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Podcast: The Benefits of Dental Therapy

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 Dr. Kevin Coughlin and you’re listening to Ascent Radio. This podcast is brought to you by Ascent-Dental-Solutions.

I’d like to start every podcast with special thanks to Mr. Doug Foresta. His company, Stand Out and Be Heard, has been participating in over 75 podcasts. And without his expertise and his business acumen, this podcast would not be possible.

I also would like to give special thanks to the VOCO Company. They have been supplying over 40 years of dental supplies and products to the dental community.

They’re a worldwide company and have headquarters in Germany and their headquarters in South Carolina, and a special thanks to VOCO for their expertise and supporting this broadcast.

This afternoon, we have three guests. The Kellogg Foundation is a foundation that is almost totally devoted to improving oral health for our most vulnerable population. And that’s the young children under the age of 18, but particularly, those most prone to dental disease under the age of ten.

This foundation has been providing services, finances and expertise and looking for solutions to improve this epidemic situation, which is dental caries and dental disease, primarily in our younger population, and primarily the population that’s underserved in need of the greatest assistance.

Today, our guests are Dr. Mary Willard, Ms. Sarah Wovcha and Dr. Terry Batliner. The three of you, thank you so much for your expertise and knowledge in the subject of improving the situation. And special thanks again to The Kellogg Foundation for their effort and expertise in this area. I’d like to start with Dr. Willard. Mary, what do you think is the most significant problem for dental education and dental care in this particular population?

Mary: The biggest issue is access to care, I believe. We have many populations living in inner cities that have trouble getting appointments with dentists. Sometimes in places like where I live in Alaska, it’s because there are very few dentists in our remote villages and communities. Sometimes in inner cities it’s because the dentists don’t accept Medicaid or uninsured patients.

Kevin: If you had the ability to snap your fingers tomorrow, with your expertise, knowledge and background, what would you say would be the single best solution, in your opinion, to improve the situation?

Mary: I don’t think there’s one single thing that we can do, but one very effective tool is to implement the use of dental therapists in our dental teams to expand access to underserved populations.

Kevin: Sarah, if I was to ask you the same question, is there anything you’d like to add or delete to those recommendations of Dr. Willard?

Sarah: No, I think Dr. Willard has hit the nail on the head. Those are precisely the issues that we face in Minnesota.

Kevin: Dr. Batliner, with your expertise and background, is there something you’d like to add or delete or do you think that’s the significant problem and that’s perhaps one of the strongest options or solutions?

Terry: Sure, let me just define the problem a little bit more. I live in two worlds. I have three dental practices in Boulder, Colorado and around Boulder and I also am the associate director for The Centre for Native Oral Health Research at The University of Colorado where we conducted research on Indian reservations.

There really are two types of problems and Mary touched on them quickly. One is that there’s not enough providers who take Medicaid. In my role in Boulder, I’m a Medicaid provider and there aren’t very many Medicaid providers, even though the compensation is pretty good in Colorado.

And then in my role as a researcher with native communities, we see that the dentist to population ratio, which averages 1:1600 in the United States, on reservations such as Pine Ridge in South Dakota and the Navajo Nation in Arizona and New Mexico has a dentist to population ratio of 1:4000 or worse than that. So it’s very difficult for people to access care.

In combination with that, in places such as native communities or in the Medicaid population, the amount of disease is much higher. And so we find that kids three years old, perhaps in Navajo at age three, 70 percent of those kids have untreated decay. On the Pine Ridge Reservation, about 55 percent of those kids have untreated decay in our latest data. So there’s a lot of issues.

We also found that the Hispanic Medicaid population in the Metro Denver area is comparable with their degree of disease to the kids on Pine Ridge. About 55 percent of kids have untreated decay.

Kevin: I thank the three of you for that feedback. I am a practicing dentist. I still practice. I was actually in my office practicing since 7:00 this morning and I deal with all different populations. My practice is fairly large. We see on an average of about 116, 000 patient visits a year and I am quite familiar with the problem.

Since we have a variety of listeners, in your opinion Dr. Willard, what would you say the dental therapist for those who may not be up on the topic, they may not be as informed or educated, and sometimes there’s misinformation.

My personal opinion here on the East Coast, but particularly in New England, you have two schools of thought. One school of thought is they’re very much against these mid-level practitioners, these dental therapists, these expanded duties. And my personal opinion, it may not be accurate, but my personal opinion is many in the dental community find this as a threat.

If we do the SWOT analysis — Strength, Weaknesses, Opportunities and Threats — they perhaps are concerned that there’s a threat to their business and to their income. Other individuals may be concerned with quality of care, the ability to monitor the quality of care. Could you address those issues and perhaps sway the listeners how those potential issues could be misguided?

Mary: Basically, the dental therapist is a primary care provider, new team member who brings additional services and brings a different team player to the dental office. What we have is a provider who is able to provide basic restorative, preventive services and is typically from the community.

For me, that’s the big aspect of what this dental provider brings, is a familiarity with the customs and needs of the community they’re serving, especially when they come from that same community. It’s a way to provide care closer to home and also having a therapist on board is a way to provide patient navigation services as well, so services that are out of the scope of a dentist.

What we see in Alaska right now is that the dental therapists are able to provide the basic restorative and preventive services that are needed and then they can provide referrals to the dentist for the higher level care. As a result, we’re seeing that the dentists are able to perform more of the higher level services and are not spending as much time on the basic restorative.

So what you’re going to have as a dentist working with a therapist is an increase in your production, especially in those higher levels like partials, dentures, implants, crowns and visits because you got that fixed during the restoration. We’re finding that it’s increasing the bottom line for the dental practices as a whole.

Kevin: And that’s possibly a motivation to move the dental profession perhaps in a more positive direction. Ms. Wovcha, Sarah, if you were to add or comment to Dr. Willard’s assessment, would you agree, disagree, add or delete anything?

Sarah: I agree with Dr. Willard’s assessment. I would also say that if we look at the facts in terms of not only the training, but what we are seeing when dental therapists are engaged in a practice, they bear out that they are quality, efficient providers. To give a specific example of that in Minnesota, dental therapists at our training programs in Minnesota are educated side by side with dentists. When they become licensed, the exam that they undergo is in a blind setting.

In other words, the evaluators do not know whether they are evaluating a dentist or a dental therapist for the procedures that they are assessing. So it’s completely competency based. Again, they’re trained with dentists at the same institutions and they are evaluated in the same way in a blind setting.

I think the difference is that dentists are trained to do around 500 some procedures in Minnesota, for example, and dental therapists are trained to do about 50 some procedures.

So they are learning in-depth how to do these less complex restorative procedures and they’re gaining a repetitive skill set. If you just look at the sort of objective external factors of the training and the assessment, it bears out that they are competent and at least at the same level of quality as dentists.

Then when we look at how they actually perform in practice, the State of Minnesota Department of Health has done an assessment of all licensed dental therapists and have found that they are productive in practice and there have been no confirmed incidents of malpractice since they have been licensed in our state. Again, there are very objective metrics that show quality, efficiency and expanding access to care.

Kevin: Dr. Batliner, is there anything you would like to add or comment or delete from the previous two experts? Is there something that you’d like to present to our listeners?

Terry: Sure, I think the quality has been studied. Dental therapists have been studied more than any other type of providers in the last ten years and have been shown to provide quality comparable to dentists doing the procedures that they perform, which is a smaller number than dentists. I think the other thing to consider is that they can operate more cost effectively.

For example, in my practice, I pay our associates 30 percent of collections. So let’s say they do — just to make it easy — $300 an hour, so they get paid about $90 an hour.

We hire hygienists in Colorado. We pay them quite a bit in Colorado, around $40 an hour. It’s reasonable to think that I could hire, if they were legal in Colorado, a dental therapist for somewhat more than a dental hygienist. I think that’s what Sarah has found in Minnesota.

So let’s say we pay the dental therapist $45 to $50 an hour and then they can do, in our studies of their performance around the country, around 75 or 80 percent of the things that people need when they walked in the office. So it’s a cost effective arrangement. It would allow more offices to provide care to underserved groups that may be parts of programs such as Medicaid that pay based on a discounted fee schedule.

Kevin: Dr. Batliner, I’m going to do a follow up question with you. If we could snap our fingers and based on the information and data, there’s roughly 500,000 dentists in the United States at any given time. And my understanding is that roughly around 200,000 to 250,000 are actually practicing fulltime. If we could snap our fingers and create another 250,000 dental therapists tomorrow morning, what would be the motivation to have those individuals go to the population in the locations that we need?

Is there a solution or a discussion that The Kellogg Foundation and the experts in this area are looking into? Let’s just say a miracle happens tomorrow, we’ve reached through the political quagmire and we’ve got these hundred thousand plus therapists, how do we get them to the areas that we need?

Terry: The first thing is we have to recruit them from those areas. As Mary has learned in Alaska, by recruiting people from the villages and they’re trained quickly in somewhat between two and three years, where they don’t lose touch with their home community and then we found that they return to their communities. That’s number one. Number two, if you want to involve more people of color, socio-economically disadvantaged people in the education system, you have to keep it as inexpensive as possible. Because it’s difficult for people to borrow hundreds of thousands of dollars and then pay that back, as many dentists have to do.

Keeping the training as short as possible, CODA, the Council on Dental Accreditation, has kept it at three years after high school. I think that’s good. The programs need to be cost effective and quick, and that will involve more people. I think those are really the issues; recruit people from the communities, keep the training as short as possible and as inexpensive as possible so that the people we need to get trained can get trained.

Kevin: Ms. Wovcha, Sarah, let me ask you a follow up question in regards to this situation. These therapists, how would they be compensated? Do you see this as they would be compensated not only through maybe a clinic such as Dr. Batliner owns, or do you see this as a State or Federal government sponsored, and they would be compensated for their services and their education through tax dollars in some shape or form?

Sarah: What we are seeing in terms of actual practice is that they are compensated as a credentials provider with medical assistance and private insurance as well. So they’re compensated in the same way that other dental providers are compensated.

We’re also seeing that they’re eligible for loan forgiveness, for example. So they are receiving in Minnesota, for example, some government dollars and there are actually private foundations that are helping to offset the cost of education. Is that answering your question?

Kevin: It is. Part of it is selfishly, I’m embarrassed to say that I’m not as well educated in that area as I should be. I’m assuming, like Dr. Willard working in the Alaska area, there are limited number of private practices. So I’m thinking out loud now on this podcast, is the therapist coming from the community would potentially have their own facility because there’s not enough dental facilities and is there an issue or a problem? Again, in full disclosure, I personally am 100 percent for expanded duties and always have been. I think it creates competition, it provides better access to care.

And selfishly from a financial stand point, I think most business people, particularly in dentistry, realize that a dental assistant provides an enormous increase in income and so does a dental hygienist and so do dental associates. So from my simplistic point of view, why wouldn’t dental therapists also? And I think Dr. Willard touched on those bases.

But in the areas where there’s just not enough dental facilities, do you see any issues or problems with these therapists striking out on their own to create more environments for the populations to be treated?

Sarah: I don’t see problems with that. In fact, the model is well adapted to be able to expand access in regions that don’t have dentists or don’t have traditional facilities.

Let me give you an example, again, speaking from the perspective of Minnesota. In Minnesota, dental therapists can practice in any setting in which there are 50 percent or more patients on medical assistance or uninsured patients in poverty. That can be a private practice setting, it could be a community clinic, it could be a mobile dental clinic, a hospital, a school based setting. There’s a large array of settings in which they can practice.

They must be in a relationship with the dentist. In other words, they must have it’s called a collaborative practice agreement, so that they can have a level of supervision by a dentist. But they are able to work independently.

In other words, in a large state, a dentist could be practicing in Saint Paul, Minnesota and the dental therapist could be five hours away in the wilderness in Ely, Minnesota practicing. So they’re certainly well situated to do that, and they are, in fact, doing that.

Just to give an example of distribution of dental therapists compared to dentists in Minnesota, our most underserved regions are our rural regions. And according to the study of the Minnesota Department of Health, right now 74 percent of dentists practice in urban settings and only 26 percent practice in rural settings. And with dental therapists, the numbers are almost double in rural and significantly less in urban.

So 47 percent of dental therapists practice in rural regions and 53 percent in urban. So we’re seeing better distribution of dental therapists that reflects the community in need.

The last thing I would say that Dr. Batliner touched on is that the way that we compensate dental therapists in Minnesota is much more sustainable for a clinic. For example, on average, a dental therapist in Minnesota receives $45 per hour and dentists receive $75 per hour. If you calculate the savings for a clinic, and this is really quite a conservative estimate.

If they see around 1,500 patients per year and I’ll say that the providers I employ see more like 2,000 per year, the cost savings is $1,200 per week or $62,400 per year. And what we do with that funding is reimbursed in our dental providers. In other words, I can hire two dental therapists for the cost of one dentist and they can provide 50 of the most commonly needed restorative procedures in our clinic.

Kevin: First of all, I want to thank The Kellogg Foundation for putting their emphasis and financial backing to this problem. It has to be addressed, there’s no reason it can’t be addressed, and with experts like we have on today’s panel and the conversation starts to get discussed, action steps can be made.

I want to thank our three speakers and guests today. Dr. Mary Willard, Director of Dental Health Aid Therapist Educational Program at the Alaska Native Tribal Health Consortium. Ms. Sarah Wovcha is the Executive Director of Children’s Dental Services in Minnesota. And Dr. Terry Batliner is a member of the Cherokee Nation and currently working on faculty at the University of Colorado and is also the owner of Sage Dental Care with three private practices also in Colorado. Your expert opinions, in my opinion, are so important.

I can tell our audience, I know that this is a difficult subject for many, but quite honestly it’s pretty straightforward. Let’s get together as a profession. Let’s recognize the seriousness of the problem. Let’s put our heads and minds together and try to eliminate our selfish own wants and needs and see if we can tackle this from a political standpoint and educational standpoint. As I see it, it’s a nutritional issue, a motivational issue, an educational issue and with experts like on today’s panel, there’s no reason we can’t improve the current situation.

I want to say thank you to all three of you very, very much for your expertise and time. I would like to follow up. I can tell from responses that there will be many other conversations and other points of view. But you’ve been listening to Ascent Radio.

My name is Dr. Kevin Coughlin. Please, for this podcast and other information, turn to Ascent-Dental-Solutions, with a focus on knowledge, consultation, training and development.

In closing, special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard, for sponsoring this expert podcast and the production of those podcast. And I also want to give special thanks to VOCO and their financial support and their excellent products and services to the dental community.

Thank you all for listening. This is Dr. Kevin Coughlin and I look forward to speaking to you soon.  

Podcast: Developing your team members

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 tonight’s podcast. My name is Dr. Kevin Coughlin, owner and CEO of Ascent Dental Solutions, with a focus on knowledge, consultation, development and training. I’d like to give special thanks to VOCO Dental Supply Company.

Without their generous support, many of these podcasts could not be provided. VOCO has been providing dental supplies and helping the dental profession improve the quality of care and service to patients for over 40 years.

I’d also like to give special thanks to Mr. Doug Foresta, his company Stand Out and Be Heard. Without his expertise and training most of these podcasts also would not be possible. So a special thanks to Stand Out and Be Heard, Mr. Doug Foresta.

Tonight, we have a podcast about developing team members. How do you take your staff or team members and make them more valuable and more engaged? I have several questions that have been written in and I’d like to address those questions. But to begin with, let’s talk about number one, what is important in developing your team.

Doug: The first thing I want to ask you Dr. Coughlin is — this is Doug Foresta — what I want to ask you is first of all, what is the importance? Can you say a little bit about what the importance is of developing your team towards the value of a practice?

Kevin: The first thing I would tell you is if you don’t have a successful team, you don’t have a successful business or practice. I think intuitively, all dentists understand that they’re generally the leaders of their organization. But unfortunately, most of us are not trained in leadership, we’re not trained in management, and many times, we don’t know how to facilitate our team members.

I’d like to tell everyone that when we talk about staff, staff to me means an infection. Team members mean to me individuals that share a goal and they are there to support your patient base, your business, and their main job is to improve the quality of care and service to our patients.

I’d like the listeners to understand that when a patient opens their mouth, they are a patient. But when that patient doesn’t have their mouth open, they’re actually a consumer. It’s important to understand the difference that day to day, we are not just seeing patients, we’re also seeing consumers.

And as consumers become more savvy, they have more information and data at their fingertips and this data and information can be disseminated so quickly. It is critical that you and your team understand that you’re not just dealing with patients, you’re dealing with consumers.

Doug: Can you give some examples? I know one of the things you’ve talked about is this idea that every team member is a sales person for your practice. Can you give us some examples of what you mean by that?

Kevin: Yes. I have been practicing general dentistry since 1983. I practice fulltime. I practice five days a week and sometimes I feel I practice seven days a week. I have 14 locations. I practice all forms of dentistry. I have over 150 employees and over 20 dental associates.

So when I speak to you as a consultant, as a person providing information and knowledge, I deal with these things on a day to day basis. Many of it has come from research, but most of it has come from the day to day trials and tribulations and the processes and procedures that we’ve been able to implement, that have not only improved the quality of care and service, but have improved our team members’ life and their lifestyle and my life and lifestyle, to make us more efficient, more profitable and to make it just an overall better experience.

The first thing I would tell you is your team has to understand that not only do they need knowledge in the basic dental procedures, whether that’s periodontics, endodontics, oral maxillofacial surgery, implant dentistry, temporomandibular joint or temporomandibular disorders, cosmetic procedures, sedation options, pediatrics, dental radiology, public health, the list is really extraordinary. And the ability to train your team to not just understand the clinical aspects, but in my opinion, what’s just as important is the value of these services. If Mr. and Mrs. Smith understand the procedure but don’t see the value, then I can tell you you’re going to spend a lot of time with empty unproductive chair time in your office.

Over and over, over my three and a half decades of training, education and lecturing, I have seen that many offices are well educated in the procedure, but they’re not trained in the sales. They’re not trained to educate their patient base or consumer about the value of the service. And that’s a critical piece that must be understood and must be taught.

I think there isn’t a dentist or a dental personnel out there that doesn’t realize that some individuals are just innately better at sales. In general, the medical and dental profession generally frown upon the word sales. Sales sounds unprofessional. We’re above the fray, we shouldn’t be selling anything. We provide care and treatment.

In the world that I live in, I believe that sales is positive. When you can educate, inform and motivate patients in a certain direction for a specific treatment, providing that treatment is the correct treatment and best for your patient, then sales are critically important because they motivate your patient to do what you think is best for them. And that’s not always the most expensive care, but it’s sometimes not only the most inexpensive care.

What I’ve learned over time is that you have generally five different patient types. You have the event-driven patient, the reactive-driven patient, the proactive-driven patient, the discretionary-driven patient and the regenerative-driven patient. It’s critical that your team members and you as the CEO of your office and leader understand these five different types of patients. Many times these groups will overlap.

The event-driven patient is the patient that just simply comes when something happens. Their tooth broke, they make an appointment. Their tooth hurts, they make an appointment. What motivates them is the event. The reactive-driven patient is the type of patient that knows they should, but unless something actually happens, they don’t do it. There’s some kind of motivator. Either they’ve gotten divorced and now they want better teeth, they’re looking for a new job and they think their smile is not as nice as it should be, they learn that their overall health may not be as good as it could be, they may be developing hypertension, diabetes and part of that medical issue is their dental component is poor.

The proactive patient is the patient that’s tooth-based. They want to treat one tooth at a time. They don’t look at the entire maxillofacial skeletal pattern, they don’t look at the occlusal schemes, they don’t look at the way the teeth upper and lower jaw and temporomandibular joint complex work as a very highly sophisticated tuned instrument. They’re proactive in that their tooth broke and they just want to fix that one tooth.

The next group or discretionary group is they want to look and feel better. Typically, in my experience, these are individuals that are a little older in life. They generally have been able to relinquish the responsibilities to their family and their children. Their children are generally grown, they’re out of college, they’re generally 50 years of age and older. They’re thinking about retirement and they say, “You know, this is the time for me. I want to look and feel better. I want to be a little selfish and start taking care of myself. The last few decades have been supporting other people.”

The last group are the regenerative-driven patients. What they want to know, is it worth the investment? They have the time, they have the finances, they have the knowledge, but really what they’re looking for is is there value in this care? If I do procedures A, B and C, is this going to be a good investment? Is it going to last me several years or perhaps several decades?

It is critical that you educate your team members to understand and sort of define these five groups because how you interact with these groups are going to determine your success rate and how patients accept your treatment plans.

Doug: Can you say a little bit how that ties in?  As you were saying that, I was thinking about the patient who says, “Is my insurance going to cover this procedure?” Are there certain types of clients who are more likely to just stick with what the insurance covers and then others are more likely to do other things that might not be covered by insurance?

Kevin: I attend well over a couple a hundred hours of continuing education courses every year. I’ve listened to experts not only in business, but in medicine and dentistry. And my analysis is you will always have that group of patients that no matter what you try, no matter how much you want them to believe, like and trust you, as I call it the BLT, at the end of the day if their insurance isn’t paying for it, I don’t believe they’re going to do that treatment.

However, we can improve our odds by isolating these groups of patients and trying to motivate them, try to manipulate. And I know that’s a poor use of word, but manipulate in a positive manner. What you have to try to focus on is the value. Not the cost, but the value.

Day in and day out, I simply say to a Mr. and Mrs. Smith, “I’ll be happy to remove your tooth today, but I don’t think it’s the correct or best treatment for you. In the short term, it will certainly be the most inexpensive approach, but in the long term it will be the most expensive approach.”

What I found over time is patients are motivated by time, money, sex and fear. What I mean by sex, just to make a point in this podcast, is people generally want to look good.

However, what I have found is if that individual is entering into a new neighborhood, a new job or a new relationship, that motivation, that hierarchy, moves higher to the top because they’ve been in a comfort zone. They’ve been in a relationship for years, they’ve probably allowed themselves to gain a little weight, they’re not exercising as much, their dental hygiene is not as good as it should be, they’re overall concern with cosmetics and aesthetics is less. But then there’s a changing event.

Perhaps it’s a death, perhaps it’s a divorce, perhaps it’s a new location and a new outlook on life and then that motivation of looking good and feeling good moves up. And basically why do you want to look good and feel good? In most cases, you want to have a vibrant personal relationship with another partner.

So keep in mind that in most cases there is an overlap of all these subjects. But in general, I think it doesn’t take long and it doesn’t take much education and training to understand that certain people are motivated by time — how quickly the procedure can get done, how quickly they can get in and out of their appointments because they’re very busy, they tend to be a type A personality.

The other group is that value. They don’t mind spending the money, but they want to find the value. Are they spending the money for the right reasons and are they going to get the results?

Another motivator which you can use to your advantage is fear. Many times patients have the finances, they have the time, but they don’t associate the fear and they are afraid of a root canal. In my opinion, if we could guide them to do the crown before the tooth breaks, there’s much less likelihood that they’re going to need a root canal. And when they understand it in those terms, they’re more likely to accept your treatment plan.

I’d like to share some statistics with you. Generally, the average patient in the United States, over the age of 20, spends approximately $500 a year on dental care. It’s critical that you understand that those $500 simply are telling us and our profession that most patients are treating tooth by tooth. They’re event-driven patients. They only come to see you because of an event.

Our job and your team’s job is to change them from event type patient to regenerative-driven patients. Showing them the value so that they’re looking at their entire stomatognathic system and they’re not treating one tooth, they’re treating their entire upper and lower arch and temporomandibular joint complex to get the best long term aesthetics function and cost results.

Doug: I have the last question for you here which is, thinking about when a dentist comes in and says you need this, you need this and I recommend this procedure, we’re talking about the importance of team members and sales. Do you find in general, that patients will sometimes if the team member either is the one to initiate saying I need this or maybe backs up what the dentist says, does that sometimes make the difference versus the dentist being the one to say you need this procedure?
Is there a difference in the level of trust with the patient?

Kevin: Based on my data and research almost 90 percent of all treatment plans are not accepted. For our listeners, don’t take this out of context, but a comprehensive treatment plan includes soft tissue management, hard tissue management and temporomandibular joint treatment and elective procedures. So a treatment typically would be Mr. and Mrs. Smith needs four quadrants of root planing and scaling. They need to be put on a three-month recall or re-care program.

They generally will require some kind of chemical intervention with prescriptions of Prevident, Periogard and Periostat to chemically fight their periodontal disease. And they need a comprehensive periodontal re-evaluation in three to six months.

In general, most patients will require the surgical removal of four wisdom teeth to create room and function and to reduce the chances of infection, pain and discomfort later on in ages. In most cases, almost all patients would benefit from some intervention of orthodontic care to align level raw teeth to provide stable accusal contacts on the upper and lower arch. That is a comprehensive treatment plan.

In most patients, what they’ll say is, “I’ll come in and have my teeth cleaned every six months.” And depending on how the practice evaluates their data and information, some patients would say that there are 100 percent success rate on the treatment plan because the patient had their teeth cleaned every six months.

If you want to be truthful, the reality is that patient did not accept your treatment plan. And the reason they didn’t accept it, in almost all cases, is they found no value. They were not motivated by sex, fear, money or time, and if there’s no motivation, there’s no reason to do something. That falls on the dentists and the dentist’s team members.

I think most contemporary offices would agree that a morning hurdle is critical. That morning hurdle reviews that patient’s medical history, dental history and treatment plan that has not been accepted. And that gets the team member and the dentist on the same side.

So a direct answer to your question is when a team member emphasizes a treatment and that treatment is supported and backed up by the dentist, the success rate increases by over 80 percent. But if you’ve had no morning hurdle, the dentist and the team members are not on the same page and you’re not prepared before Mr. and Mrs. Smith arrive at your office, your success rate drops by 80 percent.

It’s almost like anything. You never should go into a business meeting without a plan.

And that leads me to the last point, and a future podcast will deal with it, and that’s what I call the three Ds. You have to Design, you have to Develop and then you have to Deliver. Not only end to end service, not just clinical, but the business aspect.

The way the phones are answered, the way patients’ questions are answered, the way their insurance forms are filled out and monitored. These three Ds are critical.

For the dentist listening to this podcast, if you’re having a problem, take a look at these three Ds and focus on your design, focus on your development and lastly the way it’s delivered. And if you and your team aren’t on that same page, you cannot be delivering positive results.

The outcome is unproductive, inefficient time, lost revenue and most important, your patients are not getting the care and service they really deserve. They may think it, you may hope they’re getting it, but I think almost all good honest clinicians will realize that they’re short changing their patients.

Not every patient will do exactly what you say, but in the real world, if you can improve five or ten percent, that is huge to your bottom line. And that also is huge to the number of patients you’re providing a higher level of care and service and ultimately, that’s the goal.

Doug: Thank you, Dr. Coughlin. I wanted to reiterate that last part that far from what you said about sales being a dirty thing, truly if that person needs that — one of the things I hear you saying is if that patient really needs this and we fail to sell them on it, then we’ve actually failed their health. Our bottom line and we failed their health.

Kevin: A hundred percent, I agree. Most of us as practitioners, we get caught up in the run-of-the-mill day to day things. In the end, if you look at yourself not just as a service care provider but as a patient yourself, what you want is you want to know what’s best for you and your family and show the value of what’s best for you and your family.

And once you can show that, most people in the United States of America will find a way to get that care and treatment. Data says that almost 85 percent of all patients finance anything over $1,000. And part of not just training your team members, not just educating your team members and yourself, is you have to have financial policies that are available to allow your patients to come up with a structure to meet their financial needs.

Just like anyone, most people don’t pay cash for a car. Most patients do not pay cash for items over $1,000. And in most medical and dental care, $1,000 doesn’t go a long way.

So you have to have the financial plans, processes and procedures in place to make it easy for your patients to attain what they want. And that’s the best health, at the best price for the best service.

Doug: Thank you very much, Dr. Coughlin. I appreciate it.

Kevin: Thank you very much. You’ve been listening to Ascent Dental Solutions. My name is Dr. Kevin Coughlin. I really appreciate this time with you. I want to give special thanks to VOCO Dental Supply. Without their expertise in health, this podcast could not be presented.

And also special thanks to Mr. Doug Foresta and his podcast company, Stand Out and Be Heard. Without his expertise and production acumen this podcast would not be available today.

Thanks again for listening. I hope you enjoyed the podcast and I look forward to speaking to you in the near future.  

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.

How you brand your practice is crucial to its success

How you brand your business is key to how you’ll be perceived by existing clients and those looking for a new dentist.

How do I know this? Because I used to be bad at it!

I’ve learned, of course, and have leaned on the wisdom and services of branding and marketing professionals ever since.

But back in 1983, I made a blunder. Although I was marketing in many mediums at the time, I thought a humorous TV spot might be a useful strategy.

The commercial featured an absurd image of a dentist brandishing a carpenter’s drill about to start work on someone’s choppers. The idea was to apply a comedic twist to people’s fear of the dentist’s drill.

It didn’t work. Let me put it another way: people hated it!

So there I was, a successful dentist and I almost lost it due to a sixty second commercial.

The way you present yourself online, in print through marketing of any kind, is very important.

You want to consider the type of audience you have and the customer base you want to have. Look at the reviews you’re getting online to see what people are saying. Do a close review of your competitors and see why they’re getting their business to the level it’s at or even getting more business than you are. And use marketing and use the internet and social media and design to get your business to where you want it to be.

The lesson here is that you are an expert at dentistry and there are other professionals skilled at making you shine in the marketplace.

Pro-tip: if your marketing consultant suggests the carpenter’s drill idea, find another one!

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: 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: 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.