Solving the Hybrid Digital Challenge – Season 1 Episode 18

The Dr. Chris Griffin Show – Season 1 Episode 18

“The most extraordinary thing about trying to piece together the missing links and the evolutionary story, is that when you do find the missing link and put it in the story, you suddenly need all these other missing links to connect the new discovery. The gaps and questions actually increase its extraordinary.” Now who said that?

Welcome to the Dr. Chris Griffin Show. Your resource for leveraging systems and technology to easier workload, increase productivity and provide you with the time off you deserve to live the life of your dreams. It’s time to practice productivity in the passionate pursuit of a better life with your host, Dr. Chris Griffin. The Dr. is in.

Yes, yes. Hey everybody! I know that was kind of a weird quote right? That just not seem like it belonged to a dental podcast. But anyway, thanks for tuning in this week. Let me share what, why I said that. That was a quote by none other than the famous Sir David Attenborough from England. Now if you don’t know who that is, David Attenborough, he has been a naturalist his whole life. And he’s also been in charge of the BBC as a director of programming. You know he was like their big league in the 60’s and 70’s. You know, he’s been called a national treasure. He’s been voted one of the top 100 Britons of all time. So anyway, he’s got a hundred titles like all the, all the famous guys over at Britain. You know he is a, he is been a member of the Order of Merit, Commander of the Royal Victorian Order, Commander of the order of the British Empire. I mean hey, you know…some of these titles are super cool and I think it will be awesome to have them.

But why I put a quote about evolution in this podcast? Well, today, we’re going to share with you something that I’ve always called “The Missing Link” and it’s the missing link, not an evolution but the missing link in Dentistry between the front office and the clinical. There’s always a conflict. Every office I have ever even thought about consulting with has had a conflict between the front office and the clinical. They always struggle to communicate, they struggle, you know they have you know, the front office said, they have their agenda. The clinical, the back office, they a lot of times they have their agenda. It just it’s really aggravating and frustrating for everyone and especially the patients. But the big loser in all of this communication difficulty has always been the ability for the office to produce the high level of productivity. Because and one of the main reasons is, it’s just really hard to do same day dentistry.

To do same day dentistry, you have to have all your ducks in a row. You have to have really good communication between the front and the back because there’s always a very small window you have between the diagnosis when the patient’s really hot to get it done and your staff telling you whether or not they think within a reasonable doubt that you actually get paid for this okay? Or if they even have enough information to present an accurate or semi accurate number to the patient about what this might cost. I mean how can you do any kind of treatment planning if you can’t figure out what something actually is going to cost the patient, right? It just stops you in your tracks, a lot of offices just give up on it and say, “Oh we’ll figure it out and we’ll get back to you or we will schedule you for 2 weeks and by the time you come back, we’ll figure it out and let you know what you’re going to owe.”

I mean all these things run around the patient’s mind and once the patient leaves the practice, what I call the “Butterfly Effect” kicks in. We had a whole episode about this where so many things bombard the patient, that’s going to possibly keep them from coming back in. Where I live a lot of times it’s because the spouse was going to use that money to buy a new bass boat, you know or trolling motor. And that’s just, there’s just always something. And so if you can avoid the butterfly effect, by doing same day dentistry, it’s inevitable. Your office productivity is going to go up. Everyone’s going to be happier but it’s hard to do. It was very hard even for us to do until we found our missing link and that is not only the missing link for communication, it also is the hybrid system between digital practice and physical practice.

It’s an amazing concept and I hope you can stay with me because here in a minute, we’re going to describe this tool. And that’s what it is, it’s a tool, to the best of our abilities on audio. If you see me in a live lecture, or on a video doing it, it might be a little more clear but I’m going to do my dead level best to describe it the best I can. And as always if you have questions, hey email me. Well I’ll do my best to help you understand what we’re doing, okay? So after a few words from our friend, John Lee Dumas, we’re going to shoot you back to our lecture from Oklahoma City when we discussed “The Missing Link”. Okay everybody, enjoy!

This is John Lee Dumas of EOFire. And if you’re ready to ignite your productivity, explode your growth and burn down the barriers to your dream life, the Dr. Chris Griffin Show is where you need to be.

Let’s talk about the orange card then. Well does anybody have questions on the color coding and all that stuff? That’s a great question. Okay, so for exams, actually there’s 2 levels in that AB card. And so the freight finder and the endo spray, and the cotton pliers; we keep them in the little wrapped autoclave bags on the second level. And if we don’t need them, they just go right back into this. Absolutely, very good question. Yes. Well yeah but I mean, when you’re using cassettes, it’s really no big deal. I mean, I’m way more interested in not wasting time than wasting money for the instruments which is minimal, in my opinion. So, and I slowly got by super expensive stuff. So yes, and you know if you open it, if I don’t use it, so what? Close it, throw it back in the autoclave.

Okay, now this is the little jewel that I had just to make my stuff over in Arkansas for. This and also, this sort of came…I was using it before the…this is my orange card that I used for treatment planning before the fire. And this is the orange card that I used after the fire. So let me tell you the difference. So office burns down, good news, patient charts burn down. So you don’t have to worry about storing them, for 7 years right? And so, well that’s good. Also in the past, 3 times, I had in 3 different times in the last decade I would say, “You know what? I really need to go completely digital.” You know, I just need to go digital. This is like 2000 and whatever. I need to go digital. So I would try to go digital, it just wouldn’t work. I mean something just did not work; you messed the flow up, the staff didn’t like it, blah blah blah blah blah. All kind of reasons, right? And I think that I’m the kind of guy that pushes through problems and solves it. I never can solve the digital problem.

Okay, so the office burns down and I’m like, if there was ever a time to go digital, this is the time, right? It seems like it. So we say, “Okay, what would we need to do to do digital?” Well, we would need to certainly do a better job at clinical note taking, which we were kind of already doing okay clinical note taking but I got serious about doing the templated notes in Dentrix, do you guys use that? You know. So I got serious about that. So finally we fought that battle and we kind of won that. I had to get serious about, you know, there’s a lot of paper in dentistry, so what do we do? And amazing I found this scanner that is like off the hook, guys. I don’t know if you’ve ever tried new scanners but it’s not like the old days. There’s a scanner from Fuji, I believe. Fujitsu, Fujitsu called the Scansnap. And the way that I found it was I’m a big…do you guys in here use Evernote software? Evernote? So I’m like an Evernote geek, right. it is like my digital brain. Everything that I use in Evernote.

And then one day, I found out, Evernote has a special Evernote scanner; that you can scan your stuff into Evernote as a PDF and it will search it and it’s great! And so I got it, I’m a geek, I buy it and I turn it on, it’s got the little green Evernote elephant on it. I think “Wow, this is cool!” So I start feeding my papers in there and I’m like, “Holy cow! This is amazingly fast! I’ve never seen anything like this. This scans front and back and like…Shoop! Shoop! I mean it’s so fast!” and I’m saying “Wow, this is amazing! I wonder if I could use this in the dental office.” Sure enough, Fujitsu makes the same scanner without the green elephant on it, that didn’t cost $400, it only costs like I don’t know, $200; because it’s not Evernote, just big old Fujitsu. And so I got one for the dental office. And sure enough, that scanner is probably the one thing that allowed us to go really digital because now it takes no time. We’ve got it hooked into a couple of workstations. We’ve got 2 of them at the office; one at 2 different workstations.

And you know, that’s a good thing because my wife, well she’s not…she’s there like say, she’s not really like. But when she’s there, it’s a really good job for her because she just sits there and scans notes and stuff in. And on Thursdays, the staff will all pitch in and scan some of the paper, you know. You got paper, oral surgery, orthodontist, insurance, EOB, everything. So that allows to help go digital. So I’m like, “Alright, we’re going digital. So how are we going to do our treatment plans digitally? Let’s go all in.” Well, there’s a problem. I have years…and so here’s what we found for trying to go completely digital on the treatment plan. And it’s my fault but I don’t know how to solve it and I don’t know how any practice could really do a great job a 100% because there’s always going to be a time when somebody’s in for hygiene. Maybe I say they need you know I said, “Hey you want to pull it or you want to fix it?” “I want to pull it.” “Okay. Let’s pull it down for extraction.” But they don’t want to schedule.

Six months later, they come in, “Oh, I change my mind. I want to fix it.” “Okay. Let’s put it in for root canal crown.” Well you know you got those 2 things on top of each other. You guys know what I do. They’re just never 100% clean so there’s always going to be multiple stuff in that’s confusing. It is hard to figure out when you’re trying to go fast, when you’re trying to do same day dentistry; trying to go fast. Anything that confuses the person, just trying to put together the treatment plan slows you down. And so we tried and tried and tried but we could not go as fast, digital only, with treatment plans as we could using our old orange card system. But I said, “Dead gone it! You know, this is really aggravating but okay, I give. We’ll just have…this will be the only piece of paper in the office for the patients, right? Now I told you everything bad news would happen to me. About that time, that I said “Okay, the orange card is the only thing we’ll have and we’ll just use it for treatment planning. And we’ll work towards maybe going digital and that but we’ll just say that‘s good enough and it really is good because this one card didn’t take up like you know, I used to have file cabinets everywhere. And now we just have 1 file cabinet and you know, you can fit thousands of these cards in there and there’s no problem.

I don’t trust my staff to double check that and maybe I don’t even trust myself to look at the computer, right? I like to hold the medical history in my hands because I’m just, I got to do it. So I can review things very clearly. So in keeping with my efficiency ideas, and we still just have one piece of paper for the whole patient for the whole office, we go ahead and we put the medical history on one side of this orange card, and we put the treatment plan organizer on the other side. And as, you know, as this fills up, I know this is old school but we just take the old treatment organizers like we used to use and we put it over the top of the other one and then we staple it. Then as so as time goes by, sometimes you might have one of these for patient that’s got 2 or 3 or these stapled on it. And if it gets too thick, you just take the staple out, take this, scan them in a Fujitsu scanner into your Dentrix document system center and put a new one on, you know and clean it up if you have to. That’s the way that we solved it.

Now let’s go through this and I’ll show you why I really…I know it’s you know it sounds crazy and it sounds way too old school but I don’t think there’s a faster way to get information from diagnosis to financials back to the patient than this right here. So here you go, from the top of the card, it just has the stuff right here. And the way that I used this is I will walk into an operatory and this is actually we have a little paper holder flat against the wall in each operatory and this is always out facing me. So whatever we’re doing, I always this sort of my triple check last thing, I just look up, glance and I use it to cheat on patient’s names right? Because my eye sight used to be where I could see a computer screen across the room and now, I can’t. So I just walk in and I see this and I’m like, “Hey, Mr. Brian. What’s going on?” You know? And if I’m fooling anybody, but you know, it didn’t hurt to call people by their actual name without going “Hey, Mr. Brian.” You know? I can just walk in and glance and just keep talking.

How’s Suzy doing? You know you just do all that good old stuff that people talk about. So you know that’s how you use the top part. Now the bottom part is there’s room for 4 different spaces and like I said earlier, I’ll do a full mouth treatment plan. But I usually don’t diagnose past the first couple of a points. And so what I really want on here, I’m happy for Dentrix to house a complete treatment plan, but on here, I really just want the first few appointments charted on this thing. Because it’s very unusual in my practice for people to say, “Hey I want the whole lunch enchilada”, they usually just want the tooth they came in for and I might be able to talk them in for another tooth too. And so we’re going to fill out for each appointment; each one of these lines going this way is for each appointment.

And the little descriptors that we have that you know, this I also how I keep things going fast; units of time. So if I diagnose a root canal crown and a core on a molar, it’s always going to be 7 inch of time; which is 70 minutes. So it really takes me 60, I always give myself a 10 minute cushion on every appointment, okay? So in units of time, there’s a production. That’s just a “Yes” or “No” field. So the staff will just mark “Y” or “N”. That way, they know if they’re supposed to be charging for something that day or not. The things you don’t be charge for, you know. Crown seats, adjustments, stuff like that. Order, I always order these and the reason is important to have that on here is because the first time you see somebody, yeah, it’s first thing, second thing, third thing. As time goes on, they might do this, then they break this tooth. Then things kind of get out of order so you got to keep things. This allows you keep things reordered so that you’ll always know what you really need to be doing next. So let’s just say, I’m getting through an appointment. I always turn around and look at this card and then I’m talking to the patient about the next thing they need. And I quickly know, without having fumbled through Dentrix and find out on the big massive treatment plan. I always know just through the glance and I don’t know if it makes them feel like I’m so on top of their case that I’m always remembering what goes next or what. But it’s just a very seamless way to make things go smoothly as I’m doing. You know, talking to them about treatment.

And room number, that’s on here for the financial staff. So my assistants will actually, I’ll tell them, So let me give you an example: So I do a big treatment plan, I go tooth 1 to 32. And then I’ll say, number 14 was hurting and first thing we’re going to do is…in my office we say everything. So I’ll say, “We’re going to do everything on tooth 14, seven units of time.” And my staff knows that that means, to right on here number 14 root canal, number 14 core build up, number 14 all porcelain crown. Okay? And 7 units time, they put that in there and then they will carry this, actually, up to…so there’s an example of that. There’s an example of what they write into the scripter area. They will carry this up to the front desk, the front desk fills out the right side of this card for each appointment. Now for the whole treatment plan, just that appointment.

So they will actually figure out the money on the thing. So they’ll go back here and they’ll look at this and hopefully the insurance has been verified. So they fill out every one of these fields. The estimate, estimate insurance part, deductable, whether or not the patient has a credit or debit. A discount you’re offering them, final estimated patient’s part. Then let’s say the patient owe 12 hundred bucks, and they can’t pay 12 hundred bucks today, but you know, interest is going to pay you 15 hundred. So you’re glad to do it today. And you just you know, as long as you can get some of the patient’s part, you’re willing to extend some financial arrangements. So maybe they’ll say, “Okay, 12 hundred in 3 payments. 4 hundred today, 4 hundred next month, 4 hundred in 2 months.” They would actually write the financial arrangements down right here on the card then my staff person would date it, and put staff initial. They would initial in and then the…

Patient on to patient. They initial that, I’m not saying that this is going to hold up in the court of law. I have no idea but it sure does solve a lot of problems if there’s ever a dispute about payment and the patient goes back and says, “Well I didn’t really understand that was going to cost this.” And you show them, whoa you know, here we go. Therefore I initialed it after we discussed the payment options and here’s where you signed it. And that solves a lot of problems. But really and truly, the whole purpose of this, is just to be the backbone of the fast financial arrangement system that we have in my office. Now part of that we didn’t talk about is insurance. Now the reason I’m not talking about it? I don’t know that much about insurance to be honest with you. I know a little bit. We do go over statistics and insurance every week at our weekly meeting and actually everyday at our morning huddle but I don’t know that much about insurance, honestly. But I do know that over the years, we’ve tried and tried and tried so many different things. This is the only thing that we’ve ever tried that is consistently been amazingly fast to get the diagnosis from the chair side, into the computer, back to the financial arrangements, figure it out how much the patients is going to actually owe and then back to the patient to go over it. So, we can initiate our fast clinical system and deploy all of our stuff to get our procedure done quickly. And that’s the backbone of fast financial arrangement. So we’ve called that in the past in some of our lectures.

So there you go, now I know this might have been a tough show to grasp without actually looking at one of these orange cards but all the concepts are there. And the first time I ever saw a treatment card, you know, giving credit where credit is due. I actually was a client. I took a consulting class from Dr. Bob Westerman in Baton Rouge, Louisiana. And he had a card that listed out treatment you o, much the same way that the orange card does. Although the thing that differentiates the orange card from his card is that the orange card actually combines the financials and with the treatment on the same exact card. And then also incorporates the medical history. So instead of having like a single card just for treatment that you keep in a chart or something like that, this card absolutely does it all. Like we talked about, this is the bridge, the hydrid from going fully digital to the charts. You know the physical system we’ve all grown up with and we’re now trying to phase out of.

This is the bridge, it’s the missing link, it’s the solution to…if you know, if you have an interest in having high productivity and going fast on stuff, and yet you know you got to get everything right, and your staff. You know, you got to get everything paid for stuff right? You got to get all these financials. You got to have to find a link to connect everything. This orange card is the fastest thing that I found to do that. And just like I said, I went to my client’s office who’s using the orange card, and of course his staff person said, the route board actually, the Kanban style route board was what saved her practice or saved their practice but they had the orange card right there. That’s what I want to get. They used that orange card every single day. And so it sort of become a combination between the route board and the orange card. Those 2 things are absolutely 2 of the pillars of our clinical environment. Okay? That absolutely have to be there. For high productivity, if that’s something you’re interested in. and I think that you probably are if you’re listening to this podcast, right?

So and then so, let me talk just a minute about the next episode. Okay? I actually just got back from an amazing, an amazing weekend in Dallas, Texas. Where I was a guest lecturer at Kent Smith’s sleep apnea round table and it was one of the most first class events I have ever even thought of about attending. I mean it was amazing! Right? Everything topnotch, first class. The food, I cannot imagine what he spend. I used to, you know, putting up all these events that I’ve put on. Let me tell you, I know food cost a ton. It was in a super nice Marriott just in an amazing part of Dallas and Plano. The food was great, the lecturers were wonderful, Kent and his staff, April Cassenova, his right hand person. She was amazing! And you know, their whole day, their whole 2 days they were just…it was a well put event every single way. Now when I spoke because I didn’t speak about sleep apnea, now we’re doing a treatment for sleep apnea in the practice. But I’m not an expert. I’m just a novice and while I was there I actually took some novice classes right? And so…and it was okay, I didn’t feel out of place. I was the only doctor that took them, right? I’m man enough to say, if I need novice classes 101, that’s fine. And so I did that but I lectured on something that’s kind of new. We’ve been doing it for a while but I just now shared it. And that’s what our episode next week’s going to be on is the concept of visual work flow and the concept of using Kanban in the practice. It’s sort of a mystery but I’ll let you guys think about what that’s going to be about. So anyway, I’ve had a wonderful time teaching you guys our fast financial arrangement system. The orange card, the hybrid between physical files and digital; and hopefully you’ll put this to good use. As always, if you have any questions, or anything, shoot us an email or go to the content page in the website and we’ll be glad to answer you. And other than that, we look forward to talking to you next week, okay? So everybody, we will see you then.

We appreciate you joining us for this episode of the Dr. Chris Griffin Show. Be sure to visit drchrisgriffin.com for the latest resources and updates to keep you more productive every single day you’re at the practice. So when you’re not working, you can do the things that matter most in life. We look forward to having you join us in another episode of the Chris Griffin Show; where the doctor is always in.