Dental Trends with Blatchford Solutions: Dentists today are becoming better educated

Dr. Warren Roberts recently had the opportunity to speak Dr. Bill Blatchford from Blatchford Solutions on his take of what it's like to be a dentist today and what the most successful dentists are doing to stay ahead. To hear a recording of the interview, click here.

Dr. Warren Roberts: Welcome everyone today to the Pacific Training Institute For Facial Aesthetics. Our guest today is Dr. Bill Blatchford. He is originally ... or still lives in Oregon, but he practiced general dentistry for over 20 years, and then he realized the need for dentists requiring help with the practice management and he created Blatchford Solutions. This has been Blatchford Solutions for approximately 30 years. I'd like to add at the very beginning that Dr. Jan Roberts and myself had the privilege to attend the Blatchford Solutions courses, this is probably 20 years ago, and it helped us as GPs get focused at where we wanted to go. So, I'd like to welcome Bill. Bill, are you there?

Dr. Bill Blatchford: Thank you.

Dr. Warren Roberts: Okay, good. Bill, I think one of the key things that the people listening would like to know is that what does Blatchford do for dentists? Can you comment on that?

Dr. Bill Blatchford: I'll give you the thumbnail sketch, Warren. I think the biggest thing that we do is we create balance in their lives, because I believe that life is first, and what we do for a living, for most of us that's dentistry, is to support that. Not the other way around.

As you know, Warren, I grew up on a dairy farm in Oregon. On a dairy farm, life is all revolves around the dairy, and the cows, and farming. I figured, "There's got to be a better way." So I really chose dentistry for lifestyle.

One of the things I've discovered, and as we were talking dates earlier, I've been in dentistry for almost 50 years when you count dental school. Well, that's 50 years when you count dental school. I would say that most dentists never really appreciate balance of life that's possible for them. So, we start with how do you want your life to be, and then help them design a practice to support that. Part of that is the type of dentistry you're doing, part of that is the income you receive, and part of that is the amount of time that you spend doing dentistry.

What I see is we help them with a balance of their lives and the amount of times they work. In other words, we have shifted the paradigm from, I think, from the industrial revolution where there were no vacations. People were working six and seven days a week, and then vacations became mandatory and they were handed out as a reward for hard work. In other words, after a year you get a week's paid vacation and maybe after two years you get two weeks, and so forth. And then we cap it at about three.

What we have discovered, and very effectively, is that vacations are actually preparation, Warren. Preparation for being effective. One of the things that we help people do is set some daily production goals or guidelines. If you're booked under goal consistently, you're working too many days. No point in spreading the work out over more days, it's getting their work effectively, training your team, get in there, work effectively and get out and go enjoy whatever life has to offer for you, and then come back in fresh and ready to go.

So, those are the things that we do. We also, of course, dramatically increase net income for doctors. Most doctors are interested in increasing their net income.

Dr. Warren Roberts: I think everyone is interested in working less and making a little bit more. In order to achieve that, what do you think are the biggest challenges for the general dentist today?

Dr. Bill Blatchford: Some of it's changed, some of it hasn't changed. I think the biggest challenges that most doctors have... Now it depends on location. If you're in an urban area, pretty much anywhere in North America, in an urban area, there's plenty of dentists. There's no shortage. In the urban areas, doctors are all scrapping over with marketing trying to get a few patients in the door. In the rural areas, we're seeing less and less dentists, and I think that's due to a couple of things.

One is the demographics of the dental population has changed. When you and I went to school, most of our classes were men. Most of our wives were ... Well, since most of us were men, most of the spouses were women. At that time, most of the spouses were, if they worked, they were secretaries, teachers, nurses, the occasional hygienists. As we have evolved, and I think much for the better, we have more women going into dental schools. As a matter of fact, your wife. It was starting to change, but she was a pioneer at that time. So these women had husbands who were also professionals, and the men had wives who were professionals. And they had to settle in the urban areas.

My daughter has a dental school classmate who's husband is a pediatric neurosurgeon, and he needs, at least, a million people in the population base to support the pediatric neurosurgeon. It takes a lot of babies to support someone of that specialty. So they don't have a choice, they cannot go to a small, rural Canada or rural United States because he would have nothing to do. So were seeing this concentration in the urban areas and a shortage in the rural areas. So, two different sets of problems. One is not enough patients, the other one is too many patients. That's part of an issue.

The other changes I see changing in dentistry that's really helping is we're able to do things today that we couldn't do a few years ago. We're replacing missing teeth with implants. We're able to do restorations today that last longer. We're adding services, like your neurotoxins/botulinum toxin and fillers. Those sorts of things are becoming accepted for dentists to do. We have dentists treating sleep apnea. We have general dentists placing implants. We have more more general dentists doing light IV sedation, not general anesthetic, but light sedation and bringing in people that were not in the patient pool before.

I think, for the most part, the changes are all positive. I got off the phone this morning with a client, who is a prosthodontist, and he was telling me how modern technology allows him to, without skipping any steps that he would do as a prosthodontist, when it comes time for final restorations, instead of spending weeks at that, he was able to spend a day and half on a full mouth rehab.

Dr. Warren Roberts: So what would you say would are, in the last few years, the biggest trends that are happening that you see in your attendees at Blatchford Solutions?

Dr. Bill Blatchford: I think the biggest trend that I see is the doctors are better educated. There's more available to them in continuing education. After dental school, I think more doctors are taking advantage of these courses, and I'm not referring to the little one day courses here and there. I'm talking about the comprehensive courses that teach them how to do larger restorative cases, teach them how to do the complex surgery cases, teach them how to do ... Well, in your case, how to do the fillers, the neurotoxins (such as Botox), etc. I think that's a big trend.

I think another thing is occurring that I'm not wild about. It is occurring, and that is corporate dentistry is making bigger impact. I think in the United States now we have roughly seven percent of the dentists working in some corporate setting. My daughter and I, Christina, who now runs this business, we have made a conscious decision not to work with corporate. I'm not judgemental, I just make a choice not to do that. I still believe that patients probably get better care in a setting where ... If you look at your practice with Jan, you probably have three generations of a single family in your practice. I feel when that occurs, I'm probably going to do a better job for you than if I'm here for a couple of years and I'm gone. And that's the trend that I don't like in dentistry is hiring the young associates that are there for a couple of years and they're gone.

For one, they're not there long enough to see their failures, so they assume everything works. When you practice for a while, you're going to see a few of these. I don't like the corporate practices dictating the type of treatment they we're doing for patients. Those are trends that I don't care for, but I think the other trends are all, certainly, outweigh that trend. I think there's really never been a better time to be dentist than right now. Course, I'm a big believer in the future is always better than the past. I do not agree at all with the people that say the golden era of dentistry is over. Well, I guess it is in the fact that we don't do a lot of gold crowning anymore, but I think that the best time to be a dentist is right now, and I think the future is going to be better.

Dr. Warren Roberts: What's the main ingredient, or what does Blatchford Solutions do to help dentist integrate into the philosophy into the offices?

Dr. Bill Blatchford: That's a tough question. I'll take a shot at it. The thing that we do that I think is neat, is first of off we, as I mentioned earlier, we look at lifestyle. We look at how do you and your family want to live. Listen, there's a lot of ways out there. I mean there's so many variations of that. There's so much available. We start with that. And then what we do is we train the dentists to be a leader. Now, to be a leader, the first requirement of that is to have a vision yourself of what it is you want for your personal life, and then you create a vision for the practice or the business that will support that vision. For example, my wife and I just had our 50th wedding anniversary. I give all the credit to my wife on that, but it's actually been wonderful and it still is. It's better all the time. I feel very blessed. We chose a long time ago to have a personal vision for ourselves as a couple. We said, "Life is a banquet, let's lick our platter clean." Now, what that meant to us is we wanted to experience a lot of things. We wanted our children to experience a lot of things. We wanted to provide them with opportunities. So, one of the things that we did is we kind of decided early on that I was not going to work five days a week or six days a week. I worked four days a week, but I took a lot of time off.

For example, our fourth year into practice, we took five weeks, all of August, one week in September. Our daughter was 18 months old, and we loaded up our Chevy Blazer with our camping gear, got on a ferry in Seattle and went to Alaska and drove around Alaska and camped and fished and then we drove home. We got home, and I joke about this now, is our bank account was overdrawn and our appointment book was empty, and we survived. So, by the next year, we said "We did that, it turned out okay. Let's do it again." So we've done it every year since.

A lot of people would say, "That's crazy. Why would you do that?" Well, I'll tell you why. As a matter of fact right now, as I shared with you earlier, I'm sitting on my boat. I've owned this boat for 26 years, and Carolyn and I've spent two months on it every year for 26 years. We were up here with our daughter a couple of years ago, one of our daughters. She said, "You know, you guys have been doing this for 20 years." I didn't correct her. It's been way over 30 years we've been doing that.

As a matter of fact we figured we've been coming up here on the British Columbia Coast, the Gulf Islands, the San Juans of Washington, for actually 42 years for at least a month. The conversation we had following that comment was that the time we spent together as a family, during that time and over those years, was certainly more valuable to us than the money I would've made in August for those 40 years.

I'm of a philosophy, and I've had this conversation with several people lately, most of us as dentists are going to get to a point in our life where we have more money than time. As a matter of fact, everybody does get to that. If you've got a dollar left on your death bed, you've got more money than time. So, I guess everybody gets to that point. But I mean we're going to get to a point where money is not as important to us as the time that we've had, and you can't get the time back.

One of the things that I see, and I teach my clients, especially younger clients with young children, I say, "You know, your kids are going to be gone by the time they're 16." I mean, my gosh, my wife and I have three grandchildren and they are so busy it's hard to find the time to get them up here on the boat with us for a week. We succeeded so far, but they're even younger than that and it's hard to find the time in between the various camps and sports and things like that.

Now as these kids are raised, you can't get that back again. That's the biggest thing that we do for our clients is create time for them. To me, the money is the easy part. We have said for a number of years our average is over $150,000 of increased net. For most doctors, it's more like 200 and plus of increased net income during our program. And yet, what I get more comments on, Warren, is how we created time for them. How we created time. Almost every week I get an email from somebody and they're in Europe, or they're at the Grand Canyon, or they're in Washington D.C., or they're some place with their family enjoying a vacation that they never could do before.

Just last week, I had an email and a phone call from a doctor who is late 50's. We sat down at the summit, which is the meeting one on one that we have with every new client. Successful financially, his kids are through school. As a matter of fact, his older daughter is working to get into dental school right now. Both their parents were born in Europe, Italy and Poland, and have never been back. Well, this summer, they took their entire family including parents back to the little town in Italy where his wife's mother is from, and they spent two weeks, for the first two weeks vacation he's ever had in his entire career.

Another client took three weeks and went to Europe. She is Vietnamese decent, and next year she plans on taking her parents back to Vietnam and she's going to take four weeks to make that trip. Interesting thing is, her income has gone up. Their incomes have gone up as a result of this. So, I think that's the biggest thing that we do.

Warren: The results really are more personal time and increased net, which is terrific. In your opinion, what are the most successful dentists doing? The ones that come to see you. What are they actually doing now? Are they doing something different than they did two, three years ago? Five years ago? You kind of touched on it earlier...

Dr. Bill Blatchford: Well, they follow our advice for one. They work more efficiently, and they work more efficiently. We teach them how to schedule. We don't do marketing for them, but we really look and critique and help them, direct them, towards effective marketing. We teach them how to present the value of dentistry. I mean dentistry, in my opinion, is totally a discretionary service. I had this conversation recently with the husband of one of my clients, he happens to be cardiologist. This is kind of foreign to his way of thinking. I mean, if you have a heart problem, you need a cardiologist. You don't say, "I don't think I'll do that." If you need bypass surgery you don't ... He actually works with stems, not bypass surgery, but if you need one those, you do it. It's not like you sit around and debate it and wonder whether your insurance covers it, or that sort of thing.

Whereas dentistry, people can live without teeth. They can live without our dentistry. So, it's purely optional, and we present it from that point of view that, "What do I really need doc?" "Well, you don't need anything." "Well yeah, but I want." So you find out what they want, you work from that. So we teach them that. We teach them efficiency. We teach them these things, and so they can increase their net and they can get in, get their work done. We put good systems in place in their office. When I talk about efficiency, and this may scare some doctors, but they can work with smaller staffs.

So many doctors, Warren, don't train their teams. You know this from your institute. If you train the team on the Botox, the fillers and this sort of thing, how to talk to patients about it, you're going to do a lot more. But if the team is not involved, they don't. So they don't train their team, then they hire a helper. They don't have systems in place. One of my things is checklists. I was a pilot for 45 years, and I'm a big believer in checklists. Even here on the boat I have checklists. I believe in treatment rooms we need checklists. We need checklists in the front of the office. The administrative end, how to open the office, how to close the office, how to do things.

To me, a systems is not a system unless it's documented. If I have that system documented, when I have turnover in team members, I can hand this to them, basically a manual, and say, "This is how we work in this office. Study it." Whereas I find doctors all the time that will say, "Well, I had a great year two years ago, but last year I had some turnover and things kind of fell apart." Well, I just talked to a doctor. He said his receivables went up by almost $50,000 dollars. I said, "Doctor, how did this happen?" "Well, I have a new receptionist and she didn't know how to collect money." I said, "Well, what did you do to train her?" "Well, nothing. She's been in dentistry for years. I just assumed that she knew how to do what needed to be done." Well, that's a huge mistake. Cost him $50,000 by not having a documented system there to train her to get on.

In other words, the system for collections had been in the head of the former receptionist who was pretty good. Well, she left, moved across the country, and the new receptionist didn't know how to do that and she brought the system in from the office she had work in as a receptionist. As I pointed out to him, "Why was she looking for a job when you hired her?" Well, she had been let go in the former office she worked in, where we don't know, because he didn't check any references. She probably left the receivables in that office get out of hand and was looking for a new job so we hired her and she comes in and the world continues to turn.

Dr. Warren Roberts: Yes, it's almost like the dentist creates his vision and then doesn't pass the vision on to the new employees coming in.

Dr. Bill Blatchford: Exactly. You see, this is exactly the problem. I would say this as the ... Yeah, not communicating the vision, not having a vision, going to work and nobody knows what anybody else is doing, doesn't know what the objectives are. I remember, and I believe I may have shown this video to you, I showed it years ago, General Schwarzkopf, who was the American Army General that led us into the first Gulf War when Saddam Hussein invaded Kuwait, he was the General that led the whole thing. He got on a speaking tour. I heard him speak several times, and he made the comment that when he was a early brigadier general, the one star general, he thought it would be an interesting exercise to write down what he thought the priorities for this brigade are. What are the priorities? So he made a list of what he thought the priorities were, and then he asked the officers below him, the colonels, to do the same thing, and then on down. He said that he learned that he has some communication skills to learn, because he said when the time it got down to the people actually doing the work in the Army, it wasn't even close to what he thought was important. He didn't blame them, he blamed himself and his lack of communication skills on that, which he had to correct, and he did.

I think the same thing occurs in the dental office. The doctor has ideas and priorities, but they don't get translated to the people actually doing things for people. I'll give you a terrible example. We had a client literally spending thousands of dollars a month to make the phone ring to bring new patients in. I made the offhand comment one day that he was really tired, overworked, et cetera. So, the receptionist decided that she would solve that problem for him, and she was answering the phone. Now we have recording of this. I mean this is a thing that's hard to believe, we had recordings of this. She was literally telling people we're not accepting new patients at this time. While he was spending thousands of dollars to make that phone ring.

How I got wind of that was the company doing the marketing, which I had recommended to him, called ... Well, the doctor called me and said, "This marketing's not working. I'm spending thousands of dollars a month." He was spending four or five thousand a month, and this company is not working. So, I called the company immediately and said, "I got a complaint, and the complaint I'm getting from my client, who I recommended to you, is not getting results he wanted. What can we do about this?" [inaudible 00:24:52]. "I've got a recording I'd like you to listen to," because they record all incoming phone calls, which I recommend. If you're going to train your team, it's called monitor what you're doing. The way to monitor incoming calls is to record them and listen to the calls. Of course, we teach having a script that we follow on that phone call. He said, "You've got to listen to this recording." So we put the recording on, and she literally was telling people, "We're not accepting new patients at this time."

Now, when we told the doctor this, he was shocked. He didn't believe it. So I said, "Well, here. Listen to this." But see, by not communicating what he really wanted, he got what he asked for. He told his staff, "I'm overworked. I'm tired. I need a break," and that sort of thing. So they thought, "Well, okay. We'll help you with this, Doctor. We'll stop accepting new patients for a little while."

Dr. Warren Roberts: Yeah. Well, thank you very much for sharing this. It's like I, every day, always walk in through the front door and never go in the back door. I want to see what the patient is seeing.

Dr. Bill Blatchford: Exactly.

Dr. Warren Roberts: And if everyone's doing the correct thing. We found, of course, at Pacific Training Institute for Facial Aesthetics, that the most successful people are the ones that train their team. There's no doubt about it. That's what your finding.

Dr. Bill Blatchford: Yeah. I think another thing too, the most successful doctors ... I think there's one other thing too ... There's a quote that I have followed since I started my dental practice, since I started this business, and it's from a fellow named Bernard Baruch, who is an outstanding business person, advisor to several heads of state at one time. Someone asked him what the key to success was. He said, "Find out what people want and give it to them."

Well, I think it's the same thing in dentistry. What we have done is we have always looked at what people want. One of the things that I find is that ... When you and Jan worked with me, people wanted cosmetics. So, it makes sense to ... Okay, people want cosmetics. They don't want root canals. They don't want these other things. They will take the other things that are necessary to get the cosmetics, but we sold the cosmetics.

We've always tried to go where people want. So I think to be successful today, you have to offer a lot of services. I think the day where you can do crown and bridge and, what I call, restorative remedial dentistry ... There's still a market out there for that, but the successful doctors are the ones that offer more services. Implant surgery, sedation of some sort, the aesthetic things, the neuro toxins, the fillers. These are things that I think make a practice successful.

Yeah, add services. It's an old thing in retail. It's easier to sell more things to the existing customer than it is to get more new customers.

Dr. Warren Roberts: That's a good thought.

Dr. Bill Blatchford: If you look at the ... Well, take a look at your stores. Look how it's changed. I'm noticing, because I'm spending some time in Canada this summer, it's the same thing here as it is in the United States. The old service station that pumped gas and worked on cars a little bit is gone, and now a service station is also a grocery store. It's also a mini pharmacy, it's also a mini mart, and they sell all kinds of things to the existing customers. It's even a little bit of a deli. So, they figured out that, "Well, the customer is here filling their car with fuel, let's sell them some food while they're here." It fits that role.

We have a chain of stores in the Northwest part of the United States called Fred Meyer. It started out as a pharmacy. Now it's a grocery store, it's a hardware store, it's a home appliance store, it's a clothing store, and it's still a pharmacy. There's also a bank there, and a jewelry store. It just goes on and on. That's what I see in dentistry, too. These successful dentists are offering multiple services.

Dr. Warren Roberts: Right. Two weeks ago we had the luxury and the benefit of doing a webinar with you, and it was opening and we enjoyed it immensely. If I could directly ask, what are your thoughts from Blatchford Solutions of dentists incorporating facial rejuvenation procedures and therapeutic botulinum toxin procedures into their practice?

Dr. Bill Blatchford: Well, I think it's real easy. I think it's real easy, number one, in that the patient's already there. You've already got the patients. Doctor, you have a recall program. There are very few businesses, very few professions that have a recall program like you do. If you have a hygienist four days a week, one hygienist, I mean you've got about 800 patients actually coming to see you twice a year. And you can just do the math on that. I say that one day of hygiene per week is 200 patients. It's just a math exercise. You may have 1500 charts, but you've got 800 people coming to see you repeatedly. They come in every 6 months. They pretty much follow your recommendations, and many of these patients are interested in, and they're getting marketing of these facial aesthetic things already. They know about it. They don't have anybody to turn to that does it, because let's be honest, how many people actually have a dermatologist or a plastic surgeon? Hardly anybody. Well, they've got a dentist, and you've been giving injections into the head, neck, face, for years, and you're very good at it. You're a natural for it.

Again, you can take a look at your aesthetic dental cases and how many of those can you enhance with some facial aesthetics? So it's a very easy thing, in my opinion, to integrate into a dental practice. Again, it's the same thing we talked about earlier. It's offering more things to the same people that are already loyal to you.

Dr. Warren Roberts: We agree completely. It's probably due to some of your training a few years ago and the focus and the vision that we have. It's one of the key things we see with practices is that if they've got a vision, they have the patients, and from facial rejuvenation standpoint, we always say 66% of the patients are already in your office. You don't have to do advertisement. [crosstalk 00:32:03].

Dr. Bill Blatchford: Yes. We find the same thing with adding obstructive sleep apnea treatment to our practice. We find that most of them are patients in the practice already suffering from sleep apnea. Many of them have a CPAP they don't wear or don't use. Some are just simply untreated, some are even undiagnosed [inaudible 00:32:23]. I think facial rejuvenation is exactly the same thing. It's the patient's already there.

I think you'd also be surprised if you started talking this up with your patients, and your staff is trained to talk it up with your patients, I think you would be surprised to find out how many of the current patients are actually going elsewhere for this service.

I know both my wife and I go on a regular basis. I'm unfortunate enough to get some skin cancer, so I've had a dermatologist for years. When she opened a, she calls it a derma spa, with their offering these services, my wife and I started going number of years ago and go on a regular basis. These are not inexpensive appointments. People are spending money on this stuff. I think our generation especially, the baby boomers, we're not going gently into old age. Let me put it that way.

Warren: Good, good. Well, I want to thank you for your time, Bill, [inaudible 00:33:34] your comments and your expertise, and particularly we know you're on holiday. A special congratulations to Carolyn for suffering for 50 years plus with you. Okay, give her a hug for me and say hello. Just want to thank you very much for your comments and your time.

Dr. Bill Blatchford: And if someone wants to get a hold of me, Warren, they can simply go to our website. Blatchfordsolutions.com

Dr. Warren Roberts: Thank you very much. I appreciate that.

For more information on how to cross-train your entire dental team on botulinum toxin (aka Botox, Dysport) and dermal fillers, we recommend you review the Level 2: Botox & the Influential Team.