Ep. 78: Implementation: How to Turn Those “Great Ideas” into Tangible Changes in Your Practice
We’ve all been to a seminar or had a great meeting where we came up with fantastic new ideas for our business…only to be hit with reality on Monday. No matter how good the ideas are, they’re useless if you can’t get them implemented consistently in your practice. So this week, Jeff discusses the barriers to implementation and how we guide our clients to make real, positive changes that stick.
Topics:
:11 – The two biggest barriers to implementing new things in your practice
18:00 – Using the “Daily Practice Analysis Form”
Links:
Daily Practice Analysis Form - https://mgeonline.com/daily-practice-analysis-form-2/
Team training video courses - https://ddssuccess.com
Learn more about MGE - https://www.mgeonline.com
Listen to full episode :
Have a question for Jeff?
Fill out the form and he will get back to you.
Questions From This Episode
What are the two primary barriers that keep a good idea from ever actually getting implemented?
Overwhelm, handing someone a long list of things to do when they're already stretched thin just becomes more items on an already full plate, and a lack of understanding, meaning an inability to genuinely grasp the relative importance of one task versus another. Someone who doesn't understand why a specific action matters treats it with the same weight as everything else on the list, so nothing actually gets prioritized or done.
Why does giving a new client only two or three things to do, instead of ten or twelve, actually produce better results?
Handing someone an overwhelming list when they're already stretched thin in their practice usually results in nothing getting done at all, but narrowing it down to what's genuinely critical gives them a real shot at actually completing it. In one real example, a client given 12 things accomplished nothing, but the same client given just three of those same items completed them all and saw her statistics improve.
Why does Jeff recommend rolling out a multi-step program, like a three-part referral program, one piece at a time instead of all at once?
Introducing one specific change, checking on it daily until it becomes routine, and letting the team actually see a real result creates a genuine win, and wins build the confidence and momentum needed to take on the next piece. Handing over all three steps simultaneously usually means people try for a day or two, nothing gets reliably tracked, and the whole effort quietly fades out within a week.
Why does Jeff recommend tracking practice statistics on a week-to-date and month-to-date basis rather than only checking totals at the end of the month?
Checking in on the 16th or 20th of the month and discovering a practice is only a fraction of the way to its goal leaves very little time to actually correct course, while catching that same shortfall on the 2nd or 3rd gives considerably more room to fix it before the month is lost. The same logic applies to filling a schedule opening, there's a much better chance of filling next Thursday's opening today than filling today's opening today.
Why does Jeff recommend tracking recall patients specifically as the practice's real growth statistic, rather than overall hygiene numbers?
A practice bringing in 20 to 25 new patients a month should be adding roughly one day of hygiene capacity every year, so a hygiene schedule that stays flat year after year despite steady new patient flow signals a genuine retention problem, patients are being brought in but not kept. Recall specifically excludes things like new patient exams or scaling and root planning seen through hygiene, isolating the one number that actually shows whether existing patients are coming back.
Episode Transcript
-
If I asked you how to boost your practice's revenue by, say, 20 percent within 60 days, could you lay it out step by step? Or how would you consistently get 20 more new patients a month over the next three months, could you give me the actual action items involved? Your first thought might be yes, or it might be, not exactly, or I don't know.
Here's the funny thing. I'd guarantee you've run into plenty of ideas over your career that could genuinely accomplish some version of what I just asked, ideas that could improve conditions in your practice. But right now, they're just ideas, probably sitting in books, binders, and seminar packets from continuing education you've taken over the years. The problem wasn't that you learned it, it's that it never actually became a reality. It was never implemented, and that's what I want to talk about in this week's episode, specifically implementation, the real-world steps involved in actually bringing about positive change in your practice's statistics and growth, whether that's revenue, production, or otherwise.
I'm also going to give you a simple tool you can start using immediately in your office to help bring about real change in your statistics. My name is Jeff Blumberg, and I'm your host.
Let's look at the basic problem with implementation. We learn something, we hear something, and it simply doesn't happen. Say you get a referral program with ten different ways to generate referrals, that kind of resource is everywhere. You try it a little, mention it to your staff, they do it for a day or two, and then it stops. Or you reorganize your schedule, only big procedures in the morning, and it works for a morning or two, then three or four days later your mornings are completely unproductive. A year goes by, you didn't quite get where you wanted, you get frustrated, maybe you conclude the idea itself didn't work, or worse, that you're just bad at this kind of thing and write it off as your lot in life.
So I want to share how we actually approach implementation with clients, not to promote the company, but so you can get a real look at how this works, since there's a very specific series of steps we use to make sure a client can actually implement what they're learning and see real improvement.
One of the problems we identified early on: we know a lot. I say that without any hubris, but if you look at the combined experience across this company, you're looking at several hundred years of industry experience, thousands of clients across North America, throughout the EU, 49 US states, Central and South America, clients genuinely all over the place. So here's the problem that creates: I could sit down with a brand new client who still has a lot of training ahead of them and hand them a hundred things to do in their practice, or, being more reasonable, ten or twenty things, and send them off saying, go do these this month and start changing things.
What we found early on is that the average doctor, and there's always the occasional superstar, but that's the outlier, comes back a month later, and you go through the list together. Did you do this? No. Did you do this? No. What happened? I was just too busy. In other words, I gave them so much that essentially nothing got done.
I remember the first time I ran into this with a client, a long time ago. I gave her a list of twelve things to do back in her practice. She was a genuinely smart woman, that wasn't the issue, the issue was she already had a lot going on in her office, and twelve things was simply too much on top of that. We sat down at the end of the following month and she hadn't gotten anything done. So we looked at what was actually critical, narrowed it down to three things, sent her back with just those three, and she got them all done, and her statistics went up.
That told me something we saw repeatedly, not just in my own experience but across other people here too. When you send someone off to implement changes, you run into a couple of real problems. First, in a lot of cases the doctor is already somewhat overwhelmed, so handing them ten more things just becomes more items on an already full plate.
Dig a little further, and it comes back to the concept of genuine understanding. What's the actual definition of understanding? To grasp the meaning or significance of something. If I understand something, I know what it means, I know its importance, and I can weigh that importance relative to everything else.
Here's an example. Picture walking into an average dental practice as a consultant. There's a new patient standing at the front desk, the phone is ringing, and the receptionist is filing paper charts, working alphabetically, CH before CI, while the phone rings and the patient waits. What would you think, watching that? Probably that the person looks a little foolish, or that the doctor needs to let them go. What you're actually looking at is someone handling importance completely out of order. If I asked you to rank those three things, patient at the front, phone ringing, filing charts, by importance, you'd almost certainly say the patient is first, the phone is second, and filing charts is a distant third, maybe not even in the top ten.
So going back to that definition of understanding, what you could actually say about that receptionist is that they have poor understanding of their own job, they can't rank what's important against what isn't. So the problem, beyond simple overwhelm, with handing someone a list of thirty things to do is that if they're not yet steeped in practice management, and this happens constantly with newer clients who haven't finished their training yet, they don't fully understand organization, statistic management, or even case acceptance, we spend 16 full days of training just on case acceptance alone, then every item on that list looks equally important to them. Item one might be the single most critical thing, a genuine deal breaker for that month's productivity, but without real understanding, it doesn't register as more important than item two, three, or five.
When someone lacks that understanding, they genuinely struggle to isolate what actually matters most. You see this with patients constantly too, you're explaining that they need three root canals, or that a cracked tooth needs immediate attention, and they're telling you about the new big screen TVs they need to buy because their old ones aren't smart TVs. You might wonder what's wrong with this person, but they simply don't understand, they don't yet grasp that their oral health and the function of their own teeth matters more than a smart TV. They'll understand eventually, usually the night they're lying awake with a severe toothache, but right now, they just don't get it.
So those are the two primary barriers to implementation: overwhelm, and a lack of understanding, which really comes down to an inability to prioritize. Take a referral program as an example, a series of steps meant to generate more new patient referrals. Say there are three or four specific things involved: ask every new patient calling in whether anyone else in their household needs a dentist, since you can schedule more than one person per call, check with every existing patient of record when they come in whether any family members need a dentist too, and print referral cards to hand out to patients and have staff distribute in the community.
So you talk to your staff about all three at once. Here's what I want us doing, every new patient call, every patient of record, and we're printing these cards for the hygienist and assistant to hand out. Maybe you don't even assign specific accountability, which is its own separate problem, since if you want something done, someone specific has to own it. Monday rolls around, you start checking whether it's actually happening. Usually it starts off reasonably well, you don't check Tuesday, maybe you check Wednesday, and by the following week everyone's forgotten about it entirely.
A couple of things went wrong there. First, these are people who already have a full job, and you're introducing a change on top of it. Whenever you introduce a change, the person genuinely has to be on board with it, and especially with something notably different from their existing routine, expecting someone to do something specific at the end of every single procedure, you have to keep asking about it, checking on it, and reinforcing it until it becomes habitual. There's a popular idea that it takes 21 days to form a habit, whether that's precisely true or not, I genuinely don't know, but I do know that doing something consistently enough eventually makes people expect to do it.
So first, you'd want to check on it regularly. Second, you'd want to introduce it one piece at a time. Say, here are the three things I eventually want in place for our referral program, but this week, the watchword is simply this: every new patient call, while we're scheduling them, we ask if anyone else in their household needs a dentist, since they can use that same new patient special if that's how they found us. Check on it at the end of day one, day two, day three, and after a couple weeks it becomes second nature, just part of how every new patient call goes. Hey, by the way, is anyone else in your household in need of a dentist? Yeah, actually my wife could use one. Great, she can use this same new patient special too, want me to get her scheduled?
Once you implement that single piece and it becomes routine, a couple of things happen. You start seeing real results from it, and it's worth calling that a win. Wins lead to more wins. Think of it on a bigger scale: say you were convinced you could never consistently collect over $80,000 a month, then you learn a few things and get collections up to $120,000, and it holds there for a couple more months. Four months ago, $80,000 felt like a ceiling, now $120,000 is simply the new baseline expectation. If I told you to try beating $80,000 next month, of course you would, you're already used to $120,000.
This shows up everywhere in life. Someone who's struggled with diets before finally gets one working, starts losing weight and feeling good, and genuinely builds momentum, like a snowball rolling downhill, it gets easier the further it goes, purely from that accumulated inertia. Wins lead to more wins, and your staff aren't foolish. If you ask them to do something on every phone call and it isn't producing any visible result, either because they're not actually doing it, or they're doing it wrong and it's ineffective, they're not going to want to keep doing it. Whereas if you have them do it, ideally role playing it first until they're genuinely comfortable, which is exactly what I'd do with that same three-part referral program, having your team practice asking about additional household members until it feels natural, they'll do it a few times and then you'll hear about it. Your receptionist mentions over lunch that she scheduled four additional new patients this week just by asking that one question. Considering you were spending $200 to $300 acquiring each new patient through other channels, that's $800 or more saved, right there. You might even build a small incentive around it, since it's considerably cheaper than what you're spending on pay-per-click or postcards.
So you get that win, it becomes routine, and by the end of the month the team realizes they scheduled an additional 22 new patients just from that one change. When you introduce the second piece, people are already eager to jump on board, because the first piece clearly worked. Wins lead to more wins. You eliminate overwhelm by focusing on one thing at a time, and because you actually implemented and continued checking on it, it produced a real result, which makes everyone genuinely excited to keep going.
Let me relate this back to our own approach. The MGE Power Program runs 78 days and 600 hours of training, typically over about a year and a half, and it's genuinely effective, the growth metrics on our website are largely unmatched in the industry. But here's the actual point: when I'm talking with a brand new client, they're going to start by learning marketing and sales first, since that's what lets them control income, then organization, and finally executive skills. Their office manager is being trained on the same material, ideally at the same time, though sometimes starting a bit later. But that means they're not going to encounter, say, hiring or personnel management in their formal education for another four months or so.
So say this is a new client dealing with all kinds of staffing problems right now. I can't just leave them blowing in the wind waiting for that training module, I have to give them something to work on immediately, even though they're not formally educated on the subject yet. That's exactly where I have to be specific and precise. As an aside, on our online training platform, DDS Success, Sabri, whom you've heard on other episodes, recorded something we call our Jumpstart, roughly three and a half to four hours of video where she walks through essentially everything she personally does with a brand new client, since Sabri is our senior technical person and has trained our entire delivery team. A lot of what she covers there, the client won't formally encounter from an educational standpoint until much later.
We apply that same concept, combined with deliberately not overloading someone right out of the gate. Picture it abstractly: if a client is starting at a one and wants to eventually reach a ten, I'm not going to get them from one to ten with a single meeting or a few video courses. If I can get them to a two or three, some real, measurable improvement, a genuine win, they'll be at a ten by the time they finish the full program.
So we start simply, looking for improvement, not a permanent, comprehensive system for everything right away. Going back to that referral program example, sure, you eventually want all three pieces in place. This is part of what trips up a lot of doctors, since they tend to be overachievers, exacting perfectionists, so handing them a three-part program, they want all three running immediately, and get frustrated when it isn't. But you're not looking for total completion on day one, you're looking to start improving the situation. If phone calls alone start generating more referrals, that's a genuine win. Start simple, make sure people are actually doing it consistently, before adding anything else.
Let's apply this same logic to management generally. What should day-to-day, week-to-week management of your practice actually look like? I could throw a lot at you here. Ideally you're starting each morning with a meeting reviewing statistics with your office manager and key personnel, then a morning production meeting reviewing every patient coming in that day, I covered that in a separate episode, then possibly a technical meeting with your assistants covering the day's procedures and any specifics. Your office manager is managing throughout the day, you're meeting with them briefly each day, holding a weekly management meeting, doing financial planning, and running a staff meeting. That's genuinely a lot.
Do we have clients running all of that? Absolutely, and there's considerably more depth to it than what I just listed, but there's no point going further into it here. Say you're listening to this, you've never worked with us directly, or you're simply a longtime listener wanting to start improving your practice today. I could hand you a document explaining all of that, spend real time walking you through it, and you'd probably implement half of it, miss the other half, and end up frustrated with yourself over what didn't get done, especially while already overwhelmed, already struggling with personnel. It just becomes a mess.
So what would I actually do with someone in your position who wants to improve and start growing? The first question I'd probably ask is whether you set monthly goals for your practice across different areas, whether you track any real metrics at all, or whether you just glance at production or collections at the end of each month. After some basic questions like that, I'd hand you something we call our Daily Practice Analysis form, available as a download on the episode webpage.
What is this form? It shows you, every single day, exactly where your practice stands on key metrics, both week-to-date and month-to-date. Why break it down that way? Think about how you'd handle anything genuinely large, you break it into manageable pieces. If I want to produce $150,000 this month, I'd look at what that works out to daily, roughly $10,000 a day on average, accounting for the fact that some days run shorter than others. Say I'm working Monday through Thursday, fifteen working days this month across four weeks of three to four days each. So I'd look first at my monthly goal, then break it down to what I need weekly, then daily.
Why does that matter so much? Here's what typically happens: someone sets a goal to produce $150,000 this month, and plenty of people don't even get that far, they never actually set a real goal at all. But say you have, you're plugging along through a genuinely busy month, and the 16th or 20th rolls around before you finally ask your office manager how things are going. We're at $30,000, doctor. With a $150,000 goal and it's already the 16th or 20th of the month, you're in real trouble, there's very little runway left to hit that number.
Had you been checking on the 2nd, 3rd, 4th, 6th, and 7th instead, you'd have realized things weren't tracking well far sooner, giving you considerably more time to correct course and avoid a genuinely bad month. It's a bit like steering a ship away from a reef, the earlier you notice you're off course, the better your chances of actually avoiding disaster. Ask any scheduler whether they'd rather have an opening today or next Thursday, given a choice, since there's far more time to fill next Thursday's opening than there is to fill today's. The more lead time you have on a metric, the more chance you have of correcting the problem before it becomes one.
So that's the reasoning behind checking these numbers daily and weekly rather than waiting until the end of the month. Let me walk through a few specific points on the form. First, how is it actually used? It's filled out by your office manager, or whoever has computer access, your scheduler or financial coordinator, and handed to the doctor each morning, ideally completed the night before, so when you walk in Wednesday morning, it should already reflect Tuesday night's numbers.
This form tells you three basic things. First, what's happening today. Most practices are probably able to pull a good chunk of this directly from practice management or analytics software already. Which raises an obvious question, why not just use that software directly? I'd agree you should, if you're actually looking at it. I've asked plenty of doctors who pay for analytics software whether they check it daily, and my honest estimate is that maybe 20 percent or less of people who pay for these tools actually use them the way they're intended. The software itself is genuinely good, it gives you real data, plenty of it, but if nobody's actually looking at it regularly, it doesn't matter how good the tool is.
Here at MGE, in our own client services area, we have physical screens on the wall displaying live data pulled directly from our internal software, who's registered for a seminar, who's scheduled, which clients are arriving that week. Why put real money into screens for this instead of just having people check a program on their own computer? Because it's constantly visible, always in front of you. Software sitting inside a computer is easy to simply not open. If those same specific metrics were physically on your wall, I guarantee you'd be looking at them daily. If you can configure your own analytics software to automatically generate this same daily report and put it in front of you every morning, absolutely do that instead of a paper form, that's genuinely fine, the point is simply making sure you're actually looking at it every single day.
So what's actually on this form? Three sections. The first covers today: how many patients are scheduled, broken into columns for each doctor and an office total, what's the scheduled production for each provider and the office overall, what are today's working hours, and what's the projected production for the rest of this week and next week.
So at a glance, you know how many patients you'll see today, what you're scheduled to produce, your actual working hours for the day, useful just to remember when an associate might be leaving early, and what you're projected to produce this week and next. Say you've calculated that your practice needs to average $15,000 a week to hit its monthly goal, and you see next week is only projected at $6,000. You've got real work to do to build that up, and if you're seeing this Tuesday morning, with Monday already behind you, that awareness is already embedded in your mind, you know you'll need to close some real treatment plans this week specifically to fill next week's gap.
The next section covers unfilled schedule time, again likely pullable from your existing software, showing open slots today, tomorrow, and the rest of the week, broken out by provider and for the office overall.
Then we get to what we call actuals and progress, how you're actually tracking against your goals. This section includes several genuinely important metrics worth reviewing regularly, since understanding, remember, is partly about recognizing what's actually significant. We track week-to-date and month-to-date production, week-to-date and month-to-date collections, week-to-date and month-to-date new patients, and week-to-date and month-to-date treatment planned.
On that last one, I've been asked about it before, so worth explaining. Once you understand the full cycle behind how production is actually generated, you can think the whole process through and take real action to influence the outcome. Say you find that for every 10,000 postcards you send, you generate 50 new patients. If you want 50 more, you simply send another 20,000, that's something directly within your control. The same logic applies elsewhere in the practice. Where does production actually come from? You need a patient who genuinely needs treatment, whether a new patient or an existing one, that treatment has to be presented, accepted, financially arranged and paid for, and then scheduled. I covered that whole presentation and acceptance cycle at length in a previous episode. Part of that cycle depends on simply having enough people who genuinely need treatment, which doesn't mean inventing unnecessary treatment, obviously, but it does mean tracking how much you've actually treatment planned in a given week.
You can build real metrics around this. Say over the last three months you diagnosed and presented $300,000 in treatment and closed $100,000 of it, roughly a third. If that ratio holds, and if you want to close $100,000 and produce that same amount, you need to be presenting roughly $300,000 in treatment. So if it's Thursday and you've only treatment planned $10,000 this week against a target of $75,000, that tells you something's off, maybe hygiene has had openings, maybe new patient flow has dropped. It's simply something worth being aware of.
The next metric is consultations, meaning treatment presentations, something I've covered at length elsewhere. This is worth monitoring closely, because even if you're not a naturally gifted salesperson, more consultations reliably produce more closes. By that same logic, if you want more closes, you need more consultations, whether from new patients or existing ones, and your treatment coordinator following up on the incomplete treatment list, which I've noted before isn't the most fruitful source for filling same-day openings, might be calling back patients whose treatment plans never got a proper presentation the first time.
The last metric, one I've covered in a couple of other episodes, is number of recall patients, your real growth statistic. Week-to-date, month-to-date, same as everything else on this form. Why does this matter so much? A practice bringing in 20 to 25 new patients a month should be adding roughly one full day of hygiene capacity every year. If you're running four days of hygiene now and maintaining that new patient flow, you should be at five days next year, six the year after. If you're still stuck at four two years later, that tells you your retention is genuinely poor, you're driving new patients into the practice and simply not keeping them.
So recall specifically, not hygiene generally, is the number I'm watching, and there's a real distinction there. Hygiene volume can include scaling and root planing, or new patient exams your hygienist might be handling. I wouldn't count either of those toward this specific metric, I want to know specifically how many recall patients are actually coming back, since that's what genuinely reflects whether your practice is retaining patients and growing.
Filling out this form probably takes whoever's responsible for it about ten minutes a day. But you walk in each morning already knowing several things at a glance, this is what I'm producing today, this is my schedule, next week's production looks light, and here's where the remaining openings are for the week. Then you check where you stand for the month on production, consultations, treatment planned, and so on, and you're already thinking with that information.
Which brings up something I should have mentioned earlier: the very first thing you need is an actual goal for the practice. I touched on this earlier, using $150,000 as an example, but you genuinely need to know what your target is. Without one, it's a bit like going on vacation with no destination in mind, just getting in the car and driving. You need a real destination to measure everything else against, then break that goal down by week and by day.
One thing I've noticed over the years about statistics generally: the real starting point is simply becoming aware of them. When practices aren't growing, or have genuine statistical problems, it's usually because either they're not compiling the numbers at all, which most practice software handles automatically now, or, more commonly, nobody's actually looking at them. Are you checking the day sheet every evening to see what you produced and collected? Do you know where you stand month-to-date? Maybe you do, maybe you don't. It starts with genuine awareness, and you can extend that same awareness to your team. Say your schedule coordinator's key statistic is office production, do they actually know today's number, tomorrow's projection, the month-to-date total? Are they tracking it on a visible graph? I've personally put a simple graph at someone's workstation before, and if that graph starts trending downward, they genuinely dislike seeing that, and it motivates them to bring it back up. It isn't magic, it's simply human nature, having that visual in front of you all day creates a real desire to see it improve.
So keeping a statistic matters enormously, but actually paying attention to it matters just as much, and that's exactly why I like this form, whether you're pulling it from software or having someone fill it out by hand each morning, it creates genuine daily awareness of what's happening in your practice, letting you take action before a problem fully develops, or take action to make sure you close out a genuinely great month. It's a solid stepping stone toward a fuller management system, and again, we're not trying to jump from a one to a ten overnight. This alone might bring you to a two or three, a real, visible bump in productivity purely from being more aware of what's happening day to day. That's a genuine improvement, worth acknowledging before building further from there.
So to leave you with the key takeaways: if you're trying to implement something new, pick one thing, the most important thing, or at least a genuinely important one, and work on it, check on it, and reinforce it until it's truly embedded and actually functioning, and people are seeing real wins from it. Then move to the next thing. You'll have some setbacks along the way, things won't always go the way you hoped, that's fine, let those go and keep focusing on what's actually working. Before long, you'll have picked up ten different improvements, having started with just one, and all ten will be firmly in place.
If there's one thing to take from this episode, it's that: start simple, but when you implement something, really get it functioning properly before moving on. Don't try to do twenty things simultaneously. I've had a personal saying for years, I'd rather do three things genuinely well than ten things done halfway.
I hope this helps, and I hope it wasn't too long, I think I've broken the thirty minute mark again, I may need to start calling this a forty-five minutes or less podcast. If you'd like to learn more, download that Daily Practice Analysis form from the episode webpage. I also mentioned the Jumpstart video series on DDS Success, which covers exactly what we walk new clients through for immediate implementation, you can check that out and request a demo at ddssuccess.com. If you'd like to learn more about MGE generally, you can find us online at mgeonline.com or call us at (800) 640-1140, and if you have any questions at all, there's a feedback button on the podcast website, or you can email me directly at jeffb@mgeonline.com. Folks, have a great week, and we'll see you at the next episode.