Episode #618: Less Is More: How One Dentist’s Radical Approach Transformed Her Practice! With Dr. Rachel Barone

Changing office hours seems like a bad idea. What if it doesn’t work? What if it makes patients angry? What if production plummets with the new schedule? To help you dispel those negative thoughts, Kirk Behrendt brings in Dr. Rachel Barone, a mentor from the Global Diagnosis Education Study Club, to share how changing her hours improved her life and the life of her team and patients. More isn’t better — it’s just more! To learn how you can seamlessly change your hours, listen to Episode 618 of The Best Practices Show!

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Links Mentioned in This Episode:

Learn more about Global Diagnosis Education

Register for the Global Diagnosis Education Symposium (September 7-9, 2023)

Read books by Patrick Lencioni

Main Takeaways:

Be clear about why you want to change your hours.

Use your core values as a guide in this process.

Get your team’s buy-in for the new schedule.

Learn to use the time you have effectively.

More isn’t better — it’s just more.

Quotes:

“As I’ve grown as a clinician and as a person, I started to have better clarity around what I wanted in my life. I realized that it’s very important to me to have time and space away from the office so that I can show up and be the absolute best practitioner I can be when I’m at the office. I want to be able to show up fully for my team, my patients, and anyone I have the privilege of serving. So, I realized that when I was working longer hours and not really giving myself breaks, I was depleted. I was starting to feel burned out. And so, the shift in hours has not only served me in being able to be rejuvenated and a resource to come into the office, but it’s also served my team. I have to have their backs because they have mine every single day, and I want to make sure that whatever we’re doing fits for all of our lives, not just what’s going on in the practice.” (3:33—4:30)

“We used to work from 8:00 to 5:00, Monday through Thursday. Sometimes, we would do 9:00 to 1:00 on Fridays, depending on if we had some overflow or catch-up lab work or anything like that that we needed to do. And I’m very fortunate. I have team members that are dedicated to work for our practice that some of them drive from 30 minutes to an hour away to get to the office. We found that not only were the days really long, we were leaving exhausted, but then some of these team members had really long commutes. And when the weather gets bad in Colorado, it’s snowy and sleety. They’re not safe driving home in the dark. So, we all made the decision as a team that we wanted to reevaluate what our office hours were. We had a lot of discussions around what works for us as a team. It was really important for me to be able to make sure that it wouldn’t just fit my life, but that it would fit the life of my team members as well.” (4:38—5:40)

“The gentleman I bought my practice from, his name is Dr. Jerry Savory. He often said to me, ‘People help support that which they create,’ and I’ve kept that with me for years now. It’s so true in terms of team buy-in with anything, is giving them the autonomy, the respect, the space to be a part of that decision. It creates more buy-in and more support of whatever that decision is. So, we all talked about it a lot, and we decided that 7:30 to 3:30 were hours that would work well for us. Most of us got to the office pretty early anyway, and that time was being wasted just in prep for the day. By leaving at 3:30, even if we run a little late, the latest we get out is 3:45, maybe 4:00, and it makes their commutes home so much easier. They’re not in rush-hour traffic. If it’s wintertime, they’re leaving closer to when daylight is happening. It’s been a really good shift for our team. Now, I don’t think any of us could imagine working until 5:00.” (5:41—6:51)

“One of our hygienists had a planned vacation where she was going to be off for three weeks. One of the barriers, I think, when you’re thinking about changing your hours is the hygiene schedule because it books out so far in advance. So, we had this whole conversation with the team buy-in and really got excited about changing our hours. But because of the way the hygiene schedule was booked, we didn’t think we would be able to do it until August. My front office manager had the brilliant idea of testing these new hours while our hygienist was out since we didn’t have hygiene patients anyway. And so, we did that with our restorative schedule. After a week, my assistants and my office manager and I all said, ‘I don’t think we can wait until August.’ We had a taste of it, and it was so nice to have the space in the afternoons to ourselves. So, I have to give huge props to my team. They really worked hard to make this a reality. There were many hours on the phone rescheduling hygiene patients and rearranging the schedule. But as a result of their hard work, we’ve been able to implement this since April. It’s been incredible for our practice.” (7:09—8:20)

“In this profession, we want to serve our patients. We want to make sure that we’re meeting their needs. That’s a really beautiful thing. But I think in doing that, we sometimes forget our own needs. What I have found in my own practice is by changing the hours, we haven’t lost a single patient. We’ve had two patients that have had a little bit of challenge in the way that their schedules work. But we’ve been flexible and creative, and we’ve figured out ways to be sure that they’re still accommodated. For the most part, our patients are really lovely humans, and they want us to have a good life too. And so, when we tell them why we’re changing our hours, that it makes the commutes easier on the team and that it allows more time with family, they’re in support of it because they want to be with their families. They know what that feels like, and so they want that for us as well.” (8:45—9:35)

“We, as a culture and as dentists, all want to be really efficient. And it’s not that efficiency isn’t important, but I think we underestimate how important being effective is and how important efficacy is. What I mean by that is, if we can be effective with the way that we use our time, then the efficiency comes. For us, I own a small, restorative, fee-for-service practice. In that model, efficacy is what matters. You have to be effective in the way that you communicate. You have to be effective in forming relationships and building trust with patients. You have to be effective with the way that you schedule. And it seems like there’s more work on the front end with that, but it pays dividends in the back end, and it actually allows for you to be more efficient because you have the patient who trusts you, who trusts your process, who is engaged in the care that they’re getting. And then, you have a team that can support you with a very effective schedule.” (12:06—13:11)

“We have built our block schedule in a way that we have daily production goals. We have been just as productive, if not more productive, since cutting our hours than we were before. There’s a lot less wasted time. You have to be effective with how you use your time when you’re doing a model like this. You can’t schedule ineffectively. But as a result, you get more time with your family, and you get more time away from the office. And again, we’re finding that we’re more productive with this shift.” (13:22—13:52)

“We’ve been working with ACT for several years, at this point, and so we’ve been very intentional about building systems that work for our practice and having everyone know what roles they play in upholding those systems. I think we did the work, foundationally, to be able to have that be our springboard toward these new hours. I think because we have the system, we have the block schedule that if we just plug into the block schedule and manage it effectively, then we’ll hit our production goals. That has been a really big part of it. And the team, I think, is more energized around it because they had a say in it. They got to help build this new vision for the practice, essentially, and they’re feeling the benefit of being able to go home and be with their family. So, they show up more engaged and ready to work.” (14:25—15:16)

“I inherited a practice that was incredible in so many ways. It had such a good foundation, a kind, wonderful, patient community, a wonderful team. I couldn’t have been more fortunate. And I, over time, needed to be able to transition it into a reflection of me and the way I practice. What we found is there were a couple of team members who didn’t transition as well into my model of practice. We tried to support them in the best way we could. But what we learned is that by having them in the office, it actually detracted from the other team members’ ability to show up with enthusiasm and presence to the work that they were doing. There were people I also hired that weren’t good fits before I knew better and knew what to look for. I know you talk about it a lot, Kirk, but the thing that has been so instrumental for me to be able to get the clarity is having core values and a core purpose. They’re posted all over the office. We do core values celebrations once a week. They’re the hill I’m going to die on. They are what I value in my practice. And if people do not align with them, then it doesn’t make them a good or bad person. There’s no judgment here. It’s purely that they’re not a good fit for me and the type of practice I’m trying to create. Once I had that clarity, it made so much more sense in terms of who was going with me and who was maybe not going to be in alignment as well.” (16:05—17:52)

“Core values was the template we used for our hiring process. We had an assistant who left our practice in October of last year. We didn’t end up hiring a new one until January of this year because we needed someone who fit the core values. It’s really easy to get a warm body in a seat. But the impact that can have if they’re not a core values fit can be so, so draining on the team, on the management, on the patients. Patients can feel the dissonance there. I’ve had examples of that too where we were in a pinch, and we had a position open for so long that we just hired the next, most qualified person. And it really ended up being detrimental to the practice, and the morale, and ultimately created a lot more work for all of us.” (18:04—18:58)

“[Having core values] feels like practicing in the dark versus practicing in the light. I think, at least for my own journey, my dental school did a wonderful job of getting me to the point where I could be a practicing dentist. And I understand so much the limitation of, you only have four years to take people from zero to dentist. We didn’t get a lot of business training. We got the basics. We got the stuff that we needed to know, but we didn’t get the nuts and bolts of what it takes to run a business that is effective and profitable and that feeds your lifestyle and your desires. So, I think it’s just a lack of knowing, a lack of familiarity around it.” (20:07—20:56)

“When I was learning about core values, it felt overwhelming. I read some of the books, the Patrick Lencioni book. And then, there’s the Harvard Business Review article where he talks about it. I remember reading it and thinking like, all the stuff that I thought were my core values, like loyalty and integrity, those don’t go deep enough. And so, it takes a lot of intentionality and a lot of patience. I think between the management group in my office and Courtney, we reworked the core values probably four or five times to really make sure that they felt in alignment.  But again, now that we have them, I can’t imagine not having them. What I realized is they are such a reflection of me that I live them without realizing it in my daily life as well. I find that it’s become an internal barometer around how I spend my personal time as well as the time at work.” (20:57—21:57)

“It comes back to core values because you have to know who the right person is. As we know, there can be many different types of dental assistants, many different types of hygienists, many different types of dentists. You have to know what your practice needs, and not just that they’re going to come in and be able to do their job. How are they going to engage as a part of a team, and how are they going to be able to support you in totality — in your mission for the practice, in the purpose, and in the way you care for people? So, I think getting very, very clear on what your core values are is the very first step.” (22:12—22:53)

“I use [core values] as a benchmark when I’m interviewing people. We can even ask questions in the interview that are in alignment with our core values and try to get a sense of, is it something that this person really can be in alignment with, or is it something where maybe they’re not as good a fit? That’s been our guiding principle. We use them for everything, and we talk about it as a team afterwards. For example, when we were hiring our most recent hygienist, we gave her a list of our core values. We asked questions around the core values. We really made it a big part of the interview process because it is so important to us. Our existing hygienist, she’s our lead hygienist, was there during the interview. Afterwards, we had the conversation in terms of, ‘Does she meet our core values? Is she going to be a good fit? Is she going to help take the load off of the lead hygienist and further the practice in the way that we want to go?’ You can’t go somewhere if you don’t have a roadmap, and I feel like the core values are a little bit of our roadmap. We use them to be sure that we have the right people to take us in the direction we’re going.” (22:54—24:10)

“I think about when we had a person in our practice who — technically, they weren’t quite the right person because they weren’t 100% a core values fit. But there were things about her that was a core values fit, and we really tried to see, ‘Do we need to be creative? Maybe she’s not in the right role.’ We really talked about it and tried to think if there was another position in the practice that would serve her better and speak to her talents more. But unfortunately, I think being not a good core values fit made the right seat part a moot point.” (24:44—25:22)

“The other thing is that your seat can evolve over time, I would imagine, which is exciting. I know, for me, what excites me and what keeps me engaged in my life and in my profession is the opportunity for change and growth and metamorphosis. You want that for your team as well. And sometimes, you get in a position where the team — they’re a hygienist. They have the mindset of, ‘I’m just a hygienist. I’m going to be a hygienist forever.’ Or you have other people who really want to be able to grow. And so, maybe you have someone who’s a rockstar assistant, and she then takes on more and more responsibilities and maybe grows into an office manager position. I think as long as they’re a core values fit, at least in my office, I can generally figure out where they should sit in the office and allow it to change over time.” (25:25—26:21)

“For us, it’s like, why do we even exist? Why are we getting out of bed every day and providing dental care to people? For us, it’s about providing person-centered dentistry that helps a patient understand and take ownership of their dental and overall health so that we can create lasting relationships and lasting health for them. That’s another thing that the team buys into and that allows us to gauge, not only are the team members that we have good fits for the practice, but also, do our patients match our core purpose? I think that’s something we don’t always talk about or is readily talked about. I don’t have to be everybody’s dentist. One, I’d be exhausted by being everybody’s dentist. Two, my style doesn’t work for everyone. And that’s okay. But if I have people who understand our core values for the team, the core purpose for why we exist, then we can attract patients who value what I value and that want what I’m providing. Then, we can all enjoy work a lot more and actually help people in a really meaningful way.” (26:35—27:47)

“It sounds like lunacy [to have two-hour team meetings]. But it’s actually one more of those things that I can’t imagine not having. Having the space to be able to, one, connect with them — because I love my team for the humans that they are. They come in and support me in such a beautiful way. They give me their most valuable resource — their time. So, I want to make sure that when they’re there, we’re a work family and that we care for and tend to one another. And in doing that, we can care for and tend to our patients. So, it’s a time that we use for connection.” (28:46—29:22)

“We undervalue things sometimes if we can’t put a dollar amount on them. [Weekly team meetings] is something that I think, personally, in my office, is invaluable. I would absolutely not think of putting a patient during this meeting. The time that we get for connection and growth is so invaluable. And then, we use this time too to make sure we’re aligned. We make sure that our systems are in place, that we don’t need to change anything. And also, it’s a forum for the team to be able to express whatever is on their minds so that we can allow it to be resolved as opposed to — what I had before was a monthly team meeting as opposed to a weekly team meeting. What I found is things would backlog until this monthly meeting rather than having a five-minute conversation about it. Inevitably, it would get pushed to the backburner, pushed to the backburner. And so, if we had something that happened that was maybe an activating experience for our team members, it wouldn’t actually be addressed, and it would either be swept under the rug and create resentment, or it would be brought up three weeks later when no one is feeling engaged about the problem anymore. And so, it allows us to keep a pulse on the practice and keep us moving in the right direction. I think it goes back to being effective. It allows us to be more effective with the time that we do have, and that time together pays dividends towards what we’re actually trying to accomplish for our practice.” (29:50—31:20)

“For me, the thing that has been so important in my life and in my journey as a practice owner is really being clear on what I need from my practice and what I need from my life. There’s, of course, the financial needs. We all have bills to pay. We all have debt that we need to service, or vacations that we want to go on. We want to live a nice life. But I think that I found myself falling into the thought that more is more, and we need to produce more, and have more patients, and more operatories, and longer hours, and that it’s this all-consuming growth. But what I learned is that it felt like growth for the sake of growing, not growth that was in alignment with what I actually want out of my life and my practice.” (33:57—34:51)

“When I got really, really clear on what I want out of my life and my practice, I realized that the most important thing for me is time. I heard you speak at AES several years ago, Kirk, and I heard you say time is the new rich. I cannot get that out of my head. I had to figure out what was enough for me. And that number isn’t the same for every single person. What are enough hours in the dental office that I can support my team and myself and my practice? What’s enough time away so that I can recharge and come back as the best human I can be and the best practitioner I can be?” (34:52—35:33)

“Have clarity on what you need and want out of your practice and realize that you are not in service of your practice — your practice is in service of your life. If you can remember that and then start shaping things to be in alignment with that, I think you’ll find that it’s pretty easy to change your hours.” (36:03—36:22)

Snippets:

0:00 Introduction.

1:52 Dr. Barone’s background.

3:05 Why having great hours is important.

4:31 Change your hours to benefit the team.

8:20 Patients will support the change.

9:41 Customize lunch breaks.

11:38 Less hours for more efficiency.

15:34 Have the right people and core values.

26:26 Core purpose, explained.

27:55 The importance of having team meetings.

33:38 Last thoughts on changing your hours.

36:58 More about Global Diagnosis Education.

Dr. Rachel Barone Bio:

Dr. Rachel T. Barone has spent her life in dentistry. Her father was a dentist in her hometown of Coffeyville, Kansas, for 30 years. She moved to Colorado after completing her Advanced Education in General Dentistry residency in 2013. Dr. Barone passionately believes in building a longstanding, respectful partnership with her patients, providing them with comprehensive dental care to help them achieve the best long-term solution for their dental and overall health.

Dr. Barone earned her undergraduate degree from the University of Missouri-Columbia and graduated with honors from dental school at Virginia Commonwealth University in Richmond, Virginia. Following graduation, Dr. Barone completed rigorous, state-of-the-art general dental and surgical training in the Advanced Education in General Dentistry program at the University of Florida. Through this training, Dr. Barone gained extensive experience in dentistry, from fillings and veneers to the placement of dental implants, to the treatment of severely worn teeth and bite problems.

When not practicing dentistry, Dr. Barone enjoys practicing ashtanga yoga, camping, biking around town, going to the farmer’s market, or exploring the nearby trails with her dog, Lucca. If you see her around Boulder, stop and say hello!