#881: Priority Scheduling: Ideal Week + Ideal Schedules
Rereleasing one of DAT’s most popular episodes! Dr. Dave Moghadam returns to the Dental A-Team podcast! This time, he’s giving the goods on priority scheduling, something he’s been working with for over a year now. He and Kiera go deep into priority scheduling with the following highlights: How to map out ideal schedule Keeping it flexible Rolling out to the team Space for emergencies How hygiene fits in And more! About Dr. Moghadam: Dr. Moghadam was born and raised in Morris County, New Jersey. After completing his undergraduate degree at Rutgers University in New Brunswick he went on to obtain his Doctor of Dental Medicine degree from the University of Medicine and Dentistry (UMDNJ) in Newark. During his time at UMDNJ, Dr. Moghadam received extensive recognition for his outstanding leadership, academic and clinical aptitude, and dedication to the profession. Some of his achievements include receiving the William R. Cinotti Endowed Scholarship and the American Student Dental Association Award of Excellence, as well as induction into the Gamma Pi Delta Prosthodontic Honor Society. He then chose to complete a general practice residency at Robert Wood Johnson University Hospital in New Brunswick where he received advanced training with an emphasis on comprehensive restorative treatment, endodontics, and implant dentistry. Episode resources: Reach out to Kiera Watch DAT Podcasts on YouTube Practice Momentum Group Consulting Subscribe to The Dental A-Team podcast Become Dental A-Team Platinum! Review the podcast Transcript: The Dental A Team (00:05.742) Hey everyone, welcome to the Dental A Team podcast. I'm your host, Kiera Dent, and I had this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, pillar, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental. And I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A -Teams. Welcome to the Dental A Team Podcast. The Dental A Team (00:51.438) Hello, Dental A Team listeners, this is Kiera. And you guys, today I am so excited to have back on one of my favorite doctors. He and I tend to come up with some fun ideas to podcast on. And so I'm super honored and grateful to have Dr. Dave Mogadam back on the show today. If you haven't heard, he and I have chatted so many different topics from mergers to practice to bringing on your hygiene team and how to calibrate your hygiene team. And today we're gonna take it on another direction with scheduling. So Dave, how are you today? I'm doing wonderful. How about yourself? Great and guys just so you know if you heard the last one Dave's got a killer mustache going on again today He's got like I wish you guys could see him because he came like ready to go today rocking and rolling Dave How's the weather where you're at today? I mean you've got the mustache going on perfect haircut today I mean you're looking You know, it was one of those things where I got fooled in the Northeast. You know, we have these fake spring days. So yesterday was really, you know, beautiful, sunny, everything like that. So I threw on a T -shirt and a vest. I was walking outside this morning and somebody asked me where my sleeves are. It's freezing. Well, that's how we are over here. Today's the coldest I think I've ever seen Reno and it's at 11 degrees today. And for me, freezing cold. Like I don't know what this is. We also had that fake spring. was almost in the seventies and then plumbing it down, got lots of snow. So it's probably coming your way. So get ready for it. Here it comes. But you know, here we go. So Dave, let's, let's dive right in. about, mean, you guys have a fun day. get customer service with Disney today. So just going to throw that out there. That's going to be a fun day, but let's talk scheduling. I'm going to just tee everybody up for a possible other conversation on customer service, Disney style, Priority scheduling, you're a dentist, you guys have grown a lot. Tiffany works with your practice, she's excited to come see you again. So kind of walk us through this priority scheduling and what you guys have found successful in your practice. So yeah, it's a really good topic. about a, a year ago now, I was really thinking about, know, what is going on with our schedule? Because for years and years, as we've gotten busier, The Dental A Team (03:07.126) Monday through Wednesday has always been like gangbusters and awesome. And then we get to Thursday and it is just like, my God, what is going on here? It's all the little ancillary nonsense that you just don't want to deal with. And everybody's running around and trying to deal with like seeing a bunch of patients and our practice is not really, you know, like that or geared for that really. And you work harder, it's less fun and everybody really just does not enjoy it, especially me. Right. So for years and years, we've kind of always heard the big consultant saying, you got to schedule to production and this and that. And that just never really resonated with me in the least bit. Because I always have this, and know my philosophy is about this is kind of schedule everything else right, plan everything else well, do the right things, treat everybody the right way. And the numbers come. I feel like when we fixate on the numbers, it's I don't know. just don't feel good about it. And I don't think my team does either. But what I can get behind is, well, everybody wants to have a better experience at work. And when myself and the other doctor are happier, everybody else is happier too, because we're not just walking around like grumpy pants. So I'd heard the idea of priority scheduling through a bunch of other podcasts. And I said, you know think I can get behind this. know you guys had been a big proponent of actually managing the schedule, setting time out better, everything like that. So I sat down and I figured out, what does an ideal week look like? What type of procedures do I want to do? How do I want to break them up? How do we set up time where the flow of everything's better? Where do we put in the ancillary stuff so it's not something where we spend one day running around and we just end the week on just like a ugh. kind of note there. So we started doing this, think, last March. And it could be the perfect storm. It could be a lot of factors. But between that, ramping up our marketing, everything like that, all of sudden that month, we were basically up maybe 20, 30 percent. And we've pretty consistently been doing that, except for not the last couple of months. Hashtag COVID. So, what are you going to do? That has more to do The Dental A Team (05:30.216) all the other factors that come into place of, you know, switching, switching over associates, switching over hygienists, all the lovely stuff that, you know, puts all the pressure on myself and the rest of the wonderful team here. Right. We're doing it. So I love that. And I love that you brought that up of you. Number one, I think it's really impressive that you're a dentist, you're the doctor, and you're the one who thinks through this. Because while yes, teams can do it. And I encourage teams to think like this if your doctors don't. But Dave, I love that you're always a very proactive dentist. You are always thinking about like, okay, what causes this? And instead of just focusing on the symptoms, you go to the root cause. Like what is causing us to have Thursdays that aren't as productive? What is causing us to have successful Mondays through Wednesdays? And what can we do to change that? And I then love that you went and took this to like, what would my ideal schedule be? Because as a team member, that's literally what I need from you. I need to know what my doctor prefers. Because I can put together a schedule But I know working with hundreds of dentists like Kiera Dent knows that not every dentist likes to practice the same way. Some doctors love to rock and roll until about noon and then like just fill it with fluff at the end of the day. They do not want anything hard. They don't want to be doing any production. Other doctors like, nope, that's when I like to do my surgeries, put my surgeries in at the end of the day. And so it really is paramount for our dentists to give us this like ideal schedule of what they want. And then we can word Ninja as team members. I Dr. Dave loves to see his patients for this procedure at this time. So there's a lot of different ways we could do it, but how did you kind of come up with your ideal schedule that you actually wanted to do? Like, how did you even map that out? Cause I think sometimes people are like, well, I don't, don't actually know what I want or how much I want to produce. Like, did you have only the type of procedures that was going to be ideal for you? Or did you have the dollar amount that was going to be ideal for you? Like, how did you build this out for priority scheduling? Yeah. Now I only did it based on the type of procedures. I actually, zero thought to the dollar amounts. I think, you know, it kind of all comes full circle and just kind of the way that we do everything here. And it's going to be super different in every office. And I mean, I've shared my template that I made in Excel with, you know, other friends and stuff like that, but it's not going to work for other other offices for a variety of reasons. I am very different than The Dental A Team (07:49.228) the guy next door or across the country and everything like that. And I mean that in a positive way. We all have our strong suits. We all have what we like to do. We all have what makes us successful and how we want to go ahead and practice. Just like you guys can't walk in and give somebody a cookie cutter template for consulting. It's the same thing here. So I think really, how did I figure out how to do it? What do I want to do? What do I find is helpful? What do we have a demand for in our practice? I mean, these are all factors that come into play. mean, I could love to, let's pick like a random procedure. mean, I could love to do immediate dentures every single day, but unless I'm in a place where we're just a denture -lating every human being, like that's not gonna happen. So it's a matter of taking like all these factors into account, figuring out what works and then kind of some of the logistics, like what is different on different days? We have a wonderful, wonderful dental assistant who's with us only on Wednesdays and has been for forever. and she takes care of all our denture stuff. She'll make flippers immediately for patients in the chair. She'll add teeth. She'll turn partials into dentures, stuff like that. So Wednesday mornings is when I'm lining up a lot of my setting up her implant kind of cases or just big extraction cases, things like that, where it's kind of like in a pinch, we can do the extraction and grafting. She can give them something temporary or stuff like that. So a lot of that stuff, we just kind of line things like that up that way. Other than that, I mean, I like to go ahead and get the day started with at least something moderately, you know, productive. So, you know, the way we do crowns in our office, we do them in a single visit. So, you know, it's either, it's going to be a block, like, you know, we start with that. The next hour is going to be, you know, something smaller space for emergency. and then, you know, kind of sprinkle things out throughout the day, having blocks where it's just going to be just longer, you know, quadrant kind of stuff. So I mean, that's the starting point. But the I think the big thing for, you know, doctors and team members listening is like, yeah, this is like the template. But it doesn't mean like it's it's set in stone. And if you don't get anything a day before, like tell everybody else to take a hike. Right. I mean, it's a matter of having that kind of idea of like, what makes sense for you guys is it 24 hours? The Dental A Team (10:08.494) 48 hours before where we're going to go ahead and just basically put either whatever or switch it up. Or if we're like a week out and we really got to get somebody in, let's switch the block, but then let's make sure we change it in the surrounding areas to accommodate for things so we don't have, you know, weird odd dead space. Right. Exactly. And I think that's a key piece that I feel like a lot of people almost become robotic when you do have these blocks in there. And it's like only put filling here. And it's like, no, no, no, guys, like we still need to utilize our brains and we need to think of what's going to be the best flow for our patients and also for our practice. And you're right for me, my standard is typically 24 hours before I don't put anything in that block or that space because my goal is to try and fill it. I also think it's really important. I know as a treatment coordinator, I just like I was, was building a puzzle piece all day long. So patients, almost saw them as puzzle pieces and where could I fit this patient? to fit with all the rest of the patients to make a really beautiful schedule. And so if somebody walked up and they said, okay, I'm fillings today, but I know I've got a bigger block, I'm not gonna stick this puzzle piece in the big block because it's not gonna fill that space. So I'm really looking to put this patient in where it's going to work best for our practice and also for the patient. But so often I think team members are like, well, this filling wants tomorrow, Kiera. And I'm like, well, yes. A child also wants candy every day for dinner too. And so just because the patient says they want that, what they ultimately want is a great experience. And as a team, what we ultimately want is a great experience. So let's kind of word ninja, help the patient realize like, hey, Dr. Dave actually prefers to do his fillings at this time. Let's reserve this for you. So that way I'm really doing it. Also guys, like I'm gonna give some tips to the front office and for all team members scheduling, cause I'm also not just pro front office, but also back office. Please like don't set yourself up for failure by saying what day works best for you. Because as soon as you open that floodgate, that patient's gonna tell you what they would prefer. That then you get into a pickle. Like what if we only have this assistant on Wednesdays that does this procedure, but they said Tuesday? Well now I've gotta tell them the great news of, our assistant's amazing and she's only in on Wednesday, so we gotta schedule you on Wednesday, but they just told me they want Tuesday, so I'm already in a losing battle. The Dental A Team (12:25.038) be proactive and say, fantastic, Dr. Dave loves to do his implants on Wednesdays. Let's get a time reserved. I've got 9 a or 3 p What works best for you? So that way I'm being directive on the conversation as well. It's going to help minimize that frustration and also make scheduling a lot easier in that priority scheduling. So I think the 24 hour rule before and then also making sure we're as team members setting it up as well so we're not having frustrated patients merely because of how we ask the questions rather than guiding the conversation. So Dave, I'm curious when you built this schedule out, did you kind of do a rough draft and then take it to the team and ask them of what they thought? Or was it, Hey, let's try this out. How did you roll this to the team? Cause I think a lot of doctors worry that they'll, that they'll ruffle some feathers with the team members. So how did you roll this out to your team to get some solid buy -in from it as well? So the way we actually ended up doing this in the first round, it was myself. my previous associate and my office manager sat down and kind of did, you know, the, the two doctor schedules. And it was nice to do that. because I mean, I'm just going to probably be like, I just wanted to do this. And then, you know, they'll have to like reel me into be like that. Just, just probably pretty inappropriate. It's true. Doctors always think that they can get things done so fast. They're like, yeah, I could get that crown done in 30 minutes. And I'm like, I'll be honest, it's going to take you at least 45 minutes. Like, I've watched you for the last five years. Like, I know your schedule, doctor. So it's good to have somebody balance you out that knows a reality check on it as well. So I think that's a thing. You definitely need at least one other person to either look through it, talk through it. I think if you get everybody involved, you get too many cooks in the kitchen, that's generally like pretty unhelpful. there's that to it. But the other things to take into account and everything like that is like, let's say different doctors have different skill sets and everything like that. Well, you kind of have to really take into account like, well, you know, if this doctor is the only one who can do these procedures, we need space for that and this and that. And, you know, if this doctor only does, you know, these types of things, there needs to be more variety in things. The Dental A Team (14:40.702) as a result, you know, I hear a lot of, Dr. Dave, like we, can't get this patient in for a filling with you for XYZ time. And I'm just like, yup. -huh. That's okay. It's just like, it's okay. Like, you know, it's, one of those things. And like, that was a big, yeah, a little, little bit of a tricky situation. We were in a pension the last couple of months where we've been, much more shorthanded, but now that we're trying to grow another schedule again and balance everything out and as our, newer. doctor in the practice is growing her skill set and incorporating more things and it's actually perfect. Totally. And I think you were really wise in saying to one, bring the other associate, if there's another doctor and an office manager, like a front office scheduler, whomever that is in your practice, because you guys then are going to really build a really beautiful puzzle together of where it goes. I remember I had an office and, there were two doctors who could both do root canals. However, logistically speaking, they only had. one set of root canal equipment in the practice. So for us to ever schedule double root canals at the same time, and this was a pretty root canal heavy practice, they had to get really smart of where can we put this to make sure, and same thing like with utilizing a mill. If you only have one mill, you don't want to have two doctors doing two crowns at the same time, because then you're going to get into a mill issue. And so I agree, I think it's just really smart how you guys did that. And then also being able to pivot with your team. I love that you've held the line though of like, Dr. Dave, we don't have a spot to put a filling. Like team members need to realize that it's okay. An ideal schedule for us, priority scheduling for our team does not mean we're doing a disservice to our patients. I have found that when we create chaos for our team, that does not give a good patient experience, nor does it give a good team experience. And so really being okay to say, hey, this doesn't, like we have this spot available for you. versus it being like, let me try and shove a filling in and we're gonna try and make this schedule work. Like schedule should not be work in my opinion, they should flow. Yes, you need to be creative. Yes, you need to look for those puzzle pieces and fill them in. Be proactive, make those extra phone calls. Don't just wait for the patient to show up, like proactively call, look through. Guys, I don't know if you know, but on unscheduled treatment plans, you literally can filter by procedure code. And so you can actually go look like if I know I need a crown, I can sort The Dental A Team (17:04.694) my list of unscheduled treatment and find all the crown patients and contact those patients. Again, I'm looking for a certain puzzle piece. I'm not going to just get any puzzle piece. I want that certain one so I can make those strategic phone calls maximize my time. So Dave, I love that you built this out. I love that you shared and I love that you really prioritized your team and what you guys wanted. And then we're able to fill the patients in. Like I said, like puzzle pieces trying to make a beautiful schedule and it really is doable. It just requires, I think the whole team to be on board and bought in. Otherwise it gets pure mayhem. Like if one person's doing it, but the other person's not in the front office, it gets wild. And so everybody needs to play by, by the rules. And I think there's great success. Any other tips you've got on priority scheduling, Dave, you've shared so much already. thank you. mean, I got, I got a handful. can, we can all right. I think, I think another thing to take into account here, just like with everything else, you got it. You got to take it with a grain of You know, if you have a long established patient who can only come at 8 a and needs a filling, the patient in. Like, know what saying? You got to give your team that flexibility and that leeway and saying like, look, this is this. And just kind of, they give me a heads up of like, it's so -and -so, like we had to do it. like, okay, like it is what it is. Like, you know, change it up, do this. Like, you know, we're going to make it work because at the end of the day, our patients are our priority. You know, as much as like it's great if we can go ahead and word ninja things and shift everybody around and everything like That's not always possible. That's not always, you know, the thing in every practice. I mean, it's, it's, it's nice if we can, we can do it, but you know, there has to be leeway and flexibility. And the only thing I ask of everybody is, okay, just tell me what's up and change the, blocks, shift some stuff around. So things match up. So it's not like, you know, we have like an odd like wall or like, you know, nothing going on. And, know, at the end of the day, depending on where you are in your, your practice life cycle and what's going on sometimes having. blocked out space and time is actually really helpful to help, you know, get emergencies and grow things and stuff like that. So for sure, not always the end of the world. I could use more time sitting at my desk. I know, but then we feel like as team members, our doctor goes to what I call like the black hole, like you guys going to your office. I'm like, then I'll never get you back. but I think it's one of those pieces. Also, I think you brought up a good point. I think so many offices forget to find space for emergencies. cause guess The Dental A Team (19:28.12) there will always be emergencies and emergencies can actually be super great in a schedule. I actually loved emergencies because they're great same day treatment. They're great opportunities. It's great to be able to help patients. And so I think that that's a good piece to actually build into your schedule template of where you actually want these emergencies to go. Guess what guys, when somebody's in pain, they will come wherever you tell them they can come if they're truly in an emergency situation. They do not need your 8 a They do not need your 4 p Like if they are truly in pain, they will show up at whatever time you have. So I think it's very paramount to get those emergencies in there as well because that will throw an entire day for your team if there's not emergency space in that schedule to fill it in. So agreed with you. I don't like long walls, but I definitely like to plan for those emergencies when we would like to see Yeah, I think it's super, super helpful. I think at the end of the day, also something that I've always been a big proponent of, what we consider an emergency appointment in our office is very rarely kind of like, Hey, this is what's going on here. Subscription or let's reschedule. It's kind of, it's really along the lines of if it's something that we can do without, you know, having any type of negative impact on our other patients and the flow of everything else, we're going to do it. I've been big proponent of If the tooth needs to come out and wants to come out, there's no way we're not going to work that in because if you do this for a while, it doesn't take that long. Somebody can understand and be pretty patient and say, hey, I'm going to work in the schedule. I definitely want to help you out. have a lot else going on, but if you can hang out for half an you know, 40 minutes, I got to take care of a couple of the things first. I will get you all set today rather than like, yeah, let's schedule you in, you know, two weeks. And then, you know, by that point, you know, there's still in the schedule, but they saw somebody else and, know, you have, same thing with, with, know, a crown if you can, I mean, why not? Like, you know, prep it, temp it, you know, take your impression, get everything all set, take your scan, you know, make the crown, whatever you do in your office. Like if you can work it in the schedule, if somebody's patient, The Dental A Team (21:32.45) Like why not get that done the same day? think that's doing that is what, you know, I feel like really built our practice in the first couple of years that I was here. I love doing stuff like that. I love trying to help somebody out the same day. People really appreciate it. And that's what's really going to build goodwill. Exactly. That's, that's raving fans right there. Yeah. Yeah. I love same day treatment, same day treatment. I heard a quote once I said, what's the most productive chair in a practice. And it was an empty chair. because that's the chair that you can flip. Like don't prefer to have my schedule have empty chairs. But let's be honest, like that same day treatment is always very, very, very beneficial for patients. Like I feel like that's a VIP customer service that we can offer. And so I love that you've built a culture of a team that if we can do it, we will say yes. And we're always looking for how we can say yes versus how we can't say yes. I know I've shared this with so many practices There's the I just say with same day treatment, it's all about timing. You've got to be really quick and we've got to be able to say yes, because a window is only so big and it only lasts for so long with same day treatment opportunities. So being proactive and like let's say yes sooner than later, because honestly, if I can have the patient say yes and have the financials done while Dr. Dave's in the chair with me, he can get the patient numb that can move along a lot quicker. I can be taking all of my prelim work and with crowns, I think it's also important especially for same day, you don't have to do A to Z the entire way. Like you don't have to complete the crown if we don't have time. Like you said, you could temp a crown and bring them back and you can mill it and seed it. If you've got time to mill it and seed same day, fantastic. But I think especially with those same day emergencies, like say yes, but realize we can do, we don't have to do the entire process. We can still get them out of pain as other alternatives to being able to say yes. I know we did same day crowns all the time. but I also had very minimal chairs and we were always like very packed with all those chairs. So instead of like taking up a huge chunk of time while that crown was milling, we would tempt them sometimes and send them out and bring them back for a crown seat on a day where I had space for that. It wasn't my preferred, but that was a way we were able to help a lot more patients within the confines of our practice. We only had five chairs. I was running three doctor chairs and they were all jam packed cause I had Eddas. The Dental A Team (23:55.246) It's like little mini dentists all the time. So I was literally implant, implant crown. So there wasn't a lot of space on chair time because I had another surgery coming right after, but there's still like, wanted to paint that picture because no matter what your practice is, you can still say yes to same day and train your team to say yes and say it quickly. That way you guys can help more patients same day. Yeah. So, so, so a couple of things with that. Yeah. If you can expand your facility to be able to accommodate things, one, it makes things very easy and stuff like that. Like I don't, I don't, I won't, almost never make temporaries because of that, because we have an extra chair and stuff like that. the crazy thing with that is, you know, you're going to spend a lot of money on doing things. You're going to be like me who, has, you know, walls being knocked down and your office is a dust storm and has to have to stand in your attic to do a podcast. War zone right now. But, know, I'm a little nuts. I think it's worth it. You know, that's all part of it. I think the other thing that, you know, I really want to make sure that we clarify is don't say yes if you can't say yes. Like don't make it a not good experience for, you know, your other patients, respect everybody. Don't rush yourself. You know, do what you can do within the confines of things. It's just my philosophies of, you know, let's try and make it work if we can to try and help somebody out within reason. Hello, Dental A Team listeners. What would it take for you guys to just completely and utterly change your practice? Like truly, if you think about it, because for me, I know oftentimes it's just having somebody right by my side, pushing me along, holding me accountable, having somebody to spin ideas off of. And honestly, that's all it takes most of the time for us to go from good to great. Usually it's taking the knowledge that we learn and actually executing That's why I would love to invite you to join our Platinum Virtual, where we do a coaching call, a Zoom team training. We invite you to our community and we just really dive deep with you. We're that partner right by you to help you go from good to great. So if you're wanting to join, take your practice to the next level and you know it's time for you to implement, execute, and go to that next level, email us [email protected]. And I would be so excited to welcome you as our newest Platinum Virtual member. Can't wait to see you there. The Dental A Team (26:15.636) Agreed and thank you for that clarifying because the worst thing that I see is people are like, okay, we're going to say yes to same day treatment, but that ends up messing up the schedule for all the other patients that were scheduled that were coming that came on time. And that also is not VIP care. So you're right. It's kind of this nice healthy balance. but I have found that team members who are, are quicker team members that have the philosophy of, will say yes as often as possible within reason. they just think quicker. Like I know we could have a crown prep set up within like less than like two, two ish minutes. Like I was like, doc, numb, I'll have this whole room set up for you and come right back. And so I think it's that mindset of, know I need to move quick cause I don't want to throw the rest of my schedule off. But like you said, never, ever, ever compromising care. Cause I think some people can get caught up in that and then dentistry is not as good. And that, doesn't actually serve the patient longterm either. You want to talk about the other side of priority scheduling? Yes, I do. Take it away, Dave. Hygiene. Yes. All So this is something you probably have a better scope and handle on me. I'm pretty sure you guys were the ones who a long time ago started kind of pushing me more towards the lines of make sure that you put blocks in for new patients and You know, you could do separate blocks. You could do the same kind of blocks. You just need space to be able to help somebody. The worst thing in the world is like, hey, you have this crazy disease, but guess what? We'll see in three months to try and address the situation. Super important, right? It great. It makes me laugh every time. Every time. Like, man, you've got this like terrible disease. We've got to take care of it. I can't see you for six months. Cool. All right. I mean, it sounds real serious. Yeah. Yeah. Like we just told somebody their teeth are going to fall out of their head. and we can't see them for a while. Wonderful. No, it does not go well ever. Yeah. So I think that's one big thing. I think that is one of the handful of things that really helped us grow as far as being able to get more new patients was actually being able to see them and fit them in the schedule rather than kind of like we have this jam -packed hygiene schedule of one prophy after the other. You know, it helps create variety, helps mix things up, it helps grow things in your office. The Dental A Team (28:32.398) last couple of months of kind of not having those spaces have really helped me realize, you know, yeah, you can go from seeing on average 50 new patients a month to 20 when you don't have any space to put anybody and you don't have the providers to see them. it sucks for sure. I think that that's people always ask me that, Kiera, how many new patient spots do I hold? And I say, go look at your schedule, see how many new patients you've got. And you've got to, as a minimum, have that many spaces in your that are held for these new patients to come through because they will keep calling. And new patients, if you don't have space, they might wait for you, but they also might go somewhere else, depending upon the dynamics around your practice. If you're in a busy area that's got lots of dentists, they're probably not going to wait that month or two to come see you. And so I agree. I typically say, guys, build it out, however many spaces you need for new patients. Let's get that And then also get creative because I know there's some people who listen and they think, well, new patients should go in the doctor's schedule. And there's other people that think new patients should go in the hygiene schedule. And what I will say is both ways work great. They both can. I would say if you don't have any new patient spaces in your hygiene schedule, but you did block them, like I'm going to give you this caveat. If you're not blocking them, start blocking first. But if you are, sometimes some doctors will have those new patients come through on the doctor's side, make it a shorter appointment and have that hygienist come in and. you can swap it out while they're doing an exam. But that way you can still see those patients on the doctor side for a much shorter appointment and just let them. I think some good verbiage on that is like hey, Doctor Dave loves his new patients so much and he wants to make sure he sees you. So we're going to get you in on his schedule and something opens up for you to get a cleaning same day. Fantastic, but we want to make sure we get you in that way. Doctor Dave can see you find out what kind of cleaning you need and that's a great way if you have that. But then next block more spaces and people say, Kiera, we're booked out for six months, hygiene's booked out for six months. And I literally tell you guys, start putting blocks in today. There is space where patients have fallen off and start holding all of those spots as they do fall off for new patients to come through and then get those blocks in for six months. as you are scheduling out the next six months, you're making your life better in the future than not. So Dave, how do you guys do it? Do you hold it only for new patients or do you do new patients and SRPs? What's kind of been your magic? The Dental A Team (30:53.208) formula you've found in your practice? I can't say that we have the magic here. It's a work in progress. I think we've kind of just been doing longer blocks to accommodate for both. I think something that I've been toying with more so lately to kind of get to your other point of like, you put them in the doctor's schedule, the hygiene schedule, stuff like that? If we're doing a good job, in the front office and really asking the right questions. And once again, that goes with a grain of salt because my front office team does do a good job and they do ask the right questions, but sometimes, you know, the patients will tell us something that's insane and doesn't really match. But the point I'm trying to get to here is like, if somebody hasn't been in like 10 years and they're in their, you know, forties, fifties, and they, you know, they're giving you signs that very likely it's, you know, a potential train wreck, probably not gonna do the hygiene visit that day anyway. But if you have an hour in hygiene and said to that hour and a half, like why not just go ahead and help them form that relationship with the hygienist and say, know, we're going to go ahead. It sounds like there may be a lot going on. We're going to get you in. We're going to take a full set of records. The doctor's going to come in and you know, you guys are going to work through kind of putting the plan together and we're going to go ahead and go from there. But you know, with the, with what it sounds like, you know, your situation is we really want to make sure that we, take a pause here. We take a second, we make sure we evaluate everything well and then go from there. Now, mean, they very well, their periodontal status could be perfectly fine. It happens, you know, where that's the situation. But, you know, at the end of the day, it's not something where somebody is expecting like, my God, I'm gonna go ahead and do that. Most patients who haven't been in 10 years, they know they haven't been in 10 years. They expect things to be a little bit of a mess. Sometimes, they're perfectly fine, you that happens, but at least, you know, it wasn't something where their expectation was like, my God, I was going to get everything done. And like, this is all you guys did. Right. And I think, like you said, the biggest piece I hope everybody's taking from here is it's all about how you say things and you manage people's expectations. And so I think it's really important to, help them realize like, we're going to take great care of you. we're going to do a great, thorough exam on you and we're going to come up with a game plan together. And I would say to the hygienist. The Dental A Team (33:16.334) I know that sometimes patients come through that we think are going to be perio and I know it's not the most ideal timeframe where you're like, I only have 45 minutes and I really need an hour and a half. What I would say that I've seen with lots of other hygienists and Brittany and Dana both would attest to this, they're both hygienists. I think hygienists back to our same day treatment, let's see what you could do. Is there a zone that you could do? Could you do a debridement? Could you do maybe just one quad? Could and start looking for those things and seeing how could you say yes to help this patient? Because at the end of the day, you have 45 minutes. And if we send them away and try and get them scheduled back, yes, that can happen. But at the same time, could you maximize their time and your chair time to help that patient out, at least in a small way? Now get it. I understand insurance is crazy. And you're going to give me all these other reasons that things can't work. I will tell you that there are a lot of opportunities that we could do. So look to see what could you do during that time frame. And is there a way that you you can help this patient out so you're maximizing their time and your time as well. Yeah, think you bring up some really great points and some things that more so recently we've been thinking about and pivoting towards. It used to be like a big waste of time, honestly, in our hygiene schedule. Like we have an hour and a half hygiene appointment, they need scaling or root planning. let's set this up. Like, are they gonna come back? When's it gonna be? Rather than, hey, you know, this is what the situation is at this point, the patient is as bought into it. I'm most concerned about this section over here. Let's go ahead and let's get you started at least here. Let's get things moving in the right direction and let's get you set up, you know, in two weeks to go ahead and go ahead and do these two areas. And then we'll finish off with, with this one rather than just kind of like waiting and hoping, I got to do like one half now and run half the other day. Like, let's say it's going to be, you know, two to three visits, like let's show them like, Hey, that this area is that's worse. We're going to focus on just that by itself. mean, I don't, you know, I think if you explain things in the appropriate way, that builds a lot more value than kind of like somebody not coming, you know, somebody coming back one more time, like, great, they're still investing the same amount, but it shows that you're investing more in them in a sense, because you're going to potentially, you know, spend extra time. For sure. And I think that that's just the piece of like, I guess you said that they have an hour and a half, but they need quads of The Dental A Team (35:36.11) Just do something. You have the time, so please do something. And I know you're going to say, but Kiera, insurance only covers this. Guys, I want to put out a really big piece. Like most periopatients have more going on than just SRPs. So odds are they're probably going to max their insurance anyway. I'm 99 .9 % sure that almost every single periopatient has more going on. And at the same time, I'm going to work with that patient financially to make sure that it actually works and we do maximize their benefits. But please, Like don't waste an hour of that patient's time in your chair time because we're so concerned about insurance. Like there are a thousand ways that we can work around that. Because at the end of the day, like let's not let insurance dictate what we do for our patient. Let's make sure we're taking great care of our patients as well. So I love it, Dave. I'm glad you and I are on the same page. If you guys could have seen my face when he said, I don't have to have, I was like, my gosh, like don't even say that. Find the way to say yes, because like you said, You just told this patient they have ferio disease and you have some time that you could start in an area like let's take care of them and let's see how we could say yes versus not, especially where hygiene is booked out so far. Hygienists are hard to find. We would love to have an ideal schedule, but it's like how could we maximize the hygienist time and the patient's time today without compromising care? So it's always with the caveat of like let's not compromise care, but could we say yes in some of these areas? And I think if we really were all honest with ourselves. we could say yes more often than we probably do and we can help our patients. That's at least my thoughts. I think that's the big thing too. I think, you know, we, a lot of times we'll make a lot of excuses in situations and sometimes they're valid, sometimes they're not. I think really at the end of the day, everybody being on the same page in the sense of kind of what is best for the patient, how we want to do things and what our philosophies and mentalities are about, you know, patient treatment and care. And, you know, at end of the day, this also takes the right team members. If somebody wants to just kind of be there, punch the clock, mail it in and gets annoyed that like, my God, like, you know, just do the other two sealants, you still have half an hour, like don't bring them back and kill time and schedule. That's not the right team member. And sometimes that's hard. The Dental A Team (37:58.482) know, sealants, floor, like those are all opportunities that taking impressions or scans for night guards, like taking scans for ortho. Like there are so many ways that we could maximize that hour. And I will say, hygienist, I will go to bat for you all day long to protect your hour appointment. With that said, I will also go to bat that hygienist. You do maximize that hour and you are productive with that hour as well. You look for opportunities that you can do same day as often as possible. And I agree with you, Dave, I think it's important. to have the right team members. So I'm curious from your stance, like you've hired a lot of people, you've transitioned a lot of people. How do you, I mean, you're hiring new people now. What are some tips that you've found to possibly like set the tone that this is our culture, this is what we do to find these people that are like, yes, like drivers, gunners, like I am totally going to say yes. Any tips you've got on how to find those people and create that culture? I wish I had like a real good answer for you because I mean, I could use that knowledge and so every other. you know, office owner in the entire country. I mean, I think, I think it's really, it's, very difficult right now. It's always difficult in general, honestly. I think, you know, as I kind of do some soul searching on the, topic here and really kind of, you know, really kind of dive into it there, just being very upfront about kind of what your practice is, what your expectations are, and really kind weighing it all out there, not being afraid. Like, my God, am I going to scare this person? Because at the end of the day, if they come in with the preconceived notion of like, hey, this is going to be like this, and then like they see, yeah, shit, this is like very intense. I've been trying, I've tried the last five episodes, not to swear. Like biggest like potty mouth ever. I'm impressed. mean, was the editor some work to do here. No, it's because we're talking about team and the frustration of team. It just comes out. I get it. I've definitely - I might have said a word or two myself. You're already. That's the thing. You can ask Tip how much I swear when I talk to her. This is like every other word is something there. Anyway, not to get sidetracked. I mean, I think it's a matter of really setting the tone and the expectation of, this is how we are. This is our practice. Because at the end of the day, we've always been able to find pretty good people based on how they interact with each other and what our culture is like and everything like that. But if somebody doesn't want to really The Dental A Team (40:21.186) work and really get everything going and stuff like that. It's, well, you know, at the end of the day, we're, buying time until it's going to transition out. Totally. Cause for us, it's really important to, to work hard, to grow, to learn, to spend the time doing training, to sit through all the meetings that we do, to, try and really, you know, work on, work on you as a person and a part of the team. But if somebody just kind of says like, my God, this is amazing for a year. And then it's kind wreaking havoc and punching the clock for another year, that actually had more of a negative impact than a positive. Well, for sure, because it sets the tone to the team that everybody else can do this. I remember another fantastic quote, guys. I'm not quoting all over here, but I don't know who says it. So go find out who said this. This was not me. But they said, the worst thing that a manager or a leader could do to good team members. So the worst thing we can do to good team members is tolerate poor performance from another team member. Because what it does is it just tells those great team members like hey, we actually don't care We're going to allow this other team member just to be a punch like a clock puncher where I expect you to stay super like proactive so I think when I I Heard that I thought as a manager like that is my job I need to make sure all of my team members are at the same level understanding that everybody has their own levels as well But I agree with you Dave. I think that that's the biggest thing I found I remember when I was hiring and we late hours. I used to try and like sugarcoat it and I'd be like, yeah, so like maybe. And what I realized is they came in expecting not to work these evening hours. Then all my team that was there that was working evening hours were livid. That new person hired gets off at five o 'clock and they're here till seven or seven thirty. And so I just found like, just throw your dirty laundry out there. But I don't think culture is dirty laundry. I think that's a hey, it's kind of like dating. And I'm like, hey, this is who I am and I'm not going to sugarcoat who I does this vibe and jive with you? And if it doesn't, like high five, you're gonna find somewhere that does vibe and jive with you. But we're an office that is like super passionate about growing ourselves. We're an office that says yes to same day treatment all the time. We're the office that busts our buns all day long and we love it we get a freaking high on it and we all wish we could wear roller skates so we could actually see more patients. Like does that lifestyle work for you? And then also give me an example of how you've done this at your past practice. And The Dental A Team (42:42.808) quick things that are going to put them on the spot. As I found like rogue questions, people have, they've got answers for you, but I'll ask them on the spot. Like one of my favorite questions is, what's the worst thing anybody would say about you at your last practice and why? And people are like, but they have to give me an answer right then and there. And I'm going to find out also a trick question is what's your biggest pet peeve of other team members and what they tell is what they are because we only see in other people who we are. So that's kind of anything. If people say, I can't stand lazy team members, odds are this person's probably going to be a lazy team member. Not all the time. It's not like a fail proof question. But some of those things I think can really help. But like you said, Dave, I think it's so paramount to say this is who our team is. Also have your team members interview them and see what they think. because when a person comes in and they see the whole team is jiving, the whole team does same day treatment, the whole team is this way. One, they're either going to level up and rise to that occasion or two, they'll be like, this is not what I want to do. And that's okay. Let them find their dream job and you find your dream employee as well. I that's, I think that's a big part of it. I think another thing is, you look at the end of the day, I am a lot of the personality of my office and it took me maybe a long time to understand that and be okay with saying that and just be like, no big deal, but that's it. So if they are not really okay with how intense and passionate I am about certain things and this and that, and they're gonna not be happy with like, okay, we need to do this. That's just not gonna work, sorry. And we kind of fool ourselves and we kind of buy time because we worry about like, what are we going to do? Like being shorthanded, but I mean, been shorthanded for like three years now. mean, it's always that fear of the unknown, but I'm like, guys, we've actually been in the unknown. You just forgot that you've lived there for quite a while. Like it's totally fine. Don't stress. I love that you just said that Dave, cause I think so many doctors, so many managers, I'm like, know thyself and be free and don't be afraid of it because guess what? They're going to see your true colors. The Dental A Team (44:50.654) They're going to see what it's like and I'd much rather present exactly how I am I tell people I'm like do you want to work with me? I'm a pretty intense boss I have the highest standards you will ever come across and I don't sugarcoat if that doesn't jive and vibe with you It's cool. Let's high five and move on because that's what I will expect of you and then Don't be afraid and I say this because I just had to do it myself Don't be afraid that if people aren't performing to the level you want and you can see they're writing on the wall it's time to have that conversation sooner than later and don't be afraid of what your team will do. Cause I promise you, your team will like, they'll rise up, they'll figure it out. They'll pivot with you if they're the right team members, but don't, don't hold onto team members longer than you know, should. Yeah. think another thing also is, know, as things have changed and, now we're there, there are people who are coming into dentistry who don't really know much about dentistry or what it is. I found probably most helpful in one of our most recent hires, which is our new assistant who assists me, who's been with us for the last two months. Before she even came in for an interview, I spent about half an hour on the phone trying to tell her how bad of a job being a dental assistant is. And really just kind of saying, look, at the end of the day, it is very difficult work. You may feel underappreciated because it's so and days are hard and what we do is sometimes thankless. And you know, there's a lot that goes into that. I need you to understand that before you even walk in the door. If you're not going to be okay with that, it doesn't mean that I don't appreciate you. doesn't mean our patients don't appreciate you. That is just what happens. Right. So if somebody's not going to be okay with that, then like, this is not like a new career path to try and like hop into. I think if somebody understands that and they they're passionate about things they want to learn they want to go they want to create a new thing great let's do it I will teach you more here than you'll learn anywhere else. Which I think is brilliant and it's funny because Liz she is my coach and she actually interviews all of our consultants and Liz and I are a good duo I like people to like me and Liz is more direct because she has no skin in the game and she knows the skin in the game is my happiness and stress level. The Dental A Team (47:03.534) And Liz will literally talk to consultants and tell them the worst terrible experiences. She's like, are you OK to be on the road 80 % of the time away from your family? That means four out of the five days. Are you like? How do you feel getting stuck in an airport having to spend the night? Your flights are canceled because of weather and you can't get to your office like you don't eat for three days and I'm like, Liz, don't make and she's like no Kiera. I'd rather make this sound so awful and see if they're still willing to have that grit to come back. She's like because at the end of the day. A consultant has to have grit. They have to have pivot. They have to have that stamina. And I'd much rather have it be like the most like horrifying interview. And if they're like, yep, no problem. Like Britt, Britt, haven't met her yet, Dave, but Britt is somebody like, it's fine. I actually ended up getting stuck in another country because my friend had appendicitis. Like I'm totally good. And I'm like, that's even like more than I've got in my travel, travel life. She's like, I'm totally good. So I think it's important, like you said, really lay it out of not the best highlight reel. of the job, but the worst highlight reel and see if they still want the job because expectations are clear. It's hard in general. It's hard for anybody to get behind when it's kind of been just hard to find people, you know, but I think I do have a good feeling that things are starting to turn. I do feel like there's a lot more people out there who are looking for jobs now and a lot more wonderful people. feel much more positive about it than I haven't in a long time here. So I think it's a good for everybody to be okay with sacking up a little bit more and feeling okay with that and being more straightforward about that. I think it's a hard thing for anybody to do in life in general. It's not really my personality, but I think it's important to go ahead and do that for the greater good there. For sure. Again, this quote, I do know this was from Keith Cunningham and he said, as a CEO, do your job. And that has like hit me like a knife because while Dave, yes, that is not fun. It's not a fun conversation for anyone to have as a CEO, as an owner, as an office manager, people that are interviewing that are hiring. It is your job to make sure you hire and hire really well. So yes, it's an uncomfortable conversation, but that uncomfortable conversation is going to weed out a ton of people that wouldn't have lasted anyway. And I don't like to band -aid approach of like, let's just get somebody in and have a body versus it being. The Dental A Team (49:27.246) No, I want somebody who's here with me for the next five years and they're going to like go through the highs and the lows and they're going to be awesome. So I think you've just like pivoted on so many fun ideas, Dave of like number one, the priority scheduling guys. So building that schedule out with doctor, office manager, associate, making sure that you guys build an ideal schedule and then having kind of the parameters for your front office of how often do we hold these blocks and when we need to do a pivot change, for example, that 8 a patient who needs those filling times at 8 a to be able to shift those blocks around and really viewing the schedule like a puzzle and we're trying to fit perfect puzzle pieces and realizing we're ninja it, love the patient. Then going into same day treatment and how you're able to do that, let's say yes more often and look for that. Then going into hygiene and holding those hygiene new patient blocks. So get those new patient and SRP blocks in there. Let's make sure we have space to get that perio and also having the mindset Hey, if I can do this, let's do it today. Let me find ways that I could say yes to maximize this patient's time in my chair time. And then moving all the way into making sure you have the right team that has that same mindset with you. And yes, culture shifts are not easy. You might today be like, I want to have the practice like Dave, but I'm not there. Dave, I know you would attest to this. Dave's not there. You didn't start here though. not there. You didn't start there. Dave's not there yet. It's a work in progress. And I love I always feel like I listen to podcasts a lot of time, like, my God, this person has to figure out. No, that's not the thing. Like, you know, I'll give you bits and pieces. There's a lot of stuff that is not good. But the point is, if I shared that, like as the only things we shared, this would be a very like depressing podcast. At the end of the day, you know, you want to go ahead and like share what to aspire for, what's worked out well. knowing like, look, at end of the day, there's it's hard for Like, and there's a lot more that goes into things. And you know, you could sit here and you could listen to Kiera and myself for the last 40 minutes or whatever and think like, my God, like, you know, be able to all figure it out. No, nobody does. No, they don't. Don't try and get better. Exactly. And that's what I was trying to paint the picture of Dave didn't start here three years ago. This has been a work in progress the whole time. And what I would hope is you guys at least start somewhere today, start making your tomorrow's better by some of these tips that we have. I don't care what you choose to implement. I don't care how you choose to implement. The Dental A Team (51:44.61) I don't care if you choose to implement this quarter or if you put it off to the next quarter, but I just would say make sure you have it scheduled with yourself, make your practice better and do something. Because every day, like Dave said, it's a work in progress every day, but let's make sure we're progressing towards where we want to go rather than just staying stagnant, which is ultimately going backwards. So Dave, I love your mind. I love that you are a dentist, that you'll share these things. I love that as dentists are willing to put in the hard work and actually show up and do your job. I think it's very inspiring and I love having on the podcast. You inspire me. So thank you, Dave, as always. I just truly appreciate you. Thank you. I appreciate you a lot too. This has been wonderful. Awesome. All right, guys. Well, I encourage each of you to take something today, go implement it, make your tomorrow a better, better than it is today. And as always, thanks for listening and I'll catch you next time on the Dental A Team Podcast. The Dental A Team (52:37.582) That wraps it up for another episode of the Dental A Team Podcast. Thank you so much for listening and we'll talk to you next time.
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