CPR---Cash in Your Pocket Right Now

Welcome to Million Dollar Dentistry with your host, Gary Katie, brought to you by Next Level Practice. Next Level Practice is the leader in dental practice management. In fact, they are the best in the world at creating happy teams that implement sustainable results. Your host, Gary Katie welcomes you to this podcast as he discusses the common concerns, challenges and shares his decades of experience in empowering dentists and dental teams to go from good to world class. Gary Katie is the visionary voice of Next Level Practice and has for the past 20 years interrupted the status quo of the dental world. He continues to bring national attention to the oral systemic connection and believes in the complete health dentistry model. He is a powerful educator and advocate for dentistry, dentist and dental teams. He is inspired every day by the courage and personal successes of the doctors and team members he has the privilege of working with. Welcome, Gary.

Oh, Amber, you had me on the edge to respond to that introduction. I'm like, I'm ready to go. I'm like, horses lined up on, you know, on Kentucky Derby Day. Like, come on, let me go. Let's go. I was looking forward to my interview and reconnecting with you and our listeners. Super excited to get to our next chapter because it's what I love to talk about. Wonderful cpr. I'm a pastor at cpr.

That is great because I was thinking, you know, there's Cornel west is the American writer and activist, said that despair and hope are inseparable, that one can never understand what hope is really about unless one wrestles with despair. We kind of talked about that despair in chapter one, and then in chapter two, we kind of hit on that, you know, there's hope and here are the ways that we can get to that. So we've been discussing Dr. Larry Laser Guy, DDS, and how he had sunk into that place of despair and couldn't see a way out in our first episode. That was the life you were entitled to lead, introduced us to 17 possibilities for hope. And today we're going to talk about cpr. Cash in your pocket right now. And if I remember correctly, you wrote the first edition of this book around 2008, and that was a time when our economy was in a downturn and feeling a bit unstable. So these suggestions for taking control of the dental practice finances is relevant for the good times and the bad, is that correct?

Oh, there's no doubt. But, you know, we get a lot more attention when, you know, the big crash of, you know, I was in 911 and worked with the practices in and around, you know, ground zero here in New York City for sure, right back in, in 2008 when the great Recession hit. And, you know, I have a lot of friends on Wall street and, you know, here we are again in the next decade and the biggest crash of oil prices. And we just know how that's going to go. I mean, whether, you know, all the way back in the 70s when we had gas lines and you know, how that all affected the entire economy. The minute commodity like oil crashes, it's just a matter of time for the next recession. So this is really relevant in today's world as we turn into this new decade. So, yeah, this stuff works in good times are bad, but like, when you're flowing, you're like, ah, this is. I have more than enough money than I could ever spend, so I'm good. But the minute consumer confidence changes because of all the stuff that's in the news, all of a sudden it's time to put your intention and attention on CPR for your practice.

That's wonderful because I know that as humans we kind of coast along and ignore things when it's going well. But now, as soon as there's any little scare, we get all panicked. And I think this is going to be really good to know what that CPR is us. So in this chapter of your book, you tell us not to be looking for high pressure sales tactics or guaranteed closing scripts or questionable ways to persuade. So if not that, then what? How can dentists put cash in their pockets right now?

Well, look, here's what I've known and I've lived my whole career by this. When you share intelligent things with intelligent people can make intelligent decisions. You don't need to persuade or manipulate or, you know, I just have to let smart people know what's happening and why what you're presenting to them is valuable and relevant. You know, that's the key. And letting them make their own choices. You know, nine out of ten dentists hate to sell. Dental teams hate to sell. It just doesn't work. It's not sustainable. And even if you did persuade and manipulate and force, it just doesn't work, Amber, because you can't put your head down on the pillow and know that you did right by people. And when you're breaking integrity like that, you know, it just, it's even worse than a shrinking cash flow or shrinking production and collections. It's worse because that's the inside job. That's the integrity piece that will eat you alive. And so that's why we just, we look, here's what we Know, we always find the time and money for things we value. Always. Even in the biggest of recessions, even in the biggest downturns, we always find time and money for things we value. The missing element in a dental practice is you don't know how to create value. If you accept and you're aware that that's true, then you're going to change everything. And so creating value. And the other piece, the other side of this, which I love what you said, despair and hope are like, you know, one side of the coin and the other side of the coin, it's just like, you know, I never wanted to have negative energy, therefore I couldn't experience truly positive energy. So, you know, it's a yin and yang of experiences. Right, I get that. But here's what we have to really look at is when we're, when we're in creating for the value of things, you could create value, but here's the thing that gets in the way. You ready for this? I mentioned it in my last episode with you. If you don't receive, like here you are, you create, you find the problem. Then you highlight and paint this picture of value, of what you're going to provide and why they need it. And not only for their mouth, but their body, not only for their mouth, but like how they're going to, it's going to make them feel and their confidence, all these great things. Amber. But if you. It's called blocking the blessing. If you create all this and we put systems in that do that and then you can't receive. Everything that I'm going to talk about in this chapter is not going to happen. Because in my second book, and when I wrote this book in 2008, I didn't have my sequel, which is Raise youe Health, you Deserve Level. I wrote that because what I got to see after I built this machine and million dollar dentistry, doctors self sabotaged.

It, ah, very, very much a human, human trait that we do that we don't accept the things that we deserve. I mean, we get what. And what is it, how is it that you say that we don't get what we deserve? We get what we think we deserve.

Nothing more, nothing less. So here's what was happening as a, as a practice development implementarian. I'm going in there, I'm implementing, and then I would get procrastinators or I would get sabotagers. And I'm like, what is this? And then I realized that I did that myself. It wasn't until I allowed myself to receive love Receive acknowledgement, receive money. I would not do the things leading up to that in the actions that I was recommended to take. So I would have. I would give money away and accounts receivable and, you know, not charge people. I would give away free things and not charge them. And I'm providing massive value. It was funny. I was with. I was overhearing this one gal who has money issues and she goes, hey. And she was talking to another gal who has money issues, and she goes, hey, you should go to this dentist over here. I just tell them my campaign, they take whatever my insurance covers and they just. They put up with that. You should just go, and here's what's happening. It goes viral. And then you get a bunch of minions, you know, chirping down on your. On your income. I said, yo, because I'm like, you know, I'm a rapper.

There you go.

I love when you laugh, Amber. So, yeah, they get in your money and then you're done. That was my best rapper slang for the day. But seriously, it goes viral. And then you wonder why you got bottom feeders in your practice. They're just. They all hang out together. See, people that are greedy, that don't want to pay, that take advantage, they all hang out because they have the same value. So once you do it for a couple of. It creates a cascade. And that's why you end up. The money ends up somewhere else rather than in your bank account. And we don't believe in that. So that's why I wrote this chapter. So let's unpack it.

Okay. I was going to say, number one is get paid. So assign someone to this job and collect the money that you are owed. Don't be afraid of losing patients because if they won't pay, then you don't want them as a patient anyway. That was.

Yeah, yeah. And I just, I started. I started poking at that and then you start attracting people and that know they can get away with it and you're not going to do anything about it. And they go, that's my guy or gal. And so, you know, then. Then you get taken advantage of. Especially if you're a humanist doctor. You know, there's the four personality types, humanists and methodicals. Acquiesce and avoid. They just do whatever insurance covers. They don't stand for anything just because they want to be liked. And it's. And it's not their fault. It's just their personality type. So we build a business model around them to avoid that. Like if you, if you're not strong and you want to give stuff away, you got to build structure around you so that you have the right people that can actually ask for money. Right?

Definitely.

And, you know, I had a guy in this chapter, came from a guy I know in Buffalo, and, you know, he'll. He'll attest to it. You know, it's pretty amazing. He had. You know, he was doing probably 600,000. He had $450,000 in accounts receivable. He was giving away free dentistry. He had the lowest percentile of fee schedules, all connected to a low deserve level. So you will not ask for money if you don't think you deserve it. So, I know it sounds like that easy, but it is. It is. Like the minute he shifted and realized that, oh, my gosh, see, if you can mention it, you can manage it. And that is why I invented a term called Raise youe Healthy Deserve Level, or hdl. So I can mention it. Oh, there is my hdl. I am giving dentistry away. Oh, I don't hire a team member that collects money. And by the way, here's an easiest way to hire a team member. You say, when do your palms get sweaty? At what number? And if they say $500 and your crowns are 1,000, that's not a good treatment coordinator for you. Right. If they're getting nervous. So that's the key thing. You know, I'm kind of drilling down on this first one, but it really does make a difference. So, again, there's two things about cpr. Cash in your pocket right now. Your top line, your collections, and then how you manage your bottom line. I'm going to do a cursory on the bottom line, but ultimately it's going to be. We're going to really like, how do you build that top line? How do you receive? Those are the two fastest ways to get cash in your pocket.

Definitely. Okay. So bringing individual accountability to the front desk. I love the way you talked about not switching positions, like on a baseball team. You know, if you're playing shortstop, you're not going to go pitch in the middle of the game.

So. Well, that's what they do in dentistry. They go, oh, she's a floater. She's gonna float. She's just sitting there floating, like floating amber. Like, you could see me visually, but if you could picture me, like, just billowing in clouds, floating around. When everybody's accountable for everything, no one's accountable for nothing. And so what happens is, you know, in order for you to get over a million bucks, if you want to get over a million bucks, you gotta have two people, the front desk. And most people, Amber, don't think they can afford that. They, they go, I'm trying to keep my payroll down. Well, what they're doing is it's like a baseball team. It's like not paying a shortstop and 80% of the balls for a right handed hitting team go through the shortstop. And so you can't afford not to have somebody there. You know, if you look at the average annual value of an adult as a crown and two profis and two exams and a set of bitewings, the average adult is worth with PPO fees like 1200 bucks annually. And now if you don't have somebody dedicated to filling the schedule, that's 600 bucks for that hour, not the profi fee and the exam fee. So, you know, one saved, one filled appointment that would not go unfilled or would go filled, unfilled is paying for that person's payroll. And the other thing about it is you can't answer the phone and present a treatment plan simultaneously. It's impossible to do that. Well. So therefore you, you know, let's just say, you know, you're not taking the time with the patient to close the case and go over insurance and the money and do it right, do it impeccably, then, then you got two leaking holes like your boat's leaking. You know, you're not filling your schedule and you're not closing cases and you're doing everything halfway. And I just never saw a practice be able to run without somebody dedicated to the measures that, that we're going to figure out. See, we're also going to reverse engineer how much you want to do annually, how much you want to do for the hours that you want to work. Then we're going to know how much you need to do per day. And that appointment coordinator is going to fill your schedule to that day, and then your treatment coordinator is going to close the cases you need for that day. And when you do that really well, you explode. That's how we get such big increases in the first year from the inside out on what you can control.

Perfect. Okay, so number three is establish an agreement among all team members as to the standard for a completely healthy mouth. So this is where you talk about using a healthy mouth baseline with every patient every time, is that correct?

Yeah. And you could, yeah, you could download this on our website@nextlevelpractice.com it's in the resource center and it's a tool I invented because especially, you know, if you have, you know, you have multiple team members, if everyone's not looking at the same healthy mouth, what's, you know, what's healthy in your practice and what the agreement is for that health, then you have, you have all kinds of diagnosis going on. She diagnoses too aggressively. She doesn't diagnose enough. If you have multiple doctors, multiple hygienists, everybody's like, finding their aligned philosophy in the practice, and it just, it's a huge breakdown. So I invented this tool called the healthy mouth baseline. And it basically has healthy bite, healthy teeth, healthy gums, general oral health. It has, and it's a 8 and a half by 11 sheet that the hygienist or the assistant really just interacts with the patient and says, may I share what's healthy in our practice? Because most of our patients don't know. And now all of a sudden, you're benchmarking what's healthy and what's not. Here's what I love about this, too, Amber. If you ever have a patient come in from another office and they got summer teeth, some are over here and summer over there, you know, they're all over the place. And they, they go, well, where'd you come from? Oh, Dr. Joe Blow. Yeah, he, he, he retired. I've seen it for 20 years. What'd you like about Joe Blow? Oh, yeah, he didn't recommend any treatment for 20 years.

Ah, there you go.

And so now guess what happens. You recommend treatment, you know what's going to happen. All of a sudden you're the bad guy or gal, you're a thief and you're robbing from them and they're not going to come back. And then you get a bad review. That's not what happens when you have the healthy mouth baseline. That's the benchmark for health use. The intraoral pictures, use the cameras, show them visually irrefutable. Now they look at supervised neglect from that guy that took care of him down, and they thought it was great because it didn't charge them anything. So healthy mouth baseline really is a game changer. It gets everybody on the same page.

And so now what are the ways to actually visualize that is to dust off your intraoral camera. I like the way you said that. Dust that off.

Well, you know why? Because I, every, every, every office has them, but they're, they're usually, you know, an inch full of dust. And the hygienist usually goes, it's an intrusion on my hour. Don't mess with that. I don't want to deal with that. Not all of them. Some of them, just because they don't understand the value of it. And, you know, I always say you should have an intraoral camera for every room in your office. Don't use the docking station because not right there. You can't just show before and after you show value. It creates known value for the. For the patient. And I say you should have it at everyone in your office, everyone in your house, in your car, in your second home, on the Carolina. What do you call it? Thing on Carolina, where you live. What's that? Outer Banks. And you're out of banks, so take it with you on vacation. You should have an intro camera at arm's length at all times. And you know I'm playing with you. But here's the deal. If you can't, people respond 87% of the time visually. If you're auditory and you're only telling people what they need and want, they're sitting there, Amber, going, you know, it's your word against mine. And I can't tell.

You know, it's sort of like I can't feel it. So if I can't feel it, it's not happening. Absolutely.

Exactly. Well, it's like. It's like when you go get your car fixed, and they put that damn piece of white paper down, and it has an outline of footmarks, and they charge you 600 bucks, and it runs worse than it did when you brought it. After you brought it in. Then when you brought it in, you don't know what the value is. I had one. One place they put all the parts in a plastic bag. And I go, all right, now I can see it. So this is the game changer. Makes you feel better. I love when they put it in the big plastic bag and show me all the. All the broken. Everything sitting in there, and I go, okay, I understand now what you did, definitely.

So when presenting to the patient, always describe the problem first. The problem, then the consequence if left untreated, and then the solution.

Yeah, because what happens is most doctors want to fix everything. They're like, you know, they're mechanics. They're like, where's the problem? Let me fix it. Right. This is about expanding that a bit and moving toward the problem. See, most doctors don't want to be the bearer of bad news, so they don't give the negative part. They just go, hey, let me just tell them what the positive is. You need a crown. You need a filling. You need this, you need that, but they don't know why they need it. Like you said, you don't, you don't feel it. There's nothing symptomatic. And when there's nothing symptomatic, and by the way, that was created by professors who asked for the chief complaint. They said, you guys and gals, find the chief complaint and go fix it. Well, if find the chief complaint and fix it is the game that they taught you in dental school, what question do you ask when you walk in a room? What's bothering you exactly? And then you're training the patient to only do what is symptomatic. And using this system, you move from symptomatic to preventive and asymptomatic dentistry. And then once you stay in the problem and highlight the consequences of no action. Now the patient is going to buy. You don't have to sell. They're going to buy from you. Because patients only buy solutions that they know they have. If they don't, you know they have it, but if they don't know they have it, then they don't go, I should go invest in this. And this is a turning point for a lot of doctors when they start learning this distinction.

I think it helps also if you're using a healthy mouth baseline, because to me, I didn't understand that even, you know, that, that there was something wrong until you showed that. You know, when you show that healthy mouth baseline and you show me the things that can cause another problem, then, then I'm going to be more inclined to move forward because I understand the consequence there.

This is the lowest cost and least intrusion on your life. If you tend to it. Now, I don't know if it's going to, I don't know if it's going to break in six seconds, six minutes, six days, six months. But my job is to let you know what I see and why. I see it like it's sort of like tread on a tire. Like, I had to get new tires. And for me, they look fine, right? But when I took it in, the guy goes, look, and the inside tread is going down. You don't. I'm. We are conservative. Conservative to the side that if you don't want this tire to puncture with your son in the car when you're driving. To me, that's being conservative to the responsible side, not conservative to diagnosing my pocketbook. That's what we say. Becky's pocketbooks, pocketbooks. And I don't have a pocketbook. But, you know, If I did, like, don't diagnose my wallet. My Louis Vuitton, male, gray, black wallet. Don't diagnose.

Well, I've got a pocketbook. I'm just saying mine's quite large, so unfortunately, I can tell my shoulder can tell you all about it. So. Oh, what about you talk about in number six, keeping track of important statistics every day. So you mean we're not supposed to just ignore what's going on and. And just move through it and.

Oh, Amber, you know, you know, nine out of ten dentists just abhor statistical monitors. And, you know, when I wrote this book for the first edition, it was a nightmare because we had to do everything by hand or pull reports. Now it's like Fitbit. I designed this business so that we can have Fitbit that we're pushing data in real time pulled from Dentrix, Eaglesoft, and open dental, and you can run your whole practice from your smartphone. So, you know, a lot of millennials that come out are really creating just awesome group practices, and they just want a systematic way to manage their life. And they realize that, you know, it can all be like. I can tell you this is how pinpoint and amazing managing statistics are. I can tell you which hygienist in Hays, Kansas, is using the healthy mouth baseline. And if they missed it a day, I mean, we can see behaviors directly correlate with the analytics that allow us to know where the inefficiency is from afar. So, you know, it's like, it's game changing when, you know, we can put those controls in, and it's really an exciting time.

I love that because then it's. You can take the fear out of the numbers because sometimes there's. There's fear in looking at those numbers, and now there will not be.

Well, because, you know, we're living in reality. And I know, you know, when I first started with analytics, you know, the Moneyball was the game changer for me back in the day when the Oakland A's, how do you get, like, the small market team that has the ability to only spend certain dollars but get into the playoffs and have, you know, winning games? It's because it's really the analytics that each person does. And when you're chairside, you can't. You manage on feelings, not facts. But if we break it down on how much you need to do per year, per month, per day, per person, and you have pushed analytics to your smartphone, you know, when you're, when you're going in, you know, instead of playing, you Know, candy crush, you're going in. You know, you get a little time. You're not. You're going to your smartphone. You're going, bam. Okay, now I know. Now I know the levels. And not only you as doctors, but your team leader has actually got their eyes. They're measuring, monitoring, and making that go right throughout the day. And then your huddles, you do yesterday, today, and tomorrow. And now you're doing leading data instead of lagging data. You're in real time in reality. You know, so often we'll have a great hygienist will go, man, I had a great day today. How did you know you had a great day today? Well, so many people thanked me for the care that I provided. And then, you know, that's really good for customer service. Patient experience, that's one measure. But if we don't have that hygienist, $1500 a day, and this hygienist happened to $300 that day revenue, that the triple win didn't happen. The patient experience was great. The team experience was validating, but the doctor practice owner didn't win. And so that's why we really have to have the triple win from really looking at statistics.

Okay, so number seven, slow down. Busy is not always productive.

Yeah, I mean, if I said, hey, if I. How many people out there can raise their hand and say, hey, I wish I had more things to do today, or I was busier, you know, so it's like, what are you putting into? There's only so much time that you're going to go to work, but what are you putting in that time? And when we wake people up and they start seeing that what they're putting in their day is inefficient, they start reprioritizing what's, you know, what needs to go in a schedule, how it goes in the schedule, why it's not in the schedule. So, like, a lot of times, the reason why schedules aren't full like doctor schedules, because they don't diagnose and treat. And that's where the healthy mouth baseline, that's where the problem consequence, solution comes in. See, this is all. This is all interdependent. One thing is dependent on the other thing. So it's not like people go to seminars and wonder why they don't work is because they haven't handled the interdependency here, Amber. They try to get that one gem. Oh, let me use this healthy mouth baseline. But if you don't use a healthy mouth baseline into all Camera, problem, consequence, solution, and have, you know, the financial options that we're talking about in this chapter. If you don't have all these pieces and parts put together and people owning it, the machine doesn't work. It just doesn't work. But you have another gem or nugget. So we're beyond gems or nuggets. We're on like get your take off your roller skates, take a look at how much you're charging, what your case acceptance is. All those elements make up slowing down and working smarter, not harder. I love it as my fellow friends from Boston say, they're packing their car and they're working harder.

Oh, I love that. So number eight is come face to face with a person or thing you have been avoiding and take immediate action. We go into more detail in chapter five, but just, you know, who's Debbie Downer and Daryl Downers?

Debbie and Daryl Downers. You know, there's always like, you ever watch Saturday Night Live and it's like Debbie Downer's like, she's always looking for the negative thing. It's like, here's the deal, most of the time you're dealing with one negative team member that you haven't confronted. And because of that, whenever that person, when you put an initiative in, that person just kills it all off. You say black, this person says white and everybody follows. And then you don't have new initiatives in. Or the patient could be Daryl Downer where he comes in and just disrupts the schedule. Don't put up with that. And like this. I designed this for non confrontational people, so I hated confrontation. But I can confront anybody on anything. Why? Because I have a system for it. In chapter five, we're going to talk about that. But it's like get start looking at what you've been avoiding because you've been giving your power away to patients and team members. And look, if you're the dentist and you're Debbie and Daryl Downer, well, you got to get, you got to look in the mirror and you know, look, I, look, I can be resigned. I've been in business for almost 30 years, you know, since I was 24 years old. You know, and here's the deal. It's like there's some things that I just don't want to deal with. I don't want to confront. But do you ever have like, you've been like mustering up the courage for 30 years and then actually have the conversation and then you're like, man, I should have done this 30 years ago. Because it wasn't as bad as I thought it was. We, in our head, make it up worse than it is. And there's a way to confront people to say, look, I need you to line up with me, and if you don't line up with me, it's completely fine. But how do you do that in a nice, simple way? And that honors the other person, honors you and what you need. And everybody wins or they don't. But you want to get out of this misalignment and allowing people just to run rampant. And again, it goes back to. I've been adding a lot of, you know, personality types. The Persona that I am is. I'm primary humanist. So I just, you know, people ask me to do stuff and I'm busy. I'm a humanist and busy. So I'll just. I used to say yes to everything, and then meanwhile, downstream, I'd be like, oh, man, that wasn't fair to this person or this company or, you know, I'm just making decisions on the fly and just saying yes and really not thinking everything through. So slow down and come face to face with people that are not lined up with you. And you can do it in a very kind way.

I like that. Number nine just falls right in there. Fire the problem patients.

Yeah. No, give love to them and just say, look. You give them a chance and say, look, we've been serving you forever, but you haven't really wanted to take X rays, and that's really supervised neglect for us. It's, you know, I can't. I can't possibly. It's irresponsible of me to treat you without accepting X rays or accepting whatever, you know. Can I ask you why? You know, most of the time, you know, why they don't want X rays? Not because of radiation, not because of cost. It's because of what they're gonna find out, and they don't want to find out. And then you can have compassion for the person. But please, you know, stop allowing people to, you know, hijack your life, take your power back. And you could do it with love.

Absolutely. So number 10, pay your own bills on time and show up on time for your own commitments.

Oh, yeah. I mean, here's what. It's the integrity breach that you can't hold the line on. It doesn't mean that I'm perfect with everything all the time. But here's what I learned. I did not keep my word, so I could not hold another person accountable. We don't see people as they are. We see People as we are and map our values out on other people. What happens is that if you don't take care of your own time and money, you can't go, hey, I need you to take care of time and money as it relates to me. So you let people off the hook, and it's just this one big treadmill spiral cesspool pool of, like, not interrupting. This is how it works here. And it all goes back to agreements. My coach said, yeah, you're doing great, but you're late all the time. I'm going to charge you $100aminute. And I'm like, fine, I agreed to it. But guess what? I didn't think he would hold me accountable to it. I'm like, who holds anybody accountable to that? And he goes, hey, you were 36 minutes late. You owed me $3,600. So he goes. I go, I'm not paying. He goes, great, I'll see it. And then I paid him three weeks later, he goes, that's the best $3,600 you ever spent. And I had no money at the time, and that's why I hired him. And he says, gary, well, what you just did was you now put you've restored your integrity with regard to giving your word to something, whether it's a promise to make a payment or promise to show up on time. And now you know the difference between honoring your word and keeping your word. And now, my friend, you can now hold people accountable to do that. And we do exactly that. I have no problem asking people for money or time because, you know, we do that for on our side. So it's the way the universe works. It's the law of reciprocity. Start with yourself first. You go first.

Perfect. Number 11, cancel your yellow Pages ad. Are you crazy? How are people gonna find us besides Google?

You know, when I see Yellow Pages ad, you know, yelp, and, you know, it's like, that's the new Yellow Pages. But it's like, you know, you spend money on those ads. There's different ways to have accountable responses of, you know, working with companies that actually have, you know, tangible outcomes that you can count on. You don't want to put it into some of this. It's. It's mainly the conversation here is more about really have everything with a return on investment. It has to be predictable. It has to be aligned to your philosophy. It has to be simple, and it has to be team driven, and it has to have analytics associated to it. If you're doing something that doesn't have analytics, please don't do. Just doesn't work. And so, you know, we got to get in there and make sure it's all, every dollar we spend has to have return on investment. That's why I made my program guaranteed roi, because otherwise they look at our work as an expense for them.

Okay, so offer three payment options is number 12.

Yeah, and I'm grateful for CareCredit, who's been our partner for over 20 years. And you know, there's three ways people buy. The people with money buy paid in full upfront. And they want to, they want a courtesy for paying right there. And the beauty of that is you eliminate time, money and pain because you have those three conversations before the patient comes back. So, you know, here's what you can count on. You minimize the, you know, the experience so that it doesn't, you know, it's not going to feel overwhelming to them. And you keep it simple. And then you say, here's how much time it's going to take and here's, you know, we take care of the money now because then you don't have to go to the front office and you can focus in on your career. You can, and save a few bucks. So that's a pay to day courtesy. The second way is people buy by month. So, you know, when I go to Verizon, they go, oh, your phone's gonna be $58 a month. And then I signed the contract, and I just signed a contract for, you know, $2,700. They didn't say, I just signed a $2,700 contract. They say it's 50 some dollars a month. And we need to do that in dentistry. And CareCredit does that with their financial option sheet. So we break a $5,000, you know, treatment plan down to, you know, $188 a month. So all of a sudden, you know, with down payment and, you know, interest free over a period of time, I mean, you can, you can break down the payments to, you know, a dollar amount that's accessible for everybody. And then the third way is you grandfather in old people where you do a half down and half upon insert. And you know, this way you have the three options that are simple and they're easy and you exhaust one and then go on to the next, exhaust the next one, go on to the next, and then, and then the fourth one is then you minimize treatment. So often this is the biggest problem in dentistry. Why schedules are not ideal is because they're not diagnosing using the healthy mouth Baseline, they're not offering monthly fee. So therefore you do not get quad sales. You know, sales of a, or cases closed of a quad or a larger treatment. You end up doing one surface at a time. And you got to, it takes, it's so inefficient here. So this is the way that you, you really increase your efficiency. If you can't diagnose it and you don't close it, you can't treat it. And that just all works in harmony with one another.

Okay, so number 13 was quit tearing up hundreds of four dollar bills every month. Now, where did you get these $4 bills?

Well, because what it costs to actually bill people, right? So you know, by the time you take the employee, the team member, and you're sending out, sending out bills, you just want to add them up. They're about $4 apiece. So you know, you're sending a few hundred of them. There you go. If you clean these up and then stop it at the treatment planning phase, you can eliminate, we believe in a zero balance office. And you should not be sending out billing. Now this is also a treatment planning issue because you want to short the insurance when you estimate. And then here's how you have a marketing plan. Rather than $4 bills, you're giving refunds back. I don't know if you remember back in the day when Verizon used to give refunds and I thought I won that, won the lottery or. You know, the reason why tax, tax refunds, why they, why tax refunds work is because you spend that tax refund like 10 times. That's why the government stimulates tax refunds. Because in your head, you think you have more money and you spend it, oh, I got a tax refund. I'll buy this. I got a tax refund. And you didn't know you spent it four times. So you look like the hero when you're sending a check rather than asking for money.

Perfect. So number 14 present comprehensive preventative care to each and every patient. You are their trusted advisor, and you cannot be afraid to be their advocate for complete health.

Yeah. And you know, it goes back to, it's like, you know, not every patient every time, you know, like. But the reason why I say that is because I see, like, everybody's like, hedging their bets, like, maybe I'll do a crown this year. One crown a year. And it's like based, the diagnosis is based upon wallets and insurance plans. And that when you create value and then you create the understanding of whole body health and the systemic impact that it has on bodies. You're actually doing somebody a service by letting them know how, you know, this condition will affect you downstream. And we built a whole education system with oral systemic health cards using the medical history forms, really tying all, you know, what's happening in their whole body to their mouth and really understanding the investment and why they should do that. And, you know, it's just profound. Patients love when they're served like this, where they're really cared for and they there, you know, in this decade, now, the new decade, more and more people understand that, you know, if I don't floss, I could die. You know, like that kind of conversation. So, you know, it's, it's really our practitioners that need to catch up with the consumers at this point.

Perfect. So number 15, pay off all high interest debt, including credit cards.

Yeah. And this is, this is a big one. We get people out of debt. Like, the first thing we do is people come to us, they go, look, number one thing is, I want to get out of debt. But they don't have a plan to get there. So what we do is we take a look at all their outstanding debt and we start with the biggest interest rates first, and we just keep knocking them down. And when we set up their daily primary outcomes, which you're going to learn later in the book, we include the collections of the debt pay down. So we have a triple win bonus system here. And we only pay the bonus out. When you're paying down your debt, you shouldn't have to pay your team extra dollars and team members. If you're listening to this, you should not, your doctor should not pay you if he or she can't pay their own bills. So we want to really work on making sure we get our debt paid down. We get that percentage knocked down, and we get in there and you just feel good when you knock that, that credit card down and knock that credit card down. And now all of a sudden you're knocking out these big things and you're not churning cash in the wrong way. And so it's step by step, it's a plan, and it's all integrated into the amount of collections you need in order to pay your bonus. Now your team's on board and they're, they're playing the same game you are versus, you know, you looking like the. If you don't get them up playing the same game. What I found happens is that the team Amber looks like you, that you're money hungry. No. You're just trying to pay your bills. It's misinterpreted, but they don't know how much they need to pay and they don't know that the practice is in debt. Robbing Ben to pay Henry. You know, robbing Ben. Code to pay Henry Schein.

Exactly.

Or Henry to pay Ben. Whatever it is, you know, paying the guys.

Okay, that's, that's really great advice for all of us. So number 16, don't try to be everything to all people. Don't participate in the scarcity view point. Embrace the abundance point of view.

Yeah, what's happening is, is that most dentists don't know their position in the marketplace. It's called the qsp. Quality, service and price. You can only be two things. You can't be all three. If you, if you're trying to be high quality, it costs you money to do that. If you're trying to be high service, it costs you money to do that. And you're trying to be low prices. You can never outrun the expense of high quality labs. High quality, you know, location, high quality position, and then customer service. The top eight players don't get the least amount of pay. So, you know, just to paint a picture for the listener here, it's like Banana Republic, Old Navy and the Gap are all owned by the same people. Interesting. In some of the malls out front, they each, they're all next to one another. But when you get in the stores, you can crisscross and go inside of each one and you don't even know you went in there. So what happens is Old Navy is like, you know, their prices are low. 5.99 shirts. You know, the quality, you know, the 599 shirts, the guys walking around with the headsets trying to find your extra large or large. But how's the quality? You, you know, you wash that, that, that Fourth of July, you know, shirt and you know, July 5th, you're, you're throwing it away. And then Banana Republic, I mean Banana Republic is high service and, and high quality, but their prices are higher. And then the Gap is, you know, you go find your 34, 30twos on, on yourself. There's nobody matching colors. You, you find your own stuff and there's a rotunda. There's only one person, so the service is not there. So they, they reduce expenses and they just lean it down to the person that can run your credit card and you're out of there. So the same thing is true in a dental practice. You can't be a PPO provider with the super high end rent and super high end, you know, delivering super high end dentistry. You got to match it. Doesn't mean you're, you know, you just have to have a correlate. Doesn't mean that you're doing giving it away for free or, you know, but it's just you got to match it all up. And that's what. That's what not trying to be everything to all people is all about.

Well, thank you, Gary. This has been really amazing. I think that this was cpr. I feel like I understand this a whole lot better. I know these dental practices are going to be really excited about figuring out how they're going to get some money back in their pockets right now. So thank you for sharing with us today.

Well, we went from CPR to the next chapter, which my wife told me I should not name the chapter this. And I told her that, you know what, honey? She said, you know, and this was in 2008, before the MeToo movement. So maybe today in the new decade here, in 2020 beyond, I may not have named chapter four what you really should be doing with your dental hygienist.

I'm looking forward to talking about that in our next episode.

You bet. I'm on it.

Thank you for listening to Million Dollar Dentistry with Gary Katie. This podcast is brought to you by Next Level Practice. Next Level Practice is the leader in dental practice management. In fact, they're the best in the world at creating happy teams that implement sustainable results. If you would like a copy of Million Dollar Dentistry, please contact Amber Keithley at Next Level Practice. You may call us at 212-388-1712, extension 119 or go to nextlevelpractice.com podcast and record. Request a copy in our Ask a Question box. We look forward to brightening your smile.