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The Denali Group becomes more efficient

The Denali Group has been through a few changes in the last six months and we wanted to share what the impact of the changes have brought to The Denali Group and more importantly to our clients!

The entire team at The Denali Group has been able to move the schedules of our clients who were on our waiting list up to the point that we have cleared our waiting list completely! That’s right!  Our waiting list in March of this year was through the end of January 2016.  As of now, we are moving forward with every single project at such a rate that all of our clients that were on the waiting list are now moving forward with their projects!

Make no mistake.  We have not reduced our scope of work nor have we reduced the number of hours needed to get our clients the very best terms at each step of their projects.  We have simply found better ways of doing things that allows us to accomplish our scope of work faster by dividing and conquering the tasks at hand.  No man is an island unto himself.

About two years ago when we decided to grow our firm in order to accommodate more work, we implemented a cross training program of skill-sets and responsibilities.  The last thing a client wants to hear or that we want to say is that they will have to wait for someone to return from vacation or from traveling in order to get something they need.  So we worked very hard to cross-train each other in our areas of skill so that in any one person’s absence, the work can continue.

What we do here at The Denali Group is very personal to each and every one of us!  We take a vested interest in the success and accomplishments of our clients.  We bring a passion to our clients’ projects that is second to none in this industry.  We provide a level of service that is completely unheard of in this industry and take immense pride in doing so.  When was the last time a consultant was on the phone with you at 8PM on a Saturday?

We would like to humbly ask that if you know someone that is contemplating starting a new practice or is thinking about relocating an existing practice, send them our way.  We offer a very comprehensive package of services to our clients that simply doesn’t exist in any other organization.  The Denali Group does not advertise.  We do not do a hard sell to get people to sign with us.  Remember, talking is always free!  Send them to our newly designed website!  If you haven’t had a chance to check it out, go have a look!  Jeff Francis headed up the revamp and we couldn’t be prouder of how it turned out!  Here’s a link:

How to Create Team Diversity

Creating a balanced, well rounded team doesn’t just happen by accident. It’s an intentional, well thought out choice. I frequently see doctors surround themselves with people that are just like them. I remember doing DISC behavioral analysis during an initial meeting with a practice in Grand Junction, only to discover that every single one of them was a high “S”. S’s don’t like change and seeing that made my heart sink, I knew I was in for a challenge and I was correct. It was difficult to get new things implemented. Their team lacked the diversity necessary to develop a successful practice.

Successful leaders recognize their own weaknesses and see gaps in positions in other areas of their practices. They are able to assemble a team that is well rounded and able to make balanced decisions. Once the team is assembled the best leaders are then able to trust the team to understand the issues, come up with solutions and act on them.

When it’s time to say goodbye (to PITA patients)

Have you ever noticed that your PITA (aka pain in the ying yang) patients cause you and your team to lose stomach lining and cost you time and money in the process? They come in several shapes and sizes and sometimes it’s the kindest thing for you, your team and the patient to cut them loose with grace. I know that, especially if you can’t afford to let go of any patients, this may be a difficult decision but, in the end, it can be the best decision.

Let’s take a look at some scenarios:

Patients who break their appointments (the most common amongst the offenders): I’m frequently astonished when teams tell me their patient just broke their appointment for the umpteenth time. Seriously, at some point it becomes no longer worthwhile to grace them with an appointment in your schedule. Put them on a same-day call list and, if you have any unexpected openings in the schedule and you’re desperate, give them a call. Cut these guys loose, they’ll bleed you dry, cost you time and untold dollars and make your admin team crazy as they frantically try to fill last minute openings.
Patients who are rude to your team: These patients are usually the ones who are as sweet as pie to you but grouchy and rude to your team. I even had one client fire a patient for telling inappropriate jokes to his team. When you stand behind your team and ask these clueless people to seek their dental happiness elsewhere, you are making a big statement of the behavior you will not tolerate. Your team will thank you.
Patients who don’t pay their bills: This one’s a no brainer so no further comment here.
Patients who don’t follow through with your treatment recommendations: And then have the nerve to call you on a Sunday evening to help them out or call you at 2:00 am for pain medications. Fill your schedule with patients who appreciate your clinical expertise and excellence and don’t expect you to be a miracle worker.

In the final analysis, both you, your team and your practice would be well served to say a graceful farewell to that small percentage of your practice that causes you and your team to groan in your huddle.

Don't forget these important year end to-do's

Hopefully you’ve already done these but, just in case, here’s a reminder of two important year end must do’s:

Raise Fees:  According to The Wealthy Dentist publication, only 50% of dentists responding to a survey indicated that they had raised their fees in the past year.  31% had  to raised theirs in two years, 15% in three, 3% in four and 1% in over five years.  With cost of living around 3% and operating costs going up 3-4%, this leaves many practices with declining profits.

We recommend raising fees every year by 3-5%.  Regularly.  This means scheduling the event to make sure it happens.  As long as your fees were well set initially, across the board raises should do just fine without having to adjust too many one way or the other.  It’s a good idea to ask your supply company rep to do a fee comparison to make sure you’re within the range you want to be.  Most of the major supply companies offer this service.

Insurance letter:  This should have actually already have taken place in October, however, it’s not too late if you still have room in your schedule.  Send a letter (via email preferably) reminding your patients to “use or lose” their benefits before they expire at the end of the year and are once more subjected to deductibles.

Both of these events should be put on your schedule and take place every year. Protect your overhead and protect your profits.

Janet Steward – Senior VP Practice Management Consulting

Two Simple Steps towards Becoming a More Valuable Team Member

A Gallup pole estimates that 30% of the workforce is engaged while 52% are unengaged and 18% actively disengaged.  If you’re in the 18% , please, please go and find your happiness elsewhere because it’s very difficult to reengage when you’re actively disengaged.  If you fall in the 30% who are engaged it speaks highly of you and, in all likelihood, your practice culture as well.  But, is you’re in the 52% unengaged team members, it may not take as much as you think to become engaged and part of the 30% who loves coming to work every day.

First, don’t blame it all on the boss or your co-workers.  Even if some of them are not committed, that doesn’t mean that you can’t get there.  You have very little control over others’ bad attitudes so, accept that and move on.  Don’t let anyone else set your agenda.  Be the best that you can be because of what it makes of you.

Secondly, actively look for ways in which you can “up” your personal best.  For example, see what you can do to get out of your silo and set the next team member up for success.  How does what you do in your position effect their ability to do their job better and, if you don’t know, ask.  It could be as simple as a hygienist alerting the admin team that a patient with a treatment plan that needs financial arrangements is going to be coming up to the front in five minutes.  Find ways to wow your patients and this almost always boils down to a personal touch, going above and beyond, remembering the little things that tell the patient you listened and they’re important.

I love the late, great Jim Rohn.  One of my favorite quotes of his is:  “My father taught me to always do more than you get paid for as an investment in your future”.

I Love My Job

What you need to know about Ebola in Dentistry

Whereas it’s unlikely that a patient with Ebola symptoms will come into a dental practice for treatment, nevertheless, it should give us all pause to examine our infection control procedures.

A person infected with Ebola is not contagious until symptoms appear. Signs and symptoms of Ebola include fever (greater than 38.6°C or 101.5°F) and severe headache, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising. Symptoms appear anywhere from 2-21 days after contact with an infected individual, with the most common timeframe being 8-10 days.

If one of your patients has some of the above symptoms, it is wise to ask questions about their travel patterns especially to Guinea, Liberia, Nigeria, Democratic Republic of Congo or Sierra Leone in West Africa.  Make sure you and your team are fully aware that not all African countries are at risk.  I am from South Africa, I travel there frequently and find it a bit disheartening when people assume I may be at risk as a result.

The virus is spread through direct contact (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit, and semen) of a person who is sick with Ebola, or with objects (like needles) that have been contaminated with the virus. Ebola is not spread through the air or by water or, in general, by food.

While the risks to most dental practices is low, now is a good time to examine your practice’s infection control protocols and procedures and to educate your team on the symptoms and risks of Ebola Virus Disease.


CDC recommendations for evaluating patients for possible Ebola Virus Disease

CDC Recommended infection control practices for dentistry

Initial assessment and management of the returning traveller from counties affected by Ebola Virus Disease for dental offices and allied health professionals

Advance Care (a Care Credit alternative)

A client of mine who is opening a new practice at the end of the year is looking for financing options for his patients and asked me to look into Advance Care as an alternative to CareCredit which is expensive to many start-up practices. Apparently there has been some buzz about them on DentalTown.

Turns out, Advance Care has some strong advantages:  they offer 14 months no interest to patients with excellent (750+) credit scores and 6 months no interest to those with good credit scores.

The major difference between them and CareCredit is that, if the loan is not paid within the specified time frame (14 or 6 months), interest is only charged on the remaining balance as opposed to the entire balance backdated to the beginning of the loan period with CareCredit.  It was difficult to pin down a specific interest rate for this due to the unknown variables because the range (10.99% – 22.99%) varies depending on credit score, debt to income ratio, etc.
The other major difference is that it’s like a normal credit card, it gets run through the dentists’ s regular credit card terminal and the only fee is the fee negotiated with the practice’s credit card merchant company.
The one drawback is that the application is only active once the physical credit card is received which could take up to 2 weeks meaning that same day payment for emergency treatment would be ruled out.
My recommendation for my clients would be to sign up with both CareCredit and Advance Care available but too use Advance Care as the primary go-to resource.
Here’s to an Above and Beyond Practice
Janet Steward: Senior Vice President Practice Management Consulting – 720.446.1770 Ext. 106

Moments of Magic – PostOp Calls


What is the single highest impact, greatest ROI customer service thing you could do for your patients?  Why, it’s the postop call of course!  No matter what you do in your practice to engage your patients, nothing comes close to this magical end of day call when it comes to creating the WOW factor.  Let’s have a look at some strategies for simplifying things and pointers on making it highly effective as well:

  • Firstly, call every patient who you gave a shot to every time.  Your hygienists should also call their SRP patients.
  • Call at the end of the day unless the patient is still numb, in which case, call them first thing in the morning.
  • Have someone on your team give you a schedule, along with contact numbers and any conversation highlights you could reference back to, e.g. How did little Johnny’s soccer game go this evening?
  • When leaving a message, which is what you’ll be doing most of the time, say something like this:  “I’m just calling to make sure you’re feeling comfortable after your procedure today.  If you need to reach me, my cell phone number is _______.”

The discipline that it takes to make these calls is well worth your time and the return on this investment of your time will reap big rewards.

Janet Steward – VP of Practice Management Consulting – 720.446.1770 ext. 106 –

Thinking of Waiting for New Retail Construction to Get Built Before Opening a New Dental Practice? Some Things to Consider.

We recently had a new start client ask us whether he should “sit out” the market looking for lease space, and instead wait for one of several new construction/future proposed retail centers to be completed in the future.

He thought our response to him was very enlightening and that we should share it with other dentists.  Here is our response:


There are a few things a new start dentist should consider about any future construction project and waiting for them to get completed before moving ahead to open a new dental practice.  Three primary issues include: timing, rental cost, and lost opportunity costs.

The timing of many future projects in your area would mean delaying your project by at minimal probably 6 months, but for some of the projects that are still just “proposed,” it could be 2 or more years before they ever become reality.  A typical commercial retail project in fact can take 5 years to go from concept to financing to permitting to final build-out.  And even if construction plans are ready, most all projects financed through loans have to have 50-75% of their space pre-leased before the lender will fund on the project.  So even though you could sign a lease today for future space, you don’t know when the property owner is going to have the other necessary spaces leased out….and in the meantime, you just sit and wait.

Also, keep in mind costs.  Going into “first generation” brand-new space is akin to building your own new house vs. buying a “used” house—the rental rates are going to be MUCH more expensive in new construction.  Often loan conditions restrict a dentist in the amount of rental and CAM payments they can pay based on the underwriting of their loan and their unique financial conditions.  The fact is, based on many loans for a new start practice, a dentist simply cannot afford to go into a space that is charging $35-$45/sf for new construction.  There is a reason one sees the corporate dental practices in new “Class A” space…because they can afford to pay top dollar for that kind of location…they often do little negotiation of their rental rates and just take the new space at the landlord’s “face offering price.”  An Aspen Dental and the likes, for example, are the McDonalds of dentistry in that they seek out the best locations, but then also pay the top prices for their rental rates.  Keep in mind, most of the big corporate dental chains today are also funded by private equity firms—they therefore have very deep pockets without the same restrictions that bank financing requires. Furthermore, the large corporate dental practices often get their “Class A” locations because they sign on to future construction projects years in advance, and then wait to open at that location.  Again, this isn’t a strategy most new start dentists want to, nor can afford to, follow.

Lastly, waiting for future construction space means lost opportunity costs.  If a dentist sits on the side-lines for 2 years, they lose out on starting their own new practice and 2 year’s worth of earnings they could have been making for themselves…AND 2 years of marketing and establishing themselves in their new market.  As I often say to clients, if you don’t monopolize on the favorable market conditions that currently exist and that we find for clients, then another dentist (or multiple dentists) are likely to enter those market themselves over the next 2+ years and the favorable opportunity will have been lost.  Finding good market potential is getting increasingly harder and harder to find across the country…and as more dentists open yet more practices, waiting to strike is only going to work to your detriment.

So in total, although there are the benefits of being able to locate in a future “shiny and new” retail center, there are often extreme risks to waiting for future proposed retail construction to occur.  One has to make the decision to potentially sit on the side-lines with eyes fully wide open!



How We Handle Change


It’s fascinating to me how different people respond to change.  It’s my job to help my clients navigate change because, as a consultant, I am basically a change agent in my practices. That’s why I’m there – to help affect change.

It is naturally very important for me to understand how each of the behavior styles process change so that I can help facilitate change for them so I’ve included my basic cheat-sheet below.

According to DISC Behavior Profiling, here are how the four behavior styles deal with change:

D:  (Dominant, extroverted, task orientated, 18% of the population)

D’s are the quintessential change agents of this world.  They love it. They thrive on challenging the status quo. D’s are decisive decision makers once they have enough information.

I:  (Influencer, extroverted, people orientated, 26% of the population)

I’s are spontaneous decision makers. Change is so easy for I’s that they may not even notice it’s happened.  Change, for them, is easy and they are frequently unable to grasp how difficult it is for many others.

S:  (Steady, introverted, people orientated, 43% of the population)

S’s dislike change.  A lot.  S’s make their decisions by conferring with others and only when they feel the change is warranted.  They need a lot of preparation time before they’re willing to take the plunge.

C:  (Compliant, introverted, people orientated, 13% of the population)

C’s need to have all their facts and figures before making change.  Their deliberation process often gets bogged down because of their fear of making the wrong decision. They are concerned of the effects change may have.

Janet Steward

Senior VP of Practice Management Consulting