Are You Investing in Your Practice’s Most Valuable Asset? – Episode 109

How would you rank the building blocks of a valuable practice? Are there certain assets within your business that carry more weight than others? In this episode of Dentist Money™ Reese welcomes Steven J Anderson, co-founder of Crown Council and the TOPS Institute. Steven describes the foundation of every great practice and the leadership qualities exemplified by the best owners. He also shares his view on the new standard of care in dentistry.
Show notes:
StevenJAnderson.com
TheCultureOfSuccessBook.com
TotalPatientService.com
DentalWarrantyCorp.com
NoMoreHygiene.com
SmilesForLIfe.org

Podcast Transcript:

Reese Harper: Hi, everybody, it’s Reese Harper. As always, thanks for listening to the Dentist Money Show. We’ve got another great show planned for you today, you’re about to hear a conversation I had with Steve Anderson who’s been in practice management for about 30 years. He co-founded the Crown Council, the Smiles for Life Foundation, and the Total Patient Service Institute, which most of you know as TOPS. And if that isn’t enough, he’s written five books and hundreds of articles. He’s got a great mind for management, especially as it relates to building a great culture. And in this interview, Steve and I talk about leadership, team culture, shifts in the dental industry, and the opportunities that are presenting themselves to dentists everywhere. We also talk about Steve’s vision for the new standard of care for patients. I also end with a lightning round of questions that were a lot of fun and I think you’ll learn a lot from this interview.

Reese Harper: Before we get started, I just wanted to remind you that the Dentist Money Show is brought to you by dentistadvisors.com. If you’re ready to schedule a free consultation, just go to our website at dentistadvisors.com and click the link at the top of the page. You’ll find a time on our calendar that fits your schedule and then we’ll have a call to learn more about your situation to show you how to make work optional at an earlier age. And lastly, we’ve received a lot of great listener questions over the past couple of months, we want to get more and we want to start answering your questions on air. You can leave a question or a comment on the page for this episode or you can send an email to reese@dentistadvisors.com, that’s R-E-E-S-E@dentistadvisors.com. We’d love to have you reach out with your specific financial questions. And don’t forget to check out the Dentist Money Show on YouTube where we’re now posting video of our productions. Thanks again for listening, we really appreciate it, and enjoy the show.

Speaker: Consult an advisor or conduct your own due diligence when making financial decisions. General principals discussed during this program do not constitute personal advice. This program is [inaudible] by Dentist Advisors, a registered investment advisor. This is Dentist Money, now here’s 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 a special guest today who many of you probably have heard of but we’re going to get an inside take on his story and some new perspective that a really accomplished, we’ll say an experienced mentor, coach, consultant, and entrepreneur, speaker in the dental industry has for us today. So Steve Anderson, I’d like to welcome Steve to the show. How you doing, Steve?

Steven Anderson: You got a … Very good, Reese, thanks for having me on today.

Reese Harper: Yeah, man. I don’t know, for people who don’t know you, how about you give them a little bit of background? Like I said in the intro, I mean, you’ve been a co-founder of Crown Council, you started the Total Patient Services, some people might know that as the TOPS institute, you’ve done a lot of things for dentistry, so give people a little bit of an idea of what you’ve done and how you got into the industry.

Steven Anderson: You got it. Well, been in dentistry for more years than I care to admit, almost three decades now, and I am not a dentist, I just play one on TV. And originally our story goes way back when we originally started, we had a business education firm where we worked with all kinds of businesses all over the country, as varied as large hotel chains from Marriott to Hyatt to Hilton to law firms and CPA firms to large broadcast companies. And we had a dentist that stumbled across what we were doing due to a referral from one of his patients, he loved continued education and he showed up to one of our events and just ate it up and we couldn’t figure out what a dentist was doing there to begin with. And he kind of apologized for being there as like, “I’m a dentist,” and everybody looked at him like, “What’s a dentist doing in a business course?” And in fact, he kind of gave himself a way out, he said, “You know, I’m just going to stay here for half a day and then I’ll be on my way.” Well, he stayed for three days and ate it up and then put a group of his friends together and we went and worked with them a little bit.

Steven Anderson: And then things just started to snowball and dentists just started showing up. And we couldn’t really understand what the attraction was originally until we went in [inaudible] and listened to what was going on and observed it and then it all became very clear what the attraction was. And what it was originally is we’ve got a system that has been developed over many, many years that really makes it easy in the dental environment to present comprehensive care to patients in a way that makes it easy for them to say yes. And that was the original attraction, we didn’t understand the connection in dentistry specifically but there was this huge application.

Steven Anderson: And that eventually led to the beginning of what those that have been in dentistry for a long time will remember as dental bootcamp and my late partner, Walter [Haley 00:05:29], and I were business partners in that venture for over 15 years until he passed away about 14 years ago. And so we worked with dental practices all over the country. One of the most popular requests that we got as we got into that was as the dentists bought into the whole philosophy and started using it and seeing how successful it was, they wanted a place where they could continue to affiliate and exchange ideas and kind of grow this whole philosophy and that’s what became really the origin of the Crown Council, which is one of the largest organizations of its type of some of the top practices all over the world that are committed to creating a culture of success in their practice.

Steven Anderson: And out of that sprang what has become the largest charitable campaign in dentistry called Smiles for Life. We just hit our $40 millionth in money raised for children’s charities all over the world, which has just been amazing to us. I wish I could take credit for thinking up any of this, but I can’t. It was all due to just great people and great teams and great ideas. About 14 years ago we had the opportunity to kind of reinvent ourselves on the education, on the consult side and that led to the birth of what today we call the Total Patient Service Institute, which is very focused on helping dental teams not only provide great service but do it in a way that helps patients really accept comprehensive [inaudible] which is something that we’ll talk about today because there’s a bigger opportunity to do that today than ever before.

Reese Harper: Does that have to do with … When you talk about the culture of success, is that what you’re talking about is how to … It’s part treatment presentation, it’s part helping educate patients, but it’s also part of your human capital strategy and the culture of your practice overall, right?

Steven Anderson: Yeah. When you really drill down into it, culture really is the combination of your values, beliefs, and systems that you put in place to execute and really deliver on what you believe in the most. And so it’s really the whole, in a sense it’s really the whole feel of the practice. And what patients buy, Reese, when they go into a practice, is they buy the people in it, they buy the practitioners, and they buy the culture. They aren’t a judge of care quality, of care, I wish they were.

Steven Anderson: One of my late mentors, Dr. W. Edwards [inaudible] said that he asked the question, he goes, “What is great quality dentistry?” And he said it’s a question that will never be answered because dentists by and large don’t allow themselves to be evaluated much and the patient doesn’t find out for years whether the job was a quality job or not. And so i wish the patients were good judges of that but they aren’t. They make their healthcare decision based on the relationship that they feel like they have with the dentist and the team. And it all comes down to the culture that you have in the practice. And so just as there is a science behind clinical dentistry, there’s a science behind creating the right kind of culture in a practice in which patients find it easier to say yes to quality care.

Reese Harper: How easy is that for a dentist who says, “I want to improve my culture in my office,” how easy is it really for them to be able to accomplish that? It seems like a pretty difficult task for somebody who’s let’s say really busy and they’re trying to figure out where they can … They don’t even have time for a team meeting, or they think they don’t. I guess how do you coach a dentist to improve their culture and understand what it is and how to do it? I think that’d be something that most people feel a little intimidated by.

Steven Anderson: Well, I’ll tell you one of the biggest challenges in dentistry that’s no secret is that the structure of dentistry as a profession, when you get into a dental practice, it is, there are very few other businesses structured like it, when you think about it. The biggest producer of the income is also expected to be the manager and the leader and the one who’s responsible for the finances and we put a lot of responsibility on the dentist, the dentist has to wear a lot of hats. When it comes to culture, here’s really the end game and this is, and I’ll just make this comment because I’ll refer to this a number of times, Reese, I’m the product of some great mentors that I’ve had down through the years. I think all of us are. And I’ve been very blessed to have some great people, nobody gets where they are in life without some great people that had great influence. And that certainly is the case here. I’ve had some really great influence in my life.

Steven Anderson: And one of my favorite quotes by Peter Drucker is that, and I’ll paraphrase this, but Peter Drucker, for those who I’m sure the name sounds familiar but Peter Drucker’s considered to be one of the greatest business management minds of the last century. And he makes this comment about culture and basically what he says is he says, “Great organizations are great because its top people are great and if the organization decays,” this is a great dental quote, by the way, “if it decays, it does so because the top rots.” And in other words, culture, this is no secret, culture starts at the top. You attract the kind of people that you are.

Steven Anderson: And so one of the things I always tell the dentists is if you don’t like the people that you work with, if you don’t like your team, go look in the mirror because you are the one that hired all those people and we tend to attract people that are similar or just like us. Culture is an inside out proposition. It really starts with some very careful reflection of who you are, what you believe in, what your values are, how you want to project those to other people, and then how you live those every day, not just in the course of your business but in the course of your life. Because it all gets mixed up. It’s very difficult to live a compartmentalized life, all those habits starts to cross over. And so it starts at the top, it is a leadership proposition.

Reese Harper: When I hear that, I totally, I really appreciate that, by the way, I think it’s really insightful and important, I think one of the struggles that I have looking at different organizations and especially different dental practices as a financial advisor, there’s numbers that kind of tell a story about whether something’s healthy. And then there’s meeting people and sometimes the numbers might look good but when you meet the dentist or talk to the members of his team, you can tell that the culture’s not healthy and that although they might be experiencing some short term success, there could be some longterm problems with the way the team interacts with one another. My question, I guess, for you is how much control does someone have over their own innate kind of natural ability as a leader? Because some people just come the way that they are and it’s really hard for them to change, I know that everyone …

Reese Harper: I don’t want to make this sound like a depressing comment, like none of us can change, but I’ve read a lot of leadership quotes about how like leadership can’t be taught, it can only be learned or it’s inherent when someone’s born a leader or not. And I don’t necessarily believe that, I’m just kind of wanting your opinion on are people born with these inherent leadership characteristics or can they develop them and, if so, how does that happen? Because it seems like some people have a little bit stronger culture, we’ll call it culture prone leadership characteristics than maybe other people.

Steven Anderson: Sure. You can take, there’s a number of different arguments on this side, but let me just give you one perspective, I’ve got seven kids. So I’ve been in [crosstalk 00:14:20]-

Reese Harper: That’s plenty.

Steven Anderson: Yeah, that’s plenty. I haven’t figured out what causes that, I just haven’t figured out how to stop it.

Reese Harper: Good for you, man.

Steven Anderson: I’ve been in the delivery room, I’ve been in the hospital nursery a lot and I’ve never seen an isolette in the newborn nursery that said leader on it, so I don’t know, I don’t know if anybody’s born. I think there are some traits that get developed over time that lend themselves more to that end. I think a lot of what comes out as leadership is they’re learned skills. Just as they’re … In clinical dentistry you go through dental school and you continue to learn clinical skills, you learn those things, and just as you learn those, there are skills that you can learn I think in any area of life, including leadership and how to build a culture there. They’re learned skills. I always say that you can have a culture by default, you can just say, “Well, it is what it is and there’s nothing I can do about it, it’s just the way I am,” or you can say, “I’m going to have a culture by design. And there are some specific things I can do to have a great culture.”

Steven Anderson: Culture’s made up of two things, primarily, we try and simplify it. I like simple things, I’m a pretty simple minded guy, and simplicity’s one of the ingredients to successful implementation. And really those two components are productivity, how successful are you setting a goal and accomplishing it. And those things can be measured, those things can be measured in financial metrics and numbers and statistics. And then the other piece of culture is the emotional part and the way I like to measure it is how much emotional income do you get from what you do? Do you walk out of the office on a regular basis and feel fulfilled, like you’ve made a difference in the world and you’ve made a significant contribution to people’s lives, or are you continually walking out of the office and you’re just emotionally drained and exhausted and beat? And there’s a difference between physical exhaustion and emotional exhaustion and every dentist I’ve ever talked to can relate to being physically very tired but emotionally on a high.

Reese Harper: Great insight, man. What are some of the, I guess, biggest mistakes you see dentists make with culture? What are some of the big challenges that they really, maybe the mistakes they make?

Steven Anderson: I’ll tell you, the first one that always comes to mind is I get calls from dentists on a regular basis and we’re talking about the most valuable asset in a dental practice to grow, the most valuable asset, and Reese you talk about assets and liabilities all the time and one of the assets that doesn’t show up on the balance sheet is your team. And we call it a team, it’s not a staff, I look up staff in the dictionary and one of the definitions is it’s an infection and your staff is not an infection, it’s a team.

Reese Harper: Yeah, or a giant stick.

Steven Anderson: Exactly. Training your team and one of the common comments I get from dentists, they say, “Well, Steve, I just don’t have the right team yet, I don’t think I’ve got the right kind of people that I want to invest in and I really want to go find the right team first.” And my first response to that is, “Who hired these people? You made the decision to invest in them the day that you hired them, you’re paying them a wage, so what changed? What changed from the day you hired them to today? Did they change? Or is there something in your culture that’s not allowing them to perform at their best?” So probably the biggest mistake I see is the failure to invest in the most valuable asset that you have in your practice for case acceptance and for your culture is your own team. That would be number one.

Steven Anderson: The second biggest mistake, I would say, is really the failure to recognize the biggest obstacle to greater practice success in dentistry and it’s a thing we’ve talked about for years, we call it approval addiction and it is exactly what it sounds like. It is the addiction, the overwhelming need to be liked. And it’s huge in dentistry, everybody’s got it, not just in dentistry, it’s just part of our makeup that we want to be connected, we want people to like us. But when it becomes an addiction, which it can be in dentistry because on a daily basis, you have patients that come in and their opening comment is, “I hate the dentist,” and so yeah, we want to do things in dentistry to compensate, sometimes overcompensate for that. And then it becomes a huge obstacle to case acceptance success because the whole condition is downplayed and then we make the treatment sound like it’s worse than the condition. There’s all kinds of things that are totally messed up in that whole process.

Reese Harper: [crosstalk 00:19:29], that’s a good point and I think in my experience, kind of my world, it seems like a lot of the times, too, this fear of not being liked or maybe the fear of offending someone causes a lot of dentists to get professional guidance, let’s say it’s a CPA, an attorney, a financial advisor, that might be not the right person but it’s either a patient or a friend or a family member and they just don’t want that conflict of not going with the person that they’re going to let down. They don’t want to let their patient down, so they’ll let their patient manage their money. Or they don’t want to let their family, their father-in-law down, so they’ll let their father-in-law do their taxes, even though maybe he’s not as qualified as someone else might be.

Steven Anderson: Exactly. Or letting the patient, just it screams in case acceptance, it is where we first stumbled across this, we couldn’t figure out originally what the attraction was the dentists had to what we were doing. And then we stumbled across this whole approval addiction thing, which we knew about because we deal with it in other industries, but had never seen it to the degree that we saw it and have seen it in dentistry. It’s the number one biggest challenge. Every system that we’ve designed, especially on the case acceptance side of things, is designed to manage around approval addiction, to help patients see what’s possible without the dentists feeling like they’re pushing treatment on them. It really reverses the entire proposition. And so the greatest opportunity in dentistry is to truly understand what patients want before the science ever comes into play. Truly understand why they are there, what they really want, and then help them get it. And that seems like such a simple proposition but when the practice is engineered from the very first contact to really deliver on that, dentistry becomes a great profession. And the approval addiction goes away because you’re truly helping people get what they want instead of constantly having to diagnose and tell them things they don’t want to hear. That’s where the approval addiction just goes crazy.

Reese Harper: Yeah, talk to me a little bit about the changes you might see coming up in dentistry and the landscape or the industry in general, especially for practice owners, what opportunities might be there?

Steven Anderson: Huge. Yeah, there’s a lot going on there. Here’s a number of them. And let me kind of characterize this really quick because having been at this for a while, it’s easy to look back and see trends that defined the industry and so when we first got into dentistry, one of the things that was really emerging at the time was the whole advent of cosmetic dentistry and it was when science had finally figured out all these really cool materials that would make teeth better looking than sometimes the original ones and cosmetic dentistry was just coming on strong. And it was fueled by the baby boomers who were coming of age in the biggest income earning period of their lives and, Reese, you know this that the typically the highest income earning period of a person’s life is between 45 and 55. And the baby boomers were coming on strong, earning a lot of money, had a value system that said if you look good, you feel good, and so the science was there, the boomers were there, those two things collided and cosmetic dentistry went wild.

Steven Anderson: And it was just a huge boom in cosmetic dentistry all through into the ’90s and the early 2000’s and then everything came to a screeching halt, of course, in August of 2008. Because all of the elective stuff got scratched off everybody’s list when we had the financial crisis. And cosmetic dentistry is still with us, there’s a huge, huge market force, and we’re seeing a shift and where the shift is today is boomers who are now, there’s 10000 of them every day turning 65 and that’ll continue to be the case for the next 15 years, huge, huge group. Not as big as the millennials, the millennials outnumber the boomers by now some 20 million more millennials than there are baby boomers, but the boomers are still with us. And what the key to this is, here’s the shift, is the difference between the mentality at 45 and 65 is huge. At 65 you’re just holding on, you’re holding onto your money, your marriage, your family, your health, you’re just holding onto everything. And that whole generation now is so tuned in to their health and wellness and everything that’s going on and that the data now proves that America is getting more and more plugged into the correlation between the health of their mouth and the health of their whole body.

Steven Anderson: And so now we know based on some extensive consumer research that’s been done in dentistry is that consumers are getting it. They expect their dentist to address whole health issues when they go in for their regular visit. Not to necessarily diagnose them or treat them but to address them, to talk about them, to talk about the correlation between their oral health and their overall health. They expect that when they go to the dentist. Well, that’s a shift, that’s a big shift from 10 or 20 years ago.

Reese Harper: Totally, man, I mean, my wife drives probably 40 minutes and passes 100 practices on the way to get to a practice that really focuses on this idea of comprehensive health and she’s just a really … I mean, for her, natural products are really important, like the connection between mouth and body, the type of products that a dentist uses and recommends and the type of treatment that’s prescribed. Like for her it’s a really important total health concept and I think that she’s not unusual of the demographic of a lot of people in their 30’s and early 40’s, too, even older and younger. It just seems like it’s a good deal and it seems like a big systemic change for the industry.

Steven Anderson: Yeah, and a huge opportunity when you think about it, dentistry is now the frontline healthcare provider. There’s no other, well, there’s one other, but there’s no one healthcare provider that more of America sees more often than their dentist. Now there’s only one other one and that’s the pharmacist. More people see their pharm … If you can find a pharmacists, because usually the person that greets you in the pharmacy counter is the pharmacy tech, but other than pharmacists, because we know America’s on drugs, I mean-

Reese Harper: We like our drugs.

Steven Anderson: You just walk into any pharmacy and, man, there’s just exploding with pharmaceuticals [inaudible 00:27:21]. But other than that, there is more health information potentially can be delivered to America through the dental office on a regular basis than any other place. So here’s the question and this is the probing question, if I can use a dental term, for every dentist and every team member to ask is what are you doing to become the physicians of the mouth? What are you … Again, not that you’re going to diagnose whole health issues but you can identify them and you can point your patients in the right direction. Here’s one example. Standard of care today is taking your patient’s blood pressure at every visit. I’m not a clinician, so I can say whatever I want, but I think it is irresponsible as a healthcare provider if you do not take your patient’s blood pressure when they sit down in your chair. You’re putting yourself and the patient at high risk. And who else is going to do it? If you don’t do it, where else are they going to have their blood pressure checked?

Steven Anderson: The most recent now research that just came out just this week now pins the fact that half of America has blood pressure that is outside the healthy range. Half of America. We got lots of problems. Where is that going to be identified unless you take your patient’s blood pressure? That’s a very, very simple thing. It starts, this whole proposition starts in hygiene. We’re seeing some huge changes in what’s going on in hygiene departments in practices that get this because patients are not willing to just get their teeth cleaned anymore, even though that may be what a lot of people ask for when they call, it goes way, way beyond that. It’s a huge shift in what’s being delivered in dentistry.

Steven Anderson: I took a huge risk not too long ago by naming a course that we do, a hygiene course that we do, we entitled it No More Hygiene. And that sounds crazy for a course on hygiene but here’s why we named it that is because when we look at dental practices across the country, the average practice, the majority of what’s going on in hygiene is an 1110. It’s a healthy mouth cleaning. And we know that we got 80% of America that has some form of periodontal disease and yet we’re doing 1110s in the hygiene room? So hygiene has become to mean just getting your teeth cleaned. Well, no it’s not. That’s no, it’s not. You don’t go to the physician to take a shower or a bath no more than you should go to the dentist to brush your teeth. It’s not about … It’s about treating disease and there’s a whole new science and protocol around that that will become and is rapidly becoming the standard of care in dentistry. So yeah, no, no more hygiene. No more just cleaning teeth. It’s huge.

Reese Harper: Didn’t you just do an event in Boston around that, a no more hygiene presentation?

Steven Anderson: Yeah, just last weekend we were there and it’s-

Reese Harper: Yeah, if people are interested in getting more training on this, you’re doing events throughout the year, they can go to your website, which is totalpatientservice.com and see the dates for that presentation, right?

Steven Anderson: They do, yeah, in fact we have a whole site dedicated to this, as well, that is nomorehygiene.com. Just dedicated to this whole hygiene proposition and [crosstalk 00:31:06].

Reese Harper: Great concept and this total, I think, physician of the mouth concept seems like it’s pretty systemic and I think it’s here to stay and it’s excited for the future of private practice. Because I think the more … There’s going to be obviously some … There’s a lot of consolidation in the industry, which isn’t always a bad thing, but for a lot of practices that really want to maintain a high level of care, I just think there’s plenty of opportunities to differentiate in a crowded marketplace even as larger players continue to get involved in the dental market, there’s always going to be a place for a really high patient focused great team, great treatment, focus on total oral health, and a great culture. These things that you’re bringing up, they’re the essential kind of ways to differentiate a practice and be bulletproof against competition. I think it’s really a great insight.

Reese Harper: I’ve got a few lightning round questions for you that I know these are some of the questions I get most often and I know you don’t have a lot of time left and so what I want to do is try to keep some of these questions to maybe like a minute or around a minute, if you can answer them that fast. And some of these might be like, I haven’t given Steve any of these questions in advanced, okay, these are the ones I like to ask management consultants to get some quick kind of feedback on some questions that come to me most often that I know you’d have an opinion on. First lightning round question would be I’m a single practice, what’s my ideal front office setup that I should have?

Steven Anderson: Ideal front office setups, so one that immediately makes the patient feel welcome, at home, and confirms their decision that they’ve made the right decision to walk in your practice. Whatever that looks like to you, that first six seconds will set the stage for the entire experience. So make it good. Whoever’s there, if you have somebody up front, make sure that is the best personality in your practice that can figuratively wrap their arms around that patient and make them feel like a million bucks that they made the right decision.

Reese Harper: Great answer. Okay, awesome. Tell me about from a human capital perspective, who’s in charge of my front office, who are the people that run my practice? I’m a single location and I feel like I’ve got some confusion around doubling up duties, like who’s in charge of what. If you were a consultant coming in to say this is the ideal kind of human capital mix, I know it’s really hard to answer and you have to dive in, that’s why this is the lightning round, it’s hard, but how do you structure a front office from a human capital perspective?

Steven Anderson: Depending on the size of the practice, production determines a lot of times how many people you need upfront. But here would be the basics. Number one most important thing is nothing happens until the patient says yes. The first person I’m going to have on that team is somebody who can schedule and can get treatment on the books. So somebody who can get on the phone and get patients scheduled and somebody who can sit chairside and get treatments schedule, so they got to have great people skills because nothing happens until that treatment gets on the books. That’s number one. And then number two, there better be somebody who can take care of the details and make sure that the financial arrangements are handled properly, that insurance issues are dealt with correctly, and that everything lands in the right place. Because if you do the treatment and you don’t get paid for it, then you’re going to have some serious financial trouble.

Reese Harper: Super good insight. Okay, next question is fee for service or PPO, how do you answer that?

Steven Anderson: First, this is a marketing question, I get that question a lot and so the first question I ask is what’s your market like and what do the people in your market expect and where’s the demand? Look around. One of the real principles in marketing is that to a greater lesser extent, your strategy is determined by your competition. You look around because the market, the market will absolutely flock to a service that is not readily available. What does your market require, what does it … What’s really going on, what’s needed, what is there too much of, what is there not enough of, so I think that’s one. And then the second question is, what kind of practice do I want to have and there’s a lot of secondary questions that go into that. And then what kind of structure do we need to marry what the market demands and what I know how to do and want to do? Where is the intersecting point?

Reese Harper: [inaudible] I guess the long answer to that one is there’s not a right or wrong answer but you need to be informed by your market, by the way you envision practicing, and how to differentiate. It’s a marketing questions you’re saying?

Steven Anderson: It is strictly a marketing question. We get questions all the time should I just go strictly fee for service or should I bring on plans, I get the questions both, and it’s not a clear cut answer. You got to walk through a number of very carefully answered questions before you make that decision.

Reese Harper: Okay, the next question, that was a great answer, tell me do I outsource my lab or do I use the [inaudible] and keep things internal?

Steven Anderson: Again I think it depends on the practice, depends on the patient flow you have, how many chairs you have, how much chair time you have available. Certainly same day treatment is a great convenience and we have some practices we work with where that would be a disaster, they don’t have the space, they don’t have the chair time, they need to make that chair time available. So again, all those factors have to be addressed before you can make a … I don’t think there’s ever just one-

Reese Harper: There’s not a right or wrong there. There’s not a right or wrong there, is there, yeah. Great. What’s some essential technology that I have to have in my office in today’s world?

Steven Anderson: You have to have, I think there’s … The most important, there’s two, I think two critical things to consider, one, diagnostics, if you can’t diagnose it, if you can’t see it, then you’re not going to be able to treatment plan it. So that’s one, do you have all the right diagnostic stuff. Number two, then, is helping the patient grasp it. What kind of technology do you have on hand that helps people really buy their problem? People don’t buy solutions to problems they don’t perceive to have and one of the biggest challenges in dentistry is that some of the most serious problems don’t hurt. And the mentality is if it’s not broken, then don’t fix it. And if it doesn’t hurt, then nothing must be wrong. So yeah, you got to be able to diagnose it and you’ve got to be able to essentially prove it and get the patient involved in what they’re doing. Everything from something as simple as an inter-oral camera to one of the things we really look at on the perio side is how do you really get somebody to own their periodontal disease? You can’t see it until today, so there’s now technology where people can really grasp the severity of what’s really going on in their body. Diagnosis and case acceptance. Any technology around those is essential.

Reese Harper: Awesome. A lot of people call in and ask us, “Do I get a cone beam, do I need 3D x-ray,” in that sense you’re saying … I mean, that’s a diagnostic tool to some degree, it may or may not fall into that camp from your perspective, how do you view 3D technology?

Steven Anderson: I’m not a clinician, so I’m the patient and I’ve had … I’m a product of the product, Reese, I have had extensive dental work done, that saved my life, and that’s a whole nother story. But from a non clinician standpoint, I would say it is, for the most part, the majority of the cases, today it’s irresponsible to place an implant without 3D imaging. The technology is available and it’ll help you be more accurate and do a quality job and it’s readily available then, yeah, you should be using it. Again, I’m not a clinician, I’m just a consumer, but I’m just saying, if I had an implant done on me and it didn’t go so well and the dentist did not use 3D imaging, that would be the first question I would ask is, “Wait a minute, if the technology is there, why didn’t you use it because now I’m having to pay the price for the not using the current technology.”

Reese Harper: Now you and me can talk about this one for a while, it sounds like. If you’ve ever known someone who’s had complications from an implant, I mean, it’s definitely … Anyway, okay, next question, when do I hire an associate?

Steven Anderson: Maybe never.

Reese Harper: Okay, good.

Steven Anderson: [inaudible 00:41:08].

Reese Harper: There’s not right or wrong answer.

Steven Anderson: No, and that is … I get that question a lot and the biggest mistake that a lot of dentists make is they bring one on too early. Again, a lot of questions around that, what are you trying to accomplish, what’s your longterm vision, what are your marketing skills? Again, all of these questions that really need to be vetted very, very carefully.

Reese Harper: Your fear is that it happens too soon and you see that being a reflection of lack of profitability, lack of ROI generally in the practice, like the practice can’t support more than one producer anyway. You see that commonly happening?

Steven Anderson: I see a lot where the associate’s brought on too early and then the practice then gets stressed financially and then the associate’s not happy because they don’t have enough work to do and all those problems you see all the time.

Reese Harper: Yeah. Good feedback. How do you know when you should fire somebody?

Steven Anderson: If you’re asking the question, you’ve already made your decision. If you even ask the question, when should I fire this person, they should be fired.

Reese Harper: Okay, good feedback.

Steven Anderson: It’s that simple. If you’re even asking the question, that’s telling.

Reese Harper: You think it’s hard for people to fire a member of their team when they … Is that typical, people struggling with that issue? I get that question a lot.

Steven Anderson: Yeah, and what I would say is you need a good employment law attorney on your side to really answer the when question because you can have your ducks in a row, but once you’ve made the decision it’s not a good fit, you’ve made your decision, now you just got to get everything in order to do it right.

Reese Harper: Awesome. How do I find the right person to hire? How do I find the right person for a role?

Steven Anderson: The right people know the right people. Yeah, you can do all of the traditional things, run ads, etc, etc, 85%, even today in the age of the internet, 85% of the best hires in most small companies are found by way of word of mouth and people referring people to that place and employment. What i recommend all the time is be looking everywhere. You go out to dinner and you have somebody that does an amazing job of serving you at your table, you got an amazing server, then strike up a conversation, tell them, “I’m looking for somebody just like you who gets the whole service side and really knows how to serve people, so if you know somebody just like you, here’s my card, I’d love to talk to them.” Really, because some of the best people can come from outside the industry, they don’t know how great dentistry can be.

Reese Harper: Yeah. That’s awesome. A couple of financial question, there’s no right or wrong on this but I’m sure you’ve been asked them before so I want to get your opinion on this. When do I sell my practice?

Steven Anderson: One of my mentors who’s not too far from you, Reese, his name is Dr. Roy Hammond, and Roy taught me a very valuable lesson years ago, in fact he’s taught me a lot of valuable lessons, he taught me how to ride a motorcycle, which we do every year through his Learning Curves company. We do CE on motorcycles. But one of the things that he taught me early on was you’ve got to decide on your number. And what he meant by that is if you don’t decide how much is enough, it will never be enough. You need to decide early on what kind of lifestyle is enough and it’s not just more, more is never enough, what kind of lifestyle is enough and what’s my number. What is the number that I got to hit that I could be financially free based on all the planning that you’ve done for them, Reese, and that then at that point I can make the decision what I want to do. Do I want to stay in practice, go do something else, or do I want to continue practicing?

Steven Anderson: The one thing that I would say is, and I’m very adamant about this, I do not believe in retirement. Retirement was an invention of government to get people out of the workforce so that they could prop up the employment numbers and the science, the science proves that the moment that you become useless, in other words the moment you no longer have purpose that’s getting you out of bed in the morning where you’re contributing to mankind and doing something that matters, physiologically your body starts to shut down. And so I don’t believe in retirement.

Reese Harper: I agree with that.

Steven Anderson: Does that mean you practice dentistry your whole life? Maybe not, but what it means is you got to be working on something meaningful all the time.

Reese Harper: Yeah, there’s a … In our practice we like to talk about getting to the point where work is optional but we don’t talk about retirement. There’s a big difference between getting to the point where you have enough financial security to where work really is an option that you get up to do every day but I love that about dentistry, that it allows people multiple ways through either charitable involvement or slowing down to a day or two a week, to mentoring, to owning a practice that you don’t work at, there’s a lot of ways to stay involved and stay busy and stay active without quitting work. And I think that’s really insightful. And it keeps people really healthy, too. These last two, one of them’s where people, I ask my guest to be a little bit vulnerable and tell us something that maybe might not be the best about themselves and one is a great question that makes you look good. So I’ll give you both of these and I ask this to everyone, what’s the best investment you’ve ever made and what’s the worst investment you’ve ever made?

Steven Anderson: Best investment that I’ve ever made is the investment in myself and my team. The return on learning is one of the most unmeasured and most valuable investments I think anybody can male.

Reese Harper: Great answer, super good.

Steven Anderson: The courses I’ve gone to, the mentors I’ve invested my resources to get close to, best investment for me and my team. Worst investment is wasted time.

Reese Harper: Okay.

Steven Anderson: The founder of Ikea once said that every 10 minutes, any 10 minutes wasted is an investment you can never get back. Time is our greatest investment. Not using it wisely is you can never get it back. You’ll never get a return on it.

Reese Harper: When you say that, are you thinking of … I get a sense that you’re not talking about productively deploying it in a financial context exclusively, I get the feeling you’re talking about that plus making your time count in other ways, right?

Steven Anderson: Yeah, making your time count. What’s the return on time? We talk about ROI, return on investment, what’s your ROT? What’s your return on time?

Reese Harper: Yeah.

Steven Anderson: What are you getting out of where you invest it?

Reese Harper: That’s great. These are great answers, I really appreciate you going through them and giving people a lot of sense of the breadth of how much you’ve learned over the years and it’s really been great to interview you a little bit, Steve. I’m going to have to have you back on the show here over the next year and get into some more questions. What would you like to leave with people before I let you go?

Steven Anderson: I would say the biggest thing, I believe that we live in the greatest place in the world. I’ve been all over the world, we got our problems, every country’s got their problems, but all in all when you boil it all down, we got it really good. And I believe it’s the responsibility of everyone who has the benefit of really a great profession and in everything we do to do good, not to give back, that’s a term that’s crept into our vernacular. Giving back implies you took something and there’s some guilt associated with that, so I don’t believe in giving back, I do believe in doing good. There’s a lot of ways you can do good. Owning your own business and providing employment and serving the people in your community is doing good. Charitable things you do are doing good. But we all have a responsibility to pay it forward and so good.

Steven Anderson: My challenge, Reese, to everybody listening would be to find another way to do good. In dentistry there’s so many opportunities to do that just by virtue of the business and to find other ways to do it. Get involved in that. To ask that question more and more every day. One of the greatest surprises I think in my career has just been the whole success of the Smiles for Life campaign that has blessed millions of lives all over the world and just gives dentists and team members a way to do good and to really benefit the lives of other people. Find ways to do that because that is what makes your culture, one of the things that makes your culture fulfilling and makes it all worth it. Thanks for having me on today, Reese. Delightful to talk to you.

Reese Harper: Yeah, keep up the great work, man.

Steven Anderson: Happy to do it and I hope there’s some things that we talked about today that people can use to make a difference in their practice and in their life.

Reese Harper: Well, thanks, Steve. I really appreciate you coming on and we’ll put the smilesforlife.org link in the show notes, as well, and all the other projects that you’ve built over the years and look forward to having you back again on the show. Thanks so much, Steve.

Steven Anderson: Thank you, appreciate it.

Reese Harper: All right, thanks again to Steve Anderson. Obviously very well read and a great resource for learning how to strengthen your practice culture. I thought his insights about creating emotional income for your employees was a good reminder that your team needs more than a paycheck to stay motivated. The approval addiction concept was really insightful, too. We’ve put some links in the show notes for the tools and resources Steve mentioned. Go check those out when you have a chance. Also, don’t forget to check out the Dentist Money Show YouTube channel and send me your financial questions so we can answer them on the show. Just email reese@dentistadvisors.com. And if you’re ready for a free consultation with us, just go to dentistadvisors.com and click the link at the top of the page. Or give us a call at 833-DDSPLAN. Carry on.

Practice Management