Finding True North: How to Set and Stay the Course with Digital Dentistry

You're listening to the Phil Klein Dental Podcast Today, we'll be talking with Cornelia Cone. Cornelia is the office manager and wife of Dr. Miles Cone. She and her husband run a boutique prosthodontic practice in Portland, Maine. Cornelia has been instrumental in moving their practice from analog to digital and has been kind enough to come on our show and share her experiences and secret sauce for staying the course and succeeding with digital dentistry. In a second, we'll be talking to Cornelia, but first, we all know that to achieve healthy, beautiful smiles, we sometimes need to align the teeth. And to do so, aligner therapy is a great option. So why not set your practice apart with 3M Clarity Aligners Flex. Designed for comfort, Clarity Aligners Flex feature a thin, flexible design. yet they deliver excellent force persistence over a two-week period. Plus, they resist scratching and stains, and they're backed by a dedicated clinician team providing support every step of the way. With a variety of affordable case-type options, single or dual-arch, Clarity Aligners Flex offer a great value to your patients and practice. To learn more, visit 3M.com slash clarity dash aligners dash flex. Cornelia, thanks for joining us. It's a pleasure to be here, Phil. So to begin, with all your experience you've had in transforming your practice from analog to digital, what advice would you give dentists who are considering switching now to digital dentistry? Yeah, so Phil, that's a great question. And I think that if I look back at the hours that we had... for lack of a better word in our practice on things that we have now automated and just streamlined with dentistry i feel a tremendous sense of loss you know and miles and i have four children and there's a lot of late night hours that were spent just working and doing things that we now do much more efficiently with digital dentistry And so I think the biggest piece of advice I would give to people that are kind of on the sidelines trying to figure out whether it's worthwhile to make the switch is just do it. Just close your eyes and just take the leap and do it. And there's some advice, you know, additional tips and tricks that I'm going to try to impart on you and some wisdom and hard lessons learned in this podcast that maybe might make that jump a little bit easier for you. But I guess the biggest piece of advice would just be to just don't keep on pondering, hesitating, just do it. And this is such a great time of the year to do it. You know, fresh start, beginning of the year, just do something different. The benefits just so far outweigh the cons, I think. Yeah, and I think it's fascinating that you traveled with your husband. And I know Dr. Cohn teaches a lot in lectures around the world. And he's a very popular speaker, and he brings big crowds into his audience. And you were kind of hobnobbing with other colleagues out there. And you're not a dentist. You're running the show, though, for the practice. And you talked to so many people that were really excited about digital dentistry, and you encouraged your husband to get into it, which is fabulous. And then, of course, you helped make the switch. You helped with purchasing the equipment. And you also know the importance of staff when it comes to being successful. with the integration of digital workflow. So let's talk about how important it is to have the right team members, because without the right staff, digital dentistry will ultimately be an uphill battle for everyone. And if you would share with us some tips for onboarding staff so that the practice really benefits from the digital technologies in the office. So Phil, with that, I'll just kind of give you... a little bit of insight into the mindset that i had um and kind of our journey and our history so miles and i decided to make this shift into digital at the beginning of 2023 and i like to set new year's resolutions so for that year and this is going to sound kind of um maybe a little bit morbid like these these new year's resolutions that i said for 2023 but we were in a point where miles i really was terrified that miles was going to burn out and my motto is that when people ask me what my job is i say that my job is to protect the asset miles is the asset so going into 2023 with this looming burnout i made two new year's resolutions and the one was digital or death and then hand in hand with that was delegation or death So I really feel strongly about that, that if you are going to go to a digital dentistry practice, you need to be mindful about how you're going to delegate certain portions of that workflow. And I think before you make that shift to the pitfall that I see a lot of dentists fall into is that, frankly, they go to a conference. There's all of these shiny toys. They go and spend a lot of money and then they come back to the practice and they literally at a staff meeting, just point at somebody at the table and say, this, your job description has completely changed. You are now the girl that does the digital stuff. And I think that is the biggest risk. And that's where everything starts falling apart. I would say, and we don't have a big team. So it's a little bit of a different story when it came to. aligning with team members and getting buy-in, but the buy-in and alignment on the front end before you make that shift and really getting team members to feel like they can see the benefits for themselves in this and then providing them with clear workflows and support during that process, I think is just key to do. And so in our practice, We run a little bit of a different model. So in the clinical practice, physically, it's just Miles and myself. And then I have remote team members that do a lot of my front office work. And I have actually, and this is the beautiful thing about digital dentistry too, is to an increasing extent, it actually helped me to loop a lot of those people that work remotely for me. into the clinic, they could now see the scans real time. We could communicate a lot more effectively with the lab as well. So for us, I feel like... because we were mindful about how we introduced it to the staff, how we onboarded them, the workflows, all of that. I think it's just been a beautiful transition and we were able to avoid some of those pitfalls. Yeah. So you think it's very important for a dental practice, and this comes from the top, the dental owner, to really educate their staff prior to making these purchases and find out who. is going to be ultimately delegated the responsibility of handling whatever responsibility that is in the digital world. Could you break down some of these responsibilities with these remote staff people that you have? Yeah, so I'll give you a quick example. So I think it's important to just know the strengths and the interests of your staff members to just know them as a person. know what they'll do well with professionally. So a really just front of mind example of this is this morning. So we take digital scans, intraoral scans in our practice. And then those scans need to be sent to the lab so that they can do their lab steps. But we also love to take. those digital scans and we take snapshots of that and we put it into the patient records which all of our practice management software is cloud-based so this morning before the podcast we spent some time onboarding and just working through the workflow with one of our remote staff members so that she can remotely log into our computer where we take the digital scans on, and she can extract those scans, put it into the document manager, send it over to the lab if we need it. And I knew that she was the right person to do it because I know her strengths. I know her skillset. I know what she would be excited about. And I know that one of the things in speaking to her that makes her feel like... She's maybe not as involved in the day-to-day clinical dentistry that we do is because it's abstract. She sits at her house, she works remotely, and she sees these patients, just the little patient photo that pops up. She sends over the referral, all of these things. It's not... a person it becomes a lot more tangible she feels like she's a lot more involved in the process when we can kind of bring her into the practice with all of this digital technology and so i there's other staff members that i didn't think would be as excited about that or that wouldn't necessarily have the aptitude or the strengths to be able to do that. But that's why you match certain jobs with certain people. And I could, you know, when we were doing this training with her this morning, I could just see the lights go on. She was just fascinated. Like here, all of a sudden, she could see a three-dimensional rendering of this patient's jaw and she could... it around and look at everything. And all of a sudden it kind of clicked. She could marry what she was seeing in a three-dimensional scan up with what she was seeing now in a two -dimensional chart. And it all just made so much more sense to her. And so I think that's a very valuable part of that. And that's just one example in our practice, how we try to match the right kind of task with the right kind of person. We'll be getting back to Cornelia in a second, but first, if you're looking to raise the bar with your adhesive dental procedures, you should definitely be looking into Bisco. Bisco is a great company that has an unparalleled track record. I can unequivocally say adhesion is their passion. They are genuinely dedicated to understanding and improving the ability to bond dental restorations. Bisco is a company that places tremendous value on research and scientific knowledge to benefit you and your practice. Being an endodontist myself, my favorite Bisco product is Theracal LC, which hands down is one of the best materials to use for direct and indirect pulp capping procedures. It not only seals the dentin, but offers significant calcium release, which stimulates hydroxyapatite and secondary bridge formation, which is exactly what we're looking for in these kind of procedures. So check out their entire product line of premium adhesive products at bisco.com. So in the past, before you went totally digital, did you have more people in your office working? And now because of the digital application of the way you practice dentistry, that enables remote workers? No. So it's interesting because I think for different reasons, and Miles kind of alluded to this in some of the other podcasts that he did with you, but... people we kind of thought in our mind that oh we got a scanner and now it's this big jump into digital dentistry but when we really started thinking about it we were actually very digital in a lot of unconventional ways way before this so i i've always had cloud-based practice management software and um Just because Miles travels so much for his lecturing and we have a small office space, I kind of came up with this unusual idea of, well, could I get somebody to work remotely? And we kind of fell into that because one of Miles's dental assistants back from his army days contacted us one day and said, I'm in the job market. Do you think you have something for me? And I kind of on the spot invented something for her. And we built these systems to be able to help her to work remotely for us. And so for us, it's not like anybody's one. job that was primarily analog now got sacrificed in the name of digital and it was also kind of an easy transition with a lot of these things I think it was actually a big benefit because like I said a lot of our remote staff I feel like they felt maybe like they were working in in in kind of almost like an abstract clinic you know like they weren't as involved in the day-to-day dentistry and what digital did is it enabled us to be able to make that wet finger dentistry that we were doing a lot more tangible and and the remote staff felt like they were more part of the clinic and um when we were doing things analog The sad reality, and that's why we had that looming burnout, was Miles and I were just working crazy, crazy hours. And it just was unsustainable. And so that's why, as we were going into 2023, I knew that if we wanted things to be sustainable, and if my job was really to protect the asset, and if that was Miles. we had to make some kind of shift. And so that's where digital seemed like the obvious solution for us. And it just took so much burden off of us because it's not like we were doing, we're still doing the same kind of essential steps, but we're just doing it in a far more efficient manner. So Dr. Cohn is a board certified prosthodontist. He's also a lab technician, a certified lab technician. And because of that, he was probably spending many hours late into the night at his bench where he was doing a lot of the laboratory work. So you're saying the digital workflow has freed him up from many of those laboratory tasks. There's that old adage of your strength is your weakness and your weakness is your strength. And I think that rings very true for Miles because I think he is such a phenomenal clinician because he has all of this lab background and this insight and it enables him to be able to communicate with labs and come up with novel treatment plans for patients. But at the same time, it also became his weakness and his downfall because then Miles would do many of the laboratory steps himself and he had such a high standard that he just couldn't let it go i i would say numerous times can we hire somebody in here to pour and trim the models for you but he just he wanted it done a very specific way and i feel like the digital dentistry leap that we made was great in the sense that we could keep that quality, but we just cut out all of those hours. It made us so much more efficient. So a lot of that work, that grunt work, which is, I don't mean to say that in a denigrating way, grunt work, it's stuff that Dr. Cohen wanted to do because he's a perfectionist and kind of a control freak over the, you know, the work that he did. And he's an artist and I can't blame him. But do you see digital dentistry transforming? dentistry as a profession. Because one of the things about dentistry that's very difficult for all the clinicians is the stress, the day-to-day stress of doing it. The performance of dentistry is very difficult. Dealing with the patients is not easy in many times. Maybe in Maine, where you guys are, patients are a lot different than they are in New York or California, LA, who knows. But generally speaking, there's so many stressors. in a dental practice. So it sounds to me that digital technology that you've incorporated there, because you've encouraged your husband to do it, to make that leap, has really transformed a lot of these task-based procedures you've delegated to the technology rather than spending your time in the office where you can't be with your kids. Yeah, so I'll just kind of take a step back too and just... to that one comment that you made about people in Maine patients being a little bit more laid back, maybe. Well, I think it's kind of the same story in dental practices everywhere. I think true Mainers are maybe a little bit more laid back, but we've got a tremendous amount of transplants from New York and California. So if we want to vilify those two states, we've got those two people here. Sorry to hear that. There goes Maine. I'm going to lose half my audience now because there are probably many of them from New York. Listen, I was born and raised in New York. I also lived in California, so I know what both sides of the coast look like. I think that the key there to kind of underscore is the key concept is that dentistry is, no matter which part of the country you practice dentistry in, dentistry is a contact sport. It just, it is, you know? And so I think that is, it's very easy to just get completely overwhelmed with that. And in our practice, that's what... digital dentistry leap kind of provided the answer to that because, yes, you're right. We delegated, in a sense, to this technology, and it just freed up so many more hours. And so the way that I think about it is if you want things to be sustainable, and this is actually a concept that I learned from a business coach. His name is Michael Hyatt. And he's got this wonderful concept, which he calls the freedom compass. And so essentially what he says is you want to focus, if you want freedom in your life and your business, you need to try to focus as much as possible of your attention on the things that you really enjoy doing and that you're really good at. And that's what digital dentistry did for us. And in our practice, you know, if you talk about incorporating printers and milling units and all of that we to a large extent we have that capability in our practice and we use it kind of for emergency patients um from time to time it's not a huge part of our practice because the majority of stuff that we do is um big, complex, full mouth cases or very aesthetic anterior cases. And for those, we utilize a phenomenal high-end ceramist. And it's just not something that we would be able to do in the practice. And that might be very different for other practices. What about the 3D printer? Has that changed like for provisionals? Has that made it easier to make temporaries for your... prosthodontic cases. We do use some of that technology in our practice to provisionalize patients. I think that's very useful to be able to have that capability. And we use it for that. But the scanner has really been the thing that impacted what we do so much. Because if you think about it, the scanner and that scan that it creates is really kind of... analogous to that first diagnostic alginate impression and it's the foundation. for everything we do. And then the subsequent impressions as well. And I feel like that in a prosthodontic practice like ours, a huge part of our practice is treatment planning. And the alginate impression and the diagnostic cast is kind of the foundation for that. And I feel like that's just the biggest bottleneck that I saw in our practice. It's like we were just, I don't know, running in mud or something. We just couldn't gain. traction and i feel like just being able to remove that bottleneck by being able to do that so much more time efficiently and still keeping the accuracy and the quality I would dare to say even improving it, you know, because you can have real time conversations with the lab technicians with those scans. I think that's where I saw the big impact in our practice. So I assume, Cornelia, after the first week of scanning your cases, I can only imagine the look on your face when you walked into your lab area and didn't see alginate drippings on the counter and stone all over the floor. I mean, it must have been amazing. For anybody that has done that kind of dentistry. you can relate it's macy you know and miles likes to say that he likes to get his hands dirty with that but there you need to have a balance there with that they stole some things where he does that kind of those kind of molds and stuff but i would say if i look at our practice right now it's maybe 10 of our patients that that miles actually does an alginate impression so much so that I need to go and get the measuring cups and the spatulas and the mixing bowls out of a different part of the practice because I don't even keep it in the operatory anymore. That used to be the... first part of our protocol when we did that first appointment with patients and we just don't do that anymore and then miles has in one of his presentations such a good visual illustration where he shows all of the the case pans with all of the gypsum models stacked up and he says this is one month's worth of new patients and then next to it he has a picture of a little uh drive a disc on his finger and it's so small it fits on his finger and that disc with the digital scans contains the entire year's worth of new patient scans and so if i walk into our practice it's like we can breathe it's just clean there's no um you know powder and mace on the countertops there's nothing to clean out no bowls to clean out at the end of the day and our shelves are nice and clean you know i as somebody with four kids I like seeing clean countertops and all of that because it's kind of a rarity in my house. So it's nice to have that at the practice. No, absolutely. When I go to my son's house, I can't find a piece of paper and a pen. So everything has moved in that direction. And dentistry especially is affected by that because of all the various materials we've used over the years that just literally clutter up the office, mess up the office. And I can imagine how cathartic it is to just go to work and be freeing. clean of all that. You've covered some great stuff. And it's been a tremendous podcast with you, Cornelia. I'm really happy we did this. How do you measure the impact of digital dentistry on your practice and talk about the financial side? Like, what are we talking about as far as profit? Is there any difference in profit? Or is it the same, but you're just working less hours at night? So that's a great question. And this is the kind of thing that I think about towards specifically towards the end of the year and the new year, because I'm one of those people that loves to make new year's resolutions. And I feel we kind of come full circle here. That's a great question to end off with because our whole. journey into digital started with two New Year's resolutions, right? I usually ask myself, Miles and I kind of have these four metrics that we evaluate our lives by. And I just kind of picked them for the alliteration. And so we look at finances, we look at fitness, we look at family and focus, those four things. And Miles and I will sit down and take a day towards the end of the year and just rate ourselves and say, okay, in this past year, where would we score ourselves on finance? Where would we score ourselves on fitness and family and focus? And I think if I need to rate... do that rating i feel like i can truly and honestly say that digital has made a huge impact in moving the needle on all four of those fronts for us so just on the finance and i know you know if you look at the ada did some studies i think it was back in 2021 where they asked clinicians who were who had not yet adopted digital technology in their practice they said why why haven't you done it what what's holding you back and 66 percent of the respondents said that it was because they couldn't really see the return on investment they didn't think there was any roi and so i will just say and this is completely just it's one the sample size is small it's one practice it's our personal experience But on the finance front, I think it's been night and day. I actually just before this podcast, because I thought that you might ask me if there was an impact financially by adopting digital dentistry. I just pulled the year over year revenue numbers from our practice. And if you compare before the year before we implemented digital dentistry with the now I have a year worth of data because we've used it for about a year. we experienced in our practice 144% growth. And I think, I mean, there's certainly other factors that probably contributed to that. But I think that mindset that I went into 2023 with saying that I need to delegate. I have to do this. And I also need to incorporate digital. It's really made a huge difference. It's kind of driven those numbers and those figures in our practice a lot. Because I think the big impact there is the bottleneck for us was those. Alginate impressions. Miles actually used a specific kind of material that he could leave on his lab bench there for multiple days without it distorting because he just couldn't keep up with pouring those casts. And that became the big bottleneck in our practice. And without that, we couldn't get the wax up from the lab. I couldn't really put together a comprehensive treatment plan to present for the patient. get them into the practice and get them scheduled for that first appointment. And I just feel like we were just stuck in first gear there because we just couldn't do that quickly enough. So now we've contracted that time. It typically took me from the time that we saw the patient in the practice for the first appointment to when I could have the discussion with them and present the comprehensive treatment plan and get them to accept the treatment plan. I, if it was a good week with analog, I could do that in two weeks and that's on a good week. Now we can, I can turn that around and I could see somebody on a Tuesday and I can have a conversation with them next day, maybe on that Thursday, you know? So I think that was the thing. It just. That's where our practice was getting choked off. So digital dentistry had a huge impact on your practice. Now, it's interesting that that's the case because originally when I talked to Dr. Cohn on a previous podcast, he originally thought that digital dentistry was for the big practices where he wouldn't need that because, you know, we don't have nine chairs running all the time. We don't have a volume practice here in Maine. But it turns out... a smaller practice, a boutique practice, as you have, digital dentistry made a huge impact, especially since Dr. Cohen was pouring up his own models, which is not particularly common these days. I think you need to write a book, Cornelia, on all this. Yeah, I mean, seriously, you speak so eloquently and you articulate so many important factors that have gone into transforming your practice into a whole nother way of life. It's a lifestyle business dentistry. You've taken advantage of the digital aspect of all the things that you have incorporated in your practice to free you up, have more time with your kids, make more money. I mean, it's a success story through and through. You know, you need to get a book written or something where you can share all this information beyond this podcast. But we will have you on our show again to update our audience on where you are two years from the time you started. This is about a year. So we'll do it again in six months to a year. And we'll hear the new things about how you've taken advantage of this digital technology. Thank you so much, Cornelia, for your input. We hope to, as I said, have you on another program. Thank you so much. Yeah, that'd be great. Thank you. This was a great experience. Thank you for having me. If you're enjoying this podcast, please leave a review or follow us on your favorite podcast platform. It's a great way to support our program and spread the word to others. Thanks so much for listening. See you in the next episode.