There is a cost to running a business, and your team should know those numbers. Once they understand it, they will become more committed, more accountable, and more trusting. To help you build that team, Kirk Behrendt brings back Miranda Beeson, one of ACT’s amazing coaches, to reveal the ten key numbers every dentist should be sharing. To learn how to create a smarter, healthier team for your practice, listen to Episode 552 of the Best Practices Show!
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Links Mentioned in This Episode:
ACT’s Capacity Tracker: https://drive.google.com/file/d/1MdN96fVhau8tcP10kW2_cU-Tv91K8r7l/view?_hsmi=241651107&_hsenc=p2ANqtz-98AjmJ7LkC2HvkK9uuY8l577tbOQ_8dHgEv1V_RVjByeE1xTLRFEYlHJVqxNmOsEBjwFPH-Cjr7iCbb4p-dJiLdKWb7A
Numbers lead to accountability.
Sharing numbers will create more commitment.
If you are transparent with your numbers, you will create trust.
Know the top ten numbers you should be sharing with your team.
Determine whether you’re sharing too much or not sharing enough.
“Most of the time, the question stems around either, ‘Have I shared too much?’ or, ‘Am I not sharing enough?’ And the why behind it is really simple. It’s really three things. You want to create accountability. The numbers and sharing the numbers helps with commitment with your team. It also helps to build trust, to help you guys move forward. So, it’s really accountability, commitment, and trust. There’s a whole lot more, but it really sums it up into those three reasons why sharing the numbers can be helpful.” (3:19—3:49)
“Accountable people appreciate numbers. I’ve always been someone who’s a very accountable team member. Nothing brought me more joy than knowing, where did you need me to go? Where’s the goal? What’s the target? How can I get there? It’s the people who want to be held accountable, who want to grow within your practice, they’re all-in, they love having numbers to help drive them there. It also holds the team accountable to applying countermeasures when needed.” (4:53—5:17)
“[A countermeasure is], what is something we need to do — start, stop, or pause? What is something we’re doing well that we need to keep doing? What is something that is obviously not working that’s resulting in this data point or this number that we need to stop doing, and maybe we need to think about starting something different instead?” (5:56—6:13)
“If we’re committing, as healthcare providers, that we’re going to be giving the best level of care that we possibly can, providing the best options, treating their health optimally, treating their disease optimally, the numbers are going to help us to know, are we giving the best care we can give to our patients?” (13:04—13:20)
“When I was an early hygienist, I was top of my class. I did all the things right. I was that employee from day one that was all-in. But I didn’t understand the numbers. I didn’t understand tracking, KPIs, what they were, overhead — nothing. So, when I got a hole in my schedule, you best bet I was going to protect that hole. I wanted that cancellation to stay in there. I wanted it to be first thing in the morning, our last thing in the day, or maybe right after my lunch. And I was so excited because I got a break, for goodness sake. Once I learned what that meant to the practice, what that meant financially, overall, what it meant to my paycheck, in the end, and everybody else’s, I didn’t want holes in the schedule anymore. I realized how impactful it was in a negative way, and I was so committed, I would go in the hygiene re-care room and call to try to fill that hole myself.” (15:27—16:20)
“Once your team knows the numbers, what they mean, and how they benefit the practice, as well as themselves, they’re going to be more committed to maintaining a full schedule and keeping that capacity up where it needs to be.” (16:21—16:32)
“When practice owners are transparent around the numbers, team members don’t have to guess. They don’t have to guess about the security of the practice. We’ve heard about practices where, ‘I didn’t make payroll this month.’ A team member doesn’t ever want to have to experience something like that. So, when you’re open and transparent around the numbers — now, I’m not saying tell them what’s in your bank account, but enough to know that, ‘Our practice is healthy. We’re in the green quite often. When we’re in the red on these KPIs, we’re doing things to change it to get back on track.’ It helps the team to feel more confident and more secure. It limits the skepticism that might be created in their mind, the storytelling that comes up in their mind around the practice, when we’re open and honest. It builds trust between the team and leadership and the doctors.” (17:17—18:06)
“[Trust] goes both ways. As a team member, you can trust the doctor more. But the doctor can start to trust the team. When the team understands what’s going on and they can work together to put those countermeasures in place, and you as the practice owner start seeing that happening without you having to — it’s kind of like with your kids. They’re going to start cleaning their room without you begging them, and yelling at them, and asking them to clean their room. All of a sudden, I’m going to trust that they’re going to clean their room. And so, you can start, as a practice owner, really trusting your team as well because it goes both ways.” (18:58—19:31)
“We talk all the time at ACT about E – R = C. So, expectations minus reality equal conflict. And we know that trust and conflict really are hand-in-hand. If we can create expectations around these numbers with our team and expectations around what we’re going to be doing to implement changes to those numbers over time, the reality can then match and reflect that and will limit the amount of conflict that we have between team members, between departments, between leadership and team members, sometimes even between leaders, when we have multiple leaders on a team. And so, that’s going to lead to less conflict, and that’s going to mean stronger trust, overall, within the team as a whole.” (19:57—20:40)
“I’ve worked with doctors where they’re sitting in their office during the day, and they’re like, ‘What does Jodi even do up there? Every time I walk up front, it doesn’t seem like she’s doing anything.’ We talked about micromanaging for just a minute, but it really comes back to trust. If you can see that these are the key performance indicators, these are the numbers that Jodi is primarily responsible for, and they’re killing it, Jodi is probably doing some pretty awesome things up there and we really don’t need to sit in our office and stress and worry. We can trust that she’s on top of it because we can see it in the data. Now, if it’s the other way around, it might be worthy of a conversation. But it’s going to help you have that trust.” (21:42—22:25)
“Most team members don’t even know that [gross production and net production] are two different numbers.” (24:39—24:44)
“If you are someone who is considering transitioning to more insurance-independence, the team understanding those numbers — again, we go back to trust. They will trust in the security because that can feel scary to a team member. Just like most doctors, most of us lean into insurance participation. You go on any other forum, we talk about this all the time, blogs and forums online, they’re going to tell you, ‘Participate with every insurance because you’ll get more patients. You’ll get more patients.’ But what we know through our process is, that’s not the way to become more profitable, really, and live a better life and have that better practice. So, we know that. We have to help our team members to understand that too. We’re seeing that from our bookkeeper on a monthly basis, those adjustments, and what we thought we made versus what’s really going in the bank. We have to help our team members to understand that there’s a shift, and there’s a write-off, and there’s that difference there between gross and net production.” (26:23—27:19)
“Collections is super important to know. Obviously, we need to know what we’re producing. But does that even matter if we’re not collecting the money around what we’re producing? And that really feeds right into our AR percentages and knowing where we stand on accounts receivable. It’s really important for your team, as a whole, to know, what’s our collections percentage this month? Did we get 100% of what we produced, or did we get 75% of what we produced in the bank? That matters. And it falls right into accounts receivable. If we didn’t get all of that money, it’s just money owed to us that’s going to keep going on down the line. Old money, as they say. But it’s still technically money that we have to try to figure out how to get back in the bank.” (28:48—29:32)
“Our hygiene reappointment percentage [is another important number to share]. Of the number of hygiene patients that come through the practice, how many of them are we prescheduling and reappointing right then and there for their next visit? Because that’s going to maintain our schedule, over time.” (30:32—30:45)
“[Your hygiene reappointment percentage should be] in the 90s. I say 92% would be a minimum. I shoot high. I have high expectations. I would like to see 94%, maybe, or more be reappointed. There are always going to be some patients who are moving, or they just cannot preschedule because they’re around my neck of the woods, in the military, maybe. They might be deployed on their next visit. But certainly, in the high 90s. Otherwise, how much manpower and effort are we going to be spending four months from now, six months from now, trying to track that person down and getting them back into the schedule?” (31:04—31:38)
“A little healthy competition can go a long way. You could build bonus structures into this type of thing as well, if you really want to build competition when you’re in a really healthy, financial place. Even just that, those numbers are hanging in the break room on your boards, month to month, and that one person consistently is in the red when everyone else is in the green, they’re going to want to bring that number up. They don’t want to be the odd man out. A little healthy competition goes a long way.” (32:53—33:20)
“I have worked within a couple of practices where we started around two percent, and they were able to build that periodontal percentage up into the 20s and 30s within a year to two years of time. So, what that is is, how many patients are coming through the hygiene room? If I’m a hygienist and I’m tracking this, how many patients did I see this month, in general? And of those patients, how many were periodontal codes? So, our full-mouth debridement code, our gingivitis therapy code, quadrants or localized periodontal therapy, and periodontal maintenance. Of the number of patients I saw, what percentage of them were periodontal patients? And really, a healthy number is going to be somewhere between probably 35% and 45%.” (33:34—34:18)
“I think fluoride is one of those things that — actually, I was working with a coaching team recently, and they switched from foam to varnish. And they had a predisposed notion that the patients were not going to like the varnish. Like, ‘They’re used to this. They’re not going to like that. It’s also a little bit more expensive.’ So, when we were chatting about it, they’re like, ‘Well, we have noticed that the acceptance has gone down since we started with the varnish.’ And I said, ‘Tell me a little bit about how your hygiene team is bringing that up, chairside.’ And so, when she roleplayed that out to me, it was, ‘We wrap up with a patient, and we say, ‘Would you like to have your fluoride treatment today?’ And then, the patient says, ‘Well, I don’t know. How much is it?’ And then, we’re telling them, and then they’re like, ‘Oh, maybe not.’’ And so, it’s a little bit around, how do we use the verbal skills to build that value, ‘So that we can protect your root surfaces that are exposed from a higher risk of cavities and sensitivity, we’re going to apply a fluoride varnish for you today. How does that sound? Great.’ So, it’s all about how you’re delivering the value behind that.” (36:07—37:19)
“[Capacity] is, how much open time do we have in our chair? How much availability do we have of our providers? And of that availability, how much of it is currently scheduled? So, we want to know, if I have eight hours a day as a hygienist, am I consistently having eight hours of that day filled with patients, or am I at five one day, and six the next, and seven the next? And we’re busy. We’re so busy, and we’re booked out until August, and we have nowhere to put patients. But consistently, when we’re tracking capacity, we’re seeing that there is space in the schedule. There are holes. And so, now, we know, if we’re booked out six months, that must be the last-minute cancellations. That’s short notice changes in the schedule. How can we do something different to try to combat that? So, that’s what that number is able to tell us, is how successful are we being with keeping the schedule full.” (38:29—39:22)
“A lot of people start considering bringing on an associate. But we need to look at capacity, and is our schedule truly full, and can we really support someone else, or do we have some holes going on?” (40:26—40:36)
“Treatment acceptance can be measured in two different ways. We can measure, of the number of patients who were presented with a restorative or elective option today, what percentage of those patients accepted? So, if we presented to two people and one of them moved forward with something, we’re at 50%. The other way that can be measured is based on the dollar amount presented. So, we can look at, out of the dollar amounts of treatment presented today, what dollar amount percentage was accepted? You can track it either way, and it’s really important to know that the data is being entered in correctly to be able to track that information correctly on the back end. But both of those basically tell us, how much value are we building in what we’re recommending? Are our recommendations working? Is our communication working? What’s happening up front when that treatment is being presented by our front office? Do we have the right financial policies in place to help our patients be able to afford the treatment? If we’re not doing well in treatment acceptance or patient acceptance and treatment, we have to look at each step in that treatment presentation process and see, where is the kink in the chain, and how can we create some countermeasures there?” (40:48—41:58)
“You might not even need to share the [overhead] percentage. It’s going to depend on the team, to a degree. But they need to know what overhead is. Here’s why. I worked on a lot of dental teams, and this is what I hear: ‘I can’t believe the doctor is on another trip to Cancun on a private plane. And did you see that they had a $700 bottle of wine on the table? I can’t even get new Cavitron tips.’ So, that’s the imaging. That’s our storytelling that our team members are often creating . . . But when team members understand what overhead is, they don’t look at gross production at $500,000 last month and assume that the doctor is getting $500,000. They will understand that there’s a cost of doing business. We have to keep the lights on. We have to have someone clean the office. We have to buy trash bags — down to the most minute detail that it takes to run a business.” (42:52—43:59)
“Dentists and leaders, they assume that people know [the cost of running a business]. I’m telling you — team members do not know that overhead is a thing, or what it is, or how it impacts the practice. So, even just the concept of overhead is important to share. And it’s really, in my opinion, dependent upon the culture and the health of your team if you’re going to share the percentages or any numbers around that overhead.” (44:05—44:31)
“There are a couple of numbers within overhead that I think are important for the team, supply budget and laboratory, because those, the team can impact. When they’re getting those lab invoices, they can have a system for double-checking charges and making sure that duplicate charges aren’t on those invoices. And they can monitor for things around your lab overhead. Supply is huge. What we see a lot of times, coming into coaching, is we can reduce overhead percentage for doctors pretty quickly just by initially getting on top of managing supplies. So many teams don’t track and budget for supplies. They order what they need when they need it. They don’t look first to see if there’s a hidden stockpile in an operatory that they forgot about. So, when we start bringing the team into overhead, those are two components that I feel the team can have some control over, if your team members are the ones responsible for ordering.” (47:41—48:44)
“If you want to build a smarter and healthier team, the numbers are a part of it.” (50:08—50:12)
2:27 Miranda’s background.
3:07 Why sharing numbers is important for your practice.
4:44 Numbers mean accountability.
11:09 Numbers mean commitment.
17:10 Transparency creates trust.
19:55 E – R = C.
23:51 Gross production and net production.
30:27 Hygiene reappointment percentage.
33:22 Perio percentage.
40:37 Treatment acceptance.
47:32 Two important overhead numbers: supply budget and laboratory.
49:50 Last thoughts on sharing numbers.
Miranda Beeson, MS, BSDH Bio:
Miranda Beeson, MS, BSDH, has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.
Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.