I’m All In

by Irene Iancu, BSc, RDH, CDTP

Have you ever asked for a raise and been declined? What about benefits, new equipment, fancy scrubs or lab coats? I’m guilty. We all have needs and wants. Practice owners have moments of splurge when the cash in pouring in, and the next moment could be a drought. The conversation around money always rears its ugly head in matters of business, and until July of this year, I thought I knew a decent amount about the business of dentistry. Rookie move – I was wrong!

I attended a conference hosted by Dental Economics (Endeavor Business Media and the organizers of RDH Under One Roof). As an emerging practice proprietor, so extremely new that the link on my lease has yet to fully dry, I arrived armed with a list of questions focused on being a first-time practice owner. My calculated list slowly turned into two pages, as the first day opened my eyes to what it’s really like to own a dental practice as a first-timer. For every one of my questions answered, three follow-up questions appeared at the bottom of my list. I found this experience to be profound and I’m eager to share my takeaways with you in this article.

My first realization is that no two businesses are the same. What works for one may not mirror for another, and that is absolutely okay. Each presenter brought his or her own insights and experiences that led me to make some game changing decisions about life, passions, and what my 15-year plan is. Retirement seemed like an odd thing to think about so early in the game, but as the first few minutes into the event elapsed, it was clear that using your endgame vision as a strategy to plan your career was an essential reality to face early on.

Dr. Roger Levin, who was the first speaker to take the stage, opened with the question that I feared the most. “How many of you own your own practice? How many of you own two, or are on your third, fourth, fifth, sixth or seventh practice?”

Fair question. He was getting to know the audience. But then again, we were just getting to know each other, too. Considering my office only had one side of its drywall completed ironically that same morning, and only one main water line, my hand stayed down but my eyes definitely shifted. As the practice numbers increased, the number of hands decreased – as you could imagine.
When I looked around the room at the mass of people, team members, and practice owners, I immediately concluded. These are the people I want to be surround by.

These are now my people. Even folks with five to seven practices to their names were there, sitting among the newbies such as myself, openly showing their hands, sharing their bluffs, and playing at the same table with the same (yet higher stack) of chips.

Irene Iancu

Dr. Levin gave advice on the metrics that practices need to be cognizant of. He also offered insights, such as having ‘targets for every department within your practice’. For example, staff pay should be about 25% of gross earnings and that a practice needs 800-1000 patients to keep a registered dental hygienist busy full-time.

He shifted into customer service and encouraged us to think bigger and model our teams to handle patients just as the Ritz Carlton and Disney do with their clientele. This extremely condensed version of his lecture was a great introduction to the services he provides as a consultant, and merely skimmed the surface of the ‘8 most important actions that every dental practice should immediately implement. It was a great way to start off my first day.

Dianne Watterson, RDH, MBA, spent a good portion of her time talking about the dental hygiene department and the benefits of boosted efficiency by utilizing a designated hygiene assistant. Not only anecdotally but as it reflects on the daily billings. This is something that I have experienced first-hand as a gigantic benefit in practice, from complex orthodontic cases all the way to recall visits and initial records. This operating model is something every practice should consider if you’re working on increasing hygiene efficiency and productivity.

With short lectures, it’s often difficult to get all the questions answered, which made the lunch session an extremely valuable piece of the day. The moderated panel primarily focused on digital marketing, and having a consistent online presence. The session was moderated by Dr. Chris Salierno, with panelists Dr. Josh Austin and Graig Presti. Takeaways from this doubles-match were executed perfectly to hit all online skill levels. In order of importance, they encouraged us all to look into adding your own photos and details. Ensuring that all platforms have consistency and accuracy help beat the algorithms, which then help to rank you higher on Google without paying a cent to third-party agencies or providers. For local communities, direct mailers are still of value, however, they need to be repeated for consistency and exposure. If you’re using direct mail marketing, don’t be discouraged if the first set doesn’t flood the front gates. Give it some time and keep it consistent.

The post-lunch session was led by Vin Cardillo, MBA, who knew a thing or two about the business side of dentistry. A former DSO practice investor, and “private equity guy”, you could see it in his eyes that he knew his stuff about the ever-growing DSO business model. Among the group of delegates, not one person was associated with a DSO, however, we all wanted one question answered: “How do they do it?”

Vin explained that DSO’s make decisions based on business, metrics, and numbers. Dentists often make decisions based on experience, passion, fear, and sometimes pressure. Modeling office roles based on a DSO model is a great idea for anyone, regardless of size or number of locations. Having a structured reporting system is key. For example, always knowing who is responsible for specific decision making – “something as simple as having one designated person responsible for vacation approvals, budget distribution for equipment, and IT”.

Having clearly defined positions, job descriptions, and employee manuals, reduces the guessing game behind the operation of a business. The DSO model clearly has an advantage and an advantage is a good thing to have when you’re in a tight spot. In my years of practice, I can say that only a few practices have had these structured systems in place, and unfortunately, not all
at once. Vin gave us all a great deal to think about and reiterated the importance of staying on our toes.

To conclude my first day, we were in for a treat as Norfolk Virginia was a quaint little seaside town, with a stunning waterfront – making the sunset cruise a beautiful way to reflect on the day. Vendors, speakers, and delegates walked together and boarded a three-story ship to set sail towards the sunset. This was the perfect opportunity to chat with the experts, explain my personal situation, and hopefully get some free advice over a Negroni. New friendships were formed and I was able to get to know people on a more personal level. Often, we talk mainly about the business highlights but this mini getaway opened us up mentally, which helped open up to some of their business failures. In my opinion, this is the best way to learn.

Irene Iancu,

Day two was short and bittersweet, as the realities kick in of practice ownership, growth and the unknown future of dentistry. Dr. Josh Austin took the stage as the last mainstage speaker of the conference, and brought his A-game on the topic of Google/Yelp reviews and creating your practice philosophy. He shared some inspired ‘how-to’ tips on getting Google/Yelp reviews to stick and rank, then closed his set with the importance of handling negative feedback with fines delivered in his own uniquely branded style.

Dr. Austin encouraged us to isolate all little compliments we get every single day. “Don’t brush them off as ordinary patient/clinician banter”. Make it official and have a patient take that compliment and post it to your Google business page. Ask for location check-ins on your business platforms, like Facebook and Yelp, and turn those compliments into reviews to help your practice rank higher. Add a little topspin to that review and have your patient upload a photo. The photo doesn’t have to be a curated selfie. It could simply be a photo of your reception room, a cool indoor fig tree, or even a tennis ball collection. Photos will ultimately give you a little bit more credibility online and help those reviews to be ranked as more relevant to potential and existing clients.

This conference was never about how to ask for a raise, getting health insurance, or even new equipment. Though, as the hours elapsed, it helped us to get a better understanding of how it all works behind the scenes, which gave me ideas on how to successfully offer solutions that could alleviate some fiscal constraints. As an employee, you may not be privy to the financial inner workings of your department or practice, which is not your fault. However, understanding a sliver of these principals might assist in navigating conversations differently in your negotiations for your wants and needs.

Molar of the story: across the board, every speaker echoed the importance of having a solid team moral. Work on the team, keep working on the team, and grow together – not apart. I liked Dr. Austin’s parallels between the elite culinary world and dentistry. “Get creative but always maintain the level of service as a 3 Michelin Star establishment”. This includes superior customer service, strength as a team, and a led by a true trailblazing visionary. This is something in dentistry that we should all attempt to accomplish if we want those consistent 4.7 to 5-star reviews. The climb can take decades but it is possible for the strong willed and the driven. Staying at the top is another hurdle.

The atmosphere created by the exceptional organizational team that brought Principals of Practice Management together was that of an open learning and sharing environment, led by an all-star team with decades of success and failure stories, which made this experience more than just another course.

Approachable speakers, experts and involved vendors provided useful insights and realistic takeaways that can be implemented the moment you got home. I encourage you all to consider an extended conference for your future practice management CE. You’ll find that with just a few more hours, your knowledge on the business of dentistry will be more valuable, and the friendships you make will serve as lifelong benefits.

About The Author
Irene Iancu, BSc, RDH, CDTP, has worked in various specialties including Paedo, Perio, General Practice and Orthodontics. Her goal in her current holistic practice is preventing and maintaining an optimal mind, mouth and body. Irene connects the systemic effects of oral conditions to her clients, while making a change for overall health and wellness. As a Peer and Quality Assurance Mentor contacted by the CDHO, a Clinical and Theoretical Dental Hygiene instructor at Oxford College, and a practicing dental hygienist in Toronto, Irene shares her passion for education with us today in the hopes we can change the lives of our clients and their loved ones. Irene can be contacted at Irene@toothlifestudios.ca, www.toothlifestudio.ca, IG: @ToothLife.Irene, @Toothlife, @Toothordare.podcast.

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