Effortless, fun, and profitable endodontics

In part 2 of his series, Dr. Ace Goerig suggests ways to reduce stress in the practice

Almost all endodontists could be completely out of debt and on the way to financial freedom within 5 to 7 years if they only knew the secret. But the secret is counterintuitive, and here it is: By changing your mind-set and systems in your office, it is a lot easier and less stressful to complete six cases a day instead of the average four cases.

Also, the quality of the six cases you complete will be even better. These additional two cases will give you an additional $1,925,000 over the next seven years to pay off all debts and begin your path to financial freedom. It is just a numbers game. If you work 200 days a year, and your root canal fee is $1,000,  two more cases a day will give you $400,000 in net profit. After taxes, you will have an additional $275,000 for debt reduction; $275,000 times 7 years is $1,925,000.

Over my 17 years of coaching endodontists throughout Canada and the United States, I have found a common encoding among many them. They believe to obtain high-quality endodontic results, it must take time and has to be hard. Many people are imprinted from childhood in the belief that life has to be hard. I was just talking with a 55-year-old endodontist, who for the past 20 years has worked 5 days a week with only 2 weeks off for vacation and takes home $325,000 a year. While on the other hand, I show endodontists that I work with how it is possible to work only 3 days a week and take 8 to 12 weeks off a year for vacation and net 2 to 3 times as much as the previous endodontist. Most of these dentists are now debt-free and well on their way to financial freedom. More importantly, they now have personal freedom. In this philosophy, doctors never have to change their clinical technique or treatment philosophy while providing the highest quality of endodontic excellence. This is called the “retire in practice philosophy” that I have personally practiced for the last 20 years.

Recently, I worked with a 63-year-old endodontist who within 6 months was able to increase his daily completed cases from three or four cases (which he had done for the past 36 years) to seven or eight cases a day, easier than when he was doing three or four. He could have learned this system when he was younger and enjoyed the “retire in practice” model for over 30 years instead of working 5 days a week with only a few weeks off for vacation each year.

Bringing in the right associate is an essential part of this philosophy, which will be addressed in a future article. It should be noted that you cannot bring in an associate successfully until you are completing an average of six cases per day, or you will be sharing your net profit with the associate and reduce your personal income significantly.

After reviewing the practice numbers of 20% of all endodontists in the country, I have found the average endodontist completes three to four cases in a 9-hour workday. When I spoke to this group about the possibilities of treating more cases and being more profitable, many say, “I don’t want to work any harder, and I will never compromise quality.” The problem is they only know what they know, and don’t know what they don’t know. I then asked them, “How long does it take you to complete a quality molar root canal?” The more experienced endodontist will say about 1 hour. My next question is, “If you are working a 9-hour day, why are you only completing four cases instead of nine?” The good news is that it’s not about the doctor’s technique; it’s about the doctor’s mind-set, office systems such as scheduling, team training, flow of the office, and focus of the doctor.

Why are endodontists so inefficient?

The reason is most endodontists waste 3 to 4 hours each day in nonproductive time, i.e., piddledontics, non-treatment cases, doctor and team inefficiency, and the doctor talking too much. Because of these inefficiencies and lack of office systems, both the doctor and team struggle through the day. This is not a fun, profitable, or effortless practice model. Sometimes there is a disruptive team member who “stirs the pot” and does not like change. Many doctors think it is about improving technique to become more efficient, but this rarely affects the number of cases completed in the day. Some doctors subconsciously believe they are not worthy of success and feel everything in the office has to be hard. Some doctors are not open to new possibilities such as doing one-appointment endodontics. When your ego always has to be right, it will be very difficult to find peace, happiness, and freedom in your life.

8 necessary steps for a fun, profitable, and effortless career

Step 1: Write an empowered vision of how you want your practice. You can have it any way you want it to include all the right team members, all the best referring doctors, and the best patients. Part of your vision may read “Our office has a reputation of being so gentle, safe, and caring that we draw the best patients from all of the best doctors in our area. We enjoy every day to the fullest but live in each moment. Our office flows effortlessly and is filled with pride, a sense of ease, and a calmness that allows us to provide excellence in endodontic treatment that is unsurpassed.” Your vision becomes the compass for your practice and sends you in the right direction as well as a magnet to bring all the right people into your practice, including the right associate. The vision sets the tone of the practice culture.

Step 2: Write out specific goals for your practice. Some examples follow: “I will spend 98% of my time in direct patient care,” or “Within 6 months (date) I will be completing two more cases per day.” When goals are written down, they are much more likely to be accomplished.

Step 3: Change your systems. Office systems that are not working cannot be fixed and need to be replaced. Bring in a practice management consultant that has your same personal philosophy and the reputation of getting results with his/her clients. You probably have already tried to improve your office, but nothing seems to change. An outside observer can see what you cannot see and implement systems that work for your specific situation.

Step 4: Become the leader of your practice and empower your team to run the office and the schedule. Many doctors are afraid to give up control, but in reality, you’re just giving up the stress of control. When you know you have the right team and office manager, the office will run better than when you were trying to do it all. The job of a practice consultant should be to train team leaders to run the practice allowing the doctor to focus on treatment.

Step 5: Eliminate the drama in your office. If your office does not run smoothly and is filled with drama, there is always someone who stirs the pot, back stabs, gossips, or comes in late. Many times this may be one of your best employees that you would hate to lose and because he/she is good, he/she feels that he/she can get away with bad behavior. Sometimes it is difficult to identify who is stirring the pot, but there are ways to find out. Once you identify the employee, these infractions need to be documented. From my personal experience, these types of employees will never improve, and as soon as you set them free from your office, the dark cloud will go away.

Step 6: Effective marketing results in easier cases. There is an old phrase in marketing that states, “Those who need to market should not, and those that do not need to market should.” This statement means that if you need patients, there is something you are doing in your office that turns them away. This is also true with the referring offices. It may be a negative lady at the front desk; it may be you are booked out too far and can’t get patients in immediately, plus many other reasons. Before you market, make sure you have addressed all the concerns of the referring offices. It’s a good idea to send out a referring office survey to find out what is important to them. Marketing is all about the development of personal relationships. I also believe that every endodontic office needs a marketing coordinator to run a marketing program that has multiple strategies that are changed over the years. Depending on the size of the practice, it could be a 15- to 40-hour per week job.

Step 7: Efficient and predictable technique. Over the past 25 years, there has been a revolution with new technology and instrumentation in endodontics. With the new engine files, microscopes, digital radiography, CBCT scans, apex locators, etc., endodontics has become simplified and more predictable than when we just had hand files. One of the big philosophy changes is one-appointment endodontics. I have been doing one-appointment endodontics for over 40 years in the majority of my cases and have extremely high success rates with little postoperative problems. There are very few contraindications to not doing single visit endodontics. Your patients want it; your referring doctors want it, therefore, making it one of the strongest marketing strategies you can implement. If you find all the canals and instrument up to at least size 40 in every canal, your success rate should be close to 100%.

Step 8: Get out of debt. As described in part 1 and in the above paragraphs, eliminating debt should only take 3 to 7 years. When debt is eliminated, so are the stresses associated with being in debt. You will find yourself much more relaxed and much more peaceful in your practice and your life. You are now really going to work because you want to, not because you have to. What is surprising is that more abundance seems to flow into your life more easily and without effort when you are debt-free. For the specific step-by-step plan on how to get out of debt, go to free resources on the www.endomastery.com website.

In part 3 of this series, I will discuss many of the ideas and secrets to obtaining personal freedom, peace, and abundance in your life while always enjoying the process.