Monday, October 12, 2015

A Season of Opportunity

If you follow my blogs, you know I am big on lists, goals, and growth opportunities. To say I’m “type A” is quite an understatement. I am one to set lofty New Year’s resolutions—most of which make it at least out of the winter and spring. It’s only a select few that continue through summer, and by fall, well, good luck. I’m not sure that I can even remember those resolutions.

No, seriously…what were they again??

Fall in Virginia is why people choose to live here. Sweatshirt weather in the morning, windows down during the day, and outdoor fire pits by night—it really is an awesome time. But it’s more than that; it’s a time when (at least in my practice) the hustle and bustle of the summer rush slows a bit. It’s a time to sit back, reflect on how the year has gone, and more than likely, catch up on family, practice, and life in general.

Use it! Our profession is tough. Being busy, seeing lots of patients, and cranking out production is an awesome feeling (and it pays the bills), but it’s a grind. It takes it out of you. We all need a recharge. And now’s the time to do it. And don’t make it about work; make it about yourself or your loved ones.

Take up yoga.

Dust off those golf clubs for a round with some buddies.

Lace up those running shoes.

Take your kids camping.

Take your sweetheart on a weekend getaway (or a two-week extravaganza if you can swing it!).

This season, make it a point to recharge your batteries. I think that it’s the best time for it. Make sure your staff does the same. They’re as much a part of this as we are. It’s a season of opportunity, people!

Donald Murray III, DMD

Wednesday, October 7, 2015

‘I Can’t Wait to Share My Practice Secrets With You!’

My head is going to explode unless I share my practice secrets with you! I can’t wait to tell you all about them!

I’ll tell you how to take a practice that sees two new patients a month to one that sees more than 2,000 new patients a month!

I’ll explain how to increase your collections from the teeny-tiny amount you now collect to more than $1 million per month!

I just can’t wait to share this with you… all the magic secrets that ONLY I KNOW! Hurry, I am bursting with excitement over sharing all this information with YOU!

All you have to do is buy my DVD or book, or attend my seminar. And, if you thought regular books and courses were expensive, wait until you see how much I charge!

OK, seriously now. Don’t you just hate this kind of dental marketing? I know I do. I hate those emails that ask things like, “Do you know the five biggest practices killers happening in YOUR office right now? Just click on this link and we’ll be happy to tell you.” You click, and then BAM, you are hit with an offer to purchase the information. 

I'll make a deal with anyone who has such “secrets” to sell. If you agree to share your information, you can have my next spot in The Daily Grind blog rotation. Wow! You can share your info here for FREE! Something tells me I’ll be back the next time around.

I have a secret of my own: There are no secrets. If you read the dental business magazines regularly and observe successful dentists in your area, then you will learn all you need to know. I have this saying (it’s more of a generalized guideline, really) that I often repeat, “Everything has been done before.”

What do I mean? Thinking about a kitchen remodel? It’s been done before. You can look at catalogs, online photos, etc., to find ideas. Just follow the examples you like, and with your touches, you’ll have a new kitchen that didn’t require reinventing the wheel.

Want to learn how to brew your own beer? It’s been done before, too. Look at online videos or get a how-to book. Again, you don’t have to reinvent the wheel.

It’s the same thing with your practice. Successful practices were created long before you decided to attend dental school. It’s been done before. Read some dental business magazines, emulate your successful colleagues, and you’ll be fine. No secrets.

However, in all fairness, if you still feel like shelling out thousands of dollars, send it my way. I did just share some information with you after all.

Andy Alas, DDS

Monday, September 28, 2015

Teeth That Bother Me

Wisdom teeth. Third molars. The back teeth. Whatever your patients like to call them, they are the ones that I absolutely hate. Every time I see a new patient’s X-rays and I see these guys— whether they are impacted, partially impacted, or fully erupted—I always make the same suggestion: I recommend that you please schedule an appointment with our oral surgeon to have them removed or, at the very least, have a consultation to determine the risk factors.

Some of you may not agree with me. If the teeth are not bothering the patient, why have an unnecessary procedure? In my experience though, I find that, eight out of 10 times, these teeth are destined to be extracted. It could be when the patient is 25 years old, or 55. It could be when they schedule the procedure in advance and plan time to recover, or when the pain flares up right before they are scheduled to travel.

Let’s look at some of the pros and cons of keeping these teeth, which is a conversation that I frequently have with my patients.

Pros (of keeping them): 
1.      More surface area of teeth to chew with. Better digestion, maybe? Not sure if this has been studied or is clinically significant, but why not?
2.      Extra tooth to possibly replace missing second or first molar or serve as a bridge abutment. Except as a cantilever. Please don’t cantilever off a third molar.
3.      Less risk of nerve damage. This one is important.
4.      Potential for more dental work in the future. This is more for the dentist, I guess, than the patient. Who doesn’t love redoing fillings and filling cavities on wisdom teeth? I personally refuse to do so unless the patient is desperate, but I have seen some root canal treatments in third molars. That must have been one hardworking dentist!

Cons (of keeping them):
1.      Risk of infection and pain occurring when the patient has other plans, typically vacations, weddings, and holidays.
2.      Risk of bone loss around second molars. This happens frequently on the distal of those molars that we actually want to keep and compromises their longevity as well.
3.      Risk of decay on the distal of second molars. I have seen this happen, and I am even attaching a photo as evidence.

4.      More teeth to clean. This one isn’t that serious, but those hard-to-reach areas can become a big problem, leading to the issues mentioned above.
5.      Potential for more dental work. This can be a pro or a con, depending on what you are into.

So, who is with me in the quest to eradicate third molars? Except when they are close to the nerve, of course.

Have a great week!

Lilya Horowitz, DDS

Friday, September 25, 2015

‘I Thought You Said This Was Permanent’

I don’t know if you all have been reading my posts for a long time, but I used to give you book and movie reviews. 

I haven’t seen a movie in a real theater for a long time, but my kids wanted to see “Jurassic World,” so I relented. (We go to the dollar theater all the time, but that doesn't count, because all those movies are already out on video.)

The movie was fantastic, by the way. While waiting for the movie to start, we saw a trailer for “The Martian.” It looked good, so I borrowed the book (can you see a cheap theme in my life?), and I just finished it yesterday. Other than some slow parts in the middle, I thought the book was very good.

But what amazes me is that this was the author’s first novel, and the funny thing was that he initially was giving it away for free on his website after several publishers rejected him. One of the author’s friends said that the website download was too slow, so he put it on Amazon for the lowest price it would allow: 99 cents. Shortly after, he sold a bunch of copies at 99 cents each, and publishers started to notice. Next thing he knew, he had a book deal and a movie deal!

The movie comes out on Oct. 15. I am looking forward to 10 weeks after that, so I can see it at the dollar theater.

Anyway, to the topic de jour:

I have a 75-year-old patient. My father did a full mouth reconstruction on her about 14 years ago.

Today she came in with No.10 broken off at the gumline. I told her that we can save the crown if the margins are intact. But first we would have to do a root canal and a post and reverse core. 

She then got that confused look on her face. She said, “I thought your dad told me that this work was permanent.”

Hmmm… I was blown away by this. I was shocked that someone would think that dental work could be equated with forever. I was put into a position to talk to her about the difference between “permanent” cement and “guaranteed for life.” 

But this might be a great forum to talk about what to do when something fails. Man, this is a tough one, and I know that we are all different when it comes to this topic. We all have different philosophies when it comes to running a business. And, yes, this definitely falls in line with how we run our businesses. 

I know some of you are the strict type. You run your practice like it is a business (that’s funny to type). Everything is black and white. The fee is the fee, and if you don’t like it, then you can go somewhere else. You say things like, “This is our policy.”  

I, on the other hand, don’t do anything by the book. 

I don’t run my practice like a business. And, what I mean is, I am very loosey-goosey about policy, because to me it’s more about the relationship than it is about sticking to the policy.

On a side note, this is a business model; it just doesn’t always look like you’re running your practice like a “business.” Am I making sense? Because I give stuff away like crazy and my business is flourishing.

I am a very aware consumer. I go into a place and I think about what the ownership is trying to do. Is the staff friendly? Do they care about me or about themselves? How is the product? How is the execution? How do I feel when I am paying? Do I feel ripped off? Do I feel happy about giving them my money? Will I tell my friends about this place? 

And the question that I always ask myself (and what all your patients are asking themselves) is: Will I come back? 

All of these questions are running through my mind when I think about the way in which I run my business. 

I want people to like my place. I want people to feel like family when they come in. (We take photos of everyone when they come in so the next time we see them, we can greet them and call them by name.) I want them to not feel ripped off (even though dentistry is expensive). I want them to tell people about us and I want them to come back. 

So what do you do when a person who has been in your practice for 15 years breaks something that is 14 years old and says, “But I thought this was permanent?”

For me, it is to try to make the patient feel heard, try to educate her, try to make her take some ownership of it, and try to make her feel not ripped off. 

My loose policy on my work is that most of it is guaranteed.  

I think that I have told you this before, but if any composite restoration fails within five years, I do it again for free (I fully expect them to last for 15 to 25 years.) 

Now crowns are a different story. I think crowns should last a long time, more than 20 years. I usually will do crowns again for free if something fails within seven years. (Oh, my lab will also do it again for free, too. He also has a replacement policy). Between seven and 10 years, I will usually do it over for half price.

I know this might sound crazy, but I rarely do things for free. I will usually do one crown a year for half price (and sometimes less than that).

Things don’t really fail. I am not saying that I am all that. I am just saying that materials have gotten pretty idiot-proof and very strong.

But when they do fail, I just do it again. It’s the price of doing business.

I run my practice like a business—but it is my business. 

I sat the elderly patient who thought the work was permanent/forever and educated her on what those words mean (and I also told her “nice try”). We talked a bit more about how I was going to try to be conservative and save her some money, and we did the work. She was heard, she understood what we were doing, she was comfortable moving forward, and hopefully she was happy with the work and OK with paying the fee. 

Now that is a business model that will be permanent and hopefully it will last forever (see how I did that... bringing it around full circle?). 

How do you handle work that breaks? Do your patients think your work will last forever? Let me know your stories.

Have a great day, 

John Gammichia, DMD, FAGD

Friday, September 18, 2015

Hire That Older Applicant!

When you hire someone, how long do you hope she or he will work for you? How many years of service would you be happy with? Two years? Five years? Ten years? How many people currently working for you have been with you for more than five years?

My friend Doris just lost her job. She is a geophysicist and she works in the oil patch here in Calgary, Alberta. With the current global oil glut, Calgary alone has seen more than 40,000 people lose their jobs. Doris, a married mother of three (all mid-to-late teen boys) who is the primary income earner for the family, finds herself in her mid-50s with no job, no income, and a bleak future. Why? She is experienced, smart, capable, hardworking, enthusiastic, a solid team player, fit (she runs marathons in her spare time), loyal, possesses no sense of entitlement, and more. She would be the ideal employee, as far as I am concerned. But she tells me that people have been citing her age as a barrier to future employment.

I am astounded by that statement. I revisited all of the questions listed in my first paragraph above. In the oil patch, an employee who works for one company for five years is considered a veteran in that company. So with 10 to 15 years of useful productivity left in her career, why is her age a barrier now?

Carol applied to my office to work for me on my administration team (many of you call it a reception position). She was 57-years-old with 30 years of experience. She was experienced, knowledgeable, a good team player, loyal, married with an adult child, possessed no sense of entitlement, and more. Her personality testing showed her to be a great candidate with leadership potential. Her salary requests were reasonable. I hired her.

We recently celebrated five years of working together and to mark the milestone, I gave her and her husband two nights and dinner with wine pairings at a luxury hotel in Banff (a 60-minute drive from our home…we are so fortunate to live where we live) as a thank you for the five years of service, and hopefully many more. She has never called in sick and she’s a great team member.

When people heard that we had been working together for five years, they were surprised, because so many dental offices do not retain staff for that long. I was surprised to hear that, since I have lots of long-term members on my team…one at 19 years, two at more than 15 years, and so on. I have eight staff on my team and their ages range from early 20s to early 60s. Although all female, my team members are of four major religions: Christian, Jewish, Hindu, and Muslim. I love this team who I get to work with every day.

So don’t overlook the older applicant. How many years do you hope she or he will work with you? Can that older applicant fit the bill? Can she or he fit into your office culture and practice philosophy, which is way more important than age anyway?

Think about it, and share with me your older applicant stories.

Warm regards,

Larry Stanleigh, BSc, MSc, DDS, FADI, FICD, FACD

Wednesday, September 16, 2015

Diving Into the Deep End…of Your Community

I’m going to give you a little bit of backstory before I dive into the deep end of my message today.

I grew up in the country. I mean country—three stoplights in the entire town. When the McDonald’s opened, it was the highlight of an entire year of our childhood (ain’t that scary?), and we had one elementary, middle, and high school. Needless to say, everyone knew everyone. It was a tight-knit community.

Fast-forward to college in a bigger town and dental school in a major metropolitan city. Nearing dental school graduation, I weighed my options and decided to return to the city closest to where I grew up, only I wanted to be in the middle of the action. Young, single, and enjoying life, I chose to live in a downtown loft, five minutes from the social scene, 60 minutes from work. I enjoyed the city life and all that comes with it, but I was missing something with my patients. I was missing a connection with most of them that I didn’t understand until much later, when a lightbulb went on—I was missing the community connection.

I remember growing up, playing baseball seemingly every day for eight months out of the year, from ages 5 to 21. Dad was always the coach, and everyone called him “Doc.” I shook it off as nothing, but now I get it. He wasn’t just there just for us; he was there connecting with the dads/moms/kids/grandparents of his community. And he did it well. He’s run a bustling practice in that little old town with one McDonald’s (we have a Bojangles’ now—whoop, whoop!) for 30 years, and most of his patients know him from the ball field, grocery store, church, or gym.

There’s something different when patients get to know you outside of the office. It brings about a deeper level of confidence and trust in you as a practitioner, doctor, and friend. It’s a great way to build a patient base, as well as to do good for others around you. You just can’t beat it.

So my wife and I recently decided to dive in. We are making the move out near the country. It’s a big change, but I am excited to get involved with the same patients to whom I’ve said, “Hey, how’s the weather?” for years. (That’s my go-to question when I don’t have anything else to say to a patient.)

I’m excited to see people on the weekends and have them crank open their jaw, point to No. 18, and ask what I can do for it.

We have an awesome job. We really do. People always will need dental care, but, more importantly, we do some great work for people in pain, in need, or in desire of a beautiful set of chompers.

I’ve made the plunge, and I’m headed for the deep end. Hopefully, I don’t drown!

Donald Murry III, DMD

Monday, September 14, 2015

Did That Really Just Happen?

Have you ever had one of those moments where you pause and ask yourself, “Did that really just happen?” I am referring to the moments in the office that make you want to smash your head onto the desk, and also those moments that leave your side hurting because you’re laughing so hard.   

There are, of course, those times when you haven’t even recovered from the two-week notice of one staff member and you are hit with another who is moving on to something else. You sit there silently, because there is nothing you can do to change the situation and yet you have no time to deal with it either. [insert head smash]  

Or, what about that moment when you see that patient on your schedule, the one who has fallen out of treatment and was a nightmare to work with previously. You already feel your stress level rising and the patient isn’t even due to come in to the office for two weeks.   

Of course, intermingled amongst the downs of the day, are the ups. I am very pleased and lucky to say that laughter is an ever-present sound in our office. We like to have fun with each other and our patients.

Some of the moments of laughter arise when you walk by a treatment room and you overhear your assistant teaching a patient who was concerned about her speech as she transitioned from a long-term complete upper denture to an open plate implant-retained denture. You hear the assistant teaching her a tongue twister to practice but you’re unfamiliar with it… then you hear it. “I slit a sheet a sheet I slit…” and the patient is laughing, because every other word is clearly not “sheet.” Between the laughter and the giggles, you can hear the improvement and confidence the patient is gaining in her speech. [insert full-belly laugh]

There also are those times when you can hear patients interacting across the hall during their hygiene visits and laughter resonates throughout the building. Those are the moments that keep you from smashing your head onto the desk at the end of the day. 

I also enjoy those times when the team shares the funny stories of family life that has everyone giggling so hard that no one can catch a breath. These are the moments that save us time and time again—those stories that you just have to question if they even really happened, because they were so funny you barely believe that your career can be that much fun!

Be the reason that someone laughs today—just try not to do it at your own expense!

Colleen B. DeLacy, DDS, FAGD


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