United We Stand

The dental professional is waging a ferocious war against COVID-19, the invisible enemy.  To prepare for battle, dental professionals have Zoomed, webinared, phoned, e-mailed, texted, talked, reflected, discussed, shared, learned, and shopped. To reopen, dental practices have masked, barriered, digitized, cleaned, covered, sprayed, wiped, sanitized, decontaminated, autoclaved, air purified, suctioned, UVed, and fogged. 

Patients are held in their cars or hallways, the wonderfully euphemistic “virtual waiting room,” until those other potential virus-carrying patients are gone, then ushered in to be greeted by the administrative team through plexiglass and/or masks and face shields to be temperature checked and health questioned.  Patients are asked to wash their hands, and in some cases also instructed to rinse their mouths and don disposable protective gear just for them. 

In treatment rooms patients encounter a clinical team in full COVID-19 PPE regalia who look like Neil and Buzz on the surface of the moon, triumphant in a hostile environment.

For years we talked about educating patients and explaining treatment.  The pandemic has reminded us that there is a cohort of patients who are committed to optimal oral health.  They demand dental care; they hold dental professionals in high regard; and they appreciate all the extraordinary measures taken to keep them safe.

Given the dental profession’s outstanding track record of protecting patients, their team and themselves from cross contamination due to H1N1, HIV/AIDS, SARS, MERS, and other pathogens, the public can rest assured that dentists will never be satisfied in their quest to provide quality care in the safest possible environment.  When dentists cannot jam one more piece of anti-viral equipment into a treatment room, they still ask, “Are we doing enough?” 

The virus is a formidable enemy, but it does not stand a chance of getting between dental professionals and their patients.

COVID’S Big Impact on Dentistry: Teledentistry

Have you been on Zoom lately? Last year Zoom was averaging about 10 million participants per day. Now they are getting 200 million participants per day.

There was a survey recently about telemedicine that asked if people would use telemedicine for any reason to access the healthcare system.  Two-thirds said “yes.”

We now have a wonderful confluence of people who are used to video chatting and people who say that this video medium is a good way to access the healthcare system.

Enter teledentistry. Prior to this COVID crisis, I thought teledentistry was somewhere between a gimmick and a novelty. Now it’s a game changer. Many people don’t access the dental care system because of barriers, such as cost, time, fear of the dentist, or something else. Some people don’t think about dentistry until late at night when they are brushing their teeth. If they have a question or a problem, they do not always call you and leave a message. With teledentistry, they can make a quick video, upload photos, and send you a message 24/7.  The next day you can respond with a video chat to build rapport with them. If it’s an emergency, of course, you’ll get notified right away and you’ll advise them.

In terms of rapport building, marketing, and being able to break down barriers, teledentistry is absolutely amazing. It’s also very powerful in terms of case acceptance. By definition, a new patient comes to the office for the first time and they have to meet you and comfortable with the office.  With teledentistry, they have already met you (virtually). You have already established trust with this patient.  When they come to the office after a teledentistry consult, it’s not all new and intimidating.  In addition, some doctors are using that first actual appointment in the office for diagnosis and treatment, because they already have a relationship with the patient.

What platform should you use? I don’t have an interest in any company doing teledentistry and I know that doctors choose whatever platform suits their needs.

I am focusing on creating teledentistry protocols.  How’s it going to work? What are the mechanics? What are the expectations for you, for the patient, your staff? How do you capture information? What about administrative details such as insurance, whether you take insurance or not? How do you make this technology a timesaver for you and make sure that people are not wasting your time? These are all great questions and we have to work on these protocols.

I am gathering information and I want to learn from you and share information that I hear from other doctors. Contact me through my website, davidschwab.com.  Let’s start a dialogue and bring others into the conversation. The goal is to pull together the best ideas and protocols, because teledentistry is a real game changer. It’s probably the biggest change in dental practice management since computers were introduced into dental offices a generation ago.

Teledentistry is a great opportunity, and if we all work together and figure out how to use it to full advantage to benefit patients, it’s going to be one of the best things that came out of this terrible COVID crisis.

Reopening the Office: A Tale of Two Cities

St. Louis and New Orleans, two cities with fairly comparable populations, have a huge disparity in the number of coronavirus cases.

Coronavirus Cases, March 26, 2020, 8:30 a.m. Central Time:

St. Louis (population 319,000) 69 cases.

New Orleans (population 391,000) 997 cases.

These statistics are for the respective cities only, not the surrounding areas. Similar differences in coronavirus cases appear across the country.

When will you be able to fully reopen your dental office?

Three factors will determine the answer to that question:

1. Where are you located? Hot spots such as New York will be locked down longer than many other areas.

2. Statewide versus county-by-county approach. Some states, such as California, have closed all non-essential businesses statewide; other states, such as Florida, are taking a more localized approach. The decisions made by your governor make a difference.

3. Availability of Personal Protection Equipment (PPE). Even if you are in an area that has been impacted less severely by the coronavirus, government officials will be reluctant to allow dental offices to open for business as usual as long as PPE is in scarce supply in some parts of the country.

In the coming weeks, look for a mixture of good and bad news: surging cases in hot spots, a push to reopen areas of the country with relatively few cases, and (possibly) an easing of the shortage of PPE.

Stay safe!

2020 Foresight: Three Ways to Increase Profitability

The year 2020 is not only a new year but a new decade.  Here are three ways to increase profitability in your dental practice.

  1. Commit to larger cases.  Demographic trends portend more older patients with increasing dental needs.  There is also a growing market for orthodontics—for both children and adults.  A restorative dentist told me recently that he has shifted his focus to larger cases.  Although he has always had a commitment to comprehensive treatment planning, he is now explaining the benefits of treatment in more detail to patients.  By changing the mix of services in his practice, he is now increasing revenue by spending more time on larger cases, which are inherently more profitable and more cost effective in term of hourly production.  
  • Train the Team.  Practice often underestimate the synergistic effect of good team training.  When team members are not sure how to proceed or what to say to patients in certain situations, patients may take the off ramp and park their decision-making process.  Effective team training is focused and involves sufficient repetition and practice to make the new behaviors standard operating procedure.  
  • Follow Up.  There are many patients who are not ready to commit to treatment on the spot.  They need to be followed up in a low-key but methodical manner.  Two ways to ensure proper follow up are to a) ask for permission, and b) establish a texting relationship with the patient.  You ask for permission by using a script: “Would it be o.k. if we followed up with you?”  Most patients grant this permission.  When a team member calls, the script to use is as follows: “I am calling like we promised.”  The call is not an intrusion, but the fulfillment of good customer service.  Another way to reach out is with a text message: “It was great to see you.  What questions do you have?”  If you can establish a texting relationship with the patient, you break down barriers.  The patient knows that if they have a question, all they have to do is send a text, and someone will respond.

There are so many patients who need your services.  Make a commitment in 2020 to serve those patients and at the same time increase practice profitability.

Be sure to visit my website for information about new and updated seminars.

The Rise of Corporate Dentistry—and the Demise of the Solo Practice

The corporate dentistry asteroid has hit the earth.  The skies are darkening.  Solo dental practices are declining at a rate of 7% per year.  Independent solo practices may not become extinct—they are always a few contrarians who soldier on—but they are becoming an endangered species.  The 7% rate of decline may not be fixed; it is likely to accelerate.

The consolidation of practices is being driven by the DSO model, an acronym for “Dental Service Organization” or “Dental Support Organization”—the terms are used interchangeably.  DSO’s are relentless in their pursuit of efficiency as driven by technology.

There are 168 hours in a week.  The average solo practice in the United States is open 35 hours per week.  In those 35 hours, the practice has to pay all overhead expenses and generate a profit.  If we focus for the moment only on fixed overhead, the solo practice is strikingly inefficient.  For 133 hours per week, the office is dark.  The fixed overhead meter runs like clockwork, week after week, month after month; but the production needed to offset fixed overhead only occurs during those precious 35 hours when the doors are open to patients.

The average DSO office is open 45 hours per week.  DSO offices usually have more than one dentist working at a time.  If there are just two dentists in a DSO office, and each dentist works 35 hours per week, the DSO office has double the production of the solo office.

With that kind of production power, the DSO can afford to buy the latest technology.  There are nimble solo dentists who make every minute count.  They post impressive production numbers and they also buy up-to-date equipment.  Ultimately, though, the hamster wheel can only spin so fast.  With expanded hours and more dentists, DSO’s have a built-in advantage.

Next blog:  Challenges that DSO’s face.

Take advantage of the sale on my Team Training Video Series.

Click here.

Capturing Great Dental Patient Testimonials

Great video testimonials are powerful because they engender trust.  All advertising about is claims: we’ve got the best car repair place, we’ve got the best jewelry store, we’ve got the best dental practice; but is that true? If they can see you, if they can see you on video ahead of time, the credibility factor goes up tremendously.

Here is a list of some really good tips to capture those patient testimonials.

  1. Use a video camera, not your phone. It’s very tempting to use your phone. Cameras are made for this purpose and they do a much better job for you, and video cameras have dropped in price considerably.
  2. Use a tripod. You don’t have to spend a lot of money; you’re not trying to capture the wildebeest going across the plains of Africa.  You just do not want the camera moving around–you want it to be fixed when you’re talking to that patient.
  3. Use an unobtrusive background. I’ve seen so many homemade videos where plants or plaques were growing out of people’s heads. It’s distracting.  The best background for video testimonials is the one you never notice.
  4. The patient should be talking to an off-camera interviewer. If patients are told to look at the camera, they won’t do it. They not professionals, they’re not used to it, they start looking around, they look over here, they look over there. We had one lady whose eyes were darting all over the place.  I call it the ferret video. She didn’t look trustworthy. Have the patient look at you, not the camera.
  5. The next tip is good lighting. Lighting is the hardest part of video, if you’ve got a spot in your office and you have figured out that you can put some lights there and make it a well-lit scene then always use it. Be careful also not to mix temperatures of light. Sunlight, fluorescent light, incandescent light—they all have different temperatures and they do not mix well.  You want to have some consistent lighting to make the video look good.
  6. You want to have clear sound. I cannot tell you how many patient homemade testimonial videos I have watched that were hard to hear.  There’s talking in the background, doors are slamming, you hear sounds of a high-speed, sounds of suction—and it’s all so distracting.   The audio is what we call “muddy;” it’s hard to decipher. Making the audio crystal clear will really help your video.
  7. Edit the video. I don’t care how good you are, your raw footage needs editing. You don’t have to buy expensive video editing software. Just Google video editing software. There are many options and much of it is very inexpensive. And if you don’t want to do it yourself, ask any teenager because teenagers all make video projects in school and they know how to do it.  You do not need Steven Spielberg.  You’re just trying to say take this segment out, put this segment here–just to make it flow.

Video testimonials are so important to capture, and I’ve given you advice on how to do it. I go out to offices and we do welcome to the practice videos and patient testimonial videos.  Click here for more information and samples.  Call me if you want to know more; but if you want to do it yourself, these are great tips for you.

A video explaining how to create videos is available by clicking here.

How Dental Office Jobs are Changing

Dental office jobs are changing.  What will dental administrative staff do in the future?

We know that the time spent on manual, time-consuming tasks such as making and confirming appointments and collecting payments is decreasing.  Dental offices are using automated systems to confirm appointments via e-mail, text message, and computer-generated phone calls.  Even the process of making appointments is undergoing a revolution.  If people can make an appointment with a hairdresser or veterinarian using an app, then they want and demand to make dental appointments just as easily.

When it comes to collecting payments, the process of handing a plastic card to someone at a desk for processing is going the way of pegboard accounting systems.  There are automated systems that allow patients to swipe their phone over a sensor.  If it works for Starbucks, it also needs to be available in dental offices.

The new role for dental administrative staff is lead conversion.  We are moving from an era of mass marketing to micro marketing.  When I lived in Chicago, Swissair advertised on a major radio station every day.  Their pitch was designed to entice people to buy a first-class ticket on Swissair from Chicago to Zurich.  The problem was that over 99% of the listeners were a) not planning a trip to Switzerland, or b) wanted to find the best possible airfare, not pay for first class.

Utilizing the power of Facebook and other social media, you can target very precisely.  Ad campaigns can be started and stopped at will, and the automated system can be designed to operate until a preset expenditure level is reached.  There are many companies will expertise in this area.  This type of target marketing is efficient—you reach people who are your target demographic—and the campaign does not have to be unduly expensive.

The problem is that when leads are generated, the individuals who work in dental offices often have little or no training in lead conversion.  It’s not enough to be courteous and polite. Shoppers need to be educated about the practice in a structured yet low key and respectful manner.  Going from inquiry to appointment takes training, experience, and persistence.

The good news is that those talented people who work in dental offices, now being freed from many manual tasks, are eminently trainable.  They can and should be trained to respond to leads and turn as many as possible into new patients for the office.  At least for now, those skills are beyond anything an app can do.






The Secret Statistic that is Costing You Money

There is a  secret statistic that’s costing you money!  Today’s episode of The Personal Report is all about converting more prospective to patients to actual patients.  To see the video now on YouTube, click here.

You track so many things, number of new patients per month, production collections, insurance versus fee for service, everything.  You track all this stuff, but there’s one thing that you’re not tracking.  It’s the secret statistic.  What is it? If I tell you, it won’t be a secret.  I’m going to tell you anyway.  The secret statistic that is costing you money is the number of potential new patients who call each month but do not appoint.  They call, they have a conversation, but they do not appoint.  They just fade away.  They get off the phone.

It’s not that no one’s trying to appoint them, but it doesn’t happen.  Let me give you an example.  I was listening to recorded conversations, HIPAA compliant.  The patients were told that the calls would be used for training purposes, and I listened to some calls, many calls in fact, and there was a theme, a thread that ran through them.

I remember this one man who called.  He talked for 10 minutes.  He was a well-educated man.  He had so many issues, so many problems and the person on the phone was polite and courteous.  It turns out he lived five minutes from the office.  He had a good job.  I was thinking this is going to be a great patient, but after 10 minutes on the phone, he hung up.

I should explain hang-up, in the modern sense.  The old fashioned hang up if you watch old movies is “I don’t want to talk to you anymore” and they would hang up the phone.

That’s not the modern hang-up.  The modern hang-up goes like this.  “Well, thank you very much.” They just get right off the phone.   As soon as they say that they’re gone.  What do you do with these folks?  We can’t call them back.  Due to HIPAA, we can’t call them and ask, “Did you call a dental office?”

What are we going to do? Let me give you some tips.  First of all, early in the conversation, what many large companies do, what medium size companies do, and actually what small businesses, including dental practices are doing now–you use this phrase:  “In case we get disconnected, may I please have your name and contact number?”  It works like a charm.  Ninety five percent of the people say yes and they’ll give it to you.

You’ve got their name and you’ve got their contact number.  By the way, there are dropped calls from people on their cell phones .  A lot of these don’t call back.  If you’ve got their contact number, you can call them back.  We’re going to give this one shot, one shot only.  We’re going to call them a couple of days later. “Hi, Mrs. Higgenlooper.  That so and so calling from Dr.  Smile’s office.  We were chatting on the phone the other day.  I’m just calling to follow up, help you make an appointment, answer any questions.”

If you get voicemail, fine; just leave a message.  You’re going to give it one shot.  Does this work? Yes.  In some cases.   Wayne Gretzky, the famous hockey player said, “you miss 100 percent of the shots you don’t take.” So if we don’t have their name and number, we can’t call them.  If we do have it and we call, we’re going to pick up some people.

So here’s what I want to set for you as a goal.  Now that you know that this is the secret statistic and you should be writing it down, track it every month, write down how many calls you got in the previous month from potential new patients that did not result in an appointment.  Was it two? Was it four? Was it six or seven? I don’t know how many you will get, but every practice gets them.  Write it down.  Make a note.

Here’s your goal.   Reduce the number of calls without appointments by one each month, so every month we get x number of these calls.  We’re going to reduce the number that don’t convert by one, so if you do that, you’ll pick up 12 additional new patients per year.  Is that significant? You bet.

These are really good tips and now you know the secrets statistic.  You’ll be tracking it and with some consistency and persistence on your part, you’ll be able to pick up that additional one patient per month.

Beam Me Up, Scotty

When “Star Trek” premiered in the U.S. in 1966, the cost of a three-minute international phone call was about $12, which, adjusted for inflation, is $92 today.

Even in the 1980’s, when I was in graduate school, calling overseas was anything but cheap.  I remember being in a hotel in Luxembourg as part of a work assignment for a bookseller and wanting to call home.  The telephone table in the room was equipped with something akin to a taxi meter.  When my overseas call to the U.S. was connected, the meter started clicking and turning.  As the contraption shook, pens danced off the edge of the table.

The charges were calculated not in currency but in some unknown message units that started at 10,000.  Every few seconds, the counter in the vibrating table would turn in increments of 2,500.  After about two minutes, I had spent over 30,000 of these units, and I quickly ended my call.  My employer paid the bill.  I never learned exactly how much I had spent, but my boss made it clear that I was not to make any more calls during that trip.

I still  travel frequently for my speaking and consulting business, but I also take advantage of video conferencing.  There are platforms for webinars, which I have used very successfully, but I also really enjoy “virtual meetings” courtesy of services such as Skype.

In fact, when I train dental teams to use the best verbal skills, I often “beam in” to offices across North America via Skype.  When participants are able to see and hear each other, we come very close to the experience of being in the same room.  I marvel at the technology that allows me to be (virtually) in Texas at 2:00 p.m. and California at 3:00 p.m., which does not cost a penny more than what all of us pay anyway for our Internet connections.

During these sessions we cover verbal skills and other issues that come up in practices every day.   If you would like valuable team training with zero travel cost, contact me for more information and we will make it so: dschwabphd@me.com.