Courage vs. Fear

Friday FINISH – March 13, 2020

Due to the Coronavirus panic of March 2020, my weekend plans to Lake Tahoe were cancelled for an anniversary getaway my wife and I had been so excited for. We were pretty bummed about the adventure we had to put on hold, but knew it was the safer bet. Truthfully we weren’t that concerned about the actual virus, but more concerned about being quarantined away from our kids or stuck on a tarmac somewhere. I hate acting out of fear, and felt that was what we were doing at the time, but we had put our kids and family first. The majority of news and media were speaking doomsday talk as the stock market had it’s biggest day down since the 1987 crash. Schools cancelled, churches cancelled, Spring Breaks extended on college campuses – with the understanding that they would likely have to finish the semester online. Apparently the Costco near my home did 1.2 million in sales on its biggest day during the Christmas season just a few months prior, but went on to earn 1.5 million on March 12th, with people lined up out the door to get napkins, paper products and bulk food. (An valuable lesson on how Costco was prepared and capitalized on it.)

The first day of our Tahoe trip was going to be business, it was an office design tour that I wanted to attend to extract some ideas from for my new building in progress. I was excited to get some big picture ideas and further develop my plan for this big, long-term investment for my team, our patients and my family. 

I strongly believe that there is a reason for everything, even when I can’t understand why. I am a man of faith, and know that when one door closes, another opens. I’ve been frustrated so many times in the past when something didn’t work out, that finally one day I realized to always look for the opportunity in a good or bad experience. I have always been a glass half-full kind of guy, but I also have a short temper about certain things, and have let that get in the way too many times, only to later realize how much limited time and precious energy were wasted on getting hung up on something that later I would laugh about or feel foolish for being so short sighted. 

Through the many ups and downs of life’s adventures, I’ve learned that the quicker I can turn “skinning my knees” into squeezing out the valuable lessons and using them as a stepping stone for improving my life plan, the easier it is to find the nuggets of wisdom in an experience. 

John Maxwell calls these “learning opportunities” and terms it “failing forward.” I once read that in business we have only two outcomes from an event, 1) learning opportunities and 2) success – there are no actual failures. We can fail at something, but we shouldn’t label someone as a “failure” based on one static moment in time. Schools are notorious for motivating us more out of fear of not failing rather than the creative output that can come from the right kind of motivation inspiring real learning. All of this may sound too idealistic to you at first glance, but if you develop this mindset it sure makes it a lot easier to sleep at night. Some of my biggest failures in the past have totally changed my business and leadership outlook for the better, even though it took some time to develop. 

Plato is quoted as saying “courage is knowing what not to fear.” This is more important during a virtual outbreak, stock market crash or slow month in your practice. You can’t live in fear and have a good life. Not only does it make you feel terrible, but it does not allow your creative mind the ability to grow and produce new ideas and systems to build up your practice, taking your thermometer (we use whiteboard thermometers to measure production and collections on a monthly basis) of progress to the next level.

Remember to stay ahead of the majority, because as Dan Kennedy says, the majority is usually wrong, otherwise the 80/20 rule wouldn’t apply, nor would the most productive and most wealthy people be where they are today. They are the minority. Developing your mind, your education and your team is one of the best ways to avoid living in fear and to live in a mindset of growth and abundance. If the economy zigs, it’s time for you to zag. Do the opposite. If you have to close for a few days due to unforeseen circumstances, use them as personal days or planning days to boost your morale and inspire bold new ideas to take your team and practice to the next level.

Have a fantastic week!

If you would like to receive more information like this or provide your feedback, simply send me an email at twilliams@yourpracticegrowth.com and put “Friday Finish” in the subject line. 

Rinse, Return, Repeat. Be the “Dropbox” Tortoise.

Friday FINISH – March 6, 2020

We’ve all heard the story of the tortoise and the hare. Essentially the tortoise wins because he has the long-term, marathon mentality, while the hare is on a stop-go, unfocused, take-it-for granted run. Marketing legend Dan Kennedy says that people start quitting your business or lose interest the minute they start. Studies in psychology of buying have found that as buyers, our interest is highest right when we purchase something. Then it immediately begins to drop. Sometimes that act of going to buy or knowing what you are going to buy generates more “feel-goodness” than does the actual product or service that you receive.

For example, if you’re buying a new car, day one is the most exciting, and then it fades every day from there, until you either 1) begin to take it for granted, 2) get tired of it, or 3) feel you need to buy a new one. It’s how I’ve always felt about Christmas – meaning that Christmas Eve is the MOST exciting day of the season for me, because of all the excitement and anticipation (and knowing the holiday rush will soon be over). 

So you have to keep things interesting, new and exciting, constantly building the relationship to bring your patients back for their next visit. The day of their checkup or new implant is THE most exciting day for your patient. It’s also the best time to help them accept more treatment and get them scheduled for their next visit, because the feel-good feelings are at their highest on that day. 

How do you celebrate with them? What unexpected extras do you offer them?

This is why I believe most hygiene programs in our practices are underutilized. The perceived need of doctor treatment is higher: pain, broken teeth, bad breath, bleeding mouth, all of them feel more important to the average person, and therefore people will pay more and come in sooner to have these services done. 

Where are the highest opportunity recurring collections (revenue) in your practice?

When it comes to prevention (a word that does not have any sizzle or excitement) people put it off, even though in fact everyone DOES NEED a checkup and cleaning periodically based on the needs of our mouths. Hygiene is also a huge source of recurring revenue, and with a trained hygienist and recare program, it is the closest thing to passive income you can gain in your practice if you are a solo doctor. 

Here’s how Dropbox has done well with their recurring revenue program. “Dropbox makes file-sharing software that enables collaboration among work teams. Users pay a monthly fee for larger storage space. Thus, converting free users to paid accounts is a key growth driver. Of more than 600 million users, only 14.3 million were paying customers at the end of 2019. That’s up nearly 12% from 2018….One of the company’s main metrics is total annual recurring revenue, which is the key indicator of the trajectory of its business performance….It represents the amount of revenue Dropbox expects to recur, helps measure the progress of initiatives, and serves as an indicator of future growth. In the fourth quarter, total annual recurring revenue was $1.82 billion, up 3% from Q3 and about 20% from the year-ago period.” (-Juan Carlos Arancibia, March 2020 – investors.com)

Dropbox is a great example of how to build a recurring collections stream in your practice. Offer something valuable for people to join (for them a free basic plan) and then focus on creating a lifetime customer (or patient) who pays you monthly/annually and continually gets great value in the product or service. 

Other ways to build recurring revenue into your practice include hiring associates, well trained assistants, and offering payment plans. Just ensure you have daily reports to track all of these metrics and hold the proper team members accountable to reporting back on them. 

A great exercise this week is to break down your collections by the following:

  • Hygiene collections by provider
  • Doctor collections by provider
  • 0-30 Accounts receivable, 31-60 accounts receivable, 61-90 accounts receivable, 90+ accounts receivable (90+ is what we call “bad AR” in the extreme danger zone, unless it’s part of a current payment plan)
  • Over the counter collections (non insurance)
  • Insurance collections

Average these out with 6-12 months of data, and you’ll soon see where your revenue (collections) really come from. This will help you make better decisions on things such as adding more providers, offering more or less payment plans, accepting or dropping insurance plans, etc.  In my office I was pleasantly surprised years ago to see that nearly 2/3 of our payments come from patients, whether cash pay or copayment. For my practice philosophy, this means I’m not overly dependent on insurance which wouldn’t match our service model. Even though we are very insurance friendly in my practice, we don’t belive in making decisions solely based on insurance alone. But my office and yours are different, and so will your recipe be for success. You just need to make sure you have the right ingredients to flourish. 

Have a great week!

Ocean Stingrays In Your Practice?

Friday FINISH – February 28, 2020

The past week my family enjoyed a fantastic vacation in Puerto Vallarta, Mexico. It was my surprise Christmas gift to my wife and kids this past Christmas. If you haven’t been, to Puerto Vallarta I highly recommend it, we went the all-inclusive route and it had everything we needed for a great time. Plus it’s an under 4 hour direct flight for us from Salt Lake City.

We did leave the resorts a few times on some Uber rides for a visit into downtown with a stop at Walmart (an new experience for us – did you know they sell motorcycles and stoves at Walmarts in Mexico?), and the following day a water taxi and waterfall hike in Quixmito (highly recommend) where we also found some awesome street tacos – just remember to bring Pesos because the village near Quixmito is very small and the one ATM machine they had was stolen recently. Off-site excursions are a lot of fun if you like to explore – but certainly not needed to enjoy the experience. My kids had all of the beach time, boogie boarding, pool time, catamaran ride, arcade and football games, shuffleboard, virgin drinks at the juice bar, and nighttime shows they could handle. Plus the reserved restaurants had some fantastic fish tacos and Chile Relleno. 

I don’t know if the trip could have gone much better. There were some pretty funny moments that you get with a trip that are unexpected but memorable. For me, it was when I shut our res port beach rental booth down for a day with the “Purple Flag” from receiving my first (and hopefully only) Stingray sting. 

The beach rental company outside of our hotel had 4 flag colors posted each day. Green – safe water, yellow – use caution with larger waves, red – not safe for being in the water, and purple – dangerous marine wildlife/not safe in the water. We mostly had yellow conditions during our stay, which worked just fine, and only a few hours of red flag warnings one day. But on our last day, three of the five of us were boogie boarding, when suddenly I felt two quick, sharp “bites” on my right ankle, one just over the bone and one near my Achilles’ tendon. It was so quick and intense, like a nail was pushed through my foot. I scooted across the next wave so fast I was back to shore in seconds – definitely winning my wife on that ride.

When I sat down to observe what had just happened, I thought maybe something bit me because I was struck in 2 areas. It appears that the stinger first tried to hit me in the ankle bone, but when it couldn’t get through it punctured me on the softer part of my foot instead. I had a 3-inch welt and minor bleeding, and my foot began to feel numb, as it does when you sit on your leg funny and it “falls asleep.”

After some reading up on it later that day, I discovered that Stingrays are not aggressive toward humans, and only sting you to defend themselves if you step on one. Typically they swim in families and park in the sand during afternoon hours. (Hence the purple flag, when word got around in the resort that I was stung, they put that warning flag up because there are likely many more Stingrays out. I was the one people kept saying when we were in conversation “so, you’re the guy we heard about that was stung.”) The “Stingray Shuffle” is the trick that surfers do as they scoot their feet along the sand, to create movement. This warns Stingrays someone is coming and they swim away to avoid danger – now I’ll be dragging my feet more often!

What was I really afraid of?

I wasn’t afraid of the pain or the bruise, but being a rookie, I wanted to ensure I wouldn’t have an allergic reaction or infection. So I asked a resort employee and they said “Stingray” and I was quickly escorted to the on-site clinic. The doctor was very friendly with a warm Mexican smile and laugh. He took me right into his one room chair, where before I knew it I was being prepped for injections and given a bunch of pills I couldn’t recognize. Through his broken English I understood I would receive some localized numbing, followed by a cortisone shot so that the tingling in my foot didn’t radiate higher. Then he applied some steroid and antibiotic cream to the wound and a bandage. The unmarked pills he gave me were painkillers and antihistamines (Claritin) – I skipped taking the painkillers because I prefer Tylenol + ibuprofen over the counter, but took the Claritin. Then I was over to the ATM (walking great!) grabbing some cash to pay for the service. 

Within a couple hours I the discomfort was 90% gone, and I was happy to know that all along the way I could resume our beach activities. I was very grateful for the experience, because it could have been much worse! NPR reported in 2014 that on Seal Beach in California, nearly 16,000 Stingrays dwell in the water, but only about 400 stings are reported each year. Most people heal just fine afterward. Of course there are the fluke happenings, like when our favorite Crocodile Hunter, Steve Irwin was stung in the chest, and it penetrated his heart and took his life back in 2006. That was a sad day for our family, we used to love watching his passion for animals and wildlife. 

What kinds of “stings” terrify you in your practice? Do you stay up at night worrying about payroll, employees leaving, or where you’re new patient sources will come from? It would be easy for me to quit and never go back into the ocean again. Statistically it will probably never happen to me again. But most importantly, I can’t let one sting keep me from enjoying a vacation with my family. Even if I was stung again, I’d be better prepared and know what to do next. 

If you have anything that is “stinging” your practice or professional career right now, please reach out to me and let me know how I can help!

Have a wonderful weekend and strong FINISH today!

One Dimensional Marketing

Friday Finish – February 21, 2020

“One is the loneliest number.” This song by Harry Nilsson topped the Billboard charts in 1969, and it’s lyrics still ring true today.

According to Investor’s Business Daily, “On Monday, Apple warned that it likely will not meet its guidance for the current quarter because of business interruptions related to the outbreak of the current coronavirus strain known as Covid-19.

‘Work is starting to resume around the country, but we are experiencing a slower return to normal conditions than we had anticipated,’ the company said in a note to investors. Apple said its worldwide iPhone supply has been constrained by the factory closures in China due to Covid-19.”

This brings up an important point regarding your marketing, and your source(s) of new patients. 

HOW MANY GOOD SOURCES DO YOU HAVE?

I hope, and could probably guess that Apple has a backup plan in case their sources of electronics in China ever dried up, but can you imagine if your supplier of parts and pieces of your iPhone and other Apple products suddenly cut you off?

What are your best sources of new patients in your practice? How many do you have? Do you review this weekly with your office manager or marketing team?

If for example insurance is your main source for new patients, and suddenly a large local employer drops that plan, how will that impact your practice? Google changes its algorithm weekly, if not daily. If you’re new patients come primarily from Google search, like many of ours do, and out of the blue Google drops your listing or says your ads are no longer approved, how will this affect your practice?

Imagine you are filling a large bathtub when growthing your practice, not only do you need to plug the leaks to prevent it draining (and there are always a few leaks that you can never fully stop, but you should contain and slow them to a very small drip), but you also need to constantly find new ways to keep the faucet flowing. 

If your practice only has one “faucet” or source for new patients and that faucet breaks, how long until you have it fixed? What ways will you be impacted in the meantime?

A year or so ago, someone who was managing part of our online marketing, let Google change our listing type into a hospital instead of a dental office, and guess what happened? You got it – boom – no more new patients from Google for weeks until we figured it out. We weren’t coming up on any local searches for the word “dentist” at all. Luckily, since we watch the numbers on a daily and weekly basis, we noticed the problem internally and made quick adjustments. We soon had to fire our online listing manager for being so neglectful. His job was to monitor this regularly, and he let weeks go by without even noticing – we had to find it on our own.

Fortunately, this was not our only new patient source so we recovered just fine. But if we had no other marketing sources except this one, we could have been in deep trouble or even financial ruin, especially if we were the size of Apple. (A big advantage of running a small business is it’s usually easier to turn the ship around when you approach dangerous waters.) We had more than one “faucet” filling our tub so we weathered the storm just fine and learned from the experience. 

The message this week: always be looking for new ways to improve your current lead sources, and find the new one’s that are performing with at least a 3:1 front end ROI. Make your marketing plan multidimensional, always with a contingency plan

Have a fantastic weekend!

If you would like to receive more information like this or provide your feedback, simply send me an email at twilliams@pinecrestdds.com and put “Friday Finish” in the subject line. 

What do you LOVE?

Friday FINISH – February 14, 2020

Your are the reason we love Practice Growth!

Today is Valentine’s Day.

So, what do you really LOVE? What gets you out of bed in the morning? Who around you do you love? Do you love your job? Your practice? What hobbies do you love? What recreation do you love to participate in? These are all important things to recognize, not just for what and who they are, but for your mental and physical health.

I could work more than I do if I had to (not that it would be healthy to do so), especially on the practice because I love being in the “lab” of testing new ideas to grow my awesome team, make our patient experience better, and new ways to hit our goals with marketing. It gets me excited to jump out of bed each morning. 

When we reflect on the story of St. Valentine, we think of love. But he represented not just love in general, but courtly love – which ties into chivalry and respect. Interestingly, St. Valentine was also the patron saint of epilepsy according to the Epilepsy Foundation. This was thought to be derived from medieval times when people with illnesses would not just medical advice, but would also seek spiritual guidance for help.

I hope you have a fantastic Valentine’s Day with those you love. YODA reason we love helping other practices reach their potential

If I can help in any way, please reach out. Have a fantastic week!

If you want to receive more information like this, simply send me an email at twilliams@pinecrestdds.com and put “Friday Finish” in the subject line.