Episode Transcript
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Dr James (00:00):
You know, what really
helped me become more profitable
as a clinician, and also inbusiness as well, is just
looking at every little decisionthrough the framework or
mindset of a business owner andsomeone who has a business
perspective on life.
And what do I mean by that?
They're always thinking abouthow they can systemize
(00:21):
everything, or make everythinginto a protocol or define it and
quantify it by numbers, andit's more a mindset, more than
anything else.
What I realized with time andthis applies to our dentistry as
well, whether we are aprincipal or an associate, it
applies to both instances.
That's why I've got today withme on the podcast Mr Rida Alwan,
(00:41):
who helps dentists when itcomes to their practice,
whenever it comes to theirclinical skills and clinical
ability, understand how they canbe just a little bit more
efficient and profitable,because that helps as well.
Rida, how are you?
Rida (01:01):
Not too bad, James.
How are you?
Dr James (01:03):
Always good and R?
Really, we were talking offcamera, weren't we?
And there's a really coollesson, if you ask me, on
business and life whenever itcomes to profitability, which
frames this podcast extremelynicely, and that is if you wish
to be more profitable inbusiness whether you're a
principal or an associate, youknow, because if you're an
(01:23):
associate, you're self-employed,you're're a business within a
business there's only three wayson the face of this earth that
you can be more profitable, andthis applies whether you're a
dentist, whether you're a carmanufacturer, whether you own a
corner shop, any business underthe sun.
There's only three ways, andthose three ways are you can
think about your turnover.
Let's say your turnover is ahundred thousand pounds and your
costs are thirty thousandpounds year.
(01:44):
If you manage your costs, as in, reduce them, well then your
costs all of a sudden go from30K to 20K, let's say, and the
gap between your turnover andyour costs is going to be your
profit, right?
So you've just made more money.
So that's the first way.
All very simple stuff, but wedon't have this clarity until
people spell it out.
The second way you can make moremoney is to serve more
(02:04):
customers.
So let's say you've got awebsite.
Let's say that you have athousand people purchase from
your website on a Monday and amillion people purchase from
your website on a Tuesday.
Well, you've served morecustomers.
Therefore, you've made moremoney.
Those customers, their averagecart value, as in what they've
purchased from the website, maybe exactly the same as the, the
(02:27):
day, the, the, the, the thoughtof the million customers might
be exactly the same as the daybefore the, the thousand
customers, or whatever, or tenthousand or whatever you want,
but the point is more of themhave purchased.
So you haven't changed anythingelse other than the fact that
you've served more customers.
You've helped more people.
That works a little better whenyou've got a website which is
fully leveraged, as in, it'sexactly the same amount of
effort for you whether athousand people visit your
(02:49):
website or ten thousand or ahundred thousand, but not so
well always when you're adentist, because you've only got
so many hours in the day.
You've only got one pair ofhands and one brain.
So it's not, it can't beleveraged as, uh, you know as
much.
In that sense, at least,without creating, uh, more
systems or processes, processesto fill that demand, uh, you
(03:09):
know, and that can be hiringmore associates or creating the
infrastructure to facilitatethat demand.
So that's the second way.
The second way is to serve morecustomers.
The third way that you canincrease the profitability of a
business is to increase thevalue of each and every customer
that comes through the door.
So say, for example, you aredoing full mouth rehabs all day
versus single fillings.
(03:30):
Well, obviously you might seeexactly the same amount of
people, but the value is thatmuch more from a business
perspective.
Obviously you only want toundertake treatment on somebody
whenever it's clinicallyjustifiable.
Of course, we're not sayingthat for a second, we're just
purely looking at this from theperspective of numbers and
finance and business.
And that lesson was reallypowerful for me because that
(03:50):
made me think to myself right,okay, if I do want to hit the
next level, I do want toincrease the profitability of
whatever business that I'mworking in or I'm helping
somebody with this stuff.
Well, really, anything thatcomes out of my mouth is going
to help on that front is goingto be one of those three methods
.
It's either going to bereducing costs, increasing the
number of customers that weserve, potentially marketing
something along those lines, orit's going to be increasing the
(04:12):
value of each and every customer, and I just think that's so
cool.
It's such a cool littleframework through which to make
these decisions rid of.
And, on that note, that'sexactly what we're going to talk
about today.
How can we, as dentists,undertake those three methods to
increase our profitability?
And Rida's got some hot tips onthat front as well.
Rida, your area of expertise, Iwould say, is reducing costs.
(04:33):
Would you agree with me?
Rida (04:34):
Yeah, so yes and a little
bit more, I classify myself as a
brain for hire.
Now, when I say a brain forhire, I come up.
I don't see problems, I seesolutions.
Dr James (04:46):
you know, a filling
takes how long, James, you're,
you're the dentist here oh well,depends on the filling, depends
on depends on the standard ofthe filling.
It can take 15 minutes, it cantake an hour and a half it
really depends on where it is inthe mouth.
Rida (04:59):
At the same time, yeah,
well.
Well, this is it, and it dependson how deep it is, depends on
whether there's pulpalinvolvement, whether you need
rubber down patient factors, allsorts of things and then you
can factor those in when you doyour initial exercises of your
x-rays, and so you know thatthis patient that's coming in is
going to be coming in for a 20minute filling, or he's coming
(05:20):
in for an hour filling ratherthan rather than booking an hour
and 15, an hour and a half justto be, uh, giving yourself too
much extra time, what you'redoing is that you're losing
amounts of time, burning right.
So for you to optimize this isgoing to be important.
So how does that work?
(05:41):
It's about you being able totell your receptionist team,
your nursing team, this patient,when he comes back in, he's
going to need a 25-minuteappointment, a 30-minute
appointment, a half an hour, a45-minute appointment, by you
optimizing that diary andutilizing every minute, rather
than doing hour blocks orhalf-hour blocks where you're
(06:02):
losing time.
Dr James (06:04):
Well, it's a good
start.
You definitely want to tailorit 100%.
Rida (06:08):
The next is designing and
automating tasks.
Dr James (06:15):
Tell me more.
Rida (06:18):
So, as a dentist, you do a
lot of repetitive work with
regards to filling in patients,yes, or writing up your notes.
Yeah, yeah, is there a way ofautomating?
Automating this?
Can you have a set template ofpatient came in for a filling
(06:38):
and not all?
I'm not saying all of them areexactly the same, but it's where
you can fill in the blanksrather than rewriting everything
every single time.
Dr James (06:48):
Yeah, well, that's
possible, yeah.
Rida (06:50):
Yeah.
So people need to startthinking out of the box, to
think how can they optimizeeverything that they do?
I mean sitting down with thelab to negotiate.
Yes, you're thinking it's theprincipal's responsibilities to
sit down with the lab tonegotiate.
Yes, you're thinking it's theprincipal's responsibilities to
sit down with the lab tonegotiate.
But you, as the associate, needto understand this.
(07:12):
You need to sit down with thelab saying listen, if I'm going
to send you X amount, I need youto give me a hand, sort me out
a deal.
Let's work together, becausethe more work you give a lab,
the more they can discount you.
It's not a set price.
Dr James (07:26):
That's a bit outside
the box for the associate to do
that yeah, and then also trackyourself.
Rida (07:32):
Create your own kpis.
You don't need the principle tocreate your own kpis.
Why don't you track yourself?
Track how long you're taking,what you're doing, what's your,
what's your income?
What you how are you earning?
What type of patients are youseeing?
What's your, what's your income?
What you, how are?
Dr James (07:45):
you earning?
What type of patients are youseeing?
That's a good one, becauseassociates don't do that very
much.
I mean, I certainly didn't.
Back in the day it was justhappy-go-lucky.
Whatever sat in the chair, satin the chair.
You know.
Rida (07:54):
Whatever type of patient
sat in the chair, yeah, and then
the most important one and youknow this, James, without even
me saying it is upskilling howto invest in yourself, how to
improve yourself, how to youknow, going on these phenomenal
courses where you might be doing, you know implants or you're
doing all of this smile designsand all of these extra skills
(08:17):
that you can learn.
That's one of the biggestthings that any associate can
invest in himself.
Dr James (08:25):
Well, it boosts cash
flow, doesn't it?
Yeah?
Rida (08:28):
and then your side of
James and what you do, which is
phenomenal, which is, whatevercapital they do have, how to
invest, how to utilize it yeah,that's important as well you
know these things.
these are five or six littlethings that associates need to
take into consideration of theirdays, not of their month, of
(08:52):
their days and their weeks,because if you're looking at it
on a monthly scale, it becomesoverwhelming, but if you're
looking at it on a daily and aweekly scale, you can manage and
control that.
You can start thinking if I'mworking in this dental practice
for this many days, this is howmuch I planted you can now.
You can now by the way, I don'tknow if you know this, James,
and I'm sure you do you canstart getting mortgages on
(09:14):
potential earnings because you,you've got this date, date, how
much you can earn, and you canprove that to to a broker yeah,
no, it's, it's, it's.
Dr James (09:27):
Tracking kpis is a
hugely important thing that
dentists don't do enough of, youknow, and it's.
It sounds so tedious and likesuch a waste of time, or at
least it would have done to ayounger version of me, uh.
But you really have you, reallyyou master what you measure.
You really have no idea inwhich areas you're performing
well and not performing so welluntil you have it laid out in
(09:47):
front of you.
And I mean, what I wouldrecommend to everybody is
tracking the number oftreatments that you do each day
versus the number of patientsthat you've seen and the value
of those treatments.
I think that that's a really,really, really useful way to
start getting a gauge just forhow much time you're spending
and where.
And then you start to think toyourself okay, maybe I can
delegate some of this stuff,maybe I'll keep the high value
(10:10):
things, because they're reallywhat's bringing home the bacon.
Rida (10:13):
Data is key In this day
and age where we are right now,
today, with AI and everything,it needs data.
So if you don't have the dataon your working day, what are
you doing?
How can you predict?
How can you think?
How can you think you know what?
I'm going to go away on holidayfor a month.
Does that make sense?
(10:35):
You know you want to go out andsit on a beach for a month.
What does that mean to me?
What is the data?
How much am I going to lose?
What am I going to earn?
What am I?
How am I going to do?
You know this there's peaks andtroughs in the seasons.
Come Christmas time, it gets tobe quite January or Christmas.
(10:56):
People want to see what are youselling when.
What are you doing?
So then that peaks and troughs,that data that you collate
during that period, you can turnaround and say, oh, my God, I
can now start strategicallyadvertising things at a certain
time because you, you've got thedata.
Dr James (11:13):
Love it okay, so we've
covered associates some of the
simple things they can do.
Let's move it up a notch.
Let's talk about principles,because this is where it gets a
little bit more in depth yeah,so again.
Rida (11:23):
So with principles again,
is data.
Data is leverage as a principle.
Again, you know that it's the'sthe same principle in the sense
of the same idea, but then as aprinciple, as a practice owner,
what you've got to look at isstaff.
Are they at the right standardto where you are?
Are they working as a team tostreamline your work?
(11:44):
So, when a bill comes in, how'sit going through the system?
Who's doing the ordering?
At what point are you doing theordering?
Are you over-ordering?
Are you under-ordering?
That team around you is thecore part of the principle.
(12:11):
Had in-depth conversations aboutthis with regards to different
types of suppliers.
You know there are websiteswhich me and you have discussed,
James, about.
You know finding the, the bestprice point for a product, and
if you're not aware of thesethings, you know they should be
contacting you, James.
People should be reaching outto people that have got,
especially as principals,because principals,
unfortunately, they like theirhabits.
(12:33):
I've got one supplier.
I'm sticking with them.
I know where I stand.
But as a principal, you shouldbe looking to increase your
profit margin without doing toomuch work.
By reducing your costs, youautomatically increase your
profit margin.
Reducing your costs, youautomatically increase your
profit margin.
So if you're buying thingscheaper a pound cheaper per item
(12:53):
you're increasing a pound peritem.
By the way, you can actuallyreduce your sales and still have
the same amount of profit.
Dr James (13:05):
It's all about
managing costs.
It's so important.
Rida (13:09):
So important.
So people think.
People think, well, what is mycost?
It's not only about things thatyou buy.
It's about your gas, yourelectricity, your phone, the
number of nurses of.
You know the, the number ofspare nurses you have available,
the people that are doing therecalls, the people that are
checking the data on the systemto make sure that every patient
(13:29):
is coming in for theirsix-monthly checkup.
You know how are you analyzingthe data that you've got
available?
How are you utilizing that?
These are simple things thatprincipals need to look at as
well as investing in technologyright Right now, with everything
that's going on the new scannersystems, the AI that's
(13:49):
available that's going on thenew scanner systems, the ai
that's available that's behindit you have to invest.
Yes, initially the investmentsare high, but the return on
investment because what it does,it streams like in your patient
journey so that it goes throughsmoothly.
That patient journey you've gotto think of where is my patient
going to be parking.
You know that patient journey.
(14:11):
The more smoothly that you makeit, the easier it is for them.
The easier it is for them tocome into the practice, the more
likely they are to come in andthe bigger the treatments that
they'll come in to do, becauseyou've looked at the whole
patient journey very true, yeah,absolutely yeah, creating your
own in-house team.
(14:32):
You know you might not need alaboratory outside.
You might be able to do some ofthe work in-house yeah,
potentially you know that's thatcould be a humongous cost
saving because realisticallyit's about a third of the price
once you bring it in-house.
That's a big saving.
And then always renegotiate oncontracts.
(14:54):
Do not let anything justauto-renew, because, like any
business and any organization,like your car insurance, every
year it goes up.
It never goes down, does it?
They don't call you up saying,oh, we're going to reduce your
insurance this year by 10%because you've been a loyal
customer.
No, they're going to say we'regoing to increase it by 10, but
when you call up and yourenegotiate, they will reduce.
(15:17):
If you want, I can give youexamples of this right yeah,
let's do that, that'd beinteresting a basic example.
Um, I'm not going to give youthe client names or the supplier
names because I think it'sunfair sometimes, but so there's
a practice I went into andtheir sales were about half a
(15:38):
million for the year.
The supplier that they've beenwith for over I think it was 15
years this is their mainsupplier and they've been
working with them for 15 yearsand they say that they give them
the best service ever and thebest price is uncomparable.
I turned around and said okay,let's, that's fantastic news,
let's bring the rep in.
(15:59):
The rep comes into a meetingand I'm joining them into the
meeting and I was very open andtransparent, sat there in this
meeting saying guys, I'm here tomoderate between you as the
seller and you as the buyer andthe salesperson's like I'm very
confused.
The rep.
I said I'm here to defend youwhen you, when you give them
their prices, but I'm also hereto defend them for them to
(16:22):
negotiate a better price.
And I just turned around.
I said I know that you can givethem a 30 discount.
You have the rights withouteven going to your manager.
Is that correct?
That the rep turn around islike, uh, well, yeah, we have a
percentage that we can give.
And I was like, okay, what'sthat percentage?
Well, it depends on the item.
These are sales people.
They're always going to try andgive you the highest price
(16:43):
possible for them to increasetheir, because they've got
targets to me, they've gotcommissions to get as well, but
they also want to keep yourtrade.
So you've got to think likethem, what can I do?
What are you going to do backfor me?
So you turn around, you tellthem so this year we're
increasing the practice byanother chair, so we're
potentially going to be earningfrom two chairs to three chairs
(17:07):
another third.
So that's going to be anotherthird.
So that's going to be anotherthird of purchasing that's going
to be coming in.
So what are you going to do forme?
By me increasing my purchasingwith you, okay, so I left the
practice with them taking a 30%discount on all items and then
specific items 50% discount.
Wow, right, that's only becausewe sat there for an hour 22
(17:33):
minutes negotiating on what weneed regularly, so we wanted the
highest percentage of discounton those.
I think they gave us 12 itemsat 50 discount.
Wow, and the and the otheritems which they were getting
their standard.
You get your standard 10 ofeverything.
Because you are a loyalcustomer, we got that up to 30
(17:55):
so it's worth.
Dr James (17:56):
It's worth negotiating
right 100.
Rida (18:00):
Get the company reps in
spent.
I know you're taking an hourout of your earning time right
by you coming out of thepractice to sit down and
negotiate with a sales rep as aprincipal, which you might be
working in as as the principal.
Yes, you're making a loss forthat one hour.
You're not seeing a patient,but what you are doing is that
(18:20):
you're utilizing that one houronce every six months to see the
rep to find out what the dealsare, to get discounts, and
that's earning you more in thelong run than spending that time
with that one hour with apatient I mean that's gonna, I
mean it's a no-brainer, isn't itreally what you can save?
but, James, you say it's ano-brainer, but the amount of
practices that I've been in andthey've never seen the sales rep
(18:45):
is disgusting.
Yeah, it's, it's.
How can I say this?
It's not something thateverybody realizes how important
(19:06):
it is Because, as in universityand I've spoken to universities
about this I sat down with twouniversities and the discussion
they were having they were likewe don't want people to leave
the industry and open up apractice, we don't want them to
be business people, we want themto work on the NHS, we want
(19:26):
them just to churn out people.
But that's not what you are.
As a principal, even as anassociate, you've got to think
of the bigger picture.
How can I increase my earnings?
What can I do to develop myself?
And you need to invest inyourself.
Get yourself a business coach,get yourself people around you.
Make it, make a make.
A group of practice, principlesworking together well, there
you go.
Dr James (19:48):
That's a goodie.
That's a really useful oneright there, especially for the
principals out there.
Any more that you can think ofI remember there was you you
were telling me about there wasloads of ways that you can save
costs as a principal without, uh, realizing so anything along
those lines yeah, that's whereyour your expertise.
Rida (20:04):
Yeah, yeah, so so I've
touched on a couple of them.
So I mean, utility bills arehumongous um 100.
I mean I've saved people up to30 40k on utility bills are
humongous, 100%.
I mean I've saved people up to30, 40k on the utility bills
alone.
That's two salaries of twonurses.
Right, that's the easiest one.
Phone bills Do not signfive-year contracts.
(20:27):
Oh my God, the amount ofprincipals that sign a five-year
contract because somebodypromises them the world and then
doesn't deliver and they'retied into a five-year contract.
Do not waste your time signingthese phone deals with these
extortionate companies.
It's disgusting how people takeadvantage of dentists and yes,
it's called dental tax and it'sdisgusting how people abuse it
(20:49):
within the industry itself.
It really frustrates me andJames, you know me when people
take advantage of dentists, andjust in business, because people
are oblivious, they feel thatthey have the right to take
advantage.
Dr James (21:06):
It's disgusting.
What's an alternative to afive-year contract for a phone
bill for a dentist?
What should they be looking for?
Rida (21:12):
They should be looking for
a maximum of two years.
Yeah, maximum of two years,because within two years,
whatever happens that you canrenegotiate, there's going to be
a better system.
There's AI systems now outthere that inputs the data
directly into it.
It voice tracks them, ittranscripts the data.
There's so many other systemsout there and the thing is
always speak to three suppliers,never speak to one.
(21:34):
It's everything three suppliers.
The reason is is that once youstart comparing, you have a
comparable between the threesuppliers.
Then you know if you're gettinga fair deal or not.
If you're speaking to only onesupplier, they can tell you I'm
giving you everything in theworld, but it turns out you know
what.
They're giving you the worstdeal possible because they've
(21:56):
three times, three x'd it on theprice well, there you go.
Dr James (22:00):
If you don't know, you
don't know.
Okay, I'm loving these juicytidbits of hot facts.
Rida (22:05):
Is there any more along
these lines, any more big ones
see, the thing is, what you'vegot to understand is every
business is unique, James, right, and until you go in you're not
going to know.
For um, I went into a dentalpractice where this dentist was
mainly working on implants.
Right, and implants, you know,they take a while to do, right.
(22:26):
I turned around.
I said I said let's do a simplething, because you've only got
two staff in your practice.
He was working from a specialsystem.
I love the way that he works.
He doesn't have a receptionist.
You come in by appointment only.
The door automatically opensbecause he sends you a code for
you to enter into the building.
Dr James (22:46):
No way.
Rida (22:47):
You come upstairs so he's
like really reduced cost to the
next level, right.
So then you like really reducedcost to the next level, right.
So then you come in straightaway.
He welcomes you because heknows you've come in.
Once you put your pin code intothe bit as the alarm system
released the doors, he welcomesyou at the door, goes straight
in.
(23:10):
He used to have his lights on inthe corridor, in the toilets
and all of these other placeswhere he was wasting money,
because when he sat in the chairworking on this patient, he
normally takes two to threehours because he's doing several
extractions and doingeverything that he does and the
stitching and the surgical andeverything that goes along.
I just turned around and I saida simple thing get yourself a
motion detector a what, sorry?
A motion detector for thelights, so the lights are not
(23:31):
always on.
Saved him another 10 on hisutilities.
You know, it's just thosesimple things that are very
client-based, that you don'tknow, until you go and see the
practice, what you can save themlove that you know what stuff
like that is.
Dr James (23:47):
It's, it's not
anything that's you know, uh,
completely unheard of, but wejust never really get the time
to think about it, you know, orthe opportunity, because, wow,
we're just so caught up in thethick of it.
Rida (23:58):
Run the businesses any
more that you can think of in
your experience one last thingin general business and James,
you've done this and I know I'vedone this is book yourself some
time off as the principal,right?
You need some time off as theprincipal, right?
You need some time off from theworld, from the mobile phone,
from the rigmarole of thepractice.
(24:19):
Go somewhere where you've got acouple of books and then sit
down and contemplate what isgoing on in the practice.
What can you do to grow?
How can you grow the business?
How can you grow the team?
How can you grow yourself as aprincipal?
Because business, once you, yougrow the business.
How can you grow the team?
How can you grow yourself as aprincipal?
Because business, once you're inthe business, you're not
thinking about how to do it,you're dealing with the
(24:40):
day-to-day troubles.
So you don't have time tocontemplate, to think how can I
grow the business?
What can I do to elevate mystaff?
What can I do to motivate mystaff when you step out of the
business and I'm not telling youto go away for a month to think
about things three, four daysaway from the business for you
(25:00):
just to contemplate on how toimprove the business you know
the answers Most principals thathave been running a practice
for two years plus, know theanswers, but they just don't
have the time to think about itand come up with a strategy and
a plan of action.
And those three, four days two,three days of actioning,
planning and then coming backand actioning those plans
(25:23):
regardless of the resistance, isthe biggest important thing for
the business owners you knowwhat I'm just going to say one
thing on that.
Dr James (25:33):
It actually, whenever
I take some time out to do that,
what I sometimes do you knowthat little framework at the
very start that we talked aboutreducing costs, increasing the
number of people we serve,increasing the value I sometimes
draw that as a diagram on apiece of paper and then I just
do a little spider web like allthe ways that I can do these
three things, and then the bestones, I take them back the next
(25:54):
day and I use them, and that'swhy I love that little framework
.
And, as you say, until we takesome time out, that we've ring
fenced in order to ensure thatwe are actually working on the
business rather than in thebusiness, and thinking about
strategy from a high level usingthat little framework or
another framework that's outthere, well, we're just not
being as efficient as wepossibly can be, and that's why
(26:16):
it's so important to just takesome time away from the doing.
Rida (26:20):
You actually do make more
money in the long run James, I
mean, you've been, you were adentist for quite a long time,
right?
What would you, in yourpersonal opinion I'm to flip it
around here, I know you normallydo the interviewing I'm going
to flip it around for you onthis, on this occasion, right,
sure, from from your personalexperience, right, what made you
change and become the mostproductive associate?
Dr James (26:43):
I would say measuring
my numbers, because it all
starts from there.
You, you have no idea in whereyou can improve, in which areas
you can improve, unless you knowwhat your current output is.
So I would say actually that'sthe first step before anything
happens is to know your numbers,and that doesn't mean you have
to know them inside out, it justmeans you have to have some
(27:03):
semblance of what's going on.
The better you know them, theeasier it is to identify
opportunities.
So I would say that is the veryfirst step 100.
Rida (27:13):
And the next one for you
coaching and mentorship.
How was that for you?
Dr James (27:17):
amazing.
I mean, that's, that's the pathto all things good in life.
You know there's a saying thatI, like you, either pay with
time or you pay with money.
So paying with time to figureout these lessons can look like
maybe five years of you justtrial, trying things, trial and
error, uh.
Whereas if I can either paysomeone formally or I can get to
(27:40):
know someone, spend some timewith them, that's going to speed
that journey up.
That's going to turn afive-year journey into a
six-month journey.
Well then that means I've gotfour and a half years to benefit
from that knowledge that Iwould have had to wait for a lot
of time for before otherwise.
So if I can get the knowledgesooner, it means I can implement
it sooner and benefit from itsooner, and then I can just go
(28:01):
off and learn other thingssooner as well.
So you can cram 50 years oflearning into five years instead
of five years of learning, allbecause you listen and you have
an open mind.
So mentorship is massiveno-transcript.