try to operate by cutting the wrong costs and fail to invest in proper practice and business principles. Working harder is a higher overhead choice because it increases costs in order to support that kind of system; more employees, more chairs, more patients, etc. are needed. Bad systems leave you no choice but to work harder. Is that what you want?

Another way of looking at this same issue is to follow the “busy” practice model.

Do you really believe (as sometimes we are taught) that raising your overhead is necessary to increase your production and net income? Do you accept as true the notions that you may well reach your net income goals simply by adding more patients, hygiene or staff to your practice? I hope not. Proponents of more volume fail to appreciate the finer points of overhead control. Adding more patients, staff, etc. may be part of the solution later on, but overhead control should always be addressed first, nevertheless; most skip that step onto the more attractive (and harder) road to increase production. Let’s take a hard look at dental math. The numbers don’t lie. I hope you are sitting down.

If your practice is ‘average’ and is burdened with 75% overhead, lowering the expenses by a mere 10% can produce astounding results. Here’s an example.

Let’s say you have a $500,000/year average dental practice operating for 30 years. At 75% overhead, your net income would be $125,000 each year. Lowering the overhead by 10% down to 65% would result in an increase of $50,000 net/year given the same production and collection. That increase calculated over the 30 years would mean an additional $1,500,000 of net income over your practice life. Again, given a 75% overhead you would have to produce 4 times that amount to receive those same dollars in net income . . ., an extra $6,000,000 of dentistry or $200,000/year for 30 years to accomplish the same result. That’s 4.8 months worth of work and collections each and every year.

What that means to you is that by choosing a measly 10% unnecessary amount of overhead for your practice, you will have to work an additional 12 years to support someone else! That’s more than one-third of your work life.

Or, if you continue to work the entire 30 years, you can pocket the extra $1.5 million. Both these first two calculations assume that you took the extra money and just put it under your mattress. What if you were to conservatively invest the ‘overage’ generated by this overhead reduction? Your work life would be cut by more than half!

A common overhead mistake is to be overstaffed as a result of using poor systems. Let’s say you have one extra employee being paid a salary (plus expenses) of $2500/month. Following the same formula as above, you will have to work an additional 7.2 years just for having the luxury of having one more employee when the crux of the issue would be to fix the less-than-efficient systems in your practice so as to painlessly solve the overhead problem.

Please don’t get caught in the trap believing that production is directly tied to the number of employees. It’s simply not true. A well run practice can collect $25K to $40K/month/employee. Fix the systems, fix the overhead.

Where are the money holes in your practice? Even in you think you want to ‘die at the chair’ because you enjoy dentistry so much, wouldn’t it be nice to at least have the choice as to when you retire? Plus, how do you know what the future will bring? How you’re your health be in your 50’, 60’s or 70’s? How long will you live? And wouldn’t having the choice to retire sooner be better than later?

Don’t let your higher than needed overhead force you to miss the best part of your life. If you feel tired and wish you had more flexibility in your life’s work schedule, look at your overhead. Get some specialized help if you need it.

How many extra years are you going to have to work simply because you have chosen high overhead? An extra 10% is in fact doubling your work load. Don’t you have a family member or someone else who could benefit from that extra time?  What about you?

Don’t let the magic pass you by.

 

The Power of the… Pause

Those of us who have had a career in dentistry have been taught and conditioned to present a solution as soon as we hear a problem. Listening without speaking actually runs counter to the instincts of not only our communication with patients, but to sales in general. In fact, we live in a society where it’s a habit for many people to interrupt.

How you feel when you’re interrupted before you finish your thoughts? Do you feel frustrated? Annoyed? Like you are being sold to? Listening carefully to patients isn’t easy but the rewards are great.

Here’s a powerful tip for successful case acceptance – the pause. This means waiting, and not jumping in at the first opportunity.

Reasons to pause:

• Your patients may be simply stopping to take a breath, or to gather their thoughts.

• They may be gauging your interest in their point of view, to see if you’re listening or simply waiting to jump in. When you resist the urge to jump in, you are often pleasantly surprised to hear that there’s more, and it is important.

• Most people feel uncomfortable with silence, so they rush in to fill the void. Instead of you rushing in, why not let your patient fill the void?

• Your patients feel validated and important when you give them a chance to elaborate on their thoughts.

• Pausing gives you time to think before you respond to a question or objection.

How to pause –

• Minimize distractions. Focus on your patient! If you look out
the window, or think about lunch, or the patient that is waiting in the next room, your mind will jump and you could completely miss valuable information. Your patients know when you are distracted.

• Use the most natural reason to pause, which is curiosity. If you really want to hear what your patient has to say you will pause naturally as you wait for them to elaborate.

* Ask a question with the intent to get an answer. And really listen to the answer, paying attention to what motivates your patient rather than making assumptions or trying to ‘plant’ answers. Asking ‘What else?’ can always get you to the next level of information with your patients.

Eat That Frog!

Mark Twain once said that if the first thing you do each morning is to eat a live frog, you can go through the day with the satisfaction of
knowing that that is probably the worse things that is going to happen to you all day long.
Your “frog” is your biggest, most important task, the one you are most likely to procrastinate on if you don’t do something about it.

If You Have to Eat Two Frogs, Eat the Ugliest one First  –This is another way of saying that if you have two important tasks before you, start with the biggest, hardest, and most important task first. Discipline yourself to begin immediately and then to persist until the task is complete before you go on to something else.

It Doesn’t Pay to Sit and Look at it for Very Long  – The key to reaching high levels of performance and productivity is to develop the lifelong habit of tackling your major task first thing each morning. You must develop the routine of “eating your frog” before you do anything else and without taking too much time to think about it.

Take Action Immediately – Successful, effective people are those who launch directly into their major tasks and then discipline themselves to work steadily and single-mindedly until those tasks are complete. “Failure to execute” is one of the biggest problems in organizations today. Many people confuse activity with accomplishment. They talk continually, hold endless meetings, and make wonderful plans, but in the final analysis, no one does the job and gets the results required.

Develop a Positive Addiction – You can actually develop a “positive addiction” to endorphins and to the feeling of enhanced clarity, confidence, and competence that they trigger. When you develop this addiction, you will, at an unconscious level, begin to organize your life in such a way that you are continually starting and completing ever more important tasks and projects. You will actually become addicted, in a very positive sense, to success and contribution.

No Shortcuts – Practice is the key to mastering any skill. Fortunately, your mind is like a muscle. It grows stronger and more capable with use. With practice, you can learn any behavior or develop any habit that you consider either desirable or necessary.

Action Exercise – What is your “frog?” What is the one task that you despise doing each day? Once you have chosen your “frog” make it a habit to wake up every morning and do that task first.

 

5 Steps to Getting New Patients to Schedule… and Show Up!

 

1. Build a relationship – In a nutshell, this means that you listen more than you talk.  It doesn’t mean that you vomit your knowledge all over the patient.

• Learn their name and use it several times throughout the conversation. Before answering any questions at all, connect on a personal level by introducing yourself and connecting by name. You may even ask for a quick call back number in the event you lose the call, but more importantly it will make follow up easy in the event the patient does not schedule.
• Find out their ‘story’. You can’t build a relationship without showing interest and being genuinely interested in the person on the other end of the line. This means you don’t put them on hold, and you give them 100% undivided attention.
• Show Empathy in pain/emergency situations– . ‘I’m so sorry you’re having to deal with this.  Brady is fantastic and I’ll know he’ll be able to make your comfortable’.
• Be Curious – Don’t just go through the motions asking ‘dental’ questions, Get more information – ‘tell me more about what’s going on’. ‘it sounds like you’ve been told you might need a crown – tell me more about that’. ‘It sounds as if you’ve done your homework – tell me what you know about teeth whitening and more about what you have in mind.’ What do they know about the procedure they are asking about? Ask about desired end result – ‘Tell me what you’re wanting to accomplish’ ‘Are you looking for a long term solution, or something shorter term/quick fix’
• Show Enthusiasm! They chose YOU.  They took time away from what they were doing to find your phone number and call YOU.  Be enthusiastic and show gratitude, thanking them for calling. Answer  the phone every time as if your caller ID says ‘Chris Hemsworth’. (:

2. Avoid drawing attention to insurance. We’ve all been trained to ask ‘Do you have insurance?’ before we even know the prospective patients name! If insurance is important to them, they will bring it up.  Your focus should be on helping the patient, not creating a culture that is insurance-driven.  I’m not suggesting that you stop accepting insurance- yet.  But if you stop talking about it, you’d be amazed at how you can decrease the impact it has on your practice. Regardless of whether you accept their ‘plan’ or not, don’t arm wrestle with the caller. ‘We work many different plans and will do everything we can to maximize your benefit’.  Get them through the door and give them an experience that results in ‘insurance’ becoming secondary.  The worst case scenario – you aren’t contracted with their ‘plan’, and you aren’t reimbursed the full amount of the services.  Adjust off the difference, letting the patient know that you are happy to do so for their first visit.  Consider it a marketing cost – otherwise, you aren’t even giving them the opportunity to be a patient.
3. Remove the financial obstacles –

• Charge one simple fee for your new patient visit, probably not more than $200. By simplifying the fee, you don’t have to factor in all variables, i.e: whether or not they have x-rays, fluoride, etc.  All of the different fees can potentially confuse and overwhelm your prospective patient.
• Maybe you have a ‘shopper’ – If appropriate, offer a no charge quick visit to evaluate. ‘I’ll bet I could even talk Dr. Brady into taking a look at that tooth without charging you. We can then get more information about what you want to accomplish and come up with a plan to proceed’ Other than the fee, can you tell me what’s most important to you?’   OR   ‘I would love to be able to give you an accurate fee – it’s just tough to do so without more information.  It sounds like cost is a major factor for you – we have some great ways to help our patients with their treatment investment – would that be helpful to you?’
• Remember, just because a patient asks about cost, it doesn’t mean they don’t have the potential to be a great patient in your practice. Cost is the only barometer they have for comparing you to other practices when they call you.  Your goal should be to build the relationship in a way that cost becomes secondary by the end of the call.  Put the money on the shelf and focus on the person.

4. ASK FOR THE APPOINTMENT! Your objective is to get them in the practice, not answer all of their questions.  You see, there is a motivation behind the questions asked – they already know the answer they are seeking.  If you don’t have the ‘right’ answer, you don’t earn the appointment.  We have the opportunity to conduct several ‘secret shopper’ calls and believe it or not, one of the worst offenses is when the team member answering the phone simply answers questions, and never invites the caller to become a patient.  You are much more than a ‘question-answerer’- you control the new patient flow in the practice!

5. Continue to build the relationship between the initial phone call and first visit to your office.

• Be certain that your potential patient receives something from you between the call and visit – a welcome letter, testimonials, etc., can be sent via snail mail, or email if time is short. I’m not talking about a notice with all of your office ‘policies’, ie: cancelation policy, financial policy, etc., but a letter that sends a message of gratitude and builds the level of value for the new patient visit.
• Direct patients to updated social media and website – same parameters apply to your online presence as written communication – focus on the benefits and what you CAN do for patients. Create a culture where your patients are natural endorsements for your practice through a heavy web presence of online reviews, patient-centered social media, and an updated website
• Here’s a novel idea – What if your doctor called them the night before to touch base letting the patient know they are looking forward to meeting them? This can make an amazing impression and may be the difference between the patient showing up or not.

 

 

2015 was our highest collections total ever!

When our team started with the Brady Group about 8 years ago, we had previous experience working with two different consultant groups. While each relationship helped us improve, I felt we still were not reaching our full potential.

I knew what I wanted to accomplish: simplified systems, a bonus/incentive plan that motivated the team and was fair to both team and doctor, lower overhead, and more time off without
a significant decrease in productivity. I just didn’t know how to get there. Working with Chris, Amy, and the rest of the Brady Group team, we were challenged individually and as a team to create a vision of where we wanted our practice to go, and then given the tools to help us get there.  Our team has grown professionally and personally, and the interaction with other Brady Group doctors and teams has shown us what is possible and encouraged us during our journey. I have grown as a leader, and our team has reached a level of trust in each other that I was not sure was possible.

How successful have we been? 2015 was our highest collections total ever while seeing patients for only 180 days during the year.  Our profitability is excellent and our overhead is 54%. We are not contracted with any insurance plans. The systems the Brady Group helped us implement allowed us to accomplish this with 3 highly motivated and cross trained full time in office team members (and one ace full time business administrator working from home), which is two less team members than when we started. Last year, every team member ear
ned over $12,000 each in additional earned income (bonus). In 2016 we are working 12 less days, seeing patients for a total of 168 days, and structuring the schedule so that we are taking the entire month of July off. Most importantly of all, we’ve done it emphasizing an attitude of service to our patients that honors each individual’s unique priorities and wants.

We still have work to do and improvements to make (especially the doctor!), but are confident going forward that we will be able to meet the challenges that each of us in dentistry face each day. If you and your team are willing to truly look at yourself honestly, have the courage to change, and need an expert to help with that process, I highly recommend the Brady Group team.

David R. Hennington

Tradewinds Dental, Georgetown, TX

 

6 WAYS TO GAIN INDEPENDENCE FROM PPO’S

Are you hearing from other consultants that if you don’t jump on the PPO wagon, hire more people or go corporate, that you’ll drown? Well, that’s just not true.  Interestingly enough, the ‘consultants’ out there preaching this message aren’t even dentists.   Their message is appealing because it doesn’t require you to really change.  You just have to work harder. And longer.  And harder.

 With all of the mixed messages out there, it’s tough to figure out just where to start.  We’ve simplified our proven process for you…

1. Stop talking about Insurance

It’s the first question we’ve all been trained to ask when a new patient calls.  This bad habit immediately sends the message to prospective patients that insurance is an important part of our practice… and then we can’t figure out why our patients are so ‘insurance-driven’.  If it’s important, the patient will bring it up – I promise.  Once they bring it up, it’s fair game.  However, resist the urge to get caught up in an insurance discussion.  Keep it simple. Do yourself a favor and stop fulfilling the role of the ‘all-knowing’ connection to their insurance.  Instead, focus on building relationships and helping people. Additionally, remove all written communication pertaining to insurance. Take it off of your new patient forms (you can just copy their card- they fill it out wrong most of the time anyway).  Take it off of your treatment plan – what if you simply gave the patient a total for their treatment, instead of committing FOR the insurance company what you think they will pay?  I know that sounds like a crazy idea – but is it any crazier than you taking ownership for how much THEIR insurance might pay?  Don’t get me wrong – I’m not proposing that you stop taking insurance assignment –  it’s just a matter of learning how to communicate differently.  You’d be amazed at how your patient relationships will improve when you remove the insurance factor.

2. Have a reality check – Evaluate the PPO influence on your practice

Do you even know how many plans you participate in?  Do you know much more dentistry you are having to produce to make up for the adjustments?  So many doctors have no idea where to start. They just know that they have to stay ‘busy’ in order to pay most of the bills.  In spite of what you might be hearing from other consultants, you will be more profitable if you are not ‘busy’.  In fact, the more your schedule becomes clogged with extra hygiene columns (to support the ppo influx), the less time you have to spend with patients and diagnose long-term, ideal dentistry.  Your production per patient goes down, and soon you find yourself operating like an emergency dental clinic. Here’s the plan…

First, run a list of all of the PPO’s that you accept

Second, How many patients have you seen on each plan over the last year?

Third, figure the revenue that each plan has brought to the practice.

Fourth – figure your $ per pt by dividing the number of patients on each plan in to the total revenue on that particular plan

Fifth – What is your average write-off % for each plan?

Now that you have this data, you can quickly identify the plans that are costing you money when you see those patients.  You may find that you would be better off giving those patients fifty bucks and sending them to the guy down the street!

3. Broaden your referral opportunities – How many referrals are ppo vs. those that find you on the internet, through community involvement, or through non-insurance related referrals? Do you even know?  I’m amazed at how many practices don’t have a feel for where their new patients are coming from.  Do you ask for referrals?  Reward referrals? Are you so ‘busy’ that your patients’ perception is that you’re too busy for new patients? Do you consistently cultivate win-win relationships with other professionals in your area? Give back to your community?

Identify 12 professionals/businesses/community events that you can add to your calendar over the next year.  Plan to participate in the events with the purpose of adding to your marketing list of prospective patients.  Introduce yourself to professionals and businesses in your area that you already contribute to as a consumer.  Thank them for their service, and introduce yourself.  Share the benefits of your practice, and share an offer with them that makes it easy to become a patient. You then have access to their circle of influence.  It’s a win-win!

4. Build your skillset to provide services that are beyond the scope of insurance. Sleep apnea, 6-month smiles and holistic dentistry are just the tip of the iceberg.  When was your last clinical CE course?  Have you learned anything new in the last year?  If all you are doing is trying to sell more single-tooth dentistry, it will an uphill battle to become profitable, especially if your practice is PPO-influenced. However, if you are trained and confident in offering state-of-the-art solutions that extend beyond the scope of insurance (not covered by most dental plans, choices patients make regardless of insurance, significant treatment plans that max out their benefits, etc.)  you’ll find that your practice becomes less dependent upon the PPO monster. Don’t get me wrong- it’s not about adding as many products to your shelf as you possibly can – it’s about finding something you enjoy outside the scope of typical bread and butter dentistry and becoming the ‘expert’ in that area.
5. Beef up your online reputation – if someone were to google you, what would they find? Are your reviews plentiful?  Is your online presence up to date?  Is your social media updated and engaging?   If I googled ‘Dentist your town’, would you even come up?  The internet is how people make decisions.  Even referrals – if your patient Suzie tells her neighbor Jane about you, Jane is likely to go home and google you to get more information- ie: phone number, location, see what you look like etc. Would their findings reinforce or contradict Suzie’s endorsement?  I’m not necessarily talking about SEO – yes, that’s a factor, but even optimizing your website won’t do any good if your driving people to something boring or negative.
6. Provide an exceptional, relationship-based experience. I recently switched pharmacies.  Over the last 4 months, we’ve had illnesses, surgery, injuries, etc in our family that have required us to visit the pharmacy about 1-2 times/week.  This pharmacy happens to be in the grocery store 2 blocks from my home – not counting the pharmacy visits, I’m there a couple of times/week, and often walk right by the pharmacy counter while shopping for groceries.  It’s safe to say that my face is pretty familiar.  The Starbucks barista and I are on a first-name basis – just as I am with several of the cashiers.  Then there’s the pharmacy – THE SAME GUY is there 95% of the time.  One day I dropped my rx off, grabbed a few items and returned 10 minutes later to pick it up and pay.  Here’s how I was greeted – (head down looking at computer with hands on keyboard), ‘Name, please?’  Are you kidding me?   And yes, he’s the same guy that took my rx just 10 minutes earlier.  Then one night I had to go to Walgreens late to get a prescription filled after my grocery store pharmacy was already closed.  My very first time to drop off a prescription there and I was thanked… by name.  When I returned to the counter a few minutes later to retrieve my prescription, I was greeted… by name.  ‘Mrs. Drewery, we have your prescription ready!’  and after paying, ‘Thank you for coming in! Are there any other prescriptions we can help you with? If you have any that you’d like to transfer over, we’d be happy to take care of that for you – oh, and just to show our thanks, you’ll receive a $10 gift card for each RX transferred’.  Well, yeah!  Deal done. How are you even different from Comfort Dental?  And don’t even say, ‘we provide a warm, caring environment’.  Do you spend just as much time on relationships as you do teeth?

 

Are you ready to make some changes in order to regain your freedom?  

I know the Scheduling Institute probably isn’t the best reference here, but one thing I learned from Jay is that you can either live by Faith or by Fear.  He recommended living by Faith.  Of course, where the scheduling institute is concerned, living by faith basically amounted to “have faith and give us a lot of money and we’ll help you do better.”  

 Looking back now, I realize that at that point I should have hired the Brady group.  I didn’t know about you guys and I went with the Scheduling Institute instead, which taught me a few things but ultimately the math didn’t work out with them (as you know).

 If I had hired the Brady Group, you guys would have coached and encouraged me to get out of some PPO’s and I probably would have been less busy and much happier.  Instead, I hired more staff, signed up for more insurances and started spending very heavily on marketing.  We all know how that turned out.

You guys are great to work with, too!  You are always SO responsive – I feel like I can get a response from you pretty much any time day or night.  Even text messages occasionally in the evenings…that’s customer service you can’t get anywhere else.  And I can’t tell you how much I appreciate that . 

JIM CRAIG, SUMMERBROOK DENTAL

AURORA, CO

One month later, we received this note from Dr. Craig –

 Thanks to our ‘new’ new patient experience, we are having some very successful planning appointments!

It feels so good to help this patient get what he wants.  If I had treatment planned him the “old way” that I was used to (chairside diagnosis, patching things up and putting him on the “crown-a-year club”) then we would have never really gotten him the result he wanted, and he would have probably spent a lot more money over the next 30 or 40 years.  I love this concept of giving patients what they want instead of what we think they need or think they ought to have!

Are You Missing Out?

Melody, Stacy, Tracy and Dr. Scott Anderson received this from an EXISTING patient! Are you asking existing patients the same questions you would ask new patients? Or are you making assumptions and missing out on potentially being able to help those who trust you?