Can You Lie To A Druggie?

Transcription

Summer 2011
News & Information to Increase the Profitabilit y of Your Practice
The Sheet of
Paper
That Saved
1500 Lives
The Six Hour
A Week Dentist
The “Goldstein
Standard”
Can You Lie To
A Druggie?
What to do when a patient is
“Allergic
to
Novocain”
Recession-Proof your Practice
HOW MUCH DOES
YOUR FACILITY
PAY YOU
ON SATURDAYS
?
Now You Can Experience What Many Are Calling
“The Most Lucrative Niche in Dentistry,”
Your Own Dental Assisting School Business!
Assist To Succeed Dental Assisting School is a turn-key
business model that can be profitable very quickly...
AND YOUR STAFF CAN RUN IT FOR YOU!
cations
Prime Lo
Locked
Are Being
Away!
“My ATS residual income has far exceeded my expectations!”
-Dr. Kendall Skinner, Anchorage, Alaska
“ATS is the best thing to happen to me in my professional life.”
-Dr. James Drake, Idaho Falls, Idaho
“The ATS dental assisting school has been a great fit for us! We
signed up a class of 12 our very first class.”
-Dr. Michael Rockwell, Tooele, Utah
“Every dentist should consider running a highly profitable
dental assisting school business from their office.”
-Dr. Woody Oakes, New Albany, Indiana
How Do You Get Started?
Don’t Procrastinate. Call (208) 353-5301
Once They’re Gone... They’re Gone!
(208) 353-5301
www.AssistToSucceed.com
First, find out if your area is available. Go to
www.AssistToSucceed.com and submit your office
address for area availability. Dr. Taylor Clark, founder
and CEO of Assist To Succeed, will personally call
to notify you if your area is open. He will discuss the
opportunity with you and together decide if we can
accept your office. You may reach us at (208) 353-5301.
The first 27 online inquiries will receive a FREE
personally signed copy of Dr. Taylor Clark’s book
BEATING ALL ODDS, with foreword by
Rudy Ruettiger and endorsed by Dr.
Stephen Covey, Brian Tracy, T. Harv Eker
and many other Best Selling authors,
speakers and trainers.
Taylor Clark, DDS
Tell me, how can I help
make your life fantastic?
www.BeatingAllOdds.com
BY SPENDING MORE TIME
AWAY FROM HIS CHAIR
HE IS ABLE TO GET MORE PATIENTS
TO TAKE A SEAT.
A DVA N C E P R AC T I C E # 4 :
D R . W O O DY OA K E S
N E W A L B A N Y, I N
To turn his practice around, he needed to get out more.
That’s what Dr. Woody Oakes learned early on. He wasn’t
going to grow his business just by spending more time
there. He needed to go out and learn what was working
for other dentists.
After using this wisdom to build his own practice, he began
to share it with his fellow dentists. It started with his first
book in the early 1980s, and now includes a magazine,
blog and yearly nationwide seminars.
Advance your practice with advanced patient financing.
CREDIT LINES STARTING AT $5,000
12, 18 & 24 MONTH
NO INTEREST PAYMENT PLANS
BEST-IN-CLASS
ONLINE REPORTING SYSTEM
Dr. Oakes also offers his helpful advice to future dental
assistants by hosting training programs aimed at helping
them get good, well-paying jobs.
As part of the ChaseHealthAdvance Provider Network
you’ll have access to these benefits as well as more useful
financing tools, special offers and rewards.
Each day Dr. Oakes strives to not only improve his own
practice, but also his peers’ practices, which is why Plaza
Dental is an Advance Practice.
Visit AdvanceWithChase.com or call 1-888-388-7633 to learn
much more.
Information above is for providers and not for patient distribution.
ChaseHealthAdvance is not affiliated with and does not endorse
the services of Advance Practices.
©2010 JPMorgan Chase & Co. All rights reserved.
PD1110
SUMMER 2011
|
Issue 236
PRACTICE MANAGEMENT
EDITORIAL
istockphoto.com/ DeniseTorres
A Word From Woody................................................................................ 6
In the Spotlight – Six Month Smiles......................................................... 7
Editorial
So What’s YOUR Excuse?
by Dr. Woody Oakes...................................................................................8
by Dr. Joe Steven, Jr............................................................................... 10
The Five Most Overlooked Ways
Receptionists Lose Patients In
Every Practice And How You Can Help Them!
by Chris Mullins....................................................................................... 12
Failure Factors
by Vicki McManus................................................................................... 13
Recession-Proof Your Practice
by Ken Runkle......................................................................................... 16
Help for Those Drowning in Debt
by Sally McKenzie, CEO.......................................................................... 19
The Sheet of Paper That Saved 1500 Lives
by Dr. Chris Griffin................................................................................... 22
Follow the Leader
by Brooke Mott........................................................................................ 24
Free Financial Management Website
by Dr. Craig Callen................................................................................... 27
The Six Hour A Week Dentist
by Dr. Steffany Mohan............................................................................. 28
A Marketing Opportunity
by Dr. Craig Callen................................................................................... 31
“DISABILITY” or “MORE ABILITY”?
The Choice is Yours!
by Dr. Taylor Clark.................................................................................... 32
“Everyone Can Smile With Confidence”
The Perspective of a Six Month Smiles® Provider
by Dr. JoAnn Martens.............................................................................. 34
istockphoto/ Andresr
CLINICAL/TECHNICAL
Better Dentistry & More Profit
by Dr. Michael Curtis........................................................................... 36
Do Dentists, Let Alone Laboratories;
Really Understand the New Technologies in Digital Dentistry? Part 2
by David Block, CDT........................................................................... 38
Snoring Prevention
An Interesting Adjunct to a Dental Practice
by Dr. Earl O. Bergersen...................................................................... 40
The “Goldstein Standard”
by Dr. Woody Oakes............................................................................ 42
Profitable Thoughts
Hypnotherapy : Homeless Improvement with Best Friend Therapy™
by Dr. Steven E. Roth.......................................................................... 43
A Ground Hog Life
by Dr. Mike Abernathy......................................................................... 44
The Facts About Credit Card Processing.......................................... 46
Why Hygiene Patients are Worth an Extra $100,000 a Year
by Robert Winings............................................................................... 47
How Avoiding the Stock Market Can Make You Rich
by Garrett B. Gunderson..................................................................... 48
Hmmm... Interesting by Raoul Camus............................................... 51
Comedy Corner
by Dr. R. Anthony Matheny.................................................................. 51
PROFITABLE NEWS & PRODUCTS
Puzzle Piece: “Over-Sized Business Cards”................................................ 52
A Word From Our Readers............................................................................ 52
CONTACT US
Products & Solutions: .................................................................................. 53
Phone: 1-800-337-8467 or 1-812-949-9043 Fax: 1-812-949-8535
Mail: The Profitable Dentist 3211 Grantline Rd, Ste 20, New Albany, IN 47150
Email: [email protected] Website: www.theprofitabledentist.com
Excellence In Dentistry Products and Events........................................ 54-55
EDITORIAL ADVISORY BOARD
The content of this
publication may not be
reproduced either in part
or full without the written
consent of
The Profitable Dentist ®.
4
S U M M E R 2 0 11
DR. MICHAEL ABERNATHY
McKinney, TX
DR. BILL DORFMAN
Los Angeles, CA
DR. DAVID HORNBROOK
La Mesa, CA
DR. MARK HYMAN
Greensboro, NC
CATHY JAMESON
Davis, OK
DR. BILL KIMBALL
Encinitas, CA
DR. ROGER LEVIN
Baltimore, MD
DR. TOM ORENT
Framingham, MA
DR. STEVE RASNER
Bridgeton, NJ
DR. LARRY ROSENTHAL
New York, NY
DR. ROY SMITH
Tyler, TX
DR. BILL STRUPP
Clearwater, FL
Dr. Joe Steven, Jr
Wichita, KS
STAFF
Editor-in-Chief
WOODY OAKES, DDS, FAES
Seminar Coordinator
JENNIFER JONES
Associate Editor
CRAIG CALLEN, DDS
Front Office Coordinator /
Administrative Assistant
CHRISTY CLAYWELL
Executive Vice President of
Operations/Finance
DELAINE STEWART
Shipping Manager/
Coaching Assistant
LISA MERKEL
The Profitable Dentist
Designer
Leah Conder Taylor
Taylor & Associates
© 2011 Excellence in Dentistry, Inc., Publisher. Copyright enforced – no part of this publication may be
reproduced without written permission. This publication is designed to provide reliable information
in regard to the subject matter covered. However, it is sold with the understanding that it does not
www.TheProfitableDentist.com
replace the need for advice from your personal, competent
professional advisors.
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Centers for Dental Medicine:
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was BY FAR the best of the bunch.”
Recent article by Dr. David Winn, the first dentist
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“... all diode lasers are not the same. Look for a focused
beam based diode, not a bundled fiber diode. The
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Woody Oakes, DDS, Publisher of “The Profitable Dentist” says...
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Call within 2 weeks, mention “TPD” and receive
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A Word
from
Woody
I want to start out by saying, “Thanks” to our members who helped
make our 20th Annual “Spring Break” Seminar the best ever!
Megan, my wife, commented on what a nice, polite group of members
we have. Certainly different from many other shows we have attended…
and we have attended a lot!
Brooke Mott (who recently joined our team) was in Cologne, Germany
for the International Dental Meeting this year. It was a really exciting and
educational trip.
William W. Oakes, DDS
Editor-in-Chief
and wife, Megan
Big things are planned for The Profitable Dentist and its members.
Our goal is not only to grow as a company, but to add as much value as we
possibly can for you and your practice!
6
S U M M E R 2 0 11
Regards,
PS – For all of you who have
asked, my “after” photo in
the Cenegenics ad was NOT
photoshopped in anyway!
istockphoto.com/ GeofferyHolman
In The spotlight
Six Month Smiles:
Making Ortho Accessible
and Profitable for Dentists
Six Month Smiles, Inc. has
changed the landscape of dentistry
with the Six Month Smiles system.
Orthodontics, an area that has been
seemingly shrouded in mystery, is
now accessible and profitable for any
general practitioner. Dr. Ryan Swain
founded the company in 2006 based on
the premise that everyone should smile
with confidence, even patients with
crooked teeth who refuse traditional
orthodontic treatment. Dr. Swain also
believes that every general dentist
should be able and equipped to help
their adult patients with crooked teeth.
The Six Month Smiles system provides
a turn-key way for general dentists to
get involved with fixed orthodontics.
With over 1600 providers in 18
countries, Six Month Smiles continues
to garner more and more momentum as
general dentists look for ways to grow
their practices and patients look for a
reasonable way to improve their smiles.
The Six Month Smiles movement has
been recognized clearly within the
dental community as something that
has legs and will continue to alter
the way that general dentists view
orthodontics. With that in mind, I’d
like to share with you “Woody’s top six
reasons to become a Six Month Smiles
provider”:
1-800-337-8467
#1
Provide a fantastic
service for your
patients with crooked
teeth
The Six Month
Smiles system allows
dentists to help their
patients who are “stuck”
with crooked teeth by providing them
with a time sensitive orthodontic option
that involves unique and tooth-colored
brackets and wires. No previous
orthodontic experience needed!
#2
Grow your profits with an
immediate return on investment
Six Month Smiles providers are
seeing huge numbers. Most providers
charge about $4,300 per case and the
dentist chair-time is minimal. Costs
associated with getting started are
minimal and can be covered with your
first one or two cases.
#3
Re-invigorate your team
Monthly orthodontic adjustments
have been described by some dental
assistants as “arts and crafts in the
mouth!” They love it!
#4
Expand your service mix
Adult patients rarely accept
an orthodontic referral. When they
refuse traditional braces, an attractive
alternative can be provided.
#5
Create raving fans of your practice
Six Month Smiles patients are
a unique brand of patients. They
are incredibly thankful for the
transformation provided to them and
their excitement and enthusiasm is
contagious.
#6
Because everyone should smile
with confidence
General dentists finally have a
focused, simple and predictable way
to solve their patients’ orthodontic
problems while growing their practices
at the same time.
S U M M E R 2 0 11
7
Editorial
So What’s YOUR Excuse?
by Dr. Woody Oakes
L
et’s face it… we now live in a world where virtually no one wants to take responsibility for their actions. Just
watch the news each evening and you’ll see any number of celebrities and sports stars hiding behind their lawyers
rather than “coming clean.” The sad part is that such behavior spreads to regular folks like our kids, our neighbors
and even at times, ourselves.
Every time I do a consultation with a struggling dental office, I keep track of the excuses I receive. The average
number is about 20, but some offices give me a hundred excuses as to why their practice is in trouble. The following is a
list of excuses for a closed mind. As you read the list, place a check by those that apply to you and your office.
o We tried that before.
o Our place is different.
o It costs too much.
o That is beyond our responsibility.
o We are too busy to do that.
o That is not my job.
o It is too radical a change.
o We do not have the time.
o Not enough help.
o That will make other equipment
obsolete.
o Let’s make a market research test
of it first.
o Our office is too small for it.
o Not practical for our patients.
o The ADA will scream.
o We have never done it before.
o It is against company policy.
o Runs up overhead.
o We do not have the authority.
o That is too “Ivory Tower.”
o Let’s get back to reality.
o That is our problem.
8
S U M M E R 2 0 11
o Why change it; it’s still working okay.
o I don’t like the idea.
o You’re two years ahead of your time.
o We’re not ready for that.
o WE don’t have the money,
equipment, room or personnel.
o It is not in the budget.
o Can’t teach an old dog new tricks.
o Good thought, but impractical.
o Let’s hold it in abeyance.
o Let’s give it more thought.
o Top management would never go for it.
o Let’s put it in writing.
o We’ll be the laughing stock.
o Not that again.
o We would lose money in the long run.
o We did all right without it.
o That’s what we can expect from the
staff.
o It’s never been tried before.
o Let’s shelve it for the time being.
o Let’s form a committee.
o I don’t see the connection.
o Patients won’t like it.
o It won’t work in our office.
o Maybe that will work in your office,
but not in mine.
o The doctor will never go for it.
o Don’t you think we should look into
it further before we move forward?
o What do they do in our competitors’
office?
o Let’s all sleep on it.
o It can’t be done.
o It’s too much trouble to change.
o It won’t pay for itself.
o I know a fellow who tried it.
o We’ve always done it this way.
Here’s the deal: instead of making
excuses… why don’t you make solutions?
As you look in the mirror each morning,
take a good look at the only person
who can stop making excuses and start
making solutions – you!
Now complete the “Master Dream
List” on the next page and replace your
excuses with your dreams!
Write down everything you’ve ever
wanted, every place you’ve wanted to go, and everything you’d like
to become or achieve. Date each
item as you write it down.
Remember to take off the judge’s
robe and let your imagination
run free. Give no consideration
to limitations, money, education,
ability, or what may seem illogical. This is a completely unrestrained,
free-wheeling exercise in permissiveness, so make your list complete and continuous. Add to it
daily, weekly, monthly, forever.
(2009) longlens, Image from Bigstockphoto.com
Master Dream List
1-800-337-8467
Now enjoy what happens in your life!
S U M M E R 2 0 11
9
Practice management
by Dr. Joe Steven, Jr.
Editor’s Note:
A real time
waster in many
practices are
patients who
seek drugs, not
dental care. If
you don’t have
a system to rid
your practice of
these folks…
your productivity
will suffer.
Here are some
thoughts regarding
“Druggies.”
10
S U M M E R 2 0 11
About ten years ago, I was leading
“Tiny” from the treatment room as he
pulled me aside halfway down the hall
to kindly ask for another prescription of
Percodan. Tiny is a pretty unique kind
of guy. He’s about 6’6”, 300 lbs. and
well decorated with tattoos and attire
that accentuates his role as a motorcycle
gang member. One tattoo on his arm
had me looking straight down the barrel
and cylinder of a .38 handgun with the
words beneath it that read, “I’m gonna
kill sum’pun!” He bragged that he always
dated nurses so that they could sew
him up after fistfights. (If only one of my
daughters could bring home a guy like that.)
I had removed some impacted third
molars and had prescribed Percodan for
him. I refilled it a week later. After he
went through that, he was back in the
office because he was still having quite
a bit or pain (so he said). After I quickly
examined his mouth, I was pretty sure he
was a druggie (what was my first clue?).
He said to me in the hallway, “Hey Joe,
can you get me another prescription for
some of the Percodan?”
I didn’t want to write him another
one, but wasn’t really sure how to
handle this one. All of a sudden, I
embarrassingly said, “Tiny, I sure would
like to help you out here, but I recently
had a visit from a DEA agent because
they thought I was writing too many
prescriptions for pain medications. I
think they’re crazy. But now, they watch
me like a hawk, and I’m scared to death
that I may lose my license if they see
me writing too many scripts to the same
patient. Now Tiny, I hate to lose a patient
over something like this, but to be honest
with you, I would rather lose a patient
than my license.”
istockphoto.com/ DNY59
I have used this approach a couple
of dozen times, and every time I hear
something like, “Oh doctor, I wouldn’t
want that to happen to you. I’ll try to get
by without it.” Not only do they not want
to get me in trouble, they also don’t want
any DEA agents to see their names again
(it’s probably the latter).
I have used this on druggies and also
on very nice patients whom I felt were
starting to get addicted. I’ve used it on
friends and distant relatives. It works
every time while preventing any hard
feelings from erupting. Plus, this is the
most efficient way to handle these timewasting patients. We’ve all had way too
many patient visits that have annoyed us
repeatedly while taking up our valuable time.
As for the lying part, two DEA
agents actually did pay me a visit because
someone stole one of our Rx pads and
forged my signature. So in a way, I
kind of just stretched the truth with
my elaboration. But it works. I never
thought I’d be recommending lying to
your patients, but in this case, I really do
believe the end justifies the means!
For more information, contact Dr. Joe
Steven at 1-800-325-8649.
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With Stoneybrook, I had confidence that you would do it
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(800) 736-3632
PDFP
S U M M E R 2 0 11
11
Practice management
The Five Most Overlooked Ways
Receptionists Lose Patients In
Every Practice And How You Can
Help Them!
by Chris Mullins, The Phone Success Doctor™
Lost Sales Opportunity #1: No greeting, or a bad one.
In most businesses, greetings are somewhere between
lousy and nonexistent. Receptionists usually sound like they
just woke up, are bored to death, or are trying to get the patient
(customer) off the phone just as fast as possible. One thing is
for sure: They don’t sound like they’re ready to welcome your
established patients or your prospective patients.
Lost Sales Opportunity #4: Not asking “How did you
find us?”
You’ve no doubt spent thousands of dollars on lead
generation to get your phone to ring. Now it rings. But no one is
asking the question, “How did you find us?” You might as well take
half the money in your bank account and flush it down the toilet.
For countless thousands of years, humans have been
conditioned to make instant judgments. It used to be a survival
thing. Instead, now you should think of it as a business
survival thing. Someone is going to form a “buy it or forget it”
conclusion instantly.
You need to track (call measurement recording) whether
your new prospects came from your Yellow Pages ad, that new ad,
radio, word of mouth, or whatever. You don’t need to interrogate
them up front. Just somewhere in the conversation say, “By the
way, where did you hear about us?” You should be looking for a
report every day that lists the sources of that day’s callers.
Try this: “Thank you for calling Dr. X’s office....This is
Chris speaking How can I help you?” This should be done with
a smile that says, “We’re here for you!”
Lost Sales Opportunity # 5: Not repeating the
problem.
Lost Sales Opportunity #2: Not asking for the caller’s
name.
Many receptionists don’t ask for the caller’s name. This
usually comes off as being rude, or at least not welcoming.
Consider the upside, though: most people regard their
names as the sweetest-sounding words in the English language.
Asking for the name is a great way to begin building rapport
and showing the caller what kind of business you really are: a
friendly one. Insist that your receptionist asks for the caller’s name.
Lost Sales Opportunity #3: Not using the caller’s name.
“Mrs. Smith, welcome!” This is a brilliant move, because
what you’re doing is telling her that she’s now a patient. If your
business depends on scheduling appointments, you’re one step
closer to the next appointment.
This is a BIG DEAL, because in today’s world, many
people aren’t really listening to what others are saying. When
you repeat the problem, you’ve not only given the prospective
patient a chance to correct any misunderstanding; but you’re
also showing a rare courtesy.
Are any of these “earth shattering” revelations to you?
Of course not. But how many times in the last month – or
even the last decade – were you blown away by the quality of
a receptionist you reached? I bet you can count them on the
fingers of one hand, with room to spare.
Let others slice away their profits by competing on
ever-lower prices. You should compete on something that’s
not only free, but also extremely valuable in this fast-paced
world: Great Wow Customer Service... starting with your
receptionist... “The Front Desk Expert” also known as “The
Dental Concierge Specialist.”
Chris Mullins can be contacted at 603-924-1640 or [email protected].
Also visit her website at www.GreatBottomLine.com.
12
S U M M E R 2 0 11
practice management
Failure
Factors
istockphoto.com/ PeterBajohr
by Vicki McManus
Managing Partner,
Productive Dentist Academy
As achievers, we tend
to focus on success;
reading articles like
“5 Steps to Total
Freedom.” There
are times when the
best way to achieve
success though, is to
1-800-337-8467
pause and discover
what is holding us
back! Katherine Kolbe,
in her book “Instinctual
Leadership,” writes
about three failure
factors: frustration,
fatigue and fear.
How do these
manifest themselves
in dentistry? More
importantly, how can
you combat them in
order to make better
decisions?
S U M M E R 2 0 11
13
13
Frustration
Each year, Productive Dentist
Academy surveys its members to
discover their current stressors. Over
time we’ve discovered that dentists are
frustrated on many levels:
•
Restrictions on delegation
based on state legislation.
•
The speed of changing
technology.
• With equipment purchases
promising to be the silver
bullet to their success, only
to sit idle in a corner.
•
Inability to balance personal
and professional lives.
• Staff who interview well,
and seem to fall short of
expectations 90 days later.
• Working harder than ever for
less money.
14
Fear
•
Having to “market” to
gain patients – and getting
mixed messages about what
marketing works.
•
Patients not accepting
treatment; elective cosmetic
procedures decreasing 30%
in the past 3 years; patient
financing tightening.
S U M M E R 2 0 11
• Lack of business preparation,
and ability to understand
benchmarks of success. Sound familiar? Regardless of
the economic mood of the country,
these frustrations exist in our industry
and hold you back from being more
productive. We’ve found that stress is the
#1 killer of productivity; anything that
stresses you, the patient, or your team,
automatically draws focus from your day.
What you can do: start thinking
of these frustrations as “training
opportunities.” Once you’ve identified
the source of the concern, you can take
action to minimize the impact on your
practice. There’s a reason
the schedule isn’t filled, the
equipment is sitting in the
corner, and cash-flow is
faltering. Sometimes a
simple conversation with
your team can get you
back on track – other
times it is helpful to have
an outsider take a look
and help place priority
on changes.
Fear manifests itself in many forms.
Primary fears that we’ve identified
at Productive Dentist Academy are:
financial fear, confrontational fear and
fear of success. We’ve polled more
than 500 dentists during live seminar
events, to discover that only 30% of
attendees create an annual budget! Of
those that create a budget, only 1/3 of
them reconcile with actual spending
on a monthly basis. Depending on your
accountant to reconcile the books and
give you a report (often 2-3 months later)
is like driving a car using the rear-view
mirror. The uncertainty of cash-flow creates
massive stress and poor decision making.
The second most predominant fear
is the fear of confrontation. This prevents
dentists from being honest with their
patients, their team and (believe it or
not) themselves! Diagnosing, treatment
planning and conveying comprehensive
care to patients is scary for many dentists.
Lack of verbal skills creates failure in
two ways – either being too technical and
overwhelming patients, or remaining silent
about needed treatment and sharing only
what you think the patient will accept.
The good news is there is a way to
appropriately convey your message without
blowing patients out of the water. Learning
the skills to appropriately communicate
with patients has a beneficial impact on
team communications.
The third fear seems unlikely on the
surface: fear of success? Never! Before
you make that declaration, consider that
the ADA estimates that 95% of dentists
cannot retire with financial security at
age 65. Many practitioners have limiting
beliefs and mixed messages regarding
profitability. One way of combatting
this is to take a close look at your cost
of doing business – include all start-up
costs of time, education, equipment, and
then treat these costs as investments. By
our calculations, most practitioners have
“As my partner Bruce Baird often says, ‘As dentists we tend to
burn out every seven years, and want to open a Quizno’s or
Jiffy Lube – anything seems easier than dentistry’.”
a minimum of $1,000,000 invested in
their education and business – when they
start their career! Give it twenty years,
and a few advanced continuums and this
figure grows substantially. By setting a
minimum goal of achieving a 15% return
on your investment, many dentists would
see that as a business leader, they have a
responsibility to pay themselves just as
they’d pay an associate dentist AND create
an additional profit based on the investment
they’ve made. Otherwise, why would you
become an owner? Why not work for
someone else who is willing to create
abundance and guarantee your income?
What you can do: Work with your
coach, accountant, financial planners
to determine your break-even point. At
PDA we call this your PIP (profitability
incentive point). This includes the
collections needed to pay all practice
overhead, the dentist as if she/he were
an associate in the practice, as well
as owner’s ROI at a minimum of 10%
collections, and adopting a reserve
fund for future upgrades. This is very
different than traditional “BAM”
formulas that estimates overhead based
on a formula of staff salaries times a
variable (4.5 – 5). That outdated formula
oftentimes does not consider the full
overhead of the practice.
Fatigue
Fatigue presents itself in two ways:
emotional and physical. Oftentimes, the
emotional fatigue creates the physical
discomfort and is closely related to
the internal fears being carried by the
dentist. As my partner, Bruce Baird,
often says, “As dentists we tend to burn
out every seven years, and want to open a
Quizno’s or Jiffy Lube – anything seems
easier than dentistry!” Truth is, even
1-800-337-8467
though the economy has taken a tumble
since 2009, for dentistry, most areas of
the country have faired well. Many PDA
members actually report increases in
productivity. How can this be true?
The key is to focus on your energy
and how your time is scheduled.
Out-of-control scheduling creates a
roller-coaster effect of high and low
productivity. Haven’t you noticed that
some of the most exhausting days
are also some of the least productive?
During the previous seven years, we’ve
noticed an inverse relationship between
productivity and fatigue – the more you
produce, the more energy you have! That
is a bold statement, yet we see it time and
time again.
Dentists producing $450 per hour
report much higher stress than dentists
producing $750 per hour. The reason is
that in order to increase productivity,
the entire team has to begin thinking in
a different way. Systems are enhanced
to create smoother workflow, and you
begin scheduling for productivity, not
time. Once you understand the concept
of scheduling for productivity, you’ll
find that you have more time than you
ever did using the traditional “x” and “/”
system of filling the book.
The flipside of the fatigue coin is that
once you begin producing at $1,000 or
more, you may need additional down time
to refresh your senses. Productivity gives
you freedom; the freedom to earn more,
save more, and have more time with family.
The choices are up to you. We typically
see productive dentists reducing their work
week or taking more frequent vacations.
What you can do: Unlike previous
“shrink to greatness” theories that
circulated in dentistry or the knee jerk
reaction of hiring an associate when you
feel tired or busy, Productive Dentist
Academy takes a systematic approach to
increasing productivity, stabilizing the
practice, and re-assessing before making
recommendations for reductions in time,
or adding providers.
It is possible to produce $1.8 million
per year (personal production not
including hygiene). This can be done
over the course of 4 days per week or in
as little as 2 days per week with proper
systems in place. The first step is to get
clear on what you want to achieve, and
more importantly, why! Work backwards
to identify your current areas of fear,
frustration and fatigue. Now you have
the ability to ask better questions,
identify continuing education programs
and access resources that can help you
get past your failure factors.
Vicki McManus is one of the nations’ leading dental
business coaches. For a free copy of Productive
Dentist Acaedemy’s: “Three Ways to Kill a
Recession,” visit www.productivedentist.com.
About PDA:
The Productive Dentist Academy
is helping dentists across the
country boost their production and
dramatically reshape their bottom
line. Now, in just months, you can
raise your production by a minimum
of $300/hour and learn how to
keep your production healthy for
life. PDA provides bona fide, “inthe-trenches” solutions that will
lead to a surge in your production
regardless of where you practice.
Their next workshop is July 21 - 23,
2011. For more information, call
800.857.6077 or visit
www.productivedentist.com.
Special Offer for Profitable
Dentist Readers: SAVE $400 on
doctor tuition
Promo code: PDA2011
S U M M E R 2 0 11
15
(2006) jlgoodyear Image from Bigstockphoto.com
Practice management
by Ken Runkle
America’s Profitability Expert™
Re
ce
Yo ss
ur io
n
of
ro
e
-P
tic
ac
Pr
B
ased on the last recession in America, one can
assume that the current recession may last a few
years. For many in the business world, including
dental practitioners, a few bad years can devastate a business.
However, during the last two decades of working with dental
practices, we have discovered ways to avoid potential ruin in
difficult times.
Statistically, twenty percent of businesses will inevitably
fail during a time of recession. If you want to be among the
twenty percent that fail, you may want to stop reading now.
Statistics also reveal that sixty percent of businesses during a
recession will neither grow nor fade, they will simply remain
flat. For a practice with a leader committed to growing, that
is unacceptable also. Finally, these same statistics show that
twenty percent of businesses will turn lemons into lemonade
and grow during a widespread recession. If you would like to
join the twenty percent of dental practices that will grow over
the next few years, you may find this article helpful.
At Paragon Management we have resolved that we will
refuse to participate in regular business cycles of boom or bust and
growth or recession. Regardless of the economic environment, we
will grow and thrive as we help dentists and dental practices
do the same. In fact, we are so committed to this approach
that we have a beautifully framed announcement in our office
declaring, “Paragon does not participate in recessions.”
Through our commitment to help our clients withstand
the challenges of a rough economic environment, we have
discovered eight critical and proven keys to recession-proofing
a dental practice. Implement all eight and you may join the
twenty percent who will grow and thrive during these tough
times. Ignore and discard these key principles and you may
find your dental practice in need of a bailout.
16
S U M M E R 2 0 11
(2009) Habman18 Image for Bigstockphoto.com
1. Be Optimistic
In the book, Learned Optimism, author and researcher Dr.
Martin Seligman, shares research revealing that optimism is
the most important indicator of success and failure. During
the Summer Olympics of 2008, I caught an interview with Dr.
Seligman on SportsCenter as he was discussing the incredible
success of Olympic phenomenon Michael Phelps. In referring
to Phelps’ closest race in which he trailed going into the final
stretch, Dr. Seligman shared a conversation he had with his
wife. As Phelps fell behind in the race, Dr. Seligman’s wife
asked him if he thought Phelps would win. Dr. Seligman
expressed confidence that Phelps would certainly win. Phelps
won at the last micro-second and Dr. Seligman went on to
share his secret knowledge of this incredible athlete. During
an optimism study of high school athletes a few years before
the Olympics, Phelps recorded one of the highest Optimism
Quotient scores of any high school athlete. Dr. Seligman knew
Phelps’ incredible optimism would carry him to a victory
regardless of the challenge.
In dentistry, an optimistic attitude creates focus and belief
that can propel an entire dental team even when the outlook is
bleak. We have seen Dr. Seligman’s research proven over and
over by the dental practices we have had the privilege of serving.
It is important to note that the doctor, as the practice
leader, is the mood ring for the entire practice. His or her
attitude permeates the entire staff and patients, inevitably
impacting the bottom line. Dentists with a high Optimism
Quotient breed dental practices which will be much more
successful than those who choose to share in the pessimism of
a world drowning in doubt.
It pays to be optimistic.
2. Be Logical Rather than Emotional
Don’t be ruled by what I call the “Las Vegas experience.”
With an understanding that I am not endorsing gambling,
consider the following illustration. You and two friends fly to
Las Vegas for the weekend with a few dollars burning holes
in your pockets. You agree to limit your risk to two thousand
dollars each, win or lose. By the second day, you are on a
roll and now have ten thousand dollars. Friend number one
miraculously discovers a once-latent Midas touch and now
has twenty thousand dollars, while friend number two has had
modest gains and is now up to three thousand dollars. You are
all doing well, but you and friend number one seem to have
discovered the secret to beating Vegas and are considering
leaving your dental practices to gamble full time.
By the end of your trip, reality has settled in. You and
friend number one each end your time in Vegas with four
thousand dollars. With a few more lucky hands, friend number
two was also able to get to four thousand dollars.
1-800-337-8467
Even though you doubled the two thousand dollars you
brought to Vegas, you still feel disappointed thinking to
yourself that you really lost six thousand. Friend number one
is on the verge of depression and is making calls back home
complaining that he lost over sixteen thousand dollars during
his weekend. Friend number two is at the bar buying rounds
of drinks and celebrating how he doubled his money. Even
though the end financial gain is the same for each, emotion has
trumped logic.
What does this have to do with dentistry? You may have had
a terrible November, but overall you had a fantastic year. Don’t
let one month tax your emotions when overall you’ve made a
gain in the present economic environment. You may have had a
bad financial day, but over the last few months your practice has
grown. Stay grounded in the logic of the overall numbers and
results. Do not be ruled by the emotions of the moment.
3. Invest in the Practice
A noticeable difference arises between managers and
leaders during tough economic times. When revenues fade,
managers begin immediately cutting expenses. The question
they ask is, “How can we cut expenses to meet revenue?”
Leaders ask a different question. “How can we grow
revenues to exceed expenses?” Leaders begin looking for
places to invest in the practice with the goal of growing during
down times.
Here are four areas to consider for strategic investment:
 Marketing. As others pull back marketing efforts,
it’s a great time to grab more local market share and
increase your patient base.
 Continuing Education. Making yourself a more
complete and better dentist may not create an
immediate impact, but long-term you and your
patients will be thankful. Do not forget to grow your
dental team in this area also.
 Equipment and Technology. Down times present
a buyer’s market for investing in equipment and
technology. You may discover some great deals on
equipment as inventories remain stagnant.
 Professional Services. Invest in a dental management
or consulting firm to help you grow.
4. Play your “A” Game
During a booming economy, you can afford to be sloppy
and let things slide. However, when your patients tighten their
S U M M E R 2 0 11
17
Practice management
purses, you must have flawless execution with your systems,
communications, time management and case acceptance.
Consider this example. Most people eat out at a restaurant
at least once a month, or twelve times a year. Let’s assume this
year you can only eat out one time. Which restaurant will you
choose? Will you choose a restaurant that has ever left you
with a bad taste? Will you choose a restaurant that is too slow,
sometimes gets your order wrong or is hit and miss with food
quality? No. You will choose a restaurant that you absolutely
know will get it right by creating a fantastic environment,
delivering great food and providing a fulfilling evening for all.
When purses tighten, there is no longer any room for mistakes.
5. Remove Anything Negative in your Practice
As patients linger in your waiting room, what are you
communicating through the media available to them? Are
newspapers, magazines and television news feeds pummeling
them with bad news about the economy? Is that a message you
want to reinforce with those about to purchase your services?
Difficult financial times demand that your practice rid itself
of anything negative… including people. Your dental team must
understand that you are selling dentistry and only happy people
sell dentistry. As painful as it may be, it is most critical during
times of struggle that you purge your practice of negative people.
The ultimatum is simple, “Get happy or get another job.”
For some of you, this concept may seem like positivethinking hocus-pocus. I would highly encourage you to
reconsider the power of expectations. Twenty-four years of
working with great dentists has taught me that the ultimate
soft-tissue program is the soft tissue between your ears that
you personally need to manage.
How do you change your expectations? Here are four
proven steps:
1. Write down your expectations.
2. Submit your expectations to loved ones and trusted
advisers.
3. Read your expectations on regular basis.
4. Start to say your expectations out loud. It is crucial to
always say what you expect.
A final note on expectations: if you are spending time
with people who will not allow you to expect your dream,
you need to find new friends who will constantly support and
encourage you to reach your dream. Find a network of successful
dentists who will challenge you to greater levels of success.
8. Always be a Giver
6. Be Creative Financially
Isaac Newton declared that, “for every action there is an
opposite and equal reaction.” The Bible says, “whatever a man
sows, that also will he reap.”
In today’s dental environment, many options abound for
creativity in helping patients pay for dentistry. CareCredit
and other financial service companies can greatly help your
practice find an upward growth curve while other practices
slide. Now is the time to investigate and promote those options
with your patients.
In the world of dentistry, you have a unique opportunity
and privilege to be a giver. Whether you take a mission trip
to help those whose lack of dentistry could be life threatening,
or you enjoy regular trips to the inner city to serve the
underserved, I would encourage you to find a place to invest
your gifts in humanity.
Also, as patients struggle financially, it is a good time for
the front office to show some creativity and flexibility with
long-term patients. Once you have conducted a Verification
of Insurance with patients who have proven faithful over the
years, you may want to show flexibility with their co-pays.
They will be grateful and you will build raving fans who have
the potential to be future referral magnets.
Why should you consider being a giver? You always
reap what you sow, making most people’s lives a direct result
of their giving. Giving also has the power to contextualize
you as a human being. It connects you with the struggles of
humanity, thus making you more compassionate, empathetic
and understanding with your patients. Being a giver makes
you a better dentist.
7. You Are What You Expect.
Based on years of research and experience, I have discovered
that you get what you expect in life. If you expect to live to be
over one hundred years old, you will probably wake up one day
smiling as you celebrate your one-hundredth birthday.
The same holds true for dentistry. If you expect to have
a two million-dollar practice, chances are good that you will
make it. If you expect to have a one million-dollar practice,
18
your bottom line will eventually match your expectations.
S U M M E R 2 0 11
In the end, twenty percent of you reading this article will
refuse to give in to the recession and will instead see it as an
opportunity to grow your practice. Don’t let anyone convince you
that bad economic times necessitate a financial struggle for your
practice. Decide today that you will not participate in recessions.
Go for it!
Ken Runkle, America’s Profitability Expert™, is the founder and president of
Paragon Management, Inc. and has been helping dental practices reach peak
profitability for twenty-four years. You can find out more about their approach to
practice management at www.theparagonprogram.com or by calling 800.448.2523.
Practice management
istockphoto.com/ frentusha
Help for
Those
Drowning
in Debt
by Sally McKenzie, CEO
I
t’s the skeleton in the closet that few doctors want to talk
about. They may lament that the schedule has been spotty.
They may acknowledge that treatment acceptance isn’t
within striking distance of the pre-2008 heyday. Those are
areas over which they feel they have had little control. Bring
up the issue of “doctor debt” and most want to change the
subject to just about anything else. Why? You probably know
the answer. Many dentists are carrying between $300,000 and
$500,000 in debt from business credit cards, equipment leases,
lines of credit, loans, mortgages and the list goes on. In some
cases, it’s simply been the cost of doing business, in others, it’s
poor financial management.
But living through the Great Recession has stripped away the
veil and revealed serious system shortfalls that practice bottom
lines can no longer absorb.
Many dentists will sense that “things just aren’t right,”
but it isn’t until they stand toe-to-toe with serious financial
struggles that they realize the way they’ve always done things
no longer works in the new economy.
Change is Here
Consider the case of “Dr. Tom.” He has been in practice
for more than 20 years in the upper Midwest. His practice has
been pounded by monthly debt obligations that were topping
out at nearly $8,000. Dr. Tom said that over the past couple
of years, the only thing he could count on in his practice was
writing check after check after check on a seemingly endless
string of debt obligations. Overhead was pulling him under. He
had to make significant changes; not only in his debt obligations,
but in the way he ran his practice. It’s the latter that often proves
to be the greatest challenge for doctors to come to terms with.
They are eager to get their financial obligations under control.
But the real work of digging into practice systems and improving
the daily operations is what will ensure that the doctor doesn’t
find him/herself drowning in red ink down the road.
More and more dentists are eager to gain control of their
finances and thereby regain control of their practices. The
key is to address the situation before it gets out of hand. Joe
Flumian, McKenzie Management Vice President Practice
Solutions, specializes in helping dentists improve their cash
flow and has helped dentists at all stages of their careers
effectively address the debt that for many has spiraled out
of control. The first step is to come face-to-face with reality.
“It begins with conducting a cash flow assessment in the
practice. That means logging the numbers for net production and
collections over the last 12 months, the percentage of accounts
receivable over 90 days, total monthly payments on leases, loans,
and business credit cards. In addition, doctors need to look at their
average monthly payments to the lab, dental supplies, salaries,
taxes, and benefits as well as monthly facilities costs and all
those miscellaneous expenses that tend to add up.”
Early in their careers, many dentists lock into a pattern of
running their systems that consistently yields lackluster results.
During robust economic times, the inefficiencies are masked.
From there, it is a matter of evaluating each individual
dentist’s situation. “We may look at consolidating all of the
doctor’s loans and refinancing them at a lower rate. In some
1-800-337-8467
S U M M E R 2 0 11
19
cases, it is more cost effective for a dentist who is leasing an
office to purchase the space. When refinancing, we like to look
for loans that allow for additional principal payments, which
will effectively lower their interest rate over the long term.” In
some cases, the doctor refinances at a lower interest rate and
with a longer term. Mr. Flumian notes that terms on average are
10-25 years based on the individual doctor’s situation.
He says that most struggling practices can get help as long
as the situation does not get too far out of control. “If the dentist
has started to miss loan or credit card payments, if they have
lost their home to foreclosure, or if they have defaulted on a
loan, the doctor may be beyond the point of no return. The key
is to be proactive.”
Once the stress of the debt obligations is reduced, then the
doctor can focus on improving practice systems. For Dr. Tom,
who was shelling out close to $8,000 per month, he has reduced
his debt obligation payments to just over $5,000 a month
and is in the midst of overhauling his management systems,
which is expected to increase his profits considerably. When
the practice management systems are running at maximum
efficiency the typical practice can expect to increase revenues
from 25-35% within 60 days.
System Scrutiny
There are 22 systems and dozens of variables that affect
your practice, all of which require ongoing assessment and
monitoring. Effectively managing those systems goes hand-in-glove
with controlling practice overhead. But it won’t happen overnight.
You’ll need a strong commitment, a solid plan, and possibly
outside assistance to achieve your practice profit objectives.
The process begins with taking a good look at expenses
and setting goals. Your practice is constantly funneling money
into five major areas: facility (rent/utilities), staff salaries
(employee taxes & benefits), dental supplies, laboratory, and
miscellaneous. To come within striking distance of the 55%
overhead goal, start by establishing the following budget targets:
Dental supplies - 5%
Office supplies - 2%
Rent - 5%
Laboratory - 10%
Payroll - 20%
Payroll taxes and benefits - 3%
Now you now know where you’re headed, but how do you
get there?
Rent – If you’re already up to your neck in facility debt,
consider renting a portion of the space to another dentist and
explore refinancing options.
Staff Payroll - If your payroll costs are crushing your
profits, here’s what may be happening:
 You have too many employees.
 Raises are based on longevity rather than productivity/
performance.
 Hygiene production is low.
More staff does not guarantee an improvement in
efficiency or production. It does, however, guarantee an
increase in overhead. When determining the need for more
front desk staff, look at check-in and check-out. Typically, these
administrative tasks take approximately 10 minutes per patient.
If your practice is seeing 15-22 patients per day, which would
total 150-220 minutes of patient contact, one person should be
able to effectively manage the front desk duties. If that person
is spending more than 240 minutes handling patients, or half
the day, the practice should consider hiring an additional
employee.
As for assistants, if the procedures are streamlined, one
assistant can efficiently maintain two treatment rooms for a
general dentist using two operatories and seeing 13 or fewer
patients a day. This would include setting-up the room, seating
the patient, assisting the dentist, dismissing the patient, and
cleaning-up.
Performance-based Pay
Tie raises to performance, and raise – or perhaps establish –
performance standards. Set guidelines for raises when you
hire an employee and explain to current staff when raises can
be discussed and under what conditions they are given. Make
certain your employees know what is expected of them. Like
you, they appreciate knowing what the rules of the game are.
Job descriptions are a must for everyone.
Use performance measurements to determine raises. While
there are any number of models out there, systems that are
based on individual jobs and focus on specific job-related goals
and how those relate to improving the total practice are the
Miscellaneous - 10%
20
S U M M E R 2 0 11
most effective. And if the practice is losing money, employees
do not get a raise, plain and simple.
Hygiene – Appearance vs. Reality
Another major contributing factor to inflated overhead
is low hygiene production. Typically, this is the result of a
malfunctioning recall system and lack of accountability. The
hygienist’s salary should be no more than 33% of her/his
production (excluding doctor’s fees). If the hygienist receives a
guaranteed salary, the expectation must be that she/he produce
three times her/his wages. The key to achieving that is the
hygiene schedule as well as proper assessments, diagnosis
and gaining treatment acceptance of interceptive periodontal
treatment.
Hygiene schedules frequently appear to be overbooked.
But practices pay scant attention to those holes that creep into
the workday. If patients aren’t in the chair, the hygienist can’t
meet production goals, plain and simple. The practice should
designate a Patient Coordinator. This is the point person who
is responsible for keeping a steady flow of patients streaming
into the hygiene treatment rooms through a solid recall system.
Their job has an enormous impact on production/overhead
as long as this person isn’t also expected to perform other
“menial” tasks as an assistant to another front office employee.
Pay attention to perio. There are several ways to
incorporate an interceptive periodontal program into the
practice. I recommend you start at the front. The business
assistant greets the patient upon arrival and mentions the
program. She hands the patient a questionnaire and a brochure
with a checklist educating the patient on the importance of
addressing the signs and symptoms of gum disease. The patient
checks any symptoms they have experienced, which opens the
door for discussion in the treatment room.
Supplies and Demands
Supplies should run about 5% of monthly collections. If
yours are higher, first make sure you are budgeting these expenses
and giving clear direction to the person – not persons – ordering
supplies about how much should be allocated for this. Work
with your dental supply company and dealer representatives.
They are very willing to help you get your supply costs to 5%.
below that, it typically means that the amount of crown and
bridgework you’re diagnosing, selling and completing falls
short of the standard. You may need to examine diagnostic
approaches and treatment presentation skills.
If your laboratory expenses are over the 10% benchmark,
the business employees are probably not collecting from
patients. This can further exacerbate overhead problems
because the practice has paid out lab charges without the
requisite collection from the patient. Consequently, the more
lab work you do, the more it costs you. This requires a financial
policy and clear collection procedures.
Miscellaneous – This category often includes many little
items that add up to big bucks – malpractice insurance being
one of those. The annual premium is often paid with little
thought and no effort to shop around for a more affordable
plan. The same holds true with medical coverage, business, and
overhead insurance. Check out your accountant’s fees as well.
Are you paying a $300-$500 retainer each month for services
you’re actually receiving?
No question, many of the items in this category are
necessary, such as professional fees, telephone, continuing
education, association dues, repairs, advertising, etc.
Nonetheless, pay attention to what all those little percentage
points are adding up to and ask questions.
Be consistent. Monitor the systems. Avoid the temptation
to get comfortable when you begin to experience the success
of your efforts. Controlling overhead requires constant
vigilance or before you know it, high overhead will start to pull
you under again. In some cases, it’s best to bring in outside
professionals who can objectively assess where your systems
are selling your practice profits short.
Sally McKenzie is a nationally known lecturer and author. She is CEO
of McKenzie Management, which provides highly successful and proven
management services to dentistry and has since 1980. McKenzie Management
offers a full line of educational and management products, which are available
on its website, www.mckenziemgmt.com In addition, the company offers a vast
array of Business Operations Programs and team training. Ms. McKenzie
is the editor of the e-Management newsletter and The Dentist’s Network
newsletter sent complimentary to practices nationwide. To subscribe visit www.
mckenziemgmt.com and www.thedentistsnetwork.net. She is also the Publisher of
the New Dentist™ magazine, www.thenewdentist.net. Ms. McKenzie welcomes
specific practice questions and can be reached toll free at 877-777-6151 or at
[email protected]. Lab – The standard for laboratory expense is 10% of gross
production, assuming that 30-40% of your production involves
crowns, bridges, partials, etc. If your laboratory expense is
istockphoto.com/ RedHelga
1-800-337-8467
S U M M E R 2 0 11
21
The Sheet
of Paper
that Saved
1500 Lives
istockphoto.com/ linearcurves
by Dr. Chris Griffin
I
often lecture on the need for dentists to make the
lives of their dental assistants easier, thus making
their own lives easier in the process. Surely we
can all agree that the job of performing dentistry, just
as performing medical procedures, has gotten more
and more complex.
Medical advancements have gotten so complex
with so many different steps that must be performed
precisely that relying on simple human memory to get
the steps right 100 percent of the time is really asking
too much. This was proven true recently in the world
of medicine and dentistry is not far behind.
hundreds of steps required in many procedures without ever
making a mistake? No, not humanly possible. However, the
good doctor had a simple idea that would rock the foundations
of organized medicine throughout the country.
In his book The Checklist Manifesto, Dr. Atul
Gawande recounts the story of Dr. Peter Pronovost,
a physician at Johns Hopkins Hospital. Dr.
Pronovost had observed that the infection rate for
his department was far higher than what he deemed
acceptable. The infection problem had gradually
gotten worse as the sheer amount of information
that doctors and nurses were expected to remember
had grown. It seemed to him that all the complex
procedural requirements had led to staff members at
the hospital neglecting or forgetting even simple steps
in the prevention of infections.
That idea was so simple that it would even fit on one
sheet of paper. In fact it was a single sheet of paper. A simple
checklist.
He wanted to fix the problem, but how could he?
Could he go back to the dark ages when medicine
wasn’t so darn difficult? No. Could he magically
make all the doctors and nurses remember the
If you miss one key thing, you are just as bad off as if you
didn’t even do anything to begin with.
221 - 8S0U0M- 3M3 E7 -R8 426071 1
Why did he think a checklist would solve his problems and
save lives that shouldn’t have been in peril?
• Medicine is complex
• Human memory is naturally flawed in stressful,
complex environments
• Distractions add to the mix and make mistakes even worse.
Now to the uphill battle. He faced criticism from his
S U M M E R 2 0 11
22
Practice Management
friends and colleagues who were
offended that he would even suggest
that they needed checklists to do their
jobs.
Their argument was that doctors
and nurses were too pressed for
time and overwhelmed with patient
procedures to do a checklist.
They said that there simply wasn’t
time to fill out another useless piece of
paper that wouldn’t have any real effect
(in their opinion) on the patient or the
treatment.
Dr. Pronovost didn’t give up that
easily. He believed his little piece
of paper could do great things if
implemented with every single patient
setup. He persuaded and persuaded.
Finally his pestering won out and the
hospital agreed to test it out.
The results were amazing and
almost beyond belief. The infection
rates at the hospital went to virtually
zero. The hospital estimated that
during the test phase, they had saved
millions of dollars, not to mention the
lives saved.
Next the whole state of Michigan
wanted in. They hired Dr. Pronovost
to come and implement his checklist
system in all their state run hospitals.
These hospitals had some of the worst
infection rates in the country at the time.
These were the conditions he faced.
• Morale in those hospitals was
low
• Lots of poor patients with short
staffing
• Lots of stressed out doctors and
nurses
• Auxiliaries being paid too little
and asked to do too much
This posed a true challenge for
23
S U M M E R 2 0 11
sure. He dug in and went to work
anyway. Before long all the hospitals
in their fold had fully implemented his
checklists. Now, they just had to figure
out if his simple little piece of paper
would work there as well as it had at
Johns Hopkins.
Well, it did. When all the dust
cleared, the state of Michigan estimated
that it had saved over one hundred
million dollars and at least 1500 lives.
All this because of a “stupid” little
piece of paper.
How can we apply all of this to
dentistry? Even though we don’t face
situations in which our patients’ lives
are daily endangered because of our
procedures, we do face similar situations.
Our dental auxiliaries are often asked to
remember too many little details. Even
our most common procedures have an
amazing amount of detail that didn’t
exist in the good old amalgam and
extraction days. We ask and expect a lot.
We also think that we don’t need
another piece of paper lying around to
add to our mountain of paperwork. I
don’t want to add to our paperwork
dilemma any more than the next
dentist, but the value that is derived
from using checklists has to be
considered. The benefits far outweigh
the downside.
Just think about it. How many
times have you gone into the operatory
as the doctor, sat down, picked up the
drill, gone to work, and had to pause or
stop a procedure, awkwardly, because a
particular supply or piece of equipment
was either missing or not working
properly? I’ll wager it’s happened more
than you would like to admit. I know it
used to happen to me quite frequently.
A checklist takes all the guesswork
out of the equation. I often say in
my seminars that the checklist “glues
the assistant to her seat” during
the procedures. No running down
the hall or calling for another paid
employee to fetch an instrument that
was erroneously left off the setup. No
doctor sitting there chairside with a
motionless drill in their hand while the
patient gags on a cotton roll while the
assistant is off retrieving something
that shouldn’t have been forgotten in
the first place.
The checklist for each procedure is
now an integral part of everyday life at
Griffin Dental. I wouldn’t know how
to practice without them. They give me
the confidence that I can swiftly and
easily move from room to room without
delay. I can also trust that my superstar
staff has gotten everything precisely
right each time.
Do we still occasionally mess up?
Sure, human nature will sometimes
lead to even overlooking an item on
the checklist, but 99.9% of the time, we
get the setup exact and perfect. That
makes me happy.
Checklists are one of the 4
backbones of our clinical efficiency
protocol that allow us to completely
maximize our production and our time
at the office.
Whether quality, efficiency,
decreased stress, increased production
or something else is your primary
motivator; checklists should be part of
your practice today.
If you would like to see exactly
how we develop and implement
checklists in our office we have
created a video to help you with all
the little tips and tricks that will help
you get these little miracles into your
office right now. Just go to http://
thecapacityacademy.com/checklist to
watch the video.
Dr. Griffin can be reached for questions at
[email protected].
Fo
llo
w
th
istockphoto.com/ CDH_DesignCDH_Design
e Leader
W
hat is a leader? Is it the
person in charge? The person
who controls what goes on
and manages the people? Is it the person
who belts out orders and gives deadlines?
Well, yes and no; a leader may be the
person in charge, gives deadlines or
manages people, but there are ways to
be a successful leader and not a tyrant.
“Leadership is the art of getting someone
else to do something you want done
because he wants to do it,” according to
Dwight Eisenhower. But how do you
make people want to do things your way,
and what makes a good leader?
Even as a child, being a leader
is important. For example, I wanted
to be the leader in the lunch line in
24
S U M M E R 2 0 11
kindergarten. The line leader was really
just the person at the front of the line, but
still, it made me feel important to be in
the front. I liked knowing that the group
might not get to the destination without
me. In reality, the kids would have made
it just fine to the lunchroom without me
leading them there. But, would it have been
the right way to get there? Probably not…
With me standing in the front of
the line, they could mimic my behavior;
hands to my sides, not talking, and
walking instead of running. Without
me it could have been complete chaos,
my classmates could have been running,
yelling, and not been in a single file line!
So yes – they could have gotten to the
lunchroom, but I showed them the most
by Brooke Mott
efficient way – I led them. This example,
being somewhat silly, follows the same
lines as being a leader of your team or
practice – you have to lead by example,
be a role model for your staff. Obviously,
you aren’t leading a group of squirrely
kindergartners to lunch; more importantly
you are leading your team to your vision.
As a leader you should have a clear
vision and be taking steps toward that
vision. A successful leader should have a
list of rules for themselves, similar to their
expectations of their team. The list varies
by leader, but in my opinion all successful
leaders should possess the following traits
in order to have people to lead. It is hard
to be a leader of no one, and not much
gets done if you have to do it alone!
○ Honesty – No one wants to
follow a leader who is deceiving
them. As the old saying goes,
“Honesty is the best policy.” If
you are manipulating and lying to
your team about progress, or what
is expected of them, your team is
going to slowly leave you behind.
People feel respected when they
know what they are being told is
the truth. Does the truth always
have to be good? No, some truths
are not. Being deceptive about
issues only makes those issues more
complicated. With that being said,
if a truth could cause complete
panic and breakdown of your
team; you, as the leader, need to
find the appropriate way to discuss
those issues. Believe me, there is
nothing wrong with evaluating
the situation and your team before
dropping a bomb on them.
○ Competency – Know something
about what you are leading or
managing. If you do not know
what you are doing, or about the
product you are working with,
how do you expect your team to
know? Do some research and
ask questions of people who
have done it before. Educating
yourself on things you don’t
know or understand only makes
you a better leader. If you are
knowledgeable, that is great, but
be open-minded to what your
team thinks, ask them questions
and get them involved with the
decisions.
○ Listen – If you are going to ask
what your team thinks, listen to
them. It does not matter if you
agree with everything they say.
By simply listening to people, you
make them feel important. People
who feel like they have played a
role in decision making are more
interested in completing tasks and
duties. Brainstorming techniques
are great for this reason because
you have to listen to other people’s
ideas. Getting feedback from
everyone not only gives a plethora
1-800-337-8467
of ideas, but also gets your team
working together. There is no "I"
in team, and if your team is only
working as individuals – not much
is going to get done.
○ Dedication – If you are not
dedicated or passionate about what
you are doing, you are doing the
wrong thing. Who wants to work
for or follow someone who does
not care about the idea or project?
No one does. You should not
expect your team to care about,
or be inspired by, something
that does not interest you. If no
one is interested, you can fully
expect failure. Your team may not
initially have an interest in your
idea or project. But if you commit
yourself to it, get creative, set
goals, and make the project sound
fantastic; people will want to be a
part of it. People thrive at being
a part of greatness. If everyone
is excited about it
and finds something
about the project that
clicks with them then
the project’s ultimate
success or failure
will not really matter,
because the project
itself becomes a part
of you and, overall, a
success.
a thank you or a please can take
you. Revert back to manners 101
that your mother taught you.
○ Delegate – You are not a
successful leader if you cannot
delegate duties to your team. In
fact, what is the point of having a
team if you are going to do all the
work? Efficiently delegating is
not spouting orders randomly. In
a team everyone plays a role and
everyone is “in charge” of certain
tasks. This particular trait itself
can be a struggle for some because
of the idea, “I want it done my
way.” Well that is fine and dandy,
except there might be a better way.
George S. Patton once said, “Don't
tell people how to do things, tell
them what to do and let them
surprise you with their results.”
Everyone has their own system
of doing things. It doesn’t mean
they are doing it wrong, it is just
“Leadership is the art of
getting someone else to do
something you want done
because he wants to do it”
○ Humility – Give
credit where credit is due. As
I said, there is no "I" in team.
Without your team, you probably
will not be as successful. Let
your team know how much you
appreciate them. People like
to know they are doing well,
and they like to know where
they stand as an employee. If
you are not giving your team
or your employees recognition,
their thoughts of you will not be
positive. There is nothing worse
than being the employee who
worked above and beyond for
their boss’s project and did not
get credit, not even a thank you.
You would be surprised how far
Dwight Eisenhower
a system for that person to get the
job done right and more efficiently
under their terms. You are the
leader, so tell them what to do and
when to have have it completed,
but let them be somewhat creative
with how they are doing it, that is
not to say that they don’t have to
follow certain guidelines.
○ Assertiveness – This goes
right along with delegating. Be
assertive, set rules and guidelines
as to how you want the tasks
completed. There has to be
boundaries and it is your job to
make sure the team is staying
within those boundaries. It is
not teamwork if people within
S U M M E R 2 0 11
25
your team are doing whatever
they want, this can lead to the
breakdown of your team. It is
important to address these issues
right away. Those team members
who are disrupting the flow are
not not going to fix themselves.
Take control of the situation and
resolve it before you lose control
of your whole team.
○ Sense of Humor – Who likes
to be around someone who can’t
laugh? Especially at their own
mistakes? Frankly, if you are
expecting no mistakes to be made
from time to time, you must be
leading robots. People make
mistakes, that is what makes
them human. Plan on a mistake,
especially in the beginning. Does
that mean you should not expect
your team’s very best effort? No,
not all. Expect perfection, expect
your team to give 110% to any
project. However, if the mistake
does not make you completely
shut down your project or lose
your job; correct it, laugh about it,
and move on.
○ Lead by Example – Why would
you ask your team member to do a
task you would never do? I would
not ask them to. I do not expect
my team to do anything that I
either haven’t already done myself,
or wouldn’t do myself, and neither
should you. To quote Robert Half,
“Delegating work works, provided
the one delegating works, too.”
People feel more confident and
comfortable with leaders who
work right with them and do
what they do. For example, you
work in an office and it needs
vacuumed nightly, and that is
one of the responsibilities of your
employees. Now say that the
employee responsible for doing
that task is out sick and everyone
else has already done their turn for
the week. Yes, you could have one
of the other employees vacuum,
but what is wrong with you taking
26
S U M M E R 2 0 11
your turn? You are showing your
employees that you are willing to
help out and jump in if necessary.
People notice that, appreciate
it, and are often more willing to
complete tasks when asked, when
they know the person on top will
do it too.
These are just some of the traits I
use when I lead my team members. I
have extremely high expectations of
myself, as well as those on my team.
But, my expectations are realistic due
to the systems I have in place so that
everyone knows what is expected of
them. In a sense, I have set them up to
succeed.
Now, let’s go back to the beginning
when I talked about a vision. A vision is
important and to be a successful leader.
You should have a vision for yourself,
as well as a vision for your project,
company, or relationship. It does not
have to be a long drawn out idea, it can
just be your expectations of how you
want your idea to work and what you
would like the end result to be. Many
companies have a vision statement,
usually stating how they want their
company to be perceived. So your vision
should probably be how you want people
to see you as a leader.
Being a leader is not easy, mainly
because you have to lead people. People
are challenging to lead because each
team member is an individual. They each
possess different qualities and different
challenges that have to be met. So in
order to best converge each individual’s
qualities; to have your team work well
together, you need to know each and
every one of your team members. I
don’t mean you have to know their
favorite TV show necessarily, but you do
need to know how they react to certain
situations. Do they become easily
frustrated, can they multi-task, do they
struggle with big groups of people, are
they shy? If you have a person who gets
easily stressed out over multiple tasks,
why are you giving them multiple tasks
simultaneously?
A good leader realizes the strengths
and weaknesses of the team and
works with them so the weaknesses
are minimized and the strengths are
maximized. Everyone has some talent
to give, find that talent, use it, and
appreciate it. You are only as good
as your team. If you are not leading
properly, your team will not follow
properly and that only leads to chaos
and loss of control… kindergarteners
yelling and running down the hall to the
lunchroom.
Not every leader is a success.
Leadership really isn’t something you
can read about, and then just run out and
do. Leadership is usually in a person’s
personality. If you are naturally a leader,
it is natural to educate yourself on being
the best leader you can be. If you are
struggling with your team and finding
it hard to get your team to share your
vision, it does not mean that you should
not be a leader, it just means you may
need to change the way you are leading.
Not everyone is a leader, some
people are better at being the team
member behind the leader. There is
nothing wrong with being that person,
and those team members should be
encouraged to be leaders in their
own way. Peter F. Drucker said,
“Management is doing things right;
leadership is doing the right things.”
Teach your team to all be leaders in their
own way… but always following you, the
line leader.
Brooke Mott is a practice management expert with
many years experience in team training, practice
operations and patient management. Brooke’s
primary expertise lies in the operational efficiency
of dental practices. She is a master at building
relationships with patients, managing team members
and external vendors. Her primary objective is
always efficiency and profitability with a focus
on creating systems that work in any practice
situation.You may contact Brooke by email at
[email protected].
Free Financial
Management Website
by Dr. Craig Callen
Recently, I had some time to catch up on my reading.
One of my favorite newsletters (other than TPD) The McGill
Advisor had an article on a free website to organize your
finances, www.mint.com. When you register and enter your
information this site will track all of your financial data,
including checking and savings accounts, credit cards,
investment accounts and loans. You simply download the
information and passwords on the various accounts and with
one password you will be able to access everything in one
place. It will also collate all of the information to give you
an instant picture of where you are spending your money.
Now instead of logging onto multiple sites to check balances
you just go to one place for everything. As I have a couple
of business ventures other than the practice and multiple
accounts, this has greatly simplified my life.
Not long ago in my haste, I double entered a rather large
deposit into the practice account. I went along like a happy fool
paying my bills until the overdraft notices starting piling up,
eating up all of my overdraft protection. By the time the bank
notified me, there were hundreds of dollars of charges before
I could transfer money from another account. Now with mint.
com I would have known before the charges started piling up
that there was a problem with the account.
Because it is a free site, you can expect some financial
related marketing to be sent your way, but it is a small price to
pay for such a great service. Log onto www.mint.com today
and get a better handle on your finances.
Dr. Callen can be reached at [email protected].
Practice management
Management
The Six Hour A Week
Dentist
by Dr. Steffany Mohan
A
s the mother of four young children and the wife of
a doctor, my life – well, let’s just say it was out of
balance. Though I loved dentistry and still do, when
I was away from my family I was missing them. My faith,
insatiable drive, and high energy are the ONLY things, I am
quite certain, that got me through what I call the “wonder
years”... It’s a wonder I survived and I did not kill myself or get
physically harmed by someone along the way.
I hit a crossroads and began to ask myself, “sooooo what
is it you LOVE and what is it that you LIKE in your career?”
Asking this basic question allowed me to assess where to focus
my energy. The answer to that question becomes what Max
Lucado calls the “sweet spot” of life, and my life wasn’t feeling
too sweet. As a matter of fact, it was tasting and feeling a bit
sour. Once I answered that question, I learned my main love is
teaching others, particularly dentists.
I found teaching other dentists easier ways to manage
their practices and become more profitable eliminated a TON
of stress! I have always tried to fail forward faster... meaning
learn from my mistakes, but recognize I will make them and
not be too critical of myself. I understand the stress being the
main producer in your business, and simultaneously the owner
and CEO, brings.
I also recognized that in order to teach other dentists, I
could not be all things to everyone in MY practice. In 2001,
I was an Invisalign patient myself due to orthodontic relapse
28
28 SSUUMMMMEERR2 20 01 1 1
(2009) Yuri_Arcurs Image for Bigstockphoto.com
from my teenage years (I swear as a teen they did not tell me
to wear the retainer past one year!). It was the easiest process
to go through as a patient. I became an Invisalign provider and
that became the focus of my practice and I was getting busier
all the time. So I decided to step back and corner more time for
my family, myself, and ultimately to examine what was working
and not working at the practice so we would ultimately grow.
Focusing my attention on what I love led to my 6-hour a
week (yes, I said 6-hour a week) work schedule. I schedule new
patient consultations and existing Invisalign patients within a
6-hour window weekly. I devote the rest of my time to serving
as a true leader for the practice and helping other dentists get
excited about growing their practices, too.
Though making money is a great feeling, it will never buy
you a life. We are given one shot at making the most of our
lives and using our time wisely. Unfortunately, many wealthy
people, from a financial standpoint, never take the time to enjoy
what they truly love. I do not know anyone who looks back on
their life and says they wish they had worked more. It’s usually
the woulda, shoulda, coulda syndrome of, “I blew it and I can’t
fix it now.” I did not want to live with that regret.
There are a lot of ways to grow wealth WITHOUT
WORKING. I believe the key is to read everything your little
mind can absorb. There is always something to be drawn from
reading and learning. Articles, fiction, nonfiction, journals,
blogs, you name it, are full of pearls of wisdom that if applied,
are relevant to your personal and professional growth.
(2011) Hannamariah for Bigstockphoto.com
h
.
h
h
h
h
A
Learning from how others have built their business is
great, but you have to possess a sense of courage and a daring
wit as well. What worked for one may not work for you. Be
willing to not just break the mold but create a whole new one
and do something different. If I have a new idea that someone
says won’t work I always ask, “why not?” or “says who?” After
all, the definition of insanity is doing what has always been done
and expecting different results. I would rather be a trend-setter
than rule-follower. My creative ability has allowed me to stand
apart from the crowd rather than stare at the crowd as an onlooker.
So, enough about how I got here and on to what I am
sure you are dying to hear, how does it all work? First and
foremost, be sure to guard your time. Though you will see my
schedule below, whatever your schedule, guard it with your life.
Patients do come first, but if you are not careful, if you start
accommodating everyone, you will be right back where you
started. Teach your staff to tactfully share your schedule with
patients but by all means if it is the difference between keeping
or losing a patient you will have to be flexible sometimes. Just
use this as a last resort rather than the first option.
By conventional wisdom, my choice to make a change
in July 2009 was not thinking wisely. The economy was
not doing well but I knew inherently that if I did not make
this change I was going to die, if not physically definitely
spiritually! I won’t say that all my hard work, doing the
right thing and having faith allowed things to all work out
without any glitches along the way. But, from each setback,
disappointment and failure I have chosen to learn and do even
better. So, because of the combination of working hard, doing
what is right, and having faith the practice has grown and I
have been blessed beyond my wildest dreams.
Dr. Mohan’s schedule: Thursdays 2pm-6pm and every
other Friday from 7am-10am with a team meeting from 10am12pm on the Fridays the office is open. This averages out to 6
hours per week in patient care. Here’s the kicker – I produce
and collect at least $50,000 per month and some months up to
$100,000! This has stayed consistent even in months where I
have been out of the office for 2 weeks at a time on vacation or
mission trips.
I now sleep at night, enjoy my family, and do what I love
versus doing what I have to just to survive. This has all been
done by me learning one simple little word, NO. I cannot do
it all, but I have become phenomenal at delegating and I have
learned to prioritize. Right in the midst of it all is me taking
time for me and to refill my cup that for too
long was empty.
(2009) Kzenon for Bigstockphoto.com
1-800-337-8467
The blueprint I followed to get to the point where my
practice was supported is simple and can be executed easily by
any other dentist that truly wants a change. I am the sole owner
of my practice and at the time that I went to a 6 hour a week
schedule, I had two associate dentists (technically they are
independent contractors for various reasons). That is another
story entirely, so we will save it for another time.
(2011) iofoto.com for Bigstockphoto.com
S U M M E R 2 0 11
29
Our strategy is to get interested patients through the
door. This is done through very targeted marketing to a radius
around our office and a household income level of at least
$75,000. Next, we have developed a strong team system to
lead the potential Invisalign patients through to make certain
they understand the process. Then, I meet the patient and let
them know whether or not they are a candidate for Invisalign.
I answer any questions they may have and get to know the
patient by finding common ground. The principle of “liking”
comes into play here, I want the patient to understand that we
will enjoy spending time together as they have their dental care.
The patient is then given our menu of financial options.
This is NEVER done by me, as I am the worst person in the
entire practice with financial arrangements, so we stick to where
our unique abilities lie. The patient then either accepts a financial
option and proceeds with records or is put into our system for
follow-up. Either way, the patient is made to feel comfortable,
accepted and genuinely liked by everyone on the team.
Now, all other dentistry in my practice is done by three
associates. This was difficult initially because patients all have
doctor preferences. Some patients really had a tough time
letting go. But during the transition I personally talked to them
and even “passed the torch” in person to the next doctor. I
assured them they would be well cared for and if they had any
problems not hesitate to share them.
Most of our fear lies in the unknown, do not leave your
patients in the dark. Communicate clearly and concisely why
the change and what they can expect next. What they do
not know and understand will cause problems, so minimize
problems using multiple methods of communication;
newsletters, personal letters, face-to-face appointments,
whatever is necessary.
30
S U M M E R 2 0 11
(2008) walcott for Bigstockphoto.com
Marketing is not always done through the buying/selling
of products and services. I was raised to “give back” and I
am teaching my children to be givers. Community marketing
through participation in many community outreach endeavors,
has helped build our practice. Participating in efforts such
as Toys for Tots, Mission of Mercy, American Diabetes
Association’s Walk for Diabetes, Halloween Candy Buy-Back
and donating to numerous charity events helps set us apart as
the dental office that cares, because we truly do.
There is a true sense of caring and support for our patients
and a feeling of gratitude amongst the team. If our patients are
in need and don’t know we care, how will we ever reach them?
We have a wonderful marketing assistant who sends press
releases for us, which in turn becomes virtually free marketing.
In fact, it can be better than marketing because the information
is being reported rather than advertised and is often deemed
more reputable. But don’t forget, Invisalign also does a lot
of marketing for you. Be sure your website highlights their
website so you can attract patients you might not have gotten
from other web searches.
It takes a team effort to be innovative. Not only do my
other doctors do the majority of the dentistry, the team supports
them. Our goal is for the doctors to only sit down to perform
the dentistry and form real relationships with patients. All the
other essential functions are done by support team members.
Other non-essential tasks are outsourced.
Marketing is really a fairly new word in dentistry. My
strategy is to let potential patients know their benefit of visiting
my practice. Strong businesses market their business in many
ways using multiple media forms including the Internet, social
media, radio, television, direct mail, and print ads. We have
followed our marketing efforts closely and chosen to spend
marketing money on what works
rather than what we think works. Because orthodontia is not
typically a covered benefit for adults, Invisalign marketing
efforts are targeted to high income levels. Do not fear failure,
try many things but always be sure you are tracking your
efforts to you know what has been effective.
Take advantage of automation. There are high-quality,
low-cost ways to reduce the tasks that your team members
perform. For instance, we use Send Out Cards (real cards are
sent, but the message is typed online) to send Welcome cards to
new patients rather than stocking cards and stamps. They
(2007) amysuem for Bigstockphoto.com
Continued on page 50.
(2006) og-vision for Bigstockphoto.com
Practice management
A Marketing
Opportunity
A
bout 7 or 8 years ago a large, well known chain
dental group came to our small city. They
aggressively marketed dentures and dentistry. While
their fees were not a whole lot different than ours, when
you added up all the nickel and dime things they did to the
patient, the quality of their treatment suffered. The place was
a revolving door of young, inexperienced dentist associates.
I spent a fair amount of time trying to correct their problems
to help patients. Unfortunately, they also did what I thought
to be some underhanded, if not illegal, manipulating of the
patients’ finances and insurance.
Unlike a lot of you out there, I have learned to enjoy
providing higher quality dentures to our patients. With our
systems and materials we are able to consistently provide a
nice denture at a slightly higher than average fee with not a
whole lot of doctor time. So, when this chain came in offering
low cost dentures and free exams, they definitely cut into my
business. While I was able to remake a lot of their mistakes,
more often than not, the patient was broke when they came
to me. I decided to fight back and started offering free exams
and X-rays for denture patients, or at times, free esthetic
denture consultations.
(2009) c73 for Bigstockphoto.com
by Dr. Craig Callen
to be a rewarding experience helping many of them through
what for them is a major hassle.
I have other marketing ideas to come with regards to this
situation. I will let you in on them as they become available. If
you have one of these chain offices in your area, don’t hesitate
to market directly to these disenfranchised patients.
Dr. Callen can be reached at [email protected].
Just last week this chain folded with no advance notice
to their employees or patients. Thousands of patients in our
area were left without a dentist. Many were in the middle
of treatment and others paid for treatment that will never
be completed by this chain. A good portion of the patients
are covered by lower-end insurance plans and will probably
end up in another chain (a second one opened in town a few
years ago) many were just uneducated as to what is and is
not quality dental care. I decided to market to the cream of
the crop of patients abandoned by this chain. Within three
days of the company closing the office, we had an ad running
in the local newspaper. We make it clear to patients that we
have no association with the chain office and emphasize our
experience and stability. Some of these patients will present a
challenge because of a lower trust of dentists, it should prove
1-800-337-8467
S U M M E R 2 0 11
31
Practice Management
“DISABILITY” or “MORE ABILITY”?
The Choice is Yours!
by Dr. Taylor Clark
E
very dental care provider faces
unplanned, unexpected, and
unwanted challenges that would
hold them back clinically, professionally
and financially. Speed bumps always pop
up as this reality sets in time and again:
The road to success is always under
construction!
My story is unique in that it is mine.
It is however, similar to what every
dentist experiences in one way or another
during his or her practicing lifetime. It’s
my hope that by sharing my story, you’ll
be empowered to put on your clinical
“rose colored glasses” and set your
“woes colored glasses” aside forever.
Our profession and accompanying
leverage potential as dentists is
staggering as we focus on our almost
limitless business and clinical
opportunities. It doesn’t matter what
limitations or obstacles might be
standing in our way. Let me explain.
Three years following my
graduation from dental school in 2002,
my world came crashing down. I was hit
head on with a severe clinical challenge
that I could not have possibly foreseen
or prepared for. I had developed severe,
recurring skin sensitivity to wearing
any type of health-care glove. I had
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S U M M E R 2 0 11
visited five different dermatologists and
tried every type of glove I could find;
latex, powder free latex, vinyl, nitrile,
synthetic, non-rubber modifier, gauze
lined, all to no avail.
Most dentists see patients at least
four days a week. By the time I’d made it
through three full days, my hands were
beat up, battered, itchy and sometimes
bleeding. The fourth day was brutal. I’d
often wake up in the middle of the night
with stinging because the itching was
so intense. The weekends were devoted
to nursing my hands with lotions, the
strongest steroid ointments on the market
and the works—all to gear up for the
next week.
One lonely night in 2005, I hit rock
bottom. As I sat there in the dark of
night rocking my newborn fourth child,
thoughts of fear raced through my mind.
Let’s pause for a moment here. How
would you have felt if you had a spouse,
four children, a mortgage, dental practice
loans, minivan payments, thousands of
dollars debt from dental school, and had
to struggle just to get through a week of
work? All this and, let’s not forget, the
typical stresses that come with running a
practice and trying to turn a profit.
It was then that I chose to dial in
and focus on the following statement
by T. Harv Eker: “Focus on obstacles
and that’s what you’ll find. Focus on
opportunities and that’s what you’ll find.
What we focus on, expands.”
How true that is! I immediately
began to focus on opportunities like
never before. Incredible happenings
started to unfold. First, I beat the odds
by successfully bringing on a full-time
associate dentist. I cut back to sixteen
hours a week of clinical dentistry and
decided to work ON the business rather
than being hands-on IN it all the time.
In early 2006, I thought about the
hundreds of thousands of dollars in
equipment and physical plant that was
sitting idle, making me nothing over the
weekends. I came across an idea to run
a dental assisting school in my office on
Saturdays. I planned to train people to
become dental assistants over a threemonth period. They would participate
in my accelerated course, which would
include an emphasis on attitude and
clinical hands-on learning. Students
would be required to complete intense
study at home during the week. They
wouldn’t have to quit their jobs and
would save $6,000-$9,000 in the process.
I took my plan to the Idaho State
Boards of Dentistry and Education.
I went back and forth with them for
several months until my curriculum was
approved—I had the green light to run
my program. The first class was a huge
success and I was off to the races! It’s a
winning program for the students, the
dentists that hire them and me. It’s a
rewarding business that provides great
value to others and compensates me well.
The best part is, I hired my excellent
staff to run it mostly without my
involvement. Can I tell you how much
fun it is to experience a six figure annual
income aside from the practice?
Before long, I received a phone
call from some doctors across the state.
They wanted to run a dental assisting
school in their office and had called the
State Board of Dentistry. Can you guess
what happened? The Board referred
them to me! I saw another opportunity
unfolding. They wanted me to license
them to use my program and mentor
them in duplicating my success. They
were a huge success from the beginning,
even making headlines on the evening
television news and newspapers.
I thought, “If I can do this once,
then I can do it again, and again and
again.” Now 32 offices throughout the
United States have been licensed to run
my Assist To Succeed program. As I
write this article seventeen other dentists
have contacted me recently to learn
about starting their own dental assisting
school. My business has been featured
multiple times on the NBC-TV affiliate
in Boise, Idaho. It has been featured on
TV, radio and in newspapers across the
United States.
Sometimes I wake up in the middle
of the night now because I’m so excited
about all the cool stuff going on. I get
flashes of inspiration day and night that
give my life juice. The skin problem?
Though not gone, it’s completely under
control. The secret to my success? When
doubt and fear reared its ugly head, all
I had to do was look down at my beatup itchy hands. I chose “more ability”
over “disability”! That gave me the
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determination to find a way or make
a way to succeed. My dental practice
and business successes have opened the
doors to other business ventures that
have proved very profitable as well. Best
part is, I feel like the fun has just begun
and I’m just getting started. I wonder
where I’d be right now if I hadn’t faced
adversity with my hands.
What adversity do you face clinically
or otherwise? I hope you’ll choose this
day forward to focus on the abundance of
opportunities that surround you. Claim
“more ability” and never look back. Your
life may never be the same again!
Dr. Taylor Clark is an author, speaker,
dentist, small business consultant and business
entrepreneur whose passion is making life better
for people. His accomplishments have been
recognized in newspapers, radio and television in
many cities throughout the United States. He was
named the 2009 Young Entrepreneur of the Year
by the Boise Metro Chamber of Commerce. For
questions or more information, you may visit www.
AssistToSucceed.com or call 208-353-5301.
education & training for
Doctors and Staff (Ce Credit)
Home Sleep test Services
Marketing and Sales Strategy
proper Medical Oversight
Medical insurance Billing
Our program is tailored to each individual professional’s
experience, and can add $36,000-$100,000 to your
practice in the first year! Call us toll-free at 877-699-9983
to schedule an appointment and to learn more. Mention
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choice with sign up.
S U M M E R 2 0 11
33
“Everyone Can Smile
With Confidence”
The Perspective of a Six Month Smiles Provider
®
by Dr. JoAnn Martens
I
believe that comprehensive
orthodontics should always be
the first recommendation for
patients with crooked teeth. Years of
wearing traditional braces provides
for the possibility of creating the most
aesthetically pleasing final result.
However, most adults aren’t interested
in spending years wearing metal braces,
which can be uncomfortable and
unflattering. In a situation like this, I
offer my patients what I believe is the best
alternative to traditional braces: the Six
Month Smiles Short Term Ortho System.
The Six Month Smiles System is
different from traditional orthodontics.
It is a cosmetically focused orthodontic
approach that is both patient and
dentist friendly and can be easily and
economically implemented into a general
practice with great success. With this
tested, safe, and reasonable approach,
I can help many adult patients who had
previously lost hope for their smiles,
and at the same time I’m empowered to
practice something that I once thought
was complicated and mysterious.
When I graduated from dental
school, I had very little practical
orthodontic knowledge. I knew that
traditional comprehensive orthodontics
could be time intensive to learn and
cumbersome to implement into a general
practice, and for the most part I stayed
away from it. But, after getting involved
with Six Month Smiles, my impression of
orthodontics has changed, as the system
is designed with both the patient and
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S U M M E R 2 0 11
general dentist in mind, setting it apart
from many other orthodontic approaches.
The Six Month Smiles System is
being used in general dentist offices
throughout the world. A combination
of proven orthodontic mechanics and
innovative thought, the system provides
adult patients with the ability to have
straight teeth in an average time of
just six months. Contrary to what many
initially think, dramatic changes to tooth
position can be made safely and predictably
during this short time period. Six Month
Smiles utilizes unique and specific clear
brackets and tooth-colored wires to create
dental symmetry and to solve the patient’s
chief cosmetic complaints.
What’s great is that I am now
equipped to address my patients’ chief
Before
After Six Month Smiles®
Six Month Smiles® Lucid-Lok
Brackets and Chameleon Wires
cosmetic complaints in a predictable and
conservative manner. Everything I need
for the patients’ “braces on” appointment
and subsequent adjustments is included
in the Six Month Smiles Patient Tray Kit.
Also included in the kit are bonding trays
with strategically placed brackets, based on
the patients’ models or impressions. These
bonding trays make the “braces on” process
almost effortless, and my chair-time is
minimal. Once the brackets and wires have
been placed, the shape memory of the wires
exerts very light force on the teeth and
gently guides the tooth movement.
The treatment goal with Six Month
Smiles is to give patients an aesthetically
pleasing smile, while not significantly
altering the posterior occlusion. This
results in short treatment times, which
is an attractive feature of the system for
adult patients. Although the posterior
occlusion is not significantly altered,
certain aspects of the occlusal scheme
can be improved, such as deep bites and
minor crossbites.
Any dentist can become a Six
Month Smiles Provider, regardless of
whether or not they have had previous
ortho experience. I had almost no ortho
experience before getting involved. I
attended the Six Month Smiles handson training seminar in Chicago of 2008
and haven’t looked back. At the seminar,
I learned how to select and treat cases
successfully. Good case selection and
patient communication is essential,
as not all patients are candidates for
treatment. Ideally, a patient is considered
a candidate if their chief cosmetic
complaints can be corrected in 4-9
months. I’ve treated many cases over
the last few years and had tremendous
success and satisfaction while doing so.
The support that is provided did
not end at the seminar. After I became
a provider, my name was listed on the
www.SixMonthSmiles.com website
where patients in my area can easily
locate me. I also received additional
marketing support and materials
including: brochures, posters, patient
educational videos, web content, photo
books, and much more. The Provider
Resource Center, which can also be
found on the website, is a great place to
ask for help with case selection, technical
support, or even to share stories of
renewed hope for patients and dentists
alike. I spend a lot of time on there and it
is an unbelievably positive atmosphere.
Today, when an adult patient tells
me they want to fix their crooked smile,
but declines traditional braces, I’m able
to provide them with an alternative.
This has been incredibly freeing for my
patients and my practice. I feel good
about offering them a more attractive and
time-sensitive option with the Six Month
Smiles System. I’m proud to be a Six
Month Smiles Provider because I know
that my patients want to be able to smile
with confidence and I’m thrilled to be
able to help them.
Personally, I have experienced more
satisfaction from providing Six Month
Smiles than from any other service I
provide. My Six Month Smiles patients
are happy to be in the office and incredibly
thankful at the completion of treatment. I
love providing dramatic cosmetic results
in a way that is both life changing and
cost-effective for my patients.
Dr. JoAnn Martens is a general dentist
who has a general practice with an emphasis
on cosmetic dentistry. Her private practice is
in Waunakee, Wisconsin. A self-proclaimed
“continuing education junkie,” she has spent
hundreds of hours advancing her dental knowledge.
In 2007 she incorporated the Six Month Smiles
System into her practice and found this to be the
perfect marriage with her cosmetic dental skills.
Dr. Martens graduated from Marquette University
in 1978. She completed her residency at Meriter
Hospital in Madison, Wisconsin, and continues to
be involved in the residency program.
Leasing Space?
Negotiate Once.
Negotiate Right.
To level the playing field in your next
negotiation, call 1-800-340-2701 or
visit www.georgevaill.com/tpd.
“In today’s economy... don’t even think about building, going into
a new location, or signing a lease BEFORE you speak with George
Vaill. George will save you a ton of money and a lot of headaches.”
Dr. Woody Oakes, DDS
Editor-in-Chief, The Profitable Dentist®
GEORGE VAILL
1-800-340-2701 • www.georgevaill.com/tpd
1-800-337-8467
S U M M E R 2 0 11
35
Clinical
Better Dentistry
& More Profit!
by Dr. Michael Curtis
What should you do when a patient tells
you they’re “allergic” to Novocain? Should
you take them seriously? Do you follow-up
with the right questions and precautions?
Although a true allergy to local anesthesia
is extremely rare, your patient may have
experienced a very real reaction?
Consider the following possibilities:
1. Epinephrine Reaction:
We all know the symptoms of intravascular injection
of epinephrine; a sudden increase in pulse, with rapid
pounding of the heart. Do you automatically switch to
Carbocaine with Neo-Corbefrin when you hear such
a history? Be careful. While you may avoid the rapid
heart beat, Neo-Corbefrin causes a significant rise
in mean blood pressure, while epinephrine does not.
You may be putting patients at greater risk for heart
attack or stroke.
2. Toxic Reaction:
The earliest signs of toxicity are anxiety, nervousness
and increased excitability. In the dental environment
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S U M M E R 2 0 11
such symptoms are very easy to miss. Watch for changes
30 minutes after injection, if your anesthetic contains epinephrine; 10 minutes if not.
Toxicity can be fatal. Only 2 carpules of Carbocaine are
toxic for the typical 4-year-old. Seniors over age 65 have
half the liver function compared to age 30! Do you know
how to treat toxicity?
3. Latex Allergy:
Nearly 25% of health-care workers and 2% of the general
population are now allergic to latex. Most carpules of
anesthesia no longer use latex stoppers. However you can
introduce latex allergen if you flick or bend the needle with
gloved hands. Since latex dust can linger in the air, schedule latex sensitive patients first thing in the morning.
4. Syncope:
9. Other Problems:
Nausea, a cold sweat and/or fainting are characteristic of a
vaso-vagal reaction (syncope). While this is not an IgEmediated reaction, patients commonly lump frightening
experiences into the general term “allergy.”
5. Paresthesia:
Prolonged anesthesia of 24-48 hours is not uncommon
following mandibular blocks and be related as a “bad
reaction.” If numbness does not resolve, do you know
exactly what to do? Should you prescribe antibiotics or
steroids? What regimen? How must you mark the extent
of numbness and track it over time? Is parasthesia more
common with Septocaine? For answers, please consider
our “Anesthesia” guide.
6. Psychogenic Skin Reactions:
Does your patient give a history of rash, flushing, blotching
or hives following anesthesia? This may sound like an
allergic reaction. However, such symptoms are also
common reactions to stress. They may have been anxiety
related.
7. Sodium Metabisulfite Allergy:
Metabisulfite is the antioxidant used to preserve vasoconstrictors such as epinephrine and Neo-Corbefrin (Levonordefrin). Ask patients if they are sensitive to sulfite-containing foods like salami, pepperoni, dried fruit, red wine
or salad bars. The allergens are similar. If so, consider an
anesthetic without a vasoconstrictor, such as plain Carbocaine or Citanest.
Bells palsy, blurred vision, altered taste sensations, lethargy… all these reactions can occur following injection of
local anesthesia. Have you ever torn an artery when giving
a PSA injection? Within 60 seconds, you may witness
facial swelling the size of a tennis ball! Due to space, we
can’t address this in full, but it is important to be aware
of these other conditions. Please see our guide for how to
handle these problems.
10. Methylparaben:
This preservative hasn’t been used for perhaps 15 years,
but was previously common. It may account for an older
history of allergy.
11. Allergy Testing:
If you cannot clearly categorize a previous reaction,
patients should be referred for allergy testing:
• Send along sample carpules of all the anesthetics you
may use. False negatives are extremely rare. False
positives occur at about 15%.
• Patients allergic to one amide may be able to tolerate
an alternative amide.
• In the absence of a history of an anaphylactic reaction,
patients who are patch-test positive have “minimal or
no risk” that such a reaction will occur.
• When in doubt, use Benadryl for local anesthesia. You
can prepare it from your emergency kit.
8. Illness & Drugs:
Many patients have undiagnosed illnesses that may have
caused a negative response in the chair. Examples might
include unidentified diabetes, liver disease, hormone
disorders, unrealized cancer or H.B.P. Interactions with
over-the-counter meds, street drugs or herbal supplements
can also cause negative reactions. Do you know which to
worry about?
Dr. Michael Curtis practices in Connecticut and is the author of the “100s
of Pearls” books on “Anesthesia,” “Endodontics,” “Collections,” & “Case
Acceptance,” each with over 400 pearls in 80 categories. For questions, or to
order, visit www.100sofPearls.com or call 800-427-2830.
Have a topic that you’d like to read more about? Email your ideas to [email protected], subject “TPD Idea” and we’ll do
our best to research it and get an insightful article published just for you. Know of
a product or service your office couldn’t survive without? Share it! Have a fun or
interesting story? Submit it! We want to hear from you!!!
1-800-337-8467
S U M M E R 2 0 11
37
Clinical
Do Dentists,
Let Alone Laboratories;
Really Understand the
New Technologies in
Digital Dentistry?
PART II
by David Block, CDT
(2010) Hannuviitanen for Bigstockphoto.com
1-800-337-8467
S U M M E R 2 0 11
38
What is the difference between “open” and “closed
architecture” systems?
This could be very important, make sure you really
understand the option when shopping for equipment.
An “open system” (or open format file output) will give
you a universal, industry standard file that is widely used in all
industries doing three-dimensional modeling, and recognized
by most computer programs designed to do computer-aided
design and manufacture (CAD/CAM), stress and flow analysis,
animation design, and newer systems that perform rapid
prototyping and additive manufacturing to create restorations
(see milling vs. 3-D printing).
The open system will become more widely used as
more and more practices begin to utilize the new CAD/CAM
technologies. By choosing to use an open system, a laboratory
gains the ability to combine a variety of equipment from
different manufacturers as well as having an option to contract
the services of other laboratories who accept open .stl files.
A “closed system” is one where the manufacturer has
locked or encrypted the created files so that they will work
with a specific hardware and software only. When a system
is closed, you are limited to using the scanning, design and
fabricating programs of that system only and may have a
difficult time finding another laboratory who can accept the
files you have created.
What are the different output devices (milling vs. 3-D
printing)?
This is literally the difference between addition and
subtraction. With milling, you are taking a block of material
(wax, zirconium, ceramic, titanium, etc.) and cutting away
the areas you don’t need to reveal a pre-designed shape.
Three-dimensional printing (rapid prototyping or additive
manufacturing) uses a pre-designed shape and builds it up
(through selective fusion, sintering, or polymerization) with
powdered resin, wax, basic or precious metals. Both systems
can produce quality restorations, but if you are thinking
seriously of purchasing such equipment there are several
factors that you should consider.
Milling machines today can create parts out of wax,
zirconium, ceramics, and some metals. Not all milling
machines are created equal, however, and the hardness of
the material you are cutting may be a limiting factor on the
machine’s abilities. You will have to assess business goals,
concerning the types of products you wish to offer before
buying a milling machine. Many machines are new and it is
not known how they will hold up after years of use, but it is
1-800-337-8467
probably a good guess to say that a machine designed to cut
strong metals like titanium will be more durable than those
designed just for wax and soft metals.
Three-dimensional printing is unique in that no excess
material is wasted during the fabrication of parts like it is –
however small a loss it may be – during milling. Most 3-D
printing systems today are used for wax-ups, but there are machines
that can make copings out of precious metals like titanium as well.
These systems tend to be rather expensive at this stage.
How do I know that the technology will not become
obsolete in a few years?
This is a great question considering how quickly computer
technology evolves and also how new the digital technology is
to dentistry.
Laser scanning, however, or some form of laser-based data
collection, has been around for some twenty-five years. At this
point, with accuracies of +/- 20 microns for dental scanning
(and the options on some systems for +/- 10 microns accuracy),
there is not much room for improvement regarding data quality.
So, scanning hardware may not have any vital changes in the
immediate future and prices for the equipment may decrease.
Scanning software, on the other hand, is changing all the
time and so suppliers are constantly making upgrades, and that
can end up costing you more money. I recommend updating
your software whenever possible because with the inclusion
of full support in the cost of an upgrade, it is more like an
investment that you are making toward the fine quality work
offered by your laboratory.
CAD/CAM technology and machinery are constantly
changing and so it would be wise to research the latest
equipment on the market before making a purchase. However,
I believe at this time that waiting too long to invest in CAD/
CAM technology might end up costing you more money in
the long run, since other labs are most likely incorporating this
technology into their services at this very moment. Again, don’t let
somebody else “move your cheese” by allowing them to move on
an opportunity that would lead your business/practice to success!
How long does it take to learn CAD/CAM technology?
Learning how to use the technology depends on several
factors, including, but not limited to: the abilities of the
technician being taught, the number of people being trained
at any time, and what kind of equipment is being utilized for
instruction. There is a learning curve, as there is with any kind
S U M M E R 2 0 11
39
Clinical
Snoring Prevention
An interesting adjunct
to a dental practice
by Dr. Earl O. Bergersen
O
ver 40% of adults snore while sleeping, and can be a
source of major annoyance to others in the household.
Sixty percent of snorers are men usually over 50 years
of age1, overweight, and frequently have large necks. They
tend to sleep on their backs and often have a cocktail before
retiring. Most snorers are not aware that they snore so it is
usually a family member that seeks a
solution to the problem.
The Snore-Cure® appliance fixes the mandible in a
forward and slightly downward position and works most
effectively when both the upper and lower posterior areas
are lined with a specially-formulated self-cure acrylic. This
ensures that the appliance will stay in the mouth all night
and maintain it in its correct position. Research shows that
over 90% of measured snoring can
be eliminated with the SnoreCure® appliance, however, results
can vary considerably between
patients. Snoring that does take
place is usually of low volume and
sounds more like a swooshing sound
rather than the loud snoring sounds
normally experienced without the use
of the appliance.
It is helpful for a few questions
to be added to your normal dental
diagnostic procedure if you
incorporate snoring corrections
into your practice. A questionnaire
consisting of 12 questions is available
from the author on request. It is
important for you to assess the
possibility for sleep apnea prior to the
The Snore-Cure® will effectively
issuance of an anti-snoring device.
eliminate the adverse effects of
A simple device worn while sleeping
bruxism as well as correct most TMJ
can monitor the presence of sleep
problems.
Side view of the Snore-Cure ® appliance
apnea, the number of episodes present
The incorporation of snore therapy
as well as the incidence of snoring while
2
can
be
a
natural
and
profitable
adjunct for your practice
sleeping . If there is strong evidence of sleep apnea being
and
can
give
your
patients
the
feeling
that you are totally
present as a result of this simple test, a more thorough exam
concerned
about
their
oral
health.
can be made with an overnight sleep analysis at a sleep clinic.
The Snore-Cure® appliance (Fig. 1) is a preformed
appliance shell that is designed to be customized by lining
it with self-cure acrylic in order to maintain its position in
the mouth. This appliance is designed to move the mandible
forward and downward by 5mm beyond a normal incisal
position, or 4mm beyond an end-to-end jaw relation. This
moves the tongue forward, which opens the upper trachea and
allows the free flow of air into the lungs without causing the
vibration of the uvula due to a restricted airflow.
40
S U M M E R 2 0 11
For more information contact www.ortho-tain.com or call 800-541-6612.
References:
1. Young, T., Palta, M., Dempsey, J. Skatrud, J. Weber, S., and Badr, S., The
occurrence of sleep disordered breathing among middle-aged adults, N.
Engl. J. Med., 328: 1230-1235, 1993.
2 Apnea Link by Res Med Corp., San Diego, Ca 92123.
Snore-Cure
®
preformed
anti-Snoring applianCe
an affordable & effeCtiVe anSwer
tHe adVantageS of
tHe Snore-CUre® are:
n
n
Snore-Cure® appliance
n
n
n
liner Kit
Canimmediatelybe
customizedinthe
mouthatchair-side.No
impressions,additional
appointmentsor
labworkneeded
Snapsfirmlyintoplace
topreventfallingout
Advancesmandible
topreventvibration
ofuvula
Staysinallnight
Onesizefitsall
withopen-hinged
designformaximum
oxygenintake
www.ortho-tain.com|e-mail:[email protected]
phone:800-541-6612|fax:847-446-7606
CLINICAL
The “Goldstein Standard”
by Dr. Woody Oakes
O
ne of the often overlooked
secrets of productivity is
avoiding non-productive
procedures. By that I mean, attempting a
procedure you should not attempt.
In oral surgery, it might be impacted
wisdom teeth beyond your skill level. In
endo, it might be time wasted attempting
to do a root canal that should have been
referred to a specialist. Dr. Mike Goldstein
and Dr. Kit Weathers have developed a
two-part system to help you select and
treat only those teeth that are predictable
and profitable.
Dr. Mike Goldstein has developed
a fast, easy way to evaluate teeth that
need endodontic treatment and prevent
you from starting teeth you can’t finish.
Write prescription(s) as needed.
Emergency exam – Quickly
evaluate the problem tooth with the
endo diagnosis chart and a filmless x-ray
machine. Once the diagnosis is made…
re-appoint the patient for a half-hour
pulpotomy/evaluation.
See if you can locate all the canals…
if so, re-appoint to complete the root
canal or finish the endo if you have time
on the schedule.
If you can’t find all the canals, do a
pulpotomy, place medicine, and refer to
an endodontic specialist.
The charge for the half-hour
pulpotomy/evaluation appointment is
$95-$120. However, if you locate the
canals, you are well on your way to a
$750+ molar root canal.
By using Dr. Kit Weathers’ BEST/
WORST selection guide, you can also
evaluate the cases you choose to treat!
If you don’t have a high confidence
level in your endo skills, you should
definitely limit your cases to those listed
in the “Better” column. You’ll find
that you will still have plenty of endo
to do, even if you limit yourself to only
those cases. The last thing you want to
happen when you’re sedating a patient
for comprehensive treatment is to get
“bogged down” with a root canal that
takes much longer than anticipated.
Worse, you wouldn’t want to sedate
a patient, and later have to tell them
that you were unable to complete their
planned treatment.
For more information, you can contact Dr.
Goldstein at [email protected] or visit
www.ce-magic.com.
Endo Case Selection Chart
In evaluation, if you find
the case within the “Better”
column, continue with the
clinical exam/treatment as
described above. If, in the evaluation or at the
subsequent appointment,
you find the case falls within
the “Worse” column, refer
out the case to a endodontic
specialist.
You’ll save precious time
and your high status with
the patient if you don’t underestimate the complexity
of the case.
42
S U M M E R 2 0 11
Better
Vital
Anterior
Maxillary anterior
Mandibular molar
First molar
Gradual canal curve
Large pulp
Average length roots
No crown in place
No swelling
First endo treatment
Non-strategic tooth
Worse
Necrotic
Posterior
Mandibular anterior
Maxillary molar
Second molar
Sharp canal curve
Calcification
Long roots
Crown in place
Swelling
Retreatment
Abutment
Hypnotherapy
Homeless Improvement with Best Friend Therapy™
by Dr. Steven E. Roth
A
round 2 years ago, I was at McDonald’s late one afternoon when I first met Frank. He was near the front
door begging for money. Because of the appearance
of his clothes and his personal hygiene he looked as if he had
been on the streets for quite some time. To me, a dentist, the
most striking thing about Frank, was the fact that he was missing a front tooth. From my professional experience I know the
importance of a smile, and how it affects a person’s self-esteem.
I have always had an interest in learning how a person gets
to the point of being homeless and
living on the streets, and because
of this concern, I usually interview
a person before I offer any money.
And that is exactly what I did with
Frank, although I must say that in
his case I did feel some “divine
inspiration” to help him beyond a
simple monetary contribution. As he
approached me and asked for money
I asked him how he got into this
situation. To my surprise, he was
very open to telling me his story. He
had moved to the Miami area from
Georgia a few years back after losing his job.
I gave him $100 and my business
card and told him to come by the office and we’d see what we could do. A
couple days later, he showed up at my
Dental Practice (www.relaxandsmile.
com) and I had some clothing articles
gathered for him.
I invited him into the Dental Operatory with the intention
of restoring the smile that he had missed for the last 15 years. I
performed cosmetic bonding to replace the missing tooth and
the entire procedure was done in 45 minutes.
There was immediately a big change in how Frank saw
and felt about himself, so much so, that the next time he came
by the office, he looked like a different person. His hair was
combed and his hygiene was much improved. To further help
Frank, I helped him get a job as an assistant to a handyman. He
stopped drinking and the first couple weeks he was doing fine.
1-800-337-8467
But within a month – like a lottery winner who returns to poverty
- he went back to drinking and was not showing up for his job.
When he came to the office again, I realized that he still
wanted to improve his life, and I asked him what would possibly be the main thing that would help him. He said he missed
his family and wanted to return home to Georgia. I got him a
bus ticket to go back to Georgia so that his family members
would help him get back on track.
I left him at the bus station an hour before the departure
time and we said our good byes. The
next day I “coincidentally” saw him
in downtown Miami…. he had never
left! I was really disappointed and
told him so by saying – “God bless
you Frank, I wish you well but we’re
done,” and I walked away.
A month later Frank appeared
at my office again with $40 in his
hand. He wanted to repay me for my
previous help and try again to stop
drinking. He had received the money
from a government agency I had
directed him to. I refused the money,
but decided to give Frank one more
chance. This time instead of working
on his outer smile and appearance, I
wanted to help him at a deeper level.
I asked him if he was open to being
hypnotized. Because of the positive
relationship that we had developed
he trusted me and agreed.
After putting Frank into a hypnotic trance, I decided to
speak with a part of his subconscious - or alter ego as Freud
would describe it - that was “Frank’s best friend.” I have been
using this therapy since I conceived it a few years ago during
a session to help someone overcome an addiction to alcohol.
The patient stopped drinking at once because it improved selfesteem 100%. I call it Best Friend Therapy and it derives from
a well-known technique called Parts Therapy.
S U M M E R 2 0 11
43
A Ground Hog Life
by Dr. Mike Abernathy
I
n 1993, the number one comedy
movie was “Groundhog Day”
starring Bill Murray of Saturday
Night Live fame. Bill was a weatherman
who, for the fourth year in a row, was
covering Groundhog Day where this
“weather forecasting rat,” as he calls it,
comes out and does or does not see his
shadow. The problem occurs when he
realizes that he begins to wake up each
morning to the same day. Groundhog
Day begins every day the same way.
He finally realizes that he is destined
to spend the rest of eternity in the same
place, seeing the same people doing the
same thing EVERYDAY. He has no
HOPE.
Sound familiar? Have you finally
come to the fork in the road only to find
yourself reliving the same day, month,
and year and wondering why you haven’t
become the dentist you always thought
you would be?
They say a “rut” is just a grave with
the ends kicked out. Over and over I
listen to doctors struggling to pay their
bills, attract enough new patients, lower
their stress level, and retain a competent
staff. Many are burned out and have lost
all hope of building a successful practice.
The secret to taking a practice to the
next level, breaking through plateaus,
and reaching new levels of profitability,
always begins with knowing exactly
where you are. It’s kind of like walking
up to one of the map kiosks in Disney
World to try and figure out where you are
and which way you need to go in order to
reach the Magic Kingdom. As you study
the map, you find it: A small red circle
with an arrow pointing to your exact
location saying, “you are here.”
Over and over I hear how doctors
have worked months and years with
this marketing guy, or that famous
consultant, and spent thousands of
dollars with limited or no results.
I guess I’m a little surprised that
anyone would pay thousands of dollars to
a consultant or a marketing company that
does not produce results, have a clear
plan, or create consensus with the staff
and doctor. If your consultant makes
one visit, and spends the rest of the year
doing worthless telephone coaching as
an afterthought, and mini-telephone
seminars once a quarter, you need to run.
I recently received an ad from a
dental “Guru” that intimated that he
had a couple of cancellations for the
following month and he could fit me
in and visit my office for only $25,000
which would be followed by a weekly
call from my personal consultant, and
all I had to do is call within the next
10 minutes to receive even more added
features for free. I know for a fact
that he doesn’t let you know that your
personal consultant was a roofer last
44
S U M M E R 2 0 11
“The world tomorrow will belong to
those who brought it the greatest hope.”
week, because he was. Give me a break:
Is there really a fool born every minute?
I don’t know about you, but I have
hit direct mail, internet, and infomercial
overload. I am sick of baseless promises
followed by under delivering to their
clients. I’m one of you, and I can’t
believe how gullible or desperate we
have become to believe some of the
worthless nonstop ads for this new
technique or that new toy that, before
now, has never been available to you the
dentist.
Dame Cathedral in Paris: “The world
tomorrow will belong to those who
brought it the greatest hope.”
This article is about hope, not vacant
promises followed by an overpriced
bill. The Presbyterian lay minister
Fred Rogers (“Mister Rogers” to us)
once quoted an anonymous scrawling
on the bulletin board of the great Notre
Counselors and psychologists have
long known the truth of those words.
Viktor Frankl, the Austrian psychologist
and concentration camp survivor,
documented the fact that those prisoners
who believed in tomorrow best survived
the horrors of today. Survivors of POW
camps in Vietnam likewise reported that
a compelling hope for the future was the
primary force that kept many of them alive.
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Feeling The Burn From The “New Economy
...Enjoy Our FREE SOLUTION!
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A mouse dropped in water will give
up and drown in minutes. But if it is
rescued the first time, it will tread water
for more than 20 hours the next time it is
in the same situation.
Waiting is foolish; you’re already
experiencing a “groundhog life.”
Find a different way to control your
circumstances and change your results.
Be sure 2011 is your best year ever!
Contact Dr. Mike Abernathy at 972-523-4660 or at
[email protected].
Digital Technology
continued from page 39.
of training, involved in the
process of CAD/CAM technology
instruction. Typically, it could take
any one technician a full one-totwo days of instruction to learn to
use a scanning system, computeraided design, or an output device.
An incentive to the laboratory
who trains technicians in CAD/
CAM technology will be the cost
advantages of making high quality
parts in less time than it takes
to make them using traditional
methods, such as hand-made
models, etc. So, the question is
not, “should I get involved with
digital dentistry technology?” but
rather, “how could I afford not to?”
Go and find your cheese. Besides,
after reading this you should be
well enough informed to present
a good case to your laboratory for
pushing forward with CAD/CAM
technology.
David Block, C.D.T., President/C.E.O.
Aesthetic Porcelain Studios, Inc.
www.aestheticporcelain.com
(323) 876-2447 · Toll free (800) 544-9605
S U M M E R 2 0 11
45
The Facts About
Credit Card Processing
“You answer the phone. It’s yet
another person trying to sell you credit
card processing. I admit it... I’m one
of those people. And each person has
the newest, latest, greatest service at
the lowest rock bottom price you could
possibly imagine! Each has their own
angle. I know. It’s why you don’t want
to talk to me when I call,” says Cheryl
Heldt, National Sales Manager of
International Payment Solutions.
Part of the problem is that you don’t
know what or who to believe so you tune
it all out! Is that really the best decision
for your business? To help, International
Payment Solutions has come up with the
following list of verifiable facts about
credit card processing that you can rely
on when you get these phone calls.
1. Termination fees. Never do
business with a company that charges
termination fees. This fee is a clever
way to force you to stay with them.
When you find out the rates you are
actually paying are much higher
than the really great rates you were
quoted… if you want to leave, you’re
going to pay. Termination fees are
not required. We NEVER charge
termination fees. And don’t assume
that your contract automatically
expires on your anniversary date.
Most companies are now requiring 30 to
120 days notice or you will be renewed.
2. There is no such thing as a
non-compliant terminal. The
“compliance” you keep hearing about
is called Payment Card Industry
Data Security Standard (PCI DSS)
Compliance. Even though all merchants
must file an annual compliance report
which lets the industry know that
a business is taking credit cards
46
S U M M E R 2 0 11
securely, it has absolutely nothing to
do with your terminal. Your terminal
is fine! Unless it’s really old. But that
still has nothing to do with compliance.
PINpad? You may need to have it reencrypted, but that’s it. And that’s an
inexpensive fix. Also, if you’ve been
using an internal PINpad and have been
told you need to replace the terminal
– you don’t have to! You can use the
existing terminal and just get an external
PINpad. This is a much cheaper option!
3. Nothing is free. If somebody
says “free,” be very careful. Free
equipment? Free paper? There are
even ads for free processing. No
for-profit company is in business to
lose money. When you are offered
something that is “free,” you can be
sure that the cost of that something is
going to be made up somewhere else;
whether it’s in increased rates, a longer
term contract, high termination or lost
profit fees... something.
4. Special pricing for the medical
industry. There are no special pricing
structures for the medical industry.
This is just a sales ploy and do you
want to do business with a company
that lies to you from the beginning?
5. There are no good deals
on leases. Do not under any
circumstances enter into an
equipment lease. These are huge
profit-makers for the person trying to
get you to sign. You’ll pay anywhere
from $29 to $90 per month for years
to buy a piece of equipment that you
could have purchased outright for
a few hundred dollars. And these
leases are iron-clad and virtually
unbreakable. Do not sign a lease!
6. Gimmick pricing. Somebody calls
you up and says, let’s make it simple;
I’ll give you a flat rate for all of your
processing! Sound good? It might,
but what you’ve just signed is a good
deal for the company who offered you
that pricing. The fact is you are now
paying keyed rates for swiped cards.
And since you’re probably swiping
the majority of your cards, why pay
that higher cost? Call IPS today to
put that money back in your pocket!
7. Your banker is not always your
friend. What IPS has found is that
some of the highest processing rates
around are being charged by local
banks. They do this for a couple of
reasons. Chances are they aren’t
handling the processing “in house.”
Which means they are paying somebody
(like IPS) to handle it for them. So the
company handling the actual processing
for your bank will take a profit and your
bank will take a profit. That translates
to an even higher cost for you because
you have two middle men. IPS
worked with a merchant who was
being charged 8% by his friend at the
bank. Need they say more?
The more you know the better
decisions you are able to make for your
business. We have the experience and
reputation you can rely on for your credit
card processing needs and will provide
you with references!
For a no-cost, no-obligation analysis of your
current processing costs, call Leo Townsend at 866522-1169 or fax your statement to 815-273-2133.
IPS will show you just how much money you’ll save
and never charge a termination fee!
Why Hygiene Patients are Worth
an Extra $100,000 a Year
by Robert Winings
The Scope of Sleep Apnea
I
t is estimated that over 40 million
Americans suffer from Sleep Apnea.
The traditional treatment for the last
few decades has been Continuous Positive Air Pressure or CPAP. Currently,
well over 7,000 CPAPs a day are sold in
the US. Within one year, almost half of
those machines will be unused because
the patient is no longer using them. That
means that close to 3,500 new patients a
day are looking for an alternative treatment for their sleep apnea. This does not
include the 30 million people who have
sleep apnea and don’t even know it.
Now is the time for dentists to consider adding “Sleep Dentistry” to their
practice. A practice that sees 30 hygiene
patients a week can easily add $100,000
or more to their practice by implementing
“Sleep Dentistry” into their practice.
Why Screen for Sleep Apnea
Twenty percent (1 out of 5) of your
adult patients are at risk for some form of
Sleep Apnea. Here are just a few interesting facts about sleep apnea.
Of the males in the US who have:
• Drug resistant hypertension 83% have Sleep Apnea
• Obesity
77% have Sleep Apnea
• Congestive Heart Failure
• Diabetes
• Coronary Artery Disease
1-800-337-8467
All aspects of the quality of life, from
physical and emotional health to social
functioning, are markedly impaired by
obstructive sleep apnea.*
Screening for sleep apnea can be
effectively done in less than 2 minutes
as part of your patient’s regular hygiene
visit. If you average 30 adult hygiene
patients a week, then you should have 6
patients a week that are at risk for some
form of sleep apnea.
Of the 6 that are at risk, half will have
already been diagnosed and prescribed
CPAP. The other half may not even
know what sleep apnea is. We find that
out of these 6, about 1/3 are interested in
moving forward.
Diagnosed or Undiagnosed
The discussion with a patient that is already
diagnosed is very easy. All it takes is two
questions and the patient will do the rest.
Question 1: Are you currently using
your CPAP on a regular basis?
Question 2: Have you ever heard of
oral appliance?
The patient that is undiagnosed usually
presents in one of two ways. They will
either have concerns about snoring or
they will be concerned about higher than
normal levels of daytime sleepiness. All
of this can be determined during the
hygiene visit. The next step for an undiagnosed patient is to have a sleep study
to confirm a diagnosis. Home Sleep
Testing has now made this diagnostic
process much easier.
Typically, half of your patients will
be already diagnosed and prescribed
CPAP and the other half will be un-
diagnosed and need a sleep test. The
end result is 8 patients a month that are
interested in oral appliance.
Increase to Your Top Line
Of the patients that decide to move
forward, about 1/3 will cancel or delay
treatment. On average, this should result
in about 5 patients a month moving
forward with oral appliance therapy. The
range in therapy costs is typically between $1,500 - $3,000. Taking a conservative $2,000 as the average therapy cost
to the patient, a practice should see over
$120,000 a year in additional revenue.
Most health insurance companies
are now paying for oral appliance. Reimbursement ranges between $500 - $2,900.
Reimbursement levels are always subject
to the patient’s co-pay and deductible.
Having health insurance contribute to
the overall cost makes treatment more
affordable for the patient.
Getting Started
The cost for implementing sleep
dentistry into your practice can range
from $4,000 to over $30,000. Be prepared to make a commitment to properly
training your staff. The rewards are often
well worth the investment. Increased
revenue for the practice is good, but it is
nothing compared to helping your patients
improve their quality of life.
* Quality of Life in Patients with Obstructive Sleep
Apnea - Carolyn D’Ambrosio, MD, Teri Bowman,
MD and Vahid Mohsenin, MD – Chest, July 1998
Robert Winings is president of Sleep Optima, a company
that helps sleep dentists grow the oral appliance segment of their business. Sleep Optima offers training and
education, home sleep study services—including sleep
specialist interpretation— complete medical insurance
billing, and current, new and referral source marketing.
To reach Rob, email [email protected] or call
877.699.9983.
S U M M E R 2 0 11
47
How Avoiding the Stock Market
Can Make You Rich
by Garrett B. Gunderson
A
s a financial advocate for
dentists, I’ve personally and
intimately worked with dozens
of docs. Most of them think they should
invest their excess cash in the stock market, whether through individual stocks,
mutual funds, IRAs, or other vehicles.
However, this is almost always a
mistake. For the most part they don’t
know what they’re doing, they don’t understand what they’re investing in, they
have little or no control over how their
investments perform, and they expose
themselves to unnecessary tax consequences. (By the way, the same applies
to real estate – if you don’t know what
you’re doing there, it shouldn’t be part of
your investment plan.)
Most dentists are better served by
1) investing in themselves and their
practice, 2) investing where they personally have deep interest, knowledge, and
expertise if there is still extra money or
no interest in being intimately involved,
3) using fixed, tax-advantaged vehicles,
such as permanent life insurance,
guaranteed insurance contracts and/or
specialty annuities.
Invest in Yourself & Your Practice
First
In 1960, a man named Srully
Blotnick began a study of 1,500 people
representing a cross-section of middleclass America. Throughout the twentyyear study, they lost almost a third of
the participants due to deaths, moves, or
other factors.
Of the 1,057 that remained, 83 had
become millionaires. The 83 successful
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S U M M E R 2 0 11
people shared five characteristics:
1. They were persistent
2. They were patient
3. They were willing to handle
both the “nobler and the pettier”
aspects of their job
4. They had an increasingly noncompetitive attitude towards the
people with whom they worked
5. Their investment activities –
aside from their main career –
consumed a minimum of their
time and attention.
Writes Blotnick, “We originally
expected the people in our sample to become wealthy by taking the money they
earned at work and investing it wisely, in
such things as stocks, bonds, and real estate… We thought there’d be no way for
[them] to become rich unless they used
their surplus income to generate more
income… It didn’t work out that way…
More often than not they made little or
no money investing.”
In short, the study revealed that the
successful participants found something
they loved and they did it well. “In case
after case,” says Blotnick, “they did increasingly well occupationally, while their
pursuit of investment profits proved to be
largely a waste of time. In the long run, it
was their work which made them rich.”
Blotnick concludes that investing in
yourself, what you do, and with whom
you do it are the most important determining factors of wealth.
If you’ve got excess cash lying
around, use it to expand your knowledge, credentials, and capabilities and to
grow your practice before investing in
other investment vehicles. Expand your
offerings. Get a bigger office in a better
location. Hire more hygienists, or even
bring on other dentists.
Ultimately, your practice will pay
you far more dividends than any other
investment. You have true ownership and
can control the investment, you have collateral, you have specialized knowledge,
and you love what you do (hopefully).
Anything else that doesn’t meet those
criteria dramatically increases your risk.
Whatever you invest in, it should be
where you have influence, passion, and
knowledge.
Reduce Your Risk & Taxes With
Fixed Vehicles
Fixed accumulation vehicles, such as
permanent life insurance and specialty
annuities, are some of the least understood and under-utilized money vehicles.
One main reason is that they’ve been
given a bad rap by ignorant media pundits
and financial institutions with vested
interests. These are the same institutions
who feed you baloney like “high risk
equals high returns.”
Thankfully, more and more dentists
are beginning to understand and leverage
their value, for the following main reasons:
• They provide guarantees and fixed
returns. You never have to worry
about stock market volatility. You
can focus on what you do best –
Cenegenics Profitable Dentist 03-02-09 A.pdf
3/19/2009
9:31:33 AM
dentistry – without constantly
worrying about losing or managing money. And when you calculate
losses, taxes, and administrative
fees, these fixed returns can rival
variable market returns.
• They provide phenomenal tax advantages. Like qualified plans, such
as IRAs 401(k)s, your money grows
tax-deferred. But unlike qualified
plans, you have options where you
don’t pay taxes on the back end
when you begin withdrawals.
• Greater liquidity and access. Your
money can be accessed in many
of these contracts through tax-free
and in some cases even interest-free
policy loans without penalties. You
don’t have to wait until 59½ to use
your money.
C
If you love investing in stocks (or
real estate) you actually know what you’re
doing, and you have the ability to control
outcomes with your stock market investing, then by all means invest some of your
surplus profits there.
M
Y
CM
MY
CY
CMY
But if you’re like most dentists, stock
market investing is a risky distraction.
It’s not your area of expertise, so you just
throw money into a diversified portfolio,
cross your fingers, and hope and pray that
you’ll receive a positive return. That’s not
investing—it’s gambling.
K
Invest in what you know, what you
love, and what you’re good at. Grow your
practice first. And if you still have excess cash to invest after doing that, invest
in fixed, tax-advantaged accumulation
vehicles before you even consider the stock
market.
The true path to wealth isn’t to increase your risk, but rather to reduce your
risk. You do that in your practice—now do
it with your investments.
Garrett Gunderson is a financial coach and the New
York Times best-selling author of Killing Sacred Cows:
Overcoming the Financial Myths that are Destroying
Your Prosperity. Email him at [email protected].
1-800-337-8467
S U M M E R 2 0 11
49
Six-Hour A Week Dentist continued from page 30.
are mailed using an actual postal stamp and have
personalized messages but it takes little to no time to get
them in the hands of patients. Rather than hire more team
members, look into systems that can be used to reduce time
spent and minimize the margin of error – often with onetime only costs.
Trick question, can you ever train too much? The
answer is no AND yes. No, you cannot train on the same
thing too much, but yes you can train one person on too
many things. It is critically important to cross-train and to
ensure that one person is not doing everything. However,
having assigned tasks and not giving too much to people all
at one time is a must.
Training is a peculiar thing and don’t think there is only
one way to teach because there are certainly many ways you
can learn. Capitalize on electronic modes such as webinars,
teleseminars, and blogs. But also use your team members to
do the training. Nothing feels better than to be called upon
as the expert. If someone has finessed a skill, by all means
put them in front of the team. Be careful not to pit your
employees against one another but create a culture where
leadership is embraced, taking initiative is expected, and
sharing your knowledge with others is required.
Morning huddles should be done daily and small items
can certainly be addressed during that time. No less than
two full-team meetings a month is critical. One meeting
a month should be used for training, even if it is just brief.
Department leaders are a tool that you should use to identify
training topics. Monthly department meetings are a great
time to do training and development on topics that may not
be relevant to the entire team.
Hypnotherapy cont. from page 43.
Upon connecting to Frank’s “best
friend” I asked that part of him to tell
me why he felt so fortunate to be Frank’s
best friend. His answer was that Frank
has a good heart, is kind and never
means any harm to anyone or anything. I
then asked his “best friend” to give him
any suggestions that would help him in
his life. His “best friend” responded by
speaking directly to Frank: “You need to
stop drinking and go back to your family
50
S U M M E R 2 0 11
So, in summation here are the nuggets of insight I can
provide:
1.
Invisalign does not require a ton of time, therefore,
it creates a lot of time – for you.
2.
Never do what others think you should be doing. Do
what you KNOW you should be doing and love it...
if you don’t, leave it behind.
3.
You are only as strong as the strength of your team.
Invest in their development and spend time with
them. Get to know them on a personal level. As
much as you know and understand their personal
lives, is as successful as you will be in developing a
phenomenal employee.
4.
A life out of balance is not much of a life. It is
merely a rote existence that has moments of passion
but lots of time filled with resentment, fatigue,
disappointment and a longing for something
different... dare to do the unconventional.
5.
Never let someone else’s idea of success become
yours. Know what you want and don’t be satisfied
until you have achieved it!
Here’s to your continued success. I wish you as much as
you can possibly handle!
Dr. Steffany Mohan grew her dental practice from scratch to 3 million in
less than four years. She sold her first dental practice after doubling its size
and revenue in six years. Dr. Mohan’s expertise lies in growing practices to
unprecedented levels of financial viability. For more info on her method:
[email protected].
so that they can help you and eventually
you can help them.”
I woke Frank out of his trance and
he had a light in his eyes that wasn’t
there before. He left my office full of
confidence and hope. The next day he
came back into the office and said, “Dr.
Steve – I’m ready!” I said, “Ready for
what?” “To go home to my family,” he
replied.
Once again, I took him to the bus
station, bought him a one-way ticket
to Thomasville, GA and sent him on
his way to his new journey. I told him
to keep in contact and gave him all the
information to reach me.
I heard from him several months later,
and he told me that he had stopped drinking, had his own place after living with
family at first and had a part-time job. He
has been sober now for more than a year,
and he still calls me from time to time.
You may contact Dr. Roth at (786) 427-3156.
“Your New Patients are Local and Mobile”
DentalWebsites.com helps them Find and Contact you!
“Great dentists inspire us to
do great things. We really
care about our members
and we Play to WIN!”
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I am always ranked on the first page of all the major search
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(or two!) Greg and Mary. You are the best around!"
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and under deliver, Mary and Greg Rahall from
DentalWebsites.com are the real deal! I can tell you
they will give incredible value and detail for your
project. They walk you through every step, provide
great ideas, and are on the cutting edge of what your
website should be doing for you. I guarantee you
won't be disappointed.”
Dr. Steve Rasner - www.PearlSmiles.com
Attracting New Patients
Since 1998!
888-906-1667
Custom & Mobile Friendly Website Design
Google Places (Map) Local Listing
Get a Free website / Internet marketing
evaluation. Call Mary at 888-906-1667, ext 12.
Visit us online at
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World Class Search Engine Optimization (SEO)
Search Engine Marketing (SEM)
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Social Network Marketing & Coaching
S U M M E R 2 0 11
51
Puzzle Piece
0
# 20
t
r
Pa
of
the Puzzle
00
0,0
0
1
$
“Oversized
Business Cards”
by Dr. Woody Oakes
F
or those of you who have
attended my “10 Best
Practice Builders” lectures,
you know that we do an entire
section on business cards. As
you learned, photo business
cards (done properly) are 500%
more effective than regular
business cards… because people
don’t throw away photos.
Anyway, last week my
friend Steve Seltzer (Seltzer
Institute) stopped by for a visit
and gave me his new business
card plus a postcard they use
which is basically the same as
the business card but enlarged
four times. That’s when I
had a great idea… how about
oversized business cards?
Well, we tried them with
a few of my private consulting
clients and the results have been
amazing. Nobody else is doing
this and these oversized cards
almost never get thrown away.
I shared this idea with a
realtor friend of mine and she
loved the idea.
Editor’s note: I just found a way
to these on gold or platinum foil cards
(with white on the reverse side)… these
are very impressive and they don’t get
thrown away.
Here’s what to do... Take
your business card art to
any printer and ask them to
print it on a 9” x 6” postcard.
A suggestion would be to
modify your business card
just a touch by putting your
telephone number on the card
in LARGER NUMBERS.
A Word From Our Readers
Woody,
Allcare just closed their local
office along with about 60 others without
notice. They were putting patients off
through CareCredit by running up bills
for treatment not yet performed and then
being slow to refund. They were floating
millions of dollars of patients’ money.
Dr. Craig Callen
Editor’s Note: Who’s next… Aspen? Be
careful, as many of you know Heartland
Dental has also paid a huge fine to an
insurance company.
recommend every dentist should become
friends with their local pharmacist. This
person can be a source of invaluable
information that cannot be gleaned from
an ipharmacy app. I often speak to dental
study groups in my area to educate and
support their needs. I don’t think an
ipharmacy app could do this. At least
once a week I get calls from dentists for
dosing, interactions and drug therapy
questions. As a pharmacist, I try to
educate and support my patients as well
as the physicians and dentists that we
serve.
Judy
Dear Judy,
Dear Woody,
I have been married to a dentist for
33 years and am an avid reader. I always
read your magazine when it comes in,
because I usually glean some pearls of
customer service from each article. I
am writing because I have also been a
pharmacist for 34 years. I was insulted
by the iPharmacy app that you think so
highly of.
As an independent pharmacist I
52
S U M M E R 2 0 11
I agree totally, but as you know, most
physicians and most dentists don’t rely on
anything other than their “memory” when
it comes to prescribing.
$8M Doctor In Florida...
Woody,
I get so sick of these articles about
these BIG practices. Why not show us
their impressions and margins?
Anonymous in Florida
Dear Anonymous,
Okay, I hope you realize this is
a group practice? Second, while I
personally haven’t seen lab work in
this practice, I have seen Dr. Steve
Rasner’s… who does $4.1M with a very
part-time associate. Steve’s work is
pristine!
I believe people should be judged
“innocent” until proven otherwise.
Regards,
Gone are the days of the PDR. We
just think ipharmacy is a good first-step
and certainly “better than nothing.”
Regards,
Howard Farran emailed me about
some of the chatter on Dental Town
regarding Woody Oakes… here’s my
actual reply to Howard:
“Most of our list enjoys the two-perday emails. Anyone who is annoyed
can unsubscribe very easily. Since our
list continues to grow daily and very few
unsubscribe… that tells us that most
dentists find true value in them.
The reason for the two-per-day
strategy is simple… the AM one is a helpful
hint or tip and the PM one is for a product
that will help our doctors. Also, if they are
out of the office and miss a certain product
offer… we re-send the most popular ones
for those who missed it the first time.
EID has been in business since
1987 and has helped turn many practices
around and without our edutainment
seminars… many of “Dentistry Todays”
leaders in CE would never have been
discovered. For example: Dr. Steve
Rasner, Dr. Howard Farran, etc.! Can
you imagine dentistry without these
“GIANTS”?
In conculsion, all of us get a lot
of spam, but when it’s something that
can really help a dentist improve their
practice… very few complain.
Regards,
Woody”
Needle-Free Nasal Mist for Dental Anesthetic
St. Renatus, LLC, based out of Fort Collins,
Colorado, is in the process of clinically
testing a drug the company believes will
enhance pain control in dentistry. St.
Renatus has patented the world’s first
needle-free nasal mist dental anesthetic.
It is administered through the nasal cavity and is suitable for use in operative
procedures involving most of the upper
teeth. The benefits of this new technology include:
• Reducing the anxiety and fear
associated with dental injections
iPhone App:
All-in-1 Super Camera
•
Decreasing the risk associated
with contaminated needles
•
Patients will not complain of the
“fat lip” feeling
According to a recent survey conducted
by the Industrial Research Center, 96%
of dentists surveyed expect to offer
the new nasal mist anesthetic to their
patients. The company has completed
two of three adult phases of clinical
trials. With a just completed, favorable
end of Phase II review with the FDA, St.
Renatus established readiness to proceed
For more information and continuous
updates, please visit www.st-renatus.
com. Or contact Jill Shoemaker, Vice
President of Investor Relations at (970)
282-0156 ext. 16 or by email at [email protected].
DentalVibe Injection Comfort System
The best new product this month is the DentalVibe
Injection Comfort System… available at dentalvibe.
com or 1-877-503-VIBE for around $800. First – Dr.
Omer Reed and others advanced the “Distraction/
Vibration” technique for painless injections. Second –
Dr. Joe Steven at KiscoDental.com offered the VibraJect which is basically a metal syringe with a batteryoperated vibrator that sells for around $400.
This App is great for all intraoral photography. It’s a FREE app,
the upgrade isn’t worth it in my
opinion though. The best feature is
the “sketch” option.
Take a close anterior photo,
click the sketch button, email it to
your computer and print. Now you
have a piece of paper you can use to
communicate better with the lab.
DentalVibe is the next generation of this concept. It is strong, but light-weight plastic, has two
battery-operated vibrating prongs and a built in light
for around $800. Be sure to watch the video on their
site OR my new DVD on “Totally Painless Injections.”
You can draw on the paper to
connect mid-line, get horizontal
planes of occlusion and make notes
about staining, etc.
Product XXX
This new “super topical” is so strong
and so effective that it can NOT be sold
in un-enlightened states like Indiana
and Kentucky (unless you are an OBGYN?).
Call Kisco Dental at 1-800-3258649 and ask about it and see if it’s
legal to buy it in your state? It sells for
around $65/jar.
1-800-337-8467
with conducting Phase III efficacy studies. The studies are expected to conclude
in the second half of 2011 and the New
Drug Application submission is targeted
before the end of the year. St. Renatus
expects to market the new drug product
in 2012.
Best Needles in Dentistry
Hands down, the best needles in
dentistry are the new needles from
Connecticut Hypodermics.com or
1-203-265-4881. In fact, this product
is so good it recently won the 2010
“Best of Business” award.
Editor’s note: Be on the “look
out” for my new DVD “Totally Painless Injections 2011” which sells
for only $147 and can be ordered at
1-800-337-8467.
S U M M E R 2 0 11
53
AMAZING OPPORTUNITY…
“Crazy Dentist Direct Lab (In Utah)...
Reduces Doctor’s Lab Fees To Zero?”
Good Morning Doctor –
Dr. Tim Quirt
Owner, Dentist Direct Lab
Hey, when I first heard about
this deal, I thought it was too
good to be true. But “Yes”
it is true… and if earning an
extra $10K-$60K/year appeals
to you, keep reading. In fact,
this may be the most important
“financial opportunity” you’ve
ever had! Let me explain…
Dentist Direct Lab (as the name implies) is a high
quality dental lab owned by a dentist… that cuts out
the middleman and thus allows them to save you 2550% off your current lab bill.
So, if you’re collecting $100K/month and
spending 10% on lab fees, that’s $10K. Now, you
can easily reduce that amount to $7,500 (or even
$5K). All of that savings is net income.
Here’s the story…
This dentist calls my office and says…
“Woody, I’ve got this great dental lab that can
save your members a lot of $$$… but, I don’t have
the marketing budget to get the word out.”
Well, what’s a dental practice do to get more
patients when they have a zero (or non-existent)
marketing budget? Exactly, they build their business
by referrals!
So I tell this dentist… “Why don’t you build your
lab by dentist-to-dentist referrals?” Cha-Ching!!!
Okay, here’s how it works:
You use the lab yourself and then go out and tell
all of your dentist friends about this great new lab
you’ve discovered. For each referred dentist who
uses the lab… you’ll get a referral fee of $10/unit,
forever!
So let me repeat this for those of you who didn’t
“get it” the first time…
• Start sending some/all of your C&B work to
Dentist Direct Lab (DDL)
• You will save approximately 25-50% off your
current lab bill
• Next, tell your fellow dentists about this lab and
you will also receive $10/unit of everything they
send to DDL… forever!
To get started, email them at…
[email protected] and in the subject line
put “Lab Opportunity/Woody.” Then the folks at
Dentist Direct Lab will give you a call and walk you
through the entire set-up process.
One doctor using this lab, paid for his office
building with the savings. So consider this; If you
send 10 dentists to the lab (and each sends them 50
units/month)… that’s $60K in your pocket in only 12
months if they keep using the lab, forever!
This is a limited time offer!
Don’t think about this, just do it!
Regards,
William W. Oakes, DDS
PS – Doggone it… maybe I still haven’t done
enough to convince you to try this lab.
Okay, send them just 4 units and you’ll get
2 of them for FREE!
Send 4 Units To Dentist Direct Lab And They’ll Give You 2 FREE!!!
*Shipping Included*
To get started email [email protected] with the
subject line “Lab Opportunity/Woody” or call 1-800-850-2659
PPS – Remember, you must enter the code word
“Woody” (in the subject line) to get the
“Send 4 Units, Get 2 FREE” offer.
To recap… save 25-50% on your lab
bills, get an ongoing referral “cash flow”
and get 2 FREE crowns just for giving this
a try and all work is guaranteed for 5 years!
This offer is for a limited time only. HURRY!
* We appologize in advance if Dentist Direct Lab has reached capacity when you contact them. *
54
S U M M E R 2 0 11
Join
xcellence in Dentistry 7 as we present…
“Revealed... The $250,000
Transformational Team Experience”
(Discover a wildly, effective 3-step method for
pocketing an extra $250,000 or more!)
November 4-5, 2011
Sheraton DFW Airport Hotel
Dallas, Texas
FEATURING:
Bryan Flanagan
Pat Worcester, CDS, HYG, BS
Dr. Steffany Mohan and Brooke Mott
$497 per Doctor
$97 per Team Member
Call 1.800.337.8467 To Reserve Seats
For YOUR Team Today!
Excellence in Dentistry is an ADA CERP provider
ADA CERP is a service of the American Dental
Association to assist dental professionals
in identifying quality providers of continuing
dental education. ADA CERP does not approve
or endorse individual courses or instructors,
nor does it imply acceptance of credit hours by
boards of dentistry. EID designates this activity
for 12 continuing education credits.
12 CE Credits
PRSRT STD
U.S. Postage
Paid
Louisville, KY
Permit No. 354
3211 Grantline Rd, Ste 20
New Albany, IN 47150
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Can You Lie To A Druggie?

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