The Beacon-Podcasting for Dentists

David Darab, DDS, MS, MBA

The Beacon, sponsored by OmniStar Financial Group, provides Business Strategies, Tactics and Insight for Clinical Practices. Our goal is simple; provide actionable knowledge and insight curated from the industries top performers to illuminate blind spots and accelerate your practice growth. If you are ready to add rocket fuel to your practice, tune in here!

  1. 03/30/2021

    Think Stronger- Know Your Cognitive Biases (EP23)

    Welcome, You are here at the Beacon! I am your host David Darab…prepare to have your Blind Spots Illuminated! So…It’s very appropriate, since our Team here at OmniStar Financial and Dental Systems Optimization are Experts in Blind Spots, that we devote this episode to Cognitive Biases which create Blind Spots. Let’s kick off our discussion with a quote from one of my favorite thinkers, Professor Richard Feynman, A theoretical Physicist, Exceptional Teacher, and Contributor to the Manhattan Project. > “The first principle is that you must not fool yourself and you are the easiest person to fool.” > Richard P. Feynman It is possible for people to be confused or unaware about something rather important.  The fact that most people don’t know they are missing it doesn’t make it any less of a problem for them or their practices. This is the best definition of a  Blind Spot! For those of us that remember the movie City Slickers,  you may recall the main character played by Billy Crystal,  went out West with his friends to find themselves during a midlife crisis.  There he meets his guide, Curly, played by Jack Palance, a rough and leathery cattle rancher that will show them all a thing or two.    Curly teaches them about the “one thing”, the secret of life that everyone must figure out for him or herself! Well, we all have “one thing” that we carry around that is unique to us, and it too is so very important to figure out.  This one thing is with us at all times, at every twist and turn life throws at us.   Every time we are facing a challenge or problem that requires us to make a decision this one thing is there, hiding silently, but contributing loudly to our choices, direction, and decisions…that one thing is our Cognitive Bias.  It is unique to each one of us.  If we are not aware of its presence or its powerful influence it creates Blind spots.   A blind spot is something that is critically important even though we are unaware of it.   The fact that you don’t know you are missing it doesn’t make it any less important.  In fact, because you are unaware it becomes even more important. Here at OmniStar, it’s our Tag Line “Illuminating Blind Spots”.  We consider it Job #1 to help you find, Illuminate and see your Blind Spots!  It’s what we do because you can’t see your blind spots alone. “We see what you are incapable of… that's what we do.” David Darab, DDS, MBA Cognitive Biases affect how we make everyday decisions, big and small as well as how we think about and invest our money and create our wealth. A cognitive bias is an error in cognition that arises in a person’s line of reasoning when decision-making is flawed by personal beliefs. When the Bias is unseen by the individual but seen by others, it is a Blind Spot. The Cure here is recognizing and acknowledging that they exist.  Once you become aware of these Cognitive Biases they are no longer Blind Spots. I am subject to this, as I bet you are too, in the areas of clinical practice, business decisions as well as finances and investing. I tend to “cubbyhole” things, giving a lot of weight to my time in the business.  I think to myself…I have done this for 30 years, I have seen everything, I should be good to go!  But that is not always the case.  Just because it looks the same doesn’t make it the same.  I can still find myself in “the ditch” when I overlooked a small feature or minor detail that has snuck up and “bit” me.   So let’s dig deeper here. Let’s Illuminate for you what Cognitive Biases Exist so they will be less likely to create Blind Spots! Understanding Cognitive Biases first starts with understanding Heuristics. So what are Heuristics?? Heuristics are mental shortcuts that ease the cognitive load of making a decision, we use them all time. … Examples of heuristics include rules of thumb,  an educated guess, or been there and done that! When considering the term “Cognitive Biases”, it’s important to know that there is an overlap between cognitive biases and heuristics.  At times these two terms are used interchangeably but they are not exactly the same. In his book, *Thinking, Fast and Slow*,  Professor Daniel Kahneman defines heuristics as “a simple procedure that helps find adequate, though often imperfect, answers to difficult questions.” He also defines the relationship between Cognitive Biases and Heuristics as follows: “… cognitive biases stem from the reliance on judgmental heuristics.” Putting this together we see that… Heuristics are the “shortcuts” we use to reduce complexity in judgment and choice, Cognitive Biases result from the gaps between what “should be” and the Heuristically determined behavior. According to the Cognitive Bias Codex, there are an estimated 180 cognitive biases.  This codex is a useful tool for visually representing all of the known biases that exist to date. The biases are arranged in a circle and can be divided into four quadrants. Each quadrant is dedicated to a specific group of cognitive biases: 1. What should we remember? Biases that affect our memory for people, events, and information 2. Too much information Biases that affect how we perceive certain events and people 3. Not enough meaning Biases that we use when we have too little information and need to fill in the gaps 4. Need to act fast Biases that affect how we make decisions Cognitive biases can have a devastating effect on our business decisions as well as decisions relating to personal finance and wealth.  At OmniStar we are experts at Illuminating Blind spots, so let’s take a look at what these Cognitive Biases are.   Because…as it is said… What has been seen cannot be unseen, what has been learned cannot be unknown. There are over 40 cognitive biases that negatively impact our ability to make sound financial decisions.  I won’t bore you with an exhaustive list, but let’s hit some of the most common ones and see if any of these might ring a bell, and possibly be hindering your decision making ability. Some of these biases include: Overconfidence Bias Is when confidence in our own judgment is greater than the objective accuracy of those judgments.  It results from someone’s false sense of their skill, talent, or self-belief.  It can be a dangerous bias and is very prolific in finance and business. The most common signs of overconfidence include the illusion of control, timing optimism, and the desirability effect, the belief that something will happen because you want it to. Self Serving Bias Self-serving cognitive bias  is the propensity to attribute positive outcomes to skill and negative outcomes to luck.  In other words, we attribute the cause of something to whatever is in our own best interest. Many of us can recall times that we’ve done something and decided that if everything is going to plan, it’s due to skill, and if things go the other way, then it’s just bad luck. Herd Mentality Herd mentality is when you blindly copy and follow what your friends, colleagues, and peers are doing.  When you do this, you are being influenced by emotion, rather than by independent analysis. Loss Aversion Loss aversion is a tendency for investors to fear losses and avoid them more than they focus on trying to make profits. Many investors would rather not lose $2,000 than earn $3,000. The more losses one experiences, the more loss averse one likely becomes.  It is common for both professional and amateur investors to hold on to losing investment positions for too long, whilst selling winners too soon. > “In human decision-making, losses loom larger than gains.” > Kahneman and Tversky Framing Bias Framing is when someone makes a decision because of the way information is presented to them, rather than based just on the facts. In other words, if someone sees the same facts presented in a different way, they are likely to come to a different conclusion about the information. You may choose to purchase capital equipment, buy a car, or purchase an investment depending on how the opportunity is presented to you. Anchoring Bias Anchoring is the idea that we use pre-existing data as a reference point for all subsequent data, which can skew our decision-making processes.  If you see a car that costs $75,000 and then another car that costs $30,000, you could be influenced to think the second car is very cheap. Whereas, if you saw a $5,000 car first and the $30,000 one second, you might think it’s very expensive. Confirmation Bias Confirmation bias is the idea that people seek out information and data that confirms their pre-existing ideas. They tend to ignore contrary or conflicting information. This can be a very dangerous cognitive bias in business and investing.  Using confirmatory bias, we tend to search for, interpret, and remember information in a way that confirms our existing preconceptions. This unconscious bias makes it possible to miss findings or ignore evidence that could otherwise change our view. Hindsight Bias Hindsight bias is the theory that when people predict a correct outcome, they wrongly believe that they “knew it all along”, which falsely inflates their confidence for future decisions. The Curse of Knowledge Bias When knowledge of a topic diminishes our ability to think about it from a less-informed, but more neutral, perspective.   I call this… “You don’t know what you don’t know paradox!” or,  “a little knowledge can be dangerous” bias. Blind Spot Bias Demonstrated when we think we’re less prone to cognitive bias than those around us.  People see themselves differently from how they see others. They are immersed in their own sensations, emotions, and thoughts while at the same time their experience of others is dominated by what can be observed externally. Information Bias Sometimes we tend to seek information even when it does not affect action. Better decision

    Think Stronger- Know Your Cognitive Biases (EP23)
  2. 02/23/2021

    Scheduling...Are You Hitting Your Target? (EP22)

    This episode will take a look at your schedule, most importantly how to make your schedule hum with productivity and not business! Let’s start with a quote from Stephen Covey…we all know him from his best-selling books,  The 7 Habits of Highly Effective People, First Things First, and Principle-Centered Leadership. Stephen says… "The key is not to prioritize what's on your schedule, but to schedule your priorities." I, you, we are constantly bombarded by marketing messages vying for our attention and clicks. These are commonly presented with email subject lines like the following I received over the past week… * How to help your practice emerge from the Pandemic… * Dentists' biggest practice challenges… * Steps to Take for an All-Star Practice… * Positioning your practice for Growth… * How to Turbocharge your Practice… * Marketing Ideas that will take your practice through the roof… Our Team here at OmniStar  DSO is all about "Simplifying the Complex!" I can think of no better or more productive area to focus on than your Scheduling Framework or Template.   Our Subject line will be… Scheduling…are you hitting your Target? Get your scheduling meme right, and everything else will flow. Yes, there are many essential and critical KPIs to monitor and track; we coach and teach our clients.   The beauty of designing a scheduling framework is that it is easy to tell how well your Team is meeting spec.  If your block booking is set up correctly,  it should be obvious how well your Team is doing just by looking at the scheduling screen on your computer. Yes, there are other important tasks and goals your practice must monitor and achieve.  You must collect patient payments, keep receivables low, manage your employees, control operational and administrative expenses along with clinical supply costs.  And last but not least, you must provide exceptional dentistry. With that said, getting your scheduling dialed in should be a high priority. For me, “dialed in” means…having all of your chairs full with the optimal mix of ideal procedures, patients, and treatments. Let's work through some Scheduling Axioms that we use in my practice and coach our clients on. Remember, get your scheduling meme right, and everything else will flow. I use the following Axioms as my scheduling foundation.   Axiom 1: Being Busy is NOT the same a being Productive. Busy people; work at a frantic pace, are rushed, work harder, micro-manage, are fueled by perfectionism, multi-task, prioritize simple and mundane tasks and say "yes" by default. In contrast, Productive People; prioritize the most important tasks, work at a steady pace, are relaxed, work smarter, are fueled by purpose, focus on essential and complex tasks, delegate the simple, mundane, and repetitive tasks, and can say "no". Remember, it's ok to say "no." You are not the Coast Guard or US Military; you do not have to go out and rescue everyone.  “Stay in your lane,  bro…” as the AT&T commercial says. along with “Just Ok, is not Ok!” With these ideas in mind, one can begin to see that a jam-packed schedule may or may not be a productive schedule.   So let's get productive… Axiom 2: Prioritize your Schedule for Productivity Categorize and colorize your new patient exams, consults, and procedure mix on your schedule.  Determine for yourself what your ideal procedure mix is.  This will be different for everyone.   What do you enjoy most in your practice? There should be lots of time for these appointments.   What do you enjoy least? There should be very little time, if any, for these procedures on your schedule.  As you become busier, these may be procedures you will refer out or cease performing completely.  Remember from Axiom #1- it's ok to say "No." Let's make some business comparisons to help drive home this point. Your New Patient Exams, Consults and Treatment Presentation appointments are like Inventory in a manufacturing or merchandising business.  It is an Asset waiting to be converted into a Product, your Dentistry.   Your Procedure or Treatment Schedule is analogous to your Production Line, where you covert that asset into your dentistry, and in the process generate revenue. If your Inventory of New Patient Exams, Implant Consultations, and Treatment Presentations is low,  your conversion of these assets into Implants, Crowns, and Bridges, or Restorations will be low too. Put another way… You can't schedule the production if you don't schedule the patient exam. So, you need to balance the availability of a precise mix of new patient exams and treatment presentations to keep your treatment schedule full. It's a balancing act; too many new patients will delay care without sufficient treatment appointments, keeping patients waiting.  If patients have taken the time to visit you and your office, they are highly motivated. Please don't make them wait! A sidebar here…the lag time between diagnosis and treatment is a critical KPI.  As this time lengthens, the practice owner may consider expanding hours,  expanding the physical plant, or adding a provider. This can be a Blind Spot for a practice owner.   A Profit Leaks Analysis by our experienced Team at OmniStar DSO can help identify if you have a bottleneck in your practice that needs to be corrected. Axiom 3: Rocks, Pebbles, and Sand Time is a finite resource.  Use a Block Scheduling Framework to allocate your time and schedule.  I like to use the Rock, Pebble, and Sand analogy when designing a maximum productivity schedule. Rocks are your anchors, your most enjoyable, productive, and profitable procedures.  These will tend to be longer appointments.  They should be added to your schedule first and always have the highest priority.  These treatments should be scheduled at your most productive time of day.  Remember, this is unique to you.   Your Rocks are the cornerstone of meeting your daily production goals. After Rocks comes Pebbles, smaller, more limited treatments with shorter appointment times that are used to fill in around your Rocks. Finally, add the Sand; short appointments, post-op checks, limited emergency exams, and very brief restorative appointments.  These are scattered to fill your gaps between the Rocks and Pebbles. Sometimes it helps to think of Rocks, Pebbles, Sand in reverse.  If you start with the Sand, you will never add enough Pebbles and Rocks to make for a productive and profitable schedule.  You will have created BUSY, but NOT productive and violated Axiom #1- Being Busy is NOT the same a being Productive. Next… Axiom 4: Block Opportunity and Emergency Time into your schedule every day. I want my schedule to be on autopilot.  I do not want to be tracked down in a treatment room or in a hallway, or at my desk and asked what to do with a patient or referring office that is on the phone.  After all, I have hired people who should be scheduling for me.  I have found that "on the fly", “in the hallway” and "armchair" scheduling is not productive.  It is paramount that you empower and train your staff exceeding well, and hold them accountable so that they can make these decisions for you.  They will know and should know, more about the schedule than you.  Your scheduling staff should be the ones micromanaging this.   When they do make sound decisions and hit the Bull's Eye with a full and productive day, make sure to praise and recognize them for their achievement.  After all, it will not happen every day.   The one thing that can throw a monkey wrench into the best schedule is Emergencies and Urgencies, so we must plan for these eventualities.  These are excellent sources of new patients and new referrals for your practice and should be accommodated.   To make this easier for all, earmark the best time slots for these patients on a daily basis.  This can be determined in your morning huddle, where open slots for emergencies can be identified.  Bingo, they no longer have to ask you!  Let’s get these patients in and triaged. A side note here.  As a specialist, I recommend that our referring dentists see their emergencies immediately before and/or after lunch.  If a referral is needed, there is still time in the day to accomplish that. The veritable 4 pm emergency slot will unlikely have time to be seen by you, referred, and treated by a specialist that same day.  There is nothing more frustrating for everyone; the patient, the referring dentist, and the specialist to have to appoint an emergency patient the next day.   Finally, in addition to emergencies, identify an opportunity slot every day.  This can be a highly productive treatment and one that you enjoy.  For our oral surgery practice, we will always have time to see a patient with a painful, infected wisdom tooth; that's what we love to do! And last, but not least… Axiom 5: Keep Score If you don't measure it, you can't manage it…especially your schedule. I know there are countless reports your Practice Management Software can print out to monitor your scheduling.   By the nature of reports, they are historical.  The schedule is so critically important that I monitor it daily. I prefer a real-time assessment and visualization of our scheduling efficiency.  To accomplish this, I do the following. Daily, the doctors, and our administrative staff scan the schedule several days ahead, identifying available appointment times at each of our locations.  If one location is booked full, they are aware that appointments can be scheduled in the other locations. Next, I briefly meet with my Treatment Coordinator at the end of every day.  I want a summary of every new patient; did they schedule? do they need to check with family? do we need to verify a secondary insurance? do they need to apply for Care Credit? If they did not schedule and treatment was recommended, there is a follow-up plan for each patient.  We start by doing whatever we told them we

    Scheduling...Are You Hitting Your Target? (EP22)
  3. 01/12/2021

    Decide to Act for the New Year (EP21)

    Welcome… You are here at The Beacon… So glad you found us… I am David Darab, your host for this episode. Prepare to have your Blind Spots Illuminated   “To begin, begin.” said William Wordsworth. Let’s do that and get started. It’s the New Year, 2021…Happy New Year to You!  We are all excited to see 2020 end, and our hopes are that the countless challenges we faced last year will soon come to an end too! The New Year is a time of reNEWal, time for a fresh start, and a time to reset, recalibrate, and recharge.  It is also a time we are constantly reminded about our New Years Resolutions.  Seems  that we can’t say New Year’s without adding the Resolution part too.   Every year we pass this same threshold with the same hopes and desires for the year ahead. What will you do??…do you have a plan?? Will you offer up some recurring laundry list of New Year’s Resolutions like you may have done many times in the past; I’ll go first… - lose weight - workout more - eat better - work less - spend more time with your family - save more - spend less - read more books - watch less Netflix - etc, etc, etc….   I can’t  help asking you, “How’s has your plan been working for you?”  You getting things done? You Moving your needle? You Accelerating? Are you Reaching your Goals? If your response was not a resounding  YES, You are not alone.   The experts tell us that half of all adults make New Year’s Resolutions, but less than 10% follow through on their goals each year.  In reality, by Valentine’s Day, you may find yourself in the same “rut” as before. Fighting these poor odds and without a better strategy I gave up on New Year’s Resolutions years ago. The Truth is … Resolutions don’t work. Action does. I anticipate if you are like me, you know deep down, in your heart of hearts, that you could do better, achieve more, and become a better version of yourself. During these first weeks of the New Year Social Media and the Internet, heck…even my PodCast here… will have expert after expert share their guidelines, rules, hacks, shortcuts, and strategies for achieving more. How about, for a change, instead of getting burdened with lists, journals, apps, processes, and other people’s ideas, we just Resolve to do One and only One Thing. Act… Let’s make a New Year’s Resolution to Decide to Act this year!  Let’s put aside all of our thinking, prioritizing, researching, and list-making and exchange it for one simple task… to Act! Of course, Simple does Not mean Easy! We are all very intelligent, with lots of knowledge of the things we know we should do.  Just look at the list you create each year. I hate to break it to you, but Knowledge is the Easy Part… We all know that to lose weight we should eat better and become more active… We all know that to grow our Wealth we should spend less and invest more… But knowing is the easy part…taking Action is the hard part, that’s why it is so challenging to achieve and so easy to come up short year after year. This point is key and worth repeating… Knowledge is the Easy Part, Action is the Hard Part. It is your Action that leads to the Change you wish to make. The Words “Resolution” and “Goal” are Nouns, not Verbs. While the Words “Decide” and “Act” are Verbs defining Action. I like to use the acronym D.A.T.E…D…A…T…E for D.ecide to A.ct T.oday and E.veryday So…why is taking Action so very Hard? Why is it so hard to 1. Decide and 2. Act? Let’s dig deeper here and go down a rabbit hole, deconstructing this process so you can understand better the challenges and roadblocks to Action. Once this is understood,  it easier for you to conquer. I’ll take it for granted that those listening here are all high achievers, driven, competitive, and highly successful.  We want and demand the very best from ourselves.  We are, at most times, our staunchest critic.  Failure is not an option, nor something we tolerate or enjoy, after all, we are “Perfectionists”.  But alas, there is no such thing as Perfection.  A belief in Perfection is in fact a defense mechanism.  Waiting for Perfection gives you a way out, it gives you an excuse.  It lets you stall, it requires you to do more research, to think some more, and avoid doing anything that might possibly fail.  Because as we just said, failure is not an option…especially for a perfectionist. But, and here is the kicker…with the risk of failure, comes an even greater reward…the reward of success, of accomplishing something important, of creating the change we so desperately need, want, and desire. There is an irony here…we want one thing, yet do another… Does any of this sound familiar…does it sound like Resolutions, Rationalizations or Goals not achieved…??!! The contradictions never end. Why is it so difficult to do what we say we’re going to do? The answer is …as Seth Godin says, our “Lizard Brain”, or as Steven Pressfield calls it,  “The Resistance”, our Inner Barrier. The Resistance is that little voice in the back of our head telling us over and over to back off, be careful, go slow, watch out, this is risky, compromise.  The Resistance grows stronger and stronger the closer we get to achieving what we really want, the closer we get to Action.  That’s because the Lizard Brain, or amygdala, that pre-historic area of our brain stem,  hates change, hates achievement and risk.  After all, it is the amygdala that is responsible for our fight or flight response.  It is there to protect us, and it acts even without us knowing. So, we have decided to Act in order to achieve our goals, but for many, just as we are on the verge of action our primitive Lizard Brain, this Resistance,  beckons us louder and louder to hold back.  It is much like the effect Krypotite has on Superman…the closer he gets… the weaker he becomes. So… How do we Slay and conquer this Resistance, this Lizard Brain, this Inner Barrier, the Amygdala you ask?? We slay it by Turning Pro, as in Professional, and leaving our Amateur ways behind us. Let’s consider the differences…as described by Steven Pressfield in The War of Art (a great read see the show notes for a link). An amateur plays for fun, a Pro Plays for keeps. To the amateur the game is his avocation, to the Pro, it’s his vocation. The amateur plays part-time, the Pro full-time. The amateur is a weekend warrior, the Pro is there seven days a week. The amateur attempts perfection, the Pro achieves something remarkable. The amateur delays and procrastinates, the Pro Decides and Acts. The Resistance hates it when we turn Pro. So… for this New Year’s Resolution let’s try something different.  Let’s show up every day, no matter what, and decide to do act.  Because we now know that no matter how small each act might appear, it is facing your Lizard Brain head-on and completing what you started that is most important.  Each small act taken together builds on the one before allowing us to achieve our goals and move our needle.   With each achievement, we grow stronger and more confident and The Resistance,  your Lizard Brain, that Inner Barrier gets weaker and weaker. Now that you understand better what may have been holding you back, what are you going to do about it? What new decisions and actions will promote your progress? Are you starting them today? Too often, we schedule a time to adopt, embrace, and initiate better habits in the future. “I’ll start tomorrow, or next week, or next month, or whenever.   We now know those are simply excuses. Yes, I know, Biology, evolution, and past failures are all conspiring against you.  It doesn’t matter. The solution to launching a better way of being is easy.  Simply Decide to begin.  Decide to Act. In the final analysis, it comes down to your willingness to decide that today is the day, and now is the time to begin. The time to take your first small step into your potential. Every day you can decide to do things better, or do things worse.  It’s your choice. So… Let’s review… New Year’s Resolutions don’t work…Decisions and Actions do! You now know that biology and evolution, create an Inner Barrier, a Resistance called your Lizard Brain, powered by your amygdala, which has thwarted your efforts in the past… You are now armed with a strategy to conquer this force…Action! The more you Act the easier the next Action becomes… And finally, I’ll end with a quote from Walt Disney… ”The best way to get started is to quit talking and begin doing.” So that wraps things up for this Podcast.  We hope that this information has created a few “Ah-Ha” moments to help you make great things happen this year.   Please share this podcast if you found it helpful, and leave a review on iTunes too.  We welcome your feedback and suggestions for future podcast sessions.  You can always find me, your host, David Darab, at my Twitter handle, @ddarab. Thank you so very much for tuning in and listening.  We are very grateful for your time and attention and so very pleased to have you in our audience. We wish you a happy and healthy New Year. _______________________________________________________________________ REFERENCES The Practice; Seth Godin https://www.amazon.com/Practice-Shipping-Creative-Work/dp/0593328973/ref=sr_1_1?dchild=1&keywords=the+practice&qid=1610296940&sr=8-1   The Art of War; Steven Pressfield https://www.amazon.com/War-Art-Through-Creative-Battles/dp/1936891026/ref=sr_1_2?crid=26SF519HT8RPB&dchild=1&keywords=the+war+of+art+by+steven+pressfield&qid=1610297028&sprefix=the+war+of+%2Caps%2C189&sr=8-2

    Decide to Act for the New Year (EP21)

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About

The Beacon, sponsored by OmniStar Financial Group, provides Business Strategies, Tactics and Insight for Clinical Practices. Our goal is simple; provide actionable knowledge and insight curated from the industries top performers to illuminate blind spots and accelerate your practice growth. If you are ready to add rocket fuel to your practice, tune in here!