Cris started in dentistry at 18 working as a receptionist but she knew in the 6th grade that she wanted to be a dental hygienist. She began her career as a dental hygienist in 1992 and practiced for the first 19 years in Flint Mi. She took a leap of faith and moved her family to Hampstead NC to live by the sea, and it fit. Cris has a love for dentistry and after moving to NC she realized there were a lot of things that were turning people sour toward dentistry.
VIDEO - DUwHF #1199 - Cris Zimmerman
AUDIO - DUwHF #1199 - Cris Zimmerman
She teamed up with her current boss and has helped him turn his 3 dental practices around with a goal to acquire 7 more. She is passionate about turning offices around and helping people love coming to work again. She strives on making a difference for others in their professional and personal lives with speaking, writing and mentoring.
Transcript:
It is just a huge honor for me today to be podcast interviewing Chris Zimmerman, RDHBS, who started dentistry at 18, working as a receptionist, but she knew in the sixth grade that she wanted to be a dental hygienist. She began her career as a dental hygienist in 1992 and practiced for the first 19 years in Flint, Michigan. She took a leap of faith and moved her family to Hampstead, North Carolina, to live by the sea. Chris has a love for dentistry, and after moving to North Carolina, she realized there were a lot of things that were turning people sour towards dentistry. She teamed up with her current boss and has helped him turn his three Dental practices around with a goal to acquire seven more.
She is passionate about turning offices around and helping people love coming to work again. She strives on making a difference for others in their professional and personal lives, with speaking, writing, and mentoring. Chris, thank you so much for coming on the show today, and thank you for having me. So excited! So, what do you think? Um, I mean, we just had uh all the dental schools just graduated last week, they just dumped several thousand dentists onto the market. Um, my first thing I want to open with is um, what would you have said at their graduation ceremony? As they're leaving, what would I tell these dental students who are leaving dental kindergarten and about to go practice for four decades in the world? Uh, what, what advice would I give them?
Um, I think initially I'd tell them to find a really good practice manager and let her run his practice his or her practice. And I would encourage them to do dentistry because that's what they went into; they love dentistry. Um, but find a practice manager that can allow them to do that. What percent of dentists do you think when they come out of school um are excited about the business of dentistry versus just wanting to figure Out the clinical dentistry, I don't think too many are, but I have had a few associates that um, that came out thinking that they knew more than pretty much the managers on site and um, which most of our managers have also been either hygienist or some form of dental prior to being a dentist
so um, but I've had a few and I've had a couple come out worried that they needed to know the business aspect so I just encourage them to let the managers take care of that part of it and um, I think they need to once they own a practice they need to know what's going on in their own practice but as far as being in a being an associate, they need to just enjoy. dentistry so now the dentist that you're helping uh turn three offices around is that dentist jacksonville nc north carolina is that what that is because i have two websites for you dentist jacksonville nc.com and then dynamic dental inc.com so so yeah it's the the nc.com dynamic dental nc.com okay so is that is that your practice management company or is that the dental offices that you're working for that's a dental office that's a dental office so then what was dentist jacksonville nc
i'm not sure on that one okay it might not even be i might be i'm getting old and senile so your website is dynamic dental nc for north carolina so so tell me about dynamic dental nc um well we have an amazing team and they love coming to work they love uh the standard of care we have for our patients we are all about customer care customer service and uh we have a team i took a little time of getting that team the right team on place but we have a great team that that um they're all working in their area that that they're fit for working in and and when you see an office not doing well well and you've been turning them around for years what what do you think is the crux of that why why do you think they're usually not doing well and how do you get them to do better
um it starts with attitudes i think uh there there's a lot i've heard it a lot since i've been in the field with burnout people just not happy on their jobs and i think a big part of that is they're not in the right place either they're not in the right place as um what what part of the dental office they're in what role they should play or they're just not happy in the right office um for instance i had a manager that she was there when i hired on and she was she was just burnout of dentistry but i moved her to our insurance coordinator and she loves it she said now she's ready to be able to stick with dentistry until she's ready to retire And so I think a lot of it is finding what's going to work for them position-wise.
I have one of my managers as an assistant, another is a hygienist, so they were just getting tired of doing the job they were doing and we found that there was a better better place for them, uh, that is a always a good feeling. Um, so when you're a lot of a lot of dentists have, um, you know, they got their office four days a week and they think, you know, maybe if I want to be more ambitious, I should go to the next town over and start another dental office, uh, you guys uh have three offices currently correct, and that usually between two and three offices. Is the number one point of bankruptcy um, you know when they have one office they don't realize what their problems are and they don't know what to do and then they go set up another office and those problems start to surface and by time they get to the third office they just don't have the systems in place.
What do you think it takes uh to get to be able to scale for three offices? Oh, I think you definitely have to have your systems in place. Um, I came on and we duplicate each office all of our systems are duplicated so if you walk into any of our offices if I needed an assistant to go to one of the other offices she's going to find everything's in place just like the you know other office whichever one she come from um so i think that having systems in place and being able to duplicate them but when i came on board he already had two offices and we were not ready to they were both a mess so we had to get our systems in place and um
we have our team our business team our cpas and all of that which were not in place when i started up so that's where i told them we're not getting another office until we get these two where they need to be and then and that was again the right team the right dentist the right assistants all of it and then having those systems already in place and and two of those are in jacksonville and the other office is in jacksonville and the other office is in jacksonville north carolina and then one's in supply north carolina correct yeah huh i didn't know even uh um supply was the name of a city um so so
either when when you said the systems weren't in place you immediately just went to hr you just described the dentist and all the staff you didn't mention anything other than hr would you say hr is the whole crux of it i would i really feel you got to have the right teams and attitudes and you got to have the right teams and attitudes on and then you can take it to the next level but You know, you're only going to be as strong as your weakest team player, and um, and if they're not, if they don't have the same vision, the same, they got to believe in what you're doing, and if they don't then they're not gonna be able to sell it to a patient. You know, a patient's not gonna trust that.
So, it took a little bit of turnover, you know. Initially, we tried to get people on board with the systems, and then when that didn't work, then we had to let a few go and get the right team players on board. But I do feel it's definitely starts with your HR. Well, that's what... um... when I podcast interview, dental DSO founder dentist or our Prep managers over the years they, they quit acquiring a lot of practices because the uh, the what they had to do to HR and let people go, it was it was so stressful that they would rather just uh, do a de novo start from scratch uh, than buy a big one and um, so um, so everybody seems to be arriving at the same conclusion uh, that um, so, so these kids, you know we just had several thousand kids graduate, you know last week from dental school um, they don't know a thing about HR what would advice would you give them on HR on building a dynamic team?
Well it's funny because you know for us we have the we have the advantage of we have several managers That we all are able to take a look at candidates and we, we all come to a conclusion, and generally, we're all pretty much on the same page. Um, but in a situation like that where you're, you might not a new dentist might not have that opportunity to be able to do that. I would say and something I just learned about from a seminar that I went to of uh there's a Gen Wacasser test and it helps you to recognize personality traits, and there's it's not your normal personality test because you know we've all taken many of those but it's a it
there's no way around it you're gonna get their strengths, their weaknesses, and um I just actually took The test today, just to find out um if it's something we want to implement with our offices but it comes highly recommended and I would say something along that line would help you to learn their strengths and weaknesses and whether they'd be a good fit for what they're looking for, yeah. And the other thing um, I would tell them is you know when I got out of school in '87 if you look at my management team, my you know the five or six core people on my management team have all been there 20 years yet I've had a dental office for 32 years so it shows my immaturity that the first 12 years I was just running around the country learning.
All the clinical dentistry, and my F.A.G.D. M.A.G.D., my diplomats, and I just it was so exciting to learn all the secrets to doing dentistry that you know that you didn't, that I didn't focus as much as I sort of on the business of dentistry, so it's just so, but what I would say in HR, I would say that remember that movie Jerry Maguire and all these different sports movies that you know there's always someone who can do something better than you, and I learned after 12 years that there were other people in my team that were better at HR than me right. And being able to spot the talent and look at baseball I
mean you got to get a kid with great talent but you can't have them arrested in the middle of the night or you know or being crazy or in fights and drugs and bars I mean there's so much to it and then and then there's a getting along with other staff because you can bring someone in that's the greatest pitcher in baseball but he turns the team toxic and now people don't even want to go to work. So do you subscribe to Fire? Fast? High or Slow? High or Slow? Fire? Fast? Yes. Yeah. Higher Slow? Fire? Fast? I learned that the hard way because I had some collateral damage with one toxic employee that turned three, but I kept hoping that we could turn her around and it ended up all, all four of them had to leave.
One you know a couple of them left on their own, and then you know I had to fire as well, which you know that is the worst. It's the worst part of the job, but in the same token, when you recognize how much damage it does, the longer you wait, it's definitely I think it's something that you definitely I do buy into that you fire fast. My gosh, you're what you just said is so profound, and a 25-year-old kid; he's got to realize that what she just said, because we've all seen it: where you get a toxic employee, and then she turns two or three normal, productive employees with a good attitude. Into toxic, and then you end up losing all four.
I've seen several dental offices over 32 years where a consultant come in and said, 'I'm sorry to tell you this, but I am going to fire every single person in your office and start from scratch.' These are toxic, entitled, dysfunctional, and it's just it's just like you have to do that. I mean, why did the Arizona Cardinals get the first draft pick this year because they were the most rotten, horrible team in the NFL. And so the NFL says well you you need a new employee does fine a toxic employee is simple as obvious as it sounds you know you go into the offices and and like say they either have a knack for it and they recognize it and hire slow fire quickly but what are toxic signs that are red flags to you that something's really wrong.
Your continuous complainers. We had an employee that you know she would come in and and do things because nobody else did it but then she did nothing but complain about it that she did it and instead of I would tell her you need to address your co-worker and let's try to find a solution and that was that she just couldn't do that she just wanted to get other people on board to complain about it. Um, you you're you're venters you know that they they just need somebody to vent to and I encourage if you need to vent you either take it to management or you take it home to your spouse but we don't vent to other employees because it just turns them um, I guess I mean it's very negative.
Negative people that just can't see the good in anything can't see the good in anything. The good in the patients or anything that you do for them, you know everything that you do, do if there's a you know everything should be paid for for them. Um, I think probably that's my biggest indicator when they're very negative and and complain a lot and they're never happy. Yeah, they're never happy. I mean, there's so many people that are all stressed out about how horrible, like, like people are saying right now, like in politics - this is the worst politics. We've never seen it's like, dude. We've had four presidents assassinated. I mean, you know they're like this: the economy is horrible. Really, how was the Great Depression?
And if you didn't like the Great Depression, how about the Civil War, when one out of every 30 Americans was killed and the whole country was made of wood and burned down? I mean, people just... uh... um... they're worried about a side effect of the um, of a vaccine. It's like, do you remember the bubonic plague, when a third of Europe died and it took two centuries to get their population back? I mean, they're just people that just see the horrible and everything all. All I want to summarize on the HR that we've been talking about so far is that if you think the biggest problem you have is deciding which composite to use or which bonding agent or which one or which implant to use um... you're... you're not even...
um... you're not even aware of the game. I mean, the entire game is played at building a team. It's all HR, and if you're really good, you can die go to the grave and manage from the grave because McDonald's is still open and Ray Kroc's dead. I mean, Walmart's opening up 40 new stores a month and Sam Walton and his wife Helen Only opened 18 the first 10 years of their business, now they're both dead. Opening up 40 a month, so the team is uh it's just everything um I the next thing I want to talk about is a team is um it's the number one expense and as dentists uh overhead goes up and profitability goes down and yeah um so how do you pay a team and still be profitable?
Well uh we stick with I mean we're we're still one of the few that provide insurance for our employees and um we offer a 401(k) we recently started that just so that um this one is one they can pay into but um my boss is really a strong advocate for taking care of your team because if you don't take care Of them, they're going to go down the road to the next job um, so we try to, we have, we set our daily goals which is to help cover all of our expenses and to cover the overhead um, but it is definitely challenging. We're a little bit on the high end of our um, you know I know the percentage they say is about 27, 28, and we're probably a little bit closer to 30 um, and we've been trying to look at how obviously we got to raise our, raise our collections in order to bring that number back down to where it should be so we're talking about labor,
you know a lot of people will go to a study club and they'll hear someone say I have 20 labor and someone will Say you know the average is 25, you say you're closer to 30. First of all, I guarantee you that after 32 years at MBA dentists don't even know their numbers. They don't even know they don't even know their chart of accounts. So when you have any follow-up, your labor is 20%. Does that include FICA matching? What um do you provide medical insurance and 401k? Um, continuing those all these things. Since dentistry doesn't have an agreed-upon chart of accounts, you you have to combine lab with supplies because one guy has CAD cam and he has his blocks under supplies, another guy has CAD cam, has his blocks under lab.
So the math is very tricky but I've noticed um. But but you feel strong to provide medical insurance in 401k so do I. But what really upsets me is when my right-wing dentist friend uh don't believe the government should provide medical insurance or retirement but then they don't um for their employees. So you you can't have your cake and eat it too. You can't say I won't give my staff medical insurance or 401k but I don't want the government to someone has to do it um, or they're not going to stand by your side from age 25 to 65 when you walk off to go retire in a mansion and they go live under a bridge and beg for crumbs. Um, so yeah.
The fact that we have medical insurance and the 401(k) is a big deal too, so do you have profitability goals? We have uh each office has our our monthly goals and each of them are different because my boss at our main dentist he is 60 years old but he runs circles around most 25 year olds you know he's just very ambitious so um our goals at that office are set much higher than the other two locations the supply location is lower i mean we still got to cover cost but they're used to working i don't know how they kept the doors open let's just put it that way they're used to working at a snail's pace and their perio was not at all where it should be
and so now we're we're helping build that one up so but we do have goals and we'll raise them as we see they need to be raised for each office and who's the owner dentist that you're referring to done dr john romulus john j-o-h-n-r-o-m-u-l-u-s yeah and and so does he um how much of the practice management leadership is uh dr romulus and how much is you i mean is he more clinical um does he like the business side did he bring you into the business side did he bring you into the business side did he bring you into the business because he doesn't like
the business side what's the what's his uh um interest well he brought me in i mean he he's involved In it because I told him, he needed to be; he needs to know what's going in, what's coming in, what's going out, because I think a lot of times when when dentists don't know that, then it's all about all the new equipment and everything, and you know, you gotta, you gotta see where your numbers are in order to be able to do that. Um, but we do have an open book policy; everybody in the office knows what our goals are, they all know we go over them every morning in our morning huddle, um, how far off from the daily goal we are and um, our end where we are monthly as well, um, but he's very; he's involved, but he he lets me handle it so he knows what's going on.
But he and he'll bring me ideas of things he he definitely is a good person and he's a good person and he's a good person and he's a good person and he's a good all the time oh, is that right? He lets yes he is and so he um he'll bring me things that he wants me to look into and then he lets me go with it so um I always think it's so bizarre when um dentists will um go work at an office doing millions of dollars a year or some big DSO that has 500-800 offices and um and then when they graduate um they have this bad attitude that they want to get out of there so fast and leave and all that, then you say well talk about all the management systems you learn.
Because, my gosh, to run that many offices they must really know a lot about management systems and they didn't learn anything, and it's like, my god, you could at least work there. Got everything in a Word document all you do is cross out your name, uh, you know, and put in uh someone else's name. I mean, it's uh, it's um, it's crazy, but on the other hand... Do you have a profit goal, though? As a percent, I mean, so you say, lat, uh, labor is what would you say, 20 to 30? Then yeah, yeah, about 30, and then what would um, and then what would you try to have a total overhead at? What would you like your total profit to be?
Well, um, because we've started out in a lull with This other office, it's not where we would like it to be, but um I actually i didn't you know we really don't, I I don't know what his his number is on that so I guess I don't really have an answer on that one. Let's go um, you've been doing this your whole life uh, you're running three offices um, let's talk specifics about um, um like practice management software do you have a um, do you have a preference on that or not? Really currently well, I've started out with Dendrix and then um, I went to this office they had a lot of people that
were in the office that were using Eaglesoft so I had to learn Eaglesoft um, but we are looking at open dental because i've heard really good things about it and um he had mentioned for me to look into it a while back prior to us starting our third office but time wise i was i it wasn't a i wasn't able to look into it so now we're looking at doing the open dental because i've done enough research and heard enough great things about it and i'm looking at doing the open dental because i've done enough things about it that we're considering that yeah when someone tells me they love dendrix so they love eaglesoft i only know one thing they don't know anything about business or management and it's just it's just it's just like I mean, there's nothing wrong with that, why I love my homies.
I mean, they love dentistry; they love science, you know. You go in their house, they've always got 50 to 100 non-fiction books and then when you go into, uh, um, anyone else's home, you know it's science fiction, it's... you know, it's great. I have a lot of books that I've read, and I love my homies, but they, um, they're either really into business or they're not so... You like open dental; we spent, uh, all of 2018, that was just my only goal for 2018, on the practice, just switch from soft end of 30 years to open dental because it's open and that's what all the innovators are programming. Into U.M. so open dental, um, what about other technology do you think that um, technology, whether it be CAD/CAMs, lasers, all the rich, you know if it's shiny, dentists love it?
Do you think those toys make a material impact on a healthy, profitable, growing dental office or do you think they're more about noise? With my experience, we have the the cad cam and um, um, and the Serac, and all of that same-day crowns, and to me, I mean patients do like having that same-day service, um, but I think, like on our uh, CBCT, we I think we lose money because we do 3D's on a lot of people and we don't charge, um, because if he's going to do a root canal, he wants That's done if he's doing a consult for UM implants, he wants it done and a lot of times, um, he's going
to have to do a root canal and it's; we just end up writing it off because insurance doesn't cover it and the patients aren't, he wants it done regardless of whether the patient's willing to pay for it or not, he wants those, you know, um, because he sees better, you know what's going on with the 3D, um, so I guess to answer your question, I think some of those, the newer technologies definitely are going to be beneficial and helpful, um, are they a necessity, I don't know; he'd probably argue with me that it is but uh, I think that a lot of things. Can be done without them, so you have so another way to ask: do you have three uh locations? Do you have a CBCT in all three practices?
No, we only have one at our main office and we refer patients from our second Jacksonville office; they'll refer to us for things that would require that. And um, and do you have CAD/CAM at all three offices? No, just the one. Well, the other two offices have the older versions and and pretty much they're not in use, so he would have to get new ones. So, so for those, so, would you say you like the CBCT and you have that in one office and I'm going to refer but um, are you um, but you don't seem very enthusiastic about The CAD CAM technology making a big difference in the success of your practice, I don't think it maybe it doesn't get utilized enough.
Um, I know like he was looking at the newest and, you know, pretty much, I think can make you dinner; it covers a lot of things, but I think it's going to be a big difference at all, but um, there's a lot of times that he doesn't use it and we still use SendOff to labs, and so then we end up, you know, I don't know that it's, I don't know that it covers its cost maybe right. I'm sure it probably...I don't know, um, I'm sure, I'm sure it's multi-variable; there's a lot of factors, but um, um, I think that when dental X-rays Came out, when the those were invented, they ran across the country, um, in just a few short years, they went from nothing to everyone had it.
Whereas CAD-CAM has had my entire career of 30 years to expand and they don't seem to have much more than 12 to 15 percent of the market, so it's obviously showing that 85 percent uh, don't need this. I mean, far more people got a digital um X-ray, um, you know things like that, uh, internal cameras, I think scanners are taking off very fast. Let's go to treatment, um, we talked about the business skills, i mean, who's better at it, uh, Dr. Romulus or your office manager Chris Zimmerman, um, what about presenting? Treatment, um, we keep seeing national studies that every time dentists diagnose a hundred cavities, only about a third get filled. Um, you routinely see two offices in the same medical dental building and every metric is the same except one dentist has a one out of three um treatment plan acceptance, the other one has a two out of three.
So, at the end of the day, the same staff, same op, same everything, one's um twice as big as the other one. Um, what do you think are the secrets of treatment plan presentation or how to get more people to uh um to accept treatment? Well, we train all of our team to be able to present treatment initially. Like our hygienist, they'll explain to the patient what they see, what they suggest, or what they feel the doctor will recommend. That gives them a and we do what we call an 'a handoff.' So once they go from that initial hygienist, she hands off to the dentist and she tells him what she sees and what she feels. It's so the patient's hearing it over and over again, then the dentist confirms it.
And then as the hygienist brings them up to our treatment coordinator, she'll explain to the treatment coordinator as well what this patient is needing. So this patient is hearing it over and over so they're putting an urgency on it. And then our Treatment coordinator will sit down and explain cost and options for their, you know, payment arrangements or however they're going to pay for it um so um do do you think other things do you think um increase the treatment planning supplementation do you think uh intro cameras or or any any other things on intro on on anything you think that would give them a better um a close ratio? We definitely we do that as well um all of our patients we call it a tour of their mouth and we take intraoral photos and they present those as well in their explaining of what they see and what they need, and then we've decided you know some of our patients That haven't been in the hospital for a long time, they've been in the hospital for a long time, and they don't have any timely contact. And we've been worried about another COVID
pamphlet that explains what can happen if they don't have the treatment, um, that's for those cases that leave. But we also implemented what we call a two-by-two-by-two, so, if a patient doesn't schedule treatment, we'll call them after two weeks, and if they still don't, we'll after two months. Now, two days, two weeks, and two months, um, and we let them know that we're going to call again, because you know, we don't want them to feel bugged, but in the same token, we want them to understand the urgency of having the treatment done so two days two weeks and then two months yep yep uh and uh yeah that that is uh really uh amazing
um so more on the office manager what um issues in staff management issues since that seems to be um you and i both believe that that's everything you're not doing this uh on technology you've obviously got systems in place you're at three offices um i'm gonna i'm gonna say some off the wall things and see what your response is and i'm gonna say some off the wall things and see what your response is is embezzlement a lot of dentists worry about embezzlement um do you Um, I don't because of the reports and everything that I go over, um, yes it is definitely a concern, and that's why I explained to my boss when I came on board that he needs to know everything that goes in and out of an office, and so initially they had a CPA but but they weren't really running their reports to the CPA or doing anything like that.
So we have a CPA that everything goes to her, every check, every, you know, debit, anything, every deposit, all of it. And but yes, definitely, that is always a concern. But when I travel around to all of the offices and monitor the reports and see where things are, so that we can keep track of those things. And hopefully, you know, sometimes having a cash-paying patient, that's would be a challenging one to somebody could slide that one by, I imagine. What are your biggest challenges at the front desk on a team versus the dry hands? Versus in the back, the wet hands in the mouth. What do you see different challenges for dry hands up front versus wet hands in the back? Initially, we had a lot of issues with urgency and we have phone verbiage that we want used.
Urgency to answer the telephone and to probably. Slow down and do things accurately, sometimes, especially at our main location, we're a lot more busy. So there were things where I had to address, you know, we like a photo of the patient. We want to know who that patient is. It helps us help everyone to recognize them. Things like that that were not detrimental, but they definitely were things that weren't being done. But. Most of those things have been resolved, so we don't really have too many issues with that anymore. What about let's talk about dental care finance. I mean, in America, you know, people talk about, oh, last year we sold 20 million new cars. Yeah, but how many were paid in cash? They were all, I mean, 90 percent of them were financed.
GMAC financing made three times the net income of GMAC, the car maker, my entire life. Is dental care financing a big part of your secret sauce that is a part of it, but no, it's not a big part of it. We, unfortunately, we do have a lot of insurance, but aside from that, we are a lot of patients where there's a lot of elderly in our area and they just want to cover their procedures without doing the financing. But we do have, you know, some of them. Some of our much larger procedures, they may go with CareCredit versus, you know, paying it off with their credit cards, which, like I said, a lot of our elderly would rather not do the CareCredit. Right. They'd rather take care on their own.
Talk about the systems of hygiene. I mean, that's a very easy system for your practice to fall apart. I mean, dentists don't realize that, you know, if they get 25 new patients a month, 12 months a year for 40 years. I mean. They would be adding a hygienist every three to four years if no one was leaving the practice. But when you have the same new patients coming in and then the same number of hygienists for 40 years, you have leakage. What do you talk about the hygiene department? Do you think that's a big backbone of the practice success? If so, or if not, why? I do feel it is. For starters, our hygienist. Our main location, they've been there for 20 and 30 years.
And they had some adjustment because the perio was definitely not where it needed to be. But they got on board with it. And they've, you know, they actually got behind it. They actually saw the value in it. And so they got on board with it. And so they, the patients trust them because they've been there. They're the longest of anyone. So I do feel that that is a huge part of it. And when they talk to them about treatment, they trust those hygienists. And they do very well at selling same-day dentistry or treatment that, you know, that the patients need. They're very good at their verbiage and getting it across to the patients of how important the urgency. So I do feel they are a big part of it.
So, you talked about you're considering switching to open dental, correct? Yes. Are there any, there's all kinds of dental dashboards, which, by the way, you know, Dentrix is right there in Provo, Utah, in the middle of the, you know, they call it Silicon Valley in California. And they call it the Utah slopes or the Silicon slopes in Utah. But there's all kinds of dental dashboards popping up. Did any of them, did you decide to go? Did you go with one? Do you not need it? What are your thoughts on dental dashboards? We've went with Dental Intel. I had initially heard about it with the dental peeps. And then I heard about it later at a, I went to a breakaway seminar in Texas and they were there.
And my boss had continued, he really wanted dashboards. And what our CPA was presenting wasn't enough. So finally. We recently, within the last month, have went with Dental Intel. And I think that they're pretty helpful. They're pretty insightful because it'll show me, you know, one hygienist has a, you know, 50 something percent selling fluoride to adult patients. And so we can look at that and ask her what verbiage is she using? What is she doing to convince her patients that what they need? What is she doing to convince her patients that what they need? Versus the other ones who are like 17% or 25%. So I think, I think this is, this is going to work really well with us. I finally, again, I took a while to do some research on them and I've heard good things.
So finally. So how long have you had Dental Intel? It's only been about a month. It's only been a month. So what was your first month like? Uh, training, learning. We haven't really, um, we've looked at their morning huddle and they've showed me, I've done a lot of the little videos, but getting all of my managers to learn them as well. So, they've all been just doing training, um, one-on-one training on the online. Uh, um, but as the training for Dental Intel, has it been on, um, has it been all online training? Or did they, um, also send a consultant to your office or? No, they haven't sent any consultants. They just do all online. They do online. Yeah. That's the way, um, um, Open Dental does it too.
Uh, so you get something like this and you just start, uh, um, you start, you know, just, just learn as you go, but it's getting the whole team. I'm all, was the team excited about trying this or were they, um, um, was it different and change and. Was it hard for them to get on board? The managers are really excited about it because they see it as a tool to help their teams recognize areas of weakness and strengths. So the, the, the managers are really excited about it. We haven't really started with the rest of the team yet. They've been told about it. Um, but I think getting the managers excited and fired up about it first will help. And then that'll trickle down to the rest. Yeah.
You said you, um, you met them at, um, a Scott Loon seminar. Who'd you run into? Was it, um, Rob, um, was it, um, Rob Bay? Yep. At Scott Loon's seminar, yeah. I went to that seminar and I ran into Rob Bay there too. That is so exciting. Um, so, so what did you think of, uh, Scott Loon's, uh, seminar? Oh, wow. That, that one just blew my mind. I mean, they have systems for systems. They have everything. You can imagine. And, um, I am taking our managers' team to one of their, in Las Vegas in September. We're going to take all of the managers to that because I think it will be, I, I went by myself. Dr.
Romulus had gone a couple of years of years ago and I just came back so excited about it, but I feel that I feel like I need the rest of the managers to experience that. Yeah. When I had Scott on the show, um, it became, um, it, um, it was, it took three hours long. So we broke it up into one, two, and three. And it was, uh, those three shows are all in the top 10 most views, but it generated the most controversy. Why do you think dentists see breakaway and that whole genre DSOs? Why is it so emotional? Well, well, I think that a lot of, a lot of dentists aren't ready for the DSOs. Um, but unfortunately, like even in North Carolina, uh, corporate dentistry was not allowed until I believe it was last year.
And so they're coming, whether we like it or not. So you got to learn how to get on board and compete with that. Or compete with it or get on board with it, I guess I should say. And I think that, I think that's the struggle. A lot of dentists have, they feel it's going to take away, um, the small dental office atmosphere. And, um, that is one thing that our offices, we want to keep, we want to keep that individual one dentist or, you know, ideally one dentist at each location in a team that stays. Um, so I think that's probably a big portion of why they are so emotional over it, but. So Scott, um, so she's talking about Scott Loon, CEO of Breakaway Practice, um, and the co-founder at Dental Whale.
Um, are you, are you interested in the dental, mostly the, the Breakaway or are you, um, interested in his new company, the Dental Whale, or do you know anything about the Dental Whale? I've, I've been speaking with a couple of dentists. All of his representatives with Dental Whale, we have not gotten on board yet. Um, again, I'm, I'm real slow to jump on board with some things until I've done my homework, my due diligence to find out, you know, if it's going to be something beneficial for us, because, um, I don't want to get us, you know, where we're so far involved in all these other things that we're losing sight of dentistry and being unproductive. Um, so. I haven't gotten on board yet.
So he just really, what, what impressed me the most about Scott, uh, wasn't his adorable wife and kids and, you know, he just has an amazing family. I, I, I really do like the guy, um, but, um, he takes the incoming phone call more seriously than anybody in dentistry. I mean, you go to any business in America, the highest paid people are answering the phones coming in. The calls are recorded. Yeah. They're managed. They have a customer relationship management solution, they're linking it all together. And then if I called you, you were talking about your program where if they didn't schedule for treatment, you do a two by two by two that's for unscheduled treatment. So if they don't schedule for treatment, um, you call them a two days, two weeks, two months.
And Scott is probably the first dentist I ever met that absolutely took phones as seriously as every company that I learned about in MBA school. Talk, talk about, um, and, and again, you go to any factory, um, the guy who's actually, uh, the machine operator back there making the big metal box that you sell to farmers, that's a $20 an hour job. But the guy answering the phone is in a suit and tie and that's a hundred thousand dollar a year job. Then in dentistry, you know, that, that old man in overalls with no underwear and a lunch pail. That's the hundred and fifty, hundred and eighty thousand dollar doctor. Yeah. And the person answering the phone call was taken off the street with no training.
So, um, so talk, talk about your phone systems and, and, um, how, what you do and, and, or what you learned from Scott. Oh, one thing I learned from Scott is I wish we had a call center or I could utilize his. We don't, we're not there yet on that, but, um, we're, we're very adamant that that phone gets answered on the spot. That's no later than the second ring. And at each office we have a, you know, we have our initial patient coordinator that she answers initially. And if she's busy, then our, the girl that does our checkout, and if she's busy, then we have our insurance coordinator and then myself or the other manager. Um, but we, I, I, I liken it to you. Yeah.
lot of people want to go to the dentist that's a you know just a very real fear for a lot of people so you got to warm them and welcome them so our our phone verbiage our voices the tone that we use with patients those are all also trained we have different phone verbiage for different situations if they're going to call to cancel an appointment or if they're calling to schedule and you know i i don't like when somebody called i've and i've heard it in our office and addressed it but you know somebody calls in as a new patient asking if we're taking new patients and the very first question out of their mouth is do you have insurance
um so we work with them on their phone skills and their phone etiquette and how they speak to patients and um for the most part everybody is very warm and welcoming and um that and we've gotten a lot of feedback on that as well that our patients say from from the very minute they placed a phone call to the time they left they were treated very professional and very warm and wanted to come back do you do you think you're um on answering the phone um what are your hours and do you answer the phone um when you're not open or before or during lunch or what what is your um office hours and
what is your phone answering hours are those the same uh no our we always have someone to cover lunch at all three locations somebody covers lunch so they'll alternate their lunches um typically we don't take the calls on the weekends or after hours so we don't take the calls on the weekends we don't take the calls on the weekends um but that's one thing i really liked that scott had uh at his at the seminar is that they have their call center so that no call is missed now and i do really think that's important are you using his call center not yet yeah um so so yeah but but you you made one great point on that about the that question is the fact that it just blows my mind when uh dennis closed down for lunch i mean
when you look at the uh federal reserve of the united states of america which owns the which has the most phd economists as employees of any institution on earth it's like 3 000 and when they do their health care data they say that one in three americans cannot go to the doctor because they're at work and the doctors are all closed when they get off work so here's just you know the highways are swamped from six to eight and your phones are off and they're all you know um could have called and then when you take a lunch people just turn off the phone at 12 it's like staggering lunches would be such an
obvious um and also um staggering the receptions like if if you work eight to five why can't one come in at seven and start answering the phone at seven and then if you close at five why can't the other one don't stay till six um you would pick up an hour before an hour after an hour in the middle lunch you you would just open up your uh three More hours of talking to a live patient and you would be like, 'Oh my God, I'm gonna be like, Oh my God, I'm gonna be like, Oh my God,' and that would have a massive material impact uh on the dental practice but uh um it's just like say that in our in our industry the culture is that the only thing that matters is the dentist performing their art and i i think that's cool but it really means the business is secondary.
Um is there any um special thing you learn on a phone system, I mean you just use regular phones or have you tried um any phone management software? Um we had tried uh Weave at one point but we kept having outages, I guess they were having Some difficulty in our area so, um, we definitely canceled that because we couldn't have our phones down and, uh, we haven't went back to anything yet. Okay, now this is why I love Dental Town, so when you have a you know on on all the other social medias like Facebook, Twitter, and all the other LinkedIn, Instagram, it's just a um last in first out it's just a news feed, uh, but I can't go to somebody's page and do a search of what they said about a certain topic and then on on most social medias if you say something I don't like, like when people get on my Facebook page and say that I'm short, fat, bald, and ugly.
I say um hey uh you missed one. But you can go if you're thinking about buying weave, all you'd have to do is is go to Dental Town where all five million posts are still there and and do a search for weave and and what you'll find out is what she just said is what everybody says that it's a new technology, it's voice over internet protocol, um. But it's um, you think you have great internet connection when you're using your iPhone and your computer, but when you switch over to the phone, you realize that man, your town's internet is not all that you think it is, and they even and it's very bizarre with humans because even when they started satellite calls,
they went With the whole Iridium system because Motorola said, 'Um, well if we put all um the number uh Iridium satellites on the periodic table that there'll only be an eight-second delay in our conversation as the as the electromagnetic wave goes to the satellite and back, but that eight seconds killed the product; I mean humans humans can't even talk to each other on an eight-second delay. Um, even when you're watching a big news story and the guys uh you know on the other side of the world and there's that just that split second you're like, 'Hey, yeah, well let's so so yeah,' so i don't think Voice over Internet Protocol is. in the united
states yet it's 2019 it's not here um you'd probably need the whole country on fiber optic um traveling at the speed of light which goes around the planet seven and a half times a second um before internet phones are going to work so that was a good discussion but my god if you're gonna buy something do a speed of light just search on dental town to see what all the other doctors with eight years of college um who tried this with their own money um what the what they think of it um what about um what about um billing insurance um any tips on uh billing insurance uh that that type of stuff um i think it's really important To have very good narratives already in your
UMC and I, I designate one insurance person at each office because uh because first of all it is it's all about your collections and getting what you can um paid, but I think if if you have one person designated to do that um they're able to put the time and the focus and to do it and do it accurately and I have one insurance person and I have one insurance person and I have one insurance coordinator that is just she's incredibly meticulous and I um she gets our claims paid and that's that's what she's there for and that's what I need her for so she's good about getting that done and that's. What I think, and that's um, kind of interesting here.
I'll take my notes on it from my own um, from my own uh iPhone, is that um, so we started a call center for our office, and you know it's a flow, I mean the the phones could ring for one time and then and so we have it at today's dental, and then it can roll over to the back, the assistance or whatever, but um, it can roll over to our um, our call center person. But that call center person when the phones aren't ringing, they can work outstanding claims, um audit accounts for dual coverage, um, they can do all kinds of other tasks. And so then when you ask these dentists, well, what's your outstanding Claims 60-90, they don't know and then you say, 'Well, where are the um insurance claims stuck?
Well, in our office in Phoenix, Arizona. It's uh accounts for dual coverage, um, you know that that triggers off a bunch of nightmare stuff, but again, um, it's so hard for me because I'm trying to they want to go learn about implants and bone grafting and Invisalign, uh, but they don't know what their outstanding claims are. They can't tell me if last month, and I just say, 'Well, how many people tried to call your office and it went to voicemail? I mean, are we talking about did it happen once, twice, 10, 50, 100,000? They don't even have any idea. So getting...' Them onto the phone, um, is it just important? Um, what about um feeding the three practices you have to be doing how do you get new patient flow?
Um, what works for you in marketing? What are you doing there um currently at our our main location it's word of mouth we have excellent word of mouth um and then we'll refer the overflow to our other location if our schedule's too too busy for a particular day then we'll refer them to our second location uh we are working on getting um, our third location built up because it's it's pretty rural out there even though it is the fastest growing county in North Carolina right now and we are. Trying to find ways to build up that one um, but I do still feel that asking patients regularly, you know, patients that have a great experience, that are complimenting you, tell them we're taking new patients and we'd love to have your family come join us, um, friends and family.
But uh, we are getting ready to put a large sign, EMC sign at our third location; long story short, but former owners took the sign and so we didn't have anything, so I really think that that's going to also promote because it's on a pretty... you mean, former? So, you bought you bought a dental practice, yeah, this third one was an acquisition, and when they sold it. To you, they took the sign when they left. Yeah, yeah, being I mean, was that being a meanie or what? What really? Yeah, yeah. It hasn't been a good transition at all. I-I um, so, so, so, why, why did you buy? Were they failing and so they wanted to get out of it or what? Why, well, we never dealt with the dentist.
We dealt with his brother, and um, I think they had four offices, and they had them all combined. I don't know how this office...I don't really know how it stayed open as long as it did. Um, they locked the doors at lunch, and they locked the doors and didn't unlock the doors until 8 a.m., and uh, they didn't answer the phones; not an urgency, I mean there. was just so many things in this office that i don't know how they kept the doors open but well you say something very interesting we i've noticed forever that again ways we started this show is that you know most bankruptcies are somewhere between the second and third
location because you have one location and you don't even know why it's working and you're working hard you got a great team you just think it's great so you go to a second location and it's not quite as great and then and you start to realize hopefully you slow down and you start to realize well why is this one not as great and you know what what is the difference And, um, that it's a good investment, um, philosophy too. So, a franchise is 13 percent of the U.S. economy because the franchise is 13 percent of the U.S. economy is proven. It works well when you're investing in a new franchise. What do you do? You look, say they open up in Phoenix and they got one store, okay, great.
But if you're going to open three or four more stores, open them in Phoenix so your management team can quickly efficiently can do that as opposed some people opening up the first location in Phoenix then the second one will be in Denver, Albuquerque, or laws. It's like where's the scale of economy in that? So once you've got five Or six working in Phoenix, well I still have no proof that it's a national thing because it's only a local thing so then at Phoenix I'd say okay let's pick some other towns I mean we got Albuquerque, um Denver, Vegas, Los Angeles, San Diego, Tucson, let's go to another town and see if that works and
then if that works then go to a third town now at the end of three towns I look at it as like decimal place you just carried out one digit two digit three when it when you got five locations in three different cities in three different states all different cities and then you go to a third town and then you go to a third town doing the same thing. That's when you load up on this stock because it's going to roll out across all 50 states and you want to start outing your position when they get to about 45 states, because it might not do anything in Canada, Nebraska, I mean Canada, Mexico, Europe, whatever. But the best part about expanding to more than one location, believe it or not, the best part about it is just to find a report card, to find out what the hell you're doing wrong, why is this so difficult?
And you're going to first find out it's your people and then you're going to find out it's your systems. And if you um I think one of the reasons all the great franchisees made it. So big is because they had these ambitious goals of expanding, but if you look at McDonald's, like the original founders of McDonald's, um, the guys actually invented it, uh, they they fumbled with 10 stores their entire life. It wasn't until Ray Kroc came in and looked at what went wrong with those stores and they were like, 'Oh my god, this is what's going on with those 10 stores' and fixed that. Then he made it around the world, but I almost think you should go to a second location for no other reason than to find out why your first location is working and what are all the hidden nightmares that you're not even aware of, it's just going.
To bring him to the surface, and so you're talking about you, you bought a distress practice from someone who tried to own four. And it's like buying a HUD house, when you we when I got my real estate uh, I went to the Scottsdale School of Real Estate when I got out of school because I was going to buy a house and I was so stupid young and dumb that I thought 'I'm gonna go to get my I'm gonna go to the Scottsdale School of Real Estate to learn about this transaction if I do it. I learned a lot, but one thing I learned then is that when you look at distressed properties, you always see fist holes through the wall, I mean when you walk in there.
Looking at you're, realizing that this person's world was crumbling - he lost his job, he lost some money, he lost his house. And you can tell that a not very happy human was living in here and it's kind of sad, and my son uh just uh witnessed that for the first time looking at a property. He's calling me up and telling me that, and I was sitting there thinking, yeah, you're 23, I was i can still remember 27 years old realizing that for the first time. So this dentist was so sad he stole someone's sign - I mean that's just a that's just a sad story um because someone's not focused on the business um because you want to do your craft um so any other um.
Any other uh thoughts on uh uh the businesses or um things of that nature um, I think you always got to be willing to look at other people's systems as well, you know. Um, like I had told some of the team that was at this office if you have some systems in place we're always willing to look at what you have if it's going to work better than what we have um, but they didn't have any systems but um, I think maybe I've learned a lot in you know all these years of being in dentistry that I finally have recognized that I don't know it all and I'm always willing to look at other things and learn from other people as well, and um, and I think that's what I'd even you know recommend for any associates, new dentist you know, be willing to learn from people who've have done some things or been in the field a little bit.
Um, but always be willing to to look at the possibility of change because I think you know, so if I was doing dentistry the way I did years ago, you know, I wouldn't be where I am today. Um, when Heartland started out, they were getting big lines of credit and they were growing and expanding through acquisition and they got so tired and returning offices around turning staff around. They've almost entirely switched to just operating their own brand new de novo. Dental offices, you just went through a merger and acquisition of a third location from what you've learned now, um, if you had to do it all over again would you have bought that or would you just gone to town and did a de novo from scratch? Yes, I would not have.
I would have, there was just so many headaches with this, I mean literally they had three in a way employees, a front desk assistant and a hygienist. And, um, the only one who's still with us is the hygienist, but he's our office manager now. Um, but I've learned so much from this that I know if we do another acquisition, um, I definitely know how to handle it differently, but I can tell you your, your toxic employees show themselves quickly. And, um, I would in the future, I would not hang on to some of those employees because, uh, they've, they've caused me a lot of grief in a short amount of time. Yeah. And I'm, I'm always, um, amazed.
I mean, you can, you know, the difference between sports and business and politics and economics is so easy to see if you're good or not. I mean, when you go golfing, I can swing, I can tee off and instantly know I'll never be Tiger Woods. And then I go over on the basketball court and I try to dunk the ball. And at 57, I've never touched the net. And I know I'm not going to ever be Michael Jordan. Um, but they don't see their thoughts in economic policy. They, they, they just don't see their thoughts. And it amazes me how well some people can understand that. And I think that's, I think that's, I think that's, I think that's, I think - toxic, dysfunctional employees.
And because of that skill, create these winning teams that oftentimes the dentist doesn't even know why he's a winner. And it's because his, it may be his spouse is the office manager, or he just got lucky with an office manager and they never, they never know why, but, but it's always going to come down to the team. And all I got to say for dentists is that, you know, I, I was with you in, in undergrad and dental school. And I mean, we weren't the ones in fraternities going to sororities. Uh, we weren't the Miss popular con we, we were in the library reading physics. I mean, I mean, you, you wake up in the middle night trigonometry thinking cosine tangent. I mean, um, a lot of these dentists just aren't good at their people skills.
There are a lot of shy introvert physicists and, um, you know, but they, um, but gosh, what you got to do is the, is realize that HR is the most important. And even if I even know the owner of the Arizona Cardinals, he sure as hell doesn't do any of his picking, uh, um, uh, the, the people out there. I mean, he's, he knows there's far better people to decide which one of these great athletes in college is going to be great on my team, but he doesn't even get involved in something like that. So we, so, so here's what we'll end on. Because we went way over an hour, we're an hour and 15, but here, here's the deal. Um, what are red flags? Um, you don't like your team.
They're, um, um, they're, um, um, gosh, they're what, what would your staff turnover would be the easiest measurable. The easiest way to measure it is how long does your average employee stay there? My, uh, my management team, they've all been with me for two decades. So if you're having a problem with turnover, it's either two things, either there's a toxic person in there running everybody off, or you just don't know how to pick them. But, um, if you're not, if you have staff turnover, if you don't like your staff, you're on dental time. I was saying, what am I going to do? My labor is high and my assistant wants to see me at lunch. You talk about a raise and all, all these things like that.
I mean, you've got to get better at this than you are a dentist, or you need to find someone who's better at this. And then you just focus on dentistry and that that's the bottom line. Yup. Yup. When my, when I hired in with my boss, he was not, I mean, there were a lot of things going wrong at both of his locations. And we did have a high turnover because as I continued to recognize the employees, he had had a lot of employees stayed with them for quite a while. But once we recognized how, how toxic some of them really were, um, we went through a period of time where we had a higher turnover, but it was trying to find the right people. And that's where I finally brought my management team in.
Yeah. On the hiring process, because I figured it was, you know, what one of us didn't pick up on another one would. And, um, you know, I, I think as it's going to get harder and harder to find employees, I'm hearing it all over the place, not just dental, it's everywhere. And, um, you gotta, you gotta find the right ones and you gotta hang on to them. You gotta treat them right. So they want to stay. So you just said something that just makes everybody so stressed when they have a toxic employee, but that employee's been there forever. And it's like how, and so it gets, it gets, it's, it crosses function into dysfunction. People are codependent. Um, they like their crazy friend because he's their drinking buddy or he's their fishing buddy.
They, they, they trade attributes because maybe the only guy who'll go fishing with you on the river all day happens to also be a missionary. They're miserable drunk or, you know, some problem, but my gosh, there's so many codependent dysfunctional relationships in dentistry where they just got the queen of toxicity and it's doc's favorite. Is there any, on your final thoughts, is there anything you can say that can help a dentist see what a toxic employee is and why it possibly could be his assistant of 30 years? Who's his child's godmother or whatever the heck. Um, is there any, any, um, any way you could paint an image that might make it more easy for him to see? Um, well, for our situation, I had to just keep bringing to him the things that I would see.
I don't know if I would know how to tell somebody what, you know, I mean, if they're, if they're constantly complaining, if people are complaining about them, see now and where I came on board, the manager before me, everybody was afraid to say anything because they would be fired. And, um, you gotta be able to let people openly communicate. And once you get that manager on board that you trust, then your team needs to go to your manager. Obviously they don't need to be taking everything to the dentist, but, um, they need to, they need to have an open line of communication where they'll listen and see what people are telling you. Because, you see it, it's there; you hear it, you know; I mean, they, you might love them because they've been with you 30 years, but you see people's responses to others, those toxic employees.
I, the office that we took over, they had a woman that had been there 25 years, but I was amazed that patients would even come back there because of the way she spoke to them on the phone or, or the way she presented treatment to them. And, um, you know, you can tell by patients' responses to these people, you can tell by other employees' responses and you need to be a little sensitive to that. I think take a closer look at it. Well, it's, uh, it's just everything. HR is everything. And dentistry reads a book all the time from my buddy, Fred Joyle, that marketing is everything. And it's, um, and I know Mark, I know he believes that, but I know, uh, uh, HR is everything.
And, and if your HR is perfect, you don't even use marketing. So Fred Joyle's out there saying marketing is everything. And you don't even do marketing. Yours is all word of mouth referral. If you, know if you, if you, if you go through life and you, and you really get the Dale Carnegie, how to win friends and influence people and get along and not be toxic yourself, be able to spot it with others. Um, you, you see it at an early age, even with parenting, where you see these parents are staring at their phone while their two kids are being toxic each other and they're going to learn to be toxic. One's going to be damaged from it. And you're like, dude, what are you looking at your damn phone for?
Your two-year-old is being toxic. And you don't, this doesn't, this needs to be broken at a very early age. And, um, my gosh, I, I, I spot it in seminars every time. I mean, a staff member will come up and ask me some question about their office. And when she's referring to the doctor, she looks back at him and rolls her eyes. And she's like, I don't know what to do. I don't know what to do. I don't know what to do. And, and disgust and just say, oh my God. And then at half the time of how long you've been there, 12 years. Wow. Wow. Um, just, uh, you know, you know where to begin the seminar. It's like HR is everything. Let's leave on that note, Chris Zimmerman, RDH BS, senior practice manager, dynamic dental Jacksonville, North Carolina. Chris, thank you so much for coming on the show today and talking to my homies. Thank you. I appreciate it.