Rachel Wall RDH, BS, joins us to discuss key insights on growth and profitability in your hygiene department. See more of Rachel at the Practice Growth Summit 2024 with All-Star Dental Academy®!
About Rachel Wall
Rachel Wall is the founder of Inspired Hygiene, where she and her team provide coaching, workshops, and other products to help dentists in their pursuit of hygiene department profits. Rachel also serves the dental community as a consultant and speaker. In addition to private coaching Rachel draws from her 20-plus years of experience as a hygienist and practice administrator to deliver focused clinical articles and speaking programs. Rachel has written for, and been featured in, numerous industry journals including Dentistry Today, Progressive Dentist, RDH, and Hygienetown. She recently received the 2012 Dental Excellence Award from DrBicuspid.com for “Most Effective Dental Hygienist Educator”.
About Alex Nottingham JD MBA
Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.
Transcript performed by A.I. Please excuse the typos.
This is Dental All-Stars, where we bring you the best in dentistry on marketing, management, and training. Here’s your host, Alex Nottingham. Welcome to Dental All-Stars. I’m Alex Nottingham, founder and CEO of All-Star Dental Academy. With me is Rachel Wall, founder and CEO of Inspired Hygiene. This interview is part of a collection of interviews focusing on business and personal growth. Our topic is going to be, is profitable hygiene still possible?
Now, in terms of practice growth, when it comes to practice growth, we have an entire event dedicated to personal and business growth for you and your team. And that’s the All-Star Practice Growth Summit this upcoming May 17th and 18th in South Florida. And you can learn more about the event at alls Please welcome Rachel Wall. Thank you, Alex. I’m happy to be here. Happy to have you back. Yeah, always. All right. So.
Practice growth. How would you define growth from an hygienist, former hygienist, and a hygienist consultant, the best in the industry, best in the world, Rachel Wallen-inspired hygiene. That’s why we’re having you at the event. We’re so excited. So how would you define growth in general? And you can break that down any way you want, and why is it important? So you said it in the intro, really, my…
vision of growth in general is both personal and professional, you know, in the context of the dental practice. And it doesn’t always, growth doesn’t always have to mean, you know, more patients, more volume, you know, more days, more hours. It can be, how am I growing in my communication skills? How am I growing in my relationship, the doctor or dental hygiene relationship?
so that we can support each other and collaborate for the patient’s best interest. How am I growing in the services that I’m able to offer my patients in the hygiene department? So there’s a lot of areas that, you know, I’ll use this term, I’ll steal this term from the DSO world because this is a really hot topic right now, same store growth, right? You and I have been preaching same store growth for, you know, as long as we’ve been doing this, which means each location.
right, figuring out how to maximize what they already have and how to serve their patients even better within that location. So Alex, I mean, that’s what it means. I think growth can mean so many different things and the key is just defining it and then taking action on it. Excellent, excellent. And so there was a popular interview. This was something we did way, way back in the beginning of All-Star.
You were with us from the beginning. And I love the seminar you gave about return on hygiene. Because when you start getting into the details of hygiene, I’m like, I don’t know what she’s talking about. But it sounds like she knows what she’s talking about. But I love when you get to the numbers, when you get to the people skills, and all that, as you break it down, which is actually the hard part for a lot of people, as we were talking about in the green room. So is, in today’s society,
and with insurance companies still exerting a force with big competition, corporate dentistry and DSOs. And that’s who we’re speaking to typically on these calls. We do work with some DSOs, but the vast majority, at least for All-Star, are single practitioners or multi-location practitioners that just want to be able to compete. And like we said, we like people that do it well
don’t circumvent the client, the patient, and getting good care. As long as you’re doing that, it’s great for everybody. We want the private practitioner to be able to compete. And that’s why we’re doing the event and bringing the best of the best out there for you to be exposed to it. So with that said, can hygiene still be profitable? Yeah, it absolutely can still be profitable. We’re seeing it every day. And we’re actually even seeing it with clients that are heavily participating.
in PPO plans. I mean, it’s definitely, I would say, take some different skill sets in that environment, but it’s still possible there, absolutely. We’re going to talk about that when I’m there at the Growth Summit in May, and really excited to dig into that with everybody and share what we are seeing across the country that practices are being successful with and how they are creating that profitability in the environment that we’re in now. And we were talking about this concept of
you have to fix hygiene. What does this mean? I’m sure you don’t like the term, but what does that mean and do you have to fix hygiene? Or what is the fix? Well, so the hygiene department is really a business within the business, right? If we think about, you know, privately owned one or small multi-location group, you know, we think about the hygiene department and the ability of hygiene. If we just look at it from a business standpoint,
The ability of the hygiene department to contribute to practice growth, contribute to the relationships with patients and the reputation and the community of the practice. You know, a lot of times, and particularly over the last few years where hygienists have been difficult to come by, right, as far as hiring and retaining and that kind of thing, a lot of times doctors and practice owners are walking on eggshells because they don’t want to lose their hygienist.
But then they call us and say, look, this isn’t working. And we need to fix hygiene. And what we notice a lot of times is, yes, sometimes there are outdated standards or there are outdated techniques, or maybe the practice just hasn’t had the opportunity to invest in education for the hygiene department at this point.
And maybe the hygienist, here’s a little nugget, sometimes the hygienist are just as frustrated about how things are going as a practice owner is, but they don’t know if it’s fixable. They don’t know how to communicate what’s happening and what they’re frustrated about. They think it’s just the way the practice is gonna be, because they don’t always have, or they don’t perceive that they have the power to change things. But what we see and what we know in our 20 years of experience doing this at Inspired Hygiene is,
It’s not always all on the hygienist shoulders. Yes, hygienists, it’s important to have an open mind and know that we are responsible to continually learn and grow and provide our patients with the current modern outstanding level of care. But there’s so many other things in the practice that contribute to the success of the hygiene department. I mean, Alex, you know, number one, phone skills. If the team…
is not able to convert those new patient calls into patients in the chair, then that’s gonna affect, you know, the capacity of the hygiene department. On the other hand, just, you know, I’m gonna say counter even to that is, maybe they are converting, but there’s no room on the hygiene schedule to get those new patients in. So think about all of the things that affect the hygiene department’s ability to be successful, to thrive, to grow is things like clinical leadership from the doctor.
phone skills, marketing, participation in insurance, right? If we talk about is hygiene able to be profitable, you know, it takes a different skill set and we have to look at the numbers a little bit differently in a highly end network practice and really come up with what is reasonable, what can we do, how can we get creative, the scheduling systems, scheduling models, all of those things really affect the success of the hygiene department. And it’s important to have a holistic approach
really see the hygiene department grow and thrive. You know what occurs to me as we were talking about earlier is we’re kind of getting through cold and flu season and you and I both are still like recovering from that stuff. But what was most important to our success with beating any virus is having health. We take care of ourselves, okay? You can throw a bunch of medicine at it, that’s fine. And that may help or may not, but if you’re not fundamentally healthy, it’s not gonna work.
And I think that often, and these are some questions later about mindset shifts, but we’ll get to that. But with dentists or with practice owners, we’re looking to commoditize certain things. Hygiene’s broken. How do I fix it? This is off. How do I fix it? It’s a commodity. And of course, what’s so funny, we don’t want to be commoditized, but yet we commoditize people in our practice, but yet a patient calls, they want to commoditize. We don’t like that.
But we have to always go back to, and you look at the best in the business, and this goes back to this philosophy of practice growth and why we do the summit every year for you, but we also do it for ourselves because we’re around the best, and we get reminded of those fundamentals across the board. Like we’re talking here with the top hygienist coaching company in the world, and we’re saying the same things that the others are talking about, which is you gotta get the fundamentals right. And if your team, if you don’t have a proper vision as business owner,
if you do not have the right team, you’re not pouring into them. Because often when there’s a problem, your best people, you put the burden on them. And you’re saying from the hygiene department, they’re kind of like, well, we don’t even know what this is fixable, you’re putting this on us. So is there this continuity? And you can’t just, you fix one thing, then something else bursts somewhere else. So you have to take a step back and say, as an entire company, am I doing it right? And that’s why.
We are at All-Star, I did a whole series called The Five Steps to an All-Star Practice, right? And so quick review, your vision, very simply what do you want, the right team in place, that’s also we talk about our hiring service and I wanna talk about the issue with hygiene a little bit later. You wanna be training consistently, like you’re brushing and flossing, be doing coaching. Some of our best clients do inspired hygiene coaching and general practice coaching.
And then the last step is events. You wanna be able to pour into people. You wanna create a culture that is not just a job. It’s something like, wow, and this goes to this point is that how do we keep the best people, right? I’ll tell you, one of the keys to financial longevity don’t have too many successful marriages. And the same thing with only one.
And the same thing with your team is the more turnover, that’s going to make you more and more inefficient. So you got to make sure your fundamentals are strong as you were talking about with respect to phone skills, marketing, and so on. So Rachel, tell me what are some surprises that you’re seeing when you talk to practice owners regarding the hygiene department? I, you know, this is 2024. I’m still surprised how many dental owners, dentists, typically.
that I speak to and practices that we look into that still have the basics of quality of care are not being met. So for example, things like medical histories are not updated. It’s not unusual for us to audit a hygiene department. We do that every week and we do it.
I’ll say this as a sidebar. You know, audit sounds like a really scary word, right? So assess, audit, evaluate. But we look just as much as we look for areas of improvement, we look for things that the team’s doing well, right? That is a foundation that can be built upon. So it is a critical eye, but it’s a critical eye in order to bring the best to the team and to the patients. But I am always surprised.
when we look inside a practice and we see basic things like that, like, you know, it’s been two years since these patients have had an updated medical history. We’ve seen new patients, and these are not, these are not, I mean, the practices that seek out coaching from All-Star Dental Academy-inspired hygiene are in the top 10 to 20% of dental practices, okay? So let’s just put that as a marker right there.
And even in those practices, we see things like new patients that never had a, there’s no medical history in their chart. And oftentimes the leaders don’t know that that’s happening and it’s not intentional. It’s because there’s a breakdown in a system. It’s not a broken person, it’s a breakdown in a system. And a lot of times they don’t know that that’s happening until you have an outside view to audit and really look at that.
Sometimes we say, hey, congratulations, 100% of your patients had an up-to-date medical history. That’s a really strong thing that you have going for you, and keep building on that. And let’s congratulate the team on that. X-rays that are not of diagnostic quality, that are putting practices at risk for paybacks to insurance companies and things like that, and really just basic systems for the…
primary role of the hygiene department, which is really to champion and protect the oral health of our community and our patients. And the good news is that those practices are asking for help, and they’re open to that help. But there’s still a lot of work to do, as we know. And I think a lot of it, again, is not because of intentional neglect or anything like that.
There are so many things you and I know that need to be done in a business. And then by the way, very often, the owner of that business is working a day-to-day schedule that allows them no time to work on all those things that need to be worked on in the business. So that’s where it’s helpful to have a really supportive team and then to, you know, draw on the experience of experts that can bring in outside, you know, support and systems that can really help practices get to be a, you know,
a well-oiled machine. I think of our president of coaching, Eric, will often say, the ones that need it, often don’t do it. Cause you were kind of alluding to it. The top 10% are doing coaching with us. And that’s typically true. You get a few outliers that are just like, I’m in deep trouble, please help me. And those are always very dangerous clients because they’re like, fix me. And I’m not willing to do.
the work and those are what we have to be very careful to see if those are the right people to work with. Yes. Because I really believe and I think so you do as well because just by the numbers of the results that both of our departments produce that when you’re able to find a dental practice that is really in, they want, they’re willing to do the work, they’re coachable. Unless there’s something, I mean there’s always things that happen outside externally, but
as long as they stay out of their own way, they will be very successful. They will make a lot of money, return on hygiene and return on coaching with respect to that. Yeah, I’ll say this too, because it’s also interesting.
how often we hear from practice owners and sometimes from practice administrators too, you know, my hygiene department’s not open to this. And so then they don’t move forward. And here’s what I know is when a clinical leader makes a decision that they’re going to stand up for what is right for the patients and what is right for the practice and also the providers because everything that we recommend
has to be a win for the patients, the providers, and the practice, right? So if midnight appointments are great for patients and they’re great for the practice, but you’re burning your team out because they don’t wanna work till midnight, then that’s not a win. I mean, I know that’s an extreme example, but when a clinical leader will stand up for what they believe to be true and what their responsibility is as a healthcare provider,
and they can present the opportunity in a positive manner to their team.
when they’re able to present the opportunity of advanced education, support, coaching, and outside, you know, eye and outside voice, then it is amazing how often team members that are resistant will turn around. Because a lot of times they’re resistant because they just don’t, it’s just fear and it’s something that’s different from what they’re doing every day. But if they have a champion in that clinical leader, and if they have that in their practice administrator as well,
And they’re leading forward and saying, look, guys, this is, to your point, this is part of our vision. We say we want to be this elevated health care provider, and this is a gap in our ability to do that. We have to close this gap. We’ve got to get the education, the verbal skills, the systems to be able to be, to walk our talk. And I want you to come with me. And this isn’t about anybody doing anything wrong. It’s about how do we elevate? Then man, magic can happen.
So I like what you talked about when you brought it back to the vision, you were mentioning it. And it sounds so simple. And I’m not talking about how to craft a vision statement or mission statement. No. It’s really being so maniacal about what you stand for. Okay? And that’s pervasive amongst the entire team, clinical leaders, the doctor, the owner. It’s so basic, but it’s so important. If that’s not clear.
And here’s where it becomes clear. We can all talk about it, but when you find something that doesn’t fit what you’re doing, and you start to capitulate, for example, my team is not open to new verbiage. My team does not want coaching, positive or critical or improvement feedback. They know it all, remember that? We know that, or that’s basic, okay? And it should be basic, but then when we start to role play, you fall apart.
It looks easy. And that’s insidious. That’s a big problem with the culture of the practice. And what I love about when we’ve had our talks and we’ve been doing this even throughout the issue with, we’ll talk about with turnover and with the need for hygienists, is you don’t buy that in terms of, you’re like, look, don’t feel…
threatened by your hygienist. That is going to be a problem. And there’s some great ones out there that aren’t going to, that are not just like, oh, give me the best and I’m going to amount money. That’s all I care about. Because now part of it, so let’s shift that for a moment since I’m talking about it. So one of the issue is this idea of, again, we have a hiring service. We hire hygienists.
the problem, that’s one of the toughest positions right now to hire. We have many may know or may not know. And with that, we have to be able to, and I think it’s a good thing because we can use the hygienist as the example that everybody in our team, okay, because to have a profitable hygienist department, to make sure it’s still profitable, you have to keep your providers because they got to be good at what they do. They got to be coachable.
and they have a great rapport with patients. If you start losing them because you’re not adhering to your vision, either the hygienist is toxic or you’re toxic most of the time and you’re not giving them any leadership or you’re not pouring into them, they will leave. And they know that not just, I can get more money somewhere else, but I’m gonna go somewhere where they appreciate me, where they pour into me, where they gave me CE, where they take me to events because wherever, for all you listening, if Rachel is speaking,
you better find a way to get there. And we have her at the event, the Practice Go Summit. She’s gonna be there. She’s doing a breakout session. You better be sending your clinical team and yourself to see her with respect to that. That’s a level of, am I gonna invest in my team? And we don’t just single out the hygienist. The entire team is part of a team and we invest in everybody, okay? And that’s why you don’t buy making
the hygienist prima donnas, they’re like anybody else, but if you have a good, solid, healthy foundation, like an immune system, your practice is gonna do well. So, care to comment on that issue? I think it just goes back to clinical leadership, you know, and practice culture leadership. So, yeah, I think that right now, some dentists are leading with fear because they’re afraid if they…
bring something that might challenge the status quo for their hygienist that their hygienists are gonna leave. But honestly, the real fear is the risk that you’re putting on yourself and your practice because your patients aren’t getting the care that is needed and is honestly like a basic standard of care. So I get it, it’s hard. I mean, we, you know, we…
sometimes have a hard time hiring for an hour business too and finding the right fit. But there are ways around that. There are ways to, you know, ultimately get that amazing hygiene department. But it, and there are other dentists that say, you know what, if they leave because we want to give our patients better care then they’re not the right fit for the practice. That’s awesome. And we can position this in a very positive light. We give our potential clients.
communication tools to communicate with their hygienists about this. So it’s a very positive, empowering experience that will help them grow professionally. It is not threatening. It is not finger pointing. But if the dentist can get to the point where they can stand up for what they stand for and say, this is who we are, and I’m not willing to compromise that.
and I’m willing to give you the tools and I’m willing to invest and pour into you and give you the support to To to create a hygiene department that is congruent with our vision And if you’re not open to that then this may not be the place for you One of the criticisms of the newer generation is that it’s not just money. They want to be part of something I believe that they want to make a difference and I don’t
I think that’s a pre-noble thing. It’s a noble thing. It’s not a bad thing. Right. And some of the older guards like, years ago you just show up and you work and you, that’s it. And you don’t do any of that. But it’s challenging us to be better leaders and a more stable practice, a practice that works somewhat without you. I mean, that’s, I know so many, I provide a vision for dentists and I say, I wish for you to have a boring life. You go to work.
You love your patients, you love your team. Everybody is well trained, they have a good time, you make plenty of money, and you have a lot of free time to enjoy yourself. No drama, wouldn’t that be great? And that can be done. And you see the ones that are successful. Tony Robbins always taught me, I used to work with him, one of his top coaches, and he would say model the best. Why recreate it? Model the best. You look at the best businesses, and you think that, oh, they’re lucky, you might think.
But they’re not. You see the leader and how they interact with their team. They’re not afraid to do anything with them. They pour into them. They make those investments. And then in the short term, you go, oh, what are they spending this money at? They’re doing coaching, they’re doing events. But you see later the big return. That turnover, turnover according to Ben Erickson, I’m gonna be interviewing Tim Twigg over at Ben Erickson. And you know what the average cost of turnover is?
for a practice, each person that turns over, according to Ben Erickson and other HR firms? I’m gonna guess $10,000. You are so generous. It’s one to three times the value of an employee. So hygienists making 70 to 100,000. Like their salary? Yes, ma’am. Oh my goodness, wow. And it’s not, and hiring service is cheap. It’s cheap, it’s not hiring them, that’s the problem. But imagine the lost production, the inefficiencies, the mistakes. Lost patients.
the ability for the doctor for a hygienist who sets him or her up, that doesn’t happen. Restored it. So you’re saying, let’s say $100,000 salary, it could be multitudes of that. So you’re saying, I take a team to an event. I’m being coached by an inspired hygiene and an All-Star or whatever that might be. And I’m pouring into my team. You’re saving multitudes on that later. And the best business people always have long-term perspective.
Yeah, and that I think Alex is the is that mindset is the key to, you know, if we circle back to as, as profitable hygiene still possible. Yes, it is. And the successful practices, whether it’s just hygiene, I mean, what for overall practice success, they have learned that they have to release some of those old school mindsets. And some of those old school behaviors, you know, like, well, you just need to come in here. I mean, isn’t, isn’t your
you know, compensation your salary enough, you know, and what else do you need me to do for you? And, you know, require things like requiring hygienist to, you know, give six months notice for to have a day off or have to take a vacation. Like, it’s not realistic anymore. That that’s not going to fly anymore. You know, I had a doctor asked me, this is after losing two out of three hygienists within two weeks. She asked me, she said, you know, I keep hearing about culture and I need to be working in my culture. Is that really something I need to worry about?
And I’m thinking to myself, you’re asking me, because you just caused two of three hygienists. So, and you know, we know it’s not just about money. Because if those hygienists had loved working there, they and had trust with that doctor, they probably could have worked it out. They probably could have negotiated something or come up with some other compensation solution. So, you know, it’s things like that. It’s things like.
I mean, a lot of those practices are releasing some of their in-network contracts. I’m seeing that more and more and more. That they’re saying enough is enough. We’re having a really hard time being profitable, and we’re just not going to play that game anymore. So a lot of those things are mindsets that the modern practice owner is employing that’s helping them be successful.
and is helping them lead a profitable hygiene department. And we will dig into some of those things at the event in May for sure. Well, on that note, tell me about your lecture. What are some areas that we’re gonna learn? Who’s good to participate in your lecture? I mean, it’s gonna be the general session so everybody can come and listen. So tell me about what you’ll be talking about.
Yeah, so it absolutely will be relevant to any role in the dental practice because it takes every role in the dental practice to create a successful hygiene department. We’re going to be talking about some leadership tactics that dentists can utilize to help guide and support a profitable and thriving hygiene department. We’re going to talk about expanding the hygiene service mix and a few products that folks might want to look at adding to their service mix that are very high level.
very high value for patients and relatively simple to incorporate and use as adjuncts to the care that you’re already providing. We’re going to look at some of the industry benchmarks for profitable hygiene departments and some of those that are being challenged and what to do about that. And you know in May, who knows what trends will be happening by May, you know, things change all the time. So we’ll try to address some of the new things and that we’re seeing come down the pipe with
with hygiene and dentistry in general. Yeah, I like what you said there because that goes to the spirit of Practice Growth Summit is it’s every year, what is the newest thing that we have to be aware of? And we’re always innovating because if you’re not innovating, you’re going backwards. That’s right. Also, what’s kind of fun is our president of coaching is gonna break up everybody into, not the entire time, but we’re gonna do, I believe it’s an hour or two breakout sessions for one of the days. We’re gonna have one on assisting, one on treatment acceptance.
We’re going to have one on hygiene, one on practice administrators, one on dent for dentists, and you’re going to be leading the hygiene breakout. So just a little bit idea of like the feel, what is it going to be about? Is it interactive lecture? What’s that going to be like your break? It will not be me lecturing at you, right? I love really sitting on a stool and answering people’s questions and diving into some of the hot topics that we have in that arena. So
It’ll be answering questions. It will be, you know, I’m sure there will be some scenarios that folks bring to us. This happened in my practice. What do I do about this? So it will be answering the attendees’ questions. It will be interactive. We’re just gonna have a good time and really make sure that folks have a safe place to share some of their challenges.
and find some solutions. And so happy, if folks wanna send questions ahead of time, you can send it to All-Star. You can send them to me at rachel at inspiredhygiene.com and we’ll bring those to the table and we’ll just work through some of those. And I know Lynn from All-Star is gonna be joining me as well. I’m really looking forward to that. We’ll have a good time. Oh, she’ll be so happy you mentioned her. Yeah, it’s gonna be nice with these breakouts that you can come prepared and you get to.
interact with the dynamic. It’s not just, that’s the power of the organic nature of practice growth. Last question for you, Rachel. Why should dentists, hygienists, team members across the board, consultants even, why should they come to Practice Growth Summit? Well, I mean, we’ve all seen it, but the practices that attend incredible events like the Growth Summit together get an exponential return on their investment, right? Think about the telephone game.
One person goes and then they’re expected to translate everything to the rest of the team. The rest of the team didn’t get the energy. They didn’t get the experience. They didn’t get asked the questions that are really on their mind. And so that’s what you’ll get when you come to the Practice Growth Summit. The speakers are going to be incredible. I know just from my experience with All-Star that there will be a ton of implementable, you know, strategies and skills that you all will be able to take back to the practice right away. So…
And I mean, hey, it’s in Florida. It’s going to be in a beautiful place. So that never hurts. And it’s a good time to build team relationships and to have some bonding and really invest in the culture in your practice as well. Rachel Wall, inspired hygiene. Thank you so much for being on the program. And I want to invite everybody to go to alls or alls Either one of those links will take you where you can.
get information about the event, sign up for the Practice Growth Summit. Really exciting. And thank you again, Rachel. Remember to follow us on Apple Podcast, Spotify, YouTube, like everything, comment, share with your friends. And until next time, go out there and be an all-star.
We hope you enjoyed this episode of Dental All-Stars. Visit us online at allstardentalacademy.com