660: Is Quality Scalable in Dentistry? - Dr. Christian Coachman & Dr. Tal Morr

Have you faced the dilemma between seeking financial growth and also keeping high clinical quality? It’s something dentists, both seasoned and novice, consider often. Can quality really be scalable? Learn more about these two paths in Episode 660 of The Best Practices Show!

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Links Mentioned in This Episode:

Learn more about Digital Smile Design https://digitalsmiledesign.com/

Register for DSD Residency 1 https://digitalsmiledesign.com/education/attend-a-course/dsd-concept-level/dsd-residency-1

Learn more about Tal Morr https://www.tmprosthodontics.com/

Main Takeaways:

You can take one of two paths: the highest quality or just practicing. 

The size of your practice not only has an effect on a clinical level but it has an effect on the customer service. 

Identify where you can differentiate yourself and build the model that will leverage the best side of yourself.

There’s no right or wrong. There’s no correct path. It’s ultimately what you define as your ultimate goal. 

Quotes:

“I think as a young dentist the first decision you need to make is what is your ultimate objective, because there really are no right and wrong. There are 2 paths you can take: there is the path you can take of trying to achieve the highest quality or there’s the path of just practicing, building the quantity of patients that you have…and making your patients happy. Ultimately you have to make that decision. Because what I’ve always told the young people that I speak to, I said ‘If your objective is to build your name and build yourself as one of the top clinicians, everything you do is a reflection of you.’ Meaning, when I started every filling of mine was perfect, every crown of mine was expensive and one perfectly. And I remember when I first started, I worked for a guy and he said ‘you’re freakin crazy…you spend way too much time on the patient. You spend way too much money on the technician. You’re too picky.’ But what happened was everything I did became representative in my community. How? Because my patients would go to see other specialists, they went to see other dentists and they said ‘wow, who did this?’...and I built my reputation that way.” - Tal (3:41—5:26)

“There are two ways to grow. One is to see more people, have more dentists, and just do volume. And the other is to increase your pricing…how do you get to the place where you can increase your pricing? It’s based on building your reputation as one of the top people. But you’re right, it has a ceiling.” (9:48—10:37)

“[I’m raising my pricing for two reasons] One is obviously to be compensated for the effort and time and experience I invest. And the second is to…I tell patients I’m not for everybody. My patients say ‘Why are you so expensive?’ And I said ‘You know what? I’m not for everybody but if you want me to give you my hearts and my soul - which I do for every patient - that’s what it’s going to cost you.’” - Tal (10:48—11:20)

“Now where is the fine line? I believe there are different personalities in dentistry. For me, I’m a control freak. If I expand too much - I have an associate, by the way - then I’m trying to control the situation and I can’t with one associate. So that, in a sense, is stress for me. And I don’t need more stress in my life…As you expand and as you grow, as you bring in more people there is much higher stress. There is less control. It’s just another animal…that’s why for me that’s not even an option for me…Now what is the negative of that? My practice is built on me…people come here for me. What I should have done, a huge mistake that I made, was in the beginning I should have brought someone with me. I should have had associates. I should have trained them so we would grow together as a unit, then you can multiply…You’re either going to be able to do it or you’re not. ” - Tal (11:24—13:17)

“Let’s do an X-ray on your practice. How many dental chairs do you have?” - Christian

“I have 4 dental chairs” - Tal

“Dentists you said is you and one other associate. How many assistants?” - Christian

“I have 3 assistants…and I have 2 hygienists. But my hygiene isn’t like a regular dental practice because my volume is lower. I have 1 front desk and I have my wife who does the bills.” - Tal

“That’s the model. As lean as it can be.” - Christian

(13:54—14:59)

“This is the thinking process that I’ve been having with myself since 5, 6, 7 years. I’ve been teaching dentists on how to grow. On how to multiply. On how to scale. On how to delegate. But if I had to pick a dentist to do a full mouth rehabilitation, where would I go?”  - Christian (15:17—15:40)

“I call your type of practice a 3 star Michelin. It’s a very good comparison with restaurants…You cannot grow. It’s impossible to control the quality. It depends on the superstar Chef and the superstar Chef will maybe try to make more money opening a franchise with a different name, etc. But that Michelin only gets the three stars because that Chef is in charge every single day, doing over and over again and making sure the quality is exactly the same.”  - Christian (17:59—18:40)

“I’m working more now than I’ve ever worked before…I’m booked out for 3 months. So it gets to the point where I cannot accept new patients. So my associate benefits from that because she can see the new patients. But I’m involved in the initial evaluation with the patient. I introduce myself. I examine the patient. She comes and tells me what’s going on to help guide her and explain in deep detail to the patient what the findings are…as far as delegating, my girls do all the impressions, digital, CBCTs, scans, all the information that I need.” - Tal (19:32—20:58)

“You mentioned the only way that you can grow financially is raising your fees right? The other way is increasing your average ticket price right?” - Christian

“Yes. So because I was sending so much out, because I was losing so much control, I started doing my own surgeries probably 15 years ago. So now I have full control…I do everything except very complex cases that I don’t want to be involved in. I send out. I have good relationships with surgeons. They sometimes even do large sinus lifts for me and I place the implants. Because we have an understanding of what we are capable of doing. And I can control the whole case much better that way. And financially it’s much more lucrative” - Tal (28:33—29:30)

“I’ve achieved what I wanted to achieve, but I’m limited. I’m only one person. Sometimes patients forget that. It’s difficult. It’s difficult to manage, but I don’t think I’d do it any other way. I don’t think my personality will allow that.” - Tal (34:42—35:03)

“As young as possible, you need to identify who you are and what you can do the best. And you started the conversation with something like ‘When you start as a young dentist you need to define what you want to become.’ It’s like in diagnostic dentistry. You start with the wax up with the end in mind and you reverse engineer the treatment plan. With the career, it’s the same. As young as possible identify your strengths. Identify where you can differentiate yourself and build the model that will leverage the best side of yourself.” - Christian (35:16—35:57)

“There’s no right or wrong. There’s no correct path. It’s ultimately what you define as your ultimate goal. And everybody has an ultimate goal.” - Tal  (36:06—36:17) 

“Quality in dentistry is not scalable and every time you grow a little bit you end up always compromising that gold standard at least a little bit.” - Christian (39:43—40:00) 

Snippets:

0:00 Introduction.

3:41 Two paths of quality.

9:48 Two ways to grow. 

11:24 Finding the line of quality.

15:40 How the size of the practice affects quality. 

19:08 Delegating with affecting quality.

28:00 Partnerships and keeping quality control.

29:00 The downside of an individual practice.

37:07 Final Thoughts.

Dr. Christian Coachman Bio:

Combining his advanced skills, experience, and technology solutions, Dr. Christian Coachman pioneered the Digital Smile Design methodology and founded Digital Smile Design company (DSD). Since its inception, thousands of dentists worldwide have attended DSD courses and workshops, such as the renowned DSD Residency program.

Dr. Coachman is the developer of worldwide, well-known concepts such as the Digital Smile Design, the Pink Hybrid Implant Restoration, the Digital Planning Center, Emotional Dentistry, Interdisciplinary Treatment Simulation, and Digital Smile Donator.

He regularly consults for dental industry companies, developing products, implementing concepts, and marketing strategies, such as the Facially Driven Digital Orthodontic Workflow developed in collaboration with Invisalign, Align Technology.

He has lectured and published internationally in the fields of esthetic and digital dentistry, dental photography, oral rehabilitation, dental ceramics, implants, and communication strategies and marketing in dentistry. 

Join Dr. Coachman on Facebook https://www.facebook.com/christiancoachman

Follow Dr. Coachman on Instagram https://www.instagram.com/chriscoachman/

Dr. Tal Morr Bio:

Dr. Tal Morr, a dentist in Miami, Florida, is the owner and founder of TM Prosthodontics. He is a specialist in aesthetic, implant, and complex restorative dentistry. After graduating from the University of Florida with a BS degree in microbiology, he continued his education at Tufts University School of Dental Medicine where he graduated Summa Cum Laude with a DMD degree. He went on to study at the University of Washington School of Dentistry where he received his Master of Science in Dentistry (MSD) and a certificate in Prosthodontics.

Dr. Morr has over 24 years of experience in prosthodontics, the diagnosis and treatment of the deterioration of teeth and their supporting structures. He is known for his comprehensive treatment approach as he formulates and executes treatment plans that address not only the mouth, but also the face and jaw.

Dr. Morr has numerous publications in both textbooks and articles in the areas of aesthetics, porcelain laminate veneers, dental implants, and complex restorative dentistry and rehabilitation. He is a highly regarded speaker and educator both nationally and internationally. He is considered a leader in the field and highly regarded for his contribution to the field of dentistry. 

Join Dr. Morr on Facebook https://www.facebook.com/TMProsthodontics/

Follow Dr. Morr on Instagram https://www.instagram.com/talmorr/