Heather Driscoll: Hey everybody, welcome to this week’s session of Spark Strategic Thinker. I’m here with my colleague Drew Schaefer and we have some exciting dentistry decision tree information to share with you today. Hi Drew, how are you doing?

Drew Schaefer: Good, good morning Heather, how are you?

Heather Driscoll: I’m doing great, coming off another strong week of dentistry and excited to talk with you about really one of the conversations we’ve been having about our own practices and whenever we spend a good amount of time putting thought into our own strategy I think it’s beneficial to share it with the rest of the dental world, so how does that sound?

Drew Schaefer: That sounds good.

Heather Driscoll: Alright, well let’s go ahead and get started. So, one of my favorite things about dentistry is really the ability to influence outcomes. Although it doesn’t always seem that way, and oftentimes when we’re talking with our clients I think they don’t feel like it seems that way, but Drew there is a lot more about dentistry that we can control than we can’t control if we just really understand where it’s coming from. So, let’s talk through, first of all, our Enterprise Value Matrix, which really is the foundation for everything. So, if you remember, there are 4 quadrants to our value matrix and today we’re actually going to focus on a couple of them. We’ll talk a little bit about a process that ultimately helps to get financial results. But Drew, before we dive into the dentistry decision tree, anything you would add to our ability to predict performance?

Drew Schaefer: I think the key is using the data that we have at our fingers on a daily basis and knowing that even though there’s things that are out of our control, if we identify those early enough, then we can really adjust our plan with things that we can control to really mitigate any negative effects.

Heather Driscoll: Absolutely. So, one of the things I always appreciate about working so closely with you Drew, not being traditional to dentistry, right, a financial background, is that you really help challenge the way I think about the data that we’re interpreting and our ability to, again, really influence what happens. And so, sometimes you and I will be talking about our practices and how we’re anticipating a month to end or a month to go, but we don’t usually wait until the last day of the month to talk about whether or not it was a good month. We start having these conversations early on because when we can identify the direction our practices are taking early on in the month, well then we’re much more likely to be able to kind of steer them in a specific direction. So, I always love the fact that you remind me that it’s important to have a historical look back, but what’s even more important really is to be able to identify those opportunities in real time so that again we can positively influence our teams to really care for our patients in a little bit different way.

Drew Schaefer: Yeah, and accounting in its purest form, if it’s just a historical look back, it’s just compliance at that point. There’s limited value. It’s using it real time to really meet your budget, your forecast, and so, to your point, we’ll look at things throughout the month, we’ll communicate opportunities that we see throughout the month so that when we’re reporting that history, it’s in line with where we want to be. It’s not just the result of circumstances that were out of our control or we didn’t adjust to.

Heather Driscoll: Right. When we talk about financial results, specifically, I always get a little bit nervous when people are surprised by what they see, as though they had no control over any of it, as though they just showed up each day in the dental practice and then, you know, waited for a few days after the month closed to get this surprise. And, when it’s a surprise, it really helps me to understand that we have more work to do on really educating and sharing best practices as far as the decision-making process and the dentistry decision tree. So.. yeah, go ahead Drew.

Drew Schaefer: I was just going to say that the team members we expect to know these results are really, in most cases for most companies, they’re the ones that are able to influence those results. So, whether they are proving time cards, so they should be aware of their employees’ pay, they’re ordering dental supplies, paying the lab bills, they are initiating all the expenses on the expense side. And at the same time, they should be looking at daily production/collection reports on a daily, then weekly, then building up to monthly basis. So to your point, by the time it comes to a historical look back, it’s just an accumulation of everything that they already should have their hands on, or been deeply ingrained in the process already.

Heather Driscoll: Absolutely. And, we all know that really great financial outcomes usually start as a result of top line revenue. And so, one of the first things we help our teams do is to really take a look at the beginning of the month with their budget to recognize, “How did we plan for this month to go? What were the number of days we planned on working? What’s the balance of contribution between the restorative side of the practice and hygiene?” And, really truly just have an understanding of what production needs to look like so that collection can follow. And, a lot of times when we’re not really performing to our plan per se, there’s this kind of lost feeling as to, “Well, I’m not really sure why.” And so, the dentistry decision tree really starts by thinking through, “Well, do we at this point in the month in our performance, do we have a production challenge or is there more opportunity to improve collection?” And from there, it really truly takes on the life of a traditional decision tree type thought process. So, once we’ve established production Drew, and we’ll talk a little bit about collection because that’s its own kind of set of circumstances and maybe a bit of a rabbit hole, but when we identify production as maybe the area of opportunity, what’s the next thing you look at?

Drew Schaefer: Yeah, so we look at really any shortfall or excess compared to our budget, is it on the restorative side or the hygiene side? So, most practices have access to a lot of detailed information whether it’s in their practice management system or an add-on, like a Dental Intel type, to be able to drill down, but at a very high level to really keep your analysis succinct, you start with: Is it on the restorative side? Is it on the hygiene side? And then, you can drill down from there as far as, “Did we work the number of days that we expected to?” And, go down those rabbit holes from there.

Heather Driscoll: Especially in multi-provider practices, I think it’s easy sometimes to feel a little bit overwhelmed as to where to put your energy and focus. And so, being able to determine, first and foremost, if we are having a bit of shortfall in productivity, whether it’s coming again from the restorative or hygiene side, and then looking at the range in performance from provider to provider. Because, as we always say at Spark, “Where there’s range, there’s opportunity.” And, if you can identify that opportunity early on, then you certainly are much more likely to take advantage of improvements. So, when we’ve figured out if it’s restorative or hygiene, or maybe a little bit of both, then we start talking through the next step of our decision tree which is: Visits or Production per Visit. So Drew, do you want to talk a little bit about how all the magic starts by having patients in the chair?

Drew Schaefer: Yeah, I mean it’s ultimately your top line is a derivative of the capacity and the patient care that you’re able to provide. So, if you have unused capacity and not enough visits, not enough butts in the chair, then it’s obviously going to be a lot harder to reach your budget, which is typically based on a historical level of patient flow. On the other side is you have plenty of visits but the production per visit is not where it needs to be, then that’s where you need to evaluate more of the clinical diagnosis, patient acceptance and look at opportunities from the clinical aspect vs. maybe the marketing aspect.

Heather Driscoll: Absolutely, I’m glad you mentioned the word marketing because this is usually where I think people can get a little bit tripped up, if performance isn’t quite what they think it should be. Maybe month 1: not a big strategy change. Month 2: a lot of times you’ll see people start doubling down on things like marketing efforts, maybe only to find out that it really wasn’t about the number of patients coming through the practice, but really some of the processes that we’re using to support consistent, comprehensive patient care. And so, on any given day you’ll talk to providers who say, “You know, it feels like we’re running around like chickens with our heads cut off, we’re seeing so many patients and the results just aren’t really there.” And, sometimes again it’s not so much about the number of patients coming through the practice as it is about really getting clear about what the patient experience looks like, and really helping our teams create systems that allow them to be consistent with the care they deliver. On the flip side of that, sometimes it really truly is about the butts in the seats, right? And so, just really evaluating whether or not we’ve created an opportunity from a capacity standpoint, really truly to see enough patients to ultimately drive the results we’re hoping for.

Drew Schaefer: Not just in the element of marketing, but when we talk about capacity, it could also be, “Well, have we changed our hours where we’re not offering the hours that the patients want?” So, there’s multiple different facets that could really limit your visits that, to your point, knowing what’s driving it, you don’t want to just put a bunch more money in marketing if you’re not going to be open the hours that your patients want to see you.

Heather Driscoll: Yep, absolutely. And, there’s an old saying from a dental consultant that many of us learned from early on and they used to say, “You can’t give patients what they don’t want.” And so, if patients don’t want to come at 2:00 in the afternoon no matter how hard you try, that just doesn’t always work out. But, the decision tree point of Visits vs. Production per Visit - well, really any of these points, but certainly this one - spin off into really a whole set of questions you should be asking yourself, because if it’s not visits, if it’s production per visit, again what does our process look like for caring for our patients? What does our financial arrangements conversation look like, and are we consistently applying the same principles to every patient every time? Are the outcomes different if one team member sees a patient vs another? And so, really keeping your finger on the pulse of certainly the major elements of what drives performance, but then the beauty really is getting good at figuring out which questions to ask each step of the way. Alright, so our ability to identify what’s causing performance really equals our opportunity to influence outcomes. And again, one of the things I really appreciate about dentistry is that dental teams are really committed to taking great care of patients, and so you never have to worry about people wanting to do a good job. It’s really helping everybody to understand kind of some of the business levers that ultimately can get them where they need to be. So Drew, in wrapping up, if you were to lend a little bit of your experience and expertise and advice like you do to me on any given week, what would you tell our Spark members and the viewers of this video, what would you share with them would be some of the top couple of strategies to really make sure that outcomes aren’t happening to them but that they’re really being a bit more intentional so that outcomes are predictable?

Drew Schaefer: Yeah, I think the first thing is to measure regularly. And by regularly, it’s not monthly or quarterly or annually. A lot of these measures should be looked at, like I mentioned earlier, daily, weekly to where you can pull other levers and if you’re off track, get back on track. I think when you’re measuring your results and knowing what to measure it to, if you have a budget that’s done in December one year, and you’re in the following November, and there’s been a change in constraints, you add another hygienist or you added days, well you need to make sure you update your budgets as well, because you should have a higher expectation with those additions in capacity. So, just being real time with that analysis, and at the end of the day I think just hold yourselves and your team member accountable to going through this exercise. I think it’s very easy for team members to maybe not truly understand the effects, so it’s an educational process, but just when you start as simple as Collections vs. Production, I think in different discussions, I’ve heard, “Well our collections are behind because we’re waiting on this big insurance check.” And it’s like, “Oh really? Well, your collection percentage is actually 100%, so you’ve got to check this month related to last month’s production and you’re going to get a check next month related to this month’s production.” So, really getting into the details and really helping the team members that are really overseeing the offices that are in key decision points understanding the impact of their action and the importance of monitoring and overseeing and measuring the results.

Heather Driscoll: Definitely. And, a lot of times our compensation and bonus structures are tied to performance and so if you equip your teams in a way that helps them take control of really defining the outcomes of performance, well in so many ways they’re really in control of their own destiny, which I think is a pretty beautiful thing. Well awesome, I always say that my ability to lead dental practices improved when I started hanging around with you Drew, which I always appreciate.

Drew Schaefer: Thank you very much, Heather.

Heather Driscoll: And, I think certainly our patient care is better for it. When you have that insight, you can ultimately deliver better results, and that makes for more favorable patient care outcomes and a better team member experience, which I know we’re all big fans of. Alright, well thanks for joining me today, Drew.

Drew Schaefer: Thanks for having me.

Heather Driscoll: Absolutely. And we’ll be back with another edition of Spark Strategic Thinker, really just conversations to help spark the way you think and make your mind move a little bit. So, thanks everybody for joining us. Bye.

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