Dr. John Meis: Alright, hey everybody! Welcome to this edition of The Strategic Thinker from Spark Dental Network, I’m Dr. John Meis and I’m here with the brilliant Heather Driscoll. How are you doing, Heather?
Heather Driscoll: I’m doing great Dr. John, how about yourself?
Dr. John Meis: I’m doing fantastic. We had been predicting, with the Covid experience that our practices have had, that after the shutdown we’d see this big ramp up of demand, which we’ve seen that, most practices hitting records. But, we also predicted that there was going to be a drop-off. Number one, because of the general economy, the stopping of the federal unemployment very rich benefits. And the second thing is that we’ve got a black hole in October, don’t we?
Heather Driscoll: We certainly do. So, you’re exactly right, we’re seeing exactly what everyone in some ways hoped for, which was this increase in patient flow. And, that seems to really be projected to carry us through the month of September. And, then a big black hole in October. So, certainly we’re getting a lot of requests to kind of help now, to be a bit more intentional and proactive, to hopefully salvage the month of October really before it’s too late and they’re just really looking back on skimming by, quite frankly.
Dr. John Meis: So, people know that there’s this hygiene appointment deficit in October, but I’m not sure that everybody really understands what the ongoing effect of that is. So, we know that 70% of restorative care comes out of recall hygiene. If recall hygiene’s down, doctor production is going to be down. And, maybe that doctor production is in October, maybe it’s lagged a bit and is in November, but most likely it’s going to be both.
Heather Driscoll: Absolutely. And, I think people also are thinking, “Okay, let’s just prepare for maybe a bit of down October.” But, if we don’t fix October, six months from October is April, and this just will continue to perpetuate itself if we’re not careful.
Dr. John Meis: Yep, round and round we go. April will be recovered some because of new patient flow and what not, and the way we schedule, but it’ll continue to reverberate until it’s fixed. And, far better to fix it now. And, when I say “now”, I mean like right now. We’ve only got, what, 20 days until we’re in October and this mess starts to show up in our schedules? So Heather, I know you put together some thoughts on some of the creative things that we’re doing in our own practices and the creative things that we’ve seen other practices do, as well as just how to think about this, and how to measure it, and how to engage your teams and motivate your teams to start really going all out to make sure that we tackle this in the best way that we can.
Heather Driscoll: You’re exactly right. So, I’ll just maybe take a minute to throw up a few slides to help guide our conversation. We’ve kind of lovingly nicknamed October the “Covid Crunch” because that’s really kind of what it feels like. We’re being crunched a bit to not just manage what’s a bit of an abundance of patients right now, but to really start preparing for that drop off. And so, we all know how we got here, right? We had the ADA recommendations back in the middle of March where most practices switched to emergency care only, which led to pretty much practice shutdowns from 4 weeks to 8 weeks. And, depending on where you’re located in the country, some of our clients even longer. So 6 months from March and April equal September and October, which really is cutting into our hygiene flow, which to your point Dr. John, is ultimately where on average about 70% of all restorative care comes from. So, it’s certainly a crunch.
Dr. John Meis: This is our profitability formula, and these little circles and the designations in there are... I first saw this from a presentation from the president of Dental Intel, and it’s really talking about how our profit done by visits x production per visit x collections percentage - overhead = profit. And so, anything that affects any one of these things can affect profit, right? So, if we have one that’s going to be hurt, we want to make sure it hurts as least as possible. And, if we are going to get hurt, what can we do on the others to compensate so that we don’t have a drop in profitability. Underneath each of these circles are our strategies on how we affect those things. And so, on this version there’s 23 different strategies, and so this really falls into what’s going to happen right? Because we’re going to see a decrease in hygiene visits, so that’s going to affect that column. Our production per visit for the office as a whole is going to be reduced because our restorative is going to look different. So, there are a couple different ways that we can go about making sure that we manage our demand with our overhead so that we maintain profitability to the degree that we can.
Heather Driscoll: Right. And so, what we hear people saying is, “Oh now’s the time to get really creative and start thinking out of the box.” And, quite frankly, I’m saying, “No, get in the box and stay there.” (Laughs) Not that I think we can’t get a little bit creative about our strategies, but I think now is the time to just go back to what’s tried and true. And, one of the best ways to do that is to take an assessment of your current state. So, for some people, they’re gauging October just by a visual reflection. You know, they might flip through the days of the week and they kind of go, “Oh yeah, it kind of looks emptier than normal.” They may or may not really have the data they need to really, true understand what performance is going to look like. And so, we’re really just advocating for people to take the pulse of your organization, do an assessment of the current state of what’s scheduled. So back to that practice success formula, the first element being the need for visits, people in the chair. So, one of the things we’re doing in our practice is just really reassessing. How many visits were see in hygiene in October of 2019 and how many visits do we have scheduled in October of 2020? You can see in this example a pretty significant deficit. So, knowing that if nothing is done to improve what’s scheduled, the outcome is going to be pretty bleak, quite frankly.
Dr. John Meis: And, in all but one of our practices, we’ve expanded capacity, so we really should be looking at what was scheduled last year... what’s the increase in capacity? So, the goal isn’t necessarily what you did last year, it may be more, it should be more,. There should be growth in every practice. But, as a minimum, you should be shooting for what you did last year.
Heather Driscoll: Absolutely. So, one of the things we’re doing is really just keeping a continued focus on the progress our practices are making. And so, again just a real quick easy report letting them know where we’re at for September as far as visits, where we’re at for October, because I don’t think it should come as any surprise to people on October 1st as to whether or not we’re feeling good about what the month’s going to look like. Depending on the traction we’re able to make in the next couple of weeks, that will dictate some of the other strategies we have to put in place, which we’ll touch on here in just a moment as well. And, to your point, depending on what your practice looks like from a capacity standpoint, the goal may not be just to beat last year’s number of visits, if you’ve added providers, provider days, extended hours, whatever the case might be, additional operatories, you may actually need to revisit what that goal should be for number of visits.
Dr. John Meis: So, really some of the wisest of practice managers are covering that number... what’s that deficit today?... in their morning huddle. So, the entire team knows where it is, and can make a sense of making progress.
Heather Driscoll: Absolutely. Because realistically, if we don’t have patients, this isn’t just a hygiene problem. This isn’t just, “Oh well gosh, the hygienists are going to have to take a few days off.” This ultimately really impacts the entire organization, so it does need to be an “all hands on deck” kind of effort. And, one of the ways to really get that started is just to ask yourself some really important questions. So, a few of the things that we’ve been asking ourselves is just what we touched on. Do you know where you currently sit with your patient visits, which really starts the progress of everything else? Productivity per visit, your collections percentage, your ability to manage overhead, all of those kinds of things, so what’s the current state of your outlook for October? It’s really where everybody should be starting. How about the next one, Dr. John?
Dr. John Meis: Yeah, you know we talk about this until we’re blue in the face with our clients and our own practices, and that is “how easy can we make it for patients to schedule?” Meaning, do we have a lot of rules that keep patients out? “Oh, we can only do this on Tuesdays and Thursdays. And, we can’t do this until we do this.” Are you having a bunch of hoops for patients to jump through in order for them to get on the schedule. And the other thing is... are you using all the technology that’s available? There’s now real working, live scheduling in your schedule that can be done online with a smart phone. And, that is the key to ease, just taking it up another notch. So, everything you can do to make it easy is going to make a difference on how well you’re going to be able to fill up October.
Heather Driscoll: Definitely. And, we all know that an hour is not an hour is not an hour, right? All hours aren’t created equal. And so, especially now when people are potentially getting back to work and kids are getting back to school, may or may not be in person. The ability to have an adequate amount of convenient appointment times is really going to be key. After having been furloughed or sheltering in place for months, people are really unlikely to be asking for extra time off from their employers or taking their kids out of school. And so, you may not normally be working multiple late nights or multiple early mornings or Fridays or Saturdays, but we would just challenge you to reconsider that strategy, especially during the month of October.
Dr. John Meis: Absolutely. The next is we typically recommend that everyone send out a “use it or lose it” type marketing letter to all their patients letting them know that they have insurance benefits left, that they’re going to lose those benefits at the end of the year. There’s no reason you can’t start that early, right? Because you have many patients in your database that are due now and can come in now and this is just one more thing to tip them over the edge to get them in, so you might as well use the “use it or lose it” letter now.
Heather Driscoll: Right. And there’s so many different platforms that really help our practices gather these lists of patients who have benefits available, who have benefits that allow for cleanings twice a year as opposed to every 6 months, you have perio maintenance patients, you have your own in-office wellness plans and discount plans which have no frequency limitations. So, there’s this whole pool of patients just waiting to be communicated with in hopes of ending up as a scheduled appointment, it’s just really dependent upon us to tap into that great resource. Alright, the next one... flexibility in staffing. So, the investment in our people, certainly the biggest expense in a dental practice, and I use the word “expense” a little bit loosely, because I don’t usually look at people as an expense unless their presence doesn’t result in something that ultimately leads to productivity. So, having a plan in place for some elements of flexibility really starts to make sense. And, Dr. John I know you’ve been talking to some of our Spark members about the need to start this conversation now. So, do you want to touch on some of those discussions you’re having?
Dr. John Meis: Yeah, so in industries other than dentistry, occasional workforce reductions are extremely common. In some industries, they happen several times a year. In dentistry, because our flow is so consistent we don’t really face this very often. And so, our staff doesn’t really have the experience of going through a workforce reduction, and so they don’t really understand, they may be looking at this deficit in number of hygiene appointments and say, “Oh that’s no big deal. Well, we’ll just have a little more time to get some Starbucks and we’ll sit around and we’ll get to those things that we haven’t gotten to.” That may be their mindsets. So, I think having the discussion of workforce reduction ahead of time... that’s not your goal, your goal is to get everybody focused on making sure that you are getting those appointments made so that you have a full and busy October. That’s the goal. And, I know you can just take extra days off, and that maybe reduces some of the cost, but that also reduces some of the profitability. So, our goal is to do that, and if we talk about this then people start to understand how it’s going to affect them. You know, we all listen to the same radio station, “What’s in it for me?” You know, WIIFM? So, if we can talk in a way that our teams understand as a business, “You know, this is what may be necessary in October, but if we do a good job now, if we do a good job in the next 21 days, this may not be necessary, and I don’t want it to be necessary. If we have to do this, it’s because we either didn’t do it well, or it just didn’t happen.” But, I’ve seen in our own practices, and I’ve seen in the practices that have been focusing on this for a couple weeks, that deficit is shrinking rapidly. And so, I think that it’s possible to eliminate that deficit, but not without your team on board, not without their buy in, not without their effort and their passion.
Heather Driscoll: Absolutely, and if you’re having these conversations, if one of the strategies really is to be a bit more flexible with the hours of operations and the times you’re seeing patients, your team’s much more likely to be committed to picking up another late night, or working on a Friday if they don’t normally if they understand what the potential alternative might be. So, I appreciate your reiteration of the fact that the goal isn’t to eliminate or cut hours, the goal is to create an October that really requires everybody to be there, all hands on deck, taking really great care of our patients.
Dr. John Meis: Yeah, my hope is that everybody has a record month in October, but it’s not going to happen by itself. It’s going to take effort to get there.
Heather Driscoll: Yep, definitely. The other thing is, I don’t know how many times you talk to people and they talk to us about the things that aren’t getting done that they’d like to have get done. And, here we have an opportunity, potentially, if we don’t get to the point where we’ve eliminated that deficit with the number of patient visits, we have an opportunity to maybe tackle some of those bigger projects or initiatives that are really important, but tend to get pushed to the back burner. So, are you prepared with a list of initiatives for your team to work on if there is potential down time? Recognizing again that that investment of people, in their time and in their talents, it may not have an immediate payoff, depending on what the initiative is, but ultimately it’s going to help lead to future improved productivity, or future improved onboarding of new team members, or retention of patients, or whatever it is that the initiative may be, now is a really great time to prioritize some of those things so that if you do have team members available who can do other things, let’s put them to good use.
Dr. John Meis: So, what’s an example of a project or initiative, Heather? What’s your favorite one here?
Heather Driscoll: Oh gosh, my favorite one is the actual documentation of onboarding a new team member. If I had a dollar for every time someone said, “Oh, I really need to put together a few checklists or a manual to make it a bit easier to onboard new team members, that would be really great.” Especially with the practices we work with, they’re in growth mindset almost all the time, so whether that’s the addition of people or providers, locations, whatever it might be, there’s always this need to stay ahead of the curve as far as growth goes, and training of team members or the development path of existing team members always at the top of the list, but never enough hours in the day.
Dr. John Meis: Yep, again we think we one mind Heather, that was the #1 that I had on my list. #2 on my list was fixing the absolute front end of the Practice Success Loop, so that is increasing the number of contacts, making sure that you’re answering all your phone calls, and that we improve the conversion rate. That’s the other spot that I see people continue to struggle with just because they don’t take the time to focus on it. And in many practices, that’s a really quick 20-25% bump if you fix that end of the Success Loop. So, that’s another project that’s worth doing.
Heather Driscoll: Yeah, so taking a few minutes to listen to phone calls and see the range of effectiveness from one team member to another as far as answering the phone and converting to appointments, documenting some loose scripts on how to answer the phone, whatever it might be, that’s a really good one. I would support that. And, really the last question we have for all of you is... do you feel confident in the plan you have in place for October? And if any of you are saying, “I don’t have a plan,” it’s not too late, right?
Dr. John Meis: Then you shouldn’t feel confident, right? The answer to that question is no (laughs).
Heather Driscoll: Yes (laughs), your confidence should be a bit lower, absolutely. But, the good news is there’s still time. And for us in our own practices, our plan continues to evolve, quite frankly. Whether it’s continuing to double down on getting those patients on the schedule and the number of visits increased, or really figuring out again: What do our hours of operation need to look like? Do we to borrow team members from one location for another if there’s one in excess and one in a deficit? Really just looking at your overall organization as a whole and really figuring out where the best return on your energy and effort and talents of your team members is going to be for a month that may be a bit of a challenge.
Dr. John Meis: Awesome. Very good.
Heather Driscoll: Alright, so I always feel like we get stuck in dentistry sometimes thinking that a month has happened to us, right? “Oh, October wasn’t very good for us,” right? As opposed to really being a bit more intentional and proactive and kind of taking the lead on making sure that October doesn’t happen to us, but that we determine what October’s going to look like for us. And, I think there’s a lot of opportunity for us to really kind of dictate the path and set the course, and I think we could see some record Octobers for those people who are really getting serious about this.
Dr. John Meis: I think so too, Heather. It’s not going to happen on its own, but it’s certainly within the realm of possibility for those who take this seriously, that put the time and resources necessary to make this happen. So, thanks Heather very much. This is another episode of The Strategic Thinker. And, we’re in this peri-Covid time and a tool that might be helpful for you is our Covid-19 Survival Tool. You can download that here: http://www.sparkdentalnetwork.com/survival Go ahead and download that, it was designed to carry us and help us in our thinking all the way through Covid to when Covid is no longer a concern and no longer something that is affecting our practices. So with that, we’ll say goodbye and we’ll see you on the next episode of The Strategic Thinker.
Heather Driscoll: Thanks, Dr. John!
Dr. John Meis: Thanks Heather.
