Planning for a More Profitable Future By Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

Every great team needs a coach: your dental team is no different. One reason Rick Workman, DMD, founded Heartland Dental Care was to provide coaching to his fellow professionals. Heartland has grown to more than 1,750 employees, serving more than 175 practices in the United States, in addition to its coaching and partnership practices. Heartland’s efforts in striving for high clinical standards of care and streamlining operational systems in dental practices have led to greater efficiencies, and ultimately, happier, productive dentists.

Heartland was introduced to the Dentaltown community two years ago and the relationship has blossomed. Recently, I asked Rick to give us an update on Heartland and a few of its Townie clients.

DT: What is your motivation to share information with other dentists? Beyond a business, what is your mission?

RW: I have been blessed economically beyond what one could ever have hoped for. I still remember my first year in practice (and for that matter, my entire 16 years I practiced). I remember how I became extremely motivated AFTER I graduated from dental school to learn how to become more proficient with the delivery of dental care and how to deliver that dental care in a better environment for my patients and team members.

I spent 45 hours per week AT the chair and another 20 (at least) hours per week for all those years trying to figure out why there did not seem to exist:
a) unity within our profession,
b) an obvious place to turn for answers that were complex for me at the time,
c) a place that created a positive mentality (abundance thinking) that fostered better clinical care along with personal growth and development and ultimately better leadership,

I felt that someone who implicitly understood the dentist could shorten the learning curve by as much as 20 years. Heartland’s mission continues to be to help dentists achieve their goals and success whether they are part of the Heartland Dental Care family, a partner or a coaching client.

DT: What is the future for Heartland? Does it continue to own dental offices or own fractions of a dental practice? If so, how many? Are there other areas Heartland plans to expand?

RW: The future for Heartland Dental Care is certainly looking very positive. With more than 175 individual practices currently affiliated with Heartland, our primary area of business will continue to grow.

As for our coaching business, we have some very strong, capable coaches who are working with Heartland practices now. As more dentists become aware of the vast amount of opportunities they have yet to take advantage of, this area also will continue to experience growth. In addition to affiliation and coaching, partnership opportunities also are available where Heartland becomes a minority partner with a solo dentist who desires to grow in his or her marketplace.

DT: What types of dentists have demonstrated the most demand for Heartland’s services? Which type of dentist seems to be struggling? Why?

RW: Due to the number of offices that make up Heartland Dental Care, we have experience working with dentists and practices at every level. Perhaps the ones who don’t realize they need help are those in the middle, which account for about 60 percent of the dentists out there. These dentists may even be above the national average in income and they believe they are doing well. They may be following the same standard of care taught to them in dental school and also believe they offer high quality dental care. Heartland’s coaching program can help this group by sharing with them that simply by increasing their standard of care, for example implementing a written x-ray policy or written perio policy, they can take their practice and turn it into a $1 million-a-year or more practice with relative ease. While we understand growing a practice is more complicated than any single “system” or magic bullet, we know we can introduce systems that provide consistency and continuity, improve one’s diagnostic ability and treatment planning options, and help with coaching on communication skills which improve case acceptance. In addition, there is improved accountability and expectations are crystal clear.

Spotlight on Heartland Coaching Clients

Owner/Dentists: Drs. Scott and Rachelle Neil
Practice Name: Smiles for Life Family Dentistry
Practice Details: Scratch start, open for one year previous to Heartland Coaching
Location: Las Vegas, Nevada; population 1.6 million people
Ratio of dentists to population: 1:800

Practice Details        Before Heartland/After Heartland
Number of active patients: 281/480
Annual collections previous year: $503,476/$753,056
Average monthly production: $52,665/$74,677
Number of team members: 3/5
Number of operatories: 2/4

Heartland Coaching has assisted the Neils with collections, scheduling recare and training new employees. It also has given them specific direction for their practice by encouraging them to put their goals on paper.

The Neils said, “Before we didn’t give specific direction (to our employees or to ourselves). They were usually vague and general.”

“Every time our coach comes,” Dr. Rachelle continued, “we pull out our vision and we decide what we want to work on. It’s usually set up in threes; we look at three things we can accomplish and/or work on for the next quarter. Then, our coach helps us put an action plan together that includes accountability.”

DT: Which areas of practice does Heartland consider its strong suit? What is the difference between a coach and a consultant?

RW: Heartland’s strong suit is that it offers contemporary real-world solutions. This is a distinguishing factor between a coach and a consultant. A consultant teaches and demonstrates formulas, systems and skills. Our coaches provide real-world solutions regarding the full scope of a dental practice to include products, equipment and more! The real-world solutions come from years of working through many of the same challenges faced by Heartland doctors and practices everyday. In addition, our coaches, unlike consultants are very hands-on. They model through action how to implement guidelines often used in “best practices,” working side-by-side with their clients and taking on situations as they arise.

We find in coaching most dentists have a vision for their practice, but often it is not well refined or well communicated; and therefore not well implemented. Heartland coaches help dentists develop their vision and set a course to achieve it. For example, if part of a dentist’s vision is to have increased case acceptance, our coaches may first begin with a review of one’s x-ray policy. They might suggest that instead of a pano and bitewings, an office include a full mouth series of x-rays, which provide the dentist with the most comprehensive diagnostic tools. When a dentist improves his/her ability to diagnose all necessary treatment for the highest standard of care possible for the patient, the clinical team in the office can work more collaboratively together. Increased collaboration and buy-in from the team leads to increased clinical care for the patient. Once team members understand what is best clinically for the patient, they become supportive of the treatment and the vision of the practice. The coach will then provide additional training to the team on communication tools to aid in the presentation and explanation of treatment to the patient. These tools help to convey to the patient the team’s passion for the treatment, and ultimately, increase case acceptance. The “system” for increasing case acceptance is actually implementation of a series of clinical protocols along with communication coaching and teamwork.

DT: How did you develop the benchmark numbers? How often should a dentist review his/her numbers?

RW: The basis of benchmarking originated with W. Edwards Deming and involves studying the best practices and emulating them. It has taken many, many years for us to fully understand the impact of benchmarking. Anyone can pull numbers and look to see how they are increasing or decreasing. It has taken our team of very talented, experienced individuals to master the connection between measurement “X” and measurement “Y” – and the correlation of that ratio to measurement “A,” “B” and “C.” For example, if one were to review the measurements of the number of prophies completed and likewise the number of quadrants of scaling and root planning, one would likely compare that ratio to national statistical data available as to what one’s reasonable clinical expectations should be regarding the presence of periodontal disease in one’s practice. One of the telling correlations for these measuring tools is to verify the alignment with one’s philosophy of care to clinical expectations. Having a perio policy or guidelines along with a mechanism to ensure one is fulfilling that standard of care is very valuable. With our model in Heartland practices, doctors have the opportunity to compare the fulfillment of their standard of care to more than 250 doctors with the similar philosophy. Many become surprised at what the numbers and relationships often reveal, which then in turn instigates a change in their clinical approach to work toward improved fulfillment of their standard of care relative to their perio policy or other areas of patient care. Once the intended philosophy/standard of care is aligned with the actual delivery of services, which can be confirmed through these measurement tools, goals can be accomplished and success follows.

Most importantly, benchmarking helps dentists to see the opportunities in their own unique practices.

Spotlight on Heartland Coaching Clients

Owner/Dentist: Dr. C. Ryan Haygood
Practice Name: Haygood Dental Care
Practice Details: Scratch-start practice opened in November 2005.
Location: Shreveport, LA; population 20,000
Ratio of dentists to population: 1:2000

Practice Details      Scratch-start with Heartland
Number of active patients: 700
Annual collections for previous year: Not known
Average monthly production: $72K
Number of team members: 4
Number of operatories: 3

After attending a seminar put together by a dental colleague, Dr. C. Ryan Haygood joined the Heartland Coaching program.

“Things (in my practice) were not going badly. I just knew they could be better,” Dr. Haygood said. “I knew what I wanted to achieve, but had a very hard time communicating my vision to my team. I was impressed that Heartland could take new dentists just out of school and make them successful almost immediately. Heartland builds their leadership skills as well as their clinical skills and makes them successful. I felt they had the right systems to help me achieve my goals.”

Heartland assisted Dr. Haygood’s office in becoming a true team. “My team understands what I am trying to achieve…they get it now,” stated Dr. Haygood. “They know why it is important to follow the clinical and operational systems we have in place and understand the detriment to our practice of not doing the right things for our patients. Teamwork has gone through the roof. We have a more enjoyable working environment.”

In addition to practice coaching, Dr. Haygood has received assistance from Heartland in the marketing department. Heartland has dealt with the local newspapers, designed and supported his Web site and sent postcards advertising his practice to area residents. Heartland even assisted Dr. Haygood in hiring a team member for his practice. “Basically, if we have a question about any aspect of the business they have a person that can answer our questions,” Dr. Haygood said.

DT: What are some of the specific problems that prompt new clients to seek Heartland Coaching services?

RW: The reasons vary from practice to practice, but some of the usual suspects include cash flow, lack of a perio policy, low or stagnant patient flow and low treatment acceptance. Many also simply would like to boost low production, profitability, or implement systems that keep them and their teams accountable. Many clients finally have come to the conclusion that they are not on pace to meet their retirement needs, or, simply feel “left out” from the fantastic rewards this profession can offer.

DT: What is the role of Dentaltown in the expansion of Heartland Dental Care?

RW: Dentaltown provides a neutral and safe arena where its 60,000 members can openly and freely discuss industry issues, techniques, products and services and more. Heartland participates in these discusses, offering an experienced voice. Through this medium and others, Heartland will continue in its role to help thousands of dentists realize the tremendous amount of untapped opportunities that are still out there waiting for them. Once the discovery process has been fulfilled, Heartland through its affiliation, coaching and/or partnership programs will help these dentists set new goals and achieve the type and level of success they never dreamed was possible. Dentaltown and Heartland both will grow and expand throughout this process.

DT: There are many consultants, coaches and practice management companies in dentistry. Heartland Dental Care is clearly a company that is here to stay and its track record is evidence of its success. If you would like to learn more about Heartland Dental Care, talk to the Townies on Dentaltown.com or contact Heartland directly at 1-888-999-3661 or through its Web site at www.heartlanddentalcare.com.

Spotlight on Heartland Coaching Clients

Owner/Dentist: Dr. Dan Marut
Practice Name: Today’s Dentistry
Practice Details: Bought an existing practice
Location: Ashland, Oregon; population 20,000
Ratio of dentists to population: 1:1400

Practice Details        Before Heartland/After Heartland
Number of active patients: 750/1,300
Annual collections previous year: $685K/$1 million
Average monthly production previous two years: Varied greatly/$85K per month
Number of team members: 5/8
Number of operatories: 4/4

Dr. Daniel Marut was introduced to Heartland Coaching in March 2004, when he made a trip to Effingham, Il., headquarters of Heartland Dental Care, with other members of Dentaltown.com.

“I was concerned that Heartland was just getting into the coaching program,” said Dr. Marut. “Our first visit went incredibly well. Our coach was very conscious of our concerns of losing our identity and becoming a cookie-cutter practice. But during that first visit, she dispelled those myths and made us feel at ease.”

Dr. Marut feels Heartland has helped him to understand himself better, both personally and professionally. “I have a better focus to achieve the results I want,” he said.

When asked what he would say to other dentists regarding Heartland, Dr. Marut replied, “…if they aren’t going where they want or if they are let down by themselves, by the profession, or those around them, then they might want to consider getting a coach. I would highly suggest speaking with Heartland and encourage them to do so. It is a top notch group. Heartland is not a dental mill. Far from it! Heartland serves patients with their best interests in mind and is increasing care in the populations we serve.”

Currently, Dr. Marut is about to open a new office with eight operatories to accommodate the tremendous growth of his office.