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 coaches@madow.com. We are now offering a complimentary 30-minute coaching session! Please CLICK HERE to schedule yours. Doctors only please.

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Coffee

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?”

“NO!”

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

“NO!”

“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?”

“NO!!”

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.”

CLICK!

“We are currently at lunch.”

CLICK!

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…

SAY THIS

“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?”

NOT THAT

“Would you like to make an appointment?”

SAY THIS

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

NOT THAT

“This tooth needs a crown.”

SAY THIS

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

NOT THAT

“Dental office – hold please….”

SAY THIS

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

NOT THAT

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

SAY THIS

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

NOT THAT

“Open wide please…..”

SAY THIS

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

NOT THAT

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

SAY THIS

“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.”

NOT THAT

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

SAY THIS

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

NOT THAT

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

SAY THIS

“Yes!”

NOT THAT

“No…..”

Are you a dental shark or a dental guppy?

Are you a dental shark or a dental guppy?

Do you rule the dental world or do you get swallowed up by the competition?

Everyone seems to love the TV show Shark Tank. And why not? It’s fun to watch people pitch their businesses to the sharks – a panel of wealthy investors who can turn from welcoming to brutally critical at the drop of a BeardHead Beanie Hat. We even had one of the sharks, Daymond John, at TBSE a few years ago and he was a huge hit!!

So here are seven Shark Tank lessons from the most famous shark of them all, Mark Cuban. They certainly apply to your dental practice!! (Some will be paraphrased for dentistry!)

1. Learn to sell. You are always selling – to your patients, your fellow team members, and your community. But don’t sell a product – solve a problem.

2. “Everyone has the will to win – but the winners are those who prepare.” You can dream of having a great dental practice all day long, but what are you actually doing to achieve it?

3. Your patients can tell you what is broken and how to fix it. But you have to listen to them. Listen!!

4. One thing we can all control is effort. Put in the time to become an expert in whatever you’re doing. It will give you an advantage because most people don’t do this. This is not just clinical expertise, it’s people skills and running the practice.

5. “The beauty of success, whether it’s finding the love of your life, the right job or financial success, is that it doesn’t matter how many times you have failed – you only have to be right once.”

6. Get an advisory network. No one has all the answers or ideas.

What do you think? We think is great advice that will work for anyone at any practice! One thing is for sure – learning from successful people (like “The Sharks”) is much better than asking that floundering schmo at the local study club what he thinks!! It’s time to swim with the dental sharks!

* * * * * * * * * * *

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!!

Doctor, we are slammed at the front desk!!

A frequently asked question / observation we often get at our seminars:

“You guys are up here stressing customer service, treating every patient like they are the most important person in your practice, never putting anyone on hold, listening patiently, etc…

Unfortunately you have NO IDEA what it is like to be in the front desk hot seat. What are we supposed to do when we have a patient on the phone and the other line keeps ringing? What if there is a patient waiting at the front desk to talk to us? Doesn’t a live person deserve priority? It’s not easy to juggle five things at once you know….”

If your office is frequently in this situation – congratulations! You are busy! People want to come to your practice! Way to go – you must be doing something right!!

But if the front desk is constantly slammed, you are losing new patients left and right. Possibly center too.

Doctor – it may be time to crowbar your wallet open and invite another talented team member in. And the good news is – that team member will pay for themselves many times over!

Think about what a great front desk team member would earn. Then think about what a lost new patient costs your practice. (By some estimates it $10,000+!) This is what’s called a no-brainer!!

Staff up, offer the best customer service possible, and watch your practice grow!!