Episode : #1,228: Scale Back and Work Less Without Killing Your Practice

Podcast Description

Many Dental A-Team clients have been able to successfully pull back on days worked while maintaining practice success, and Kiera’s here to tell you how they did it (without feeling guilty). Kiera touches on multiple ingredients to scale back successfully, including developing current associates or bringing on new ones, picking a date and making a plan, knowing the ins and outs of your numbers now and in the future, and more.

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Transcript:

Kiera (00:00)

Hello, Dental A Team listeners. This is Kiera, and today is a great day. I am excited to talk about how to create more and do less. so many dentists want to scale back, they don’t want to work as many days. And we have several clients that have successfully been able to go from where they were to where they wanted to be and be able to do it really successfully and not kill the practice. Some do, some genuinely do.

But today I want to work with you and talk to you about how you are able to do this successfully and not call like slow down completely your practice. So I hope you’re excited for it. I’m excited for it. Welcome to the Dental A Team podcast. If you’re new here, welcome. I’m Kiera Dent. I love podcasting and I love all things dentistry. If you’re an OG and you’ve been here for a long time, thanks for hanging out with us. and for all of you listening, thank you for sharing our podcast and making it one of the top most elite dental podcasts out there.

I come in and I give you guys the best of the best. You go out and you share it. You like it, you review it, you share it with your friends and colleagues. And I just want to say thank you because you know our mission is to positively and measurably, I added a new one, everybody, positively and measurably impact dentistry in the greatest way possible. And our clients tend to see a 10 to 30% increase in production. we just had an office and like their numbers weren’t as high as I wanted them to be. I was a little disappointed in it. However, we were doing multi, multi-millions.

And we were able to still grow them 1%. Now you might be like, 1% here, that’s not something to brag about on podcast. No, and we’re in the upper, upper, upper millions, 1%, and increasing their collections by 3%, and increasing across the board of multi-locations their diagnosis on an average of about 15 to 20% per location and increasing their case acceptance. Those things, well, yes, my first year was not sexy.

It was still in the upwards of 500,000, all in of how much they were able to grow in one year, which is very impressive. but what’s super rat is I feel like we gave them the diet, the exercise, and they don’t quite have the six pack yet, but they’re on their way. So just so you know, our clients tend to see massive results. and also they do that in their life, not just their business. So I guess I care about your PL and your numbers.

I also care about your life PL and how are you living and is this the best life you’ve got, which is why today’s podcast is so fun for me because how do you actually scale back and work less days without destroying it? And like I said, I have a dentist, he’s working three days now, about to go down to two days, and the practice is growing exponentially. I have another dentist who’s down to two days because that’s what she wanted to work, and her practice maintained what she did last year working five days. So, just so you know, she didn’t grow.

But she also didn’t lose. And so there’s ways to do this and there’s ways to do it successfully. So I just want you to know that you’ve got to be preparing for this. We can’t just say, like, my gosh, I want to do this because we can’t just like delete a day. But I will say that there are a lot of ways that you’re able to do it. A lot of times it’s developing a doctor, sometimes it’s maximizing your schedule. So I want you to know that, like, also when you scale back and you want to step away, please get rid of that like mean girl, mean guy on your shoulder that’s saying, like, you’re just not gonna care about your practice. Like, no.

You still care about your practice, you still love your patients, you also care about yourself and you want to have the best life. You built a business to have your best life. Your business should be serving your life. And I want you to just keep that as a mantra. Whatever life you want is totally doable. There is no playbook of how to run life. There’s your playbook of how you want to run your life. So let’s make this business serve your life. So there’s a few things that I want to go over today. I want to talk about like the timeline and how you reduce clinical days.

How you can develop current associates if you want to. You don’t always have to. Like I mentioned, there’s another dentist and she just cut back days and we were able to maintain her same production. And how to like look for other future associates if your practice is not there yet, because there might be certain things that you want to do. So I am so excited for you. I really do like to help dentists become CEOs of their practice, help them become the business owners that they were meant to be, not the business operators, and really truly obsessing about the life that they’re living, not just like the paycheck they’re taking home.

I think you can have both. I don’t think it needs to be an or my paycheck or my life. I think it can be my paycheck, my practice, and my life all together. So let’s build this backwards so that way stepping away becomes a planned transition as a so de instead of like it being a production emergency. So number one, I want you just to kind of put a date on the on the calendar. So we love to work with our clients. I follow the traction model, one, three, 10-year goals. What are we looking at? How are we building that? What is your future? And what’s that date? this year I said I wanted to be.

Fully in the CEO seat by September. Well, guess what? It’s past September and I’m not fully in that seat. So just because I put it on the paper doesn’t mean that it’s automatically going to happen. However, that is the goal that is the star that is the lighthouse on the hill that helps us get closer and closer. Am I closer today than I was in January when I set that goal? You better freaking believe it. Am I perfectly there? No. Were there setbacks and unexpected things? Of course.

But that’s not what, like again, goals are stars to guide by, not sticks to beat ourselves with. And I really want you to take that. I want you to hear that. And I want you to take that mantra on. So we’re gonna set the day of where we want to have it. And then all we have to do is work backwards. In our in-person Doctor Mastermind, yes, we bring our doctors and our leadership teams together twice a year. And it is freaking lit, guys. Like I am obsessed. Doctors are telling us it’s one of their favorite things Dental A Team’s putting on. We just did one of these in September and had almost a hundred people in the room. Like it was just an epic.

Like I love a good brainstorm mastermind think tank version of people that are just there. Like not everybody’s at the exact same level. There’s so many different people there. But to just learn and obsess and to walk out of there as a better person and to rub shoulders with really smart people and to be one of those really smart people rubbing shoulders as well, like our clients are the best. So that’s something that intrigues you. reach out. [email protected]. Come be a part of it. If you think you’re one those awesome people.

And even if you’re curious or you’re doubting yourself, that means you actually are an awesome person. So come reach out, [email protected]. I’d love you to be in the room with us. but while we were there, we were talking about like what their goals need to be and where they need to get to. And it was fascinating because people get so obsessed about their goals and their pieces, but then they have the the how, right? So they’re able to talk to other people, they’re able to ask other people how they did that, what’s the steps that they took.

So that way they’re able to learn from other people’s decisions as opposed to just needing to do it on their own. So when you’re looking at this, put the date on the calendar. What’s the date? And we’re gonna work it backwards. And that was something I was meaning of at our mastermind. We literally just took this of like, what hours do people want to work? How many vacations do they want to have? What’s the production we need to cover our costs? We do this with our clients. We actually build you an annual plan of what is our what do our costs? How much does it cost to run our business? How many days do we want to work?

Got a lot of doctors that want to take a week off every quarter. By all means, let’s put it in there. It just changes what we got to produce per day. But that’s very easy. Like it genuinely is easy. I said this on the podcast a few weeks ago. if you want to add 10 grand to your practice, you need to add an extra 600-ish. 625, I think is the total dollar amount per day if you’re working four days a week. That’s it. 625 in dentistry is a couple fluorides, an FMX, doing an extra filling here or there.

It is not a lot. And that’s what I just want you to realize is dentistry is so incredible on how you’re able to do this. So stepping back can actually be sooner than you thought it was. So I want you to put a date of where do you want to be? Do I want to be down to three days? Do I want to be down to four days? And let’s be realistic. Like for me, saying going from like all in to just being in the CEO seat, like that was pretty aggressive. And I didn’t stair step it back to say like what specifically needs to happen and when. We have been pushing hard, we’ve been interviewing a lot of people. And guess what? Some of them work, some of them didn’t work. That’s just

Okay. Just like you’re probably gonna interview associates and they’re going to work and they’re not going to work. That doctor that I mentioned, who’s working three days a week, his practice is booming, he’s probably gonna end this year at 5.5 to 5.6. and he’s working three days a week. Well, guess what? He had to go back in the chair. We lost an associate. So certain things don’t always plan, but as long as we have that guidepost for us, we’re going to actually get there with a lot more ease. So what do we want? What does it look like? How many days? What’s our production at currently?

And then how are we going to like move things around? Do we need to have more doctors, more space? Are we going to cut some of our insurance plans that aren’t paying as well? Be careful. Don’t hear that. A lot of you just heard that and you’re like, curious that I can cut insurance bonds. Do it strategically. You can if it makes sense. and then what do we need to have financially happen before we’re able to make that change? So if you want to go down to three days clinically in 12 months, let’s look at your production, let’s look at your associate’s production or just yours. I do have some, especially female doctors, nothing against my male doctors.

I think female doctors when they have babies, they’re like, gosh, like I need to be home with my kiddos. So I need to produce this in two to three days as opposed to working four days. Well, we just look and you gotta increase your dollar per hour. So you’ve got to get better at your diagnosis. You maybe need to get better at the procedures that you’re offering, and you gotta make your days count. I watch this at the dental college a lot. My female doctors that had babies, they could get out of that sim clinic by five o’clock because they had a baby waiting for them and they were on their way out.

Where some of my male doctors shouldn’t have to get home as quickly. They were maybe there until midnight. Now that’s not a complete across the board. I’m not being sexist at all. I’m just saying I’ve watched people have this in both sexes where they’re able to get out the door by that or they’re able to produce more. a lot of times when we’re working with doctors, we’ll say, like, perfect, we want to cut you down to three days. We have associates. Everybody needs to increase their dollar per hour this quarter by fifty or a hundred dollars. So let’s go look for that. Let’s see what we can do. How’s our diagnosis? What are we diagnosing? What are we closing? What

Like, which lever do we need to work on? And then sometimes they put a star chart up for offices. I know that sounds so silly, but if you’re tracking how many days you’re hitting your goal, what we track and measure improves. And so we’re able to easily increase your production, which then means I can do more in less days. Did you hear that? More in less days, and you get the life you want. So work backwards from your desired schedule and sometimes even just noodling. I remember I sat in a conference one time and they were like,

Dream big. And it was like, you want to have a private jet, how much does that cost? You want to have an in-house nanny? What does that cost? Your dreams might be closer than you actually think they are. And I felt like that was such a pivotal moment for me because I’m like, you’re right. Like I don’t even know what a private jet costs. I have no idea what an in-house nanny would cost. I have no idea what like having somebody come cook food for me would cost. Like I just didn’t know that. And for you, it might not like, well, what would I need to produce per day to work three days and still make the same amount?

Let’s just run the numbers. Math is math. And I love it because it actually makes sense. And then you’re like, okay, well, right now I’m producing 5,000 a day. Well, if I bumped it up to 6,000 a day, I could cut down a day potentially because I’m making an extra thousand every single day. Maybe it’s not quite enough. Maybe I gotta do 2,000 a day to offset that extra day. But math, math. So don’t remove this clinical day until we know that the math is going to math. And we’re gonna look to see do we need to replace this and bring on an associate? Can we maximize and shorten our days? And ultimately, what’s the vision for your practice? Because if you shorten your days, you’re probably gonna lose some of your patient base.

Right? Like I’m not here as many days. You can produce more on less people, but may we need to have hygiene running. And so check your state laws to see can hygiene run when you’re not there. Looking at those things, those are gonna have it, but put a target on our schedule and an actual date beside it of what day. And then have that on your mirror so you’re constantly looking at it. So we get much closer to it. Now, if we’re gonna develop an associate, this is a zone of like how like the doctor who’s now working three days doing over five million. they

Created a million dollar associate. And we talked about that in our mastermind of what did he do to make this associate a million-dollar associate in one year after hiring him straight out of school? Now, this doctor is a great doctor. We actually had that associate speak. So we had both sides of the coin: the owner doctor mentoring and the associate doctor being like groomed into this. But you’ve got to, you gotta look at this. What’s their production per hour? What does that associate want to make? What’s their case acceptance? What’s their procedure mix? What’s their clinical confidence? What’s the patient communication, leadership and team relationships?

And procedures that are still being referred to the owner. You as an owner, if you know that you want to cut down days in like a year or two years, let’s start grooming our associate and getting them to be able to take things over. So that way you’re able to do this higher level procedures. Your associate’s able to still produce and crank and you’re able to really grow them into the provider that you need. So if you’re doing most of the larger restorative or you’re doing a lot of the bread and butter, please don’t just dump all that on your associate. They’re probably not gonna produce as much and they’re not gonna be as happy, but that could work. So

If their day’s a $3,500 day and yours is a $7,500 day, well, let’s do the math and figure out what we need to each produce that’s realistic and reasonable. And then we set those targets for both of you. Owner doctor starts to fizzle out by this date. Associate doctor starts to pick up by this date. We work together right now to get both doctors producing what they need to produce. It becomes so fantastic. And then owner doctor starts to elevate the associate doctor. Owner doctor starts passing some of those procedures to the associate doctor. We make sure associate doctors

Clinical dentistry is doing really well, that their patient case acceptance is doing really well. We refine, we put them into courses, we give them access to higher things. There’s a lot of things you can do to really grow this associate. And it’s so fantastic because this is where we’re able to then figure out what does each doctor need to produce? What does each person need to do to be able to get to the numbers that we’re actually looking for? And it becomes like just this fun math equation for you. Math maths. And that’s how you’re able to do less with more. And sometimes just knowing that number is going to help out.

And getting your associates say, I want you to be a million dollar associate. Let’s work you towards that. Let’s find out what their goals are. Put them in courses. There’s tons of awesome courses that you can do to increase their clinical skill set while you also mentor them. Most of my doctors, when they’re doing this and they’re wanting to transition, are meeting with their associates weekly. So please don’t think that this just comes with a hope and a wish. There’s hard work, there’s elbow grease, there’s things that we put into play to get us to where we want to have. But again, that work is going to pay off undue dividends for the rest of your life.

So let’s make that a reality for you. now if you’re the doctor who’s like, I don’t want to hire an associate, I want to cut down days. Fan freaking task, but don’t you dare tell me you’re annoyed that your practice didn’t grow last year. Like, I’m just gonna throw that out there because there’s a doctor and they’re like, Well, Kiera, I didn’t grow. And I’m like, I am aware of that. You are absolutely correct, but guess what? You didn’t go down either. So you’re working three days instead of five days and you’re making the same amount. I say that’s a whole freaking win because, well, yes, your numbers did not increase 10% or 20%. You cut down.

days. You got your life back. You can’t put a monetary number on that for me, but you were able to do that. And to me, that sometimes we’re doctors like recognize that’s also a win. And if that’s still covering our bills and it’s still giving us the life we want and we’re able to be with our kids more, that’s a win too. So I want you just to look at that of like, all right, what’s my base and where am I going? Am I hiring associate? Do I need to develop my associate? How many days do I want to work and what’s the production and the the revenue and the take home pay that I want let’s do that.

Now let’s work it backwards. Let’s build that annual plan. How many hours per day? What do I need to be working on? what do I need my associate to produce to be able to offset this? Or what might like what are my days? I’m not here to say that you can’t cut your days and also grow your practice. I just know usually your first year doing it, you’re not usually going to grow your practice, but we are gonna grow your life. Then after that, we’re going to increase because we are seeing less patients. So less patients mean less diagnosis opportunities. It’s just math. Like it is. So we got to get really good and we gotta look to see where can we add more new patients.

Maybe we need to cut down insurances, but by cutting it, we got to then build it, right? So there’s just not as much space to do it. Very doable, and you are able to do that. But I just want to do some call-outs of realism. Let’s make sure we’re setting realistic goals as opposed to aspirational that we can’t actually achieve. Both are great. Let’s just make sure that we’re being realistic for it because everybody’s happier. So I just want you to think about it. What’s the date? What’s the target date? What do you need to do? How do we need to produce that associate? And sometimes having a team member sit here. This is what we love to do.

We, as your consultant, get to get you and your team rallied. We can say, like, doctor wants to be at three days. Let’s build the plan. There’s no guilt. There’s no like, my gosh, what’s my team gonna think? No, this is your life. We’re here to say let’s rally, just like everybody else. They want to live their best lives. Let’s get your associate on board. Let’s help your associate see the goals. Let’s run these team meetings for you. Let’s help you realize that it is okay to be selfish to live the life you want. That is okay. And you should live that life. So, and then we also help you figure out like,

We did with this other doctor. What does our associate need to produce? What are things that we can help you with? Here are the goals. This is what the reality sells us. Now, how do we make that happen? Let’s look at our procedure mix. Let’s look at our block scheduling. Let’s look at how we’re closing cases. Let’s look at how much we’re diagnosing cases. Having somebody sitting alongside of you can make these goals become so much more real, as opposed to you sitting there trying to like keep drafting the dream without a plan to execute. Your job is to dream, our job is to execute that dream for you with your team.

So reach out. I’d love to help you. [email protected]. But this is a way that you’re able to continue to scale your practice while also scaling your time and availability with your kids and your family. Both can be true. You don’t have to sell to a DSO. You’re more than welcome to, but you don’t have to to get the life that you want. So let’s make it a reality for you. Reach out [email protected]. Commit right now. I want you to put a timeline on when we’re going to be there by reducing clinical days.

Let’s figure out what our numbers need to be. And either we accept that we’re gonna reduce or we accept that we need to get an associate. We need to get them producing more. And then also we can hire if necessary to get to that future level. I want you to commit to yourself. This is the time for you. I know you’re able to do it. And if we can be a a partner in the journey, a cheerleader, or like somebody who’s strategically pushing this dream along.

Like I said, not all of our numbers are going to be sexy, but you better freaking believe we’re always going to cover our feet and we’re always going to get you going. And sometimes we got to build the foundation before we’re able to run. That is part of the journey. That’s okay. This year I set a goal. I wanted to be out. Guess what? It didn’t happen. We weren’t able to find the right people. And I’d rather sit here than hire the wrong people. That doesn’t come from a lack of effort. Sometimes it just doesn’t pencil, but guess what? We at least have the guide rails. We have the guide posts and we’re going to get you closer and closer and closer. I know with full confidence.

Probably by end of year, I’ll be very close to it. September was a little, that was like very aggressive. I’m okay with it. I also knew if it didn’t happen, this is what it is. And these are the zones that I am willing to compromise, but I’m not willing to compromise here. Your dream is much closer than you think it is. So let’s make it a reality. Let’s make 2027 your dream life. Join us. Like come be in the room with us. Be around great people. Your net work is your net worth. So look to see who your friends are and are those people pushing you forward.

Or they ones that maybe aren’t growing you and you’re the biggest fish in the pond. Come be a part of it. I’d love to see you there. Reach [email protected]. And as always, thanks for listening, and I’ll catch you next time on the Dental A Team Podcast.