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Dentist Money: Gary Takacs Gives Six Keys to Practice Success – Episode 43


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Consultant, coach, practice owner, professor, founder of the Thriving Dentist Show, internationally-acclaimed speaker. Dentists around the globe refer to Gary Takacs by a number titles. We simply call him The Legend. Having worked with over 2,200 practices, perhaps no one is better qualified than Gary to motivate and mentor dentists at every career stage. In this Dentist Money™ interview, he shares a collection of stories and experiences to illustrate how the most successful dentists thrive.

Show notes:

www.takacslearningcenter.com

Thriving Dentist Show with Gary Takacs: https://itunes.apple.com/us/podcast/thriving-dentist-show-gary/id488260412?mt=2

 

Podcast Transcript:

Reese Harper: Welcome to The Dentist Money Show, where we help dentists make smart financial decisions. I am your host, Reese Harper, and you are about to listen to an interview with the legend himself, Mr. Gary Takacs.

Reese Harper: Gary is super busy but he was nice enough to come into the studio and share his wealth of knowledge. He has been doing this for a long time and had a lot of stories to tell which made our conversation a lot of fun. As you will learn, Gary has worked with thousands of practices and has been able to identify the most important factors that lead to growth and profitability. Most of you know he hosts a podcast called The Thriving Dentist Show. He is also the founder of the Takacs learning center and a super popular speaker all over the world. It was really cool to have him on the show and I am excited for you to hear what he had to say. There are a few nuggets in there for dentists at every career stage, so everyone pay close attention. For links to Gary’s website and podcast visit dentistmoneyshow.com, also make sure to follow The Dentist Money Show on Facebook and Instagram where you will get helpful updates and tips. Thanks again for listening, enjoy the show, and carry on.

Reese Harper: Mr. Gary Takacs, welcome to the show.

GaryTakacs: Hey Reese, it is great to be here. Lets see, when you sent me the invitation and said, “come on we would love to have you in the studio.” It took me just about two seconds to make that decision. Let’s see, middle of August in Arizona, 115 degrees and frankly humid?

Reese Harper: It’s an interesting time of the year for humidity.

GaryTakacs: Ya, 115 and humid. I ran yesterday morning before this trip. I have to run in the morning at 4:30 to even beat the heat, ok? 4:30 AM yesterday morning on a six mile morning training run, I made the foolish mistake of checking the weather on the app on my phone.

Reese Harper: That is not demotivating for a guy like you though!

GaryTakacs: 88 degrees and 76% humidity.

Reese Harper: Dang.

GaryTakacs: So when you said, “Hey, come on up”, it took me about two seconds to make that decision. I am staying up at Sundance.

Reese Harper: I was going to say that is a favorite spot for you.

GaryTakacs: You know, I love Sundance. Weather is beautiful this time of year. It is 72 degrees and gorgeous. Beautiful alpine setting. When Bob Redford saw that and had his vision for Sundance, man, very special.

Reese Harper: Pretty special. Well, let’s jump right into some content today because I really feel like of all people who can give advice across the spectrum of ages and demographics and career experience, you are the guy. I want to find a nugget of wisdom for almost anyone regardless of the part of career they are in.

GaryTakacs: Very cool.

Reese Harper: So let’s look at the early phase. What about someone who is graduating and is at the point of determining “where should I practice?” A lot of times they will have a few different locations to choose from. They can go to Texas, Seattle, Florida, South Carolina? Metro, rural, high population density, low population density? Close to family, away from family? It is a tough choice sometimes and sometimes the easiest choice is to just to do what feels comfortable. Maybe a place they grew up or know about. Sometimes that is not always the best decision, and I guess I just want to ask what is your perspective on that? How do you balance the choice of where you want to live vs. what could be a good financial decision and should one rule the other.

GaryTakacs: I am going to get real specific on this one. I have the privilege, you probably know, to teach at Midwestern school of Dental medicine. So I teach. Dr. Brad Smith recruited me, our dean. I teach practice management but it is not practice management in a numbers sense. I teach the people side of dentistry. I teach all four classes. It is pioneering curriculum. To our understanding, it is the only school that is teaching the humanistic behavioral side of dentistry. It is very cool. But one of the things I do with our D 4’s is I go through fourth year students and I talk to them about career paths in dentistry. As you graduate and you launch your career there are two things you want to be doing early in your career. You want to be working on your hand speed. You want to learn how to get quicker. Dental school education is fantastic to teach the fundamentals of providing good care, but it doesn’t teach you speed. Think about it. In an afternoon clinic session from 1-4 you might have 1 patient or 2 patients. And it has to be that way because there are instructors that have to check your work and so on. But you are learning how to do the fundamentals of the care but you are really not learnings speed. So early on you need to be working on your hand speed. The second thing you should be working on early in your career is increase the range of services. Perhaps at dental school you had an opportunity to do some root canals, you had an opportunity to do some extractions, and to do fillings, and some crown and bridge. But probably not a lot of any particular area. So the two things you should be working on early in your career is speed and range of care. Find out what you like. Maybe you do like adult orthodontics? Maybe you like simple oral surgery? Find out. The other thing you want to do early in your career is you want to put yourself in a work environment where you are going to be busy. I think one of the mistakes that happens accidentally to a lot of dentists is they graduate they get into a job situation and they aren’t very busy. You are sitting around. And I’ll give a great case study in one of my business partners Dr. Tim Schmidt. Tim wouldn’t mind me sharing this with your listeners. Tim graduated in 2010 from Oregon Health Sciences, OHSU. And his first two years out of dental school he worked in a community health clinic in Moses Lake, Washington. He had five other dentists he worked with so that was great because he had mentors and it happened to be really good experience because he had mentors who could help tach him right there. He was salaried and he worked a five day work week and he was busy from start to finish. He was busy. It was a great experience for him. I met him at a conference. In fact, it was Gordon Christensen’s conference here in Provo, Utah. I met Tim and we talked and he said, “Hey, I am having a great experience but this isn’t something I want to do for my career but it’s been a great foundation. I eventually want to get to Phoenix, my wife’s family is from there and we would like to get back there.”

Reese Harper: Enjoy that humidity and weather.

GaryTakacs: 8 months out of the year it is a good place??

Reese Harper: No, it’s an amazing place! 4-5 million people think so!

GaryTakacs: I said, “Hey, we are looking for an associate doc, come join us.” But his first two years working in a very busy situation like that prepared him well. Paul Neilson, my business partner, we co-own Life Smiles, he took a different path. He graduated in 2005, from University of Washington School of Dentistry. His wife was also from the Phoenix area and there plan was to locate in Phoenix for family reasons. He worked in three different associateships each one was two days a week. So he was working six days a week, he was young, hungry, wanted to pay of some student loans. Had a young family, so he worked in each one of these associateships two days a week. Two of them were very good and he learned a lot from them. But one of them wasn’t very good, he may have learned as much from the one that wasn’t good of what not to do.

Reese Harper: Ok, so a couple principles here it sounds like. One, rather than thinking about the money that you might be making, focus on the experience that you are going to gain early in your career.

GaryTakacs: Right, yes.

Reese Harper: I do think people make a mistake of jumping right in to thinking, “well this guy told me he was going to pay me X or I’m going to make X here!” I find that to be the case in a lot of careers where people who are young sometimes chase what they think is the right financial decision at the expense of gaining skills right?

GaryTakacs: Ask the question if you are in an interview situation. Give me an idea of how busy I can expect to be in your practice? Sometimes it’s a senior doc that is too busy for one doc and he wants to hire an associate and has never had an associate and the young associate comes on and they are just sitting around. They are waiting for the crumbs to fall off the table. The senior doc can’t back off yet, and you are not doing anything to develop your skill set.

Reese Harper: Time is money. You are spending years of your time developing skills too slowly and not preparing yourself for the future.

GaryTakacs: I don’t want to create any more pressure on young dentists. They have a lot of pressure, and I can empathize with that. But I will say that and I want you to take it to heart. The decision you make early in your career can have a radical influence on how much enjoyment or fulfillment you find in your career. But one other thing I would say is that, I learned this from one of my mentors, and interestingly enough I will use his name, Dr. Joe Harris, he was a great guy. Joe has three sons that are dentists. When each one graduated from dental school he said, “I am so thrilled and want to recognize your amazing accomplishment on graduating from dental school but what is interesting about it, is that your education is just now beginning”. So if you are a dentist, and what he meant by that was, yes, you have the foundation of the academic aspect of dentistry but the real education begins the moment you graduate. I will tell you, I am going to brag on Paul for just a minute. Paul is an amazing young man, he is the youngest dentist to have performed both a fellowship and mastership through the academy of general dentistry. He is involved with the AACD and he is working on becoming credited there. He takes about 200 hours of CE a year.

Reese Harper: How do you really feel about Paul?

GaryTakacs: Hah! He is a great guy. I’ll tell you, in Arizona, 32 hrs are required every two years. So 16 hrs a year. Paul takes about 200 hours of CE a year. It has made a massive difference. So early in your career, and there are ways to invest in CE that are affordable. I know your perspective might be I can’t afford to do this now, and your perspective should be I can’t afford not to. So, for example, Glidewell Dental lab, they have a great free videos on their website called Cheer-Side-Love, you know over 300 hours of free videos. You have to pay for this, but you can invest in something like Spear Education, their online curriculum for a couple thousand dollars you can have access. Now that is not chump change if you are a young dentist, but you can have access to literally hundreds of hours of the highest quality CE available. Gordon Christensen? I love Gordon. Through his practical clinical course he offers dentists a 50% discount who are five years or less out of school. That is 50% from someone who I would consider to be an absolute master.

Reese Harper: Ya, premier. In finance we often talk about the concept of the time value of money and the earlier you start investing a dollar the faster it compounds and 25 years from now you end up with a sum that is a lot greater than what would have happened if you had waited for ten years. I think the same thing applies to continuing education and experience. Where you really start making a financial impact in your life is in your late 30s, your early 40s, your mid 40s, your late 40s, that is when your business and career maturation has hit a point where you can really start increasing your net worth quickly. If you have invested in education really early in your life it just accelerates the time that you can produce at a high level. Be extremely efficient and it really helps augment your personal net worth as well. I feel like too many times people choose a shortcut through education to try to get to what they perceive to be a faster track to financial stability. But the education is the barrier to getting here, in a lot of ways.

GaryTakacs: Yes. Hey, let me give you a great tip guys. Every year in mid January, the Hawaii dental association, HDA, puts on their annual meeting. I repeat, mid January. You should go to that meeting.

Reese Harper: We just had a meeting in our office about which national and state association we were going to be presenting at and that is at the top of our list next year. So talk to me a little bit about another question ok? I am now going to choose, mid career kind of decisions. Well, still early career with this one. Then mid career, then latter career. So don’t tune out all you guys waiting for your part to come up. I am deciding whether I want to be an associate or an owner right out of the gate. Do you think it has to do with that education idea as well? How do you determine if I’m an owner or associate right out of the gate?

GaryTakacs: Great question. I would say, I am very bullish on ownership. Very bullish on ownership. I would say that ownership is not the track for everybody.

Reese Harper: How do I determine that? How do I determine if it’s right for me?

GaryTakacs: Here is a case study. I’ll leave the names out. I never remember if we are protecting the guilty or innocent when we leave those names out. Anyway, I was contacted by a young dentist who was interested in purchasing a practice and he asked me to evaluate it and see if it was the right one for him to buy. I said, “ya, I’d be happy to do that.” Turns out that the seller was a very different seller than the typical seller. He was 29 years old. Two years out of school and he made the decision to sell the practice because he found that in the two years he owned this practice he was temperamentally unsuited to own a practice. And how so was that the only thing he liked was clinical dentistry. He only liked being in the mouth doing clinical dentistry. He did not enjoy anything relating to the management of the practice and hated everything relating to HR. Because of that, the practice was really struggling because he had no interest in the others. He was working a day a week in a big clinic where all he had to do was come in, put his head down, and do dentistry. That was the day of the week he enjoyed the most. So I would say while I am bullish on being a practice owner because I think ownership provides so many great benefits, it is not for everybody. You have to evaluate whether you have the temperament to lead. You have to be a leader. Now, you don’t have to necessarily think of yourself as a great leader. You can develop those skills as a leader but you have to have some management skills. You have to have the ability to motivate and inspire your team. You have to be able to find the resources and spend the extra time to develop the resources because when you own a practice you have two jobs. You have your job as the dentist and your job as the business owner. I happen to think that is exciting and provides so many benefits but do a self evaluation and ya know owning a practice is not for everyone there are other career paths. There are good corporate offices. We talk a lot about corporate debt, can I take the 500 pound pink elephant in the room? You know corporate dentistry? It is just like when we talk about dentists at large. Dentists: there are good dentists, there are average dentists, and there are poor dentists. There are good, average, and poor practices. Is that a fair statement? The same could be said when we talk about corporate dentistry. It is not fair to paint the same brush across all of it. There are good corporate environments which provide a very positive work environment for doctors. There are some that okay. There are some, that frankly, you don’t want to work with. They don’t have an ethical foundation that you want to put your heart and soul into. There are some that provide vey positive track and are supported by good systems good team members so you can put your head down, if you are the kind of doctor where that is all you want to do. The only interest you have is to put your head down and do dentistry, you may not be suited to own a practice.

Reese Harper: I think that is good feedback. Talk to me a little bit about, now I’m an owner, lets say I do have the temperament, the ambition, the interest, and I own a practice it is going well. I have got to a meaningful level of size and now I’ve got to determine when should I hire that first associate?

Reese Harper: Or should I have one at all? My practice seems like it’s growing, I’m getting booked out several weeks in advance, some people might be booked out a month, or six weeks, or they are only out a week or two. When do I determine whether I should hire someone? How do I go through that process?

GaryTakacs: Reese you know my background but some of your listeners may not know my full background. You know, I’ve been a coach and a consultant in over 2200 practices since 1980. 36 years. I have been in over 220 practices.

Reese Harper: So a couple?

GaryTakacs: A few. I can tell you that the decision to add an associate has… I have seen this through my eyes and experienced it as a coach. It kind of mirrors that famous movie, The Good, the Bad, and the Ugly. I have seen situations where it has been the best decision that dentist could have ever made. I have seen the same decision where it was actually reported back as the WORST decision I have ever made. Very rarely is it neutral. I can think of a few, Ah it’s all right.

Reese Harper: Everyone’s got an opinion. Rarely ho hum.

GaryTakacs: It tends to polarize though. It is either a very good experience or a very poor experience. Some of it comes down to the individual. The person you chose as an associate. But I’ll tell you just speaking from our own experience, when Paul and I bought our practice, your listeners may know that I’m NOT a dentist. I’ve never been one, my background is in the business side of dentistry. I looked in Arizona to own a practice. In 2007, I partnered with Dr. Paul Neilson, he graduated in 05’. Although I could own that practice by myself, I wanted to have a dentist with skin in the game. So we bought it in a 50/50 partnership in may of 2007. Just last year Dr. Tim Schmidt, our associate doctor became an equity partner. We now own the practice 1/3, 1/3 , 1/3 and I’ll tell you that adding Tim Schmidt was on elf the best decisions we have ever made. Here is a couple of things that you can use to help you make that decision. What are your reasons for bringing an associate on? Evaluate those. You should have some clear reasons and there can be good reasons. You might want to take more time off and have your practice covered. You might want to bring more services into your practice but maybe they are services that you are not interested in. Let’s say hypothetically you are not a dentist that enjoys endo. But you have lots of need for endodontic treatment in your practice. Maybe we bring in general dentist that enjoy doing endo. Perhaps you are a dentist that doesn’t enjoy seeing children, maybe we bring in a dentist that enjoys pediatric dentistry. So there are good reasons to bring an associate on. If your reason to do that is driven by those good reasons, then it tends to be a decision matrix that is the right type of decision. Another matrix you can use and what finally prompted us. Paul wanted to be a solo dentist for as long as he could. He wanted to captain his own ship a little bit. He didn’t have any leadership authority, or management authority previously, he wanted to captain his own ship. So our decision always was to bring an associate in at some point but only after we got busy enough in this schedule to support that. I remember the day very well it was Nov12, 2012, and I remember looking at the schedule and we literally did not have another appointment that year. Now we would always work in emergencies, Paul would stay through lunch or work early and evening hours. Always take care of patients. But there was not an appointment, That’s when I said, “Paul, we need to bring in an associate.” That is another way you can look at that, how is your schedule? Is it busy enough to support the associateship. Where many associateships fail, is that the doc will say, “I am too busy for me but I don’t know if I’m busy enough for two”, but they bring the associate in and the associate ends up sitting around and it ends up being a failed experience for both parties.

Reese Harper: That makes a lot of sense. So to recap a little bit, let’s say I’m a general dentist that is doing a little bit more than I can really handle, I feel kind of like I’m being stretched thin. I’m working a solid 5, or I’m working solid 4’s. I’m getting burned out. I’m doing that much production, I probably went too far before I started considered bringing on an associateship if I’m that ragged right?

GaryTakacs: Ya, let’s knock the top off that one. I really do believe that a four day clinical schedule is absolutely full time in practice. Dentistry is hard work.

Reese Harper: It is, it’s a grind.

GaryTakacs: It’s hard work physically, emotionally..

Reese Harper: So if you see a 5 or 4 day full schedule it’s too much for one person?

GaryTakacs: I’ll prove it. Can I prove it to you? Every single coaching situation I’m in where a doctor has been working 5 days, I have encouraged them to go to a four day a week clinical schedule. Often met with some resistance believe it or not. “I don’t want to go backwards on my income.” Every single time we have done it, we have increased his or her production in four days over what they were doing in five. Every single time. In my experience base, there is no exception to that. Now interestingly enough, in our own practice today, Paul and Tim both work a three day schedule, by choice. Paul works Mon-Wed. Time works Wed-Frid by choice. I encourage that because it allows them to have balance . They have wives and young families. I told them both when Paul first came to me he wanted bounce the idea of a three day schedule. I said, “you know, I am really supportive of it. Because if I could do one thing, knowing what I know now. I have four adult children. Our oldest is 39, youngest 21. Knowing what I know now, if I could do something different I would go back and spend more time with them when they were younger.” I would absolutely do that. So I said for lifestyle reasons. Plus think about this. Paul can take lots of CE. Tim can take lots of CE. They can manage the business side of the practice. When you are done seeing patients four days a week, you typically have at least another half, 3/4 or full day on the business side of your practice to handle everything else. Then on top of that, I am just a huge advocate of success measured by balance. If doctors have a successful practice at the expense of your relationship with your spouse, or children, or relationship with health, your relationship with your hobbies and interests. Then I would not consider that successful. So I think some balance is really, really important. Here’s the interesting thing, when Paul went down to a three day a week schedule. So I had 100% success going from 5-4 and becoming more productive with four days a week. I now have two case study examples of going from 4 to 3, and increasing production working three days a week instead of four. It doesn’t make analytical sense, but I have the data to prove it.

Reese Harper: I think that’s really good insight, tell me a little bit about, one of the questions that comes to mind when describing this. If I have the chance to choose the ideal size of my practice to be able to maximize what I want to do over the next ten years. Whats too big and whats too small?

GaryTakacs: That is such a brilliant question. I’m going to answer it differently than you might expect. It is not a generic number. It’s not a number I can pull out of my head. I am going to answer it on the achievement of six specific goals. These are the goals that I have established as a thriving practice in 2016 and beyond. Not numbered in order of importance. All are equally important.
Overhead no higher than 60%. Ideally 50%. But I’ll accept 60%.
You’ll appreciate this one Reese. The ability to fully fund financial independence and a plan for financial independence through your practice. The ability to create and fund your own financial independence with a plan through your practice. You are not banking on the lottery ticket, or an inheritance that may or may not come or appreciation of some real estate. Some windfall. Your ability to fund your own financial independence through your practice resources.
State of the art facility, state of the art technology. All the gadgets and toys that make work fun. High paid team members so we can retain them. Quality CE program. Using the best vendors and labs and still control overhead at 60% or less. It just got a little harder didn’t it?

Reese Harper: Toys?? There are a lot of toys.

GaryTakacs: I want you to have it, I want you to have it all.

4. I high performance team that you truly love and enjoy working with.
5. Patients you enjoy taking care of.
6. Treatment mix that gives you satisfaction.

GaryTakacs: The answer to your question in my opinion is whatever size practice that allows you to achieve those six goals is the perfect size. So rather than the mythology, or the million dollar practice, or somedays a million dollars isn’t what it used to be. Is it a 2 million dollar to find success? Benchmark it based on those six goals, whatever size practice that will give you those six goals. That’s the right size.

Reese Harper: That is really, really good insight. We should take note of those, and think through it. There is probably a size in my experience where you have over built to the point where you can’t achieve some of the goals that you have set and there are sometimes where I see people re locating multiple times during their career because they didn’t really think through their practice quite enough in advance.

GaryTakacs: Reese, I’ll leave names out again. I was in a practice recently that was producing over 2 million dollars with 90% overhead.

Reese Harper: {laughter}

GaryTakacs: So do the math on that. Lets just call it 2 million to make it easier. There is a 200,000 income pre tax. Another one I was in recently was a 600,000 practice with a 66% overhead and he netted 200,000 pre tax. Which one would you rather have?

Reese Harper: Easy answer!

GaryTakacs: You know, it is not always driven by that top end number. I hope that I gave your listeners a different sense to look through that perhaps a different way to measure success.

Reese Harper: We kind of look at it the same way Gary. In our practice, we measure someone’s financial health based on a multiple of what they spend in a calendar year. So whatever it takes you to be comfortable every month if that’s 10,000, 15,000, 20,000 of for some people its 50,000.

GaryTakacs: So you are not judging that, it’s their call.

Reese Harper: Whatever choice they make. We just measure what it is and say this seems to be what it takes for you to live the lifestyle that you want to live. I don’t want to restrict that. I don’t want to tell them that they need to cut their expenses. Unless it prohibits them from making progress, but we take that annual number and we take what they are worth. Everything. Practice value, real estate, and we call that your net worth. Kind of a fancy word. So we divide that big number by what they spend in a year and we get a multiple. Recently I was looking at someone’s financial statement who is worth many tens of millions of dollars but on an annual basis they spend a couple million dollars a year. Kind of an incredible situation, unusual situation. Where someone spends a little more than normal. That person’s financial strength was very different than someone I just had reviewed in your neck of the woods actually. They had a net worth just over 2 million dollars but they ended up spending a little less and there financial strength was a lot greater. The multiple we call it, is a total term. It’s a 10 tt, 20 tt. It is interesting to give someone satisfaction it is all relative. It really isn’t a one size fits all situation. But the more it takes for you to be content with your goals and the things you want to achieve the larger the facility, the larger the net worth.

GaryTakacs: You’re case study there reminded me of an experience I had early in my career in the early 1980s I worked with physicians and dentists. It was anat 1982 I was working with physician client and he was very unique individual. Cardio vascular surgeon, very, very accomplished and hw as recruited to go to Alaska. They were underserved in the medical community at that time. So he was under contract with three different hospitals and he actually made in pre tax income about 2 million dollars a year. The only problem was he and his wife were spending about 2.1 million dollars a year and he felt every bit as poor as that college student that only has a five dollar bill in his pocket you know to get through the rest of the week. It was a different level of poor, but he felt poor because of the fact that the spending was not matched up to the income.

Reese Harper: Ya, it really is relative. Lets ask a couple more questions about what you talked about I think it was number 4 or 5 you talked about having a team that you love.

GaryTakacs: I crafted that statement. It was a high performance team that you truly love and enjoy working with. And Reese, I chose the term love. I didn’t say like, I didn’t say tolerate, I didn’t say put up with. I didn’t say you should have seen the last one, she’s better than her! I count myself very blessed at Life Smiles, we have a team of twelve. Paul, Tim and I make fifteen. I love every one of them.

Reese Harper: I think that is a good, I like the word choice in that phrase. The question I was going to ask is related to that, which is, “How do I determine what attributes make for a good office manager?”

GaryTakacs: Hmm…

Reese Harper: Because that is kind of one of the crux. It is a central part of whether a practice is going to sink or swim.

GaryTakacs: Can I challenge you and your listeners?

Reese Harper: Ya, go ahead!

GaryTakacs: I am not sure you need an office manager. We don’t have one. Ok now, and I don’t know that there is a right answer there. By the way if you are an office manager I am not trying to create job insecurity for you. There are practices that absolutely need an office manager. We have built a culture in our practice of accountability. We use numbers and data to create that. Training and we have a culture of accountability. We ask our individual team members to be accountable. We don’t have an office manager and this is a very large practice production wise. However, I think once you get to a certain size maybe the HR function does begin to bring in that element of an office manager. And, you know, above a certain size and I think you do need one.

Reese Harper: How would you distinguish that then in the roles that you think are essential within a highly efficient practice? What’s your opinion of a highly efficient practice and what the roles look like?

GaryTakacs: For example, we have three administrative team members in our practice. We have two docs, and a big strong hygiene department. We have two docs and twelve days of hygiene a week, or the equivalent of. We have four hygienists two of them work 4 days a week and then the other two job share a two day a week position, or maybe three. The equivalent of three full time hygienists each working four days a week. One of my team members is in charge of Paul’s schedule, one of them is in charge of Tim’s schedule, one of them is in charge of the hygiene schedule. That doesn’t mean the one in charge of Paul’s schedule doesn’t make appointments for Paul or Tim. They all work together but they have accountability for the particular KPI. That’s how we see performance. They own it.

Reese Harper: So tell me what other responsibilities those individuals carry that sometimes might be, sometime you will see people less efficiently utilized in their practice.

GaryTakacs:Among our three front desk team, if you think of the big functions. There are a zillion functions. Many, many functions have to go on up front but they fall largely into two categories. Scheduling and payment.So relative to the payment side we divide and conquer. We have one person responsible for over the counter payment. One person responsible for follow up patient payment. One person for follow up insurance payment. And again, they own those areas we have established benchmarks. We have ways of measuring it and we reward it! I don’t mind sharing that. We have an incentive system that is reward based on their individual management of their KPI. Key performance indicator. And we reward it.

Reese Harper: One thing that comes to mind as I’m thinking about this is that most people don’t have Gary Takacs in their practice and so if an office doesn’t need an office manager, but they don’t have Gary Takacs, it might be a bit more of a challenge.

GaryTakacs: Agreed. And I recognize that. And that’s maybe where we will see a perhaps greater application or need for an office manager to help with that. But i also say that I have many clients that are in that situation. I am there as a coach. They can have department leads. You can have a lead administrative member, a lead hygienist, and have them work on initiatives related to their department. You know, how can we develop our hygiene department further? What could we be doing to further excel in the assisting department? What could we do to further rock the business or admin. side of our practice? I’ll share a case study with you that might be enlightening for your listeners. I have a client that uh, was, kind of stalled out at 1.2 million a year. That’s not a bad place to be stalled as a solo doctor. But any way we want to account for that, thats a strong practice. However, the issue that I identified when I came in as a coach was that he didn’t have good systems in place in his practice. A lot of times felt like they were chasing their tale. So we put in 24 systems. I have got 24 systems that need to be in place in a practice, so over a period of time we put in these 24 systems. We added one more assistant. The only thing we added was one more assistant and we added one more day a week of hygiene. So I just want to put it into perspective. So the same team that was doing 1.2 is now one more full time assistant and one more day a week of hygiene. This practice now does OVER 2 million a year. This is the cool part, doctor would tell you that he has way less stress today at 2 million a year, then when the practice was at 1.2 because of the presence of these systems.

Reese Harper: And probably because he’s making some good money. Just kidding.

GaryTakacs: I think that doesn’t hurt.

Reese Harper: I think that is great advice, good insight.

GaryTakacs: May I provide a resource to your listeners as well Reese? I discovered this resource a few years ago and absolutely love them: ADOM.

Reese Harper: Heather Colicchio

GaryTakacs: American association of dental managers. I discovered them a few years ago. I love that organization. Doctors invest in your, and when it says association of dental office managers, it really is your administrative team members. It means anyone who works on the administrative side, business side, or front desk side. Provide your team members with a membership there. Go to their annual course and conference. You can take team members that maybe have an interest in expanding their role and skill set and develop that through the association of dental office managers.

Reese Harper: Heather is great. I think we released an episode with her a couple of weeks ago.

GaryTakacs: Heather is one of my favorite people in dentistry. She is an individual that has a passion for dentistry, she is brilliant, and she has surrounded herself with a fantastic team.

Reese Harper: Totally. Well anyone who is listening to this, I gave out a code last week it is DA 2016 they have a little bit of a subscription discount for our listeners that they were willing to apply.

GaryTakacs: That is very kind.

Reese Harper: I love those guys, so the last question I want to ask you before we part ways here is any last piece of advice that you would want to leave with our listeners? Any last Gary Takicsism?

GaryTakacs: Well, ya know, thanks for that opportunity. Pardon my enthusiasm man, I love our profession. This is a fantastic time to be in our profession. I learned this in 1980 from one of my mentors Dr. Omar Reed. Omar taught me that dentistry is a people’s game. Ya you have to be proficient but what separates a decent practice from a world class practice is your ability to connect and develop relationships with your patients. Along those lines, the best way to do that is to develop an extremely positive practice culture among your team. Doctors whether you have thought about this or not, you are developing a culture in your practice. You are developing a culture.

Reese Harper: Ya.

GaryTakacs: Some of you may realize you have never even thought about that word. Well, you are.

Reese Harper: It happens.

GaryTakacs: It just happens, it’s not intentional. I want to encourage you to develop a culture, with your own stamp on it, that is one of abundance. Abundance meaning that you know we really believe that we put heart and soul into this we can all be successful so your success doesn’t have to come at the expense of someone else. Create a culture of safety in your practice for your team members. Too many practices have a management style that accidentally is management by a stick instead of by a carrot. I have a plaque in my office, it is a sarcastic plaque, I want to emphasize that. I found it in one of my client offices a couple of years ago, he is a sarcastic guy in a good way and it said, this was back in the team room. By the way, I use the word team, Staff is an infection. I guess you spell that different, but anyway, it was back in his team room. It read, the beatings will stop when morale improves. And to know this doc, you would have to understand how sarcastic it was because he is probably one of the most generous, kind, men you’ve ever met. But anyways, how many practices, doctors, are you accidentally leading and managing with a baseball bat instead of a carrot? By the way, the carrot that most of your teammates want, the one thing that they want more than anything else? Is your recognition and appreciation. They want you at the end of the day to come up to them and give them a genuine thank you. Let me help you with this, it is one thing to say, “Reese good job today man, thanks.” That feels good right? But what if I was to say, “Hey Reese, I want to take a minute to say thanks. I noticed at about 2:00 this afternoon you had that patience in your chair and she had countless questions that were never going to end and I looked in and thought Oh my goodness you were handling that so well. You were patient and kind. You were totally attentive. You were present with her. I just want to take a minute and say thanks man”.

Reese Harper: It is concrete. It’s something you really noticed, it was genuine right?

GaryTakacs: So this is my closing comment. Fantastic time to be in our profession, develop the people side of your practice, and develop a culture among you and your team members that is one of a positive, contribution, love and compassion for your patients, one of achievement. Where you can do it! We can be better tomorrow than we are today. I believe if you do those things the world is your oyster.

Reese Harper: Thank you so much, that was a really insightful interview, really appreciate your time coming up here to the studio and catching some fresh mountain air.

GaryTakacs: My pleasure to be here, Reese! And Thanks for all that you do, you are doing so many things. I love directing clients to you on the financial side, and helping clients have a financial game plan. It’s my belief that every dentist has the ability to develop financial independence by themselves.

Reese Harper: We appreciate all you do in the industry, definitely have one of the best attitudes and optimistic perspectives. We are thankful for that. All right everybody, you heard it here. Dentist Money Show with Gary Takacs, we will catch you all next week!

Practice Management

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