Create a Culture of Success

Me.  I. I try not to use either of those words, yet here I do it again…and again.  How do you turn Me and I into WE? The answer is delegation, cooperation, and training.

My business consultant made a comment to me the other day that got my attention.  Afterall, I do pay him each month; Rhonda says I should at least listen to what he says with an open ear.   “One great employee is worth three good ones.” My first thought was yeah, right. Then he went on, “How come I can consult two businesses that do the exact same thing; they have the same number of employees; yet one of those businesses does $8M a year and the other only does $2M?”

It’s the employees.  It’s YOUR employees.  Do you engage them in your DSM practice?   Do you let them interact with the patients?  Within the bounds of your state dental board, do you allow each of them to do as much as possible?  Or are you like most dentists, micromanaging your team and constantly looking over their shoulder? I hope not!

Here’s a quote from Herb Kelleher, perhaps you’ve heard of him; he’s the guy who started Southwest Airlines. “We have a strategic plan.  It’s called doing things.”

Strive to build a stellar team who engages a patient, each at some point along the preferred path, from the first phone call, to tracking down sleep studies, to verifying insurance benefits, to getting the Rx/LOMN, to scanning, to follow up, etc.  You are only as successful as your team.


Strive to be the best you can be

Assemble the BEST team possible

Be proactive; Be smart; Be efficient

Get Ready for the Snow

Just back from family vacation in the mountains of southern California.  Cool mornings, warm afternoons. Each morning we walked up to the ski lift where, despite the 80 degree heat and barren slopes, there was a bevy of activity and workers. I ran into Jake, “El Jefe”, and he shared with me a few of the reasons the ski season goes so well for them. They work hard in the “off season”, making sure that the slopes are groomed, overgrowth is trimmed back, the lifts are serviced, chairs fixed, picnic tables made, and on and on he went. I couldn’t help but think about how this relates to what we do in Dental Sleep Medicine.

We monitor a lot of statistics around my office, and for nearly a decade now, the slowest months of the year for me have been July through September.  What to do? Worry? Thumb twiddling? Take up knitting? No. Be like Jake. Get ready for the snow. Believe that it is coming.

Be proactive and productive.  Instead, work on stuff like this:

  1. Go back in your schedule three years.  Start January 1.  Contact every patient that you made a dental device on.  My bet is a few of them have fallen through the cracks. Most are due for a follow up. Some will need a new device.
  2. Review your website.  Look at it from a NEW patient perspective.   Would I know that you make dental sleep devices?  Would I be educated about sleep apnea and want to make an appointment?
  3. Ask your friends to look at your practice brochure.   Does it make sense?   Do you get the feeling that I care about my patients?  Would someone know what I do from looking at it?
  4. Organize your lab.  Lab scripts.  Outgoing cases.  Incoming cases. Get yourself one of the fishing tackle organizers and fill it with dental sleep device paraphernalia.  
  5. Work on your progress note and letter templates.   If you’re like me, things change, and you do things differently today than you did a year ago. Update your templates and letters to reflect those new changes.  It’ll save you a lot of time down the road.
  6. Engage your team to come up with new ideas and processes. From the first phone call to the titration sleep test.  What can we tweak to make it better?

Remember that success is contingent upon preparation. Don’t take up knitting in July. Follow the steps above instead. Also, remember, this will put you in a better position when the snow is falling and patients have met their deductibles. Don’t be passive. Take an active role in your the future of your practice. Make it snow!

Collaboration is Key

The bottom line is this. You must learn to collaborate with the physicians in your community if you are going to succeed in treating patients who have sleep-disordered breathing. Let’s talk about a few things to help make you more successful.

GET OUT OF YOUR COMFORT ZONE: We lecture to thousands of dentists across the country, and it still amazes me that dentists think they know less than physicians. You have to remember that physicians, outside of those who are board certified in sleep, get little, if any education about sleep medicine. There is more information packed into DS3 than most Physicians get in their lifetime about sleep. Just yesterday I did a lunch and learn for three cardiologists. I started my PowerPoint presentation and started talking The Talk. I was getting a bit of that deer-in-the-headlights look. “What’s up, guys?” I asked as one of the cardiologists sheepishly said, “I’m sorry, but I don’t know what AHI means. I think you have assumed that we know more about this than we do.” So Walk the Line between talking the talk and not patronizing someone, but understand that you know a lot more about this than you think you do and you need to start acting like it. Put yourself in front of doctors and start talking about how you can help patients. You’ve got to get out of your comfort zone and start spreading the word.

WRITE MORE LETTERS: Correspondence is how physicians communicate. Most dentists only write a few letters a year, and that’s not enough to help you succeed in dental sleep medicine. Letter writing is hard and it’s time consuming. DS3 has tried to make this as automatic as we can but it still takes time. But it is time well spent. The best marketing tool besides meeting someone face-to-face is writing letters about the mutual patients that you share with physicians. I just checked my performance report in DS3 and it tells me that in the first three months of 2016 my office produced more than 1,000 letters! Dentists ask me all the time “How do you get so many referrals?” Well, there is your answer.

ENGAGE YOUR TEAM: Many of them have their own physicians, and most of them are married to someone who snores. We all have people at arm’s length who have snoring or sleep issues. Make dental devices for them and for their spouses. Get them to believe in what you do. That all starts with you as the leader of the team. You have to believe in what you’re doing, and you have to feel comfortable about the fee that you charge. Remember that there are hundreds of questions asked in a dental office every single day, but very few of them are asked directly to the dentist. The more knowledge your staff has the better they can answer questions about snoring and sleep and the more patients you will start seeing and the more devices you will start making. It’s really that simple.

Does Advertising Work? Part 1

You’ve screened all of your patients of record and treated dozens, hundreds, THOUSANDS of patients with Oral Appliance Therapy. You’re getting some physician referrals, but that can be inconsistent. Ten in one week and then none for two weeks. So what do you do? I’ve recently begun a pretty extensive external D2P (Doctor 2 Patient; I think I’ll coin that one) marketing campaign. Has it worked? I don’t know. It’s still in progress, but guess what? I’m going to bring you along the journey with me.

We spent time interviewing media buyers and marketing gurus to finally come up with “the plan” last fall.  Two themes, we thought:  one for PAP failures, and one for snoring and tired all the time. That about covers it, doesn’t it?   The 10%, and the 90%, respectively, of the 400,000 plus sleep apnea candidates I estimate reside in San Antonio, Texas.  We hired an actor, an actress, and a camera crew.   We set up the bedroom scene in the media buyers home, and before you can even write the $10,000 check it took to make three thirty second commercials, I heard someone say “Lights, camera, action!”

Concurrently, we held staff meeting after staff meeting trying to distill our current systems to better handle and route the calls we soon expected.  Phone scripts.  Updated job descriptions.   How long do we schedule for an undiagnosed patient?   For a diagnosed, in network patient?  For a diagnosed, out of network patient?  Expected time to capture VOB info, sleep studies, and the dreaded LOMN’s.

The TV commercials start tomorrow night on the 10 o’clock news, she said, excitedly.   I hope you are prepared for the calls.  You betcha!   We’ve been working on this for months!

Fast forward 60 days from the day the first commercial aired. What’s happened?  Did we get the calls?   How many?  How much did we spend on the advertising?   Did we also do radio?  What type of patients did you get?   Did they show up?  Were you able to convert them to a dental device?  What percent?  ROI?  I know. You have a thousand questions.

March, 2017:  178 calls.  45 appointments scheduled.  22 showed.  11 dental devices made from media leads alone.  Yikes! I thought we were prepared, but we were far from it.   ROI after the first month would have been break even IF we could have averaged $4,113 per dental device, which we did not, of course.

We ever UNDER-PREPARED for what happened.   You see the numbers, and I hope that you’re saying to yourself “We could have done better than that!”  Back to the drawing board.   I hired a business consultant, someone outside the realm of dentistry and medicine, and we started over again. Updated job descriptions.  New hire for a New Patient Coordinator.  What worked, what did not?  Tweak.  Tweak.

April, 2017:  155 calls.  90 appointments scheduled.  60 showed.  34 dental devices made from media leads alone.  Better.  ROI after month two is break even if we just average $1059 per dental device (we did better!)   More meetings.    Now the business coach is holding kaizen events for the staff.   Things are looking up, and we’re getting better.

Unintended Consequences

Last week I listened to a lecture from a PhD in Communications about the unintended consequences of connectivity: internet, smartphones, tablets, Facebook, Twitter, etc. Honestly, what she said scared me a little. Just a few stats for your Saturday morning coffee:

One hundred college kids were asked to “unplug” themselves for 24 hours: 72% could NOT do it. Not for a single day. “Why would you even sign up for social suicide like that?” a friend asked a participant.

Cyber bullying resulting in teen suicides. High school teachers bemoan trying to teach in a class where half are phubbing (you might have to look that one up). Teens spending the equivalent of a full work day on social media platforms every day. These are all negative unintended consequences.

Let’s switch gears, now that I’ve got your blood moving a little (social media effects is a hotly debated topic that few agree on) and talk about the unintended consequences of treating snoring sleep apnea patients in your practice.

Unintended Consequences of Treating Snoring and Sleep Apnea in your practice:

  • Screening for sleep disordered breathing creates an atmosphere that you care more about your patients’ lives than you do their teeth
  • Facilitating sleep testing for your patients creates goodwill, better relationships, and builds trust
  • Goodwill, better relationships, and trust, simply means that your patients are more likely to get the work that you recommend done
  • Patients who snore less create happy bed partners. If that bed partner is a patient of yours, she likes you more. In fact, you may be her new superhero

Treated patients who snore less and sleep better talk to their neighbors, their friends, fellow church members, to their doc-tors. This leads to more new patients, and the doctor part leads not only to a new referral source for sleep patients but patients in general.

I never said that creating a successful dental sleep medicine practice was easy. It takes work, but what most of you don’t realize is that a successful DSM arm of your practice makes the rest of your practice more successful, too.

Doing the right thing and for the right reasons is seldom the easiest thing to do, nor the path of least resistance. But it remains the right thing to do.

Screen. Test. Treat. Bill.

Saving lives, one dental device at a time! I’ll bet your coffee is still warm.

Starbucks, Fishing Line, and Dental Sleep Medicine

Some years ago, Grandpa (my dad) was with me and a couple of my boys, and Garrett wanted to stop at Starbucks. His lawn mowing money was burning a hole in his pocket, and he just had to have a Vente Froppa Loppa Chino. WHAT? $7 for a cup of coffee? Later, I stopped by a fishing tackle shop and bought some braided fishing line….for $250. What? $250 for fishing line? “Well, I guess I can go ahead and die now” I remember hearing my dad say. “I never thought I’d live to see that!”

Funny; time marches on, and we soon become our parents. I found myself saying just the same thing the other day. You see, I pay a guy $2750 per month to manage my digital presence. What? I never thought I would live long enough to say that. I was listening to a financial guru give a talk recently, and a spritely young college kid in the audience asked what he thought the next big money idea would be. The guy didn’t even hesitate. He said “It doesn’t exist yet; the next big thing to make money in the next five years does not exist today.”

That got me thinking about where I may be five years from today, and how different dental sleep medicine will be. Or will it? “Eat right; get some exercise, and get a good night’s sleep.” We’ve been saying that for over a hundred years now, and I imagine we’ll be saying It a hundred years from today. When I made my first dental device 17 years ago, dental sleep medicine was much less sophisticated, and the number of dental devices was far fewer. Today, thanks to dentists like you, yes, YOU, awareness of sleep disordered breathing is increasing at a faster pace. More dentists are screening their patients; more dentists are visiting the physicians in their community and educating them about how effective a dental device can be, and the volume of evidence based medicine supporting the efficacy of dental devices simply can no longer be ignored.

So we are gaining ground. Patients are more aware; dentists are more aware; physicians are more aware, but we still have a long way to go. We need to continue to fight for a larger market share. 5% is not enough. We need more dentists to pick up the phone and call the patient’s primary care doc and discuss a plan to get their mutual patient sleep tested and treated. If just 1000 dentists did that once a week, a year later, 52,000 physicians would be more knowledgeable about dental devices and more likely to refer a patient to the dentist.

Let’s get this party started!

  • Screen your patients
  • Call the patient’s physician and have a meaningful conversation (I promise that it WILL help your practice grow!)
  • Get out of your comfort zone and start speaking to public groups

Overcome Dental Sleep Medicine Obstacles

Setting goals is a part of life. Obstacles on the path are a part of life, too.  Let’s just face it. It’s how we choose to view and deal with these obstacles that will determine how and if we overcome them.  When a dental practice makes a commitment to add Dental Sleep Medicine (DSM) to its list of services it’s important to understand that will obstacles might surface, and there are ways to move past them.  There is no obstacle large enough that it should prevent any dental practice from offering this life saving treatment. Control what you can control and minimize barriers. There will likely be enough of them with insurance or difficult patients.

Here are a few tips to help prepare a team in advance of encountering DSM-related obstacles.

  1. Education: Do this together as a team. It is essential to provide everyone with a foundation on which they can grow together. Understanding the clinical aspects of DSM is just as important as understanding all the processes involved with a successful DSM practice.  Before the team starts talking about Oral Appliance Therapy (OAT) with patients, an education plan needs to be established.. This education can be done remotely or live in person. Or both. It just needs to be done TOGETHER.
  2. Coaching: Ongoing coaching and support for the dental sleep team is vital to success. If the dentist is solely responsible for DSM in the practice, it will create a road block. DSM is largely team-driven. It takes a village. Be sure to team up with an organization that provides continual, ongoing coaching to help with everything from clinical aspects of DSM to case presentation and medical billing.
  3. Software: DSM has a lot of moving parts. Using a software developed especially for DSM in a dental practice will allow streamlining of all the processes and allow the team to stay organized so nothing falls through the cracks.  From screening tools to electronic medical billing, make sure the software is cloud-based, simple and easy for the team to use.
  4. Support: This includes utilizing a 3rd party medical biller to manage the medical billing process. Let the experts handle the medical billing. The nominal fees most charge are worth your team’s sanity and time.  Who better to help overcome DSM medical billing obstacles than an experienced medical biller who specializes in billing for DSM for dental practices?

To get started on the right path, contact me at 877.95.SNORE x2.  Our industry experts are available to provide all the education, coaching, software, and support to dental practices committed to making DSM a priority.

Better or Bitter?

Slowly, with some pain, I rolled over to turn off the clock radio alarm. Sammy Hagar blasting “I can’t drive 55.” That’s funny, I thought, since that particular day, I did in fact turn the double nickel. Sure, not everything works as well as it used to, and there is pain now where there used to be none, but I remain thankful for each day I get on this wonderful plan-et.

As I age, especially in my chosen profession of dentistry, I’ve found a challenge that I fight every day: bitterness.

Patients, staff, insurance companies, MD’s, sleep labs, the powers that be… Most days it seems they are ALL against me. I want to be-come an old man; I do NOT want to become a bitter old man and I fight this battle every single day.

So in between patients these days, instead of running to the gym, or taking a ten mile bike ride, like I used to do, I’m usually heading off to a doctor visit, if not to market my dental sleep practice, then for a person-al appointment. The dermatologist: several more skin cancers frozen off; one excised off the top of my head, but when she sewed it up, my ears were a little higher and I had a few less wrinkles. You get the picture. The good news, though, as my wife put it the other day, is that my frequent visits to the doctor have made me a better doctor. “Really”, I asked. She retorted, “You’re more patient with your patients now. You’re a better listener. You occasionally even believe what they tell you.” Wow! That’s not bitter. That’s BETTER!

Bitterness rears its ugly head every time someone in my office says the word “insurance.” Patients look me in the eyes, tell me they under-stand exactly how important it is that we treat their severe sleep apnea, and in the same breath, tell me they have to get their dog’s surgery done first.

“You know, those veterinarians aren’t like you real doctors; they want all their money up front, BEFORE you even get treatment!”

“Dr. PCP, what do you mean you won’t sign the LOMN? WHY not? The patient has a disease that is slowly sucking the life out of him each night. It’s knocking days, months, years off his life. Is it medically necessary to treat? Of course it is!”

“Dr. Drake, the insurance company has asked for more documentation before they will pay…..again. I’ve sent it to them several times al-ready…….”

If you’ve been practicing dental sleep medicine for any length of time, then you feel my pain. It’s a real challenge. But stay the course. Endure. Hang tough. Be persistent. Stick with it. Remain determined. Persevere.

Each day, we get to choose how we will respond to life’s challenges. Think of it all as a game. Get up for it. Play it. Play it well. Don’t let them get you down. Don’t let them pull you down to their level.

Take the high road. Your patients sleep better, feel better, and live longer, because of what you do. Now, why not you? Be the best you can be, and provide the best service to your patients you can.

Choose better over bitter.