The Subtle Trap Undermining Your Practice's Success

Your front desk can look busy all day and still leak production, profit, and patience. When phones, check-ins, insurance questions, and balance collections are treated like one giant job, “urgency” wins every time. The ringing phone gets answered, the insurance fire gets put out, and the real growth work quietly disappears: filling tomorrow’s hole, following up on that $10,000 treatment plan, and building systems that keep the practice steady even when someone is out.

We walk through a cleaner way to think about dental practice management by creating levels inside your admin department. Foundational front desk skills can be trained fast, which means you can hire great people with the right attitude and communication even without deep dental experience. From there, you intentionally develop advanced roles like insurance, treatment coordination, and true leadership. That structure gives your team a path to grow, makes onboarding easier, and stops your practice from depending on one superhero employee who “knows everything.”

We also get honest about the office manager role. Promoting the best insurance expert and changing nothing else is not management, it is a title swap. A real dental office manager needs protected time to coach people, track KPIs, improve systems, and drive proactive work that increases case acceptance and reduces schedule chaos. If you want a front desk team that scales, you need clear ownership and redundancy so every critical function has at least two trained people.

If you found this useful, subscribe, share the episode with another practice owner, and leave a review so more dentists can find the show. What role on your admin team needs the clearest definition right now?

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Transcript

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Why The Front Desk Feels Swamped

Paul Etchison 1:40

Does your front desk like always seem overwhelmed? And it like doesn't matter how many people you have up there, no matter what. I mean, the phones are ringing, the patients are getting checked in, somebody's got an insurance question again, and someone's collecting a balance. There's a big giant hole in tomorrow's schedule. And we got all these patients that we saw last week that still haven't scheduled any of their treatment. And where's your office manager? Well, they're either sitting right there at the front desk or they're over in an office doing some, I don't know, insurance stuff, something, something that office managers do. So you start thinking, man, I need some better people up here, or I need another person that has more dental experience, somebody that knows how an office runs. And you probably already have that one person who's just absolutely amazing. You know who they are. They know the insurance, they know how to present treatment. They're that person you go to when you got a big treatment plan. They know how to fix the schedule, they can be proactive, they handle your angry patients for them. So you're so thankful. I mean, they they know how to do everything. And anytime anybody has a question, they always go to them and you know you can count them, which feels great, right? Until that person takes a vacation or they're sick, or even worse, they quit. And suddenly you realize that your entire admin department has been built around this one person that knows everything. So here is what I have learned from working with offices for so many years now is that a lot of the problems you think that you have with your front desk, they aren't actually people problems. They're structural problems, they're system problems. Uh, you haven't clearly defined the different positions up there. You haven't clearly divided the responsibilities, and you haven't created backups or the a pathway for people to grow. And you say to yourself, Well, I'm too small. I don't need that yet. That makes sense for you. Actually, you got a big office. But I promise you, this makes sense in any size of office because you've got some of your most talented, most expensive people spending most of their day with their heads buried in insurance work that somebody else with a few weeks of training could probably handle. So today I want to show you a different way to think about building your admin team. Because when you intentionally create different levels of responsibility, you can hire better people with less dental experience. And you'll even retain your most talented people even longer. You're gonna create redundancy so that your practice doesn't depend on that one person. And finally, you will allow your office manager to actually manage the practice instead of just being that office manager by title. So that's what we're gonna teach you today. It's gonna be a good one, and I know you're gonna love it. Now, you are listening to the Dental Practice Heroes podcast, where we teach dentists how to be the CEOs of their practice, empower their teams, and build a practice that runs without them. Now I'm your host, Dr. Paul Etchison. I'm a practicing dentist, I'm a dental business coach, I'm the author of two books on dental practice management, and the owner of 11 op practice in the south suburbs of Chicago, collecting nearly $6 million annually, while Paul just practices one or two days each month. And I want to teach you exactly how to do the same. All right, let's get into it.

Stop Treating Admin Like One Job

Paul Etchison 4:50

Now, I think we make a huge mistake when we think of the front desk as just this blanket, one generic position. Because think about this: like answering a phone and checking someone in, that is a completely different skill set than understanding all the nuances of dental insurance. And understanding dental insurance is a completely different skill set than like sitting across from a patient and presenting a $10,000 treatment plan and identifying what's holding them back and handling their concerns and helping them figure out how to make it work in their life and move them forward. Those just aren't the same jobs. Yet, in so many dental practices, we hire somebody for the front desk and basically tell them eventually you'll need to learn all of it. And we wonder why everybody up there is so overwhelmed. So, a lot of your front desk problems, they're just not people problems. That's like the easy escape. That's what we want to say. I really believe that they're structure problems. Before you replace anybody or you add another salary to your already big payroll, um, look at how much you've actually like put some like effort into designing that department. I mean, do people know what they own up there? Do you have different levels of responsibility? Do all of the big critical responsibilities have a backup? Are your most skilled people spending their time doing the most skilled, highest value work that they could be doing? Or is everybody just doing everything, right? And that's how most offices are. But I want to hammer this home. You don't need everyone to know everything. What you do need is clear roles, you need trained backups for things, and you need a path. You got to create a path for people to grow. Now, you know that at Dental Practice Heroes, we are always about the mindset beneath everything. The mindset shifts that we need to get people to do the things that we expect them to do without using intimidation and write-ups and all that stuff. We want them to do it because they want to. So here is your first mindset shift from this episode. I want you to stop treating the front desk like it's just one job. There are different levels of skills that are required in your admin department. There are the foundational, like these entry-level, the foundational admin skills. And these can generally be taught, I mean, pretty quickly, right? I mean, the answering the phones, checking patients in, uh, basic just collecting of balances, basic scheduling, just patient communication, handling some questions. And that matters that we create that sort of position there because that gives us an opportunity to hire differently. Now we don't necessarily need somebody with five years of dental experience because we're not expecting them to do all that stuff. So you can find somebody that might work in a different industry that just has great values, a great attitude, maybe a really strong communication skills. And all they have to have is a willingness to learn and we're golden, right? You can train the dental skills. And now you've created this position that's very entry-level where you can start to find talent. Now, don't hear me wrong. I don't want to say it's an easy job out there, but I'm saying that there are responsibilities that are easier to learn. And there's some responsibilities

Hire For Attitude Then Train Skills

Paul Etchison 7:48

that take a lot longer to master, like insurances. You know, we to all the little nuances of insurance and treatment presentation, right? I mean, that takes a special skill and a special person, and it can really make a big difference. I mean, think about this. Most treatment coordinators, what do they do? Most like most people at the front presenting treatment, they go, Well, here's your treatment, here's what your insurance pays, here's what you're supposed to pay. Do you have any questions? No, did you want to schedule? And they say, No, I'll let you know. And they cool, I'll let us know. Thank you so much. If you have any questions, call us. But see, that's not a great treatment coordinator. A great treatment coordinator is part of the case acceptance process. They're identifying the hesitations, they're using their curiosity combined with what I like to call power questions to go fishing for objections so that they can address them. They're figuring out with the patient what is the barrier? Is it money? Is it fear? Is it time, trust, uh, urgency? Did we not create enough value in the back? They are doing more than just presenting the treatment and the financials. They're helping. They're helping that patient understand what their options are and essentially giving the patient everything they need to make an informed decision. So, in my opinion, your treatment coordinator, they cannot fix crappy case presentation in the back. If the doctor can't effectively talk about what treatment is needed and create the urgency for the patient, the treatment coordinator is not gonna save it. But in my honest opinion, I think the treatment coordinator is really responsible for about 30% of the sale. And the reason I say this is because we've worked with offices and trained these positions, and we've seen the bottom line results that it causes when you arm somebody with the proper skills that's already good at that. You make them even better. But pretty much every office that I work with, I mean, they're just completely missing it. And that's why they want more new patients because they just say, okay, well, I just need more new patients to come through because I don't want to work on my case acceptance, or I don't even know where to start with working on my case acceptance. So it's just easier to try to get more new people and more new patients into the office. But I promise you, and this is so true. If you spend a little bit of time here, just spend a little bit of time working on this position, it is so much more valuable than more new patients. And dude, it's so much easier to do. So, big idea here. If everyone at your front desk is expected to do everything, what does this mean? Well, it means that your highest skilled person or your highest skilled people, they spend way too much time doing work that somebody else could learn in a short period of time. So you're not utilizing them to their fullest

Treatment Coordination Drives Case Acceptance

Paul Etchison 10:13

extent. Now, I also see in a lot of offices that they will build everything around one person. I remember I had one client on the East Coast years ago and she lost her main person. And then we watch the AR climb month over month, two, three, four, five, six, seven months. And I remember the owner is just stressed, and she takes out a home equity line of credit so that she can pay her team. Now, we're producing just fine. We're doing great, but nobody's sending the claims, nobody's working the AR, and it's just getting worse and worse. And what do you think the stress level is for this person running this practice? I mean, they're feeling like a complete failure. The team, there's nothing to celebrate anymore. I mean, everyone's everyone's stressed out. And the only solution then is to either find somebody to come in here and fix this with a lot of dental experience or try to train somebody up from zero, which it's really hard to train from zero if nobody knows how to do it. So somebody has to know first. And the thing is about this person's office and the story is that this person they lost was working with two other people at the front desk alongside 40 years. So you would think these other two people knew what this person did. So if this person was ever to quit or leave, like they did. No, they didn't know any of it. They had their problem solver, they had the person they could bring every issue and would solve everything. And no one was emphasizing training any of the other people. So this one person had like a monopoly on all their work. And when they left, the practice just lost all those skills. It lost all the knowledge. Just like that, you know, that old story of that ancient library in like um something like Egypt. I don't know, Alexandria or something like that. Remember, it burned down and like all the scrolls were gone. That's what happened to this person's practice. Now she eventually did find somebody with enough dental experience where my team could work with that person and get them up to speed. And we created the positions, we created the onboarding program at this office. And guess what? You know what we did? We sent those two long-term employees through the same onboarding program as the new employees did, so that this was never ever happened again. And everything worked out, but man, I mean, it was a solid good seven to eight months of stress that really wasn't necessary at all. So don't let yourself get in that position.

The Danger Of One Person Knowing All

Paul Etchison 12:25

So, Edge, are you saying that I'm supposed to train everybody up on everything? No, that's not what I'm saying. You build redundancy, but you don't have to make everybody an expert. You don't need six people who are equally great at every single task, but you do need at least two people capable of handling every single critical function. And your strongest people, they need to understand that though it is important to be the problem solver and be that person for the team, part of being a valuable team member is multiplying themselves. They need to teach someone else how to do what they do so that we have a backup. We have to develop the next person. See, your best employees, they shouldn't just be great at their job. They have to be great at making everyone around them better. And doing this actually protects that person too, because now they can take vacations without getting bugged and texts from the office while they're on vacation. And they can now get focused work done when they're at the office. Because let's face it, this is how it is at your office right now. Tell me if I'm right. This person is constantly interrupted all day long and they they get taken away from what they are really, really good at and they feel like they're carrying the entire department. But I promise you, they're dragging the department down. And it's not their fault, it's just the way it is if they don't multiply themselves. And eventually, if that person leaves and they don't multiply themselves, the knowledge, the skills, it's gonna walk out the door right when they walk out. So know that you've got strong people on your team. These people have special skills that need to be multiplied. Also, you want to protect them from doing low value work. And this is where the structure really starts to affect your profitability. When everybody does everything, urgency will always win every single time. The phone that rings will feel urgent, the patient standing at the front desk feels urgent, the insurance problem feels urgent, all these things are urgent. Meanwhile, who is following up on that patient that came in the other day that had a $12,000 treatment plan? Who's trying to fill that two-hour hole we have tomorrow? Who's trying to find out why Mrs. Jones didn't schedule the other day? Who's looking at the KPIs, making sure that our cancellation rate, who's developing the team, asking questions, being proactive, who's improving the practice? Those are the things that don't scream for your attention. So they won't get done because urgency is going to win. But the thing that's crazy about it is all these urgent things are keeping your best people from doing the activities that have the greatest potential to grow the practice and recover that lost production and income. So, I mean, your team, I mean, they can be super busy. We're not saying that they're lazy and they're not doing their jobs, we're just saying they can be incredibly busy, but not make any progress and really ignore the work that moves

Urgent Tasks Crowd Out Growth Work

Paul Etchison 15:03

the practice forward and lose a lot of opportunities. And man, man, man, does this happen with office managers? Oh my gosh, right? Somebody at your office knows insurance better than everybody else. They've been there forever. Everybody brings them the questions and they're reliable and they can deal with it. So then we say, Congratulations, you are the office manager. And guess what changes? Well, nothing about their job changes except for their title because they're still doing insurance, they're still answering phones, they're still fixing the schedule, answering everybody's questions, putting out all the fires. And now what's different? Well, they just have a different title. I mean, that's not management. I'm sorry. I mean, it it's that's just not office management. A real office manager needs time to be proactive. They need to be going out of their way to have conversations and develop people. They have to follow up on things, they got to look at the KPIs that you assign them to. They got to get out there in the practice, identify the problems, improve the systems, come up with solutions, and help you, as the owner doc manage the growth. But they can't do that if you don't set up their role right. So just because they know the most about insurance doesn't make them an office manager. I mean, managers manage people, they manage systems, they manage the growth. And that's one of the things I really love about our coaching programs is we focus so much on helping you create and train your leaders, especially your office manager, so that they can manage. Because I know as a dental coach, if I can get your office manager to behave like a true office manager and give them the skills they need to be effective at it, I have just multiplied you. And if I can create more leaders around that person with you, oh my gosh, what can we accomplish? So remember, when you promote somebody to office manager, you have to remove their old responsibilities. They have to train somebody else to take on their old responsibilities so that they can be freed up for that proactive stuff that's gonna move the business forward. Because if you don't do that, you didn't create a manager, you just created an overwhelmed admin employee that has a really cool sounding title, right? So,

What A Real Office Manager Does

Paul Etchison 16:59

what does the structure look like? What should it look like? Now I'm not gonna go too deep into like the details of this because it's always gonna be different based on the office size. But conceptually, what we're trying to create is some sort of ladder at our office. We got our entry-level admin that's gonna be doing like the check-in and the very simple things. Then we're gonna start learning the insurance. And then when someone learns the insurance, now they can present treatment. We teach them how to properly present treatment. And it's not hard, but it's really difficult when you have zero training and how to properly do it. Like I said, we've seen it happen in so many offices. We train the treatment coordinators and we're like, holy cow, look at our case acceptance. And then eventually, you know, the leadership positions like office manager or other leads. And not everybody has to follow that progression. You don't have to climb the ladder. I mean, the idea is that there's somewhere to progress to and that you've created an entry level so that you can see who develops these skills, who's got, who likes doing this. You know you have those people on your team that like to present treatment. They enjoy it. And you know you have those people on your team that hate it, they hate talking about money. So why are we having those people talk about money? Either we're gonna teach them how to do it or don't have them do it anymore. Because I love having just someone focus on treatment coordination, because then you can pay those people better. You can give, you can incentivize them, you can protect their time and just focus on the things that make a big difference. And you get to build them. It's so much better to pour quality stuff, like just quality effort into one person to get really good at one job versus spreading it and diluting it across everybody so that everybody just kind of gets proficient at it, but no one ever really gets really good at it. So if you're thinking about your admin team and you're like, dude, they are constantly overwhelmed. I I want you to not immediately assume that you need better people. Look at the structure in your office, okay? Define your levels. Don't treat the front desk as just one job. Find out what the foundational responsibilities are at your office, how you want to train people, how you want to onboard them, and how you want to specialize and have that manager, if you have that manager position, have that person doing true management responsibilities and create redundancy. Every critical function that I'm talking about claims, the insurance stuff, the verification, all this stuff, every critical function needs to at least have two people that know how to do it. You can't have anything in your office that only one person knows how to do. So your strongest people need to understand that while they are strong and while everything they do is fantastic and great, and we're so appreciative of it, but part of what we need them to do is to be developing their backups, building up the bench. They can't keep themselves the permanent rescuers. We need to build up the rest of our team and protect the high value work. You know these people are good at that. So don't let your highest value people spend their entire day doing entry-level admin work. Don't let your office manager spend their entire day reacting to things. Give your highest skilled people, give them the space to do the work that actually moves the practice forward. Because a great admin team, it's not built by finding these magical four or five people that just can do everything. It's really built by intentionally creating the positions and and the responsibilities around them and making sure you've got that redundancy, building a pathway for great people to grow in your organization. And if you're listening to this and you're thinking, yeah, we don't have any of this stuff clearly defined, we're screwed. Well, guess what? This is exactly the kind of stuff that we

Build The Ladder And Add Redundancy

Paul Etchison 20:21

help with our coaching programs. It is designed for this, and we've done it so many times. We've got it down to an art. And man, am I proud with what we're doing and the results we're getting with our clients right now. So if that's something you want to discuss, you want some help with that, go to dentalpracticeheroes.com/slash strategy, book a strategy call with me. We will talk about where your practice is right now, where you want it to go, and I'll give you some ideas and what might be keeping you stuck and what you can do to get unstuck. And if you've been enjoying these episodes, man, I really appreciate if you took a minute to leave the podcast or review. It really helps other people find the show and it makes me feel so good. I just like it. You have my word that I will read your name on the show, and I promise you, that's gonna be your big break, man. I mean, you remember that modeling or the acting or the remember how you wanted to be a singer growing up? Oh man, when you were a kid. Well, I dude, I'm I don't want to brag. But a lot of famous people and like celebrities that you've heard of, they've gotten their big break just by leaving a review for the Dental Practice Heroes podcast. And just, you know, just do it. I mean, write nice things about me and the show, and and then just um I mean, when you when you make it big, don't forget about me when you're all famous and stuff, right? I mean, don't forget how you got there, bud. Well, hey, I really appreciate you taking some time out of your day to listen to this

Strategy Call And Review Request

Paul Etchison 21:40

and to make yourself better. Get in the office, take a hard look at your practice today, take a hard look at your front desk, and start thinking and strategizing. How can we improve this? This is such an area of opportunity in so many people's offices. And if you need help with it, reach out to us. Thanks so much for listening. Take care, we'll talk to you next time.