How TO EFFECTIVELY Streamline Your Data With Gaidge

[00:00:00] [SPEAKER_01]: Welcome! You're listening to the GrowOrtho Podcast presented by HIP. This podcast is dedicated to orthodontists who want to stand strong in their market and be leaders in their community.

[00:00:13] [SPEAKER_01]: Now, on to today's show!

[00:00:16] [SPEAKER_01]: Ryan, thanks for coming on the show today. Super excited to chat about Gaidge and the orthodontic market.

[00:00:22] [SPEAKER_02]: Thanks. Thanks for having me. This is great.

[00:00:24] [SPEAKER_01]: Tell us just a little bit about yourself and your background.

[00:00:26] [SPEAKER_02]: Yeah, it's kind of a fun story at least for me. Maybe not for others, but for me it's a fun story.

[00:00:32] [SPEAKER_02]: I started off as a finance guy so I really loved data and analytics. That was my undergrad degree.

[00:00:38] [SPEAKER_02]: And I ended up going over to Intel and did budgets and planning and financial analysis for manufacturing facilities for the first four or five years of my career.

[00:00:47] [SPEAKER_02]: Then I went back to, and actually I had a stint at Ernst & Young as well managing some of the finance stuff that they had done for their engagements,

[00:00:54] [SPEAKER_02]: for their auditors and their partners. Then I went back to Georgetown to kind of make a career switch, so to speak.

[00:01:01] [SPEAKER_02]: I got my MBA there and moved into more strategy, marketing.

[00:01:06] [SPEAKER_02]: And from that standpoint, I went to 3M. And so 3M kind of brought me on this journey to where I was able to work across,

[00:01:11] [SPEAKER_02]: at that point 3M had seven big businesses across 42 different industries.

[00:01:16] [SPEAKER_02]: And I was able to work across the disciplines of marketing, strategy, business development

[00:01:22] [SPEAKER_02]: to really understand and to make that career transition.

[00:01:27] [SPEAKER_02]: The great thing about it is these were a little two to three month consulting opportunities for the first two years.

[00:01:31] [SPEAKER_02]: There was a group of us all out of MBA school that came in and did that.

[00:01:34] [SPEAKER_02]: And then through that process you kind of figure out what industry you want to go into and what discipline you want to go into.

[00:01:40] [SPEAKER_02]: And so I ultimately ended up in the dental space.

[00:01:43] [SPEAKER_02]: And so I ran the restorative portfolio for 3M from a marketing standpoint.

[00:01:47] [SPEAKER_02]: And that led me to be a regional sales manager.

[00:01:51] [SPEAKER_02]: So it was the first time I got to get out into the field and basically manage a bag of a bunch of different reps, which was kind of cool.

[00:02:00] [SPEAKER_02]: And that led me to Orthodontics, which I ultimately transitioned from that regional sales manager position into the vice president of sales for North America for Ormco.

[00:02:11] [SPEAKER_02]: So that was about 2013.

[00:02:13] [SPEAKER_02]: So I do have a long history now in the dental slash ortho space, primarily ortho over the last 10, 11 years.

[00:02:20] [SPEAKER_02]: And so that led me, did that for two or three years and that was the vice president of global marketing for Ormco.

[00:02:27] [SPEAKER_02]: And then at that point, you know, I was traveling a lot.

[00:02:30] [SPEAKER_02]: I had young kids at home and I felt like it was an opportunity when Mary Beth Kirkpatrick, founder of Gage,

[00:02:37] [SPEAKER_02]: we her and I started a conversation and it was an opportunity to come manage the Gage business, which was, you know, it already been a startup, but it was kind of in its infancy and

[00:02:46] [SPEAKER_02]: basically gave us an opportunity to go see what we could grow the business.

[00:02:49] [SPEAKER_02]: So I packed up the family.

[00:02:50] [SPEAKER_02]: We were in Sacramento, California, we moved to Atlanta, Georgia.

[00:02:53] [SPEAKER_02]: And that was about seven years ago and took a big risk.

[00:02:56] [SPEAKER_02]: I would say call it back in 2016.

[00:03:00] [SPEAKER_02]: I would never even think about going entrepreneurial and taking such a risk and actually doing it has been one of the greatest things that I've done professionally and personally.

[00:03:09] [SPEAKER_02]: So it's really cool story there.

[00:03:11] [SPEAKER_02]: Then we, you know, Gage gave us an opportunity to, you know, grow the business and then I brought over a few folks from my Ormco days as well to help run marketing and sales with Jake and Suzanne.

[00:03:22] [SPEAKER_02]: We had Katie here who is Mary Beth's daughter.

[00:03:24] [SPEAKER_02]: So kind of the five of us collectively helped build the company with our consulting group with Jessica and Shannon.

[00:03:31] [SPEAKER_02]: And so it was a really cool opportunity, I think to kind of work with your friends but also build a business.

[00:03:37] [SPEAKER_02]: And so we were able to, I think over that first five year period just really build an imprint into the orthodontic space and with data and analytics.

[00:03:45] [SPEAKER_02]: This is where my career background kind of comes full circle being that finance person at the beginning allowed me to leverage, you know, I was always on the clinical side with the

[00:03:54] [SPEAKER_02]: 3M and Ormco, allowed me to get back on the business side, which is where I feel like I have much more insight and expertise versus the clinical side and, you know, help grow the business there.

[00:04:04] [SPEAKER_02]: And then a couple of years ago we did Transact with a private equity firm and we're now part of a bigger group called Practice Tech.

[00:04:11] [SPEAKER_02]: And so Practice Tech is basically focused on retail healthcare.

[00:04:13] [SPEAKER_02]: And over the last two or three years we've been able to with Practice Tech, you know, kind of move a lot of small entrepreneurial companies into over a $200 million business that has four different distinct verticals.

[00:04:26] [SPEAKER_02]: I do currently now manage the dental ortho vertical and we have seven brands that roll up under that opportunity and yeah, Gage is definitely a huge piece of that portfolio and it's part of data intelligence and business insights

[00:04:41] [SPEAKER_02]: and what we're able to provide to the orthodontic business owner in practice has been a really fun journey.

[00:04:47] [SPEAKER_01]: That's really cool also just on the Practice Tech side, you know, being able to I guess scale faster and use a lot more resources that a larger company would have to help a startup.

[00:05:01] [SPEAKER_01]: So what was that transition like?

[00:05:03] [SPEAKER_02]: Back when we did Transact, I mean Gage was primarily just an analytics platform.

[00:05:07] [SPEAKER_02]: And so being part of Practice Tech, now we have 19 different brands across those four verticals that I mentioned.

[00:05:14] [SPEAKER_02]: But we've now been able to implement, you know, some different technologies within the Gage platform.

[00:05:19] [SPEAKER_02]: So for example, we have a company called Intake Q that's in the portfolio and all they do is digital patient forms.

[00:05:25] [SPEAKER_02]: And so now that is basically white labeled into Gage as our Gage forms platform.

[00:05:30] [SPEAKER_02]: So we're able to leverage, you know, that part of the platform and provide that to the orthodontist which has been great.

[00:05:35] [SPEAKER_02]: We've also made an integration with the accounting platforms with zero and QuickBooks.

[00:05:42] [SPEAKER_02]: And so now not only can you get the operational data that we pull with Gage that comes out of the practice management system,

[00:05:47] [SPEAKER_02]: but we also now have the accounting level data.

[00:05:49] [SPEAKER_02]: So that gives us a lot of insights.

[00:05:51] [SPEAKER_02]: And I think as we go deeper into this podcast, we can kind of share, you know, what that looks like and how doctors are able to get more insight into their practice,

[00:05:58] [SPEAKER_02]: kind of combining those two pieces of information.

[00:06:00] [SPEAKER_02]: And then recently we've launched our Gage consult manager, which basically is a tool to help give control,

[00:06:08] [SPEAKER_02]: total control of the new patient conversion process from when that patient calls to managing them through the practice.

[00:06:13] [SPEAKER_02]: And that's as we get into the business model of orthodontics, that's a key piece where you can see a lot of leakage in your practice.

[00:06:20] [SPEAKER_02]: Oh, yeah.

[00:06:20] [SPEAKER_02]: The patients just kind of slipping through the cracks, but kind of having a CRM tool, so to speak,

[00:06:25] [SPEAKER_02]: to move them from that new patient experience all the way to their collecting their first payment is another module that we brought on.

[00:06:32] [SPEAKER_02]: So I think the power of practice sec has enabled us to move faster and create just a more robust business intelligence tool for the market to be able to take advantage of it.

[00:06:41] [SPEAKER_01]: What is Gage exactly?

[00:06:44] [SPEAKER_01]: How would you just describe it in 10 seconds, one sentence?

[00:06:48] [SPEAKER_02]: It's a business intelligence tool that allows an orthodontist to run their practice more efficiently.

[00:06:53] [SPEAKER_02]: I know there's more in 10 seconds here, but if you can imagine pulling data out of your practice management system, a lot of times that could be manual and you have to do a lot of analysis.

[00:07:00] [SPEAKER_02]: Gage automates that process and then visualize and charts and graphs it to where that you can see where your practice is performing very, very quickly.

[00:07:08] [SPEAKER_02]: So I'm going to not show that's kind of what Gage does.

[00:07:10] [SPEAKER_01]: What do you guys see, you know, orthodontist obviously they're they're very busy individuals.

[00:07:16] [SPEAKER_01]: A lot of them are having to manage and also be in the clinic and also think about things like payroll or marketing.

[00:07:23] [SPEAKER_01]: Some of them we found are doing their own marketing or, you know, approving time off request, all this stuff I would imagine and I've talked to a lot of orthodontists where this is the case where there is a big gap in looking at these metrics and being able to understand them.

[00:07:40] [SPEAKER_01]: Maybe they don't have them.

[00:07:42] [SPEAKER_01]: They work with an accountant who maybe does some things a couple times a year, but they really don't know where they're at or how to leverage data to be able to move forward in the best way.

[00:07:54] [SPEAKER_01]: What do you guys see?

[00:07:55] [SPEAKER_02]: I would agree with that.

[00:07:56] [SPEAKER_02]: You know, at the core and orthodontist as a practitioner, you know, they don't teach them the MBA skills of running a business in the ortho school and residency.

[00:08:06] [SPEAKER_02]: So that's where, you know, industry partners like ourselves, you know, we feel that we can be a great resource for those orthodontists to be able to and I think to looking at all the different data that you have in your practice can be extremely overwhelming.

[00:08:21] [SPEAKER_01]: Oh yeah.

[00:08:21] [SPEAKER_02]: And so what Gage is hopefully trying to do with the orthodontist is take that in and distill that down into bite size chunks, right?

[00:08:28] [SPEAKER_02]: And so when we take that data, you can go mine your practice management system.

[00:08:32] [SPEAKER_02]: You're going to pull out the raw data.

[00:08:33] [SPEAKER_02]: You're going to have to have a data analyst look at it.

[00:08:36] [SPEAKER_02]: What key performance indicators are you looking for?

[00:08:39] [SPEAKER_02]: Gage was designed through Mary Beth Kropatrick and her consulting team to kind of cut to the chase, so to speak, right?

[00:08:45] [SPEAKER_02]: They have been in thousands of practices and so they know what to look for, what's good, what good looks like.

[00:08:51] [SPEAKER_02]: And so the key performance indicators that actually get rolled up with engage are driven by consultants that have been in these practices and not only just Mary Beth's group, but she partners with and now Jessica is running the group with all the other consultants in the industry.

[00:09:05] [SPEAKER_02]: And so there's a collaboration going on there as far as what should be tracked, what should be measured in order to be able to course correct or improve that.

[00:09:13] [SPEAKER_02]: So that does hopefully simplify the process of running your business as an orthodontist because you have the access to the information in a much more seamlessly visual quicker way than having to go gather it yourself and analyze it yourself.

[00:09:32] [SPEAKER_02]: We kind of do the work for you, so to speak.

[00:09:33] [SPEAKER_01]: What are some of those main KPIs that you guys bring to the forefront?

[00:09:37] [SPEAKER_02]: If we're going to start simple, you think about just the orthodontic workflow from the beginning is obviously it's production collection, right?

[00:09:45] [SPEAKER_02]: That drives your business.

[00:09:47] [SPEAKER_02]: But then when you get into the patient funnel, it's okay.

[00:09:50] [SPEAKER_02]: How many new patient phone calls did I get?

[00:09:53] [SPEAKER_02]: How many of those did I convert to come in for an exam and then ultimately how many of those did I start?

[00:09:58] [SPEAKER_02]: And so along the way, you know, there's more sophistication within that if people go to observation.

[00:10:04] [SPEAKER_02]: How does that?

[00:10:05] [SPEAKER_02]: How do you manage those observation kids that aren't necessarily ready right now so that when the time comes, you make sure you maximize pulling them into a start.

[00:10:12] [SPEAKER_02]: And then once you do get them into a start, how do you treat them efficiently so that your clinic can run on time and you can maximize the profitability within your clinic?

[00:10:20] [SPEAKER_02]: So we've done a lot of analysis and I go back to what I said before.

[00:10:24] [SPEAKER_02]: We have the operational data coming out of gauge and we combine that with the accounting level data which talks about the expense side of the house.

[00:10:31] [SPEAKER_02]: And when you put that together and you put it through a multi-linear regression model, you can quickly identify certain push points within a practice of what you should be focused on in order to drive the most profitability.

[00:10:43] [SPEAKER_02]: So at a very basic level though, it's about production collection, new patient adds into exams, into starts, and then ultimately how efficiently are you treating patients?

[00:10:54] [SPEAKER_02]: Or what I would say would be kind of the starter kit to get going in your practice and understand kind of where you stand there and then you can get more sophisticated off of that.

[00:11:01] [SPEAKER_01]: Some of the things that I've seen, we have over 200 practices active with us and a lot of those are on gauge.

[00:11:09] [SPEAKER_01]: And so to be able to look at our side of data and then the gauge side of data, it really paints the complete picture.

[00:11:23] [SPEAKER_01]: 100%.

[00:11:38] [SPEAKER_01]: And with the data you can actually look and paint the real story and know exactly where to drill down.

[00:11:50] [SPEAKER_02]: Yeah, and even to your point to get more sophisticated on that patient funnel, like we do, we have a lot of things that we can really look at.

[00:11:54] [SPEAKER_02]: We know adult child exams.

[00:11:56] [SPEAKER_02]: We know how many, what's that ratio?

[00:11:57] [SPEAKER_02]: Then we also know start types.

[00:11:59] [SPEAKER_02]: So is it a bracket and wire start?

[00:12:01] [SPEAKER_02]: Is it a phase one?

[00:12:01] [SPEAKER_02]: Is it a phase two?

[00:12:02] [SPEAKER_02]: Is it an aligner?

[00:12:03] [SPEAKER_02]: If it's a phase one, is it an appliance aligner?

[00:12:06] [SPEAKER_02]: Or is it an appliance phase one or is it an aligner appliance for phase one?

[00:12:10] [SPEAKER_02]: Same thing for phase two.

[00:12:11] [SPEAKER_02]: And then aligners as an adult child, like what's the spread there for full starts as well as an adult child as well.

[00:12:18] [SPEAKER_02]: So we have that granularity.

[00:12:20] [SPEAKER_02]: So if you're looking at your practice and we even look at, okay, during COVID adult, for example, during COVID adult starts spiked through the roof.

[00:12:27] [SPEAKER_02]: Like on average, they're around 6% growth year over year.

[00:12:31] [SPEAKER_02]: During COVID, they ramp up to 24%.

[00:12:33] [SPEAKER_02]: What happens is the zoom effect, we're all looking at ourselves in a camera all day and we're like, oh, wow, I better get to the orthodontist and fix that.

[00:12:39] [SPEAKER_02]: So that becomes a phenomenon, not lasted for 18 months maybe.

[00:12:44] [SPEAKER_02]: But in the last two years, we've seen adult starts just completely fall off the cliff.

[00:12:48] [SPEAKER_02]: They're negative now.

[00:12:50] [SPEAKER_02]: So then you start looking at aligner growth.

[00:12:52] [SPEAKER_02]: Obviously aligners are still extremely healthy in the space continuing to grow.

[00:12:58] [SPEAKER_02]: But year over year, we're not necessarily seeing the aligners do what they did in the past as a function of some of those adult patients that aren't necessarily coming into practice.

[00:13:07] [SPEAKER_02]: So just some different dynamics that I think has changed over the past couple of years as a function of COVID and kind of where we're at.

[00:13:17] [SPEAKER_02]: But ultimately, it's still a very healthy industry, but there's some definitely changes that are on the horizon that definitely need to be understood.

[00:13:25] [SPEAKER_02]: And I think that's where you kind of come back to do you know the numbers of your business?

[00:13:30] [SPEAKER_02]: Are you able to manage that?

[00:13:31] [SPEAKER_02]: And then do you look at that more on a, do you have a process for that?

[00:13:34] [SPEAKER_02]: Do you look at that on a weekly monthly basis?

[00:13:37] [SPEAKER_02]: Do you have a review with your team?

[00:13:39] [SPEAKER_02]: Because if you look at it to your point earlier, every half year, once a year, like that you're not going to be able to make changes based on.

[00:13:45] [SPEAKER_02]: You're just going to get what you already what you have.

[00:13:48] [SPEAKER_01]: And the cool thing about Gage too is you can set your goals inside of the platform to be able to measure against where you are and where you want to be again.

[00:13:57] [SPEAKER_01]: And you know, I'm not trying to bash anybody but when we even find this in our own business, it can be very hard to take the time to set goals.

[00:14:05] [SPEAKER_01]: You know, but if you don't have a goal, what are you actually working towards?

[00:14:10] [SPEAKER_01]: You're kind of just coasting.

[00:14:11] [SPEAKER_01]: I love that feature too.

[00:14:13] [SPEAKER_01]: And I think for the people listening who are a Gage user but maybe not using that function, that would be something really good to do just so you can track towards something and rally the team around it.

[00:14:26] [SPEAKER_02]: 100%.

[00:14:26] [SPEAKER_02]: Yeah.

[00:14:27] [SPEAKER_02]: And I, you know, it's great point that you mentioned on so take that step further.

[00:14:31] [SPEAKER_02]: Obviously you can set goals within within the Gage system and you can track that on a daily basis.

[00:14:37] [SPEAKER_02]: So it also gives you like a progress bar of where it's if you want to do 20 starts a month every single day, it's going to show you how many starts are you and then how what percent are you to your goal.

[00:14:46] [SPEAKER_02]: Taking that a step further to set goals to your point.

[00:14:48] [SPEAKER_02]: We have a projections module as well.

[00:14:50] [SPEAKER_02]: So all of your history that you have within the Gage system.

[00:14:53] [SPEAKER_02]: Now, if you're going to look at setting goals for 2025, you can see what your run rates are and then that will give you kind of an understanding of like where are you going to perform and then you can start using a slider bar that's in the projections tool and says, okay, I grew at 6%.

[00:15:08] [SPEAKER_02]: I want to see if I can grow at 10%.

[00:15:09] [SPEAKER_02]: So if I grow at 10%, what does that mean?

[00:15:12] [SPEAKER_02]: That means I have to have X number of new patient calls.

[00:15:15] [SPEAKER_02]: And then my conversion rate from patient call to exam is is X to Y.

[00:15:19] [SPEAKER_02]: That's going to cascade me to this many new exams and then my conversion rate into a start is this is going to cascade me into that.

[00:15:26] [SPEAKER_02]: So we all have that opportunity as well, you know, to take that goal setting a step further but using data analytics projections in order to really kind of guide you and enable you to be able to scenario play so to speak how that how that works.

[00:15:41] [SPEAKER_02]: So it's a really cool tool.

[00:15:43] [SPEAKER_02]: That's probably a lot of folks don't even know about within the system that you can leverage.

[00:15:46] [SPEAKER_01]: Yeah, it's interesting with us because obviously our history has been marketing but now it's really marketing and education and a bit of practice management as well.

[00:15:56] [SPEAKER_01]: And there's a software piece, but because of that, there's a there's a lot of focus on that first part of the funnel attracting when we start to get into things and you know when we have access to gauge, we can see that case acceptance or conversion rate.

[00:16:12] [SPEAKER_01]: And in a lot of practices, you know this year that really the past two years or so has been pretty tough comparatively speaking getting used to that crazy growth after COVID and they may not really be aware of the conversion rate and how far it's dipped.

[00:16:29] [SPEAKER_01]: And so we've been able to look at that process and say, you know, I go back to sports like what do athletes do they watch film constantly so getting teams to listen to the new patient phone calls getting teams to watch the consultation process and objectively just look at well how could we do this better.

[00:16:47] [SPEAKER_01]: And as we start to refine that then you can start to see that trend upwards with engage and so that's been huge to not just focusing on that first part of the funnel but being able to use gauge to bring education and training and coaching and really transparency transparency all the way through that new patient funnel.

[00:17:08] [SPEAKER_02]: Yeah, it used to be a badge of honor that I had a three week wait time to get a patient in for an exam. You're going to lose them now because they're when shopping right so I mean that's another key metric is that when that patient calls how fast can you get them in for an exam because a lot of times they probably are looking at a couple different orthodontists so you want to be the first to create that relationship and and win them and capture them right there.

[00:17:28] [SPEAKER_01]: Yeah, and I think when I was talking to Jake, he mentioned if it's over 10 days they may not even show up at all. Yeah, we advise people like get it within 72 hours that exam scheduled and if you can't maybe even introduce a virtual option but it's a small window or the bias some really good data on just exam leakage.

[00:17:47] [SPEAKER_02]: And so they have some cool graphs on looking at as time wears on how that falls off the cliff.

[00:17:53] [SPEAKER_01]: Even you mentioned phones. I think Jamie Reynolds told me when they go look at a practice on average it's anywhere from 20 to 40% of new patient calls are missed. That's a huge leak in the bucket.

[00:18:09] [SPEAKER_01]: If you're down this year, you're listening you're watching really doubling down on am I making the most of every single opportunity so huge.

[00:18:20] [SPEAKER_02]: 100% and there's a lot of AI tools now even on the front end that will help you know with this make sure you don't miss those calls as well which is nice you know to be able to if it's not a human there that at least you can kind of start to get them in their funnel because yeah it's the one thing that we look at is that you don't

[00:18:34] [SPEAKER_02]: even get net back with a lot of these patients as a function of just your systems and processes. Do you have all those tightened up and buttoned down to make sure you maximize the opportunity.

[00:18:42] [SPEAKER_01]: You talked a little bit about COVID. What did COVID create now in the aftermath? What are we looking at within orthodontics.

[00:18:52] [SPEAKER_02]: We do a rates of change model so like when I'll do some lectures and basically what we're comparing is what is a three month rolling average compared to a 12 month rolling average and when you compare those two line graphs you want the three month average to be above the 12 month and that's just kind of a sign of growth health.

[00:19:09] [SPEAKER_02]: Those types of things so if we and we look this data back all the way to kind of pre COVID in 2019 or 2018 2019 but if we look at the orthodontic industry leading up to COVID.

[00:19:20] [SPEAKER_02]: There's a pretty there's a lot of stability there that it grows between 0 and 5% and just oscillates within that range really tightly and so on average you know if that's 0 to 5 it's 2 to 3% average growth that's kind of what the industry does or has done in the past then we hit COVID and you see the

[00:19:37] [SPEAKER_02]: rates of change models spike right so we see data that I mean we've never seen and we're not normalizing against the shutdown either we kind of make sure that we take that information out and compare it against actual data so we can see true growth rates but in

[00:19:51] [SPEAKER_02]: 20 back out of 20 and 21 I mean we saw growth for a good 18 months that was 15 20 25% net production and we've never at least in my history never seen that type of growth in an orthodontic space period.

[00:20:05] [SPEAKER_02]: And then as we got into the back out of 21 and are even into 22 kind of fell down fell off the cliff a little bit so I think going all the way back to September of 21 is when the three month rolling fell below zero and so and then I will say between now and then

[00:20:21] [SPEAKER_02]: if you look at the chart it's a very tight window there but it's oscillating between minus three and zero so the shift before was between 0 and 5 the last call it 24 months have been maybe maybe more than that 30 months have been between minus three and zero and it's in that type range too

[00:20:41] [SPEAKER_02]: so we have stability back but we're not necessarily seeing growth but if you look at the cat the compound average growth rate over that six year period you know what used to be probably three to four percent two to three percent two to four percent is now like one and a half

[00:20:56] [SPEAKER_02]: percent growth because of that big spike and then history but if you look at it over the last two and a half two two and a half years you're in you're in negative territory flat to slightly down so that's kind of the impact of where we are as a as a profession right now.

[00:21:09] [SPEAKER_02]: Maybe even looking into the future are there any type of models or predictions you guys are looking at for the next two three five years we tie a lot in some of the lectures to the some of the economic trends and keep key indicators that we see out there and I would say last year.

[00:21:29] [SPEAKER_02]: You know we look at four different phases whether it's in recession or growth or slowing growth and a lot of those key economic indicators and a couple of them that we follow pretty closely are around the financial markets housing wholesale wholesale trends and those have kind of gone through that recession

[00:21:46] [SPEAKER_02]: period and now on the growth back up so that's a positive some of the other leading indicators you have you have hard landings when you get into recession soft landings where you just kind of go from slowing growth to back to growing or declining growth to back to growing.

[00:21:59] [SPEAKER_02]: So I will say if we look at we benchmark this with it our economics and we look at their kind of current economy and I would say there's a lot of healthy signs as far as some of the key performance indicators are key leading indicators are kind of going through that soft landing and then the big ones which is financial

[00:22:14] [SPEAKER_02]: and housing are kind of coming out of those recessionary periods into more accelerating growth for financial and then starting to grow for housing so that's positive now I do think that for the back half of this year and in July.

[00:22:28] [SPEAKER_02]: This year has actually been pretty interesting because of the calendar and so with the leap year and the way the calendar is fallen the days aren't matching up so we're seeing a lot of big gyrations in the monthly numbers so you'll be up 8% you'd be down 8%.

[00:22:43] [SPEAKER_02]: So over time though as we look at this now that we got we have July's data July was actually a double digit growth month. Why was that right. We had two extra days in July this year versus last year.

[00:22:55] [SPEAKER_02]: Accounting for 4th of July and stuff like that so every day is probably worth five points so you get two extra days you get 5, 5, 10 you're up double digits but Europe but year over year now as we look through seven months of data.

[00:23:09] [SPEAKER_02]: The industry is pretty flat so it's it's it's was flat to negative as of last month and as we go through July.

[00:23:16] [SPEAKER_02]: Now we are kind of flat to barely positive on the key indicators and I look at net production that collection, new patient exams, new patient calls new patient exams and starts those five things and kind of look all that and they all seem to be within a very narrow range of each other so we're seeing you know the good news is after a very strong July we're seeing the

[00:23:34] [SPEAKER_02]: industry is at least positive now where I mentioned before we've been kind of stuck in this minus three to zero range for the last 30 months so that's that's a good news as far as seeing this over the last you know seven months at least so

[00:23:47] [SPEAKER_02]: I'm hopeful for that I think you know there's still probably some headwinds with inflation that we have that we're gonna have to deal with the back half of the year interest rates are still there.

[00:23:57] [SPEAKER_02]: You know there's another graphic that we have on just media and American household disposable income it's about $94,000 and if you start peeling out you know what's after taxes and then when you spend it on housing and all the other fixed expenses that you have what's left over to spend on discretionary is about $9,000.

[00:24:15] [SPEAKER_02]: So you know you think about going into an orthodontic office okay I got to spend five to six.

[00:24:21] [SPEAKER_02]: I've got nine to spend for the average American household with all the inflation I mean look what it's costing you to fill up your car what it's costing you to go to a restaurant to buy groceries you know you name it it's just everything's just skyrocket right to pay your electric bill so there's less disposable income out there I believe now to be able to drive folks in an orthodontic office so kind of fighting those headwinds it'll be interesting to see obviously with the election where that goes you know as far as what does that do.

[00:24:44] [SPEAKER_02]: Due to the economy and inflation there is at least predictive with the the itr and the economists is that 25 and 26 should be pretty good growth years.

[00:24:53] [SPEAKER_02]: So I think there's some optimism for the next two years that will have a good deal of growth we've been kind of in this flat to down range you know since kind of covid settled itself out I think the rest of this year is probably going to be a little rinse and repeat of last year which is flat down and then we hopefully 25 and 26 are predicted to be some growth years.

[00:25:11] [SPEAKER_01]: That's definitely something to look forward to and while a number of people may be experiencing being down or flat it is interesting like you said there's months where you know you'll be up 8% and then down 8% a bit of a sporadic type of response with the practice and growth but what we find to is it's also kind of sporadic and there's pockets.

[00:25:33] [SPEAKER_01]: Where markets seem to be just doing really well versus maybe a market a couple hours away we've seen partners even grow in Southern California where maybe they they were just under leveraging things that they could actually do to move the needle but by and large like the Gulf Coast area you know we have a partner in Baton Rouge huge growth so it's interesting to see where some of these markets people are just continuing to grow and expand and they're not really

[00:26:02] [SPEAKER_01]: feeling it and then you have the practice that's down 10% you know so it is pretty interesting where it's really based on location we find and also are there things that practices weren't doing at all like maybe a practice wasn't even marketing and they started aggressively marketing putting some key roles in the practice looking at stats like missed phone calls conversion rate and they're up significantly.

[00:26:28] [SPEAKER_02]: You know you're looking probably at a when you look at your partners you're looking at one or two different practices maybe I don't know if it's statistically significant you know as far as having 30 plus you know in some of our aggregate averages they have over 30 to 100 practices to show kind of aggregately what's happening and I would say in those pockets right.

[00:26:48] [SPEAKER_02]: You're always going to find folks that are that are leveraging the tools or running their business at a different level or leveraging data analytics marketing you know a lot of services you guys provide as well to grow your business and I guess I kind of go back to that on message is that in this day and age with the competitiveness that's out there and I know GPs are.

[00:27:08] [SPEAKER_02]: I don't have the data for it but anecdotally we're seeing the GPs are taking more and more worth the Donik starts as a function of them you know being able to do that and you go to the dentist twice a year and they just keep you in house there versus refer you out like they used to do right.

[00:27:22] [SPEAKER_02]: Like I said I don't know the true impact but I anecdotally hear that it is it's having an impact so to your point when you you have your business and you're looking at all the different processes and systems and how you're going to get patients to call you and then into your practice and then treat them.

[00:27:38] [SPEAKER_02]: That's really important to have those systems down and have those partnerships down to make sure that you're managing your business as effectively as you can considering the changing dynamic that we have out there.

[00:27:48] [SPEAKER_01]: Well as we start to maybe wrap up is there anything that we I didn't hit or prompt you with that you want to you want to bring up or talk about.

[00:27:57] [SPEAKER_02]: You know the biggest thing that I see you know as you kind of unpack the patient funnel.

[00:28:03] [SPEAKER_02]: You're leveraging the data analytics I always go back to that because and I know you guys do such a wonderful job on the front end of pushing patients into the practice and you have a lot of data analytics with your practice beacon around that to really provide that.

[00:28:16] [SPEAKER_02]: And so I you know I always recommend you know from a from an orthodontic perspective you've got to have some sophistication in your in your marketing there's a lot of it now that's been digitized right and you guys do a great job with that.

[00:28:28] [SPEAKER_02]: You know we had some data on some persona based marketing opportunities I know we've talked to you all about that you know we're not the marketing group to do something with it but we can definitely pull that so there's you know there's opportunities out there that practices can take advantage of really kind of getting streamlined and specific when it comes to how they go and approach the market.

[00:28:46] [SPEAKER_02]: And I know you guys do a great job of helping in there but then once you start getting that patient into the funnel I think we look at it and we look at a metric called the new patient exam to patient call ratio.

[00:28:58] [SPEAKER_02]: And so a lot of times if we look at this in aggregate across the single doctor practices that we expect about a 10% fall off.

[00:29:05] [SPEAKER_02]: And so if you think about I had 100 patients call me and 90 came in for an exam.

[00:29:11] [SPEAKER_02]: We would expect that but we're seeing only about 80 are coming in for exam so if you start to play that out you really you're losing those 10 from 80 to 90 that are for whatever reason not coming to your practice.

[00:29:23] [SPEAKER_02]: That's 10 that you don't get in at bat you know you start to do math I'm at a 70% conversion rate at 5000 bucks you know quick math could be somewhere close to 50 grand now that's just the same.

[00:29:35] [SPEAKER_02]: So I think it's a small example you start cascading that up to the average orthodontic practice it's on gauge is going to be a couple hundred thousand dollars a year so I think it's really important as you move through the patient funnel not only on the front end with what you all do but then once that patient comes into the practice how do you get him into an exam and then how do you get him into a start.

[00:29:51] [SPEAKER_02]: Another offshoot of that is the the the OBS opportunity and with engage we all of the OBS patients are classified by age.

[00:30:01] [SPEAKER_02]: And so if you go in and you can see okay in my OBS group I have let's say 400 patients that are an observation but I also know the age ranges for the buckets of each one of those so you know the data that I've looked at aggregately is that 57% of them are 11 years or older.

[00:30:18] [SPEAKER_02]: So if you think about that that is a happy hunting ground for you to go make sure that you're pulling those patients into your practice versus just letting kind of sit within your practice management system so what are you doing with your observation program to really mind that and understand where they're at right.

[00:30:33] [SPEAKER_02]: And then you're supposed to see a certain amount every month that's that's not being seen and then a third of them haven't even been seen in 12 months so are they even your patient technically they moved on.

[00:30:42] [SPEAKER_02]: So there's there's just there's like low hanging fruit I think throughout the whole system that that can able enable a practice to drive more starts and then I talked earlier about us having a call it a multi linear regression model we took the operational data and we move it with the the expense data and so it comes up with three things that you should be focused on

[00:31:11] [SPEAKER_02]: and then value per visit goes into how effectively and efficiently can you treat your practice your patients right so if if you're spending 30 months with them and 25 visits then you're not being efficient because every visit times money is costing you.

[00:31:26] [SPEAKER_02]: So do you have a metric and you have a way to understand you know with the technology you're using with the appliances you're using like how fast can you move them through because statistically it's proven that for every point or every dollar value per visit you can save is

[00:31:41] [SPEAKER_02]: is helping you gain more profitability in practice and then expenses is the third vector of this whole thing and then if you look at you know just your big five buckets which is kind of staff it's your clinical marketing it's your office expenses how much are you spending on staff as a percentage in that collections right is that higher low comparison to the benchmark right because that's and then the more digitized you get the better your value per visit gets can you be more efficient with staff spend and I'm not advocating here to go have layoffs

[00:32:11] [SPEAKER_02]: or anything but another big thing outside of covid is that there's it's harder to gain staff and there's a lot more employee turnover. So as you become more efficient and you do get turned over to just not backfill right and then now I can get my staff as a percentage collections for 24% maybe down to 20% because I have overall less appointments because I'm more efficient with my treatment modality so

[00:32:32] [SPEAKER_02]: you know as you start to really unpack this at a much deeper level than just looking at production collection new patient exams and starts and new patient calls like there's a lot of nuances in the finance that's behind the scenes that can really help drive profitability at a much higher level so you know that's that's kind of where I think our consulting team and engage as you get deeper into the

[00:32:53] [SPEAKER_01]: into the tool can really you know help help you from a practice perspective. Yeah so many things come to mind as you're as you're talking and just at a high level I talked to a lot of orthodontist and dentist across the country and there's really maybe two buckets I put them in which is there's the reactive group who just kind of rides the waves of highs and lows technically nothing wrong with that if if that's okay with you but then there's the side that they do set goals they do set targets they do work on leadership

[00:33:23] [SPEAKER_01]: they maybe work with consultants and they're growing but there's still opportunities for them to double down on certain things or maybe uncover certain things like because of that growth they maybe get a little comfortable and it's like well how do we keep this growth going is really how they should be thinking

[00:33:43] [SPEAKER_01]: and are you know what's our new patient phone caller are we answering every caller we responding to every message are we following up with people to your point and I think it's the consult manager tool when people go into pending what is that process if they're not setting a start date or they're not same day starting how are we following up with them what is that experience like how's it tracked where's it tracked what's the messaging all of that stuff.

[00:34:10] [SPEAKER_02]: And their statistics to on just you know obviously the same day start is 100% closure right there they're going to be in the club and then you get a same day contract you got like a 98% and then if you're starting to follow up.

[00:34:22] [SPEAKER_02]: You're moving down the funnel and pretty soon you're flipping coins as far as you know are you going to get that patient or not at 50%.

[00:34:29] [SPEAKER_02]: So that's that's the critical piece is just and that's why I say just even from a marketing perspective to getting the patient in to that new patient call to exam ratio into a start managing your observation and then the treatment efficiency that whole piece has to have processes

[00:34:44] [SPEAKER_02]: and systems behind it to maximize your profitability and maximize your patients starts across the funnel.

[00:34:49] [SPEAKER_01]: And I think it's important to understand consumers because people can come in have a great experience and there can be the belief well I don't want to you know hard sell anything so we're not going to do same day starts and we'll just give them the information and see what happens again.

[00:35:04] [SPEAKER_01]: Nothing necessarily wrong with that but what if we just changed our mindset on sales and sales was actually helping somebody because that's exactly what it is if if you do good work and you operate with integrity.

[00:35:16] [SPEAKER_01]: So understanding that consumers today have changed and just like you said somebody with the greatest intention of I want to get braces or I want to get in this line even someone like myself.

[00:35:30] [SPEAKER_01]: If I come in and the process is still set, you know, in old systems of we'll just give you the information will see if you call us back.

[00:35:41] [SPEAKER_01]: I am so busy and people these days are inundated with Instagram tick tock text messages.

[00:35:48] [SPEAKER_01]: I mean, I can't even tell you how many spam phone calls I get in a day and we just forget I find myself sometimes missing text messages to confirm appointments with people who I've been doing business with for years.

[00:36:00] [SPEAKER_01]: You know, and it's just it's that natural part of we are in the information age and just inundated with all this stuff coming at us everywhere.

[00:36:12] [SPEAKER_01]: And so make the most of the opportunity when somebody is in front of you that human to human element if they're right there maybe just tweaking the process and making it better and really valuing that person's time because it seems to be getting less and less.

[00:36:29] [SPEAKER_02]: That's what I was going to say is they probably would appreciate it because of the business factor.

[00:36:33] [SPEAKER_02]: Like do I have to come back in for one more appointment or can I have a same day start and can we get started?

[00:36:39] [SPEAKER_02]: Can we do all this stuff today because yeah, the old school model is okay.

[00:36:42] [SPEAKER_02]: I have a console and I come in now that I'm going to set my start date, you know, two weeks later a month later whatever it is.

[00:36:49] [SPEAKER_02]: But if I could knock those two points out now because I'm here, I've taken off work got the kid out of school.

[00:36:54] [SPEAKER_02]: Here I am as a parent right.

[00:36:56] [SPEAKER_02]: It's much easier and they like to say I think they'd appreciate it if that it's not to be as the TC on that side, not to be fearful to ask for the sale.

[00:37:06] [SPEAKER_01]: Right.

[00:37:07] [SPEAKER_01]: Literally have to ask for it and there's language that you can do that softens that but also hooks them in and I think you have to zoom out and look at what's driving the market and when you look at things like streaming platforms like Netflix when you look at Amazon Prime with two day shipping Uber eats

[00:37:22] [SPEAKER_01]: and store dash the list goes on and on and also with social media.

[00:37:26] [SPEAKER_01]: It's like literally the world's at your fingertips with an iPhone and so we have to understand that is the shift and there's nothing we're going to do to change it like we're not going to change tech.

[00:37:39] [SPEAKER_01]: We're not going to change consumer behavior and it's even getting more automated with AI.

[00:37:43] [SPEAKER_01]: And so we have to change our business to be able to respond to that in a positive way be proactive and just embrace change because it's going to happen.

[00:37:54] [SPEAKER_02]: I mean, it's an instant gratification world right and sadly the technology has made us all more impatient and I think we all you know we need those dopamine hits right with alerts and texts and all that other kind of stuff and but yeah it's changed the human race to a degree.

[00:38:12] [SPEAKER_02]: As far as how we communicate, react, respond. We're not patient anymore. I mean I know I suffer from it and I don't necessarily like it about myself but I need to be more calm and patient and just relax in the moment versus I got to get on to the next thing right so yeah as a consumer it's absolutely something I got to take into consideration.

[00:38:31] [SPEAKER_01]: Before we go I want to read something that orthodontist sent me Dr. Carter Thomas. He's used Gage for a number of years they're in Mobile Harvey and Thomas and they have been a hit partner for about a year and a half.

[00:38:45] [SPEAKER_01]: And I think this is really key for people to understand who may work with us or they're thinking about it and they also work with Gage how it can kind of work together so he says if an orthodontist wants to optimize their entire practices performance

[00:39:00] [SPEAKER_01]: they need software on two main fronts. First you need software like Practice Beacon from Hip Creative which helps you manage new patient starts.

[00:39:09] [SPEAKER_01]: Practice Beacon organizes and manages leads, the new patient phone call process, tracking the new patient journey. It helps you efficiently handle these aspects ensuring more new patient exams are scheduled and providing a great patient experience.

[00:39:22] [SPEAKER_01]: After that you need to track the performance of the practice and that's where Gage comes in. Gage allows you to efficiently analyze critical numbers to make informed management decisions such as evaluating conversion rates, productions, collections and identifying what is or isn't working across the entire practice.

[00:39:41] [SPEAKER_01]: In essence Practice Beacon is excellent for prospecting new patient opportunities and ensuring they don't fall through the cracks while Gage excels in real time retrospective analysis helping you track and evaluate your performance.

[00:39:55] [SPEAKER_01]: It goes on to finish, using both really prevents that leaky bucket so any thoughts around that?

[00:40:02] [SPEAKER_02]: Absolutely I mean I think it's a lot of what we've talked to you today so you know just to reiterate having you know any corporate business has business reviews they have metrics that they track and they look at it on a frequent basis so you know the great thing about the orthodontic market is that if just the basic business model is very lucrative from a profitability standpoint.

[00:40:29] [SPEAKER_02]: Yeah I think you know if you look at average orthodontist you do million and a half, two million maybe higher and then your overheads maybe 60% is kind of what the industry averages say so you're putting 40 cents of every dollar in the profit.

[00:40:42] [SPEAKER_02]: That's a lot of money but if you're also at that level of million and a half, two million every one percent change is a very very significant amount of cash.

[00:40:51] [SPEAKER_02]: You know just to give to your teams, to build your own wealth you know however you want to distribute that right and I've been introduced before on stage with Gage and the doctor said before I use Gage I would just look at my bank account and I had money in it and that was cool.

[00:41:08] [SPEAKER_02]: And now that I actually manage my metrics I have a whole lot more money in it as a function of that so I think and we do you know even with our overhead module where we look at our executive module where we look at all the overhead.

[00:41:21] [SPEAKER_02]: You know we'll run Pareto's and you know they'll be efficient doctors that are in the call 40 to 45% overhead and then it'll range up to 75-80% so they're only making 20 cents on the dollar right.

[00:41:32] [SPEAKER_02]: And then you'll go look at okay you peel that onion back and it's like okay I'm spending 35% of my staff.

[00:41:38] [SPEAKER_02]: You know or my clinical lab is 25% which should be 15.

[00:41:42] [SPEAKER_02]: Is there awareness for that or even where and if you're looking at it once a year you can't make any adjustments but if you look at it monthly or weekly you can start to understand where you're at.

[00:41:51] [SPEAKER_02]: So I think you know just going back to like most businesses look at numbers that track KPIs have business reviews have some type of tools that really walk them through that funnel of however there's whatever they're selling right and understand that so I think it's really important that you know with the

[00:42:08] [SPEAKER_02]: Don is do that as well and there's just there's still even though the business model on its own is very lucrative there's still a lot of upside to continue to make it even more lucrative.

[00:42:17] [SPEAKER_01]: And I would say you know don't let the overwhelm keep you down like it's easy to just be always reacting and maybe thinking that you can't work on the business and there are people like ourselves gauge there's consultants there's people who focus on hiring training team members.

[00:42:36] [SPEAKER_01]: So it's easy to get overwhelmed and think about all these things I mean you mentioned hiring and keeping team members that's become a massive pain point but there are people who can help you with that and you don't have to do all of this yourself and I think that's where most business

[00:42:53] [SPEAKER_01]: owners get so overwhelmed it's there in the business and how am I going to get all this done but you have to be able to zoom out and take a deep breath and then find the right people to partner with because at that 1.5 or $2 million

[00:43:08] [SPEAKER_01]: practice you do have the capital to invest back in the business. It may not be a ton of money but there's going to be some and if you invest in the business it's just going to pay dividends like you're saying just that 1% just that 5% it can be a huge growth.

[00:43:26] [SPEAKER_02]: The ROI on partnering with different partners in the industry is is it's always there.

[00:43:33] [SPEAKER_02]: Yep. So if viewers or listeners want to learn more about gauge where should they go. Well thank you for listening to this. If you're at this point in the podcast I appreciate that you would go to gauge.com and gauges.

[00:43:55] [SPEAKER_02]: So that's the best way to get started and that can be pretty I mean you can get a demo within a couple days so Ryan thanks so much for coming on the grow worth of podcast. I appreciate it. Thank you for having me. Thanks for listening.

[00:44:07] [SPEAKER_01]: If you'd like to learn more about hip or any of the topics in this episode, send an email to hello at hipcreativeink.com that's hello at hipcreativeinc.com or jump over to our website at hip.agency.