Word of Mouth

If Not for You...How About For Your Family?

Cyndee Johnson - Monday, August 22, 2016



If Not For You....How About For Your Family?



Over the years, my team and I have worked with hundreds of dental practices. Our focus is to drive practice success by enhancing the level of care being delivered in the hygiene departments. We teach profits through excellence. Many of the dentists and teams have become personal friends. Several of them will call from time to time and we noodle out ideas when they are trying to overcome this or that. So many wonderful friends!


One dentist comes to mind who I speak with from time to time. He has been working with a dental management consulting company for nearly 8 years! He says while some things have improved, he just can’t seem to reach his financial goals. And one of his many frustrations is he “can’t seem to get his hygienists on board”. He'll always say, "Boy! As soon as I can let Company X go...I'm going get you and your team in here!" As always, my reply is, "Whenever you are ready, you know where to find me".


He and his administrative team attended a recent course we offered. When I asked why he didn’t bring his hygienists he replied, “I offered to bring them, but they have an hour drive didn’t want to make the trek”. He then went on to say, “They grumble when I suggest CE on their days off”.


If this example was a one-off situation, this blog wouldn’t be written. But in a very high percentage of dental practices there are hygienists (and therefore dentists) who are not providing standard of care.


There many reasons why success isn’t realized and each are worthy of individual blogs. This article only refers to the hygiene department.


Doctor’s who understand the value of a successful hygiene department are experiencing extreme success and satisfaction. And by success, I am not referring to the production which is squeezed out of a hygiene schedule at the end of the day. It is much greater than that. To have a finely tuned hygiene department doctors, you must accept responsibility as the business owner for what is or is not taking place in the hygiene operatory.


When a hygiene department is sick, the dental practice is sick.


The library of comments I hear holds volumes. Here are just a few, with a cold reality of what it costs your practice:


“Jane is going to retire soon and hopefully I’ll be able to find someone who can do a better job” Your chat and polish hygienist is costing you THOUSANDS of dollars every single day.


“I’ve said to Haley that I need her to be diagnosing more SRP, but she just won’t do it” Your chat and polish hygienist is robbing your practice of financial sustainability and allowing your patients to leave your office sick and infected.


“I’m afraid if I fire her, I will lose half of my patients” Statistics show that very few patients are willing to switch dentists in order to follow a hygienist. It is too much trouble and an added expense to re-establish themselves elsewhere.


“I wish I could just clone the one you sent me and get rid of the other three” I can't clone her, but there are plenty more where she came from! And your practice and patients will LOVE you for it!


“Their moods are terrible if I bring up anything about their job” Their moods are terrible in general and they bring baggage to work and deliver it straight to your patients.


“I’ve said they need to probe, but they say they don’t have time” These hygienists are failing to provide standard of care and are setting you up for legal disaster.


Doctors let me ask you, would you tolerate this behavior at home with your children or loved ones? Do you approach life this way? Imagine saying, “Well...Betty’s going to leave me soon and hopefully my next wife will be better” or “My children’s moods become horrible when I ask them to do chores so I just don't ask.” or “I’ve asked my oldest to feed the dog while I am at work, but she just won’t do it"?


Of course you wouldn't!


Yet we allow these things to happen with our business and we do nothing about it. We allow our employees to determine our success without any accountability. In fact, we guarantee their pay, regardless of our own success. Heck, I've even seen bonuses paid to employees when the doctors wish they were more productive.


And I get it! It's easy to just go with the flow and not rock the boat. Here’s a thought doctors. If you're not going to insist that your team performs for your business, how about thinking about your families?


Many of you have spouses and young children at home. Many have children in college…and grandchildren. Imagine if you could easily add another $500,000 to your annual production by investing in training and setting accountabilities? What would that do for your family? And what would this comprehensive care do for your patients?


Wouldn’t it be a wonderful feeling to go to work each day and know that you and your entire team of employees were not just working to provide for their families, but also doing everything in their power to provide the level of care which creates a successful business. And in so doing, improving the health of your patients and your practice!


When your team is not performing, at a minimum, standard of care they are stealing from your business. And you're allowing them to rob your family of the financial support they need and deserve. Every licensed hygienist is well aware of the level of care he or she is obligated to provide according to their license. Don’t you think you owe it to your family to be an incredible steward to your business, your retirement and your children's inheritance?


It only requires an email to get started.






















Fees & Rules? No Thanks!!

Cyndee Johnson - Tuesday, August 16, 2016


Fees. Policies & Rules? NO Thanks!!



Things that make you go hmmmm.


I recently wrote an article on The Cancellation Fee and Your Business and how this practice could actually be perpetuating the behavior it is designed to curtail. Today's experience came as a reminder of why we as a profession ought to re-evaluate our out dated, practice-crippling ideas.


While visiting an office I heard a patient ask what the total for his two crowns would be with the 5% courtesy. He was given the fee and when he took out his Visa to pay the $2,808 in full the office manager Mary said "Oh, I'm so sorry, we cannot offer the courtesy if you use a credit card because Dr. has to pay fees to the credit card company". The patient said he didn't have a checkbook with him (who carries a checkbook these days) nor did he have cash. Mary replied, "Would you like to put it all on your card then?" to which he replied, "No, I was hoping to take advantage of the courtesy you mention in this sign", pointing to the "We gladly offer a 5% courtesy to our patients who pay in full at the time of service" Mary stated their office policy was to offer the 5% on cash or check only. So out he walked, promising to put a check in the mail when he returned home.


Having wasted 10 minutes of time, turning down a payment of $2808 which was the amount minus the 5% of $72.00 and having the patient walk out of the door feeling less than pleased, Mary turned to me and said, "Everyone wants a discount! Do they not understand how much it costs the doctor to take credit cards"!


So let's talk about the costs of all of our rules, policies and fees. Having spent 10 minutes explaining why we couldn't accept a payment of $2808, allowed the patient to leave without collecting anything! Even if he puts the check in the mail that day, it will be a few days before the check arrives and will then require a trip to the bank to deposit it. I wonder how much of the $72.00 courtesy has just been burned up in inefficiency. Not to mention that Mr. Jones was disappointed with the inconvenience. And remember, he wasn't asking for a discount, it was posted on a notice sitting right in front of him.


This was a golden opportunity for Mary to graciously accept Mr. Jones credit card, thank him for his payment and ask him for a referral. Instead she chose to enforce a rule which most likely cost the practice the $72.00 anyway! Wouldn't it have been much more efficient to accept the payment and have the money in the bank that very day?


Circling back to the sign on the counter "We gladly offer a 5% courtesy to our patients who pay in full at the time of service"...don't we want all of our patients to pay their bills in full at the time of service? Why confuse things? And if your practice accepts insurance payments, don't you want their portion at the time of the visit? This is an archaic policy left over from the days where dentists and doctors were the bank and carried balances for their patients. Today, we have so many ways for patients to schedule comfortable payments through third-party companies, it's no longer prudent for us to carry account balances. And having the ability to accept credit cards is not only a convenience to the patient, but another way to get the money for your services deposited into your account immediately. What a gift!

Offering our patients convenience along with an excellent experience are paramount.


Below are some important tips on how to avoid the profit crippling pitfalls associated with fees, rules and policies which are not patient-centered. Today's patient is looking for a great experience delivered by dental professionals they trust. And they tell their friends.


Train your team on how to properly deliver a financial arrangement and associated payment for service. And be sure the person handling your financial arrangements is comfortable discussing finances. You don't want someone who feels badly about a $5000 bill, simply because it would be a personal hardship for her if she had were facing a bill of $5000.


Deliver your fees with confidence in their value. Who better to deliver this outstanding dentistry than your office. The fees are in alignment with the quality of the service and the experience. Be proud of that . And be gracious to those who are paying for this excellence, by thanking them and ensuring their visit went well for them.


Be very cognizant of using the word "Policy" with your patients. That simply translates to, "It's easier to fall back on a rule, than it is to evaluate a process and determine if it's really the best thing" This word throws a wall between you and whomever is trying to communicate with you. Instead, use phrases like, "I understand" and "I hear you" and "Mrs Jones, you've brought up a very good point? and "What I can do is...", and most of all...
"Thank you for your payment. If you have a friend or family member who you feel would benefit from the services we provide, we would be honored to care for them. We would love to have more patients like you".


Invest in communication skills and office guidelines which make a patient feel fantastic about the experience rather than choosing a simple reply based on an erroneous rule that allows  them walk out saying hmmm....


If you like what you're reading, feel free to share it with others! Thank you.



Cancellation Fee

Cyndee Johnson - Friday, August 12, 2016


smug assistan




When returning from events, our team reconvenes for the follow-up, evaluation and evolution of the information we’ve delivered. Our presentations cover several topics that often ignite a series of questions from the audience. Being able to motivate our audience to cross the wide chasm of change is why we do what we do. Inevitably, there are concepts which some attendees will be hearing for the first time.


One of the topics which elicits a notable number of gasps is when I suggest they return to their offices on Monday and immediately rid themselves of their office cancellation fee.


"But our schedule is full of holes"     "What about the patients who call us last-minute?"       "So we're supposed to just let the no-shows get away with it?"     "How am I supposed to pay my hygienist when she doesn't have a patient?"


All of these questions seem perfectly reasonable. After all, one of the top concerns we hear from dentists is "My schedule looks like Swiss cheese!"


What I am about to share with you is important. Your cancellation fee is actually part of the problem. And the more frequently it is used, the solution to your schedule challenge will remain an enigma.


Let’s have a look at the main reasons these openings occur:


Last-minute conflicts

 We all know what it’s like when a wrench is thrown into our calendar. Perhaps your patient has been called into work. Not everyone has the ability to say to their employer, “I can be there, except during 9:30 to 11:30 for my dentist appointment” especially if they need the money. Or what if their child’s school calls to say their child is ill or injured and they’re the only one available. Or traffic on the interstate is blocked due to an accident. My goodness, we’ve all been there and it’s a stressful feeling knowing we have to change a pre-scheduled appointment. I promise you, when one has to make the call to say “I won’t be able to make it to my appointment” because of one of these occurrences, the last thing they need to hear is “You will be billed for a missed appointment fee of $50.00”



 And what about the patient who calls with an emergency. Or a cancelled flight. Or a death. Or "I just don't feel like coming to a dentist appointment today...too stressful". Regardless of what you may think constitutes an emergency…you don’t get to decide. Only the patient can make this call.

MoneyMany of us have experienced the last-minute call from our patient saying, “I can’t afford today’s visit”. Hmmm…the day of the appointment is a fine time to come to that realization! Imagine hearing a receptionist respond to this with, “Well Mr. Jones, I am going to have to assess our $50 cancellation fee because of your short notice”


The No Show

 These patients are our fly-under-the-radar-and-drop-the-stealth-bomb patients. As we all stand around looking at the clock 10, 20, 30, and BOMB! Worse yet, most of us know exactly who those patients are! So we serve up another cancellation fee.


Believe me, I understand the frustration when the above leave us with a schedule that looks like it was shot up in the war. But just for a moment…take off your defensive glasses and put on your customer service lenses for the duration of this blog.


Why are we allowing our chronic no-show patients to schedule appointments in advance? That’s not to say that your unorganized patients don’t deserve dentistry, but rather we must handle their appointments differently. In other words, these patients require us to be experts in scheduling in addition to creating value. They require us to work outside of what we normally do.


Consider placing these people on your short call list and offering this. "John, with your busy schedule it seems that scheduling in advance is challenging. I'll put you on our VIP list and give you a call when a short notice opportunity arises?" By offering this option, what we have done here is leave John with his integrity in tact and we have taken control of our schedule for patients who keep their commitments in a positive way. We have just determined the best way to schedule John in our office in the least disruptive way.


Recently, I was caught up in the middle of an unprecedented airline debacle with a company whose tag line is “We’re a customer service company that just happens to fly airplanes”. This was such a debilitating event for them and what was exposed throughout the drama was that their customer service training was mediocre. You see, anyone can provide good customer service when things go right. But things go wrong…and in a big way…THAT is the testament to how good or not-so-good the customer service team is trained.


In a dental office the same applies. It’s easy to treat people great, using excellent customer service skills when things go according to plan (i.e. a nice productive, full schedule of happily paying patients) but the true test is when things don’t go according to plan. (i.e. the patients start dropping like flies off of the schedule for the day)


It’s equally easy to throw the “Cancellation Fee” at these patients to remind them “Doctor’s time is valuable” or “We set aside an hour for you today” or one of the worst of all “Doctor is paying his team to be here” (Yikes! I would hope so!) But what if we take this opportunity to do some self-reflection and evaluate the success rate of our processes.


How about the patient who calls last-minute because they cannot afford the visit? Again, if we have our customer service glasses on, how might we have mitigated this disruption to our schedule? Having a person who understands the fine nuances when setting financial plans is critical. Have we truly evaluated the patient's ability to pay for the treatment or have we hastily scheduled in order to fill our day. Was there a clue? Perhaps we could have collected at the time the patient scheduled?


The cancellation fee is nothing more than a way to offend or upset your patient. Equally important is that if you were to ask yourselves the question “What is $50.00 going to do for the time lost”? you’ll undoubtedly find the answer to be “Not much”! And in reality, if you’re able to collect, is it worth the team time, statement or phone call that has reduced it to $27.50? Can that buy your team a Starbucks? Not likely…and it certainly won’t keep the lights on. But what it will do is leave a bad taste in your patient’s mouth.


People buy things they value from people they trust. Your patients may trust you whole-heartedly, but they don’t come to your offices with pre-loaded value for treatment. So it’s up to us to create that value. Creating value begins when the patient calls our office for the first time and at every touch point from that moment on.

For example, when we ask our patient to commit to an appointment following their hygiene visit we want them to want to commit. The way to help them get to that point is to have handled any pushback before it occurred, answered questions, prepped he/she for the financial consult and helped the patient value the difference between a body that is sick and infected vs. a healthy one. These are all important pieces of the value puzzle.


Building value doesn’t happen if we spend our appointments discussing the weather, the weekend or our upcoming family reunion. We have to work diligently to help our patients value the important work we do. And it requires methodical processes, assessments and time management.

I work with clients who have stopped confirming appointments except by request. When a patient values the appointment they will make it a priority in their calendar too.


When a patient doesn’t prioritize their commitments to our schedule we ought to view it as an opportunity to evaluate ourselves and our processes. Are we providing ample time for our hygiene appointments to provide five-star care? Is our new patient process comprehensive and does it provide an excellent experience? Does the assistant and dentist carry on a personal conversation over the patient during a crown prep or are they focused and concerned about the patient’s comfort? Does your front office team have a cancellation mitigation process and are they trained in guiding patients to where the schedule needs them to be vs. where the patient prefers? Is this a patient who would find himself seeking the services of another dental practice?


Is your cancellation fee is shining a bright light on your customer service or casting a shadow on you and your team? We believe it is the latter and encourage you to try something new and service oriented! Continuously evaluate your processes and evolve using the information gleaned from each day.


We cannot become what we want, by remaining what we are. This requires a clear focus and constant massage of our current practices.


If you would like more information on how to remove the fee and get those patients to keep their appointments, give us a shout. And if you like what you're reading...give the compliment of sharing with others.









Plugging Your Leaks

Cyndee Johnson - Tuesday, July 12, 2016






Building profitable hygiene departments is an art.


And its success is dependent upon the entire dental team's understanding of the how and the why.  


But what exactly does it mean to have a profitable hygiene department?  When I ask this question I am surprised by the varying answers.  If you answered "My hygiene department is profitable when my hygienists produce greater than 3X their salary" you're only partially correct.  


In fact you're only partially correct... if your  focus is on the small stuff.  And if you are completely unaware of the substantial leaks in your practices financial bucket.  


It's easy to pack a hygiene schedule full of laser, and sealants, and fluoride varnishes, and whitening promotions to "keep 'em coming back"...the latter of which hardly promotes value.  And day after day of this type of thinking will usually do two things: Burn out your hygienists and most importantly, limit your potential overall office production.


It takes a real forward thinker and change agent to look at the hygiene department as the hub of the practice's success and implement that thinking.  With the investment in training and processes to make this go, well let me tell you friends...the financial clouds part.  In a very big way.  An there are some delicious side effects to this model.  Your hygiene department will feel as if their career has improved ten-fold, your financial stressors will fall away and your patients will be receiving the highest level of care offered.


But what about those leaks?


We help mentor incredibly successful dental business's around the globe.  We have helped change the way dentists utilize and view their hygiene departments and these dentists and their patients are experiencing unprecedented success as a result.  But there is so much more!!


Take for example the hygienist who in 6 months discussed nearly $400,000 in restorative and cosmetic dentistry and whose patients have accepted more than $175,000  of that treatment.  She called me exasperated!  She said, "Cyndee I am so frustrated with my front desk person.  I have patients who are excited and  ready to go with treatment and when I look on the schedule I see they didn't schedule!  I asked "Suzie" why they didn't schedule and she said she was on a call and told the patient she would call them back!  Today, I heard her say to my patient, "I'll send that in for a pre-auth and get back to you when I receive it" and the patient didn't  even ask for that!"   


Colleagues...those are some pretty big leaks!  How much dentistry is walking out of your doors?  When you and your hygiene team is working to help your patients receive the dentistry they need and deserve, you cannot have the flood gates open at the front desk.   It takes the skills and commitment of the entire team for the process to come full circle.  



I saw an interesting ad yesterday. It was for a Dental Office Manager. "Must have two years of dental experience and be willing to work five days" Hmmm...might this be part of a larger problem? We give someone a title, plug them into a seat and expect them to help us build our business and our team? How do we expect them to help plug the leaks when they don't even realize what a leak looks like?



But who is at fault here?  One of the things we try to instill in the teams we work with is this:  "Rarely are problems, people problems.  They are most often process problems"  or better said, lack of processes.  


So what about those leaks?



There is only so much your hygienists can do for your practice when there are limits put upon the department. Do you have dental professionals or chat and polish hygienists in your office? Have they been trained and calibrated to your philosophy and mission? Is the hygiene schedule reflective of an office that provides comprehensive care in the hygiene chair? Or does it indicate an office that crams as many services as possible into the time slot in hopes of breaking even? And do you come into the office and ask yourself, "Who Bombed the Hygiene Schedule"?


And you too doctors...have a look at your unscheduled treatment reports. Is your front office team skilled in case acceptance and financial arrangements? Or are they insurance-driven thinkers who create their own pushback? Are they skilled in offering incredible solutions which allow the patient to receive the treatment they need and deserve? Your unscheduled treatment report is the great indicator of what is walking out your doors. It let's you know whether or not the pieces of the puzzle are in place for the entire team.


What are the processes you have in place to support case acceptance. When a hygiene department partners with their dentist to facilitate patients scheduling the treatment they need and deserve...wowza! This is when office production skyrockets! And it's limitless! Why limit your success? Offer the training your team needs and the training you deserve for the huge investment you've made into your business. I promise...you won't regret it!


If you would like some simple solutions to close some of your practice's leaks, watch for space in our next "Who Bombed the Hygiene Schedule" webinar. September schedule coming soon...



























Cyndee Johnson - Monday, March 21, 2016




Over the years, I have come to meet some amazing dental professionals.   Ones who are are committed, hungry, passionate and unwavering in the delivery of the care they provide.  In fact, many of whom I would have scooped up and brought on board with us…but for the risk of being considered the dental team burglar!


Dental professionals are caregivers by nature and are some of the kindest, most dedicated people I know.  But every now and again, as we gather around the team punchbowl there is someone who decides to take the proverbial you-know-what right into the beautiful ice ring floating in our bowl of team deliciousness. And to add unpleasantness to the resulting splash into the sweet, crimson liquid these team members throw out an additional stink with resolute statements like,  "Oh, I see Mary's on the schedule today.  Oh boy...we've been telling her she needs a crown for two years!  She'll never do it so don't waste your time" or "Don't mention that treatment to Joe.  He's used all of his insurance for this year and he can't afford it" or "Don't  do the FMX today...she still hasn't paid me for her last visit so just hurry and don't spend a lot of time".  When she is not setting limitations to the day with the preceding comments, she is busy micro-managing, polarizing and will never delegate as the expose would be frightful.  These team members often work under the shroud of "I'm so busy and overloaded", yet seem to aways have a steaming hot cup of coffee at their desk and a few calls per day from friends and family.


Can anyone relate?   These employees are so busy coming up with reasons why we can't do what needs to be done they lose sight of the possibility that other ways exist. Meanwhile, your other team members are working in a very frustrating  environment. These employees  are  detracting from the very offices they claim to promote.  And they know who they are.  They are the ones who feed on unrest stemming from a  lack of confidence and skills.  These traits filter down through everyone in the form of bullying, wave making, spiteful behavior and lost patients..  None of which have any place in a business, certainly not a business that derives its livelihood caring for others. 


Times are a changin’ doctors and the patients of today are discerning.  And they have choices.  And don’t think for a second that the office environment doesn’t fill the air our patients breathe.  And doctors, you know who these people are too. 


Let me translate some of the excuses I hear:


“She has been with me for 20 years”

Translation: She has been creating havoc on other team members for 20 years and they’ve left, or learned to accept it. Not to mention the detriment to my financial success.


“She is here every day working after everyone leaves”

Translation: She is inefficient with her time during working hours


“She is very protective of me”

Translation: She is bullying everyone else – brown nose extraordinaire



“She knows all of our patients so well”

Translation: And I guarantee some like her and others can’t stand the way she speaks to them, but they love you.


“My assistant gets along fine with her”

Translation: Well you have 3 other employees who do not


My favorite and most exasperating …“She won’t do it”

Translation: WHAT???


But here is the most important translation of all.  Each of the above excuses has one thing in common.  They say to your positive, hard-working, dedicated team members “You don’t matter”


So dump the punch bowl and start fresh.  Invest in training and team support.  Insist that  each team member bring an ingredient for a delicious blend.  Establish a culture guide and require that your team adhere to its processes and hold them accountable.  There is no room in dentistry for bad behavior.  Clean it up doctors and I guarantee you will see an immediate change in productivity along with a very happy team.

























Cell or Sell: How Devoted is Your Team?

Cyndee Johnson - Friday, January 29, 2016



We recently presented to a group of dentists who asked the ever-frequent question, "What's your policy on cell phone use in the office?". This is a conundrum faced across the workforce, but in a healthcare setting we believe in one simple solution.  Here's why:


In a successful dental practice, each day is an elite mix of experts in their respective areas coming together to provide excellent service and care to their patients. We must do everything in our ability to present ourselves in a positive way at all touch points.


Selling ourselves as Elite Professionals requires conscious effort and commitment to office culture. Why do we do what we do? What level of care is our entire team committed to providing? How does our team convene to embrace our patients and the day? And most importantly, are we all focused and onboard?


For a moment, think of a world class sports team. Their practice is rigorous, consistent and focused. The reason is clear! In order to be the best of the best and deliver a winning game, every single player must maintain crystal clear focus on his or her role within the team.


An elite dental team of is no different. We work hard taking ownership of the practice culture and the treatment delivered to our patients. We duck and weave through our busy days like limber athletes passing off to the next team mate when the time is right. We’re all here to back up a team mate who fumbled in the midst of a well played game. That's what team players do!


Have you ever seen a professional athlete on the sidelines texting or checking FB? Of course not! It’s unacceptable for the rest of the team to have to bear the burden of those whose focus is not on the game.


Our team visits offices where we often see employees burning valuable patient time sending the next text or checking the latest FB update. In fact, I recently watched a hygienist duck into her op to send text messages while her patient was waiting in the reception room!


Here is a simple and respectful Office Cell Phone Policy:

Personal cell phone use has no place in a dental practice.


Cell phone use during business hours presents a disregard of patient time and of the dental business.  They are a disruption to success.


1)  Cell phones are to be secured in your car or a locker during working hours

    • 2)  They are not to be on your person at any time during patient hours
  • 3)  Employees may give the office phone number to friends or family who would need to reach any employee in an emergency situation and they will be notified       immediately by the office team member who takes the call.
  • 4)  Personal cell phones may be used during breaks.

Thank you for your dedication to our office, your team and our patients



We have found that the doctors of often unaware of the blatant disregard of useful business hours that are spent by their employee cell phone use.  Studies have shown that 61% of workers waste 30-60 minutes on their cell phones while on the clock.  Biggest culprits? You guessed it...Google and Facebook.  What's most interesting is when we interview individual employees around the country there are those that do and those that do not.  Every single one of the employees who claimed they do not use their cell phone's while on the clock, felt frustration and animosity towards their co-workers.  


In an environment where we work closely with one another, and among many different personality and behavior types, the simple solution above can help dilute office stress and maintain the high level of patient care and service we strive to provide.  






Disrupting Dental Disruption

Cyndee Johnson - Friday, November 20, 2015



I am both saddened and intrigued by the number of colleagues who suffer through situations which cause them extreme stress and frustration. The sources from which vary greatly, but all boil down to one simple word: Disruption.

Disruption has become an entrepreneurial buzzword and has found its way into the likes of ridesharing, crowd funding and customer relation’s management products. But as I put the words to the screen, I reference both uses of the word; it’s new entrepreneurial use as in Andy Rachleff’s “What Disrupt Really Means” Crunch Network, Feb 16 2013, and its Webster’s definition: To throw into confusion or disorder.

In Rachleff’s article, Clay Christensen, a Harvard Business School professor, defined “disruption” in The Innovator’s Dilemma. “In short, a disruptive product addresses a market that previously couldn’t be served — a new-market disruption or it offers a simpler, cheaper or more convenient alternative to an existing product — a low-end disruption”. He also states, business models, not products, are disruptive.

So why then is there so much ado about corporate competition and why are so many dental practices struggling to compete? After all, a low-end disrupter is designed to attend to the unserved. And what services are being provided in the corporate setting that differs from private practice? Are the unserved searching for affordability? Great service? Convenience?

For those who fear this behemoth, might we be too quick to dismiss the micro-level disruptions in our private practices? Or our short-sighted view of our unprofitable, insurance-driven patients? If we were to hone our communication skills to a level that could reach the part of our patient that made their treatment recommendations resonate as mandatory? Might we build sustained success for our dental business and actually become the competition?

Let’s look at the basic definition of disruption: To throw into confusion or disorder. The corporate model has simply brought to light an industry of which a large swathe have been resting on their laurels. And to throw into confusion and disorder is exactly what this entrepreneurial movement, or disruption, has done.

So then how do those of us who believe in the private practice business model, maintain solid footing and sustainable growth? We must disrupt our own disruptions! With this I bring you back to the first paragraph. Why are so many of us willing to live with stress and frustration in our practices? Why are we willing to struggle with disruptive schedules, systems, employees and patients? The answers are simple: We don’t know how to fix it. And moving outside of our comfort zone is well…uncomfortable.

And when I hear comments like, “I’ve told my patients every six months that they need to floss. It’s not my fault they have perio” or “She is just a difficult and disruptive patient. I am going to dismiss her” or "He hasn't been in for three years...I deactivated him" or "I only get 40 minutes for a hygiene appointment" it becomes crystal clear why we need to embrace greater accountability for our roles as healthcare providers if we don’t want to be left sitting on the tracks.

The new, successful dental environment requires focus, continued education and coaching. It requires business and new technology savvy, proper hiring and insisting the team understands and maintains high emotional intellect and cohesiveness to provide your patients with the level of care they deserve. This successful dental environment is excited to implement efficiencies and requires more clinical and communication skills from their team in an effort to provide the highest level of care and experience for the patient. These practices have highly trained hygienists who drive practice profits with today’s new hygiene model and these teams understand the importance of quality telephone skills. They know what it means to provide a Five Star customer experience.

This new model requires us to step outside of our comfort zone and provide an experience, which creates value in the minds of our patients. And the cherry on top is a dental practice with sustainable profits. That’s right. The above investments are not only a professional obligation, but they pay delicious dividends in the form of dedicated patients who desire quality care and overall health. Patients want service, they want what they value and it is up to us as dental professionals to give our patients reason to find value in the services we provide..

Let's not let our disruptions allow the a real disrupters leave us  on the dusty trail. Remember the words of Will Rogers, “Even if you’re on the right track, you’ll get run over if you just sit there.”

If you like what you're reading...pass it along!



Caught in the Act: Part I

Cyndee Johnson - Monday, October 05, 2015


Last week I covered a day of hygiene for a friend and witnessed something horrible. 


My blood pressure rose. 


I perspired. 


I was afraid. 


In fact, I was so distraught by this heinous crime I had witnessed, it took nearly an hour that evening for me to settle myself to a point to discuss it with my other half


And it's like a bad dream that repeats itself. This is not the first time I have witnessed this tragic occurrence.


When is our profession going to wake up? We are good people. Yet we allow ourselves to contribute to the demise of our patient's health on a daily basis. The incongruence of our ethical promises and the delivery of our care is mind boggling. How has it come to this?


My day was the result of years of bloody prophies. And reviewing the patient notes prior to beginning my day gave no clues to the scene that was unfolding before me. And it went something like this.


8:00 am prophy, BWX, exam patient 25 minutes late and office manager requests "Just do the cleaning. He is super healthy and usually out quickly"


Well all right. I've been at this for nearly 30 years and the perio chart says no pockets greater than 3mm with accompanying notes stating great home care and very light calculus.


Normally, I would reschedule the patient, but with a healthy guy like this, doing the prophy and rescheduling the exam and BWX to tomorrow? I'll make it work.


As soon as I picked up my probe I realized he was a victim. I entered this bloody crime scene shocked and dismayed. Moderate to advanced periodontal disease throughout the posterior. And he had no idea. "What do you mean?", he asks. "I come in every 6 months like she tells me to."


Needless to say, my schedule was on its way into the dumps and this man needed to a completely different course of treatment. And he was not happy. Up to the front he went, scheduled 4Q and left in a daze.


And me? Officially running 20 minutes late. Full of apologies, I bring my next patient back for his radiographs.


Obese, diabetic, statin meds, HBP and guess what? Advanced, bloody perio throughout. No insurance. Vet. And no idea.


Patient 3. Healthy appearing man in his early 60's. Groovy ponytail and self proclaimed "health freak". Had a heart bypass four years prior, a wife 18 years his junior, organic diet and a brushing routine like there's no tomorrow. I was happy to have him in my chair and looked forward to the opportunity to get back on schedule. He had requested to be on a 4 month recall, "because his teeth were important to him".


Extra oral exam, intra oral all looking good...and then I pick up my probe. Aghast, I am witness to another crime. I discover bloody, 7mm pockets in the maxillary molar region and more bloody 4-6mm pockets mandibularly.


Patient 4. Thirty five year old father of five children, yes, I said five. Mod Periodontal disease throughout. Heavy sub, bleeding and plaque. In, fact, there was so much inflammation the home care instructions caused hemorrhaging. He had no idea. But yes, his gums did bleed sometimes when he brushed (on the odd chance that he might actually hit the gum line with his brush)! Nobody had ever shown him how to brush. Needless to say, he was shocked by my findings, agreed to the 4Q and booked his treatment before leaving.


Patient 5. I complimented her beautiful whitened teeth. She said her father had dentures and she was planning to keep her teeth. Took photos of the moderate wear on facially tipped 24 & 25 and their 4mm lingual recession/abfraction. She said she could feel that with her tongue and wondered if it was a problem. Explained functional trauma and referred to orthodontist. She was so thankful that something might stop this progression.


And the afternoon was more of the same. 23-year old mother with an 11 month old son. Super excited to be moving to the City for her husband's new job. Generalized 2-3mm recession throughout posterior buccals and #23 and #26 presented 4mm and 5mm facial recession impinging on mucogingival junction. Mod bleeding throughout with mod decalcification and plaque posteriorly. Recommended increased frequency of prophies, remineralizing products, sensitive bristle power toothbrush with instruction and perio referral. She had no idea and was genuinely upset.*


40 year old school teacher with 5mm pocketing around molars. Again, discussed eitology and progressiveness of perio recommended 4Q 1-3 which she scheduled.


With the exception of ONE patient, each of these patients were on 6M recall's! What is going on out there? Hygienists, pick up your damn probes! Our profession is about to be busted! People are suffering. Their health is at risk and we are chatting and polishing and talking about our vacations?


Doctors. This has got to STOP! You must all hold your team accountable. You need to pick up your probes at your exams. Your patients are counting on you to be their advocates, yet they are walking out of your offices sick and infected.


The victims of whom I speak of are alive. And there is hope that they will heal and enjoy many years with their loved ones. But how many heart attacks, strokes and systemic infections are we responsible for?


We have been caught in the act! And yet we are fortunate. Our patients give us a second, third, tenth even twentieth chance. Please. Today. Insist that your patients are being properly assessed and provided the treatment they deserve when they visit your hygiene department. Our patients can "love their hygienists" because they talk about personal things while their gums and health go to hell in a hand basket or they can "love and appreciate their hygienist" because they give incredible comprehensive preventive care. What type of care do you want coming out of your hygiene department?


These victims are mothers, fathers, sisters and children. We must protect them as if they are our own.


* Incidentally, I ran into the young mother at dinner the next night. She and her husband came to me and thanked me for the care I had given her. They asked if I could help them find a dentist in their new city. "One with a hygienist like you". This broke my heart. Aren't we all hygienists like this?

Watch for Caught in the Act Part II, where we will break down the reasons why these crimes are being committed and best of all...how we can fix this broken model.


Your comments are appreciated!  What do you think is happening here?


A Gift for Your Team

Cyndee Johnson - Wednesday, September 30, 2015

Ah, those team meetings. 


Often productive, but sometimes droning on and on...and off point. 

Looking for ways to stay focused while continuing to grow and evolve?

It's time for a gift! A gift that really does "keep on giving".

Give the gift of a book!


Choose a short, easy read or one that you can take a chapter at a time.

How about a great book on marketing, social media, personalities or communication? The list is endless.

Ask your team to read a chapter or two for the next team meeting and have each of them make a note about a point they felt was important and meaningful. How can it be used to have a positive effect on the practice, the patients or your team?

Set the time aside for open discussion at your team meetings and consider these points carefully.

Another great attribute to the book idea is the opportunity to design the discussions around particular needs of the office.

Are you experiencing a break-down in team harmony? Are patients failing to follow through with treatment recommendations? Would you like to know how to make your social media more fun and engaging?

What you just might discover is new-found motivation, excitement and solutions to challenges you may be facing. Perhaps you can involve your team and rotate the choices by allowing your assistant to choose book two. However you decide to do it, be accountable. Make the time and promote you and your team's personal and professional growth.

This is a GREAT way to foster team development through positive change and the best part...it can be FUN!

There is a book out there which speaks directly to your needs and I will leave you with a few of our favorites.

Here are a few easy reads:

Fish, by Stephen Lundin
One Minute Manager, The Purple Cow & Dip,
by Seth Godin
Who Moved My Cheese, by Spencer Johnson

And a few "By Chapter" recommendations:

Drive and  To Sell is Human, by Daniel Pink
The Greatest Salesman in the World, by Og Mandino
Full Frontal PR, by Richard Laermer

Our small sampling only touches the surface of the long list of fantastic and worthwhile reads.



Cyndee Johnson - Friday, September 25, 2015




Happy Birthday Mr. Jones! 

What else can we do to WOW our patients?


If we aren’t asking ourselves this question every day we need to start!


Begin each day with a careful review of your patient charts and check for birthdays.


Did one of your patients recently celebrate their special day?


Are they going to be celebrating one soon?


If the answer to either question is “yes”, make it a point to celebrate them at their appointment


“Mr. Jones, I see you recently celebrated your birthday! We hope you had a wonderful day!”

And try one of these ideas:


Purchase some lovely cards and have each team member sign the card with a special note at the morning meeting


Have some gift cards on hand if you would rather give a little something


Ask each team member pop in and deliver birthday wishes during the appointment


Or if they are there on their special day,


“Mr Jones, we are so excited to be celebrating your birthday with you!"

Have sparkling cider chilled in the fridge! Bring as many people together (patients included) and pop a bottle of bubbly cider, pour into patient cups and give your birthday boy a “cheers”.


A coffee mug with your logo in a nicely presented bag with tissue wrapped especially for him or something as simple as a birthday card signed by each member of the team.



Display a sign at the front desk celebrating the day for your patient!


Tie a balloon to the dental chair.



Or place a flower on the chair for her...

Have a boxed cupcake for after the appointment!  However you choose to celebrate your wonderful patients, rest assured that they’ll feel like a million 

bucks with this special attention.These suggestions take only a few minutes and the impact of making someone feel like the special person they are, will be well worth it!

Brainstorm at your next team meeting and come up with ideas for celebrating your patients!


This is a fabulous way to let your patients know you are thinking of them beyond the dental chair!

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