Dr James: 0:46
on Dentsune the Best with my good friend Barry Olden. A little impromptu, we were gonna shoot a podcast and then we thought why not have some fun and go live on the community, cause it’s been flipping ages since I’ve done one. I’m sat here with my good friend Barry Olden and we’re gonna talk all things profitability in our dental practice, especially in the current cost of living crisis. Barry, how are you, my friend?
I’m rocking mate. It’s so good to see you. I’m loving it. I would just angle so I can see myself. Yeah, good, I’m really good. I’m very interesting that we’re talking about profiting some of my clients and myself. I’ve had the best financial month ever. I think at the last, at the last, really. Yeah, yeah, but we’ll chat through that, and why?
Dr James: 1:33
Yeah, no, we definitely, because there’s a lot of people out there who will be saying the opposite right now, especially in the cost of living crisis. In verdict commons, barry, we were talking off camera and I just wanted everybody to know this as well. Just before we came online, barry and I were talking off camera. Those paintings behind Barry were drawn by Barry’s daughter. What a phenomenally talented young lady. Isn’t that just fabulous? Thanks.
Her handle on. The answer is Amelia Brooke Art. Okay, Amelia Brooke.
Dr James: 2:03
Art. Shout out to Amelia. Hopefully she gets a few followers out of this. Those are flipping fantastic. You know, whenever I look at drawings like the Mona Lisa or any form of art okay, with any form of art that actually resembles a person of which there are lots right that just baffles me. I have no idea how someone can be that skilled at drawing, because from my frame of reference when I draw, it looks terrible. You know, I’m like you know, whenever I draw and then you’re trying to guess what it is to kind of save my feelings. Quite, often times people don’t have no idea what it is. Okay, that’s actually how bad it is, even though I’m now 31. So when I see something like that, I’m just blown away. I’m honestly I’m blown away. So hats off, fair play. I appreciate it.
Where did the?
Dr James: 2:48
talent and art come from? Did it come from you or your mother?
Actually me. I’m quite artistic, I have to say it. Yeah. Okay, okay, yeah, yeah, I wanted to do art as a kid, but I wasn’t allowed. My dad was like it’s a nice hobby to have, but you can’t make a living out of it. So when my eldest was like, daddy, I want to do art, I was like, yeah, come on, let’s do it. So this is her. We share this space as it’s her art studio in my office.
Dr James: 3:19
Right, got you Cause you’re in the middle of moving hearts at the minute, right? So this is your office, right?
I know. So the other side of here is the garage where myself, Chloe and the boys are living. So we’re currently living in our garage.
Dr James: 3:34
Right, okay, and that’s yes Cause I remember you telling me that you’re between houses, but things are looking up now. Right, the house is in 2000.
Yeah, we’ve, we had the. It was funny actually, cause I phoned Chloe and I went oh my God, the plumber’s here, this is on Monday and he went excuse me, heating engineer. And I thought fair play, fair play. That’s like you’re going dentist and somebody goes, excuse me, cosmetic dentist. So our heating engineer has actually got the heating on today, so that’s the first time. So, yeah, it’s great, we’re looking forward to it. And it’s a story you know, the story of of how we’ve lived together for four months in a garage. Yeah no, it’s interesting right.
Dr James: 4:20
Well, it’s something you’ll look back, and that’s. I try to remind myself of those sorts of things. One day I’ll look back and laugh. Maybe that’s how you felt the last four months. Anyway, the heating engineer has come, the messiah is here, the house is now warm, flipping, fabulous. Anyway, barry, let’s talk about the things we’re probably supposed to talk about today, which is profitable practice and you said something just a second ago that this month has been your most profitable month, and that will dumb find a lot of people. Given what’s going on in the back line, maybe it might be nice to just explore that and how you did that.
Okay, well, I think it’s actually what’s just come to mind is that I think one of the things I think I’m very good at is finding the silver lining out of the shit. Okay, it’s finding you know what is is having gratitude, regardless of what’s going on. So the fact that we’re living in the garage and it’s bloody cold and what I’ve done is I’ve insulated the ceiling. What I’ve actually, what I’m saying to myself, is this has been a wonderful opportunity for the four of us to be in the same room and to be in the same space and to spend time with one another. It’s also a great opportunity that when we move into our house, we will enjoy it more and we’ll appreciate it more. And actually transfer that into practice right now is that there’s a lot of people going. This is really bad. There’s the cost of living and if we focus on that, it’s a mindset right. If we focus on that, the answer is yes, it is, and yes, it can be, and then we miss all of the good that’s coming out of this. And this is an opportunity to with my clients yesterday I was talking about you know, they’re competing on price locally with people. I’m charging this for Invisalign because the people around the corner and I said look, you’re competing on price and what we really ought to be doing is using this as an opportunity to compete on service, is to see this as a chance to cement the relationships that we’ve already got with our existing patients, to add more value to those existing patient relationships, but also to demonstrate to people that are new just how good we are, how caring we are, because they will still spend the money that they need to in order to be fit and healthy and they are far more likely to spend the money on the additional would like to have with you either now or in the future. So I think there is a huge opportunity right now, both in terms of building our relationships with patients and actually ultimately building a business. So, yeah, I just had the highest grossing month I’ve had for, I think, for the last five years of being an associate. So, as an associate, I’ve been working. I work three days a week. I owned my practice, obviously, for 20 years, and I’ve been an associate now for four and a half, and last month I worked three days a week. I don’t do implants, I do very little, although and my gross was 71 grand, and that is I know right, but that’s because of the systems that we have, of the way that we carry our patients through the patient journey and the choices that we give our patients and then help them choose so and we transfer those into our clients and it just works and it’s all about service. It’s not about money and accidentally we end up making more money. So it’s about two key things that I think have made a big difference, and that is how we zone our diaries to allow us to be productive and it’s how we conduct our examinations and our treatment planning. Is that we do? We go through every single tooth with a patient, allowing them to make a choice, and I think there’s an opportunity now for everybody to just look at their processes, look at their systems and look at where they can tweak, develop and grow and change their systems to improve them, because it’ll help now, but without shout out, without helping the future.
Dr James: 8:31
I love that and you know what I’m really intrigued to delve into those two things that you mentioned, just so we can understand, by all means, a little bit more about them, because the whole point of this podcast and all the content and investing investors to give value, and the reason I really like these sorts of podcasts is you can quite literally hear something within the next 40 minutes that you can go take to work tomorrow and increase your profitability, not so you can be like loads of money and all of that stuff, but so that you can offer a better service to your patient, because, ultimately, if each hour is more profitable, you can give other people more time and give them a higher level of service. That’s the trap that people fall into. They think that there’s only one dimension to being able to give someone good value, and that’s to decrease the price as much as possible. There’s actually two ways to give your patients the best value. One is to basically decrease your prices way down to nothing. That’s a race that nobody wants to win, okay. The other way is to make the product so good that, no matter what someone pays you, it’s still good value, because you would rather have one kilogram of gold that’s priced at 1000 pounds than 50 kilograms of wood that’s priced at 100 pounds, wouldn’t you? Because 50 kilograms of wood is just a huge oil lump of wood. What are you going to do with that? You’d rather actually have some gold, some really valuable stuff, even though there’s less of it, even when the investment is higher. And for me, I love that little analogy because it makes people think oh, actually, clearly, price can’t be the only factor. It’s totally to do with the quality of the product. Otherwise I’d rather have the wood.
I love it. Let’s just quantify what the product is, because in my model of the world the product is not the dentistry. Too many people focus on the quality of the dentistry. Now it’s got to be good. Let’s say that seven out of 10 is great dentistry. Let’s agree that it has to be seven out of 10. Most patients do not give a hoot whether it’s seven, eight, nine or 10, because they don’t have an appreciable understanding of the difference. It’s us, it’s people like me, that want the dentistry to be 10 out of 10. But too many dentists and too many practices strive for 10 out of 10 in the dentistry at the cost of what the real product and services and that is the patient journey Is that in my model of the world, if your dentistry is seven out of 10, seven and eight out of 10, but your patient journey is nine or 10 out of 10, you are there for the long game. You get constant recommendations and referrals, you get a greater uptake on treatment. If your dentistry is 10 out of 10, but your patient journey is five out of 10, then you’re struggling. Imagine you go out for a Michelin star meal, right, and you’re in this environment and you know that the food is impeccable, but what you hear is the matriarch D and the sommelier having a blazing row in the back and you hear the chef balling out and effing and jeffing the juniors and it just spoils the journey. It spoils that whole process, because the food can be wonderful, but if the atmosphere and the ambiance isn’t there, it can destroy it. Yet you can go for a meal and if it’s a seven, eight out of 10, and they’re attentive and they clearly demonstrate that they support one another and it’s a lovely environment and everybody’s enjoying themselves. You talk about that being a wonderful experience, so that you’ve got to get both of these things right. And I think now is an opportunity for people to really begin to focus on their patient journey. It’s begin to look at we’ve done what we’ve done all these years. What can we do to tweak it? That might make a difference? And that’s where zoning comes in, the how you process. We do a co-pilot examination which ultimately massively changed the value of our examination. So typically, shall I explain this Is this worth it? Yeah, yeah, I’m all ears, okay. So what used to happen is a patient would come in and I was. I was one of the old school mixed practice dentists, which I would say hey, james, how are you Any problems? Or I’d ask that fricking awful question, james, how are your teeth? Hi, and anybody watching this is going to go oh, I’ve been guilty of that. Some of you might be going oh, I just did that half an hour ago, but I would say any problems. And the patient would go, no, no, no problems, since I saw you last. And so then I’d be looking around for anything obvious, because I was indoctrinated in being a bit of a firefighter and the firefighting was any problems. Oh, yeah, I’ve got a chip tooth. It was like it’s like I pulled out a super dentist, I can fix that. And I ended up doing single tooth dentistry. Very well, right, but single tooth dentistry, and if they didn’t have a problem, I was like my own worst enemy and their worst enemy in not wanting them to spend money on it. And I’d be like, but you got to these old feelings, I’ll keep an eye on them. And it was the adage if it ain’t broke, don’t fix it. Yeah, I’d look around their mouth. I know in my head I’m doing an oral cancer screening, I’m maybe doing a BPE, I’m looking at what’s going on and then I go, yeah, everything’s fine. And that was it Right. There really wasn’t a great deal of information shared because it was really focusing on do you have a problem? And if you don’t have a problem, everything’s all right. So I developed a co-pilot system. You know like you get into a plane and you’ve got the co-pilot and the pilot and the co-pilot gets his manual out and he goes right wing check and the captain goes, yeah, wings check, engine, one lights on check and they go through this checklist but it’s verbalised. That’s what we do in our examinations, all of our examinations. It’s in our exact. I’ve written it out and for me it’s nurse led. There are several benefits to this. Number one is I’m a shiny object syndrome kind of guy. I’m global, I’m like a magpie, I’m like ooh shiny object and I’m off. It was easy for me to get way laid in my examination process when I saw that somebody was para-functioning. Because that’s one of my areas of special interest, I’d get deep into conversations about oh, you’re grinding your teeth and they’ll have a lot. Then I will have forgotten to do the BPE. That was the most common thing. I forgot I would get to the end. The patient would go and the nurse would say, oh, you didn’t do a BPE and I was like, ah, sugar Medical, legally. It’s really important. It means that I don’t forget anything. Next thing that’s beneficial is the nurse is much more heavily involved and that, I think, makes my nurse feel more involved and more important, because she is incredibly important, but it also elevates her in the mind of the patient. But the most important thing is that with this co-pilot system going on over the patient and I say, look, we’re going to hear us say a few things At the end, when I first introduced it, old patients would sit up and go whoa, you’ve never done that before. My response was do you know what I’ve always done? That I just never told you what I was doing. The perceived value of our clinical examinations went through the roof, because they then were like, oh my God, these guys actually do so much. So co-pilot diagnosis, co-pilot exams massively change things.
Dr James: 16:22
So you mean just to dissect that for two seconds and you might have said this at the start and it might be me as the only person who missed it you mean towing and throwing about the system that you have for your exam, the nurse calling out barry BPAs, barry hard tissues, barry soft tissues, something like that.
Exactly, exactly, exactly right. So we have a systemized approach, as you would in your head, as we do on our notes. But my nurse is calling it out, so she’ll say muscles, amastocation, temporalis. I’ll be doing my palpation, I’ll say temporalis, tension, any tenderness, no, no tension, okay, tension, but no tenderness. And then we move through in a systemized approach and the patients are blown away. That’s the biggest comment. New patients come in and they go. I have never had anything like this and I’m like I told you we were good, because the other thing is I have something called a UFC and it’s not Conor McGregor, it’s an upbrunk contract. And I will say to my new patients often some of them are nervous, a lot of them are nervous, and I say look, here’s the deal. My job is to knock your socks off. I’m gonna ensure that this is the best dental visit you’ve ever had. My job is to knock your socks off to the point at which you are very comfortable to go outside and tell everybody that it’s the best practice you’ve ever been to. It’s the best you’ve ever been looked after. Is that okay? Now, no one has ever gone. No, don’t knock my socks off. They all go, yeah, and I go great. Now here’s a presupposition right in hypnotherapy Not if I knock your socks off, it’s when I then go. So when I knock your socks off, can I ask that you will go and tell people how good it was? And they go, yeah, sure. So I’ve tapped into Chaldean’s principles of influence. I future-paced them into. When I knock your socks off, chaldean’s principles are consistency. When you say you wanna do something, there’s something in your head that makes you wanna do it, and I remind them at the end of the appointment. I go how was it? And they go. That was the best I’ve ever had. I go see, told you I was good, and you said that when I knock your socks off, you go and tell people. And so I’ve been doing this for years, which is why we haven’t marketed now for 19 years. No marketing, purely word of mouth, because we set it up. Anybody can do this, and particularly now, if you have a little more downtime, now is the time to begin to play with this, with your routine patients, with your new patients that are coming in. Start setting up these upfront contracts of what you can expect from me and, to a degree, what I expect from you, which is you can expect that I’m gonna work my backside off to give you the best experience ever and when I do not. If I do, when I do, you’re gonna go and tell everybody how good it was.
Dr James: 19:18
I love those presuppositions. You can actually remove the word if from your flippin’ vocabulary and replace it with when, and it takes a little bit of practice because you’ll find yourself about to say the I word, if, it, I, when, when, like that, after the first few times. And then also another one is if you replace but with, and it actually totally changes the sentence, because when you say but it almost sounds, it almost sounds like a compromise, and when you say and, it sounds like an additional value, increased, increasing in compound, in the effect. I really like those two, by the way, called any 48 laws of power. The most recent book that I bought was that, the book that you’re referencing, chaldeany, oh, ah, mispronounced his name. There’s an.
I there, chaldeany.
Dr James: 20:03
Chaldeany. Show me the book, show me the book. 48 Laws of Power is just here, this one, Show me mate. Oh, no, no, no, no, sorry, I’m wrong. I’m wrong. I bought two books recently. I’m getting them mixed up. It’s actually Pre-Swagin’. Yeah, yeah yeah, sorry, I bought this book as well, but it’s someone else. It’s Robert Green Robert.
Green, so Pre-Swagin is his second book.
Dr James: 20:26
Influences, his first book.
Dr James: 20:29
But I’ve done a whole. I wrote it into dentistry, probably about 10 years ago, and then I love this stuff.
Dr James: 20:37
The power of words is huge. It’s so underappreciated, thanks. We all speak, but very few of us speak, if you know what I mean. Very few of us speak in such a way that it’s audibly attractive to other individuals. And these are, these mechanisms, are the methods that one can undertake.
Dr James: 20:55
Yeah, Cool, cool, cool cool. You talked about zoning earlier.
Mmm, yes, so there were lots of people zoning. If I would say the majority are not zoning. Those that are typically are zoning where they can zone NHS and private. My clients zone nine zones and the three treatment zones are based on that old story of sand, pebbles and rocks. You know the story of the guy with the jar.
Dr James: 21:37
Um, something to do with. You can get more rocks in if you put the sand in at the end, something like that. Right, yeah, yeah, exactly.
So, in essence, if you put the sand in and then the pebbles, you’ll get one rock in. Yeah, if you put all of the rocks in and then you throw the pebbles and around and give it a little shake, and then you throw the sand in and give a little shake, then you get a lot more in. When it comes to dentistry, the rocks we call are the highly productive treatment that often takes a little bit longer, right? Not always, but often. So we zone our diary. Three of them are sand appointments, pebble appointments and rock appointments, and we base it on production, not collection. Very briefly, just to explain that, let’s assume that my crown fees are £800. Let’s assume that I’ve had the conversation with Doris about the fact that her six is broken and it’s decayed, that one has to be treated and in an ideal world the best treatment is an indirect restoration. I then talked to her about the five and the seven which have got aldermalgums in, not decayed On our treatment plan. The six is red, immediate, the five and the seven are orange, they’re preventative. 68% of our patients say yes to doing all three. So we have two indirects and one direct. So one crown, one inlay, one composite and let’s say that that’s $1,800. There are there abouts $1,800 plus two $1,800. Most practices, and certainly all corporates, split the fees between the preparation fee and the fit fee, and what that does is it means that roughly speaking, you got 900 quid and 900 quid. Well, our rocks are anything that is production worth a thousand or more. In that scenario, our production on appointment number one is £1,800. And our production on appointment number two is zero. So appointment number one would be booked in a rock space and appointment number two would be booked into sand. What that does is, when we have two to three hours of rock a day, make sure that we are productive every single day. So, for example, I cut my finger so I wasn’t in on Monday. I worked Tuesday and Wednesday and I’ve produced nine and a half grand in those two days. Why? Because rock time is sacrosanct. You cannot book anything into rock time that is under a thousand pounds, apart from 48 hours before. If there’s a rock time that’s open and available and hasn’t been filled, you can stick anything in it with two days to go. So we zone based on production, which means our production is high. We have the right conversations with patients. Where it’s not single tooth, we give them the opportunity of whether they wanna do the five and the seven at the same time. 68% of people say yeah, that makes sense, let’s do it. 32% of people therefore say no, not right now, and that’s fine. I don’t mind whether they do or they don’t. But here’s the thing the 32% that say no, they know what’s around the corner. We’ve got it recorded on the notes that we’ve discussed, because we know at some point those orange old amalgams in orange will ultimately become red. We’ve explained to them the benefits of the contact points and therefore they understand that if we’re making a new piece of jewelry on the six, the contact points on the five and the seven, they’re not gonna be ideal. So they’re already aware that there might be some additional cleaning to do because ideally, I wanna shake that six with an anatomical convexity. I don’t want to create the contact point and the marginal ridge which has been for 25 years with those amalgams right. So they already know what’s around the corner. We already know what’s around the corner. We’ve got a record of it. It’s just a really beautiful way of involving the patient more.
Dr James: 25:53
I love it. Okay, so I get. I get what the rocks point, rock appointments are. Yeah, anything over a thousand pounds in production, correct, right, and is that? And do the appointments have to be of a certain length as well, or is it just anything? Oh the specific appointment itself is over worth, over a thousand.
Correct and that appointment could be 40 minutes. It’s usually more likely to be an hour or more. Yeah, and the the fit appointment could be an hour. If I’m fitting, yeah me to is 40, maybe 50 minutes. That still goes in sand Because it’s zero production. Now it may be that Doris, my patient, pays half on appointment one and half on appointment two, but that’s collection, not production, and we want to run our business, even as an associate.
Dr James: 26:45
I want to run my business, mine, on my production, not my collection production being production I’m actually collection being specifically when they pay it, production being the value and when I’m doing.
Right okay, because also that production can be over a couple of months because my lab turnaround is three weeks. So if I prep you the third week in November, I’m going to be fitting you probably the second week in December. So what I get paid is based on collection. But what I’m working out of how productive I’m being and how you know as a small business how I’m operating, I’m going to be basing that on productivity and production, not on collection.
Dr James: 27:32
That’s crazy. That’s so interesting. I’ve never heard that before. And does the? Does the rock time have to be at any particular time of the day? Is it better to have it in the evening?
So no, so my nine zones Mapped out. I do a two week rotor and those two week wrote that two week rotor has been the same for the last eight years. We pay it forward in SOE up until 2026, whatever it is, because we’ve then varied where the slots are and the first and the most important slots that go in are New patient slots to a day and treatment planning. Everything else then works around it. So rock time is is I choose a header game when up, when I Prefer to do big stuff, when I prefer to do my cram perhaps, and things like that, and then we vary also sand because sand or recall exams and because that’s under a hundred pounds, we count that as Anything under a hundred is sand, so it’s non-productive. So we will also vary in our diary where they are so that we have patients have an option, because we used to run our diary based on patients right and patients would book ahead for their exams and in my experience of coaching now that the dentist that struggle the most Are the dentist that are hugely successful and have been there for 15 years and they don’t zone their diary and they patients love them, they love their patients and they end up doing hours after hours after hours of recall examinations and then something suddenly comes in where they go oh, can you do me some composite bonding? And they look at the diary, they go, yeah, it’ll be February next year, whereas I’ve been there for 23 years and if I see a new patient this week who wants some composite bonding, I can see them within two weeks. That’s amazing and it just means we’re productive, productive, productive.
Dr James: 29:35
That’s awesome and it obviously works because that is the figure that you said earlier is quite the gross. For three days a week, and you’re you know, I would have thought your, your crown prices were higher. I mean, that’s pretty pretty average coin price 790 for crown. Yes, that is good value. They, there’s people far as way more than that, you know, yeah, yeah, I’m so gross as much.
So I would say our so last four months was 5868, 5471, with the last four months gross, and Typically then that what what we share. So when we put these systems in with clients so we had a weekly meeting or weekly coaching call One of our clients said she’s had the best financial month she’s had in 13 years of running two practices. Another client said he’s had the best that he’s had in the last 10 years and it’s and they both put it down To the zoning and the examination process because it’s exposing patients to having more choice. And what happens when we have more choice? We tend to choose more. Awesome, I love it. That’s cool, man Cool.
Dr James: 30:43
Cool, cool, cool. That’s a top top tip, is that one? There was one more thing you mentioned as well at the start. There was, there was a few things that and you were able to do. These are the, these are the. These are the top ones. These are the most important things to do when you make a practice more profitable, or is that my memory playing tricks on me? Was there another one? No, no, no, well, as a couple really is, I’m.
I’m a love giving upfront contracts. Like I said, it’s making sure that patients are told everything, we’re not just problem-solving. So I think our biggest Influencer is how we Treatment plan and treatment present and we use a traffic like system of treatment presentation so Patients get a guided tour of, ultimately of every single tooth. We never treatment present on the day we do the new patient consult. It’s always a week later and we present three treatment plans red, amber, green. Red is anything that is diseased and is required in order to be dentally fit. So decay, fractured tooth, any perio, things like that orange, is preventative. In other words, it’s not essential that you do this, james. We just want you to know that you can do that, because when you look at the decay in the six, the amalgams in the six, when you look at the decay in the six, the amalgams in the five and the seven, we’re done a roughly the same time. We can’t guarantee that they are decay free. I can’t see any and I can’t see any on the x-ray. But you have the option and the choice of whether you’d like to do those at the same time. We explain about contact points, we explain about strength of tooth. The fact that you’re only in wants to do, or two visits to do, all three we do with them at the same time with the same injection. There’s a benefit to you. No, no, no more time off, work, all of this stuff right. And then we also have the treatment plan, which is green, which is whitening, straightening, filling spaces, facial cosmetics, anything like that, and we say, look, whether you wish to whiten or not is kind of irrelevant. The key is that, before we do any of the work that you want to have done and need to have done, it’s important that we’ve just explained to you that you could whiten if you wanted to.
Dr James: 33:05
Whoops, sorry mate. I was looking at the feed just then and I just cut you off slightly. Really sorry about that. You said just after the green treatment plan you were saying any any of the treatment that you want or need to.
So green is additional stuff, so it’s like whitening or straightening and it’s not important whether you do it. It’s just important that you’ve been told so you can choose whether you do it, because often we do that first.
Dr James: 33:28
Got you. That’s awesome. That’s, that’s a. That’s a novel way of doing that. Is that something that you coined yourself for?
Well, chloe and I some. Chloe is my wife and was my tco. She now goes into practices and implements our tco process for them and and helps them develop that. It’s actually. It’s simple, it’s. It’s easy. It’s not simple to implement once you’re doing it. It’s simple but it has a profound effect because typically that doubles your production. So typically our clients will be it, massively increasing their turnover, even if they are doing well already. By just these little changes of conversations, of the use of the word buts right, you, you mentioned the word but, but negates what comes before it, just by changing how you describe something. So I used to say, james, you could crown that tooth, but a filling is cheaper. Everybody did the filling. And when you change that and you go, james, you could, you could fill that, which is cheaper, but To preserve the tooth and for it to last a long time, a crown is better. Everybody started crowning. So, using language as part of how you’re explaining, based on integrity, right, because the crown is the better option. My job is to ensure that I help my patients make the best choices. So be be aware of your language, talk more about what you’re doing so that a patient can understand that and they begin to feel more value, because if they value you and they value what you’re providing, they’re less likely to bugger off, they’re less likely to cancel their plan. Have the right language skills to answer questions over the next 24, 48 months when people go. I’m thinking of canceling my plan. Is having the right language to answer those questions where the patient goes? Okay, yeah, that makes sense.
Dr James: 35:19
I love it. One to add on top of all the things that you said here is a huge one for me Any word that is not positive. Remove it from your vocabulary. What do I mean by that? Instead of saying, instead of saying something is bad, say something is not so good. Instead of saying that this, you know what we’re very, what we’re very good at doing is saying that something is a bad treatment option versus a good treatment option. We always you know if it wouldn’t be a treatment option unless there was some sort of actual net positive gain there from doing it. So instead of saying that, why don’t? We can say this one is good, this one is better in terms of longevity, or make some sort of comparison. The second I eliminated any negative word from my vocabulary, particularly painful. When you say something is not going to be painful, that he’s still here, the word pain. You can say the total opposite of that. You can say this will be comfortable. You’re saying the same thing. You’re still saying it’s not going to be painful, but you’re just using words that are so much more pleasing on the air, and then the patient hears the word comfortable rather than the word pain, even when you’re saying it’s going to be the opposite of painful. I really liked that one, I agree. Cool, cool, cool. We had a question that came in, actually, barry, so let’s go ahead and answer that. Let’s have a little. Look down here, kara O’Connell. Shout out to Kara O’Connell how do you, how do your patients, react to pain before they have received their fit, as in fitting their cranes or lab work? Otherwise, I’ve had resistance to this in the past.
Great. Hi Kara, thanks for your question. So the way that we’re calculating production is the value of the treatment that I’ve provided. We will offer our patients to pay everything upfront, and many of them choose to, but downstairs as well, we offer that they can pay half of it now and half at the fit. I’m still calculating what I’m doing on production, which is it’s all produced even though it’s not collected. So I would definitely want my patients to be paying. Ideally, I like them to pay upfront, but it’s not essential. It’s not essential and I don’t I certainly wouldn’t fight them on that. I’m using it as a calculation for what our production is, not necessarily what our collection is, and I hope that answers is that we don’t. Not everybody pays everything upfront at the time, however, we have reception that will explain to patients. So your total investment that’s the word your total investment for everything that Barry’s going to be doing is £1,800. Would you like to pay that today, which means that you’re not paying anything when you come on your second visit and if the patient goes okay, that makes sense, then fine. If they want to spread it out, then that’s fine as well. I don’t mind either way.
Dr James: 38:14
I like what you’ve done there actually, because there’s actually something very subtle there, and perhaps you do this intentionally, I’m not sure, but I’m just going to point it out. What you’ve done there is you’ve actually offered them an incentivized reason to pay, as far as they’re concerned, to pay it all upfront, all at once, right, because too many people this is the thing. So you said, oh, you can pay it now. And then what that means is we’re all square and we’re all. We’re all fair and square, we’re all even. You know, there’s nothing to pay going forwards, right, and they’re like, oh, okay, that makes sense, then I’ll square up all my debts and then we’re good to go. And then, from this point onwards, we’re all good, right. Whereas if we just say, can you pay that all today? Something like that is a lot more abrupt. First of all, and second of all, how that comes across is that we’re actually being self-interested by asking them to pay. If we fully explain why there’s an advantage for the other person to do it, then we’ve just incentivized it. We’ve got them to see the incentive, because there is an incentive. We’ve just articulated that 100%.
Yeah, would you like to? Which means that if you, whenever you make a suggestion or something to somebody, it’s much easier for you to insert the which means than to give it to them, because if I say to you, would you like to pay £1,800 today, you might go £1,800 today, which means that I won’t have any money left in my bank account, or which means that when I get home I’m going to get it in the neck. Or which means that If I say to you, would you like to pay the balance today? Which means that next time you come there won’t be anything else to pay, and it means that you just you know you’re done and dusted. I’m inserting the positivity of the which means because it’s about effectively communicating or selling the benefit.
Dr James: 40:01
I like that. Yeah Well, this is the thing. There’s two ways that people move. There’s two incentives. Effectively okay, that you can give someone right. We can either give them a punitive incentive Like if this if you don’t do this, then this bad thing will happen, or we can give them we can dangle the carrot and say this good thing will happen right Now. The energy of a negative thing is all wrong. You don’t want that to be your dental practice whatsoever. That just creates bad juju. That creates a bad relationship going forwards which could faster and lead to issues further down the line. It’s just as well as that. It’s actually more effective when you incentivize things to, it actually works better. It actually is more likely to yield you the result that you want. That is from another book actually, which is over there in the corner, called how to Influence and Influence People, and when I read that, I always did incentivize people, but it made me triple down even more and it made me so much more conscious that actually, every single time you articulate something, in which instance there is you’re relying on somebody else to do you something, when you allow them to see the incentive for them specifically, not just for you they are so much more likely to do it.
Can I add? Do you mind if I add something to that mate?
Dr James: 41:15
Love to love to hear it.
Just from a slightly different perspective how to Win Friends and Influence People. Brilliant book circa 1940, 1942. And what I like about Dale Carnegie is he’s wholly positive. It doesn’t take into account, though, that through the 70s, 80s and 90s we’ve become much more aware of people’s psychology and personality preferences. There is a personality preference in neuro-linguistic programming called direction filter, so I will find out by one question, the one question that makes the biggest difference in a conversation with a patient. It will tell me their direction filter, and let me explain very briefly. It’s how we’re motivated, right? So, in terms of dentistry, you can have people that are motivated. They want healthy teeth, they want to be white and bright and a beautiful smile, and they want them to be beautifully shaped and well-organized and lovely. We then have some people who I don’t want crooked teeth, I don’t want them to be yellow, I don’t want them to be broken, chipped, I don’t want any pain, I don’t want to lose any, I don’t want to fall out. Now, the net result is the same. However, the way that they are motivated to do what we want them to do is very different. So it’s worth being aware that not everybody is motivated towards a goal. Some people are motivated to move away from what they don’t want. So when we’re talking dentistry, if I’ve asked the question that I ask and the patients go, look, I don’t want to lose any teeth and I don’t want any problems, then I’m just going to mirror that back to them and say you said to me it’s important that you don’t want to lose any teeth, you don’t want any problems, and you told me that you don’t want yellow teeth. This is what I’d recommend in order to do that. So I just want anybody watching or listening to be aware that if somebody is telling you in the don’t want, I don’t want, I don’t want, it’s good to use the away from as well as the towards.
Dr James: 43:29
Got you. No, that’s added an extra layer of insight onto what I was saying. So thank you for that, barry. We’ve just about got time for one final question which has just come in the chat, and that’s from Kriti Mahendra. Shout out to Kriti Mahendra and Kriti has said how do you put a cost on your new patient exam? That’s the okay. There’s actually a few questions here. That’s the first one. Go for it. Oh well, that was it. That was it.
How do I put a cost on a new patient exam? I purposely believe that I am cheap, and that is because the way that we do our new patient exam knocks their bloody spot, knocks their socks off and tends to result in quite a large amount of once based industry. So our new patient exam, I think, is 79 quid, and then X-rays are charged on top. So it works out about 110 pounds. And let me tell you what you get for that. You get 40 minutes with my treatment coordinator, first of all to find out a lot more about what’s going on. Then you get 24 photographs, an inter-oral scan with one of my top nurses, and then you get me. I do the clinical examination and we take any radiographs, and then a week later you get up to an hour and a half to come back and sit with my TCO. All of that for 110 quid.
Dr James: 45:00
Now is a bargain.
Well, that is a bargain. But actually, guess what’s gross in us 70,000, me personally 70 grand on three days a week is that whole process. So that whole process is a complete loss. Leader in winning this patient and knocking their socks off. And we’re presenting comprehensively then and our patients are like, yeah, I want to do that, it’s great. Med Potter 1.
Dr James: 45:25
Quick, tiny, tangent question. That’s awesome, by the way, what you just said. Quick, tiny, tangent question. What do you think? What do you think to free new patient consultations Good idea or bad idea?
I think a free new patient consultation is a great idea. If it’s not with the dentist, okay yeah, not with the dentist, and it’s with a team member, and it’s purely for orientation meet and greet, not their socks off. In terms of this is who we are, this is what we do, this is how we look after you. I am not a fan of free consultations by dentists, because I am worth more than that. What I do do I do do when I have a facial aesthetics patient who’s not been to me before is we will charge a nominal fee and if they go ahead with treatment, we will discount that fee off the treatment if it’s there and then. But I will not do free consultations as a dentist for patients and with our word of mouth recommendation like I said, we’ve not marketed for 19 years I don’t have to do that. I will pop down. So if somebody’s come in they want to talk about implants or something, I will pop down and say hello and just kind of breeze in. Hi, I’m Barry, lovely to meet you. You know, if you feel that we’re a really good fit for you and you want to come and see me, I look forward to seeing you and getting all the information and the data that’s required. I just wanted to come and say hi, so that’s literally it.
Dr James: 46:57
Cool. I actually would agree with you that I think that patients value it more when there’s some sort of investment for the new patient exam. Also, I’ve been in dental surgeries that have done both. I’ve been in ones that have charged and also ones that have not charged the dentist’s time. Sometimes when you don’t charge, you get these people who come with the mindset that actually they just want to try to get everything, as many things as they possibly can, for free. So what I find was that they wouldn’t let me take x-rays because there was a nine point charge for the x-rays and I’m like, come on, I can’t do a full job and then also, as well as that, you’d find yourself writing lots of referrals to the hospital and stuff and spending like a good 30 minutes doing that. I feel like, at least when there’s some sort of investment, that tends to happen less, because they’re already primed to understand that actually for you to do your job right, there needs to be something that they invest in you, some sort of exchange financially, only so you can do a better job and actually serve them more. Can I give?
you another challenge and let’s just come to my head, and that is I was lecturing a few months ago and somebody just happened to say when you’ve got a new patient who’s in pain, what do you do then? And I’m very clear on this I will never, ever do a new patient examination and get them out of pain. Let me clarify that You’re either a pain patient and I’m looking after your problem, for today we’re doing a new patient consultation. I cannot do both and I can’t do justice to both, so it’s explained on the phone when they go I’m in pain, I need a new patient. What we’re going to do is we’re going to book you to see Barry for what we call a problem appointment, and the fee for a problem appointment, I think, is more than a new patient it’s about the similar 190, 510, whatever and Barry’s going to work on this in order to get you out of pain. Now, if I have a new patient consultation, come in and they’ve got a rough tooth or something like that, of course I’m going to polish it, but if they’ve got a proper pain, I’m going to say to them look, what I really want to focus on today is I want to focus on getting you comfortable, finding out what’s causing the pain and then to serve you in the best way I’m going to. If you’re happy with the way that I’ve looked after you, then I’m going to invite you to come back. I’m going to invite you to come back for a full new patient consultation. I don’t want to mix those both up because I really want to focus on the acute thing that’s going on right now. So my advice to anybody that’s in that situation is never do both. It’s either a problem appointment to help them and sort a problem out or it’s the new patient consultation. Don’t combine because you end up losing the value in the new patient consult because you’re having to deal with the problem and that’s really what they need to get done. So they’re not listening to really what’s. Yeah, one elsewhere. Plus, I found out to my own detriment. Patient came in for a new patient consult this is years ago had a irreversible pub itis in a tooth and I went I’ll solve it. I opened, extirpated, then she came back. We quoted for the endo, for the core and the crown. We did all of that. We finished it. Then she came back for a new patient consult. We took bite wings and she had decay in multiple teeth, did a treatment plan and she went well, I’ve just blown all my money on one tooth and I was like, oh my God, so now I will get them out of pain. And they go, look, can you do that? And I’m like I will do that for you now that you’re comfortable and out of pain. I will do that when we’ve identified what else might need to be done so that you can make your best choice with your investment of where you spend your money. And if it’s just that tooth, great, but if it’s other teeth that might influence what you choose to do with this one.
Dr James: 50:56
I agree, and I’ve also been there before. I’ve also been there and I think that probably most people learn that the hard way, don’t they really? Because it’s again, it’s with pulling off the shirt, it’s the Superman logo, it’s the cape, all of that stuff, and you jump straight in because you do. You want to help them, right, of course. But actually there’s a better way to do that and that’s by pausing and breathing and looking at the bigger picture, taking off the blinkers Also. As well as that, when you have free new patient exams, sometimes you will get people and then you have, like charged emergency appointments. You’ll sometimes get people who will ask for the new patient exam because it’s free, and then come with a problem anyway. And then then there’s this whole dynamic where they think it’s free for you to get them out of pain and it’s, I’m not. I’m not a fan either.
I’m really don’t do. Don’t do free clinicians, don’t do free or complimentary, whatever you want to call it. The complimentary is with a team member to show them around and demonstrate how bloody lovely we are.
Dr James: 51:51
That’s what I would say.
Dr James: 51:53
I wholeheartedly agree and I never actually really realised all the faults without model until I saw them in the rearview mirror. I just accepted it for what it is, Whereas look back now and I think what the flip anyway. Final question it’s the second part of Criti’s question from earlier. Do you ask are your recalls the same price as your new patient exams? I don’t think they are. Are they by?
I think they’re very, very, very, very, very, very very similar.
Dr James: 52:23
As in bearing in mind that our recalls don’t need radiographs and we can, I could find out. I have to be honest. I have to be honest, they’re not. They’re not dissimilar, but I’ll be honest, I don’t entirely know. I don’t really get involved with that because to me the recalls again are just, you know, if they’re sand.
Dr James: 52:52
Are they longer or shorter in appointment time? Or the same? They’re shorter, consumably shorter. New patient exam 30 minutes.
Exams, exams. So you got to, you got to realise. So I operate slightly differently. A new patient exam is 40 minutes with my TCO and then it’s in my diary for 40 minutes Nice. That’s a lot of time, but I’m only. I’m only in there for about 20. Got you? So TCO comes up and is explaining to me all the information that I’ve asked her to get. She’s asked the 20 year question. She’s telling me their direction filter, their chunk size, some personality preferences. Whilst that’s happening, my nurse is taking 24 photos doing a scam. So they’re in the room and my nurse is scanning. Listen. The reason I produce so much is that I like to say I am the laziest dentist on the planet. I want to do as little as possible of the things that other people can do, probably do better than me. That enhances their job and their enjoyment and frees me up to be more productive. I really would like to spend as much time as possible only doing the things that I really love to do and that are hugely productive. That means that I do as little as possible of talking to patients. I’ve trained somebody else to do that, so I don’t present treatment plans. I don’t do pre and post op instructions. I don’t do consent it’s all done for me. I don’t do scans, radiographs, impressions. I do as little as possible of those things that my amazing team are capable of doing and ultimately get paid more for doing, which means that I’m just more productive, productive, productive. So my time for a recall exam is in my diary for 20 minutes. But we have a system where it’s called. We have a check-in process where the nurse that’s with that patient will have a conversation about what we’re doing today and the upfront contract. And then we have a process that we coined from Kathy Jameson in America called the three to five minute checkout, where I bugger off to see another patient and my nurse then goes through a three to five minute checkout of explaining to the patient what he just did, what we’re doing next time, what the estimate is for next time, when we’re going to book it, so on and so forth, and then carries literally a score to the patient down to reception to get booked. So we have a beautiful systemized approach to a five star patient journey and the idea is that my involvement is as much as possible involving a handpiece, because that’s where I’m at my happiest and that’s where I’m at my most productive.
Dr James: 55:37
And also, as well as that, something that I’ve got into recently is conserving your energy. So the what it means is the things that you do spend that energy on, you can do them to the best of your ability, rather than trying to spread yourself too thinly, because, ultimately, every single person on this earth has a finite amount of energy some of more, some have less. However, when you can manage that and get the most out of it, then you can make yourself as effective and as efficient as possible, and I really like that. Nice Barry, you’ve been super generous with your time today. Thank you so much for coming along to any time.
buddy, thank you for having me. It’s lovely to see you again.
Dr James: 56:15
My pleasure, my friend. I hope you have a smashing day and a smashing Christmas. We’re going to speak before then, so I don’t need to say that.
Of course we are. Of course we are.
Dr James: 56:22
Tossed off me. Always good to see you. See you later, bye, bye, bye man.