Endo Mastery

THE PERSONALITY OF PRACTICE SUCCESS

CYNTHIA GOERIG

CHIEF EXECUTIVE OFFICER

Even though all endodontic practices are essentially engaged in the same business and deliver the same services, there can be vast differences in the level of practice success. While some of the differences can be chalked up to demographic variations between communities, even two practices in the same community can show dramatic differences.


It is the practice owner’s personality that is often the key variable which determines how successful a practice is likely to be. Some doctors have a personality and natural leadership ability that stimulates growth and success. For other doctors, it takes more effort to get to the same level (more about this at the end of the article).


In a world where unlimited knowledge about practically anything is just a Google search away, attitude is the differentiator. Here are some key personality factors of an owner doctor that contribute to making a practice more successful:

  • Passion and push
    When you love what you do, there are follow-on effects: a desire to be good at what you do, having fun and enjoying every day, and a work ethic to be focused and productive with your time spent meaningfully. That passion and the innate drive to keep pushing yourself to improve keeps a practice owner moving forward.
  • Curiosity and enjoying the game
    Business has an economic result, but the experience of business ownership is an intangible benefit to be enjoyed. When you are curious about how to keep growing and optimizing the business, then roadblocks and limits are seen as opportunities. It’s a fun game of possibilities to play where learning and growth inspires persistence to succeed.
  • Future-Focused Priorities and Decisiveness
    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.
  • People-based investment mindset
    You need others to help you reach your goals, which means surrounding yourself with people who have the skills to support you. That means investing in people to align themselves with you. Whether it’s your team, your referrers, a mentor or coach, or other professional advisors, building relationships where you can amplify and access the expertise and resources of others is vital.

It’s easy to see how these leadership factors work together to create a positive, happy, engaged, forward-looking practice. When the doctor embodies these qualities fully, it creates a culture for the entire team. The full force of growth potential becomes unlocked. 90% of practice growth is driven by the team, and the team’s attitude and mindset reflect the doctor.

Upping your game

It is estimated that only 10% of people have natural superlative leadership qualities. Another 20% are within reach of being very effective leaders. What does that mean for the 70% that agree in principle but haven’t found the knack of putting leadership into action?

 

Everyone can take stock of their strengths and weaknesses. You might be great at vision but limited when it comes to motivating your team. Or you might be great at creating an enjoyable work environment, but weak at building referrer relationships to drive growth. Or you might provide excellent clinical care but have trouble staying on-time with your schedule.

 

Many doctors focus on their leadership strengths but gloss over the impact of their weaknesses. That inattention to certain aspects of business ownership dilutes your success far more than you would think and compels you to work so much harder to achieve the success you want.

 

The secret is put the right delegation, systems and accountability around your own limitations as a business owner. Having a coach support you with a 360-degree approach to your team and practice systems could be all it takes to achieve your next level of success.

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.

FRIENDING REFERRERS

MARKETING FOCUS

Friendship is more than just knowing someone, or even knowing them well. With our friends, there is a social contract: we like them; we are interested in what they are doing; we care that they are happy and successful; we enjoy talking to them; we plan to spend time together; we look forward to them as a part of our future.

 

Of course, professional friendships are different than personal ones. But the best professional friendships feel like personal friendships, even though they exist primarily in the business side of our life.

 

We can take cues from our personal friendships to create a system for building and growing professional ones. Some of these may seem basic and obvious, but many doctors are inconsistent with them.

●  If a personal friend was eating at the same restaurant as you or shopping in the same store, you would go up and greet them. To do that with a professional friend, you would need to recognize their face, remember their name based on their face, and feel confident they recognize you too. So, creating professional friendships begins with establishing a face-to-face relationship between doctors. Do this by visiting them in their practice, inviting them to lunch, or creating connections at dental events.

 

●  With a personal friend, we always communicate with them around important milestones, such as birthdays and important holidays. Holidays are easier because they are the same for everyone (although religious holidays can vary). Birthdays are harder. It may take time and circumstances to learn your referrers’ birthdays.

 

A great marketing coordinator can often coax this vital information from the GP’s team. Your marketing coordinator can create a shared calendar that appears on your phone so you know any personal messages you need to send, as well as flagging important important birthdays (40, 50, 60, etc.) that require extra attention.

 

●  Gift giving with friends is important too. Sometimes gifts are meant to be significant. Sometimes they can be small acknowledgments. Sometimes they are meant to surprise and delight. Birthdays and holidays are good gift-giving times albeit predictable. Unexpected surprise gifts that are especially focused around something you know they will like are really noticed. For example, tickets to a concert, sport or event that you know is a passion of theirs.

 

●  Although not everyone is active on social media, if you are and they are, then make an effort to add them as a friend or follow (both their personal and practice accounts if they have them). This is a great way to learn about important events in their life, their family and their interests.

 

You don’t need to spend a great deal of time on this. You can give your marketing coordinator access to your socials to create and accept friend/follow requests, and quickly scan your feed for notable posts and activity by your referrers. Your marketing coordinator can ask GP teams if their doctor or the practice is on social media and how to connect.

 

●  Plan events and activities that you can do together. Many endodontists take referrers for lunch regularly, but you can expand this strategy. It can be as simple as taking the initiative to meet up when you’re at the same event, such as your state dental meeting. You can host open houses and invite your referrers. You can plan team-to-team events that bring everyone together, such as a summer barbecue. If you are a dog lover, you can set up a canine social party. You can organize a golf tournament or sports outing.

 

●  Learn their hobbies, interests and goals, both personally and professionally. Find articles of interest around those things that you can email to them with a note: “I thought of you when I read this article about [sailing/wilderness trekking/practice growth]. I think you will enjoy it!” It’s so simple to do, exactly as you would for a personal friend.

The greater the effort you make to engage with your referrers and establish a personal relationship as the foundation for your professional one, the easier it gets. A key part of the process is building up that intelligence portfolio of key facts and insights on each of your referring doctors, which is something your marketing coordinator should manage for you.

 

Gather information, take notes, review and internalize what you know whenever you are going to be reaching out or interacting. It lets you move beyond boilerplate communications to personalized engagement, and in time you won’t need crib notes. It will just be effortless. Once you’ve crossed the threshold to genuine personal goodwill, professional goodwill follows and increases. It’s just human nature to support our friends, and for them to support us.

WORK LESS AND EARN MORE IN ENDODONTICS

DEBRA MILLER | DIRECTOR OF COACHING

Given the chance, I think most doctors would enjoy being able to work less and earn more. Not only would work/life balance improve but rising income would add to your lifestyle spending power and overall net worth.


At the same time, a lot of doctors don’t believe it is possible for them to work less and earn more. In their minds, they have an equation that links how much work is required to earn a certain level of income. That equation tells them that to earn more, they need to work more. On the flipside, it also tells them that if they work less, they will earn less.


They also point out factors in the practice that seem to preclude the possibility of working less and earning more. Often, they believe their team as not ready or capable of rising to the challenge. Or they express doubts that their referral base could refer more cases.
More referred cases are the primary driver of higher income for endodontists. (A secondary driver is which insurance plans you participate in, which affects the reimbursement rate per procedure completed.)


So, for your income to rise, you need to complete more cases and there is no denying that sounds a lot like working more, not working less. In fact, completing more cases in the context of your current team structure, practice systems, and clinical workflow is probably more work. But it doesn’t have to be!

How More Cases Equals Less Work

In my mind, “work” has two meanings. The first is the “I’m going to work today” meaning, which is the time we spend away from our family to earn an income. The second meaning is “labor” … something that draws our physical and/or mental energy to accomplish tasks. Before I address the first one, let’s talk about the second one.


How much you feel the labor of anything depends on how much you love doing that task, and how much resistance you feel while doing it. Even when you love something, if you experience a great deal of resistance to achieving your goals, it can diminish the love significantly. Likewise, even an easy task that you hate to do feels like a huge burden.


Most endodontists have settled around a middle ground between what they love (delivering endodontic care to patients), the “labor” it takes on a daily basis, and the income it generates. But when you try to change the parameters, such as completing more cases to earn more income, the resistance scales up dramatically.


There are doctors who complete 4 cases a day and they feel stressed and labored. Other doctors complete 8 or 10 cases a day and feel effortless ease all day. The difference between the two is how you have optimized your team, systems, marketing and workflow. It’s no different than if you were a baker. The systems to bake and sell 100 loaves a day aren’t going to work for baking and selling 1000 loaves a day.


When doctors refine and improve their systems so that 8 cases per day are just as easy as 4 cases per day, what happens is that 8 cases actually become easier than 4 cases. It’s literally less work and more income on a per day basis! Professionalizing your practice to that level means purging out so much inefficiency, repeated effort and timewasters that were rampant at 4 cases per day (but allowed to persist). Suddenly, everything is in place for you to effortlessly complete more cases than you ever thought possible.

How Efficiency Drives Growth

What is common is that inefficient doctors and teams have difficulty believing they could complete twice as many cases during the same time. Their inefficiency is literally obscuring their opportunities for growth. Getting past the disbelief mindset is often the biggest challenge at the beginning.

 

The truth is that 90% of growth in an endodontic practice is driven by the team. When the team becomes focused on optimizing the doctor’s time, improving daily flow, and scheduling patients smartly so the doctor is never rushed nor ever idle, the value of the doctor’s time inside the practice can soar.

 

Value outside the practice soars too. If you have 50% overhead expenses to begin with, and you increase the number of cases you complete by 50%, then profits almost doubles! Wow!

Cases, Income and Work/Life Balance

It might be hard to visualize from where you are now, but this transformation of “work” is experienced by our clients over and over again as they grow. And it’s matched by a tremendous increase in income. For most doctors, going from 4 cases per day to 6 cases is enough to double their take-home. 8 cases per day can triple income!

 

Once you are successful at that income level, then you really have choices about how many days you are going to “go to work” … the first definition of work that I mentioned. For example, rather than 3 times the income, maybe choose 2 to 2.5 times the income while working one day less per week. Or, you can also keep your practice and income growing by integrating an associate, which opens up many short- and long-term options for amazing work/life balance.

 

There are so many possibilities and I always love to talk to doctors about their vision and how it can be achieved. I invite you to contact me anytime for a complimentary practice analysis and transformation conversation using the button below.

PREVENTING NO SHOWS AND CANCELLATIONS

DEBRA MILLER | DIRECTOR OF COACHING

An appointment that is broken by a cancellation or no show has a high cost in the endodontic practice. Practices invest a lot of time before the patient even comes in because the objective during the appointing process to make sure the patient is prepared for treatment on the same day when the diagnosis is made. In effect, endo teams work hard for the patient to “pre-accept” and be ready for potential treatment as soon it is diagnosed. For this reason, we talk to the patient, we do over-the-phone triage and symptoms assessment, and we pre-estimate insurance amounts and copays.

 

When a patient cancels their appointment, we have to do all that work again … assuming they cancel early enough that we have enough time to fill the appointment time with a different patient. If we don’t have enough time, or if the patient simply no shows, then the cost to the practice is the highest. The doctor will be idle, and a treatment fee will not be collected for that appointment time.

 

In the past year, during the height of the pandemic, we adapted to the fact that many patients were experiencing anxiety. Now, as states open up again, we would expect patient behaviors to return to normal. But that has not happened yet. One reason is that there are lingering financial effects from the pandemic, and financial reasons are a huge driver of cancellations and no shows. Also, and expectedly, there are always patients who have a fear of treatment itself.

 

When taking a cancellation call from a patient, you need to keep them in the schedule because if you let them “call you back”, they never will. Be a detective and find out why they are canceling. Ask open-ended questions and listen carefully to their responses. Sometimes the real reason is just below the surface. A lot of patients may feel embarrassed or reluctant to say it is a financial issue. Be prepared to suggest third party financing options and tell patients, “Right now, your finances are temporary but if you lose the tooth, it is permanent.” Express genuine concern for the patient and their health.

 

Another idea is to make sure at the time of scheduling that you tell patients their appointment is now confirmed. Although we often describe “confirmation” as the call or text message the day before an appointment, these are actually reminders or notifications done for the courtesy of the patient. A subtle shift in language will strengthen the patient commitment to their appointment, rather than seeing the “confirmation” as an opportunity to cancel or reschedule. This will also help with no shows.

 

For no shows, remember that those patients often come from doctors who allow no shows. You can reach out to the admin team at those offices to ask them (in a friendly way) if they would like to share and collaborate on ideas you both can use to prevent no shows. Also remember that when a patient no shows you should notify the referring office immediately since it will put a damper on their treatment plan with the patient.

 

Your reminder system (“confirmations”) should take advantage of current technology and ask patients how they would like to be contacted. For more and more patients, texting is the most favorable. Check your software options or a third-party solution. Also, review the message you are sending. Rather than “We are confirming your appointment for tomorrow.”, try “We calling to see if you have any questions about your visit to our office tomorrow or questions about your estimated co-pay.”

 

Finally, when a patient no shows, make a follow up call right away (if they haven’t arrived within 10 minutes of when expected). The goal is to get them back in the schedule as soon as possible. Ask them “Is everything okay? We were expecting you and I’m concerned something has happened.” Again, when this is done with genuine care, it will open the conversation to find out what happened and schedule them again appropriately.

THE SAME DAY MINDSET FOR GROWTH

DEBRA MILLER | DIRECTOR OF COACHING

Given the chance, I think most doctors would enjoy being able to work less and earn more. Not only would work/life balance improve but rising income would add to your lifestyle spending power and overall net worth.


At the same time, a lot of doctors don’t believe it is possible for them to work less and earn more. In their minds, they have an equation that links how much work is required to earn a certain level of income. That equation tells them that to earn more, they need to work more. On the flipside, it also tells them that if they work less, they will earn less.


They also point out factors in the practice that seem to preclude the possibility of working less and earning more. Often, they believe their team as not ready or capable of rising to the challenge. Or they express doubts that their referral base could refer more cases.
More referred cases are the primary driver of higher income for endodontists. (A secondary driver is which insurance plans you participate in, which affects the reimbursement rate per procedure completed.)


So, for your income to rise, you need to complete more cases and there is no denying that sounds a lot like working more, not working less. In fact, completing more cases in the context of your current team structure, practice systems, and clinical workflow is probably more work. But it doesn’t have to be!

How More Cases Equals Less Work

In my mind, “work” has two meanings. The first is the “I’m going to work today” meaning, which is the time we spend away from our family to earn an income. The second meaning is “labor” … something that draws our physical and/or mental energy to accomplish tasks. Before I address the first one, let’s talk about the second one.


How much you feel the labor of anything depends on how much you love doing that task, and how much resistance you feel while doing it. Even when you love something, if you experience a great deal of resistance to achieving your goals, it can diminish the love significantly. Likewise, even an easy task that you hate to do feels like a huge burden.


Most endodontists have settled around a middle ground between what they love (delivering endodontic care to patients), the “labor” it takes on a daily basis, and the income it generates. But when you try to change the parameters, such as completing more cases to earn more income, the resistance scales up dramatically.


There are doctors who complete 4 cases a day and they feel stressed and labored. Other doctors complete 8 or 10 cases a day and feel effortless ease all day. The difference between the two is how you have optimized your team, systems, marketing and workflow. It’s no different than if you were a baker. The systems to bake and sell 100 loaves a day aren’t going to work for baking and selling 1000 loaves a day.


When doctors refine and improve their systems so that 8 cases per day are just as easy as 4 cases per day, what happens is that 8 cases actually become easier than 4 cases. It’s literally less work and more income on a per day basis! Professionalizing your practice to that level means purging out so much inefficiency, repeated effort and timewasters that were rampant at 4 cases per day (but allowed to persist). Suddenly, everything is in place for you to effortlessly complete more cases than you ever thought possible.

How Efficiency Drives Growth

What is common is that inefficient doctors and teams have difficulty believing they could complete twice as many cases during the same time. Their inefficiency is literally obscuring their opportunities for growth. Getting past the disbelief mindset is often the biggest challenge at the beginning.

 

The truth is that 90% of growth in an endodontic practice is driven by the team. When the team becomes focused on optimizing the doctor’s time, improving daily flow, and scheduling patients smartly so the doctor is never rushed nor ever idle, the value of the doctor’s time inside the practice can soar.

 

Value outside the practice soars too. If you have 50% overhead expenses to begin with, and you increase the number of cases you complete by 50%, then profits almost doubles! Wow!

Cases, Income and Work/Life Balance

It might be hard to visualize from where you are now, but this transformation of “work” is experienced by our clients over and over again as they grow. And it’s matched by a tremendous increase in income. For most doctors, going from 4 cases per day to 6 cases is enough to double their take-home. 8 cases per day can triple income!

 

Once you are successful at that income level, then you really have choices about how many days you are going to “go to work” … the first definition of work that I mentioned. For example, rather than 3 times the income, maybe choose 2 to 2.5 times the income while working one day less per week. Or, you can also keep your practice and income growing by integrating an associate, which opens up many short- and long-term options for amazing work/life balance.

 

There are so many possibilities and I always love to talk to doctors about their vision and how it can be achieved. I invite you to contact me anytime for a complimentary practice analysis and transformation conversation using the button below.