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The football world online was thrown into a tizzy this week when the NY Football Giants traded away Odell Beckham Jr. (OBJ), their star wide receiver whom they just signed to a massive long-term contract. Most were shocked, and couldn’t understand what happened. After all, you don’t generally sign someone to a $90,000,000 five year deal and then trade them one year into it. The comments about General Manager Dave Gentleman and the Giants were relentless.

“The Giant’s are crazy.”…”Gettleman should be fired.”…”I can’t understand their plan.”

And my personal favorite “#LongLiveDaveGettleman”….written by a rival team’s fan page.

While the Giants have made some questionably horrible moves this past week, this one perplexed me as a business owner and not a sports fan. After all, they are losing so much money on this deal. How could the very traditional and deliberate acting ownership allow it? There had to be more to it, right?

The press was decidedly against this deal on every level. Then, a couple of days later, some articles started discussing how Odell was a on-field distraction with his antics and the team had just gotten tired of it. How OBJ had supposedly said “FU” to his coach twice in one game last year. How he threw his QB under the bus in a recent interview. How the three highest paid (and arguably biggest prima donna) wide receivers in the NFL have 22 seasons among them and zero super bowl wins. All of a sudden, the discussion had shifted and it made me think of my practice teams over the last 27 years and my willingness to “trade” a superstar, prima donna employee when they weren’t acting in a way I needed.

However, unlike the general manager of an NFL team, we’re often afraid to let go of an employee who might be hurting our culture. When I was a younger practice owner, I operated from a position of fear. I was fearful to let someone go because they seemed too valuable. It would hurt my practice. They meant too much to the office operations.

Nonsense.

Nobody in your practice is too valuable. Culture and teamwork are the number one priority for long-term happiness and productivity. Nobody is above that.

That employee who feels they may know it all, who has done all the ordering, or tracks all the lab cases or scans faster than the rest but has openly displayed hostility or undermines your authority must go no matter how valuable you think they may be. No, another 15 conversations won’t change it. No, you’ve given them enough chances. Yes, you CAN go on without them. You’ll actually thrive without them and it should a simple decision. As the old saying goes: “There is no ‘I’ in ‘Team’.”

So, maybe the NY Giants ARE in freefall and maybe trading OBJ will turn out to be a huge mistake. In the end, I don’t really care. But, if we use this moment as an opportunity to examine our own handling of our practice teams, and a chance to upgrade our practice culture, that would be an amazing thing.

So, don’t drop the ball on this one.

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

I love crazy socks (and weird belts too, but that’s another post). So, when I recently came across a couple of interesting pairs online, I snatched them up.

When the socks arrived and I opened the package, my wife rolled her eyes and my kids laughed, but I noticed something else. Tucked in the back of the package was a little, handwritten note from John, the owner of the company. All it said was: “Thank you so much. I hope you love the socks. John.”

It wasn’t a long note and it wasn’t even written for me. “He” probably wrote hundreds of these to be added to the packages, but it’s interesting how that turned this purchase into a more personal transaction for me. Instead of simply buying from a company, I was supporting what seemed to be a nice guy. In the back of my mind, it makes me more likely to WANT to buy from “him” again.

I don’t know if there is even a “John” from “John’s Crazy Socks”, but it’s amazing how one little 2 sentence note made all of the difference for me. Now, if their socks are bad quality (they’re not) or aren’t interesting enough to purchase (they are) no note would make up for that. But they are, and it does.

All too often, we practice owners try to develop new ways to grow our businesses. Marketing, advertising and contests seem to rule the day, but sometimes as simple handwritten note or personal touch can make all the difference.

When I started my practice, every new bonding got a phone call that night. Every referral got a hand written note to the doctor who referred them. As I got busier, the noted stopped and the calls diminished.

I think this is a reminder it’s time to start them again. It’s simple, easy and representative of the kind of practice I run. I’m not a huge DSO. I’m just a guy who tried to do good ortho and take care of those around me. I’m not “Krieger Orthodontics”. I’m “Glenn” the doctor who cares about his patients.

Oh, and thank you to all of you for reading my blog and attending our meeting. It means the world to me. 🙂

Glenn

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

 

 

A 2018 study by Bright Local showed some interesting trends about online reviews that every orthodontist should consider reviewing:

86% of respondents use reviews to decide on businesses: If you’re not actively asking your patients and their parents to give your office reviews, your not helping your practice with one of the greatest marketing tools out there.

Of all of the industries for which people use reviews to decide, “healthcare/medical” was third behind “restaurants” and hotels. I know, times have changed. I remember the days when it was illegal for dentists to advertise at all. A large, bold name in a phone book was about all they could do. But, good or bad, today’s consumers choose their provider based on reviews. (bit it’s different based on age group.)

91% of 18-34 year old consumers trust online reviews as much as personal recommendations. Keep that in mind. This is the segment of the population that’s becoming a growing part of our practice and will continue to grow over then next 25 years. Be prepared to market to them in the way they want you to.

84% of people trust online reviews as much as a personal recommendation. Yep, they care as much about your reviews as they do if one of your patients (a friend) tells them about how wonderful you are. That’s a huge shift from years ago.

90% of consumers read 10 reviews or less before they feel they can trust a business. This means that even if you get a bad review, think of burying it in a lot of great reviews. Unless they’re specifically looking for a bad review, they’ll probably not see it unless they’re specifically looking for it.

Oh, and 73% of consumers think reviews older than 3 months are no longer relevant. So, even if you have 500 reviews, never become complacent.

Ask yourself what you are doing to generate reviews to grow your practice. It could mean all the difference to your practice’s future.

I hope this helped!

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

“Pigs get fat. Hogs get slaughtered.”– Business lesson #1

The other day, I showed a method of treatment that our private OrthopreneursRD group had seen in one of our monthly webinars. It was designed by a PhD in Biomechanics and is a very different and interesting concept in tooth movement. Of course, many were skeptical, and that’s to be expected until results of many cases are seen. But some had seen a clip of the inventor saying that he might sell this product to restorative doctors and of course, that caused great concern. Many orthodontists are worried about general practitioners (GPs) doing orthodontics and their concern is that it will cut into their business growth.

I’m here to tell you not to worry about restorative doctors doing lots of braces.

I was a GP for 20 years and I know that space. I still have many close friends who are restorative doctors and most of them do not want to be involved in orthodontics beyond the occasional clear aligner case. I was at a lecture where a representative from Align showed that only 10% of their annual cases are submitted by GPs. When I occasionally go into my referring GP’s Invisalign accounts to help them with their cases, they rarely do more than 10-15 cases/year, which equates to one case per month. Sure, if you add up all of the “10-15 cases per year” it can be a big number, but it’s been that way for a while.

The overwhelming majority of GPs don’t want to do tooth movement beyond the occasional clear aligner case. Maybe you know those one or two docs who love to do in-house braces, but they are not the norm and many of that group do it for a few years and then give up. Their practice software isn’t set up for long-term payment plans and most restorative assistants aren’t trained in ortho. Tell me why a restorative doctor would rather dabble in ortho when they could do quadrant and implant dentistry, which is far more profitable with way less headaches when done properly. It’s only when one scales orthodontics that it becomes profitable and most GPs don’t want to do that. Don’t believe me? Think back to your first several years in practice. How profitable was your ortho practice?

Many DSO’s have in-house orthodontists to capture restorative cases, and corporate orthodontic chains can certainly attract a fair part of the population, but most aren’t looking to implement the latest and greatest approaches to tooth movement.

I remember when many of my oral surgeon buddies were worried about GPs doing in-office implants and they were right. Since I graduated in 1992, GPs have certainly embraced doing implants in their offices instead of referring them to oral surgeons or periodontists, but somehow, the oral surgeons have continued to do well. It appears that the sky is not falling after all.

We should be looking at technological innovation as a place for us to set ourselves apart from everyone else doing tooth movement. Sure, new techniques and technology need to prove their worth, but we should be far more concerned with learning how to master them than whether or not GPs will be using them.

As the opening quote of this post infers, it’s alright to want orthodontists to do most of the ortho cases out there, but we also need to acknowledge and accept that a percentage will be done by restorative docs, and that’s OK.  Let’s focus on becoming the best clinicians we can become and help the cereal public understand why our dedication and training set us apart.

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

As I write this post, the AAO MidWinter Meeting “Sleep Apnea and Orthodontics: Consensus and Guidance” is wrapping up. Numerous sleep medicine courses for the orthodontist are popping up and even our Orthopreneurs Summit in September will be have a fair amount of lecturers teaching about diagnosing and treating sleep disordered breathing (learn more about the meeting here).  Sleep disordered breathing is definitely a hot topic in our field.

But I recently saw an AAO sponsored lecture entitled: “Is Sleep Related Breathing Disorders Another Déjà vu of Temporomandibular Disorders in Orthodontics?” The title caught my eye because I lived through the “TMD Revolution” and remember how everyone in all of dentistry (not just orthodontics) diagnosed TMD issues for everything from headaches to ringing of the ears. Courses sprung up everywhere and like many other fads in dentistry, a weekend course could be taken to make you an “expert” in all things TMD, as well as help your bottom line.

There are numerous “fads” (others’ word, not mine) in today’s orthodontic world . From clear aligner therapy to lingual orthodontics and sleep disordered breathing, we can find courses and meetings to help us learn more and like TMD, there are debates on both sides for each topic.

But my specific question is: “If we make a considerably better living treating our pediatric patients’ sleep disordered breathing, does that mean our motives are corrupt and that this “fad” is wrong?”

Many out there act as if the answer to the aforementioned question is “yes”. I’m biased because I’ve been following the world of SDB for about a decade. Like many of you, it took me many years to “see the light” and while the essence of the proper treatment modalities for each presentation and the diagnostic criteria are still being unraveled, we know for sure that we can help many pediatric patients who are slipping through the cracks. In doing so, we WILL make a better living in our practices.

While I am sure there are some out there who will embrace the world of SDB to make more money, helping these children who suffer from a poor night’s sleep is one of the most rewarding things I do. To see a mom crying tears of joy because her child’s life has been changed by our intervention, or to hear a parent tell me that her child is now a “totally different kid” because of subtle, easy to implement treatment is incredibly fulfilling.  Don’t believe me? Watch a testimonial video of one of the moms in my practice HERE.

There are so many voices out there screaming about SDB being a fad because of cynicism or a false sense of comparing SDB to some sort of previous dental or orthodontic fad. I don’t believe it is, and when TMD was in vogue, I took a 500 hour course on the impact of occlusion on the muscles of mastication and TMD to separate fact from fiction. I see SDB as being no different. We need to “separate the wheat from the chaff” in the rapidly evolving world that is pediatric SDB. How do we do this? Take many courses from many instructors. Do a lot of reading and of course, document your results from your own treatment outcomes so you can review the impact of your treatment choices. Don’t think that you can attend any single course or meeting and suddenly become an expert.

As I’ve said numerous times, I believe that Orthodontics is the central hub of the wheel that makes up the pediatric SDB treatment team. We, as a specialty have the ability to “own” this field as ours and we have all of the tools in front of us to become gatekeepers for this problem. By educating and working with well informed and trained ENTs, GPs, oral surgeons, myofunctional therapists and pediatric dentists, we can helps countless children (and their parents) lead better lives.

And yes, you WILL grow your practice if you immerse yourself in the educational world of SDB. As you help children sleep and breath better, word will spread and new patients will come to you from far away. You WILL see a better bottom line as you help children who were never screened in the pediatrician’s office. When you treat them, suddenly you will find siblings, parents and friends who become your non-SDB patients and yes, your practice will grow.

The literature is there to support what we’re doing and prudent screening, interviews and proper referrals can change lives and bring tremendous fulfillment.

If it’s a fad, I hope it doesn’t go away.

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

How important is money to your practice? As an orthodontist, how do you feel about the title of this post? It’s actually a quote from one of the most respected motivational speakers, Zig Ziglar. He was a huge inspiration in my life when I was a young dentist. I would listen to his tape series (yeah, an actual cassette series) on my way to work every day and I realized that for every hour of clinical CE I took, I personally needed 10X more time working on my business growth and profitability. How about you?

But Ziglar’s comment tended to rub me the wrong way at first and I needed an explanation to better understand it. After all, I wanted to help people. Saying that I wanted to make money sounded, well, disrespectful. Zig’s point is that if you don’t make money, your ability to practice and help others dies.

My experience with my fellow orthodontists is that most consider themselves artisan health care providers first and business owners second. As a matter of fact, it’s almost impossible to have a discussion about a new clinical approach or a way to be more profitable without someone adding “but always do what’s best for the patient” as if the best clinical outcome and most profitable almost have to be in conflict with one another. We also tend to get more excited about a new clinical technique and not so much about a new book on leadership or marketing.

Let’s move forward in agreement that almost every orthodontist I know wants what’s best for the patients and tries to give their best outcomes for every situation. But, we need to make a living and we need to acknowledge that money is the reason we go to work every day. Orthodontics is the profession that allows us to make the aforementioned money and Ziglar’s comment tells us to never forget that.

Allan Dib, author of “The 1-Page Marketing Plan” states: “If you didn’t go into business to make money, then you’re either lying or you have a hobby, not a business.”

Are you OK recognizing that you run (or plan on running) a for-profit business? I know that you’re doing everything you can to become the best clinician you’re able to become, but are you doing everything you can to become the most profitable business owner too? Reducing overhead often requires many tough emotional decisions and we need to be prepared to make them.

Yes, we must serve our patients well, but I knew an amazing clinical instructor in dental school who actual declared bankruptcy twice because he was so focused on clinical outcomes and not the business side. His story isn’t unique. A dentist friend of mine (an amazing clinician) recently shut his doors and while chatting on the phone, he said : “I wish I had worked harder ON my practice and not just the clinical.”

I beg you to PLEASE focus on the business side of your practice. If you’re diligent, you already have the skills to become a great clinician. You were trained for that, but I’m asking you to work on becoming more profitable, focus on your business strategy, read business books, find business mentors, go to business meetings, because you need these things to help your practice succeed.

Sure, there are new clinical techniques you need to learn and new technology you have to understand, but keep in mind that you were trained in clinical and not business. And if your business doesn’t make a profit, like my clinical instructor, you won’t be able to help others. In addition to being your clinical best self, strive to be the most profitable orthodontist you can be. And never forget my other favorite Zig Ziglar quote:
“Honesty and integrity are by far the most important assets of an entrepreneur.”

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

If you’re old enough to remember a time when Southwest planes could only fly in the State of Texas, then you certainly will remember how Herb Kelleher changed the way Americans flew. He passed away this previous Thursday at age 87, but his story should continue to inspire those who want to learn from it. There are MANY lessons that orthodontists can learn from the way Mr. Kelleher ran Southwest Airlines.

Risk: Mr. Kelleher was an attorney who had no history of wealthy parents or dreams of running an airline. He was simply smart (or crazy) enough to take the bait when one of his clients suggested that he join him in opening an airline that flew exclusively in Texas and from 1971-1978, that’s exactly what they did. He competed with much larger established companies and figured out how to become profitable doing more with less (at first, they served only 3 cities in Texas and focused on doing it well).
In today’s competitive orthodontic market, we can learn many lessons from Mr. Kelleher related to taking on calculated risk and serving needs that may be right in front of all of us. The term “core competency” is overused, but finding ways that we can take calculated risks to grow our practices should be something we strive to do.

Profitability: Southwest airlines remains the only major US carrier to never file bankruptcy and has been profitable every single year after their second in business. After 9/11, Kelleher had the foresight to lock in contracts for fuel when the prices were low. Kelleher added just a few routes at a time, growing in a way that allowed the company to remain solvent and profitable.
Southwest is a great example of a company that grew within its means and used every possible strategy to protect its financial viability. Be smart with your finances. It’s not what you produce, but rather, what you “take home” that matters.

Commitment to Employees: Early in their history, when finances were tight, Mr. Kelleher chose to sell off a plane instead of laying off employees. Can you imagine what kind of message that sent to his employees? Under Kelleher’s reign as CEO, employees were well paid and a spirit of fun was instilled in the company. He was so well liked that when he stepped down as CEO at their annual meeting in 2008, not only did he get “an ovation usually reserved for rock stars” but the Southwest pilots’ union, in the middle of negotiating a new contract, took out a full page ad in USA today thanking him for what he had done.
The success of our practices is dependent on the culture we build, the loyalty of our team and the smiles on our employee’s faces. Don’t be “penny-wise & pound foolish” by skimping on your most valuable asset, namely, your team members.

Humility: Mr. Kelleher was famous for boarding random Southwest flights just so that he could chat with passengers. I have no doubt that when he introduced himself, he was “Herb” and not “the CEO for this airline”. Customers loved him and when asked by the media how he became CEO, he responded: “Because I am unable to perform competently any meaningful function at Southwest, our employees let me be CEO.”  When Southwest and Stevens Aviation got into an argument because they both used “Just Plane Smart” as their taglines, Mr. Kelleher suggested that instead of a long legal battle, he and the other CEO, Mr. Kurt Herwald simply arm wrestle to see who could use the tagline. Kelleher lost the match, but Herwald felt that the publicity was so great and Kelleher’s approach so unique that Herwald simply let Southwest use the tagline.
Sure, we have graduate degrees and have made it through the crucible that is the orthodontic education process, but we need to remember that we serve the needs of our patients and we need to listen to what they want. We need to be in touch with our team members’ needs and care for them while being respectful to those around us.

Values: While there were many high end air carriers, Southwest’s niche was about efficiency over frills. All decisions were borne out of the set of values Mr. Kelleher infused into the company. He was quoted as saying: “If somebody makes a proposal, and it infringes on those values, you don’t study it for two years. You just say ‘No, we don’t do that.’ And you go on quickly.”
Define your set of values for your practice, write them down and use them as a guide for all future practice decisions. Be true to your vision and you and your team members will always feel great about your practice.

Herb Kelleher was a visionary who changed the way the entire US airline system worked. He opted out of the larger reservation systems and cut out the “hub” concept, allowing a fledgling operation to be profitable when no other carrier could make money. He did all of this while respecting his employees and loving and serving his customers.

Think of that. Making money while laughing and having fun, surrounded by customers and employees who loved him.

We can learn a lot from Mr. Kelleher’s legacy. May he rest in peace.

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

All facts about Mr. Kelleher’s life in this post were taken from his 1/4/19 NY Times Obituary.

The goal of every business owner is to see profits grow every year, and as far as profitable businesses go, orthodontics is pretty solid. If you’re not doing as well as you’d like, there are usually a few easy ways to correct that. So, how do you ensure that you’ll finish 2019 better than 2018?  Here are a few suggestions:

1. Plan your upcoming year properly.  Things don’t happen by accident. There are too many moving pieces and while you might get lucky by just simply showing up for work every day and growing by brute force and sheer determination, great businesses grow by focusing on growth strategies that were planned out in advance. Figure out your plan for growth, for personnel and any other major aspects of your practice that can guide you in the coming year.
2. Make an HR plan. Have you found yourself simpy adding team members when you needed them? You’re bursting at the seams, so you throw in a new front desk or assistant? After you determine your growth plan for the coming year, figure out your strategies for adding new team members and be prepared for that growth rather than having that growth put you into a place where you’re stressed out and find yourself in crisis mode. You can almost always anticipate when you’ll need an additional assistant or administrative team member and use your numbers to confirm it.
3. Figure out your “niche”. There are a lot of orthodontists out there, and unfortunately, being a great orthodontist alone is no longer enough to see your practice explode with growth. So, figure out what sets your practice apart.  Do you provide some service that would set you apart from the rest of the community? Do you have a passion within our specialty that would allow you a subspecialty within your practice (airway, TMD, etc)? Figure out what sets you apart and double down on it. Remember, the first one to a niche is often the one who owns it long term.
4. Make a plan to manage your overhead.  The old saying says that it doesn’t matter how much you produce, but rather, what you take home. Many of us produce quite well, but can’t figure out how to take home more because our overhead keeps expanding. As your practice grows during its infancy, many fixed expenses will start to get smaller as a percentage of your production, but focus on the variable expense items and see how you can be more efficient. The best way to do this for 2019? You got it. Plan ahead, and now is a great time to do it.
5. Develop a CE plan. Think you know it all? If you do, I definitely don’t want you practicing on me. The one thing that the best clinicians have in common is a voracious appetite for continuing education and that doesn’t mean simply getting clinical tips on Facebook and using that as your strategy. If you’re worried about meeting your state minimum for CE, there’s a problem. To have the best practice, you need to be taking a lot of CE, and it should be a well balanced diet of management, clinical and leadership. Step outside of orthodontics and take some courses on managing a team  better or sales. You’ll be surprised what it’s like when you learn sales with folks from outside our industry.
6. Visit other practices. As I’ve previously written, visiting other offices is the best way to change your practice quickly. Seeing others at work in successful practices will help you learn “best practices” and you’ll be amazed at how quickly these small changes can help you grow or mange your practice. I’ve also found that the positive energy I bring back from other practices is infectious and my whole team gets excited when I come back from my monthly visits.
7. No excuses. Yes, I know you have a young child. Yes, I know you have vacations planned. Yes, I know that you have very little money. You know what we call those? Excuses. Your practice doesn’t care about your life. Sorry, but it’s true. It’s going to grow or not grow based on your effort and the more time you put into it (to a point) the more it’s going to grow, so, get on it.

Great practices don’t happen by accident. I’ve visited a lot of them and they all share one thing in common: A leader who is passionate about growth and works on it constantly. While there are many different styles and sizes of successful practices, only YOU can determine the type of practice that’s right for you. So, with the new year nearly upon us, what better time is there than now to figure out how to make 2019 your best year ever?

Go ahead and work on your practice and make 2019 the year that brings you the success you always dreamt of!!!

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

If you listened to the 3rd episode of my Orthopreneurs podcast, you heard Emily, a 30 year old Uber driver/cocktail waitress talk about her reasons for seeing a GP for Invisalign and how, in retrospect, she would pay far more if he had realized what an orthodontist could have done to make the process smoother and faster. It was an AMAZING insight into what we can learn to do better in terms of marketing ourselves as specialists.

Bit did you catch what she said about her two friends?

To me, the most important part was when she said that two of her friends went to see orthodontists for Invisalign and were told they weren’t candidates, so they went to GPs who ended up treating them. Moreover, Emily said that she didn’t even realize that Orthodontists were comfortable doing Invisalign because of her friends’ experiences. She thought that most Invisalign was done by GPs because her friends were turned away by specialists but treated by GPs. We don’t know what their cases looked like beforehand,  but it sounded like they were refused treatment with anything other than traditional orthodontics. We don’t know what the outcomes looked like after the GPs were finished, but she didn’t remark that her friends were unhappy.

We live in interesting times. We see patients getting ortho done through the mail, in malls and with GPs. This is NOT the orthodontic profession of the 80’s, 90’s or even the first decade of the millennium.  As Bob Dylon wrote: “The times, they are a changing” and the question is :”Are you changing with them?” We don’t have to like the changes and akin to the digital camera movement of the 90’s, when film companies refused to believe they needed to change their model, many in our profession refuse to accept that the billions of dollars behind the clear movement is shaping what consumers want and how they expect to get it.

And, at the same time I hear many of my peers complaining that their practices are too slow and they’d love to have more patients. But…

Every single day I have at least one adult patient who comes into my office telling me that they saw another orthodontist who told them that they “aren’t a candidate” for clear aligner therapy. However,  I generally look at their case and figure out a solution with clear aligners. Sometimes it includes some appliance to help with A/P correction. Sometimes it’s understanding attachment protocols. But there’s generally a solution to give them a good outcome based on their limitations.

However, I didn’t get here overnight.

I was an Invisalign provider as a GP, starting in 2003 but stopping two years later. I was that rare GP who realized that I couldn’t do it as well as my Orthodontist and I sent every spec of ortho to them starting in 2005. When I graduated ortho residency 4 years ago, I was so firmly anti-aligner (from my previous experiences and many faculty who espoused that belief) that I tried to talk every patient who wanted plastic into brackets, and I did so very successfully. But there were some who simply didn’t want aligners and they went elsewhere.

I started taking every aligner CE course and fellowship I could get my hands on and analyzed the results of my cases so I could get much better with plastic. Little by little, that improved and as my skill got better, patients started seeking me out for aligner therapy. Now, I have a 62.9% aligner share of chair (SOC) for all new patients coming into my office. I’m not saying that’s what you should do or that it’s for everyone, but my point is that I rarely see a case that I can’t successfully treat with aligners. For me, it was about getting more comfortable with the “tool” and figuring out a financial model that worked for me. I just didn’t like talking people into something they didn’t want. They came in looking for plastic and they deserved that.

This isn’t a clinical discussion, but rather a customer service one. There are many, many peers out there who are far more experienced with plastic than I am and the point of this article isn’t to tell you HOW to treat cases. Rather, I want you to remember the story of Emily’s friends who showed up at two ortho offices to get Invisalign and were turned away. Two patients who could have become raving fans.

Two patients who didn’t realize the remarkable difference between getting teeth straightened with an orthodontic specialist who only moves teeth and a GP who does it as a small part of their practice.

Two patients who might have shown up to my (or your neighbor’s) office saying that their previous orthodontist told them that they weren’t a candidate for Invisalign.

Two patients -whom I (or your neighbor) may have started- who could have started in your office.

Just some food for thought…

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.

4 years ago, when I started my practice,  I had one team member. She was my my phone answerer, my TC, my assistant and pretty much everything else. Thankfully, we grew and I found some great team members to help our practice expand along the way.

Like many of you out there, I still have a younger, growing practice. I tend to add team members when I feel I must and I watch with mixed feelings as I see my peers post images of their teams that include 10,15 or even more employees.

On one hand, I tend to relate the number of team members to success. After all, no sane person would simply hire folks to take up payroll without a need, right? So, when I see a large staff, I naturally equate that to healthy practice. I think of all of those extra marketing, lab and clinical efficiencies I wish I had in my younger practice. But, extra team members come with a few costs, right?

Of course, the payroll costs go  up, along with optional costs of things like medical expenses, bonuses, uniforms, etc and anyone who has practiced for even a few months knows that the more team members, the greater the chance for friction among personalities.

But, more team members also has benefits when properly implemented. You can run so much more efficiently, apply individuals to specific tasks that might be underserved with a smaller team and more can be delegated.

However, if we’re in business to serve our patients AND make a living, every penny paid to a team member is a penny out of our pockets, so it’s wise to keep an eye on staff salaries as they relate to overhead.

There are those out there who recommend being slightly overstaffed when a practice is young so that it is always ready to embrace the next phase of growth. Others believe that overhead is key and that you shouldn’t employ the next new employee until you’re “bursting at the seams”.

There are metrics by which one can measure their team size versus efficiencies, but for growing practices whose numbers are rapidly changing and often unpredictable, it can be tough for an inexperienced orthodontist to know when is the right time to add someone.

I don’t know if there’s a right answer to how many team members one should have but I believe it all comes back to the written plan for the practice. How do you feel about overhead control, efficiency, patient experiences, in-house marketing, etc? Let your written plan guide your decisions.

The good news is that if you’re a younger practice and feel like you need to add a team member, it probably means that you’re growing and that’s not a bad thing.

All the best,

Want to be a part of a geographically exclusive Facebook group like none other? With monthly webinars and CE courses with top speakers in the industry, there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at Glenn@OrthoPreneursRD.com to learn more and to see if you’re region is available.