Learn the SECRETS of the best dental practices with Kirk Behrendt, CEO of ACT Dental, through interviews with leaders in the industry.
What Holds You Back in Dentistry & Sleep with Dr. Erin Elliott
What Holds You Back in Dentistry and Sleep?
Episode #292 with Dr. Erin Elliott
Maybe you want sleep and airway in your practice, but you’re feeling held back. Today, Dr. Erin Elliott returns on the topic of airway with advice on how to get started! Kirk Behrendt and Dr. Elliott talk about the most common obstacles dentists face and the best practices on how to overcome them. For tips on positive thinking, staying motivated, and having confidence in your work, listen to Episode 292 of The Best Practices Show!
Don't let medical billing be a roadblock to doing sleep in your practice.
Fear of being sued shouldn't stop you.
Avoid thinking about the “what-ifs" — most of those fears never happen.
Have confidence in your work. Don't let imposter syndrome hold you back.
Learn how to communicate and talk to your patients and team.
Always think about what's best for your patients.
Don't try to do it all — delegate.
“Complexity is the enemy of implementation. And dentists do one thing really well, is overthinking and making things more difficult than they need to be.” (04:29—04:40)
“I recently took a poll on the forum that I mentor on from people that have attended the course, ‘Why are you not doing as much sleep as you want to?’ And number one was medical billing.” (05:35—05:49)
“If you take care of the patient and do what's best for them — there are some jerks in this world. But to get to the point where you're sued, legally, it’s standard of care. And it’s also clinically acceptable work — you won't get sued. They have to have an expert witness in order to win. Ask me how I know, because I had to go through the process.” (09:21—09:45)
“You do feel like you're behind the ball all the time. And then, of course, people only post their most amazing work, and you're like, ‘Man, I am a crappy dentist,’ when really, you're getting patients out of pain, you're restoring their smile, their function. You're doing everything well, [but] you always feel like a failure. So, you've just got to get out there.” (10:48—11:11)
“Don't start expecting physician referrals if you don't even know what to do with a patient when you get them.” (22:42—22:47)
“It’s really the team that gets things going, and I think we don't utilize them enough.” (27:37—27:40)
“Stop being nice. It doesn't mean not to be nice, but it means that people are okay with you leading them. And it’s not being a jerk to have certain expectations that you expect them to meet. And if you have to correct them, they have given you permission just by being your employee.” (33:59—34:24)
“Just know that: (1) you know what you're doing; (2) you won't get sued; (3) take care of people, [and] you'll find satisfaction in your job.” (45:00—45:06)
Dr. Elliott’s background. (02:53—07:18)
Don't let your fears stop you. (08:09—12:06)
Don't let imposter syndrome hold you back. (12:59—14:41)
Have your “why” to keep yourself motivated. (15:21—16:19)
You can't do everything yourself/the champion concept. (17:07—21:13)
Other obstacles holding you back from doing sleep in your practice. (21:35—24:35)
Mistakes made and lessons learned. (25:46—27:45)
Have confidence in leading your team. (28:31—32:11)
Heidi vs. Howard study, and the origin of the word “nice”. (32:11—39:30)
Don't be easily defeated. (40:02—41:16)
Dr. Elliott’s sleep courses. (41:33—43:03)
Dr. Elliott’s contact information, website, and S1 course. (43:11—44:07)
Reach Out to Dr. Elliott:
Dr. Elliott’s website:https://3d-dentists.com/ ( https://3d-dentists.com/)
Dr. Elliott’s email: email@example.com
Dr. Erin Elliott Bio:
Dr. Elliott grew up in Southern California but went away to a small NAIA school in Western New York, where she played collegiate soccer and gradu
Move It or Lose It – Beyond Ergonomics with Dr. Uche Odiatu
Move It or Lose It – Beyond Ergonomics
Episode #291 with Dr. Uche Odiatu
We've all heard the benefits of exercise, but it goes beyond ergonomics. To remind you of the neurological benefits of being physically active, Kirk Behrendt brings back Dr. Uche Odiatu for a lesson on how exercise can keep your mind healthy and add years to your practice. And the best part is, you don't need a lot of time to get moving — start today! For more, listen to Episode 291 of The Best Practices Show!
There are neurological and physiological benefits to being physically active.
Exercising and fitness goes beyond just “looking hot”.
Fitness isn't a cost, it’s an investment.
Sitting is the new smoking!
Walk more, walk briskly, and live longer.
You don't need a ton of time to exercise!
“Most people, when they think of exercise, they're thinking a flat stomach. They think of squares. They're thinking of “looking hot” for your high school reunion . . . Dr. Church from the Cooper Institute in Texas said the benefit of being regularly physically active, 90% of it is from the neck up, which means neurologically, longer telomeres, better synaptic connections, less toxin buildup, better sleep.” (05:27—06:04)
“People who aren’t physically active are 1/10th as productive as people who are physically active.” (07:06—07:12)
“Michael Colgan, PhD, in a book called Save Your Brain, said by age 55, for most people who are physically inactive, which is basically 85% of the audience here . . . almost half of their mitochondria are no longer fully functioning.” (09:21—09:43)
“I don't think fitness costs anything. It’s an investment. Nutrition is an investment for me. My exercise equipment is an investment for me. My yoga mat is an investment for me. My Lululemon is an investment for me . . . Everything in your body that costs, it’s actually an investment, from my brain to my nutrition to my equipment.” (16:01—16:31)
“We weren't designed to sit. It literally shuts down our physiology. It shuts down breathing. And you're thinking, ‘Is that a big deal?’ Well, the brain, at three pounds, is the biggest oxygen hog. At three pounds, our brain uses 25% of the incoming oxygen. So, when you're sitting, your brain is being starved of oxygen.” (25:27—25:45)
“If you can't be in the top 2% in income, be in the top 2% in having a complete exercise program.” (36:34—36:40)
Dr. Odiatu’s background. (03:17—04:48)
Why movement is so important in dentistry. (05:27—11:05)
Sleep is the secret weapon. (11:42—13:21)
Treat your body like a high-performance race car. (14:51—18:00)
Move it or lose it. (18:52—20:36)
Dentistry is a sport. (21:15—24:28)
Sitting is the new smoking. (24:55—27:15)
Movement is life. (28:10—30:35)
Walk more (briskly) and live longer. (31:21—33:21)
The ergonomic side of movement. (34:11—36:40)
Myths of exercise and Dr. Odiatu’s exercise routine. (37:09—39:16)
Interval training is important to the body. (39:26—41:39)
Don't overdo it! (42:01—43:39)
Keep yourself healthy to add more years to your practice. (44:33—46:14)
Dr. Odiatu’s contact information and virtual presentations. (46:43—48:26)
Reach Out to Dr. Odiatu:
Dr. Odiatu’s Instagram: @fitspeakershttps://www.instagram.com/fitspeakers/?hl=en ( https://www.instagram.com/fitspeakers/?hl=en)
Dr. Odiatu’s email: firstname.lastname@example.org
Dr. Odiatu’s website:http://www.druche.com/ ( http://www.druche.com/)
Save Your Brain by Michael Colgan:https://www.amazon.com/Save-Your-Brain-Michael-Colgan/dp/0978348605 ( https://www.amazon.com/Save-Your-Brain-Michael-Colgan/dp/0978348605)
Mother-Daughter Wisdom: Understanding the Crucial Link Between Mothers, Daughters, and Health by Christiane Northrup:https://www.amazon.com/Mother-Daughter-Wisdom-Understanding-Crucial-Daughters/dp/05
The 5 Things That Patients Want with Dr. Sam Low
The 5 Things That Patients Want
Episode #290 with Dr. Sam Low
If you've ever thought to yourself, “I don't know what my patients want,” and don't know where to begin, today’s guest is here to help demystify what patients find important when it comes to their dental health. To teach you how to hook and educate your patients so they are motivated to make better decisions, Kirk Behrendt invites Dr. Sam Low to explain patients’ fears, desires, and expectations from their dentists. To learn about the five things patients want, listen to Episode 290 of The Best Practices Show!
1. Patients don't want pain!
2. Patients want to look good.
3. But patients don't want to pay.
4. Patients want things done now.
5. Patients want everything done by you.
Create trust and communication with your patients and your team.
Create your niche in dentistry.
Find the patient you want, and then keep them.
Use motivational interviewing.
If you educate your patients, you can keep them for life.
“This is basically what they want — first of all, [patients] don't want to hurt. And if you hurt them, I promise you, they're going to get on up and they're going to kill you. You can't hurt them.” (05:21—05:33)
“Number two, [patients] want to look good. I don't care if they have no money. They expect to look good. They expect to look fantastic. We’re selfish. That's what we want.” (05:38—05:47)
“Number three — sorry — [patients] don't want to pay . . . ‘If I'm a Medicare patient, how come I can't get any dentistry done?’” (05:48—06:06)
“[Patients] want everything done now. You know this milling game? Sure, I love the technology. What really pushed the milling game is patients want it now. They don't want to wait 30 days. They want 30 minutes.” (06:09—06:24)
“Patients want everything done with you; it’s convenience. ‘Doc, are you sure you can't take the impacted wisdom teeth out of my daughter? You did such a great job with these ceramics.’” (06:31—06:45)
“40 years ago, a dentist was the only game in town. There weren't a lot of other dentists around. You do know, we’ve got 65 dental schools. You've got to create a niche. Because if you don't create that niche with you, your nonverbal cues, do you know what's going to happen? [Patients are] going to go to somebody down the street — because [they] can.” (08:37—08:58)
“The number-one way to build a practice is relationships.” (09:45—09:50)
“Find something in [a patient’s] medical history or their dental history you can hook into. That's the way you do it. Find something that you can parlay into the conversation.” (10:50—11:01)
“Do you know the number-one phrase that sells more perio than any other phrase? ‘We see today the irreversible loss of your jawbone . . .’ Did we say we’re losing teeth? No. We said your jawbone. That is the number-one elevator pitch for you. And the second is, ‘There is absolutely a mouth-body connection.’” (12:40—13:14)
“Once you educate [patients], they’re yours for life.” (16:48—16:51)
Dr. Low’s background. (02:15—03:07)
Origin of the “five things” framework. (04:04—07:00)
Create a niche in your dental practice. (07:40—10:04)
Find something in a patient’s medical history to hook and motivate them. (10:50—14:05)
The importance of motivational interviewing. (14:54—17:39)
Is there a link between the amount of perio and restorative that patients do? (18:07—22:15)
The future of perio. (22:59—25:57)
Last thoughts. (26:10—27:05)
Dr. Low’s contact information. (27:55—28:36)
Reach Out to Dr. Low:
Dr. Low’s email: email@example.com
Dr. Low’s website:https://www.drsamlow.com/ ( https://www.drsamlow.com/)
Dr. Sam Low Bio:
Dr. Sam Low provides dentists and dental hygienists with the tools needed for successfully managing the period
The Dental Sleep Medicine Recipe for Success: Part 5 – Billing and Documentation with Dr. Mark Murphy
The Dental Sleep Medicine Recipe for Success:
Episode #289 – Part 5 – Billing and Documentation with Dr. Mark Murphy
Screening and treating your patients might’ve been easy. But now comes the worst part — billing and documentation. In the final episode of this five-part series, Kirk Behrendt brings back Dr. Mark Murphy to help you understand the biggest barrier to success in DSM. His solution? Outsource! To learn how outsourcing could benefit you, your staff, and your practice, listen to Episode 289 of The Best Practices Show! If you missed any of the previous episodes, be sure to go back and listen to Episodes 285 – 288!
Over 90% of dentists will quit DSM out of frustration with documentation.
Outsource! Third party companies know how to communicate with insurance companies.
Outsourcing will save you time, money, and give you peace of mind.
Third party billing and documentation companies know how to get you paid!
There are only 4% of dentists doing DSM.
The population of people with obstructive sleep apnea is growing.
“Whatever an hour or an hour-and-a-half is worth to you, write that down. When we finished using a third party as a documentation support software system . . . I would not spend three minutes at the end of my last patient finishing my documentation for the day, because there's a checklist, there's punching buttons. Everything gets done automatically.” (03:06—03:43)
“When I've talked to people who said, ‘Well, I've tried sleep medicine, but I just quit,’ I said, ‘Why’d you quit?’ The number-one answer is, ‘I couldn't get paid.’ I said, ‘Why couldn't you get paid?’ ‘Well, we tried to bill.’ ‘Did you try to do it yourself?’ ‘Yes.’ I go, ‘That might be the problem.’” (03:47—04:00)
“90% to 95% will quit doing dental sleep because of the documentation.” (04:59—05:02)
“If you say, ‘The hour I spend cutting the lawn every week is like Zen meditation,’ then knock yourself out and do it. Absolutely. Let me tell you, you're not going to feel that way about documentation and billing.” (05:57—06:08)
“I probably pay $300 a month for my software. I probably pay $49 a claim and 8% for my claims. That is a cost of doing business. That is a cost of not having to spend an hour-and-a-half at the end of my day, or not having to upset my team by trying to get them to do something that they're not capable of doing.” (13:03—13:21)
“The billing and documentation part, I always say, are the biggest barriers to success in dental sleep medicine. What I probably should say is they're the biggest barriers if you try to do them yourself.” (23:55—24:06)
“The number of people that have obstructive sleep apnea in our population is growing faster than the number of people we’re treating.” (25:55—26:02)
“There are 180,000 dentists, 150,000 GPs, ballpark. Maybe 6,000 dentists are doing dental sleep medicine. That's 4%. . . So, there's an incredibly large population of patients in need, and it’s growing . . . So, if you decide to cross that chasm and step into the arena to do some dental sleep medicine, it’s a pretty easy downhill path.” (27:16—27:54)
What outsourcing really means. (04:47—06:16)
Myths of medical insurance. (06:42—10:35)
Things to know about billing and documentation to get started. (11:05—13:21)
Third party billing companies get you paid. (13:38—16:07)
SOAP (Subjective, Objective, Assessment, and Plan) notes. (16:21—19:40)
Why Dr. Murphy chose to be a Medicare provider. (21:19—23:31)
Last thoughts on billing and documentation. (23:55—25:09)
The future of dental sleep medicine. (25:33—28:12)
Advanced education and associations to join. (28:18—32:59)
Reach Out to Dr. Murphy:
Dr. Murphy’s email: firstname.lastname@example.org
The Dental Sleep Medicine Recipe for Success: Part 4 – Treatment with Dr. Mark Murphy
The Dental Sleep Medicine Recipe for Success:
Episode #288 – Part 4 – Treatment with Dr. Mark Murphy
Now that your patients have been tested, it’s time to figure out the best way to help them. In part four of this series, Kirk Behrendt brings back Dr. Mark Murphy to talk about treatment — the easiest part of dental sleep medicine! He reviews the steps after a positive test result, his appointment process, and how to follow up with your patients. To learn more about how to treat your patients effectively and efficiently, listen to Episode 288 of The Best Practices Show! If you missed any of the previous episodes, be sure to go back and listen to Episodes 285 – 287!
Don't dwell on the 20% of patients you can't help. Focus on the 80%.
Compliance with CPAP use is still low.
But sometimes, CPAP is the only solution for particular patients.
Using a digital scanner has advantages for you and your patients.
Adding sleep even one day a week is profitable.
Treatment is physically and mentally the easiest part of this process.
“See, we’re dentists. We dwell on the patient who’s focused on the money, or we dwell on this one outlier, and we build systems for that. Don't do that. Don't do that. Build systems for the 80% that are moving forward. Just run with those 80%, and tell the other 20%, ‘I can't fix you. I can't fix that. That's not my fault.’” (06:29—06:44)
“Most studies will tell you that the average CPAP patient is only wearing their CPAP 40% of the time. This gets worse. What do you mean “wearing it”? Define wearing it. Eight hours a night, seven nights a week? Oh, no. In the CPAP world, they define compliance or adherence as 4.5 hours per night, five nights out of seven.” (22:33—22:57)
“They’ve been making CPAP smaller, quieter, cleaner — everything. Masks, better fitting. They’ve been doing all kinds of things. And still, compliance stays like crap.” (26:14—26:24)
“[New doctors] say to me, ‘Well, this patient only has this many teeth, and they're really mobile. What do I do?’ Well, you probably don't make an oral appliance. You probably tell them they have to have CPAP. Sorry. We can't fix everything. I can't fix that. I don't have a solution. Oral appliance therapy has some requirements, and that patient might not meet the requirements.” (30:50—31:06)
“Today, the hard cost of a scanner has come down so much that I think it’s going to make it a more cost-effective decision for somebody to move from analog impressions to scanning. Dentists who do dental sleep medicine have made that switch like that, because a full-arch upper and lower impression costs about $45.” (36:30—36:47)
“I scanned her upper, her lower, and took the bite in three minutes and 49 seconds . . . I'm not looking to save eight minutes. Maybe I am. Because if I save eight minutes a day, at the end of five days, that'd be 40 minutes. At the end of a month, that'd be a couple of hours. Maybe I can make my kid’s soccer game, or maybe I could schedule another crown prep or two. Or maybe I could get out of work earlier, take another vacation. I would have choices to make with my time.” (37:43—38:15)
Next steps after a positive test result. (04:48—06:46)
Appointment structure. (07:04—10:53)
Evolution of oral appliances. (11:09—20:40)
“Effectiveness” of oral appliances. (20:59—23:30)
The New England Journal of Medicine SAVE trial. (23:31—29:05)
Dr. Murphy’s treatment process. (29:52—34:29)
Advantages of digital scanners. (35:57—38:19)
Follow-ups with the patient. (38:45—40:05)
Results: four indicators to look for after treatment. (40:14—45:04)
How to score each of those four indicators. (45:26—50:19)
Does airway health go hand in hand with restorative dentistry? (50:57—52:30)
The logistics of adding DSM into y
The Dental Sleep Medicine Recipe for Success: Part 3 – Testing with Dr. Mark Murphy
The Dental Sleep Medicine Recipe for Success:
Episode #287 – Part 3 – Testing with Dr. Mark Murphy
You've talked to your patients about sleep apnea, screened them, and finally convinced them to see a physician. But what do you do once your patients get tested? In part three of this airway series, Kirk Behrendt brings back Dr. Mark Murphy to teach you the next steps once you have their test results. But how do you get patients interested in a sleep test to begin with? Listen to Episode 287 of The Best Practices Show to find out! And if you missed the previous episodes, be sure to go back and listen to Episodes 285 and 286!
Don't be cheap — pay someone else to figure out the medical billing.
Get patients in the right perspective and interested in wanting a sleep test.
85% of sleep tests today are done at home — a simpler and less invasive method.
For patients who have a lot going on, refer them to a sleep physician.
Diagnosis is neutral, not judgmental. You're just telling patients the truth.
Get comfortable with 75%. Accept that you can't help 100% of your patients.
“There’s an old John Wooden quote that I like. Failure is not fatal. Failure to change because of the mistakes you make and try different things differently may be fatal.” (01:39—01:51)
“I think where most dentists get [airway] wrong is not figuring out how to get paid for it.” (03:06—03:11)
“It’s so hard for [dentists] to accept 75% success as world-class. And yet, I think to myself, you'd be in the Hall of Fame in every sport if you shot 75%, if you scored 75% of the time, or you batted 750. You'd be in a Hall of Fame of the Hall of Fames.” (06:32—06:48)
“Some patients are unaware of things, and then they become aware. Once they become aware, that's still different than are they interested or not in what's going on . . . If I've engaged them enough, asked them enough questions, engaged them in conversation, been a good listener, shown them how much I care, then they probably come to trust me a little bit. So, unaware, aware, interested, they believe and trust in you. And then, they say the magic words, ‘Well, what do you think we ought to do?’ That's where I want a patient to be on that learning ladder.” (10:26—11:21)
“My triage in my mind is, am I confirming or denying that this patient has sleep apnea, or do I need a broader diagnosis — this patient has a lot going on. If they have a lot going on, I always send them to my local physician. I punt.” (16:56—17:10)
“Am I putting a little bit of fear in [patients]? Well, hell yes, I am. Because it is a serious disease. They're 23 times more likely to die of a heart attack if they have sleep apnea, and I want them to move on to get treatment.” (39:00—39:08)
“So, you see a patient who you think is at risk, and you don't encourage them to get a test, and they die. And you could've saved their life. Is that your partial responsibility? Boy, that's a discussion I don't want to have to have. Now, you've got somebody who has a positive test result, and you paint the picture as, ‘Well, if you kind of want to and you're interested, you might want to go get this device thing,’ and they die. And you could've saved their life. Do you feel the responsibility of that?” (42:24—42:52)
You can't learn something without doing it. (01:22—02:30)
Where dentists go wrong when it comes to sleep. (03:02—07:33)
How to get patients interested in a sleep test. (07:59—12:32)
The presumptive close: assume your patients say yes. (13:05—14:26)
Types of sleep tests. (14:55—19:23)
You can't treat 100% of your patients. (20:29—22:18)
Four types of tests and consumer wearables. (22:37—29:51)
Treatments and side effects. (30:50—34:18)
Should you review test results with patients? (34:48—41:24)
Telling patients the truth. (42:18—46:07)
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