Motivate and Engage Hygienists Using The Triple Win Bonus System

Hello everybody. Welcome to the Elite provider track. I am Tanya Dunlett from Periprotect and I am here with Gary Katie from Next Level Practice. Welcome, Gary.

Oh, thanks, Tanya. It's good to be back. I love our monthly event here. It's pretty awesome.

It is awesome. We've been hearing a lot of good feedback from people who've been attending and watching both live and also in replay. So I'm just so grateful that you set this time aside not just for Perio Protect Providers but for everybody through Dental Learning. And I just want to give a big shout out to Dental Learning for hosting this year long series.

Really incredible.

Yep, it is incredible. We get to talk about different, different aspects of your book, Million Dollar Dentistry. We are on chapter four. People are following along. You've all received the links to where you can get a copy of that book. There it is.

This is the first one. Look at this young guy right there. It always cracks me up.

Tanya, how many years ago was that?

This was 2005.

Yeah. So counting up those years, right? 16, 17.

A little chubby face and dark hair and then, you know, then you learn to get your picture off of there after a while.

So. Yeah, well, it's still, it's holding its own and I know you've made updates to it along the way. But as we get into chapter four, which really is about motivating and engaging hygienists with the triple win system, we're going to talk specifically about bonuses today. But we're also going to refer back to our second episode where we had the million dollar hygiene formula. And then our episode last month was really situating your practice as a complete health practice. We talked about the healthy mouth baseline. What's your number? These really key takeaways and this time really examining the hygiene department for what it, for what it is. It's getting patients healthier. It's also a center for practice revenue. So we're going to talk about how hygienists are not just a cost, an overhead cost, but how they can drive profit. And we're going to tap into their superpower. Their superpower. Patient education. Advocating for patient health, giving clear directions to patients and not selling treatment. That's not what this is about. This is about presenting what patients need. And Gary, you always say it's informed. Patients can make informed decisions. And this is one of the things that your team is so good at teaching, really teaching the people how to do this.

Yeah, yeah. It's really, it's really an exciting time. I know Doctors right now, there's so much tension, Tanya, about, you know, like, I just got off a call with a doc, she's in, in south side of Chicago. And it's like, you know, they're dealing with like the hygienist. They had to give cost of living increases, but, you know, the constraints of, you know, not more profitable, reduced reimbursements. I mean, we're dealing with that. You know, the cost of running a practice in today's world is dramatically different. But here's the challenge, you know, if you don't make changes, like, docs want to sit in their comfort zone and I get it. I want to just draw this out. Like, I want. I just want things to just run the way I want them to run. I want to go home, be with my dog and my wife and my son, watching basketball, watch some, you know, sports, play some sports, workout, ride my bike and just have it go away. But avoidance is not going to get us there, right? So, like, what happens is, you know, what we're dealing with in today's world is the world has changed, right? Let's just say that you, you know, got to a million and, you know, what we're hearing is people want to get back to pre pandemic levels. I'm going to say, you know, maybe you can get out of that mindset. The first mindset shift to take today is let's not go back to pre pandemic levels, you know, because what we're seeing is, let's say pre pandemic levels for you was $1 million. And you got there basically by doing what you've done. And now all of a sudden you're starting to see, I mean, Tanya, we're seeing this all over. If you haven't made a change, you're like looking at 750, right? And so the constraints of, like, what you're dealing with, hygiene, either not being able to have enough hygiene hours or the ones you have, the cost is rising for that. So you gotta make some shifts because not only is your top line going down, your bottom line, expenses, your expenses are rising and your, your top line is increasing. That squeezes your lifestyle as a. As a practitioner. So, you know, what we want to really do is we want to really. This is called the valley of avoidance. And I love this. I've shown this before. If you've seen it, just please. I think it's worth looking at again. It's like, okay, I have hygienists who are. First, I need to hire a hygienist Now I have hygienists who are coming in and they want more money. And I. If I get more money, like, how do I. How do I make more money at this point, this fee. Oh, now I got to start looking at my insurance reimbursements. Oh, geez. Oh, that's a lot to look at. Oh, I haven't had the conversation that I needed to have because my. Basically his team's running amok, and I need to deal with that. So we understand this, and all there is to do is raise your hand. You know, in Today's world, in 2022, raising your hand is a form of strength, not a form of weakness. And, you know, look, this is predictable, you know, going down. And so what there is, is an opportunity to really get across the value of avoidance, because it's not going to get any better. And what you'll find is docs like to make practice owners. Sometimes make this up is harder than it really is. And I'm not trying to minimize it. There are things to do, but if you work with somebody, you know, find somebody that you trust and they'll walk you across the valley of avoidance and then march you up to 1.5. See, if you're trying to get back over here, consider that maybe the better look is to go forward and just do some reinvention. You know, we're not talking about upsetting the apple cart. We're talking about really going back to getting your practice in. Post pandemic. Business model nuances, Tanya, that allow you to be profitable, make a difference for your team first and your patients, and then you get to have a practice running the way you want it to run for the next 10, 15, 20 years. But if you don't reset, you know, don't think that you're going to be able to, you know, have a practice that runs in profits the way it did before the pandemic.

Right? And we want. We want doctors and teams to actually be excited about coming to work, right? To have a place that they want to be in and that reset can happen. It is real. Everybody but. So, Gary, people are talking about how much hygienist costs right now, how much costs of goods are. Right. There's supply chain issues. We've had all these complications and challenges that make running a practice more difficult. So some people are like, I would love to pay a bonus structure if I think it would motivate my team and help them do the right things, but I'm already paying a lot, right? How can I afford to pay a bonus. Now this is something that you cover so well and do so well with. Next level. Talk to us about it. How do you. How do you do this?

Well, you know, my first practice, by the way, my first practice, I'll never forget it was in. In San Diego, North County, San Diego. And the doc goes, man, I want to grow. Can. Can you just fire all my people? And so we get another. Get a bunch of new people. And like, it's not. You don't. You don't build a better practice by firing people. You build a better practice by building a business model. And the business model supports the team on what to do. So I always say, like to paint this picture. And I had to learn this the hard way. Cause I was just trying to be a better Roger Levin better, you know, a better. You know, all the people that I honor who have come before me that do this work. And what I found was what was missing was there wasn't a real business model being implement it. And here's what I mean by that. So if we're playing chess, I'm playing chess, and you're playing chess. You could pick any piece of a chess game. If I asked you this question, what piece would 99% of the people pick to beat me in the chess game?

The queen.

Yeah, the queen. Because the queen, you know, first, she's female and she runs the show. We all know that. Most guys. And if you're a guy out there, trust me, this is the way the world works. And it works great when you surrender to that. And then when you put. You give the queen the free reign to run all over the board. You're going to beat me unless I have something senior than the queen. And I have the game board. You see, I said piece of a game. And the piece of the game is also the game board. But nobody thinks about the game board. And that's what is needed in 2022 and beyond getting the board. Because I could tell the pieces on how to move every day. So I could tell you, Tanya, your queen cannot move. Can move like, not like a queen, but like a pawn. And your pawns can move. My pawns can move like queens. So I have you beat. So the point is, how do we set up the game board in a dental practice? That's the key to this whole game. And then when you give dopamine shots to people on a daily basis, on a patient by patient basis, and they're playing a game, first of all, they're having more fun. Second of all, they know what's expected of them. Third, it's not a group bonus because group bonuses on collection is what the doctor can afford to give. But here's what happens, here's the problem about that. And docs you can, I guarantee you'd be nodding your head right now. It becomes expected as part of their salary and you haven't made any more money. The top, you haven't changed behaviors of your team. Your top line hasn't grown. Your bottom line is more expensive now because now you've added that bonus that people would get because for. Not for a cause, causative reason. Tanya.

Right, right.

But for a reason that was like all the things in the universe came together. Let's say you had three big cases sold, four Invisaligns, you know, you just three airway like everything came. Cause you're on collections. And as a group that actually does the opposite. It demotivates when they don't get it. Here's the other thing. There's some team members. It's usually the 8020 rule. 80% of the revenue is generated by 20% of the team members. If you have five team members, that's one team member generating the revenue. You can't afford to run a business in today's world if everybody doesn't know what their measure is. So here's the way we do it. The first thing you want to do is. And I'm going to draw it out. Is that okay, Tanya, if I draw again?

Go ahead. Let's see it.

I'm telestrating today, man. I'm on fire with the telestrator. Here we go. So it's coming up now. It should be coming up. Yep, here we go. So I'm going to do this very simply, right? So let's just say, you know, if you want to do a, A, you want to have a million dollar hygiene department because I want to pick up on our last, last call. You haven't. If you haven't seen our podcast or our session last time, look up and it's the million dollar hygiene conversion product.

Second one, right?

Yeah, second one, right. But let's just, let's just say if you want to get, if you want to do 2 million, right? And I'm going to say just, you know, and now if you, if you write off 25%, you have to produce 2.5 to collect 2 million. So you always have to add production dollars on the write off amount. I'm just going to say we're collecting 2 million right now. So if you collect 2 million. What you need to do is you need to do 167,000 per month, right? So if you take 2 million, and I'm gonna do the math right now, if we take 2 million, right, and divide that by 12, that's 167,000 per month. Now, two hygienists, by the way, should always have. You should have. For one doctor, you should have two hygienists. So it should always, if you have two doctors, should have four hygiene. That tells us your ability to retain your patient base. So if you don't have that ratio and their schedules are on fill and booked out, that means that you have a retention situation. And you'll be able to get how to fix that in our, in our podcast going forward. But two hygienists doing 1001600 $50, that allows you to get to your $300,000 per hygienist per per year. And if you have two hygienists, that's how you get the 600,000. And when you get to 600,000, the treatment that comes out of those rooms is equal to or greater than 400,000. Now, your hygienists are producing $1 million. Now, this is important in today's world that they're. They're producing on this level because the, you know, and I have a range from $70. Some, you know, some people are throwing money at hygienists just to show up. And I've heard up to $70 in, like, places like Maryland. You know, supply and demand is different in Maryland. And I had Minneapolis. I mean, different, different pockets around the US I'm seeing. And then, you know, there was the cost of living increase to see people moving from 30, 38 to 45. You know, there's that kind of stuff going on. Again, please don't quote me hygienist if you're listening onto this call, because it's all dependent upon your, you know, you know, your situation. I'm just reporting what I'm noticing out in the world. But as I speak to you hygienists, and I speak to practice owners, you got to change the game in hygiene. Hygiene is the machine that makes the entire practice run. But you have to reframe how you look at the revenue that the hygienist generates. So if you have two hygienists producing 1650 a day, that's 600,000. Two hygienists doing 300,000 each, plus your 400,000 of the revenue that comes out of hygiene, which is the restorative care. Now all of a sudden you have a million dollar hygiene department. So I want to stop there. I'm throwing a lot of numbers out right now. Tanya, I want to make sure you're clear because then I know our audience is clear. Tell me what your thoughts are.

So what we're trying to get to is daily Production per hygienist, $1,650. That's revenue generated per day. And you're assuming they work four days a week and there's days. I mean, you assume all of this, all of the time off. What that turns into is $300,000 in production per hygienist. That's how you got to the $600,000 total.

Right.

And then the 400, that's additional. The 400,000 that's additional is work that's recognized from the hygiene visit that needs to be done, that is then done in the doctor column.

Yep, you bet.

All right, so.

And that's how we get to a million bucks at a high.

That's how we get to a million. So we're talking about a bonus system here, but we have to figure out how we motivate folks to get to this 1650. How do you add services in also to do this? Services that they need. Right. This is how periprotect factors in. But this really is called hygiene driven dentistry. Right. Gary, this idea that you have a million dollars coming out of the hygiene department is basically our hygiene driven dental model.

Yep. And we're going to just have these three things that need to be in place. First, you have to have a team bonus system by position. If you don't have a by position, it's going to be very difficult to go from where you are to where you want to be. So bonus is number one, added value services. And that's why Tanya and I are even together. We, we got together by accident because I was like, I had a practice in, in Hayes, Kansas, and they were, they had our, they were our first million dollar practice. And I, when I did my analysis, it was the work we put in, plus adding perio protect as an added value service as, as, you know, a place to really add value and take care of patients and not only change their, you know, the makeup of their soft tissue, but the overall health of their, their body as well, you know, because the impact that that soft tissue has on the overall health of the body. And so that combination got us to over 1650 a day. We had hygienists doing up to 2000 a day.

Right.

And then really making sure you're measuring, monitoring and making things go. Right. Right. So I want to make sure we're, we're all clear so far in what I communicated. Any, any gaps that you want to add here? Are we good?

No, I think we're good. What people are not going to understand is the bonus bunk position that next level practice is so good at is based on a bare butt minimum, which I think is just a fun thing to talk about. Right. You got your bare but minimum and everything is pretty much automated with you, with your system. Right. But let's talk a little bit about how that buy position works.

So it's a triple win bonus system. Right. It's a systematic process that reverse engineers from what you want to do annually. And by the way, this is where you take your time off. We actually pull you out for vacation weeks. And if you want to move from five day. I just helped a doctor that I was, same doctor I was talking about in Chicagoland moved from five and a half days to down to four and she was taking three to four weeks off, she's taking five weeks off. And the way you do that is upfront. You figure out what the algorithm needs to be. And I'll just give you a general sense. If there's a two doctor, you know, let's say it's two doctor to hygiene. Right. So you want to do. So our doctors need to do 8,000 a day. Right. And hygiene needs to do 1650 per hygienist per day. Right. Times two. Right. So when you reverse engineer and you take the amount of time off now, all of a sudden you have what your measures are per day. Now if you pres. If you need to do 8,000 in the doctor's column, that means you need to present. And if you have a 67 conversion rate, 0.67. If I take 8,000. Right. And I divide that by 0.67, I have to present $12,000 per day. So out of the hygiene room, you know, each hygienist presents 6000 and ideally averages 4000 on each of those out per day. So 6000 per day is not a lot. But if you don't have, you know, this is the tool that you'll keep seeing reoccurring, which is a healthy mouth baseline. These are the benchmarks for what's healthy and then being able to educate its impact on the overall health of a person. You'll never get to that amount treatment presented and treatment accepted. It just doesn't happen and it's not selling. All it is is setting the benchmarks for what's healthy, soft tissue and hard tissue in your practice, putting it up on a screen before the patient. And then when you're doing your diagnostic, you're showing them the gaps between what you say is healthy and what their condition is. That creates a gap co diagnosis. The patient comes to you, it changes the behavior. So if we look this triple win bonus system out, Tanya, we have to present 12,000 and get 8,000 accepted. The doctor needs to do 8,000 in their schedule and the hygienist needs to do 1650. So let's break it out. So in the front desk, in the front desk of a practice, there's an appointment coordinator and a treatment coordinator. Minimally, you have to have two dedicated people. Now, this is usually new to almost 90% of the practices we work with. They don't delineate the responsibilities. The problem with that is everyone's accountable for everything. Therefore, no one's accountable for anything and no one's at cause in the matter. So in the appointment coordinator, their job is to fill the doctor's schedule to 8k and the hygienist is 1650 a day. When they do that, they would get $10 per column per day. And if they did, if they filled it to 8016 50, that would be $20 times 16 days or $320 in bonus. But it only gets paid out when we collect $167,000 a month. So now you have a team that is broken down by position. They know how much they need to do per day. They know what their reward is or their dopamine shot per day. If you're not getting dopamine shots, they're not changing their behaviors. So if it's just on collections, that person in the appointment coordinator role is not playing the game called 1650 and 8000. That's their only game is their outcome. Obviously, they need to be nice on the phone. They need to follow the system on how to, how to answer the phone. They know they have to know how to overcome objections if the patient doesn't want to show up. You have to have all that set in place. Those are the tools they need. And by the way, they only want to use those tools if there's something in it for them, if there's something not in it for them. If you don't fill the hygiene schedule to 1650 in revenue and keep it that way all day, you know, you get busy and then it doesn't get filled. And then you have open time. Now your open time is so costly because it's not just that $195 in hygiene revenue. It's, you know, the 650 in revenue for half a crown coming out of that room. Right. Because if they come back twice and on average, the adult will invest in the crown annually. So it's not just the hygiene revenue, it's the restorative revenue, like we were talking about before. I'm going to stop here, Tanya, because I'm going pretty fast and I don't want to overstep anything. Anything you want to add here. Is this clear?

Well, let's go back. I had mentioned the bare. But minimum. 167,000 is our minimum. Right. You don't get anything bonused until you hit your minimum, which you reverse engineer based on what your loans are, what you need to make, what the office needs to make, everything you need to go just to pay off your expenses. Right. And that can even be towards retirement. Yeah. And so the bonus structure comes once you get past that amount.

Yep.

And what you're saying is you're giving her an example here of what you might get by position. And this is a great way just to talk about from your front. And, you know, people might say, well, well, $10 bonus, you know, will that matter to somebody? Well, if you hit 320amonth, you're coming in there near $4,000 extra a year. It matters.

Yep. And, you know, again, we're. We're going to break down each person, each person on the team, just very briefly, but just. I wanted to show you one all the way out. The treatment coordinator gets 1% on the treatment that's signed and has a dollar agreement to it and a schedule. See, most people think, oh, did she schedule? Scheduling is not closed. That's scheduled. I'm spelling poorly here today. I'm just gonna do scheduled. So it's signed, paid, and scheduled. Now, if you're grandfathering people and you let them pay half and half, you honor that we're not gonna disrupt the Apple card. But I'm just giving you the ideal. If they don't sign, they don't pay, and they don't schedule. Those three elements really say, I'm committed to time, I'm committed to money, and I'm committed to taking responsibility for what you presented to me. And then they get 1% on that. The assistant. The assistant gets paid. Now, they're going to be working columns. So let's just say they're they're working the doctor column. They get paid $20 per day. If they work 16 days, they 2 equal 3 20. And pardon my chicken scratch, but you get the general sense that when you have the appointment coordinator driving the production from the front of the office and then the assistant doing same day dentistry, if you're short of that number, the Assistant's number is 8,000 a day. See, it changes the assistant's mindset. They're thinking, they make patients comfortable, they sterilize instruments, they turn rooms. Yes, those are the doing things. But the outcome, we need to get them focused on two outcomes. How much do they need to produce per day and are we going to collect as a team? 167,000. What it does, Tanya, is it gets the team in the currency that the practice owner needs and removes the employer mentality and employee mentality. The reason why doctors get stuck is because they want to grow, but the team wants to stay the same or not lose their job if they take this on. Now, this might sound like a really complicated thing. It is really simple and easy. And it's just the initial thing might be overwhelming, especially if you're a doctor that hates numbers. I just got off the phone with that doctor, she goes, I hate numbers. I'm spontaneous. I don't like tracking anything. And I said, we automate the whole thing. Your team tracks the whole thing. They report up to you, you verify it, and then the bonus gets paid. It's a simple tracking system and it's all automated now. It's really fantastic.

I think the part that might be overwhelming for some folks is to share this much information with their team. But Gary, if I could share my screen, I want to show how well it can work. So, Gary, I want, I'm excited about this. I want to show you these numbers because those offices that work with next level are some of the most profitable. And this is when you are being this vulnerable, right, this transparent with your teams. So this is 2020. This is the year of the pandemic. And I did not make any adjustments for those months that we were totally down. But you can see what doctors are, what the team actually, because Periphertector is almost 100% team driven. But what the, what the doctors are collecting every month right now, this was 2020. These are all next level practice offices. And the reason it works so well is because they're using those tools that we talked about last time last month. Healthy mouth baseline and what's your number? And if you want to go back and hear that Episode. Let's do it. And then I have 20, 21 numbers for you that I know you haven't seen yet. This one office in California, Right. That doctor owns two practices now.

Yep.

They have made Perio protect just part of their regular hygiene and they're getting fantastic results for patients. Right. Less bleeding, reductions in inflammation, resolution in infection. Really exciting health measurements like you. That's your benchmark, right? How healthy you're getting your patients. That's over $19,000 a month that they're bringing in. And you want to hit 16, 50 a day. This is how you do it.

Yeah. You can't do it just doing bloody profies. If your philosophy is bloody profis, you're never. You're never going to get there. So it's really elevating. There's four levels, remember, of the type of dentistry. There's the emergency dentistry, there's maintenance dentistry, there's optimal dentistry, and then there's complete health dentistry. So part of the reinvention is like the type of care that you're going to provide for people and the type of patient education that you provide for people, which is really important.

Right.

But the thing is, staying the same is not going to get you to retire financially free. We know only 4%, 4% of dentists retire financially free. The doctor I was Talking to is 30 some years old and she has a whole trajectory. But a lot of docs wake up, 40, 50, 60, and they want to try to recover. And you can, you can get ahead of yourself, but you can't do it the same way. Like I showed you at the beginning of our session today, you. You can't do it by avoiding things. You got to get on the court. I see you put this up.

Yeah. If they want to get on the court. So this is the. This is like the best part of being here today. Everyone, you have an opportunity to work with Gary to discover some of the changes that you can make. If you are ready to try this, if you really are ready to do dentistry differently, have a business model that moves the practice towards health and healing of patients. You maintain your focus. This is why this is such a great organization, because you're doing the right thing to improve patient health. And that's what we're all about. But you also need to run your business. Right. And Gary, so tell us, tell everybody what they can discover with you. Right? To discover their practice potential.

Yeah, thanks, Tanya. The first thing that happens on these calls, by the way, they're just incredible. This community, the dental learning community, is Definitely a progressive group. They like to share their stories. Sometimes they don't get a chance to share their story about how they're feeling or what their experience was. And they know I'm a very safe person to do that in. They really get a really safe zone to go, look, here's what's really happening. Here's what I'm dealing with. You know, I. I feel like, you know, some come in, in really three different places. Like, I'm losing hope. I'm really, like, losing hope. That's like level one, and that's only because they've been in avoidance of it, and I don't make them wrong for it. They like. I go, hey, do you want to get it fixed? They go, yeah. And I go, let's start talking and looking. And I start running all these numbers, quick numbers in their eyes. They leave with hope. You know, that's the lowest level. Some are in reactivity where they. They're finding they're putting themselves fires out, Their team's putting out fires. Maybe they don't have a team leader yet, so they're responsible for all the management. You know, it's like the backside of a pandemic. So you kind of picked up the pieces, but never really put structure in. And then, you know, there's the proactive people that they, you know, they're stuck because they've done everything they know to do, but they haven't been able to elevate their game. And they're dealing with these nuances of, like, increases in pay for hygienists or not hiring them. And, you know, it's not a hiring crisis or a new structure crisis. It's an identity crisis and a business model issue. And once they see that, they're like, oh, I can reinvent and. And march forward, you know, so those are the three places people meet with me on, and we have good discussions and there's no obligation and we just have a great chat and they leave. Much better than what they walked into because they were trying to do it all themselves. And like I said earlier, raising your hand and asking for help is actually a strength in 2022 because we don't have it all figured out and, you know, work with somebody who actually does, whether it's me or somebody else.

Yeah. And I just want to thank you so much, Gary, for making yourself available and for doing this. I didn't set it up really at the beginning, as I have in the previous episodes, but the reason we're doing this for with it through dental learning is that we've done it for years just for the periprotect community and we decided this year to like take it out, let share. We've been through a couple of years and everybody needs to regroup and figure out what can work better. And so that's why we're bringing this through Dental Learning. Um, and Gary, I'm just so grateful to do this work with you. Thank you for being here again.

Oh, it's my pleasure. Thanks, Tanya.

All right, everybody, we'll see you next month. Be on the lookout for the Dental Learning site. You'll see all of the episodes that are coming up in the next few months and also the ones from the last ones that we've been referring to if you want to go back and watch those if you weren't able to make it. So thank you, Gary.

Thank you, Tanya. Thanks, everybody. Have a great day.