The Economics of Efficiency

Part 1 - Recognize what the problem is

Instructors:

Dr. Chris Griffin, DDS

Dr. Chris Griffin, DDS

Dr. Chris Griffin founded The Capacity Academy in 2008, which focuses on helping dentists increase production and efficiency.  He has published several books and publishes an online magazine called, The Winning Dentist.

Dr. Chris Griffin reveals the issues that he learned were keeping him from being efficient.

Hey, everybody. This is Dr. Chris Griffin, a solo private practicing general dentist from Mississippi for the last 14 years. I founded the Capacity Academy for Dental Production in 2008. And ever since, we’ve been trying to increase the capacity and the production of dentist all around the country. Today, we’re going to talk about the economic of efficiency. Now I want to ask you guys a question. What would it mean if you could make your practice twice as productive as what it is right now? Just have that thought in your mind. I guess for you guys to understand where I’m coming from, let me share with you a little bit about how I got to where I’m at. And I made a lot of bad decisions along the way and let me share those too. So back in ’99, I’d went out into my own practice and I really hope and dream about all these things I thought dentistry would be. And as I started my new practice I found it very challenging. And I was always looking for the new thing or the new way to grow my practice. And so somehow along the way in early 2000 I stumble into one of those famous institutes. You know the ones you hear about or you heard so much about back in the early 2000 and late 90’s especially. And so I went out there and I guess I drank the cool aid a little bit and came back to Mississippi and I thought you know what, I’m going to be the best cosmetic dentist in the history of the United States of America. You know that’s the craziest thing you’ve ever heard now. But it’s really true. That’s what I thought. And so I come home and I try to turn what I had started creating as a very good little general practice into this boutique practice. You know in Mississippi, thing just did not fly the way that they told us at the institute they would. They told us if we practice this certain way and we were great at veneers and great at cosmetic that everything just fall into place and people would flock to our doors. But that’s not really how it happened. And so I took a growing practice and I sure enough nearly bankrupt that thing. I took it from a good solid production all the way down to basically nothing. A good example of that is you know how it’s hard to tell how your hygiene department is doing for about six months because that’s how we do recare in hygiene. So, the February after I came back from one of my institute trip I started this new hygiene policy. And we just had our greatest hygiene production ever that month. And it was I think $14,000 at that time. I thought that was the same as a million bucks. Six months later after all of these policies I was putting in place from the institute, we were down to $7,000 in hygiene. And I was really in a lot of debt. I didn’t know what to do and I was just drowning. Well let me share with you guys some of the things that I did that got me to that place. And let me see if you have made the same mistakes yourself. So one of the first things I did I came back and I jack my prices sky high. Now I know right now that sounds crazy especially in this economy. But back then I thought it sounded okay. Let’s just be the highest guy in town. In fact, at the institute they would tell you if you’re considered the most expensive guy in town, a lot of times people think you’re the best. So I did that. I told a lot of patients that had insurance that I didn’t want to accept that I just could not be the quality dentist that I wanted to be if I was a member of their insurance plan. I tell you a good example is Delta Dental. When I went to the institute I had 99 Delta Dental patients. A factory in town had Delta Dental insurance and sure enough I had 99 patients. And I took a letter that I’d crafted at the institute while I was there saying this very thing. I’m just such a quality dentist now I just can’t be your dentist for these prices but I really love for you to stay in my practice. I think we’ll give you a very high quality care. Well one year later does anyone out there want to guess how many Delta Dental patients I had in my practice? Two. And let me tell you what’s bad about that. I had more two who were relatives of mine and they still left the practice, right. The hygiene I was telling you guys about. I was force-feeding those big hygiene programs down my patient’s throat. That’s why so many left and drove. That was the whole problem. I had taken some courses along the way too where you’re supposed to always let your staff and your team, you’re supposed to let them sort of tell you how to run the practice. If your staff is happy, everybody will be happy. I even took classes where it said your staff should take precedence over your customers or your patients. Well hey I’m drinking the cool aid. I did that too. In fact, I was always a little bit scared of my staff because I wasn’t a 100% sure how to coach them, how to teach them, how to say anything they didn’t like. When they would fight back, when I would introduce a policy and they would push back even just a little bit of a push back, I was such a total wimp about it. I would just them tell me what they want to do, the hours they want. I let them tell me how many sick days they wanted. How many vacation days. I mean I was doing all that stuff. So I’m trying to keep them happy. I started not one but two bonus programs which grew such a disproportion manner their income grew as oppose to mine that those also added the money problems in the practice. Then I thought well golly if I can just certify myself in all these fancy new types of dentistry maybe that will work. Maybe people will just flock on my doorsteps. So I went to the institute for cosmetic dentistry and I got certified in that. I went and took I think at one time I’d taken 200 or 300 orthodontic hours in a couple of years. I still do braces these days but I thought golly I’ll be the orthodontist, general dentist orthodontist in town but that didn’t just blow things up. I got certified in IV sedation. I thought well that of course is going to do it. All those things are good things but they couldn’t build the foundation of the practice that you really going to have. And I’ll talk about that later. I really believe in this age that you’ve got to have such a solid foundation of your practice with general dentistry and hygiene that this sort of throws off dentistry. It makes everything else easier. But back then I was trying to certify myself to success. Another thing that I look back on and I kind of cringe is we would have people in the practice and in the event that they made it through the very long and strenuous new patient exam that I offer and still wanted to be my patient and let’s say they had a broken tooth and they wanted to do a crown today. Well my staff convinced me we were so busy. We’re talking about production level of fifths probably of the level we’re at now or less. We’re just so busy we just couldn’t work him into the schedule. All those things added up. You couple that with the trait that I have where I have tried to work my way out of it that most dentist also have that is very difficult for me to delegate anything. The staff I was always micromanaging and I was always trying to take all this stuff on myself. The truth is I was just scared to turn things loose because I was afraid it could get worst. But all of these things were just bearing down on me. I was really stressed out about it and I really didn’t know what to do. I thought I was going in a bad direction but so many people were saying Chris just stay with it. Stay with this concept. If you just stay with it, it’s going to eventually work out. Then one of the last times I ever went out to the institutes I was on my way to the airport and pop in a cassette tape. You know back then you have cassette tapes, right. So I always subscribes to these cassette of the month clubs. And one was a dentist named Scott Perkins and he was talking about clinical efficiency. I thought man that sounds really good. I think I’d be good at being really efficient and I know right now we’re so inefficient it’s terrible. And another one was by a doctor named Roy Smith, Dr. Roy Smith from Taylor, Texas. And he talked about some of the same things that I was experiencing and how he had build up a general practice very big and it allowed him to be the dentist that he wanted to be later on. So I know when I talk about a big general practice a lot of you are thinking well Chris that’s all well and good. But those big practices they’re just…they’re so stressful. They’re so hard to manage. I just don’t know if I can do something like that without getting really stress out. And I didn’t either honestly. I didn’t know if I could do it. But I’d heard Roy and Scott talk about it. I’d been out in the institute. It just didn’t feel right the way they were teaching things. So I face reality and I said Chris I think this is the kind of practice that will work in Mississippi. You know, we’re one of those states that Forbes just declare a death spiral state because we have such a low level of income and people just could not seem to afford the dentistry I was trying to do. So I got down. I had all those cassettes and I sort of made a list out of all the dentists that I want to travel and see. And so I started working down the list. Now interesting thing happened along the way. I would call up these dentists and I would say hey. For example Dr. Smith or Dr. Monticello. My name is Dr. Chris Griffin, I’d love to come visit and learn from your practice. I’ve heard great things about you. Could I please come? And I think that every single dentists I ever asked to come see their practice let me come. They were generous and nice to me and I learned from each one of them. And I made a little graph and it shows how my practice production level grew as I went to see each dentist. And I always joke around with Dr. Roy that one time after I came I went down a little bit and then I went back up after I went see him the second time but it was just because I actually carried my staff the second time. And he jokes back that my staff is obviously smarter than me and that’s why when I carry them the practice went up that time. But if you look at the body work that I learned about those doctors, I’m calling them the blueprint doctors for now, one thing they had a common they didn’t have these amazing skills. They weren’t these like, I mean they’re very good. Don’t get me wrong. Tremendous clinicians. But I wouldn’t say that any of them were like Michelangelo with a drill. I don’t know if any of them had 200 IQ. I don’t know if they were geniuses. They did have great staff, all of them. But mainly I think the one thing I took away from visiting all those dentist was their mindset, their mindset was just so focus and in tune and a lot of them focus on the business aspects and the clinical aspects and sort of mix them together. And so that really appeal to me because I love studying the business side of things. And of course my business was doing terrible at the time. So after that I wanted to come home and train my team. Now I hope you’re paying attention to this because this is also I’m kind of giving you a blueprint of how that you kind of have to work through things because it’s real easy to say okay you need to be twice as productive as you are right now. But it’s quite another to make yourself twice as productive, right? So what I’m sharing with you, these are all the hard knocks I went through. And hopefully, if you kind of follow the same blueprint I did then you can make these same results happen for yourself. So we formed a blueprint from the doctors I visited. The next step we had to train our team to follow the things that we wanted to change. So coaching is something that I you know. I like to play ball but I’ve never been much of a coach. I didn’t really know how to coach. One thing I did and this may seem crazy to you but this is the way I approach it. I want to be a better coach so I actually wrote personal handwritten letters to who I though were maybe the 50 best college best basketball coaches in America. I asked them very simple one question each and I asked them how they approach coaching their team to very good, team work performance. Now very few responded. I think maybe three responded, maybe four. The best was a guy named Coach John Calipari who’s now coach of the Kentucky Wildcats. At that time he was in Memphis. He actually wrote me back a whole page. And this is the letter that Coach Cal wrote back to me. I mean he was so great in writing me this letter. I mean maybe its nothing earth shattering but hey when a guy like him writes you, you should pay attention. One of the funniest things I got back was coach Bobby Knight who used to coach Indiana. He sent no personal response back but he did send an order form for autograph memorabilia if I would like to purchase any of that. So I thought that was pretty good. So I’m studying. And one thing that is a fair question is why we need to go to all these extra effort. I mean is it not just easier to do what we’re doing, just keep getting by. Maybe just do something else. A lot of dentists are looking for other things to do beside dentistry. But what I would like to share with you through my story and what I learned is that maybe there are things that are available to you through dentistry that you’re really not aware of. Maybe there are things you can do that you don’t know you can do.