Million Dollar Dentistry Masterclass April 2021- What you should really be doing with your Hygienist

Hey, practice owners. Welcome back for our fourth in this series. This episode based on Gary Katie's best selling book, Million Dollar Dentistry. Got it right here. Actually, I have the, I've got the original. So, you know, I'm still keeping that. Like I said, you can always see my, my dog ears, my notes, my highlights. So I'm going to keep the original copy. How you doing today, Gary?

So good. You know, on ebay those things were like a thousand bucks.

I know, it's crazy. It's like a first edition of Mark Twain or something.

Unbelievable.

It really is. You know, this is 2006 and I mean it's the fundamentals of building, growing a dental practice and kind of the tools that any practice owner needs that when they try to start making it too complicated and think they need a, you know, a 24 volume series, if you could get that stuff anymore, I mean, this really is it. This is really all the, the information you need in a dozen chapters. And we're going to go over number four today. But before we get started, I want to show you something that as we were moving that I trolled up from exactly the same time period. Gary, you recognize this?

Oh my gosh.

Went to the archives. This is recession proof. Your dental practice, Gary Katie, want to make sure I'm not reflecting 2008, which is on the heels of this. And I think for docs who are listening if they don't remember, that was the tail end of the real estate bust, banking bust, the everything bust, the dot com bust. And you live in Manhattan, which is like, you know, ground zero in another respect of the financial crash. And this was one of our best selling, you know, for any docs under about 35 or 40. This is a DVD. You put it in a machine and it spins around and you know, now we have YouTube. But this was really one of our best sellers and it came out of your book. And the exact same principles we're going to talk about today, right?

Yeah, yeah, for sure. And Steve, thanks for bringing back old school Katie, man. That's funny as hell, man. And then, you know, the relevancy, it's like Beatles.

There's a picture of you on the back there. I think you just got more handsome, a little more salt and peppery, but a little more George Clooney ish or something.

Thank you, thank you, thank you. But you know, it really goes back to this. It's like the fundamental principles of running a business and the fundamental principles of what a patient needs and a team member needs is, is like The Beatles and Led Zeppelin and those types of things, they're classics, and they never go out of style. And actually, through crisis, it's more important to have the fundamentals in place. And a lot of businesses, when they don't strengthen their fundamentals, Steve, what happens is that they become weaknesses. And then they're usually blaming the circumstances, not what they can control. And we're going to talk about how to take control over your life and your practice. And it's not something out there. It's something that exists over here or over here or over here. And it's not usually dental CE for the clinical side. It's really the business side that allows doctors to have profitable businesses.

And really, the reason I did dig that out is, again, you and I, as guys who have run a lot of businesses, I mean, it is the fundamentals. And I know that's what you teach your consulting clients, and you've taught for years and years and spoken on a thousand times, and, you know, and it's those fundamentals, you don't need to invent anything. It's not nuclear fusion. It's regular, good, solid business principles, just in a dental practice. And which is a good transition to chapter one of your book that we did, first episode, A Day in the Life of Larry dds, which really, for anybody watching or listening who hasn't heard that I would start there. It really is a. To me, what comes through is it's a common experience. You know, Gary, you and I hear it every day. I graduated from dental school. I'm an awesome dentist. And I come out and, you know, now I'm struggling, and I bought the biggest practice and bought all the equipment and hired all the greatest people. And, you know, now a year later, you know, I can't make payroll and I'm scared to death. It's a very, very, very common career trajectory. So check. Chapter one is that chapter two is the life you're entitled to lead, which I think is. Which also dovetails with another thing that you do that I won't take your thunder. But the entitlement part of it is not a bad thing. But it's about, you worked hard, you got a dental degree, you started a practice. There are certain things that come with that that you've got to get right in your own head. Right, right.

That's right. Yeah. And if you don't establish, if you don't set minimal expectations for time, money, experience, fulfillment, peace, those types of things, you never end up getting them. That's why in the recent ADA statistics, Dennis, have been flat for the last 20 years. They're extending their retirements seven years from 62 to 69, and only 4% are retiring financially free. STEVE and that's really what this is about, is having, having it all now while you're practicing, and then when you get to the end of your career, you can really sell at top dollar and really live financially free. And that's the game here. But if you don't set the intention and the trajectory, you don't land the plane there, and then you have to extend the time that you work, which to me is unacceptable for these great men and women who do this work with patients every day, you know, well.

You call it your healthy deserve level, your hdl, and that's, you know, another book and another episode. But I really am a big believer in that, that you, you know, again, you, you, and I think dentists just struggle with that because they're trying to merge that clinical training they got with the, you know, the bruises and battering of running a business. And they think, you know, I don't deserve it. Because when you do, I mean, you've done something extraordinary. If you want to just show up and get a paycheck, you know, work for somebody, get a job, go work for, you know, a big dso. If you're a practice owner, it's not like you get it just because you got a dental degree. You get it because you put the effort in your practice. Chapter three, our third episode. Cpr. Another one of my favorites, cash in your pocket now, which again, is more about getting your money right in your mind, how it works. You are a business owner. It's going to be a lot of cash passing through your hands. And, you know, the idea, you know, it's practically the, you know, the name of my business is profit is just the money that's left over. So if people give you $1.2 million a year for the dentistry you're doing, the idea is you keep, you know, a few hundred thousand dollars of that for you and a little bit extra, you know, save them for a rainy day and then a little bit extra to build your business. And you can do that if you plan it.

And then I just want to really just jump in here real quick for doctors, and it really picks up. STEVE ON if you've ever noticed that when you have new income levels, your expenses rise to meet the new levels of income, and you, you made more top line, but you didn't keep money. So it's, it's an actual phenomenon that you have to protect yourself from the money and know what, how to receive money and keep it, because a lot of people just end up passing it through, and then they never, they, they never get debt or they never amass a stockpile so that they can retire financially free. And that's really what we do in chapter three, and really begin to teach people about get rid of money with wings and start structuring how much a top line is, how much a bottom line is, and then how much you keep. So it's find the money, get the money, keep the money, and to do that ethically, that's the philosophy here.

So chapter four. Don't know why, but we, it looks, I can tell we have a record number of registrations and a lot of people pouring in. I'm not sure what they're expecting or what they want to, what they think this chapter is about, Gary, but it is what you really should be doing with your dental hygienist. Now, I've read ahead, so I know it's not quite what we think or, you know, what we've probably seen.

You were thinking that, Steve. Not anybody.

I never see. I don't see that train wreck every week, Gary. So as we dive into that, and before we start, I do want to throw one thing out here. They popped up a little message. Ask questions. Anybody who's watching or listening, you have the ability click the little button as we're recording this, and we'll record it for later. Ask your questions. If we're, if we don't discuss them today as they pop up, we will respond later. If you got to ask, if you want to ask Gary anything, just put it in a little box, send it, and if we don't get to it tonight, then tomorrow we'll be able to. Whoever it's to will be able to answer it directly. And Gary's promised to answer any questions, no matter what it's about. Anything from, you know, every chapter in the book, the whole book, what he does, you know, where he buys, you know, those awesome Manhattan clothes that he wears to the really fancy studio he has that Ryan set up for him. Anything. Anything's open, right, Gary?

Well, Steve, I, you know, I've been so touched by the questions I've been getting, usually on the next morning, because they're like, you know, we're not able to get to all of them. And what I really appreciate it, Steve, is the transparency, the vulnerability, the authenticity, people really getting into, like just opening the kimono and saying, here's what I Got, and I love that. And just know that this is a judgment free zone. A lot of people are afraid to ask questions because they feel like they're going to be judged. And what if this question isn't right and it sounds, I sound stupid. I don't want to sound stupid. So, you know, I want to create a super safe space for our listeners and you know, just type in and we'll, we'll, we'll give you great support, you know, on your answers.

Yeah, ask and ask away. So during the whole, like I say, the whole thing, I'll kind of monitor questions and usually I lump them together. We kind of get the same, you know, if I can, two or three are really the same question a different way. And I see we got a couple popping in here right now that we'll get to as we get rolling. So first off, I want to get into, into this particular chapter, what you should really be doing with your dental hygienist. And what you've done, I think is really reframe how you look at a hygienist. But before you get into that, the very beginning of the chapter is the three ways that you can grow your practice. One is new patients. Just get a lot of new patients. It's a thing you and I hear every day. It's extremely expensive. It's a long term effort. You can't throw some money at it this month and just have a whole bunch of patients next month. You got to spend money month over month over month to get new patients. And I know one of the things that you're a big advocate of is, you know, is sort of farm what you already have in, in house, which we'll get into here when we start talking about the hygienist. Number two is increase visit frequency. That includes selling. So if you, you know, you go to your patient and say, hey, instead of two hygiene visits or profi visits a year, let's do four. And you know, really what can you generate off of that? That takes selling and it takes time and it takes money. But number three, one of the things that you have built this chapter around is you increase treatment acceptance by using the tools, the patients, everything you already have in place. So can you take a minute and kind of explain how that's probably the, that's a much better approach than saying, hey, I'm going to watch a webinar, sign up for some program and get a, and you know, expect 20 new patients next month.

Yeah, you know, when I go to a, when I, when I go to live events. I go, who wants to grow their business? I get everybody's hand raised. And I said, what do you think the number one way to do it is? And guy says, new patients. I said, who thinks new patients? 99 say, that's me. And I got in this business, Steve, 27 years ago because I was delivering new patients to the front door of dental practices. I had a marketing company, direct mail coupons. I would mail them out to the surrounding areas and they would get out of 10,000, they would get 1% or 100 patients. And the guy couldn't pay, he couldn't pay me for my advertising. What do you mean? I go, I got you 100 patients. Here's what, here's what I learned. The average case acceptance in a dental practice is 28%. The average patient coming back twice in your hygiene department, 22%. Look at the inefficiency here, Steve. The patient comes in the front door, they go out the back. 22% of the time, they're retained. 28% of those patients, they're retained twice. 28% of those patients accept treatment. Extremely bad formula. And this is why, like, I'll get a dentist who has been practicing for 20 years. And they had the same 1,000 patients. All they're doing is exchanging patients where they're coming in the front door and they're going out the back. And when they're there, they're not investing any care. And so we fix this model. We plug the retention. If you don't plug your retention first, what happens is if the patient's not sitting in your chair, you can't present cases to them, so you got to fill the hygiene chair in retention number one. Then after retention is taken care of, then you handle the case acceptance. Then and only then do you drop them in the top of the funnel. And then turbocharged the system by adding new patients. So that's, that's the strategy on how to do that. Because you reduced your cost per acquisition in new patients, because if they come back year over year, and let's say it costs you anywhere from three to $500 for that patient, you multi. You can divide that out and amortize it out over 5, 6, 7, 8, 10 years. It's $30, not 300 plus.

You're investing money in which we'll get into. You're investing money in a team that can now propose more treatment that gets and help get that treatment accepted on a patient. You've already paid 3, $500 to get in the chair as Opposed to just saying, well, we'll take what we'll get out of them. They never came back. And so we'll start fishing for more new patients. And really fundamentally, I know you and I have talked before about these numbers. You've got a lot of practices that can double their production with no new patients. Not one new patient.

Zero, zero. And that flips the script for a lot of doctors because they're not used to hearing that because all of their friends are going, give me a new patient. But if you follow this strategy, see, I've learned this, Steve, in business, one good strategy to trumps 10,000 tactics. So if you put this strategy in to go inside your business first, then go outside, this one strategy is going to just blow up your profitability, reduce stress, give you more time off, and life is going to be amazing. So it's a game changer. The other thing I want to say about this is it's things you can control. The inside is what you can control. It's very hard to control your external marketing. So you're. We know 100% of the time this works when you work it. If you don't, you, if you don't do it, it doesn't work. If you do do it. I want to give doc certainty out there. When you do this, it works 100% I've not seen in 27 years and 6000 practices this not work. The only time is if you don't do it, that's it. So that's, that's, that's worth something there. And then the other piece I want to say about this is you can, the cost per implementation is a lot less. Because if you have to implement a whole marketing system, it doesn't work. And here's what I found, Steve. A lot of marketing that I see is separate from the product that's actually being delivered internally. When you solidify what you're actually delivering, see a lot of docs you got to get out of transactional dentistry trading, you know, a dollar for a crown. When you get into transformational dentistry, you close the larger cases, they stay longer. Relationship based dentistry, very different than what's the chief complaint? Let's fix it. You give me money, I'm a, I'm a molar jockey and a gum gardener. I'll do the gum gardening and the molar jockeying and then we send you on your way. Get out of that mindset and get into the transformational mindset. A lot of people want to do sleep, they want to do bigger implant cases. You can't do that if you're selling transactionally and if the doctor is doing the presentation. That's why this chapter is so important.

You also, and I think you just said something that I wrote control down here with an exclamation mark. Yeah, I can mail 5,000, you know, awesome postcards. I can't control who opens them. I can't control when they get them. You know, to some degree, Gary, you can't even control if they get them. We mail a lot of magazines and I can tell you there are times when a month later I get a call that says, hey, I didn't get my magazine. And I call the post office and they said, oh, yeah, well, those are, you know, they're bundled with this area code or zip code. And yeah, they're sitting in a pallet out in the back in South Florida. Wherever they mail from, you know, I can't control any of that. In this case, patients in your chair. It's your team, your practice, you can control all of that. So. Well. So let's transition that into a conversation about the hygienist and what you should be doing with your hygienist. And in the chapter, what was really interesting to me is you say, no phones, no selling that. If you've got a hygienist and you go in tomorrow and you say, hey, I saw this masterclass and this Steve and Gary guys were talking about it. So Mary Jane, do this. Propose more treatment and push them to close it. That's not what you're talking about. Your hygienist, you starting off, the first thing they're going to say is, oh my gosh, they're going to make me do recall or recare calls or oh my gosh, they want me to sell more stuff. Your first thing is don't do that, right?

No, no, do not do that. No, let's take no phones first. A lot of docs will put their hygienist on the phones if they have open schedule. And first of all, it really upsets the hygienist. And then they feel like, oh, I have, I have entitled hygienists. We believe that the business should be generating the work for the hygienist. Yes, once in a while. But a lot of docs are throwing hygienists on the phones all the time. You know, with the advent of, with technology and texting, it is cool. I like getting my text from my hygienist saying, hey, I haven't seen you in a while. I like that. I Also like emails a little bit. Like if you had somebody cancel, fill in a little bit. But this concept of always, you know, wanting the hygienist to go on the phones. Take responsibility as a business owner, that is your front office responsibility. That's a front office challenge. Because especially now, Steve, especially out west, the supply and demand for hygienists are different. And you. And if you don't create an environment for them, a lot of doctors are overpaying hygienists on a dollar amount. And we're going to get to that next. That's a big problem. So because they're throwing money at the problem, they're not. And then what happens is they have entitled hygienists who aren't driven to do what we need them to do. And then I even had this on one of our callers who came in. This is no joke. They were, they were a month ahead, by the way, Steve. They were like, I paid my hygienist $55 an hour. And now he also is demanding that we do 40 hours. So he's like dictating how many hours and how much time. And the doc only wants to work three hours. Like, what do I do? It was a great question. Right. And I don't want to get ahead of ourselves here, but like, that's a perfect example. You have to set up your hygiene department to just do hygiene. Now, I know we have some accelerated hygiene and I'm okay with that. That's a little nuanced because a lot of docs have this philosophy, let me pay this person this amount. And the benchmark for return on investment for a hygienist should be 3 times what you pay him or her. And that's okay. My. But I want you to look at a bigger connotation for hygiene. It's not just the revenue coming to and from hygiene. Yes, that's a part of it, but it's the, it's the treatment plans that come out of that room. And you need as a doctor to leverage your time because if you're the one doing all the case presentation and your hygienist isn't generating it at its source and they just need to be the educator and so that you don't have to do all the legwork and then in your recare visits, you call balls and strikes. That's a very efficient system. So that's what we're looking for. It's not just the revenue that you get from your hygienist hygiene, revenue wise. It's hygiene plus the restorative care that comes out. And we say it's about an average of a crown and a buildup. So let's just say that's 1,000 bucks, Steve. And two pro fees, two exams. A set of bitewings is another 300. Now, all of a sudden, I want you to look at your hygiene department different. If they come back twice, and the average adult value with two profis, two exams, set of bitewings and a crown of buildup is 1300. That's $650 for each hygiene visit that comes through. So if you don't have two people at the front desk, one scheduling and one doing treatment plans, if you just say one appointment in hygiene per day, you've more than paid for that additional person. Does that make sense, Steve?

Absolutely. Yeah. Yeah.

And then, then from there, the hygienist is. Now, you're not looking at the hygienist just as a person that does soft tissue care, but soft tissue care plus the patient education, that equals the case acceptance. So that's the strategy here. It's very simple, not always easy for people to implement. And that's why, you know, I'll talk to you, you know, any listener that wants to. We have 10, 10 spots this month to talk to me about this, but it's a very profound system that we've been implementing for 26 years, and it's a game changer.

And I think, fundamentally. I know we're going to talk about profit centers here in just a minute, but I got a question here that says that kind of to your point, what if I'm already overpaying my hygienists? And I think that is a mindset that hygienists are a cost, that there are necessary evil to. To. To the dentistry I want to do. If you change that, what do you say? Flip the script. I love the way you, the Gary Isms, you got to flip the script. They're not. They're a generator, a driver of profit, not just a cost and a necessary evil. And if you look at them like that, I know you're a big believer in bonus systems. And you know, my. I always say we pay everything out of new money, money that was generated because of this person's effort that I wouldn't have gotten if he or she hadn't done anything. That kind of goes to that question, right? Can you really overpay your hygienist? If they move from generating this to generating this just by their behavior and their attitude and their Approach.

Yeah. And if you don't reframe it, you're always going to be in the treadmill of I got to get three times the salary. And that's very myopic. When there's a big opportunity here to leverage your time for those doctors that want more time off. Imagine removing the patient education piece and you're spending five minutes in each hygiene visit and it should be one doctor to two hygiene. You should have two full time hygienists. If you're a doctor, that's how you know you're retaining your patients. That's my ratio. A lot of docs have zero hygienists or one hygienist. You know, our high performers have three hygienists. Now, you can't possibly do three hygiene checks if you're a one doctor. This is how we get super high efficiency where we can get docs. I got docs up to about 2.1 million with 1 doc and 3 hygiene, depending on your fee structure. But, you know, but you can, if you, if you're spending 20 minutes in each of those, that's an hour that you should be at your chair doing dentistry. Imagine spending 15 minutes of that one hour doing your hygiene checks. And now all of a sudden you had three cases being closed. And what you close in this month will show up next month. And now all of a sudden you have a very high efficient business model that really cranks out dentistry, closes cases. And you can go home at night and know how your next month is going to be.

I know your number two is after no selling and no phones, is give your hygienist enough time. And I think that's what you were just saying. If you're kind of cranking them through and expecting them to clean, kick a couple things up maybe on the intraoral camera and then move them through. And you know that's what they're going to do. They're going to crank patients through and you don't get to do that awesome dentistry that you want to do. So what do you mean by give your hygienist enough time? How much is enough time?

Well, I like an hour. I like an hour because we went to 70 minutes with PPE protocols in the height of the pandemic, which is not efficient. We want it to be 60, because here's the way I want you to think about it. Two thirds the time you're working on maintenance and care and one third of the time patient education. So the time comes out of your hygienist not your doctor time. So you're leveraging your time as a doctor because now a hygienist is doing the education. And what's really powerful about this too, is you only make this change if you understand that it's hygiene revenue plus case acceptance revenue. You don't make this change. Now, for some doctors that have accelerated hygiene, we use the hygiene assistant to do the patient education. So we have a way to do it with accelerated hygiene. We adjust for that. And it works so beautifully. There's other layers to this machine, but I'm getting, giving you quick landscape for this particular chapter right here.

Yeah. And number three is, which I think is really interesting, pay your hygienist for the production that he or she drives. And I think it's important to understand because I've got a couple again, some questions coming in here. You know, my team hates to sell. How can I convince them to do it again? You're not. This, this isn't saying you're going to start pushing stuff off on patients that they don't need. This is saying you're going to treatment plan what they do need. You're just gonna, you're gonna take the time to talk to them about the things they do need that might be broader than just, you know, what do you say, drill, fill and bill dentistry and your patient feels better, they're more receptive, your hygienist is happier. And now they're not selling, selling, selling. They are treatment planning, explaining why they need it. And just out of that conversation, the treatment grows. Right. So the production that they drive wouldn't have happened without this sort of approach.

No, there's zero. And that's why a lot of practices are stalled, Steve. Like you want to look at your hygiene department as a way to exponentially increase your profitability without leveraging more time. See, this is where you un. Collapse that I have to work harder to have more. But if you restructure the strategy in your hygiene department to do this and leverage two things. The hygienist can do two things that if you don't have the business model set up, they won't do this nine out of 10 times. And it's two things increase their productivity per day. And it is largely because a lot. There are three types of hygienists, Steve. There are the tooth polishers, the gum gardeners, and the complete health practitioners. You can turn any of them into a complete health practitioner because when you start educating that the mouth is the gateway to whole body health and you have A simple tool like a healthy mouth baseline. This is what's healthy. Here's how it connects to the body. Now, all of a sudden, soft tissue care, bacteria and, and bleeding points that get into the bloodstream. We have all the science behind it to educate patients. Right. And it's very simple to do. We have, we built a system for this, or you can build a system for it, either way. And what happens is now the patient understands the value of what you're providing, and you're not going to be doing bloody profis anymore. You're going to be really charging for 4341s, 4342s. And when you do that, and then you add things like perio protect, which is a tray that actually gets down 9 millimeters deep. You know that we have practices that are doing one case per day, that's $800. And it's saving people from heart attack, stroke, diabetes, dementia, like preventively. And they're doing one of those a day. You do one of those a day, you do two to three soft tissue, advanced perio, and then you do some profies. You know, we take a hygienist, we call them hygienists, not hygienists, by the way.

I love that.

Yeah, well, because it changes their mindset. They're actually the catalyst for getting people healthy and they don't relate to that. If you take a tooth polisher to a gum gardener to a complete health hygienist, now all of a sudden they relate to their work differently and they're having different kind of conversations and watch what happens to their revenue. Because now they're getting some soft tissue care, they're getting some perio, and then all of a sudden you go from 1000 a day to 1500 to 2000 a day. And then the other part that the hygienist is responsible for is educating the patient on the problem. And the consequence of no action. The doctor comes in and gives the solution, edifies the hygienist for what they recommended. And now the patient's buying treatment. You're not selling it to them. The patient doesn't know what they need and why they need it. And the hygienist has the relationship to do that. And the time now, now all of a sudden they can sit there, set it up, and the doctor just calls balls and strikes, edifies. The hygienist gets to the next chair, then gets back to their chair. And that system works flawlessly. Once you have it in place, it's.

Also A. I've always seen it as a conversation starter. And you got, you still have. You have your healthy mouth baseline, a little chart there, hold. I know you. You advocate that and use that. It really is just a conversation starter. And where it struck me one day is, you know, in the practice world, I had a doc come to me one day about how mad he was at the guy down the street. He went on vacation, and a patient had been coming to him for 10 years, twice a year for 10 years, and he needed some implants, but he never asked him about them. And I said, well, did you ask him? And he said no. I figured if he, you know, if he really wanted implants, I didn't want to embarrass him, but if he really wanted, he would ask me about him. And I said about him, and I said, you know, did you ever think that he came in every time, you know, twice a year for 10 years and thought, well, if doc thought I needed him, he'd mention them? And I think that happens over and over and over and over and over. And where practices are stalled, they just don't know how to start that conversation. And that's exactly. That's sort of what you're talking about, how to help your team start that conversation, right?

Well, not only started, Steve, but here's what I noticed that was happening. This practice, like you said, has all these modalities and all these offerings, but the hygienist, first of all, nine out of ten of them are humanist, methodical, so they don't like presenting treatment in the first place. The second piece is, and by the way, I'm not dissing on hygienists. I love hygienists. They changed my life. And I'll get into that in another conversation, but changed my career, changed my life, but they just haven't been set up to be successful. And this healthy mouth baseline actually highlights all the symptoms that exist. Like, you know, a lot of docs want. Want to do sleep, but guess what? They don't even have. They don't even ask about, how are you sleeping in the hygiene room. This, this is like the report card for the checkboxes of all the elements of the modalities. These are all the symptoms and that allow you to present treatment if you don't diagnose it and if it's not on the patient's radar. And by the way, it just keeps the hygienist on us because they can't think about all these things all the time. It puts a systematic Consistent structure to unveil the problem and then look for the highlighted solution with the doctor coming in for the recare visit.

Well, one of those is do your gums bleed? And I'm always shocked at how many patients think, well that's normal. They're supposed to happen, you know, and, or they're sitting in the chair thinking, you know, my gums bleed a lot. If that was a problem, you know, my hygienist would mention it and she's thinking, wow, maybe they're think, you know, maybe they don't realize that their gums are a problem, but if they did, they'd mention it to me. And it really is just that, that whole little, that using your hygiene. And I noticed there's a question down here. It kind of goes back to what we talked about and I want to make sure we sort of put a bow on it as we come to the end is I said mentioned profit center earlier. And this particular chapter in the book, which I would highly recommend anybody who's listening get the book. We're going to put a link down here, Gary, to download for the book also. But in this chapter you talk about making hygiene a profit center. So I have somebody who said, isn't my whole practice a profit center? What do you mean by that? What does a profit center mean? And I've got a couple questions about profit center. And I think that's a fundamental concept you and I might get. But a dentist thinks, well, gosh, a lot of money comes in, a lot of money goes out. At the end of the year, my accountant says, here's my profit. So that's my profit center. You're talking about making hygiene basically a place you focus on. There's, there's, there's costs, there's expenses, there's revenue and there's drivers for more production. But it's looking at the hygiene department as a place where profit is generated as a part of the whole of the whole practice.

Right, Steve? Look, if there's 20 profit levers in a bit in a dental practice, the number one profit center is turning your hygiene department into a machine. I was going to say turn your hygiene into a machine. This. Look, I have guys that are going, gary, I need social media. They treat that the same of same importance as doing what we're saying here. They're going, man, I need to have social media or hey, I need to get more CE for, you know, to do more modalities of things. Well, if you, you know, they'll say, hey, I'm going to go, go get trained in sleep. But if you can't close a case, it's not a profit center. If you go do a vivos training and then you come back to your practice and you have no patient education machine in place to have that airway close. So that's not a profit center. That's actually a high cost because you just spent all this money on this education that has no return on investment. This is the number one place to put your attention and energy because you will get the biggest return on that investment. That's where the profit center is.

Yeah. And also it's as you say several times throughout the book, this is infrastructure you already have in place. Employees you already have in place. You're already paying them. It's patients that are already coming in. It's a whole mechanism that already exists. You're just squeezing this many dollars out of it and letting three and four and five times that just walk out the door.

Well, the biggest thing, Steve, let's add one more thing that I know every doctor out there wants more time and more energy. You don't have to touch this once you build runs throughout your day. So you're not going to be spending any more time at work to have, have more profit turnout. You're just going to have what you have, be more efficient and more productive. And you're, you're actually, by the way, guys and gals can go from four and a half days to four, four down to three. You can take more vacation time because you have more control points and you're not working more hours to make more money. That is the biggest thing that this gives you.

Yeah. And I think as we kind of draw to close on this one, the important thing is you get the book. Cost you nothing. You can implement this on your own. Cost you nothing. You can sort of help with that mindset of your own. Cost you nothing. I know what, you do this with your clients and so you help them walk through it. But this really is something that cost you zero. I mean, you can start doing this tomorrow on your own, no doubt. Now you have to change some of your behaviors, probably as a practice owner, and you have to change a little bit of your mindset and that can be hard. And you know you're going to get a little pushback from your existing staff because you know, they sometimes they like doing it that way.

They love it.

They don't want to change anything. Their paycheck is exactly the same every two weeks. They could care less.

Exactly.

Your profit every two weeks. Might be getting less. And certainly as we go from year to year, your insurance reimbursements are a lot less and your rent, fuel taxes, all that is going up. So you're not happy about doing the same thing, but it really is something you can do on your own. And, you know, so as we, I wanted to throw out here, you have agreed and they're going to do a little thing where it pops up here at the bottom. I do have a lot of unanswered questions too, so we will get to all those, I promise, tomorrow. But you're going to. You alluded to it earlier. For the first 10 people that just want to ask you anything, click the little link, put your information in, you'll get an invite back for a 30 minute call with Gary. That again, they can ask anything. They can say, how did I do this on my own? You know, I'm not paying you a nickel, but how can I do this? Or they can, you know, whatever they want to do. You're very generous with your time. I know. And you've lived through a lot. You've done, holy cow, you were doing DVDs back in the 60s or whatever this is, and writing books in the 50s or, you know, you got a lot to share and, you know, we've known each other long enough that I know that, you know, you just want to see practices do well, whether they're working with you, whether they're not working with you. You and I both have seen a lot of docs struggle. And anybody who's listening to this and struggling and can't figure this out and sees their hygiene department as an expense and ask questions like, what if I'm already overpaying them? Gary's a good guy to help you sort of reset your own compass in that respect. So first 10 people who click you, you'll let them talk about anything, right?

Absolutely. Yeah. And I have, like, I had this one poor gal last month, Steve, who actually had cancer and she's a young galaxy and she shared with me her situation and she's like, I'm not going to die and I'm going to do something about my practice. Like, it took me to wake up by getting like, realizing that I have a second chance in life, I'm going to beat this cancer thing and I want to get to work on it. And, you know, like, that's the kind of stuff that I, I get really excited and motivated by people really waking up and saying, you look, you know, what we're seeing is through the pandemic Steve, it's been like this. People didn't know. There was so much uncertainty. They really didn't work on their practice. They kind of. Some did and some didn't. But now what's happening is we know that with all the vaccines and everything going on, Steve, it's going to be like everything's reopening and people are ready now to make new decisions and take new actions because they're not going to have their practice operate like it was before. I'm seeing such an influx of people raising their hand who haven't for many years. And I applaud them for their courage.

Well, and that I think so. Which is a good segue into our next episode. Number five, why your team hates you. And I don't know who wrote the titles to these, but they're awesome. And again, I've read ahead, you and I have discussed it. I know what this means, but it does get your attention. And I think there are a lot of docs who are listening tonight. We got a lot of people on, by the way, who immediately said, yeah, I want to know that right now. Well, you know, get to wait till the next session. But why your team hates you. A great question. You know, they don't necessarily hate you. A little bit of a spoiler there, but it's going to feel like that some ways. And again, as with all of these chapters, it really is up to you, the practice owner. And you know, there's no system you can buy, there's no magic, there's no DVD that changes everything. It can inform you, but you have to do the work of it. So. Gary, any, by the way, excuse me, I meant to ask, here, here's a question from Steve Parker. It says if I call you, if I'm one of the first 10, can I call and just talk about the Yankees for half an hour?

Yes. Heck, yeah. Because I live at Yankee Stadium, Steve. And when you come out, whoever comes out, I'm hosting you. So, yes, I'm a crazy Yankee fan for sure. And don't forget, you owe me reciprocal. I want to go to an IU game.

You bet. And we got a new coach, so I might be going to games again.

Congratulations. Well, my alma mater, Rutgers, beat up on Indiana three times, so it's been a good year for us.

So that's what, that's why we have a new coach, Gary.

But yeah, it's, you know, I just, you know, I want to, I want to leave with this. I have this thing where you're not your circumstances I want you to get, like, the one lesson I got in sobriety. I'm coming up, by the way, next month. Thirteen years of sobriety, Steve. Like, that's. And I was. I was a bourbon and cigar guy, you know, like, I can throw down, man. I enjoy that, right? But my wife came to me and said, you don't have to quit drinking, but you can't stay here. We got to get your son healthy and you healthy. And I'm grateful for her for that. And I realized that I had so many circumstances, so many things, that life was unmanageable for me. And the minute I took responsibility, it all ended. All the unmanageability, all the upset, all the fears, all the stresses. So I get it, man. It is sometimes hard to raise your hand. Raising your hand is a form of strength in 2021. It is not a form of weakness. And I really. I really applaud the people that are really taking responsibility. And we're playing one game, and I want everybody to play. You ready? You can't blame your circumstances on the Rona. You cannot. You can never say because of COVID Those three words. Because of COVID That's three words. You're not allowed to say that. Play that game with me, because now, all of a sudden, the responsibility will be on you to create anything bigger than that circumstance. So that's what I wanted to leave our. Our viewers and listeners with this time.

Great. You know, great advice. And I. I happen to know, I know a lot of your docs, clients, and people you work with over the years, and I know a lot of them are up dramatically during COVID So I'm a big believer in if somebody else can do it, I can do it. The question is just how. And I know, in fact, all of your docs are up, I think. Did you tell me all of them are up this year? That's a. That's a lot of practices.

Well, but also, it's like, no coincidence. No one wins alone. And the secret to success is no secret, Steve. I mean, I'm slinging them all here at the end here. The secret to success is no secret. It's already been figured out. You just need to follow the dang system. I mean, it works every time, so.

Yeah, well, practice owners. And Gary, I appreciate you showing up. Million Dollar Dentistry. Click a little. Click a link, get 30 minutes of Gary. And I hope you've enjoyed what you should really be doing with your hygienist. I hope I didn't disappoint some docs. Who were expecting a little bit different masterclass on this and tune in for the next one. Why your team hates you and I hope you're getting a lot of value out of this. Please send us comments. Click like below. Take advantage of the free book. Take advantage of 30 minutes with Gary and Gary until next time. I appreciate you, buddy.

Love you. Have a good one.

See you, practice owners.

Yep. Bye, practice owners.