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Xtreme Dental Practice Makeover

Jan. 1, 2005
Dr. Kristy Vetter was tired of it. Now her practice will get some TLC.

You know when nothing goes your way? Dr. Kristy Vetter was tired of it. Now her practice will get some TLC.

WDJ PROUDLY INTRODUCES Dr. Kristy Vetter, the winner of the Xtreme Practice Makeover 2005.

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Thanks to her mother’s prodding, Dr. Vetter submitted a poignant “plea-for-help” letter. Realizing her practice needed help was the first step, but admitting and sharing such a story required courage. The 34-year-old dentist impressed the selection committee with her positive attitude after separate health crises involving her former boss and 3-year-old son detoured her professional goals.

“I was shocked, pretty much,” Dr. Vetter says of her selection. She and her husband, Robert, have three boys: Jason, 6; Cameron, 4; and Zachary, 2. They reside in Laguna Niguel, Calif.

Dr. Lori Trost, WDJ editor, developed the practice makeover to share such a journey with readers.

“To watch a practice transform during the next 12 months will be not only a great learning experience for our WDJ readers, but also an affirmation for many practices,” Dr. Trost says. “I admire Kristy’s willingness, courage, and energy to undergo this process.”

After Dr. Trost shared her concept with dental industry leaders, Levin Group Inc. volunteered consulting services, Dr. Lorne Lavine became the technology expert, and a list of dental companies joined the team.


Dr. Vetter began practicing dentistry in 1996 after graduating from the University of Southern California School of Dentistry. She graduated from Northern Arizona University in 1992 with a degree in dental hygiene.

“The story of my office begins before I bought my practice,” she says. “I started working for a wonderful female dentist in March 2000. We both had young children and enjoyed working part time together.

“Things were going great until 2002, when my boss was diagnosed with breast cancer just after adopting her second child. We were devastated. The practice managed to stay afloat through the many surgeries and unexpected complications, but the illness took its toll. In December of 2003, my boss told me she was going to sell the practice and retire from dentistry.”

Dr. Vetter purchased the practice in February 2004. Despite having eight years of experience as a dentist, she knew little about business management and running a practice.

Ready to run

“The day-to-day management and running a practice was new to me - and at times overwhelming,” Dr. Vetter says. “Trying to sort out the financials for a practice that had been in a downward trend for more than two years was challenging. Through countless hours and determination, I learned the business basics and began to take steps toward success. I was just beginning to feel somewhat comfortable when tragedy hit my own family.”

Family crisis

While Dr. Vetter was reading a book to her sons, Cameron, then 3, fell off his brother’s top bunk bed and broke his neck.

“It was good that I was there so I knew what happened,” Dr. Vetter says. “When it happened, the other kids were great. This ultimate calm came over us.”

She spent the following few weeks next to Cameron in pediatric ICU.

“I took about two weeks off, and luckily my sister is a stay-at-home mom, so she did a lot of his recovery with him,” Dr. Vetter says. “I had just started this business and I didn’t want to fail. I was working two days a week at my own business, and one day a week as an associate. Needless to say, the practice suffered.”

Part of Cameron’s rehabilitation included wearing a 20-pound halo attached to his head with eight bolts. Dr. Vetter remembers how difficult it was to follow doctors’ orders.

“He was off-balance, and kids like to spin around,” she says. “He couldn’t walk, and the doctors were telling us he wasn’t allowed to fall. How do you tell a 3-year-old, ‘You’re not allowed to fall’? But his recovery was so quick. It’s just amazing how quickly he healed. The amazing thing is that Cameron is walking today. I am so grateful to God for that miracle. You cannot tell he was in an accident. I don’t know how I got through that.”

Shortly thereafter, another blow hit the Vetter family.

“My husband got laid off two weeks after the fall happened, which was good and bad,” Dr. Vetter says. “If he hadn’t been, I probably wouldn’t have returned to work so quickly. I guess God works in weird ways.”

Supportive team

Dr. Vetter credits her staff with keeping her on schedule during that time. They include office manager Lisa Elkins, dental assistant Nancy Keys, and dental hygienists Irene Willis and Kirsti Livingston.

“Lisa is incredible,” Dr. Vetter says. “A more organized, efficient woman you will not meet. She knows exactly who someone is, where something is, and why it is supposed to be there at all times. I could not have survived without her.

“Nancy is my assistant in the back. She is a fantastic RDA who knows her dentistry. She’s a new grandma and has a genuine heart.

“Irene and I went to undergraduate hygiene school together at Northern Arizona University and have know each other for more than 15 years. It has been a pleasure to work with a friend and a talented hygienist dedicated to soft-tissue management.

“Kirsti has been with our team for two years and is a real asset. She is a gentle, very experienced hygienist, and her rapport with the patients is excellent.”

LoAnn Ray will begin in January as Dr. Vetter’s new office manager.

Moving gratefully forward

Dr. Vetter and her staff are excited to make changes within the practice through the guidance and consultation offered by participating consultants and dental companies.

“All members of the practice are open to new ideas, new techniques, and want to be on the cutting edge with new technology,” Dr. Vetter says. “I think my staff deserves something extraordinary - they have been taking care of the doctors for the past two years.”

Her goals include incorporating more extensive cosmetic cases, enhancing their soft-tissue management program, increasing the number of new patients, and growing the practice.

Readers may follow Dr. Vetter’s progress in a series of WDJ articles published throughout the coming year.

Questions, suggestions, and contributions regarding the transformation team may be emailed to Dr. Trost at [email protected].

Levin Group Helps

As part of WDJ’s practice-makeover contest, Levin Group will donate a year of comprehensive management consulting to Dr. Kristy Vetter.

“We are honored to take part in this exciting contest and help Dr. Vetter make over her practice by implementing documented systems to achieve her goals,” says Angela Pickett, Levin Group Consulting vice president.

Levin Group helps dentists create and implement customized data-driven business models based on 20 years of successful dental consulting.

Dr. Vetter was selected from a list of highly qualified entries. In addition to one year of management consulting, she also will receive a technology consultation from Dr. Lorne Lavine and products and equipment from supporting dental companies as listed.

Her strictly fee-for-service practice is located in southern California about halfway between San Diego and Los Angeles.

Five in 2005

Levin Group consultants will work with Dr. Vetter and her staff on ways to improve and transform the practice in five areas -

  • Leadership for the high-performance practice

  • Creating a high-impact schedule

  • Using KPIs to manage practice finances

  • Building the best team

  • Achieving the “WOW” factor

    Will WDJ readers be able to apply the lessons learned through Dr. Vetter’s practice to their own situations? Absolutely.

    Many women dentists have traveled similar paths to Dr. Vetter’s and face similar challenges trying to build profitable practices based on outstanding patient care and strong data-driven business systems. The article series will document step-by-step the processes, procedures, and systems implemented by Dr. Vetter and her team.

    Inspired by dentistry

    Dr. Vetter was inspired to become a dentist as a young girl.

    “I was 12 years old and had braces. I thought that was really cool,” she says. “My orthodontist always looked like he was having fun.”

    Her mother tried to dissuade her from this adolescent “whim” by joking with her daughter that she could only be an assistant and that she wouldn’t be able to go to college like her older sister, who was enrolled at UCLA.

    “So I told her, ‘Well then, I’ll just have to be the doctor,’” Dr. Vetter says.

    That determination has served her well. She worked her way through college and dental school as a hygienist.

    In addition to general dentistry, Dr. Vetter has received training and performed some endodontics, orthodontics, periodontics, and implant dentistry. She recently completed training in cosmetic dentistry and wants to offer more esthetic services in 2005.

    Challenges and goals

    Dr. Vetter’s practice is in a state of transition. She is a new practice owner who has greater responsibilities now as the main producer and practice leader compared to her former roles as an associate and employee.

    Previously, the practice had been working three days a week. It has expanded to four days a week starting this month. Her former office manager decided to leave to start her own business this past fall, but stayed on through 2004 to train the new team member.

    Since 2001, the practice has been in a state of decline. In 2002, the practice experienced a 5 percent loss in production. That downward trend accelerated in 2003 with a 17 percent drop in practice revenues. This year, the practice is expected to post a modest 2 percent increase, but since 2001 the practice has suffered an overall 19 percent reduction in revenues.

    Dr. Vetter is determined to move her practice forward. Her goals include -

    • Increasing production by 33 percent

    • Bringing in more patients

    • Increasing elective services

    • Expanding successfully to four days a week

    Levin Group Method™

    Dr. Vetter and her team members will begin their one-year management consulting program in February. They will arrive at the Levin Advanced Training Institute near Baltimore, Md., for two-and-a-half days of intense training, workshops, and seminars. Levin Group provides practices with comprehensive practice-management consulting. Fixing or tweaking only one system usually creates more problems. Levin Group Method addresses all aspects of dental practices. For a practice to achieve peak performance, every system must be reviewed, analyzed, and upgraded. But that is not enough to achieve maximum success. Systems must be upgraded, modified, and integrated with one another to achieve the best results.

    To make the necessary improvements to achieve maximum profitability, the dental team must engage in “outside-the-office” thinking.

    Doctors and team members are so busy providing patient care at the practice that they have little time to think strategically about the best ways to make lasting systemic changes that will benefit the practice and patients.

    During the year, Dr. Vetter and her team will participate in training workshops and breakout sessions, receive an in-office evaluation and continuous support from their Levin Group consultant, and develop strategies for long-term success. One of the most important tools is the use of Key Performance Indicators, or KPIs, to track practice performance. KPIs provide a quick, accurate, statistical snapshot of practice systems allowing dentists to better manage their practices. Dr. Vetter and her team will aim for success in these five areas during 2005 -

    Leadership for a high-performance practice

    A key step toward providing excellent leadership for staff occurs when the doctor creates a vision statement that will help the practice achieve long-term success. At Levin Group, this is one of the first tasks undertaken with the practice. Once established, the vision statement must be incorporated into practice activities, including morning meetings, staff meetings, and coaching opportunities. Dr. Vetter needs to craft a vision statement that will guide her team to achieve breakthrough practice performance.

    Creating a high-impact schedule

    Levin Group will analyze Dr. Vetter’s schedule for opportunities to eliminate down time, bottlenecks,

    and other inefficiencies. The goal is to build the best schedule for the practice based on proven mathematical formulas. In addition to scheduling, Levin Group will work with Dr. Vetter on improving other operational systems, including hygiene efficiency, office appearance, and use of information technology.

    Using KPIs to manage practice finances

    Collections, accounts receivable, and overhead are all aspects of financial management. Levin Group recommends using KPIs to track and monitor practice progress in meeting financial goals. To realize the doctor’s vision, a practice has to know where it has been. KPIs will provide this information to Dr. Vetter and her team quickly, simply, and easily.

    Building the best team<

    A practice is only as strong as its team. Levin Group will provide Dr. Vetter’s team the tools they need to enhance efficiency, improve productivity, and reduce stress. Developing a policies and procedures manual with written job descriptions is necessary to clarify roles of staff members. Dr. Vetter’s practice does not currently use a procedures manual, so documentation will be another area where a Levin Group consultant will assist the practice.

    Achieving the “WOW” factor

    Excellent communication skills are required for ­successful case presentation and “WOW” customer service. To expand beyond traditional need-based dentistry, practices should develop team members with strong case-presentation abilities. “WOW” customer service depends on treating every patient like a VIP so when they leave the office, they are amazed by the treatment they received from everyone in the practice.

    Scripting is a communication technique that enhances both the case presentation and customer service skills of team members. Dr. Vetter has a strong team that promotes elective services, but no formal scripts training is in place. Levin Group will coach the doctor and her team in developing and using scripts.

    Dr. Vetter faces some significant challenges to meet her goals during the next year. She is a new owner of a fee-for-service practice that has been in decline since 2001, but she is “optimistically hopeful” about the future.

    She should be. She is an enthusiastic, highly skilled dentist who is focused on improving her practice. She has the backing of a strong team and the support of Levin Group.

    Look to this article series each quarter for a continuing report on Dr. Vetter’s progress on the “Five in 2005.”

    Supporting Companies

    Care Credit
    Crown Seating
    Levin Group Inc.
    Smart Practice
    Young Dental

    Dr. Kristy Vetter appreciates her staff for their support.
    They are (in descending order) Lisa Elkins, Irene Willis, Nancy Keys, Kirsti Livingston, and newest employee LeAnn Ray.

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