Hi, I'm Frank Spear.
I wanna welcome you to this lesson.
What we're gonna talk about today can be one of the more challenging things to deal with
in any practice, and that's money.
The reality of life is we don't think about it, but we all have different beliefs about
money.
Everybody on our team might have a completely different belief about money.
And part of why money is so charged as a topic, is we go all the way back to Abraham Maslow
and his Pyramid of Self-Actualization, his Hierarchy of Needs, what he said is, "Humans
always will go to the lowest level on the pyramid, where their needs aren't getting
met."
And the absolute lowest level on the pyramid is what he called the Physiologic Need, and
that would be water, food, air, what we need to sustain life.
But right above it is safety, and safety is really a couple things in our modern times,
it's a place to live and it's money.
And so there's no doubt that in fact any issues surrounding money have a lot of energy surrounding
them, whether it's among the team and the doctor, but far more commonly among the team
and the patients.
So what I wanna do in this particular lesson is I really wanna focus, and help you perhaps
understand a little bit more about what your personal beliefs are about money that you
actually might not be aware of.
And what we often don't realize, in fact, what we believe about money actually often
influences how it behaves in our life.
We've all heard stories of the lottery winners who end up broke.
And you'd say to yourself, "How could that be?"
Well, the truth is, if you don't ever see yourself as having money, you will typically
find a way to make sure that that's true, you won't.
And so, there's a group of what I'll call negative beliefs about money, and there's
a group of what I might describe as positive beliefs about money.
I just wanna share a few of those with you.
And then I'm gonna use a couple stories to illustrate how those beliefs play out in our
practice, particularly as they relate to our patient interactions.
Some examples of what I might consider a negative belief about money would be things like, "Well,
my family's never had money.
And because of that, I'll never have money."
Or, "I'll never have enough money."
And so you start thinking to yourself if you walk through the world, and you're holding
that thought every day, how do you talk to patients about money?
How do you talk about raises, or about any of those things concerning money?
There's a longstanding belief among a lot of people that to have an abundance of money,
you have to suffer, you have to work really long hours.
There's a belief among people that people that have money aren't caring people, or that
people that have money are selfish people.
And you hear all of these things as we grow up in our environment, whether we hear 'em
at school, whether we hear 'em from our parents, or from our siblings, or whoever.
And they start to impact the stories we tell ourselves about money, and that influences
how we have conversations about money with our patients, or with the people we work with,
or with our friends and family, for that matter.
And then probably the killer one in dentistry is, "My patients don't have the money to do
the kind of dentistry I'd like to do."
And you know what?
That's actually true.
Some of your patients don't have the money to do the kind of dentistry you'd like to
do.
The challenge is, if this is what you believe about all of your patients, then you treat
all of them as though they won't do anything.
And that means you modify your behavior towards them, you modify what you present to them.
The assumption that none of 'em will do it, basically makes you stop presenting anything.
Now, if we go the other direction, and we think about what might be some positive kinds
of beliefs about money, perhaps one of the most positive would be, "I'm valuable and
I deserve to be well compensated for my efforts."
Another would be that money, in fact, is good and can be used to help others.
My favorite definition of actually what money is comes from Joseph Campbell.
And what Joseph Campbell said is, he described money as congealed energy, waiting to be released.
And what he meant was this, that what happens when we work and we make money is what we're
really doing is we're storing energy.
We're receiving energy that we can then use to do some other things we'd like to do.
And there's no question, one of those things is to help other people.
And so money really is an energy.
It's something that can be used in a lot of different ways that can be very positive.
A few other positive thoughts.
Money is attracted to positive energy and it's attracted to ideas.
It's not necessarily how hard I work.
If you really look at the wealthiest people in the world, they didn't get there from working
typically thousands of hours; they got there from being very creative, and realizing that
if you create something that's very attractive, you tend to be rewarded for it financially.
A few other things, positive ideas.
"I will have enough money."
Instead of walking around the world thinking, "I'm never gonna have enough."
What would it be like to go through the day thinking, "I will have enough"?
I'll care for money enough to make it grow because as an energy source, we can grow it.
We can save it and as we save it, it does grow.
And then finally, I think a really positive one is, "There's enough money in the world
for me to have an abundance of it."
In other words, I don't have to try and compete to make sure I get my share.
If I do the right things, and I have a positive attitude, that you'll be rewarded.
So those are some positive ways to think about money.
And then finally, the opposite of, 'My patients don't have enough money to do what I wanna
do,' the opposite of that would be, 'When people, patients value something, they find
the money to get it.'
And I can tell you that is absolutely true, after practicing as long as I have practiced,
you find patients, and if they really want to do their teeth, they find a way to do their
teeth.
If they don't wanna do their teeth, nothing you're gonna say is gonna make them wanna
do their teeth, even if they have the money.
So what I wanna do is walk you through how this could play out in a practice.
So this patient shows up in your practice for the first time, and somewhere in that
conversation, there's gonna be a conversation about money.
And what I want you to realize is the beliefs you hold as a team, those beliefs will come
out of you towards those patients.
And so I wanna tell you a few little stories, two stories actually.
So I graduated from dental school in 1979 and what you see on the screen, that group
of photos, that's half of my graduating class.
And I'd had a really good friend, his name is Jeff.
So I'm gonna tell you a story about Jeff's practice.
So I went from dental school into a graduate program, Jeff went from dental school into
private practice.
But one day, about a year after we'd gotten out of school, I decided to drive over to
where his practice was, and he and I were gonna have lunch.
So I happen to get there a little bit early, so he was still seeing patients.
And so he's in seeing a patient and I'm waiting in the reception room.
And one of his other patients walks out and walks up to the reception desk, and this patient
apparently had been treatment planned for a crown and been told what the fee for the
crown was.
And so the patient comes out into the reception area, walks up to the receptionist and says
to the receptionist, "I can't believe the crown is that expensive."
And the receptionist says, "I know, I think our fees are too high too."
That's death for a practice, where is that coming from?
That's the receptionist's beliefs about money, that's the receptionist's belief about the
value of the dentistry, or the lack of value of the dentistry.
Those kinds of things would simply destroy a practice financially.
So that's why understanding what's at your core belief about money and how you talk to
patients about money is so important.
Now, all he was talking about was that simple single crown.
What really happens in those examples when patients say things like, "I can't believe
it's that expensive," is two things have typically happened: Number one, they didn't really understand
why they needed the crown, they were just told they needed a crown.
So a large part of talking to patients about money, especially about what I would call
needs-based dentistry.
For example, dentistry that needs to be done because of decay, because of fractures, because
of cracks, those are things that need to be done.
And when you're talking about needs-based dentistry, what you really wanna make sure
the patient understands is that they have a problem, and you want them to understand
the consequences of doing nothing.
And you want them to understand that if you did treatment, you can prevent those consequences.
And ideally you do that first, you show them the crack, you show them the fracture, you
talk about what's gonna happen if nothing's done, and then you talk about the fact that
you could stop that from happening.
And then ideally, you wait for them to ask you, "Well, what would I do?
How much would it cost?
Would my insurance cover it?"
You want them to be involved in the process of knowing why they need the crown.
That goes a long way to alleviating those discussions.
But the other issue becomes when a patient says, "I can't believe it's that expensive."
I get that, but it's also part of our job to help them understand the value of why it
is as expensive as it is.
Why for us to do it at the level we wanna do it quality wise, it can't be $100.
And that's up to the office to have those conversations.
Now, the second story I'm gonna share with you is my own practice.
So as I mentioned, I got out of dental school in 1979, I went to a perio-prosth program.
That was me in 1979, I had a whole lot more hair there, I had a mustache too, and was
thinner also.
My graduate program ended in 1982, and I actually rented out of a couple practices, but I became
an associate in the small town I grew up in from 1982 to 1985.
And I associated with my family dentist.
The town I grew up on was only 1,500 people.
He was a great dentist, I mean, truly excellent dentist, excellent clinician, patients loved
him, I loved him.
But he'd gotten out of dental school in 1939, so when I went in with him, he'd been practicing
39 years.
And what he really was was a superb operative dentist who did more single tooth dentistry.
But I learned so much from him about how do people interact with patients, communicate
with patients, keep them comfortable, comfortable injections.
But the bottomline was he retired in 1985, and I brought in a partner, and the partner
and I bought the building, and then my partner bought the retiring dentist's practice because
I already had built up a pretty decent practice so there's no way I could take on his practice
as well.
The team that was with us had been with the previous dentist 17 years.
I think the youngest had been...
Well, the receptionist had been there 17 years.
So he's a small town dentist who did mostly operative dentistry, a lot of amalgams, big
amalgams, single crowns.
But to give you a perspective, we're talking back in the years where a big amalgam might
not have even been much over $100.
And so he had patients that had known him 20, 30 years, and they paid him 20 bucks a
month and it all worked for him.
But I come into this practice, my partner comes into the practice, we've both came out
of the same perio-prosth program and we start to do things that are a lot more involved
but our receptionist's really not comfortable talking about money at all.
She can talk to him about $20 a month.
She could talk to him about a couple hundred dollars, but I might be doing a four-unit
case or a six-unit case or a 10-unit case, and those cases have lab fees associated with
them.
And even though back then my fees by today's standards were super low compared to what
she was used to, those were pretty big numbers, even if it was just $2000 or $3000, that was
huge to her.
Well, the bottom line was there's a problem because she was the contact who arranged finances
with the patients.
And a year and a half after taking over the practice, I literally had six months of production
that hadn't been collected was sitting on the books, and in a perio-prosth practice,
especially with high lab fees, you can't do that.
I was literally going broke.
I was working 10-hour days, I was busy as can be seeing patient, I wasn't collecting
any money.
And so, the bottom line is I had to have someone discussing money with the patients who was
comfortable with money 'cause if the person discussing money with the patient isn't comfortable
with money, there's a problem because the business is not gonna make it.
And so the bottom line was, I hired a person named Debbie.
She's still with me here 30 years later.
And Debbie had a completely different set of beliefs about money.
The other receptionist was a delightful woman, nice as can be, just very uncomfortable talking
about money.
Debbie on the other hand had been a receptionist in a very high end perio practice in Seattle,
and it was a fee for service practice, everybody wrote a check, everybody paid.
And she had been an assistant before that so she really understood the value of dentistry.
Interestingly enough, what happened is Debbie worked for me for two weeks and she watched
the office and how everything operated and how we treated patients and how we managed
things financially.
She looked at my accounts receivable which was massive and at the end of two weeks, one
day she said, "You know, you and I have to have a talk."
And she went in the office with me, my private office, she looked at me and says, "You know
what, you're pathetic."
She said, "I've never seen a dentist more unhappy than you.
I've never seen more beautiful dentistry.
You work as hard as anybody I've ever seen in dentistry but you're so unhappy 'cause
you're treating all these people and they're not paying you.
So I'll work for you and I'll stay here but we have to have these people pay for their
dentistry.
Well, from my point of view when she said that, I grew up in this little town and I
said to her, I said, "Debbie, if you ask these people to pay, they're gonna leave."
And she said, "So what?
They're not paying."
I was like, "Wow!
I hadn't thought of that one."
And so my story always has been when the pain gets great enough, usually, people change.
My pain was great enough, and I said yes.
I said, "On Monday, you go ahead and tell people they just have to start bringin' a
check for whatever the insurance won't cover."
And sure enough, we had people get angry.
We had people leave.
We probably had 30% to 40% of the patients leave.
But an interesting thing happened.
In three months' time, she collected all of the outstanding money, my productivity went
up dramatically, my income went up dramatically.
But what was really fascinating was the practice became really fun.
I actually understood that the patients that were sitting in that chair were actually choosing
to be there and value the dentistry and were paying their portion of it, and I was never
gonna see that big number sitting out there uncollected.
And the entire office changed because of that.
So I hope this gives you some thoughts about beliefs about money.
I leave you with a few, few final thoughts.
Every practice needs someone who's comfortable discussing money.
It has to be at least one person who really has no issues talking about money.
The good news, not everybody in the practice needs to be comfortable discussing money.
Not everybody has to have those conversations but you have to have one in there that really
is.
And it may be the dentist, it may be the receptionist, it may be a treatment coordinator.
All practices are so different.
But somebody has to be very comfortable with it.
Debbie is so much better at it than I am, she's so much more comfortable at it than
I am that since 1986, she's done it for me.
Now, what everybody does need to do, 'cause you don't have to be comfortable talking about
money but you do need to be responsible for helping patients perceive the value of the
practice, why your practice is special, why in fact you need to create an experience for
patients that really makes them go, "Wow, this is just an awesome place to be and I
get it.
I wanna be here, I wanna have the crown done by this dentist, by this team."
Everybody has to help out with that responsibility.
So I hope that this has been somewhat enlightening for you.
For those of you that are very interested in learning more about where you got your
beliefs and also learning more about perhaps changing some of them, I would highly suggest
this book, it's called The Energy of Money by Mariah Nemeth.
It's an excellent book, it is not an easy read, and the reason it's not an easy read
is she has you do exercises.
She has you actually do things, so you read a section and then you do some work.
But if you really have an interest in going deeper into this topic about beliefs about
money, it's an excellent resource.
So I've enjoyed sharing this with you and I look forward to seeing you again soon.