Since joining TTI, their production is up, patient satisfaction is up, and the value of the practice increased $700,000.
systems, increasing production, company culture, team development
In 2019, Dr. Adam Almeida and Dr. Paul Bell were doing well. Located in Lone Tree, Colorado, they were operating two successful, high-end dental practices specializing in cosmetic dentistry and were doing better than most. Their English-speaking practice, Almeida and Bell General, Cosmetic, and Sedation Dentistry was started by Dr. Almeida’s father in 1976. Twenty-two years ago, Dr. Almeida bought into the practice and thirteen years ago Dr. Bell joined the practice. They also added a Spanish-speaking practice, Tu Dentista.
But despite their success, their hygiene department wasn’t profitable, and Tu Dentista was floundering. Frustrated with hygiene and feeling they weren’t reaching their potential; they weren’t quite sure what to do. Dr. Almeida admits he’d felt stagnant with dentistry for over a decade. He was tired of dealing with the same old problems day after day.
While chewing on their production problem, Dr. Bell’s interest piqued when he saw an ad on Facebook promoting the book, The Ultimate Guide to Doubling and Tripling Your Dental Practice Production by Dr. John Meis and Wendy Briggs. After buying the book, the two doctors signed up for a live workshop and joined the Blue Diamond Coaching Program.
Since joining The Team Training Institute at the end of 2019, their production has increased, profits are up and satisfaction among patients and employees is better than ever. Both dentists are working fewer days per month and the value of their practice has jumped up $700,000 in the last year and a half. Most importantly, both doctors say their own enthusiasm for their work has improved significantly. “I’ve found my level of excitement has increased,” Dr. Bell said. “I was never really frustrated with dentistry. I was just always looking for ways to improve and now I’m excited constantly about what’s next.”
“The Team Training Institute opens up your eyes to a whole other world of dentistry,” Dr. Almeida said. “It creates an atmosphere of happiness, and you feel like you’re actually moving forward. I now feel so confident about adding practices, something I never would have ever thought of just two years ago. I’m 52 and I feel like I have a new lease on life with dentistry. I could easily practice for another 10 years because I feel like there are so many different things we can do with dentistry now that can bring a lot of joy and happiness. I see it in our staff. There’s a whole different feeling with our staff now that we’ve implemented these systems. They understand why we’re doing it and that it is best for the patient. We’re also more profitable as a business, which means our staff is making more money that they can start putting away for retirement. I’m sure they’re going to have more freedoms down the road as well, as far as being able to travel and to have those things that they want in life.”
Here are Dr. Almeida and Dr. Bell’s experiences working through the TTI system and the 6 ways it helped them find a new lease on their life in dentistry:
#1: Create an Immediate Cash Surge by Optimizing Production
Because they felt their primary weakness was hygiene production, they started by optimizing their production. They fixed a capacity problem, implemented Hygiene Explosion, got better at preventative treatment, and added same- day dentistry. Even before fixing their capacity problem or adding same-day dentistry, they saw a huge increase right away. From the end of 2019 through the first quarter of 2021, both of their hygienists increased well over 50% on their production per hour. In 2020, even with a six-week shutdown because of COVID-19, they increased collections by 20%. “It was crazy how much we grew in 2020,” Dr. Bell said. “If it hadn’t been for COVID, we probably would have increased by 30%.”
They were surprised to find out that to increase production they didn’t need to focus on getting new patients. “I like Dr. Meis’ common-sense way of thinking about things,” Dr. Bell said. “Everyone out there talks about increasing the number of new patients. But with The Team Training Institute, it was all about becoming more profitable. By doing same-day treatment and performing our services and hygiene the way we should be doing it, our patients are better served. They’re happier too because a lot of times, they want to have same-day treatment.”
In the past, the doctors experienced high tension amongst their hygienists. Prior to the TTI trainings, they also weren’t doing any sealants and minimal fluoride on adults. They added these preventative measures and started to do some lasering. And at the suggestion of TTI, they created a hygiene department to give them more autonomy. “We have seasoned hygienists and all of them want the best for their patients,” Dr. Almeida said. “When we presented these new systems, they loved being able to be preventative masters. Plus, we offer a great bonus system as well. I don’t think our hygienists have ever been happier individually and collectively. Now that we’re all on the same page, everybody’s just happy and ready to go. They’re ready to work on the patients and deliver the best treatment possible. And if we hit our collection bonuses, they make a little bit of extra money in the process.”
Based on looking at their numbers and the average amount of money their other chairs were producing, Dr. Meis suggested they add two more chairs. “John is smart,” Dr. Almeida said. “He pulled up our Dental Intel and in about five or ten minutes was able to tell us all the areas we needed to improve and vice versa, where we were doing really well. John asked us if we’d done the math on adding chairs. I’m kicking myself because we hadn’t. We’re going to make an additional, almost three-quarters of a million dollars.”
#2: Improve Performance in Every Area by Implementing Replicable Systems
The two doctors confess their biggest weakness is systems. While still improving, they’ve implemented The Team Training Institute systems that have had a big impact and made it easier to replicate results. Systems include the Hygiene Explosion System, the Same-Day Dentistry System, morning huddles, management systems, and the TTI system for tracking their business. They acknowledge that these systems will also be critically important when opening additional practices.
“Everyone in the office kind of knows what our systems are, but we were not good at writing them down. And we can improve in that still,” Dr. Bell said. “Our morning huddles and the way we work with management is different because we’re using Dental Intel, which we’ve never used before.”
#3: Make Work More Enjoyable by Building a Management Team
The doctors don’t manage the staff much at all anymore. They organized their staff into departments, assigning a leader to each department. This freed them up from the daily hassle of answering questions and dealing with staff drama. “We’re meeting with management and going over our numbers,” Dr. Bell said. “And then our management has more interaction with the staff they’re managing which has taken a lot off our plate. We don’t even hire and fire anymore. That’s up to the management team.”
While managers will come to Dr. Almeida or Dr. Bell if something can’t get resolved, since changing their organization structure, they’ve not been bothered with anything. “We’re able to focus on being good dentists and on expanding our business which is what we want to be focused on,” Dr. Almeida said. “We want our minds a hundred percent on that. Not dealing with so- and-so is not getting along and so on. We can focus on the bigger picture now and that makes it more enjoyable to come to work.”
They also take more of a hands-off approach in how they decide what plans to execute. Following Dr. Meis’ advice in which he told them it was better to go with the staff ’s good ideas, even if the doctors think their ideas are better, Dr. Almeida and Dr. Bell started letting the staff come up with ideas and decide which ones to implement. “Now that the staff has self-autonomy, they’ve come up with ideas they feel are going to work best,” Dr. Almeida said. “It’s made them more invested with programs that they’ve come up with versus what we come up with.”
Dr. Bell added, “That might be 90% as good as what you think your plan is, but then they’ll be 0% invested in your plan if you shove it on them.”
To build their management team, they’ve gone to training events on leadership, included team members in TTI meetings, done internal training, and have their management teamwork with TTI coaches. “We’ve also talked to our staff about growing with us and they love that idea,” Dr. Bell said. “Our Spanish practice is really small right now. We don’t have it broken out into different teams yet because we don’t have enough employees. We plan to replicate our management process when we move to the new office we’re building and start growing quickly. Then, because we’ll have two large practices, at some point, we’re going to transition our office manager to be more of a regional manager and promote a new office manager. When production is where it should be, we’ll look for other leadership teams, such as someone to train the dentists and someone to handle finances. Those are all things that are exciting for us to think about because those are jobs that we do right now as dentists and we’d rather not.”
#4: Prepare for the Future by Tiger Proofing
The doctors had already done some tiger-proofing before TTI, however now that they are more aware of it, they’ve done more to tiger proof the office by cross-training in preparation for their expansion and in case of turnover. Before starting with TTI, they had two leaders, an office manager, and an assisting lead. They added a front desk lead who is training to be the future office manager when they need one. They also promoted a second assistant who is always ready to step into the lead assistant position.
For the hygiene department, they promoted one of their hygienists who’d been working with them for years. “We challenged her to work on her leadership skills and she did,” Dr. Bell said. “So, we gave her the hygiene lead job and she’s been doing amazing. It’s really increased her excitement to come to work. She’s putting a lot of effort into the leadership side of things and really enjoying it. I think she’s more fulfilled in her career as well.”
#5: Set Yourself Up for Retirement by Replacing Salary with Profits
Up to this point, the doctors have focused primarily on optimizing production and profits. Profits have increased dramatically, despite reinvesting heavily into the practice. Profits overall increased more than 10% and hygiene profits are up over 50%. Their long-term plan is to live more off profits rather than salaries and eventually roll into retirement slowly and take steps back from the dental chair. They credit same-day dentistry for a big portion of why their profits have soared.
“We were not doing same-day dentistry at all,” Dr. Almeida said. “It was just never a thought in our mind. If we did do it, it was because the patient would ask, ‘do you have time now?’ We weren’t giving the patient that opportunity. Now we ask all the time. Also, the two new dental chairs are almost complete. We expect to see a big boom in profits and production from them.”
“Before The Team Training Institute, we would have great months where we’d do a lot of cosmetics and produce a lot and that would be very profitable, but it was always kind of a rollercoaster ride,” Dr. Bell said. “Now we are profitable every month. And when we have a month where lots of big cases come in, we’re super profitable.”
To replace their salary with profits, their immediate plan is to build out a new office for their Tu Dentista office and get it to about half a million dollars profit a year. This would allow them to cut back from practicing dentistry three days a week to two days a week. They also plan to look for other practices to purchase. “Last year between the two practices, we did about $3.5 million,” Dr. Almeida said. “Our goal is to be at 15 million in the next 10 years by adding practices and maintaining profitability. When we hit that point, then working in the dental chair will be an option for us.”
#6: Execute a Bigger Picture Through the CEO Mastermind
Adam and Paul joined the CEO Mastermind Group eight months ago which they describe as being a part of a “collective think tank where you can bounce ideas off each other.” They not only take the ideas back to their practice to implement, but they’ve also found it’s helped them develop a much bigger picture.
“Dr. Meis has given us the confidence and the tools to want to go out and start acquiring more practices,” Dr. Almeida said. “When people would tell me they were a multiple practice owner, I used to think they were nuts. It just seemed like so much extra work. While it is work, when you implement the systems that The Team Training Institute taught us, it really isn’t a lot of work. It’s just implementing the systems, following through, and getting the staff excited about those new systems. You can have multiple practices be extremely profitable without killing yourself.”
“Dr. John helped us realize that the diamond was right there in front of us,” Dr. Bell said. “Everybody always says the only way you can grow is by getting new patients. You’ve got to spend all this time and money on marketing and that’s the only way you’re going to grow is if you get new patients every month and The Team Training Institute just opened up a whole new world. Your diamond is not in the rough, it’s right in front of you. It’s in your existing patients, especially in the hygiene part of it. You don’t need to have all these new patients come in because you’ve already got existing patients. They trust what you tell them to do. By implementing all these new systems, the sealants, fluoride, lasering, and same-day dentistry... you almost don’t even need new patients. You’ve got a goldmine right in front of you. Before we just assumed that the only way we were going to get bigger and more profitable was continuing to add new patients. Now we realize that’s not true. You don’t have to worry about how many new calls you’re going to receive every month or how many new patients come in—the goldmine is right there already. It’s your existing patient base.”
Now the doctors say their entire perspective on dentistry has changed.
“Before, Paul and I would just look at each other and say, ‘man, hygiene sucks. We’re not making any money. There’s not a lot of profitability there,’” Dr. Almeida said. “Now we’re doing lasering, Hygiene Explosion, and Same Day Dentistry, which we never even thought of before. As a result of joining The Team Training Institute, I enjoy practicing dentistry more because I feel like my horizons have been expanded. For me, before it was just a nine-to-five deal. People would ask me; do you enjoy what you do? And most days I did, but there were days when I’d hate it. But now it’s interesting. I enjoy coming to work. We’re so excited about all the changes and our new dental equipment in our two new ops. And without The Team Training Institute, I don’t think anything would have changed. Without them we never would have thought about expanding to multiple practices. We were just always looking forward to the next big cosmetic case. That’s kind of how we relied on our profitability. And now we know it can be profitable, whether those big cases come in or not.”