Patients First

Feb 28, 2017 No Comments by

Using Total Team Training Principles for a Patient-Focused Practice.
Dentistry is my family’s business. My grandpa, his brothers, my dad, my uncles, and my sister all chose dentistry as their profession. My mom also worked at our dental practice in Shelby Township, MI, as a bookkeeper, and my other siblings have worked there too. Even the team members who work in the practice but aren’t related to me feel like my relatives because most of them have been with the practice for several years. It’s a family practice in every sense of the word.

I told Dr. McKinley that I thought the entire staff should attend the TTT seminar when it was offered again.


When I was in high school, I started working at the dental practice as a sterilization assistant. I did some chairside assisting when I was 14 years old, and I kept at it until I moved away to go to college. After that, I worked at Walt Disney World® in Orlando, FL, for three years before eventually returning to the family business. I started working as the office manager of the practice five years ago and I’ve been there ever since.

Third Time Is The Charm
In 2013, I learned about the Total Team Training (TTT) seminar offered by the Dr. Dick Barnes Group. In the fall of that year, Dr. Dick Barnes and Hernan Varas (from Arrowhead Dental Laboratory) visited our practice. They invited our team to the TTT seminar in Dallas, TX. I was the only person from our practice to attend the seminar, but I returned to work with enthusiasm about what I had learned.

I shared my newfound knowledge with Dr. McKinley. I told him that I thought the entire staff should attend the seminar when it was offered again. Dr. McKinley wanted to attend the seminar before committing to take the entire team, so the two of us flew to Utah for the next Total Team Training in February 2014. After the seminar, we were both convinced that everyone needed to attend.

In May 2014, we finally had our “total” team at Total Team Training. At that time, the seminar was offered in Lexington, KY. To get to the seminar, we loaded our team members into my dad’s motor home and rolled on down to Kentucky. About 12 or 13 team members attended the training. It was an eight hour drive, and I drove the entire way.

Why would I attend Total Team Training three times? I was motivated by the concepts in Total Team Training and believed it would help our practice improve. The principles made sense to me and I learned something new every time.

Also, Tawana Coleman, the TTT instructor at the time, was inspiring. Tawana was very sincere about the principles of TTT and she spoke from her heart. In hindsight, I can see that my training at Disney World® prepared me for the similar structure that exists at TTT.

The “Guest” Experience
Disney World® is a well-known, well-respected brand. They’ve created a strong and successful brand largely by focusing on the “guest” experience. Much of their employee training concerns employees’ behavior towards the “guests” (all visitors to the park). Employees use scripts with specific words for common scenarios so that the experience is the same for all visitors. It’s a structured environment where the goal is to create a positive, memorable experience for each guest.

When I attended TTT and heard Tawana talking about the “patient” experience, it immediately resonated with me. She suggested specific words and messages to use with patients in a dental practice, and because I was already comfortable with a similar process, I was excited to implement her ideas.

Putting Words Into Action
After the first seminar, I returned to our practice and decided to implement the new patient interview with the specific form that each participant received. Prior to TTT, we were the office that handed new patients a clipboard with a pen and new patient forms. There was no opportunity to engage with the patient and learn about them, other than through their demographic information, insurance, and medical history.

All of that information is absolutely worthless when you’re trying to build a relationship with a patient. When we started doing the new patient interviews as instructed by TTT, I noticed a deeper connection with my patients. I wouldn’t have called them “my” patients before. Doing so now makes me feel like an advocate for them. I have an almost familial attitude toward our patients now.

After the second seminar, Dr. McKinley started to understand TTT case presentation techniques. He has been practicing dentistry in Shelby Township, MI, for a long time—more than 40 years—so, of course, his habits are fairly set. But talking about the benefits of the dentistry was a strategy that really resonated with him—how it serves the patient in the long-term versus offering piecemeal treatments to patients, which he had fallen into the trap of doing before.

I participate in the case presentations now. Dr. McKinley presents the dentistry and I discuss the fee and payment options with the patient. We learned that strategy at the second TTT, and it works very well for us.

The third time I attended TTT, I was interested in seeing what the staff wanted to do. I listened to them and did what I could to support them in implementing those techniques into the practice. My role was to encourage them to apply new ideas.

As far as the numbers side of things, after TTT our accounts receivable practically went away.


One staff member, Tina (who answers the phone at our practice), adopted TTT techniques for getting new patients in the door. She took the “shopper caller script” to heart—making it clear to patients that not all procedures are as simple as one might think. Tina always invites patients into the practice for a brief exam with the doctor at no cost to them. She liked that Tawana gave her permission to offer the patient their first visit as a no-fee visit. Tina is always doing everything she can to save the patient money, so that was an important script to her.

The no-fee first visit is now a principle in our office, but we’ve been flexible with that rule and sometimes go further than just a brief visit with some patients. That’s a judgment call that the doctor makes. It’s his time, so we leave that up to him.

Dr. Barnes said that we should be firm in principle and flexible in procedure. That policy definitely applies to the no-fee visit.

One important thing that everyone learned from Total Team Training was accepting the patient’s decision. It’s very presumptuous to say that dentistry is the most important thing in somebody’s life. Sometimes other things (family illness, loss of job, etc.) can take precedence.

Now when we present cases, we don’t presume that dentistry is the most important thing in our patients’ lives, but we still show them that there are some clear benefits to the dentistry. Hopefully, at the appropriate time for the patient, they will proceed with treatment.

Attending TTT three times in succession was great! Each time, I was able to build upon what I learned in the previous sessions.


We’ve been doing dentistry like this long enough to see patients wait on treatment, and then proceed in the future once they are ready. Time changes things and we have learned that often patients return when the time is right for them. We work with all our patients, no matter what their circumstances. We try to be patient with our patients.

As far as the numbers side of things, after TTT, our accounts receivable practically went away. The financial message in TTT is such an integral part of the training. Now we always discuss financials in advance with our patients, and they are never surprised at the front desk about what they are expected to pay.

Something New
Attending TTT three times in succession was great—each time, I was able to build on what I learned in the previous sessions. I also heard things in subsequent sessions that I had missed earlier. By the time I attended the third training, I had implemented certain elements of TTT in our practice and I was able to drill down even deeper on specific strategies that enabled our practice to grow.

Having the entire staff at the third seminar was great! The team members each had different perspectives, and even though we took the same course, each of us took away something completely different.

If one person attends Total Team Training, you can implement a few principles that enable your practice to grow. But when 12 people attend Total Team Training, you can implement 12 principles or more. Each person can work on his or her own little piece, and the growth in the practice is accelerated.

Continuous Learning
We’ve been running a dental practice for a long time, but we still have things to learn. I return to my TTT workbook and read through it to see things that I might have missed and things that we could do better.

One of our chief challenges is helping people find money for their procedures. Every single patient has his or her obstacles to overcome, especially when it comes to the money. Just being creative and brainstorming with the patient is a good way to get them through their financial obstacles.

Sometimes it can be a bit tricky to apply the TTT scripts—especially when it is new information. For example, once I had a conversation with a patient and I tried to follow Tawana’s script. It didn’t go quite as well as I hoped. After that conversation, my next call was to Tawana. She went over the conversation with me and let me know what I got right and what

I could improve upon in the future. Whatever obstacle you encounter in practice management, TTT offers strategies to overcome it.

One of the most unique and valuable things about TTT is the post-seminar coaching. Tawana made herself available if I needed help with anything after the seminar. So if I ever became frustrated when implementing something new, instead of quitting, I called Tawana or Hernan and explained the problem. Usually they would quickly point out something that I had missed. Their support was invaluable!

One of the most unique and valuable things about TTT is the post-seminar coaching.


I’ve taken a lot of continuing education for dental practice management and it’s NOT common for the instructor to be available for consulting after the course ends. I understand that TTT still offers this coaching with their new instructors—even though Tawana has retired.

Total Team for Everyone
Since attending the TTT seminars, our practice has retained more patients—whether they accepted treatment or not. Yes, we still have those big cases that are slam dunks and the patient spends $30,000 to $40,000 in our office, which is great. But the smaller victories (like retaining patients) are still victories and contribute to the overall success of the practice.

Change is a step-by-step process. Implement things a little bit at a time, rather than trying to do everything at once. The great thing about the TTT principles is that they can apply directly to your situations as soon as you’re ready for change. You really can’t fail!

A Closer Look, Winter 2017, Winter 2017

About the author

Blake McKinley graduated from Lutheran High North in Macomb, MI, and attended college at the University of Detroit Mercy, and the University of Michigan in Ann Arbor, MI. He has worked as an Office Manager for five years and draws heavily on his experience working at Walt Disney Parks and Resorts in Orlando, FL, for three years. He shares the vision of Dr. McKinley and Dr. Holloway—taking the best ideas in dentistry and implementing them in a high-tech, patient-centered practice.
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