17: Adding Specialty Services

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Hello, everyone. This is your fearless host, Emmett Scott. And I'm so glad to have you here on another episode of DSO Secrets. All right, we're going to take on something super complicated today, and that is adding specialty services. How do you integrate a specialty service in maybe you've a vendor come talk to you and tell you about how some other dentist is making a ton of money doing the specialty service, or you got inspired at a CE class, or maybe you're seeing other dentists offer some level of specialty that you think, oh, man, that would be great. Let's put that into our practices. So how do you do that? How do you actually integrate it? Because we've all tried to and had that fail. So I'm going to give you a list in order of the issues or the obstacles, let's say, and the questions that have to get answered first that I found for specialty integration to actually work. And probably the first thing is having gone to a CE or hearing it from a vendor or seeing that someone else do it successfully is not the right place to start. That can inspire you. That's fine, but it shouldn't be really what drives your decision at all. The first thing most important is, is this going to enhance the patient experience? And even though we could say, well, sure, anything that we offer should enhance the patient experience, we should dig a little bit deeper, because is it gonna enhance it exponentially or is it just gonna be kind of incremental from the patient's perspective? If it's going to be incremental, if it's not going to have a wow to it, then the amount of investment, time issues and obstacles you overcome is not going to be worth it. To do this well, on one side, you have to know that the patient experience is going to be so much better by having this capability, by having this specialty within your practices, within your DSOs. So that's number one. It's also going to be the touchstone for the big why that you're doing this? Because as you start to roll this out, you're going to notice a ton of obstacles. And if you have that why around the customer, around the patient that says, guys, we've got to do this, this is going to enhance for the patient these outcomes to make their smiles so much better, to make their life so much better, to make their relationship so much better, that's going to be really helpful and critical in order to get those specialties fully integrated into your DSO supported practices. So, number one, I think a lot of time and attention should be spent on how does this add to our patient experience and our overall culture of what we're trying to deliver. Okay, once you've got that nailed down, the clinical team, your chief dental officer, clinical director, whoever is taking this message out to the clinical team has to be grounded in that because they're going to go to the clinical team and they're going to say, we've got to do more for our patients, we've got to bring a higher level of service. This is who we are. We are a group of dentists that, that bring this level of care to our patients. And those dentists have to buy into that. So if you have general dentists and you're asking them to add on specialty because they're gonna help do aligners or some other sedation or whatever it might be, they're gonna have a lot of questions around that. But it's gonna come back to does this really, is this really important to who we are, our culture, the patient experience? If you're bringing in an outside specialist, it's probably going to be a little disruptive to the general dentist or others who are already in that facility. And there's scheduling issues and equipment and tools and everything else that there's going to be crossover in. And at the end of the day, if there's none of that, you want them to be referring to those specialists. So understanding, going back to understanding that patient experience and that why is absolutely critical. And then setting the expectation with the clinical team to say, this is who we are, this is who we're becoming. And then in getting that buy in and getting that, that culture set at the clinical level, okay, now you got to support your clinical team, their body in, you can't say, okay, so go do it right. If the general dentist is going to have enhancements and capabilities, what's going to be the new onboarding process, support, CE training, staffing and the equipment that's going to come up behind and ensure that they're successful. Too often I see specialties brought in almost like they're just a product. I don't know, almost like a vending machine rolled into the office. And one day we're now doing X. Okay, that's not going to work. This is an entire business model, entire clinical model that we're trying to place inside of another business model that's already happening. And again, even if you're saying to yourself, well, no, I'm setting up a different specialty and we're going to have kind of the hub and spoke model where they'll refer in to that specialty specialists, you still want to go through the grind to really figure this out because otherwise those referrals aren't going to come. You know what is. As you just kind of go through the checklist, I think with those two frameworks as number one and number two, patient experience, clinical expectation, clinical culture, what is that? Then pretty quickly the other things can all have to happen, but the order isn't quite as critical. But compliance components, the forms, the consents, the software, how is, does this software handle that specialty as well as it's handling our other services? And if not, what. What's different that's going to be needed? Do we need to be on a different platform, a different software in order to provide all the features and functions that this specialty is going to need? And if the answer is our current practice management software isn't going to do that, then so how are we going to take care of two disparate systems and then bring all of that data in and be able to see that on a consolidated basis? What are new technologies and capabilities down at the hardware level? And workstations. What about facilities? Is this going to need another front desk person with a different capability? What training or scripting is that front desk person going to need to now be able to handle the fact that there's multiple services offered within the practice? And so much comes down to the facility constraint and the flow there. Do we really have room for that? So a lot of the, the pieces, after you've set the, the, the patient piece and the clinical culture piece is going to come down to your facility systems part and then the change management and what is the support, whether it be around the, the clinicians that's going to need to be in place or around the staff. We, we sometimes come up with these great ideas. We might even run financial performance around what the possibilities are. We might even slice and dice our, our patient mix by different ages, by different Treatments that, that have been prescribed to them. And, and, and so we've fully justified in our mind why this specialty based on the patients we're seeing is totally justifiable. But at the end of the day, that whiteboard isn't going to be what executes. You know, whatever you've written on the whiteboard, it's going to be that human, that staff member down at the practice level who's going to have to have all the support. It's going to be those clinicians, those specialists that are going to need all of the support to make sure that that schedule is organized well to ensure that the right equipment that they need is available if additional, you know, cocktail of drugs is being used. What's all the DEA regulations that have to be thought through on that. Now some of this as I'm going through might seem extremely obvious, but so often I see clinicians come back or entrepreneurs see this vision and they're chasing constantly different specialties, different possibilities or products that they could sell or offer. And I think if you think of those as different business models and you take the time to methodically go through and organize them, then you're in a much better place towards success. So as you think about offering pediatric services, sedation services, ga, oral surgery, ortho, endo, perio, whatever, it might be thinking through each of those different specialty services as unique models and not combining them just as, as dentistry. Right. Don't even speak to them that way. But what is the breakdown of capability, systems and supports that are needed? Then you can start putting a plan together. The other thing I would suggest is sometimes we see the full opportunity and we try to race to get it all to happen at once. You may have to stair step into it very slowly. Sometimes that means that the specialty doesn't actually make money initially because the staff can only handle so many patients kind of taking that on and they have to prototype that. You could think of that as, as a new practice, if you will. A new practice isn't going to make money. The first week, month, whatever. You're going to have a ramp up time. So you may need to organize your capital and some of your budgeting to think about. Adding those services are actually going to depress your net income for a period of time. But obviously your goal is ultimately that that can be accretive and add to your outcomes. So hopefully this gives you some ideas to think about as you're so excited about that next specialty service. We should all be thinking about how do we bring more value to our patients? What can we do to enhance our value? Offering to them and specialty services is great way to do that, but there are real obstacles to make that happen. If you have additional thoughts on how to add specialty services, I'd love to hear those in our private Facebook group at DSO Secrets. And until next time, keep smiling. Thank you for listening to DSO Secrets. Join our community on Facebook at DSO Secrets and get answers and resources to some of your most challenging questions. 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