How to Strengthen Your Team, Streamline Systems & Boost Production: A Discussion with Dr. David Rice

because most of the time what happens is one of two things we either have one bad experience so we add 10 minutes to everything that we don't need or we have one home run and we shave 10 minutes and then we're stressed the rest of the day so we want to find what's predictable what's repeatable and schedule our lives to that and then when the exceptions to the rule come in we handle them Welcome to the Phil Klein Dental Podcast. In today's episode, we'll explore the three key pillars of a successful dental practice, people, processes, and production. We'll discuss why a strong team culture is the foundation of any thriving practice, one that values good character, accountability, collaboration in fact a positive culture is one of the most powerful factors in boosting team morale enthusiasm and synergy it plays a crucial role in retaining employees increasing case acceptance and ultimately driving the success of a dental practice. We'll also talk about effective time management, how eliminating waste and inefficiencies can reduce stress and create a more productive, enjoyable work environment. And of course, we can't overlook the impact of technology and AI in streamlining operations, enhancing patient care, and fueling practice growth. So if you're looking to build a stronger team, refine your systems, and maximize your production, this episode is for you. Our guest is Dr. David Rice, the founder of Ignite DDS. He's a popular speaker and writer, editorial director of Dentistry IQ, and leads a team-centered restorative and implant practice in East Amherst, New York. Before we begin talking with Dr. Rice, I would like to thank our sponsor, Microcopy. Microcopy is a great company that has existed under the mindset of creating innovations for efficient, safe, and simple dentistry for nearly 50 years. They're a perfect sponsor for this episode as we focus on efficiency and productivity. You're probably familiar with their exceptional line of rotary instruments, including their Neo Diamond Burr. Used by thousands of dental clinicians, the Neo Diamond Burr is getting great feedback. Many are saying, and I quote, It cuts like a hot knife through butter. And with today's hard ceramic materials and zirconia, of course, that's exactly what we need in a rotary instrument. So check out microcopydental.com. They have single patient use packaging, which is ideal for infection control and also keeps your costs down overall. To learn more about the entire product line at Microcopy, visit their site, microcopydental.com. I assure you, you will love the burrs and you will also love the price. So we thank you, Microcopy, for sponsoring this podcast. Dr. Rice, it's a pleasure to have you on the show. Hey there. How are you today? Good, good. We haven't talked for a while and I do see you at the conventions, at the meetings. You're always into something. Congratulations on your success with Ignite DDS. And we're very happy to actually have you on the show to give us some insight on some of the coaching recommendations that you make with your program. I'm hearing great things about it. If our audience is interested, as I said in my introduction, Ignite DDS is the name of the company. And Dr. Rice has been involved with that. He founded it. And it's a huge success. And we really, as I said, I appreciate, Dr. Rice, your time. So it's no secret that the cost of running a dental practice is growing. And we all know insurance reimbursements are not correlating with the costs. In fact, they're going the other direction. And that's why some dentists are extricating themselves from insurance and going strictly fee-for-service, cash only. Not all of us can do that and some of us have a hybrid approach where we have both. So we want to maximize and optimize our productivity and our revenue and our profits and our happiness at the same time, which is something you do really well with your Ignite DDS program. So you speak about people, you speak about process and production. Those are core elements that you teach. So before we get into the details, tell us how they interplay. Sure. So, you know, I'm a big believer that in today's dental practice, we have to have three controls. So we have to have financial control, systems control, clinical control. And for me as a dentist, like the natural next question is, how do I have those? And what we found over the years is we need people and not just people. Some people talk about culture, but I like to talk about leveling people up to character. We need to have great process so we could literally unplug anyone on the team on any given day and still fire on all cylinders. I think that's really important. And obviously on the production side, at Ignite, we look at it a little bit differently. The money's going to come if our diagnostic process is on point, if our treatment's on point, if we have core pieces of technology, kind of universal to most practices. And then other tech sort of comes and goes based on what model you have in your practice and what style of dentistry. But you have to have all three. And I think the one differentiator that I maybe push back against a lot of people in this space is as important as process is, people come first. Because people who don't have character, they're going to break process every single time. So we focus a lot on that trifecta and how they all interplay with one another. And this culture of good character has to come out of every employee in their actions, that they're trustworthy, they're honest. They're passionate about what they do, and it comes from the heart. They're truly interested in the success of the practice, and it's not just a paycheck. And all of this comes from the top. It comes from the culture of the office that begins with the leader of the practice. And this is great for employee retention, holding on to these good people. Obviously, that's so important. And also, the patients pick up on it. When they come into the office, they feel the vibes of a culture like this. And they're happy that they're in that practice getting that treatment. You know, it's a win for everybody. Yeah. And you know, you said a lot there. I want to recap that because I think sometimes we, you and I say it because we understand it fully, but a lot of practices may not get it. I, of course, believe in taking care of our patients, but I've always preached like be a team centered practice. Focus on building that culture. And when you can level it up to character based off your vision, where you want to go, then patients will see it. They'll feel it when they walk in the door. They'll know it. And when somebody walks in the door and everything is firing on all cylinders and people are happy and happy to help, people say yes more. And when they walk in and that culture's off, they're tuned out right away. So what do you do in an example where you have an office, they're very dedicated to hiring good people, but then you get this one employee who just doesn't fit in. That one employee could unfortunately create a toxic work environment there. And there's a hiring crisis right now in the dental industry. It started with COVID. Only 25% of matriculating hygienists that start their program finish. So just think of that. One out of four hygienists that apply and get accepted to hygiene school do not finish and they never end up in the workforce. Dentists are kind of reticent to let someone go, even if they don't fit in to the culture. What's your recommendation there as someone who coaches so much at Ignite DDS? Let's assume that the circumstances and the culture are there. Let's assume that we've spent time developing that person. And now it's just a matter of will. And they're choosing as that team member to really not bring who they promise to be to the table. From there, our first step is to learn to have a crucial conversation. And, you know, I think it's hard for a lot of dentists. We don't like that relationship. We just want everything to be smooth. But think of a crucial conversation as anytime you need to talk to somebody or anytime you are talking to somebody and emotionally you either feel fear. or anger like that's a time to take a deep breath realize you're in a crucial conversation or you're about to have one and you need to learn how to unplug the emotion There's strategy and steps to that and really plug in the logic and just share with people, hold them back to that original vision, pull them back to who they promised to be. And if they're willing to try to be that person, then, Hey, I'm willing to try to develop them further. And if they're unwilling to be that person, then I'd rather a practice run short. then have that proverbial bad apple in there because all the people who are doing it right are watching and eventually they're going to get sick and tired of being sick and tired of that bad person. Right. Now, some of us as dentists are great clinicians, but not necessarily great leaders. And like you mentioned, Dr. Rice, and that's a good point, you know, there's an emotional thing in having that conversation and some dentists don't feel comfortable with that. What do you suggest, what do you recommend to the dental practice owner who has to have that conversation and they need to get this employee to understand that if they don't fulfill what they promised to fulfill, they're not behaving within the culture of the practice. So they're not additive and they're not helping the practice grow. They have to be let go if they don't improve. How do you get that doctor to step up and not kind of defer that? conversation to someone else in the practice, like maybe the head hygiene person or maybe an associate dentist. They'll say, hey, you know, John, can you do me a favor and talk to Tracy? Because we have to have this conversation. It has to come from the leader, the owner of the practice. If that person doesn't feel comfortable, what do you recommend for them to do? Yeah, I love that question because you're 100% right. As the leader, you need to be the person who has that conversation. Your team's watching at all times and you have to walk your talk. So the first thing I would say is be vulnerable. One of the greatest leadership qualities I've ever really witnessed are people who are vulnerable and admit that maybe as you sit here today, you don't have that skill set yet. but you can learn it. And the first step is just to own that. Maybe it's not in your repertoire today. Then find people. And there's lots of great people out there. Some in dentistry, some outside of dentistry who can teach you how to be that person. And third, I would say, if this is happening to you right now in the moment, and you don't have time for any of that stuff, I would say, take a minute and remember that it's not you who brought this conflict to the table. This is the team member who brought the conflict to the table. So lots of times you feel bad as a leader because you're punishing somebody, so to speak, but you're not, you know, they're really punishing you. They put you in an awkward position. They've made life uncomfortable for you. So that doesn't mean be nasty. You can be professional, but you can be fair. You can be firm. You can be friendly and just let them know what you expect of them. Bring that back to that original expectation. And simply ask them a question if they're living up to who they promised to be and stop talking. That might be the easiest thing to do without the actual skills to maybe have that conversation at a deeper level. So as dentists, we're human beings. We all have emotions. But when you have an employee that's not behaving properly or they just don't have, they're not a good fit for the culture and you have that discussion and you give them a chance, you try to get them to fit in. Sometimes a dentist's compassion and empathy isn't in balance with their business acumen. So their business could suffer. The business itself is at risk. Like you mentioned, the other employees are not going to certainly be happy to have someone who's adding toxicity to the work environment. So what recommendations do you make to a dentist who naturally is very compassionate, has a tremendous amount of empathy? for other people, which, as I said, could be a good thing, but they're not balancing their business decision-making properly. It's heavily weighted on the emotional empathy side, and that could ultimately hurt their business for obvious reasons. How do you coach in situations like that? Yeah, and absolutes are really dangerous. So if you're always emotional or you're always on business, we can get into trouble. So in this instance where you're firing, on all emotional cylinders i you know i would i would have to honestly say my wife anastasia is a master of this and healthy boundaries so set healthy boundaries for yourself and that you know fuel the business success you have to do it so sit back and understand the level of impact that this person or these people are having on your business and and look at it from the standpoint that they're harming the other people on your team. They're putting the other teammates at risk. And if you don't manage this one person and get them to the other side or invite them to a career change, then they're not just negatively impacting you. they're negatively impacting two, three, four, 10, 15 other people. So bring that emotion to the table and have the empathy for the people who are doing it right and recognize that boundary. Yeah, that's a great point. That is a great way to look at it. All right, let's talk about process and then we'll move on to production. Process, there's different processes in a practice. Tell us about, from the top view, what this means and then we can get into a little more specifics about some of the recommendations you can make. Sure. I always look from a process level and start with KPIs, so key performance indicators. And you line up 100 people who coach dental practices, and you'll probably get 100 different answers on how many of these are important. But there's about 10 of them that are critical that we should be measuring all the time. And if you want to add others, go for it. From that measuring stick, then there's really two types of operating procedures in any dental practice. Some are standard operating procedures. So people have heard of SOPs. And those are the things that run your business, how you answer the phone, how you schedule, how you fill, how you collect, HR, all those things. And then there's clinical operating procedures. So COPs. And those things are all about the efficiencies that happen when we're with patients. Because the crazy thing is most dental practices that we walk into, we find about 90 minutes a day of waste. And I don't want anyone working harder. That's not the goal when we examine those. But when we work smarter and we realize there's an extra 90 minutes in a day, boy, if we capitalize just an hour of that times four days a week, because we're dentists, we're lazy, you know, that's our full time, you know, times 48 weeks a year, that's a lot of production we can generate. And then we've got a 30 minute buffer if we want, or we can go all in and maximize all 90. So how do you identify that 90 minutes that's being wasted? We look at how everybody does the procedures that they do all day, every day. That's where we start. I think it's really overwhelming people to try to globally look at everything they do. So we say, hey, on the clinical dental side. hygienist, tell me what your average day looks like. Well, I have X perio procedures, X recare procedures, et cetera, et cetera. Dentist, what are you doing on the average day? Business team, what are you doing on the average day? And then what we do is we measure how long it takes to do each one of those processes. We look for opportunities to improve and we find the true time allotment that it. could be in a practice because most of the time what happens is one of two things we either have one bad experience so we add 10 minutes to everything that we don't need or we have one home run and we shave 10 minutes and then we're stressed the rest of the day so we want to find what's predictable what's repeatable and schedule our lives to that. And then when the exceptions to the rule come in, we handle them. Right. No, that's good. So how inefficient is that typical hygiene check where the dentist has to get up from the operatory, go into the hygiene? I mean, I hear that all the time. I do a lot of podcasts and I hear that hygiene check. Tell us about that. Absolutely. So for your hygiene listeners, I don't have to tell you how long you wait for us as dentists. And dentists, you're usually frustrated and annoyed because your hygienist walks in at the most quote inopportune time. So if you can write it always that you're in the middle of something that's stressful and you want to finish it. And I understand that. So the key is to schedule in times with the range where you can pop in early or Hop in late. You know this is a team. You have a flow that you develop together that works for you. And you make it happen. What we schedule happens. What we randomly think is going to happen becomes really difficult to execute. So staying with processes, Dr. Rice, with your experience as a coach, give us some examples that routinely come up as processes where the dentist is pretty inefficient, where they're losing productivity, they're losing efficiency, doing these processes day in and day out. Sure. So I'm going to give you low hanging fruit accounts receivable. I have yet to coach a practice where we couldn't go in and find them literally $80,000 minimum in the first 45 days. So there's a major gap with the process. And that happens on two sides. It happens on the patient side and collecting money. And it happens on the insurance side and how you. expedite getting paid. And then everybody has their own quote process within that process of you collect payment at time of service or you collect payment after insurance comes in. So that's a big, big area. Another one is new patient process. You know, the data shows us, this is crazy to hear, but data shows us that if a new patient calls us and we don't get them scheduled within two weeks, over 85% of them are not coming in for that appointment. So we have to dramatically improve our process to get new patients in the door while they're ready on their schedule. Now, do these offices have online scheduling? Like, you know, in the medical field right now, if you call, you know, you can't call anybody these days. I mean, getting someone on the phone is, and now they say, you know, the wait's 20. I called my dermatologist. The wait's 28 minutes. Do you want to wait? Do you want us to call you back? And that's really kind of nice that. you know, they have a way of having you opt in to being called back, although I never did get the call. But then you can go on to a website and actually make an appointment. You can do that with your car to the dealership. And you can go on and you can choose, you know, four weeks, I want to bring my car in. It's seven in the morning and you grab the spot and there it is. Is that something that dentists are doing or not? I would say not enough dentists are doing that. You know, and we started with those three controls, right? Financial systems and clinical. And I know dentists feel out of control when they allow a patient to schedule via their website. But I promise you that you can have a process. You can have systems to make that go smoothly for you. But I highly, highly recommend if you do. Nothing else from this podcast that you get with your IT team and create the ability on your website for patients to schedule there. It's very important. Now, as a coach for Ignite DDS, do you see AI? coming into play as you continue to coach doctors as ai becomes more and more developed and it's basically pervasive in almost everything we do today a lot of things that are we're doing on a regular basis we don't even realize ai is a big part of but there's so much in dentistry that ai could actually streamline efficiency for us So tell us about that. What does it look like for you as a coach in this, how AI is becoming so relevant and could have such a big impact on the practice? Sure. So for the SOP, the standard operating side, there's a few things that are happening right now that are amazing. I'll say person because they're that good these days. Answer your phones for you and guide a patient through the process. Like gone other days where it sounds like a machine and it's automated. The best AI systems out there are amazing. We can teach them to share what we want to share. Their inflection is on point. That's awesome. Also on standard operating procedures. you know, the move towards AI helping us with insurance companies. We all know how long that takes a team member or team members to do AI streamlining that process. And on the clinical operating procedure side, there are some really strong players out there that help us from a diagnostic side with radiographs, both in perio and the dental carry side of things. And they're not only excellent for... almost like a second opinion for us, but they're tremendous at calibrating our team. So the patient gets the same exact experience and explanation in every hygiene room and in every restorative or surgical room. It's powerful. Since we graduated dental school, the changes that have taken place in the dental industry, I mean, between materials, imaging. And now we're getting into AI. And CBCT is also a really big game changer. I talked to a doctor who is doing a lot of implants. He does a CBCT on every patient as a new patient, but does not charge for that. Literally, he doesn't charge. He could charge $300. He does it for free. But he uses the rendering from the CBCT to actually sell his cases. And he says that. And he's an implant, mostly an implant guy, even though he's a GP, primarily does anything surrounding implants, whether it's grafting, single tooth implants, full arch. Is that something that you cover in your program where you talk about case acceptance? And is CBCT becoming a big player in that? We absolutely talk about case acceptance. It's really sad for me. But if you look at the data on that, it ranges between about 22% and 34% max for... complete care case acceptance in North America, which is stunning to me. Stunning how much we think we're treating our patients and delivering optimal care and we're not. And then the revenue we lose on the business side of it because they're not saying yes to the treatment. And I would say, yes, the CBCT is one of those core technologies that as soon as you can afford to bring it into your practice, it's a tremendous diagnostic tool. It allows us to see so many things. And let's be honest, right? If we can't see it, we can't treat it. Yeah, it's interesting to point out, Dr. Rice, that the CBCT of today is similar to the investment that was made decades ago with a pan. You know, when you account for inflation, the cost of an office buying a CBCT machine, it probably was similar, very similar to buying a panoramic x-ray machine back in the day. And of course, CBCT is just phenomenally better diagnostically and eventually will be the standard of care when it comes to diagnosis in dentistry. So production, let's talk about production. We talked about people, process. Tell us about production and how that interplays into all this. Sure. So like I said, when we look at production, we're really looking at diagnosis, treatment, technology. And the greatest dentists I know clinically, as well as the most successful dentists I know, I think they're master diagnosticians. So it's like they have a magic eight ball. They see the future. So when David Rice walks in as a patient, you know, he's not no treatment or minimal treatment. He's somebody that we can predict what's going to happen and we can intervene early, save patients tens of thousands of dollars, a lot of heartache. And also, yeah, that's great for our practice. The treatment scope really is about... I love dentistry because we can choose the scope of our treatment, but whatever scope you choose, I would say be a master of it and don't try to be all things to all people. We've got tremendous specialists in dentistry. We still lean on them. The practices we coach, many of them still lean on specialists and that's a wonderful way to practice and deliver optimal care and win a lot and build your brand and reputation in the community. And then the tech side, like I said, CBCT being core scanner, you have to have a scanner today. I mean, it's, it's, it's, uh, I still talk to dentists who don't, um, it's, it's a must. And if you're a seasoned pro and you're thinking, well, I'm on kind of the home stretch. Do I really need to make that investment? The answer is if you want a young dentist to buy your practice, yes, absolutely. yeah they want turnkey they don't want to walk in and change the carpets and repaint the walls and buy some tech they want it to you know walk and talk the way they like it yeah and they're buying they're buying the goodwill which yeah and the goodwill part of that are those patients that obviously see the office as being digital and being high-end and You don't necessarily have to have the latest and greatest gadget across the board, but an intraoral scanner. I mean, at this point, what is it, 40% penetration now? Yeah, I think that's a really great number at jockeys, but 40 is fair. So boy, that's 60% of us out there that can level up our practice with one investment. And it's not even really a large investment anymore unless you choose to bring in a milling machine and other components to that technology. But you can get into a really solid scanner for, you know, 20,000 bucks. Yeah. So I want to ask you about this. Dentists often bring this up on the episodes that I do when I talk to them. They feel that it's important to differentiate their practice. Now, we're talking about general dentists now. So a lot of them... are thinking of what they refer to as a subspecialty in general dentistry. And that could be airway, that could be TMJ, that could be both. Sleep medicine, of course, is part of airway. And implants. Some GPs are specializing in implants. And this certainly makes a lot of sense for a number of reasons. Career satisfaction, competition with other dentists that are out there, boosting awareness in the... dental population that's in your community that you do these things to attract new patients. What are your thoughts about a subspecialty approach by a GP? Yeah, I love, you know, once you feel really solid in the diagnostic space, I love the concept of niching. I think that's always worked in any business, dentistry or outside. So absolutely. What I would share with your listeners are First, niche in something you really love. Don't be concerned about the shiny penny because that shiny penny is going to change in six months, in a year, in a year and a half. So find something that you really love, whether it is in plant placement or the OSA space or, you know, anterior aesthetics or name whatever that is for you. And then invest in yourself. Take deep dive, continue in education. Take hands on education. I love online learning for the 30,000 foot view. But if you really want to master something, you're going to need to be in a small classroom space with a limited amount of other clinicians and a lot of one-on-one attention. And that will serve you very, very well. Yeah, there's no question that. professional development, continued education, opens the doors to so many possibilities in dentistry. And it could really get you out of a routine of what you're currently doing. Even though you may enjoy your work, you may not be aware that there's something else that excites you. So you can try different things and see what moves you and keep your mind open and say yes to opportunities. And before you know it, you might find something that you really love even more than you're doing now. And you start to allocate more time in your practice to that. And your career satisfaction, your level of career satisfaction will just skyrocket. Yeah, I agree with that. There's this thing called the competence-confidence loop. So the more we master a subject, the greater our confidence level is and the greater our confidence level is. Our competence then rises and it just keeps cycling and cycling and cycling. So your best investment is always yourself. So take the time. Make that investment. Find the places that you can take a deep dive in. Commit to them. I'll tell you my greatest mistake was thinking I needed to go to Panky and Dawson and Spear and Kois. And I didn't. I needed to focus on one and take a deep dive. And I learned that lesson over time and subsequently did it. Every penny you spend, you're going to get 100x back when you're with the right people who can teach you the right dentistry and how to get your patients to say yes. Now, that last case acceptance piece may not happen at one of those same places. You might need a second dive, but those are the two keys. Love the dentistry, dive deep in it, and then learn how to get patients to say yes. So as we approach the bottom of this podcast, Dr. Rice, and it's been very enlightening, tell us about Ignite DDS a little bit. What would one expect if they were to get involved with your organization? Sure. So we work one of two ways, really. We work a year to click with people. And I love that because that is the deep dive. It's an investment in time and energy and money on your part. But I can tell you this, we've never had anyone who didn't minimally 5x it. So that's a nice number. Most people do seven to eight X, but five is pretty darn good. Or if you're kind of a shallow dive person and you need to build trust and learn, you know, we work 90 day jumpstarts. Those are keyed into very targeted areas of your practice, like case acceptance, like accounts receivable. like just simply answering the phone at an excellent level so you get those people in the door for all the marketing dollars. In order to make the recommendations and coach a particular practice that's specific to them, you have to assess the office, obviously. How do you do that? Yeah, so the first thing we do if you reach out to us is we're going to, one, jump on a Zoom call with you because I need to learn where you are, where you want to go, and how fast you want to get there. And two, we'll send you an assessment that pulls some of those key performance indicators, asks you a few questions that are a lot of a mirror test. And then we go from there. And if our listeners want to reach out to you, Dr. Rice, what's your email? It's my name. It's david.rice at ignitedds.com. And you can find me on pretty much every social platform that exists as well. Dr. Rice, I really appreciate the discussion. Great, great stuff. Really enjoyed talking with you. You brought up some great points and we hope to have you on the show again. Thank you very much. Thank you.