"Turn Your Payroll Into a Profit Center" Ft. Gary Kadi & Pam Maragliano-Muniz

Hello, everybody, and welcome to DE Solutions Lab. I'm Pam Maragliano Muniz, chief editor of Dental Economics. And with us tonight is a dental industry expert and advocate, one of my favorite people to chat with, Gary Katie. He is the CEO and founder of Next Level Practice. Gary, thanks for joining me today.

Oh, Pam, it's always a pleasure. I'm so excited for what we're going to talk about today.

I am so excited, too. So, okay, everybody, are you ready for this? Because when I think about my payroll and kind of things that I deal with in my practice, I always think about, I don't know, kind of the money suck that goes along with it. You know, taxes and all of those things. And I'm like, really? They work that many hours, like, all the things. And Gary today is joining us to talk about turn your payroll into a profit center. The secret to ensuring everyone on your team is motivated and productive. So after this conversation, I'm expecting that when I get my payroll reports, I feel like, yes, this is an investment worth investing in because I'm going to see these numbers just increase over time. Gary, welcome tonight.

Oh, it's a pleasure, Pam. And, you know, here's the thing. It's like so many of us, when we're running a business, we're stepping over dollars to get to pennies. And, you know, we're trying to cut expenses. And I've learned that you can't shrink your way to growth. But if you learn this basic principle of taking your biggest expense, which is our payrolls, right. And turning that into a machine of profit and, you know, obviously caring deeply about them, taking good care of them, but really showing them what their return needs to be individually and having them become aware of it, all of a sudden, that payroll starts to turn into a profit center, and you can't. You can't stop the madness. It's just like you'll outpace your expenses and get yourself to a profit that is really dramatically different than the one you're in.

That's incredible. And this is why, everybody, this is why Gary is joining us every single month for this year. He basically is like Celine Dion, but better. He's the presidency with us. And this is why, because Gary's going to give us the tools that we need to really motivate our team, keep our team inspired and excited, but also for us on the back end and as a practice owner, to see a return on this investment. So, Gary, I couldn't be more thrilled to be doing this with you.

Yeah. And it's like, you know, such a big topic now because what's happening is, you know, the expense of running a business is just, it's getting greater and our remuneration back from insurance companies isn't changing any anytime too soon. So it's like something needs to give and usually it's the back of a dentist. Cause they have to work harder. And that's not acceptable. The relationship at home, which is not acceptable to me or parents that can't be with their kids because they have to work more hours. You know, something has to give. So it's so exciting when I get a chance to talk to people from DE after our sessions, they come on and spend time with me and they share their story and they're like, gary, I can't take it anymore. What do I do? And today that's why we really, like had this topic based upon what your community is asking for. It's like, I really need to focus on my profitability and the one place to look is in your payroll. And we're going to unpack that today.

So let's get right to it. We know that hiring, training and retaining team members has been a grind, to say the least, in the dental community throughout this pandemic. And practice owners seem to be stuck in a vicious cycle of team turnover. And this trend does not seem to be slowing down. And so you promised to let us in on the secret to ensuring that our team stays stays motivated and productive. But before we get to that, I wanted to start with getting your take on why do you feel the industry is still in crisis.

Yeah, well, you know, there's been a supply and demand issue, Right. And it's really, it's, it's dichotomous because there's a supply and demand issue, especially in hygiene, especially in, you know, different specific states that we work in. But then there's the great resignation happening, which is 50% of people wanting to leave their position. So it's like, well, if that's, why don't I have team members? Well, there's a great divide as well going on, Pam, that I'm seeing is the people that have made the changes that need to be changed after the pandemic. Then there's been people sitting on the sidelines thinking business as usual is just like it's just gonna magically turn around. And it's just not the case. Now here's the interesting thing. The pandemic wasn't done to us, it was done for us. And what happens on the backside of crisis is it Highlights that there's something that needs to be taken care of that hasn't been taken care of. And if you've been avoiding something and sitting on the sideline and hoping it goes away, that ain't gonna happen this time. I use the word ain't. Ain't here because, you know, it just ain't gonna happen. It's like. That's my harsh word for like, get off the sidelines and step on the court. Now you might be sitting there like, just like the doctor I just got off the phone with before we. We started tonight. And he was like, well, Gary, I'm running out of gas. Like, what is this going to take? You know, I'm running out of gas. Do I just sell to a DSO or do I take responsibility? And he really got to see that he was leaving so much on the table. And really, just a couple of tweaks will get him there. We're going to talk about that tonight in terms of what there is to do. But it has to do with the seismic shifts in supply and demand and then the great resignation going on where people, they show up physically, but they're not really there and they're not really engaged. And if you don't have a fully engaged team, you're not going to be able to produce results. Even if I give you this model that I'm going to give you tonight about training and putting a business model in and having them be accountable to a measure, none of that's going to work because you're working with an unwilling person. And we see that a lot in a lot of dental practices.

I think so, too. And I think that it's important to also keep in mind that. And I get it, everyone, because I'm doing it, too. I'm sitting back, I'm listening to Gary, and I'm not only listening, I'm thinking about how this information can be applied to my practice. And I know I mentioned this before and I mentioned it several times, and obviously this is a big deal for me. You know, it took me a pandemic to realize I did not have the right team in place. And I think that a lot of these practices and a lot of this recommendations that you're going to be giving us are really only going to work when you have the right mindset for yourself as a practitioner and as an owner, but also if you have the right team in place. So while we're. Many of us are hiring and trying to do that, just because you have that team member that just won't Leave you doesn't mean that there's a great reason to make them stay.

Exactly. Yep. And you know, the other, the other part I want to highlight here is what I call the Debbie Downer panel. So I just identified this. This is another reoccurring thing where there's the Debbie Downer on the team. And that Debbie Downer sucks the energy out. See, what happens is I just took up pickleball. I'm not gonna lie, it's pretty awesome. Bam. But the thing about it is, is I played with a world class pickleball player and I just started playing and I was playing great. When I played with my son, who's 17, and he was just like batting the ball around, it was horrible. So we play up to the people that are on our team. If you let B players on an A team, they're not going to. They're. They're going to play down to the B player and everybody's playing down. All boats rise the minute you deal with it. And here's the other thing I learned about this. The average doctor doesn't want to confront and deal with whatever that is, and they hope that that goes away. But in today's world, if we don't come face to face with people who are misaligned on our team, it brings the rest of the team down. And you'll see it in your revenue. So these are a couple of the nuances that I wanted to highlight on the front end of our conversation today.

I think that's really important to say that and I think that you're right. I think that while we might have the energy sucked out of us on a day to day basis, it will impact our bottom line. And I think that that's something that we have to kind of keep in mind because I think we don't always think about the energy in the practice and the motivation in the practice will ultimately impact our numbers. And so, look, I get it. And for those of you that are stuck and may need a helping hand, Gary has such a great opportunity for you. So I encourage you to stick around to the end. You definitely don't want to miss what Gary's going to offer you. But also, we are fielding questions. So please feel free to ask your questions, enter them into the question box on the right hand side of your page here, and we will do our best to get to your questions. The other thing I love about Gary is if we don't get to that question tonight, he'll get to your question and get back to you. So you answered. So please, by all means, type away and you will get your questions answered.

Yep.

We've spoken about your approach to getting the right team member hired in a prior session, which was great. But tonight I want to talk about how do we train them and how do we retain that new team member? The last thing a practice owner needs is to lose a new hire that they worked so hard to find. Trust me, it's happened to me like twice right now. Let's start with training, because training is a ton of work.

Yeah. And, and, and this is. I want to highlight two things that are in the way of training people. Number one is the ability to understand how to train somebody. And number two is the time to do it. You know, it's more like you get thrown into the fire and they gotta kind of like swim at the school of fish that are going on inside that practice. And I don't usually dive right into a solution like this, but I am in this specific instance, Pam, you know, I like to give away things in books and stuff, but find yourself with somebody that has a learning management system that already has it built. Don't do it yourself. It is. This is a very different thing because it took us since 2013 to build an, a robust vault of video and downloadable education. And millennials learn differently. So we're dealing with basically like 65% with millennials. They're, you know, you know, parenting. Millennials look for YouTube for parenting. Like, they go to YouTube for their parenting skills. It's awesome. So it's very accepted to have video education. And I'm talking small, small four minute videos that once you give them the how tos, like how to deal with broken and canceled appointments or how to be. And one of the things that you and I talked about, Pam, is in dentistry, compounding this is people don't have dental education. There was a lot of hires being done that, that don't have a dental background or a dental education. You know, like bank tellers or customer service, people like that. You know, a lot of doctors, because of the supply and demand, did that. And that's cool. But, you know, and I love that because they come from a fresh perspective and we don't have to help them unlearn the quickest point from A to B. Here, Pam, is find yourself a company that already has the training already developed in a learning management system, short videos and accountable learning that has them either. You know, like we have a system where we show a video. Here's how you handle a broken and canceled appointment. How to do it. They hate role playing. Do you ever notice that teams hate role playing? Do you know why they hate role playing?

I don't know, but everybody hates it.

Because they, you know, public speaking is the biggest fear before dying, right? They have to public speak in front of people that they, they work next to. So the embarrassment of that doesn't work. So the way I think is like, how can I Tai chi this thing? Tai chi thing is like they come with energy. You twist the energy and give it back to them. I'm like, voila. We show them how to do it in a short video. They were going to utilize the leverage of looking good and fear of looking bad. They record their video. We found that the average recording is eight takes because the hair is out of place. They said the wrong word. Then they up level it to the system, they upload it to the system and then the team leader on the team actually gives that review of that video. So now let's say you had a broken and canceled appointment and you have some time or you're going to let your front desk take, you know, half hour of, you know, time to, to train. They watch the video, they, they practice it, they upload it. Now you have an accountable feedback system on actually what they do on the specific things that they want. So this type of learning management system, whether you, you know, and we have one where we're giving all dental, dental economics users. So if you get on my schedule, we'll give you a free month of, you know, just try it, make sure you like it. No cost, no obligation, just jump right in and you get full learning management system and full access to it for a whole month.

Wow, that's amazing. So I told you, you're going to hear all of these things. Gary. Yeah, right. He just kind of like gives you.

So it's right here. This is called our abundance University. Everything that you want, you just type it in. Broken and canceled appointments, you'll get the video. It's right here. We have a whole curriculum for one year. Tools and tasks, morning huddles, how to get, how to get your team on board, patient retention, you know, everything is right here. You just click. The video comes up, you do the training and you're all set. And you also get access to the back of the house so you can actually pam jump right in. And the t, you can see how long people are training for if they pass the quizzes, if they've uploaded. And by the way, I know you didn't know I was going to do that. I hope it's okay. I just, I'm like, I'm sitting here going, I can't explain it. Like, let me just put it out there. So I hope I'm okay that I just did that.

Oh, this is your residency. You can do whatever you want.

Oh, I. And you know, I think Katy Perry is cooler than Celine, so I'll go with the Katy Perry residency at Planet Hollywood. Although, do you like Celine? Are you like a big Celine fan?

You know, you know, every once in.

A while she's good.

I could try to bust out a tune like her, but it's nowhere near where it needs to be. But I also love Katy Perry.

So you can sing too, on top of everything. Oh, okay.

I try to sing, but I don't.

Trust me.

That's a story for another day. But no, you do not want me to sing. In fact, when I lecture and I give a break, and after the break, it takes people time to settle down, I have to say, okay, if you guys don't get quiet, I'm gonna start singing. And that makes the room silent like a piddle drop. So they. They can tell, but they don't wanna hear us.

I love it. I love it. So, yeah, so get a learning management system. Don't do it yourself. Somebody's already mastered it. You can get it at low or no cost. We're giving away a free month. Get on my calendar and then I'll give you the link after we're done. So just wanted to put that in. That was just my added value today.

I love that. Now, I have a question. I would imagine that if you're using this type of automated learning system, I can tell you I've never used one. And so in my head, it takes people about six months to kind of settle into the role. I would imagine that using this type of system, that their learning curve must be so much faster and the time it takes them to get settled into the practice is probably so much less.

Well, and then they're coming from the right place because the first thing we do is plug in their purpose. Most people don't have a purpose. Ask people their purpose, they don't know, and that's the ground of where they come from. So they create a purpose, like helping people or making a difference in people's lives. So, like, the way of being gets elevated. And then we give them the step by step process to operate as a treatment coordinator, as a, you know, a person who's going to schedule for. To goal. Like they. They don't. They don't default, especially if you don't come from dentistry scheduling to goal, it's like, what does that mean? How do I do that? And we actually give them the step by step process. And it's all done by video. So millennials and baby boomers like it too. They secretly like it because they don't have to read a bunch of stuff and take forever to get there and read a big book. It's like big snippets. And what they love, Pam, is they go out and take a break and have some coffee, and then they come back on the court and they practice it right away. Like, imagine practicing and reviewing and doing this individual role play that you're uploaded and you just practice it eight times. So when you're live with a patient that cost you money to attract and that person wants to cancel, you're going to help move them into that spot. And, you know, one of the things we found, Pam, is that the most they don't want to look bad or feel bad for another person. We help them overcome that by like, oh, I just had somebody say, well, I know that person doesn't have any money. I feel badly for them. So I didn't present any treatment. And it's like, meanwhile, that's affecting your bottom line. That's how you turn a payroll into a profit center, by elevating the skill set and the abilities of your team.

I agree. And I think it's also something that we always just have to remember that it's our responsibility to tell our patients what we see and what recommendations are there. And it's their decision to decide if they're going to do it or not. But it's our ethical responsibility to tell them what we see and not say, cavity there, there's a crack in their tooth. But I feel bad. I'll just, you know, wait till the tooth cracks in half and then they have triple the fees they have to pay. So I think, you know, if nothing else, your team needs to know that it's, you know, that's our ethical responsibility, too. So there's something to be said with that. So, all right, you have this amazing training system, but what happens once they're trained? How do we keep our team members engaged? Gary?

Well, here's the big thing. And this is also how you turn your payroll into a profit center. If you don't have a. You can have all the training and motivation in the world. You can have all the great motivators, great morning huddle motivators. You can have great training but it goes out of existence because it's reliant upon how people feel in that day. And then if I feel good, if I had to argue with my husband, my wife, it takes, you know, you get this ebb and flow and like, you feel as a doctor, like you have to be Tony Robbins and then, you know, a systems analyst. And it's like, that's why we hold our doctors as heroes, Pam, because you have to be a great clinician, then you have to be a great entrepreneur, and then you have to be a great, you know, marketer. And it's just to be a great practitioner. It takes a lot. So the more we can automate things and the more we, the more we can bring consistency to things, Pam, the. That's when doctors can go forever. You know, they don't run out of gas, their body doesn't break down, their wife doesn't want to divorce them, their kids know who they are. All those things get fixed with a business model. So it's important. You got to have a team. If you don't have a team, we can help, you know, watch our videos, get on my calendar. Recruiting, hiring and onboarding is, it's just a system today. And if you know how to, how to run the system, you'll get the right people on your team, even if you haven't for the last two years. Then once you get them, just outsource the training. It's low cost and it's, somebody has it already figured out. You don't have the ability of your time. Don't do it. Now let's get into the nuts and bolts of the infrastructure that keeps it alive. One of the old, old systems in dentistry. And here's. I like getting to root cause problems and flipping the script. So root cause and flipping scripts are my, like, what I like to do because that's how you get people to buy in. So if I said to a team, man, you should really train and you know, they're going to be avoiding that like the plague. They're not going to want to do it, you know, or you're going to want, you know, I, I need you to look at your numbers. They're going to go, I'm not a numbers person, you know, just don't like numbers. So how we fix the problem is we put skin in the game and we create what we call the triple win bonus system. This is where the patient wins because they get all the care they need. This is where the team members win personally, professionally, and financially. And this is where the business owner wins because he or she doesn't have to micromanage anymore. They can run the practice from their smartphone and analytics that are proactive, that allow them to take off vacations and not worry about their business crashing. That's the level of control and certainty that what I'm about to share with you puts in place. I just want to stop there. Is there anything that you want to unpack or talk about there? I. I talked about a lot there.

There's a lot to unpack, I guess. I. I want to see what's next because I want to see how you lay this out. Because I'm thinking how, where, when I want to see.

Okay, all right, cool. All right, cool. So we have to first reverse engineer the lifestyle that you want to live. Consider, Pam, that our doctors have been defaulting into the vacation days and the money based upon how everything unfolds. And it's all. It's all. You're at effect rather than at cause in the matter. So I want to stop there. What did you hear me say? I want to have you give me back. Because I'm going deep here. So I want to make sure our listeners are understanding.

It sounds to me like we need to sit down for a minute, consider what we want as an end game and see what kind of lifestyle we want to have. And then once we kind of figure out what we want, now we have to figure out what it's going to take to get there.

Yeah. Very good. Very good. Perfect set. And please be patient with me. I want to. I'm so dedicated to making sure that our listeners get everything and understand it. That's why I'm just, you know, doing a test on you today, you know, and we see the questions coming in and keep those coming in. I think that's really valuable if you have specific questions. So let's get right to work here. I'm going to. I'm going to actually go to. We've added the teleprompter, the Madden teleprompter, we call it. And so we're going to get in here and I'm going to draw this out. So let's. Let's do this together. Okay. So, Pam, how much do you like? How much? Let's just pick a, you know, a case study. Let's just say that the doctor wants to create $1 million. Does that sound fair? Let's just do a million as our number today. Okay, So a million bucks. And I'm going to say that it's fee for service. Just for rounded numbers. But if it's a, if it's a PPO practice, you would add your write off amount. Let's just say you're writing off 25%. You will need to produce 1.1.25. If you're writing off 25%. So you have to add it. But just for a simple rounded numbers, we're going to do a million. Okay. Now this is also where you un. Collapse time and money. So this is where doctors like go. I can actually say how many vacation weeks we have and. Yes you can. You know, most of our doctors are, are millennials, young families. They have kids from like 5 to 11 and they're going, I take, I just talked to a doc from, from your community and he's like, I take one week off a year. I'm like, with four kids like one week a year. Not on my watch. So at least four weeks a year. So I'm going to say 48 weeks. All right, fair enough. And he was working four days. And every other Saturday I'm like, you're cutting your Saturdays off and you're going to work four days. So that's 192 days. 192. So now I have 192 days. Does that is. So do you see how we just like designed his life and he's now taking four weeks off, right? 192 days. He has two hygienists. So the ratio of doctor to hygienist is always minimally one to two. So one to two is our minimum ratio. So if I take 192 times two, so it's 384. So I have 384 hygiene days. Clear so far. So this is doctor days and 192 or 384 hygiene days. Got me?

Gotcha.

So if I have 384 hygiene days, I'm gonna take 384 and we start with hygiene minimally. I like to see 1200. I'm going to be conservative here. And ideally about 1500 a day for a GP practice. All right. With decent PPOs, we add things like perio protect and added value things that are, you know, aligned with the philosophy of the dentist. Let's just say 384 times 120 or 1200. So 384 times 1001200 a day is 460. So 460, 800 is our hygiene revenue. Follow me so far. So we always pull that out first. Now if we take out, we're going to minus the 1 million. We need to do 539200 and the doctor, and we divide by 192, that's $2800 a day in the doctor's schedule, which is absolutely ridiculous. That is a low number. Right. So do you follow me so far? So far, the doctor's daily primary outcome is 2,800 and the hygienist is 1,200. Do you follow me so far?

Yes.

Right. Now, one thing that doctors miss is they need, if they're, if they have a good case acceptance system in place, they need to do, they need to present more than they need to do for that day. So if you're, you have to present, let's just say you have. I'm going to round it off to 50%. If it's about 50% case acceptance, you need to do 5000 presented per day. And to get 2800 accepted. This is presented, this is accepted. He followed that so far. Right. Most people don't track this. And the reason why this is a problem is because if you don't present enough per day and get enough accepted per day, your month after is not going to have enough dentistry in it in order for you to do that for, that for the, for the next month. So this is how you get peace of mind. So now what we do is we set up the front office. We have the appointment coordinator. They fill the schedule to 2,800 each day for the doctor and 1,200 for the hygienist when they fill that schedule per day. And again, I'm going to give you a bonus system here, very generic, $10 per day per column, they can make up to $20 per day. Additionally, if they work 16 days times 20, you're going to give them $320. Now, you only pay that at the end of the month when collections is at least 85, which is what you need up here. Is this clear?

Yes.

Cool. So now you have your team focused on the daily primary outcomes and letting them know that you have to collect at least your number to pay the bonus out. Now they're looking at production and, and collection simultaneously. And the entire team is looking at it. Okay. Now that's the appointment coordinator, the assistant. Their job is to hit $2,800 a day in the doctor's schedule. Now when they go to the morning huddle, they're looking at making sure that the doctor's schedule's filled. Now they're going to be, behaviors are going to be different because they're not just going to Be doing sterilization and turning rooms. They're going, hey, I need to get my number. They get $20 per day. When the doctor hits their number, they're looking for incomplete treatment. Having the patient stay extra, using the intraoral camera, educating the patient on same day dentistry. So it changes the behavior of the assistant to be outcome based, not being busy. That's the flip of the switch. Not being activity based, but being outcome based. So that's the assistant with $20, the hygienist, they do $1,200 a day and they present, if there's two and we have to get 5,000, they have to present at least 2,500 a day, which is very doable for a hygienist that has eight patients throughout the day. Very, very simple. Especially if you're getting about a thousand for a crown. So they get 10% above their 1200. And the reason why we do this is because there's a lot of practices that are under diagnosing soft tissue. The Average practice diagnoses 8% and gets 4% perio to prophy ratio. We want to see that not at 8%, but 35% because 50% of adults have some form of perio. So that makes sense. Right, but, but most hygienists are not. They either. There's always a reason. They don't have a soft tissue program. They don't have that philosophy. Whatever reason is, I don't have time. But when you can fix this in your hygiene department, that 1200 goes to 1500, 1800, 2000 a day. Because they're not just doing bloody profies all day. It changes the philosophy of hygiene. And then they get 1% of the treatment that comes out of their room. And so now you have them focused on presenting care and helping you educate the patient, the doctor, so that when you walk in the room, everything's already set up on the intraoral cameras, the pictures are set up, the education set up. As a doctor, you're the only one that can diagnose. But they set up the education and began the education. Right? And then lastly is your treatment coordinator. And the treatment coordinator gets 1% on the treatment that gets accepted. Right now at this point, most people go, well, that's a lot to track. Very simple. The appointment coordinator and the treatment coordinator have the tracking. And we also do it on an automated fashion so they don't have to really, you know, manage it. But, but it's very simple. Two people tracking these numbers. And then the bonus gets paid out as long as the 85 is hit. This is how you have a business model. Having people motivated with skin in the game and driving the measures that you need at the end of the month, there was a lot there. I want to slow down here and answer any questions that have come in or any questions that you might have.

I want to go back to the hygienist. You said 10%. So say they produce 1500. So there's $300 more than their goal. So they will get $30 that day. 10% of the 300, correct?

That's correct. Beautifully done. Smart mathematician in addition to clinician. Very nice, but yeah, no, it's brilliant. But see, now we have them have skin in the game to actually do better care, more care. You know, a lot of times they're just focused on getting through the day, getting the profi. Done. But we want our hygienists to be patient, educators, advocate. You know, there's four levels of practice philosophies. The lowest level is emergency. The next level is maintenance. The higher level is optimal. And then the top level is complete health dentistry, where you're educating from a whole body perspective. So you want to look at your four philosophies and see where you fit. And then when you elevate it, when you elevate the value proposition, all of a sudden the team mobilizes and starts raising to that level as well.

I like that. So if you produced 84,000 instead of 85,000, nobody gets anything.

And here's what happens. I can tell you when a month ends on a Saturday, I've had team members go in and get the mail to get to 85,000. So everybody could bonus. See, this is where you flip the script and you ha. See what's missing in dentistry? And the reason why we can't get our team on board is because, first of all, a lot of docs, Docs are afraid to share the numbers here on all this. But the other thing is the docs playing for this number of 85 collections. The team doesn't even know that. What they have to collect to pay their bills and get a bonus and all that, nobody's ever figured that out. So that's why I built this proprietary system that has everybody win. But once, once you, once you educate the team and you give them the game to play, they play the game and they change the way they look at where they go. And they want to help you as a practice owner be successful. And they know if it's 85,000, and you said that Benchmark, they go after it.

So I'm going to play devil's advocate.

Thank you.

Right now we are spending a lot on our staff per hour. So what about the doctors that say, hey, you know what? I'm already paying them more than I would three years ago. How do I justify this additional money that's going to be given out?

That BBM, that 85,000 number? We just raise it so that they're paying for the gap of the salary that, that you're having to pay. So let's just say you went up your 6% more than you need to be. We go up and make up that number. So the trigger, Pam, doesn't happen until the overhead is more than paid for, including the bonuses that you're going to pay out. The way I have this set up is you're sharing the percentage. So I want to, I want to highlight this. This is very important. I want to highlight this. And going back to telestrator time, one second. So there's two levels of profitability. Do you see my screen yet? Okay, here we go. So there's two levels of profitability, right? There's, this is your, this is your break point. And this has been like where you've been stuck right here. And let's just say Your practice is 30% profit down here. Inside here, there's fixed costs and there's variable costs. Okay. Once the fixed costs are taken care of, that profit on the rung above this number is 70%. Because you're only dealing with lab supplies, your bonus, third party financing, because third party financing helps you close bigger cases. And so when you add all those up, it ends up being 30% of a variable expense. When you, when you're only adding 30%, the profitability up here, if you're getting more to your team, you know, so often a practice is underperforming by, by half or a third because they're not looking at patient retention and case acceptance. We'll take care of that at a future session on how to build your top line. But this is how you deal with the expenses, by keeping your fixed costs flat and getting more out of turning your payroll into a profit center.

Gary, that was awesome. And I see a ton of questions coming in and we will get to them whether now or after. I know we've been a little content heavy today as opposed to answering all the questions, but there's a lot of questions coming in about how can you help me? I need help in my practice. And so I know you're busy, but you are offering your time free of charge to meet with our dental economics doctors personally. Can you tell us about that?

Yeah, and thanks, Pam. Yeah, I blocked 10 hours out of my schedule and they're half hour increments and you know, you can link in here to my calendar and get right on my calendar. And the reason why I do it is because, you know, there's so much information out there and it's like, how do I sift through all this? And I have my own story. You know, doctors share their story with me when they get on the call. That's the first thing they tell me their journey and they tell me what they want to create or if they don't know what to create, then we get to that. But it's really been profound to get to know people all around, across the US and North America. And then from there we really sit down and say like, what they're wanting is they want certainty. What they're wanting is control back because they've lost control through the pandemic. What they're wanting is a step by step plan to get there. And we actually have those conversations and, and they leave with like their shoulders down, hope for a better future. And then they, they really, you know, it's interesting, they pick up on some of the things that you really highlight or the questions you asked and they say, hey, can you tell me a little? Just for instance, the gentleman who I spoke to before, he's from D.C. and he said, you know, you were saying I had to present, you know, 5,000 a day. And I, I don't know how to do that, how do I track that? And like, I don't want to seem like a salesperson. And we actually had that dialogue and worked through it and he was like, wow, literally. And he was like, I can now go back and like, you know, know what to do and how to do it. So that's what I like to do on those calls. But it's really free reign. It's just joy for me to do and it's something I, I, it's my way to give back to the profession. So I'm, I'm grateful to do it.

Thank you so much and thank you on behalf of dental economics that you're taking care of my people. So thank you. I think this is going to be amazing. So I really have time for one more question and I know we have to wrap up. When you were talking about the triple win bonus system, having the whole team on board and knowing that there's different numbers if you will of a bonus that they can get. Does that fragment the team or how does that work?

The number one question I got, so I'm glad it came up here. It actually brings them together on a whole new level. Logically you're looking at that and you're going let's just bonus them at the end of the month on collections. That doesn't work. And here's why it doesn't work Pam, because it becomes a part of their salary and if they don't get it, they're like angry and it demotivates them. The other thing is it does the 8020 rule. 20% of your team members are producing 80% of your results. In this model it's 100% of your team members producing 100% of your results. And then here's the other thing. There's three types of team members. There's the dependent. There's the, the independent. Dependent, independent. And what we want to create is the interdependent. In this system, the way it's designed is you're only as good as the person before you and the person that you hand off to. So if you don't get the appointment scheduled, the hygienist can't do his or her job. And if they can't educate, the treatment coordinator can't do his or her job. And then you can't fill the schedule and then the assistant can't do their job. It creates an interdependency and, and it strengthens the team. And here's the other thing. It allows the doctor to get out of the center of their business so that the team takes over and they're self managing themselves and the people before them and after them. Because now everybody has skin in the game. The better that that appointment coordinator does, the better the hygienist does, the better the hygienist does, the better. So it, it raises the bar and what it does, what I call healthy tension. You see, yes, there's going to be some tension here because people have to operate differently and they have to be accountable to more people. And that's what you want as a business owner. If you don't have that, then you're going to have to be the micromanager in the center of the game. Very good question. But it actually does the opposite and it fixes the problem of having the team be accountable and support their brothers and sisters next to them. Great question.

So interesting. And I think that there's obviously so many more questions coming in and unfortunately that's all the time we have for today if we didn't get to your question, don't you worry. We'll make sure that Gary is able to answer them and get back to you on that. And again, Gary, this was such a pleasure. This time flies by every time I'm with you and I can't wait for next month.

Yeah. Thank you, Pam. And thank you to all the listeners for all your shout outs and support each month. Thank you very much.

All right, everybody, we will see you next month. For de Solutions Lab, I'm Dr. Pam Maragliano. Muniz and Gary, Katie, this is the best time tonight.

Thank you, Pam.

Thank you. Bye, everyone.