Case Acceptance: Tips That You Can Start Using Today!

Case Acceptance: Tips That You Can Start Using Today!

Chris Pistorius talks with Sean Field, the Senior Consultant at Patrick Consulting Group, about the challenges dentists face on improving their case acceptance rates.

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Chris Pistorius (00:04):

Hey, everybody. It’s Chris Pistorius with you today again, with The Dental and Orthodontic Marketing Podcast. Unfortunately, I’m having some technical issues, so you won’t get to see my pretty face live, but we’ve got an awesome guest today. Mr. Sean Field is with us live. You can see him. Sean is with the Patrick Consulting Group, and he is one of their senior dental consultants, and he works a different angle than some of our past podcasts, in the sense that he helps people, or he helps dentists with their acceptance rates. So when somebody comes in, how you can actually schedule more of the procedures that you’re you’re offering. But Sean, thanks so much for being on. Please tell us a little bit about what you do and more of those details.

Sean Field (00:52):

Sure, yeah. Thanks, Chris, for having me on, I appreciate it. Again, like you mentioned, I’m with Patrick Consulting Group, we are essentially treatment coordination trainers, and what our specialty is, is we help increase the case acceptance rates in a practice, in a dental practice. We work with any sales organization, but our specialty is in dental, and really just kind of getting the entire team on the same page, and realizing what role they play in the case acceptance. Again, our specialty is case acceptance rates, so what we’re trying to do is we’re trying to acquire more of the comprehensive dentistry from the patient, and really what our goal is, is if we’re working with a practice and they were looking at case acceptance rates and they’re lower, we want to try and increase those. So simply put, if you’ve got three patients that are coming in all with the same treatment, occlusal cavity and number three, and only one out of those three are accepting treatment, our goal is really to get you closer to that three out of three, but then more of an entire comprehensive treatment plan as well.

Chris Pistorius (02:01):

Awesome. So tell me a little bit about what you see. What are some of the biggest reasons why those acceptance rates might be one out of three, instead of three out of three?

Sean Field (02:12):

Yeah. I mean, really, a lot of times the breakdowns happen with… Typically, there’s two different closes. So what we refer to as a clinical close, and then a financial close. So that’s a big step too as well. Sometimes the team is just using very clinical terms, and we’ve just got to really put things in language that the patient will understand, because if they don’t understand the need for the treatment, when we start talking about costs, they’re never going to understand why there’s a cost involved, especially why there’s a high cost with dentistry as well.

Sean Field (02:46):

So, the other thing too, is that we’ve got to make sure that everybody’s on the same page. So is the hygienist doing a fantastic job, making sure that they’re controlling the nucleus of the retention of the patient? Is the dental assistant, when asked the question, “Do I really need this root canal?” They’re really prepared for that, and reinforcing the need for the treatment rather than going, “I don’t know.” And especially with the front desk too, when we pass off the patient, whether you want to call that a power pass or a power play, whatever you want to call that, that’s really important that we’re not just kind of letting them walk up there.

Sean Field (03:20):

The patient and one person, I always say that everybody in the practice, it’s kind of like they’re people on stage, they’re in a play, everybody plays their role. So if one person drops the ball, that’s going to hurt the perception of what the patient thinks about us in the practice, and they’re less likely to choose the treatment. And really, the thing is that whatever’s good for the patient, is good for the production, so why feel bad about the collection?

Sean Field (03:47):

And to answer your question specifically, a lot of times, people are either watching things too much, or they’re underdiagnosing, and they’re kind of assuming the objection before it’s even said in their head, and they’re breaking things down, and where that really hurts things is that every time the patient’s coming in, they’re having to spend money, rather than what we do as a company, is we try to acquire that entire treatment upfront, get the patient to pay up front for it, and then just work off the credit as they go, so then it kind of flips the switch on everything. The cliche, “Well, okay, I’ll have you pay for half of your crown now, half of the crown when you come back in,” but they’re always wondering, “Well, how do I get the patient to come back in, so I can seat that crown and get the other half, and then bill the insurance?”

Sean Field (04:30):

With us, what we’re trying to do is get everything paid up front so that the patient’s knocking at your door going, “Hey, where’s my crown? I need to get in here. I paid for that.” And again, it’s just really switching the mentality of, “Well, the patient’s not going to want to pay for this,” or “The patient’s not going to want to do all this.” Really, the cold, hard fact is that the patient has this treatment, and if we don’t do anything about it, we’re really not doing them any favors, and it’s just going to get worse. So we want to do as best as we can to explain things in general enough terms that the patient can understand, so they’re therefore more likely to understand why there’s a cost involved with it, and every person in the office, the dentist, the hygienist, the front desk, the dental assistant, anybody that tends to your problem, all plays a part in that.

Chris Pistorius (05:13):

Awesome. That’s a really cool concept of it kind of does flip the switch on how a majority of dental practices work now. I love the idea of let’s get the money upfront, let’s get the treatment done upfront, and then it makes things easier on the back end. I have to ask, and I’m sure other people listening to this are going to wonder, what do patients think of that? Are they typically okay with it, or is it kind of in the method of how you deliver that information to them?

Sean Field (05:45):

I mean, it’s absolutely in the method of how we deliver it to the patient, and a lot of times, it’s funny because when I start working with a provider, they’ll have preconditions in their mind of what the patient’s going to think, and they’re going to kind of judge that. And really, what they start to notice is that the more that we’re kind of telling them exactly what’s going on in their mouth, rather than trying to think, “Ooh, they don’t want to pay for that,” that they’re really actually very motivated to get treatment done, and they’re going up to the front desk going, “Okay, I know I need this treatment done,” that they’ve done a very good clinical close and understanding why they need the treatment, so then it makes it a lot easier to do the financial close in the practice.

Sean Field (06:28):

And really, patients kind of appreciate it. It comes down to the belief of the practice, and really, what we’ve noticed is that the patients actually appreciate it. And at a minimum, the goal isn’t to push them into anything that they don’t want to do. They have to get this treatment done, otherwise, it’s going to get worse. It’s just really just letting them know, essentially planting the seeds, so even if they do tell you no, and if they say no to this crown now, and then they come back six months later in pain because they need a root canal, it’s going to be a much easier discussion, simply because you’ve planted that seed.

Sean Field (06:59):

And the trick is always to put the ball back into the patient’s court, and let them decide. We’re not pushing them into anything that they don’t want to do, we’re not diagnosing treatment that isn’t there. We’re simply just educating them on what’s going on in their mouth, why they need to get that done, what’s going to happen if they don’t get that done, and then at the end, really just making it through a lot of times, through third-party financial companies, not only financially affordable, but mentally affordable for them as well.

Chris Pistorius (07:28):

I see. So it’s kind of like the old adage in the sales process of, “Sell the value of what you do, and then talk about the price,” right? So show the patient, “Look, this is the situation you’re in. This is just going to get worse, or this, or this, or this is going to happen,” and then everything just falls naturally into, “Okay, well, what does it cost?” Would you agree with that?

Sean Field (07:52):

Yeah, 100%. 100%.

Chris Pistorius (07:56):

Okay. Awesome. So tell me how your process works when you work with a dental practice. How long does this process take? Is this something that they’re with you for weeks, months, years? I mean, how do you incorporate this type of training into a practice?

Sean Field (08:14):

Sure. So we do work nationwide throughout the country. Typically, nowadays, because of all the technology, it’s easier to either do it, depending on the preference of the practice, but we can work over a Zoom call, we can do over phone call. Really, traditionally, what we’ve noticed is that we charge on a per call basis. So if we’re going to do an hour call, we try and make it relatively affordable, so we can kind of deliver this to the mass general provider public. Usually it’s about $99 a call, or a Zoom call that lasts about an hour, and then the provider decides how long or how often they want to do these calls. So there’s no contract. They can do one call, they can do 30 calls. It’s totally up to them.

Sean Field (09:02):

And to answer your question specifically, how long does it take? It really just kind of depends on the team and the provider, and where they have essentially breakdowns in the communication. It just depends on the provider. So usually what we do is that we kind of get a general understanding of what they’re looking for, what they want to do. Again, we specialize in treatment case acceptance, so we know that that’s probably why they’re calling us.

Sean Field (09:25):

And then a lot of it, it really has to do with a lot of role-playing, kind of scripting, letting them know what they should be saying to the patient, letting them look at as a whole, what cycle that the patient goes through in the office. Like we were talking a little bit before we started the video, we have a thing called the Dental Communication Model, so it’s basically the 26 step process from when the patient, even before the patient picks up the phone and gives you a ring, all the way through their entire visit, all the way back down to getting them through the visit, and then back again for their recall or the treatment that they need.

Sean Field (10:00):

So again, it really just kind of depends. Sometimes it’s easier I can get… We usually start with a training that we call The Five Steps of Treatment Coordination: The Psychology Behind Why the Patients Say Yes or No to Treatment. And if we do that, we usually start with that, that is 499, if we do that with the entire team, it doesn’t matter how many people are there. And then that is a general basis of setting the foundation of those five steps to treatment coordination, and really, the psychology behind when a patient says yes or no. Really, the first couple of things is we want to see where the base is at, where the foundation is at, what is their case acceptance rate, where are they having issues with?

Sean Field (10:40):

And then after we figure that out, then what we’re doing is we’re making sure that we’re doing a lot of role-playing. So, “Okay, well, present this crown to me. Present this perio to me. Present this cavity to me,” and really, the goal is to get them so flawless with their presentation, that they’re very prepared when they sit down with a patient. Because again, I’m not a clinical provider, I’m a salesperson, but I’m really just getting them to understand why we need to do certain things to be able to get the patient to say yes, and what kind of things that we could be doing that could be hurting our chances of getting that yes. And if we’re getting more nos, there’s something going on. There’s a breakdown in the communication, whether it’s at the front desk, or whether it’s the hygienist, or whether it’s the doctor themselves. And really, what we’ve noticed is that essentially, the more we really just kind of role-play, the more prepared they are when they’re actually in the chair, and the more likely that they’ll get the yes out of a patient.

Chris Pistorius (11:36):

That’s awesome. That’s a very unique way to look at this. And I know that in our business with our clients, I know that we have some folks, some clients that could get better at this, and I think you could make a huge impact the bottom line. So let’s talk about results a little bit. After you work with somebody, what kind of results do they typically see, once they start incorporating your training?

Sean Field (12:05):

Case acceptance, I mean, when it comes down to it, so not every single person in the entire world is going to say yes to you on that day. If you’re 65, 70% case acceptance rates, you’re doing fantastic. But usually, to answer your question specifically, if they’re in like the 40% case acceptance rates, we’re getting them closer to that 65 to 70% closing rate. And again, so you may not want every single person in your office, you may not want them, it may not be a fantastic fit.

Sean Field (12:34):

So to answer your question specifically, it’s case acceptance, and that’s really how the company got started, was that I have a long background in dental, and what I really noticed was that the providers were fantastic clinical doctors, and they would do fantastic treatment, but they just couldn’t get the cases sold, because it’s a much different situation if I say, “Okay, well, you’ve got [inaudible 00:13:00], a carie on number two, that’ll be $300,” compared to, “Okay, well, Sean, you’ve got a cavity on this tooth, and essentially, it’s like rust to a car, and the longer that we let that sit, the more unnecessary damage is going to happen to that tooth. And really, why we don’t want to do that, is because we don’t have to cause that damage. We can take care of it right now, and really on top of it, it’s going to cost you a lot more money if we just let this sit. Now, it’s totally up to you, Sean, what you want to do, but if you were my brother, that’s what I’d suggest. That’s what I do if I was you.”

Sean Field (13:36):

And again, just kind of putting the ball back in their court and stop talking, let the patient make their decision. Lng-winded answer to your question is we notice that the case acceptance naturally rises because they are focusing, they’re understanding what the patient in front of them is going through on their end, and the more they understand why they need that treatment and what’s going to happen if they don’t do that treatment, the easier that financial close is. And again, going from what do we usually see? The breakdown.

Sean Field (14:05):

So if the doctor’s doing a fantastic clinical close, and then the patient’s coming up to the front, and Nancy at the front desk is saying, “Okay, well, that’s $200. This is $300, this is $500,” the patient is just literally checking out like, “Oh, thanks.” That treatment plan’s going to go in the back seat when they get in the car and out of sight, out of mind. So really, the case acceptance is just naturally going up because we’re getting everybody on the same page, and everybody is, for lack of better words, closing that treatment, which again, is the best thing for the patient, because it’s just going to get worse if they don’t do it.

Chris Pistorius (14:38):

Yeah. That’s great. And I mean, if you could just increase the acceptance rate by 10 or 15%, just think of the impact financially that could have at a dental practice. Do you ever run across this? And sometimes we do on the marketing side of things when we’re trying to incorporate the team and to helping with marketing, is sometimes there’s always, and it’s not just dental, it’s any business, somebody’s been there maybe 10, 15, even 20 years, and you’re trying to really get them to do something a little different or new, like in your training too, and sometimes they’ll give some resistance, right? Because they’re kind of set in their ways and they don’t want to really have to change anything. First of all, have you seen that with your training, and what are some ways that you can overcome that?

Sean Field (15:26):

Sure. Yeah. I mean, we absolutely see that, and like you said, I mean, usually it’s somebody that has been there a really long time. So maybe an office manager that’s been there 15, 20 years and is in the paradigm of, “Well, this is always how I’ve done it, what’s wrong with that?” And I think to kind of overcome that, there’s two different ways to approach it in a consulting genre. I can either push them and fear them into it and say, “Okay, well, this is what’s going on, and you either have to do it or you don’t,” or I can really kind of first, Stephen Covey’s first seek to understand, and then be understood. If I’m listening to Nancy and what her concerns are, and why is that holding you back? And then finding essentially, just like we’re doing with the patient, finding out what her motivation is, and why she feels that’s a good fit, then I can adjust and pivot, and show her why I feel that this would be a good fit for them.

Sean Field (16:18):

And again, the greatest thing about dentistry is that, like we talked about at the beginning, if one of those three people come in and they have an occlusal cavity or carie, however you want to put it, it’s not going to get worse, and we didn’t put it there. Our job as providers, that’s the whole reason that the dentist went to school is to take the best care of the patient as possible. And really, I don’t think that there’s any office manager Nancy out there that would disagree that if we can get this treatment done and not just… Usually people think, “Okay, well, Sean, you’re all about the money. You’re all about the money.” I’m not. The money just naturally comes, if I can take good care of the patient, and the patient, we’re not doing the patient any favor if they continue this treatment, because it’s just going to get worse, and really, what they’re really concerned about is that it’s going to get more painful and it’s going to cost more money, the two things they don’t want.

Sean Field (17:14):

So we have a saying that says, “Positively influence the positives, and negatively influence the negatives,” and to answer your question, if I can get Nancy, if she’s resistant to me, the office manager, because she’s been doing it for 20 years, if I can get her to understand, “Hey, really, it’s not about the money, it’s just what’s best for the patient. What’s good for the patient, is good for the patient. So why feel bad about the collection?” And everybody’s kind of always heard, if you’re going to go into a grocery store, there’s no grocery store in the world that would let you put a cart full of stuff in your cart, roll past and say, “Hey, I’ll pay you when I can.” You’re not to do that. That’s just not how business works. And I think that sometimes people just feel bad, “Okay. We’ll just bill them. We’ll take care of it later,” and then they end up with a huge AR nightmare, simply just because they’re not believing in the value of their treatment.

Sean Field (18:03):

So forgive me for the long-winded answers to your questions, but if I can understand where Nancy’s coming from, from the foundation, I’m more likely to get her to buy into it, and really, because she’s a star player, or whoever the manager is, they’re a star player in that role, in the dental office, and in the case acceptance rates, then naturally then it’s going to be a more copacetic, synergetic environment where everybody is winning together, and that’s really what the thing is. We’re looking for a triple win situation. We’re looking for number one, the patient, number two, the practice, and number three, as a consulting firm, I realize that you guys are walking billboards for me, so the more that I increase your case acceptance rates in a very copacetic way, changing the paradigm or the mind shifts of the people in the practice, then everybody wins.

Chris Pistorius (18:58):

Yeah, no, that’s cool. It’s obvious that you’ve put a lot of thought into this, and that it’s important to you and you’re passionate about it, and I think that’s important when you consider any sort of a consultant for anything, really. But talk to me about quality assurance. Let’s say you come in, you do training. Is it kind of up to the provider to make sure that his staff is doing kind of what they’ve been taught from you, or is there any way that you can kind of quality assure that?

Sean Field (19:29):

I think working one-on-one is a different mindset. So typically, what happens is the doctor will fly, not with us, but they’ll fly the entire team out to a conference. Everybody gets totally pumped up about, “Oh my God, that’s awesome. I’m going to put this into practice. I’m going to do this, I’m going to do this, I’m going to do this,” and then Monday morning comes, and things get busy and the phone starts ringing, and everything goes out the door, and they go right back to their traditional way of how they’re doing things. And by working with them consistently, then we’re really reinforcing why we’re doing this, and naturally, through the progression, they’re more likely to continue why we’re doing this.

Sean Field (20:12):

And a lot of times too, one of the easiest ways to get any team member or any staff member, nine out of 10, there’s always going to be one person that doesn’t, but nine out of 10 people are going to be motivated monetarily. So, and that’s one of the things that we talk about too, is one of the easiest ways to keep them on track is that if we offer them some kind of bonus system, where if we work together as a team, and we’re slowly increasing, let’s say 10% per year, and we’re hitting those goals month, after month, after month, naturally, the team’s going to be very motivated for that monetary part of it. Because a lot of times what happens is that the team member will say, especially if there’s not a bonus system in place, they’ll say, “Well, Dr. Sean’s going to make all the money. He’s driving the Mercedes. What’s in it for me if I don’t do that?”

Sean Field (20:57):

So the easiest way to keep them on track is to add a bonus system, attach a monetary reward to it if they do this, so everybody wins again. And then again, consistency. That’s one of the reasons that when we first started, we had an agreement. So we usually had about a year agreement, and we noticed that it wasn’t as copacetic, it didn’t flow as well as if we just had like, “Look, here’s your call. You can stop at anytime you want, so there’s absolutely no pressure to move forward. If you’re done, you think you’re fantastic, that’s fine. And then if you feel like maybe you’re slipping and you want to come back, that’s fine as well.” But if we’re constantly working with the team member, understanding them, what’s in it for them, then the more likely they are to, again, focus back on what’s good for the patient.

Sean Field (21:45):

And that’s really the only reason that we turn on the generators in the morning, the only reason that we turn on the lights in the morning, the only reason that we’re spending all this money on this PPE with everything that’s going on, is because it’s the patient. Without the patient, we just don’t have anything. So really, that’s the main goal, but we’re all human, when it comes down to it, so we just have to figure out what the motivation is, just like when we’re trying to figure out what’s the treatment. What’s the motivation that you want these 12 veneers? What’s the motivation that you want this ortho? And really understanding that, and being able to bring that back up, so it’s going to be the same thing with the team members. But again, long-winded answer to your question, what we’ve noticed is that the more we work over, and over, and over with them, the more excited they get about the process, the better they get about the process, the more rewarding it is for everybody involved.

Chris Pistorius (22:32):

Yep, that totally makes sense, and I know that after hearing this, I’m definitely going to recommend you to our clients.

Sean Field (22:42):

Well, thank you.

Chris Pistorius (22:43):

As I know that our job is to get new patients in the door for them, right?

Sean Field (22:47):


Chris Pistorius (22:48):

But if they can close more of those patients and get more treatments as a result of that, then that just makes everybody more successful. So certainly win-win-win for everybody. So, Sean, I appreciate you being with us today, but first, before we take off here, could you tell everybody what’s the best way to get a hold of you? How does the process start? Do you do some sort of consultation first, or how does that work?

Sean Field (23:12):

So typically, we offer a free hour of consulting, just to kind of figure out what is your main want, your main needs in the practice, and give you a chance to kind of get to know us, and then give us a chance to get to know you guys, because we may not be a fit for everybody, everybody may not be a good fit for us. So we want to make sure that we initially build that rapport, and break that initial ground. From there, to get a hold of us, you can get ahold of us either through our website, There’s a link on there where you can schedule your free hour of consulting. Also, you can reach us via email at You can call us at (331) 225-3635. Again, (331) 225-3635. If we can’t get back to you, we can’t answer the phone right away, you can just leave a message, and we’ll get back to you as soon as possible.

Sean Field (24:05):

But yeah, the whole process, again, it’s very easy and it’s very straightforward, and nowadays with technology, we can work with somebody in Texas. We’re in the Chicagoland area, very easily and do the same thing, it’s just being able to have them on the phone. So really, a lot of people want to know, “Okay, well, Sean, what’s Patrick Consulting Group’s agenda, and how do you approach that, and how do you do that?” I don’t have a certain thing to say, “Okay, well, this is exactly the procedures we go through,” because everybody is different. It could be the hygienist that needs work, it could be the front desk that needs work, it could be the assistant that needs work, it could be the doctor that needs work.

Sean Field (24:40):

So during that first hour of consulting, that free one hour of dental consulting, we talk about it, we talk about why we think we’d be a good fit for you guys, you talk about us, let us know what you want, and then from there, then we would schedule those calls. And again, the calls are very easy, we try and make them very affordable. They’re $99 a call, and you can either choose to do Zoom, or you could do an over the phone call. Some doctors prefer to actually just do it over the phone, simply just because it’s listening back and forth and really kind of working on that treatment coordination skills that everybody has.

Sean Field (25:15):

And really, I think that the thing is that most of the clinicians think, “Well, I’m a dentist. I went to school to be a clinical provider,” and the hard, cold truth is that you’re a salesperson, whether you like it or not. And one of my best things that anybody ever told me was that you could be the best dentist in the entire world, you could be using the best composite material, you could be using the best labs, you could be using everything, but if you can’t sell the treatment, you’re not going to do anything. So that’s really where we come in, is that’s our profession is the sales profession, and just getting the team to really kind of understand that.

Chris Pistorius (25:55):

Yep. I love it. Sean, thanks so much. I’d like to maybe check back in with you in a few months, see how things are going, and see if anything’s changed with your business, if that’s okay.

Sean Field (26:05):

Yeah, that’d be great. I appreciate you having me on today.

Chris Pistorius (26:08):

Awesome. Everyone, thanks so much. I know you got a lot of great information out of this, and if you’re looking to increase the bottom line and get some more acceptance rates, then I think Sean’s got a great, great offer here at Patrick Consulting Group. So thanks again for all of your time and watching this episode, and be sure to tune in next week for our next great guest. Thanks again.

Sean Field (26:30):

Thanks, Chris. Thanks.


How You Can Make Virtual Dentistry Profitable For Your Practice

How You Can Make Virtual Dentistry Profitable For Your Practice

Chris talks with the Co-founder and CEO of SmileSnap, Greg Pellegrom. Listen in as they discuss how dental practices are using SmileSnap’s technology to increase new patient numbers and profit.

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Chris Pistorius (00:04):

Hi, everybody. This is Chris Pistorius with another episode of the Dental and Orthodontic Marketing podcast. We are here today with Greg Pellegrom. He is the CEO, and I’m sorry, co-founder and CEO of SmileSnap. Guys, this is a cool technology that I’m going to let Greg talk about, but I personally looked at it. My agency is going to get involved with this because this is the future, I believe, of dentistry. And there’s a lot of exciting stuff here if you’re looking to really grow your practice. So Greg, thanks so much for taking the time to be on the show today.

Greg Pellegrom (00:41):

Absolutely, Chris. Thanks for the opportunity to be here. I’m excited to talk a little bit about what we do here at SmileSnap.

Chris Pistorius (00:48):

Yeah. In doing research for finding people to come on the podcast, I was surprised that I hadn’t ran into you guys before, because this is technology, I think, that you’ve come out with that is exciting and is exactly the kind of stuff that we try to keep our clients on the cutting edge of. So why don’t you tell us about SmileSnap? What is it? What does it do? How did you get started with it? Just a little background, too.

Greg Pellegrom (01:15):

Yeah. Happy to. I’ll tell you a little bit about myself and then the company because I think it’s important to know who’s behind the platform. I started as an orthodontic sales rep with 3M Unitek back in 2003. So I really cut my teeth, getting to know the industry, and I immediately fell in love with orthodontics and what it provides for patients in creating that self-confidence. And I did that for about 15 years with a few different companies and got to the point where I really wanted to try my hand at some entrepreneurship. And I felt like I had the right idea and product market fit because what I was hearing from a lot of my customers, we weren’t talking products much anymore. We were talking more about changes in the industry. In particular, challenges around new patient acquisition.

Greg Pellegrom (02:06):

Orthodontists were benefactors of the GP referral system that has existed for decades. And that was changing, where they were either doing the treatment in house themselves or maybe bringing in an orthodontist to do that. And so they knew that they had to look at other ways and they didn’t quite really understand the world of digital marketing. A lot of them were having their in-office team member, because she’s on Facebook all the time, do that. We were seeing changes in the industry around Invisalign and opening retail stores. Obviously, the direct to consumer market by Smile Direct Club was a major wake up call to them. And a lot of corporate or DSOs were popping up.

Greg Pellegrom (02:57):

And so they weren’t quite sure where to turn. And so the idea really came to me of, there’s a lot of people who want to know more about orthodontics, meaning am I a candidate? What does it cost? How long does it take? And the traditional way was for you to call the office, schedule a consult, take time off of work, or pull your kid out of school. Go in just to find out some of this basic information. And that’s a major hurdle for a lot of people who are busy today.

Greg Pellegrom (03:30):

So really, the simple way to boil down my idea or concept was, why aren’t we using these things, the most powerful tool on the planet to just begin that engagement, that sort of a pre-consultation. Send me some pictures, answer some questions, and we’ll let you know some basic information around treatment. And then if it makes sense and it’s something you want to take to the next step, then we can jump into either a live video consultation or come on into the office and give that person a choice of which one works for them.

Greg Pellegrom (04:10):

And so we built SmileSnap. We’d launched it in April of 2019. So we’re just over two years out there. It was myself, my partner, who’s built the platform, the other co-founder, Jamison Stafford. And we had one full-time employee for about 11 months. And so from April of 19 to March of 20, we were doing everything we could really get our name, our brand, our concept out there. And it was well received, but a lot of the response was, “This is great. We’re going to do this someday.”

Greg Pellegrom (04:46):

And then when COVID hit, obviously, that was the precipice for virtual consultations and virtual visits. And we just happened to be in the right place at the right time. And we grew substantially over three months. We were very blessed and fortunate. The team grew, the platform grew, the awareness grew. And most importantly, we started to learn that people will use this platform. If you have this on your website and it’s built and designed as a widget, it’s fully customizable to the practice. It can work in general dentist’s office, pedo, perio, ortho, oral surgery. There’s all kinds of applications to use our platform.

Greg Pellegrom (05:35):

But we learned that people will use this. And we see patients flowing through our system, 24/7, 365. It doesn’t matter. Chris, we just had July 4th, a couple of days ago, and we had a couple of hundred patients come through the platform on July 4th. Why? Because this is where and when and how you meet today’s consumers.

Chris Pistorius (06:03):

Because they can, that’s why.

Greg Pellegrom (06:07):

The word I use over and over and over, because I apply it to my own life. It’s convenience. It’s convenience. Make it simple, let them inquire on their time. So maybe it’s after they put the kids to bed, or on the weekend, or on holiday. But it really expands access to your practice without expanding the physical footprint, adding more hours or days or columns or a treatment coordinator. So it’s a way to scale your practice, even geographically. We’ve had customers tell us because of SmileSnap, I have a greater geographic reach where people will find my website because I offer a virtual consult and I give them meaningful information. They drive past all kinds of competitors to come to me. So there’s a lot of advantages to offering this.

Chris Pistorius (07:02):

Yeah. I’ve got so many questions here, Greg. But first of all, you just hit something that’s interesting, because in our business, we do marketing for dental practices. So we’re always looking for … We talk to our clients a lot about USPs, unique selling propositions. So why should somebody choose your orthodontic practice or your general practice or whatever it may be over the maybe 50 others that are within 10 square miles or whatever? And this type of technology, I think, could definitely be part of that. [crosstalk 00:07:34]

Greg Pellegrom (07:33):

A hundred percent, Chris. There’s nothing more frustrating than if I’m looking for something online and I get to a website and I can’t get the meaningful information that I need to know to move through that buying process. I go to another website. And if I don’t find it there, I go to another website until I find the one that is giving me the information that I’m looking for.

Greg Pellegrom (07:55):

Now, what is that in dentistry? Traditionally, it was almost taboo to even market or advertise your dental or specialty practice. Well, those days have come and gone, all right. We got to get past that. Everybody needs to have a marketing budget and they should be working with an agency like yours that understands how to properly do this for a dental practice. But if they get to a website where they can do a virtual consultation and know that, “Hey, we have people that will respond to patients within hours or minutes.”

Greg Pellegrom (08:37):

We always say give them a heads up and say, “We’ll respond within 48 hours or two business days,” whatever that might be, because you want to set their expectations. Speed is also very important with these folks. You can’t go four or five days because they now mentally have moved on, but we’ve made this so simple where you can respond. You don’t have to be sitting in front of your computer. We’ve got a mobile app for both Apple and Android. So you can respond anytime, anywhere to these patients. And the most powerful way to do it is we have an asynchronous video capability built right into the platform. So all you need to do after you reviewed their photos and answers to your questions is simply hit record in about 30 to 40 seconds, tell them the things they want to hear.

Greg Pellegrom (09:28):

You want to let them know, I understand what your concerns are. Here’s what my recommendation is. We’ve got flexible payment options to fit your budget. The next step would be, whatever that is. My office manager, treatment coordinator or scheduling coordinator will reach out to you tomorrow. And we can either then do a live video chat like this, or come on in.

Greg Pellegrom (09:58):

But the beauty and the thing that people appreciate the most, that practices appreciate the most about SmileSnap, This will filter out those price shoppers, those tire kickers, the looky-loos, whatever you want to call them, so that when they do jump into this video chat or their next step is to come in for live consult, they’re very much committed because you’ve given a meaningful information around some fees, how invasive the process is. If there’s someone that’s scared of the dentist, you’ve eased their fears. So they’re highly convertible type patients.

Chris Pistorius (10:35):

Yeah. And something that I’ve found is that the younger we get as terms of potential patients, everybody’s wired a little differently. Millennials don’t necessarily want to pick up the phone and call and do a traditional phone call to set up an appointment. And what I’ve found in dentistry is that people, not just in dentistry, but anywhere, want things now. Right this second. And they’re used to being able to get that with their phones. They want food, they order it and it’s there within a few minutes.

Chris Pistorius (11:07):

Dentistry, traditionally, hasn’t been like that. And to me, it seems like this as a platform to allow people to get almost some immediate type feedback. So what I want to get into first though, is let’s talk about the platform itself. So let’s say, how does this work if I’m a dental practice owner, this widget goes on to my website? What happens? Do they have to sign up first? Do I have to gather insurance information first? What’s the first step. Second step, third step. How does this work, I guess?

Greg Pellegrom (11:38):

So the one thing I always like to point out at first is, before you go live with SmileSnap, you definitely want to have a full strategy around your new patient acquisition with this. How are we going to use this? And that starts with marketing, which is where you come in, Chris. Okay. And they’ll work hand-in-hand with you on how are we going to promote and market and advertise to our demographic that we’re offering virtual consults? And a great place to start is to let every single existing patient know you’re now offering this. So have that marketing strategy work with you to design that. This is great for social media ads, email campaigns, there’s lots of ways whether it’s new patients or existing ones. So you get more people in the door, butts in seats, and getting new services.

Greg Pellegrom (12:34):

Secondly, is that they don’t have to do everything all at once. So what we like to say is, start off by choosing one or two or maybe three services that you really want to focus in on. And you can expand later. So pick some cosmetic services. Implants, veneers, whitening, Invisalign. Those are great for this because when the user gets to the website and they go to do the virtual consultation, the widget’s going to be coming clearly branded to the practice. So it lives in your environment. We don’t take them to another website or landing page. It’s completely branded to the practice. So we want their logo on there, we want a picture of the doctor, because this is not AI driven. This is not a bot. We want the colors of the practice. So the look and feel is there. And then you can create questions. And depending on what questions you ask, it’ll take them down a different path.

Greg Pellegrom (13:39):

The other thing that we just recently launched is you have the ability to select what photos those you want to capture. In the past, we always did the five intra oral photos that you usually see. Upper, lower occlusal, right and left side. But you don’t always need all five. Or some people want more than that. So now you can create which photos do we want to capture. And right through our widget, and we’ve got the easiest way to capture good quality photos. They take these pictures. If they don’t look good, they can simply hit try again until they get it right. So it’s a real intuitive process we take them through to get good photos.

Greg Pellegrom (14:23):

Once they’re done, a series of texts alerts will go out to the patient, to the practice, along with emails, and you can set up those alerts however you want to which team members get them. But basically, now the ball is in the core of the practice. That person can go back to their life, whatever it is. They’re probably not going to keep searching dental websites. They found the one they’re interested in, because they’re motivated if they’re willing to go through this process.

Greg Pellegrom (14:56):

And really from there, someone in the practice needs to follow up. And this is where somebody in the practice needs to own this process, be held accountable. Yeah, you might respond in the evening or on a weekend, but you know what, again, we’ve built that mobile app. And if you just take three minutes, you don’t have to be in the office to record that video and send it. That person is so impressed. They’re like, “Man, Dr. Pistorius, I think the guy’s golfing.” Okay. “He took time out of his golf round to tell me these things. He’s pretty cool. I like this guy.” It humanizes that.

Chris Pistorius (15:39):

[crosstalk 00:15:39] their information, this app allows them to almost immediately just do a quick video after you’ve looked at some things and respond to them pretty quickly, huh?

Greg Pellegrom (15:52):

Absolutely. It’s all about speed and ease with the platform. Again, we try to make it convenient for both sides. We don’t want this to be disruptive to the practice and their daily flow. But depending on how many requests you’re getting in a day. And look, there’s some people that might get one, maybe two a day, and we have some that really push this, and they give this option to all new patients and they might get four or five, six in a day, because they have the confidence that they know they’re going to deliver a high touch quality experience, even though it’s digital, that they feel confident that they’re able to convert these consumers into patients.

Chris Pistorius (16:40):

That’s awesome. Wow. Okay. So tell me about who uses this? Do you have any demographics on what age range, or have you gotten in any of that yet in terms of what type of patients are really using this technology?

Greg Pellegrom (16:58):

Yeah, absolutely have that. Let me take a step back and talk about what our customer base looks like. And the majority, probably 90% of users on our platform today are orthodontists. And that’s not because this is built for orthodontists, it’s because that’s where my network, my background resided for so many years. So from a sales and marketing perspective for our company, that was our initial focus. It works, like I mentioned before, for GPs, and pedo, and so on and so forth. And we’re trying to get our name and our brand out there, which is why I’m grateful for this opportunity today.

Greg Pellegrom (17:45):

So it can be used in all these different areas. Who do we see using it? It is a lot of young adult all the way on up to 50, 60, 70 year old people who are interested in orthodontic treatment, is primarily what we see. And a lot of that is Invisalign.

Greg Pellegrom (18:13):

But it’s so easy and people are getting more and more comfortable all the time using platforms like ours. Doing things digital. The average person in the US today taps, types or swipes their phone 2,600 times a day.

Chris Pistorius (18:30):


Greg Pellegrom (18:31):

Yeah. Look it up. And I can only imagine that number continues to grow as we go forward. What we see, Chris, is people inquiring 24/7, 365. It doesn’t matter. I was really curious to see on Christmas this past year, if anybody was going to submit requests, and we had three people. It wasn’t a ton, but we had three. We had a lot during the Super Bowl game, and we just celebrated 4th of July here a couple of days ago and we had a couple of hundred come to the platform.

Greg Pellegrom (19:05):

So, people will use this if you give them access to your practice. And it’s a great way to scale and expand. You and I were talking before this started, traditionally, how do you expand a practice? Well, do I bring in an associate? Do I add a satellite location? Do we open up more hours, work another day, work evenings, weekends? These are things that are either expensive or nobody wants to do. If you put a widget that offers virtual consultations not just for new patients, but also for your existing patients. It’s great for them. You can also use it for virtual visits. Not every patient needs to be seen in the office every single time. And if you offer that convenience, people will brag about you like you [inaudible 00:20:08].

Chris Pistorius (20:08):

Yeah. I could see this working well on a marketing side of things, when we do Google ad campaigns, Facebook ad campaigns. I mean, we could put language in there, like submit your photos today, or speak with somebody now or language like that. And that goes a long way, especially to people that are … Google ads, we find these are people that have their credit card in hand, they’re ready to buy. They’re just trying to figure out who it is to buy from. So language like that really appeals to those people that do have their credit cards in hand and are ready to buy. So I could see this working well on a lot of different aspects.

Chris Pistorius (20:44):

So, Greg, tell me, obviously, you’re to get a lot of interest from our viewers here. What’s the best way to check you guys out and what’s the signup process look like? And does it take a lot of work for them to get your product on the website? Or how does all that work?

Greg Pellegrom (21:04):

So the best way is to go to our website, which is There’s a couple of ways that you can look at the product. You can request a recorded version of a demo, which you can then watch on your own time. Or the other way, which I think is more effective, is to schedule a demo with one of our account executives. Because then you can ask questions on the fly, you can have your whole team there and walk through a personalized demo of the platform.

Greg Pellegrom (21:38):

Once you see it, it’s really easy to sign up. Click the button, fill out the form. That gives you access to the platform. And at this point, you can go in there and you can check it out and play with it and do some things before we even collect payment. So, we really want you to get in there and make sure that this is something for you.

Greg Pellegrom (22:00):

Once you’re ready to go, all they need to do is enter their credit card. That’ll give them access to the code that they need to give you. And then you guys put it on their website. It’s really, it’s just a snippet of code that gets put into the header. And the widget is live.

Greg Pellegrom (22:21):

We are big on education and training, not just in the beginning, but ongoing. So this is very important, and I don’t want to overlook this part. This is new to most practices, and we want to hold your hand until you’re ready to fly. So we have a three-step process. Step one is what we call our foundational onboarding. This is where we’re going to work with you to get your widget ready to go. Meaning, we’re going to set it up, we’re going to get all your verbiage in there for the emails, for the text messages, how to use the patient portal, which really helps me everything that we do, HIPAA compliant. And then you go live.

Greg Pellegrom (23:11):

Once you go live, we have two success sessions, and this is really where we want to take you through that, what are best practices for workflow in the practice? How do we implement this? Tell us, how do we do this? And then we let you go for a couple of weeks and experience it. And then we do an additional success session with you, because there will be questions.

Greg Pellegrom (23:37):

And then after that, as part of your monthly or annual subscription to SmileSnap, additional training sessions are included. So we don’t nickel and dime you if you need additional training, new team members, whatever that might be. That’s really important.

Chris Pistorius (23:53):

Yeah. It sounds like a pretty simple, straightforward process. I can’t tell you how many softwares I’ve signed up for and just didn’t use because I didn’t fully understand it and I didn’t really want to take the time to fully understand it. And so I think that handhold process of making sure it’s set up correctly, making sure that they understand what’s going on will certainly help, and we’re not just buying stuff that we wind up getting charged for six months and don’t ever use it.

Greg Pellegrom (24:23):

Right, right. Yeah. We’re here. You got to take advantage and we’re going to push you and remind you to do that. So take advantage, for sure.

Chris Pistorius (24:32):

Well, Greg, thanks so much for being on today. I want to follow up with you in a few months, if that’s okay and just see what direction this is going and talk about your success. Because I think this is exciting stuff that is here to stay. This isn’t just a COVID special where people’s minds have changed now. And we talked off air about there’s so many companies now that since COVID, they aren’t going back to real offices. They’re getting rid of their office leases. And because COVID has permanently changed the way they think, and I think that we’re seeing the same for teledentistry type stuff where people now realize that they can go to the dentist using a camera sometimes. And dentists are realizing, “Hey, this is a valid option.” And I don’t see that changing just because of that convenience feature.

Chris Pistorius (25:21):

But I want to thank you so much for being on. All of the information about how to reach out to you guys and get signed up for a demo, get signed up initially, will be in this information. Thanks again so much for taking the time today.

Greg Pellegrom (25:36):

Absolutely, Chris. Glad to do it. And again, appreciate you having me on.

Chris Pistorius (25:40):

Absolutely. Thanks, Greg. And thank you all for another viewing of our latest episode of the Dental and Orthodontic Marketing podcast. Be sure to check out our next episode, coming in about a week. Thanks, and we’ll talk to you soon.


How To Manage & Grow A Multi-Location Dental Practice Effectively

How To Manage & Grow A Multi-Location Dental Practice Effectively

Chris Pistorius speaks with Candice Hansen, the office administrator at St.Paul Pediatric Dentistry, about what has made them successful. They also unpack some great strategies on how to manage & grow a multi-location dental practice effectively.

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Chris Pistorius (00:00):

Hello, everybody. This is Chris Pistorius again for another edition of The Dental and Orthodontic Marketing Podcast. We have an excellent guest with us today. We have Candice Hansen. Candice is the practice administrator with St. Paul Pediatric Dentistry, obviously in the St. Paul, Minneapolis area of our country. She is really is the grit and the hard work behind three practices that is under the St. Paul Pediatric Dentistry name. Candice, thanks so much for taking the time to be with us today.

Candice Hansen (00:41):

Yes, of course, Chris. Thanks for having me.

Chris Pistorius (00:43):

Great. Well, why don’t we start off? Tell us a little bit about St. Paul Pediatric Dentistry. What are you guys all about and what makes you guys unique?

Candice Hansen (00:54):

Yeah, well, I think you might’ve mentioned it, but we are a multi-location multi-doctor practice. We have three locations, three dentists that practice. We’re open full-time. What we are all about, we are pediatric specialists and we really strive to provide the highest quality of care and also deliver a pretty fun experience, as fun as dental can be for kiddos.

Chris Pistorius (01:29):

Yeah. Well, that’s awesome. You’ve been with the practice for four years now, is that right?

Candice Hansen (01:35):

Yep, a little over four years.

Chris Pistorius (01:37):

Okay. Tell us a little bit about what you specifically do. What do you do for the practice itself? Everything, right?

Candice Hansen (01:45):

Yeah. I think you might give me too much credit. I work with a really great group of doctors, which makes my job fairly easy in that sense, but a big part of my role is the growth of the business, so I oversee the business, just making sure our expenses and our overhead fall in line with our production and collections.

Candice Hansen (02:18):

Then probably, and I think if there’s other practice managers and/or dentists listening to this, they can relate to that right now, the biggest thing, the biggest part of my job is staffing and making sure that we have the right team, we have a team that’s elevated and also growth-focused because at St. Paul Pediatric Dentistry we started with one very small location that on paper did not look like it was going to be thriving, did not look like it was probably a good investment, and we found a formula that worked and we’ve taken that and duplicated it now three times, so yeah.

Candice Hansen (03:08):

Overall, a big part of that has been the team. Growing the business, a big part of it has been growing the team correctly and timing that right, so yeah, I would say overall, I wear many hats depending on the day, but the biggest part of my job is taking care of my team, building my team, and building the business.

Chris Pistorius (03:32):

Yeah. There’s a lot there to unpack for sure and I’m sure some people that are listening to this are nodding their head like, “Yes,” but then their question is, “How did you get to where you are now?” so let’s unpack first the first thing where you had talked about one location maybe not doing great and then you figured it out and then you duplicated that. I guess the question that everybody’s probably asking themselves is: How did you figure it out? How did you find that way to move forward?

Candice Hansen (04:04):

Well, I don’t know that we have figured it out exactly just yet, as we always think we’re a work in progress, but a lot of it goes to the owner of our practice, Dr. Julie Hammond. She’s always forward-thinking and it took a lot of time and effort and there were times as a doctor, she was answering the phone herself. But as far as figuring out the formula for what worked, it just really was trial and error. It started first with the team and then it went into our schedule, scheduling accurately, productively. When I came on board, I brought with some past experience that I think, I hope, helped to scale the business as far as insurance companies and negotiating our fee schedules and timing, evaluating what’s worth employee’s time and what isn’t, outsourcing services. There are just multiple things that have went into this practice. Yeah, sorry, I’m not even sure exactly where to start.

Chris Pistorius (05:31):

Right. There’s a lot there, right? Yeah, I think the point here is that there’s no magic button that you just figure it out, right? It’s trial and error and what works for some may not work for others. I mean, would you agree with that?

Candice Hansen (05:45):

Yes, most definitely.

Chris Pistorius (05:46):

Yeah, yeah. You had some dental experience before you came into this. Has your experience always been pediatric, or no?

Candice Hansen (05:54):

It has not, no.

Chris Pistorius (05:56):

Okay, okay. When you came in, you took this job four years ago or so, what did you start to figure out? What are some of the biggest differences? Obviously, I mean, you see kids and not adults, but other than that, from a business standpoint, what are some of the nuances that you found with pediatric that maybe didn’t exist with general dentistry?

Candice Hansen (06:16):

Yeah. Well, I actually have been in a specialty my whole career. I was in oral surgery as a specialty prior to this, yeah, so 10 years in total with oral surgery, or about 10 years.

Chris Pistorius (06:31):


Candice Hansen (06:32):

But when I came into this office, and very open-minded, I would say that is the one thing when you’re transitioning or going into any new business, you can see it from a different lens because the people working in the day-to-day, they’ve got their normal routines, right? I came into it really open-minded. I knew I was working for a doctor that our values aligned and I took the first few months to really just watch and observe what and learn what was working.

Candice Hansen (07:09):

Then after that, I started to give some feedback as far as things I saw and the first one was the insurance companies that we were in network with and saying, “I see that we’re charging out for this and we’re packing these schedules full, but do you know that you’re getting paid 30% of your fee on that? What if we cut out this insurance company so that you had more room to see?” I’m going to reference, say, Delta Dental that pays us 70% of our fees versus… Those were the first things, yeah, that I really started looking at. It was that, then looking at the hygienist schedule, and saying, “She’s always consistently getting done with these appointments 15 minutes early. If you add that up in the day, we could fit an additional four appointments in today, so why don’t we change her standard appointment lengths to 30 minutes?” I do a lot of time auditing. Yeah.

Chris Pistorius (08:30):

Yeah, I see where you’re going. I mean, those things make a huge impact and I can see where bringing experience from even outside of that specialty can make a big difference. You brought up hiring before. I hear that a lot from dental practices that we work with or just people I interview on this podcast and they’re struggling right now. I mean, COVID obviously us all hard, and I believe pretty much every dental practice in the country shut down. Obviously, there were some layoffs that happened there. I know some practices that didn’t lay people off, but I guess from your perspective in hiring, in my opinion, that’s one of the most critical aspects of growing any type of business, no matter what you are, but what advice do you have, specifically in dentistry? How do you hire people and find them and keep them, I guess?

Candice Hansen (09:25):

Magic question, Chris.

Chris Pistorius (09:28):


Candice Hansen (09:30):

There’s so many things that play into this. If my team listens to this, I am going to have to just give them a little shout-out. I do really feel I have a really strong, solid team, but we pride ourselves in what we say, choosing wisely. We do really follow the theme that hire slow and let go fast if it’s not [inaudible 00:09:57]. We also look more for, honestly, personality traits. There are a lot of skills that we feel can be taught to the right person, so we have started hiring more to culture than we have to the actual position or job description.

Chris Pistorius (10:23):

Yeah. Yeah, I’m hearing more and more of that and I’m getting more of people are having more success with hiring, perhaps, people with no experience, right, and because they feel as though they can teach them the job, it might take them a little longer, but then they can craft them the way that they want because if they don’t have experience, you’re really teaching them the dental industry and how to do things. Would you recommend that as well, then?

Candice Hansen (10:51):

Yeah. Minnesota specifically for dental can be tough because they do require every assistant, and I know it varies from state to state, but that they have a license, they’ve graduated from an accredited college. You can hire unlicensed assistants, but then they’re very limited as to what they can do within your practice. But hiring with no experience, I actually, we do love that. We say that coming in very green allows us to teach you specifically to our practice and the best compliment I can get is when an employee has found a position where they feel like they’ve maybe outgrown us and need to look at a different opportunity and whomever that hires them says, “Oh, I’m so glad you were trained at St. Paul Pediatric Dentistry.”

Chris Pistorius (11:46):

That’s great, yeah.

Candice Hansen (11:48):

Yeah, and it-

Chris Pistorius (11:49):

That’s an interesting perspective. It’s not like some people where somebody leaves and goes to somebody else and you’re all kind of upset over it. If it’s a good opportunity, a growth opportunity, that’s kind of a compliment, huh?

Candice Hansen (12:01):

… Yeah. I think in dentistry sometimes that’s where we maybe need to have a mind shift is that some of these team members, there’s fear of plateauing or fear of, “Where do I go next from here?” so what we look for in our practice is really, and I think any business probably wants this, is you want employees, you want longevity. Being a very growth-focused practice, we instill that in our teammates from day one: Where do you see yourself in five years? What are your goals? What do you want from this position? Being very honest, we have a lot of open, upfront conversations from the get-go in saying that, “Okay, you’re a dental assistant, but you hope someday to be an office manager. Let’s see what kind of track we can put you on within this practice to grow your skillset. Then if in five years, that position isn’t available here, but you feel like you’re ready for it, if we can help you, even if it is moving on from us.”

Candice Hansen (13:15):

But I think where we have success with keeping our employees long-term is that we do instill that, again from the beginning, that if you are looking for growth or for your future, that we’re going to help to get you there, and we hope that it will be within St. Paul Pediatric Dentistry, but if it is not, that’s okay, too, because we see that we see that you have it.

Chris Pistorius (13:45):

Right. Yeah, you can tell. Yeah. That’s great. I mean, I was referencing a little bit also towards front desk people, that when we have clients bring them in, it seems like people have been in the business 15 or 20 years don’t work out as well as people that maybe don’t have that experience and can be molded a little bit more freely, if you will. I think that’s an interesting perspective. Do you guys do anything in terms of employee retention in terms of bonus structures or goals or anything like that?

Candice Hansen (14:28):

Yes. Yep. For employee retention, the first thing that we do is a lot of communication. To start, we’re very transparent and we do a 30-day check-in from hire, a 60-day check-in, and then a 90-day check-in to graduation, which means 90 days you’re fully ready to be independent. We remind them what assets they are to our practice and then we say, “Okay, the next time we’ll sit down again at your six-month checkup,” referencing the dental world there, so then we do a six-month checkup, and then we do an annual checkup or an annual, what is it called? Just an annual performance review. The transparent communication upfront is huge for them from what we’ve found because every employee, we do surveys and we ask for feedback, and the one thing they say, when you’re a practice of multi-locations, is “Communication.” Everybody wants to know what’s going on, everybody wants to know how they’re doing. As you grow your team, that can get really hard. We’ve gone from a team of three in 2000, gosh, ’13, to now we have 24 employees total, and they all want to hear how they’re performing.

Chris Pistorius (16:05):

Wow. Yeah.

Candice Hansen (16:05):

I think the biggest thing I’ve learned in this industry is that a lot of people get comfortable and start to say, “Well, no word is good word.”

Chris Pistorius (16:13):


Candice Hansen (16:14):

In the year that we’re living, that is not how people perform. They want to hear, they want their accolades, they want to hear what they’re doing well, but they also want to hear what they could work on because they don’t want it to come up in one year and say, “Oh, if you would’ve told me that six months ago, I would have done it differently,” so that’s our first big thing is giving consistent feedback.

Candice Hansen (16:39):

The second thing we do as far as retention is we do offer for individual positions. We do different goals. Say for the scheduling managers or scheduling coordinators within our practice, we offer a production goal, right, so if you’re scheduled to this production goal, you get a bonus. It’s a daily bonus and it correlates to our clinical team, too. The way we structure those bonuses is we are always trying to incorporate fostering our team, so the bonuses are something that they do at the end of every day when they meet those goals and they actually pull a poker chip from a bag and whatever amount they draw, that’s their bonus for the day.

Chris Pistorius (17:27):

Oh, wow. It’s a daily thing, huh?

Candice Hansen (17:30):

It is. We’ve structured it daily. I’m going to be honest, they don’t hit it daily, but it’s something that the team is working to get towards.

Chris Pistorius (17:41):

Yeah, that’s cool, the daily thing. I didn’t even think of that. It keeps everybody engaged on a daily basis, huh?

Candice Hansen (17:48):

Yeah, and then at the end of the day, the great thing is when I say about fostering the team is then they get to celebrate together, right, because if they each draw a $100 chip, they each get a hundred bucks.

Chris Pistorius (18:00):

Wow. Nice, so there’s a lot of pressure on the person that’s drawing the chip.

Candice Hansen (18:06):

Well, actually, Chris, we let them all draw.

Chris Pistorius (18:08):

Oh, I got you. Okay. Gotcha.

Candice Hansen (18:10):

Yep, so they each draw their own chip, yep.

Chris Pistorius (18:12):

Gotcha. Nice. Well, that’s a great idea. I might have to steal that. That’s a cool way to do it, yeah. We’re going to wind things up here soon, but it seems to me with pediatric dentistry, you’ve got some extra pressures that maybe a few years ago you didn’t have in the sense that, and really, all the specialties, in that general dentistry really tries to encompass more than what they used to, right? We see them doing a lot more ortho procedures within their own office, like Invisalign, things like that. We also just see them turning to specialize in seeing kids, even though they’re not officially a pediatric dentistry. Do you see that as well, and do you think because of that, there’s education that needs to happen in a market as a pediatric dentist to inform parents that pediatric dentistry is specialized and there’s a reason that it’s there?

Candice Hansen (19:06):

Yeah. I think there’s a place for everybody, right?

Chris Pistorius (19:09):


Candice Hansen (19:12):

I think for pediatric specialists, yes. There’s definitely some education to be had around the specialties. We specialize in a specific industry for a reason. It’s all we do, it’s what we focus on, it’s what we know, and we do it well. But as far as the general dentists doing orthodontics and that kind of thing, there also is so much opportunity for dentists now. Sorry, I’m going to wait for this phone call.

Chris Pistorius (19:43):

No worries.

Candice Hansen (19:46):

Yeah. There’s a lot of opportunity for dentists right now as far as continuing education where they can expand their practice and I think really, as a specialist, it’s just finding a way to have relationships with your general dentist and other specialists in the area to set yourself apart because knowing that there are going to be those doctors that want to keep everything in house, and that’s understandable, but there is a time and a place for pediatrics and referring out those that we see children with special needs, we see children with behaviors, we see parents that just would prefer to have a specialist, so there’s education that needs to happen there.

Candice Hansen (20:37):

Then as a pediatric specialist, there is also education that needs to happen within our medical community as far as pediatricians and people in general understanding that really your child should go to their first dental appointment around 12 to 18 months of age. It used to be three years of age was the old saying, and now, it’s just educating people around that the sooner you get to the dentist, the less likely you are to have decay, kids aren’t going to get comfortable, and all of that.

Chris Pistorius (21:18):

Yeah. Yeah, totally makes sense. Totally agree with all of that. Pediatric is one of my favorite niches just because of the power of a lot of these pediatric dentists in terms of how they can really sculpt a young person’s oral health and make sure that they’re on track to be as healthy as they possibly can be, so it’s always fun working with pediatrics and crafting marketing campaigns specifically towards parents and things like that. Candice, I know you’re extremely busy with three practices, so I want to thank you so much for being a part of the show today.

Candice Hansen (22:01):

Oh, yes. Thanks for having me. I hope whoever’s listening, they took even just a little something from anything I said.

Chris Pistorius (22:09):

I know that they will, for sure. We always get feedback and I’ll be sure to share that with you once we get it. For Candice and myself, I want to thank everybody listening or watching this for tuning in. Make sure you check back next week for another great episode of The Dental and Orthodontic Marketing Podcast.

Need a COO For Your Dental Practice? It May Be Easier & More Affordable Than You Think

Need a COO For Your Dental Practice? It May Be Easier & More Affordable Than You Think

In this episode, Chris speaks with Kevin Wheeler, president at Simplified COO, about how dental practices can benefit from having a Chief Operating Officer and just how easy & affordable it can be.

This is an episode you don’t want to miss!

View Full Transcript

Chris Pistorius (00:04):

Hi everybody. This is Chris Pistorius again with you with the Dental and Orthodontic Marketing Podcast. Thanks for joining us today. And Kevin Wheeler, who is the President of Simplified. Oop, did I do that right? Simplified COO, did I get that right, Kevin?

Kevin Wheeler (00:20):

You did.

Chris Pistorius (00:21):

Gee, I just balked right there, but … So Kevin is the President of Simplified COO, and this is a really cool concept. And by the way, Kevin is our guest today.

Chris Pistorius (00:31):

And this is something we haven’t really talked about here on the podcast, is being able to bring in a COO when you don’t really need a COO, if that makes sense. So you bring somebody in that can help you out as a COO role, but you don’t have to have them full-time and you don’t have to pay them full-time money. But Kevin, you know way more about this than me. Why don’t you tell us a little bit about what you do and why you do it?

Kevin Wheeler (00:58):

Yeah, Chris. So I saw a need … I have many years background in large dental service organizations. And what I saw was a real need from the smaller that wanted to grow, whether it’s organic growth or whether it’s locations that they want to add. And that’s where my mindset is to help in any way I can. And so I was like, “Let me get involved with that.”

Kevin Wheeler (01:21):

Now, the cost is the prohibitive part of a lot of the smaller group practices. So I started a business as a fractional chief operating officer. And my goal was to be able to offer my services at really a fraction of the price of what a full fledged COO would be. And then my goal is to help in any way that I can, because there’s a lot that wraps into that. I do a lot of coaching, I do a lot of project work. Sometimes they just need a SOP manual created for their group. Sometimes they need everything.

Kevin Wheeler (01:59):

And so I have clients that range from three offices, two offices, to … Really the sweet spot seems to be the 10 to 20, is where people are trying to get to and what that dynamic difference is. And then my goal is to get them so financially secure that they can then find a chief operating officer that can be boots on the ground moving forward.

Chris Pistorius (02:23):

Wow, so you’re working your way out of a job, right?

Kevin Wheeler (02:26):

That’s true, that’s true. But onward and upward to the next opportunity.

Chris Pistorius (02:31):

Yeah, right.

Kevin Wheeler (02:31):

And so that’s how I want to create more of a footprint on helping many groups in dentistry, since it’s moving towards the group practice anyway. My goal is, we all do better in the dental field if we’re all doing well.

Chris Pistorius (02:46):


Kevin Wheeler (02:46):

There’s not really a competition. It’s more of an opportunity for patients to get good care wherever they go.

Chris Pistorius (02:54):

Right. So what made you think of this? You’ve been doing this for six or so years now, right?

Kevin Wheeler (03:00):

Yes, yes. Yeah. Again, having that background, working with a lot of different larger DSOs. I had a lot of success and it was really fun and I was honored to be able to work for them, but in the end I was just part of a larger wheel. And I just wanted to break off and be able to have a bigger impact than just making one region or one company successful. I wanted to make multiple providers successful.

Chris Pistorius (03:31):


Kevin Wheeler (03:31):

So that was really where my heart was in.

Chris Pistorius (03:34):

Yeah. Well, that’s awesome. I think it’s a great concept. How many practices do you typically work with at one time?

Kevin Wheeler (03:43):

Usually, depending on the size of the groups, I can do about six where I have the bandwidth to make sure that I give them the time.

Chris Pistorius (03:50):


Kevin Wheeler (03:50):

But I’m always working with groups on what can they financially afford, what do they need. And so sometimes I’ll move around where I’ll just have one group, and then other times four or five. And six seems to be about as far as I would want to go to, again depending on the size of those groups.

Chris Pistorius (04:10):


Kevin Wheeler (04:11):

Because I want them to get the attention they deserve.

Chris Pistorius (04:13):

Right, right, right. Now, do you work with individual practices at all too or is it mostly just groups?

Kevin Wheeler (04:18):

Yes. Yeah. Yes, I worked with individual, and a lot of those requests come with coaching on case acceptance.

Chris Pistorius (04:25):

Oh, I see.

Kevin Wheeler (04:25):

And so all in all, that’s a big passion of mine because that’s an immediate impact in revenue. So there’s a lot of systems that I can create, but really, when you see immediate impact on revenue then everyone gets excited. And they’re more open to listening to other ideas that you have.

Kevin Wheeler (04:48):

So I dive right into the case acceptance because it’s fun. It really starts on that patient experience journey, all the way to them saying yes to the dentistry that’s needed.

Chris Pistorius (04:57):

Right, right, right. So it’s almost like hiring a coach or a consultant, but packaged as a fractional COO, would that be a [crosstalk 00:05:07]?

Kevin Wheeler (05:07):

Yes. Yeah, yeah.

Chris Pistorius (05:08):


Kevin Wheeler (05:08):

I mean, there’s so many great consultants out there and business coaches, I try to view myself a little bit different because I’m going to get much more involved. I’m not just sharing good ideas and then following back up of how those ideas worked. I make a lot of visits, I’m on the road a lot.

Chris Pistorius (05:28):


Kevin Wheeler (05:28):

And so I get into the office and make sure that I can see the systems working as much as possible. And I’m there with them, holding their hand through the process of, again, whatever they need.

Chris Pistorius (05:42):

Yeah, [crosstalk 00:05:42].

Kevin Wheeler (05:42):

So it’s much more detailed than what consultants would get.

Chris Pistorius (05:46):

Right. I see. Gotcha. So what kind of tips or advice would you give somebody … We’re all coming out of this COVID fog, if you will. What do you see going on in the industry now? Do you see the industry as a whole rebounding, or some things that you’re telling the practices that you work with on how to come out of COVID?

Kevin Wheeler (06:06):

Yeah. So the one thing I noticed right away that with the slowdown initially in the pandemic, it gave an opportunity to go back to the basics. To go back to some systems that maybe were in place and just got lost. And we’re still at that point where this is a great opportunity to reset.

Kevin Wheeler (06:28):

A lot of people know what to do, they just don’t know how to implement it and how to follow through. And that’s where they need some help. And coming out of the pandemic, that’s a big focus of mine is, okay, let’s reset. Let’s get back to the basics. Let’s make sure the patients are having an amazing experience.

Kevin Wheeler (06:50):

And so one thing that I tell a lot of my clients is dentistry now where it stands is first a behavioral art, and second a clinical science. And the groups that understand that and embrace that are really successful. And the ones that aren’t, are having a little bit more of a struggle coming out of it.

Chris Pistorius (07:08):

Right. Yeah. That totally makes sense, for sure. So how long do you work with, when you’re doing this fractional COO services, what’s a typical length that you’re with them until you’ve have worked your way out of a job?

Kevin Wheeler (07:21):

For the ones that I am doing the full COO services, it seems to be about two years, maybe just a little bit under that, where they’re … Again, my goal is to get them there as quickly as they’d like.

Chris Pistorius (07:34):


Kevin Wheeler (07:35):

But normally I stay engaged because there’s a lot of things I can do as far as helping them find new practices. What I really thrive on is creating a relationship. So it never truly goes away. And I help them actually recruit and train [inaudible 00:07:55] if they want.

Kevin Wheeler (07:56):

So I want to make sure that they feel really good moving forward. And then I still get lots of phone calls on, “Let’s talk about some stuff that we had done before. And so, yeah, so it’s ongoing. But for the most part, it’s right in that just under two years.

Chris Pistorius (08:13):

Yeah, awesome. What do you like most about the dental industry?

Kevin Wheeler (08:18):

Oh, the relationship building. I mean, it’s a relationship business. Some people don’t like to talk about it as a sales job, but in the end it is. So you’re selling yourself, you’re building that trust. And so I actually like that, and I like how it trickles down then to the patient experience.

Kevin Wheeler (08:41):

So it’s from the moment you pick up that phone, the information that you get, that’s different from any other dental office. That’s what I always coach. We need nuggets on how we’re going to apply the value of the dentistry, not cost, to the patient. And the only way to do that is to find a way to connect with a patient.

Chris Pistorius (09:00):


Kevin Wheeler (09:01):

So it’s really the connection from the doctor, to the team, to the patient, that I really enjoy.

Chris Pistorius (09:06):

Yeah, absolutely. What do you least like about the dental industry? What would you like to change about it if you could?

Kevin Wheeler (09:16):

I’m a very optimistic person so I haven’t really given a lot of thought in that. Again, like I say, I don’t view that we’re in competition with each other, different offices. I guess what I would like the least are just those groups that still are in that clinical science minded. The degree on the wall and the white coat mean you should move forward with dentistry, because those days are just done, and so …

Chris Pistorius (09:46):


Kevin Wheeler (09:46):

But it also, those opportunities when I’m given, I’m able to show those people. So really what I dislike ends up being a great opportunity to help them get to the goals that they have.

Chris Pistorius (09:56):

Yeah. Yeah. Are you seeing a churn at all in terms of what you talked about, the more traditional dentists that are … Maybe call them the baby boomer dentists, the guys that are retiring now, and then the new folks are coming in. Are you seeing a big churn going on between those two generations?

Kevin Wheeler (10:15):

Yeah, yeah.

Chris Pistorius (10:16):


Kevin Wheeler (10:16):

I mean, for the seasoned dentist, there’s more emphasis on what will my legacy be. And there’s so many opportunities now for exit strategies-

Chris Pistorius (10:27):


Kevin Wheeler (10:27):

… whereas before they didn’t really think about it until the end, and then they were like, “Gosh, what am I going to do?” Now there’s many groups that approach these dentists and say, “Hey, when are you going to retire? You know, we’re here for you.” A lot of the dentists received letters from group practices saying, “Hey, do you want to sell?” So that opportunity.

Kevin Wheeler (10:48):

And then from the new, there’s really an openness, an excitement, a buzz for the new graduates, that’s an all-time high because they know they have the opportunity for private. They know they have the group practice. It’s just created more opportunities, and so there’s a lot more buzz around their success.

Chris Pistorius (11:11):

Right. And do you ever see a situation where you go in and help a new person, whether they’re starting from scratch or they’re buying an existing practice, do you get into that business at all?

Kevin Wheeler (11:20):

Yes. Yeah, yeah.

Chris Pistorius (11:21):


Kevin Wheeler (11:21):

Quite a bit. So whether they’re looking for an acquisition or starting up a Denovo, that was actually in the larger DSO world, that part of my life. That was my biggest focus, was to help those doctors get ramped up quickly.

Chris Pistorius (11:37):


Kevin Wheeler (11:38):

And taking some of the older mindset of that, when you get your new practice, you work a couple of days a week. You do all the hygiene. You plan a strategy of month eight and you’re going to add specialty if you’re going to do that.

Kevin Wheeler (11:54):

And what I found is, if you put in the marketing efforts and you’re going to get patients on the books, let’s say 80 patients, are going to be on your books as you’re opening your office, you need to get going right out the gate and assuming that those patients are going to say yes to dentistry.

Chris Pistorius (12:11):


Kevin Wheeler (12:12):

So I do a lot of coaching on, “Let’s get started quicker. You can get out of cash burn in month three if you’re diligent about it.” It doesn’t take the old mind of month nine.

Chris Pistorius (12:24):


Kevin Wheeler (12:25):

And sometimes I’ve seen it as well as month two.

Chris Pistorius (12:29):


Kevin Wheeler (12:30):

So that’s a focus that I like to get involved with.

Chris Pistorius (12:35):

Gotcha. What would you say to somebody coming out of school or maybe they’ve been an associate for a year or two, they’re ready to do their own practice, start from scratch, or take over an existing practice?

Kevin Wheeler (12:44):

Ooh. Some of that has to deal with their finances, so we have to be realistic. And they’re going to have probably a lot of bills coming up, a lot of school fees and whatnot. So I would say, my advice would be not to jump right into their own practice right out the gate. Again, there’s so many opportunities to join groups or to join other doctors that will give a little bit of mentorship. And they can start planning immediately on what that looks like on their own exit to their own private office.

Kevin Wheeler (13:17):

But it’s a big hurdle, because you’ve got so much knowledge in your head as a new dentist. You’re not even thinking about what the patient experience is going to be like.

Chris Pistorius (13:28):


Kevin Wheeler (13:28):

You’re just thinking about, “How am I going to do this crown? How am I going to do this filling? How many patients will I see? What is the flow going to be?” So you really got to get some practice.

Kevin Wheeler (13:37):

And so I have talked to a lot of the new grads that are like, “My dad’s going to … My mom’s going to help me get an office rolling right away.” And I don’t want to bash their goals, but I’m like, “Okay, but just think about it, you don’t have to rush into this.”

Chris Pistorius (13:52):


Kevin Wheeler (13:53):

You can get a lot of experience by jumping in with a group.

Chris Pistorius (13:57):

Yeah, yeah. And not only that, but what I find is in, and I’ve said this several times on this podcast, but we find new dentists coming out of school. They know a lot about dentistry certainly, but that doesn’t necessarily mean that they know a lot about business.

Kevin Wheeler (14:10):


Chris Pistorius (14:11):

And there’s a book out there called The E-Myth Revisited I think it is, where they talk about being good or being at the technical work of [inaudible 00:14:21] of something. Like being a skilled technical worker is great. But if you don’t know how to do the books, how to do sales, how to do marketing, anything else, you’re probably not going to have a successful business.

Kevin Wheeler (14:32):


Chris Pistorius (14:34):

I think you’re right. I think new people can learn not only and refine their skills, but also learn about business as well.

Kevin Wheeler (14:41):

Yeah. I mean, gosh, I wouldn’t want to take those two on right out the gate.

Chris Pistorius (14:44):


Kevin Wheeler (14:45):

My clinical aptitude and then my business acumen-

Chris Pistorius (14:48):

Right, right.

Kevin Wheeler (14:49):

… that’s a tall mountain to climb right out gate so soon.

Chris Pistorius (14:52):

Yeah, yeah, for sure.

Kevin Wheeler (14:53):

But those that really want to do it, they just need to reach out and look for help.

Chris Pistorius (14:57):


Kevin Wheeler (14:58):

Because there’s a lot of help out there, they don’t have to do it alone.

Chris Pistorius (15:01):


Kevin Wheeler (15:01):

They’ll have to work that into their finances, but there’s people out there such as myself that that’s there to support them.

Chris Pistorius (15:07):

Yeah. Yeah. Well, great. Now when you work with practices, new or existing, I’m sure you get into some of the marketing aspects of things too. What have you seen work great for dental practices in terms of marketing and bringing in new patients?

Kevin Wheeler (15:21):

Yeah. I mean, for me, the internal referral is huge.

Chris Pistorius (15:27):


Kevin Wheeler (15:27):

You’re going to have to spend money to get people on the books. Once they are, it’s going to be the buzz around the community.

Chris Pistorius (15:35):


Kevin Wheeler (15:35):

So I’m really big on keeping things in line. Marketing can get expensive, but it’s very necessary. So while you’re pouring in those dollars into that, make sure that everyone is a raving fan of you.

Chris Pistorius (15:48):


Kevin Wheeler (15:49):

That you’re thinking about, and I talk about this a lot with teams, why would somebody drive past three dental offices to get to yours? And if you’re not thinking about that every day and pretty much in front of every patient, then you’re missing an opportunity.

Chris Pistorius (16:05):

Right. Yeah.

Kevin Wheeler (16:06):

So there’s a lot of competition out there, and so we have to be thinking, how are we going to be different?

Chris Pistorius (16:12):


Kevin Wheeler (16:12):

So internal referrals, having a great experience. I love having new patient gifts, they come in. Making sure again, if you apply what they need done clinically to the value of what’s important to them, then you’re going to be good with the internal referrals. And then have your team get out there and do some business to business, shake hands, kiss babies, all that stuff.

Chris Pistorius (16:39):

Right, yeah.

Kevin Wheeler (16:39):

You need your community to know that you’re there.

Chris Pistorius (16:42):


Kevin Wheeler (16:42):

And I have a big passion. For many years, I’ve gotten involved with outreach. And so anytime I get into an office, I asked them to consider partnering with a homeless shelter or Toys for Tots. Or whatever they feel passionate about and bring that into the dental office, because that gives a unique experience to the patient.

Chris Pistorius (17:03):


Kevin Wheeler (17:04):

You can actually give back to the community and they see that you care about something other than dentistry as well.

Chris Pistorius (17:10):


Kevin Wheeler (17:10):

And that helps build a relationship. So that goes really wide as an overview, but that’s basically it.

Chris Pistorius (17:20):

Awesome. Awesome. Well, thanks, Kevin. I really appreciate your time. This has been really good information. I know that our base is going to get a lot of great info out of this.

Chris Pistorius (17:31):

If somebody is watching this and they’re like, “Yes, I need some help like this,” what’s the best way to reach out to you and work with you?

Kevin Wheeler (17:38):

Yeah. So I have a website Simplified COO-

Chris Pistorius (17:41):


Kevin Wheeler (17:43):

… so they can definitely reach out to that. I’m on LinkedIn, they can look up for Kevin Wheeler specifically. And my email is

Chris Pistorius (17:56):

What’s the process when somebody reaches out to you, do you a free consultation or something like that?

Kevin Wheeler (18:01):


Chris Pistorius (18:01):

Just see where you are? Okay.

Kevin Wheeler (18:02):

Yeah, yeah. So free consultation. I’m not really big on the contracts because again, I build my business around relationships. And at any time, if they don’t see the value of the services, I’m not going to hold them to anything specifically.

Chris Pistorius (18:15):

Right, yeah. [crosstalk 00:18:17].

Kevin Wheeler (18:16):

I’m more about I’m here to serve, and I hope to be a good fit for them.

Chris Pistorius (18:21):

Awesome. Kevin, thanks again so much for taking the time. I know that this is going to be hugely valuable for a lot of people.

Kevin Wheeler (18:29):

Thank you, Chris. I appreciate you.

Chris Pistorius (18:30):

Great. And thanks everybody for tuning in for another episode of the Dental and Orthodontic Marketing Podcast. Be sure to check back with us next week for another great guest.


Tips From A Dental Consultant On Increasing Case Acceptance

Tips From A Dental Consultant On Increasing Case Acceptance

In this episode, Chris talks to Eric Vickery of Vickery Coaching on case acceptance and insurance.

With more than 20 years of experience in his field, Eric takes us through his methods on increasing case acceptance in practices and how he helps dentists move away from insurances.

You won’t want to miss this episode!

View Full Transcript

Chris Pistorius (00:04):

Hi everyone. This is Chris Pistorius, again, with the Dental & Orthodontic Marketing Podcast here for another great episode this week. Today, we’ve got Eric Vickery of Vickery Coaching. Eric has worked with over 250 dental practices throughout the country and just coaching, helping out with a multitude of things, but one of his specialties is case acceptance. Once you present a need to the patient on what your recommendations are in terms of what type of service and treatment they should get, how do we get more of those people to say yes and come back for that? So, Eric, thanks so much for being on the show today.

Eric Vickery (00:47):

It’s great, Chris. I’m so thankful that I get to be on here and talk to you about case acceptance. This is great.

Chris Pistorius (00:53):

Yeah. Well, I know it’s a big need in the market. We have clients all the time. Our job as a marketing company is to bring in new patients, new cases for our clients. Then once we bring them in there, there’re some things that we can do to help, but that’s always that next step. We’ve got them in there. We recommend treatment. How do we get more of those people to raise their hand and say, “Yeah. Let’s go for that.” That’s something that you specialize in, right?

Eric Vickery (01:21):

Yeah. It’s funny that you say raise your hand. I do a two day seminar on case acceptance and at the beginning, I’ll say, “All right, raise your hand. Who likes to sell? Who likes selling dentistry?” There’ll be one or two administrative people in the room that will raise their hand, and by the end of the two days, I do that same thing again and they raise their hand. Here’s the thing, selling is a bad word. It’s an S word. Sell, it’s a four-letter S word and we can disguise it however we want. We can call it case acceptance, case presentation, what have you. But at end of the day, we’re exchanging information to the patient. They’re buying something from us. We’re exchanging a service for financial profit, and hopefully we’re doing it in a profitable way.So what we don’t like about the S word, sell, is that people feel pressured.

Eric Vickery (02:10):

They feel like, “I don’t want to be someone who’s a pressure salesman.” They don’t want to get into that mode. So what I train offices on for the last 20 years is how to sell in a way that there’s no pressure. In fact, we call it mutual agreement. They feel they got good advice from somebody they trust. Closing has this negative connotation to it, just pressure and understanding how to do that in a way that is comfortable for you as the dental team member, the doctor, or for the patient. Nobody in either side of that feels they’re being pressured into something. In fact, to me, this is what pressure sales sounds like and I hear this all the time. Quote, “You need a crown. Go up front and see Jenny and she’ll get you scheduled. Have any questions for me? Nope. All right. You’re all set. We’ll see you for your next visit.”

Eric Vickery (03:03):

That’s it. To me that is telling someone what they need to do. When you’re pushing and you’re telling someone, that’d be like you saying, “Hey, you need to upgrade your website.” “No, I don’t want to have one.” You don’t ever approach someone that way. You approach someone with some real basis, and we want to transition from telling people what they need to provide them with something that they want. They’re not there on accident. We just need to do more investigating and work on our soft skills to figure out what it is that’s really driving them… their butt sitting in your seat right now.

Chris Pistorius (03:33):

Yeah, yeah. Totally agree. I tell dentists all the time that you’re not selling dental services. You’re not selling dental products. You’re really selling, and it is selling, you’re right, you’re selling a solution to a problem. Tooth pain, you don’t like how your teeth look, whatever it may be. You’re trying to get somebody to that place where they want to be whether it’s out of pain, or a beautiful smile, whatever it is. If we can focus on marketing that, that checks a lot of the boxes and it’s all about, I think, selling the value. What are some tips and some things that you teach to your teams about this?

Eric Vickery (04:18):

Yeah. So there’s two rules in sales that I abide in. The first one is people buy for their reasons, not your reasons. So you can have all the initials after your name. You could be DDS, DMD, MAGD, AACD, whatever you want. They don’t know what any of that means. At the end of the day, they’re going to be making this decision and again, back to not pressuring them. So if you can discover what their reasons are. So, I’ll talk about that in a moment. Number two, people don’t buy a solution to a problem they don’t perceive to have. So if I live on a dirt floor and the door to door salesman comes to my door with a vacuum, I’m not buying a vacuum from him because I’m comfortable walking around barefoot on my dirt floor.

Eric Vickery (05:00):

But all of a sudden, he shows me his vacuum and he shows me what’s underneath the dirt floor. There’s beautiful wood floors under there. “Oh, wow. I didn’t even realize that was an issue. I wasn’t feeling any pain.” So I’ll use it all the time where I say, “No pain, no problem, no pay.” The patient’s perception is, “No pain, no problem. Therefore, I’m not going to pay.” That’s why… ask your admin team whether they can finish the sentence. They make the call out for a… the courtesy call two days before their crown appointment and the patient says, “Oh, I’m so glad you called me. I was just getting ready to call you. You know what? That tooth’s not even bothering me. So, I’m going to go ahead and wait.” I guarantee you your administrative person has heard that before.

Eric Vickery (05:38):

If so, that means they don’t understand the problem, the condition of what’s going on and there’s something chairside that we can do to fix that. All of this stems from these two rules that I have abide in. It stems from want versus need and most purchases we make in our lives fall into either one of those categories. “I need to go get gasoline for my car. I need to go buy groceries. I need to pay the bills. I need a new dishwasher. I need a new fill in the blank.” Those are the things that life thrust on you in a need for… it’s called push. It’s like it’s pushed onto you. It’s a need. Most people I would rather be in the pull category, the want. “I want to go on vacation. I want to go out to eat. I want to go to dinner.”

Eric Vickery (06:29):

Most people don’t wake up in the morning and go, “Oh, I really want a new crown today. You know what? I’m going to give Dr. Smith a call and get that scheduled.” So what we have to figure out is what do they want, and you mentioned it. They want, so you do back, to number one, people buy for their reasons, not your reasons. So you would do an interview with them, a tool that I use, and you would ask the right questions. You’d set it up properly before you ever look in their mouth and you’d find out what it is they are looking for, what they like, what they don’t like, what they’re looking for. The kicker is to find out why they’re looking for that. What’s important about that to them? You’ll hear things like, “My son’s getting married in a month and I want to whiten my teeth. I don’t like my smile. There’s going to be wedding photos.”

Eric Vickery (07:12):

Whatever it is, you’re going to hear, “Potential job promotion, but I don’t smile enough at work. I keep getting overlooked.” That was one we heard from an MDNA employee back east. We’ve had a grandpa brown tooth before. There’s just people who have this attached emotion to a justification. People buy with emotion, justify with logic. So there’s something there that’s driving them to you and they may not verbalize it upfront, may or may not, but a lot of dentists or team members get confused and they say, “Oh, this person really wants to brighten their smile or change their smile or fix this.” Well, that’s a what they want, but that’s not the driving force behind that to decide why they want that.

Eric Vickery (07:55):

So we’ll use this question. “Chris, why is having that so important to you?” You discover that your grandpa lost his teeth and you don’t want to end up like that. So everything that we diagnose clinically now becomes in relationship to that. It’s the center of the table setting at Thanksgiving dinner, and everything has to match to that. It points to that main thing, the main dish. So if we find something you were unaware of, gum disease, fractured teeth, whatever that might be, we’re relating that back to how that connects to losing your teeth like grandpa probably did or how that could affect the photographs or whatever. So for, I don’t know, 14 years and longer. I’ve been doing this 20 years, but about 14 years ago, I started to really perfect the verbiage of how you represent this to the patient in a case presentation formula.

Eric Vickery (08:48):

I train it and teach it all over it, but it takes the summation of what they said they wanted and why. So let’s use this example. “I don’t want to lose my teeth like grandpa did.” Okay. Then we take our diagnosis that they fully understand, eliminate all the technical jargon. We put those two things together and it goes like this. I say, “Chris, earlier, you shared with me it was really important for you to have peace of mind knowing that you weren’t going to lose teeth like other family members have. Keeping that in mind to the exam, I’m concerned about the infection of your gums, the decay, the cavities, and how those things cause people to lose their teeth. So how concerned are you with that?” You get that test the buy-in right there to see, do they really buy in for their own reasons? Did they solve both those two rules? Did they buy the problem and did they buy it for their reasons?

Eric Vickery (09:38):

When you make that connection, it’s like when the patient asks you, “Oh my gosh, I didn’t realize it was so bad. What do I got to do to fix it?” That’s a very small percentage of time that that question gets asked by the patient. Usually you hear things like, “Don’t find anything today, doc,” when you walk in the room. So this is a way to get the patient to get to the want side of it. You told me this was really important for you. Here’s something standing in the way. How concerned are you OF this? Yes? Okay, great. Would it makes sense… do you want to talk about a plan on how we can take care of this?

Eric Vickery (10:11):

When you say, “Yeah, I want to talk about a plan,” then you finally have the right… you’ve earned the right to now talk about treatment. Before that I never talked about zoom, implants, crown and bridge, anything. It’s all been condition and emotion focused. Then they’re saying, “Yeah, what do I do to fix it?” Now you get to talk about treatment plan. I still never say, “Need.” Need is a four-letter word, but at the end, we would talk about mutual agreement and close. So, that’s a big overview. It’s a lot of information at once, but does that make sense?

Chris Pistorius (10:39):

Yeah, absolutely. It’s like the old… when I first got in professional sales or my career long time ago, they taught us it was the feature, function, benefit, tie-down It all came from the original consultative sales approach where you ask… still today, when I bring on new clients, that first meeting is all about them. I want to find out what sparked the call, why they think that they need help marketing, what do they think they need help marketing in? Then they start telling me those things that builds a story. Okay, three more patients a month would mean that the doctor and his family can spend six more days together on vacation a year.

Eric Vickery (11:22):

There’s a benefit.

Chris Pistorius (11:23):

Absolutely. So once you have that approach, you presented as three more cases a month and you’re on the beach an extra week with your family, what would that do for not only your bottom line, but your quality of life? If you can build a story and refer back to that, it’s amazing.

Eric Vickery (11:43):

It’s the anchor.

Chris Pistorius (11:44):

Yeah, absolutely. I can tell you there’s, geez, a low percentage of dentists that are doing that today, I believe. Because in dental school they do a great job of teaching these folks how to be dentist, but so little about business and marketing and selling and things like that which leads me to my next question. When you go in and you help somebody and you take on a new practice, are you training the entire staff, just the dentist, just the hygienists, or what does that look like?

Eric Vickery (12:18):

Well, so the phone call is a great second impression and you know that from what you do because they’ve already seen the website. They’ve already been referred by someone. So I believe that case acceptance starts with the second impression, which is how you answer that phone. Unfortunately, you know this as well, almost two thirds of dental offices don’t ask for the appointment. They just they’re helpers, they’re… they problem solve and they’re just there to help people. They don’t take the time to really ask, “Would you like to go ahead and get that scheduled?” So from the phone call, I’ll say this to team members all the time. I’ll say, “All right. You’re asking questions on the phone. That’s great. What’s the most important question you ask? You have to earn the right to get there, but it’s…”

Eric Vickery (12:58):

I hear their name, the marketing source, the website, primary issue, how long it’s been, all of these things. Then I’ll keep waiting. “Those are all good questions. What other questions?” Finally, I’ll say, “All right. What’s the goal of every new patient phone call?” They’ll say, “Well, to schedule them.” Okay. So therefore, the most important question is the last question. “Would it make sense to go ahead and get you an appointment scheduled with our office?” So getting the team’s whole psyche on board with case acceptance and how we then prepare the clinical team for that patient’s arrival at morning huddle so the doctor doesn’t walk in the room or the hygienist or the assistant and go, “So what brings you in today?” That’s shooting ourselves in the foot. We just built all this rapport on the phone and then we just… we just drop it.

Chris Pistorius (13:45):

No idea why they’re there.

Eric Vickery (13:46):

Yeah. We walk in and say, “Oh, Chris. It’s great to meet you. I heard a lot about you from Jenny. I know you talked on the phone. She told me that.” You replay those things. All the gurus that you and I probably both listened to talk about credibility. If you don’t have credibility, they’re not doing business with you. They’re not conscious of it necessarily, but there are things that either create confidence in your competence or decreases confidence in your competence. Seating them on time versus late or early. Were you interrupted and put on hold a bunch on the phone? Did you walk in the room and say, “So what brings you in today?” He calls you Carl or something instead of Chris. It’s… are we on the right page? Do we really know what we’re doing? This is what creates that credibility. Your every interaction is creating confidence in your competence.

Eric Vickery (14:40):

So you have to have all of the soft skills. The system set up, you mentioned dental school and preparing them. Dental school prepares dentists this way. Where does your success come from? 15% is your foundation. That is your clinical expertise. You’re constantly doing clinical CE, but it literally is only 15% of your success. If you stood out front of your office with a sign that says, “I’m a great dentist, come see me.” It’s not going to carry any weight. People got to talk about you. You have to have bedside manner. You have to have these skills. So 85%, this is from Mellon University, Carnegie and all those guys, 85% comes from your people skills and your systems and how you do this.

Eric Vickery (15:19):

So I focus on training the whole team, the entire team on how to get case acceptance from the phone call, to the doctor walking in the room, to transferring that patient back to a clinical team member who then transfers that person back out the front, to financial arrangements, to scheduling. It’s a process, and if everybody, it’s a team, if everybody’s not on the same page, it will… you’ll get tripped up pretty easily.

Chris Pistorius (15:45):

Yeah. It’s important. You can get as many new patients as you want, but if we’re not getting them in for the treatments that you recommend, it doesn’t really matter a whole lot.

Eric Vickery (15:56):

Yeah, exactly. They tell me they sell 50 new patients and I just want to know how many of them have a future appointment, and you bring up a great point. I’ll ask doctors all the time, I’ll say, “Well, what is the goal for case acceptance?” They’ll go, “80, 85%.” Well, 85% of what? What does that mean? It’s really specific. So we use a case presentation tracker, a case acceptance tracker, and it’ll track existing and new patients, their name, the type of procedure, the dollar amount. Then if they scheduled or not. If so, how much of that dollar amount? If there’s nothing scheduled, there’s a follow-up column. We’re looking at three things. One is 80% of the people are scheduling something. So that’s, you would think, “Oh, 100% of people scheduling something.” That’s not going to happen.

Eric Vickery (16:44):

We’re we’re being realistic with this. 80% of the people are scheduling something. That could be a cleaning down the line. It could be a supervised neglect. I don’t know what would define what that is. Something in the future. We need to maintain relationship with this person, but 60% of the dollars are being scheduled at the time of presentation. A lot of doctors would be shocked to see how low that number is when they actually track it. So, I love KPIs. I love advanced tracking and I love good old fashioned hand counting and looking at it and getting the team involved in owning that and being a part of the culture. If you were to hire a hygienist, you’re interviewing two hygienists and you say, “All right, so I want the one that has 100% case acceptance or the one that has 50% case acceptance.” Part of us goes, Well, I think 100%, but it must be a trick question.” It’s a hundred percent of what?

Chris Pistorius (17:37):

Yeah. It’s the old adage, what is it? What gets measured gets done.

Eric Vickery (17:42):

What you measure you improve.

Chris Pistorius (17:43):

Absolutely because I talk about it all the time. I’m like, “All right.” So one of the things that we do are reactivation campaigns. Maybe a patient hasn’t been in in nine months. That’s off a red flag in some system, somewhere, it gets to us and we take them through a marketing process to try to get them back in. So one of the initial questions is, “All right, what percentage of your patients are inactive versus?” That’s a pretty easy number to find if you have a system. A lot of times I get the glossy eyes like, “Oh, I don’t know.”

Eric Vickery (18:13):

Yeah. Nobody wants to touch that.

Chris Pistorius (18:15):

Any business owner, and this applies for dentist, auto repair guy, whatever it may be, you got to know your numbers. When you know your numbers, that makes running your business that much easier. Would you agree with that?

Eric Vickery (18:26):

Absolutely. In fact, the dentist, I find, that our most successful know their numbers because here’s what happens. It’s not just, this’ll get really deep now Chris, it’s not just about what I’m getting from case acceptance and dollars coming in. That means patient, by the way, I’m not a money hungry type of coach. I know that when the dollars hit a certain number, patients are getting healthier faster. That’s what this is about. The good news is we’re selling health, but it’s not just about what’s coming in. It’s also about what’s going out. So the most successful doctors are really paying attention to both. They know how to balance both. They know how to reward their team the best for not having turnover. They know how to appreciate. There’s intangible and tangible things that we do with those numbers. If you look at a number and you go, “Wow, my production per patient hygiene is… gosh, it’s 140. Oh, what does that mean Eric?”

Eric Vickery (19:16):

I can look at Perio percentage. I can look at production per hour and say, “Oh, there’s open time versus production per patient.” We compare all those things and then we say, “Here’s how you turn that dial up. Here’s how you can fix that,” with an actual verbal skill and system to fix your periodontal percentage that’s at 20% or lower. We want it at 35% or higher so… and there’re exceptions to that, but for the industry standard, we know where we ought to be and with tracking, we can actually coach from a position of numbers and the doctors love it and the team loves it. It’s not like, “Oh, more money, money, money, money, money.” It’s not like that. It’s… we’re being as efficient and effective as we possibly can by understanding what these numbers mean and getting… not somebody just going, “Oh, that number’s low. Go fix it.” But having somebody who says, “This is how you fix that number.”

Chris Pistorius (20:01):


Eric Vickery (20:02):

Yep. Yep.

Chris Pistorius (20:03):

It makes sense. It’s like in marketing. When we first start working at people, we’re like, “Okay, what’s working best for you now marketing wise? It’s just like, “Ugh, I don’t know.’ They’re just throwing money and stuff up against a wall and hoping something sticks versus having an actual plan in place. We’re like, “All right, we’re going to track everything and we’re going to know where it’s coming from and budget according to that.” So I know you do a lot with case acceptance, but we were talking a little bit offline too about your work with insurance as well. Could you maybe expand on that a little bit and how you can help practices in that role?

Eric Vickery (20:37):

Yeah, yeah. So my father-in-law’s a dentist and that’s how I got my start. That’s how I got here. I managed his practice for six years and we dropped Delta Dental in that time. We used a consultant and a coach to do that, and I learned through helping clients over the last 20 years, how to do that in a way that is actually better for the practice. When you’re getting a 42% write-off rate, I was doing a fee analysis with a client in New York and she was showing me, it was anywhere from 40% to 53% write-off rate. Well, when your profitability is, depending on how long you’ve been a dentist and how much debt you’ve paid off, is somewhere between 25 and 40%, you’re actually paying that patient to come in if you’re going to provide high quality dentistry. An hour long hygiene appointment and spending time with these patients.

Eric Vickery (21:23):

So insurance participation was built around group clinical setting procedures and process and speed. When you’re a high quality dentist, you’re not built in those same regards. So, my client load, I’m probably helping somewhere between six and a dozen clients at a time take six months to drop an insurance plan from any participation all the way to Delta. That’s hard to do. So, you have to have really good insulators in place to make sure all your systems are in place. You have new patient flow from the right source for the right dollar. All of these things play a role, and not only that, but how you say it to the patient over that six month process. You’re not going to… please, please, if you’re listening to this, you never send a letter to your patient base and saying you’re out of network with something. You’ll never see them.

Eric Vickery (22:13):

Do it right. Have a one-on-one conversation with them the right way. I just take teams through that. Hygienists become a huge player in that game because they’re doing this conversation chairside and hygienist will go, “Well, I don’t know anything about insurance. I don’t want to talk about insurance.” It’s not about that. It’s about relationship and connection and quality. Who do they have the best relationship in the practice? A lot of times it’s the hygienist and it’s also we know that we’re seeing them every six months. So we actually track, there’s another tracker. We track all the names in that insurance plan. You export that out of your software and you go, “All right, we’ve talked with Ricky Bobby, we’ve talked with Betty White, we’ve talked with all of these people.” What was their reaction to that conversation? Was it positive or was it negative?

Eric Vickery (22:52):

At the end of the six months, we could look at it and say, “All right, we’ve got a great result in that conversation. Everybody was really positive. All the people scheduled their next six month hygiene visit. Let’s go ahead and let the insurance company know we’re going to move out of network.” The key thing is to know this Chris, whatever percentage your write-off is with that plan. So let’s say it’s really conservative. Let’s say it’s 20% write-off. That means you can handle losing 20% of that patient base of that insurance plan and still be at at least a break even and probably better than that. You will see fewer patients making 20% more on the 80% who stay. Math always works. So I have a client that dropped six plans at once, which was big.

Eric Vickery (23:35):

I usually try to deal with about 15 to 20% of the patient population at times. So I have a tracker that we put together and it says, “All right, you have 1500 patients in Aetna, you have this percentage. In Cigna, you have this percentage. We add up a couple of groups. We get to about 15%. We say, “All right, we’re going to handle those three for six months. Then we’re going to handle the next 15% of the population the next six months.” It starts to help the… that way, I’m not having this conversation, every single patient all day long and we’re not changing everything at once. It’s a slow roll and it works beautifully. I love this system that I’ve created and it just works well with practices.

Eric Vickery (24:08):

I’ve never had anyone… I’ve had one client go, I take that back. I’ve had one client in Nebraska go back into Blue Cross and Blue Shield because Lincoln, Nebraska is the hub and it’s just so many patients. It’s amazing how it works and the doctor realizes, “Wow, there’s so much more money left at the end of my month now to pay my team more, to reinvest in my practice, to invest in myself in CE.” To do that extra vacation you’re talking about, whatever it is, a team event and not feel so strapped.

Chris Pistorius (24:42):

Just eliminate some of the stress with trying to bill insurances and just keep all of that stuff straight. Wow. So basically what you’re saying is somebody could hire you to increase their case acceptance rates and decrease their dependency on in-network insurance. Is that about right? Where do you sign up?

Eric Vickery (25:02):

Yeah, yeah. It’s definitely doable, but you got to put… you got to have all the insulators in place to do those things. Meaning I need to see the numbers. I need to see what you’re doing now. I might look at it and say… I have clients who are in-network with insurance and it’s working beautifully because we’ve created systems around that process to make it work. So it’s not for everybody. It depends on where you live. I have a client in San Francisco. It just… .it’s a different game you got to… so a lot of young dentists come out of school thinking, “Oh, I’m just going to sign up for every plan. I’m going to get in-network with everything. Then later on if I want to I’ll drop it.” They don’t really understand the depth and the deal they’re making right there.

Chris Pistorius (25:40):

Deal with the devil right, that’s right.

Eric Vickery (25:43):

That’s right. So it’s big. So if I could first say, if you’re young and listening to this, I’m happy for free to talk to you if you’re right out of school and tell you, please don’t sign up for every plan. Take a slower time to get patients who pay you the full cost. You have so many expenses from an overhead standpoint, you need to be getting a hundred pennies on the dollar. Not 60, not 50. So… but yeah, I’m happy to help. They can reach out to me. I love helping people be able to reach more patients and help more people. So…

Chris Pistorius (26:15):

Yeah. Well, let’s talk about that, Eric. I appreciate you taking the time to be here. I know how busy you are, but I know you live in California, right?

Eric Vickery (26:24):


Chris Pistorius (26:24):

But you work with practices all over the country and in other countries too, right?

Eric Vickery (26:30):

Yeah. So, because my father-in-law’s in Maine, I actually lived in Maine for six years. So I have a lot of east coast clientele, but I now live in California where I grew up. My family now lives here. So I have clients in Alaska. I once had a client in Newfoundland. I work with clients in Canada. I’ve been all over traveling. A lot more Zoom nowadays than traveling, but it works great and keeps costs down for clients. So I found a win-win in this too, but I’m all over the place. Yeah.

Chris Pistorius (27:04):

Yeah. So what can you offer, maybe somebody that’s listening to this or watching this, what can you… what’s the first step? How do they reach out to you? Do you do a free consultation of any sort or?

Eric Vickery (27:14):

Yeah. If they’ve listened to this and they like what they heard, they can just mention it. I’m happy to give out my phone number, or you can just text me, that’s a quick way. You can text me there. If you’d rather you can email me either way, but you can go to my website, You can go there. You can text me at my phone or email me either one.

Chris Pistorius (27:37):

Awesome. Do you want to give your phone out or?

Eric Vickery (27:39):

Yeah. Yeah. Sure, sure. Yeah. The phone number is 530-356-4011. For all the east coast clients, just remember I’m on the west coast when you text me. 8:00 AM your time is 5:00 AM mine. So, 530-356-4011. Or you can email me. Yeah, you can email me through the website at I’m happy to help answer any questions you have. It’s what I do. I love what I do. So yeah.

Chris Pistorius (28:08):

Well, Eric, thanks so much, man. This has been incredibly helpful to me just to learn more about it, but I can’t imagine how helpful and valuable this is to somebody maybe just starting out, or maybe it’s been somebody that’s been in business for 20 years and is tired of the insurance game and is tired of losing patients that are hard enough by themselves to get it on the door that are not accepting the cases. So thanks so much for taking the time to be with us today.

Eric Vickery (28:33):

No, thank you. It’s been a blessing. Appreciate it.

Chris Pistorius (28:35):

Awesome. Everybody, thanks for tuning into another episode of the Dental & Orthodontic Marketing Podcast. Be sure to check in next week as we’ll have another awesome guests that will help you grow your practice. Thanks and we’ll talk to you soon.


Financial Tips From A Dental CFO

Financial Tips From A Dental CFO

Chris Pistorius, CEO of Kickstart Dental Marketing speaks with Brandon Rogers, the CFO at Verber Dental Group, about smart financial decisions that should be made by dental practice owners.

Chris and Brandon also get into the future of dentistry, how DSO’s will play a part and other interesting aspects of the dental industry.

This is one that you won’t want to miss!

View Full Transcript

Chris Pistorius (00:04):

Hey everybody. This is Chris Pistorius again with the Dental and Orthodontic Marketing podcast. Today we have got a super awesome guest. We have Mr. Brandon Rogers from the Verber Dental Group out in Pennsylvania. He is the chief financial officer there and we’ve interviewed several DSO presidents and CEOs, but never a CFO. So Brandon, welcome to the show.

Brandon Rogers (00:34):

Thanks so much for having me. I appreciate the opportunity.

Chris Pistorius (00:37):

Absolutely. So I just said that we typically will interview CEOs, marketing guys, but never a financial guy and maybe possibly you’re the most important part of that whole core, right?

Brandon Rogers (00:52):

Well I saw you at important. It’s like the members of the body. I mean, everybody’s got a different function, but specifically around watching COVID happen and certainly people got a little bit tighter and a little bit scared. I think-

Chris Pistorius (01:07):


Brandon Rogers (01:07):

I think we saw finance jump out and people with a decent macroeconomic understanding of the world were able to capitalize and I feel very fortunate that we were in that group.

Chris Pistorius (01:18):

Yeah. Absolutely. And off air we were talking a little bit about the landscape of now we’re coming out of COVID hopefully, knock on wood and people’s behaviors and how we’re starting to see some rebounding. Why don’t you, first of all, I guess, let me back up. Tell me a little bit about Verber and what your goals are and just a little bit about the organization.

Brandon Rogers (01:39):

Sure. So Verber Dental Group’s been around for a while. We started as a single prop as most dentists typically do, but then we’ve got a great visionary CEO, Dr. Michael Verber. He’s brilliant, he’s got a great visionary mind, and that really kind of set us all in motion. So I’m the newest of the executives and partners of the 13 partners we have and over 150 employees, but they got moving, they started to grow and said, “Hey. In 10 years wouldn’t it be great to have five locations?” And that happened within, I think, three. So growth is one thing, but what makes Verber such an amazing brand and product really is the way that we connect with our community. So we do a lot of community outreach.

Brandon Rogers (02:32):

We’re very big on giving back. We talk about the holistic approach to dentistry and how that impacts the people. So people understand when they come in, there’s a concierge service model that we provide, but we don’t over diagnose, we don’t under diagnose, we give you what we know is important for you to know and then we talk about it. It’s a very conversational interaction and I think that just goes to speak to our wonderful staff of clinicians and everyone from our TCS, our front desk to the admin team. Everybody works to make this work well and again, we’re in a space now where we feel like we just want to continue to increase our influence and be able to do that for more.

Chris Pistorius (03:17):

Yeah. I think those are awesome points and we talked a little bit also about how DSOs typically kind of have this negative tone to them when you talk about them in the industry. And I’ve spoken with several leaders in the industry and could you talk a little bit about that, about why maybe there’s a little bit of that negative attitude towards DSOs in the industry and how you guys are trying to change that?

Brandon Rogers (03:46):

Sure. By definition a DSO is a Dental Support Organization. The concept is about shared services and I’ve worked in different environments where they do have that. Sort of like a hub and spoke FedEx model. The difference though is that most DSOs they centralize what they think is the core and then they take the opportunity for the producers, the dentists, and they create the spokes and then they have all these accesses. What makes us different, I would first remove the DSO acronym and put a DHS acronym.

Brandon Rogers (04:19):

So that allows us to talk about what a dental health system is. And dental health system for Verber Dental group is more about having the holistic approach much like what the Mayo Clinic might do. So we have all of the specialties right now with the exception of orthodontics so that when we have someone internal that has a big case and there’s everything from the K to a crown to a root canal and veneers and everything, surgery, we have them end to end covered because it’s important for us to understand that they’re not a product, we’re not referring out.

Brandon Rogers (04:53):

This isn’t a dollar sign to us. This is a person looking for holistic care and we want to be able to provide that. So the DSO gets a little bit of a bad rap and some people use the definition by proxy of growth and numbers when in reality what we are creating is anything, but that. We’re creating something of a closed system so that we can protect the product more sufficiently.

Chris Pistorius (05:18):

Yeah. So I think that’s an interesting analogy when you mention the Mayo Clinic and it just kind of hit me. So if somebody has a complex case, we’ll say in one location, you guys have the ability to bring the entire team together, specialists and whoever, and talk about a particular case to help that patient. Am I on the right track there?

Brandon Rogers (05:38):

You’re 100% spot on. Yeah. I mean, the connectivity of the managing partners, the other associates, the doctors, we’re extremely communicative. And I think as everyone scales, as you grow, you want to keep that communication strong. But for sure, having a big workup with a lot of different moving parts requires collaboration, requires good conversation, and friction. We’re not afraid to disagree with one another. We’re not afraid to push one way or the other. And that, to be honest, is what makes a familial organization like ours so successful and poised for such good growth because we’re not afraid to fight a little bit to make sure that we’re doing what’s best for the patient.

Chris Pistorius (06:19):

That’s awesome. And I think that you hit it right on the head. People think DSOs, they think companies that come in and take over a community, offer $19 cleaning and x-ray and churn and burn, right?

Brandon Rogers (06:32):

That’s right.

Chris Pistorius (06:33):

And this is really the first time that I’ve heard somebody explain it as it doesn’t have to be that way. It can be a holistic, very personalized care, and, “Oh, by the way, you’re not just getting one doctor or two doctors.” You’re getting a team of specialists all around the area that can help at any given time that they’re needed.

Brandon Rogers (06:50):


Chris Pistorius (06:51):

I think that’s really cool. So tell me a little bit as a CFO, obviously the financial guy, you got to make sure that you’re growing responsibly, I think is probably the best way to put that. What are you seeing now that we’re coming out of COVID? Are you seeing a rebound? Are you seeing your organizations starting to rebound a little bit?

Brandon Rogers (07:10):

Absolutely. Not just a rebound. Fiscally I can see that happen. What happened with COVID was an interesting, it’s going to be talked about for years and I’m an economics interest. I wouldn’t say aficionado. No one’s that good, but I love them. And so I think studying macro micro trends in any industry, but specific to dental, it was an opportunity for us to look at something like this pandemic and try to figure out, “All right. What are our lessons learned?” And there is a remarkable rebound, but people are rebounding for different reasons. Before it was a mentality of, “We need to do this to maintain.” We’ve changed the narrative here a good bit. It’s not about maintenance, it’s about prevention, it’s about understanding the whole. We recognize that a lot of COVID patients there was preventative opportunities from the source of the mouth.

Brandon Rogers (08:08):

So we have dentists being able to get in there and do some preventative measures or even identified some opportunities. So the rebound is coming in what I think is illustrating more of what dentistry is as a whole unit. It’s not just microcosm of health. It is truly the gateway to the whole body, through the mouth and we do a lot with it. I mean, we’ve got doctors here that are advancing sleep studies as it relates to your oral care and it’s pretty remarkable. So I would say we took this time to stop, pause, spend a year making sure that financially we were solvent and we were positioned to grow, but more than that, I think we re-evaluated what’s important to our organization and how we get there.

Chris Pistorius (08:52):

Yeah. That’s good to hear and that’s why I really was excited about having you on the show is the financial side of things because I think when dentists come out of school, they know a lot about dentistry, but sometimes we find that they don’t always know everything about business. Certainly marketing from my perspective and how to run a business and how to understand the economics of a business. And I think it’s important, not every dentist is going to be able to bring in a CFO certainly, but it’s great to get a perspective on where the market is now kind of post-COVID and where you think it’s headed. And so I want to get into that. What do you think the next 12 months to 24 months looks like in dentistry?

Brandon Rogers (09:36):

Sure. No. It’s an interesting juxtaposition right now. COVID being one part of that variable, but the other part of it’s just happenstance on timing. You’ve got a whole generation of single providers that are just aging out. They’re ready to retire and COVID maybe was an accelerant, but it was inevitable nonetheless. And then you’ve got people that are just remarkably interested. This is why you see DSOs such a recurring theme because they want to gobble up and make sure they’re giving these sole props this great premium. What we’re trying to do is a little bit different. We see that the market’s consolidating, but we understand that the consumer’s still looking for quality of care and they’re still looking for trust. I mean, that’s a big thing when you’re handling anything that has to do with your body, but specifically the form and what can be seen.

Brandon Rogers (10:29):

So we see the opportunity as consolidation, not slowly, but I think strategically and consolidation in a way that allows other people to recognize that we’re not looking to grow for profit over patient. In fact, it’s always patient first, profit is always a secondary variable. It’s always secondary. If you’re doing the former first, the latter, is handles itself.

Chris Pistorius (10:54):


Brandon Rogers (10:55):

The market at the end of the day is moving to a place where if we can marry those two things well, we’ll actually have providers preferring to sell to us because you preserve their brand, which is what we do. It’s a big thing here at Verber. We’ve got all of our locations have their own brand. They have their own unique style and look, even when you walk into one and every doctor their own and we encourage them to stay that way. We don’t want them to be different. I mean, we don’t want them to stay the same, we want them to be different.

Chris Pistorius (11:23):


Brandon Rogers (11:24):

As an admin and me and my role, my job is to support that. My job is to make sure that they have the tools fiscally, the tools operationally to do their job well and to maintain that brand identity. And I think that’s what is going to allow us to flourish.

Chris Pistorius (11:41):

Yeah. I think that’s a great strategy. I’m going to put you on the spot a little bit here and I know this isn’t your deal, but it sort of is. So you’re the CFO of a large DSO. Talk to me about if you had an individual practice, right, and you’ve been in business for a few years, what are some tips that you can give somebody that’s looking at their financials? What should they be looking at? What kind of strategies would you suggest to a smaller network?

Brandon Rogers (12:08):

Sure. Yeah. So it’s all about the balance sheet really. The balance sheets a funny thing. People get scared when you talk about financial statements. They think about income statements and it’s all about debt coverage ratios, debt to equity ratios, those things matter, but really you can simplify it. It doesn’t have to be that difficult. It’s much like the way that you were raised and this is kind of how I approach finance in general. what is your income? Understanding taxation and those kinds of things. What’s your income and what are your expenses? How do you deploy the excess when there is excess and how do you create a safety net?

Brandon Rogers (12:44):

So for those that are single prop that may not have the acumen that they would want to pay for it otherwise I would say look at the way that you’re growing or look at the way that you’re maintaining what you have. Treat it the same way you do your personal budget, your grocery list. Prices go up and your personal rate of income doesn’t move in tandem with that. So what do you do? Well, you make concessions here. I do a lot of personal negotiations with a lot of the vendors to make sure that they’re keeping up with what we’re keeping up. So negotiations important and it’s not about beating up people for price. It’s about making sure that everybody’s winning. Going back to that concept I was talking about earlier. Nash equilibrium is a very real thing and you can create it when you’re talking honestly and openly.

Brandon Rogers (13:32):

So for those that are wanting to get a better sense of their finances, take a look at the relationships you have, keep them honest and make sure they’re keeping you honest, and then make sure that when you are deploying capital that you’re doing it in a way that’s from a fiduciary perspective, enabling the whole and not just yourself. When you take care of the people that are taking care of you, your hygienists and assistants and your front desk, make sure that they’re taking that because they work harder, they work better, you grow. It’s a nice cycle.

Chris Pistorius (14:01):

Yeah. That’s great advice. If you’re a dentist that’s looking to age out or retire, maybe they’re looking at a couple of different DSO options, what should a dentist have in place and ready to go so that they can make a sound financial decision about selling their practice?

Brandon Rogers (14:19):

Sure. It’s a great one. So I’d say always have your collections ready to go. 2020 was this big black hole that nobody really understands, but you can study trends and understand where things are going. And then you make adjustments to your point about the rebound in ’21 post-COVID, what that rebound looks like and then you apply a certain multiplier or a premium to help understand where the trend dipped in 2020. However, I would say that they come to the table with their collections, their patient base, more importantly than that their loss ratio on retention from their patient base. Those are very good indicators. For me, I’m looking for guys and girls, females and males in this industry, they have high retention, they’ve got a solid patient base.

Brandon Rogers (15:08):

Long-term because we don’t want to come in and take over, want to come in and empower. Keep doing your job well. If you want an associate we can provide an associate, but those people are there because you’re there. So if they’re looking to sell, we’re also saying, “We’re willing to pay a premium if you stay on for 12 or 24 months,” because that way it’s the best win for everyone. We learn your patients-

Chris Pistorius (15:31):


Brandon Rogers (15:31):

They kind of adjust to you and to us. And then they understand that this isn’t a transaction. This is a transition much like the Baton in an Olympic race. We’re not done our piece. It’s still required that all the other legs are keeping up their end and that’s very much part of it. So it’s a relational dance when we talk about acquisition or purchasing because on both sides they’ve got to be transparent, they’ve got to be okay to talk the numbers, and then they’ve got to understand that for all of us, the money means nothing. When you’re talking about the products you’re buying the goodwill and you’re buying the brand equity of the organization.

Chris Pistorius (16:10):

Yeah. That’s great. That’s great. Let me ask you a little bit about your organization. You have eight locations now, is that right?

Brandon Rogers (16:17):

Correct. Yeah.

Chris Pistorius (16:18):

All in Pennsylvania?

Brandon Rogers (16:18):

All in Pennsylvania.

Chris Pistorius (16:21):

Tell us what are your growth plans for the next year or two? Where do you plan on being?

Brandon Rogers (16:24):

So there’s opportunities all over. We want to keep the footprint, I think, within a certain radial mileage. That’s a partner conversation we’re still discussing, but I don’t think anything’s off the table as far as geography. I think what kind of drives those decisions, expansion is going to happen, growth is going to happen, is where we can have product control. QA QC. We want to be able to shore quality and we want to be able to control the quality. The whole is only as good as the sum of its parts and we got to make sure all of those parts are moving in tandem synchronously and they’re also moving in a way that allows refinement and some friction, I mentioned that earlier.

Brandon Rogers (17:13):

You’ve got to be okay being able to look at a different way. And so for us, our growth is also internal. What are we doing differently? What could we be changing? And at the end of the day, what needs to be done? Everybody’s got a different playbook in all those locations, who’s got the best play on this one? And we take our cues from them.

Chris Pistorius (17:35):

Yeah. That’s awesome. It’s so exciting to start talking about growth again, isn’t it?

Brandon Rogers (17:40):

It is. One is I’ll tell you, this world, we can do a lot for the consumer in a post-COVID world, not just about the dentistry. It’s also helping them work through some of the anxiety about what just happened. A lot of people are still reeling, not unlike what happened in the crash of 2008. What happened in 2001. You can keep going down, but everything has one common denominator and that’s that people, they get scared and they have three responses. They flight, they freezer, or they fight. And Verber Dental Group that were fighters. We push through because we don’t know another way and we want to continue to stay loyal to our organization and our people.

Chris Pistorius (18:26):

Wow. Well Brandon, I got to thank you for being on. You’ve given myself and I’m sure everybody that’s going to watch this a very fresh perspective on the whole DSO landscape and how you are doing things a little bit differently. So thank you so much for your time today. I really appreciate it.

Brandon Rogers (18:45):

I appreciate your time Chris, and thanks for having me on.

Chris Pistorius (18:47):

Great. And thanks to everybody for listening to this episode. Make sure you tune in next week for another great guest. Thanks again.