By Mercedes LoRusso,

Happy New Year. This month has begun with disappointment at the continued interference of COVID on our lives, and on our practices. Every challenge gives us the opportunity to make ourselves better, instead of bitter. When so many are faced with a similar challenge, it serves no benefit to let the challenge kick you down. There were practices in 2020 that still had great years in spite of missing three months. They proved that it is more important how you respond to knockdowns and proceed with a plan. The current slowdown is an opportunity to give you and your team “Time To Plan.”


We have definitely been hearing from some of you that your schedules have been adversely affected by the resurgence of COVID among your patients, their families and your teams and their families. The bad news is that every practice has had the same challenge recently. The good news is that the open time in our schedules creates an opportunity to plan for the days when COVID is out of our lives, and this can and will make your offices more productive and less stressful for the rest of the year.
Once upon a time there was a very strong wood cutter. He asked for a job with a prominent timber merchant. The pay was very good and the conditions very favorable for this type of work. For this reason, the wood cutter was determined to do his very best. The timber merchant handed the wood cutter an axe and showed him where in the forest he would be working.
The first day the wood cutter cut down 18 trees. His boss was very impressed and called him the best wood cutter that had ever worked for him. Motivated by his boss’s words, he tried even harder the next day, but he only cut down 15 trees. The third day he tried even harder and only cut down 10 trees.
Day after day the wood cutter cut down fewer and fewer trees. His boss came to him and told him that if he couldn’t cut down more trees he would lose his job. The wood cutter needed the job very badly and tried harder and harder. He even worked during his lunch breaks, but still he could not cut down enough trees. “I must be losing my strength,” he thought to himself. He worked overtime but it was still not enough.
Eventually the boss came to him and told him he was fired. The wood cutter was devastated and handed back his axe to the timber merchant. The boss took one look at the axe and asked the wood cutter, “When was the last time you sharpened this axe?”
“Sharpen my axe? The wood cutter replied. “I have never sharpened my axe. I have been too busy trying to cut down enough trees.”
Obviously, the morale of this story is that you should never be too busy to sharpen your axe. Similarly, you should never become too busy to define your vision, sharpen your skills and hone your business systems and strategies in your dental practices. Last month in our newsletter we spoke about the need to properly set goals for the coming year. Here we will give you a strategy to make those goals become a reality.
Every sports team spends their off-season planning for the coming year. Every successful  corporation has meetings to plan for their coming year. Every successful businessman begins the year with meetings with their accountants and financial advisors to plan tax strategies for the coming year. We should do the same.
The lighter schedules from COVID give us an opportunity to try to consolidate the patient appointments to free up one day for a day-long practice planning day or “retreat”, similar to what many successful companies do. The “Retreat” Planning day can either be in the office or in the conference room in a local hotel (their bookings are down also, and the rates for this are quite reasonable.) During the lunch break, cater in a nice “Appreciation Lunch” for your team.
Here are a dozen things that can make this day a resounding success:
·     Review your accomplishments of the past year
·     Review and revise your vision
·     Identify things that you had wanted to achieve but didn’t get to and plan them better for the new year
·     Find out from each team member what it is that they would like to achieve personally within the practice in the coming year. You will find that many would welcome additional responsibilities and expanded skills.
·     Find out if team members have any obstacles to overcome in order to achieve these personal goals, and develop strategies to help them.
·     Set bold goals for the coming year and determine a really special reward if the goal is achieved. One of our client practices this past year set a bold goal of a 25% increase in order to award their team with a trip on a cruise. The goal was such an incentive that the team drove the practice to hit a 50% increase and, instead of the cruise, they are going to Turks & Caicos for two weeks, while their office space is increased with 3 additional treatment rooms.
·     Determine one thing that each team member can do to make the team stronger.
·     Allow each team member to identify one thing that the doctor can do to help them or, more importantly, one thing to stop doing that hinders them.
·     Establish a yearly calendar for fun marketing ideas
·     Establish a yearly calendar for fun team activities: Miniature golf, “Escape the Room”, attend a baseball game, attend a high school football game, have a potluck lunch at a lake or beach, bowling one afternoon or early evening, a painting night.
·     Include training on a new piece of technology OR the management system. Our team of coaches could help with advanced Dentrix training, or teaching your hygienists and clinical team to scan at a higher level to help generate more aligner ortho cases.
·     Smile Potential can be of help in creating this day for your practice, or we could help to facilitate a day to make it a resounding success.
Many of the practices we meet are under producing. Doctors are producing $300-$400 per hour. Hygienists are not producing much more than $100 per hour. This is your typical $600,000-$700,000 practice. More concerning is that we speak with practices producing significantly less than this. Ironically, these doctors are often too busy to come to the phone to receive a pearl or two that could help them generate an extra $30,000 or $40,000. The thought of scheduling an entire day for a team meeting, and take away from “productive time” would be inconceivable for these doctors. How could they ever fathom the thought of taking away “production time” working with Kelly and I, and our team, in a coaching engagement?
The fact of the matter is that practices cannot afford not to take the time. Let me make my case:
·     Every single-doctor practice that worked with the Smile Potential team last year achieved at least a $200,000-$300,000 increase in production and collections.
·     In the last 6 years we have worked with 116 practices and those practices have achieved over $90 million in increased revenue.
What do all of these practices have in common? They took the time to plan and to “sharpen their axe”. Their visions are sharp. Their teams have sharpened clarity of expectations. They have sharpened systems in place. Their engagement and focus is laser sharp. Their skills are the sharpest they have ever been. Their patients accept more of the treatment they recommend and have less concern for what insurance will pay. And most important, their sense of perspective…” that they work to live and not live to work” is razor sharp in the mind of every team member.
Doctors, use this temporary slowdown to take the time to plan and “sharpen your axe.”

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By Mercedes LoRusso,

This year, while very successful for all of our coaching clients, has still been a source of stress for many. Rebuilding teams, welcoming back patients, and acclimating to a “new” normal has made successes the product of greater emotional toll. Our vision for 2022 will be to help offices continue to grow while making processes more predictable and less stressful through improved adherence to systems.
We want to wish all of you, our clients and friends, and all of your families, a wonderful holiday season. We hope that 2022 will be a year of consistently good health, unprecedented success, great prosperity, limitless happiness and new opportunities.
Howard Hill is considered the greatest archer of all time. He won 196 consecutive matches and he never lost in international competition. With that being said, I can boldly say that even with minimal training and practice, most of you could beat Howard Hill, on his very best day. The minor caveat here is that Howard Hill would need to be blindfolded and spun around a dozen times to destroy his sense of orientation. Many of you will laugh and say “That’s ridiculous! How can you hit a target you can’t see?” Exactly! Many of you are, day in and day out, trying to hit goals that you don’t have. You must have goals! Clearly constructed and defined goals!
For a goal to be effective it must effect change.  Here are the steps in establishing goals for you and your practice:
1.     Write your goals down.
2.     Set a date.
3.     Identify the obstacles.
4.     Identify what you need to know.
5.     Identify the people you need to work with
6.     Establish a plan
7.     Identify “What’s in it for me?”
Figuratively, set long range goals as far as you can see, and when you get there you will be able to see further. In 2007 when Peyton Manning won his first Super Bowl he was asked if it was the most thrilling achievement of his career. Without hesitating, he responded, “So far!” Do not let your accomplishments be limited by past achievement or by underestimating your capabilities. Use the steps outlined above and take aim on your target.
Frequently when we work with a doctor, the doctor will, within only a couple of months, ask, “Are we there yet?”. It is easy to understand the lack of patience in wanting to achieve one’s goals, but it is almost always the wrong question. It demonstrates a failure to recognize the process of change and not trusting the concept of a vision. Change doesn’t just happen. Change requires a dedication to the processes that create change. This means that introduced systems need to be understood and implemented. Skills need to be practiced and executed. Scripts need to be rehearsed, role-played and utilized. There needs to be consistency in repetition of the implementation and a degree of confidence that the repetition will create success in due time, if executed effectively. When this is understood, you should not need to ask if “you are there yet?”. The results become the automatic source of your answer.
As a passionate golfer, I am constantly pursuing the quest to improve my score. Each month I read the various golf magazines and I see that the ways that I can improve my score include hitting my drives in the fairway, hitting the greens in regulation and limiting myself to no more than 2 putts per hole. This is the formula for playing par golf. Executing it is an entirely different challenge, but asking if my game is better is unfair if I have not been coached on how to accomplish each of these building blocks for lowering my score.
Coaching is a process to implement skills and strategies to grow your practice, lower your stress, and profit from your efforts to a greater extent. Don’t lose sight of the process. Apply your attention to all of the lessons and their implementation. Recalculate your route as challenges arise. Appreciate incremental progress. Celebrate measurable improvements, and when you arrive, it will not happen by chance, but it will be because you never lost sight of your bull’s eye.  You’ll know when you “have arrived”.

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By Mercedes LoRusso,

November is the month that we express our thanks to those who deserve it.
Thank you to my amazing wife who encourages, supports and loves me day in and day out, even on the days when I don’t deserve it.
Thank you to my family for putting up with my sick sense of humor and compulsive idiosyncrasies.
Thank you to my friends for laughing at my jokes more than my family does, and for tolerating the fact that out of my enthusiasm, that I sometimes speak more than I listen.
Thank you to Kelly and the wonderful group of coaches who make up Smile Potential. I am so proud of how you help doctors and their teams fulfill their dreams for success on a daily basis.
Thank you to the doctors and their teams who put their trust in us and for the privilege of allowing us to help them grow their practices, lower their stress and deliver a higher standard of care.
And last, but not least, thank you to all of you who read this newsletter on a monthly basis. I hope that once or twice each year that I am able to write something that enables you to find a way to do something easier or better, and that it makes a positive contribution to the growth of your practice or to improving your life in some small way.
When we create a vision for our dental practice, we are essentially creating the treatment plan of what will become our legacy. Later on, because our visions change as we progress through our career, it can be assumed, then, that our legacies change as well.
Throughout my career, my mission has been to make a difference in people’s lives. For most of that time I always viewed that this mission could be applied to the ways that my dentistry changed the lives of my patients, removing pain, providing comfort, eliminating infection, restoring health, overcoming embarrassment, creating opportunities and changing the way they looked, felt and felt about themselves. For the most part I believe that I accomplished what I had set out to do.
Along the way, I enjoyed the ride. I found great meaning in the relationships that I made with my patients. I enjoyed asking them about their families and I found it gratifying when they would ask about mine. I enjoyed feeling that I was more than their dentist, that I was also a friend. Many of the patients confided in me, and that often times that made me feel that I was a therapist and crossing over into the role that my wife had always occupied for the patients in her therapy practice.
In order to accomplish this mission I developed an understanding, very early on, that the most important people in my practice were my team. I knew that if I treated my team like gold, they would play it forward to my patients. I was careful to absorb women into our team who displayed warmth and exhibited sincere caring. I never tried to motivate them, for I knew that trying to motivate anyone is merely trying to manipulate them. Instead, I strived to inspire in each of them to an internal phenomenon of becoming motivated. I did this by constantly being aware that they would become motivated if I reinforced the things that gave them satisfaction by working in our practice, and by removing things that would be considered dissatisfying. I knew that culture was something that occurred either by accident or purposefully and that anyone entering our office would feel it organically.
I believe my patients felt the positivity in my practice. I know my team felt it, because many of the women who worked for me, through the time I retired from practice, still tell me and write to me that they appreciated the respect and appreciation that they felt from everyone. No one felt more privileged than me to be able to enjoy the type of culture that existed in our practice, often times in spite of me.
Recently, I experienced an epiphany. During this past summer a family member of one of my previous team members passed away. I encountered some of the “old” team members at the memorial service on a Friday morning. One of the women invited me to a lunch get together the following afternoon to comfort our team member. When I arrived that sunny Saturday afternoon I was amazed to see that nearly all of the women who worked with me in my practice over a 15 year period, ending in 2015, were there. Furthermore, while I always knew that they were friendly, I had not realized that they were now the best of friends…all of them. We shared stories that afternoon that only dentists and dental team members can appreciate about their office experiences. And then it hit me…my legacy had nothing to do with the dentistry we performed. The legacy of our practice had become the relationships that were born out of an amazing culture. These relationships are lasting far longer than the shared work experience. Most of them will last a lifetime and will outlast me, and I find that so comforting and exhilarating.
What will be your legacy? Will it be that you helped people, or will it be that you made a lot of money? Will it be that you constantly strived for perfection in your care, or that you survived a stressful career? Hopefully your legacy will include some consideration of the effect your life had on others. Wouldn’t if be wonderful if those individuals included the men and women who shared the mission, and that in turn gave all of you a greater sense of shared and mutual fulfillment.
Thank you Mercedes, Denise, Francine, Lucrezia, Amanda, Ashley, Sherry, Jackie, Dorothy, Espy, Priscilla, Heather and Lesly, from Smiles On Broadway, and Kelly, Donna, Jamie, Judy and Yana, (in addition to Mercedes, Lucrezia, Denise and Amanda) from Smile Potential.

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By Mercedes LoRusso,

The last time that Kelly and I spoke to a live audience was the first week of March in 2020. We are so excited once again be speaking at the Greater NY Dental Meeting next month. We will be presenting for an entire day on Wednesday, December 1st. This is a great opportunity to reignite the enthusiasm for you and your team. Our morning program is “3 Definite Strategies to Grow Your Practice”. Kelly and I will be joined by our good friend, Kay Huff, who is one of the most dynamic speakers in the country. A fun fact is that when I won the “Speaker of the Year Award” from the Speaking and Consulting Network in 2014, Kelly then won it in 2015, and Kay won it the following year in 2016. This will be an opportunity to see three award winning speakers on one stage giving you and your team actionable strategies to grow your practice immediately.
In the afternoon on December 1st, Kelly and I will be presenting “7 Steps to Increase Treatment Acceptance”. This course in a blueprint to insure that the patients who you know could benefit from your care will want to have it done without objection.

The loss of my dental practice to a series of life tragedies 20 years ago has served as my stimulus to now be dedicating my energies to helping doctors overcome struggles and challenges. The great success that my team and I had after we returned from two years of my disability and recovery has also laid the groundwork that enabled Kelly and I, and our amazing team of Smile Potential coaches, to help doctors, who have been underachieving, set the wheels in motion to discover incredible new success in their practices. It has been very fulfilling helping practices achieve routine first year growth of $300,000 – $500,000. Since January 2016 Smile Potential has now worked with 115 practices and the gain in revenue for those practices now exceeds $85 million.
I can still remember when I was disabled and unable to practice, how alone I felt. Sure, I had friends checking in on me, especially my good friend, my Schein dental supply rep, Mitch Cutler, who spoke with me daily, giving me encouragement and hope for a better future. But dentistry can be very isolating, and that was certainly made more evident over the last year and a half for almost everyone in our profession. The pandemic worsened the isolation that most dentists felt even prior to COVID.
In a suburban town outside of New York City there is a very modest dental practice. There had been reports that the dentist was not paying proper wages to members of his team, so the State Labor Department decided to send an agent to the practice to investigate. When the inspector entered the office he met the dentist and asked for a list of the employees and how much each of them were paid. The dentist responded by saying, “I have a Dental Hygienist who is paid $2,000 per week, an Administrative team member who is paid $1,500 per week and a Clinical Assistant who is paid $1,000 per week.” The inspector asked if there was anyone else, as he scribbled in a notepad. The Dentist responded by saying, “Yeah, I have one person who gets about $20 per week and enough cash to pay the car lease and gas money.”
“Aha!” the agent roared. “I want to talk to that man!”
“Speaking,” said the dentist.
Of course, this story is made up, but the situation is, unfortunately, not a gross exaggeration of what is sadly happening in too many dental practices today.  Many, who have found a path to profitability, will hear this and say, “No Way.” Believe what you want, but Kelly and I have encountered far too many practices in this situation to dismiss it. We have seen busy practices generating hundreds of thousands of dollars and the dentists are deeply buried in debt and taking home less money than their dental assistants. These dentists have no path out of this devastating spiral.
Craig Presti, a dental marketing guru, in 2018 published an article naming that year as “the year of Dentists declaring bankruptcy”. In 2019 he published a book titled “The Dental Apocolypse Survival Guide”. This was certainly not very encouraging.
Recently I had the opportunity to see the new movie revival of the hit Broadway musical, “Dear Evan Hansen.” It is about a socially anxious adolescent and the difficulties he encounters with teenage life, including the suicide of a classmate. In the worst of these situations, teenagers may suffer in their loneliness and make devastating mistakes without receiving the help of others. There is a song in that show called “You Will Be Found.” As I hear that song, I listen to the lyrics that keep repeating “You are not alone, You are not alone, You are not alone”… and I immediately thought of so many dentists that we’ve met needing help.
Dentistry attracts many individuals who are task-oriented and introverted. In today’s world, running a dental practice requires considerable business acumen. “They Didn’t Teach Us THAT In Dental School”…someone should write a book with that title. Many socially anxious dentists used to attend study clubs where they heard the other members bragging about how well they were doing, whether they were or they weren’t, and they became too ashamed to ask for help, out of embarrassment. They received no help and they continued to spiral downward. They suffered in their loneliness and they committed “practice suicide”. The pandemic even eliminated the outlet of live study groups. Virtual study groups did not allow for robust two-way conversation, but rather featured one-way lectures or presentations. This certainly did not allow the type of discussions that could serve as support for those suffering. And mental health is taking a toll throughout our society. It has been brought to the forefront by athletes like Naomi Osaka., Michael Phelps and Simone Biles. Mental health is also a problem in our dental community from all of the stresses we encounter on a daily basis
Dentists are not alone. “You Are Not Alone” We are a community. We are not in competition with each other. There are more than enough mouths with teeth that should guarantee that everyone of us can achieve great success. Smile Potential is dedicated to helping dentists find a way out of their challenges, whether they be team attraction or retention, patient satisfaction and retention, practice growth, team development, systems implementation, stress reduction, life/work balance and profitability.
Dentists, team members, sales representatives, vendors and accountants should help identify practices that are not reaching their potential and offer to help them, even if it is just referring them to someone who CAN help them. If you are a dentist, you have some sense about your nearby colleagues who may be suffering. You may be even getting patients from their practices. Acquiring these patients is not a win. Don’t celebrate these gains. Find out what is behind them.
If you are a vendor, a representative, or an accountant, you know which accounts are ordering less and less with each passing month. You see the facilities in disrepair and the empty reception rooms, or empty schedules. You know the practices that are not finding a way to “get by”. Let them know that you see the signs of struggle and let them know that they are not alone.
Kelly and I, and our team of coaches, are here to help any doctors who are struggling, or who are not struggling, but just want to assuredly take their practices to the next level. Dentists are faced with so many additional challenges now more than ever before…hiring shortages, rising team compensation and supply costs, difficult team retention, corporate competition, challenging policy compliance, HR nightmares, increasing stress. As my grandmother would say, “Oy vey!!!” The good news is that we serve a population that needs dentistry more than ever. Cosmetic dentistry is at an all-time high. Technology is available to make dentistry more fulfilling than ever before. And we are here to help you feel not as alone in your challenges. The systems, diagnostic criteria, verbal skills, computer proficiency and training we provide in our coaching programs helps struggling practices find success, and successful practices achieve unprecedented growth and potential.  You are not alone. We are here to help you.

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Smile Potential E-Newsletter – September 2021

By Mercedes LoRusso,

This month Kelly and I begin our 14th year helping doctors and practices raise their standard of care, raise their patients’ appreciation of the value of that care, and organically helping their practices grow and become more successful. Our goal is to inspire doctors and their teams to create an environment where patients are welcomed in increasing numbers, systems enable these patients to accept more dentistry than ever before, and patient satisfaction is the highest ever, which generates more referrals and positive reviews to feed the new patient flow and  this compounds the growth of the practice. We have been very successful in working with over 100 practices in the last 6 years and we have helped them cumulatively generate over $75 million in increased revenue. But despite this increase in production/collection, greater fulfillment and higher level of fun, there is still the understanding that “you can’t please everyone all the time.”

Too many of the dentists that we meet seem to constantly be in fear of losing patients. Many have not yet brought everyone back from COVID. There are certainly skills that can be learned on how to inspire these patients to finally return by invoking a program of emphasis of the oral-systemic connection. Everyone wants to be well, so a dedication to taking patient blood pressures, doing thorough Oral Cancer Screenings, using adjunctive devices for the OCS, doing FULL periodontal probing to diagnose periodontal disease, scanning for wellness and doing more thorough comprehensive exams would certainly seem like a good place to begin in differentiating your practices. But, when practices make these changes, they often encounter some patients who give pushback to the improved practices and they toy with going back to the same old – same old.
A farmer and his son were bringing a donkey to sell at the market in their village. They passed a group of girls who made fun of them walking alongside the donkey. So, the farmer put his son on the donkey. Further down the road they passed a group of older women who scolded the farmer for allowing his son to ride, when he should be riding because of his age. So, the farmer asked his son to get off of the donkey and he got on. Later, they passed some travelers going in the opposite direction who told them that if they wanted to sell their donkey, they should not tire the donkey out, for it would be worthless when they finally got to the market. So, they tied the donkey’s legs to a pole and they carried it to the village. When they approached the market in the village square, the people who were in the market began laughing at the site of them carrying their donkey.
They laughed and screamed so loud that the noise frightened the donkey and the donkey kicked itself free from the bindings and ran away. The farmer and his son returned home empty handed, except for learning the lesson that you will achieve nothing by trying to please everyone.
We cannot satisfy the demands of every patient, but we can purify the services we offer and how we deliver those services and care, so that the majority of our patients see the value of doing things to a higher standard.
1.   Establish your vision for your care and service so that your patients become more concerned with missing appointments with you than of what they will experience in your office.  This comes from raising your standard of care.
2.   Dare to be different, because differentiation gives you your competitive advantage over the other doctors in your area who do things the same ways they have always done them. Be proud of what differentiates you and your practice and team from others.
3.   Show more empathy, be more caring and be willing to listen more than you speak. Show more sensitivity to patients’ anxiety, and build a greater understanding about how you can make a difference in their lives.
4.   Raise the value of what you do in the eyes of your patients. This comes by not educating them about what they need, what you do, or how you do it, but rather, by emphasizing the benefits to THEM of WHY they should WANT the care that you know they need.
5.   Make your office become a place where people want to be. This means that you want to create a culture of common courtesies, everyone saying please and thank you for everything, and constantly giving praise in every direction. When team and patients experience this type of an environment, the team wants to be more empathic and deliver the greater care, and patients appreciate the concern for them and accept more comprehensive care without concern for cost or insurance coverage.

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Smile Potential E-Newsletter – Summer 2021

By Mercedes LoRusso,

We believe that one of our greatest successes of the past year was the Doctors Dedicated to Success (DDS) Mastermind Program. We were very happy that we routinely had between 25-30 doctors participating and the quality of the guests made each of the meetings a worthwhile experience for all who joined. We are delighted to announce that we will be hosting our second year of the program beginning in September. We have received commitments from some incredible guests to insure that this year will be another very worthwhile program. Our first guest will be Tim Twigg, of Bent Erickson and Associates. He will address a very timely topic : how to deal with team members who have not been vaccinated, and how to answer patient inquiries about the vaccination status of the members of the team. In addition, each meeting will continue to foster a culture of sharing the ideas that contribute to all of your successes and some solutions to the challenges that you may share with one another. All participants will be able to schedule two Practice Growth Coaching Phone Calls during the course of the year, and will receive feedback on a recorded Secret Shopper Call, all included in the cost of the Mastermind Program. The first Mastermind meeting will be Wednesday September 22nd at 7:30 pm.

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Smile Potential E-Newsletter – June 2021

By Mercedes LoRusso,

I remember how much my wife and I used to look forward to going out to eat at one of our favorite restaurants. The owner would give us a great greeting and ask us how our family and friends were. The hostess would ask us which table we preferred. The waiter described the specials from off the menu that would make our mouths water. The chef would prepare our meal “to order” and accommodate some of the substitutions that we requested.
During the pandemic this restaurant had to find a new way to survive and developed a robust takeout and delivery business. The volume of the food they prepared ended up not being much different than what they used to prepare on a typical busy evening. When winter turned to spring, this restaurant was easily able to accommodate the limited outdoor diners and a few who were brave enough to dine indoors.
Now that all of the restrictions have been lifted, this restaurant, and others like it, are trying to figure out how to satisfy a full load of indoor diners, in addition to the patrons who enjoy the new outdoor seating, and the many more takeout customers who learned to appreciate their food taken home to enjoy at their own dining room tables. But this busyness is not all good. What we noticed recently was that there were more parties waiting at the hostess stand for longer than they ever had before…and they were complaining and not happy. It was taking longer to turn over tables due to a shortage of bus boys. The waiter was not able to spend as much time describing the specials because he was handling more tables than before. The food took longer to prepare because the capacity of the kitchen had not changed and the number of food preparers was still not at full capacity. More customers were complaining that their food took too long and others were sending food back to the kitchen because it was not prepared to their liking, too well done, or not cooked enough. It has gotten so bad that my wife and I will not return to this restaurant until these kinks are ironed out. We are not alone, because we see there have been others who have given the restaurant less than stellar reviews online.
Busy people say they don’t have the time.
Productive people make the time.
We see the same thing happening in dental practices. When there were still some limitations on how many patients we could see during Covid, the patient load expanded to meet the time allowed. Many patients delayed their return due to continued apprehension. There was a challenge from team shortages secondary to the pandemic. While most teams are now approaching full staffing, the increased patient load from confidence and relaxed restrictions has created some backlogs in office schedules. We see many practices now with full schedules and long waiting periods for patients to make appointments. The extended wait for first appointments has resulted in an increase in broken appointments from a loss of interest, or impatience. Some offices are double booking and even triple booking to try to accommodate the flow. The result is that patients are not receiving the same quality experience and there is insufficient time necessary to create a strong relationship with their dental care-givers. This results in lower treatment acceptance. This has also resulted in some less than stellar online reviews affecting future new patient flow. Many patients have switched practices during this period.
The lesson learned from these occurrences is that it is better to schedule strategically for improved patient experience, and not for sheer busyness. Block scheduling maintains places for new patients to be inserted in the schedule without having to wait or lose their enthusiasm. This is an ideal time to switch to having the doctors see new patients first to begin the establishment of a stronger relationship with the doctor. In the practices where stronger relationships are created with the doctor, there is a shortening of the cycle of trust and patients are more likely to accept more comprehensive treatment earlier in the relationship. The goal is to work smarter, not harder. Achieving greater comprehensive treatment acceptance enables doctors to schedule fewer, but longer and more productive appointments, which increases the level of fulfillment while lessening the exhaustion factor. Don’t be busy. Be productive.

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Smile Potential E-Newsletter – May 2021

By Mercedes LoRusso,

One of the joys of Spring is the return of baseball. The crack of the bat, the sound of a pitched ball hitting the catcher’s mitt, the sight of a majestic homerun, the precision of an around-the-horn double-play, the celebration between a pitcher and catcher upon the final out. As a former catcher, I focus on the pitcher-catcher relationship. Here in New York we have the joy of watching Jacob DeGrom take the mound for the Mets every fifth day. Over the last four seasons he has established himself as the pre-eminent pitcher in the game. One of the things that I observe in watching DeGrom is that he rarely shakes off the pitches called by his catcher. I will admit, as a catcher, having a pitcher as good as DeGrom makes the pitch calling much easier. But the importance of the pitcher and catcher being on the same page cannot be understated. In your dental practices, it is equally important for the hygienist and doctor to be on the same diagnostic page in order to achieve higher treatment acceptance.
The relationship between a professional pitcher and his catcher should be a foundation on which a successful baseball team is built. The communication between the two should be precise. The ability to read what the other is thinking, and feeding off of each other’s energy, makes for better baseball with the expectation for better outcomes. Building the relationship takes time and it is dependent on adherence to a common philosophy, understanding a common strategy and communication that leaves no questions.
The relationship between a dentist and his, or her, hygienist should be a foundation on which a successful clinical dental team is built. The communication between the two should be precise. The ability to read what the other is thinking, and feeding off each other’s energy, makes for better treatment acceptance with the expectation for better patient outcomes. Building the relationship takes time and it is dependent on adherence to a common philosophy, understanding a common strategy and communication that leaves no questions.
When we look at a dental practice’s level of treatment acceptance, there are several issues that must be factored in. Dental Intelligence has studied levels of treatment acceptance in thousands of general practices. They have determined that the average dental practice achieves 39% treatment acceptance. The top 10% of practices achieve 58% treatment acceptance, and the bottom 10% achieve 21% treatment acceptance. We also compare these percentages with the relative percentage of hygiene production to restorative production in a particular practice.
Most practices suffer from treatment acceptance far beneath their potential. When we train a practice on the skills necessary to achieve greater acceptance, we see these percentages climb, their schedules fill with more productive procedures, and practice revenue soars.
We frequently see a relatively high treatment acceptance rate with a simultaneous low restorative percentage. This is an indication that the diagnostic criteria may be very conservative. I am not judgmental when I find this, but rather I choose to inform the doctor how their criteria relate to what we see among a wide cross-section of practices. I do not like the relative terms of aggressive vs conservative. I prefer to think of the criteria being proactive vs conservative with proactivity often times being the more conservative approach long-term.
We teach practices to establish uniform, and understood, diagnostic criteria for a particular practice. I do not care about their ultimate philosophy. That is their prerogative. I stress the importance of all of the clinicians within a practice, having the SAME criteria. There is no room in healthcare, especially within a single practice, for individual preference. This leads to inconsistency and confusion, which leads to lower patient confidence. We establish diagnostic criteria by reviewing a collection of photos of teeth with varying degrees of decay, fracture and pathology. The goal is to establish laser focus on agreeing on what the recommended treatment will be for a particular condition. Once these criteria are agreed on among the doctors in a practice, they then do the same exercise with their hygienists. The expected result is that every doctor and hygienist would likely agree on the recommended treatment for a particular tooth. This enables hygienists to confidently predict what the doctor would recommend and engage in co-diagnosis with the patient prior to the doctor entering the room.
If you would like to engage in this exercise for the doctors and hygienists in your practice to establish universal diagnostic criteria, we can conduct this exercise for you with a scheduled teleconference just for you and your practice. If you would like to schedule this, please text me at 516-524-7573, or email me at
We observe hundreds of practices every year. One of the things that I focus on is the interaction between the hygienist and doctor during “hygiene checks”. The scenario that I see most is that hygienists either do not point out teeth with problems, leaving them for the doctor to find, or they ask the doctor to look at a particular tooth or two, with no particular concept of expected recommended treatment. This forces the doctor to spend far more time than should be necessary to inspire a patient to accept needed treatment. These longer hygiene checks cause the hygienist to run behind in their schedule, and it cuts the doctors production by taking them out of their treatment rooms for more time than is necessary.
The system we teach client practices has the hygienist using intraoral photos to identify teeth with problems of decay or fracture. The hygienist uses these photographs to demonstrate to the patient that a particular tooth, or teeth, have a problem, that the problem, if untreated, could develop into worse problems of pain or infection and they conclude with a discussion of the benefits of the treatment. Our patients do NOT buy crowns or restorations from us. They buy the benefits of having those restorations done. This discussion describes how “the doctor will recommend treatment for the tooth that will make it stronger, make it last longer, be healthier, and look beautiful.” This discussion avoids crossing the line between what a hygienist can do according to their scope of practice. With this discussion repeated to the doctor by the hygienist when he, or she, comes in to check the patient, the BENEFITS of the treatment are reinforced. Finally, the doctor needs to merely confirm the recommendations predicted by the hygienist in a much shorter span of time.
This all works well when the diagnostic criteria are uniform. When the hygienist and doctor are on the same page, there is rarely disagreement. In rare occasions of differed opinion, the doctor can always explain that the hygienist was correct, but that an effort to be more conservative may be possible at the time of treatment…WITHOUT THROWING THE HYGIENIST UNDER THE BUS. When universal criteria do not exist, hygienists may try to predict expected treatment but then get shot down when the doctor comes in and says, “We can watch that.” “Watching” is wrong on many levels, which can be described in another article. The bottom line is that watching transfers ownership of the problem for the patient to the doctor and it deprives patients of the ability to make proactive decisions about their own care.
The act of differing opinions on recommended treatment in the hygiene room is very similar to the pitcher shaking off the signs of their catcher. When the catcher gives a signal and the pitcher shakes it off, asking for an alternate pitch type, it shows a lack of uniform diagnostic criteria on the hitting ability of the batter, or the situation. When we see repeated signals contradicted, it raises the confidence of the batter and this is frequently followed by a bad outcome for the pitcher and their team. When doctors “shake off” the signals of their hygienists, their confidence is deteriorated and the patients often leave with a lack of a sense of urgency and they say, “I’ll think about it”, or “I’ll call you when I’m ready”.
Let’s work on our signals. Let’s limit the “shake-offs. Let’s get on the same page, diagnostically. And let’s start hitting home-runs when it comes to treatment acceptance. Play ball !!!.

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