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Dentist2Dentist
Join Dr. Mike Miyasaki as he talks dentist to dentist about the trends, products, and clinical applications in dentistry today.
Dentist2Dentist
5 Tips to Unraveling the Secrets of Dental Practice Success with Garrett Caldwell
Ever thought about how to navigate the rapidly changing dental industry? Wonder no more, as we unravel the secrets of strategic decision-making in dental practice with our distinguished guest, Garrett Caldwell. Get ready to redefine your business objectives, as we walk you through the five crucial steps to ensure a successful dental practice. From identifying the importance of your unique value proposition to creating a comprehensive business development blueprint, we've got you covered.
But hold up, it doesn't end there! We also tackle the business management skills that every dental practice should master - think analysis, planning, managing internal processes, and more. In the ever-evolving world of dentistry, we highlight the importance of multidisciplinary services, such as aesthetic treatments and implant services. It's all about giving your patients the best services while maximizing your practice's potential. So, buckle up and join us on this insightful journey full of valuable tips and strategies to ensure the longevity of your dental practice. With Garrett Caldwell's expert insights, you're in for a treat!
Hi everyone, I'm Dr Michael Miyasaki and today we have a great podcast, great information again from Garrett Caldwell, ceo of the PAC Pacific Aesthetic Continuum and Core Dental Lab. And what Garrett's going to cover today are really the five things that we as clinicians have to do to have a successful practice. I will tell you. I just felt like this was so valuable. It's quick, sweet and simple. I hope you enjoy, and let me. I just want to read this one part because it was interesting. It was an article that I read.
Speaker 1:It says that with an sometimes, with sometimes there's problems or issues in a business, whether it's increased competition, changes in the marketplace or any number of changes at any given time, and there's basically three options we have, and I think we're going to cover some of these options. There's one you can stick it out. Two pivot in a new direction. Or C just quit what you're doing and then do something else. Well, in dentistry we can't quit and do something else. So we either have to figure out if we're going to stick with our plan that we have or pivot in a new direction and make a change. So in this article it goes on to say that many times we want to do well in business. So that's kind of our game plan. But the way that we're going to do well in business has a bunch of steps how we approach dentistry, if we take insurance, if we don't take insurance, what services we offer, and all that.
Speaker 1:In this article. It made a very interesting point. It said if you were the NFL coach whose team was getting creamed going into halftime, would you say we've got to stick to our game plan, because often that's what we think Stick with the game plan. But if it's not working, I think what we have to do is if you're getting your butt kind of kicked in the game, you have to fire that coach before the halftime is actually over and you have to pivot and meaning you have to adjust. So you persist in your intention of winning but you change the strategy. So I think that's kind of what we're going to talk about today.
Speaker 1:One of the quotes I use is Wayne Gretzky talks about being successful in hockey. He says he's going to where he intends the puck to be. He doesn't skate to where the puck is right now or he'd always be behind. And I think dentists, especially those of us that have been practicing for a long time, we get comfortable practicing dentistry the way we've been practicing it for 20 or 30 years. But when you look at the industry of dentistry, it has really changed. Even the last 10 years, with all the DSO changes, the changes of insurance, how patients are now selecting their dentist and how they transition and move between offices a little bit more. The business side of dentistry has really changed. So how are you doing, garrett?
Speaker 2:Mike, good morning. How are you? Nice to be with you again. As always, I like your intro. Unfortunately, the coach of most dental practices is the dental team owner, and so it's a little difficult to fire yourself, although that may be an option.
Speaker 2:We talk about practice management, but we talked in our last discussion and, more to your point, I like what you're saying because it's kind of what we talked about today. Do you restart or do you continue? So I'll just take it from there. I look at the five strategies you're going to need to address for the rest of the game and assuming that you may want to fire the coach and you may want to keep the coach, but at the end of the day, we can't walk away from the game. We have to finish it. So let me just jump right in Number one defining your practice and then writing a business development blueprint. So I'm gonna take a big step back.
Speaker 2:A lot of doctors have a practice that they just ended up with. It started and it is where it is today, and not a lot of thought went into defining, before they started, what they wanted their practice to look like one year or three years or 10 years down the road. So I think the first step is stepping back, and these are individual skills that I'm gonna talk about as a leadership. Skills in business that I'm really gonna talk about here is really for the doctor or the dentist to define the practice that they feel that they want to be operating or that they want for their career in writing, and we call that a business blueprint. A lot of guys don't understand what a business blueprint is and it's very simple. Number two we're gonna talk a little bit about business management skills, because I think business management we all have clinical skills. We spent a lot of time and energy on understanding clinical skills and how to deliver different procedures, but very little time is spent on business management skills, and we'll talk a little bit about that.
Speaker 2:Also, the relevant services that you practice must provide patients today in order to win the game. So it's very different today, I think, than it was even 10 years ago or certainly 40 years ago, in terms of a general practice. I'm not even sure that that's a relevant term anymore. So, understanding what those services are and what services you must deliver and what your patients are gonna be expecting from you, and that ties directly in with education. And then, finally, technology and I'm actually gonna defer this back to you, michael technology, because certainly, if you don't have the appropriate technology within your dental practice, you're not going to be able to win the game. That's very clear. And that's now from teledentistry moving forward, everything from lasers and all the other things that we talk about. So I'm gonna defer back to you on that.
Speaker 2:But, starting with the first one, defining your practice just a little bit about that. When we talk about defining the practice, really it's about understanding and defining your vision for your practice. Okay, and when I say vision, what I'm referring to is possibly how much time you wanna spend at work, what your lifestyle is. We were talking a little bit this morning about your daughter. She's having a second baby, she's practicing. The vision for her practice is gonna be very different next year and the following year than it maybe was the first year. If we have a practice that we're beginning for a lot of doctors that are just starting out, or if you have a practice that's been it for 20 or 30 years and you're not happy, you're certainly gonna wanna be listening to this discussion because you need to take a step back, I think, and start with what's your vision for your lifestyle, how much time do you wanna spend in your practice and what are those goals? So writing down your vision, I think, becomes very important. And really, when we talk about that, one size does not fit all, and I'll tell you what I feel about this. Personal lifestyle preferences do matter and I think, now more than ever, doctors are very diverse in their lifestyles. They may not wanna spend 30 or 40 hours in their practice. They may only wanna spend a couple of days in the practice. So I think it's very important to understand what your lifestyle is and really how much time you attend on investing in the practice. And then, finally and most importantly, don't be swayed by influencers or somebody else's vision. Doctors tend to be around a lot of great information delivered by a lot of very influential people, and they tend to follow advice, which is great, but I would encourage dentists to be independent thinkers and really be honest with themselves and not be swayed by what somebody else tells them is the right way to practice or the right amount of time to practice.
Speaker 2:So sitting down and writing a business blueprint involves the elements that I just discussed, so it may be a part time. If you're an associate, you may just want to work part time If you're going to have children or family. If you're a skier, maybe you only want to work six months a year, or five months a year If you like to vacation and travel, or possibly you are the opposite of that you really want to go knock them down and you want to have an eight or 10-operatory practice and have a multi-million-dollar practice. I think you need to define that. We look at employees of DDSO's entering retirement. If you're a doctor now that's possibly entering retirement, I think your blueprint really matters now. I think understanding how you're going to transition and what that means and how you're going to do. That would be part of a blueprint for a senior doctor.
Speaker 2:For a private practitioner, maybe you want to have a boutique practice and so maybe now's the time to make the change and stop taking dental insurance and go independent and sort of live the life you want to live and practice the way you want to practice and take a little more risk with that serve yourself. So those are the kinds of things I'm talking about there. That all relate to defining your practice, and I think it starts with writing a business blueprint for yourself. That's number one. Number two business management skills. This is sort of where we could spend a long time, but we're not. We can talk about this more, I think in the future, but I'm just going to start with this.
Speaker 2:So in my opinion, the biggest shame probably besides how dental insurance has impacted the dental industry over the last 20 years and really created a lot of challenges for doctors has been really the opportunity that the lack of business education has created for the DDSOs in our industry. The DDSOs have come in and, I think, really leveraged the fact that doctors don't enjoy running their business. They like practicing dentistry but they just are challenged by the operations of the business and that's created a whole new industry. I think it's fantastic for senior doctors that are transitioning out for the DDSO, but I think it's the opposite effect for younger doctors that are at the beginning or the middle of their career. Now they're facing a DDSO that's grinding prices down, that has a lot of dollars behind them, that makes it difficult to compete to provide the highest level of service to the patients, and that's definitely changing. When you combine DDSO and dental insurance, I think that creates a big problem for the private practitioner moving forward.
Speaker 2:So we talk about business management skills. I just want to take a step back and make a statement here. So you're going to have to understand how to manage your dental business. We call it a dental business now because it's not a practice anymore. It's a competitive business that can suffer as of a million dollars to open and you need to have the business actor men to do analysis in your practice. So going through analysis and planning is a business skill that you are going to have to have, along with your clinical skills. What are those skills? We talk about internal processes that we talked about in our last meeting. We talked about analysis and how analysis relates to the efficient operations of your practice, especially if you're going to go from insurance to non-insurance.
Speaker 2:Being able to know the impacts of the decisions that you make every single day are really critical, and most doctors are flying blind in their practice. They're going in there, they're working really hard, their head is down all day, but at the end of the month they look up and say how did we do? They don't really understand how each element of their business model affects profitability, whether it's good or bad, or whether they should change or what they should change. So analysis will allow you to focus on inefficiencies. I think that's number one. So getting skill, enough skill where you can sit down and understand how to use a financial analysis to evaluate the performance in your practice.
Speaker 2:Many doctors are challenged when it comes to business development because of two reasons, I think. One a lack of business training or they're just too busy treating patients. It's just too difficult to find the time. Monthly and yearly high level analysis should be taking place. We obviously look at daily numbers and weekly numbers, but I'm talking specifically about your business blueprint, your operational plan, being analyzed every month for profitability. We call this internal practice development. You can't really develop a good strategic plan unless you can measure performance. This relates to the team processes as well as financial and internal inefficiencies. And again, I'm going to use that word internal inefficiencies a lot because with analysis you can have a phenomenal practice that's very profitable. But I promise you, if we could analyze it, we could find inefficiencies without any more effort, make more money. More money makes more time. So I think understanding that's important. All of these affect the practice value both your profitability currently and your practice value down the road by increasing positive patient experience. So when you're analyzing and finding out what's working and what's not working. It's very likely that you're also improving your patient a positive patient experience, because the patients are ultimately who are asking for these services and accepting these services. So, whether it's clinical or personal, by increasing a positive patient experience, most practices will experience a significant increase in their annual production of profitability.
Speaker 2:I think that's pretty simple. So I think analysis is critical. So what do we do? Take a basic business class OK, we spend so much time and money in the dental industry and I will add that it's fear based on clinical programs. We spend hundreds of hundreds of hours every year. That's required for your license and we spend literally hundreds of thousands of dollars in our career on understanding the clinical. But relatively no time.
Speaker 2:Taking a business class, one simple business class, to be able to, so you can sit down and understand the difference between an income statement right and a P&L, a profit and loss statement, which are different, so you can analyze in your business what's working and what's not working. You need to clearly understand your practice, health and plan and understand those inefficiencies. So, like you said earlier, mike, so you can pivot, but you pivot through analysis of financials. You cannot pivot or change a game plan unless you can measure yard by yard if you're making any progress or not. So at the end of the month, if you're not making any money, that's analysis. But why is the question that probably 95% of the doctors or more asked me, and it starts off as simple analysis so profit and loss statement versus income statement? When I go in and do a chat with you and election, we talk to doctors on the break and I asked them you know the difference between those two. Almost 100% don't know the difference between those two, which tells me that they're really not in a place where they have the most basic fundamental business knowledge. So please take a business class and then, finally, within that, debt management, for both business and personal. We talk about debt management, understanding what's in your means and making sure that any money you spend on the practice, whether it be on technology or education, you have a blueprint for a guess for the return. So you're spending money based on profitability, not based on influence. And then, finally, a savings plan for retirement. What is your strategy for retirement? Business development involving these simple metrics really all relate to, at the end, how much money you're keeping every month, how little debt load you're carrying and are you putting money away for retirement? I think those are critical strategies when we talk about business.
Speaker 2:Number three, we talk about relevant services. You mentioned relevant services and what services we need to provide. I think it's really important that the doctors offer its patient relevant services, and relevant relates directly to what your competition is providing Both quality of care and the types of services. So we talked a little bit, mike, about multidisciplinary practice, so general dentistry, sort of the drill and fill practice. It will be impossible to survive in today's market with the investment you've made in dental school and on the practice itself to just provide basic services as a dentist. So this includes providing services that will meet your patient's needs and serve your business profitably. So I don't wanna get too much into multidisciplinary medicine or multidisciplinary practice offerings. I think we all know what that means. But we talk about cosmetic and aesthetic treatments. We talk about orthodontic treatment services, implant services, we talk about sleep services. Most of the competition that are doing well in their practices are offering all of these.
Speaker 2:In-house. Patients are busier than ever and don't have time to reschedule appointment after appointment after appointment. So, again, if you're going to be relevant as a doctor and your business is gonna be successful. Part of your business plan has to be taking a look at your client and asking yourself does my client wanna be scheduled with a specialist or is it something I can do right here? So if I can keep them here and make it easier for them, they're gonna be more loyal to my practice and they're gonna reform our patients. If I have the skill to provide that service, I'm gonna be more profitable.
Speaker 2:I think it becomes very important and multidisciplinary concept to consider whether you have the skills to do that as a doctor, and we're gonna talk a little bit again about education when it comes to that. So patients are busier than ever. They don't have time. You wanna be able to provide those treatments in your office. I think it's crucial to being competitive, but I think it's crucial to being profitable. So when we talk about education as part of this, in this category, the message is clearly you need to be taking some consistent post-grad education based on the analytics of your practice where you're weak and you feel you could create more strength. So maybe you're not comfortable with dental bonding or anterior aesthetics. I think it's really important that you become comfortable with those. I wanna just read something really quick, mike, it's out of a dental CFO and it's interesting.
Speaker 2:It says dental practices that don't make cosmetic treatments readily available will likely lose out on competitors. If your practice doesn't offer corrective and cosmetic procedures, you could miss out on a significant revenue opportunity, since those patients who desire these procedures are often willing and able to pay for them and prefer to work with dentists they know and trust. It says here that cosmetic dentistry, which includes procedures such as teeth whitening, veneers we talk about a liner's mic are also increasing in popularity. While cosmetic dentistry is often associated with electric procedures, it can be and it is used for restorative procedures. So we often think of doctors thinking of this is an elective service. But chip teeth, crack teeth, small gaps, spaces between the teeth all of those relate to cosmetic dentistry. We talk about tooth alignment, we talk about implants. All of this really falls under general restorative. So I think if doctors don't have the ability to provide these services, they're not gonna be competitive in the game.
Speaker 2:And lastly, technology I'm gonna defer my due to this, but clearly we talk about digital dentistry. Lasers, inter-oral cameras, artificial intelligence, a UI, augmented intelligence is coming into play. Now You're far more knowledgeable about these things than I am. Digital impressions, 3d printing all of these things the best practices are using In the laboratory. We receive more and more digital impressions, which is a time saver and increases accuracy, so I would defer a little bit to you on those and how you feel about those.
Speaker 1:You know, I think the technology side goes back to what you said earlier. I think every practice, because there's not only the cost to acquire the technology but then the time and cost to acquire the education to use the technology. And so I think a statement you made earlier with the financials I think we have to understand the ROI and if there's an ROI for your practice to get into whatever area of technology you're looking possibly to jump into, like the AI, as far as diagnosis is really becoming a big part and I think that's going to really change our field. Once again, my feeling is I always like to kind of be on the leading edge of acquiring new technology. So we have the $100,000 plus lasers and the $100,000 plus CBCTs and all that, and I think there is value in that.
Speaker 1:But I think you're right you take that blueprint, you figure out what type of practice you want to have. You look at the financials to figure out where maybe you could create more revenue in your practice. Take implants, for example. Today if you're placing implants and you really want to do a lot of implants, you'd want to have a CBCT. So then go back to your financials and see if your practice could then support having a CBCT, which I was reading an article where they interviewed Gordon Christensen, and Gordon Christensen again likes things to be affordable for the practice. He loves new technology, but if it's super expensive he doesn't go out there and recommend it. And a CBCT, he said, is one of the best revenue producers within your practice because you can delegate the use to your team to take your CBCT and that CBCT image is going to generate revenue because you can charge a fee for it, as you should. So I would encourage just using that as one example.
Speaker 1:If a doctor is looking at possibly buying a CBCT and right now, just the kind of frame where we are, we're ending October of 2023. So we're going into the last quarter of the year where a lot of docs want to take care of the section 179, the tax benefits. I would look at some technology, but I would make the decisions very carefully and if we know the financials of our practice, we could say, ok, I could afford to adopt that. I would look at trying to get technology that's going to help us treat our patients better and therefore generate revenue. And there's some things like the integral scanners where some practices just don't have the volume to really make it a true benefit, because you have to buy the technology and many times you have to get a service contract along with that technology and it may be even less expensive just to keep taking the analog impression. So I think every practice has to kind of figure out if it does make sense.
Speaker 2:No, I agree, I agree 100%. Yeah, so you know again, defining sort of how you want to live your life as a dentist and creating a blueprint for that, and then creating a business strategy, a financial strategy and getting some really good analytics. And I can't overemphasize, if it's something that the doctor doesn't have time for, then I do think hiring a practice management company, at least to help with that specific part, helping you to get all of your numbers in an analysis format and then having help to go through those numbers and understand the impacts of each of those departments whether they're profitable or not and, if they are, what percentage they contribute towards your day to day practice to really help guide your team into where you want to be doing more or less or make those changes. I think that's really important and that's the start.
Speaker 1:I think those five tips that you gave us today are like worth their weight in gold or maybe cryptocurrency. Whatever it may be more valuable.
Speaker 2:I'll take an IOU.
Speaker 1:Yeah, bitcoin. I think you gave us some great ideas. All of this can really change, you know, my colleagues' lives, and so hopefully that's what we're able to share.
Speaker 2:Thanks, mike, appreciate your open thoughts. Yeah, so let's get this out. If anybody has questions, they know how to get ahold of us, I think.
Speaker 1:Yeah, it sounds good. All right, well, thank you very much, garrett.
Speaker 2:Thank you, Mike. Have a good morning.
Speaker 1:Thank you. Thank you very much.
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