Real vs. Not Real

Are you ever stuck in a situation in your practice where you wonder – is this happening elsewhere? Or am I the only one? Bethany gets the opportunity to field “real vs. not-real” questions from her clients all the time. She often helps them decipher if they are truly alone in their struggles or are struggling along with the rest of the dental community. In today’s episode, she tackles four recent scenarios, rumors, and trends that she deems either real or not real. Find some comfort and encouragement today as you navigate how connected your situation is to others. 

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Transcript

Are you looking for a podcast where you
0:04
can hear from real people regarding
0:06
their real dental drama? If so, then
0:09
you've come to the right place. Join
0:11
hosts Bethany Penny and Dr. Reena Kuba
0:14
as we dive into the solutions we've
0:17
created and the mistakes we've made
0:19
while managing dental drama.
0:22
Let's get started. Good morning and
0:24
happy Monday everybody. Before I jump
0:27
into today's content, I wanted to remind
0:30
you guys that we have a fantastic free
0:32
webinar that's available on customer
0:35
service. It's meant to be a training for
0:38
you and your teams. So, make sure to
0:41
check in the show notes and go find that
0:43
free webinar today. Okay, so the topic
0:47
of today is real or not real. This is
0:52
coming from some inspiration. My eighth
0:54
grade daughter is in the middle of just
0:56
being obsessed with the Hunger Game
0:58
books. And so in order to have some good
1:01
dialogue with her, I jumped in and have
1:03
been reading those as well, just
1:05
finished reading those. And there is,
1:08
for those of you who have read the
1:09
books, uh there is a period of time
1:11
where the main character named Peeta is
1:15
tortured by the capital mentally,
1:17
physically, all of that. Uh but mentally
1:20
he comes out of it having a real hard
1:23
time dis discerning what's real and
1:26
actual truth and what is not real
1:30
untruths that have kind of been fed to
1:32
him uh through the capital. So through
1:34
this mental torture he just had this
1:36
inability to distinguish between real
1:39
and not real. And as I thought about
1:41
that in today's episode, I realized how
1:47
accurately that scenario describes what
1:50
so many dental professionals and dental
1:54
owners go through every day. They're
1:58
recognizing things around them and
2:00
they're just trying to figure out, is
2:02
this real? Is this really happening
2:04
across the dental world or is this not
2:07
real? Is this a microcosm in my little
2:10
world? And I see this a lot when I am
2:15
interfacing with my clients. They it's
2:18
almost like I'm their link to the
2:20
outside world and and they're describing
2:22
some of the things that are going on in
2:24
their practice and wondering are other
2:26
people going through the same thing? Is
2:29
this real? And so I wanted to actually
2:33
attack some of those topics today and
2:36
hopefully it will be helpful to know
2:38
what is truly a trend that I'm seeing or
2:41
something that's prominent in the dental
2:43
world and then some things that I think
2:46
are not real that may be circulating
2:50
around. So without further ado, let's
2:53
dive into real versus not real. So the
2:56
first one that I put on my list was the
3:00
slowness of dentistry.
3:04
I have had several people asking me is
3:06
this happening elsewhere? I am so
3:09
dismally slow.
3:11
Many of them are citing that it started
3:16
in November December that they started
3:19
to feel some of the painstaking slowness
3:22
that they were experiencing.
3:24
And I will tell you this is a very very
3:28
real trend that I'm seeing right now. Of
3:32
course there's going to be outliers to
3:34
every trend. So if this is not you,
3:37
congratulations. Your reality is not the
3:40
reality that most people are
3:41
experiencing. Um most people are
3:44
experiencing a very rare downturn.
3:49
November, December has always been
3:51
historically busy for dental practices
3:54
and many of my clients experienced a
3:56
less than busy November December.
3:59
Now, if there has ever been a slow
4:02
November, December, it usually picks
4:04
back up in January and we kind of hit
4:06
the new year running and things get back
4:09
on track if they were off track. And
4:12
that has not been the case this January
4:15
and February. Um, we are obviously into
4:19
March now and I'm getting little little
4:23
glimmers of maybe a little bit of hope,
4:26
but not like I was hoping to see. So,
4:30
even January and February, which can be
4:33
some strong months for dental practices,
4:35
have also been slow.
4:38
So, I can speculate all day long on why
4:41
this is. All I do know is that this is a
4:44
trend that breaks the norm. I've been
4:48
involved in dentistry for a very long
4:50
time now and there's been these cyclical
4:53
patterns of busyiness and slowness that
4:56
tend to hit dental offices at about the
4:59
same time. Whether that's on the west
5:02
coast, the east coast, or straight up in
5:04
the central, the patterns tend to be
5:07
similar quite honestly. And so there's
5:10
this very there's always been this
5:12
predictable pattern in dentistry that is
5:16
broken right now and we're not following
5:18
that same pattern. And so that trend
5:23
that slowness that you are wondering is
5:26
this really happening or is this just
5:28
all in my head? I actually believe it is
5:31
real. And some of what I think is
5:34
happening is we're finally catching up
5:38
with some of the economic concerns that
5:40
people have had. Some of the just
5:43
worldwide unrest is finally hitting
5:46
people. I do think a number of people
5:49
have dropped dental insurance and are
5:52
therefore being more cautious about
5:55
jumping into a dental office.
5:59
I also think that people if they are
6:03
still coming, they're coming for
6:05
prevention and they're hesitant to
6:07
schedule their dentistry either due to
6:09
wanting to preserve funds, wanting to
6:12
push funds towards something else or
6:14
just in general just not being connected
6:17
to their health care as much as they
6:19
have been in the past. So, it is a very
6:23
real trend. And my just short little
6:27
advice to you on this trend is this is
6:31
where you dig deep and lean into all of
6:35
those retention efforts that we talked
6:37
about in the last episode as well as
6:41
your internal systems to ensure that you
6:44
guys are doing everything in your power
6:47
to make it easy for the patients to
6:50
remain active in your care. Whether
6:53
that's them coming back consistently for
6:55
hygiene, whether that's making it
6:58
possible for them to get that crown that
7:01
they've been waiting on, or whether it's
7:03
something larger like starting and
7:06
maintaining their orthodontic treatment
7:08
or starting that implant process and
7:11
procedure, you want to just use this
7:15
kind of downtime to evaluate or
7:18
re-evaluate
7:19
how smooth it is to get the patient from
7:22
point A to point B and is there anything
7:24
you can do to improve that process and
7:27
make it better? This is a time to dig
7:30
deep and refine those skills that are
7:33
going to help you hopefully get back on
7:35
track.
7:36
Okay, so that's number one. Real or not
7:39
real, the slowness of dentistry is
7:41
absolutely real. If you're experiencing
7:43
that, I know it's not super comforting,
7:46
but you're ultimately not alone in that
7:48
category. And I'm going to continue to
7:51
keep a close eye on when this abnormal
7:54
trend starts to correct.
7:58
Trend number two, the absence of
8:02
hygienists.
8:03
I can't tell you how many times I've
8:05
been asked this lately. Are hygienists
8:08
just did they all quit? Did they all
8:11
leave? Are we not turning out enough
8:13
hygieneists? Like where in the heck are
8:16
they? I feel like we have fewer
8:18
hygienists or I feel like they're
8:21
absent. So, I would say this is actually
8:24
not real. You might be surprised to hear
8:27
me say that. I think there's as many
8:30
hygienists as there has been. I know we
8:33
lost a good bit in the pandemic who
8:36
decided to not come back into the field
8:38
or to pursue other interests like
8:42
nursing or myofunctional therapy or
8:44
things like that. So, we definitely lost
8:46
our fair share of hygienists, but we're
8:49
still graduating a great number of
8:50
hygienists. I think the reason that it
8:53
feels like they are absent
8:56
is so many of them are taking a path of
8:59
not permanently placing themselves in a
9:02
dental office. They are instead
9:05
affiliating themselves with
9:08
either staffing platforms, temp
9:11
agencies. They the trend at least that
9:15
I'm seeing is that they're still
9:16
hygienists and they're still working in
9:18
the field but they're doing it on their
9:20
own terms and they're doing it through
9:24
temp or
9:26
platforms basically so that they can
9:29
pick up jobs as needed. Now
9:32
that is not helpful if you aren't
9:35
affiliated with a platform or a temp
9:38
agency. then it can feel like there's
9:40
truly no hygienist available. Uh but if
9:43
you are affiliated with a temp agency or
9:46
platform, then you'll realize that when
9:48
you do need a hygienist, in a good
9:50
portion of those situations, you're able
9:52
to find one through those platforms.
9:55
Now, I could talk all day about the
9:57
long-term consequences of this on dental
10:00
practices and the exorbitant expense of
10:04
those hygienists definitely makes you
10:06
think twice about booking one through
10:10
the agency and at some point it will be
10:13
become an unbearable price tag is what I
10:16
foresee happening. But in the interim,
10:18
they are still available and they're
10:21
usually available through those
10:22
platforms.
10:24
The other thing that I hear or have
10:27
questions asked about is I feel like
10:30
there's a real absence of RDAs
10:33
that
10:35
when we need an RDA, there's very few
10:37
that apply or maybe some new ones, but
10:40
it just doesn't seem like there's near
10:43
as many as there used to be. And I would
10:46
actually say that that trend is real. So
10:50
I am seeing a severe lack of dental
10:53
assistants that are graduating out of
10:56
programs, a lack of people that are
10:58
choosing to go into dental assisting. It
11:02
has become a field that has shrunk in
11:05
size and part of that could be we
11:08
haven't advertised the field enough.
11:10
this could still be results of the
11:12
pandemic and how RDA schools kind of
11:16
minimized their
11:19
enroles or I've heard of many RDA
11:22
schools that have gone completely under
11:24
and no longer have a school operating
11:28
but I think a lot of it is we're not
11:31
attracting people to the field for one
11:34
reason or another and so we're
11:38
experiencing after probably sever
11:40
several years of this slow trickle of
11:42
RDAs leaving the field. We're really
11:45
experiencing the loss of them and we're
11:48
not doing a great job of reactivating
11:51
people or seeking out new people for the
11:54
field. We just kind of keep waiting for
11:56
the RDAs to come back. So, I do think we
12:00
need to really consider what it takes to
12:04
start sharing how great the dental field
12:07
is with other people. people who are
12:10
looking for a great career or people who
12:13
are thinking medical and could be
12:15
convinced dental. I do think there's a
12:18
lot of opportunity and a lot of talent
12:21
out there that just hasn't considered
12:23
the dental field and we may need to
12:25
change up our strategy a little bit and
12:27
look for those people who are eager to
12:29
learn a new craft or a new trade and are
12:33
interested in doing something that
12:35
matters which is dentistry. So I think
12:39
this takes all of us talking to friends,
12:41
family members, schools, community
12:44
colleges, and really working to get
12:47
people interested in the dental field.
12:50
But the the absence of RDAs that you're
12:53
experiencing is absolutely a real trend
12:55
that I'm seeing.
12:58
The next one, and maybe the last one
13:01
that I'll talk about for this episode
13:03
today, is
13:06
I I have to prevent myself from laughing
13:09
on this one, but insurance
13:11
reimbursements are improving
13:15
that there are positive trends that are
13:17
happening.
13:18
I am going to land on the side of not
13:22
real, and I'll tell you why. Um, first
13:25
of all, there have been multiple rumors
13:28
over the last year to year and a half
13:32
that insuranceances are making some
13:34
positive changes and that they are
13:38
essentially attempting to write their
13:40
wrongs of the last you 20 years or so.
13:44
And part of writing the wrongs is to
13:47
have better reimbursements,
13:50
better approvals, less denials on
13:53
claims. Uh there have been rumors of
13:56
companies like Delta Dental who are now
14:00
paying their out of network providers
14:02
directly rather than all of them sending
14:07
checks to the patients.
14:09
And while I've seen some changes in
14:14
insurance being willing to negotiate
14:18
with a client for a better fee schedule,
14:20
whereas for a while there was absolutely
14:22
no negotiation. and you took your fee
14:24
schedule and you liked it and I am
14:28
seeing that some of my clients have been
14:30
successful with negotiating some higher
14:32
fee schedules. Now, is it a an
14:37
applaudable amount? No. But it's an
14:40
improvement and and after a long dry
14:43
spell of no improvements, I have seen
14:46
some companies make better choices in
14:49
their re reimbursements when a client
14:52
initiates that change. So for that, I
14:54
would say yes, we've seen some glimmers
14:56
of improvement there. But collectively
15:00
across the board which unfortunately you
15:03
have to kind of group dental insurance
15:05
together and talk about it in this way.
15:08
Collectively I am seeing that dental
15:10
insurance is unfortunately not improving
15:14
or at least not improving a make to make
15:16
up for the large deficits that they've
15:18
created over these last 20 years. I have
15:22
continued to see rule and regulation
15:24
changes on something as simple as
15:27
X-rays. I know many of people listening
15:30
to this episode probably got that letter
15:32
in the mail from um I wish I could
15:36
remember the name of the company. It's
15:38
left me now, but an insurance company
15:40
that ultimately said, "By the way, based
15:43
on ADA protocol, you've got to write a
15:46
narrative for every PA that you send.
15:48
Now, there's got to be clinical reason
15:50
that you would take a PA." And so I had
15:54
so many clients reaching out to me about
15:56
that like, can you believe this? Yes, I
15:58
can believe this. Unfortunately,
16:00
insurance is still acting in the way
16:02
that they always have, which is to
16:05
reduce reimbursement as much as they
16:08
possibly can. So, yeah, maybe we went up
16:11
5% on our fee schedule, but we're going
16:14
to gain it back in some way by starting
16:17
to deny every PA that's sent to us. And
16:20
so insurance continues to leave dental
16:22
practices in this weird predicament of
16:26
what do we do with that? Like we needed
16:28
to take a PA of those front teeth
16:31
because of concerns that we saw visibly
16:34
or we needed to take those PAs because
16:37
that's a part of our X-ray protocol that
16:40
we do on an annual basis or whatever the
16:42
case may be.
16:44
dental offices are now stuck in that
16:46
position of do we do what we believe is
16:48
clinically best for the patient or do we
16:52
abide by the regulations and
16:54
restrictions that insurance has put in
16:57
place to keep us from taking those
17:00
x-rays and for that reason that is why
17:04
when I say insurance is improving I have
17:07
to say not real on this I just have not
17:10
seen enough of a turn of events I still
17:13
am not seeing Delta pay their out of
17:16
network providers directly. Of course,
17:18
some of them do. You guys know that that
17:21
work with insurance that some Delta
17:24
dental plans still pay the out of
17:26
network provider, but some don't. And
17:29
the ones that have not historically paid
17:32
the dental providers, I'm still not
17:34
seeing those payments come to the dental
17:36
offices. And so I'm just I think the
17:39
rumors of insurance or dental insurance
17:41
improving may have very well been
17:44
started by the insurance companies
17:46
themselves in an effort to kind of
17:48
garner people back or garner practices
17:52
back into the fold. Now, there's a part
17:55
of me that's wondering too if a lot of
17:58
people as they became more and more
18:00
discouraged with their dental insurance,
18:02
if they elected not to have dental
18:05
insurance and that now could be
18:07
contributing to that first rumor, which
18:10
is the slowness of dentistry. And so,
18:12
obviously, all of this can can
18:15
potentially play together, but the
18:17
bottom line is I just am not seeing that
18:21
in dental insurance is improving. So if
18:24
you've heard that, I would qualify that
18:27
as a not real statement.
18:31
So these are a few that I had at the top
18:33
of my mind that I just wanted to put out
18:35
there for those of you who have been
18:37
wondering.
18:39
I know that none of these topics has
18:42
real strong solutions, but I do think
18:45
it's helpful for you to chart your own
18:48
course forward or your own improvements
18:50
forward when you know the realities that
18:53
you're facing. And they're not just your
18:54
individual realities, but they are
18:57
realities that I'm seeing on a broader,
18:59
more collective basis. So when you know,
19:02
oh no, this is true, this is reality,
19:05
this is real, then you can actually
19:08
invest the mental and emotional energy
19:11
into coming up with your own solutions
19:14
that are fitting for your practice and
19:16
your team and yourself for that matter.
19:18
So my challenge to you today would be
19:22
dig deep and figure out how you can
19:24
fight against the slowness of dentistry.
19:26
Get get smart on that. Get your think
19:28
tank together. get your colleagues, your
19:32
advisors, your team together and figure
19:34
out what can we do to combat this
19:36
slowness that we're experiencing in
19:38
dentistry.
19:40
Okay, we have had trouble getting
19:41
hygienists. That is a reality for us,
19:46
but Bethany is saying that that's not a
19:47
reality collectively that collectively
19:50
hygienists still exist. So, do we have
19:52
the relationships we need to have a
19:54
hygienist when we need one?
19:57
Bethany says that the reality is there
19:59
are fewer RDAs. What can we all do to
20:02
recruit an excellent RDA to our team?
20:04
And yes, maybe she does not have any
20:06
experience, but can we train that
20:08
person? And then the last reality of
20:12
insurance, do with that what you will.
20:14
If you're out of network, I would not
20:16
believe the lies that insurance is
20:18
getting better and thus go in network. I
20:20
think that's what they want you to do.
20:22
And I think you're going to experience
20:23
the same dank dark world of a few years
20:26
ago when you dropped. So don't fall for
20:29
that line. And I would say for those of
20:30
you that are still in network, do
20:33
everything in your power to hold those
20:34
insurance companies accountable to the
20:36
best of your ability and continue to
20:39
remove yourself from the mediator role
20:43
between patient and dental insurance
20:45
company. You can no longer and have not
20:49
been able to for a long time explain
20:52
dental insurance or why they are
20:55
choosing to deny or not pay for things
20:57
as critical as PAS for crying out loud.
21:01
You can't explain them. So, don't try.
21:04
If your patient is frustrated with their
21:05
dental insurance plan, reroute them to
21:08
the source, which is either their dental
21:10
insurance company or their HR company.
21:14
All right, I hope this was a fun little
21:16
episode of real versus not real. Of
21:18
course, if there's any other subjects
21:20
that you're curious about and you want
21:22
to know on a collective level if these
21:24
things are happening, don't hesitate to
21:26
reach out to us and let us know what you
21:29
want to hear about and we can do more of
21:30
these real versus not real realities.
21:34
All right, have a great rest of the
21:35
week. It's been a pleasure to spend some
21:37
time with you today. Thanks for joining
21:40
the conversation today. We hope that you
21:42
are comforted in knowing that you are
21:44
not alone, but we also hope that you're
21:46
walking away with some really great tips
21:49
and tricks to try in your practice.
21:52
We value your feedback, so please take a
21:55
few moments to rate and review the
21:57
podcast. Finally, we want to make sure
22:00
that we're covering the topics that
22:02
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22:07
let us know what topics you want us to
22:09
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22:11
As always, please know that we are
22:13
rooting for you today as you manage your
22:16
dental drama.