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Practice Achievement Formula Part 1 -Season 1 Episode 13

Years of searching led me to a discovery that changed the way we view every single action involving the pursuit of practice growth and happiness.  The answer to Ultimate Practice Success is not found on some remote mountaintop in a monastery or in a tiny cabin in an inaccessible swamp.

The true secret to solving the riddle that has eluded so many dentists is in creating synergy between the 4 elements that make up any dental practice.  Those elements are represented by the acronym S-P-En-D, and any dentist who ‘spends’ enough time concentrating on improving these elements will without doubt create the practice of their dreams.

In this episode you will learn:

  • The way to master the element that drives the engine of the practice and the element that can make any dentist miserable when it is out of kilter.  This solves 90% of your practice troubles if you get it right, sadly few ever solve the riddle
  • How to cure the incurable disease of no-shows in the practice in a very unconventional way.  Few will have the guts to proceed and those who do will wonder why they ever did this any other way.
  • Why “Mystery Calls” are no longer effective and the simple trick that REALLY fixes the phones.
  • The first step of our Famous 3 Step Diagnosis that Most Miss and that Can Skyrocket you Case Acceptance when done right.

And Much, Much More….

Read Full Transcript

The Dr. Chris Griffin Show – Season 1 Episode 13

“Without continual growth and progress, such words as improvement, achievement and success have no meaning.” Now who said that?

Welcome to the Dr. Chris Griffin Show. Your resource for leveraging systems and technology to easier workload, increase productivity and provide you with the time off you deserve to live the life of your dreams. It’s time to practice productivity in the passionate pursuit of a better life with your host, Dr. Chris Griffin. The Dr. is in.

Oh, that was a good one. That was a good quote now, the reason that I picked that quote is because today we’re going to dive in to our practice achievement formula. If you’ve been following along, you will know that we’ve been taking little excerpts from our recent full day lecture in Oklahoma City and this is the part of that lecture where I dive into my Practice Achievement Formula. We won’t have time to get through the whole thing today, but we’re going to definitely get started on it. Now the quote was from our friend, one of our founders from the one hundred dollar bill, Benjamin Franklin. The last great renaissance man of America, some said. But then had a ton of great quotes and I will probably quote him again before the show’s over, I’m certain. But let’s take Ben’s advice and keep that quote in mind as we listen to our Practice Achievement Formula today. And I’m going to shoot you back off to Oklahoma City. Here we go.

But anyway, here’s the formula. So I finally sat down and thought about it long enough that I decided, there’s really only 4 parts to any dental practice, okay? There’s…and the letters would be SPEn and D. So there is 3, that is the staff right? Because that’s the big part. We found out earlier, that if your staff’s not on board, it’s really hard to get stuff accomplished. Okay? That’s part 1. As you get this sheet that I got you guys to write on as we go through all this, you know. I don’t expect you guys to take everything I say and go home and try to do it next week. But what I would love is like if you guys just picked…if you could come up with 4 things for each of these letters, write it down, and work on one of those things each quarter. And at the end of the year, a year from now, you would have, you’d have 16 really good thing down at your practice that would surely help you.

The second part is patience, okay? Because without patience, there is no practice. Environment is a big one. Environment is a big one because it is very possible to put a good team in a bad environment and it will not work. But you can put a subpar team and a great environment and that subpart team will actually rise up and become a better team. Maybe there’s a subpar because you can do enough good stuff teaching team, right? And the doctor, the doctor is the last part and I put that in there because just like, if you want to do like Dr. Ted? And you want to run wide open and have 20 people at the parking lot all the time? Hey, go for it. If you want to do like Dr. Bryan? And you want to work 2 days a week and go fishing a lot? Do that but you need to figure out what you…what makes you happy because at the end of the day, if you as the doctor are not happy, what’s the point? I mean what’s the point in any of these. Right?

And the 3 questions I want you to think about as we go through all this, or how would you…how would you want your practice to look? How do you want to live your life in general? And then once you get everything cooking like along those lines, how would you like to grow? And that would be sort of growing significance in contribution. And probably, as I can assure you, I do appreciate…man, I appreciate Oklahoma City Dental Society for paying me this nice honorarium to come talk to you guys, I do appreciate that. But I mean I got to drive 10 hours both ways and I took a day, you know, a day that I could have been working and I’m here.

So if you think about it, there must be some reason that I do stuff like this besides the honorarium money, and it’s really just because I love the…I love to sort of spread this message and help people do better in their own practices. And I guess that’s kind of what…once I get my practice is going good, I got you know, I got my setup where I wanted it from my life, then I’m thinking, well now it’s time for me to help other folks. And these are kind of symbols, so as we go through like I put these symbols up on the slides or something, it just kind of let you know what category something falls in. But that’s the staff, the patient, I guess that patient one is kind of like a symbol of there’s a lot of patients out there and you, they’re trying to find the patients for the practice. And of course you get the globe, environment, Al gore and then the doctor.

So the new patient life cycle. So let’s think about the patient, this is all about the patient part right now. We got to figure out…now last night, I had to warn you guys because I forgot something to draw along so last night I actually drew some little sketches on my iPad and then put them on here, they’re pretty ugly but they’re coming here in a minute. But to fully understand where the new patients are coming from or any patients are coming from, period. You got to kind of understand where they started out. So this is the first ugly drawing of the day. Alright? So way over her on the left, you’ve got the patient pool, so out there, anywhere you work. Oklahoma City got more that most but anywhere you’re working, there’ a pool of folks that might could be patients at your practice.

Now what you’re always trying to do is you’re trying to pull out 8 patients from that general pool, by some form of marketing. Okay? They could be direct marketing, it could be indirect marketing through referrals; that’s always the best. But you know, sometimes you got to get the ball rolling with external marketing. Then once you have attracted a person that thinks enough of you, to actually call your practice, you have to make sure that however that person tries to connect with you, whether it’s by phone, or these days they could be by text or email or contact form on your website even. You have to make sure that your systems are down on that process so that they actually finally make it to the building of the practice, right? Because we’re still not doing digital outsource dentistry yet.

And then once you get to the building, then there’s a whole lot of stuff that has to happen inside the building. So the patient has a really good experience, so that when they leave the building, they decide to come back to the building and stay as your patient instead of going back to the general pool, right…because that can happen. It happens to everybody, it happens to me all the time. I had a patient this week, had been my patient for since 1999. I had done 15 crowns on her, her husband’s insurance changed. I was on their PPO and it changed to one I’m not a member of. But he still would have paid for the cleaning because it was pretty much all she needed. So she came into my, and stayed for a while… I didn’t even thought about it. She came in, whatever, Wednesday, the last day I worked. She came in Wednesday, a crown I did in 1999 had fallen off, it was a solid gold crown she wore a hole in it and it came off and she said, “I just thought I should come to you for this.” She said, “You know I had to stop coming here as a regular patient.” I said, “What?” She said “Yeah”. She said, “I’m sorry that I’m not, you know, you can’t see me anymore.” I said, “What are you talking about, Maggie?” She said, “Well I got this letter from my husband’s insurance and said that I had to go to one of these dentists on this list, you weren’t on it.”

And so I said, “Okay.” She said “But I went to him, I didn’t like him very much. I was thinking about coming to you anyway. But I just hate to pay for a 100% on my pocket.” So I said, “Well hey, you know I am not a member of this PPO, yes, but you know your cleaning stuff will still be covered and it still covers you, it’s just you don’t get as big a discount.” But I said, “You know I’ve worked with you, you’ve been my patient since 1999.” She said, “Are you serious?” And she’s like get a red in the face and get mad because she liked misunderstood this insurance company letter and in her mind it was saying that she was not allowed to come to me anymore, right? And the reason she didn’t…I said, “Why didn’t you call us and ask us?”She said, “Well I was so embarrassed you know I love you guys so much I was just embarrassed to call and say I was going somewhere else.”

So that is the kind of thing that’s going through our patient’s minds guys. I mean it sucks, it’s not right but it’s…that truthfully happens. Anyway, to make a long story short, she went ahead and she cancelled her insurance. She dropped her insurance and she ended up, before she left she signed up for my in-office dental membership plan which I’ll talk about later this afternoon; which is awesome by the way. Are any of you guys doing that? You do that. So we’re not good enough for you guys? Well hey, you know. Yeah you can do, you can’t do anything wrong. I’ll share with you guys what I did. I actually doubled my memberships. Two years ago, I doubled them from 350 to 700 in 6 months. I’ll tell you guys what I did to do that.

So anyway, let’s see. I bet these guys get to bring their lunch in 7 minutes. Alright so that’s the patient life cycle. So here’s the new patient. Like I said, I apologize to these drawings. This is last night, but this is you know, I was testing out the new Ipad pro pencil, so this is what I came up with last night. Like I said, there’s a bunch of you out there, I mean if you don’t think there are, how do we get them? So who…I mean this has been done to death, and I hate to even go over it but it’s really every practice I work with, there’s generally an issue here. So I might as well go over it. But how many of guys feel like you have a really good handle on what happens at your incoming phone calls? Or do you use…you think you do? You may, you girls are here. So maybe you do.

A lot of places don’t, so I’ll just share with you guys what is not supposed to happen on any incoming phone call. Because think about it, this person likes your practice enough to try to connect with you. Do you think at least…will you at least owe it to them to try your best to let them connect to us but the goal on this is not to verify their insurance. Okay? I cannot tell you, we’ve lost so many patients from people they’ll call in, we ask them a thousand questions, part of that is verifying their insurance. We used to do that, we used to do their medical history, and what’s the argument for that? You guys, do you all…anybody know what the argument is? For why you would ask somebody a thousand questions on the phone?

The argument I hear all the time, people say, well if we don’t ask them the questions when they call in, and when they get here, it takes forever to verify their insurance or get their medical history filled out. Of course these days, there’s cool stuff where you can do medical history when you’re on the website and all kind of stuff like that. But you’ll be surprised, there’s still a lot of practices out there when somebody actually calls your office, the receptionist probably starts ignoring whatever. You know a human being is standing there, instead of being a concierge and giving them a great experience that are already standing here, they’re on the phone asking somebody who may not even show up for their appointment a thousand questions. Right?

And what we have found is, my staff resisted this forever. But what we found was, we actually measured it. And so we took 30 people that they did it their way, they asked a thousand questions, 18 of them showed up. A 30 booked appointments, 18 showed up. We did 30 my way, who have proved that said “Oh that’s great, yeah, when can you come in? Alright now that will be great. Oh, okay. We’ll see you then.” So out of 30 people who made appointments, 25 of them showed up, okay? Still 5 didn’t show up, but that’s going to happen. That’s just going to happen; I don’t care where you are.

So we had, obviously, way more showed up now. You spend all that time on the phone, with the 7 people that never showed up. What difference does it make if it would have taken you longer when they got there to ask them questions or verify their insurance, they didn’t show up. You wasted precious resources when you could have been using those resources for something else on those 7 people. Our goal is not to make sure they’re a good fit for our practice now. I will give you a caveat if you’re in a heavy Medicaid area like I am. And people are asking you, do you take MedicAid? Absolutely. I’m okay with saying, no. No if you don’t want them but because you can’t run into trouble there. But pretty much if it’s not that, I mean, well I’d like to take everybody because I can’t tell you how many times farmers that have pig manure on their feet, on their boots getting on my brand new A8 chairs, by the way. Will whip out a fold $100 bills and pay off a $15,000 crown or root canal with cash.

You know that happens all the time, so we don’t prejudge anybody. We don’t stress them out and I really think that a lot of like those 7 people who didn’t show up, I think the reason they didn’t show up is because we stressed them out. I mean they’re thinking, Oh crap, they’re asking me all these questions, maybe they don’t want me there. You know? I think that could be it. You could…be careful you don’t schedule an appointment they’re not ready for. If you pressure somebody into an appointment, you’re just asking for a no-show. And I don’t know, how many…does anybody in here do these mystery calls? Where people call your office? You do everything.

Alright so this half is nearly a hundred percent of the time. You’re staff, they’re not stupid. So they know I you’ve hired somebody to do mystery calls at your office. They know that as the doctor, you’re going to get a report every month. Okay? So in these cases, if you don’t ditch what I’m talking about, but every month the doctor gets a report, and they graded out somebody’s called the office, pretended to be patient, report it, graded it and told you what you do wrong. And told you what Suzy does wrong. So the staff knows that right? So they figure out, you know either if it’s the area code, they are used to get the mystery calls on; which is usually not your area code. Or if it’s like blocked, they know, “Oh blocked call! I’d better be on my toes and do it right.” But the rest of the time, they do it how they want to do it. I guarantee you. So the goal is not to get a perfect score on the mystery call by doing the scripts exactly right. The goal is to get them exactly to come show up at your office. Okay? That’s the whole 100% goal.

And there’s my new office, guys. After the old one burned down. It’s so pretty isn’t it? Oh, I’m proud of that. The only thing that survived is this plaque. I’ve prized that off the wall of the one that burned. That’s the only thing that made it through the fire. So then the next part of the lecture is going to be primarily about going through the in-office staff which is actually what I’m really good at. Alright so, yeah the first impression is they want to do business with you is because they like you. That’s the whole point; make them like you so that they’ll hopefully stay there forever. We have found empirically, that gifting does improve our frill numbers because when we do it, our frill numbers are high and if we don’t do it, our frill numbers are lower. They don’t dip off the charts but they do dip.

So years ago, when I was heavy into external marketing, there was a period of time where I thought I was a genius. For about 2005 to 2008, we averaged a 150 new patients a month; and that’s a lot. And that’s a lot. We’re working 3 days a week, too. That’s really more than you need. That’s more than you should have because when you’re trying to run a 150 new patients through there and do any kind of reasonable treatment plan on them, I mean it’s tough. That’s a tough one but we did it. Now overtime, I’ll just tell you, I mean it’s so silly but I’ll tell you what I did. I haven’t been able to create lightning in a bottle twice. In 2005, I started advertising, free exams and free x-rays. And for whatever reason, it just hit and it was so good, but overtime, that stopped working as well. And you know, I never really loved the offer anyway. It just worked so well, I quit doing it. But as I quit working, we jerked it off the market and kind of got tired of doing it anyway.

But what we were able to do, is we were able now, my practice is almost 75% of my new patient has come from referrals. So we get about 40-45 referrals every month. But my new patient numbers are way down however, actually my production numbers are up a little bit from then because the 150 new patients a month, a lot of them, you know just wanted the free exam, free x-ray. Now I was willing to do it because a good many of them converted to great patients. But it’s a lot easier to practice when you get 60 new patients or 65-70 and you’re not on your head off. The referrals, they are just plain ‘o better when they get on there. I remembered the good old free exam, free x-ray people, Gee whiz! They were hard to convert. But these referral people, they pretty much…it’s not a question of whether or not they’re going to accept treatment. It’s just a question whether or not they can afford the treatment that you’re recommending. And I may not always do exactly what I want to on them, but if they come in as a referral, it’s almost a slam dunk. They’re going to stay and do something.

I think it is good if you can come up with your own way to roll out the red carpet for your new patients, whoever they are. Create your own unique new patient experience, now that handout and I don’t see nearly enough people writing on those. So when you leave here, man, it’s going to hurt my feelings if you all don’t have at least written down to take home with you. But flip that over, and you’ll see, this is a sort of a flowchart I’ve printed off for you guys. This is our office. That’s the new patient experience in my office. So we kind of charted exactly how that should look the second they walked in the door and the second they leave. That’s called the new patient experience choreography.

Let’s see, you start up here with the prospect. We talked about phone call and it goes without saying, you want to make sure that you’re treating people right. Especially in a small town if you’re in a small town because you want the right reputation; people already trust you when they get there. You want your building to look right, you know. It doesn’t have to be the nicest newest building in town but it needs to look professional and nice. When they show up, we’re going to go ahead and give them their paperwork; we’re going to do the gifting. Now when I had my old office, and it was kind of a beehive of mismatched carpentry and you know, it was okay but it wasn’t super nice. I want it as big on the tourists but yeah, when I got my new building after the fire, yeah, we like to lead them back and show them everything and I even put my sterilization room right in the middle with 2 doors you know, as you walk by you can see in and it’s good and bad. If your staff is laxed on keeping your sterilization room really nice, it’s bad because you know, that would be bad. If you can keep it looking pristine though the people walk by like “Wow, you must be really, you know you’re keeping stuff really sterile and clean, that’s awesome!”

So we do new patient tour now. There needs to be some sort of a system for the way the staff retrieves the patients out of the waiting room. I think you know this is stuff that nobody does that makes the big difference. Like if you have, let’s say you have a main assistant whose awesome right? You probably have one person that you like better than anybody else. (Laughs) I’m joking, I’m joking. I’m kidding, I’m just kidding. But let’s just say, for example, in this mythical dental practice, there is one person who’s great. And you’re thinking, “Okay she’s probably going to do everything.” The truth is, you got probably 3 assistants and one of them talks like that character on Fat Albert’s you know, it’s like *murmurs*, you know. You can’t understand them.

Well if you’ll take the time on, a you know, we have training days every Thursday. So if you got to take the time in just 15 minutes and run through and you know, have somebody sit on your waiting room and have assistants go and open the door and say “Hey Mr. and Mrs. Jones, we’re ready for you…Come on back.” or whatever. You decide on the script and practice for your office. If you would just practice that, I can assure you, the University of Oklahoma doesn’t just go up on Saturdays and play football without practicing all week right? I know if you have never done this, it sounds weird. But a little practice goes a long way. We’ll talk about the route board in a minute. Radios, anybody in here use radios now in the office? This is amazing, this is great. I’ve never talked to a script like you guys, some of this stuff, I’ve never seen it.

Anyway, the radios…one way we improve speed of communication between the people in the office. As we all, where the radios in the ear, have you seen them? KISCO sells them. Generally speaking, the doctors buy them. The staff says, “I can’t wear this” and then if the doctor says “Oh, okay. Well I’ll get you the more expensive ear bud that you can wear.” And then they say, “I won’t wear this because I just don’t want to.” But you have to stand firm if you think it’s important for communication to go faster in your office. Just stick with it and I’ll promise they’ll get used to it. I have one girl that’s got kind of smallish ears. I don’t know there was such a thing, but she’s like “Dr. Griffin, I got such small ears, this won’t work”. So anyway, we finally found the ear piece she could wear. If it’s important, stick to your guns.

Introduction to the doctor, it’s good to practice this one. Have the waiting assistant or whoever, the hygienist, the way that you come in the room that you’re introduced to the patient. I mean, yeah you can just walk in and say “Hey, I’m Dr. Smith.” But also the assistant who’s already made conversation with them figured out that her niece and her daughter are in the same taekwondo class, you know. And they went you know to the same high school or whatever; they figured all these out already. So they’re already kind of connecting and that’s a good thing. Right? So then you walk in, this person doesn’t know you yet but they already liked the person that they’ve been talking to. Well it’s extra good if that person would just do a little quick introduction. “Hey, well you know, here’s Dr. Griffin, you know. I was telling you Dr. Griffin here he is and you know…blah blah blah blah” whatever script it is that you come up with that you think is good. Practice it, practice it. Take a few minutes every week until you get it down and then every month or two, you take a few minutes to practice it again.

Patient exam, there’s a lot of ways to do this. I’m not sitting here telling you this is the only way to do it. I kind of go with things, you know. I’m not the kind of guy that sits down and does a full mouth…I do a full mouth exam but I’m not the kind of guy that sits down and does a full mouth exam, prints out a gigantic treatment plan, and then present it to the patient and says “Hey, here’s your treatment plan. Would you like to give me fifteen to twenty thousand dollars to do this?” I mean I’m just not that guy.

So I usually start out, I’m doing some real casual…you know, it’s a three step deal for me. First step, chitchat, glance in there, ask them what their chief complaint is. But I don’t use the word “chief complaint”. But you know, I do that and then I’ll you know, that was just my get acquainted first part of the diagnosis and then I’ll leave the room and my assistant will take an x-ray, and then I’ll come back in there and I’ll do the full mouth exam with the x-ray and I’ll chart everything but I don’t sit there and say, you know, I don’t say we got a lot…I have to go cipher on this gigantic thing because I don’t have a clue on how much it’s going to cost. I mean I’ll usually say, things like “You know you were telling me that the tooth on the upper left’s hurting, we’re going to take care of that first. Let me go back and we’ll get your…we’re going to work on this first appointment for you and we’ll figure out how much the cost it’s going to be on that or whatever.” I mean very, very simple stuff. And then, we do finally present. We do finally get around and present the case and generally speaking, I mean we do really good, I don’t know. I think our…I chart case acceptance percentage. Does anybody in here chart that?

Okay so that is the, that is the beginnings of The Practice Achievement Formula. Now I hope everybody stay in with me on this. Just a recap, make sure you’re paying attention. The formula is spend, S-P-En-D. S stands for staff, P stands for patience, E stands for environment, D stands for the doctor. If the doctor’s not happy, why are we doing this anyway? So the worksheets there fall along within Oklahoma City. I’m going to put that on the show notes page. I hope everybody has the chance to download that, look at it if you have an opportunity. You will actually go through this exercise for your practice. I promise you it’s going to make a big difference. I hope everyone takes advantage of that. We’re not through with the formula at this point of the lecture, we’re going to continue on next week as we go to part 2 of The practice Achievement Formula. And we’re going to knock this thing out to where you have actually an opportunity to apply it to your life and your practice. I’m really excited about it; I know it’s going to make a big difference in everyone’s practice. So please take advantage okay? Alright everybody, we had a great time this week. We will see you next time.

We appreciate you joining us for this episode of the Dr. Chris Griffin Show. Be sure to visit for the latest resources and updates to keep you more productive every single day you’re at the practice. So when you’re not working, you can do the things that matter most in life. We look forward to having you join us in another episode of the Chris Griffin Show; where the doctor is always in.

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