Very Dental: Hygiene Dollars vs. Doctor Dollars with Amy Morgan

[00:00:00] This is a production of The Very Dental Podcast Network.

[00:00:04] This is The Very Dental Podcast

[00:00:17] Welcome to The Very Dental Podcast where you'll find entertaining and relevant conversations with visionaries, clinicians, and your friends in the dental space.

[00:00:25] Now here's your host Dr. Alan Mead.

[00:00:29] Very Dental people, welcome back to another episode of The Very Dental Podcast. My third day at Spear Summit 2022.

[00:00:36] They literally just

[00:00:38] Everyone's leaving breakfast and going to the speakers just started so it's a little quieter out here in the exhibit hall

[00:00:43] So I get a little bit of quiet to speak with Amy Morgan of Spear Educated. Amy, how you doing?

[00:00:48] I'm good, and I'm glad I'm out with you because if I see another x-ray or bloody teeth,

[00:00:54] My little business heart will burst.

[00:00:56] Honestly poor Amy, she's in dentistry and like all we want to see is guts and blood and like broken teeth and all that stuff

[00:01:02] And and all she wants to do is help us run our businesses. Really? I mean like can't we do that in a bloodless way?

[00:01:08] That's all we're asking. Well, I mean it's interesting because Gary DeWitt and I are doing so much together and did so much during

[00:01:15] COVID and and the formula that that I have become very comfortable with is that to run a

[00:01:22] Great dental practice. It's 51% clinical excellence, but 49%

[00:01:29] Business excellence now, we're gonna give the clinical the 2% because I believe in karmic capitalism

[00:01:35] I believe that if you're doing the right things for the right reasons, it's okay to be filthy dirty stinking rich, right?

[00:01:42] So we're not gonna do scaling and root planing for the sake of profit

[00:01:46] However, it's 49% business and I guarantee you there is not a dentist on planet Earth that devotes

[00:01:54] 49% of their brain space. Oh, they don't to business. I'd be happy with 10%. Yeah in

[00:02:00] Turbulent times such as now

[00:02:04] 20% is needed but here's an interesting thing in scarcity

[00:02:10] What tends to happen is we overwork?

[00:02:12] Mm-hmm and

[00:02:14] underthink and and so, you know huddles

[00:02:17] Meetings strategic planning time goes out the window because if I just stay busy, yeah, I'm gonna be okay

[00:02:23] So I'm good with the clinical. Yeah, I just don't want to watch it. Yeah, I

[00:02:28] Feel like you've earned that really

[00:02:31] Little while. So yeah, right really so the first thing we talked about was the fact that

[00:02:36] In in Arizona when you go to a conference in Arizona

[00:02:39] You go into the room, you know

[00:02:41] You would you would think that Arizona being in the desert it'd be hot every every room

[00:02:45] That's that's like a lecture hall. You can see your breath

[00:02:49] Like I was in yesterday and I was like shivering

[00:02:52] I'm like, I don't I don't think I can keep doing this and and then you go outside

[00:02:56] It's like a hundred and ten degrees

[00:02:58] So you sit out there for a couple minutes you cool off and so the trick is and as Adam said everyone has to have

[00:03:02] Us you have to have a sweatshirt or sweater. You can't you can't be in Arizona without that

[00:03:05] well, I have a funny story about that not exactly but

[00:03:08] in

[00:03:10] 2004

[00:03:11] Jim Pryde passed away, but the week that he passed away we were doing our

[00:03:16] leadership summit in the Atlantis Resort in the Bahamas and

[00:03:21] He was rushed to the hospital and they were good. It was a DNR

[00:03:25] But as they were wheeling him in he said like hell I have an event. Where's Amy?

[00:03:30] So yeah, they get me on the phone. I'm in the Bahamas and our fearless leader is passing away

[00:03:35] And I'm he's like, are you there and I'm like, yes, I'm there are the doctors that they're there tell them tell them and I'm waiting

[00:03:42] for the profound

[00:03:44] Leadership statement. He goes tell him to not use the air conditioner but to acclimate. Yeah to the climate and I was like

[00:03:52] Okay. So the next day I was I go how do I spin this into a leadership?

[00:03:58] Statement, but we can because whether freezing cold or hot you gotta acclimate. Yeah

[00:04:03] No, that's actually there's

[00:04:06] Exactly. So and so when you get used to that it is sort of funny I

[00:04:11] Arizona's not a hard sell for someone. I'm from Michigan. So

[00:04:15] Particularly in January. That's when we have our podcasting me. That's the last time I saw you

[00:04:19] So Amy spoke at the voice of dentistry at 20 to in 2020 and that was literally like a month or so before

[00:04:25] The world ended pretty sure I may have been patient zero

[00:04:30] Because I was running a hundred and two fever and spewing on everybody but yes

[00:04:34] Well in and there are a lot of people that that I my previous podcast partner Jason

[00:04:39] He was sick before voices of dentistry and we had been in New York in December and like looking at the timeline

[00:04:46] Like yeah, he probably had it. He probably had it

[00:04:47] so I mean, I'm sure everyone was spreading it to each other at the time and

[00:04:51] But it is so funny because like no one we were all in the same meeting and none of us could have predicted what was

[00:04:57] No, and you said something kind of funny it's like you said in management, but honestly in

[00:05:03] everyone's timeline there's there's

[00:05:05] BC and after Kovac, you know, and it's such an interesting concept. So let's talk a little bit about that. What?

[00:05:12] What has changed for you and in what you do at spear?

[00:05:17] You know since what happened during the pandemic and then what is what has happened after and how did you how'd you manage that?

[00:05:23] Everything has changed and and you know from change management point of view

[00:05:28] You you got to go through the stages of death and dying and just get through it and accept the fact that everything's changed

[00:05:34] It's interesting on a funny note

[00:05:37] My husband and I have been married 23 years and 21 of those 22 years

[00:05:43] We were never in the same building for and we are now

[00:05:46] Yeah, we are now in the same thing

[00:05:48] I have been trapped in my office on zoom for the last two years, which being live is magnificent

[00:05:56] It's worth mentioning that this meeting has an incredible energy three years since they were able to do the summit

[00:06:01] Which I mean it was an amazing energy before but now everyone being able to come back. It's really yes worth mentioning

[00:06:07] This meeting feels amazing. Well, there's no question

[00:06:09] There's zoom fatigue and and we're gonna have to and we're gonna get through that

[00:06:13] Because we're gonna need to evolve and figure out that human connection

[00:06:17] To answer your point it was right after Kovac

[00:06:21] I started as you recall as a cash flow crisis consultant, so I felt I was on a mission from God

[00:06:26] I I was like I in your wheelhouse. I am built for this and

[00:06:32] we went into hyperdrive and

[00:06:35] Because what I know is that dentistry

[00:06:39] No matter what is a survivable profession

[00:06:43] And it's the panic things that get done that can hurt much more than the actual

[00:06:49] Urgency itself. So we went into

[00:06:52] You know, it wasn't fight or flee. It was probably fight, you know instead of flee is we went into

[00:06:59] Overservicing so we started

[00:07:01] You know live web every single day. I started to take all of my years of

[00:07:08] crisis prevention

[00:07:10] Created a you know everything from how to hold your staff intact during the furlough

[00:07:16] Yeah, how to engage your patients through the whole thing how to start delineating healthy

[00:07:22] How to find the PPE all the way down to?

[00:07:25] One of the things I'm most proud of is we also for our spirit practice solutions clients because we could see

[00:07:33] The gap that would occur six months later because of what was going on during the furlough

[00:07:39] We were able to prevent it

[00:07:41] And we called it the mind the gap initiative. We were able to keep it steady. So so the crisis itself

[00:07:48] was

[00:07:49] was incredibly

[00:07:51] fulfilling in a very weird way because

[00:07:54] You know, we were we were at the front lines

[00:07:58] Then you've got the post crisis

[00:08:01] Where you start to have you know, how do we adjust to the new normal?

[00:08:07] Should we be back to the great vaccination controversy

[00:08:11] right that we're spreading across the team reluctant to come back or

[00:08:16] Demanding more now we have I call it jokingly the great hygiene

[00:08:20] migration where hygienists now get to be brought to work in a limo with diamond tiaras and and

[00:08:26] own your children and so that there's there's you know, and

[00:08:31] And you know add to that monkey pox and and in recession inflation and gas prices

[00:08:38] It's a still very challenging time

[00:08:41] Yeah for dentistry the optimist in me says once again, there are specific things

[00:08:47] That any dentist can do to lean into their business to not only

[00:08:53] Survive, but I believe thrive in any and all economies

[00:08:58] Mm-hmm to champ the hygiene thing is really funny because I

[00:09:03] Had a it's really funny my hygienist of a lie

[00:09:06] I had a full time and a part-time and in my full-time

[00:09:10] Quit three days before they closed us down, but she you couldn't hate her for it. She she had an hour commute

[00:09:16] She found a job close to home. I'm still friendly with her

[00:09:19] I mean and and I'm like, okay

[00:09:21] But she gave me plenty of time to find another hygienist except then the world shut down three days later and you're like

[00:09:26] That's that's something and so I

[00:09:29] And you know attempting to hire a hygienist when you're not even honest to God sure when you're gonna when they're going to be able

[00:09:35] To see patients again. That's where I was in that spot

[00:09:37] It was bizarre in what what I did I lucked out

[00:09:40] I was able to take my part-time person and she became my full-time person and for me it worked out great

[00:09:46] however, I have a fair amount of anxiety and I talked to lots of people on the podcast and off that it's not even about

[00:09:54] Finding it challenging to hire

[00:09:55] There's no one to hire like like, you know

[00:09:58] You're putting all your feelers out and you get you don't get one applicant

[00:10:01] You can't even screen which applicant is better. You got no applicant. Yeah. I mean have you been hearing this? Oh, absolutely

[00:10:07] I mean, it's that's why I call it the great hygiene migration. It's like the wildebeest they've disappeared

[00:10:12] Yeah, and you know, I I jokingly sometimes wonder if hygienists were secretly

[00:10:19] independently wealthy the whole time

[00:10:21] But

[00:10:23] But the other thing is that I mean what you probably know that what's the percentage of hygienists that that just did not come back

[00:10:30] It's it varies from you know, and it's very different urban suburban. Yeah, right

[00:10:35] there's definitely geographic barriers, but I want to say something about this is

[00:10:40] You know every time whether it was the HIV

[00:10:45] disaster 2008

[00:10:46] There's lessons to be learned and going back to our theme of acclimation, right?

[00:10:51] There's ways to adapt there's ways to be agile. For example

[00:10:55] I'm you know, because the reality is is that if doctors just

[00:11:01] You know on a wing in a prayer just hope for a hygienist to come through the door

[00:11:07] And all of a sudden their systems start to fall apart

[00:11:10] You can't do that. You can't wish for something that for right now may not exist

[00:11:15] There's a whole bunch of hiring

[00:11:18] You know tips I can give but let's go to

[00:11:20] Let's go to the reality of the fact that there may not be either a hygienist or the right

[00:11:26] Hygienist for you, right? And so what you have to start doing is how do we actually

[00:11:31] Grow our systems to be able to adapt to it. And one of the things that I think you know is

[00:11:36] you know a way to consider is

[00:11:39] everything from

[00:11:41] starting to use your

[00:11:43] Assistance for coronal polishing to you know

[00:11:46] One of the things that Gary has always said is, you know being much more clear about your healthy patients

[00:11:53] versus your unhealthy patient very true, you know going beyond the myth of the six-month interval and

[00:12:00] Graduate, you know have a graduation ceremony, right?

[00:12:03] You really start to bucket your patients in a different way start to look at your scheduling differently where you might have

[00:12:11] An all-day hygiene day where the doctor is doing nothing but exams which can be very productive anyways

[00:12:18] There's there's many many

[00:12:21] Innovations that can be done that can take hygiene to the next level because if this is the reality

[00:12:27] The last thing I want to do is the doctors start to to actually

[00:12:32] Co-opt their schedule and start to do hygiene themselves because I was teaching this yesterday in one of the breakout courses that I had

[00:12:39] is that the the truth of the matter is is that the best percentage in a healthy practice is is

[00:12:48] 30% or less of

[00:12:50] hygiene production

[00:12:52] 70% doctor because

[00:12:55] hygiene dollar

[00:12:57] even in the best of times has at best of 15 to 25 percent profit right in a doctor dollar has up to

[00:13:05] 60% absolutely

[00:13:06] So so the minute you start start changing that percentage

[00:13:11] It's not just the rich and famous problem. It is a bottom-line profitability

[00:13:18] Sustainability problem so you you have to hold the line

[00:13:21] Yeah, and I gotta tell you I know a lot of people it's hard because our model has depended so much on on the the

[00:13:30] People coming through the door for hygiene

[00:13:31] It's like in in the story is is that I think a lot of doctors are so hung up on that that they're like well

[00:13:37] Hygiene we have to make sure our hygiene is going this way and I know a ton of doctors that either working more days

[00:13:42] to do their own hygiene or in

[00:13:45] And it's hard not to when you feel the desperation of I don't have a hygienist that I can count on to come in here

[00:13:50] But we got to get this done. What's your answer to someone like that? The answer is to that is keep calm carry

[00:13:56] Yeah, it's like actually I wanted to smack them across the face

[00:14:00] Yeah, and here's why I mean again is that if the profit you know, it's not no dis on hygiene

[00:14:08] I understand how they support and promote restorative which is the biggest bang for the buck always has been

[00:14:13] But the the the exam fee or the hygiene dollar fee is not what?

[00:14:20] Makes the practice viable. It is the relationship. It's the engagement. It's the connection and it's the dentistry that comes out of hygiene

[00:14:27] so if if you go quality over quantity not

[00:14:32] Mistreat your patients because as I say the myth of the six-month interval we all know is a toothpaste commercial, right?

[00:14:38] It is is that if we if our healthy patients are being cared for in a way that they're still

[00:14:45] Engaged and happy and we're able to spend more time on our unhealthy patient

[00:14:50] One would assume that more dentistry is going to be coming out of the unhealthy patient

[00:14:55] Anyways, so the idea of having to see everybody in order to sustain the machine is a false

[00:15:01] So I just boil it down because what I'm hearing you say is that some people don't need the six-month recall

[00:15:06] Because I mean every dentist listening this knows it's true

[00:15:09] There's people that there's people that

[00:15:11] Walk in the door almost as clean as they leave because they take good care

[00:15:14] And those people probably a six-month recall might have been overkill for them on some level

[00:15:19] Yeah, and I've had great success just to let you know with period honest that you know

[00:15:23] Period honest who do lots of implants get choked by their hygiene department and I've done amazing

[00:15:29] marketing campaigns where where they're graduating them back with a

[00:15:35] Celebration and a certificate back to their general dentist because they're maintaining, right?

[00:15:41] Right. I mean and it's it's a boon to everybody

[00:15:45] which remind me I'll come back to something else about a tip that might work, but

[00:15:51] So you can use this as a marketing opportunity a contest for you know, you know

[00:15:58] I see you to become a a PhD in flossing and you get to you get to

[00:16:04] You know come less right as long as we're doing status evaluations every three to five years

[00:16:11] Around their full mouth series or panos and and making sure that they stay healthy. No monitored neglect really interesting

[00:16:17] you say that you just just

[00:16:19] we

[00:16:20] I'll bet you I'll bet you I mean it

[00:16:24] We've done more full full mouth x-rays in in panos since the since kovat

[00:16:29] We literally have we've done more diagnosis since and it's just because because there was a time when people

[00:16:35] Didn't come because they were afraid to come

[00:16:37] But so they almost we almost get a shot at treating like a new patient

[00:16:40] Especially especially when when you've had I you know

[00:16:43] I've had my practice for a long time a lot of the patients were treated by the old guy

[00:16:46] I've learned a lot how I would prefer to treat someone

[00:16:48] Let's say to get sort of a patient that you've known for a long time. You still get to treat him like a new patient

[00:16:54] It's pretty cool actually wasn't bad at all. So there's something just there's something be said about that

[00:16:58] Well, I want to say something about that too, but I'm gonna come back to my tips

[00:17:01] Okay, I don't know about you

[00:17:03] But but the good thing about a tremendous health scare is I personally have embraced my inner hypochondriac

[00:17:10] Right, I mean I there is not one thing that happens in my body that a I don't say it's not Kovat first and B

[00:17:17] I don't immediately think that I'm like dying. Yeah of the bubonic plague, right?

[00:17:22] Yeah

[00:17:22] so but when that happens

[00:17:24] It's a boon for dentistry because the awareness of one's health always goes up

[00:17:31] Yeah

[00:17:31] And this is the battle cry of the systemic link between oral health and overall health, right?

[00:17:37] People tend to be much more

[00:17:40] intentional

[00:17:41] About their their health and well-being and so and this crisis is the gift that keeps on giving because it's not going away

[00:17:48] And so that is an opportunity to do a deep dive into patients of record who have maybe have been more ambivalent

[00:17:56] About their care. So yeah, I agree

[00:17:58] It's it really has been I didn't I don't know if we were intentional about it really to start with but it's it's been

[00:18:04] Pretty obvious to me that like there's nothing better than you know, just haven't having that all that information

[00:18:09] It's like you get a chance to start over with him, you know

[00:18:11] and to tie in the scare about the r-word recession is

[00:18:17] The bottom line is that people will always find money for what they want

[00:18:23] Not necessarily what they need but what they want. And so if you parallel embracing your inner hypochondriac

[00:18:30] with

[00:18:31] Wanting you know as Gary DeWitt always says you got to want the own the problem before you want the solution, right?

[00:18:38] So it's that fear of they won't pay

[00:18:43] Is a false fear because if they're if they're engaged in the process and own their problem

[00:18:49] They will find the wherewithal to pay

[00:18:52] especially if we

[00:18:54] Make it affordable for them to be able to percent. Okay, so

[00:18:58] Hand in hand and I don't want to derail but one of the things you hear that probably the two biggest things I've heard from

[00:19:05] Dentists and dental teams and that sort of thing. Is that one?

[00:19:09] Hiring is really tough. There's the hiring has just gotten tougher because of the other thing is is that

[00:19:14] no shows

[00:19:16] even verified appointments they in in because kovat is the

[00:19:21] The easiest excuse ever basically to for whatever whether it's true or not

[00:19:26] It's easier for a patient to not come even though they are plain and coming and so it's harder

[00:19:30] It's harder to keep your schedule together. Have you heard that? Well, it's interesting that you said that because I was

[00:19:37] Extremely excited on day one here at the summit. We did what we called a fireside chat. That was our internal

[00:19:44] and

[00:19:46] We picked the eight that what we did is we brought not the superstars but but four of our

[00:19:53] SPS clients who I voluntold yeah to to join me in a panel and

[00:20:00] What I wanted to do was because you know people listen to me and they're like, yeah, she's kind of funny

[00:20:06] But she get it. She don't know. Yeah

[00:20:08] Yeah

[00:20:09] I wanted it to become of the reasons the podcast work because I talked to normal dentists exactly right we want to come from the

[00:20:14] Horses mouth

[00:20:15] So I wanted to address the eight areas that I felt were essential to

[00:20:21] thriving in any and all economies no-shows and cancellations came up and all of them had very

[00:20:27] very

[00:20:28] foundational but solid

[00:20:30] Reasons on our or ways to hold the no-show and cancellation down number one

[00:20:35] I I will go to this to my grave is a no-show or

[00:20:41] Cancellation is a passive-aggressive way of saying I never bought into it in the first place very much is yeah, right

[00:20:47] I mean, I can't come right totally to the dental office. So so the all-important

[00:20:54] RFR reason for return

[00:20:57] Becomes that much more essential that seatbelts the patient to their next appointment

[00:21:04] I and that whether it's coming from hygiene is that that the reason for return has got to be more than

[00:21:10] Because it's your next interval which goes to our healthy patient piece because if there isn't a really strong reason for return

[00:21:16] Yeah

[00:21:17] Maybe not so a reason for return that gets baton pass to the front desk that then gets that gets

[00:21:25] reinforcing whether it's through the text through the email through

[00:21:29] Reinforces that behavior before however, our doctors were talking about the fact that they've got everything from a patient concierge

[00:21:38] Which works to help problem-solve their patients to

[00:21:42] The prepayment strategies I will tell you from the beginning of time if there's a financial

[00:21:47] Commitment tied to the appointment. You're gonna see more no-shows and cancellations to the fact that there are

[00:21:54] Almost like core values and and as opposed to just calling it policies about a cancellation policy in a charge

[00:22:01] Getting people to sign their their agreements and their commitments

[00:22:05] That holds them to the appointment they're working

[00:22:09] And tell you more about that. This was came from Alicia beta. I have always been

[00:22:16] concerned about you know, the no-show cancellation fee because that

[00:22:21] That I always feel like the no-show cancellation fee if you're gonna enforce it

[00:22:24] That's telling the patient you really want to come back. Yeah, and I mean and sometimes that's what I want

[00:22:28] Actually, but sometimes it can work

[00:22:30] I mean again when you think about if you're coming from a values driven

[00:22:36] reason why right

[00:22:39] Alicia

[00:22:40] practices in New Mexico

[00:22:42] she very pointedly pointed out that it's a

[00:22:45] Lower than poverty state and she's fee for service and she's having one of her best years and she does

[00:22:52] Have them sign commitments and there is a fee connected to it

[00:22:57] but it's from the viewpoint of we're partners and we're here together and

[00:23:03] Because this is a special time reserved for you. This is how you hold your account. We do it exactly

[00:23:10] that's that's an important thing the fact is that

[00:23:13] If the patient feels like they're one of four people being seen at once and there's sort of a number in the practice

[00:23:19] I guarantee you it's a lot easier to if in in if they if you use that verbiage where we hold this spot for you

[00:23:25] Because we're working together. I like that

[00:23:27] I like that a lot but but like I don't double book and so when if someone doesn't come

[00:23:31] I really am sitting on my hands because we we booked this spot for you and

[00:23:35] More importantly we booked this spot for you and there's no one else in the just you

[00:23:38] Yeah

[00:23:39] And you can use it as I said

[00:23:41] I got I I am a true optimist and I believe that if you set the patient up that the cancellation fee doesn't have to

[00:23:47] Happen, but like anything else. I'm not cookie cutter. And so when it works it works and there is

[00:23:55] Reasons now because you can say because we're setting aside

[00:23:59] Extra PPE for you and things like that. There does need to be a lost time fee not a cancellation fee a lost time

[00:24:07] See, that's even better right? I like that. Um, actually that's huge. I've done that that makes it

[00:24:12] And I mean what a simple way to

[00:24:15] Lost I like that. I like that a lot. I think I just invented that right now, but you really yeah

[00:24:19] Did you really Wow cuz that's really good like the other thing is is like the cancellation fee is

[00:24:26] Like you just poked me in the eye in a lost time fees. Well, you know, this was the time we set aside

[00:24:32] That's really good. Yeah, well, there you go. Well, it's like way less passive-aggressive than cancellation. I like that

[00:24:37] We invented something. Oh, yeah, that's how this works. Let's make lots of money. No, we will not know

[00:24:42] We'll give it away for free. Okay, but that's but again it all depends upon the relationship with your patients

[00:24:49] It's it's not

[00:24:50] Transactional it has to be transformative right and and going all the way back to zoom

[00:24:57] zoom fatigue

[00:25:00] The more we can lean into transformative. I mean here here's a manly Feinberg. I don't know if you got a chance to see him

[00:25:08] But he's he's a dear friend of mine and and

[00:25:12] Build a bear but even more important the dude is a crazy

[00:25:17] Mountain climber rock climber and he he uses the leadership strategies around summiting and things like that and embrace the challenge, right?

[00:25:25] But he was talking about the fact that here's a guy who's like scaled every mountain El Capitan

[00:25:31] And he goes it felt like

[00:25:33] The first time I was able to go into a grocery store without a mask that I was scaling El Capitan. It was my summit

[00:25:40] Right, so people are coming out like groundhogs like is it winter still?

[00:25:45] So the idea that people are craving human behavior, but they're canceling the dentist appointment means there's not a connection

[00:25:52] That's interesting. Yeah, right. There's not a connection. So making it a community. We're so happy to see you or we're

[00:26:00] Doing whatever we're doing is really important

[00:26:02] So it does do do not get stuck from the easy ways

[00:26:09] You can judge what's happening in your environment look in the mirror

[00:26:13] Engage and connect in significant ways and it'll pay off. Yeah, I love that. I love all that. It's really good

[00:26:19] It's really good. I mean because it's easy to

[00:26:23] It's easy to make it in us versus them. They're just irresponsible

[00:26:27] They're just in and you're saying well, okay, maybe but probably it's just they're not connected

[00:26:32] Yeah, because there's there are some things they're for sure gonna go do you know good because they're connected to it

[00:26:37] And so if you can make that connection, you're much less likely to and there's a lot of ways you can reinforce that connection

[00:26:42] Well, I always used to joke before BC before Kovat

[00:26:45] Yeah

[00:26:46] that you know the as a an older woman who recently discovered that I am

[00:26:52] Deathly allergic to hair dye and the only thing that's keeping me from looking like, you know

[00:26:59] 97 years old is highlights. I will jump over

[00:27:03] You know fire trucks to not miss my hair appointment

[00:27:07] I mean there is not I remember sitting in traffic just crying because I'm like, okay

[00:27:11] I cannot I mean because the sands of time are ticking through my hourglass

[00:27:14] How is that same that same reaction to a hair appointment?

[00:27:20] More important than my reaction to a dental appointment, right and it's all what we value. Yeah, it's all 100%

[00:27:28] It's one but but you know

[00:27:29] I'm gonna tell you that every dentist and every team member listening to this

[00:27:34] Even if even if they don't have that with every patient there are let's just say that you don't you just

[00:27:40] You're just a transactional person

[00:27:41] But there even if you're just a transactional person

[00:27:44] There are some patients you make this connection with you can't even help it

[00:27:47] like there's some people that you just

[00:27:49] Get a new patient walks in the door and you just click you can just tell there's some people that you do that now

[00:27:55] Even though that's unintentional that person is probably they're more connected

[00:27:59] They're more likely to listen to what you have to say, and they're also more likely to kind of

[00:28:03] Engage in the in co-diagnosis to all those things like

[00:28:07] Imagine if you if you if that was your goal

[00:28:10] If you were trying to make that connection all the time and the team

[00:28:13] Was trying to make that connection all the time all of a sudden that you know

[00:28:16] Not only does it become a different experience for the patient different experience when you're at work. I mean like

[00:28:22] Because it's more fun to connect with people than to do an MO on 19. You know I mean yeah

[00:28:28] And it is okay to not like somebody and here's the deal

[00:28:31] In a scarcity we're gonna go for both staffing and patients, right?

[00:28:36] Dentists build a wonderful sandbox and and not everybody gets to play in the sandbox it is okay

[00:28:43] And in fact it's freeing to be able to look at someone and say you know what this is a vision-based practice

[00:28:49] And our vision and philosophy

[00:28:52] Mandates that our patients partner with us, and it seems like you may need something else

[00:28:58] Can I help you find another?

[00:29:01] Practice like the least judgmental the way to say that you know I'm saying and you

[00:29:06] we've come to I we had a

[00:29:08] Stephanie a couple weeks ago, and we realized that we can say anything that we want to to a patient

[00:29:14] But we can say it in a way. That's kind and understanding that like in other words

[00:29:19] In your you know in your brain

[00:29:21] I hate this person

[00:29:22] You can say that to the person in a way that they'll thank you for it

[00:29:25] but you just have to and I mean spear has really changed the way I look at and a lot of those things because

[00:29:32] Every time I talk to Gary. I'm like god. Damn it. Why didn't I say it that way?

[00:29:36] Why can't I say it that way, but it's true you really can and so on some level

[00:29:40] Knowing that you it's okay to hate this person

[00:29:43] And it's okay to but you can deliver that in such a way that they'll thank you for it

[00:29:46] It's not like like literally having those communication skills is

[00:29:51] You said it's very freeing it really is you know you can make that choice

[00:29:54] You can't be held hostage

[00:29:55] And as I say there's the only difference between patients and and team is once an internal customer ones an external

[00:30:02] Right and the fact of the matter is is to not be held hostage in any shape or form

[00:30:07] The person you're talking to needs to want the relationship a milliscope

[00:30:13] I'm Millis and I don't think a Scotia is a real thing, but I think I assume it's very tiny

[00:30:17] yeah, a milliscope more than you want that relationship right for if we're talking about a

[00:30:25] Win-win situation right is that that patient needs to want the dentistry a milliscope more than you want to do it

[00:30:32] Yeah, and the that team member needs to want to be there a milliscope more than you want the team member

[00:30:38] Otherwise you are always going to be held hostage

[00:30:43] And and honestly going back to the hygiene thing I get the idea as it becomes like a Patty Hearst

[00:30:49] Situation yeah, you start to love yeah, you're you're sure you know

[00:30:54] You're you're kidnappers. Yeah, but the fact of the matter is is that you it you cannot

[00:31:01] You cannot

[00:31:04] Allow that to occur and so that means even if you do believe a team member

[00:31:11] Is the only team member in town?

[00:31:14] If that team member doesn't want to be in your practice that team member has to go. It's still yeah

[00:31:20] it's as you say you know I'm

[00:31:23] For the last year I've had a lot of podcasts where you're just like

[00:31:27] admittedly

[00:31:29] When you have a decent team

[00:31:31] Dennis and maybe smart Dennis are kind of throwing money at him at this point

[00:31:34] Yes, because every team member knows that they can start looking around someone's looking to poach him someone's looking

[00:31:39] So I mean like on some you have to value the team that you have

[00:31:42] But you still have to you still have to have the right team like you can't

[00:31:47] You can't plug someone in that's the wrong person just because they're a person and I mean

[00:31:52] post Cove it has made it like

[00:31:55] The I can't even tell you the number of conversations

[00:31:58] I have a lot of times in private groups where people are like oh god

[00:32:01] I found someone you know and it's it's a desperation move, but the reality is

[00:32:05] They also saw but they really worked me for and you could I literally talked to someone said every everyone

[00:32:10] I've talked to is

[00:32:12] Half the time they're using me as leverage against their current employer to get a raise and that sort of thing you're just like and people

[00:32:17] Are gonna be manipulative that that's the way the market is I completely agree

[00:32:21] I'd rather have no one than someone that's not the right fit at this point

[00:32:25] Well, let me let me talk to that because that raises my piscidity too because every time a dentist panics

[00:32:30] Mm-hmm and goes above the competitive norm for a wage

[00:32:34] they are doing a disservice to the rest of the dental community because the right you're right the three laws of

[00:32:41] compensation are

[00:32:42] number one the wage has to be competitive with what the market is paying and and the

[00:32:48] Interesting thing is that we are killing ourselves as a profession because the minute that a group of uneducated or

[00:32:57] Doctors are

[00:32:58] Promising the Sun Moon and stars they're starting to raise that wage ribbon and and there it is so that's number one

[00:33:05] Number two though is the practice has to be able to afford to pay

[00:33:10] The wage so you have to know your numbers the most important thing is you know when we do annual planning cash flow

[00:33:16] forecasting there are range norms for employee expense and

[00:33:21] you know the range for

[00:33:23] employee wage

[00:33:25] hygiene clinical admin and

[00:33:28] I'm actually gonna share another formula with you admin taxes benefits is

[00:33:33] Anywhere from 25 to 32 percent it can go as high as 35 percent in the big cities right of production

[00:33:40] So

[00:33:41] So once you know your percentages you never have to say no again

[00:33:46] So let's say the team wants more say well right now our wages are running above the wage if

[00:33:52] Imagine when we get to productivity level of here

[00:33:55] We'll be able to you know so at least to have the negotiation the third which I think is the most important

[00:34:01] They're all equal, but the third law is it has to be demonstrated

[00:34:07] merit

[00:34:09] Demonstrate you know there's no such thing

[00:34:11] Let me just demonstrated merit is an warm body where there's a spot open that somehow doesn't that's not demonstrating merit

[00:34:17] That's a zombie yeah demonstrating a pulse a zombie team member actually yeah

[00:34:22] I mean so that you know the Jerry Maguire show me the money

[00:34:26] I say show me the skill and so when a team member comes to me. I just

[00:34:31] You missed this, but it was so funny as we were I was teaching courageous conversations and a doctor while we were learning courageous

[00:34:38] conversations got a text from his office manager

[00:34:42] Saying that I just talked to the office manager next door the doctor who is next door was sitting next to him as he got

[00:34:49] The text the office manager next door

[00:34:52] said that she made eight dollars an hour more and was surprised that I was making less and

[00:34:58] She was texting the doctor at the course saying

[00:35:02] It was perfect they were both sitting there and of course he went into the blame shame and regret

[00:35:07] But I just gave her a raise and she's now only working two days a week and benefit

[00:35:11] I mean it was perfect. It was like oh my god, so I grabbed the text used it as the teaching point

[00:35:17] Yeah, and the teaching point going to back to it going Mary. I'm so happy first of all

[00:35:22] I said don't you dare text back any of the vitriol yeah, just say so so glad

[00:35:28] I'm so sorry you're feeling this way, but I'm so glad you brought it up

[00:35:31] I can't wait to do to review this with you when I get back home period

[00:35:35] But the next thing was just said though. You know the vitriol is okay

[00:35:40] Letting the world know or letting her know that but the vitriol because that would piss me off. Oh, yeah

[00:35:45] That's incredibly horrible, and there's a lot of that going on

[00:35:48] I hear about it constantly on Facebook that made me look so the reality is feeling that feeling angry about that 100% legitimate

[00:35:54] Yeah, I mean coming out over the top to fix it is not but like you said

[00:35:58] I mean like putting it into text where one exclamation point can no don't right?

[00:36:03] Yeah, so it was like your phone down put your foot

[00:36:07] But it was also and it's interesting that you said that because when we were teaching I messages the whole thing about an I message

[00:36:13] Is you it's all about I it's all about you you own the emotion so you can say I got really angry

[00:36:20] But you can't say it angrily right a leader has to be vulnerable and transparent so anyway

[00:36:26] So that was part of it, but what I also wanted from a transparency point of view is

[00:36:32] That I want I wanted a the first thing that you do is

[00:36:37] Because what Manly Feinberg said is that you don't chase behaviors you question beliefs

[00:36:43] so the behavior

[00:36:45] You're not gonna. Do it, but you know yeah, that's hard to buy

[00:36:48] I mean particularly when you're the emotional spot right so it would be like you know first of all

[00:36:54] He's gonna go back and just listen yeah, because you got to bring you know everything

[00:36:59] I hear it take notes listen mirror back because you can mirror back without agreeing the next thing is is to say you know

[00:37:07] You know part of my vision in philosophy is to compensate for merit for value and the job description

[00:37:15] So so what you know one of the things about

[00:37:19] Compensation is the hours that works the additional benefits. I would like you to do a

[00:37:25] Discovery for me, and there's actually a compensation worksheet. That's part of what I teach on the spear online series

[00:37:31] I just put out on compensation which is

[00:37:33] to actually have a

[00:37:37] Comparative of the wages past two wages future that includes

[00:37:41] Benefits additional taxes any non cash compensation because a $25 an hour

[00:37:46] Employee is more likely at 32 for sure right for sure and sometimes. They just don't know yeah

[00:37:51] Let's do a discovery like a parallel of the job description. Let's do a competitive wage discovery

[00:37:57] What I also want to point out is you know I would love to be able to pay more in

[00:38:02] Order for us to do that and remain viable we need to be able to sustain a productivity level of X

[00:38:08] Help me to do that

[00:38:10] Yep, right. I mean now. There's more. There's a lot more to it, but I mean be open anybody's allowed to have

[00:38:17] Whatever thoughts they're having yeah, but you also hold the line on the business principles the 49%

[00:38:24] Yeah, and the other thing is the accountability on that is that?

[00:38:27] Everyone feels they're worth everything all the time, but it's like until you can put that the

[00:38:33] Quantify that in some level. It's just it's just feelings at that point

[00:38:35] Well now you're just doing a paid political announcement for me because then you need

[00:38:40] Here's the deal if the doctor isn't functioning as a coach which means growth conferences

[00:38:47] wage reviews

[00:38:49] progress meetings growth plans job descriptions and

[00:38:53] Here at Spear scorecards right the scorecard is one of the neutral ways that way it's not a report card

[00:39:00] But it's a neutral form of communication that if there is

[00:39:05] Specific focused areas of

[00:39:07] result in merit that

[00:39:09] That is that team members summit

[00:39:13] There is at least progress meetings quarterly to go on a scale of one to five. Yeah, how do you think you're doing?

[00:39:20] This is where I think you are

[00:39:22] What how can we get that number even higher so as opposed to to I feel like I'm the best

[00:39:30] Assistant you've ever had yeah, it's it becomes a process of

[00:39:36] Show me

[00:39:37] Demonstrate it right and it's not it's not that team members are bad

[00:39:42] You know that I always joke and say no one ever looked up at the sky in third grade and say dear Lord someday

[00:39:48] I want to sex bit and make a dentist life miserable, right?

[00:39:52] There there. They're just trying to survive themselves

[00:39:56] So when you have there's no difference in parallel of getting patient accountability to team accountability

[00:40:03] right what we just said about the how to handle the no-showing cancellation is

[00:40:09] It requires talking it requires structure Stephen Covey says make the parameters black and white

[00:40:14] But why tell them where the quicksand and wild animals are?

[00:40:18] And you're gonna be okay. The other only other point I want to make is because there is

[00:40:23] Ridiculous reactionaries that are expanding the competitive wage. Yes. Yes

[00:40:28] more and more for some positions a

[00:40:31] variable component of

[00:40:33] Pay can work

[00:40:35] Which doesn't doesn't force us to be tied into this forever

[00:40:42] right and a variable component can be

[00:40:45] something like

[00:40:47] A certain point of this is the wage that you get and over a quarter

[00:40:53] I don't like to do it month to month because I want to even out cash flow. Okay over a quarterly basis

[00:40:58] Is that the ability to have a variable piece that then gets paid out over the next quarter?

[00:41:05] Okay, right every month. Okay that you do more than this then we can go there and if you stick to the

[00:41:12] The percentages that I just showed you and I promised you a percentage about hygiene

[00:41:17] Then you can actually

[00:41:19] Do this with a little less risk

[00:41:22] And a little bit more entrepreneur ownership on the team's part. Yeah, make sense. It does it does don't mind you

[00:41:30] 40 minute podcast probably not the place but let's just this is this is literally the fattest pitch you're ever gonna get

[00:41:37] I'm I guarantee you right now. There's people listening. It's going okay

[00:41:39] There's a lot here like drinking from a fire hose, but I'm interested. I like this

[00:41:45] And let's say someone is

[00:41:47] If they want to be able to use

[00:41:49] Use and apply these ideas and have you hold them hold their hand in how this stuff works

[00:41:54] What's the best way for them to to start doing this? Well, it's interesting that you say that because

[00:42:00] Spear practice solutions is an all-encompassing and evolving by the way. I'm working on the next level

[00:42:08] post-covid

[00:42:09] Approach because we are also customizing to handle zoom fatigue and stuff like that

[00:42:15] Which were beta testing as we speak because we evolve we want the dentist evolve spear practice solution is the most all-encompassing

[00:42:25] Unfortunately because it is anchored by an analytics platform. That's not the unfortunate

[00:42:30] I'm very happy because we make data driven decisions. We are exclusive to Dentrax open dental and Eagle soft

[00:42:36] However, we also recognize that the entire spear population is is

[00:42:43] Needing more practice management help. So part of my

[00:42:47] Growth in the company is I am now I just went to FGTP

[00:42:51] So I'm almost a dentist and I think everybody has sleep issues

[00:42:55] But we're dancers always

[00:42:59] But we are now looking at

[00:43:02] Applying more management to all levels. So thus the compensation model going over to spear online

[00:43:08] I just did a whole series on the influencing cycle on spear online

[00:43:12] I have some very exciting news that I probably can't say yet on faculty club elite

[00:43:18] Having access to some of the more in-depth workshops. We are looking at bringing some leadership training online

[00:43:25] Okay, so there is more and more coming

[00:43:28] Obviously, I'm a fan of

[00:43:30] In the worst of times you need a deep and profound coach

[00:43:34] so I'm gonna go the spear practice solutions model every time you need a partner, but

[00:43:40] This this community is so wide

[00:43:43] That we want to be there and and so we're there there's going to be more than less

[00:43:50] even here we did a a

[00:43:53] leadership symposium

[00:43:55] Because we feel that leadership is

[00:43:58] Essential right now, but I did promise before we go. I want to give a very quick thing about hygiene

[00:44:03] Okay

[00:44:03] Is there is a specific formula that if you are doing a variable component to for your hygienic?

[00:44:10] Your mythical unicorn hygienist is that there's a rule

[00:44:14] It's a simple rule of thumb and it's always worked is that hygiene wages

[00:44:19] Should range somewhere between

[00:44:22] 30 to 40 percent of their direct hygiene production and the 30 40 covers whether the exam fees are given to the doctor or not

[00:44:29] It's just somewhere between the 30 and 40 when you're creating a variable component. It's very easy to go

[00:44:35] If I'm paying you this today

[00:44:38] Your daily hygiene production needs to be this to justify it if we are consistently going above there can be

[00:44:46] More do you get what I'm saying? So that's that's one of the baselines that I use

[00:44:50] It really I mean it empowers it empowers and what's what's funny and I don't want to I want to drag into you. I

[00:44:57] Think a lot of times

[00:44:59] Employees when you empower them with stuff like that, they either you've got they either think this is great

[00:45:03] this is he's literally telling me how I can do more and this is what I need to do or

[00:45:09] She's telling me that I that you know

[00:45:11] I'm not gonna get a raise unless I have to do like like I always wonder it depends on how they look at it on

[00:45:16] Some level but I do feel like as we said before

[00:45:19] You can say anything in the right way you can and that's it sounds manipulative

[00:45:24] I don't mean it that way because

[00:45:26] Especially if you can detach the emotion that comes from you with it to to the to what you really mean in other words

[00:45:32] You're literally telling them. This is how you can if you if you're looking if salary or you know being paid more is what you want

[00:45:38] Here's how we do it. Yep

[00:45:40] I mean that's that's the important thing instead of instead of them making you feel bad

[00:45:43] Are you feeling bad that you're not paying them and there's there's so much of that going on

[00:45:48] Like you said very early don't panic. Don't panic my god when you asked about my big paid political announcement

[00:45:53] I forgot a really fundamental. We just did a profitability webinar series. Okay, that is recorded online

[00:45:59] I did the first one was all about how to do a break-even

[00:46:03] So, you know these numbers Frank then did one and then Gary and I just did one on financial arrangements

[00:46:09] So those that's is that is that spear online? It's spear. I it's I think because it was a webinar that was open to the masses

[00:46:15] I think it's recorded online. There were there were

[00:46:19] 500 people signed up and of course 50 or 60 were their lives. So because that's how zoom works

[00:46:25] I will admit I said this too. I said this to Greg I think earlier, too

[00:46:29] I said, yeah, I didn't I do anything zoom

[00:46:31] I I refused basically the only time I did anything on zoom was when I was recording with spear people for podcasts

[00:46:37] That's it. That's all I I did zero guy. I didn't develop my own personal

[00:46:41] I I ran I ran and I and I I exercised that was it

[00:46:45] I was like, I'm like, I'm not doing this not doing it. I was I was the worst

[00:46:48] So, yeah, I mean, I'm more open to a zoom

[00:46:51] Lifestyle now that I was then I swear it was like it was like literally

[00:46:54] It's like the only thing that I I was gonna push back on because it was I don't know because everyone

[00:46:58] Remember how zoom became the thing like days after everyone got shut down all of a sudden the world was gonna be on zoom

[00:47:04] So yeah, I just I told you

[00:47:07] We're gonna have to figure out how to engage. I know

[00:47:10] Give it a shot. There's a lot of good information out there for sure for sure

[00:47:13] But any other notice that she gave you several different ways that you can you can kind of dig in deeper on this thing

[00:47:19] You know, whether it's a spear online or going full-on with those beer practice solutions

[00:47:23] There's lots lots here, but I guarantee you there's lots of discussion lots of questions

[00:47:28] I'd like to

[00:47:30] If I can't get you into the Facebook group, we have a very dental Facebook group

[00:47:33] I'd love to have you in there where you could answer questions

[00:47:36] But even then I'll make sure if you have questions, I'll make sure Amy gets them too. So hey

[00:47:39] I'm a Facebook pal. You can see pictures of my new granddaughter. It's like yeah, okay, we'll get you in right away

[00:47:44] We need and it's it's pretty good

[00:47:46] What's really cool about my community is that I don't let anyone in unless they listen the podcast

[00:47:51] So like you basically everyone there is already engaged in the podcast. I'll listen to your podcast if you go on zoom

[00:48:00] This was great as always I really appreciate you being with me and and we'll keep the conversation going. Okay. Thank you

[00:48:06] Thank you. Stay safe folks and thrive. Yes, definitely. Thank you much