Dr. John Meis
Hey everybody, I'm Dr. John Meis. Welcome to this episode of the Double Your Production Podcast. I'm here with my partner, Wendy Briggs. Hey, Wendy, how you doing?
Wendy Briggs
Doing great.
Dr. John Meis
Fantastic. Hey, this is a part two and the part two is our strategies to prepare for a recession. Now, nobody's got a crystal ball. We don't know what's going to happen with the economy. There are signals. We talked about that on part one. There are signals that a recession may be coming. It may be. It may not be. But really, each of the things that we're going to talk about are useful, whether there's a recession coming or not. So these are strategies that you can employ.
right now and they will improve the performance of your practice. So we went through the first three strategies on part one. So we're going to go through the other four strategies today. So the first one is protect and optimize staffing.
Wendy Briggs
Yeah, this one's a hot topic right now, right? I mean, with where we are in dentistry, it's been really difficult over the last two years to hire and retain a full team. We still hear from doctors on a regular basis how difficult it is for them to recruit and hire hygienists. We hear it's difficult to recruit and hire assistants in many states as well. And so protecting and optimizing staffing within your team is a long-term all-the-time strategy for many of us, especially after COVID. We've seen tremendous shifts in the market, and it's a hot topic right now because some states have introduced very controversial pieces of legislation in their effort to make this easier on themselves and other practices that are having difficulty hiring. And it's been really a dumpster fire on social media lately about these efforts and the reaction of hygienists, particularly to these efforts. In fact, we have a webinar coming up not too far off in the future in just a few weeks. We'll dig into this. You did a couple of videos about this a few weeks ago that I know were very well received and very necessary. But the reality is staffing is never an easy thing and there's always going to be some struggles. But it seems like the struggles recently have been really, really challenging.
Dr. John Meis
Yeah, we have people that came to us as new clients who during COVID had let their entire team go, thinking that when it was done, they were just going to hire them back. Didn't work out that way. And so now they're trying to recruit in a time of workforce shortage. And it was absolutely devastating to these practices. So we want to make sure that we are able to field a team to care for the patients that we have. And if we have a recession, demand for treatment may go down. It doesn't necessarily have to. And I know in my own practice, when we went through 2008, 2009, we had virtually no impact on our patient flow, our patient demand, and I know some markets did. At the time I was practicing in Iowa, the real estate market didn't fluctuate as much there as it did in many areas of the country. So it wasn't as big of an impact as it was, say, here in Phoenix where I live now. So if we have that situation where we don't have enough treatment to do to keep everybody busy, how do we handle that, Wendy?
Wendy Briggs
Yeah, you know, there's a lot of things that that we can do. Certainly during COVID, we saw this to the nth degree. We had a lot of practices that that use that open time for advanced training. We actually had clients that joined us during COVID and really made advantage, took advantage of the downtime. They had our coaches come in and they were doing some training, certainly once it was safe to travel again and use that open schedule for training opportunities. So if we have open time in the schedule, or if we see a certain day where it's particularly slow, some practices are like, okay, you know what? We only have a couple of patients in the morning, let's move them to the afternoon and let's open the entire morning for some really important training and get caught up on some things that we've wanted to do for a long time. We also just had a client hire us to come in while he was doing an expansion that was behind schedule. So he had his entire team scheduled to come back to work on a certain day. Well, the practice wasn't done yet, but he'd already committed to pay them and have them come back. So they began, you know, one of our, our programs so that they could get some coaching and training done during that time. So that's a great way to use any open schedule time. I think a lot of times in COVID, you know, we, we saw a need to catch up as well. So there's a lot of practices that are over capacity anyway. So we can use any changes or downtime in the schedule, fallout in the schedule to really catch up on our overdue or unscheduled treatment plan list. Those are some other great ways to use that time.
Dr. John Meis
Yeah, all those things that that our team does when they have time, but they don't have time and it just kind of gets backlogged. So cleaning, organizing, working the AR, working aged insurance claims, working the recall list, working the 222 or the unscheduled treatment list. All those things are things that we could do now at some point. We may reach a point where all that stuff is done. I've never experienced that in my career, but it might happen. And at that point, then we've got to think about, do we reduce our hours a little bit? Not our head count, but reduce our employees' hours a little bit so that they stay employed, they retain their benefits, and we retain the employees because We don't want to make the mistake that many people did during COVID where they let their teams go and then weren't able to build a team. took a year or two to be able to build a full team again.
Wendy Briggs
Right, you know, it's interesting because we're also hearing at the same time as we're hearing all the trouble about the economy, I have my ear to the ground on what teams are struggling with and what teams are asking for. And one of the ways that we can really enhance our team retention is by keeping morale high. One the things that I often hear is it's difficult for hygienists particularly to request time off. You some practices have said because it's so hard to find hygienists, you can't take vacation unless the team, the practice is closed or if you do take vacation, have to find your own subs or your own replacements. And that's causing a problem with morale and retention. So that might be a great opportunity for us to really focus on elevating morale retention, ask the teams who wants vacation time. And that might be one way that we can thoughtfully monitor how we're utilizing our team. And again, I can't stress enough the importance of morale. Again, the current dumpster fire that we find ourselves in, this disconnect between doctors and hygienists and really doctors in the teams, can be really harmful and damaging if we don't thoughtfully put some effort into repairing that. And I think, you what we also hear on the ground is practices that can't hire somebody it's because it's a toxic workplace. So we don't wanna be that practice. We wanna make sure that we have a good culture, a strong culture that we're a supportive place to work so that we don't have to deal with, I guess, additional challenges on top of a workplace shortage, right? So this might be a really good time to dial in and focus on What's our team morale look like? How are we with retention? And as a part of that, we've got to evaluate how we're compensating our team, what our incentives look like, and are they really achieving the desired result.
Dr. John Meis
Yep. So we never get out of having to stay relevant in the marketplace with pay and benefits. That is that is just economics 101. And it's a good time to look at, where where we stand on that. OK, so that's strategy number four, protect and optimize staffing strategy. Number five, adapt insurance and PPO strategies.
Wendy Briggs
Yeah, so with this one, often begin by analyzing again, capacity and demand is where we often start. But then we look at which of your PPO plans that you participate in are the most profitable or the least profitable. Which are the ones that cause you the most headaches? Which are the ones that are the most difficult for your team to get to get reimbursement from? You know, those are all the things that we want to take a look at when we're looking at which insurance companies should we continue participating with if we are in a circumstance where, We have too much demand, for example. Too often we see practices going with the flow or the common trend of drop them all, get rid of all plans. And that's not always the best strategy.
Dr. John Meis
If you're in a certain place, it's a great strategy. But what I see many practices do, and this is also an upcoming webinar, what I see practices doing is making a decision about insurance from an emotional standpoint, not from a strategic standpoint. So making sure that we have the right strategy. And part of that, if we are participating with PPOs, making sure that we're doing everything that we can to negotiate the best rates, and during a recessionary time, unemployment rises. As unemployment rises, people are going off dental insurance. The revenue coming to insurers starts to go down. And now they start to get worried that they're not going to have the providers necessary when things ramp back up. So making sure that we're using the opportunity to look at what we can do to maximize insurance reimbursements.
Wendy Briggs
Certainly there's companies that specialize in this and negotiating better rates. Some companies really do negotiate, others just don't, right? But it's always good to look at where you are from a profitability standpoint on those PPO plans to make sure, know, again, if you're trying to grow patient flow, it's probably a necessary strategy in some markets to participate. But if you are participating, let's make sure we do it the best possible way, And you mentioned earlier, Dr. John, that if you are dropping insurance, or we mentioned the importance of a membership plan for patient retention, this is another key area where it's important to have a membership plan in place. If you do decide to drop some plans, you need to have an option for those patients to continue to be served in your practice in a way that both of you are happy with. And so a membership plan can fill the gap there as well.
Dr. John Meis
And membership plans can be as simple as a discount plan. They can be as complicated as having a menu of benefits that patients can pick what they want and the pricing is related to what they want. It can be as simple or as complex as you want to make it, but it is definitely worth doing and a really great strategy. So that's how we adapt insurance and PPO strategies. Strategy number six, maintain operational efficiency. This is our stuff right here, right?
Wendy Briggs
So important to be efficient. Again, another practice pillar of success is delivering care efficiently. And one of the things that we were wanting to do when we look at operational efficiency is to look first at scheduling. We talked about how to handle if there's gaps in the schedule earlier, but this is one of the things we want to look at. What are our cancellation rates, our no-show rates? Are we following all of the strategies that we teach to help us recover that open time?
Recovery is key in helping us reduce gaps in the schedule and helping us maintain production per hour. A lot of people don't really understand how important strategic scheduling is in helping us maintain that production per visit production per hour.
Dr. John Meis
The common mistakes that we see is that practices start letting their appointment times get longer and the gaps between appointments get longer and therefore the general pace of the office gets slower. And then when the recession is over, should we have one, when it's over, then it's hard to gear back up. And so part of the strategy is making sure that we are maintaining, we may adjust the hours that we're seeing patients, but we're trying to maintain the production per hour where it is so that we don't have that ramp up lag or delay.
Wendy Briggs
Yeah. And speaking of delays, that's another area where we need to be focusing in on operational efficiency. We've got to monitor our revenue cycle management activities and using our revenue cycle management system. This is such a critical thing. I remember reading a circumstance just yesterday, somebody posted online about how they had begun to delegate some of the revenue cycle management stuff, like reaching out for overdue insurance claims. And they had began passing this off to a team member. Well, unbeknownst to them, that team member was shoving all of those claims in a drawer. And like you mentioned earlier, they were going to get to it when they had time and it hadn't been addressed in more than two months. was, know, hundreds of thousands of dollars in insurance claims that hadn't been paid and hadn't been followed up on. And those types of mistakes are just absolutely devastating, even when not in an area of economic uncertainty, but in an area of economic uncertainty, it's even more important to stay focused on those vital systems.
Dr. John Meis
Yep, absolutely. And part of having a great system is having a way to monitor it so that you know exactly how that you're doing. So we need to have KPIs or key performance indicators that let us know is the system being worked and is the system working. And so if we know the performance, we know that the system's being worked and the system is working. So that's maintaining operational efficiencies. So strategy number seven, focus on stability and smart growth.
Wendy Briggs
Yeah, so key here. And again, we talk a lot about the practice profitability formula and there's so many practices that really, as you mentioned on the last podcast, don't understand what their profitability even is. I remember hearing from Dr. Davenport at our summit, we had him share his story and it was really powerful. He was sharing how the year before he hired us, because there was some unique challenges with adding a second location that wasn't performing well, his entire profitability was under $5,000 for the entire year. And he had no idea of that until we dug into the finances. And of course, the next year was significantly better, and he's continued to grow at really an unbelievable pace ever since then. But understanding the practice profitability formula is really an important part of practice stability.
Dr. John Meis
Yep. And the last one, and this is one of my favorites, and that is look for opportunities for business development. so business development, we think of six different strategies. We've done a podcast on that. But that is looking for expansion. So can we expand? during a recession, often it's easier to get equipment. It's easier to get people to build out spaces. It's easier to negotiate better rents. So if we have space in our office that we can expand into or adjacent space, that's fantastic. It's also a good time to look for practices that are for sale. know, after COVID, there were many practices where a doctor was nearing retirement and COVID was just kind of the last straw that broke the camel's back and they just wanted out. And so many of our members, particularly in our CEO group, identified practice opportunities that they could practice and whether they kept the location or whether they folded it into an existing location, they were able to pick up practices at a really, really reasonable rate. So just because there is a time when we're in a recession, that doesn't mean we're always going to be in a recession. And often in a recession, there's opportunities that are underpriced that we can take advantage of.
So that is strategy number seven, focus on stability and smart growth. So we're all hoping that there is going to be no recession. Of course, aren't we,
Wendy Briggs
Of course, yes. But just in case, like we said, over the years, we've had a variety of circumstances that could have ended tragically. And thankfully, because our doctors understood these core principles, they were able to survive and really thrive on the other side of whatever that challenge was. And certainly, that's one of the reasons why we wanted to do this podcast is to help those who may not be aware.
of some of these strategies, begin preparing now because even if it's not a recession, there is most likely something coming your way that's unexpected that could derail your progress and we want you to be prepared to survive that. So again, on the homepage, make sure you visit the homepage and download this resource so that you can review, access some of the other assets, videos and such that might be helpful as you dig into these concepts.
Dr. John Meis
So these seven strategies and the systems that go along with them are appropriate whether there's a recession or not. Your practice will perform better if you do these seven strategies. And so it's worthwhile getting it. It's worthwhile looking at each of the seven strategies and identifying how is it that we can do this at an even higher level.
Wendy Briggs
Very good. Well, that was an awesome conversation and a great part to our short series on recession proofing the practice.
Dr. John Meis
Yeah, there you go. Well, that's it for this episode of the Double Your Production Podcast. Thanks for listening and we'll see you next time. Bye bye.
Wendy Briggs
Bye everyone.
