Dental Entrepreneur Spring 2020

CLASS OF 2020 | SPRING ISSUE

Bianca Velayo,DMD

My Story Today, in Real Time Laura Mach, DDS

5 Ways to Improve Your Mindset as a New Dentist Kyle Bogan, DDS

Responsible Business Growth is Rooted in a Thriving Office Culture

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Welcome

CLASS OF 2020 SPRING ISSUE VOLUME 3

How are you doing? Lately, this simple question has been weighing heavily on my mind. We ask it of each other all the time, but it’s one of those little acts of engagement that I think carries even more importance in our current situation.

Business Beyond the Classroom

Seriously … how are you doing?

Spring 2020

I hope you’re taking this time to reset your mind and body while also keeping an eye on your future and the future of dentistry.

We do know that there are a lot of unknowns, but the good news is that we have had the opportunity to pull back and reflect.

COVID-19 is like nothing else we have ever experienced, so there is no right or wrong. There is only what is in this moment.

VOLUME 22, ISSUE 3 Editor & Publisher Anne M. Duffy RDH Assistant Editor Michael Duffy JoAnn Schutte Susan Beatty Production Curative Group Editorial Board Dr. Dirk Fleischman Dr. Gene Heller Dr. Harold Sturner Dr. Ryan Dulde Dr. Earl Douglas Rachel Teel Wall, RDH, BS Dr. Tom Snyder Derek Champange Dr. David Rice Layout and Design Brian Rummel Cover Photography Juan Naula Radical Company Class of 2020 Contributors Stephanie Baker , RDH Kyle Bogan, DDS Chad Johnson, DDS Laura Mach, DDS Lucas Shapiro, DDS David Rice, DDS Bianca Velayo, DMD

Editorial Office

12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 anneduffyde@gmail.com

Deep breath. It’s going to be OK. Better than OK if we prepare for the new normal by understanding what we want when we get there.

Our Cover Doc, Bianca Velayo, dreamt about what she wanted way before the worldwide pandemic struck, and even though it hit us all right before this edition of Dental Entrepreneur was set to publish.

I appreciated her moving ahead to deliver a heartfelt and inspirational message to you. I can’t wait to visit her in Vegas someday.

Similarly, Dr. Luke Shapiro and Dr. David Rice switched gears, but I know their timely articles will connect you in ways you never knew were possible, especially now. Their thoughts on how to reach your potential, no matter what’s going on in the world, will help keep you focused during these uncertain times.

Please do not hesitate to reach out to our authors and sponsors featured in these pages. They are here to help and would be happy to answer your questions and concerns by sharing their experiences and connections. If I could impart some advice, don’t pass up a good opportunity when it is offered. That’s a key to success.

We’ve included several articles in this issue that are evergreen, and if you save them in your Dental Entrepreneur folder (I hope you have one!), you can reference them at any time. In addition, as we expand our digital library, we’ve archived even more content that will serve you well as your career progresses. Always stay engaged in the process. Dental Entrepreneur: Business Beyond the Classroom is here to help.

So, how am I? Well, one emotion I’m feeling is compassion for our senior dental students who have had this epic disruption amidst graduation. But through disruption and fear, you will find growth. You wouldn’t be where you are today if you didn’t have grit and determination. Now is the time to see it through.

Wishing you the best as you maximize your careers by enriching your lives and the lives of others.

Stay safe and healthy. We need you!

Send materials to:

Dental Entrepreneur Magazine 8334 Pineville Matthews Road Ste. 103-201 Charlotte, NC 28226 When you have finished enjoying this magazine pass it along to a friend and PLEASE RECYCLE Copyright 2020 Dental Entrepreneur, Charlotte, NC Material herein may not be reproduced, copied or reprinted without prior written consent of the publisher.

Acceptance of advertising does not imply endorsement by the publisher.

4 Spring 2020 Dental Entrepreneur

Anne M. Duffy Publisher

DentalEntrepreneur.com

Contents PROLOGUE

18 Responsible Business Growth is

Rooted in a Thriving Office Culture Kyle Bogan, DDS

6 My Story Today, in Real Time Bianca Velayo, DMD

10 Weighing in With Dr. Luke Shapiro Lucas Shapiro, DDS

PRACTICE BUILDERS

20 Attracting and Maintaining Quality Employees Stephanie Baker, RDH

GETTING STARTED

12 5 Ways to Improve Your Mindset as a New Dentist Laura Mach, DDS

BUSINESS FUNDAMENTALS

THE POWER TO SUCCEED 32 You Are Not Alone David Rice, DDSS s

16 How Understanding Patient Risk

Tolerance Will Make You a Better Dentist Chad Johnson, DDS, FAGD

DentalEntrepreneur.com

Dental Entrepreneur Spring 2020 5

Prologue

My Story Today, in Real Time Bianca Velayo, D.M.D.

I

am writing this at what I hope to be the peak of the COVID-19 pandemic. My dental practice is currently open on a limited basis to see emergency patients for the foreseeable future. If you’re a dentist, then you also know how much this pandemic has been affecting our entire practice.

Although I’m understandably afraid about the uncertainty of this unprecedented situation, I am not panicking. In fact, the last decade taught me that the world is constantly evolving, and the most successful people are those who can adapt and adjust to it.

In dentistry, as in life, I have found that there are many people who follow the beaten path without hesitation because in their eyes, there is only one “right” path. When asked to genuinely consider new options, their response can be, “Well no, because this is the way it’s always been done.” On the other hand, I learned early on that success comes to those who can stay flexible and open minded.

I grew up on Long Island, New York, as a first generation Filipino-American. Being a natural people-pleaser, I was heavily influenced throughout childhood by the expectations set by my family, friends and society. Nevertheless, rather than follow in the footsteps of most Filipinos in my community who became nurses, in high school, I decided to break from the mold and pursue a career in dentistry.

Like most teens, college for me was a time of major personal growth. I remember setting foot on campus at Tufts University in Boston confidently knowing exactly how the next 20-plus years of my life would play out. It looked like this: Graduate. Go to Dental School. Meet my future husband (probably a doctor or a lawyer). Graduate. Get married. Move back to New York. Open my own dental practice. Buy a house close to my hometown so my kids can grow up around their aunties and cousins. Live happily ever after …

6 Spring 2020 Dental Entrepreneur

My worldview expanded dramatically during my undergraduate studies, however. I was exposed to many different ideas and people, which continued as I moved on to Tufts University School of Dental Medicine. While there, not only did I learn dental skills like how to prep a crown, but I also found my own voice and identity. Most importantly, the biases and expectations I carried with me my whole life began to fade away, and I was able to see opportunities with a fresh set of eyes.

The first major break from my preconceived life plan occurred in the relationship department. While all of my dental-school girlfriends were going on dates with guys who worked in the Financial District in Boston, I ended up dating this rocker dude with long hair. My parents were definitely not thrilled when they first learned of our relationship, but I trusted my own judgement and intuition and ended up pursuing that relationship further.

To everyone’s happy surprise, including my own, Shaun ended up being my true love as well as my most trusted advisor and now husband.

Around this same time in dental school, there was a clear and overwhelming belief shared by my classmates and the dental faculty that the most respected and prestigious postgraduate options were to pursue a dental specialty, to complete a general practice residency or to join a private practice. Still, none of these options appealed to me.

To further complicate matters, new licensing guidelines were established in New York state – where I had always dreamed of having my own practice – that required all dentists to complete one of these postgraduate programs to practice dentistry. I finally found clarity during my third year of dental school, when I had the privilege of attending the ASDA National Leadership Conference. This is where I first genuinely considered another postgraduate option: taking a job with a Dental Support OrganiDentalEntrepreneur.com

DentalEntrepreneur.com

Dental Entrepreneur Spring 2020 7

the connections and resources to start my own dental practice immediately after graduating dental school. Looking back, I am so glad I followed my intuition and accepted my job offer with Dr. Mugleston because I was able to fast track my career. Partnering with Pacific Dental Services allowed me to own and operate my dream practice by the age of 26! By independently assessing the opportunity at hand rather than relying on other people’s opinions on the way things should be, I put myself in an ideal position to achieve my goals. My career is now coming full circle, as I am mentoring my three associate dentists at my office.

Honing my personal niche and passion within dentistry was the next major step in my career. When I first became a dentist, my friends and family would constantly reach out seeking a second opinion on what their own dentists were recommending. They were often confused and overwhelmed, and this led to distrust of their dentist. I realized that this was a HUGE area of opportunity for me. If I could improve communication with my patients, then I knew they would trust me as their dentist. This realization influenced the way I educated my patients; I made sure that I was relatable and easy to understand.

zation. I learned about Pacific Dental Services and met my future boss and mentor, Dr. Cody Mugleston. He was passionate about mentoring young dentists, something I also felt strongly about, and he offered me a job as an associate dentist in Las Vegas upon graduation.

I was beyond excited to land what felt like the ideal job for me, but I faced judgement and discouragement from some dental faculty and classmates who accused me of “selling out” by accepting a job in corporate dentistry. Again, rather than play into the expectations of others, I decided to accept the position and form my own opinion. As an East Coaster, never in my wildest dreams did I think I’d end up moving to Las Vegas! But, I knew I had to chase an amazing opportunity that checked off all of the “musthaves” on my list, namely getting to work in a state-of-the-art office equipped with all the latest dental technology, working with a doctor who was committed to my growth as a dentist and getting firsthand experience and mentorship with the business aspect of dentistry.

This last must-have was perhaps most critical for me, because as the first person in my family to become a dentist, I lacked

8 Spring 2020 Dental Entrepreneur

In February 2018, I debuted Oral Health Minute on Instagram.

At the time, the active dental accounts on social media were generally dedicated to sharing clinical cases. My goal was to do something different that wouldn’t narrow my audience to only the dental community. I wanted to create quick and entertaining educational videos that appealed to real people and potential patients in order to change the way people view dentists. Oral Health Minute was well received, and since its inception, I have grown my social media following to over 12,000 followers and amassed hundreds of thousands of views on my videos! It’s so cool to learn that other dentists are using my videos to help educate their patients, as well!

Inevitably, family and personal life grows and changes alongside career. Last summer, my husband and I welcomed our first child into the world. I remember when I was pregnant, I received endless advice from family, friends and patients. There was a recurring theme, and it freaked me out to think that I would become a completely different person after I had a child. People would tell me that my goals and dreams would change, that I wouldn’t want to go back to work, and even that all my best days would be behind me! Part of me felt like this couldn’t possibly be all true, but then again, I had never had a child before, so I just had to wait and see …

I’ve found that being pregnant and being a mom has not prevented me from chasing my dreams. I like to think that being a parent can give us superpowers, so we have even more clarity on what’s a true priority. Indeed, as much as I deeply love my family, I am lucky to also love my work. I’m very passionate about shatDentalEntrepreneur.com

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By following my heart and going against the status quo, I was able to find my soulmate, start my own business and establish my own brand on social media. As Ralph Waldo Emerson said, “Self-trust is the first secret of success.” I know these are uncertain times for everyone, and it’s difficult to predict how things will play out. But in my experience, uncertainty can also provide opportunities. By being flexible and innovative and by trusting ourselves and our own judgement, we can come through this stronger and happier!

Bianca Velayo, DMD, is a 2015 graduate of Tufts University School of Dental Medicine and the owner of Green Valley Smiles Dentistry, a PDS-supported practice in Henderson, NV. She is the creator of Oral Health Minute, an educational and entertaining video series. You can watch them on her Instagram page @dr.bianca.velayo Website and email www.velayodental.com velayob@pacden.com

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Dental Entrepreneur Spring 2020 9

Prologue

Weighing in With Dr. Luke Shapiro Lucas Shapiro, DDS

D

entists Against Coronavirus is a Facebook

group with over 34,000 current members that is exclusively FOR dentists. The group membership exploded in less than one week. Only four days after it was created on March 12, 2020, the group gained an amazing 20,000 members. In a time where we would normally feel isolated and alone, social media has become a virtual gathering place for dentists to look for support, ask for advice, share memes and work through this together. So many educators and industry experts have come together during this time to offer free advice so that we can all come out of this healthy and successful!

I got the chance to interview Dr. Eszter Kiss – the founder of the Facebook group, via none other than Facebook messenger. She currently lives in Bern, Switzerland, and has been practicing for 20 years.

Could you delve into some of your background? Where did you grow up, where do you practice, etc.?

I was born in Hungary and grew up with the socialism in the 1980s. My family and my schools taught me critical thinking, not to believe or accept all things as they are being told. I was raised by a single mother with a motto: You can only count on yourself, and with a sense of humor, you can survive everything. At 24, I opened my first dental practice in the outskirts of Budapest. It was 18 square meters altogether. I worked there for more than a decade. I believe in small practices. They are cozy, and the patients are awesome. It’s like a big family! The changes and the financial planning are less stressful, as well. I also spent a few years in the British NHS, where I first experienced how important it is to discuss things with your dentist friends. This is a lonely profession, and we don’t even have time for ourselves or our families. Competition is high, and you don’t know who to trust. It is a gift to find some like-minded colleagues you can talk to. For a short while, I studied life and business coaching, which helped me overcome perfectionism and support others in their goals. I taught dental

10 Spring 2020 Dental Entrepreneur

nurses for one year before I came to Switzerland in 2014. I have been working here in my own small practice since then.

Why did you start the Facebook group?

Since the outbreak in China, I have been looking for resources about what to do in the dental practice to avoid cross-infection and self-contamination. I wanted to be prepared. I was curious how the Chinese dentists handled the virus, but I couldn’t find anything. I was searching the WHO website and various dental associations for information, there was nothing specific for dentists. I looked into some dental groups I subscribe to, and nobody seemed to care about the coming pandemic. Now that the pandemic reached Switzerland, I felt our dental community was paralyzed and unaware of the consequences of postponing to take action. I felt an increasing pressure to stand up and think together, or at least inform other dentists in countries where the virus had not been as widespread. I just wanted to talk to some colleagues ... Now we are over 22.000 members in only four days.

What’s the situation like in your area?

Switzerland took things quite relaxed and slow. Hardly anyone took the outbreak in China seriously. However, I made a pandemic plan for the practice well before any official recommendations. I ordered some advanced PPE to survive a few weeks of possible crisis and started screening and asking all my patients to disinfect their hands on entering. Some of them refused, so I started to educate them about infection control. After Italy was run down by the virus, we still kept the borders wide open. The infection then started to spread here rapidly, but reactions seemed too mild. Meanwhile, the country ran out of disinfectants and all kind of face masks. Moreover, Germany stopped exporting both of these times. People started stealing masks, respirators and disinfectants from hospitals. Meanwhile, our country managed to rank in second place after Italy on the list of cases per million population. Our healthcare is of high quality, but the resources DentalEntrepreneur.com

are quite limited. There are around 10 ICU ventilators per 100,000 people. The state of emergency was announced on March 16th, and dentists can see only emergency patients until April 19th at the earliset. To be honest, I was relieved to hear that, and our patients accepted these measures really well.

Luke Shapiro, DDS, received his undergraduate degree from Washington University in St. Louis with a major in Spanish. He then went to dental school at Stony Brook and graduated in May 2018. He is now an orthodontics resident at Tufts in Boston.

In dental school, Luke did research, focusing on 3D imaging, with his most Thoughts on what the future is to bring?

This is going to be a tough time for everybody, and we all have to recent project on the application of iPad take part in caring for those in need. If we all could keep our life 3D imaging technology. He was also simple without the greed to consume more and more, the coming very involved in the aesthetics club and months would be less painful. I still trust in solidarity, however I ASDA. Luke is the leader of the dental also know human nature ... Communities will play a great role student section of IgniteDDS. He is also in surviving the coming period. It might sound contradictory in the founder of @futuredentists these times of social distancing, but I think our group is an inter- Lucas.shapiro@ignitedds.com esting example of this.

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Dental Entrepreneur Spring 2020 11

Getting Started

5 Ways to Improve Your Mindset As a New Dentist Laura Mach, DDS

B

ack when I graduated from dental school in 2007, I had an unusually high amount of debt for the time.

This was due to the fact that I had three children while in school, requiring that I pay for four years of daycare with student loans. I had the shocking total of $190 thousand in loans. I thought for sure this was the most debt anyone ever had, or would have, in the history of the world incur for the privilege of putting DDS after their name. During the 12 years that have passed since graduation, two important factors have changed.

States have been increasing their tuition for dental school, while at the same time insurance companies frequently fail to increase reimbursement rates. In fact, some reimbursement rates are actually decreasing. This has created an economic challenge that prior generations of new grad dentists have never before encountered.

Possibly even more challenging than my world record debt!

If you choose to focus on the negative thoughts you have about your new career, you’re going to get negativity in return. But there are other ways to look at your profession. Here’s one I would like to suggest: It’s still a good time to be a dentist, possibly the best ever! How many of you have been in the Facebook Group dumpster fire discussions where everything is doom and gloom?

“Our employees suck, our insurance companies suck, the patients suck.” You know what else sucks? How I feel after participating in those conversations. I suggest that you, instead of falling down these rabbit holes, you shut your laptop and change your focus for a better outcome. I promise you, keeping the strategies listed below in mind, things will start to look better. When you start to feel better, you’ll find that you’re much more capable of creating a new future for yourself.

Here are some key factors will help you overcome these challenges:

In the face of this bad news, does it feel like maybe our new dentists should just give up, sell out, move to Mars or sell plasma for a living? I’ve seen many a dentist on Facebook exclaim that being a hygienist would earn them a better salary. I believe that identifying trends in dental economics is helpful for the industry, as it allows us to better understand the challenges we are facing.

However, I would like to humbly suggest that hanging onto the bad news, playing it over and over in our minds, could also cripple us. Since we know that our thoughts create our reality, what if thinking over and over again that “everything sucks” is actually making it suck?

Whether you realize it or not, your mindset creates your reality.

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Be a True Entrepreneur Have you ever thought about what it means to be an entrepreneur? When Phil Knight started a little shoe company which would someday be Nike, it was a side hustle in his parents’ house.

He saw that the U.S. was ready for better, more affordable shoes.

At that time, German shoe manufacturers like Adidas dominated the market. It looked like there wasn’t space for his dream. However, he believed he had value to offer runners. So even though nobody was buying his shoes yet, he set out, path unknown, to see if he could find people who wanted what he had to offer. He sought to be different, and eventually after many mistakes, he DentalEntrepreneur.com

succeeded. Overnight when Nike went public, decades after his dream was born, Knight finally went from being perpetually broke to being worth $40 million. What can we learn from Mr. Knight?

Well, do you think that reading all those dumpster fires in your dental Facebook groups is going to keep you hustling towards your goal? What if Phil Knight was a new dental grad? He would be studying like crazy, looking for places where his skills could be put to use. He would be asking his patients if there is anything else he can do for them or their family. He would be asking his employer what skills would be most advantageous to learn. He would do demographics studies to see which areas of the country needed his services the most. Dental disease is all around you right now: caries, periodontal disease, acid erosion and cracks. What do you want your contribution to be in fighting these problems? A limited number of individuals are as privileged as you to do anything at all about it. You have a license to practice dentistry, which means you are the possessor of a critical piece of paper that allows you to solve a virtually unlimited supply of dental problems.

Give Value to Your Patients Have you heard the saying, “Take good care of your patients and they will take good care of you?” It may sound cheesy, but it’s so true. The more you strive to add value to the patient experience, the more grateful they will be, and the more value you will create for yourself. It’s cyclical like that. Every time you sit and really listen to your patients, your team or the cashier in your town’s local grocery store, you are showing that you care. As you listen, you will see where you can add value. For example, if I’m sitting in a hygiene exam and I discover a patient has a stained margin on an anterior composite, I will offer to see if I can buff out the stain right then and there. It takes me 60 seconds max, it’s something that the patients cannot do for themselves and they love the result.

Gratitude from your patients is value. Try it and see.

Keep Your Ear to the Ground to Find Unmet Needs Dental disease is all over the country. Are you currently working in a place where your skills are underutilized? Too much down time twiddling your thumbs instead of delivering care? I have good news for you! There are other places that need you more! How do I know that? Because our country is experiencing a shortage of dentists! Okay no, it may not be it NYC, L.A. or Seattle, but if you are willing to look, you will find a place that needs you.

Besides geographic options, you also have the choice of working at different times or for a different demographic in the area you already serve. For example, many shift workers cannot get to a dentist during typical business hours. If you worked two evenings per week but your income went up significantly due to a shift in demand, would it be worth it? A colleague of mine works in an DentalEntrepreneur.com

office called Day and Night Dental, and they are literally busy around the clock.

Remember that what you have to offer has tremendous value.

As a new dentist, I frequently felt apologetic about my fees. I didn’t want to tell people how much things cost, or I often downplayed the cost. I didn’t think very much about the fact that the services I could provide were much less costly than no care at all. For instance, many times a crown is the most conservative, value-filled service you can offer. If it stops a crack from inching down the root of a lower molar or if it prevents a tooth from imploding on itself due to the poor support of the giant composite you would place instead, then yes, there is value! Think of the cost of the implant that would replace that tooth. Worse yet, think of the cost of not getting the implant. We all know it’s a slippery slope. You have the tools and the license to help a patient stop the slide.

Learn From the Smart People Who Have Gone Before You There are about 200,000 dentists in America. They have all experienced similar, common challenges. From holding back a strong tongue to successfully blocking that pesky inferior alveolar nerve and even to the art of delivering bad news to a patient, many embattled dentists have been here before you. Find mentors.

Learn from the greats. Seek out a tribe. Countless resources exist, including courses, podcasts, magazines, books and more. Look for the ones who lift you up. Put on your learner hat and be unstoppable in gaining skills to add value for your patients and your practice. You are going to literally change lives. Now get out there and make it happen!!!!

Dr Laura Mach is a general dentist in private practice. She is also a certified Life Coach through the Life Coach School. Dr Mach coaches dentists on how to improve their leadership by improving their mindset and their understanding of the mindsets of their employees and patients. You can find more material from Dr Mach on her website www.thelifecoachforbusydentists.com or by listening to her podcast Feeling Good, A Podcast for Dentists on iTunes, Spotify and Google.

Dental Entrepreneur Spring 2020 13

Business Fundamentals

How Understanding Patient Risk Tolerance Will Make You a Better Dentist Chad Johnson, DDS, FAGD

I

magine we’re on a Facebook forum, and you see that alltoo-familiar question (with photo included, of course): “My patient has this tooth problem, and I’m wondering what I should do? Should I have fixed it or pulled it?” Most responses are clinical: “I would pull the tooth,” or, “I’d do an onlay.” However, my response is always, “What does the patient want?” While knowing the correct clinical approach to a dental problem is good, being a great dentist requires a deeper understanding of the people, not just the teeth we are treating. We have heard of Risk Factors regarding patient management; it’s time for us to explore Patient Risk Tolerance – the degree of variability that a patient is willing to withstand in his dental treatment plan decision-making, in regard to the patient’s perception of time, money and possible adverse outcomes such as pain, tooth loss and other forms of dental disease.

Understanding Risk Tolerance I’ll admit something, I’m underinsured in some areas of my life.

And I don’t care. I accept the unlikely possibility that a catastrophic event could happen, and I save the money now rather than pay for something I’m frankly not that worried about. And, even if I paid for the insurance and something happened, there always a clause that prevents me from getting the help I need. I’m someone who has a high-risk tolerance. I will take on a higher level of risk in certain areas of my life. Patients do the same thing. They weigh out whether the consequences are more severe than the financial burden of mitigating that risk through dental treatment.

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As their dentist, we need to ask our patients what amount of risk they will take on in each situation. We can advise and suggest, but they are responsible for their choices, and those choices come down to their risk tolerance.

What Does ‘Need’ Mean Anyway?

“You need a crown,” I say.

The patient responds, “I need a crown? Am I going to die if I don’t get it?”

Need is a complicated word. Do you need coffee in the morning?

Do you need to wear your seatbelt? Does your child need that new video game? We use the word when we strongly desire something, feel like we cannot live without it, feel a lack of something or are being hyperbolic to make a point. But in dentistry, need boils down to the patient’s psychological position within the context of their life; and that isn’t something we can decide for them because we love healthy, natural teeth. Orthodontics is a great example.

When patients ask, “Do I need it?” what they really want to know is (and sometimes subconsciously) will the negative outcomes from not getting orthodontic treatment (tooth wear, periodontal disease, occlusal trauma) outweigh the cost to getting the treatment? Will the positive outcomes (dental health) be worth the cost (financial, time, dental treatment discomfort) right now in my life? As the professional, our job is to outline all the options, risks and benefits. Then let the patient choose. Their answer DentalEntrepreneur.com

is exactly what they need. I’ve learned to stop saying a patient needs something, and instead I say, “How would your health be improved by doing this treatment, and is that worth it to you?”

What’s Best?

Best is just another version of the complicated need. When we talk about the best treatment, we can’t know what is best without patient feedback.

Let me give an example from my office this week. I’m prepping tooth #18 for a crown, and I notice that the crack is deeper than the ideal prep, running mesiodistally through 2/3 of the tooth.

I take a picture, sit the patient up, and show him the picture. I say, “Typically, I don’t bother showing patients intra-procedural photos, but once every couple months I stop, because there’s a risk worth discussing. I notice this crack is deep and there’s a chance it will be deeper than I can drill. So, I need to know if you’d like me to crown it today as planned, and hope the tooth will simmer down, and it might be years before we have to address it? Or would you rather me extract the tooth?

What Is the Best Option?

Or: The Best Treatment Option is the One the Patient Chooses I get it. We all want the patient to choose what we would choose.

We even recommend that! Historically, at times I would get cynical and jokingly say to my team ... “If I give the patient five options, this particular patient is going to choose the worst one.” But what is the worst option? Is it simply my least favorite?

Don’t get me wrong – if an option is not a viable option, then tell the patient that it’s not an option! And explain why. Or, if it’s ridiculous, don’t even mention it. I then walk them through what each choice may mean, while also understanding eventually the tooth may need extraction. For some patients, having the peace of mind the tooth is out and won’t cause pain at an inconvenient time is the best option. For others, they’d rather go with the crown because they might get more time out of their natural tooth.

The point is, it’s their choice. Depending on their risk tolerance, financial situation or the value they place on the tooth, they need to determine what best means for them. Will it be the best choice for us as the dentist, knowing what we know? Maybe, maybe not.

However, studies show patients that make choices about their own treatment experience better treatment satisfaction, treatment completion and clinical outcomes. What’s more, the onus is on the patient and not the dentist.

Managing Patient Expectations is Key Dr. Bruce B. Baird is a great mentor of mine and taught me many things about managing patient expectations. One of the greatest DentalEntrepreneur.com

lessons he taught me is the oral condition of the patient is solely the patient’s responsibility, not mine. I’m there as the dentist to help mitigate risk, either proactively or reactively, to understand the patient’s risk tolerance, ask them what they want, and then do a stellar job delivering the treatment they choose.

Regardless of what he or she chooses, the patient has chosen out of his own volition and understands the risks of treatment versus no treatment versus purposeful procrastination, perhaps. I can rest easy at night knowing that I didn’t dictate what they need or what is best for them. I will not offer an unreasonable option to the patient, but there are plenty of times that two or three options are viable, and the key to doing great dentistry is being able to gauge whether the patient will invest his time, money and potential discomfort for ownership of his choice.

So if you see me on an online forum, asking, “What was the patient’s risk tolerance?” or, “What does the patient want to do?” you understand why I want the patient’s feedback in the decision making. We need to make patient risk tolerance an hourly discussion within our practices. Ask the patient, “What’s your risk tolerance if what we’re proposing fails?”

If you haven’t taken this approach before, try it. It’s been one of the most liberating choices I’ve made in my practice.

Dr. Chad Johnson is a general dentist in Iowa, co-hosts the weekly podcast, Everyday Practices, and is on faculty for Productive Dentist Academy. He also has been unofficially conferred the designation of DeWd

by Ms. Anne Duffy. You can reach Dr. Johnson at ChadDDS@gmail.com

Dental Entrepreneur Spring 2020 15

Business Fundamentals

Responsible Business Growth Is Rooted in a Thriving Office Culture Kyle Bogan, DDS

W

hat is office culture? Why have I spent my entire career blazing a trail unheard of in most businesses and in the majority of dental practices to intentionally create an office culture that equips my team to thrive both personally and professionally? My whole life, I have seen the effects of toxic culture on employees. The sad truth is even businesses and organizations that simply ignore their work environments are complicit in negatively impacting those that they should be leading to greater heights.

I spent the Summer months during college working in a local factory building dryers. It was a great job because I could keep moving, build things with my hands and meet a lot of people due to the nature of my position. I was the person who filled in on basically every position on the assembly line, so I interacted with different personalities on a daily basis. The people I met were dedicated to their craft and, quite honestly, some of the nicest I have ever met. I witnessed good people in a work environment that only cared about quotas and keeping the assembly line moving feeling suffocated by their positions. They remained dedicated to their posts in an effort to help their coworkers survive the day, but any measure of dedication to something bigger than themselves was absent. They simply wanted to survive the day and collect their paycheck. Who could blame them? After only a few weeks of being submerged in that culture, I, too, simply wanted to survive the day and collect my paycheck. Counting the minutes until I could clock out and go home.

After graduating dental school, I entered my career as a dentist with the memories of working in that factory feeling thankful that I picked a career where I would be surrounded by inspired teams working toward the goal of improving the health of others.

I mean, I went to college all of those years to enter a prestigious profession so the work environments should be amazing, right?!

Boy, was I young, naïve and flat-out wrong! Office after office,

16 Spring 2020 Dental Entrepreneur

employee after employee, I met uninspired individuals who were simply trying to survive the day, clock-out and collect their checks. It doesn’t matter what career you choose if your leader isn’t committed to fostering a culture to empower his or her team to thrive. I decided right then and there that when I was privileged to lead a team, I would break the mold in dentistry by valuing my team and create a culture to be proud of together.

Despite my apparent passion for office culture, I am sure you are still asking yourself the questions, “Why is this important?” and, “Will it really impact my business?”

As business owners, we spend a large amount of time studying marketing plans, profit and loss statements (P&L), overhead, and revenue sources. I did this too. I lived and died by the numbers in the early years of my start-up dental practice. Something started to stand out to me as I closely examined my P&L statement. I could either lose sleep over trying to save 0.5 percent on dental supplies, or I could make sure that the areas of the P&L where I was investing the most were optimized. If 90 percent of business owners look at the overhead category where they spend the most money month after month and year after year, what do you think they will find? The largest expense for most businesses is in their people. Payroll is the largest piece of the overhead pie. That is exactly how I believe it should be – especially in a service industry.

One thing that every dentist – and really every business owner – needs to realize is that they cannot do it alone. Without a team, there is no business. The honest truth is that dentists would be nothing without their teams. Why, then, are we not concerned about creating the absolute best environment for the group of individuals who are the face of our company and who constitute the largest part of our overhead expenses?

The culture of an organization can be hard to define. Webster’s Dictionary defines culture as “the set of shared attitudes, DentalEntrepreneur.com

values, goals and practices that characterizes an institution or organization.” In the simplest form, our culture is created by EVERYTHING in our business. It is comprised of leadership, onboarding, communication, benefits, people, policies, mission, vision, core values, environment, hiring and firing principles, delegation, etc … The good and bad news is that whether you know it or not, if you own a business, it already has a culture. If you haven’t been leading the formation of that culture, it has formed on its own. This is why it is important that you intentionally foster the creation of a “team-first” culture and surround yourself with team members who protect that jointly formed culture with a fire of passion.

One of the main reasons that culture is important is that it creates a positive, collaborative environment where team members feel valued and appreciated. In my career, many of my most valued employees have come to my office from another position where they were fleeing a toxic culture. Every one of them had a different story: (1) The owner did nothing but yell at us, (2) Our benefit package was cut, (3) The office was full of gossip, (4) No one but me even cared about the customer service that was provided, (5) There was no communication, (6) Everyone was only interested in what was best for them. The list goes on and on. In my office, every employee who entered our culture fleeing a toxic culture has flourished. If you give your people the opportunity, tools and environment to succeed, they will surprise you. They do, however, need to feel like a valued member of the team to care enough to invest their time and energy in your mission and vision. If you can accomplish this you will see increased employee retention and job satisfaction.

DentalEntrepreneur.com

If small and medium-sized business owners are honest, owning and managing a business can be a lonely endeavor. Long hours of working and problem solving within the business can be isolating as the owners feel as though they are the only person in the room who truly cares whether the business lives or dies.

Owners who create a “team-first” culture don’t experience that loneliness. A team emerges that is completely and totally focused on the culture of the office, and this fosters teamwork. Out of this teamwork, employees no longer feel like they are a cog in a wheel, and they start to take ownership of their contributions to the office. They begin to walk and talk like an owner, and the actual owner is no longer alone. He or she is now the leader of a team of leaders who choose to be led. Nothing is more powerful than a culture where a team chooses to follow a leader instead of being managed. If you want to see real growth, don’t be a manager – be a leader!

One of the most surprising and unexpected benefits of intentionally creating a team-first culture was patient retention. Your patients are not as oblivious as you might think. They choose to interact with your business largely based on how that interaction makes them feel. You could be the best dentist in the world, but if you have a terrible culture, you will never reach your full potential. Patients and clients want to spend their time and money with a business that makes them feel appreciated and valued – much like employees want to feel that from the organization for whom they work. I worked at an office shortly after I graduated dental school that had a culture problem. It was rooted in a divided staff that was constantly bickering. The infighting was a poison to not only the staff, but also to the patients. There was a Dental Entrepreneur Spring 2020 17

You could be the best dentist in the world, but if you have a terrible culture, you will never reach your full potential. palpable negativity when the patients entered the office. Everyone did their job – but only their job. The patients came and went like numbers, and the services they received were adequate. Yet, the practice was losing patients and revenue was decreasing. The patients could feel the negativity in the practice and, although the services were adequate, they chose to take their business to an establishment without a culture problem where they didn’t feel that uncomfortable tension. In my office, our patients can feel a difference. In the end, happy employees equate to happy customers which equates to sustained business growth.

The bottom line is that culture is important because it exists. The question is, do you want to be intentional about creating a culture that represents you and your business that is team-focused, or do you want it to create itself, thereby taking control of your office.

If you want to experience accelerated growth and completely differentiate your practice from everyone else, creating a team-first culture is the path you must take.

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After completing his dental training, Dr. Kyle Bogan entered the profession ready to light a fire and change the way patients experienced oral healthcare. While he wanted financial success, he also wanted to measure success by the culture that exists for the team members that join him to serve their patients. Dr. Bogan’s presentations share the principles and strategies that transformed his practice culture while generating happy patients and practice growth. He has earned a Fellowship from the International College of Dentists (FICD) and a Fellowship from the Academy of General Dentistry (FAGD). He serves as the General Chair, Ohio Dental Association Annual Session (2020), the President of Columbus Dental Society (2020), and represents District 7 in the ADA Council on Membership (2019-2022). Dr. Bogan graduated Magma Cum Laude from Ohio State University. He was inducted into the Omicron Kappa Upsilon (national dental honor society). During his schooling at OSU, he was involved in dental research involving the release of fluoride from “smart” polymeric hydrogels. He also played sousaphone in the marching band, dotting the “I” three times. email: kyle@NorthOrangeFamilyDentistry.com website: drkylebogan.com DentalEntrepreneur.com

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Elizabeth H. Guerrero, DDS Get off to the perfect start. Call your ADS transition specialist for AL, GA, LA, MS, NC, SC, TN and VA today.

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Dental Entrepreneur Spring 2020 19

Practice Builders

Attracting and Maintaining Quality Employees Stephanie Baker, RDH

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sk any business owner about the ongoing challenges in owning a business, and I guarantee, finding good employees tops the list. Let’s face it, finding individuals who value your business, the investments you’ve made and your brand are difficult to come by. And while there is no quick, 1-2-3 method to finding that one-in-a-million rockstar, there are some key principles that will assist in attracting rockstar team members and achieve your professional goals.

People Don’t Plan to Fail. They Fail to Plan.

A vision is the picture you have for yourself and your business.

Having a clear vision is the ability to maintain your vision and not be dissuaded by peripheral things. Your dreams, aspirations and goals are contingent upon your drive toward the pursuit of their fulfillment.

What are your goals? Be specific. Write them down and find a means to monitor your progress in achieving them. Share your goals with your team. Employees are integral to your vision and its success. Their emotional investment in your vision will promote connectivity and fuel their own passion in its success. This all begins and ends with a mission and vision statement. These statements should be the mainstay of your business and the driving force behind the decisions made toward their accomplishment.

Set Your Team Up for Success Having the appropriate training protocols in place before an employee starts eliminates confusion and sets a standard of excellence and professionalism from day one. This would include an employee handbook, required training or continuing education, and their responsibilities in written form.

20 Spring 2020 Dental Entrepreneur

Offer Competitive, Attractive Salary and Benefits This is the least-favorite topic for employers, but it is the source of much chatter around the watercooler. After all, why should we pay top dollar for an employee who’s yet to prove themselves? The reality is, you often get what you pay for. When seeking highquality employees, it’s necessary to offer high quality benefits. As much as we’d like to believe our employees would do what they do for free, reality states otherwise. A little extra goes a long way.

After all, would you continue working every day for free? Most of us would not approve. It’s not necessary to break the bank, but often, paying a salary based not on what you can afford, but what you seek to acquire, is necessary. And this leads to the next key point ...

Find Out What’s Valuable to the New, Prospective Employee While this may sound contradictory to the last paragraph, money is often not the primary employee motivator. Security, respect, responsibility and growth opportunity are high-ranking nonmonetary values team members seek. Discover your employees Language of Appreciation, based on the best-selling series The 5 Love languages. The concepts in this book help employers and those in supervisory roles, communicate appreciation to their staff using their unique appreciation language. For example, Words of Affirmation may communicate value to an employee, while Acts of Service (offering to help out) sets another employee up for joyful success in the workplace. This, in turn, motivates the employee. It fuels passion and motivates a desire to succeed and grow your business.

DentalEntrepreneur.com

As our list of services and treatment options continues to expand, our team should feel partnered together with us in that growth.

Meet Regularly Team huddles and leadership meetings are an excellent way to keep day-to-day scheduling snags and squabbles at bay. Quarterly meetings however, allow you to motivate your team and hold them accountable in their roles. These are critical in moving forward on the path toward growth. Dentistry is changing and evolving into a greater entity than it’s ever been. Our role is quickly moving alongside mainstream medicine. As our list of services and treatment options continues to expand, our team should feel partnered together with us in that growth. Business growth requires a business growth mindset. Your team is critical to that success.

Let It Go! As mentioned before, dentistry is changing. In fact, it’s already changed! If you are living in the past, let it go! It’s time to let go of old ideology and paradigms. Let go of the old mindset, the outdated equipment and dated workspace. Shag carpet and antiquated equipment sends a message that your business practices are equally archaic. Investment in your office space will attract patients and better-quality employees.

While you’re at it, let go of the toxic employee. Many business owners admit to hanging on to a negative, trouble-maker far longer than they should have because they were afraid they couldn’t replace them. Once they did, they realized the addition of a team player can alter the dynamic of the entire office in the most positive way!

Finally, let go of preconceived, assigned roles. Perhaps the wideeyed, bubbly person you hired to be your dental assistant is great with people and would be a tremendous addition to your front DentalEntrepreneur.com

desk, admin team. Be willing to present that option. You may find they’ve been hoping for an opportunity like this for some time! You only stand to win when the right people are in the right positions.

Talk About It Get a little nervous when your spouse says, “Honey, we need to talk?” Communication does not have to be uncomfortable. Regular, open communication strengthens relational bonds, family or otherwise. We’ve all heard the silly adage, “Do you know what happens when you assume?” Assumptions can lead to dissension.

Open and clear communication eliminates confusion. Refusing to address concerns ultimately leads to the proverbial white elephant in the operatory. No one enjoys walking on eggshells. Send the elephant packing and sweep the egg shells off the floor. Squelching issues while they are small will strengthen your work-family bond.

Your team will thrive in the safety of effective communication. As an added benefit, your commitment to communicative excellence will cause their respect in your leadership to soar.

Be the Example Looking for amazing employees?Be an amazing employer.

Looking for loyalty? Be loyal. It truly is that simple. If you are looking for a hard-working team but want to have fun while working, be the employer known for having a great time while being productive. Like attracts like. Remembering the years you worked for someone else will keep you humble and grounded.

Always be that example.

Dental Entrepreneur Spring 2020 21

Leaders Lead Assume your position as the captain of your dental ship. Even if you are not a natural born leader, cultivate leadership skills.

Leadership is an action, not a position. No one will ever cultivate your dream with the same intensity as the heart from which it originated. Step up and lead by humble example.

mate goals in focus. Great leaders become great because they are intentional about becoming a great leader. Great teams are made by being intentional in your leadership. It’s never about the role.

It’s always about the goal.

Learn the art of true leadership. Recognize the difference between effective management and micro-management. Confusing the two could potentially drive off team members and destroy all you’ve created.

Stephanie Baker is a registered dental hygienist, contributing writer, speaker, coach & consultant. Her clinical and support team experience are the inspiration for her writing and the motivation for her passion in coaching clients to success. She is the owner of Volume 52, board member for the National Network of Healthcare Hygienists, an active member of ADHA and a passionate DeW. She sings professionally and spends time with her husband, children, and grandchildren in sunny Florida.

Two keys to successful leadership are investing in yourself with continuing education and maintaining accountability via mentors. These non-negotiables are vital to propelling yourself forward and keeping yourself in check. You are only as good as the company you keep. Keep the company of stellar individuals and you will eventually emerge a star.

Intentionality Running a quality business begins with quality-based principles.

Implementing those qualities is the result of keeping your ulti-

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DentalEntrepreneur.com

De W Li fe Retreat signup i s no w OPEN w w w.dewliferetreats.com

Power to Succeed

You Are Not Alone David Rice, DDS

N

ormally, I have the you are not alone talk with new dentists who’ve graduated anywhere from six months to six years out. Friends, these are not normal times.

Covid-19 has truly turned our world upside down.

• Dental practices across the U.S. are advised to treat urgent care only.

• Residency programs are struggling to figure out what to do.

• I’m guessing if you’re a D4 reading this, you’re wondering if you’ll graduate or be coming back for another semester.

All that super fun stuff said, this isn’t our first rodeo.

• In 1918, with a massive flu pandemic, world health crashed.

• In 1920, with incredible financial impact, the stock market crashed.

• In 2008, when I was a young dentist, not too off-base from you, the housing market crashed.

Depressed? Don’t be.

lifts you up at all times. And finally, one who sees the world 180 degrees differently than you.

D4’s: Get Disability Insurance Right Now • The dentist’s who have Covid+ and have the right disability insurance are covered. Please email me TODAY so I can help you get what you need.

And Get Business Overhead Insurance the Day You Own Your Practice • The dentists who have the right coverage are covered. Make a note. This is not you today. It will be you tomorrow.

Lastly, I’ll leave you with this. Every single student who asks for my help, gets it … so ask! Every single student who believes they have all the answers already becomes the dentist who learns lessons the hard way. Don’t be that student or dentist.

I don’t know it all. In fact, I’ve learned I was a fool to try. I am blessed to know many incredibly intelligent people. They’re my mentors. And you know what? We are all here to be yours.

• The pandemic in 1918 was bad …We’re still here.

My email is david.rice@ignitedds.com.

• The stock market crash was also bad …We rebounded.

My cell is 716-912-7970.

• The housing market in 2008 … In hindsight, it was a huge opportunity for those who were prepared.

I don’t share them lightly. I share them because I wish someone would have when I was you.

Friends. You are not alone. In fact, as a student today, you just may be in the best position possible! Keep these factors in mind: • Online education is in full swing.

• No one’s calling on your student loans.

• YOU have an amazing opportunity to learn and leverage this moment.

Here’s what you can do that MANY of today’s dentist’s missed.

Plan for the worst and hope for the best.

D1-D4’s: Get Great Mentors ... Today!

• You need at least four. One clinical. One dentist who is crushing it and is open to teaching you everything they know. One who

24 Spring 2020 Dental Entrepreneur

David Rice, DDS, is on a mission to improve our profession by leading the next generation of dentists to grow successful lives and practices.

The founder of igniteDDS, Dr. Rice speaks to over 35 dental schools and residency programs a year on practice building, team building and wealth building. Dr. Rice is a private practitioner, educator, author and mentor who connects students, young dentists and professionals from diverse dentalrelated businesses - “fueling passion beyond the classroom.” https://ignitedds.com/user/david_rice/

DentalEntrepreneur.com

AN

L IN E AUCT

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ON

ON

BENEFITTING AMERICA’S TOOTHFAIRY

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To everyone who participated in Bid For Smiles this year,

THANK YOU!

YOU MAKE US SMILE! Proceeds will provide our nation’s most vulnerable kids with preventive services to protect their teeth from decay, opportunites to learn how to keep their smiles healthy, and best of all, a new reason to smile.

Thank you to our sponsors and major product donors:

Did you miss your chance to bid? You can still help us eliminate suffering from pediatric dental disease and improve quality of life for underserved children. Visit AmericasToothFairy.org to make a tax-deductible donation, ...because every child deserves a healthy smile.®

DENTAL ENTREPRENEUR CLASS OF 2020 | WINTER ISSUE

Spring 2020

DeW Life Retreat 2020 info inside

Business Beyond the Classroom

Dr. Rich Constantine

Imperfect Minal Sampat

Synergy Jasmin Haley

Strength Katrina Sanders

More Than a Dancing Dentist Dino Watt

Will Your Core Values Be Just a Bunch of White Noise to Your Team?

Kathryn Gilliam

Yesterday’s Protocols Don’t Work for Today’s Oral Cancer DeW Spring 2020

DE Winter 2020

Index of Advertisers ADS Dental Transitions South…………………………………………………………….......................... 19 America’s Tooth Fairy................................................................................................................... 25 Henry Schein Nationwide ............................................................................................................ 27 Patterson Dental........................................................................................................................ 2,3 Patterson Dental........................................................................................................................... 9 Pulpdent..................................................................................................................................... 23 Zirc.............................................................................................................................................. 9

26 Spring 2020 Dental Entrepreneur

DentalEntrepreneur.com

TOP 10 LIST

HOW TO GET AN EXCEPTIONAL DENTAL ASSOCIATESHIP!

PREPARE TO FIND AN EXCEPTIONAL DENTAL ASSOCIATESHIP! Our top 10 recommendations for a successful search: 1.

Determine your goals, objectives, and priorities (e.g., What are your financial needs? Do you want a practice ownership opportunity?)

2.

Start early (i.e., Start 6 months to 1 year prior to availability.)

3.

Prepare a professional curriculum vitae and cover letter (Check spelling and grammar)

4.

Reach out to potential references (i.e., Ask their permission, confirm contact information)

5.

Before an interview, research the practice and owners/principals (e.g., Social media, website)

6.

Prepare questions for the interview (i.e., You are interviewing them too, you want to show interest)

7.

Make sure the practice is ready for an associate (e.g., Do they have the space, equipment, support staff, and a sufficient number of patients?)

8.

Ask for next steps and timing at the end of the interview

9.

Send a “Thank You” after the interview! (Mailing a personal note is best.)

10.

Align your resources. Be ready for an opportunity. (i.e., Find an attorney for employment agreement review)

To find the best dental opportunities, contact: HENRY SCHEIN NATIONWIDE DENTAL OPPORTUNITIES

866-409-3001 or NDO@henryschein.com Nationwide Dental Opportunities service is 100% FREE to candidates (job seekers)! www.dentalopportunities.com

1-866-409-3001

© 2020 Henry Schein, Inc.

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3/22/2019

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