396: To Expand Your Practice or Not?

It’s Brittany, folks! 

Dental A-Team consultant extraordinaire Brittany Stone is here again! For those of you wondering if it’s time to grow your practice, this episode is for you. Brittany and Kiera talk about whether the time is right to expand and what needs to be established to get things going.

The short version: Three things to have in place before you move forward …

1. A location

2. An operations manual

3. A leadership team

The pair also discusses how to bring your team on board with such an important decision.

More on Brittany:

I have spent my life in and around the dental field. Raised by a dental assistant, my training started young and my journey in dentistry continues as I strive to help teams realize their dreams!

Working in dentistry for over 15 years, I have had the opportunity to work in a variety of structures from small to large and private practice to dental support organizations. I have learned how the organization and management of an office impact the lives of each team member and patient. I have studied healthcare administration while working most positions in a dental office including hygiene lead, coach, and office manager. This helps me bring an understanding of driving value and patient care to help dental teams cultivate a fulfilling work environment. 

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Podcast Transcript:

Kiera Dent:

Hey everyone, welcome to the Dental A Team podcast. I'm your host Kiera Dent, and I had this crazy idea that maybe I could combine a doctor and a team member's perspective because let's face it. Dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, biller, office manager, regional manager, practice owner and I have a team of traveling consultants we have traveled to over 165 different offices coaching teams. Yep, we don't just understand you we are you. Our mission is to positively impact the world of dental and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create a team. Welcome to the Dental A team podcast.

            Hello Dental A Team listeners this is Kiera and you guys, this is going to be a fun topic for you. I'm excited about it I've got the awesome Britney, she is a traveling consultant she's just got a wealth of knowledge. She's grown several practices so I'm actually going to have her tell you a little bit about her experience that she's already had because we're going to be talking about growth of practices when to add another location, how to grow your team. So a lot of tangibles, but I want you guys to hear Britney's story and background of what she's already done for practices. And then we're going to dive into how do you grow your practice into that next level as well? So Britt, welcome to the show, no pressure give us your background. [inaudible 00:01:32]

Britney:

Thanks yeah, I'm happy to be here excited for this one. I feel like we work with a lot of practices who are looking to either expand operatories or expand locations. And we work from a lot getting the team ready, getting the office ready and what do we need to do to actually make that happen? Now my experience I've worked in a variety of sizes of offices from small doctor one [inaudible 00:01:56] practices to up to five doctors in their practice, have watched DSL model, watch practices grow, watched additional locations be added. And so I think for those who are looking to grow their practice, either adding operatories or adding locations, really being able to focus on what needs to be happening with your team and with your systems for you to be able to scale up is huge. So that's where we're going to go today.

Kiera Dent:

Oh my god.

Britney:

So it's fun it's always exciting when practices are looking to grow and they're taking care of so many patients to determine yep we're at that point we need more space. We can't handle the number of patients we've got we need to expand, which is great it's a great place to be in.

Kiera Dent:

So-

Britney:

I think I really... yeah go for it.

Kiera Dent:

I want to ask on that one because I get asked this a lot and I'm just curious on your opinion on it. How do you know that you're ready to expand? Because that's always the question of... I feel like I'm drowning but I mean I saw a schedule today and this person's like, look at this schedule and I looked at that and I'm like, that's actually not too bad. So it's almost that relative notion that I feel a lot of people are like, well, I'm drowning I feel like we need to expand, but Britt what's been your experience of when do you expand, when do you add that extra operatory? When do you know you're ready for that next location? What's your thought and what you guys have done in the past in your practices.

Britney:

Yeah, I think a big thing is how many new patients do we have coming in so looking at what new patients do we have coming in, what's our attrition rate and are we consistently growing? Because if you are and you're consistently growing with new patients, then you can expand and add more operatories or add another location. So I think that's a real big key factor and then we also just want to make sure that our office is actually profitable. So the model that we have working for us right now is something that we can duplicate or expand upon so that we will continue to be profitable.

Kiera Dent:

Mm-hmm (affirmative).

Britney:

But the big thing is making sure we've got new patients where additional providers that might be added that we're going to be able to wrap them up and get them busy and we're not just staying busy with the same number of patients we've been taking care of.

Kiera Dent:

Yes and I think that also ties into attrition. So knowing how many patients are attritioning out of your practice, because you might be able to close that back door where patients are falling out the back and be able to keep them in then that becomes like a balloon where then you really do need to expand to another location. I also recommend to my offices and our clients, before you expand though check to make sure that's what you actually want to do. I think there's a lot of glam and glory around, oh, we had to add another practice or, oh, we had to add another operatory because we're so busy.

            That feels really good for our egos, but bottom line is do you actually want to run another location? Do you want to do that? Because I had an office today actually, we were talking, they're getting so many new patients so I asked them, I said, well, do you guys want to expand? Because you're at the spot you're bursting we don't have enough space to reactivate patients because our hygiene schedule is booked out to three months, nowhere to put these new patients that are coming through. And the doctor said, no, I don't want to expand that's not the model that we have. So then we can pivot back and say, okay, what do we do? Do we start cutting insurance plans?

            Do we look to see the type of patients that we're bringing in? Do we rework our business model? Maybe we start to become a little more fee for service, start to limit the number of patients coming in because they literally sat there and thought, do we want to expand or do we not want to expand? So I think that's an important point to make sure you're not just growing for the sake of growth, but growing because you genuinely want to grow and that's something that inspires you, you want to help our patients and your team's on board with that as well.

Britney:

For sure and I think that's a really important point to make because that vision and where you ultimately want to end up is what's going to either take you to the next level or let you know that you need to revamp what we're doing. Because I think in order to grow, expanding the team, adding operatories or adding locations, your team needs to know your vision that's one of the most important things. They need to know what it is it needs to be communicated to them. Something that they can understand so that if we are growing and we are changing, because change can be hard for people, they know why we're changing and where we're headed.

Kiera Dent:

How many of you have wished that there was an easy way to get that dang operations manual done? Well, guess what? We are here to deliver, that's right join us for an entire eight hours and get eight hours of CE Friday, September 17th, for operations manual creation. That's right we are literally going to walk you and your team through step-by-step workshop style, it's virtual. And we're going to get that operations manual started and quite a few pieces completed. So join us on Friday, September 17th, utilize our coupon code podcast ops that's podcast ops, head on over to the DentalATeam.com backslash events. I cannot wait to see you let's get that operations manual done, done, and done bring your entire team and I'll see you guys there.

            Yes, because I think if you don't have a team that's behind you and backing this, then you're just growing and that's your own vision, but it's so much easier if you've got a team that's like, heck yeah, let's go. We're ready to do this because then they want to build the protocols, they want to build the maps. They're very invested in this process and it's much easier to drive that growth versus pulling people to that growth .

Britney:

Hundred percent and so I think true leaders are really good at being able to communicate and express their vision and to get people on board. And so I think some ways that you can help to do that once you've determined yep this is our vision we want to grow, we want to either expand our location or add an additional location is to make sure that you can communicate that vision, keeping it simple, making sure you're being authentic. I think in healthcare, anywhere we appreciate when it's authentic, but in healthcare we really are here for our patients. So making sure it links back to the reason why we're here and why we do what we do.

            And then just making sure you're communicating it to your team through multiple channels and repeat, repeat, repeat so that we all know the vision, we're all on the same page and we're ready to go with it and then making sure to get some feedback from your team on where you're headed. So that again maybe they see something a little different, they can have some important feedback for you. And also, so you can work through maybe some barriers with your team members as you bring them along with you.

Kiera Dent:

I really love the idea of bringing your team along with you. So Britney, let's dive into this so we've decided, Hey, we have the number of patients, we're profitable, we're ready to expand and add extra operatories. Don't forget to look in your current space too I'm going to throw that out there I had an office that I walked into. They listen to the podcast so shout out to you guys. I walked in there and I asked them [inaudible 00:09:00] all right guys, I'm here what do you want me to help out with? And they said, well, we're max on space so there's nothing we can do. We're building a practice across the street that's all we can do. I'm not going to lie to you guys I was in there for 10 minutes and I found space for two more operatories within their own location.

            The doctor looked at me and said, I should have hired you long before I built that other building because I needed more space so I thought I had to build another building, but in their own space they actually had enough space to add two, if not three, like they could actually get squishy in there. There could be three operatories in that practice so first of all, make sure we're not doing that. So that was kind of a fun experience, and then I love that you talked about getting your whole team on board so to that point, we know we want another practice or expanding. We've explained it to our team, our team's like, heck yeah, let's do this. We're doing this because we want to help more patients we've expanded, we have the growth. And I'm usually really big on making sure I watch my growth for three to six months typically before I decide to expand. Sometimes that can be too long I just want to make sure it wasn't seasonal.

            So maybe it's seasonal on the fact of having... maybe you're super, super busy in Q1, but then Q2 three and four, it actually drops off and the reason why is, or maybe it's in the summer, like Arizona [inaudible 00:10:15]. So they come in and you're so insanely busy, but then guess what? You actually will slow down. So you wouldn't want to be expanding there so I'm really big on watching trends as well before you go to expand. So let's say you've done all that homework you've researched it you're good to go. What's the next step? What should you be repairing? I personally don't think you should be like, ah, we're ready to go we need to expand. I think that's too late, I think as you're watching, preparing, watching your trends, you start to build and prepare for this growth. So Britt, what are some of those things they should be preparing for? If they know they're probably going to need another operatory expand to another location, what do you suggest they do?

Britney:

Yeah so always looking for the opportunities like Kiera said to see where you could expand within your office you can start to plan the practical construction side of things. And then the other part of it that's going to come along is going to be your team is going to be growing and how are we going to manage that when we've got more people in the office, more things going on? And so that's where I think from the team perspective is making sure we've got our leadership and chain of command in place often in dental offices, we're used to a small office and we may not always have an office manager or the doctor might be doing everything on their own when it comes to managing and really starting to build out that leadership team to where we've got an office manager in place. We may need team leads in place for assistants and hygienists and admin team.

            Maybe even like a clinical manager in place to help keep things running smoothly. So really starting to build out that leadership team to help to support the doctor and doctors in the office so that they're ready to take care of the patients and make sure everything's running smoothly.

Kiera Dent:

Gotcha. I really love that we have an office that we're coaching right now and we're purposely coaching them to grow so that way they're in their next location. So it's credentialing another provider they're growing team membered with in the practice right now of leadership. The OEM who's been the main shipping the whole time is now starting to delegate to other team members to see which ones can be their right hand, because they're going to be transitioning to that next location and need to make sure that their current location doesn't fall when they're not there so creating KPI, reporting scorecards now, having people follow through having people start getting on coaching calls with us to grow them on their leadership skills. I think that's a huge key piece of it and then also another piece is stamping out your ops manuals.

            So that way you really do have a cookbook, a recipe book to take with you to the next location. So how do we answer the phones? How do we schedule our patients? How do we set up our operatories? How are our hygiene exams? Because you're going to have a new team there thinking about how we want to onboard new team members, are we going to take a traveling team? I know when I was in private practice, we opened seven locations. I helped open the first few and we had to come up with a training plan of where would we send these team members to ensure that the team members were being trained. So we had to set up a process where they'd go through our main location before they'd move on to their second location and building out that training process but I'm big on listing all these topics and processes out.

            Then I work backwards so let's say we're going to have our new location built in six months. What's my work backward plan? What needs to happen this month, the following month, the next month? So I have checklists the whole way through to make sure I'm not missing anything and I really think a lot of our clients utilize us as coaches during that time because we've done it. We've done it many times so we can see those blind spots I wish and Britt, I don't know how you are but I wish with my whole heart and soul the whole reason Dental A Team consulting came about is because we built a consulting company of what we wish we would have had, like who I am today is due to the school of hard knocks and I had a lot of hard knocks through school and I wish that I would've had a coach that already been through it.

            It would have saved me a lot of time, a lot of stress, a lot of mistakes, and so we guide a lot of offices when they're ready to grow on, yeah, you're ready to do this, let's get these people in, here's also resources for outfitting the equipment for the operatories and ways to save on that area, growing your leadership team, building those KPI scorecards so when you're out of the office the whole team's reporting, building up those operations manuals, all those things that I did not think of I'm like, yeah, let's just buy our next location it'll be fine. And it was psycho mania that took place but then ended up shaking out. So those are some of my thoughts on how to do this growth and the steps through. Britney, what were some of your step throughs that you did as you were building out your next locations?

Britney:

Yeah, I think really having your ops manual operations manual and systems built out, just knowing that when you're going to grow a team, you're going to go to another location. If you've got something that's working, you want to make sure you can have some continuity and have it work somewhere else. Also, along with that you're going to be bringing on new people so when it comes to training, like you said, having an onboarding process, figuring out a way to really ramp them up and bring them up in the company so that they can be successful. And then just knowing long-term the bigger you are, you're going to have some degree of turnover so setting yourself up for success to where you're training them in the same way and setting all of your team members up for success.

Kiera Dent:

Amen, and as I was listening to this, I was thinking, Hmm, I wonder how offices feel hearing this if I was listening to this I think, okay, it's a good checklist that's a good start, now I've got to go do that. And you need to remember, it's not as scary as it might sound it's not as daunting and it's really important and much easier if you utilize your entire team. So I like to use the team as, okay, Who's got strengths in these areas? Who can own creating the operations manual? We know we're going to be buying another location at this time we're all super jazzed about it. So let's think logistically what needs to happen and when, let's build that timeline back and then have team members own those areas so it's not all falling on you.

            Credentialing, when does that need to take place? Are we branding it the same way? Or are we going to have a different name on it? What about tax ID numbers? What's going to happen with that? What about getting all of our insurance set up in that place? Are we going to be on the same software? I would strongly recommend yes or your swap softwares, if you need to have another software, what about our social media handles? Is it going to be the same or do we need to have another one? What about team members? How many team members do we need to staff? What about our marketing efforts down there? What about our Google accounts? All those little things you've got to think through, go back and remember what you did when you started your very first location, build that out, look at it and then really, truly utilize your whole team.

            Like Britney said, you will have turnover. That is part of business 101, guys that's part of it. And so also preparing, because I think getting team members trained up as quickly as possible to the standards and the models you've already had. It also helps realize how much was tribal knowledge right now we realized in Dental A Team, like a lot, we brought Britney in and I'm like, Aw man, you have not been here for the last four years we've [inaudible 00:17:22] build up manuals and operations. So she knows how to do it quickly and effectively and always refining that process. And I think it's an exciting time it's a great experience and making sure that your whole team's on board and bought in is going to make the process so much easier too.

Britney:

And that helps you to build up your leaders too as you rely on them and engage them in the process of it and have them help you, build up things for their department, they get more engaged and invested in what's happening and really are excited for that growth.

Kiera Dent:

Mm-hmm (affirmative), absolutely. So Britt, if I'm an office thinking I might want to expand what would be my three quick hits from you to like, okay, I know I've got the patients and let's say, I'm going to build another location. What would be your three steps that you'd give me to get started today?

Britney:

So I think if you're looking for another location, so you're going to have to... Picking location is going to be big, picking a good spot for your office. I think making sure that you've got your operations manual and your leadership team, those are going to be the three, I think key things to have in place.

Kiera Dent:

For sure, and there's a lot of companies out there that help you with the locations, a ton of them out there that is going to be not 100% our world. We do the systems the inside, but we are well connected to a lot of companies that help you find your location. It's a lot about the analytics they can research the area for you, let you know if it's a good space or not. And then also deciding how big you want it I'm always a go bigger than smaller. You might think I only need five ops go 8 ops, you always want more operatories if you can, and that's available. And then definitely that SOP manual. And we have one on the Dental A Team it's a 750 page, don't worry, guys we keep adding to it, customizable, broken to every department within your practice.

            So we have dental assistant, hygienist, scheduler, biller, office manager, associate marketers, all those different pieces and we have it broken down into little guidebooks for you guys, and so if you don't have an ops manual you're looking for it. We have one on the Dental A Team on our website, the DentalATeam.com click on the virtual academy. It's in there, also any of our clients that sign up with it in gold or platinum also receive that as part of their coaching, offices love that so that's a great place to start even if you're like, ah, I might be thinking about this, get the operations manual do that now.

            And then start building those leaders and a great way to do leaders I personally think are in meetings look to see who speaks up in your meetings, delegate certain tasks and see who responds back to you without you needing to follow up with them, who's looking and guiding your team anyway, and start to give them more tasks and maybe bring them on maybe don't tell them that they're the leader if you don't want to, but really start to grow them and give them opportunities to be leads.

            I really think is a great way to build that leadership team, get yourself ready and prepped for the next location. And then there's a million other things in between so definitely reach out I think it's smart to work with somebody who's already been there, done that and can help you, guide you, prevent those pitfalls and really be a sounding board for you as well.

Britney:

A hundred percent yeah, so I think it's really again planning ahead being proactive. And when it comes to expanding you either things, you're like, ah, debating it now, but it's really something you want to start thinking about it and planning for it now.

Kiera Dent:

Exactly, they always say the best time to plant a tree was yesterday the next best time is today so I feel like ops manuals, preparing for another location it's time to do it now because I also feel that forces you to be a more equipped business versus just running as a very dependent on people practice which is always a scary place to be so regardless if you're looking to grow into another location or just running a business, these are some of the pieces to be thinking of so that way when the time comes you're already ready and you're not scrambling and preventing the growth that you're being much more proactive than reactive. So Britt, as always way to bring the heat and the ideas I love it so fun having you here, love having you on your team so thank you so much for today.

Britney:

Thank you.

Kiera Dent:

Absolutely, all right guys as always thank you for listening and we'll catch you next time on the Dental A Team. And that wraps it up for another episode of the Dental A Team podcast, thank you so much for listening and we'll talk to you next time.