On the hottest Sunday afternoon of the year, we drove to a suburban shopping mall. There was plenty of parking right in front of The Bay – Canada’s oldest department store. Inside – the signs hung from every conceivable post – ‘up to 50% OFF!’ and the like. You could have shot cannon down the isles and not hit a soul. The dozen women in the cosmetic department yawned as they waited for the elusive retail customer to overcharge for face paint.

Two doors into the mall later – we arrived at our destination – the Apple Store. It looked like they were having a half price sale on $100 bills. It was sheer bedlam in there – with a minimum of 100 people attempting to spend money simultaneously. The number of new I-Phones, I-Pads, and MacBooks going out the door was amazing. You had to wait in line to get the opportunity to give them your money. The man in front of us purchased 8 gift certificates worth $700 each. Another gentleman was buying 93 I-Pads as a bonus for his staff. He paid out over $90,000 and said his staff would love him for it. I saw a dentist client ponying up $1,000 for 2 phones. The staff had mini-cash registers (OK – my terminology is in the 1960’s) around their neck, and they politely charged us $110 for a CD to convert word documents on our MAC. Couldn’t have been more than $95 profit margin in that.

On Friday’s financial page last week the Wall Street boys were wondering what Steve Jobs at Apple is doing. He is sitting on cash reserves of over $45 BILLION at present. 

The man clutching his new $3,000 MacBook behind us in line had a beaming smile, bright yellow teeth and halitosis that would wilt a rubber flower. Chances are he hasn’t seen a dentist in 7 years. No doubt someone somewhere is wondering why he doesn’t care enough about his oral health to keep his hygiene appointments – or perhaps they simply concluded that he (like everyone else in the store) just couldn’t afford dentistry.

Do you see what is going on here? Consumers are spending money on things they WANT, as opposed to what you think they need. Yes, they are turning their disposable dimes over two or three times before they spend them – but if they want something they still spend like no tomorrow. The Bay couldn’t sell a heater to an Eskimo with a half price sale, but Apple next door probably did $1 Million that day in one store alone without a sale on anything! Go figure.

I’m tired of battle weary retailers (and dentists too!) telling me the economy is bad. Do something about it! Learn to sell – learn to attract new patients instead of waiting for them to stumble into your door because you have a ‘New Patients Welcome’ sign in the window. Invest in some proper training for your team to convert some of the ‘drill, fill, and bill’ patients into higher value propositions.

Or – wait for things to turn around with that guy from the buggy whip factory. Your choice!

E-mailing dentists is different from any other business. Some don’t believe email is ever going to catch on – others check their messages once a month – many fill up their entire ‘in box’ to the point messages get bounced back stating the box is full. We have been asked to print and fax emails, and documents sent by email get edited by fax and sent back. One spread sheet this morning had 30 separate items on it. Someone has redone the entire list twice in two days by hand, and then scanned the hen scratch and emailed it back. I cannot imagine the cost of this redundancy here.

Another doctor left us voice mails about his graphics package for a project, asking what is holding it up. Last night the graphics company emailed me, asking why nobody will respond to them. He has been awaiting ‘proof’ approval for 2 weeks now, and cannot proceed without it. I checked – and the doctor was physically handed the originals of the proof weeks ago and tucked them away in his briefcase. 

I appreciate that dentistry always trumps anything else – that is the way you folks are wired. Dentistry must be your priority. However – when you are attempting to move your business into this century you must help us help you. Never have we worked in an industry where it is as difficult to get calls or emails returned in a timely fashion. I emphasize this is a generalization, and not true in every case. Some dentists are very astute businesspeople, with a good grasp of electronic and other communication. Unfortunately, the majority are not in the same category.

If you rented a cabin in the mountains and paid for a full week from Sunday to Sunday – odds are you would arrive on Sunday to enjoy your full week. When paying a consultant – please do yourself justice by following through and keeping your promises to him and to yourself. It would be like checking in to your same mountain cabin on Thursday, and wondering why you weren’t as relaxed after your vacation as you anticipated. You hamstring the results. We have heard many times about programs that ‘didn’t work’ but I can comfortably state that things ‘not working’ had as much to do with the practice not following through as not. We recently flew 1000 miles to work with a client for a day – only to be told upon arrival they had booked 8 patients throughout the day. We could have a grand total of 2.5 hours only, spread over 3 time slots that day. He ran over, so we logged a lot of Starbucks time that day.  It was his dime – so we made do and he got a fraction of the benefit he paid for. What would you tell a patient who told you this was their criteria for being your patient?

Patient communication is identical. You may follow through with your lab and treatment plans, but it is extremely rare to see a practice adequately follow through with marketing communication. The patient receives the same tired old ‘Garfield’ card reminding them of their next appointment. The treatment proposed in prior appointments is rarely followed up, and the conclusion is usually that the patient simply doesn’t care enough about their dental health. You better help them out – or they, like you, will follow the path of least resistance and simply not follow up!

This day I’ll cover how often it is asked of me. Many dentists who consult with us have a set idea of what they want to accomplish. It usually boils down to ‘higher case values with less chair time’ or a rendition thereof. ‘I’ve got all of that other stuff covered – just show my front desk girl how to close more cases.’ Get me a quick fix – so we can sell more dentistry now. And, how much will it cost?

The dental equivalent is a patient calling on the telephone, saying they think they need a couple of crowns (in the front), and maybe a veneer on a bad front tooth. Before they come in, they want your best price so they can shop that all over town with any village idiot silly enough to quote prices over the telephone. This will be the sole determining factor as to where they go for their treatment. Do you want this patient? I didn’t think so.

We have now a total of 30 separate strategies we may or may not implement into a single practice. Most dentists adopt perhaps a half dozen only. Done properly, they may have all the business they can ever handle. One fine dentist had 1100 active charts when we met him in 2004 and still engages our company for lead generation. He also contracts us for special events which have garnered him nationwide television coverage. Presently his active chart list tops 5,000 – and his associate earns significantly more than the president of the USA. He had not engaged us for team sales training (but it is booked for the fall), nor have we employed 25 other strategies with them. Of the 5 programs he has signed, 3 have been home runs. One was a draw. One was a complete bust. Different demographics produce different results. The program that didn’t work produces 100 new patients per month for another client 750 miles away (yeah – some of our clients, like me, still think in miles).

The last thing this doctor asks me is ‘how much’?   Do you think for one moment we would recommend any program that wouldn’t work in our best estimation? We have earned his trust with results. He is a good businessman to boot. Non producing employees are shown the door without reservation. His CE hours likely exceed 150 in a poor year. His production has easily tripled with the same single associate in 6 years.

A prospective client (with 6 years behind his DDS) tells me he wants to interview our successful clients to see if our programs are worth his while. Not only do our very successful doctors not have time to ‘hold hands’ – the new prospect doesn’t even know the questions to ask! The senior client told me straight – ‘Don’t give my name to anyone who wants someone else to make up their mind for them’.  The young prospective client believes he is in control of his 5 year plan because he is working on his mission statement. He still wants the magic pill, and is quizzing me on the ‘cost’ of every program. He is just like the patient with the crowns on the phone. They know not what they speak. Plus, he hasn’t any idea of the real problems in his practice. We picked it up within 20 minutes during our first (and perhaps only) visit. Mind you – we have looked ‘under the hood’ of perhaps 1,000 dental practices. Maybe that’s why I cannot quote what it will cost to ‘fix’ everything in your practice (sight unseen) in a 2 line email. 

I don’t mind it when someone asks what something costs, nor should you. I just scratch my head when someone proves in spades they have no clue about ROI – just face value dollar amounts. Ever have patients like that?

Drop us a line – bryce@prosales.tv – if you have any questions on this or any other post on this site!

“Sometimes you’re the hammer, sometimes the nail. Today I was the nail.”

In practice management – leadership, or the lack thereof, makes the difference between the dentist being the hammer or the nail. If team members tell you when and how they are working rather than the other way around you are the nail. If they make the decisions on dress codes, makeup, surfing the web during work hours, and personal phone calls and emails – you’re the nail.

We often say that a ‘wrong’ hire on the front end costs a practice 6 figures annually. Allowing a practice to run itself costs you much more than that. It sets the tone, ruins new employees in a matter of weeks, and establishes conduct that can frequently never be changed. One practice we consulted with was a new purchase. The retiring dentist had an office manager who earned almost $100,000 per year when you factored in her BMW lease. The purchasing dentist got rid of her as quickly as possible – but then something odd happened. The entire business began to crater. It turned out that the office manager was worth every penny of her income package, and she was indeed the ‘grease’ that kept the business on keel and extremely profitable. By firing her – they ‘saved’ $100,000 and likely lost 5 times that amount in the first year. It took 3 years to get the business back to the previous level. Egos get in the way of a lot of good business, particularly in dentistry.

If you don’t know anything about automobiles, hire a mechanic you trust and let him do his job. If you don’t have leadership skills (when did they teach that in dental school?) you better hire some help to fix that. Get your system manuals in place, and update them regularly. Make the ‘book’ your bible. New hires read it – sign off on it – and that becomes a condition of employment. If it says you must formally request in writing casual time off, or vacation time – follow the system or you have chaos.

Most of our clients have a personal billing goal of $700+ per hour – more for big cosmetic and implant cases. How much of your billable time are you willing to squander dealing with minutiae when it should all be documented in your Office Policies Manual? We see it happen time and again dealing with bruised egos and office politics.

You’re running a business. If some people cannot handle that they better either get over it, or find some other place to work. Your banker agrees with us! 

This is the same couple who asked me about dental implants a few months ago, knowing that I work in this field exclusively. I provided all the appropriate answers – ranging from implants being the standard of care today up to and including potential costs for same. He has a flipper on his maxillary central incisor, and it drives him crazy. He was told by his GP he would need bone grafting, and it would be ‘expensive’. After a referral to an implant dentist, the total bill was going to edge the $11,000 range, and there were no credit options available. Care Credit has pulled out of Canada, and the one viable option – Patient Link – was not on a plan with that dentist. So – he continues to play with his ‘flipper’ – and drive around in a brand new runabout that cost twice as much and was paid for on the ‘no money down – bi-weekly payments until you die’ plan. The fact that the husband told me he only pays X $ per paycheck gives a clear indication of where his monthly finances are. Of course this is pure marketing on the part of the boat dealer!

Restorative dentistry is an asset – something that has tangible and intangible value. Ask any HR manager about interviewing the client missing teeth compared to the one with a full set! Your dental appearance speaks volumes about you – and your sense of values. This affects self confidence, success in the job market, success in personal relationships, and overall emotional health. If a lender would rather hold the paper on a depreciating ‘asset’ like a car or a boat I understand that from a purely banking point of view. You, as the dental professional, have the opportunity to compete in this arena providing you do your own homework. The patient will purchase regardless, but instead of your work he might end up at the big box electronics store with a new home theatre system. After all, they provided him with financing.

Get creative. Align yourself with a lender (such as Patient Link) and walk through a hypothetical $10,000 case to determine how you can best present all the options. If you need help on stepping up to the plate to compete with Future Shop and the boat dealers, don’t hesitate to call our office at – 1-800-208-9903.

We were called in to work with a client, and the first thing we do is disregard almost everything we have been told by the dentist. With a completely open mind, we interview each employee off-site and conduct numerous job shadowing sessions. What we see and what we have been told initially is usually significantly off base. In this incident we found an admin employee who had been coming in on the one day the practice was closed to ‘do her books’. This was her habit for over a decade. Our conclusion was that it was at most a 90 minute per week task. Further investigation revealed a multi-level marketing business on her part that she was running from her employer’s office. A conservative estimate was $10,000 per year in wages paid out for nothing (on top of an already generous benefit plan, CE package, and bonus). As the overhead was abnormally high, we recommended termination with cause – and we were prepared to document it. Not only was the hour padding dishonest, she was virtually useless in that her computer skills were abysmal and she was unwilling to take upgrade courses. The client spoke to a friend who was a lawyer in an unrelated field, and this person suggested terminating without cause – much like a lay-off. We protested, but the client completely ignored our advice. He let her down gently with a severance cheque large enough to purchase a new automobile (to our astonishment). This employee was in her sixties, which turned out to be significant.

She applied for a few positions, but her unwillingness to work one day mid week (family obligations) hampered her search. No doubt she was unwilling to travel more than a limited radius from home as well. In any event – soon after the client received legal demands threatening court action based on an age discrimination suit. This ‘poor woman’ had apparently been turfed because she was too old, and cast off like an old shoe. He had no leg to stand on, because he had already paid her significant severance and issued paperwork ‘without cause’.   A second cheque that would have paid for a nice new Mercedes Benz followed the first – and both were totally unnecessary. What a horrid example to the rest of the team.

There is a moral to this story – get your house in order and keep it that way. Do not tolerate hour padding, and break out a calculator to determine what logging in at 7:20 and actually starting to work at 7:50 costs you annually. It isn’t just the cost of the muffin and coffee. These people are not your friends, and this is not a group hug. They work for you, and have a legal obligation to follow employment standards. The practices that work best are benevolent dictatorships. Management by consensus is guaranteed to produce a result that favours everyone but the person who actually owns the business. Your banker and your accountant agree with us!

In this particular session, he handed out a bow tie to all participants (even the ladies). He insisted on giving a bow-tying lesson to everyone present, and told these doctors that the most valuable tool in their arsenal to grow their business was a good tuxedo.

There were a few disbelievers in the room, but I know this to be fact.  You become who you associate with (remember Mom telling you not to bring that guy around the house again?).  If you regularly attend black tie events you will meet ‘black tie’ people. These are the folks who can best afford advanced care dentistry – from cosmetics to implants. Frequently there is free publicity at these events – so remember to smile for the camera. It doesn’t matter what size your town or city is – they have to fill up their newspaper. You will have the opportunity to be perceived as an expert if you have some visibility around town. Don’t be surprised if your table partners ask you questions about dentistry which can only lead to your chair if handled properly. Your banker (or his boss) will be there, and you will be viewed as being a successful contributor to your community.  In the scheme of things, the cost is incidental and you might even pick up some good habits.  For the male dentists – attending a Gala for the opera or the symphony with your wife may garner you more points than asking her to join you on a round of golf!

Another habit this dentist taught was sending a detailed letter to all patients whose treatment case exceeded $600. To him – his day was not complete until his letter writing was done. He started this BWP (Before Word Processors) and never faltered in 45 years of dentistry. Patients appreciated it back then, and equally so today. I’ve mentioned in previous columns that the bar is ridiculously low in dentistry. Most of your colleagues do such an abysmal job of patient follow-up that you can easily outstrip patient expectations by doing just a couple of things different. When they go home to ‘think’ about case acceptance it is a given that the one thing they really remember is the price! Why not give them a professional written recap on why you arrived at this treatment plan so they now have some ammunition to help with the other decision maker at home?

Learn to tie a real bow tie. Be visible in your community. Provide better patient follow-up than they have ever seen before. You can double your high value accepted cases by following this simple advice.  Doubt that?  Call me and we’ll prove it!

My partner was on a training call with another client who is doing everything in his power to bring his practice into the 21^st century. He is developing systems, has completed team sales training, and is working the late shift getting his house in order. His team is complaining that a very minor amount of paperwork is going to really take ‘a lot of time’. We are talking 10 minutes per day for one team member. They are ‘not sure they can get this done’. Talk about dreaming. If some of these spoiled team members worked for anyone else in private industry, or many government operations – they would be told this is the way we do it now – and simply do it or move on out. Don’t get me wrong – we work with some great teams. But, those founding members of the Flat Earth Society resident in many practices think that any change in any procedure is a personal ordeal.  The number one mistake in dentistry – above any other – is keeping a team member after their expiration date. In most cases when someone is let go (or allowed to be happier elsewhere) they have been poisoning relationships and practice profitability for at least 24 months. They have cost you at least 6 figures per year while refusing to get with your program.

Don’t for a moment think I am ranting about age here. I have seen 65 year old team members worth their weight in gold, and 23 year olds who don’t have the slightest clue about a work ethic. You know who I am talking about here. The employee who is constantly sub-grouping, undermining team morale, griping about how unfair life is in general, and watching the clock with military precision. Dare I mention hour padding? We’ve seen blatant examples of this type of EMPLOYEE THEFT that has gone unchecked for years! In this economic climate you cannot afford boat anchors in your office – that is unless you are independently wealthy, and working simply for a hobby with masochistic overtones. 

Business ain’t a group hug. Treat your practice like a balance sheet. If all members of your team are not on the right side of the ledger – get rid of them without a second thought. If the offender is your wife’s niece, or represents some other conflict – get a professional in to do that work for you. We’re only a flight away.

She explained that she ran a human resources placement firm, and that she had implemented just one strategy she learned from our seminar back then – and it provided her with all the clients her business needed for at least 6 years.  Now, her business was just another casualty of the downturn and she was looking for some new direction to weather this storm. This is far from a normal ‘sales cycle’, but a classic example of a single tool she picked up in a free workshop that fed her business for over half a decade.

We employ up to 30 different strategies when marketing a client’s practice. At most, a dentist may utilize up to a dozen components – and more often than not, fewer than 6.  Are all of them valid? Of course – but some are not best suited to a GP practice – an ortho or endo specialty practice etc. Some specialists are strictly referral based, while others do independent lead generation as well. Some programs may not suit an individual doctor’s personal image of him/herself.  This is all fair game – wouldn’t it be boring if we were all the same?

The reality is that if you take just a few pointers – or ‘ideas’ like we provided for the HR lady 7 years ago – your business can grow exponentially.  Last week we conducted a dental team sales training program in a distant city, and one hygienist whom we anticipated would resist the program surprised the daylights out of me. The first day was uncertain, but by the end of the second day she really ‘got it’. The scripting exercises and role playing allowed her to realize that selling dentistry is nothing more than organized communication. The first week back in the practice she ‘sold’ a dozen extended perio programs from a structured approach instead of her previous chatter. This ‘perio health’ program sells for $995 each – all from a team member who hated the entire concept of selling.  She admitted she had been verbally harpooning her practice for over 10 years because she didn’t like to talk ‘sales’ to patients. Was she good at scraping teeth?  You bet. Was she bringing any ‘new’ business to the practice?  Up until now – it was – in her words – not her job.  How many on your team fall into this category?

Here is another example of a single strategy.  A great practice has done long term lead generation through our firm, and it works well every month. Our idea of a great practice, incidentally, is a doctor who follows through by completing what he started!  We had tried to talk him into a newspaper column on one aspect of his practice for over 2 years, and he resisted because of his time constraints. Finally he relented, and 3 weeks ago we began a weekly article under his name. We provide the content (subject to client edits), and in just 2 weeks he has had 27 calls and booked 14 specific high value consultations into his chair!

How many methods, strategies, or great ideas does he really need? So far, he is using just 2 out of 30.  I can categorically state he has, in just 5 years, tripled his annual billings, and grown his active charts by 400%.  You don’t have to be doing everything in the book!   But – you sure have to follow through on the ones you start.

There should be anywhere up to 8 such manuals.  If you think that is too many, McDonalds Restaurants has 32 to run a burger joint. Do you think Ray Kroc wanted those pimple faced kids to ‘decide’ what temperature to cook the fries today?  It is either ‘on’ or ‘off’. A new hire is handed the manual for whatever position – is responsible for reading, and agreeing to adhere to the system – and you now have a form of an employment contract. 

Wouldn’t this make your reception duties, CDA function, hygiene duties, treatment scheduling, accounting, and general office policies much easier to administer?  So, why do certain members fight systems like crazy?  We ran into this situation this week where someone who cannot put a paragraph together told her dentist that ‘nothing works’ with the manual template, and it would be easier for her to start all over and rewrite it. Translation: I am too lazy to do it – and I don’t want to share information. I’ve seen her material and she couldn’t write a letter to Santa without a spelling mistake. She can possibly edit, but writing will never be her forte.

It is painstaking work to edit a manual, let alone write one from scratch. We know from experience the issues that must be addressed in each category, and it is a ‘starting point’ not a finished product. Every practice uses different tools, preferred techniques, and has their own unique ways. We encourage you to adopt a true franchise model by first getting your house in order. Do this before you entertain any ideas of expansion or hiring new team members. 

Your team members should take anywhere from 8 to 30 hours to itemize their areas of responsibility. You should pay them for this time, or you will get from some a thoroughly sloppy incomplete job. If it is done across the board you should eliminate the fear of job security that always crops up with insecure employees.

Once complete – this ‘work in progress’ should be brought to every team meeting. Of course you will change procedures and details, and they should be penciled right into the hard copy. They can be digitally corrected periodically.

This is how any well functioning business is run.  Doesn’t your practice deserve the same?