Starting in Practice: The Millenial Perspective

Starting in Practice: The Millennial Perspective

In this week’s episode of T-Bone Speaks I meet with Dr Zach Meyer from Clarksville, Tennessee.

Zach graduated in 2016 and joined his Dad’s practice as an associate directly out of school.

To listen to our conversation hit play on the podcast player below:

Challenges with joining the family practice

We jumped into our discussion by sharing some of the challenges that Zach has faced when he started working in practice. Zach explained that the practice has been running since his Dad started out 25 years ago. One of the struggles they have encountered was transitioning from one doctor to two in the office.

Space was also an issue (they have six operatories), and since Zach has come onboard they have been considering buying, renting or renovating in order to acquire more space.

I always say one of the biggest mistakes I made when I started my practice was not being an associate somewhere else to get some money and to pay the bills. I depended solely on my practice from the get-go.

Implementing cone beam technology and making it the standard of care in your office

A year before Zach joined the practice his Dad replaced a broken panorex with a CBCT system…knowing it was the way of the future.

On the podcast Zach and I talked a lot about cone beam technology as it’s something Zach is really keen to learn more about.

My advice to Zach is that you’ve got to stop using it when you think you need it, and you’ve got to start using it when you don’t think you need it! That’s when it hits its true value. To me, the goal is making the cone beam the standard of care in your office. That may mean taking it on 90-95% of your patients. 

In our office, cone beam has replaced our panorex. Everywhere we would normally use a panorex, that’s what we use now.

Resistance to change

Zach asked me about facing resistance to change from staff members when introducing cone beam.

My answer - when your team is used to the panorex there is no difference - cone beam is simply taking a three dimensional panorex. This should not be a concern.

However, whilst to the team there is no change, the change is with the dentist. Dentists have to review the scan. I say “review” the scan because a scan can only be “read” by maxillofacial radiographers. There is only so much a general dentist can do. Once or twice a month I have to have scans read by a professional reader (out of the 80 to 100 scans we take).

Dental implants and other opportunities with cone bean

With cone beam technology, there’s the opportunity to work with dental implants and Zach explained that this was something he was looking forward to. As we spoke he had put four implants in that week!

We looked at the size of Zach’s practice; with around 3000 active patients statistically that’s approximately 50 implants a year.

Another area to look at is sleep; there are probably 300 sleep apnecs in a practice that size. A legitimate number to get into treatment would be 10% to 15%, around 30 to 50 patients. This could be another $250k into the practice. Then there’s infant phonectomies, adolescent orthodontics, and adult orthodontics.

The value of ongoing education

I believe there are many reasons for my success. It’s not because I’m an educator and I have classes to sell. But one of the most important things I did straight out of school was I committed to ongoing education.

Starting in Practice: The Millenial Perspective

I made decisions about where I spent my money. I literally lived off about $2000 a month. I think it’s those choices I made.  Just like when you invest money, you have doubling cycles when you invest in CE.

I always say, the earlier you learn the more years you have to recoup that investment

We talked about how a lot of people are cautious about buying new cars and houses but a big thing is external pressure. Husbands and wives want big TVs or better houses or fancy vacations. We have fight that urge and have really tough and hard conversations with our spouses or significant others about how every dollar you make goes into the best investment you can make.

There’s no better investment that you’ll ever make than in you! It is the safest, most secure investment you’ll ever make.

I found talking to Zach inspiring, because at such an early stage in his career he already has a clear plan and great mind-set when it comes to investing in himself.

He explained how he wants to introduce one new service per year to the practice, starting with dental implants.

What took my generation eight to ten years to get comfortable to do; you guys are getting comfortable to do in two to three years. The timeline scrunches due to technology.

When I came out of school I didn’t talk to any dentists. There was no community, you literally practiced alone. And then Dental Town came around and then social media. But before that, dentists met once a month at their monthly county society meeting. Today, we meet and converse with people every day, multiple times per day on that level. We’re doing that thirty times a day when back then it was once a month. So everything is compressed.

Setting clear expectations about compensation

Something that Zach asked me about is compensating team members, and whether to pay hourly rates or pay based on production, like an associate.

My take…I have a frank conversation with my team members – the gist is that your degree affords you a pay range but I define what a top-end assistant makes.

Assistants and hygienists know in my office that they’ll never have a cap because they can always make more by adding procedures or championing a service. So in other words, at some point they will hit the ceiling but they can go above and beyond if they produce direct revenue for me.

I have that conversation with my team members so expectations are clear.

I think that you have to have some type of ‘bonus program’ in place so that people don’t feel like they’re stuck in a level. As the practice does better, they do better as well.

Getting to know your team

Something I’ve holding doing is departmental meetings. We have open conversations about what’s going well and not so well – and it’s a two way feedback loop. They’ll give us feedback about what we’re doing well or not so well too!

The other thing I try to do is get to know my team members on a personal level. I try to sense the stress, how the home life is doing. I’ll talk to them and try to get in their life a little bit and help them make correct decisions.

Doing the numbers and setting daily and weekly goals

Zach explained that something he’s trying to work through is how to get busy enough. The key thing here is defining his daily and weekly goals, and knowing his numbers.

For example, let’s say you get 30% out of what you collect and your goal is $3000 a day, doing 50% of the business.

For example, you need to do: 12 hygiene checks = $360, 5 (or 6) fillings a day = $750 and 2 crowns a day = $1800 and you’re going to hit your goal.

There are different models out there and you don’t need to follow that model, you can follow another model. The key here is have goals and work back.

I had a great conversation with Zach and look forward to hearing about his dental career. His current position of joining his father’s practice, which has been running for 25 years presents huge opportunity…and some challenges as well!

About the Author Tarun Agarwal

Dr. Tarun Agarwal represents the next generation of leadership for the dental profession. As a respected speaker, author and opinion leader, he is changing the way general dentists and their teams practice.

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