Latest / My Dental Playbook / 057 Is Your Hygienist Holding Your Practice Hostage?

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057 Is Your Hygienist Holding Your Practice Hostage? · My Dental Playbook

• 0:00
  SPEAKER_01: I have a hygienist that got mad at me yesterday.
• 0:02
  SPEAKER_01: She punched me in the nose.
• 0:03
  SPEAKER_01: And then I was like, Does that mean you're showing up tomorrow or not?
• 0:07
  SPEAKER_01: And he was joking, kind of, but he was also telling a very obvious truth, which is like, I don't have a choice.
• 0:13
  SPEAKER_01: I know there's certain dentists that are gonna listen to this out there and be like, I have two hygienists.
• 0:17
  SPEAKER_01: I don't want to hygienist, but I can't get two other hygienists.
• 0:20
  SPEAKER_01: Welcome back to another episode of My Dental Playbook.
• 0:22
  SPEAKER_01: I'm your co-host, Gary Bird.
• 0:24
  SPEAKER_01: Along with my friend Dr.
• 0:25
  SPEAKER_01: Blake Hamlet, we're gonna be diving deep into his office and we're gonna be breaking down how you can build your hygiene team.
• 0:32
  SPEAKER_01: I know this is one of the biggest obstacles that offices face, and we created a multi-part series, and it's gonna really help you solve the problem around hygiene.
• 0:43
  SPEAKER_01: We're gonna be talking about the current state of the hygiene market, why you can't find a good hygienist and the recruiting framework that Dr.
• 0:51
  SPEAKER_01: Blake uses that works really well.
• 0:53
  SPEAKER_01: We're also gonna be talking about marketing to hygienists and how to get them to come in and interview and actually get the ones that are talented and want to work.
• 1:02
  SPEAKER_01: That's kind of important.
• 1:03
  SPEAKER_01: And then we're also gonna be talking about onboarding and KPIs, and we're gonna be talking about compensation and structure.
• 1:09
  SPEAKER_01: And lastly, we brought in some heavy hitters to help you understand the difference between fee for service versus in-network, rule versus city versus, you know, suburb type areas.
• 1:23
  SPEAKER_01: So we're gonna be talking about every kind of situation that you could possibly look at.
• 1:28
  SPEAKER_01: This is an amazing series.
• 1:30
  SPEAKER_01: Stay tuned.
• 1:31
  SPEAKER_01: There's a lot of conversation, a lot of buzz on this.
• 1:34
  SPEAKER_01: And we are going to attempt to break down the hygiene market.
• 1:39
  SPEAKER_01: Now, I will say Dr.
• 1:41
  SPEAKER_01: Blake is the only dentist that's willing to do this with me in the whole planet of Earth.
• 1:46
  SPEAKER_01: Um, this is a very touchy subject.
• 1:49
  SPEAKER_01: So I appreciate him doing this.
• 1:51
  SPEAKER_01: We've done this lightly in a podcast before, but this is gonna be a full, in-depth breakdown of the hygiene market and what we're gonna be talking about and what you're gonna get out of this is first of all, we're gonna talk about uh what the shortfall that's coming for hygiene.
• 2:06
  SPEAKER_01: It's gonna get worse before it gets better.
• 2:08
  SPEAKER_01: Uh how impactful hygienists are to the dental world.
• 2:13
  SPEAKER_01: Like, do we even need hygienists?
• 2:15
  SPEAKER_01: And if so, how and why?
• 2:17
  SPEAKER_01: Like, how does Dr.
• 2:17
  SPEAKER_01: Blake use him for his growing of his practice?
• 2:21
  SPEAKER_01: We're gonna talk about temps and how those can be used, but also can destroy your business if you're not careful.
• 2:28
  SPEAKER_01: Um, we're gonna talk about culture, uh, the difference between being an out-of-network office versus a PPO office versus a full like fee-for-service office of what that means and how that impacts hygiene.
• 2:40
  SPEAKER_01: And really, what's really gonna impact you is how to effectively onboard a hygienist.
• 2:46
  SPEAKER_01: We're gonna give you the full plan.
• 2:47
  SPEAKER_01: We're gonna give you the ads so you can run ads to attract hygienists to your practice, as well as Dr.
• 2:54
  SPEAKER_01: Blake's uh comp plan and incentives, along with ghost scheduling and how to use that for your hygiene.
• 3:02
  SPEAKER_01: And uh lastly, all the KPIs that Dr.
• 3:04
  SPEAKER_01: Blake looks at for his uh hygiene department.
• 3:07
  SPEAKER_01: So this is gonna be like a full-blown multi-series step by step.
• 3:12
  SPEAKER_01: And Dr.
• 3:13
  SPEAKER_01: Blake's like, sure, just throw it out there.
• 3:15
  SPEAKER_01: I was like, these are all the things I want.
• 3:16
  SPEAKER_01: It's Christmas.
• 3:17
  SPEAKER_01: What can we do?
• 3:18
  SPEAKER_01: He's like, let's do all of it.
• 3:20
  SPEAKER_01: So, right off the top, before we even jump into this, I want to say congratulations on winning the golden Rhino Award.
• 3:28
  SPEAKER_01: And uh, you won one of the uh the the you and Colin, you and your friend Colin, which is really cool uh that you guys both won it at the same time.
• 3:36
  SPEAKER_01: You guys had the fastest growing dental organizations and you were both honored at uh the dental success summit with by Mark.
• 3:44
  SPEAKER_01: That was awesome.
• 3:45
  SPEAKER_01: 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.
• 3:53
  SPEAKER_01: And we just got more new patients at our current practice.
• 3:56
  SPEAKER_01: So we're looking for another dentist here.
• 3:58
  SPEAKER_01: 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.
• 4:06
  SPEAKER_01: This is the place for you.
• 4:07
  SPEAKER_01: Dr.
• 4:08
  SPEAKER_01: Hamlin is looking for the perfect dentist.
• 4:10
  SPEAKER_01: This sounds like you, reach out to us.
• 4:11
  SPEAKER_01: You can DM us, comment down below.
• 4:13
  SPEAKER_01: We would love to hear from you.
• 4:14
  SPEAKER_01: Yeah.
• 4:15
  SPEAKER_00: No, thanks so much.
• 4:15
  SPEAKER_00: It it was a huge honor.
• 4:17
  SPEAKER_00: And honestly, Mark's had a big part in all of that.
• 4:20
  SPEAKER_00: Um, and and the organization he built within DSI.
• 4:25
  SPEAKER_00: Um, there's there's elbows that I've rubbed and people that are in my life now that that they weren't in my life, you know, two years ago, three years ago when I joined, and it made the huge, the biggest difference and being able to really process through higher level uh decisions and stuff like that with people that have done it before me.
• 4:44
  SPEAKER_00: Um and and for them to not feel like they were better, but that they were willing to help uh is is really the reason I was I was there and on stage.
• 4:53
  SPEAKER_00: Uh, but it also just meant a lot to do it with Colin, um, a guy who has literally walked through every it feels like every decision from the very beginning of of my business.
• 5:05
  SPEAKER_01: Yeah, and you went to dental school together, right?
• 5:07
  SPEAKER_00: Yeah, and so um, I mean, we we we do a lot of life together.
• 5:11
  SPEAKER_00: And so it was just a huge honor to uh to be able to do that with him.
• 5:15
  SPEAKER_00: And he his business is just like it's insane.
• 5:18
  SPEAKER_01: It's booming, yeah.
• 5:19
  SPEAKER_01: Which which is cool because you guys are like complete, like literally polar opposites from a business strategy.
• 5:25
  SPEAKER_00: For sure.
• 5:26
  SPEAKER_00: Yeah, and we were hoping to be able to get get to that a little bit more on stage, um, so that people can understand that you can do this in so many different ways.
• 5:34
  SPEAKER_00: Uh, but yeah, it was it was a huge ones awesome, yeah.
• 5:37
  SPEAKER_01: That was that was amazing.
• 5:38
  SPEAKER_01: And if you're not part of the Dental Success Network uh or Institute or Summit, all the D S S I N, um they're they're awesome.
• 5:48
  SPEAKER_01: They're great people, very entrepreneurial mind.
• 5:51
  SPEAKER_01: So go check them out.
• 5:51
  SPEAKER_01: And this is not like a sponsor plug or anything like that.
• 5:54
  SPEAKER_01: I just think it's awesome and I I've seen how much it's helped you.
• 5:57
  SPEAKER_01: So, all right, let's jump into this.
• 5:59
  SPEAKER_01: So, first of all, Mark actually talked about this at the summit where he did all the math on the screen.
• 6:05
  SPEAKER_01: There's going to be a huge shortfall of hygienists as we move forward.
• 6:08
  SPEAKER_01: The schools are not graduating enough people.
• 6:10
  SPEAKER_01: We do know that a lot of dentists, really smart dentists, are working on other alternatives.
• 6:15
  SPEAKER_01: They're trying to get foreign national dentists to be able to do more hygiene.
• 6:20
  SPEAKER_01: They're trying to get the fourth-year uh dental students to be able to do hygiene.
• 6:25
  SPEAKER_01: They're trying to get um dental assistants to be able to do hygiene.
• 6:30
  SPEAKER_01: Some people even floated the idea, and some states are looking at like having like a mid-tier provider that can do some dentistry and some hygiene.
• 6:38
  SPEAKER_01: And so there's all these options out there.
• 6:41
  SPEAKER_01: The medical field does a lot of that, right?
• 6:43
  SPEAKER_01: Like you can be a nurse practitioner, which is different than just a regular nurse.
• 6:47
  SPEAKER_01: It's not a doctor, it's in between, right?
• 6:50
  SPEAKER_01: And so, but so people are trying to come up with that with solutions.
• 6:54
  SPEAKER_01: But right now, the problem that we face is that dentists are feeling crunched because the amount of money that they have to pay to hygienist, it doesn't make sense from a business standpoint.
• 7:05
  SPEAKER_01: Like just mathematics.
• 7:06
  SPEAKER_01: That doesn't mean we don't like hygienists, it just doesn't add up.
• 7:09
  SPEAKER_01: On the flip side, dental hygienists are really important.
• 7:12
  SPEAKER_01: They're the ones that usually the new patients come to first, like right away out of the gate.
• 7:19
  SPEAKER_01: They also come back because of the hygienist because they need to get their teeth clean.
• 7:22
  SPEAKER_01: So it's like, I love my hygienist.
• 7:24
  SPEAKER_01: And when hygienists leave, we know that patients leave with them, uh, usually.
• 7:28
  SPEAKER_01: Um, and then also uh you get a lot of referrals from uh from hygienists, like, oh, I love my hygienist, you should go see them.
• 7:36
  SPEAKER_01: And that doesn't discredit what dentists do.
• 7:38
  SPEAKER_01: It's just that the hygienist is getting more touches for longer periods of time on the patient.
• 7:43
  SPEAKER_01: So they get to build those out.
• 7:46
  SPEAKER_01: And I know for you, Dr.
• 7:47
  SPEAKER_01: Blake, like the hygiene department's super important because your number one KPI is active patient base.
• 7:54
  SPEAKER_01: So, what are your thoughts as you look at this market?
• 7:58
  SPEAKER_01: Where are we at?
• 8:00
  SPEAKER_01: And like, how do you think through it?
• 8:02
  SPEAKER_00: Yeah, to your point about active patients, to me, and and really for the past 18 months, that's been one of the only metrics that I've been tracking from a marketing perspective is to make sure that the snowball is getting bigger and bigger.
• 8:16
  SPEAKER_00: Um in our practice, because we are out of network, we can actually make hygiene a profitable um center within our practice.
• 8:27
  SPEAKER_00: However, I can totally resonate with those that are in network to where you're either breaking even or losing money on hygiene, and I can understand where that's really frustrating.
• 8:37
  SPEAKER_00: I will say that's where rubbing elbows, whether it be in our mastermind or DSI or DSN, where you can still make that make sense for your practice.
• 8:47
  SPEAKER_00: Um but there's there's so many businesses that are built on loss leaders or or otherwise.
• 8:54
  SPEAKER_00: And not that I think your goal should be that hygiene is the loss leader, but it's quite literally the only thing that gets people to come back.
• 9:04
  SPEAKER_00: Like we have patients, we saw a patient today, hadn't been in since 2022, right?
• 9:09
  SPEAKER_00: And it's like I had a phone call today with somebody, and one of their growth ideas was hey, let's call on 18 months reactivation.
• 9:17
  SPEAKER_00: Like, that's a great idea.
• 9:18
  SPEAKER_00: However, you're gonna get a lot of voicemails and you're not gonna get a whole lot of people that come from that.
• 9:23
  SPEAKER_00: And so the goal, the the name of the game for me is how often can we get people coming to our practice?
• 9:30
  SPEAKER_00: Whether that's coming in um three times a year instead of twice a year for hygiene, which I think that is a huge missed opportunity in so many practices.
• 9:39
  SPEAKER_00: They don't even bring up the fact that they've got plaque and tartar on the back side of their teeth every time they see them.
• 9:45
  SPEAKER_00: Well, we probably should see a little more often so that you don't get plaque and tartar on the wax out of your teeth, right?
• 9:51
  SPEAKER_00: Um, and there's there's just a lot of ways that you can give hygienic junctive procedures or more procedures to do so that they can become pro they can be uh a uh a part of the practice that uh is valuable outside of just recurrence, right?
• 10:08
  SPEAKER_00: Um I don't think hygiene is going anywhere, um, but we do have to strike a balance between the goals of the hygienist financially uh and maybe even flexibility with what the business can actually support.
• 10:23
  SPEAKER_00: And that's where my fear would rise is if at some point um and we may be close to that point, those two things diverge, right?
• 10:34
  SPEAKER_00: And um I don't want that for either party because I think hygienists are a huge part of our industry.
• 10:40
  SPEAKER_01: Yeah, agreed.
• 10:41
  SPEAKER_01: I've had I've had hygienists reach out to me and they're like, Gary, I'm really concerned.
• 10:46
  SPEAKER_01: Like we're almost to the point of no return.
• 10:48
  SPEAKER_01: Like I love making great money, but I can also I I run a business over here doing not in dentistry, but like something else, and I understand basic business and these things, the math is not mathing.
• 11:01
  SPEAKER_01: And this is a hygienist, you know, I'm really concerned that we're losing sight and we're just gonna like kind of miss the golden opportunity of like, okay, well, let's take a little bit less money, but let's make this great relationship clinically that we can work together and make more money overall, but make a little bit less money hourly.
• 11:22
  SPEAKER_01: And um, another another thing that I think is really important to understand around this is uh temps.
• 11:28
  SPEAKER_01: So a lot of dental office are building off of temps.
• 11:32
  SPEAKER_01: And I've even told people before, like, go get a temp then.
• 11:34
  SPEAKER_01: You know what I mean?
• 11:35
  SPEAKER_01: Because they're like, I've been trying for 10 years.
• 11:36
  SPEAKER_01: And it's like, go get a temp then.
• 11:38
  SPEAKER_01: Um, but temps, like for what you're building, you couldn't use temps.
• 11:44
  SPEAKER_00: No, having having the same uh provider continuity is so important, right?
• 11:50
  SPEAKER_00: Like, we there are certainly moments when patients walk into our practice and they see a different provider, but the goal would be that they see the same hygienist every single time because that's what people want.
• 12:02
  SPEAKER_00: People want uh people don't like surprise, right?
• 12:05
  SPEAKER_00: Like when when they come in and they know that they're gonna sit in that chair in the corner in the office every time they come in, and Sally's gonna bring them back, and Julie's gonna take their x-rays and clean their teeth, and then they're gonna say bye to Sally on the way out.
• 12:21
  SPEAKER_00: Like, that's what gets good Google reviews.
• 12:24
  SPEAKER_00: That's what get that's what gets all of the I know.
• 12:26
  SPEAKER_01: My high my hygienist is from um her family's from Honduras.
• 12:32
  SPEAKER_01: I went on a cruise to Honduras, she told me where to go.
• 12:35
  SPEAKER_01: I know what kind of food she likes, she knows like what problems I have clinically, and she helped me navigate it.
• 12:41
  SPEAKER_01: And she's like, she was one of those people like, Gary, you should come.
• 12:45
  SPEAKER_01: You build up really fast right here.
• 12:47
  SPEAKER_01: And I know you've done everything you can.
• 12:49
  SPEAKER_01: So you should probably just come and get your teeth cleaned one more extra time a year.
• 12:52
  SPEAKER_01: That would really help.
• 12:53
  SPEAKER_01: So come every four months instead of every six months.
• 12:57
  SPEAKER_01: So, like, yeah, that would stink if I just all of a sudden got another hygienist.
• 13:01
  SPEAKER_01: Um, that's what patients actually want.
• 13:03
  SPEAKER_01: So temps are not the answer, but I think temps are a reality because the the hygienists get flexible hours, they get more pay, and they kind of get to pick and choose.
• 13:17
  SPEAKER_01: Yeah, it's a little bit more dumpster fiery, um, you know, because you're going, you have no idea what you're walking into.
• 13:22
  SPEAKER_01: You know what I mean?
• 13:23
  SPEAKER_01: Like, no clue.
• 13:24
  SPEAKER_01: Um, and so, but temps are a reality right now.
• 13:28
  SPEAKER_01: What would you say?
• 13:29
  SPEAKER_01: Like, if someone's listening right now and they're like, dude, I'm having to use temps and I feel like I'm getting strong armed, what would be your message?
• 13:36
  SPEAKER_01: Watch the rest of this and don't use temps anymore, or is there a model somehow you can use temps?
• 13:42
  SPEAKER_00: Yeah, I mean, there I know there's markets that I've I've talked to these people who are like, I've been looking for a or I've been looking for a hygienist for 18 months and I literally can't find one.
• 13:52
  SPEAKER_00: Um so I I I'm hesitant to give out advice outside of just like keep trying.
• 13:57
  SPEAKER_00: But I also think creating in in my market, I feel like we've created the best situation for our hygienists.
• 14:06
  SPEAKER_00: Our hygienists work seven-hour shifts, they don't take lunch, um, they work either from seven to two or nine to four.
• 14:12
  SPEAKER_00: They have a very strong base salary and they have commission on top of that that gets them well above what they would make as a temp anywhere else.
• 14:21
  SPEAKER_00: And so they they can arrange with their husbands where the husband takes the kids to school and they pick them up, and they can still be a mom or a dad if you have a male hygienist, like they can still have a life outside of being at the office, in our case from seven to four or eight to five, right?
• 14:39
  SPEAKER_00: They can like there.
• 14:40
  SPEAKER_00: I remember one of my hygienists actually, her neighbor was like, Do you work?
• 14:44
  SPEAKER_00: You know what I mean?
• 14:45
  SPEAKER_00: And it was like, that's what you want to create.
• 14:48
  SPEAKER_00: You want to create the job that you would want.
• 14:49
  SPEAKER_01: Well, for moms, especially for moms.
• 14:51
  SPEAKER_01: Most hygienists, I know you said for the guy, there's like one or two high male hygienists out there, but uh for percentage-wise, but it's almost all women, and most of them have kids.
• 15:01
  SPEAKER_01: And so what does a mom want with kids?
• 15:05
  SPEAKER_01: Well, I want to take them to school, I want to be able to pick them up.
• 15:07
  SPEAKER_01: Well, taking them to school starts at like eight o'clock, right?
• 15:10
  SPEAKER_01: 7 30, 8 o'clock, depending on you know your school.
• 15:13
  SPEAKER_01: Um, and then picking them up starts around 3 30.
• 15:16
  SPEAKER_01: And then uh on Fridays, it's like it's way earlier because it's like part day if they have younger kids or whatever.
• 15:23
  SPEAKER_01: So, yeah, creating that environment.
• 15:25
  SPEAKER_01: So uh let's just talk through that really quickly.
• 15:27
  SPEAKER_01: Do you just have to have that means you have to have more hygienists, though, right?
• 15:31
  SPEAKER_01: That's right.
• 15:33
  SPEAKER_01: So Blake, so so the reason nobody has hygienists is because they're all at Dr.
• 15:38
  SPEAKER_01: Blake's office working two hours a day, making$7,000 an hour.
• 15:43
  SPEAKER_00: It's honestly part of the strategy, though, to be honest with you.
• 15:46
  SPEAKER_00: Like, I I want to have the best people that we can possibly have, and I want to give flexibility to the people that that we have.
• 15:53
  SPEAKER_00: We have hygienists that work full-time and they work four or five days a week, and we have hygienists that work one day a week.
• 16:00
  SPEAKER_00: Like we literally have the whole gamut, and I'm just like, if you want to be a part of our team and you're you're it, then we want you, right?
• 16:06
  SPEAKER_01: Well, and and the reason this is so valuable for people to learn, and we're gonna jump into the like the nitty-gritty here in a minute, but I just wanted to get like a really good idea of like the the the overarching market right now is that gives you a competitive advantage.
• 16:22
  SPEAKER_01: If every other office is like, nah bro, it's full time, we work Monday through Wednesday, 10 hours, and well, can I do that?
• 16:29
  SPEAKER_01: No, you can't do anything.
• 16:31
  SPEAKER_01: It's like you lose a huge piece of the market.
• 16:33
  SPEAKER_00: What I what I've learned, and this goes outside of hygiene, but even with technology or otherwise doctors, redundancy is the biggest cheat code in the whole.
• 16:42
  SPEAKER_00: Like having multiple hygienists, having multiple doctors, having multiple front office people to where if and it gives benefit to both the office and the hygienists.
• 16:54
  SPEAKER_00: If the hygienist needs off, they can coordinate with their other hygiene team to see if they can cover and they can.
• 16:59
  SPEAKER_00: I don't care when they they're here or when they're here or whatever.
• 17:01
  SPEAKER_00: I just care that somebody's here and I know that they're qualified, and I know that I like them because I hire I know they're a you know what I mean.
• 17:08
  SPEAKER_00: And so um that that's been the biggest benefit to us is it it's given us flexibility because I've been I have been the the office that had two hygienists and one of them gets married or has a baby or quits or whatever.
• 17:23
  SPEAKER_00: And then you're really you're really in a bad spot because you need a hygienist.
• 17:27
  SPEAKER_00: You have to find one, and then that's when you make bad hiring decisions.
• 17:31
  SPEAKER_01: Yep.
• 17:31
  SPEAKER_01: Okay, so let's let's jump into the meat and potatoes of this.
• 17:34
  SPEAKER_01: So let's talk about the situation that most dentists find themselves in right now.
• 17:40
  SPEAKER_01: And I I know this because I talk to them regularly.
• 17:43
  SPEAKER_01: They have hygienists, but they're not good culture fits.
• 17:49
  SPEAKER_01: They're not they're not nice to them.
• 17:52
  SPEAKER_01: I had one dentist online, he was kind of joking.
• 17:55
  SPEAKER_01: Um, he said, Yeah, I had a one dentist online, he was kind of joking, but kind of not.
• 18:00
  SPEAKER_01: He said, Gary, I have a hygienist that uh got mad at me yesterday.
• 18:05
  SPEAKER_01: She punched me in the nose, and then I was like, Does that mean you're showing up tomorrow or not?
• 18:10
  SPEAKER_01: And he was joking, kind of, but he was also telling a very obvious truth, which is like, I don't have a choice.
• 18:18
  SPEAKER_01: And I I know there's certain dentists that are gonna listen to this out there and be like, I have two hygienists, I don't want these two hygienists, but I can't get two other hygienists.
• 18:28
  SPEAKER_01: What what's your thoughts on keeping or cutting your current team?
• 18:32
  SPEAKER_00: I love my team, but we're always adding.
• 18:34
  SPEAKER_00: So if you're looking for a position, let us know.
• 18:36
  SPEAKER_00: Uh but um I think what I've learned, and I've shared a lot of this on the podcast, but the level of leadership has to increase across the board.
• 18:51
  SPEAKER_00: And and a lot of times we pay for the sins of those that are willing to let that type of stuff happen because then it becomes normalized, right?
• 19:03
  SPEAKER_00: And so generally, as leaders, if we wanna if we want to be be called business owners, then do the things that that are required to own the business.
• 19:12
  SPEAKER_00: And being punched in the face by a team member should never be expected or allowed, uh, period, whether they're a hygienist, whether they're highest produced figuratively and literally.
• 19:24
  SPEAKER_01: Obviously, literally, if someone assaults you, yeah, don't don't allow that.
• 19:27
  SPEAKER_01: This state of Texas frowns on that for sure.
• 19:30
  SPEAKER_01: But but um, but also figuratively, where you're if you're being strong-armed in your business, it's not a fun feeling.
• 19:37
  SPEAKER_01: I've been there before where it's like this person knows I need them more than they need me.
• 19:43
  SPEAKER_00: Yeah, and and you have to sometimes you do have to climb your way out of that.
• 19:47
  SPEAKER_00: Like, I I couldn't go from two hygienists to six overnight, right?
• 19:51
  SPEAKER_00: But I I did create a unique structure to where it allowed us to bring on a whole nother hygienist because of the amount of hygiene days that we had.
• 20:00
  SPEAKER_00: Whereas, like, hey, you can work less hours and actually make more, and we can solve this problem of having an extra hypost.
• 20:08
  SPEAKER_01: How much of this issue is the hygienist, not in your office, your office separate, right?
• 20:13
  SPEAKER_01: I'm talking about just like you talk to a lot of dentists.
• 20:16
  SPEAKER_01: How much of this is like there's a the culture's bad, there's a bad leader, they're not leading their team properly, versus um, this is just hide the hygiene market running wild and just demanding too much.
• 20:28
  SPEAKER_01: Is it like a 50-50 or where where do you think like where are we at?
• 20:33
  SPEAKER_00: I think generally people want to be led.
• 20:35
  SPEAKER_00: And if we're honest, and and I was in this boat six months ago, honestly.
• 20:42
  SPEAKER_00: Like you've gotta have systems, you've gotta have protocols, and when people don't have them, then guess who gets to come up with the people doing the thing, right?
• 20:52
  SPEAKER_00: And then that's what gives us frustration.
• 20:54
  SPEAKER_00: Whereas if from day one they came in and they knew this is how we bring a patient back, this is how we do this, this is how we do that, this is how we do that, this is how we talk to people, these are the things you don't do, these then they generally do those things, and it's not a dictator, like they they want that, they want to know what the rules to the game are.
• 21:14
  SPEAKER_00: But so many dental practices don't have that.
• 21:18
  SPEAKER_00: So many dental practices are just like, yep, we just need somebody to come in and clean your teeth.
• 21:22
  SPEAKER_00: And it's like, no, you don't.
• 21:23
  SPEAKER_00: Like, you need more than that.
• 21:24
  SPEAKER_00: That's not that's not what a hygienist does.
• 21:26
  SPEAKER_00: They enroll treatment.
• 21:28
  SPEAKER_00: Like they if your hygienist doesn't co-diagnose with you, you will do infinitely less dentistry than if they do help you.
• 21:35
  SPEAKER_00: They they're in there cleaning teeth and they find things that you would never look at, you know, around the corner of this canine that you would never see, they're like, Oh yeah, there's a hole right there.
• 21:45
  SPEAKER_00: I I fell in it when I cleaned it.
• 21:47
  SPEAKER_00: Like you've gotta have that.
• 21:48
  SPEAKER_00: And it's not but you've got to lead that.
• 21:52
  SPEAKER_00: And I just don't think generally we weren't built to do that.
• 21:56
  SPEAKER_00: We were built to be technicians, but you chose.
• 22:00
  SPEAKER_00: To step into a different role when you bought a practice.
• 22:03
  SPEAKER_00: And so now you get to either level up or level up.
• 22:08
  SPEAKER_01: Yeah.
• 22:08
  SPEAKER_01: So one thing I think that would help a lot of Dennis, it would really help me when I I figured this out for my company is that I used to think like culture, that's so stupid.
• 22:16
  SPEAKER_01: Like it's warm and who cares?
• 22:18
  SPEAKER_01: Well, no, it actually really matters.
• 22:20
  SPEAKER_01: And culture is really at the end of the day, it's winning or losing.
• 22:24
  SPEAKER_01: Like just think of it like sports.
• 22:26
  SPEAKER_01: If you and I are on a basketball team and we were losing every week, but we were like, we have great culture.
• 22:32
  SPEAKER_01: The people are like, no, you don't.
• 22:34
  SPEAKER_01: You have horrible culture.
• 22:35
  SPEAKER_01: You guys are losers.
• 22:36
  SPEAKER_01: You guys are both losers and you're okay with it, right?
• 22:39
  SPEAKER_01: So good culture on a losing team doesn't exist.
• 22:43
  SPEAKER_01: So winning and losing.
• 22:44
  SPEAKER_01: So does your team know if they're winning or losing?
• 22:49
  SPEAKER_01: And do and they can they see it by themselves without you telling them or coming up and reminding them every single day.
• 22:56
  SPEAKER_01: That's like, that's the hugest thing about culture.
• 22:59
  SPEAKER_01: That's number one.
• 22:59
  SPEAKER_01: Number two is your systems, which you touched on, which in sports is like your playbook.
• 23:04
  SPEAKER_01: Do you so if you're a coach and you're trying to build a winning culture and you're just like, oh god, just go out there on the court and just just do just play, just be you.
• 23:12
  SPEAKER_01: And then you're losing all the time.
• 23:15
  SPEAKER_01: And the scoreboard at the end is like, you lose, you lose.
• 23:17
  SPEAKER_01: It's like, yes, of course.
• 23:19
  SPEAKER_01: No one wants to be on that team.
• 23:20
  SPEAKER_01: Everybody's like, all right, how do we get off this team?
• 23:22
  SPEAKER_01: How do we get out of this situation?
• 23:24
  SPEAKER_01: Because the coach doesn't give us plays and the scoreboard says we're losing every single day.
• 23:29
  SPEAKER_01: That's bad culture.
• 23:30
  SPEAKER_01: Good culture is here's our system.
• 23:33
  SPEAKER_01: That doesn't mean it's always going to work, but we have a system.
• 23:36
  SPEAKER_01: We believe in the system.
• 23:37
  SPEAKER_01: We practice the system.
• 23:39
  SPEAKER_01: We all know what the system is.
• 23:40
  SPEAKER_01: So that way we can work together.
• 23:43
  SPEAKER_01: And each of you knows what your role is and you know if you're winning and losing.
• 23:47
  SPEAKER_01: Gary, your job's to rebound.
• 23:48
  SPEAKER_01: So you make sure that you had 20 rebounds.
• 23:51
  SPEAKER_01: Great job.
• 23:51
  SPEAKER_01: You're boxing out.
• 23:52
  SPEAKER_01: Dr.
• 23:52
  SPEAKER_01: Blake, your job's to score.
• 23:54
  SPEAKER_01: So you're averaging 24 points.
• 23:55
  SPEAKER_01: Good job.
• 23:56
  SPEAKER_01: You're doing what you're supposed to be doing on your team.
• 23:58
  SPEAKER_01: And if we don't do those things, we know.
• 24:00
  SPEAKER_01: Like, man, I had a bad night.
• 24:01
  SPEAKER_01: I didn't get, I didn't really rebound well tonight, or you didn't score well tonight.
• 24:05
  SPEAKER_01: And if you, and we're going to talk about these because Dr.
• 24:07
  SPEAKER_01: Blake's going to give his KPIs, his uh um, and some of his other guidelines and different things like that, that in system so that way you can actually take these things, implement them, and watch what it does to your culture.
• 24:20
  SPEAKER_01: It actually will fix your culture if implemented properly.
• 24:22
  SPEAKER_01: So I absolutely love that.
• 24:23
  SPEAKER_01: Now, what are your thoughts on uh out of network versus PPO versus fee for service?
• 24:30
  SPEAKER_01: So I personally think for most offices, the reason they're nice dentists, they're trying to be good to their team.
• 24:36
  SPEAKER_01: They have nice hygienists, the hygienists want to help the dentist, but then they're in network with all these insurances.
• 24:42
  SPEAKER_01: And so it's like the insurance is like, okay, we're gonna pay you$12 for that cleaning today, Bobby.
• 24:47
  SPEAKER_01: And the and it's like the dentist is like, how am I supposed to, how am I supposed to uh pay my hygienist who's making$80 an hour and you pay me$12, you know what I mean, or whatever.
• 24:59
  SPEAKER_01: Um, what what are your thoughts on on this and how how we make this work?
• 25:04
  SPEAKER_00: I can tell you what I know.
• 25:05
  SPEAKER_00: I I only know out of network is the practice that I bought was out of network and we've remained out of network.
• 25:10
  SPEAKER_00: So I I feel like I know how to grow that side of it.
• 25:13
  SPEAKER_00: But what uh what I will say is is I think both work.
• 25:19
  SPEAKER_00: I know guys like Colin, uh guys like Andrew Valo, who literally use insurance as the cheat code, right?
• 25:27
  SPEAKER_00: Whereas for me, marketing is a cheat code, right?
• 25:30
  SPEAKER_01: Um which insurance is marketing, just so everybody understands I like so they're they're the same thing.
• 25:36
  SPEAKER_00: But what what I what I think is is like you've got the 10% of the Collins and the Valas, and then you've got the other 10% of the Mies and the other people doing out of network, like bigger office type of stuff.
• 25:50
  SPEAKER_00: And then you've got the 80% in the middle who are just using insurance as like the lazy, like the poor man's way of getting there.
• 25:58
  SPEAKER_00: And so their frustration is is like, well, the insurance is only paying.
• 26:01
  SPEAKER_00: Well, then go fight the insurance for it.
• 26:03
  SPEAKER_00: Like I I know those guys, and those guys are actively with their vendors, with everybody.
• 26:08
  SPEAKER_00: They're they're getting the best prices.
• 26:10
  SPEAKER_00: They're working on that.
• 26:11
  SPEAKER_00: They're not just saying, Well, I'm in that work with insurance, so I guess I'll just take what they give me.
• 26:16
  SPEAKER_00: No, they're like, hey, do you do you want me?
• 26:19
  SPEAKER_00: Like they're the prize, not the prisoner.
• 26:21
  SPEAKER_00: And so often, I think that's how insurance is well, I'll just go in that work and I'll just get more patients and I'll just pay less, but it'll be fine.
• 26:30
  SPEAKER_00: I I think there's a way that both can work really, really well, but you've got to, you've got again, you've got to own your mark like your method.
• 26:38
  SPEAKER_00: And if you don't own it and you're just hoping that being a network is gonna solve your new patient problem, it's not.
• 26:44
  SPEAKER_00: You know what I mean?
• 26:44
  SPEAKER_00: And going on a network and marketing more, that's not necessarily the you're gonna have so many other systems in place.
• 26:50
  SPEAKER_01: Agreed.
• 26:50
  SPEAKER_01: Yeah.
• 26:51
  SPEAKER_01: Okay, so that could be its whole own topic.
• 26:54
  SPEAKER_01: Um, how to how to and maybe we could bring somebody on and we could have you and maybe call in, and then we could talk about okay, how do you think through it and how do you take advantage of this?
• 27:04
  SPEAKER_01: And then how do you think through it and how do you take advantage of it?
• 27:07
  SPEAKER_01: Because it really is just like two opposite sides of the coin at the end of the day.
• 27:11
  SPEAKER_01: Um, there is no escaping paying for something, though.
• 27:14
  SPEAKER_01: There is no, I don't want to do any of it and I'll do nothing, um, and I'll grow.
• 27:19
  SPEAKER_01: So some insurance, you might you might uh eat it on the insurance side, you might eat it on the marketing side, you might eat it on the location side.
• 27:26
  SPEAKER_01: Uh, there's a lot sooner or later you have to you have to eat something, right?
• 27:31
  SPEAKER_01: Every and everybody goes through that.
• 27:33
  SPEAKER_01: Okay, so now this is the part I think that most people are gonna really be able to sink their teeth into.
• 27:40
  SPEAKER_01: And uh we're gonna talk about specifically always be hiring.
• 27:44
  SPEAKER_01: I don't if I was a dentist, there would be two positions I would always be hiring for 24-7.
• 27:50
  SPEAKER_01: It would be dentist.
• 27:51
  SPEAKER_01: I'd always be looking for another great dentist.
• 27:53
  SPEAKER_01: And well, what we don't have room for another dentist.
• 27:56
  SPEAKER_01: Yeah, we can get a new building, we can build room for a new dentist.
• 27:58
  SPEAKER_01: The right dentist, we could we could do something for.
• 28:01
  SPEAKER_01: And I would always be looking for another hygienist, not because I want to replace my team, but I never know what my team's gonna do.
• 28:06
  SPEAKER_01: They might, like you said, get pregnant or they might have to move, or their husband might move out of town, or whatever it may be.
• 28:13
  SPEAKER_01: Like these things all happen and you get a two-week notice, and you're like, Oh, I'm not gonna find a hygienist in two weeks, right?
• 28:20
  SPEAKER_01: Um, so though those two, those things are really, really important.
• 28:23
  SPEAKER_01: So uh always be hiring.
• 28:25
  SPEAKER_01: And so this comes with a couple things.
• 28:28
  SPEAKER_01: Number one, how do you onboard your new hires, your ads, your marketing, all of those kind of things, and then your comp and pay and commission and all those kind of things.
• 28:39
  SPEAKER_01: So let's start with the onboarding plan.
• 28:42
  SPEAKER_01: How do you onboard your dentist?
• 28:44
  SPEAKER_01: Or I'm sorry, your hygienist.
• 28:46
  SPEAKER_00: Well, I'm I'm blessed enough in in the podcast you guys got to meet out on, but she's our hygiene lead, and she honestly like we built out the system and then I gave her the system to go onboard them.
• 28:58
  SPEAKER_00: And so I I couldn't necessarily walk you through each and every step, but I will tell you that they understand the important KPIs, what's a win, what's a loss, a lot of the things you mentioned already.
• 29:11
  SPEAKER_00: Um but we also just hire so much for culture because when we find when we find the winners, when we find the people that are a little bit competitive and they they wanna they want to work with their team members, but they also kind of want to be their team members, that's a perfect person for us.
• 29:29
  SPEAKER_00: Like we want somebody that's not they don't want to just stay the same, they want to grow, they want to eventually do something even bigger than what they're doing now, right?
• 29:38
  SPEAKER_00: And there's there's a world in which that can happen, but you've got to go create it, just like we've been talking about, like as the owner of the practice, you can't sit idle, you've got to go create it.
• 29:48
  SPEAKER_00: Um so onboarding is probably the most critical thing.
• 29:52
  SPEAKER_00: You know, we're onboarding um a lot of front office personnel right now and treatment coordinators.
• 29:57
  SPEAKER_00: And uh we we brought somebody on that I had uh we did not coach her, but she I had worked with her at Dr.
• 30:05
  SPEAKER_00: Lathrop's office prior to uh buying my practice.
• 30:09
  SPEAKER_00: And then she went to another office and she moved closer in town, so she reached out and I ran into her this morning and I was she was just like, Blake, this is amazing.
• 30:17
  SPEAKER_00: Like the onboarding process is great.
• 30:19
  SPEAKER_00: I'm learning so much.
• 30:20
  SPEAKER_00: And she's been in dentistry for five, six, seven years.
• 30:23
  SPEAKER_00: Like, and she's telling me she's learning something and onboard, right?
• 30:27
  SPEAKER_00: And so for me, uh the onboarding process, the the Q code for that is finding other leaders and empowering those leaders to be able to go and do those things because it's really hard when you're the operator or the technician to go and tell somebody these granular things that you don't even yourself really understand.
• 30:47
  SPEAKER_00: Whereas when someone else doing the job can say, Hey, like this is the goal, but here's what's gonna happen.
• 30:53
  SPEAKER_00: You're gonna run into these five things, and here's how you handle those five things.
• 30:58
  SPEAKER_00: The you fold so much time by doing that versus you thinking that you hold all the keys and that you need to teach them every little detail.
• 31:08
  SPEAKER_00: It's the like get them eighty percent of the way there and let them fail and and just know that they'll fail.
• 31:13
  SPEAKER_00: Look at failures uh as information, not as a problem.
• 31:18
  SPEAKER_00: You know what I mean?
• 31:18
  SPEAKER_00: And and then you can go solve those those things.