Endo Mastery

SUMMER S’MORES

What goes better with summer than camping? And what goes better with camping than delicious s’mores? Surprise your referring offices with this summertime classic! You can package up the ingredients in a small cellophane package:

Add a tag that says “To many S’MORE good times and great patients! Thank you for your referrals!” You can also add a note about how s’mores can be made in the microwave at work (about 20 seconds).

IN RECOGNITION OF INDEPENDENCE DAY

DR. ACE GOERIG

OWNER & CO-FOUNDER

Dear Colleague,

 

Every day, I feel blessed to be a citizen of this wonderful nation. Both myself and my family enjoy a life of such prosperity and freedom. I am also proud to have served in our country’s military for 20 years, where the principles and ideals of America have daily significance.  

 

Behind everything that we enjoy in our country today, there was an idea nurtured into existence by our founding fathers. A vision that was so potent and powerful, I do not believe they truly understood the full impact that would ripple forward into the future.

 

That’s an important thought because what our founding fathers have shown us is that if we are pure in our principles and intent, and we are committed to a powerful vision, then we put ourselves onto a path of inevitable greatness.

 

Greatness is found everywhere in America. Greatness in business, in technology, in innovation, in the arts, in communities, in faith, in families, etc. … and the most important is greatness in opportunity. The inherent opportunities in America are why so much of the world dreams of coming here.

 

So, we must have gratitude every day for the gift of opportunity that was handed to us by the foresight of our nation’s founders. And we must ask ourselves if we’re using that gift fully to create greatness in our life, for our families, and in the lives of those around us.

 

In endodontics, we have an amazing profession that is filled with vastly more opportunity and potential for greatness than most doctors realize. With the right principles and vision, you can put yourself on a path that will ripple forward into your future with profound and life-changing benefits for you and your family.

 

And not far off in the future, either. Within a year, you can experience a level of greatness in your practice and life that you never believed possible. Work less, earn more, de-stress, and spend more time on the things that really matter: your family, your friends, and creating the memorable experiences of a life being lived to the fullest.

 

As we celebrate the independence of the USA, it is my hope that you also live with independence, gratitude and abundance … and that you fully embrace and enjoy the gift of being an American and the opportunities of being an endodontist.

 

All the best,

Ace Signaturex200

Dr. Ace Goerig

DDS, MS, ABE Diplomate
Owner, Endo Mastery

TEAM TO TEAM
REFERRAL MARKETING

What are the chances that your GPs tell their patients, “It’s very important that you see Dr. X. They are the best endodontist in the city, and I’ve personally chosen them over all other endodontists.”

 

For some referrers, that may be true. But most of your referrers, it is likely that you are just one of several endodontists taking them to lunch. Their patients are told they need a root canal by a specialist, and it’s left to the team to give the patient all the details. In many practices, patients are asked to choose the endodontist they want … often by who is nearest to where the patient lives or works.

 

Ideally, you want to develop referral relationships so that you’re more than just one of several options. You want to be the preferred endodontist. That preference is best developed doctor to doctor, but it can take time. However, there is a backdoor into becoming the preferred endodontist, and that is through the team-to-team connection.

 

Everyone in your practice who talks to a GP team member in any capacity should remember that they are building a relationship. They are not dealing with an impersonal nameless employee that is far flung. It’s likely someone just down the street, so your team needs to be in relationship-building mode:

Projecting this kind of energy, even just on the phone, makes people feel closer to you. When it is supplemented with the goodies and pop-by marketing gifts organized by the marketing coordinator, a strong sense of goodwill and friendship develops.

 

Then, when the patient is given their endodontic specialist options, a team member might spontaneously suggest, “If I was choosing, I would definitely want to go Dr. X’s practice. The team there is incredible, and I like them a lot.”

 

That’s enough to nudge a patient’s decision in your favor since everyone else on the list are just names that they don’t know. They know something very specific about you: you have an amazing team, and you are recommended by a team member in the practice they trust to take care of them.

 

Everyone in the endodontic practice is part of your marketing team through their daily interactions with patients and referrers. It’s not just your marketing coordinator toiling alone. Always remember, 90% of growth in your practice is driven by the team.  

BUSY DOCTOR SYNDROME

DEBRA MILLER | DIRECTOR OF COACHING

There’s an old saying about how, if you want to make sure something gets done, you should ask a busy person to do it. Busy people have to stay focused in order to get things done, and consequently they get many more things done than unfocused people. It’s a blessing and a curse. The curse is what drives Busy Doctor Syndrome.

 

Doctors caught up in the busy syndrome are resistant to anything that appears to make their life more complicated than it is now, even things that will eventually make it better. They have their nose to the grindstone and they are not looking up to even notice the opportunities around them. All they care about is checking off that daily list of things that need to be done.

 

The list gets populated by things that need to be done in the practice, and things that need to be done in life. Most people divide their time between work and life and many people talk about work/life balance. But what is generally true of the busy syndrome is that regardless of where you draw the line, a busy person tends to fill up the available time on both sides. It’s rare to find someone who is time-limited and overwhelmed at work while being relaxed and unstressed at home, and vice versa.

No one else can do it …

The problem is that busy people fall into the “no one else can do it” trap. They take on tasks and responsibilities because they feel they are the only person who can. In reality, “no one else can do it” is actually an abbreviation for:

This leads to some unusual anomalies in the choices of busy doctors. For example, consider a task that occurs over and over again every month that a team member could be trained to do very well. Every time the task comes up, the busy doctor has a choice to slow down and take the time to train a team member, or to do the task easily, quickly and correctly themselves. Because their mindset is predominantly shaped by the feeling and focus of being “too busy right now”, they endlessly put off the beneficial step of training and delegating.

Overcoming the busy syndrome

Not surprisingly, resistance to training and delegating is actually commonplace in endodontic practices. When Endo Mastery begins coaching with our clients, we analyze the doctor’s activities and daily flow. Almost as a rule, doctors are generally losing at least 2 hours of every day on tasks that could be delegated to team members. That’s a big chunk of time that could be better spent by the doctor to reduce their busy syndrome while delivering care to more patients with less stress.

 

If you’re feeling the busy syndrome in your life, start by asking what is the simplest thing you do all the time that you could train a team member to do. Nothing is too small, and small things are the easiest to train at first. Do one thing every week, and progressively move to more comprehensive tasks. It is a process for sure and one that is a lot easier with coaching because Endo Mastery does the training for you. But on your own, you can make a big dent on your time crunch as all the little delegated tasks add up.

PROGRESS VERSUS PREDICTABILITY

CYNTHIA GOERIG

CHIEF EXECUTIVE OFFICER

Every endodontist-owner wears three hats. The first is the clinical hat, which is what you are trained for and where you spend most of your time. The second is the management hat, which is untrained but taken on by necessity of owning a business and employing a team. The third is the leadership hat, which where your vision and dreams reside, but it often takes a back seat to the first two.

 

The management hat is vital because every business needs defined policies, procedures and team roles. It’s the manager’s job to keep track of everything that needs to be done, how it needs to be done, and by who. Managers have to deal with all the mistakes and issues that occur and ask, “Why did this happen?” and “How can it be prevented in the future?” The manager also studies the successes, asking again “Why did this happen” but then “How can it be replicated in the future?”

 

Ultimately, it’s the job of the manager to create predictability in the business’s operations. A focused manager implements effective and efficient systems so that the team has clear direction, and every day is a solid step toward the practice’s desired outcomes. The results of great management are a smoothly functioning team, days without unnecessary stress and a reliable cashflow that you can count on. In short, managers seek to control anything that creates a risk to practice operations.

 

By contrast, the leadership hat is focused on pursuing possibilities that aren’t being achieved yet by the practice. Leadership requires growth to make progress, which means making changes for which you don’t yet have a track record of success. To the manager hat, that sounds like a lot of risk.

 

The manager voice in your head will come up with all kinds of “buts” and “what ifs” that take the wind out of the vision sail. And, even if you do make some growth-focused changes, if the results aren’t immediate and perfect, the manager inside you takes that as proof that it isn’t worth rocking the boat or creating uncertainty.

Moving out of the danger zone

When the manager dominates the conversation, the practice moves to a state of inertia. Often called a comfort zone, it’s really a danger zone. The team becomes entrenched in current processes and resistant to change. Referral relationships settle around established relationships without improving or growing. Worst of all, the doctor stops believing in their vision. Their expectations become settled too, around what their practice has always done.

 

Over time, a practice in inertia creates its own issues because the world around them is moving forward while it is stuck in the past. The loss of a key referrer is often a telling sign. GPs can react when another endodontist starts marketing to them better, communicates more effectively, provides more responsive scheduling or gives patients a better experience.

 

When you find yourself in this state of needing to rebalance the management and leadership hats, the most important thing you can do is get outside of your own definition of predictable success. As motivational speaker Jim Rohn famously said, “You are the average of the 5 people you spend the most time with.” That’s a powerful thought, even if current research suggests the network is broader than five and the factor isn’t necessarily just how much time you spend.

 

In my view, the “time” in Rohn’s quote isn’t literal. It’s a metaphor for who you prioritize to help shape your viewpoint and vision. So, the best way to stay in balance with your leader and manager hats is to always have a mentor, always have inspiration in your practice life, and always seek out people whose own benchmark for predictable success is higher than your own.

OVERCOME BLIND SPOTS TO FIND YOUR NEXT LEVEL

DR. ACE GOERIG

OWNER & CO-FOUNDER

Last week, I was discussing the growth and success of a coaching client with my team. By implementing Endo Mastery systems, the client had added over $750,000 to their take-home profits in the last year compared to the previous year. At the same time, their stress level has plummeted, their team is happier, and the doctor is loving their practice and life at a whole new level.


Real-life success stories like that are unbelievable and incredible … and that’s the fundamental challenge we were discussing. When we can help doctors create success that is literally best described as defying belief or credibility, how do we communicate those stories in a way that motivates other doctors? How do we help doctors overcome their instinct to disbelieve when the results are so amazing and disproportionate to their own experience?


Doctors trust other doctors more than they trust marketing claims but putting a figure like $750,000 in a client testimonial is difficult. First, a lot of doctors don’t want their income exposed in such as public way. It’s regarded as impolite in many circles to talk about your income so openly. So, we’re often left to describe success in abstract terms like percentages or case numbers, which don’t have the same truth-telling effect.

 

Now, I agree that $750,000 is an eye-popping number. But would your reaction to $500,000 be any different? It’s still disbelief from most doctors. What about $250,000? That would nearly double the take-home income of the average endodontist, so it’s still in the realm of incredulity that would trigger the inner critic of many doctors.

Blind Spots and Incremental Mindsets

Most doctors are tied to the mindsets around their current practice systems, team dynamics, schedule, referrers and economics. They’d be happy with 10% growth in a year, which is such an incremental way of thinking that is driven by blind spots doubting what can be achieved. That’s why the first reaction to learning about what Endo Mastery does for clients is, “How is it even possible?”


That incremental mindset and disbelief is also why coaching seems like an expensive cost at first. The client I’ve been discussing had the same wavering concerns at the beginning: “How can I trust these success stories?” and “Will it give me a return that is worthwhile?” Hindsight is 20:20. I wish I could have told the doctor that our program will pay him back over $4 million in the next 5 years.


When you accept that your blind spots are what limits your success, then the only reasonable course of action is to get out of your own way. You need to look at your practice and life differently—in a vision and possibilities way rather than an incremental way.

Inspiring a New Vision

The first step is always finding inspiration to believe in a new vision. I personally want every endodontist to truly know how great their practice and life can be in endodontics. While we can’t put everything into a testimonial, we can provide you with a list of doctors who are happy to talk to you personally and tell you about their experiences on a first-hand basis.

5 TIPS FOR EFFECTIVE ONBOARDING OF NEW TEAM MEMBERS

CHRISTINE HOXHA

PRACTICE COACH

Onboarding a new team member can make or break their transition to becoming a productive and valued member of your team. Great onboarding is a planned and supportive process that purposefully brings the team member up to speed with the practice’s operations and goals. The opposite is an unplanned or non-existent process that leaves the team member to either sink or swim — with everyone likely to be frustrated or disappointed.

 

Great onboarding is vital to integrating the team member with your current team and aligning them to your daily flow and systems. Remember there are two sides to every task performed in the practice: what is done and how it is done in your practice. Even if you are able to hire a new team member highly experienced in endodontic practices and what needs to be done, their training and habits will be based on how their previous practice did those things … which can be significantly different from your way.

 

A great onboarding plan is designed to close those experience/training gaps and support the new hire to become as competent and successful in their new position as possible. Here are 5 things you should always do:

1. Set expectations early

the job description and the performance criteria that is expected. Explain that their past experience is a foundation, and they must be coachable to adapt and learn your practice’s approach and systems. Emphasize how everyone in the practice contributes to onboarding by sharing their knowledge openly and supportively.


The most important expectations that you set establish a vision for the new team member about your practice. Share your vision for teamwork, for patient care, for clinical excellence and for the practice’s current and future goals. If you have a strong and effective team, allow them to interview the new hire as well; it sends an important leadership message that great team performance is recognized with trust and responsibility.

2. Have a Day 1 plan

The first day is important. The new team member will likely be nervous and unsure what to expect. Personally welcome them with warmth and appreciation and set aside time for the entire team to welcome them too (perhaps with a first-day celebration lunch). A positive energy start will make everyone more relaxed.


Prior to the first day, have your office manager and your lead clinical assistant ensure all policy, procedure and office manuals are up to date. On the first day, the new hire should read and initial all pages. All HR paperwork that hasn’t been completed beforehand should be prepared and completed on the first day, especially payroll information, benefits enrollments and any legal documentation required.


You should also have computer logins and email set up, do a basic orientation of the practice facility, their primary workspace, the location of supplies, and other useful information. Give the team member a list of everyone’s names, positions, phone numbers and emails. Perform any OSHA or HIPAA training and certifications.

3. Allow the first week to shadow all departments

A new team member joining your team is like a car merging onto a high-speed freeway. Observing everything in motion is critical. For the first week, allow the new team member to shadow everyone and everything in the practice. For example, 2 days with the admin team and 2 days with the clinical team.

 

Not only does this allow the new team member to see tasks being performed, but they are also observing how you manage the schedule and patient flow, how you work together as a team, how you communicate with each other and patients, and how the team supports the doctor’s productivity and preferences.

4. Create a structured 3-month training plan

After the first week, you will begin integrating the new team member while following a training plan that has been developed in advance for the position. Your new hire will begin to take on tasks, usually after one-on-one training with another team member. For example, a new administrator would learn the scheduling template and strategy to appoint a referred patient. A new assistant would learn fundamental clinical tasks like sterilization, tray set up and the doctor’s clinical processes and preferences during treatment.


You should not take for granted anything until you have observed the new hire in action. Be thorough to train and review all tasks and responsibilities. The first month of training should focus on routine daily tasks so that the new team member can be relied upon to execute those tasks effectively and consistently at the highest level as soon as possible. The second month should focus on more advanced systems, strategies and responsibilities. The third month should be focused on rounding out their knowledge and cross-training so they would be capable to step in fully if another team member was sick or away for personal reasons.

5. Schedule regular competency review meetings

Finally, it’s important to have regular competency review meetings during the training period. The doctor should participate in these meetings to monitor progress and share their insights and observations; however, these meetings would be led primarily by the office manager (or lead clinical assistant if appropriate for an assistant position). In the first month, meet every week. In the second month, every other week. In the third month, meet at the end of the training. 

 

During these meetings, completed training should be reviewed and the progress of the new hire assessed. The goal is not to find fault, but to focus on positive and steady improvement and growth. The leadership of the practice should act as an advocate for the new hire by coaching and supporting them to master proficiencies and achieve success in their role.

The labor landscape

Given the challenges of today’s tight labor market, a strong onboarding process can save you a lot of heartache. You really don’t want to give up too soon on a new hire because starting that process over again is time-consuming and costly. It really is best to hire the best person you can and bring them up to speed the right way so your team becomes stronger than ever.

THE MARKETING OPPORTUNITY THAT MOST ENDO PRACTICES MISS

Referral relationships drive endodontic practices, so naturally endodontists care about developing, growing and protecting those relationships. Strong referral relationships result in steady case flow and higher productivity.

 

Your software system’s referral analysis report shows you who is referring to you and how many cases they have referred. In most endo practices, there is a familiar pattern in the referral base. At the top of the list are your top referrers who send cases regularly every month. These are the GPs with whom you have the strongest relationship. Many top referrers typically send all their endo patients to you as their preferred specialist. The rest of the list are doctors who are less predictable, from only referring the occasional case to not quite sending enough cases that you can count on every month.

 

Most endodontists pay careful attention to their top referrers because top referrers drive such a high percentage of referrals coming in. A lot of endodontists naturally focus their marketing strategies on keeping these relationships engaged and happy. At the other end of the scale, most endodontists pay careful attention to new referrers … GPs who refer for the first time.

 

What usually gets missed is identifying those existing middle to low-end referrers where there is a small but significant change in their referral patterns. Because these GPs are irregular referrers to begin with, unless you are tracking referrals over time in a way that can be compared easily with past referral levels, you often cannot see important changes.

 

For example, consider a referrer who sent you only 6 cases in the past year. Perhaps they do endo themselves, or perhaps they are “sharing the love” and dividing their referrals among a number of endodontists. Either way, to you it looks like they only refer 1 case every other month. Or they might refer two cases in a two-month period, and then you don’t hear from them for a few months.

 

Because the referral flow is so unpredictable, at what point would you identify that something is changing? What if they referred a case every month for 3 months in a row? Would that pop up on your radar instantly? It should because if they continued with that trend, it would put them in your top referrers! Maybe they’ve decided to do less endo themselves, or they’ve soured on sending referrals to one of their other endodontists. In either case, they should be targeted by you and your marketing coordinator for some one-on-one relationship building and marketing.

 

At Endo Mastery, we work with our clients to implement a referral tracking system that exposes when pattern shifts are occurring so referrers can be targeted for effective marketing. Whatever system you use, you need to be able to identify these hidden marketing opportunities. A good rule of thumb is any referral pattern that has shifted 25% or more compared to past referrals.

 

Also remember that it goes both ways. A plus 25% trend and a minus 25% trend both require marketing and relationship attention. And for your top referrers (at least one case referred monthly), you should narrow that rule to 10%, especially for downward trends. The loss of a top referrer has a significant cost to referral flow, and an early warning system when the relationship might be wavering allows you to find out what’s going on and take corrective action before it’s too late.

PREDICTING YOUR PRACTICES FUTURE

CYNTHIA GOERIG

CHIEF EXECUTIVE OFFICER

Two years ago, no one predicted exactly how much the worldwide supply chain would be disrupted by the pandemic. Even today, there’s a global shortage of computer chips needed to manufacture cars, a national shortage of baby formula, and many other examples.

 

Likewise, no one predicted how significantly the labor market would be disrupted, and how hard it would be today to hire practically anyone. A Bureau of Labor Statistics report earlier this month noted that there are 11.5 million job openings in the USA, which is the highest on record in over 20 years since they first started tracking.

 

As a business owner, predicting future possibilities and influences on your practice is important. You need to pay attention to the signs and signals that are coming your way, and interpret how you may be affected, and make plans to be prepared. Contemplating and preparing for things that, on a balance of probabilities, are becoming more likely to happen, lets you be proactive rather than reactive.

Underlying Assumptions

Even when things are going well, everything in your practice is based on certain factors continuing along the same path. What underlying assumptions in your current success dynamics are most vulnerable to change? For example:

We have a tendency when things are going well to take our eye off the ball. We behave more like grasshoppers than ants, assuming that summer will go on forever and winter will never come. A lot of endodontic practices have been in the grasshopper mode for the last 9 to 12 months. The pandemic shut down patient flow in GP offices early in the pandemic, and last year when restrictions started to lift, there was pent-up demand for dental care. Referrals in Endo Mastery-coached practices surged above average.

 

At some point, soon probably, the surge will diminish and we don’t know yet what level it will fall to. Maybe we’ll go back to our pre-pandemic normality. Maybe the concerning level of inflation will drive up interest rates and suppress discretionary spending again (yes, for many people, dentistry is discretionary). Maybe companies struggling with supply issues, rising costs and employment challenges, will reduce or limit insurance benefits. Plus, it’s pretty much guaranteed that insurance companies will pass their increased costs onto providers in the form of lower reimbursement.

Counting On Yourself

Whatever you believe may happen in the near future, the goal with prediction is to identify the factors that you have some control over, and take action on that basis. You may not be able to influence external factors like the rate of inflation or the stock market, but you do have control within your own sphere. For example, you have influence over your team and referrers, and you have the ability to drive your profitability high enough to weather any up or down cycle without distress.

 

The best investment you can ever make is in yourself and your practice. It gives you both the highest rate of return and the least dependence on external forces that you can’t control. You are your own best bet to drive growth and success, and Endo Mastery is a great partner to support you!

OPTIONS FOR NEW ENDODONTISTS

DEBRA MILLER | DIRECTOR OF COACHING

Last week at the AAE meeting in Phoenix, I spoke to a lot of young endodontists about the challenges they are facing. Overwhelmingly, it is a financial precipice for these doctors, who are sitting on a mountain of debt as they try to get started in the profession. With 83% of the dental class of 2021 having student loans and the average debt load of over $301,000, young dentists are caught between the proverbial rock and hard place. Young endodontists have even more debt on average when you add in the financial burden of their residency.

 

Education is, of course, an investment in your future. But it is an investment that needs to begin producing a return right away after graduation. Servicing that debt is an immediate need, as well as supporting your cost of living. So, for new endodontists, they need to act quickly and, more importantly, in the right direction that sets up their entire professional future.

 

Most of the young doctors I spoke to have the goal to eventually own their own practice. However, their educational debt greatly affects their ability to get financing, and buying an “average” endodontic practice in every way (average productivity, referrals, staff and facility) is even out of range.

Start Ups and Associateships

Faced with this limit, there are really only two options. The first option is a cost-controlled start up consisting of an affordable location, minimized square footage, essential equipment and minimal staff. With a start up, you avoid paying for goodwill in a buyout, which means you’ll be starting with a zero referral base. Your life from day 1, will be about marketing, marketing, marketing to develop referral relationships.

 

A lot of doctors choosing the start up route make some pretty fundamental mistakes that cost them a lot of unnecessary expense and stress at the beginning. Real estate and leasing mistakes, over-equipping beyond the essentials, under-trained team members, poorly set up practice systems, and none of them obviously have any realistic experience in dental referral marketing. It can be a long row to plow without careful planning and support.

 

The second option when faced with financial limits is to associate in a practice, at least as a stepping stone while you pay down your debt and save money. The challenge with associating is determining what your income could be in the practice you join. You want to be in a practice that is ready to grow quickly by expanding clinical capacity. Otherwise, you could end up in a practice where you only complete two cases a day (or less!) on average, and you end up spending most of your time twiddling your thumbs (with your take-home pay reflecting that reality).

 

There are specific criteria that are helpful for associate doctors to determine if a practice is ready for them and can get them busy quickly. The first criteria is whether the practice is already successful at an above average level. If an “average” doctor completes only 3 to 4 cases per day, a truly associate-ready practice will have an owner doctor who is completing at least 50% more cases (5 to 6 cases per day).

 

Above average productivity is a sign of two important things that every associate wants to find in an employing practice. First, that the practice knows how to market and build referral relationships. Second, that the practice has figured out how to be efficient and productive clinically. That’s what will drive your income most as an associate, and that’s why associates in Endo Mastery-coached practice typically earn 2 to 3 times as much as associates in other practice environments.

 

Finally, I should mention the corporate vs. private practice landscape. Corporate entities are building their presence in the profession, and they are on a hiring spree for associates. I would suggest you use the same criteria to evaluate corporate positions. Focus on the specific practice you would work in, how truly associate-ready is it, how many cases will you complete daily, at what fee and collection ratio (since your compensation is percentage driven on collections). Also, keep in mind that working for these organizations adds another layer of management and oversight above you. Carefully consider whether the corporate culture is something you want to live with.

Your Career Start Options

There are a lot of questions about starting out and it’s hard to find clear answers. To help solve this problem, Endo Mastery has launched a free Career Start program for endodontic residents and new endodontists. This program features twice-monthly videos and a free one-day livestream seminar in June: “Pathway to Your Ideal Success in Endodontics”.

 

Whether your focus is new practice start up or associating, the Career Start program will give you some very practical information to make the best choices, plus crucial financial guidance to eliminate debt quickly and maximize your income. We’re really excited about this program. It’s something we’ve wanted to do for a long time, and we hope you join us!