#870: Office Autopsy: A Complete Schedule Overhaul

The Dental A Team Podcast

In this office autopsy episode, Kiera shares an example of a doctor who’s hungry to evolve. After approaching the Dental A-Team with the hope to be a more confident business owner, Kiera and the doctor reviewed the practice’s systems with a fine-toothed comb. Improvements to the practice were made by establishing core values, building a more positive team mindset, running effective meetings, overhauling the schedule, and more.

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Transcript:

Kiera Dent (00:00.974)

Hello, Dental A Team listeners. This is Kiera and I felt like it was time for an office autopsy. It's been a hot minute since I've done an office autopsy and I thought, hey, let's do it. So if you're new to the podcast, welcome. An office autopsy is where I peel back the covers of what we've done on a practice and kind of give you a almost like a case study of a practice. So I hope you guys are ready for it. I hope you love the podcast. I hope you love dentistry and I hope you love you as a person.

Today's the day for you just to be a little kinder, give yourself a compliment that might feel awkward, but say, Kiera, you truly are incredible at doing the podcast and genuinely mean it because the kinder we are to ourselves, the more we're able to give to other people. So if you have loved this podcast, please do me a favor and go share it with somebody today. Share this with somebody, put it in a Facebook group, put it on social media, tag us on LinkedIn, whatever you need to do. Because my goal is to get this podcast into the hands of every single dental practice, because I believe that's my way of helping you become a more

profitable practice, but also a happier place to work for your team and for your patients. All right, with that, let's office autopsy. So this is going to be kind of a fun one because this is a practice that I've worked with for a few years. I really love this doctor. And just so you guys know, when I office autopsy, I will change a detail here or there, still staying true to the facts, just so that way you can't completely figure out which exact office I'm talking about. So just so you know, this office is incredible.

The doctor reached out to me because they wanted to be a more confident business owner. And they just felt like they weren't as confident running the business, even though they knew the numbers, even though that they had been in practice for several years, but just really wanted to be a more confident business owner. And so what's really awesome is this doctor was actually doing a lot better than they gave themselves credit for. And I love that because so often we think that we're missing out on pieces, but we're actually doing a lot of things really, really well. And so just...

reminding you guys that you're probably doing better than you think you are but kudos to this doctor because they really wanted to be more confident. They wanted to know the numbers better, they wanted to run the team better, they wanted to be able to have those uncomfortable conversations with the team more and so that's what we worked on. And so in the course of time this office started out as an in -person practice and then they moved to a virtual office with me for consulting and so just know we get results in person and virtually really really well but we started out

Kiera Dent (02:22.99)

helping this practice get some really good perspective of mindset because I noticed that they were kind of negative. There was a lot of negativity. And so I taught them how to look through different filters and what are we saying? And it was crazy to start to watch this practice morph into more positivity, into seeing how things could be done. And what we ended up doing, the doctor started looking at their numbers, put into place a KPI scorecard so that way tracking the numbers every single week, every single month, reviewing the numbers, looking for the trends over the years.

taught this office we put into place core values for them and it's amazing because now they hire for core values and culture. They have their core values that the team has built. They made bracelets for the team of the core values and just kind of made it like really fun for these core values. And the doctor said I made these years ago but they didn't mean anything and so we really broke it back down and when we were building those core values for this office I asked the doctor if you were hiring somebody today to come to your office what would you want them to do? Like what would be the attributes you want them to have and what was amazing is we

put it out there and the core values just shifted and I think modernized into what the practice is today. And so it was really fun to watch this practice really just morph into this incredible space and then hire, getting more confident on hiring and onboarding. We helped them create an operations manual so systems were no longer an issue. And then I think the most fun thing that we did with this practice was this office, like I said, they wanted to be a more confident leader and so.

We set into place how to run effective meetings together. We put into place, like having agendas and what do we talk about and how do we look at our systems every single month to really dive into the pieces? How do we take numbers to the team and get the team bought in and excited about it? How do we get them all owning their positions and building an org chart for them? And then what we did was this office, I started looking at their production and I looked at how ragged the team was and I looked at the schedule and what was so cool.

is as a team, we're able to, like, I heard their issues and I talked to the team and I asked them, you know, what do you guys want? What are you needing? And it was always a schedule, like getting out on time and the schedule and the schedule and the schedule. And so what we did as a team is we actually revamped the entire schedule. So I looked at the production, I looked at the output, we made a block schedule. And what we did is we were able to flip and have procedures where they made a lot more sense. And then I taught the team how to actually guide patients to those blocks.

Kiera Dent (04:43.31)

And it was, I'm like, I'm talking a whole schedule overhaul. So we were doing certain procedures only in the morning, certain procedures only in the afternoon. Teams started getting out on time. We were able to maximize all the team members way more efficiently. The doctors weren't as exhausted in the practice. Their production went up exponentially, but the stress level went down. And it was this whole rollout. Like I did this over the month of like, here's month one, here's month two, here's month three. Like this is what we're going to do. This is what each person's going to do.

And to watch that team who had kind of started out as a little bit sour, we'll say, really embrace and take on. And now the doctor is able to look at the schedule and figure out and optimize as they bring in a doctor or if they lose a doctor, how can they optimize this schedule? Because they know now how to build a schedule and what we looked for. We're looking for productivity. We're looking for how many appointments we needed to have. We looked at what an ideal schedule would be. What time did that doctor want to be out? What time was that doctor the best at doing certain procedures?

train the team how to do it and then put these blocks into play and they're able to actually see more patients because they were feeling like they were maxed on space and they wanted to actually expand the practice but didn't know how to expand the practice. And we were able to add in a ton more patients to the practice without even needing to expand it and add more operatories. So just better utilizing the schedule. So, you know, all these things are fun. We were able to grow the practice exponentially. We were able to get the operations manual done, run these leadership meetings, build the core values, build an org chart.

But then the doctor said, okay, I want to start rolling out a bonus. And I think this was one of the coolest things that we did because so many people want to roll bonuses, but they don't know why. And they don't know the numbers and I'm very anti bonuses for the bulk of it. But what I did, because you know, you guys will hear how to roll bonuses and oftentimes it's like the poker chip one, which I actually love that bonus where, when we hit goal, people grab a poker chip out of the bag and it's worth X amount of dollars. And either that person gets it or the whole team gets it.

But I've also watched offices get into a lot of hot water with revenue when they do this poker chip bonus. I've seen other people pay a percentage of collections, but that oftentimes is really hard for practices because if we don't hit it or is everybody working together? And then there's bonuses on hygienists and if they're hitting production and why did hygienists get a bonus, but the team doesn't get a bonus. And so I think my favorite thing I did with this office was I helped the doctor look at the bonus structure and to see...

Kiera Dent (07:08.91)

let's figure out our worst case scenario. So let's use the numbers and the metrics before we just haphazardly roll a bonus. Let's figure out one, why do you want to roll the bonus? Two, let's look at the numbers and use it. And three, let's make sure that we're not going to get you into hot water in a worst case scenario. So I remember on one of our calls, we actually sat there and we did, let's, let's go with the poker chip one. So let's say, cause she was like, I was thinking it would be, I don't know, like $10 for this, $15 for this, $20 for this. And then $50 would be the highest one. And I said, well,

Let's do a hypothetical. What if they got the $50 every single day that we hit goal? How much would you be paying out in a bonus? And is that something that we actually want to do? Then we ran all the numbers of like, how many days are they going to hit bonus? And let's go back to last month and see rolling this out. How many days would they actually have hit their bonus? And what would that be financially for you? And I remember the doctor after we did the call,

They said to me, Kiera, I'm so grateful you did this with me because I would have been paying way more money than I needed to. That was unnecessary because once we figured out, like, let's just say even if it's a $50 bonus a month, what we did is we actually broke that down to see what their hourly would be. And it was a huge uptick for a lot of them of what they would be making daily or hourly.

just with a $50 bonus. And sometimes we think we need to go for these hundred or 200 or 300 or $400 bonuses or our team will be grateful. Number one, they should always be grateful if it's a bonus and you're doing above and beyond what like our contract is binding between the two of us. But secondly, I think this doctor was about to roll out so much more revenue than she needed to, or he needed to, you'll never know, is it a boy or a girl, but more than they would have needed to because we actually worked through

all the pieces. And then the doctor, once we got done with this bonus system, they actually went through and they said, I feel so confident rolling this out. The team got excited. The team started hitting it. We also knew that we had run it for three months. And then after that, we're going to assess our goals and we're going to reassess and we're going to set new goals because if we're hitting it consistently, it's no longer a stretch goal and we need to raise that goal. And so we just set the expectations with the team. The team loved it. They're able to have a good time with it, but we ran.

Kiera Dent (09:22.158)

all these different scenarios, but the doctor came to me wanting to know how to look at the numbers. And I said, this is how you use your numbers to look at a practice. This is how we look to see, can we hire a new person? Well, what are we producing? What have we been producing? Bring this new person in. Can we afford it? What is our overhead? What's the cost? Then when it's like, I want to do raises, we then go through and we figure out, all right, if we were to give raises to all these people, this is what the impact would be. This is what we'd need to produce. This is what we'd need to change our daily goal to.

and then yes, it works. Other times you look at it and say, okay, could we actually for hygienists, like maybe I don't want to be paying that amount. Could I pay this amount, which is pretty much within market value, but then I add a bonus structure on top of it. But before we even roll that bonus, we actually go back through and we run the numbers to see what would their bonus be? And is this actually going to be something that this office, this is going to incentivize the hygienist or is it just a hope and a wish they're probably never going to hit?

because so often with bonuses, the problem I see is that offices rolled them out and it's either a ton of money for the office and they weren't expecting it and then they have to take it away because they couldn't afford it or two, the team can never hit it and they actually get disincentivized by it. And so for this doctor to use the numbers to know, can I hire? Can I not hire? What does this bonus system look like? How can I feel confident in it? And then start looking and going deeper. Let's look at our PNL every single month. Let's look at our supplies every single month. Let's look to see.

What are we paying? And so we went through is really awesome. We went through her PNL or his PNL. And we started looking to see, all right, what are we paying for supplies? What are we paying for labs? We put it together. We're every single month tracking this overhead to see where we are with our supplies, our labs, what is running through the practice that is this doctor's actual income, even though it's going through as a tax deduction. Totally fine to do.

But we often forget and we think that we're not making as much, but the reality is we're actually making more. It's just running through the practice and we forget that that's actually income to the doctor. So as the doctor saw that they're able to see that they're actually making more than they thought they were able to see the profitability margins. We're able to see where we could cut down and shave off. We got them connected to some partners to have a buying group through synergy. So if you guys are looking for that, be sure to tell them Dental A Team sent you, but able to get the supplies reduced down, looked at the labs, looked at the.

Kiera Dent (11:40.462)

the cost. And then what was crazy is the doctor looked and they lost a team member and they said, Kiera, I don't think I need to rehire this person because I've looked and I think I could actually have a lower payroll cost, better production increase, and be able to hire this person as opposed to a different candidate that's going to give me everything I want and more and also benefit the practice even better. But they use the numbers to be able to make those decisions confidently and the

Crazy thing is like, I'll never as a consultant be able to teach in office every single scenario to look at. Like, that's not my job. My job is to teach clients how to use their numbers, how to look at their P &L, how to train and guide their team to look at it as well, to make educated decisions, to feel confident moving forward. And this doctor really is just impressive to me because they're hungry to grow. They want to keep evolving.

And sometimes we come to the meetings and it's just like, I don't even know what we're going to talk about. And so it's like, well, let's dig into the PNL. Let's dig into our systems. Let's look to see where we at, because oftentimes when problems aren't happening in the practice, that's actually where we get to create and dig and optimize as opposed to just being a firefighter with problems. And so watching this talk go from almost firefighting of problems with culture to owning unapologetically their role as a leader.

delegating out to figuring out their billing to tracking the KPIs to rolling out a bonus confidently. This doctor can walk with their head held high of I actually know how to run my business. I know how to bring on an associate and look to see what amount should I be paying that associate that's so profitable for me. I know how to look at the numbers to see what am I truly making versus what I thought I was making and see how the numbers do work out.

to look to see how can we reduce the overhead or increase the production, how to change a schedule to make a schedule work for me that's so profitable. This doctor lost their associate and had to work for several months by themselves. And we watched year over year with the new schedule and they actually didn't lose any production. They lost a full doctor, but because we'd made this productive schedule that was manageable for one doctor to do, we're actually able to make the numbers work. We were able to hire another associate and kudos to them for that.

Kiera Dent (13:52.334)

but just looking at this doctor of what they came to me for, but I think the greatest transformation of this, like, yes, we've got the cool stats. We've got the increased production. We lost an associate. We brought in an associate. We rolled out a bonus. We have a team that's bought in. We figured out how we could change team members around. We have an office manual. We've got a billing system. We've got KPIs that we're tracking. The doctor knows how to look at these items and be confident in it. But I think the greatest transformation of all was the fact that this doctor...

feels confident running their business, that they're proud of the business that they've built, that they enjoy working there, and that with me being there or not, this doctor is able to make educated decisions and feel confident in it. And I've watched this doctor, they ride the waves, right? The ups and the downs of the business and how it's going to be. But the fact is they're confident. The fact is they know how to make the decisions, whether I'm there or not. And to me, that's the greatest gift I could ever give an office is for them to know with confidence,

what's going to sink their business and what's going to grow their business, that they can look at the numbers, that they can grow their team, that they can have the uncomfortable conversations, that they figured out how to build a new vision and core values after being in business for years to almost reinvent the practice and re -energize the practice as well. It's just really fun. And so I love these stats. I love these numbers. I love the things that we're able to do for this practice. And I just, I enjoy giving people the freedom that they're looking for.

This isn't the same. Like what I did for this practice is not what I would do for another practice, but this is what this practice needed. And this is what they want. And for them to feel confident is the greatest gift I could ever give anybody. Yes, the numbers are fun. The confidence piece is what's going to drive those numbers though. Being a confident business owner that knows their numbers forward and backward, to have a team bought into it, to be able to have those conversations with team members is the greatest gift I could ever give any practice. So that's the office autopsy today. If we can ever help you.

with your practice or you're in those things of what I do for a bonus and I don't know how to look at the numbers and I don't know how to get get team bought in and I might have a little bit of a sour patch team right now that's not as excited about things. Watching this office transform is why I love to share an office autopsy. So with that, if we can help you reach out, Hello @ TheDentalATeam .com, it does not have to be hard to run a successful practice and that's what I'm all about. So come reach out, let's help you be the next office autopsy. And as always, thanks for listening and I'll catch you next time on The Dental A Team podcast.