Practice Achievement Formula Part 2 – Team Chemistry – Season 1 Episode 14

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We all know that without the Doctor or the Patients, no treatment can exist.  I contend that without a sound team of fun, hard-working, motivated, and upbeat team members, neither the Doctor, now the Patient can have an outstanding visit to the practice.

The Dental Team is THE KEY to unlocking happiness in all aspects of your office life.  Today, we explore the Staff component of the SPEnD Continuum in the Practice Achievement Formula.

In this Episode You Will Learn:

How your Team members can Make or Break Case Presentation and How You Can Leverage Their Ability to Connect with the Patients in Ways that You Just Cannot

How to Destroy the Disease of Duplication in the Dental Practice to Make Your Own Team as Efficient as Greased Lightning!

The Blueprint of How You Can End the Days of Team Members Disrupting the Flow with Distracting Confusion and How You Can Become the CEO of Your Practice, Plus the Benefits that Come from Now Having to Deal with Every Single Problem, Every Single Day

And Much, Much More….

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The Dr. Chris Griffin Show – Season 1 Episode 14

“The strength of the team is each member; the strength of each member is the team.” 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.

Folks, that was a good one, that was one of…well you all know how much I love basketball. I talk about it all the time. And well NCAA’s over now, I’m not as much of a pro basketball fan. But this particular quote came from the one, the only, Zen master himself, Phil Jackson. Who coached not only the world famous Chicago Bulls from the 90’s with Michael Jordan and Scottie Pippen. Who made you know this year, their record, the All-time single season wins record is in jeopardy from the Golden State Warriors. It’s not that I don’t think the warriors are amazing, which they are. But of course the bulls are from my wheel house era, so I kind of seen how the records fall. But he was their coach and then he was coach for the Kobe Bryant, Shaq O’Neil, Lakers. Now he’s the coach of New York Knicks, not having as much luck with the Knicks this year or last year. But Phil, you know, if anyone can turn that ship around, he can do it. But there’s no question, Phil Jackson has a place in history as one of the greatest thinking coaching minds ever to set foot on a basketball court.

So that’s one of the reasons why I picked that quote because when I was looking through good quotes for today’s episode, which is all about staff and teamwork, this one just jumped off the page because it really is true, the strength of the team is each member but the strength of each member is the team. That’s so like Phil, such a Zen Master quote. So anyway, today’s episode is going to be awesome because we’re going to go back to the Oklahoma City lecture but this lecture started to get really good because as we deep dive into the Practice Achievement Formula, and we all know that staff, that’s the very first part of that formula, today we get to that part of the lecture and really get deep deep into detail on that. And we’re going to cover a lot of other cool things right? We’re going to talk about you know, how to avoid duplication in the practice. We’re going to talk about how to delegate, how to be a real CEO, how to develop team leaders. Just a lot of stuff, okay? It’s going to be really awesome. So listen up, here we go…

Now how do you count a case accepted when you chart it? Okay, okay, that’s good. That’s good. How about you? Alright. Do you know what your percentage is? What?! You’re lying. It’s not 98, what are you talking about? 98. Huh?! I’ve never heard of 98. 73 is decent. That’s like what people shoot for. Darn front desk run. See she should know that she should at least get close to the National average but yeah…98? Golly, man that’s yeah, yeah no kidding. Yeah I don’t know about all that. Okay, well good. Well you have some interesting, you have some Sherlocking to do next week. See if you’re really at 98%. Check out form, “Hey what happened to that patient?”

Okay, anyway. Get around to do that now. The thing that holds up a lot of people is financial arrangements. So I have probably managed to convince somebody they need to do something. They probably say, Okay let’s do it. But the thing that holds us back a lot of times is the money. Is the money ever an issue in any of those prices? Okay. Well good! I’m glad that’s the same in Oklahoma City. Good. So that’s the problem we all have anywhere. Now I have told you guys it bumps up the percentage of chance if you get them to do it, bumps up significantly if you can do it today, while they’re here. That’s not only possible, right? Found the middle of doing that implant, I’m not going to try to work in another root canal and a crown, a number 15 probably. But you know, within reason, there’s always more time available than you think there is. Behind the scenes that got everything verified, so your team should be able to you know, staff feverishly charts what you say, get it into the computer, get it to the financial people. About you know, the front office people who already verified the insurance. They figure out the patient’s part. And now it’s time for somebody whether it’s you, I hope. You know, I’m too wimpy to do it myself. So I actually have Lupita do my financial arrangements with people.

And so she let my practice go and now she’s got a number and now she can figure out how she can actually going to pay for it, right? So they’re making, the patient’s going to make a decision. We hope that they’re going to accept the case. In which case, we go into our really quick room setup protocol that involves a lot of cool stuff. We’ll talk about it here in a minute, do the treatment. You know, at the end of the appointment, that’s another way we can get a lot of referrals after the appointment’s over, we do a good job. And after bleeding everywhere, you’re hurting real bad, you probably want to bypass this. But if everything went well, you got a little script that the assistant gives to him as he’s working him up and says you know, “We’d love to have more people like you here.” And check out person at the front desk, they also have a little part in that. They give a nice little card, care to share card, or whatever you want to call it.

And then the person appoints for the next appointment. And if they didn’t accept the case, then that’s when we kick into our marketing protocols and we actually have follow up when we do that; by phone and by mail. And then if they still don’t do anything, they go into a reactivation project protocol where we actually every few months will get the patients who haven’t been in it. So you wrote in 6 months or 6 to 13 months and we classify and we send them mail pieces or column or whatever we decide to do for that particular reactivation project. So I’m going to a lot of more detail here in minute but that’s kind of a broad overview of that’s how it works in my office. That’s how things kind of flow through. That’s how it is generally kind of looks like you get behind my back when I’m telling my staff that I wanted to do something in a hurry. Or something like that.

That’s one of the 2 things that Dr. Ted’s staff changed their practice was the route board and the orange card which I got up here which I’ll show you guys in a minute too. Alright, so but first, let’s go through the staff, the staff part of the lecture because that is one of the 4 parts of this formula. That is…this was taken before the fire; this is for long term staff. They’re making them smiling big because they’re all making a lot of money and now there’s only 1 left…Lupita. Lupita is the only one left, right? All the others have gone away. It’s sad too because I’m actually the third one there is cousin, my cousin. She couldn’t stick it out either. I went to a high school with the first one. I went to high school with the first one and this third was my cousin and they were *woosh* right out of there. It’s too tough…too tough Dr. Griffin! And Amber actually, her husband moved to North Dakota and the oil fields, that’s not really you know, whatever.

Alright, let’s take a couple of minutes with this. I’m just going to share some insights for the doctor’s staff, close your eyes and ears. Don’t watch any of these or might get a kick out of it.

For 2 years, I actually taught a class in Atlanta that was just for dental staff. Doctors really were encouraged not to come and so doctors would actually say “I want you to train my staff” and so I would train their staff but I would know if a doctor came, the staff would not act right? They wouldn’t act honestly. They would lie and it’s like you know, if I get the staff away from the doctors, then I could sort of get into the bottom of things and try to help the doctor actually come up with the solutions. So at each course, and at each course I don’t know how many hundreds of people came through that course. But you know, every doctor’s got 6, 7, 8 staff would give a handout and one of the questions on there was “I wish the doctor would…” and it’s always got the best answers. So here’s some that I’ll share with you. I wish the doctor would…”communicate better with his staff, be more aggressive with authority”. I don’t know who this person was but “and stop worrying if people like him or not.” Okay?

Well she’s actually…I got a lot of these actually. A lot of staff would tell me that their doctors worry so much about what the patients thought about him that it affected the way the treatment plan, that it affected the way they ask for money and everything else. So this is just something that the staff thought. Here’s another one, “I wish the doctor would stand up and enforce his standards, not worried whose toes his stepping on, make sure everyone is following his rules.” And this is a theme too we heard all the time because a lot of team members would tell us, that some tyrant in each office was running things but they can get away with anything and if I do something, you know, whoever knows who’s telling the truth in these deals. But it’s something to think about because these are actual quotes. And I can guarantee you, some people in your staff are saying things that are probably kind of like this.

“*Sigh* I wish the doctors would put his foot down and stop of all of the office drama. Make sure everyone knows what is and isn’t acceptable from his employees and stop trying to please everybody.” You see a theme developed in here? This is…this is something that, I mean, you see over and over. “Communicate better with us and appreciate what we do.” This is also a common theme; a lot of staff feels underappreciated. They feel the doctor don’t appreciate them. “He doesn’t take time to listen to the issues that we have. We want to make the practice better.” Now listen to this, if you’ve actually got somebody that honestly says something like this, that’s great, right? You got somebody who cares about the practice. If you’ve got somebody who truly cares about the practice and it’s not you, then you need to figure out how to make that person, and give them an environment where they can excel.

“I wish the doctor will allow a light to shine.” Now this person went into some detail and literally they 1, 2, 3, 4, or let go of negativity. This trust and security, uncertainty of his staff, communicate what he wants better. You know I worry every time you see numbers and something like that I would worry about it. “Communicate with his staff more often and more clearly.” “Spend less time on his desk and more time with us.” Now this is interesting, I used to get this a lot. Team members from all over the country and Canada would tell me, I can’t get the doctor out of the office. He’ll see a patient then go right into his office and shut the door and I think he’s just on the internet in there. I hear that all the time and I’d have some doctors that will be like “Hey man, isn’t there…surely it’s…do you go in your office a lot?” and I have one guy telling me who’s like “Yeah, you know, I just hate being there so much and I like to go in my office and watch haunted videos.” Okay. But I mean, I heard this so much, there’s got to be some truth in it.

So and maybe somebody even in this room that maybe do that more than they should, I don’t know. Here’s a good one, “I wish the doctor would fire Tina or at least stand up to her. Follow through with the standards he has for the whole office.” You see a trend here? It seems like a lot of office have one person, you know that, everybody hates but just the doctor who loves her for whatever reason. “I wish the doctor would talk to his wife about not calling so many times during the day.” I just thought, I’ll just throw it in for fun. Does anybody here ever had that issue? You know what’s funny is, my wife actually used to…she used to call. Then I quit taking them actually. But then you get, you know, then you get in trouble at home but I’m so…that’s one reason why I quit taking the lunch just I’m like “Listen, I work through lunch what do you want me to do? I’m so busy.”

“I wish the doctor would stop yelling at me in front of patients and get a new office manager not his wife.” Which now, I have looked in the mirror on this one because since the fire, my wife actually works at the front office. She’s not the office manager though but she does work out there. And you know typical, she comes when she wants to come in and then leaves when she wants to leave. So I’m a hypocrite. “I wish the doctor would be a better leader. Stand up and let this practice be as good as we know it can be.” I say, I mean if you could really…I mean I know the doctors would get ticked off if somebody telling them you need to be a better leader but if you can have somebody who really cares? I mean heck, figure out a way to make their life easier. How do we make their life easier? Now here’s where it gets tricky, because we’re trying to make everybody’s life easier, our life, their life, whatever. But there’s some painful parts in this to make it really easier, you first have to set some standards. And part of the standards, you know, you really need a job description. Okay?

How many people are running around the dental office, and here’s what we find. If somebody does not have clear job descriptions, don’t feel bad if you don’t. 10% of the dentists probably do. So what you invariably have, we used to do this. Like I said, it’s part of that big coaching program. And this would happen every time, so we would, one of the first projects we would do with people. So you guys are getting this for free, it is like $35,000. We would have the whole staff sit down, and on a piece of paper, just write down, line item, line item. What do you do in the practice? You know? Turn on the lights, suction you know, whatever. And then we would take and we would look at the staff and we just lay it out and had a big old table before the fire and we’d lay it all out, and I was “Alright, let’s look for duplication.” Okay?

Invariably, 2 or 3 people would have exactly the same thing down. For multiple stuff, exactly the same thing. I mean as simple as turning the lights on in the morning, it would be 3 people that would think that was their job. Turn the nitrogen tanks off at night that would be on 3 or 4 people’s list. You know, everything you can think of, in doing treatment plans to financial arrangements to verifying insurance cards, photocopying insurance cards, whatever it is. There’s always duplication in every office and tons of it, right? So what do you think happens when more than one person thinks it’s their job? There’s always somebody else to do it; it’s always somebody else’s fault. Or somebody else, “Oh I thought, I thought somebody else was doing it.” You know?

So one of the first things we would do, is we would take in, we would rate a natural job description for every person and we would remove all that duplication and we would take everything that was duplicated and we would ask the doctor, who do you want to do this? 3 people say it’s their job, and they would always say. The doctor would always say, “Oh really? I didn’t know that. I thought that it was Tina’s job.” So you know, but the staff didn’t know. So we would get all and we’d make a job description, for every single person in the office. And that’s painful, let me tell you. People pay me big money to set this up for them and I would say, 20-25% ever actually followed through and did it. Even after we went to the trouble of giving it to the doctors, the doctors still wouldn’t do it. Why do you think they wouldn’t do it? Push back from the staff. They would scare of the push back from the staff. They knew it was better for the practice but they were scared of the push back from the staff.

Create team leaders, this is painful. There’s always going to be somebody that’s a…if you’re the doctor, and the way that I compress my workweek from 5 days to 3 days, okay, was that I couldn’t do every job. Right? I had to take a lot of stuff off my plate, so when I’m at the office 3 days a week, if we’re going to get, if we’re basically, if we’re going to do a minimum. In our office, we try to do a minimum of $12,000 in a work day and my crown fee is 693 for a you know, all porcelain crown; so that’s low. So that’s a lot of dentistry right? 12 grand a day. If we’re going to do that and if we don’t do that, there’s problems. You think money doesn’t work out right then I cannot, I cannot have the hygienist coming up to me, asking me if you can get off work in 6 weeks. I cannot have an employee coming up and telling me that their kid’s sick. I can’t have somebody coming up and having a complaint about the way they’re being treated. I cannot have any of that. That cannot happen.

I have to produce Monday, Tuesday and Wednesday. That’s already not optimal days, it’s just better for me alright? So these, all this stuff has to go away. So how can it go away because I mean the bill, it still has to run, I’m still the CEO. The place still hasn’t happen. So the way that I fixed it, and the way that these offices would have done well have fixed it because they will actually have 1 or 2 people that are in charge of different areas. And there’s even, you can have 3. You could have, so like in my office, we have an office team leader, we call it clerical team leader and we have a clinical team leader. Well and since the fire and everybody quit, now we just have 1, office manager. It’s not ideal but Lupita is the only there that’s really qualified, I think, to do the job. But when we had a bigger staff, and we had 14 ops, we had…Lupita was in charge of the clinical staff, including the hygienist. I know you guys don’t like that but everything clinical flowed down to her and if she couldn’t solve it, she could come talk to me. But that was it because she knew how to talk to me. She knew not to interrupt me in the middle of something that’s really important. She knew how to approach me so that we could get things done officially.

And then one of the girls that did quit, Kim, everything in the office would flow to her. Okay? And then she could come talk to me. But only 2 people in the office could ever come talk to me Mondays, Tuesdays, Wednesdays. And that’s the only way you can make, if you want to really bust your production out, you have to be the doctor. You’re the producer, you have to be…that’s all you can focus on because it’s your responsibility to focus on your patients on at a time. You can’t think about anything but doing the best job possible for each patient one at a time. That’s all you could ask of yourself.

But all this other stuff, somebody else needs to handle it for you. And I, it gets to the point where nobody talks to me. I mean even the team leaders, they would just handle it. And then on Thursday mornings, I would have a 1 hour meeting with my team leaders. And we would go over any problems during the week. And well I still do this with Lupita, one hour every Thursday. Usually from 9 to 10, I go in her office and everything for the week is solved. Nobody will bug me Monday, Tuesday, Wednesday and that’s how we produce so well Monday, Tuesday, Wednesday. You have to set goals. The painful part about setting goals is, when you don’t hit them you know. It’s a little bit depressing but you got to eventually set some goals or there’s no way you’re going to grow.

Managing is hard. Man, managing is hard. And if you don’t have team leaders right now to take pressure off you, you have to create them and there’s problems there. Why do you think there’s instantly a problem? If you pick…if you have a team of 10 people and you pluck 2 out to become team leaders, what’s the problem? Well yeah, the staff is immediately ticked off because they didn’t get picked. If you take on the role of being a team leader or an office manager, you’re taking on the hardest role. It’s just like you know, the deacons in the church. It’s the hardest role there is. You’ll think “Oh hey, it’s a high position.” But the truth is, it’s the hardest job there because you’re going to do the most work. It’s just really difficult. And another painful part is measuring everything. So once you set these goals, you need to find a way to measure it.

There was a, I don’t know, a background in 2005. I got around and kick where we did statistics for just about everything. And so there was a time where I would actually put these little paper holders on the wall and had an operatory when we weren’t using. So I had it lined, I had 36 things we kept statistics on and I have, the staff was responsible for the drawing graphs. And it would chart our progress on each statistics. And that was really, the turn, one of the highest growth periods we ever had. So I know it worked. But yes, you know, that’s a lot to do. Right? So over time, we condensed all those 36 statistics down and now we have 6 graphs that we keep in our conference room and so there’s only 6 now I keep up with that we feel like the 6 that’s most important.

But I mean there’s something to say here, it takes time but it’s painful if you are at the beginning of a new product, if you’re really focused on measuring what you’re doing, and coaching things to the measurement. I mean I don’t think there’s anyone who failed if you take the time to do that. The problem is, taking the time. Yes Bryan? Man, I haven’t done one in so long myself. It’s going to be hard to remember. See that’s the beauty of this, you give this to your team leaders then you never have to think about anything else.

So that’s a good place to end this deal. So hey look, I’m going to be good to my words. Since you were not at the lecture, I’m going to go ahead and give you the answer to the question that was posted to me. “Hey Dr. Griffin, what are those 6 statistics that you now have narrowed down from your wall of 32 stats that you used to torture your team with?” So here we go guys, here are my 6 key statistics that I think every doctor should keep in their practice; of course, obviously, production versus collection. Office production and collection, that’s a no brainer, you got to keep your collections up pretty close to your production. Okay? And if you got write off issues or PPO issues, you better figure them out and know that you’re collecting what you’re producing. Okay that’s number 1.

Number 2, you need to chart hygiene production versus doctor production. You know what? There’s nothing wrong with having whatever percentage of hygiene it is as long as it’s consistent. It’s consistent with the way you practice. If you have a lot of kids, you’re probably have a lot of hygiene volume, you know? You could enjoy taking hygiene, you might be the kind of doctor that wants 30-35% hygiene in the practice. I personally like for her to be around 10-15% but that’s your call as long as you know what your practice needs; keep that stat okay? The next one, hygiene percentage time field versus doctor percentage time field. Okay? You need to figure out which time is actually being wasted each day. Because you don’t want your hygienist sitting around the back drinking diet cokes and reading people magazine. I said that word for 10 years.

What I like to see is hygiene percentage time field basically 100% if it’s all possible. Sometimes it might even be over a 100 percent is they’re working in extra people and we’re lending them assistance and helping them get more use out of the time on their schedule. But on the doctor side, I’d like to see that hover around 75-80%. If it’s more than that, you kind of have a tendency to have a sore back and can get burned out. Plus if there’s sometime on the schedule to work stuff in, Hey, that’s where your big time production it can be today. The day I’m recording this, I was able to work our dental office special, we call it the Dental Griffin Special. Core Buildup, root canal, and all porcelain crown. Okay? We work that at the end of the day, I was 15 minutes late for that production. Do you think it was worth it 15 minutes late for supper? Yes it was. Okay, that’s number 3.

Number 4, new patients, okay? Everybody knows that new patients are the last blood of the practice. It’s not anything new. We like to chart total new patients and we also have a notation there for the number of direct referrals from patients because they are the best patients; the best new patients to come into the practice. Number 5, case acceptance percentage. We’ve talked about this. I think the industry standard is considered to be 73%, it’s a crazy number but that’s what I’m told. As good, we like to shoot for 75%. People tell me they have 100%, 98%...baloney, okay? It’s not true. Somebody’s even like, is that right? Somebody’s lying to you, you don’t want to hear the truth or your process are so low that nobody says no to you. But even if they were free, people would not do it because they don’t want to get their teeth drilled on and get shots, okay? It’s not 98%, you’re living in a fantasy world. Figure out your true percentage and chart it, okay?

And the last one, this is one that only I can keep. Because I may be the only one person that thinks this is that important but we chart crowns versus fillings. And why do we do that? We do that because I have a tendency to see a gigantic cavity in a tooth and let the patient talked me into doing it a gigantic M-O-D-B-L-I-F-M-N-S-Q-R-S-T resin when I know I should be doing a crown. But they try to talk me into it for processing purposes. Sometimes I just feel guilty and I let them do it and I lot of times I just wanted to get the decay out of the tooth and I’m hoping later I’ll be doing the crown but if I see that filling number creeping up on me? Then I don’t like it. So I like to keep that ratio of about 2.5 fillings to 1 crown. If you get something like 4 to 1, which I have a tendency doing with my bleeding heart, then that’s bad and we try to go back and make sure we’re really presenting the value of the crowns okay? So that’s my 6 statistics. That answers the question from Oklahoma City, too. So hopefully, you now will know what you should be keeping up within your practice and streamline that thing down so that you don’t have to keep 32 stats on your walls. So I think that was a great episode today, right? So a lot of fun, we got into a lot of team stuff…a lot of team stuff. And I really had a great time and hopefully you did too and we will continue next week along the Practice Achievement Formula. Keep working down the line and there’s going to be a lot of good stuff then too, right. So tune in and we look forward to talking to you, then. Okay everybody, have a great week!

We appreciate you joining us for this episode of the Dr. Chris Griffin Show. Be sure to visit drchrisgriffin.com 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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