Dental Entrepreneur Fall 2019

DENTAL ENTREPRENEUR CLASS OF 2020 | FALL ISSUE

Business Beyond the Classroom

Dr. Miguel A. Ortiz

My Story is Her Story Lynne Leggett

Mindset of a Coach Dr. Gene Heller

The Big Picture When Considering Dental School Debt

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Welcome

CLASS OF 2020 FALL ISSUE VOLUME I

Happy fall, you all! It has been so rewarding traveling across America to meet with dental professionals while attending the plethora of meetings and conferences autumn brings. It is the face-to-face connection that stimulates me to keep pushing forward with our mission to help young dentists maximize their careers as successful businessmen and women, serving their profession and finding fulfillment in their life goals. It is an honor to meet you and discuss your future and the future of dentistry. I wish I had more time to meet all of you! Thank you for reaching out to me via social media, texts and email.

I so appreciate your invitations to visit you in your academic homes and will continue to seek out those opportunities.

Business Beyond the Classroom Fall 2019 VOLUME 22, ISSUE 1 Editor & Publisher Anne M. Duffy RDH Associate Publisher Rebecca Paciorek Assistant Editor Michael Duffy JoAnn Schutte Susan Beatty Production Curative Group Editorial Board Dr. Dirk Fleischman Dr. Gene Heller Dr. Harold Sturner Dr. Ryan Dulde Dr. Earl Douglas Rachel Teel Wall, RDH, BS Dr. Tom Snyder Derek Champange Dr. David Rice Layout and Design Brian Rummel

Class of 2020 Contributors Andy Grover Cleveland Gene Heller Mary Fisher-Day Lynne Leggett Roger P. Levin Scott Livingston Rob Maguire Rebekkah Merrell Miguel Ortiz

Editorial Office

12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 anneduffyde@gmail.com

You know how I always say, “Good DeWs find Good DeWs.” Well, guess what? “Good DeWds find Good DeWds,” too. That is how I was introduced to Dr. Miguel A. Ortiz! Our resident columnist, Dr. Lucas Shapiro, mentioned to me that I should reach out to Dr. Ortiz as he would make a good cover doc. Not running in his circles, I had no idea that he was being followed at the time by 170k Instagram followers. Wow! By the time Dental entrepreneur lands in your hands, he will be up to 176k followers and growing. What struck me on our first call was his humility and appreciation for being considered for the cover of our fall issue. We asked him for his personal story that had nothing to do with his clinical skills. We wanted to know about his journey. He had never shared his story before - the real story - how he reached such a place that even he could not have imagined. It is our honor to share it with you. And it’s not just his story, it is their story. Colleen and Miguel’s story. As he states, it takes two; and, when you have that kind of honest, loving partnership, magic happens!

If you don’t already follow him on Instagram, you will now. You can find him @Dr_Miguel_ Ortiz. I am not a dentist; but, gosh, do I love his posts, pics, funny sense of humor and dental lit. This is one of my all-time favorite cover stories. We thank them for sharing! Please enjoy.

Not only will you learn about Colleen and Miguel, you will also get great insight from Lynne Leggett on coaching your teams. Mary Fisher-Day is an expert at finding the right associateship or practice to buy and the importance of partnering. You’ll see why you need to own your own practice in the first place, from the always practical and guiding Dr. Gene Heller.

Plus, there is a great deal of sound advice on pitfalls, communication and leadership from our esteemed authors.

As always, the amazing Dr. David Rice will leave you with some inspiration to carry on and continue to soar. He is the perfect example of what happens when you travel the country to meet face-to-face, learning and connecting with this incredible profession.

Send materials to:

Dental Entrepreneur Magazine 8334 Pineville Matthews Road Ste. 103-201 Charlotte, NC 28226 When you have finished enjoying this magazine pass it along to a friend and PLEASE RECYCLE Copyright 2019 Dental Entrepreneur, Charlotte, NC Material herein may not be reproduced, copied or reprinted without prior written consent of the publisher.

Acceptance of advertising does not imply endorsement by the publisher.

4 Fall 2019 Dental Entrepreneur

Anne M. Duffy Publisher

DentalEntrepreneur.com

Contents PROLOGUE

6 My Story is Her Story Dr. Miguel A. Ortiz

10 Weighing in With Dr. Luke Shapiro Dr. Lucas Shapiro

GETTING STARTED 12 Mindset of a Coach Lynne Leggett

16 Buying a Dental Practice: How One Decision Saved My A** and Likely, My Career Dr. Rebekkah Merrell

18 How a Qualified Transition Advisor Will Give You Peace of Mind and Save You Money Mary Fisher-Day

BUSINESS FUNDAMENTALS

24 Three Career Potholes You Want to Avoid Dr. Roger P. Levin

26 How to Become a Ninja in Motivating Your Patients to Fork Over the Cash!

Andy Grover Cleveland

PRACTICE BUILDERS 30 Clear, Crisp Communication Creating a Positive and Productive Practice Dr. Robert M. Maguire

THE POWER TO SUCCEED 32 Breaking Your Four-Minute Mile Scott Livingston

36 The Dental Student Herd and the BIG Social Media Lie Dr. David Rice

20 The Big Picture When Considering Dental School Debt Dr. Gene Heller

DentalEntrepreneur.com

Dental Entrepreneur Fall 2019 5

Prologue

My Story is Her Story Dr. Miguel A. Ortiz

I

don’t have the same backstory as most of the friends I met in Harvard Dental School. I didn’t have an ivy league legacy to live up to or a trust fund to fall back on. I was never planning to become a dentist, much less an entrepreneur. Yet, here I am, doing both. I run a clinic and an ever-growing online platform that is revolutionizing dental education.

I grew up in a very humble neighborhood in Argentina during the turmoil of the 80s and 90s. Throughout high school I was a delivery boy for my family’s small store. I worked in construction, as a bartender, even became a pizza maker at the age of 17. Yup, I can throw that dough up and spin it around, too. When the economy of the country collapsed in 2001, I was forced to leave so I could find a way to help support the family. I was 18 years old.

I arrived in Los Angeles, USA, with $34 in my pocket and absolutely no English. I was a dreamer, in every sense of the word. I had all the cliché big dreams: a successful career, making my mark on the world, building a beautiful family…but I was alone in a strange culture, with no prospects. I was focused on paying the bills and fitting in, not creating my own business opportunities.

I’d always been a dedicated student, but this new life had a steep learning curve. Some of the lessons were painful, some were hilarious. For instance, straight men do not kiss each other in greeting as they do where I come from. “Wow, wow, wow, Bro - whatcha doing?” I got that a couple of times. I missed my family and my home, but I was determined to make a new one.

I found teachers along the way. I enrolled in LA City College and then found a job as a dental technician while I continued my studies. 6 am to 10 pm, every day. My professors and employers taught me, challenged me and put up with my tenacious personality. Looking back, that personality trait is one that has made all the difference. While my wonderful mentors guided me along the established path, they didn’t teach me how to start a company from nothing, or to transform an idea into a sustainable reality.

That I had to figure out on my own. I didn’t find my place in this new world. I made it.

Full-time work with full-time school is no picnic; add a beautiful wife and a couple babies into the mix and you’d better believe 6 Fall 2019 Dental Entrepreneur

that I had plenty of excuses to coast through life. But that’s not my style. I had opportunities that no one in my family had ever had. I was, and am still, determined to honor the sacrifice and support they gave me.

Many people think that what comes next is what made my success possible. After 8 years of working and studying, I was accepted into Harvard School of Dental Medicine. The level of educational excellence was amazing, yet more teachers to build me up...some of the most amazing minds in the field! I learned to embrace DentLit (dental literature) here. The only way we can learn and improve is to rely on rigorous scientific research, staying as up-to-date as possible. I also learned the meaning of sharing. Harvard has no grades. Yes, tests and classes are not graded! It’s strictly pass-or-fail, and if you fail you take the exam again. This creates an environment with zero competition among students. There’s no class ranking, we all share whatever resources we have. Sharing is truly caring, not just for your classmates, but ultimately for your patients.

It was a brilliant opportunity. But it’s no magic key. While I credit my alma mater with my success and expertise as a dentist, slapping Harvard grad on my resume didn’t open doors as an entrepreneur. That’s a whole different game, and I hadn’t learned how to play yet.

With my newly minted “DMD,” I continued to seek improvement, training to become a surgically trained prosthodontist. At this point, working, studying, and, with kids running around the house, I realized that the dreams I’d begun having, of sharing dental education all over the world, could only happen as part of a team. Lucky for me, I had the best teammate right next to me all along – my wife Colleen.

There I was, a perpetual student in my 30s, with absolutely no business training or know-how. Colleen (with master’s degrees in ethnomusicology and education), equally untutored as an entrepreneur, and I decided to do it our own way. How frustrating that our renowned schools provided us with all this knowledge but little in the way of practical know-how on establishing a business.

But we weren’t going to let that stop us! We started learning and making plans.

DentalEntrepreneur.com

I arrived in Los Angeles, USA, with $34 in my pocket and absolutely no English. I was a dreamer, in every sense of the word.

This is me bicycle racing at the age of 5 in Argentina

Our wedding in 2007

As a prosthodontist resident I found a unique outlet for my skills.

Years of experience as a dental technician translates into great lab work. A sideline job as a professional photographer results in quality photographs of that work. I started sharing this online, and people valued the effort. My following grew into the hundreds of thousands, and I started to feel a responsibility towards my colleagues. I talked to Colleen about it, and she refused to let me off the hook. “If you have a calling to help others,” she said, “not only should you do it, but I’m willing to help.”

I realized that the platform was becoming shallow. Pretty pictures and silly quotes. Making friends. Mocking enemies. I knew it could be a better place. We all know how pathetic Facebook is nowadays. Hate spills out of every corner. I could’ve gone along, choosing the easy success of pretty pictures and superficial influence. But I had a dream of Instagram as Facebook reinvented. I took a risk. I decided to share, educate and grow myself and others...refusing to buy likes, comments and followers, as well as not focusing on follower numbers, but content.

I graduated from the prosthodontics program with a booming social media presence, a ton of information to share with my colleagues and a vague idea of what that meant. Colleen and I were thrilled to move back to Boston with our three boys where I joined Brookline Dental Center, a group practice where Harvardtrained specialists aim to give patients the highest quality treatment. I love working with patients.

I wasn’t satisfied to post now and then. I needed to do more for my online community. Although we had no business training and no idea what we were doing in the beginning, we weren’t afraid to try. Both Colleen and I are researchers. I’m the risk taker and she’s the voice of reason. We had something unique to offer the industry, we just had to figure out how to make it sustainable.

My online hobby had evolved into an opportunity to support my colleagues by passing on the same learning that had been given to me. Still dedicated to my private practice, I decided that half of my career time would now be focused on educating others.

Colleen set aside her teaching plans and focused on our business

All the while, my social media presence continued to grow. More and more people were contacting me, asking questions...learning from and teaching me at the same time.

8 Fall 2019 Dental Entrepreneur

DentalEntrepreneur.com

We founded an organization called DentLit – dedicated to mutual learning and a reliance on the latest and best scientific research.

I dreamed of new ways to extend dental education to everyone, where scientific debate trumps opinion; an open-minded and democratic space to fight the allure of dogmatic stagnation; always learning, correcting ourselves, improving, and ultimately serving patients the quality of care they deserve.

DentLit also hosts “Let’s Talk Prosth,” a weekly discussion hosted on my IG page and then followed up with a free, curated list of relevant academic literature. It’s a quick, organized and enjoyable way to stay up-to-date. I draw most of my inspiration from questions and concerns that crop up in my own practice. I’m not a mountain top guru; I’m a fellow learner.

I was also able to publish a book earlier this year. It was a huge project to create this comprehensive guide for visual learners. “Lit: The Simple Protocol for Dental Photography in the Age of Social Media” blew pre-sale records out of the water for Quintessence Publishing USA. That success underlines the importance of relationship and reputation in our new economy. Sight unseen, yet my colleagues I learned early on that my “one-man show” was destined for fail- knew they could trust me to deliver. What a thrill to see it ship all ure. I could not build the responsive and interactive community over the world!

I wanted without help. I needed a structure. I needed a support team. I needed to outsource some of the work, while maintaining We have, just this month, added online courses to DentLit. Dental Photography and Impression Techniques are the first of many to control of the content myself. come. Online education is a convenient and easy way to learn, espeI designed a hands-on dental photography course and began cially in places where quality dental education is hard to find. Not to teaching it locally on weekends. Pretty soon I was travelling every mention, it’s a great way to earn those CE credits from the comfort other weekend all over the country, then North America, and of your own home. lately, around the world to run courses. Colleen and I quickly realized how crucial the organization was to success as we deliv- I’m not a status quo, rest-on-my-laurels kind of guy, so I’ve already ered 35 dental courses in over 25 cities worldwide. There are a mil- got new resources in the making. A new book, new courses to teach, lion details to consider: booking venues, hotels, flights and meals, new online content… living is about growth. creating a platform for registration and finances, dealing with CE certification, and, most importantly, carving out time for me Patient care will always be my first love (other than Colleen and to create the content my dental colleagues deserve. My brilliant my boys, of course). I think that being in the trenches with the rest and adaptable life partner became my rock as she took on the of my colleagues is one of the reasons I’ve been successful. The old business side of our new company, making sure everything runs saying has it backwards – those who CAN should teach. We owe it smoothly and my colleagues are treated respectfully. I began to to each other. collect talented people who had the skills I lacked. “Entrepreneur,” I’ve learned, is not synonymous with “lone wolf.”

Making this dream of mine a reality has been a thrill and SO much hard work, but most of all, it’s been a team effort. Starting with my I partnered with my dear friend Dr. Carlos de Carvalho to teach partner Colleen, who keeps me on track. We stumbled into our roles a two day hands-on course on adhesive rehabilitation and tooth as entrepreneurs, without even meaning to. If you ask me what it preparation. These are now sold-out a year in advance. I love means to be an entrepreneur, the answer is simple: follow that crazy meeting so many of my fellow professionals, working to make idea that you just can’t get out of your head, work hard to make it sure they have the best experience at the best venue (with the happen but don’t attempt to do it alone. Find your own team, your best food). We all work hard, and new skills make it possible to own “Colleen” and you’ll be alright. work smarter, too. I’m a practicing dentist, so I know how it is.

Maybe someday you, too, will be giving a cheesy pep talk in a DentLit has grown many arms over the past few years: literal arms magazine like this! in the people and partnerships that it’s built on and figurative arms as well – structures and systems that make it possible to grow. Dr. Miguel A. Ortiz It has become a huge undertaking. We have a central website at Prosthodontist & CEO of The DentLit Academy, the hub of the learning center. We offer some of the products for Instagram: @dr_miguel_ortiz https://dentlit.com/ sale that I use and love. We offer new courses every month.

Let it never be said that I think small. I love to be busy, and it’s easier to get the results I want when I do it all myself. I wouldn’t call myself a control freak, but others certainly have (ahem…

Colleen).

DentalEntrepreneur.com

Dental Entrepreneur Fall 2019 9

Prologue

Weighing in With Dr. Luke Shapiro Dr. Lucas Shapiro

C

an you imagine a dental office with no front desk or office manager? Have you ever double trained your hygienist to be an assistant? What about triple trained your hygienist to also work the front desk? Listening to Dr. Courtney Lavigne talk about her office at first seems crazy, almost radical. But the way in which she nonchalantly talks about this set up, it quickly begins to make sense. Listening to her, my opinion changes from “How does she operate her office like this?” to “Why are there not more dentists who practice like this?”

I met Dr. Lavigne at a lecture for the Tufts Aesthetics Dental Society. She is a talented lecturer with the ability to explain complex topics in an easy manner. I approached Dr. Lavigne after the lecture, and we quickly hit it off. Dr. Lavigne grew up in North Kingstown, Rhode Island. She has two older sisters – ten and twelve years older. Her dad was a carpenter and her mom is a nurse – the perfect combination to raise a budding dentist.

She did a lot of finished carpentry with her father, teaching her to be detail oriented while her mother passed on the desire to help people. Originally, she wanted to be a facial reconstructive surgeon but soon realized that she would be almost forty before finishing her residency and would have a lot of debt and a crazy work schedule.

Dr. Lavigne started her practice from scratch about four years after finishing dental school at UConn. She did not buy an existing practice and had to do the entire build out of the office. For the first 4 months of practice, she worked as an associate at another office but quickly built up a stable patient base using Facebook and friends of friends.

At the beginning she had an office manager, but one day the office manager broke her leg and that led to a lot of questions: For how long would the office manager be out? How long would it take to train a temp or advertise for one? So, Dr. Lavigne trained the assistants and hygienists to schedule, which they picked up quickly because they knew how much time was needed for each procedure. The hygienists then started to collect payments in the 10 Fall 2019 Dental Entrepreneur

chairs. The hygienists were also trained as assistants, so Dr. Lavigne could do a small filling or a crown insert in a hygiene chair.

This was a huge benefit to the patients because in a fee-for-service practice, time is just as important as money.

Do you think this model could be the future of dental practices?

Dr. Lavigne thinks so. It helps cut down on costs, keeps the staff busy and increases efficiency in the office. Only time will tell.

Luke Shapiro received his undergraduate degree from Washington University in St. Louis with a major in Spanish. He then went to dental school at Stony Brook and graduated in May 2018. He is now an orthodontics resident at Tufts in Boston.

In dental school, Luke did research, focusing on 3D imaging, with his most recent project on the application of iPad 3d imaging technology. He was also very involved in the aesthetics club and ASDA. Luke is the leader of the dental student section of IgniteDDS. He is also the founder of @futuredentists @courtneylavignedmd courtneylavigne.com DentalEntrepreneur.com

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Getting Started

Mindset of a Coach Lynne Leggett

“M

indset” is a word that is thrown around a lot. Many people mistake it as another word for “attitude.”

This is key: Mindset is NOT the same thing as

attitude.

Attitude changes with emotion and environment, whereas mindset is intentional. It doesn’t just happen. It requires hard work and focus every single day. It’s essential if a doctor, as the head coach, is going to be successful.

Most people don’t realize there are two different types of mindsets: growth and fixed.

A growth mindset can be described as someone who wants to learn. This is a team member with an open heart. This team member is coachable.

A fixed-mindset individual doesn’t want to learn anything new… and they won’t. They’ll dig in their heels or quit. You can’t coach somebody in a fixed mindset.

A Great Coach Encourages Success The best coaches and leaders, in the dental world or the sports world, look for opportunities for their team members to succeed.

It gives you an opportunity to give praise and recognition as well as encouragement to the team.

Let me explain this in a little more detail. Every day on your dental team, instead of looking at what somebody has done wrong, look to see what they’ve done that’s good and positive.

If you focus on that, it will bring joy back to the practice and give you something positive on which to focus. Most times in your practice, doctor, you’re wearing two hats: owner and clinician both of those roles are full-time jobs. It’s difficult at times to step away from the role of looking for problems to solve and take time to encourage and uplift.

Appreciation is a Gift that Keeps on Giving

You don’t want anybody with a fixed mindset on your team, or your team will lose. It’s as simple as that!

When you see an assistant who does something as simple as holding suction the way you want, be able to say, “I appreciate the way that you worked with Mrs. Jones and me.” That compliment will make your team member glow!

As the coach, you must be intentional about what you want for your team. The correct mindset is a key component of your practice culture. As the coach, you get to control any allowance of toxic behavior such as complaining or gossiping.

It’s a game-changer when you create an environment where it’s common to hear something positive coming from the doctor. Try to say something positive about everyone in the practice. You may think it’s minor, but your team members won’t.

If you want opportunity and a positive construct, you must keep a growth mindset in your practice.

You are the leader; when you start thinking about your practice and team members from a positive standpoint, everybody else will begin looking for those positive aspects as well.

You must take the time to know your team and their personalities because you’ve got to be the one to communicate with them.

You’ve got to understand what makes them tick. When the coach expresses faith in a team member’s skill, it will automatically improve their mood, their motivation and their opportunity for success.

12 Fall 2019 Dental Entrepreneur

I’ve taught this technique for many years. In all that time, I’ve never had a doctor tell me this wasn’t a game-changer in their personal life as well.

Can you imagine getting back home after a hard day at the office and looking for something positive done by your spouse and your DentalEntrepreneur.com

children? Instead of coming home and complaining because somebody didn’t unload the dishwasher or another chore they missed, see something positive and focus on it.

The negative will take care of itself; I promise you.

Owning a business can be tough. If you can always focus on the positive, it will make you a happier person. That’s one of the other goals I have for you, doctor: to be a happier person and to have joy back in your life.

do the right thing, it will snowball in a good way. Take the time to focus on being the encourager and the coach.

Have you ever been around other dentists when they are working?

Have you noticed that most dentists don’t say “thank you”?

Most doctors think, “Well, I hired you for this job, so why aren’t you doing your job?” There must be open communication. If you want to keep your team together and happy, from a leadership standpoint, you want to point out good things when people do them, and, by all means, thank people.

The Happier, the Better Let’s stay on the topic of happiness. The happier you are with a positive construct in your business, the more grateful you will be for all the positive things that may happen in your day, large and small. Having a positive outlook encourages clarity: you can see the silver lining in the storm clouds.

As the coach, I want you to have tremendous clarity for your team.

You should be able to understand and define the roles and responsibilities in your practice.

Do you know what you want to accomplish? Do you have everything you want to accomplish written down?

Stay Focused If dentists have the mindset of being thankful when team members DentalEntrepreneur.com

As a basketball coach, it’s easier to see improvement if I know that somebody’s working on something because I can see a player improve right in front of my eyes.

A dentist knows when one of their assistants has improved after listening to their suggestions. Even a slight change of an angle or how they’re helping hold instruments or suction makes a huge difference.

Focus on the change. Even a slight change in the visual field of the dentist looking down at the patient is a total game-changer.

If you don’t have to move when focusing on something as small as a tooth, the angle at which an assistant holds an instrument can make a massive difference to the complexity of a case for you.

Thank your assistant and say, “I appreciate your moving that,” or “Even before I asked, you knew what I needed by looking at me.

Dental Entrepreneur Fall 2019 13

We were on the same wavelength today; that was awesome.” The gratitude to say, “Thank you; that’s what I was looking for,” makes the environment so much happier for everybody.

The happier you make the environment, the easier and more enjoyable it will be for your team to say, “I love working here. I love taking care of Doctor Smith’s patients.”

Gratitude is Good for Everyone Every practice has departmental teams within the dental practice team. I want to talk more about the administrative team’s duties in your business.

From an administrative team’s standpoint, the phone rings all day long. It’s more important for the scheduling coordinator to put the appointment in the correct slot than it is to fill a vacant slot.

The administrative team needs to understand the work required by the clinical team and the time it takes to complete their tasks.

Many problems can be avoided by the administrative team’s filling in the correct slots.

Every doctor is different, even in the same practice, and will have different preferences on how they like their schedule to flow. A new scheduling coordinator needs to understand both the general rules of scheduling for each doctor as well as the exceptions to the rules (such as emergencies). The assistants should work with the scheduler to ensure that patients are scheduled correctly according to the doctor’s preferences.

Let’s say the administrative team used their knowledge of how the doctor likes to work and how the team works in the back, and thus scheduled an emergency where it needed to be, so it flowed perfectly for the clinical team.

That will make for a much better experience at work. If people aren’t on top of each other and running around like crazy, trying to make sure they’ve taken care of all the patients, the whole clinical team (not just the doctor) will appreciate that thoughtfulness.

Every person on your team will feel they are a truly valued member.

So, doctor, you’ve got your administrative and your clinical teams complete with a growth mindset. Praising both teams will be crucial to your success as a coach.

As the Founder & CEO of Victory Dental Management, Lynne has over 25 years of business experience in several different industries dentistry, medical, pharmacy, sales, transportation, logistics and project management. As a seasoned basketball coach, Lynne loves to help and encourage others.

Her passion is to help dental practices reach their full potential and increase their productivity and profitability while enabling them to deliver the best patient care and customer experience.

Lynne is also a coach, consultant, speaker and author. She is a member of the Academy of Dental Management Consultants, Speaking Consulting Network, AADOM Speaker Consultant Alliance and a lifetime member and Fellow of AADOM. She frequently contributes articles for Dental Products Report.com, DentistryIQ.com, DeW Life (Dental entrepreneur Woman), Dental Entrepreneur magazine, multiple state association newsletters, SWYP Dental, The Observer and Trojan Today. She has created online CE courses and published her first book “You Can’t Coach Quit” in 2019.

Here is the link to order my book -just published today on Amazon! https://youcantcoachquit.com/ Instagram @bballcoach12 Facebook @VictoryDentalManagement

For example, the doctor, as the head coach, can say, “Thank you. I know you had other open spots in the schedule where you could have put this patient, but you chose correctly and helped us out by choosing that appointment slot.”

Twitter @LynneLeggett12

Something as simple as that will have a calming effect. The coach and leader’s verbally expressing that will make everybody happy.

When you can communicate with your teams and openly give them praise and encouragement, you will be surprised at how the environment changes for the better.

14 Fall 2019 Dental Entrepreneur

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Practice Makes Perfect “Dr. Earl Douglas and the staff at ADS South have been real helpful in steering me in the right direction in the purchase of my first practice. Dr. Douglas’s experience, organization and detail-orientation, pointed out to me where improvement is needed and how to go about achieving it.”

Elizabeth H. Guerrero, DDS Get off to the perfect start. Call your ADS transition specialist for AL, GA, LA, MS, NC, SC, TN and VA today.

ADS South (770) 664-1982 ADSsouth.com DentalEntrepreneur.com

Dental Entrepreneur Fall 2019 15

Getting Started

Buying a Dental Practice: How One Decision Saved My A** and Likely, My Career Dr. Rebekkah Merrell

I

graduated from dental school, so I’m smart, right?

A few years after finishing my residency, I decided I wanted to own my own practice. I was trapped working for a corporate practice that made me hate going to work everyday.

I was itching for a change and fast.

I began looking for practices to purchase in my ideal location. I would see a practice come on the market, and by the time I heard back from the listing agent, the practice would be under contract.

I was frustrated and desperate.

After multiple requests for practice information, listing agents and sales reps realized I was actively looking for a practice and began providing leads for practices coming on the market. I would look at a practice. I would review a practice prospectus with all the amazing highlighted aspects of the practice and be told what I wanted to hear. Yet, many of the practices I looked at had red flags even I could see. I was even more afraid of what I didn’t know.

By the time I was ready to make an offer on a practice, it slipped through my fingers, and I became more desperate. I wanted out of my job.

I found what I thought would be a great fit, and I wanted to move forward. I did the smartest thing I have ever done: I hired a buyer’s consultant, “aka” a transition advisor. My transition advisor saved me from making this biggest mistake ever on different practices on multiple occasions.

16 Fall 2019 Dental Entrepreneur

On each occasion, I liked the location of the practice, the pretty décor and what the practice numbers appeared to be. I almost made a million-dollar mistake not once, but on three different occasions.

Dental school taught me to be a good dentist; it did not teach me how to buy or own a dental practice. The smartest thing I ever did was find a trustworthy advisor who had my back in addition to a dental-specific attorney and accountant.

The practice owner pays the listing agent or broker. While they are also supposed to help the buyer, they directly benefit from selling you the practice. They don’t have to point out the not-sopretty details of the profit and loss statement to you or explain the prospectus. It is your responsibility to make a wise choice on purchasing a practice. Without a transition advisor, I would be up a creek without a paddle. I cannot stress enough how important it is to protect yourself as the buyer - not just with a good lawyer and accountant but with a transition advisor who can tell you the good, the bad and the ugly.

While going through my search for a practice, I came across a horror story about a dentist who was purchasing her first practice. She purchased a high-end general practice. After opening the doors, she discovered the seller’s many skeletons: the fabricated procedure codes fraudulently used to make the dental practice appear to be a high-end practice. Patients received unnecessary treatment, and there was no disclosure to the purchaser of the fact that the patient base included a managed care contract.

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The purchaser was compelled to hire an attorney and take the seller to court “seeking rescission of the purchase agreement and monetary damages.” Every penny paid for goodwill went up in flames. All of this was due to her failure to do her due diligence.

She won the case, but the practice is now worth less than what she paid for it as patients left the practice because they lost all trust in the dentists. Moral of the story: do your homework and find someone who has your back.

Want to stop yourself from making a mistake that will affect the rest of your life? Hire a transition advisor! The few thousand dollars you spend on the front end will pay off big in the end.

Dr. Rebekkah Merrell received her undergraduate and master’s degree in bioengineering from Clemson University and the Medical University of SC, respectively. She then went on to obtain a dental degree from the University of Pennsylvania School of Dental Medicine. She then completed a general practice residency at Carolinas Healthcare System. She practiced dentistry in the Charlotte area for a few years prior to purchasing her own dental office in Asheville, NC - where she and her two dogs are extremely happy to work and call home!

I’ve since found the practice of my dreams and successfully closed on it a few weeks ago.

Please meet the advisor who saved my bacon. Her name is Mary Fisher-Day. (Continued in the next article How a Qualified Transition Advisor Will Give You Peace of Mind and Save You Money)

DentalEntrepreneur.com

Dental Entrepreneur Fall 2019 17

Getting Started

How a Qualified Transition Advisor Will Give You Peace of Mind and Save You Money Mary Fisher-Day

(Continued from prior article Buying a Dental Practice: How One Decision Saved My A** and Likely, My Career)

A

s a dentist, it’s one of the most important decisions you will make in your career, yet most will not have a transition advisor when buying a dental practice. I get it; you’re paying an attorney and a CPA and feel they have you covered. They will certainly provide you with legal and accounting advice and you may be advised as to reports you should review.

How will you know whether the reports are accurate? There’s no way to know for sure unless you have a well-qualified transition advisor represent you.

Most selling dentists assume the practice management reports speak for themselves. The fact is, the more PPOs or managed care accepted, the more likely the production to collection percentages are inaccurate. Many practices with a large PPO or managed care patient base bill at the PPO fee, rather than the practice’s normal fee schedule. Chances are, the practice owner doesn’t truly know how the data is entered and under what parameters. It’s easy to understand how they would take their numbers at face value.

An example: Dr. Smith’s year-end report shows production was $960,000.00 and collections were $949,000.00. This puts their collection to production percentage at 99%. Looks great!

In looking further, I note that the practice participates in 5 PPO plans and immediately realize that something is off. The average PPO adjustment is over 30%. This practice participates in 5 PPO plans, so there’s no way they’re truly collecting 99% of what they’ve 18 Fall 2019 Dental Entrepreneur

produced. Unless…they are billing patients via the insurance plan’s fee schedule, rather than the practice’s fee schedule.

There are multiple problems with billing insurance and your patient based on an insurance company’s reimbursement rates.

This is one that most don’t realize: Unless an insurance company is billed at your normal fee schedule, the practice will not receive a raise in reimbursement rates unless you hire a PPO fee negotiator.

Why would an insurance company pay you more than the fee you billed? They won’t In this case, it does no good to review the normal practice fee schedule when trying to determine the potential of the practice and what the production to collection percentage really is. A purchaser will need to review the practice fee schedule in addition to each participating PPO fee schedule. Keep in mind that if the seller is a premier provider for Delta, they are likely compensated at a higher rate than you will be. Check your state plan.

You may wonder why the true production numbers matter. These numbers matter because you incur a majority of your expenses based on your production. You can’t produce without employees, equipment, supplies, lab fees, electricity, etc. You need to know the true production numbers.

Other important considerations for an advisor: You need someone who not only knows what reports and documents need to be reviewed but also where and how to find them.

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Your advisor should have a great understanding of the practice’s cash flow, and an understanding of the profit and loss report is essential.

Know your lenders. There are options out there. I am a fan of dental-specific lending institutions as they typically make the loan process less daunting and loan 100% of the sales price plus working capital. It’s a good idea to obtain pre-approval for a loan.

You need an advisor who can help you stand your ground on the practice A/R. If you don’t want to pay an employee to collect the seller’s A/R after the transition, you can make an offer to purchase the A/R. There’s a simple formula to which most buyers and sellers gladly agree.

Other issues that require advice following the acceptance of an offer: 1. What to do about work in progress 2. How are remakes handled?

3. Lease or real estate purchase negotiations 4. Proration of employee benefits 5. Credits on patient accounts 6. Letter to patients announcing new ownership

In summary, hire someone who understands the ins and outs of a dental practice transition. Every practice is different. No two teams are the same. It’s unlikely that two philosophies will be the same. There will always be variables. Having a personal transition advisor will give you a huge advantage.

Regardless of how you transition into or out of dentistry, surrounding yourself with people of integrity is a decision you won’t regret.

Mary Fisher-Day, Transition Advisor at JPA Transitions, has served the dental industry for more than thirty years. She is an author, educator, transition advisor, and coach.

Mary is the founder of The Dental Business®, Bites and Business, and Legacy Dental Coach and author of “The Dental Business; a Blueprint for Success.”

Mary launched Legacy Dental Coach after realizing that, whether buying or selling a dental practice, most dentists are under-prepared and under-represented when making the most important decision of their career. She has witnessed how a lack of preparation and representation can be devastating on either end of a practice transition.

As a personal transition advisor, Mary helps young dentists successfully navigate the purchase of a dental practice and assists dental practice owners in the planning, preparation and transition of their practice.

7. How and when to tell the team about the practice sale What I’ve listed above are just a few of the things with which an advisor will help you during a transition, and these are just a few of the decisions you will make during the transitions process.

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Through her years of practice management and transition consulting, Mary has gained the experience and knowledge dentists need to have peace of mind before and during their transition.

Dental Entrepreneur Fall 2019 19

Business Fundamentals

The Big Picture When Considering Dental School Debt Dr. Gene Heller

T

he key to maximizing your investment in your dental education can best be achieved as a practice owner.

And while this is often what dental students start out having as their ultimate goal, the amount of dental school debt they are carrying when they graduate often leaves them with the impression that they cannot become practice owners or get financing to start or buy a practice. But this is not true.

The Big Picture and Dental School Debt

The Myths

1.

• Dental school debt makes it impossible: • To become a practice owner; • To obtain the financing required to become an owner; • To learn the skills required to own, operate and manage a dental practice; and • To succeed as an entrepreneur in dentistry.

The Facts • The cost of dental education is high.

• Many graduating dentists have school debt in excess of $300,000 (or even $500,000).

• Dental school debt is manageable.

• Practice owners, over the course of their career, earn two to three times as much as associates.

• Even with large amounts of student debt, young dentists can qualify for financing to buy or start-up a practice, if they manage their other debt properly.

• The real problem comes if they try to support a lifestyle that exceeds their income.

• Money is available to finance practice ownership.

20 Fall 2019 Dental Entrepreneur

Looking only at the large amount of school debt incurred, you miss the big picture. College and dental school debt, when compared to the value of what will be obtained in return, is relatively small.

Consider the “Big Picture” of a dental career: Depending on how well you manage the benefits of that dental education and maximize its economic benefits, the school debt allows you to earn 3 to 10+ times more income over your lifetime than the average high school graduate.

2. Your education puts you in a unique position of either becoming your own small business owner/entrepreneur (whose health care product will always be needed, regardless of the economy) or having an employment opportunity with significant income potential.

3.

As a practice owner you will earn, including your practice equity, two to three times as much usable income as you can as an associate working for another practice owner.

4. The “Big Picture” is the income that a dental school education provides, whether as a dental associate or a practice owner. The imperfection is the debt associated with getting there. That is not to say that the debt levels are insignificant, but when viewed in light of the “Big Picture,” which is a dentist’s income over their career, they are relatively small.

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Consider the following very simple cost-to-benefit explanation of various educational alternatives: Current average high school graduate income (unadjusted for inflation) Current average dentist associate income (unadjusted for inflation)

Minus 8 years of lost income @ $30k per year Minus $400,000 school debt @ 6% amortized over 20 years Minus total combined cost of lost income and dental school debt Equals net taxable income/benefit from dental education as an associate

$40,000 times 40 years = $1,600,000 $150,000 times 30 years = $4,500,000 $240,000 $680,000 – $920,000 $3,580,000

Current average dentist practice owner income Minus total combined cost of lost income and dental school debt Equals net taxable income/benefit from dental education as a practice owner

$280,000 times 30 years = $8,400,000 – $920,000 $7,480,000

After high school, many people go on to higher levels of education to increase their earning potential. According to the Social Security Administration’s Office of Retirement Policy, the current average high school graduate earns $1.54M over their working years, and the average college graduate earns $2.43M. Compare this to the average general dentist associate who earns $4.5M ($150,000/year), and the average practice owner who earn $8.4M ($280,000/year) plus equity. I recently completed a practice valuation for an endodontist with a taxable income of $800,000+, and among the specialties, this is not unusual.

As the calculations illustrate, based on today’s average general dentist owner taxable income, the net benefit of the dental education, after deducting the cost of that education and the lost income while obtaining your DDS/DMD, is still 2.2 to 4.7 times that of a high school graduate. This 2.2 to 4.7 multiple is despite the higher than ever dental school related debt levels. The Big Picture: the net cost of your dental education, when compared to the overall income potential, is still actually relatively small and is a more than a worthwhile investment.

Conclusion If a dental school student or young dentist wants to maximize their educational investment, practice ownership is still the better choice. Granted, ownership is more work than just punching the clock as an associate, but the rewards are significantly higher.

And having student loans, even large amounts of student loans in and of themselves, will not prevent a dentist from obtaining the financing they need to become a practice owner.

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Associateships are a great place to start a dental career. They provide an opportunity for a young dentist to hone their clinical skills, and if working in a private practice for a willing dentist, to learn the business of dentistry from the owner.

But unless the owner also offers future ownership or a partnership, the “associate” practice should be just that, a first step toward eventual practice ownership. Dental practice ownership has a track record of being the safest business to invest in today and for the foreseeable future. Lenders recognize this minimal risk, which is why new dentists, seeking to start practices or acquire an existing practice, were the only businesses banks were lending to during the last recession.

Practice ownership will still give you the best and greatest rate of return on your dental school educational investment and also help pay off educational debt quickly. The amount of educational debt will typically not prevent a dentist from becoming a practice owner; only a poor credit history and credit score will do that. Until you are a practice owner, control your spending, pay your bills on time and protect your credit score. While the large amount of educational debt is acceptable, taking on other discretionary debt (e.g., credit card debt, large auto loans or leases) are not.

Most new graduates will not give a second thought to taking out an additional loan of $300,000-$500,000 to buy a home after graduation. This 20-30 year investment is a good investment but, aside from appreciation, provides no income. Today’s practice owners average $280,000 in taxable income plus their equity Dental Entrepreneur Fall 2019 21

build-up. It is estimated that 50% of graduate practice owners with 10 years of experience are seeing taxable income in the $300,000-$700,000 range. Now that’s the “Big Picture.”

For more information on securing practice ownership, visit: https://dentalpracticetransitions.henryschein.com/ For more information or assistance in securing a general dental associate position, visit: https://www.dentalopportunities.com/ Cost of Dental Education

Dr. Eugene Heller has led Henry Schein Professional Practice Transitions since its inception. A graduate of Marquette University’s School of Dentistry, his prior academic background included accounting and tax consulting for small businesses.

Prior to joining Henry Schein, Dr. Heller owned and ran his own practice, where he developed an extensive background in practice management. He has consulted on hundreds of practice transitions involving the sale of practices and the formation of partnerships, group practices and office sharing arrangements, in addition to conducting appraisals for many of these transitions.

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Business Fundamentals

Three Career Potholes You Want to Avoid Dr. Roger P. Levin

I

n the face of rising competition, dentists are making decisions that at one time would have spurred growth but today can often lead to failure. Avoid these three potholes on your path to practice success:

Pothole #1: Over-building the New Office When a dentist decides to move offices, they often take on more space as they start to consider adding associates or even buying a building that doubles as rental property. While these options can be successful, they can also lead to failure. When a new office is built or purchased, a large capital contribution is made. If the dentist finds that the new office isn’t growing as quickly as anticipated, or the practice experiences a decline, the dentist will not see a return on all the associated expenses that come with owning a larger, higher tech facility. Whether it’s a good idea to build a bigger office should be grounded in strategic planning. However, just as in everything else in life, there are no guarantees.

decisions never get made. One common example of this is a senior partner who is hesitant to invest in improving the practice because of their impending retirement, while a younger partner is ready to go all in.

Unfortunately there are no easy solutions for this scenario, and there is often no compromise; thus no decision is made. Younger partners will often wait for senior partners to retire so that they can make the necessary changes to move forward. Unfortunately, sometimes this comes after the practice has been hurt by the indecisiveness. All partners must be taught and reminded to think of the practice first before they think of themselves.

Summary If you are in, or have experience with, one of these potholes, bouncing back is not difficult as long as there is an awareness of what is happening. Watch for these potential problems in your practice, and don’t wait to act.

Pothole #2: Relying on the Anti-Change Office Manager There are many dedicated and motivated office managers. However. there are also many office managers who are resistant to change and want to hold onto their positions, keeping the rest of the staff at a certain level so that they won’t be challenged. When this happens growth will be reduced, and status quo will set in. According to the Levin Group Data Center, approximately 96% of dental office managers have no management background. It is imperative that office managers have access to training and education and are motivated to continually improve their own performance. The key is to use training to help develop the office manager skill set, continually add to that skill set and measure performance using quantitative statistics to objectively determine performance.

ROGER P. LEVIN, DDS is a thirdgeneration general dentist and the Founder and CEO of Levin Group, Inc., a dental management consulting firm that has worked with over 26,000 dentists. Dr. Levin, an internationally-known dental practice management speaker has written 65 books and over 4,300 articles. He is also the Executive Founder of Dental Business Study Clubs – Dentistry’s only All-Business Study Clubs, the next generation of dental business education. www.dbsclubs.com

Pothole #3: Indecisive Partners When partners focus more on their individual self-interests, many 24 Fall 2019 Dental Entrepreneur

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Business Fundamentals

How to Become a Ninja in Motivating Your Patients to Fork Over the Cash!

Andy Grover Cleveland

L

et’s get one thing straight: almost every dental practice in America has accounts receivable over 60-90 days... you are not alone!

Being owed money is a fact of life. Such as plaque and tooth decay, you can do a lot to reduce it; but it’s always present, and the key is to effectively minimize it.

in various softwares. Some charge hourly or, more commonly, a percentage of collections. I have invested significant time and resources vetting and developing relationships with these companies so that I can confidently connect you. Regardless if you choose to outsource or keep it in house, the patients’ portion is contingent on this being done efficiently.

Patients Have Less Money to Go Around.

Dentists currently have unprecedented financial pressures due to increasing practice acquisition costs, human capital, equipment and operational expenses. Everyone is struggling to produce more, while making less in an increasingly competitive environment. Simply put, dentists are more than ever actively looking for solutions to improve their profitability and efficiency of their businesses.

If you are frustrated with patients that owe you money, if you feel like you are working hard and not earning enough or if you are evaluating your best billing practices, this article is for you!

Once your patient has obtained their primary objectives...their smile looks fantastic, they are out of pain, the tooth is gone, etc., what is their motivation to pay? Surely if your patient is a moral person and they have sufficient financial resources, they understand that a contract exists. You provided a service, and they are obligated to pay you for it. However, this is not the current state of many living in the U.S. According to https://www.cnbc. com/2018/01/18/few-americans-have-enough-savings-to-cover-a1000-emergency.html only 39% of Americans have $1,000 in savings to cover an emergency. You must make it easy for the patient to pay you: being empathetic and creative is key!

Managing Insurance Is Difficult and Time Consuming.

Life Happens, You Must Become a Priority.

Insurance has become a game of cat and mouse with stagnant reimbursements that often don’t budge for years: https://www. beckersdental.com/benchmarking/34177-reimbursement-ratesto-drop-2-7-for-dentists-5-stats.html . There are an infinite number of plans, varying deductibles, co-insurance and out-of-pocket maximums. Managing this part of the practice is downright exhausting and why shifting to outsourcing to a virtual team of insurance billers is worthy of consideration. I have found there is no one-size-fits-all; they have different options and are proficient 26 Fall 2019 Dental Entrepreneur

Job loss, divorce, medical problems, holidays, death, vacation, car troubles...it’s inevitable for all of us. As soon as your patient walks out the door, there is a noisy world of choices, decision making and consequences that take precedence. I would argue that your biggest competitor to getting paid is the chaos of human existence. To make matters more difficult, being turned over to a collection agency is not that big of a deal. As many as one in three is already in collections with other vendors https://money.

DentalEntrepreneur.com

I would argue that your biggest competitor to getting paid is the chaos of human existence. cnn.com/2014/07/29/pf/debt-collections/index.html Since there are very few natural consequences after the patient has been seen, you must create them artificially. You can attempt doing this yourself or consider hiring a company like mine to take the heat off of you. The key is to encourage the patient to not only pay but come back into the office for further treatment, not creating drama and negative reviews.

People attend to core needs, and you are not on the top of the list.

munication and people skills? Or are they weighed down by their own financial problems, lacking confidence, mean or simply choose to not have candid conversations with your patients? Having the wrong person can drive your patients away and ensure you don’t get paid. Make sure you set up proper expectations and give feedback on their performance. Do they get rewarded for successful collection, or are they simply trading their time for a paycheck? Do they know what is expected of them? Watching what happens at the front will surely help you identify opportunities for improvement.

Need proof? Look at how many people have temporary crowns and never come back for the permanent to be seated. Check out your patients’ Facebook pages and see the last vacation, new car, iPhone or manicure they have received yet they still have not paid you! Very often what people say and do are entirely different. A great refresher is to go back to your Psychology 101 course, and check out Maslow’s hierarchy of needs. https://en.wikipedia.org/ wiki/Maslow%27s_hierarchy_of_needs Continue to strive to be a priority on their list of financial obligations! It is my opinion that with the increasing evidence on the oral systemic link, the dental profession is crucial in maintaining health similar to a primary care physician!

Are you the weak link?

Are you asking for the money?

We know you have an interest (or you would not be reading this article), but do you exemplify the leadership traits necessary to run a high-performing office? Do you see your front office team as simply worker bees or do you empower them to live up to their potential? Do they have skin in the game? Having candid conversations about your A/R, where it currently is and where you want it to be and appreciating and rewarding people are a great start. Spend some time introspecting; it is a painful exercise but crucial to your progess.

It’s very simple but often not done properly. Have you listened to what is going on in the front? When it comes to money, if you don’t ask, you don’t get; it’s as simple as that. Who wants to pay when they can delay? Almost all of us would rather pay later. We are not bad people but simply taking advantage of the opportunity. Make sure your team is asking politely, firmly with tact (even adding humor)...it is extremely effective. You wouldn’t go to the grocery store or gas up without paying. Why is the business of a dental office different? I will tell you why - because we make it so! One can dramatically boost your over-the-counter collections by simply asking! Persistence wears down resistance!

If you allow patients to undermine your staff by coming directly to you for sympathy on repayment, how does that make your team feel? Empowered or demoralized? Your front office may not tell you this, but I promise they will not only resent you but learned helplessness will occur. Why should they care more about your money than you? If employees don’t feel appreciated and valued, they will not perform and give that extra effort when it’s needed most.

Do you care enough?

I hope you enjoyed this article and that it has helped shed light on improving the profitability of your practice. If you just implement a couple of these key strategies, you will see a measurable improvement in your cash flow, and your operations will improve.

Do you have the correct team member at check-out?

Does this person have exceptional emotional intelligence, comDentalEntrepreneur.com

On a side note, even Ninjas do not get paid occasionally; don’t take it personally. Simply put, it’s the cost of doing business, and Dental Entrepreneur Fall 2019 27

running a dental practice has both risk and reward. For perspective, step back, and you will realize the patients that owe you are most likely a very small portion of the grander trajectory of your practice.

Should you wish to discuss these strategies further or need help with your insurance billing or patient collections, please reach out to me.

Andy Cleveland, “The Dental Accounts Receivable Ninja” has been in the revenue cycle space for almost 20 years and has served a variety of capacities. He started working with dental practices on the collections floor motivating difficult patients to pay on everything from hygiene visits to full mouth restorations.

Learning the business from the ground up, he developed a proficiency in recovering lost revenues and rose to the top of his field.

He realized his skill sets were better utilized working with clients, so he moved to the consulting and service side of the business where a greater impact could be made. Currently, he works with individual and group practices optimizing their patient accounts receivable process to ensure maximum profitability and patient retention. He has partnered with Tek Collect, the nation’s leading full-service billing and collections firm. You can check him out at www.DentalPracticeNinjas.com He recently was interviewed on DentalTown, is a member of The Academy Of Dental Management Consultants (The ADMC), AADOM and is a speaker and networker who enjoys specializing in the dental field.

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Dental Entrepreneur Fall 2019 29

Practice Builders

Clear, Crisp Communication Creating a Positive & Productive Practice Dr. Robert M. Maguire

C

lear, crisp communication is the window to creating a positive and productive dental practice. In short, you could say that, “The three C’s lead to the three P’s.” During my last lecture titled “The Economics of Great Communication,” I surveyed the audience and asked them, “What was the name of your most recent continuing education course?” Of the almost 100 in attendance, by far, clinical courses like cosmetic dentistry, implant dentistry or the latest innovations in dentistry were the most popular. Courses on practice management ranked second and included various topics like reducing broken appointments, collect what you produce or more efficient scheduling. To my surprise, not one of the participants had taken any courses on effective communication.

Why is it that very few dentists and their teams take courses on communication? One reason may be that only a few communication courses are offered at regional or state dental meetings. A second reason is that most dentists, being predominantly left-brained, analytical thinkers, prefer to take courses that focus on technique or the latest innovations. Lastly, and probably the primary reason, is that most dentists don’t see the need, the value or the benefits of courses on effective communication. Here are five reasons why clear, crisp communication will help you create a successful practice; one that is more fulfilling, more fun and more profitable.

1. When your verbal and written communication is clear, you will develop “clarity of purpose” and “clarity of your thinking.”

When you think more clearly, you will make better decisions, and you will relate better with others. You’ve heard the phrase, “hav30 Fall 2019 Dental Entrepreneur

ing a clear head.” Having clarity is like the sun appearing after the morning fog has lifted away. Here’s the reality...dentistry is a people business. When you communicate clearly, you will “connect” better with your team, your patients and yourself. How does this happen? First, clear communication helps you to effectively shape your thoughts and ideas. With this new awareness and intentionality, you will express yourself in a way that better motivates and encourages your team members. In regard to your patients, when you’re thinking more clearly, you can better come alongside your patients to help them “see what you’re seeing.”

When your patients truly understand their dental situation from a perspective that makes sense to them, they are more likely to accept your treatment recommendations. To phrase it another way, clarity of communication builds trust. Some specific steps you can take towards developing clarity within your dental practice include writing mission, vision and value statements along with outlining your office systems and protocols. I think you would agree that “When the windshield is clear, it’s easier to see the road in front of you.”

2. Whether it’s scheduling or dealing with broken appointments, workflow efficiency and timeliness will improve when the specific steps of your administrative and clinical procedures are clearly outlined and understood by everyone. Want to impress your patients? Always be on time for their appointments and always “inform before perform.” Your patients will start talking to their friends telling them, “This office is the best! They take the time to explain things to me, and they are always on time. I never have to wait!” When you do these things, you’ll set yourself DentalEntrepreneur.com

apart. Your patient seating area will be a “reception room” rather than a “waiting room.” Being a good communicator will become your best marketing tool.

3. Your productivity and profit will increase for two main reasons. The first reason is more obvious. With a clear sense of purpose and an outward focus on your patients, on your team and on your systems, you will work more efficiently and productively. A second and more powerful reason is that when clear, crisp communication becomes the most important part of your office culture, team members will feel heard because you’ve created a safe work environment for them. When people feel safe, their sense of self-worth, their creativity and their sense of belonging increases. A cohesiveness will result as your team enjoys being part of something greater than themselves. As a result, your overall practice production will improve as each team member is allowed to perform to the best of their ability. It is similar to the magic that occurs when a sports team has a winning season. As morale continues to increase, so will your profits. And with this increase in profits, you, the dentist, will be equipped to better meet the needs of your practice, your team, your patients and yourself. Joy, fulfillment, sense of purpose and financial success will become a self-perpetuating prophecy.

4. Your relationships with your team and your patients will improve with clear, crisp communication. Your team will work together better. Collaboration will replace competition. With effective systems on board, your practice will run more smoothly and become a fun place to work. Patients will notice the increase in joy and laughter. They themselves will feel more comfortable because of the contagious and positive energy emanating from the team. As the patients’ comfort levels increase, so will their level of confidence and trust in you and your team. And as a result, your patients will accept more of your treatment recommendations.

5. Your ability to make decisions and solve problems will dramatically improve when your mission, vision, values and your expectations are clearly expressed, shared and understood by everyone. Want to fire up your team? Seek their input, and tell them how much you appreciate them. Showing respect along with clearly communicating “the rules of the game” will create an environment that is authentic and real. Subsequently, your ability to work through conflict will improve as you shift your focus from playing “the blame game” to solving problems. Another huge benefit is that, at the end of your work day, you will have energy left for your family and friends.

find someone who is knowledgeable, one who can partner with you to help you and your team learn these new skills. Remember, dentistry is first and foremost a people business. Once you have a better understanding of the “people side” of your practice, the “financial side” will follow, proving once again that clear, crisp communication does in fact result in a more positive and productive practice.

Dr. Maguire is a Navy Veteran who received his DDS degree from Georgetown University School of Dentistry in 1984. He completed his Bachelor of Arts at the University of New Hampshire in 1980 and Master of Arts Degree in Strategic Communication and Leadership at Seton Hall University in 2009. He is a past president of the New Hampshire Dental Society, serving from 2014 to 2015. Dr. Maguire is a fellow in the International College of Dentists and the American College of Dentists. He is also a member of the American Dental Association, the New Hampshire Dental Society and the Speaking Consulting Network. In addition to these credentials, he is also a certified trainer for the DISC Personality Assessment Tool. Early in his career, Dr. Maguire became an avid student of both the Dawson Center and the Pankey Institute, completing all of their week-long continuums. It was the “Pankey Philosophy” that inspired him to continually develop his technical and communication skills.

For 28 years, Dr. Maguire had a fee-for-service solo private practice in Wolfeboro, NH. His practice thrived without the influence of PPOs or Premiere programs with set fees. He attributes his success to the deep relationships he made with his patients and team. Retiring financially secure at age 60, Dr. Maguire founded Dynamic Dental Communications where he now specializes in coaching and teaching dentists and their teams how to be effective communicators. “I want dentists and their teams to thrive rather than survive,” says Dr. Maguire. The ultimate goal is to help dentists and their teams experience more joy, more professional fulfillment and more financial success in their lives and in their practices. Robert M. Maguire, DDS www.dynamicdentalcomm.com contact@dynamicdentalcomm.com 603.759.2931his website at www.dynamicdentalcomm.com

In summary, if you want to transform your practice into a positive workplace and at the same time increase your practice production, become a better communicator. The first step is to have the courage to admit that you need help in this area. The second step is to DentalEntrepreneur.com

Dental Entrepreneur Fall 2019 31

Power to Succeed

Breaking Your FourMinute Mile

Reaching Your Dental Practice Goals, One Step at a Time Scott Livingston

3:59.4 Recognize that number?

How about this date?

May 6, 1954.

May 6, 1954 is the day on which 25-year-old English medical student Roger Bannister succeeded in overcoming what many thought was an impossible obstacle – the sub-four-minute mile.

Bannister ran the mile in 3:59.4 on a cool and cloudy spring day at Iffley Road Track in Oxford, England, with only a few thousand spectators present to witness history.

the four-minute mile. When that limit was broken, the others saw that they could do something they had previously thought impossible.”

Once Roger Bannister had broken through the four-minute barrier, Landy, who had previously run the mile in 4:01, believed he could now do the same because someone else had already done so.

Remarkably, since Bannister ran his sub-four-minute mile in 1954, more than a thousand runners have also run under four minutes, with the current world record, 3:43.13, being held by Moroccan Hicham El Guerrouj.

What’s Your Four-Minute Mile?

Prior to Bannister’s breakthrough, some had thought such a feat was physically impossible or perhaps even deadly. Many had made the attempt to run under four minutes, but until Bannister did it, none had succeeded.

Remarkably, just six weeks after Bannister broke the four-minute barrier, Australian John Landy also ran a sub-four-minute mile at a track meet in Finland – 3:58 to be exact – more than a full second faster than Bannister had run. How is this possible? How did two runners suddenly accomplish what some believed could never happen?

In a recent Harvard Business Review article about this historic accomplishment, Bill Taylor writes: “Was there a sudden growth spurt in human evolution? Was there a genetic engineering experiment that created a new race of super runners? No. What changed was the mental model. The runners of the past had been held back by a mindset that said they could not surpass 32 Fall 2019 Dental Entrepreneur

As a dental practice owner or team member, what’s your fourminutemile? What’s a performance goal you’ve set for your practice that you’ve not yet achieved? A certain number of new patients in a month? A percentage increase in production? An annual revenue achievement? What you are hoping to do but haven’t yet done is secondary in importance here. The fact that you have a goal, but haven’t yet accomplished it, is awesome!

Goals can be valuable markers of progress, but achieving a goal isn’t the sole measurement of success. Any incremental progress towards a goal is also significant and should be celebrated, no matter how “small” that progress might be.

The Method to the Madness There were actually three runners trying to be the first to break the four-minute-mile barrier: Bannister, Landy and an American by the name of Wes Santee. Sadly, Santee was the only one of the three never to achieve this goal. In a recent episode of the Art of DentalEntrepreneur.com

Manliness podcast, Neal Bascomb, author of the book “The Perfect Mile: Three Athletes, One Goal, and Less Than Four Minutes to Achieve It,” talked about how Bannister went about preparing to reach this “impossible” goal: At the same time Bannister was training to break the fourminute mile, he was also studying to become a doctor. He was interning at Saint Mary’s Hospital. He attended Oxford. He was achieving this excellence in medicine to become a neurologist while at the same time, trying to break this record. He had very little time to do that. He was training at lunchtime at best for only a half-hour daily by walking to the track near the hospital and putting in his time and then going back and seeing patients.

So, with his medical background, he got scientific with how to best approach breaking the four-minute mile and he researched.

He was testing VO2 max. He was testing lactic acid in his muscles. He had built this treadmill in the lab at school and he would put himself on that thing and hook himself up and run as fast as he could and then hop off and take blood samples and then do it again. Really trying to see from a scientific level what was possible, what was physiologically possible and how to push DentalEntrepreneur.com

himself to a higher level. He experimented on his friends, Chris Brasher and Chris Chataway and other people. He was running a scientific experiment in some ways on the four-minute mile.

Bannister…was racing time and time again to break four minutes. He took a much more measured approach to it and decided that if he was going to achieve this, he would have to pick a date, pick a time where he was at the absolute supreme level of his conditioning. Also, to do that race with pacers, with people, his friends, Chataway and Brasher, who were both runners, to in some ways push him along the track as pacers to bring him to the level where he could push past four minutes.

To say that better, Bannister took this as a team approach. He knew he couldn’t do it alone on the track by himself. He needed someone to chase after and to push himself. He organized this race on May 6th, 1954 in Iffley Road track at Oxford, a track that he knew very well, and his two pacers would go out before him and he would follow them around and then ultimately, leave them behind while finishing in under four minutes.

This is so instructive. Bannister didn’t just wander onto that Oxford track and start running. He prepared. He experimented.

Dental Entrepreneur Fall 2019 33

He made adjustments. He failed, again and again and again. Also, notably, he didn’t achieve this goal alone. His teammates were critical to his success and not just on the day of the race. They provided him with encouragement. They participated in his extensive testing efforts. They pushed him to try harder. All of this speaks to a process. A system. An incremental, measurable effort to progress from one place to another.

On Your Mark, Get Set, (don’t) Go…Yet! Once you identify your practice’s “four-minute mile,” now what?

Should you just start running? Work longer and harder? Spend more money on adding staff, marketing or new equipment? Some or all of these might be part of the answer. But before you run too far ahead of yourself, you need to slow down. That’s right, slow down. You need actionable data about what is actually happening, right now, in your practice. Put another way, you need to know where you are before you can really determine where you want to go. Roger Bannister achieved this “impossible” goal by first identifying how far away he was from reaching it and then went to work. This is a great model to follow for any dental practice with goals to improve.

Scott Livingston is the Director of Communications for Dental Intelligence. His focus is on helping the company to tell the story of how data can measurably improve patient care, team collaboration and dental practice profitability. Outside of work, Scott enjoys spending time with his family, hiking the many trails in Utah and serving others in his church and community.

Dental Intelligence O: 1-855-776-2673 C: 801-450-6525 E: slivingston@dentalintel.com

If you want to increase production, for example, you need to know some critical things about how you’re currently doing. Here are a few numbers that every practice should be tracking: Hygiene Re-appointment AVG production/visit Same Day Treatment Acceptance % Treatment $ Acceptance % You likely have other performance metrics that are important to your practice. Fantastic! Schedule a few minutes every day and look at them as a team, discuss what they mean and how you feel about them, and then – the key – make a plan to act. If you hold a morning huddle, that’s a great place to do this. (If not, what are you waiting for?)

Roger Bannister will be forever remembered as the first to break the four-minute-mile barrier. What most people don’t know about is what he did to prepare to break that record. It was those incremental, behind-the-scene processes that made all the difference. This is also true for your dental practice. With the right information, with a plan, with daily, incremental effort, you, too, can achieve your own “four-minute mile” goal and celebrate as you cross that finish line.

34 Fall 2019 Dental Entrepreneur

DentalEntrepreneur.com

Power to Succeed

The Dental Student Herd and the BIG Social Media Lie David Rice

I

’ll tell you a story. I am a recovering dental student of twentyfive years now.

In that time, in addition to building and selling three different dental practices and founding igniteDDS, I have taught thousands of amazing dental students. What I’ve noticed are a few very predictable and very sustainable trends.

Trend 1. People are People.

I know you hear generational chatter day in and out. It’s only… kinda true. Some superficial ones hold true…ish….but in the end, older folks have been labeling younger folks since the day they looked in the mirror and started seeing they weren’t young anymore.

Labels from age, race, religion melt when you and I take the time to know the person sitting across from us. We all have highs and lows. We all have passions and pitfalls. And outliers aside…we ALL FOLLOW trend 2.

Trend 2. People are herd driven.

One of my fave natural laws of human behavior is the law of the herd, which goes something like this: Most people do…what they believe…most people are doing.

The point is, people are people, and you and I tend to walk, talk and think like we believe most people are walking, talking and thinking.

Trend 3. The herd thing’s a bad thing.

Defaulting to our inherent herd mindset can be a BIG minus. So if you take home any one concept from this, make it this: Social media thrives today because of the law of the herd. As a result, many dental students, like many people, invest too much time seeking what it lures us to seek… affirmation.

What I want you to do now that you see it is this: Seek information…not affirmation.

Safety and comfort drive us to seek people who tell us what we want to hear, when we want to hear it. That can make you feel nice in the moment. That won’t drive you to your best you.

Your best needs you to thirst for knowledge. Surround yourself with people who challenge your thoughts and your actions. As life has taught so many, we become the five people with whom we spend the most time. Make those five people who support you AND challenge you.

David Rice, DDS, is on a mission to improve our profes-

Way back in our ancestral days, people followed this law to protect themselves. It was a physical, safety thing. Just binge a lil’ naturedriven Netflix on your next rainy Saturday. Plenty-o-other animals still livin’ it.

sion by leading the next generation of dentists to grow successful lives and practices. The founder of igniteDDS, Dr. Rice speaks to over 35 dental schools and residency programs a year on practice building, team building and wealth building. Dr. Rice is a private practitioner, edu-

Present day, we still do live the herd mindset…just for a different safety…emotional.

cator, author, and mentor who connects students, young dentists, and professionals from diverse dental-related businesses - “fueling passion beyond the classroom.”

Picture your circle of friends over your entire life. Same clothes, hair, music, per above, Netflix binges…

36 Fall 2019 Dental Entrepreneur

https://ignitedds.com/user/david_rice/

DentalEntrepreneur.com

Fortune Management

extraordinary practice. extraordinary life.

Introducing

Fast-Trak

See it, Plan it & Do it. Don’t wait another second…your future depends on it!

“

Do you understand where you are going? Can you see the lifestyle you want?

Don’t wake up 5 years from now wondering what you should do with your career.

I wish I had this available to me as a young dentist.

- David Rice, Founder of Ignite DDS

”

Enroll in the Fast-Trak Program & Accelerate your Journey to Success.

As your vision for your dental career continues to evolve, you don’t have to figure it all out on your own. You are not alone.

It doesn’t have to be a daunting, complicated process filled with hard lessons learned along the way. This is why igniteDDS and Fortune Management have teamed up to build a program tailored for the young dentist, guided by mentors and practice success coaches.

Join the Fast-Trak community and begin your journey with a defined destination, and a clear, direct route paved by the experience of those who have traveled the same path. We’ve built a program help you Fast-Trak your success.

Meet with us and your peers for three live workshops and stay connected throughout the year in the private on-line community.

Fast-Trak Online With enrollment in the Fast-Trak program, you will gain access to the private Fast-Trak Online community. It’s designed to prepare you for the live workshops, reinforce curriculum, and provide access to success coaches.

• Private Forum • Access to practice success coaches • Resources: – Articles – Blogs – Case Studies

Fast-Trak Live

Attend the Fast-Trak Workshops in Las Vegas, NV March 2020 Re ce i ve 24 CE Cre di ts

Course 1

Course 2

Designing Your Future

The Business of Dentistry

• Determine your career path • Develop leadership skills • Build your personal brand • Create your business plan • Financial goal setting • Debt analysis

• Financial statements • Scheduling productivity • Hygiene – lifeblood of the practice • Successful recruiting & hiring • Develop team culture • 3 ways to grow your practice

Course 3

The Marketable Patient Experience • Develop clinical diagnosis criteria • Handling objections • Making care affordable • 5 steps to treatment acceptance • Experiential marketing • Effective treatment planning

Interested? Enroll at www.ignitefasttrak.com

Dental Trade Shows Lucy Hobbs Project October 3-5, 2019 Chicago, IL thelucyhobbsproject.com DeW Retreat November 14-16, 2019 Charlotte, NC Greater NY Dental Mtg. 2019 Nov 29 - Dec 4, 2019 NY, NY Jumpstart 2020 January 9-11, 2020 Phoenix, AZ SCN Unplugged January 11, 2020 Napa, CA Hinman March 19-21, 2020 Atlanta, GA www.hinman.org

Autumn 2019

Girl, Know Your Worth!

Lisa Moler

A Dental Perfectionist's Confession Kandice Swarthout

A Griever's Guide to Life After Loss Kimberly Harms

Once an RDH, Always an RDH Debora Carrier

Index of Advertisers ADS Dental Transitions South…………………………………………………………….......................... 22 ADS Dental Transitions……………………………………………………………................................... 28 America’s Tooth Fairy................................................................................................................... 29 DeW.Life . .................................................................................................................................. 35 DentalItelligence......................................................................................................................... 23 Henry Schein Nationwide ............................................................................................................ 39 Hinman...................................................................................................................................... 15 Ignite......................................................................................................................................... 37 Invsalign.........................................................................................................................Back Cover MacPractice................................................................................................................................ 25 Patterson Dental........................................................................................................................ 2,3 Patterson Dental......................................................................................................................... 15 Pulpdent..................................................................................................................................... 15 Wells Fargo................................................................................................................................. 11

38 Fall 2019 Dental Entrepreneur

DentalEntrepreneur.com

TOP 10 TIPS

HOW TO GET AN EXCEPTIONAL DENTAL ASSOCIATESHIP!

PREPARE TO FIND AN EXCEPTIONAL DENTAL ASSOCIATESHIP! Our top 10 recommendations for a successful search: 1. Determine your goals, objectives, and priorities (e.g., What are your financial needs? Do you want a practice ownership opportunity?)

2. Start early (i.e., Start 6 months to 1 year prior to availability.)

3. Prepare a professional curriculum vitae and cover letter (Check spelling and grammar) 4. Reach out to potential references (i.e., Ask their permission, confirm contact information) 5. Before an interview, research the practice and owners/principals (e.g., Social media, website) 6. Prepare questions for the interview (i.e., You are interviewing them too, you want to show interest) 7. Make sure the practice is ready for an associate (e.g., Do they have the space, equipment, support staff, and a sufficient number of patients?)

8. Ask for next steps and timing at the end of the interview 9. Send a “Thank You� after the interview! (Mailing a personal note is best.)

10. Align your resources. Be ready for an opportunity. (i.e., Find an attorney for employment agreement review)

To find the best dental opportunities, contact: HENRY SCHEIN NATIONWIDE DENTAL OPPORTUNITIES

866-409-3001 or info@henryschein.com Nationwide Dental Opportunities service is 100% FREE to candidates (job seekers)! www.dentalopportunities.com

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