Latest / My Dental Playbook / 061 OON vs FFS: Structuring Your Hygiene Department

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061 OON vs FFS: Structuring Your Hygiene Department · My Dental Playbook

• 0:00
  SPEAKER_01: I view hygiene as a loss leave.
• 0:02
  SPEAKER_00: I want to be profitable in every procedure.
• 0:04
  SPEAKER_00: The number one complaint in dentistry as a business is hygiene is broken.
• 0:08
  SPEAKER_03: Well, I want hygiene to be a profit center.
• 0:10
  SPEAKER_03: I'm totally okay if it's not.
• 0:12
  SPEAKER_02: There are little to no metrics, a better predictor of future success than hygiene reappointment.
• 0:18
  SPEAKER_00: Hey, welcome back to another episode of My Dental Playbook.
• 0:21
  SPEAKER_00: I'm your co-host, Gary Bird.
• 0:23
  SPEAKER_00: Along with my friend Dr.
• 0:24
  SPEAKER_00: Blake Hamblin, he's allowed me to ride Shotgun on his journey to build a$10 million fee-for-service office in the super competitive market of Houston.
• 0:34
  SPEAKER_00: If you haven't watched our previous hygiene podcasts, there's four of them.
• 0:40
  SPEAKER_00: Go check those out.
• 0:42
  SPEAKER_00: But today is going to be like the cherry on top.
• 0:45
  SPEAKER_00: Not everybody can operate a fee-for-service office, and I totally get that.
• 0:48
  SPEAKER_00: It's not for everybody.
• 0:50
  SPEAKER_00: And so we brought in two of the best dentists that we know that are running in network amazing hygiene offices.
• 0:59
  SPEAKER_00: Dr.
• 0:59
  SPEAKER_00: Vallo has a lot of offices spread over Florida, and he's going to share how he's built out his hygiene department.
• 1:07
  SPEAKER_00: And if you don't know about Dr.
• 1:09
  SPEAKER_00: Valow, he does a lot of marketing.
• 1:10
  SPEAKER_00: He's also in network and he ranges everything from rural all the way up to city centers.
• 1:16
  SPEAKER_00: And then Dr.
• 1:17
  SPEAKER_00: Collin, he's going to share how his office in a rural area where he does no marketing and he's in network, he's going to tell you how he set up his hygiene department.
• 1:26
  SPEAKER_00: Dr.
• 1:26
  SPEAKER_00: Blake's going to compare notes and you're going to learn a boatload from this.
• 1:31
  SPEAKER_00: They're going to share at the end what they wish they would have done differently over this journey.
• 1:38
  SPEAKER_00: And this is what's going to bring you the most value from this episode.
• 1:41
  SPEAKER_00: As always, make sure that you check out our sponsor, Cherry.
• 1:45
  SPEAKER_00: They're amazing.
• 1:45
  SPEAKER_00: If you're not using Cherry, you're missing out on uh opportunities for treatment acceptance.
• 1:51
  SPEAKER_00: We have a link down below that has a training as well as an opportunity to uh get a discount with Cherry.
• 1:59
  SPEAKER_00: And then lastly, Dr.
• 2:00
  SPEAKER_00: Ballow has an amazing podcast.
• 2:02
  SPEAKER_00: So make sure you check that down in the show notes down below.
• 2:05
  SPEAKER_00: You're gonna enjoy this one.
• 2:07
  SPEAKER_00: Buckle up, stay tuned.
• 2:10
  SPEAKER_00: All right, we are live.
• 2:11
  SPEAKER_00: And as you can see today, we got an absolute powerhouse of dentistry right here.
• 2:18
  SPEAKER_00: And I'm excited to have this conversation.
• 2:20
  SPEAKER_00: And the thing I love most about this group right here, I literally am like, hey, is there anything that I can't talk about or not ask you?
• 2:26
  SPEAKER_00: They're like, nope, ask me whatever you want.
• 2:28
  SPEAKER_00: And so I love that because dentistry needs more of that.
• 2:32
  SPEAKER_00: I love listening to content like that.
• 2:35
  SPEAKER_00: And today we're going to be talking about the dreaded topic of hygiene.
• 2:39
  SPEAKER_00: The number one complaint in dentistry as a business is hygiene is broken.
• 2:44
  SPEAKER_00: It doesn't work.
• 2:45
  SPEAKER_00: How do you make it work?
• 2:46
  SPEAKER_00: And Dr.
• 2:47
  SPEAKER_00: Blake and I have had a lot of conversations about this.
• 2:49
  SPEAKER_00: And the number one feedback I always get about it is, well, Dr.
• 2:53
  SPEAKER_00: Blake, you're out of network, so you can just make it work.
• 2:56
  SPEAKER_00: So we brought on some people who have very successful practices that are in network and they're making it work.
• 3:02
  SPEAKER_00: So we're going to compare notes, and this will be something that I guarantee you that you'll learn some great things from.
• 3:08
  SPEAKER_00: So, Dr.
• 3:09
  SPEAKER_00: Blake, let's first start with you.
• 3:11
  SPEAKER_00: How do you in 2026 view the hygiene situation and how do you view it with your office?
• 3:18
  SPEAKER_00: We're looking for an amazing dentist to partner with us in our local market and maybe even potentially in other markets for us to open up more practices.
• 3:26
  SPEAKER_00: And we just got more new patients at our current practice.
• 3:30
  SPEAKER_00: So we're looking for another dentist here.
• 3:31
  SPEAKER_00: If you're looking for an amazing opportunity where you can have as many new patients as you can handle, learn new treatments, tons of CE mentorship.
• 3:39
  SPEAKER_00: This is the place for you.
• 3:40
  SPEAKER_00: Dr.
• 3:41
  SPEAKER_00: Hamlin is looking for the perfect dentist.
• 3:43
  SPEAKER_00: This sounds like you, reach out to us.
• 3:45
  SPEAKER_00: You can DM us, comment down below.
• 3:46
  SPEAKER_00: We would love to hear from you.
• 3:48
  SPEAKER_00: How do you in 2026 view the hygiene situation and how do you view it with your office?
• 3:55
  SPEAKER_03: Uh well, I think a lot of it has changed as we've grown, and I've learned a ton by trying and utilizing new tactics to be able to grow and whatnot.
• 4:05
  SPEAKER_03: And while I while while I want hygiene to be a profit center, um I'm totally okay if it's not.
• 4:12
  SPEAKER_03: And for me it's it's a it's a gateway to the practice.
• 4:16
  SPEAKER_03: And if we can remove barriers to get into the practice, then I am all for that.
• 4:21
  SPEAKER_03: And I don't think that's gonna differ much from anybody here on the call, is we have an abundance mindset that believes that like if we just if we can get the at that, then we'll we'll win every single time.
• 4:34
  SPEAKER_03: And so that's the way we approach it approach it.
• 4:36
  SPEAKER_03: I think our team more and more believes that as well.
• 4:39
  SPEAKER_03: And we found success with it.
• 4:41
  SPEAKER_00: Yeah, that's awesome.
• 4:42
  SPEAKER_00: And and I will say, you can go check out the previous episodes about how much he pays, his bonus system, all those kind of things.
• 4:48
  SPEAKER_00: Dr.
• 4:48
  SPEAKER_00: Blake has been very open book about that.
• 4:50
  SPEAKER_00: And so, Dr.
• 4:51
  SPEAKER_00: Vallo, let's go to you.
• 4:53
  SPEAKER_00: You you have several practices, a lot of practices.
• 4:56
  SPEAKER_00: I don't know what number you're at, and you're in network with most of them, and you have a big hygiene department.
• 5:02
  SPEAKER_00: So, how do you view the hygiene situation currently?
• 5:04
  SPEAKER_02: Yeah, I'd say I have somewhere between several and a lot.
• 5:07
  SPEAKER_02: Um, we we've got, I think currently we've got about 17 hygienists spread out over nine of our 12 practices have hygiene.
• 5:16
  SPEAKER_02: Um so we we you know we we have focused in on trying to uh create consistent systems across the board.
• 5:23
  SPEAKER_02: Um and and one thing for us, you know, we we are in network at all those offices.
• 5:28
  SPEAKER_02: The only offices we're not in network is our implant only offices.
• 5:31
  SPEAKER_02: So any anything related to general dentistry hygiene, you know, we do have a network status.
• 5:36
  SPEAKER_02: Um and I and I did that intentionally because my my goal was to quickly grow a group of startup practices and um you know as as incredible as Blake has done over there, I I can't imagine uh growing the way that we have being uh in network.
• 5:53
  SPEAKER_02: It would it would it would take more marketing dollars than I would ever have access to, I think.
• 5:57
  SPEAKER_02: So um you know, I guess big picture view for us is I I view hygiene as a loss leader.
• 6:04
  SPEAKER_02: So like especially when it comes to new patients, like I I don't look at uh you know how much money we're making off every new patient coming through hygiene.
• 6:12
  SPEAKER_02: I instead look at like how much money am I losing on every new patient that comes through hygiene, but on the flip side, how much money could we make, how much revenue could we generate off that patient when they actually do treatment, when they refer friends and family, when they leave us Google reviews, whatever else it is.
• 6:30
  SPEAKER_02: So, you know, for us it it really is a volume game.
• 6:32
  SPEAKER_02: Uh, you know, I I pride myself on our patient experience.
• 6:36
  SPEAKER_02: So like we we are high volume in that sense that we do get a lot of patients in the door.
• 6:40
  SPEAKER_02: I mean, most of my offices are seeing 150 new patients a month.
• 6:45
  SPEAKER_02: We've got some seeing 250 a month, some of the bigger practices.
• 6:49
  SPEAKER_02: Um but you know, we we run a$98 new patient special.
• 6:53
  SPEAKER_02: I've done that for years.
• 6:55
  SPEAKER_02: I I tested things when we first opened, and and that includes X-rays, exam, healthy mouth cleaning, and and a free teeth whitening kit.
• 7:03
  SPEAKER_02: Um so once again, you think about the cost of marketing to get the patient in, you think about the the$98 we're paying you, you think about what you're paying the hygienists, it's obvious you're not making money there.
• 7:14
  SPEAKER_02: And I actually I recently made the switch.
• 7:17
  SPEAKER_02: It's temporary, but it may end up being permanent.
• 7:20
  SPEAKER_02: Uh we we we switched from the$98 special to a$58 special.
• 7:24
  SPEAKER_02: Uh, and and that's because we were going in the summer months, which are traditionally slower, we're trying to add additional hygienists at some offices.
• 7:32
  SPEAKER_02: We've got four new offices opening in like a two-month span.
• 7:36
  SPEAKER_02: Um, so that was that was my way to lower barriers even further.
• 7:39
  SPEAKER_02: And my mindset was if I'm not making money on the$98, what do I care if it's another$40 more people?
• 7:47
  SPEAKER_02: Um and and so far, I mean, it's it's it's been a success.
• 7:50
  SPEAKER_02: Our our cost per new patient has gone down even further.
• 7:53
  SPEAKER_02: We are uh seeing our hygiene schedules more full, our new offices that have just opened, we had one just open in in June, and I mean it collected$243,000 in its first month open.
• 8:04
  SPEAKER_02: So I I would say that$58 special is probably not really hurting us there.
• 8:08
  SPEAKER_00: So that's awesome.
• 8:09
  SPEAKER_00: All right, Dr.
• 8:10
  SPEAKER_00: Colin, what about you?
• 8:11
  SPEAKER_00: Where where are you at in your dental journey and how are you viewing the hygiene situation?
• 8:17
  SPEAKER_01: Um I first thanks for uh having me.
• 8:21
  SPEAKER_01: I'm excited about this.
• 8:22
  SPEAKER_01: Uh, but also I'll say I'm grossly underprepared uh and unqualified to speak after listening to the two people that just talked before me.
• 8:32
  SPEAKER_01: Our our philosophy is very different, and we just come from a little different organization.
• 8:38
  SPEAKER_01: Uh I'm like less than half the size of Balo and uh very in-network uh with our model.
• 8:45
  SPEAKER_01: And yet marketing has never been a thing that we've been sophisticated at.
• 8:49
  SPEAKER_01: And uh being able to grow new patients has been uh a byproduct of having offices.
• 8:54
  SPEAKER_01: Um, when we open, they come.
• 8:57
  SPEAKER_01: Uh that's kind of been our trajectory to this point.
• 9:00
  SPEAKER_01: So as a result, uh early on, my decision was I want to be profitable on every procedure we provide, every service we provide, because I want to own this business for a long time and I don't want anything to be uh to make me afraid to continue to operate.
• 9:16
  SPEAKER_01: And we didn't have a growing problem.
• 9:19
  SPEAKER_01: Um, from the very beginning, we were seeing 100 to 150 new patients a month.
• 9:23
  SPEAKER_01: And now uh, like Valor, we have offices that see 200 new patients a month.
• 9:29
  SPEAKER_01: We have our our lowest uh goal is 150 new patients a month per office.
• 9:34
  SPEAKER_01: So as a result, the volume of new patients that we see, even though we are in network with insurances, I think that's a huge piece of the growing uh for us.
• 9:43
  SPEAKER_01: Um as as I've known a lot about Blake's journey to this point, I agree with Vallo that that in our model, like being able to be uh out of network and uh and really be competitive and drive marketing dollars as the source for um new patients, that may have worked for us.
• 10:02
  SPEAKER_01: It just wasn't what I started with.
• 10:04
  SPEAKER_01: And it wasn't uh the plan was big practices that served large communities that had tons of need from day one.
• 10:12
  SPEAKER_01: And as a result, in network just did that.
• 10:14
  SPEAKER_01: And then if I'll say, you know, another piece of that for me was when I when I took over my first practice, I acquired it, and very quickly we grew beyond what I could handle on my own as a young doctor trying to serve a community that I was from.
• 10:29
  SPEAKER_01: Um, I remember saying, I know enough about business to know there's only two choices here.
• 10:34
  SPEAKER_01: Either we move to a new location and we get a lot bigger, or we start to cull our patient population.
• 10:41
  SPEAKER_01: And that's a really weird way to say it, but that's what country people from the south say, you know, we know how to cull a herd.
• 10:46
  SPEAKER_01: And uh the idea of that meant that we were going to go out of network.
• 10:51
  SPEAKER_01: And I remember telling my parents, my mom's a nurse, my dad's a teacher and a coach.
• 10:56
  SPEAKER_01: I remember telling them that.
• 10:58
  SPEAKER_01: And they were just like, yeah, that makes sense.
• 11:01
  SPEAKER_01: But how would we ever be your patient?
• 11:03
  SPEAKER_01: Yeah.
• 11:04
  SPEAKER_01: And I thought, what do you mean?
• 11:06
  SPEAKER_01: What do you mean, mom?
• 11:06
  SPEAKER_01: Of course you'd be my patient.
• 11:07
  SPEAKER_01: And she said, you know, when you were a kid, we would have never gone to a practice that was out of network because for us, all we understood was our dental insurance is what drove our decisions.
• 11:17
  SPEAKER_01: And we needed the most affordable option.
• 11:19
  SPEAKER_01: I think that breaking that barrier of patient education is really challenging.
• 11:23
  SPEAKER_01: And that's the task that Blake is faced with inside of that fee for service model.
• 11:27
  SPEAKER_01: And yet, when you break it, you get the most valuable patients.
• 11:30
  SPEAKER_01: But for us, I wasn't willing to tell my mom that she couldn't be a patient.
• 11:34
  SPEAKER_01: And in her mind, that's what that decision meant.
• 11:36
  SPEAKER_01: So instead, we just built big practices and we continue to do that.
• 11:40
  SPEAKER_01: And yeah, I too have 16 hygienists.
• 11:42
  SPEAKER_01: I just, like I say, I'm less than half the size of Alice.
• 11:45
  SPEAKER_01: So I again unqualified to be on the conversation, but I'm excited to listen to these guys.
• 11:50
  SPEAKER_02: I will say I'm I'm a little jealous of uh Colin's field of dreams he's got going on there.
• 11:55
  SPEAKER_02: And it truly is a if if he builds it, they will come.
• 11:59
  SPEAKER_02: Um, I'm not jealous that at uh what he said, I don't think he's actually half the size, but what you know, what he says half the size, he has the same amount of hygiene drama going on.
• 12:08
  SPEAKER_02: So that's that's kind of uh a downside, I guess.
• 12:10
  SPEAKER_00: But one one thing I want to call out is that we have three totally different models here that we're talking to, and they are all successful.
• 12:18
  SPEAKER_00: So this idea that it doesn't work is just not true.
• 12:21
  SPEAKER_00: You can actually build what you want.
• 12:23
  SPEAKER_00: Dr.
• 12:23
  SPEAKER_00: Blake built in a big city center, fee for service, tons of sees over 200 new patients, so he's gonna break 200 new patients a month, spends a lot more on marketing, but he's also not in network.
• 12:33
  SPEAKER_02: So he's that is incredible at fee for service, man.
• 12:36
  SPEAKER_02: I just the way that you guys have grown that new patient numbers, I just kudos to to both of you guys, you know, working.
• 12:42
  SPEAKER_03: Yeah.
• 12:43
  SPEAKER_03: Well, and I I know this isn't what the podcast's about, but I I totally get and we live every day the same thing that y'all do with insurance.
• 12:51
  SPEAKER_03: Like we have patients that come and they want to see us utilize their insurance.
• 12:55
  SPEAKER_03: Um however, um what I'm actually trying to do is build a patient population that doesn't care about insurance.
• 13:04
  SPEAKER_03: Like I just saw on our schedule right before we got on this call, patient showed up, had a balance on her account, uh, appointment got canceled.
• 13:13
  SPEAKER_03: And I'm like, I need to find out more about that.
• 13:16
  SPEAKER_03: But at the same time, my I'm so committed to our model that I would rather have people that don't have insurance.
• 13:23
  SPEAKER_03: And I think there's a lot of people, especially in our city, that don't have insurance, and we can serve those people and not have to fight over what everybody else is fighting over in our city with insurance.
• 13:35
  SPEAKER_03: Does that make sense?
• 13:36
  SPEAKER_00: Yeah, yeah.
• 13:36
  SPEAKER_00: And I one thing, so you have the city center.
• 13:39
  SPEAKER_00: I just want to call these models out for our audience.
• 13:41
  SPEAKER_00: So you have the city center fee for service, spend a lot of your money on marketing, but you're not in network with insurance.
• 13:47
  SPEAKER_00: Dr.
• 13:48
  SPEAKER_00: Colin, you're uh uh in network with most insurances, I think.
• 13:52
  SPEAKER_00: Um, but you're in, I would call it more role, yeah.
• 13:56
  SPEAKER_00: Would role be more appropriate, like lower competition.
• 13:59
  SPEAKER_00: But you're just like, I'm gonna build the best dental office for these people to come in and see me.
• 14:04
  SPEAKER_00: Don't spend any money on marketing, but definitely in network.
• 14:07
  SPEAKER_00: And then Dr.
• 14:08
  SPEAKER_00: Vallo, you're more, I would say mid-market and uh more, is that right?
• 14:13
  SPEAKER_02: Like Orlando type uh cities, they're not, it's not we're I mean, yeah, we're we're kind of spread across Central and South Florida now.
• 14:20
  SPEAKER_02: So we've got like Miami and Fort Lauderdale offices, but we've also got ones in like smaller beach towns like Venice and Boynton Beach and things like that.
• 14:29
  SPEAKER_00: So you're a blend of it all.
• 14:30
  SPEAKER_00: So you're from rural.
• 14:31
  SPEAKER_00: It's hard to define, Gary.
• 14:32
  SPEAKER_03: It's hard to define.
• 14:33
  SPEAKER_00: Yeah, yeah.
• 14:35
  SPEAKER_00: So so it's but it's a defin it's a different model than Dr.
• 14:38
  SPEAKER_00: Collin, all right, and it's definitely a different model than Dr.
• 14:40
  SPEAKER_00: Blake, but you're in network and you're marketing.
• 14:42
  SPEAKER_00: So you're doing, you're like sitting between Dr.
• 14:45
  SPEAKER_00: Blake and Dr.
• 14:45
  SPEAKER_00: Collin on the spectrum.
• 14:46
  SPEAKER_00: If I was gonna say on a business uh model.
• 14:49
  SPEAKER_00: Now, the the reason we're having this podcast is because most people believe that the hygiene models just doesn't work.
• 14:57
  SPEAKER_00: Hygienists want too much money, there's no way to make this work.
• 15:00
  SPEAKER_00: So I would love, like I posted online and said, okay, I'm gonna have this podcast.
• 15:03
  SPEAKER_00: What are the questions that you have?
• 15:05
  SPEAKER_00: And people said, I want to know about pay, benefits, perks, retention, KPIs, like all the things, right?
• 15:11
  SPEAKER_00: And so I would just love to ask you guys like, what are you doing that makes it work from your point of view, knowing that people are gonna have a ton of questions about your model?
• 15:21
  SPEAKER_00: So, Dr.
• 15:22
  SPEAKER_00: Collin, what what are you doing to make this work on the hygiene side to just make everything happen?
• 15:27
  SPEAKER_01: Yeah, I'm happy to break it down from a fundamental standpoint, as my hero, Kent Murphy, would say.
• 15:32
  SPEAKER_01: Uh, but the concept is, and if you haven't seen Kent Murphy videos, you should watch them.
• 15:37
  SPEAKER_01: Uh, the concept is A, a competitive comp.
• 15:42
  SPEAKER_01: Like initially, you have to hire at a salary that is competitive in your market, or else you can't keep growing.
• 15:48
  SPEAKER_01: People don't look when you post an ad, they don't look at how awesome your bonus package is.
• 15:52
  SPEAKER_01: They look at what they can make versus the office down the street or the job they have currently.
• 15:56
  SPEAKER_01: So A is competitive compensation.
• 15:59
  SPEAKER_01: And I'll say it's different for everyone.
• 16:01
  SPEAKER_01: And if you wanted me to say the number out loud for our market, it'll offend many of the people who listen to this podcast because we're just a different market.
• 16:08
  SPEAKER_01: It's a lot of hygiene schools near us, and there's not many dental offices.
• 16:12
  SPEAKER_01: So uh give me a percentage.
• 16:13
  SPEAKER_00: Are you in the top five percent of pay?
• 16:15
  SPEAKER_01: We could you give me five percent bottom five percent of uh of the US, I would guess.
• 16:21
  SPEAKER_01: No, no, no, no, no.
• 16:22
  SPEAKER_00: For your market, for your market.
• 16:24
  SPEAKER_00: So if there's 10 dentists, okay, okay.
• 16:26
  SPEAKER_01: What what we say is our our most experienced hygienists should never be able to leave because of an ad that's posted.
• 16:33
  SPEAKER_01: So there shouldn't be a job available to them that would pay them more.
• 16:36
  SPEAKER_01: That that's number one, and that's on hourly.
• 16:39
  SPEAKER_01: And then number two is that because you're in the best office in this market, you also have an opportunity to participate in upside.
• 16:46
  SPEAKER_01: And what upside is to me is an incentive-based bonus compensation.
• 16:50
  SPEAKER_01: For us, our target is 3.3 tons of pay.
• 16:53
  SPEAKER_01: So if you take what our hygienists make on an hourly basis and multiply it by 3.3 tons, that's what we want them to produce.
• 17:00
  SPEAKER_01: When they average that level of production over the course of a month, they participate in the upside.
• 17:06
  SPEAKER_01: They get 20% of everything over that 3.3 tons pay multiplied by the month.
• 17:11
  SPEAKER_01: Um, that has worked well for us.
• 17:13
  SPEAKER_01: And honestly, for the longest time, I thought that it was not possible.
• 17:17
  SPEAKER_01: But I have an incredible director of operations who showed me things that I didn't know before.
• 17:21
  SPEAKER_01: And we now have been able to do it where almost every one of our hygienists participates in that incentive program.
• 17:27
  SPEAKER_01: So that's it.
• 17:28
  SPEAKER_01: And then we also have a lot of incentives.
• 17:31
  SPEAKER_01: So to me, when a person applies for a job, they're looking for hourly rate and they're looking for your benefits package.
• 17:38
  SPEAKER_01: So our benefits package, health insurance, supplemental benefits, uh, short-term disability.
• 17:43
  SPEAKER_01: We have a lot of hygienists who are gone through, you know, the early years of life of childbearing and wanting to grow families.
• 17:49
  SPEAKER_01: So short-term disability has been something that we negotiate hard with our benefits provider to make it the best package that's available.
• 17:55
  SPEAKER_01: And uh, and then we do a lot of fun stuff.
• 17:58
  SPEAKER_01: Uh, we love to we're going on a cruise in uh three weeks.
• 18:01
  SPEAKER_01: We'd take the team just about every year.
• 18:03
  SPEAKER_01: As long as they hit our five-star review goal, we we go on a cruise.
• 18:07
  SPEAKER_01: Well, what is that?
• 18:07
  SPEAKER_00: What's the five-star review goal?
• 18:09
  SPEAKER_01: Uh, each office we want to do 500 five-star reviews a year.
• 18:13
  SPEAKER_01: That's the goal.
• 18:13
  SPEAKER_01: And if an office hits 500 five-star reviews in a year, we go on a cruise.
• 18:18
  SPEAKER_01: And we love cruises.
• 18:20
  SPEAKER_01: So it's been it's been a fun way to celebrate.
• 18:22
  SPEAKER_01: But uh, these are the things that we love to do.
• 18:24
  SPEAKER_01: And then we also have a culture that's worth having.
• 18:27
  SPEAKER_01: Uh, this week, this Friday, we're doing our gift kids a smile day.
• 18:30
  SPEAKER_01: We're scheduled over 225 uh kids from our community who are going to come in and get free care, uh, emergency services, and hygiene and exams.
• 18:38
  SPEAKER_01: And um, that's been a really cool piece that allows our team to participate in something that's bigger than themselves and feel like dentistry had a purpose.
• 18:45
  SPEAKER_01: You know, this wasn't just my job.
• 18:46
  SPEAKER_01: This was a calling, this is a thing that I can make a difference.
• 18:48
  SPEAKER_01: And we've even had hygienists from other offices who've asked if they could participate in our give kids a smile days.
• 18:53
  SPEAKER_01: Um I think these are the things that make us competitive inside of our market.
• 18:57
  SPEAKER_01: And at the same time, I'll say I go back to the fundamentals.
• 19:00
  SPEAKER_01: Your hourly has to be competitive in your market, and your benefits package has to be something that someone, when they look at you apples to apples, you're you're at least on the table.
• 19:10
  SPEAKER_01: You don't have to be the best, but you have to be on the table.
• 19:13
  SPEAKER_01: And then the incentive, the the bonuses are what retain your top talent.
• 19:18
  SPEAKER_01: That's what makes sure that your best people are the highest paid by far in your market.
• 19:22
  SPEAKER_00: That's awesome.
• 19:23
  SPEAKER_00: Now, real quick, before I punt to you, Dr.
• 19:25
  SPEAKER_00: Vallo, I know somebody's gonna listen to this and say, Well, I'm a little practice or I'm just buying a practice.
• 19:30
  SPEAKER_00: So if you were to start over, Dr.
• 19:32
  SPEAKER_00: Collin, is there anything that you would have done differently than than you did before?
• 19:36
  SPEAKER_00: I would have done all that sooner.
• 19:37
  SPEAKER_00: Okay, so you would have done everything you just said, but faster.
• 19:40
  SPEAKER_01: Because it it it is good for the team member, it's good for the patient, and it's good for the business.
• 19:45
  SPEAKER_01: It's a win-win.
• 19:47
  SPEAKER_01: And I didn't know it at the beginning.
• 19:49
  SPEAKER_01: So instead, I said, You want how much?
• 19:52
  SPEAKER_01: No way, I can't do that.
• 19:53
  SPEAKER_01: Yeah.
• 19:54
  SPEAKER_01: And later on I realized, no, the conversation is wow, you really are able to generate that much value for our business?
• 20:00
  SPEAKER_01: That's amazing.
• 20:01
  SPEAKER_01: I'm so excited about what that'll look like once you get here.
• 20:03
  SPEAKER_01: That's awesome.
• 20:04
  SPEAKER_00: All right, Dr.
• 20:04
  SPEAKER_00: Vallo, how how about you?
• 20:06
  SPEAKER_00: How are you looking at the hygiene situation currently for your office?
• 20:10
  SPEAKER_02: Yeah.
• 20:10
  SPEAKER_02: So I, you know, I want to piggyback you for a second off Colin and I I agree with what he's saying about base compensation.
• 20:18
  SPEAKER_02: I I've I've realized over the years, you know, as as we've added benefits and you know, as as we think our our organization is a great place to work, and we do all this fun stuff too, and you know, whatever, at the end of the day, people are looking to feed their families.
• 20:32
  SPEAKER_02: And so, you know, while while you may have great bonus packages, and I I personally think we have some of the best bonus opportunities out there, especially for you know certain positions.
• 20:42
  SPEAKER_02: Um at the end of the day, until they're in the organization, they're not going to fully understand that.
• 20:47
  SPEAKER_02: So what what they're what they're comparing is that base salary, and and you have to be competitive if you want to get a number of you know high caliber applicants.
• 20:57
  SPEAKER_02: So we're the same way.
• 20:58
  SPEAKER_02: I would I would say we're you know, we're probably typically in the top 10, 15 percent of base salary uh for most positions across the board.
• 21:07
  SPEAKER_02: Now our areas of unfortunately I'm in the state same state as Colin.
• 21:12
  SPEAKER_02: So Colin Colin would have offended me if he had said, you know, what he's paying.
• 21:15
  SPEAKER_02: Because I I have an idea what he's paying as hygienists, but uh we're unfortunately our our average price range down in central and south for is a little bit higher.
• 21:25
  SPEAKER_02: So typically speaking, uh upper 40s to low 50s for most areas is is kind of the the typical range that we see.
• 21:32
  SPEAKER_02: It's not as bad as Denver or California or you know, or some of these other places where uh Seattle, I think, you know, where they're paying hygienists$100 an hour.
• 21:42
  SPEAKER_02: Um something I was thinking about.
• 21:44
  SPEAKER_02: So, you know, same same school that Colin came from, 3.3 times base pay of what our hygienists are shooting for.
• 21:51
  SPEAKER_02: That's when they unlock commission pay.
• 21:53
  SPEAKER_02: So we we pay commission once they're over that point.
• 21:56
  SPEAKER_02: Um the higher their base pay, especially in a fee for or in a TPO model, the harder it is for them to hit that 3.3x.
• 22:03
  SPEAKER_02: So I I would say our hygienists, even doing a good job, probably have a tougher time hitting that 3.3 times and hitting commission pay just because of higher, higher base pay.
• 22:14
  SPEAKER_02: But I can't even imagine how they would do it in Denver or in Seattle if they're making$100.
• 22:20
  SPEAKER_02: Like that would be very, very challenging.
• 22:22
  SPEAKER_02: So we got creative.
• 22:26
  SPEAKER_02: I mentioned earlier that we look at new patient hygiene as a loss leader.
• 22:30
  SPEAKER_02: I don't look at hygiene overall as a loss leader.
• 22:33
  SPEAKER_02: So you know I may have kind of slightly misled there.
• 22:36
  SPEAKER_02: We hide our hygiene is profitable even in our PPO model, but the way we do it is we focus in on uh existing patients, on patients that do have insurance, on periodiagnosis, on you know things like fluoride.
• 22:51
  SPEAKER_02: And honestly, the most important KPI of all is the one you actually don't get paid for that day, but it's the reappointment rate.
• 22:57
  SPEAKER_02: So, you know, we we didn't used to hone in on these KPIs.
• 23:02
  SPEAKER_02: Over the last couple of years, we've we've gotten better and better about it.
• 23:06
  SPEAKER_02: And at this point in time, I would say we've got a really good system in place.
• 23:09
  SPEAKER_02: And we we have a chief hygiene officer who kind of runs the whole uh herd of hygienists here, and she runs meetings every other week and she does one-on-one calls and she does she sends them podcasts to listen to and uh you know provides information and researches new products they can use, um, reports on KPIs, and and we have we have like a uh like competition is one of our core values, like friendly competition.
• 23:35
  SPEAKER_02: Like we we want our TCs to know how they stack up against the other TCs.
• 23:39
  SPEAKER_02: We want our hygienists to know how they're doing compared to other hygienists.
• 23:42
  SPEAKER_02: And so there are like weekly and monthly scoreboards going out with how hygienists are doing with KPIs.
• 23:47
  SPEAKER_02: And so that's one of the areas we got creative with the bonuses.
• 23:51
  SPEAKER_02: While some of our hygienists do struggle to get the commission bonus at 3.3 times their base pay, um we also bonus based on leaders of different KPIs.
• 24:01
  SPEAKER_02: So, like, for instance, if you're the top reappointment rate for the month, you're gonna get a bonus for doing that.
• 24:08
  SPEAKER_02: If you're the top period percentage for the month, you're gonna get a bonus for that.
• 24:12
  SPEAKER_02: If you're the top fluoride percentage for the month, you're gonna get a bonus for that.
• 24:15
  SPEAKER_02: Um we're also big on team bonuses.
• 24:19
  SPEAKER_02: And and actually we've kind of expanded the team bonus from we used to do each office individually and we got rid of that, and now the team bonus is based in the organization.
• 24:28
  SPEAKER_02: So our entire organization has a monthly revenue goal, and we have different tiers of revenue goals.
• 24:34
  SPEAKER_02: We've got tier one, tier two, and tier three, and each one you know pays higher incrementally.
• 24:40
  SPEAKER_02: Um, and hygienists get to participate in that.
• 24:42
  SPEAKER_02: So, you know, if our entire organization has a great month, which most months as of late were hitting at least tier two, if not tier three bonus, the hygienists, in addition to their KPI leaderboard bonuses, they can also participate in that team bonus as well.
• 24:56
  SPEAKER_02: So there are some other avenues uh, you know, where they can get some some additional compensation there too.
• 25:02
  SPEAKER_00: That's awesome.
• 25:03
  SPEAKER_00: Now I'm gonna ask you the similar question in Dr.
• 25:05
  SPEAKER_00: Collin.
• 25:05
  SPEAKER_00: People are gonna, I've seen your post online, which are awesome.
• 25:08
  SPEAKER_00: And I also see some of the hate that people are like, well, you you have all this or you have all these locations, so you can do that.
• 25:14
  SPEAKER_00: What would you say to somebody who's like, hey, I'm only one or two practices?
• 25:18
  SPEAKER_00: Like, uh like what would your model look like if somebody was only gonna have one or two practices?
• 25:24
  SPEAKER_00: Would it look very similar to what you're doing, everything you just described, or would you tackle it in a totally different way?
• 25:29
  SPEAKER_02: If I could go back to the very beginning when I had one startup practice, I would do things almost exactly as I'm doing them now back then.
• 25:38
  SPEAKER_02: So I I would say like probably the one big exception is I, you know, at one practice, I probably wouldn't have a cheap hygiene officer.
• 25:46
  SPEAKER_02: Now, if it was a if it was a big practice and there were six hygienists, maybe maybe I still would.
• 25:50
  SPEAKER_02: Maybe you call them a lead.
• 25:52
  SPEAKER_02: Um, but like of everything I'm doing now from a hygiene model, that's probably the only thing that would change if I went back to one practice.
• 26:00
  SPEAKER_02: I I wish let me let me let me all right let me harp on this for a second.
• 26:06
  SPEAKER_02: In the early days, I paid very little attention to hygiene, and part of that was because I didn't really understand hygiene.
• 26:12
  SPEAKER_02: You know, I was I was more focused on doctor production, revenue, you know, top line numbers, all that stuff.
• 26:18
  SPEAKER_02: I I I I actually had dental intel since day one, and I didn't really use it for the first year or so.
• 26:24
  SPEAKER_02: Um longer than that, probably.
• 26:27
  SPEAKER_02: I we didn't track reappointment rates.
• 26:29
  SPEAKER_02: So like it was something I knew was important, but I didn't track it back then.
• 26:33
  SPEAKER_02: And I finally, you know, as as I got maybe 18 months, two years into ownership and was opening more practices already, I started to track reappointment rate and I realized like our hygiene reappointment was like 65 to 70 percent at our offices, which might not sound horrible, but when you think about it, like it's a snowball effect.
• 26:53
  SPEAKER_02: So, you know, that means 30% of your patients aren't getting reapployed for hygiene, which means you need 30% more new patients to continue to kind of grow at the same rate.
• 27:01
  SPEAKER_02: Uh, and it's obviously a lot more expensive to acquire more new patients than it is to keep those patients in your practice.
• 27:08
  SPEAKER_02: So we started to focus on it, and you know, things you give attention start to grow.
• 27:12
  SPEAKER_02: And so slowly it came up, and then it was 75%, and then it was 80%, and then it kind of got stuck and hovered in the low 80s for a while.
• 27:20
  SPEAKER_02: And then I brought in the chief hygiene officer and I started really like setting some goals and quotas and all this other stuff, and we gave it more attention and more attention and more attention.
• 27:31
  SPEAKER_02: Uh, and all of a sudden it took off and 85%, 90%.
• 27:36
  SPEAKER_02: This last quarter, you know, Q2 of 2026, this was our first quarter where as an organization, our hygiene reappointment was over 95%, and our goal for Q3 is 98%.
• 27:48
  SPEAKER_02: And I will tell you of everything I've learned about the business of dentistry over the years, there are little to no uh metrics that are a better predictor of future success and growth of your practice than hygiene reappointment.
• 28:02
  SPEAKER_02: And even at 95%, I know the difference between 95 and 98% is still gonna have a dramatic impact on our long-term growth.
• 28:11
  SPEAKER_01: So and can I just say, I think the reason is the name of the game is active patient count.
• 28:17
  SPEAKER_01: It's not new patient count, it's active patient count.
• 28:20
  SPEAKER_01: So when you retain, you stack these new patients on top and your organization grows.
• 28:25
  SPEAKER_01: If you don't retain the patients, your new patient count has to continue to grow into perpetuity, or else you're just recycling the same ones out.
• 28:33
  SPEAKER_01: Yep.
• 28:33
  SPEAKER_00: Yep.
• 28:34
  SPEAKER_00: And you're also doing dentistry and fixing their problems over time, too.
• 28:37
  SPEAKER_00: So there's there's like two sides of the coin, but I love that the retention, the top of the funnel.
• 28:42
  SPEAKER_00: Dr.
• 28:43
  SPEAKER_00: Blake, so based on what you've heard here, what is different about your model?
• 28:47
  SPEAKER_03: Nothing.
• 28:48
  SPEAKER_03: We we all run in the same circles and we all believe the same things and we talk a lot.
• 28:53
  SPEAKER_03: So uh there's literally nothing that's wrong or different that I believe than what these guys have shared, and I believe wholeheartedly in all of these things.
• 29:03
  SPEAKER_03: What I will what I will say is we've talked a lot about how you can do this.
• 29:07
  SPEAKER_03: Um what I will tell you is is that anytime that you you put together an incentive package or anything like that, you want it to be durable.
• 29:15
  SPEAKER_03: You want it to last and you want it to be able to be uh to to be able to be completed for a long time.
• 29:22
  SPEAKER_03: Remember that these compens these bonus packages are um and your benefits packages are also compensation.
• 29:31
  SPEAKER_03: So when you're building in that that 3.3 times, you want to take that into consideration as well.
• 29:38
  SPEAKER_03: You want to feel good about the deal that you made with your hygienists or other team members and not become resentful towards the bonus that you agree to.
• 29:47
  SPEAKER_03: And so just remember there's employer taxes, there's uh there's 401ks, matches, there's health insurance stipends, there's all of these things that also go into their compensation.
• 30:00
  SPEAKER_03: And if you don't account for that, you'll quickly find that your 3.3 is turning into 2.8 and you won't feel as good about the dogs.
• 30:07
  SPEAKER_03: And so just remember that as you're building.
• 30:09
  SPEAKER_03: Awesome.
• 30:09
  SPEAKER_00: Well, I know we're coming up on time.
• 30:11
  SPEAKER_00: Any closing thoughts on um either comments that you think would be helpful to the audience or anything else anybody else said?
• 30:21
  SPEAKER_00: Dr.
• 30:22
  SPEAKER_00: Collin, we'll start with you.
• 30:23
  SPEAKER_01: I feel like I've unpacked most of the things that matter to me about hygiene.
• 30:27
  SPEAKER_01: I I would just say the idea of giving up on hygiene shocks me.
• 30:32
  SPEAKER_01: Um mainly because I know the name of the game in my mind is active patient count.
• 30:40
  SPEAKER_01: And having an active patient base that doesn't come in for regular recurring appointments, that we have a cheat code in all of healthcare, that we have these recurring appointments, not committing to solving this hygiene problem, like just abandon it altogether feels crazy.
• 30:59
  SPEAKER_01: Yeah.
• 31:00
  SPEAKER_01: And and I've seen that there are challenges.
• 31:02
  SPEAKER_01: I mean, I agree with Valow, like having a hygiene lead is magical, except when you have less than five, because then you just put a person on a pedestal who will inevitably let you down, just like everybody else does.
• 31:14
  SPEAKER_01: So only when you have a team big enough that like you can't be the point of contact for them anymore should you elevate a person.
• 31:21
  SPEAKER_01: But these problems are worth solving.
• 31:24
  SPEAKER_01: An active hygiene base is such a magical tool to the health and growth of a dental business.
• 31:31
  SPEAKER_01: So uh, yeah, with everything we've said, I mean, I just think compensation, you can figure it out.
• 31:36
  SPEAKER_01: You can create competitive structures, you know, driving new patients.
• 31:41
  SPEAKER_01: There's so many different ways.
• 31:42
  SPEAKER_01: We've talked about, you know, every practice has its own way of driving new patients.
• 31:46
  SPEAKER_01: And Dr.
• 31:46
  SPEAKER_01: Blake is the best example of all.
• 31:48
  SPEAKER_01: You can generate new patients in any model.
• 31:52
  SPEAKER_01: You just need to find a way to make them sticky.
• 31:54
  SPEAKER_01: And hygiene is that.
• 31:55
  SPEAKER_01: So yeah.
• 31:56
  SPEAKER_01: Dr.
• 31:56
  SPEAKER_01: Bellow.
• 31:57
  SPEAKER_02: I I guess my three tips that I just wrote down as I was thinking about that question, uh, you know, since Colin didn't get any time to think about it.
• 32:04
  SPEAKER_02: But uh, what what I would leave the audience with one is if you're doing a startup, and and this this goes against all the advice that you probably hear out there in the uh dental community, but I was a believer of this when I did my first startup, and I honestly attribute a lot of our quick success to it.
• 32:25
  SPEAKER_02: You gotta hire a full-time hygienist from day one.
• 32:28
  SPEAKER_02: So traditional wisdom says you can't afford it, you gotta be lean and mean, you've got to do your own hygiene.
• 32:34
  SPEAKER_02: Uh, and and you know, there's just so much of that out there.
• 32:37
  SPEAKER_02: I actually had to argue with a consultant from Paul Spargo, who was my bank, who was, you know, I it was an obligatory call that I had to do with them.
• 32:47
  SPEAKER_02: And he's telling me about how I can't afford a hygienist, and I'm basically told him, hey, I appreciate the advice, but I'm not gonna listen to it.
• 32:52
  SPEAKER_02: Like I've already got one lined up, I'm hiring her.
• 32:55
  SPEAKER_02: Um, you dude, as a doctor, you can't focus on the dentistry that really moves the needle if you're doing hygiene.
• 33:03
  SPEAKER_02: And honestly, like you want your patients to have the best experience.
• 33:06
  SPEAKER_02: I think I was a great dentist.
• 33:07
  SPEAKER_02: I don't think I was a great dental hygiene.
• 33:09
  SPEAKER_02: I'm I maybe did like two cleanings in 10 years after dental school, you know, out in the real world.
• 33:17
  SPEAKER_02: You don't want me cleaning your teeth.
• 33:18
  SPEAKER_02: That's that's not the experience that you want.
• 33:20
  SPEAKER_02: Um, I'm not patient enough either.
• 33:23
  SPEAKER_02: Uh, second is hire additional hygienists before you need them if you want to grow quickly.
• 33:29
  SPEAKER_02: So, you know, again, against traditional wisdom, everyone says, you know, you you gotta wait.
• 33:35
  SPEAKER_02: And and actually it's funny, I had a lot of dentists that reach out to me from the podcast and they'll say like ask me questions like, how do I know when I'm ready to bring on an associate?
• 33:44
  SPEAKER_02: How do I know when I'm ready to bring on another hygienist?
• 33:47
  SPEAKER_02: Um, and and my advice to them is always like, well, how fast do you want to grow?
• 33:52
  SPEAKER_02: Because if you want to grow quickly, you should probably hire them before you really need them and just go into it with an open eyes, knowing that, hey, they're probably gonna have holes in the schedule.
• 34:01
  SPEAKER_02: And there will be days that you feel like you're paying them to sit there and not do a whole lot.
• 34:05
  SPEAKER_02: But guess what?
• 34:06
  SPEAKER_02: If you if it allows you to see one extra patient that day, and that patient does one crown in one filling, you are more than paying for their hygiene salary for the day.
• 34:15
  SPEAKER_02: And chances are they're probably gonna see more than one patient, and you're probably gonna get more than a crown out of out of that patient.
• 34:20
  SPEAKER_02: So um I that's again, I just goes against traditional wisdom, but I'm I'm a big proponent in you know, building things for building the practice you want tomorrow today.
• 34:29
  SPEAKER_02: So just you know, attack it early.
• 34:31
  SPEAKER_02: And the the last thing was scripting with hygienists.
• 34:35
  SPEAKER_02: So one of one of the bottlenecks we realized with getting our hygiene reappointment rates up was that our hygienists just didn't know how to talk to patients about why they overcome object.
• 34:46
  SPEAKER_02: Like the same thing you should be doing with your treatment coordinators about overcome the objections, the patients moving forward with treatment.
• 34:52
  SPEAKER_02: You got to do that same thing with the hygienist about helping patients uh reappoint in the operatory before they leave.
• 34:58
  SPEAKER_02: Um, and basically we've simplified it over the years, and it's to the point now where if a patient has an objection, and unless they are like moving out of state, I basically told them unless the patient's moving out of state or they just got arrested and they're going to jail, those are like the only two exceptions, then you need to reappoint them.
• 35:17
  SPEAKER_02: And and if the patient does not want to pick a date, just let them know, hey, the way our system, the way our computer system is set up, if I don't manually schedule an appointment for you after you're cleaning, it's gonna automatically just pick a random date and time and it's gonna set that.
• 35:31
  SPEAKER_02: And wouldn't you rather pick a day and time that you think's gonna work for you than just getting a random day in time?
• 35:35
  SPEAKER_02: And like for 99% of cases it works.
• 35:38
  SPEAKER_02: And and like the proof is in the dab.
• 35:41
  SPEAKER_02: I mean, that you we've seen since we implemented this system, that's when we saw that that really big jump from like the upper 80s to the 95% plus.
• 35:49
  SPEAKER_02: Um, so that that's that's my three kind of closing tips for the audience when it comes to hygiene.
• 35:54
  SPEAKER_00: But I love that.
• 35:54
  SPEAKER_00: Yeah, and a lot of to to your first point too, hiring beforehand.
• 35:58
  SPEAKER_00: I've seen that over and over and over again, where that actually works in your favor.
• 36:02
  SPEAKER_00: I think a lot of people are just scared because they don't have new patient volume.
• 36:04
  SPEAKER_00: So they're like, I can't hire somebody before I know if my marketing is gonna work.
• 36:09
  SPEAKER_00: And the reason their marketing isn't working is because they don't have availability.
• 36:12
  SPEAKER_00: And so it's like this chicken and egg situation they find themselves in.
• 36:14
  SPEAKER_00: So it forces you to.
• 36:16
  SPEAKER_02: It forces you to get uncomfortable and and to reinvest.
• 36:19
  SPEAKER_02: And now at the same time, that's a good point, Gary.
• 36:22
  SPEAKER_02: You gotta turn up the marketing.
• 36:23
  SPEAKER_02: If if you're hiring before you need it, you gotta turn up the marketing, but it forces you to do that, something that you probably should have done earlier anyway.
• 36:30
  SPEAKER_01: So we're we're talking about variable expenses that you can choose to spend on in order to drive down fixed cost.
• 36:41
  SPEAKER_01: In a startup, the one thing you can't change, and this is why I would argue with anyone who's the whoever the talking heads are who told everyone don't hire hygienists at the beginning.
• 36:50
  SPEAKER_01: The the thing they miss is that fixed costs can't change.
• 36:54
  SPEAKER_01: I've got to pay rent no matter what.
• 36:56
  SPEAKER_01: I I have to pay these utility bills no matter what.
• 36:59
  SPEAKER_01: There are certain aspects of this that I can't change.
• 37:02
  SPEAKER_01: But by adding a hygienist, by adding an additional assistance, it makes it so that I now have the capacity to produce what will drive down those fixed costs.
• 37:11
  SPEAKER_01: And those are choices, active choices that will defend against the things that you can't choose anymore.
• 37:16
  SPEAKER_01: You can't choose your rent once you've already moved in.
• 37:19
  SPEAKER_01: So yeah, I believe that you should do the math and figure out this is only if you know you can generate new patients.
• 37:25
  SPEAKER_01: And on this call, I would say you have ways to generate new patients.
• 37:29
  SPEAKER_01: Worst case scenario, call Gary.
• 37:30
  SPEAKER_01: Gary will generate new patients.
• 37:32
  SPEAKER_01: Uh, but if you there's the plug.
• 37:35
  SPEAKER_00: Uh we're literally waiting for 45 minutes.
• 37:38
  SPEAKER_01: So yeah, I I over Gary, but Gary is awesome.
• 37:40
  SPEAKER_01: I believe in everything he does.
• 37:42
  SPEAKER_01: Uh, but if if you look at your average cost per patient, and if you don't know, then just put in$800.
• 37:50
  SPEAKER_01: $800 is a pretty good number in dentistry.
• 37:52
  SPEAKER_01: If you figure out what it would take to drive down your fixed cost to where your your overhead will get somewhere around 55%, that's what you need to do.
• 38:01
  SPEAKER_01: For us, we have to get to 70,000 in order for that to make sense.
• 38:05
  SPEAKER_01: So our we have to see 80 to 90 new patients a month to even drive down our fixed cost enough that we can start to make money, even start to think about making money.
• 38:15
  SPEAKER_01: So if we don't have enough opportunity in our hygiene schedule to see 90 new patients, then we shouldn't have opened the office in the first place.
• 38:21
  SPEAKER_01: So we open the two hygienists every time.
• 38:23
  SPEAKER_01: And I would encourage you to think about maybe doing the same if you have the guts to lose money for a little while.
• 38:28
  SPEAKER_01: But you're gonna lose money one way or the other.
• 38:30
  SPEAKER_01: So either lose a lot at the beginning and get profitable, or lose a little bit for a long time.
• 38:34
  SPEAKER_02: You know, and Colin, it's funny you say that because I'll I'll tell you one thing we changed in our most recent startups.
• 38:40
  SPEAKER_02: We we actually we haven't hired two hygienists yet.
• 38:43
  SPEAKER_02: We just we haven't had the demand from the hygiene perspective.
• 38:47
  SPEAKER_02: But on the flip side, we've actually brought in like one and a half doctors from day one.
• 38:51
  SPEAKER_02: So we we've realized that, you know, they're our our doctors are actually more limited, you know, doing these big implant cases and things like that.
• 38:59
  SPEAKER_02: They can only do so much at one time that we we're we've actually opened like two of the last three with one and a half doctors.
• 39:06
  SPEAKER_02: And we used to open at three days a week, and now we open all the startups at four.
• 39:10
  SPEAKER_02: So it's like kind of that same mentality of just opening more capacity from the very beginning.
• 39:15
  SPEAKER_02: And since we started doing that, it's been our most successful startups yet.
• 39:19
  SPEAKER_02: So I'm sure you're on to something on the hygiene side as well.
• 39:22
  SPEAKER_00: But that's huge.
• 39:23
  SPEAKER_00: Dr.
• 39:24
  SPEAKER_00: Valo, uh, Dr.
• 39:25
  SPEAKER_00: Collin, you guys, amazing job.
• 39:27
  SPEAKER_00: Dr.
• 39:27
  SPEAKER_00: Blake, thank you for making this happen.
• 39:29
  SPEAKER_00: I know Dr.
• 39:30
  SPEAKER_00: Blake ran QB on that.
• 39:32
  SPEAKER_00: Any final thoughts, Dr.
• 39:33
  SPEAKER_00: Blake, before we shut this down?
• 39:35
  SPEAKER_03: Uh no, we're on a time crunch.
• 39:37
  SPEAKER_03: But what I will say is what one thing that we've taken, and again, I agree with everything these guys have said.
• 39:43
  SPEAKER_03: Part of the reason we've grown as fast as we've grown is because I sit in rooms with people like this and minds like this.
• 39:48
  SPEAKER_03: And so uh a lot of credit goes to these guys.
• 39:51
  SPEAKER_03: But giving your hygienists autonomy and making them uh feel like they're mid-level providers, uh, take taking that term from our buddy Ben Caicos, like making them feel like they're not just sitting there doing bloody prophecy, plaque pickers, like use whatever words you want to use, where they have autonomy to have the discussions with patients that they need to have, that they feel like you've got their back, that they're never gonna be wrong if they tell a patient that they're gonna let uh Dr.
• 40:21
  SPEAKER_03: Meyer know that they're concerned about this tooth, that you're never gonna say, Why did you ever bring that up?
• 40:28
  SPEAKER_03: Uh I think there's just not enough leadership from doctors to be able to get the outcomes that these two have created.
• 40:35
  SPEAKER_03: Um and I think if you look internally, it can happen.
• 40:39
  SPEAKER_03: You can't sit here and say it can't, because the the proof is in the pudding.
• 40:44
  SPEAKER_03: It can't happen.
• 40:45
  SPEAKER_03: The question is, is how are you going to make it happen?
• 40:47
  SPEAKER_03: And so I would just encourage you, if you listen to this and you say, Yeah, but yeah, but yeah, but look inside and see what's stopping you and and blocking you from being able to see what the reality could be in the future.
• 41:01
  SPEAKER_02: Awesome.
• 41:02
  SPEAKER_02: I got I got one question for Blake before I gotta jump off here.
• 41:06
  SPEAKER_02: First of all, Gary Blake, I love your podcast.
• 41:09
  SPEAKER_02: It's it's like my second favorite, I think.
• 41:11
  SPEAKER_02: It's up there at least.
• 41:12
  SPEAKER_03: Top five for sure.
• 41:14
  SPEAKER_02: Um thank you for doing this, and thank you guys for putting a lot of valuable content out there.
• 41:18
  SPEAKER_02: Uh my my question for you, Blake, is are you gonna be salty at all when your most popular episode is the one that you talk the least on?
• 41:28
  SPEAKER_03: Not at all.
• 41:28
  SPEAKER_03: I love it.
• 41:30
  SPEAKER_02: Make sure.
• 41:31
  SPEAKER_02: I can't wait.
• 41:32
  SPEAKER_02: Let's make it happen.
• 41:34
  SPEAKER_02: Go ahead and spend the money.
• 41:36
  SPEAKER_02: I'm gonna leave this up just to make sure it uploads all the way.
• 41:38
  SPEAKER_02: I think I'm at like 99%, but I I do got to run.
• 41:41
  SPEAKER_02: So I'm gonna see you guys later.
• 41:42
  SPEAKER_02: Awesome.