The Investment Grade Practice with Victoria Peterson

Gary Takacs: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice, one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, the Thriving Dentist Show podcast founder and co-host. A very excited to bring you an awesome episode. many of you, know that, I like to mix up the format of the podcast, partly to keep it interesting for me, and maybe even more importantly, to keep it interesting for you. So, one of the formats I love to do are interviews with people that I’ve known, in our profession that I think you need to know and you need to hear from. And this episode, is an interview with my longtime friend, Victoria Peterson. Victoria, welcome to The Thriving Dentist Show.

Victoria Peterson: Thank you so much, Gary. It’s always a pleasure to hang out with you.

Gary Takacs: Well, it’s mutual. for our listeners benefit, Victoria and I have known each other for a very long time, and professionally and personally. And, my life is, richer for having, for knowing Victoria. and I’m excited to, have you, contribute to, our listeners and, share some really interesting conversation. We’re gonna, we’re gonna make this a conversation,

Gary Takacs: Arranging conversation that I think our listeners are gonna find, just tons of benefit that they can apply in their lives.

Victoria Peterson: I love that so much.

Gary Takacs: I know that, most of our listeners, of course, know who you are, but in case they’ve been under a rock and they haven’t heard of you, would you be kind enough to take a minute and share a little bit about your background?

Victoria Peterson: You know what, I think that’s fair because, I’ve had a name change. You know, I’ve been in the public eye as a speaker and a consultant, particularly in the field of hygiene and practice management for a long time. I’m gonna say it out loud. You and I met at the turn of the century .

Gary Takacs: We did.

Victoria Peterson: We can’t figure out if it was 99 or 2000. Yeah. But it was like right in there. We

Gary Takacs: Might have met when the Met when the first two numbers were 19. Oh, in the, yeah, we met in the 19 hundreds.

Victoria Peterson: Late. We look really good. We look really good for 150. Pretty well prepared, aren’t we? ? Yeah. But you know, when you and I met, I was Vicki McManus. I was a hygienist. I was working in a Tony Robbins organization with Fortune. I had developed Hygiene Mastery. And I’ll tell you what, some of the consultants that came out of that are still rock stars, Rachel Wall, Janet Hagerman, Chris Duval. I mean, they’re still superstars in the, hygiene arena. And, yeah, I exited out of that probably in 2002, 2003, worked at sabbatical, which was really wonderful. And at the time I was living in Atlanta, and I just had time to be still and quiet. I recommend sabbaticals. I’ve had one about every seven years or so, I thought, if universities professors can do this, you know, what do I need to do?

Victoria Peterson: So, part of my personal budgeting has always been 10% of my income directly towards a sabbatical. So, those have been intentional pauses in my career, since I was 21. You know, I think I had my first sabbatical when I was about 27, 28, something like that. And so, from there and Pack Live where you and I met in that clinical container, 2004, I’m living on a little island north of Seattle, Anacortes, if you’re in the Northwest. Do you know how beautiful that is? Amazing. Bruce and our good, amazing, our good friend Bruce Baird called and said, Hey, Vic, I’m doing, a program for doctors, and they want a team program, and you’ve worked with my office, love for you to come down to Dallas, see what I’m doing. And that sparked what became the Productive Dentist Academy. And from there, we’ve been growing and going, you know, ever since.

Victoria Peterson: And, the update to my name changing from Vicki to Victoria Peterson, represented both a marriage and the cumulation, of my doctor of spiritual studies. It was almost, I became a new person. And so I claimed a new name. So Vicki McMahon is, I’ll tell you what was hilarious, a couple of years ago, I was hanging out with, Carrie Strain, and he is like Victoria Peterson. He is being very respectful. And then all of a sudden it dawned on him, he goes, you’re Vicki McManus, that hygienist who used to write all those articles, you benchmark the whole thing and da. And I said, yeah, Gary, we’ve known each other for a long time. So a long

Victoria Peterson: Yeah, same person. Two different names. One wonderful industry,

Gary Takacs: That’s for sure. We share a passion, yeah. For our profession, that’s for sure. that I’m

Victoria Peterson: . Well, you and I also are two non-dentist who have owned dental practices. , you know, there we put our passion where our money is too

Gary Takacs: another commonality. And if I can speak to Productive Dentist Academy, when I became a practice, owner in partnership with a young dentist, one of the first places I sent him was PDA productive Dentist Academy . And he came back, saying, oh my goodness. I just got a serious, a jumpstart, on learning how to, become a dentist committed to quality dentistry and becoming more productive at the same time. when we added a second doctor, the, one of the first places we set him was PDA Productive Dentist Academy. And I’ve had the privilege of sending many of my clients. and I remember what Bruce told me, as I was learning more about PDA, he said, you know, we can work with, ’cause I asked Bruce, is PDA appropriate for dentist at every stage of their career, or is it geared towards a particular phase?

Gary Takacs: And he said, no, we can really work with dentists at every stage of their career. if they’re early stage, we can, we can teach them, you know, what they need to know at this point to, become more productive and always committed to quality. So it’s not just about produce, it’s about maintaining quality dentistry, the kind of dentistry we’d want in our own mouths. and yet also, becoming more productive at the same time, and helping more patients along the way. and there’s so many different strategies that could be done at dentists. They were early stage, mid stage, later stage, maybe if they’re adding certain high value services, you know, PDA could be adapted to them. and, very excited, about, you know, the work that you’ve done all, over the years with PDA, terrific organization.

Gary Takacs: you know, there’s, Victoria knows a lot about, many different topics, some of, some of your areas of expertise. I think about as leadership. you have brilliant, information on leadership. I think about emotional intelligence. You know, eq is more important than iq. and I love the work that you do. I think we’ve even shared some stages together on emotional intelligence, on eq. You have, think about emotional intelligence. I think about, culture and how to create a really positive practice culture. you know, about ai, you know, about groups, about private equity and, the good and bad of private equity. And, really, another area that I think about is leading teams through uncertainty. Mm-hmm. you know, I don’t know that there’s ever been a more uncertain time, in our history than right now, in a lot of ways.

Gary Takacs: but certainly, there is a lot of uncertainty that we’re all experiencing, now. but there is a topic I’d like to kind of focus on a little bit. I think we can incorporate all those different things into it. But you’ve coined a phrase that I love. and, it’s, it’s an acronym, IGP, it stands for an Investment Grade Practice. Investment Grade Practice. and I think that might be a new acronym and a new phrase for many of our listeners. but can we talk a little bit about investment grade practice and what that means?

Victoria Peterson: Absolutely. In fact, I think it’s a whole new category, you know, to practice investment grade dentistry. And, you know, the first thing I can remember some of the first few people I said this to maybe four years ago, and they were like, well, what does that mean? I’m, this is really fun. I was talking to financial planners and I said, well, how do you know a stock is investment grade? And they’re like, oh, I get it. Right? Like, there’s, there’s ratings. Yeah. Every,

Gary Takacs: Everybody got the first word investment. They,

Victoria Peterson: They got investment and investment grade. Oh, like, you’re a, you’re an a, you’re an A stock, you’re not a D stock, you’re not a penny stock, right? So there’s, there’s a mindset of that. But then the other, embodies more humanistic spiritual side of it, which is investment. And if you’re, particularly, if you’re Catholic and you had, and you see the priests, and they have the robes and the ves are in our Jewish traditions and our Hebrew traditions, you know, it means to clothe yourself, most directly, like in rites and ceremony, like the Eucharist, holy Communion, things like that. And so, I really am passionate that people not lose their soul to their work. And my whole thesis was on Sacred commerce. So I thought, how do we bridge the gap between soulful, meaningful, purposeful work, which is what we were teaching at Productive Dentist Academy.

Victoria Peterson: We shorthand that for comprehensive patient care, doing good while doing good, do what you would do in your own mouth, right? So, honoring the sovereignty of a person, giving patients the right to choose, which, by the way, is in the a DA code of ethics. They call it veracity, to be honest and tell ’em everything, you know. But doing that brings up a lot of fear and a lot of pushback, right? So you’ve gotta have a method for that. So how do I honor the human spirit and be profitable, right? We’re, we work in a capitalistic ecosystem. So that’s my framework. They

Gary Takacs: Aren’t mutually exclusive.

Victoria Peterson: They’re not mutual. In fact, they work very well together. And the journey of that. So investment grade practice is really a journey of connecting clinical excellence, authentic marketing. Nobody wants to see, you know, pereg grand and her cousins and your stock photos on your website, and they come in and see a totally different team in your office. So authenticity really matters in your marketing and marketing from the inside out. You probably have more patients inside your practice that need your help without spending, I have an ad agency and I go, don’t spend external dollars until you get the internal systems corrected, right? To practice optimization, authentic marketing, culture, and leadership and business value. So I think the thing that was breakthrough for investment grade practices, we started years ago. When we onboard a new client, the first thing we do is a true practice valuation, one they could take to the bank.

Victoria Peterson: because what we were seeing in this time of consolidation, solo dentistry is hard. So you’re either rising up an associate into a partnership, you’re thinking about joining a group, you have an opportunity maybe to purchase a retiring doctor’s practice and fold it into your group. All of that requires that you can go to the bank and say, this is the value of my business, right? And my financials are clean. So pulling a page from Steven Covey, I said, that’s where our consulting starts. What is it worth today? What’s your financial freedom number? And what’s the gap? Hmm. Now let’s build a business that over the course of time can fill that gap. And what’s amazing is that most dentists think it’s gonna take 10, 15, 20 years, they can put it in place, usually within five. Right? is that your experience as well? Like, you could be totally 100% financially free, dead under control, everything humming if you focus

Gary Takacs: When there’s intention

Victoria Peterson: Yes. . Yeah. So

Gary Takacs: There’s gotta be some intention in there. You know, Victoria and I were talking, before we hit record, and, we were catching up and talking. And, you know, one of the things we commented on is both of us have experienced the, what I believe, you know, I really feel it, like in my soul, the sadness of how few dentists actually achieve financial independence. I, that breaks my heart, you know, to experience that. and there’s all kinds of explanations for that, including missteps, you know, along the way. but, however, I have such a profound appreciation for what our listeners do, you know, for the care they provide, yes. For the passion they put in, for the heart and soul, you know, they put into their work. And I know that doesn’t apply to all dentists, but I believe that’s an accurate description of our listeners. You know, they wouldn’t be listening to this if they didn’t care deeply about their profession, , you know? Absolutely. It’s not required. It’s not mandated. they’re listening to this on their own. but when I encounter, you know, doctors that, legitimately feel like they don’t have any pathway to successfully retire, it breaks my heart. And yet, with some discipline, yeah. And with some direction and, with, some intention, that can be done in a fairly short period of time. and then we can be talking about,

Victoria Peterson: And, or you get fired up. Yeah. We’ve had so many doctors come through PDA that Yeah, I’m retiring. I just wanna get my practice shore up because I know they’re gonna need two years financial. So I wanna, you know, not cook the books. I don’t wanna say that, but I wanna shore it up, you know, and maximize my value. I’ve only got 24 months, so let’s do that. And what happens is, in the course of those 24 months, their stress decreases, the team gets happy, they’re bonusing, they’re profitable, and suddenly they fall in love with their business again. And they go, you know, I think I could do this for another decade. Yeah.

Gary Takacs: Yeah. It’s, it’s so cool to see that happen. Yeah. yeah. And the joy that comes out of that, you know, the fulfillment and the joy and, the passion to continue to do what they do out of choice, not outta necessity,

Victoria Peterson: and think about how many more patients are getting taken care of. Yeah. ’cause the spark is back, the passion’s back, the capacity.

Gary Takacs: It’s such a positive, motivator to grow that. Yeah. We wanna help more of our existing patients enjoy the benefits of great oral health, and we wanna help more people in our community, you know, en enjoy the benefits of great oral health, then growth becomes a lot more than, you know, numbers and dollar bills. It becomes a mission.

Victoria Peterson: that’s right.

Gary Takacs: And, but I really, love that phrase in investment grade practice. Let’s, let’s dive a little bit deeper into that, because I think we piqued our listeners’ interests. you know, and you started with, you know, you own consulting foundation start, which is start with evaluation, find out where your beginning point is, yeah. And then figure out what your number is, and then close that gap in be between. Let’s go into a kind of a rambling discussion about some of the details about developing an investment grade practice. Where would you advise our listeners to, you know, what kind of thoughts do you wanna put on the radar screen?

Victoria Peterson: You know, you call me on a great day because I’m in final edits of my new book investment. Great practice, surprise by the name of that. This is my third book. But it really is how dentists return to the work they were called to do. I think dentistry goes beyond a career. I think it really is a calling for most doctors. You don’t, you don’t grind out dental school and , you know, do what you do to end up this exhausted. And so what are, what are the police systems that we’ve adopted that stand between us and our joy? That’s where the book opens, because I’m sure you ask the similar questions, the same two questions I ask every doctor we begin with is, tell me about your dream. What’s your dream? What do you want? And they say, oh, it’s too big.

Victoria Peterson: I can’t tell you. It’s ridiculous. It’ll never happen. Or I don’t, I don’t have a big dream. I just want, you know. And so they’ve kind of shr. So I asked that question. And then I also ask if they, if they’re not coming in, you know, joyfully and smiling with the country club, facade, and you can tell there’s a little bit of crisis there. I just start with, where do you feel stuck? Mm. And how long have you been there? And what’s the next small step that you could take, you know, that would feel really good today, because like you said, I am, I’m not a counselor. I am definitely not a therapist, but I am trained in eq, I am trained and just naturally am empathetic, and I’m a deep listener. And so the crisis, the financial crisis, when you have 20, $30 million flowing through your hands, but at age, what did the a DA say that, retirement age just went up again to, it’s something like 69 now, and you don’t have 2, 3, 4, $5 million to carry you through retirement.

Victoria Peterson: That’s, that’s a shame. Yeah. But the bigger crisis is the emotional toll of those decades. And so there is a deep recognition that we do still struggle with mental health burnout and all of these things. I just did a podcast today with an amazing client. He is, been with us nine months, and he said, I really got to a low place. He did, I know you and I both speak about this, but he did the one thing you and I would’ve never told anybody to do. He was drowning in insurance write-offs. So he worked with an insurance negotiator, didn’t get any other background information, and immediately cut half the plans, just kept the traditional two. And by the time he realized the impact of that, I say the elevator of his, of his business kind of went from the penthouse down to about the third floor.

Victoria Peterson: Yeah. He wasn’t in the basement, but he was hurting, and revenues had fallen in half, and he couldn’t make salary, he couldn’t make anything. And he said, I had to do something. I had a friend that went to PDA, talked to her, borrowed the money, and thought, I’m gonna do some marketing. So I called up your marketing agency, and thank goodness, Sarah told me like, you don’t have a marketing problem. You have a leadership and a management problem and sent this over to you. And so that’s where it starts. It’s either I’m successful and peaked and plateaued and kind of feeling hollow inside. ’cause you know, what, is it all worth or I’ve, I’ve made some uninformed choices along the way, and now I’m feeling a little stuck. Yeah. And how do I get out of it?

Gary Takacs: You know, Victoria, one of the things I like to, think about, and I’d like our listeners to think about is, you know, you think about the journey that, an individual is on to become a dentist and go through their career. And I think about, you know, back to, before dental school, right? and, you know, a potential dentist was applying to dental school. And back in the old day, old days, they, used to use mail to inform, oh boy, dentist about their acceptance into dental school. Today, it’s all done electronically, but let’s go back to the day when, you know, potential dentists were going to the mailbox every day to see, they applied to multiple dental schools. And, yes. You know, and here, you know, here, an envelope arrived from one of the schools they applied to, and they held that envelope nervously in their hand. It’s like, should I open it? Should I open it? Should I open it? and, they finally decide they’re gonna open it. And they open it up and it says, congratulations. We’re, we’re thrilled to inform you that you’ve been accepted into, you know, Dell School class. You know, and now that’s done electronically, but you can kind of get the symbolism

Victoria Peterson: There. Sure. Same anticipation. Same. Yeah.

Gary Takacs: It’s anticipation. And I would argue that for many dentists, up until that moment in their life, that was one of the happiest days in their life. yes. And now that may have been superseded in the future with, the day they were married. Their kids were born and such. But maybe up until that point in time, that was their happiest moment in their life. And it was happy because literally, the entire world was in front of them of unbridled enthusiasm of what they could become. Okay. and it was, and, but many dentists said, gone downhill ever since .

Victoria Peterson: Yeah.

Gary Takacs: That it didn’t, you know, dental school wasn’t quite what they had to kind of survive dental school. And, you know, they made it through their first, foray into practicing dentistry. Maybe it was in a bad associateship. And, you know, rarely do dentist come right out of dental school and become a practice owner. right. But maybe at some point they said, you know, I’m gonna become a practice owner. And, I’m, I’m a huge fan of entrepreneurship and dentistry. I think any career path in dentistry, it can be an amazing career path. Yep. You could be a teacher and absolutely love it. You could work in community health and find tremendous fulfillment from that. of course you can be in a great, associateship. but I do have a bias, my bias, I think if you’re inclined that way, I think the greatest career path is to become a practice owner. But for many dentists that didn’t, it didn’t, real, it didn’t meet their, elevated expectations about what it could be. and they start making decisions that lead ’em, down into a, you know, kind of an exercise in frustration, instead of that unbridled potential that they had . So, I’d like our listeners know, whatever you, whatever stage of you are, you are in your career, you can flip that switch and get back on that path to

Victoria Peterson: Oh, absolutely.

Gary Takacs: A of optimism.

Victoria Peterson: Absolutely. Do you

Gary Takacs: You believe that?

Victoria Peterson: Oh, absolutely. Yeah. Justin that I was interviewing today, he was in that place last June. Here it is, the beginning of March. His, everything turned around and he said, I had to turn around. That was the thing. My leadership is better. I’m clearer. And he goes, I started listening to Bruce’s podcast, and I did the first thing he said, he said, when I was paying attention to insurance, and I was driven so fast, if I saw a crack in the tooth, I would say, yeah, it’s a crack. Let’s watch it. ’cause there was, you know, I knew that. And here comes the limited. And this is how the sys the system systematically decreases your enthusiasm, right? As you would put it. Because, you know, you could take all the intraoral photos, you could CB, CT, whatever, you’re not gonna get paid for it.

Victoria Peterson: You’ve got an uphill battle with your patient about reimbursements, da. So two or three of those conversations, you stop talking about the cracked tooth. And the very first thing we had him do was be honest with your patients. Whatever you see, tell them that’s what you see, and that’s what you would do in your mouth. He said, the very first patient, he said, I was shaking in my boots. I didn’t wanna do it, but I had to do it. And I said, you do have a, you have a crack in this tooth, you have a fracture. It’s not broken today, but if I were you, this were my mouth, I would go ahead and preemptively put a crown on this tooth. And here’s why. Because when it breaks, not if, but when it’s going to be unpredictable, I don’t know if it’s gonna split the root, how it’s gonna, we may end up extracting, we may end up with an implant.

Victoria Peterson: I don’t know what the outcome would be when it cracks, but I know it will. Right? It’s up to you. We can do it now, or we can do it later. And they went, sure, doc, I trust you. I’ve been coming here for years. He goes, all those years of being afraid of talking about cracked teeth. And he said, in my area, I notice that my patients are on a lot of anxiety meds and depression meds and things like that, which leads to a ton of bruxism and grinding. They’re breaking their teeth left, right, and center. And he said, so I just started focusing on that kindest, dearest, wonderful man. So he didn’t do any fancy practice management techniques or any marketing at all. He just started being honest and compassionate and preventative. Those are my three mantras. Like I, if you can be compassionate with yourself and others, you have a preventative mindset in your own health as well as your patients, and you can be comprehensive. Let’s look at all of it. You’re successful doing those three things. And block scheduling, you know, finding places to put ’em. He went from 50,000 a month to 115,000 a month in eight months. Like, wow. It’s not, it’s not magic, but it does take courage to buck the system that you’ve been Yeah. Limited by.

Gary Takacs: Well, and you know, our listeners know that, I try to get, have them look at, adjustments. yes. Difference between your usual fee and your contracted fee. I like them to look at that as a marketing expense.

Victoria Peterson: Absolutely.

Gary Takacs: It’s a marketing expense that’s never gonna show up on your p and l because you’re not actually writing a check to Delta Dental. It’s even worse. They’re taking it out before you ever get it. but, you know, you look at that, those adjustments. You used, the term earlier, authentic marketing, you know, it’s, it’s one of those components, of an investor grade practice. They have authentic marketing. But if you’re using, Delta, blue Cross, blue Shield, United Concordia, whatever insurance company you wanna name

Victoria Peterson: That’d be generic marketing. Yeah. ,

Gary Takacs: Generic marketing. It’s, you know, I have this, and it pays, you know, that kind of marketing. and I think of the ludicy of that in that, you know, Victoria, I consider you to have one of the finest business minds of anybody I know. and imagine that you owned a restaurant. Imagine that you were in a different line of work than you owned a restaurant. can you imagine, as the owner of a restaurant ever allowing a third party to set your menu prices? Would that make any sense at all? ?

Victoria Peterson: No. No. Especially if I was required to serve like filet mignon, and it cost me 16 bucks a pound, and I was forced to sell it at 12. Yeah.

Gary Takacs: , I mean, and you know,

Victoria Peterson: That’s a, because the insurance company owns the cattle yard, you know, ?

Gary Takacs: No. How about, no, you know, there’s an epidemic of, overhead out of control in dentistry today. It is. It’s a combination of, you know, inflation, wage inflation, everything we buy for the price is more expensive. And yet, in many cases, the fees we’re getting reimbursed from insurance companies are actually going down in light of that.

Victoria Peterson: You know, what I’m seeing, Gary, and I wanna ask you about this, ’cause I think you can solve it. the last three or four new doctors that I always talk to everybody who’s interested in consulting. ’cause I wanna know, like fit, is it gonna, you know, bring value to them? And the last three or four I’ve looked at the contracted rates might be 30, 35% adjustments, which is egregious. But it’s, it’s there, it’s in writing. But the reality is I’m seeing 55, 60 2% write off

Gary Takacs: Ex That’s exactly right. It’s, it’s, it’s,

Victoria Peterson: And there’s a fee for service component. So is that like the talent wars and the, and the churn that happened in COVID, and people coming in and sitting in those roles aren’t as detailed or trained in the submissions. Did the, did it get a little more gamified? Are we not posting correctly?

Gary Takacs: All of the details relative to insurance has become infinitely more complex. Yeah. You know, we used to remember when the day we used to call, a process in the practice called collections. Remember, we had you pay attention to collections today. That’s called Revenue Cycle Management.

Victoria Peterson: That’s right. Or

Gary Takacs: RCMR

Gary Takacs: Cm. It’s a fancy way to call it, you know, collection. But there’s all kinds of moving pieces in there. and none of it I is, works in our favor. the cards, the cards are stacked against you, , you know, as a practice owner. You know, I’ll share something with you, Victoria, I’d love you to, think about this and share your thoughts about whether you’ve seen this happen in the practice. So I have a wonderful husband and wife, Dr. Dr team, mm-hmm . Just a fantastic practice. and, but over the years, they had successfully developed a practice and created some authentic marketing, and were able to, reduce their insurance dependence. And they had gotten down to where the last plan that they had was Delta Dental.

Victoria Peterson: I was gonna say, let me guess, because I,

Gary Takacs: I was guess, but you would’ve known it. Yeah. It was Delta. And this is an area where Delta’s very prominent, not only for public employees, but for private companies. And, you know, they’re the 5,000 pound bully. and they were afraid to, resign represented a significant part of their pr, part of their practice. Yeah. And yet as they sat down, they really looked at it, from a values perspective and continued to participate with Delta. Just didn’t, no longer met their values, no longer met their values. And they, that’s when they contacted me and said, I, we need your help. We know what we’re gonna do. We’re gonna resign, but we want to do it in the way that’s gonna, produce the best result.

Victoria Peterson: That’s

Gary Takacs: Right. As we’re going through this, we did a lot of training with the team, and this practice was, when we finally pulled the plug, what was so ready to do this, that my crystal ball said they were gonna do extremely well. and in fact, they did. They lost some patients, but, they only lost the ones that really didn’t value them. they lost the patients that looked at dentistry as a commodity, you know, a crowns of crowns, crown, doesn’t matter where you get it. right. Or hygiene appointments, hygiene, appointment hygiene. It just doesn’t matter. You know, we all, we know differently. You and I know differently, and our listeners know differently than that. and anyway, the wife in the, practice was very analytical, and she did something for me, and I wanna share it with you and share it with our listeners.

Gary Takacs: Great. She went through the analytics here, and she said, Gary, I went back and looked at our Delta patients. And, I went back and looked at their history of case acceptance and treatment acceptance, and you know, what their, history was in our practice. And she said the vast majority of them, came in regularly for their hygiene appointments. But the only time when they would respond to treatment recommendations was when it was urgent. If something hurt, they would then respond. And, but I noticed as I looked through there, that very few of those patients, selected any of our elective care or comprehensive care, or ideal care, however you wanna put that. And I know her to be very analytical. And I said, the majority of your, you said the majority of your patients, I bet you could define that more accurately. she said, yeah, I’ve got the number right here, Gary, only 4% of our Delta patients accepted treatment that had, that wasn’t urgent in terms of any recommended treat. So, and then, she got a little emotional about it, you know, in a fun way. She said, yeah, all they’re doing do is coming in for their free cleanings. And that was, wow. Does that

Victoria Peterson: that could be, it resonates. So did, do you think it could extrapolate across all markets

Gary Takacs: Without hesitation? Yes, absolutely. Yes.

Victoria Peterson: Well, I get some reassurance to anybody who wants to go off Delta, your volume will drop. But what you’re doing though, is you’re opening up capacity. Yeah. What are you gonna do with 3000 patients and five operatories, you know, and they’re, they’re jamming up high. well, yeah, I was trying,

Gary Takacs: Well, you know, I mean, with you, with your, you know, earlier , am I

Victoria Peterson: Gonna tell on myself as a hygienist,

Gary Takacs: As a hygienist, you know, you follow this, you know, as detailed as I do, there are, states now where your reimbursement from a bad insurance plan doesn’t even cover the hygienist hourly rate.

Victoria Peterson: I have seen it so egregious. I have seen it where it reimbursed like 50% now that hygienists are rightfully so, making 65, 70, 80 bucks an hour. I love that. Doctors don’t boo me . But, when I came outta hygiene school in 1982, in 1980, hygienists in Florida were making a hundred bucks an hour. And because hygienists were making a hundred bucks an hour, they opened up more hygiene schools and flooded the market. So it would dilute the salary. So there’s always been this love hate relationship tension around that, the dentist and hygienist. And whenever one professional is governed by a board of another, there’s gonna be those legal tensions. But here’s the thing, I was, I, oh, I’m so dating myself, but that’s all right. I’ve already claimed that I’m 150 . I entered hygiene when I had a belt driven handpiece. And I had a manual reclining chair, which meant I’m like 103 pounds and 250 pound men had to be physically hooked down and back with the big rheostat.

Victoria Peterson: So I was doing standup dentistry with the big belt driven thing. Scaling and root planning was not a procedure. Gloves had not entered the operatory. And I thought, and the hygienist before me in this practice had no scalar that went below the gum line. And within two years, I thought, I can’t go home with, I felt like a butcher. Right. Teeth were literally falling out of my hands. We don’t often see that amount of tartar anymore. So, to go from that, I went to the University of Pennsylvania, one of the first classes on scaling and route planning. I had to pay for it myself. And it came back, the doctor still, I was paid on commission, $7 and 50 cents for a cleaning. And I said, but I need to see them four times. And he goes, well, you can’t charge ’em four times. That would be inconvenient.

Victoria Peterson: So I charged the patient $24, and I did quadrant by quadrant by quadrant scaling and root planning with via dent, and worked with a periodontist that we were referred to get them healthy. And what I noticed back then, we’re talking like 19 84, 85, I noticed that their insulin usage dropped. I noticed that they, their stamina was improving. I noticed that health metrics on so many levels were improving. So here I was in the mid eighties doing, glucose monitoring for my perio patients. I can’t name you a dozen hygienists who do glucose monitoring today. And we’ve got osh, we’ve got oral systemic. You just hit my passion button. Yeah. So here’s the thing. Hygienists, we just had a hygienist recently text her doctor and said, I’m resigning because I only want to do, the standard of care for dental hygienist. I refuse to do periodontal replanning and scaling.

Victoria Peterson: And so that’s the conundrum. Yeah. Because the legal standard and the optimal care, huge gap. Big gap. And I thought, you know what? That’s a blessing, doctor, because actually, you know, providing, periodontal therapy is part of the State Practice Act. It is, by the way, in most states, you know, for hygienists. So if she doesn’t wanna do that’s cool. Let’s, let’s find something. ’cause comprehensive care, your patients just deserve more. And when you’re so completely centered on you deserve more, and we’re here to help you get that. We’ll make the payment options, manageable. We’ll schedule in your own time. We’ll phase it. We’ll do whatever it takes to help you get healthy. ’cause I’m your partner and health, I’m not your auto mechanic with a reimbursement coupon. It just changes everything. It changes everything.

Gary Takacs: It really does. you know, this is an episode for our listeners. You’re gonna have to go back and listen to this more than once. There are so many takeaways from Victoria. I want you to go back and listen to it and start to incorporate these things. you know, Victoria, as we start to kind of come to the finish line here, we always end our episode with, a wonderful piece of music, that I ab absolutely love. It’s my favorite band, and my favorite name of a band. the band is Ryan Chupe and the rubber band Ryan Chupe and the rubber band . So, Victoria, look it up when you get a chance on Spotify. You bet. Ryan Chupe is a friend of mine. and when I started this podcast in 2011, I reached out to him and I said, Ryan, I absolutely love your song that you wrote called Dream Big, dream Big, nice.

Gary Takacs: And it’s got wonderful lyrics about how, we all deserve to dream big and achieve those dreams. yes. And, I had the privilege. He was here, touring around, the holidays, this year. And, Theresa and I went, did, hung out with him in person what he was here in Scottdale, and they had a great time. But, I’m gonna put you on the spot, if that’s okay, Victoria. I think you’re gonna do just fine. if not, we’ll edit it, but no, you’ll do just fine. can you leave our, listeners with, a positive thought that they can absolutely dream big. they can achieve financial independence, they can, develop an investment grade practice, and that they can, practice in a way that truly, brings them fulfillment. What would be your parting thoughts about that, being something that all of our listeners deserve and frankly, it is within their reach?

Victoria Peterson: Yeah, absolutely. I think beginning with the concept that my net worth is not, my self-worth is a really good place to start. And because valuing yourself first and bringing all of that leadership, that positivity, you know, all of that to the game is what really wins the game. And so,

Gary Takacs: So you introduced a wonderful, question I heard earlier. I wrote it down. where do you feel stuck? Yeah. And I’m gonna use it here. If any of our listeners are feeling stuck in terms of self value, what would you encourage them to do?

Victoria Peterson: well, step one, whatever’s coming up in your mind that’s making you stuck, just be willing to question that and say, is that really true? Yeah. Like my, you know, whatever it is. You know, is that true? ’cause nine times outta 10, it’s not, your thoughts just have its own loop. Are

Gary Takacs: You suggesting we tell stories to ourself? 00:41:2

Victoria Peterson: What I think we are, I think we tell stories to ourself and we’re predisposed to tell the bad ones. So stop going to that movie. Stop going to that movie and say, you know what? Even if that is true, lemme put that aside and let me, let me just, one of the, we bring a dream inventory, and I challenge my docs to write out 50 things. They want, they can be big, they can be small. I want, I want gelato once a week. I wanna go to Italy to eat gelato. You know, get your dream inventory and really get back in the habit. Because I think positive mindset, dreaming big and finishing well, it really is habit stacking. And so, start wherever you are. It’s exactly the perfect place to start. And then begin with the end in mind. You know, pull a Stephen Covey.

Victoria Peterson: And, the simplest way, you know, to get to financial freedom is just take your expenses each year. If it takes you a hundred thousand dollars to live, multiply that by 30, you need $3 million. It’s not hard to figure that out, to figure it out and just start surrounding yourself with successful people. wave the white flag. You probably hear this as much as I do. Doctors go, I, yeah. I finally wave the white flag of surrender. I hired a consultant. It’s so embarrassing, . It’s like, go back and talk to your 2-year-old self, because two year olds are absolutely, and babies are the best example of this. They ask for what they want, they’re curious, and they never lose that sense of wonderment. So if you could somehow just tap in to your 2-year-old self when you’re thinking about business planning, make it fun, make it silly. Make it all about you. Be indulgent for just a minute and shut out the rest of the world and say, I wanna be in the center of it. Because when you are center stage leader, which we all are as dentists working in the practice, you’re on center stage all the time. Make it fun, make it inspirational, make it something that you want to come and live and have the people around you join in with you,

Gary Takacs: You know? Well, I anticipated a brilliant response, and, you delivered, Victoria. Where can our listeners, reach out to, connect with you and learn more about you?

Victoria Peterson: Yeah, absolutely. info@productivedentist.com will go directly to me and my team. That’s a great one. If you’ve got a more personal question, just reach out to victoria@productivedentist.com. And, yeah, we’re, we’re, as you said, we could, we could talk about a lot of different things. We just celebrated our 20th anniversary and we’ve laid down the foundation for another 20 years. So hopefully I’m walking the talk of building an investment grade business that I’m delighted to be a part of, love being at the center of, but also have it built so that it’s gonna last and take care of people for a long time to come.

Gary Takacs: Well, remember that, way to connect with Victoria info@productivedentist.com. and I’ll, I’ll put you on the spot in front of all our listeners. Can I, can I bring you back for a follow up, interview at some point, and, continue this conversation?

Victoria Peterson: Anytime. Let’s just not wait until the turn of the next century. No,

Gary Takacs: We won’t . We’ll make it soon. . well, Victoria, I wanna thank you. Thanks for your, wisdom. thanks for your passion. Thanks for your amazing leadership. thanks for your friendship. we’ve enjoyed, many years of friendship, and it’s something I treasure ed. Thank you for, entertaining and, sharing wisdom with our, with our listeners. I know they’ll get lots of value out of this. thanks. thank you Gary. And lastly, I wanna thank our listeners, here at Thriving Dentist Show. We appreciate each and every one of you. thank you for the privilege of your time. And on that note, we look forward to connecting with you on the next Driving Dentist Show.