Within five months of joining TTI, Dr. Henderson's net income has more than doubled as she saw a 129% increase in value.
preventative care, efficiency, systems, leadership, core values, patient experience
Practicing dentistry for 32 years, Dr. Tana Henderson battled close margins every month. One of four practices operating in Ripon, CA, population of 20,000, her percentage of staff salaries was running close to 50%.
“Even though I was working hard, I knew my margins were high,” Dr. Henderson said. “Yet I felt like I was paying everybody at a fair rate, and I didn’t understand how to fix the problem. There was a lot of stress from month to month to make sure that we didn't spend too much.”
Then last fall, her hygienists asked for a raise, but she couldn’t afford to give them one. Plus, she had hired an associate doctor, Dr. Jonathan Rodriguez, who came on full time after COVID-19. She was struggling to keep him busy, pay the bills, and keep her head above water. “It was scary because I felt this responsibility for everybody,” she said. “I didn’t want to lay anyone off, but we weren’t as busy as we needed to be.”
Thinking back to eight years earlier when she had gone through hygiene training with Wendy Briggs, she believed Hygiene Diamonds might be the solution. She’d had some success with it before even though she’d never fully implemented the system and had fallen away from working it. In October 2021, she decided to go all in and became a Team Training Institute Blue Diamond member.
“Here I had this great young doctor,” Dr. Henderson said. “I wanted him to be successful and busy–and to make sure both our schedules were full and that we were productive. I also wanted to be able to give my hygienists a raise, and I didn’t know how I was going to give it to them. I thought we could do the Hygiene Diamonds training to refresh their memories and maybe they’d earn the raise, but I didn’t know about the Blue Diamond program. When I found out about it, I thought instead of reinventing the wheel on our own, why not utilize what others have found to be effective?”
Within five months of joining The Team Training Institute, her net income has more than doubled as she saw a 129% increase in value. Payroll has dropped from close to 50% to now just a little over 30%, and that includes paying out bonuses which she had previously stopped doing for an entire year.
“I learned from The Team Training Institute that the reason my margins were so close had a lot to do with our efficiency,” Dr. Henderson said. “As we became more efficient, we became more productive. We’re thrilled to see that our hard work is paying off and are extremely excited about the increases we’ve already seen.”
Here are four things that contributed to Dr. Henderson’s transformation:
Don’t Let Insurance Dictate How You Treat Patients
When Dr. Henderson joined Hygiene Diamonds eight years ago, she and her team didn’t go all-in. They did their own bonus program and didn’t follow all the recommendations. “That didn’t work well, so this time we decided to go all-in with what Wendy Briggs suggested,” Dr. Henderson said. “And that’s been a lot more beneficial for everybody. There are clear guidelines, which gave me hope because I was feeling this angst about how I could make this better when I didn’t know what to do. The Team Training Institute gives clear guidelines we could do such as same-day treatment, sealants, and fluoride–all these things we should have been offering long ago but weren’t because we had been allowing insurance to dictate what we offered. We no longer do that. I’m learning the verbal skills, going to the retreats, and putting the processes in place that make us function more smoothly.”
While the hygienists were reluctant at first, the management team, which includes Dr. Henderson, Dr. Rodriguez, and the office manager, Ali Cruz, all agree the team is on board now and continuing to improve.
“The hygienists were surprised that patients want the best care for themselves,” Dr. Rodriguez said. “They were concerned about overwhelming the patient and themselves with the things we were asking them to do, but they're doing a fantastic job. They're still conservative in talking with the patients, however, I’m happy they’re doing their best and going forward.”
Dr. Henderson is also still assembling her team, which will make a difference once she’s able to get fully staffed. To give the hygienist support, they are adding a dedicated assistant. “They’re not quite to their full potential yet,” Dr. Henderson said. “They appreciate the bonuses and the guidance too.”
Preventative care and same-day treatment are two areas that created big impact on their numbers.
“The numbers of fluoride have drastically improved,” Ali said. “The hygienists are more comfortable talking to their patients and not just focusing on the children but focusing on EVERYBODY that can benefit. They’re using the risk assessment pamphlet and we’ve seen a huge impact with sealants for adult teeth this year too. Now that everyone is comfortable offering these treatments to their patients, every month there’s more and more growth.”
At first, the team had to develop a routine together for same-day treatment. Now that they have their routine down, everyone works fluidly. Patients are happier with their experience too.
“Patients are excited to be able to get things taken care of right away,” Ali said. “The team works together which makes every day as productive as possible. Taking care of all the patients that we can and our team working together feels good.”
Give Your Patient The Highest Care Possible
Dr. Henderson has more than doubled production, increasing 118% in the first quarter of 2022. But it’s not just her bottom line that is benefitting. Patients feel more cared for, which has increased their trust in their hygienist and dentist. Plus, she feels this is setting them apart from other practices. “By focusing on prevention and comprehensive treatment planning, it’s a win-win for us and the patient,” Dr. Henderson said. “We’re not just telling everybody they need fluoride either. Everything is individualized. We back up what we recommend with why we are recommending this treatment. By not being in a super hurry and giving 100%, they see the difference and that we’re focusing on quality, not quantity.”
“Optimizing our day to its fullest and utilizing what The Team Training Institute teaches us, we don’t need to make up things to do,” Dr. Rodriguez added. “We’re not selling them things. We just focus on each patient, educating them and making sure they are given the care they need and receiving the highest quality of care possible. It’s helped with production tremendously. We also find that most people want the best and highest level of prevention and care. Seeing the difference between where we started and where we are now is exciting.”
“Preventative care wise, a lot of patients are extremely thankful,” Ali said. “They are appreciating that we're helping them be preventative and aggressive in helping them to prevent problems in the future. Interestingly, a lot of people want to know why we didn’t do this before but they are positively happy that we are doing it now. They're grateful and feel cared for–like we’re going above and beyond to make sure their dental needs are being met.”
Create Efficiency & Consistency With Systems
Putting systems in place for bonuses, case acceptance, and recall has improved performance and made them more efficient. In some cases, it’s mostly working on the dialogue they use that makes a difference, for example, with their collection system. Systems also give clarity to their main goal, which helps them to work as a team and give consistent care.
“We’ve been working with the hygienists to cue up the patients for what might be coming and that is working really well as far as case acceptance,” Dr. Rodriguez said. “We are also working on tribal language for treatment plans. Everybody knows what the goal is so now that we have the hygienists being more diagnostic, they keep everything uniform, so we are all on the same page. Plus, if a patient sees a different hygienist, the patient has the same exact experience and expectations as if they see a different hygienist the next time they come in. The diagnosis or treatment is on the same page and everybody feels comfortable when asked questions.”
Dr. Henderson admits she was hesitant to do the separate bonus system for the hygienists because she wanted everyone to be a cohesive team, but when she decided to go all-in, she set up the bonus system as recommended by The Team Training Institute, which included doing a team bonus and a hygiene bonus. “They get some of both bonuses and honestly I was worried about that, but everything has been positive from the bonus system,” Dr. Henderson said. “My fears were unfounded.”
Before TTI, they didn’t have tracking in place for their recall system. While they previous had a high recall, now with a system and tracking in place, they have one of the highest recalls at 98%. “We had lost track of a lot of people, especially coming back from COVID, so getting people reactivated and back into the system was the challenge,” Dr. Henderson said. “I’m really impressed with our recall system now. The girls are doing an awesome job of making sure their patient comes in for their six-month appointment and very few people leave this office without an appointment.”
Get Support For Your Management Team
Before The Team Training Institute (TTI), Dr. Henderson already had Ali as office manager. Then Dr. Jonathan Rodriguez joined the team, now it’s the three of them acting as the management team together. Dr. Henderson appreciates the training and guidance Ali receives from TTI as well as having someone to go to for help. “It gives us all a clear idea of where we're going so that we're headed in the right direction,” Dr. Henderson said. “It also gives Ali support, which is helpful when we have questions. We are all learning from our TTI business coach during our regular meetings too.”
Having an outside perspective from someone who works with the business side of dental practices day in and day out has helped the entire management team become better leaders. “It’s awesome having the business coach,” Ali said. “I love receiving guidance and insights from someone who has an outside outlook. To receive feedback about why this isn't working or what to try is incredibly helpful for me as a manager. It's also helped us to build morale in the office. We are a stronger force together and it’s helped us lead by example.”
Core values training helped them learn a different way of approaching conflicts and drama. “We learned a lot about each other,” Dr. Rodriguez said. “Discovering how we work and how different personalities clash or click really helped us move forward in a positive way. There’s more understanding of the differences between people, so everyone loved it.”
Dr. Henderson is happy to no longer be struggling trying to figure out how to make her practice profitable while giving the best care and taking care of her employees. She also feels good that she’s setting up a successful practice for Dr. Rodriguez. “He’s the future, I’m not going to be able to do this forever!” she said.
“I’ve learned a lot from The Team Training Institute,” Dr. Rodriguez said. “It's given me a different outlook on things and now realize there is a lot more to running a practice than just doing the right thing. More than that, I appreciate Dr. Henderson investing in The Team Training Institute. She took the leap to make the handoff as smooth as possible for me. She didn't have to do that, and I think everyone's benefited from it--from the team bonuses, the productivity, and the patient, everybody's winning which is great and morale is better.”
“You go into dentistry thinking if you just do the right thing by everybody, it'll happen organically,” Dr. Henderson said. “But it doesn't happen that way. You must have a plan, and you must put the plan into action. Before The Team Training Institute, the anxiety over being responsible for everybody and trying to make sure everybody was busy so I didn’t have to lay anybody off was overwhelming. Now, I feel more fulfilled in the practice. To be compensated without over-diagnosing or over-treating and be able to keep our ethics and give a high level of care to people all at the same time is amazing. Not having to triple or quadruple book schedules just to make ends meet and things like that. We are able to focus on quality over quantity, educate our patients, and do our best for everybody. We no longer allow insurance to dictate how we treat our patients, so I definitely feel like I’m providing a higher quality of care. It’s much more fulfilling because that's my whole reason for being a dentist in the first place. Now I feel like I’m taking care of people at a whole other level while also being compensated for it. We’ve created so much momentum already in just five months that I’m excited to see what we do by the end of the year.”