Episode #391: Why Dentists Stay Stuck in Insurance and How to Break Free with Melinda Heryford

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

Gary Takacs: 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.

Lester De Alwis: Welcome to the Less Insurance Dependence podcast. I’m your host, Lester De Alwis. This show is all about helping dentists take control of their practice, reduce stress, and build something that works for them, not for insurance companies. So now, before we get into today’s topic, let me ask you a quick question. If your practice relied less on insurance, would you be attracting the kind of patients you actually want to treat? That’s where the right marketing makes a big difference. So a big shout out to the sponsors of this, episode with that is Ekwa Marketing. Ekwa Marketing helps dental practices attract high quality patients consistently. So your growth does not depend on insurance plan. So if that’s something you’ve been thinking about, you can take the first step by scheduling a complimentary marketing strategy meeting by visiting the lessinsurancedependence.com/msm. Now, let’s get into today’s episode. I’m excited to welcome Melinda Heryford. Melinda brings deep insight into why dentist feel stuck and what it really takes to move forward. She has worked with teams and leaders to help them break through the patterns that keeps practices dependent on insurance. And today’s episode is title, why Dentist Stay Stuck in Insurance, and How To Break Free. Melinda, we are so excited to have you here. Thank you for joining us.

Melinda Heryford: You’re welcome. It’s so great to be here, Lester. Thank you for having me.

Lester De Alwis: Amazing. So, let’s start with the beginning. Where, what is the real reason dentists stay stuck in insurance dependence, even when they want to move away?

Melinda Heryford: Yeah, it’s a great question, right? Because I think burnout for dentists is at an all time high. You hear about it a lot, Lester, you’ve probably been hearing about that, and I think this is, I think this contributes, right? And when I think about being stuck in insurance, I notice that really it is, it’s not really about the insurance. It’s really about clarity and a fear of execution, of a lack of clarity and a fear of execution. So when dentists are chugging along in their practice, Lester, we call this the whirlwind, right? That’s like patient after patient after patient, and patients fall out of the schedule. And you have to be busy getting patients back in the schedule. And really the truth is, day after day, we could just be busy with just taking care of one patient after another.

Melinda Heryford: But the difficulty with that, Lester, is that then we’re just kind of stuck on a, on a, on a circle, right? Just circling around doing the same thing over and over again. So when dentists don’t have a clear goal or a destination where they’re headed, and their systems aren’t defined for yeah. for effectiveness and profitability, then really that makes it so that the team, we hire team member after team member and we’re just like, come in, do the job. Right? And so really then everyone’s stuck in the whirlwind. And so when it’s like that Lester, everything is reactive, right? We’re we’re just reacting to the day to day to day. And so you could, a dentist could spend their whole career in that place. And the difficulty is that does lead to burnout. You can imagine why, right? Because you’re just, it’s like, you’re on, you’re just in a grind basically. The grind up, wake up, see a patient, drill the patient, fill the patient, bill the patient, and that’s it. Yeah. Patient after patient. And so, I think that leads to that stuckness leads to just doing the same thing over and over and over again. And then the fear, then, brings up fears, right?

Lester De Alwis: Yeah. Yeah, exactly. So I think, when you, mentioned about doing, or they were doing the same thing over and over again, it pictured me an image of like a hamster on the wheel. Yeah. They keep doing the same thing over and over again. So yeah, it makes sense. Yeah. So yeah, go ahead. You wanted to say something?

Melinda Heryford: Yeah, I just wanted to say, Jim Collins, we all know that book Good to Great. Mm-hmm . it’s a, it’s a business. Even the, even the dentists know it. When the dentists are trained in dentistry, they know that book Good to Great. Jim Collins wrote this great book. And, what makes Good company’s great is that they have, they have clarity, we call it the wig, the wildly important goal. He called it the BHAG. . And so, there’s this idea of one important goal, and then the other thing Jim Collins shares with us is if we have more than three priorities, we have no priorities. So you can see mm-hmm. A, if we’re hanging out in the whirlwind and we’re doing on the hamster wheel doing day after day, then that is a bad feeling, right?

Melinda Heryford: That just that really, you could see the alarm clock goes off. And this is, I can’t even tell you the number of the dentists that tell me this when I first meet them, Lester, the alarm clock goes off and they do not wanna go to work. They don’t wanna go to work. I know after all that training and all that stuff, they don’t want to go to work. So clarity about where you’re here heading really is like a primary piece for not being stuck, but it’s also a primary piece for not being so dang dependent on those insurances. It wasn’t meant to be that way. Anyway, I don’t even know how we got here.

Lester De Alwis: Exactly. And you also touched about the fears. So what fears or misconceptions, oh, this could be even myths whole dentists back from taking that first step to as independence.

Melinda Heryford: Yeah. So I think they really worry about, like, the biggest fear is if I make this change, I’m gonna lose mm-hmm . All my patients mm-hmm . And, there’s this knee jerk reaction that to stay busy, I need more insurance. I had a client the other day, he wanted to be busy. He signed up with some PPOs. It’s like, oh, okay, well that’s one way, right? Is it the only way? And so, you know, the other thing is they don’t feel like they’re worried that their team can’t handle the conversations because lesser, when we go into insurance independence, we get to stand in the dentistry. And not all team members have been trained to, the first thing that they say when you bring a treatment plan up front is your insurance covers X. Right? That’s the first thing they say.

Melinda Heryford: So if there’s anything you get out of this, at the this podcast, go back tomorrow to your practice and like get that dialogue out, right? We no longer start with your insurance covers. We start with what it, what are the conditions we’re treating and how are we gonna help those? How are we gonna help those teeth get better? So, it’s, it’s these fears though, Lester, if I drop insurance, all my people are gonna, my patients are gonna leave. My team can’t handle it. It isn’t the right time. it’s easy to find the excuses mm-hmm . But really the truth is there’s a loss of control and predictability that was known, that is known. And if you step back from that really mm-hmm . There’s already a bunch of not control, a loss of control, like scheduling swings. We have massive write-offs. We have inconsistent collections. Right. There’s really a lot of ba difficult things that happen because we have insurance, right. We’re dependent on insurance. So we Exactly. it’s that thing, that we talk about Lester, what’s familiar. We kind of hang in what’s familiar because what’s unfamiliar seems too scary and I think this is what it is for dentists. It’s like, that is too scary to take that step into less dependence.

Lester De Alwis: Yeah. Yeah. Makes sense. Now coming, talking about team dynamics, how do team dynamics and communication impact a practice’s ability to successfully reduce insur insurance reliance?

Melinda Heryford: Yeah. It is such a, it’s such a good question. Last year. ’cause it makes mm-hmm. A big difference, right? Yeah. That when the team’s all in. So I think you can, you can say a team is going to accelerate the growth of this or the desire to make this happen, or they’re gonna anchor the practice in place. And so if the roles are unclear and the conversations are inconsistent, it’s gonna affect the team dynamics in making this shift. If accountability is in exist, not existent or weak systems get stuck, they don’t like, it’s hard to move forward. If there’s no accountability, then like, we’re, we’re gonna go back to what we know. And yeah. If the team lacks confidence, and I think this is the biggest thing that I see Le Lester when the team lacks confidence, case acceptance drops. And so yeah.

Melinda Heryford: When that, I think that’s why they start with your insurance covers because it’s like, they’re, they’re afraid that it’s too much money. They’re afraid, like afraid of a bunch of things. And so, yeah. building your team’s confidence is so important. But, I think the, a doctor and a manager’s success really is based on what our team actually does with the patients, right? Yeah. And it’s not really all what the doctor does in the operatory. It is every conversation we’re having, with each patient. And so when the teams align, patients hear that consistent message and the we’re building value, we’re talking about conditions, we’re talking about what we see, and that mm-hmm. Value gets communicated clearly. So this is my most passionate piece about it. Lesser, it’s, it’s our job to go back to the dentistry. Let’s talk about the dentistry, let’s talk about the teeth, let’s talk about the conditions that we see because mm-hmm . That treatment acceptance starts there, right? And treatment acceptance rises when we build value for the care. And so mm-hmm . It’s not about the money, right? So it’s, it’s really about, we’re not really transitioning away from insurance alone. We’re actually building value for what we see. And the team can either make it or break it based on how well they’re trained.

Lester De Alwis: Yeah. The team plays a big role. so yeah. So what systems or mindset shifts are required for a practice to confidently move towards an independent model?

Melinda Heryford: Yeah. this is the hidden piece, Lester mm-hmm . I’m a systems gal. I treat, I train systems. I love it when everybody is aligned around systems and we’re all doing the same thing. Mm-hmm . But systems are only as good as the beliefs that we hold in our mind, right? So belief systems and mindsets are huge. And so this is the incre. this is why I’m glad you’re doing this podcast because this helps kind of doctors see those hidden beliefs. Because one of the mindset shifts is we’re going from like, I gotta have all these patients to, so from volume to value, from volume of patients to value of care, and from all the procedures that we do, really to what are the conditions that we seek? What are we worried about? What are we concerned about? And what’s gonna happen if we don’t do anything about it?

Melinda Heryford: Mm-hmm . And then a mind. So how we’re shifting from, okay, I’ve gotta do all these things, or this is what you need, Lester, you need a crown. No, there’s active decay. And the sooner we treat that active decay, the better off that tooth is gonna be. So how that’s so different. So that’s value, that’s conditions. And we go from like, I gotta be busy to productive. And so this is one of those pieces that, it’s like you could see 20 patients a day, or you could see five, what would you rather do? And this is the beauty of making this shift. And it’s not just insurance dependent. It’s really shifting to a better managed practice. And then this mind shift of I gotta control everything to my team’s accountable. And we really are, all focused on the same thing and holding ourself accountable.

Melinda Heryford: So there are specific systems that are required to make it happen, right? And the systems that make it happen. So this is kind of our zone of genius mm-hmm . Which is, we insist on a wildly important goal, if not 21 1 clear target. And then we have what we call myths, Lester. And those are most important things. So every team member has two to three actions to get to that wildly important goal. And we scheduled a goal, and that’s really why we go from 20 patients to five. Because when we scheduled a goal, it’s a genius, right? It’s a, it’s a way of scheduling. It’s not like we’re throwing all the patients in there, and it’s just about being busy. It’s not about being busy. It’s about being productive. And any doctor will want to see five, not 20 typically, right? yeah.

Melinda Heryford: But what would you say, Lester? Would you rather see 20 or five and produce five? Yeah, five is better, right? Is that Yeah. And then a system that’s critical that we’re talking about here is what we call our getting to Yes system. It’s our case acceptance system. And so really the, you gotta tighten up on that case acceptance system because everything we say to the patient either leads to them saying yes to the care and being connected to it for themselves, or saying, no, I don’t, I don’t wanna do it right now. So getting to yes is critical. And then if we don’t measure our success, Lester, we’re, we’re in the, we’re in the, in the hinterland. We think we’re, we are working hard. if you ask anyone, they’re working hard, but we’re working hard to what effort.

Melinda Heryford: And so when we measure what we’re doing, then we can go, okay, what’s working and what’s not working, and what do we need to dial in? And so we call that, once we measure it, we have a weekly accountability cadence where everybody gets to see where they are in relationship to goal and what they, what action they need to take to get back on goal. So you can see mindset shift and system shift. how they work hand in hand. Yeah. They really do. And this is the, this is the value that Jim Collins was trying to teach us. When we have a focus, when we have something that we’re all going for, then all of our effort, it’s like this streamlined, elegant effort going towards the same thing. So it takes less effort, it’s way more satisfying, and we’re way more productive. So it’s beautiful, isn’t it?

Lester De Alwis: Yeah. Yeah. Yeah. It is. I love, I love how you explained, and, touched that question and with so much of, I think there’s so much of nuggets shared in just that, piece of a piece of a question we just, went through. So for a dentist listening today, who feels stuck? What is the first step they should start breaking free?

Melinda Heryford: I think that’s awesome because that clarity leads you to great things, right? It, when you, when you take one step, it’s like one action step. So I would recommend they start with one wildly, important goal. And here’s the question, and I’m gonna say it twice, Lester, if everything, if everything stayed the same, what one change would you make that would make the biggest impact? So look at the whole practice. If everything stayed the same, what one change would you make that would make the biggest impact? So we have a formula for this. Like, if you’re at X on that and you wanna go to y, it’s by win. So it’s from X to Y by win, a lot of the time we support our doctors and having an hourly production goal. And so it really is from this production goal to that production goal by when and when we align our team. So then that’s the next piece of it. Align the team around that one wildly important goal, identify a couple things for each team member, and then start tracking it weekly. So it is a simple system, and, the message here is don’t try to fix everything. Focus on one thing and create some momentum. And the first step isn’t really dropping insurance, it’s deciding what winning looks like for you right now.

Lester De Alwis: Amazing. Amazing. So, Melinda, I know listeners listening to this episode will have a lot of questions they might want even to get in touch with you. And they might also want to, just share the experience, and get firsthand, coaching or even understanding of what they should be doing. So, what is the best way that they can reach out to you and, have it, have us have a, have a open mind chat.

Melinda Heryford: Yeah. Beautiful. we’ll put it in the show notes. My name is melinda@melindaheryford.com. That’s a great way to reach me. Also, you could go on our website practicemanagementconsulting.com, and there’s a link there. I also wanna offer you our listeners our scheduling, our 10 steps scheduling audit. And Okay. the beauty of that is, one, once you take it really assesses one or two things you can make a change to, which is exactly what we’re talking about here. it does, it does start with the schedule. And when our schedule’s more effective, our life mm-hmm . Is way more satisfying.

Lester De Alwis: Amazing. Amazing. So, of course, to anyone listening in the show notes, the information will be on the show notes, and also the 10 step, scheduling, guide will also be there as you can take benefit of it. So Melinda, thank you for such an honest and insightful con conversation.

Melinda Heryford: You’re welcome. It was my pleasure being here. And really, I wanna encourage all the dentists to go back to building value, build value, and stick with the dentistry and stay focused on the dentistry and the conditions. I think this is just an opportunity in, at this time in dentistry for us to get back to dentistry and talking to patients about conditions and what’s possible for them for full mm-hmm. oral health. So I love that you’re doing this. Thank you for having me.

Lester De Alwis: Amazing. So the key takeaway from today is this, dentists are not stuck because of insurance. They’re stuck because of patterns, mindset, and systems that can be changed. So one, those one of, once those change, everything else follows. If today’s episode got you thinking about what’s possible for your practice, here are two simple next steps. First off, if you want to bring in better patients and rely less on insurance, schedule a marketing strategy meeting with Ekwa at lessinsurancedependence.com/msm. And secondly, if you’re looking for mentorship and you want a clear roadmap to build a practice that gives you more freedom, you can connect with Gary Takacs for coaching and that, and that is at coaching, for thrivingdentist.com. And, all these are all complimentary, just like what, Melinda shared as well. So you can go to the show notes and get these all for yourself and make benefit of these. So these are all great starting points if you are stuck and if this episode helped you, helped you chat with a colleague who might also need to hear this and, make benefit of it. So thank you for listening in. We’ll see you in the next episode of The Less Insure, less Insurance dependence podcast.