1 00:00:03,333 --> 00:00:09,613 Host Track: : Welcome to Shared Practices 2.0 with another Update Ask George episode. 2 00:00:09,953 --> 00:00:14,333 Host Track: : The collision of frameworks that we talked about last week, the mess, 3 00:00:14,353 --> 00:00:16,073 Host Track: : the goodness, the learning, the joy. 4 00:00:16,673 --> 00:00:19,513 Host Track: : We're going to talk about that a little bit more today. So, George, welcome back. 5 00:00:20,213 --> 00:00:24,393 Guest Track:: Thanks, Richard, for having me back. And, you know, this will be a shorter episode 6 00:00:24,393 --> 00:00:29,033 Guest Track:: because a lot of people who have kind of heard our, you know, 7 00:00:29,053 --> 00:00:31,973 Guest Track:: original framework, this will sound more or less familiar. 8 00:00:31,973 --> 00:00:38,313 Guest Track:: And I think that on the last episode, we talked about Scott coming on to the 9 00:00:38,313 --> 00:00:39,193 Guest Track:: Shared Practices podcast. 10 00:00:39,613 --> 00:00:43,593 Guest Track:: And we talked about shared practices, sharing best practices. 11 00:00:43,813 --> 00:00:47,733 Guest Track:: And we talked about where Scott changed our framework. 12 00:00:47,993 --> 00:00:53,533 Guest Track:: And he changed our framework in the minds of income, right? 13 00:00:53,613 --> 00:01:01,113 Guest Track:: Like we've always proposed dentists take a fast path to growth that has a period 14 00:01:01,113 --> 00:01:03,933 Guest Track:: of income turbulence that we just 15 00:01:03,933 --> 00:01:07,353 Guest Track:: call something that they need to set expectations for and move through. 16 00:01:07,753 --> 00:01:13,413 Guest Track:: And Scott suggests taking a slower, more patient path that doesn't necessarily 17 00:01:13,413 --> 00:01:14,693 Guest Track:: have that drop in income. 18 00:01:14,873 --> 00:01:18,473 Guest Track:: And that was a lot of what we talked about on the last episode of Ask George. 19 00:01:18,853 --> 00:01:24,573 Guest Track:: And this episode, we're going to talk about the y-axis of that chart, 20 00:01:24,673 --> 00:01:30,413 Guest Track:: which is just the movement through avatars of our philosophy through a patient 21 00:01:30,413 --> 00:01:31,813 Guest Track:: flow hygiene-led growth. 22 00:01:32,093 --> 00:01:37,793 Guest Track:: Because when we were in the process of recruiting Scott to join Shared Practices, 23 00:01:37,933 --> 00:01:42,113 Guest Track:: that was one thing that we kind of said, no, this is our flag in the ground 24 00:01:42,113 --> 00:01:44,193 Guest Track:: where we're different and we're unique. 25 00:01:44,413 --> 00:01:50,353 Guest Track:: And it's what makes us, in our minds, so good at what we do is that we have 26 00:01:50,353 --> 00:01:54,093 Guest Track:: this totally different way of taking practice management and topping it upside down. 27 00:01:54,373 --> 00:01:59,533 Guest Track:: And that's through our hygiene-led growth. And so I feel like this episode, 28 00:01:59,713 --> 00:02:04,893 Guest Track:: it's just a really good place to kind of bring that back into the conversation. 29 00:02:05,273 --> 00:02:10,253 Guest Track:: Because, you know, we've removed the whole, you know, 700 episodes of the podcast. 30 00:02:10,933 --> 00:02:16,353 Guest Track:: And, you know, that was, you know, like early, we hadn't yet discovered that way. 31 00:02:16,793 --> 00:02:19,613 Guest Track:: And then later, it kind of came to fruition. 32 00:02:20,253 --> 00:02:23,893 Guest Track:: And then we did start discussing this new way of doing things, 33 00:02:23,933 --> 00:02:25,013 Guest Track:: what we call hygiene-led growth. 34 00:02:25,413 --> 00:02:29,773 Guest Track:: And so I think that that, for me, is really where I would like to go in today's episode. 35 00:02:30,976 --> 00:02:34,396 Host Track: : This was an instant light bulb, even as we hit record, because we just talked 36 00:02:34,396 --> 00:02:39,336 Host Track: : about this in our previous episode a little bit in terms of there are two different 37 00:02:39,336 --> 00:02:41,356 Host Track: : tracks or what are we maximizing for? 38 00:02:41,396 --> 00:02:47,276 Host Track: : Are we maximizing for income all along the way or are we maximizing for growth speed? 39 00:02:47,616 --> 00:02:53,356 Host Track: : And I think as you have been talking, the light bulb turned on for me of the 40 00:02:53,356 --> 00:02:56,296 Host Track: : hygiene department is really where the rubber meets the road here. 41 00:02:56,296 --> 00:02:59,216 Host Track: : We are either maximizing the hygiene 42 00:02:59,216 --> 00:03:05,176 Host Track: : schedule for the most productive hygiene schedule and therefore a ton amount 43 00:03:05,176 --> 00:03:09,516 Host Track: : of profitability in a dental office comes from that hygiene schedule or we're 44 00:03:09,516 --> 00:03:15,236 Host Track: : maximizing it for openings and new patient growth and expanding of hygiene days 45 00:03:15,236 --> 00:03:17,616 Host Track: : as a constant in our practice, 46 00:03:17,776 --> 00:03:24,076 Host Track: : which is a little inefficient in terms of cost and in terms of maximizing profit. 47 00:03:24,376 --> 00:03:31,396 Host Track: : You are sacrificing a jam-packed schedule for a schedule that can grow faster. 48 00:03:31,696 --> 00:03:35,696 Host Track: : And you still can be profitable all along the way with a hygiene schedule like this. 49 00:03:35,816 --> 00:03:41,756 Host Track: : But I love this episode because it is a major difference in these two frameworks 50 00:03:41,756 --> 00:03:47,756 Host Track: : or these two paths is the ability to make a decision with what you're going 51 00:03:47,756 --> 00:03:49,076 Host Track: : to do in your hygiene department. 52 00:03:49,516 --> 00:03:52,276 Guest Track:: Yeah. And I'm going to kind of bring back Dental Money Ball, 53 00:03:52,396 --> 00:03:54,316 Guest Track:: right? Dental Money Ball is the book that we wrote. 54 00:03:54,436 --> 00:03:58,216 Guest Track:: And the purpose of that book is saying, I've never heard of shared practices. 55 00:03:58,316 --> 00:04:02,196 Guest Track:: I have no idea what, you know, hygiene-led growth is. 56 00:04:02,796 --> 00:04:07,896 Guest Track:: And, you know, we essentially kind of explain it all in 180 pages. 57 00:04:08,076 --> 00:04:13,056 Guest Track:: And in that book, we talk about the dental two-point shot versus the dental three-point shot. 58 00:04:13,296 --> 00:04:19,336 Guest Track:: And so I want to kind of talk through, you know, these two different hygiene 59 00:04:19,336 --> 00:04:23,416 Guest Track:: gene approaches and what they each optimize for. 60 00:04:23,596 --> 00:04:26,676 Guest Track:: And so let's start with the dental two-point shot because that's what... 61 00:04:26,676 --> 00:04:32,576 Guest Track:: So the dental two-point shot, and a two-point shot is a known, 62 00:04:32,736 --> 00:04:36,136 Guest Track:: predictable, responsible outcome. Robert Leonard. 63 00:04:36,782 --> 00:04:40,662 Guest Track:: So if you kind of look at like our, you know, high income earning, 64 00:04:40,762 --> 00:04:46,242 Guest Track:: slower growth path, that's where this slides in, you know, very effectively. 65 00:04:46,342 --> 00:04:49,622 Guest Track:: And the question that you asked between the two point shot and the three point 66 00:04:49,622 --> 00:04:51,062 Guest Track:: shot is what are we optimizing for? 67 00:04:51,342 --> 00:04:55,662 Guest Track:: What is our strategic approach aimed at accomplishing? 68 00:04:55,882 --> 00:05:02,922 Guest Track:: And in the case of the two point shot, the strategic approach is aimed at optimizing 69 00:05:02,922 --> 00:05:06,622 Guest Track:: for hygiene department profitability, right? 70 00:05:06,622 --> 00:05:12,502 Guest Track:: So if you're taking that slower path and you are interested in income being 71 00:05:12,502 --> 00:05:16,982 Guest Track:: something that is highly prioritized, then your hygiene department needs to 72 00:05:16,982 --> 00:05:20,122 Guest Track:: be an income-generating engine for you and the practice. 73 00:05:20,982 --> 00:05:24,662 Guest Track:: And so when you're making decisions around hygiene, you need to be thinking 74 00:05:24,662 --> 00:05:25,982 Guest Track:: about it with income in mind. 75 00:05:26,122 --> 00:05:30,662 Guest Track:: And so that's really the perspective that Scott is bringing into our podcast 76 00:05:30,662 --> 00:05:34,982 Guest Track:: is the, Scott is a proponent of the assisted hygiene schedule, 77 00:05:35,122 --> 00:05:43,702 Guest Track:: and he's a proponent of the profitability being like a staple of a well-run hygiene department. 78 00:05:44,702 --> 00:05:52,142 Guest Track:: And that is optimizing for that hygiene department contributions to the practice level profits. 79 00:05:52,382 --> 00:05:57,822 Guest Track:: And that ultimately means that you have a tight schedule, you focus on adjunctive 80 00:05:57,822 --> 00:06:02,282 Guest Track:: services, You focus on kind of pulling value out of the hygiene department, 81 00:06:02,462 --> 00:06:05,962 Guest Track:: but you're not laser focused on growing the hygiene department. 82 00:06:06,202 --> 00:06:09,562 Guest Track:: And that is kind of the key difference. So, Richard, like, 83 00:06:09,622 --> 00:06:16,302 Guest Track:: what do we need to say about kind of the responsible profit-focused philosophy 84 00:06:16,302 --> 00:06:21,262 Guest Track:: on hygiene that, you know, has really been a staple in our industry for a long time? 85 00:06:22,565 --> 00:06:28,625 Host Track: : I mean, this is where you can just build that stable profitability of, 86 00:06:28,665 --> 00:06:33,165 Host Track: : you know, the beauty of a GP practice is your recurrent hygiene base. 87 00:06:33,305 --> 00:06:37,665 Host Track: : And if you can really push towards maximizing, okay, we've got the assisted hygiene. 88 00:06:37,885 --> 00:06:40,225 Host Track: : Here are the patients that maybe have less dental needs. 89 00:06:40,465 --> 00:06:45,245 Host Track: : They're less likely to need SRP. They're less likely to need ongoing restorative care. 90 00:06:45,445 --> 00:06:49,365 Host Track: : And so they're the straightforward patients. We kind of move those onto these 91 00:06:49,365 --> 00:06:51,945 Host Track: : schedules and we've got the patients with higher needs. 92 00:06:52,565 --> 00:06:57,685 Host Track: : But I also think there's the ability to evaluate all these parts and pieces, 93 00:06:57,765 --> 00:07:04,745 Host Track: : and we're providing some paths, but there is the ability to take the best of 94 00:07:04,745 --> 00:07:06,365 Host Track: : these and your unique situation. 95 00:07:06,565 --> 00:07:10,405 Host Track: : So it's like maybe you really just can't find another frigging hygienist. 96 00:07:10,445 --> 00:07:14,945 Host Track: : And so you're trying to grow, you're trying to accelerate your hygiene schedule, 97 00:07:15,205 --> 00:07:19,065 Host Track: : and you need to do assisted hygiene to have more hygiene openings. 98 00:07:19,065 --> 00:07:24,745 Host Track: : So while we're describing these as kind of dogmatic paths of here's one way 99 00:07:24,745 --> 00:07:28,385 Host Track: : to go, here's another way to go, as an entrepreneur and as, 100 00:07:28,585 --> 00:07:31,925 Host Track: : you know, this is why we provide coaching, this is why we help people on an 101 00:07:31,925 --> 00:07:36,165 Host Track: : individual level, there might be times where your path is a blend of these or 102 00:07:36,165 --> 00:07:40,125 Host Track: : you have to use one tool for a little while before you can use the other tool. 103 00:07:40,125 --> 00:07:49,225 Host Track: : But the profitable hygiene department and a periodiagnosing fluoride using case 104 00:07:49,225 --> 00:07:55,525 Host Track: : acceptance driving hygiene department is the pinnacle of a systems-based practice. 105 00:07:55,725 --> 00:07:57,345 Host Track: : We love all of this stuff. 106 00:07:57,745 --> 00:08:00,945 Host Track: : But what are you doing with all of that? 107 00:08:01,025 --> 00:08:05,885 Host Track: : Are you really doubling down on profitability and controlling the costs? 108 00:08:06,005 --> 00:08:12,025 Host Track: : Or are you doubling down on growth? And so it's the same tools just applied 109 00:08:12,025 --> 00:08:13,245 Host Track: : in different directions. 110 00:08:13,685 --> 00:08:16,725 Guest Track:: And I think, you know, one thing that was really interesting in our process 111 00:08:16,725 --> 00:08:18,845 Guest Track:: of bringing Scott on board is... 112 00:08:19,586 --> 00:08:24,806 Guest Track:: We both agreed that assisted or unassisted hygiene is not a one-size-fits-all 113 00:08:24,806 --> 00:08:26,666 Guest Track:: answer to all situations, right? 114 00:08:26,786 --> 00:08:30,246 Guest Track:: And so I think that we've always approached it from an unassisted hygiene perspective. 115 00:08:30,286 --> 00:08:36,306 Guest Track:: But I say that saying that we have a client who I personally worked with very, very long ago, 116 00:08:36,406 --> 00:08:40,666 Guest Track:: who started with five operatories, is now in 11 operatories, 117 00:08:40,686 --> 00:08:46,606 Guest Track:: and grew using the the dental three-pointer in assisted hygiene the whole time. 118 00:08:46,826 --> 00:08:53,046 Guest Track:: And so I think that whether you do assisted hygiene or unassisted hygiene is 119 00:08:53,046 --> 00:08:57,086 Guest Track:: more a function of your local environment, the wage of a hygienist, 120 00:08:57,266 --> 00:08:59,806 Guest Track:: the ability to attract new hygienists. 121 00:08:59,966 --> 00:09:04,146 Guest Track:: I think that's where you make the decision if you're assisted or unassisted. 122 00:09:04,406 --> 00:09:10,506 Guest Track:: I think that is almost independent of optimizing optimizing for profitability 123 00:09:10,506 --> 00:09:13,446 Guest Track:: versus optimizing for growth. Those are two separate things. 124 00:09:13,586 --> 00:09:17,126 Guest Track:: You can optimize for profitability, assisted or unassisted. 125 00:09:17,286 --> 00:09:21,046 Guest Track:: You can optimize for growth, assisted or unassisted. 126 00:09:21,226 --> 00:09:28,586 Guest Track:: I actually don't think assisted or unassisted hygiene is really a differentiator 127 00:09:28,586 --> 00:09:31,546 Guest Track:: between the two schools of thought. I think they're just tools in the toolbox. 128 00:09:32,046 --> 00:09:35,766 Guest Track:: And I really think it's like, if you're paying $60 an hour for a hygienist, 129 00:09:35,766 --> 00:09:38,486 Guest Track:: like you're probably going to want to get an 130 00:09:38,486 --> 00:09:42,646 Guest Track:: assisted hygienist like right and if you're paying 35 40 131 00:09:42,646 --> 00:09:45,466 Guest Track:: an hour for a hygienist you may want to 132 00:09:45,466 --> 00:09:50,406 Guest Track:: skew towards the unassisted hygienist and so i think that you know it really 133 00:09:50,406 --> 00:09:55,466 Guest Track:: depends on the makeup of your local market and the economies that are around 134 00:09:55,466 --> 00:09:59,126 Guest Track:: your local area with insurance reimbursements and that type of thing to really 135 00:09:59,126 --> 00:10:03,246 Guest Track:: dictate and also practice footprint right like you know assisted hygiene is 136 00:10:03,246 --> 00:10:04,726 Guest Track:: more financially efficient, 137 00:10:05,066 --> 00:10:07,386 Guest Track:: but it's like a little less space efficient. 138 00:10:07,786 --> 00:10:11,306 Guest Track:: And so I think that you also kind of have to consider your practice as well 139 00:10:11,306 --> 00:10:13,106 Guest Track:: in making that decision. 140 00:10:13,226 --> 00:10:15,066 Guest Track:: And I actually don't think assisted 141 00:10:15,066 --> 00:10:17,906 Guest Track:: or unassisted, it's something that somebody could easily focus on. 142 00:10:18,206 --> 00:10:21,906 Guest Track:: And I would almost rather say that Scott and I kind of, I was the unassisted 143 00:10:21,906 --> 00:10:25,946 Guest Track:: camp, he was the assisted camp, we kind of both agree that it's not a one size fits all. 144 00:10:26,286 --> 00:10:29,786 Guest Track:: And it really has nothing to do with your hygiene department strategy, 145 00:10:30,086 --> 00:10:33,246 Guest Track:: like in terms of the bigger picture of what you're optimizing for. 146 00:10:34,273 --> 00:10:41,473 Host Track: : I think this all does come to a head when you are at the moment of having the 147 00:10:41,473 --> 00:10:46,713 Host Track: : right number of hygienists or hygiene columns for the number of doctors. 148 00:10:47,153 --> 00:10:53,033 Host Track: : In that moment, what are you doing next? So you've got a full hygiene schedule. 149 00:10:53,333 --> 00:10:59,493 Host Track: : This is the fork in the road. Do I take that excess pressure of new patients, 150 00:10:59,613 --> 00:11:04,973 Host Track: : of trying to fit people into the practice, and renegotiate insurances, 151 00:11:05,013 --> 00:11:10,433 Host Track: : drop insurances, try and increase the profitability per patient right now? 152 00:11:10,953 --> 00:11:14,353 Host Track: : Or do I want to grow into my footprint? 153 00:11:14,513 --> 00:11:19,453 Host Track: : Because I think there's more opportunity in quickly growing into my footprint 154 00:11:19,453 --> 00:11:22,853 Host Track: : and what's possible in this location and getting to another doctor. 155 00:11:23,033 --> 00:11:27,713 Host Track: : And so do I take that excess demand and add more hygiene days? 156 00:11:27,713 --> 00:11:31,573 Host Track: : And I think that's the crux of which path are you going to. 157 00:11:31,753 --> 00:11:36,773 Host Track: : And until you reach that moment, this problem doesn't exist yet. 158 00:11:36,873 --> 00:11:42,353 Host Track: : It's like you keep adding hygienists and assisted or unassisted until you have 159 00:11:42,353 --> 00:11:45,513 Host Track: : maximized the amount of hygiene patients that one provider can see. 160 00:11:45,733 --> 00:11:50,373 Host Track: : And as you're approaching that limit, now the fork exists in the road. 161 00:11:50,613 --> 00:11:55,673 Guest Track:: And to Richard's point, there's kind of a fundamental truth where a dentist, 162 00:11:55,873 --> 00:12:00,033 Guest Track:: if they're checking for too few exams, then they're not as productive as they could be. 163 00:12:00,553 --> 00:12:04,553 Guest Track:: Then there's an optimal amount, and we kind of believe that to be two columns 164 00:12:04,553 --> 00:12:06,113 Guest Track:: of hygiene per dentist, right? 165 00:12:06,213 --> 00:12:11,453 Guest Track:: That's kind of what we've always said, is like two hygienists is sort of that amount. 166 00:12:11,693 --> 00:12:14,433 Guest Track:: But there's that amount where I'm seeing, and that's maybe a little different 167 00:12:14,433 --> 00:12:19,333 Guest Track:: for every dentist, but this is the amount where I'm peak productivity per patient. 168 00:12:19,453 --> 00:12:21,213 Guest Track:: I'm seeing a healthy volume. 169 00:12:22,064 --> 00:12:26,564 Guest Track:: But also, I have enough time with each one to focus on good case acceptance 170 00:12:26,564 --> 00:12:29,784 Guest Track:: and comprehensive treatment planning and diagnosis. 171 00:12:30,164 --> 00:12:37,504 Guest Track:: And so there's this optimal spot where you are in that good 55-mile-an-hour 172 00:12:37,504 --> 00:12:39,064 Guest Track:: pace that Scott was talking about. 173 00:12:39,264 --> 00:12:44,324 Guest Track:: And Richard's kind of fork in the road is, if you're in that place and you have 174 00:12:44,324 --> 00:12:51,224 Guest Track:: more demand, and both philosophies generate more demand, it's just, what do you do with it? 175 00:12:51,224 --> 00:12:58,304 Guest Track:: The kind of the Scott's approach is to increase the fees and value of each of 176 00:12:58,304 --> 00:13:00,624 Guest Track:: those patient interactions to further push profitability. 177 00:13:01,104 --> 00:13:05,924 Guest Track:: And our approach is to open the schedule ad providers and grow towards, 178 00:13:05,924 --> 00:13:10,584 Guest Track:: you know, more hygienists, more patients, more providers, and that may mean more dentists. 179 00:13:10,844 --> 00:13:15,644 Guest Track:: And that's kind of where, you know, Richard's saying the rubber meets the road. 180 00:13:15,644 --> 00:13:19,204 Guest Track:: And so I want to kind of talk about our dental three-pointer, 181 00:13:19,344 --> 00:13:23,624 Guest Track:: which we call retain, open, fill, or like those three things in that order. 182 00:13:23,904 --> 00:13:26,584 Guest Track:: And where this originated was me. 183 00:13:26,944 --> 00:13:31,324 Guest Track:: I bought a solo practice thinking it was a group practice. 184 00:13:31,664 --> 00:13:37,324 Guest Track:: And so I elevated my costs all the way up to my revenue, and I was making no money. 185 00:13:37,544 --> 00:13:39,924 Guest Track:: And I kind of had two options. 186 00:13:40,184 --> 00:13:45,644 Guest Track:: I had a group practice. I had multiple dentists. I had three hygienists. I had four assistants. 187 00:13:46,064 --> 00:13:52,164 Guest Track:: I had this big team. And so it was like, if I wanted to go back to earning a 188 00:13:52,164 --> 00:13:58,044 Guest Track:: sustainable income, my options were to remove a lot of people costs, 189 00:13:58,384 --> 00:14:00,604 Guest Track:: maybe remove a dentist, remove a hygienist. 190 00:14:01,224 --> 00:14:06,944 Guest Track:: Maybe get rid of a front desk and an assistant and really free up some overhead 191 00:14:06,944 --> 00:14:08,704 Guest Track:: so that I can have profit. 192 00:14:08,924 --> 00:14:15,504 Guest Track:: Or on the other side is grow my practice this to have four hygienists so that 193 00:14:15,504 --> 00:14:18,404 Guest Track:: each dentist was seeing enough patients to produce. 194 00:14:18,624 --> 00:14:24,084 Guest Track:: And then the revenue would grow to a point where I could be profitable as a group. 195 00:14:24,404 --> 00:14:29,884 Guest Track:: And that was really kind of the genesis for our philosophy. 196 00:14:30,084 --> 00:14:33,484 Guest Track:: And so I went to practice management courses that I'd been to. 197 00:14:33,544 --> 00:14:35,364 Guest Track:: One of them was the Scott Lewin Education Course. 198 00:14:35,544 --> 00:14:40,844 Guest Track:: And I saw Scott's philosophy about maximizing hygiene profitability. 199 00:14:41,344 --> 00:14:48,664 Guest Track:: But in my unique situation, hygiene profitability is not solving my problem. 200 00:14:48,724 --> 00:14:53,084 Guest Track:: My problem is that I had too many team members for the number of patients I had. 201 00:14:53,384 --> 00:14:57,764 Guest Track:: And that was where I had this lightbulb moment, which we call kind of the epiphany 202 00:14:57,764 --> 00:15:02,224 Guest Track:: behind our philosophy, which is there's a very linear correlation between... 203 00:15:02,224 --> 00:15:05,764 Guest Track:: There's like a very like, you add more patients, there will be more exams, 204 00:15:06,024 --> 00:15:10,164 Guest Track:: there will be more diagnosis, diagnosis there will be more doctor treatment and it's like. 205 00:15:10,937 --> 00:15:15,817 Guest Track:: It's almost accidental practice growth. If you focus on adding more patients 206 00:15:15,817 --> 00:15:20,237 Guest Track:: to your recurring subscription of hygiene, right, then there's more patients 207 00:15:20,237 --> 00:15:21,537 Guest Track:: coming back every six months. 208 00:15:21,697 --> 00:15:26,217 Guest Track:: You will just have more revenue each month because you have more people walking 209 00:15:26,217 --> 00:15:27,977 Guest Track:: through the door that have potential solutions. 210 00:15:28,297 --> 00:15:35,037 Guest Track:: And so our, you know, turning hygiene up on its head is essentially saying we're 211 00:15:35,037 --> 00:15:38,017 Guest Track:: going to optimize for hygiene department growth. 212 00:15:38,397 --> 00:15:41,637 Guest Track:: And that's really going to be where we sell out. 213 00:15:41,857 --> 00:15:46,517 Guest Track:: And we're going to sell out so much so that maybe for a period, 214 00:15:46,577 --> 00:15:51,737 Guest Track:: the hygiene department won't be as profitable because we're going to have openings in the schedule. 215 00:15:51,897 --> 00:15:56,997 Guest Track:: And openings in the schedule are hygiene department profitability hindrances. 216 00:15:57,217 --> 00:16:01,677 Guest Track:: They make it harder for the hygiene department to produce as much profit if 217 00:16:01,677 --> 00:16:04,777 Guest Track:: you have periods of time where your most expensive hourly employee, 218 00:16:04,937 --> 00:16:07,417 Guest Track:: the hygienist, is sitting there without seeing patients. 219 00:16:07,917 --> 00:16:12,297 Guest Track:: And so this was a very innovative philosophy because what it allowed for us 220 00:16:12,297 --> 00:16:17,617 Guest Track:: to do is to grow practices at a faster rate because we took this kind of risk. 221 00:16:17,977 --> 00:16:22,097 Guest Track:: But the downside and the flip side of that is that for a period of time, 222 00:16:22,137 --> 00:16:26,917 Guest Track:: a dentist has a reduced income because they have less profit contributing from hygiene. 223 00:16:27,137 --> 00:16:32,837 Guest Track:: And so, you know, that's really the kind of the hour side of things is, 224 00:16:32,897 --> 00:16:34,137 Guest Track:: you know, first we focus on retention 225 00:16:34,137 --> 00:16:38,057 Guest Track:: because we're trying to grow that hygiene base as much as we can. 226 00:16:38,297 --> 00:16:41,837 Guest Track:: Then we open up the schedule to allow for more people to come in. 227 00:16:42,157 --> 00:16:47,257 Guest Track:: Then we fill that openings and we teach team members how to be really creative in filling openings. 228 00:16:47,477 --> 00:16:51,197 Guest Track:: And then we retain all those people. And we just kind of do that in a cyclical fashion. 229 00:16:51,717 --> 00:16:55,757 Guest Track:: And the number of patients who come into the hygiene department grows. 230 00:16:56,377 --> 00:17:00,777 Guest Track:: And we can go from a solo to a group. And then we can go from a group to a mega 231 00:17:00,777 --> 00:17:05,177 Guest Track:: group, because we're essentially methodically growing the practice by adding 232 00:17:05,177 --> 00:17:10,357 Guest Track:: hygienists and adding a subsequent group of patients with each hygienist. 233 00:17:10,437 --> 00:17:14,737 Guest Track:: And so really kind of the dental three-pointer and the hygiene-led growth kind of. 234 00:17:15,511 --> 00:17:21,111 Guest Track:: Elements of our philosophy are around that predictable practice growth through 235 00:17:21,111 --> 00:17:24,811 Guest Track:: increasing the number of patients who come to your practice every six months 236 00:17:24,811 --> 00:17:29,811 Guest Track:: by aggressively opening and filling the hygiene schedule and optimizing for 237 00:17:29,811 --> 00:17:33,231 Guest Track:: practice growth instead of hygiene department profitability. 238 00:17:33,671 --> 00:17:37,771 Guest Track:: So you're running a hygiene department with growth as the key objective, 239 00:17:38,011 --> 00:17:44,471 Guest Track:: and it does trade for income in the short term, but it does grow your practice faster. 240 00:17:44,471 --> 00:17:49,371 Guest Track:: And so that was kind of where the shared practices hygiene-led growth philosophy 241 00:17:49,371 --> 00:17:52,991 Guest Track:: takes some of the, you know, maybe more profit-focused, 242 00:17:53,031 --> 00:17:55,991 Guest Track:: you know, traditional beliefs in the industry and kind of flips them upside 243 00:17:55,991 --> 00:17:59,831 Guest Track:: down because we say, you know what, the hygiene department does contribute profit, 244 00:17:59,971 --> 00:18:02,791 Guest Track:: but we actually want it to contribute practice growth instead. 245 00:18:03,051 --> 00:18:07,631 Guest Track:: And so we need to operate it differently with that in mind. so that was a very 246 00:18:07,631 --> 00:18:12,091 Guest Track:: long-winded but just kind of like the full very my most succinct way of describing 247 00:18:12,091 --> 00:18:15,231 Guest Track:: kind of what we do that's different as it pertains to hygiene. 248 00:18:15,231 --> 00:18:18,111 Host Track: : Well and and one of the key parts of 249 00:18:18,111 --> 00:18:23,711 Host Track: : this too that redeems this you know ache in a dentist's stomach when they're 250 00:18:23,711 --> 00:18:27,731 Host Track: : like oh hygiene openings and they push back one of the redeeming qualities of 251 00:18:27,731 --> 00:18:31,911 Host Track: : a new patient is the higher production per new patient and i also think it it 252 00:18:31,911 --> 00:18:35,091 Host Track: : leans back into this conversation we were having earlier that's not that important 253 00:18:35,091 --> 00:18:37,751 Host Track: : around assisted hygiene versus a hygienist. 254 00:18:37,971 --> 00:18:43,131 Host Track: : Hygienists are going to close better on needed treatment when well-trained than 255 00:18:43,131 --> 00:18:44,871 Host Track: : in an assisted hygiene setting. 256 00:18:45,131 --> 00:18:52,131 Host Track: : And if you've got more new patients, your ability to close on these higher potential 257 00:18:52,131 --> 00:18:57,391 Host Track: : dental need patients because not been regularly in your care is going to be 258 00:18:57,391 --> 00:19:00,071 Host Track: : better, which can redeem some of those openings. 259 00:19:00,411 --> 00:19:04,191 Host Track: : And I also just had a light bulb moment. I'm sure we've addressed this before 260 00:19:04,191 --> 00:19:07,291 Host Track: : and talked about it before, but I haven't fully grasped this. 261 00:19:07,391 --> 00:19:11,291 Host Track: : By having openings in your schedule, your retention is better. 262 00:19:11,391 --> 00:19:16,371 Host Track: : If your schedule is packed, not only do you decrease your number of new patients, 263 00:19:16,531 --> 00:19:21,471 Host Track: : you also inherently decrease your retention numbers and percentages. 264 00:19:21,811 --> 00:19:29,811 Host Track: : So we're accelerating the two halves of practice growth by paying for those 265 00:19:29,811 --> 00:19:35,651 Host Track: : openings, both the retention and the new patient flow and the overall growth of the practice. 266 00:19:35,811 --> 00:19:40,531 Host Track: : And the economics of it is helped by the additional revenue per new patient. 267 00:19:40,811 --> 00:19:47,611 Guest Track:: And so, Scott, if he was listening to this, I think he would say that he also 268 00:19:47,611 --> 00:19:54,831 Guest Track:: has sufficient openings in his philosophy for new patients and patients who want to come back in. 269 00:19:55,031 --> 00:19:58,031 Guest Track:: And that's like Like if you're going at 55 miles an hour, 270 00:19:59,240 --> 00:20:03,120 Guest Track:: There's going to be, you know, three openings in the next week or whatever it 271 00:20:03,120 --> 00:20:04,300 Guest Track:: might be to offer a new patient. 272 00:20:04,380 --> 00:20:07,460 Guest Track:: Like that's kind of something that's like kind of believed to be like best practices 273 00:20:07,460 --> 00:20:11,920 Guest Track:: is to offer a set number of opportunities in the next week, but to not have 274 00:20:11,920 --> 00:20:16,960 Guest Track:: like 13 chances for them to come in in the next week, maybe three or four. 275 00:20:17,120 --> 00:20:21,160 Guest Track:: So it's like we're kind of riding that line between profitability with breathing room. 276 00:20:22,240 --> 00:20:27,460 Guest Track:: And where we come in is we say, okay, let's have 13 openings in the next week 277 00:20:27,460 --> 00:20:30,880 Guest Track:: to bring in a new patient. And, you know, to Richard's point, 278 00:20:31,060 --> 00:20:33,640 Guest Track:: if you do that, there's going to be two consequences. 279 00:20:33,940 --> 00:20:37,680 Guest Track:: One, the hygiene department will be less profitable. And two, 280 00:20:37,940 --> 00:20:43,120 Guest Track:: more patients will book and more patients will be retained because there's more availability. 281 00:20:43,540 --> 00:20:50,120 Guest Track:: And so, you know, we have always slanted towards that patient growth is the 282 00:20:50,120 --> 00:20:54,160 Guest Track:: number one objective in operating a hygiene department because we've always 283 00:20:54,160 --> 00:20:58,000 Guest Track:: had a very entrepreneurial dentist who wants to grow their practice aggressively, right? 284 00:20:58,000 --> 00:21:02,280 Guest Track:: But we also have some dentists who have gone to two dentists, 285 00:21:02,340 --> 00:21:05,000 Guest Track:: they've gone to a group practice, they've gone from a solo to a group, 286 00:21:05,040 --> 00:21:06,660 Guest Track:: and they say, all right, I don't want the third dentist. 287 00:21:06,920 --> 00:21:10,180 Guest Track:: I want to have myself, I want to have an associate. 288 00:21:10,520 --> 00:21:14,880 Guest Track:: And then we're going to use that strong retention, but the openings are going to dwindle. 289 00:21:15,060 --> 00:21:20,540 Guest Track:: And we're going to kind of evolve back into hygiene department being profitability driving. 290 00:21:21,000 --> 00:21:26,420 Guest Track:: And so we view it as like a gas pedal, where it's like, yeah, 291 00:21:26,460 --> 00:21:29,000 Guest Track:: I'm going 55 miles an hour. I can keep doing that forever. 292 00:21:29,340 --> 00:21:33,360 Guest Track:: But I really want to get to this place. So I'm going to go 110 miles an hour 293 00:21:33,360 --> 00:21:34,460 Guest Track:: for a short period of time. 294 00:21:34,920 --> 00:21:38,340 Guest Track:: And it's going to hurt my income. I'm going to get there. And then I'm going 295 00:21:38,340 --> 00:21:39,840 Guest Track:: to kind of turn the screws back to 55. 296 00:21:40,400 --> 00:21:44,980 Guest Track:: And that's kind of where we really include that. It's like we want to have those 297 00:21:44,980 --> 00:21:47,160 Guest Track:: intermediate periods be as fast as possible. 298 00:21:47,580 --> 00:21:53,660 Guest Track:: And so we're going to use practice growth through hygiene opening as a way to 299 00:21:53,660 --> 00:21:55,400 Guest Track:: get there maybe a little faster. 300 00:21:56,060 --> 00:22:00,700 Guest Track:: But, you know, in the meantime, maybe hygiene won't be contributing as much 301 00:22:00,700 --> 00:22:03,860 Guest Track:: profit to the overall picture, but we're going to be growing. 302 00:22:04,040 --> 00:22:07,380 Guest Track:: And so that's sort of the trade-off that a dentist needs to make. 303 00:22:07,620 --> 00:22:10,020 Guest Track:: And you can see how this kind of builds on the last episode, 304 00:22:10,080 --> 00:22:14,780 Guest Track:: because we were talking about it from the perspective of choosing what you want and avatar selection. 305 00:22:14,980 --> 00:22:18,880 Guest Track:: And now we're talking about it in the framework of how are we going to operate 306 00:22:18,880 --> 00:22:21,380 Guest Track:: the hygiene department with different objectives for different people. 307 00:22:21,720 --> 00:22:25,160 Guest Track:: And, you know, hopefully that kind of starts to come together for people, 308 00:22:25,220 --> 00:22:28,200 Guest Track:: and I'm sure we're going to touch on it again in future episodes. 309 00:22:28,260 --> 00:22:32,680 Guest Track:: But that's kind of more or less on a high level, how the differences in how 310 00:22:32,680 --> 00:22:37,580 Guest Track:: we think impact how we operate, you know, the same thing, which is a hygiene department. 311 00:22:37,760 --> 00:22:41,900 Guest Track:: One school of thought optimized for profitability, the other school of thought, 312 00:22:42,000 --> 00:22:43,840 Guest Track:: optimize for practice growth. 313 00:22:45,187 --> 00:22:50,967 Host Track: : The instant like place my brain goes here is I really want to have a conversation 314 00:22:50,967 --> 00:22:58,107 Host Track: : next about the alternative of the dropping insurances because I think people talk about that as like, 315 00:22:58,187 --> 00:23:02,787 Host Track: : you know, it's easier than it sounds or it sounds easier than I think it really 316 00:23:02,787 --> 00:23:07,987 Host Track: : is either renegotiating insurances for higher rates, dropping insurances, raising your fees. 317 00:23:08,867 --> 00:23:13,387 Host Track: : And that is a different version of painful. There is different things that will 318 00:23:13,387 --> 00:23:17,387 Host Track: : occur in your practice. And so exploring that other fork in the road of, 319 00:23:17,467 --> 00:23:21,707 Host Track: : do we optimize for hygiene growth and practice growth? 320 00:23:21,867 --> 00:23:24,967 Host Track: : Do we optimize for revenue per new patient? What is the good, 321 00:23:24,987 --> 00:23:29,007 Host Track: : bad, and ugly of that? What is painful about that? What's good? What's hard? 322 00:23:29,227 --> 00:23:33,687 Host Track: : Where are the challenges? How long does this realistically take to go through this process? 323 00:23:33,687 --> 00:23:37,307 Host Track: : And whether that's you, me, and Scott, or Suzanne and Scott and I, 324 00:23:37,467 --> 00:23:41,767 Host Track: : I would love to have one of those conversations here in the next month or two, 325 00:23:41,847 --> 00:23:46,067 Host Track: : because I think it's the natural place my brain goes when thinking about these options. 326 00:23:46,067 --> 00:23:51,387 Guest Track:: Yeah. And I think that we've always taken the philosophy of saying, 327 00:23:51,507 --> 00:24:00,667 Guest Track:: we want to get a client to their ideal patient flow before we start making it 328 00:24:00,667 --> 00:24:02,807 Guest Track:: more difficult for patients to stay in the practice. 329 00:24:03,167 --> 00:24:06,307 Guest Track:: And so, you know, like if we're going to start cutting insurances, 330 00:24:06,427 --> 00:24:11,947 Guest Track:: we want to cut insurances when we've met the long-term configuration of the practice. 331 00:24:12,107 --> 00:24:16,187 Guest Track:: So if a dentist comes to us as a solo, and they say, I want to have one associate 332 00:24:16,187 --> 00:24:20,347 Guest Track:: in a group practice, we've got seven operatories, and so a two-dentist configuration 333 00:24:20,347 --> 00:24:22,947 Guest Track:: is the long-term configuration I'd like for the practice. 334 00:24:23,347 --> 00:24:28,047 Guest Track:: We're going to keep the insurances, grow to that size, then we're going to use 335 00:24:28,047 --> 00:24:30,047 Guest Track:: all the growth that that our philosophy creates. 336 00:24:30,934 --> 00:24:34,414 Guest Track:: To cut insurances, the same way Scott has been discussing, right? 337 00:24:34,454 --> 00:24:38,414 Guest Track:: Scott's philosophy, retention-focused, also efficient systems, 338 00:24:38,534 --> 00:24:42,894 Guest Track:: he's also going to generate in practices this excess demand. 339 00:24:43,214 --> 00:24:47,934 Guest Track:: And so we're both using that tool, it's just we may be using it at different 340 00:24:47,934 --> 00:24:52,634 Guest Track:: times, or we may be more strong in saying we're comfortable with the insurances 341 00:24:52,634 --> 00:24:54,714 Guest Track:: to get us to our desired volume. 342 00:24:54,814 --> 00:24:58,254 Guest Track:: And then once we're at our desired volume, then we will bring them back down, 343 00:24:58,254 --> 00:25:00,194 Guest Track:: maintaining our long-term desired volume. 344 00:25:00,574 --> 00:25:05,014 Guest Track:: And so, you know, I think we, it's so, you know, when you can hear these things, 345 00:25:05,094 --> 00:25:06,474 Guest Track:: you could think that we're super different from one another, 346 00:25:06,614 --> 00:25:09,414 Guest Track:: but it's like, we all have the same tools in the tool belt. 347 00:25:09,494 --> 00:25:12,234 Guest Track:: There's only these set ways to kind of operate dental practices. 348 00:25:12,614 --> 00:25:16,334 Guest Track:: And I think it's more of an order of operations differences than it is like 349 00:25:16,334 --> 00:25:18,174 Guest Track:: we have different beliefs on what to do. 350 00:25:18,234 --> 00:25:20,674 Guest Track:: It's just, we have different beliefs on when to do certain things. 351 00:25:21,014 --> 00:25:24,994 Guest Track:: And I think, again, that goes back to personal preference for the client, right? 352 00:25:24,994 --> 00:25:31,314 Guest Track:: We use these different tools to help our client know the best way for them using 353 00:25:31,314 --> 00:25:34,354 Guest Track:: all the analytics and knowledge and everything that we bring to the table is like, 354 00:25:34,414 --> 00:25:39,634 Guest Track:: we're going to help you based on your situation and using all these tools assess 355 00:25:39,634 --> 00:25:41,874 Guest Track:: what's the best path for you and your practice. 356 00:25:42,894 --> 00:25:47,474 Host Track: : Well, I couldn't summarize it better. George, this has been an awesome discussion 357 00:25:47,474 --> 00:25:49,154 Host Track: : of, once again, kind of the merging 358 00:25:49,154 --> 00:25:53,634 Host Track: : and the exploring of these similar but slightly different frameworks. 359 00:25:53,634 --> 00:25:57,654 Host Track: : Works, but it's really just a set of tools to get the dentist to wherever they 360 00:25:57,654 --> 00:26:00,774 Host Track: : want to go in whatever route they want to get there. 361 00:26:00,894 --> 00:26:03,734 Host Track: : So thank you, George, for coming on. This has been awesome. 362 00:26:03,854 --> 00:26:06,774 Host Track: : I love these conversations. And I'm looking forward to the next one. 363 00:26:07,594 --> 00:26:11,394 Guest Track:: Absolutely. Thanks, Richard. And I look forward to coming back on to another episode of Ask George. 364 00:26:12,114 --> 00:26:17,154 Guest Track:: And keep chugging along and creating great content for our audience on the Shared Practices podcast. 365 00:26:19,354 --> 00:26:22,514 Host Track: : Love it. We'll talk to you next time on Shared Practices 2.0.