What Would Happen if You Lost Your Office Manager? – Episode 119

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Is your office manager irreplaceable? Or do you have systems in place to stay afloat if you had to find someone new? In this Dentist Money™ interview, Reese welcomes Kiera Dent, founder of Dental Masters and practice consultant for dentists across the country. Kiera covers issues related to embezzlement risk, office manager dependency, daily reporting, and setting budgets for staff. She also shares three simple things you can do to boost production immediately.

Show notes:

Podcast Transcript:

Reese Harper: Hey, Dentist Money listeners, it’s Reese Harper here, and thanks for joining us again. I’m excited to share today’s interview with you. It’s with Kiera Dent. She’s the founder of Dental Masters, and an expert in practice management. She worked as a dental assistant for several years, and then managed the front office for a couple of practices, before becoming a partner in several practices of her own.
she now consults with dentists all over the country to help them run better practices. In this interview, we talk about the factors that lead to embezzlement, how to set expectations with your front office manager, the numbers you should be looking for on a daily basis. And, some of the easiest things you can implement, to boost production right away.
Our conversation was a lot of fun, and I can promise you’ll get some valuable advice in this one. Be sure to take notes when she talks about setting budgets, and which reports you should be looking at. If you haven’t already, be sure to check out our new website at denistadvisors.com. We’ve put together an educational library, with videos, podcasts, and articles for dentists on a variety of financial topics. While you’re on our site you can book a free consultation with one of our advisors. You’ll find a time on our calendar that works for you, and then we’ll have a call to assess your situation, and show you how you can take control of your financial future.
If it’s more convenient for you, just give us a call at 833-DDS-Plan. And, don’t forget to send us your financial questions for the podcast. You can go to the podcast tab at dentistadvisors.com, and you’ll see a button that says, “Submit Question to Podcast.” We’ve made it easy to fill out a quick form, and then we do our best to answer your question on an upcoming show. Thanks again for listening, and enjoy the interview with Kiera Dent.

Speaker: Consult an advisor or conduct your own due diligence when making financial decisions. General principles discussed during this program do not constitute personal advice. This program is furnished by Dentist Advisor, a registered investment advisor.
This is Dentist Money. Now, here is your host Reese Harper.

Reese Harper: Welcome to the Dentist Money Show, where we help dentists make smart financial decisions. I’m your host Reese Harper, here with Kiera Dent, founder of Dental Masters. Kiera, I’m really excited to have you, and welcome to the show.

Kiera Dent: Thanks. How are you today?

Reese Harper: Good. Where are you at today? Am I calling you from home, or are you on the road?

Kiera Dent: I’m on the road. I’m in Phoenix right now.

Reese Harper: Okay.

Kiera Dent: Yeah.

Reese Harper: Phoenix is not too bad of a place to be. Have you been in cold climates, here, recently?

Kiera Dent: Yeah. We live in Reno. So, yesterday when I flew out, it was actually snowing. And then, jumped right into 85 degrees. It was fantastic.

Reese Harper: That’s perfect, yeah. This is a great time to be down in Arizona. It’s beautiful right now.

Kiera Dent: It really is.

Reese Harper: I think I just wanna let everyone know that you’ll be speaking at the Dental Success summit, coming up in April. You recently created a new course and a membership site for dental office managers, is that right?

Kiera Dent: That is right, yep. Mark Costas and us are doing some cool magic out there in the world.

Reese Harper: Cool. Well, I think our conversation today … We’re gonna help dentists understand how they can work with their office managers to improve profitability a little bit more. It will be a little bit of a financial angle on office management. Hopefully, I think we’ve got a really good interview planned, and I’m really excited about it.
So, let’s start by having you give people your background. You started a company called Dental Placement Pros, before you started focusing on the Dental Masters program. What’s been the evolution of this in your background?

Kiera Dent: Yeah, awesome. Thank you. So, back in high school I did dental assisting, and then worked in the dental office for several years. When my husband went to pharmacy school at Midwestern, in Phoenix, I worked at the dental college there, for three years. Then, upon graduation, I actually partnered with a dental student, and her and I started some amazing practices in Colorado. Had some really, really, really solid success.
Nine months after we bought our first practice, we bought our second practice. There’s now six practices, two and a half years out. So, it was a really, really fantastic moved. Once my husband finished his residency, I decided to start doing consulting, and that’s when Mark Costas and I joined forces together, and it’s been great. With the dental success institute I’ve been able to learn a lot, and to see a lot of practices.
Last year alone I went into 80 different offices, consulting. It was fantastic because I learned so much. And then, Dr. Smith, the Dean of Midwestern, had approached me last year as well, and said, “You know, Kiera, we need a place where our students can go to find jobs.” And that’s how Dental Placement Pros evolved.
So, we kind of, started to place people. Dental Placement Pros has taken on so many, different faces. I realize hiring for associates in rural areas can be really, really, really hard.

Reese Harper: Interesting.

Kiera Dent: But, it’s also so satisfying. So, we kind of turned that one into a little bit different of a model. But, we’re still actively helping students find great jobs in private practices. Then, the evolution of Dental Masters came about from, really, the consulting. From my own experience as an office manager, and then working with Dental Placement Pros.
When we were hiring, we realized that office management was something that … People were always asking, “Kiera do you have an onboarding for office managers? Hey, Kiera, do you have anything I can put my office manager in? Kiera, I literally don’t know what my office manager even should be doing.” And then, office managers, every time I’d go into an office to coach, the bulk of time was front office.

Reese Harper: Yeah.

Kiera Dent: When I was an office manager … I was a dental assistant for several years, and then I worked for an office. And then, when I bought the practice with my friend in Colorado, I started managing, and I was a business owner, all in one thing. I remember as an office manager, and as a business owner, I was like, I don’t even know that I used to do half these things. Like, “Oh, yeah. Regular meetings. Oh, KPIs.” I didn’t even know what credentialing was. I didn’t think that was a big deal, at all.
There’s no training out there. So, Dental Masters, we decided to create it for a two fold mission. One is to help office managers actually know what they should do. To give them training, and to bring all of the office managers-

Reese Harper: Give them background. Okay.

Kiera Dent: Yeah. Also, to create a community, because I remember so often … Just like dentists. Dentists want to have a community where they can ask questions. Like, “Hey, I don’t know about this implant.” Or, podcast with you of financial planning, and things. We’re always looking for information from peers that really are experts in their field. Well, revert that over to our office managers. If we could give them a community, where we pull all these brilliant office managers together, instead of having them in their isolated offices, we can make way more powerful office managers.
So, that was one mission. But, the other mission … Because I worked at Midwestern. I realized because I get students, that have graduated that call me. So many of them don’t know front office. That is just this hard area, and I’ve seen in the last year … I’ve seen six offices that have been embezzled from. It’s just from a lack of knowledge. They don’t even know what reports to run. They have no idea what’s going on up front.
So, I was like, “Okay, I want to make something that as an office managers is a fantastic information base. But, then, I’m also creating one for doctors specifically, so you’re not handcuffed to your office manager.” So often, doctors get into these financial binds. There was an office that I worked with, and they were paying their office manager … I think her salary was $120,000 a year, but she wasn’t doing anything. And yet, they were handcuffed and shackled to her, because they felt like if they got rid of her, their whole practice would fail, because they didn’t know how to do it.

Reese Harper: It’s sad, yeah, how common that is. I’ve seen that, quite often, where you kind of get into a point where you feel like you’ve got this person … Had that person, out of curiosity. Had they been with these doctors only themselves? Or, was she there, or he there, prior to … Is it a multi generation office manager, or was it just one generation of dental owners that had worked with this person?

Kiera Dent: It was a multi generational. So, she had been there prior, then they bought it, and she stayed.

Reese Harper: Yeah, exactly.

Kiera Dent: It happens all the time.

Reese Harper: And that’s usually when it happens, right?

Kiera Dent: Yep.

Reese Harper: There’s this person that’s been there for so long that they have all the keys to the kingdom, and it’s kind of a black hole of knowledge, and you don’t really know what they do. But, it’s scary to think about what life might be like. I’ve had clients that have been in that situation, almost feeling held hostage for two to three years, in some cases, right.

Kiera Dent: Absolutely.

Reese Harper: I’ll meet them and I’ll be like, “Wow.” There’s not a right or wrong compensation number for a person. Some people are well worth a six figure income, as a general manager.

Kiera Dent: Absolutely.

Reese Harper: And then, there’s people … That might not be the case for a smaller practice, right. That only produces $600,000 a year. And so, you see this range of inefficiency with both, what people are compensated, but also more importantly, the lack of knowledge around their role. That’s an interesting thing you’re highlighting, because I’ve seen that, I don’t know, a half dozen times in the last five years.

Kiera Dent: It’s just, it’s one of those things where I felt like if we could educate dentists, and office manager, in a two fold mission. No dentist, do I want them doing this work. Absolutely not. But, I just had another client and his entire practice is falling apart because he doesn’t know how to do anything front office, and his office manager walked out on him.
Another client, same scenario. So then, they quickly hire another office manager thinking that this person’s their fairy godmother that can save them when they’re plummeting. And the reality is, in those moments, if you’re not wise, and you don’t know what’s going on … I mean this one office … Both of these offices that I’m giving examples for, they’ve both hired in new people to come and save their practices because they didn’t know how to do simple things. That was no fault of their own. They’re doing the dentistry in the back.
But, both of them hired, and then both of those office managers actually embezzled from both of them. They didn’t even know. So, when they’re in the bottom of the bottom, and then they bring in these people, and they get embezzled from again. So, it’s just one of those things of, if dentists could learn and just have a quick … The goal is to have it be a three week course, and then to do some CE where you literally learn how to submit a claim, how to run reports, what to look for. And, how to schedule.
So, you at least have an awareness of what to do front office wise. And then, at the same time, our other course, that’s specifically for office managers for their community … We’re teaching them the same types of things without … I thought about putting the embezzlement piece in office management. And then I was like, “Actually, I’m gonna save that just for doctors.” Because, then the doctors have, at least a leg up on their OMs to be sneaky, and not teach the OMs how to embezzle.
But, I really want them to then have so many tools that they could be empowered with, and I believe that that is the key to financial freedom for a dentist. You can then coach your office manager up. You can train them. You can utilize them to their maximum capacity, and potential. But, at the same time, as a dentist you are no longer tied to having to keep that OM there. Or, to not know what they’re doing, or to be able to run reports and make sure that everything is actually operating the way that it should be in a practice.

Reese Harper: Yeah, I think you’re really right on that. The right system and process, and transparency around the role allows two things to happen, in my opinion. It allows that to be more of a role, and not a person. Which, is really important. That there can be some … If you have turnover in that position, you’re not left holding the bag.

Kiera Dent: Right.

Reese Harper: But, it also takes pressure away from you, from that … I’m familiar with several pretty intense embezzlement cases over the last few years.

Kiera Dent: I’m sure you are.

Reese Harper: I’m pretty confident that most people don’t go into the OM job assuming that they are going to embezzle from the doctor. It’s a slow process.

Kiera Dent: Absolutely.

Reese Harper: The lack of systems, and the lack of accountability and transparency promotes … It’s just like if you sit around and you’re in an office every day, and there was … Let’s just say you’re a really healthy person and you love to run and exercise. But, you work in a donut shop and there’s donuts being placed all around you, all day long. See, I would end up eating those donuts eventually, and I would cave, and probably not be in as good of shape anymore.

Kiera Dent: Right.

Reese Harper: I’m trying to use the most benign analogy I can.

Kiera Dent: It’s perfect.

Reese Harper: I didn’t wanna use drugs, okay.

Kiera Dent: We gotta have it as an even playing field. We all can relate to donuts.

Reese Harper: We all can relate to donuts, okay. I just think that ultimately, it’s difficult to be in an environment where you feel like, you might not be compensated fairly. But then, you see all the cash that a doctor’s making, and you see all the work that you’re doing, and you start justifying that over time. I’m not saying it’s right, I’m just saying, if you’re not careful, you can create that environment unknowingly, as a doctor, just by having a lack of systems in transparency.

Kiera Dent: Definitely. When I see these offices where they get embezzled from, it’s simple things. I mean, there was one case in particular that just stands out in my mind of, they … Like you said, it’s not the first day they come in and they swipe you for 10 grand. It was, “Oh, I couldn’t afford my bills, and there’s the cash that was deposited today. That’s an easy way, and we can figure out how to do the write-offs.” Then after they didn’t get caught doing that, that becomes okay, and they can justify and rationalize.
And then, it’s “Well, we can do the insurance checks. And then, we can do refunds on our credit card.” And, it just keeps going, and then, before long you look back and you’re like, “Why am I not making any money?” And you look back, and you’re like, “How did I miss this? This has been going on for so much time, and I didn’t even see it.”

Reese Harper: Yeah.

Kiera Dent: So, I think that that was more … You’re right. It doesn’t start off, typically, as the massive amounts. It’s that small little trickle, and then it just gets into a big mess.

Reese Harper: I’ve been surprised at how many people, looking back, see six figures worth of embezzlement that they just would’ve never thought happened. I just saw a case where it was north of $400,000. And it’s just like, how does that happen over a period of years, and not get missed? It’s just sad.

Kiera Dent: And then the dentists feel like … They beat themselves up of, “What could I have done? Why didn’t I notice this? What was wrong with me? How could I have let this happen?” The reality is, you can’t falter yourself for things that you don’t even know you don’t know. I think that that’s the awareness that so many dentists, they lack.
I’m the same way. When I first started my businesses, I was so naïve. I had no clue what I was doing. My first partnership I just like, “Yeah, absolutely. That sounds like the best deal of my life.” I had no clue what I didn’t know. So, it’s a learning and evolvement process, but my thoughts are, if we can educate and help people before. I don’t want to have to learn, always, by the trial of those hardships. It’s like, why not just give you the education and the know how now, and then you can just continue on and not have to have that fear. You can keep progressing and know.
But, even just knowing some of the front office things … Dentists that know it, can exponentially grow their practices, because they actually know what can be done front office wise.

Reese Harper: Yeah. Well, tell me a little bit about budgets. Since we’re getting into financials. How can dentists hold their team members accountable to budgets? Is that a thing that they should even be thinking about?

Kiera Dent: Absolutely. I am a huge believer. And, I think because … I am a weird person, in the sense that I’ve come from being a dental assistant, being an employee, to then, flipping to the other side of being an owner. So, I see both sides of it very clearly. My mind was blown when I became an owner, and realized, “Oh, I did not realize how many expenses a dental office actually had.” I was a very naïve employee, which I think a lot of people are.
I think that education is paramount. If your team knows, I think that they can help you grow so much more, than if they don’t. And, some dentists get nervous. They feel like, “Well, I don’t want my team to know certain numbers, because then they’re gonna think I’m greedy.” I’m like, “The reality is, whatever your comfortable with. Do you think you’re greedy? Because, if you do, yeah your team is gonna feel that way.” Do you think you’re being honest and upright? Then great, your team will feel that way.
So, I feel like budgets, some of the easiest ways to do it are your supplies and your labs, and your office expenses. I feel like, the numbers I like for your dental supplies should be 5%. For labs, it should be 9%. And, for office supplies, that’s one of those weird numbers. You can decide. 2% is my typical number I like. And that’s off of your collections. So, then every month just look at what your collections were.
So, for example, we’re in March. Let’s say in February we collected $100,000. Then, for March, you give all your leads, that are over each of those orders, their budget. And, I love Excel spreadsheets. I think they’re great, and I think they’re super easy to use. Some of you are gonna be super savvy, and wanna make something way cooler than Excel. And, by all means send it on over, because it will just make everyone else better.
But, I would just then give the person who orders an Excel spreadsheet with the 5,000, and then every single order that they put in, it will deduct throughout the month. So, they can see how much money they have to order. And, in doing that, your team is then so much more aware of how much they can actually spend. Because, I used to order, and I will not lie to any of you, I had no clue what I was ordering. I would just go, and I wanted to make my life as an assistant easy, so I would order in mass quantities. I loved my rep, so if they told me that this was a great deal, I believed them, I didn’t do any research.
I think a lot of assistants, not all of them. They’re some that are gonna be super savvy and get the best deal. For me, that was not my … I didn’t care. This sounds terrible, but being an assistant … I didn’t intentionally do it. I really liked my doctor. It was the ease and the efficiency because I knew I needed to get back and be an assistant.
being on the owner’s side, I was like, “You guys better look for the best deals. I expect you, and hold you accountable.” So, then if you just give them the budget, then they’re able to then break it down. They’re gonna make smarter choices. Maybe they’re not going to order in bulk, because the reality is, we don’t really need that much. They’re gonna be much more cautious, and they’ll get the whole team and say, “Guys, we only have $1,000 left for the month to order.”
I was a terrible assistant sometimes, when I think about it.

Reese Harper: You were Kiera. You really were a terrible assistant.

Kiera Dent: No. The things that I confess now, that I did. We’d have lidocaine on the county, and it was not used. A normal person would just wipe it down, and we could reuse it. It had not been used. Same thing with composite carps. I was efficient. I would just swipe them all, toss them, and go on.

Reese Harper: Yeah.

Kiera Dent: But, now, on the side of owner, I was like, “Oh, my goodness. You were just tossing money, when you didn’t need to.”

Reese Harper: Yeah, that’s interesting.

Kiera Dent: It wasn’t that I was trying to be a bad assistant, but my focus was being efficient. My focus was I’m gonna get my rooms clean the quickest way possible. I’m gonna get my patients back. So, I think giving your team … Like we talked about, having your team be aware of those budgets, and those numbers, it just changes their mindset. Because, now they’ll think of how to be more creative.
It’s like your own personal life. If you know you only have $25 left in the month, and you have to buy food and groceries, you’re going to be strategic in how you buy.

Reese Harper: Then, you’re in trouble. You’re in trouble.

Kiera Dent: No, you get real creative.

Reese Harper: If you’re me. Yeah, okay.

Kiera Dent: In pharmacy school my husband and I ate Top Ramen. You get creative.

Reese Harper: Yeah.

Kiera Dent: You’re not gonna go out to dinner because you only have-

Reese Harper: If you had to.

Kiera Dent: Yeah. And, same thing with your office. That doesn’t mean scrimp on your supplies, and do poor dentistry. It just means having that awareness, and having them help you out, they will make smarter decisions that will benefit you in your practice. There’s nothing wrong with giving people boundaries and limits. People, typically, want to know what’s expected of them, so they can achieve that. so, you giving them a budget, you giving them their expectations, they then are able to achieve those, and everybody in the office feels better about it.

Reese Harper: Okay. Let’s take this example then. I’m just trying to understand this. I’ve got my March collections, and I hit 90 grand. I’m like … Crap I gave myself I tough number here. So, 5% I would say $4500. I’ve got $4,500 at 5%, that’s my forward looking … For the next month, that’s what you’re setting as my goal, because of my previous month’s collections, right?

Kiera Dent: Correct.

Reese Harper: Okay. Did you say 9% for lab, right? I’ve got an $8100 lab bill. How’s my office manager have anything to do with that? What’s her role relative to the lab?

Kiera Dent: This is fantastic. Your office manager doesn’t really do much with these, except for just look over these reports, and have the team members report to your office manager throughout the month of where they are, so you’ve got your check in point.

Reese Harper: How many people do you think actually do this? This is surprising. I don’t think this is happening very often, ever.

Kiera Dent: It’s not. It’s the offices that are running at 50 to 65% overhead, are doing this. The ones that have their overhead down … My thoughts are, this is so easy to give your team a budget and then to just have them account to your office manager periodically, and tell your OM, “Hey, we need to have 5%, 9%, and 2.5%. Those are the budgets we have. I need you to make sure that we hit those numbers monthly. Fantastic.” OM goes out, they then delegate out to team members. “Hey, Sarah, you order. Here’s the budget for the month. Hey, Sally, you’re over all of our lab cases, and Amanda, you’re ordering all of our front office. These are your budgets for the month. I need you to report to me mid month, and end of month, and we can not go over budget. Fantastic.”

Reese Harper: Okay.

Kiera Dent: If you did that, and your team stopped over ordering, which is usually a really, really, really big deal … That’s going to help your overhead exponentially, and it’s not that hard to implement. But, so many offices don’t do this because they think it’s too hard. They think it’s, “How do I even start this?” They make it into a giant project, when I’m like, “No. Get an Excel spreadsheet. Do your five, nine, two and a half, and just start with those numbers, and then keep building upon it.

Reese Harper: Type it in. Easy. I think this probably applies to some KPIs, too. Some important numbers to track that have to do with the office itself. I bet there’s a principle that can tie over here. Tell me a little bit about daily, weekly, monthly, quarterly, maybe annual type of reports that you feel like people should look at, and what kind of numbers you’re really getting people to acknowledge.

Kiera Dent: Yeah, okay. I feel like, I’m huge on seeing your numbers every single day. So, when I go into an office, I feel like you tracking your production and collection every single day, and you see it. My model is I like the thermometers. I take you back to elementary school. You’re trying to get up to the top, and you have your whole team doing it. That visual, every single day, looking at you, you naturally will just produce more.
So, I’m big on production and collection. I’m not crazy about monthly production and collection. Like, trying to get your team to hit it monthly, because I feel like that’s such a far away goal that offices tend to miss it. It’s like, we coast for three weeks, and then last week of the month, we all panic mode, and we try and throw in as much treatment to hit our goal, and we tend to miss it constantly. Whereas, I’m more, I like you to track your numbers and hit goals based on a weekly number, because that’s more achievable, and it’s more attainable, and it keeps your team better engaged.
So, those are two big things that I really like offices to track. As far as just a quick overview, every single day, most of my offices are tracking production and collection. They’re tracking their new patients. They’re tracking their treatment case acceptance. They’re tracking their re appointment percentages, and they’re tracking their reviews. I like them looking at their reviews online as well.
You can track attrition. You can track so many things. I have team members engaged, and I have them write in their morning huddles every single day, and we update those numbers every single day. Because, I firmly believe that what you focus on is what you achieve. So, if you’re actively engaged, everybody’s looking at it, you know your goals daily, you’re much more likely to achieve them. As opposed to tucking them under the drawer, and then at the end of the month, you’re like, “Dang it. We missed it again.”
If I wanna reach a goal, I repeat it to myself every single day, and I’m much more likely to hit than if I’m missing it. So, those are really, really, really, my big … Just grab a white board, and write these things every day, and I am not kidding you, you will probably see at least a 10% increase in your practice. In your first month doing it. I have seen offices that have done 50% increases, literally by tracking everyday.
So, it’s something that is such an easy thing to throw in.

Reese Harper: Okay. So, you like goals on a weekly basis for production and collections. Is that what you said the first two were?

Kiera Dent: Mm-hmm (affirmative).

Reese Harper: Then you said a daily basis, re appointment percentage, case acceptance percentage, new patients, I think it was reviews, was your other one. Are those the four that you listed?

Kiera Dent: Yes.

Reese Harper: Okay, cool.

Kiera Dent: Yeah.

Reese Harper: So, those are the daily accountability numbers that you think are helpful to track?

Kiera Dent: And the reason why is because those are the numbers that are going to have the biggest impact on your practice. So, if you pay attention to all the numbers I listed off, those ones are the ones that your team can have the most impact, to influence, to be able increase your practice.

Reese Harper: Yeah.

Kiera Dent: And then, also those are really good indicators to see where your team’s lacking so that when you do your weekly or monthly team meetings, you can then look at your key indicators at a snapshot every single day and week, and see, “Okay, our production’s really low.” Or, “Our case acceptance is really low.” Those two correlate. We need to work on our case acceptance. Or, we need to work on our new patients. So, it really just gives you a good road map of what you need to work on. And it’s not hard to do.

Reese Harper: That’s great.

Kiera Dent: And, your office manager can help you with that. Those can be your morning huddle reports that you do, and you really can grow your practice exponentially watching those. To answer your question about quarterly and yearly, I like to look at my quarter, and just make sure that we’re on track for where we wanna be for the year. So, at the beginning of every year you need to setting your goals of what you’d like.
I think it’s important to let your office know that, “We are an office that’s in growth mode. We will always be increasing our goals, because if we’re not … And, that doesn’t mean that we’re putting it out of range so you never get bonuses.” But, I think they need to know that you’re constantly going to be raising those because economies raise, and expenses raise, and if we’re not actively in growth mode, we’re in decline mode.
But, setting that expectation for your team at the beginning, is going to be paramount, because otherwise they’re just gonna think your this rude boss, that’s super greedy and wants to get rich because you just keep increasing the numbers. When, the reality is, your practice needs to keep growing, and if they understand that, they’ll keep helping your grow. As you grow, it benefits the team as well.

Reese Harper: Yeah. That’s great advice. I like that. I’m gonna hit one last question before we let you go. Some practice management solutions that you’ve probably implemented with doctors have helped, and some might’ve not been as efficient. I’m just curious, generally speaking, what are some of the practice management solutions that you feel like you’ve implemented that have boosted production?

Kiera Dent: One of the biggest things that I’m all about, is I want people if they meet me, or they listen to podcasts, to be able to take something today that you could implement. So, we’ve talk about quite a few action items. So, here’s just a few more that I’ll throw out that I’m literally … I’m not kidding. My one office, he was doing $70,000 in the first month I worked with him. He brought them up to $130,000 by doing these three simple things.
So, these things work. Route slips. I’m huge on route slips. Anyone who knows me, knows I will shout from the rooftops to use a route slip. The reason why is because a route slip just produces so much information if you use it correctly. And, so if you use those, and you look … The reason I like them is because they help each department. They have a front office piece. They have a back office piece, and they have a hygiene piece that can all work together for one patient. I call this the VIP patient care, because you maximize that patient, which is a benefit for the patient, and it’s a benefit for the practice.
So, if you look they have the balance. So, if there’s ever balance, because i watch offices consistently. But, patients leave the office without paying their balances. So, if on your route slip you highlight that if they have a balance. I highlight these, because I feel like on a route slip there’s a lot of words, and I just like people’s eyes to go to the main points that I want them to see. So, everyday I do have somebody in the front office highlight the route slips. Yep, that takes 30 minutes, and I think those 30 minutes convert into, usually, thousands of dollars for your practice, and for that patient.
So, you highlight if they have a balance. You also look to see if that patient and their family members have been scheduled for cleanings. That is such an easy way to boost your hygiene department, and you just use it patient by patient by patient. And then, the next thing is, plus treatment. So often, patients, when they’re scheduling their appointments, they just wanna do maybe one or two fillings. But, when they come into the office, and it’s the reality that they’re going to get a shot, and they’re going to numb, they are usually a lot more likely to do all the fillings in that quadrant as opposed to just two. So, it’s a great way for your back office to look to see what additional items they have, and then the patients taking time off work, they usually can get them to do additional treatment, which is a benefit to the patient, and a benefit to the practice, and a benefit to the doctor’s time. Because, instead of bringing them back three times, we can just get it done in one visit.
That’s what I use a route slip for. I also think it’s a great communicator from front office to back office, and all the way around, so you are a more cohesive office. I always have offices write the next visit at the bottom of a route slip. Of what the treatment is, how much time, and also making sure they’re always scheduled for their cleaning appointment before they leave. Having those things. That route slip, just that little snippet will grow your practice if you’re not doing it. It’s magical.

Reese Harper: That’s crazy good advice, yeah. That is crazy good advice.

Kiera Dent: That’s the one. I think route slips are the biggest things. And then, the next one would be morning huddles. If you do your morning huddle correctly. We talked about tracking and how to use your whiteboard. But, I have every team member come prepared with different areas, so hygienist don’t chart prep, and they’ll look for plush treatment. Family members that need the cleanings. Utilizing the right route slips. Back office is the same thing. Front office discusses the numbers.
I will tell you, I hear this all the time. Reese, you probably know as well as I do. When offices just rattle off numbers like, “Okay, we’re at 45,000 and we need to get to 65,000, and we need 65,000 more. Yesterday we did 2,500. We need to make sure we call Sister Smith, because she’s having a problem.” Whatever you do. I ask teams when office managers do this, and they just rattle these numbers off, nobody knows what you just said. They don’t remember. “Okay, we’re at 45,000, but we need 65,000.” They don’t internalize that, usually.
If you have the visual, and you talk these numbers into your morning huddle, and you make it super effective, your practice, I promise you it will grow. So, have your morning huddles. Make it a priority. If your starting 15 minutes before, don’t let people lollygag and come in late. Like, no. It’s set in stone. We are starting because then it becomes a priority and people are focused on it.
So, those are just some quick tips.

Reese Harper: That’s cool.

Kiera Dent: That hopefully they can take and implement, and really see a huge financial increase in their practices.

Reese Harper: That’s awesome advice. Okay. Every time I finish up here, I like to do a lightning round, and the lightning round is short. You only get one minute to answer a question. That’s all you get. It’s just a question that I throw out there, and then you get one minute. Which is gonna be hard for both, you and me. I can barely ask a question in a minute, so it’s hard for me to get … I talk so much, and I can tell you’re a talker, so this will be a fun experiment.
All right. So, first lightning round question … And, if you don’t really have an opinion about this, that’s fine. I, obviously, haven’t given you any of these in advance, so it’s totally from the hip, which I think is interesting to hear.

Kiera Dent: Okay.

Reese Harper: So, tell me an opinion. Do I use a lab, or do I do Cerak and do things internally?

Kiera Dent: Great question. I think labs can do better for aesthetic, but if you’re looking from a financial perspective, my first practice that we took from $500,000 to $2.4 million in nine months … One of the ways we were able to do that was with Serak. And E40. I think that they can produce amazing results. We were able to cut our lab bill from $10,000 down to $2,000 a month. So, the savings that you can do if you’re good and you’re trained on it, out of control amazing.
Also, if you’re bringing in associates, most of the schools are teaching the same day crowns, and you’re gonna be able to have an associate that can help you do it, even if you don’t know how to do it. So, I am a huge proponent of same day crowns. I think they can just grow your practice. They’re better patient care. As long as you do it well, but I really think the aesthetics and the materials that they’re using for E 40 and Cerak, and all the same day crowns, definitely a great, great thing, just because I’ve seen it work.

Reese Harper: Perfect. You’re right at one minute. That was awesome. Nice work.

Kiera Dent: Thanks.

Reese Harper: Okay. Second lightning round question is, the ideal front office HR setup. If you can describe that. I’ve got a practice, I’m collecting a million dollars, it’s just me, it’s one location. I might have an associate that I have working with me. We’re doing between a million, a million five. It’s just me and it’s maybe one associate, one location. How many people do I need at the front, and what do they do? Go.

Kiera Dent: Okay. So, you definitely need to have an office manager who is overseeing the entire practice. With the million I would recommend you at least have check in. A designated check in and check out. That check out should be a TC, not doing anything else. They should probably be outsourcing your insurance verification. You could also be outsourcing E Assist for your insurance claims. But, if not, bring in a third person up front. So, you’d have four front office, and that’s what they should be doing.
As far as HR. When you’re at that million point, I would be hiring an HR company that you can utilize for a lot of those things that your office manager can then help with.

Reese Harper: Okay, cool. Good answer. Okay, this one’s maybe a little bit outside your scope, but I thought I’d throw it out there anyway.

Kiera Dent: Okay.

Reese Harper: What about, does my location matter? And if so, do you have any opinions on location?

Kiera Dent: Location, as far as the profitability of the practice?

Reese Harper: Yeah, where my practice should be, if I could pick.

Kiera Dent: Okay. I’m so excited. This one, so many people say you need to search your demographics, and I think yes. That is true. But, I also have proven it otherwise. That if you have good systems, and you’re a good dentist with good reviews, you can do it. We were in downtown Denver, and we blew up our office. There’s another practice in the tri cities. Super, super saturated area, has blown up from a scratch practice.
So, I believe you can seriously have a successful practice anywhere you go. You just need to be smart with your numbers, smart with business, and the way that you outreach with your marketing dollar, and you will wildly be successful. If you want easier, go rural, but I think that you can do it anywhere.

Reese Harper: Okay, cool. Next lightning round question is, what’s the right way to compensate my office manager?

Kiera Dent: Oh, gosh. That’s just …

Reese Harper: Not a dollar amount, okay? You don’t have to say the dollar amount.

Kiera Dent: So, I will say, on average office managers do make around $50,000, is typically what they make as long as they’re doing it. I think having clear expectations, which we do have if you hit up our website. I’ve got an office manager job responsibility, so you can know what they should be doing. But, then do other things. You can bonus them if you want them to hit certain levels. I don’t think there’s any right scenario. But, don’t feel you have to constantly give them raises and bump them all the way up the ladder to keep them. Appreciation truly can go a lot longer ways than just compensation.

Reese Harper: Okay, that’s great. What benefits do I have to give my staff that really makes a difference? What kind of benefits should I give my staff?

Kiera Dent: The answer is you don’t have to give anything, because most dental offices don’t besides just free dentistry for them and their families. However, I did the hiring company, and I will say 50% of offices are offering healthcare and 401k. I think with millennial generations those are big things that people are looking for. So, I would say, if you’re going to definitely implement a 401k, or some type of retirement. Implement a bonus system if you can. If you’re sitting about 50 to 65% overhead, and also doing healthcare. Those tend to be bid ticket items that are attracting better team members.

Reese Harper: That’s cool. Good to hear that. Last question. If you had to give me … If I said, what is working to attract new patients from a marketing perspective, how do you answer that?

Kiera Dent: Oh man. I think it depends on the area, and that’s such a vague answer. I’m just gonna shoot it out there. Something that I feel works so well is utilizing your internal marketing, but offering membership plans. People hear my talk on [inaudible] with Jordan Comstock. Membership plans are like money and gold, and they attract new patients like crazy. I just think it’s a better benefit, and you don’t have to work with insurances as much. So, that works well.
Also, I just think using the patients you have. We so often look for outside new patients, but we forget about all the patients we have and you could be so much better if you’d use that. So, kinda two crummy answers on that, sorry. But, membership plans really do work.

Reese Harper: Its a hard one. You only had a minute. You only had a minute, so you did great.

Kiera Dent: I only had a minute, and I was like, “You want me to market across the US?” Membership plans. Membership plans is where I’m gonna stop.

Reese Harper: Okay, cool. I like that. Okay, well that was really fun. You did great in the lightning round.

Kiera Dent: I felt like I was on the Price is Right, or something. And it was like going for all the marbles.

Reese Harper: Yeah, yeah. Well you did a great job. So, Kiera, last question is did you make up your stage name?

Kiera Dent: Yeah.

Reese Harper: Did you make up a stage name in order to fit better in the dental industry? For those of you who don’t remember, her last name is Dent, and I kinda thought that was awfully convenient and something a song writer or actor might do, but rarely an entrepreneur changes their name. So, true or false, is it a stage name?

Kiera Dent: It’s not, and my husband’s not a dentist. I tried real hard to get him to be, but he’s not. No, but if you wanna know my stage name, in high school I decided I was gonna be a rapper. I wanted to rap with Eminem. I was gonna be Skittles and Eminem.

Reese Harper: Oh, there you go.

Kiera Dent: I can’t rap to save my life, so it was even funnier.

Reese Harper: I only know one other Dent, and it’s Harvey Dent from Batman.

Kiera Dent: I know, I know.

Reese Harper: He’s a dangerous criminal. And, he had some oral hygiene issues as I recall, at the end of one of the movies. Your names very easy to remember. I’m never gonna forget that. I’ve now cemented that in my brain.

Kiera Dent: It is funny, because people will all the time, write … I just got check the other day from a client and it says, Kiera Dental. People always think … My last name’s Dent, but they throw in Dental all the time.

Reese Harper: That’s funny. Yeah, you could probably cash checks either way.

Kiera Dent: We’re gonna try it out. We’ll see.

Reese Harper: All right Kiera. You did really great today. I really appreciate all your time, and all this great information. Dentists all over are gonna really enjoy this, and I’m excited to share it with them.

Kiera Dent: Thank you.

Reese Harper: Thanks for coming on. We’ll put all of your information, our show notes … Any final parting thoughts you’d like to leave with everyone before we go?

Kiera Dent: Yeah. Thank you for letting me be on it. I’m always humbled that … To be able to share with your audience that I know is something so valuable that you worked so hard. So, I just hope that when people here me, my goal in my life right now, mission is to just positively impact the world of dentistry in whatever way I can.
So, my parting thoughts are for everyone listening, we listen and we acquire so much information every single day. But, what really matters is what you actually do with that information. So, I’m gonna challenge everyone listening to take something from what we said today, and try it. I don’t care if it implodes on you. You are at least going to be trying something, and you’re gonna be progressing and you’re gonna be moving yourself forward. That is the way that you truly hit change and become the person that you wanna be.

Reese Harper: Great advice. Kiera, I really appreciate. You have a great temperament, and I can tell you really care a lot about people, and that means a lot to us and our audience. So, thank you so much. We look forward to having you back on soon.

Kiera Dent: Awesome. Thank you. See you at summit.

Reese Harper: Yeah. Excited to see you. See you in a few weeks.
All right. Special thanks to Kiera Dent. I thought she did a fantastic job, and I hope all of you will take her closing remarks to heart, and look for something you can do right away to make a difference. Sometimes it’s just a matter of getting out of your comfort zone a little bit. And don’t lose track of those budget percentages she gave us for supplies, labs, and office expenses. I always love it when people offer really practical suggestions like that, and Kiera did a great job.
We’ve put Kiera’s information in the show notes for those of you who might wanna reach out to her with more questions. Once again, if you’re ready to talk to an advisor about your financial goals, be sure to visit dentistadvisors.com, and click Book a Free Consultation. You’ll choose a time on our calendar, and we’ll have a call to assess your personal situation, and show you how we can help you get organized, and start tracking your financial performance. If it’s more convenient just give us a call, or text us at 833-DDS-Plan. Carry on.

Practice Management

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