Care Before Coverage (E.257)

“I’ve got you. That’s all patients want to hear when trust is real.” — Dr. Wade Kifer

Brief Overview

Dentistry is shifting fast, but connection hasn’t changed. In this episode, Dr. Bruce Baird sits down with Dr. Wade Kifer, a Kois-trained dentist and faculty member with the Clinical Calibration Institute, to show how personal trust, risk-factor diagnosis, and team consistency outperform PPO-driven plans. With stories from his own practice and life, including surviving a heart attack at 37. Dr. Kifer explains why care before coverage builds loyalty, treatment acceptance, and practice freedom.

What This Episode Reveals

• Insurance is a payment method, not a treatment plan
• Risk-based exams build trust by reframing problems without blame
• Why scripting language consistency across the team matters more than “sounding smart”
• How a personal health crisis can sharpen your patient communication
• How Clinical Calibration creates repeatable alignment through turnover and growth

What You’ll Learn

• How to shift from coverage talk to care-first language that patients understand
• The power of simple scripts: “I’ve got you” > “You have three surfaces to treat”
• Where AI fits once the patient connection is secure
• Why quarterly calibration keeps teams unified long-term
• How FFS stability comes from loyalty, not insurance

If This Sounds Familiar

• Patients ask: “Why has no other dentist told me this?”
• Your team explains care in five different ways and confuses patients
• PPO rules shape your diagnosis more than the patient’s risk factors
• You feel productive, but not deeply connected to your patients
• You want dentistry to be less stressful and more enjoyable again

Next Steps

1. 1. Review your new patient exam. Are you building three “links” of connection every time?
   2. Script your risk-factor explanation so every team member speaks the same language.
   3. Swap technical jargon for friend-first consulting language.
   4. Explore how CCI can keep your entire team aligned: Clinical Calibration Institute
   5. Track one metric for 30 days: same-day acceptance of risk-aligned care.

TRANSCRIPT

[00:00:00] Dr. Burce Baird: Hi, this is Dr. Bruce Baird with the Productive Dentist Podcast with one of my good buddies, Dr. Wade Kuer Wade, welcome. 

[00:00:08] Dr. Wade Kifer: Yeah, well, I’m glad to be here, Bruce. It’s always fun to get to talk. It’s been a little while since I’ve seen you, so always fun. 

[00:00:15] Dr. Burce Baird: Oh, I know. It, it, it’ll be fun. We’re, we’re gonna have a good, we’re gonna have a good evening. Um, I’m really, you know, we’ve started this new program called Clinical Calibration, and I know you’re on the faculty, but it’s, it’s. I’m starting to realize how important, you know, the things that we’ve been teaching all along, but how important they are day to day for every dentist out there, and we’re getting that kind of feedback. Um, you know, it’s kinda like we’re we’re talking about initially talking about, you know, that. Patient connection and we’ve done that, you know, and, and how do we do risk-based care? And, and the stuff that you learned at John Kois, and, uh, by the way, Wade is a, um, you’re an instructor at Kois, you’re. You’re every, everything you could have done, you’ve already done it, John’s. So, um, that’s why we’re so excited to have you as part of, as part of what we’re doing with clinical calibration because, uh, the doctors who’ve been in it up to now, uh, had just picked up so much. The other thing that really kind strikes me is how things are changing so rapidly, and it’s kinda like, if you don’t stay on top of this, you’ll be behind in, in, in weeks or months, and I think AI is gonna play a role there. Um, what are, what are your thoughts? I’m, I’m just throwing this out there, but I mean, what are your thoughts on AI and diagnostics? 

[00:01:45] Dr. Wade Kifer: Well, well, you know, I mean, as we talk about all these things, I think they’re all tied in together. You know, I mean, I obviously started at PDA 12, 15 years ago, and you used to have this joke about all these repeat offenders that would come back, right? And so with things like. Clinical Calibration Institute, it gives us the opportunity to be updated all the time. We’re not waiting to come back every two years or three years and bring all the team, and so I still think in-person learning has great value, um, in certain situations, but things like AI and and dentistry, things change so fast, and you know, as John Kois says, none of us is smarter than. All of us, right? And so when we can get together and work as a group in some of these small learning environments and not wait for one a year, once a year meetings, I think it gives us a bigger chance to update quickly in those things because what do I think? I mean, I think it’s the future. There’s no way around that, but what does that look like? I don’t know. I mean, every day I think I’ve got something figured out and it changes so fast that, you know, if, if we’re waiting a year for an update on it, we’re gonna be behind the times. 

[00:03:03] Dr. Burce Baird: Oh my goodness. Yeah. I, you know, I put the handpiece down as you know, six years ago. I, I go up to the office. I just did veneers on, uh, on one of my daughters last week, and I did veneers on another one of my daughters about three months ago. I haven’t forgot how to prep. You know, I, I feel super comfortable. I haven’t forgot how to numb people hug, but what’s really crazy is just the software changes, just the stuff that I was using, I was kinda like, can you show me how this works? Can you show me how that works? And, and so I feel like, you know, with AI there’s so much coming at, but it doesn’t matter if you have AI, if you don’t have the personal connection, wouldn’t you? That’s a, I mean, to me, patients are gonna, I think that they’ll, they’ll value AI. They won’t value AI if they don’t like you. You know what I’m saying? 

[00:04:00] Dr. Wade Kifer: Yeah. You know, and that was one of the first things, you know, as I talked about when I went through Productive Dentist Academy, you know, it’s, it’s almost like every time I went, I tried to pick up a new thing, and I got better at it, you know, but one of the first things we picked up was you’re, you, you taught one thing and you said something that really stuck with me, and it was always that three links to a chain, right. Things we had to have in common, and you said, I only treat my friends. 

[00:04:28] Dr. Burce Baird: Yeah. 

[00:04:29] Dr. Wade Kifer: Right, and the links, when you go in to do that new patient exam, they’re, they can’t just be superficial if they’re going to be your friends, and you’ve really gotta get down and and link with the patients, and I know some dentists find that uncomfortableness, but there’s a level of trust. I went from when I came, I used to go to the patients and go, “Hey, you’ve got these three surfaces. These are the surfaces of the tube we’re gonna treat the mesial, the distal, the occlusal,” and I describe all these things in technical terms, and now I’m in such much better relationship with my patients that, you know, if they’re nervous I just say, “I’ve got you. Don’t worry about it,” right, or a line I stole from you is it’s time. It’s time we get this done, and I don’t even mention teeth numbers anymore or anything ’cause when you’re talking to your friends, your friends don’t want to hear about teeth numbers, right. They just wanna know that you got their back and you’re gonna take care of them, and so I feel like, like you said, that was one of the first lessons we picked up a long time ago, and yeah, you break it down into three links on a chain, but it’s deeper than that because it’s really, we use those links in a chain to build that relationship and really become friends.

[00:05:49] Dr. Burce Baird: Yeah, I, I mean, I tell you when I, when it first hit me that, that, you know, that I only wanted to work on my friends and it was, uh, I don’t know, I was probably 15 years in, but I started realizing that it’s that connection we’re missing. I’ve got the clinical skills, I’ve got that, but, and guys that go to John or go to, you know, wherever they go, they come out, they, they may have the clinical skills, but. It’s like going to the dance and not having anybody to dance with. You know? It’s, it’s, and what I found was when I started really paying attention, and one of the things that I know you, you found too, but I, I, I would look back at the new patients I saw for the last week. Do I really remember them? Was I, am I really working on my friends? You know, that, that type of thing, or am I just going through a script to supposedly make them say yes. Well, yeah, that’s part of it, but I, I only wanna work on if I’m a part of that trust and a part of that, they know that they’re in the right place. I just did an exam. I went out and I said, I’m not gonna do the work, but one of my good buddies here I play golf with, and he was like, “Man, would you just take a look at my teeth and stuff? I know you’re not working anymore,” and I said, “Sure.” Well, he and I already had the trust. So it was, you know, and so all of a sudden it was like bringing in somebody who was already gonna say yes to treatment, just because I was gonna say it, and you know what? It, it was, I, I, I, I didn’t go through the risk factors like I usually do. I didn’t go through all that stuff just because I felt like we already had that trust, but I think it’s so important to have them understand that those risk factors. It, it’s, it’s not that. It’s not that I, I just want ’em to know it. It’s just that I want them to know that they may be part of the cause for what’s going on. Does that sense that?

[00:07:45] Dr. Wade Kifer: Oh, totally, and you know, you said something, I always use this line when I, uh, talk to PDA sometimes and I always kind say, if I can make ’em cry, I, oh, it’s over, and I mean, that sounds terrible when I say it, and I, and I do put that out there a little bit for shock value. Yeah. When we do that, even on a new patient exam, first, we’ve got that link, right? Right, but then all of a sudden we’re gonna get deep with them because we’re gonna go, “Hey, how long has this been bothering you?” And, and we’re gonna listen and we’re gonna say, “Can you tell me a little bit about, about that?” Right, and I keep going deeper and deeper ’cause I’ll just say, “How does that make you feel? Has that bet that’s been frustrating, and then you’ll listen and you know, you’ll get all the way down to, I mean, is this affecting your life? Have you avoided stuff?” And it’s uncomfortable sometimes, but if you’ll get deep down and, you know, you can’t just ask that first question, does this make you emotional? Right, but sometimes, but if you’ll work it down with them and, and then it’s just sympathizing with ’em, right. So we may not have talked treatment at all, but if you’re willing to get emotionally involved, and sometimes that’s you telling a little story about yourself, how that you’ve been affected by a situation. Not to make it about you, but just to be vulnerable with the patients, because that’s what you do with your friends, right? You share with your friends. That’s right, and you know, when you get that deep with a patient by the time, like I said, if they’re willing to vent all their frustration and fears and anxiety, at that point, all I gotta say is I’ve got you. Yeah. I love that. We’re gonna make it better. 

[00:09:28] Dr. Burce Baird: I love that. I mean, I love that, and I’m from, from my perspective, it’s, it’s kind of like. You know, I went through probably the first 15 years of my career telling people what they needed and then I’d step out of the room and hope that they said yes, which is, I know some of you guys listening to this guys and guys listening to this have been through the same thing, but it’s like now I pretty much know they’re gonna say yes. They may not be able to do it all today or tomorrow, or even this year, but I’m their dentist from now on. When they can come up with the cash to do stuff, they will, uh, if they, if they can’t, they’ll find a way, um, and if they can’t find a way, I’ll usually find a way to help ’em. So it is just changes everything with that trust. The risk factors, the, I think the personal stories we share, you know, with, with the patients, um, what do you do, and, and you, you have really become a master of the risk factors. I mean, you really have. What do the risk factors mean to you in your communication strategy with patients? 

[00:10:41] Dr. Wade Kifer: Well, for me, you know, I mean, you, you always taught us this line that, you know, our, their problems are not our fault, right? It, it, it’s their problem, and so, but even more so than that, when I look at the risk factors, I put their problems on their disease risk. Yes, and I actually take it off of them, and so I can tell a little story and I got to meet someone through you, uh, nonetheless, but Bradley Bale, yeah, and, and Bradley Bale wrote a book called Beat the Heart Attack Gene. Um, it had personal impact on my life because I had a heart attack when I was 37 years old, and so I tell patients that when I go through risk, I say, “We look at your risk as your odds of developing trouble and think of it like this,” and I tell ’em about the book and I go, there’s a very important topic in this book, and it’s called Beat the Heart Attack Gene, and I give my personal little testimonial on that 30 seconds, not long, and you know, they’re feeling sorry for me at that point. Sure, sure, but I go, the beauty of the book is it says, beat the gene. Meaning some people are genetically predisposition to heart disease, and you know that, right? Certain women are pre, they’re gonna have the breast cancer gene, right? We all have things. There’s a gene that makes you more likely to have periodontal disease. There’s genetics that make you more likely to have cavities even on just your four lower front teeth. Now what’s different is, and what that book is so powerful to me. Yeah. It’s beat the gene. I have to do extra stuff to beat the genetics. I have to eat right. I have to exercise, I have to take my medicines, I have to do all these things, and it is what it is, and you can say, yeah, that’s genetics. I was fairly skinny, pretty good shape, 37 years old and had a heart attack. I remember you. Yeah, you the patient, have genetics for this. It is not fair that you’re having to do extra. It is not fair that you’re gonna have to get your teeth cleaned three times a year, that you’re gonna have to bacterial testing and deep cleaning, but that’s the genetics. We can beat it. If you and me team up and work together, we have a very good shot of beating it, and in your case, at least it’s not heart disease, but if we don’t get this under control, it could turn into heart disease. 

[00:13:10] Dr. Burce Baird: Oh my gosh. I just love that. I’ve loved you taking your own personal story and, you know, I do the same in a different, different way, but it’s, uh, I, I think it’s our responsibility as a healthcare provider to educate them not on mesial and distal, or not buccal and lingual, which I did the same, but educating ’em on the things that you were just talking about. I mean, that is not fair. You know, some of us have had these issues and it’s just not fair, but I have a, I have a, I have a plan that could help us, um, and, and help you keep your teeth the rest of your life, and golly, that is just, I, I tell you, it’s amazing. You know, some of your patients only have one, one risk, you know? And gosh, some of your patients have a different risk. Might be perio, one might have the decay problem, and then there are those train wrecks that, you know, they have ’em all and they, they’re abusing themselves and their teeth and everything else. What really kills me, what, what tears me up is that most of the time those that are just really tearing stuff up, they don’t have a clue. They’re just living, they’re just living their life and no one, and, and this is where it really gets hits on, and I know you hear this too, is it’s, they go, why is nobody else ever told me this all the time or dentist, no other dentist has have ever told me this, and I could, you could easily say, “Well, no other dentist knows what we know,” but that’s not what we do because it’s not about that. I, I always look at it as says, you know, we’re learning new stuff every day. What we do in our business is I only like to work on my friends and you and our buds now, and it kind of changes from you being Dr. B or whatever. A lot of times they’ll just call me Bruce. I said, that’s great. I don’t, I don’t have that there’s no real hierarchy as far as that’s concerned for me, but, but I, I always want to be. They’re consultant. I, I don’t really want to tell you what you need, but I wanna consult you based on my knowledge on what I would do if it was you. I mean, if it was me in, in your situation. Is that kind of the way you, that you follow it or whatever? 

[00:15:35] Dr. Wade Kifer: Yeah, ’cause you know, I, whatever the generation is of the patient, you know, I mean, if it’s a female my age and say if I would treat my wife just this way, if it’s someone older, it’s like, this is what I do with my dad. I had a lady in today, she busted out two teeth. I’m like, she, she’s 22 years old, and I’m like, if you were my daughter, this is exactly what I would do, and, and I mean that, that’s, oh, that’s exactly what I would do. So first you have to get in that relationship and then it’s relate that way, and I do, I’m the same way. I introduced myself as Wade. I, I wanna be on first name basis with you. I’m not trying to be above you. I am your consultant. Get with him. I’m like, I bet you’re frustrated. ’cause I’ll tell ’em too. I’m like, “I can look in your mouth and you have spent thousands of dollars. I know, and you’re still having trouble. That has to be frustrating, doesn’t it, right?” I wanna be on their side as a consultant, not someone, and you know, it’s just the way we’re taught in school. All of us, there’s your problem, there’s your fix, there’s your problem, there’s your fix. 

[00:16:40] Dr. Burce Baird: Yeah, and when what we found is that, you know, and productivity, um, you know, we’re not doing it. I, I, we’re not, I’m not doing it. To be more productive. I mean, it happens. I do it because I know if I take great care of my patients, the, the money always has taken care of itself. Now, if I start to, you know, try to nickel and dime people, whatever, you know, and, and things don’t work that way, but when we kind of converted our mindset into working on friends, and to tell ’em what I would do if it was me. I mean, I think that’s always been part of our nature, you know, to do that. We, we want to take great care of people and, but the ability to be able to have a system in place and now good grief, I mean, we had, you know, we’ve had, uh people come tell us about caries, and, uh, Kim Koch has done an entire program for clinical calibration, four and a half, five hours. This is the, probably the leading guy in the world on decay risk, and, and 

[00:17:45] Dr. Wade Kifer: I don’t know anyone better than Kim. 

[00:17:47] Dr. Burce Baird: He’s, yeah, and he, he’s been friends of ours for years and, but, but for him to come of, put five hours of time into, and he said it’s the first chance he’s ever had. He’s taught a lot of people about caries, but he said it’s the first time he’s ever been able to be a part of an overall solution or an overall calibration of treatment, you know, which is kinda weird, you know, but I can understand if you’re, if you’re, if you’re in this lane, but now he feels very much so that he’s a part of a, of a movement in dentistry, and I, I, I do really like clinical calibration. I like what we’re doing. I like the fact that your team can get on and, and get calibrated to the same thought processes that, that you and I have, that your front desk can hear things that calibrate them to understand dentistry in a way that, well, they didn’t understand. They, they worked front desk at, uh, at at, at the bank, you know, or whatever, and now they’re in your office, they’re really good. They don’t know, and all of a sudden. You’re taking your hygiene, you’re taking your chairside, you’re taking your administrators, you’re taking people on the phone, and everybody now ends up with the same philosophy that we have, you know, that we have built our business around. Do you find that the, the same thing when you’re looking at it. 

[00:19:15] Dr. Wade Kifer: Well, yeah, that’s that. That’s exactly what I was trying to say earlier, and you just put in better words because we would go back to PDA every couple years, every time we had a staff turnover and some change, and it’s like, oh, we’ve gotta get everyone back on the same page, right, right, and so we developed a whole program in our office. Where, and we’ve been doing this long enough where we meet every quarter and go over different risk factor, right? So we get all four or five of them in a year, but it took years for us to set that up and just to have it laid out in Clinical Calibration, where when you have staff turnover or changes or just need a refresh ’cause even all of us, I mean, I go back and learn the things I’ve always learned. I’ve heard Kim Koch lecture so many times, and it could be the same lecture or the same time I’ve heard you lecture, I pick up something new every time, right, because wherever you are in life, you hear something, whatever you need to hear is just one of my philosophies. So no, I think it’s brilliant that now we have, not only are we having live information, but we’ve got everything recorded too, so that, oh, you get a new associate, you need to hear what Kim said and we can go back and pull it back up, and you listen to it when you’re a new associate, you’ll pick up something you didn’t pick up the first time, I promise 

[00:20:32] Dr. Burce Baird: a hundred percent. I mean, I found that I love doing live programs. We, you know, we, 21 years, we’ve been doing two to three to four a year, but what’s really interesting is kind of same thing is I meet people. I learned something at each seminar that I’m supposedly being the teacher, you know, I’ve learned so much from you and so much from the other people that have come to the programs. I’m going like, “Really? When did you start using that? Well, how, let me, how does that work?” And then I go back to the office. Now, the bad part now for me is I’m not going back to the office, but trust me, I’m, I’m doing my very best to stay as integrated with the new treatments and the things that are going on as I possibly can. Cynthia, my wife, she laughed. She goes, “Why are you looking at that?” You know, I’m, I’m on a video watching somebody do something. She goes, “Why are you doing that?” And I said, “Well, it’s really interesting man. They’re printing these things and then they’re doing this,” and she goes, “Yeah, you’re retired. Just let it go,” and I go, “I’m not dead. I’m a dentist. I love dentistry. I love my patients, and you know, you never know when one of your buds might just ask you, Hey, have you heard of this new deal? I don’t wanna be the dentist that goes, oh, that was, you know, oh, that’s, I, I don’t wanna say it’s no good, just because I don’t know it. What I’m gonna say is, “Hey, it’s pretty exciting. There’s so many new things out there.” So anyway, but golly, that what a, what a wonderful way to practice dentistry. Do you enjoy dentistry more now than ever? 

[00:22:03] Dr. Wade Kifer: Oh yeah. I mean, I’m getting to do, I mean, I’m still a general dentist, but I’m just getting to do more of the dentistry I like and you know, it’s, it doesn’t seem as stressful, like you say, I don’t worry about, I’m at the stage of my career. I don’t worry about are they gonna say yes or not right. Um, you know, I hear patients referring me new patients that never got the treatment done for whatever reason. Maybe they just wasn’t time yet. That’s right. It’s. There’s no confrontation or very little, you know, we’re able to turn it back to we’re on the same side, and it’s just a much more pleasant way to practice dentistry. Um, I look at some of my role models and, um, I could see myself two or three days a week as long as I can. Mentally and physically to it, you know, but I enjoy, PDA has given me a lot of freedom too. I’m probably 10, 11 weeks off a year, so it, it’s easy to keep going when you’ve got it built and the systems, it takes time to build it that way. It doesn’t happen overnight, but the journey’s definitely worth it. 

[00:23:06] Dr. Burce Baird: Oh my goodness. It, it does. I got you, Wade. I, I just love that line. I’m gonna start using that line a lot. So everybody, I hope you guys have enjoyed. Um, Dr. Wade. ’cause I tell you what, I enjoy visiting with him every opportunity I get. Uh, I’m so thankful for you and all the things that you’ve done. You’ve sent a jillion people through PDA over the last few years, 20 years, and, um, certainly appreciative of it, but I, I am just, um, I just love visiting with you. I love learning new things and, uh, if you guys need anything, we’re gonna be doing some, some videos out of Wade’s office on some of this stuff, uh, I think you know that now, but if you don’t, sorry to break it to you, but I,

[00:23:52] Dr. Wade Kifer: I got some word. We’re gonna do some over the shoulders and it’ll be, it’ll be a lot of fun doing some risk factors and treatment planning and just how to set all this up in your office so that you’re not having to reinvent the wheel. So. 

[00:24:05] Dr. Burce Baird: That’ll be so much fun. When I was doing the Over the Shoulders, the one thing I would always get, people would say, well, you just seem so relaxed, you know, and you’re seeing a bunch of people, but you just seem so relaxed and, and. I, I think they expect it to be, if you’re gonna be a, a, a good producer and produce well, it doesn’t take a lot of dentistry to do very, very well. Yeah, and if patients are saying yes to treatment, you’re gonna find you’re doing very, very well, but it’s getting to that. That relationship, it’s getting to that trust. It’s going through those things, and so folks, I hope you guys have really enjoyed tonight, and, uh, we’re gonna be doing some more talks with Wade and I’m gonna get Wade to help out with, uh, with our Productive Dentist Podcast here in, in the future as we go forward, but, uh, thanks Wade for being with me today. 

[00:24:52] Dr. Wade Kifer: I love you, Bruce, I’ve learned a ton from you. 

[00:24:54] Dr. Burce Baird: Thank you. Well, I’ve learned a ton from you too, so thanks buddy.