Dr. Howard Farran from Dentaltown joins the program to discuss how to create a thriving dental practice, and the biggest mistakes that young (and not so young!) dentists make.
Jamie Scherban, Senior Business Consultant at Paychex, discusses payroll solutions for dentists and the most common problems that dentists face regarding payroll.
Joel Dearing joins the program to discuss the takeaways that he learned in his over 30 years of coaching women’s and men’s volleyball on how to build a successful team and the lessons for dentists.
Read more at http://ascentdental.libsyn.com/#tzje0FdSBgQ0bOKf.99
Kevin Henry joins the program to discuss how and why you should empower your dental assistants and the impact that can have on your practice.
An advocate of today’s dental assistant, Kevin Henry speaks to dental audiences across the nation on topics that empower dental assistants, helping them recognize the leadership role they hold in the practice.
With 16 years in the dental publishing industry, Kevin is the managing editor for Dental Economics and former group editorial director for Dental Products Report. He was recently named as one of the top five influential voices in the industry on Twitter (@kgh23) and serves as the co-founder of IgniteDA, a community designed to enlighten, empower and educate dental assistants.
Read more at http://ascentdental.libsyn.com/#tzje0FdSBgQ0bOKf.99
Stacey Brown Randall from Growth By Referrals joins the program to discuss how dentists can use referrals to grow their practice and attract ideal dental patients to their business.
To learn more, visit www.growthbyreferrals.com
Kevin: Welcome. This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions with a focus on development, training, education and knowledge. Before we begin with our special guest, Dr. Howard Farran, I just like to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise, we would not be able to provide this podcast. We hope you enjoy today’s podcast. I can’t tell you how excited I am that Howard is taking the time from his incredibly busy schedule.
If you don’t know who Dr. Farran is, he not only is a dentist, he’s not only an MBA, but he’s also an international lecturer and he’s fast, easy and understands what’s important to our profession, not only clinically, but business wise. I’m a firm believer that the best clinicians in the world, if they don’t have an association and a knowledge of business, they’re in an uphill battle. And if you’re a great business person and you don’t attain basic clinical skills, then you’re also in an uphill battle.
Without any further ado, I’d like to introduce Dr. Howard Farran for today’s podcast. Howard, thanks so much for joining me today and thanks so much for everything you’ve done for the field of dentistry and all the aspects of dentistry. Thank you so much.
Howard: It is a huge honor to be on your show. I’m a big fan of your AD podcast and thanks for uploading on the Dental Town website and the Dental Town app. These kids have an hour commute to work every day and they just love listening to dental podcasts like yours and mine.
Kevin: Thanks so much. I thought what would be valuable to our listeners are basically three segments of the dental profession. I’d like to start off with that first segment, and that’s that new graduate. They’re in their senior year, they’re really focused on just basically getting the hell out of school, getting things started, but they really don’t have a roadmap. With your expertise, your background and all the information that you have coming into Dental Town, what would you say would be the three to five bullet points that you’d recommend for these young graduates just getting started in their career?
Howard: I had an extremely lucky childhood. My dad was dirt poor and when I was ten years old, he saved up his money and bought a SONIC Drive-In franchise. He went from making like $11,000 a year to $60,000 his first year, then he opened up another SONIC every year for nine years. We went from dirt poor and I didn’t even know what an air conditioner was — I didn’t even know that people had air conditioners in their house — to living in the wealthiest area of Wichita, Kansas in United States.
In that church that we were in was also the founders of Pizza Hut, Dan and Beverly Carney, who ended up with 2,800 Pizza Huts that they sold to PepsiCo, the Shah family that started Godfather’s. So when I was a little kid and went fishing, I would sit next to my dad who had nine restaurants, Roger Carpenter who had 100, Jim Williams had 1,000, Roger Carpenter had 2,800 and there was a lot of takeaways from growing up with these guys.
Number one, you would never know any of them had a dime. I mean, my God, they lived below their means. When Sam Walton died, everybody always says that Bill Gates was the richest man in the world it’s because they don’t know addition. When everybody said Bill Gates is the richest man in the world during my entire life, if you look at the Walton family and Sam and his wife Helen and his four kids were like number 17, 18, 19, 20, 21, 22. If you added them up, they were worth the 40 percent of the poorest Americans in that one family. And his desk was a door on two sawhorses and he drove a pickup truck.
Dan Carney, my God! You damn well would have thought he was homeless if you ever ran into the guy. He had these old corduroy pants. I think he only had about five different pants and shirts. They all lived below their means.
And then the second thing that the takeaway was is every one of those legends in the restaurant franchise business, by the time they had five employees, one of them was a fulltime bookkeeper. All they did was master their costs. These dentists would go in a room and they’ll do two MOD composites and I’ll say, “How much did you charge for that?” And they go, “Like 250 for an MOD composite.” And I’ll at them and say, “250! Dude, 90 percent of your practice is PPOs and this plan you got 125. How were you off a Benjamin on each one of these damn fillings? And what did that room cost you?” No idea.
I remember when I was ten years old and I was working at SONIC and I was making a number one cheese burger and I was dressing it and I put on four pickles, my dad picked up that hamburger and threw it at the wall as hard as he could and he said, “Howard, if you’re going to put four pickles on a hamburger, you might as well give it away for free.” And I was like, “Wow! How many pickles are supposed to be on a hamburger?” He says, “Three.” These guys all knew their cost. And by the time they had five employees, one of them was a bookkeeper. It was amazing.
I hired a bookkeeper when I started out. She’s now the president of my company and makes $200,000 a year. It’s all about cost. These dentists, they don’t know their cost. When you go in there and they have practice management information systems like Dentrix and Eaglesoft, they don’t even have an accounting software. So all your day you only manage people, time and money so all their costs were incurred in time, but they bill in units. The PPO price doesn’t even matter. The only thing that matters is what does that room cost for an hour and how much production do you do in that hour.
Southwest Airlines takes 100 percent of all their cost and reduces it to one airline seat flying through the sky for a mile. If that chair takes off where you’re at in Boston and flies to my house in Phoenix and no one’s sitting in it, it still has costs. That plane is not being flown by the tooth fairy, it’s not being pulled by magic fairy dust, it has costs. These dentists don’t even know what an operatory costs because Dentrix and Eaglesoft, those are the two worst things that ever happened to dentistry. They’re the WWI and WWII of dentistry.
The receptionist is out there, she books an hour for two fillings, she doesn’t even know what it is, then she books some lady to come in for a cleaning for an hour, she’s getting $55 for the cleaning and the hygienist is getting $40 and these dentists don’t even know they’re in quicksand. You have to hire a bookkeeper at every position you have.
I’ll go into a dental office and the supplies last month they were five percent, the next month they’re eight percent, the next month they’re seven percent, the next month they’re nine percent. It’s like how do your supply costs vary 100 percent from month to month? But if I hire a bookkeeper, she’s not in health care so she’s not used to inflated wages. Everybody in health care and government and unions are used to these overkill wages that are market reality so you hire outside of health care, outside of government, outside of unions. You bring in a bookkeeper, I can teach her how to be a dental assistant in a month. But then my supplies, if I say my supplies are 4.5 percent a month, then she’s totally organized, puts up all these bookkeeping accounting systems.
Same thing upfront. My gosh, you hire a girl that worked across the street in a dental office for ten years on Dentrix and I’ll ask during the interview how many reports does Dentrix have? Does it have five, ten, 20, 30? She has no idea. I’m like how did you sit on a software system for ten years and never even go up and click this icon? Mainly because what Dentrix and Eaglesoft does, instead of hooking it up to Quicken or Payroll or Peachtree or Microsoft Great Plains Accounting, they sit there and you send in all these wish list features so they’ve added so much bullshit that 85 percent of all the functions are not even used in any dental office.
Anybody go into anybody’s dental office, go to report generator, go to the utilization, none of it is utilized. But when you Marriott, it’s striped down. They only do like seven things to check you in, but they always do every one and you can’t go from four to five or five to six without doing it in order. When you go to return your rental car to Hertz Rental Car, they only do like five things to check you in. That’s why we switched to Open Dental. I have no connection with Open Dental, they don’t advertise in Dental Town. In fact, they don’t advertise anywhere because they’re the best damn software ever because they are open. So you can have your own programmer program right into it and make your own self a dashboard or whatever. But it’s the most open software for your data.
And if you get a bookkeeper in there — what we have to do is we have to dump everything out of Open Dental into Excel spreadsheets and then dump everything out of Peachtree Accounting into Excel and make all these damn reports because the receptionist, you call up and — if I sell bottled water, I make this bottled water for 90 cents and I sell it to 7-Eleven or Circle K for a dollar, I know it costs me 90 cents, I know I make a dime on every one and then they sell it for $1.15.
In dentistry, the average dentist is signed up for about 12 to 15 different PPO plans, he has no idea what he is charging for any procedure, he has no idea what his room costs and then the receptionist is scheduling your only cost, time — the Fortune 500, the SD500 average payroll is 53 percent. That’s what it is in dentistry. The dentist is making 35 percent on 65 percent overhead, the staff is making about 25 percent, lab bill 10, supply is 6, rent/mortgage/utility is 5 – 6, but that’s all spread out over time and the receptionist is just sitting there saying, “Well doctor, how much time do you like for an MOD composite?” I don’t care how much time you like for an MOD composite. What does that room cost and what are you getting? If that room costs $200 an hour and you put in $145 MOD, you just took a $50 bill grant and shredded it in a shredder.
Dentists also do weird things like they only do quadrant dentistry where they’ll say, “Let’s do the fillings on your right side and have you come back in two weeks to do your left side.” And then right next door to him is an oral surgeon that numbs up all four quadrants all day eight times a day, five days a week for 40 years. I just tell them, they’ll say, “I only want to do the right side today.” “Well, due to your insurance plan, it’s a heavily discounted plan. The only way this works is if I do all of them at the same time. I can only afford to do all these fillings that we do all at once. On this discounted PPO plan, I can’t schedule an hour four different times to do four different fillings. The way your plan works, I have to do them all at the same time or I can’t even do them.” And then it’s like, “Oh, okay,” and then they do it.
When you staff your assistants and your receptionist with bookkeepers, they get numbers, they get cost. Some dentists make 25,000 a month on 40 percent overhead, they only got to do $41,000 a month to make 25,000. At 50 percent overhead, obviously, all you have to do is 50,000. But at 65 percent overhead, which is the national average, you got to do $71,500 for the dentistry to make 25,000 a month. And 20 percent of dentists have 80 percent overhead, they got to do $125,000 of dentistry to make 25,000.
The other thing they do wrong is that they’re doing everything right in their mind, like they get out of school, they go to their church, they ask their pastor or the Rabbi, “Hey, I need a CPA. Do you recommend anyone?” And they’re like, “Sure, there’s a CPA in our church, in our mosque and he’s just a great guy. Go talk to Rick.” Rick doesn’t know anything about dentistry. I’m sure he’s a great guy.
But now we got the Academy of Dental CPAs at www.adcpa.org, they got 6,000 dentists on one database, they got the Institute of Dental CPAs at www.indcpa.org, they got another 2,000. But every dental office, every dentist I know that has switched to someone like Cain Watters and Associates, someone who only does dentists, then they’re sitting there because dentists know if all, they just know it all. They’re not a doctor of dental surgery, they’re a doctor of freaking everything. They don’t listen to anyone, so they’re not going to listen to their CPA.
But dentists listen to other dentists because they hang. They hang out with these dentists in dental school. They know everybody that got into dental school got A’s in calculus and physics and geometry, they know how many ATP come out of glucose on the Krebs cycle, they know their homies are smart. So when that American Academy of Dental CPAs or Institute of Dental CPA sits down and says, “Well, Dr. Kevin Coughlin, we have 6,000 dentists and their supplies range from 4 to 8 percent and the mean is 5.25 and yours are 7 percent. Can we talk about that?”
The dentists love numbers. Just kind of like when you’re in dental school and you’re taking a test and they went and posted the computer printout of everybody’s score and what the curve was, dentists are used to that herd mentality with their other doctor homies. So when they start seeing this data bank and they start realizing what’s going on…
The other thing is with PPOs. Let’s just say you’re in Wisconsin, that’s a very different PPO market than New Jersey, which is extremely different than Kansas. And so when you got a dental CPA who’s doing 150 dentists in Kansas, he can sit there and say, “I don’t know what’s correlation or what’s cause effect, but I do know everybody who’s on this PPO here, whether it’s Connecticut General or Blue Cross, whatever it is, everyone that’s on this PPO is running like 68 percent overhead. But we’ve had several doctors, we’ve had five that dropped these two plans and what we saw is that their gross production went from $1 million a year down to $900,000 a year. But their net went from 1.75 to 2.25, which shows you how much dentistry they were doing at a loss because now they do less dentistry and they net more money.”
And then the other thing is your hygienist comes in and your staff, the whole promotion system is based on astrology. They come in your office once a year and say, “Doctor, the earth has gone around the sun and past Uranus and it’s time to give me a dollar raise.” And you’re like, “A dollar raise? My God! I just talked to my dental CPA and I’m paying you $40 an hour to do $55 of cleaning and we’ve reduced all of our costs for operatory. Of course, we took out crown and bridges and applied that to the dentist, but your operatory is costing $90 an hour and you’re doing $80, I lose $10 every single time you do a cleaning. You take an hour. Is there any way you could schedule 50 minutes so I could break even? Or if you go to 45 minutes, I’ll give you a raise.”
But once you get the team on the same page and you build trust and integrity, if you have no trust and you have no integrity, if you lie, cheat and steal, you can’t lead a team, you’re not going to get repeat business, you lose everything in life. And then when everybody starts getting on the same page with the numbers, everybody starts making better decisions. The front office makes better decisions on how much time to schedule.
A lot of dentists are realizing that composites, I mean oil is trading this morning at $71 a barrel and CLEARFIL SE is trading at $1,250,000 a barrel. These dentists say these crazy whacko things like composites last longer than amalgams. When a dentist says that, you almost got to think his mom dropped him when he was a little kid. The average composite lasts six and a half years, it’s a neuroplastic, the [recut 00:16:45], decay and release composite is just much. You take out with a number four, number six, number eight round bar.
These amalgams are half mercury, you’ll never find mercury in multivitamin. The other half is silver, zinc, copper and tin. Every one of them is antibacterial tin, stannous fluoride, that’s tin. Silver diamine fluoride [detrinia 00:17:04], pediatric nursery, everything in an amalgam is toxic. And when you put in an amalgam, those things last 38 years but the thing is an amalgam doesn’t cost anything and they’re fast.
So when you sit there and you start realizing that this room cost you $200 an hour and you’re getting paid $100 for an MOD composite and you can barely do two of them in an hour, it makes you start thinking well maybe instead of putting in a six and a half year old inner plastic composite without an active ingredient, maybe I should just go back to amalgam. And a lot of these dentists are going back to amalgam because their patients prioritize PPOs and price over aesthetics. I can’t make a bottled water for 90 cents and sell it to you for 45 cents. These are what dentists are doing. They’re doing it all day, every day.
Gosh, at this point, I don’t even know what question you asked.
Kevin: I’m going to tell you this, Howard, first of all, the information is terrific. And if I was to paraphrase and summarize, I think what you’re trying to tell these new graduates is number one; live below your means. I know you want a new Porsche, I know you want a Mercedes, I know you want a Tesla. Hold on to it and save some money and spend below your means. Even though you think you deserve it, in the real world, my data says you’re going to be close to $300,000 in debt. And at a 6 percent interest over seven years, it’s going to cost you almost $4,000 a month to get out of debt. So the first $78,000 to $80,000 is going to go just to deal with school debt. So I believe what you’re trying to say is live below your means. Save some money.
Number two; know what the hell your costs are. When you sit there and look at your schedule, say how much time am I planned for and what am I going to generate for revenue? All that’s great, but if you don’t know what your overhead costs are for your business and your personal life, you’re just swimming in a circle going nowhere.
Last, if I was to say what I learned is remember, three pickles are just as good as four pickles and it’s going to put more money in your pocket and your old man taught you the right way.
Howard, I can’t tell you how much I appreciate this. If these young graduates, these people getting started in the profession they wanted to get more information on you, they wanted to learn more about you and how you’ve conducted your business and helped thousands of dentists throughout the country and the world, how do they reach you?
Howard: I would have them go to Barnes & Noble and buy my book in print or audio called Uncomplicate Business. You only manage three things; people, time and money. That book is my masterpiece. I was 50 years old, had an MBA, had been practicing 30 years and collecting a million dollars a month before I wrote that book. It’s my magnum opus. The secret to writing is rewriting. The first draft was 600 pages, second draft cut down to 400, the final draft, 200 pages. That book could tell you everything you ever need to know. And then it costs like ten bucks.
Kevin: Howard, I can’t tell you how much we appreciate that you’re doing this podcast. I know how busy you are. I personally want to thank you and I want to also say, thank you for what you’re doing for our profession. I hope that we can do a follow up podcast with a focus on those dentists who started off with a bang and a flurry, but for a variety of reasons that I think we both know, their practice is not going in the way they wanted to, they’re not accomplishing what they want and it’s sad. And with the proper processes and procedures, their lives could be turned around, not only clinically, but financially, and that’s better for them and their family.
And then that final podcast is how do we prepare that dentist for the ultimate exit strategy. For whatever reason; health, nerves, desire, they know that they’ve got to take this asset and they’ve got to, in most cases, sell that asset. And how do they get the most valuable return on investment for that asset? And I think with your knowledge and expertise, if you’re willing to spend the time with me, I’d love to follow up on those two additional podcasts.
Howard: Kevin, it would be an honor to come back two more times on your podcast. I’m a huge fan of your podcast. And again, thanks so much for putting it up on Dental Town because these dentists tell me they get in their car, they open up the app, they scrawl through the podcast, say what are they in the mood for. I’ve gotten so many great feedback and comments on your podcast on Dental Town. I think what you’re doing is just amazing.
Thank you so much for transferring your amazing knowledge from doing that for so many years and all the, hell you’re at 14 dental offices — to think that some dentist who’s done it for 30 years, who built 14 years telling these little kids that just walked out of dental kindergarten class everything you know is just a noble course. I’m so proud of you. Thank you for all that you’ve done for dentistry and Dental Town.
Kevin: Thanks so much and I look forward to our next podcast. This is Dr. Kevin Coughlin. You’ve been listening to Ascent Radio.
Kevin: This is Dr. Kevin Coughlin. You’re listening to Ascent-Dental-Solutions and this is Ascent Radio. Ascent Dental Solutions has a focus on knowledge, education, development and training. Before we begin today’s podcast, I want to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his time and expertise, this podcast would not be available.
Today, we have another guest and his names is Eric Diffley. I have met Eric, and in full disclosure, he’s been associated with the company Cynosure which is considered the premier, and perhaps, one of the largest and best medical dental laser companies in the world. I can tell you that I was blown away by his knowledge, his expertise, but most importantly, his desire to suit the right products and services for me as a dentist and for other health care providers.
Eric, I thank you so much for taking time from your busy schedule to be on today’s podcast. Can you tell me a little bit about your company and the direction it’s going? I know there’s been a lot of exciting new things going on. And introduce yourself to our listeners.
Eric: Absolutely. And again, thank you both Doug and Kevin for having me. It’s an absolute pleasure and honor to be here. Again, my name is Eric Diffley. I work for the company called Cynosure which is out of Westford, Massachusetts. Cynosure has been around for 26 years. It’s in over 138 countries so we have a global and a national presence.
Started off as a very blue collar mechanic-like company with one laser out of a workshop and it kind of blossomed into this overnight success with different types of technologies. And how we got there, really, was build out and start with just one core and good laser. Had great results, great outcomes. Business owners and doctors truly believed in it and it helped grow their businesses. That allowed us to grow into the second, third, fourth laser.
We got to a point where there were other competitors that were doing thing very well, things that we admired and we wanted to grow with them. So there were three different points in Cynosure’s career where they actually purchased different companies. Those companies are Palomar, ConBio and Ellman, leaders in the industry that are now under the Cynosure umbrella.
And very recently, in 2017, Cynosure partnered up with a company called Hologic, who is a woman’s health and mammography company out of Marlborough, Mass, which has allowed Cynosure to grow into this billion dollar company that it is today. So what that means for its customers and our customer’s customers is that endless support, whether it’s from our clinical side, whether it’s from our marketing side, whether it’s from our research and development side. We want to provide our customers with the topnotch support and give them the best products possible.
Kevin: Eric, when I talk to dentists through my business consulting company, Ascent Dental Solutions, I was blown away by the continuing education courses that your company offered. You opened up a whole realm of possibilities and ideas to the dental profession that I really never thought about. I’ve been practicing for 35 years, I have 14 offices, about 160 employees and there’s almost no aspect of dentistry I don’t do. But for whatever reason, my own faults mostly, I never explored the extra-oral options that lasers could provide to the dental profession. I’ve been using intraoral lasers for well beyond 15 years and today, I’ve seen the ability of what your company and their products can do.
And for our dental listeners, please keep an open mind as we’re confronted over and over again with more PPO type of insurance plans, more paperwork, reduction in our financial returns on investment. For example, we do an amalgam, a composite, an extraction, whatever we’re doing intra-orally, there’s always an insurance plan that’s downgrading and making it more difficult to be profitable and putting more overhead on us. But in the field of aesthetics, what I’ve learned over the last two years, in particular with your company, is the incredible demand. Perhaps, you could talk about the aesthetic demand that your company has seen.
Eric: Absolutely. A big time for the aesthetic industry came around 2008/2009 when Obama Care was implemented and reimbursement rates really dropped. So it’s now see more patients and make less money. It’s such a tough industry now in the medical field, as you were saying, Kevin, is that the reimbursement process is just a pain. It’s a pain in the medical industry. It’s not what it was in many aspects 10, 15 years ago. So I appreciate you telling all of the listeners to keep an open mind.
I understand there are plenty of companies and sales reps that do like to say that they can make them money, but it’s really a business opportunity here to have these types of discussions and add these types of revenue streams to your office and to your business. What this comes down to is this allows any type of practitioner, doesn’t matter which field they’re in, specialty; family medicine, dentistry, plastic surgery, to make that income and focus more on their specialty with greater care. Going home at night knowing that they’re able to feed their family and are able to live a comfortable life, however, they’re still focusing on what they currently chose to do.
Kevin: That is exactly correct. From your market research and a company with your size and breadth of information, what would you say the largest demand is? Is it hair reduction and hair removal, is it tattoo removal, is it the reduction of fat cells or adipose tissue, a combination of all three? What would you say to our listeners that your company sees as the highest demand?
Eric: That’s a great question and that also leads into why Cynosure has this whole rapporteur or arsenal of different types of devices. It’s not a one trick pony. We do everything and we do everything very well. So whether that is tattoo removal, skin tightening, photofacial, body contouring, invasive, noninvasive, hair reduction, even dipping into women’s health, we have it all.
To answer your question, I would say that the noninvasive body contouring market as well as photofacial market is extremely high right now. Two reasons being for body contouring is that while liposuction is still a sort out procedure and everyone has fat that they’re looking to get rid of, no one anymore wants to go under the knife. It’s a let’s do it and let’s do it now type of lifestyle that everyone’s living. So with this procedure that we have called sculpture, it’s 25 minutes and it’s noninvasive and there’s zero downtime.
How the science works — to keep it simple — the laser heats up the fat cells to a point of destruction, apoptosis; when a cell dies off. And over 6 to 8 weeks, the lymphatic system flushes those fat cells off contouring the body.
And then photofacials; everyone has them, whether it’s a sun spot, blood vessel, telangiectasia, Rosacure, acne scars, stretch marks, all things of that nature on our face which we can’t cover up. And in our society, those are things that all bother us and those are why we’re coming out with these options or solutions that people are seeking very heavily.
Kevin: I can just tell the listeners that over a year ago, I had Cynosure come to my office. With no preparation, whatsoever, they just showed up and they brought their 1540, their MaxG, their MaxY and their MaxRed laser systems and IPL for Intense Pulsed Light systems into my office one afternoon and I had eight employees immediately ready to sit in a chair to have little nevuses or brown or red spots, what we call liver spots or sun damage for their face. I had others asking for hair reduction and hair removal. I had others wanting to have tattoos removed, and that go without any marketing, without any preparation. I was amazed of the number of employees that I had that were willing to just sit down immediately because they wanted the latest, the best and the most up-to-date technology to resolve their aesthetic wants and needs.
And perhaps me being a man, perhaps me not being abreast to the aesthetic demands that are out there, which is shame on me, the number of female participants that were interested in hair reduction rather than going through electrolysis, waxing, tweezing and sugaring and other aspects of the aesthetician background to reduce and remove hair, this was quick, it was exciting, it was fast, and it was extremely profitable.
Perhaps, Eric, if you were to say to the dental profession and they were considering getting into this field, what would be the first piece of equipment? Assuming they’ve had the appropriate training, they’ve got all the appropriate paperwork and things completed, what would you recommend for that dentist who’s interested in going down this exciting road?
Eric: Absolutely, that’s another great question. And that’s the honest conversation that we both had. We shut down and we talked about where you’re looking to go and how you’re looking to grow your business. So keeping it inside the realm of dentistry and facial work, we didn’t jump right into the body contouring for you, we stuck within those walls. So for any dentist that is looking to stay within their practice or their scope somewhat, I would recommend IPL or photofacial.
And again, it’s keeping that open mind. A lot of dentists that I’ve spoken to over the years here is that they correct smiles but I ask them, “Doctor, have you ever thought about correcting the smile on the outside? You work on the teeth on the inside, but let’s focus on the out.” And once you start to look at the bigger picture, you realize that a large portion of your customer and client base have these issues or concerns, I should say, that can be treated with photofacial.
And like you said, you had eight of your colleagues or staff members ready to jump on the table to get treated and I would bet you that six out of the eight of them were already having treatment elsewhere. It’s the type of industry where the people if they don’t see it, they won’t ask about it, but once you have a type of solution, they start to come out with all these problems.
And again, like we spoke, Kevin, it’s the type of procedure where you can take care of a patient and say, “Do you mind if I just take care of that little stretch mark or scar on your face?” Once you take care of that as a complimentary service to that customer, they will come back to you, (1), in good faith, and, (2), to say, “Now that that’s gone, I realized that I have these freckles or these melasma over here. Can we start treating that?” And that’s how you really start these procedures that they focus on one thing and once that’s taken care of, they start to realize that there were a couple of other issues or problems that they want to take care of and resolve.
Kevin: I think for many of our dental listeners, they are familiar with Ellman because they’ve been associated with the dental profession for quite some time. One of the things that Eric did for my personal dental practice was to introduce me to Ellman, which is radiofrequency, reduction of gingival tissues, coagulation of blood, the removal of fibromas, frenectomies, the list goes on and on, intra-orally. But I didn’t realize Ellman had attachments that would help with skin tightening, improving tone, texture, appearance. And it was quite interesting to me that I had the machine, I just didn’t have all the attachments. And with your company’s expertise, we were able to put them together and expand into facial photo improvements and texture tightness and appearance of the skin. And maybe you can discuss that in a little better detail.
Eric: Absolutely. Again, Ellman was a company that Cynosure acquired in September 2014. Ellman was the leader in aesthetic and radiofrequency technology. So Cynosure kind of looked and said, “Hey listen, we could probably come out with something pretty good or pretty similar, but we have the cash flow right now, we have the stable company that will allow us to purchase them and make them part of the Cynosure family. Let’s not reinvent the wheel here.”
Again, as you mentioned with the coagulation and soft tissue cutting, there’s a separate attachment that is radiofrequency and it stimulates collagen and elastin. And how it does that is that you heat the skin to a certain temperature and it’s attracted to water in the skin. So the more hydrated you are, the better result you’re going to get. And then over a series of treatments in weeks and months, the skin starts to become more unified as that elastin and collagen is reproduced.
Kevin: I can tell you through my own experience that the patients generally find it very, very relaxing and very comfortable. I won’t kill our listeners with didactic information, but basically, you’re using three or four different size heads, you’re placing a moisturizing cream or an ultrasonic type cream on the tissue and you’re heating it up to about 40 to 44 degrees centigrade, which is roughly between 102 and 105 degrees Fahrenheit. And for three to five minutes, you’re massaging areas of the face that your patient or client has concerns with.
It’s really like a souped-up on steroids facial that’s giving you long term much better results and much more cost-effective. Typically, your average facial makes you feel good and relaxed, but the long term success and improvements are minor, at best. Whereas when you start implementing radiofrequency, I can tell you first hand, you’re seeing a significant improvement in the tone, texture and appearance of the skin. And the clients have been extremely satisfied because they know the results are much longer lasting. And it’s just a very nice way to introduce your team members and your practice to the extra-oral aesthetic aspect of health care.
Kevin: Eric, I want to say thank you to you and your company, not only personally, for providing guidance, training and education. But before we close, can you just provide a little bit of information? This Pellevé, this radiofrequency device, on average, what would you expect the dental profession to have to invest to incorporate that particular system into their practice?
Eric: While our many different platforms range from different prices, it matters how you configure it as well, the Pellevé system will range somewhere within the 50, 60, 70 thousand dollar range, depending on how you get it configured as well. Because there’s facial attachment, there’s body attachment, and then there’s also a surgical component, that you mentioned, that you can add onto it as well. So there really is different configurations on pricing, but that is the ballpark.
Kevin: If you were to expand into Intense Pulsed Light or IPL, what would you say, again, in a range for the dental profession to consider investing in those types of procedures and equipment?
Eric: Again, it’s different configuration with our IPL device because there’s about five or six hand pieces so it definitely ranges. But you’re looking anywhere from $80,000 and it can get all the way up until $160,000, $170,000. But the point I like to make here is not that final price because there are a lot of times it’s a lease-to-buy situation. So what we break it down is a monthly cost, an ROI at that point. How many patients does it see to make that monthly payment? And generally, it’s anywhere from two to three to four patients a month, which seems pretty reasonable. Which bring it back to that perspective of it comes down to patients per month on how many you can treat, and then it’s a good business opportunity from there because they are cash-based procedures.
Kevin: Eric, I want to thank you again. I want to thank your company, Cynosure. I want to thank you from employees and team members on the wonderful adjunct that you’ve provided. I’ve actually, for our listeners, started another company called Ascent Laser Aesthetics with a focus just on extra-oral treatment to improve the overall condition of the skin and the contours of the skin. And I can tell you, at age 59, it’s put another spark in me and I’m excited and it couldn’t have been done without your expertise and your company’s support.
You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin and my company is Ascent Dental Solutions, with a focus on education, training, development and knowledge. Our guest today was Eric Diffley and he is the sales manager and business consultant for Cynosure and I can tell you my response to this company has been over the top. Their support, their care, their service and their ability to support me through this new education and training has been outstanding. Eric, thank you so much.
In closing, I want to thank Mr. Doug Foresta and his company, Stand Out and Be Head. Without his expertise, this podcast would not be available. Thanks so much and I appreciate your time and expertise again, Eric.
Eric: Thank you both very much. It’s been an honor.
Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.
Kevin: Welcome. This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions and it’s brought to you by Ascent Radio. My special thanks are always to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise, the over 80 podcasts that we’ve produce would not be possible. I’d also like to give a plug to Short Circuit Media and the owner of that, Mr. Aidan Crawford. His marketing skills have brought my dental and dental consulting business to the next level.
Tonight, I’m pleased to announce that we have a special guest, Mr. Kellen Kautzman. Kellen owns the company Send it Rising. It’s an internet marketing and he’s a manager of a team of at least 20 internet marketing professionals. One of his claims to fame is his first book Everybody’s Doing It, which was the number one new release on the CEO category of www.amazon.com. He was also the keynote speaker at Planet Hollywood on the Las Vegas strip and he’s spoken at various universities. He’s also been part o the Lance Tamashiro podcast. Kellen holds a master’s degree in education and has taught for five years before transitioning his career as an internet marketer.
As a health care professional with a business degree and 14 locations and a fairly large dental practice, I can tell you that at least the dentist that I know, Kellen, certainly are remise and have a lack of education and knowledge when it comes to internet marketing. And an expert like you certainly should be a great adjunct to this podcast. Thank you so much for taking the time to join this podcast.
Can you tell us what you think the biggest mistakes that health care professionals make when they try to market themselves, their services and their company?
Kellen: Sure. I would say that they forgot that they were once young. All of the amazing stuff that’s happening in internet marketing starts in that 16 to 20, 22-year-old demographic. That’s where Facebook started, that’s where Instagram is taking off now. And so all these things that will become dominant are now in the land of, “We don’t really have to worry about it.”
And so there’s this curious phenomenon that when we’re in junior high or high school and we’re asked to step in front of an audience, we can feel the perspiration and we can feel that anxiety. And the second, as adults for many of us, we have the opportunity to avoid those circumstances, we do. And so when it comes to YouTube, as a good example, this is now and aged platform on the internet, there is absolutely no excuse whatsoever as to why a dentist should not be making continuous content, video content, and placing it on at least YouTube.
Google, which the overarching company is called Alphabet Now which owns Google and YouTube, has artificial intelligence that is absolutely mind-bogglingly intelligent. It’s smarter than you and me combined and every other human on planet earth. It’s so smart, in fact, that it now speaks and understands English incredibly well. If you want an example of what this looks like, create a YouTube video, upload it and then click on the little CC icon, the little closed captions box that appears in the upper right hand corner once it’s uploaded. And what you’ll see is that within two minutes of the file being uploaded on YouTube, there is an automatic captions box that — with call it 98 percent accuracy — will tell you exactly what you just said.
And so for most dentists, as they attempt to get more patients through the door, they think I have to create blog content or I need to be posting more on Facebook. But the reality is that if you just stare into a camera and speak, all of those words are understood by the artificial intelligence and its job is to judge where your site appears in Google.
Google is still incredibly important in regards to getting patients through the door. If you rank for dentist, dentists, dental practice, tooth, whatever, you name the keyword, YouTube can get you there because in the description of the YouTube video, you can add a link back to your website. And for those of you that have studied any SEO at all, you know that a link is a vote and the more votes, the better.
Kevin: Kellen, staying with the topic of YouTube, with your expertise and your company’s background, is there a specific length of time that is suggested for, let’s say, a beginner like myself that’s interested in uploading content into YouTube? Is it 30 seconds, is it four minutes? What does the data suggest?
Kellen: That’s an excellent question and a good segue into YouTube advertising. If you’re not familiar with AdWords, look it up. Via AdWords, you’re able to create what’s called an in-stream video. In-stream videos are the yes, annoying videos that appear in YouTube prior to the video that you actually want to watch. Here’s the magic of in-stream videos; you’ve got six seconds before the patient, in this case, has the opportunity to hit the skip button. And so the great travesty is creating YouTube videos that in the first six seconds don’t say your name, don’t say your company name and don’t give your contact information. So if you move forward with YouTube videos, make sure that in those first six seconds, you’re putting out that information.
If you run these ads via YouTube, you don’t pay, and it’s bears repeating, you do not pay until the viewer gets to 30 seconds. Twenty nine seconds or less, it’s free. That is incredible. So when people are skipping those annoying ads, they’re actually doing you a favor because you’re walking away with free impressions. With the understanding that you will explore YouTube advertising which can be geo-targeted, so you can pick your area, you can pick your keywords, maybe it’s braises for kids, maybe it’s Invisalign, maybe it’s Fastbraces — that’s a new thing — whatever it happens to be, you’re getting them in via keyword and you’re getting them some good content.
That basically says don’t make videos that are less than 30 seconds. That will be a mistake. If you have 20 seconds and you’re throwing these ads outs, you’re paying when you get to 20 because the video is over. So at least 30 seconds and the rest of it, that’s art. Because I just released a book called Everybody’s Doing It and the video we just created is over 20 minutes, Kevin. Over 20, incredibly long. And as I was editing this video, I thought to myself, this is too long. I’ve never done something quite this long. I know it’s really good, I worked really hard on this, this is great content, I know it is, but it’s really long. Put it out there, so many people have told me that this is one of the best videos I’ve ever done. They watched the entire thing, they love it, it’s great, hurray!
So I can’t say definitively yes or no, but typically, our videos are in like the two to four minute range. Because if you even get close to kind of saying the same thing over and over again, people’s time is too valuable. Move on.
Kevin: In your expertise, Kellen, and in your company’s expertise, I know that content is incredibly important but you touched based on the artistic aspect of it. Do you get a better response when there is a music, do you get a better response when you’re using certain audio/video special effects, or do you just focus in and get the content out there, don’t mess around and just make it straightforward to your viewers?
Kellen: I think anything that prohibits you or stops you from moving the ball down the field should be avoided. So if you’re going to spend time trying to mess with this graphic and it’s been 45 minutes and you’re getting frustrated, forget the stupid graphic. What you’ll find is over time you will evolve incredibly. As an example, my first YouTube video, bad audio, lighting was rough, but now we’ve got the double lights, the condenser mic, the lapel, the double camera angles, the whole nine yards, it’s great. But you can’t get there just by — maybe you could do your research, but you get what I’m trying to tell you which is you have to grow into it.
There’s two pieces of the puzzle that folks should walk away with from the video production angle that are really sharp. If you’re unfamiliar with the vernacular picture in picture, think of a news anchor with a little box in the upper right hand corner where that just pops up, you can do that easily in almost any video editing software like iMovie. The other is a Kanban’s effect, which is the small pan into the video in or out or to any angle. With just those two things you can take a pretty boring video and make it interesting.
Kevin: Great information. Thank you so much for that. I can tell you that at least in the health care providers that I know, and I interact with literally thousands of them, most of us did not get any of this training in our medical and dental education. So most of us need to reach out to an expert such as you and your company to get help, get information and knowledge in how to pursue this. You touched on this a little earlier. I know with the podcast it seems to me that if we can continue to do podcast weekly, the following increases. Is there a repeat with YouTube? Would you suggest or did you mention earlier in this podcast that you felt weekly by weekly, monthly? What’s your recommendation for content?
Kellen: Consistent, that’s the hardest thing. It’s whatever pattern you want to establish, you want to stay on that. There’s a part of our brain that sounds like you’re going faster, it’s called the basal ganglia and it’s walnut-shaped right in the center, that old reptilian mind that fires when we’re on autopilot. There was an incredible study done where a gentleman had lost a part of his hippocampus due to a virus and so he had no short term memory at all and they put him in front of this board and they had him pick either A or B. And A, when he flipped it over, would be either green or red. If it was green, that was good, red was bad. Over the months, he just started picking the green ones. He had no idea why he was doing it and when they studied his brain, they found that this basal ganglia was firing.
And so when you start a new habit, know that whatever frequency you administer in the beginning is the frequency that will create that habit. You could drive yourself crazy and be like, “I’m going to do something every day,” and you could develop a habit. But guess what, other aspects of your life are going to make way for that habit. Succeeding could actually be detrimental to your practice. So just be very cognizant and assume you’re going to succeed. If I were to succeed creating, let’s say, a monthly podcast, would it be enough? Would it drive me crazy? Would I have too much on my plate? And so assume success and then get into that habit.
Kevin: Kellen, could you take a few minutes and explain to the audience about link building and how we go about it, what your suggestions are to help the health care profession improve their ability to community with their clients, their patients, their team members, etc?
Kellen: We can do a segue from YouTube links all the way into one of the pieces of a secret software which is Pinterest, believe it or not. In your YouTube videos, in the description you can add a hyperlink. It won’t turn blue and it won’t be a link if you don’t include the http://. If you forget that, you get no link. It’s very important to include that. So you can get a link from YouTube. There’s something called Google Search Console, it used to be called Google Webmaster Tools that if you have Google Analytics installed on your website you can easily install this. You’re literally about a minute away. So remember Google Search Console. In the backend of Google Search Console you can see how many links you’ve earned.
And this is important information, and there’s a bunch of other important information, but the reason I’m mentioning it is when I log into the backend for a couple of our websites, I see tens of thousands of back links from Pinterest. It’s almost as if Pinterest found me and not the other way around. So when I was looking at Google Search Console I went, “Whoa, what’s this?” And so I started digging into why this was happening.
What I found is that if you create an image that’s funny or interesting of shareable in any way, shape or form, for some reason, if you put that image on Facebook, you might get two shares, maybe. You put that same image on Pinterest, you might get 20,000. And every time — it’s called the Pin in Pinterest — every time this image, this pin is re-pinned, it duplicates the image and when you click on the image, it takes you to the website. So the image is the link, not your standard text link.
So start thinking about viral images. How could you poke fun of yourself as a dentist? What kind of stupid derail jokes, what kind of dumb dentist jokes could you throw out there? What interesting information could you talk about hygiene or the new tech that’s coming out or any of those things via images on Pinterest? A lot of people get confused here and they say, “Yeah, Kellen, but nobody’s going to come to my website from Pinterest.” I know that. I’m not under any impression that they will, but tens of thousands of links from a relevant social media platform will jump your Google rankings. And when those jump, the phone rings.
Kevin: That is just an eye-opener. I can tell you, I believe I mentioned, this is probably the 80th podcast and the information you’re providing myself and our listeners is just fantastic. Can you take a little bit of time and explain how we can reach out to you? How do you help us? What does your business do? I don’t want to put you on the spot, but do you do a formal contract, is it a consulting agreement? How do our listeners reach out and you help them improve their communication, their business and ultimately, their bottom line?
Kellen: As you mentioned at the top of the show, I used to be a teacher and so I come at this from a very different angle. We are as honest and transparent as it’s humanly possible and so we do month to month contracts. So if anyone’s interested in working with us, know that if it’s three months in and things are looking great, hurray! Wonderful! If they’re looking bad, we would be the first folks to tell you that they are. So no contract of any kind, none of that nonsense. We provide everything you’d expect: SEO paper click, social media, internet marketing, the whole line.
The book that I just wrote, that’s the easiest way to kind of start digesting our philosophy and what we’re all about. All you have to remember is Everybody’s Doing It. If you go to www.amazon.com and you punch in Everybody’s Doing It, I’m Kellen Kautzman, I’m the writer, hurray! It’s 15 bucks, no big deal. On Kindle it’s ten bucks. And then the audio book which, by the way Kevin, if you really, really just love hearing the sound of your own voice, let me recommend recording and editing your own audio book. It’s so much fun. Choirs of Angels, is just so much fun. That’s also out as well.
Kevin: Terrific. Again, I don’t want to embarrass you or put you on the spot, but can you give a range? What would it cost our listeners to participate with your company? Give us a ballpark or a range of what our commitment is. I know you mentioned there’s no contract, you can do it basically at will, but can you give us a range so we know what our investment would be?
Kellen: Absolutely. The smallest client we have is of $100 a month consulting, giving them direction, that’s great. Our median price is $700, our largest client is north of $4,000. So it just really depends. And these are wildly varying clients with wildly varying needs. That kind of gives you a sense. And then if anyone’s interested, the number is 702-263-0141. And I believe in transparency, I’ll give you my personal email address, just shoot me a mail. It’s Kellen@senditrising.com.
Kevin: I want to say a special thanks to Mr. Kautzman. Kellen, you’ve been a terrific participant, a terrific guest. The information that you and your company are providing I think will provide unlimited amounts of return on investment.
You’ve been listening to Dr. Kevin Coughlin, Ascent Radio. The name of my consulting firm is Ascent Dental Solutions, with a focus on knowledge, consultation, development and training. I hope you enjoyed Kellen’s podcast. The information that he has I can’t emphasize enough how it can help our bottom line. Any time we can learn to improve communication with our team members and our patients, it’s a home run. His book, Everybody Is Doing It has already been ordered by me and I would strongly recommend the rest of you consider this book. Kellen, thank you so much for joining today’s podcast.
My special thanks to Mr. Doug Foresta, his company, Stand Out and Be Heard. Without his expertise, this podcast would not be possible. And special thanks to Mr. Aidan Crawford and his company Short Circuit Media.
Kellen, thanks so much for participating and we look forward to speaking to you in the very near future and you can expect a call from me and my organization in the next few days. Thanks so much.
Kellen: Thank you.
Tonight’s podcast is one of many podcasts based on the business of dentistry. There’s always been a theme, as we approach our 75th podcast, in how do we relate the clinical aspects along with the business aspects of medicine and dentistry. I had mentioned in a previous podcast the importance of training, continuing education, knowledge, role playing. But one of the things that we had talked about in previous podcast were the use of audio and video in the office, not just for surveillance, not just to protect us from break-ins, but to use so team members can be trained. So you see how they operate, how they interact with patients and other staff members and then those video/audios can be reviewed, edited for training. Nothing is so powerful as seeing how you react in front of team members and your patients.
This podcast has a similar message and it’s something that I instituted at my company over 15 years ago and I refer to it as Quality Assurance and Quality Assessment. No matter what size your practice, no matter how many team members you have, I can tell you through firsthand experience that my company sees in excess of 116,000 patient visits in a 12-month period. That’s through 14 dental offices in western Massachusetts. And what I’m constantly looking for is something that’s repeatable, something that’s inexpensive, and something that, most important, is effective.
The quality assurance quality assessment forms can be done in many different ways. In today’s day and age, an electronic signing pad is a nice, efficient and effective way, but the most important thing are the questions associated with the quality assurance and quality assessment forms. Basically, question one is;
1. Was your patient happy with the care and service? Yes or No.
2. Was your provider on time for your care and service? Yes or No.
3. Did your provider discuss various options and fees associated with your care and treatment? Yes and No.
4. Would you refer a family member, friend or associate to this practice? Yes or No.
And then there’s a few lines for comments. I cannot tell you how effective and efficient this is to improve the quality of care and service in either your medical or dental practice.
In the beginning, we simply used small 4 by 3 tear off pads. At the end of each procedure, the patient was given this to fill out and the role playing would be something like this; Mr. or Mrs. Smith, I know you’re very busy, but if you wouldn’t mind filling out these four questions, we would greatly appreciate it. I would tell you that over 99 percent of the time the patient or client is willing to fill out the short quality assurance, quality assessment form.
The other option is to use an electronic pad and the patients fill out the same yes and no answers. The advantage of your electric pad is it’s immediately scanned and accessed into your patient chart if you’re computerized. When you do it on the tear off pad or paper situation, it is imperative that at the end of the day, those are scanned so that this information and data is in the computer.
I’d like you to think about the power of this. Again, with 116,000 visits plus each year, if we have a 95 percent success rate where patients are happy and satisfied, and five percent of our patients aren’t, that’s over 5,000 complaints in a 12-month period. That’s unacceptable, it will tear down your business and the results can be catastrophic if they’re not addressed. It is extremely difficult for Mr. or Mrs. Smith to bring you to litigation, to ask for money back, to bad-mouth you on social media when you can show that each time Mr. or Mrs. Smith came to your office they registered on the quality assurance and quality assessment pad that yes, we were on time, yes, they believe we solved their problem, yes, they would refer family and friends, and yes, we explained and introduced them to different options and fees. The power of that to protect you and your team members and to establish goodwill is critical.
If we look at it from the opposite end of the spectrum, when we do get a negative comment, and we certainly do in our business and I believe all businesses do, I can only tell you in my experience of a fulltime practicing dentist for 35 years and still practicing fulltime at this time, that the single biggest complaint that I have seen over my 35-year career is not being on time and keeping your client or patient waiting. Nothing is more frustrating and aggravating to not just your team members, but to your patients and clients than being kept waiting.
We all know in the health services that sometimes this can’t be helped, but my personal opinion is if you’re scheduling effectively and efficiently, and you manage your time effectively and efficiently, you can eliminate or significantly reduce this particular problem. When it can’t be helped, a simple straightforward, “Mr. or Mrs. Smith, I know your time is valuable. I’m so sorry I’m running behind. I will try my best to make it up to you. It just couldn’t be helped.” Acknowledge that you’re behind. Let the patient know that you’ll be with them. Don’t leave them in the exam room unattended. Don’t leave them so that they think that they’ve been forgotten. It’s a simple straightforward solution, just simply explain or have one of your team members explain the doctor is running behind, we’re so sorry and we will do our best to make it up to you.
The other issue that is critical is not only were we not on time, but the second biggest complaint that we get is no one discussed the fees. I cannot tell you when you’re seeing the volume of patient visits that we do, and quite honestly, it doesn’t matter what size your practice is, any problem that creates a negative review will have a negative influence on your overall bottom line, your personal stress level and a reflection on your team members and your organization.
When the patient says to you, “No one explained the fees or options,” that is a direct reflection on your organization that you have some serious communication issues. Many of the practitioners listening to this podcast will automatically assume that they being the doctors do not have to discuss fees. They will leave that to their front desk personnel. I cannot tell you that when you leave it to your front desk personnel, in many cases, the treatment and procedure has already been performed and at that point, it’s actually too late.
An example I use quite often during my training and coaching sessions is after the bottle of wine has been uncorked and you find out that that bottle was a couple hundred dollars, it’s really too late. You’d be much wiser, much better off, mostly likely not embarrassed and certainly, financially better off, if you knew before the bottle was uncorked that that wine was $200.
The analogy that I’m making here is what I see in office after office is procedures and treatments are completed and the fees are discussed afterwards. Never should that occur. In my opinion, it is a break of trust, it creates hardship and it creates problems for your team members and your organization. And in many times in my 35 years of experience of coaching and mentoring, in most cases, the owner doctor has no idea that this has actually even occurred.
The best way is ideally, Mr. or Mrs. Smith know before they’re scheduled what they’re coming for, how long it’s going to take, what the fees are associated with those services and procedures and the finances are taken care of before they’re ever appointed. However, in the real world, we all know as health care providers that things occur on an emergency basis. Things occur that we didn’t necessarily expect. We’re preparing a crown and we find out that the tooth needs a root canal in a buildup. We’re providing a root canal and we find out the tooth may be unrestorable and we’re doing an extraction, a bone graft and potentially, an immediate implant.
All of these potential clinical scenarios create financial hardship for patients and difficulties in the management of these financial arrangements because the services have already been started and in many cases, these services are irreversible, the patient is left with a bill that you may or may not know. But in most cases, they will be upset and unhappy because they weren’t aware of the overall cost and out of pocket expense to them. I strongly suggest that the individual, whether it would be a dental hygienist, a dental assistant, or preferably, in my opinion, the dentist or health care provider, simply explain to Mr. or Mrs. Smith the fees for these procedures are going to be X.
Again, in my own experience, looking at literally hundreds of different practices over 35 years, I don’t understand why providers don’t assess and give an estimate that’s higher. I have never, in my 35-year career, had a person complain that I quoted them one fee and I charged them something lower than that fee. However, almost on a day-to-day basis, I can find complaints in my own organization where someone was quoted at a fee of $105 and the bill came to $135 and the patient is aggravated and upset. And typically the response is, “If I knew it was going to be that much more money, I would have selected a different treatment or I wouldn’t have done the treatment at all.
For those individuals who are not doing quality assurance and quality assessment, I would strongly recommend that you check my website www.ascent-dental-solutions.com and take a look at some of these forms. Also you can find them in the three books that I’ve published along with my electronic books, this information is there. You can customize this to fit your own needs, but in my opinion, if it’s going to take Mr. or Mrs. Smith more than 30 seconds to a minute to fill it out, you may find that it may not be as effective. I can tell you with almost 99 percent assurance, our quality assurance and quality assessment forms get filled out. And I can tell you at the point of service to solve the dissatisfaction is absolutely imperative.
In some cases, because of time constraints, procedures that we’re doing, we can’t always, at the point of service, resolve Mr. or Mrs. Smith. But I can tell you, practicing 35 years, an evening does not go by where I don’t make a phone call to Mr. or Mrs. Smith and the phone call goes something like this, “This is Dr. Coughlin. I’m very sorry to bother you. I noticed your quality assurance and quality assessment form was less than ideal. I want to first say I’m sorry and I apologize for the dissatisfaction. If you have time now, I’d like to discuss it. If not, we can make a time or an arrangement later on during the week to address it. I want you to know you have my severe apologies and I will do everything in my power not to let it happen again.”
I hope you’ve enjoyed this podcast. You’ve been listening to Dr. Kevin Coughlin, my company, Ascent-Dental-Solutions, with a focus on education, knowledge, training and development. I look forward to speaking to you soon. And my special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard, for his expertise in creating this podcast, and Mr. Aidan Crawford and his company Short Circuit Media for making this material available on my website www.ascent-dental-solutions.com.
Thank you, again, for listening and I hope you have a pleasant evening.
This is Ascent Radio. You’re listening to Dr. Kevin Coughlin, owner and producer of Ascent-Dental-Solutions. I welcome you to this evening’s podcast. But before we begin, I want to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise and knowledge, this podcast would not be possible. So I want to say thank you to Mr. Foresta and his company, Stand Out and Be Heard.
Ascent Dental Solutions, provided by Ascent Radio, is focused on knowledge, development, training and education. Tonight’s topic is how do we make our organization better? All health care provides, and in my opinion, all businesses, have similar issues. How do we provide an outstanding amount of care and service while staying on time, staying under budget and providing the level of professionalism that is necessary in today’s competitive market?
I’d like to share with you something that I’ve implemented in our practices in western Massachusetts. It’s a combination of audio/video. It actually happened like most good ideas as more or less an accident. I was looking for the opportunity to protect our facilities from robbery and theft and break-ins and that morphed into the establishment of audio and video cameras in every one of our operatories, in our reception rooms, in our front desk areas and in our consultation areas. What this turned into is an excellent training facility.
But before you jump out and buy the latest and best, understand a couple of things. First and foremost, initially, the team members in our association were not comfortable being taped, audio and video. They felt it awkward and uncomfortable. Through training, knowledge, education and information, it became clear that these tools offered in a unique way to evaluate group practices and how we interact, not only amongst ourselves, but with direct patient relationships. I must tell you that the offices have signs that inform every patient that the facility does have audio and video tape running.
It’s also important to understand that these audio and video techniques provided extraordinary information and feedback to me and my partners as we evaluated how we collected money at our front desk. How those front desk individuals interacted with patients. How did they ask for financial arrangements? How did they schedule appointments? How did they create an optimal experience for the patients so that they became what I call raving fans?
We would then be able to clip on our computer system snippets of anywhere from 30 seconds to 46 minutes of various areas of front desk training, hygiene training, interaction among staff members during team meetings and how doctors interacted with patients. And it was quite interesting to see not only the verbal skill and communication and how drastically improvements were necessary, but the body language that occurred between clinical practitioners and the patient base. It was also very interesting to see how patients related to specific providers.
All in all, I would say it has been an extremely positive experience and I would recommend it strongly. I would tell you that it is critical not to force the audio/video situation on your team members. I would suggest you start with a meeting and explain the reasons for implementation. That you assume, and I believe assume correctly, that when people know that they are being video-taped and monitored, they generally tend to be on their best behavior. In my own personal experience with 14 dental offices, I found that less than a couple of weeks, most people completely forgot that they were being audio or video taped.
I could tell you that there are also subliminal advantages, underlying results that were brought to myself and our organization. And that was when patients behaved inappropriately, when patients said things that were inappropriate, it was to our advantage to have this information on audio and video tape. So many times in my 35-year career, I’ve had patients say, “No one ever explained this to me.” “No one ever told me about this.” “The doctor was unprofessional with me.” “The doctor did not explain things in its entirety or correctly.” And a view of the audio/video tapes, in most instances, not only show that the providers did a good job, they did an excellent job. What we found is that there were a variety, various, however that could be improved upon.
I strongly suggest that after reviewing hundreds, if not thousands of hours of audio and video tape, that practitioners made a better impression when they were eye-to-eye with their patients, rather than them standing and the patient sitting. I also found that patients seemed to interact better when there was a distance between the practitioner or team members and the patients. And generally, once you got more than two or three feet close to the patient, there was generally a sense of discomfort and an awkwardness. So I suggested that we maintain a safe zone of between three and six feet during discussions, treatment planning and education and training.
I can also explain to you that during staff meetings, we found that there was an enormous amount of wasted time. We found that certain individuals took up most of the valuable time during a team meeting and evaluations of the team meeting provided documented records of what needed to be addressed in the following team meeting and those areas that weren’t addressed completely in the previous team meetings. There were so many advantages and so few disadvantages.
In actuality, perhaps once every two weeks, a patient would explain that they were uncomfortable being audio/video taped while having procedures done or during communication with team members. In cases like that, we simply shut off the camera in that operatory.
I would also tell those interested in considering these training options to make sure on their medical history form that they place that the organization or office is monitoring audio and video so that all parties are aware and it’s written and signed in the patient chart or electronically signed in the computer.
I would tell you that there were some basic questions that have been asked over the last ten to twelve years of us doing this in our organization. And that is why is it necessary. And I hopefully have made it clear in this podcast that it’s necessary for the protection of your organization and to provide the highest level of care and service.
(2), as an owner, in most cases, you’re busy on a day to day basis. You don’t have the time to oversee all the little nuances that are occurring in your general practice or specialty practice. The ability to sit at the end of the day and review complaints, address complaints and also to provide positive reinforcement on things that you saw that were done in an exemplary manner provide tremendous positive background and tremendous positive feedback to your team members and that, in essence, provides an excellent outcome.
After 35 years of providing all sorts of general dental and specialty care in our 14 locations, I have experimented and implemented a variety of different office policies and procedures. In my opinion, the audio/video has been one of the best and most cost-effective of everything I’ve done.
I hope you’ve enjoyed today’s podcast. You’ve been listening to Dr. Kevin Coughlin and Ascent Dental Solutions sponsored by Ascent Radio. Special thanks to Mr. Doug Foresta and his podcast company, Stand Out and Be Heard. I hope you’ve enjoyed this evening’s podcast and for additional information, please check out the website www.ascent-dental-solutions.com.
Thanks so much for listening. I look forward to speaking to you in the near future.
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