In this episode, Casey and Jarrod explore the empowering effects of accountability in patient care. They discuss how setting expectations and boundaries can enhance the patient-provider relationship and drive positive behavior change. From setting realistic goals to providing continuous support, discover how accountability can be a game-changer in improving patient compliance and overall health outcomes.
Announcer:
Hello, everyone. Welcome to the Millionaire Dentist Podcast brought to you by Four Quadrants Advisory. On this podcast, we break down the world of dentistry finances, and business practices to help you become the millionaire dentist you deserve to be. Please be advised we do speak with an honest tongue and may not be safe for work.
Casey Hiers:
Hello and welcome. This is Casey Hiers back at the Millionaire Dentist Podcast in studio with Jarrod Bridgeman.
Jarrod Bridgeman:
Hey, how are you?
Casey Hiers:
Thriving.
Jarrod Bridgeman:
Thriving. You visited somewhere again recently. You're always out and about aren't you?
Casey Hiers:
Yeah, the Academy of General Dentistry, the AGD, their national meeting down in Orlando.
Jarrod Bridgeman:
Nice. How'd that go?
Casey Hiers:
It was a nice meeting, really all the way around. A lot of good learning. A lot of CE opportunities. Looked like everybody was smiling.
Jarrod Bridgeman:
Nice. Yeah.
Casey Hiers:
It was a good one. We had a packed house for the business side of dentistry. They come in smiling and they leave concerned,
Jarrod Bridgeman:
In tears.
Casey Hiers:
Because they realize all the areas that they can be challenged in or challenging as a practice owner and so many of them want to fix it now.
Jarrod Bridgeman:
Yeah. How does that feel for you being on stage and seeing people's faces drop when they find out this information?
Casey Hiers:
Yeah, probably what you'd guess. It's like, you'd rather just see big smiles. And so there's nods typically with the look of angst because it's almost like, oh, you got me.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
Like finally, somebody's called out these things that I don't really know about and I'm not good at.
Jarrod Bridgeman:
Yep.
Casey Hiers:
And nobody helps me with.
Jarrod Bridgeman:
Right.
Casey Hiers:
So there's nodding, but looks of concern. A couple people get up and I'm like, oh, I guess they're leaving. Well, they come back. My question is, did they just have to use the restroom, or did they go throw up? Because they really like, we just hit them in the bullseye.
Jarrod Bridgeman:
Right there.
Casey Hiers:
The point is awareness. But no, it was a packed house. A lot of people are now wanting to fix it, to see if it's fixable.
Jarrod Bridgeman:
Good. Yeah.
Casey Hiers:
So, no it was a nice resort.
Jarrod Bridgeman:
There's always room for improvement, so.
Casey Hiers:
Here's a sidebar too. There's a park down in Orlando that a lot of people like to go to and you pay a lot of money to stay on properties inside that park.
Jarrod Bridgeman:
Great.
Casey Hiers:
This was just outside the park. It was a family-owned hotel on a golf course. So nice, so amazing, and probably less than some of the places,
Jarrod Bridgeman:
Yeah.
Casey Hiers:
In the park. So sidebar look at the resorts near,
Jarrod Bridgeman:
Said place.
Casey Hiers:
That place.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
Because I was blown away by how good that resort was and I would much rather stay there and get dropped off at a gate than stay on property.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
Still takes 20 minutes to get there. That's just a little sidebar. Not what we're talking about today.
Jarrod Bridgeman:
Nope. No, but we are talking about money. So save some money.
Casey Hiers:
How about patients, ornery patient? How would a practice owner go about holding patients accountable and why would they want to?
Jarrod Bridgeman:
Okay. Well, first off, what does that mean? What does that mean to you? What does that mean to practice owners out there, holding patients accountable?
Casey Hiers:
Yeah. Good question. Patients who miss an appointment.
Jarrod Bridgeman:
Okay.
Casey Hiers:
And not just one, but you can see a trend. They miss appointments. They skip appointments. They're late to appointments.
Jarrod Bridgeman:
Is this ghosting an appointment and canceling at last minute on a regular basis kind of,
Casey Hiers:
No shows, but I think it also goes into also how about those patients who complain all the time, who potentially treat your staff poorly,
Jarrod Bridgeman:
Right.
Casey Hiers:
In the chair and outside the chair. How about folks that don't really take their dental hygiene seriously, folks you have to hunt down for payment.
Jarrod Bridgeman:
Right.
Casey Hiers:
So I think it's a broad net. Folks who never, they never accept cases or your clinical opinion on what needs done. And they clearly don't take pride in their dental hygiene themselves, but then simply come back and complain. That's probably, what do you do with those folks?
Jarrod Bridgeman:
Right. So before we even get to that, what are some of the side effects that can come from people? We've got a couple different camps, [inaudible 00:04:05] know skipping appointments versus, and then there's just crotchety patients.
Casey Hiers:
Time and money. Right. So with scheduling and schedules and all of that, I mean its time and money is what is at stake. But then also how about the happiness or culture of your practice as a practice owner. And not that you need to take a shot across the bow all the time. And, but let's say there is this group of patients, and let's say, you take the worst one and you literally fire them as a patient, which sounds like this. I really think you would love my colleague down the road.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
And obviously, keep it professional, but your team or your staff, that could send a message. Wow. We've been complaining about this person and they did something about it.
Jarrod Bridgeman:
Right.
Casey Hiers:
So there's a lot of benefits, but time and money and culture and morale, I think within an office potentially. But we're jumping ahead a little bit, but that's the topic. Let's get into it. As a practice owner, is there a place for that, and what factors are involved?
Jarrod Bridgeman:
Right. So let's start with looking at people who are skipping, not showing, canceling on a regular basis. What's that look like?
Casey Hiers:
Well, it comes down to policy, right? But that's three words, clarity, persistence, and we'll call it coaching, right? So if you can have those components with your patients, you're going to have better results, but clarity, clearly defined listen, if you are late. I changed primary care physicians.
Jarrod Bridgeman:
Okay.
Casey Hiers:
Went to one really good, big waiting list, but they text multiple times and emailed multiple times. If you are late to this appointment by five minutes, you will be reshuffled in the deck and there's going to be a price to pay, but it was very clear. There's a lot of clarity. So that could be something but listen, everybody gets them all again, but whatever your criteria is, it's got to be very clear. Maybe there's a financial penalty, or maybe it's yeah, we're not going to get you in for another four months. Now we're going to,
Jarrod Bridgeman:
This is something that needs to be laid out.
Casey Hiers:
Clear and persistent. They can't be surprised. If they come,
Jarrod Bridgeman:
Or taking it personally.
Casey Hiers:
Well, that's right too. No, absolutely. But if they come 12 minutes late, they can't be surprised let's say, if there is a policy that says, if you are more than five minutes late out of respect for our team and other patients there's a price to be paid. It might be monetary. It may be appointment wise, things of that nature. Now what a lot of people thinking, well, I don't want to lose that patient. Right. I'm busy. And so just to kind of dip our toe in this, you have to understand what your patient's per day is and your time with... There's a whole bunch of data that needs to be understood to determine how severe or how light your policy is going to be.
Jarrod Bridgeman:
I will say the other benefit I just thought of too, would be showing respect to the other patients that are in the waiting room. We've all been to a doctor's office or the hospital or someplace else where our appointment was at 10:00 AM and it's 10:45 and we're still in the lobby. So I think that's another great thing you're showing. They may not see it themselves. Like, oh, they're,
Casey Hiers:
They'll appreciate it.
Jarrod Bridgeman:
But they'll be like, oh, I was in and out today. I recommend Dr. X to my friends.
Casey Hiers:
Yeah. Now here's the rub. Some people listening aren't in a position to really do this.
Jarrod Bridgeman:
Right.
Casey Hiers:
If you're starting up a scratch practice, if your problem is patients and production and you're climbing that ladder, you can still have clear policies in place to make sure that to your point, some patients will respect that and tell their friends, Hey, I go to a place that's buttoned up and they're really sharp. And they actually keep things on time, but you're going to have less leverage if you're in need of that. Some practices they're on skates all day, they accept a ton of insurances. They're booked out months and months, and months, then you're in a position to really implement some of these things that might have some teeth into it.
Jarrod Bridgeman:
Right. So, you talked about how some practices can easily implement something like this. Some may not be able to because they're new or they're really needing patients. But how does one know if they meet the, I don't know, criteria is the best word, would meet that level of being able to start doing this [inaudible 00:08:22].
Casey Hiers:
Good question. And again, we would encourage all practice owners to implement something of this nature in some regard, because it's going to help with culture and business structure. And as growth occurs, it's going to be good to have these things in place, but it comes down to, okay, am I really going to get rid of nine patients because they fit into this category. And so then you have to look at, okay, what's the practice? What's the business model? Is it an insurance shop? Is it quantity shop or is it more of a fee for service? If it's insurance, what are your insurance adjustments? How many patients per day are you currently having? How much time with patients are you currently having? A lot of those data points are going to be important to really ultimately determine how aggressive,
Jarrod Bridgeman:
Right.
Casey Hiers:
This again, option, people should do this, but how intense is this going to be to hold patient's accountable?
Jarrod Bridgeman:
And so depending on what practice you are trying to operate, the numbers will be wildly different for you.
Casey Hiers:
Yeah. I mean, there's some practices that this could be a blessing.
Jarrod Bridgeman:
Right.
Casey Hiers:
Right. If you're X amount of minutes late, there's a monetary penalty. It really comes back to leadership from the practice owner and what they want their practice to be.
Jarrod Bridgeman:
Right.
Casey Hiers:
And this is just looking at patients, but this can go broad with your team and your staff. There's a lot of things, but holding people accountable, what's the right level for you and your practice. But whatever it is, it's got to be clear. It's got to be persistent. And there can't be any mistakes. Right. The worst thing you want is somebody who genuinely was late or missed something.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
And then they get hit with some penalty and they're like, what are you talking about?
Jarrod Bridgeman:
Right.
Casey Hiers:
That's the worst case. This has to be clear, signs everywhere, on the software that's text messaging, reminding people. But for me, I really like that when I saw it from my new primary care physician because what that told me is they respect time, theirs and mine and other patients. They don't want one patient screwing it up for everybody.
Jarrod Bridgeman:
Right.
Casey Hiers:
And so for me, I was attracted to that. It's not why I went to them, but that was a bonus. And so just knowing that this can really enhance the, honestly the reputation or the feel people have about the practice,
Jarrod Bridgeman:
Yeah.
Casey Hiers:
But also help you run more efficient because as a practice owner, if you're trending in the right direction, you don't need these people.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
And if you're in a position where you do your business model might need to be looked at by a firm like ours.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
But again, that patients per day and insurance and where you're at has a lot to do with it.
Jarrod Bridgeman:
Well, a lot of this, as you said, with culture and all that can really help build towards either A, keeping top talent in your team or attracting new talent.
Casey Hiers:
Sure.
Jarrod Bridgeman:
They're like, oh, I heard that's a great place to work for.
Casey Hiers:
Right. But for a lot of practice owners, they're not confrontational and it goes against their almost, like their personality.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
So this can be a hard topic for them. They have a hard time with people they employ and pay.
Jarrod Bridgeman:
Yep.
Casey Hiers:
They have a hard time with these conversations, let alone a patient who's paying them. That's why,
Jarrod Bridgeman:
So if you need me to come in and just kick a patient out and fire them,
Casey Hiers:
And just drop the hammer, you're offering those services.
Jarrod Bridgeman:
Fly me out. I'll take care of it for you.
Casey Hiers:
Well, and that's good humor.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
But that's why people like us as the third party, as third party oversight, we fall on the sword. We're the bad guy,
Jarrod Bridgeman:
Right.
Casey Hiers:
A lot of times with what gets rolled out in any regard and a lot of practice owners like that, because again, they're not necessarily confrontational by nature.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
And this kind of goes against that feeling of superior customer service, but it's just like anything. You can't let your bottom 15% of patients screw up your entire practice for all your other patients.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
And your team and staff that you're working with. That's not fair. Why put up with those, let's call it the bottom 15%.
Jarrod Bridgeman:
Because those bottom 15%, you may lose some of the top 15% who are tired of waiting and...
Casey Hiers:
It's a great point, and I think a good exercise could potentially be, you don't want to give your people too much extra work, but maybe your top assistant or top hygienist and a front office person, just a fun, little exercise of, Hey, who are the people that you just dread seeing or they're constantly calling and canceling, knowing what that list is. Maybe it's a small list. Maybe this isn't really even an issue for somebody.
Jarrod Bridgeman:
Right.
Casey Hiers:
But a lot of times you might find out, wow, there's a lot of people on this list. What's that costing me besides being frustrated. So a lot of ways to look at this, and it's not just hold them accountable, to pound your chest and be some tough person. But again, it's to honestly help all the other people that are negatively affected by a few bad folks.
Jarrod Bridgeman:
You know what, Casey, this was a pretty interesting topic. And I'm glad you came up with it. You normally don't have anything to talk about, which is fine. But as we shift from that, I do want to bring up, we will be out at some more events coming soon. I know we'll be in Schaumburg, Illinois at Topgolf, September 30th. Please visit fourquadrantsadvisory.com/events. We've also just about to announce several new events as well. We'll be in Colorado Springs, we're going to Tucson, we're going to be in Charlotte. So visit our pages, check us out. And if you're in those areas or close enough to drive, sign up, come see us.
Casey Hiers:
Yeah. We've had people drive three and four hours and I don't think it was for the Topgolf, it's for the subject matter.
Jarrod Bridgeman:
That's right. The Topgolf and the food is a nice bonus. Thanks, Casey.
Casey Hiers:
Thank you.
Announcer:
That's all the time we have today. Thank you to our guests for their insight and for sharing some really great information. And thank you to you, the listener for tuning in. The Millionaire Dentist Podcast is brought to you by Four Quadrants Advisory. To see if they might be a good fit for you and your practice go on over to fourquadrantsadvisory.com and see why year after year, they retain over 95% of their clients. Thank you again for joining us and we'll see you next time.
