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Author: Dr. Ace Goerig

Trusting your endodontic team

DR. ACE GOERIG

OWNER & CO-FOUNDER

Do any of these situations (or similar ones) apply to you? 

  • A doctor overhears a team member conversation with a patient in the practice (or with a referring practice on the phone) and thinks, “That is not the way I would handle that conversation.”
  • There are tasks in the office or during a patient appointment that the doctor persists on doing, even though those tasks could and should be done by an administrator or dental assistant.
  • The doctor repeats all the basic triage assessment questions with the patient, as well as pre- and post-treatment instructions, even though the dental assistant has already done so.

Situations like these are examples of where a trust gap exists. The doctor isn’t confident that a team member will handle a situation the right way. This often results in the team being under-utilized and less empowered to achieve the practice’s goals. The little things can add up until the doctor has a generalized feeling that their team isn’t at the right level. That’s frustrating for both the doctor (who wants a more effective team) and team members (who feel the doctor is holding back). 

 

Developing confidence in your team to rise to the challenge and execute their tasks to a high standard is vital for practice growth and success. In a successful practice, the doctor’s job is to provide patient care. They shouldn’t be floating around the hallways doing other things that don’t require an endodontic specialty diploma.  

 

That’s why I always say that 90% of practice growth is driven by the team. The doctor’s responsibilities, as a practice leader, is to set and communicate the vision to the team, be clear about the standards and goals to be achieved, empower the team with what they need to execute well, establish accountability and team self-leadership, and then step out of the way. That means giving the team more responsibility and trusting that the team will deliver.  

 

It is a progression of steps to get to that point. Training is vital, from big picture clarity down to the smallest details like the phrasing and language to use when talking to a patient, or with a referrer, in various situations. Or the various factors that need to be considered in symptom assessments, so the doctor can enter the treatment room fully informed without duplicating effort.  

 

The challenge that many doctors have is pulling it all together, especially when team members can be at different levels, or appear to have different aptitudes for higher expectations. Sometimes the biggest challenge is just having enough time. These are situations when coaching is an ideal choice that provides professional support for the team to learn and grow. 

 

The remarkable thing is that when the trust gap is closed and doctors finally feel great confidence in their teams, practices light up with new energy. Growth happens organically and quickly, and the doctor starts having the most productive and enjoyable days that they’ve ever had in their career!

A PERSONAL RECOMMENDATION 

Legacy Life Consulting is my favorite personal development company and I refer many of my clients to them for both personal growth and leadership development coaching. They have lots of happy clients, including me. They’ve just released their new website for 2023, with great personal and executive coaching options. It’s a great way to center and strengthen your life and your family.  

Check out their website and give them a call.  

 

— Ace 

Why endo practices stop growing

DR. ACE GOERIG

OWNER & CO-FOUNDER

It’s a familiar pattern that we see often in endo practices. Growth is strong at the beginning when the doctor is young, eager and hungry. They often have pressing debt to service, including education, practice and mortgage payments. Growth is a necessity because these bills need to be paid, and so new practice owners are ready to hustle.  

 

As growth continues and cash flow strengthens, most doctors reach an equilibrium point where they are earning enough to have a somewhat decent lifestyle while continuing to pay off their debt. It’s not quite a comfort zone yet, but it’s a manageable phase when doctors balance their financial stress with the realization that they’re not going to be bankrupted overnight by their financial commitments.  

 

During this time, growth often slows or becomes intermittent because the doctor is busier with patients, spending less time on marketing, and they are no longer walking a financial tightrope. Because the “edge” is off, it is often the start of a settling process where many doctors begin to program their brains with what “normal” is for their practice.  

 

Once doctors reach mid-career accompanied by their “normal” expectations, this is when the comfort zone really kicks in. If the practice stays within range of “normal”, there is little external motivation to spur on the pursuit of growth. Doctors and teams become creatures of habit, repeating long-established patterns. Growth can be negligible except for fee increases, which is pared down by inflation on costs, so it’s not true growth in real dollars.  

 

If unchallenged, the comfort zone can deepen and last a long time—sometimes decades. Some doctors never get past it and so the last decade in practice before retirement often shows the practice shrinking. Doctors start to prioritize more time off, sometimes they slow down clinically, and some of their top longstanding referrers start retiring around them (and stop sending cases). That’s when the comfort zone can lead to a slow gradual decline.

The challenge to grow 

The paradox of the career stages I’ve just described is that growth seems to become harder the longer that you practice. Why is it that younger endodontists (who have the least experience in business, referral relationships and clinical endodontics) can create steady growth?  

 

You might, for the sake of argument, suggest that growth is easier for someone starting on the ground floor, and so younger doctors have nowhere to go but up. It is true that many young practice owners are able, within a few years, to grow their practices to the level of the average endodontist (3 to 4 cases per day). Young doctors who get Endo Mastery coaching often grow well above average in the same period. 

 

To me, this clearly shows how big of a blockage is created by the “normal” mindset when doctors are in their comfort zone. There is no valid reason that mid-career and older doctors (who have the most experience in business, referral relationships and clinical endodontics) can’t create the same growth as a younger doctor who might open a practice two doors down the street. 

 

Here’s a challenge for anyone who is currently in a no-growth comfort zone for 2 or 3 years or more: Mentally put a lid on your current practice. You’ve already done that with your “normal” mindset. Now, start a new practice. I don’t mean a physical practice, but conceptually “a second practice within your first practice”.  

 

Put yourself back on the ground floor as if you just opened with no concept of what “normal” should be. Just like that young doctor two doors down, you have no referrers in that practice yet. Unlike that young doctor, you have the advantages of more experience, a positive reputation and visibility among GPs in the area, an experienced and trained team, and all your costs are already paid for in your first practice.  

 

In a few years, can you grow your new practice to produce 3+ new cases per day? And if you did, what would be the financial impact when you combine both practices? You’ve probably at least doubled or even tripled your net income. 

Prioritizing growth 

Doctors will come up with many reasons why they can’t make progress on growth. Most of those reasons are mindsets: expectations are fixed around their current practice dynamics, they have a low deserve level, they believe it will be too difficult, etc. 

 

I would tell you in response that bringing a growth motivation back into your practice will re-energize you, strengthen your team, make endodontics fun again, and keep your referral base vitalized. Growth is one of the most exciting things that Endo Mastery helps our clients to achieve.  

The secret to great clinical days

DR. ACE GOERIG

OWNER & CO-FOUNDER

There’s an old story about a psychology professor holding up a glass of water and asking the class how heavy it is. The students call out their answers, ranging from 8 ounces to a pound or two. After all the guesses have been made, the professor finally says, “The right answer is that it depends on how long I hold it.”

 

She continued, “If I hold it for a few minutes, it is very light. If I hold it longer, an hour or so, then my hand will start to feel tired. If I hold it all day, my arm will be sore and aching. And, if I hold it day after day without stopping, it will feel like an incredible burden that takes all my energy.”

 

Now think about your practice in that context. If you are stressed every day, if you have financial worries, if you are constantly interrupted or distracted, and if there is always some kind of team or business issue to deal with, then every day is going to feel very heavy. That’s when doctors start dreading going to the office in the morning and counting the years until they can escape into early retirement.

 

A great day for the doctor should be free of the heaviness of these concerns. It should be stressless, productive and enjoyable from your arrival in the morning to your departure at the end of the day. While there are many parts of the practice that can be optimized to contribute to great days, for the doctor it comes down to two primary objectives: improving clinical focus and doctor flow.

Clinical focus

Clinical focus is your ability to concentrate without interruption during a patient treatment, which is how you should be spending most of your time in the office. Ideally, once you begin treatment, you should not have to look up or away from the microscope until treatment is completed.

 

The secret to great clinical focus is well-trained dental assistants who are completely knowledgeable in your clinical methodology and preferences for routine cases, which is about 90% of the cases you do. Your assistants should be able to anticipate every step of a routine procedure, which means they are ready with everything you need at the exact moment you ask for it, including being ready for all the predictable complications that can occur, such as a perforation or to begin an apico.

 

Great clinical focus means that you don’t get interruptions from outside the treatment room, the assistant never has to leave your side during treatment or hunt for supplies, and you have worked out the choreography of how everything is handed to you so you never need to break focus with the microscope. All these little things add up and by optimizing your coordination with assistants, you can save a ton of time in every clinical procedure and never feel rushed.

Doctor flow

By comparison, doctor flow is what happens between patient treatments. Ideally, when you complete a patient’s treatment and exit the treatment room, the next patient is ready for you to begin. The assistant of that patient is waiting for you outside the treatment room to brief you on their preliminary assessment of the patient’s symptoms.

 

When you walk into the treatment room, you can spend a minute or two establishing rapport with the patient, and then you can begin. Your preferred imaging view are already displayed on the monitor. Because your assistant is highly trained, you can “trust and verify” their assessment, rather than beginning from scratch with the same diagnostic questions to the patient that they have already answered for the assistant.

 

The secret to great doctor flow is mastering clinical focus, so you have a clear understanding of how much treatment time you need for each case. Then, between patient scheduling and arrival with administrator and patient preparation in the treatment room by your assistants, you should develop very smooth efficient movement between patients and cases.

Great days for the doctor

Ideally, the doctor should be in treatment rooms and focused on diagnosis and treatment delivery. Patients should be scheduled with sufficient time for the doctor to complete cases with high clinical focus and efficiency, without being rushed, and without the doctor losing flow and waiting between patients. Everything else should be handled by your highly trained team effortlessly and automatically.

 

A great day for the doctor is when they can just be the doctor and have fun practicing endodontics and helping patients. With practice coaching, many doctors tell us that even though they are growing and completing more cases than before, their practices (like that glass of water) feel lighter than ever.

 

Endo Mastery Practice Coaching can help you have great days in your practice. For more information, visit https://endomastery.com/practice-and-team-coaching/

Happy new year! It’s time to raise your fees!

DR. ACE GOERIG

OWNER & CO-FOUNDER

Dear Colleague,

 

I am a person who likes to celebrate major holidays and events like New Years. How great we feel when we can simply enjoy a celebration with our family and friends. There’s such positive energy and optimism that we carry with us even after the celebration ends.

 

I am also someone who likes to celebrate in more personal and individualized ways too. I am always looking for reasons to celebrate with the people in my life, whether that is for a birthday, anniversary, milestone, or accomplishment. It’s part of being close to someone to share those important events in each other’s lives.

 

In the practice, celebration also has a role as a very important leadership and growth technique. The team bonus system in my practice offers a tangible benefit to team members, but even more important is that it gives me a daily way to celebrate the team’s progress and contribution to the practice’s success.

 

Plus, throughout the year, I find ways to recognize or celebrate both the team collectively and individuals on the team. Sometimes those celebrations can be as simple as positive words of deserved recognition spoken in front of everyone that makes someone feel special and validated.

 

The celebration mindset also extends to referrers, where I strive to personalize each GP relationship and show my appreciation for their professional support. I’m not a huge fan of the routine and predictable “let’s have lunch” system. Instead, I make sure my marketing coordinator regularly connects with the GP’s team while I focus on the doctor-to-doctor connection.

 

I like to invite doctors to a sporting event, a day of sailing, a fishing weekend, etc. I can usually find a shared interest with every doctor to connect with and celebrate them in a meaningful way. Lunches are probably forgotten by the next day, but personalized recognition and celebration are remembered.

 

Finally, the most important person to celebrate in your life is yourself. Too often we get caught up in the day-to-day busyness of practicing and we forget to honor ourselves. We need to create those celebration moments to remind us that we are deserving of happiness, success and recognition, both professionally and personally. It’s from that energy that we remain inspired by the profession and inspired to reach for new goals.

 

Now is a great time to put into action your plan to achieve new goals and success for the coming year. Otherwise, if you don’t harness that energy when you have it, the whole year can slip by. There are some people who don’t celebrate the New Year or birthdays, saying, “It’s just another day like any other.” That may be fine for a day, but it’s something you never want to say about a whole year in your practice. Every year should be better than the year before.

Time to raise your fees

I always remind doctors at the beginning of the year that it is time to raise your fees. In fact, some doctors prefer to adjust their fees twice annually in January and July since the cost of living and business expenses are always increasing. At a minimum, at least once a year you need to calibrate your fees to current financial realities. It’s one of the most overlooked but necessary actions you can take to keep your practice finances healthy and profitable.

 

This year (and the foreseeable future) continues the trend of elevated inflation across the board, so a fee increase isn’t optional. If you have delayed or omitted fee increases during the pandemic years, it is especially important this year to get back on track. My recommendation for all doctors this year is at least a 5% increase, but you should look at your expense ratio to finetune the right percentage for your practice.

 

To help you with your fee setting process, here are two resources. The first is an article about fee increases that addresses the concerns and factors to consider when adjusting your fees.

DOWNLOAD ARTICLE

The second resource is an Excel calculator that you can use to estimate the impact of a fee increase on your practice. Just plug in the numbers from last year’s Procedure Analysis report to model the impact of a fee increase.

DOWNLOAD CALCULATOR

I hope you have an amazing year,

Ace Signaturex200

Dr. Ace Goerig

DDS, MS, ABE Diplomate
Endo Mastery Owner

Sailing into the new year

DR. ACE GOERIG

OWNER & CO-FOUNDER

I’ve written before about how sailing is a great metaphor for your endodontic practice. You want your ship to be in top form with your crew, rigging and sail in ideal alignment. When you catch the wind, the sail snaps into fullness and you surge forward powerfully.

 

People who go sailing for the first time are usually surprised by how quiet and peaceful it is when the boat is fully under sail and effortlessly cutting through the waves. It’s the same with an endodontic practice: a great practice with optimized team roles and practice systems is free from noise and resistance to forward momentum.

 

I always tell new coaching clients that it is easier to do 6 or 8 cases per day than to do 3 or 4 cases. Many are doubtful at first because their context is what they are doing now, which is equivalent to a person trying to sail a boat with an inexperienced crew and a big hole in the sail. Coaching helps doctors correct practice deficiencies and create team alignment, and suddenly they discover how easy and stress-free it is to optimize their schedule for effortless productivity.

Filling your endodontic sail

One thing that sailing does require is wind. A sailboat on perfectly flat windless water goes nowhere. It doesn’t have enough wind and so it just drifts on external currents without making any progress toward the desired destination. Conversely, a sailboat in a storm requires constant stressful reactive attention and course corrections. Between the two extremes, there is a sweet spot—a good steady wind that energizes the boat to operate efficiently and intentionally.

 

In your practice, the energy you bring as the leader is akin to the wind in your sails. Without energy, the practice will be at a standstill, drifting without making progress. Likewise, if you don’t have a clear vision for your practice, you can end up over-reacting to the challenges of the practice and losing your way forward.

 

As we move into 2023, good questions that every practice owner should ask are: What is going to fill my practice sail this year? What will make my practice more successful, meaningful and enjoyable?

 

The answer might differ depending on where you are at with your practice and in your life. If you are averaging 3 or 4 cases per day (like most endodontists), adding 2 more cases per day could change your life so significantly. This result, from improved marketing and scheduling efficiency, would probably double your take-home income while simultaneously reducing stress. That completely changes your relationship with (and your mindset about) your practice.

 

For other doctors, lifestyle changes may be the focus. This might include reducing the number of days worked per week or taking more vacation time. Lifestyle changes have an economic impact on the practice, so filling your sail with renewed growth and improved productivity is often needed.

 

Filling your sail also varies for doctors at the bookends of an endodontic career. Startup doctors will need to focus on profitability and getting a strong return from every dollar they invest in their new practice. As new practice owners, they have an uphill climb to put their team and systems in place quickly and effectively, become productive, and pay off their debt.

 

For doctors in their near-retirement years, preserving or maximizing practice value prior to an equity sale is paramount. This often needs to happen while accelerating savings for retirement and also transitioning to a better lifestyle with more time off from the practice. How can you achieve a lifestyle practice without giving up practice value or profitability?

It’s the journey, not the destination

Whatever your focus is for the coming year, it’s important to remember that the journey is what counts. Any destination you choose will ultimately be only a stop along the way to the next destination.

 

Practice ownership is a game, but not a “how can you exploit the system” game. It’s a game of enjoyment about doing something worthwhile. How can you have fun everyday with your team to fill your sail and achieve new goals? 

Serving the endodontic community

DR. ACE GOERIG

OWNER & CO-FOUNDER

I love endodontics. It’s such a great profession with incredible opportunities, especially once you crack the nut of how to be very productive and efficient clinically. At that point, you are on a glide path to such an abundant and rewarding life that easily surpasses most other dental specialties.

 

It’s important to me to give back to the endodontic community. The greatness of our profession today is the result of generations of endodontists contributing to the science and practice of endodontic treatment. The American Associate of Endodontists was founded in 1943 to further advance endodontics, and 20 years later endodontics was recognized as an official specialty in the dental profession. In the same way, as practicing endodontists today, it is our actions that will shape the profession’s future.

 

I like to help as many endodontists as possible experience the highest level of success in the profession. Within that objective, helping endodontic residents and new endodontists get started by taking the right first steps into the profession is near and dear to me.

 

Earlier in November, I held a complimentary one-day seminar program, “Pathway to Your Ideal Career in Endodontics”, for young endodontists. It was such an enjoyable day with a lot of energy and interactivity from these hopeful and ambitious young doctors. In the past, I’ve also given one-day virtual seminars to residents at many of our endodontic graduate programs.

 

Young endodontists today face a different world than those in the past. Most of them graduate with truly eye-watering student debt. In the past 40 years, while the average dentist’s income has tripled and the average home price has gone up 6-fold, the average tuition for dental school has skyrocketed by 16 times … and that’s not including specialist residency.

 

Young endodontists literally can’t afford to make any mistakes starting out. I honestly worry about them stuck in low-paying associate or corporate positions where they are saddled with their debt for decades, have limited opportunity to save for purchasing a practice, and limited control over their future.

 

That’s not the endodontic profession that I’ve experienced. Without someone urging young doctors to explore all their options, they can too easily fall for the first position that can give them a salary … and potentially lose access to the amazing opportunities that independent practice owners have.

 

I want endodontics to continue to be a strong profession that is full of opportunities, both for doctors just starting out as well as those currently practicing with established practices. For new doctors, Endo Mastery will announce its complimentary resources for 2023 in the spring.

Thanksgiving and nurturing the best life

DR. ACE GOERIG

OWNER & CO-FOUNDER

Dear Colleague,

 

I have enjoyed incredible success as an endodontist, first in the army and then in private practice. It continues to be a very meaningful and satisfying professional life for which I am very grateful. It has provided an incredible foundation for my life.

 

Most of all, my professional success has afforded me such abundant resources to live the best life possible. Naturally, that includes material goods where I have the economics to purchase and enjoy practically anything I want in this world. As endodontists, we are very fortunate in that regard, and it is another aspect of my gratitude.

 

More importantly in my gratitude are the nurturing experiences that I’ve been able to enjoy with my family over many years. Nancy and I have built our family life around providing our children with uplifting and empowered experiences. These have not only enhanced their lives, but have shaped their world view, their goals, and their values. And now we have the great pleasure of being a nurturing presence in the lives of our grandchildren.

 

As our family and yours gather this Thanksgiving, I have no doubt that we are all acutely aware of the blessings in our lives. As family leaders, you will look around your holiday meal and feel a great deal of love and abundance with everyone at the table—all of whom to various degrees have benefited from the nurturing life you have opened up for them.

 

As endodontists, we have such an opportunity to be an agent of good in the world. We can support and nurture others and help them rise to their best level and experience their best life. It begins with us, our spouses, and our families, but our life leadership doesn’t stop there.

 

In fact, there is a vast circle of people who are influenced by you. This includes your friends, your practice team, their families who depend on them, your referrers and, of course, your patients. When you can give all these people around you the benefit of your attention, caring and goodness, what a force you become! That’s truly a responsibility and privilege that we should be very grateful for.

 

You may even have a vision that extends beyond your immediate contacts. You might have a cause or community in which you are impassioned about serving and supporting. For example, I am personally dedicated to helping every endodontist enjoy the same level of success and abundance in their lives that I have experienced. It truly is my personal mission to improve the profession that has given so much to me.

 

I believe that when we become successful professionally, then the stress and focus on “me” can shift to “we”. What is our legacy going to be and how can we achieve that higher calling? Every Thanksgiving, I am reminded of this, and so thankful to have the means to make a positive difference in the lives of others.

 

At this wonderful start to the holiday season, the Endo Mastery team and I want to express our gratitude for letting us into your practice and life. We strive to be a force of good for you, and help you experience all the professional and personal happiness possible.

 

Happy Thanksgiving,

Ace Signaturex200

Dr. Ace Goerig

DDS, MS, ABE Diplomate
Endo Mastery Owner

Beating your endo competition

DR. ACE GOERIG

OWNER & CO-FOUNDER

For every endodontic case that you complete in your practice right now, there are at least two other potential cases in your patient community that could be referred to your practice. That’s a significant opportunity for growth if you can tap into it.

 

However, even though that opportunity is available to you, it is also available to every other endodontist in your area too. Why? Because over two-thirds of endodontic cases are completed in GP practices without being referred. Truly, the competition in endo is not with other endodontists.

Factors that drive referral relationships

The question we are really facing is what moves a GP to prefer to refer endodontic cases rather than completing those cases themselves? If you think about your best referrers and analyze why they are great referrers, then you generally find they have one or more of the following mindsets:

  • They like you and see you as a trusted interdisciplinary partner.
    Everything begins with the doctor-to-doctor relationship, which is established both socially and clinically. If you look at the top GPs in your community who have busy and successful practices focused on high-value comprehensive care, none of them reach that level without embracing an interdisciplinary philosophy. That means they have optimized comprehensive treatment around a team of trusted specialists with whom they feel aligned clinically and that they enjoy working with.

  • Treatment in your practice is more convenient for patients and less stressful for the GP practice.
    While most endodontic practices typically have a schedule that plans for a certain number of emergency same-day treatments, that is not the case in the GP practice. The typical productive GP is usually scheduled 2 to 6 weeks in advance. They often have two hygienists seeing patients every day, which require hygiene checks in addition to the patients scheduled in the doctor’s chairs. It’s very difficult to carve an hour or more out of those tightly scheduled days for an emergency endo, and it’s easier to refer.

  • Treatment in your practice results in better clinical outcomes.
    You see the limited results of GP-performed endo all the time: missed MB2 canals that blow up, retreatments, separated instruments, and cases where the doctor simply realizes they are in over their head. Every time they refer a case where they get in trouble, it’s an opportunity to help them realize endodontists provide a faster and more predictable clinical outcome with a significantly reduced risk of a failed case or need for retreatment. It’s generally not possible for them to rise to your level: They lack the clinical techniques plus all the specialized technology and tools we have in our practices, such as CBCT, microscopes, etc.

  • Endodontic procedures dilute the GP’s productivity.
    GP practices grow differently than endodontic practices. In endo, we grow by focusing on efficiency because most of the core procedures that we perform have relatively the same economic value. In a GP practice, at a certain point adding more patients does not result in any more growth. There is an upper limit to how many patients can be retained in hygiene, after which GPs need to focus on case acceptance for less frequent but larger cases, such as quadrant dentistry, esthetics and discretionary care, and full mouth cases. These cases feed into the interdisciplinary mindset mentioned above, but it also results in the understanding that any GP time spent on endodontic treatment would be more productively utilized on comprehensive restorative care.  So, for economic reasons, it is better to refer out endo.

It is all about the relationship

While we think about GP referrers every day, GPs rarely think about us in the same way. We’re part of a treatment plan generally, but they don’t usually view the success of their practice as dependent on referring to us.

 

The most important things you can do is provide excellent, responsive and timely patient care (especially for emergencies), build up your doctor-to-doctor relationships through personal interaction, and back that up with a great marketing system to stay top-of-mind with referrers.

 

When we can nudge GPs over time by understanding what leads them to prefer to refer endodontic care, we become the specialist for all their endodontic treatment needs, which potentially triples the number of referred cases they send now.

Life sentence practice or lifestyle practice?

DR. ACE GOERIG

OWNER & CO-FOUNDER

I haven’t “worked” in over 25 years … at least that is what it feels like. I love every day that I spend in my practice, and I have a lot of fun with my patients, team and referrers. Every day is stress-free and effortless. I arrive in the morning with high energy and feeling great, and I leave at the end of the day feeling the same or better!

 

This is possible because I created a “lifestyle” approach to practicing endodontics. I used to call this approach retire-in-practice—which reflects my personal feeling that I’m not really “working”—but the word retire gives the impression to others that it is something you can only do later in your professional life as you get closer to retirement. That is not the case.

 

I spent my first 20 years practicing endodontics in the army, so I was a newbie to private practice endodontics in my mid-forties. I was 20 years behind my residency peers! However, within 10 years I was far ahead of them because after talking with my contemporaries, I knew there had to be a better way than what they were describing. Here’s what they told me:

  • Meaningful growth in their practices had stalled, at least 5 or 10 years earlier. They had plateaued and were frustrated.
  • They were completing only 3 or 4 cases a day, which means they were making more money than the average Joe on the street but by no means rolling in riches like they imagined.
  • Most of them still had debt: school, practice acquisition and personal mortgage—a never-ending source of stress.
  • Some of them felt okay with respect to saving for their eventual retirement, but most felt they were seriously behind. A few were concerned they could never afford to retire.
  • Many felt worn out or tired, but they were afraid to take time off because they felt they had to be available for their referrers.
  • There was daily stress in the practice with the team and other management concerns. They weren’t having fun and there was a monotonous predictable drain on energy every day.

In short, the overall impression I got was that most of my peers were feeling that their practice life should be easier and better by that point, and their personal life was stuck as a result. The practice was taking up too much time, it was wearing them out, and they didn’t have the flexibility in their economics to do anything about it.

Defining the lifestyle practice

The list above became my focused checklist of things to avoid when setting up the lifestyle model in my practice. Therefore, the lifestyle practice is defined as having:

  • An easy, powerful and effective marketing system, driven by a marketing coordinator on the team, that strengthens referral relationships and allows the practice to keep growing.
  • Mastery of the scheduling strategy and financial systems of the practice with a highly trained office manager who is accountable for the efficiency of the team and success of the practice. Train the team to highest professional level so you never have to look over their shoulder and you never second-guess whether they are taking care of your practice with the utmost attention. Establish excellent reporting systems so you can “trust but verify” the key numbers and factors that drive the practice within minutes each day, week and month.
  • Implementing a coordinated clinical team approach to patient flow, treatment room efficiency and doctor productivity, so the doctor only does what is medically necessary for the doctor to do. This takes the heaviness out of a day and allows the doctor to routinely complete 7 or 8 cases per day with less stress than with the 3 or 4 cases they are doing now. This also results in the practice’s profitability to be 2 to 3 times higher than average.
  • Use the higher profitability to first pay down their debt and the stress burden that comes with it. Almost every doctor can become completely debt-free in as little as 3 to 6 years. After that, channel higher profitability into savings and personal (family) lifestyle.
  • Work no more than 4 days per week at first, and then when clinical efficiency and productivity allows it, cut back further—ideally to 3 days. Endodontics is mentally and physically demanding, and your long-term enjoyment of the profession depends on having sufficient rest. Working fewer days per week takes the heaviness out of the week and allows more balance with family and personal time.
  • Take at least 10 weeks off per year for regular vacation time so you remain energized and never feel worn out, burnt out or exhausted. Really take the time to enjoy your family and your life together. It’s the most important thing.
  • Enable a 3-days-per-week schedule (and eventually less if desired) by expanding the clinical capacity of the practice with another endodontist. This ensures full coverage 5 days per week for referrals. There are various ways to add another provider, from long-term associates, to associates who eventually buy-in as partners, to facility partnerships, to traditional business partnerships. In my case, I have long-term associates with minority ownership stakes and a right of first refusal when I finally sell. But for now, I’m still in control of the practice as majority owner.

Achieving your lifestyle vision

In summary, what creates the lifestyle practice is 5 things:

  • Being debt-free and stress-free
  • Earning 2 to 3 times the average endodontist
  • Working 3 or fewer days per week (with coverage)
  • 10+ weeks of vacation per year
  • Effortless daily flow and productivity that is fun.

This is our philosophy and vision at Endo Mastery for our clients, and it is what our coaching program is designed to do for every endodontist. In a year or two, you can close all the gaps that tell you things should be easier or better. In fact, we have clients in their early thirties who have done this already. They are living such an abundant life that every day inside and outside the practice is a dream.

 

It’s really not about how old you are, or how many years in practice. It’s just about making the decision to optimize and prioritize the practice and team with expert guidance so that you get growth back, get enjoyment back, and get your life back.

 

Stop feeling like your practice is a life sentence!

 

I encourage you to give us a call at 1-800-482-7563 or email Debra Miller, Director of Coaching, at debra@endomastery.com to set up a complimentary 1-on-1 conversation about your lifestyle and practice goals.

Making critical leadership decisions

DR. ACE GOERIG

OWNER & CO-FOUNDER

I’ve been working a lot with young endodontists this year, helping them navigate the crucial decisions they have to make when they are just starting out. But once you’re launched, that doesn’t mean the decisions are over. A lot of doctors reach a point in their careers where they have a gut feeling that it’s not living up to their expectations. Common reasons include:

  • Feeling stressed and not enjoying every day
  • Team issues and drama that never ends

  • Too much business management and busywork

  • Tenuous referral relationships that fail to prosper
  • Disconnected from endodontic colleagues
  • Lack of personal and family time
  • Lost enthusiasm and feeling tired or burnt out
  • Debt and financial stress that persists

The right time for change

All of the above points are symptoms of the need for a practice leader to make changes. Concerns don’t correct themselves on their own and allowing them to continue very often leads to them getting worse over time. A gut feeling becomes discomfort, which can become pain. It’s no different than a patient’s clinical symptoms. Untreated, things are likely to get more difficult (and more  expensive) in the future. The best time to figure out your options and take steps is when you first notice symptoms.

 

Often doctors are reluctant to take action at the first signs because they are not sure if the concerns are temporary. I would say after a year or so of anything nagging in your head or causing stress that it’s not a temporary concern that will resolve itself with your current approach and processes.

 

The other common reaction to concerns is to doubt their validity or question whether anything can be done anyway. This is the procrastination voice inside your head that searches for reasons to delay making difficult choices. Whenever you find yourself saying “I’m too busy to deal with it now,” or “My team isn’t ready or capable,” or any number of similar deflections, it’s a sign that you are reacting negatively rather than taking the proactive steps that you should be making.

Making decisions

Once you’ve decided to take action, the question is “What action?” There are different ways that people approach this question, but my preferred approach is to always educate myself first, and quickly. This is especially the case where I’m treading in new waters. I recognize it is my knowledge gap that is the primary limitation holding me back.


It’s tempting to put yourself into an endless cycle of gathering options, comparing and contrasting, and ruminating over the pros and cons. This is also a delaying tactic because, to be honest, if you sincerely investigate options for any problem for a short and focused time, the primary reliable solutions reveal themselves very quickly. You don’t have to go on an exhaustive quest to Timbuktu to find what you actually need.


It is rare to have a situation where you have to deal with something that has never been dealt with in dental practices or business before. If you look around you, you will find colleagues who have conquered the very challenges you are facing. You will find companies who specialize in helping you address and implement the changes that will improve your practice and life.

Is it the right choice?

By far, our greatest fear is being wrong. Often, we want to have the entire process laid out in front of us with all the answers spelled to such a level of detail that we can quell our doubt. This “need to know all the answers in advance” is not usually possible, because you and your practice are unique.

 

A better way to think about it is headlights on your car when you’re driving at night. You don’t need to see the entire road ahead of you all the way to your destination. Your headlights illuminate enough of the next step or action you need to take to keep moving forward.

 

Think about everything you have successfully completed in the past without knowing the entire process. You completed dental school, endodontics residency, started your practice, hired a team and created a functioning business. Outside the practice, you probably have gained experience in getting married, purchasing a home and having children. Children, especially, don’t come with a handbook that answers all the parenting questions.

 

Your past successes should drive your confidence to address anything in your present and future. And with that mindset, all you need to do is to make a timely decision to begin the next stage of your journey of growth and success. Everything else will flow naturally.