Podcast: Tips for recent dental graduates

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of healthcare and the business of healthcare. And now here is your host, Dr. Kevin Coughlin.

Welcome. Today’s podcast is brought to you by Ascent-Dental-Solutions. You’re listening to Ascent Radio and my name is Dr. Kevin Coughlin.

As always, I’d like to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise in podcasting none of this information would be available. I also would like to thank VOCO. VOCO Dental Supplies provide some of the topnotch, best supplies in the dental business.

VOCO has been sponsoring Ascent-Dental-Solutions and my thanks go out to their company and their support in providing information to the dental community.

Today’s topic is from dental school to a dental practice. Twenty questions to get your career going in the right direction. My name is Dr. Kevin Coughlin. I have 14 practices here in Massachusetts with 150 plus employees, 23 dental associates and I’ve been practicing general dentistry for the last 34 years, and still practice to this day, and actually was practicing a few hours ago.

So the trials and tribulations that I deal with on a day to day basis are coming from personal experience.

But today’s topic, if you’re interested in hearing more, you can go to www.ascent-dental-solutions.com, sign up for our program and we have a free webinar offered June 26th at 6:00 pm EST. That webinar will go into greater detail about the trials and tribulations of being a recent grad and looking for that first job. Also, this ties in for the senior dentist, knowing what that new graduate is looking for so that both parties end up with the best results.

Let’s get started. First, as a new graduate, you must actually have some kind of background and understanding of where you’d like to go. Your options are generally as follows: you can start in a solo practice on your own, you can join a solo or group private practice, you can consider your corporate options such as a DSO or Dental Support Organization or MSO, Managed Support Organization.

The difference between the two is, in general terms, the Dental Support Organization is backed by dentists, owned by dentists, controlled by dentists. The MSO or Managed Support Organization is generally backed by venture capitalists equity groups.

And although the probably would like to think that the dentist is in control, in general, like most business, the people who put up the money and are paying the bills are generally in control. That would be up for further discussion in a follow up podcast.

But to stay on topic today, what I really would like the new graduate to look at and to consider is to determine what course is best for you. Think about dating. Think about marriage. If you decide that you’d like to have a different partner every six to eight weeks, if you like to play the field, if you’re not really interested in children or settling down, then probably a marriage would not be the best opportunity for you.

In business, ask yourself the following questions;

  1. Would you prefer to handpick your employees, yes or no?
  2. Are you good at networking, meeting new people and marketing your services, yes or no?
  3. Do you have a clear and unique vision for the type of dental practice that you want to create, run and manage, yes or no?
  4. Are you comfortable developing policies and procedures for a wide variety of topics, not just clinically but business-wise for your practice?
  5. Are you passionate about creating a professional environment and surroundings?
  6. Do you have an idea or goal or vision of what you’d like to see your practice and how you’d like to treat your patients and provide care and services?
  7. Are you willing to invest the time it takes to get started? In general terms, in my 34 years of practicing dentistry, I have found that it takes between six and 18 months before your business starts running a profit. And for the new graduate, you must understand the trials and tribulations of not being on a guaranteed income. The risks that not being on a guaranteed income create for you and your family.
  8. Are you comfortable being financially frugal for at least some period of time? Because in those growing years, there’s tremendous risk and there’s tremendous trials and tribulations until your processes and procedures are in place and your patient flow is in order.
  9. Are you interested in handpicking your equipment and your employees?
  10. Do you have a distinct idea of what you want in an employee and in an equipment and supplies?
  11. Do you enjoy and have the self-knowledge and acumen to make business decisions, whether that’s deciding whether to lease or purchase, whether it’s deciding which insurance plans or third party players you’d like to join or not join?
  12. Are you flexible with the location and the community in which you’re willing to work?
  13. Is having a commitment and a tie to the community important to you?

If the answers to those questions are yes, then then more than likely, your personality profile will fit ownership; buying an existing practice, running it and controlling it yourself. If the answers to these questions are no, then in most cases, you would probably be better off considering some kind of corporate entity or group practice where you’re more or less an employee.

And by all means, there’s nothing derogatory with being an employee. Some people actually are much more happy just focusing on their clinical care and treatment and letting the trials and tribulations of running a small or medium or large size business to people who may have better business training, better knowledge and expertise in these areas . So please, don’t take this podcast out of context.

My personal opinion is based on your personality, your drive, your fortitude and what you’re looking for in the ten to 20 questions that I just posed, will probably help you decide whether you really like to be in business for yourself or you’d rather have someone else be in charge of those types of decisions.

I cannot emphasize how critically important coming to that conclusion and answer within yourself will drive you in the correct direction and make your business and personal life so much more comfortable and in my opinion, so much less stressful.

So think about those questions and consider the podcast on June 26th at 6:00 pm for additional information when I’ll go into greater details with Mr. Steve Parker, the CEO of Excellence in Dentistry and also the producer with Woody Oakes, Dr. Woody Oakes of The Profitable Dentist Magazine. I cannot emphasize the importance, again, of asking these questions, reflecting on them and having them determine the direction that’s best suited for you, your family and your personality.

Once you get through with the direction, you must then consider, what are the options for developing and purchasing a solo practice? In this short 20 minute podcast, I could generally tell you these are some of the things that you should consider. You should be able to obtain the last three year tax returns from the office that you’re interested in purchasing.

For this hypothetical example, assume that the average is $1 million. I will then tell you in general terms, somewhere between 35 and 60 percent of that fee would be the purchase price, excluding any real estate. That would be generally 80 to 65 percent would be associated with goodwill and the balance would be accounts receivable, supplies and inventory.

Just as a general rule, anywhere between 35 and 65 percent of those average three years will be a ballpark figure of what I think will be a relatively fair acquisition for the practice. The reason there’s such a broad range between 35 and 65 percent is the practice that you’re considering, is the existing owner going to stay with the practice or are they going to leave the practice immediately, or in some timeframe in the next 12 to 24 months?

The longer the existing owner is willing to stay with you, in my personal opinion, the higher the percentage and the more valuable the practice would be for you. Because more likely than not, the goodwill that you’re paying for you’ll actually get value for. More than likely, the staff will stay with you. More than likely the majority of patients will stay with you.

When you make this acquisition into a solo practice and the existing owner plans on leaving the practice relatively soon, then my personal experience over three decades is that approximately 30 to 40 percent of the patient base will be lost and approximately 50 percent of the staff will leave within 12 months. And that’s because they haven’t had a chance to adjust to your philosophies, your process and procedures.

Taking a look at the next option, which is joining a corporate entity, I think you have to understand some of the basic business principles. When you’re joining a corporate, whether it be a DSO or MSO, understand one thing; it is a business and they have investors and they must provide a return on their investment to those investors. If they don’t, then that equity group has made a bad decision and in my opinion, very seldom do they like making a bad decision.

Knowing that, the first thing you have to understand is in most cases you’ll be compensated on either a production or collection basis. Right now throughout the United States, anywhere between 25 and 35 percent of net collected money is generally considered a realistic compensation package. In many cases, these corporate entities will want you to pay between 25 to 100 percent of your laboratory bill.

In most cases, they’ll be willing to offer you some kind of continuing education package, some type of 401k profit plan. In most cases, they won’t contribute to their profit plan, but at least it would be managed and maintained and be a vehicle for you to put in pre-tax dollars. In many cases, they will pay for your malpractice insurance.

And for the new graduates, generally you can expect the malpractice cost annually of anywhere from $1,800 a year to about $5,500 dollars a year, depending on the procedures, your background and training that you’re implementing.

I cannot emphasize enough that from my own personal bias, owning something, in most cases, offers the greatest likelihood of financial success. Obviously, there are exceptions all over the place, but my personal opinion is for the best financial success I would guide the new graduate to consider ownership.

Remember, for those novices, when you don’t own the majority or 100 percent, many times the decision processes will be made by other people. So you may share in the profit, you may have ownership, but the decision process may be out of your hands because the majority or principal ownership is owned by other entities, other individuals. And that may or may not be something for you to consider.

In the end, corporations that offer MSOs and DSOs, they offer you a work-life balance. As I like to say, they paint a tremendous picture of how you can go home at night with less worries and stress, focus in on what you’ve learned over the last four to six years of dental education and provide excellent high level care and service to your patients, which in my personal opinion as a healthcare provider, should be the number one goal.

What you give up is control. What you give up is the autonomy to take your business, your patients and your practice in the direction that you think is best.

That corporation may in the back of their mind want the best, but they have a different strategy and different obligations. Their obligation is to minimize expenses, maximize profit. So in a specific period of time, usually between three and seven years, they’ll plan on selling that asset and move on to another category of assets or perhaps in an entirely different business direction. And the new owners may have similar or different wants and needs. So you must understand that you may have to be flexible because what you like now, three to seven years down the road may be entirely different. It may be better, but it could also be worse.

When you’re in that solo practice or group practice that’s owned and provided by dentists, many times you’re on like minds. You have a similar idea, you’re more focused on quality control, you’re more focused on long term relations and you’re more focused on building long term relationships and business processes and procedures that will prove over the test of time. You’re in it for the long gain.

I always say that these are difficult decisions. They need a process and a procedure. You need to really think long and hard about what makes you tick. And once you understand that, you’ll make the correct decision, or most likely the correct decision, to move in the direction of solo and group practices controlled and owned by dentists or corporate dentistry that are generally managed and run by VCs, business men and women that may or may not have a similar strategy that meets your wants and needs.

Like everything in life, there is no 100 percent guarantee in any route. Each of us in our dental profession have strong beliefs and desires about what corporate dentistry is and is not, and what private practice is and is not. And after 34 years, my personal opinion, again, is your personality, what makes you tick will determine whether one direction or the other direction is best for you.

I’m planning in going into greater detail on the upcoming webinar this June 26th at approximately 6:00 pm at night. Please go to Ascent-Dental-Solutions, in that website to sign up. I look forward to going into greater detail with Mr. Steve Parker and I hope to be able to answer questions online.

Please feel free to submit them to Ascent-Dental-Solutions so that I can, perhaps, address some of these questions ahead of time and be prepared for them.

You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin. And again, special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard.

Podcast: Chris Collins on building your dental brand online

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: Good afternoon. This is Ascent Dental Solutions. You’re listening to Ascent Radio. My name is Dr. Kevin Coughlin and I want to thank Doug Foresta. Without his expertise and his business, Stand Out and Be Heard, we would not be able to have this podcast on a weekly basis. Doug, thank you so much for your expertise and your knowledge in podcasting.

I also want to give special thanks to VOCO. VOCO has also been a sponsor of Ascent Dental Solutions. VOCO is a German company with headquarters in South Carolina and they provide over 210 different dental products to the dental market. These products are excellent. They can compete with any brand and their care and service to my organization has been exceptional. Thank you, VOCO, for your promotion.

Today, our guest is Mr. Chris Collins. Chris is a web designer, a graphic designer, a creative freelancer. He works with entrepreneurs, small businesses around the world to help their businesses grow and start their dream products.

In full disclosure, the logo for Ascent-Dental-Solutions, which focuses on knowledge, consultation, development and training, was produced and done by Chris. Chris, nothing but positive reviews for my logo. I want to thank you very much.

How can you help the healthcare profession, but dentists in particular, improve their branding? What are your suggestions and recommendations? And is branding even important for a solo practitioner or a small group practice or large group practice?

Chris: Thank you for having me on and thank you for complimenting me about the logo. It was a lot of fun to make and I’m glad that you got good feedback. I think branding is of the utmost importance for all businesses, dentists and healthcare alike. We’re living in an age where folks can pick and choose a lot of different options and the world is at their fingertips on the internet. A quick Google search away they can find many different options, get in the car and go to many different practitioners, dentists, anything.

Having very strong branding, I think, is quite important because a lot of people make their decisions based on what they see online or what they see in print and sometime it just comes down to do I like the look of this business? You want to have it be consistent as well.

I see a lot of businesses thrown around different materials both online and in print and in person that don’t really give a cohesive and consistent look into what their business is all about. So I think that branding can really help with that and especially logos and flyers, advertisements, all those things.

Kevin: In your research, Chris, in your opinion, from the general public standpoint, what is probably most important in our listeners, or let’s just say our patients or clients? What are they looking for that, in you research, is most important to the physician or dentist in healthcare? What are their patients and clients really looking for?

Chris: I think it depends on the person who’s looking. I think there are a lot of different aspects to why someone would pick a certain business. So the way that you present yourself, both online and in print through marketing of any kind, is very important.

So you want to kind of cover all your bases and think about the type of audience that you have or the type of customer base you have. You want to look at the reviews you’re getting online, which are very important, and see what people are saying. You want to take a look at your competitors and see why maybe they’re getting more business than you are. And use marketing and use the internet and social media and design to your advantage.

Kevin: I’ll share with the listeners a story that just happened to me last week. I started business in 1983. For those listeners, we have 14 offices, about 150 employees here in western Massachusetts. I’ve been doing double trunk ads in the Yellow Pages back in the early 80’s, radio shows, TV, all kinds of different marketing. Recently, one of the individuals associated in our business thought it might be sought of comical to do a TV ad where the doctor is actually holding a carpenter drill and that drill is held in the hand like they’re drilling on a patient’s mouth.

The objective, in my opinion, was to lighten up the advertisement, to add some humor. The negative feedback from that, in my opinion, was astounding. In other words, I spent 34 years building a state of the art practice with the highest levels of efficacy, service and care, and in a 60 second pitch you sort of defeated almost all of that in such a short period of time.

I know that the intentions were positive, but the results, in my opinion, were less than positive. And certainly, the feedback that I’ve heard from individuals like, “Dr. Coughlin, what was the idea of having that old-fashioned drill? That scared me.”  Et cetera, et cetera.  

I learned firsthand how something unintentional can have very intentional consequences.  It could have happened to me, it could have happened to any of our listeners, but I would be very cautious on how you present your business and yourself and the points you made, also depends on the individual clients that you’re promoting.

My particular expertise is you generally have three categories of patients or clients. You have those gold card patients that have no insurance. They demand the highest level of care and service. They have the financial means to get that care and service. They can be extremely demanding and want only the best.

Then you have the other extreme that are many times under subsidized government plans. They generally pay for no care and no service. These are subsidized by taxpayers and generally their treatments are dictated by government agencies. In other words, they only pay for certain procedures and processes, not everything.

Then the vast majority falls somewhere in the middle. They’re looking for the highest level of care and service, but it has to be affordable for them or at least terms have to become available for that affordability so they can get the care and service they’re looking for. In your professional opinion, with those three basic marketplaces, do you see anything particular in a brand that works better in one area rather than another?

Chris: Yeah, I think it goes without saying that I’m learning something. Thank you for telling me a lot about this. I don’t know too much about dental industry, but that makes a lot of sense that those three exist and that you may want to look at them in a different light. I think that yeah, your branding can definitely differ.

If you have someone who has a lot of income to spend on this and is basically paying for things out of pocket, if I’m understanding that correctly, they want to know that the quality is there. And maybe the price isn’t as important, so they want to see all the options. They want to be impressed by what you have to offer.

Whereas other folks really want a kind of down to earth, very comforting like you come in, we are not going to cost an arm and a leg, we’ll take care of everything for you. Your insurance will be accepted. Everything is going to be easy and painless.  And they may not want to be scared away by the big ticket items that they may want but they just can’t afford.

I’m not sure if that answers your question, but branding can do a lot and marketing can do a lot to discourage folks from coming if they only are interested in one thing, say price, or it can encourage people if they’re interested in more. So you can’t ignore those aspects of marketing and let customers fall through your fingers or be scared away.

Kevin: Chris, take us through the process. For those listeners thinking about hiring you or just trying to gather additional information, what is the actual process where you educate the healthcare professional in how to create a brand, how to market that brand? What are the actual steps and the time that’s associated and potentially the cost of creating a brand that’s going to be successful in the short and long term?

Chris: It’s different for everyone and I think that’s an important part of my process which is every business and every person and every entrepreneur has a story. I really liked hearing your story about the failed TV ad, that was really interesting to me. So if I were meeting with you or any other business, I would want to hear your stories first and usually within a few minutes, I get a very clear idea of what the business is like and what the person is like and the kind of customers that they get, and more importantly, the kind of customers that they want.

It’s usually very clear quickly what their target demographic is and what their business is all about. It’s funny that in such a short time I can get that information.

People, when they start speaking about their passion, project or their business or whatever we’re working on, it becomes clear that they are interested in a particular demographic. There’s a particular vibe, I guess. And that’s one of my strengths, I think, is seeing right away the type of business and the direction that they want to go in.

From there we kind of know who they’re looking for as a customer and we can kind of drill down what has worked in the past and what could work. And a lot of times what they’re doing now they may know I want to attract this kind of customer to my business.

But everything that they’re doing in terms of branding or marketing isn’t really attracting that type of person. So we can kind of look at it and say, “Why don’t we start here? Why don’t we design a brand that speaks to those people?”

First we may start with the logo. Website is of great importance. Do we want to do advertising? Do we want to do social media? Are you thinking you’re going to be getting a lot of new customers from the internet? If so, we probably want to spend a lot of time thinking about SEO, which is Search Engine Optimization. So I do pretty much all of that for my clients.

They could start with just an idea and by the end of working with me we have a logo, we’ve got a website, we’ve got a whole plan going forward, we’ve got a store online. Whatever it is they want, I guess in your case it wouldn’t be a store, but we can do it all. It really starts with the vision that they have.

Kevin: Nationally, the United States, the average dentist has revenues depending on who you’re quoting and the data you’re looking at, of anywhere between $800,000 and $1.2 million. And as a general rule of thumb, the marketing budget for that is between two and four percent.

So basically speaking, if we took $1 million and we said five percent, you have roughly a $50,000 to $ 35,000 budget yearly. Are those dollars adequate to create the expertise that you have for, I hate to use the word average practitioner, but to give our listeners some down and dirty information so that they can help process the information and create the right processes and procedures that work best for them?

Chris: Yeah, I would say that’s adequate. I know that all businesses are different and I pride myself and I hope other people in my profession do too, on working with companies of different sizes. I really like working with small businesses as well as larger businesses and entrepreneurs.

Typically, to create a brand and a website and just to get it all started online, which is the biggest part of my business, usually costs less than $5,000 at least for a basic but beautiful website. That leaves quite a bit for, I would suggest, advertising.

I don’t know if you want to talk more about advertising, but advertising using Google is an amazing tool. You talked about your television ad, but nowadays you can target your ads; who is searching for a dentist within five miles of this particular location?

So you can really drill down and you’re only paying for it when people click on your ad and go right to your storefront or your website or you’re paying only when people call your business. So you’re really drilling down to potential customers. You’re drilling down to I’m paying for when people call, new customers call. And then you can work with your staff to make sure that hopefully they make the appointment and you get a new client or customer.

Kevin: I can tell you from my own 34 years of experience owning a small business and building a small business that there’s two things our listener should consider. One, getting them to call the office. How do you get them through that front door? But equally, if not just as important, if you screen, your profile, you evaluate the calls coming in, the single biggest question that we get day in and day out, is do you accept a dental insurance?

Since the vast majority throughout the United States has some kind of dental insurance, for the vast majority of dental practices, they would be marketing to an insurance based clientele.

And no matter how great the brand is, no matter how much the patients love you, at the end it many times comes down to dollar and cents for the vast majority of patients. And the question that we’ve been charting for years, and that single one question is, do you accept our plan?

For our listeners out there, please make sure you know the dental plans that you’re accepting and not accepting. Because you can have a hundred calls in a week, but if I’m correct — and I believe I am — that they want to know, is the procedure covered, do you accept my insurance, and the answer is no, then you may be paying for a click you may be marketing. And really I think for the vast majority of healthcare professionals, certainly in the field of dentistry, certainly your easiest clienteles to deal with, your most profitable clienteles are those that are fee for service.

You don’t need ancillary team members to process claims, call insurance companies, hunt down those finances, determine what’s approved and what’s not approved, what would be paid for, what’s not paid for. So those individuals that don’t have insurance, in my personal experience, those are the ideal, best clients for your practice to build the most profitable and successful business.

For all of us we probably have to meld these different groups of clients in there and I would caution you to make sure your front desk team members, your patient coordinating schedulers know exactly what plans are covered, what plans aren’t covered and what kind of dollars would be generated from the procedures that you’ve accepted in those plans. And if not, you many times find out you’re seeing plenty of patients but you’re losing money month after month because the plans that you’ve signed up for are no longer cost effective.

I’ll give you a quick example. The state pays $14 to provide inhalation sedation. And I’m saying to myself, if it’s costing me $100 to get my nitrous oxide tanks filled and I’m being reimbursed $14, you don’t have to be a mathematical wizard to find out that this is probably not a profitable procedure for you and your staff.

We’ve got a few minutes left and Chris, if people were trying to find you, if they wanted to get out there and give you a call or send you an email, what’s the best way to contact you?

Chris: I would say, just go right over to my website which is www.chriscollinscreative.com. My brand is Creative. I was going to mention, if we do have a minute, about what you just said. You can be very creative about getting in front of some of these problems that you had.

You said a lot of people are asking the question, do you accept my insurance? If I heard that from a client, I would say, this is maybe something you’re wasting a lot of time on answering that question, maybe saying no, maybe saying yes. So we should have on the website a very easy to spot place where that question can be answered right away for them.

In terms of the advertising, you’re right. You don’t want to be paying for a click from someone who may not end up being customer, so why not create advertisements online that cover those basics? I know when I’m searching for a practice I may say, who accepts in the western Mass area, my insurance. That may be my search online. And you can profit on that by creating an ad that targets people who are searching for just that.

So you could have a series of ads that are targeting folks who only accept the types of insurance that you accept. Or if you’re looking for people who don’t have any insurance because they’re the better customers, create ads that look for folks who don’t have insurance. So there’re a lot of ways to do that.

Like I said, my website is www.chriscollinscreative.com. So if you’d like to find creative ways to get more business, that’s pretty much what I do.

Kevin: Chris, it’s been a pleasure for you to take your busy schedule and speak to us on today’s podcast. Again, my personal thanks. The logo you developed and the assets that you’ve helped me with in developing a brand for Ascent-Dental-Solutions has been instrumental in providing success. Thank you so much. And again, for the listeners, it’s www.chriscollinscreative.com. Thank you Chris so much for your expertise.

And I want to thank Mr. Doug Foresta and his company Stand Out and Be Heard for the production of this podcast. Week after week he spends his expertise and time to put out the best product available.

You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin and the knowledge, understanding, education and training of Ascent Dental Solutions is paramount.

And I also want to end by thanking VOCO for their expertise and their help in sponsoring this information to get out to the healthcare profession and businesses in general.

My name is Dr. Kevin Coughlin, thanks so much for listening and I look forward to speaking to you very soon.

Podcast: Jeff Rock on the benefits of LinkedIn for dentists

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of healthcare and the business of healthcare. And now here is your host, Dr. Kevin Coughlin.

Kevin: Welcome. This is Ascent-Dental-Solutions. You’re listening to Ascent Radio and my name is Dr. Kevin Coughlin.

Before I begin the podcast, I’d like to thank VOCO Dental Supply Company who has been providing sponsorship for this. They are one of the world leaders in some of the best dental products available for the clinical treatment of our patients, which is perhaps, our most important asset. I’d also like to give special thanks to Mr. Doug Foresta. He is the owner of Stand Out and Be Heard and without his expertise none of this podcast would be available.

I’m pleased today to introduce Mr. Jeff Rock. Although most of our listeners are dentists, we have business leaders and business people all over the world listening to this podcast. And I’m fortunate enough to have Mr. Rock, who is a story activist, a career coach, a personal branding consultant, speaker and workshop leader.

I’m fortunate to have Jeff today in particular, talk about LinkedIn and how it can affect our profession, how it can affect actually all businesses. You think after 34 years of operating a small business and owner of 14 dental practices and 160 employees, I would know more than I do about LinkedIn. That’s why I asked Jeff to speak today.

Mr. Rock, thank you so much for taking your valuable time to talk to our audience today. Can you just tell us what you think some of the best attributes of LinkedIn is for our audience.

Jeff: Sure, and please call me Jeff. I’m really glad to be here talking with you today, Kevin. I’m a big proponent of LinkedIn, not because LinkedIn pays me anything, but because I’ve seen what’s it has been able to do for my clients. So why would someone who owns a dental business want to be on LinkedIn? And there’s lots of reasons and we can go into them in more detail, time permitting, but if you look at LinkedIn in broader terms of social media, it’s the place for professionals. No one’s even close in terms of the number of professionals that are on there and active. It’s a place for you to establish and communicate your brand and your brand value.

Also, it’s a way to connect with others in the dental community and other business owners so that you can keep your practice current and keep in touch with what’s happening in the industry and again, maintain the brand of your practice.

Kevin: Jeff, in your experience and expertise, what are some of the biggest mistakes that we as professionals make using LinkedIn?

Jeff: The biggest mistake is not being on it. Disregarding it as part of your practice. I have a friend who’s probably one of the best known people in social media, Neal Schaffer, and he says social medial replaces nothing, yet compliments everything. I think that that’s absolutely true of dentistry as well. You have to show up and have a presence.

It’s trite to say that we are going through a lot of change technologically. We absolutely are, but it’s relevant to dental practices. Things change quickly and from a technology perspective, from a demographics perspective, it really pays to be plugged in. And LinkedIn is one of the places where you can have a presence.

I think the biggest mistake is not being there and then the second biggest mistake is ignoring your community. And if I had to put a third, I would say it’s not understanding that you’ve got multiple audiences. So your audiences are patients, but also potential employees.

You’ve had a lot of employees, Kevin, and I’m sure that you would attribute a lot of your success to having really good employees. Top talent is a differentiator. And being present on LinkedIn and establishing yourself as a great place to work is a competitive advantage and will be more so as the talent pool gets smaller and all the baby boomers retire.

Kevin: Let’s get into some of the nuts and bolts since our listeners have all different areas and levels of expertise when it comes to social media, but in particular LinkedIn. As far as your expertise and your Swift River Coaching expertise and experience, what would you say the contact frequency is? Should you be updating your LinkedIn profile weekly, monthly, quarterly, daily? What’s your recommendation?

Jeff: My recommendation is probably for something along a practice, weekly is fine. If you do it on a daily basis, once you get everything set up to your liking, and by set up I mean you’ve got a great headshot, professional headshot there, that your headline differentiates you to some degree, that there is a summary that expresses your brand and your personality and that you’re connected to the groups and the organizations and the thought leaders that you want to follow. Once all that is established, if you do a daily practice, ten minutes a day is plenty to keep in touch with your community and also to feed your community so that you are recognized as an active member. But realistically you could probably do an hour a week to keep on top of things.

Kevin: Do you create, Jeff, a master link or do you take the entire LinkedIn community that you’re associated with and break them into categories? For example, just self-promoting myself, do I break it down into being a speaker, a business leader, a clinician, or do you consider that as one group and you talk and educate that group as one single entity?

Jeff: I would say as one single entity. For yourself as example, those are all parts of you and who you are and what you do. Many of my clients have different aspects of their careers. Some are speakers, some are running their businesses, they are authors. They tend to have multiple disciplines or cross disciplines and different ways of expressing who they are. And maybe they’re doing soccer coaching on the side. I like to have it as one continuous cohesive message because it’s really all about who you are as a human being. And one of the things you want out of LinkedIn is to come across as a human. Not just a dentist, but someone who’s a real person with lots of interests and things that make them interesting and that are particular to the individual that brings a different perspective to the practice. So I like to see everything combined.

Kevin: Let me ask you a follow up question, Jeff. When you go onto LinkedIn and Dr. Jones or Dr. Smith says, “Will you accept?” And then after you accept them into your LinkedIn network, there is a multitude of other individuals who you may or may not know. Do you, as a general rule, recommend accepting all of these individuals? How do you determine which ones you should accept?

Or is it true of LinkedIn, like it is advertisement, there’s almost no bad advertisement and there’s no downside of connecting with pretty much anyone on LinkedIn? What would be your guidance and expertise to new people to LinkedIn or those considering joining LinkedIn to promote themselves and their businesses?

Jeff: What I tell people is that it’s very much a numbers game. Because the more people you’re connected to, the further your reach. The deeper you reach. I have, I think I’m closing in on something close to 1,400 direct connections where you see three levels down.

So that puts me in the many, many, many millions of people that I can then connect with or who can see me. It’s very rare where there is someone on LinkedIn who is fraudulent like you often get in Facebook. If somebody has a photo and there’s some history there and more than a couple of connections, if they look legit, then I accept them.

One of the other reasons that’s most compounding is, you don’t know who they’re connected to that will connect with you. There may be someone that’s two or three levels down that could make a huge difference in your life or their life that will happen because of that.

With all of the connections I have globally, I can see into most companies at some level in the world and particularly, in the United States because I have so many connections. So it behooves you to have a high number.

The other thing is once you hit 500, you get the 500 Plus badge in LinkedIn and so people who look at you will think of you as a super connector and that’s a positive aspect.

Kevin: You mentioned earlier in this podcast, Jeff, that as a general rule, you might want to reach out and update contacts on a weekly basis. When you’re updating either your own profile or expressing some kind of program or interest that you have, is there a certain volume, a certain number of words or paragraphs that we should stick to that gives you the most recognition or let’s just say, the biggest bang for your buck?

Jeff: When you’re reaching out to individuals directly, keep it short and on point. If you’re writing a post that you’re going to post on LinkedIn, generally speaking, 500 to 1,000 words is a good amount. If it’s much beyond 1,000 you’re going to lose people. And if it’s much below 500 then it’s hard to really get a point across.

Kevin: How long have you actually been a coach of Swift River Coaching? How long have you been doing this particular area of expertise?

Jeff: I started my company in 2010. I’ve been an official coach since 2006, but I had a lot of stuff when I was in Corporate America and coaching was part of my role. But as a career coach and story activist, it’s been seven years.

Kevin: That’s fantastic. If people wanted to reach out to you, Jeff, if they wanted your expertise and your knowledge, and particularly the healthcare community, but my area of expertise in the dental field, how would they reach you? How would they be able to get in touch for you to share your expertise and knowledge to get them started in LinkedIn so that it can be the most effective for their business and their team members?

Jeff: The easiest way is to visit my page which is www.swiftrivercoaching.com. I offer a free consultation for 30 minutes to tell you if and how I can help you. Or just send me an email jeff@swiftrivercoaching.com.

Kevin: Fantastic. And is there a number, a cell number or phone number you’d like to share?

Jeff: Sure. It’s 413-668-8433.

Kevin: I’d like to let the listeners know that if you’re new to my podcast, I am a practicing dentist. I work full time. I’ve been practicing since 1983. I have 14 locations, approximately 150 employees, and we see on average about 116,000 patient visits a year.

And for those healthcare professionals listening or any business people listening, a day does not go by where someone hasn’t connected with me or my office through social media, whether it’s LinkedIn, whether it’s Facebook.

Jeff, I cannot thank you enough. We’ve been fortunate enough to be listening to Mr. Jeff Rock. He’s the owner and creator of Swift River Coaching and his expertise is a career coach, personal branding consultant, speaker and workshop leader.

If you’d like to speak with Mr. Rock, he can be reached at 413668-8433 and his email is jeff@swiftrivercoaching.com. Jeff I can’t thank you enough for being with us today. I really appreciate your expertise and taking the time to educate our listeners.

My name is Dr. Kevin Coughlin. You’ve been listening to Ascent Radio with a focus on knowledge, development, expertise and training. This is Ascent Radio and my special thanks to VOCO, who’s been sponsoring our podcast. Their areas of expertise and their products in dental services and dental products is without compare. Thank you, VOCO.

And I’d also like to say thank you to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise this podcast could not be available.

My name is Dr. Kevin Coughlin. Thank you so much for listening and I look forward to talking to you very soon. Thank you.

Podcast: Should you consider starting a second – or third – practice?

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of healthcare and the business of healthcare. And now here is your host, Dr. Kevin Coughlin.

Kevin: Welcome to Ascent Radio. My name is Dr. Kevin Coughlin. You’re listening to Ascent-Dental-Solutions, where the focus is on knowledge, training, education and development.

This podcast is brought to you by VOCO Dental Supply, one of the largest and best dental materials company in the United States. Originally from Germany, but have headquarters in South Carolina, and I want to thank them for sponsoring this podcast. I also want to thank Mr. Doug Foresta and his podcast company, Stand Out and Be Heard. Without his expertise and mentoring, this podcast could not be possible. What he’s done for my professional business and my consulting business I cannot say enough about.

With no further ado, I have some questions today about a topic that seems to be getting more and more attention and more interest in the dental community. And that’s corporate dentistry, in particular, MSOs and DSOs. Why don’t we start with the first question?

Doug: Sure. Thank you, Kevin. Great to be here with you. My first question for you is — there was an article recently about how to know if it’s time to create a second practice. If you’re a solo practitioner, when is it time or what are some considerations? So my first question for you is, if I’m a solo practitioner, maybe I’ve been in business for five years or so, what are some of the considerations that I should think about when thinking about the idea of potentially starting a second practice?

Kevin: Since this podcast is only roughly 20 minutes, I will do my best to stimulate your interest. But keep in mind that I have been practicing and still practice dentistry every single day, Monday through Friday. I have 14 offices and I have gone through the trials and tribulations and these questions in my own mind and still do to this day. In summary, my first recommendation would be to think long and hard about what your end gain is.

Are you building additional practices to sell to a DSO or MSO to get the maximum value down the road? Are you growing because your facility is just over utilized and you’re no longer efficient and effective and you’ve decided that you’ve been so successful at one practice you want to continue and grow your business with another location?

Those two general questions would drive my answer when I’m doing consulting to dentists all over the country. And that is, what is it you’re trying to obtain? To cut to the chase, my personal opinion dealing with hundreds, if not, thousands of dentists over the last 35 years is that most are interested, whether they know it or not at the beginning, to get the best return and the biggest return on their investment.

Meaning that if one practice is successful and the second practice is just as successful, the investment and the return on your investment will be significantly better than just selling one solo practice. I’m going to assume that if you’re not aware of it you ultimately will come to the conclusion that the more successful practices, and the better the processes and procedures, the more valuable this entity is to a potential purchaser.

When we talk about potential purchasers, depending on the number of practices you accumulate and run successfully, your value will go up, but the number of individuals interested in that practice will go down. For the average dentist to be able to afford and purchase three, four, five, ten or fifteen practices, I believe there are few and far between potential purchasers.

So in most cases, you will ultimately be leaning towards a DSO or Dental Service Organization, which by definition are run and owned by dentists, or an MSO, Managed Service Organizations. Which no matter what we talk about, not matter what we think, in the real world, they’re run and operated by equity partners, venture capital groups that hold the money, that pull strings and ultimately the decisions for better or worse.

With that being said, my learning curve taught me that you should never expand into another location, unless your first location has excellent processes and procedures. That means infrastructure is in place, you have adequate staff at your front desk, you have adequate chair side assistance, you have adequate dental hygienists and you have adequate, and let me emphasize this, hardware and software controls. The older you are, the greater the likelihood that your return on investment could be much less.

I look at this very much like anything that you do in the market. You can afford to lose almost everything in your 20s and 30s and you still have plenty of time to rebound and be very successful financially, in your 60s and 70s. But when you start this type of aggressive expansion, the money and time effort when you do it in your mid-career to late career, sometimes may prove out to not give you the best return because of the significant amount of money you’re going to have to invest and the significant amount of time.

So for those listening to this podcast in their early 50s or late 50s, make sure you fully understand the financial and the emotional time commitment of opening up additional practices and what you can expect for your return on investment. Unless you’re an incredible superstar and you can get that practice up and running, profitable, with an EBITA of at least $300,000 to $400,000 within 12 to 18 months, you may find that your return on investment may not benefit when you put in the amount of risk and effort.

Doug: And that’s the other piece I was going to ask you. Have you seen dentists who have gone for it, so to say, and it hasn’t worked. What do you do if you try it and either financially it’s not doing the way you thought it would or it’s just not for you, like you decide this is not me, what then? I guess would be the question.

Kevin: You deconstruct. I would say, take the practice that’s the weakest and unload it as quickly as possible to an associate or a dental broker. You may lose a little bit of money in the process, but my opinion is there’s no reason beating a dead horse. Bad is bad and usually, the longer it takes you to make a decision, the more costly it is and the worse it is in the long run. So I would say, cut your losses as soon as possible and unload that practice as quickly as possible and focus in on your initial practice and continue to build it and consider it a learning experience.

Obviously, with proper mentoring and coaching from someone like myself or other experts in the area, what ideally you want to do is avoid the mistakes that people like me have made so that you’re the most effective and most profitable with the least amount of stress. And it’s like anything, reduce your learning curve will increase your chances of success not only emotionally but financially.

Doug: One of the things I was going to ask you as well, Dr. Coughlin, is that is this something that is even talked about at this point in dental school? That’s what I think is so important about what you’re doing. Is this something that’s even discussed, that I would learn if I went to dental school?  

Kevin: I know starting in 2006 I started lecturing at Tufts School of Dental Medicine in Boston Massachusetts. At that time, I was not aware of any of the schools in the Unites States really addressing the business component of medicine and dentistry. I think with the average school debt of about $267,000, the time commitment, the loss or opportunity cost of spending four to six additional years of training and education and with a high debt structure, it is absolutely imperative that these young practitioners get basic business knowledge either from people like myself or I’m happy to say I see that the schools  in order to keep their accreditation are now mandated to offer between 18 and 22 hours of practice management before these students graduate from dental school. So more and more I see this drive to educate and inform these young practitioners so that they can minimize their errors and maximize their potential.

Doug: Thank you, Dr. Coughlin. I really appreciate you taking the time to share your words of wisdom and perspective from someone who, as you said, owns and operates 14 dental practices.

Kevin: Right, and they’re certainly practitioners out there that have more practices than me and have been just as successful or more successful. I’m happy to share my trials and tribulations and I’m pleased to present this on Ascent Radio and I want to thank VOCO Supply Company for sponsoring this podcast and our previous podcasts. And special thanks to Mr. Doug Foresta and his podcast company, Stand Out and Be Heard. Without his expertise and production acumen, we would not be able to present this on a weekly basis.

Thank you so much for listening. This is Dr. Kevin Coughlin. You’ve been listening to Ascent-Dental-Solutions, with a focus on training, education, development and knowledge. Thanks for listening and I look forward to talking to you soon.

Podcast: Nick Raithel on how to promote your dental practice by writing a book

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. You’re listening to Ascent Radio. My name is Dr. Kevin Coughlin, owner of Ascent Dental Solutions. I want to give a special thanks to Mr. Doug Foresta and his company Stand Out and Be Heard. Without his expertise in podcasting and the production of this podcast, this could not occur.

Today, we have a special guest. This is Mr. Nick Raithel. Nick has a claim to fame and the excellent background in how to help the dental profession and health care profession in general promote themselves, their business and their expertise by using the written word.

The ability to use books to convey a message and to improve a marketing strategy. Nick is owner and CEO of the company Content Corps. Nick has been at this for many, many years and has written the book in how to create a 7-hour book.

Nick, thank you so much for taking time from your busy schedule to talk to our profession about this unique way and how to improve a marketing strategy and a message that most of us in health care profession don’t think about. Thank you so much for joining us. Give us a little bit of background about your company and how you got started.

Nick:    Absolutely. Thank you so much for having me here, doctor. It’s a pleasure to be on your show. I really have a lot of respect for that. I think you’re really helping out our profession in terms of just educating and empowering people. So for starters, just thank you for that. Keep up the good work.

With respect now to what you were asking with kind of my own background and my sort of service, my offerings, what we’re doing really with the 7-hour book is we have a system that allows any dental professional to create their own professionally published book. And with that book, establish their authority, establish their credibility and really position themselves apart from other dentists in their market.

Kevin: I could tell you that I wished I knew about your expertise and your company. As you know, I’ve published three books. One of them; Your Tooth is Killing Me, the other is Business, Processes and Procedures Necessary for a Successful Dental Career and the third one Just Enough to Be Great in Your Dental Profession. And the hours, the time, the drudgery of producing these three books, I would say, most in the health care profession would say it’s not worth the time and effort.

But with your process and procedures, you’ve streamlined it to make it much simpler, much more efficient and effective. Describe a little bit about how that’s done.

Nick:    Absolutely. One of the biggest things people don’t know is that working with us, doing our system, only requires a grand total of seven hours of your time. That’s it. And with that, you’re not doing any work beyond just talking to us over Skype or the phone in a series of conversations. That’s it.

So you don’t have to do any of the writing or any of the review that would normally be required in doing a book. You’re certainly not sitting alone, as many book producers know, alone at a desk having to write anything for hours and weeks on hand. You don’t do any of that. You just talk to us over the phone or over Skype, we walk you through some questions — a framework we have — and your book gets created from there.

Kevin: Nick, once that book is created, how does it get out into the public? Are you using an outside publishing or does your company take care of that also?

Nick:    We take care of it through various publishing services we have partnerships with.

Kevin: And would Amazon be one of those services or do you use other services?

Nick:    Depending on the author, Amazon could definitely be one of those services, but we are unlimited in that respect.

Kevin: For those listening that may not be familiar with what it takes to be an author, although you’ve really created a very effective and efficient means, I can tell the listeners that not hundreds, not thousands, but multiple thousands of hours were spent developing my books. And I can tell you that that time and energy probably could be much better spent using Content Corps and Nick’s process and procedures.

I can also tell you that — well, why don’t I let Nick — about the advantages of having a book with your name and you’ve published it, the affect that it has on credibility, speaking engagements, what it means to our patients base when they see that their dentist or health care provider has the expertise in which to put something in print.

Nick:     Sure. Kevin, I think that a good place for listeners to start with this is to understand that a book makes you more than just another dentist. More than just another health care professional. With a book, you have a chance to take the knowledge, the experiences, any insights you have that make you unique and the unique way in which you see the world and show that to people. Do you ascend above the competition?

Kevin: I could tell you Nick, that I’ve had the privilege to listen to you on other podcasts and one of the take-away messages that I never really thought about, but when you’re forced to talk about a subject, whatever that subject is, in our case it’s health care or dentistry in particular, you actually learn more about the subject. You become engaged. I believe you become more of an expert.

I know during my research and listening to my thoughts and writing down those thoughts, you actually become, not only more engaged, but more knowledgeable about the subject. Do you find that?

Nick:    Yeah, I definitely do find that. I think that frankly, one of the best ways is to understand your business, if you view your dentistry as a business per se, or just to understand it as a craft. If you’re looking at dentistry as a craft and you’re a professional practicing that craft, one of the best ways to do it is a book. Because it forces you, as you’re saying Kevin, to kind of get outside of your head and look at it from different perspectives and really understand it better so you can communicate it better.

Kevin: One of the quotes that stuck with me when I was listening to you is what’s perhaps one of the most important assets we have as health care professionals and dentists in particular. Your quote was really, I thought, astounding. You basically summed it up by life experiences are probably our best property, our best asset. And when you start to write a book or use your particular system to write and publish a book, those life experiences are re-engaged, they’re re-ignited.

I can tell the listeners that a day doesn’t go by that I don’t get an email or a phone call regarding questions about a book. What did I mean by this, did this really happen? Et cetera. And it’s opened a whole venue of contacts and networks that I didn’t even realize or understand.

And I can tell you that from my own personal experience, not only does it give me great pride, but you touched on it; the patient base and the team members of my business, which are close to a 160 employees in 14 different offices here in the Massachusetts area, it does give you that extra credibility that I think deep down they’re saying, “Jeez, he could have been doing so many other things and he took the time to write his thoughts down to provide education and mentoring for new generation and the existing generation out there.”

When you do this, I don’t want to put you on the spot, is there an average fee or cost from start to finish Dr. Smith or Dr. Jones connects with your company Content Corps, what is the length of the process? I know you mentioned that through Skype or phone call it’s roughly seven hours of speaking and then your team takes those words and puts them into a book. How long is the process from your company after you’ve received the content to complete the project?

Nick:    Certainly. As I’m sure you would imagine, it’s really going to vary depending on the client themselves. The very first step though is for us to determine if someone who’s thinking about this, if what they have in mind and their ideas really are a fit for our system. Because a lot of people do want books and a lot of people really should go out there and create books, but what they’re thinking may or may not be a fit for our system. So we always just want to make sure that it is and that begins with a simple 20-minute conversation which people can schedule by visiting our website www.contentcorps.net.

Kevin: And is there a charge for that 20-minute consult?

Nick:    No, that’s completely complementary. We want to hear your idea and there’s absolutely no fee for that.

Kevin: Are you comfortable giving a range of what individuals could expect in an investment? I know that time is roughly seven hours, but an investment for the individual to create this book?

Nick:    That’s the kind of thing that, again, is really going to depend on the individual themselves and if it is a fit. So I would encourage anyone who’s curious about that, just to kind of go to our website and have a look and see if it’s something they might be interested in. And then from there, if it was, we would again determine if it was a fit and go from there.

Kevin: Nick, with your expertise and background, is there a general number of pages that seems to be the best? We know in the podcast industry that roughly a 20-minute podcast is considered ideal because it’s the average commute time in a car for most people in the United States. But for a book, is it 50 pages, 100 pages, 150, 200?

Nick:    It does depend on the person themselves and their own specific goals. I think above all, that is what this comes down to. This comes down to goals. What are your goals in producing the book? And then from there the number of pages will be determined by the content that will be used to produce and to fulfill those goals.

Kevin: That’s a nice segue. I know when I first started for the listeners, so many times I’m asked, “Why? Why did you do the book?” And I teach at Tufts School of Dental Medicine in Boston, Massachusetts and I teach practice management. These young men and women are getting prepared to graduate and they really don’t have business experience, business acumen. They’re not sure how to apply for a job, what to look like in the job.

I continue to do the same course over and over again and one of the students and faculty said, “You really should put this in a book.” And I said, “You know what, this is a very efficient and effective way to get the message. Because in a 90 minute lecture, sometimes you can’t cover all the basis.”

Nick, as we’re getting close to coming to an end to this podcast, you’ve mentioned your website, is there a phone number that you’d like to share with our listeners?

Nick:    I think the website really is the best place to start. With that website www.contentcorps.net, I think that’s the best place.

Kevin: As far as a response time for our listeners if they’re webbing into your company today, this week, you get back to them within 24 hours, within a week? What’s the turnaround?

Nick:    We have a very quick turnaround. So if you’re filling it out, we’d be getting back to you quite soon.

Kevin: I know as we come to a close, something that sometimes we’re a little uncomfortable talking about or a little outside our comfort zone, but when we do podcast, when we do webinars, many times those are difficult areas to monetize. There are ways to monetize them and I learn week after week with my expert Doug Foresta on Stand Out and Be Heard. But with the book, it’s a very easy way to monetize because you can sell those books or you can use them for marketing purposes, which also generates a stream of income. Would you agree or would like to expound on that?

Nick:     I would and I would say that not only are you selling the book, not only are you using it in your marketing, but a book really can be kind of your gateway into other things and other ways of monetizing. For example, using a book to launch your speaking career, using a book to launch your coaching career, if you want to get into coaching; dental coaching or business coaching. You can really use it to create many new avenues of revenue for yourself.

Kevin: Nick, I can’t thank you enough and I thank the listeners again. And special thanks to Mr. Doug Foresta and his production of this podcast. You’ve been listening to Ascent-Dental-Solutions and this is Ascent Radio. My name is Dr. Coughlin and our focus is on knowledge, development, training and education.

Mr. Nick Raithel and his company Content Corps and The 7-Hour Book, I strongly recommend to our listeners to consider his expertise and consider taking the time to put your thoughts down in writing and I think you’ll enjoy it and hopefully you’ll enjoy it as much as I did. Nick, thank you so much for taking your time. I appreciate this evening’s podcast with you.

Nick:    Thank you so much for having me, doctor. It’s been a pleasure.

Podcast: David Wolf on the power of communication

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: Good afternoon. You’re listening to Dr. Kevin Coughlin and Ascent Dental Radio. Today, I have another super guest for the next 20 minutes for another amazing podcast. Ascent Dental Solutions is focused on helping the dental community market themselves, improve patient relations and just improve their bottom line.

I would be remiss if I didn’t mention Mr. Doug Foresta. He has helped produce over 50 podcasts for me and without his intellect, his expertise and his stick-to-itiveness, we wouldn’t be here today.

As important, if not more important today, we’re dealing with communication issues which to me, are the fundamentals of success in any business, but in particular, my area of expertise: dentistry.

Today’s guest is Mr. David Wolf. He’s been creative director and producer of content for radio, TV, film, podcast, audio books and multimedia. His clients are Amblin, Universal, Disney, Discovery Channel, South West Airlines, children’s medical centers, Kidney Care, Miller Brewing, Budget Rent a Car, Frito-Lay, Pepsi, McDonalds, Texaco and the list goes on and on.

You may be asking yourself, why would the dental profession be interested in having an expert like David speak? I can only tell you with 35 years of practicing dentistry, owning 14 dental offices, 160 employees that the single most significant thing that I’ve seen over the years is the ability to communicate with your team members and your patients.

And without any further ado, David’s going to introduce himself and tell us what he’s seen over his number of years in this field and how he can, perhaps, improve our ability to communicate with team members and patients.

David, thank you so much for taking time from your busy schedule to speak to our audience today.

David: You are most welcome, Kevin. Thank you.

Kevin: Give us a little bit of background about what you’ve sensed and what you see as far as communication in health care, but in dentistry in particular.

David: That’s a fascinating subject because it’s infused by years of producing talent, singers, speakers, musicians in the context of pure communication which is music and audio for advertising and communications and training films so my perspective is somewhat skewed to the entertainment preparation or production side of the business.

As an observer of those who I’ve encountered in the medical profession and also in dentistry, and we were talking offline about this is as well, I think that because of the nature of the work and the nature of the type of minds that enter those fields, I think from a personality perspective they tend to be very scientific.

And I would check this with you to see if you agree, I know you’ve been in the industry for more than 35 years. Would you agree that most of the folks, it seems to me, tend to be more, let’s call them introverted. They’re really measured by their grasp of technology and emerging technology in dentistry. And then with that emersement, they are then almost tasked to come up for air and talk to mere mortals as they’re sitting in the chair ready for a procedure. Do I have this right?

Kevin: I think you hit the nail right on the head. We’re all somewhat prone to these idiosyncrasies. We focus on the minutia. We focus on infinitesimally small areas of the human anatomy and many times we lose sight of the actual patient. We’re not actually listening to what they’re telling us or what they actually want.

And I think in today’s competitive market in medicine, in dentistry, the ability to be able to connect, what I call BLT; you want your team and your patients to believe in you, you want them to like you and you want them to trust you. And in order to accomplish that task, there are certain areas of expertise that you bring to the table that maybe you can help our listeners learn from your teaching standpoint.

David: Absolutely, and I appreciate that. You hit it on the head with BLT because at the end of the day, what I’ve learned, if I’ve learned anything in my 30 or so years in the communication space, is that for the most part we’re emotional beings. And the communications and this connection that we make, the belief, the like and T was trust, forming that foundation in a relationship, it’s all about emotion.

So how do we communicate emotion in a world that is somewhat technical and there is sometimes a clock running and there is a procedure to be done and there is a lot of preparation?

It almost, from my perspective, might require that the practitioner almost compartmentalize a bit, and as I said earlier, come up for air and understand that okay, now I’m going to speak to this patient in emotional terms. I’m going to use my voice in ways, almost the tone — one of the things I do is I coach people around the use of their voice. I call this program The Power of Voice.

There are some fascinating things about the voice that despite the fact that we use it for 80 percent of everything we do, no matter what business we’re in or vocation or avocation we’re in, we rarely think about it. We just assume, oh, this is my voice, this is what I’ve been given and born with and I’ll just use it however I can use it. But very few people really think or exam or even practice simple aspects of their vocal mechanism. And I think some of this could apply to the practitioners that are listening here to better understand how their voice affects the emotions of the patient in the chair.

Kevin: I would tell you that some of the things that I’ve seen is in my particular organization, we see over 938 new patients a month. And over and over again I hear the same thing; how come no one ever explained this before? How come no one ever told me this before? And when you’re talking about the inflections in the tones, in your voice, I would tell you that over and over again I hear the same thing and that is, “I didn’t notice any empathy. The practitioner explained the A, the B and the C, but there was no inflection, no empathy, no real concern. It was a matter of fact. They need A, they need B, they need C and the cost is D.”

I think many times we as clinicians miss that connection that people, as you mentioned, they want that emotion. They want to know that you care. They assume that you already know how to do the A, the B and the C, that you’re clinically astute, but what they really want to pay for, what they really want is you to connect with them emotionally and understand why they want what they want and how come they need what they need.

And that’s been my 35 years of experience and sometimes, myself included in this, we miss that because we’re on the clock or because we’ve done it so many times.

Are there specific tips or training drills that you can suggest for the whole health care? But I believe it applies to anyone who deals with people.

David: I think you’re right. I’m glad you asked because I have a lot of notes ready for us today around some specifics. We’ve been kind of nibbling at the edge of this.

We’ve established that it’s an emotional connection we need to make, but how do you do that with your voice in the context of a practice? And by the way, I would say also Dr. Coughlin, that this applies to speaking too in public, it even applies to guys like you and I that do podcasts and Doug that are on mic technique. It really applies to a lot. And I’m a student of this stuff. I’m working on it all the time even though I help others accomplish it.

So here it goes. I have a list of things I like to call the Elements of Voice and that includes breathing and tone, melody and pitch modulation, word formation, rhythm, pacing, phrasing. And then this thing we call filler words which may not as much relate to this emotional content that we’re talking about with respect to empathy, some of these traits or some of these elements of voice absolutely do inform the emotional content of our voice.

If I may, maybe I’ll demonstrate a few of these things. What’s amazing and again, I’m a student of this as well, as you pointed out here after even 35 years we’re always students, so few of us have really thought about how we breathe. Unless you’ve played trombone or some wind instrument in a band when you were in grammar school or high school, no one ever taught us that we really need to breathe from our abdomens.

And almost think of the abdomen as a balloon and the first step in breathing is not the inhale, but the exhale. So what we’re doing is we’re clearing [exhales], we’re exhaling out as much as we can — there will always be some air in our lungs because that’s what is required to keep them inflated — but to clear the lungs out to a comfortable level and then allow them organically or naturally to re-inflate.

What I’ve been practicing lately as I’ve got more and more into studying this is putting my hand sort of right around my navel and really feeling the expansion of my abdomen in a way that may feel a little silly. And many of us are weight conscious so if you’ve got a little belly you’re like, “I’ve been taught and conditioned socially to hold in my stomach all the time.” So for me that was a little bit of a I work on my weight, but push the stomach out as you exhale and really pull it in so it’s lower than your chest.

What happens when we, so much of us project or create the stream of air that our vocal folds use to create sound, we tend to focus in our neck area and in our chest area. And so where this folds into what we’re talking about with empathy is that if there’s enough sufficient breathe to support the stream of air as you talk to a patient or as you’re talking to someone in public, I believe that that support that you’re providing, your vocal tone, will feel more soothing to the recipient. So that’s just one example of breathing.

Kevin: I could tell you David also another thing that I saw is the physical presence of a dentist or any health care provider in their cubicle or operatory. I’ve been a student, not as astute as yourself, but I videotape a lot of the presentations that occur in a medical setting. And one of the things that I noticed is often the practitioner is standing and the patient is sitting and immediately you’re creating a dominance. I strongly recommend that you take a look at not just the tone and the breathing, but the physical space that you’re in and try not to impinge by being too close or too far away.

I talk to my students, my staff, my team members and say, “Try to be eye-to-eye contact. Try to stay within an arm’s length or three or four feet from the individual and talk eye-to-eye rather than looking down or looking up at them.” Would you agree with some of those comments?

David: Absolutely. We can’t ignore the fact that communication is multidimensional. And so in a room with a patient, or with anyone for that matter, a very high degree of adaptivity to what they’re comfortable with is called for here. And so in a world that is very procedurally driven, which is the world most of you live in, I think, in the medical space, you almost have to step out of that and suddenly become highly adaptive.

Now, I may have that wrong. It may be that even though you’re dealing with known anatomy, you go into a mouth or a cavity or a gum periodontal situation, you may have a whole lot of adaptiveness that’s required in order to treat. I may have misspoken on this, but these levels of sensitivity about hierarchy and body language are all a part of the communications process.

Of course, I’m focusing on the voice, which is only one component. The visual, yes. Bottom line is I absolutely agree with that premise. It’s a total communications process.

Kevin: David, are there actual courses out there that you teach that can give more instrumental techniques? Is there ways that people can touch base with you to learn some of these tactics that really, I hate to say, we try to sell to people? But in the world that I live in, we’re all selling something and in my opinion, selling is good providing it’s done ethically and honestly. I’ve never looked at selling as bad. I think I’m selling myself on this podcast.

You’re selling your techniques to people. But so long as they’re done with the idea of providing value and a service and to improve the way we connect with people, I look that as something very good and I appreciate the expertise. How do they get in touch with you? How do they reach out to learn more about these techniques to improve their accepting the patient and the patient accepting them?

David: Thank you very much. I appreciate that, Dr. Coughlin. By the way, I listen to your podcast regularly and I know that really you’re sharing great and valuable information that you believe in. That’s what I’m trying to get to there. So thank you for including me in the fold there. The way folks can get a hold of me and learn more about this program I call The Power of Voice is they can reach me at www.podcastandradio.com.

There is a contact me area or page on that site. There is also a little bit of an explanation about The Power of Voice. I do coaching. I’m developing a course that will be ultimately sold online as well and a lot of exciting developments around all of this is as an adjunct to my background. So thank you for inviting me in.

Kevin: No David, thank you. For our listeners here, sometimes I like to digress from the technical aspects because I think sometimes more important than the technical aspects of health care is the people aspects of health care. And I think we take with a grain of salt what we should probably spend more time on. And that’s patients come to us to listen to explanations, options, the risk, the benefits and the alternatives.

And unfortunately, if we’re going to provide the highest level of care and service, the ability to communicate, the ability to connect and the techniques to make us better at it are many times completely overlooked in the health and medical profession. And bringing experts like David wolf and his programs to our listeners, I think, is a great boon to our profession and to our patients.

David, with your expertise in the creative director and producer, we need people like you in our health care profession to make us connect better and more efficiently with our patients and I can’t thank you enough. Please, don’t hesitate to reach out and get to David at smallbizamerica@gmail.com.

You’ve been listening to Dr. Kevin Coughlin, Ascent Dental Solutions, where the focus is on knowledge, consultation, training and development. And in closing, my great thanks to Mr. Doug Foresta, Stand Out and Be Heard. Without his expertise, this podcast would not take place. Thanks again and I look forward to speaking to everyone soon.

Podcast: Excellence in Dentistry 2017 Conference highlights

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: Good evening. This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions. This podcast is brought to you with the expertise and production management of Mr. Doug Foresta. His company, Stand Out and Be Heard, is responsible for the 50 or so podcasts that you’ve been listening to over the last year. Without his expertise and his training and background, none of this would be available.

Today, we have a specific topic. A little self-promotion, you might say. My name is Dr. Kevin Coughlin. I’m the creator of Ascent-Dental-Solutions, where the focus is on training, coaching, education and consultation. Today’s topic is about an upcoming continuing education event located in Destin, Florida, which is on the gulf coast.

I have a little backdrop to this particular story. Many years ago, a Dr. Woody Oakes contacted me almost on a cold call and said that he had read one of my books and was interested in some of my thoughts. From that conversation, we generated a friendship and he asked if I would participate in a radio show. He interviewed me for several hours and produced radio shows about my dental career, my background and my business acumen.

From that, he introduced me to a Mr. Steve Parker. And the combination of the Profitable Dentist and Excellence in Dentistry, I was introduced and asked to do some speaking and some training, some coaching and some education. I’m happy to say I’ve been pleased with their organization and I believe their organization has been pleased with me.

Coming in April, to be exact, 26th, 27th, 28th and 29th, will be the annual Destin, Florida Excellence in Dentistry Seminar, Meeting and Education. I hope for those that are available you’ll attend. We typically expect between 400 and 750 doctors and staff members from all over the country and actually, all over the world, to listen to presenters, educators, teachers, lecturers on a vast variety of subjects that relate to dental care today in the 21st century. Doug, do you have any questions?

Doug: I do. Thank you so much, Dr. Coughlin. One of the things that I was wondering about is first of all, I believe you’re speaking on Processes and Procedures to Improve Profitability. Is that correct?

Kevin:         Yes. I have a variety of different topics, but this particular presentation will be on Processes and Procedures to Improve Profitability. Basically, as most dentists and most people in health care in general feel the pressure, the strain of trying to meet excessively high overhead and significant reduction in fees and reimbursements, the profession, in my opinion, is forced and not necessarily in a negative way, to be more effective, to be more efficient.

And it’s incumbent upon us as a profession and as individuals of being small business owners to take a look at all of your processes and all of your procedures and how can we get rid of the fat. How can we make our procedures more profitable by being more efficient and more conscious of the bottom line?

I’m expecting to get, in my opinion, a very nice review from these particular processes and procedures which I’ve developed over 35 years and helped me develop my 14 practices here in Massachusetts. Keep in mind that I am a practicing dentist. I do practice full time. So I just don’t go out and lecture. Every day, today included, I worked almost all day long doing the things that most people in health care have to deal with. And that’s providing a high level of service, a high level of care. But being small business men and women, we also have to be conscious of our overhead and ways in which we can develop and provide better care and better service.

Doug: Dr. Coughlin, you mentioned and yes, you are a working dentist, and one of the things you mentioned was you said you’re cutting the fat. Can you give an example of things that you see that dentists do in their practice that cut into that profitability?

Kevin: That question we could spend the next couple of months on, but to summarize in this podcast, in most cases, my personal belief is that we as health care providers are not necessarily prepared to be as efficient as possible. I strongly recommend what I call a chichi. Some people call it a morning hurdle. But basically, it’s a review of all the scheduled patients so we know exactly what we’re expected to do, we know exactly how much time we anticipate to do it and our operatories are set up for those processes and procedures to provide care in the most efficient and effective manner.

The next thing that I see that I believe really affects profitability is the operatories or the areas in where we practice health care and dentistry in particular, they’re generally not set up to be efficient and effective. I cannot emphasize having cassettes available and those cassettes should be organized for restorative dentistry, separate cassettes for amalgams, separate cassettes for composites, separate cassettes for oral maxillofacial surgery, orthodontics, endodontics, periodontics and pathology.

If you don’t have the cassettes with the proper instrumentation and a staff that’s trained to provide this care and service in an effective and efficient way, you’re probably losing hundreds of thousands of dollars a year.

The ability to change from one particular treatment to another — in the dental sense, we begin to do a root canal and for a variety of reasons, the root canal may be failing and it may not be a successful treatment. To change gears within one to two minutes and make that a surgical extraction and then turn that into bone grafting and surgical placement of an implant really provides an enormous way for your patient base to receive not only excellent care, but efficient and effective care. So many times we consider doing things quickly and fast as being done cheaply or not as well or as effective.

I honestly think that our patient base is so busy and they have so many time constrictions that the more efficient and effective we can provide their care and treatment, the better they will like us, the more responsive they will be to our care and service, and the more likely they’ll be willing to keep their appointments. Those are just a few of the comments.

Doug, what I wanted to spend a few minutes with is to sort of just give the audience some of the speakers that you can expect to hear in Destin, Florida on April 27th, 28, 29th, 2017.

Doug:    There are some really great topics I was looking through that.

Kevin:  Oh yeah. The topics in this particular continuing education forum is varied. There’s practice management and there’s clinical. We have Gary Kadi who is talking about where are you taking your practice. Do you know the direction? Do you know what you want to accomplish in your dental practice? And it seems like an obvious question, but many times we’re not prepared to answer it. We just go in, work, do what we’re supposed to do and we really don’t have a clear cut direction.

We then have Dr. Mike Abernathy and his topic is how do you become that super specialist. You’re a general dentist, but in order to meet overhead, in order to stay engaged and excited about your profession, you have to introduce specialty into your care and treatment in my personal opinion. Obviously, others would disagree, but I think to be able to offer surgical implantology, prosthetic implantology, bend and bracket orthodontics, fixed and removable functional appliances, MTM which is Minor Tooth Movement orthodontics, Invisalign orthodontics, endodontics with rotary instruments, same day root canal procedures and treatments, CEREC restorations where crowns, bridges and veneers can all be constructed, designed and inserted in one visit, bone grafting procedures from extractions. The ability to have in-house laboratories to perform immediate prosthesis or full and partial dentures within a day or two days.

This offers an enormous amount of care and service to your patient base. Not only does it provide a better bottom line, but to me, more importantly, you’re offering your patients your most significant asset, a way to receive care and treatment in an efficient, effective manner.

Just take, for example, you went to a restaurant and you decided to order steak and they say, “Well, we don’t serve steak here, we only serve chicken.” And then you went to the chicken restaurant and they said, “We only serve chicken, not steak.” And then you decided that you wanted dessert, but they don’t offer dessert, you have to go to another restaurant.

Today, time, money, effectiveness is so critical that most people have double incomes. They have children, they have events, they have a busy schedule, offices and corporations are reducing time off for medical and health care and to be able to provide treatment in a very efficient, effective manner is an enormous service that you’re providing to your patient base. And I also believe as a subliminal advantage, your staff and team members will appreciate the excitement of being able to offer a variety of procedures and processes to your patient base.

We have other speakers too, Doug. We have Dennis Urban, a certified dental technician. Those of us that practice health care and in particular, dentistry know if you don’t have good laboratory support, you don’t have conscientious laboratory technicians and you’re not communicating well with them on a day to day basis, you’re having remakes, you’re wasting money and time and your products and services are suffering.

I cannot emphasize the importance of listening to Dennis Urban and how he expects to be communicated with and his tips to improve that communication. As many of you know listening to the 60 or so podcasts, I was a dental technician before I was a dentist and my heart goes out to these men and women in this profession. They really are artists and they’re experts in what they do.

We also have some dental hygienists. Wendy Briggs will be speaking about the five steps to increasing case acceptance. I think those of us who practice health care in the field of dentistry know that most of the care and service is going to come from your support members and your team members.

And it’s critical that your dental hygiene team and you as the practicing dentist be on the same page so you’re conveying the same message to Mr. and Mrs. Smith. And that message is clear, it’s concise, the finances are in order so that the treatment acceptance goes up not from five to ten percent, but to 75 and 85 percent.

We also have other speakers. We have Dr. Daniel Haghighi who’s going to talk about 3D Positioning of Dental Implants. I think those of us placing implants, myself since 1983, the ability to virtually place an implant reduces failure, increases speed and efficiency, and most importantly, provides a higher level of care.

We also have Dr. Thomas Nabors who will be speaking about why traditional hygiene programs in a typical dental office is no longer considered the standard of care. You have to look for better ways and more efficient ways to use your hygiene department.

We also have Mary Govoni who will be speaking as a registered dental hygienist and certified dental assistant and also has Master’s in Business Administration. Basically, her message is how do we work all day and go home feeling good and rested?

On top of that, we have Dr. Nathan Dallas who will be talking about how to improve the root canal or endodontic success in your practice by reducing time, increasing efficiency and improving the end results.

We also have Dr. Avi Weisfogel who will be talking about sleep apnea, obstructive sleep appliances, the advantages of these appliances over CPAP, how you can use combined therapy with obstructive sleep apnea appliances along with the conventional CPAP units. I think you’ll find his topics enlightening and I think it’s critical that all dental health care providers are knowledgeable in instructing their patients and staff in sleep apnea appliances and the advantages of those appliances.

We also have Mr. Charles Loretto, who is an expert in finance, business and helping dentists transition their practice to an associate or to some kind of DSO or MSO.

We also have several other lecturers such as Christine Taxin who will be working with insurances and explaining to the dental office and their staff members the quagmire of issues that dental insurances and medical insurances present to small and large dental offices.

I’m excited about the program, I’m promoting the program. I think it will be a benefit to those who can attend. We’ll be closing out the program with attorney Ali Oromchian, who is an attorney, and will speak to us about what all health care professionals just shriek about, and that is defensive medicine. What we need to do to prevent ourselves from getting in trouble. Not to save us money, but to provide a higher level of care and service and do it in the most efficient and effective way.

There’s an excellent program out there. My name is Dr. Kevin Coughlin. I am owner and producer of Ascent Dental Radio. In closing, I want to give my thanks to Mr. Doug Foresta. Without his expertise in podcasting, none of this would be available.

I know today’s podcast seemed more like a sales pitch for Excellence in Dentistry and The Profitable Dentist, but I believe your attendance or your ability to review it on CDs or video stream may be to your advantage. It’s an expensive way to get some significant continuing education in a vast array of subjects. I hope to see you in Destin, Florida on April 26th, 27th and 28th and I look forward to our next podcast.

Thanks for listening. My name is Dr. Kevin Coughlin. You’re listening to Ascent Dental Radio.

Podcast: TMD and what patients and dentists need to know

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 Radio, where the focus is on knowledge, consultation, development and training. I believe this is the 40th podcast that we’ve been doing and it wouldn’t be possible without the special help of my production and consulting guru, Mr. Doug Foresta. His company, Stand Out and Be Heard is responsible for the webinars and the podcast and I always like to give a shout out to think him very much for his expertise and his talent in this regard.

Today, we have a topic of temporomandibular joint. For most of the listeners you’ve been hearing me and listening to me focus on the business of dentistry, but I want you to know that I am a clinician and have been practicing for 35 years as a general dentist in all areas of dentistry.

Over and over again I get questions and comments about Temporomandibular Joint disorders or TMJ and I thought today’s podcast might be valuable to the listeners on how do we treat TMD issues and what’s going on in the field. I’m proud to say that I’m going to have some questions asked to me today. Those are general questions and if you have specific questions, you can reach me on www.ascent-dental-solutions.com. I’m very good about checking and getting back to you with specific questions. Doug, what’s your first question?

Doug: Thank you, Kevin. It’s a pleasure to be here. My first question for you is what is TMJ or TMD? Can you explain what that is?

Kevin: For the lay patients listening to this podcast, TMJ stands for Temporomandibular Joint. It’s the acronym for the most complicated joint in the human body and it’s located right in front of your ear canals on the right and left side. For the clinicians listening, we refer to the problems, the signs, the symptoms of temporomandibular joint as TMD or Temporomandibular Disorders or Dysfunction and there are a slew of them. Many times, the patient will come into the office and say, “Dr. Coughlin, I have a TMJ issue.” And my response is everyone has a TMJ, but not everyone has TMD issues. Hopefully, that answers that question.

Doug: Thank you. What are some of the patient signs and symptoms then of those TMD issues?

Kevin: I would say, in my 35-year career working pretty much five days a week, sometimes six days a week, a day has not transpired where a patient or an employee or team member hasn’t said, “Dr. Coughlin, I have pain, stiffness, popping or clicking in the joint region.” And when I say the joint region, I’m referring to the temporomandibular joint. Generally, the complaints are pain and discomfort and a limited range of motion.

I would say to the clinicians out there I have been doing expert evaluations for insurance companies for close to 30 years and the vast majority of the cases I review are TMD disorders and over and over again, I feel that the records that have been taken by the diagnosticians, the dentists in particular, are less than adequate and could be greatly improved by following some simple rules. I would strongly suggest to the clinician that on every single patient you document Range of Motion, ROM, not only vertically, laterally, but also protrusively.

This means, you have the patient open vertically as wide as possible without causing any pain or discomfort and for the average adult that should be close to 60 millimeters. If you want to save a lot of time and a lot of aggravation, generally, if you take your hand and use your forefingers and put them on top of each other and place them from the incisal edge of the upper anterior teeth to the incisal edge of the lower anterior teeth, you’re going to get about 60 millimeters. If you eliminate your baby finger, that will be about 50 millimeters and that would give you a good indication that the patient’s range of motion vertically is within normal limits.

Laterally, you have the patient bring their jaw all the way to the right and then all the way to the left and generally, that should be about four to six millimeters right and left to be an adequate range of motion laterally. Protusively, you’d like to see the patient move their lower jaw forward, at least, 6 to 10 millimeters anteriorly or protusively.

I would strongly recommend prior to the removal of wisdom teeth, prior to any orthodontic care or any extensive treatment where the patient’s jaw is going to be open for any significant length of time, let’s say more than 30 minutes, make sure your charts document range of motion.

The next item that I think is critical is during this range of motions, you want to document if the patient has any deflections or deviations. A deviation simply means when the patient is opening their mouth vertically, the jaw deviates either to the right or to the left and does not come back to the mid-line. This is an indication when the jaw deviates to the right that more than likely, the temporomandibular joint on the patient’s right side is not functioning properly.

Just going back to some basic anatomy and physiology, the first 25 millimeters of opening, the temporomandibular jaw rotates. After 25 millimeters, it translates down and forward. So when you see the patient’s jaw deviate to the right in this particular exercise, you know that the left TMJ is rotating and translating properly, but the right TMJ is not and it’s a pretty good indication that that joint is not healthy and is not in a correct position. And usually, the culprit is the meniscus or the disc that separates the temporal bone from the mandibula bone.

The next documentation would be a deflection. This simply means that the jaw upon maximum opening deflects either to the right or to the left, but comes back to the mid-line. So the opening is almost an S-shape. This means that the joints are not working properly. But in most cases, the disc has been recaptured and it allows the jaw to come back to the mid-line. Whereas in a deviation, that disc is not allowing proper translation and is most likely not being recaptured.

The critical thing here in this particular podcast is to give you a few simple inexpensive tips to improve your diagnostic records and your diagnosis and to help your patients and also to protect you since in my 35 years of experience, most patients have some temporomandibular joint signs and symptoms prior to dental treatment.

And then the dental treatment triggers the episode of pain and discomfort and the patient immediately associates it as a dental problem that was caused by a dentist when it actuality, the problem was predisposing. But because the records are inadequate in the documentation of range of motion, deviations and deflections have not been adequately documented. How about another question, Doug?

Doug: I was going to say, I know I was doing it as you were speaking, I could picture our listeners moving their jaws back and forth as you were talking about that. What are the treatment options for TMD?

Kevin: The first thing that I would tell our clinicians and for patients listening is you’ll never get success unless you have a proper diagnosis. And you’ll never get a proper diagnosis unless you have appropriate dental and medical records. The fundamentals and basics are a thorough medical history and a thorough dental history. To augment those two bits of information, I would strongly recommend that there be a complete clinical palpation and exam of the head and neck region, with emphasis on the medial and lateral pterygoids, the temporalis and masseter muscle, which are the four major muscles of mastication or the muscles responsible for chewing and function.

Palpation of these muscles, which start almost if you could just put your finger above your ear and move it forward in the shape of a question mark, you’ll be palpating the posterior middle and anterior temporalis muscles on the right and left side above the ear.

From there, you will go down and palpate the masseter muscles and if you clinch your teeth together, you’ll feel a bulge in front of your ear and those are typically the masseter muscles. Those are the two large muscles responsible for a large majority of the pain and discomfort.

During the palpation examination and the clinical examination, tenderness to these four muscles of mastication usually indicate that there’s a muscular problem and a muscular cause of the patient’s pain.

Also, you’ll find customarily, the patient will complain of tension and stress headaches, many times sometimes misdiagnosed as migraine headaches, and they’re really caused by the clenching and squeezing down of the upper and lower teeth together. And that constant aggravation causes spasm in these muscles which cause pain and that pain emanates from around the ear, in the head and neck region.

Next, you should have upper and lower diagnostic impressions so that we can see what your teeth look like and how they function. On top of that, I would suggest radiographic examination so we can determine the health and the condition of the temporomandibular joint. Typically, this would be a cephalometric view or a panoramic view and sometimes, we can even do a temporomandibular joint view. The more views, the greater the likelihood we’ll see damage and injury to the joint.

We can sometimes, depending on the severity of the problem, we may want to augment these diagnostics tools with an MRI or a CAT scan. But in most cases, for this particular type of podcast, I would function on the easy reversible treatments and diagnosis first to distinguish is the joint problem purely muscular or is it what we call internal derangement or intracapsular disease where there are some orthotic condition and the disc is not in its proper condition.

And there is sometimes, and actually many times, a combination of both problems, which makes the treatment in the diagnosis sometimes confusing and difficult.

After the proper diagnosis is done and records are done, generally, the treatment are broken into phase one and phase two types of treatment. The phase one treatment is simply to get the patient comfortable. And if it’s a muscular problem, we can many times test this by putting you on a pharmaceutical medication called Flexeril, generally, 10 milligrams, either in the morning or at night or a combination of both, to see if the patient’s signs and symptoms decrease. If they do, you’re pretty clear that you’re dealing with a muscular situation.

The next thing, in my 35 years of experience treating TMD disorders, is what we call Anterior Misguidance. You’ll find that your patient occludes or contacts the anterior teeth prematurely. Generally, these people tend to be very good looking in nature and generally, their teeth appear to be straight, but their upper anterior teeth are vertical. They have very little angulation and the angulation on the upper anterior teeth should be closer to 110 degrees.

And in most cases these upper teeth are up and down vertically so when the patient’s lower jaw goes into occlusion or opens and closes, the anterior teeth hit prematurely, causing the mandible to move backwards, irritating the ears, creating tinnitus, ear aches, neck, upper back pains and a tingling in the joint and just general discomfort.

A quick test for the patients and clinicians is to put your index finger lightly on teeth 7, 8, 9 and 10 or your upper anterior teeth and tap your lower teeth gently. If you feel a vibration or fremitus in that region, it’s a pretty good indication that the patient is suffering from anterior disclusion or malocclusion.

And a simple task would be to create some type of orthotic, sometimes referred to as a Night Guard, even those that’s inappropriate, to not allow the upper and lower anterior teeth to touch. Keep them out of occlusion and determine how the patient responds. If they immediately feel that they no longer are getting headaches or the headaches are reduced, the range of motion improves and their joints are no longer tender, then you know you’re dealing with some anterior misguidance. And you can correct this problem in phase two with some adult orthodontics.

Doug: Let me ask you this, Dr. Coughlin, the question that I think especially for patients would want to know, what is the cost generally of these treatments?

Kevin: I’d like to get as much as I possibly can, but that’s probably unprofessional and unethical. In fairness, it’s an excellent question. But generally, the diagnostic records will probably range somewhere between $175 and $650. As far as the actual treatment is concerned, the orthotics or the temporomandibular joint appliances and generally I would recommend one appliance for the lower jaw to be worn during the daytime and then an upper appliance to be worn at bedtime so you don’t wear both appliances simultaneously, what you’re trying to do is balance the jaw and keep in mind that this treatment approach is reversible.

It’s basically a phase one type of treatment to make sure your diagnosis is accurate and you’re providing value and care to your patient. Those orthotics can range from anywhere from about $850 to $2,250 per appliance and in most cases, the patient will need two appliances.

The course of care and treatment during this phase one is anywhere from three to six months and the patient is generally seen about every 14 to 21 days for adjustments and checks. Those visits are broken into short, medium and long, and the visit fees will range anywhere from $45 to $95 per visit. Please, keep in mind, I never hesitate to quote fees or recommend fees to give the audience some general guidelines, but the fees are general and they will be determined by the individual providing the care and treatment.

That is generally phase one type of treatment. If we find that the patient has responded and they’re doing quite well, their signs and symptoms have been eliminated or significantly reduced, a fair number of patients go into what we call a Phase Two type of treatment.

The phase two treatment is instead of wearing these orthotics day in and day out, we try to use a combination of orthodontics, prosthodontics to align, level and rotate the teeth to the new jaw position so that the orthotics or appliances are no longer necessary. That type of treatment can run into the several thousand dollar category. In most cases, the orthodontic care can run anywhere from about $3,850 to about $7,200 depending on how much and how we’re going to move these teeth.

In some cases, if the patient has a beautiful dentition with little to no dental disease, I will push the patient and guide them more towards and orthodontic type of treatment. If the patient has significant restorations, existing amalgams, composites, crowns or fillings on the teeth, I many times will suggest using a prosthetic type of treatment rather than orthodontics. The reason for that is the patient gets a double whammy. Not only does their jaw feel comfortable and their bite feel correct, but the cosmetics are improved significantly.

And in some severe cases, the patient will need a combination of both treatments. Keep in mind the physiology of the human body we cannot move the jaw indiscriminately as far as we want or as needed in some cases, and in those rare cases, a surgical approach is sometimes needed.

And that’s categorized as orthognathic maxillomandibular facial surgery. These are cases where positioning the jaw, even with the most up-to-date orthodontic care and prostatic care is not adequate. We actually have to surgically reposition the upper and lower jaw to the get the patient in that phase two success.

Doug: Would that be covered by insurance?

Kevin: In most cases, in my experience, once you’re going into the surgical phase, in most cases, that would be covered by your medical insurance because there would be a letter of medical necessity and no longer will your dental insurance be involved. I should comment a little bit on the fee structure for the dentist and for the patients listening to this podcast; my personal opinion is temporomandibular joint of TMD issues are medical issues.

The debate is the medical insurance feels that it should be billed through dental, the dental feels it should be billed through medical. But make no mistake about it. The temporomandibular joint is a joint and it is a medical procedure and a medical treatment, in my personal opinion, even though in many cases the individuals best suited to treat these most common problems are dentists.

Doug: That makes a lot of sense. I really appreciate it, Kevin. Thank you so much for sharing on this important topic of TMD and what people need to know.

Kevin: Thank you, Doug, very much. I just want to leave the listeners with what I call the 3 Ps. I would strongly recommend as you see your TMD patients, look for the 3 Ps. The first P is what was the patient’s precipitating event? It’s either going to be macro or micro trauma.

The second P is why are they predisposed? The patient usually will have a class two division one or a class two division two, malocclusion or a recessive mandibula or retrusive lower jaw. The third is what’s perpetuating the problem? So the three Ps are Precipitating, Predisposed and Perpetuating.

The perpetuating problem is TMD patients typically are clenchers. They’re constantly over exercising and irritating the muscles of mastication. When you can identify the three Ps and are comfortable with those 3 Ps, then you’ll probably have an excellent result in treatment and the patients will be happy and you will find that the treatment of TMD can be extremely rewarding and very cost-effective once you understand the basic principles.

You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin. If you have particular questions, don’t hesitate to reach me through my website www.ascent-dental-solutions.com.

My special thanks to Mr. Foresta, whose company is Stand Out and Be Heard and is responsible for the professional production of the webinars and podcasts that you’ve been listening to. Thank you very much and Doug, thank you for your questions.

Podcast: Lisa Norton on how dental hygienists can improve efficiency and effectiveness

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: This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions. This radio podcast is brought to you by VOCO Dental Supplies. As usual, we’re here to talk about different areas of the dental profession and today, I have a special guest. Her name is Ms. Lisa Norton. She represents VOCO Company, but she has a unique background. She graduated from Albany State University in New York and then went on and pursued dental education in dental hygiene at Forsyth University.

She practiced dental hygiene for many years and then for a variety of different reasons, got into the consulting business. And as all of us know in the field of dentistry, there is no more difficult department to manage and improve upon than the dental hygiene department.

All of our dental individuals struggle with some of these issues and we hope that with Lisa’s expertise and the background of her exceptional company, she’s going to offer values to today’s podcast.

Lisa, thank you so much for joining us on this podcast. We’re excited to have you here. If you were to tell us over the years of experience as a dental hygienist and a consultant for VOCO, what would you say are the top problems in most dental hygiene departments?

Lisa: I think hygienists are faced with multiple time constraints. There is a lot of expectation from the dentist that they’re going to be able to take radiographs, treat the patient, educate the patient, reschedule them, treatment plan for them in a very short period of time.

One thing that I feel helps to increase efficiency in this area is to streamline their systems or work with the hygienists to eliminate some of the extraneous conversation, use paperwork that can streamline the protocol and better communicate with the patients. So when the dentist does enter the treatment room, they’re ready with what needs to be addressed by the dentist and have the back-up of what they’ve already discussed with the patient.

Kevin: In your opinion, with your background and expertise, what do you think the ideal timeframe is for a hygiene patient, if there’s such a thing? Do you recommend 30 minutes, 40 minutes, 60 minutes, longer than 60 minutes? Do you recommend scheduling by procedure? We have almost 20 minutes so you should be able to answer this fully and completely for our listeners.

Lisa: That’s a loaded question and I’m sure there are a lot of people on the other end listening to this waiting with bated breath on what my response will be. I think it’s really different for every practice. I think that depending on what the expectation is from the dentist and how large the practice is, what is expected to be accomplished within the appointment time, all those things need to be taken into consideration. I think that depending on what the patient is appointed for will depend on the time that the hygienist needs.

I think the first thing the office needs to identify is what they’re trying to achieve within that appointed time. Once that’s identified, then the office should sit down as a team to evaluate how much time is going to be effective and efficient. And then able to achieve what the hygienist is trying to achieve, what the doctors are trying to achieve, what the administrative staff is trying to achieve.

Multiple systems are in place and each one has to be addressed. Because the hygienist may present treatment that then has to go out to the treatment coordinator who has to address what the costs are, what the fees are. All those times need to be taken into consideration.

I think it would be unfair for me not knowing what the practice is to throw out a time. I can only speak from my experience where I worked on a 10-minute increment. We had a lot of freedom to appoint what we felt was necessary.

If I had a perio maintenance patient that required only a deep cleaning for that day but wasn’t required an exam or radiographs or was due for periodontal probing, I could see them in 30 minutes. That was me having the autonomy to book that patient on my own, but all offices have very different systems in place.

Kevin: As a practicing general dentist myself for 35 years, some of the problems that we all face is Mrs. Smith and Mr. Jones have been given a 60 minute slot and, of course, their dog got hit by a car, their child came down with a fever, they cancel and now you’re trying to find the appropriate patient for that appropriate time. I think we all struggle with this. Some of the processes and procedures that I’ve put in place that may not be politically correct — it’s what I call profiling — is the patient a one, a two, a three, a four, or five?

One means they’re the gold card. They’re the American Express Gold card. They have no insurance. They actually have been pre-approved by a soft credit check and we know those patients are prior approved. So no matter how badly the periodontal need is, if the individual does not have the financial funds, they’re probably not going to fulfil the treatment plan that’s best for them. So we do a soft credit check to determine the financial situation which is generally done through either Wells Fargo or Care Credit.

The second is categorizing the groups of patients. In our particular practice, we have five groups. Group 1; they have no insurance. What we consider the Gold Card. Group 2; they’re over the age of 65. As a general rule of thumb, usually your home is paid for, your kids are out of college and generally you’re in a retirement mode and you can finally take care of your own needs.

Type 3; you have insurance, but that insurance allows you to balance bill. Which is almost a dinosaur in today’s dental market, but they’re still out there. Type 4 are government assisted plans. These plans the government usually reduce your fees by between 60 and 70 percent, but you’re guaranteed a fee. And generally if you fill out the forms correctly, you’re going to be paid within 45 days.

Type 5 are those groups of patients that have insurance, but do not allow us to balance bill that patient. Or if we do balance bill, we’re taking a reduced fee because the dental office has signed up on a contractual basis that they’re going to provide us with X amount of patients, but for that luxury they’re going to reduce a reasonable and customary fees.

This way here the hygiene department knows from a financial and didactic stand point the profile of Mr. and Mrs. Smith before they go in. What are your feelings on that? And I hope you say positive because we’re on air.

Lisa: I will say I worked in two different types of practices: one which we only participated with two insurances and one we participated with many insurances including GHI, which was all the government state workers were signed up for, which was very slow reimbursement.

We were faced with either only presenting what we felt the insurance would pay for or presenting to the patient their actual need and allowing them to accept or reject treatment. The way that we did it was we created a system where the fee was placed at the bottom with all of the therapies included. That included the fluoride varnish, that included each quad scale, that included oral irrigation.

During that visit where they were assessed based on their periodontal probing that they were a moderate periodontal case, if they were a GHI patient, they were shown what their payment was going to be in total, including the co-payment which were procedures that were not reimbursed by their insurance.

Which were out of pocket payment because they were not covered by GHI. Yes, it was a reduced rate, but it was — as far as time, we were able to achieve a very effective treatment within a shorter period of time, a 50 minute time where typically it might be 60 minutes or an hour and 10 minutes. Just because we had the protocol and the procedure in place. Sometimes even less because we used the paperwork to streamline the efficiency of that chair time. And then when patients returned, we could rebook at a lower time frame. I would say I’m probably in agreement with you in the sense that time was taken into consideration, but we were able to shorten the time by streamlining the process.

Kevin: You’re more efficient and more effective.

Lisa: Absolutely.

Kevin: I want to get into some nitty-gritty. It’s amazing to me the number of sealants that aren’t done on premolars and second molars and first molars. The amount of fluoride that’s not offered to our geriatric patients and to our adult patients. I’m amazed at the number of ancillary procedures that are so critical to overall dental health and care and the outcome of our prostheses that can be implemented by a well run hygiene department.

Can you go into some data, some procedures, some materials that you find that are extremely helpful for most hygiene programs?

Lisa: Absolutely. One thing when I enter an office and meet with the hygiene department for a lunch period, typically, I’m there to talk about some of the systems I’ve used in the past, but also materials that my company offers to implement into their protocol. I try to work with the ADA risk assessment forms to help the hygienist use a framework in which they’re able to present fluoride to their patients. Again, we go back to streamlining the protocol.

The ADA recommends about 80 percent of your practice should be receiving some type of fluoride adjunct therapy. Many practices aren’t even aware of what their baseline is. So when we start to ask or I start to ask the hygienist, “Typically, who are you offering fluoride to?” They’ll say, “All kids.” And they don’t necessarily take the risk into account. When we introduce or when I introduce the ADA risk assessment, they’re able then to see this is an objective opportunity for me to say to my patient that they’re presenting in my chair at a high risk. And I’m going to recommend an adjunct therapy.

Often, hygienists, I think, are faced with a struggle of selling product or selling procedure and not just administering care. This takes that subjective part of their presentation out of it. And now they’re using an objective form, which is the ADA, which almost everyone is aware of. And it’s add a little of validity. Not that it needs to, but it does.

Kevin: More importantly, it’s showing value.

Lisa: Absolutely.

Kevin: In the professional healthcare systems selling has a negative connotation.

Lisa: Absolutely.

Kevin: But value has a positive connotation. And over and over again in my 35 years, I’d be a hypocrite if I didn’t say I’m interested in bumping my revenue. I’m interested in improving my numbers, increasing my profit. I would be wrong if I said anything else, but it should never come before patient care and service.

So if you’re selling a product that isn’t delivering value, then I think you’re a charlatan. If you’re not selling a product and recommending a product that provides value, then I think you’re not doing your job as well as you should. And the profession needs that.

Can you talk specifically about some fluoride products that you’ve seen some phenomenal results with VOCO, in particular?

Lisa: Absolutely. Profluorid Varnish is a varnish that is very well received in hygiene practices. The application goes on clear, it’s very thin. The flavors are great. We have caramel, melon, mint, cherry and now bubblegum flavor so it offers a wide range of option for hygienists. Plus, it’s at a very competitive price point. You think about when you’re offering a fluoride varnish to a patient and you’re a little bit over a dollar application, it takes less than a minute to apply. And you’re offering your patient a service and improvement in their oral health. And you’re increasing your hygiene production, as you just talked about. So it’s a win-win.

Kevin: This fluoride product by VOCO, is it applied by a brush or is it applied by a swab or is it up to the hygienist and doctor to decide what works best?

Lisa: It actually comes with a brush. It’s packaged with the brush and has a little well so it’s very easy to use. It’s unit dose. And we also have tubes available. If doctors are concerned about the waste, there are tubes available with all the flavors.

Kevin:  Do you recommend that the area be isolated, such as an isolite or a dry shield?

Lisa: No. Actually it sets with the saliva. Sometimes it will go on a little bit easier if you take a 2 by 2 and wipe the teeth and then just you swipe the tooth. You do not have to cover every surface. It does become available in the saliva afterwards. So not every surface needs to be covered.

Kevin: And home care instructions; are the patients supposed to avoid eating or drinking for 15 or 20 mins or can they go immediately to resume their diet?

Lisa: They can eat and drink. We ask that they avoid anything hot liquids or anything hard and crunchy. If it in the geriatric population, at the end of the day, we ask that they avoid alcohol for four hours. And the recommended time for it to be left on is about four hours.

Kevin: As far as ADA codes, what would be the code that our listeners would be using?

Lisa: It would be the varnish code which is 01206.

Kevin: And that code that you’re talking about, does the ADA do it by quadrant or by individual tooth? Do you know how our listeners would build this? For example, if we’re going to isolate the lower right quadrant, 28, 29, 30 and 31, is that billed as four individual surfaces or is it billed as just one varnish treatment?

Lisa: There are more than one code you can use in this situation. If you’re doing localized areas, there is a desensitizing code. My apologies that I do not have that on me and I don’t want to mistaken the number for you. There is a code that I could do some research on and get back to you as far as desensitizing. So if you’re working in a specific area, there are per tooth codes that can be used. But the 1206 code is for the whole mouth for a varnish treatment.

Kevin: Okay, very good. As far as sealants, I know VOCO has some different sealants that are available. Could you speak to that?

Lisa: Right now, we just have the Grandio Seal. It’s a 70 percent filled sealant which is a great opportunity because that high filler allows for increased wear. It’s going to hold up longer. It goes on very easily. We have a non-drip technology. So in the syringe, you don’t pull back on the syringe to stop the material from flowing out. When you stop pressing, it stops flowing. Hygienists can really appreciate this type of application because they’re not required to pick up a explorer afterwards to tease the material through or have to call the dentist in to adjust it down because it’s too high.

Kevin: My name is Dr. Kevin Coughlin. We’ve been listening to Ascent Dental Solutions. This is about the 60th podcast that we’ve produced and I have to give thanks to Mr. Doug Foresta who his company, Stand Out and Be Heard, without his expertise and his knowledge in podcasting, I certainly couldn’t do this on my own. And I like, at the end of each episode, to thank Doug for his expertise.

Today, I wanted to introduce VOCO and their ability to provide value, not only because of their products, but their ability to bring people into your office, train those people and help them to add value to our care and our service that we’re already providing. I could tell you that our company Bay State Dental had a 115,000 patient visits in 2016. And I cannot tell you whether it’s large or small, you need proper processes and procedures and a well-trained team to support your organization.

What I particularly care about with VOCO is their ability to come in and do lunch and learns to provide expertise to the staff that many time we as dentists don’t have that expertise. We should, but many times we’re confused on the new products, we’re not sure how to use the new products, and many times we don’t have a baseline.

Experts like Lisa can come to our practice and help us improve, more importantly than our bottom line, but our care and service to our patients. Lisa, I can’t thank you enough and your company VOCO for being here today. I’m sure we’re going to be having you back. Thanks so much for your expertise.

This is Dr. Kevin Coughlin. You’ve been listening to Ascent Dental Solutions. Thank you all for listening and we look forward to talking to you in the next week.

Podcast: Mike Pedersen on improved dental SEO

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: Good afternoon. You’re listening to Ascent Radio. My name is Dr. Kevin Coughlin, owner and operator of Ascent-Dental-Solutions, with an emphasis on knowledge, consultation, training and development. I’d like to give special thanks to Mr. Doug Foresta. He has produced all of my podcasts with Ascent Dental Radio and Ascent Dental Solutions. His company is Stand Out and Be Heard and I just always want to thank Doug for his excellent production.

Today, we have a special guest. His name is Mr. Mike Pedersen. Mike is the CEO of Dental Boost. It’s a cutting-edge dental SEO company for both solo and group practices with a focus on the dental market. Mike has been in this business for over 17 years with an emphasis on online marketing and six years, he’s been working exclusively with dentists.

His agency is able to help clients dominate all of their locations in Google organic searches. They’ve also provided custom high-converting dental websites. Most of the dentists out here listening and health care professionals realize that a website and a mobile app is part of our marketing program, but Mike takes it with his company, Dental Boost, to a whole new level.

Mike, thank you so much for taking time from your busy schedule. Can you give us a little bit of background about the particulars; why you saw this niche, why you decided to get involved with this particular aspect of the dental business?

Mike: Kevin, first off, thank you very much for having me on your show. I’m honored and it’s very much appreciated. Instead of going after the normal approach for dental SEO which is city dentist, city veneers, city Invisalign, city sedation dentistry, those are very general terms and the unfortunate thing is everybody else is going after those terms. And if you’re in a big city, you’re talking about hundreds of dentists going after that term.

Well, that chance of that one dentist, even when they hire an SEO company, the chance of that one dental practice ranking in the top three organically is pretty slim or none, even after one year, Kevin. One year of investing in SEO, the chances of ranking in the top three are very slim, depending on the competition.

So what we decided to do was, do our exhaustive research to find out what kind of what we call buyer-intent dental keyword phrases are people typing in Google for specific searches. And we came up with some staggering numbers, absolutely staggering. The first number we came up with from kind of a general standpoint was 577. The typical dentist when they hire an SEO company goes after all of their services and they tap on the city and then they’ll go after city dentist, city cosmetic dentist.

So we typically see that the approach with all dental SEO is about 20 keyword phrases. We’ve come up with what we call Phase 1 SEO. We’ve come up with over 500. And when we tell our dentists that, they’ve never even heard that number before. It’s kind of like, “What is that? I mean, 500?” And they don’t think we’re serious. And then when we give them our references and they talk to some of our dentists that we’ve done it for, then they start believing that we do what we say we can do.

The exciting stuff for us is the back end, we’ve got a proprietary system we use that’s Google friendly that makes it through all the updates. But the neat thing that we’re able to do is from a robust standpoint, we’re able to not only go after the city the dentist is in, but all the surrounding areas up to five. And so what we’ll tell our dentist is, “Hey, what are the areas you draw your patients from outside of your city?” And they’ll name a bunch of areas. And it could be neighborhoods, it could be outlying towns, things like that. So now we’re going after five to six locations per dental practice.

When we do that, now you’re talking about ranking for upwards of 2,500 keyword phrases for your dental business. And that’s called pure domination in dentistry. Pure domination.

Kevin: I can tell Mike, you’re quite an athlete. I don’t know if our listeners understand what your previous background was in athletes, but I can tell with your desire, your drive and just your overall excitement with your business, Dental Boost. For some of our listeners, even the word SEO, Search Engine Optimization, may be foreign.

For those dentists not as, let’s just say, digital savvy, my understanding is that there’s close to 13 billion Google searches very month. And out of those billions of searches, is it true that the majority, 50 to maybe 75 percent are coming on mobile devices and can you discuss with our audience how that’s changed?

A typical dentist like me who’s been practicing for 35 years, I used to think if I have a website, I’m doing online marketing and I’m free to go. But in reality, experts like yourself realize we’re probably throwing our money into the wind and not getting much of a return on our investment. Could you address that for us, Mike?

Mike: Exactly. And you said something that’s very important when it comes to Google search too is we call it Voice Activated Search or Voice Search. Where people are on a mobile device, and they will talk into their phone — they use SIRI a lot for Apple devices — but they’ll get on Google and they’ll type in “cost of veneers, Portland” or whatever it may be and they’ll start — voice activated search is exploding.

And when you think of voice activated search, which is what we optimize for in our SEO campaign, people don’t talk in general terms. They talk as if they’re talking to somebody right in front of them. And when they do that, you’re talking with three, four, five words so that they get a really defined search result.

And that’s another benefit of our approach, is that mobile search is exploding. And you’re exactly right, it’s over 50 percent on mobile now and growing.

So people are spending more and more time on their mobile devices, including shopping, which Kevin you and I, I don’t know about you, but I’ll speak for myself. I’m 53, tech savvy obviously, running my agency, but I’m old school. I’m not about to make a purchase on my phone. I’ll do it once in a great while, but I don’t think the user experience is very good on a little phone to make a shopping purchase. But a lot of the younger millennials, 25, 30, 35, 40 year olds, they’re doing everything on the phone now, everything.

So you make a very, very good point and it’s a great reminder for me to tell the audience that voice activated search is exploding as well. And that voice activated search is not somebody saying Portland dentist, you’re saying, “Looking for male dentist in Portland, Oregon.” They’re talking into their phone, is what I’m trying to get at. And if you don’t optimize your website for a mobile search, you are losing a huge percentage of people that are using mobile to search for a dentist.

Kevin: Mike, let me just follow up with another question. I know you’ve been doing this for a long time. I know that your clients have been over the top satisfied with the service that you and your company have been providing. But how do you track the results? At the end of the day, when you take on a client, how do you track so that we have objective data to determine the return on investment with your company?

Mike: Great question. First and foremost, we always send ranking reports every month. And that is just hard core data to show if we’re performing what we promised we would perform, which is ranking higher in organic search. Number one as an SEO company, we’re hired to rank our clients higher in Google organic. That’s number one. That’s right off the top. So every month we send a ranking report. We just sent one the other day to a client and this is pretty damn exciting. Kevin, honestly, this is unheard of in dental SEO. This particular client had 973 top three positions in Google. 973, can you imagine?

Kevin: Absolutely fantastic.

Mike: Yeah. So first off, we send a ranking report. Second, we’re going to look at the traffic boost that our services are bringing that particular website. So we’ll go into Google organic and we want to see an increase in traffic. The increase is going to be incremental each and every month because as we rank more and more buyer-intent keyword phrases, that traffic is going to keep going up.

Unfortunately with the old style of dental SEO, traffic hardly ever goes up because it takes so long to get those rankings for those general terms. We’re able, with our robust proprietary back-end system we use, what we’re seeing on average is the first month ranking report we send a client, they have over 200 top three positions in Google is our average right now, after only four weeks of working with us.

Kevin: Mike, if you don’t mind telling the audience, you talked about the organic search. What’s the inorganic search when it’s associated with Google?

Mike: Great question. It’s called Google AdWords. Google has continued to show us something. As SEO experts, we’ve seen this happen more and more, but they can always go so far and then people will stop using Google, which is this; you will see the first page of Google with more and more ads because that’s how Google makes their money. But if they sabotage that and they can’t, there’s no way.

There’s a lot of people that say SEO is dead. Well, they don’t quite understand SEO when they say SEO is dead because if Google littered the whole front page with ads, people won’t use them anymore and Google as big as they are will go away.

People hearing this might say, “That’s crazy, they’re a 50, 60, 80 billion dollar company,” there’s been many multibillion dollar companies that disappear and we can name them over and over and over again. If Google littered the first page of their website with ads, people would leave them. There’s no doubt about it. So people that say SEO is dead, they’re uninformed.

But when we talk about organic and then what’s left is called Google Ads and also the map section, and Google is even taking more of that away. The map section, that little box on the first page when you type like a city dentist, it used to be seven positions in that map. Well, good old Google didn’t like that that map took a big section of the page one for a search so they cut that down to three. Good old Google, rumor has it, it might cut that down to one and throw an ad in there.

So as you can see, Google constantly is trying to, without getting in trouble, put more ads in there. So Google ads typically are the four positions on page one and the top four positions on page one as well. So top and bottom, that’s eight positions of ads.

But let me tell you something, Kevin, about ads and especially with those dental support organization owners that are listening to this audio. If you want to play the Google ad game per location, you are talking about thousands and thousands of dollars per month to get an ROI because it takes a lot of investment to gain the trust with Google to lower the cost per click. But even when you lower the cost per click, you still might get a lot of clicks, but that doesn’t necessarily mean you’ll get a phone call or a new patient.

So we’ve done some research and we’ve found out a number that I want all the listeners to understand, and it’s this; we have found out through research and studies that Google AdWords only send 10 percent of all website traffic to a business. Hear what I just said again; Google ads only send 10 percent of website traffic to a business.

That means if that business, whether it’s a dental practice, a DSO with 50 locations, if you are not doing any kind of organic optimization, you are leaving 90 percent of the potential traffic on the table for all those locations. Ninety percent!

Kevin: That’s huge.

Mike: That’s a big number.

Kevin: Mike, I was wondering if you could share with the audience in your business experience Dental Boost, without getting too specific, whatever your comfort line is, but for the dentists out there, large groups, solo, corporate groups, what generally can they expect for an investment to get your expertise to help them grow their business, improve their position on Google? And at the bottom line, you want people calling the office and you want to convert this tracking to new patients for your business.

Mike: Are you asking what our fees are?

Kevin: Generally, how do you charge the dentists that are listening? Is there a set fee, a monthly fee, a start-up fee and then follow up fees? How exactly does your company run in that regards?

Mike: We’re pretty standard, but what we do, especially the offering that we have with this buyer-intent and hundreds of phrases we go after, we’re priced about right in the middle of what most credible dental SEOs charge. But remember, most dental SEO companies are using the old method that takes six months to a year to see any kind of result, any at all. That is true. That’s a fact. But what we don’t want to do is we don’t lock our clients into contracts.

We’ve heard horror stories and I dealt with a lot of clients. I’ve got one right now, a solo practitioner out of Seattle, no names mentioned because I love them to death. They brought us on and his previous company basically will not let him go and they’re trying to extort a bunch of money from him.  

We don’t want to do that. We don’t lock our clients into contracts. With a thirty day notice, they’re out. They give us a thirty day notice, they’re out. But we do have an agreement because we have a formal agreement that lets them know what they can expect from us and the investment per month and that kind of thing, but we do not lock clients into like a 12-month contract, 18-month contract. If clients aren’t happy with what we’re doing, they can leave within 30 days. So that’s one. Really we’re proud of for that one.

Secondly, we don’t have start-up fee, we don’t have this fee, we don’t have that fee. We typically have a monthly retainer that our clients hire us on. That monthly retainer never changes unless they want to add on more services. And Kevin, I didn’t even get into all the stuff that we’re doing that’s getting really exciting for a lot of our clients, what we call add-ons and keyword clusters.

And I can tell you that a little bit, but for the investment it’s basically just one fee per month for SEO and depending on how competitive the area is, if you’re a solo practitioner, we’ve got kind of a baseline we start with as far as investment. It’s definitely not in the low end. If you’re looking for hundreds of dollars a month, we’re not the company for you. That would be another company that you would want to call on. It depends on the competitiveness of the city or the investment for our services. But our services only fluctuate $300 to $500 from top to bottom. So it’s not a real massive increase, if somebody has got a city that’s 500,000 we don’t like triple the cost, we just incrementally go up.

For a DSO, we basically cut each location in half. For example, the ideal situation for a DSO, so if the DSO owners are listening, please listen to this; Google is looking more for brand recognition now. No longer do you need individual websites for each one of your location. And I would strongly recommend against that. Have a brand that has all your locations on one website. That makes it consolidated, that makes it more cost-effective. And for us, now we can treat it not as separate accounts, like we would have to with each website, now we can treat it as we’ve got an initial investment for location one and then location two through the rest of them, we cut in half basically.

So it becomes way more affordable when you look at the investment with each location as its own business, even in a DSO, it’s still its own business but in this umbrella of a DSO, we cut it in half. So we feel like we’re very accommodating for a DSO to cut that price in half for each and every location after the first one.

Kevin: I can’t tell you how much I’ve enjoyed and I’m sure our audience has enjoyed listening to your expertise as CEO of Dental Boost. Your particular interest and expertise to dentist is a credit to you and your company and it certainly will help us who struggle trying to find new patients and how to handle this new world of digital marketing. Can you tell our audience the best way to connect with you ; a website, an email, a phone number?

Mike: Sure, absolutely. One thing I want to say is there are a couple of dental practices on the east coast that have the name Dental Boost. Our company name is The Dental Boost. Because if the listeners just went to Google, they’re going to find a couple of dental practices back east so we want to make sure the word “the” is in front of that. The website is www.thedentalboost.com. My email address is mike@thedentalboost.com. Our business number is 866-500-1414.

And Kevin, I want to say one last thing too that’s really important to the listeners, and I love doing this, by the way. Anybody that’s seriously interested in doing this, we really don’t want anybody just trying to just kind of pick our brains and not have an intent into possibly hire us. I do a personal thing we call a Digital Assessment.

That Digital Assessment is I will do a screen share of my computer with all of your online presence. If you’ve got ten locations, if you’ve got one location, I will pull up all your different web properties and I’ll analyze them right there in front of you on your computer screen. You’ll watch me click around. I did it with you, Kevin.

Kevin: You’re not kidding. And for those listening to us, it was an extraordinary eye-opener. The time and energy that Mike and his company put in to evaluate, in my opinion, is worth a pile of gold.

We’re not experts when it comes to marketing. We’re experts in the web. My personal opinion is talk to the experts like Mike. Have them get you straight and narrow so that you get the best results and you don’t waste money and time. Mike, is there anything in closing that you’d like to tell our audience?

Mike: When you make a decision to invest in your practices, you own a business. So it is an investment. A lot of dentists we talk to really kind of fret over I don’t want to spend this much money or I can’t spend that much money. It’s an investment in your business and because everything is online now, I would strongly recommend giving serious consideration to investing in a digital marketing program for sure, whether it’d be with our company or another company. But other than that, Kevin, I just want to thank you so much. I’m very honored to have been on this call with you and I thank you very much for that.

Kevin: Right back at you, Mike. We’ve been listening to Mike Pedersen, CEO of The Dental Boost, an expert in online marketing, but in particular, search engine optimization to get the best bang for your dollar.

My name is Dr. Kevin Coughlin. You’ve been listening to Ascent Dental; my company, Ascent-Dental-Solutions, with a focus on knowledge, development and training and education for the dental community.

I also would like to close with a thank you to Mr. Doug Foresta who produces each and every one of our podcast and his company Stand Out and Be Heard. If you’d like any additional information in how podcast can help your business, give me a contact at www.ascent-dental-solutions.com.

Thank you everyone for listening. And I can assure you we’re going to get Mike Pedersen back from The Dental Boost to talk about the inorganic along with the organic portions of SEOs. Mike, thank you again and thanks to our listeners. I’ll talk to you soon.