Episode #359: Introducing an All-In-One AI-powered Platform to support your practice with Josh Gosnell

Intro: This is the Less Insurance Dependence podcast show with my good friend Gary Takacs and myself, Naren Arulrajah.

Intro: We appreciate your listenership, your time, and most of all, we appreciate your intention to reduce insurance dependence in your practice. Our goal is to provide information that will help you successfully reduce insurance dependence and convert your practice into a thriving and profitable dental practice that provides you with personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. Uh, we have an awesome podcast interview for you today. Uh, those of you that are regular listeners know that, uh, I like to mix up the format in our podcasts to keep things interesting for you. And you guys know that one of the formats that I love to use is an interview. And, uh, today I’ve got an interview, uh, with my good friend Josh Gosnell. Hey, Josh, how are you?

Josh Gosnell: Hey, Gary. Thanks for having me. I’m excited about this interview.

Gary Takacs: So, uh, one of the things I like to do is I like to keep my ear to the ground about, uh, companies in dentistry that are doing some really cool things. Uh, and, uh, I have, uh, found just that in Josh and his company. Uh, you’re gonna learn more about what they do.

Gary Takacs: But, uh, I love the operational side of dentistry, and they have developed some really cool functionality, uh, that seamlessly integrates in your practice with functions that were previously kind of held out on their own. And, uh, so they allow you to, uh, do some really cool things, uh, with, uh, with your patients, um, that I think will, uh, be a great enhancement to just the day-to-day practice of, uh, the business side of dentistry. And I think you’re really gonna enjoy it. The company’s name is ADIT. We’ll talk more about that. But before I get into our podcast interview, I’d like to make a quick announcement, uh, coming up, uh, not too long after this is published. Uh, we have our 2025, uh, RIDA Virtual Summit, Reducing Insurance Dependence Academy Annual Summit. It’s happening Friday, um, October 24th. Um, it is from noon to five thirty Eastern time, uh, five and a half hours.

Gary Takacs: Uh, it’s a virtual summit. This is our fifth annual virtual summit. Each year we’ve doubled the attendance. We started this in 2021, and the idea was to share, uh, lots of information with you about how you can successfully resign from PPO plans. Uh, I’ll do an opening keynote. We’ll have a couple other keynote speakers. We’ll also have multiple panels throughout the day. Everybody that will be appearing, uh, in that virtual summit will have something to do with you successfully resigning from PPO plans. And here’s the great news. You get five hours of CE credit, and the tuition is free. We’re gifting you your tuition as a courtesy to your listenership. Uh, you do have to register. Um, and to register, just go to, uh, rid.academy  Reducing Insurance Dependence Academy, and you’ll notice a quick popup for you to register. So come join us, uh, Friday, October 24th, uh, five hours.

Gary Takacs: Uh, it’s actually five and a half hours. We have to take a couple breaks. Uh, uh, during that we’ll take a couple short breaks, but you’ll get five hours of CE credit. And, and more importantly than that, you’ll be armed with everything you need to know, uh, about successfully resigning from PPO plans. As you know, that’s a passion of mine. Alright, uh, mark your calendars and come join us. But, uh, Josh, I’m excited to have you on this podcast. Um, we’ve been, uh, working on this for the last little while, and, um, every time we talk I discover new things about Add It that I didn’t know before. Um, and you have really put together, um, an amazing, um, I mean, I call it a product. It’s a product and a service. Would that be a fair way to describe what, uh, uh, what you’re providing?

Josh Gosnell: A hundred percent. Yeah. The platform.

Gary Takacs: Platform. There we go. Platform’s even better. Um, you know, I know that there, you’ve been in, in, in dentistry, and I know that some of our listeners might recognize you, but many of our, our listeners might be, uh, learning about you for the first time. Would you mind, uh, starting by sharing a little bit about your background?

Josh Gosnell: Yeah, absolutely. Uh, formal background was, uh, in finance and international business, what I studied coming outta school. I did what, uh, a lot of people who study business do, and I went into sales. Um, worked in, uh, chiropractic, so small medical practices for the first several years. So, chiropractic, optometry, you know, veterinarian as well. Uh, about 10 years ago, moved to Houston, Texas. Met, uh, met a very brilliant guy named Ali, who’s the founder of our company. Um, we got together and we started a business within dentistry, um, doing digital marketing. And so we were doing, you know, website design, Google Ads, SEO, the whole nine in that respect for dental practices, helping them grow. You know, we were doing that several years. That was the main service that we offered. We had a program that we called our Patient Booking Guarantee, where we would actually guarantee a dental practice.

Josh Gosnell: We’d book them a certain amount of new patients, or we’d refund them, you know, for their fees for that month. And, uh, something really interesting happened. Once we started seeing a lot of success there, we, you know, maybe had 500 practices that we were working with and we were doing the marketing for. So we had a unique insight into some of the numbers, you know, for dental practices. But there was a problem. There was a gap in information that we could see from a practice booking a new patient appointment and whether or not that patient showed up for the appointment, and whether or not they accepted treatment and were reappointed, et cetera. And so about seven—

Gary Takacs: Years. Yeah. The game doesn’t end when they make the appointment.

Josh Gosnell: Exactly. Exactly. And so as a marketing company—and you guys know, you know, seven, ten years ago, most marketing companies were just bringing leads, or, you know, and it’s still—some do. But, you know, we were based around—we wanted to make sure we actually booked you appointments. But we wanted to take it a step further and make sure that these people showed up. But we needed the integrations into the practice management softwares. So we had to go build these integrations into the OpenDent, the Dentrix, the Eaglesoft of the world, so that we could actually see the full patient journey. Well, as we kind of connect the dots there and pull more analytics, it started to reveal more and more problems that dental practices were facing. You know, and it started with, you know, I’m getting a ton of unique visits to my website, but I just can’t get these people to book appointments.

Gary Takacs: We got the visitors. They’re visiting, but they’re not taking action.

Josh Gosnell: Exactly. And so it was, it started with, you know, can you put my schedule online? Is there a way that someone can actually see my schedule and book online? So we said, yeah, you know, so we go build the software for online scheduling. So of course, as soon as people can start scheduling, what goes up? Your no-shows and your cancellations, right? So the next thing was, "Hey, is there any way we can confirm these appointments? Can we remind them of these appointments? Can we send them digital forms?" And it just kept evolving over the years, you know, and building different products and different, uh, technologies on top of what we were doing.

So fast forward to 2020, um, when COVID happens, you know, we’re still widely known as a digital marketing firm that offers technology to assist with the digital marketing. Well, what was interesting, you know, when COVID hits, the first thing that people get rid of is their marketing.

Josh Gosnell: You know, so we get a ton of calls saying, "Hey, we gotta close down for three months. You know, we can’t even take any new patients, we don’t need it." But what was really interesting was that they were also saying, "But now that we use you for our phone systems and for our texting and for our online scheduling, et cetera, et cetera, is there any way we can just use this?" And at the time, we didn’t even offer it as a service. You know, it wasn’t—we didn’t set out to be a software company.

So we said, "You know what? Give us a couple hundred bucks a month and you can just keep using what you’re using." Well, it was a complete 180, you know, over the next 12 months. It was a complete shift to where all the business was calling us saying, "Hey, my friend uses you guys for his, you know, patient management software within the practice. Can I get onboard?"

Josh Gosnell: And so we reallocated a lot of our resources, and we said, "You know what? We want to be the best engagement and analytics platform out there." There’s nothing that really exists right now that brings all of this into one place. I would say there is—there are certain pieces of technology, but for a practice, they’re having to pay three, four, five different companies, you know, with different user interfaces to make those things happen. We said, "You know, we’re the only one that’s really doing it all in one place." Yeah. So we evolved on that. You know, it’s been going strong for about 10 years now. We’ve got about 5,000 practices using the software across the country. So really excited about what we’ve done so far and about what’s on the horizon as well.

Gary Takacs: Well, we’re gonna take, with your permission, uh, Josh, we’re gonna take kind of a deep dive into this. Is that all right?

Josh Gosnell: Let’s do.

Gary Takacs: So what I see—and again, I’m on the outside looking in—but what I see, um, is at the core of your system is, uh, a VoIP phone system. Would that be a fair, um, a fair statement?

Josh Gosnell: Absolutely. One of my most popular services, for sure.

Gary Takacs: And, you know, our, our listeners, uh, will have, you know, various knowledge about all this, so I don’t wanna assume that anybody knows anything. Um, but, uh, VOIP—would you, uh, explain what the acronym VOIP is?

Josh Gosnell: Yeah. So VOIP is Voice Over Internet Phones. It’s basically connecting your phone system through the internet so that you can use some different technology features, like being able to call through a computer or call through an app on your phone, et cetera. Where we take it a step further is integrating said software into your practice management software and vice versa. So not only are you able to use some of these tools and technology for calling, receiving outbound calls, et cetera, you can take advantage of some other cool things like being able to actually pull up patient information on your computer screen when a patient calls in, you know, um, being able to—

Gary Takacs: That information’s there. Information’s in the, in the practice management system, but it’s buried under many, many windows.

Josh Gosnell: Exactly.

Gary Takacs: And now you’re making it accessible so that if, if I’m calling, uh, your office and I’m in your practice management system, you’ll, you’ll see on the screen who it is.

Josh Gosnell: Exactly.

Gary Takacs: Pretty cool. Um, so it’s an integrated, uh, as opposed to just a, a VoIP phone system. It’s an integrated phone system that integrates with your practice management. So, so rides alongside your practice management, uh, software, pulls information out. We’re gonna get a lot into the functionality in this, um, and then allows you to use all of that more efficiently in so many different aspects in the practice. Like patient communication.

Josh Gosnell: Exactly. Exactly.

Gary Takacs: Yeah. Yeah. Um, well, you and I both know that, uh, dental practices sit on what I would think of literally as a gold mine of data, that there’s unbelievable data in that practice management software, but most don’t use that data. Is that a fair statement? Am I being too harsh?

Josh Gosnell: No. Uh, I think our data shows that 96% of dental practices don’t have any way to track their KPIs.

Gary Takacs: That, that, um, that scares me, but I recognize it as true, uh, for sure. So we don’t use it. How does Addit, um, help teams turn the data into smart, actionable decisions? So, data’s great. I’m a data hound. I’m a nerd. Let, let’s be honest, I don’t mind admitting that. I wear my nerd badge with honor. Josh, you’re a nerd too.

Josh Gosnell: I’m a nerd. I’m a software nerd.

Gary Takacs: Yeah. I’m using it as a term of endearment. Uh, but the data’s great, but until you use it, until it’s actionable, um, it’s a bit academic. So how do you—how does Addit do that, convert it into actionable decisions?

Josh Gosnell: Well, you know, I’d say, first of all, you have to make the data easy to digest. You know, it’s gotta be set in a format that’s easy to read, easy to understand, easy to navigate, because, you know, all of this data exists in a practice management software. The problem is, is that the software has changed, and you have to be extremely trained in order to know where to go, what to search, to kind of create these reports, to pull out specific pieces of data that you wanna see, right? And then once you pull that data one time, it’s now out of date. So if I wanted the same report next week, I’ve gotta go re-pull the report, et cetera, et cetera.

Gary Takacs: Could be hours—hours later, it could be out of date.

Josh Gosnell: Oh yeah, exactly. Especially if you’re doing, you know, like a morning huddle type situation where the schedule’s gonna change consistently. So the first part of it is just making the data easily accessible and easy to digest. You know, like a nice graph that’s easy to understand, that you can look through. If you’ve ever sat through like a—I don’t know, I’m gonna use, um, I’m gonna use Dr. Andrew Huberman as an example. If anybody’s watched his podcast, he’ll sometimes go on these tangents that are just so scientific. It’s hard for me as a software guy to follow the science, right? But then at the end of the episode, he’ll say, "So here’s the takeaways. Here’s the main three things," and—normal language that we can understand. So we try to do that, number one, for the data. We try to take the data, we try to group it, put it in a nice, easily readable graph so that we can know, first of all, what is going on.

Josh Gosnell: And then to your point, the next part is, okay, well, this number is great, but if I don’t act on it, then, you know, it doesn’t mean anything if I’m not executing on this data. So we want to use that as a measure, as a predictive measure of what’s going on in your practice and what’s possible. So what we do there—the term I use is called feature stacking. There’s a lot of different things that Addit does. I mean, obviously we’re a phone platform, we’re the texting, we’re the automations, we’re the online scheduling, the digital forms, et cetera. But just an example would be, you know, if you’ve got a graph that’s tracking your unscheduled treatment—and believe it or not, a lot of practices will have seven figures in unscheduled treatment at any given time just sitting there.

Gary Takacs: They’re literally, uh, have, have, uh, over seven digits in, uh, treatment that’s been diagnosed that remains to be completed. And if they’ve been in practice any period of time, that could be multiple seven-digit figures.

Josh Gosnell: A hundred percent. A hundred percent. And you’ll see if you go online in the forums, everybody wants to know how to grow their practice. And what is the first thing that everybody thinks about? Everybody thinks about new patients. You know, "How can I do new patients? How can I do bigger cases?" Et cetera. But, you know, we’ll find these practices that have millions of dollars in unscheduled treatment, and they just don’t know how to access it.

So, for example, with Addit, we’ve got a feature called Patient List. But basically, you can go in and create a custom segment of patients that you want to communicate with based on certain sets of criteria, right? So I could go in and say, I’d like to see all of my diagnosed but unscheduled treatment from the last six months. You could even go in and add an additional filter and say, "You know what? I only want to see the treatment that is greater than a thousand dollars. I only want to see patients that have this as their primary insurance," you know, or whatever the case may be. Continue to add these filters, right? And it breaks out that list for you of every patient that fits that specific criteria.

Now, what typically happens in a practice is that list is printed out and taken to someone at the front desk, and you say, "Hey, can you start calling these people? See if we can get them back in." And we know now that most of those calls don’t get answered. I mean, with Apple’s new update, it can send numbers that they don’t know straight to spam without even ringing the phone anymore, right? You know, so it’s just ineffective.

So what we do is we take that list and we give ’em a very easy way to just highlight all of them and send a text or an email campaign, right?

Josh Gosnell: But now we take it one step further. Again, going back to that feature stacking term—imagine I am, you know, sending a unique text message to a very specific segment of patients, but now I’m including the link to my online schedule as well. So now it’s very targeted, saying, "Hey John, we know that you haven’t scheduled to get your crown yet, but here’s a link to our availability. Go ahead and book yourself." And we’ve seen practices book $40,000–$50,000 in production from taking five minutes to send out a text. I mean, it’s pretty absurd what’s possible.

Gary Takacs: You know, um, real-time online scheduling is still, in terms of adoption, it’s in the early stages in practice. Yes. Um, and I would like to politely suggest that all of our listeners need to jump on that train. Um, and you can choose to be as involved as you want, uh, with, uh, real-time online scheduling. I mean, think about it, Josh.

My wife and I enjoy, uh, supporting restaurants—and especially if they’re locally owned, you know, independent restaurants—we enjoy that. That’s a hard business, and we like supporting them. Uh, I can’t remember the last time that I’ve called a restaurant to make a reservation.

I use OpenTable.

And so imagine, for those of you that are still trying to get your arms around real-time online scheduling, it’s OpenTable for your practice. Now, you can segment it. If you wanna get started with this, maybe you only want to open up the hygiene schedule—that can be done. Is that correct?

Josh Gosnell: Yeah, fully customizable. I mean, you can do new patients only or returning patients only. We’ve got a lot of practices that will include the scheduling in their automations, right? So you’re already sending—most practices are already automating a text to their patients, you know, saying, "Hey, it’s been six months, you haven’t been in to see us." But now it’s just taking that extra step and saying, "Hey, you haven’t been in in six months. Here’s a link to our hygiene schedule. Just go ahead and book yourself."

Gary Takacs: Pick a point. And it avoids all that back and forth. Uh, you know, the patient calls, they get your voicemail in the office, you call ’em back, you get their—I mean, it just is, uh, it’s an exercise in futility, the old way of, of—yeah—calling back and forth. But meanwhile, they can just go on your schedule and just book an appointment.

Josh Gosnell: I mean, that’s where everything’s going, man. I’ll give you an example. Myself, I’m 33 years old. Um, I went to play golf with my fiancée this weekend, and I book all of my tee times online. I never make a phone call. And she starts calling the clubhouse and puts me on the phone and says, "Schedule a tee time." I’m freaking out. Like, I don’t know what to do. laughs Like, I’ve never taken a phone call, you know, just ’cause I always book my tee times online. But it’s, it’s as simple as that.

It’s just—everybody’s doing it. When I go to the barber, I book my appointments online. You know, it’s—I’m something I’m not proud of, laughs, but it is where the industry’s going for sure.

Gary Takacs: Well, and you know, I think, um, uh, it’s a human dynamic where people wanna be efficient, and it’s a very—and you’re in control. Yeah. You know, you’re in control. Uh, and so that’s a feature set within Addit, uh, correct? So you talk about, uh, the term you used was feature—

Josh Gosnell: Feature stacking.

Gary Takacs: Stacking. So now let’s stack some of these up. So one of the things that I really love about AIT, um, is your CareCredit integration.

CareCredit—I’ve been a fan of—uh, back, some of you will remember this, this will, uh, this will date some of our listeners, but I remember CareCredit when it was called DenCharge. DenCharge. It was simply a dental, uh, you know, financing option for dental offices. And of course, over time, it expanded into other verticals and it became CareCredit.

But, uh, you know, using financing to grow your practice is underutilized. Um, you know, we have a common friend at CareCredit that is one of my favorite people in dentistry. Uh, why don’t you name him, Josh? He’s our mutual friend.

Josh Gosnell: Oh, Samir. Shout out Samir. We love you, buddy.

Gary Takacs: Let’s give Samir a shoutout. Uh, Samir is, uh, really one of the really good guys in our profession. But I think most practices underutilize financing as a way to help patients accept ideal care. And you’ve got some super cool integrations. Talk about some of those integrations.

Josh Gosnell: Yeah, absolutely. Uh, you know, we’re big fans of CareCredit, and we always have been in the space. And you know what they do by making treatment accessible for, you know, a broader set of patients. But, uh, we found that practices were having difficulty having certain conversations around financing.

And it’s not something that you’re necessarily trained on or that you feel confident in a lot of the time. And a lot of it was based around, you know, making a suggestion and a patient maybe not getting approved for financing or whatever the case may be.

So we said, you know, is there a way that we could basically pre-qualify these patients for financing and make that accessible for the practice through our software?

A lot of different things that we’ve done here, but basically CareCredit’s got a feature they call the Batch Quick Screen, right? And it basically goes through your active patient database and, using previous purchase history without any kind of soft or hard credit check, it’s saying that, you know, this patient is pre-approved or is already an existing cardholder with us, with a credit limit of this amount, right?

Just like when you get a letter in the mail from Chase that says, "Hey, you’re pre-approved for $10,000 on this credit card." Exact same thing, right?

What we did was we took that information and we made it accessible within things like your morning huddle, right? So when you come in, you log in for the day, you’ve got this list of patients coming in—you know which provider they’re going to see, you know which treatments they’re coming in for, all the numbers associated. But now you’re also gonna know: is this patient an existing cardholder, and what is their credit limit?

Or, is this patient pre-approved, and how much are they pre-approved for?

So now, when we come in and we have that initial conversation around money—around the potential for patient financing—we can be a lot more confident in what we present and we know.

So what we’ve seen is a 96% approval rate on what Addit shows as their credit limit. So if we’re showing pre-approved for $5,000, there’s a 96% chance that that patient will be approved for that $5,000—at least up to that $5,000.

So then we were thinking, okay, what other ways can we take this and use it?

You know, I mentioned the Patient List feature earlier in segmenting your patients. What if you could filter that same segment of patients by their financing capabilities?

So now I’ve gone, and I’ve looked at my unscheduled treatment. I said, I want to see all of my treatment, you know, that is greater than $1,000…

Josh Gosnell: And now I want to see only the patients that are existing cardholders with a credit limit of above a thousand dollars. So now, from your marketing perspective, you’ve really narrowed down this niche that I’m targeting, saying, "Hey, we know you didn’t accept this treatment yet, but we’ve got some amazing financing options in place that could allow you to get this treatment done ASAP."

And, you know, we’ve included it at different places. You talked about the phones earlier and how the information pops up on the screen—we call that a "call pop" in our world. But including that little CareCredit image there—so when the patient calls in, you’re already gonna see: does this patient owe us any money? Does this patient have outstanding treatment? And are they pre-approved?

You know, so making it easily accessible. We’ve seen some crazy numbers. So we’ve had the integration for about a year now. We’ve seen practices do more patient financing in a three-month period than they had in the previous three years. It’s making a huge impact.

We even had one practice we did a case study on—they saw a 90% increase in case acceptance. That’s a big number.

Gary Takacs: You know, it’s—again, it’s so profound. And Josh, I know you know this and many of our listeners do, but, um, you live in—you live in Nashville.

Josh Gosnell: Yes.

Gary Takacs: And I had a chance to visit Nashville recently. And one of the things that amazed me was just the sheer growth that’s happening in Nashville right now. But I have a solution to the traffic congestion in and around Nashville—uh, Miami, New York, Chicago, L.A.

Would you like to hear my solution for the traffic?

Josh Gosnell: Please. We need it.

Gary Takacs: Require everyone to pay cash for their car when they buy their next car. The freeways will instantly be empty because very few people will be able to do that.

Josh Gosnell: Yeah.

Gary Takacs: And yet, that’s what we do in dentistry. You know, we assume—think about all the cool things we can do clinically with patients today—and if the only way they can pay for that is to write you a check, you’re not gonna do a lot of that treatment.

I mean, uh, you know, the F-150 is the most popular vehicle by sales numbers, and the vast majority of those F-150 trucks are financed. And, uh, you know, it’s something I think we need to recognize, uh, in our profession.

And I love the way—and I want to emphasize something. You said something quickly, but I want to emphasize it for our listeners. When you’re doing that quote “pre-screening,” there is no soft or hard, um, credit check involved. Correct?

Josh Gosnell: Yeah.

Gary Takacs: No involvement.

Josh Gosnell: There’s no ding on the credit whatsoever.

Gary Takacs: Yeah. Well, I love that integration. That integration, I think, represents a great opportunity to grow your practice.

Our listeners know that there are many things I’m passionate about on the operational side of dentistry. One of them is helping them successfully resign from PPO plans. But the other is to help a practice grow internally.

And I like to frame growth as helping more of your patients enjoy the benefits of great oral health and helping more people in your community enjoy those benefits. And using financing more effectively—like you make it so seamless—is a great way to do that.

Well, let me shift gears. I know that you—and you and I share a passion on KPIs, key performance indicators. Our listeners—I’ll put you on this. Is it okay if I put you on the spot for a second, Josh?

Josh Gosnell: Yeah. Hit me.

Gary Takacs: What are the top five metrics that you think every dental practice should be tracking, and how does Addit make it easier and more effective to keep tabs on those?

Josh Gosnell: Totally. A loaded question. Uh, there’s so many things that I think are important for a practice, and I hope you agree with me ’cause you’re an expert, but—top five. All right, so no particular order.

I would probably say production by hour. Production per hour, um, by provider—if you’ve got multiple providers in your office—would be something extremely important to track. Yep. Uh, just shows how efficient you are with your chair time. I think it’s super, super important to know.

Collections—collection ratio, I guess I would say. Production’s great, but obviously if we’re not collecting, you know, that’s not…

Gary Takacs: Well, some of it’s fiction.

Josh Gosnell: Yeah. Um, so—collection ratio. How much of your produced dentistry are you actually collecting on?

Gary Takacs: And I would modify that slightly to say, how much of your adjusted production are you collecting on? Adjustments can take many forms. The one that causes smoke to come out of my ears—insurance adjustments. Yeah, the difference between your UCR fee and your contracted fee. But there are other forms of adjustments. For example, warranty work, if you’re redoing something because it didn’t meet your quality standard, that’s an adjustment. Charity dentistry you choose to do, family dentistry, team member dentistry—there are a number of different adjustments. But I would measure your collections against that adjusted production. I think we’re kind of picking nits there, but collections would be very—

Josh Gosnell: We’re on the same page. We’re on the same path together. Agreed. Agreed.

Gary Takacs: Gimme a third one.

Josh Gosnell: So I’m gonna use a software term here, but I think it applies to dentistry as well—probably looked at differently. The term I would use is churn. I guess a better term for dental practice might be patient retention.

One of the things that we realized super early—if you go back to my story about how we started as a marketing firm—was a lot of practices, even when they’re doing pretty well in the new patient realm, are losing a lot of patients out the back door.

And it’s something that they’re not really tracking or focusing on. And it will absolutely stunt your growth as a practice if you’re not keeping in mind, number one, the patients that are going inactive—so, going 18 months without an appointment—or patients that we consider lost.

So what is your net growth rate? Track your patient retention. Track your churn to see: how many new patients am I getting, but also, how many patients am I losing? What is my net growth rate of patients?

Gary Takacs: Especially, I would say, in the post-COVID era. You know, if you think about what happened five years ago when offices were shut down from anywhere from six weeks to sixteen weeks, it threw everything in the lurch.

And there are a lot of patients that—they’re not intentionally staying away. They aren’t consciously doing that, but all of a sudden, it’s been five years.

So I like to reactivate people that are past due for hygiene, because a lot of those patients think they’re still patients in your practice, but they haven’t had an appointment in a while.

I was sharing that very same conversation with one of our clients, one of our Thriving Dentist clients recently, Josh. And I said, “Doctor, I bet if you went into your local Safeway grocery store and you’re pushing your cart one way down the aisle, and the other way down the aisle comes one of your patients that you haven’t seen in five years—that patient still thinks you’re their dentist.”

They haven’t gone anywhere else. They just haven’t gone anywhere.

Anyway, my client—we’re on Zoom, so I could see his face—and his eyes lit up and he says, “Oh my gosh, Gary, I got a true confession.”

He said, “I’m pretty good about getting my annual physical.” His father had some heart disease, so he wants to stay on top of that. He’s 60 years old.

He says, “I’m pretty good about getting my annual physical, but the last few years, it’s gotten away from me. It had been a couple of years since I’ve had my annual physical.”

So he said, “I called my primary care physician. I know the office manager—her name’s Beth—and I said, ‘Beth, it’s Dr. So-and-So. I’d like to make my appointment for my annual physical. I’m a little embarrassed—I think it’s been three years since my last one.’”

And she said, “Doctor, it’s been eight years.” And she gave the date. She said, “Last visit was here.”

He goes, “Oh my gosh, I thought it was three!” And he said, “If I would’ve had a polygraph on my wrist—a lie detector test—I believed it was three years. I would’ve passed that polygraph test.”

But in fact, it was eight years.

My point, right?

Josh Gosnell: Exactly.

Gary Takacs: Give us a couple more—couple more KPIs you’re fond of.

Josh Gosnell: I think case acceptance is an obvious one, obviously.

Gary Takacs: How do you measure that? So, uh, it’s a polemic. In order to have ultimate case acceptance accuracy, we have to have a tail on it at some point, right? Because not everybody is ready for it—especially if it’s elective dentistry or ideal dentistry. They’re not necessarily ready for that. So how do you manage the accuracy of case acceptance data?

Josh Gosnell: Well, you would go in and you’d, first of all, set your timeline that you want to look at. And then you’d look at how you want to pull the data.

Because, you know, some people consider—if you put together a treatment plan, and let’s say I take a couple things and I accept treatment on a couple things and a couple things I don’t—would that be considered that the treatment plan wasn’t accepted? Depending on how you look at it. Or am I doing it by treatment, and which treatment gets accepted?

The way that I think is generally accepted—and again, correct me here—is just based on presented treatment versus what was accepted during a given timeline.

Gary Takacs: And so you could set parameters on the timeframe?

Josh Gosnell: Yeah. Because everybody looks at it a little bit differently. And again, remember—we are pulling data from a practice management software. Every practice management software looks at things a little bit differently. Every dentist looks at things a little bit differently. So there’s a little bit of give and take—how is the information presented, what do I consider a case accepted—and then coming to meet those things together to give you as accurate a number as possible.

But regardless, it’s something that we need to keep an eye on. I think case presentation is one of the most important things.

Gary Takacs: If a doctor doesn’t have data on that, then they respond anecdotally.

I remember in my own practice, I would ask Dr. Paul—one of our dentists—“Hey, how are you doing on case acceptance?” And for example, let’s say the day before he saw two new patients and both patients scheduled for treatment. He’d say, “I think we’re doing really good—yesterday I had two new patients and both of them scheduled.”

Conversely, let’s say neither of those scheduled—he’d say, “Man, I gotta work on that. We’re not getting any case acceptance.”

Well, neither one of those answers are accurate. An anecdote doesn’t help here.

Can I add a fifth that I’m fond of?

Josh Gosnell: Please.

Gary Takacs: I know you guys do this. I’ve coined the term hygiene occupancy. It’s the idea of—all the available hygiene appointments in your practice—what percent got filled with a butt in the seat by the time that appointment came around? Hygiene occupancy.

To me, that’s critically important, because obviously we want to keep those filled. And it kind of allows us to work with our hygiene scheduling coordinator to achieve a very high level of performance—by having ASAP lists and having people they can contact to get into the schedule.

But that would be a fifth KPI I’d put high up there as well.

Josh Gosnell: Oh yeah. And I mean, you can continue to expand on these things. You know, I go back to production per hour—that can be for your hygienist too.

And the more data that you have on these certain things, then all of a sudden that hygiene occupancy rate—I’m able to show you how much open chair time you’ve got and what that relates to in terms of dollars.

And I think that really—one of the first things I said was presenting the data in something easy to digest. You know, when you’re talking about occupancy rates and percentages and open chair time, maybe that doesn’t connect.

But when it’s a dollar amount sitting in front of you and you say, “This is how much money we are not getting because we’re not being efficient…”

Gary Takacs: Well, it either becomes something to celebrate or it’s a painful reminder. laughs Either way, you want to know it.

Josh Gosnell: There’s not a ton of practices that fail. You know, I would say that there’s just a lot of practices that are kind of coasting and don’t really know their potential—until they see the numbers.

And like you said, anecdotally—“I’m doing pretty well. I know what we’re producing, I know what I’m collecting…”

But what am I capable of? Is really the question that I would ask.

Gary Takacs: Yeah. Um, I wanna go in a different direction on functionality. And, uh, this is something that I believe—by my own experience—is an epidemic in dentistry today: missed phone calls during business hours.

Again, if you don’t know your data on this… when I ask—and it’s a loaded question because I usually have the answer in my pocket before I ask my client—I’ll say, “Doctor, how do you think you guys are doing on answering calls during business hours?”

And again, I’m emphasizing during business hours. If a patient calls at midnight, as far as I’m concerned, it’s perfectly okay for that call to go to voicemail. Would you agree with me on that?

Josh Gosnell: Yeah. I think that one would be okay.

Gary Takacs: But during business hours—and if they don’t have the data—the common response is, “Oh, we got that down. I’ve got many phone lines, multiple team members answering the phone. That’s not a problem.” And then you pull the data, and the data tells a different story. Talk about that.

Josh Gosnell: Yeah. I mean, what we see is still about 33% of calls go unanswered during business hours.

Gary Takacs: So one-third of them?

Josh Gosnell: One-third of them.

Gary Takacs: One-third of them. I saw an actual—this is data from a particular client, who I’ll leave nameless for confidentiality—great practice. A top 1% practice in terms of production, collection, production per hour, patient retention. They were missing 42% of their calls during business hours and had no idea.

And think about it: marketing’s job is to get the phone to ring—at a very simple level, right?

Josh Gosnell: Yeah. I mean, there’s several different steps to it, you know?

Gary Takacs: And we’re not answering it.

Josh Gosnell: To even get the call is difficult. I mean, to know—I think it makes it even more impactful when you know what you’re paying to get these calls.

Obviously, I go back to data one more time, but—you know—knowing what you’re spending on your marketing or your new patient acquisition, and knowing what it’s taking to get that phone to ring…

And then also, another number just to go back to that: lifetime value of a patient. Knowing how much a patient is worth to your practice, knowing what you’re paying to get that patient to call you…

And then not being able to answer the phone, which is kind of the most basic part of it—to be able to convert that patient.

Gary Takacs: Yeah, just answer the call! And today, Josh, I think we have an ever-impatient society, right?

And I have to admit—a true confession on this—the other day, I landed at my destination, I pulled up Uber, and it was gonna take eight minutes for the Uber to get there. Eight minutes! I’m like, “I’m not waiting eight minutes.”

And I pulled up Lyft—and Lyft was there in six minutes. laughs But can you imagine what I would’ve said years ago, before we had Uber?

“Hey, you just punch a thing on your phone and a car shows up and takes you door to door. Would you wait eight minutes for that?”

“Oh yeah, sure!”

Josh Gosnell: Yeah. Well, wait till the fully autonomous cars are everywhere and it’s just waiting outside for you when you—

Gary Takacs: It’s there for you.

Josh Gosnell: Man, that’s crazy. But yeah, I mean, it’s the same concept.

If a new patient’s calling in—think of it like sales—the hottest time to get that lead converted is when they are top of mind. Like when this is the one thing that they’re trying to figure out.

And if we miss that—even if we call them back an hour later, an hour and a half later—we don’t know what’s going on in this person’s life.

I could have been calling you on my lunch break, and I’ve gotta get back to work, and now we play phone tag for the next four days.

By the time you get me, I’ve already made an appointment at a different practice.

Gary Takacs: Well, that’s what I’m saying. People will go to the—if they found you by organic search engine optimization, where they Googled and they found you—and if they don’t, you know, if you don’t answer that phone, they’re going to the next office on the Google search.

And it’s just the reality of society today. I know you’ve got some cool functionality inside Addit, you know, to help convert those calls, help reduce missed calls during business hours, and some really cool ways of dealing with it that result in more appointments.

Josh Gosnell: Yeah. I mean, to keep it basic off the rip, you know, we want to automate a text to the patient right away, right? If there’s any reason that we miss a call—even if we’re just helping a patient at the front desk—we want them to get a text right away from our practice phone number. That’s an important distinction. We don’t want them to get a random text from a random number. We want them to get a text from the number they just called.

Gary Takacs: So that’s going to avoid—that’s going to go right to their pocket or purse.

Josh Gosnell: Correct. Yeah. So it’s not something that just gets overlooked, right? So it’s a quick text, and you customize your messaging, obviously, to just say, “Hey, sorry, we’re helping someone at the front desk. We’ll be back with you in two minutes.”

I mean, I think that’s the most basic version, and I firmly believe every practice should be doing that regardless. Because a lot of the time that patient might just text back and be like, “Hey, I just need to reschedule my appointment for next week,” or whatever the case may be. And you can just communicate that way.

Where the industry’s going—I mean, this is already active in a lot of places—I’m sure some practices have tried the AI receptionist or, you know, more as an overflow.

I would say right now, I really haven’t come across—obviously, in the space, I’ve done a lot with AI—I haven’t come across anything that I love as a true receptionist yet. And I don’t think that the patient experience is going to respond well to fully navigating there.

But I think maybe having it be as an overflow, to where an AI can answer your calls and do a few basic functions—that’s certainly where Addit is going.

With our phone system, in addition to the missed call text, having an AI be able to actually answer and respond.

But because of our integrations with all the different features that we offer and working with practice management softwares—this, just as an example:

Patient calls in, they’re a new patient—we can actually book them and write that appointment all the way into your practice management software without having a live person on that phone call.

Gary Takacs: So talk about efficiency in the office.

You know, one of the things we’re experiencing—and it’s no secret to all of our listeners—is inflation. Everything we buy is more expensive, but especially wage inflation today in dental offices is extreme.

And, you know, this will allow you to be a lot more efficient.

I’d like to put you back on the spot for a second. Can you share an example of how ADIT has helped a practice maybe change course or uncover a blind spot using analytics?

Maybe they thought everything was going just fine, but they had a blind spot and didn’t see it. How did Adit—and your analytics—benefit that practice that might be in that situation?

Josh Gosnell: I wanna give you a couple different examples here. I’m gonna give you one on the new patient side and one more on the growth side.

You know, I told you the story of how Addit kind of came to be, and one of the first realizations that we had that we needed more data was a client that was doing marketing with us. And they were performing traditionally very well in the new patient realm—you know, they were getting, let’s say, 40–50 new patients a month, which for most practices is beyond what they need.

But the practice would keep coming back to us saying, “I need more, I need more. I’m not growing. I need more.” And it goes back to that patient retention I was talking about earlier—where you’re losing patients out the back end.

Gary Takacs: So the front door is open, and the back door is wide open.

Josh Gosnell: Exactly. Exactly. And just being able to give that practice the data to say, “Hey, you’re getting 40 new patients a month, but you’re losing 42.”

Like, we’re going backwards here. We’re not even breaking even.

And that was just such a realization because, you know, marketing is a subjective thing, right? What is successful in marketing to you and to the next practice are probably gonna be different things in most cases.

But being able to put hard data in front of someone and say, “Hey, new patients is not your problem—patient retention is your problem.” That was a huge impact.

Gary Takacs: Well, I can see just that revelation and the understanding of that would change internal behaviors and internal operations to correct that.

It would change everything.

If you don’t know it’s a problem, you’re not gonna work on solving it.

Josh Gosnell: Exactly. You know, they say that 90% of solving a problem is figuring out what the problem actually is.

Gary Takacs: Recognizing what that problem is. Exactly. You might be solving the wrong problem.

Josh Gosnell: Exactly.

So I’d say that’s number one.

And then on the growth side, you know, I go back to unscheduled treatment. Man, there’s just—a lot of opportunity sitting in your average practice.

I’m in all kinds of forums. I talk to a lot of doctors. I speak all over the country, and a lot of people are focused on growth—but they’re focused on the wrong things.

And so just understanding what opportunity is available within your current database now, and properly leveraging those patients—making sure we’re making dentistry available to those people, making it clear and obvious, and making it easy for them to book.

So I go back to:

knowing your numbers on what’s sitting there,

being able to very quickly and easily contact them or create a list of people that you want to contact,

making it easy for them to book,

make it easier for them to show up,

and just automating as much of that process as you can, right?

But if you don’t know that it’s there, and you don’t know how to contact them, then it’s all for not anyway.

Gary Takacs: Well, Josh, you had me at hello when I did my demo. laughs Literally—you remember that demo that we did?

Josh Gosnell: Yes sir.

Gary Takacs: And you had me at hello—because of the deep integration, the all-in-one aspect of it, and the coordination of all the different functionality that you had there.

I’d like to invite our listeners to schedule a demo. Would you talk a little bit about that? And then we’ll direct them—and you’ve been kind enough to offer our listeners an incentive, we’ll talk about that in a minute—but give our listeners some encouragement to set up a demo.

Josh Gosnell: Yeah, absolutely. I mean, if any of what we’ve talked about today is connecting with you—if you’re trying to grow your practice and just can’t figure out what’s missing in that recipe, or if maybe you’re doing a lot of the right things but your overhead’s just too high—we talk to practices every day that are paying four to five different companies.

Maybe you’re paying one company for your phones and spending $350 a month, maybe you’re paying another company for your analytics and spending another $300 a month. You’ve got a third company that does your text-to-pay. I mean, it is super normal.

So if that sounds like you, if that sounds familiar to your practice and you really want to consolidate and make things more efficient—maybe cut costs on your overhead while still growing—then I think Adit might be a great fit for you. Definitely encourage you to check us out.

Gary Takacs: Josh, I did an analysis for one of my clients, and in terms of combining those functionalities, this office was paying close to $1,200 a month for these different functions. And when we put it all, you know, packaged it under Adit, it was a fraction of that cost.

You’ve been kind enough to offer our listeners an incentive. Could you talk about that?

Josh Gosnell: Yeah, absolutely. So we want to incentivize you guys just to take a look—right? No strings attached.

We want to give you a $50 Amazon gift card just for taking a look. Obviously, no pressure.

If you do decide that Adit’s the right fit for you and you want to move forward, one of the things that has been really great for us is our insurance verification services.

We’re going to include that for free for life in your package. So no additional cost—we’re going to include that for free if you call in.

Gary Takacs: Josh, I want to thank you for spending some time with us. Literally, you had me at hello in that demo.

The way you’ve integrated all these different functions, the way you’ve added unique functions that don’t exist in other places—and talk about efficiency.

I’m a big fan of efficiency. One of the reasons I’m a big fan of efficiency, Josh, is that it allows our team members to do the face-to-face stuff with patients that’s so important.

You know I’m a huge advocate of a relationship-driven practice. And when you’ve got all these things happening through technology, it frees up your team members to actually be talking to Linda about her family, talking to your patient about her last vacation trip.

And it really allows you to leverage your team members to do what they can do best, which is connecting with your patients. And then we’ve got these functions here that are allowing your practice to run at a supreme level of efficiency—and knowledge—and data.

Josh Gosnell: Yeah, people are really—I think when the AI topic comes up, people are very concerned about losing their jobs or about technology replacing certain jobs within the dental practice.

But I would argue that it’s not about replacing—it’s about enhancing.

It’s about taking things off your plate that take too much time or that you’re not able to do efficiently, and giving you back that time to where it can go to patient care.

Gary Takacs: Patient care and patient interaction.

Josh Gosnell: Yeah.

Gary Takacs: Well, Josh, thanks. I really appreciate all you and your team are doing to help dental offices thrive.

Josh Gosnell: It’s been a pleasure.

Gary Takacs: I also want to take a minute and thank our listeners. We appreciate each and every one of you.

Thank you for making us the number one dental podcast, and thank you for the privilege of your time.