Latest / My Dental Playbook / 060 Hygiene Compensation: Bonusing Your Way to Growth

Transcript

060 Hygiene Compensation: Bonusing Your Way to Growth · My Dental Playbook

• 0:00
  SPEAKER_01: What I don't want people to do is leave this conversation and say I need to commission hygienist or I need to pay for 1k or whatever.
• 0:07
  SPEAKER_01: I think the the beautiful thing about what you did was you went and just asked the question, what would be a win for you?
• 0:12
  SPEAKER_01: Right?
• 0:12
  SPEAKER_01: And you got the answer and then you asked it.
• 0:14
  SPEAKER_01: So just ask it.
• 0:15
  SPEAKER_01: It may be that people don't want more money, they just want more freedom.
• 0:18
  SPEAKER_00: Welcome back to another episode of My Dental Playbook.
• 0:21
  SPEAKER_00: I'm your co-host, Gary Bird.
• 0:22
  SPEAKER_00: Along with my friend Dr.
• 0:23
  SPEAKER_00: Blake Hamblin, we're going to be diving deep into his office and we're going to be breaking down how you can build your hygiene team.
• 0:31
  SPEAKER_00: I know this is one of the biggest obstacles that offices face, and we created a multi-part series, and it's going to really help you solve the problem around hygiene.
• 0:42
  SPEAKER_00: We're going to be talking about the current state of the hygiene market, why you can't find a good hygienist and the recruiting framework that Dr.
• 0:49
  SPEAKER_00: Blake uses that works really well.
• 0:51
  SPEAKER_00: We're also going to 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.
• 1:00
  SPEAKER_00: That's kind of important.
• 1:02
  SPEAKER_00: And then we're also going to be talking about onboarding and KPIs, and we're going to be talking about compensation and structure.
• 1:08
  SPEAKER_00: 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 area.
• 1:21
  SPEAKER_00: So we're going to be talking about every kind of situation that you could possibly look at.
• 1:26
  SPEAKER_00: This is an amazing series.
• 1:28
  SPEAKER_00: If you haven't watched the previous episode, make sure you go check that out.
• 1:33
  SPEAKER_00: All right.
• 1:33
  SPEAKER_00: We are live.
• 1:34
  SPEAKER_00: And today I am on vacation on the beach.
• 1:37
  SPEAKER_00: Dr.
• 1:38
  SPEAKER_00: Blake did one from the beach one time, and I was like, you know what?
• 1:41
  SPEAKER_00: We need to do a podcast from the beach.
• 1:43
  SPEAKER_00: But in all seriousness, we weren't going to record today because Dr.
• 1:47
  SPEAKER_00: Blake had jury duty and he's a good citizen.
• 1:50
  SPEAKER_00: So he actually showed up to that and went to that.
• 1:52
  SPEAKER_00: And so I we didn't, we were like, maybe we'll record, maybe we won't.
• 1:56
  SPEAKER_00: I had a trip plan, but this episode is so good.
• 1:59
  SPEAKER_00: I'm taking an hour out of my vacation, and Dr.
• 2:02
  SPEAKER_00: Blake basically had an open day today, and he was like, hey, let's record.
• 2:06
  SPEAKER_00: And we've been talking about the hygiene crisis, and it truly is a crisis.
• 2:10
  SPEAKER_00: Uh, we're we're at a short a shortfall of about 40% of hygienists over the next couple years.
• 2:16
  SPEAKER_00: Uh offices can't afford to pay the hourly rate that that a lot of hygienists want.
• 2:22
  SPEAKER_00: And we've talked about just the problem at great length.
• 2:26
  SPEAKER_00: We've also talked about how to onboard hygienists, how to recruit them, also how the KPIs and all of those kind of things.
• 2:34
  SPEAKER_00: And this is the one that probably gets the doctors in the most amount of trouble is how to compensate them.
• 2:40
  SPEAKER_00: So we're gonna talk about compensation, bonuses, all those kind of things.
• 2:45
  SPEAKER_00: And I think if you get this one right, it kind of makes everything else work properly.
• 2:50
  SPEAKER_00: But it's there's a the devil's in the details.
• 2:53
  SPEAKER_00: Uh it doesn't, it doesn't just work out.
• 2:55
  SPEAKER_00: You can't just just roll it out and baby step it and hope that it works.
• 3:00
  SPEAKER_00: You you gotta really understand the structure.
• 3:02
  SPEAKER_00: And Dr.
• 3:03
  SPEAKER_00: Blake has you almost hit$700,000 in collections last month, which is insane.
• 3:10
  SPEAKER_00: Um, you're on there's a clear road to like eventually getting to a million dollars, but a big part of that is your active patient base.
• 3:18
  SPEAKER_00: And the only way you can have a big active patient base that keeps coming back is if you have great hygienists.
• 3:24
  SPEAKER_00: So we're gonna jump in.
• 3:24
  SPEAKER_00: Dr.
• 3:24
  SPEAKER_00: Blake's gonna just tell you how he does it.
• 3:27
  SPEAKER_00: You may not like it, you may love it, you may get some ideas from it, but I promise you it'll help you one way or another.
• 3:33
  SPEAKER_00: And before we jump into that, make sure you check out our sponsor, Cherry.
• 3:36
  SPEAKER_00: They're right down below.
• 3:37
  SPEAKER_00: They're amazing.
• 3:39
  SPEAKER_00: Almost everybody that I work with directly uses Cherry now.
• 3:43
  SPEAKER_00: And we have some trainings on it, some discount codes, different things like that, right down below.
• 3:47
  SPEAKER_00: Make sure you check that out.
• 3:48
  SPEAKER_00: So, Dr.
• 3:49
  SPEAKER_00: Blake, let's just start with hourly rates.
• 3:54
  SPEAKER_00: How do you think through, okay, this is how much I'm gonna pay my hygienist hourly?
• 3:58
  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.
• 4:06
  SPEAKER_00: And we just got more new patients at our current practice.
• 4:10
  SPEAKER_00: So we're looking for another dentist here.
• 4:11
  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.
• 4:19
  SPEAKER_00: This is the place for you.
• 4:20
  SPEAKER_00: Dr.
• 4:21
  SPEAKER_00: Hamblin is looking for the perfect dentist.
• 4:23
  SPEAKER_00: This sounds like you, reach out to us.
• 4:24
  SPEAKER_00: You can DM us, comment down below.
• 4:26
  SPEAKER_00: We would love to hear from you.
• 4:28
  SPEAKER_00: How do you think through, okay, this is how much I'm gonna pay my hygienist hourly?
• 4:32
  SPEAKER_01: Yeah, and I frankly, I used to used to pay my hygienist strictly hourly.
• 4:37
  SPEAKER_01: And um, that worked well, and you can certainly do that.
• 4:41
  SPEAKER_01: There's there's a lot of upside for you potentially uh if you do that, because there can be some fluff into that.
• 4:49
  SPEAKER_01: And so what I what I wanted more than anything was for them to own their outcomes and to own their jobs and responsibilities more than me having to double check, are we taking x-rays every year?
• 5:01
  SPEAKER_01: Are we updating medical histories?
• 5:03
  SPEAKER_01: Are we doing like the basic things that need to be done?
• 5:06
  SPEAKER_01: And some people say, Well, yeah, that's just part of your job, and why would I pay you more to do that?
• 5:10
  SPEAKER_01: And others would say, Well, there's there's a lot more uh meat on the dome if you allow people to have autonomy, and that's the way I that that I uh approach that is um I want our hygienists to be able to feel like they um couldn't find anything better, right?
• 5:28
  SPEAKER_01: Like the best thing that I could create, because I know actively like we have people in our market that are actively recruiting our hygienists and they tell me and they're not leaving, right?
• 5:37
  SPEAKER_01: And so that I know that we've built a good model for them because of that.
• 5:41
  SPEAKER_01: And so um you can certainly pay hourly, and I totally can uh empathize with the owners that are in network that struggle to be able to even meet the minimum, maybe that we're we're gonna get to.
• 5:55
  SPEAKER_01: Um, but for me, I wanted our hygienists to own their outcomes.
• 5:59
  SPEAKER_01: I didn't want them just to be what we call plaque pickers, but mid-level providers that are doing it and really serving the patients and making sure that they're keeping everything up to date.
• 6:08
  SPEAKER_01: Um if if they have any level of uh ethical morality, uh then the issue of well, I don't want to pay somebody on uh commission or otherwise goes out the door.
• 6:23
  SPEAKER_01: And frankly, like you wouldn't have a job in our office if you weren't ethical.
• 6:27
  SPEAKER_01: And so like that's that's step number one.
• 6:30
  SPEAKER_01: And so I don't worry about that.
• 6:32
  SPEAKER_00: Yeah, I love that.
• 6:33
  SPEAKER_00: And I totally agree.
• 6:34
  SPEAKER_00: And the other way I think about it is you want to align incentives.
• 6:39
  SPEAKER_00: When incentives are aligned, then everybody wins.
• 6:42
  SPEAKER_00: So you want the patients, your team, and the owner to all win.
• 6:46
  SPEAKER_00: When you can create a win-win-win situation where everybody's getting the best outcomes for themselves as well as for the other party that they're working with, then everything works.
• 6:55
  SPEAKER_00: And another thing is, is like we were joking before I hit record.
• 6:59
  SPEAKER_00: I've seen Medicaid offices that are running complete scams and they get popped, and the government's paying for everything, and the patient's not paying, the doctor's making a boatload of money, and the taxpayers are just writing the check and they get caught.
• 7:13
  SPEAKER_00: And so you can scam any system.
• 7:15
  SPEAKER_00: You can scam any system, you can be a bad guy in any system.
• 7:18
  SPEAKER_00: The goal, this this episode is not for bad guys and people who are scamming the system.
• 7:24
  SPEAKER_00: This is for people who want to grow an office that actually works for the hygienist as well as the owner, as well as the patient.
• 7:31
  SPEAKER_00: So, in your market, what is like what is oh, let's start with temps.
• 7:36
  SPEAKER_00: What are temps making in your market?
• 7:38
  SPEAKER_01: I've seen temps in our market get anywhere from 60 to 70 dollars an hour, which to me is wild.
• 7:45
  SPEAKER_01: And I totally empathize with those that like that's the northerner market because that's so challenging.
• 7:51
  SPEAKER_01: Um but yeah, temps are I would say if we could hire a temp at 55 an hour, I'd be pretty happy with that.
• 7:58
  SPEAKER_00: Yeah.
• 7:58
  SPEAKER_00: So, so but 60 to 70 is like the going rate, and you can't build what you're building with temps.
• 8:04
  SPEAKER_00: Like, you can't build a great culture, even if the temps, and and temps sometimes hear this stuff and they get mad, right?
• 8:10
  SPEAKER_00: Or whatever, but you can't build a great culture if you're renting the players on your team, right?
• 8:15
  SPEAKER_00: Like if I'm trying to build a team and it's like, hey, I'm just gonna have this guy come on a 10-day contract, you can't build an awesome team with that person because they're not around and they're they're probably gonna leave.
• 8:24
  SPEAKER_00: So temps don't really work.
• 8:26
  SPEAKER_00: So then the going rate hourly then is like 50 to 60 bucks then for a full.
• 8:34
  SPEAKER_01: Yeah, we're I would say 60 would be uh an outlier.
• 8:38
  SPEAKER_01: We I would say anywhere from 48 to 53 would be a good uh middle ground for for an hourly employee.
• 8:46
  SPEAKER_01: So if you were if you were hiring an hourly hygienist, you could probably hire one anywhere from 48 to 53 an hour.
• 8:53
  SPEAKER_00: Okay.
• 8:54
  SPEAKER_00: And then where do you fall hourly, like in that in in that uh range?
• 8:59
  SPEAKER_01: Yeah, we're a little bit lower.
• 9:00
  SPEAKER_01: Um not by much, but we're we're right at about 45 bucks an hour, and then we pay a commission on top of that, which gets them well above what they could even get as a temp.
• 9:11
  SPEAKER_01: Um, and they get 401k and they get health insurance and they get benefits, and they get to come into this beautiful building every day, and they get to work with the same people every day and have autonomy.
• 9:23
  SPEAKER_00: I think health insurance in 401k is the one thing that I always hear from dental just team members, all the team members, whether it's an associate, all the way down, hygienist, dental assistants, all the way to the front desk, is we don't get insurance, we don't get a 401k, we don't get any of these benefits.
• 9:41
  SPEAKER_00: So you do all of the benefits.
• 9:43
  SPEAKER_01: Yep, we we totally do.
• 9:45
  SPEAKER_01: And like I said, it it's the cost of doing business and and it's the cost of retention, honestly.
• 9:50
  SPEAKER_01: Like um, I I I believe that people do value that.
• 9:53
  SPEAKER_01: And I've had I've had people that don't value it.
• 9:56
  SPEAKER_01: And the ones the ones that do, they sign up for it, and the ones that don't, they don't sign up for it, or they they choose uh to go a different route.
• 10:03
  SPEAKER_01: And and that's okay.
• 10:04
  SPEAKER_01: Um, I want them to do whatever is the best for them.
• 10:07
  SPEAKER_01: But there's there's a what we've tried to do is create a situation where they feel like they're getting all the benefits that they uh believe that their friends that live next door to them have and their corporate job, but also can make more money than they could ever make, even tempting.
• 10:24
  SPEAKER_01: You know what I mean?
• 10:25
  SPEAKER_01: And there's a world in which that can happen, uh especially in a model like ours where we're at yeah.
• 10:30
  SPEAKER_00: Now, how does that how does that work, Dr.
• 10:32
  SPEAKER_00: Blake?
• 10:32
  SPEAKER_00: Like, why do so many dentists believe that you can't do benefits and 401ks and that kind of stuff?
• 10:38
  SPEAKER_01: It's expensive.
• 10:39
  SPEAKER_01: I mean, it it's not free uh and it costs money.
• 10:43
  SPEAKER_01: But I I I found like in and so many doctors can resonate with this, it's so challenging to find good, especially hygienists.
• 10:52
  SPEAKER_01: Um people that can come in and really integrate into your culture, integrate into what you're trying to build, and not just be there to fill a spot or fill a job, but to really embody what it means to be a part of Hamblin Family Dentistry or whatever your organization is.
• 11:07
  SPEAKER_01: And the cost of that to me, that and I've learned this the hard way, is much more costly to try to replace these people than it would be just to keep them and give them a little bit more money or give them a little bit more freedom or give them a little bit more control than you would otherwise.
• 11:25
  SPEAKER_01: But I would much rather do that than have my day filled with trying to recruit and uh interview hygienists that might be a good cut for it.
• 11:33
  SPEAKER_00: So, so translation for the audience I'm gonna take home less money so I don't have as big of a headache, so I can grow the business.
• 11:41
  SPEAKER_00: So in in the future, I can make more money.
• 11:43
  SPEAKER_00: I went through the same thing.
• 11:44
  SPEAKER_00: We used to not do benefits, 401k, none of that stuff.
• 11:47
  SPEAKER_00: And we were just constantly turning over team members.
• 11:49
  SPEAKER_00: This is a long time ago, and finally we were just like, what do we need to do to make everybody happy?
• 11:55
  SPEAKER_00: And we did a we did a uh ENPS, it's a blind thing, and we got everybody's feedback, and it was like better benefits, 401k.
• 12:03
  SPEAKER_00: And then we and then we did it, and then it was like better benefits 401k.
• 12:07
  SPEAKER_00: And to your point, some people had like spouses that had benefits, so they don't use them, and which basically is just like they're it's cheaper, right?
• 12:15
  SPEAKER_00: For for to have them on the team, but then uh a lot of people did use them, but then our retention went through the roof.
• 12:22
  SPEAKER_00: And what I I think the math that I don't see talked about enough in dental, especially private practice, is the cost of replacement.
• 12:31
  SPEAKER_00: So the cost of replacement for a hygienist, your hourly rate is somewhere between 40 and$80,000.
• 12:38
  SPEAKER_00: You say, How do you come up with that number?
• 12:40
  SPEAKER_00: It's about six to 12 months of pay.
• 12:43
  SPEAKER_00: And the reason for that, the reason that you do that is when you have somebody who says, I'm quitting, I'm giving you a two-week to a month notice, that person kind of checks out.
• 12:52
  SPEAKER_00: So you start to lose revenue from that.
• 12:54
  SPEAKER_00: You start to lose patient referrals, you start systems start to break.
• 12:58
  SPEAKER_00: That puts strain on everybody else in your company.
• 13:01
  SPEAKER_00: Then you have to recruit, which costs you money.
• 13:04
  SPEAKER_00: You have to run ads, you have to interviews.
• 13:06
  SPEAKER_00: Someone has to do those.
• 13:09
  SPEAKER_00: And and someone has to sign off.
• 13:10
  SPEAKER_00: You do multi-step, blah, blah, blah.
• 13:12
  SPEAKER_00: That all costs money.
• 13:13
  SPEAKER_00: Then you finally find somebody and they go, Oh, I gotta put in a two-week notice at my job.
• 13:18
  SPEAKER_00: So then you got to wait two more weeks there.
• 13:20
  SPEAKER_00: Then, then, then they come on and they go, even if they're amazing, whoa, you guys do this like this, or how do you use this thing or mab?
• 13:27
  SPEAKER_00: Or how do you how do you do this?
• 13:29
  SPEAKER_00: And that's another 90 days.
• 13:31
  SPEAKER_00: By the time you're done, it's about six months of salary that you've lost in just all labor and all the things, the minimum up to 12 months, depending on your process.
• 13:43
  SPEAKER_00: So it's just cheaper just to bite the bullet and take a little bit less.
• 13:48
  SPEAKER_00: Now, if you're not growth-minded and you're not like, okay, well, I'm gonna get more new patients and I'm gonna grow into this, then it doesn't make sense.
• 13:55
  SPEAKER_00: Just keep grinding, right?
• 13:56
  SPEAKER_00: Um, so I I totally agree.
• 13:58
  SPEAKER_00: Now, the big part I know everybody's gonna wonder about is the bonuses.
• 14:04
  SPEAKER_00: How do you how do you think through the bonuses?
• 14:06
  SPEAKER_00: Like, how does it work from a dollar standpoint?
• 14:09
  SPEAKER_00: And then what's the upside for the hygienist?
• 14:11
  SPEAKER_01: Yeah, so we we basically just take um their compensation and multiply it by what we what we feel is what we want the hygienist to do is about 3.3 times their pay, right?
• 14:24
  SPEAKER_01: And so if they can produce above and beyond that, then they get to share in some of that gain that they've created for the office, right?
• 14:31
  SPEAKER_01: So you just take their hourly rate times 3.3, and that's what they should be producing per hour within the chair.
• 14:39
  SPEAKER_01: So then you just do that times whatever if you decide to bonus it quarterly or monthly or uh every pay period, then you would just do that times the amount of hours they worked, and that's their break-even.
• 14:53
  SPEAKER_01: And then anything over that they get 20%.
• 14:56
  SPEAKER_01: And that's honestly like my goal is that most of their compensation comes from that.
• 15:02
  SPEAKER_01: Like I want them to see that the value that they're creating in the office.
• 15:06
  SPEAKER_01: And I specifically separate it on their uh their pace note so that they could see that it's not just this is how much you made, this is like this is what you made hourly, but this is also the value that you created with your commissions.
• 15:20
  SPEAKER_01: And when they see that bigger number uh on the commission side, it I f I hope that it's just reinforcing good behavior, it's reinforced reinforcing like we helped a lot of people.
• 15:33
  SPEAKER_01: Um, we utilized the microscope, we did some things differently.
• 15:37
  SPEAKER_01: Uh, I changed verbiage with this thing, and it made a difference, right?
• 15:43
  SPEAKER_01: Versus just showing up and doing the same thing over and over again for 30 years.
• 15:47
  SPEAKER_00: Yeah.
• 15:48
  SPEAKER_00: So, so walk through the microscope and the camera and how you how you think through that for for uh the hygienist, but ultimately it's really for the patient.
• 15:57
  SPEAKER_01: Yeah, I mean it's it's all for the patient.
• 16:00
  SPEAKER_01: Like we wouldn't do it if it wasn't good for the patient.
• 16:02
  SPEAKER_01: But at the same time, there's there's value created, just like when you go to dental school and you learn how to prep a crown, you're you're becoming more valuable to society, so you're gonna get compensated for that, and there's nothing wrong with that.
• 16:14
  SPEAKER_01: It's perfectly normal, right?
• 16:17
  SPEAKER_01: And so um the the challenge with hygiene, and it was in our office as well, is how do we get the hygienist to be more productive per hour?
• 16:26
  SPEAKER_01: Right.
• 16:27
  SPEAKER_01: And you you can sit there and just sulk about why they're not productive, or you can figure out ways to make them more productive.
• 16:35
  SPEAKER_01: And so one way is that you could we don't do this, but you could pay them for uh for every night guard that you you close, they get a percentage of that night guard, right?
• 16:47
  SPEAKER_01: Um we can do laser here in Texas, and so we do a lot of laser bacterial reduction.
• 16:52
  SPEAKER_01: And when we we can physically show uh bugs swimming around in people's gums instead of just saying, hey, you've got a seven millimeter pocket and you're bleeding, they tend to make better decisions for their health, right?
• 17:06
  SPEAKER_01: When you show rather than tell.
• 17:08
  SPEAKER_01: Right.
• 17:08
  SPEAKER_01: And so the microscope has been huge, and we still don't use it as much as I'd like, but when we do, I notice that we get more acceptance with laser bacterial reduction, fluoride, hydroxyapatite.
• 17:21
  SPEAKER_01: There's so many ways, uh x-rays, I mean, there's so many ways that the hygienist can add value, even even going as far as like and this is this is radical, and I learned this from Sully Sullivan, but what if the hygienist's main job wasn't a clean team?
• 17:36
  SPEAKER_01: What if the hygienist's main job was actually to close treatment?
• 17:40
  SPEAKER_01: And I'm not saying they present treatment, but they set it up correctly.
• 17:44
  SPEAKER_01: And you've got one hygienist that with Dr.
• 17:48
  SPEAKER_01: Farrell closed a hundred thousand dollars and the other one did fifty.
• 17:52
  SPEAKER_01: Well, what if you could get that other hygienist to perform exactly the same way?
• 17:56
  SPEAKER_01: There's a reason there's a difference, right?
• 17:59
  SPEAKER_01: And so there's so many ways that you can make your hygienist more valuable, but you have to give time to think about that.
• 18:05
  SPEAKER_00: It's it's so to me, it's so simple as a patient.
• 18:08
  SPEAKER_00: So I'm speaking non-clinical, non-salesy, non-business wise, just as a patient.
• 18:13
  SPEAKER_00: When I go to my hygienist and she goes, Ooh, and I go, What?
• 18:18
  SPEAKER_00: And she goes, Yeah, I see over here your gums are doing this, whatever.
• 18:22
  SPEAKER_00: You know what I mean?
• 18:22
  SPEAKER_00: And I'm just I've had this happen where she's like, Yeah, it's it's not, it's there's a problem here.
• 18:27
  SPEAKER_00: I'm gonna have the doc look at it and we're we're gonna create a plan for you.
• 18:30
  SPEAKER_00: And I'm and now at this point, I'm like, oh no, great.
• 18:34
  SPEAKER_00: And the doctor comes in, hey, what's up, man?
• 18:36
  SPEAKER_00: What's up, Gary?
• 18:37
  SPEAKER_00: Yeah, that's that's a problem.
• 18:39
  SPEAKER_00: We're here's what here's what we're gonna do.
• 18:43
  SPEAKER_00: I'm like already sold because the hygienist already teed up.
• 18:46
  SPEAKER_00: But what happens a lot of times is the hygienist doesn't say anything, and then the doctor has to come in and explain it all.
• 18:54
  SPEAKER_00: But if you have just two people, if someone just does ooh, just that with the doctor coming in confirming it, it's such an easy for me as a patient.
• 19:03
  SPEAKER_00: It's just like, oh, okay, you guys both see it.
• 19:05
  SPEAKER_00: Okay.
• 19:06
  SPEAKER_01: It's the simmer slowly.
• 19:08
  SPEAKER_01: Like, if to your exact point, I would rather a patient sit with that and have 30 minutes to think about like the problem that's already been made known to them, versus I just spent 30 minutes, 40 minutes with this human that I that I know and trust even more than the dentist because I spend the most time with them, and she didn't say a word.
• 19:28
  SPEAKER_01: And then all of a sudden the rich dentist walks in and wants all your money, right?
• 19:33
  SPEAKER_01: And it's like, well, we can't do that.
• 19:35
  SPEAKER_01: Like part of your job is to share what you see, and you're not diagnosing, but you're sharing concern, you're sharing, hey, these are the things that I see, and I'm concerned about it.
• 19:44
  SPEAKER_01: I don't know how Dr.
• 19:45
  SPEAKER_01: Hamlet or Dr.
• 19:46
  SPEAKER_01: Krill or Dr.
• 19:46
  SPEAKER_01: Rusty take a look at, right?
• 19:49
  SPEAKER_00: Yeah, I'm totally, I'm totally with that.
• 19:50
  SPEAKER_00: Okay, so so it's so simple.
• 19:53
  SPEAKER_00: And so um then, so what is a hygienist effective hourly rate once you work in the bonus?
• 19:59
  SPEAKER_00: How is that working out?
• 20:00
  SPEAKER_01: I've had hygienists at their highest, uh, be at 80 to 85 an hour.
• 20:05
  SPEAKER_01: And uh I always make sure to text them and just congratulate them and tell them great job.
• 20:11
  SPEAKER_01: Um, but I would say on average, they're probably in the ballpark of 57 to 62 an hour on average.
• 20:20
  SPEAKER_01: Um and again, like that's basically what they could make as a temp, but they're getting so much more stability and not having to go to these like Medicaid offices and it like there's there's so much that's not great about temping.
• 20:34
  SPEAKER_01: I get it.
• 20:34
  SPEAKER_01: Like they'd make they make a lot more money.
• 20:36
  SPEAKER_00: Right and driving.
• 20:38
  SPEAKER_00: Driving is another one, like you're just like, hey, you have to drive three hours this way and that way, especially in traffic where you guys are at.
• 20:44
  SPEAKER_00: So yeah, and the stability.
• 20:46
  SPEAKER_00: Now, now one thing about stability, and I know that's really important to hygienists is uh hour like uh the hours that they work, right?
• 20:53
  SPEAKER_00: I don't I don't want to work six days a week, nine hours a day, ten hours a day.
• 20:58
  SPEAKER_00: I have a kid's a lot of hygienists are female, they want to have certain times off.
• 21:02
  SPEAKER_00: How do you how do you deal with that?
• 21:03
  SPEAKER_01: Yeah, this is just turning into a hygiene recruiting model for us.
• 21:07
  SPEAKER_01: So uh uh yeah, so we we've gotten really um creative with that.
• 21:13
  SPEAKER_01: And so obviously most hygienists are female.
• 21:17
  SPEAKER_01: Um we've we've had male hygienists and we've had female hygienists, but most are are female in our experience.
• 21:24
  SPEAKER_01: And so we've we know that they're gonna get married, they're gonna have kids, life will change, all of those things.
• 21:32
  SPEAKER_01: And so if we can create a world in which they can take their kids to school or pick them up and coordinate with their husband to do one or the other, it it gives them a lot of flexibility.
• 21:42
  SPEAKER_01: So we have we're open from seven to four, and we have two different shifts for our hygienists, and they coordinate together on who's gonna work which one and all that stuff.
• 21:52
  SPEAKER_01: But we have a seven to two shift and a nine to four shift.
• 21:55
  SPEAKER_01: And so now it's getting even better because as we're adding more hygiene providers, we can Actually, we have the providers we need with our ghost column to support those hygienists.
• 22:04
  SPEAKER_01: Uh up until this point, our hygienists have just done a great job of being able to serve these patients as they come in.
• 22:12
  SPEAKER_01: Um yeah, that we've we've created such a great schedule for them to where they come in and they don't waste an hour eating lunch when they'd rather be with their kids.
• 22:22
  SPEAKER_01: They come in, they work, they do what they need to do, they go home, and they enjoy their life.
• 22:27
  SPEAKER_00: And I and I know what people are thinking right now.
• 22:29
  SPEAKER_00: Well, Dr.
• 22:30
  SPEAKER_00: Blake, you have a bigger office and you have all these things, but you can build this with a smaller office.
• 22:35
  SPEAKER_00: There's no rule that you have to have 20 hygienists to be able to do this.
• 22:38
  SPEAKER_00: You can have two hygienists both working part-time that you say, hey, you just super faithful to these morning four hours, and you're super faithful to these, and you can have the school and or you can have three hygienists and one working full-time and two working part-time and backing up each other.
• 22:55
  SPEAKER_00: Like you can take more hygienists even if there's less hygienists for everybody else.
• 23:00
  SPEAKER_01: We kind of backed into this, to be honest with you.
• 23:02
  SPEAKER_01: I I was tired of being in the position where I needed a hygienist.
• 23:06
  SPEAKER_01: Like for so many years, when we had two hygienists and we were fully booked with two hygienists, if one of them was sick, quit, left, got married, had kids, whatever, we were we were in a bad position.
• 23:19
  SPEAKER_01: We needed a hygienist, right?
• 23:21
  SPEAKER_01: Um, and so I was like, well, how could we hire another hygienist without the need for it, but also not steal from everything else, right?
• 23:31
  SPEAKER_01: And so that's where we kind of backed into this.
• 23:33
  SPEAKER_01: Well, what if we just cut an hour?
• 23:36
  SPEAKER_01: We actually gain like three appointments per provider that we do that.
• 23:39
  SPEAKER_01: Well, that's almost that's six appointments per day.
• 23:42
  SPEAKER_01: Well, like in our model, they see seven.
• 23:46
  SPEAKER_01: So that's a whole nother hygienist.
• 23:48
  SPEAKER_01: You know what I mean?
• 23:48
  SPEAKER_01: And so we've kind of backed into that by trying to solve the problem of how are we not going to be totally hamstrung by not having hygienists.
• 23:57
  SPEAKER_01: It gives you more flexibility.
• 23:58
  SPEAKER_01: If if one of your hygienists needs to go on vacation, they can coordinate with their friends uh to cutter one another and switch switch and all the stuff.
• 24:06
  SPEAKER_01: And so it just like you talked about earlier, it's better for us as an office, it's better for them as providers, it's great for the patients.
• 24:14
  SPEAKER_01: And if we can have that triple win, then that's all I look for.
• 24:18
  SPEAKER_00: I've also seen people, and I know this people are gonna freak out about this, but I've seen people do like, hey, we're gonna run a 6 a.m.
• 24:24
  SPEAKER_00: to a 7 p.m.
• 24:26
  SPEAKER_00: model, and we're gonna run two shifts like a hospital.
• 24:29
  SPEAKER_00: Yeah.
• 24:30
  SPEAKER_00: And it's it's a lot more work because you have administrationally, but it also creates so much flexibility because you're like, I can't work this day.
• 24:38
  SPEAKER_00: It's like, get one of the afternoon people to cover you.
• 24:40
  SPEAKER_00: You know what I mean?
• 24:40
  SPEAKER_00: Like just swap spots, cover for each other, and you are effectively taking two whole dental teams off the market, and there's already a shortage, right?
• 24:51
  SPEAKER_00: So now you're you're taking that shortage and you're taking more to yourself, uh, which makes you more effective.
• 24:56
  SPEAKER_00: So this is really, really good for all everybody listening.
• 25:00
  SPEAKER_00: If you haven't watched the other episodes, go back and watch those.
• 25:03
  SPEAKER_00: They're gonna be really helpful.
• 25:04
  SPEAKER_00: This is one component.
• 25:06
  SPEAKER_00: If you get this right, it'll help with the other parts, but you still have to get the other parts right.
• 25:10
  SPEAKER_00: And um, this has been really, really good.
• 25:12
  SPEAKER_00: Any other thoughts before we let everybody go, Dr.
• 25:14
  SPEAKER_00: Bike?
• 25:15
  SPEAKER_01: No, this has been great for me just to revisit like why we've created what we've created and really uh remember some of the challenges that we bumped into.
• 25:23
  SPEAKER_01: Um, I think the biggest thing you mentioned earlier about the uh EMPS.
• 25:28
  SPEAKER_01: Is that is that what it was called?
• 25:30
  SPEAKER_00: Yeah, ENPS, yeah, and employee net promoter score.
• 25:33
  SPEAKER_01: There you go.
• 25:34
  SPEAKER_01: Um, and I I think that what I don't want people to do is leave lead this conversation and say, I need to commission my hygienist or I need to pay him 401k or whatever.
• 25:44
  SPEAKER_01: I think that the beautiful thing about what you did was you went, you just asked the question, what would be a win for you, right?
• 25:51
  SPEAKER_01: And you got the answer and then you acted on it.
• 25:54
  SPEAKER_01: So just ask him.
• 25:55
  SPEAKER_01: And it it may be that people don't want more money, they just want more freedom, they want to be able to have more vacation.
• 26:02
  SPEAKER_01: They want, right?
• 26:03
  SPEAKER_01: Like not everybody's gonna be incentivized by making more money.
• 26:06
  SPEAKER_01: And we we tend to drift that way because we believe that that's because that's how entrepreneurs are right and so um asking the question was beautiful.
• 26:17
  SPEAKER_01: Uh, but yeah, I I I think really sitting down and under I don't think most people understand what what does a hygienist need to do to be to pay for themselves.
• 26:27
  SPEAKER_01: And that number is three to three point three times their pay.
• 26:30
  SPEAKER_01: And if they're not doing that, then you're actively losing money on that hygienist.
• 26:36
  SPEAKER_01: And that's okay for a season, but you can't build a business on that.
• 26:39
  SPEAKER_01: So you've got to figure out a way to make them productive.
• 26:41
  SPEAKER_00: What I've seen you do too, really, really well is like a hygienist is like, I want to make a billion dollars.
• 26:46
  SPEAKER_00: You're like, yeah, this is and this is one of my companies, our leadership.
• 26:50
  SPEAKER_00: I'm like, guys, the answer is always yes.
• 26:52
  SPEAKER_00: Always.
• 26:52
  SPEAKER_00: Well, what if they ask for a billion dollars?
• 26:55
  SPEAKER_00: We can do it.
• 26:56
  SPEAKER_00: Um, we might have to find dentists on other planets to go work with, plus all the dentists in the you know, in the world.
• 27:02
  SPEAKER_00: But but if they do, if they can go get every dentist in the universe to come work with us, I'd be willing to pay them a billion dollars.
• 27:09
  SPEAKER_00: And so you've you've you've done what you've done is you said uh the hygienist said, we want this.
• 27:16
  SPEAKER_00: And you said, Great, here's what we need to do to make that happen.
• 27:19
  SPEAKER_00: And then you you made the rules to the game effectively to do that.
• 27:24
  SPEAKER_00: So if you want help with this, come join our mastermind.
• 27:27
  SPEAKER_00: Uh, it's$2.99 a month.
• 27:29
  SPEAKER_00: Dr.
• 27:29
  SPEAKER_00: Blake will walk through your exact problems, your exact scenarios with you, and I'll yell at you and tell you to uh hire more associates.
• 27:36
  SPEAKER_00: That's all I'm that's really the value that I bring.
• 27:39
  SPEAKER_00: And then lastly, Dr.
• 27:40
  SPEAKER_00: Blake, you you got a hat?
• 27:41
  SPEAKER_00: You got a new hat?
• 27:42
  SPEAKER_01: Yes.
• 27:44
  SPEAKER_01: I gotta take the wrapper off, but this thing is just amazing.
• 27:48
  SPEAKER_01: Look at that.
• 27:49
  SPEAKER_01: I can't wait to wear those.
• 27:50
  SPEAKER_01: Thank you so much.
• 27:51
  SPEAKER_00: Put it to the side of your head.
• 27:53
  SPEAKER_00: Put it to the side of your head.
• 27:54
  SPEAKER_00: Yeah, there you go.
• 27:55
  SPEAKER_00: Jesus.
• 27:55
  SPEAKER_00: Yeah, there you go.
• 27:58
  SPEAKER_01: That's awesome.
• 27:59
  SPEAKER_01: It's so awesome.
• 27:59
  SPEAKER_01: You were wearing one of those at the uh the DSI event, and I was just like, that's amazing.
• 28:04
  SPEAKER_01: And you were kind enough without even telling me to do it and send it to me.
• 28:08
  SPEAKER_00: We need to get your whole team.
• 28:09
  SPEAKER_00: We're gonna get your if once you hit ten million dollars, uh, we'll get your whole team one.
• 28:13
  SPEAKER_01: I love it.
• 28:14
  SPEAKER_01: That's a good goal to shoot for.
• 28:16
  SPEAKER_00: You have a good one, Dr.
• 28:17
  SPEAKER_00: Bike.
• 28:18
  SPEAKER_00: I have a man.