In this Dental All-Stars episode, Eric Vickery discusses the importance of tracking case acceptance and how coaching helps dental practices grow.
About Eric Vickery
Eric holds a degree in business administration and brings a strong business and systems approach to his consulting. His initiation into the field of dentistry was in the area of office management. He managed dental practices for over ten years and has been consulting over 250 offices nationwide since 2001.
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, and we are with Eric Vickery, our president of coaching who needs no introduction. Thank you for being on the show, my co-host, Eric. Yes. Hi, Alex. Awesome. So, Eric, I would like to talk with you about, pick your mind. I know you’re the expert on case acceptance.
tracking case acceptance. Because you also have built in the coaching program a wonderful tracker, your KPI tracker that you use with all the clients. And as I was thinking about case acceptance, we talk a lot about it. But it’s also important tracking. Tell me about how important tracking is in case acceptance and just tracking in general. Yeah, there’s so many, I don’t know, cliches about this. What you measure, you improve, those types of things. It’s a lot like call grading, if you think about it.
I don’t know, we have this avoidance to really measure ourselves. We say we wanna be healthier, but we don’t step on the scale. We say we wanna grow and improve in our verbal skills or in our new patient flow, but we don’t listen to the phone call. We say we wanna improve and get patients healthier, but yet we don’t wanna put the time and energy into tracking our case acceptance. And so I think there’s this natural, like in speaking, speak like an all-star. We record.
you know, that three minute speech, we start, you need to watch yourself back. You want to transcribe it. You want to look at your body movement, all of that. And we avoid it. We don’t like to actually measure ourselves, but we love to challenge ourselves. Love to say we want to do it, but we really don’t want to see if we’re failing or push ourselves. Does that make sense? Makes a lot of sense. Yeah. I tried that too, with weight losses. I said, you know what? I’m just going to go by what I feel. I’m not going to step on the scale. And it…
doesn’t work that way. No, no, two tricks, I think on the scale thing, this is just side note. Sure. You have to step on the scale morning and night. Yep. And you have to tell someone your number. You have to do that. That’s what creates accountability, just that communication part, because you know if someone else is helping you along the way, you’re that much more likely to get there. So find someone who’s a support for you doing that. So back to case acceptance. Here’s the analogy I love to use.
Alex, you’re now a dentist, you’re getting ready to hire a treatment coordinator. And all they do is they’re known for, you know, connecting with patients and presenting dentistry and getting things scheduled. And you have two great applicants and one tells you, man, I get a hundred percent case acceptance. And the other says I get 60% case acceptance. Which one are you going to hire? Well, you think the a hundred percent. Yeah. Yeah. Not enough information, right? Right. And that’s, I would.
Honestly though, I would be like 100%, no way. Yeah, or even 90%. Even 90%. Even 90%, no way. And most dentists, when we ask them, we say, all right, so what’s your case acceptance like? Oh, we probably get 80 to 85% case acceptance. And I also hear, oh, well, if they come to me, I always convert them. We just can’t get them to call or get them on the schedule, which is a phone skills problem, yeah. Yes, it’s all connected, right? It’s all connected.
So when we look at our case acceptance tracker, it’s doing a few things that are really important. So let’s look at those two analogies to finish the circle here. The one that’s getting 100% case acceptance is presenting $10,000 in dentistry a month. The one that’s presenting or getting 60% case acceptance is presenting $100,000 a month in dentistry. Now which one do you wanna hire? So both have their pros and cons, I guess, to them.
but what’s in alignment with your vision. So when we look at the tracker, here’s a few things that we track. We track the number of patients you’re presenting to. We track the number that are new patients versus existing patients. Does that number of new patients match what you told us your new patient intake was? We had 20 new patients this month. Why do we only present to 10 of them? That’s important information. Then we track the total dollar amount that you present. So we list everybody out, the tracker.
It computes it for you and it puts it in and tells you, okay, you had these, I don’t know, 40 patients, 50 patients, and you were at $100,000 presented. Well, average case size, $2,000. Sometimes we get in there and the average case size is $800 for a client. We’re going, well, wait a second. You’ve got plenty of patients you’re talking to. The problem isn’t the number of patients. The problem is how unhealthy they are. Or there’s an approval addiction issue where they’re not actually presenting.
everything in their mouth. So we have to do some coaching to figure out what they’re after. Define approval addiction for those who don’t know what that is. A fear of rejection. People that are afraid to tell patients the diagnosis, they fear that rejection, and so they play it really soft. I don’t wanna scare anybody away, I don’t wanna lose anyone, so I’m just gonna tell them the one crown a year club type mentality. And then we track, so total dollar amount divided by number of patients. Then what we’re looking at is
how many dollars do you schedule? And I wanna do a little side note here on dollars. I’ve been talking a lot about dollars and money. We’re just looking at that as a measurement. It’s a value, it’s a metric. It’s not about, oh, money, money, money, money, money, money. It’s just the way we have to value things, to put it in a metric that is calculable. We just figured out that way. So don’t look at it like, oh, we’re just money hungry. Look at it as though this is our measurement technique. So,
Here’s the total dollars of the treatment plan you presented and here’s the total dollar amount they scheduled at the time we presented it to. So if you present a $5,000 case and they present zero, zero percent dollars accepted, 2,500, 50% and so on. The other thing the tracker does is it tracks the number of patients who schedule something and the total dollar amount accepted. So we have two percentages we’re looking at. So back to the original analogy, 100% versus 60%. Well, of what?
Well, in that scenario, it was dollars, but we’re also tracking people. So our minimum that we want is, this is the key part, 80% of the people scheduling something and 60% of the dollars we present being scheduled. Okay. Okay, so we want both of those things happening. With the caveat that you’re not playing it safe, the $10,000 presented one where you have approval addiction and you’re just presenting an average case size of $800.
I typically look for a mature practice that has about 15 new patients a month presenting to all of their hygiene patients as well, about an average case size of 2,500 or more. If you look at that and you go, oh my gosh, they’re playing it so safe. Their average case size is 1,200 or they don’t have enough unhealthy patients, different problem we need to deal with. It’s funny telling a story about a client.
that I’ve worked with for years and years and years, when we first started using that tracker, their average case size was eight or $900. Now their average case size is $3,800. Just from looking at those numbers and going, what are you doing differently? You know, it’s like looking at scale and communicating it with someone. There is a balance in terms of how we relate to numbers. And just off the bat, I know maybe not everybody knows this, but one thing I love about Eric, probably one of the most ethical people that I know.
and he’s so good at getting people to make a lot of money ethically. So that’s always a caveat for those who are, most people know this, who follow us, but we’re all about customer service, transformation, doing things the right way. Why not have both make money and help people? And I think that we have to have a healthy relationship with what we track. And the same thing we can use analogy of the scale. You know, that that’s a result. You can also overdo it. And the same thing with numbers with KPI coaching, for example.
you’re when you’re using a tracker, it’s once a month you’re talking about it. You’re tracking every day. You don’t have to look at it every day, but you can say, okay, here’s what we’re, we’re focusing on serving people, using our systems, using our training. And here’s what the numbers say. And here’s what, again, it’s, it uses us to make a decision. I often talk with our clients about the KPI numbers are there to give us guidance on what next we coach on and do. It isn’t to obsess about it. Isn’t to.
feel bad about it, it’s just information. And then we use it to take action. And then there’s the other area where I know a lot of dentists will obsess about numbers, or they’re using great services out there that can pull numbers from Dentrex and Eagle Soft and give you information. Now, A, we’re not sure how accurate it is, very important. Just because a number spit out doesn’t mean it’s accurate. We have to understand the assumption behind it. That’s why the way we track it, we do it by hand.
by getting the right information and not everything, just the things that we need. But you could also, again, we want to make sure that numbers are accurate, but also it can be overdone. And then really the key to all of it, what do you do with it? What do you do with the information? That’s what’s important. The numbers are secondary. They’re giving us just what we then do about it. The action is primary, right?
If you do it, it’s just giving you a roadmap of where we have to adjust a bit. Otherwise you’re going blind. And I’ll tell you, us humans are very poor at approximating what reality is. Yeah. So I’ve been writing down everything you’re making me think of while you’re talking. So I don’t want to forget anything. So first of all, yeah, if you’re integrity wise, if you’re quote selling something that isn’t needed and you’re overselling, you won’t be in business for very long.
The assumption we’re making is that you have healthy integrity, that you have the right motives. The next thing on case acceptance, we always, I mean, you’re very familiar with this phrase, what got you here will not get you there, right? What got you to this point will not get you to the next place you want to do it. There’s always something to improve. And if you’re not evaluating what you’re currently doing, you won’t get there. Just like the client I mentioned going from an average eight or $900.
case size to over 3500.
When we think about the case acceptance process that we teach and train, when we think about having integrity, here’s something that’s really important. Most dentists are all about getting their clinical skills to that top, top level, that 10. The problem can be that their verbal skills, their relationship management skills, their EQ, can be a five. Well, if you’re a 10 clinically trained, but you’re a five verbally, the patient’s only gonna experience the five. EQ is emotional intelligence.
Yes, emotional intelligence and your relationship management. They’ve got to be following along, Alex. They’ve got to be listening to everything we say to keep up with us. So if you’re a 10 clinically, but you’re a five and you’re on your verbal skills or emotional intelligence, the patient perceives you as a five, all that training did you no good. Now, reverse that. If you’re a one, two, or three clinically, but you’re a 10 verbally, you’re now phony. You need to have both. You’ve got to have both at a 10. That takes…
as much practice of working on your clinical skills as it does working on your verbal skills. So think about how many clinical CEs you’ve gone to, this in the last 12 months, versus how many non-clinical human skills CE you’ve worked on over the last 12 months, and now see how do they relate? How comparable are they? That’s where we want people to recognize there’s work to be done here. Use the tracker to measure it. And lastly, you mentioned it’s gotta create action.
The favorite column I have in the tracker for case acceptance is this one that we present it to them and they don’t schedule anything, they skip all these lines and over here’s the follow-up column and it says why the patient didn’t schedule, what the follow-up list is to it. And then we go over to Dentrix or Open Dental, Egosoft, whatever it is, and we have an appointment and an event, we have a system connected to follow-up, the verbal skills that match, how to do proper follow-ups, our message one, conversation one, things that we say.
to get the patient back on the phone or at least in the schedule somehow. So you’re right, action has to come from the information. Okay, tell me more. What else you have in that list? So I look at it every month. Every month you could go back with your team. You could look at this tracker and go, okay, it’s June or July. We’re looking at August. We have openings in our doctor schedule. Let’s go to our case acceptance tracker.
Let’s go to May, let’s go to April, let’s go to March. Let’s look at our follow-up columns and see who hasn’t scheduled yet and get on the phone with them, send them a text message, whatever system we choose to use in our follow-ups to make sure that we’re reaching out consistently. I gotta tell you a story. So I canceled my chiropractor appointment back on July 11th. It’s July 27th time we record this, okay? And they also have a massage therapist.
in the building, they work together, they refer to each other, and I can text the massage therapist to get my appointment scheduled. I cannot text the chiropractor. I left a message. I said, hey, I need to reschedule this appointment. Like two weeks before my appointment, I said, I had a client there, I had to move it, and never heard back from them. In fact, I got a confirmation text message from them saying, do not respond to this text message. If you need to cancel your appointment.
please call us instead at this number. And I was like, I already left a message saying I needed to reschedule that and they never even called me. So again, I called them, left a message for them. I don’t know why they didn’t answer their phone to cancel the appointment. So then this week I’m getting, I see the massage therapist like, yeah, I need to reschedule them. They still haven’t called me back. She goes, oh, they are so busy, they will not call you back. You have to call them. Now I put myself, all the experiences I have, I always then translate to dentistry. And I think,
I wonder how many patients are out there saying, I canceled my hygiene appointment, but I haven’t heard back from them to reschedule. Because we’re so busy, busyness prevents successfulness, right? We’re so busy. You made that up. What? That’s my own, that’s my own thing. No, it’s an ericism. That’s an ericism. Busyness prevents successfulness. We’re so busy, we don’t even take the time to work on what we’re doing, but we also don’t take the time to follow up with our patients and reach out to them.
where is your system for that follow-up? So in case acceptance, we have a system for that. In hygiene, you have a system for that. So everything is intertwined, it’s all connected when it comes to case acceptance and getting patients healthier. So pay attention, have you, when you look at that list, say patients said they would call us back, but they didn’t, have you reached out to them? Because they’re wondering if it’s really that big a deal or not. Well, they haven’t called me, it must not be that big of a deal. So it makes sense. Yeah, give me a couple action steps for terms of tracking case acceptance.
What’s important to track? What are some numbers you want to look at? Yeah, so we actually can do this a couple of ways. But by provider, by presenter, so if you have multiple providers, you can have hygiene, you can have a tracker for each provider, each hygienist, each doctor. I have a big client. They have like 17 operatories. They only track new patients. That’s all they track, their large case acceptance. Some offices track every single thing. Most doctors have a daily goal of what they want to schedule every month, right?
Well, if you look at, let’s say your monthly goal on the million dollar model for one doctor is 53,000. Okay? Well, if you look at that and you look at your case acceptance tracker and you look, well, we presented $40,000 last month. Are we gonna be able to schedule $53,000 when we’re only presenting 40? So it will tell you something by provider if you wanna do it that way. It will also tell you, okay, out of this hygiene chair, I’m getting this much acceptance. Out of this hygiene chair, I’m getting this much acceptance. Out of my doctor side, I’m getting this much acceptance. It’ll tell you,
Who needs to work on what? So I love that we can divvy that up and help people with it. It’s interesting timing, because we’re doing some focus on tracking at All-Star. And the question that I kind of ask myself and our team is, what do we want to know? Or what are we looking to accomplish? And so that kind of informs what we’re going to track.
And again, you can go crazy. You can have all these numbers, but they’re not giving you what you need to know. So I think that’s also something to be careful of. Let me ask you this before we conclude this episode. One is, I’ll put a link to our events page. We got a lot of great events. And I break the events into the mastery series of events and the summit. So the summit, a lot of fun all about practice growth,
Again, practice growth. Then we have our mastery kind of series. And there’s three levels. Now, that does never change. It’s a system that you run. And tell me about, because a lot of mastery is on case acceptance. Tell me about mastery and how teams that come and dentists that come will get better with case exceptions. You know, your.
gonna be most like the five people you hang out with the most, you’ve heard that before, right? And so who are you rubbing elbows with? Who are you rubbing shoulders with? Who are you around? Who do you wanna be like? Who are you striving to be? Well, you need people in your life that are already doing those things. You wanna emulate them. You wanna see how they’re getting there. Take the things that you like from what they do that work. That’s where Mastery Series comes into play. When you have people who are presenting this, who’ve done it and it’s changed their practice, changed their teams.
And then it’s basically thinking about it like, I love to say you are what you eat. I didn’t make that saying up by the way, Alex. You are what you eat. So be careful what you’re listening to, be careful what you’re watching, be careful who you’re hanging out with, be careful who’s talking to, who’s pouring into you, because that’s what’s gonna pour back out of you. So the Mastery Series is meant to be something that you go and you’re poured into, you’re around like-minded individuals who are striving to create a customer service experience built around your team who operates the same way.
to get the patient as healthy as possible, as quickly as possible. We know when you do those things, the business will be healthier moving forward. And I want to share a story, it does. There’s a story that we had a doctor that came and he was kind of, he got a recommendation to come, heard great things about it, and I got to meet with him. And he was very negative, I’m not gonna say names, very negative about it. He came by himself, he came by himself. He didn’t bring anybody. And he’ll know, he says, I’m not bringing my team, I wanna see what this is about.
I don’t trust you consultants. I don’t trust these events. And he came, left, said it was a good time. And he committed to go take his team. I had pleasure speaking with him about a week ago and the transformation, he’s doing coaching as well. Transformation was unbelievable. From before to after what he has become, I’m like motivated, like so happy to speak with him. And that’s something special that
And I think it’s great content at the event. And like you said, you’re around people that want to be there and improve. And you can’t read about it. You can’t, you have to be around that. So I think that’s amazing. So certainly look at the events. We’ll put the link there too, especially mastery for that structure and the growth summit for growth. So you have, Matt, yeah.
Yeah, no, you’re right. Mastery series, think about it this way. If you’re not hitting the bare minimum levels of what it takes to run your practice, it now becomes, do I invest or do I, because you’re either growing or declining. There is no middle ground. We’ve established this over hundreds of years. So if you’re not growing, you’re not hitting the numbers you want, the way you wanna be, well, then you gotta decide, okay, how am I gonna invest myself? So similar story. We have a client who’s been eyeing the October course in Portland, Maine.
And they’re talking to their team about it. And they’re almost like they’re trying to get their team’s permission to go. And I’m listening, I’m hearing them talk about it. It’s like, yeah, half our team can’t go. We want this to be a team event. I said, listen, if you’re growing your practice based upon the lowest common denominator, who can’t go, who doesn’t wanna go, oh, we don’t have the right team, you’re now holding your best part of your team back. They’re like horses getting ready to run out of race and you’re just keeping that gate closed.
because you don’t have every horse lined up ready to go. You just run with who you got. So I told him, I was like, bring the six people. We’re not gonna be in your location again. Bring the six people you can bring and watch what happens to people who didn’t go. They go, oh my gosh, I want to be around that. One of our dentists who came ended up adding two, well, one left, didn’t come, and he had to hire two more people. So he came in May to Mastery Level One. Now he’s sending two plus one. He’s sending a returner.
So they have someone to go with. To the next event. Yeah, in October. Yeah, in Portland, Maine. So the team will love this so much. They’ll encourage those that didn’t go to make it to the next one. That’s why this is a recurring event, like you said. And I love this, because one question that doctors are like, well, what if I don’t keep the teammate? Why would I put that investment in training? I love this quote from a consultant. Well, actually this is from Steve Jobs said this, and I said it before in the podcast, and I just love it so much.
One day I’ll memorize it, but I’m reading it. What happens if we train people and they leave, but then we say, well, what happens if we don’t train and they stay? Mm-hmm, exactly. So we just gotta be, you know, guys, we’re making this simple for you. We’re seeing, we know what works, and it’s like, if you just use this template and do it over and over again, it’s simple. And you don’t have to evaluate. You’re gonna train if you’re working for me. And I’m making that investment, because we think about case acceptance.
If a person we only have for three months and we spent money to have them trained, but they help with improve case acceptance by their effort, by 10 or 15% versus what they would if they weren’t trained. Those are thousands and thousands of dollars that that paid for that team member to be trained. So you just got to think, think numbers and don’t approximate with it. And lastly, tell me, uh, I’ll put a link as well about coaching. Tell me about coaching.
because a lot of people that come to the events are also doing coaching. It’s not mandatory that they do it, but it’s a great combination. Tell me about coaching and how coaching when it comes to tracking case acceptance helps. Well, back to the original story about stepping on the scale. You know how to have someone to communicate your numbers to you. Most doctors just have a gut feeling. At the end of the month, they’re like, run that report, run that report, and they don’t know how to really put all this together. It’s what created our tracker back in 2001. I got so frustrated.
with my father-in-law, Dr. Bryant, saying, hey, I need to know what we collected last month. Hey, can you run that report again for the month before? How are we doing year to date? And you just needed so many pieces of paper over and over and over again. And they just have this feeling like, okay, the schedule is busy. I feel like things are good. You need to measure, you need to step on the scale. I need to verbalize that number to someone who can then say, oh, I understand what’s happening with each of these numbers. Cancellations, open time, periopercentage, production per patient, production per hour.
a collection rate, new patient flow, source, all of it plays a role. And different numbers mean you gotta turn different dials. It’s like, I don’t see the matrix anymore. I just see, okay, you have a low peri-percentage and you have a high open time rate in hygiene. The two are actually connected. Let’s talk about how to repair that. So when you are actually in coaching, you’re being fed, you are what you eat, you’re being fed over and over and over again. You’re MBA, you’re being fed.
verbal skill training so you can go back with your team and do this. And the bottom line is conversation disappears. You come to an event, you hear it being preached from the front, you hear everybody going, oh my gosh I want to say it just like that. And then you leave the event, you’re inspired and you want to do, you want to take action. And then you’re going, wait, how do you say that? What are we going to do with that system? And you need someone periodically once, twice a month, keeping you in line, helping you refresh, keeping things accountable so that you have that steady growth.
That steady growth. And that’s how it all works so well together. You have your brushing and flossing, I say, which is the online program. You have the events that gives you that shot of B12, that enthusiasm, that movement, that experience, and then coaching kind of reigns it all in, glues it all together, and it becomes like, you’re really hitting it from different angles, and you almost ensure that you’re gonna be successful. Listen, I have not seen anybody who
did all these things and wasn’t an egomaniac, right? And was open to coaching who did not only succeed but thrive. I mean, not only make what I call, we have a self-funding coaching concept that you make that coaching pays for itself. All these things pay for itself within 90 days because you’re doing it, but you have to be coachable. If you’re there and you do these things and you’re open, the momentum
you know, absent some life situation, the momentum is always moving towards what you choose. Make sense? Yeah. The practices that need this the most will never come. Yeah, true. Their mentality of, you know, I don’t know, this is just who we are, oh, the numbers don’t matter, or we just are who we are, they’ll never come. We would double those practices. We would get so many more patients healthy.
You always say that people that need coaching won’t do it. No, it’s those that are, that are interested in growing, that really know there’s a, yeah, we’re not asking you to be perfect, but we are in pursuit of excellence. So if they want to be in that pursuit, they want someone to run the race with, they’re not looking to double or triple or that sort of thing. They’re looking to grow five, 10, 15%. Those are the ones when you look at it, you go, okay, we have ways to help you do that. Right. And, and now more than ever,
team members are moving and rotating and all this sort of stuff, you have to keep your training wheel going. You’re always on training, always on training. So whatever that is for you, podcasts, YouTube videos, online training with All-Star, coming to an event and get fired up. I have a client, they don’t do coaching, but every year or two, I go do a one or two a day event with them and get them fired up and get them back going in the right direction. So- Yeah, it works, but it’s not ideal. I keep having to go back.
I know. I keep going back. Well, and that’s, look, like you said, there are ones that really are struggling, that need to kind of make that leap of faith. We see a lot of business. Yeah, I mean, 5% and 10% for a successful practice is a lot of money, being able to incremental success. And I know one of your clients, you even said to them, you’re like, you’re doing great. You don’t really need, well, you never say you don’t need coaching, but you’re doing great. Tell me what you get out of coaching. We interview them.
I love just knowing that I have all my Ts crossed and I dotted that I’m making sure that I’m being diligent because once I stop, then it goes backwards. We’re always improving and so on. There are a lot of probably like maybe 40% of our clients, I would say, coaching clients, they don’t want to grow more revenue. They want to just optimize what they currently have and stay successful.
efficient with it. It goes back to the stepping on a scale thing. The moment you hit your goal weight. Oh, good point. And you just go, I got it. Hey Alex comes a pizza baby back down to one 93. I’m back down to one 93. Here I go. You know, and then you’re out living your life and you stop skipping on scale and you go back a month later and you step on scale. You go, Whoa, two Oh three. What happened? Yeah, it’s true. So it’s about maintaining a pace that you want to run when you’re with a coach. That’s true. Implementation happens. So, you know, we teach it.
I don’t know, 25 systems consistently to clients. And that’s on recurring, recurring, recurring. Because again, talking about 12 to 24 months, the last time you heard that thing, you’ve got to keep hearing it. You’ve got to have leaders in the practice that are continually talking about it. So that’s why we have clients for, I mean, I’m thinking of one client in particular, 2004 I started working with him. Wow. Very successful practice. I mean, we’re almost on year 20. Wow, we’re off to celebrate that. So he’s in San Jose, California.
He’s a dear friend of mine, of course, by now. And he’s happy to continually work with his team and do these sorts of things. He’s the one that demanded the weekly motivational video. Oh, that we’re adding that. Yeah. That’s being added. So, yep. Well, thank you, Eric, for helping us demystify tracking case acceptance. Thanks for listening. And remember to follow us on Apple Podcasts, Spotify, and YouTube. Get the episodes as they are released. Share with your friends. And until next time, go out there and be an All-Star. An All-Star.
We hope you enjoyed this episode of Dental All-Stars. Visit us online at AllStarDentalAcademy.com.