The Number One Problem for Dental Practices

We all know what it is. It’s no-shows. New patients never showing up, existing patients canceling at the last minute or forgetting their appointments altogether, and it wreaks havoc on our schedules and production.  So famous practice coach Gary Takacs and I are getting together to do a webinar and give practical solutions that will drastically reduce your no-shows.

Gary has been a practice consultant for over 30 years, and also owns a practice in Phoenix, so he has to walk his talk every day, and he knows what gets results. I guarantee you will come away from this webinar with tools and techniques that will take a big bite out of your no-shows!

It’s happening Friday April 21st at 11am PST, 2pm EST.  If you can’t make that time, register anyway and you’ll get a recording of the entire webinar.  Click here to register.

Howard and Fred Go Head-to-Head!

Next Wednesday, February 8th, my old friend Dr. Howard Farran and I will take a deep dive into the raging waters of building a dental team!  You can be sure that it will be a lively discussion, and will give you some practical ideas on creating a team that will make your practice thrive in this ever-changing economy.  It’s a free webinar (retail value $1 million+) so be sure to join in at 11am Pacific, 2pm Eastern, etc. Register here to join the fun!

Also, if you can’t watch at those times, if you register you will be sent a full video recording of the webinar, so don’t miss out, register today!


The Three R’s of Building an Invincible Team

Over the past 35 of my business life, I’ve seen many different approaches to team-building. In our own business we refined the process to a very simple philosophy, which I call the Three R’s, which are Retrain, Repurpose or Replace.

We have over 250 team members at 1-800-DENTIST, and many different skill sets and levels of income, but this approach works throughout the company.  I’ll explain them each in detail.


The first step for us when hiring someone is to make sure that they are a cultural fit for the company.  Once we determine that, and believe that they can do the job, then they are hired. We then monitor them throughout their career, coaching them, evaluating them and giving them feedback.  Sometimes you get an employee that is a terrific cultural fit, but they are missing some key skills, or they have let some bad habits slip into their workday.  That’s where retraining comes in.

A typical example would be an operator in the call center, who is a great employee, liked by everyone, and has been doing a great job for years.  And then suddenly his productivity falls off.  Since we record all their calls, we can listen to see where that team member might have drifted from his training.  This is when you put them through retraining, refreshing their skills and reminding them of the fundamentals of their job.  And usually within a week that team member is right back to her old level of productivity.

The same thing can happen with a salesperson, or a customer service team member. Over time it’s easy to drift from the essential behaviors, skills and verbiage that work best, and eventually it shows up in productivity. The manager’s responsibility is to observe this and put the person through retraining as quickly as possible.

Also, to really grow employees, you and the individual team members need to be willing to look at their gaps in skills, and offer them the opportunity to close those gaps with education. Retraining then means “more training,” to broaden their skill set and make it possible for them to keep up with the changes in the marketplace as well as develop the skills to advance.

In a dental practice, this could mean regular seminars to maintain peak team performance,  reminding your team members of the importance of fundamental skills and introducing them to new ones.  Or it could mean that the practice has added CEREC, and the assistant needs to learn how to do as much as possible with the new technology, and how to talk about it to the patients.


Sometimes you find a team member that is an excellent cultural fit for the business, and is a diligent worker with a positive attitude, but they are just not thriving in the position they were hired for.  No matter how much retraining or coaching you do, they remain a “B” player, so to speak.  What we do then is try to determine if they would fit better somewhere else in the organization.

Why do we do this? Because great people are hard to find. And experience has taught us that most people want to do a great job, but are just better at some activities than others.  We have repurposed employees hundreds of times over 30 years. Let’s say someone on the sales team really believes in the product, but just can’t seem to consistently sell month after month.  We’ll might then try them out in the customer service department, and suddenly they excel at their new job.

We’ve also graduated many people to higher positions.  This is another part of repurposing.  Some team members may be slipping into lower performance because the job is not challenging enough, and they are not working to their full potential. At that point, their manager could realize their capabilities, and promote them, or another manager could “steal” an employee for her department, when he believes the person is a great fit and would excel in the new role.

Now you may be saying, “Fred, this doesn’t work in a dental practice.  You can’t repurpose a hygienist, for example.”  Really?  Maybe she would be a much better treatment coordinator. Or maybe she’s just bored, and if you assigned her the social media responsibility as part of her job she would get jazzed about coming to work every day, and take on an important role.  You can even repurpose the dentist.  Maybe he or she is not great at case presentation, and is never going to be, despite retraining.  Time for that treatment coordinator role again. Do you start to see the possibilities?


It’s expensive to find new employees, and it’s expensive to train those employees until they get up to speed in their position. But sometimes that person has got to go.  Short of some sort of misconduct, this is our last resort.  But we’re not afraid to pull the trigger. If they can’t be retrained and there isn’t a better position in the company for them, or they’ve not succeeded after being repurposed, it’s time for them to work someplace else.

As a side note, the hardest team member to let go is a B player who, no matter how you try, is not getting better and will never become an A player.  Letting go of C players (and F players!) is easy by comparison.  But if you want everyone functioning at an A level, you have to be strong enough to eventually face the fact that this person is never going to give you all that you need.  And also–and this is critical to understand–it is not fair to all the other A players to keep that person around.

And of course, an invincible team is all A players.

For more thoughts on why it’s important to be comfortable letting an employee go, check out my previous blog, “Why Firing Someone is an Act of Kindness.”

I know that employee management is even more challenging in a dental practice, where there is a fairly small number of team members.  This is why I recommend two key resources: Dental and HRforHealth.

HRforHealth is a program that, at its most basic level, does all the things that keep you fully compliant with regard to employee laws in your state.  But beyond that, it systematizes the review process for your employees, so that if you need to retrain or repurpose them, you’ve already made it clear what your expectations are of them in the position and the practice. And if you do need to terminate someone you can do it without being at risk of litigation, because you’ve laid the legal foundation properly.  With HRforHealth, you can easily take advantage of all the human resources tools that large business use, at a very low cost. is a job search site specifically for the dental industry.  It doesn’t cost anything for a potential employee to list him or herself there, and for a reasonable fee the dentist or office manager can search for the best fit for the practice.  I recommend it because practices can be very clear about the type of practice they operate, from culture to philosophy to clinical approach, and this makes for a much better hire. The site also does personality testing, so that you can see what type of individual you’re bringing into your team mix, and where they are most likely to thrive and contribute to your invincible team.

I hope you find the Three R strategy useful as a guiding principle in building your stellar team. We’ve found one of the biggest benefits is it makes your business a great place to work, which means it is a whole lot easier to attract the best people. That’s a big bonus!

[Full disclosure: I’m on the advisory board of both these companies, which I only do when I believe a company is exceptional and I can contribute to their serving the industry better.]

Mentoring Is Its Own Reward

I recently attended the award event for INC Magazine’s 5000 fastest growing companies. As a guest, of course, not as someone with a company on that list. (After 30 years, that kind of accelerated growth is a lot tougher!)

It was an amazing group of entrepreneurs, and the energy at the event was inspiring.  The company that topped the list, Loot Crate, grew at a phenomenal 66,789% over three years.  That number is not a typo, by the way.  And their last year’s revenue was $116 million. Not bad.

Chris Davis, CEO of Loot Crate, and me at the INC 5000 gala.

Chris Davis, CEO of Loot Crate, and me at the INC 5000 gala.

But there were many other businesspeople with amazing growth as well. I knew two of them, and eAssist, both in the dental industry and coincidentally both with female founders.  DentalPost is a sophisticated job site, and eAssist outsources dental billing for practices. In fact, they were both in the top 2000.  And for DentalPost it was their second year in a row.  Impressive.

A very interesting thing happened to me when I was there. I walked up and introduced myself to the CEO and founder of Loot Crate, Chris Davis, and to my surprise he immediately recognized me. Not as the 1-800-DENTIST guy, but because I had mentored him seven years ago as part of a startup class for new entrepreneurs.

I honestly didn’t remember him, but he was effusive in his praise of me as one of his mentors, and explained that after the class he launched his first company and it didn’t take off, so he moved on after two years, but then he started Loot Crate and it succeeded. Spectacularly.

I can’t tell you how gratifying it was to know that he had taken his entrepreneurial drive and  ran with it. Now, I’m not taking any credit for his remarkable success. (Okay, maybe I’m taking a little!)  My point is that I did those mentor sessions and still do because I want to help young businesspeople avoid some of the mistakes I made, and inspire them to chase their dreams, no matter how difficult.

I have a personal rule: I’m never going to discourage anyone from pursuing their idea. I will coach them as to how to do it better, or caution them as to some of the risks they aren’t considering, but I know that plenty of other people will try to discourage them along the way, including friends and family, and I’m not going to be one of those voices.

Back in 1986, several people told me 1-800-DENTIST would never work.  My partner Gary and I used it as motivation. And that’s what I tell young entrepreneurs to do as well.  Proving your detractors wrong can be very satisfying.  And Chris Davis didn’t succeed on his first try.  But he told me that everything he learned with the first business made it possible to turn Loot Crate into a major success.

And that’s my second rule: persistence and determination will get you further than you ever imagined. Chris is living proof. We may not all achieve such stratospheric results, but we can all reach our dreams by showing up every day and giving it our absolute best.

There won’t be any financial reward for me because of my mentoring of Chris.  And I could care  less.  The joy I experienced seeing his marvelous success, knowing that I played some part in it, however tiny, is more than enough for me.

You can read more about Chris’s story and the INC 5000 by clicking here.

The Night I Slept with a Knight

Last week I completed what was definitely the most physically challenging experience of my life.  I signed up for part of the Strive Challenge, a 27-day fund-raising event that is still taking place. It involves a five-day hike, a 1350 mile bike ride, swimming from Italy to Sicily and then a half marathon up Mount Aetna.  I just did the hike segment, which had over 100 participants.

I call it a hike, but it was more like mountaineering, which I did not know ahead of time.  On the longest day we covered 11.4 miles, ascended 5400 feet and descended 5900 feet, and took almost 45,000 steps. Virtually none of it was level and little of it was smooth, and large portions of it were simply climbing over rock slides like the one below.

This is not my idea of a trail!!

This is not my idea of a trail!!

Because I thought it was basically like a normal hike, I foolishly did not train for this.  Oh, and we also were carrying packs weighing 25 pounds.  In other words, this damn near killed me. I was so trashed after the first day I could hardly summon the strength to feed myself!

And we also stayed primarily in “refugios”, which are essentially eating and sleeping lodges for hikers. The first was the most spartan, with no showers, cold water to wash, toilets that were essentially open troughs, meals that were the equivalent of prison food, and rooms with bunk beds.

Though my childhood was fairly simple and spare, I’ve certainly grown accustomed to creature comforts over the years.  But what was perhaps the most striking aspect of this adventure is that Sir Richard Branson was also doing the hike right along with us.  In fact, he’s doing all 27 days.  And did he sneak off to somewhere luxurious, or even comfortable? No. The first night he was in the same room with me in one of the lower bunks, ate the same food, and walked the same routes. (He’s the knight in the blog title, of course). I know few millionaires who would put themselves through all that, never mind billionaires.

I also took two Ambien that night, which makes me snore, and I pretty much kept everyone else awake for the four hours it allowed me to sleep.  (I think Sir Richard has forgiven me by now!)

My admiration for this man grows with every encounter.

My admiration for this man grows with every encounter.

This was called a challenge, and it was meant to be, and for me it really showed me how much difficulty I could endure, how much will I could summon, and how much harder I could push myself than I ever imagined.  Finally, at the end of the fourth day, I crumbled.  My 62-year-old joints and untrained muscles rebelled to a point where I couldn’t be cheerful, and that was a hard lesson.  But I also learned that being comfortable isn’t anywhere near as important as I thought, and that I’ve been way too easy on myself in the past ten or twenty years.

And perhaps most impressive to me was that a billionaire, who could have had a helicopter take him to the nearest Ritz Carlton, not only did every step of the hike, but did it with a sense of humor, an amiable nature and not a hint of entitlement behavior the entire time. (By the way, he wasn’t the only billionaire with us.  Hartley Richardson, who I believe is the second richest man in Canada and recently beat throat cancer, also did the hike.)

I have been both humbled and inspired by this experience, more deeply than I could have imagined.  I can’t count the number of times that I felt like giving up, except that I had no other option but to keep going, and I had my hike mates toughing it out with me, and encouraging me, and cheering me up and cheering me on.  It was grueling, unpleasant, tedious, and painful.  And I already miss it.

I saw beautiful sights that I would never have seen any other way.  And I saw myself laid bare.  And I spent time with a remarkable group of people.  The whole experience was filled with unexpected gifts.  At one point on the fourth day we stopped at a little inn and I had one of the most memorable snacks of my life: an orange popsicle.


My lesson from this was simple and powerful, and I give it as advice to you: Do something hard. Harder than you think you can do.  It doesn’t have to be physical. It can be learning a new technique or new technology, instead of coasting along on your current skills.  It can be learning a musical instrument, or a language, or getting a degree. Whatever it is, get way out of your comfort zone, and you will amaze yourself.  And if you can, do it with other people.

The charity that this was for, by the way, is called Big Change.  It leverages the money raised to create programs that encourage young people to learn about the possibilities of business, and how they can make a good living and a better world.The last time they did this, in 2015, they raised $800,000, and leveraged it to get over $40 million in government support around the globe for their programs.  If you would like to donate for my efforts, I welcome that, and you can do so by clicking here.

I’ll end with the motto of the Strive Challenge: “Growth begins when you get out of your comfort zone; magic happens when you do it with others.”