Dental CEO - Managing Operations

Show Notes

In this episode of the Shared Practices Podcast, Richard Low and Scott Leune explore the critical role of managing operations in a dental practice. They break down practical strategies for streamlining daily tasks, creating efficient systems, and developing leadership skills that allow you to run a more effective and profitable practice. Key Highlights: 

1. Creating Efficient Systems: Richard and Scott discuss how building consistent systems can reduce inefficiency, improve productivity, and ensure your practice runs smoothly, even when you're not directly involved.
2. Delegation and Accountability: Learn the importance of delegating tasks and holding your team accountable. Scott shares insights on empowering your team while ensuring they take ownership of their roles.
3. Leadership in Operations: The hosts discuss the key leadership skills needed to manage operations effectively, including communication, decision-making, and inspiring your team to perform at their best.

 

 

Want to take control of your practice operations and lead with confidence? Tune in to this episode for actionable strategies and expert advice!

 

 

Have a question or topic you want us to cover? Reach out to us on social media or our website at www.sharedpractices.com. Don’t forget to subscribe and leave a review if you enjoyed this episode!

 

What is Shared Practices | Your Dental Roadmap through Practice Ownership?

A bootcamp in small business ownership and practice management for dentists, giving the new graduate a roadmap to successful practice ownership. We interview the best dentists, experts, consultants and more on our weekly show. Here's the topics we will be covering in our 8 Seasons:
1. First Years as a Dentist
2. Think Like a Business Owner
3. Money and Numbers
4. Startups, Acquisitions, and Partnerships
5. Internal Systems
6. Marketing & Growth
7. Leadership, Vision and Culture
8. Beyond Dentistry
Go to SharedPractices.com to download the 8 Season Roadmap.

Host Track: :
Welcome back to the Shared Practices Podcast 2.0 with my co-host, Dr.

Host Track: :
Scott Luna. We are in the middle of the dental CEO discussion.

Host Track: :
Scott, tell us a little bit overall, people need to go back and listen to the

Host Track: :
last two episodes, but we're talking about these three pillars and we're in

Host Track: :
the middle of this first pillar.

Host Track: :
Can you introduce this concept for people that maybe have forgotten from last week?

Host Track: :
Yeah, I love this because my mind is always in some big outline line format.

Host Track: :
So if I outline on paper, what we're talking about with being a dental CEO,

Host Track: :
we start with the big titles, the three big pillars of what we have to manage as a CEO.

Host Track: :
We have to manage number one, the operations that happen day to day.

Host Track: :
That's what we see people doing, answering phones, scheduling patients,

Host Track: :
reappointing, collecting.

Host Track: :
Operations create the collections that come into our practice. That's pillar one.

Host Track: :
Pillar two is we've got to manage the expenses.

Host Track: :
How we spend our money is a whole nother super important area.

Host Track: :
That, of course, takes away the collections of our practice.

Host Track: :
And then the third pillar, how we manage and lead and hold a team accountable,

Host Track: :
how we inspire them, how we make sure they're doing what they're supposed to be doing.

Host Track: :
That team management is the third pillar.

Host Track: :
Now, in the last episode, we started with the first pillar, operations.

Host Track: :
And I'll keep on going and it's okay with it. Yeah, absolutely.

Host Track: :
Okay, so we said, okay, in operations, what we want to try to do as a CEO is

Host Track: :
first start out by building kind of like this, if you could visualize this kind

Host Track: :
of imaginary dashboard.

Host Track: :
It says, all right, what are the things that tell me if my company's healthy or not?

Host Track: :
Like, I need an EKG reading. I need a blood pressure reading.

Host Track: :
I need a temperature reading, like oxygen saturation.

Host Track: :
Is this patient, my business, healthy? and if not, I need to diagnose what to do about it.

Host Track: :
So this kind of dashboard, the CEO dashboard has five main components that we

Host Track: :
talked about in the last episode.

Host Track: :
Patient flow is the first one that's made up of reappointed patients and new patients.

Host Track: :
Those patients, that patient flow has specific numbers.

Host Track: :
You'll listen to the last episode, but we talked a lot about it.

Host Track: :
Then when people come in, you have the second kind of area, diagnosis.

Host Track: :
Are we diagnosing on those patients?

Host Track: :
And are we diagnosing in enough exams? You know, compared to the exams we see,

Host Track: :
are we diagnosing an appropriate ratio?

Host Track: :
And how big of a treatment plan do we actually diagnose? And is that okay?

Host Track: :
Do we need to get more training?

Host Track: :
That diagnosis area is that second of the five knobs.

Host Track: :
And that's where we left off from the last episode. Okay.

Host Track: :
So the last three knobs that we're about to get into are this aspect of case

Host Track: :
acceptance, acceptance, capacity, and our collections.

Host Track: :
So let's get into that.

Host Track: :
Welcome to Shared Practices 2.0. I'm joined by my co-host, Dr.

Host Track: :
Scott Luna. Scott, how's it going today?

Guest Track::
It's going great today. I'm looking forward. I've actually got a men's retreat

Guest Track::
for four days starting tomorrow.

Guest Track::
So this is a great kind of cap to my work week right before I do something really cool.

Host Track: :
I love it. That's amazing. I've had a few of these men's retreat experiences

Host Track: :
before, And it's just like something to look forward to that's unlike anything else.

Host Track: :
So, you know, I might bug you offline afterwards to hear how that was for you.

Host Track: :
But I'm excited to return to the series that we started this last episode about the dental CEO.

Host Track: :
And we teased and talked about these three pillars of areas within this role

Host Track: :
of being a dental CEO that dentists need to think about.

Host Track: :
And this first pillar around managing operations, I think is what a lot of people

Host Track: :
are more inclined to lean into as an entrepreneur.

Host Track: :
It's like, okay, let's figure out all the systems and manage the numbers,

Host Track: :
manage the people and manage the production.

Host Track: :
So talk to us, why is this kind of part one of thinking about how to be a dental CEO?

Guest Track::
Yeah. And maybe just to like review real quick, the three pillars we had talked

Guest Track::
about in our initial episode last time, where a CEO has to manage the operations of a practice.

Guest Track::
Those are the things we see every day. When we're watching people do things,

Guest Track::
they are answering phones, scheduling patients, getting case acceptance,

Guest Track::
submitting claims, collecting money.

Guest Track::
Those are the operations. Operations are creating the collections.

Guest Track::
So that's the first pillar that we're going to talk about today.

Guest Track::
The second pillar is we have to manage our expenses.

Guest Track::
Those are the things that take away the money we collected, right?

Guest Track::
That's a whole nother category. And then the third pillar is managing the people.

Guest Track::
And there's specific strategies we need to understand when it comes to leading

Guest Track::
and managing a team and having accountability.

Guest Track::
And our habits as a CEO kind of become the glue that holds these three things

Guest Track::
together in a healthy way.

Guest Track::
So this episode is about the first thing. the operations, the things that we see every day.

Guest Track::
And this is what I think a lot of us think of when we think of being a CEO.

Guest Track::
When we think of like, I want time to focus on the business side.

Guest Track::
What I think a lot of us are saying is, I want time to make sure that the operations are healthy.

Guest Track::
And yes, of course, that's important. That's just one of the pillars.

Guest Track::
But it is the first big foundational pillar of bringing in money.

Guest Track::
So can we optimize things that bring in money?

Guest Track::
And to kind of lead us off on this thought, what I see is I see a lot of us dental CEOs.

Guest Track::
Confusing the important operational activities that give results with the loud,

Guest Track::
noisy things that are thrown onto our laps.

Guest Track::
So being a CEO starts off maybe by being able to identify what are the things

Guest Track::
that are incredibly important for me to almost habitualize in my life as a CEO,

Guest Track::
versus the kind of loud, distracting things that typically might fall on my

Guest Track::
lap and might pull me away from what's important. Does that make sense?

Host Track: :
Absolutely. You know, the fires to put out.

Host Track: :
The one thing that's nice about a crisis is that you know you have to focus

Host Track: :
on that one thing. So I think there's people who,

Host Track: :
get comfortable living from crisis to crisis to crisis because it's clear I

Host Track: :
need to focus on this one thing.

Host Track: :
I don't have to make CEO decisions of where is my time best spent to improve operations overall.

Host Track: :
But if you can't get out of that mode and actually look at this from a higher

Host Track: :
level, create systems, create structure and accountability, we're stuck in that cycle of fires.

Host Track: :
So I'm excited to get into the specifics. And hopefully by the end of the episode,

Host Track: :
I'm going to see if we can find, you mentioned last time, even checklists,

Host Track: :
items that we can hold ourselves accountable on for this to keep people organized.

Guest Track::
Well, when you hop from crisis to crisis, what you're doing is undisciplined management.

Guest Track::
You don't have to think of what to do. You don't have to be disciplined and

Guest Track::
proactive and organized and focused.

Guest Track::
You get to just sit back there in a a lazy kind of way and just become a victim

Guest Track::
of a situation and react.

Guest Track::
So the situations are telling you what to do. And so often these situations

Guest Track::
don't tell you the smart thing to do.

Guest Track::
They tell you the loud thing to do that your dental assistant is upset about

Guest Track::
or a patient's upset about or you're worried about some collection crisis or who knows what.

Guest Track::
See, to be disciplined as a CEO is to force in your CEO life these activities,

Guest Track::
these actions that have nothing to do with the crisis.

Guest Track::
They are the actions that result in preventing a crisis, but those actions don't make any noise.

Guest Track::
So we don't get to sit back and let the universe tell us what to do.

Guest Track::
No, we actually have to control our own destiny proactively by having the discipline

Guest Track::
and the focus us to do something that's not asking us to get done.

Guest Track::
It's not making any noise.

Guest Track::
An example of that is, let's just start with a simple example.

Guest Track::
Auditing a couple of phone calls every week.

Guest Track::
If you have a bad phone call, there's no alarm bell that goes off that tells

Guest Track::
you, uh-oh, alarm, you just had a really bad phone call.

Guest Track::
Or, oh, you just hired someone that is saying the wrong thing over the phone.

Guest Track::
Or, oh, your scheduler just said you don't take MetLife when you do.

Guest Track::
There's no alarm bell for that. So if we don't proactively habitualize auditing

Guest Track::
a call on a regular basis,

Guest Track::
we will eventually become the victims of poor operations. And we may never even know it.

Guest Track::
It may be a silent cancer that happens for years. And we're scratching our heads

Guest Track::
thinking, man, I hate my marketing company because nothing's working when the phones are imploding.

Guest Track::
So kind of start this out. What are those actions, those activities that are

Guest Track::
going to actually bring results that need to be habitualized?

Guest Track::
That's how we start. What does it mean to be a CEO?

Guest Track::
It means to number one, identify the big knobs we got to turn the right way

Guest Track::
and then identify the habitual activities to make sure that those knobs are

Guest Track::
actually being turned the right way and they don't go backwards.

Host Track: :
It makes me think of the grid of important and urgent.

Host Track: :
Oh crap. I can't even think of the other two sides of the grid.

Host Track: :
Do you remember? Do you You know what I'm talking about?

Guest Track::
Yeah, yeah. So you've got kind of the Y-axis and the X-axis and it forms kind of these four squares.

Guest Track::
And on one corner, it says, this is very important and very urgent.

Guest Track::
And on the opposite, the catty corner, it says, this is not urgent and not important.

Host Track: :
Right.

Guest Track::
And then you've got, of course, the urgent, not important stuff and the not

Guest Track::
urgent, important stuff.

Guest Track::
Yeah, it kind of makes you think along those lines.

Guest Track::
I tell you that, why don't we start by identifying the major wheels of a practice?

Guest Track::
Because what's not a major wheel is the fact that the monitor in OP2 isn't working.

Guest Track::
That's not a major wheel. That doesn't hurt our new patient flow or our collections

Guest Track::
for the day, but it becomes loud.

Guest Track::
We've got a leaky toilet is a loud thing, but it's not a major wheel.

Guest Track::
So we're, of course, going to have to handle the distractions,

Guest Track::
but let's not skip and prioritize. Prioritize. Now let's not skip the important

Guest Track::
things and prioritize the distractions, right? So what are the priorities?

Guest Track::
I kind of like to look at the creation of collections in a linear fashion.

Guest Track::
There are specific, incredibly important benchmark moments in the creation of

Guest Track::
collections or in operations.

Guest Track::
So the first one is it starts with patient flow, patients coming in.

Guest Track::
And that's one big knob. And before we dive into that knob deeper,

Guest Track::
I'll just review kind of all the knobs I I see. So you got patient flow to start with.

Guest Track::
And then those patients must be diagnosed.

Guest Track::
So how much do we diagnose typically as a practice or typically as a doctor?

Guest Track::
That's a major knob. And then once they're diagnosed, got the third knob that

Guest Track::
says, okay, do they say yes? Do we get deep case acceptance?

Guest Track::
Or do we get light case acceptance? Like what is that case acceptance knob? Where's it turned?

Guest Track::
And then once we get case acceptance, we obviously have to have room in the

Guest Track::
schedule to produce it. So we need capacity.

Guest Track::
And after we produce it, we need to collect it. So we've got collections.

Guest Track::
So those might be like just in a simple way of thinking, five of the knobs to

Guest Track::
focus on, patient flow, diagnosis, case acceptance, capacity, and collections.

Guest Track::
And obviously, if we're strong at those five knobs, everyone listening knows

Guest Track::
that we will be collecting a ton.

Guest Track::
So how do we get strong at those five knobs?

Guest Track::
Well, we have to understand the components of that part of our machine, that patient flow knob,

Guest Track::
when we turn it, what are the components that's actually controlling how far

Guest Track::
that knob goes? Now, does that make sense so far?

Host Track: :
Absolutely. And I love these kind of large categories and that we're going to

Host Track: :
talk about, you know, not just what

Host Track: :
is included here, but what is actually important and non-urgent in these,

Host Track: :
aspects that you can be auditing and improving as a CEO.

Guest Track::
Mm-hmm. So those five knobs, you may also look at them as like,

Guest Track::
okay, those are five things I need to do and improve to grow my collections.

Guest Track::
But as a CEO, those are all five very important moments I need to audit,

Guest Track::
I need to measure, I need to keep an eye on.

Guest Track::
Kind of like, you know, we're looking at the blood pressure and the pulse rate,

Guest Track::
you know, and our oxygen levels, right?

Guest Track::
Very important important things that we need to make sure we monitor on a regular basis.

Guest Track::
So that first area, the patient flow, what's that made up of?

Guest Track::
That's made up, of course, of new patients, but it's actually primarily made

Guest Track::
up of existing patients, patients that have come back.

Guest Track::
And so as a CEO, I need to know, all right, what are the activities to make those numbers go up?

Guest Track::
So what's the best practice? And how do I know if I'm winning or losing?

Guest Track::
Like, what should I be hitting?

Guest Track::
So like on recall, on reappointed patients, what is a healthy number?

Guest Track::
You know, how often should patients be reappointed for a future your hygiene visit?

Guest Track::
What would you say would be kind of a healthy number for that?

Host Track: :
I mean, we want it in the 90 to 95% range.

Guest Track::
Yeah. And we might actually take that reappointment of a patient and break it

Guest Track::
up into two different categories because there's two different types of activities.

Guest Track::
You've got the regular hygiene patient that's coming in regularly,

Guest Track::
and we want to reappoint them regularly.

Guest Track::
And that might be a 95% and up reappointment that we want to achieve.

Guest Track::
Then we got the new patient. New patient, never met us before.

Guest Track::
They might need scaling, or maybe they're only in for a limited exam.

Guest Track::
And that is going to have a different action to get them reappointed.

Guest Track::
We have to have case acceptance maybe to get them reappointed,

Guest Track::
or we have to diagnose a prophy that they didn't come in for to get them reappointed.

Guest Track::
So it's good to kind of look at those two things separately because they involve

Guest Track::
two separate sets of actions.

Guest Track::
And maybe on that new patient, we might achieve an 85% reappointment rate because,

Guest Track::
for example, there's plenty of emergency new patients that come in that have

Guest Track::
no intention of ever coming back.

Guest Track::
Or there's plenty of new patients that come in that need scaling and replanning.

Guest Track::
They've got periodontal disease.

Guest Track::
But your practice might have policies that say, we're not going to give them

Guest Track::
a future appointment unless they say yes to the scaling.

Guest Track::
And so you're going to have a lower expected rate.

Guest Track::
Now, we're not talking right now about like, well, what should you do?

Guest Track::
What should the action be? Right now, we're talking about or being a CEO.

Guest Track::
You need to, in a way, take the concept of these five areas and build out a way to measure it.

Guest Track::
A very simple dashboard. So in the first area of patient flow, what is that made up of?

Guest Track::
Well, so far we've said we'd want 95% or higher reappointment rate on recall patients.

Guest Track::
We'd want an 85% or higher reappointment rate on new patients.

Guest Track::
And so let's have those two little numbers we look at at least once a month.

Guest Track::
Let's check the health once a month. Let's not allow more than a month go by

Guest Track::
where someone in our practice is now doing the wrong thing and that numbers drop down.

Guest Track::
It might make sense so far.

Host Track: :
Oh, absolutely. And this is where we start. I also think it's the,

Host Track: :
you ask someone if they're a better than average driver.

Host Track: :
And of course, who doesn't think they're a better than average driver?

Host Track: :
Why else would you be driving?

Host Track: :
Most dental practices think they are doing pretty well at this and are not looking at the data.

Host Track: :
And what you just said, every month, looking at these two numbers should be a bare minimum. them.

Host Track: :
And you should believe the numbers if they say something other than what you

Host Track: :
expect or what we're saying here.

Guest Track::
Yeah. And if you look at data, but don't understand, if you don't step back

Guest Track::
and understand the entire picture, then the data itself is just a pixel that

Guest Track::
doesn't mean anything to you.

Guest Track::
You have to understand how all these pixels come together to build the image.

Guest Track::
And so just looking at a reappointment rate in hygiene doesn't mean a lot to

Guest Track::
you until you understand, Oh, that's part of the new patient flow driver.

Guest Track::
Oh, that means I need to be looking at it in this way. And if it's down,

Guest Track::
oh, that means that we are not doing the right action, the right activity.

Guest Track::
That other patient flow side is the new patient flow side.

Guest Track::
And while we may not have a number that tells you, are you good or bad,

Guest Track::
healthy or not, what we do have is we have your own trend.

Guest Track::
So if you start seeing your new patient numbers go down, that should be an alert to you.

Guest Track::
If they start going up, that should, of course, make you feel like some other

Guest Track::
things are working. But I'll ask you, where do new patients come from?

Guest Track::
What actions of our business ultimately result in a new patient showing up in our practice?

Host Track: :
I'd say insurance participation, reputation, referrals, and marketing,

Host Track: :
direct marketing to patients, sometimes organic search.

Host Track: :
Those are some of the avenues. news.

Guest Track::
Correct. So I love what you said. So how about we organize those in different topics?

Guest Track::
So on one topic, what brings in new patients are marketing efforts,

Guest Track::
whether those are paid marketing or organic marketing efforts.

Guest Track::
I put them all in the kind of marketing efforts bucket because today so many

Guest Track::
things kind of blend in with each other, right?

Guest Track::
We've got all this organic social media kind of content and connections we're

Guest Track::
trying to get so that our paid marketing has a bigger audience that's going

Guest Track::
to click on it and get retargeted.

Guest Track::
So it's all kind of a marketing bucket.

Guest Track::
Marketing, I'd say, brings in the leads, the potential new patients.

Guest Track::
But then once we get the lead, all right, what turns that lead into an actual patient?

Guest Track::
And nine times out of 10 or more, it happens through a phone call.

Guest Track::
So what does happen through a phone call? Well, we have to answer the phone.

Guest Track::
And if we talk to a new patient, we have to schedule them.

Guest Track::
You mentioned insurance participation. What I've found from our studies is that

Guest Track::
that doesn't generate more calls.

Guest Track::
What it does is it causes more people after they called to actually schedule.

Guest Track::
So I would say that's converting people to an appointment.

Guest Track::
Insurance participation is one policy that helps us convert a caller.

Guest Track::
Just like being open on Saturdays or in the evening, just like accepting children

Guest Track::
in a practice or having a really low fee for a limited exam.

Guest Track::
All of those are examples of policies that lower the barriers to scheduling.

Guest Track::
Of course, policies aren't the only thing that impact whether someone schedules.

Guest Track::
What might you say, besides policies, if we've got a phone call and we answered

Guest Track::
it, we can cause them to schedule or we can screw it up and not cause them to

Guest Track::
schedule. What might that be?

Host Track: :
That is the skills of the person answering the phone in their ability to demonstrate

Host Track: :
warmth, handle objections, be clear, and actually get someone to convert.

Guest Track::
Yeah, that's great. So how we handle the phone.

Guest Track::
Now, I don't like to call it skills because there's a connotation there that

Guest Track::
says someone is sounding skilled.

Guest Track::
And if I were to ask ask you or anyone else, what does a good phone call sound like?

Guest Track::
I ask that in my seminars, by the way. When I give seminars,

Guest Track::
our price management course, which is my biggest one, I'll ask that question.

Guest Track::
What does a good phone call sound like? And the answers I get are things like, they sound positive.

Guest Track::
They sound like they're answering with a smile on their face. They're very thorough.

Guest Track::
They answer all the questions a patient has. They're calm.

Guest Track::
None of that to me means it's a good phone call.

Guest Track::
So a good phone call, ultimately the result of a good phone call is someone's schedule.

Guest Track::
What gets people to schedule? Smiling doesn't.

Guest Track::
Now, the opposite of that can hurt you. So being rude obviously hurts you,

Guest Track::
but being happy doesn't get people to schedule.

Guest Track::
Being super thorough in answering all of their questions actually hurts your

Guest Track::
ability to schedule them.

Guest Track::
Because what we need to do is we need to actually convert this call from them

Guest Track::
asking all the questions to us asking the questions.

Guest Track::
When they are asking the questions, less people schedule compared to when we

Guest Track::
are asking the questions.

Guest Track::
So we don't want to be super thorough and just wait for the next question,

Guest Track::
the next question, and the next question, because our conversion rates go down.

Guest Track::
It's proven it goes down.

Guest Track::
So we're really in the weeds right now, but when we talk about,

Guest Track::
okay, what's a good call?

Guest Track::
A good call is where we have taken charge in a way that flows and is appropriate. It makes sense.

Guest Track::
And it results in a person scheduling. If you were to ask me,

Guest Track::
what does it mean to be skilled?

Guest Track::
To me, it means that the person that answered the phone is following that exact framework.

Guest Track::
They're saying very specific words and sentences. They have a very specific strategy.

Guest Track::
That strategy isn't be happy and be thorough in answering questions.

Guest Track::
That strategy is a very unique way to take control of the call,

Guest Track::
to lead them to schedule an appointment and getting it done in a relatively short amount of time.

Guest Track::
And And that is what I would say is a skilled call.

Guest Track::
So if we kind of back up a layer or two, we're talking about patient flow,

Guest Track::
new patients specifically, and marketing gives us the leads,

Guest Track::
and the leads hit our phone.

Guest Track::
And assuming we answer the phone, we need to convert that to an appointment.

Guest Track::
That conversion is going to happen with policies and with our verbiage on the phone.

Guest Track::
Now, that's, again, assuming we've answered the call.

Guest Track::
I'm curious. I don't know if you happen to know, but do you happen to know about

Guest Track::
what percent of of calls do not get answered in a dental practice?

Host Track: :
I've seen offices where it's 50% or more, unfortunately.

Guest Track::
Yeah. So the national average is depending on the size of the practice,

Guest Track::
there's two sizes they measure.

Guest Track::
One is 32% missed call rate and one's 38% missed call rate.

Guest Track::
And then when you look at startup practices, they're over 50% of their calls

Guest Track::
are missed primarily because they've got a small team and they're not open every day.

Guest Track::
So another way of saying that is, you know, a decent performer in the United

Guest Track::
States is going to miss one third of their new patient calls.

Guest Track::
That's like throwing Throwing away one third of your practice,

Guest Track::
it's throwing away one third of your leads, your marketing dollars.

Guest Track::
It's just, and it's not, it's actually, I would say it's even more than throwing

Guest Track::
away a third because that third of the patients you could have had would have

Guest Track::
come back and refer to other people who would have come back and refer to other people.

Guest Track::
And when you go down the timeline, you've really thrown away a lot more than

Guest Track::
a third of what you could have been.

Guest Track::
So what does that mean to a CEO? Well, you tell me, what are some numbers that we need to add?

Guest Track::
We started on the patient flow side with regular hygiene patients.

Guest Track::
Are they going to reappoint 95% of the time or not?

Guest Track::
New patients, are they going to reappoint in hygiene 85% of the time or not?

Guest Track::
So there's two little numbers we're just going to look at once a month.

Guest Track::
But what about the new patient flow side? What might be some numbers we would want to look at?

Host Track: :
So I mean, the final result, the new patients scheduled,

Host Track: :
and I would say not even scheduled, the ones who actually show up and become

Host Track: :
new patients in the practice, but then our calls, total call volume,

Host Track: :
missed calls, and conversion to appointments.

Guest Track::
Great. So if we simplify it down to the very basics, we'd say,

Guest Track::
okay, how many new patients did we get this month?

Guest Track::
So we know if we're trending up or down. The number by itself means very little,

Guest Track::
but are we trending up or down?

Guest Track::
And then what percent of the calls did we answer versus miss?

Guest Track::
Okay. That tells us, are we healthy or not? We should be answering in the nineties.

Guest Track::
If we're not answering in the nineties, we are, we are definitely not in kind

Guest Track::
of that top performer mode we could be in.

Guest Track::
And then what percent of the calls convert to an appointment?

Guest Track::
So the national average is around 40%. It's 42, actually the exact number is 42. to.

Guest Track::
We should be in the 70s and up. My practices have almost always been in the

Guest Track::
high 80s, but in the 70s and up would be considered a good performer.

Guest Track::
So if we just stand back, and I am your dashboard, you're the CEO,

Guest Track::
and you log in once a month, and I say, hygiene reappointment rate,

Guest Track::
96%, new patient reappointment rate, 88%.

Guest Track::
New patient flow, 62 new patients, just like last month.

Guest Track::
Missed call rate, 49%. And conversion rate, 48%.

Guest Track::
What does that mean to you?

Host Track: :
It means we're focusing on missed call rate and call conversion rate because

Host Track: :
the other three metrics were trending well.

Host Track: :
They're doing well. And therefore, now I can actually appropriately allocate

Host Track: :
time and attention and we need to work on those.

Guest Track::
Good. So you're going to look at the hygiene numbers for five seconds and forget

Guest Track::
about them for a month because they're healthy.

Guest Track::
So you don't have the burden of that on your mind. You're going to look at your

Guest Track::
new patient numbers and say, yeah, they're normal.

Guest Track::
You're going to forget about that for a month. But then what you said is our

Guest Track::
phone numbers could be a lot better.

Guest Track::
And if they are better, our new patient numbers could really go up, right?

Guest Track::
So how do we make them better would be the next thing the CEO needs to know and learn.

Guest Track::
And gosh, that could be a whole episode right there. But we first have to be

Guest Track::
able to diagnose this dental practice before we know how to surgically enhance it, right?

Guest Track::
So the CEO's job is to do an examination on its dental office every month to

Guest Track::
diagnose any potential cancers that might be building up and growing here.

Guest Track::
And in this little example we did, you diagnosed, oh, we've got kind of tumor forming with phones.

Guest Track::
And so let's just make that next month's implementation project.

Guest Track::
What an effective CEO you would be if that's what you did. because all these

Guest Track::
other CEOs are just cutting another tooth instead of looking at that number.

Guest Track::
Or even if they are looking at it, they're just not doing anything about it.

Guest Track::
So that's the first knob.

Host Track: :
Well, and one last point here on this knob.

Host Track: :
The thing that I think even a lot of dentists fundamentally are missing in all

Host Track: :
of this is they don't have the ability to measure all of these,

Host Track: :
whether that's through being able to see the call volume, the missed calls,

Host Track: :
tracking the conversion rates.

Host Track: :
They don't have metrics hooked up and so they're not

Host Track: :
looking at these things but the one thing that dentists

Host Track: :
know is that it's painful to make marketing activity

Host Track: :
decisions because i need to choose where to allocate money and

Host Track: :
i need to you know i feel like that's the the source of all of our patient flow

Host Track: :
issues so ironically the areas that they need to be the most astute about often

Host Track: :
they can't even see and if they can see they often don't have the skills or

Host Track: :
the policies to move the needle on those.

Host Track: :
So, you know, like you said, this is future episodes that we're gonna have to

Host Track: :
dive into to multiple aspects here.

Host Track: :
It's just amazing how far off the average dentist might be based on these.

Guest Track::
It's too cliche to say yet again, well, they didn't teach us that in dental school.

Guest Track::
But that cliche is actually pretty correct.

Guest Track::
We learn so much about so many other things that are less important to our lives

Guest Track::
than something like this.

Guest Track::
But could you imagine being a cardiologist and trying to diagnose disease of

Guest Track::
the heart and never having blood work on patients,

Guest Track::
never having lipids, never having heart rates and never having EKG readings,

Guest Track::
never having blood pressure readings.

Guest Track::
How on earth could you be a good cardiologist?

Guest Track::
You'd just be reacting to things that just walk in and hoping for the best.

Guest Track::
And you as a cardiologist would absolutely pay for the machinery needed to measure

Guest Track::
those things so you could properly diagnose your patient.

Guest Track::
Yet us CEOs, so many of us are missing replacing the EKG machine.

Guest Track::
And we're trying to decide if the heart rhythm is okay or not without a freaking EKG machine.

Guest Track::
You know, we have to know what those reappointment rates are.

Guest Track::
We have to know what the conversion rates are on the phone.

Guest Track::
Like we need the EKG machine to be a good, effective CEO.

Guest Track::
Otherwise it's so much more work and so much more stressful.

Guest Track::
And the results are so much worse in treating our practice than had we had a machine like that.

Guest Track::
So the second knob, I said, so first knob was like patient flow.

Guest Track::
People walk in, we're going to have, you know, four or five numbers there. Done, easy.

Guest Track::
Second knob, after they walk in, we diagnose them. All right,

Guest Track::
well, what are some things we could measure?

Guest Track::
Let's still have like this whole theory of like, we're going to measure a number.

Guest Track::
We're going to look at an EKG machine to see are we healthy or not.

Guest Track::
Before we dive into what to actually do to make it better, how can we first

Guest Track::
diagnose the issue? What are some numbers you might think about?

Host Track: :
So diagnosis, we would say maybe dollar amount per new patient or per existing patient per exam.

Guest Track::
Yeah. So what you're saying is, and correct me if I'm wrong,

Guest Track::
but some dentists diagnose a larger dollar amount per patient on average.

Guest Track::
Some diagnose smaller dollar amount.

Guest Track::
Or another way of saying it is some practices seem to bring in patients that

Guest Track::
need a bigger dollar amount.

Guest Track::
And some practices tend to bring in patients that need a smaller dollar amount.

Guest Track::
I'm curious, if you had to guess, if a practice has a low dollar amount diagnosed,

Guest Track::
is that primarily because of the philosophy of the dentist?

Guest Track::
Or is that primarily because of the demographic of the patient base of that

Guest Track::
practice? What would you guess?

Host Track: :
I would guess that the skill set of the dentist,

Host Track: :
both from the, here's the procedures that we do and that we're comfortable doing

Host Track: :
here in our office, as well as the skill set of the dentist of bringing up hard

Host Track: :
things and resolving, you know, patients' doubts and concerns,

Host Track: :
in my opinion, I think would play a bigger role than the average demographic. But I could be wrong.

Guest Track::
Yeah, I totally agree. From what I've seen,

Guest Track::
it's so heavily weighted on the fact that dentists are diagnosing based on what

Guest Track::
they know and not necessarily based on what people need or what people could

Guest Track::
use to prevent problems or what people could use to benefit themselves cosmetically,

Guest Track::
for example, right?

Guest Track::
We've got disease we can diagnose. We got prevention, but we've also got elective care.

Guest Track::
And like you know when

Guest Track::
you think about a hundred patients getting exams what percent of those patients

Guest Track::
could benefit from fixing disease or preventing disease or elective care like

Guest Track::
what would you think out of a hundred people who would qualify for a diagnosis

Guest Track::
of at least one of those three things 98.

Host Track: :
To 100 yeah.

Guest Track::
I it'd be a big number right so what's interesting is when i talk to these dentists

Guest Track::
that, to the number you listed, the dollar amount per exam diagnosed.

Guest Track::
When I talk to the dentists that have lower dollar amounts, so common,

Guest Track::
I hear things like, well, it's the demographic of my practice. It's my patient type.

Guest Track::
They've had a lot of work done. They don't need a lot of work.

Guest Track::
I so often hear that. And I think that is short-sighted for most dentists to

Guest Track::
say that's what's happening.

Guest Track::
What I see is happening is that they are just choosing not to diagnose the complete

Guest Track::
list of things that we could possibly diagnose.

Guest Track::
They're looking for a much more narrow list of things.

Guest Track::
And that's a whole other conversation too.

Guest Track::
But there's another number that I could pair with your number that you already mentioned.

Guest Track::
What percent of exams actually get something diagnosed? notes.

Guest Track::
And to your point, gosh, maybe it should be like 98% because 98% of people might

Guest Track::
either need something or should have something preventative or would qualify

Guest Track::
for something elective.

Guest Track::
And it's our job as clinicians and as a dental practice to show them everything

Guest Track::
that they could benefit from.

Guest Track::
So maybe that number should be something like 98%. Well, when you you look at

Guest Track::
the national averages, it's in the 30s.

Guest Track::
It's in the 30s. So there's a there's a big opportunity there in diagnosis,

Guest Track::
if we can embrace being more comprehensive in what we talk about.

Guest Track::
And that doesn't necessarily just mean be aggressive.

Guest Track::
That's not what I'm talking. I'm not even talking about it. I don't even think

Guest Track::
there is really much of a thing as aggressive.

Guest Track::
You know, if someone has a cracked tooth, what's the

Guest Track::
conservative thing to do fix it someone has

Guest Track::
a small cavity what's the conservative thing to do fix it i

Guest Track::
maybe i it'd be aggressive to not fix it right but we

Guest Track::
somehow like have told ourselves like if we diagnose something that's not being

Guest Track::
conservative it was i don't really see it that way so if we look at this big

Guest Track::
knob then to your point you know we need a high percentage of exams resulting

Guest Track::
in a diagnosis if we truly are comprehensively communicating to patients

Guest Track::
and we'd like to know and measure, well, what a dollar amount of dentistry are we diagnosing?

Guest Track::
And there's not necessarily a right or wrong number when it comes to the dollar amount,

Guest Track::
But the trend is important. And of course, that's an opportunity to better ourselves financially.

Guest Track::
If we can learn a bigger procedure and add that to our mix, we would see that dollar amount go up.

Guest Track::
So that might mean we go learn how to place an implant. And maybe we don't go

Guest Track::
learn about bonding agent or occlusal schemes just yet.

Guest Track::
Maybe we're going to choose something that drives that specific number up a

Guest Track::
little more. Am I making sense to you?

Host Track: :
Absolutely. And the question I have for you is, you know, we talked about clinical

Host Track: :
education, expanding your skill set.

Host Track: :
I think there's also the conviction behind what I'm diagnosing and why it's

Host Track: :
needed and preventative care.

Host Track: :
What's your sense on like the psychological baggage that some dentists have

Host Track: :
around wanting to be liked and wanting to not deliver bad news and all of that, you know?

Host Track: :
And on the other side, what we were just talking about, the clinical education,

Host Track: :
the conviction of what you're doing and saying, is there also some work that

Host Track: :
needs to be done around challenges, bringing stuff up, giving this quote-unquote

Host Track: :
bad news, and getting rejection from patients?

Guest Track::
Yeah, I think you're speaking right to the heart of the problem for a lot of dentists.

Guest Track::
The way you get around, well, first of all, if you're just using words and relying

Guest Track::
on trust to tell a patient, we got some bad news.

Guest Track::
That is going to be a less confident moment for us subconsciously.

Guest Track::
Because we know we're just using words and relying on trust.

Guest Track::
There's no heavy evidential moments there. There's no co-diagnosis occurring.

Guest Track::
It's just us diagnosing and it's just us convincing them. We have to influence them in a way.

Guest Track::
It can feel manipulative. It could feel aggressive or overzealous,

Guest Track::
especially if what we're diagnosing is kind of in a gray area of priority.

Guest Track::
It just feels like maybe it'd be better if I label myself as conservative and say less.

Guest Track::
A good way to get around that is to rely on technology, gadgets and gizmos.

Guest Track::
And instead of being someone that verbalizes a diagnosis, we instead become

Guest Track::
a teacher of technology.

Guest Track::
So if we use AI on the x-rays, we become a teacher of what the AI says.

Guest Track::
If we do a smile simulation with software, we become a teacher of what happened

Guest Track::
in the smile simulation, what kind of procedures would result in that?

Guest Track::
Or if we utilize intro photos and show kind of what I call consequence photos,

Guest Track::
we become a teacher of like, this is what happens in disease progression.

Guest Track::
And all of these images, all of these technologies remove us from needing to

Guest Track::
rely on trust and on words.

Guest Track::
And now it feels freeing in a way.

Guest Track::
It almost feels more valuable to the patient.

Guest Track::
And we're earning authority in our position when we are the expert on technology,

Guest Track::
the teacher of technology, as opposed to the wielder of words.

Guest Track::
So we should make a whole nother episode on this, by the way.

Guest Track::
But we could definitely restructure the exam process so that these components are being used.

Guest Track::
And now we are teaching and we are diagnosing things side by side with the patient,

Guest Track::
as opposed to speaking down to them with our authoritative diagnosis that they

Guest Track::
may not have been expecting.

Host Track: :
That's great. And what I love about this approach is that it's not,

Host Track: :
you need to go work on your mindset and hang ups around asking for money.

Host Track: :
This is, no, let's become educators about technology, about what's going on

Host Track: :
in the mouth, present data, co-diagnose together.

Host Track: :
And that's not dependent on getting a doctor who is extremely charismatic or

Host Track: :
has a really easy time convincing people with words.

Host Track: :
Instead, it's system-based. So have I gotten us off track in terms of the overall major metrics?

Host Track: :
Are there any other in this knob?

Guest Track::
No. And honestly, I know how long we've already been talking.

Guest Track::
There's no way we're going to get done with this in one episode.

Host Track: :
Yeah. I think we have to split it into two. Yeah.

Guest Track::
Yeah. I mean, yeah, at least. So yeah, if we kind of back up here,

Guest Track::
because all we're doing right now is in a way visualizing what a CEO's dashboard might look like, right?

Guest Track::
We haven't even talked about what we even do, you know? So what does this dashboard look like?

Guest Track::
We talked about these five major components, the first one being patient flow,

Guest Track::
having the hygiene reappointment, those two numbers, having kind of a new patient

Guest Track::
flow number and having the two phones numbers.

Guest Track::
And then we go to the second component, diagnosis, and we're looking at maybe

Guest Track::
what percent of exams are getting a diagnosis and how big on average is that

Guest Track::
diagnosis, a trend that we want to pay attention to, and a number we'd like to improve.

Guest Track::
And that's enough right there on diagnosis. And again, it takes under a minute

Guest Track::
to look at these things and to understand this EKG of our practice.

Guest Track::
Is it healthy or do we have a problem in our rhythm, right?

Guest Track::
The third area after diagnosis was the area of case acceptance.

Guest Track::
Which is connected to diagnosis sometimes.

Guest Track::
Sometimes practices that diagnose less have higher case acceptance and they

Guest Track::
diagnose more and they got lower case acceptance, right?

Guest Track::
And so it can kind of be a teeter-totter when you're not mature and disciplined about the process.

Guest Track::
When you're mature and disciplined about the process, you're not going to see

Guest Track::
such a big effect from that.

Guest Track::
But nationally speaking, in 2023's numbers, the national averages,

Guest Track::
surges, diagnosis did go up and case acceptance did go down and it created almost

Guest Track::
the exact same result in dentistry.

Guest Track::
So that did happen naturally. We don't want to be like that.

Guest Track::
We want to counteract that.

Guest Track::
As we diagnose more of what people need, we still want them saying yes to it.

Guest Track::
So case acceptance, how might we measure that?

Guest Track::
What are your thoughts on numbers or measuring of case acceptance?

Host Track: :
Sure. We'd want to look at percent of patients who say yes to something,

Host Track: :
as well as the dollar amount of treatment actually done off of a treatment plan.

Host Track: :
So in my mind, those are some starting points.

Guest Track::
Those are the main numbers. So did they say yes to something is what's actually

Guest Track::
called case acceptance.

Guest Track::
And then what you said is actually, I would say the more important number of

Guest Track::
the two, how much did they say yes to?

Guest Track::
They might need five crowns in the filling, if all they did was the filling,

Guest Track::
that's case acceptance, but it's nothing we should be proud of,

Guest Track::
operationally speaking.

Guest Track::
We want them getting most, if not all the work that they need done, right?

Guest Track::
So better number to know that is like, how deep in the treatment plan are they going?

Guest Track::
And the way we measure that numerically is, you know, what percent of the dollars

Guest Track::
that were diagnosed were actually scheduled and done.

Guest Track::
So the percent dollars, dollars. That's the way we kind of get a sense or feel

Guest Track::
of how deep are they going.

Guest Track::
Now, that percent, there are definitely national averages we can compare ourselves to.

Guest Track::
And the trend is also, of course, very important. What happens,

Guest Track::
for example, if you get a new treatment coordinator, you're wondering,

Guest Track::
how are they going to do with case acceptance?

Guest Track::
Is it going to be better or worse than the last treatment coordinator?

Guest Track::
We don't just have to wonder, we can just go look at it by looking at this percent

Guest Track::
dollar accepted number.

Guest Track::
So those are two vital numbers.

Guest Track::
Now, what I see, which I kind of mentioned earlier is sometimes practices get

Guest Track::
a false positive, their case acceptance numbers through the roof,

Guest Track::
but then they hardly diagnose anything.

Guest Track::
And the dollars, I mean, it's just not a lot of dollars.

Guest Track::
So of course, if you barely diagnose anything, it's easier to have people accept very little.

Guest Track::
So we have to be a little bit holistic here when we look at that.

Guest Track::
If all you diagnose are all on four cases, you're going to have a different

Guest Track::
case acceptance number than if all you're diagnosing is regular restorative work.

Guest Track::
So we need to be holistic about it.

Guest Track::
But those are definitely the two numbers that the CEO needs to look at,

Guest Track::
I'd say, on a monthly basis. Does that make sense?

Host Track: :
Yep. And I would say one of the challenging things about that second number

Host Track: :
is that it is a little bit of a lagging number to get an accurate picture.

Host Track: :
You know, if it takes several months to get that treatment done,

Host Track: :
you're not just looking at this last month.

Host Track: :
You're looking at the last maybe quarter or three or four months.

Guest Track::
Yeah, you are absolutely right. It depends on the software that's tracking it.

Guest Track::
Some software tracks it when it's done. Some software tracks it when it's scheduled.

Guest Track::
And your practice may be a practice that pre-schedules everything like the practices I train.

Guest Track::
Or you may be a practice that doesn't pre-schedule everything.

Guest Track::
You just schedule just the next visit, the next visit, the next visit.

Guest Track::
So your number would have a big lag if you were not pre-scheduling everything.

Guest Track::
So that's absolutely right. All right. So that's, that's the third knob, right?

Guest Track::
The case acceptance knob. Then, you know, what happens if we see patients and

Guest Track::
they need work and they say yes, that means there's dentistry to be scheduled. Well, do we have room?

Guest Track::
So, you know, we can do all this work to get all these people in to diagnose

Guest Track::
and to get case acceptance.

Guest Track::
But if we have nowhere in the schedule to put them, we're putting them farther

Guest Track::
and farther and farther out. And we're just running into like no-show land.

Guest Track::
Like we schedule people so far out, they start changing their mind.

Guest Track::
And we have a full schedule theoretically, but when the schedule actually comes,

Guest Track::
there's holes from these cancellations and no-shows.

Guest Track::
So we have to track as a CEO capacity.

Guest Track::
Capacity to me means do we have openings within the next two weeks?

Guest Track::
So there was a study we did with the practices that we were connected to.

Guest Track::
This was about a decade ago. So it's 10-year-old data.

Guest Track::
But at the time, we plotted how far booked out practices were and compared that

Guest Track::
to their profitability.

Guest Track::
And then we correlated that to their no-show rates. When we plotted profitability

Guest Track::
and days booked out, there was a peak profitability that happened at 10 and a half business days.

Guest Track::
10 and a half. So let's just like round that and say that's about two weeks out.

Guest Track::
When we're fully booked two weeks, we kind of have this perfect moment of the

Guest Track::
most dentistry being done.

Guest Track::
If we're booked out less than two weeks, we have less dentistry to do.

Guest Track::
If we're booked out more than two weeks, we see no shows go up and we have less

Guest Track::
dentistry to do. The most dentistry we can do is when we're booked out two weeks,

Guest Track::
not any less or more than that.

Guest Track::
So in the way we measured booked out is we took on the doctor's schedule,

Guest Track::
we took a two hour appointment and we said, do I have a third opening available?

Guest Track::
So if a patient needs two hours worth of restorative, can I offer them three

Guest Track::
appointment times in the next two weeks?

Guest Track::
So I don't mean when I say two weeks booked out that I only have one opening in the next two weeks.

Guest Track::
I mean, like we've got a third option. We did the same thing with new patient

Guest Track::
flow and saw very similar results.

Guest Track::
Do I have a third new patient opening in the next two weeks?

Guest Track::
So that's how we measure it. So this is something that I don't know of any software

Guest Track::
that gives you some sort of capacity number.

Guest Track::
But luckily you can use your own eyes and you can scroll through two weeks of

Guest Track::
your schedule and see very quickly if you are full or not.

Guest Track::
Have you seen anything like that or do you have any experiences when it comes to capacity no.

Host Track: :
So i i don't know of a solution that looks at that way of measuring,

Host Track: :
We've looked at this ourselves on our denture and implant practices and it's

Host Track: :
been a focus of ours, especially when we're doing online booking,

Host Track: :
we're working in the call center.

Host Track: :
But I think for the average dental practice, there's not an easy button on calculating this.

Guest Track::
Yeah, you know what's really cool about the shared practices,

Guest Track::
analytics-based philosophies that y'all have taught in the past is there's this

Guest Track::
one philosophy that says,

Guest Track::
hey, we need to grow our hygiene departments as large as we can within reason

Guest Track::
so we can capture the most recalled patients who therefore generate the doctor's

Guest Track::
appointments and the doctor's schedule.

Guest Track::
Well, when we think of capacity, here's something interesting to think about.

Guest Track::
Let's use an analogy first. First, if I've got a restaurant that only has four

Guest Track::
tables and they're always fully booked, they're booked out really far.

Guest Track::
That means that a whole lot of people that log in to book a table see that there's

Guest Track::
no availability and they just leave.

Guest Track::
A whole lot of people that call, we tell them you're gonna have to wait two

Guest Track::
months and they just hang up.

Guest Track::
We never actually know how big we could have been.

Guest Track::
As long as we're too booked, we never know what is our real opportunity.

Guest Track::
The only way we can really understand, like with great accuracy,

Guest Track::
how big could we actually be when it comes to kind of customer flow is if our

Guest Track::
restaurant had too many tables.

Guest Track::
If we were never fully booked, we'd know, okay, we got 50 tables and we always

Guest Track::
have 38 to 40 or so booked. We're a 40 table restaurant.

Guest Track::
We'd never know we were a 40 table restaurant if we only had four. We'd never know. No.

Guest Track::
So I know that's kind of a weird analogy, but now take that to a dental practice.

Guest Track::
If we're booked out more than two weeks, we really don't know how big we could have been.

Guest Track::
We only really know when we have gentle openings consistently.

Guest Track::
If we have openings, a modest amount consistently, then we know we are hitting our max size.

Guest Track::
Now, your mindset could look at those openings and say, oh, I'm overstaffed.

Guest Track::
Oh, we're not full enough.

Guest Track::
Oh my gosh, we're sitting around doing nothing, right? But your mindset could

Guest Track::
also look at that and say, that is actually the healthy amount to have.

Guest Track::
That gives us the ability to convert same-day patients calling,

Guest Track::
same-day dentistry from our exams.

Guest Track::
That gives us the ability to also work on non-scheduled patients,

Guest Track::
other tasks in the practice that might need to be worked on.

Guest Track::
Like there's a lot of things that give us or that that time allows us to know

Guest Track::
and do So we almost need to reframe what a healthy schedule even looks like

Guest Track::
we need to kind of relabel that I would say you've got a modest amount of openings

Guest Track::
within the next two weeks.

Guest Track::
That is like peak beauty right there That is what I would want now.

Guest Track::
I know how big we could be I've got the highest conversion rate on the phones

Guest Track::
producing as much as I can I can convert same-day calls, same-day dentistry,

Guest Track::
and every now and then we all get a break.

Guest Track::
Yeah, that's nice too, because to be at peak performance, peak case acceptance,

Guest Track::
peak diagnosis, hygiene and the doctor's side, peak accuracy in the front office,

Guest Track::
that doesn't happen when we're exhausted at the end of a marathon.

Guest Track::
It happens when we get to take a little water break every now and then.

Host Track: :
Does that make sense?

Guest Track::
Yes.

Host Track: :
I love that in that as we are optimizing for growth, and this is something that

Host Track: :
George and I have now talked about of optimizing for income,

Host Track: :
optimizing for growth, you have to have those openings.

Host Track: :
And that's what our coaches do is reframe what you just said,

Host Track: :
this mindset around gene openings, and in addition,

Host Track: :
You aren't optimizing for profitability because you're always going to be adding

Host Track: :
a little bit more. So, you know, as soon as you fill that out, you grow.

Host Track: :
And now you're like, you've gone from the 25 table restaurant to the 27 table restaurant.

Host Track: :
Let's add four more tables and make sure that we're staying ahead of that curve.

Host Track: :
And with hygiene days, you can do that as long as you have chairs and you can

Host Track: :
hire two days of hygiene.

Host Track: :
So anyways, you know, we're, we're on, we're on knob four and we have one more knob to go.

Guest Track::
Yeah. And we're running out of time here. So let's just hit that last knob.

Guest Track::
The last knob said, can we collect?

Guest Track::
We brought these people in, we diagnosed, got case acceptance,

Guest Track::
we had room in our schedule.

Guest Track::
So we did the dentistry. Great. Are we actually collecting it?

Guest Track::
And how would you say a CEO could look at collections, numerically speaking,

Guest Track::
maybe from a big view and look at a report card and say, all right,

Guest Track::
did we score an A or not? Are we okay or not in collections?

Host Track: :
Sure. Looking at overall production to collections immediately, are there write-offs?

Host Track: :
And then of the collectible dollars, what percentage do we collect?

Host Track: :
And we could divide that into insurance and non-insurance patients.

Guest Track::
Yeah. So what I'm hearing is on one hand, we've got this ratio.

Guest Track::
Are we collecting 98% of what we produce?

Guest Track::
Right. Of course, that ratio goes up and down depending on if we have big swings

Guest Track::
in our months, especially, you know, practices like the shared practices group

Guest Track::
when you've got like huge swings from one month to another, depending on how

Guest Track::
many big cases got started.

Guest Track::
And if you're pre-collecting or not, you know, that can all impact it.

Guest Track::
But there's that number there.

Guest Track::
The longer period of time you look at, the more significant or valuable that number is to look at.

Guest Track::
So if I'm looking at a collections percent over a week, that can be heavily

Guest Track::
influenced by things that have nothing to do with the health of collections.

Guest Track::
But if I look at it over three months, I'm getting a pretty accurate number

Guest Track::
because I've got a large enough sample size and the fluctuations have evened out.

Guest Track::
Another thing to look at is the average days of sales outstanding.

Guest Track::
Average days sales outstanding. Complicated thing to say. AR days is what a

Guest Track::
lot of people kind of refer to.

Guest Track::
The dollars that are owed to us, how long on average does it take to collect

Guest Track::
a dollar that's owed? And that speaks really well to the health of our collections process.

Guest Track::
If it's taking us more and more days month after month, we are getting worse at collections.

Guest Track::
And if it's taking less days, obviously we are getting better.

Guest Track::
And if your practice is less days than mine, you are better at collecting than me.

Guest Track::
It might mean you have better collection efforts.

Guest Track::
It might mean you have better collection policies.

Guest Track::
It might mean a difference in insurance participation compared to me.

Guest Track::
So there's reasons that you could have a better number than me.

Guest Track::
That doesn't necessarily mean I'm unhealthy.

Guest Track::
But if I just only look at me, me from April to me to May, me to June,

Guest Track::
me to July, and if that number is getting bigger, we are getting more unhealthy.

Guest Track::
Days of sales outstanding are AR days.

Guest Track::
Now, you mentioned something important. You said, well, we could look at write-offs and adjustments.

Guest Track::
Adjustments that's kind of going down a layer deeper

Guest Track::
than the the core number the

Guest Track::
the dashboard number so on one

Guest Track::
hand if our dashboard number is getting worse we have

Guest Track::
to go down to the next levels and we'd want to go audit our adjustments and

Guest Track::
write-offs are we making mistakes there or is there funny things happening but

Guest Track::
even if our numbers aren't bad there's also going to be a a series of audits

Guest Track::
that a CEO is going to want to do anyway.

Guest Track::
We might have healthy collections. We might collect 2 million a year,

Guest Track::
but even if they're healthy, we don't want to be making mistakes with wrong

Guest Track::
write-offs because that's just throwing away money.

Guest Track::
So maybe we still want to audit that. Even if there's no alert that says we're

Guest Track::
unhealthy, we might still want to check it.

Guest Track::
We can look fit, but there still may be a little issue we want to fix.

Guest Track::
So that kind of brings up this whole strategy that says all right these core

Guest Track::
five areas are going to be our big numerical alerts do we need to focus more heavily.

Guest Track::
But some things we still want to just audit and check on.

Guest Track::
So like even if our conversion rate on the phone is healthy,

Guest Track::
we still want to go listen to some phone calls on a regular basis because a

Guest Track::
bad phone call can happen from miscommunication,

Guest Track::
mistraining with our team, assumptions that aren't correct.

Guest Track::
And it doesn't take very long for us to audit that and find that because we

Guest Track::
can find it before it impacts one of our big drivers.

Guest Track::
We can find it before it actually causes our blood pressure to go up or our

Guest Track::
EKG reading to be whap, right?

Guest Track::
So we definitely want to, as a CEO, look at the big knobs.

Guest Track::
But we need to also proactively have simple things that we audit that are important

Guest Track::
so we can stay ahead of anything screwing up a big knob. Does that make sense?

Host Track: :
Yeah. And I think that might need to be the next episode of translating,

Host Track: :
looking at the numbers of the big knobs, as well as the routine auditing that

Host Track: :
needs to occur in each of these areas, whether or not they're doing well or not.

Host Track: :
And turning this into a blueprint of disciplined actions as a CEO in this area of operation.

Host Track: :
So what do you think, a part two episode for this?

Guest Track::
That sounds perfect. I think we're ready. We need to do it.

Host Track: :
Okay. Well, Scott, this as always has been amazing.

Host Track: :
And I'm excited for that part two. too, I think our audience really wants to hear this.

Host Track: :
Now that they understand the big picture, the big things to look at,

Host Track: :
now we're going to put it into action. So thank you for outlining that.

Guest Track::
Okay, let's do it. Looking forward to it.

Host Track: :
Sounds good. We'll talk to you next time on the Shared Practices Podcast.