Endo Mastery

Is your practice keeping up with your personal goals?

DEBRA MILLER | DIRECTOR OF COACHING

After the startup phase of practice ownership, most doctors and practices stabilize around a predictable level of productivity and success. But as your personal goals grow and evolve over the years, often the practice remains unchanged at a certain level. Life events such as starting a family, home ownership, paying off debt, saving for future needs (kid’s college, retirement, etc.) and lifestyle spending growth can result in feeling stressed and pressured if the practice doesn’t rise to the challenge.  

 

However, endodontic practice owners can directly shape their work environment and practice performance. Here are 4 key questions that reveal when it’s time to make some changes that better suit your current and future goals: 

1. Do I love coming into my practice every day? 

Other than sound asleep in your bed, your practice is probably the single place where you spend the most time devoted to one activity. It should be an environment that energizes and inspires you to deliver the best care to patients and enjoy your time.  

2. Do I have the right level of work/life balance? 

When you are younger, you expect to work hard to get your practice set up. As you get older, having the right balance between work and personal time becomes more important. You may want it for your family, for travel, for pastimes and hobbies, etc.  

 

You also need to consider your physical needs as an endodontist. What is the right number of days to work in a row, after which your body and ability to provide care is better served by rest? This is a factor that frequently evolves over time and is frequently ignored by many doctors, resulting in a perpetual feeling of exhaustion at the end of the workday.  

 

If you are going home exhausted, plus you’re taking work home from the office (reports to write, accounting, management issues), then your personal time is actually being robbed of relaxation and enjoyment by your business. 

3. Am I free of limitations and issues concerning my team? 

Unlike practice owners, team members are employees who adapt primarily to the expectations placed on them. If you have low expectations based on past or stale goals, or you have allowed team drama to persist, the team will remain at that level. If you evolve to high expectations, the team will eventually adapt. However, teams don’t easily move from low to high expectations without clarity, support and investment from you in their professional growth and development. 

 

Great teams really understand that their job (in addition to great patient care) is to make life easy for the doctor. Great teams anticipate the doctor’s needs in advance and focus on practice goals that achieve the doctor’s vision. Empowering your team to embrace change and excel at a new level takes leadership.

4. Is my practice in alignment with both my short and long-term financial goals? 

It’s often the bottom-line results that are the clearest and quickest barometer for assessing your goals. If you are having a lot of fun in your practice but you’re not taking home enough income, eventually it won’t be fun anymore. If you are spending everything you earn and you don’t have practice growth, you’ll never be free of debt or save enough for retirement.  

 

Endodontists generally do well compared to the average person, but many endodontists still feel financial limitations and stress. However, you literally have the ability to decide how much income you want to earn. From the 5th percentile to the 95th percentile, solo endodontists can earn between $100,000 to several million dollars per year. That’s a big range in which you can find the right level for you now and in the future. 

Adapting to your vision and goals 

Above all else, if you are at the point where you are just “putting in time” or “making do” with a practice that is falling short of your ideal goals, why would you want to do that any longer? Whether you have 5 years or 15 years or 30 years ahead of you in endodontics, that’s a long time to feel like you are coming up short. 

 

At Endo Mastery, we specialize in helping doctors achieve their goals. We have helped so many doctors to grow, and it doesn’t matter if you are one-visit endo, two-visit endo, GentleWave endo, part-time endo, startup endo, big city endo, small town endo, associate-based endo, multiple location endo, etc. Our strategies and systems successfully adapt to your practice and your vision. 

Preventing collection problems before they happen

DEBRA MILLER | DIRECTOR OF COACHING

Payment is the last step in a patient’s endodontic journey into your practice. If the patient has a problem paying, discovering that fact at the moment they are leaving the practice is the worst time. At that point, you already have a collection problem because the patient balance will be added to your accounts receivable to collect later.  

 

Collecting after the patient leaves is troublesome. No matter how much a patient promises to pay soon, inevitably a certain percentage of accounts don’t get paid promptly. That results in statements being sent and phone calls being made to prompt the patient to pay. When this happens too often, the accounts receivable keeps growing, and the administrative team must devote more and more time to chasing down overdue accounts.

 

If you end up sending accounts to a collection agency, that creates its own set of problems. Collection agencies can be very aggressive, and a patient (even though they haven’t paid their bill) may end up complaining about your collection methods to the referring GP. They will say they were not prepared for the cost of treatment and were financially blindsided in your practice. Plus, collection agencies charge a large fee for any amount they collect, so your net collections are reduced substantially.

Prevention is the cure 

Like brushing and flossing to prevent dental problems, collection problems are best solved through prevention. In other words, the solution to patients not prepared to pay when they leave is to ensure they are prepared to pay before they arrive.  

 

The patient phone call to schedule their appointment when they are first referred is the key. While there are many things that need to occur on this call, part of the call should be thought of as a financial consultation with the patient. This includes to: 

  • Ensure the patient is aware that even if they are being referred for a consult that treatment will proceed immediately at the same appointment if they are diagnosed. 
  • Collect insurance information from the patient to determine if they have coverage, what the insurance plan fee will be, and their expected copay.  
  • Give a clear estimate of their out-of-pocket costs due at the appointment (full fee for non-insured patients, copay for insured patients) and the methods of payment available. 
  • Ascertain if the patient has any concerns about their out-of-pocket costs and give them options such as third-party financing.  

Due diligence on insurance

When the patient has insurance, determining their expected copay is essential. Often the administrator will need to collect the insurance information and then call the patient back after carefully estimating the copay in order to complete the financial consultation.  

 

Estimating the copay means using the insurance company’s online tools (or contacting an insurance company rep if online tools aren’t available) to confirm the patient’s eligibility, remaining deductible, remaining benefits, and any other plan details that may affect the patient’s coverage. Realtime information is vital, especially when the patient is concurrently receiving treatment (and using up benefits) in the GP practice.  

Administrative team organization 

For a non-insured patient, the fee is known (your regular fee-for-service fee), and so the full financial consultation can occur on the first call. For an insured patient, almost always a second call will be required after the copay is estimated with the insurance company. This second call needs to occur as soon as possible after the first call.  

 

Given that endodontic practices often have emergency patients appointed to come in later the same day, the administrative team needs to be organized and efficient. An administrator needs the time capacity to contact the insurance company immediately, estimate the copay, and call the patient back … within the hour sometimes! It’s the only way to ensure the patient arrives prepared for their costs. 

 

Likewise, sometimes patients are appointed on a longer timeframe, and it’s important the administrative team updates the copay estimate close to the patient’s appointment date. In the weeks since the appointment was made, significant insurance benefits could have been claimed by the GP office.  

 

Great admin teams carefully keep track of patient estimates, including when copays need to be determined and updated. By doing so, payment issues when the patient leaves can be significantly reduced, and the accounts receivable will go down.  

Three reasons to love endodontic emergencies

DEBRA MILLER | DIRECTOR OF COACHING

In businesses that are driven by salespeople, you often see a motivational activity around ringing a bell when a sale is made. In car dealerships, for example, they often have the customer themselves ring the bell to celebrate their purchase. In endodontics, we’re not in a sales-driven business but there is one thing you and your team should metaphorically ring the bell for: every time you schedule an emergency patient who is in pain.

 

Dental pain is the entire reason behind dentistry’s origins. From the Middle Ages until the early 1800s, a person experiencing dental pain would visit their local barber for a tooth extraction. Then, in the mid-1800s, dentistry and barbering diverged as (obviously) separate disciplines, which unofficially makes endodontists the oldest profession among dental practitioners.

 

Even with all the advances in preventive and restorative care, emergency endodontic care continues to be a significant part of our practices. Today, however, we’ve come a long way from the crude extraction forceps of a barber, with advanced root canal techniques that can quickly eliminate the pain while saving the tooth.

 

Every time an emergency patient calls the practice, it’s a reason to celebrate as an endodontist … not to celebrate their pain but to celebrate why endodontics is such a great profession. Aside from historical recognition, here are three reasons why you should love emergency patients in your modern practice:

1. The patient is committed

Endodontists probably suffer the most from patients who really don’t want to be there in the first place. But an emergency patient in pain is highly motivated to receive treatment, and that means they are highly committed. In short, that makes them a dream patient in many respects and less likely to cause administrative, scheduling and financial problems.

 

An emergency patient fundamentally respects you as a specialist, which means they are going to appoint for the first possible appointment time that your team recommends, and they show up on time. That appointment should ideally be the same day they call, and you can reserve time in your schedule every day where emergency patients can be appointed.

 

Emergency patients are also more committed to their treatment costs and prepared to pay in full whether they have insurance or not. They won’t hesitate to use their credit card or sign up for third party financing if they need to spread their copay costs out over time.

2. Emergency cases are (usually) easy

From a clinical perspective, emergency cases are often relatively easy. They are frequently the kind of cases that you have done many times and that you can do very quickly and efficiently. That makes them among the most productive cases you have in terms of revenue vs. time required. Scheduling emergency patients on the same day is one of the best ways to make sure you meet and exceed your productivity goals each day.

 

When emergency cases are more complicated, one common reason is that they are a retreatment case. Over two-thirds of root canals in the USA are performed by GPs, and they usually don’t have the same clinical tools (like cone beam) or clinical skills that you have. When one of their cases blow up and they need to refer the patient, it’s a great opportunity for you to build your collaborative relationship with the GP. They will grow to see you as a clinical partner and that leads them to understand how much easier it would be if they just referred their endodontic cases from the beginning.

3. Referring doctors are appreciative

Regardless of whether retreatment is involved or not, referring doctors are appreciative when you can get their patient out of pain quickly, and the patient returns to their office singing your praises. They pay attention to patient feedback and they like to hear patients tell them how well they were cared for in your office.

 

In fact, organizing your practice around efficient same-day treatment for emergency patients in pain is one of the most effective referral-building strategies in endodontics. When you plan your schedule for same-day emergencies and you commit to referrers that you will get their patients out of pain on the same day—and you prove that consistently without fail—then referring doctors learn to count on you more and more.

They’ll refer more cases because they know the patient will return happy, quickly, and ready for a final restoration. And that kind of restoration is an easy, highly productive case for them too, so everybody wins.

 

Endo Mastery Practice Coaching can help you and your team optimize and master the scheduling, productivity and marketing of emergency care in your practice. For more information, visit https://endomastery.com/practice-and-team-coaching/

Achieving peak practice performance

DEBRA MILLER | DIRECTOR OF COACHING

As Director of Coaching for Endo Mastery, I am in the lucky position to observe the success of every coaching client. I speak in detail with every doctor prior to starting coaching, and then at their annual year-end review. What a difference there is! It’s the same doctors, but they are in a completely different place mentally about their practices and lives.

Commitment and Self-Belief

Overwhelmingly, there is such a sense of accomplishment and feeling of joy coming from doctors after their first year of coaching. Coached practices truly progress and grow significantly during this time, and it does require commitment from the doctor to provide leadership for their team as the practice evolves.

 

Again and again, doctors tell me that they didn’t believe it was possible. Often their practices had been in a holding pattern without improvement for several years or longer. They were starting to doubt whether they and their team had the capability to grow any further. Or they were facing a challenge, concern or goal in their practice that seemed too much of a reach.

 

At Endo Mastery, we have a great track record of knowing how much practices can improve. So, when doctors tell me that they didn’t believe it was possible, they are saying they didn’t believe it was possible for them. Sometimes when you are at the base of the mountain looking up, it can appear far more difficult than it is.

 

I get to experience the moment of reflection after a year when doctors celebrate their commitment and the growth achieved by the team, but also realize it was so much easier than they expected. That’s the power of coaching, because the journey up the mountain is supported by an expert guide who has helped others climb the same mountain many times before. All the risks are avoided, the best path is chosen and when you reach the top, exhilaration!

Renewed Spirit and New Possibilities

The mindset shift that happens with doctors is the result of several factors that we see in coached practices. Here are the factors most mentioned by our clients:

  • Renewed team spirit. teamwork excellence and daily enjoyment
  • Streamlined scheduling and systems for effortless daily flow
  • Effective referral marketing that is easy and actually works
  • Relief from typical time-consuming management burdens
  • Ability to focus on excellent clinical care without distractions
  • Leaving the practice each day without worries or stress
  • Doubling (or more) their previous take-home income
  • Eliminating debt and enjoying a better family lifestyle
  • Having a coach that truly cares about your success and goals
  • Rediscovered joy to enjoy the profession

All of this leads me to the conclusion that what counts as peak performance is very personal, which is why Endo Mastery works so closely with doctors to understand their individual goals. For some doctors, it’s economic. For others, it’s how they feel each day working with their team in the office. Still for others, it’s clinical care and professional relationships. And, of course, family is vital and how the practice ultimately supports your family goals tops everything.

 

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

Trust in endodontic marketing

DEBRA MILLER | DIRECTOR OF COACHING

In the past month, we’ve witnessed an extraordinary example of how trust gets broken. Elon Musk’s nascent tenure as owner and CEO of Twitter has seen a flurry of changes that have altered trust:

  • The team doesn’t trust their leader after brutal workforce cutbacks and vastly increased work requirements on those remaining.
  • Advertisers don’t trust the service as a safe moderated place for their brands and have stopped buying ads.
  • Users and key influencers don’t trust the platform’s verification and are looking at other options.

Of the three stakeholders, the trust of advertisers is the most important since they are the true “customers” of the business. 90% of Twitter’s revenues come from advertising. When they stop spending, the company’s financial foundation is shaken.

Referrals and trust

In the endodontic practice, you have the same kind of vital relationship with your referrers. Your practice is driven by referrals, which means that GPs need to know they can trust you. If you take steps (like Elon Musk) that damage trust, you can expect referrals will go down. But the opposite is also true. If you take steps to increase trust, you can increase referrals.

 

What does a referrer need to trust about you? Clinical ability and taking care of patients are the top two, but that’s obvious. It’s safe to say that practically every endodontist has those two points covered. So, what are the less obvious trust factors that can influence marketing and growth? These are more discretionary and it’s your choice how much you commit to building trust in these areas. Can they trust you and/or your team to:

  • Always schedule an emergency patient in pain on the same day?
  • Answer the phone promptly in a welcoming and caring manner?
  • Calm a nervous or fearful patient before and during their visit?
  • Ensure patients have financial clarity and no payment surprises?
  • Speak highly of the general practitioner?
  • Support the GP’s treatment plan?
  • Provide treatment quickly and gently?
  • Call the GP directly if any patient leaves the practice unhappy?
  • Receive referral reports on the same day as treatment?
  • Ensure patients return to the GP as soon as possible?
  • Be available to answer questions about a patient case?
  • Make it as easy as possible to refer a patient?
  • Establish a friendly team-to-team relationship?
  • Visit their practice periodically with pop-by marketing gifts?

You might think that your practice is good at most of these things, but the question to ask is whether you are clearly reliable to the point where it becomes as equally obvious as your clinical ability.

 

Even some of the simplest things, like the pop-by marketing gifts, become much more effective when the GP’s team realizes they can count on it. That’s when you have established such trustworthy processes that they know, without a doubt, they will see you every month or two. Presence of mind at the highest level!

Most important trust factor

On the list above, there is one factor that is particularly important to drive growth in your practice. That is why it is listed on the top: scheduling emergency patients in pain on the same day.

 

When a GP can absolutely trust—without question—that their patient in pain will be seen and relieved of pain on the same day by you, then you become the easiest, most reliable and most obvious choice for their referrals. You end up getting 100% of their emergency referrals once that level of trust is achieved, which leads to getting 100% of all their other endodontic referrals. It’s the ultimate relationship-builder in endo.

 

Becoming a practice that can deal with emergency patients so responsively and nimbly takes effort. The schedule must be tuned and optimized to allow it, and the team must be prepared and know how to adapt for emergency patients throughout the day. And all this needs to be done in a way that isn’t stressful for you and the team. It should be effortless.

Endo Mastery Practice Coaching can help you enhance and grow referral relationships significantly. For more information, visit https://endomastery.com/practice-and-team-coaching/

Hiring for attitude and aptitude

DEBRA MILLER | DIRECTOR OF COACHING

It’s a puzzling situation that we find ourselves in when it comes to hiring. Dental jobs should be among the most desirable. They are very stable jobs in a caring and supportive environment with a relatively small team where every person has a vital and appreciated role. Plus, they are pretty good jobs income-wise. And yet, finding qualified or even interested team members is like pulling teeth recently.

 

Last month, at our Mastering the Effortless Endodontic Practice seminar in Philadelphia, an informal survey of doctors revealed that over half of them have an unfilled team position in their practice. That means that if you are looking for someone, and half the doctors in your community are also looking, there is some pretty significant competition for skilled dental personnel.

 

Even worse, doctors talk about hiring someone who literally doesn’t even show up on their first day, or someone who stays for a few weeks and then jumps ship without warning to go to another practice for 50 cents more per hour.  At Endo Mastery, we believe that a team that performs well should be paid well, but if you end up in an all-out bidding war for new hires, it creates additional problems. It’s hard to justify paying a new team member more than someone who has worked for the practice loyally for several (or many) years already.

 

I believe the turbulence in the employment market will eventually settle down, but until then doctors in many dental markets should not expect to easily hire someone who has high level experience and skills.

Personality and trainability

If a new hire can’t come with the whole package already in place, then you need to hire at a lower level and train them up. In this regard, you’re going to have to start somewhere, and you should focus on finding people who have a great personality and who are trainable. That’s attitude and aptitude!

 

Attitude characteristics that are desirable include people who are fundamentally happy, drama-free, a people-person who is caring and empathetic, highly communicative (which is different than being excessively talkative), self-motivated to do well in their job, and a team player.

 

Dr. Goerig always likes to ask prospective employees about their current or past involvement in team sports, because that often reveals someone who has some competitive drive to do well, knows how to work with others to accomplish goals, and is accustomed to being coached.

 

For aptitude, you want someone who has a natural ability to learn quickly and become proficient. Look for people who are engaged, highly curious, detail oriented, have an ability to stay focused, and track record of teaching themselves new things. Some people are doers, which is what you want. Watch how fast they walk because that’s a big indication of how much energy they bring to everything they do.

Keep your eyes open everywhere

If you are prepared to hire for attitude and aptitude—and train for dental to the level that you want—then your pool of candidates expands significantly. In fact, you can find great people in non-dental environments who would be so grateful for the opportunity for a dental career.

 

Look for people who you notice repeatedly that they excel at face-to-face interactions with you in the businesses you patronize. That could be a barista at the coffeeshop (service-oriented), a bank teller (detail-oriented), or the person behind the counter at a jewelry store (very accustomed to talking about high-value items so that people happily pull out their credit card).

 

Give them your business card and say, “If you are thinking about making a career change sometime, give me a call.” That way, you’re not committing yourself to anything until you’ve had a chance to vet them more thoroughly, including having your office manager in the conversation.

 

You will know if you have a good candidate when your office manager agrees that the potential hire has an energy level and ability to be a great team member.