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The Key to Effective Time Management in Dental Offices with Cornelia Cone

In this episode of How I Grew My Practice, we have the pleasure of hosting Cornelia Cone, Vice President of Nuance Dental Specialists, to discuss the crucial topic of in-office management.

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Alec Goldman (00:04.43)
Welcome to How I Grew My Practice, a podcast presented by NexHealth. My name's Alec. In this episode, we have Cornelia Cone, VP of Nuance Dental Specialists, here to talk about in-office management. Cornelia, welcome to the show.
Cornelia Cone (00:23.063)
Like, yeah, I know the name of the practice and my name, it's a mouthful, so you don't do a good job. Yeah.
Alec Goldman (00:29.41)
How'd I do? I did okay. So quickly, just the way that we always start, for the audience who may not know who you are, if you can share a little bit about yourself and just what you're up to, where you're at, a little bit about the practice.
Cornelia Cone (00:44.503)
So I'll give you guys a snapshot of where I am now. So I work with my husband in our practice. We have a small.
Cornelia Cone (00:53.363)
kind of boutique-style practice in Portland, Maine. It's limited to prosthodontics. My husband is a board-certified prosthodontist and a certified dental technician as well. So that's the one part of what we do. The other part is that we are on the lecture circuit. So for instance, on Monday, we are jetting off to New Zealand and they were doing kind of 14 lectures between New Zealand and Australia, and we're coming back and...
Cornelia Cone (01:22.215)
At home, we have four children ranging in age from 16 to eight. And so that's kind of what we've got going on in this phase of our lives. And then a little bit about my origin story. So if you couldn't tell from my accent, I'm not American. So I'm an immigrant. I came here from South Africa. My husband and I, I made him actually in South Africa. And then after we got married, I moved here and I have.
Cornelia Cone (01:51.147)
no dental background. I vicariously went through dental school and residency with my husband, but my formal education is I have a master's degree in international relations. So where I've ended up in the dental industry is kind of a departure from prediction, but I love it and it's a really good place to be right now. So.
Alec Goldman (02:13.782)
That's a really cool story. So, I mean, I asked you ahead of the, you know, agreeing to jump on the show, you know, what's a topic that you're really interested in something that you think would really benefit our audience. And we were talking about time management. So obviously time management, both in the office and in your personal life, especially for somebody like yourself, it's extremely important. But what specifically about time management did you want to speak about with the audience today?
Cornelia Cone (02:40.343)
So I guess just to toggle back a little bit, I, if I think about our practice, I think about there's basically in my life, really, there are three big levers that I can pull and toggle on to manage things, right? The first thing is money. The second one is people. The third one is time. And of those, you can come up with ways to make more money. So you can kind of toggle that one up.
Cornelia Cone (03:08.351)
or if you want to in your practice, you can get more patience or you can hire more staff. There are ways of kind of scaling those things up. The only thing that is finite is time because you only have so much of it. So for me, the most challenging part of trying to walk this tightrope between home life and work and kind of steering clear of burnout has been trying to figure out how do I effectively manage this.
Cornelia Cone (03:38.259)
one finite resource that I have, which is time. And then the interesting thing about the dental industry too is that we're actually in the business of monetizing our time. We're attaching a stream of revenue to our time. So in your practice, if you're trying to think about being profitable, it's really a game of managing time as well, right?
Alec Goldman (04:00.598)
really cool to put that in perspective. So can you tell us a little bit about the practice? Obviously, it sounds like there is only, I mean I know factually there's only a finite period of time that you guys have to supply your services to however many patients but give me the practice setup. How many hygienists, how many staff do you have at the front desk, how many dentists do you guys have? How much time are we talking about that you are overseeing and managing?
Cornelia Cone (04:27.735)
So I think like with a lot of things that we do, we kind of try to forge our own way. So we have a very unorthodox practice. So we have a specialty practice, right? So it is only limited to prosthodontics. So that's the first thing. And then it is even more unorthodox in the sense that we have one dentist, one clinician.
Cornelia Cone (04:53.243)
in the practice. And I like to think of the way that we run our practice instead of being at the helm of a huge platoon of soldiers, I have a SWAT team. That's what I have. So in our practice here, physically chair side, there are three people. It is my husband, myself, and the chair side assistant.
Cornelia Cone (05:16.987)
And then because we travel so much, I've come up with these out-of-the-box solutions, that's kind of our trademark. We do things differently by finding a way to have all of my other staff, my support staff work completely remotely, which has opened up this huge pool of possible people that I can pull from. So I've managed to be able to pull a really strong team together.
Cornelia Cone (05:45.103)
I even, because I am from South Africa, I even have somebody that works for me in South Africa. And it's awesome because she works through the night and we wake up and all of these tasks were done throughout the night. And that's actually part of the reason why we teamed up with NexHealth is because you guys help us in order to be able to empower our remote team.
Alec Goldman (06:08.642)
So it is very unorthodox to hire such a remote team for a dental practice, but it is something that I was just speaking about the other day on our very podcast about labor and how fractional work should be something that dental practices consider a little bit more. But it's really awesome to speak with you because you actually are living that truth, right? So can you give me a little bit about what are the types of activities that you have your outsource staff performing?
Alec Goldman (06:38.226)
And what do you think about what are the right tasks to outsource to somebody who's not specifically in the office?
Cornelia Cone (06:45.787)
Okay, so we think about, so what I've basically done is I think about time zones, right? So my staff that answers the phones are all East Coast time, just like our patients, because our practice is based in Portland, Maine. So they're both those staff members are in upstate New York and they, any incoming call that comes in and we use weave, which has been great for us in terms of the calls.
Cornelia Cone (07:16.787)
They answer those phone calls and there's no difference between them answering the phone calls and having somebody in the practice here. On the contrary, I think there are huge advantages to having somebody that can just focus on that phone call and doesn't have all of the distractions associated with the hustle and bustle in the practice itself, right? So everything that needs to be done kind of during East Coast...
Cornelia Cone (07:43.455)
business hours, I have those two staff members that do that. Then I have somebody that works for me in South Africa, and she's obviously in a completely different time zone. There's a six or seven-hour time difference, depending on whether we have daylight savings or not. And she does everything for me that can be done remotely, and you would be astounded by the amount of stuff that you can get done remotely.
Cornelia Cone (08:11.723)
And she does that, the things that aren't time-bound. So she doesn't answer phone calls, but she does all of my insurance claims, all of my record requests, all of my paperwork input. She sweeps the schedule for us, and makes sure that all of the x-rays are attached, the appointments where they need to be attached, and all of that stuff. She does. And it's amazing because it's like we have people working around the clock.
Cornelia Cone (08:41.107)
We come in in the morning and all of those things are just perfectly done for us and then we can pick up from there and go on. And then I also have an executive assistant who works for me and she is based in Missouri and she handles everything that has to do with our speaking engagements, and support for that. So she makes all the travel arrangements. She makes sure that everything is arranged in terms of
Cornelia Cone (09:10.46)
audiovisual and dietary needs and anything that you can think of in order to make our travel and lecture schedule go smoothly.
Alec Goldman (09:20.29)
Kriinile, what was the realization that you had to think, maybe some of these jobs to be done, if you will, could be outsourced. Because again, it's such an anomaly that you guys are doing this. And it is something that I think other practitioners should really consider. But what was the like, wow, like, I really should be doing this?
Cornelia Cone (09:35.35)
Cornelia Cone (09:42.731)
So I think as if, I think what usually happens is there's some kind of pressure, right? So evolution happens when there's environmental pressure and that's exactly what happened here, right? So the reality of it is, Portland is not a very big city, right? And so there's only so many staff members to pull from and.
Cornelia Cone (10:06.687)
those people, it's hard, you know, like you have like a limited pool of people that work within the dental industry. The other thing too is our office is a small footprint because we are in the old port, which is in the heart of the city center of Portland. And so, I mean, we were on a waiting list for three years to get a parking spot in the adjacent parking lot here. And...
Cornelia Cone (10:33.951)
the access is difficult, the footprint is small, you know like it's expensive to have more space associated with the practice. And so out of that kind of environmental pressure and that necessity, I just started to think about out-of-the-box things. And I thought, wow, is it possible? Is there a way for me to basically increase my applicant pool?
Cornelia Cone (10:57.639)
make it so that I can hire really from anywhere, right? And how would I go about doing that? And could, is this something that I don't have to have dedicated a desk and a chair and a computer to somebody in the practice here? Is it possible to do that? And then once I started kind of thinking in terms of that.
Cornelia Cone (11:18.739)
I mean, the systems started evolving over time. We kind of figured it out. The first person that worked with me remotely, had to hash out all of those systems and kind of make it up as we went. But then I feel like the whole pandemic, people made this shift to realizing just how much could be accomplished virtually. So we were really, and I guess we were prepared for that already. The moment that the pandemic struck,
Cornelia Cone (11:46.759)
and everybody was scrambling to figure out how they set up their staff at home, we just didn't skip a beat, you know? And then, on the contrary, there was this proliferation of technology that all supported that. And so then we were just in a really good spot to be able to take advantage of that in addition.
Alec Goldman (12:07.35)
I want to touch on the technology part, but for the folks who are out there considering, I guess what we would call a 1099 employee, right? Or W9, or forget what it is exactly. But then I got it. Thank goodness. I got it. It's so easy to say like, oh, I should do this. But like, what's the next step? Like, where do you go to find your staff that is reliable, that you feel that are equally a part of the team and they feel invested in the team? Like, where do you go for that?
Cornelia Cone (12:14.73)
Cornelia Cone (12:17.299)
That's a 10-9-8-9.
Cornelia Cone (12:37.179)
Yeah, so I'm sure, you know, like, so I actually made a company. And now the name escapes me, I should find it and link it for you guys. But there are actually companies now that are trying to tap into this remote. Team members that you can have, you know, and essentially create or curates a pool of people that you can pull from, right?
Cornelia Cone (13:06.679)
I never used something like that. Our first employee that we had that is still an employee with us, she used to actually be my husband's chair side assistant when he was still in the military. And then, if you're a military wife, which she was, they move you from base to base and she just contacted us out of the blue and it was this odd...
Cornelia Cone (13:35.531)
convergence of things where I kind of started to think in terms of, well, maybe I could have somebody that does these things for me remotely. And right at that time, Christy contacted me and she said, I'm in Alabama. Do you think you have a job for me? Because I'm here and I'm likely going to move again. And I think I could add value. And I said, you know what? I'm going to invent a job for you. I think I can do this. Let's figure this out.
Cornelia Cone (14:05.339)
And so that's actually how I found her. And then it kind of had this domino effect where then when I had her, then she said, you know, there's another military wife. So we kind of tapped into that because we are, uh, my husband is, he had all of his residency training through the army. And so I really sympathize with that situation that a lot of military wives find themselves in where.
Cornelia Cone (14:32.139)
you just get moved from army base to army base and you're a lot of times really the support for your husband who's either deployed or the army kind of owns them you know and that's the case with every branch of the military and so both of the people that I have that answer phones for me that are working remotely are military spouses now so that's kind of what that's what worked for me but I'm sure there's more formal routes that you can tap into
Cornelia Cone (15:01.359)
things and find people, but that's just how we've done it.
Alec Goldman (15:05.45)
Yeah, I mean, listen, at NexHealth, we have tons of 1099 employees from Upwork, from Fiverr, from really from even our own, the NexHealth employee-based communities. Tons of folks are able to help out as kind of just like the freelance and creator economy is growing so tremendously. But it's really cool that you guys kind of like tapped into where your husband had started kind of like learning his own education and really, you know, almost like paying it forward to other folks who are...
Cornelia Cone (15:29.58)
Alec Goldman (15:34.898)
kind of walking the same path as him. So I know that you alluded to this before with both Weave and NexHealth, but can you share a little bit about how technology and programs like these are the reason that you're able to actually do this remote type work and have a remote type process for your patient experience?
Cornelia Cone (15:36.691)
Cornelia Cone (15:59.015)
Yeah. So I think there's three big kinds of like companies that we rely on that make this all possible and they each kind of have a role in this virtual working environment that we've created. So it is Weave for the incoming phone calls. And then we use NexHealth for scheduling, new patient paperwork, reviews, and all that kind of stuff. And then the other one is Dendrix Ascend, which is cloud-based practice management software. If I hadn't, and it kind of started with Dendrix Ascend too. So I think, initially, when we opened up the practice and we were trying to pick up a practice management software, we decided to go with Dendrix Ascend because it was cloud-based.
Cornelia Cone (16:50.323)
And the idea was really that my husband would be able to do his notes at home. So we have small children and we are practices about, you know, depending on the traffic, 30 to 45 minutes away from our house. And so the idea was that he could come home, at the normal time, eat dinner with us, and then be able to do his notes at the end of the day and take care of that stuff. And then also out of necessity. So if we're traveling and there's some
Cornelia Cone (17:19.163)
something going on with one of our patients, it's really nice to be able to pull up that chart, look at all the notes, be able to do, we even do, you know, like teledentistry too. That was something that my husband and I actually spoke about a lot during the pandemic as well. Then you can get on a teledentistry call with a patient and help them out or tell them where they need to be referred. So that was kind of the catalyst to all of that.
Cornelia Cone (17:46.087)
And then when I had this, started building this remote team, I thought, well, we use Grasshopper for a little bit, but it's really not, I think, ideally designed for what we're doing. And so then we moved to, to weave. And so that kind of became, our technological support for the phones. And then we plugged NexHealth into that as well. So that's kind of the pieces of all of that.
Alec Goldman (18:14.83)
Can you explain kind of how you went about selecting Weave and NexHealth for the variety of things that...
Cornelia Cone (18:21.843)
Yes. Yeah. So I will. And I guess this kind of comes into my time management philosophy, too. So one of the tools that I love to use when it comes to time management is twice a year. And this is something that I can't take credit for. I so Mike McCallowitz is an author that writes on all things entrepreneurial. And he has a book called Clockwork.
Alec Goldman (18:25.646)
Thank you.
Cornelia Cone (18:51.439)
and in there he explains this method called the trash transfer or trim method. And that's what I use. So twice a year, the staff doesn't like it because it's tedious and it's laborious, but for a week we track our time. And by that I mean we use either an app or a traditional stopwatch and if you answer the phone, you start the stopwatch. If you get off the phone, you stop it.
Cornelia Cone (19:19.567)
And then you keep track of, okay, I was on a phone call or if it's answering an email or requesting the record, whatever it is, we kind of take stock of how we spend our time. And then we analyze that. And we basically ask the question for every line item on that data that we get. And we say, do we need to trash it, transfer it, trim it? And by that, I mean.
Cornelia Cone (19:46.119)
So trash means if we stopped doing this thing entirely, will it have any impact on our business? And I think people will be shocked if they critically ask that question. There are so many things that we just do because we've always done it. Right. And then if you just stop for a moment and you like, it is astounding. There is, there are certain things that
Cornelia Cone (20:12.219)
It would occupy 70% of one of my staff members’ time. And we looked at it and just discussed it in our group and said, why on earth are we doing this? There's no reason for us to do this. It doesn't have any benefit for the business. It doesn't benefit our patients. There's no reason to do it, but it made sense in a season of our business. And then it just remained as this artifact, right? So that's the first one. Then
Cornelia Cone (20:41.311)
trim and that is where NexHealth came in. Trim means are there routine repeatable tasks that we can automate? Things that have to be done that we can do in a much more efficient way. In other words, trim the time that we allocate to it but still get it done and probably get it done more reliably, more efficiently by automating it. And so that's where we plugged NexHealth in because we looked
Cornelia Cone (21:10.603)
the amount of time that we spend trying to fill open appointment slots on our books. And then, just frankly, chaos ensues, right? So you guys have something called, I think it's called wait lists, right? So you basically pair patients that wanna be seen sooner with open slots on the schedule. And we trimmed the amount of time that we spend on that by automating it.
Cornelia Cone (21:39.591)
So you guys take care of that. It was a disaster before that. We would hold appointments. We had a list that we kept track of it. We would call patients and then they wouldn't call us back. By the time they called us back, that slot would be filled. Then we'd have to do spin control and why is this so, huge, huge, huge amount of time just wasted on that? And so we just plugged you guys in there, the same with the forms, the automation of forms, reviews that took up.
Cornelia Cone (22:06.947)
so much manpower to do that. And that's where we put that in. And then the last one is transferred, right? So any task that falls into that category that we label transfer, that's where we start asking questions about is the person that's currently doing it the best person to do it? And then if that person is not, we basically swap tasks. We'll say, oh, like,
Cornelia Cone (22:33.659)
Is this a yuck or a yum for you? And somebody's yuck might be somebody else's yum. That's a term I got from my high school kids, by the way. And so then we just swap it out and then you end up having people do the tasks that they're good at and that they enjoy doing. And we transferred it to somebody else and it just creates a lot more time efficiency and happiness in general. So that's how we slotted you guys. It was...
Cornelia Cone (22:58.803)
You guys fit in neatly in the trim category of our time analysis.
Alec Goldman (23:04.014)
It's a really, really awesome way of thinking about just running the business and your processes, right? And just to recap on it, so you said it was trash, which is unbelievable, even in my own life, how many things you're just like, wait, why am I doing this? Trim, which are the things that are often extremely important, but how do we reduce the amount of time it takes? And then transfer being that, you know, I love the yuck and yum thing. I've heard it a few times.
Alec Goldman (23:33.226)
But something that I may really not like, somebody else may love, and something, you know, vice versa, and it may be a great task for me. I want to give you one last opportunity, we're at the 23-minute mark. Give us your last thoughts on something you haven't shared on time management that you'd want to share with the audience.
Cornelia Cone (23:53.031)
Okay, so I always think that if I really want to do transformational things, I need to make a mindset shift and then I have to have a tool. So the mindset shift comes before the implementation and the tool is how I'm going to implement it. So I've given you guys a tool, which is the trash transfer or trim tool. But then the mindset shift that I want to leave you guys with is this idea that, and I think it's a very.
Cornelia Cone (24:22.063)
insidious idea that it's possible to do everything and I just think that is not true. There's a very famous quote by Warren Buffett that I live by which says that really, really successful people say no to almost everything.
Cornelia Cone (24:44.183)
And I think that is kind of, for me at least, that has been instrumental in trying to manage my time, where I really have to think critically about, is this something that I should be doing? Am I the best person to do it? Like, should I say no to this? Should I stop doing it? Should I automate it? Should I transfer it to somebody else? Because, and this is really important for me as a mom of four children,
Cornelia Cone (25:13.831)
I feel like there's always, if I'm not very intentional about it, there's an invisible trade-off. And for a lot of people, if you're ambitious, you like to say yes. So you're always a yes before you're a no if you're ever a no. And the invisible trade-off usually happens on the personal side.
Alec Goldman (25:36.398)
I think I could certainly relate to it. I have to talk to, yeah, it's great advice. It also is something you mentioned earlier on in our conversation, but the number of yeses, it's almost like a domino effect to burnout, or at the very end of it, you may, one more domino just keeps pushing, pushing, pushing, and you're like, holy crap, I need a break. And it's so important to figure out a process that you think you can run a marathon on and not treat every single day like a sprint.
Cornelia Cone (25:37.931)
I'm going to go ahead and close the video.
Cornelia Cone (26:05.991)
Yeah, no, exactly. And that analogy really, really resonates with me because my husband, we've kind of fallen off the wagon a little bit here in the pandemic, but we used to run ultra-marathons and there it's all about pacing, right? It's a long game. You need to be able, you need to think about sustainability. And what we're always flirting with, if you're ambitious and you wanna put a lot on your plate is you're flirting with burnout.
Cornelia Cone (26:33.907)
Right? That's the thing that you're trying to avoid. And so those are just things like that mindset shift. And then that very practical tools are the things, at least in my life, that have helped me to avoid burnout.
Alec Goldman (26:49.39)
Courtney, we're at now at the 27-minute mark, but this was awesome. And I know that there are a ton of relevant stories, and facts, just like anecdotes that you've shared that I know will be tremendously valuable to so many different practices you listen in. Thank you so much for making the time on Friday afternoon.
Enlive will officially sunset in

Welcome to "How I Grew My Practice," a podcast presented by NexHealth, where industry experts share their experiences and strategies for success in the dental field. In this episode, Cornelia Cone, Vice President of Nuance Dental Specialists, will shed light on her unique perspective on in-office time management, drawing from her experiences in running a successful practice and navigating the ever-changing landscape of dentistry.

Trash, Trim, or Transfer Your Tasks

According to Cornelia, there are three big levers you can toggle on to manage things: money, people, and time. “Of those, you can find ways to make more money and hire more staff,” says Cornelia, “but the only thing that is finite is time.” So the most challenging part is maximizing your staff’s time.

Cornelia likes to follow the “Trash, Trim, Transfer Method.” Twice a year, Cornelia and her staff use either an app or a traditional stopwatch to track daily operations like answering an email or requesting a medical record and analyze how the team spends time. From there, decide if they should trash, trim, or transfer that task based on how much time is spent and how much it impacts the practice.

Leveraging Offsite Support Staff

To overcome staffing limitations and enhance flexibility, Cornelia has embraced the concept of remote work. By implementing out-of-the-box solutions, she has created a virtual support team that operates from different locations and time zones. 

This approach has enabled her to tap into a larger talent pool and assemble a highly skilled team. Cornelia's remote staff handles various tasks, including phone answering, insurance claims, paperwork, schedule management, and administrative support. Their remote work ensures that essential tasks are completed round the clock, optimizing overall practice efficiency.

Finding Reliable Remote Staff

Finding reliable remote staff can be a challenge, but Cornelia has found success through various methods. In some cases, she leveraged personal connections, such as former colleagues or military spouses who shared a similar transient lifestyle. These connections allowed her to tap into a pool of talented individuals looking for remote work opportunities. 

Additionally, Cornelia suggests exploring platforms like Upwork, Fiverr, or specialized companies that curate pools of remote employees. These platforms can help practitioners find reliable remote staff who are invested in the team's success.

Technology as Enablers

Cornelia attributes the success of her remote work model to key technology solutions like NexHealth. NexHealth streamlines scheduling, paperwork, and patient communication, optimizing the patient experience. Technological tools empower Cornelia's team, including remote employees, to operate efficiently.

Task Allocation and Outsourcing

Cornelia strategically allocates tasks based on time zones and skill sets. Staff members located in the Eastern time zone handle phone calls, ensuring efficient communication with patients during regular business hours. Meanwhile, her remote team member in South Africa handles non-time-bound tasks such as insurance claims and paperwork, leveraging the time difference to accomplish work overnight. Additionally, Cornelia employs an executive assistant based in Missouri to manage speaking engagements, travel arrangements, and other logistical support, allowing her to focus on core responsibilities.

Environmental Pressure and Necessity

Cornelia's decision to explore remote work was driven by environmental pressure and necessity. As a prosthodontist in Portland, Maine, she faced challenges associated with limited staff availability and small office space. By thinking outside the box, Cornelia aimed to expand her applicant pool and create a system that did not require a physical presence in the office. The COVID-19 pandemic further validated her approach, as the shift to remote work became more prevalent. Cornelia's practice was already well-prepared for this transition, benefiting from advancements in technology and virtual collaboration tools.

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