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Episode #525: I Dropped Delta & I'm Still Too Busy, with Dr. Kevin Groth

the best practices show podcast Jan 16, 2023

Do you and your team provide exceptional service for your patients? If you do — and you believe it — why are you accepting average or below-average fees? It’s time to make some changes, and today’s guest is here to help. Kirk Behrendt brings back Dr. Kevin Groth, who recently dropped Delta, to share his journey, what he’s learned, and advice for dentists looking to be free from PPOs. You deserve to get paid for the work you do! To learn how to get started, listen to Episode 525 of The Best Practices Show!

Episode Resources:

Main Takeaways:

You should get paid for the work you do.

PPOs mean working one out of every four days for free.

Do your homework and the prep work before dropping PPOs.

A few great patients will leave you, but don't take that personally.

Believe in yourself and your team. You can do this and be successful!


“At the beginning of the year, you always look back on the previous year. And I hate that because you look at the numbers and be like, ‘I wrote off that much money from doing the work but not getting paid for it?’ And that's what we’ve done the last couple years, to the point that I always bring my manager into the office and say, ‘This is crazy. Should we think about doing this? What do we do? I think it’s time to maybe think about dropping.’ And then, we get on with our busy week and we put it to the wayside.” (4:02—4:28)

“It became time to say, ‘Let's get paid for what we’re doing.’ Actually, I remember the day. It was a day where I did like three hours of posterior composites. And then, I realized, Delta, I had to write off like 55% of what I just did. And I worked so hard for those composites that it’s crazy to me.” (4:42—5:02)

“I'm not saying the write-off is 55% for everything. But those specific procedures that I did was close to that. And my hourly wage was less than what my hygienists were producing at that time. So, to me, it made no sense. And I'm like, ‘You know what? I'm too busy, too many patients, and I'm writing off so much. It’s time to make some changes here.’” (5:03—5:24)

“If someone is listening to this and they're thinking about [dropping PPOs], I would also look at your office and what you do as a practice. Are you separating yourself amongst the peers around you that make you stand out from a value aspect? Because patients see this as a monetary thing. If they don't value you, they're going to walk. And I think it’s an important thing to say, ‘Am I ready for this? Do I have the right team? Do I have the right technology? Do I have the right services? Do I have the right brand to make a pretty drastic change without going crazy or doing it the wrong way?’” (6:20—6:54)

“We looked at last year, and it was like, ‘Dang, we wrote off half a million dollars’ worth of work.’ And this is another thing, is we raised our fees last year to combat inflation. And yet, it didn't do anything besides make our collection percentage go down.” (7:17—7:35)

“Pick one out of four days, and those are the days you work for free.” (7:39—7:41)

“About 20% to 30% of Delta patients will probably leave you, according to the research. Some people say 10%. But also, if you lose 30% of those Delta patients, you're still going to net even. So, when I looked at that, I was like, ‘Okay. We can lose 300 patients out of the 950, and I can still be at 2,100 patients,’ which is still too many patients for me to occupy. So, why wouldn't I jump in and [drop Delta]?” (8:30—8:55)

“This is the best time you can drop Delta because everything is more expensive. If I dropped Delta two years ago, people would think it’s a money-hungry grab. But the reality is, everything is more expensive, so people anticipate this, saying, ‘Okay. I pay more for groceries. I pay more for gas. I pay more for my dentist visits. And that's okay because this is part of life and what we’re going through right now.’ And people that value you won't think twice about that. That's the key, is you've got to look at these things from those perspectives and say, ‘You know what? I can do this. I believe in myself and my team.’” (9:47—10:25)

“I said, ‘Guys, we’re better than the average dentist. I think we all agree with that, right?’ ‘Yes.’ ‘Okay. Then why are we accepting fees that would be usual and customary in our area? It doesn't make any sense because what we provide is a service that goes above and beyond anything that's usual here. Nothing is usual. We’re extraordinary in how we do it. I know all of you believe in that. So, it’s time that we start looking at this, and it’s time to start thinking about these things. Because if I don't do this, then we’re going to have to make some changes internally, which I don't want to do. So, it’s either we make these changes that would be beneficial to everybody, or I start looking at things and saying we need to start cutting back here, here, here, and lower our bar to the lowest common denominator of the area.’” (10:25—11:14)

“The process of it is really getting yourself mentally on board, that this is the process that we’re going to go through. I believe that this was what's best for us, and I believe that this is something that is going to be better for our office to continue to provide the care that we’re doing without changing who we are as a business or an organization.” (11:59—12:17)

“[The reception to the Delta letter] was a mixed bag. We had some patients that dropped us right away. And we started making an Excel spreadsheet of this, saying, ‘Okay, here are the patients that left us for this.’ It was a handful. They didn't even give us a chance. Some people said, ‘It’s strictly financial. I'm sorry. I have to go somewhere else.’ Or maybe they were waiting for opportunities for us to change so they could leave, because maybe they moved further away, or whatever it may be. There was a combination of things that people left us for.” (14:42—15:09)

“I was actually surprised by the number of overwhelmingly positive reviews or feedback of the letter that we got. And people would want to talk to me. So, I'd be running three hygiene and seeing 15 patients a day, but then they'd be like, ‘Can we talk about this letter?’ And I'd be like, ‘I don't have time for this.’ But I guess you need to prepare for that. Know that you're going to have a five, 10-minute dialogue about Delta. And as long as you are confident in terms of how you deliver that message, people understand and say, ‘I get this is why you're doing this. I respect it. I understand that you are better than average, and we’re not going anywhere.’”  (15:10—15:44)

“I also have an amazing, amazing front desk that has taken on the bulk of the phone calls and dialogues with these patients. So, I'm not putting a fresh 21-year-old up at the front desk to answer these phone calls. I have people that believe in who we are. They’ve been through the process with this office. They know what they're saying. And quite frankly, I gave them the autonomy to do whatever they need to do that is right to make this patient happy, or communicate how we need to. And at first, they were a little clunky in the dialogue. Like, you can try and script this as much as you can. The reality, you're going to evolve that script to the point where it’s going to get to a different position by the tenth phone call with somebody versus the first phone call.” (15:50—16:30)

“I think we’ve lost about 60, 70 patients so far, which is not too bad for 950. And of the 60, 70 patients, there might be five or six that I'm going to be missing. The rest were probably good weed-outs anyway. And it makes sense. If they don't value who we are, they were there for the financial component of things, because we took their insurance. And they left us because it wasn't aligning. But I don't want patients that don't value me. And to me, it’s like, if you don't value me and what we do and how we do things, why are we in this relationship?” (17:30—18:02)

“[Dropping Delta has] weeded out some of the dead weight. And I don't want to call people that. But at the same point, we all have those patients that you see on the schedule, and you're like, ‘Ugh. Gosh, I can't stand this person.’ Or they drive my front desk nuts, or there are always issues with the billing, or whatever it may be. Those people leave, and I'm like, ‘Good. Find some other office that you can do this to. Because, quite frankly, you probably shouldn't have been here all along.’ And this is a good reason to have them go.” (18:05—18:30)

“This is one I took from Zach [Sisler], is I will say, ‘My door is always open. You're always welcome back here.’ . . . And I don't tell that to everybody.” (18:33—18:46)

“It’s crazy, looking at the schedule. I look at the monthly report, or whatever it is, and I'm not writing off $3,500 a day. That's insane. That's so much work. You're talking about two crowns’ worth of work that you write off every day on that sheet. It’s like, this is crazy because I'm working so hard. And I'm sure everyone listening is working hard. You should get paid for what you do. I work hard. I go to these courses. I get a bunch of great labs, and materials, and all these things that I do to give my best to these patients. And yet, I can say that I'm writing off 30%, 40%, 50% of what that is. It’s not right.” (19:12—19:45)

“I hope that other people have a brand of some sort, and they believe in what they do, that they believe that they offer a service that goes above and beyond the usual and customary. Because if you do, then get paid for that.” (21:16—21:28)

“You have to be flexible. You have to keep a blind eye to that list and not get yourself so hung up on why people leave you because you don't know their life experience or circumstance that they're in. So, if they leave, I hope the best for them. I really do. And I'm going to miss several of those patients that left me. But it’s what's best for me. It’s what's best for my company. It’s what's best for our patients. It’s what's best for my team. That's what you've got to look at. It’s not the individual that leads you.” (24:00—24:30)

“[Even after dropping Delta,] I'm still busy. Still way too busy because I didn't lose enough people.” (24:42—24:46)

“People don't like surprises. So, if you can make it so they're not surprised and they know exactly what's coming, I think people are reasonable with it.” (25:54—26:02)

“We have a lot of patients that think Delta Dental is the best insurance. And they always say, ‘Well, I don't understand. I have the best insurance plan. Why don’t they cover this much?’ Well, that goes down the rabbit hole of what Delta Dental is and what insurance is in dentistry versus medical insurance. There's a huge difference with that, and they don't understand that. I've had patients that said, ‘Well, I don't get it. You're doing a write-off. Can't you write that off in taxes?’ It’s like, ‘That write-off is very different than what a governmental write-off is for taxes. You have to receive money in order to pay the taxes on that.’ And he goes, ‘It looks like you're getting taxed twice.’ I'm like, ‘Pretty much. I'm glad you understand this now.’” (26:07—26:47)

“People have called me disgusting . . . ‘This is disgusting. I can't believe that this is happening at this office. I've been a patient for decades. He’s disgusting.’ ‘Oh, okay. I'm sorry you feel that way.’ The paying upfront thing, ‘Doesn’t he have enough money? I don't understand. Is this practice struggling? Because he has to now get paid upfront. Is that a big change?’ I'm like, ‘No. That's because that's a Delta policy. You have to get paid upfront.’” (26:56—27:24)

“I had one guy, I saw his wife one time when I was right out of dental school. I don't even remember her anymore. And obviously, something didn't happen well. But I had seen him for nine more years. And I've treated him well for the nine years. And as soon as he got the Delta letter, he said, ‘This is the last time I'm coming here because you didn't call my wife back nine-and-a-half years ago.’ ‘But you've been a patient here for nine-and-a-half years, and you haven't had any issues with me, have you?’ ‘No.’ But you're going to find any excuse to leave. And if you want to say it’s your wife’s problem, no. It’s because of financials.” (27:28—28:07)

“Here’s a big caveat. Most of the time you have conflict in your practice with a patient, it’s because of finances. And that's what it comes down to. What's really the true problem here in those that have left my office is because it’s a financial thing. And I respect it. I understand. I know people are in different positions, no matter what it is. But if they value you enough, they will stick around.” (28:08—28:29)

“[What most people get wrong is] I don't think they believe in themselves. I don't think you believe or have the confidence that you could do something like this, and that you should be part of the system. You are just another fish going down the stream type of a thing. Stop that stream. That’s what I think people get wrong, where they get so hung up on who leaves you, or they don't believe that they should ask for this as the value of what they do. But I ask that value when I ask for somebody that's on a different insurance plan, and they have to pay the full fee. So, why is it any different than if it’s Delta? I didn't have any problem with that beforehand, but because it was the mighty giant of dentistry, things had to be changed. There's no way. So, to me, I think it’s one of those things that you've got to believe in what you do. You've got to believe in your brand. You've got to believe in how you do things. And the people that surround you need to be an awesome team. Because if I didn't have an awesome team, there's no way that I would do this. I can't.” (28:42—29:42)

“We also said if people are going to be paying more, we should probably step up our game more. So, we sat down in a meeting and said, ‘Okay, what are some things that we can do as an office to bring more value to people?’ And something got brought up, ‘Why do we keep giving out manual toothbrushes if we are a big electric toothbrush office? Let's give electric toothbrush replacements heads.’ That's been very well-received.” (30:11—30:33)

“We’re big into giving people gifts at our practice. So, if someone graduates, or if someone retires, or if someone has surgery, whatever it is, a baby, we send them something. We send them all these different gifts because it makes us seem like we’re doing something that goes above and beyond the usual and customary. And that's what we are. I mean, I set up a library at the front desk. Our waiting room, I have all the books I love, and I put them on a bookshelf. It says, “Dr. Kevin’s favorite list. Take, if you want it. Free books.”” (30:44—31:16)

“You can get creative with those things. You can have some fun with it. It doesn't have to be a negative process. And you can celebrate the victories because now, looking back on it, we’re a month in after dropping. And so far, it’s been extremely positive. I don't think there's anyone looking back saying it hasn’t been. I can still support my practice. I can still support my team. I don't have to let go of anybody. I don't have to reduce the supplies. Whatever it is, we can do what we need to in order to function at an optimal level.” (31:43—32:11)


0:00 Introduction.

2:43 Dr. Groth’s background.

3:27 His journey to dropping PPOs.  

8:57 Getting beyond the resistance and fear.

11:15 The process, prep work, and writing the letter to patients.

14:33 How his Delta letter was received from patients.

16:51 Weeding out patients.

19:05 How it feels to get paid your full fee.

19:46 Getting your brand right.

21:47 What he learned from the process.

25:12 Front desk conversations with patients.

28:32 What most people get wrong about this journey.

30:11 Ways to go beyond the usual and customary.

32:11 What the future looks like for Dr. Groth.

33:06 Last thoughts and how to get in touch with Dr. Groth.

Dr. Kevin Groth Bio:

Dr. Kevin Groth’s primary goal is for every person to walk out of his office knowing that they received the highest-quality, most personalized care possible. Dentistry is more than just a profession for Dr. Groth. He sees every patient as an extension of his own family, and when you are in his chair, you’ll always be treated well. 

Dr. Groth’s favorite part of being a dentist is that every day and every patient is different. He loves the variety of people he gets to meet and procedures he performs to help patients maintain their smiles. 

Since graduating from the University of Michigan School of Dentistry, Dr. Groth has been recognized locally by Hour Detroit Magazine as a Top Dentist, and nationally as a Top Doc. As a passionate dentist who wants to provide the best care for his patients, Dr. Groth pursues continuing education through The Dawson Academy, serves on the executive board of the Periodontal Bunting Society, and is the Assistant Clinical Director of the Society of Comprehensive Dentists. He has also served as an adjunct clinical faculty member at the University of Michigan School of Dentistry. 


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