Special List #2: Just 5 Things I Know About Periodontal Practice Management with Dr. James Woodyard

Dr. Jason Souyias (00:02):
You are listening to the Special Lists presented by Referral Lab, a podcast for dentists and dental specialists. On every episode, we bring you a special guest specialist featuring a special list. I'm Jason Souyias.

Dr. Michael Seda (00:16):
I'm Michael Seda.

Cameron Full (00:18):
And I'm Cameron Full.

Dr. Jason Souyias (00:21):
This evening's specialist is Dr. James Woodyard. James Woodyard received his doctorate of dental medicine from the University of Kentucky and completed a residency in Periodontics at the University of Louisville, earning a master's in oral biology and a certificate in Periodontics. He maintains a private practice in Newburgh, Indiana, specializing in periodontics and dental implants, and is actively involved in professional organizations including the American Academy of Periodontology, the Pierre Fauchard Dental Honor Society, and the North American Society of Periodontists. A diplomat of the American Board of Periodontology, Dr. Woodyard lectures nationally on dental implants and periodontal therapy, and is a founder of both the Select Study Club and the Tumbleweed Mastermind Group. Help me welcome James Woodyard to the show tonight, gentlemen.

Cameron Full (01:12):
Come on down. Come on down.

Dr. Jason Souyias (01:16):
Well aside. Oh, there it is.

Dr. Michael Seda (01:19):
There you go. There we go.

Dr. Jason Souyias (01:20):
Aside from all that written mumbo jumbo, one of the things I can tell you is James is one of my good friends and I think the world of him. I think he's an outstanding clinician and incredible practice manager and a damn good clay shooter. He's the reason I got into clay shooting as a hobby, and I have had the fortune of visiting his practice probably about 65 total practices in the last 15 years of my career. And I can honestly tell you that his practice is one of the most well run practices I've ever encountered. And with that, I'd just like to welcome James. Thanks for joining us tonight.

Dr. James Woodyard (02:01):
Thank you guys for having me. Thank you so much.

Cameron Full (02:03):
I don't think he gets tired of hearing that.

Dr. Jason Souyias (02:05):
He doesn't get tired of hearing that even on multiple takes, huh?

Cameron Full (02:09):
The bio.

Dr. James Woodyard (02:09):
I definitely get embarrassed. You see my face gets red, so I do get embarrassed when people say nice things about me.

Dr. Jason Souyias (02:14):
You know what though? It's so true. I've been to a lot of practices. I've been with the software opportunity and with visiting practices of our friends through some of the groups that we're in together, I'm always blown away and I always learn such incredible things when I've been able to see your practice, not only clinical stuff because you're an outstanding clinician, but also especially how you manage your team. And some might say that you're a little cheap. I call it frugal, but.

Cameron Full (02:47):
That was quick.

Dr. Jason Souyias (02:48):
Yeah, that was frugal. But man, you crush it on keeping your overhead down and making your practice profitable. In all seriousness, and some of those conversations you and I have had together, I'm so excited to hear what kind of list you brought with you tonight to share with us on today's episode of the Special List.

Dr. Michael Seda (03:08):
Well, we know he is a master clinician and business owner. We know he is a champion clay shooter, but we also know that James, you do know your way around the meat as well, don't you? You are a, is it a world champion barbecue champion?

Dr. James Woodyard (03:28):
No, no. It's just local champion. Just local champion. Just local. Local.

Cameron Full (03:33):
We don't know that. Do you know that?

Dr. James Woodyard (03:34):
It is just local?

Dr. Michael Seda (03:39):
Yeah.

Dr. James Woodyard (03:39):
Yeah. It's always fun. I cook a brisket or some chicken and I've got to take a picture of it and send it to Seda. Check it out, man. And I remember one time he called me late at night like, dude, my brisket stalled. My brisket stalled, what do I do my brisket. That was like when you were first starting to cook.

Dr. Michael Seda (03:52):
That's exactly right. Yeah, you saved me. You saved me.

Dr. James Woodyard (03:55):
That was so funny.

Dr. Michael Seda (03:55):
Yeah. Really looking forward to diving in. James is Jason and Cameron. I'll just piggyback on what they've said. You've influenced me so much over the years. When you first met me, I was just a young fledgling periodontist and over the years you've been like a big brother to me. I've learned so much and super excited to share you and what you have to offer with our listeners.

Dr. James Woodyard (04:20):
I appreciate it.

Cameron Full (04:20):
Let's roll, let's roll

Dr. Michael Seda (04:22):
Let's dig in guys. Let's get right to it.

Dr. Jason Souyias (04:25):
Let's roll. So of course this is the kind of overachiever James Woodyard is we ask for a list of five things and he sends us eight. So we've got eight topics that we can,

Cameron Full (04:35):
80 things.

Dr. Jason Souyias (04:36):
80 things, but we narrowed it down to eight that we'd like to cover tonight. And so let's dive right into it. The first topic, practice management, and this is something that you and I have talked about a lot and we believe in so strongly and we try to teach this to the offices we work with and it's rethinking the hygiene periodic exam. Tell us more about that, James.

Dr. James Woodyard (05:03):
Where that came from, is Mark, Mark Setter. And I always believed it, but I never really thought about it that much, is that we get these new patients and we do all this extensive new patient exam and we're super thorough, but then once they're in recall, we assume that they're just going to be fine and then problems start to occur and we treat them almost like second class citizens. You can't be afraid in your hygiene exam, you see an existing patient that is starting to go downhill. I will even just say to them, I said you were healthy and now you're not. Now I've got to pull you out of this and I've got to look at you with fresh eyes. Got to pretend like I've never seen you. I want to treat you just as good as I treat a new patient coming into my practice.

(05:54):
And then they're just like, oh my God. That's like, wow, okay, yeah, I get it. And that's key. I see that with the dentist that I work with a lot, and they're so afraid to do that because they don't ever want a patient to think anything's going to go wrong. Well, everything's going to break, everything's going to fail. People that happens, let's not get upset about it. Let's just pull 'em out. Let's treat 'em like they should be treated and look at 'em with fresh eyes. So that's one of my first pearls there that was really important to me.

Dr. Michael Seda (06:27):
So what does that look like in your practice, James? You go in to see a patient during a hygiene exam and they've identified some issues. Where do we go from there in terms of looking at them with a fresh pair of eyes?

Dr. James Woodyard (06:42):
So there are times that it's just a simple issue. Mrs. Smith, she's been seeing us for a long time. You now have a tooth that has three millimeters of recession and it needs root coverage. So they take a picture of it, we show it to the patient there. That's not somebody you need to pull out yet. So you start to see the patient, especially a periodontal patient. And then it's been like five years since you've taken a full mouth series. In my practice, I require every patient to have a full mouth series by every six years or I will not have on my hygiene program. And we start to see them breaking down universally. We start to see, okay, you've had several fillings, you've had this and that, and there's a lot of different things to talk about and it's way too much than what you can talk about at a hygiene exam.

(07:33):
So say, okay, I can see these particular problems, but I really need to dive in. I'm going to bring you back just like you're a new patient. We're going to do a comprehensive periodontal examination. It's going to be some of the things that we've already done, but we're going to go in more depth because we want to stop this. We want to be proactive rather than reactive. And we want to catch this at its the easiest point. The patient's fairly appreciative, appreciative of it. If my hygienist, I've coached them to the point that we're very aligned on how we talk to people, they're not going to present treatment plans to them in the chair. They're going to present problems to them in the chair. They're going to expect me to present treatment plans. Just like I don't want you to paint yourself into a corner and saying that I'm going to do one thing. Then I come in and tell you something opposite, then it makes you look bad. We got to be aligned. But it's always pulling back, doing that comprehensive exam, having them back for a treatment conference, not trying to talk about too much in the chair. And the patients will then listen to you. They're going to have more likely say yes than if you're just trying to throw something out there quick to 'em just because you felt like know 'em.

Dr. Jason Souyias (08:44):
So this is one of those areas where we're as periodontists, we're unique in the specialty field, but it's more like a general practice, right? Because you have your patients and you've got your hygiene schedule going at the same time. How much time does that take you out of your schedule to come in and do this kind of a check?

Dr. James Woodyard (09:05):
Well, that's one of the reasons why if I'm going to come in and they're going to have to do a whole new patient exam, then honestly probably that's going to put me behind for the day. I'm going to have to find someplace to make that up. If it's really extensive, I'll just come in and identify it, have them gather as much data as I can and then either bring them back for a treatment conference or if I feel like I need to gather more data, then I'll just bring them back for either a limited exam or just a complete exam to start from the beginning.

Dr. Jason Souyias (09:38):
Sometimes do you do that just you don't have time in your schedule even though you might want to or you do, right?

Dr. James Woodyard (09:43):
I do.

Dr. Jason Souyias (09:44):
And this is one of those things, have you trained your partner providers, like the dentist that refer you patients? Have you trained them in this kind of topic as well?

Dr. James Woodyard (09:54):
Oh yeah.

Dr. Jason Souyias (09:54):
What kind of response have you had from the general practices?

Dr. James Woodyard (09:58):
A look of fear,

Dr. Jason Souyias (10:00):
Right? Why?

Dr. James Woodyard (10:02):
Because they just think in my area, we're very lucky in that everybody's pretty busy and the idea that they're going to have to bring these people in for hygiene, for comprehensive exams kind of makes 'em scared because they don't know where they're going to put. And the other thing that makes 'em scared is because they feel like that they're going to be viewed as a failure because the patient is no longer completely healthy. They have not been maintaining that patient, which is completely untrue. No matter what we do, periodontal disease will progress. Our job is to intercept it and treat it when it's needed. The average patient, if they're perfectly healthy, non-smoker, non-diabetic, seven to 10 years, they're going to have to have some more treatment. If they're smoking and diabetic and they don't have good oral hygiene, you're talking four to five years or maybe less.

(10:54):
And we're really open about this. We don't try to sugarcoat it. We're like, Hey, listen, this is where you're at. This is why we see you on recall because we don't want to have you go away for 10 years and then all of a sudden they're diagnosing your perio off of a bite wing and you haven't had any probings. And we want to catch this quick. We want to help you keep your teeth for a lifetime. It doesn't mean we're not going to have to treat it doesn't mean we're not going to have to do anything. But this is how periodontal disease works. The case the same way, do one filling, they're never going to have another crown or anything like that. I mean, it happens.

Dr. Jason Souyias (11:31):
So, you were saying that you're very blessed in the area that you work in that most practices are very busy, but have you ever had the opportunity to teach this someone who's just starting or not as busy, and what did they find on the back end of this?

Dr. James Woodyard (11:48):
That's a good question. They were a little more receptive to it, and I think they were more receptive to it because most of 'em were younger. Most of them I think with age becomes more fear of failure. And I see that the people that I see that, well, we're just going to watch it. We're just going to watch things. That seems to be an older population that's been, and it seems to be cultivated, and it isn't always of course, but I just see that the younger population is more proactive. Hey, listen, I know things progress, this and that and the other. They don't get so caught up in and don't even think it's ego, but it's fear. If I tell them that they need more work, then they're going to leave my practice, which is really just the opposite. It's all in the presentation.

Dr. Jason Souyias (12:40):
So I've also, in teaching that to others that I've worked with, I've noticed them get their schedule busier for the doctors because they're more comprehensively diagnosing their patients. They're finding the work. They're not trying to cram presentation into a five minute hygiene appointment when it really needs its own time because they're talking about a full mouth problem. So it's one of those things that I learned it from the same person you did, and it is one of those things that's so incredibly powerful. And Cam, you and I were just talking the other day through text right now, the American Dental Association is showing dentistry to be kind of stagnant, not growing, not shrinking, but staying steady, kind of plateauing at the moment. And what better way to build your practice or make it a little busier than getting your patients as healthy as they can be.

Dr. James Woodyard (13:31):
Now, the only reason that I can do what I can do, I mean, like I said, I probably bring 'em back about 40% of the time, is I have trained my hygienist. My hygienist can probe and gather all the data. I mean, we're calibrated on Miller classification and mobility implications and Grant. I mean, they do it just as good as I do, if not better. And if basically all I'm doing is walking over there looking at their data and presenting the problems and looking at the problems to the patient and then saying, you know what? I'm going to have to think about these problems. I've got some homework to do and we're going to bring you back and talk about it. So that's probably the majority of what I have, but I can do that because of the intense amount of time I've spent with my hygienist doing that and calibrating them and debriefing them after we do examinations and teaching and teaching and teaching and teaching. But not everybody can do it that way.

Dr. Michael Seda (14:34):
Also, James, to your point about bringing the patient back, another benefit of it is that a lot of times patient comes in for a hygiene visit and they're expecting everything to be okay. And finally after many appointments, someone catches something and there's this emotional readiness, you have to have to kind of hear it. And so to bring a patient back also gives them that time to, okay, they told me there's something wrong. I'm going back. We're going to figure it out. And there's less of that panic that initially sets in when they're first told something as well. So patients are more ready to hear

Dr. James Woodyard (15:07):
Exactly right.

Dr. Michael Seda (15:08):
About the problem and the solution.

Dr. James Woodyard (15:11):
Even with new patients, we very rarely talk about larger treatment the same day. I mean, if they're super prepared, great referral recession on tooth number 24. Yeah, we'll talk to 'em that day. They know it that we got a picture, we're good. But also, and one thing that I have learned, and this is kind of going on to this, but if you were going to have to bring a patient back and you're telling them all their problems and you know that they're going to lose a tooth, tell 'em you're going to lose a tooth. Because when they come back for that treatment conference, all they hear is, oh my God, I'm going to lose a tooth. Oh my God, if they're already prepared, I'm probably going to lose that tooth. Then the conversation goes a whole lot easier. In your case, acceptance will go up. It's just that one little thing. It seems like such a big deal.

Dr. Michael Seda (15:53):
Yeah,

Dr. James Woodyard (15:53):
I mean it is a big deal, isn't it, tooth, but just something about the mindset, just like you were talking about.

Dr. Jason Souyias (15:59):
Yeah. It's funny you say that. I have a dentist that refers to me, and she would always tell her patients, oh, it's just one implant to replace a tooth. It's no big deal, until she had to have an implant done. And then when she came in and she says, I stopped telling my patients that it was no big deal after I had to have it done. So it's true. People kind of really forget that, that it is a big deal.

Dr. James Woodyard (16:21):
When I tell patients all the time, there is nothing that I can do for you that will last forever. An implant won't last forever. A crown won't last forever. Yeah, that is true. Ask Chris. But one of the big problems that I see is for say, dentists, a lot of general dentists make patients think that implants are going to last forever, and then they come back in 10 years and they've got probing around their implant like, well, yeah,

Dr. Jason Souyias (16:47):
It happens.

Dr. James Woodyard (16:48):
They've got peri implantitis. So nothing we do last forever.

Cameron Full (16:53):
I think there's two really important themes here that are coming out in this first bullet. And number one, as a guy that's also been in James's practice, he's had all the big wins. He's looking for 1% at a time, and he's willing to test and try and explore ways to get that 1% because he knows that 1% accumulates over time. And so these are some sneaky things that he's done, I think to capture that 1% over and over again. And I think that by allowing yourself that flexibility, James, it's allowed for you to do things, I think, which leads into the second comment. And that is everybody's just, they're so focused on bigger, faster, stronger, and what's everybody else doing? Meanwhile, you're processing patients slower, right? You're taking your time, and just because I did something today that I've done the same for the last 40 years, doesn't mean I should do it that way tomorrow. Always being willing to reevaluate. And I think that that's a testament to why your practice performs the way it does, and I think that is evident through this first conversation.

Dr. James Woodyard (18:11):
One of the things too that Seda brought up is the patients aren't always ready to hear this. When I am talking to a patient in the hygiene chair or even the new patient exam and I'm explaining to them what's going on, I'm explaining to them and I'm looking at them and I'm watching their eyes, I'm watching their reaction. And different people, just like you said, are different. I mean, we can't just have one thing. We have to cater this sort of a bespoke way to treat people because everybody's a little bit different in their personality, and we have to be able to understand that because what we do is much more valuable than a big screen television or a trip, and we know that, but we have to create that value with the patient. And sometimes it's waiting to talk to 'em, and sometimes it's saying different things and doing things different ways, and you have to adapt.

Cameron Full (19:04):
Sometimes it's time.

Dr. James Woodyard (19:05):
Yes. Yeah.

Cameron Full (19:07):
We're so focused on speed, and yet you are giving them your most precious commodity, and that's your time.

Dr. Jason Souyias (19:15):
And time to digest, like you said. I think that's really important and it gets overlooked. People just want to present treatment right away so frequently, and I think giving them that time to digest their problems before they hear what the plan is.

Cameron Full (19:31):
Or the beef tallow

Dr. Jason Souyias (19:31):
Or the beef tallow and frozen brussels.

Cameron Full (19:36):
Or digesting the beef tallow.

Dr. James Woodyard (19:37):
Or the turtles. The turtles. Yeah, I'm sure Cameron's probably got some turtles, some chocolate turtles stuck under the table there. He's been snacking on biggest sweet tooth in dentistry. Right there is Cameron Full.

Dr. Michael Seda (19:54):
I think that was a great first bullet point. By the way.

Dr. Jason Souyias (19:58):
We call 'em Seda segue for a reason.

Dr. Michael Seda (20:01):
We're going to keep it rolling here. All right, let's bullet point number two.

Dr. James Woodyard (20:07):
Okay, leadership and goal alignment. You've got to have leadership meetings with your office managers and your teams. You got to focus on setting, tracking and achieving clear and strategic goals. If you don't take the time, going back to what Cameron said, to really train your team to meet with them specifically to get everybody on board and everybody going in the right direction, then you're going to be in trouble. It's like that book. It's your ship, which is an excellent book if you all have ever read that. If you're going to have a battleship, you have the whole team on board, so you've got to create a system in your office every month. We have a half a day office meeting the team. It rotates

Cameron Full (21:01):
During production.

Dr. James Woodyard (21:02):
Yeah, during production.

Cameron Full (21:03):
Did you hear that? During production, okay.

Dr. James Woodyard (21:05):
Yep. During production, yeah. Whole afternoon off buy 'em lunch. But the team is responsible for putting together the office meeting. So one team member is in charge of it every month, and it rotates. They're in charge of picking where we're going to have for lunch. They're in charge of putting together the written agenda. Of course, they have a template in between those office meetings. I meet with my office manager every Monday morning at 6:00 AM We meet from six to seven. We're going to go over, we've got a list of tasks that we do where they're at, where they're complete. We update each other on Smartsheets right now. Used to be monday.com, and that's invaluable. Every Wednesday I meet with my marketing coordinator, Thursdays in the afternoon, and this is after patients are done. I see patients until three 30, my hygienists patients until four. So those last 30 minutes of every day, I have some sort of meeting scheduled with my team, whether it's to go over treatment plans to my treatment coordinators, meet with my marketing, or on Thursday, I have a rotating spot to where that I'm either meeting with the business team, not the front desk, because the front desk is a piece of damn furniture.

(22:18):
By the way, I don't know if y'all know that I meet with my business team or I meet with my assistants or my hygienist, and that's every quarter. So we each have a meeting with every one of them, and they are responsible for putting together an agenda. I will give them some items, but we have a written agenda. If I don't have a written agenda for a meeting, meeting's closed, we don't have it. And I've literally walked in and been like, oh, no written agenda. We don't have a meeting. They're like, what? No, it's got to be a written agenda because all the written agendas come back with notes to the office meeting, which are put in the minutes for everybody to reference.

Dr. Jason Souyias (22:52):
Well done. I think when I talk to people about having meetings, the most common reaction I get is like, oh, how can I afford to take that time away from production? And yet, I mean, explain why you don't mind taking away that time from production.

Dr. James Woodyard (23:13):
Oh my gosh. It would be chaos. And I'm always going to meetings with you guys and different things, and I'm always changing. The joke is, don't sleep too long with your periodontics because it's going to be different the next day because I'm always changing and adapting. If you're going to change and adapt and grow, you have to bring the team along with you unless you have a fixed time. You can't say, well, we just meet when we need to. No, then you're not meeting. Okay. You have to have a fixed regular time consistency. Cameron, remember that? What is Woodyard Periodontics? It's consistent. He told me that one time. But yeah, that's key. And I've always done it to an extent, probably for the last 15 years, first five years, it was not as consistent. But then after that, I just saw too much going on and my production, well, hell, I mean, I think last year I was 21% and I didn't think I could grow anymore. And so that's the only way you're going to grow. It's the old, you got to sharpen the saw to cut down the tree. Okay, Franklin, the Covey? So Steven Covey for you.

Dr. Jason Souyias (24:33):
So since this podcast is sponsored by Referral Lab and we all agree meetings are so important, why Cam did we put templates for meetings into the software

Cameron Full (24:42):
< Referral lab sound effect> Sorry. Had to use it.

Dr. Jason Souyias (24:45):
Had to use. Had to.

Cameron Full (24:46):
I had to use it once. Go ahead. Go ahead.

Dr. Jason Souyias (24:48):
No, it's a question for you.

Cameron Full (24:50):
Oh, I didn't, I was trying to find the button. What did you say?

Dr. James Woodyard (24:54):
The Referral Lab meeting templates for the marketing for the office manager for.

Dr. Jason Souyias (24:59):
Why did we decide to put that in there? Because we all think it's so important, right?

Cameron Full (25:06):
Oh, absolutely. Jen is I get the great fortune of speaking with Jen on a regular basis, James', office manager's, administrators, wonderful human being. And what we found is that not a lot of practices have the wherewithal to formulate what that structure needs to be or should be. They don't know where start. And so we kind of kicked that off because of all of our engagements, and I know James's team uses some of those engagements as well because they add to. It's just a seed to add to that structure that's already there. But if we're deploying the type of resources that we are into stuff like that, it's for good reason. We don't do unnecessary surgery either. Nor do you guys, so I love this topic. Meetings are near and dear to my heart. I talk about them a lot, and I think that people that find that space and time to integrate them into their production, it just shows the team that they're valuable to you. That's important. This is valuable to me too. I'm not asking you to come in Saturday and 6:00 PM or whatever.

Dr. Jason Souyias (26:15):
And one of the things I heard you say, James, that I agree with so strongly is a little summary of what you were saying is basically if you want to change your practice, you better be having meetings to bring your team along with you.

Dr. James Woodyard (26:27):
The Referral Lab templates are great. I mean, it's one of the things, so I'm with a DSO, I'm not going to advertise for it, but you all know I'm with gen four, but I get to coach and mentor a lot of the periodontists in gen four. And that's actually one of the things that I'm pushing, pushing like, well, how do you do this? And then I've got this huge operations guide, which I've probably sent you guys a couple of times. It's like the manual, and I send them that. Then they just sit there and their eyes get glassy. You see 'em fall out of their chair. But the templates in Referral Lab correlate the data. I mean, they dump the data automatically. They give you a template and give you somewhere to start for sure. And they're very good. No, those are great things.

Cameron Full (27:16):
Hey, sometimes I have good ideas.

Dr. Jason Souyias (27:19):
All right, let's bullet three. Let's do it.

Dr. James Woodyard (27:21):
Bullet three. Okay, so building team accountability.

Cameron Full (27:24):
Edge.

Dr. James Woodyard (27:28):
Yeah, so the edge method, okay, so one of the things you guys probably saw on my list that I was proud of is that I have been a scout leader for about the past 14 years. And during our training, that's what we use in the Boy Scouts. Okay, edge, educate, demonstrate, guide, and enable. So you show somebody how to do something or you tell somebody how to do something, you show them how to do it, you let them do it, and you do it over their shoulder, and you look over their shoulder and you guide them, and then you enable them to go do it. If you just go over and tell somebody how to do something, you walk away. Well, you didn't train anybody. You just told somebody how to do something. If you want to train them, go through that.

(28:15):
And on top of that, have a check sheet. We have check sheets for all of our training, and they have to train in this way. And then when that's completed, then they've enabled them and they've shown that they're proficient. Then they have a coach that was going through this with them. They have to sign off on that during their training. And we have weekly check-ins with them. Jen does now, and she goes through and looks at all that and where they're at, what they need help with. They've got a new why. They've got a new how. One of the biggest mistakes that I see in practices that I talk to is that they just go up and tell 'em how to do something and then they get mad because they don't do it right. Well, you didn't really train them. And guess what? That takes time. But it's like teach a man how to fish eats for a lifetime, give a man a fish. You got to define really clear roles with your team. It's got to be super clear on who's responsible for what. And we have written job descriptions that every year the team members have to look through, and then they have to tell us what's changed, what's added and what's deleted. Then they have to sign off, Hey, yeah, this is my job description. So it's very clear

Cameron Full (29:25):
You do that yearly.

Dr. James Woodyard (29:27):
Yeah.

Cameron Full (29:27):
Interesting.

Dr. James Woodyard (29:29):
Yeah, it's part of their review process. So when they have their review process, the last part of their review is they have to print out their job description and they have written all over it. And then we go through and look at it with them and we, yeah, yeah, that's right there. You don't actually do that anymore. Kaylee does that now or whatever else. Then that has to be changed in the manual. So they update it. So when I first did it, I had to update it. So guess what? It didn't happen then. That's one of the, when old APC was there, that's the thing that they taught us to do, have them update their job description, plus that creates ownership and that creates more accountability, the ones that updated it.

(30:10):
One of the biggest mistakes I've made as a leader is asking somebody to do something and not setting my expectation on when I would like it done. Anybody ever done that?

Dr. Jason Souyias (30:23):
Never.

Dr. James Woodyard (30:27):
So when you ask somebody, when you create accountability for a team member, what I do is I was like, Hey Michelle, I need you to give me a top 10 list of the most expensive items that we order every month. Okay? Do you have time for that on your plate right now? I would like to have that in a week. Okay. So I have to ask them because I'm adding to their plate, but I'm not taking anything off of it. So I have to be respectful of that. And if I get a yes, that's great. If I don't get a yes, I'm like, okay, so when do you think you could do that? Because that's pretty important. Is there something that I can help you take off your plate temporarily because a priority to me, and that's really key.

(31:12):
One of the things that we do, and Cameron saw the post-it note method when Jennifer was at the Referral Lab training, but we're constantly reassessing the office needs and roles. So as you hire somebody on redundancy, you don't know 'em very well. You don't know what you don't know what they're good at. You don't know are they a people person? Are they an organizer? Are they a strategist? And you eventually figure out what that person does. So every one of my assistants has specific roles. I have one assistant, she does all the medical consults. She calls all the doctors for me. She does this, she does that. She gets the drug holidays off of Eliquis if I need 'em to. I've got one that does maintenance. I've got another one that is my quarterback that coordinates all the schedule, assigns people. So we have everybody just get a piece of paper with their name on it and get the little bitty post-it notes like this.

(32:11):
And on each one of the post-it notes, they write their job duty, like medical consults, and they stick those all along that piece of paper and everybody does it, and we give everybody a different color post-it note. And so assistants we're wanting to restructure the assistant duties. One person was getting heavy weighted and we knew that. And so we laid 'em all out and we looked at 'em. I was like, oh yeah, this girl, she's got too much on her plate. What could we do to reassess that? Who would like to do different things? So I said, and then what? Do you know who initially looks at it? They do. We leave them in the room, we walk out, we say, Hey, listen, why don't you guys take about 30 minutes, go through this, see what you think. We'll come back up and we'll talk a little bit about it to see if we need to tweak it.

(33:00):
And because it's got the different colored sheets on there, we know which one came from who. And then ultimately we come to an agreement and then we go back to those job descriptions. We give it to 'em, they have to change them. And then now we reorganize the duties in the office. One of our girls had a baby and she's like, I don't have as much time to come in and do maintenance now. Okay, well let's see who would like to, let's reorganize. Let's give them a little bit of accountability and a little bit of ownership. That is a wonderful way. And we do that with the business office. We do that usually once a year just about with everybody.

Cameron Full (33:34):
So you let the team determine when that engagement needs to happen, or there's things that you get your finger on the pulse and you're like, I've got some disarray, or I've got somebody that turned over or I got somebody that's complaining, or you just keep your finger on the pulse when you do that exercise and then you reorg?

Dr. James Woodyard (33:52):
Yes, every bit of that. One of my friends was he couldn't believe that I took two of my days off to do staff reviews and my staff reviews. They have to fill them out. They score themselves on all these very specific things. Then we score them blindly. I don't see what they do it. We don't see it until we're together. Then we put upon a screen if we agree on the score, we don't talk about it. If there's a difference, whoever has the highest score talks. I learned so much from being part of those, what's going on in the office, I mean everything. And so inevitably after those occur, that's my key to say, okay, we got to reorganize or somebody has a baby or somebody's different things happen. And because we've created this accountability and this transparency within my team, they'll come to me.

Cameron Full (34:50):
It's an expectation, now. It's part of your culture, which is, I think the bigger thing when you talk about the consistent that you have in your practice is it's a result of this multitude of 1% upgrades over and over and over. And they expect that now. They expect this type of engagement. And I think it allows for you to not only keep the right people, but when you hire people in, they either fit to that or they're not a good fit. I think it's something that is not dangerous, but it takes, it's so methodical and purposeful to build.

Dr. James Woodyard (35:28):
The staff review really opens up a lot. They always find out a few things you wish you didn't know, but ultimately you're like, oh my God, thank God. Thank God I did that.

Cameron Full (35:38):
Like with the meat. I wish I didn't know that.

Dr. James Woodyard (35:42):
Yeah, exactly. The last part of that is I want to bring up is Well Done, it's an old book. I just love that book though. How do you get a fricking killer whale, to jump out of the water and go through a hoop? You don't spank it. You don't whip it, and you can't do anything to the killer whale. How do you do it? So you ignore the bad behaviors or you don't give them attention. You reward the good behaviors. You got to be specific in your compliments. You got to, when somebody does a good job, don't say, Hey, good job. Say, Hey, you know what? Mrs. Smith was really hard today. You handled that so well. She is always so grumpy and you really did it good. And find out if the people on your team, how they like to be complimented, have a sheet. I have a sheet called the Getting to know You sheet. It has all their favorite foods, their favorite candies, where they like to go eat. So if I want to give 'em something special, if I want to give 'em something for their birthday, we use that sheet. It says, how do you like to be recognized? Some of 'em say privately. Some of 'em say publicly. I can tell you on everybody on my team how they like to be recognized. And that's important. Little bitty touches like that are important.

Dr. Michael Seda (36:58):
It's not just the team. To your point, James, a lot of times when we're working with patients, I'll start complimenting a patient that's having just a challenging moment just to say, Hey, I think you're doing a really good job. You're being so graceful, even though they may not be. And what that does is it seeds in someone's mind perhaps how they maybe want to be, and now they have to fulfill it. So a lot of times we compliment things that we see or sometimes we can compliment to things we'd like to see, whether it's with patients or team. And I find people will try to usually rise to that occasion if they can, to what it is that we're calling out and recognizing.

Dr. James Woodyard (37:48):
You're exactly right. I mean, this reminds me of a little story. I have a patient that his job is, he works on these huge earth movers. I mean these crazy things that are out in the river and all this stuff. And he loves talking about his kids. And so he's talking about these earth movers and how he takes 'em down with his kids, and our kids are about the same age. And I was like, my kids love that stuff too. So I said, what type of things do you do with your kids that you really think that they really, so I'm asking him, I'm trying to get his opinion as his doctor on what to do with my kid. And we still talk about that. He goes, remember that time you got that big earth mover thing I told you in the sandbox and you got 'em playing in the dirt? And I said, oh yeah, they love that man. They remembered every time when we talk about you. And that created a bond with him. And just by those, and sometimes complimenting somebody is asking for their help because they see you as "the doctor", and all of a sudden you're lowering yourself down. You're not lowering yourself down. You're a human. You need to show that you're a human. And so that's a great point. Yep.

Dr. Jason Souyias (38:50):
Yep. Well done. Well said. Alright, let's do a transition to point number four. That was a great topic.

Cameron Full (38:58):
Ready to go. Buckle up.

Dr. Jason Souyias (39:00):
Get ready. Get ready. Communicating risks, risk to patients.

Dr. James Woodyard (39:05):
Yep. Yeah, yeah. Something that dentists do wrong is they take the risk on their shoulders. The patient says, well, how long do you think that'll be okay? Well, it'll probably be all right. Well, you just took the risk on your shoulders. Oh, you have an abscess tooth. Instead of saying, well, it'll probably be okay. I said, well, that's a good question. I said, these are the consequences that you could occur if we delay this treatment. This is an abscess tooth. People end up in the hospital from an abscess tooth. And I said, when it's going to happen, it's going to be on Saturday night when I'm out of town. And then an antibiotic is going to kick in right away.

Cameron Full (39:49):
Running with the bulls.

Dr. James Woodyard (39:51):
Yeah, running with the bulls. These are the consequences that you have. I'll even ask him, I was like, is that something that you're comfortable with? And I just look 'em right in the eye and that isn't me being mean. I'm like, are you comfortable with that risk? I said, I wouldn't be. But it is your choice. It is not my choice. And we communicate that way with all of our patients. This is the risk to you. I understand you have these barriers. I had a guy the other day that said he wasn't going to floss and he wasn't going to wear a night guard and he was going to continue to smoke, but I sure do want implants. Okay, well, you got decay on all of your teeth. It's going to continue. We can do implants, but then your other teeth are going to decay. I said, you're going to have to make some choices if this is going to work, unless you want to have to pay for all of this all over again, because that's what's going to happen. Is that a risk you're willing to take? I'll sometimes sayI don't really know what your risk tolerance is. Mine is pretty low. And so you put that to them.

Cameron Full (40:56):
You're also empowering them to make the decision themselves. You've given them all the information they need, and then you've made it very clear what the right answer is. But at the same time, you've empowered them to make that decision. And most importantly, which I've seen you do is you just shut up. That's the powerful thing about persuasion is sometimes the most persuasive thing to do is just not say anything at all. And it's like, okay, well, what do you think is best? And then zip.

Dr. Jason Souyias (41:33):
And so many times dentists put all that pressure on themselves, and it's not on us. It's the patient's call like, okay, here's what the reasonable dental future looks like if you don't do anything, is that okay to you? Yes or no? And your call, no judgment from me. If you say no. Okay, but then don't come crying to me in a week when you're like, oh my God, my tooth hurts. I need to get in right away. Well, I told you this was going to happen three months ago. So it wasn't an emergency to you three months ago, but it is now today. And James, you and I have talked about, it's like, why should I schedule someone through my lunch or add an extra patient on at the end of the day when I told you this was going to happen and you chose to wait? So now because you chose, this is an emergency for me? I kind, and again, I feel bad for people in pain, but at the same time, if you came to me and you chose to wait, that's on you.

Dr. James Woodyard (42:40):
And what Cameron was talking about with the pause and letting 'em digest it. It's always amazing to me when somebody comes in and says, well, I've only got $2,000, but I need to have all this done. And then you start talking to them about the actual risk. 200 to 300% increased risk of heart attack and stroke with periodontal disease and active dental infection. Oh, you've had two strokes. Oh, okay. How'd that go? I mean, are you doing okay? Are you willing to risk that again? And you all have heard me talk about this before. The word I use is predictable. This is the most predictable thing I can do for you. And then if I see, for instance, if you're going to lose tooth two and three, the most prediable thing I can do for you is to replace those two teeth with implants. Okay.

(43:36):
Can a person live without tooth number two? Of course they can. They're only going to lose 10% of their chewing capacity. But is it as predictable just to do one implant? No, it's riskier. There's a risk there. So I'll put a treatment plan together, and I'll say most predictable plan is to replace those two teeth riskier plan is just to replace one because the bottom tooth could super erupt. You're losing your chewing power and you grind your teeth and it's their choice. But even by me titling those plans that most predictable and then risky, that sets a tone and that sets accountability in your patients. And when something breaks down, you're like, gosh, I really didn't want this to happen. But I was a little bit worried when we did the riskier plan.

Dr. Michael Seda (44:22):
James, as you're talking, I'm thinking to myself, in addition to being the most, what do they reference him as? The most incredible man in the world, the most interesting man in the world ,to the list, you could add author. If you wrote a book on all those little scripts and ways that you communicate things to patients, there's just so much gold in there, really. And I know there's so many people that would just really devour that. I know I would just hearing you talk and the way you communicate, it's years of experience and knowledge all coming together, something to consider moving forward.

Dr. James Woodyard (45:10):
Well, that's cool. I appreciate that. I mean, the bad thing is though, as I get older, that mesh that is in between what I want to say and what I actually say gets bigger and bigger holes in it.

Dr. Jason Souyias (45:19):
The filter goes away a little bit, huh?

Dr. James Woodyard (45:22):
I made the mistake about a year ago. I didn't even know I said this. I literally told a patient that she could kiss those teeth goodbye. Didn't even realize it came out of my mouth and my assistant looked at me and was like, no, no, you didn't. I was like, so I backed up and re-spun it. But sometimes it comes out so good, but then other times, boom, oops, I screwed up. But you got to, I've worked all my life to try to keep my foot out of my mouth and it sends a lot of the time in my mouth, but I really appreciate that.

(46:01):
But yeah, that's huge. The risk thing is huge. And you want to talk about increasing your case acceptance and your average case value, which is a big thing in Referral Lab. So one of the things in my office that's really cool is my average case value is very high. And people are always like, well, how do you get people to do all these things? Well, we don't really sell things to them. We're honest with them. We're transparent. We speak with them this way, and they decide that their risk isn't to the point that they want to do something riskier. They don't want to do minimal. They want to do the most predictable. So

Dr. Jason Souyias (46:36):
Awesome. Really, like Seda said, there's some gold in that words do matter in how we say things absolutely matters. And I'm going to transition to your fifth one here of creating a no gossip culture and it maintains zero tolerance for gossip and toxic behavior. This is one close to my heart with an office team of 22 people. This is close to my heart, and I would love to hear your thoughts on this subject.

Dr. James Woodyard (47:06):
Guys, this is something that it's always amazes me. I got a wonderful, wonderful team, but often it's something every year we got to touch on. It's something it kind of builds after a while. And then you got to say, Hey, hey everybody, come on. You talking to her about what the problems are in the office doesn't do anything. If there's a problem in the office, you need to talk to us. Gossip is somebody griping to somebody else that has no power to solve the situation.

Dr. Jason Souyias (47:37):
Well said.

Dr. James Woodyard (47:37):
And so we just go over that and over that. Again, when we look at things, we're big on creating accountability. But I also make the point is like, you know what? You can make a mistake and that's okay, and I'll still love you and I'll forgive you. But just come to me and say, Hey, I made a mistake.

(47:57):
I mean, I've had Jen come to my door before saying I screwed up. I was like, okay, tell me about it. And she tells me about it. She totally fesses up. And it was like an honest mistake. And you know what? I've done the same thing and I've done that with my team. I said, you know what? I made a mistake. And they're like, what? Yeah, yeah. I made a mistake. I made this decision to do this way. I made the decision to do telephone post-ops on implants. Remember me telling you about that, Souyias not too long ago? And that was a mistake because patients don't know if their implant is having problems, so we need to see 'em in the office. That was my mistake. So we want to focus on solutions, not focus on picking at the person. And that helps to alleviate some of that. We don't try to focus on blame.

Dr. Jason Souyias (48:47):
Doesn't it drive you nuts though, when people try to hide things? Oh yeah.

Cameron Full (48:53):
Probably why you don't have a lot of turnover, James.

Dr. James Woodyard (48:56):
Well, I do the best I can. I got a great team though. I mean, I really do. And one of the reasons, I mean, I do have some turnover, but the reason that you don't see them is they aren't here very long. Because when I see that happening, again, my next thing is don't hesitate to let somebody go if needed. Do not be afraid to let somebody go. I had a employee that was here for about two weeks and she said she needed to talk to Jennifer and I. So she began to sit down and tell me what this person was doing wrong and what that person was doing wrong. Oh my God, I can't believe they were doing this. I'm like, really? Okay, so it sounds like we've got some problems. Yeah. Okay. Said, well just, Hey, you stay right here, okay. Jennifer, pull up a couple of more chairs. And so I brought in the people that she was talking about and we all sat down together and she goes, what are you doing? I said, well, you were telling us about some problems that we were having with the team, and here's the team and this is how we fix those. You coming to me and just complaining about it and telling me I can't say anything to somebody, doesn't work. So unless you're willing to discuss it as a team, as an adult, and go through and fix these problems, this might not be the place for you. And guess what? It wasn't.

Dr. Jason Souyias (50:13):
It wasn't. Bye bye.

Dr. James Woodyard (50:17):
And you're going to have problems with different team members. And one of the things that I've seen people do, my brother's a dentist as well, and he kind of did this on one person and he learned, but never reshape your practice out of fear of losing one person. One person comes to you and tells you, well, I want to do this and I want to do that, and this is what I need to do. Or otherwise I'm going to have to leave. So I'm going to make everybody else change what they're doing just because we do what's best for the practice. That's a big thing. That's a big thing you cannot have that just eats away at the core of your practice. And everybody sits around and looks at you and is saying, how is he tolerating that? And if they see you getting pushed around and dealing with somebody talking to you ugly and this and that, nah, it's dead.

Cameron Full (51:09):
Who was that NAS keynote a couple years ago?

Dr. Jason Souyias (51:13):
South African guy?

Cameron Full (51:14):
Yeah. I'm here to save my, I'm here to

Dr. Jason Souyias (51:18):
Protect.

Cameron Full (51:19):
There it is. Go ahead, say it. Thank you.

Dr. Jason Souyias (51:21):
Yeah, I'll protect you from the practice, but if need be, I'll protect the practice from you. He really good. That was a great quote.

Cameron Full (51:28):
Wonderful quote.

Dr. Jason Souyias (51:32):
What was that guy's name?

Dr. James Woodyard (51:33):
He was really good. I really liked him lot.

Cameron Full (51:34):
Alister, Alister?

Dr. James Woodyard (51:34):
Alister. Yes. David Scharf really, really liked him. He's the one that kind brought him to the NASP thing. Wasn't that right, Jason? Wasn't it Sharps? Yeah. Sharp is another great guy too. You need to have him on this one too, by the way. Sharp would be a good one. But no gossip culture. That's huge.

Cameron Full (52:00):
But I think what underlies that though isn't even the gossip culture. It's the, if your team knows that you're going to stick up for them like that, what do you think that bakes into the team? I'll, I'm going to take shots for you and we're going to do this together. And not allowing that stuff to happen just shows the team. It's not just about the gossip culture, it's about the ability for them to see that you're the leader. That it's one thing to advertise leadership. It's another thing to actually fundamentally live it. And that's a leadership quality and that's cool stuff. Did you actually do that or is that just a good story?

Dr. James Woodyard (52:51):
No, that's

Cameron Full (52:51):
I was just maing sure.

Dr. James Woodyard (52:52):
Totally. Yeah. Jennifer is here. She remembers her. And the funny thing is, I called the orthodontist that she worked with before who had given me a really good review of her and I told him what happened. He goes, oh yeah, same crap happened in my practice too. I'm like, oh, well thanks buddy. But on your same note, Cameron, and you got to take up for your team, just like you said. And there was this guy that we had years ago, and he was just a total rear end to the front desk, just so rude to them. And then he was trying to check out, he was really anxious and I guess he had to go to the bathroom. So then he turns around to go to the bathroom. This little lady with a walker got into the bathroom before him, and I'm walking up to the front to tell somebody something, and I see this whole thing happen.

(53:39):
The lady with the walker comes out of the bathroom and he literally looked at her and said, while you okay to this little old lady? And I looked at him and my team looked at him and I looked at the, I said, has there been something going on with you all? And she goes, yeah, he's been yelling at us. And I said, sir, you got a second? He goes, yeah. I said, come over here in my consult room. I want to talk to you for a second. And so I sat down and said, you know what? Have we ever shown disrespect to you? He said, no, no. I said, if I recall that we actually gave you some money towards your treatment, we knew that things were hard for you, they, he goes, well, yeah, yeah, you guys have always been really nice to us. I said, okay. How do you feel about how you talked to my front desk earlier? Do you feel that was reflected of the same way we've been treating you? No. I said, how about that little lady that's been coming to my office for 20 years in the walker that just happened to go in the bathroom for you? What type of interaction was that? Is that how we treat you? He said, well, no. I said, well, I'm going to tell you this. This is your warning. If I ever see that happen again, I will never see you as a patient. Life's too short people

Cameron Full (54:53):
Remember the last time you in my practice? This is the last time.

Dr. James Woodyard (54:57):
He never, no, let's just say you remember that didn't happen again. That didn't happen. Again, don't

Cameron Full (55:05):
Give credit for, that's my wife. That's my wife's line.

Dr. James Woodyard (55:07):
That's a good one. That's a good line.

Dr. Jason Souyias (55:11):
That's fantastic. It goes by sometimes it's not always easy to, the larger your team gets, the harder it is to keep this culture going. And it does come down to leadership. But also what I heard you say too is very clear expectations of this will not be tolerated in the practice. This does not happen. If we have problems and disagreements, this is how we solve 'em. And unfortunately, it's unfortunate that we have to tell people how to act like mature adults these days, but it's a clear expectation of this is how the practice handles things. And I think that's so important to have it go that way and be that way because the stress of a busy practice goes away when the last patient's done. The stress of a toxic work environment does not go away. And so your team will find it much more stressful to come into that kind of culture. It's harder because then you wake up in the morning and you go, Ugh, I'm not looking forward to going to work today. And that's not what you want out of a team that's strong and giving you good results.

Dr. James Woodyard (56:27):
For sure.

Cameron Full (56:28):
So we're coming towards the end of the session here, and I'd like to ask James if he was reflecting on his time and if he was talking to a younger version of himself, let's call him Jamesy. If you're talking to a younger version of yourself, what's the one thing that you would tell little Jamesy?

Dr. James Woodyard (56:56):
It would be my last one, become invaluable to your referring dentist. Invaluable. When they have a problem, when they have anything happen, when they're going to buy something new, when they're wondering what class to go to, they should have your cell phone and that you should be the one they're thinking of. If you can become invaluable to your general dentist, it is going to make you feel good. Sometimes it is a little exhausting. Okay. It is. It really is. And some people will abuse that, and you have to have a talk with them. And I have, I'm not afraid to have talks, but position yourself as a indispensable resource. I mean, give education to 'em. Host study clubs, foster, collaborative, not subordinate relationships you don't work with for a dentist, you work with a dentist.

(57:52):
Build a culture where they feel like they don't need to refer anywhere else. And honestly, when I was looking at this whole thing, if you can do that, it's all going to be okay. You got to do these other things too. But if you can do that and take some work, take some special talking, and sometimes it takes late night phone calls and you'll going to get some crazy texts. When COVID hit, when COVID hit, I went downstairs and I took a nap and I woke up and I had 77 texts. I had 40 something missed calls, and I don't even know how many emails I had, but everybody was like, what are you going to do? What is your plan? What is this? Because everybody knows I'm a planner. Okay. So yeah, the first thing I did is I was already getting, and Jason, I've shared it with you, I shared it with Seda. I had a whole plan written out on what we're going to do and share it. Okay. Share it. And that's going to make you

Cameron Full (58:51):
Only reason to keep it is to give it away.

Dr. James Woodyard (58:51):
Yeah.

Cameron Full (58:55):
Love it.

Dr. Michael Seda (58:55):
Fantastic session guys. James, thank you so much.

Dr. James Woodyard (58:58):
It was fun.

Dr. Jason Souyias (59:01):
It was good time guys.

Cameron Full (59:01):
We'll bring you back for the other 32 that we didn't get a chance to go over, James.

Dr. James Woodyard (59:06):
That's just what I had a week to do.

Cameron Full (59:07):
So we appreciate you coming on the show James and everyone, James Woodyard, Woodyard Periodontics. Thank you.

Dr. Jason Souyias (59:16):
Thanks for joining us again this time on the Special List. Thanks for listening to the Special Lists presented by Referral Lab, the podcast for dentists and dental specialists featuring a Special List from a specialist. Got a question for us? Send us a message at speciallists.com with two Ls. Transform your referral workflow with Referral Lab, the purpose-built platform for dental specialists to track, manage, and convert every referral. Request a demo at referrallab.io.