084 Figure Out Where You Want to Go When Growing Your Practice With Dr. Jeff Trembley


dentistry is changing technology. Education and resources are closer to our fingertips now more than ever. Are you ready to learn what millennial dentists are doing to exceed? Patient expectations enjoy dentistry. More and take more vacations or how this generation can join up with the previous ones to make for an unstoppable dental team. Well wait no longer hear your host of the millennial dentist Dr Holzinger Dr Perez and Dr Silly Sullivan. Welcome back. Everyone tried awesome. Hey super first off payment. I gotta say it's good to be back at studio minute. My new smile. I'm glad to be here. Super excited. Have Dr Jeff firmly back on the show? Look I'M NOT GONNA lie. We've had a lot of requests that want to hear about what Dr Tripoli's doing with his practice startups working and payments. Same Way that that's a that's a message. I think that I get a lot is people wanting to you. Know they heard about what was happening with startups. They heard about this. They WanNa Kinda see. Here's what I would like to almost title this episode and see if you see if you all don't mind going this route yes. I'm kind of thinking that we tell something like The top things I've learned or I wish I had known before I started my practice. Oh that's a good one or something something along the lines of like almost like the complication lecture. Yeah Gosh I wish. I wish I had known this. I wish I'd done this different I wish sooner or etc so first off before we kind of jump into the details of the weeds. Why don't you both give me an overview of kind of how things are going and just the overall sense of where the practices at and then I'm GonNa you know stopped me? Stop and I'll jump in and ask questions to try to dig in and kind of pull some of this out because I think that would really really benefit our listeners because we have so many people who are either have either bought practice. They're trying to make it their own more. They're considering taking the plunge and starring practice from scratch and I think that it would be very very helpful to list. Okay so jeff. Why don't you start off? Yes Jeff Okay. My Name Is Jeff. Tremblay I. I opened a practice about a year and a half ago November. Twenty Seventeen And this was a very sudden thing where I left an old practice ads you were an associate whereas associate and you've been associate for how many years graduated in two thousand thirteen. Ut Dental school. I I then left. That practice took up shelter in Dr Pay. Raise place he. He rented a room that was by the way I think that all the time. And how gracious you were imagine. Some somebody comes to you and says doc I need one room in your in your place you mind renting it out to me belly only did he. Do that. Gives you patience. Only did he do that? I didn't really do much. But it was so just laid back. I mean I would imagine because when I came over here I didn't get all my cotton all these things. I just used. Well in the end I ended up like you know I would. I ended up getting him back for it or hang him and you know it all worked out but he extended that that's cool being so so anyway so after two months of being here ms a lot yeah forgot about. I'm like I never signed contracts. You know I'd ask. I know word. I just got cool though. It's cool thing about it but now go ahead so yeah. That happened back in November or October. Right number October of seventeen right okay. So you could have had an and like most people do knowing you know you kind of had a kind of a rock bottom moment or a a moment of you know what it is time for me to smile. Yes I think. A lot of dentists whether it's getting ticked off with who they're working for. Whether that's you know money issue or just wind bill and cultivate with day. Want to cultivate and the culture you know at some point every every has this moment where I'm ready to take the plunge for you. Then you you start going. I found a beautiful spot. A fantastic space about three thousand square feet. I got five ops. It is beautiful. They're very spacious. I love it. It honestly feel like because I'm one of those people who are not wanted to get somebody else's practice. It was so garbage. I'm sorry but there is nothing good and I kept looking looking looking and then whenever this happened I was like where is it. And he's like this is right here. I'm like how is it and they're not winning in. I'm like dude. This is like a lottery ticket. So that's it's a beautiful practice will thank you guys but to to kind of keep this going. I got in there. I didn't have a single patient of record. It was a is using it as a satellite office. He would only come in on Fridays to see. I don't really know what his plan was. I think he you know life got busy for him. He just Kinda held on to hold onto it. I came in purchased it. I didn't purchase a single patient. So you basically buying equipment and renting the space. I don't own the building but it ended up being a blessing in disguise. Here's why the bank had a tough time lending me the money because you have. No how are you going to identify exactly? Well they also didn't know that You know I was receiving one hundred patients a month it my practice was one mater way. Sure and how do you communicate that? That's a hard thing the underwriters act so I had to go out and raise kabbage. Build that office though. Yeah don't want to talk about this so anyway so you had to fight tooth and nail to get help get money and get the dogs make to make it happen in twenty four hours. I found enough money privately to make it happen. Yeah well the reason I set that up. Is the listeners out. There are going to be in their own. Situations are totally have their own hills to climb the hill that I had climbed was unique in that I had to really fight and claw for everything even though I found a great space but the fight really began once I Wants the door open in the practice was mine? Everything from you know redesigning or or how do I update place without spending one hundred thousand dollars and how does how does how do you start to do that? Jeff like how do you like when you get because my question is when when you. You've you've leased space. You bought this equipment you you show up one day. Unlock the door. And it's yours and it's like heck yes I did it. How do you prioritize? What's next like attracting patients? Redesigning stuff hiring team members. How how did you even start to wade through that? That question right there could be a whole podcast but I can go into a little bit. Well okay so when I got there You know the one thing that was was actually okay with the OPS. They're nice and big chairs places to work with you ready to go there. One of the first purchases I made was an electric can piece two of them. I have to let you can't piece motors into the rooms. The two that I work mainly I bought my hygienist Nice Ultra Sonic enhance scaling. Just are equipped her char. I've got a few. Tv's to put in the rooms so he can look at photos and x Rays. And that's you know you can get decent. Tv's for not not a lot of money and they really can but also they're not Samsung. You can't do Samsung eight hundred bucks. I know that's true. So my my big thing is always been if I'm GONNA do Dentistry. I'm not interested in turning and burning. I WanNa be I WANNA do quality. I want to provide something that other. That patients weren't even really aware of and and if I could describe what my opinion of modern dentistry is. It's it would be The most minimal inter- intervention biologically to give you what you're looking for or even getting as close chairman so it's easy to slap tin veneers on a patient. Yeah but what about whitening what about What about doing Added additive resin. Maybe smoothing here Me and then you've got a beautiful smile. What does that look like? You know so. That's always been what attracted me to how I wanted to run an office. So that being said I feel like I'm still in the midst of what's next so kind of in between this for a lot of August that don't know you and they want to like to Kinda give our feedback or a flashback or what your personality is or what kind of finish you are so jeff is always about before even he even practice wanted to open this. His mind was always through a biological dentist. You'd like somebody who. Why do we need to cut? Why don't we change our materials to fit the patient instead of changing the patient to feed our materials kind of mindset so when he started or how that vision of building that practice that he's doing right now that whole vision talk about having vision or the passionate? He's very very passionate about doing that. So we're been never. He was doing this whole website to build out. Everything goes again he goes talks about he had TV because he's important for him. He bought electric campaigns because he's preps are so important so this is him whatever you are because a lot of people are going to be wanting to do for example surgery stuff they. WanNa do sleep stuff. It doesn't it just the practice that they wanna like have passion and that's good. How did you so whenever you have that vision that you this very unique Lot Of people love cosmetic dentist. It's like flash by employ a lot of social media before you even did the office. Tell people that you you started branding yourself as that duck. That's the thing right He used he took advantage of the social media even before he opened his office. Because that's a great thing. Feel like I helped you right. Well what the best move I ever made? I stand by today was contacting Dr Edward Owed the with the Y. Yes I found him back in. Two Thousand Fifteen got brought him to Nashville now. I will forever favorite can get him again. I I it will never be that one. That one was so that was so I was like you can't reproduce this up with Dr Apple. Took that course that was that was but no so he came in here so he got sure he was kind of like your mentor. He's he I would consider him a best friend right over brother. Great Guy I love him. He's flown out to to to San Francisco on a whim just to meet me out there anyway. But the reason that's important is. I realized that the photography was so important for what I was doing because I was seeing some other work for some guys who were cosmetic Denniston town in up until very recently up until the last two three years. How did you get that distinction you? You got that distinction by buying magazine. Ads and billboards. Yeah right exactly or or you. Just you worked long enough right. You became known by the Community Dennis but even still it was still largely perception because it was lack of it was it wasn't like there was no show right. Exactly that's the thing it's all perception based right so what I did was. I decided you know I love the a CD but the most boring thing is they're put us. Yeah and I understand why they have those restrictions but so what I did with my instagram which is J. F. Tremblay shut out J. F. Trembling Alum Nashville is my office. But what what was you know? And this is all kind of rolled up into how my office got going was. I realized early in getting my camera that taking a retracted view in photographing it putting it on the screen and I could look at it as sit back in my chair and look at it and things start revealing themselves to me There with my favorite case that I've done I ended up calling the ceramicist after he was already making the veneers and say we've got a candidate. Midland. I'm looking at this photo. You know we got to make this adjustment. He made the adjustment. It looked great so the photos. I got those going to show instead of taking out magazine ads. Having money to that I would just share. I would be an open source like this is what I'm doing if you see something that I'm doing that maybe applies to you as a consumer. Come see me. I had no idea how it would work in right now. Without a doubt my greatest source of referrals revenue. It's through instagram crazy in out arguments. It's even more just through sharing its direct to consumer marketing through sharing your your stuff right which happens to be one platform business. Graham facebook you know whatever it is but it's it's that direct to consumer right. I make sure I don't do it in a clinical way. I want it to be artistic. I always tell people on the artists who slipped in dental school. Sure you know Because I am. I don't have an not some brainiac so I continue just kind of stayed true to what my strengths were So you know the whole photo studio I had the choice of building out an extra op or putting a photo studio in and I did the photo so let me let me jump in now because I want to. I want to kind of dive into some of this detail. What's crazy to me? Is I look back and even in our early conversations last year when you're starting this is like that's A. That's a hard uphill battle to stay true to yourself. And when money's not coming in right you know when you're trying to fight to make it you know. As far as I know you really didn't go into the insurance route. You stayed fee for service. I Yep which talk about trying to start a practice in this day and age in Nashville with Dennis on could point how did you? What was it like early on? And for those people who are considering trying to follow their dreams when it's going in network with every insurance seems like the right thing to do to make the bills. How did you stay true to that when because I imagine there were there? Were weeks where you're like. Crap that there's no money for me to take out we'll ministries heart industries hard. Starting a new business is hard. I imagine on any platform so by no means. Am I sitting here trying to paint beautiful rosy picture? The struggle's been amazing. In fact this one thing that I've learned now where I am today. Is that the importance of data. And I didn't went opened the practice. My mindset was this is such a new thing that even I'm not gonNA toil over numbers because that's not a real high priority. I think if you deliver high quality product to people see it all work out right well if it's not time yet to toil over these numbers when I couldn't have been more incorrect about that so so talk go into detail. Give me some specifics. That like me like cash which I had seen that great. So so is you know. I'm not in network which means Which means golly. I connect all this but that means the conversation with the patient right away on. The phone is very important. I very very important in in people are uncomfortable with this fact that they've got this great insurance or everybody thinks he got insurance. So that means I get free stuff So realizing that you know the conversions was important. I initially started out in hygiene by accepting thirty five dollars. When you come in you pay thirty five bucks. We received the insurance check if it's short. What our fee is we. Keep the thirty five if they pay in full which a lot of them did. We'd kicked a thirty five back and then stop asking for it. That was the plan. It got so convoluted confusing that January twenty nineteen I said are without. We're going all in. We're going straight up fee for service. If you have the best insurance in the world great you pay US and expect to get that back. Wow this is that going back to them or going back to you. Gotcha which means he's filing a former filing. Oh we file it nice but you know what that means is I kinda doubled down on the philosophy in not on the practicality the business move because patients have left a handful of patients will cau- and and really almost be offended at that because they have heard of it. Before I would see that. Yeah but then about seventy percent once we process and explain it to him on the phone and when I say explain it it means any other way is is kind of a gamble. It's it's sort of a gambling on our behalf My Office is gambling whether we're going to get paid or not so what I did. Is I lowered my fees to something that I thought was Good for the area in in knowing that ninety percent of my patients are Gonna get their whole hiding check back every time yeah And then explaining to them why we do that is important without you know so. That whole process was really important. How did you learn how to do that? How did you learn you train your the person on the phone? Did you bring anybody? How did you also? Did you go through a consultant as you wanted to have some coaches? I do have consultant from. She's great Her name's Danny Monteverde she worked for Jameson and what Danny have really helped me with was looking through our system to find you combing through the numbers to find certain things that are happening that I wasn't aware of when I say I wasn't aware of. I never run a dental practice ensure me things I found out from twenty eighteen that about forty three percent of my hygiene patients had a second appointment while means aside half the time they were leaving and nobody was scheduling them. What is your percentage? Because I tell if we sat down mine hygienist and said you. Don't let anybody out the door without an appointment. I love that you take ownership on that. It's totally because I agree. Totally me you don't take ownership on everything. I'll be the first myself an idiot eight sites other idiots just like at some point. Look I say this all the time? We only have so much bandwidth you only so much. Focus on so much at a certain time. So it's the priority was certain things and so you know you you reset and look back in hindsight. Gosh here's a great area I approve. Let's talk about making this a priority and now sure what you'll see is. That number will start to skyrocket your priority. Here's what's here's what I'm trying to get to about that about pulling numbers so I think you know there are. There are things that are off the though the record book or off the Balance Sheet and then there are things that are on the ballot sheet. If you're planning to run a dental practice or if you're looking to getting into a new startup purchasing an old one one thing you've got to do is understand what reports to pull when the pull them not just pull them but spent some time looking at him thinking about them. What are they me? And I don't have it all figured out but I have a a group of of reports that should be pulled weekly in monthly and then adjustments be made to that because everything else is less concrete you know give you some other Other other reports are statistics that you've seen that have been impact for that. You're glad you're tracking now Well the hygiene reschedule rates won the that's big. Because that's that's essentially that's the the whole at the bottom of the bucket. If if that's not being you could be spending all this money or whatever. It is to get new patients in the door. If they go straight up the bucket. Sure absolutely no good. So you've gotTa Stop. The Leaky Bucket. You've got a you've got to create the behavior in the Office. Almost like impose it on the patient's not in in a forcible way but in a way that they're leaving with an appoints expectation that. I look I come here and then I get my next yeah Some other reports man like Knowing not only looking at reports but seeing how they change so new patients for the first bit I mean. We weren't even really coming through the paperwork. In making sure they filled out who they referred from. So then the next thing you this is important so we put the how they're getting here right so I made it so that the the IPAD. You have to put that in to go the next question. I've got a few of them. Were you can't leave it blank. Well then what so you look at these things and you say okay. Last month I had. I don't know forty to sixty do patients. Where are they coming from and then realizing what we were talking about before we started here? Is that truly? The best source for new patients is other patients in town referral. How does that change your behavior? Okay so I look at this. Say My best patients. My the things that are going the best for me here are coming from other patients and then maybe my instagram. That means how does that change my behavior. I realized instead of running around feeling like I'm in a rat race trying to get back to this or that I slowdown. I think patients for coming in I tell. Them that really helps me they. They want to post on their instagram. I'll leave and go up front with them. We'll have fun and and realizing that I need to. I need to give the gratitude. I need to show them that. There are important to me. And although you don't feel that right away you can see it in these reports over time you know for sure. We're we've been as a team we've been going through Paul homily his making it. Easier patients to say yes his whole kind of curriculum and one thing that he talks about his early on last week is if you're a practice or what. If if your restaurant what were you what would you serve? And if you think about it and you think about it like from a restaurant and hotel standpoint. But you'd think about someone like the Ritz Carlton or like a Fleming's whatever the experience that you get from the person that you know greets you too when you leave is such a different experience than you get at you know. Okay a maybe step down. Oh Charlie's or you know Cheddar or something like that To a Burger fi or AAA to McDonald's. What kind of chicken? You get exactly. Yeah like everywhere. When you think about it like you can get so for someone who wants to deliver the kind of Dentistry. You want to deliver and run. The press is so critical that your practice not only because when he talks about essentially as an. I love this. I think this is gold. Right here said the level of of the level of your dentistry has to equal the level of your basically experience and the care they give to patients because the problem is that to a patient. The quality of the dentistry is less important to some degree. Because it's hard for the they don't get it exactly so they don't. They see an aesthetic outcome. They don't know how much harder it is to do conservative restorations or to to make things blend without just veering. Eighteenth right so to them. It's the experience so we have to make sure that our experience equals the quality of our districts you know what else is interesting people. We have a tough. We don't do a good job of saying exactly what it is. We want people to know. Yes it's meaning. Communication Communication has all types of forms. You know but this. One Tinto Communiqu whenever dentists for example that goes back to our talking about how much we had hard time of a lot of dental students or dental classmates in ut for example or any dental students right now if you back and see that eighty ninety people in your class how many of them were really truly. Would you as a patient go to them and in the same patient or the dental students is going to be a dentist later on so I think the communication comes be a big big factor. Lot of dentists. They expect to pay a lot of money to their assistance to do that for them where they can do it themselves or they do. Like I think it'd be real directing this. Tell me be very very created a lot of drama right so you know the the one thing we podcast viewed by the way has got to find the one of our pissed off. Go ahead go ahead so what I mean is in and I'm not pull the best example from this but what I mean is if you you know if you don't say exactly what it is you mean in your range you know like the This this is my world. My office shore Obviously I WANNA act gracious to everybody in there but this is my turf. You know this. Is it to your name on the building or your loan. It's your s that includes you gotta say exactly what you mean to staff to patients. Expectations For example. I had a friend who cancelled three points consecutive Right so instead of my staff putting him through the protocol. I text him as like look. No more missed appointments. This really compromises me. I have staff here waiting on you. I can't make this up. I can't feel you spot. Don't do this again song today. He came in. He apologized three years ago. He did he did it. Two or three good. But it'd be it'd be so easily to thinking about it right also but what? I mean is with patients You know you you've got to be. I've learned that it helps to be very direct even with Older well whether treatment plan. Why do I WANNA do it this way? Well we could do it that way. But I think he's been finance example. Audience is talking about my own personal experience been built the office. Because we're talking about the same thing pretty much I had about one hundred seventy five thousand one hundred eighty thousand dollars. We've talked about before that didn't collect from the that I had done. These hybrid patients is like I did immediate loaded. Implants everything is there. This patient is not coming back so then I'm like. What did he tell them like? What were they expected? Like what we and what you just said as far as be direct debts what they didn't get from us or I feel like they didn't get but I mean honestly what you have to do what we're doing right now. In order to fix that whole financial problem is writing everything down as a Kaz sometimes also patients like to have that ruin think look is everything is computerized everything right right but then when gladys gets onto like when she's talking to them in the treatment consult rumor. They writing everything K. A. B. Agreed to this thirty thousand twenty thousand ten thousand even five thousand. You have to pay by this date initial this initial that scandalous and give it to them. Because that's your only copy then if you're not directly with them because this is how I was you can't pay it it. It's okay next time for your post op and then the post op became two years later. So that's why direct talking about T- Kazan struggled with the whole one hundred seventy thousand dollars. How much to write off and do it. It's it's hard to be directed till the the direct message to you. Is You just lost? Two hundred dollars not being direct. You learn very quickly. So so what would as we kind of Jeff? I WANNA bounce over to pay me here in second and kind of get his experiences from this way if you had to kind of give me the one what's been the one hardest thing that you didn't necessarily expect before you went in this whole journey. What would you say that's been you're asking me? Yeah okay The hardest thing the rate of well if I get real real narrow on it. I'm pretty savvy with Computers Photoshop. Light Room I can get through programs. I've had the toughest time with my website with my marketing. It's almost like the one thing that I that I run. Which is my instagram. Is the only thing she shooting? Us alive in in in the reality that nobody is ever ever ever going to give you their best effort right away unless you extracted out of them unless you don't you know how like for example. I had a meeting with a girl that I'm GonNa do some radio ads for It wasn't really clear how many how many actual radio spots I was going to have I was like I'm not signing still you right. How many total ads there are. She's like well. You can look at counted up. I know like go back. Redo this because I want to know how many because you you'll learn if you don't do that you'll find out you had twenty eight instead of fifty five like you thought and then it's too late you so I'm learning that One of the hardest things about opening the practice was having to be on top of so many things. Yeah and then also the realization that if you let something go or don't give it the attention it's not gonNA be. Yeah I got burned out now. Your yours was in websites which is thank God. I didn't have to worry about bat. But there's a lot of different things that I got burnt. First thing for me was like I always said it. 'cause COUPLE OF WEEKS AGO. I had another podcast with the students of North Carolina and this was my biggest thing was whenever I bill. Is it rainy? My biggest thing was when I built the office. I had no idea how much the front off because I was show. Workup up in the clinical world that I didn't know how much front office meant so going through opening the office and there were days. I remember my answer. The phone there working. I from what I didn't know how important the front was and did not just the front person because is what I thought and let me tell people because I'm going to tell you the problem and then tell you this Lou. Shir Scher so the problem was I thought my money. Whatever I save up I'm going to hire the best front office team in the world so I'm going to have like a Real Madrid Barcelona in the front and then I'm going to be like Real Madrid and Barcelona back because I got this right. The clinical mind and then just figure out how much you want or how much so now let me find his best front office people and trust me. It's not that person is then I realize it's not them. It's me is expected them to read my my expected them to know. I expect these people were getting paid. Pretty good sixty seventy even close to. Sometimes you're higher but me being they. I don't know if the word but like not wanting to go through the struggles of learning the front and wanting to have to pay for it. You know like Hey. Do it not learning. That's where he caught me. That's one hundred. Eighty thousand dollars came from swear. I saw that is missing and all of that. I got a dime a Pearl for pearls. So give me the Pearl. Recently office. A small got a front desk high jettison in assistant so obviously duties get blended between people correct a sharp separation. So what I did because I love lists. I've got clipboards upfront. Everybody's got their name on it just blank lines and so. Somebody needs me to send a photo to a specialist. They don't come to me. They go right it on the clipboard. Because if it's not on the clipboard it doesn't happen. I love that when it finishes I cross it off so right now list. I've got a whiteboard. Office is my giant Whiteboard for that reason. Whiteboards are great however their psychology behind it because I like because the crossing off saying and seeing that. Oh you see the progress you know. And then like if. Somebody's got eighty things on their list and one person has crossed off. You know what I say. Go grab her clipboard. And see what you can do. I'm serious it's great. It's it is like this thing I've done that's good. It's list ability being eternity which is nice so so payment. When did my question? What point did that become a priority for you or when did you really notice it when I realized the money? There's like my bank account is getting negative and then the bank is calling like getting overdrawn and that's been. I was like wait. This is getting serious so then I was like okay. Do I need to do. And that's when I started learning about the front desk which I'm still learning. I don't get me wrong. But what one of the things? I thought it would be cool. Not Cool but one of the things. I felt like we need to have done or should have had done. Is the vision for my team. Members like okay. So when are hired? Yeah tell us about that so I hired. When I first opened the office I felt like a lot of these things. Okay so it was your vision vision. It was like you guys talk about always your name on it and this and that and that's how I felt but then it is not the same thing to these people that work there. So how do you? How do you make that transition? How do you make them to be a part of that? How do you make that the how you make them feel like they are just like you kinda where? I'm here because there's almost two visions right like there's some degree there's your vision correct really. What ultimately makes what moves the practice. Is this this? Cumulative team being witch so you have wider in right so without seem vision has been the hardest thing that now that I have a good car. Gosh it's been two and a half years now that I have people the video but then we have. We have like a really. I think another thing that is really good. Good people that are like me a like minded people so for example. Talk about there was. There's so many people that want to work and there are so many assistance out there but they might not be the right person for you. Charles your vision. Whatever it might be why not be the same with like okay. So here's my thing. I felt like you know how back in the day they say. Oh leave whatever is at home. Don't bring it into your day. Forget that no matter what you do in their home matters so if I right now when I interview people I don't care about you tell me who is your honestly. It's all about your personal life because if you cannot handle your personal life you see you think you're gonNA handle these thirty thousand forty thousand dollars or this office. That has so much going on. So there's more to it if you have The staff member that or a struggling Like crazy on a lot of different. Bring him in talk to them and some of that stuff. I felt like helped me when I had these consultants recently. That are hired. Where we're going to have you had him on the show a couple of times crabtree people. That are Kinda. Lighten enlightening mean like. Hey you gotta sit down talk to them about. This is what you want to do and expectations. It'd be more direct so like you. Jeff already said it. How you gotta be more directly to be like telling them. This is what I want because a lot of times to you might. Perfection might not be what they're wanting to do when you'll be talking to buy in. It's it's dangerous right now and it really takes. That's been trying 'cause they're me more than because they're asking. Hey do this and this and I'm like Oh my God. This is what I want but before then he was just me trying to cry out for help luggage. Somebody sees what I tried to do and it was so hard. Don't get me wrong. It's still hard because I'm going through that whole transition and I feel like honestly I was talking to another person Somebody Akil Alexander Menia Minne- Minneapolis yesterday. Because he's opening his office and he was talking about it and I said how important how much mature I feel like. I've got or adult like literally thinking of building this office. Because he was asking me. Is it worth it or should I just do these corporate corporate corporate And I was manny makes you a different person. I feel like I'm so much more superior than what I was two years ago. Honestly in so many different aspects that it allows me to be more better for my patient's also will somehow you figured out how not to sleep and just work all the time right? That's his you know to to get on to touch exactly on what you're saying. I think we talked about reports. There's a story that's being told in your software. One of the first things you've got to do whether you have opened dental or you you're using we've if you don't sit down and learn all the intimate ways to run that you won't. I mean we've been operating with a lot of inefficiencies. I sat down. I watched some open dental towards I found out so many th- basically there are ways to pull reports that paint a picture of your practice. It's insane do you recommend dental or some of those reporting dental Intel atom pain or reports practice. I think at the end of the day ultimate miles says just track them. I don't care you do them. I like dental intel or practice by numbers. Because I'm because it's it's I'm lazy and it paints a very clear picture for me and some other aspects of it I like beyond the reporting from From a recall standpoint in finding patients ultimately they all pull the numbers from your practice management software meeting all the data's in your practice management software. So you can pull reports from Eagle. Soft opened at all districts softwares is. You could have somebody not you know like. Let's say you have a consultant halfway across the country. They don't have to get in your software to look right and that's a big advantage. That is nice Another thing is when you You know as we evolve as practice owners. I've learned that having the data organized is great but it has to become through. So what I'm doing now with my team. This very recent like in the last two weeks is pulling them together. Such as accounts receivable issue. There shouldn't be a single cat receivable now office. No fee for service for service's exactly so it should be in but they're on there right so what's going on. Why are these things exactly? It's or you know for me. It's okay what is the cumulative hygiene reported percentage but like I is really good. One suck okay. What what's your verbiage that they're not doing you know that they're doing or they're doing or what. What's your collection percentage? Or what's your what's your ninety day. Are you know what your you know all these things all these things matter? Will you know what I they do matter? But you know what I'm finding out in at least it doesn't exist right now. It would be something I would love to put together for the future generation. Let's talk about reappointment. Reappoint would be nice to review once a week because if you do it once a month. They may not remember that patient. Or what HAP- Shirt. So once a week daddy go down. There's an accountability and it's clear for a while. So we we were doing that for I was. I was having them every week for a while. I was printing out every patient that din reappoint. I wanted a reason why they didn't report. And you found that it was a waste because they were giving you good reasons why we gotten to the point where yes burdette into them and low at some point when you're ninety billion our like ninety to ninety nine percents so when you're when you're nine out of ten patients okay you're not going to have a hundred percent like there's going to be a college kid there's gotta be someone moving there's GonNa be stuff that happens sure so I just but I see that Or or it was stupid stuff right like not attaching procedures. It's like if you don't attach the if you don't if you just reappoint them but don't attach brophy code or whatever it is will but that's sloppy to me right. It's not sloppy. You're you're sorting through a problem when you do that. That's what I've learned is so important to go through with the sorting through the problem. Where you find out what's going on well because because ultimately because but because what will happen with these numbers crapping and crap out right so if you don't if you don't put in numbers I get shitty numbers. Yeah a lot of it. Lot of it was was that regard. But what I love about this episode though what I love about both of what we're y'all told me is nothing has to do with clinical dentistry. That's true we didn't talk about if you think about it. Not One thing. Y'All mentioned have to do because I think so. Much of it is the fear of. Okay what can I do this or can handle it? It is Gosh I mean it's nothing was clinical nothing. Yes it's interesting and so to me Stephen. Look at who to me to me GAM if I did the video of him look at this guy to the young doctor who our older doctor it. It comes down to business and building a team around you to help you sh- wade through a lot of that stuff. Well you know what's Funny Cam? You know we've been talking kind of the guys peeling off these new practices. I would love to run you through all these because I feel like you're much more seasoned his systemized mature office. You're dealing with more people more patients more. You got another doctor. It's it's similar the different it would be super. It'll be fun that the big differences are. It's the same stuff. It's just trying to is rewiring in existing practice. A lot of it do because what because the perspective that would be nice day too is the differences the differences between having to rework a practice already. Like you buy a practice outright. And now you're trying to redefine it versus starting from scratch. There was never no pre. There's no it is what it is. There's no no we used to do it. This way. You know that that becomes the difficult part is as well. We've done it this way for so long. So you know what I would have been one of the hard things that you've had to do would be tomato audit assistance like if you have somebody who's kind of had that front desk they're running the front. They're responsible for these systems their season. They're respected. They need to be audited too. I mean you need to see what they're doing And I imagine that would be a very difficult thing to come in and say. How do we make sure that this because everyone is flawed? Everybody's got their shortcomings. So how do we make sure? Everybody's how can I coach this person find out where they need to be coached without offending them or seeming? Like you know it's just it's it's tough. It's real tricky. I mean I still deal with that my staff. I don't want to seem like Coming down on them or being too hard but I gotta ask some direct questions to me though. It's easy for us Because what I what I say is it's it's I lead by example. Who takes more see than us who who works harder on what we do more than us who stays later like at some point payment can sit there and say to anybody because because if his team doesn't respect how much ever he's putting in himself trying to get better than he's got the wrong team you know so at some point like. I need my team if my if I truly if they if they truly know and believe in that I'm constantly trying to get myself better than they than they know what I come to them that it's more out of this cultivating of overall trying to better the tied result ships. Even Michael Jordan had coach you go on and on and on about look. It's not a it's not a negative. I'm getting mad at you. I'm doing this to me. I'm the one that's got like I wanted to. And when it comes from US point they either. It's either the wrong person or I think they get on board and a lot we have. We had eighteen members Before I got there only three of them are still there. Well so he said Joe. I'll tell you it was less that though a more they realized they weren't gonNA fit in the culture came to. I can vouch for this because I was. I'm insured. I see him every week. And I've been going back and forth back and forth and it is not really what he what he really did after he started working. There is what I realized after I started working at the corporate where I came in and I saw what's going on and I was like dude. There's no way for what I WANNA do to do it with these folks exactly. What he was doing was exactly what I did you get. There's no way you can work with these for because their mentality mindset is in the eighty s and most honest. Well Ninety minutes to go back to your point. Jeff is they won't and Stephen they'll be res they'll be held captive by exempting existing systems or existing team members even though their names on the building. And and I don't mean that in a cocky way are good but at some point like I gotTa have the people there that want to support the vision one because even though it's a team vision it'd be on the same page there. There's a lot of psychology involved. And and if you you know thank goodness for my dad. He got checks me. A lot asked me a lot of hard question. Do you may two and may two has staff patients. That's what I've learned patience. I tell you where I was three years four years ago. Whatever when I come in where I am. Now it's so much just like it one cooling off before I really assess something Not Trying to react in the moment yet. Don't be reactive. Be Proactive and trying to like. Okay let's take a deep breath. Let's let's gather the information. Let's think about it then. Let's have a conversation you know but but it's it's interesting. It's so it's so much more about managing people running a business. Those think I think the heart the heart aspects of what we do a lot of times. Yeah no you're right. You're right slowly in in for people who feel lost in almost like they're overwhelmed. Start with that damn checklist. Tell everybody you can even go as far as saying few initiate something. Write it down. I love it. I love the checklist so so I could see. Chiklis manifesto from Atop Gandhi have the book. I haven't read it yet. I read the first page is pretty good. But then it's to considerable. Yes too long. I want to wrap it up with this question. Yes What is what is something. You're you're try having come from where you where you've been having both now. I think you're both on the H. A. Incredible Path to success with these practices. What is one big goal? The you're wanting to achieve in two thousand nineteen with your practice. Gophers I go. I go go go I want to achieve. The my lifestyle is going to change your soon. I'm GONNA BE OWNING A lab and lab work in the House. It's big it's huge. That is my biggest thing. I've been looking forward. I just closed on a house yesterday that I'm not as excited as I am about building that lab here this so that's ultimately the goal is honestly not the lab is not the money's not all that is to me. I felt like I became a dentist because I wanted to control my work in quality and I just cannot do that with talking on the phone and communicating and Photoshop on worklessness. Billet here and do it all together. So that's my biggest goal dreamed this year. That's maybe hopefully next year. My biggest thing is to find a lab within a mile of me just couldn't payment my without a doubt the mine mine is. It's very similar to yours. Payment but in a different stroke plan is because I spend hours and you do too well. I spent hours waxing things. Yeah and he you know. He's got his own vaccine. His office Razi. Last time I saw waxing instruments was indeed one well and I paid somebody sorry base. And here's why give me a smile and I can. I can make it better additive. If I can't send them to Ortho and then I can so you WanNa be also on it so what I WANNA do is in two thousand nineteen to kit out of the analog in be digital the you know everybody I talk to says you don't WanNa be doing your own digital mockups. No way outsource set to the lab even payments says that. Yeah just like they told me you don't want to spend too much time on temps or whatever you WanNa make crappy so they come back. I've done the opposite. I'll do smile design four people. He's fine I for impatience from my chair. I'm like I'm like dude. You're making eight out of ten come to make so this is what I really WanNa do. I WANNA become a an expert in EXO cad. Because I see that that'd be cool that X. Academy as a dentist. The one thing that's really really important is smile design so I would rather outsourced a lot of the other stuff I'm doing now and just people come in. I look at them. Scan them take a few photos. Spent forty minutes designing the smile. Now I don't have the printer yet but all this stuff will flow out of four out of the right and there are guys doing that when you say forty minutes forty minutes or are you going to these. Because don't you think this is going to be a lot easier in the down next few months to where you can actually take six different teeth and put them in Chur or but it's the thing is again going back with Jeff. Jeff is extremely extremely Selective in terms of like what is your with to length ratio. What is the cusp is GonNa look like how much light is going to come in? If the the lateral is curved and a lot of these things that me and solely are like it looks the same for Jeff is five trains. Yup so that's why you gotta be like. Why are you GONNA DO FORTY MINUTES OF WAX DESIGN? Because you're not getting paid for that but you're going to charge patience for that are you. Well it all work out. Well what's going to happen very soon? Is You'RE GONNA pick. Yes a series of teeth. You're GONNA hit enter. It's going to sink it where thinks it should be and then you make the and then you send them to. My Buddy over here does along for a week later. Dr Diego good to see you. May you slowly to imprint. I don't think it's classic rightness for those of you. Who Don't know. This only Sullivan was in dental school. Yeah cray time. That's funny transit. Look up to this guy so much man. Cool man to his killing at Tony Robbins. Dench here all right bye. Thank you so much for joining us. I've really enjoyed this episode Help you to please reach out to us at J. F. Tremblay at Dr Pay Ray Admiral on Instagram. Yes please write us a good review or something. Oh we payment is totally off spot on. We're trying to build and we've been bad about asking our patients in this case our fellow colleagues and so we were asked to go on I tunes leaves at Five Star of you and you WANNA leave us a two star this. How many listeners? Do you have on any one episode a couple thousand okay. Everybody go on to Sullivan Dental partners. Please leave a five-star argue Asheville by new smile. Yes I hope to see. Thousand New Five Stars should not thank you so much guys. It's BEEN AWESOME FOR SMARTER. Not Harder thank you for listening to the millennial dentist visit. Us Online at millennial dentist DOT COM.

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