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Want to increase new patient starts amid increasing competition? Then it’s time to make sure your treatment coordinator’s scripting is effective with today’s patient. Practice consultant Roger P. Levin, DDS, of Levin Group, joins host Alison Werner to talk about the trends he’s seeing in the orthodontic industry and why today’s treatment coordinator needs a reset. 

  • Orthodontics, and dentistry as a whole, are changing at “rocket ship pace,” according to Levin, and that’s uncomfortable for a lot of people. But if you’re not keeping up and reacting and acting on those changes, your practice could begin to fall behind.
  • Competition is increasing, says Levin. And it’s down to a number of factors: new advances in technology and new service models. Levin breaks down the five sources of competition today’s orthodontist is facing. They include other orthodontists, DSOs, OSOs, general dentists, and pricing.
  • What’s more, the orthodontic specialty is beginning to fragment in terms of success. Those in the top 50% are seeing good incomes and retirement savings. Those in the bottom 50%: They could be in trouble, explains Levin. They will experience lower and more erratic income, as well as low retirement savings.
  • The solution: Having an effective treatment coordinator, or TC. Levin points out that most TCs don’t have a sales background or sales training, when sales is the core responsibility of the job. 
  • Levin talks about how the pre-pandemic orthodontic treatment coordinator is now obsolete. That doesn’t mean the TC should leave. But, according to Levin, “They desperately need to be retrained.” He points out that employees should be retrained at least every 3 years.
  • When it comes to reinventing, or retraining, the treatment coordinator, Levin offers tips for rebuilding from the ground up. To start, today’s treatment coordinator needs to excel first and foremost at building relationships. The goal at the end of every new patient appointment should be to have a parent or patient say, “I want to be a patient in this practice” and the price is worth it.
  • In this episode, Levin breaks down the 60-minute new patient appointment. But he’s quick to point out that the TC process doesn’t start when the patient/parent walks in the door. It starts on the new patient phone call. That phone call begins to shape how the patient/parent sees the practice. Levin offers advice on scripting that call.
  • Once in the office, Levin breaks down the new patient consult into chunks, starting with the TC interaction with the parent/patient. Here, the goal is to get to know the patient/parent. Find things in common and understand why they are there. From there, Levin lays out the orthodontist’s role in those 60 minutes and how it should also be scripted.
  • Levin also talks about the importance of offering patient financing to new patients, even if your practice offers monthly payments. OP

Roger Levin
Podcast Transcript

Alison Werner 0:07
Welcome to the orthodontic products podcast. I’m your host Alison Werner. In this episode practice consultant Dr. Roger Levin from the Levin Group is back with us this time to explain how to increase starts by improving the TC or treatment coordinator process in your orthodontic practice. Here’s our conversation.

To get started, let’s say let’s actually talk about where the orthodontic industry stands today. What are the trends you’re hearing about or seeing?

Dr Roger Levin 0:31
Well, you know, it’s really interesting, I encourage orthodontist to be very open minded about thinking about trends, because for many years, and I’m a general dentist, I’m a third generation general dentist. So I’ve got a lot of dental history. And by the way, I never did a single ortho case when I was in practice, so everybody can like me. But but the reality is Dentistry was a slow changing field. We had innovations, we had advancements, but now it’s like any other business. We are changing at rocketship pace, and that’s uncomfortable for a lot of people. But if you’re not keeping up and reacting and acting on those changes, the practice could begin to fall behind. So what I’m seeing is shaped mainly by one word competition, competition is increasing, due to new advances, new technologies, new service delivery models, which we can talk about at some point. But basically, we believe at the Levin group and we have a lot of data. But we also have a lot of anecdotal information from conversations and calls and people we talked to and clients, we believe the orthodontic specialty is beginning to fragment in terms of success in practice, and that there’s a top 25%. And when we look at the top 25%, they will have higher incomes and higher retirement savings than ever in history. And the next 25% the second bucket will have very good incomes, and it’ll take them a little longer. But they’ll have Okay, retirement savings. Now, that’s the top 50%. And if you want to be in practice today in ortho, you want to be in that top 50% Because the third bucket down will have erratic income and low retirement savings. And the fourth bucket down will have low income and low retirement savings. So this is what we’re seeing. We’ve been we’ve kind of had this model that we predicted, and it’s beginning to happen. So you want to be in that top 50%.

Alison Werner 2:39
Okay, so then how are these trends affecting new patient starts?

Dr Roger Levin 2:45
What what’s happened with competition, let’s break it down a little bit. You’ve got different types of competition. And for any orthodontist listening to this, that’s uncomfortable, don’t shoot the messenger, please. You know, we’ll see how this all plays out. But I think this is what we think is going to happen today. competition comes in many forms. Number one orthodontist competing with other orthodontist I got off the phone two hours ago with a very successful orthodontist, doing very well financially, but he said, I need to reach out more to my referring doctors, I’ve been ignoring them for a couple of years. And my practice is fine. But I’m concerned that if I don’t start reaching out to them, I’ll lose some of the that segment of referrals. So number one, so now he’s going to be a bigger competitor to the ortho other orthodontist in his area, so to speak. So competition from other orthodontist number one, number two, competition from DSOs. DSOs love ortho. It’s high profit margin. You can do a lot of volume, their business people they understand this. Ortho is their favorite specialty to bring in. And the number of orthodontist and DSOs is going to grow, I think fairly rapidly. And along those lines number three are OSOs. The orthodontic only support organizations, they’re all ortho. Right now, some of them are only okay. They don’t have great management, they don’t help you enough with your practice, but they’re gonna get better all of these organizations will improve. They’ll get more MBAs you know forget whether you like them or not. That’s not relevant right now. They’re gonna get better and better. general dentists. Now this is the most fascinating of them all and I want to make some very key points. Yes, orthodontists are now competing with general dentists because of aligners, a GP. Most of them who know nothing whatsoever about ortho can start doing aligners because most of the treatment, the way they see it, the way it’s being sold to them is in the trays with artificial intelligence. Having said that a lot of Orthodontists are giving up on GPS and that is a A horrific mistake. And some people hearing this are going to say, Roger, you’re wrong. We hear this a lot the GPS in my area doing all the ortho. But as you saw Alison and our survey, our annual orthodontic survey that was published with you, in your magazine and online $3.6 billion, billion with a B, each year of revenue are being sent to orthodontic practices by general dentists. 3.6 billion. Now, it may have been higher five years ago, I don’t know, we weren’t doing the survey then. But 3.6 billion is a big number. And if you’re not getting GP referrals, it’s because somebody else is so competition is growing. And then the last number five is price competition. And I’ll be very specific just because it’s a fact Aspen dental has well over 1000 practices today. They’re offering aligners called motto M-O-T-T-O to their $1,999 The last time I checked, and you leave that day with your first set of trays, so you’re now locked in. So we’re going to start to see through advertising more and more parents or patients wondering, should I pay the $19.99 or the $5000 or $6,000 in the orthodontic practice, but optimistically, ortho practices can win. There’s a huge way to win this game for many, many practices in that top 50%. But you’ve got to be proactive, and you’ve got to make it happen.

Alison Werner 6:36
Okay, so I would imagine one of the ways to win is making sure that you have an effective treatment coordinator, or TC, yes. So what should a TC be doing today to work effectively in this environment to overcome these new challenges?

Dr Roger Levin 6:52
So let me let me just start with with a quick anecdote. I was talking to an orthodontist last week, who I know very well, we we’ve worked with him several times. We’re working with him now. And he’s got a $4 million. He has two offices doing $4 million. So that’s a good practice, you know, by any stretch, and he’s a great guy, and I love to talk to him. very visionary. And we’re talking about economics. And I believe, you know, I love economics. I study economics. I try to look at everything economically. But the older I get, I am convinced that the economic law of supply and demand is the greatest law ever created. If you have a small supply of orthodontists and lots of patients, you don’t have to do much, you’re going to be very successful. That was the nature of orthodontics until about the last 5, 8, 9, 10 years. But definitely today, today because of competition that’s reshaping the orthodontic industry. And we’re, we’re at the very beginning. So an orthodontist who says I’m not seeing that. You’re right. You might not be seeing it, but it doesn’t mean it’s not happening. And that’s my not a warning. That’s my statement to orthodontists, get going now. So you can be successful, stay successful and have a great career. And you can, but one of the keys is the orthodontic treatment coordinator. The truth is that most of them and I have great respect for the staff. But most of them were okay. They didn’t have to be experts. Not most of them had no sales background, no sales training, no previous sales jobs, they were just catapulted into what is now a sales position a an orthodontic treatment coordinator has a single word job description, sales, they should have a single goal 500 or 300 or 600 starts a year, whatever it may be. And the the orthodontic treatment coordinator of the pre pandemic, I think is now obsolete, that person is now hurting the practice. Now that person doesn’t have to leave. But they desperately need to be retrained. And I remember a professor at Harvard Business School saying, in today’s world, he meant every industry. If you’re not retrained every three years, you’re obsolete in your job.

Alison Werner 9:18
Okay. So then you mentioned there that you know, the treatment coordinator that existed before the pandemic is obsolete. So can you talk a little bit more about how you think the job has changed?

Dr Roger Levin 9:30
Yes, one of the business terms I love is reinvention, we have to reinvent the orthodontic treatment coordinator. Now some things can be fixed. This cannot be fixed, you need to start over. And in other words, we’re not going to fix this treatment coordinator. We’re going to rebuild from the ground up and the treatment coordinator today has to excel first and foremost in building relationships. Sales in orthodontics are about trust. This is not making a decision to buy a new pair of pants. This is not making a decision, what restaurant am I going to eat in this week? This is a health care decision and an expensive decision. Both are very important factors. And the goal of the new orthodontic treatment coordinator is very simple. At the end of the appointment, you want the parent or patient to say I want to be a patient in this practice, not I can afford it. So I’ll do it here. Not it’s near my house. So I’ll do it here. But you want that parent or patient to literally say to themselves, I want to be a patient in this practice. And it’s worth paying orthodontic practice fees to be in this practice.

Alison Werner 10:45
Okay, so then what is the outline of the process that an effective TC can have in this environment.

Dr Roger Levin 10:53
So understanding this is really easy. Doing it’s hard, but understanding it’s easy. It’s a 60 minute appointment. Now, first of all, I’m going to tell you things that you might not hear in other articles, read in other articles, or hear and other webinars or seminars. The TC process begins with the new patient phone call, and the TC is not on that call. That phone call begins to shape, the image, the brand, the feeling feelings are so important of the new patient caller or the parent. So you need scripting. I can’t stress enough I don’t after all these years I I can’t stress enough that your success comes from having systems and systems success comes from great scripting. If you don’t have scripting, you’re going to have trouble making this transition. And for the first time, Alison, we’re getting a lot of calls and this is anecdotal, but I’m a big believer in anecdotal evidence. We’re getting a lot of calls from orthodontic practices that are in decline, some 10% some 50%. Now, many are still growing. But if you want to keep growing, you need to take new steps a script out that new patient phone call and make it about welcoming the parent or patient to the practice, not just scheduling an appointment. Everything should be about relationship when they come in the 16th. Once the treatment coordinator brings them back to a consult room, the 60 minute time time clock begins. But the first 10 minutes is completely on getting to know the parent or patient. Who are they what do we have in common? Where do they go to school? We have tons of kids from that school. Why? Why are they interested in orthodontics, and by the way, it’s very important to recognize that the only reason most parents or patients want orthodontics is one singular thing, a beautiful smile. They don’t care about rotation. They don’t care about periodontal, they don’t care about axial forces. They care about spaces from the aesthetic standpoint, only mother and patient want a beautiful smile. That’s why they’re there. So we have refocused the entire appointment around building beautiful smiles unless they bring up something else. After 10 minutes, the TC starts talking and she reinforces why the orthodontic practice is the right place for this parent or patient. What is an orthodontist, their parent their patients who don’t know that an orthodontist is not just a general dentist that only does ortho. They don’t know there’s a special residency, we have to build value now for that higher fee that we’re going to be telling them a little bit later. Or they may wonder through advertising, why don’t I go somewhere else and get this for $1,999. So the first part of the appointment is relationship, you need a very friendly person, you need a person that likes people, you need a person that can do five, six or seven new patients a day and still be on that each new patients the beginning of a new party and you want to have a great time. That’s part one. Now we build the 60 minute appointment minute by minute script by script. We can take a TC and in a very short time teach them the scripting to go from this to this to this that three minutes here two minutes here four minutes there to build that relationship. And one of the keys is get to know the parent or patient on a personal level. The next step is what is answering the question why this orthodontic practice. Talk about your brand years of experience advanced technology, why you can do it faster, why they may not have to come in as often. Whatever your attributes are, you build them into your scripting. And then you take whatever records you need and if 30 minutes, the orthodontist comes in for exactly 10 minutes. Why exactly the if the orthodontist stays longer than 10 minutes, you start creating more questions than you’re answering. And you actually will lower the start rate of that TC. So the Orthodontist but the orthodontist doesn’t just get to come in and be a doctor. Meaning Well, I’m the doctor. So I’ll just come in and everybody’s going to be impressed with me. Know, the orthodontist is also scripted. They come in, they they read, they meet first with the TC for two to three minutes in the hall. They go into the room, they they reference personal information, they tell the mother and child how it’s wonderful to have you here. We’re delighted you came in, you make them feel really good. You look in the mouth, you look at the records, you and then the main job is to tell that parent or patient, this doing orthodontics will be fantastic for you. And your result of a beautiful smile is going to be excellent. That’s the entire messaging. Repeat that messaging three times we’re very big at levin group on the number three, three reinforces it, people get it after three, and three is about all they can handle, the orthodontist leaves. And the the treatment coordinator then reinforces how great the orthodontist is how nice it was to meet that him or her, and then asks for questions. Because they’re often questions they don’t ask the doctor, or they haven’t thought of yet. And now the TC is their friend, make your patients your friends, what am I biggest statements at Levin group, make your patients, your friends? And you answer the questions and you get them comfortable. By the time you’re talking money. It should be over before you ever even tell them the fee. They’re now saying I want to be a patient in this practice, then it’s a matter of just working out the financial options. One quick comment, you need to offer patient financing. And a lot of Orthodontists hate this because you give up a little bit of your fee. So they think well wait a minute, why do I have to offer financing, I’m already offering a payment plan. Two reasons. There are people today that cannot afford your downpayment. And there are people today that cannot afford your monthly payments. If you don’t offer them financing, they’re gonna go somewhere else, then the key is to get them to make the appointment to start. If they make that appointment, you have an excellent chance they’re going to follow through. So that’s the anatomy. We follow. But it’s very, very detailed and easy to train and that builds your new TC going forward.

Alison Werner 17:42
Yeah, that’s really helpful. But so my next question is what about for Orthodontic practices? Don’t that don’t have a treatment coordinator on staff? How does the orthodontist need to go about doing the job?

Dr Roger Levin 17:53
Yeah, so So I’m a dentist. So I can kind of say this, we dentists, sometimes overestimate our position as doctors. And you know, when I went when I first came into practice, many years ago, if you walked in a restaurant said, I’m Dr. Levin, they moved you up on the reservation list. I mean, there was it was a whole different view. So today, yes, people respect doctors, and they should and they are nice to doctors, and they appreciate doctors and they should. But at the same time, a doctor cannot walk in to do the consult on his or her own. And just assume because I’m a doctor, they’ll automatically trust me. Because this whole thing comes down to trust. If the parent or patient trusts you, they’re going to want to do the orthodontic treatment in your office. And they won’t wonder why they have to pay more because they’ll know what an orthodontist is. They’ll know what happens if there are problems that have to be corrected. They’ll know that you’re going to get them that beautiful smile. But a lot of orthodontist just come in orthodontists are really nice people I have never seen a scale but I’m gonna guess on a scale of 1000 different types of professions orthodontist would be pretty high up there as super nice people, and they want to have fun, they enjoy the work they do. But having said that, nice is not enough. You’ve got to make a presentation. So you need to follow the same process that a treatment coordinator would follow. Or you’re going to have a lot of patients shopping second practice third practice general practice DSO so don’t assume just because you’re a doctor, you have credibility. Assume that because you’re a doctor you need to do the same thing that the TC would do and go through TC training to learn how to do it now. What you said at the beginning is really powerful Alison and I know you know ortho inside and out. You’re better having a TC. I’ve made this statement for years a good TC can outsell an orthodontist every time because they take more time. They schmooze better they relate better remember, 80% of kids are brought in by a mother and therefore by definition a woman and most and I don’t know the number, but probably 98% of TCS are female. So there’s there’s the beauty conversation, there’s no male TC’s don’t always look at a child and go, Oh, your daughter is beautiful. But women do this all the time. We women are so much better at this than men, and more open and we’ll talk more about things men don’t talk about. So having a good TC, I think really advances a practice tremendously.

Alison Werner 20:41
Okay. Well, I’d like to thank you for this. I think this has been really helpful in kind of breaking down where what a treatment coordinator needs to be doing today, given the thing back that things have changed. So thank you so much for joining us, and you will be back with us soon for another episode. To our listeners standby for that. Definitely. But thank you so much.

Dr Roger Levin 21:00
Thank you, Alison. See you soon.

Alison Werner 21:02
As always thank you for joining us. Be sure to subscribe to the orthodontic products podcast to keep up with the latest episodes. And be sure to check out orthodontic products to keep up with the latest industry news. Until next time, take care