Kiera shares the three most common pieces of bad advice out there when it comes to growing a practice. She encourages doctors not to keep applying new pieces of information to growth, but to understand how to filter the best pieces for your practice — and shares three truths to making this happen.
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Transcript:
Kiera Dent- Dental A Team (00:00)
Hello, Dental A Team listeners. This is Kiera. And today we're gonna talk about a couple of lies feel so harsh, but I think these are maybe some misnomers, some beliefs that a lot of dentists are told about growing a practice that aren't true. Or they could be true, but they don't have to be true. So again, like I don't want to say it's lies. I just think it might be a possibly wrong way to look at things if you want. And so I want to talk about some of those like what are the
like three biggest lies, if you will, with air codes around lies. Because I think about a lot of advice is given to you about how to grow a practice, but I don't think it's all true. I think that there's ways that we can look at it differently and get different outcomes. And I don't think people are trying to mislead. ? but I just I feel like it's incomplete. And so I want you guys to recognize that growing your practice and evolving your practice isn't about following more advice or doing more things. I think it's actually about filtering like what is the best way to do it. And for me,
Lazy or efficient, take your pick. I prefer the term efficient. ? let's just get you the most efficient way to grow your practice that keeps you sane, that doesn't burn you out. Because again, I'm about the yes success model. It's all about you, making sure you're living your absolute best life, followed by earnings and profitability and then systems, structure, and scale for you. We've got to have those in place for you. And so I'm really, really big on growing, not for growing sake, but to grow in the way that's best for you, which is why vision and you are the most number one important thing. So when you go through this, I just
I want you to realize like we don't have to stay stuck, we don't have to say overwhelmed, and we don't have to plateau. But there's ways that we can walk through the most common lies, if you will, that are talked about with growth. And then three truths that actually will drive real sustainable growth for you. So number one that I hear a lot is like you just need more new patients. Now, this can be true. Like I said, lies are with an air quote, and you don't always have to be doing marketing spend and you don't have to constantly be attracting people. And like to me, it's constant marketing spend.
Attracting instead of retaining and full hygiene with low case acceptance. Like that can be some of the things. And what's wrong with that is a lot of offices, like when they're telling me, Kiera, we're at like 90 new patients a month. I'm like, cool, you got a backdoor open problem. Like, if we just close that back door, you probably wouldn't need as many new patients, but your ego is screaming, I need more new patients. Or I've got just all these patients coming through, and that's again, we're not retaining them. Or our hygiene schedule is full, but like our doctor schedule is wide open. Well, we don't have great case acceptance. So to me,
Gotta have like great patients coming in, retaining them, and follow through. So growth actually comes better from conversion, not volume. You do need both, which is where I don't think it's a lie. Like you do need patients. We gotta have at least 30 new patients per doctor per month in a like a GP practice. Pediatrics usually run in like 75 to 90, depending upon the the location and what we're looking for. So, like more patients aren't gonna fix leaky systems. So another
Another one, like I said, I'm gonna go through them and they'll tell you like some solutions to fix it. Work harder and produce more, like outproduce your problems, add more days, work longer hours, do more dentistry personally. But like that's burnout. I just had a doctor and she's like, Kiera, we talked about production and I just can't do it. And I was like, Yes, because you're not supposed to do it. We're supposed to have goals. We're supposed to have the whole team. Like I I was with an office and their goal is like twenty-five thousand a day.
But the dentist isn't doing all that and they're out by like four o'clock and we're just scheduling better and we're making sure all the hygienists are up to goal and each doctor's up to goal. Like profit doesn't always follow production. I don't care what your top line is, I care what your bottom line is. So you have to like there is a zone where a lot of doctors work more, but they don't actually make more or they like take home the same. And to me, that's nonsense. Like I'd rather you scale it back and have a small practice than having this high, I don't know, ginormous one and not taking home profit. So
You've got to have, we've got to have efficiency, we gotta have systems, and we gotta make sure it's not all on hue. And then like let's talk about what growth and profit are that we actually wanna hit, not just a top line number. So I I'm really big on like you don't have to work harder and produce more. There's actually a way of how like what do we really need to produce? How do we actually build a schedule? How do we use the entire schedule? How do we use our morning huddles to win rather than just produce, produce, produce? Okay.
Another myth is hire more people and we'll fix it. Like just throw money at your problems through hiring people, through doing this, like this thing will help us. Like, let's add team members. I have an office and I think they've got like 10 people in the front office. I'm like, my gosh, that's psychotic. Like, but everyone feels overwhelmed and overworked. And I'm like, yeah, because no one has clear job descriptions. No one has an end-of-day checklist. No one has like ownership of it. We just keep piling more and more people on rather than like, all right, what's broken? What's a true system? Because I typically say,
Per doctor, I want one for an office team member, except for if there's only one, then I want two. But that's usually a pretty good ratio. Office managers are like debatable if they're there or not. So if you look at that, this is where, but like we overstaff, but we don't have clarity. We got payroll, but like our payroll sky high, but we saw the same issues. Payroll should be sitting at 30%. Like that should be where we're at. Even if you're like here, it's so expensive. I'm like, I know, but we also can't overpay. We can't have so many team members. There are ways that we could like.
You can outsource. There's so many things that we can do. And that's not for me to say we can't hire people. It is for me to say, like, we got to be smart business owners too. So a lot of times people don't fix broken systems. Confusion scales with headcount. Trust me, I used to have a team of five. Now I got a team of 25. It's crazy. It's very thrilling. So, like, you can add more and more people, but if we don't have systems and processes and like,
clear job descriptions, you're just gonna create more chaos and you think you're gonna fix it, but you just add more, then you're stressed because your cash flow is less. It doesn't fix. You got have structure before you have growth. So people don't fix systems, systems support people. So a couple of now like truths. Okay. So we had like lies. All right. Number one, like I said, you just need more new patients. Number two is work harder and produce more. And number three was hire more people. It'll fix it. Now like I said, hiring people might fix it. Producing more could fix it.
having more patients could fix it. But things that are really going to help are like set systems. Like I was in a practice and I'm like, okay, we just need to get a set schedule. Like I said, they're like, I'm exhausted. I was like, perfect. What is each provider's daily goal? What's their hourly goal? What's our hygiene goal? We need to make sure those are in place. So that way it's not just reliant on one doctor. Now we got to look at our case acceptance. Let's look at our patient flow and let's look at billing. Like to me, a lot of these things like if I just fix case acceptance, I don't actually need a ton more patients. If I just fix case acceptance, it's like why don't we actually
clothes the patients that are in our chair. Can we do same-day dentistry for them? Can we get referrals from them? So I'm having quality patients come through. We're diagnosing and we're accepting. Like, what if I just have those? Like those things in place will actually grow your practice. Having 30 new patients a month per doctor is going to grow your practice. Having reviews that tie to that, making sure our collections are at 98%. So many offices actually are profitable, but they're not collecting the money. So they feel broke.
But I'm like, that's actually a system that's going to grow you. So like let's just go after a few systems that are gonna truly grab scheduling, block scheduling. What are the provider goals? Let's hit that. Let's talk about that at Morning Huddle every single day. Let's look at our case acceptance. Our case acceptance, if you're at GP, like we're not doing huge cases, you should be at like a 70% acceptance. If we are at all on X, I'm usually at like 35 to 40. What's our case acceptance? What are we closing? Are we doing single dentistry? Like what are we diagnosing? Are we diagnosing three tens of what we're trying to produce? If not, I need to go fix my case acceptance.
That is my system to fix. That's going to actually grow my practice. That's gonna put money on my books. Billing, just collect the dang money. Like fix that. That's actually gonna grow your practice. That's gonna grow your profit. That's what's actually gonna grow you. Now, another thing that's actually gonna grow you is having strong, strong, strong profit. You've got to have profit. Like that's gonna grow you. I don't care what your top line is, you gotta know your profit.
So, what how do we figure that out? We're gonna look at our BAM. We're gonna figure out exactly what our practice needs to make, including paying you. And then we're gonna make sure that we have enough patients, we have enough case acceptance, we have enough providers, we can block schedule this to actually produce it. Then we gotta make sure we're collecting it. Because if not, we're not going to get it. You have to be profitable. We gotta look at efficiency. How many team members do we actually need to have? What are their job descriptions? Have clear job descriptions, a KPI per person of a number that's gonna drive the business forward. That's going to fix our practice.
You don't need more people. You don't need more production. You don't need more overhead. We need to make sure our overhead is correct, that we're adequately staffed, that we have the correct amount of production and procedure mixes. Some people just don't do enough dentistry. Like you don't diagnose enough. I need you not to diagnose a single crown filling. I need it to be a crown if it's really a crown. If we can't do this, like we might not need as many team members. Can we outsource and use a biller that's not an in-house? I don't know, but there's ways to get creative. You've got to look at it.
For me, it's non-negotiable. Your overhead needs to be at 50% or less. Doctor pay needs to be at 30%. Our profit margin needs to be at 20%. You've got to go look at it. We either need to cut costs, increase production, or increase collections. One of those three things is gonna make you there. You've got to get profitable. It's not like that's really going to grow you. And sometimes growth comes from contracting. Businesses are like breathing. It's gonna expand and it's gonna contract. Sometimes we're gonna be a bigger team.
Sometimes we're gonna be a smaller team. I've done this myself. I've grown too much and I've had to cut. And then we grow again and then we have to cut. It's not because I'm trying to be irresponsible. It's because I genuinely need to like the business didn't grow as much as we thought it would. We now have to contract. You have to be able to make those decisions. Now I hope that you are not like grow, contract, go contract. Like let's not be like adding and cutting team members on a consistent basis all the time. Like more stability. But really look, what are the job descriptions? What is the KPI? If I hire this other person.
How much more revenue are they going to put in? What are they going to do? I get it. We want to help our team. But I was in a team the other day and they had an outsource builder and this builder was asking for more hours. And they were like, no, this is what you agree to. This is how many hours we want. Let's see if we can actually like what needs to get done. They're under staff. They have a front office team member that's out on maternity leave. But for that team to recognize like more hours doesn't fix our problems. Like we need to be more efficient. How can we be more efficient? A lot of team members, when I go into offices, are not being fully utilized.
So before you go and say, like, we need more team, maybe we should look at their job descriptions, maybe look at our org chart. Let's look at what people are doing and what they should be doing and what they're capable of doing. And then let's see how we can like simplify things. What things can we like delegate out? What things can we hire out? What does that look like? Because if we can get those things put into place, do you realize how much happier every single person is? These are the things that actually grow a practice. Looking at your numbers, knowing your profit margins, having the systems in place that actually put money on your books, hygiene.
Let's talk about hygiene. Making your hygienists are doing three times their pay. That's going to grow your business. It's not like just pump new patients in. It's not pump production on the books. It's not these things like work harder. It's not that. It's genuinely right, people. Let's look at our numbers. Let's see. Now it's like okay, if I know the payroll should be at thirty percent, I now have the dollars allotted for that amount. How I spend those dollars is your decision. It's your discretion. I don't really care.
But you know the metric. So if you know the metric, you know most offices are able to accommodate this. You've got to figure out how for you you can accommodate this. Do I need to increase my production? Then can I look at my block schedule? Can I look at different ways? Can I look at my case acceptance? Can I look at my diagnosis? Do we have better handoffs amongst all of us? What little things are gonna be able to grow you and your practice? That's going to be like those things actually put money on your books. Those things actually move you forward. Like I said, they're not necessarily lies because you do need patience, you do need production, and you do need people.
But making sure that we're not pumping money into those areas or we're forcing those things to grow our business. There's a lot of ways that we'll actually grow your business with a lot of less effort. So look at your practice. And I want you just to say, like, okay, what is my payroll? What is my overhead? What is what is my bam, the barriers minimum of my business? What do I need to produce and collect in my practice? Let's start there. And if I'm like
Someone told me the other day that their payroll was 40%. I was like, okay, great. We have two choices. We can either produce more and collect more, or we can find where we're inefficient and what things we need to change. I don't care. You know the metric, you know it. And then you have a choice. You can either do it or not. But this is what's going to grow your practices and grow your bottom line. And these are not as being cutthroat. These are industry standards across the board. If your hygiene team's not producing three times the pain, you're like, but I'm in California. I know I hear you. Practices are able to do it.
It's just like the four-minute mile. If someone else is able to do it, let's get creative and see how you can do it. I would recommend cutting the excuses and starting to look for truth, starting to look for how, what are the solutions. Kiera Dent is well known for a famous line of there's always a solution, let's find it. So I want you to really truly, what is the solution? What's really going to grow your practice? And if you're stuck, if you don't know, I'd love to cut through the noise for you. I feel like I play Mario. Like I see all the little, like, I don't know, glitterally.
Like, here's your gold star. Here's this thing. It's above your head. Like, my gosh, if they just increase their case acceptance and they fix their blocks and they knew their number, all the practice will grow. In my own business, I struggle with that. In your own business, it's hard to see it. So sometimes you need somebody who's got a bird's eye view, someone who's sitting above the noise, someone who's able to cut through that, someone who's able to say, these are the three systems we're going to put in place first. This is going to grow you exponentially. Let's get the business fundamentals for you. Let's actually grow your business for what you want, not just
So like playing like whack-a-mole and trying all these things that don't actually move you forward. So hopefully that was able to give you three lies and three truths, things that will actually move you forward. And like I said, they're not lies. They're just things that I feel a lot of people put effort and energy in trying to solve their problem rather than doing the work. It's like I want a six pack, but until I get on that freaking floor, I can do a lot of things. There's even things to help me lose weight now. But until I want that six pack, I gotta do the work to get there. So for you.
We gotta do the work that's actually gonna grow your practice, not just like create noise and make it feel like we're moving. ? I love this quote. I don't remember who said it, but they said, Don't confuse progress with motion. A rocking horse has motion, but there's no progress. And I love thinking about that because when we think about it, that can be that can be something I think we feel. Like you are having
motion but it you're not progressing. And like they say, I think it says Alfred A Montagu. I think sorry if I said that wrong. I'm really sorry, but it says don't do not confuse motion and progress. A rocking horse keeps moving but does not make any progress. So for you, are the things that you're doing actually making progress or do they just feel like motion? Because we've got to make sure we're making progress. We're actually growing. We're not just doing motion. So reach out. I'd love to help you. And if this helped
Or you thought about it or spurred it, please share it with somebody. Leave us a review. I'd love you guys to take time to get more people, more offices, just like you to be part of our Dental A Team family. I adore you. You're doing better than you think you are, and I'm happy to help you in any way we possibly can. Reach out, Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.