ROSS BRANNON

I believe there are two extremes in the dental profession: Dentists who own their own practice, but really just own a job, versus a business owner who happens to be a dentist. Do you also see those two opposite ends of the spectrum?

SCOTT MANNING

Yes, and a lot of times, doctors just don't know the difference because they see becoming a doctor as the success. It’s often not until they run around in circles that they realize, “In dental school, we invested a lot of money and put in a lot of effort and sacrifice, but we didn't get anything about how to manage people, anything about how to manage money.”

To me, the big difference between owning a job and owning a business is that you question the status quo. Ultimately, a doctor with any level of success becomes instantly hamstrung and limited by their capacity of the things that are finite, predominantly time, but also space and people. These are not expandable things, unless we also want to raise the overhead.

When you take a business, and you add leverage to the business as a job, you get a business that can produce so much more in so much less time, effort, stress, people, space, everything. That's where you build the profitability. The question is, at what point in somebody's career will they wake up to that? Some people never do.

ROSS BRANNON

Why is it so critical to figure out what you want, and then reverse engineer it?

SCOTT MANNING

We think about a result or an outcome that we desire. Then we orchestrate a plan backwards, and the good news for our doctors is it's not hard once they flip the switch.

Most people are just trying to be a little bit better, or they're constantly putting out fires. They're constantly being reactive to things and they just haven't given themselves permission to dream. It really links back to your very first statement.

To me, reverse engineering is just common sense, and to borrow from the great Stephen Covey, it’s beginning with the end in mind. It can't just be about activity or accomplishment. Doctors want to know why they stay stuck. That’s because they're trying to just outwork the problems instead of engineering the practice to really win a game. My work involves motivating them to change that mindset.

They need to manage their cashflow on purpose, not by accident. That means looking for the end. We even break it down to how profitable they want to be. What do they really need to make their life work in terms of savings and vacation and bucket list and lifestyle? Most people are running up their overhead and hoping at the end of the month there's a little extra money. Instead, they should know exactly what their hourly value and their daily value need to be to make the ultimate end game possible.

ROSS BRANNON

It's so true. I see it in the personal world. I've asked people, "What's your burn rate? What does it cost you to live every month?" Most people don’t know. They need to know that, and they need to know how much they want to make.

You and I believe the same thing about business ownership, which is that your focus should be creating wealth and maximizing your money. You also talk about the schedule being the bank account. Could you speak more to dentists who feel like their bank accounts are running their lives?

SCOTT MANNING

What's the point, if not to get money out of the business and it into motion and other things? That's a whole other form of leverage. We call it, literally, “the money business.”

Nobody invents new letters because they’re bored of writing. If you use the core foundational principles of success and dental practices, one of them is that in order for money to actually flow into the bank account, it has to flow through the schedule.

So, you get this filter-like system, where if you have a dysfunctional schedule, you're not going to get the result you want in the bank account. Vice versa, we can predict what goes into bank account by controlling the matrix of time, space, people, and how dentistry is delivered. Then we take it a step further: we get prepaid, so we get the money before the dentistry is in the schedule.

One of my great mentors used to talk about the “future bank account.” Every day in dentistry, we call that “diagnosis.” We have to be putting things into the future bank account, in the schedule bank account, ultimately to get it to the real bank account. That's total empowerment because it means you own the responsibility and the control of what you're going to shoot out at the back end instead of leaving it up to happenstance.

Doctors often say they had a good month or a bad month, but they don’t know why. With my approach, it’s very easy to understand what’s happening and actually prevent anything that you don't want to happen, because we're taking control.

ROSS BRANNON

You say in your book, "We don't want you to be busy. We want you to be productive. Activity is not accomplishment." Talk about that.

SCOTT MANNING

Busyness is a disease. The first thing we say to our practices is, "You absolutely must stop considering a full schedule a good day, because it's the wrong metric." I'd rather have one patient, have nothing else to do the rest of the day, and do a lot of dentistry.

There are also people out there that judge by quantity. I tell them, "We can get you a lot of patients, but that’s all you want, you're coming to the wrong place. On the other hand, if you want a lot of meaningful dentistry, then bada bing, bada bang." The right doctors are what we would consider the high level dentists, where everybody's dream is as few patients as possible doing as much dentistry as they need. That's something special.

ROSS BRANNON

How can a dentist loosen up their schedule by using what you call “anchor appointments?”

SCOTT MANNING

I'm a very simple man. This is not a complicated thing. None of it is rocket science. An anchor appointment is exactly that. It's starting the day with the meat and potatoes, the biggest substance you can get, and ideally, having the longer appointment, doing more things. That reduces the stress of the day, because the stress is in the transition, the room turnover, patients coming in and out.

We want to achieve the production in the morning or first two-thirds of the day, accomplish 100% of the goal, so you can leave real time room for opportunity.

There are going to be emergencies. There are going to be days that are not perfect. If you're anchoring the day, then you're ahead of what's necessary. You can't get a day back. You have to leave it all in the field.

The best way to do that is to wake up in the morning, walk into the practice, do your morning huddle, and then hit the ground running. Throw down an amazing anchor appointment, and reduce the pressure of the day, to where you don't run out of a day before you hit the goals.

ROSS BRANNON

You encourage dentists to focus more on profits than revenue, even when revenue is easier to track than profits.

SCOTT MANNING

People ask me "What's the industry standard or average percentage?" I say, "Well, first of all, that’s a stupid question, because who would want to be standard, or average? I'm happy to give you those numbers as long as you promise to not want them.”

Imagine telling every dentist you meet with, "Well, let me pull out my sheet of paper that lists out the formula that every dentist should want," and tell them they need a certain amount of dollars in the bank to be able to retire or live the life of their dreams without asking them any questions, getting to understand them, knowing how many kids they have, what their wishes and dreams are for other people.

That’s why, to me, revenue is an irrelevant number, because you don't know all the other details. I want to focus on the number that drives their life.

If we understand the leverage points in the practice, we can ramp up the profitability without having to grow revenue at that same rate. That's where we get “work smarter, not harder,” which is my shtick, and more life outside the practice than inside.

ROSS BRANNON

Do you help people move away from insurance, and more toward fee-for-service?

SCOTT MANNING

I'm not here to play doctor. I'm never going to tell you to work faster, to charge more, to get in or out of insurance, or how you should do your dentistry. My job is to be a great listener, and to be an architect of their dreams, to put together a masterpiece business plan I call a blueprint that we can then make happen.

But the short answer is, 100%, yes, most doctors in insurance want to get out or at least diminish the impact insurance is having on the culture, the environment, the case acceptance, the profitability of their practice. I'm not here to force people down a particular path. There's no cookie cutter or one-size-fits-all approach to success in dentistry or life. If you're out of insurance, why on earth would you get in? If you're in insurance, you probably do want to get out, but there are a whole lot of things we can do regardless of the dynamic to be able to work toward profitability.

I don’t want to wake up in the morning and be at the mercy of what other people tell me I’m worth. I don’t want people telling my doctors what they should or shouldn't charge, or playing doctor and telling them what they should or shouldn't do for a patient.

ROSS BRANNON

One of my physician clients says medicine is the career of diminishing returns because reimbursements are always going down. Medicare reimbursements are always reduced, then the insurance companies just follow suit. Another physician recently told me he hasn’t had a raise in 10 years, and he’s probably never going to get one because it's all about the insurance plans. Luckily, in dentistry, you have the option. How can a dentist max out their business ability before they max out their clinical ability?

SCOTT MANNING

Doctors are fed this idea that you have to learn forever. You have to add every new technology, you have to do all this stuff. I agree that you have to continue to evolve, but not through what somebody tells you, through your own life experience and wisdom.

I can immediately know how successful somebody will become when I know how true they are to their own clinical identity. The more they know what doctor they are and what doctor they are not, the more we can focus in and truly hone the business. I believe the industry is over-educated clinically, so as a default, they're under-educated from a position of how to make their clinical skills more valuable. In other words, the business.

A majority of doctors that come to me literally want to get their life back, which means more profitability. The two common themes are “I'm not paid what I'm worth,” and “I'm not using the skills and my passions as often as I should be.” They have a repertoire of procedures under their belt, but they're still doing single units all day long, and they have write-offs to insurance. There is stagnant, or at best has grown just a little. We at least have to level this up and we have to focus on what their practice vision is going to be.

ROSS BRANNON

Your book mentions how dental schools don’t offer MBAs, and how keeping dentists as dentists is in other peoples’ best interests. Talk about that.

SCOTT MANNING

The dental mold has no regulation. They can choose how they want to practice. They're entrepreneurial. They own a business and happen to be a doctor. But doctors can be limited by their own self-worth and confidence. Until they see what's possible, they get stuck, and they fall into this rut of the industry telling them that they're never enough. Every practitioner is the customer to the industry, and there are all these powers that be.

We talk about corporate dentistry, which is a fraction of the overall industry, yet it's made out to be like it's this tsunami washing over the country. Then we talk about insurance companies, because they have more money to lobby than the ADA themselves, but maybe they're all in cahoots together. And then you have these equipment companies. If they don't sell the next bright, shiny object, what are they going to do? So, we are constantly being pulled in different directions. Our doctors are being distracted, and they're led to believe that they're not enough.

The answer is another whack of a credit card, another service or software, another piece of new technology, heaven forbid another insurance company, instead of just getting rid of all that noise and distraction, coming down to their core and making the business the way they want it to be. My first book was called The Dental Practice Shift, which was about shifting the soul of the practice back to the vision of the doctor, because they get out of alignment.

They're listening to everybody else, patients included. We want the dentist to break through, to shift from being an order taker to being a leader and a guide. The industry is constantly trying to push the doctor down a different path, often at a total adversarial direction than where they want to go.

ROSS BRANNON

You say dentists must embrace the business side of dentistry, to optimize their potential as a practice owner. That means thinking outside the box. Don’t be a sheep, don’t fall into the status quo. Push back, because the powers in the industry are trying to put you in a box so they can just do what they want to do with you.

SCOTT MANNING

They have to be willing to be mavericks and renegades. They're all worried about what other people think, what their colleagues are going to say. Meanwhile, the most successful doctor in their town is bucking every trend.

You have to believe in the impact you're making on patients, and you have to do it in style. You cannot be a martyr in this world of running the business.

One of my life-changing moments that allowed me to go all in on dentistry was when I overheard a doctor saying, "I just can't wait until life after dentistry." I thought, "What a terrible thing, to invest and sacrifice all the things in your entire life to have this career in business just to be excited to be living once it's over." That's when I developed my dentistry and life in parallel idea, and the concept of lifestyle practice. If you are willing to challenge the norm, and you're willing to avoid the noise and the clutter and just stay true to yourself, you won't have time for any of that other stuff. You'll have time for all the things that you want to have time for, and that's the big, giant difference.

ROSS BRANNON

You say in your book that the difference between consultants and trainers is that consultants get paid for what they know and trainers get paid for what they do. It sounds to me like the talking head on television versus the guy who's getting his hands dirty on the ground.

SCOTT MANNING

You said it better than me. I empathize with everything our doctors have to deal with. In their world, they get paid on results. They get paid on what they do, the dentistry they deliver, not the dentistry they talk about. They don’t need more patients as much as they need more dentistry.

The same thing applies to you and me. I don't want to get paid to just talk. There's a limit to the value of that, no matter how great or smart somebody is, or their track record. I make no bones about the fact I want to make a lot of money.

Zig Ziglar says the way to do that is to help other people make a lot of money first. So, I want to work with people that want to do a lot of dentistry, that want to be very successful. I attach myself to that outcome so they know they have a partner in success, and I have a vested interest in that. Trainer, coach, advisor, whatever, I think the right person is one that wears all those hats.

That's why I believe everything boils back down to relationships. If somebody is going to take time to get to know you and understand you, listen to you, learn about you, then and only then could they give you advice that's warranted. They should be able to show a track record of success of similar things to what you would want to accomplish. I want to be on the field, and I am, playing with my doctors every single day, not just standing on the sidelines shouting things and telling them how to do their job. I also believe in divide and conquer. We each do what we're best at doing. That's how we put together a winning playbook, because there are more variables than similarities with practices all over America. If you don't embrace those variables, you're not going to put together a winning formula.

ROSS BRANNON

What is your opinion on marketing?

SCOTT MANNING

Marketing peoples' responsibility is to get the phone to ring, get patients engaged. If they do that, then you have to take over. A lot of people are not good at that part. I'm a believer that if you embrace the essence of dentistry, it really boils down to patient retention, and you can build a referral exclusive practice.

That doesn't mean you should not market, because I also believe that word of mouth is not a strategy, it's a hope. Unless you're doing things to create word of mouth, it's not something to bank on. When doctors tell me, "I get my patients from referrals. It's all word of mouth," I say, “Then, we should do that deliberately." There are a lot of different ways to do it, but here's what we know. If I tell someone I think they should use you for their finances, they’re still going to do research. They’re still going to get on Google. There's a real need for digital offense and defense in this world today. However, any practice that is reliant upon marketing because they think that's the answer to their goals, will learn it’s not going to work. I always say that if you can't do a great job with the patients you have, what makes you think getting more is going to make any difference? So, we always maximize the core first, and then marketing supplements what should already be going amazingly well.

ROSS BRANNON

What's your opinion on DSOs?

SCOTT MANNING

Number one, I would worry about it. Number two, the old saying “if you can't beat them, join them,” is a stupid idea. I call it “play a different game.” I just did a recent training called “A Radically Better Way to Practice Dentistry” about changing the rules of insurance, of time, of money, and of people. You don't try to win at that game. People don't understand DSOs and how they make money, because it’s not on dentistry. They’re making it with other things, buying power and all that.

You might decide you can make more money by constantly suppressing your overhead. If you go too far, all of a sudden you can't produce because you have no supplies or people to do it with. Out-earn your problems. You're going to grow and abundantly achieve great results.

Therefore, here's the good news. All DSOs and corporate dentistry do is let patients pick and know their doctor. Patients thrive. If you have concierge relationships, a slower pace-based boutique practice, yes, every time corporate or DSO pops up or somebody else takes insurance, you may have to delay gratification a little bit, but all the right patients come back to you.

People still and always will value relationship and personality. But if you try to play that game, you're going to lose, because you don't understand the rules of the dynamic they're operating under. Instead, we go back to where we began. Why not figure out what's a victory for you, reverse engineer, and build the business of your dreams? Be able to work by choice, not by necessity, and you can't imagine ever selling it or leaving it because you just love it so much.

ROSS BRANNON

What advice would you give a new dental school graduate?

SCOTT MANNING

Expedite your experience. Don't let people pigeonhole you, get as much exposure as you can to as many different things, including potentially practice models.

If you have fire in your belly, a little spark in your eye, and you want to become more than just a doctor, there's nothing better on planet Earth than being an entrepreneur and an owner of your own business, in control of your own destiny. The faster you can own, the better.

It's the equivalent of compounding interest in the bank account, or investing in your future. The faster you do that, the better. You may want to get a year or two of life experience, maybe in an existing practice or associate with a doctor where you can transition into ownership. If it were up to me, I would pick an amazing doctor that values mentoring and wants to leave a legacy and put their patients in good hands. I'd go and pay my dues, and I'd have a path to ownership with a doctor that believes in all the right things. You're going to be set up for success so incredibly well.

You leapfrog your future by decades, you achieve things in a few years that it took others decades to do, or that many doctors never do, because you put yourself in the right environment. That’s far greater than anything you're ever going to get in school.

ROSS BRANNON

Thank you for sharing your knowledge, it will benefit a lot of people.