Home » Podcasts » The Productive Dentist Podcast » Beyond Insurance Limits | Why Clinical Care Must Lead, Not PPO Rules (E.259)

Beyond Insurance Limits | Why Clinical Care Must Lead, Not PPO Rules (E.259)

“Clinical autonomy isn’t a luxury. It’s the only way to practice with integrity.” — Dr. Nikki Green

Episode Overview

In this episode of the Productive Dentist Podcast, Dr. Bruce Baird sits down with Fort Worth dentist Dr. Nikki Green, who sold her practice to a DSO while preserving her philosophy of care. Together they unpack the tension between ownership models, clinical autonomy, and maintaining comprehensive, patient-first dentistry in a system often driven by volume and insurance limits.

What This Episode Reveals

Even in the corporate landscape, autonomy and calibration to disease—not insurance—are the true metrics of success. Bruce and Nikki share what it takes to protect your philosophy of care, mentor young associates, and deliver treatment that aligns with both ethics and equity.

What You’ll Learn

How to maintain autonomy after selling your practice
The DSO models that respect (and those that restrict) clinical freedom
Real strategies to calibrate associates to diagnostic standards
How to lead with philosophy, not production quotas
Why comprehensive care always outperforms volume-driven dentistry

If This Sounds Familiar

You feel the pressure to “produce” instead of treat.
You’re frustrated by owners or managers who don’t understand clinical judgment.
You want to protect your standards and mentor a team that thinks like you do.

Next Steps

Autonomy starts with alignment.
The Clinical Calibration Institute (CCI) equips your team to diagnose with confidence, speak the same language, and deliver care-first dentistry.

Learn more at ClinicalCalibration.com

Start Your Calibration Today

For less than the cost of one crown a month, your team can access the full CCI platform: on-demand training, live masterminds, and a supportive online community dedicated to helping dental teams thrive.

Download our free guide: 5 Hidden Signs That Kill Case Acceptance to uncover where misalignment is costing your practice.

Or take the first step today and enroll your team in Clinical Calibration Institute.

Because when your team is aligned, case acceptance grows, stress drops, everyone feels safe, and every patient gets the level of care you know they deserve.

TRANSCRIPT

[00:00:00] Dr. Bruce Baird : Hi, my name’s Dr. Bruce Baird with a productive podcast, and I am here with one of my close friends and, uh, fellow dentist, Dr. Nikki Green. Nikki, thank you so much for joining us today.

[00:00:18] Dr. Nikki Green. : Thank you, Bruce, for having me. I’m, I’m excited to be here.

[00:00:21] Dr. Bruce Baird : Well, I tell ya, Nikki had as a practice in Fort Worth, Texas, a cosmetic, I, I would call it a cosmetic practice.

[00:00:28] Dr. Bruce Baird : I think that’s

[00:00:29] Dr. Nikki Green. : primarily,

[00:00:30] Dr. Bruce Baird : that’s pretty fair. I mean, uh, during one of my meetings, uh, I lost a veneer and had to go to her office and have it re-put on. I remember one night, uh, after cocktails, that worked out very well, though I’ll have to say,

[00:00:42] Dr. Nikki Green. : uh, absolutely. I’ll be your emergency dentist any day. Not that I want you popping veneers off.

[00:00:47] Dr. Nikki Green. : That’s not fun, but I’ll be your emergency dentist any day.

[00:00:50] Dr. Bruce Baird : There you go. Well, we’ve had, you know, we’ve had a lot of great experiences together in dentistry, and I know that you have, uh, you’ve actually been to PDA [00:01:00] multiple times and, uh, you’re married to another friend of mine, Dr. Bob. Uh, from Abilene, Texas, and I’ve got a chance to go into Bob’s practice a few months ago and just ha have had a lot of fun.

[00:01:13] Dr. Bruce Baird : But a few years ago, you sold to a DSO, like I sold to Heartland years ago. But, um, what, uh, how, how has that been? I mean, as far as clinical autonomy, you know, you were doing dentistry a certain way. Were there any changes to that or have you, what have you felt?

[00:01:33] Dr. Nikki Green. : No, that’s a great question. I, I can. Report from my situation, clinical autonomy has remained untouched, which is amazing.

[00:01:43] Dr. Nikki Green. : It’s part of even how I chose my buyer. Uh, when I even got interested in selling to A DSO, I was very particular about my buyer, and a big part of it was I wanted to maintain autonomy. To be perfectly honest, I really didn’t want ’em to. To mess with me at all. That was really kind of what I was looking for.

[00:01:59] Dr. Nikki Green. : I was looking [00:02:00] for a buyer that wasn’t gonna mess with me and let me keep doing things the way I wanted to do. Um, I really just was looking to kind of take some chips off the table if you really wanna know the truth, you know, sure. Invest vest some funds, maybe not carry a hundred percent of the weight myself anymore.

[00:02:14] Dr. Nikki Green. : But I really wanted to be able to continue doing things the way I’d always done them. And four years in, we are now right at four years in, because I sold in October of 2021. A test that I’ve, I have that I have complete autonomy, even to the point where some days I’m going, why am I still running this place?

[00:02:30] Dr. Nikki Green. : I don’t own it, you know?

[00:02:34] Dr. Bruce Baird : Yeah.

[00:02:35] Dr. Nikki Green. : Um, but you know, and maybe we can talk a little bit about this. What I’ve also found out is that’s a difficult, um, business model for the d. You know, so my DSOI would even say has struggled because they contractually, you know, gave us full autonomy, um, contractually they can’t even come in and change things, systematize things, centralize [00:03:00]things.

[00:03:00] Dr. Nikki Green. : And I have learned as also an investor in that DSO that that’s not the best business model for A DSO. Um, so it’s a double-edged sword for me. Practicing dentistry. I love it. Me as an investor in that DSO, I’m going, Ugh, not a great business model.

[00:03:14] Dr. Bruce Baird : Yes, yes. Been there, uh, been there. I sold to Heartland, I don’t even know how many years ago, but, uh, and then of course clinically retired six years ago.

[00:03:23] Dr. Bruce Baird : Hard to believe. But, uh, no, but, you know, I wanted clinical autonomy and I, I basically told them, you know, you can, you know, I’m, I’m interested in selling. This is back. During the Obama administration where I was worried about, oh, I’m gonna have to provide all kinds of insurance, all this stuff, and I just got freaked out.

[00:03:42] Dr. Bruce Baird : Plus I had some other friends that sold and I was like, wow, maybe it’s time. I was 50. I dunno what I was 52, 53, and I just decided, all right, it made sense, but I kind of contractually did what you did. But over the last probably six years, spending a lot of time studying [00:04:00]DSOs and going, even starting one, um, I realized the model is very difficult for, for the investors, um, because you want to come in and help offices that need help.

[00:04:13] Dr. Bruce Baird : You also wanna buy practices that don’t need help. You know, it’s kinda like, where’s your growth gonna come from? And so that’s, that’s kind of one of the things that, that I, that I notice more than anything. How about, did you notice a. A little change in, in supplies or anything else? Were you able to continue to do the same things or get better deals?

[00:04:32] Dr. Nikki Green. : Yeah, so I mean, honestly that’s one of the benefits. We’ve definitely gotten better deals and, you know, when they came in and, um, you know, my, my team didn’t love it at first when we had to change ordering platforms and, you know, yes, there were some relationships that we had long time had with Pattersons and some different things that maybe some of those relationships didn’t get.

[00:04:49] Dr. Nikki Green. : Severed, we still have those relationships, but they just weren’t supported so unilaterally like they had been for a lot of years. But at the end of the day, that saved me money. And that was, [00:05:00] that was not a bad thing. And, and that’s kind of where business of, of dentistry is going. Uh, so yeah, so they got us onto an ordering platform.

[00:05:07] Dr. Nikki Green. : That was one of the things that they did. Kind of require of us. Um, and yeah, getting a lot better deals. I, I like seeing my supply costs. I had always struggled to keep my supply costs, you know, down around that 5%. And I don’t struggle with that anymore, you know? Um, and I really do attribute all of a lot of it to the pricing.

[00:05:24] Dr. Nikki Green. : Uh, ’cause I haven’t changed what I’m ordering. I haven’t changed the types of supplies that I’m ordering. Uh, they’ve just gotten to where they can work with some, some better deals. So I do appreciate that.

[00:05:33] Dr. Bruce Baird : Oh yeah, for sure. The, as far as. Um, in the DSO environment, uh, with other docs that are a part of the same group that you’re a part of, have you seen a big, I mean, I know it’s very tough pushing for productivity.

[00:05:49] Dr. Bruce Baird : You know, I mean, it, it’s because people take that the wrong way and I, and I, you and I have talked about before, but it’s like if you take great care of your patients, productivity takes care of [00:06:00] itself. Um, and I know that. You know, insurance shouldn’t determine where and how we determine what treatment plan to provide.

[00:06:11] Dr. Bruce Baird : Um, and that’s where clinical calibration that you’re, uh, one of the instructors in and helping us, uh, really beat the drums that you have to have this. This clinical philosophy, and I think that makes it much more, uh, attractive to A DSO to, to go in with a dentist who already has a. Clinical philosophy.

[00:06:36] Dr. Bruce Baird : Did you tell us a little bit about your clinical philosophy and, and, and why it was so successful for you?

[00:06:43] Dr. Nikki Green. : Right. Well, mine has always been very much a comprehensive care philosophy. You know, I mean, you described my practice as a cosmetic di. Practice. And we are, I do a whole lot of cosmetic dentistry and I love doing that, but we do a whole lot of general dentistry and we treat perio and, you know, we do surgery.

[00:06:59] Dr. Nikki Green. : I mean, we really do it [00:07:00] all. Um, and that’s one of the things I, that was always one of my visions for our practice is I wanted to be a place where patients could come and pretty much have, you know, 90% of their care taking care of underneath one roof. So I was always looking to build a group practice that we could treat.

[00:07:16] Dr. Nikki Green. : Treatment plan comprehensively, treat comprehensively, and we could take care of all of our patient’s needs. So that’s been my vision. Now, I, for me, how that’s, that’s worked out is, is we as different doctors in the practice and now I have five doctors in my practice. By the time I count myself and Bob and Yep.

[00:07:32] Dr. Nikki Green. : Um. So we all kind of have our niche, you know, kind of our area. I am a believer, even though you and Bob Leady have proven me wrong on this, but not every dentist could be a jack of all traits. You know, not every dentist can be good at all of it, and I would say most. Maybe are not capable of being good at all of it.

[00:07:51] Dr. Nikki Green. : So the way I’ve kind of managed that within my practice is I always encourage my associates to, let’s pick a lane. You know, let’s pick a niche. Let’s pick something [00:08:00] that, that you can get super passionate about. I’ll send you to the best CE courses. We’ll seek out the very best, but I want you to kind of.

[00:08:08] Dr. Nikki Green. : Nurture that lane. I never tell my associates they can’t do other things, but I want you to nurture this lane. I’m gonna nurture this lane. Um, and I, I think that works out really well for our patients and, you know, and our patients, part of their new patient tour is that they may say, see one or all of us, because we all do different things.

[00:08:25] Dr. Nikki Green. : And depending on what the patient’s needs are, they may get to meet several of us, you know, on their journey through their, their dental care. And, and I like that.

[00:08:35] Dr. Bruce Baird : I, I, I agree. I mean, I’m, I think back when I first opened my practice, that was at a time where I, I, you know, I was right outta the military.

[00:08:44] Dr. Bruce Baird : Four years. I had great surgical skills because I had done a lot of that. Um, and some great pre-prosthetic stuff. I, I really was getting into implants in the mid eighties, early eighties, and. But I didn’t feel like I knew perio, um, [00:09:00] even though we had great per program I in, in school. So I hired a periodontist to come in and then, you know, I had endo, I, I had an endodontist coming in.

[00:09:09] Dr. Bruce Baird : And so at that time I brought in as a young dentist. I brought in three, four different specialties to help me. And as I got more an orthodontist I had in the office because I didn’t know anything about ortho and I really honestly don’t wanna know anything about Ortho, but. I, I had them there kind of with the same philosophy that you’re talking about, is like, I really wanted to be a one-stop shop.

[00:09:34] Dr. Bruce Baird : And, and so as I got my clinical skills aligned for different things and, and the periodontist, it was time for him to go because I had the perles and I thought, I wanna do this now. And then the more education we get, I think it allows us to do that. And then the ultimate, um. Solution is where you’ve got a mature practice that’s been growing like yours, and [00:10:00] then as you bring associates in, you actually get to do the same thing.

[00:10:03] Dr. Bruce Baird : Because at that point in time, I really wanted to be in that one lane. I wanted to do reconstructive stuff. If, if. If you were a train wreck, that’s what I wanted to do, but I didn’t really wanna do the endos that needed to be done and all that stuff. So I found that same philosophy to be extremely helpful.

[00:10:22] Dr. Bruce Baird : Had, has being in your DSO, do they have any specialists that travel, uh, office to office, or is it pretty much allowing you to do whatever you decide?

[00:10:33] Dr. Nikki Green. : Yeah, so our, I, I, they don’t within the DSO, but they have forged some relationships with some traveling specialists and such. You know, my DSO is somewhat unique and not really unique.

[00:10:45] Dr. Nikki Green. : The DSOs are every state, shape, size, and color, as you know, but we are spread out throughout the us. I mean, we are not regional. Um, we’re also not even, um. Um, specific as far as specialists, I mean, we’ve got, we’ve got an endo group in our practice. [00:11:00] We’ve got GPS in our practice, we’ve got keto in our practice, we’ve in our DSO, so we’re, we’re very diverse in that way.

[00:11:07] Dr. Nikki Green. : So again, it would be, they do not have a clinical calibration for us as, and you know, and that is one of the things, I mean, that’s one I was talking with, uh, Victoria at Dyma just a couple of months ago, and she was. Telling me about clinical calibration and her wanting me to be involved, and I got so excited about it because.

[00:11:27] Dr. Nikki Green. : As I’m experiencing my own DSO and as I’ve talked to lots of other people in the DSO world, you know, traveling for support DDS over the last couple of years, man, that’s what they need. They need, because to me it’s like, um, rather than you mentioned, you know, they pushed productivity and, and, and I, I have to be honest, I was venting to Bob about it this weekend.

[00:11:47] Dr. Nikki Green. : You know, these, uh. These laptop quarterbacks, you know, that wanna look at, look at the numbers. And they’ve never hardly stepped foot in a dental office, you know, and somewhere they think this is gonna happen because they’re seeing a [00:12:00] trend on their laptop and they think they’re gonna blast out this message to everybody and all of a sudden productivity’s gonna go a different direction.

[00:12:06] Dr. Nikki Green. : You know? And that’s just not the way it works. I mean, you know, I was, I was venting this weekend. We’re not making widgets over here. You know, it’s not about, we just need more people on the production line to make widgets. Uh, there’s a whole, you know, there’s a lot of things that go into that. So, um, I do think what you guys are, are.

[00:12:24] Dr. Nikki Green. : Getting into clinical calibration and man, you know, if you could take that to the DSO world and get them to adopt it and implement it, that’s where they’re gonna get their productivity. Because you’re gonna teach doctors, just like you’ve taught me over the years, being a PDA client of just how to take really good care of your patients and how to talk to ’em and how to, you know, I’m going back to my own practice being a cosmetic practice.

[00:12:49] Dr. Nikki Green. : You know, you, you taught me to. It’s okay to talk cosmetics with every single patient that comes in the door and it, and it’s not about you’re trying to sell ’em something, it’s about, you know, we’ve [00:13:00] got these risk, risk factors and then we’re a cosmetic practice. And sometimes people wanna talk to us about the looks of their smile, you know, and you just go through, you’re gonna talk about all these other risk factors.

[00:13:09] Dr. Nikki Green. : Would you like to discuss the looks of your smile? And you know, they happen to have. You have that big smile picture up on the screen behind them and guess what most of them say, yeah, I wanna talk about my smile. You know? So you are definitely one of those people that taught us how to have those conversations and how to make it flow and, and thus productivity follow-ups, because does just take good care of patients.

[00:13:33] Dr. Bruce Baird : Yeah. How do you, I mean, I’m gonna ask two different questions and one of them I. I think I have a pretty good idea what the answer is, but I’m gonna ask it anyway. But first question, the, the kids that are coming out, and I can say kids now, ’cause I’m old enough to do that. The kids that are coming outta school today really haven’t gotten the same training.

[00:13:55] Dr. Bruce Baird : I feel like I got. A century ago, you know, I mean, [00:14:00] I, I had done presurgery. I had done, uh, over 300 extractions I had done. I mean, there was so much stuff I did in dental school and now after COVID and all this stuff, there were some, there are dentists that are actually graduating that have never extracted a tooth, and there’s graduating from dental school.

[00:14:19] Dr. Bruce Baird : So have you seen anything along those lines in, in your. Because you’re out doing a lot of other things too, uh, with support, uh, DDSO and, uh, all of that. So have you seen in your.

[00:14:35] Dr. Nikki Green. : Yeah, def I definitely have, and I mean, I have a, I have a young doctor in my practice right now who’s said You’re outta dental school.

[00:14:41] Dr. Nikki Green. : And, you know, um, I, yes, there’s a big difference between how we were trained. Mine was 25 years ago, even just even how associates were trained 10 years ago. And man, I hate to keep giving COVID credit and blamed for everything that you are exactly right. Post COVID, something [00:15:00] significantly shifted and I, you know, I think we could probably talk about that if we were talking about elementary schools right now too.

[00:15:05] Dr. Nikki Green. : I think we could talk about it just about education and, and experiences in general. But o honestly, I think what might’ve just happened is that the bar got lowered. Yeah, just we had two years of things being shut down and I could imagine in dental schools, you know, patient availability not being the same or having to space patients out.

[00:15:25] Dr. Nikki Green. : I can only imagine what those, those bays looked like during COVID. You know, we used to, would have 30 patients in one bay. They probably went down to, they could only put five in a bay. I don’t, I don’t know. I wasn’t there experiencing, I was trying to keep my own business alive, but I can only imagine that that’s part of what happened.

[00:15:41] Dr. Nikki Green. : And so the bar just really got lowered. You know, those kids graduated, they went out into, they didn’t kill anybody, so, hey, let’s just lower the bar, let ’em go moving forward.

[00:15:51] Dr. Bruce Baird : I wonder if tuition dropped.

[00:15:54] Dr. Nikki Green. : Yeah, I bet it did.

[00:15:57] Dr. Bruce Baird : I don’t think, you know, I’m just wondering. But I, I [00:16:00] look at that as kind of a responsibility, you know, how do you calibrate your associates and your team to the diagnostic standards?

[00:16:08] Dr. Bruce Baird : That you want. Uh, and it can be within A DSO or it can be in a private practice fee for service, or it can be in a private practice. Totally insurance driven. But what are some of the ways that you learn to calibrate your associates?

[00:16:23] Dr. Nikki Green. : I mean, one, it’s been, it’s been evolving, right? And it’s still evolving.

[00:16:28] Dr. Nikki Green. : And one of the things I’m, I’m grasping onto right now is this curriculum that you guys are putting out there, you know, and what, how can I utilize that to continue, um, calibrating my associates? Because there’s been times I’ve been good at it and there’s times I’ve. I’ve kind of, I’ve pretty much failed at it.

[00:16:42] Dr. Nikki Green. : Um, and I think the things we do right now, we have a weekly doctor meeting. Um, and part of that weekly doctor meeting is always going over cases. You know, sometimes it’s cases they bring to me that they have some questions about or that we’re gonna talk about as a group. Um, the question isn’t always for me.

[00:16:57] Dr. Nikki Green. : Sometimes it’s for one of the other associates, which is great. I [00:17:00] love it. Um, and then, but then there’s sometimes it’s, it’s me pulling up an x-ray from something I saw yesterday. And we, a, a, a common topic of conversation is, you know, when is a tooth saveable? When it’s not? And man, you know, you line this up and man, that is the place where there could be a lot of disagreement.

[00:17:19] Dr. Nikki Green. : And, uh, and so, uh, we, I just try to. Not tell ’em what they have to do, but hey, let’s look at this a different way. You know? And what would you want if it was your tooth? You know, I mean, I mean, could you do a little crown lengthening on this tooth and, and save this tooth? You know? And sometimes it’s because they’re scared to death of crown lengthening.

[00:17:37] Dr. Nikki Green. : Well, crown lengthenings not that difficult. You know, there’s a lot of ways to go about doing it. Um, you know, I’ve got a great laser now that’ll do it. Hard to, she like, they’ll do it, but a bur works too sometimes. You know, and the question might be, did you even have that conversation with the patient?

[00:17:52] Dr. Nikki Green. : You know, or did you determine that it wasn’t saveable and so you, you know, doomed this tooth to an extraction implant or what [00:18:00] have you. Did you even talk about with the patient what the steps that it would be required to save the tooth? You know, so, you know, just things like that that we try to calibrate on and, and, and I enjoy those types of conversations.

[00:18:12] Dr. Bruce Baird : Oh, absolutely. What I found, and you’re. You’re probably getting to a point to where you’re seeing it, um, being in practice a long time, but I used to, early on in my career, I wanted to save everything. Because I figured if I can save it, I will save it. Right? And it was my philosophy that changed drastically when I realized that the patient was never gonna brush their teeth.

[00:18:36] Dr. Bruce Baird : They were drinking Dr. Pepper all day long and their gums and you know, their perio was gonna be, in other words, I wanted to save the tooth because it was a tooth. And that’s what I knew. That’s really where the risk factors started to come to play when I was making that decision. Okay, what are the chances of this tooth being in the mouth if I don’t treat it at all five years from now, I, or [00:19:00] what?

[00:19:00] Dr. Bruce Baird : You know? And so I was always, and I was really a one of those guys who I would talk people, because I’m pretty good at talking people into stuff. I would talk ’em into doing a full math rehab right. And spending 30 grand and, and, and then. I would see him four years later and they’re starting decay all over again and, and I thought, well, at first I thought, well.

[00:19:23] Dr. Bruce Baird : I, my preps must have been bad or my margins weren’t good enough or whatever. And then I realized when I heard John coy years ago talking about it, I go, Hey, when I’m making my plan, let’s make it successful for both of us. You know, not I, not that I can, yes, I know I could fix it to, but you got seven more just like it right in a row.

[00:19:43] Dr. Bruce Baird : Are you gonna change the habits that got ’em here? So that’s what really. That’s what really kind of changed in my thought process. And that makes it really hard when you’re working with an associate to get them up to speed. But that becomes part of the conversations we have with [00:20:00] younger docs. Right. Um, Braden, uh, my nephew, I mean, Braden is like knocking it out of the park because he’s heard this philosophy now for seven years and he’s only two years outta dental school.

[00:20:13] Dr. Bruce Baird : But. The more we just reiterate that there is no, it dentistry is, there’s a lot of gray in dentistry. It’s,

[00:20:23] Dr. Nikki Green. : that’s to say that I was about to say. I mean, isn’t that, you know, ’cause because people expect there not to be, I mean, people expect there to be no gray in dentistry, but it is not black and white. I mean, I, in fact, a, a common thing I say to my team, I’m like, dentistry is a.

[00:20:37] Dr. Nikki Green. : Thinking man’s game. It’s a thinking man’s game. Like you gotta be thinking, you know, ’cause what was right yesterday may not be right today. For factors, you just said this, patient’s risk factors, you know? Um. There’s all kinds of things that have to be weighed in, uh, to, to making a decision. So it’s not, it’s not black and white, which I love that.

[00:20:55] Dr. Nikki Green. : I, I think I kinda live in, I I, I feel bad when I say that, like, [00:21:00] in fact, I have a team member that says her name’s not Dr. Green. Her name’s Dr. Gray. And that kind of makes me feel bad. Like, does that mean I have no values? I don’t think it does.

[00:21:08] Dr. Bruce Baird : No. It, it really is something that I think, um, I, I, I think the.

[00:21:16] Dr. Bruce Baird : All of our experiences that we go through, all of the courses, we go take all of the friends that we have that are in dentistry and, you know, because Cynthia gets so bored because we talk teeth all the time, but she’s now found her friends to come and, and talk about their stuff too. So, but it’s one of those things where the more you see, the more you know, and uh, the more you know, the more you do.

[00:21:43] Dr. Bruce Baird : And then that’s why treatment plans for a young doc might be $1,500 and treatment plans for a more experienced doc might be 8,000. It’s not that the one doc is telling you need this. I like, like the, what was it? Reader’s Digest said, oh, [00:22:00] one dentist said that all you needed was a cleaning and that was it.

[00:22:03] Dr. Bruce Baird : But right. They didn’t ask, do you like your smile? They didn’t ask, do your jaws hurt? Right. They don’t because they don’t have that skill. So what, what advice would you give docs under pressure to produce by volume? Uh,

[00:22:21] Dr. Bruce Baird : the question would be how does that fit into, well, it doesn’t necessarily, but comprehensive care, how to, you know, they’re, they’re being kind of pushed into this volume environment. But that they, we know that there’ll be such a more enjoyable experience for their career if they can just learn the comprehensive care approach.

[00:22:42] Dr. Bruce Baird : So what, what, what are your thoughts on that? What advice would you give a doc that’s stuck in that position?

[00:22:48] Dr. Nikki Green. : Yeah, no, and thank goodness I’ve never been stuck in that position. I, I’m probably as close to being in that position now just because I do have DSO partners, you know, that look at things like productivity.

[00:22:57] Dr. Nikki Green. : But thank goodness I’ve really never been in that position. [00:23:00] Um, ’cause I do, I hear the horror stories and that is what most people assume about, you know, you go into a DSO world and you’ve gotta, you’ve got an office manager that’s telling you, you know, you gotta do 18 crowns. You know, this week or whatever.

[00:23:12] Dr. Nikki Green. : And it’s not about how you’re gonna treat the patient. It’s, you gotta do 18 crowns. And they don’t even think about the fact that there’s human beings on the other side of 18 crowns, you know? Um, and, you know, and, and so then they think they’ve gotta go in and do a. Two crowns on a 16-year-old. Well, Bruce, do you wanna do two crowns on a 16-year-old?

[00:23:30] Dr. Nikki Green. : No, I don’t wanna do two crowns on a 16-year-old, you know? Um, so, but they, but they feel like that’s what they have to do, and they think that’s what the productivity is about. And it’s not, it’s, it’s the same thing you’ve always said. It’s about learning how to take more comprehensive care of your patients, um, you know.

[00:23:49] Dr. Nikki Green. : We’re, we’re about to introduce the product and I know it’s been around for a while, so people listen just to be like, oh, wow, she’s behind the times, but we’re about to introduce the product. Radon, you know, I’ve heard [00:24:00] some good stuff about radon and, and I’m, I’m all about that 16-year-old with an incipient class two lesion.

[00:24:06] Dr. Nikki Green. : I would much rather put something on that tooth that I think is going to reverse it than to cut a class two box. Right. I mean, you’re shaking your head. You don’t wanna cut a class two box either. You know, Bob and I have a philosophy that like we want our patients to leave better than they, than they came in.

[00:24:26] Dr. Nikki Green. : And I, a 16-year-old that I’m cutting four class twos, they’re not leaving better than they came in. They’re just not, even if I do the best class twos in the world, that tooth is compromised for the rest of their life, you know? Um, so anyway, so, you know, just doing some things like that, I think, and, and unfortunately it’s going to, it is going to require my advice for that young dentist that you, it’s gonna require some fortitude and it is gonna require some checking of your own value system and, and standing up against, against the manager that just wants you to do 18 [00:25:00] crowns.

[00:25:00] Dr. Nikki Green. : But you also have to have a, you know, they’re running a business, so you also have to have your solution. So what is your solution? Is it to get more education and bring in new products like a Radont or, um, you know, laser periotherapy or something along those lines? I, I just think you have to expand your own knowledge so that you can still meet the production demands.

[00:25:25] Dr. Nikki Green. : But maybe not in the way that the arm, the, the laptop quarterback thinks you should do it. Right.

[00:25:31] Dr. Bruce Baird : Right. Yeah. I mean, it’s like, it’s so funny, you know, I get the, I don’t know, I get the, uh. Pleasure of going into offices. And when I came into, you know, I went to five offices this spring. Went from, you know, uh, from from Oklahoma to Missouri to Kansas, to West Texas, to northeast Texas.

[00:25:56] Dr. Bruce Baird : But it was really. With all phenomenal [00:26:00]dentists, really clinically just superior dentists. But one of the things that, that I noticed is everybody’s got their way of doing things and it’s not bad to have another set of eyes come in, you know, because I just walked around and said, how do you do this? Okay, well how do you do that?

[00:26:21] Dr. Bruce Baird : I actually learned a lot, uh, about man, if I was still. Prepping teeth, I would do it this way, right? But then there were other things I said, well, why don’t you do this like this? Or why do you call this a a a a two surface composite? Or, you know, why are you doing this type of stuff? And what I found was every practice has the opportunity.

[00:26:41] Dr. Bruce Baird : Even if you’re doing comprehensive dentistry and you were doing comprehensive dentistry when you came to PDA and all of a sudden you go way up here. Absolutely. I see the dentists that are, and it doesn’t matter if A DSO or whatever, ’cause we get the chance to, to visit with somebody, different dentists, but if we can take a young dentist, [00:27:00] back in my day, we used to have study clubs.

[00:27:02] Dr. Bruce Baird : So we would all sit in a study club and then we’d ask questions and drink beer until we got a lot of answers. And that’s how we caught up with the older doctors. And what are you doing? Why do you do that? Well, why is that? Well, I went to this course and this is the research behind it. Whereas today. Well, today is very different Today.

[00:27:22] Dr. Bruce Baird : The answers are right there for you. Um, you just have to be interested in finding ’em out, you know? Yeah, absolutely. And it’s very tough when you have a production. I remember one time listening to a DSO telling everybody on the call hundreds of dentists that we’re doing 1.6 crowns, you know, per day. And, and, and do you realize that if we were doing 2.2 crowns per day, that that would be another 30 million to the bottom line?

[00:27:52] Dr. Bruce Baird : And I’m going. Yeah, but that’s not the way you do 2.2, you know, what are they gonna do? Just all of a sudden just out of their [00:28:00] brain, just say, okay, let’s do one extra half crown a day. They,

[00:28:04] Dr. Nikki Green. : if you wanna be the recipient of a half crown, I don’t want a half crown in my mouth.

[00:28:08] Dr. Bruce Baird : I know. I just, I just shook my head.

[00:28:11] Dr. Bruce Baird : But you know, bottom line is we’re just trying to, to, to balance in the DSO world, balance our autonomy with right. Comprehensive care and taking great care of people and I really think. You can do that in any environment. It’s really up to the doctor and kind of what you’ve learned. But, uh, I I I love that.

[00:28:29] Dr. Bruce Baird : Yeah. And TCI, the, the, the reason that Clinical Calibration Institute came about was because of us seeing this big difference between somebody who is being very productive and someone who’s not. And even in our own office here, young doctor. Now, I mean, he was doing probably, I mean, FCC doctors are doing less than the hygienist.

[00:28:53] Dr. Bruce Baird : They’re doing 200 an hour, 150 an hour. How do you make a living? How do you enjoy work when you’re not making a [00:29:00] living? And so we even had one of our docs here that was really struggling to, to be what we found was. I told him, let’s do education. Let’s go here. Go to this course. Go to this course. Go to this course.

[00:29:13] Dr. Bruce Baird : But I knew in his heart he wanted to be a comprehensive dentist. He just didn’t have the experience. Today, he’s going over a thousand an hour. He is just, you know, and the thousand an hour is not an indication that he is working fast. A thousand an hour means I believe he’s taking better care of the patients and I care more.

[00:29:30] Dr. Bruce Baird : Boy, I just love Dr. So and so, you know. Because he’s learned and we all have to, and I think this absolutely is gonna take not only the doctors, not only the associates, but it’s also gonna help front office learn. Because you know a lot of people, your front office came from the bank, they don’t know any of that.

[00:29:50] Dr. Bruce Baird : I don’t. Or they came from a collection agency or they came from wherever. But you have to have a clinical philosophy that is. Comprehensive. And I, I just loved [00:30:00] visiting with you. You make me feel better every time we talk, so, um,

[00:30:03] Dr. Nikki Green. : well, like, well, those, likewise.

[00:30:05] Dr. Bruce Baird : Well, for those of you who you know, would like more information, send me a, uh, send, send me an email toBruce@productivedentist.com.

[00:30:14] Dr. Bruce Baird : Um, Nikki, thanks so much for your time. I know you are a busy, busy, busy doctor. She, she travels all over the world actually, and just to have you on my podcast. Is is everything to me, so, well, thank you Bruce.

[00:30:28] Dr. Nikki Green. : I, I always enjoy chatting with you. I, I definitely get smarter every time, whether, even, even if it’s a, a dinner over cocktails, I, I’m smarter by the end of our conversation.

[00:30:36] Dr. Bruce Baird : I get a lot smarter after a couple cocktails. Actually, I do that. I know Bob does too, so for sure I know. But thank you guys for listening to Productive Dentist Podcast, and please tell your friends about it. And tell your friends about CCI Political Calibration Institute. Just go to productive dentist.com and you’ll see all the information about it.

[00:30:57] Dr. Bruce Baird : I mean, it’s gonna cost your office less than 500 [00:31:00] bucks a month to train your entire team and to get so much education. So I look forward to seeing you guys meeting you in the future. Thanks, Nikki.