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Episode 556: How to Recession-Proof Your Practice

recession proof Jul 28, 2022

 Dr. Erin Elliot speaks with Kiera (from a pickleball tournament!) about how to make your practice invaluable to a community — even during a recession. They touch on the following:

  • How to expand your in-house services

  • How to hire highly motivated team members

  • Tasks you can do proactively today

  • How to keep your mental stamina

  • And more

Dr. Elliot was able to produce and collect during the early days of Covid-19 because these approaches were established in her practice. Listen up to learn how your practice can be just as valuable.

Episode resources:

Learn more about Dr. Elliott

Take Dr. Elliott’s sleep apnea course

Listen to episode 436, Tackling Adding New Comprehensive Dentistry

Listen to episode 166, Expanding Your Dentistry Scope

Reach out to Kiera

Subscribe to The Dental A-Team podcast

Become Dental A-Team Platinum!

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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 had 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 coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of travelling consultants, where we have travelled 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.

0:00:52.1 KD: Hello, Dental A Team listeners, this is Kiera, and you guys, I'm super, super jazzed. One of my favourite people that I just wanna hang out with all the time in real life... She's one of the raddest people. Today, she is podcasting at a pickleball tournament, this is a true story, I'm looking at her sitting in that beautiful sun, it's the one and only Erin Elliott. If you haven't met her, you must. She's hilarious, she's a dentist, she does all the dentist-ing things, plus she does sleep apnea and about a bajillion other things, and she sits at a booth at a pickleball tournament. So Erin, how are you today?

0:01:23.2 Erin Elliott: I am awesome. It is summer in Coeur d'Alene, Idaho, and I tell people, 'Come visit us in the summer, it's the best three weeks of the year', so I am embracing this like crazy and utilising every minute.

0:01:38.8 KD: I love it. I know when we definitely got on I thought you were on the beach 'cause that's where I last saw you on social media, was on the beach somewhere, I don't know where you were travelling, but I'm like, 'She's seriously soaking up her beach life and podcasting.' I dig it, so. But Erin, for those of you who may not have heard of you, you do so many cool things. Guys, she's been on the podcast before. Erin is one of my favourite people to podcast with, but Erin, just fill people in on who you are, what you do, so that way we can give the listeners a little background on you.

0:02:07.0 EE: Well, I am a general dentist, and I graduated from Creighton University Dental School in 2003. I was asked, 'Yo, Elliot, I didn't know you were smart.' This is when the class ranks came out. This is from a professor, by the way, and he said, 'How come you're not specialising?' And I was like, 'It's because I wanna do everything.' As a general dentist, we get to choose. We can actually have almost a specialty within general dentistry. I just liked it all. So my husband and I beelined it for Coeur d'Alene, Idaho way up in the northern part of the Panhandle, and I started at Post Falls Family Dental, where I was an associate for eight years, and now I've bought in, I've been at it 19 years now. Like I told you, I'm embracing my age and stage in life. Everyone at covid was like, 'Oh, I've really learned what's important now through covid', and I said, 'What I learned is that I really liked my life, covid messed it up.'

0:03:10.4 KD: I agree.

0:03:12.7 EE: But I also learned I should... That I really love to work and all those things, but I discovered I should probably get a hobby as my kids were getting older, so pickleball was it.

0:03:23.7 KD: Pickleball.

0:03:24.0 EE: I'm obsessed, and golf.

0:03:24.2 KD: Good for you. Golf is my... Golf is the next hobby I wanna get into this year. My brother-in-law does have a pickle court in his backyard, which I think could be pretty epic, one day maybe I'll be that cool, but golf has been the thing I feel like I wanna get into.

0:03:39.3 EE: Good for you.

0:03:42.8 KD: Look guys, the reason I love working and podcasting with Erin is because, Erin, you are a dentist, you've done this for a long time, and so today I was thinking, a really fun podcast we could do... You just heard, you've been in dentist-ing for 19 years, that's a long time, and I feel like what a lot of people are concerned about right now is like, 'How can I recession-proof my practice?' And I thought, 'Who better than Erin?' Who I feel you add adjunct services, you work with T-bone, you guys do all the things to add in adjunct services, but you also don't sugarcoat that adjunct services take a while. They're a slow burn. I remember our last podcast like how you really talked about making sleep champions and how you can get sleep incorporated into your practice, but I thought you would be a really great guest to really talk about some things and some ideas from your perspective of how to recession-proof your practice.

0:04:33.6 KD: They talk all the time that recessions and economy turns are actually when the best businesses are made, and I'm a firm believer of that, I've seen it. You look back, like covid was either your best of the times or the worst of the times, and I feel like you get to choose what side of the coin you wanna be on. So Erin, what are some of the things you've seen through adjunct services, through other things, to really help recession-proof your practice?

0:04:58.9 EE: Well, just to start with my background as far as at Post Falls Family Dental, we built a brand new beautiful million dollar building right in 2007. So we built 10 ops, and if you've been around long enough, it was scary for dentistry during that time. We moved from this cruddy old craphole, five ops, rundown... The practice was great but the space was terrible. So we moved into this new practice and it was crickets. We were like, 'How are we gonna pay the bills?' And now we are figuring out a way to turn our fish tank room into another operatory 'cause we're maximising the 10 ops five days a week. We are maxed out. And some of it, I would say is Coeur d'Alene is growing quite a bit, people are moving here for the opportunity of freedoms that we have, but it's also because we do stand apart, and sleep has helped us do that. I incorporated sleep 13 years ago, and it was right after that economic time in dentistry from before, it meant just adding ortho, implants, anything that we... Basically it was anything that we were referring out the door, we're like, 'How can we keep it in our practice? 'Cause patients don't wanna go somewhere else. So what CE do I need, what team members need to be in place?' And for example, impacted wisdom teeth, we bring a guy in who likes doing them. Think of the... Think of the overhead on that. It's like zero.

0:06:47.6 KD: Exactly.

0:06:48.2 EE: And so that was... That's a great opportunity for revenue without me being there. The big thing that we preach at 3D Dentists, where I teach, is team web. It does stink when it's really hard to find a team right now, but on the other hand, we have retained so many team members because they love their job. They've got a specialty, they have a purpose. They have a mission versus just a job, and so I think that has benefited us. But sleep is something that... You do the slow burn, you get the systems in place, and it kinda runs itself, even when I'm not able to be there every second of the day, I have a team member that's highly motivated and she gets the job done, and so we get... Even through covid, we were getting medical insurance payments. We were seeing patients because it was, as I say, oxygen and sleep is essential. So we were carried through covid even without producing, we were still producing and collecting.

0:07:56.4 KD: Totally.

0:08:00.8 EE: And so that's why I think... And it hasn't really slowed down yet either. So with this doom coming and scarcity and kinda fear, we're set up to be okay.

0:08:11.8 KD: For sure, and I think that that's why I wanted you to talk about it because I feel like you can get every side of the coin, but it's like, 'Let's look at somebody who's gone there, done that.' And I think even going back to your intro of how it's like, 'Erin, oh, I didn't know you were smart, why don't you go into specialty?' And your exact reason for being a general dentist is to be able to do everything, and so I feel like something that I... There were a few key points that I hope to highlight, and one was, how can you bring in-house more of the services and do it really, really, really well? It's like you said, you don't like to do impacted thirds, but you found somebody that can come do those for you with minimal overhead. It's a great benefit for your patients, like you said, 'Guys, patients don't wanna go somewhere else.' You can sit here and rationalise and justify all day long but the bottom line is they wanna do a one-stop shop 'cause they don't understand an endodontist, a periodontist, an orthodontist, a dentist. You're just all dentists to them. They don't get it and they don't wanna go somewhere else.

0:09:04.9 KD: So I think you did something really wise there. That I feel like... Highlight that, let's see how you guys can bring more of these services in because then you have... I feel like your crayon box has got a lot bigger and brighter. You have so many more choices to choose from and you're also looking for more opportunities. Nobody has ever checked me for sleep, nobody. Nobody has ever checked my husband, no one has checked my in-laws. Nobody has ever done that. I have my number 10 that drives me nuts. It is slightly rotated. No one's ever talked to me about ortho, nobody. And I'm like, 'Guys, if you just asked me and said, 'Hey, Kiera, in three weeks, we could get this turned',' 'Cause that's honestly probably how long it will take. I'm the fastest, easiest ortho case you could ever imagine, but nobody says anything to me. Those little things like, I'm a perfectly healthy patient, but yet, those things could benefit me. Botox, why the heck don't you talk to me about Botox? I don't wanna get old and wrinkly. Come on, talk to me about these things.

0:10:01.7 EE: And you might as well get it when you get your cleaning. Why not? 'Let's do it.'

0:10:06.0 KD: Exactly, and I think that those are some of the things that I feel like... Really the highlight. Those are things you can proactively do today to ensure that you are being recession-proof. But the second thing... And I wanna ask because I know people heard you. You said, 'I have a highly motivated team.' You guys are a super pro team. It is hard to hire team members. But you said, 'I have a team member who is highly motivated.' And I can already hear the critics in the crowd saying, 'Erin, good for you that you have somebody highly motivated. I have somebody who I can't even get to answer the phone or show up on time.' So how do you get highly motivated team members? 'Cause I think you can get lucky but I also feel like it's a culture. So what are some of the things you've found because I think it's one, have all the services, but two, also have the right team. So how do you create, mould, morph, motivate these team members so they do wanna do more adjunct services? Is it just a person or is there a way that dentists can actually foster this kind of a culture?

0:11:06.0 KD: How many of you would just love to DIY and get the secrets of people who have been there, done that, on your own time? Because I know for me, I love to learn from the best of the best, the people who have been there, done that, and can give me the shortcuts. That's why we have created our Dental A Team Virtual Academy, where it's on-demand courses for you at your fingertips, where you literally can learn the secrets from all of my experience, all of Tiffany's experience, Britney, Dana, our entire team's experience at your fingertips. So stop taking the hard route, guys, there's a shortcut sitting there waiting for you, and it's also CE. Head on over to and click on our Virtual Academy. Be sure to use coupon code 'podcast' and get started on that DIY and become the practice of your dreams.

0:11:51.0 EE: I would say I feel like... I know hygienists are the rare animal right now, it's a extinct species, but I have a hygienist that wanted to work more, but physically, her body just can't take it. She's in a place where she needed more hours, and I was sitting here on the Pediatric Airway program and just sitting there 'cause I never made the time. I say, 'I don't have the time', I never made the time to implement it, and you always have time for what's important. But she came to me and she's like, 'Can I do this?' And I was like, 'Oh, my God. Here I am preaching team, team, team, and I never even presented it to the team 'cause I thought they wouldn't wanna do it.' So kids is something that parents will spend money on, no matter what, especially their health, and that's been very robust. As far as finding the team, yeah, looking within, it may be your favourite chair-side assistant but if she's motivated and she has a passion for it, you need to let her go. It's easier to find another chair-side assistant than someone that will really take this on. It's almost like a provider mindset.

0:13:06.6 EE: So I did lose my sleep person last September. We couldn't find anyone. I was doing it myself. I had one assistant that could get us through one day a week, and then finally, I was like, 'Let's hire a CNA because they're in the health field. They are getting $13 an hour for wiping butts. So maybe this will be a step up for them.' That did not work out well at all, so I was... She just never got it, she just never picked it up. So then we're also hiring for a front desk like everyone else in the world, and we had a woman in her 50s that just got divorced, back in the workforce, she was an orthodontist before but wanted front desk and wanted admin, and I was like, 'Wow, I have the job for you.' And so it was kind of that, it's a perfect meld of getting to help people and admin, so I don't know the perfect solution to finding that person, but... We put out ads for assistants, that didn't work. Finding the right person, being patient. And sometimes I think it is luck, but Lany, she being that age I think really helps her identify with patients. They are all in that same place in life. She talks to them like, 'Why wouldn't you do this to... '

0:14:36.7 EE: She's more straightforward and she really believes in it. She didn't even hear it... Know about sleep before, and now she is all in, so finding someone with that passion for it and understands the why is super important. If you don't have that person, you keep looking.

0:14:55.1 KD: Yes.

0:14:55.9 EE: And it may be someone that you really, really like working with chair-side, you may have to sacrifice that to make it work, but yeah.

0:15:02.5 KD: I'm so glad you said that... I'm so glad that you said that, especially as a dentist, because as a consultant, I'm not a dentist, I am a team member, and being that team member, I know I was my doctor's right hand, I know it. Guys, I didn't become a dental consultant, open my own company by being your shmuck of an assistant. I know I was a dang good assistant, but I love that you just said like those are the people that are gonna take your practice and run with it, and it is a lot easier. Dentists can train chair-side assistant. I get that you don't want to, and it does make your composites a little bit slower, but we're talking a couple of weeks of pain to train them, and then you have these highly motivated people that are your die-hard right hands. I also feel like chair-side assistants, they're probably some of the most loyal people to their doctors, like I want to make Erin's life so easy as an assistant because I'm here, I work with you day in day out, that these people are probably not gonna be the people that leave you either, they're gonna be the people that you've built these relationships with as well that I just feel really needs to be highlighted.

0:16:06.1 KD: I think, Erin, another thing that you pointed out that I hope listeners are hearing. You tried quite a few different options. You're posting for CNNs, you're thinking of different options, you're looking... Like your hygienist asked the question. So you didn't just stick mainstream of, 'I need an assistant, I will only hire an assistant, this is what we have to hire.' It's, 'Alright, we can't find anybody, nobody can find anybody, so what are some of these alternatives that could work?' And I think because you kept trying, you kept looking, you kept pivoting, you kept innovating, that's how you're able to keep thriving, and I feel like to really recession-proof, is our theme today, it's one, you added all the services in, so you innovated outside of general dentistry. You got outside of bread and butter dentistry, and you started thinking, How can I make the patient experience better internally in-house, what can I do to get all these services internal? And then second, you said, 'Hey, I need an awesome rock star team, I'm gonna keep innovating, thinking, continuing to push for it', and I feel like honestly, it's sometimes that grit that people lack in recessions, it's the grit and the stamina to keep going.

0:17:11.5 KD: So Erin, as a dentist, as someone who does all the things that dentists deal with, you're a wife, you're a mom, you're a busy dentist, you own a separate side gig business, you teach in 3D, how do you keep that mental stamina, how do you not give up when you lost your sleep champion, you've had these hits against you, you have... You're in Coeur d'Alene, Idaho guys. If you're staying in Phoenix or Chicago, I don't even wanna hear about your hiring problems, you are in the mecca of meccas. How do you... Erin, what are some of the things you do to keep a mental stamina? 'Cause I feel like that's honestly half of the battle of recession or hard times, is having that grit and that mental like just, 'I'm gonna do it.' So what do you do, what are some of the things that have helped you?

0:17:54.1 EE: Well, I never ever, even before I was a dentist, had like that victim mentality. And what I mean is, if you don't like your situation, change it, so I don't sit there and complain, I do something about it. And like for example, the CNA that I hired was so bad and created so much stress in my life, which I don't normally have. I just looked at my husband one day and I said, 'I cannot continue like this, it's so frustrating, she's frustrated too. I want her to like her job.' And he's like, 'What can I do to help?' As every man always does. And do you know what I said? I'm like, 'I need you to be my sleep champion.' He's never scanned but he's listened to me enough and he knew the basics, all it is is talking to people, and the scanning and all that stuff, I can have my assistant run in and do that, but just talking to people is all I needed, and he did awesome for the two weeks I had him, but it's one of those things, the patients were coming, so I didn't have an option.

0:19:06.7 EE: I don't know, I always feel like failure is not an option, so if I have to get in there and do it myself, no problem, but we just... I don't know. We came together and made it happen, so I don't know the right... I don't know, advice for that, but for me, is never been a term that I've used and #makeithappen. I don't know. If you don't like your situation, change it.

0:19:36.4 KD: Which I think is brilliant, and I feel like that is some of the best advice. I love also that you are a dentist, and you said, 'If I have to do it, I'm going to do it to make this happen.' I think there's sometimes a dentist mentality of, 'I'm a dentist, so I shouldn't be doing that', and you're like, 'Forget that, if I gotta have my husband come in and do it, we're going to do it because we've got the patients and we need to serve them.' And so I feel like I knew, Erin, that this topic... 'Cause I've been thinking about it, I've been hearing some offices stressed out about this recession, they're stressed out about their overhead, and I just keep thinking, 'I want somebody on this podcast that's gonna whip them into shape', and I knew you'd be the person because Erin you just motivate me every time we chat, and I feel like pieces that you've listed off today have been so beneficial. So Erin, if people are wanting to incorporate sleep... I send people to your course all the freaking time. If anyone asks me, 'How do I get sleep incorporated?' I'm like, 'Have you chatted with Erin Elliott? Have you gone to her course? She will tell you how to medical bill, she'll get your team involved. She will do from A to Z because, like you said, you guys are so team-focused, so it's not the heavy lifting on the doctor as much as you're saying how you can make it easy.

0:20:44.4 KD: So if people are like, 'Alright, I heard you, Erin, I'm not gonna say what was me, I haven't incorporated sleep or endo or extractions or Invisalign or botox. There's a thousand things you guys can do, if it was me, I'd be looking at what's gonna be the easiest to implement with the least amount of friction, the fastest to get it done. At least learn the skill. I know you've said sleep and ortho, those things can take some time to ramp up, but if people want to connect with you, if they want to enhance their skills, how can they connect with you, and what are some of the courses that you guys do teach? Of course, I'm rocking out the sleep 'cause that's what I know you for specifically, but I know you guys do more. So what are some of the things you guys do and how can they connect with you?

0:21:24.8 EE: The 3D Dentists, we have the sleep apnea implementation and it is online as well, but saying that, what T-bone or Tarun Agarwal has created is amazing, it's exactly for these doctors to recession-proof first. There's a mastermind, it is the business of dentistry, and everyone that has gone through there, it's revolutionised their life, meaning they have more time off, less stress and more money. The second is the Digital Implant Continuum, and that is not the cowboy implants, it's the onesie, twosies, it's the straightforward, keep you outta trouble, feel confident in doing it. Then there's an overdenture course, there's... Oh, this ortho course, because what I was gonna suggest to you, even with that number 10, if you did aligners, it wouldn't be three weeks and it would be a huge lab bill. We do brackets all day every day, and I have an assistant that does brackets all day, every day, and so we...

0:22:31.8 EE: 3D Dentists has an ortho course that teaches you aligners and brackets, and everything that we do is agnostic, meaning you can have any technology and no technology, and we can teach you how to use it, it's not brand-specific. One last thing I wanna tell you too is my philosophy in life too about the stress and impending doom is that my philosophy is, I don't worry until it's time to worry because there's so many things out of your control, and this is not religious in any way, but if you just remember, 'God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference', that is a good mantra and everything in your life, because there are some things that are outta your control, so why are you wasting your anxiety and mental energy on something you can't control?

0:23:25.1 KD: Gosh, Erin.

0:23:26.2 EE: But change the things you can.

0:23:27.5 KD: Brill. My husband says to me from his grandpa like, 'Worrying is interest on a problem you don't have.' And I've thought about that so much. I love, love, love that that is your mindset. I love that you listed off those. So guys, if you're interested, recession-proof your practice today. It is coming... Before we even got on the podcast, Erin is like, 'I don't know why people are freaking out. We've been talking about this coming, so it shouldn't be a surprise.' It's not like all of a sudden it's like covid, I feel that was a little bit of a surprise. That was something that I don't think anyone could have planned for, a pandemic, recessions, they happen. Patients not showing up, they happen. Not being able to hire people, it happens. These are not surprises, and so I really love what you said. So Erin, if people wanna get involved with 3D Dentists, they wanna start enhancing their skills, recession-proofing their practice now, how can they get in touch with you guys?

0:24:18.7 EE:, and [email protected], and then of course, I'm on Facebook and Instagram. My email is [email protected] Erin Elliott, two Ls, two Ts, dds, two Ds,

0:24:40.4 KD: I love it. And guys, I think something else that she said, follow her on social media. I personally believe the people you follow, the people you engage with, the people you wanna be like, follow them. Watch to see how they live their life because you're going to become them, so I love hanging out with Erin, I love... Your posts are hilarious, you just live such a happy life, and I know it's actually genuine. Erin, you're not someone who sugarcoats, you're not someone who puts on a facade, you are just real, raw, this is who you are, and that's what... You are sitting on a freaking pickleball thing, people are going all around you, you're like wiping your... It's like that is who you are, so I'd say, guys, if you want more positivity in your life, follow people like Erin. And Erin, I just appreciate you in my life and what you do. It's always fun. So thanks for being on the podcast today.

0:25:21.7 EE: Thanks for asking me.

0:25:22.8 KD: Of course. Alright, guys, go recession-proof your practice, it's time, recession-proof your life, be less stressed, stop worrying, like Erin was saying, and take action to do so. Roll up your sleeves, get to work, and as always, guys, thanks for listening and we'll catch you next time on The Dental A team podcast.

0:25:40.8 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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