For How Long Should Dentists Guarantee Their Work?

For How Long Should Dentists Guarantee Their Work? Should They Guarantee it at All?

By May 3, 2019Episodes

For some reason in dentistry we have been accustomed to not charging patients if they come in with something that broke that we did, no matter how long ago the work may have been done. Why is this? Patients have been expecting this and we have obliged for the most part for decades. Would a heart surgeon say “no charge” to a family if a patient passes away during bypass surgery? Would a knee procedure be redone for free if it failed a year later? We think you know the answers. So why is dentistry different and what can we do about it?  Listen to what Dr. Richard Madow and Dr. David Madow have to say. Then of course we do the call of the week. We call an office asking a fairly simple question – we just moved into the area and the wife needs a LOT of work. Is it ok if she brings her comfort animal to help relax her? You will NOT believe this one in a million years! If you have a question that you would like answered on our podcast, please send it in to podcast@madow.com. We will do our best to get yours answered!


For How Long Should Dentists Guarantee Their Work? Should They Guarantee it at All?

 


Voice Recording: The Dental Practice Fixers Podcast is brought to you by the Madow Center for Dental Practice Success. To find out how we can help increase the success of your practice, check out madow.com or call us at 1-800-258-0060.
[music playing]
Dr. Richard Madow: Hey doc! How long is this crown going to last? What do you mean you don’t warranty your work? What are you talking about? Don’t you hate it when patients try to pull that bullshit? Why is it that they think that dental treatment should last forever? Do they ask the same thing about the surgeon, about a veterinarian, about a plumber? We’re going to find out on today’s episode of the Dental Practice Fixers. I’m Dr. Richard Madow. Welcome to the Dental Practice Fixers Season 2, Episode 11. And I’m here with my co-host and I’ll let you introduce yourself.
Dr. David Madow: Hey there Rich, glad to be here. I am Rich’s brother Dr. David Madow. How is it going? We are so happy to be here with you on the Dental Practice Fixers. You know why? Because we are going to fix your practice today. We’ve got a great question and not only that, we’re going to be doing a call later in the show. To tell you something, this is the first time asking this question ever. It’s going to be unbelievable. So stay with us, the all-time…
Dr. Richard Madow: Or older calls I believe.
Dr. David Madow: I have a feeling this one is going to be like the cold call. I just have a feeling.
Dr. Richard Madow: It’s just incredible.
Dr. David Madow: We don’t know which direction it’s going to go in.
Dr. Richard Madow: Hey anyway. Let’s get started. Dave, I think you’ve got a really good listener question that you pulled off of the Dental Place Facebook group. Dave, do you have another chance to check that out? Go on Facebook, search for the Dental Place. We’ve got some great private group discussions there. We’d love to see you there. It’s so nice we get Dental Practice Fixers from the group and that’s the case this time.
Dr. David Madow: It’s funny Rich, because this question starts with a headline.
Dr. Richard Madow: A headline.
Dr. David Madow: It’s like a headline, so I’m going to read the whole thing. It’s a little bit on long side but bear with us because it’s a great question, and it’s one that Rich and I are going to get this detail with here on the Dental Practice Fixers Podcast. So the headline is just picture this like big bold letters, this dental work better last forever. Then he goes, hello Brothers, isn’t that the mentality of patients now with dental work? Why is this and how did that mentality come to be? I know two people who have had a knee replaced, where something went wrong. One was laid up for an additional year and three months. [cross talking - 0:02:35.0].
Dr. Richard Madow: So 15 months.
Dr. David Madow: A year and three months. And the knee had to be replaced, in both cases, the additional surgery was charged at full price, and both people said while they were a little disappointed the first surgery failed, they had no issue with the additional charges as they understood working on a human body is a risk. It’s unpredictable. Likewise, this stole the question, I have a patient that is a heart surgeon; unfortunately he occasionally has folks he works on who don’t make it. And he’s a good friend of mine so I was comfortable asking him if he charges for his surgery where the patient does not make it or passes away soon afterwards.
Dr. Richard Madow: They don’t make it or they passed away. One or the other.
Dr. David Madow: They don’t make it or they passed away. Sooner or later they billed…
Dr. Richard Madow: They know they’re down on the table.
Dr. David Madow: Like a month or two later they passed away. So he was asking that question. The surgeon was asking that question, you still charge. And so, he looked at me like I was crazy or something and confirmed it. Of course, I charge for those cases. Like what do you mean, do I charge? I charge. So here is the dentist asking this question. How many people when a filling breaks, five, ten or more years, they rush right back in and say that filling YOU did broke. Of course, with the unstated or stated, believe it. You should fix this for free and somehow, you’re at fault that it broke. Even when teeth you never touched bridge or have a problem. But the patient often gets confused and comes in believing that it was something that you did wrong. So the overall question is how did this mentality ever come to be? Seems like this is a common happening for most dentists and some common topic for discussion on various dental sites. Better question might be how do we reverse this seemingly ingrained mindset in the general population? Signed, Dr. Ken Henley. Dr. Henley thank you so much for that question. This is definitely an age old question in dentistry for decades and decades I think.
Dr. Richard Madow: I agree. First of all Ken, I’m a big fan of your brother Don Henley. Drummer for the Eagles, lead singer, great musician. They say somewhat of an A-hole but I can forget back some music and so…
Dr. David Madow: Can you say that? They say that…
Dr. Richard Madow: He does not have the best reputation. It was always like Glenn Frey was the good guy and Henley was the A -hole, but Glen unfortunately is no longer with us. Those were the two main guys.
Dr. David Madow: What kind of rep?
Dr. Richard Madow: Wasn’t they own the band?
Dr. David Madow: Who was the guy that was – wasn’t there was somebody else was pretty well…
Dr. Richard Madow: Joe Walsh.
Dr. David Madow: Joe Walsh. That’s what I’m thinking. I’m thinking Joe Walsh.
Dr. Richard Madow: He’s not really one of the principals of the band. He’s still to this day kind of a hired gun.  I think very well-paid hired gun.
[cross talking - 0:05:26.4]
Dr. Richard Madow: Okay we got off topic way too quickly. I’ll tell you something.
Dr. David Madow: Well this question is incredible.
Dr. Richard Madow: I remember one time I heard a very learned rabbi who was asked one of those religious philosophical way of how could god let this happen type question. And he just said, I don’t know. And I think sometimes that’s the wise answer. Right? I say speaking for myself. I have no idea why dentistry is segmented from medicine and both of us, I mean Dave speaking for you, totally agree that this is true. This has happened constantly. We both saw it in our own practices. Why does it happen to dentists and not physicians? I have no idea. Is it our fault? Do you think we’re to blame?
Dr. David Madow: Like me and you or just…
Dr. Richard Madow: No, no. Dentistry in general.
Dr. David Madow: Yes. Dentistry – dentists are to blame. But here’s the caveat to that. Dentists are to blame, but I think this is so ingrained and it goes back so many decades. This is not something that started five years ago. So many decades that I think it’s going to be very difficult to change or reverse. I think we pretty much, this is the way we’re doing things now.
Dr. Richard Madow: Okay let’s back up too. Are we sure that if someone had a knee replacement that failed in a month, that they will fully expect to pay full fee for their new knees? I don’t know the insurance they need for…
Dr. David Madow: Said right here in the question.
Dr. Richard Madow: Well that one reason. That’s one purpose. I don’t know and I don’t also the insurance restrictions over that. And I used to say this to patients sometimes when they say how long will it last. I would say, well the insurance companies will pay for a new one in five years. It’s our expectation that it will last way longer than that. The insurance company is based on their data. Feel that it’s acceptable for it to last five years. So it could be a little longer, could be a little shorter. Sure, but on the average. And then, I was kind of setting the expectation though because crowns typically do last more than five years. Now, a tricky restoration with a weakened cusp, that can probably last less than five years. So why do patients think and they all do. Why do you think that the redo is free?
Dr. David Madow: I mean like any redo. Why would there be any redo in dentistry? Anything we did, as long as we’re doing it as best as we can, simply did. You did a [inaudible - 0:07:40.9].
Dr. Richard Madow: What if the best as you can is your shit job.
Dr. David Madow: Then that’s a whole different story. Let’s say you do a class 2 composite and do a composite, making this up. Patient comes in the next day, let’s say two days later.
Dr. Richard Madow: That afternoon.
Dr. David Madow: Let’s say the next week. Okay we’ll go with the next week. Patients comes in the next week and said this filling broke out of here. I think most dentists are going to say, okay I’ll replace it for you.
Dr. Richard Madow: 100%.
Dr. David Madow: But should we be replacing that at no charge? Should we do it?
Dr. Richard Madow: I got to tell you.
Dr. David Madow: It takes up chair time…
Dr. Richard Madow: There’s no dental patient in the world that would be totally accepting of – and then if the insurance won’t cover it, they have to pay for the thing out of their pocket.
Dr. David Madow: I totally agree.
Dr. Richard Madow: They will flip.
Dr. David Madow: So I think that’s maybe how maybe some of this come along because – but that insurance [inaudible - 0:08:31.5] so I’m not sure, but yeah you’re right. If insurance pays for the filling and they got to come in a few days later and have the things replaced. They say, okay it’s going to be $300, they’re going to flip out. But what’s the analogy in medicine?
Dr. Richard Madow: Well I was going to say if the doctor removed some mole and the mole grows back, the patient never said the doctor did a shitty job. They say the mole grew back.
Dr. David Madow: The mole grew back.
Dr. Richard Madow: And your doctor goes, well we got to go a little deeper this time. They never blame the physician.
Dr. David Madow: Well I don’t know. If you have a mole taken off and you felt in your mind that doctor didn’t go deep enough, you’re probably upset.
Dr. Richard Madow: Yeah but we never go too deep and cause like a scar, we’ll take out healthy tissues. So I think we almost like it. Because many – these days with the MOSE procedures, they can tell right away if they’ve gone deep enough or it’s like a cancerous lesion. I think this is a good analogy. I think people don’t blame the physician but they always blame the dentist.
Dr. David Madow: Well the mole might be a better analogy than the knee or the heart. Because let’s face it, you’re dealing with life and death and it’s a known fact that if you’re in for heart surgery, you could die on the table.
Dr. Richard Madow: And you better be sure that you sign a release saying that that could happen. And anytime you get anesthesia, same thing. You’re signing your life.
Dr. David Madow: Right. You’re probably not signing your life away that if this is to be repeated next week. I don’t know if they’re doing that, but I think it’s – with heart surgery, I think it’s understood that this is so risky and you’re saving a life and it might not work, and you might die. And if you die, you still gotta pay, I think that’s kind of implied. I think it’s understood by the general population. But the mole is probably a better example because if you get something taken off and then two months later, it’s something that’s growing back. You go into the dermatologist and say, I’m not happy with this. It’s growing back. You better do this for free. I don’t know the answer to that.
Dr. Richard Madow: Or how about botched plastic surgery? It happens all the time.
Dr. David Madow: I mean look at mine. I need to go back.
Dr. Richard Madow: I was going to say something. Not everybody is renewed unfortunately.
Dr. David Madow: But I think this has been a tremendous problem in dentistry for a long long time. To summarize, we can still talk about it but I don’t think it’s going away.
Dr. Richard Madow: Okay so it’s then, isn’t it up to us to preface our dental treatments to make the patient more aware of the fact that anytime you do work on the human body, that there’s a great chance that it will fail. Will it be in a week? It’s possible. Will it last the rest of your life? That’s possible too. You can say to the patient, look, when I was in dental school, we worked on these fake plastic teeth, they weren’t surrounded by saliva, they weren’t surrounded by thousands of pounds of biting forces all day long. Every filling had a kind of a plaster tooth in dental school but still in perfect shape. Kind of blame it on the patient.
Dr. David Madow: And the ones I did, they all fell out. So yours are just still there?
Dr. Richard Madow: That explains a lot. I mean I don’t know if it’s worth going into a lengthy explanation. I would certainly drive the point home that we’re dealing with your body, your saliva, your biting forces. All those things. Yeah if I did this on a plastic tooth, fake mouth, it will last forever, but it’s not reality. So if a patient said hey doc, how long will this crown last? That gives us the opportunity to make their expectations more accurate. And should we preface every dental procedure by making their expectations accurate? And when we have this problem…
Dr. David Madow: Well you wouldn’t say if somebody said to you that you were doing three crowns on a patient, and the patient said, hey doc long should these crowns last? You’re not going to say, well it could fall out as soon as you walk out the door. If they do, that’s your problem. I’ll charge to redo them again. You’re not going to say that.
Dr. Richard Madow: Yeah. When you do that, is you say, Mr. Jones, I’m going to give you a warranty. As a matter of fact, we call it a taillight warranty. And that means these crowns are warrantied until we see your taillights pulling out of the parking lot. They’re guaranteed with our taillight warranty.
Dr. David Madow: And I realize that’s a joke. But seriously, what would you do if you do a crown on somebody and they come back – let’s be fair. Let’s be really fair. A year later, there’s recurrent carries around the margin.
Dr. Richard Madow: This is serious now. Hard to believe.
Dr. David Madow: Things should be serious. It’s a serious show here.
Dr. Richard Madow: Why not – pretend you’re the patient Dave. You have to call me Dr. Madow.
Dr. David Madow: Dr. Madow.
Dr. Richard Madow: Yes. I’m going to put my hand on your shoulder like I do [cross talking - 0:12:58.8]. I can feel the tightness in that.
Dr. David Madow: It’s a little sore.
Dr. Richard Madow: In other words, we’re going to – what’s the word, not preface. We’re going to anticipate their question. Because they’re thinking of it anyways. Dave I know a question a lot of patients have is how long will this crown last? So they are difficult questions to answer because we’re dealing with a human body, we’re dealing with saliva, we’re dealing with thousands of pounds of biting forces, bacteria. Even healthy people have millions of bacteria in  their mouths. So all kinds of other factors. So we will fully expect and the insurance company expects actually that the crown will last about five years. We’ve put crowns in place that have lasted 10 years. We’ve seen patients from the previous dentist who are in this practice that their crowns have lasted 30 years. We’ve also had crowns placed that only last a year. Even a perfectly done crown, so it’s really impossible to be able to tell how long it will last. Now you have a realistic expectation. Right? And you never mentioned cost…
Dr. David Madow: Dr. Madow, if I get this crown – thinking I might be getting it done. If I get this done and let’s say a year from now it falls out. What do we do?
Dr. Richard Madow: Well hopefully we’ll be able to cement it right back in place. There’s just a very minor charge for that. But if the tooth underneath decays or if there are other circumstances like that, then we’ll have to build a brand-new crown. It’s not our expectation, very well may last for 10 or 20 years. That’s what happens when we’re dealing with a human body. Who could argue with that?
Dr. David Madow: I don’t think anybody can argue with that.
Dr. Richard Madow: Maybe I think dentists are afraid to bring it up?
Dr. David Madow: Yes. Not only afraid to bring it up, but I think most dentists are probably not going to do that thing. Most dentist are going to – okay here’s another. I’ve heard of this going around and a lot of speakers talk about this and I think maybe even because you and I have spoken about this, and I’m not so sure I agree with it, but some dentist will say, hey Jimmy, as long as you come in – if we do these crowns, as long as you come in for your regular cleaning every six months, if anything needs to be done with these crowns, we’ll do it at no charge. Now is that something you want to begin? You’ve heard that too.
Dr. Richard Madow: I used to do it in my practice
Dr. David Madow: Is that something you want to be involved with?
Dr. Richard Madow: I’ll tell you something. I’m not recommending it at this point in time. But I can tell you, when I did that in my practice, I found that when people did come in every six months, their dental restorations lasted. Now, granted I did sell my practice eventually, and I don’t know what happened after all that.
Dr. David Madow: I’ll tell you what happened.
Dr. Richard Madow: And I’m sure whenever anything happened, they blame it on the team.
Dr. David Madow: I’ll tell you exactly what happened. Some sucker that bought your practice, we do a bunch of crowns for free. That’s what happens.
Dr. Richard Madow: Well I don’t know if you took that deal. So again, these days I wouldn’t recommend doing it but it did work well in my practice. I knew I was taking a risk that I wouldn’t have to redo some crowns for free that certainly won’t by far that think that better things happen. I also knew that you encourage the patients to come in every six months. And that was a good thing. And I think that restorations did last longer when they came in for six months.
Dr. David Madow: Not only that, but if they came in every six months, any dental treatment that you saw need to be done will be treatment planned, they would get it done. So it could be argued that that technique is in the long term more profitable for the practice because they’re coming back every six months anyway, they’re getting more treatment than getting all their treatment done.
Dr. Richard Madow: They have pretty much like a warranty. As soon as they went in [inaudible - 0:16:15.3]. And as soon as they leave your practice, that thing is over. So I encourage you to come in.
Dr. David Madow: Somebody could…
Dr. Richard Madow: So somebody could find that idea.
Dr. David Madow: That’s the thing. That’s why we’re talking this out. I think they really don’t know the answer because the bottom-line question was how do we reverse this seemingly great mindset in the general population? I’m not so sure we can.
Dr. Richard Madow: I think if we do that little speech that I just kind of made up here, and answer the patient’s question before they even ask it, it covers that entire topic. So maybe we should all start doing that.
Dr. David Madow: So your job – every single day in the US sees this show because we’ve got the answer to take care of this whole promise. Only going to work if every dentists sees it and does it. Otherwise, our profession is going to be in trouble. So it’s up to you to make sure it’s being passed around. We’re all going to do it.
Dr. Richard Madow: We just saved dentistry. It’s better that to someone to save dentistry.
Dr. David Madow: Is this the summit to save dentistry?
Dr. Richard Madow: I think this is right now the summit to save dentistry. Alright, hey let’s do our call of the week. What do you say?
Dr. David Madow: That sounds fantastic. But before we do it, before we get into the call, you want to just talk about a couple of things first real quick?
Dr. Richard Madow: Sure, real quickly. It’s funny, I just asked Sylvia for some data on our coaching program, because people always want data. Well we heard your coaching program is great. I have a friend that loved it, but what are the statistics? So there are a million statistics. One thing that really struck me as a success which we were so proud of is that the average practice that works with us gets six times more than their coaching fee in collections during the first year. Six to one return or investment. Our coaching fee is very reasonable. What they pay in coaching fees comes back to them in collections. Production over six X for they paid. So that’s one little data point. Want to find out more about working with us? We’d love to work with you and your practice so you can earn more money, and love dentistry even more. We even have an upcoming Masterclass at our Madow Center in Baltimore. It’s free, we even provide breakfast and lunch. You have to get your butt to Baltimore, doctors only, go to masterclass.madow.com to find out more. Masterclass.madow.com and we hope to see you here.
Dr. David Madow: I thought you were – way to store your new website. I really thought you were going to say getyourbutttobalitmore.com.
Dr. Richard Madow: I think we should see if that’s available.
Dr. David Madow: If that’s available we’ll take it. But for now, just for now, go to – make sure you go to masterclass.madow.com.
Dr. Richard Madow: I like that, getyourbutttobaltimore.com. Don’t go to that site yet. Go to masterclass.madow.com
Dr. David Madow: Before we do the call really quickly. That was a great tip. I got a real short little tip for you or from us. But, this is not going to make you or save you as much money as the masterclass, because that is not – but we’ll take every little thing we can get. And right now you are using a credit processing company. So you’re paying certain amount for that every single month. How about if we told you we can save you a ton of money on your credit card processing? No overage fees or anything like that, and it’s very very simple to switch. When you do it, it’s a no brainer. It’s like make a phone call and click a few buttons and you’re done and you’re saving money every single month. Well you can do that. We’re recommending you give our friends at Fattmerchant a call or a click. Click is better, they’ll give you a website to click to right now. It’s BIT.LY/FATTMAD, and fattmad, we’ll get back to that in a second. In case you’re now watching the video, you want to know this for sure. It’s FATTMAD. Okay we’re going to spell it out for you. If you’re driving in your car, please be careful. Don’t write it down. Just go back and rewind later. It is BIT.LY/FATTMAD. Whatever you do, if you wrote it down, check it out. We promise you, you will save money every single month on your credit card processing. Good enough, do it. So let’s make the call.
Dr. Richard Madow: Absolutely.
Dr. David Madow: Hi Michelle, I got a question for you all. My wife and I are kind of new in town, and she is going to be needing a lot of dental treatment and she wanted me to find out if it’s okay when she comes in if she can bring her little comfort animal with her.
Female Voice: What do you mean by little comfort animal?
Dr. Richard Madow: She’s got a little animal she carries around everywhere just to make, you know, to give her a little more peace – she’s a very anxious person. It just kind of helps calm her down, take the edge off and she just feels more comfortable with it with her comfort animal.
Female Voice: My concern is if she needs a lot of dental work, our schedule is booked up until – first of all, I’ll put you on a sixth month schedule. My only concern is we don’t have the schedule to see if she needs the work right away. The next one that we have is not up to the end of June.
Dr. David Madow: End of June, and it’s April right now. So two and a half months.
Female Voice: Yeah. So it might be, like for us, let’s say if you come in now and you went into the end of June, even after at the end of June, it’s going to be many months.
Dr. David Madow: Well she just moved here and she was told she needs I think like 12 crowns and she’s ready to get them done. So you’re saying she have to wait that long?
Female Voice: Oh my goodness, that’s 12 crowns. We thought we won’t have time for that 12 crowns.
Dr. David Madow: Oh you wouldn’t have time for 12 crowns?
Female Speaker: Yeah.
Dr. David Madow: Oh okay. Because 12 crowns and not…
Female Voice: Here’s the thing, one of the crowns, it depends on – some of the crowns if it was next to each other, it means that you have to – in ideal world you have to do it at the same time. So that is – let’s say if you have  four crowns, I’m not sure if you need a crown or that you need a bridge.
Dr. David Madow: Well I know that she needs a bunch and not only that, it makes things a little more complicated for you. The same dentist told me that I need a whole lot of dental treatment. So we’re trying to establish ourselves with a new dentist, but you say you wouldn’t be able to see us anytime soon. Right?
Female Voice: Yeah. I mean with a crown, like for us – let’s say assuming that you have ¾ tooth for the crown next to each other, you have to do it all at once so that [inaudible - 0:22:46.8] and to get that [cross talking - 0:22:50.1]. And that procedure alone is like a whole day by itself. You are not going to be able to do sit in a chair the whole day.
Dr. David Madow: Right. I think between the two of us we probably need like 90 to $100,000 worth of dental treatment. That’s probably way too much. That probably takes a lot of time.
Female Voice: It’s a lot of time and money. I can tell you one crown is 1400 at least. And if you need 10 crowns that’s $15,000.
Dr. David Madow: Well we also need some gum treatment so that’s going to add to that, but okay…
Female Voice: Wait, how do you know – well it is true, you probably need that and if you need a gum treatment and things like that, I can refer you to a gum specialist right now.
Dr. David Madow: Yeah but I’d rather just associate myself with one practice first. That’s probably the best thing and I know we need a lot of crowns, a lot of crowns. We both need it.
Female Voice: Yeah. That’s why I want to be upfront with you. Because I don’t want to get you in and then we don’t have time to – it’s not that we don’t have time. It’s just that you’ll have to wait longer down the road and that’s no good.
Dr. David Madow: Sure. I understand. Let me see if I can find an office that’s maybe not as quite busy. That might be a little better choice. Is that right?
Female Voice: Yeah. And then also, some office that would be able to accommodate a lot of the stuff that you and your wife needs.
Dr. David Madow: Right. Well you’ve been very kind and I appreciate it. Because like I said, we need a lot of work done. You’ve been very kind. It sounds like you guys are a little too busy.
Female Voice: Yeah. I just want to be honest about it. I don’t want to be greedy and get you in and just to get the money and then…
Dr. David Madow: No that’s good. I’m looking for a good, honest dentist and not greedy. So that’s perfect. So thank you very much. I do appreciate your time. Thank you so much.
Female Voice: Alright. Next time.
Dr. David Madow: Bye.
Dr. Richard Madow: Holy shit.
Dr. David Madow: You know, it’s funny, when we made that call, we didn’t even think we would go in that direction. We wanted to find out more if they would accept their comfort animal.
Dr. Richard Madow: It kind of brings right over the comfort animal thing and…
Dr. David Madow: She really took one of the fact that my wife needs a lot of crowns but it’s going to be too long before they fit her in. They’re just too busy for seeing – she needs all these dental works. 12 crowns. I don’t even know what to say.
Dr. Richard Madow: Well another case where I would imagine the dentist has no idea this kind of stuff was going on in their practice. Their front desk person is unilaterally telling the patient that wants 12 crowns to go somewhere else. Go somewhere else.
Dr. David Madow: Now here’s the weird thing. I just thought of this one. Let’s say he’s doing some kind of – assuming he’s the dentist. There were doing some type of marketing and they were spending a lot of money every month at some marketing company and they’re saying we’re not getting any calls. This isn’t working. Meanwhile, she never asked how we found out about them. So, this could have been a hundred thousand dollar case from this marketing company, whoever it is. For a hundred-thousand-dollar case, she said we’re a little too busy, we can’t really take you on.
Dr. Richard Madow: And they’re booked 2 ½ months out. That’s a huge problem. How can your practice grow if you’re booked 2 ½ months – are you really…
Dr. David Madow: I assume that was for hygiene. I assume she meant that for hygiene.
Dr. Richard Madow: Why would she ever think that she has to wait to get his patients for hygiene? That is ridiculous. Get that patient and say, say come over right now. If you’re on your cell phone, let me give you directions right now.
Dr. David Madow: I would send a Lyft over for her. If she needs 12 crowns and her husband needs a whole bunch of dental work also, I would send like a limo.
Dr. Richard Madow: She was really nice, let’s give her that. I also like the way that she was going to refer you to a specialist without doing an exam first. That was really good.
Dr. David Madow: Here’s the deal, this dentist – what’s her name. I can’t remember…
Dr. Richard Madow: Michelle. How can I forget that? She said Michelle.
Dr. David Madow: If you ask this dentist, how is Michelle doing. He’d probably say oh she’s doing great. She’s really great with our patients. Our patients all love her. Meanwhile, she sends hundred thousand dollars out the door just now. A hundred thousand dollars.
Dr. Richard Madow: So okay, that’s a good point though. Two and a half months out, probably it’s a hygiene. This one in the front desk, was like, well when a new patient calls, they get an appointment for a cleaning. So hygiene is booked two and a half months out. This person knew that they needed 12 crowns, 14 crowns, whatever. How many patients are you losing that don’t know they need a tremendous amount of work, but probably do if you’re making them wait two and a half months.
Dr. David Madow: Two and a half months for hygiene.
Dr. Richard Madow: Millions each year you lose. If a new patient calls and they want to come in, and you’ve got to wait two and a half months out for hygiene, you are short a hygienist. You’re going to need a new hygienist, you need to be putting new patient time in the hygienist column, whatever you want to call them, on their schedule. Or you can treat them as you [inaudible - 0:28:01.5]. And then if you sense the patient needs any kind of restoration or a decent amount of – get them in with the doctor right away. Don’t make them wait because you will never see them again.
Dr. David Madow: This was perhaps one of the most unbelievable calls I think we’ve done in the history, seriously.
Dr. Richard Madow: It was unbelievable.
Dr. David Madow: I think last episode we did one and that one did great. I think we both gave her an A.
Dr. Richard Madow: She was the one that had a free pizza dentist.
Dr. David Madow: Right.
Dr. Richard Madow: There’s no way that she would have made this patient wait two and a half months. They would have been getting their crowns and their pizza way before this patient is even coming into the office.
Dr. David Madow: Was this unbelievable?
Dr. Richard Madow: It was pretty unbelievable. That’s why you hear it on the Dental Practice Fixers. We even fix this practice. As a matter of fact, we can just show up with this practice. We’re here to fix your practice.
Dr. David Madow: Not only fixing, we’re busy, we’re booked until June. We don’t need fixing. Well sorry, your front desk person just turned down a $100,000 case.
Dr. Richard Madow: So this is a million-dollar practice which is based on the skills of the front desk person. I doubt it is. So it’s a million-dollar practice. They just turned down a chance to increase by 10%.
Dr. David Madow: If they are 10%. Here what else we’re going to need. That’s when I said we might need a lot.
Dr. Richard Madow: And how many more patient is [inaudible - 0:29:15.9].
Dr. David Madow: I don’t know what to say.
Dr. Richard Madow: So many lessons here, but one main one is if you can’t get a new patient for two and a half months, your practice cannot grow nearly the way it should be growing. So stop complaining. Take some action.
Dr. David Madow: Well I’ll tell you one more lesson and then we’re going to end this episode. But another episode – and we found this out really in one of the most recent Masterclasses that we just did, is the doc that we had there, admitted that he has no idea what his front desk people say on the phone. And I’m not saying we need some micromanaging, need to be there recording every call on this. You need to set up some guidelines and rules and know the exact – you need to know what they’re doing. You need to know what they’re saying.
Dr. Richard Madow: You need to get proper training for your front desk. It is an incredibly important position, and dentists just tend to hire someone, they stick the new girl in the front desk. This person has 10 years’ experience, their office is down the road, so they’re great front desk. If you stick in there, no training, you have no idea what’s going on up there, and it leads to disasters like this or like disasters you hear every week on the Dental Practice Fixers except for last week. Maybe she was actually good. So hey, thanks for listening. Give us a rating on iTunes. Tell all your friends about the Dental Practice Fixers. We’d love to grow on our podcast just like we’re helping you grow your practice. So from the Dental Practice Fixers, I’m Dr. Richard Madow.
Dr. David Madow: Dr. David Madow, we will see you next time.
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