Your Ideal Patient Avatar

what's up everybody and welcome to another exciting episode of the automatic patient podcast I am your co-host today Jordan Comstock with me I got our new co-host Dr Dan Nelson Dan what is up man living the dream just I'm excited to be here dude this is cool like uh you know one of our tenants is uh uh our core values is collaboration so let's put some money where our mouths are yes I love collaboration that is how I built my entire company from the ground up

without investors it's all collaboration so no this is fun I'm excited to have you on ongoing now we had a a great episode uh several times ago with you guys and I'm like man I really need to be recording more with with you guys so today we're gonna be talking about a lot of cool stuff we had a a a pre-episode meeting and we discussed some things Dan is seeing and things that I'm seeing running my own company um so first of all Dan let's let's

let's start off with some proper introductions introduce yourself and kind of talk about why you find passion in in in talking Dentistry with with me and and we'll go from there yeah man so um I mean I've been in the game for a little while I've seen a couple of uh of of things over the few last few years I I actually came through Midwestern University that was my education my my dental education I loved it there um and uh we were in the inaugural class

so that was a wild ride but end It ultimately it was really fantastic and um I decided to go Air Force uh to help pay for school I've got a lot of motivations on why I did air Air Force but uh I got a friend that just did that yeah it's a good way to go man anybody ever wants to talk about going the military route they can reach out to me I'd love to give them some insight um but yeah I went I I decided

to do an AEG uh so I did that through the air force as well went to Nebraska did a a residency there love that that was a a kick in the pants and uh learned a lot and uh got station in Japan for a while I I H my skills in Japan um working on our our awesome uh active duty members and their families over there that's cool um yeah it was uh uh uh it was rad and then you know I had a really cool

opportunity kind of fall in my lap I wasn't expecting it my partner Jared Hill reached out um well it was kind of funny he didn't actually reach out I won't get too far into this story but just some Serendipity we ended up together through a very odd meeting in Tokyo I met with one of his buddies that that really yeah it's a it's it's a wild story but yeah just things the Stars lined up I moved out to Sun Valley Idaho and I bought half this

practice we we own and operate Wood River Dental Care in Haley Idaho which is part of Sun Valley and uh we've been here since 2016 so eight years now and uh dude this is this is the A rad place to be and now we're just chasing the dream so um because of that Synergy that that you know uh that collaborative effect that Jared and I had um through another crazy s ious series of events uh we ended up meeting our our elevation Association partner Ryan passy

who uh brought you know call him a numbers wizard yes a wizard dude everybody needs a wizard on their team like yes I have one of those yeah right yeah I do it's too hard without a wizard there's it's there's too many things going on in this world yeah not have a wizard if you don't believe me just watch uh you know The Lego Movie anyway so we we brought him on um actually as a business uh manager for wood rer dentl but his skill set

was so astounding that we were able to bring an a missing component to Elevation Association and EA was born and then from EA from elevation Association we created this crazy 501c3 nonprofit called the foundation so um I'm just burning the candle at both ends just yeah you're busy but it's now you're doing a podcast with me yeah man yeah this is this is the fun stuff like this is I seek out and that's the thing Jordan is that and I think that everybody needs to understand

that that listens to the show is that we're facilitating the reason this show exists and the reason that we're doing this is to facilitate and enable people to to live their best life to literally like Chase those dreams and make it happen and and allow their business to serve their personal lives not not be a slave to the job like you know and if you are buried in po you know rubbish you're not gonna be able to see through it and and really chase after the

things you want you're you're going to be married to a very uh scornful and evil and mean uh po spouse Insurance house not a good marriage Insurance not a good marriage no uh we share a very similar Vision on that we're helping practice owners live their best life I so my story for those that I mean I'm sure our listeners know cuz you heard enough of me uh which is why I'm bringing Dan because he's probably cooler um uh I so I I Deb I used

to own a a dental lab with my dad and and my twin brother who's now with me at at boomcloud which is a software company a dental software company that helps practices create patient membership programs um but years ago I very similar to your comments of the Poo the bad PP the bad poo spouse in the practice we were feeling the effects of that the dental lab where I remember getting uh calls from our our our practice owners that we were working with and a lot

of them are are our friends right in the we're we're here in Utah and I remember getting calls all the time saying hey Jordan can you discount your guys' pricing because his patient's on a really bad po plan yeah and feeling because it just would the the the pain would roll to the to us at the dental lab I'm like man I really enjoy helping patients but we we need to be able to function as a business or else we're not going to be in business

and I saw as I I mean I was at the dental lab for I I ran that for about eight years before exiting to to start boomcloud and which was great I learned a lot of clinical skills from a you know restor from building Restorations and working very closely with with practice owners it was really really fun I actually really enjoyed it other than the PO conundrum that we were all deal with that just drove me crazy and I got thinking I'm like man if we

could if we could really help practices run run better without these ppos so that they can live a better life because we have you have to keep in mind a lot of our a lot of our customers were friends like I had a best friend from high school who's a dentist that he was dealing with it as well we're like man we got to figure this out dude so we we we figured something out that's helping a lot of practices uh Across the Nation but yeah

I share that same vision with you guys well how can we help more practices achieve more uh success without ppos and live a better life yeah dude like isn't it crazy how I mean crap rolls downhill right and so like their their crappy situation their crappy contract you know with the insurance company like you didn't make that contract you didn't have anything to do with it you know then they're com not even a negotiation or collaboration to core value yeah hey Jordan can you fix our

sucky situation that we've trapped oursel in you know what I mean and it's it's so common and it's not like it's it it's a sucky thing because so many docs think it it's necessary yeah right like they're like oh I'm new or I'm you know I don't have enough patience or and they're focusing on the wrong things scarcity mentality yeah yeah not just that but just like they equate being busy with being successful you know a hamster and a wheel is is plenty busy they're not

going anywhere and yeah that's it's the same thing and now you know and and I wanted to hit on this in this podcast is that you know as far as the industry goes um it's not good right now as far as overhead like overhead we're getting pounded right now in overhead and I don't mean to pick on Labs you know but I mean it's part of it they've got rising cost too yeah and I've got not offended yeah dude it's crazy I've got data here um

that that since 2021 Staffing costs have risen uh as much as 10 or over 10% yeah in some areas it's like 25% I've heard yeah it just depends where you're at we have a client in in h California that this will make some of you guys throw up listening to this he's having to pay his hygienist over $90 an hour just there they can't and he's losing money he knows he's losing money on the hygiene front but he feels like he's beholden to that because he

feels like I don't have patients coming in I diagnose and I can't yeah it's it's part of it is part of the marketing or Revenue funnel a practice so yeah I I get that's that's a scary situation to be in though it's like oh my front end of the funnel is more expensive now which is not not good crazy goods and services is up 9 to 20% brutal brutal and so if you know and it the crazy thing about all that is if you are if

you are stuck in the the the PO quicksand yeah and there so across the board if you look at the national like trend of reimbursements from insurance it's actually going down yeah so overheads gone up insurance reimbursements down down so you have this like pretty crappy situation as far as you know if you're if you're a PO or if you you know if you're in that that Insurance Quagmire that I call it quicksand because it just slowly pulls you down yeah um well it's invisible it's

invisible costs they a lot of practices don't aren't looking at them right so it's it yeah it's exactly what it is it's they just know they're not bringing home as much and they're scratching their head going well how come I'm not bringing home as much as I was I'm working my tail off but I'm not bringing home as much yeah exactly yeah it's Buck Wild dude it's it's it's a it's not good that's for sure and I think you know I think what we can get

into that a little bit and talk a little bit more about you know um the effects of of of signing those contracts and becoming provider for these insurance companies what that does uh and how overhead affects your practice more that way because it's going to have a lot more impact with those those increases are going to affect you much more because you're getting reimbursed less just because you're busy doesn't mean that all a sudden your overheads going down no no yeah that's insane uh those are

interesting stats Dan um so let's let's get started with some of these questions why why do people purchase poo plans from a patient perspective and a why do practice owners sign the contracts let's talk about both man that's that's a great question I think there's I think that there's multiple things that go into why on both ends of it right like so why does a why does a patient say yes put their hand up when they a lot of times it's because they're they're they equate

d mental insurance with medical insurance or even car insurance it's not even the same no it's a bloody coupon you know I've said that in the previous show that we did you you know I equate it to a coupon because that's what it is it's a yeah a lot of a lot of doctors will say that like hey this is just a it's a limited coupon it's not even like a real coupon yep yeah it's one expensive coupon too like uh but I think that the

reason that so many people opt in is that their employers will pay for it you know so it's a it's a perk and so uh when the employee is getting it as a benefit for a company they're working for they just opt in you know and they're like yeah and it's kind of mindless and I think we're programmed say yep I'll take that you know do you have dental yes we do and they don't even know the details of what that means no they don't even

until they go and visit and they say what you only pay 50% of my crown like I have to pay the other 50% and then once this $2,000 or $1,500 in my coupon is used up then I have to pay all of it like it's never explained that way I used to work for an insurance company I can tell you it's not did you really yeah gez yeah we had so go ahead oh I was to say it was my you know shaking hands with the

devil I I was employed by you know I won't say the name of the company but not good things that go on in insurance companies yeah I have several employees that uh also worked at the insurance companies and find uh relief here at boomcloud um I was going to say we uh you talk about the reason why is employers pay for it so here at boomcloud me as the employer we educate them why they don't want to sign up for Delta and we we all of

our employees here have a a dental benefit plan with Dr Anderson from essential dentists and Pleasant Grove we actually should bring him on the podcast he's got he's got a very successful membership program and he he targets like the local uh business scene here in Lehigh Utah Right which is a buzzing business scene and he's done he's done really well but we love to bring him on the podcast to discuss that and what he's done but yeah you're absolutely right people buy it mindlessly because of

of the employer relationship the interesting thing is over because these are like large companies we're we're talking about right now yeah over I read an article the other day that over 74 million Americans lack dental insurance and where does that where do they mostly live well people that are getting ready or are are already retired and then small business land right I don't I don't purchase anything for my employees because well I have a different mindset because I understand how the ppos work in Dental so

we we just don't do that um and and in Optometry too right we have optometrists that use our platform and and we buy Optometry plans for all of our employees directly through the practice right um but there's 74 million Americans that don't have have dental insurance that's a lot which tells us there's a huge total addressable market for practices to uh really optimize their their business outside of ppos with their own plan right so I'm always excited to talk about that stuff so okay employers pay

for it any other any other patient mindset there they just don't understand the difference between medical and yeah I think I think it's and it's it's the path of least resistance for so many of them you know it's like in the in The Busy World if they come to you and say you have dental it's a benefit check the box they check the box move on and so it's it's one of these things that you know um I would say that there's four four main things

to to limit somebody from some type of success right it's arrogance ignorance ambivalence and fear right sure and you run into it all over the place right but this is one of those places where they're mostly ignorant they're ambivalent you know they just don't care it's like okay yeah it it just is something that I think sadly that it's just not there's not a lot of education on it they don't know those Alternatives and they end up in that in that pool of of people that

just like yeah I have dental insurance I'm good you know but then it the mindset you guys every doc that's listening to this knows the insurance mindset and like yes oh does my insurance cover that you know no it doesn't cover anything yeah 1500 bucks yeah it doesn't cover yeah not really yeah that's the answer uh it depends well actually not really I think Jordan I think on the flip side of the coin is why are doc signing up like why are docs like hey yeah

this sounds like a good idea um and I think again it's those it's the same things it's arrogance ignorance ambivalence and fear that those things come into play it is it's so true it's so simple D it's simple but it's think about the things that inhibit us and it's one of those things right yeah um and so I think if you know if you're and you're listening to this and you're like hey that offends me it's because it's true and the the problem was is that

probably fear was one of the great motivators to get you to sign up to become a provider and ignorance was definitely in there because I promis that most of the people that didn't didn't read through all the contract and understand like what goes into a global fee for example like yeah I bet most docs don't know what the heck a global fee is no and all the garbage that gets rolled into a global just to to absolutely neuter your bottom line so and you know on

the other side I this is the thing that we tell with our clients is is like factor in your writeoffs right so one of our golden rules or or or Commandments is never ever ever ever adjust your fees to match that of the reimbursements of the insurance company ever sure because happens a lot yeah all the time because the front Des does it and the doc doesn't even know and and they invisible costs yeah yeah and totally the thing that you don't know then is how

much are you losing you know what do you actually leaving on the table by being a provider and so if someone does that and there are some offices that do um that are good about not not breaking that commandment but just take that write-off amount right and then instead of applying it to writeoffs apply it to your marketing budget marketing budget should be 3% of your total overhead operating overhead yeah if you apply what you write off to marketing you're going to be upward in the

anywhere from 25 to 50% of my that now is is just take that slide that what should be 3% now you're in upward of 50% of your overhead is going into marketing because the idea is well I need to bring people into my practice I need to be P bring patients into my practice and they're willing to sell off 50% of their their revenue right or 50% of their profit yeah of their profit to bring those patients in well sorry that's marketing that's what marketing does

so yeah it has to be this Paradigm Shift of like oh my gosh it's I'm I'm not just you know taking a write off no no you are shifting your money or what you're willing to give up in profitability into this marketing component to bring patients in and you're paying as much as 50% of overhead towards that plus admin costs plus admin costs right there's there's that too yeah that's really interesting that you say that because uh a lot of practices don't think that way um

looking at as a marketing cost or a reinvestment into the practice cost um and and a lot of practices don't understand that when they sign the the data line of the the the evil poo Empire um that the there's such a thing called patient acquisition cost cost and that contract you you will always play pay because of the writeoffs that patient acquisition costs which is a very inefficient and costly way to attract and retain patients to the practice if I had somebody that that like like

our sales team here right and marketing team if every if every new customer that signed up for boomcloud they're like well we're going to take 50% of that revenue for the life of it whether we're working for boomcloud or not I would probably fire them and get rid of them as and stay as far as possible away from that type of mindset because it's like oh you're you're taking you're taking something that yeah I should have like a temporary cost and making it an ongoing forever

cost that doesn't make any sense making it a fixed cost making it a fixed cost that doesn't go away so that's what insurance does so all right that's awesome um what other the reasons do do practice owners buy so we got the fear probably because like I need more patience because I need to figure out how to grow any other reasons Dan I I think that sometimes there's pressure um I think the big one is is either maintaining whether they're buying a practice an existing practice

or they're a startup is the patient base is a big part of it right and so if they walk in and they're like oh you know 70% of our patients are you know are some type of insured you know typical uh traditional insurance they are fearful of losing that base and so they're just going to stay in it um and the other thing that we've noticed Jordan is is that you know this is kind we sound like a broken record with this but Dentistry is relatively

easy to it's it's hard to get there right there's a lot of sacrifice a lot of work but once you're in it yes it is a profit and a revenue generating machine Dentistry yeah oh yeah it's a great business it's a great business and you don't have to be good at business you most most dental schools have a very underdeveloped uh management and business like lineup they don't have they don't teach you much as far as business goes sure so it's because they haven't had to

you know and now with the onset of more dsos and corporate D Dental like yes graduates need to know less and less matter of fact most of them there was uh one of the schools I was talking with the Deans at one of the schools and they had close to 70% of their graduates Go corporate or DSO this last year so what does that say that say you say 70% 70 and and it again that's only a sampling of one school so I don't think sure

it's not Nationwide but yeah that's interesting um and the year before that was about 50 so you know Co has had an effect on this we have to factor that in yeah some of these there's other things going do we don't need talk about right now but but but still that's an interesting statistic that tells you that out of that 50 to 70% there's probably some that are like I don't want to do the business aspect a maybe I'm scared of it I don't understand it

I don't like it whatever the motivation is you know whether it be IGN arrogance ignorance Ence or fear to keep them that such a good framework yeah it'll come up over and over and over I know it's so good um but whatever those that that is that's going to push them into that where now they're just adopting whatever the DSO and the corporate model has so you have that component as well well and some of these DSO and corporate you know Dental uh companies are extremely

streamlined and their bottom line can handle the ride off they're built to handle the ride off and they Thrive and their model is based around patient turnover and high volume and so to have high volume you have to take the insurance companies like you have to be a provider for it and they probably know their processes like the back of their hand it's fine it's a fine- tune machine I mean I saw that the lab too when we we worked with a large DSO it was

very fine-tuned um it kind of fascinating as well for a geek like me I guess a business geek no that's awesome all right so we covered why why patients purchase and why practices sign the the the dotted line uh the evil dotted line evil the evil dotted line um right insert maniacal laugh here yes yes uh so what uh let's let's shift gears a little bit talk about the ideal patient Avatar what why is it important to understand this concept of of of business and practice

management why should a practice create the ideal and ideal patient Avatar and why is it so critical to master this this concept I love that you you know before we started recording I love that you're so pumped up on this idea yeah I have a geek about it yeah yeah but also cool is that that the fact that that's something that we're working on behind our scenes right now as well and um our partner Ryan he got real pumped this week it was actually this week

that he came and he's like he's like guys check this out and he gives us this like four page document of like and it said and I'm looking at it right now I've got our I'm in our conference room here and I'm just staring at this this uh data set yeah well I've got data sets up and I've got this uh and I'm going to read what it says sure right off the top it says ideal patient Avatar questionnaire so when you said that like no

way Jordan I got it right here like this is awesome I swear there's like we're we're having some synergies happen at the same time at over there in Idaho and over here in in Le Utah boom collaboration baby yeah baby yeah so so this is this is a concept uh and and yeah God bless Ryan for for being ahead of the game all the time what again he's a wizard this is what happens wizard they see got get a wizard but he he uh he put

together this questionnaire and and um you know you ask what does the ideal patient avatar look like you know and it's different for every office right so every office has a different we say Avatar we've stolen that from Gino Wickman that was a used in traction um in his book traction which you if this go buy it read it um but that idea of having an ideal patient profile right so you what who is the perfect patient for your practice what do they not not like

you know do they have brown hair or red hair that's not what I'm talking about that's a dating app so is like what do you look for so what we look at is so here's some of the questions this will help frame better frame this concept right so the questions is what is the ideal age range of your patients what what what gender do you identify more with we work with a practice in Arizona that the doc her vision was to treat um to be more

female oriented um and be more attractive to where they more more females are comfortable coming and seeing a female team sure and then to have anxiety patients like people that suffer from anxiety she wanted to Target the the high anxiety female graphic so okay so that's kind of some you know what is what is the average household income you know U what type of insurance comp this is a big one what type of insurance coverage do most of your ideal patients have are they cash patients

everybody should say cash patients if you're not like a huge group practice right yes um you know geographic information do they how big's the household these are the things that start to create income demographics all that yeah these are the things that we're looking for demographically that will create this Avatar or this ideal patient and it's so important to understand because if you're going to Market you better know who you're marketing too yeah if you're G to be spending if I'm gonna take whatever money I

was let's say if I just get rid of ppos all together take that money that I was wasting on that ride off and then apply it to marketing so let's say instead of 3% I bump it up to six you know I really want to throw some money behind yeah you really want to get it in care what's that you really want to get it in gear if you're put throwing six yeah yeah yeah you really want to get in gear and just kick it into

gear then you would better know who you're targeting and how to Target them otherwise you're just going to be flushing money down the toilet yeah and I've I've done just that I flushed money down the toilet and I've learned some hard lessons there because uh the lack of clarity of ICP or I I call it ideal customer profile for for us boom Club but it's an ideal Avatar of a client right whether whether you're run a practice or running a software company it's all Universal right

and and they all have the same effects when you get it you really can and hit the you can hit the ground running from a marketing and new patient attraction and retention perspective because that's just as important is attracting um to to making sure you're finding the right customers that that fit what you can you can serve them right with your superpowers so I'm a huge advocate of this uh we're we're doing a whole Focus Factor here at boomcloud on that because we we've realized that

the the practices we work with well with have a certain criteria right qualifications that we want to find more of them because we we like hanging out with those types of practices we like we like helping those types of practices and we know it's a it's a better collaboration between our company and and their company so this is really critical stuff that I think uh number one yeah we're we're not taught this in in Dental I don't think even business School teaches this this is this

is this is street cred stuff that's right you only learn this when you're Harden in the streets yeah I I don't think you really learned uh too much of this in in business school you just kind of learn it the hard way at least that's been my experience well you know and Jordan the thing is is like don't you think that like Nike don't you think they have an avatar like they totally do easy answer is well I want everybody to come in okay that's fine

but now throw some marketing money behind everybody and it's a really expensive in yeah we did we uh years ago I had a VP of sales and I had I brought this concept of really honing into our Avatar right and he said exactly what you just said uh well don't you want everybody to give you money it's like there's such a thing as bad Revenue right as weird as that sounds there is such a thing as bad Revenue meaning the cost to acquire is too high

for what the output uh the output or the the the end outcome of that type of patient or or customer it may be not enough to cover the cost of the acquisition of that customer so uh yeah that's that's that's why we talk about this it's really important let's let's paint a picture of that for a practice so practice a practice says okay we're gonna do offer free free free free free free this that that the other it's all free come in it's free so they

attract patients that are like o free I'm going to come in and then all of a sudden they notice the no-show rate skyrockets and like why aren't people com in anymore why is it all set so high your IDE patient profile off yeah you just attracted a bunch of people that are motivated for by getting something for nothing they're not investing in their own health they're they're they they don't value your time I'll tell you that much you know yeah it's it's the entitled mentality type

patience you're you're driving the funny thing is Dan this actually happened to me the other day you know we record these podcasts and we cut them up and we put them on Tik Tok you know and other platforms and we I had that exact comment on one of the videos that made me laugh from a patient not a practice owner right patient gets on like membership plans for for dentists no way I've only been surviving on the the free offerings from dentists is what the comment

was and I'm like geez that is a that is a poor patient yes you want you want the membership plan to scare that patient away because he's this this particular patient in the mindset was well I only I only go to the ones that offer free offerings and then I turn out go to the next one like no don't attract those patients that's why that's why clipon veneers from online places exist not good man it just sucks there's patients out there that are that mental and

that's sad and it sucks because they're they're obviously the oral health is is suffering but ah like it it's a real thing and do you want to do is that something you want to build your practice off of you know and so you really should understand I mean we believe so much in this that and we've been preaching avatar for a long time so good but at elevation Association like I said we we've actually now generated thank you to thanks to Ryan's Wizardry that we've been

able to generate a very we can actually show you like you give us you fill out this questionnaire and we will create an absolute Avatar profile for you that we can hand you and say this is your ideal Avatar and not just that we're going to show you you can attract this ideal Avatar we'll work with your marketing company and we're going to show you like how to not throw bad money at this we're going to show you how to effectively attract this ideal patient yeah

that is so good I I I love hearing that you're helping practices with that uh over the years I've learned the the hard way and the easy way right we all do yeah and I I am learning more so now than ever because you know we we are really investing into to our growth at boomcloud so we just don't have ppos that take 50% of our margins right um so I'm putting a really aggressive growth more than six% we'll say uh back into our growth engine

and as I've as I've been doing this because I I want to help more practices um as I've been doing this we've been learning and refining the the Avatar and I I'm just going to tell you all of our listeners that this is a critical part of your your practice to get in order to compete with dsos and to find those and to live a better practice life right a well balanced life what you guys say it's like man don't you want to find that those

ideal patients that are really great to work with because I I know at the dental lab we worked with a variety of patients because we didn't control the Avatar we control the Avatar of the practice right of who we were targeting and we got some wild cards patient wise in there like I mean we can just have a weird one of these days Dan let's have a weird patient episode I've got plenty of stories yeah we're going to do that dude we'll bring on some other

we'll bring on some other docks and let straight out weird patient that is definitely goingon to be part of our our plan here I'm writing it down right now write it down I'm serious because I got some stories man all right so shifting gears uh so we G talk about the effects of Po overhead and then the last question we'll talk about what is the PO patient value versus a membership patient Val yeah I'm excited to talk about that yes really fun stuff let's let's jump

back to that effect on P I think this is an important concept to understand is the effects because we think oh well I'm I'm generating more Revenue generating more re so it's production right so I'm generating more production yes therefore I must be making more money no because there's no such thing as I mean there's such thing as bad Revenue totally yeah and the thing happens so this is what happens um you go let's say you decide to go into a growth model and you're like

okay I'm gonna I'm going to go ahead and and I want to grow my practice and so in order to do that I need to I'm going to sell my soul to the devil and I'm going to become provider for every insurance that I can sign up for because I want them to refer patients to me so let's say you do that and let's say it's even successful and let's say you go from a thousand patients a thousand patient base and let's say it jumps up

to 3,000 now now you have 3,000 patients in your in your practice well in order to service all those patients you've probably had to bring on one two three more hygienists you've had to bring on one two three more uh assistants you probably had to bring on an associate you probably had to bring on another front front office person you probably had to bring on you know maybe somebody else in another capacity whether it be you know Insurance coordinator whether it be hygiene assistant whatever it

is and so now you've increased your overhead a lot just by doing that all of your goods and services have gone up which which we talked about in the beginning of the show have gone up 10 to 20% since 2021 so now we've increase all of those things 10 to 20% in addition to adding the payroll overhead the insurance overhead the keeping the lights on overhead the additional chairs all of the loans you've taken out because maybe now I want another C in my office I

need you know and now I need another sterilizer all these little things start adding up as you are in this growth phase so you're in this growth model but now you you you used to have a thousand cash paying patients let's say or you know whatever let's say that you were and this is the thing I think that that that every doc needs to understand if you're a if you're a practice owner you absolutely must know the percentage of patients that are cash percentage of patients

that are patient benefit plan or whatever you want to call it um and then the the percentage of patients that are insurance so if you don't know that you are oh you're Flying Blind but let's assume you know that big time yeah yeah and so now you've you've increased your patient Base by 2,000 patients so you've grown a lot exponentially you've grown but your reimbursement on those is not growing expon itially your reimbursement and we're seeing ride offs it is not Jordan it's not uncommon for

ride-off to be over 50% and matter of fact in C like I was saying alluding to earlier uh our docs in California certain areas of California are losing money on all not some all of their hygiene procedures every code they're losing money on it's just a big squeeze yeah all of them so if you can imagine if you ran let's say because I would assume that with the two do practice you're going to need four hygienists at least right yeah so if you are barely covering

your costs or you're losing money when you're seeing eight hygi or eight hygiene patients per row per or per hygienist per day think about what that adds up to now you're still paying that hygienist the same amount and they're supposed to be a provider they're supposed to be able to pay for themselves right so based on on on profitability models they should be able to provide for themselves here's the other thing that sucks what if you have cancellations so they don't show up you're still paying

your hygiene no Revenue production and now now you've increased that patient load uh which if you just take 20 Revenue per patient declines when that happens exactly yeah so now you're still your overhead is increasing and your reimbursements are going down down down and so this is something that can have we know this from firsthand experience we know that if you get to a certain point that you are going to start to feel the pinch of the insurance on your overhead even though you might producing

you might be producing at record levels it it doesn't matter it it you've really got to get granular and break down and look at how this is affecting the overall bottom line and so you know it's again it's one thing to be and you need a track production it's important and it it's good to know that you're you're jamming on Revenue but if it affects your profitability if your true overhead is too high because of this sacrifice it's having that insurance and having them feed you

these patients is actually it can be very detrimental to the pra the health of your practice Yeah that's insane that I'm still thinking about Revenue per patient going down with the lack of with with the cost of the hygienist and assistant um and whatever whatever else costs them there's so much more that goes into that with like skimming the Surface cost yeah I mean this is I mean we we with our clients we have to get super granular with this so we can break it I

mean you've got to look at your p&l you've got to I mean there is a lot you've got to break down pl's a component of of what you've got to be able to dissect and look at but you got to look at production per visit how much are they prod your hygiene and and moreover you know what is collections per visit you know so what's the profitability and that's an interesting that's an interesting um kind of side note Jordan is that we ran a in our

own office we ran a comparison of the annual patient value of our patient Benefit Plan patients against our uh the Delta patients that we had and Delta it's tough to get out sometimes yeah yeah it is yeah Delta patients annual p in our practice and we're we're in Idaho so keep in mind reimbursement rates from Delta and Idaho are awful to be fair yes yeah Utah is the same Utah is I think worse than Idaho is there a good State not that I've heard of it

um honestly I don't know maybe no I don't know maybe if maybe if you're on Delta was it Premiere or whatever if you okay so yeah that's a whole another discussion but yes that maybe that's a grand that's a dying plan though oh they're trying to yeah they're trying to squash it that's for sure that yeah but if on our our Delta patient annual patient value was five around $500 okay our patient Benefit Plan members annual patient value with $1,700 plus the subscription plus that's not

including the subscription so that's just with treatment which is yeah just treatment we call that we call that Revenue stacking over here at boom Cloud crazy right that's fascinating what uh yeah what is that two that's is that 3x yeah 3X it's actually more than 3x little over 3x uh so membership patients are over 3x more valuable than po patients plus you get the subscription which adds more value so if you're charging I don't know 400 bucks a year that adds that 1,700 our average I

think the average P membership plan price across the country is at 450 a year so if we added the 450 plus that 1700 that you showed us it's roughly 2150 or time yep so that's that's how things stack right where um I call that the the revenue value ladder so you're stacking uh Revenue so it's it's higher quality yeah versus the the opposite of what we're seeing here with with Delta and other po plans I'm sure very similar comparable $500 value that's yeah so 3x plus

what ppos are doing man why don't you want more wouldn't you want more patients that are high quality and and probably happy and to to join a plan you're not looking for those freebie the the freebie uh type practices the freeloaders that patients that are freeloaders like the Tik Tock example I said earlier of oh I've been surviving my whole life on on freebies from dentists I'm like gez yeah that's proof right there Tik Tok is giving us proof of why you shouldn't offer freebies because

it attracts the wrong Avatar well and I you know and I can appreciate that when you're coming out of school you're carrying a lot of debt like yeah Dental debt is scary right it's it is scary yeah and and there's a lot of there's a lot of again fear is a a a primary motivator you know it's a sucky motivator but it is such framework we need to make an image of that to to give to everybody I that's such a great framework now this has

been awesome um and and to our audience listening I hope this has been bringing you guys value this is I mean I'm not a dentist I'm more business guy and I I'm fighting value off of this episode with you Dan this has been awesome it's fun right it's I I just think it's so important and it's it's it's obviously a passion that we have at elevation Association that we share with boom Cloud you know likewise yeah it's just it's we want to see people in our

profession do well you know I think that there's enough to go around you know that you know what's not going away illness diseases you know so it's not people needing crowns yeah that will never go away right in fact the insurance companies are the leeches on top of you guys leeching leeching they're just leeches they're parasitical they're absolutely parasitical and you and the sad thing is is that insurance controls so much of the decision-making process either by the the doc or the patient or the employees

in the office that that insurance mindset is very hard to break it is not easy to overcome even if the doc can see through everything it's like yes I see what you're saying I I can tell you right now if anyone is listening to this it's having this thought and I think there are some that it's like yeah yeah yeah Jordan yeah yeah yeah Dan but but I have this situation but but I have this problem I have this issue and it's it's like okay what

are you doing to work through it like what have you done to like what you to solve it we just why just lay down like why just like well I'm just gonna let this parasite just suck me dry you know yeah the truth is we're all dealing with challenges that can be solved and the other truth is uh we have a thing here at boom Club what we call Distortion right mental Distortion where we may look at a a small segment of a customer base and

then distort it on up right and make a big decision over over the over the entire customer base or the industry it's like no that's just actually a really small segment so you may be talking about 20 different patients that you're like saying but you know what I mean that that's usually the truth when we dig into it's like oh it's only like 3% of your patient base bro it can be solved right most of the time we're we're making mountains out of Mo Hills because

you've had an experience with a patient that I feel like I feel like yeah it's not backed with with with real raw data yeah it's it's not a massage guys don't make decisions off the feelings yeah that's good no I love this this was a a great episode we'll be posting this um Dan tell everybody what you guys are doing I know you guys have an event uh share that and I'll share some things that we're doing at boomcloud yeah man we've got so um got

two big things coming up uh I am leaving in two weeks to go to Africa we're going to Tanzania with the dental Legacy Foundation uh my partner Jared Hill he is going in November uh to to Tanzania we are have a few trips Mark costus took his um D you know with through the DSi D success Institute yeah he uh had he opened a 501c3 not 501c3 nonprofit similar to den Legacy Foundation that we've been able to collaborate with collaborate yeah Mark's A rad dude he's

super good work with he went in January their group would like to go again so the bottom line is if you would like to um experience a a humanitarian Aid trip over in Tanzania and and really you know add to your legacy and and build something bigger than yourself you know get a hold of us and and come volunteer if you don't do it with us do it with somebody but that is that we're doing we go do it with them yeah yeah but but Tanzania

is pretty special I will say that uh and then I've been watching your videos because me and my wife Christine are are thinking about going we just got to solve our our Nanny conundrum because we've got three wild girls daughters um but yeah it looks amazing it is amazing it's incredible it it really is incredible yeah the it's lifechanging I will say absolutely for that's what everybody says when they come back that was life changing geez yeah that's been one of my wife's dreams to go

and do stuff like that it's it's it's so special it really is special CU my my wife was a dental assistant for a while so she's everything's Dental in our family Plug and Play baby you put right to work like that's what we need I'll make I'll make I'll make the Dentures or do the relance because I think I can still do that well even if even if you're not a dentist we still like there's a lot to do so there's plenty of yeah my only

use is lab work still I guess dude you have no idea how busy we would make you control talked to Mark Cy about it with his and I'm like I I think it'd be fun to get to get back into that and and kind of brush up on my clinical skills from a from a lab perspective it's so funny that's awesome go ahead oh I would just direct I would say direct people to dental Legacy foundation.org yep that's there's a volunteer page there you can you

can fill out an application or if you just want to get more information learn what we're doing or if you want to donate um that's awesome we take donations so that would be great if you need a tax ride off or if you just want to do it the goodness of your heart um either way works yeah whatever the the uh the other thing we've got going on is uh we have our uh our annual International summit we're going to so last year we were oh

I got my shirt on last year we were in El Salvador cool um uh this year we are going to Nicaragua and um we do a week there over the week of Valentine's Day this is meant to be you the doc with your significant other come and spend some qual quality time um and and get some CE hours this is a CE event We Do It um this is not a clinical CE we focus on life Leadership and Legacy and go to our our web page

to learn more what that means at elevation association.com you can find us on H social media as well uh but this is this is next to Africa this is my favorite event that we do every year it's so cool oh it's so R to go that's the one I'm looking at sorry I got confused no both man like I should go to both I'll do both the the uh the cool thing about our we do CE completely different we do it way different um we do

it I mean to have a CE event sometimes Beachside you know so fun yeah it's it's just so different we that's my language right there Beachside yeah to say Beachside yeah you got with with a nice cold beverage in your hand is not a bad way to go down um we focus on small groups um we do small group discussion we do breakout discussion we limit the amount of attendees to these events so that that we can create a uh open cohesive environment where people can

uh afford to be vulnerable um that's really important to us that they can talk about the pain points talk about the things that are bothering without feeling judged or or you know have feeling stupid and I think that's a big deal for a lot of us is we don't want to bring something up um because we feel dumb you know um so we create this very cool environment the other thing that we do differently and you know we were on the the Dennis advisor podcast uh

recently great guys yeah yeah they're rad such good dudes and and I'll make the same promise here is that I guarantee that you're going to see more people copying the format of our CE events because what we do is we do a little C in the morning we usually do some at lunch and then we do some in the evening and in between is it designed to go and spend some time with your friends your significant other talk about the things that matter and we yeah

and it's it's Jared and I hated it when we would go to a CE event and they're like let's greater New York Dent meeting and then shove you in a box an air conditioned box for eight to 10 hours a day right it's like like why are we here like couldn't we just go to like would it matter where we go if we're just gon to be inside the whole time yeah it doesn't no yeah go Albuquerque New Mexico there's nothing to do there it doesn't

matter where you go so we've created something that um that people love and and our members in the attendees have have uh really really taken to this concept and our presenters are fantastic you don't have to come and just listen to me jaran Ryan um you know we're trying to get uh some guys from boomcloud to come wonder and maybe present but no I mean this is what we look like we look we look we vet our people and um and we want people that are

of an abundance mindset have the right mentality to come in and also have you know a wealth of of um Insight knowledge wisdom uh so in this year's event Mark cus will be presenting U the dentist advisors will be presenting we're got a killer killer lineup and uh it's going to be a really special event so again elevation association.com check that out if you're interested in coming awesome man yeah go check that out and if you're really looking at your your patient avatars and you want

to scale your membership plan uh go check out boomcloud boomcloud apps.com we have practices that are really scaling their membership program nicely uh some of our top clients are generating over a million dollars a year in predictable recurring Revenue just from the membership fee now if you apply Dan formula of what he saw in his practice with uh treatment uh that can get really interesting really fast so I would recommend you guys go check out do schedule a demo we've got tons of books and resources

um that are that are free don't don't just do the freebie stuff though just go download it and uh and schedule a demo and see if boom Cloud could be a great fit for you guys as you're building and trying to optimize your practice so with that said Dan awesome episode thanks for all of our audience uh for listening and we'll see you on the next show rock on everybody