You Have Four Options: Which One Will You Choose?

Our current crisis will end at some point. How long will it last and how tough will it be, nobody knows, but it will end and we will be practicing again. So, the question is: what are you doing now to get ready for when we do go back to treating patients in a regular way?

I was recently reading Grant Cardone’s book, The 10 X rule. Grant is a self-made entrepreneur, businessman and he has only one speed: fast forward. Love him or hate him he certainly has inspired many entrepreneurs and small business owners to new heights.

The 10X Rule has many interesting concepts related to “success”, but with regard to the topic of business “options”, he states that you have four choices when it comes to growing your business: retreat, do nothing, take normal business actions and take massive business action. Let’s explore all of these.

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The first one, “retreat”, isn’t something that any normal business owner would take. It would mean literally going backwards with your business which I couldn’t imagine anyone doing, so let’s go to the next option

If one were to truly “do nothing”, they would have to do something. This means firing the team and putting them on unemployment, putting the phone on voicemail with a message that someone will call them back when this was all over, handling just an emergency number and sitting at home basically taking a vacation until we get back. I don’t really know anybody doing this either. It’s an option, but it certainly can’t be helping your business.

I’d say that most orthodontist have been “taking normal business actions”. Handling the team (either firing them or keeping them on payroll or some combination), dealing with incoming calls and emails, reducing costs across the board, reducing advertising spends, handling emergencies, taking some CE, contacting scheduled patients, maybe some virtual exams, watch some webinars, read a book on growth or leadership here and there, Zoom meetings with the team once or twice a week, follow the PPP situation and hunker down for much needed time with the family or focus on their personal growth. Seems like a very fair and appropriate approach. It’ll mean that they’ll come out of this with probably the same footprint they went in.

What if you took “massive action”, though? What would that look like? Imagine all of the aforementioned actions from “normal business actions” and adding things like posting a daily youtube video for prospective patients, writing a blog article every day, connecting with existing patients in unique and interesting ways, massive number of social media postings, new patient virtual exams with a click funnel to drive patients there, significantly increased ad spends because the “per click” costs would be down these days, work on revamping the website for content and SEO, daily meetings with specific members of the team for marketing, growth and systems meetings, outreach to local community leaders and schools to help in any way possible, new technology testing to see how to make the practice experience easier and seamless, working on daily systems and policies with the team, having team members assigned specific tasks, webinars and reading topics specific to their jobs, take out a motivational billboard on a busy highway, and more.

You see, the idea is to go “massive” and most of it does not require a ton of capital. It’s about time. You have lots of that. There are 168 hours in every day. You sleep about 30% of the day, and spend another 30% with your family.  Maybe 10% of the week for fitness and eating. You can’t leave your house, so you have 30% of your week left for your business. That’s 50.4 hours a week leftover for your business. Sure, you can watch Tiger King or Hunters or some trending show, but remember, this isn’t a vacation and we are talking about “MASSIVE ACTION” here. So, you CAN do everything I mentioned above and more.

Yeah, it’s a lot of work, but imagine emerging from this with a stronger practice than you had before. That would be amazing, right? Less stress, more growth.

Like I said above, you have 4 options. Which one will you choose?

I’d love to hear your thoughts.

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we come together to help each other build better practices and lower stress, please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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Technology and Overhead: Can They Coexist?

The Coronavirus pandemic has caused us to shut down the face to face interactions we’ve been used to. As a result, many new (and older) technologies have moved to the forefront. Many have changed the way they’re practicing and the conversations have turned to things like virtual exams and teliomedicine options. Moreover, the discussions have gone further to suggest that this virus might have made changes to the way we will all practice moving forward.

At the same time, there has been much discussion about running practices on “skeleton” crews with significantly reduced overhead. Doctors have described how great it’s been connecting with their patients while answering phones, taking all emergencies and doing things they may not have done in years. Many have mentioned how “simple” it was when they saw fewer patients and had smaller teams with lower overall overhead.

This leads to the question: When all of this is over, will we adopt more technology to help make our practices more efficient and will these technologies really deliver on their promise of making us more profitable through their efficiency?

Video conferencing has been around forever and the costs aren’t that high. But what about machine learning programs to help track treatment, texting apps, software to schedule online exams, virtual assistants, online documentation signing software, software to create in-house aligners, virtual payment portals, and on and on. Everything has a price and someone has to pay that price.

One could make the argument that each of these softwares and technologies are essential in today’s environment and that if we are to tailor the experience to the needs of our clients, we need to be heading down that road. Can we afford this?

Historically, a well-run orthodontic practice in a suburban area can run effectively at a 50-60% overhead. Let’s be honest, very few orthodontists have starved. However, every penny spent on technology is a penny out of the practice owner’s pocket, so it needs to make sense.

The biggest problem used to be the cost of acquiring new technology. For instance, a new compressor or Pan/Ceph cost a lot. What’s changed is that everything now comes with the ever present “monthly fee”, so while you might not spend much for a new app, software or device up front, one could find themselves with thousands of dollars in monthly fees just from the ongoing maintenance of the practices upgrades. In perpetuity.

Which technological advances REALLY make us money or pay for themselves through efficiencies and which technologies are just “cool” to have?

Every doctor needs to make the decision for themselves and figure out how to make them affordable. It used to be that one simply “raised their fees” to accommodate the increase in practice costs, however, today’s market-and recent economic downturn-make raising fees a difficult option.

To be honest, after 27 years in practice (albeit only 5 in orthodontics) I have come to rely on those around me and the technology available to reduce my stress and make practice more enjoyable. Yes, it makes my overhead higher, and yes, I can tend to get excited about introducing new technology into the practice, but my partner helps us decide what’s right and what’s affordable. An extra set of eyes on most decisions is a great help.

So, which apps/programs/software/devices make the most sense to you? Which ones are the ones that our patients will demand AND recoup their costs?

I’d love to hear your thoughts.

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we come together to help each other build better practices and lower stress, please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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How Will You Emerge Stronger…?

At the time of this writing, most orthodontists in the US are either “closed” to routine care, or headed in that direction for anywhere from 2 weeks to 3 months and in some cases, “indefinitely” .

A lot of the recent discussion has been around what to do with teams, governments, loans and the now ubiquitous “virtual” exams and consultations. Yes, I think it’s important to create strategies and protocols to mitigate the impact on our practices as well as figure out how to serve our patients who are in active care, with no ability for us to actually actively treat them. However, there is one discussion that seems to be in the background…

How can we use this impending down time in our practices to come back stronger when this is over?

Yes, the Coronavirus will not be the end of humanity or orthodontics and there will be a time -in weeks or months from now- when we will go back to operating our practices with a “business as usual” approach. I know it sounds crazy right now, and things are likely to get worse before they get better, but it will happen. So, rather than worrying about things we cannot change, I have a suggestion.

Work on yourself as a leader, manager and entrepreneur while you have the chance.

Sure, it’ll be great to spend time with family…in isolation…for a while. Don’t get me wrong. I LOVE my family, but I can tell you that our two favorite days of the year are the day school ends and the day it starts again. It’ll be great taking walks, going on bike rides and spending quality time as a family while we endure our sequester. Maybe you can learn how to play an instrument, write a book, master a new game or app. That’s all amazing stuff to do.

However, there will be a lot of hours in a lot of days that you simply haven’t had up until now and won’t possibly get again. Use them wisely to help your practice emerge with a stronger core.

There are so many resources out there for you to develop your “emergence strategy” using books, webinars and online workshops. Ever wanted to become an expert in Photoshop so you can edit images? There are online workshops. Want to learn Adobe Premiere Pro to edit videos for social media? There are resources. Want a new logo? Master your PM software? Clean up your virtual case photo albums for your practice?  For everything from business plans to entrepreneurial goal setting, management courses to books on adapting to chaos, it’s all there for you.

So, knowing the resources are there and you have a lot of time on your hands, what steps are you committed to taking to make your life better when we go back to work?

You’ll have the time, but will you have the discipline?

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we come together to help each other build better practices and lower stress, please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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Folks, Let’s Be Smart…

Let me start with as much clarity as I can convey that I AM taking this Covid-19 virus seriously. This week, I spent 2 hrs on the phone with my parents who are both in the highest risk group. They’re both over 75, my mom has multiple sclerosis and my dad is 5 weeks removed from a kidney transplant and is as immunocompromised as they come.

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Both of my parents fall into the “70-75” age group but their susceptibility, because of their immunocompromised systems, is much higher. This is a VERY real situation for me.

I’ve also (like may of you) spent the last 4 or 5 weeks glued to the CDC and WHO websites watching what’s been happening well before the virus started growing in the US. I’ve always been fascinated by epidemiology and this has been a remarkable time to watch the global pandemic situation.

So, my comments below shouldn’t be misconstrued as ambivalent or not caring about every single soul affected by this horrible virus.

We’ve all been reading articles penned by, and podcasts including experts from the medical fields. Social media has been full of stories about “My friend the infectious disease specialist told me…” and “My family in South Korea said…” and so on. We’ve been lucky enough to see academic articles on the spread of Coronavirus in the dental setting and most of us have made videos or sent letters to our patients explaining the situations in our offices.

Next came lots of conjecture. “What are you going to do in your office this week?” The answers included everything from following the ADA recommendations to the letter, to closing up shop, to having people wait in cars until their appointments, to “not much else because it’s just like the flu and we’ve always used universal precautions.”

Are we really going to tell people to stop wearing aligners and elastics indefinitely because it causes them to put their fingers in their mouths and we can’t trust them to sanitize afterwards?

We’ve seen enough graphs and charts to make our heads spin and everyone telling us what they know “for sure” when we’re truly in uncharted territory. It is 100% true that if we “can stop the virus now, our healthcare system might not be overburdened.”

But here’e the thing: We’re not shutting down. Go on social media to see proof that while schools are closed, the common gathering places like malls, supermarkets, coffee houses, gyms, Costcos, churches, nail salons, dentists, doctors, parties, etc are still happening. All over the county. Borders are open. Interstate travel is open. Pediatric dentists that I personally know have added days into their schedule because of all the parents wanting treatment RIGHT NOW because of the fear of potential loss of insurance due to perceived layoffs due to the economic impact of many of the necessary preventative measures.

Yet, orthodontists-arguably the least invasive practitioners in dentistry-are considering shutting down their offices, or perhaps being shut down by the government. Is this the right approach? With all of the other areas of daily communal life still open, does shutting down your office really make sense?

On one hand, the idea that “I can make a difference” is somewhat true. If you shut down your office, less people have the opportunity to transmit to one another in your space. But until they stop going to church, supermarkets and all the other places listed above where they will run into and interact with WAY WAY more people in an environment that isn’t watching out for them, what difference does it really make? Are you sacrificing your livelihood and the livelihood of your team and the welfare of your patients who need your care for no really good reason? That is NOT a rhetorical question, but rather one we need to ask ourselves.

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How infectious is Coronavirus? The “R0” for Covid-19 is around 2-2.5 and the seasonal flu is around 1.4. For a virus to spread and survive in a population, it must be above 1.

If you REALLY want to know how China imposed a quarantine, read this article HERE and see that what we, as a society are calling for is nothing compared to what they did. But it raises a far more important question. It took over two months IN CHINA with what are being called “Draconian measures” for the virus to reach past its peak tipping point. And they need to continue the measures and they are FAR MORE vigilant than we will be.

So, if you’re thinking of shutting down your office for a week or two, think about this:  It’s going to take months for this to pass if we want to look at China or Italy or South Korea as an example. Are you prepared to shut down or delay your patients’ treatment for 3-5 months? Moreover, looking at this from a logical standpoint, if you’re truly worried about transmitting this disease from patient to patient, and you’re going to close when there are 1600 active known cases in the United States, shouldn’t you FOR SURE be closed when that number hits 20,000 or 50,000 or 500,000? What’s the sense in closing for two weeks and reopening when the chance of a known carrier in your office is much more likely.

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Testing in the US has been pretty light considering we’re “quarantining” the population. Due to the non-severity of symptoms in the general population and the similarity to colds and flu, the number of actual cases is probably much higher than the estimates.

My point is that let’s not -as orthodontist and NOT epidemiologists or infectious disease experts-decide what’s the right or wrong path. Let’s not get on to social media and say “My wife is a doctor and she suggested..” or “My friend is an epidemiologist and he suggested…” or “My practice financial manager/CPA put out a letter that suggested…”.

The economic impact is uncertain. People aren’t making orthodontists a priority right now and the idea of us being out of business AND having to pay our team can be downright frightening for those starting their practices. As of the writing of this article, the Coronavirus Jobs Bill  (learn more HERE at the NY Times article) might affect us because of paid leave but also states “…and the Labor Department will have the option of exempting workers at any company with fewer than 50 employees, if it determines that providing paid leave ‘would jeopardize the viability of the business as a going concern.’ ”

I appreciate it when I hear orthodontists say: “I’m going to pay my team even if it means that I can’t take a salary” and while admirable, is that really viable in the long-term? If your office is shut down for 2, 4 ,8 or 16 weeks, at what point does your family have to play a role in this? Are you ready and certain that the financial policies you enact right now are implementable in the longer-term? I’m just suggesting that you think wisely before implementing any policies.

Let’s listen to the protocols and procedures suggested by our parent organizations and do the best we can to protect our patients, ourselves and our team members. There ARE resources out there and we should try to follow their ever changing suggestions as best we can. The ADA suggestions HERE apply to dentists , who create an aerosol using water on virtually every patient (we drill far less and never use water) so these should be more than enough for us. A great article on dental aerosols is HERE. (Note that there is A LOT on the web about dental aerosols when one is using water, but very little about what we as orthodontist do with just air or even a slow speed alone.)

I explained to my parents that while many of us are taking precautions, as high risk individuals, THEY are in charge of making sure they protect themselves. They must wear masks and gloves when handling anything that comes through their door, set up a “containment zone” as best they can and they shouldn’t rely on anyone outside of their door being able to keep their home a virus-free environment. However, the fear mongering folks out there created an environment where my parents-the highest risk- cannot obtain masks or gloves or even the most simple disinfectants necessary because of the hoarding that’s happened.

THAT’S the real danger in this situation. People (us included) making decisions based on fear and over-reacting (as the public has) leaving many worse off than if they had done nothing.

These are unprecedented times for all of us. Most importantly, let’s not panic and make policies and protocols that don’t align with the recommendations of our governing bodies. Let’s stick together and help one another and no matter our personal opinions based on what we’ve heard or seen, none of us knows better than the CDC and the organizations making policy. This isn’t going to go away in a week or two, and things are likely to go through multiple iterations.  Let’s watch it unfold and help one another.

We MUST act to “flatten the curve” of the spread of this virus. We MUST do what we reasonably can to protect our patients. Let’s just not make hasty decisions based on emotion rather than what is being recommended.
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This will pass. Life will go on and we will hopefully learn from this and do an even better job the next time we’re faced with this kind of crisis.

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we come together to help each other build better practices and lower stress, please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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You Can Be Right Or You Can Be Healthy

Your front desk just said “ummm” 37 times in a new patient call after intensive call training.
Your assistant just dropped her 4th instrument today after you asked her to “slow down”.
A mom, who has been shown her child’s poor brushing 3 times with documented paperwork blames you for her child’s white spots.
A parent wants a full refund for her teen’s Invisalign treatment because the teen wouldn’t wear them as suggested, so it’s “your problem”.
A dental assistant from an office that never refers gets upset at the discount you offered.

Every day we’re faced with situations that test our patience. Some are reasonable and some are way beyond anything considered acceptable. The problem is, we’re not in the tooth straightening business. We’re in the customer service business, and whether we like it or not, our responses to everyday problems will shape how well our practices and mental health will be.

We want to scream and just let it all out, or take a stand and hold our ground and say “NO!!!” but realistically, that’s not how it really works. Communication and setting expectations is always the key, or so you’re told, but what do you do when you’ve done that and yet, you’re faced with the same problems, over and over again.

I am reminded of a situation from 22 years ago, shortly after I had taken over my restorative practice.  Like many of you, I practiced alone. No partner and at the time, no Facebook groups where I could share my problems.

I had a patient come in for a simple DO amalgam. No biggie, and it went well. However, the patient had sensitivity afterwards, which isn’t unusual. What was unusual is that the patient refused to accept that we needed to give it time. I had adjusted the bite, used a rubber dam so there was no contamination, took my time and gave my best work. Yet, here they were, as unreasonable of a patient as I had met in my short 5 years of practicing, threatening me with a whole series of ridiculous statements (you’re not going to sue me for $220 or get my license taken away) and it was clear that they simply wanted their money back.

I called my attorney, a quiet, skilled and experienced practitioner. I went on and on about how insane all of this was and there was no freaking way I was going to pay them back the $220. After all, I did good work. The filling was great and the sensitivity would likely dissipate in time. He asked me one question which I remember to this day:

“Glenn, is it worth $220 to never see this person or hear from them again?”

He was 100% correct. In that particular case, I could be right or I could be happy, but not both. This has been my motto since that time. I don’t need to be right. I just want as little stress as I can in my life.

I can write nasty letters or emails to people who piss me off. I can stand my ground when I’m sure I’m being taken advantage of. I can make examples of people and “show them!”. But it’s not healthy for my mental well being and it’s not good for my practice or culture.

So, the next time you’re faced with someone who takes you for granted or tries to take advantage of you, simply take a deep breath and repeat what I say every morning as I prepare for my day: “I will NOT react emotionally.”

It’ll be better for your patients, your family, your practice and your well-being.

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we come together to help each other build better practices and lower stress, please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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Here’s a great article on non-emotional decisions to peruse: https://www.idealist.org/en/careers/6-ways-to-control-your-emotions-and-make-better-decisions

We Need To Spend More Time Together

A couple of nights ago, I was a guest on Dr. Kyle Fagala’s live stream show, “The Digital Orthodontist Live”.  It was great because he does an awesome job interacting with the at-home audience who chime in through the Facebook chat side of things. We had a lot of fun and got to see a lot of comments. Kyle’s a master interviewer and a true gentleman who works so hard to help bring the profession together in a fun, informative way.

What people don’t know is that both Kyle and I had just both spent the entire day in a private OrthorpeneursRD course with Dr. Ron Roncone. We went to San Diego with about 60 of our “RD’ers” getting together to learn and share and simply enjoy each other’s company.

As soon as the live stream ended, we packed up and walked over to a steak house where 60 of us enjoyed a sumptuous meal with wine, drinks, steaks and desserts while connecting. I mean REALLY connecting. People were talking about families, dreams, goals, travel plans, life struggles. For a few hours, our practice issues fell away while people smiled and leaned into conversations with folks they may not have ever met in person before that day.

Statistics would say that most of us practice alone. I’ve been there, but am blessed to now have an amazing business partner in Dr. Douglas Shaw. We chat every day and practice life is sure easier. But having friends who are peers-not just acquaintances-with whom I’ve shared special times is important to me. I know their backgrounds and I’ve seen their cases and been in their practices and that recharges my battery. And when I have a question about CBCT or 3D printing or Sleep Disordered Breathing literature, I can reach out instantly to someone I trust and know.

But it doesn’t happen by accident. Like almost any great thing, it takes work to get what you need.

People constantly ask me why I started Orthorpeneurs Summit and the RD group, and why I have worked so hard to create “in-person” meetings for the group. I’m totally honest when I say that I need meetings and face-to-face get together with my peers to keep me going. I love the conversations that only we understand or speaking about struggles that we all face but others have no idea exist. We relate to one another in a way that most don’t, and I don’t want any of us to ever feel alone. THAT’S why I do it and will continue to create meetings for us to spend time together, sharing, enjoying and growing together.

We all have ups and downs and we often feel helpless or despondent. I’ve said it time and again that ANYONE who feels depressed or needs to talk should ALWAYS reach out to me. I’m serious. And keep in mind that another great antidote is to get together with those who care about you, won’t judge you and want to hear your story.

Like I said, we need to spend more time together. The “where” is up to you.

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we do deep dives into these discussions (and more) , please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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What Do We Owe Our Peers?

A patient walks into your office and tells you that she’s just been to a “competitor” down the block and hated their office. The front desk lady “kept saying ‘umm’ every other word” and “put her on hold for 10 minutes and then hung up on her”. Then, while she was getting her new patient photos taken, the rest of the clinical team sat around near her talking about their weekend and laughing about how much they plan on drinking. You get to know the patient and she seems pretty sane. No crazy questions or weird expectations. She schedules treatment and leaves.

If the “competitor” was a friend, you’d likely pick up the phone and tell them about the situation, right? You’d let them know that you had someone in your office who gave valuable feedback about their team and you want them to know.

But what if the office in question wasn’t a friend, but someone you causally knew and saw at meetings from time to time? Would you feel an obligation to call or text them? Moreover, would you actually keep it from them because you “owe them nothing” and it might even cause more patients to come to you?

Or maybe you had a toxic employee leave your practice and you heard she’s working at another office. You wouldn’t wish her on anyone, so do you contact the new doctor who is an acquaintance to let him know to be careful? Or, do you keep your mouth shut and let them find out for themselves?

These aforementioned examples are real situations that occur every day in our practices. How do we handle them? What do we really owe our fellow orthodontists? What’s the right thing to do?

I don’t know if there’s a right or a wrong answer. On one hand, we would always want someone to tell us any information that could help our practices and contacting another office to help them seems like the right thing to do. On the other hand, many people don’t want to hear bad news and if you’re not really friends, it could strain a relationship because nobody really likes a neighbor who sticks their nose where it doesn’t belong.

I’ve done both things. I’ve called orthodontists to let them know about situations and I’ve been both thanked and attacked. I’ve also kept my mouth shut and let others deal with issues in their practices on their own.

So, what would you do? How would you handle these situations? What do we owe our peers?

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we do deep dives into these discussions (and more) , please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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THIS is the time for us to stand together and do EVERYTHING…except limit our rights

I’m not a huge fan of TV “investigative reporting”. I’ve often found them to be “hit pieces” where some person or company gets destroyed by a sharp tongues reporter or clever editing. However, this past week, NBC did one heck of a job questioning SDC about the complaints from customers. Unless you’ve been living under a rock, go take a look at the interview. You can see it HERE.

It’s fun to see someone on the side of patients and the orthodontic profession.  Smile Direct Shares dropped 20% on Friday after the NBC interview. Look at the hottest internet stores today. Words like “teledentistry” are now becoming a part of the online lexicon.  DTC is obviously a lot bigger than just SDC, but it was fun to sit back, grab the proverbial popcorn and watch the back and forth in the interview.

Plus, in 1 day I got 57 shares of my post!!!  We need to stand together and get the word out whenever we can. If you look at the responses on the shared posts, you’ll see many patients responding that they had no idea that DTC aligners weren’t good for them. I know it seems insane that patients don’t recognize this, but that’s what’s happening. It shows that no matter how much education we do on our web pages and with the AAO, there is still a huge percentage of people out there who don’t “get it”.

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There’s no question that orthodontics has faced some very interesting times in recent history. From GPs doing lots of Invisalign to DTC aligner companies, the old paradigm of private orthodontic specialty care has certainly morphed.

There has been a lot of discussion about what to do about the changing societal role of the private orthodontist. Some point to the idea of standing behind the shield of the AAO to show our strength as a profession while others talk about legislative headway to protecting our patients as well as social media post campaigns to better educate the public. All are correct.

But, two things stand out to me:

  1. We need to stand together as a specialty profession to protect the public and maintain the highest level of healthy outcomes for our patients
  2. We need to be smart about how legislation affects our future practice lives

I posted the following in Orthopreneurs and it bears repeating. Any prospective legislation to protect patients with regard to HOW we practice is fraught with potential issues. Want a dentist to have to be on sight for a scan? Great, now we can’t have assistants do a simple scan for a patient who lost a retainer and these DTC companies will find a way around it. Want to force a dentist to perform the treatment plan? They’ll figure out a workaround somehow.

I know I don’t have the full answer, but why not simply do what I remember Washington state doing when I used to practice there and take it a step further.  Simply make the law that all dental and orthodontic practices/companies/LLC’s MUST have a dentist licensed in that state as a majority owner and that only a dental and orthodontic practices/companies/LLC may render care or treat patients in the state. It makes it simple. It doesn’t tell us HOW to practice and how many dentists do you know (aside from DSOs) who do not have a licensed dentist as at least a 51% owner? It doesn’t affect how we practice and we can treat patients in any way we see fit, instead of having more and more restrictions placed on our day to day actions. Sure, the VC backed DSO’s won’t like it, but it would  be great for our profession and would make it impossible for DTC companies to function in their current model.

Like I said, I don’t have all the answers, but I do know that we need to stand together to protect patients and we don’t need more restrictions on our daily practice.

I feel like it’s when we speak to our teams when someone screwed up, and we’re afraid to acknowledge the mistake in front of everyone, so we speak in generalities. “Hey everyone, I really need you to all make sure you clock in and out every day and not miss a punch in or punch out, ok?”. When we’re really just talking to one person. It’s ambiguous, doesn’t help and leaves everyone no better off than before, with the best employees wondering why they’re even part of the discussion in the first place.

Let’s make sure that the best of our profession aren’t saddled with way more legislation because those in charge are afraid to tackle the actual problem head on in a way that lets us keep practicing the way we want.

What are your thoughts? Do we need more restrictive practice laws? Is there a better way?

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we do deep dives into these discussions (and more) , please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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To Bonus or Not To Bonus…That Is The Question

There are many studies that show that bonuses can have significant downsides. From motivating employees to use unscrupulous tactics to achieve bonuses, to the long-term negative motivations, it’s been proven that offering people incentives for performance can have disastrous consequences. If that’s the case, why do we still find doctors offering bonuses to their teams?

Maybe there are benefits…

Sure, giving incentives to reach goals should help motivate team members in the short term. Even when one is given daily or weekly bonuses, the power is still reduced over time. But, there’s no doubt that when the bonus is paid, team members are excited and happy. Morale can soar.

However, what about jealousy? How do we handle those who are part time employees? Or perhaps different bonuses for different positions?

If your TC currently converts at 70% but you’d like her to be at 90%, or perhaps you’d like her to hit a specific number of starts, would a bonus help? If she does hit that number, does no bonus get paid to those who helped that new patient get to the TC in the first place? And when the bonus gets paid, is it really in the best interests of the cash flow of the practice?

Don’t forget taxes. When you pay bonuses, do you take care of the taxes, or, do you expect the team members to pay the taxes? There’s no right or wrong and I’ve seen every permutation.

So, do you bonus? If so, who do you bonus and how? Last, how has it worked and what would you do differently?

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we do deep dives into these discussions (and more) , please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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Give Away Your Work

I once worked for felons. Yep, actual, plead guilty to fraud in federal court, serve time in prison, felons. As a really young dentist just happy to have a job, I didn’t see all of the warning signs when I worked for them, but I guess looking back now, the fact they carried guns everywhere they went, had extra ones hidden in the office and even bought me one was a pretty good sign that something wasn’t right. But, they did teach me one really positive lesson.

Every single day in their morning huddle, they reminded the front desk and the rest of the team that we needed to give away THREE things for free that day. Best of all, the team got to choose-on the spot-what they got to give away. Maybe it was a free filling or a free cleaning, but when the team told them what they had given away at the end of the day, the owners beamed with pride and were genuinely thrilled that they had helped those in need. It certainly was a Robinhood-esque sort of existence with the whole steal from the rich, rob from the poor mentality, but their lesson of giving to those less fortunate has stuck with me to this day.

As orthodontists, we live blessed lives. Our complaints really are “first world” problems and thankfully, even with student debt, we have the ability to change the lives of those around us. We are indeed fortunate.

While orthodontics is very different than general dentistry in that we don’t have many “small ticket items” to give away for free, we should still do our best to give something to people when we get a chance. Maybe it’s a free retainer, or free whitening or something else you typically charge for. Maybe it’s a significant price reduction on treatment just because you know someone is in need. Maybe it’s doing a case free every week or month. I don’t propose to know what you can and can’t afford to do, but here’s the thing: Don’t do it for gain. No asking for a Facebook review, or tell everyone about it on your office Facebook page or ask them to send you a friend in return. Do it because it’s the right thing to do and end it at that.

Most importantly, make sure you and your team discuss it afterwards. Let them revel in the generosity of the office, and the life-changing decisions we all make together. Many of our team aren’t in a financial position to give money freely to others and this is a nice way to use our profession to give back from EVERYONE on the team.

You may go as an office to volunteer at charitable causes, and that’s awesome. Your business may donate a ton of money to local schools or charities and you should be proud of that. You may personally give a huge amount of charity and never brag about it and that’s a beautiful thing. But the next time you have a morning meeting, let your TC know that he/she has the right-no, an obligation- to take money off of someone’s treatment plan that day because of an expressed need. Watch the way your team looks at you.

Yes, you might get fooled by someone playing the charity card and that’s on them, not you. Remember that the gift is for the giver. And don’t let the receiver know it’s “charity” because it isn’t. It’s one person doing a nice thing for another. They get to choose. It’s an office thing and while you can’t help the entire world, you can make a difference in a family or individual’s life. It will give your team one more reason to jump out of bed in the morning.

At first, they’ll be astonished. “Wait, don’t we want collections to be as high as possible?” Eventually, they’ll catch on and everyone will clamor to be the one to help others. Of course, there need to be ground rules, but you’ll figure it out.

Admittedly, I haven’t done this in ages and it’s time to get back into the swing of it again. I can remember how awesome it felt to make sure that giving happened every single work day. Give it a try and see if it fits your practice.

I didn’t keep in touch with the dentists I mentioned at the beginning of this post. I don’t know where they are, or if they are even still practicing. But, this was a great lesson to me that no matter where I worked, or with whom I was working, there are amazing life lessons to be found everywhere.`

Wishing you the best,

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If you want to be a part of a geographically exclusive Facebook group (OrthopreneursRD) where we do deep dives into these discussions (and more) , please message me. To learn more about your region’s availability and what it’s all about, click HERE.

gk-deep-elleum-1_pp.jpg
GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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