Podcast (Dental)

The Eight Rules to Increase Dental Treatment Acceptance

April 12, 2023

Before dentists can begin treatment on their patient, the patient first needs to agree to get the treatment. In this episode of The Art of Dental Finance and Management podcast, Art meets with Debra Engelhardt-Nash, Practice Development and Team Improvement Consultant, to discuss the eight rules Debra recommends dentists follow to increase treatment acceptance.

Reach out to Art if you have any questions regarding dental finance and management for your dental practice. More information about the Eide Bailly dental team can be found at www.eidebailly.com/dentist.

Being more strategic in all aspects of your dental practice will lead to increased profitability.

Debra Engelhardt-NashGUEST

Debra Engelhardt-Nash
Speaker, Practice Development and Team Improvement Consultant

Show Notes and Resources:

The Transcript

Art Wiederman, CPA: And hello everyone, and welcome to another and very exciting edition of The Art of Dental Finance and Management with Art Wiederman CPA. I'm your host Art Wiederman. Welcome to my podcast that has now entering its fifth year. I can't believe it. I mean, I wonder that when this is over, when I get to my fifth year. Like, you know, when you've hosted Saturday Night Live five times, you get a five timers jacket. I don't know if I'm going to get one of those, but. Well, there's nobody to give it to me. But if anybody wants to send me a five timer's jacket, I'd love to have it. Or five year anniversary as we're going to be coming up at the end of this year. And the reason I say this is exciting because I have one of my dearest friends in dentistry who is my guest today. Deborah Englehart Nash is a national dental management lecturing, teaching treasure. That's all I can tell you. I met Deborah when I was with the Pacific Institute of Management in 1984, when I started, when I knew her as simply Englehart and not Deborah Englehart Nash. 27 years ago, she married Dr. Ross Nash, who is one of the most prominent cosmetic esthetic dentists in the world. And Deborah, I'll tell you a little about about the Nash Institute, which if you don't know about it, you should. And I attended Deborah's course when I was speaking last summer at the Academy of General Dentistry meeting, and Deborah's course was on case presentation. And I've been a dental CPA for 38 years. I know enough to be dangerous, but I'll tell you what. She is gold and she is spot on. And we're going to focus today on Deborah's eight rules for increasing treatment acceptance. And folks, let me say this, and I've said this from my pulpit four on lecture stages all over the country on the podcast to my clients for 38 years. When you go to dental conventions or dental meetings, if you go to CDA, Ada Hinman, Dallas, wherever you're going to go, your state meeting, make sure that while clinical dentistry is very, very important, that you find courses on how to speak and talk and communicate with your patients because that's what it's all about. And that's what got me talking about today. So I will get to Deborah in a moment. Just a couple of announcements are a thank you again to my wonderful marketing partner Decisions in Dentistry magazine W WW.DecisionsinDentistry.com. They have incredible clinical content 140 continuing education courses for very, very reasonable prices. And we've got a lot of new exciting things on the business end that we're doing with Decisions in Dentistry magazine, which will be telling you about as we go along here in 2023. So make sure you check out their website WW dot Decisions in Dentistry dot com. For those of you in Northern California, we are doing wonderful lecture programs for younger dentists who are trying to figure out what is it that you guys want to do when you grow up? Do you want to own a practice? Do you want to be a partner in a practice? Do you want to work for one of the large dental companies out there? What do you want to do? Well, we've got you covered, so you might make a note that June 10th we're going to be in the Bay Area. We don't have the location nailed down yet. It's either going to be probably East Bay ish, but we're not 100% sure. And that is June 10th. And then on June 22nd will be in Sacramento. In that location is still being finalized. But we want you to go on to the CDS websites, dawg, and sign up for those courses. June 10th, June 22nd. If you need more information, let me know. My phone number is 6572793243 and my email is awiederman@eidebailly.com. I am a proud dental division director at the CPA firm of Eide Bailly. I know I talk about and you guys are probably sick of hearing, but it's getting nasty out there. Regarding this employee retention tax credit. We are hearing from the state societies, from the national societies, from our clients that it has almost become a boiler room situation. And I actually saw a YouTube video last week which absolutely abhorred me and that is a word abhorred or abhor. I guess whatever it is, it made me really mad. And it was a young person who was on YouTube talking about how easy it was to, as I put it in his words, do this side hustle of getting people to do the RTC. It's easy. It's not a big deal. And you can make tens or hundreds of thousands of dollars by signing up these people for this RTC. This is where this is going. I have another client who got a notice in the mail that had his name and address of his practice and an amount of $162,000 on it saying, this is your RTC and it looked just like an IRS notice. And he emailed me and said, Art, is this real? Am I getting this? So, folks, here's what I'm going to tell you. If you get phone calls from these companies and they just tell you to go online and fill out a form and you're going to get this money, don't fall for it. Talk to your CPA, talk to your financial advisor. We at the Academy, a dental CPAs, one in five CPA firms across the U.S. that represent over 10,000 dentists. And I'm proud to say that my friend Deborah, who you'll hear from shortly, is coming to speak at our meeting for the first time in May. That's exciting to me. And so, you know talk to one of them W WW That adds CPA Hauger Call me if you are being pressured by people or all your friends are saying they did it and you feel like you're missing the boat. You're not missing the boat because many of you were not, I repeat, not shut down by government orders and you probably don't qualify for the RTC. So I just want to put that warning out there for you. So be it. Be aware of that. Also, last thing before we get to Deborah, I will be at I will be speaking, giving three different talks at the California Dental Association. I believe that is May 17th to the 19th in Anaheim, California, at the Anaheim Convention Center. We will be at booth 1472. Please come by and say hi. I would love to see all of you. All right. Well, this is the quietest that Deborah Englehart Nash has ever been. She has not spoken now for five or 6 minutes. She's she's I know she's exploding and ready. She sure head's coming off. Joking aside, Deborah Hart Englehart Nash is the co-founder of the Nash Institute and is a practice management expert. And I have no problem saying she's an expert. She practice management consultant, seminar leader. Throughout her career, Deborah has worked in hundreds of dental offices, evaluating teams and practice development day to day operations and offering creative solutions for communications effectiveness and increased productivity. She writes and lectures internationally on practice management and team building. She's been an instructor for the Central Piedmont Community College Dental Assisting program in Charlotte, North Carolina. She's taught for Oregon Health Science University, continuing General Education Department. She has repeatedly presented programs for the ADA and probably every single. Meeting you've ever heard of. She is a founding member and served two terms as the president of the National Academy of Dental Management Consultants, where she received the first Charles Kidd Meritorious Service Award and is on the board of the ADA Association Foundation. And I must call you now, Dear Madam President, because you are now the incoming president of the Academy for Private Dental Practice, formerly known as the American Academy for Dental Practice. I'm exhausted. I'm going to fall over. I can introduce you and welcome.

Debra Engelhardt-Nash: The recently installed as the as the president. Now.

Art Wiederman, CPA: Did you have, like, a gala ball where you dressed up and got to dance with Ross in front of cameras?

Debra Engelhardt-Nash: Got a nice. No, actually, Ross, there's a whole situation that happened during Chicago in winter, and Ross was home recovering from.

Art Wiederman, CPA: I know, I heard that.

Debra Engelhardt-Nash: Yeah, and that sort of thing. But no, it was a nice, it was a very nice installation luncheon and it was a great announcement for our 2024 meeting. I've been a member of that organization for 23 years, I think.

Art Wiederman, CPA: Tell us about the organization.

Debra Engelhardt-Nash: The America, the it's no longer the America because we you can be international now. So the academy for for Private Dental Practice was actually founded in 1957, which, by the way, was the year that the high speed headpiece was debuted.

Art Wiederman, CPA: Is that right?

Debra Engelhardt-Nash: And bubble wrap? Yes.

Art Wiederman, CPA: And I love bubble wrap.

Debra Engelhardt-Nash: Bubble wrap.

Art Wiederman, CPA: My favorite. I pop bubble wrap whenever I can.

Debra Engelhardt-Nash: Now I like to eat a puppet. So it was a group of dentists, private practice dentists who said, Hey, let's get together and talk about our businesses and how could we make them better and how can we help each other with situations of, you know, regarding employment and team and costs and, you know, building our building our practices. So it was almost it was like a mentorship organization that really, truly grew. And in the end, it was by invitation only. When I say invitation only because I remember these days and you remember some of my friends Andrea Klaassen and.

Art Wiederman, CPA: Oh, dear.

Debra Engelhardt-Nash: Pam Struthers.

Art Wiederman, CPA: My big sisters in dentistry.

Debra Engelhardt-Nash: Yes, you would get and basically an engraved invitation to attend that meeting. So it is truly by invitation only now they relax that they've become less discriminating and I wouldn't even take, you know, about it. So so it was the ADP a and then it was the ADP. They dropped administration because people always thought it was all about practice management, but they're actually seven pillars to the organization, which I'll talk about. So we have adopted the the new name the Academy for Private Dental Practice. We want people to know that this is a niche organization or a niche organization. If I wanted to be French for dentists who are or what do either want to maintain private practice or be in private practice and don't want to go into the DSO world. That's India. So world is bad, It's different.

Art Wiederman, CPA: It's different. It's different.

Debra Engelhardt-Nash: So when you take a look at and you mentioned your programs, which I think are awesome, I heard a statistic last week that private practice dentistry is shrinking by 7% per year.

Art Wiederman, CPA: But that could be. But I'll tell you, this is an interesting conversation before we get into case presentation. Yes, I know that medicine is 98, 99% PPO, HMO capitation. Big corporations. Okay. But, I mean, you and I have been in this business 40 years, right? And there are, I think, enough dentists out there who are going to look at this and say the private fee for service practice of dentistry must be maintained. Must go on to the next generation. And yes, right now I think the statistic is, is maybe 25 to 30% of dentistry right now is some sort of good practice.

Debra Engelhardt-Nash: Yeah. Or D or.

Art Wiederman, CPA: D.O.D. has, you know, I mean, you have the big ones that there's 200, 300, 400 groups and there are groups emerging and it's a big deal. Okay. And it's not something that you and I dealt with at the Pacific or Pride Institute. And there is a place that we're not going to get that discussion today. But but don't you think, Deborah, that there is groups like yours need to be known about they need to be, you know, nourished and fed, because that is where dentists are happier. They're providing better service to their patients, better total health coaching. Right.

Debra Engelhardt-Nash: I think, you know, it's interesting that you that you mentioned this. I think that's true. I think it's a different offer. Some for some it's okay. What is your personality? Is it what is your strength of of commitment and conviction for the kind of dentistry that you do? We had a young dentist. We we offer scholarships to the app, the academy for private dental practice to doctors who have been out five years or less so we can offer scholarships. And I granted two scholarships this year and want one of the doctors is working for a very large group. I mean, 16 laboratories, four doctors, eight hygienists. Crazy. Yeah. And I said to him, I don't want to mention his first name because it's so unique. And other people say, Oh, I know who you're talking about. And I said, So tell me what what your what you're working on. And he said, My speed. Uh, speed, high speed.

Art Wiederman, CPA: Faster. Yeah. Uh, what about.

Debra Engelhardt-Nash: What about faster? Or do we want to be more effective? So there's, there's the dilemma in, in this kind of segways into treatment presentation. Is it how many patients that I see or is it what I do per patient? That's important. I was just in our office this morning and I was conducting their team meeting and we talked. We took a look at they had 44 new patients and I said, That's a great number. Depending on what you did with those 44 patients. So we actually have to really break that down because sometimes and you do this because you talk about metrics. All right. So sometimes officers say, oh, we had 44 new patients and they get all excited. And I always said, but wait.

Art Wiederman, CPA: Wait.

Debra Engelhardt-Nash: You had 44. You acquired 44 new patients. What was your attrition? Did you lose your tuition rate?

Art Wiederman, CPA: I just wrote an article on that.

Debra Engelhardt-Nash: And what was the value of each one of those 44 patients? Because do you want 44 patients who come in with a new present and a $400 treatment plan is accepted? Or would you rather have 22 patients who come in and you present a $4,000 treatment plan and a $4,000 treatment plan is accepted?

Art Wiederman, CPA: Oh, you are so good at Segway. Do you ride a Segway, by the way? I don't know.

Debra Engelhardt-Nash: So I think that that's, you know, for for the for young doctors who are trying to decide. And that is why the the Academy for Private dental practice is perfect for doctors who are trying to navigate. What I want to do and I understand I was talking to a professor from the University of Nebraska. He said, hey, we get it. They come out of debt. I mean, they come out of school with a whole lot of debt. And the question is, do they come out with this school debt? And then they go into more debt by opening a private practice or buying a private practice. But then you also have to take a look at what is my and you're you're the master, this art, what is my earning? What's the differential of my earning potential, being a corporate dentist or being a private practice?

Art Wiederman, CPA: It's it's night and day. Yeah. What's my.

Debra Engelhardt-Nash: Long term earning potential.

Art Wiederman, CPA: And just being being nuts, having people tell you what to do. You are your. Oh, what was it, a Seinfeld? You're the master of your own domain. Is that what it was?

Debra Engelhardt-Nash: I don't know. I don't know until person.

Art Wiederman, CPA: Oh, I was.

Debra Engelhardt-Nash: Important thing is, yes I have a client who started with a DSO and he absolutely I mean he said the regional and I'm not once again. No, no, no, no. The regional director would make the rounds come to to his office and she said you need to change labs because you're paying too much for your for your your laboratory fees. So you need to use this lab and you need to you need to do this. So now we've got a regional director dictating his clinical treatment. Yup. And he said, That's what I said. You know what? You can talk to me about management. You can talk to me about team you. But when a regional director who's not a dentist until is telling me is dictating my treatment for to my patients based on cost, based on how can we reduce the cost of you doing this dentistry is that that's when I knew that I was not in the right place. Example He's a private practice dentistry and now he has three associates and he has two locations and he did that in like five years.

Art Wiederman, CPA: And he's happy. He's happy and he's happy. He go, he doesn't throw up every day process work. Okay, So real quick before, because I want to get into your eight roles and we'll be lucky if we get through one of them, you and I. Right. It's really terrible. How does someone find out? Is there a website? Is there? And I'm going to let you give out your contact information here.

Debra Engelhardt-Nash: Well, there is a there is we actually are now just converting our website over to the new name. So people still find the academy under ADP dot org. So it's still listed American Academy of Dental Practice. We haven't converted the website yet, but if you go on to ADB and we're just getting ready to post, we just finished having the 2023 meeting. So now we're posting our meeting in 2024, which is March 7th through the ninth in Coral Springs, Fort Lauderdale.

Art Wiederman, CPA: Nice. They have good golf courses.

Debra Engelhardt-Nash: They're great golf courses there and a great have a great program chair for the year. And she has put together an amazing, amazing program out very, very briefly because I have I have my eight roles, but I also have the the Academy has seven pillars, and that's sort of what we design our meetings. And when when when the organization was designed, they basically said these are sort of the seven pillars of a well-rounded, comprehensive dental office and it's based on clinical aptitude. So there's always a clinical some clinical training, mentorship. Know, we collaborate, we talk to one another. How are you doing this? How are you? How are you handling that? There's a woman I mean, she's amazing. And I'll say her name is Dr. Mary Roth, and she is 58 years old and she's just opened her practice, a startup. She just opened a startup practice. She's a.

Art Wiederman, CPA: 58.

Debra Engelhardt-Nash: 58 years old.

Art Wiederman, CPA: Wow. God bless her. Oh, excited. God bless her.

Debra Engelhardt-Nash: She has gotten a lot of information from coming to that meeting and say, okay, who are using for this and who's doing your website and how are you doing this and how are you handling this? And so so mentorship is important. Leadership is you know, we talk about leadership because I think strong dental practices have strong leadership. Leadership doesn't have to be loud. I'm going to write an article about that, about that. Leadership does not have to be loud. That doesn't mean you are gregarious and you are a cheerleader. And there's very strong leadership that's very quiet.

Art Wiederman, CPA: Leadership is another podcast you and I need to do.

Debra Engelhardt-Nash: But leadership and the new patient experiences, that's one of the pillars. So we have clinical mentorship, leadership, patient experiences, business obviously.

Art Wiederman, CPA: Yeah.

Debra Engelhardt-Nash: And culture is another one and finance. So those are we think these are the seven pillars of if you're going to build a dental practice, you've got to have these things well in place and that's what we want and that's what our national meetings are all about.

Art Wiederman, CPA: Well, I'm excited for you and your organization, and I would encourage all of you to check out the Academy for Private Dental Practice or the Academy of Design.

Debra Engelhardt-Nash: It's not a large group. It's, you know, we're not trying to get to thousands of people. I mean, like they just had the women in DSO meeting. They're like, yeah, 50 people. Yeah, I think 1500. Members. We like to keep it niche, like boutique like. We actually do a lot of social things. People bring their their significant others and we always have an activity for a significant others so that they can talk together. They collaborate. They have a women's women in Dentistry mastermind group, So we like to keep it family oriented, if you will, Right? That doesn't mean we don't that doesn't mean we don't swear, but we've got.

Art Wiederman, CPA: You can't swear on my podcast, but we will swear if I ever get to one of your meetings. I might I might swear.

Debra Engelhardt-Nash: We had a.

Art Wiederman, CPA: Dance. See, there I go. I said, Darn.

Debra Engelhardt-Nash: Yeah. So there we are. I'll tell you, there was an exceptional speaker. This last meaning that. Oh, my gosh, his name is Dr. Darren Pretzel. If you ever have a chance, I mean, just a shout out for him. Oral surgeon. He was an oral surgeon in Iraq. And I mean, he talks about. Oh, but his whole story, it is not just Iraq, but it's also about being a private practice oral surgeon. I it's just an amazing, inspirational, tear jerking but heartfelt motivating. And that's what that is what the app is all about. It is all about inspiring. You did go back to your practices and be better and do better and have better, be more productive, be more effective and be happy.

Art Wiederman, CPA: I wish yes, yes, I wish you luck as your president, your tenure. So I want to read something from your eight rules. Let's get into our topic. Okay, Because this is one way or another going to turn into a seven hour podcast. What does it take to get a yes to treatment from your patients? There is no quick fix, magic wand or potion that will give you the treatment success you're dreaming for. The difference between success and failure is not a single secret, but it is a secret formula. There is a series of eight critical principles that will lead you to success. Some of these are fundamental steps that successful salespeople and entrepreneurs have been executing for centuries. They're attributes that high achievers have in common. So do you work since you're the defendant here? Would you like to make an opening? I mean, the counsel would you like to make an opening statement, or do.

Debra Engelhardt-Nash: You feel like you just caught a video of me in the dog kennel?

Art Wiederman, CPA: I'm that's rough. Oh, okay. So, well, let's you want to just jump into the roles here.

Debra Engelhardt-Nash: Well, here's what I will say this a lot. I'm going to give a couple really important points, pointers from the get go and then we can back up.

Art Wiederman, CPA: Sure, sure, sure.

Debra Engelhardt-Nash: One of the one of the ways that dentists sabotage presenting treatment to patients is they start with Let me tell you what you need.

Art Wiederman, CPA: Uh huh.

Debra Engelhardt-Nash: And I mean, that's that's that's says that's a sabotage because patients don't become interested in being bombarded with being either scolded or lectured to about what their treatment needs are. So I always say to my clients, you know, when you're getting ready to sit down with a patient to talk about your findings, ask permission. Yeah. You know, so it's like, so, you know, when we talk about communication communicating, we'll get into that. So the the, the opening question for presenting treatment is, would you allow me to tell you what I'd like to do for you, or would you allow me to tell you what is possible? Would you allow me to tell you what I would like to do If you were my sister, would you allow me to tell you what I have found as opposed to I mean, tell you what you need and here's what oftentimes happens as well. So when we talk about the rules, I mean.

Art Wiederman, CPA: No, no, you you have carte blanche to talk about this is all great stuff.

Debra Engelhardt-Nash: That's a critically I think that's a critical piece that we sit down and it actually we even back up to and we won't go into a phone call today. But oftentimes a new patient calls your office and you say, okay, you're going to have a new patient examination and we're going to do x rays of the study, Miles, that all cancer screening exam we're going to do, period, all probing, which sounds scary. We're going to do blah, blah, blah, blah, blah. We're going to create a treatment plan for you. We're going to tell you what your insurance is going to cover. We tell you what you need and what your out-of-pocket expenses are going to be. We regurgitate, we just like a vomit. But. But.

Art Wiederman, CPA: Deborah, I just want my teeth cleaned.

Debra Engelhardt-Nash: Yeah, well, you know what? You know what? I'd be happy to. I'd be happy to talk about how we do that for you. So it goes back to. So we go. I'm sorry. We don't just clean teeth. I'm sorry. I mean, I would say, you know, if you tell somebody they're not going to get what they ask for, you've lost them. So if you said, I just want me to clean, I'd be happy to tell you how we can handle that for you, Art. Would you allow me to ask you a few questions before I do? May I ask you a few questions?

Art Wiederman, CPA: Yeah.

Debra Engelhardt-Nash: So I can go in, back into the conversation and I can back that into that. I see. You know, you know, a lot of patients do. A lot of new patients do call us asking to have their teeth cleaned because they haven't experienced what we have to offer.

Art Wiederman, CPA: Right. Yeah.

Debra Engelhardt-Nash: Tell me more about what that is.

Art Wiederman, CPA: So asking permission is huge.

Debra Engelhardt-Nash: Asking permission is huge. And even asking when you're when you're gathering information on the telephone, you know, May I ask you a few questions as opposed to what's your name, what's your address? What's your Social Security number? Do you have any artificial joints? Do you have to be medicated? Do you have any sexually transmitted diseases? Do you. I mean, we started asking some very personal questions and we don't even.

Art Wiederman, CPA: We don't even know these people. We don't know we don't know what their hot buttons are. We don't know what their life looks like. Oh, my God. Oh, my God.

Debra Engelhardt-Nash: We have to say, okay, we want to make sure that we schedule those appropriately for you. And then you're going to have the most exceptional experience you've ever had to develop is so that I can accomplish that for you. May I ask you a few questions? Right. The first question we ask is not name number what insurance you have. I have to back up to that because so many times you call me, you say my name is. Aren't my teeth clean? Oftentimes the first question is what a dental insurance do you have? And I spend 10 minutes talking to you about your exclusion, your your out-of-pocket expenses, your deductible, your rules and regulations of your dental, of your dental insurance. And then we wonder why the patients want to talk about Dillinger's. We brought it up.

Art Wiederman, CPA: We brought it up. We're training them. We're training them.

Debra Engelhardt-Nash: That dental insurance is the focal point. So I think it's important that the most important question that I would ask you are, you know, so when I have my teeth cleaned, are happy to talk to you about a little bit about that. Before I do, may I ask you a few questions? And one of my questions for you are would be tell me what inspired you to call our office? What was it? What was it that inspired you to call us on our call today? Because today you wanted to make a decision in your dental. You want to make a change in your dental life. And I need to find out what the what what it was that inspired you to call me. So that starts that whole process, right?

Art Wiederman, CPA: You got to get them in the number one thing that you've taught me. Andrea, Pam, all the people at Pride, get them into the office. You got to get them in like you can't. You can't do dentistry on people that are not in your office, so.

Debra Engelhardt-Nash: Well, you have to. You have to create the differential you have, right? You have about 15 seconds. You show the patient that you're different, that you are different. So I think that's really also important. I think what's also critical for dentists when we talk about the, you know, the eight rules, the number one rule is believe you can do the treat. Yeah. And that's.

Art Wiederman, CPA: The first one.

Debra Engelhardt-Nash: And believe that the patients want it because so many times, oh, this happens so many times, especially with patients of record, the patient isn't interested, the patient can't afford it. The patients to all the patients to young patient doesn't want their insurance is going to cover it. We create all of these roadblocks, our own roadblocks. So the first thing we have to do is we have to we have to eliminate those items in our head, those roadblocks we created. They don't want it. They're not interested. Insurance is going to go right there.

Art Wiederman, CPA: They can't afford it.

Debra Engelhardt-Nash: Yeah, I mean, a whole lot of people and I'm not going to make any discriminating remarks, but there are I mean, I live near a major shopping mall. I'm not a big shopper. But, you know, if I have to go, I have to go. If I have to go pick something up. But when I go there, there is a Gucci store and a Louis Vuitton store and and a Tiffany. That's it's. Oh, What's the raincoat from England? Oh.

Art Wiederman, CPA: I don't know. Well, I don't wear raincoats from England

Debra Engelhardt-Nash: You're in California, so the rain.

Art Wiederman, CPA: Oh, it's raining right now, dear.

Debra Engelhardt-Nash: Oh, Burberry. So there's.

Art Wiederman, CPA: Burberry. Burberry. Okay.

Debra Engelhardt-Nash: Louis Vuitton, Tiffany's and Gucci. And they're all kind of far these four pillar stores in this mall. There is a line in each one of. There's a line to get into each one of these stores. There's a line.

Art Wiederman, CPA: There's a reason.

Debra Engelhardt-Nash: There's. Well, there's a reason because. Buying one of those items makes me feel good about me. And there's never a conversation about what Louis Vuitton insurance do you have? There's never a question about what Burberry or Tiffany and shares do have. It's all about Let me show you how this is going to make you feel. And that's what we have to do in dentistry, as opposed to here's what you need. And here's the other thing that happens. We apologize, you know, So you come to me, Art, and you have a tooth that's fractured or you have an old wrist, you know, you have like a 17 surface pin build up that's finally broken down. And we have an I and I apologize. I say, Oh, all right, I'm so sorry, but we can't we can't replace that feeling. There's too much natural to surface. God, you're going to need a crown. I'm so sorry. We apologize. As opposed to, say, art. Oh, my gosh. I have great news. We have a solution. For what? The problem you brought to me.

Art Wiederman, CPA: Aha. We. We.

Debra Engelhardt-Nash: Yeah. Yeah. There's a solution to this. You know, you're not going to. You're not going to lose that tooth. We're not going to have to do anything dramatic. You know, we were going to take a radiograph or we're going to take digital images, we're going to see that everything underneath is sound. But we and we have a solution for how we're going to protect that.

Art Wiederman, CPA: And when we're done with you, you are going to look amazing.

Debra Engelhardt-Nash: Yeah. I mean, you're talking about, you know, cosmetics and esthetics. But even so, here's the other thing. What do we have to look? What we're talking about presenting treatment area. For me, I always tell my clients everything is elective. You know, you say, well, this patient needs a crown. No, they.

Art Wiederman, CPA: Don't. No, they don't.

Debra Engelhardt-Nash: They don't need it.

Art Wiederman, CPA: They have 31 other teeth.

Debra Engelhardt-Nash: And so we have to say, well you need you need this. No, but you know, what? Can I tell you why I think this would be in your best interest. This would be the best solution for you, because not you need a crown. We're just talking about this today. This office was working with patients who who want to refuse radiographs. And we were we were walking through conversations about, you know, radiograph refusal. But same thing about Del it we also have a tendency to say, here's what we can do for you, but. And the minute I the minute the patient hears. But they forgot everything you just said. They want to write. They want to hear what's happening after the book.

Art Wiederman, CPA: Right.

Debra Engelhardt-Nash: Which sounds kind of weird, but yeah, they say we could do this for you, but you only have $1,000 insurance allowance.

Art Wiederman, CPA: Oh, you just killed the whole thing. Just kill the whole thing. Yeah.

Debra Engelhardt-Nash: So everything I said before that, because what you just basically said is it's okay to say no. You just gave the patient, right?

Art Wiederman, CPA: No, You gave them an out.

Debra Engelhardt-Nash: You gave them an out. So what you can turn around and say is actually, you know, this is an interesting statistic. 50% of Americans have have some level of insurance. Right. You know, not everybody. And so people who are listening to this say, yeah, they're all in my office and they all want to know what insurers is going to cover. And if I'm in network and if I, you know, if I participate in their plan. But here's what we can say is you are so lucky that your employer has provided a dental allowance for you.

Art Wiederman, CPA: Exactly. It may be you're lucky it's a dental benefit, not insurance. It's a dental it's a benefit allowance.

Debra Engelhardt-Nash: So I think we have to let the patient know. Your employer has provided a dental allowance. They have determined how much they are willing to. A lot for you don't care. And it was never designed to cover all costs. Right. So we always say, you know, we do our best to help you. And I always say, we'll do it. We're going to do our best to help you utilize the dental allowance that has been provided for you by your employer.

Art Wiederman, CPA: Exactly.

Debra Engelhardt-Nash: So you're not going to compromise our standard of care based on the exceptions, limitations or restrictions of any plan?

Art Wiederman, CPA: Exactly. I love that. That that's so number one is believe you can go. I mean, I mean, one of the things that I talk to doctors about is become an outstanding clinician. You know, I mean, take courses. And again, you know, obviously, your institute is as good as it gets. But wherever they're going to go, wherever, you know, spear panky, coyote, Nash, wherever it is, just continue to learn and continue to be. What is it? Bill. Bill and Ted's Excellent Adventure. Be excellent. Right. That's what we want them to do.

Debra Engelhardt-Nash: You know, the other thing is, and I might be a little bit happily biased after hearing Dr. Pretzel, they were all surgeons speak, and you don't know what know what's in your wheelhouse and no one to refer out.

Art Wiederman, CPA: Right.

Debra Engelhardt-Nash: I see a lot of a lot of dentists who try to to to do a procedure. And it it's laborious for them. And so I get really good at some some things don't you know how to get good at everything. And actually I'm a big fan of of outsourcing when you can. I was I was again Dr. Petzel said I can take up for his wisdom teeth in 3 to 6 minutes. Can a general dentist do that? Don't do that. So the patient's going to have a better experience. I mean, if it if it's easy to deal with the thing out, you know, great. But if the patients can have a better deal experience somewhere else, help them find that somewhere else. So they come back to you and say, oh, my gosh, that was an amazing patient space. We just referred a patient. Has his practice referred a patient to a periodontist? And in order to to increase to expedite a healing, he actually takes the patient's blood and does the whole spinning thing and gets the platelets and puts it back into the tissue to heal. How many general dentists do that? Don't. So I think. No. So when you say believe, you can be careful that you don't have to be an expert in all things, but you can have experts around you who can help you be a better dad.

Art Wiederman, CPA: It's the same thing in my profession. It's the same thing as an attorney or an architect or anything. All right. Intention, Deborah. What's intention?

Debra Engelhardt-Nash: Yeah. So the intention is know. Make sure that you share. What is the purpose of your practice? What is your intention? And I always tell now, I've actually since I've written this article, there's even more reasons about intentional. Intentional body language means how I sit when I'm talking to a patient. So if I'm if I'm intentionally I mean, if I'm intentionally listening to you, art, I'm going to be leaning slightly forward. I'm going to be we're going to have eye contact that says I'm I'm intentionally painted, I'm paying attention to you and I'm intentionally listening to what you have to say. But I also think it's also when you talk about intention, when I talk about intentional, does your team understand what you're trying to accomplish? Can your team describe your purpose to their to the patient? Because what are the other pieces down here is team involvement.

Art Wiederman, CPA: Yep. That's number three.

Debra Engelhardt-Nash: The lutely critical for the team to understand the doctors intention, the practice's intention, so that I can articulate that to the patient. And here's the little weird little marketing phrase. My responsibility as a dental assistant, as receptionist, treatment coordinator, hygienist is to create the perception of quality remote from doctor's presence.

Art Wiederman, CPA: See, and my question, Deborah, is what happens when the doctor presents the treatment and leaves the room and the patient says to the assistant, Well, do it. Do you really think I need that?

Debra Engelhardt-Nash: Or or here's what they say. We talked about this this morning in my group. Well, that sounds expensive. Yeah. So we have to make sure that the team understand. Now, here's the other piece where if we back way, way up. If I'm the treatment coordinator, the dental system, the Hijos, whatever the the format is in the particular practice, how the new patient comes into the office. There should be a story before we launch into radiographs and x rays, before we launch into our mechanics. People need to understand the why. And that's why I'm a big fan of Simon Sinek and the book. Start with why the doctors need to read that. People your patients want to know your why. That's your intention. And the team needs to say, My name is Deborah and I and I have worked for Dr. Lederman for 38 years. Can I tell you why been you so long? Because I have found throughout the years that he has an amazing an integrity. He's got a strength of character. He absolutely loves his patients. He's an advocate for continued education. And even though he's been a dentist all this time, he continues to grow and learn to provide his patients in the best technology. He treats me with great respect and for that I really admire. So sometimes patients will ask me, does he pay? Does he pay me to tell you this? And so, you know, he pays me to be here. But for what I've just told you, he earned that. He earned my respect in my regard. I mean.

Art Wiederman, CPA: Right. And I wouldn't have and I would not have anybody else do any dental treatment on me, my family or my friends. He is as good as it gets. And if he says that you need that, this is it, then you can take that to the bank. I mean, really? Yeah, So I know so.

Debra Engelhardt-Nash: And once again, the patient, the team members must that it has to be an authentic feeling. Yes. I can't say if I don't believe it. So there's a believable factor. If I don't believe it, I can't say it. And if I don't believe it? Yeah, I'm in the wrong place.

Art Wiederman, CPA: Right. And that and that comes back to culture and that comes back to the leader, the doctor treating the team with respect and not like AIDS servants. And really, I mean, because would you if you were a dental assistant, Deborah and that and the doctor would berate you all the time and be mean to you all the time, How difficult would it be for you when that question comes up from the patient to say what you just said? Right.

Debra Engelhardt-Nash: I know if I don't feel validated, if I don't feel important, it's hard for me to endorse my employer. So it would be hard for me to go and say, you know, I'm happy to be here. And this is like the best place for me to be in this work is impeccable. That's the other thing. I have to feel that the work is impeccable, which goes to the next rule. There has to be education. So the team at the office, you know, my husband just sold us. He sold his practice last year, and we're taking the team through the whole from analog to digital. So the team is doing two days of training on digital technology. You know, we can't just throw the team into, Hey, guess what? We're going to now start doing 3D printing and we're the team doesn't know what we're talking about. The team hasn't been educated, so there is an investment involved for to educate the team so that they in turn can educate the patient and endorse the treatment. So if I'm not educated, then I can't that I can educate the patient and and I can't validate the practice if I can educate the patient. So education and taking time to whether you bring in a coach or you bring in a consultant or you take the team to a consumer education event, it's critical for your team to learn to learn. Okay. I just think about go ahead. We've been a dynasty for so long. I remember that day. I mean, I was I was a pretty good front office person and I was pretty savvy. I got recruited out of an audience by Pacific Institutes to be a consultant.

Art Wiederman, CPA: I remember that story. Yes.

Debra Engelhardt-Nash: Yeah. And I knew I knew systems. But back in the day, the systems were we had a you know, we had an appointment book, there was paper, and it was like 36 inches long. And we had we at a glance we wrote in pencil.

Art Wiederman, CPA: And we had safeguard. We had safeguard.

Debra Engelhardt-Nash: I was really good at that. We had letters. Yeah, get that. But if I said, you know, I'm really good at this and I don't need to learn anything new because I'm really good at this, I would be obsolete. I would be I would have been absolutely obsolete. So and so. I mean, here I is. I'm married to kill. She's going to kill me. I'm married to a 75 year old dentist who's practicing three days a week. He sold his his practice and he is as excited about dentistry and technology and about digital opportunities and about growing as he was when when he started be the cosmetic dentist back in the in the late sixties early seventies. Yeah. So you've got if you stop you know what it's say you know when you stop growing you start dying. So I think it's important to constantly get your team excited about learning new. And that's not necessarily just technology, not simply just product, but it's also learning new ways to to communicate with the patients. I mean, we can we don't even have time to talk about social media.

Art Wiederman, CPA: No, we don't wish we did.

Debra Engelhardt-Nash: We? Yeah, but if you're talking about, you know, what do your patients want most now? Do they want do they want a phone call? Do they want to be tech? Do they want to text? Do they want to be emailed? Do they want a pigeon? What do they want? They want you know, they want it fast, right?

Art Wiederman, CPA: So it's a different world than when you and I grew up. You know, in.

Debra Engelhardt-Nash: The day we were like calling patients to that to to verify their appointment times. Hi.

Art Wiederman, CPA: On the rotary phone where you dial the phone. Right.

Debra Engelhardt-Nash: Hi, Art. I'm just calling to remind you of appointment on Tuesday at three. I mean, my gosh, we spent half a day calling to verify a.

Art Wiederman, CPA: But Deborah, one of my favorite things when I speak to dental schools, I keep an old copy of the Yellow Pages in my bottom drawer in my kitchen, and I bring it with me and I say, So now we're going to talk about marketing. How many of you have ever seen this? I hold up the yellow page. I say, This is the Yellow Pages. And the fun part is to watch their faces because they don't know what that is. So it's it's very, very different. Hey, I want to get to some more stuff. Tell me if people want to get a hold of you to tell me a little bit about the National Institute. Tell me a little bit about what you do and let's give out some contact information if someone wants to give you a call.

Debra Engelhardt-Nash: Sure. Well, the National Student Learning was we started that and my gosh, we were talking about this. We started that in 1997. It's a continuing it's a post-graduate continuum. And it was designed that it can be take it ala carte. You don't have to take the whole continuum but you to. So you could take it whatever you want, however you want. But Ross designed it to be ideally to be taken with direct restorations. So director set a direct esthetic so that the posture and interior and then indirect. So that would be anything that's crown and bridge in the Onli which today's Dell students say what's an inlay.

Art Wiederman, CPA: That's amazing to me I hear that.

Debra Engelhardt-Nash: Sounds veneers. Anything that's you know lab fabricated or indirect. And then he also does a course on full mouth rehabilitation or rejuvenation. So that's his three course continuum. And then we have the Dell Business School, which is two days of from and I always say it's from phone call to recall how you walk the patient through your business systems to, first of all, to attract them, to attract and retain and increase your attribute acceptance rate and then move them in to recall and keeping them. So that's at Del Business School.

Art Wiederman, CPA: Is there a website that they can get to or a phone number?

Debra Engelhardt-Nash: It can go to the Nash Institute for Dental Learning website. If they want to call, then it's they can call the Nash's to they can. But the easiest thing is they go onto the website and look at the curriculum. Okay, If they have any questions on that, they can actually ask their questions on the website. See, that's new technology we answer right away. Or they can or they can call us. So but they get all information they need on the site and they can answer, you know, they can answer questions on the site as well.

Art Wiederman, CPA: And you still do consulting and private offices.

Debra Engelhardt-Nash: And I still want to I'm doing one into an office tomorrow and Friday to work with the front office team on language in and language.

Art Wiederman, CPA: You want to give out. You're the one that's teaching about how to do this. And I'm trying to get you to sell yourself. You're not doing a very good job, Debra.

Debra Engelhardt-Nash: So if you want me, you'll find me. Yeah, that's so I used to date to.

Art Wiederman, CPA: Yeah, I believe that.

Debra Engelhardt-Nash: You know, I do have a website. Fact, I'm just getting ready and revamping my website now, but I. Deborah Englehart, Nash dot com I have a website. I always give out my cell phone number because I never know where in the country I might be this time. Best way to reach me is through my cell phone, which is 7049043459. And you can text me or you can call me. I don't have a meter on my telephone. I'm rare. Very rarely had anybody abused by time now, so I'm willing to ask to answer any questions and talk about my services and what I do. Absolutely.

Art Wiederman, CPA: Okay. Because I wish I could make this a three hour podcast. Empathy, dear. What is empathy in case Presentation.

Debra Engelhardt-Nash: Empathy means that what matters to you most is how the patient is receiving what you're saying, not how. Not that you're saying it. So I think that there's the empathetic response is, once again, is body language. What is our what is our body saying? Is our body open and is are we are we paying attention to how the patient is responding? And I think that's important. And now we have to be careful about physical touch for all kinds of reasons. Right. There was a time that we used to put our we would put our hand on the patient's, you know, the patient's forearm here. And we almost can't do that anymore. But but our body and our and our eye contact. Eye contact is huge. To demonstrate empathy to a patient, once again, our body language being 55% of the way we we communicate with our patients is in what our bodies are telling them. So I think the way you sit, where you sit in the arbitrary, so that's that can actually exemplify empathy. Sometimes I go to offices and the doctor and the dental assistant are have there are they are behind the patient's head. And I've got a doctor on one side, I got the dental assistant on the other, and the patients can't even see them. So one of the ways to to demonstrate your empathy is to move yourself forward in front of the patient so they can see you. And actually, in an ideal world, if I have an ideal situation, the dental assistant and the dentist are not standing like this. The dental assistant of the dentist are standing like this because now the patient has one focal, they have one focal point. They're looking here. And when I have a dental assistant behind the doctor. And the Dell assistant is validating, non-verbally, validating with the doctor saying, Here's what I'd like to do for you. Would you allow me to tell you what I could do for you? And the Dell and the assistant that she recorded her ideas is behind the dentist saying yes. And another way of doing that and I have an actual visual of this is actually if the Dell a sister just has her hand just slightly resting on the doctor's shoulder, what does that say to the patient?

Art Wiederman, CPA: I trust the guy.

Debra Engelhardt-Nash: I trust the guy. I believe him and I know it. Anyway. Here's another piece, another key. That's fine that we have to talk about, because we can talk about how we talk about presenting treatment, because oftentimes we can talk about new patients and what we can talk about are eight rules Will we'll get through them. But I also think it's important to take a look at patients of record going through hygiene. And we and we have to talk about intention and team involvement and education and creating opportunity. That's one of the other rules is created the opportunity. So many times we have a historical bias that the patient isn't interested. They're too old, they don't want it, they can't afford it. Insurance is going to cover it. So we take a look at a treatment plan that had been recommended and has not yet been completed. And sometimes we never say anything again to the patient. And sometimes in the morning huddle we'll say, You know what? I know. I know Art, He's not interested in that. He needs some crowns on the upper right side, but he knows how to do it. And we go in to the hygiene appointment with that theory, and we don't bring it up again because we're afraid we're going to offend the patient. Well, if we don't bring it up, it goes back to creating the opportunity. If we don't bring it up, the patient will say, Well, I guess it didn't matter. So here is one of the most important questions that a High Janis ask. And it could be anybody. But let's say in the care department, I have a patient coming to my to my in my room. I see that they have an outstanding treatment plan, treatment that has been planned, that has not yet been completed. And I have to and I have not even you should or you could I have to ask the patient this question. Art. I see the doctor's recommended treatment that we have yet to be completed. That has yet to be completed. Tell me what has prevented you from having that done. And then I'm going to then I'm going to be quiet. Got up now I'm going to shut up. And I want to and I want to and I'm going to once again, my body is I'm leaning forward. I'm not on a computer. I'm not over here distracted looking at a computer. I'm not behind the patient. I am I watch again by word intention. I'm intentionally looking at you and say, Ah, this treatment has been was planned for you and it's yet to be completed. Tell me what has prevented you from having that taken care of? Having that done? No quiet way for you to say. I don't need it. It doesn't bother me. I can't afford it. So. So. So. I mean, I closed my door because my. My decided to make an announcement, so.

Art Wiederman, CPA: I see. Okay. But. Yeah. And this is. Oh, okay. Good. Go ahead.

Debra Engelhardt-Nash: That was that easy. So.

Art Wiederman, CPA: I mean, if your has any tips on casing presentation, I'm more than willing to add it to the podcast.

Debra Engelhardt-Nash: She is so spoiled. So I think that, you know, when we have to walk through, that goes back to also training. That's one of my roles. We have to train the team. So what if the patient says I can't afford it or it doesn't bother me? We have to we have to train them to have the right answer. Not a scripted answer has to be an authentic answer. So let's say the patient says, you know, it's just it's just a lot of money. And I might say, you know, Art, you're right. It's significant. Think about if we had done this five years ago. When we actually first talked about it, what it would have cost you then and what it will cost you five years from now. So if money is money is the issue, you will never cost you less than today.

Art Wiederman, CPA: So it's all about how you phrase it. I mean, they teach people in all kinds of sales industries and sales jobs how to do this. This is Decisions in Dentistry. Okay. Number six is enthusiasm. Now, you're one of the most enthusiastic human beings I've ever met. So why do we need enthusiasm?

Debra Engelhardt-Nash: Well, because it's because enthusiasm is infectious. It also demonstrates to the patient that, once again, that that you believe what you're saying. And if I come to the patient, you know, if I'm enthusiastic about what we could offer, if I'm enthusiastic about our new technologies. If I am, you know, if I come in with with the with cheerfulness and happiness and enthusiasm, your patient's going to come in that if I come in and say, Oh, Mrs. Venables, it's so nice to see you. And sometimes, sometimes the patients come in and they may be like a Debbie Downer. I'll use that. Well, then my responsibility is to say, What can I do to make you make you have a better day? What can I do to. To. To improve your day to day? That's my responsibility. You should be glad that you're here. So we have to be glad that we're. That we're. That we're coming. I mean, people say I'd rather be on the beach. Well, yeah, being on the beach would be really nice, but. But you're not on the beach, so you're at work. So how do we make the best out of the day? I'm convinced that I can decide whether or not it can be a great day or a bad day. And I'll be right either way.

Art Wiederman, CPA: Yes. And you can make it. You can make it whatever you want. And you're going to be dealing with the public. There are all different types of people, different personalities. You can't fix people's lives. Yes, but remember, again, doctors again, this is Art Wiederman, the broken record you did. You are not here to fix teeth. You are here to be a better life, a better relationship, a better self-esteem, a better job, and a better everything. And that's what you do. And if that's what you resonate in your office, then people are probably, Deborah, more likely to buy from you, right?

Debra Engelhardt-Nash: Well, here's the reality. And I hate to I hate to burst anybody's bubble. I do not choose your treatment plan based on your clinical aptitude or your clinical abilities. I do not say, Gee, Doctor, can you show me samples of your tertiary anatomy? Right, Right. I mean.

Art Wiederman, CPA: I. Let's see your study models. I will not accept your treatment until I see at least five study models.

Debra Engelhardt-Nash: Yeah, and I'd like to see your ad. I'd like to see the radiographs, please. I choose I typically will choose based on the relationship that we develop with one another. I buy from people I like. Let me say that again. I buy from people I like.

Art Wiederman, CPA: Okay, Deborah, in your course. Not that I didn't take more away from your two hour course, but the one thing that I take away and I actually I have not gotten written permission from you to use this. I just use it. But you came up with this statistic. Well, you you and I, you and I are way beyond that. But okay, you said and I don't remember, it was something like 77% of the people that leave dental offices leave because they they don't like the doctor and they don't like the team.

Debra Engelhardt-Nash: Actually, you're really. That was really, really good retention. And actually it's 70, 72%.

Art Wiederman, CPA: 72%. Okay. It's like my golf game or the talk quoted approximately, you know.

Debra Engelhardt-Nash: 70% of leave a practice, not because they don't like them, because they feel an attitude of indifference. Yeah. Feel like they don't matter anymore. They feel like they're just a recall. It's just Deborah it, you know, or it's just it's just a patient. They don't feel like they matter enough. 72% of patients don't move forward with treatment because they don't feel like they matter enough as a person.

Art Wiederman, CPA: I mean, you also in this course and I've heard heard this before, but but it really hit home is when the when the the person comes out into the the reception area. Okay. And goes and says now, now Deborah. Oh hello Deborah. Where your room is your room that we've set up specially for you is ready and we are so happy. How are you? How's your husband, How's Johnny and Susie and, and all the other kids? I mean, as opposed to when you walk into some health care offices, someone opens the door and yells.

Debra Engelhardt-Nash: Nash Yes.

Art Wiederman, CPA: Deborah Nash And then they turn around and they walk away from you like you're supposed to know where to go.

Debra Engelhardt-Nash: Yeah, exactly. That happens sometimes. Sometime I go to a very large optometry ophthalmology group and they do that. They stand at the door, they they call my name and the reception room is huge. And if I didn't, I love the doctor, but and I and then they become a little bit more personal. But man, I can start that. I can start making that patient feel special when I actually go to them and say. Mr. Lederman, Hi, my name is Deborah. I'll be working with Dr. Nash today. In your treatment. We have everything ready for you. Really been excited to meet you. So that whole as opposed to Are you ready or we're ready for you. So. Or how do we change that goes back to that environment? How do we create that environment of of welcoming of what we have to remember? First of all, we say open wide every day to 20 to 30 patients a day or maybe even more. But to that patient, they're an individual. I mean, so when we take a look at no matter how many patients we see the day we get it, stop and say this is this patient's experience now. And I can't look at them as just another patient. They've got all kinds of phobias and they have questions. And I have to make them feel like they're the only person who matters right in this this next 90 minutes.

Art Wiederman, CPA: And if you want your patients to refer their friends, you must create that kind of an experience that you care. Absolutely.

Debra Engelhardt-Nash: If we want to take it next, if we want to, in today's world where we know Google is king now, Google reviews are huge, right? 85% are almost probably 90% in our patients, even though they may have been referred to the practice. They want to read those reviews. So part of you or you said, oh, my gosh, this is some of my questions should be to the patient. Tell me about your experience today. And you say, Oh my gosh, it was amazing. You guys are incredible. So you what? I hope you're going to be getting sent. We sent a request to to review us. It's really important to us and it would mean a lot to me personally. And I know it'd mean a lot to Doctor Nash if you would make a comment about how you were treated today and how and how well you were. You felt served. We had an idea. Hi. Just tell me just this morning that a new patient came to them because she did not like the way the hijras treated her. She said she felt scolded. She felt ashamed. She felt embarrassed. She's. I like that. She said I like the doctor just fine. And she says, But I did not like the way the hijras treated me. And I'm not going back.

Art Wiederman, CPA: Okay, one more thing before we move on to sincerity and presence. The last we got to six out of eight. Would you like that? That's really good. Okay, tell the story real quick about the patient that called at 4:00 and said I needed 20 crowns and I tell that story, please.

Debra Engelhardt-Nash: All right. So, yeah, a patient call, I think her appointment was at 3:00 in the afternoon and she said she would like to have a new smile in time for her. Her daughter's graduation. This is 3:00. That's 21 years.

Art Wiederman, CPA: And this is in Ross. This is in Ross's office.

Debra Engelhardt-Nash: Right here In Ross's office, right? Yeah. And that's when you all the practice teller wasn't there yet. So it's 3:00 and she wants 20 veneers and she like them in time for her daughter's high school graduation, which is in three weeks. So that means if we have to turn this case around in three weeks, we're going to have to get started. When?

Art Wiederman, CPA: Now.

Debra Engelhardt-Nash: Now we should have gotten started. So we turn to the team and we said, you know, what do you want to do? And they said, we will stay. And it's a 42,042, $44,000 case.

Art Wiederman, CPA: Well, and they stayed you said to like 11:00 at night or something.

Debra Engelhardt-Nash: Was 1030. Board me and and they knew that the patient was really fatigued. So they asked the patient's permission and they said, One of us will drive your car home for you, you and then the and we'll have another assistant follow so you don't have to drive home tonight. Wow. A long time. So they drove her home. Now, how many patients for cosmetic and esthetic dentistry do you think this patient is referred? I want to say eight. I think they're about eight. Eight of her friends that they said, oh, my gosh, we love her teeth. We love her smile. And a story.

Art Wiederman, CPA: It's Ritz-Carlton service. I Deborah, sincerity.

Debra Engelhardt-Nash: Well, we've been talking a lot about this in terms of you have to you have to be you have to authentically feel that what you're saying is true. So I'm not a big fan. I mean, I believe that there are certain things you can say, but but if it's done because you were told to say it and not because you believe it, that's that sincere and your patients are going to they're going to know. So but you can you can also there's things you can avoid to really demonstrate sincerity. So when you say that's our policy, that is not sincere, policy is not a sincere word.

Art Wiederman, CPA: Nope.

Debra Engelhardt-Nash: It's it's a rules and regulations. So when we want to demonstrate our sincerity, we don't say things like these are the rules of our of our practice. I was just looking at some forms that a software company has, and I said, What is this? Page seven? What is all this? What are all these rules and regulations? And and I said, we've got to eliminate that. I mean, that is not the way you ought to start a relationship with a patient. You want to really, sincerely care about them, which also you which goes into one of the other rules and that's give them the time that they deserve for the investment you're asking them to make.

Art Wiederman, CPA: Exactly. Exactly. Is that okay? So the last rule we made it to the last rule, Debra. Last rule numero number eight is presence. What does that mean.

Debra Engelhardt-Nash: That I mean, I if I when I'm with that patient, I have to give them the time. In fact, one of the things that I that I always say, speaking of time, when patients are asking about fees and I always I always will, people say, well, you know, boy, that's a lot of money. And I'll say, I'd be happy to tell you how we determine our fees. Our fees are based on three things the skill and the skill required to do it right, the time it takes to do it well, and the materials that we use, the laboratories that we with whom we partner, so that we know that your restorations will endure and that you'll be satisfied. So that also means we're going to take the appropriate amount of time. And that also means we're going to take focused time with the patient and sincere, which means we're going to be sincere. We're not going to be jumping, especially with big cases. We can't be jumping up and down. So we have to schedule appropriately. And I would say we have to schedule sincerely. We have to schedule that this is an important part of this patient's life and we have to sincerely give them the time that they deserve. And I also think the the and I'm going to steal this for my nephews, steal it because I'm married to the man. Ross always what he's talking to to to doctors and especially young doctors about dentistry and he has he has said this for years. He said never diagnosed to pay a bill.

Art Wiederman, CPA: Right? Yeah.

Debra Engelhardt-Nash: Well, it will hurt you in the end. You will you will regret that you took on the case. The patient will not be happy and it's going to be nothing but a nightmare. So never diagnosed to pay a bill. Diagnosed? Because you want to do this. You want to you want to you want to take care of this so you're not so. So that would be also sincere treatment planning. I know I can do this. I know I can do this well, and I'm not going to you know, one of the things that we always say to the patient, this is strictly elective. You don't have to do anything. Because the minute you say to the patient, you know, this is totally elective, you don't have to do anything. However. There's a lot of solutions here and there are a lot of options. Would you allow me to tell you what we could do?

Art Wiederman, CPA: Always asking for permission.

Debra Engelhardt-Nash: One of the options are to do nothing, and you could see the patient relapse. But you say, you know what? You don't have to do anything. And the patient's receptivity, their receptors kind of open up and say, Wait a minute. Well, you're not going to try and sell me. You're not going to try and convince me. You don't have to do anything. However, if you don't do something about this, this is what can occur.

Art Wiederman, CPA: Right. Or gaining their trust. I mean.

Debra Engelhardt-Nash: Yes. So here's what we can do. And the of course, the what are the questions we have to always ask the patient is now what questions can I answer for you? Tell me how you're feeling about. That's a sincere question as well. Tell me how you're feeling about your visit with us today.

Art Wiederman, CPA: Yeah. Yeah. Well, let me look. Well, you know what? You are a treasure. I adore you. You're wonderful. I wish you were closer. You're 3000 miles away. But I will see you. I will see you the first week of May in Scottsdale. Art Academy of Dental, CPA Meeting I. You are going to present. I'm going to heckle you, by the way, just so you know. When are you.

Debra Engelhardt-Nash: So you. You and you didn't mention this that you are now.

Art Wiederman, CPA: Oh, am. Yes, I am now a member of the speaking and consulting network folks. And my friend Deborah will slap me for not saying this. I am so excited to be part of this organization. Deborah talked me into it and I'm excited. So if you are looking for a speaker, if you're looking for someone to speak about dental management, if you're a meeting planner or you have a study club, there is no better speaker that I know of than Ms.. Nash or Mrs. Nash or Madam President or whatever your name is. Okay?

Debra Engelhardt-Nash: It is metrics and you're looking at transition.

Art Wiederman, CPA: Yeah, yeah, yeah. So my and my subject, my subjects, if you need a lecture, folks, is financial planning, taxes, accounting transitions, buying a practice, selling a practice, going into partnerships and metrics other of a dental practice. So I can speak and all that. If you need someone. Deborah, you are giving your case presentation course some time here in the future. I think I'm guessing.

Debra Engelhardt-Nash: A couple times I'm giving it for Bulletproof Dentist in Las Vegas. I'm yeah, in Fort Bend, Indiana. Nice. April. That's really fast. I'm doing it in Fort Lauderdale in May. Yeah. So?

Art Wiederman, CPA: So go on to Deborah. You have your own website, right? Thank you, Deborah. Just googled Deborah, Deborah Englehart, Nash and go go listen to her because her stuff is golden. It's stuff that you can take back. Thank you for coming out. This is just so much fun for me. I can't even L'ue We just have fun. I can't wait to see you. I will see you twice. At least this year. I'll see you in in May, in Scottsdale. I'll see you in Nashville. I've never been to Nashville. You don't want to see me dance, so I don't know if. We'll see. We'll talk about it.

Debra Engelhardt-Nash: Nashville is a very, very fun time. It is absolutely a very robust meeting. I have to say one other thing. I think that, you know, one of my pieces of advice, if you say, Deborah, what would you want to leave them with? First of all, always ask permission before you present your treatment, get their permission to do it. But I think the other the other piece is I go into some middle offices and I watch opportunities get missed. I watch so many opportunities go by. And it's also it's because they're not being they're not intentionally looking. They're they have they're creating their own. They're putting their own blinders on. They're creating biases. So I think that it's important to, you know, go in with an unbiased eye, with a caring, sincere eye that there is no bias. If the patient two years ago, five years ago, ten years ago, said they didn't want to do it and they can't afford it, doesn't mean that they're not ready now. So never assume the patient. So that would be the other thing. Never assume the patient doesn't want it. And that happens so many times. We sometimes defeat ourselves because we assume the patient isn't interested. They can't afford it, they don't want it. And we approach the whole treatment presentation and the whole consultation with that bias. And that goes back to what does that do? It kills our enthusiasm.

Art Wiederman, CPA: If you invest time and money in yourself and your team in learning how to communicate with your patients, your practice will grow. Your case acceptance percentage will go up. You will be happier. You will have happier, healthier patients, healthier patients, doctors. I can't emphasize this enough, Deborah, hang with me as I take the podcast out. Thank you so much. I seriously you are you are golden. So folks, do not forget to go to our dear, dear partners. Decisions in Dentistry magazine w WW dot Decisions in Dentistry dot com. They have 140 continuing education courses at an incredible price. Very. Very reasonable price for their courses. Go to their website the best clinical content on the planet. There is no better w w w that Decisions in Dentistry become my mothership, which I helped form 22 years ago, is the Academy of Dental CPAs. W WW dot ADP dot org. 25 wonderful CPA firms of which Eide Bailly is one of them that represents over 10,000 dentists w w that 80 cpa org. If you are looking for a dental CPA, we do that work at Eide Bailly. That is what we do. We work with over a thousand dentists in our offices, about 300 plus in our office in Southern California. My partners, Don and Pam are fantastic, wonderful people. In order to be a partner in our office, you have to have a three letter name. It's either Art, Pam or Don. And then Sam is our tax manager, so he has three letters. It's just required, I guess. But anyway, my phone number is 6572793243. Or send me an email at Awiedermann@EideBailly.com. Come see me at Booth 1472 at the California Dental Convention. Third week in May. Make sure you if you're in Northern California and you are an up and coming dentist and you want to figure out what do you want to be when you grow up. Go to the dot org and register for our courses June 10th in the San Francisco Bay Area and June 22nd in Sacramento. And with that, I I'm exhausted again. I'm exhausted. But it is so much fun to talk to you, Miss Deborah. Mrs. Deborah Englehardt Nash, the incoming President, Academy of Private Dental Practice. And with that, everyone, I will say thank you for the honor and privilege of your time. This is Art Wiederman for the Art of Dental Finance and management with Art Wiederman, CPA. And we will see you next time. Bye bye.