Key Excerpts from “Unfair Advantage”

Another outcome of being a Category Killer Practice is that these doctors do a lot more of the procedures they enjoy and because of their market position can more easily shift their focus as technology changes occur. For these doctors, the Category Killer Practice concept even opens up a new door called the why-retire-ever door where you can keep doing something you love for as long as you desire to do so.

Definition of a Category Killer Practice

Let’s get the definition out of the way. Category Killer Practices are those practices where niche procedures or bundled niche procedures are marketed and sold according to the principles of ongoing accumulated advantages discussed in The Dentist’s Unfair Advantage series while also acquiring advantages in clinical systems, staffing systems, and general administrative systems. As a direct result, the Category Killer Practice eliminates most competitors and removes most pricing constraints. It’s worth repeating – competition and price become basically irrelevant.

Competitor elimination (or reduction) routinely involves a principle called the category of one creation as discussed in Volume 2. They are also keenly aware of the fact that much of what they want and need to say about themselves can only be said through others (patients and other 3rd parties), and they devote significant time and resources to such efforts.

Much like a dental version of Cirque du Soleil, which combined theatre and circus to create their own unique entertainment category, these doctors have created a package so that there are few (or no) direct comparisons with others. Ultimately, it means the doctor and team are fully compensated for their training, technology, years of experience, and their care, skill, and judgment.

Goal of the Category Killer – An Insurmountable Market-Leading Position

Practices attaining Category Killer status in their area develop market-leading positions that are difficult, or impossible, to match or surpass. The number of Category Killer Practice positions available varies based on market geographic size, total population, and population density. Category Killer Practices don’t happen by chance, but by knowledge, intention, and action.

The same niche procedure or clinical bundle performed by those who haven’t created a true Category Killer Practice is far more commoditized in pricing. As discussed early in this volume, without even the most basic set of advantages it is very difficult to separate your practice from any of your competition much less from the vast majority of competitors – which is the ultimate goal of the Category Killer Practice.

Specific Note to the Specialist

Beyond fee issues, in many cases the behavioral actions of the doctor (generalist and specialist) and team routinely discourages patients from making better decisions. This is due to the failure to address selling as something that occurs only inside a systematic process; and a failure to address human nature and known patterns of decision making that patients considering significant dentistry (or other goods or services at a similar price point) are likely to exhibit.

To make matters worse, when multiple doctors are involved (hint: you) in a major case, the opportunity to confuse the patient and further reduce the chances of their making a good decision, is even higher. This last reality is the number one reason more specialists aren’t doing what they would like to do in their practices clinically because of how selling is handled, or more appropriately not handled, between the multiple practices, doctors, and teams involved.

You Get to Decide – If you choose nothing, be happy with the result and don’t complain.

Most dentists (generalists and specialists) with advanced clinical skills, who perform the exact same or very similar procedures, find themselves in never-ending price wars, stuck in circumstances where fees are difficult to get much less adjust on a regular basis. They have patients who don’t trust their recommendations with complex care, and feel constantly trapped beneath reimbursement contracts.

On the other hand, those who fully address the advantages as discussed here, leave these headaches and hassles behind, allowing the less-informed members of the profession to deal with such.

Category Killer Practices routinely ask for and receive 50-200% more for their niche procedures, performed at high standards, while simultaneously having the happiest patients who appreciate the service received. What’s not to love about the idea of you acquiring enough advantages in marketing, selling, and other systems so you become a Category Killer Practice in your niche since the ultimate end result is far more patients ar helped? For most readers the option is available, you simply have to desire it and then choose to get it.

I’ve been teaching this concept of the category killer since the mid-2000s. I was the first in the profession to apply the term to the practice of dentistry, and to teach it, and dispense ads, protocols, and case acceptance (sales) training for accomplishing it. As the information age has progressed, the understanding of what are the Key ingredients are has been refined and continues to evolve.

From Concept to Everyday Reality

For doctors who want to dominate a particular specialized niche procedure in their local area, understanding the concept and then implementing strategies to create a Category Killer Practice, is not only possible but extremely desirable in today’s economic reality. Look at the highest performing practices helmed by dentists truly enjoying their work, and you’ll find some variation of this theme at work that quite a few have landed on after years of trial and error. The goal of this chapter is to help eliminate many of the wasted years required that can easily be consumed as part of a trial and error process.

There are a lot of astute doctors amongst us. A number of them after simply reading this chapter will get it about this concept and have a gestalt moment realizing what needs to be done. Over an 18-24 month period, some of them will attain this status completely on their own; maybe with perhaps some simple tools provided in the Resource Section at the back of the guide. This type of practice owners is typically one who understands that he truly doesn’t know everything, that at times he needs expert help in things he is not in full command of. (The same situation exists for any of us are in when needing to learn a completely new technology or clinical technique.) They understand we live under the rule of you don’t know what you don’t know. The latter is addressed by either personally becoming educated, or attaining help in what you don’t know, to bridge over gaps in information and/or systems that are present when seeking to attain status as a Category Killer Practice.

Welcome to a New and Improved Understanding of Yourself

For the less astute, the concepts in the previous paragraph will feel foreign. (Vous ne parlez pas le meme langue!) Because of such, now is the time to bring you into an awareness of the concept of conscious and unconscious competence and conscious and unconscious incompetence. The absolute best way to create understanding (besides using simple language) is via a story. The best example for this is to think back to that first day of dental school and to your very first dental-school-specific class (meaning not biochemistry, anatomy, etc.) in whatever that subject might have been. Even if you were a legacy dentist, having family members as dentists, this still applies because there is simply no way to know what is in the head of a dentist without having been through a similar educational process, regardless of how much time you spent in a practice growing up.

Within the first few hours of the very first day of dental school, in that dentist specific class, your awareness of the immensity and weight of what you really didn’t know about teeth very likely landed on you hard. I can recreate the sinking feeling I had in my stomach that day by simply visualizing where I sat and who was around me. I remember a distinct realization arriving about the next four years of my life. My first dentist specific class was a Monday morning 8 am dental morphology laboratory in which I realized within the first 10 minutes there was a lot more to tooth anatomy than I had ever imagined.

On day one, the instruction was to carve a lateral incisor out of a block of wax while looking at a morphology guide for guidance. I really felt stupid (incompetent) with this task. There were also plenty of willing faculty members there to make sure I felt stupid by telling me what a poor job I was doing! All 55 of my other classmates mostly felt the same. (There were two outliers with unfair advantages–one girl who had been a lab tech and one guy who was repeating year one.)

As an aside, looking back, the group of mostly unhappy private practice dentists roaming the lab as instructors (overseers) was an early warning sign of what I would learn about the profession as a practitioner and consultant over the years. Most of the unhappiness emitted a side effect of these faculty dentists missing the advantages that you are learning about and seeking to acquire via this guide series!

It certainly helped to lighten matters (pun intended) when a neighboring alphabetically arranged classmate by the last name of Munson caught part of his short afro on fire from getting too close to his Bunsen burner as he focused intently on that block of wax. Fortunately for him, the internet, YouTube, and Tosh didn’t exist otherwise millions would be laughing and sharing in his misery to this day.

The end result and moral to the story of what REALLY happened on that first morning was that I became acutely aware, or fully CONSCIOUS of something that had been there all along – that I was INCOMPETENT at the task at hand. An hour earlier, I had been happily UNCONSCIOUS about my INCOMPETENCE, but nevertheless just as INCOMPETENT.

You and I also know the rest of this story since we all share a similar one. Over the course of months and years, in this subject (morphology) and in numerous others, you and I moved past these multiple phases of being unaware (UNCONCIOUS) of what we didn’t know we lacked in knowledge or skill (INCOMPETENCE), to an awareness (CONSCIOUS) of the deficiency, and ultimately into the state where we are both CONSCIOUS AND COMPETENT. The end result is a degree! Most readers will be an owner of a practice or have owned several, and the same pattern holds with many things related to owning a business. Only those who have owned businesses know these things.

So, you’ve been through this many times in your life already, and you still go through it. It’s just that you probably never realized that this pattern existed and that it was playing out over and over again. The same is true with the advantages being discussed in this volume and other volumes. The same applies to the concept of the Category Killer Practice and the advantages needed to be in that category. It is only by realizing this fundamental truth in knowing that you can move from where you are now to a better state should you desire to do so.

Whether the end result is Category Killer or not, that’s not even the most important outcome of this discussion. The single most important outcome is that at least in some areas of your practice, you become aware of what’s missing and then make a conscious choice about whether you stay incompetent – because it really isn’t that important to you – or you move towards a position of competence.

By the way, the scientists who look at quantifying happiness (no surprise, in the age of specialization there’s researchers studying this), agree that it is the combination of things happening on the journey of life which creates happiness and not some final destination. The very activity of embracing an ongoing challenge, such as acquiring significant advantages, can influence your ongoing state of happiness positively. Yes, this is profound stuff, and we haven’t even dwelt on the patients’ lives which you also get to transform!

In the next chapter, we’ll review some always items that are consistent across the Category Killer Practice niches discussed individually in subsequent chapters.

Chapter 17
Category Killer Practices Part 2 Commonalities among All Niches

Before we discuss nuances of Category Killer Practices based on specific clinical niches, there are some overriding constants that are consistently seen among every Category Killer Practice regardless of the clinical niche focus or focuses.

These include:

•   Always — The use of mass media (invariably some combination of radio, newsprint, niche websites attached to SEO or PPC, You on Dr. Oz News Interview Show, and on occasion network TV)
•   Always – Ongoing attendance in an active phone sales training program plus using a phone selling system with scripts and appointment booking phone slip designed with behavioral science taken into account. Active means participatory attendance at phone training sessions (conducted by phone of course!) and 3rd party review and proficiency scoring of live patient phone call recordings at least once each month.
•   Always — 24/7 phone answering when out of office or when staff is overloaded. The elimination of calls going to voice mail for prospective patient calls.
•   Always — A real sales process or system (actual steps with what happens when and done by whom, plus a check-list to consistently follow the steps.)
•   Always — Providing proof of more credibility and trust as compared to other practices.
•   Always — Clinical training that puts one in the top 5% with clinical skills. We are no longer talking about basic niche skills, but advanced skill sets and a serious command of clinical technique. In this day and age, due to debt levels of graduates of all kinds (generalists and specialists), realize that labor is easily attainable and can be supported by fees – meaning that no niche is really off limits since one can hire out for any type of clinical help needed.

Practices that become Category Killers are typically a 1-2 doctor practice (occasionally a multi-location group), produce $2M-$10M each year and invariably invest $7500-$20K+/month in direct to consumer marketing. While it’s outside the mindset of many, even in this club, multiple doctors can team up in a region to split advertising costs and benefit from amassing advantages together and further expand their reach as Category Killers.

In our remaining chapters, we’ll move on to some niche specifics that vary based on the clinical niche and further fill in any gaps in understanding about the Category Killer Practice.

Chapter 18
Category Killer Practice Nuances for Dental Implants (Speed, Convenience, Technique)

In dental implants, the overriding concepts interwoven throughout a practice achieving Category Killer Practice status always include speed of treatment, convenience of services, and, as of this writing, some very specific same day techniques that involve a lab on-site or one close by that is ready to go on a moment’s notice to deliver a result faster than others.

Here are the procedures that are NOT amendable to the creation of enough meaningful clinical advantages around which would help the practice attain achieve Category Killer status in the Dental Implant niche:

•   Basic single and several missing teeth implants.
•   Mini-dental implants.
•   Over-dentures.Here are the procedures that are amendable to the creation of enough meaningful clinical advantages around which would help your practice attain Category Killer status in the Dental Implant niche.

•   Immediate loading – Get Your Teeth in One Day Implants.
•   Teeth Out – Implants In – Teeth In and Teeth Not Removable (All on Whatever It Takes).
•   Unbreakable Teeth – Patients at this point are tired of breakage and repair of all things dental. Do not discount this annoyance!
•   Combination Procedures – Other Same Day Services like Cerec + Implants.Fees for category killer dental implant services ranges from $10K-$100K+, when these services are sold inside a systematic sales process that attaches your marketing to your phone and then to the step by step sales process in the practice. Basic powers of deduction make it obvious that practices in this niche and at this level have some of the highest net profits in dentistry and can afford to market more than the vast majority of competitors regardless of specialty designation. If you skipped the discussion about Alan and Mark in the case studies early on, maybe it’s time to revisit their story as in their area of the South-East they have Category Killer Practices in this niche.

As an aside, when one becomes a Category Killer in a specific niche, there is also a spillover of other cases both in HIGHER and lower fees, simply due to these practices being seen as the go-to best local expert. Thus, those choosing to develop this advantage have multiple layers of benefits beyond simply the procedure being marketed the most. The dental implant niche routinely has spillover because not every patient needs full arches of treatment but nearly every patient inquiring needs some level of service.

Who can have a Category Killer Practice with a focus on dental implants?

It can be created by an implantologist (the most common), by an oral surgeon with a hired prosthodontist, by a prosthodontist doing everything, by a prosthodontist with a hired oral surgeon, by an oral surgeon-multi-practice GP referral base, or by a GP directing the oral surgeon team.

It’s the most wide open niche for different types of practices that can choose to enter and have a Category Killer Practice in a market. Since the transmission of information is easier, thanks to digital cable and websites, those becoming Category Killer Practices focused on implants can leverage and extend their message further afield to dominate entire metro areas, regions within states, and even entire states or province if desired.

It’s worth pointing out that a novice in this clinical niche can speed up the process of becoming an overwhelming expert, if he or she is willing to go to the public and offer educational discounts to gather cases for the necessary coursework. The necessary education can even be obtained in a break-even fashion by marketing specifically for teaching cases, using Smart Discounting for patients needing dental implant therapy.