Episode 788: How to Remove Bottlenecks for Practice Productivity

 Dr. Dave Moghadam returns, this time to chat with Tiff! In this episode, Dr. Moghadam reflects on how he’s addressed being overwhelmed as a doctor/practice owner over the past year, including:

• Learning to delegate

• Utilizing your team to make the right systems and processes

• Scheduling meetings and personal time

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Transcript:

Tiffanie (00:00.994)

Hello, Donald18 listeners. I am so excited to be here today. I am here today with one of my favorite people. And I say this a lot and I say it to him and I don't think he ever believes me, but he really is. He really are one of my favorite people. We've been working together for a few years now, Dave, and you have just this wealth of knowledge that it's unexpected. Like I know you're a smart man and you just, you know so much, but sometimes you just come out of the gates with something.

 

Dave Moghadam (00:12.405)

I don't.

 

Tiffanie (00:29.634)

totally off the wall and I'm like, this is the brain that I just I love picking your brain. So I'm excited to be here with you today. It's been a long time coming trying to get this scheduled. And I'm super excited because I we've been talking a lot lately, but I actually I get to be there like, less than a week from right now. And that's so cool. I was thinking this morning on my drive with my kid and I was like, Oh my gosh, like, it's literally less than a week that I'm gonna be freezing cold with you in Pennsylvania, Dave.

 

And you guys, this is Dave Mogram. And if you don't know him, if you haven't heard the other podcast, go back and listen. He's an excellent dentist. He is a brilliant man. Um, he's out in Pennsylvania. So we are across the country from one another and he's been working his tail off, uh, for the last little while for the last few years to really get his practice to where it's at. And it really is. In my opinion, in my.

 

As your consultant, your personal consultant opinion, you really do have a pretty well running machine, but there's always tweaks to be made, there's always growth to be made, and there's always things to be changed because we're ever evolving. So Dave, I'm just, I'm constantly impressed by you and I hope that you know that. Thank you for being here with me today. I know you love being gushed on and it's your favorite thing in the world, but how are you today, Dave? You so excited?

 

Dave Moghadam (01:42.344)

Thank you.

 

Dave Moghadam (01:51.096)

I'm doing great. I'm excited to be here. This is this is wonderful. It is it is definitely a long time coming. Glad we got our schedules aligned and everything and I'm excited to have you out on Tuesday.

 

Tiffanie (02:00.151)

Yeah.

 

I know, I'm so excited. I'm so excited to see you and the team and just all of the changes. I feel like every time I come out there, there's something new and there's some sort of new tech and something that you're doing and something that you're integrating and some scheme you've got going on with the practice and some sort of tech. So I think that's something that I really, really love about you and about your practice. I know earlier in our chatting, you mentioned that you've had hundreds of hours of CE.

 

and you just you dig in you find the new things but you vet you vet things really well before you bring them into the practice and you do your due diligence and you go to the CE courses and you learn as much as you can. But Dave, like just jumping right in I feel like something that I've noticed in all practices and something you mentioned this morning is CE versus implementation and first of all tell us a little bit about some of the CE that you've done this year.

 

And then second, let's talk about like bringing that back home. Cause I think that's a struggle for a lot of dentists out there.

 

Dave Moghadam (03:07.46)

Yeah, so I myself, like most dentists, I'm a constant victim to the shiny new object syndrome. And we can dig in a little bit more on that later, but when it comes to CE, it kind of goes in waves for me where I'll do a lot at a time and then I'll realize, well, this is all great, but I need to get the parts and pieces in place. Otherwise it's gonna get lost in the shuffle. So that's kind of been a lot of this year

 

learned a lot of great things and some things are easier to implement than others. So I did a

 

three-part series at the Mott Institute in Charleston, South Carolina, which is Exceptional if you want to get into the world of digital dentistry That's the place to be if you want to expand your knowledge beyond what you thought was even possible also the place to be Wally and Mike the guys who run it are exceptional great team and you know, that's outstanding and

 

Tiffanie (04:00.34)

Yeah.

 

Dave Moghadam (04:08.024)

What I learned there is a lot of things that are more intricate and more involved than I will probably do on the day to day basis. And we still partner with Lab Techs to do a lot of that design. But having done it myself and all the ins and outs gives me a better understanding and I provide them with better records and we get great results when we, you know, try and coordinate things same day, whether, you know, it's doing somewhere from four to 10 teeth, which most people.

 

Tiffanie (04:35.596)

Yeah.

 

Dave Moghadam (04:37.068)

Myself included, I never want to sit there and carve acrylic and hope that things are incanted or anything like that. Uh, it's not that I'm, I'm making a mess because I do regardless, but it's just not fun. It's not predictable. So, you know, these, these workflows that you'll learn that even if you don't have some of those programs like ExoCAD, you play with them there, you see what it's like, uh, you know, we have a bunch of.

 

Tiffanie (04:40.558)

Why?

 

Tiffanie (04:48.655)

That's fair. Yeah.

 

Dave Moghadam (05:01.192)

courses that, you know, we're sending a handful of our teammates to their 3D printing course in January, myself and Dr. Mallier doing a smile design course, and then we're doing a removable course with them next year around this time also. So that's, that's great stuff. And that's been actually a lot easier to implement because you don't have to do everything yourself there.

 

Tiffanie (05:16.615)

That's awesome.

 

Tiffanie (05:23.662)

Mm-hmm.

 

Dave Moghadam (05:26.783)

That was one big leg.

 

Tiffanie (05:28.838)

Yeah. So you said you mentioned that you're sending some team in January. So that kind of that spins. That's a huge, that's a huge course. That's a huge undertaking. That's a lot of stuff to learn and absorb. Um, and then get excited about. And I think that like, that's that shiny new object syndrome, right? And, and you just, I think we all do it, right? We go to a course, we get excited, even team members, we go to a course, we go to a convention and we're like, oh my gosh, I learned all this really cool stuff and I'm hyped up on Friday.

 

Dave Moghadam (05:34.972)

Yeah.

 

Tiffanie (05:56.118)

But then come Monday, like actually implementing that stuff is really difficult and usually goes to the wayside. So for you even, right, you're and for dentists alike, like you guys are going to these amazing courses. You're learning all this incredible information. You are ready to come home and implement it. But your team, they were at home. They were with their families on over the weekend while you were at this course. So what's something that's worked really well for you or like that you've noticed bringing things back with your team? That's been a struggle.

 

with that because that's a lot of stuff to bring home to them.

 

Dave Moghadam (06:30.588)

So this one was a good example of something that's a little bit easier because it is more doctor-driven. But regardless, what I always will try and do when we have our monthly team meetings, one third of that meeting is something, whether it's like a condition, a dental condition or a clinical topic or something like that. So when I go to a course like this, I make sure that's what our focus is at the next one. So this is definitely easier to implement. I did a sedation course

 

surgical surgery out in Utah. Great course. Definitely makes it very manageable, amenable, figuring out a safe way to go ahead and do things for your patients. I mean, implementation for that is a bear. They actually do something great where one of the course directors will basically do a consulting program for you where she'll help you get all set up. So I've been working with her on that. We're pushing through the finish line on that.

 

Tiffanie (07:01.911)

Uh-huh.

 

Tiffanie (07:12.468)

Mm-hmm.

 

Tiffanie (07:22.914)

That's cool.

 

Dave Moghadam (07:29.636)

And then right before we do the office inspection, we're gonna have her and the main assistant fly out and do an in-office training to get the team ready. So I've learned over the years from making a lot of mistakes and trying to struggle through it myself. It's worth it a lot of times, if there are opportunities like this in place, you gotta go for it. Because they're also gonna understand and relate to the team a lot better than I will.

 

Tiffanie (07:37.294)

Perfect. Yeah.

 

Tiffanie (07:51.286)

Yeah, yeah, yeah.

 

Tiffanie (07:56.374)

Right? Right, yeah. Yeah, we'll talk about that. We'll talk about that. Great.

 

Dave Moghadam (07:59.8)

I mean, we could literally say that everybody knows we could say the same thing. I talked about co-diagnosis for about four years. I played a Frank Spear video that was 10 minutes long and everybody thought this was like the greatest idea ever. You know? Yeah.

 

Tiffanie (08:11.398)

Yeah, yeah, I know. I know. Well, I come in, I come I've come in a couple times, right? And we've been like, jamming and doing the stuff. And they're like, all right, we can do this. And you turn around and you're like, what the heck like this? I talked about this two days ago. And I'm like, well, you primed them for me. Like, you're priming them. I come in and they're like, Yeah, I can I'll do whatever tip says.

 

Dave Moghadam (08:24.616)

Thanks for watching.

 

Tiffanie (08:33.386)

For a small amount of time right until tiff comes back in and she's like, why did you stop doing these things? So I totally get it. I have a lot of practices and a lot of doctors who say that same thing I literally I was consulting at practice one time and it was this incredible meeting and I walked right I was like dang We freaking nailed it guys. Like that was so cool Doctor was on a high. I was on a high the team was like just excited and the lead assistant turns around and she's like doctor How's it feel to have somebody come in and see the same things you've been saying to us?

 

in a slightly different way and we are just ready to go and she's like I'll do whatever it takes to get you guys to do the things I want you to do. Yeah, yeah I totally get it happens all the time I think that's why I have a job so I get it.

 

Dave Moghadam (09:08.244)

Yeah, I mean that's the big thing, absolutely.

 

Dave Moghadam (09:15.64)

I was going to say it's a big part of our working relationship.

 

Tiffanie (09:20.443)

I know, I know, I know. Like what are your goals? How can I frame it in a way that they're going to understand, accept it and get on board with it and push for it? That's my main job. So you've taken on a lot and I know that and I've seen it. I've seen it in your practice. You're constantly innovating, you're constantly growing and you're constantly looking for not just the next shiny new object because I understand that's definitely a thing.

 

But I also am on the side of if we stay where we're at and we're just content all the time, especially in dentistry, like you're going to fall really far behind really quickly. Dentistry is ever-changing, ever-evolving constantly. And I think people who are outside of dental, or maybe not even clinical, maybe people non-clinical, they sometimes don't understand that. So I definitely see that. And I think it's really incredible that you're able to take all of that on. But on the same vein, I think that one thing we've worked really hard on together,

 

is like, I hate the term work-life balance. I like to call it like life-life balance. You have one life, right? You work and you have a family and it's one life intertwined. And one thing I feel like we've worked on really hard is making sure that those lives, right? Those two lives are one life so that you're not constantly juggling one or the other and you're really more seamlessly working them together. And so...

 

I want to talk a little bit because I think this will hit home and it goes in line here with a lot of the stuff that you're taking on. You're doing all of the CE, which is not at home. You're away from your family. You're away from your practice. You're learning all of these things. You're growing. You're taking on side projects. What does that feel like? I want you to just be super relatable for these doctors who are doing the same thing, trying to stay on top of it, but maybe feeling like...

 

They're just overwhelmed. Like, what is that like when you just sit back and you're like, what did I do? How did I get to this spot right here? Take me through that a little bit.

 

Dave Moghadam (11:17.7)

Yeah, so I like creating things. I like growth. I like, you know, all of these things. So it's always super exciting. And if I think something's gonna be a great opportunity that's gonna help expand or benefit in a way, my initial reaction always is, oh yeah, like, let's go, let's do this. Not keeping in mind that fortunately, you know, in every other aspect, there has been change, there has been growth and we have been, you know, doing better in things.

 

Tiffanie (11:35.841)

Yeah.

 

Dave Moghadam (11:47.594)

So what that ends up coming at is a cost to me most directly, but then also my family and friends and everything like that. Because at the end of all of it, like you're still going to do your best to try and make time for your family and your friends, but there's no personal time ever. And that's kind of, not kind of, that's where I got to.

 

Tiffanie (12:05.633)

Yeah.

 

Dave Moghadam (12:13.736)

uh in these last couple years between the practice was doing really well and growing, I took on a second, this is gonna sound nuts actually when I said out loud, a second full-time job that's the opposite hours of my other full-time job which is owning a business and practicing which is already like two jobs, uh because I thought it was interesting and it was, uh but at the same time also there's not room for focusing on your family.

 

Tiffanie (12:23.79)

adventure.

 

Tiffanie (12:33.326)

Mm-hmm.

 

Dave Moghadam (12:42.556)

there's not that CEO time really of like, how do I go ahead and think big picture about the business and get changed that way? So it wasn't the best use of my time, but it was very interesting. I was able to help a lot of people. So this job that we didn't, I don't think we talked about specifically was, uh, I was a broker for dental practices in New Jersey for about a year and a half. So I live and grew up in Northern New Jersey, even though I practice in Pennsylvania.

 

Tiffanie (12:56.031)

Yeah.

 

Dave Moghadam (13:11.336)

So there was no conflict and I knew the area really well and I'm proud of what I did. There's about at least three practices that I don't think would have sold if I wasn't there. And it worked out really well for both sides because I took the time to create the relationships and build the trust in sticky situations. But it comes at a cost of, you know, everything else. Partially your sanity too.

 

but that's not be like overly dramatic. But I guess the point in what I am getting to and all of this stuff is it is great to be able to continue to learn and grow and expand. And sometimes you think you have that plan ready of, okay, you know what, like I got this in place, but if you're not continually paying attention and really taking...

 

Tiffanie (13:41.312)

Yeah.

 

Dave Moghadam (14:08.444)

Taking account into where you're at, all the moving parts, and do I have enough help? Do I have a plan in place? Do I have balance? It's gonna be unbalanced like yesterday.

 

Tiffanie (14:18.61)

Yeah, yeah, I agree. I agree. I remember vividly. I think about it often. Actually, I remember vividly a phone call. I remember two phone calls. I remember the phone call of tip I have this great idea. I'm going to do this thing. And I'm like, okay, I think that sounds like something we should consider. And you're like, well, I already did it. I'm signed up. And I said, great, let's do this. I got you. Okay. I remember that phone call vividly. And I remember the phone call about a year ago.

 

Dave Moghadam (14:27.213)

Okay.

 

Tiffanie (14:47.382)

Um, and I feel like it was, I feel like that phone call about a year ago was really like grounding, I think for both of us, honestly. And yeah, it was, it was the same time. I remember because I was driving, um, I was driving from my Newport, Rhode Island practice, uh, one of my other all time favorite humans. Maybe I just love the East coast vibe. Um, but he, I was driving from his practice to the airport and I remember you're texting, I was like, let's get on the phone now. I've got a 45 minute drive. Let's do this. And that.

 

Dave Moghadam (14:55.876)

Yeah, I remember this now that you say it.

 

Tiffanie (15:17.154)

phone call, I think was the moment when you were like, I don't like my plate is full. Like my plate I know my friend used to tell me, you've got this dinner plate. It's like a Thanksgiving plate. And you've stacked all the Thanksgiving food on top of there. You've got rolls, you've got green beans and turkey and all these things. And then people are like, well, do you want this? And you're like, Yeah, sure. And now your food is not just on your plate, you're shoving it underneath. And it's on the table. And it's like that was that moment for you where you were like, tiff.

 

My team is up in arms. My, I don't know what my practice stats are anymore. I'm like, what is going on? So tell me like, how did you come to that realization of like, aside from maybe it was just stress and you're just like, I can't like, I'm not, I'm going to explode. But how did we get to that point where we had that phone call of like, what is going on because I feel like that the reason I asked this question is that moment was the moment I was like, Dave.

 

has got this figured out, like he's bottlenecking so many spaces of life because he's trying to create these amazing things and reach these incredible goals, but he's trying to control it all himself. And how did you get to that point where we got on that call?

 

Dave Moghadam (16:35.724)

Yeah, so I think, fortunately or unfortunately, I'm very good at taking on more than probably most people think is...

 

capable, slash helpful, slash good. I mean, that's generally the comments from friends and family of, I don't know how you do that. And I say, I don't know either, but it's interesting. And I like to try and do it. And I have a good support system in trying to do the things I do. I think what happened in these cases is, even though I had like prior to that planned, you know, we got a administrative assistant for myself, which then moved over to the office to put out all the fires,

 

still, you know, there and I'm very thankful for that. But we've continued to, you know, as we continue to grow, I didn't like plan thinking forward and everything kind of came through a head where it was like, this is just way too many things. And there's just not any time for me to do anything that I actually really enjoy, not for some type of outcome, other than just the actual enjoyment of it. And

 

Once again, it's not to like sound dramatic or anything. It's just like you get to a point where you're like, well, this doesn't like, why, like, why am I doing this? This is not really fulfilling, even though on the surface, like this is cool. And like these things and these results are, are nice and it's great to help other people, but also you need some time for you. So that has been a big part of this.

 

Tiffanie (18:05.729)

Yeah.

 

Dave Moghadam (18:10.728)

journey this last year and will continue to be in this next year because now I've gotten rid of the other job but I've managed to shift it all onto practice plate which I actually think is okay because as we continue to grow and we build more of a team and there are things that I've offloaded and a lot that I would like to offload that I haven't yet that we're working on. That makes it more

 

Tiffanie (18:36.128)

Yeah.

 

Dave Moghadam (18:38.304)

manageable in that sense but when it comes down to when you incorporate the other parts of your life and it's just you in those aspects of things then it kind of all comes to ahead and you feel very um

 

all on you and it's a little more isolating than it needs to be for lack of better terms and that's even with having good friends, family, close-knit relationships around you, you just feel like I'm the only one who can do all of this stuff and it's not a good feeling and it's not the way anything should really be. Especially when it's by choice.

 

Tiffanie (19:11.05)

Yeah, for sure. I agree. Yeah. And, and some of it was by choice, right? I do think, I think the broker position, right? That job that you held, I think it did add the, obviously added an entire level of stress and it was a whole nother full-time job, like you said, um, but I think that it allowed you, like, I think everything happens for a reason. And I think what it did is that it allowed you to see.

 

areas of the practice, like you had to pull out of the practice a little bit in order to give some attention over here and it allowed you to pull out enough that you were able to see some systems from a higher level, I think, and not such a small granular level that needed improvement or that were going really well. I think one kudos I have, one giant kudos I have for you is that you have done so good this past year really seeing the things that are going right because you're

 

Tiffanie (20:08.674)

by dentistry to look for what's wrong, right? Human nature is to find what's wrong. We all do that. So we're already evolutionarily primed to look for what's wrong. Then you go to school to find on this, you know, granular level of this tiny little tooth in a mouth, what's wrong with it. So you're just trained to see all of that. And something you've done really well is to start seeing the things that are going right. And that, and you mentioned that like.

 

things are going well, the practice is doing well. And if we're constantly on that smaller level, we tend to bottleneck situations. So what are some implementable things that you felt like you really did this last year that helped you to relieve some of that stress? Because that job or not getting rid of that job helped, but you as a human are far less stressed today than you were two and a half years ago when we started working together. And that was prior to that job. Like you are, you're just more

 

slow than I've ever seen you.

 

Dave Moghadam (21:06.652)

Oh, that's very nice of you. You know, I appreciate the feedback there. I will add on the other side, this was also a compliment, but it's the complete other way you did tell me the other day that I was way better than almost anybody else you've ever met at figuring out the things that are wrong, too. So I mean, so I've talked about talk about balance. There you go. We brought it back full circle there. But as far as I think what has been helpful, and honestly, it's a working

 

Tiffanie (21:12.916)

Of course.

 

Tiffanie (21:24.419)

despair. I did. And I mean it. I mean it. I agree. I agree.

 

Dave Moghadam (21:35.44)

I think every day you kind of see, oh, this is better than that. Oh, God, it's gone sideways. But I think the big things that have actually pushed things more is as much as we all say it, it's like, oh, operations manual and systems and stuff like that. When something goes really, really wrong, I've been trying to make a better effort of whether it's myself or honestly what's worse better is getting other team members involved on kind of like, okay, let's get to the root of like.

 

Tiffanie (21:51.198)

Yep.

 

Dave Moghadam (22:03.696)

what do we need to do where this is going to be more predictable? How are we going to do it? Let's try and write it out. The next steps are going to be what I realized with a lot of things is maybe we have to make videos, maybe we have to do stuff like that because I myself, as many quote unquote books that I've read, I've literally read almost none of them because I don't have the attention span to read. I listen to stuff.

 

I don't like reading instructions to figure out how to do something. So I search on YouTube and I watch a video and then I do it. So you know, I think these are the things that were definitely better. But those I think are the directions that we need to continue to move towards to go ahead and alleviate that and not keep being, you know, like the yodeler on the Price is Right just starting at the bottom of the hill every single time. So one is creating those things with.

 

the other people and two, the other part is making sure we all know what's where and actually using it. Once again, way better. Not where we want it to be, but where we're getting it.

 

Tiffanie (23:10.122)

Yeah, yeah, I agree. I agree, I agree. I think that's brilliant. So implementable wise, you saw me for an operations manual, which you guys have been working on for a long time. And Tina, your personal assistant, has done an incredible job of getting all of that together. She's taken our courses and she was like, I can tell you right now, she was one of the people in those courses that was like.

 

I'm doing this test. I am doing this every single day. She showed up. She showed up to everything we've ever done. She shows up too. So she's just fantastic. You have a great team. And she was crucial in getting that written operations manual really streamlined. But I think, like you said, implementation wise was really figuring out how your team learns and how your team is going to utilize the information. Because you can have every system, every operations manual, you can have every instruction booklet.

 

for everything, but if they're not a check list or if they're not a like follow these flow charts and this guideline style learning, it's all for nothing. So implementation wise was, it sounds like you took that information and then duplicated it by video, by audio, however it needed to be, you're working on it. Yeah, yeah.

 

Dave Moghadam (24:21.832)

Well, we're trying. Like, it's still a work in progress. I was going to say that's the sick joke of the operations manual. We had it done like four years ago, you know, and then it's just like we're talking about it. That's never done. But where you are, there's always going to be more and things are changing and you're adjusting how you're doing things. And that's the nature of

 

Tiffanie (24:29.194)

I know, I know. It's never done.

 

Mm-hmm.

 

Tiffanie (24:38.442)

Yeah.

 

Dave Moghadam (24:43.844)

what we do and just life in general. You know, so I mean, I think that that's a big part of it is it's never actually done. And it's always figuring out how and what works and it is different for different people. And that's been a big part of what I've realized even the last month, I think we talked about this, I gave somebody an assignment, and they did a great job writing it out. And then I put the photos in for them of like how to do it in detail. And for them, it really like quick then.

 

Tiffanie (24:45.006)

demonstrate yeah

 

Tiffanie (24:57.532)

Mm-hmm.

 

Tiffanie (25:03.124)

Yeah.

 

Dave Moghadam (25:12.968)

I was like, okay, well now I know this is what we need to do because this is definitely within their grasp. We just have to help them succeed in this role.

 

Tiffanie (25:19.794)

Yeah. And I think in that vein right there, like an implementable that they can take away, I think what you're saying is making sure that everybody is super clear on the expectations. And I think that's something we've worked really hard on together and separately is really making sure people understand what your end results is. Like, what do you want that to be in the end? And narrowing down.

 

your visionary mindset and really narrowing it down into how can these team members accomplish those goals and then creating the systems around that. Which also kind of one leads me to tell me what's worked best for you on narrowing that down because you do your brain is constantly, constantly going, you're constantly thinking, you're constantly looking for improvements. You're constantly.

 

engaged. So how did you go from all of this visionary style ideas, big picture, to really be able to hone in with your team on what your expectations of them were?

 

Dave Moghadam (26:26.316)

a really good question. I don't know if I have a great direct answer. I think the best thing I can tell you is something that I feel has probably been working better, is trying to get it all out for myself. Whether it's like writing it out on paper in different like pages and things like that. Which I think I've shown you some of those things that I do. Or just like typing it all out

 

Tiffanie (26:48.298)

Yeah.

 

Dave Moghadam (26:56.43)

kind of figuring out okay like what's one thing in each department that we can try and figure out and work on a system because it's too much and I think a lot of times it is too much to expect what I would kind of think given all the other craziness of having a

 

reasonably busy office and everything else going on to go ahead and do that because change is hard no matter what even if you're sitting around twiddling your thumbs it's hard to create that time to work on that so i think that's a part of it and i think you know a lot of things that will probably make this better because there's it's just like everything else there's like a roller coaster so you're at different points in uh you know your development and organization and having

 

Tiffanie (27:19.495)

Mm-hmm.

 

Tiffanie (27:25.559)

Yeah.

 

Dave Moghadam (27:47.66)

off the rails on that. So trying to get back into a routine and a big part of what I want to push towards is like when I look at a lot of times things in work it helps me actually understand a lot of things that may work in life better. So when we actually started doing priority schedule, which we do rather than block scheduling by dollar amounts we do based on types of procedures and flow of the day and everything like that.

 

Tiffanie (28:03.884)

Yeah.

 

Dave Moghadam (28:16.052)

A big thing that I was thinking about the other day is I need to start doing that with the rest of my life stuff, which sounds nuts. It sounds insane. But it is very, it's actually easier than I think most people think to get busy enough where that actually would be beneficial and make sense and you'll start to prioritize and not say yes to everything.

 

Tiffanie (28:21.426)

Mm-hmm. Yeah.

 

Tiffanie (28:32.547)

for saying.

 

Tiffanie (28:39.026)

everything, not overload that plate. I agree. I agree. Because I think it helps you to see the time that you have left in your day. Right? I know in the dental team, at the beginning of every week, we all look at our schedule. And we look at what's our open time to do projects, right? Like, how many open hours do I have to take on a project for dental team this week? And I think when you're scheduling your personal life, the similar way of the priority scheduling, like you do your block scheduling at the

 

Dave Moghadam (28:41.546)

Yeah.

 

Tiffanie (29:08.298)

the practice, it allows you to see there's not white space. Like I don't have, I feel like this seems like an easy task and I could easily take it on and I could accomplish it in no time at all. But if I'm really looking at my schedule and what I have available of white space, there's really not enough left to take something else on. So I think in that, like answering that initial question means delegation, like you've gotten much better at leaning on your team.

 

to help you accomplish the tasks that you need to and being able to give them like more clear, almost a clearer direction than previous on what your expected end result is. So I think Tina has been instrumental in that. And I know we talked, I mentioned her earlier already, but I think that's an important piece as you were talking and talking about your scheduling. I think a lot of doctors don't know what to do with a personal assistant.

 

You know, we say all the time, like, get a personal assistant. It's going to change your life, but just like CEO time, right? So I think going through both of those, like what, how you hired a personal assistant, what do you, what does she do for you? Like, what are the tasks that she does and how can, how can doctors listening today see how that might benefit their lives?

 

Dave Moghadam (30:26.26)

So this is a really good question and it's one of those things initially I was like, I don't even think I'm gonna have like five to ten hours like a week and then within a few months it was, nope, this is another full-time employee. Now in our particular situation, which is probably similar to most offices around the country, the last couple years have been very hard to get enough people who want to be there, who want to work, or just in general. So her role has shifted pretty

 

Tiffanie (30:33.061)

Yeah.

 

Tiffanie (30:50.315)

Absolutely.

 

Dave Moghadam (30:56.494)

far away from stuff that has anything to do with personal. Sometimes she'll help me with some things, which is great. But a lot of times, honestly, when I try and figure out, well, what's the priority now? It's a lot of...

 

projects we're working on there that I don't physically have to have to do myself. Like, you know, let's say designing certain things in like Canva and things like that. That I think is fun. But like at the end of the day, when it, yeah, when it comes to, yeah, she is. And when it comes down to it, it's like, it's probably not the best use of my time, unless it's like the one-off kind of thing where it's like, ah, it's, I find this relaxing, I'm going to do this, but she does a lot of stuff for us there. Like, and organizing things like our quarterly, like patients.

 

Tiffanie (31:09.782)

Yeah.

 

Tiffanie (31:19.374)

She's really good at that though.

 

Dave Moghadam (31:38.782)

like raffles and all our like meetings making sure that we have everything ready ordering food and things like that for when you're coming all these other things that would probably get lost in the shuffle between other team members or it would be like oh god i have to do this on top of seeing this patient helping over here doing that doing that so it's another layer there a lot a lot of really good projects and with our office the way that it is

 

Tiffanie (31:39.924)

Mm-hmm.

 

Tiffanie (32:03.639)

Yeah.

 

Dave Moghadam (32:06.492)

Uh, we have basically a small to medium sized type of like construction type project, literally every year. Like I, I've single-handedly probably supported most of the local economy here with that, and I say that jokingly, and I, I love our contractor. He's, he's the best. He, uh, but we've given him a project, you know, every year and that's not easy to kind of remember all the parts and pieces and what's going on, where are we at?

 

Tiffanie (32:14.902)

Yeah, you do.

 

Tiffanie (32:18.83)

I'm going to go to bed.

 

Dave Moghadam (32:34.496)

we get all the things? Like it opens up opportunities to do all these things that you physically would not be able to do or you just would not never be able to sleep. And even it goes with I should say this even with all of that I don't sleep enough you know there's still too many things so that's like another so that's another thing of like one of my other projects that I have for myself later this week is starting to look at well what do I still do?

 

Tiffanie (32:36.152)

Yeah.

 

Tiffanie (32:46.896)

Mm-hmm.

 

Tiffanie (32:53.202)

Yeah, no you don't. Yeah.

 

Dave Moghadam (33:04.264)

that I can delegate out. Is it something where we can either hire somebody else part-time to help Tina with this or she can kind of like push things that way. Is it something where we can do something, you know, virtually to have somebody kind of help out with some of these things? Because I'm sure I could make a laundry list of stuff for.

 

the office but even personally like all these things and that's everybody's like hang up is like oh I'm like that sounds too bougie to do this and that but really at the end of the day it's like I mean I haven't cut my hair all year like I say that jokingly Tina used to Tina used to schedule my appointments until I told her that I was I was growing it out this year but like even something as simple as that you're gonna forget about like setting up these appointments and other things like that and it's in the shuffle of

 

Tiffanie (33:33.684)

Mm-hmm.

 

Tiffanie (33:39.414)

I can tell. I'm just kidding.

 

Dave Moghadam (33:53.7)

everything, it's going to get pushed to the side and some of those things can actually be really important and have a negative impact if you don't address them.

 

Tiffanie (34:02.378)

Yeah, yeah, I think that's brilliant. And I think something you said in the beginning that resonates with most doctors is you thought it was going to be a couple hours a week, five, 10. I remember you telling me like, Tiff, I don't even know what she's going to do. I'm like, she can do everything. Like, you're going to be surprised at how many things you can pass off to her. And she really is there. As many hours as we can get from her, we've got her there. So implementable wise for doctors, like...

 

I think something you did, Dave, that you're going to do again, right, is you really took a look at what are all the things that I'm doing as a CEO, as a business owner, as a dentist that I really, I could keep doing. That's fine. But you don't have to do, someone else could do that. So you did, you know, time journaling and you're looking at all of the different things every day that you're doing, like scheduling your hair appointments. You can do that. But like,

 

Why not allow someone else to do that who has access to both your both your personal and your work schedule To be able to combine those to see the most ideal times like why wouldn't you be doing that? So for dentists and doctors like that's how you're going to do it You're going to look at what are the things that i'm doing now that I don't have to do That also my manager or my dental assistant doesn't need to do that's what a personal assistant is going to do It's going to be personal life. I know I have a doctor

 

in California, who's hired recently her first personal assistant. And she's picking up her kids from school and she's doing all of these things that are personal life and helping with dry cleaning and all of these things. But she's like, but Tiff, she also comes in the office and helps with the operations manual with converting things from PDF to word with white labeling our practice logo on all of our paperwork. Like these are the things that not only dentists aren't, you're, you're

 

guys are doctors, you're in your chair site and your CEO time. You don't have to do these things and you shouldn't be doing them. But also are there things that maybe the team can't get to? You said she's helping with the marketing with the, you know, with the design of the posters, how much time, right? Are you saving your office manager from having to do those things that now she's able to take on more things from you, which I think is what you're going into figuring out what else can I delegate to my office manager? So.

 

Dave Moghadam (36:14.97)

That's the next big step there because it's still...

 

Tiffanie (36:16.573)

Yeah.

 

Dave Moghadam (36:18.824)

too much on that end. And I've been realizing more and more at where we are, you know, my highest and best use is going to be one, obviously with patients, which I still love and appreciate and will always continue to do, two, with coaching and mentoring, another doctor, or hopefully eventually, you know, in the near future, an additional other doctor, our hygiene team, you know, working with them. I mean, I have, you know, exciting plans for where

 

we'll talk about there. Like, you know, first and foremost, there's these aspects of it, you know, and, but there's a lot more even than that, but to do every little nitty-gritty thing and to, you know, be interrupted in the middle of patient care for this, like that's, that can't like work, you know, that's just not something that's feasible in general, but also as you get, you know, busier and grow and everything like that.

 

Tiffanie (37:15.402)

Yeah, yeah, I agree.

 

Dave Moghadam (37:16.208)

Like you don't need to make another decision. Like if you've already gone through it all and everybody kind of knows what the deal is, they gotta be able to do it.

 

Tiffanie (37:25.482)

Yeah, yeah, I agree. How do you go about accomplishing that time journal and like figuring out what it is that you can delegate?

 

Dave Moghadam (37:35.204)

Um, I think for, for me, uh, it's, it's been a while since I've done it in that manner, but I think it's the same thing. It's just sit down and just word vomit, like write it, write it all out and then kind of then kind of comb through it and everything and see, well, what, what do I definitely not have to do, especially if you don't like doing it? Uh, you know, what are things that, okay, no matter what, like I'm going to have to do this. And then there's the, the in between, like, can I teach somebody how to.

 

Tiffanie (37:46.258)

Yeah.

 

Tiffanie (37:56.066)

Mm-hmm.

 

Dave Moghadam (38:04.672)

do these things. So that's another big project, work in progress for sure, but I think that's going to be super, super helpful overall as things get busier and we grow more and as there's a lot of things we want to implement in this next year because that's just the way that it is. I think Shining Object is okay when it comes to technology, procedures,

 

Tiffanie (38:25.204)

Mm-hmm.

 

Tiffanie (38:31.042)

fair.

 

Dave Moghadam (38:33.772)

the patient experience, whether that's with or without a direct return on investment. A lot of times, we're just going to do it.

 

Tiffanie (38:42.09)

Yeah, yeah, I agree. I agree. Okay. So you realized, you know, a long time ago that now that you're the bottleneck, right, which I think most dentists come to me and they're like, Tiff, I need systems and I know I'm the bottleneck. I'm the problem. And I'm like, this is the first step, right? It's the ownership mentality. Um, so what do you feel like were the top, maybe three things that you've done over the course of the last couple of years to

 

really help that situation and get yourself out of that bottleneck space.

 

Dave Moghadam (39:16.808)

I think part of it is growing your team. I would say that's probably the most important thing is having more people, but more people who are aligned with what you want to do, who are behind it, who can help you actually implement things. And sometimes that's not easy. Sometimes you add people and they're not on the same page and then you have to tell them that they can't be there anymore.

 

Tiffanie (39:28.286)

Yeah.

 

Tiffanie (39:37.065)

Uh huh.

 

Tiffanie (39:41.992)

Yeah, yeah.

 

Dave Moghadam (39:42.856)

and sometimes your car windshield breaks. But you know, that's a story for another day. Yeah. You know, so I think a big part of it is the team and also not just kind of in that regard, just going along because it's been like that. Like if something's a real problem, you have to address it. And that's hard for myself, that's hard for everybody. And I'm sure.

 

Tiffanie (39:47.974)

That's the story, yeah.

 

Tiffanie (40:05.232)

Mm-hmm.

 

Dave Moghadam (40:08.392)

probably everybody listening to this that owns an office or even works in office understands like sometimes you still feel like you have a gun to your head and it's a matter of finding that balance but you know I think we've been better at kind of setting our priorities and moving in that direction so I think that's first and foremost that's probably the biggest impact on it I think two is trying to spend more time to get the clarity of like what to prioritize.

 

Tiffanie (40:16.557)

Yeah.

 

Yeah.

 

Tiffanie (40:24.131)

this year.

 

Tiffanie (40:33.742)

Thank you.

 

Dave Moghadam (40:37.976)

And three is something that I'm gonna say is something that I want to make a better effort at, which is making more time for yourself, for your own actual being, but also getting out and away gives you a bigger perspective on things. So even just taking like long weekend trips with your spouse or your friends or something like that, every time I've done that this year. Yeah, I don't really want to be thinking about work, but sometimes your head goes there, but you see something.

 

Tiffanie (40:50.478)

Yeah.

 

Dave Moghadam (41:07.524)

much, much differently than when you're in the thick of it.

 

Tiffanie (41:10.794)

Yeah, yeah, I love that. I love that. I think you're like, you're using different parts of your brain at that point, right? And so you gave that other space rest, you allowed it to, to calm down. And that's when that thing pops up. And you're like, Oh, my gosh, I've been trying to solve this for six months. And it's that easy. It's just right there. I love that. So growing your team, setting your priorities. I think one thing you mentioned in the growing your team was

 

I mean, you're windshield, but being willing to make those changes within your team that need to be made. I think one thing you've really honed in on, um, especially in the past year is right people, right seats. Um, even if they're still with your practice, but they've moved chairs, right? They've moved seats. Um, they've moved into a different position that's suiting them a little bit better. Um, I think you're going through that growing pain again right now and kind of seeing how that can play. Now with that same statement, I want to say.

 

One thing we've worked really hard on is developing the seats, especially for the front office. I think this is more applicable for the front office than anywhere else, but really developing the positions and seeing when someone is a fit or not for a position rather than saying, okay, what are all the things that this person is good at? Let me create this position based on those things for that person where you're seeing, okay, well, she doesn't fit here in this one. We've got to find someone who does. She will fit better in this position.

 

Or like you said, the hardest part of all is being willing to see and understand that sometimes they're not a fit for your goals in your practice. And that's not always easy, but I think you've done a really great job at it. Now, when it comes to setting priorities, making the time for you, you said spend more time to get that clarity and really making that happen. Has that been easy for you to figure out with your schedule? Like what's the most difficult piece for you in that? Yeah.

 

Dave Moghadam (43:01.452)

Oh god no.

 

Tiffanie (43:05.326)

Because I think that's what dentists are like, cool, but like, when am I supposed to do that? I have to be at the office. Like, how do you make it so that your practice and your practice very much only ran because you were running it for a really long time, right? You controlled it all out of necessity and out of desire, I think. It was a combination of both. But.

 

you've gotten to a point now where you can take a longer weekend. And while I know the text messages are probably still flying in and you've got all these things going on, you do have a little bit more of a sense of like, I can let go. What do you think helped that the most?

 

Dave Moghadam (43:43.064)

I think it's a lot of what we were talking about, you know, having the right team in place, getting more aligned with what's okay and not okay. I mean, I think those are the two big things.

 

You know, I will say one thing that was helpful in that kind of in between, and we kind of mentioned this previously there is like, kind of sucks to say out loud, but basically I did take a day off of clinical dentistry, which some people are like, oh yeah, that's great for me. Now I actually really like it.

 

Tiffanie (44:15.055)

You hated it. You were so mad at me.

 

Dave Moghadam (44:17.944)

Yeah, yeah. So basically between what you and Sean O'Grady recommended at that point, actually, a big shout out to Sean. I was just like, you know what, I gotta call it quits on Tuesdays, which weren't so busy anyway. But it worked out really well in regards of like I was able to like this was, I guess, maybe for what like a

 

Tiffanie (44:23.758)

I'm going to go to bed.

 

Dave Moghadam (44:38.6)

about a year ago for a year, we were really able to start getting things going in doing so because of that devoted time to spend time with each team member, make sure that we were on the same page, like really get level and understanding them so doing those meetings, having time to, you know, if the other doctor needed, you know, help or guidance or even just like, like a thumbs up, you know, kind of thing like we set time there.

 

Tiffanie (45:04.215)

Yeah.

 

Dave Moghadam (45:06.512)

And we still kind of do that on Tuesdays where I do like a lighter schedule at sometimes to do that. So that was a good thing and planning became as a result of that. But yeah, it took a long time of me taking a day, a week out of actually practicing almost not at all. Like we still had some assistant stuff, you know, going on assistant driven things where it's just kind of like, Oh, scan looks good. Uh, so that wasn't, it wasn't the end of the world. It actually was kind of like a blessing in disguise because production didn't really change. And we were able to go ahead and.

 

Tiffanie (45:22.657)

Yeah.

 

Yeah.

 

Dave Moghadam (45:36.392)

create better relationships and set priorities better and get things implemented. But I think now I'm kind of like rambling and soft topic, but that set the foundation to be able to start, getting towards implementing, getting a manager in the office to go ahead and keep pushing things in that direction. And even with that, like you still have to devote the time to do those meetings then. So that's one part of it.

 

But that doesn't solve the actual question you're asking of like creating that time. I think you got to schedule at least some time during that week. You know, if you work Monday through Thursday, at least a chunk of Friday or like, you know, Sunday for a few hours, something. Just even a little bit, I think, of kind of looking big picture and like for your own sake, writing out what's working well.

 

what's not, you know, what are things that are like, oh my God, if we don't fix this like tomorrow, like somebody's gonna have a heart attack, that person might be me, it might be somebody, you know, it's like, you know, so it's, and I think a big part of that is prioritizing that.

 

Tiffanie (46:34.266)

Mm-hmm. Yeah.

 

Tiffanie (46:40.626)

I love that. I love that. So things that I'm gathering from you today, which thank you, Dave, for like taking the time I know you've got I know you've got patients and stuff in the other rooms there you're tucked away in your bath office and I love that you're I love that that's how we're doing this today and it's middle of your day. But things I'm taking away that I that I hope other people I hope doctors listening and team members listening you guys are taking away other things as well. But things I'm hearing is like, you've done an excellent job at really dedicating to train your team.

 

to really just take information that you've learned, train them on it, and ensure that the steps and processes are there, and utilizing your team to create those systems and operations manual, right? So Tina's helping with a lot of it, but the team that's doing the things, they're helping to create those processes, so it's not all on you. Another thing that I heard was your CEO days, you've mentioned that a couple of times, and the meetings. So I think you've coupled those, those kind of came together.

 

at about the same time, really scheduling out meetings, the doctor calibration meetings, the team trainings, like individual meetings with the team members, the one-on-ones, all of those things, plus your CEO time kind of came together, and then delegation, and not being afraid to delegate to your team. So even in the most, in the spaces of the most untrust of your team, you have still.

 

been diligent about delegating and building some sort of trust with those specific team members. And that's something that I've seen you do. You've talked a lot today about finding things that you don't have to do that someone else can do and that comes with that delegation. So I think if anybody can take things away from this and seeing like you are insanely successful in your brain, you've got this giant brain and I think so many doctors are like you where it's

 

constantly creating. But if you're constantly chair side, you don't have time to get it out and to create all of those things that are happening in your brains. And I tell, I tell doctors all the time, like you're a practice owner, because that's how your brain works. You're looking to grow things and you want to grow things that are around you and your brain's constantly thinking that way. You've got to let other people though, implement those things figure out

 

Tiffanie (48:59.634)

Okay, great. How am I going to take Dr. Dave's idea, this thing he wants to do? And now how am I going to make that happen? And that's something that I think you've developed in your team, especially with your personal assistant, you've got your office manager, you've got a lot of key team members, um, your, you know, dental assistants, your hygienist that you've got, everybody's playing a part in seeing, okay, I understand this is what he wants. Now how can I make it happen rather than you being the only one that's putting all those pieces together? I think that's really cool. And I think that's a lot.

 

You've given so much valuable information today that doctors can really, I think, relate to. They can see themselves in it and now they can see, okay, I know what to do with a personal assistant. I know what I can at least build some CEO time into. Cause I think both of those spaces and you did this too, right? There, you're like, why am I taking a whole day off of production? Because what am I going to do? There's, I don't have eight hours of things to do, but you will fill it. So I think being just

 

Just being like forthcoming and saying, okay, I'm just going to do it. You just got to jump in, do it, see what happens and make it stick. Dave, do you feel like there's anything else that is like key and crucial that you hope people took away from our candid conversation here today?

 

Dave Moghadam (50:13.937)

Um.

 

Yeah, I mean, I feel like I say this almost every time I come on here is like, it's not all, you know, bubblegum and rainbows and everything like that. It's always a work in progress. Because it definitely have come a long way. I'll be the first person to say there's still a lot longer way to go. And that's not necessarily the best way to look at it. But you have to keep in mind that it's always a day at a time. And nothing's ever linear.

 

Tiffanie (50:39.382)

Yeah.

 

Dave Moghadam (50:45.174)

on your trajectory that's wonderful nothing is ever a constant growth you just have to believe in what you're doing and yourself and take it a day at a time

 

Tiffanie (50:55.834)

I love that. And laying on your resources, right? Dave, you do an incredible job of really looking to see, like you said, get a team trainer, get somebody in there who's gonna train on the things that you're learning, if that's an option. And I know we talk a lot and just making sure that you don't feel like you're isolated and you're by yourself and that you are supported and making sure you help those people around you. So I think you've done an incredible job at filling your life with that. And I-

 

I know I tell you this all the time and I know you're always like, don't, I don't want to bother you. I don't like, I love hearing from you. And I tell all of my doctors, I tell all of my, I tell all of my clients, team members alike, like reach out to me when you need me. I'm here to support you guys. And not all of you use me. So Dave, like that you get to, you reap the benefits sometimes, right? Of other people not believing that. So don't ever feel like you can't. I'm always here for it. I love our conversations and I love seeing your growth. I'm so excited.

 

to see you in person next week and see the team. And I'm excited to see this ding hiding department and just get this thing like trailblazing.

 

Dave Moghadam (52:03.556)

Oh yeah, absolutely, I'm very excited too. Thank you.

 

Tiffanie (52:06.558)

You're welcome. You're welcome. Thank you for being here with me today. So guys, train your team. I think that was one of the biggest takeaways I had was just investing in your team. If you're investing in you, you're investing in your practice, like invest in your team. And if they may not be there forever, we know that the last couple years has shown us that that's okay, as long as you're getting the systems and processes down. So, Dave, like you mentioned doing it written, but I think the videos that you guys have been working towards creating and the ones that you have created were fantastic idea and really honing in on how your team learns.

 

CEO days, CEO days are huge and meetings and making sure that you guys stick to them, something that Dave's done really well. Because if it's on the schedule, he's typically making it happen. And if it can't happen, it's getting rescheduled. It's not just getting canceled. I've seen that happen with like one on ones and stuff. And he's like, well, if I can't do them, he was doing them all. And then he decided, you know what, my manager can start doing some of these too. So he started delegating things off. And that's your next piece. So

 

Train your team, make sure that they've got the information, make sure it's written down so that they can train the next person, and make sure you've got CEO time and meetings in the books, and delegate like a king because it's worth it. Dave, thank you for your time. I know, like I said, you're in office, and I just love that, I love that I can picture where you're at, and you're just sitting there waiting for the screamer to start, and it didn't. It was fine. It was totally fine. I love it, I love it. Well.

 

Dave Moghadam (53:16.712)

Thank you.

 

Dave Moghadam (53:28.211)

Yep, they're holding it down out there. Thank you.

 

Tiffanie (53:32.202)

Thank you listeners. I hope that you guys took a lot away from this today and we'll catch you next time at the WITM.