No Limits Gems


JC – 2020 Rules to growing your practice.


Six steps for 2020 growth

  1. Open prime time hygiene schedule & phones inflow parameters
  2. Give patients what they want
  3. Diagnose every patient
  4. Pre-appoint patients when they want to return
  5. Proactively add prime time hygiene in proportion to new/existing patient flows
  6. Optimally market to fill


Out of the top five attributes patients want in a dentist, four of them have to do with trust & honesty… which ultimately has to do with money. Can they trust that you don’t just want their money? You must earn trust before asking for their money.


The lower the patient portion, the higher the case acceptance rate & the more that is completed.


75% of dental consumers don’t rely on online reviews when choosing a dentist.


For every 100 hygiene appts added per month, NP increase by 27.


89% of patients reported that they wanted appointments before 8, after 5, or on a weekend.  59% actually had a future appointment that didn’t make them miss work or school.


The phone placebo effect is an AMAZING marketing tool that costs you $0/NOTHING.  The front desk associate sets the tone for the visit. They can leave the patient feeling like they are in great hands…or have them feeling like you are like every other dental office. Be different.


Offering multiple prime-time hours to a new patient is a marketing tool, similar to when you go to Target & see 10 shirts in each size… they want you to know that they will always have what you & your friends/family /coworkers need. Make sure your team is boasting about your availability.  Offer a 7, 7:15, or 7:30 when someone asks for an early appointment.


Exceeding expectations is a far better way to get referrals than asking patients for them.


Weak secret shopper grades will cause you to misdiagnose the effectiveness of your chrisad marketing.


Keep personal data about your patients in the database. Have the team refer back to it prior to appointments. Make the patient feel like you care about them & you know them. It builds trust, which is the most important factor in terms of whether a patient stays in your practice & refers others.


Customer service is a huge opportunity that is not being taken advantage of.  Customer service is anticipating your customers’ needs & adjusting your policies accordingly (i.e. appoint/pre-appoint cleanings around an individual patient’s unique work schedule).


It is far better to be open late than to be open early because the number of prime-time hours that can be offered.  If you open at 7am, you get one hour of prime time…. If you stay open till 8pm, you can get three!  There is a direct correlation between the number of prime-time hours you have & your growth rates.


Visits to your website are largely a result of other, more active media driving users to it.  Much like how your phone is not the driving force behind patient flow… your website is just the pass-through to get to your practice’s information (phone number/address/biographies/etc.). Don’t misdiagnose the effect of your marketing dollars by giving the website all the credit.


1/3 of all appointments made via local med/online scheduling were made when the office was closed! If you don’t have this component, you could be missing out on these patients.


You can’t track your marketing (how patient heard about you), you can only calculate reach & CPM (cost to reach 1,000 people).  You don’t need to track marketing when you use the right media because you already know how they heard about you.


To increase profitability…infuse your practice with the best patients by opening your practice when they want you to be open, assist hygienists, don’t alternate between hygiene checks & restorative work (your case acceptance is greater & better when you are only doing exams), limit prime-time restorative appointments, maximize sales per chair, minimize taxes with a great CPA, keep supply costs down with Unified Smiles, optimize insurance billing (eAssist), strive for 200 hygiene exams per doctor, optimize insurance payment amounts (5 Lakes), monitor case acceptance (consider Treatment 24/7).


Steps to adding an associate

  • must have surplus hygiene exams (200) for the associate to check
  • achieve perfect secret shopper call scores
  • pay on net production, or better yet, upon case acceptance, so the associate is more geared toward wanting to check more hygiene patients (connect the dots between exams & their income)
  • look for an associate who has worked in a mill for 1–3 years after graduation
  • have 1–2 week working interview
  • don’t schedule them to work primarily midday/midweek
  • don’t cherry pick cases from them
  • monitor pre-appointment of hygiene extremely closely
  • senior doctors must open up & train/guide/mentor new associates, especially on soft (selling/communication) skills
  • insurance must be handled correctly
  • 1–2 days a week, associates will swing for the fences
  • limit case presentation to urgent & immediate needs
  • ensure hygiene & assistants are preselling them & treatment before the associate comes in for the exam
  • if acceptance is low, give the associate the freedom to waive a co-payment
  • pay the associate a percentage of the exam or some won’t check
  • watch staff members because they will quietly guide patients to senior doctors’ schedules
  • do personality tests & background checks
  • keep the associate agreement simple
  • don’t worry about the associate stealing patients & opening up down the street. It never happens & if they do open up, they won’t do it correctly.
  • new patients are over-rated…they are NOT that valuable unless they come back again & again. Patients accept & refer more the longer they are in the practice. Focus on hygiene retention above all else!


Baylin & Eisin – Creating a Team That Shares a Passion


Ensure that your practice has a vision statement & that all of your actions align with that vision.  Post this vision statement everywhere.


They were able to keep their practice overhead around 50% over the past 16 years by ensuring that all their chairs are being used & maximized (under one roof, not several locations) before expanding doctors & operatories.


Getting good employees begets good employees.  Many of their employees are referrals from their other employees.  Look for nice friendly people in the service industry & invite them to work for you. Many of their employees, who are now hygienists & assistants were found working in Subway.


People don’t care about how much you know until they know how much you care. – Teddy Roosevelt.


They use Weave for text/email correspondence & to increase Google reviews.


They write a personal letter, signed by all of the doctors, whenever someone refers a patient to their office. They also include a $25 gift card to their office for the patient.


Building a strong culture:


You need to give your team a sense of belonging.  They need to feel like they are part of a team.


  • Do not settle for a negative person, They WILL bring your team down.


  • Have team meetings, sports teams have practice not just games. Meetings will allow you an opportunity to get everyone on the same page & focused on the same topic.


  • ZAP Board – Provide a whiteboard where teammates can write positive things about other team members.


  • They use Blue Note for interoffice communication.


  • They allowed their team to decorate the staff lounge.


  • Have staff outings & contests (for example, a pumpkin carving contest). Get them engaged with one another & make them feel like a family.


You need to give your team a sense of purpose


  • Start each day with a morning huddle, so everyone knows what their purpose for the day is with each patient.


  • Post your monthly stats (goals & where you are MTD), so the team knows the score every day.


  • Ensure that your team is communicating with one another in front of the patient & make sure that they are citing things that the patient has voiced as a concern. The ultimate purpose for being there is to treat the patient the way they want to be treated.


  • Encourage the team to further their careers. They routinely encourage their team members to go to assisting/hygiene/dental school. They always come back.


  • Give your team additional responsibilities beyond their job role, so they feel they are more important & that they are more than just a position.


  • Offer to volunteer together. Be a bigger part of your community together.


You need to understand & embrace that you & your team are vulnerable.


  • Identify & acknowledge where you are weak. Do not run away from it.


  • Quarterly & annual meetings with each department are a great way to discuss strengths & weaknesses with each individual department & not in front of everyone.


  • Have your team list out 10–12 “commandments” that they, as a group, want to follow at all times.


  • Get staff reviews & input, not just patient reviews. What is something the doctors should do more of? What is one thing that the doctors don’t do, that they should start doing?  What is one thing the doctors can do to make them more productive? Then flip the roles.



Justin Coke – Focus on the NEXT appointment.


  • Don’t put your patients in categories (consults, comp exam, emergency), they are just patients. There are only two kinds: new & returning.


  • If you have the same team as you had last year, you have bad patient retention. If you have good retention, it forces you to hire people.


  • Every patient leaving your office should have a returning appointment for SOMETHING. Don’t solely focus on hygiene pre-appointments, many patients fall through the cracks after a restorative/consult/emergency appointment. Make sure that you have them on the books for their next:
  • Six-month cleaning
  • Three-month periodontal maintenance
  • Post Op
  • Delivery
  • Operative
  • Next Phase of operative

The next appt will eventually lead to a hygiene.


  • How much treatment you present greatly defines if you’ll get them to show up for that next appointment.


  • The more you present to a patient, the less likely they are to return & refer.


  • Patients view cleanings appointments the same way you view an oil change. If you throw too much at them (especially as a new patient & using jargon they don’t understand) when they have no perceived dental needs…it feels similar to the mechanic telling you that you need “new gaskets, calibrators, oil sensitivity cleaner, & headlight fluid” during a routine oil change.


Steve Mascarin – Your team is your most important customer


Mission Statement – “We provide exceptional guest experiences customized to each individual’s unique needs in a positive, caring environment that will astound you at every interaction.”


  • Thinking like a corporation is not a bad thing. Corporations became corporations by doing a lot of things right! Product on the shelf (Target/Walmart), the product the way that they want it (Starbucks), & fantastic customer service (Chick-fil-A)


  • Corporations use brands & they do not veer from that brand. Your practice shouldn’t either. Every aspect of their practice brand goes through chrisad. We are your one-stop-shop for ALL things design. Make sure your brand is synergistic among ALL elements.


  • Never skip a mailing. They constantly have last-minute reschedules & cancellations. There is always a need for your phone to be ringing.  They thought they were too filled with appointments & skipped three months, but then the decline came & it took six months of advertising to get the numbers back up.


  • They hire employees only if they fit into their company culture, not based on experience, that means nothing to them. They look for people that give back to the community, people that have been part of a team & referrals from other employees.


  • Their mission statement & core values are posted on the front walls for patients & employees to see right when they walk in. They give their team a pamphlet with their core values listed in it & will quiz team members about these core values. If employees say them enough times, then they believe them & live them.


  • Be “guest obsessed.” They do not call them patients, they call them guests & treat them like guests in their home.


  • They found that people with dental experience will not work the hours they want them to (they are open 7 days a week, until 9pm most days). Hospitality employees are used to working those hours & you don’t have to teach them how to be nice. Bartenders are used to working until 2am!


  • They are not afraid to hire new grads. They find old habits are tough to break; training someone from scratch is easier for them.


  • They build the loyalty of their employees through opportunity. because they give people who may currently work at places like Subway, opportunities, they find those employees are far more loyal. Plus, in most cases, they are getting paid very low wages at those places, so the regular pay at a dental office is a huge boost to their income.


  • Hiring from out of the industry & hiring new grads requires a very structured on-boarding system. Document your training protocols. You will be adding & replacing people in the future, guaranteed, so make sure you develop training manuals. They make their new hires watch all the chrisad videos on our website & study with them until they get it right & they quiz them on the topics presented in those videos.


  • The initial part of their training involves their philosophy & why they are doing what they are doing. The second phase are the hands-on hard skills they need their employees to learn to work effectively.


  • Make things simple for your team, have checklists…from how to open the office & how to monitor insurance claims…to the sequencing of events that take place during a hygiene or restorative appointment.


  • They make sure every patient leaves with two appointments, one for restorative work & one for hygiene.


  • They have a patient concierge that monitors what is going on with each patient during their visit & serves as a floater to help with non-clinical elements of the patient experience. This practice gives them that one additional customer service touchpoint. They shift who plays this role among their front-desk employees. The concierge is on their feet, not behind a desk & everyone wants to be the concierge. They love it.


  • During every patient phone call (new & returning) & interaction, they ensure the patient knows their fantastic hours.


  • They offer a $99 cash deal for cash pays…for both new & existing patients…for a cleaning, exam & x-ray.


Bickling – Wants & Needs


  • In order to get what you want out of your practice, understand what you need to get there.


  • There is a hierarchy of needs in a dental practice that must be accomplished in order to get to what you WANT.


  • The basic needs of a dental practice (like air, water, food, shelter are the basic needs of humans) are
  • Filled hygiene
  • 100% pre-appointment (85% is not good enough, 90% is NOT good enough, 100%!!)
  • 2–3 prime-time, available slots in the next two days
  • Reactivation system

…without these needs satisfied first, you won’t be able to get what you need (growth, more income, backing out of the chair, hiring associate, etc).


  • MANUALLY track pre-appointment rates, that way it is top of mind. Make sure you pay attention to whether or not working patients are being pre-appointed into prime-time slots.


  • You may WANT 100% filled hygiene appointments every day, but what you NEED is appointments available that the marketplace wants tomorrow. 50% filled hygiene departments are the new full. If you have 50% of your hygiene appointments filled, you need more hygiene appointments.


  • Hygiene reactivation – His offices made 100 a day. Why do telemarketers continue to call you? Because it works. Track it as well…very important!  You have no idea how few calls are actually being made until you track it. Everyone on his team makes reactivation calls.


  • Do the math on reactivation. Even if only one out of 20 of the calls results in a reactivation, you will get 130 patients reactivated a month (if you make 100 calls a day), which will bring most practices $780K annually. Find someone to do this for you as a part-time job. It costs almost nothing & pays big.


  • Weekends/Evenings – He pays an extra $10 per hour for employees on weekends. It’s worthwhile because the office is more productive on weekends (the patients seen on weekends end up causing the practice to be more productive the following week via all the hygiene checks that were done that lead to a ton of restorative work).