Episode #478: Getting Out of PPOs By Blowing Up the Box, with Debra Engelhardt-Nash

Thinking outside the box is great. But why not get rid of the box? And to help you start thinking beyond the ordinary, Kirk Behrendt brings in Debra Engelhardt-Nash, practice management expert and co-founder of The Nash Institute. Go above and beyond to exceed your patients’ expectations, improve their experience, and increase revenue! To learn more about out-of-the-box thinking, listen to Episode 478 of The Best Practices Show!

Episode Resources:

• Debra’s phone number: (704) 904-3459
• Debra’s email: [email protected] 
• Debra’s website: https://debraengelhardtnash.com/
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Main Takeaways:

• Go above and beyond what's usual and customary in dentistry.
• Respond to patient questions with above-usual answers.
• Give patients information to help their decision-making.
• Build relationships with patients as quickly as possible.
• Always tell patients about everything you offer.

Quotes:

• “If we’re going to change our behavior, if we want to behave in an above-usual and customary way, if we don't want to do things usually and customarily, then get rid of the box that we pigeonhole dental practices in, ‘We have to do it this way because this is how dental offices do it.’ Do it your way.” (3:18—3:38)
• “Patients expect certain things in offices. They expect a toothbrush at their hygiene appointment. They expect to be re-called. They expect cleanliness. They expect sterilization techniques. That's expected. And then, there's what we call augmented behavior. So, augmented behavior is, what do we do that’s usual, but we do it in an unusual way, we do it in an above-performance way?” (3:42—4:07)
• “Let's talk about the little bag. Sometimes, the patient comes in, they're paying $200 to $300 or more for a re-care, and you give them this little plastic bag that, frankly, looks like a dog poop bag. You know that plastic bag that doesn't cost you anything? You might have gotten it free from Crest or Colgate or somebody, and it’s the kind of bag I use when I walk my dog. So, think about, what can we do that would be exceptional and people say, ‘Man, when I go to my dentist, I get this kind of bag’?” (4:43—5:14)
• “When patients say, ‘Well, my insurance company says that your fees are above usual and customary. My insurance says that your fees are higher than the fees that they're going to allow,’ my answer would be, ‘I'm so glad you've given me an opportunity to address that. Because I am sure that we have demonstrated that our behavior and our abilities and our professionalism, our techniques, our materials, are above usual and customary. We would never want to be considered usual and customary. We always want to be considered above usual and customary, and some of the things that we do are not recognized by your insurance plan. But they're recognized by you, aren't they?’” (5:56—6:37)
• “If you never tell your patients what you have to offer, they will never choose it.” (7:59—8:02)
• “I don't have the right or responsibility to tell somebody what they can or can't afford. My responsibility is to tell them what we could do for them and let them choose that for themselves.” (8:11—8:21)
• “For so many years, we get frustrated that the patients are insurance-dependent. Ladies and gentlemen, we made them that way.” (10:38—10:46)
• “[The reason I ask patients what inspired them to call] is I want to engage in a relationship as quickly as possible. Because truly, patients are choosing our treatment based on relationships. 85% of the time we spend with our patient is building relationships, is communication. 15% is spent on clinical application.” (11:51—12:07)
• “I remember a fellow who called and said, ‘Hey, do you take Delta insurance?’ And I could say, ‘Well, I'm sorry, we don't.’ We never say, ‘I'm sorry.’ I said, ‘I'll be happy to tell you how we handle insurance. Before I do, may I ask you a few questions? How did you choose our office?’ And he said, ‘Well, I was driving by, and you're close to my work.’ That is not why people choose us. But I said, ‘Oh, I'm so glad we’re convenient. May I tell you a little bit about our office? That is typically not why people choose us. People choose us because of the way they feel while they're in our care. And when you walk into our office, you are going to immediately notice some differences about us. Can I tell you what they are?’ So, insurance became insignificant.” (13:36—14:23)
• “The other call that I love to field is, ‘How much do you charge for it? How much do you charge for veneers? How much do you charge for cleanings?’ I say, ‘I'd be happy to discuss our fees with you.’ I never — I mean, never — say, ‘I'm sorry, we don't quote fees over the phone,’ because it sounds like we’re embarrassed or apologetic about them, or they're too high.” (17:25—17:52)
• “You have to believe to be believed.” (19:40—19:41)
• “If I'm going to ask my team to give their all to me, I need to give my all to them.” (21:20—21:26)
• “I think it’s absolutely critical that, first of all, we have to understand that we've hired people who have lives, and we need to respect those lives. And if we do that, when we ask them to maybe go the extra mile — which, by the way, the great thing about going the extra mile is there's not much traffic — so, if I'm going to ask my team to go the extra mile for me, man, I need to go the extra mile for them.” (21:28—21:54)
• “The question is, do you really need more new patients, or should you talk about how you can elevate your acceptance rate on the patients you're already attracting?” (25:22—25:31)
• “If you don't want to do something, there are two reasons: you don't know how, or you don't want to.” (28:34—28:37)
• “Never make insurance the bad guy — or the good guy.” (33:50—33:53)
• “I'm not going to say, ‘Oh, your insurance is terrible,’ or, ‘Oh my gosh, your insurance doesn't cover very much. Your insurance is stupid.’ That's like telling a mother that her baby is ugly. You don't ever want to do that.” (34:36—34:50)

Snippets:

• 0:00 Introduction.
• 2:42 Engage in augmented behaviors.
• 6:39 Offer patients the best you have.
• 10:37 Build relationships as quickly as possible.
• 13:19 Favorite questions from patients.
• 20:16 Advice for interviewing potential team members.
• 23:34 Do you really need more new patients?
• 25:33 Advice for offering bonuses.
• 28:25 Cross-train your team.
• 29:54 All work is elective.
• 31:48 Educate your patients.
• 33:31 Other limiting beliefs.
• 37:09 More about Debra’s courses and how to get in touch.

Resources:

Academy of General Dentistry: https://www.agd.org/agd-meeting

Debra’s courses at the American Academy of Dental Office Managers: https://aadomconference.com/courses/debra-engelhardt-nash/

Debra’s courses at The Nash Institute: https://www.thenashinstitute.com/about-the-nash-institute/meet-debra-engelhardt-nash/

Debra’s other programs: https://debraengelhardtnash.com/programs/