E39: Podcast: Developing your team members

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of healthcare and the business of healthcare. And now here is your host, Dr. Kevin Coughlin.

Kevin: Welcome to tonight’s podcast. My name is Dr. Kevin Coughlin, owner and CEO of Ascent Dental Solutions, with a focus on knowledge, consultation, development and training. I’d like to give special thanks to VOCO Dental Supply Company.

Without their generous support, many of these podcasts could not be provided. VOCO has been providing dental supplies and helping the dental profession improve the quality of care and service to patients for over 40 years.

I’d also like to give special thanks to Mr. Doug Foresta, his company Stand Out and Be Heard. Without his expertise and training most of these podcasts also would not be possible. So a special thanks to Stand Out and Be Heard, Mr. Doug Foresta.

Tonight, we have a podcast about developing team members. How do you take your staff or team members and make them more valuable and more engaged? I have several questions that have been written in and I’d like to address those questions. But to begin with, let’s talk about number one, what is important in developing your team.

Doug: The first thing I want to ask you Dr. Coughlin is — this is Doug Foresta — what I want to ask you is first of all, what is the importance? Can you say a little bit about what the importance is of developing your team towards the value of a practice?

Kevin: The first thing I would tell you is if you don’t have a successful team, you don’t have a successful business or practice. I think intuitively, all dentists understand that they’re generally the leaders of their organization. But unfortunately, most of us are not trained in leadership, we’re not trained in management, and many times, we don’t know how to facilitate our team members.

I’d like to tell everyone that when we talk about staff, staff to me means an infection. Team members mean to me individuals that share a goal and they are there to support your patient base, your business, and their main job is to improve the quality of care and service to our patients.

I’d like the listeners to understand that when a patient opens their mouth, they are a patient. But when that patient doesn’t have their mouth open, they’re actually a consumer. It’s important to understand the difference that day to day, we are not just seeing patients, we’re also seeing consumers.

And as consumers become more savvy, they have more information and data at their fingertips and this data and information can be disseminated so quickly. It is critical that you and your team understand that you’re not just dealing with patients, you’re dealing with consumers.

Doug: Can you give some examples? I know one of the things you’ve talked about is this idea that every team member is a sales person for your practice. Can you give us some examples of what you mean by that?

Kevin: Yes. I have been practicing general dentistry since 1983. I practice fulltime. I practice five days a week and sometimes I feel I practice seven days a week. I have 14 locations. I practice all forms of dentistry. I have over 150 employees and over 20 dental associates.

So when I speak to you as a consultant, as a person providing information and knowledge, I deal with these things on a day to day basis. Many of it has come from research, but most of it has come from the day to day trials and tribulations and the processes and procedures that we’ve been able to implement, that have not only improved the quality of care and service, but have improved our team members’ life and their lifestyle and my life and lifestyle, to make us more efficient, more profitable and to make it just an overall better experience.

The first thing I would tell you is your team has to understand that not only do they need knowledge in the basic dental procedures, whether that’s periodontics, endodontics, oral maxillofacial surgery, implant dentistry, temporomandibular joint or temporomandibular disorders, cosmetic procedures, sedation options, pediatrics, dental radiology, public health, the list is really extraordinary. And the ability to train your team to not just understand the clinical aspects, but in my opinion, what’s just as important is the value of these services. If Mr. and Mrs. Smith understand the procedure but don’t see the value, then I can tell you you’re going to spend a lot of time with empty unproductive chair time in your office.

Over and over, over my three and a half decades of training, education and lecturing, I have seen that many offices are well educated in the procedure, but they’re not trained in the sales. They’re not trained to educate their patient base or consumer about the value of the service. And that’s a critical piece that must be understood and must be taught.

I think there isn’t a dentist or a dental personnel out there that doesn’t realize that some individuals are just innately better at sales. In general, the medical and dental profession generally frown upon the word sales. Sales sounds unprofessional. We’re above the fray, we shouldn’t be selling anything. We provide care and treatment.

In the world that I live in, I believe that sales is positive. When you can educate, inform and motivate patients in a certain direction for a specific treatment, providing that treatment is the correct treatment and best for your patient, then sales are critically important because they motivate your patient to do what you think is best for them. And that’s not always the most expensive care, but it’s sometimes not only the most inexpensive care.

What I’ve learned over time is that you have generally five different patient types. You have the event-driven patient, the reactive-driven patient, the proactive-driven patient, the discretionary-driven patient and the regenerative-driven patient. It’s critical that your team members and you as the CEO of your office and leader understand these five different types of patients. Many times these groups will overlap.

The event-driven patient is the patient that just simply comes when something happens. Their tooth broke, they make an appointment. Their tooth hurts, they make an appointment. What motivates them is the event. The reactive-driven patient is the type of patient that knows they should, but unless something actually happens, they don’t do it. There’s some kind of motivator. Either they’ve gotten divorced and now they want better teeth, they’re looking for a new job and they think their smile is not as nice as it should be, they learn that their overall health may not be as good as it could be, they may be developing hypertension, diabetes and part of that medical issue is their dental component is poor.

The proactive patient is the patient that’s tooth-based. They want to treat one tooth at a time. They don’t look at the entire maxillofacial skeletal pattern, they don’t look at the occlusal schemes, they don’t look at the way the teeth upper and lower jaw and temporomandibular joint complex work as a very highly sophisticated tuned instrument. They’re proactive in that their tooth broke and they just want to fix that one tooth.

The next group or discretionary group is they want to look and feel better. Typically, in my experience, these are individuals that are a little older in life. They generally have been able to relinquish the responsibilities to their family and their children. Their children are generally grown, they’re out of college, they’re generally 50 years of age and older. They’re thinking about retirement and they say, “You know, this is the time for me. I want to look and feel better. I want to be a little selfish and start taking care of myself. The last few decades have been supporting other people.”

The last group are the regenerative-driven patients. What they want to know, is it worth the investment? They have the time, they have the finances, they have the knowledge, but really what they’re looking for is is there value in this care? If I do procedures A, B and C, is this going to be a good investment? Is it going to last me several years or perhaps several decades?

It is critical that you educate your team members to understand and sort of define these five groups because how you interact with these groups are going to determine your success rate and how patients accept your treatment plans.

Doug: Can you say a little bit how that ties in?  As you were saying that, I was thinking about the patient who says, “Is my insurance going to cover this procedure?” Are there certain types of clients who are more likely to just stick with what the insurance covers and then others are more likely to do other things that might not be covered by insurance?

Kevin: I attend well over a couple a hundred hours of continuing education courses every year. I’ve listened to experts not only in business, but in medicine and dentistry. And my analysis is you will always have that group of patients that no matter what you try, no matter how much you want them to believe, like and trust you, as I call it the BLT, at the end of the day if their insurance isn’t paying for it, I don’t believe they’re going to do that treatment.

However, we can improve our odds by isolating these groups of patients and trying to motivate them, try to manipulate. And I know that’s a poor use of word, but manipulate in a positive manner. What you have to try to focus on is the value. Not the cost, but the value.

Day in and day out, I simply say to a Mr. and Mrs. Smith, “I’ll be happy to remove your tooth today, but I don’t think it’s the correct or best treatment for you. In the short term, it will certainly be the most inexpensive approach, but in the long term it will be the most expensive approach.”

What I found over time is patients are motivated by time, money, sex and fear. What I mean by sex, just to make a point in this podcast, is people generally want to look good.

However, what I have found is if that individual is entering into a new neighborhood, a new job or a new relationship, that motivation, that hierarchy, moves higher to the top because they’ve been in a comfort zone. They’ve been in a relationship for years, they’ve probably allowed themselves to gain a little weight, they’re not exercising as much, their dental hygiene is not as good as it should be, they’re overall concern with cosmetics and aesthetics is less. But then there’s a changing event.

Perhaps it’s a death, perhaps it’s a divorce, perhaps it’s a new location and a new outlook on life and then that motivation of looking good and feeling good moves up. And basically why do you want to look good and feel good? In most cases, you want to have a vibrant personal relationship with another partner.

So keep in mind that in most cases there is an overlap of all these subjects. But in general, I think it doesn’t take long and it doesn’t take much education and training to understand that certain people are motivated by time — how quickly the procedure can get done, how quickly they can get in and out of their appointments because they’re very busy, they tend to be a type A personality.

The other group is that value. They don’t mind spending the money, but they want to find the value. Are they spending the money for the right reasons and are they going to get the results?

Another motivator which you can use to your advantage is fear. Many times patients have the finances, they have the time, but they don’t associate the fear and they are afraid of a root canal. In my opinion, if we could guide them to do the crown before the tooth breaks, there’s much less likelihood that they’re going to need a root canal. And when they understand it in those terms, they’re more likely to accept your treatment plan.

I’d like to share some statistics with you. Generally, the average patient in the United States, over the age of 20, spends approximately $500 a year on dental care. It’s critical that you understand that those $500 simply are telling us and our profession that most patients are treating tooth by tooth. They’re event-driven patients. They only come to see you because of an event.

Our job and your team’s job is to change them from event type patient to regenerative-driven patients. Showing them the value so that they’re looking at their entire stomatognathic system and they’re not treating one tooth, they’re treating their entire upper and lower arch and temporomandibular joint complex to get the best long term aesthetics function and cost results.

Doug: I have the last question for you here which is, thinking about when a dentist comes in and says you need this, you need this and I recommend this procedure, we’re talking about the importance of team members and sales. Do you find in general, that patients will sometimes if the team member either is the one to initiate saying I need this or maybe backs up what the dentist says, does that sometimes make the difference versus the dentist being the one to say you need this procedure?
Is there a difference in the level of trust with the patient?

Kevin: Based on my data and research almost 90 percent of all treatment plans are not accepted. For our listeners, don’t take this out of context, but a comprehensive treatment plan includes soft tissue management, hard tissue management and temporomandibular joint treatment and elective procedures. So a treatment typically would be Mr. and Mrs. Smith needs four quadrants of root planing and scaling. They need to be put on a three-month recall or re-care program.

They generally will require some kind of chemical intervention with prescriptions of Prevident, Periogard and Periostat to chemically fight their periodontal disease. And they need a comprehensive periodontal re-evaluation in three to six months.

In general, most patients will require the surgical removal of four wisdom teeth to create room and function and to reduce the chances of infection, pain and discomfort later on in ages. In most cases, almost all patients would benefit from some intervention of orthodontic care to align level raw teeth to provide stable accusal contacts on the upper and lower arch. That is a comprehensive treatment plan.

In most patients, what they’ll say is, “I’ll come in and have my teeth cleaned every six months.” And depending on how the practice evaluates their data and information, some patients would say that there are 100 percent success rate on the treatment plan because the patient had their teeth cleaned every six months.

If you want to be truthful, the reality is that patient did not accept your treatment plan. And the reason they didn’t accept it, in almost all cases, is they found no value. They were not motivated by sex, fear, money or time, and if there’s no motivation, there’s no reason to do something. That falls on the dentists and the dentist’s team members.

I think most contemporary offices would agree that a morning hurdle is critical. That morning hurdle reviews that patient’s medical history, dental history and treatment plan that has not been accepted. And that gets the team member and the dentist on the same side.

So a direct answer to your question is when a team member emphasizes a treatment and that treatment is supported and backed up by the dentist, the success rate increases by over 80 percent. But if you’ve had no morning hurdle, the dentist and the team members are not on the same page and you’re not prepared before Mr. and Mrs. Smith arrive at your office, your success rate drops by 80 percent.

It’s almost like anything. You never should go into a business meeting without a plan.

And that leads me to the last point, and a future podcast will deal with it, and that’s what I call the three Ds. You have to Design, you have to Develop and then you have to Deliver. Not only end to end service, not just clinical, but the business aspect.

The way the phones are answered, the way patients’ questions are answered, the way their insurance forms are filled out and monitored. These three Ds are critical.

For the dentist listening to this podcast, if you’re having a problem, take a look at these three Ds and focus on your design, focus on your development and lastly the way it’s delivered. And if you and your team aren’t on that same page, you cannot be delivering positive results.

The outcome is unproductive, inefficient time, lost revenue and most important, your patients are not getting the care and service they really deserve. They may think it, you may hope they’re getting it, but I think almost all good honest clinicians will realize that they’re short changing their patients.

Not every patient will do exactly what you say, but in the real world, if you can improve five or ten percent, that is huge to your bottom line. And that also is huge to the number of patients you’re providing a higher level of care and service and ultimately, that’s the goal.

Doug: Thank you, Dr. Coughlin. I wanted to reiterate that last part that far from what you said about sales being a dirty thing, truly if that person needs that — one of the things I hear you saying is if that patient really needs this and we fail to sell them on it, then we’ve actually failed their health. Our bottom line and we failed their health.

Kevin: A hundred percent, I agree. Most of us as practitioners, we get caught up in the run-of-the-mill day to day things. In the end, if you look at yourself not just as a service care provider but as a patient yourself, what you want is you want to know what’s best for you and your family and show the value of what’s best for you and your family.

And once you can show that, most people in the United States of America will find a way to get that care and treatment. Data says that almost 85 percent of all patients finance anything over $1,000. And part of not just training your team members, not just educating your team members and yourself, is you have to have financial policies that are available to allow your patients to come up with a structure to meet their financial needs.

Just like anyone, most people don’t pay cash for a car. Most patients do not pay cash for items over $1,000. And in most medical and dental care, $1,000 doesn’t go a long way.

So you have to have the financial plans, processes and procedures in place to make it easy for your patients to attain what they want. And that’s the best health, at the best price for the best service.

Doug: Thank you very much, Dr. Coughlin. I appreciate it.

Kevin: Thank you very much. You’ve been listening to Ascent Dental Solutions. My name is Dr. Kevin Coughlin. I really appreciate this time with you. I want to give special thanks to VOCO Dental Supply. Without their expertise in health, this podcast could not be presented.

And also special thanks to Mr. Doug Foresta and his podcast company, Stand Out and Be Heard. Without his expertise and production acumen this podcast would not be available today.

Thanks again for listening. I hope you enjoyed the podcast and I look forward to speaking to you in the near future.