#885: Perks of Being an Associate Dentist

Dental A Team Podcast

Kiera joins Haley Schultz on The Dental Download podcast to talk about maximizing associate dentistry. They discuss how to go about learning about numbers, overhead, meeting cadence, leadership and more, as well as the Dental A-Team’s educational resource for new dental school grads.

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Transcript:

Kiera Dent (00:00.91)

Hello, Dental A Team listeners. This is Kiera, and I am so excited because I actually did an amazing podcast with Haley from Dental Download, and it was all about associates, and I really feel like you guys are going to love it. And so I wanted to actually do a crossover episode on our podcast, so I really hope you guys enjoy. It was all about associates, getting you guys a ton of perks, coming out of school. I think it's great for you guys, and I hope you really enjoy it.

Haley Schultz

All right, hello, everyone. Welcome back for another episode. I know last time I had you on, we talked a lot about kind of the business side of dentistry and a lot of what you do with improving practices. But today I thought we could talk more about kind of advice for people that are going in as associates. So maybe they're not owners yet, but how can they maximize that time to kind of be prepared for ownership? So I'd love kind of your opinion. So if someone is going in as an associate for their first time at an office,

Kiera Dent (01:20.878)

Thank you.

Kiera Dent (01:33.806)

Thank you.

Haley Schultz (01:39.466)

What are some things that they can do or maybe what should they be trying to learn from the owner to get themselves prepared for ownership down the line?

Hey, I'm so glad you asked this question because I did work at Midwestern University's dental college for three years in Arizona and I just want to like plant a seed and then I'll answer your question. So planting the seed is I've talked to so many owner doctors. I know the students and I feel like sometimes what students do because they're in such a learning phase, right? I worked with hundreds of them and so many of them told me Kiera.

I know you told me this before, but I really wish I would have just taken the plunge into ownership. Initially, I was so afraid to do it, but really like an associateship is, it is beautiful, but I think it's kind of like dental school, right? You're D1, D2, D3, D4. It's almost like you guys have this path of D1, two, three, four, associateship, and then I'll become ready for it, or even residency associateship, then I'm ready for ownership. And I think it's similar. I mean, we don't have children. You can use this example. I've heard it many times of...

You're never really ready when you get married. You're never really ready for children, but you jump in and you know you're going to be able to figure it out and we learn it along the way. So I just want to plant a seed. Um, almost every single owner I've ever talked to asking about their associate path. They all have told me, I wish I would have just straight on into ownership. So I'm just going to plant some seeds out there. It does not mean you need to do it because I know it can feel scary, but maybe just like percolate on that a little bit. So if you do elect to, cause I think most people go into associateship cause you feel like.

I'm not prepared. And I want to say that most dental students, I'm saying most, you know yourself, so go for it what it is. But most dental students are actually more prepared than they think they are. You don't have as much like quote unquote, real life experience. And so I think the, the part that feels daunting is you don't really know how to like run a team. You don't know how to do the billing aspect of it. You don't know how it's, it's the nuances of running a business. But what I want to let you know is most associates in that they're super proactive, just like some of those students in school.

Kiera Dent (03:38.094)

owning a business is still gonna feel very daunting when you do get to that point. So just throwing those ideas out there, like the pieces you don't know about ownership that you're scared about, it's gonna hit you when you do buy the practice regardless. So, but if I was saying like, okay, I know I wanna go into an associateship, I know I wanna go in and I wanna own, basically I'm gonna take this time as like my mini residency in business. That's how I would treat this as an associate of.

But that doesn't mean you're, I mean, cause you're also trying to learn like, Oh, I got to get my hand skills up and I've got to get my speed up and I've got to figure out how to work with an assistant. I think there's that piece that is beautiful that an associateship does allow you to do. But on the flip side of that, if you're going to go be an associate, I would definitely go learn all the billing and all the front office and go sit with the biller and say, Hey, I'm Haley. I have no clue what I'm doing here. I want to learn how to submit claims and just sit with them. They'll laugh at you. They'll giggle with you and be like, I have no idea what I'm doing.

teach me how to do this, and then you actually submit claims. You actually call on the insurance plans. You actually answer the phone and schedule a patient. You actually go through and you present a treatment plan with the treatment coordinator. You listen to them. Listening and observing is different than doing. And so I really would just take it as like, that's my mini residency because the business aspect is going to be the part that's going to rock your world of managing the team, of reading the books, getting the PNL.

I would talk to your owner doctor and say, hey, I'm super intrigued by business. Can you teach me? Like, I want to see how you look at your P &L. How do you talk to your bookkeeper? They might be willing to share. And if they're not, then hey, rock on. Come talk to me and I'll show you how to do a P &L. But really, I think that that's the pieces that are going to maximize you. You've got to learn the numbered aspects of the KPIs, the overhead, the bookkeeping, financial, the legal aspect. Like, that's the whole business side. And then the flip side is the billing, the office management.

how we run our meetings, what's the cadence. Those are, I think are the two pieces in addition to getting your hand skills up that really is, I think a great way for you to maximize your associateship if you elect to go that route. But remember sitting in someone's house, like think of us growing up in our parents homes. We lived in a home. We saw our parents pay the mortgage. We saw them pay the bills. So we saw it, but until you have that ownership piece on you, it is a magnitude that I don't think there's really a way to prepare you. You like,

Kiera Dent (05:55.662)

It's up to here at your neck of like, oh my gosh, I have so much debt. And so just realizing that I haven't found a great simulator to prepare you for real life, just like our parents couldn't prepare us for marriage. Like we watch our parents with marriage. We watch tons of people with it, but living a day in and day out, I think there is an element that really you just have to jump in and then gain the mental stamina and grit. I think is the best advice of how can I manage those emotions, master my emotions to ride the tidal waves of life and not get thrown off.

Yeah, that's great insight. And I'm curious in terms of if you do work with doctors right out of school that are going into ownership, are you working with many people right when they are getting started on they just bought their practice from ground zero or are you mostly having clients come in years into ownership and like, okay, we need to turn things around, we're struggling with this?

Yeah. So, Haley, I'm glad you asked and you actually inspired me on our last podcast. I realized our consulting company didn't really have something that I felt was affordable for new grads. And I felt like that was just a zone. And we know my model is I just want to serve and help as many dentists as we possibly can to like love life and enjoy the aspects. So we actually just created a part of our consulting that is way more budget friendly, but gives the foundations.

of the practice, it's more of a kind of like there is some DIY, but also you get massive access to the consultants. It is more in a group setting mastermind style. So you're learning from other doctors. You can ask your questions. We almost walk you through, not almost, we do. We walk you through like the 12 systems of how to set up your practice based on the months of the year to like get you in this good place. But it's way, way, way more budget friendly because I can do it on more of a math scale. And then when you're ready, you can add on calls and whatnot, because I just noticed that was a gap.

And I feel like it's a gap in a lot of consulting because it's like kind of like financial advisors and me and Ryan Isaac, like we talk about this all the time. Like dentists, when you get out of school, you need a financial advisor to make these decisions, but financial advisors usually don't take you until you're making over a million. Well, same thing with consultants. Like we don't want to deal with they, you don't have the money. That just seems ludicrous to me. Cause then like you said, you're in hot water and now we're trying to bail you out of it. So, um, I'm actually really excited. We have.

Kiera Dent (08:11.118)

quite a few new like brand new doctors in there. We've got some existing doctors too, because I didn't want to just like only have newbie docs. Like we do have some advanced doctors. So, and it's just been really, really fun to see it evolve, but the doctors are loving it because it's doctor and team. And we'll talk about it more at the end, but truly any person who comes from this podcast, just mention it. You guys are getting 25 % off your monthly fee for life because I want students to feel confident owning practices.

I want you to feel like you've got resources of a consultant on demand basically, because you're going to have a ton of questions. I know what you're going to go through. And I just saw that was a gap. So, math kudos to you of just planting the seed. And then our team went to work and we built a product that is beyond beautiful. And you get nine hours of consultant access per week or per month, excuse me, which right now most clients are only getting an hour and a half of time from a consultant. So we tried to just like...

maximize it. Yes, it's in a group setting, but I believe that there's a massive, massive, massive advancement. Think about in class, students raise their hand and they ask questions that you never would have thought of, but you at least get the answer to it, similar to our consulting, and you still can have access to answer all your questions. I just thought that that was a gap, so we decided to roll that out, and so 100%. Then there's also a lot of clients that when you're going to buy a practice, I think this is really important to note.

you usually see the cost of the practice and so you go to the bank to get that. And I recommended for years, ask for a little, like I'm talking 50 to 100K more of working capital if you can. And that's what you invest in CE and consulting and equipment because that's going to propel your business forward. It's not the actual line item of my practices as much. Tack it on and say, I'm hiring a consultant or convince the practice you're buying to hire a consultant. So it goes into the roll up fee.

Those are the things to do so that way you have the funds available when you really need the help the most.

Haley Schultz (10:07.85)

That's awesome that you created that program. That's exactly like there was definitely a need for it. So I'm excited to know that that's available now for people. But when it comes to again, an associate perspective, and I mean, it can just be anything you're seeing with your clients for if they need to increase production, if that's one of their problems that maybe they're not producing enough. Do you feel like the time needs to be

Yeah.

Haley Schultz (10:31.082)

towards clinical skills, actual CE, or is a lot of time it more communication skills that people need to really increase that production.

Hmm. I think that there's gosh like like tenfold I think there's a lot of things that can go into it and so I'll just kind of like hit the high points number one I think given a lengthy amount of time Students and new doctors tend to take that amount of time. So my biggest piece is timing yourself There's these cool little blocks on Amazon and you can get your assistant to do it where you can like wipe it and it can be clean But you can actually flip the timer once you walk into the operatory and see how long it's taking you to actually prep the crown. I

in addition to going and getting the exams and see how long your exams are taking you and just start timing yourself. It's kind of like when we train for like marathons or you're training for your race times. And if we're not tracking our metrics, you're actually not able to improve that. So I found like one of the biggest pieces of increasing production is just being able to shave off one, two, three, four minutes. That's going to radically help you. If you can shave five or 10 minutes for every procedure in a day, you're actually opening up space to add in one or two more procedures.

and you're getting that dollar per hour production up. That's also gonna track you in on your dollar per hour for production. And so, not on the, don't get wild on me. Let's not go for our gross. Let's go for our true like office fees of like what the insurance will pay you. So go off that number. But when you actually start tracking what your dollar per hour is, most associate doctors come out and they're producing about 500 per hour. So like trying to get us into that $4 ,000 a day.

But if you can get that up to even $600 an hour or up to $700 an hour and you productively schedule your day, that radically will increase that production. And so, and then also having confidence in yourself and pushing yourself, like you're going to get into a bind. And that's where I think communication skills come into play. If you know, I can push myself on my procedures and I can get my hand skills faster. I just need to have the word ninja skills to communicate to a patient in case something goes awry. Guys, it's dentistry. You are a real life artist working in someone's mouth.

Kiera Dent (12:34.83)

own that and be okay with him. Be like, you know what? Things just didn't quite go as planned. Push the next patient down. You learn, but don't get scared of that because you're learning. It's like a child who falls off a bike. They're not, they need to get back on that bike and keep riding. Same thing with you. So I really feel like tracking your production per hour, timing yourself and making sure it's there. And then figuring out like what takes you a long time. Is it the crown prep? Is it because you're not using your assistants and so many associates right out of school don't use their assistants. Like I am an assistant.

Let me help you. Let me hand you the instruments because it's crazy. We think like, I'll just grab it. It's faster. No, if you can keep your hands right in the mouth and you've got a really good assistant that constantly is sending it to you and they're right there, your production is going to go up exponentially because, and then also have your assistant. Like I recommend associates going into a practice and find the most seasoned assistant and ask them like, Hey, when do I need to go to an exam? Like almost have them guide you.

of when you need to be leaving the room. Cause that assistant knows your most optimal time. Like get out of here. I'm going to take an X -ray and then get back in here in five minutes. And we're going to keep rocking and rolling. So I oftentimes, my opinion is when associates go work for practices to give that associate the most seasoned assistant. I know the doctor never wants to give their perfect assistant up, but that assistant is going to force an associate to move faster, show you how to really get the rope. So I think there's like multifaceted. Usually it's not CE right out of school. You might be struggling with like,

sensitivity on that, just get your owner doctor to come in and assist you, or you go assist your owner doctor and figure out like, how do they actually put the band then? How do they cure? When are they doing these things and pay attention to almost their efficiency flow? And I think if associates will also do that, like, I know it sounds weird to go assist them, but you're watching to see how quickly they move and when do they go do the exams? And I think you working with your owner doctor a little bit more can really increase that production up for you. So tracking your numbers.

figuring out how much time it really does take you, shaving it off one or two minutes every time to just get it a little bit more efficient, seeing that owner doctor and then getting those beautiful communication skills with your patient of like, it was a day today and this is just real life dentistry and real life and thank you for waiting. Never apologize. I think a good phrase is like, thank you so much for waiting. I really appreciate it and let's get rocking and rolling. Don't be like, I'm so sorry, I'm so, cause you put yourself in a wrong phase.

Kiera Dent (14:55.566)

Thank you so much for waiting. Let's get rocking and rolling. I always give my best patient care to every patient and then figure out where you went awry that day and make it better the next day is what I'd recommend.

I love all those tips. And when it comes to communication skills in terms of like case acceptance, I know a lot of offices now have treatment coordinators anyways, so the doctors aren't so much like selling treatment anymore in a lot of cases, but at the end of the day, like the patients want to ask the doctor questions. So what are some things that you recommend people kind of hone in on when it comes to discussing treatment with patients?

Mm -hmm.

Kiera Dent (15:32.59)

This will be my favorite thing that I'll ever give everyone. Doctors, remember you are selling treatment and they're buying your confidence. So many doctors push off like, oh, it's a TC. And the TC's are like, no, no, no, you T for me. You've got to get this T'd up for me and you're confident. And you've helped this patient realize this is what they need. So a lot of doctors feel bad because they don't want to give bad news. And I'm like, you're not giving bad news. You're just educating them what the state of the mouth is in. That patient, they made choices.

they chose to drink the diet sodas, they chose to like sip on this, like those are choices they made. Educate them and then always end it with like, and the great news is we're going to be able to get you healthy, I'm here for you. And then this is what I say of your best case acceptance tip and I call it NDTR is my perfect handoff. And I think in my, what I love and associates love this is it kind of gives you a framework of how do I do my exam? So I recommend comprehensive exam, walk them through it.

tell them everything that's going on and then you do NDTR. You can remember New Dentist, Tough Road, Newter, Nevada Dentist, Totally Rock. Like I've heard all the things, Never Date the Rookie. Like however you want to remember this, I don't care. But someone says Newter and that just makes me giggle. But it's next visit, the date to return, how much time is needed and make sure their re -care is scheduled. So at the end of it, and I call like putting a bow on your treatment plan package.

And so it's like, all right, Haley, I want to get you back. Like the great news is we're going to be able to get you healthy. And I'm excited to get your mouth healthy and clean again. So I want to see you back in about two weeks. We're going to get started on the upper right. We're going to get, take care of that crown and that root canal for you. It's going to take me about two hours for that. And I want to make sure you've got your cleaning scheduled. What questions do you have for me? Um, I want to make sure you're super confident. I didn't ask, do you have questions? I told them what needs to happen. They're super clear because oftentimes patients feel like.

Well, where are we starting? And a lot of new grads, especially really get funky on their, on their exam. Cause like in school, someone else does it. They bring them back. Like they have to come back. They're here for like 500 hours. Cause you guys have to get all the checks on it. And so in private practice, they have to know where you're starting. You have to know where you're starting and you'll get faster at that. So worst case scenarios, you just start in the upper right. Always like, okay, I go up for right. Like that's always my go -to until I get better at like where my chief concern is. But it's, I want to see you back in about two weeks.

Kiera Dent (17:52.654)

Or if you know your schedule is wide open, I want to see you back in about a week. It's going to take me two hours for this. Please don't underestimate or overestimate. Like let's try and get that dialed in. This is where you also time yourself. So you're more confident on giving that timing. But if you will do that pretty bow and your team takes that up and they use that perfect bow, your treatment coordinator now can say, all right, Haley, let's get you scheduled. You're going to come back with Dr. Schultz. She's incredible. She wants you back in one week. So I'm going to schedule you on Wednesday at this time. She needs two hours for the crown, the root canal.

and then they'll go over the finances. Doctors, you are convincing this patient, they're buying your confidence. That's what they're buying. They're not buying the crown, they're not buying the root canal. And I do think you having that confidence and not like, well, you know, you kind of had this. And I'll say a lot of females tend to be a little more passive on their diagnosing. And I just want to give the female doctors the bike, girls, like we can do this and you are totally capable and like, don't feel bad about it. Cause I think we have these empathetic hearts.

Go in and diagnose confidently because they're buying your confidence is what they're buying. And looking at you, are you the person who can truly make my mouth healthy again? That's what I'm buying. And I'm looking at you of like, are you sure? And the more confident you doctors are, men have it too, don't worry. But I just watch it and Haley, you're a female, so I think I'm talking more to you than anyone else. But like truly, I hope that all doctors have the confidence in themselves. Another question is like, hey, how long have you been practicing dentistry? Four years.

You guys have been practicing for four years. Don't tell them you're brand new out of school. Like they don't need to know that move along. It's fine. In a year, you're going to look back at your treatment and be like, wow, that was terrible. It was the best you did at that time. And you're always going to judge yourself as you move on. And that's how you make yourself better. So like, don't feel bad about it. You can always fix it and you move on and you just make it better and better and better every single day.

That was good advice as well. And before we wrap up, I know you've already given us like so many great pearls, but I like to give people a chance for just like any closing thoughts in terms of advice for dentists that are just getting started.

Kiera Dent (19:53.934)

when you have way more skills than you think you do. And I think like having that confidence within you, you went to a great school and you're going to make mistakes. And I remember, so I started with a dental, a dentist, she was straight out of school and we started our first practice and we took our practice from 500 ,000 to 2 .4 million in nine months as a brand new grad. So I like to paint that story, not that you need to do that, but I love to hear what's possible because then you can expand what's possible for you. And I remember there was one night we were sitting there and she,

bombed a root canal. Like I'm telling you, it was a bomb. Like we broke off a file. Like it was awful. And I remember we were sitting there at the end of the day and I said, you're better than this. And I remember she was like, wow, you're like cut throat when she's down. But I think it was one of the best things I ever said because she is better than that. And she knew she's better than that. And so because like she made that one mistake, she could have let that haunt her or she can make it like make her better. And so you will make mistakes. And that's part of being a dentist.

but it's how quickly can you recover from that mistake and make it better and realizing nothing is permanent in dentistry. Like everything can be fixed, everything can be resolved. Like most of the time we're probably not gonna kill a patient. So our risk isn't super high. And I just really wanna give you that vote of confidence that you are well -trained, you are going to learn, you are going to make mistakes and that's part of the journey, but the faster you can learn from that mistake and do better and be better.

the better you're going to be for those patients. And to me, I feel like as a dentist, this isn't about you. It's about you being the best for your patients and giving them the best clinical care. And when you remove yourself from it and your ego and realize I got to be the best for this patient, it gives you that motivation to rise up, to do the best treatment plans, to give them the confidence of when they need to come back, to realize like, if they don't come to me and I know I'm a good dentist, they're going to go to someone else who might not be as good of a dentist. And I owe it to my patients to be giving them the best dentistry possible.

We only have our 32, which most of us only have 28 teeth. We get one set and you as a dentist, I want you to take that on and realize you are the best for those patients. Rise up to the level you're capable of and believe in yourself more than you give yourself credit. Cause gosh, I've seen a lot of rough dentistry and most students coming out of school are not that way. You've been trained, grow, evolve and realize you've got so much potential in you. Don't give up. Even when you have that bad case, do better, be better and come in tomorrow and be better.

Haley Schultz

Thank you so much and thank you again for your time today.

Kiera Dent

Of course, thank you. And as always, thanks for listening and I'll catch you next time on the Dental A Team Podcast.