5 Dumb Things Smart Dentists Do—with Dr. Richard Madow

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Welcome everybody back to another episode of the Dental Boardroom. I'm Wes, your host, coming at you today with a great guest whose podcast I recently did an episode and I invited him back on mine. I have Dr. Rich Maddow with us on this episode. Rich, I'm going to give a little bio into you if you don't mind. And I've got this written down. I think there's such good content in here for our listeners to know who you are. Do you mind if I just sort of review this?

It's your boardroom, Wes. You go right ahead.

Awesome. All right, just so our listeners know who is on the other end of the line with me right now. This is Dr. Richard Maddow. In 1989, Dr. Maddow Co founded the Maddow center for Dental Practice Success with the goal of helping his fellow dentists achieve success and happiness in their practice through truly personalized hands on coaching. Having been named a leader in dental consulting by Dentistry Today for many years running. His and blogs are some of the most popular in the dental profession and have reached over 100,000 practices across the world. Known for his hilarious and spontaneous style and I will echo that for his hilarious and spontaneous style, Rich has presented to standing room only crowds in practically every major city in the United States and Canada, teaching dentists and team members how to enjoy their careers, supercharge their practice, define and create their own personal success, increase profitability and have more fun than ever before. He is the co founder of Innovation tbse, a groundbreaking dental show that challenged the way dental meetings were structured, providing an exciting and entertaining event for the entire team. On a personal level, Richard is a lifelong and award winning musician and songwriter having performed in many venues across North America. His music can be found on Spotify, Apple Music and all of the regular streaming sites. Among his other achievements, Rich's book Is yous Frog Boiling? Was an Amazon.com bestseller and he has traveled to 57 countries. Let's welcome today our guest, Dr. Richard Maddow.

Welcome Wes, that was so nice. And I especially want to thank you for plugging my music on Spotify because I think if I get 10,000 more listens, I'll get my first royalty check for 17 cents. And I'm so anxious. I check my mailbox every day for that. So you know, maybe you helped in a, in a large way. Thank you.

Well, I will add one and I would love to listen to it. I'm a huge fan of music. Wish I was a musician. I believe personally underneath my CPA Shell, there's an artist deep embed, Wes Reed. I love to go to concerts. I love especially when there's a piano element to it. So this is, this is an honor for many reasons, Rich, to have you on today. Let me give everyone a quick intro to what we're going to be talking about. You and I have worked with dentists a lot. You are a dentist or were a practicing dentist, sold your practice, maybe, maybe you can give a 60 second bio about your sort of experience selling when you sold, why you transitioned, that kind of thing. And I of course, as a dental CPA and financial advisor have been working with dentists for about 15 years, years and done just a lot of, a lot of financial work with them. I'm not a consultant. You are the consultant. You are the one who goes in and helps the doctor think about their main patient, which is their business, that that's their main patient and how to run that operationally and to keep that healthy, not just the oral health of their own patients. I am more around the finances. When the dollar hits your bank account, how do we manage the flow of it through all of your overhead, debt, taxes, etc to help accelerate financial independence and in many way you and I, I think, are a great team or a complement of services to our dentist. What we're going to talk about today is this subject, dumb things that Smart Dentists do. Now, this was Rich's title and it just feels so rich. It feels very you, this title.

Well, I hope not the dumb part, but.

No, not the dumb part, but just sort of the humor of it. So why don't you tell us a little bit about anything else about yourself, maybe your background as a dentist and why this is a subject that you've actually presented on a few times and why we're going to talk about it today.

Yeah, it was a subject I presented on a few times. I actually came up with this topic during COVID when everything shifted from live meetings to webinars and I was being asked to come up with some truly original content that I'd never presented before. And I just started making this list of all the stupid things that I did in my practice and that so many dentists are doing when they come to us for consulting help. Because, you know, let's face it, you got to be pretty smart to be a dentist. You went to college, you had a difficult major like biochemistry or physics or, you know, whatever, molecular biology. And you did really well and you got into dental school. Then you were tortured for four years, learning way too much Information to cram into your brain in a short amount of time. And you managed to do that, then you're kind of thrown out. Why did a residency so I one more year of education after that, Then you're like, mercilessly thrown out into the real world not knowing what to do. It's kind of like when you get your driver's license, you know, you hope that you spend the first five years not killing anyone. It's the same thing in dentistry. You don't know what the heck you're doing. And I mean clinically and management wise. Clinically, there are some fantastic courses and mentors and just genius dentists out there teaching great clinical techniques. So you got to take advantage of that management. Maybe not so much. So a lot of these mistakes dentists tend to make on their own. I did the same thing. And when you just start listing them, you think, it's amazing. How many dumb things can a smart person possibly do? Well, there are a ton of them. And during the presenting webinar period, I zeroed in on a bunch that I presented. And I just think it's a fun topic, but it's also a really meaningful topic because sometimes you got to think, you know what, maybe that is kind of dumb, but can it be easily corrected? Hopefully, yes. And that's what this is all about.

Great. And you could also do a whole separate podcast on dumb things that CPAs like Wes do. So this isn't unique to dentists. This is just, I think, learning and growing, especially as business owners, we stumble. And you know what? For me, at least, the stumbling is the most effective teacher in my career. So no one should feel, I think, ashamed if they've done any of these things. This is just part of the process. But if we can help prevent this or mitigate the fallout and the damage from these things by some listening to this podcast, then I think it will be worthwhile. Why don't we jump into them? Let's kick off with number one. Rich. What is it?

Okay, and I'll say these are in no particular order, but the one that I want to talk about first is focusing too much on new patients while you're ignoring your existing patients. And I got to say, when people contact the Matto center about a possible coaching relationship, obviously we start chatting about some things. What are their strengths? What are their weaknesses? What are their goals? What do to see more of in their practice? And every single person says, we want more new patients. It's like a mantra. It's like something that's just Stuck in our heads. If I only had more new patients, everything would be great. And they're spending money on marketing and not enough on front desk training and just doing all these things backwards because they're so focused on new patients just about every single time. When we analyze their data, we find a couple things. We find one thing and we'll talk about this maybe in another dumb thing, maybe number two or three. One thing is they are getting more new patient inquiries than they ever believed, but the ball's being dropped somewhere along the line. But the main thing is that they're ignoring their existing patients. It takes so much effort to get a new patient, whether it's marketing, referral, internal marketing, as we call it. You're doing great things for our patients to get them to want to come back and refer their friends and all those things. And we put all this work into it. And then if you're in a big city, like you are Wes in San Diego, like I'm here in Baltimore, there are a thousand dentists between, you know, my home and where I get my haircut, you know, for example. And the odds that a potential new patient picked up the phone and called your office are one in a gazillion. And then we're just going to do something to get them into the practice and then just ignore them. We found that so many dental practices have a poor reappointment percentage. They have 1,000 or 2,000 patients who have been in before but have slipped through the cracks. And they have no systems to get those patients back in. They all say, oh, nobody leaves here without an appointment. Yet they do. We found about half the time a patient will leave without an appointment, and it's just a matter of getting your systems and protocols down so patients don't slip through the cracks. If and when they do, we've got a great system for bringing them back. And I would never recommend this, but one time I was so fed up with a practice, I said, you know what? We are not going to accept new patients until we get this straightened out. Because you've got thousands of patients, I call it the million dollar file cabinet, just waiting to be reactivated. So that's dumping, number one. Focusing too much on new patients while you're ignoring your existing ones.

Is the mentality of that driven by the fact that new patients usually have more treatment needs and therefore are maybe a little bit more rich clinically to the practice. And so doctors tend to, I don't know, just gravitate to thinking about new new patients more than existing Patients.

Well, it's a really great point and there's no question about it, that new patients have more clinical needs than existing patients. Existing patients who were well cared for, let's put it that way. But no, existing patients often have, you know, they already had their examination and their diagnosis and their treatment plan recommendation and they just never got around to making the appointment to get their treatment done. So many times existing patients are just as clinically rich and even more primed because they know what they need. They're, you know, they've thought about it. They're going to reach a point where they're ready to rock. And when they do reach that point, you want them to be in your practice and not somewhere else because you let them drift away. But, you know, it's an excellent point. New patients are, I love that phrase, clinically rich. That was a great way to put it. They are. And that might be one reason why we focus on them so much. But you gotta have a great maintenance program. So much treatment that's easy and low overhead comes out of the hygiene column.

I know for in my business, the largest feeder by far of new, we call them clients, of course, is our existing clients. Is this not the case with dental, that if you give great service to existing patients, then those patients are your largest sales force to refer their family and friends to you? Which could be more effective than the traditional marketing spend on social media, pay per clicks, that kind of thing. Any commentary on that?

Well, it should be a great source. Referrals are fantastic. I think these days the modern version of the word of mouth referral is getting a ton of reviews, which is also very important. But we love referred patients. There's nothing as strong as a trusted friend or colleague saying, you gotta go see Dr. West, he's the greatest dentist around. Also, they tend to, if they're work colleagues, they'll have the same insurance. So you already know that that's an insurance plan that you're participating with. They have other commonalities. Maybe their office is close to your office. So yeah, referred patients are the best, but I think we can't depend on only referred patients. But yeah, they're the best.

And I would think that if there's a growing unaccepted treatment plan in the software, that the issue probably isn't marketing. It's probably not getting new patients. It's probably converting those to, to treatments actually being fulfilled with the existing patients. And that's a whole other set of communication skills and process skills and team skills to get a higher Acceptance rate on treatment planning. Great. So that's number one. Tell us about number two.

Okay, number two, I call. If you buy it, they will come, obviously in a play on the old Field of Dreams movie. If you build it, they will come again. I see dentists who want growth. There's something not right in their practice. They want to improve it. And that's great. And that's why people like me are here and all the other great consultants across the country. But too often they'll go to a big dental show, the Chicago Midwinter, the cda, whatever, or even a smaller dental show. And the exhibit floor is just littered with people waiting to take their money. And there's nothing wrong with that. Those exhibitors want to help our practices. Most of the equipment and technology are first rate. But people who are struggling in their practices, dentists who are struggling for some reason, find it much more attractive to purchase a piece of equipment. And they go to these shows and there's some slick salesperson selling them something they don't necessarily need. And they're saying, if you buy this machine, this piece of technology, people are going to be banging on your door all night long. There's going to be a line when you get there in the morning. You're going to need five more new phone lines and three new treatment rooms. And it's just not true. Do I think that cone beam X ray technology is incredible? Yes, of course. It's amazing. Is it amazing that you can get a CEREC and do crowns in one visit? Yes, it's amazing. But if you have practice deficiencies, such as all these patients who have slipped through the cracks, poor treatment plan, presentation skills, as you mentioned, all these other things, this equipment's not going to help you. Then you're going to find yourself with $120,000 note you're paying out. And that salesperson who promised this would change your practice, they're on to the next show in the next city. They don't care about you anymore. They got their check. So again, I don't mean to diss the great people who work in dental sales, because there are some really cool, great, knowledgeable people there, or even equipment and tech, it's fabulous to get these things to play with and we can provide better treatment diagnoses and all these things. But now if you're dropping big money on a piece of equipment, thinking that's going to be the thing that changes your practice revenue, it's not. And as I've said before, I'll only get that Crown done. If you can do it in one appointment, said no patient ever, ever. It's not going to be the make it or break it point. So don't get caught in. If you buy it, they will come.

I talked about this on your podcast, which I'm going to promote everyone to go to. What's the title of your podcast?

Well, that was actually our mod membership program. It wasn't our podcast. So.

Okay, that's right, that's right. That's a subscription basis. Well, check out the mod program and sign up. But I talk about how dentists with equipment reps, again, I have good relations with equipment reps. Our dentists need good equipment. They need to do great clinical skills and the equipment that they use is important to that. But sometimes there's an overemphasis that if, yeah, if I buy that, everything's going to be solved and I'll get case acceptance and my revenue is going to go up and all that stuff. In reality, that should be a support, not a lead to creating more revenue in your practice. But I also find that one of these mistakes as we're talking about dumb things is buying that $100,000 equipment because the tax deduction, you get to accelerate all the tax deduction through this thing called a 179 deduction, and then you finance it. So you're paying it over five years, you take all the deduction in year one and then you got money going out of pocket for the next four years and you get no tax deduction or very, very, very little tax deduction for it. And it gets you in a financial trap. And so that's something related to this subject of buying things that I always advise my clients to be very, very careful of. It's not a magic tax deduction pulled out of a hat when you buy equipment, and I know it's sort of sold as such, all it is is it's accelerating or front loading the deduction of the purchase price into the current year rather than deducting it little by little over a five year period called the depreciation period. And if you buy it in cash, great, take the deduction now match the deduction with the outflow of cash. Otherwise, match the deduction with the outflow of cash over the five years. And there's some planning decisions to be made around that for variations to that piece of advice. That's a very, very solid one.

I want to say, Wes, I'm so glad you brought that up too, because unfortunately it is part of the sales pitch that I Hear all the time some. Oh, buy this before the end of the year. It'll be practically free by the time your CPA gets done with you. No, it's not, it's, it's not.

There's just a little bit more to the story. It's like a half truth is what it is. And if I were a salesperson, you know, we just are tended, you know, we tend to want to just say the truth that makes us look good and leave out the rest. So I really don't hold that against anybody. Let's go on to number three.

Okay, number three, I'll use kind of a southern expression here. I'm from Maryland, which nobody's sure if we're a southern state or a northern state. I think we're a northern state. But that's a topic for another time. But I'll use the southern expression and that is dance with who brung ya. And so many dentists don't dance with who brung them. And what I mean is, Dennis, you know, they're looking for more fun out of their careers, they're looking for more income. They just want to change things up and they get involved in like oh my, my brother in law just opened up a brew pub and I'm going to go in and partner with them and then I'm going to, you know, just hang around and shake hands every night and stay up till 2 in the morning and then try to treat my 7am Patient is going to be so much fun. And meanwhile six months later, the brew pubs out of business. They lost all their money or they tired of it and they lost focus on what really brings them their revenue. And that's their dental practice. Or even inside the dental practice things aren't as robust as we would like. So what do we do? We take some esoteric course where you buy a ton of equipment and you're learning to do these procedures that most people don't really want or need. So starting the most basic way, and I know many of your clients probably are multi practice owners and they, you know, are doing really, really cool things. But I think the most basic setup that can be extremely successful for a dentist is a very simple low overhead practice. It can even be one dentist, one hygienist, one assistant, one front desk person. There's nothing wrong with that where you're doing the procedures that people actually want and need. Endocore and crown scaling and root planing, implant abutment and crown things that just about every patient population has a huge need for. Start there and then grow your practice. And another way that I see Dennis get kind of distracted is they've got one practice, it's doing okay. It's not doing great. And they think, well, I'm earning X amount of dollars. I'm going to double my income by opening up a satellite practice. And then. And I hate that term anyway, satellite practice is, like, insulting. Oh, well, we can't see you at the real office, so you got to go to this one that's rotating around the sun. You got to, you know, go there and catch it when it's in the northeast quadrant. It just makes no sense. And then what do they do? They have more overhead. They've got an absentee practice. They've got one mediocre practice and one struggling practice, and they're actually making less and they're being more distracted. So, again, I know multiple practice ownership has worked really well for some dentists, but for most of the dentists that I see, it's just a distraction. And if your practice is maxed out and it's running smoothly and everything's great and you want to think about a second location and you've got a great plan for it, maybe a partner or a manager, great associates, whatever, that's fine. But if you've got a mediocre practice, don't even think about opening a second location. I've seen it way too many times. That's not dancing with who, Branya.

A lot of comments that are coming to mind as I listen to you, Rich, and I fall subject to this sometimes, too, which is I have this idea, this vision about something that if I introduce into my practice, into my professional life, that it's going to automatically trigger a more profitable output, a more. A more financially beneficial situation for me. And it's like an itch that's constantly coming up and you want to scratch it. And we all have heard the phrase, you got to spend money to earn money, but you got to be very careful with that. You have to spend money wisely on something that has already proven itself as having the potential to be successful. And this is the belief that the grass is going to be greener over there. If I just buy this, if I just do this, if I just drop money on this, like, it's. It's going to be better, but it's not always going to be that way. And generally it's not, especially when it comes to second practices. I'm 100% with you on this key, like, concept of make as much success, prove success in the block and tackling prove success in what you have now, your current structure. What is basic dentistry, core dentistry, that doesn't need all these peripherals, it doesn't need another office, it doesn't need this fancy technology. All of those things may come, but for me, they should only come after you've proven the model successful in what you currently have. Now, I get when you buy a practice, sometimes you gotta renovate the practice a little bit just to get it sort of up to current standards. I'm not talking about that. I'm Talking about dropping 100,000, 200,000 on all of these fancy items, thinking that those will translate into more money. And they, and they definitely, definitely don't always do that. So. Very good one right there, Rich. Very good one.

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On to number four.

Sure. Okay. Number four is throwing someone at the front desk without the property training. You know, I do a podcast. It's not the membership program. It's called the Dental Practice Fixers. And one of the features of my podcast is every week I do mystery shopper calls. I call dental practices posing as a potential new patient, asking the questions the potential new patients ask. Nothing complicated. How much is a cleaning? Do you do braces? Do you take my insurance? Do you have evening hours? These are the typical questions that a potential new patient asks and the responses I get. And the way that these simple questions are handled is mind boggling. And most of the people who answer the phone in the dental practice are nice. They seem intelligent, they want to do a good job for the patient, they're caring, but they haven't truly been trained. It's so amazing. I mean, we would never have a dental hygienist in our office who doesn't have a degree. We would never have a dental assistant who doesn't know what she or he is doing unless we properly train them. And that could be in house training, it could be, they could go to dental assistant school, whatever. You can't just throw, buddy, throw somebody into this job. Yet it seems like when the new person comes in the office, sit at the front desk, here's the phone, when it rings, answer it. And man, and then we go back to some of these other dumb things which as we're spending time and money and resources trying to get new patients into the practice and one does call, and we never know about it because they're never appointed. They're lost and gone forever. And all that effort that was spent on getting a new patient to call is completely wasted. And what I've heard and seen at the front desk, unfortunately has just been horrendous.

You know what keeps coming to my mind is a statement. Spending money. I'll just call it spend, spend cannot compensate for a lack of leadership and management. And maybe that's what I was trying to get at in my prior comment. There is that sometimes I think if I just spend money on this, these issues, certain issues will be resolved when in reality those Issues don't require spend, they don't require money. They require my time to be a good manager and a good leader. Training in the office is an example. Processes in the office is an example. Learning how to be an effective communicator to both my team and patients is another example. Now, some of that may come with the price tag. For example, for me, hiring a practice management consultant who's going to teach me to be a good manager and a good leader and create great culture is way, way more valuable than buying $150,000. Really nice piece of equipment. I would always say get the management and the leadership and your communication skills really dialed in first as a business owner, because that's going to help you be Prof. Without all that other stuff. And then when you get all that other stuff, you do it better. You're more efficient. It may help you generate a little bit more revenue. Great. It's going to help you be a great clinician, but it's not necessarily going to translate into economics, which is what good leadership and management and communication skills can do. That's why I'm fairly bullish and very optimistic on doctors at some point in their career having really good consulting come in and, and train them how to be great leaders and managers of people.

Yeah, I so agree. And since we're talking about phone and you brought in leadership, which is so great because everything revolves around the dentist being a great leader. And it doesn't mean that you have to be super dynamic or a real people person. You can be an introvert, kind of quiet person and still be a great leader. Sometimes you can use that to your advantage. So don't say I don't have the personality to be a great leader. That's just making an excuse. But before we get off the front desk topic, you know, again, we train our teams to be incredible at the front desk of phone answering. But I'll just give you any of your listeners two tips. It'll take me 30 seconds to give these two tips that will dramatically, I mean, improve the phone answering by a thousand percent. The first one is, this is going to sound kind of silly. Answer the phone when it rings. I do these mystery shopper calls. I got to tell you, during normal business hours, 40 to 50% of the time it goes to voicemail. If you're hearing this recording during regular business hours, it means we're busy treating other patients. What's your potential new patient going to do? Boom. Hang up, get distracted by something else and never call you back? Unacceptable. Or we're Currently at lunch. Well, they don't care. You know, they've got a job. They've got great insurance that their job provides them, which means they have one time during their day to make their dental appointment. That's during their lunch hour. And you're not going to answer the phone. Come on. Forward the office phone to a cell phone of a team member during lunch. Have all your team members trained to pick up the phone if everybody's busy. Voicemail is unacceptable during regular work hours. And the second real quick tip is just answer the phone. Be warm and kind, be inquisitive and enthusiastic. Answer the patient's questions. But then as the phone calls winding down, offer the appointment. It's just unbelievable that this isn't done. Give two good choices. We'd love to see you as a new patient in our practice. We're so glad you chose us. We can see you tomorrow at 3:30pm if that's not convenient. We've got Tuesday at 11:30am which works best for you. If you just made those two changes, your new patients could double or triple. That's how easy it is. Obviously there's much more that goes into front desk training and phone training, but if that's the only change you make, things will get better.

It's one thing I try to remember is that sometimes getting a patient to take that next step forward in the process of getting a new patient in the chair, case acceptance, treatment, all that stuff, getting them even to refer so much of that is just. It's little, small things. It's the way a sentence is stated, it's a question that's asked that takes them to that next step. And sometimes we think we have to spend all this money or do something really big in order to get change in our office. And a lot of times it's just basic training and some basic tweaking of the way communication is handled. I'm such a big believer in managing communication in the office, communication between team members, communication from doctor to the team, communication from the team to the patient, all of that is just more valuable and more relevant to a successful practice than I think, almost anything else. And it just drives home the need for good leadership in dentists. And it's tough because when I got my CPA degree, I worked for a big accounting firm. Nowhere in that process was I really taught about communication and about leadership. And so it has to be something that a doctor is very deliberate about and intentional about in creating that growth in their life, because it's not going to happen within the built in structure of their education and career. Which is why I think a lot of dentists and a lot of business owners and in my case a lot of CPAs don't become great communicators because they don't step outside of the normal track of education to learn something that isn't built into that normal track.

You know about leadership because you keep talking about leadership and I so agree. It's the important thing. And you know there are great books on leadership. I'm sure you've read some. I've certainly read some. But the first step in being a great leader is so easy. It's be the person that you want your team members to be. You know if you show up five minutes after the first patient scheduled. What kind of example is that? If you'll stick cash into your pocket because a patient pays in cash for an emergency visit well then your team members know that you're willing to bend the rules and bend the law. What kind of example is that? If you fly off the handle when a patient no shows and go into the back room and steam coming out of your ears. What kind of example is that? Be calm and treat the patient respectfully even if they no showed. We've got to start by doing all the things that we want to see our team members do. That's to me that's leadership.

00001 would you say that if somebody were to engage you or maybe I'll even keep it more general. A practice management consultant that they are engaging consulting on leadership and communication or do you think there's that's more niche that they would need to go to a very specific type of leadership course or leadership company. There are many companies out there that that's their. Their focus is it's all about you as the leader. It's less about the operations, it's less about the consulting on the practice, operations, management. But it's about you as a leader, as a communicator, as a goal setter, as all of that that defines a great leader. Is that built into something that you do or do you think that's something that a dentist needs to go and get specific training on elsewhere?

It's a tricky question. I mean as part of our consulting coaching. Sure there's definitely a leadership aspect to it. But we are not one of those institutions that has leadership training. But. But I'll tell you something though. When we start working with a practice, even a practice that's doing really well, a practice that wants to go from good to great or great to spectacular. There are so many holes in the leaky boat that need to be fixed before we're even talking about intense leadership training that I think there's a place for leadership training. But what good is pure leadership training if your practice is falling apart at the same time? Because you and your team haven't been trained, as you said earlier, to block and tackle, to get the new patients in, to get your treatment plans accepted, to make sure your patients are saying yes to periotherapy. You've got a great recall system. Your hygienist is not just a cleaning lady, but she's a true periodontal therapist. All these things are so important. And if you're the leader of a team and an office where these things aren't happening, I'm not so sure how far it's going to take you.

Great, great comments there. I love this conversation because this is one that I just such a believer in when it comes to leadership communication. All of those things are there. More Rich We've done four dumb things that smart dentists do well, I'm not.

Sure how much time we have left. I know you have a time limit to your podcast, which is very respectful to the listener. I like that because we could chat for three hours. So I usually talk about 10 when I do this as a webinar or a lecture, but I've got one that maybe we'll spend a little more time on if you wanted. That'll be our last one, and it's a bit more esoteric than the rest. And that is having a staff, not a team, is a dumb thing that smart dentists do. Because your staff, that's a bunch of employees, staff members, punch the clock. Staff members don't really care that much. They do what they can to get by and collect their paycheck. A team, and I know it's kind of a cliched word and overused, but a team in the dental practice absolutely cares about the patient. They want that patient so badly to be in good dental health. And when we work with practices, you know, you can come in as a consultant and say these are our financial goals and we've got to hit goal this week and we're going to do it by scheduling for production and this and that. And what's the team thinking? Okay, maybe I'll get a bonus. But what I'm essentially doing is making the doctor rich so those things don't work long term. Our philosophy is healthy patients equal a healthy practice. So let's talk about ways that we can all work together to get our patients healthier. But the other thing about a team is this is our work family. We spend so much time with our dental team members, the doctor and the assistant, the hygienist, the front desk people. We spend so much time together and so many practices, they're miserable and they don't want to spend all that time together. So if you like, I can just go over a few really quick tips to having a true team and not a staff.

Let's do it.

Okay. Well, some of these, I feel like I'm a kindergarten teacher when I say them, but it's just basic stuff. And this is for the doctor. Doctor, use the magic words you learned in kindergarten. Please and thank you. We're not heart surgeons here. We don't have to say scalpel sutures. I mean, come on, you can say, peggy, can you please pass the explorer? And then when she does it, say thank you. You can just be so polite to your team members and your patients that they know that you mean it. It's got to be sincere. Another thing, greetings and farewells. When you come in in the morning, are you in a huff and you're running into your office so nobody can see what kind of bad mood you're in? That's no way to start the day. When I come into my office, I walk up to every single team member and give them a personal greeting, a little non dental chitchat. Hey, did you see, you know, Succession last night or whatever TV show they happen to be watching? You know, how about, how about demos as we see stay here in Baltimore about our Orioles baseball team? Just some kind of little personal topic that's important to them, make them feel like they're a real person and this is their second home at the end of the day. Goodbye and thank you to every single team member. And it's got to be done. Sincerely. A well organized morning huddle, 30 minutes before the first patient is essential. If the doctor or a team member's coming in a minute before the first patient scheduled, or even, as I've seen, 10 minutes after the first patient scheduled, you're like guaranteed you're going to start the day chaotically and be putting out fires all day and be non productive. So well organized, stress free morning huddle, 30 minutes before the patient. It should take 15 minutes. Then everybody can go, you know, get their rooms ready, have a sip of hot tea or whatever it is they'd like to drink in the morning, relax, have a little bit of five minutes to socialize about, you know, whatever they want to socialize with their friends about. Boom. Always have an atmosphere of respect towards others. You know, I can be. I have to admit, my innate personality is very snippy and sarcastic in the dental office. It doesn't work. We've got to be incredibly respectful to our patients, our fellow team members, our fellow doctors, our lab people, our equipment reps, all those people. Never say anything about a person that you wouldn't say if they were standing right in front of you. I know it kind of seems a little silly, but you know when Mrs. Jones no shows and everybody runs in the break room and screams, that idiot. We confirmed her five times. What is wrong with that moron? Doesn't she know how to use a calendar? Her? She's so inconsiderate. Blah, blah, blah, blah, blah. It just causes negativity. You could say something like, Mrs. Jones no shirt again. Maybe she doesn't understand the importance of this hygiene visit. Maybe, you know, our confirming efforts aren't getting to her. Let's put her on our VIP list so we can not make her an actual point. You know, whatever it is, let's just be nice all the time about everybody. But if you have time, three minutes. I hope so. For a quick story. I'll tell you. I think the most important thing in having a team, not a staff. I call it the seating chart rule. So many years ago, Dave and I. Dave is Dr. David Maddow. He's my brother, my partner in the Maddow Center. We had our annual holiday dinner. We go to a big steakhouse downtown. I think we had 16 team members at the time. We get the semi private room with the big oval table and it's just beautiful. And everybody loves the holiday dinner. So Dave and I get there early, first of all, because I get everywhere early. It's just the way I am. I was on this podcast link three hours before it started, just nervously tapping my fingers. But I love getting everywhere early. So we're there early and we're putting out place cards on each, you know, so everybody knows where to sit. And one of the reasons we're putting out place cards is we have a little gift for everybody that's personalized. But the real reason we're putting out place cards is because as we're putting out the place cards, we're saying things like, oh, Harriet can't sit next to Dee because they've been at each other's throats for a year. And we can't put Sally and Gertie next to Each other because they're just going to be whispering and gossiping and backstabbing and all this, all this stuff. And hell if I'm sitting next to Linda. I sat next to her last year. It was horrible. And we're putting all these. And we're thinking, what is going on here? This is our business. This is where we go every day. These are the people we spend every day with. And we're acting like little babies. Like we can't put two people next to each other for one reason or another. I don't want to sit next to that person. These two people are fighting. This is ridiculous. And we said, you know what? We are going to have a goal that next year when we meet back in this very room, we are not going to need a seating chart because everybody in our office gets along well with one another. So how do we tackle this? And we were really serious about this. We said, how do we tackle this? Well, first of all, there were a few people. We made a little list. We just need to have a real sit down, heart to heart with these people, telling them that we love them and they're great team members. But if they really want to remain in this practice, here's a skill you need to work on. Whether it's getting along with others, not gossiping, not getting down somebody else's throat all the time because you can't stand the sight of them, whatever, let's work on these skills. A few people actually couldn't work on the skills well enough and had to be given a job opportunity elsewhere, as we like to say. But with proper training, a little pruning of the staff, being really careful about new hires, sure enough, a year went by and our goal was met. We did not need the seating chart because everybody got along. I'm not saying that we should all be best friends and take vacations together. That's a little extreme. But everybody that we work with should be somebody that we really enjoy spending time with. We really enjoy their company. And it's just not always the case in the dental practice. So my last dumb thing. I think this is my last one. We can do a few more if you like. That's up to you. But this dumb thing is having a staff, not a team. It's never a good idea.

Just so much good thoughts in there. And for me, again, this goes back to leadership. But I tend to be more attracted to the leaders that are humble and almost vulnerable. And it feels more real and authentic around those people. And I'm able to feel more open and honest myself about I don't have to sort of present this facade of perfection around those types of leaders. So I'm actually a big believer in that. And I think that type of leader does give pleasantries. Thank you. A lot of thank yous people feel really appreciated. Please. And, and also the other thing that I'm very much attracted to in a leader is consistent energy and optimism. I remember working for somebody a few years back before I started practice cfo. And every day when he would come into the office, I didn't know what to expect. Was it going to be this personality or that personality? Was it going to be grumpy or really excited? And it just wasn't consistent. And then when it was sort of grumpy or irritable, I felt like I was walking on eggshells all the time. And it just made for an uncomfortable place to work. And so one thing that I believe in and try to practice myself, not perfectly, but I try to practice this myself, is that when I open the door to my office every day or I get on a virtual meeting, that it is the same demeanor, it is the same positive believer, optimistic believer. And even though I might have things underneath the hood rumbling around that are causing me frustrations or irritations, I try to screen those out so that people see, no matter what, I believe in our business and I believe in our model. I believe in our service, and therefore, so should you. It's almost like it's an unspoken message. People really rally behind a believer, somebody who's passionate about what they're doing. And if they smell at all that you're having doubts in yourself or in your business, your service, your quality, those doubts are going to be accentuated in the people that you are attempting to lead. This is one thing I think about, like Tony Robbins, for example. If anybody doesn't know what Tony Robbins is, he's probably the biggest motivational guru ever to exist. Don't you think, Rich?

Yes, ever. He's the goat. He's the goat of motivation.

He is. He's the goat of motivational speakers. And I went to the Sarek 30 conference, I was a breakout speaker, and I went to their main session, and he was their keynote speaker, him and Emmett Smith, which was pretty cool. But the thing I learned about Tony Robbins, and I've listened to a lot of his stuff since then, is he primarily is about energy.

It seems to me his main focus is that you are an energized human being, that people feel your energy, they feel your positivity. They feel your optimism and that great things just naturally extend out of that consistent approach to life and yourself and your relationships and your business. Now he gets into sort of frameworks and do's and don'ts and things like that. But if you look at him and the crappy life that he emerged out of in his younger life, I used to almost make fun of him as like, you know, your guru. Oh, the guru. And I don't want to, I don't need a guru in my life, but I've actually come to really appreciate his. His own story on what he's done. And it's had an impact on me wanting to have that type of energy in my life. The last thing I'll mention on this subject, if it's helpful for anybody, is the other thing around this is tension is inevitable when you're in business. When you're in work, it just is. Problems come up, disgruntled patients, disgruntled staff members. Something breaks down, somebody doesn't show up. There's just, just problems that arise. There's no way to get around that. Now you can maybe put in processes to mitigate that. Great. But attention is going to arise. I believe that whether people feel like they're part of a team and excited about that, or whether they're just a staff member, you know, there to. To. To make somebody else money is how effectively does. And, and I think culture is driven much by this too, is how effectively do they manage that tension. And I think this relates to marriage, I think it relates to relationship with kids, I think it relates just to relationships in general. And in a dental office, it is a set of relationships coexisting every day. And how you manage that tension, to do so in a healthy way makes the problems actually become things that unite the team in a beautiful way, as opposed to drive wedges between relationships in the team. And I to want. I won't go into sort of methods to create a healthiness around solving tension, but just figure out a way to have tension, not be a bad thing, but have everyone in your office view tension as a way to get to a higher level, to grow, to develop and to use those problems to become better as a practice and improve the relationships here at practice cfo. When differences come up, I have sort of my initial response internally, instinctively, is to sort of immediately push back, to fight back, to lash out or to disagree or say why somebody's wrong. That's our first consciousness. Our second consciousness is stop, pause. Let those feelings sift out, settle your brain Step back, think about it from the outside, and this is what we can do, as opposed to, you know, the rest of the animal kingdom, is we can pause the instinctive response to digest it, process it, and come up with a non instinctive response that ends up being so much better. And when it comes to tension, I think that's the first thing doctors should always do in that moment and try to teach their, especially their leadership team, if they have an office manager, things like that, is to never react emotionally and instinctively and right away when conflicts arise, but to back up, process it, and then approach it much more thoughtfully and with care with the people you're talking to. And I always find that the other person then responds the same way. And then we actually get to a solution that we both feel maybe not is the perfect solution for what we want, but we feel good about that relationship right there. Just took on a new level of closeness and value to be able to do that the right way. Now. I just, I didn't mean to be that long winded on that subject.

No, no, no, it was great. And it's funny, I used to always tell people that if something's really bugging you and when you feel that fight or flight response that the caveman had to survive, well, we don't need that. As you said, we've evolved above that. Just take a deep breath and think to yourself, this thing I'm going through right now, will this matter in a week? Will this matter in a month? Will it matter in a year? Will it matter in five years? And when you have that attitude, you find these little things that irritate us are usually pretty darn meaningless.

I agree with you. I think, Rich, we're going to end it there. It was fun. This was a party for you and me to go over this. We will maybe have you back to go over this the next five things. We'll call this podcast the Top 5 Dumb Things that Smart Dentists Do. And maybe people in general. Some of these relate just across the human nature. So thank you so much for being on the show, Rich, and look forward to having you back again soon.

Wes, it was my pleasure. Thanks so much for inviting me.