Who Leads While the Dentist Treats? (E.337) – Part Two

“You don’t need to have all the answers to ask all the questions.” – Joanne Miles

EPISODE OVERVIEW

A number drops and the story starts immediately.

Patients are leaving. Case acceptance is down. The team is underperforming. Something needs to change.

But the number may be telling a different story.

In Part 2, Joanne Miles joins Regan Robertson and Sara Hansen to explore how doctors and office managers can use KPIs without allowing emotion or assumptions to drive the response.

Joanne explains why one metric rarely gives the whole answer, how behaviors influence the numbers, and why strong leaders slow down long enough to understand the context before deciding what needs to change.

WHAT THIS EPISODE REVEALS

• Why a KPI is the beginning of the conversation, not the conclusion
• How emotion can distort the way doctors interpret practice performance
• Why office managers need to bring questions along with the data
• How team behaviors influence case acceptance, production, and growth
• Why percentages alone can hide what is actually happening in the practice

WHAT YOU’LL LEARN

• How to investigate a KPI before reacting to it
• Why related metrics need to be viewed together
• How Joanne’s leadership radar identifies wins, friction, opportunities, and risks
• How to involve the team without turning numbers into judgment
• Why stronger doctor-manager conversations lead to better decisions

IF THIS SOUNDS FAMILIAR

Your office manager brings you numbers you do not like.

You immediately start wondering what is broken.

The team gets defensive when KPIs come up.

Case acceptance looks good, but production tells another story.

You are looking at the metric without understanding the behavior behind it.

The next move may be to ask a better question.

NEXT STEPS

Choose one KPI your practice watches closely.

Before deciding whether the number is good or bad, ask what changed around it. Look at the related metrics. Talk with the team. Find the behavior behind the result.

Then decide what deserves action.

Want to develop a stronger leader inside your practice?

Joanne Miles and Sara Hansen host Emerging Leaders, a monthly leadership development session created for dental office managers.

Register for an upcoming Emerging Leaders session:
https://productivedentist.zoom.us/meeting/register/66WY74JYS2SNK9l4lXqMpg#/registration

TRANSCRIPT

00:00:00:04 – 00:00:02:15
Speaker 1
The Productive Dentist Academy Podcast network.

00:00:02:16 – 00:00:19:17
Joanne Miles
KPIs are important. We need to keep our eye on. We need to understand the behaviors behind these KPIs. But if we’re not slowing down for a moment and using what I call kind of the leader radar and asking more questions first.

00:00:19:20 – 00:00:36:23
Speaker 3
Thanks for tuning in to the Everyday practice of Dental podcast. I’m Regan Robertson. My co-host Sara Hansen, and I interview real dentists and experts who grow their dental practices using authentic marketing in a way that you can remember, repeat, and use in your own practice to get the patients you deserve. Let’s dive in.

00:00:37:04 – 00:01:18:17
Sara Hansen
Doctors. Do you ever find yourself feeling that maybe you’re not attracting new patients? You’re low in collections. Patients aren’t accepting treatments, and then your office manager maybe brings you analytics or data that shows a different story. Doctors. That’s the gap we’re talking about today with podcast favorite Joanne Miles. I am joined by my girl Reagan. And we’re this is going to be our second series with Joanne today where we’re talking about that gap, the gap between as a doctor owner, oftentimes it’s our blood, sweat and tears that we’ve invested in this practice and we’ve grown it.

00:01:18:17 – 00:01:45:08
Sara Hansen
And so, of course, you’re emotionally invested. And sometimes things can go away that we feel emotionally maybe disconnected to. Or maybe it’s telling us a different story through emotions. And our office managers can come in with data that we’ve asked them. So, Joanne, let’s talk about KPIs today. And why is it important that our practice leaders and office managers have really great KPIs?

00:01:45:10 – 00:02:15:15
Joanne Miles
Yeah. So I might be throwing some of our managers a little curveball when we’re talking about KPIs, because there’s a there’s a filter, if you will, or a lens that I think that we miss. There’s an opportunity that’s missed on how we view our KPIs, because often what happens is like for an example, we could I could look at a practice and I can look at we’ll just pick one the the active patient base and yeah that number.

00:02:15:17 – 00:02:45:09
Joanne Miles
Right. And we know that numbers should be going up each each month. We don’t would you would want to see it going down right. So I could look at a practice and say wow they had 2000 patients in January but now they have 1500. Well, I could make up a story about that practice just from, you know, that one metric I can make up a story probably wouldn’t be a good one, right.

00:02:45:11 – 00:03:09:07
Joanne Miles
But it may not be the truth. And the question. And so that’s really the key. So yes, KPIs are important. We need to keep our eye on KPIs. We need to understand the behaviors behind these KPIs. But if we’re not slowing down for a moment and using what I call kind of the leader radar and asking more questions first, right?

00:03:09:10 – 00:03:11:11
Regan Robertson
Context is everything.

00:03:11:13 – 00:03:12:07
Joanne Miles
Everything.

00:03:12:12 – 00:03:33:24
Regan Robertson
Joanna and Sarah, both of you have taught me so much. Really. I mean, it is it is the the the free education I get every day. Listening to you has helped me in my own leadership. Not to make knee jerk reactions when I see a number that I don’t like. So my brain went right away. When you said 2000 to 1500, I was like, well, maybe the practice switched to fee for service.

00:03:33:24 – 00:03:57:01
Regan Robertson
Maybe they’re saying higher value clients right now. And so that’s the reason why. But so there’s like a picture run it. But it can be really hard. It can be an emotionally charged conversation. Especially if like our numbers aren’t like not just those numbers, but like our financial numbers aren’t looking good. It’s so easy to need jerks. So tell me about this, this leadership thing that you’ve developed here with this.

00:03:57:01 – 00:03:58:08
Regan Robertson
This sounds great.

00:03:58:12 – 00:04:21:05
Joanne Miles
The leadership radar. And it’s I’ve taken the model of Swat, but I don’t like I don’t like Swat as it sits on its own. So Swat is this the strengths, the weaknesses, the opportunities, the threats. Right. But generally, what happens when a team goes through a Swat exercise? Then the results are in this beautiful piece of paper and it goes into a draw.

00:04:21:06 – 00:04:29:19
Regan Robertson
Yeah, yeah, it feels so abstract. Swot analysis of like something a consultant gives you that lives in a binder and you’re like, you look okay, what do I do with this.

00:04:29:20 – 00:04:30:13
Joanne Miles
So this.

00:04:30:15 – 00:04:31:14
Sara Hansen
Back end data.

00:04:31:14 – 00:04:32:07
Regan Robertson
That we pull.

00:04:32:07 – 00:04:33:14
Sara Hansen
My strategy. Yeah.

00:04:33:15 – 00:05:01:17
Joanne Miles
Right. So I like to you know me I like to put spins on things and find different ways to look through, look at things. And this is more about as me as a manager and a leader. This is about a behavior change in myself on how I approach things, seeking first to understand more before I react. And so I sort of took that and kind of created this radar, which is like, okay, what are the internal wins?

00:05:01:17 – 00:05:21:23
Joanne Miles
Which are the strings? Right? What are the internal friction of the practice? That could be considered a weakness. But I like the line, you know me with language. This is about the internal friction. So it opens up a little bit more than you’re just looking for a weakness. Right. Because a weakness is considered bad.

00:05:21:24 – 00:05:22:14
Regan Robertson
Yeah.

00:05:22:15 – 00:05:42:20
Joanne Miles
And then you have these emerging opportunities. What are these things that are emerging out of this analysis of looking at the internal wins and then the internal frictions. And then you have okay. External risks are always there. We need to know what those are. And you look at that and you see and then and then you put that into a framework.

00:05:42:20 – 00:05:54:06
Joanne Miles
And then here’s the difference managers. You don’t need to have all the answers to ask all the questions. Oh.

00:05:54:08 – 00:05:59:07
Sara Hansen
Okay. Joanne, you know OMS we want to have the answers for everything.

00:05:59:08 – 00:06:00:02
Regan Robertson
I want to fix.

00:06:00:02 – 00:06:00:19
Joanne Miles
It all.

00:06:00:23 – 00:06:11:21
Sara Hansen
Yeah. So I was going to say we’re the fixers of the practice. So okay I’m going to slow you down. So they need to have more questions. What does that sound like for an Om to a doctor.

00:06:11:24 – 00:06:34:13
Joanne Miles
Yeah. So what it could be to the doctor and the team I, I personally like to bring the entire team in. Yeah. Say, hey, this is what we’re looking at, you know, and what I’ve seen, I’ve done a little observation here are the areas we’re really winning. And here are the areas where I’m seeing there’s some friction. And I want to get your feedback to know if I’m, like, off or not.

00:06:34:15 – 00:06:58:11
Joanne Miles
And then you know, where, you know, what do you see as maybe some solutions that we could, we could do to bring this all together. And then is there anything kind of hidden that we’re not seeing, like what could potentially derail us? So once the solutions are kind of brought forward okay. So what do you think would prevent us from being able to achieve these things?

00:06:58:12 – 00:07:21:19
Joanne Miles
Right. And I think it’s important to to again, this is about slowing down in the process of finding a solution. Again, we don’t have to have all the answers our team actually have have the answers. They have ideas. They just want to be heard. They want to be of the space to have that freedom, to be able to share it.

00:07:21:19 – 00:07:48:10
Joanne Miles
So I know we started out on KPIs, which are super important, but one KPI alone isn’t going to give you the answer. Right? And to Reagan’s thing is like I learn the hard way, you do need to ask, well, did you just go out a network with some offices, you know, insurances because they’ll have attrition. If you know, even the best laid runway, you’ll have some attrition, you know.

00:07:48:11 – 00:08:06:15
Joanne Miles
So it’s better to understand that. And then once I had the answer to that, then guess what? I’m going to start looking at other KPIs at that point. Right. So I’m going to say okay. Sure. You went from 2000 to 1500, but now let me look at your productivity. Let me look at you. Let me look at your write offs.

00:08:06:15 – 00:08:36:18
Joanne Miles
Let me look at your. Yes. You shouldn’t, you know, reappointment rates. Let me look at I mean, there are a plethora of other metrics that go to this, right? So it’s KPIs are important. Managers should absolutely have the things like if let’s just say example that you wanted to the office wanted to make one of their big economic objectives that year to place more implants.

00:08:36:19 – 00:08:57:07
Joanne Miles
So last year we did ten. This year we we want to do 20 right. So we break that out. We should have X amount a month. Let’s watch the metrics. Let’s do that. But then there’s behaviors around case acceptance for implants. Are we identifying missing spaces. Are we having great conversations like so. There’s always a behavior behind a metric.

00:08:57:07 – 00:09:25:07
Joanne Miles
And that’s where you help your team realize that you’re not you’re not judging them on numbers. You’re just the the metric is the metric. It’s just a way for us to measure how well are we getting patients happy? How well are we getting patients healthy? How well are they having that experience in our practice? It’s not a measurement of the hygienist value as a human being, and.

00:09:25:07 – 00:09:25:24
Sara Hansen
It’s.

00:09:26:01 – 00:09:28:19
Joanne Miles
Being able to tease it apart, you know.

00:09:28:21 – 00:09:31:09
Regan Robertson
Which is powerful. Joanne. There’s more.

00:09:31:09 – 00:09:34:14
Joanne Miles
To metrics than just a number.

00:09:34:16 – 00:09:59:11
Regan Robertson
Yeah. Well, I love how you’ve diminished the emotional the negative emotional impact of changing weakness to friction, for example, so people can get sensitive defensive. And when you hear weakness, it’s it’s almost intuitive to want to downplay it or hide it or like, let’s not let’s not highlight that. Like, let’s not talk about it because weakness makes it feel like, well, I’m then weak.

00:09:59:12 – 00:10:19:19
Regan Robertson
That’s to that point of, you know, I’m not valuable or, or wherever negative root your brain might take it to, whereas friction feels like something that can be ironed out. It feels like it can. Definitely. It’s not it’s not an it’s not dire to the point where it’s, you know, career ending, for example, like it doesn’t trigger that type of response.

00:10:19:19 – 00:10:21:21
Regan Robertson
Is that why you changed it to friction where you see.

00:10:21:22 – 00:11:01:04
Joanne Miles
It is. Yeah. Because I believe words have power. They they have the power to build us up or tear us down, even within our own mind. We may not even speak them out loud. Actually, I think what we say to ourselves quietly is more damaging. So I, I have and I know that for myself. Right? So if that’s happening to me, then how I lead and the words that I use are very important because they can empower somebody to, you know, maybe step outside of their own comfort zone to, to try to take a chance and succeed or not.

00:11:01:04 – 00:11:28:14
Joanne Miles
And if you’re going around, I mean, weakness is okay, weakness is weakness, whatever. But I think everybody, to your point, has an interpretation. There’s a there they take a they take a little trip with that word. So if I can soften it but still give the same message, friction to me feels I. You can you can find solutions to friction, right.

00:11:28:16 – 00:11:30:16
Regan Robertson
Yeah. It feels like more definitely.

00:11:30:17 – 00:11:34:24
Joanne Miles
It’s more empowering than well, a weakness could just be your weakness.

00:11:35:05 – 00:11:54:09
Regan Robertson
Yeah. What you mentioned active patients as being one of the numbers that can be misinterpreted unless you ask great questions. What are the other top metrics that you’ve seen that can that can really put a wrench between the office manager and the dentist and the team, if not properly investigated?

00:11:54:14 – 00:11:58:05
Joanne Miles
Well, case acceptance. Oh, sure.

00:11:58:07 – 00:11:58:24
Sara Hansen
Yeah.

00:11:59:00 – 00:12:21:19
Joanne Miles
That’s a huge one. And it’s one of those where I, you know, I kind of get on my soapbox a little bit, but every, you know. Yes. There’s percentages. Right. Oh we have 30 you know a 50% case acceptance. We’re doing great. But if we’re not looking at the dollars that are attached to that metric, then you don’t really know for sure.

00:12:21:20 – 00:12:53:22
Joanne Miles
How do you know that you’re diagnosing enough that is going to actually help you meet your goals? Unless you look at the actual dollars, because 50% of $100 diagnosed is $50. Yeah, right. You know, versus, you know, you could do 10% of 100,000 more. Right? So the percentage alone is not yes, it’s a piece of the metric. But there’s a deeper story to it.

00:12:53:23 – 00:13:31:08
Joanne Miles
So you have to look at what are you diagnosing, how much is being diagnosed versus how much is actually being accepted. And you have to look at those dollars because I’ve seen I’ve seen practices go from 50% to 35%, but yet their productivity has gone up 2 or 300,000. And that could be because the doctor has chosen, you know, has worked with us to get their philosophy of care locked in, say, and have gone through the clinical calibration and really, truly understand, like I went to school and then I went and did all this extra C because I wanted to comprehensively diagnose.

00:13:31:08 – 00:13:51:07
Joanne Miles
But the behaviors of myself and my team weren’t in alignment with what that philosophy was. So yes, that metric might have been 50%. But now we did all this work and he has dropped a 30. But now I’m truly diagnosing comprehensively and I’m getting the acceptance for it.

00:13:51:09 – 00:13:51:22
Sara Hansen
Yeah.

00:13:51:23 – 00:13:55:17
Joanne Miles
So it’s it’s like a, like a seesaw that.

00:13:55:18 – 00:14:18:19
Sara Hansen
Yeah, that’s what I was thinking. It’s like this, this perfect marriage of, you know, behaviors, metrics, reactions, like how it all comes together, how we move forward with the team of finding, you know, what’s holding us back. What does that look like? What are the steps we’re going to take to to fix that? So I love what you’re saying, Reagan.

00:14:18:19 – 00:14:20:10
Sara Hansen
You had a big idea, I could tell.

00:14:20:11 – 00:14:49:02
Regan Robertson
Well, the road to case acceptance is so bumpy and it’s filled with so many micro moments leading up to the big ask that I think it’s something I love that you called that out as a metric. It is wildly multifaceted and and it does warrant a lot of attention to look at each of those micro, micro touchpoints that the patient has along the way to kind of figure out what may be having friction, what may be breaking down that can be remedied.

00:14:49:03 – 00:15:12:04
Regan Robertson
To that, I know that you have an emerging leaders group session that you that you run. Is it every month, Joanne, with office managers. Okay. In the last episode, listeners, if you if you missed Joanne’s first appearance with us, definitely go back where we talk about what makes an office manager a leader and where we talked about emerging leaders as well.

00:15:12:06 – 00:15:28:04
Regan Robertson
And Sarah, I believe you’re joining. Yeah, Emerging Leaders Group. So Joanne, could you quickly tell us what that is. And I know we’re opening it up to the public. So I think that could be a wonderful way for them to experience your learning. And Sarah’s learning in real time.

00:15:28:09 – 00:15:49:24
Joanne Miles
Yeah. So Sarah and I started the Emerging Leaders program about three years ago, I would say, and it came out of our our just desire to create a space for office managers to come because we often feel like we are on the island. We are. We are in between managing a team and managing the doctor, and then managing this financially viable business.

00:15:49:24 – 00:16:17:03
Joanne Miles
And a lot. It gets messy and leadership is a learned skill. Everybody can learn it, everybody can. But it’s not. It’s not the same path for everybody. That how you how you arrive is a different path. And so we wanted to create the space where we are actually tackling the topics that it really matter to make us better leaders.

00:16:17:03 – 00:16:41:12
Joanne Miles
It can be in how we have conversations with team. We’ve had episodes on making the distinction between solving a problem versus solving and managing a dilemma to very, very distinct things. You know, we’ve done HR things, we’ve done profit and loss, and what are the true benchmarks of a healthy practice? And then what are the levers that you should be pulling to affect your pals?

00:16:41:12 – 00:17:04:19
Joanne Miles
And make sure that the doctor has a very high EBITDA at the end of the year. So there are it’s just this gamut of of topics that we do. It’s monthly, it’s 90 minutes. And we are now now that we’ve really kind of we’ve we’ve figured out the formula for this. We’re opening it up to all managers, whether your clients of ours or not.

00:17:04:20 – 00:17:27:22
Joanne Miles
And every once in a while we during the year, we will ask and open it up to the doctors because doctors are like, well, I want to come. And we’re like, no, no, get our space or one space. But we use topics that we we that the doctors have to be part of again, because the manager and the doctor are the true leadership partnership.

00:17:27:22 – 00:17:32:09
Joanne Miles
So there are times where we have to cultivate both.

00:17:32:11 – 00:17:54:07
Sara Hansen
It’s it’s a really great opportunity. Doctors, get your office manager signed up. I’m telling you it will. It will be the best 90 minutes of the month that they invest in their time. So, Joanne, how do they get signed up? Reach out to you. Maybe we can have a link in the show notes. What does that look like?

00:17:54:08 – 00:18:15:01
Joanne Miles
We could do a link in the show notes with the remaining topics for the rest of this year. In the in that calendar, there’s a link to register for each one. I would say go ahead and register for the rest for the year. And and managers, you you deserve 90 minutes out of an entire month where you can step away.

00:18:15:01 – 00:18:35:13
Joanne Miles
And if you can’t, then this will be your first task is to put that on your calendar. Let your team know that I have 90 minutes uninterrupted and you will see the sky one fall. So the toilet might plug up, but the sky is.

00:18:35:15 – 00:18:51:17
Joanne Miles
You know, and come, come. You deserve it. You deserve it. And then we could. You can always email me. It’s Joanne Miles at Productive Dentist and I can get you connected with it as well.

00:18:51:19 – 00:19:05:14
Regan Robertson
Thank you. Joanne, it’s been a pleasure. I know we have another episode coming up where we are going to drive into the behaviors that make a great office manager, a leader. So listeners stay tuned to that. And Joanne, thank you again.

00:19:05:17 – 00:19:07:00
Joanne Miles
Yeah, thanks.

00:19:07:02 – 00:19:24:10
Speaker 3
Hey, thanks for joining us on Everyday Practices Dental Podcast. It would mean the world to me if you could leave us a like or a review on iTunes, or go to Productive Dentist Academy through Google and leave us a review there. You know, we are here each week to talk about what’s possible when you leave your practice with clarity and courage.

00:19:24:11 – 00:19:41:18
Speaker 3
If you are ready to build a business that supports your life and not the other way around, investment grade practice coaching powered by productive, dense academy can help. Visit investment grade practice to schedule your free 60 minute coaching session so you can start designing the practice and lifestyle you’ve been dreaming about all along.