Episode 482: Checklist: Is Your Practice Healthy?

No matter how successful you are, there’s ALWAYS a next level. In this episode, Kiera guides listeners through what it takes to have a healthy practice. She touches on the 12 systems comprehensive cycle (below) and provides a checklist for what it takes to get your practice from good to great.

Don’t be intimidated by this list! Find out where you fall today, then come up with a game plane to get to the next level. The Dental A-Team is here to help you do that!

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0:00:05.6 Kiera Dent: Hey everyone, welcome to The Dental A Team Podcast. I'm your host, Kiera Dent, and I have this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a Dental Assistant, Treatment Co-ordinator, scheduler, filler, Office Manager, Regional Manager, Practice Owner, and I have a team of traveling consultants, who we have traveled to over 165 different offices coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress and create A Teams. Welcome to The Dental A Team Podcast.


0:00:51.7 KD: Hello, Dental A Team listeners. This is Kiera and you guys, happy day, I hope it's a great day wherever you are today. Today's topic, I'm super jazzed about. This is something that I just wanna give you guys... I love checklists, and a lot of our clients love checklists. I love to just see kinda how I stack up. I know a lot of you doctors and offices wanna know, how does our office compare to other practices? Now, I will say before I go any further on this topic, be careful of comparing, because we don't know everybody's back story. We don't know what's been going on with them, we don't know why they're choosing the choices that they made, and we also don't know the struggle that we got in there. There's a book, I love to share books with you guys. Don't worry, I'll probably do a Book Club with Kiera again for all of you. If you haven't seen it, you guys can always go to thedentalateam.com, click on our Podcast tab and you can search any podcast. So if you want my Book Clubs, I think I've done two or three of some books that I read.

0:01:49.4 KD: I really am a big reader. So I wasn't... I didn't use to be... Thank you, thank you, Audible. [chuckle] But speaking of comparing with other practices, there's a book, it's called Comparisonitis by Melissa Ambrosini, I think is her name. She's got a couple of great books out there. I love this book. I felt like I was always comparing and wanting to see how I was stacking up to other people rather than just living my life. I don't think there's anything wrong with wanting to know what other people do, but just making sure that we're growing for our own sake. I see a lot of dentists grow because they feel like that's what the next step is. They feel like I've gotta do all these things, 'cause this is what I saw on a blog post, or this is what I saw on a Facebook group. And the bottom line is, I want you to trust yourself, I want you to know what's best for you, your life and your practice. For some people, growing is actually not the right answer, expanding to multiple locations is not the right answer for them. It doesn't mean it's the wrong answer for somebody else. So I'm going to give you guys a checklist today of what you can do to check to see, is your healthy practice... Or excuse me, is your practice healthy? There we go. [chuckle]

0:02:57.1 KD: But I really do think it's something important that I really wanna hone in that, yes, I will share what elite practices do. Yes, I will share a lot of these different pieces for you. But I really, really, really wanna make sure that you aren't comparing or growing for the sake of ego, that you're growing for the sake of, this is what you love to do. This is where you wanna go. And I also want you to be okay that you don't have to change these things, you don't have to do all of these things. I want you to know that that's okay. It's totally fine. You absolutely can just live your life, you can do the things that you wanna do, and that is fine, you are perfect exactly how you are. However, I also believe that there is always, always a next level. So, I want you guys to know that this is the next level. So, if you guys don't know The Dental A Team, Tiffanie and I... Gosh, this is during COVID, we realized we wanted to have 12 systems for a practice.

0:03:52.9 KD: So I wanna kinda give you guys an overview of 12 systems, and then I wanna give you a checklist to see, is your practice healthy or not. So, we have this mapped out to follow every single month of the year. So, in January, we focus on company goals. In February, we do key performance indicators. In March, billing procedures. April, operations manual. May, scheduling. June, patient flow. July, treatment planning. August, marketing. September, hygiene. October, meetings. November, office management and human resources. And December is communication and morale. Okay. So, there's kind of an overarching theme for every single month. Our Dental A Team clients, they actually get a scorecard every single month to see if they're putting these systems into play, because what happens, we put a system into play, then we get another system, then we forget the systems we had in play before. And so what I like is because this follows a 12-month system, you guys actually can follow along. You can check and make sure you're healthy, but at any moment you can also check to see where you're at.

0:04:56.2 KD: So, we have quite a few different things within each of those systems, there are quite a few systems within, obviously like company goals. We have a checklist of items that should be within that system from our standpoint, and we have for brand new practices and we have for more elite practices. So, I would start with that on... We'll make sure we link on the show notes for this one, the graphic of the 12 systems as well. It's also on our website, it's actually kind of tricky to find, I was trying to pull it up. If you click on our About tab and then go down to the bottom, there's an FAQ, and in the FAQs, it's a bunch of things about us. That's where our 12 system lies. So again, kind of tricky to find, but we'll make sure we link it for you, but that at least will help you see January, February, March, April, May, June, July, August, September, October, November, December. It kinda gives you a theme. Now, that doesn't mean we... Our problems all go away, but at least every single year, we make sure we touch on all 12 of those systems to ensure our practice is systematized. Okay, so that's step one.

0:05:54.6 KD: So, I'd recommend just check that, look to see in all those areas where you may be weak. Maybe you don't even know, maybe you say KPIs and you're like, "I actually don't even know what that should look like." Hey, you should email us, ask us, we're happy to share. You could also join our Facebook group. Dana is one of our awesome consultants, and she does Donuts with Dana, every Friday. I think it's adorable. You should definitely eat donuts, I love to eat donuts. [chuckle] But we do Donuts with Dana, and it's just... We should call it probably Dentistry and Donuts with Dana, so maybe we will change the name, who knows? Or if you guys have another name you want, but really she goes into these tactical things. You have a live Consultant every single Friday, she does a Facebook Live. She'll happily answer your questions. So if you're like, "I don't even know what I should be doing with the KPI system." Hey, reach out, that's what we're here for. So email us, join our Facebook group, join Dana every single Friday with Donuts With Dana. We'll call it Dentistry and Donuts with Dana.

0:06:43.9 KD: But yeah, so then the next piece is, when we go into a practice, I wanted to give you guys kind of that checklist. So, we call this an office scorecard, we have a couple of different things that we're looking at, so what I'm always looking for, I'm looking for your production, your collections, your collection percentage, don't worry guys, I'm gonna rattle this off, so you better get your freaking pens ready to go.

0:07:03.2 KD: This is literally what I look for, I am giving you the checklist. Am I going to print it for you? No. Maybe if you email me and say I'm awesome, maybe, but we'll see. But I want you to take this in, because I think sometimes when you get free things, you don't actually put this into memory, so we'll see, we'll see how I feel. I'm usually like, I'll give you anything, this one I've got a reason why, 'cause I want you to actually like take this in, okay. So I want you to do month before production, month before collections. That means last month, what was your collection percentage, what's this month's schedule to production, what's your year-to-date production, your year-to-date collections, your year-to-date collection percentage? How much unscheduled treatment is sitting in your unscheduled treatment, why is it unscheduled? What about unscheduled re-care? What about your AR, how much do you have in current, 31-60, 61-90, over 90? How much of that is patient portion, and how much is insurance portion? What's your company's overhead? What about on your billing? Claims, outstanding claims, year-to-date, how long does it take you to get those paid? How many unsent claims do we have? How many procedures do we not have attached to insurance year-to-date? How many new patients are we getting?

0:08:07.4 KD: Are we tracking every single referral source, that means if I came in there and I looked at all of your 50, 30, however many new patients you have, does every single patient have their new patient referral information tracked, yes or no? If not, get that going. I also wanna know what, and how and who is coming in for all those referrals, this way we know where to invest our marketing money. What's your year-to-date new patients, and what's your monthly average total?

0:08:31.7 KD: What about your scheduling openings, how many hygiene openings did you have last month? How many total hygiene opening spaces did you have last month? Did you get that? So it's how many total hygiene appointments do you have, and how many open hygiene spaces did you have last month? Same thing for doctor, 'cause I wanna know how many are open last month and this month, same thing for doctor, open last month and this month, out of the total number of spaces I could have. What I'm looking for on that, I'm looking for a percentage of open space, it's gonna tell me how well you're doing on your scheduling, it's also gonna tell me on if we need to be opening up more ops and expanding, changing, reducing insurances, based on how much open space you should have in a schedule. You actually don't wanna be completely full the next month, if you're completely full, we don't have enough space in there, or we're not diagnosing effectively, we're not scheduling effectively because you actually need to have quite a bit of your month open the next month, otherwise, we can't get those same day treatment percentages in there.

0:09:21.5 KD: We don't want a full month packed up the next month, if you are, we need to chat. I also wanna know how many hygiene openings are in the next three day, how many doctor openings are in the next three day, I wanna know how your hygiene department is producing, what's their perio percentage, what's their florid acceptance rate, what's their reappointment percentage? Also, I wanna know how many incomplete procedure notes you have, okay? That's like my quick hit list. Now, I'm gonna go through another hit list, you guys, like I'm not kidding, you can replay this, you can check it, overall, I wanna know how many Google reviews you have, are you over 250-300? If not, let's bump that up. And this is a yes or a no. Is your website current. Current photos on your website? Yes or no?

0:10:02.6 KD: New patient paperwork online, are you a paperless practice? #Chartless. [chuckle] Do you have a referral program in place that you are constantly feeding? What about weekly calibration meetings with your entire team? What about level 10 meetings with your leadership team, that's pulled from traction? What about one-on-one monthly meetings with each team member? Do you have a vision statement in place that your entire team can recite from memory? Do you have core values created and referenced consistently? I'm talking weekly, if I walked in and said, what are your core values, could they each tell me? Do you have a dental analytical software in place? Are your morning huddles tracking numbers, production, collection, reappointment percentage, case acceptance, florid percentage, how do you get your... How to get to goal per department every single day, so if our hygiene department's not there, are we tracking that? Do you have your yearly goals in place and everybody on the team knows it, and you're tracking towards it? Do we have end of day checklist in place and being used? Do we have routes such as perfect hand-offs? Is our morale high? Everyone works as a team, a bonus is in place, if we want, you guys know I have strong opinions on bonuses, and now are you profitable before you put that bonus into place? Do you have automated systems in place for texting, calling, confirmations? Has your office met your goal for the last three months?


0:11:13.8 KD: Have you guys heard? But really, have you heard? And are you the type of person that loves to take massive action? Well, if you are, I would love to invite you to Dental A Team's virtual summit, April 22nd through 23rd. And yes, right now, guys, it's early bird, that means it's $200 off the normal ticket price. You guys are going to learn how to optimize your practice this year. We know it's been a rough year, people have quit, we've had COVID, we've had changes, so we wanna teach you guys how to optimize within your practice now and execute. Friday is full team, Saturday is all things leadership, so bring your team, get some CE, take massive action, head on over to thedentalateam.com, coupon code is summitearlybird, and it's valid until March 31st, that's summitearlybird, all one word, and is valid until March 31st. So guys, head on over, I can't wait to have you take massive action, optimize your practice and execute. Let's make 2022 your best year.


0:12:12.4 KD: Ready for more? Are you thirsty for more? 'Cause if you are, you should join Thirsty Thursdays, this is where we actually dive into deep talk, it's totally free, it's CE, join us every Thursday, Thirsty Thursdays, super fun. The third Thursday of every month is Thirsty Thursdays, so are you thirsty for more to see if your practice is healthy? Keep going. Doctors, do you have another location in place? Yes or no? It's okay if you don't. Is your schedule full two weeks out? Did you at least... Diagnose at least... I like you to be diagnosing three times as much as you wanna be producing, now that's a scary number, check to see where you rank, you might not be doing enough elective services. Case acceptance at 90% or higher if it's one-to-one. And doctor production, I actually like you guys to be at $1000 per hour. However, $500 is a pretty good one. You're not gonna be my elite practice until we've got you to those numbers, just so you know. I'm literally rattling off what I look for in every practice, so this is what I score our practices on. This is what I grow them into. Some doctors don't want this, that's okay. This is just my benchmark, this is what I come in and I give you a yes or no on all these different items, so I can actually give you a systematization score when I'm in your office.

0:13:21.7 KD: So clinical team, do we have digital X-rays? Do we have tip out bins for supplies so we're not over-ordering? Are we max on procedures, endo, implants, sleep, ortho, Botox, PRF for gum grafting, same-day crowns, 80% of all of our treatment is scheduled in the back with our clinical team. Same-day treatment is tracked. Assistants are all calibrated and can do every procedure. Morning huddle prep sheets are completed nightly, and they're prepping for the next day, and they know how to get their doctors to goal. KPIs are tracked weekly. Supplies are below 5% of collections. Patients seated on time, there is a 10 minute or less wait time. 10 minute temps for every single assistant, 10 minute scans on the iTero or less, able to assist on all procedures. Weekly level 10 meetings in the clinical team department. Able to present 90% of all treatment plans, note templates are actually in place and utilized. Quick buttons are used for charting, you make calls to fill the schedule during downtime. Rooms are pre-set the night before. Hygiene, can you do credit card payments for fluoride? Are you producing three times your pay?

0:14:19.8 KD: Do you hit your goal 80% of the time? Fluoride therapy is in place. Making sure we're doing fluoride. Fluoride on all of our patients, I say 80%. I'm a huge fluoride fan. If you're not, guess what? You don't have to do this. This is not like the Holy Grail of dental offices. I'm literally giving you guys a snapshot view into what I look for in a practice. So take it, grow, elevate, see what's best for you. Pay is at 30% of the practice. A full-mouth probe is taken yearly. Sealants are performed. Four bitewings and two PAs are done yearly. Frequencies or FMXs are taken on their frequencies. Morning huddle on how to get to goal is done. Weekly meeting level 10's are in place for the hygiene department. Tracking hygiene stats and reporting weekly on a KPI scorecard is done. Re-appointment percentage at 98%. Doctors on time to exams, 90% of the time. Actually tracking that. Standardized exams for hygiene and doctor calibration, like what would doctor do? All the hygienists know how to do this, yes or no? A perio protocol in place and used. Exam cards used for doctors so they come in on time. Note templates in place for the hygiene department. Intraoral pictures for all patients, giant monitors to show patients pictures and they're being utilized.

0:15:28.7 KD: That's just like there's so many more pieces, but this is a quick snapshot. For an office, new patient track referrals was 100%. Re-care calls completed daily to fill the schedule to goal. Unscheduled treatment below 150,000. Do you know how many offices I've walked into and they have millions and millions? I wanna make sure you have this down, that you're calling on it, that we're scheduling patients. It can be higher than that, you set your own goal. Hygiene hits goal at least 80% of the time. Doctor hits goal 80% of the time. Actually bump that up, I want you hitting it 90% of the time. Less than 10% cancellations or openings per month, per month. So I go back and look at your last month. If you had 100 spaces, I would want 90 of those 100 hygiene spaces filled. Why? 'Cause that tells me you are a freaking rad office that can fill a schedule when we have cancellations. You're not just like, "Well, darn it." No, you are busting your buns, you're getting those calls made. You guys have a solid plan for re-care, we're asking for family members. You keep that schedule so full.

0:16:24.4 KD: Okay, that's my rant. You're welcome. Next month is scheduled to goal. We want at least 60% of you scheduled to goal for next month when the month starts. Our case acceptance is at 65% dollar-for-dollar, and 95% one-for-one. If you don't know what that means, you should email me or listen to other podcasts. [chuckle] Morning huddles, you track emergency time. Morning huddles, you follow up on the information presented. Family members who are due for cleanings, calling on extra treatment that could be added in. The phones are answered by the first ring. Less than 2% missed call rate, another hard one. Guys, this is like the top tier. Not every practice gets here. That's okay, but at least you have a goal and a standard of what I aim for. Prior day new patient scheduling tracked for morning huddle. Call tracking in place. We know why our patients are cancelling, we are listening to our phone calls, we're reviewing the calls. Role play for phone calls, hand-offs, all practice weekly. Cancellation policy in play. I call it "appointment changing," but everybody knows how to do it, and we don't have a lot of cancellations. Assign treatment plans given to every single patient and scanned into their chart or just automatically put in there.

0:17:32.3 KD: A walk-out out given for every single patient. I know a lot of you guys don't like to do this. Do you know how much money I have saved a practice by printing that darn piece of paper? Okay. Front office team members, review it. So today, we did your X-rays, your fluoride, your cleaning. We don't have your exam. I have saved thousands upon thousands of dollars by printing that, so if you want to go for it, you don't have to. I know that kind of defeats the paperless. Intraoral pictures... Excuse me, a walk-out given to every single patient. A 2-2-2 follow-up on re-care and unscheduled treatment plans that don't accept. Two days, two weeks, two months. Treatment tracker in place, used and assessed every single week. Look for your patterns. Insurance verified two days out, full benefits one time a year, and eligibility check every single time. Your AR 30 to 60 is below 10... I do this one at 15% of collections. 60-90 is less than 10% of collections, and over 90 is less than 5% of collections. Credit card on file and being used, statements are sent out weekly. Confirmation calls are done 48 hours in advance. New patients are seen within 48 hours of calling for appointments, ASAP list used, credit card on file with a form.

0:18:39.1 KD: Online payments are available, online scheduling is available. Whew! How are you guys doing? Billing, refunds are given monthly. Claims submitting nightly. Non-attached procedures and claims report run weekly, insurance and patient aging worked weekly. Fee schedules are up-to-date and current, statements sent out weekly. 98% collection ratio, unpaid claims are followed up on monthly. Electronic claims submission is used and followed up in the morning for submission. Your AR is intact. Office manager, monthly one-on-ones completed for every team member. KPIs tracked weekly and reported to with your doctor and reviewed. 5% growth of the practice. It's actually 10% growth of the practice year over year. Weekly, monthly, and quarterly meetings ran. Team is involved in growth. Podcast, book club, something. There's amazing morale. Passwords are on all computers, HIPAA and OSHA standards are followed.

0:19:27.1 KD: No credit card refunds in play. Handbook given for all new hires and updated annually. Operations manual is completed. Oversee each department and grow it. Each department hits their KPI monthly. You negotiate fees annually. Morning huddle agenda used, and you're consistently growing yourself personally and professionally. Dang guys. And then I have a whole list of systems in play, too. I just gave you guys 18 minutes worth of systems and checklists and things that I do. Now some of you might be like, That was awesome, Kiera. Thank you so much. And others are like, Oh my gosh, there's no way. There actually is a way. Guys, it... Don't worry, I went to Business Mastery with Tony Robbins and was basically given a checklist like this for my business, and I was like, There's no way.

0:20:07.1 KD: I'll tell you how. Check to see where you line up today. What don't you know? Where are you the weakest? It might be your overall practice, it might be your doctors, it might be your clinical team, hygiene, front office, dental assistants, billing, office manager, scheduling. Where are we the weakest? And then let's execute. So let's come up with a game plan. Let's create a solution. Let's call somebody. Let's hire a coach or a mentor that could help us out. End all be all, guys, I couldn't have done everything I've done in the company without my coach. No way, José. Not a chance could I have done that. But guess what? Slowly, inch by inch, day by day, we're gonna get these systems in play.

0:20:46.5 KD: So I wanted to give you a jam-packed podcast today, where you literally see everything that I'm looking at. 'Cause guess what? I know some of you are gonna go execute on it and I'm high-fiving you. I also know some of you will be like, Kiera, there's no way, I'm definitely using you and your team. Awesome, I'd love to help you out. Email us [email protected] And there will be other of you that will do nothing. I would hope that you're at least in option one or two. I hope that you don't take this and be like, Oh, there's no way. I'm just too busy. If you make the time for the most important things, your life will actually free up. So make the time for the most important things. I encourage you to do it, I challenge you to do it. I will help you do it.

0:21:22.6 KD: Whatever we need to do. But guys, see how you stack up. How do you measure up? Email me if you want some help on it. [email protected] Check out our 12 systems. Notice there are 12 systems. All those things I just listed off to you fall in one of those 12 systems. So I actually created a roadmap for you. So it's like, okay, maybe in January, I'm gonna work on something that I'm weak on that she just listed off that's going to pertain to our office goals. Then in February, we're gonna start tracking KPIs, even if it's just at the morning huddle. Then in March, we're going to improve our AR and our claim submission, I'm just gonna focus on that one piece. Do not try and do all of this at one time, but make sure you're at least seeing how you measure up. You're not comparing. These are things I come in and look at and I GSD, and we get done in our practices.

0:22:06.9 KD: These are things... This is what people pay us to do. This is what we come in and we get your practice up to this par. No, it's not always overnight. No, these things are not always done. No, we don't always hit every single one of these, but guess what? We get darn close. And guess what? We're constantly working on it. This is how you can check to see is your practice healthy? So I'd encourage each of you to do it. Let me know how I can help you. [email protected] As always, guys, so much love. Don't beat yourself up. There are no failures, there are just results. Are you getting the results you want? And if not, make massive changes and make it happen. Alright guys, so much love to you. As always, thank you for listening. Catch you next time on The Dental A Team Podcast.


0:22:47.9 KD: And that wraps it up for another episode of The Dental A Team Podcast. Thank you so much for listening and we'll talk to you next time.



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