Dental & DSO
Podcast & Interviews
Excellence is in the Details
"The theme we’re going to hear throughout this conversation is that details really matter," prefaces Erika Pusillo, Practice Optimizer at Spodak Dental Group, in a recent episode of Call Box Dialed In. From patient communication to office design, Spodak Dental Group hones in on a key aspect of dental care that often gets overlooked — experience.

Pusillo is a strong proponent of differentiating oneself as a practice on the basis of overall patient experience. She sat down with Katie Lorenc, Strategic Consultant at Call Box, to discuss why the rapidly growing practice has chosen an emphasis on experience. Despite the dental industry's tendency to underestimate the effect of patient experience, Pusillo and her team understand that patients have come to expect a high level of customer service both inside and outside dentistry.

Patients don’t know how to judge great dentistry; they only know how to judge good experience."
Erika Pusillo
Practice Optimizer, Spodak Dental Group

"When you think about iconic businesses that really have that experience down, you think about Apple and the way they revolutionized the customer experience. Just walking into the Apple store, you see how that’s organized and how different it is from any other type of retail chain or store," Pusillo describes. "You think about businesses like Uber or other disruptors, and some of the things they all have in common is that they have the experience — and the end result of that experience — as their main driver to make decisions about their business."

Organizations that prioritize experience provide customers with a memorable impression that often leads to repeat business. Pusillo knows that patients have many options when it comes to their dental needs; providing a seamless experience from start to finish allows Spodak Dental Group to stand out from the competition and ensure patients return.

"Patients don’t know how to judge great dentistry; they only know how to judge good experience," Pusillo explains. "Your crown is only as good as the way [the patient] felt. There are tons of studies out there that say that what goes into the experience is the way your practice smells, the way it looks, the way teams interact with each other, the way they interact with patients. We really considered all of those things and the design of our building too. We touch on all of those senses and really develop that comprehensive experience for the patient."

Just a few of the many areas Spodak Dental Group sets itself apart on the basis of experience include:

Referral workflows
Spodak Dental Group boasts a team of 10 dentists, both general and specialized, under one roof. In doing so, the often arduous process of being referred to a specialist becomes a quick and seamless experience for patients. Through coordination of care, patients often meet their specialist or surgeon chairside during their initial hygiene visit and are able to schedule any future visits on the spot. Patients reduce the time spent in the office and increase the trust they have in their dental team. They're also able to experience a vast improvement in the communication of their care among their dental providers.
Call center development
In a continued effort to improve patient communication, Spodak Dental Group has developed a full call center model to handle patient scheduling calls. In doing so, front desk staff members are able to focus solely on the patients in front of them, and the call center agents are able to better serve patients over the phone. Spodak Dental Group has seen calls answered more promptly, reduced hold times and voicemails, as well as increased appointments booked. Patients receive the full attention of the staff and, as a result, end up scheduling appointments more often.
Leadership titles
Spodak Dental Group uniquely did away with typical job titles. Pusillo's role, for example, is office management and operations. Her title, however, is Practice Optimizer. The practice realizes words have significant meaning to both patients and staff, and “office management” often comes with negative connotations that lack empathy and personal connection. By creating specific role titles that have more positive connotations, leadership is able to better serve both staff and patients, and develop a more collaborative office environment.
Pusillo has helped Spodak Dental Group develop a detail-oriented culture that is often unique in dental. The practice's emphasis on improving patient experience at every point of interaction positions its team to better serve its patients. As a result, the practice has realized ongoing growth and created a distinct advantage in an increasingly competitive market.
Read the transcript

Katie Lorenc: Hello and welcome to Dialed In, a podcast by Call Box. My name is Katie Lorenc, and I am a Senior Account Consultant here at Call Box. My guest for today, I'm so happy to welcome, Erika Pusillo, Practice Optimizer at Spodak Dental Group in Delray Beach, Florida. Thanks for joining us today, Erika!

Erika Pusillo: Thank you so much for having me. I'm really excited to be a part of the podcast!

Katie: Great, great! We're so happy to have a chance to learn from you today. I took a look at your website this morning and was just beside myself thinking that I live in the wrong part of the country. My goodness, it looks beautiful out in Florida.

Erika: It is! I think that most of the country has a lot of envy for us. We just got a cold front actually this past weekend, so we're bundled up. It's like sixty degrees.

Katie: Oh my goodness.

Erika: I know. It's so funny, everybody else is getting snow and here we are bundled up with sixty degree weather. It's beautiful and sunny and definitely blessed to live here in this part of the country.

Katie: Absolutely. In Texas, we have been hovering around twenty degrees, so I would take sixty for sure. Well to start out, I would love to just hear a little bit more about your background and how you ended up at Spodak Dental Group.

Erika: Yes! I actually have an interesting story and dentistry kind of found me. I went to Florida State University, and while I was in school, I actually sold jewelry at the local jewelry store. Got some sales background there. My field of study was Biomedical Engineering, and I also joined the first responder group and became a pharmacy technician as well. While I was in school, I kind of knew I wanted to do something in the medical field. I didn't quite know which discipline or which one I was going to choose, so I dabbled in a little bit of each. And my mom was in dentistry; she had her own dental assisting school. She had said hey, maybe consider being a dentist. So I said okay, well I don't know much about it, so let me do an 8-week dental assisting course to see what that's about. So I ended up doing that, and life happens. I met my husband and ended up having a kid. I have a 7-year-old boy. So school, at that time, just wasn't going to happen. I went in and actually got a job as a dental assistant at Spodak Dental. This is ten years ago.

Katie: Oh wow, my goodness. You started as a dental assistant then?

Erika: I started as a dental assistant here. And actually in the Sterilization Department. I literally started from the ground up. So that's my background there.

Katie: Wow, that's incredible. Okay, nice. Talk to me a little about Spodak Dental. I know the website talks about this — elevated customer experience and making sure the patients really have that sort of luxurious feel when they walk in. Where did that come from with Spodak and what role does that play within patient experience?

Erika: Sure. We want to take a look at other businesses that are doing it right, especially outside of dentistry. When you think about iconic businesses that really have that experience down, you think about Apple and the way that they revolutionized the customer experience. Just walking into the Apple store and seeing how that's organized and how different it is from any other type of retail chain or store. You think about other things like Uber or other disruptors, and some of the things that they all have in common is that they have the experience, the end result of that experience, as their main driver to make decisions about their business.

Katie: Yeah, that's true.

Erika: Yeah, patients don't know how to judge great dentistry. They only know how to judge good experience. So your crown is only as good as the way they felt. That is why we designed it that way. There are tons of studies out there that say that what goes into the experience is by the way your practice smells, by the way it looks, by the way that teams interact with each other, the way they interact with patients. And we really considered all of those things and the design of the building too. We kind of touch on all of those senses and really develop that comprehensive experience for the patient.

Katie: Wow, that is incredible. I love what you said about that a patient can't judge good dentistry, they can judge good experience. That's an incredible perspective to have because I think, as the consumer and as the patient, we have a little bit higher standards than maybe what used to be the case. And you're right, every industry is trying to figure out how to play into that. But medical, for some reason, seems to have overlooked it in some ways, so I think that's unique that Spodak is really focusing in on that aspect. Man, I love that. I hope it's ok, I'm going to quote you on that later.

Erika: You're right. I feel like the field kind of lacks a little bit because this is something that everyone needs — medical care of some sort. In a little sense, I think that if you don't have that experience down pat, you can kind of survive as a business. Because of the necessity medical creates, you need to come in and get that resolved. And sometimes you can overlook that experience. But I think for a sustainable business, especially in times where the economy is not so great, you can get those patients that are more experience-oriented.

Katie: Sure, absolutely. And it's no secret that the competition is pretty fierce within dental right now especially. There are dentists popping up on every corner. Anything to be able to make sure that the patient has an experience that will want to make them want to come back I think is huge. And obviously I know your role within Spodak has a really big part to play in that. I know you call yourself a Practice Optimizer, so help out our listeners a little bit. What does that mean and entail and how did that title even come to be a thing?

Erika: So I think the theme we're going to get throughout this experience and conversations we're having is that details really matter. So all the details with the patient experience and even the way the practice smells, and the way they look and interact with the team. But words actually have a lot of meaning to them. And we're really careful about the titles that we use and the language that we use. So I'm really Operations, which is really Office Management. And when you think about the traditional Office Manager title, there's a lot of negative connotation to that. Even Operations, it really lacks empathy or personal connection. So Practice Optimizer really adds that, I guess, more human touch or element there. And really what it's about is just making things as good as they can be. And that's the point behind that name — Practice Optimizer. And actually Dr. Spodak came up with it, so I can't take credit for that. So yes, I'm the Practice Leader here.

Katie: Okay, awesome. Yeah, that's incredible. So you mentioned Dr. Spodak. So the name Spodak — he's a real person, I guess?

Erika: Yes! He's a real person. Dr. Craig Spodak, yes, he's a third generation dentist. His father, Dr. Myles Spodak, still practices here in office and Dr. Craig still practices as well. He's got his own podcast, Bulletproof Dental Podcast, and a new book that came out, The Bulletproof Dental Practice. So he's very much into the industry and developing and shaping the dental profession.

Katie: Yeah, that's awesome. And you guys have built out quite a team alongside him, I know. Your website boasts of 199 years of experience and ten dentists, specialized and general. Can you talk a little bit more about that structure and how that team was built? Because it's all in one location, is that right?

Erika: Yes, all in one location. We have a 1300-square-foot facility. So a dental hospital, modeled a little after the Cleveland Clinic, and the point behind that is to really manage that patient's experience from start to finish. When you do that, you actually improve the time the patients are spending within the office and the coordination of that care, instead of them having to find another specialist, for instance, and finding time for them to fit in the schedule and then communicating the restorative aspects back and forth. There's a lot that could be lost in translation from that. Not to mention the time away from work for all these multiple appointments. Most often times, when someone comes in for hygiene, they ended up needing oral surgery or periodontal therapy and that oral surgeon or periodontist can come chairside and do that consult right then and there.

The other thing is we really monitor the quality of the care. So we know the type of work they're going to be getting and it also aligns with our vision, our values, and that patient experience that we strive for. So it's all very much connected to that, and that's one of the reasons why it's all under one roof.

Katie: Sure. It's so funny to hear you talk about that. I was just talking to my mom actually recently about this same concept of having to go to nine different offices to try to get everything done, instead of just being able to do it under one roof. So that's such a great thing to be able to offer and, I would imagine, to make sure that the care is consistent from start to finish. The patient isn't having to worry about what's going to happen at this other office or unknowns of going from one place to another, but truly being able to depend on their experience from start to finish. I think that's incredible, such a cool thing to be able to offer when a lot of dentists are spread out. It's such a separate process to go from one specialty to another. Talk to me about… do you have any patient stories or experiences that you can share or point to as just some success that you guys have seen with this?

Erika: Yeah, absolutely. I think some of the biggest stories that we have with the comprehensive care with the patients, they come in for routine dental care or maybe they have a problem they come in for and they need that specialist. Even though we're a large office, we like to focus on giving that family, smaller office feel even though we're in that bigger office — building that relationship and that rapport. So we have a really seamless follow up and communication all along the way throughout their treatment. And we have several stories and videos actually online on our website with patients' reactions to that care. Because we have that surgical center in-house, we also have an in-house dental lab. We have patients that have outcomes that are much faster and better because we have all those things under one roof. The patients meet the technicians that are making the teeth, obviously they meet with the specialists, they continue to have the treatment with the restoratives or the referring doctor and the results are really phenomenal.

Katie: Sure. Yeah, I would imagine so.

Erika: Yeah, we have a lot of stories online about that and patients actually shedding some tears when they see that smile for the first time.

Katie: Yeah, that's incredible. I know one of the specialties you guys focus in on is Invisalign, right? I saw that you guys have won a pretty big award for your work in Invisalign — one of the top dentists in the country, if I'm not mistaken. Is that correct?

Erika: Yes, we are actually Diamond Providers. Basically, how Invisalign works is based on the volume of the Invisalign cases that you do determines the level or the award that you have. Being a Diamond Provider, we are there amongst the top doctors that do the highest volume of Invisalign cases. What Invisalign recognizes is that when you have experience, you actually end up getting better outcomes. Patients are happier, treatment is much shorter, less corrections and so forth and that's what it's about — what's the best outcome for the patient and you certainly want to go to somebody that has the most experience.

Katie: Right. Definitely. Yeah, I would for sure. Okay, let's switch gears here just a little bit and talk about just the scheduling struggle that it probably is to have so many specialists under one roof. I know you guys have a full call center model to ensure that patients receive that optimal phone experience. Can you tell us a little bit more about the decision to utilize a call center and how you guys have seen success with that?

Erika: Sure! Yes, we have an in-house call center. We have four people that operate the phones there. And, again, when you're thinking about that experience, if you think about your typical dental office that the front office person that's collecting the payment is also taking the phone calls is also making the outbound patient confirmation phone calls. So often times, a patient can come up to pay, and they're greeted by somebody on the phone. And then in the middle of them taking the payment, that person interrupts the person that's in front of them to answer the phone. So it's not a great experience all the way around. So we said let's take away that distraction. Let's have the people in the call center focus on taking inbound calls and making those outbound calls, which frees up the other team members to give the best experience to the patient that's right there in front of them.

So we actually have an interesting flow with that. Our dental assistants, our treatment coordinators, our dental hygienists — they all collect payment in the back. So when they're done with the appointment, the hygienists will take a payment as long as they're not running behind. If they're running behind with that treatment coordinator that sits in the back in a consult room and so forth with the assistants as well. And what we found is that patients want to meet as few people as possible. And if you can imagine just from your perspective, if you go to a medical facility and you're presented treatment and the next person that you see is somebody in a suit, you're automatically going to think, "How much is this going to cost me?" Here's the person who actually diagnosed the work you need and then they present that to them, even go over those fees. You can ask those questions so much faster and they have a lot more trust with that person. And, again, you're not meeting so many faces which can be really overwhelming, especially for a practice of our size; we have 35 people in here. So that is how we manage that patient experience.

Katie: Okay, that's great. Talk to me about the success of the call center. What has been the outcome in moving to more of that model? I can hear the vision of it, but what are the results?

Erika: We find that phone calls are being answered much more promptly — less voicemails, less patient follow-up, more focus on the schedule, and less interactions that get disrupted over the phone with the patient and when they're in the practice. What that means is that when they're on the phone and patients have a lot of questions, you're able to spend the time they need to get those questions answered and also to get them on the schedule — that's why they're calling. What also happens when you have that patient in front of you and you're forced to answer that inbound call, you're less likely to spend that time with the patient on the phone and they don't know that you have somebody in front of you. That can actually deter somebody from wanting to schedule that appointment, which could mean less patients on the schedule. You have to have that focus and that experience with the patients. There is no opportunity to even see or treat or accept treatment unless that patient gets on the schedule and that's going to be on the phone. So that's one of the first operations we typically focus on the most; nothing else happens until that patient is on the schedule.

Katie: Right, that's so true. You guys are obviously, we've mentioned this before, using Call Box and some of our metrics to incentivize and really measure how the call center is performing. Can you tell us a little bit about that program and just maybe an update on how it's been going?

Erika: Sure! I think it's fun that when your team understands what the expectations are, then they can really live up to those expectations. When you have metrics to back that up or to really keep track of the score on how they're doing, you can get to those goals so much faster. I always think about sports and my husband is really big into sports and football. If you don't keep track of the score or the numbers, you don't know who's winning the game.

Katie: Yes, it's so true!

Erika: Yeah, we keep track of that. We use Call Box to know how we're doing. Then we do gamify it for our team, so we hit specific metrics. We actually do little fun things, whether it's providing special coffee like Starbucks or Dunkin' Donuts for the next morning or bagels or fun little lunches or that kind of thing. And you'd be surprised how motivated people are with those incentives. It's just a funny thing really, but it's about the rewards. It doesn't have to be big, but we did notice that shift that once we had those numbers, the expectations, they had access to those numbers, so everyone could follow them and see them. And then we gamified it and we start to really see the results starting up from there.

Katie: I love that. Yeah, it's so true; people are weirdly motivated by food and t-shirts are another big one too. We find that at Call Box, if you'll promise a t-shirt, then people are all in. That's really good, that's awesome. Within the Call Box data that you guys are looking at within the call center, can you tell me a little bit about which positions or which job responsibilities are really looking into that call data and then how that's being used day to day in the call center?

Erika: Sure! So everybody in the call center has access to the Call Box data. We don't hide anything from anybody. With absence of information, you don't know the score, you don't know how well you're doing. So we like everybody to have that information. Our team leads, we have two business team leads, and they listen to the recorded calls weekly. So that's their staff that they look at to make sure that patient experience is continuing to happen on the phone. They use it for training purposes. We do have a point person in the call center, Mari, who once a month actually reports back the stats via email to the business team to let them know, hey, here's the goal, here's how we did for the goal, here's what we did last month, here's how we've done for the quarter, if we're trending up or we're trending down, and it just brings that conversation back to life. I think whatever you focus on tends to improve. And when you have a dental practice and maybe 20 things you're focusing on, inevitably one thing kind of falls by the wayside and something else improves. So that monthly reminder, that monthly email, is done by one particular person that's responsible for that to send to the team to say, hey, if you haven't checked the score in a while, here's where we're at.

Katie: Yeah, that's so true. At Call box, we like to say what gets measured gets managed. So I think you're exactly right; if you put the numbers in front of the correct team members, there's automatically going to be some improved management in terms of how they're dealing with their individual metrics. Then obviously from a leadership standpoint, the person leading the team gets the chance to really focus in on which metrics we want to touch this month. I think that's great. You guys could be the poster child for how we want a call center to look at this, so that's awesome. In terms of leadership, talk to me a little bit about just the leadership style within the call center and you specifically — what your individual leadership style is. How are you motivating your teams and really staying involved with what they're doing?

Erika: I think the keyword that you just said is staying involved. Leadership is about participation, it's not about delegating things and not looking back at it and not being a part of that team. The senior leadership style is very transparent, open, and honest. I also tend to consider myself a servant leader which means I'm here to serve everyone around me to bring people up. So my job as a leader, as much as it is to get results, is to train other people around me so they can have better performance, get better results, and have better opportunity at the end. So when people feel that you are there to support them, then they support you in return.

The leaders that we have here within the practice, because we do have such a large team, every single one of those leaders were voted in by the team. So nobody was pre-appointed or designated a leader. They became a leader because they demonstrated that they were a leader by being involved with the team and helping where help is needed. And reminding people that mistakes will happen, but mistakes are the best way to learn; those are the best opportunities. So not penalizing or making someone feel bad that they made those mistakes. I really focus on that to acknowledge what is going right. That's one part of it because when we're busy and maybe 100 things went well throughout the day, but we only have time to talk about the ten things that went bad. When you do that day in and day out, the team can feel like their performance is bad and that's really the opposite of what's going on. My leadership style would definitely be to also make sure that the team knows what they're doing well, just as much as what they have to be doing better.

Katie: Yeah, that's so true. It's so true also that leadership starts with demonstrating; I want to make sure that was heard by our listeners. I think we may have had an audio hiccup there. One of the things that's so key that you mentioned is this idea that leaders emerge; they're going to demonstrate that they can be trusted, that they are involved with the metrics and with the individual people they're leading. It's not just about can we improve the numbers. It's also about can we do this mission together, can we be a part of something that's a little bit bigger. I love that idea. As more of a personal favor, I would love for you to give our listeners just any advice that you have. I've got a couple of clients that I've been talking to who are working on starting up a call center and starting to look at how their management styles are going to be formed and some things they want to do. What advice would you have to give other dental leaders or people aspiring even to leadership? What can they be doing now?

Erika Yeah, I think the first thing is not believing that to be a leader you have to have all the answers. A lot of times people believe that now that I'm the leader, I have to have all the answers and that's not true. So focusing on using the people you have around you; they have a lot of experience and a lot of knowledge. They're the ones that are doing the work day in and day out managing those phones. Asking questions back to the team, keeping them involved in every step of the business. When things need to change and decisions need to be made, making sure you include them in that process and get feedback and opinions and ask them what's going well or what could be improved and being transparent with that. For instance, if I'm expecting a team member to be open to me coaching them, I also have to accept coaching back. I know that, at times, managers have a negative connotation and are not so open with that two-way conversation. For someone wanting to get started… making sure that you know you don't have to have all the answers, include your team — it provides a lot of fulfillment for them. You'll actually end up with better results and you'll have less resistance when you want to make change because when you're a part of creating what that change is, you're more likely to follow through.

Katie: Oh yeah, there's more ownership involved with it. I think you're right.

Erika: Yeah, there's more ownership with it. Actually I think you end up developing more respect and leadership isn't about force. I think really staying connected with the team is going to make that process a lot easier.

Katie: Yeah, that's awesome. Well it sounds like you guys are set up for some pretty big success this year. Do you have any specific goals and for 2019 that you want to share, either personally or with Spodak in general?

Erika: Yeah, absolutely. So we have always, I think like most people, we always focus so much on the gross. Like oh gosh, this year we want to do ten or eleven or twelve million in a year. You just increase that gross number. What we've realized, again, is what you focus on you tend to improve or you get. And our goal for this year is not gross, it's actually profit. As cheesy as that sounds, it makes sense. You could actually do less in gross, and if you're focused on profit, you actually end up taking home more at the end of the day. So that's been our focus is profit, not gross, which seems like a duh, but that was our idea.

Katie: No, that makes a lot of sense. I actually haven't heard somebody word it that way. That's even helpful for me to think about that idea that yeah, growth is great and we want to keep growing. but if profit falls off, then the growth isn't worth it, right? There has to be that. That's great, I love that.

Erika: After that, continuing to develop the team. We have a lot of team members that are outside of dentistry. Again, when you're talking about that patient experience, you're talking about finding people that are aligned in your vision and executing on that patient experience. Sometimes they're in customer service or different industries and hospitality and fields like that. We take people that have that right mindset and the right personality for dentistry. So that's one of the goals is to continue to develop the team and their knowledge and providing that dental experience.

Personally, I am a fanatic about learning; I love to read. I am constantly working on myself and how I can be better because I know that we have to evolve and continue to better ourselves. I am always learning and listening and being coached by other people on how to be a better version of myself. So those are my personal goals.

Katie: That's awesome. Yeah, I'm a big reader too. We'll have to swap book recommendations at some point so that we can make sure we stay up to date here. Erika, I am so grateful just for you to take the time this morning to chat with us and our listeners. I learned a ton, so I am guessing that anyone who listens to this is going to learn a lot too. So thank you for taking the time. It's been really great to get to chat with you and we're excited for what Spodak has coming up this year.

Erika: Thank you and glad I could contribute. I really appreciate being a part of this and I hope anyone who is listening found value in it, even if that was one person out of everyone that listens. That's the best for me and worth the time.

Katie: Absolutely. Well thank you, we appreciate it.