The Diagnostic Drift That’s Destroying Your Value (E.151)

What This Episode Reveals

Your philosophy of care doesn’t live in your team’s heads.
It lives in yours.

When that happens, diagnostic drift begins. Small inconsistencies pile up. Treatment quality slips. Patients hesitate. Left unchecked, it erodes patient outcomes and the long-term value of your practice.

Victoria Peterson and Dr. Bruce Baird break down how misaligned systems and untaught standards create invisible cracks in your business and how Clinical Calibration fixes them.

What You’ll Learn

• Why diagnostic drift costs you more than you realize
• How to translate your philosophy into systems your team can own
• What MAD Skills training does to eliminate bottlenecks
• The role of technology in expanding diagnostic confidence
• Why alignment protects patient care and increases practice valuation

If This Sounds Familiar

Your team delivers good work but every day feels slightly off.
You’ve taught and retrained yet mistakes keep surfacing.
Your practice is producing well but stress levels are climbing and patients leave with questions.

This episode shows how to bring your vision out of your head and embed it across every role in your practice.

Stop Losing Value to Drift

Document your philosophy.
Train your team to deliver it.
Build a practice that works with or without you.

👉 Learn more

 

TRANSCRIPT

[00:00:47] Victoria Peterson: Welcome back to investment grade practice. I am here again with my partner, Dr. Bruce B. Baird, continuing our series from the Chairside to the Boardroom. We both have done that.

[00:00:59] Victoria Peterson: We’ve both been [00:01:00] clinically chairside and taught a lot of clinicians, and then taught a lot in practice management. And in this episode from chairside to boardroom, we’re connecting the value of clinical systems. To practice value. And Bruce, in this episode, I wanna talk about diagnostic drift and how that just destroys the value.

[00:01:24] Victoria Peterson: And just to set the stage, you know, a lot of times when we first talk to doctors, they have a philosophy or they know what they want, but it’s living in their head. Uh, what do you think happens to a practice when it’s all just in the doctor’s head and isn’t communicated to the team?

[00:01:42] Dr. Bruce Baird: Well, I’m kind of an expert at that actually, because for 15 years in practice, probably 18 years in practice, everything was in my head.

[00:01:53] Dr. Bruce Baird: I just expected my team to know what I was thinking. Uh, and [00:02:00] truth is, I didn’t spend much time training. I didn’t spend much time. I just wa I had expectations of excellence without. Without teaching excellence, without working with my team to teach them. Um, you know, the philosophy of care is one thing, but having us all on the same page as far as what do we do when we’re doing a class two, you know, or, you know, class two, you.

[00:02:25] Dr. Bruce Baird: Three surface, you know, four surface. What do we do when we’re doing endo? What do we do? In other words, having everybody on on not only chairside, but the front office, understanding everything. And that’s really where clinical calibration, uh, you’re, you’re gonna lose so much value when your team, you know, every day your expectations are different.

[00:02:46] Dr. Bruce Baird: Um, and so what I found was it’s like. If I sit down with a team member and I just become the, I don’t know, the continuous instructor and asking questions [00:03:00] and my day, it’s really hard to do. You know, we talked about scheduling before, but really hard to do when you’re running behind. So it’s, which comes first, the chicken or the egg, and in my practice.

[00:03:14] Dr. Bruce Baird: I don’t know which came first. It was the scheduling philosophy that came up first, as well as my philosophy of care. But it allowed me to teach my team, you know, this is what I expect when I see a temporary crown. I want it to be polished. I want it to look like, almost like the real crown. And you know, summer can do, I mean, I’ve got a temp on on 27 and it looks just like the permanent and uh, because she did it and I’m like.

[00:03:40] Dr. Bruce Baird: How, how did you learn to do that? Well, I mean, not only did she get. Thousands of reps, but I taught her exactly what I wanted. Then I never had to teach her again. You know? Now if I saw something, that’s what we always say, a training opportunity. That’s where I would say, okay, uh, summer, you notice that little jagged edge on that margin.

[00:03:59] Dr. Bruce Baird: [00:04:00] Well we need to fill that in ’cause that’s gonna change how the tissues come up to the tooth. And then when we try to seat the permanent, it’s gonna be harder. And you know, all of those things. Same philosophy. When we start talking about technology, um, you know, I, I ask doctors, what type of restoration would you like to have in your mouth?

[00:04:18] Dr. Bruce Baird: And diagnostically, uh, it’s interesting. People who don’t extract wisdom teeth rarely recommend extraction of wisdom teeth.

[00:04:29] Victoria Peterson: It’s said, right? Yeah.

[00:04:30] Dr. Bruce Baird: It’s, it’s pretty crazy, but Oh, no, those will be fine. Yeah. When you get pulled,

[00:04:35] Victoria Peterson: so are you saying your skillset. Kind of creates the lens that you see the world.

[00:04:42] Dr. Bruce Baird: 100%. I mean, okay,

[00:04:43] Victoria Peterson: so if I don’t do crac restorations, I, I mean, what’s the big, what’s the difference between having a milling unit in my office and sending everything el to the lab? What would I, what would shift in my diagnosis?

[00:04:56] Dr. Bruce Baird: You know? Well,

[00:04:58] Victoria Peterson: I mean, only look at that [00:05:00] as like a cost thing. Right? But it’s not just cost.

[00:05:03] Dr. Bruce Baird: Yeah, I would, I would ask the doctor. This simple question is if you had a choice of materials in your mouth and you were having a filling done for surface. Composite, uh, and that’s what you were recommending? I mean, is that what you would recommend? What type material would you like to have? What type composite?

[00:05:21] Dr. Bruce Baird: Would you rather have something that was pre-made and put into that, that thermal cycles? Just like the tooth that’s bonded in place that has a chance a less in the rest of your life, or would you like a composite resin that would give you eight to 10 years? You know, I ask Dennis this all the time, and I would say 95% go, well, I’d rather have.

[00:05:40] Dr. Bruce Baird: I’d rather have it inlay and onlay. I’d rather have that type material. That’s what I have in my own now. Why? Because I didn’t really want the composite resins. I’d rather have something, something that had a great chance to last in the rest of my life. So that philosophy went on with my patients. Why do we not offer those to patients?

[00:05:59] Dr. Bruce Baird: [00:06:00] Well, you, you ask the one who wants to send it to the lab or the one who wants to, uh. Wants to do it inhouse. Uh, if you wanna do inlays and onlays in-house, easy. I mean, it’s so much easier for me to do a three surface, um, indirect restoration than it is for me to do a three surface composite. I mean, I prep.

[00:06:23] Dr. Bruce Baird: I walk away. It’s try it in, it fits perfect. And we, and we bonded. So it’s simpler for me and it’s better for me. But what about the doc who doesn’t have technology? What they’re gonna do is it becomes, first of all, doing an inlay or an onlay temporary is a nightmare, right? Very. Uh, they come out, they break, they, they’ll, they’ll end up fracturing the tooth because it wasn’t done properly.

[00:06:49] Dr. Bruce Baird: Bottom line is that’s when the doc becomes either a crown or a filling guy. There is no such thing as LA Long. I either do crowns or fillings Well, when does it become a Crown doc? Well, I don’t [00:07:00]know. It’s just how I feel that day. You know, I look at it, I go, Ooh, this is a big one. I think I’ll do a comp. I don’t think you could afford a crown.

[00:07:08] Dr. Bruce Baird: In other words, you start worrying about what patients can afford and what they can’t afford, when in fact they’re coming to you to get advice on. What they need. And what would be best? I’m always gonna tell them the best option in my own mind. Now, if I had never done any training with cec, if I’d never done anything on, all I’d ever done was, and cac, there’s so many other milling machines now.

[00:07:33] Dr. Bruce Baird: We say cec, but there’s milling, there’s, you know, fast mill, there’s all these different things. AI is making it. If you think, oh, well, those aren’t as good as the restorations if I send it to my lab. Well, I hate to tell you guys this, but your lab is using AI, using mill it, so you’re, you’re, you’re nuts if you think that.

[00:07:50] Dr. Bruce Baird: So if you have your own milling machine, which, oh my gosh, that’s a lot of cost. You know what, when you start looking at it, it’s very, it’s very, um. [00:08:00] It’s very, um, cost effective.

[00:08:03] Victoria Peterson: Yeah. And you get your ROI on it in the first year.

[00:08:07] Dr. Bruce Baird: I mean, I’m, people say, yeah, but you have to buy a hundred thousand dollars machine.

[00:08:10] Dr. Bruce Baird: Well, you could, but I pay for that a hundred, a hundred thousand dollars machine. Weekly, you know, I mean, it’s like, I’m, I’m gonna pay for this. Why? Because I’m doing, I mean, I was working two days a week for the last 14 years in practice, but I was doing a hundred units a month on two days a week, a hundred units of inlays and onlays and cramps.

[00:08:30] Dr. Bruce Baird: How? Because that’s what I recommended to the patients. Now, would I ever have some people say I just really would rather have a feeling okay. I’m, I’m, I’m cool with that.

[00:08:39] Victoria Peterson: Let’s pause right there because you’re bringing up two things that are, um, lessons or actually courses in our Clinical Calibration Institute campus.

[00:08:50] Victoria Peterson: Uh, one, you did a beautiful course and thank you for doing this. It only took me 20 years to get to, like, throw your hat. You, you have [00:09:00] some of the biggest clinical chops I’ve ever seen. You’re a diplomat or a fellow in almost every organization, but. Over time, you’re like, no, I wanna help people in their communication skills and their business skills.

[00:09:12] Victoria Peterson: And I really respect that. And until now, there was such argument over CR and Co and all that, and I, I respect that you didn’t wanna get into that either, but this course that you did on diagnostic distinction and differential diagnosis between class 1, 2, 3, 4, 5, you know. Really looking at distal and occlusal and those lingual cusp, um, really looking at the depth of the decay and when does it get into the pulp and all that.

[00:09:43] Victoria Peterson: I, I’m so excited about that one course because in like 15 minutes you clarified so much. Um, so that’s, that’s a, a new course that we’ve developed that goes beyond traditional. Productive Dentist Academy training. And [00:10:00] then the second one is, uh, I’ll give this up to Dr. Joe Valen and his office manager, Lisa Rogers, if you remember them down in, uh, Daytona area years ago.

[00:10:10] Victoria Peterson: She was a school teacher. And Joe, Dr. Joe was a former instructor at Yale Dental School. So he’s a teacher, teacher, teacher teacher. And he said, Victoria. Why can’t I get my assistants to actually do it? I’ve, I’ve taught ’em and I’ve shown ’em, and I’ve trained them, but they still won’t do a great impression or a tip.

[00:10:32] Victoria Peterson: And I said, well, you need to stop teaching and let them start doing so Lisa came up with a system called MAD Skills, mastering Assistant Duties, and created a leaderboard of, here are the diagnostic things that an assistant has to master on a scale of one to 10. Have you mastered it? Here are the restorative, basic restorative, advanced restorative surgical ortho, so the [00:11:00] assistants could build their skills and she put it up like a teacher, right on the bulletin board and made a poster out of it and decorated it.

[00:11:08] Victoria Peterson: And everybody in the office got to cheer the assistants on because everybody’s name was there. And the goal was to get each assistant to an eight or above. On that particular thing. So if it was, you know, the diagnostics, we’re gonna cheer Summer and Gay and Cammy and everybody on until everybody gets to an eight.

[00:11:29] Victoria Peterson: And it was just like you said with um, with summer, you’re like, this is what a great temporary looks like. Feels like seats, like very detailed. And then when you know that they’re at an eight, you can delegate. And live with maybe the 20%, uh, uh, course correction. So I just, you pointed out a couple of really great courses that even if you’ve been in PDA for a while, we’ve got on our new campus.

[00:11:57] Victoria Peterson: That’s pretty exciting. So these are some [00:12:00] tools that we’re building to help prevent that diagnostic drift because you get busy and you get tired and you forget. So, um, how do you. Beyond that. I know you’ve mentored a lot of young docs. Um, how do you get them up to speed with expanding? I heard you talk a lot about expand your vision, right?

[00:12:24] Victoria Peterson: Like go beyond just the emergency one tooth. How do you help young doctors to expand their confidence and expand their vision?

[00:12:33] Dr. Bruce Baird: Well, I, I, I do think, you know, it goes back to the, the original systems that you put in play in your practice now. What about all those docs that don’t have a system in play in their practice?

[00:12:45] Dr. Bruce Baird: Well, it, it’s really hard when you’re stressed and you’re running behind and doing all those things. To do all the things that we talk about. So what I try to do is I work with these young docs to, to give them, and, and most of the guys that I [00:13:00] end up working with are people who do want to do comprehensive dentistry.

[00:13:04] Dr. Bruce Baird: I don’t really think I lose interest when somebody says no. I, I’m just, I really enjoy what I do. I, I love doing one crown. I don’t wanna do full math rehab. Nine. I hope your life is good. I’m not gonna be able to help you because that’s not my philosophy of care. So, but doctors who have a philosophy, they want to help their patients at the highest level.

[00:13:23] Dr. Bruce Baird: You know, let’s get your scheduling properly, let’s get all those things right to reduce stress. Then guess what? You may be working less, making more, but you’re also gonna have a goal of, when I ask the docs what is it you would love to do? What is it you love to do? Or what would you love to do? And if you love doing a certain thing, then that’s how we target their marketing.

[00:13:48] Dr. Bruce Baird: Um, if it says, I would love to do. I would lovewell on X. Well then good. Here are the courses that I would take if I were you, so that you will now expand your knowledge, expand [00:14:00] your treatment options. So

[00:14:02] Victoria Peterson: I wanna make sure we don’t, I’m sorry to interrupt you. I wanna make sure we just don’t skip over this step.

[00:14:06] Victoria Peterson: Yeah, because sometimes people hear comprehensive care and they automatically default to, oh, he means I have to do all on. X treatment. Mm-hmm. Or he means I need to do, you know, a certain type of dentistry. What if I don’t place implants? Am I not a comprehensive? So back up to the diagnostic piece that you calibrate, to go back to the risk factors and what does comprehensive care really mean?

[00:14:35] Dr. Bruce Baird: Yeah, I mean, a lot of us, I mean, one of the things when I heard John Coys talking about risk factors, some 20 some odd years ago. It, it was a, an epiphany for me because I realized that a lot of the dentistry that was failing that I had done wasn’t my fault. It was because of the habits and the inherent risks associated with that particular patient.

[00:14:59] Dr. Bruce Baird: And [00:15:00] so I go through the risk factors with the patient, um, that builds a treatment plan. It’s not good enough for me to do a filling that I think is. With, I’m gonna give you this. I, I don’t think it’s okay for me to do five buildups, not crowns yet, just five buildups without talking about nutritional counseling with my patient, without talking to ’em about all the, all the, the, the shit they’re eating, you know, all the sugars and all this stuff.

[00:15:28] Dr. Bruce Baird: You’re drinking Dr. Pepper all day long. Once they understand that, then they can become my partner and maybe my restorations will last. Maybe they’ll continue to do the things that they’re supposed to do, maybe they won’t. Um, but it’s not my job anymore. I’ve given them, I’ve, I’ve, I’ve gone over their risk factors.

[00:15:47] Dr. Bruce Baird: I’ve gone over what they’re doing to increase their risk and what we need to change. Uh, it’s not good enough for me to just. Tell a patient, yes, I can do the filling. And we, we’ve talked about [00:16:00] that. You know, if they, can you do a filling on this tooth? I, yeah, I can. But wouldn’t you wanna know how I would do it if it was gonna last the rest of your life?

[00:16:06] Dr. Bruce Baird: Unless you like coming in every six years. So five years, no, I want it to last the rest of my life. Well, if you want it to last the rest of your life, you’re gonna have to wear the occlusal guard. You’re gonna have to drink. Quit drinking Dr. Pepper, or at least understand what Dr. Pepper is doing to you, or Mountain Dew or Big Red, or whatever it is.

[00:16:22] Dr. Bruce Baird: And once you understand that. I’ve done what I can do and it ain’t my problem anymore. It’s now your, and you know, so my stress levels go down drastically when things used to fail in the practice, which it does. Dentistry fails when people, you know, it just fails. That’s the way it is. But I was stressed.

[00:16:44] Dr. Bruce Baird: It caused me stress every time something that I felt like I had done a great job on ends up failing. I never did look at their risk factors. I never looked at the sugar. I never looked at them not wearing enclo guard. I never looked at any of that.

[00:16:57] Regan Robertson: Doctor, are you tired of repeating yourself [00:17:00] with your team over and over again and yet you still see treatment?

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[00:17:28] Regan Robertson: This is your home to grow. Head over to clinical calibration.com today to join every member of your team for one very low monthly membership fee. That’s clinical calibration.com.

[00:17:39] Dr. Bruce Baird: So now. You can get diagnostic drift big time. You know, if you’re not going into the causative agents, why things are happening, and once the patient understands your stress level drops drastically.

[00:17:54] Dr. Bruce Baird: Um. Patients will come in and say, I thought, you know, like my old implant patients, I thought this was gonna last the rest of [00:18:00] my life. And I told him, Joe, I didn’t know you were gonna live this long. You know, and he didn’t follow any of my advice. I didn’t see him for 20 years. And he shows up like it was supposed to be magically still in there.

[00:18:09] Dr. Bruce Baird: But, um, those are all things that are, are important. I

[00:18:14] Victoria Peterson: wanna put a pin on this really important piece. Most people, when they hear diagnosis, you know, our brain automatically defaults to, uh. I’ve got a patient in my chair, I’m looking at them. You’ve got a hole in your tooth, let’s fix it. What I just heard you say is that diagnosis is more of a continuum.

[00:18:35] Victoria Peterson: It’s not just one moment in time. It’s this really being this, uh, healthcare detective of, let me look at your medical history, your dental history, your lifestyle habits. I wanna figure out how you got here. Then I wanna know what here is. Yeah. And I wanna know how to prevent this or reverse it in the future.

[00:18:57] Victoria Peterson: So diagnosis is really, [00:19:00] uh, discovering the risk factors, connecting it, and then preventing it. Would you say that’s accurate?

[00:19:07] Dr. Bruce Baird: It is, and, and the patient ha you have to do a good enough job. So the patient has understanding. You have to have the time to be able and time, I, I go through all four risk factors with new patients in probably eight minutes, seven, six minutes.

[00:19:22] Dr. Bruce Baird: And they understand. They go, oh, I didn’t know that. Oh, well, good grief. And then what do they say? Why has no one else ever done an exam? This is the best exam I’ve ever had. When in fact, I haven’t even really told them what they need with their teeth. I told ’em why all the stuff I, and I would say, Victoria, I know it’s pretty frustrating coming in and always having dentistry that needs to be done.

[00:19:45] Dr. Bruce Baird: Would you like to change that? I mean, I, I think we can change that. Well, yes. Okay. That maybe that motivates that patient. Um, you know, the, the periodontal patient that’s had apically repositioned flaps and bone reduction and [00:20:00] pain, you know, those people, they get religion, you know, well, I’d prefer to, to get them, you know, um, without doing all that.

[00:20:08] Victoria Peterson: Right.

[00:20:09] Dr. Bruce Baird: Um, but, you know, the patients have to have, uh, an understanding of why they’re having the problem. Then you become, you’re not a drill and fill, you’re not. You’re an advisor. You’re a consultant on their dental health. And when you change your whole philosophy to say, you know, Victoria, there’s a lot of options.

[00:20:31] Dr. Bruce Baird: There’s multiple things we could do, but lemme tell you with your bite and with your periodontal risk, and in my own mouth, this is what I would do. Well, if you come at it from that perspective, the patient can’t really say. Anything about that? I mean, I, if you’ve built trust and relationship early in the appointment, uh, with a new patient, then all of a sudden they believe you and they listen to you and now you’re doing more comprehensive dentistry.

[00:20:59] Dr. Bruce Baird: [00:21:00] And I wanna say, if you’re not doing anything analyze, that’s fine. You might be the best dentist in the country at doing four surface posterior composites. You may love doing this and doing ’em yourself. And you know, the, all of that, my only statement about that is. That’s fine. And there’s these restorations can last a lifetime as well.

[00:21:20] Dr. Bruce Baird: It’s just what are we starting, you know, one, we’re starting with a, maybe a ceramic material that that has been engineered to to thermal cycle and then we got a composite that we scored in and we hope that that lasts. But I Well,

[00:21:32] Victoria Peterson: do you think that there’s a difference based on like, this is a low risk patient that doesn’t have a lot of acid.

[00:21:39] Victoria Peterson: It’s their first. Have ever, and they’re 40 years old, like, that’s a different patient than you’re, you’re in your late thirties or forties and this is your 15th and they’re breaking down. And the Dr. Pepper and the acid, like, so I think that’s, that’s what we’re excited about really diving into [00:22:00] deeply, uh, every, every.

[00:22:03] Victoria Peterson: I think there were six disciplines to complete a comprehensive exam. I don’t even know if I can name ’em all, but you gotta look at caries, perio function, airway, aesthetics. Uh, and maybe Endo. Endo. Implant. Periodontitis. Right.

[00:22:24] Dr. Bruce Baird: And psycho risk.

[00:22:25] Victoria Peterson: Well, and psycho risk. Yeah. But those six clinical disciplines, if, if you were educated.

[00:22:34] Victoria Peterson: You know, pre two thousands, some of this stuff wasn’t even in our nomenclature, like general dentist screening for airway risk has just become mainstream in the last 10 years. Like you and I have been aware of it and teaching it for 20, but it’s just now upcoming mainstream and. The American Dental Association and the insurance codes now include [00:23:00] airway screening in that comprehensive exam.

[00:23:03] Victoria Peterson: And I, I bet you, uh, more than one or two people listening to this podcast just got their hair raised and went well. What do you mean? I’ve got a screen for sleep apnea? I don’t screen for sleep apnea, but it’s part of the risk. Uh, how do you, how do you get people healthy if they can’t breathe?

[00:23:21] Dr. Bruce Baird: Yeah, I mean, it’s not only breathing, it’s uh, the acid that comes into their mouth when their epiglottic snaps shut when they’re snoring and they have that, that big gulp and, uh, all of a sudden you have acidity in the mouth that affects your dentistry.

[00:23:34] Dr. Bruce Baird: Um, uh, AP acnes also tend to grind the crap out of their teeth. How do I know? Because I, I am one, but so, so when you see somebody that has severe wear. As well as, uh, you know, erosion as well as a 17 and a half inch neck for a male or 16 and a half inch neck for a female and they snore. They got a 95% chance having sleep apnea.

[00:23:58] Dr. Bruce Baird: I don’t care what you do, what kind [00:24:00] of dentistry you do, and you don’t even have to treat it. You can send ’em to a sleep lab and say. You know, I don’t wanna treat sleep fine, but at least diagnosing it and getting them treated is gonna help your long-term results, and that’s what I’m interested in. I hate redoing stuff.

[00:24:15] Victoria Peterson: I know, I’m just, this is a, this is a curve ball question. How do you tell the difference in erosion when it’s apnea versus, uh, maybe eating disorders or, or a medical condition with gerd or, uh, you know, I don’t think there is a lot of toothbrush erosion. I think that’s a myth. But how, how do you, how do you tell like what’s causing that erosion?

[00:24:39] Dr. Bruce Baird: Basically location. You know, when you see the location of the erosion, a lot of times if you’re seeing the, the linguals of the upper, um, uh, of the upper anterior T that could be bulimia, you’re starting to see erosion in the posterior areas that might be, uh, apnea. So it’s a differential diagnosis. You’re looking at all [00:25:00] of this and you’re saying, okay, what is causing this ’cause I wanna get to the bottom of it.

[00:25:04] Dr. Bruce Baird: And by the way, Victoria, what medications are you on? Okay. I noticed you have a dry mouth. Well, okay. Maybe that’s the problem. Maybe now we can’t get you off the medications, but we certainly can get you on, you know, uh, rinses that can help and that can neutralize the acid in your mouth. So those are all differential diagnosis where you’re just like, if you were, somebody came in with a belly ache, if you were a physician, you’d have to figure out okay, what’s causing it?

[00:25:30] Dr. Bruce Baird: You look at the different things. Um, I’m. I’m pretty astute at, at asking questions, you know, and so I just, if you ask enough questions, you’re gonna get. And especially if you’re in good relationship with a patient and you say, I know this might sound crazy, but do you snore at night? Oh, well. Well my wife says I do.

[00:25:51] Dr. Bruce Baird: Oh, okay. Well,

[00:25:52] Victoria Peterson: she

[00:25:52] Dr. Bruce Baird: might

[00:25:52] Victoria Peterson: be right.

[00:25:53] Dr. Bruce Baird: Well, she may be. Or the wife.

[00:25:56] Victoria Peterson: I love how this is full circle. ’cause in our previous [00:26:00] episode we talked about scheduling and having the time to sit and talk to the patient. And you know, you’ve in this episode, given us so many reasons why you wanna sit down and create that rapport and gain their trust and then ask some of these really sensitive questions.

[00:26:19] Victoria Peterson: You know, it, it takes, it takes a lot to slow down and be. Be there, be present, be empathetic because don’t you think the patients feel like, um, if I go to a physician, then it’s like my body betrayed me. Something happened. I was talking to my dad the other day and he goes, oh, your uncle Gary, uh, the diabetes done, come and jump on.

[00:26:44] Victoria Peterson: That’s, that’s a very southern thing, right? Yeah. Nothing that Gary did throughout his life caused diabetes. That diabetes just jumped on him. But when you go to the dentist, it’s this pel sense of, it’s my fault, but it’s not always [00:27:00] right. It’s the bacteria. It’s the acid, it’s the genetics. It’s. So many things.

[00:27:05] Dr. Bruce Baird: Yeah. Give ’em a solution. I, I know that, you know, when you’re going into hygiene, you have three minutes or four minutes to, to tell somebody about their risk factors and everything else. You’re probably gonna miss a few things. You’re not gonna build a relationship with a patient. It’s gonna just, it is going to determine what type of dental practice you have.

[00:27:26] Dr. Bruce Baird: And so my preference, because I want to. Have time to get to know my patients. And when you get to know your patients, guess what? They don’t miss their appointments. They, they, they show up. Um, they pay, you know, they, you know, ’cause they want what it is you’re offering. So, um, clinical Calibration Institute is something that’s gonna bring all of this together in bite-sized chunks that you can.

[00:27:55] Dr. Bruce Baird: You can get in your head and it’s not about just training [00:28:00] you as the doc, it’s also training your front desk, your chair side, your associates, your everyone in the office, right? Calibrated to a philosophy of care and to. Specific modes of treatment that you want to do so that everyone understands this is what we do in our practice.

[00:28:22] Dr. Bruce Baird: That doesn’t mean what we do in our practice in 2025. It’s the same as it’s gonna be in 2026, because there’s gonna be new things that come up. There’s gonna be new materials, there’s gonna be new bonding, there’s gonna be new, all of this. So just having the time to be able to stay up on what’s the latest and greatest and and producing at the highest level I wanna produce at the highest level.

[00:28:44] Dr. Bruce Baird: And I wanna work, um, as much as I wanna work.

[00:28:48] Victoria Peterson: Well, let’s, let’s end this episode, uh, right there with, um, you are a huge proponent of [00:29:00] hygienist and what is your expectation with your hygienist co diagnosing? I’m gonna put the CO in there ’cause we’re all afraid to diagnose, but everybody on your team should be able to understand.

[00:29:13] Victoria Peterson: So what is your expectation of your hygienist when you walk in for the exam? For the hygiene annuity? I mean, we teach a 1 3 5 minute exam. How is that accomplished? What is the hygienist doing to set the doctor up for success?

[00:29:32] Dr. Bruce Baird: Well, I mean there’s a couple, couple different angles to that, to that question.

[00:29:37] Dr. Bruce Baird: One, one is, what do I want the hygienist to do? And I want them to become oral healthcare experts, which they are. I want them to look at a patient, uh, just like Michelle working for me for years. And the other hygienists I. I want them to see the same things I see. And those, when I see it and they see it, we’re on the same [00:30:00] page.

[00:30:00] Dr. Bruce Baird: Um, whereas as opposed to me going, oh yeah, your, your gums will be fine, fine. And yeah, it’ll be good later. Just brush better. You know, that kind of stuff. I, we have, we. The oral systemic connection is amazing. Uh, you know, we’re, we’re finding out all kinds of things, so I want my hygienist to, to go to courses on that.

[00:30:20] Dr. Bruce Baird: I want them to read about that. I want them to become the leading expert. On the oral systemic connection in the practice. Now, to me, when they do that, that gives a different perception to the patient. Yeah. Because now they’re a healthcare provider. They are truly. Changing how you live and, and that, that is critical.

[00:30:45] Dr. Bruce Baird: The, the flip side of that is, you know, and hygienists now there are hygienists making 120 grand a year, you know, but I’m pretty sure they’re producing more than 120 grand a year, you know, by doing additional services, additional treatment. That is [00:31:00] well. Documented, well, um, well researched, you know, doing laser pocket disinfection, doing all the things that they do.

[00:31:08] Dr. Bruce Baird: But from a hygiene standpoint, when I walk in, it becomes very easy If we’re doing a comprehensive exam and a patient needs 10 restorations, but they only did three. Right. Is it my problem? Is it my, no. I told them all they needed. Now they’re floating in my hygiene annuity. They’re coming in every four months.

[00:31:30] Dr. Bruce Baird: Maybe they’re coming in every six, maybe they’re coming in every three. But at some point in time, my hygienist, I just want them to be aware of what the recommendations I had before. Yep. Pointing out things when I come in and, and talk, um, Dr. Period, I was worried about tooth number 19. You know, we, we scheduled it for an onlay, but I’m, I’m afraid it made meet a crown.

[00:31:55] Dr. Bruce Baird: Okay, great. I look in, I go, I, I agree, Bob, it’s time and [00:32:00] that, that’s my two words that I use. It’s time, and I just look at ’em and nod. I said, let’s put this on the front burner as soon as possible, because I just don’t want this to turn into a root panel or lose the tooth. And so I walk outta the room. I couldn’t do that if, first of all, if I didn’t know the patient, if I hadn’t spent time to get to know the patient, if I sent ’em into my hygiene annuity and they had never met me more than three minutes in a hygiene exam, my treatment plan would be 2,500, and that might be a crown and a filling and something else.

[00:32:30] Dr. Bruce Baird: It wouldn’t be a comprehensive evaluation of their risk factors as well as what dentistry they need to have done. It just wouldn’t be, and so in that statement. I would not be taking comprehensive care of my patient. I would just be doing whatever the patient asked me to do. Uh, you know, order to come.

[00:32:47] Dr. Bruce Baird: Yeah, that’s it. What do you want? And, and I. I chose in 1991, I could have signed up for every plan that was out there. I never have. But uh, and then just had all these [00:33:00] patients come in, hire a bunch of associates and just say, fill and drill and do all that, and I’m gonna go play golf. But I didn’t wanna do that.

[00:33:05] Dr. Bruce Baird: I wanted to take comprehensive care of my patients and my patients respect me for that. And they. They refer patients because you’ve gotta go see Dr. B. And, and they do the same thing with Dr. Busier. You’ve gotta go see them. Why? Because they think different. And you want to have a different practice. If you wanna have a different, if you wanna lower your stress, double your productivity, then you need to sign up for CCI.

[00:33:28] Dr. Bruce Baird: That’s about all I can tell you.

[00:33:29] Victoria Peterson: Well, I’m glad you highlighted, uh, hygiene because Michelle Hudson is on faculty for us, and in fact, a core pieces of content are taught. In, in by Michelle and by summer and by myself and others, so that your team understands this. It, it really is all about helping the. The owner doctors and the dentists get really clear on their philosophy and their diagnostics and then documenting [00:34:00] it, and we provide the training.

[00:34:01] Victoria Peterson: You just have to provide the time to take the materials, walk through it, and discuss it with your team. That’s, that’s really, uh, what we saw missing and. Uh, you know, you and I do a lot of work through in invest investment grade practice. I do a lot of work with seller readiness and this and that. And when I’m evaluating practices to go to market, I’m like, uh, you just missed out on about, you know, $10 million over the last 10 years.

[00:34:31] Victoria Peterson: Uh, your stress could have been lower. And not that it’s about the money for both of us. It comes down to you have patients that need this. That you just weren’t organized and now the next person who buys your practice is going to get the benefit of that. So it’s, he would gold mine, true he’d gold, gold mine for somebody, but it won’t be the gold mine for you.

[00:34:52] Victoria Peterson: So all of this leads to two things. One, amazing care and helping great [00:35:00] dentists, you know, kind of create systems that are not only productive, but profitable and building value along the way. Uh, that way when. Just like you did successfully. When you’re ready to put down the handpiece and step away, the value of the practice doesn’t drop.

[00:35:15] Victoria Peterson: It continues. And, uh, especially and group. Anybody who’s thinking about partnering with A DSO, it’s critical. Like if you sell your practice and it drops, there are penalties. So, uh, the, the world kind of gets real when you get, when you get to those end stages. Yeah. Bruce, thank you so much for highlighting, uh, your philosophy of diagnostics and how diagnostic drift, you know, happens so easily if we’re not paying attention to it and just showing us how.

[00:35:47] Victoria Peterson: It erodes patient care and it erodes the value of your business.

[00:35:51] Dr. Bruce Baird: Absolutely.

[00:35:53] Thank you for tuning into this episode of Investment Grade Practices Podcast. If you find value in this episode, help us [00:36:00] spread the word by passing it along to a dental friend. Subscribe and give us a like on iTunes or Spotify.

[00:36:06] Learn more about building your investment grade practice@productivedentists.com today.