Today’s question involves a simple no-cost strategy for practice growth

Madow Brothers,

My practice seems to be a bit stagnant and I am worried about the trend, but don’t want to add a lot to my overhead either. What did you guys do to grow your practices that didn’t cost a ton of money?

Dr. H. Jebko
Provo, UT

Great question Dr. Jebko!

There is one answer that pops into our heads immediately. But first, let’s address something else. You say you want to help your practice grow but don’t want to add to your overhead, and that makes sense. But please don’t forget that there is a huge difference between adding to your overhead and investing in something that generates a positive return on your investment.

For example, if you go to your local dental meeting and some slick salesman talks you into buying a gadget that will supposedly take away your patient’s facial pain by holding it up to their TMJ, wiggling it around a bit, and reciting the “hamotzi,” well shame on you. You just added $20,000 to your overhead.

But if you were ready to invest in a new marketing campaign, a great clinical course that meets a true demand you were not previously servicing, or really effective coaching, the return on investment should be positive and you did not add to your overhead. Does that make sense??

Okay – now back to your main question. When we were both young practitioners, we actually lived on the same street. Not in a compound like The Kennedys, but a few doors down from one another. Even though our practices were separate, one of our rituals was to meet up every evening, even just for a few minutes, and discuss what happened in our offices that day. If something really worked well we would share it, and sometimes even more importantly, if something was a total disaster we would advise the other one to avoid it!

Little did we know it at the time, but we were doing a very early (and small) version of a “Mastermind.”

We went on to form a larger mastermind group with some dental friends, calling it the “Maryland Bridge Club!” We would meet at a local restaurant every month (and sometimes due to the punny name they would have card tables set up in anticipation of a bridge tournament!). There weren’t many rules – just that we were there to help each other (no typical catty dental competitiveness) and that nothing was held back. The spirit of sharing both triumphs and goof-ups was amazing, and we all benefited so much! The power of this group was so much stronger than the individuals in it.

So Dr. H – if you want to do something that will help your practice immensely without spending a lot of money – form a mastermind! You will also get a great feeling when your input helps others in the group. Call a few dental friends and set up the first meeting. But here is the warning – only get involved with people who truly understand the concept of the mastermind. If someone is there just to steal ideas and not help everyone else, the mastermind is poisoned.

And if you (or anyone else reading Coaches Corner today) is interested, in just a few weeks we are having our very own “Madow Mastermind” – and you are invited! You see, a few times a year we have masterminds for our private coaching clients, but every once in a while we hold one where you don’t have to be one of our coaching practices to be invited.

This is an incredible opportunity to share and learn with some fantastic dental minds from across the country, including us! It’s an amazing day that starts in the morning and doesn’t end until we cap off the night with a fantastic dinner filled with idea sharing, camaraderie, and laughter. (Last time we did this the ideas were flowing so fast and strong we stayed until the restaurant folks had to ask us to leave!!)

Wanna join us? Well hold on pardner – not so fast! You do have to meet one requirement. And that is – you need to be having some kind of struggle or challenge in your practice or life that you would like to share with the group. (Yes – personal struggles are welcome as well.)

It takes place on Friday March 16th in Baltimore, MD, and we are limiting it to eight dentists. We haven’t really announced it yet and four people are already signed up (and to be frank, we have turned down a bunch…)

The cost for the entire day, including lunch and dinner, will be $497. And of course you need to get yourself to Baltimore!


If so, then simply CLICK HERE TO RESPOND and let us know three things.

1. What you would like to accomplish during the Mastermind. In other words, what is your goal or your struggle that you need help with?
2. Your personal email address. Not your general office email. We need the one that goes directly to you.
3. Your direct mobile phone number.

If the link above does not work, the email address to reply to is

We would love to see you there, and spaces are truly limited. If you are interested, do it now!! See you at the “Madow Mastermind!”
Coach Rich
Coach Dave


Dr. David Madow and Dr. Richard Madow are actual dentists who have been helping dental offices become more successful for over 28 years. They are down to earth, real people who personally connect with their clients and are proud to call them friends. If you have a question for this column, please write to them at We are now offering a complimentary 30-minute coaching session! Please CLICK HERE to schedule yours. Doctors only please.

To sign up for our mailing list CLICK HERE

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HELP! My dental ship is sinking…

Dear Madow Brothers Coaches,

Things are so bad in my practice I don’t even know where to begin. I am producing close to a million dollars a year and collecting around $750K. This is considered really good for my mid-sized Midwestern town. But I am earning practically nothing. My hygienist and my associate are both earning more take-home than me.

Our new patient flow has collapsed, and we are losing patients to two new practices that have opened nearby. It gets worse.

My lab just cut me off because I owe them over $50,000. I owe money on two credit cards, and am still paying off a practice construction loan (when I can). Sometimes I feel like I am the captain of the Titanic and my staff is the orchestra, just blindly playing as the ship sinks. Can you help?

Dr. Jay
Somewhere in Ohio

Dr. Jay-

Wow – you sure have a lot of things going on there. So first of all, let’s make this clear. There are no coaches or consultants in dentistry who can wave a magic wand and fix your practice. Not us, not Roger, not Cathy, not Lois, not Mayer, and certainly not those people who call you every day, belittle you, and scare the shit out of you until you sign up. But the good news is, based on our years of experience, there is light at the end of the tunnel and it can be found. 

There is an old saying – “How do you eat an elephant?” “One bite at a time.” And while we are certainly not recommending or condoning eating elephants, this will be the way you need to approach things. That said, here are a few questions and starting points for you.

When you say that you produce close to a million and collect 750K, does that mean you are writing off a ton of PPO stuff? That is not necessarily bad, but the fact is, if you agreed to a PPO fee schedule you never actually produced at full fee. So that figure is a fantasy. If you are not talking about write-offs, you have a seriously bad collection problem that is adding considerably to your overhead.

If your associate is out-earning you, what is the point? Not every practice needs associates.

Why are you being beaten by those new practices? Our guess is that you are doing little about this, trying to depend on your reputation and word-of-mouth, Hint: It’s 2018. 

We can guess (and we are right) that you do not have an effective system to reconnect with your patients who have not been in for a while, do not have a hygiene appointment scheduled, or have diagnosed but untreated dental needs. And remember, any old system is not necessarily an effective one. 

Has an outside expert (such as an accountant who specializes in dental practices) reviewed your expenses and debt issues? It is pretty safe to say you are missing a lot here.  

Just a guess here (again based on experience) that if we called your practice posing as a new patient your front desk team would not make the appointment. We cannot even tell you how many times we have heard “Oh – my front desk person is fantastic!” only to call and be connected with Clueless Claire. 

And here is where it gets a little deeper. We have found that when we work with someone with a practice similar to yours (and we have done that lots of times) the problems are not just with the dental office. We always start with a pretty intense interview process, and nine times out of ten when someone has a similar situation there are factors that go WAY beyond new patients, collections, etc.

Yes – that means that there are some screwed-up things going on in their lives that are negatively affecting their practice. (Not to brag here, but we are the only dental coaches that go deep like that!) Of course that is not always the case, and we are glad to work with “just the practice.” But again, experience shows that outside factors typically contribute to this kind of stuff.

Bottom line – you need some help! This is not a situation you can fix yourself. Keep doing what you are doing and it is just a matter of time before there is a padlock on your door and a “For Rent” sign in the window. Let’s make sure that doesn’t happen!!
Coach Rich
Coach Dave


Dr. David Madow and Dr. Richard Madow are actual dentists who have been helping dental offices become more successful for over 28 years. They are down to earth, real people who personally connect with their clients and are proud to call them friends. If you have a question for this column, please write to them at We are now offering a complimentary 30-minute coaching session! Please CLICK HERE to schedule yours. Doctors only please.

To sign up for our mailing list CLICK HERE


Okay – time for another restaurant story. It’s a quick one that can have some serious implications for your practice!

At checkout in a local Baltimore lunch spot:

“Would you like anything to drink?”

“Yes – coffee please.”

“We don’t serve coffee here – but a lot of people ask for that.”

Okay – just for effect let’s repeat that line again.

“We don’t serve coffee here – but a lot of people ask for that.”

If there ever was a “duh” moment – this is it! Buy a commercial coffee maker for a few hundred bucks, or even easier, call a coffee service and tell them to set it up today!!

When our practices were young we both had a “policy” – no cleanings on the first visit. Yes – we knew that clinically that was the best decision. After all, how can you properly appoint a patient with the hygienist without an examination?

But after losing hundreds of new patients due to this policy, we both loosened up a bit and realized the number one customer service lesson in history –

Give the people what they want!

What do you hear yourself saying on a regular basis?

We don’t have Saturday hours.
We don’t take that insurance.
We don’t do cleanings on the first visit.
We don’t have a financial solution for you (so you can’t afford treatment).
We can’t get you in today or tomorrow.
We don’t do even simple orthodontics here.
We don’t do cleanings on the first visit.
We don’t.
We can’t.
We won’t.

Want your practice to grow?

Do. Can. Will.

A simple lesson. Yes.

The answer is “NO!” Now what is the question?

A short time ago we were at lunch with a coaching client at a Chinese restaurant near their office. (Some of the best ideas are generated during lunch meetings!) They were excited to take us there because they were a “regular” and knew we would get great treatment.

“The lunch special comes with an egg roll. Is it possible to get a spring roll instead?”


“Can the Szechuan green beans be made with no sauce?”


“Can brown rice be substituted for white rice?”

(Care to guess the answer?)

“NO!” (At least they could have said the classic “One dollar extra!!”)

No exaggeration here – this really did take place. And then it got worse.

Someone came in and asked, “Do you sell gift cards here?”


What if that customer bought five $50 gift cards for his co-workers? That would have meant a $250 sale. Then what if one of the recipients had never been there before, and loved it so much they became a regular customer, bringing in their family ten times a year for an $80 dinner? And then what if….you get the picture!

So, every time someone in your practice says “no” – you could be missing a similar opportunity.

Even if the answer is technically no, at least try to turn it into an opportunity. Here’s an example:

“Does Dr. Garvey have appointments on Wednesday evening?”

And he doesn’t. But instead of saying “NO!” – how about something like this.

“Oh – sounds like daytime appointments are tough for you, is that right? Well we start at 7:00 AM on Mondays and Thursdays, and our new doctor, Dr. Grant, sees patients on Saturdays. Which works best for you?”

A little creativity and positivity go a long way!!

One of the most typical examples is “Do you take my insurance?  It’s a PPO and I don’t see you on the list.” The typical response to this is “NO.” Then the conversation ends.

How about trying this instead?

“While we are not a member of that plan, we are an unrestricted provider with all insurance plans. That means you can still come see us, and we will give you the best dental care possible. You can pay us directly and we will help you maximize your insurance benefits with that company.

Would you like to come in for a no-charge consultation? That way you can meet the doctor, she can answer any questions you have, and we can explain exactly how we can make financial arrangements comfortable for you! Is tomorrow at 11:30 AM convenient?”

Granted – most people on a ‘list’ will say no to this, but nothing is lost. And sometimes someone will say yes, become a great patient, refer lots of others, and well – you can figure out the rest!

Sometimes it’s the simple, easy things that can help your practice grow. And to that we say “YES!!!”

Slightly disappointed

Yes – we are slightly disappointed. In your office? Maybe. But it’s okay – it’s not too late.

You see, a few weeks ago we set out to call a bunch of practices that have attended“TBSE – The Best Seminar Ever” recently to get their opinions on some things. But the project was pretty much a flop. Why?

Fewer than half of the offices we called even answered their phones! And this was during normal business hours. Instead we received voice mail messages like:

“If you are hearing this message during regular office hours, we are currently serving other patients.”


“We are currently at lunch.”


Sorry to tell you – this is simply not acceptable. The phone is where 99% of your new patients make their first contact with your office. Way too many people tell us they need more new patients, but more often than not, that is not their real problem. If your phone isn’t answered EVERY time it rings during normal business hours (and yes – that means during lunch and during your day off) you are losing new patients you never even knew existed.

How do you make this happen? That’s a lesson for another day. And honestly – you are smart enough to figure it out!! But for now, listen to our friends from Sugar Ray, and answer the phone!!

Say this, not that…


“We would love to see you as a patient in our practice! Would tomorrow at 3:00 PM or Tuesday at 11:00 AM be better for you?”


“Would you like to make an appointment?”


“I know what the problem is and I can help you.”


“This tooth needs a crown.”


“Would you mind if I place you on a brief hold? I’ll be right back and able to give you my full attention.”


“Dental office – hold please….”


“We have some fantastic financial options to help make the cost of treatment more comfortable.”


“Sorry – it’s not covered by insurance.”


“Hello Mrs. Costello, I’m Dr. Luther. What may I help you with today?


“Open wide please…..”


“Thank you for calling Hill Valley Family Dentistry, this is Lorraine – I can help you!”


(Voice mail answers) “If you’re hearing this message during normal practice hours, we are busy treating other patients…”


“When you return for your next cleaning and examination in three months, we want to pay close attention to that area on the lower right to make sure the inflammation is under control.”


“You’re due for a check-up in six months.”


“If you were a member of my own family, that is the treatment I would recommend.”


“If you can’t afford a crown we can always do a large filling.”






Everyone loves some good and simple tips to help their practice and their life, right? That’s why we asked some of our TBSE 2016 speakers to share some of their favorite ones with you! We will be presenting them from time to time throughout the year.

For the first stop in this series, we will visit Dr. Ric Zambito. “Dr. Z” was a surprise guest speaker at TBSE 2016, and even though he wasn’t on the stage for a long time, his incredible message really resonated with everyone there! Ric is a general dentist who has one of the most successful, productive and happy practices we have ever seen. His figures easily put him in the top one percent nationally, and he does it all in the small and depressed town of Wheeling, West Virginia!

One of the best things about Ric is his leadership abilities and the way he deals with his team. These four tips from Dr. Z will give you some insight into how he accomplishes this – and how you can too!!

1. Leadership is the process of getting everyone to the place they are supposed to be.  It is the opposite of controlling people.  No one can be a leader unless they are trusted and possess the number one characteristic that staff and patients want – integrity.

2.  The only way a team member will know what you expect is consistency.  You must constantly be teaching your staff, and be sure to compliment them when they achieve the success you expect.  Complimenting may be important, but so is helping your staff grow.  Making them aware and accountable when they have fallen short is equally important.  This will lead to improvement of your team.

3.  Why would anyone want to settle for being an average dental office? That is the best of the worst and the worst of the best.  Dreamers and achievers will never stop at this level.  It is always the doctor’s opportunity to help team members become the best they can be.

4.  Have you noticed that your dental office takes on your personality?  By speaking to just one employee, you should be able to decipher the tone of the entire office.  If you have a positive doctor, it will permeate throughout the office to the rest of the staff.

Want to hear more from Dr. Z and get his tips delivered to your inbox on a regular basis, including some fantastic ways to handle 14 scary situations that are probably happening in your dental practice right now?

Just visit

Simple Referral Tip

After over twenty-five years of teaching, we have learned quite a bit. And one thing that we have definitely learned is that most people will not take action, even on a good thing.

It’s pretty safe to say that if we wrote:

“Fax us your address and we will send you a crisp new twenty dollar bill” most people would not do it.

The odds get even worse with something like asking a patient to refer someone to your practice. No matter how many courses you take with some great script that is supposed to do the magic, the reality is most patients simply will not do it.

One of the problems is that when it comes time to ask for the referral, the doctor or team member makes it about them and not the patient.

Picture the typical scenario. A patient is happy with the new crowns you just cemented. They are glowing and say:

“Oh Doctor Pickles – I just love my new teeth!”

Boom! You know that’s the best time to ask for a referral. But why doesn’t it work? Because we say something like:

“That’s great Lucinda. If you have any friends or family who could benefit from the same type of dentistry, we would be glad to see them here at Pickles Dental Care.”

Okay – Lucinda knows that at this point it’s all about trying to increase your practice.

When asking for a referral – it’s crucial to work with human nature. Make it about the patient. Engage in a little conversation first before jumping on the referral question. Let’s do an example.

“Oh Doctor Pickles – I just love my new teeth!”

“Lucinda – thanks for saying that. It really made my day! But actually, you made it easy. It’s a pleasure treating you here.”

“Oh – thanks!”

“As you can imagine – in the dental field we hear all kinds of crazy stories, so it’s our goal here to make every single patient as comfortable as possible.”

“Yeah – I know what you mean. My Mom went to the dentist and they started drilling before she was even numb!”

“Oh – so sorry to hear that Lucinda. We would be glad to make room for her in our practice and would be sure to treat her extra gently. Debbie will even give you a few cards.”

See the difference? We engaged Lucinda in a valuable conversation before jumping to the referral issue. It was about her (and subsequently her Mom) – not about the practice.

And most importantly, the conversation was tailored to lead to the referral of a specific person. This is SO much more powerful than asking for a referral of generic “friends and family.”

So yes – asking for referrals can work, especially if you put a little bit of extra oomph into it, make it about the patient not the practice, and try to hone in on a specific referral.

The point is, don’t get discouraged. It’s normal for people to not take action on anything! Just keep the gentle reminders coming and don’t be too pushy, whether it is asking for referrals, treatment recommendations that have not been completed, or anything else. The goal is not always instant gratification, but the fact that when the patient is ready to refer or have their treatment completed, you are the beneficiary of the action.

Trust us – it works!!

Would You Have Sex With a New Patient?

Would you have sex with a new patient?

Sounds like a crazy question. And before you get too offended, in a certain way you just may be trying to do just that!

In the dating world, most women complain that men are way too aggressive.  They’re always going for the “close,” without paying attention to the real details!

“I want to know more about my man before I have sex with him.”
~A somewhat famous woman

Do you think that sounds crazy?

How about this typical scenario at the bar:

Step 1. Man: Here is my cheesiest pickup line.
Step 2. Man: Give me your phone number.
Step 3. Man: Let’s have sex.

Now if you are a man, we know YOU would never do anything like this. You’re probably not even going to any bars!  We realize that!

But whether you are a man or woman, could you be possibly be doing something like this?

Step 1. Doc: Here is my cheesy brochure!
Step 2. Doc: Thanks for calling our office. Come on in.
Step 3. Doc: You need $20,000 worth of treatment. Sign form!

Funny, do you see any similarities above to that scene at the bar?

You might as well be asking for sex. You may have a better chance!

Now don’t get us wrong, this approach will likely work some of the times. And if you don’t mind getting slapped in the face a lot, maybe it’s worth a try.

But as a dentist, you probably don’t want to get slapped in the face every day by new patients.  You want to build relationships, right?

We have been huge proponents of nurturing your new patients. And using the “100% treatment plan acceptance strategy” (see your Mega-Bundle, module 6) is a big one because it always works!

Wouldn’t it be nice if you got them to like you first?

Get them to believe in you.

Get them to trust you.

Now you have yourself a great patient!