Dental Consultant Recommended Dropping Two PPOs and Now Practice is Declining

stacks of coins with plant stem on top, decreasing in size from left to right, representing a decline in business or insurance money

Welcome back to The Dental Practice Fixers podcast, dentistry’s most unique show! Today we have a question from a listener asking for help. He hired a consultant and she immediately recommended that he drop two PPOs. Upon doing so, he noticed that he is now not nearly as busy as he used to be. Was it a good idea to drop these insurance plans even though they were PPOs? What is the next step to becoming more productive? Listen to what Dave and Rich have to say. Then of course we do the call of the week. An office in Delaware claims that they were voted one of the state’s top dentists. But when questioned about it, things all of a sudden begin to fall apart. Listen in to see how this one was handled! If you have a question that you would like answered on our podcast, please send it in to podcast@madow.com. We will do our best to get yours answered!

Dental Consultant Recommended Dropping Two PPOs and Now Practice is Declining

Female Speaker: The Dental Practice Fixers Podcast is brought to you by the Madow Center For Dental Practice Success. To find out how we can help increase the success of your practice, check out madow.com or call us at 1-800-258-0060.
 [Music Playing]
 Dr. David Madow: Hello there and welcome to the Dental Practice Fixers Podcast. I’m Dr. David Madow, and Rich and I really appreciate you being here. I’ll bring Rich here in one second. But before I do, I just want to thank you so much for being a friend and a listener. If you have a second, we will would appreciate some help from you. Simply if you like what you’re hearing, we’d love to have you go to iTunes and give us a nice honest review. If you give us five stars on that, it’ll be great, but just if you want to give us a comment, like, a review or whatever what you want to do, it helps to show a message. So, we appreciate whatever you do. And without further ado, I’m going to go ahead and bring my co-host Richard Madow. That’s Dr. Richard Madow into the show. Rich how are you doing today? 
 Dr. Richard Madow: I am doing great, and you don’t have to doctor me but I’ll take it. So this is Dr. Richard Madow…
 Dr. David Madow: Oh you told me to always call you doctor. That’s what you’ve always said in the past.
 Dr. Richard Madow: Yeah okay.
 Dr. David Madow: Even when we were little kids. I had to call you doctor for some reason. I don’t know, I certainly don’t understand that.
 Dr. Richard Madow: Yeah I want to be called maestro now. 
 Dr. David Madow: As long as your nickname is Downtown.
 Dr. Richard Madow: I have a lot of nicknames. 
 Dr. David Madow: You really do. But anyway, same thing with the last episode. Rich and I are in different locations right now. Rich is in beautiful downtown Baltimore, Maryland. Right?
 Dr. Richard Madow: I am. Still in my home studio. 
 Dr. David Madow: Beautiful, and I’m here in Salt Lake City, Utah and we are probably roughly 2,000 or 2,500 miles apart. We sound like we are in the same room due to modern technology here. 
 Dr. Richard Madow: I’ll tell you something else. I could just drive about from home, in about less than 20 minutes. I can be right at the very beginning of I70, and they just take I70 all the way out to Utah but it doesn’t go to Salt Lake City but it goes somewhere where I can just take maybe I15 to Salt Lake City.
 Dr. David Madow: I believe that would be right.
 Dr. Richard Madow: In my two terms could be wherever the heck you are.
 Dr. David Madow: I’ll tell you something, Rich come at me. 
 Dr. Richard Madow: I’m not doing it. I’d rather fly out there. Hey can I just go on a tiny rant here?
 Dr. David Madow: Please.
 Dr. Richard Madow: I cannot stand dealing with irresponsible people. 
 Dr. David Madow: Oh I love it.
 Dr. Richard Madow: Here’s an example; let’s just say that… I’ll just make a situation up because this happens all the time. You get like a little dent in your car, you take it to the body shop, they look it over, they say okay I’m going to send you an email this afternoon with your estimate. Does that email ever show up? No. And then like a day or two you don’t want to be the pain in the ass because that’s the worst thing to be. And then you have to start hocking the person then you feel you’re being annoying to them, when meanwhile they’ve been irresponsible in the first place, you wouldn’t have had to go through this.
 Dr. David Madow: Well that’s quite a rant. Tell me what happened. What’s the story? Did you bash your car for some reason?
 Dr. Richard Madow: I’m not commenting.
 Dr. David Madow: What did you do? You didn’t tell me you hit your car again.
 Dr. Richard Madow: I’m just saying this is a rant. I’m not saying I did it.
 Dr. David Madow: Oh you made it. I’m going to guess. You were in your parking garage at your home, and you backed into a pole. That’s my guess.
 Dr. Richard Madow: I’m not commenting on that. I’m just fed out with irresponsible people. 
 Dr. David Madow: And I’m going to say one more thing. If that is true, which I’m not sure because you’re not commenting. It’s not the first time. Why don’t you have them remove that damn pole or relocate the pole or give you a new spot or something.
 Dr. Richard Madow: It’s so funny. In my parking garage, the poles and the walls all have like a million dents like black spots on them where you can see people rub up against them. it’s a disaster down there.
 Dr. David Madow: What’s the story? Why do you keep hitting walls and poles?
 Dr. Richard Madow: I didn’t hit a wall and pole. I’m just ranting on irresponsible people. 
 Dr. David Madow: Okay got you. We won’t take this any further.
 Dr. Richard Madow: Let’s put it this way. When you tell a car insurance company that you live in my building, they won’t give you insurance. That’s how bad it is here. 
 Dr. David Madow: Or they double the premiums on travel. Maybe triple them.
 Dr. Richard Madow: There’s like a pole clause. 
 Dr. David Madow: Oh my god. Well you tell me more of the story offline. 
 Dr. Richard Madow: I am not commenting. 
 Dr. David Madow: Okay.
 Dr. Richard Madow: So hey, we have a great question here today. Thanks so much for sending this in. Just like the last time, we’re not going tell this doctor’s name because they asked us not to. So, if you want to send in a question and you’re fearful that we’re going to out you in front of all of our listeners across the world, just put your name with how or if we’re not sure where to withhold your name, we want to protect everybody’s privacy. But as usual, I think a lot of these questions are so universal that they could apply it to anyone anywhere. So, what do you say? Get down to it.
 Dr. David Madow: I can’t wait to hear it.
 Dr. Richard Madow: Okay. Did we say that this is Episode 5? I can’t remember if we established…
 Dr. David Madow: Well we didn’t say it. I say it.
 Dr. Richard Madow: Okay good. Well I’m going to say it now too. This is Episode 5 of Season 2. Just look in my notes. I want to make sure everything is in place here.
 Dr. David Madow: Yeah we said it. I might not have said Season 2 so to be clear, to be very clear, it’s Season 2, Episode 5.
 Dr. Richard Madow: We’re just doing a little housekeeping here. 
 Dr. David Madow: Bathroom is into the right.
 Dr. Richard Madow: I'll tell you something. When we speak at seminars all over the place, I don’t like it when the person introducing comes up and said we have a little housekeeping first. Well let me just say this is how you get your credits, there’s not going to be a break. Why do they have to say we have a little housekeeping? 
 Dr. David Madow: Yeah. Turn off all cell phones. 
 Dr. Richard Madow: Exactly.
 Dr. David Madow: I know.
 Dr. Richard Madow: It’s kind of an insider’s term, housekeeping. 
 Dr. David Madow: We’re going to put that to rest. At TBSE, if somebody does it, we’re going to kick him off stage.
 Dr. Richard Madow: Right off stage. Okay here’s our question. Here’s our question for today. It says, “I hired a dental consultant”, then in parenthesis “(not you guys).” I love it when there’s some parenthesis in their question. Last episode’s question had some parenthesis too, I think. “I hired a dental consultant (not you guys), and she”… well shouldn’t “she” be a giveaway of whatever? Actually, most of our coaches are she. “So, I hired a dental consultant (not you guys) and she suggested that my cash flow would improve and overhead would go down if I drop two of my PPOs. So, I listened and now have lost many patients. We are not busy anymore. What should I do? And what do we tell people who call and ask if we are in their network?” Signed, name withheld.
 Dr. David Madow: When you were reading the question and the parenthesis and little inside jokes, why did I feel like we’re like drive-time DJs? 
 Dr. Richard Madow: I’m not sure if that’s a compliment or an insult.
 Dr. David Madow: Maybe another complement. We’re just killing this one. It’s a great question. I’m going to say that number one, I don’t think enough information was given on this either. 
 Dr. Richard Madow: Well okay, but let’s take it for what it is. Okay so I know where you’re getting. Like did the consultant actually do an analysis and say I’ve determined that you should drop this two PPOs or they just come in and say, hey let’s drop a few PPOs.
 Dr. David Madow: The later is my guess. But what I meant was this doctor is saying… was the doctor he or she? Did you indicate that? I can’t remember.
 Dr. Richard Madow: I did indicate them. The doctor was a she. We’ll say that.
 Dr. David Madow: Okay so doctor was a she.
 Dr. Richard Madow: I’m assuming by name. I mean you’ll never know.
 Dr. David Madow: Yeah okay. So, she could be not as busy, but still here bottom line could be better because last thing I would want is to be seeing patients all day long working my butt off and actually draining the practice and calls in a negative cash or not making any money. So she might have a feeling of not being as busy, but maybe it’s… I don’t know the answer to this but maybe it’s better for the practice. That’s why I’m saying there’s really not enough information here.
 Dr. Richard Madow: I’m going to interpret and say if that were the case, she probably wouldn’t have written in. I think if she were less busy and more profitable, then she wouldn’t have had the need to ask this question. Just kind of an assumption but I think that’s true. 
 Dr. David Madow: You know I think unfortunately, from my experience also, a lot of doctors feel that the busier they are, the more patients, the more hustle bustle during the day, the more successful they are even if they’re not. Even if they’re not making money from the patients. So, I’m not sure. I don’t know the answer but let’s assume that maybe she’s not as busy and she’s not making as much money. Let’s go under that assumption. 
 Dr. Richard Madow: Right. I think it’s kind of those things. Nobody likes PPOs and so they drop them and then their practice goes downhill. So, it’s not something you can just do randomly. You’ve got to really figure out if that’s the best move for you. And I’m also thinking, again just reading into the question that sure you can drop PPOs but it has to be done carefully and cautiously and correctly. For example; let’s say that you decided to drop your worst PPO, you don’t just drop it and say I’m not longer in this PPO. You do it over a period of time say maybe in 9 months I’m going to drop this PPO and then as each patient on the PPO comes in, talk to them and let them know what’s going on and let them know that they’re welcome to stay in your practice and that we figured out that you can join our membership plan or this is a good way that we can help you if you no longer have this crappy… I hesitate to call it an insurance because it’s crappy insurance. But if you no longer have insurance, they’ll just drop it and hope for the best. Do it strategically and start with your worst one, and then do it at a time where you would be able to at least speak to each patient personally and let them know what’s going on and let them know if they go to some crap office that they’re not going to get the same level of care. Don’t just drop it and hope for the best.
 Dr. David Madow: And not only that. Have a plan to fill the void. I mean you can’t just drop a whole bunch of stuff and then not have a plan. So in other words as you’re dropping this PPO, you’ve got to have a marketing plan in place. How are we going to replace these patients? Well you better have a great marketing plan in placed that you start right away, and you’re getting more new patients. There are cash paying patients or better endemic insurance patients or something like that.
 Dr. Richard Madow: It’s a fantastic point. We’re dropping it, we’ve been super busy, we’re dropping this PPO, we anticipate and we won’t be quite as busy. What can we do now to fill the schedule that we haven’t been doing? Really good point. 
 Dr. David Madow: And the worst thing somebody could do is we’re going to start doing some marketing and they just start has or different marketing things without really having a plan, and we see this so often Rich. I don’t know, typically what will happen, they’ll go to a dental conference so they’ll walk around an exhibit hall or talk to some kind of rep that comes in or something like that. And they’re just kind of it’s a hit or miss marketing campaign. That is ridiculous, it could be expensive, it can fail. You’ve got to make sure if you’re going to be doing marketing, do it right. Have a plan, have a budget, know what you’re doing, know what you’re… anticipate what the ROI is going to be and do it the right way. Not to put it in a shameless plug for what we do, but the Total New Patient Plan. We’ve got this total… it’s a total plan all together we do everything for you. You might want to look into that. It’s on our website somewhere, madow.com, check it out. And again, we didn’t even mean to plug it but why not plug something that totally works and it’s totally well-thought out.
 Dr. Richard Madow: I don’t know that there’s a shameless plug at all. It was kind of a shameful plug. 
 Dr. David Madow: Well I think the most important thing is what we see is all the time, docs are mainly doing a hit or miss marketing and that just does not work in the long run at all. Yeah you’re getting a few patients, it’s a start but it’s not going to work long term.
 Dr. Richard Madow: Totally agreed. And also, as we reinforce on every episode when we do our call of the week, you better make sure that your front desk team is incredibly good at turning every potential new patient on the phone into an actual patient in the practice. And maybe just homing that skill will get that schedule full again. 
 Dr. David Madow: I’ll tell you something, that was a really important comment. It bears talking about for a couple of seconds because so many doctors out there are complaining of how they need more income. They need to be more successful, they need more new patients. And Rich, when we do these calls and I want to make it very clear. We don’t do 20 calls and the take the best of the best. We generally… every time we do a call, unfortunately it’s a bad call on the dental office’s end. What I’m trying to say is most doctors think that the person answering the phone in their office is an exception to the rule, and they’re doing a great job. But I’m here to tell you, statistics really don’t lie and most front desk people need a lot of work because just listen to our calls every week. You’ll see what’s happening in most dental office across the United States.
 Dr. Richard Madow: Yup. And it’s kind of circling back to what you called your shameless plug. And whether you use us for your marketing or someone else, whatever you’re doing, there’s so many great avenues in there. You can do all the marketing in the world and it stops at the front desk. You can have 50 incredibly qualified cash paying potential patients calling and if they never get on the schedule, it doesn’t do you any good. 
 Dr. David Madow: Yeah so let’s just circle back to this, kind of like summarize the answer to this question. Do we know that the dental consultant did the right thing? Do we know that the dental consultant ran reports and really understood the mathematics behind that suggesting dropping two PPOs? We don’t know the answer but you did drop them, let’s move on and do the right thing to get better patients and by marketing, by training your front desk. Again, it just comes down to basics. We’re not reinventing the wheel. It comes down to these basic things that you need to be doing in your dental practice to be successful. Are you doing them? 
 Dr. Richard Madow. Totally agree. And also, let’s make another point. People that are not… if people have a PPO that you don’t accept, let’s face it, most of them will not come to you but some will. And the ones that do come to you for a reason and they can be some of your best patients. So, if you’re about to drop a PPO and you’re having a discussion with the patient about it, make it very clear. They are welcome in your practice at any time. And should they leave your practice, still it make it clear. They didn’t burn the bridge. They are absolutely… if they don’t care for the practice they went to, they’re absolutely welcome to come to your practice. You can work on financing, you can offer them a membership plan. There are so many great things that you can do. And same when somebody calls and says are you on my plan? You don’t just say no and hang up on them. You let them know that we’re not technically on your plan but you can still come here and this is how it will work if you do. And we’d love to have you and we think you’ll really see the difference. So again, most won’t do it but some will, and some will go to an office and get burned and then come back thankfully. So just don’t count them out automatically. 
 Dr. David Madow: Right. And if you’re listening to this and you’re at a place where you can actually take notes. We’ve talked about this before, write down the term “you are a non-restricted provider” which means again, you’re not technically on the list but you can work with the company and get some benefits. So yeah always use that. We are non-restricted providers. You can come to us. You’re welcome to come with us. We’ll do the best we can. 
 Dr. Richard Madow: Fantastic. Great question. Thanks so much for writing in. What do you say, speaking of front desk skills? Let’s do our call of the week. This is not just any call of the week. This is the call of the week to one of the best dentists in the state. How do we know they’re one of the best dentists in the state? We’re going to find out. 
 Dr. David Madow: I’ll tell you, before we do it really quickly, I want to remind you that Rich and I are running this Masterclass for dentists. It’s a small intimate setting. We’d love to have you attend. It’s a way to take your practice into the next level and the best way to find out more about the Masterclass and how the whole thing works is we set up actually a web page for it. It’s masterclass.madow.com. Check it out. We’ve got all the information you would want. If you need more, just get in touch with this. We’d love to see you in a future Madow Masterclass.
 Dr. Richard Madow: I got to say, the Masterclass has been a turnaround. There are so many dentists, the day they made a huge difference in their lives. Don’t you think?
 Dr. David Madow: No question about it. I think we are really helping dentists become more successful and happier in the practice of dentistry. We really are. We’d love to have you join us at one.
 Dr. Richard Madow: Speaking of… there’s things like a Masterclass, they make a huge difference in your life. Other things that you can make difference in your life like saving a few thousand dollars every month on your credit card processing. So please check out Fattmerchant. They will save you money on your credit card processing because they just charge a low monthly fee and no overage percentage. Check them out at bitly/… well I’ll spell it out because who knows how the heck to do that. It’s B I T. L Y/fattmadow. Fatt with two Ts. So it’s F A T T M A D O W. We’ll work out a special deal just for our Madow listeners. You’ll get a free processing terminal, you’ll save money. Your patients won’t know the difference. You won’t know the difference except you’ll lower your overhead. So again, Fattmerchant is the best way to process your credit cards. B I T. L Y/F A T T M A D O W. And now we teach you a little bit…
 Dr. David Madow: Hey Rich!
 Dr. Richard Madow: Go ahead.
 Dr. David Madow: I’m going to make a really really quick comment about Fattmerchant because in the old days, when somebody said hey you got to change your credit card processing company and then it was a real hassle. There was nothing easy about it; it took a long time, there was a ton of paperwork. These days, I’ll tell you something. With Fattmerchant, you pretty much contact them with pressing a few buttons, they can change you over to Fattmerchant and there is just no reason why any dentists should not be using Fattmerchant. What you said Rich in the beginning of that segment, save a few thousand dollars a month. Who wouldn’t want that? I would take a few thousand dollars in my pocket every single month from here till the end of eternity.
 Dr. Richard Madow: And we started using Fattmerchant at the Madow Center. It’s fantastic. It’s cool.
 Dr. David Madow: Absolutely. It’s great stuff.
 Dr. Richard Madow: So, we kind of tease the call because we’ve got the call lined up and we just noticed from this person’s website that said they’re one of the top dentists in the state. We have no idea what’s about to happen but let’s find out. Ready? 
 Felicia: Thank you for calling. This is Felicia. How can I help you? 
 Dr. Richard Madow: Hey Felicia, I saw on your website that you were ranked top dentist by Delaware Today Magazine? 
 Felicia: Um-hmm.
 Dr. Richard Madow: And what that does mean exactly?
 Felicia: Here one moment. 
 Dr. Richard Madow: It certainly doesn’t mean you have the best on-hold messaging. Anyone home? Okay this is literally over one minute of hold time. I’m watching the timer. Tick, tick…
 Felicia: Hi, sorry. I’m sorry I just… it looks like we were just awarded that for being one of the top dentists in the state.
 Dr. Richard Madow: Being one of the top dentists in the state? Like based on… I’m not trying to be a wise guy. I’m just wondering what the criteria was for that. Do you have any idea?
 Felicia: I personally am not sure. Yeah, I’m not sure. I’m sorry. 
 Dr. Richard Madow: Oh, so do you think it’s one of the top dentists in the state?
 Felicia: Yeah, I think so. I think we’re a great dental office.
 Dr. Richard Madow: Fantastic. Thank you so much. 
 Felicia: No problem.
 Dr. Richard Madow: Okay bye. Wow! So many things to say about that but they’re one of the top dentists in the state. They really are. 
 Dr. David Madow: How do you get to be one of the top dentists? 
 Dr. Richard Madow: I think first of all you have to put people on hold for a long time. 
 Dr. David Madow: Let me tell you something. When we were on hold for a like a minute?
 Dr. Richard Madow: Over a minute.
 Dr. David Madow: Over a minute. I was just picturing, what are they doing or did she go to a big huddle and they’re trying to figure out how to answer the question. What was going on? 
 Dr. Richard Madow: It’s funny Dave. I was thinking the same thing like is she getting coached on this, but then she came back and all she can say was yeah I think we’re one of the top dentists in the state. 
 Dr. David Madow: That call was unbelievable. 
 Dr. Richard Madow: Plus, she was getting like five texts during the call. Did you hear that text tone that kept ringing?
 Dr. David Madow: Yes. I was wondering where that thing was coming from too so that maybe  texts that were coming through. She didn’t know what was going on. I’ll tell you something though. I mean I don’t really know much about the award they got but she could have really played that thing up and made themselves sound really good. But she turned it into a call that made us tell us she didn’t know what was going on. And using the term “we’re one of the top dentists,” that didn’t give me a whole lot of confidence in that practice.
 Dr. Richard Madow: But you made a really good point. We always love to teach front desk team members to brag about the office a little bit. Could there have been a better chance to brag? Yeah, we have been voted one of the top dental practices in the state and Dr. Jones is such a fantastic dentist and he’s gentle and the smiles that we produce are just a beautiful, we’re changing people’s lives every day and we’re just so flattered that we won this award. Just anything. 
 Dr. David Madow: Well unless the thing was totally bogus and like you busted and she just doesn’t know what to say because maybe there was really no vote. Who’s voting for this anyway? Where does this vote come from? Other dental practices voting?
 Dr. Richard Madow: Well I know here in Baltimore there’s a magazine called Baltimore Magazine and they have the top dentist issue and it’s actually voting by peers. I’ve been asked many times to vote for top dentists in all the different specialties and GPs for Baltimore Magazine. So of course there’s a lot of politics and who knows, and it seems like the dentists who will throw full page ads in the magazine seem to do a little bit better. 
 Dr. David Madow: They’re always the top dentists. 
 Dr. Richard Madow: Right. Look at those airline magazines. They’ve got top plastic surgeons in the country. And where was that? The person that writes a check, I always thought.
 Dr. David Madow: I think it must be. 
 Dr. Richard Madow: Nevertheless. It looks good for patients if your reception area has plaques showing that you’re the top dentist in the state and on your website it says vote of the top dentists in the state. It looks great. So be able to speak intelligently on it. 
 Dr. David Madow: Yeah I think chances are that shows, I think it sounded like they were in Delaware or somewhere, and if it truly was in some type of Delaware Magazine and they were voted one of the top dentists, all the team member should know about it. She should have been at least been able to say yes we’re so proud. Delaware Magazine voted us one of the top dental offices in the state, and we are so proud of the small… they should at least know it.
 Dr. Richard Madow: She knew nothing. 
 Dr. David Madow: Nothing. Zero.
 Dr. Richard Madow: I just have to keep going back to that she said we’re one of the top dentists. It was just great.
 Dr. David Madow: And insult to injury, did she tried to get an appointment? Nothing happened.
 Dr. Richard Madow: Nothing.
 Dr. David Madow: The call went nowhere. 
 Dr. Richard Madow: Sir if you come in, we’ll show you why we’re one of the top dentists in the state. Let’s get you on the schedule right now. 
 Dr. David Madow: Right now. 
 Dr. Richard Madow: You come right now.
 Dr. David Madow: Oh my god. Again, I just want to reinforce that doctor if you’re listening to this and you think that these are all exceptions to the rule and your front desk people are the… maybe yours are. I don’t know the answer. But again, we just don’t make any calls that make perfectly. It just doesn’t happen. So please, our goal is… we want anybody answering the phone in a dental office to be great and perfect and gets the appointment. We’re working on that, it’s just not happening yet guys. 
 Dr. Richard Madow: At least don’t put somebody on hold for a minute and a half and if you have to put somebody on hold which let’s face it, it happens from time to time. At least have something playing. We’d love having customized messages playing to tell how great your office is but at least some nice soothing music or something so they don’t think you hung up on them.
 Dr. David Madow: Yeah. Maybe breakfast with the Beatles or something. Just something.
 Dr. Richard Madow: That would be perfect. 
 Dr. David Madow: Rich that was a great call.
 Dr. Richard Madow: Alright. We’ll keep them coming. So that will give us something to look forward to on Episode 6, but this was Episode 5 Season 2 of the Dental Practice Fixers Podcast. Thanks everybody for listening. I’m Dr. Richard Madow with my co-host, business partner and co-worker, Dr. David Madow. Thanks so much everybody and we will see you next time.
 Dr. David Madow: See you later.
 [Music playing] 





If you enjoyed this podcast, check out our previous podcast, Associate Dentist Deep in Debt With Poor Treatment Planning Skills

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