As a second-generation dentist, Dr. Brian Isaacson inherited a practice in Cedar Hills, Utah, rooted in 1970s systems and mindsets. Working alongside his father gave him a terrific place to see a working practice, but after the first five years, the reality of generational inertia and a fiercely competitive Utah market hit. Struggling with inheriting decades-old systems and a resistance to change that ran deep, Dr. Isaacson found “it was impossible to make changes.”

When his father decided to retire in 2013, Dr. Isaacson hired a consultant familiar with the Utah market to help with the transition. Unfortunately, he was met with intense pushback. “My dad only worked with me for ten months before leaving because he wasn’t on board with the changes I was making,” he said. “The office manager, who’d been there for 35 years, also did not want to adopt new systems.”

This led to a painful transition and the need to rebuild the practice’s operational foundation. Growth was slow, and the dream of a thriving, modern practice felt out of reach. “I felt like I kept hitting a wall where I couldn’t grow any further,” he lamented.

When Wendy Briggs, co-founder of The Team Training Institute (TTI), approached him and told him they could help him double his production, he was skeptical. “I felt like I was already maximizing what I could do,” he said. “And I didn’t think it was possible in Utah because the saturation is high, and our fee schedules are the 49^th lowest in the country. Plus, I’ve got three other really good dentists right here in my complex. I just didn’t believe I could make a jump like that.”    

Practice growth continued to stagnate despite countless continuing education courses and working with various other consultants. Facing looming financial insecurity, Dr. Isaacson read Dr. John Meis’ book, 11 Habits of Highly Successful Dentists.

Dr. Meis’ story resonated with him—especially when Dr. Meis discussed retirement. “My wife and I felt pressure to consider alternative income streams,” he admitted. “We were watching a lot of our friends with all these retirement plans and all these things they were doing, and we really didn’t have anything. My dad’s retirement from dentistry was just putting money aside every month and hoping eventually to have enough saved up that he could retire. I didn’t want to be in the same boat.”

Facing ever-present stress and an uncertain future, Dr. Isaacson decided to give The Team Training Institute a try, committing to one year to evaluate his results.

In just 2 years with The Team Training Institute, Dr. Isaacson’s revenue increased 60%. His hygienists’ production and his personal production have more than doubled. Treatment acceptance increased and his schedule is booked out weeks ahead. He now has multiple retirement strategies in place and enjoys life more.

“I was totally surprised with my results from The Team Training Institute,” Dr. Isaacson said. “I had heard that promise before, such as, ‘Do guided implants, and you’ll kill it.’ Yes, I’m doing well with that, but I didn’t double production. In fact, all these things that were supposed to help me put money away for retirement only made a little blip. I wanted to produce more to save up for retirement and to provide for my family in case something was to happen. It wasn’t until I worked with The Team Training Institute that I saw real change.”

Strategies that contributed to his transformation include:

Optimizing Production: $3,500 in One Day by Lead Hygienist, More Than Triple Previous Average

Within the first month of completing The Team Training Institute’s Hygiene Explosion training, he saw a 30% increase in hygiene production. His team has not only sustained that increased level of production “easily every month” but continues to grow. Currently, hygiene production is 87.5% higher than when he started.

“Before TTI, the most we ever did was $100,000 in 4 months of the year,” Dr. Isaacson said. “The first year with TTI, we hit a $100,000 for 11-12 months out of the year. Now our average is over $130,000, our highest at $150,000, and the number just keeps going up.”

Strategies from both the Hygiene Explosion and Perio Explosion training programs empowered his hygienists to proactively identify and present preventative and periodontal treatments, which include fluoride, sealants, and seal and protect. Before training, hygienists averaged between $800 to $1000 per day. Now, $2000 per day is common. “About three months after implementing, my lead hygienist did $3,500 adjusted gross on collectible in one day all by herself,” Dr. Isaacson exclaimed. “That was just unheard of, especially in Utah with our predominantly insured PPO practice.”

While initially, his staff felt unsure about their abilities and were apprehensive about patient resistance, by the end of the first morning, they were surprised by the high acceptance rates and patient enthusiasm. “They had a mindset barrier at first,” Dr. Isaacson said. “By the end of the first day, we were all dying over how much people were loving it.”

“We used to only present fluoride and preventative services to approximately 20% of our patients and had about 80% acceptance,” he said. “Now we present to every patient, and we are closer to a hundred percent acceptance. That was eye-opening because we thought our case acceptance would go down if we presented this to everyone.”

Incentive Program Keeps Team Motivated  

Dr. Isaacson created a bonus system for all his employees that is based on practice performance numbers. This not only helps to hold employees accountable, but it also provides an incentive for them to hit daily, weekly, or monthly goals such as scheduling reappointments or providing preventative services to every patient. To receive the bonus, they must go above and beyond what they’re supposed to produce. “This gives my team an opportunity to earn more while still keeping my payroll numbers in line,” Dr. Isaacson said. “If they’re going to produce more, then we will pay them more.”

Identifying Where He Could Improve His Production: “My Dollar-Value Per Patient Increased 100%”

Recognizing that he needed an improvement in patient acceptance of care, Dr. Isaacson participated in TTI’s Case Acceptance Workshop. During the training, Dr. Meis emphasized diagnostic assertiveness, encouraging him to identify and recommend necessary care more confidently.

“My dollar value per patient was the lowest out of all the doctors in the room,” Dr. Isaacson recalled. “It hit me hard because these doctors ranged from brand new doctors to doctors who’ve been at this as long as me. They were all diagnosing way more than me. From that day forward, my diagnostic percentage doubled. My staff now holds me accountable. This made the biggest difference in the practice for me.”

Doubling his diagnostic percentage not only improved patient outcomes, but it significantly increased practice revenue, as more comprehensive care was both diagnosed and accepted by patients. Dr. Isaacson’s case acceptance rate improved, allowing the team to deliver more care that patients need.

Decisions Guided by Metrics

Learning how to evaluate the numbers in his practice helped Dr. Isaacson expand his practice with confidence. It’s also helped him become more efficient and increased his profitability. He optimized his physical and operational capacity, investing in updating underutilized operatories and is adding a sixth.  

“Before, I didn’t want to spend the money to update or add operatories,” he explained. “Dr.Meis helped me understand that each operatory could generate $25,000 in monthly production. Once he showed me the metrics, it just made sense.”

Dr. Isaacson restructured his schedule and used the diagnostic assertiveness training he’d received from Dr. Meis. This led to a fuller schedule as it eliminated openings and the underutilization of his operatories. Now, his schedule is booked three weeks out, and his hygienists are booked six weeks out. This operational focus helps the practice consistently surpass previous production ceilings.

“I just thought I needed more new patients, ”Dr. Isaacson revealed. “But looking at the metrics, I have 1,700 active patients. I should have been busy, and I wasn’t. Instead of watching the trouble spots patients had for too long, I became proactive. Now, my schedule is right where it needs to be. I used to do two crowns a day, and I thought that was great. Now we’re doing six to eight crowns a day, and it’s awesome. Recently, while doing insurance negotiations to help raise our fee schedule, I mentioned that I was ready to hire an associate because I am extremely busy. The guy was shocked. He said, ‘I don’t know anybody in Utah that talks like that. Nobody says they are busy. Everybody’s dying on the vine, flatlined, or their revenue is going down. What’s your secret?’ I told him it was The Team Training Institute. This is what made the difference.”

Dr. Isaacson credits Dr. Meis for also helping him evaluate cases, noting that some procedures weren’t worth doing because they weren’t a good return on his time investment. “Now I refer those cases out when the profitability just isn’t there,” Dr.Isaacson said. “I’m happier with that because it’s not as stressful. Being proactive, filling my schedule, and evaluating my profitability made a huge change in saving for retirement.”

Creating Systems That Make It Easy to Replicate Care

Putting systems in place allows every patient to receive consistent care. Focusing on creating systems based on what works and gets the best results eliminates the subjective side when making changes so that no team member feels like it’s a personal attack on how they do things.

“It was tough when the office manager of 35 years left,” Dr. Isaacson admitted. “We had no systems in place. It was all her, so we had to reinvent everything. Now, I bring my office manager to all the Team Training meetings. She has put together training programs and systems for new hires. Looking back at the office manager who had been with my dad for 35 years, I can now see that she saw the changes as trying to change HER. If only we’d had systems in place, it would have been about changing the systems and the training. I think it would have been different. That was our fault for not having the training and systems in place, but I had no idea.”

Protecting His Practice Against Disruption

Dr. Isaacson has built a strong team, increasing from three employees to ten, duplicating each position. He’s also actively looking to hire an associate and plans to expand on that idea to tiger-proof his practice. He now has an office manager he describes as “awesome” and is no longer struggling to hire the right people.

“After COVID-19, I lost several staff members,” Dr. Isaacson recalled. “We couldn’t even get a warm body in, let alone someone qualified. We made a couple of bad hiring choices, too. Now we have momentum. I have a great team with three up front, three assistants, and four hygienists. Now, if I have anybody out sick or someone quits, it doesn’t grenade the whole operation. Before, we would have been in trouble if that had happened. The Team Training Institute has provided the exact tools and training my office manager needs, too—she loves it!”

Now that there is a bigger team, meetings have improved too. “Before we had one person in charge,” Dr. Isaacson said. “It was kind of boring. Now, we split it up. There’s more engagement. Meetings are extremely succinct. Everyone knows what’s going on and what their part is. We look at the numbers every day, which helps keep us accountable.”  

Dr. Isaacson also plans to add additional associates so he can continue to run the practice for as long as he wants, working as little or as much as he desires. “Dr. John (Meis) said you can put a bunch of money aside, but you could also have your retirement working for you,” Dr. Isaacson explained. “This means having associates working for you while you manage them as much or as little as you want. This allows you to make passive income—which you could do forever. There’s really no reason to walk away from that fully. If you feel like it’s too much work, just add more staff. What makes sense to me right now is to have three associates working for me in two different practices. I never thought that was a real thing, but now it is much more than a realistic possibility. I never thought I would or could say this.”

The Future Is No Longer Uncertain --Practice Growth, Associates, and Business Income Will Fund Retirement

The Team Training Institute relieved Dr. Isaacson’s stress and improved cash flow and his retirement outlook. He reports being a lot more comfortable taking vacations and time off, saying he unwinds within a day versus the three days it used to take. While stress is still apart of his life, he says it’s “a new kind of stress that feels healthier.” Whereas before, there were times he struggled with monthly bills and payroll, now he’s able to pay for renovations with cash rather than taking out loans. He’s purchased investment property, a new car, and four-wheeler recreational vehicles.

“Speaking with other dentists in The Team Training Institute, I get to see what they are doing,” Dr. Isaacson said. “It’s given me peace of mind that this is not some pie-in-the-sky group that just wants your money. Before, I was making small jumps. Now, it’s not unheard of for me to make a thirty percent jump in one year. We just bought an investment property—something that never would have been an option before because we didn’t have any kind of extra income. TTI is the real deal. When I started with TTI, I was stuck in a rut. Even though I had grown the practice from around $400,000 to a million after I took over my dad’s practice, it took me ten years. Now, with TTI, we are growing a lot faster. My patients love the changes to our care. My staff loves providing it, and they love getting paid more. It’s a win, win, win all the way around.”