93: Making the FFS Leap with Dr. Anissa Broussard

Welcome, everybody, to another episode of the Dental Boardroom podcast. It is Monday, May 19th. I'm just getting back from the California Dental association event in Anaheim, which was massive and very busy and lost. I spoke three straight days. My voice is a little bit questionable at the moment, but I'm back to be excited to be back in my office and now doing another episode of the podcast. And on the show Today, I have Dr. Anissa Broussard. Welcome to the show, Dr. Broussard.

Thank you so much for having me, Wes. Really excited to be here.

So we're going to take here about 20 minutes or so. It's going to be a little bit shorter because I know your time is a little bit limited, but I think we can make some good education points on a subject that is very important to me, which is how to move to more of a fee for service model. And I just did an episode a couple of weeks ago on the economics, the difference in the economics between a PPO practice where you're getting 700 or so, 7, 800 for a dental crown versus your UCR, which is probably, you know, 14, 15, $1600 or so, and the cost structures are the same. And you could literally do probably less than half of the dentistry you do if it were fee for service and take home more money and work half the time. And yet it's a hard thing. It's a difficult bridge to cross to move to a fee for service model when we're very much dependent on what is our most expensive marketing channel, which is PPOs. That's essentially what they are, very expensive marketing to fill the chairs. And so I'm going to do a series here where I talk with some people about moving to a fee for service model. And I actually found you, Anissa from ChatGPT, believe it or not, believe it or not, I said, who out there is helping dentists move to a fee for service model? And you, you came up. So. So kudos to you on your. On your marketing. There it came through. And so I've got a series of questions here on this subject. Are you ready?

Absolutely.

Yeah. Let's go ahead and dive in. Number one, what mindset shifts. Oh, you know what? I. Sorry. You know what I need to do here is actually explain why you're an authority on this subject. So Dr. Broussard ran a dental practice for 20 years. She still owns it, although it's. It's a little bit more run by associates and a really great manager in the practice. And it's allowed her to pivot into some other areas that she loves. About eight years ago, she started doing practice management consulting to show other doctors how she sort of found a formula that was very successful for her. And it's called delivering. It's called delivering. Wow. Right, Dr. Broussard.

That's right.

Delivering. Wow. And that's why I recruited her on the show, because as a practice management consultant, she's done a lot on helping dentists move to more of a fee for service model. So that's why you are the authority on this subject. As my listeners know, I'm just the financial guy, so I may sound clumsy, but you won't. So here we go. What mindset shifts are necessary for a dentist who wants to move away from PPOs and into a fee for service model? So let's talk about the mindset shift.

Yeah. And let me just preface it. Preface it as well. And again, thank you so much for having me. And kind of what I'm doing now and my main focus, and it's really tied in really beautifully of what we're talking about today. Right. And that is. And you shared, you know, PPO really is a marketing tool. Right. So we're putting it out there to be able to get patients right. And it's really interesting because for years and years, I spoke about data and analytics and profit margins and things like that. And what many people don't even realize, right, when they look at how much does it actually cost? Or when I was speaking, I'm like, how much does it actually cost to do a filling? And no one knows. And I'm like, it's the simplest, easiest procedure that we do every single day, and no one understands how much it costs. And so it's really interesting that. Alan, I'll tell you, it's 120, $130 typically, to do an occlusal fulfilling. However, many practices are actually, you know, taking in $80 or $120, and this is before the doctor even gets paid. And so when we start looking about, you know, why did we decide to go into dentistry? Right. I'm a dentist myself. Is because we're healers. We want to really help people, and we want to be able to change their lives, and we want to be able to take care of the people around us, our team members. We want to be able to be a good steward to them. And so the truth is that oftentimes when we're in this model, our team thinks that we're wealthy. They think that we're rich.

Right.

Because they see patients in the chair, our friends and our family, they come in, they're like, oh my gosh, Dr. Is so wealthy, right? Because they see patients in the chair. But the truth is that I know after working with doctors for so many years, they're like, yeah, but where's the money? Like, I'm barely paying myself, Right? And the truth, I believe is that when we step through the fear, okay, and we understand that there's an infinite number of people that we can help, okay? There's an infinite number of people out there that need all on four implants or need clear aligners, Right? There's an infinite. We look around, right? But why don't they know or why aren't they there? And it's because they don't know about us. And so I've had a very interesting journey. As you shared before. You know, I became a dentist, did that for 20 years. I have a manager. I actually started the podcast. I was the first female dentist podcaster in the dental industry. Yeah. And it was because I had a book, you know, and delivering well. And people started to hear about, like, how is it that's great that you're teaching practice management or you're.

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Book is about this. But how are you getting, you know, 50 patients a month on social media? How are you getting, how do you have 50,000 people? Like, I want to know about that. And so kind of my journey's been very interesting. So I winded up teaching social media and Facebook courses and went down this like really beautiful journey and then did the consulting. And so where I'm back now is I actually am founder of Digital Floss. And so that came because doctors in the coaching program were like, well, this is great. I want to grow, I want to expand, I want to become fee for service because they understood the truth about profit margins and they were like, how do I do that? Right? And so I've had a very interesting journey. But know the question really is, what is the mindset shift? That was your question, right? And I think the first mindset set shift is realizing number one, that we are the creator of all things, right? Like whatever we want, we can create and there's an infinite number of people that we can help, right? And the reason why we're not able to help them is because they don't know that we exist. And so a lot of times people are, are putting money or pulling money out of their practice by going into this ppo? But what if instead, right? And I'm, I'm really just painting a picture for you. What if instead you said, how do I build a brand, right? How do I build.

An opportunity for people to actually know who we are, right? And so imagine for example, you're going on and people are doing their due diligence right now, by the way, right? They are hearing from a friend, you know, I, I needed a dog trainer and my friend said, you know, I go to instagram and go to Rough Rules, and they've got an Instagram. And I saw. Okay, I saw that. In the first week, there was a dog that was a Velcro dog, okay? That's the next week, the dog is calm. By the third week, they're walking the dog without a leash at the park. And I'm like, I want that, right? So I reach out to them and I'm like, I want to be able to have you to train my dog. I already decided from the videos. And she said, it's going to be a little expensive, like, whatever, $4,000 for an hour a day for three weeks. I'm like, I don't care, right? Like, I want you to train my dog. And the same thing actually happened when I was searching for my dentist right here in Fort Lauderdale. There was this beautiful video that was like, you know, it takes integrity, right? And team members are coming on. They're like, I've never worked for a doctor like this. And the doctor saying, you know, at our office, you can do this service and this service and this service. When our patients come here, they don't have to go anywhere else, right? And so it's interesting that when I went through that process and I requested an appointment, and about an hour later, we're texting, and they're like, I don't know if you're aware, but your insurance doesn't take or we don't take Delta hmo. Now, here's the thing. I'm a dentist, and I signed up for the hmo, right? So if I don't know, how do patients know? And I'm like, thank you for letting me know. Now I'm going to go cancel it because it was January, right? But here's the thing. Like, they were like, it's going to be $160. Are you okay with it? And I was like, yeah, because I watched the video. And so my challenge to you in terms of mindset is to stop thinking about discounts, right? To stop thinking about desperation, right? Like, I need to have patience and shift that energy and focus into how do I help people to see me as my authentic self, right? So if you are an expert, coming on and, you know, letting people know, you know, if you've been thinking about some dental implants, you've got some questions. Here's what you need to know. You might think you're going to need a prescription. And at the end of the day, you'll probably ask yourself, what was I so afraid of? You know what? Come on, let's talk about it. Come in and let's talk about it. After we talk about it, then we'll figure it out, you know, and so we're able to put these messages out where people are seeing that we are an expert. I was over the weekend on a strawman full arts symposium. And these are incredibly gifted and very intelligent practitioners, right? And so going on and talking about, you know, how lives are changed with patients who are now able to smile because they have this all in four full arch denture versus for years, you know, showing up to dinner and they left their. Their denture at home, you know, and it's. It's just like really powerful. And so I would say, like, the. The mindset is that you don't have to. And the truth also is you cannot take care of people. You can't take care of your team if there's, like, nothing left to take care of them. Right? And so we want to build a business that people say, just like Whole Foods, you know, like, I want to go to Whole Foods versus, you know, when I was in high school, I worked at Winn Dixie, and Winn Dixie was all about doubling coupons. And the minute that Winn Dixie stops doubling coupons, people are going to Publix, right? And so it's. It's really thinking about how do you want to be known, do you want to be known as the cheapest? Because, you know, if you are the best, no one expects you to be the cheapest. And if you're the cheapest, you can't be the best.

It's almost implied in the pricing whether or not you're the best. I mean, I think about. I think about this a lot. And for me, a mindset that it all starts with leadership and vision. When it comes to branding and how other people perceive you and how your team sees you, it all starts with the way you think and the way you communicate those thoughts. Everything starts. That's the first domino to fall, is creating a vision for what how you want to be interpreted and viewed by the outside world, including your team. Everything starts there. Now, what I find a lot of times is that when a business owner in a dental practice or in any business, really, when a leader first shares a vision, it may inspire, but that inspiration will die fairly quickly if it's not recurringly lived and recurringly repeated. The stats are that for leaders to implement a significant change strategically in the practice around brand and vision, it takes seven times of consistently saying, what is the vision that you have, seven times before the team finally says, oh, I think Dr. Broussard is actually sticking with this. This is a real change. He's serious about this. It's not just an emotion or momentary thought or a momentary whim. This is real. We better get on board. And if we don't get on board, I may not, I may not be able to, to stay here. I mean, it needs to be that, that, that, that drilled in. And it's not just about the insurance contracts. It's not just a focus on cost, it's a focus on the value. And I, in my case, I'm a CFO company. Yes, we do accounting, yes, we do tax, yes, we do, um, yes, we do payroll. But I'm a CFO company and I cost more. I'm like a fee for service model. But what you're going to get with practice CFO is you're going to get regular meetings. You're going to get a really white, white glove relationship. You're going to have red carpet. We are boutique. And you're going to feel that in that it's a very personal relationship. We know you, I know your goals. I know, I know quite a bit about your family life and what you want out of your family life and your kids. I know your practice cash fl. And of course I understand your taxes and I understand your debits and credits and your P and L. I understand all that stuff. But it's a totally different branding and a model. If I wanted to, I could just say I'm going to do your books, I'm going to import, reconcile and post the P and L every month. And that's what you're paying me for and pay me X. And it's just a matter of a commodity pricing. Those are two entirely different models. Same thing with dentistry. Ppo, hmo, especially hmo, but PPO versus fee for service, very different models. And it all starts with the mentality of the leadership, in my strong opinion. What are the first three steps? Let's really get the rubber meeting the road here. What are the first two or three steps that a dentist can do to start to shift into this mindset and actually start making changes in the practice to move toward a fee for service model?

A couple things are personally, what yourself, right? So the first thing is I'm worthy of this, right? Like I'm worthy of this. And you know, I, I was meant for a really, really big purpose. And when I step into that purpose, what does that look like? Right? And so for me, you know, when I practiced dentistry for 20 years, I was the prosthodontist. There was no prosthodontist in my area. And so I was able to see smiles before they happen and be able to make them happen. Right? And so for me, like, I couldn't even think about, like, the ppo. Like, I couldn't. I was just like, what do I, what do I want? What's my purpose? How do I want to serve? Right? And, and then aligning with that, again, going into your heart, how are people seeing you show up? And it's interesting. So many dentists, you know, come to me, like, again, we have the marketing agency and they're like, I need new patients. I need a patience. I need a patience, right? And it's like this kind of, like, panicky kind of feel in energy, right? Instead, what some people do. This one doctor came to us in his second year of his startup and he said, I want to do a million dollars this year. What do I need to do? I said, well, the first thing is we need to look at your numbers, okay? And look at where are you getting the majority of your, your revenue? And the majority of his revenue was not coming for implants or even crown and bridge or clear liners, right? It was coming from, like, fillings. And so I said, we've got to create a financial circle of focus, right? So tell me a little bit more about your clinical skill set. And he's like, oh, when I was associate, I did implants. And I'm like, cool, well, that's going to be your circle of focus if you, if you like it. He's like, yeah. So I said, okay, what we're going to do is we're going to reverse engineer how many implants. If you do an X, Y number of implants, what are you going to get at the end of the year? What's going to be your revenue? Let's look at your margins, right? And so now that he has this clear focus in his morning huddles, he knows that's the focus. With their verbal skills trainings, they know that that's the focus, right? And then bringing that in and tying that into your marketing, that's your focus. And so when he first came into our agency, he didn't have a focus. And so his, his videos were like, you know, when do you change your toothbrush or, you know, how often should you go to the dentist? No, we're changing that. Okay, now we are going to be talking about implants. And so the next weekend, next week just so happened. We're coming in to fly and what we do is we fly and we get video content and then we run meta ads, geofence to drop them in different neighborhoods with your phone. And we're running funnels. But long story short, his content was about implants, okay? And so we started to geo fence and he started to get 20, 30,000 views of him showing up talking about, you've got questions, here's what you need to know or One of the things that I love most about this office is my team, you know, and he's talking about how like combined experience they've got over xyz or he's got a funnel video and he's in Chicago and he's like, it all started in the chi. This is where I was born, this is where I was raised. You know, I decided to bring the same technology and things that I was doing in Chicago here into Bellwood, right? And so what wind up happening is by the end of the year he hit his million dollars, right? Which is really, really beautiful. But he started to say this. So people are coming from the other side of Chicago to see me and they're like, I saw you and I saw you not just on Instagram, but I saw you on Facebook and now, you know, distributing content, seeing you on LinkedIn and seeing you on X and seeing you on Google and like you're everywhere and they're like, I want you to be my dentist, right? And so what winded up happening is two things that alone shifted some things in his mind. He became someone different. He said, you know what, I don't want to be a part of these insurances anymore. Like, this is not making any sense anymore. And he realized because he saw the value in himself and he saw through his messaging, that's what I'm saying, from the heart. He people were showing up and resonating with that. He was like, I don't need that. You know, people are going to come in and they want to do this implant case with me. And it gave him the, that itself gave him the confidence to see that he like where he was and who he actually was all along that he didn't see for himself. And so all of a sudden he's like, I'm dropping these insurances.

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I'M not doing this. And I said, you know what, you can, you've now put yourself in a position four or five months. It took four or five months to build this, you know, he said, you know, the bamboo, it's on the ground and then one day it just shoots up and it doesn't stop. He's like, that's what's happening. And I'm like, and it's just going to continue to happen. Like the mango tree is going to still is going to continue to drop the mangoes. And I said, you don't need it anymore. Now you see, now he has the confidence. And I said, so what's your new goal? And he says, you know what, I think it's going to be 5 million. And he says, you know, and he goes, and now I said, okay, well what's going to be required, right? And that's where the coaching side again, I own a marketing agency, but that's where the coaching side comes in. I'm like, okay, right. What do you have to do clinically? Go take a course, right? So he literally went in and two weeks ago I messaged him and he's like doing a hands on course in Vietnam or whatever, like, and because his goal is 5 million and so it's like, what do we have to do now? And I said, as you get the clinical competency in that now all of our marketing is going to be all around full arch, right? And so that's how you do it. First of all, you have to see that there's an infinite number of people out there. Let's just Say you're doing single fillings. Go take a course. Like, learn how to do all in four full arch, right? Like, I was just at Stroman event. Their training is phenomenal, right? Like, get out and do a course. Get a mentor for airway, right? And get the clinical skill set. So you have confidence, right? And then you want to make sure that people are seeing that confidence and people are seeing you. Because if you are amazing and no one sees you, then you can't help anyone, right? And that's where the marketing, particularly the social media comes in. And you mentioned you found me on ChatGPT. Everything's completely changed in 2025, guys, right? Like, so everything used to be Google and Google Ads and Google reviews, right? But the reality is that people are now searching on Siri and when they're on Siri, they're going to Apple Maps and people are going to ChatGPT. And now SEO on ChatGPT is not like SEO on Google. It is a part of it, which is scanning websites. But the next part of it is like, can I help you more? What demographic do you want? Or do you want somebody who's a general dentist or a specialty? And do they need to take a specific insurance? Like, this is what ChatGPT is asking people when they're asking for a dentist and it says, great, let me do my research. And then it's going through websites and then it goes. It scans LinkedIn and Facebook and Instagram. So social profiles are incredibly important. One for omnipresence, but number two, to be picked up. Um, because this whole thought of, oh, yeah, we're good, we're doing some Google Ads. Yeah, still keep doing the Google Ads. So you can be omnipresent, but at the same time, having video content that gets uploaded to Google. Right. Is going to allow you to be able to drive down your costs, optimize your buzz, budget, and become omnipresent so that now those patients who are connected with that message are gonna find you. Right?

Yeah. I'm gonna just share a couple thoughts to parlay off that. I. I like that concept of believing that you are worth it. I do think that is an absolute, very first step is believing that you are worth it. A lot of times I find my clients will underestimate themselves and they'll downplay a little bit the incredible journey they've been on that required intense endurance to get to where they are as a practice. Owning dentist, from undergrad to grad to the associate years, to getting a loan, to hiring accountants and attorneys to taking on a tax ID and a P and L and all the vendors, your tech stack, the debt. You know, all of this is a massive journey. And most Americans don't go through that journey. It's only a very narrow group of people who span that journey. And when you're there, it's not fake it till you make it. You are there. You are worthy of that. Now, it may feel a little bit like that imposter syndrome, like am I really the one that can be doing these big fee for service treatments? The answer is yes. Now obviously you have to have the clinical training, no doubt about that. That goes without saying, but yes. And you determine you can shape how the world views you and how your team views you. It's really important, I think, for leaders. I consider all dental practice owners who have employees and patients. They are a leader. They may be a bad leader, they may be a good leader, but they're a leader nonetheless. And as a leader, they have this discretion, this ability to shape how the world views them. And that is just so vital as sort of a first step there. And once you start doing these bigger cases or moving to doing more fee for service, I'm assuming here, because I'm not a dentist, I have similarities or corollaries in my own space. But after time in doing it, you really settle in to the reality that you are that doctor, you are that doctor that has the credibility in any field, whether it's accounting or in medical or dental or in law or architecture. It doesn't matter. There are certain standouts who people talk about and say that's the one you want to go to. That's the one who has invested X amount of time, who's got the skill set because of xyz. You know, you want to be that person.

It's so interesting. So a couple of weeks ago I was in Tulum and I was at a, a mastermind and it was dental company CEOs.

And high level executives for dental companies in, in the industry. And we actually had a free day and we were out on a catamaran, right? And I actually spoke at the, at the event. And so I looked around and there were all of these beautiful homes, right, that were along the waterways, right? Kind of like in Fort Lauderdale. We've got the intercoastal and they're these beautiful homes. And I said, you know, the difference between people that own those homes, okay. And people who don't like the polarity of it, right. That I can't have it. Oh my gosh, those rich people. And like, the difference is that they decided that that's what they wanted. Like, they decided that they were worthy of it. And they're like, what do I need to do? And probably in business, and they decided that they didn't want to be like everyone else. Like, it's so interesting. You know, I talked about in our agency, and there's no other agency right now that's focusing on taking, doing reels and omnipresent marketing and, and getting, you know, doctors seen on all of these engines. Right. And I could have been like, yeah, I'll just do what everybody else does. Right. And that's not what I did because that's not where change happens and that's not where you make the biggest impact. Right. Of following, like, the status or what's going on. And so understanding that, you know, purpose comes from your creativity of what can I do that's not being done? And then with that, again, there's an infinite. I know. You know, there's an infinite number of people that I can help with what I'm doing in my purpose. Right. And what in my dental practice we're doing. And so if there's an infinite number of people that we help, then there's no fear.

Here you go. There's no fear that the money is.

Going to run out.

And if there's no fear that the money is going to run out, then it guides us and allows us to have the, the courage.

Right.

To say, you know what? I'm going to go take that course. I'm going to buy that piece of equipment that's going to be required to be able to do this level of dentistry because I'm worth it and I deserve it for myself. And at the same time, with the journey, whether you're there or you're in the process of being there, how are people in your community going to know that you're there? And that's where, again, having people to see who you are is very, very important. So hopefully this was helpful. Hopefully this was helpful. I wish we had like another an hour so I could talk about this all day.

Yep, I think it has been helpful. I, I do want you to give a quick plug for the, this marketing effort that you're in, this new venture and how the AI relates to it and how that that service or that technology could help our listeners if they were to explore it and maybe engage it, how they could use that to, to pivot to more fee for service.

Yeah. So my agency's been around for a couple years it's called digital floss. And we really help people get seen as their authentic selves so people can find them and heal. Like that's what we do through that vehicle. Right. So we fly out twice a year and we give video content. The doctor meets with the copywriters so we can feed you line by line if you're an introvert. We got that figured out.

And.

But we geofence it. So this neighborhood, that neighborhood, when people enter with their phone, they can see it. And we're getting 10 to 40,000 views. I'll go into a funnel with a beautiful video where the doctor's saying it takes integrity and courage, but then taking that content and putting it omnipresent on Instagram, on Facebook, on Google, on LinkedIn, on X. Right on YouTube. And that way there's croc brain. After Covid, people are popping all over the place. And so now no matter the way they go, they see you and then you show up in ChatGPT, which is amazing. Right. And, and, and why does that matter? Because, you know, yeah, about the money, it's fine. But if we build a business based on how having more people to find us so we can serve our purpose and we can heal them, money is never going to run out. Right. So that's the beauty of it. So that's what we do. Digital floss connect. If you guys feel that it's calling you, excellent.

So I'm going to adjourn here with just a couple final thoughts on this, a little bit of a summary and a little bit of just some final concluding thoughts. Number one is that it all does start with mentality and the way that you view yourself. And all transformation starts with great leadership and vision and moving from PPO to fee for service. That's not like a little step. That is a massive step and it's not an easy step, but it is an imminently possible step. But I think doctors need to have the confidence in them that they are not. It's not fake it till you make it. You are not fake. You have the skill set and the ability and the training and you've taken the risk and you've taken the journey to be there and to deserve to be compensated for all of the opportunity cost that you gave up. You could have started college for, I mean, work making money four years earlier and had you put some money aside in those early four years because of compounding interest, that could have been a pretty big pile of money that you had saved. But you set that aside. In fact, you took on debt. Not only did you give up earlier savings, you took on debt in order to go to dental school, and most for most people and to start their dental practice. And so it's not a matter of saying that you inappropriately deserve anything. You absolutely deserve to be compensated for the skill set, the risk, the time, the energy, the blood, the sweat, the tears, all of that that you put in to be where you are. So go shape the world's view about who you are and what you stand for. So mentality is number one. Number two, I do want to really emphasize the importance of narrative and communication. I have yet to see a doctor who is a very poor communicator. Breakthrough financially. And every doctor that I work with who has broken through financially has become a good communicator and some great communicators. This is the one thing that I have found in working with a lot of dentists over the years, is there's a direct correlation between their success in their practice breaking through and their ability to communicate effectively, which means listening, which means communicating clearly and consistently to the team and to patients in a way that's confident and believable. And it enrolls what it does. It enrolls the team, and it enrolls patients into this vision that you have. And we love, as humans, we love to be caught into a vision of something. It makes us feel like there's something personal, purposeful, and valuable behind that vision. And that's what a great doctor can do, is enroll them in that vision. And I also think technology is changing. The face of a lot of dentistry right now is in a lot of spaces. So I think what you're doing is very, very cool. Dr. Broussard, thank you for being on the podcast show and good luck with your new venture in the AI and marketing space. Much appreciate you coming on.

Thank you so much for having me.