Wendy Briggs (00:01.294)
Hi everyone, welcome to The Double Your Production podcast. I'm your host, Wendy Briggs, and I'm so excited to announce our special guest for today, Kellie Black. Hi Kellie!
Kellie Black (00:01.7)
Thank you. Hi Wendy, good to see you.
Wendy Briggs (00:13.08)
So good to have you on. Now I know listeners of our podcast, most of them probably know who you are, but for those of you who don't, we absolutely love working with Kellie. Kellie worked with us for quite some time as a client at The Team Training Institute and then has joined us as our coaching director at The Team Training Institute. We're so honored to have her because she has really great experience and background on both the business side of dentistry and she also is a hygienist. So we couldn't choose a more... I guess capable and well-rounded individual to lead our coaches. So thanks again, Kellie, for joining us here today.
Kellie Black (00:47.675)
Thank you, Wendy, and thanks for having me.
Wendy Briggs (00:50.04)
So for those that don't really know you, maybe just give your version of your background real quick and then we'll jump into our topic today. It's gonna be a really, really good topic and I know a lot of interest is around this topic currently. So I'm excited to dig in.
Kellie Black (01:03.675)
Awesome. Well, thank you. I'm excited to be here. I'm Kellie. I have been practicing hygienist for 17 years. I did practice full time and I love hygiene, but I also love the business of dentistry. I just feel like there's always so much opportunity. Sometimes we just, you know, have to have to see the opportunity and acknowledge it and work through it. So I did move into the business world about 10 years ago and spent some time with, of course, with you and Dr. Meis and Heather learning the business of dentistry and was able to work through regional operations of about nine practices. So after I did that for probably about four to five years, I really wanted to help more practices do what we were, what they are capable of doing.
And sometimes, like I said, it's just really seeing those opportunities and taking advantage of them when they're there. And so I joined The Team Training Institute five years ago and have had the pleasure and the opportunity to work with you and Dr. Meis and Heather. So I'm really excited to be here today.
Wendy Briggs (02:12.118)
Yeah, thanks Kellie. And again, we work with the best and the brightest in dentistry all around the country and really all around the world. So it's really an awesome thing to be able to do what we do. Well today, Kellie, we have a pretty interesting topic and that is team compensation. Now, Dr. John and I over the years have held quite a few seminars or bonus sessions about this, and it's always such an interesting topic. But we're in it. We're in it at a unique place in dentistry right now, and that is, I believe over the last few years, we've had some upheaval in the marketplace, right? We've had, maybe some would argue, a necessary salary adjustment. And we see this in society at large too, right? It used to be that there were kind of entry-level positions that would pay minimum wage. And in the last few years, those positions have kind of gone away.
Even entry-level positions, I saw a sign at In-N-Out Burger the other day that they're starting people at $19 an hour. So that's created some struggle and some stress in dentistry as we have dentists reaching out saying, "Hey, the going rate in my area is higher than what I'm paying my current team. How do we deal with that?" Right? And also we're getting questions on how do we keep the team incentivized and motivated? How do we keep the team like staying with us rather than seeking out other opportunities that are willing to pay more?
So let's... Let's dive into that, Kellie. What are you seeing in dentistry right now when it comes to salaries and pay? And what are some of the questions that you're hearing from dentists?
Kellie Black (03:49.273)
Yeah, that is it's been a changing topic. I feel like we've had a lot of ups and downs really in the last five years more than we've seen before that. But it really does come down to the different areas. Of course, what we've seen is, you know, a lot of, "tough to get hygienists in the market in some areas," we've seen some turnaround there. But we do get a lot of questions of how do we pay our hygienists? How do we pay our assistants? And like you said, it has increased, which we know does usually come off of the bottom line, and that's tough for practices to maintain.
Some things that we've been seeing recently is, I believe it's one of the most common sights that we see our dentists, we really recommend really doing a market search in the area and finding out what are you seeing in the area and what are other people paying? Because, you know, we do provide next level care. And that's what we, you know, teach at our company. So we always want to try to be competitive with the market and or a little bit above because we do, you know, work with exceptional teams that do provide next level care. So we always recommend starting there and finding out what is the market in your area like always just asking around, asking other dentists in the area, asking other, you know, even your supply, who you work with for your supplies, your labs, just really finding out what are you currently hiring at right now. So you always have a baseline so you know where are we going to start when we start marketing for this position.
Wendy Briggs (05:24.204)
Yeah, I think that's great advice, Kellie. And frankly, let's talk about what happens in some practices. We've had people reach out and say, this is a problem for me because the going rate in my area is actually higher than I'm paying my current team. How is this sustainable? How is this possible? What are we going to do here? Can we just hire on the newbie and tell them they have to keep their wage secret? That doesn't always end well, does it?
Kellie Black (05:51.925)
No, no, what we're finding is, you know, that might be a thing of the past where we used to keep a lot of that stuff private is not so private anymore. So we have to go into it knowing that if we do and also team members are going to see our ads. Right. So if, you know, we have a hygienist making set amount and we're going to advertise for five more dollars an hour, we have to 100 percent know whether it's the same role, somebody on our team is going to see that and there are going to be questions that come up. So if that's something that we're going to entertain, we definitely have to be prepared to answer those questions.
But it is not always sustainable. And it is something that does come up regularly of, "What do I do? The going rate and what I'm seeing is set amount and this is what I'm paying right now. And I don't know how I'm going to be able to raise everybody up to that. Is that sustainable?"
And I do think that that's something that, you know, we really have to think about, can we really hire at that rate? So I would love some of your feedback on that too, Wendy, what you're hearing and how you're responding to that.
Wendy Briggs (06:55.63)
Yeah, you know, we've always been a huge fan of creating a system or a process where there is unlimited earning potential, right? So what that means is in our world, we love to see the team earn a bigger future rather than just demand it. And I would say, you know, hygienists certainly are compensated differently than other team members. Hygienists have the ability to influence their own personal productivity to basically justify or earn their incentive.
When we hire hygienists based on a production-based compensation model, we calculate their earnings as a part of that. But that doesn't mean we can get away with paying our team less than market rate. So we've had a couple of unique circumstances over the past few years. One example I'll share is that all five hygienists went to the doctor and said, we're all walking if we don't get a $10 an hour raise. Now this is an extreme circumstance. We certainly would never recommend hygienists behave that way because it's a dangerous place to put yourself in.
Well, in this circumstance, in that situation, what we said was, "Why would you want to limit your earning potential? Instead, let's look at our production-based comp model and help you figure out how you can earn even higher than that." So with the right formula for a producer, like a hygienist, you can basically get the best of both worlds.
Now, that doesn't mean that you're going to be able to recruit or attract or hire a new hygienist if you're $5 an hour below the market rate. You're going to have to figure out how to sort that out. And I know it's a challenge with the profitability squeeze when insurance reimbursements haven't been keeping pace with the hourly increases. That's why we have such a strong focus on maximizing three roles of hygiene, making sure hygienists are practicing at the top of their license and really maximizing the opportunities we have to serve patients at a higher level. When that happens, many times we are able to afford to pay the market rate and hygienists even often earn more than that as a part of their production-based comp model.
Now, other team members and other places on the team may have more of a challenge in that regard because they don't directly affect productivity in the same way. But what we need to have the team understand is what the profitability formula looks like. You know, the number of visits times the production per visit times the overhead, you know, all of that profitability formula helps us as a team know how we can contribute to the profitability of the practice. And if the practice isn't profitable, nobody's going to be earning their wages, right? So having an understanding there is important.
But I also think dentists have to understand that the general feeling in dentistry on a lot of these forums where team members and office managers and assistants and hygienists are talking is that they don't care. This is what the wage is, they deserve it and dentists better pay up. That's a lot of what I hear, which probably is very off-putting to a dentist.
So I've seen this divide, right? Between the doctors and the team. And sometimes the team look at the dentist and say, "They don't want to give us a raise. They're greedy. They want to keep more of the money themselves."
And the dentist are looking at the team and saying, "If I pay the team this much, the practice doesn't survive."
So we have to, think, as human beings, come to this conversation with a broader vision. A vision of what's the goal? What's the profitability formula look like in the practice? If we really are going to need to level set everyone's salaries to the going rate, what does that mean we need to do differently as a team to accomplish, you know, a higher level of profitability.
That might mean we have to commit to doing more same day dentistry. It might mean that we have to really focus on getting those AR days down so they get paid faster from insurance. You know, there's other things that we need to do there too. So it's interesting when we come to this crossroads, isn't it Kellie? Because sometimes I feel like as coaches, we end up being the referee. We have the dentist on one side, the teams on the other side, and we're trying to help come to a consensus, bridge the gap and help everyone be able to realize, you know, the earning potential that they desire, but we have to do it the right way.
Kellie Black (11:01.242)
Absolutely and something that you said that I think is really important there even just went through training with a practice in Texas and we talked through the profitability formula and how each of the roles really does play a role in the overall profitability. But as they're continuing to expand and add another doctor and another hygienist, what does that look like? What is profitability? You know I think it's really important for the doctor to be transparent on it you know with what you're comfortable with of course and what profitability really is because I do think sometimes we don't understand that we see patients coming in the door patients getting treatment and we just we think as team members, you know, "They have all this money to give, I should get that five dollar an hour raise." But in reality, like you said with those insurance reimbursements not changing for years, in some cases, actually going down, that really does just a small dollar amount every single day takes a huge percentage off of that profitability.
And if we're not profitable, we can't always, we can't ever give that back to the team. So I think being transparent as much as we can with profitability and something else that, you know, I like to see, like you said, was same day is that has been especially recently with all of the wage increases, one of the areas where we see the biggest impact is really talking through how can we do a lot of this treatment same day.
The patient's already there. It's a win for everybody, right? It's a win for the patient. It's a win for the practice. That's a win for everybody all the way around. If we have the patient there, we all know when we go to an appointment and if we need some other treatment done and they say, "Do you want to do that today?"... "Of course I do. I don't want to come back if I don't have to."
That's the reality of the situation. So, do we have good systems set up in place? Have we had those conversations? How do we talk to the patient about same day? Can we float around? Can treatment be done in hygiene rooms and hygiene be done in treatment rooms? Are we all set up the same?
So most importantly, just having those conversations of, we have any non-negotiables? That's a big one. I talk with teams about a lot. Non-negotiable, if we have two one-service fillings or any one-service fillings, I don't need to go to the doctor and say, "Doctor, is it okay if we do that today?" I already know, right? It's a non-negotiable. I'm going to go ahead and get that patient numb and he can come back in the room, he or she, whenever they get time. You know, "I've already prepped the patient. You may have to wait a few minutes. Is that okay?" And they're like, "Yeah, of course. Versus coming back, I would love that." So I'm just having some non-negotiables, but I think same day treatment is really huge when it comes to helping with the bottom line. It really makes a big impact.
Wendy Briggs (13:42.222)
I cannot agree more, Kellie. Yeah. And so with that said, you know, we've talked a lot about hourly wages and where to set that, but there's other ways to incentivize the team, right? Other comp models that are win-wins. And again, we've had sessions on bonuses and sometimes those can go on for several hours because some of the things that we've seen over the years in some practices, you know, they want to give the team a bonus, but the bonus might become unsustainable over time. Sometimes the bonuses don't account for future growth or adding additional providers. And so, the numbers aren't changing as the practice is changing. And so what we see there is sometimes struggles with bonuses. I've seen some team members say, "Hey, we hit our goal of $20,000 in production today and my reward was a $5 Starbucks card." And that's really deflating for the team, right?
So how do we find that magic formula where we're creating a culture of celebration, the team's able to, you know, earn a bigger future, but it doesn't harm, you know, the patient or the practice as part of that journey, right? So we often talk about activity bonuses and you mentioned same day and that's one of our most common activity bonuses in dentistry that we see practices embracing in life.
So let's talk about that for a minute. Activity bonuses are meant to be temporary. Some become permanent, but at least initially while we're testing the waters, we say, "Hey, this is for the next 90 days. We're going to test this and see if it has its intended result." Motivate the team to achieve more, help us improve the patient experience, improve the process. And so with same day, see practices embrace an activity bonus. Let's talk about that for just a minute.
Kellie Black (15:31.001)
Yeah, yeah, we do. And same day is usually one of the first ones that we see and that we talk about. I think, like you said, one of the most important things when we're implementing a same day or an activity bonus in general is that we talk about putting timeframes on it because we always want to be able to have that flexibility to come back and revisit it. Is this working? Is it not? And is it still sustainable?
Because we will get to a level where some of the incentives we put in place aren't sustainable anymore. So we do have to make some changes. So I always want to be very clear with the team and have this well thought out ahead of time that we're going to try this. We're going to try it for two months and then we're going to reevaluate it. And what's important is that, you know, we put it on our next team meeting or in two months that we are going to talk about that and say, "What did we like about it? How is it working? Is this something we can continue for another two months?"
So an activity bonus is really, you know like you said, more for a change of behavior and more to really incentivize the team for going above and beyond what they were doing yesterday, right? If we want to try some new things, we want to implement some new things. How can we reward our team members for their hard work? We do want to make sure that we're celebrating that. So same day bonus. What we've seen a lot of teams do is sometimes they'll do a whole pot and sometimes it's really just asking the team, "How do you want to be incentivized?" And maybe we do it as a private because people don't want to necessarily say in front of everybody, "I just want cash or, you know, I want to gift card." So we can even do something private. But, "How do you want to be incentivized?" A lot of times what we see is they put a dollar amount on who recommends the treatment and who does the treatment.
Wendy Briggs (17:11.692)
So for the team member who proposes it to the patient and gets the patient to say yes, they receive a bonus. And the assistant that says, "I'll assist the doctor with that procedure," also receives a bonus. Is that right?
Kellie Black (17:22.094)
Yep, absolutely. And then every role, right? Thinking through every role. Does the front play a role in that? Well, they do, because they go over the treatment plan. So I think it's really important that we think through all of these scenarios ahead of time. So we know, and it's never going to be 100%, right? But just thinking through, does front get a portion of that? Does the hygienist get a portion of that? If they're doing same day, what does that look like?
They do have their hygiene compensation model. So do they play a role in that as well? So just really being clear with the team who gets what and where, but at the same time remembering that we never want to trip over, what is it? Trip over dimes to save pennies or trip over pennies to save dimes. We don't ever want to get too far into it that, you know, people get discouraged along the way that, you said this, but now I'm only getting this. At the end of the day, the goal is really to incentivize and celebrate our team. So just making sure we can be as clear as possible. Have some deadlines on that so we know, okay, let's revisit it, let's address it, do we like it, let's keep going. And sometimes we do find, like you said, we find teams that keep these indefinitely.
Wendy Briggs (18:27.694)
Yeah. And sometimes I've seen activity bonuses for a variety of things. Same day is just one of them. I've seen teams do a reactivation blitz. And if you reactivate a patient and they actually keep that appointment, you receive an activity bonus. Like you said, there's a window of time for the next 30 days or 60 days or what have you. I've seen bonuses after the 2-2-2 process that we teach. So contacting patients after two days, two weeks, two months. If someone comes in with unscheduled treatment plans that we've contacted in that time, there's an activity bonus tied to that. I've seen a variety of things. We've seen aligners. We've seen activity bonuses tied directly to doing digital scans. There's all sorts of things that we can incentivize.
Kellie Black (19:08.062)
Perfect day schedules.. And then cancellations and no shows. And this is a big one right now too that we've heard a lot because we do see a lot of cancellations and no shows. know, we don't want to, you know, push people to come in if they really are sick. But if somebody does call and they want to change their appointment and we have them scheduled for two hours with the doctor for, you know, two fillings and a crown, are we trying to save that appointment?
So an activity bonus, if someone calls to cancel and we save it, yeah, that's awesome. We should celebrate that. That's huge because we could have potentially had an hour and a half open in the schedule. But whatever you said to the patient was awesome. Even if we say, you know what, I understand that you can't come at three. Can you still come at 3.30 and we can still do at least one of those fillings for you? So just really trying to do anything we can to save the appointment.
Wendy Briggs (19:57.09)
Yeah. Yeah.
Kellie Black (20:01.546)
The perfect day schedule one, I love this one. We see more and more teams doing this now where if the schedule is 100 % full, team members at the front get, you know, %5, $10, $15 a day. If the schedule, and of course it's never gonna start and end the same way. We're not saying that, that's never gonna happen. It's just a suggestion schedule.
Wendy Briggs (20:22.606)
If they're able to recover cancellations or last minute changes, right? Those are the things I'm talking about. If someone cancels, they need to be able to recover that time with another appointment. Those are the things that coaches can give you a little more clarity on exactly what that looks like. But that's such a great example, Kellie, because there's so much harm that comes over time. I believe I read that if you miss one hygiene appointment a day, goes unutilized. It adds up to, I think, $145,000 in losses over the year.
Kellie Black (20:26.222)
Yeah, just for one.
Wendy Briggs (20:52.482)
And that's considering lost production from the visit, but also lost treatment that would have been diagnosed at that visit. So it can be really damaging long-term if we don't embrace those systems to really keep that schedule full. So I love that one too.
Kellie Black (21:04.244)
And sometimes it's just a small incentive every day, but really over what 16, 17 working days, you have that opportunity to add another $10, $15 a day. That's huge at the end of the month. That's awesome.
Wendy Briggs (21:16.16)
It is. Now let's talk for just a quick second because I know there's probably some doctors listening that are throwing their hands in the air a little bit frustrated saying that's their job, right? That's their job. That's what they're getting paid to do anyway. They get a paycheck for doing that. Why should I give them an incentive? Well, like we said before, activity bonuses are designed to improve behavior, right? Improve performance and bring a focus on certain behaviors we want to encourage. What gets rewarded gets repeated.
So that's why we say, yes, if it is something that should be part of their job, that's why we do it for a temporary timeframe. Now, if again, it goes well and you see increased effort and increased productivity and increased profitability from that, that might be something you want to keep on for a while. But we do recommend that you change these types of incentives out. These types of incentives should be changed because they do become static. They become an expectation and we wanna keep things fresh. So some activity bonuses should only be for a certain period of time.
And then they go away and another one comes into play. So anyway, this is just one way that you can inspire your teams to achieve more. And certainly, Kellie, we don't have time to talk about all the different ways we incentivize. And certainly, there's so many comp models. We couldn't discuss all of them on one podcast either. But I think this is a great conversation for those that are wondering, OK, how are we going to be able to level up? Team members that are wondering, how can I go in and ask for that raise?
You know, in our world, what we love to see is create a concrete plan or bring a proposal on how you can add more value to your every day. And I think that's going to go a long way in helping you achieve what everybody wants, which is to take better care of patients, to see the practice grow, to improve profitability. And again, where we are today is kind of a difficult place, right? So the more we can work as a team to create a bridge between where the doctor is and where the team is, I think everyone wins in that scenario.
Kellie Black (23:17.624)
At the end of the day, that's what we really want, right? We want to win for the patient first, of course, win for the practice and win for the team, 100%. These are all great ideas too, Wendy. Thank you so much.
Wendy Briggs (23:28.224)
I love it. Thanks Kellie for this conversation. Like we said, you one of the things that we love at the team training institute is when you work with our teams, the members that we're coaching directly have a hygiene coach and a business coach. So there's a lot of great value in having a sounding board and learning what other practices are doing. And sometimes dentistry can be such an isolating profession. And that's one of our goals is to make sure that we support dental professionals in improving the dental health of the world. And this is just one of the small ways that we do that.
So thanks for your insights and your expertise, Kellie. It was an awesome conversation. And we will continue this conversation because I believe Dr. John and I have a podcast coming up where we'll talk about provider compensation in more detail. So that's associates, doctors, and hygienists, even team leaders, right? What does that look like? And do they have an opportunity to earn a bigger future as well? So good conversations, really, really important systems that we have established and set forth so that everybody has clarity. you said, clarity is really, really the key to growth. So I love it. Thanks so much for joining us, Kellie.
Kellie Black (24:24.354)
Awesome. Thank you for having me, Wendy. I really appreciate it. Thank you so much.
Wendy Briggs (24:29.304)
It was awesome. We'll probably have you on again soon, I'm sure. And thanks everybody for joining us for another episode of The Double Your Production Podcast. We'll see you all soon.
