Dr. Miyasaki doubled hygiene production and one of their hygienists, Janet, is one of the most productive in the country.
production, company culture, case acceptance, new technology, leadership
Dr. Wilfred Miyasaki always dreamed of passing his dental practice down to his son, but he never wanted to push him into dentistry. He was ecstatic when his son graduated dental school and he patiently waited for 4 years before Dr. David Miyasaki gave him the best news – he would be taking over the practice. In 2018, Dr. David Miyasaki took over the day-to-day management as the majority owner of his father’s practice, A Downtown Dental Group, in Honolulu, Hawaii. “When he finally decided on dentistry, I was quite happy about that and appreciate David taking over the practice,” Dr. Wilfred said. “It’s so much more fun having a family member in the practice rather than some stranger. I also love that David took over because it means I can still practice.”
Dr. David Had Plans, The Staff Had Resistance
Like many young dentists, Dr. David had plans and visions to modernize the practice. But while Dr. Wilfred was supportive of Dr. David’s ideas, many of the staff, who’d been with the practice for twenty to thirty years, were more resistant to the changes.
Dr. David wanted to make. While Dr. Wilfred knew coaching would help, Dr. David wasn’t ready to commit.
In March 2020, the practice was down $40,000 and then COVID hit. One of the most restricted states in the country, Hawaii went on full lock-down and by April 2020, the practice was down $150,000. “I was pretty new at handling the basic operations, staffing, finance, payroll, HR, etc. and then COVID hit,” Dr. David said. “It was a nightmare.” And then COVID derailed their plans.
When the lockdown lifted, the Miyaksai’s discovered that patients were reluctant to come in. Many were afraid or out of work and could not afford dental care. With production way down, no hygiene for nearly four months, and working with a limited staff, the Miyasakis’ biggest fear was losing staff. “We took a big hit at the beginning,” Dr. Wilfred said. “I’ve never spent more time sending out emails and communicating with past patients and the public than I ever had in my whole life. Things were pretty desperate, and we were struggling.”
When patients finally started coming back in, they thought the worst of their nightmare was over, only to discover their problems had shifted. Now there was fear in the workplace about contracting COVID, making people irritable. The staff was distracted by childcare issues, stresses with spouses, and family members losing jobs. At great expense, the Miyasakis purchased and instituted state-of- the-art safety equipment and protocols, offered extra support to staff, and advertised what they were doing. But they continued struggling to alleviate their teams fears, while maintaining the extra expenses to make patients and staff feel safe. Despite all their efforts, they found the practice performance still declining. “Everyone was not mentally checked in to the practice,” Dr. David said. “They were always thinking about something else, and they weren’t in a good mental state. It was extremely difficult...we were really struggling to support the staff and expenses. We were having a hard time with the understaffing situation, and life stress. I had significant fears about turnover because at that point I oversaw recruiting, and staffing was already tough. As business owners, we were on the verge of a nervous breakdown with so many problems to manage.”
“I liked their philosophy, their ideas, and their down-to-earth way.”
Fortunately, Dr. Wilford, had already been looking into coaching because he wanted to make sure he did everything he could to set David up for success. He’d interviewed several local coaches, in addition to looking into The Team Training Institute. Already familiar with Wendy Briggs and Dr. Meis, he’d had Wendy come out to his office to do training ten years earlier. “Even before COVID it was a goal of mine for a long time to get coaching for David,” Dr. Wilfred said. “After reading Dr. John [Meis] and Wendy’s [Briggs] book, I liked their philosophy, their ideas, and their down-to-earth way... I thought, ‘these are the guys I want.’ When COVID hit, I thought we’ve got to do it now because we are so far behind, and we need to catch up.”
“All I saw was the consulting fee, and it was a big number.”
Dr. David was hesitant to commit to coaching but trusted his dad’s guidance. “My dad’s done a lot of coaching over the years, so he’s familiar with it,” Dr. David said. “I just saw the consulting fee, and it was a big number. I was super nervous about what we were going to accomplish because I haven’t had any experience with that sort of thing before. I was nervous about my ability to get ROI from what seemed like a really huge number. In retrospect, that was a drop in the bucket compared to the benefit that we got for our practice.”
In August 2020, the Miyasakis’ signed on with Team Training Institute. Wendy Briggs did a half-day hygiene training with their team in September 2020, and they finished the year $200,000 ahead of their production numbers from 2019 despite the nearly four months off and being over $150,000 in the hole earlier in the year.
Finished 2020 $200,000 ahead of 2019 with the practice shut down for 4 months.
Since joining The Team Training Institute as Blue Diamond members, the Miyasakis not only recovered, but they also increased production significantly, coming out way ahead of their projected number for 2021. Dr. David successfully modernized the practice with his team’s support, and they didn’t lose any long-term staff. Plus, the value of the practice is up by 25%. Staff involvement, participation, and accountability have increased and there is more staff satisfaction, too. Both doctors are enjoying dentistry more and decreased their workload. Dr. David also has a clearer vision for the future. Here’s what helped them recover, modernize, and pass the torch from one generation to the next.
Boost Enthusiasm and Up Your Preventative Game
Before The Team Training Institute did the Hygiene Explosion and Perio Explosion training, their patient experience was good, however, the Miyasakis’ distracted team, caused lapses and unpredictability. They also weren’t doing a lot of adjunctive services. They didn’t know about bonded protective agents and didn’t have aggressive, preventative protocols in place. “We didn’t have perhaps some of the understanding behind the disease process,” Dr. David explained. “We all learned it in hygiene and dental school, but sometimes you need a refresher. Specifically, Paige and Wendy were helpful in reminding us that, ‘Yes, this is important and when the patients understand what their disease is, and here’s how we can help you to address that it a very specific way, we really up their game in preventative services, preventative education, and also advanced services like bond and protective agents and laser, which now both our hygienists use a lot and find it helps with these difficult cases.”
They’ve doubled hygiene production and one of their hygienists, Janet, is one of the most productive hygienists in the country. Patients and hygienists also report being happier.
“The Team Training Institute gave us the push we needed to get everybody off to a positive start,” Dr. Wilfred said. “Wendy [Briggs] really connected with the staff. She got them enthusiastic and excited and motivated the hygienists. Everybody saw the Team Training Institute training as a positive thing and could see it would make us better.”
A Successful Framework with Flexibility
Dr. David didn’t like previous coaches he’d worked with because they used an authoritarian style. He found The Team Training Institute’s approach much more appealing because they give him the autonomy to create the practice he envisions. “I really connected with The Team Training Institute,” Dr. David said. “I liked that they set a framework for you, try to understand what your unique problems are, and suggest solutions within their own successful framework, but without pushing it on you or saying this is the only way to go. Other companies say, ’This is how we do it. You either do it our way, or we will not work with you.’ Personally, I’m not comfortable with that, which is why I like the Team Training Institute’s culture and approach.”
Mediate Your Practice Issues
Their hygienists like that the Team Training Institute coaches are their friends and partners where they can voice their opinions freely. This helps them work through issues without arguments and resolve problems, some of which have been going on for a long time.
“Sometimes the staff felt uncomfortable approaching us directly, or they weren’t sure how to say something,” Dr. David said. “We’re working to make our practice a safe place so we can bring up these discussions, but sometimes it’s helpful to have a third party who understands what life is like in the dental practice. TTI Coach Paige worked like a mediator. She is able to say, ‘Yes, I understand what you’re going through, and here’s how we can help you. And doctors, you can help your staff by making this change that will make it better for everybody.’ We needed encouragement to implement changes we thought were uncomfortable and on the flip side, sometimes hygiene needed to make changes that were making us, the staff, or the patients uncomfortable.”
Systems Save Time and Increase Case Acceptance
Team Training Institute (TTI) helped the Miyasakis clarify standards in treatment, so the staff could better understand what the doctors were trying to do, get on board, and help recommend treatment. After attending the TTI Case Presentation seminar, the doctors found they are more efficient and that their team is helping more to engage patients to want to accept treatment. “We gained a lot,” Dr. Wilfred said. “Now we have a method for doing a case presentation right in the chair, all in one appointment to save time. The staff is now more involved in presenting cases and recommending treatment, so we can do this in one shot. It’s going to become even more valuable with our same-day dentistry.”
New protocols such as TTI’s Risk Assessment Survey have been eye-opening for patients, making them more willing to get involved. “Whether it’s medications causing dry mouth or they’re drinking ten Cokes a day, we’ve found that patients are starting to own their problem,” Dr. David said.
“Once they own their problem, they ask us how to change their habits and how to solve the result of that, whether it’s cavities or something else. They perceive their problem and feel empowered to take the next step.”
The bonus system recommended by Team Training Institute incentivizes the team to set goals and meet them. “They produce more and give more services to patients,” Dr. Wilfred said. “The patients like it, and the staff likes it because they are well compensated. They almost always hit the daily goal.”
Stick to Scripts and Systems to Improve Reliability
After starting with The Team Training Institute, Dr. Wilfred reevaluated their scripts and systems, including their recall system, confirmation system, the new patient exam system, and telephone protocols. He rewrote and updated them, integrating COVID protocols. Meanwhile, Dr. David took on the technical aspects, updating computers and phones. “All the systems are more streamlined, so they work better now,” Dr. Wilfred said. “David established a whole new phone system and put all the computers on two monitors, which was a huge project but really helpful.”
“The Team Training Institute helped us to refine our verbiage for dozens of our scripts and systems which were based on the original training my dad did with them years ago,” Dr. David said. “It helped us to refocus and say things with intention. We gained an understanding that when we say something, it means something very specific to patients and that to gain the effect we want, we must stick to that verbiage.”
Avoid Costly Mistakes When Modernizing Your Practice
Dr. David dove headfirst into making a lot of changes and modernizing the practice after he purchased the majority share of the practice in 2018. “The practice was at around a nineties state,” Dr. David said. “I wanted to bring our operations up to ‘best practice standards’ and ultimately automate unending tasks to get those off my plate. We started changing one thing at a time and my dad was a good sport about it.”
Dr. Wilfred fully supported Dr. David in his vision. “We didn’t discuss his plans, but I knew he wanted to make changes and I did my best to learn the new things David put in place,” Dr. Wilfred said.
Even before the distractions of COVID, one of the major challenges was their older staff. Dr. David found it difficult to get staff who weren’t tech-savvy to move from old school to new and high-tech processes. Since working with The Team Training Institute, Dr. David has successfully brought the practice into the modern age, shifting from paper to paperless, upgrading to a new advanced cloud-based phone system, new dental equipment, and a remodeled office. As a result, the practice is more organized, running more efficiently, and the staff is now on board.
“I’m a techy person and understand a lot of the things that need to be done,” Dr. David said. “But even with how much I know, I would suggest people find a team of professionals who have done this because it’s a huge learning curve. Organizations like The Team Training Institute can assist you in this process. Yes, you might save money doing it yourself, but you’ll cause yourself headaches and you might end up spending more in the long run. There are many things to consider and the cost of making a mistake can be hugely expensive and waste a lot of time. It’s better to spend more and get a professional to help you get it right the first time. Also, you cannot change things up without a focused staff that is mentally in the game. Team Training Institute helped build up the staff culture and processes so they could weather the BIG changes I am trying to implement with equipment, tech, and processes. Additionally, facility improvement requires capital and the increases in production from Team Training Institute definitely helped.”
The Team Training Institute also helped them get the staff acclimated and 100% on board. “David would not be where he is now with all the changes without Team Training Institute’s guidance,” Dr. Wilfred said. “We had to get the older staff involved in all the nitty-gritty changes and to buy into the process so they were vested. It helped that they heard from our TTI coaches who explained things and encouraged the staff to get involved during our monthly meeting. This was invaluable to get them on board.”
Reduce Your Workload
Before Dr. David came into the practice, Dr. Wilfred and his wife owned the entire workflow from start to finish. But when Dr. David took over, he took on most of the responsibilities by himself. Prior to working with The Team Training Institute, he was also trying to onboard several new staff which he describes as “the most stressful time in his life.” Already Dr. David has seen a twenty percent drop in his workload, which has created “a pretty large improvement” in his lifestyle.
“Before, pretty much every decision was made by dad and my mom,” Dr. David said. “Every task was executed by them, which was good in a way because you control everything. It’s also bad because it’s extremely time-consuming. We’ve actively sought to create a way to delegate and empower the staff to take responsibility. We’re developing leadership skills amongst certain staff members to take care of certain things and automating those processes. We’ve also outsourced some management-type processes. These all things take things off my plate so I can focus on the patients and the staff.”
An Easier Way to Make Decisions
Dr. David is working on tiger-proofing his practice by automating redundant tasks and hiring an associate. The Team Training Institute helped him with a method for making decisions, so they line up with his vision for growth. “I feel like I have a second mentor in my life besides just my dad,” Dr. David said. “It’s great to have such a terrific support group with different ideas and solutions. Whenever I make a decision these days, the question I always ask myself every time is, ‘Is this process scalable and repeatable? Can I teach these to new people so they’re predictable?’ I’ve discovered the goal in the future is not to block us out of expansion.
You shouldn’t limit yourself. Right now, I don’t have the mental capacity to do that. As my dad cuts down his days, we are in the process of seeking an associate to replace his production, and in the future, I may consider additional locations.”
Dr. Wilfred who was working between three and three and half days per week prior to working with The Team Training Institute was able to cut back to two days a week in 2022. He enjoys working and mentoring his son and the staff and plans to continue as long as he’s able and enjoys it. He likes that he’s come full circle, doing what he set out to do from the beginning of his career... providing a better way to do dentistry to avoid pain and make it more preventative. He recalls getting cavities when he was a child and having work done on him with low-speed drills and without Novocain. “It was extremely traumatic,” Dr. Wilfred said. “I didn’t like going to a dentist and was fearful myself. I figured dentistry must change to make it more friendly to the patients and more preventive rather than having to fix all these things. I’ve always wanted to teach people to take care of their teeth and prevent problems. When you help them, they’re willing to accept more treatment. The Team Training Institute has helped me go back to where I started—focusing on prevention again. I want to give back to the dental profession now that I can and hope that David will someday be in a similar situation much sooner than me due to Team Training Institute’s help.”
For Dr. David, The Team Training Institute has given him clarity, helped him get unstuck and enjoy his profession again. “Before The Team Training Institute, I really wasn’t enjoying dentistry, especially right after COVID and having just taken over the practice not that long ago, because of all the challenges associated with management and dealing with staff and all sorts of problems,” Dr. David confessed. “The Team Training Institute helped me to focus myself and the staff to just be better at what we do and make things more efficient and easier. I’m no longer stuck in the daily struggle of the basic management of the practice. It’s helped me reinvigorate my joy for dentistry.”