Welcome to Bite Size Dental Marketing. In this
episode, we talk to the one and only Marissa
Krugoff. Marissa is co -founder of the Dental
Practice Management Agency and is a certified
life coach trained under Tony Robbins. With over
25 years in dentistry, Marissa brings a rare
blend of clinical expertise, business strategy,
and a people -first leadership to the table.
We talk about the real challenges that dentists
face when they go straight from graduating into
being expected to own and run their own dental
practice. Marissa shares how understanding human
needs, training with intention and practicing
radical candor can transform not only the systems
in your practice, but also your entire team.
Enjoy. So Marissa, one thing that I always love
to do is to just understand the background and
the story of our guests when they come and join
us on the podcast. I went and I had a look and
everything from life coach to your experience
in dentistry to the type of unique techniques
that you implement. You don't just learn that
overnight. So if you can please just give us
a bit about your background and how your journey
has led you to where you are today. Absolutely.
Yeah. So I've been in dentistry my whole life.
I started when I was a very young teen and I
started as a hygiene coordinator and I was very
lucky to be with a dentist that taught me kind
of everything dental. He taught me how to read
x -rays and kind of taught me like you would
an associate. And so I fell in love with dentistry
and his wife taught me everything insurance.
And so eventually that led me to the front office
where I was a front office admin person, Eventually,
I was a regional manager for a large DSO or a
corporate office dentistry. You know, I loved
that because I could help people on a greater
scale. But what I was missing was the culture.
And so I loved the systems. Corporate has some
beautiful systems. But what they are missing
typically, not always, is that culture and communication
piece. And I just thought if you could marry
the two of those. What could that do for an office?
So that's why I started consulting and being
able to grow that in the practices and watch
not only the humans grow. But the business grow,
because if you grow the humans, you grow the
business. I wanted to do more. And I found life
coaching. I took a class and got certified under
Tony Robbins. For those of you who are under
35, Tony Robbins is a big life coach guru. He
was like the first authentic rough and tumble
kind of life coach. And I just really resonated
with that. I thought he was so authentic that
I wanted to be like that. So I got certified
under him. And we now use that in our business
to. grow communication grow culture grow the
humans um and and couple that with that beautiful
system um you know accountability that grows
the business and that it's been amazing it just
kind of has been a journey that fell in my lap
but i just i don't say no to anything it's always
yes i want to know more just keep growing yeah
the tony robbins um you being a certified tony
robbins coach i saw that and i was like that
is very interesting i definitely want to ask
marissa about that was it just like You said
now you resonate with him and you're like, I
just want to learn more and go take that on.
Or was it that was dentistry in the back of your
mind of we need to marry this in some way? Or
did it just come kind of come together for you
when you had done both those things? Dentistry
was not in my mindset at all when I took those
classes. I really wanted to. grow people and
give that's my purpose is to give back to people
and to help them find their best selves it just
that's my purpose and it took me a minute to
find out that that was my purpose but I just
get to do it both with my life coaching and with
dentistry now and I just kind of put those both
together because I love them both. One thing
that I hear again and again and again that I
feel so many dentists are faced with is they
study for a minimum of eight years to even just
become a dentist. I mean, now I don't know anything
else at this point. I've just become a dentist.
And they're then thrown into this world where
they're expected to run a business and know team
dynamics and the psychology of a team and dealing
with the emotions of a team and processes. What
is your thoughts on... the experience that dentists
have during that time, during that transition
of having to wear so many hats when they've just
kind of completed one chapter. When you first
get out of dental school as a dentist, what I've
seen time and time again is they're just getting
their feet like on solid ground of, oh, I don't
have to have a professor check me every time
I do something. Oh, my crown can't take me four
hours to do, you know, like they're just getting
the dental piece. And so it really takes. about
three to five years for them to start to look
up and be like okay i've got this dentistry thing
down and the dentistry is the easy part it's
all the other things you were talking about the
business all of that stuff and you know we we
have this joke in dentistry that um dentists
don't know business because we don't teach it
to them in dental school kind of where it's always
you know they're terrible you know business people
but the honest truth is is that that joke is
not that funny because after these docs get out
within five years of them graduating typically
most of them own a business a small business
that they don't know how to run and and i think
that that's the scary part for me you know they
know the dentistry that's easy to them you know
there's some harder things but they what they
don't know is what's the admin team doing how
are they billing and collecting money how are
they supposed to take all that paperwork at the
end of the day and make sure that the bank account
matches that stuff how are they supposed to deal
with the fact that susie the hygienist is mad
at you know rachel the assistant because they're
not doing their own instruments you know like
all of that stuff or you know the talent pool
is so shallow in dentistry right now that you
can't find a great human if you do they want
so much money how are you going to pay them so
all of these things including bill paying all
that just it stacks up and they're in a mouth
all day long So it's really hard for them to
switch gears from, I have to be the main producer
to, oh my gosh, my business has to be ran as
well. And honestly, the best advice I have in
those moments is get a team of Avengers. Like
you need just everybody that can teach you how
to do those things. One of the things I learned
in my life coaching class that Tony Robbins preaches
is if you go your lifetime and learn your lessons,
you'll know a lifetime of lessons. Get those
gurus or those people that are just like, I know
these things very well. And you learn what they
know. You've learned many lifetimes of things.
And I think sometimes dentists, especially because
they're in their own small little practice, they're
on their own isolated island. They know what
they know. And sometimes they're held hostage
by their employees because of that. So it's hard.
That's the biggest challenge I see is the business
piece. It's not the dentistry. You can figure
that out. And there's plenty of CE out there
if you can't. But when it comes to business,
there's not that many. And recently, within the
last three years, I have caught over a million
dollars of embezzlement just in dental practices
because dentists don't know their business. They
take whatever Susie at the front desk tells them
at face value because they have no idea what
insurance is doing, how they're billing, how
they're collecting, what are they supposed to
do with all these papers at the end of the day.
So if I, again, had the best advice I could get
is, Get educated on your business because that's
the part, no matter how much you're producing,
if someone's taking your money or not billing
it correctly or writing it off erroneously, that's
hurtful. What are those main problems besides
embezzlement or the problems inside of the team
or the team dynamics that you are seeing with
all of the dental practices that you've worked
with in your time? What are some core issues
that you can mention to us that dentist maybe
won't feel as alone or can get a better understanding
of hey these things are happening but you can
do something about it lately what i've seen the
most of is dentists being held hostage by the
person that's the only person that knows how
to do this thing whether and typically it's admin
team because you know you can find an assistant
that knows how to do things unless the assistant
that's leaving is the only one that knows how
to run your airway practice or the only one that
knows how to do your seric crown so you know
obviously making sure that people are cross -trained
i oftentimes hear docs when i go in you know
and we're just doing our observation to see if
they want to be a client we want to bring them
into our program I hear them tell me, oh yeah,
you know, if Susie ever goes on vacation, my
insurance claims don't get posted. Like I don't
get paid. So they just stack up and I wait for
her to come back and then she posts them because
nobody else knows how to do it, you know, or
she won't let anybody else. So there's just certain
things that I think, you know, having people
cross -trained, making sure that no one can hold
you hostage in your own business because of their
level of knowledge is very good. That's a good
way to protect your business. You know, the other
thing that I see is lack of leadership. I have
a lot of doctors that, you know, because they're
in a face all day and they frankly didn't want
to be business owners, they wanted to be dentists.
So, you know, they get done with that and they're
so exhausted. They don't want to have to go into
the leadership mode and holding people accountable.
And it's just like, gosh, I just want to go home.
and i get it you know after all of that i totally
understand that but when we sign up to be a business
owner it is an ultimately heavy responsibility
and that means we take on all of it and again
that's having systems of accountability making
sure you're holding people accountable so that
they're coming to you and bringing you that information
instead of you like wondering all the time which
is something we set up with our teams but we
years ago put leadership first so we have a 12
months program our first two months is just leadership
It's making sure that the doctor and the leadership,
whoever that might be, if they have leads or
office manager, whatever, are solid, communicating
well, holding people accountable, creating systems
well, before we ever even work with the team.
Because if we don't, it's going to fail. It's
not going to work. And you mentioned a word multiple
times there, accountability, accountability.
I heard that word three or four times now. Tell
me. I know that is a cornerstone of the work
that you do and the systems that you implement
with practices. What does accountability mean
to you in a practice? You know, accountability
is we have set these systems. We've all agreed
that this is how we're going to do something.
And our integrity level is so high that we hold
each other accountable. It doesn't have to be
a doctor or an office manager. It could be a
front office person. holding an assistant accountable
to passing really well so that they can get good
treatment acceptance and the patient is communicated
well with. It could be, I'm going to go to the
person that I have an issue with instead of gossiping
behind their back or going and tattling to somebody
that is in leadership. I'm going to kindly go
to them and now I have ways to do it and ask
them, hey, what's going on for you? You haven't
been showing up to huddle on time. Showing up
to huddle on time. Everybody shows up on time
because they know that's what's expected. There's
plenty of agreements and rules, but a lot of
it is just us agreeing together that this is
how we are going to roll. This is our brand.
This is who we are. And we are unapologetic about
holding everybody accountable. It's kind. But
when we see teams get to that level, it has to
come from the doctor first, though, or the owner
first. Yes, because the tail will wag the dog.
Like if they're not holding people accountable,
all of a sudden they're like, none of these systems
work. We had block booking forever ago, but no
one ever followed it. And the first thing I wonder
is, well, why isn't the doctor holding them accountable?
And usually it's because they're uncomfortable
with having those hard conversations, which is
90 % of people, right? Nobody wants to have that
sit down conversation and talk about what people
aren't doing right. The level of success that
doctors achieve or any person really in their
life is equal to the level of hard conversations
they're willing to have. Just that complete radical
candor of this is what's going on. And I loved
what you said there of if the team, and that's
why I know you said now talent density is thin,
but I will still say it. The team that you choose
and surround yourself with. needs to agree with
the vision of the practice that the work ethic
of the practice the type of patients we want
in the practice how we want to treat our patients
i guess i'll ask you then let's say i am trying
to do that as a dentist but ian is a difficult
team member and in i've asked him to show up
now i've asked him to do this a certain way in
that a certain way And I'm still struggling.
And the team knows it. And the doctor knows it.
But Marissa, I can't fire Ian. Because where
am I going to find another hygienist? Or where
am I going to find? Because it's a problem. So
where do you land on that when that does become
a problem? You can't necessarily fire someone.
But you need to deal with it. Yeah. I mean, we
teach what we call high confront. So when moments
happen that are little, like Ian first decides
that he's not going to show up to huddle, I'm
going to immediately pull him in privately and
have a conversation about what's going on for
him. I noticed you were not in huddle today on
time. What's happening for you? Immediately.
I'm not accusing. I'm first just asking the why
to try and understand so that the person doesn't
get defensive immediately. Exactly. Yeah, because
if you get defensive, your walls are up and you're
disconnecting to self -protect. So I just have
a human conversation. I had to have three of
these last week with different team members.
It happens a lot. But what conversations have
always worked well for me, and I learned this
way back in my DSO days, is when you sit with
someone and you pull their walls down so that
they're human and you're human on a level and
it's not a... me coming down at you you're bad
you did something wrong it's more of a you know
ian you are so valuable to this team when you
show up to huddle you're prepared you're ready
you're my rock star and you bring such a light
we're always so happy and like joyful when you're
here when you're not i notice it and i need you
to be here tell me what's going on for you that's
having you not be here and i listen and once
you give me whatever the reason is can i count
on you in the future to show up for us I want
you on this team. Can I count on you for that?
So I just already told you, you've got this beauty,
this crap that you're doing in the middle, it's
kind of overshadowing your beauty. Can I count
on you to give me your beauty? Because I need
that. I look forward to it every day. That's
a different conversation than if you don't show
back up to huddle, I'm going to write you up
and you're going to get fired. Would you say
most dentists do that? I know it's not their
fault where dentists aren't taught psychology
or the type of techniques that you just said
of build someone up, empower them, don't just
tell them what they did wrong. I mean, I'm sure
we get it wrong every day in our daily lives
too with how we approach it. So how can dentists
change? Are there some techniques besides what
you said now that you learned with the Tony Robbins
coaching and stuff that people can use? to help
them to keep mind of these things as they work
with this stuff? Yeah, I mean, you know, what
we do on our team is we do a DISC personality
profile for all of our people, for every team
member, and then we talk about it with the team.
So everyone communicates differently. Some people
are very direct. Some people are a little bit
more sensitive. You know, some people are more
analytical. So we break that down for the doctors
and the leadership so they know exactly who they're
dealing with. And then we also talk about the
six basic human needs, which is a Tony Robbins
idealism. But it basically talks about which
human need is your most important one that drives
you. So there's certainty, uncertainty, love
and connection, and significance. Those are the
top four. Those are the main ones that we have
as drivers. So certainty is just, I need to know
that my paycheck is here at 4 p .m. on Friday,
like you said it was going to be. I don't like
not knowing. So it's I'm not going to go just
go to Vegas and on a whim and like, you know,
go live my life like that. Nope, I'm not going
to do that. I'm going to plan it for seven months.
Right. That's certainty. Exactly. And whereas
variety would be the person that's like, hey,
you want to go to Vegas right now, Ian? And you'd
be like, heck, yeah, let's go to Vegas. I'm down.
I don't care what we're doing. Let's just go
right now. Don't threaten me with a good time.
Exactly. Exactly. And, you know, significance
are people that really need to know that what
they're doing is unique and special. And they
need that attaboy often. They need people to
notice how great they're doing. And, you know,
love and connection is pretty self -explanatory.
It's just they need to feel important and loved
and connected with and with the team as well,
not just them specifically. We all have that
in us. We all need those things. It's like the
food, water, and shelter of the spirit, basically,
that we have to have those things. And so those
four top basic human needs for us is find out
which one is driving that person. Because if
it's significance for you and you're not showing
up to huddle, that thing that I just said about,
I need you here, you're my rock star, I lean
on you. It fills you up. You're like, oh my God,
they need me here. That's my one. I was just
about to say, Marissa, as you mentioned and explained
that, that is 100 % me. Like if I lose significance
in the work that I do or if I'm working on something
and I've not gotten some direction from Eric
and Andre or my team members or something as
like, hey, this is aligned with what we need
in the agency. You're doing great, amazing. It's
not about feeding the ego as much as it really
just is about that reassurance. And that probably
goes back. to my childhood days where my mother
was someone that was very telling me like you're
doing an amazing job keep going i know you took
one on the chin but you can do this and we need
you like so i can see how all of us i always
like to say is we are children in some way we
all grew up in a certain way needing certain
things and if you can be the type of boss or
the type of leader that can understand the employees
as you just said and to tap into that side not
to manipulate but to actually and encourage and
engage and support. I mean, it's the magic. That's
the magic. 100%. It's not one size fits all.
And that's the thing I often get from docs is
like, how do I do all of this for all these people?
It's sad to say, but it's like kids, right? Like
if you had six kids, you wouldn't be able to
treat them all the same. They all need different
things. So what we help them, and that's why
we do leadership ahead of time, is we help them
figure out what do each one of their kids need,
right? Like what is it that they need? Because
if I come to you and give you significance and
you need certainty, That's a different conversation.
That's not going to fill you up. It's not going
to work for you. So I need to figure out what
your driver is, exactly what your personality
style is. And then I can come and communicate
to you in a way that you're really going to hear
me and it's going to make a difference. And if
that doesn't work, have we had to fire people?
You bet. I mean, there's plenty of times, but
I will tell you, I've never once fired anybody
ever in all my 28 years in dentistry and not
had them look at me and say, I know I lost this
job for myself. because I worked through that
with them. I tried everything I could to support
them. I asked them what they needed. And in the
end, I didn't take that job from them. They lost
it on their own. But you have to be unapologetic
about that. You know, I think because the talent
pool is so shallow, people are accepting people
that should not be in their business and they're
losing the good people because they're doing
it. And when doctors are scared to let someone
go because, oh my gosh, what's going to happen?
Susie's been here forever or whatever, you know,
whatever the answer is. It's like you're running
forward with a weight around your waist. You
are not going anywhere until you let go of that
person. And every person has been like, I wish
we would have done that sooner. We are so much
better without that person. 100%. And you just
sparked a thought for me, Marissa. Can you share
with us the toxicity or how negative that is
actually to your business if you try and hold
on to that person just because you're scared?
of they've been here so long or i'm not going
to be able to find someone else have you seen
examples of it destroying a practice's culture
or or even the production of that practice the
actual success of that business oh yeah yeah
i've seen it happen time and time again um where
you know docs are for whatever reason they're
unable or unwilling to let that person go um
and it it ultimately does affect production i
mean like their numbers start to tank And there's
been clients I've had to let go because they
weren't willing to take their business by the
horns and be like, no, this is my business. I
am working hard about it to get it where I need
it to be. And they weren't willing to do those
hard things. And I can't get people past that
success level. I can't. I can only get them so
far if they're unwilling to make a change. You
know, it's my same in my life coaching. When
people tell me they want change, but they actually
show me they want change are two very different
things. So I have plenty of people that say,
I want to lose weight, Marissa. I want to save
money. I want to have a better relationship,
whatever. But they don't do the work. Well, that's
not true. You don't want it. So at some level,
we've had to let clients just go fly on their
own because they weren't willing to make those
hard decisions. Because for me, I cannot sit
back and watch them not be successful because
they're unwilling to make those hard decisions.
We don't get to do that in business and be successful.
You can't have both things. Nothing changes if
nothing changes. Exactly. Yep. And you will get
what you allow. Yeah, you will get what you allow.
And it can even be one employee. It does not
have to be this person's bad. And that I've seen
time and again, as you mentioned now, Marissa,
like one person in the team can just poison that
entire well and just make it bad for everyone.
So dentists like really listen to what Marissa
is saying here. it can ultimately impact your
business in a very real way. And make those difficult
decisions. Like you need to step up and do something
if you want to protect your baby. Because at
the end of the day, that business is not only
looking after that one person, it's looking after
your family, the other families that's also in
that business, and this whole tribe, and the
patients that love and care for your practice,
that want to come to you. deserve better so so
practice doing the uncomfortable things as marissa
is saying you've said that a one -size -fits
-all type of approach does not work with practices
because each practice has their own needs based
on their team can you share with us a bit about
why you've taken that approach how would how
it applies in the real life for when you go to
a practice or you judge these things yeah you
know i think um All of the people that are on
my and my business partner, Chris's team now
in our Wolfpack, we've all had consultants in
the past before we became them. And we all had
the consultant that really tried to squeeze us
into that cookie cutter approach, no matter where
we were, small town, big town, whatever. And
what we noticed was, is that it doesn't work.
You know, you have certain pieces of it that
might work, but not all inclusive. And when dentists
go from consultant to consultant to consultant
to consultant, they have all these weird mismatch
systems. They don't know what's going on. It's
too much. The team gets confused. It's a lot.
So we really try and customize the best we can
so that they have this one -stop shop. And we're
happy to do the 12 -month program and let them
fly. We do not keep our clients into perpetuity
like most people do because we want them to go
out and never need a consultant again. They shouldn't
if they keep doing the right things, right? what
we do first is we do an observation we see what
they're doing well and we don't touch it we might
spit shine in a little bit but that's it like
we're not touching the good stuff but the stuff
that might need some more love we really go in
and and dive into each department so we have
department trainers for each department so we
have assistant trainers digital dentistry trainers
hygiene trainers admin trainers leadership trainers
and then doc doc we do the business training
with And we go through each department and just
leave no stone unturned. And it's really customized
to creating an SOP manual for each one of those.
And then we leave them with an online electronic
SOP manual for each department. Again, so they
don't need us forever or anyone else for that
matter. But that really has been our best approach
to make sure that all of the things really fit
in well. That's how we customize it and why we
customize it. Because again, not everyone's the
same. I can't go to... You know, I grew up in
a very small town in the dentist there that I
started with. He did not do things like those
big DSOs did down in downtown Denver, right?
Nor should he have, right? So I think us looking
at that and realizing that every single office
is different. Now, do we have a core set of 12
-month program? This is how we do this every
single month? Yes, we do. But we kind of customize
it along the way to make sure that they have
exactly what they need. You obviously work across
multiple types of dentistry and you work with
all types of people, all types of dentists. Have
you picked up any trends and things in certain
types of dentistry or in certain even areas in
the States or the work that you do that you're
like, we tend to keep finding these type of problems
with? this kind of or like a cosmetic dentistry
because of them having to deal with x y and z
or maybe an implant specialist because their
systems are a bit different and the type of money
that's being dealt with is full arch forty thousand
dollars so it's a bit different than the general
or do you kind of see it as these are problems
that dentists are dealing with and i and we need
to solve them they're honestly very similar there's
like it just it's it like it's all the stuff
we've been talking about you know holding team
accountable and running the business and what
to do and i don't have enough time and you know
all the things like it's it's all exactly the
same um there really isn't much difference i
mean of course like a surgeon's going to have
some a couple of different things as far as systems
go differently but for the most part the bigger
issues that we're seeing it's mostly just not
knowing how to communicate well with the team
and not having the gumption to hold them accountable
and is the Anything if you look forward, I mean,
the dental industry moves fast. Trends and things
that you're seeing, I'm even just thinking how
technology changes or how we work with insurance
companies or how anything with how fast the industry
is moving. What are you seeing that dentists
will potentially deal with in the future and
that they can be aware of within their team dynamics
or how they're running their business that they
can think about? The biggest thing that we've
seen lately that's been just kind of like this
bubbling, tumultuous thing is insurance. And
it's getting harder and harder to work with them.
There's all these different rules. They're not
paying these things. You have to have this x
-ray and that x -ray. It has to be this many
days between this to get paid for this. There's
so much that... I'm starting to see more and
more doctors be like, I don't care anymore about
how many new patients I have. I don't want to
be in network with all these insurances because
you know, that's a big marketing push for doctors
is that's how they market. I just get a network
with a bunch of insurances. Even if I get them
negotiated with a PPO negotiator and I'm getting
pretty good reimbursements, it's that great.
You're getting great, good reimbursements. If
insurance pays you. If your front office knows
how to appeal things and does the hard work,
if they follow up, you know, it's just, it's
so time consuming. And so I think within the
next five years, hopefully sooner, we're going
to start to see a shift of dentists being like,
I'm done with this. I'm not, you know, I'm over
the insurance dictating my care. And sadly it
has. tough person at that front desk or the person
that's doing your insurance claims and those
things to battle with these people. And often
that is, I know that's likely where your team
comes into in training these people and helping
these people, but it's, man, that's a difficult
job because insurance companies make money when
they don't pay you money. Exactly. That is ultimately
their goal is to make this as difficult. I mean,
I hear this similarly to you, Marissa. I hear
this all the time. It's just like I'm sick of
these insurance companies that are trying to
dictate the type of care that I do, the money
that I'm actually going to make from this. And
sometimes you do all that work and then the insurance
is like, no, we're not going to cover that or
we're not going to reimburse for that part or
something. And it's tough. It creates problems.
So I'm with you. Marissa, I have a last question
for you, which is something that I always enjoy
doing. This is your megaphone. This is your platform
now. If you had a message to dentists out there
now to summarize a bit what we spoke about and
everything that you've learned in all the years,
what stays true to you after all of these years
of being in dentistry that you want dentists
to understand? That's a really good question.
And it kind of reminded me of an article that
I read years ago in Dental Economics that talked
about how the average US dentist spends anywhere
from like $8 ,000 to $16 ,000 on clinical CE
every year, just becoming a better dentist, clinician,
whatever. But the article later goes on to talk
about how the average US dentist spends $0 to
$100 on anything business acumen, leadership,
communication, $0 to $100. So that would be my
biggest push. and best advice i could give a
dental practice owner is educate yourself and
don't just grab you know podcast after podcast
after book after you know this guy that you used
to know in dental school like get somebody who
is knowledgeable in that specific thing that
you're trying to learn and find out what they
have to to give you so that you'd have their
lifetime of knowledge i mean we we are small
business owners we we are and so it's very important
that we protect our business and the only way
you can do that is by knowing the ins and outs
of everything especially that front vest like
i said i've caught so much embezzlement if dennis
knew what was going on up front half of that
would not have happened fantastic marissa tell
me if people want to get in touch with you if
people want to to learn more about what your
team is doing workshops website please tell us
where we can find you. Yeah. So if they go to
dentalpracticemanagementagency .com is our website,
all the information's on there. The contact is
actually my cell phone. So reach out. We'd be
happy to help with whatever, even if it's just,
I have questions. I'm worried. I'm five years
before retirement. I don't know what to do. We
talk to people all the time and don't charge
them. truly are here to make sure that people
are successful and not suck their time and money.
That is our motto of our company. Fantastic.
Marissa, thank you for your time. I appreciate
you being with us today. Yeah, thank you for
having me. It was awesome.