Thriving in Any Economy discusses ways for dental practices to succeed even during difficult economic times. It recommends getting back to basics and working smarter by [1] understanding the current economic climate and how dental practices fit within it, [2] recognizing how the new consumer's mindset has been shaped by technology and history, and [3] examining one's own practice personality and making necessary changes to adapt. The document provides strategies for practices such as managing expenses, assigning tasks to reduce the dentist's workload, and embracing change to thrive during uncertain economic periods.

1. Thriving in Any Economy
By Getting Back to Basics
and Working Smart
By
Ralph Laurie

2. Items
 Paper, Pencil or Pen
 Smorgasbord of information
 Notes
 Questions

3. 10 questions about you
1. Why did you get into dentistry?
2. Do you like/love what you’re doing?
3. What’s the most important thing you can do to build a
successful practice?
4. Has the practice been effected by the Recession?
5. What is the greatest fear that you face in your practice?
6. What single change would you make tomorrow that would
benefit your practice?
7. Do you have practice goals? Are they written?
8. Does your practice have a theme? If so, what is it?
9. Do you have a written business plan? Is it a 1 year, 2 year, 5
year?
10. Does the team have written job descriptions?

4. The Speaker

5. About the Speaker
 Official Senor Citizen
 36th year in Dentistry
 RCI, Sierra Dental, IDT, CAESY, Lighthouse, TLG
 Lot’s of stories to tell

6. What I’ve discovered
 Have fun or get out
 Make a difference .
(Pat Hyland)

7. What I’ve discovered
 Your customers expectation, Dentist!
 “NAIL IT”
 You never fail until you give up
 Noble Purpose, Passion & Perseverance
 Love your customers
 Money is important
 Branch and Prune
 Lot of right answers
 Have knowledge, just don’t participate.
 Success or failure lies between your ears



9. Getting Back to Basics & Working Smart
What We’re Going to Cover Today
1. The Economic Big Picture
2. Where you fit in the big picture
3. The New Consumer
4. Where you stand now (baseline)
5. What do you need to do to have a great
practice

10. Business as usual
 1787 – Ratified the Constitution
 225 – Years as an operating Country
 5
 5
 27
 167
 74%
 The Cycle – Regulation – Deregulation - Regulation

11. When should you be most paranoid?

12. When should you be most paranoid?
During the good times

 Prosperity is temporary

 Be Disciplined, booms always bust

 Be Ready for what’s next (Sharks in the Water)


13. Economic Picture

14. Economic Picture

15. Economic Picture

16. Consumer Realty in Alabama
U.S. Census Bureau & American Community Survey, 2005-2009 5-year estimates
 $172.5 Billion GDP
 4.8 million population, 1,821 million Households, 2.3
per household
 Median household Income $42,081 (family of 4, $64,016)
$64,016
 Single parent families 188,162, 302,000 children
 Average income $25,172
 Child care averages over $5,200 yearly
 Persons at or below Poverty rate 17.1% = (820,000/356,000
households)

17. Consumer Realty in Alabama
U.S. Census Bureau & American Community Survey, 2005-2009 5-year estimates
Consumer Spending Opportunity
 70% of GDP = $120.7 Billion of $172.5
Billion
 20% of the consumers spend 40% of
consumer spending
 $48.28 billion is spent by the Top 20% of the
wage earners

18. A Look at Dentistry
 $2.5 Trillion, 16%
 $107 billion - .04%
 Industry Description
 130,000
 616,000
 312
 $650,000 (Dep of Consumer Affairs)
 $148,000 - $227,500
 68% or $442,500
 70% ($928,571 diagnosed)
 $278,571

19. The new Consumer

20. Historical Events
Molding the New Consumer
 1968 – 60 minutes
 October 19, 1973
 1978
 1980's Life Changes
 1999 Repealfinancial speculation, like mortgage back securities banks
from high-risk
of Glass-Steagall Act under Clinton which blocked
and
collateralized debt obligations and played a role in the 2008 financial
collapse.
 2008 Financial collapse, Real Estate bust
of 2007, high unemployment….

21. Dentistry’s Brand
Molds the New Consumer’s
Worldview

23. Technology has molded
The New Consumer
 The Internet
 Information
 Surveys
 Blogs
 The World is seconds away
 Truth = My Worldview
 The internet reinforces
everybody’s opinion

24. Consumers Expect
 to be the most important part of the
equation
 full disclosure
 greater value for price
 proof
 Internet
 Social Media
 convenience
 you to work on their time frame, not yours.

25. The Effect on Dentistry
from the New Consumer
 Each patient has access to the “Land of
public opinion”
 Case acceptance is lower (ADA)
 Longer time between care visits
 Fewer cosmetic procedures
 Limited Use of Credit Cards
 Difficulty Qualifying for Outside Financing

26. The Practice Personality
1. It’s established by,
 The Doctor
 The Team
 The Location
 Potential Patients
 Competitors
 Current Patient Mix
 Current New Patients


27. The Doctor
 Attitude about the patient and the team
 The goals?
 More Revenue & Profit?
 Reduced Hours?
 Less Stress?
 Happy and Contented?
 Sell my practice?
 Transition into retirement?
 Do you lead or are you lead?
 Is the staff aligned with your goals?

28. The Team?
Are you on the Same Page?
 What is a team?
 The Coach/Manager/Leader
 The Players
 Try outs
 Season
 Off season conditioning
 Continual Learning

29. The Team?
 Killers (Gossip, Triangulation)
 Practice killers (Texting, Outside Talking)
 Cutting people from the team
 The way you practice is the
way you play

30. The Location
 Physical Location
 Geographics (Dividing Lines, Rivers, Hills, Other)
 Do you have easy access to the practice?
U-turns
 Parking lot adequate
 Signage
 Condition of building
 Type of building (Mall, House, Strip Mall, Medical Complex)


31. Potential Patients
 Population Homes, Apartments
 Density People per household
 Males, Females, Age Groups, Married,
Single, Children
 Major Employers
 Income levels
 Unemployment
 Poverty
 Insurance based area
 Medicaid based area


32. The Competition
 How Many?
 Where are they located from you?
 Web Presence?
 Social Networking capabilities?
 What are their hours?
 What do they do that you don’t?
 What don’t they do that you do?

33. Current New Patients
 Who are they? Male, Female, Families, Age Groups

 Where do they come from? By Zip Codes

 How do they come? Competition, Referral, Advertising,
Location, Employers, Insurance Groups?

 How Many per year?

34. Current New Patients
 What’s the Average Amount spent by
each new patient within One year?
 What’s the Amount diagnosed and
not accepted?
 After One year, are they still here? On
Recall


35. What we’ve covered
1. Today’s economic climate
2. Where you fit in the economy
3. The new consumer’s mindset
4. Your Practice Personality
1.
2.

36. What’s Next?
• Expense Management
• Assigning tasks
• Time Posteriority
• Live for change

37. Watch your Expenses
 Make money without adding Revenue
 At a 70% overhead, it takes $333.33 in net
collections to earn $100.00
 Reduce expenses by 5%, you increases your
profit by 14.3%. It would take $285.71 to
generate $100.00

38. Managing Expenses
Make rules for
spending (Awareness)
Lease versus Purchase
Equipment Loans

39. Managing Expenses
Professional fees, attorney,
accountant
Credit card transaction fees

Electronic Claims processing

40. Managing Expenses
Overtime and Part-time
expenses
Lab and supplies

Leverage Marketing Costs

41. Watch Capital Purchases
 Don't add Expenses without a significant Return
 Negotiate Everything
 Avoid Long-Term Contracts
 Pay cash if you can
 What is the ROI?
 What is the “mean time between failure” rate?
 What are the hidden costs? (shipping & handling)

42. Watch Capital Purchases
 Ability Vs. Capabilities? Training is
important
 What are the Psychological
Mindsets? Subconscious sabotage

43. The Business Paradox
 You need money to attract new
patients.
 You need new patients to attract more
money
 What do you do and where do you go?

44. Assigning Tasks
Accountability

46. Time Posteriority

48. Time Posteriority
 There’s Only an Hour In An Hour
 Self Regulating
 Decisions are effected by the degree to which you
are suffering from posteriority


49. Live for Change

50. Change - Only 1 in 100 do it
 It's hard

 There is no magic pill

 You're not ready to listen or change

 There's no perceived “discrepancy”
“discrepancy

51. The Change Pyramid
Behavior
Environment

52. The Change Pyramid
Behavior
Chaos
Environment

53. The Change Pyramid
Beliefs
Progress
Capabilities
Behavior
Chaos
Environment

54. The Change Pyramid
New
Outcom Identity
e
Beliefs
Progress
Capabilities
Behavior
Chaos
Environment

55. The Change Pyramid
New
Outcom Identity
e
Beliefs
Progress
Capabilities
Behavior
Chaos
Environment
Begin Again

56. Psychological Mindsets to Change
Even Keel

57. Psychological Mindsets to Change
Growth
Even Keel

58. Psychological Mindsets to Change
Growth
Discrepancy
Even Keel

59. Psychological Mindsets to Change
Growth
Discrepancy
Even Keel
Trouble

60. Psychological Mindsets to Change
Growth
Discrepancy
Even Keel
Discrepancy
Trouble

61. Psychological Mindsets to Change
Growth Overconfidence
Discrepancy
Even Keel
Discrepancy
Trouble

62. Psychological Mindsets to Change
Growth Overconfidence
Discrepancy
Even Keel
Discrepancy
Trouble

63. What we’ve covered
1. Today’s economic climate
2. Where you fit in the economy
3. The new consumer’s mindset
4. Practice personality
5. The Team
6. Expense Management
7. Assigning tasks
8. Time Posteriority & the business paradox
9. Live for change
1.
2.

64. What’s Next?
You can’t do it all yourself

65. You can’t do it all yourself
Task Reduction


66. Total Tasks 138
Staff can
perform 60
Base line

67. Total Tasks 138
Posteriority
Discrepancy
68
Staff can
perform 60
Base line

68. Total Tasks 138
Automation 48
Staff can
perform 60
Base line

69. Total Tasks 138
Posteriority
Discrepancy
30
Automation 48
Staff can
perform 60
Base line

70. Implement Task Reduction Strategies
 Patient Communications
Software
 New Patient Tracking
 Practice Surveys
 Appointment Confirmations
 Recall Systems
 Patient Reactivation
 Newsletters
 Practice Marketing

71. Implement Task Reduction Strategies
 Vendors
Lighthouse www.lpmg360.com
Demand Force www.demandforce.com
Smile Reminder
www.solutionreach.com/dental
Televox www.televox.com
Sesame www.sesamecommunications.com
Patient Activator www.1800dentist.com

72. Who's your Caddy?

73. You need a Caddy
It's impossible to do it all on your own
 Forever proposition
The Wind Changes Constantly
 The Caddy knows the whole game
 He gives the advice, you hit the ball


74. You need a Caddy - Who do you select?
 Are they Current?
 Last books read, Courses attended
 Who says so besides them?
 Investment?
 Cost, payment options?
 Expenses
 Opportunity Lost Costs
 Time frame
 Where does the coaching take place?
 Is there a GUARANTEE? ROI, Contract?

75. What we’ve covered
1. Today’s economic climate
2. Where you fit in the economy
3. The new consumer’s mindset
4. Practice personality
5. The Team
6. Expense Management
7. Assigning tasks
8. Time Posteriority & the business paradox
9. Live for change
10. You can’t do it all yourself
1.

76. What’s Next?
1. The Interaction Game
2. Ralph’s Laws to Winning

77. The Interaction
Game

78. Relationship Management
This is more important today than ever before
 Objective is to Win Every Interaction
 Richard Cialdini, PHD, Arizona… Persuasion
 Interaction Points
 Industry No Control
 Indirect Contacts In Control
 Outside the Practice In Control
 Inside the Practice Indirect In Control
 Face to face
 It’s the soft stuff that makes the difference

79. Excel at Relationship Management
This is more important today than ever before
 The Point System
 Delight = 1 Point
 Neutral = 0 Points
 Negative = -2
 Winning the Game
 Can’t, the game never ends
 You start at -12 points with most new
Patients

80. Live By Interaction Laws
First Law for Winning Interactions
Find the
1.

81. Live By Interaction Laws
Second Law for Winning Interactions
Never Let your

82. Live By Interaction Laws
Third Law for Winning Interactions
+6= Chaos

83. Fourth Law for Winning Interactions
Solve the Compromises
 Patient Sacrifices to be your patient


84. Fifth Law of Winning Interactions
The Law of Opposites
Money compromise
Patient Mindset:
Dentistry is Expensive
Opposite Mindset:
We Make Dentistry Affordable

85. The Law of Opposites
Time compromise
Patient Mindset:
I’m forced to come in when you’re
open even though I work 8 to 5!
Opposite Mindset:
We work on your time frame not ours!

86. The Law of Opposites
Waiting compromise
Patient Mindset:
I hate waiting after my scheduled appointment
Opposite Mindset:
We will see you no later than 10 minutes from your
scheduled appointed time.
time

87. The Law of Opposites
Pain compromise
Patient Mindset:
Dentist equals pain.
Opposite Mindset:
We have a no pain policy. We make
you comfortable, because we care.

88. The Law of Opposites
Lecture Compromise
Patient Mindset:
I don’t like being talked down
too.
Opposite Mindset:
We don’t lecture, you’re in control.

89. The Law of Opposites
Pressure compromise
Patient Mindset:
I don’t like being pressured to
accept treatment
Opposite Mindset:
We Listen, Learn, & Educate. The decision to
select treatment is yours.


90. Sixth Law of Winning Interactions
 Establish a Practice Theme
 The Theme describes you and your
practice.
 All your processes, procedures, and marketing
revolves around the theme
 Dentistry
 Distinctive, Affordable, Patient Centered
 Trust, Knowledge, Compassion
 We work on your time frame, not ours
 Shortcut to decision making for
you and the patient

91. Seventh Law of Winning Interactions
The Practice Portfolio
 It’s the outline of your entire practice
 Who are you
 What do you do
 Where are you located
 When are you open
 Why you’re in business
 How you treat your patients
 This outline is used as a guide for goal setting,
advertising, systems development


92. The Practice Portfolio
 State the Practice Theme  When are you open
Distinctive, Affordable,  What procedures you do
Patient Centered
 High Technology
 Compromises Solved
No waiting
 Photos of
Dentistry that fits into  The Doctor and Team
your budget  The Outside of the
A no pain policy Practice
Free Second Opinions  Reception Area
 Doctor & Team Bio’s  Front Desk
 Where are you located  Operatories
 How to contact you  High Tech Equipment
Web, Phone, Email  Doctor’s Video


93. Eigth Law of Winning Interactions
$10,000 Meeting
The Morning Huddle
 If you live in a mill town does the smell
go away or do you just become
desensitized?
 Keeps the team, keen
 Interaction Feedback
 What did we do great yesterday?
 What are we going to do today?
 What do we need to change?

96. What we’ve covered
1. Today’s economic climate
2. Where you fit in the economy
3. The new consumer’s mindset
4. Practice personality
5. The Team
6. Expense Management
7. Assigning tasks
8. Time Posteriority & the business paradox
9. Live for change
10. You can’t do it all yourself
11. The Interaction Game
12. Ralph’s Laws to Winning
1.
2.

97. What’s Next?
The Interactions you can control

98. Interaction Advertising
Publicity
Points Referral
Patients

99. Marketing Interactions
Definition
The process or technique of
promoting, selling, and
distributing your products and
services

100. Marketing Interactions
The Team
 Uniforms
 Name Tags
 Business Cards
 Conduct IN and OUT of the Office
 Presentations
 Trade Events

101. Marketing Interactions
The Patients
Surveys
Referrals

102. Marketing Interactions
Advertising
Designed to develop Attention, Interest and move
the prospect to the next Interaction Point
 Direct Mail
 Use your Practice Portfolio
 Develop your target market
 Solve a compromise
 Make an offer
 Be consistent, Be consistent, Be consistent
 Know your return on investment

104. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social
Network New
Google Places Patients
Adword
Landing Site
Mobile Apps

105. Expectations Theme What, Why How Who, Where, When,

108. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social Network
Google Places
Patients
Adword
Landing Site
Initial Call

109. Initial Call
It all comes down to this
Every inbound call can make you
$1,026
This interaction must be at least as
delightful as the last or you will
lose
Don’t let your water be off
Beware of electronic buck passing


110. Initial Call
1. Answer by the third ring
2. Use the appropriate greeting
3. Identify yourself by name
4. Maintain a pleasant tone and be business like
5. Handled the call efficiently without being abrupt
6. Provide accurate information or refer the caller
to the appropriate person
7. Reflect the best image for the company
8. Ask Permission


111. Initial Call
1. Always ask for the
appointment
2.
$1026
3. Practice, Practice,
Practice
4.
5.
6.
7. Know the answers to
commonly asked
questions


112. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social Network
Google Places
Patients
Adword
Landing Site
Initial Call
New Patient
Appointment
What Type?

113. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social Network
Google Places
Patients
Adword
Landing Site
Initial Call
n t
a tie
o P
n tt
Se
New Patient
Scheduled
Save the Date email Confirmation email
Welcome Letter Confirmation Text
Medical Dental Forms Assistant Call

114. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social Network
Google Places
Patients
Adword
Landing Site
Initial Call
n t
tie
Pa
o
tt
S en
New Patient Outside Signage
Scheduled Parking Lot
Landscaping
Save the Date email Windows, Roof, Paint
Confirmation email Foyer
Confirmation Text Other Businesses or
Assistant Call vacant offices
Medical Dental Forms

115. The Internal Marketing Campaign
Lighted Signage
DENTIST

116. The Internal Marketing Campaign
 The signage
- - - TI - T

117. Signs Can
Tell the
Story

119. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social Network
Google Places
Patients
Adword
Landing Site
Initial Call
New Patient Outside Signage
Scheduled Parking Lot Reception Area
Landscaping Meet & Greet
Save the Date email Windows, Roof, Paint Patient walk through
Confirmation email Foyer
Confirmation Text Other Businesses or
Assistant Call vacant offices
Medical Dental Forms

120. Front Door Entry
 Classy looking
 Beware of Law Suits!

Texting and Glass
don’t mix.

121. Reception
?????

122. Meet & Greet
What’s wrong with this?

123. Meet & Greet

124. Interaction Advertising
Points Publicity
Referral
External Interactions irie
s
u
Inq
Website
Social Network
Google Places Patient Ed in Consult area
Patients Dr. & Assistant Review
Adword New Patient Exam
Landing Site IntraOral Camera
Perio Exam
Initial Call
Diagnosis
n t
tie
Pa
o
tt
S en
New Patient Outside Signage
Scheduled Parking Lot Meet & Greet
Landscaping Reception Area
Save the Date email Windows, Roof, Paint Patient walk through
Confirmation email Foyer
Confirmation Text Other Businesses or
Assistant Call vacant offices
Medical Dental Forms

125. Case Presentation and Follow Up
 Do it Now, if you can
 Set a dollar amount to move them to the
consultation room
 Set a dollar amount to move to a
consultation appointment
 Prepare a Visit Report and make it
available via the Internet (secure) or
Send via 2 day delivery.

126. Case Presentation and Follow Up
 Develop a Treatment Findings Report
 Explain this can be used for a second
opinion. (Builds Credibility and Trust)
 To be shared with spouse or significant
other
 List Present conditions
 List Pathology Found
 Treatment Recommendations
 Supporting docs / IOC / Xrays
 Optional with $$ amounts
 Include financing options

127. Case Presentation and Follow Up
 Consultation Visit
 Call the night before
 Clarify any issues prior to the patient coming in
 Be ready with financing options
 CareCredit
 Phased treatment, etc.
 In-House if applicable
 Insurance estimates
 Doctor presents the treatment and goes over the
details
 Financial Coordinator goes over options and
schedules


128. Interaction Advertising Case presentation
Financial Consult
Points Publicity
Referral
Case Acceptance
Restorative Appointment
Hygiene Appointment
External Interactions irie
s
u Patient on Recall
Inq Patient Survey
Website
Social Network
Google Places
Patients Patient Ed in Consult area
Adword
Dr. & Assistant Review
Landing Site New Patient Exam
IntraOral Camera
Initial Call
Perio Exam
n t
tie
Pa
o
tt
S en
New Patient Outside Signage
Scheduled Parking Lot Meet & Greet
Landscaping Reception Area
Save the Date email Windows, Roof, Paint Patient walk through
Confirmation email Foyer
Confirmation Text Other Businesses or
Assistant Call vacant offices
Medical Dental Forms

129. Interaction Advertising Case presentation
Financial Consult
Points Publicity
Referral
Case Acceptance
Restorative Appointment
Hygiene Appointment
External Interactions irie
s
u Patient on Recall
Inq Patient Survey
Website
Social Network
Google Places
Patients Patient Ed in Consult area
Adword
Dr. & Assistant Review
Landing Site New Patient Exam
IntraOral Camera
Initial Call
Perio Exam
n t
tie
Pa
o
tt
S en
New Patient Outside Signage
Scheduled Parking Lot Meet & Greet
Landscaping Reception Area
Save the Date email Windows, Roof, Paint Patient walk through
Confirmation email Foyer
Confirmation Text Other Businesses or
Assistant Call vacant offices
Medical Dental Forms

130. You’ve Come a Long Way
 The Outcome of getting back to basics and
working smart
 Increase New Patients?
 Improve Case Acceptance?
 Enhance Collections?
 Decrease Stress?
 Work Less Hours?
 Reduce Expenses?
 Strengthen Efficiency and Effectiveness?

131. End
Slide

136. Operatories

137. Sterilization
 Wide open to view
 Must be clean
 Consider Labeling

138. The Lab
Keep the
door closed

139. Staff Lounge
 Location in the practice
 There’s no Cup Fairy

140. Doctor’s Private Office
 Close door if not neat