Gem Publishing October 2018

Blow the Roof off ‘Usual and Customary’ Dentistry, Part I By Dr. Tom “The Gems Guy” Orent

need $20,000 in dental care — you’d send new patients running to the hills. More often than not, dentists choose one or two teeth to treat cuz it’s easier than trying to convince an asymptomatic patient they need five figures’ worth of care. The patients seem happy, the practice still has recurring revenue, and you can keep the doors open another month. In the last issue, we discussed Gems’ mission: “Together we are dedicated to improving the health and longevity of 3,000,000 people, one smile at a time.” If we were to treat one tooth at a time rather than focusing on the overall best possible care for our patients, we would never accomplish our mission. BLAME THE ABSENCE OF SYMPTOMS Compromised care isn’t your fault. In addition to the meddling from managed care insurance, we also have to overcome a significant challenge every time we plan and discuss treatment… the fact that 95 percent of the care our patients truly need is CARE NEEDED in the ABSENCE of SYMPTOMS. Common issues indicative of stomatognathic deterioration often go untreated. Pathologic occlusion, muscle tenderness, excessive anterior wear facets, and posterior enamel wear are frequently missed. Many patients have even worn through their enamel into dentin. We must intervene. The good news is that you have proven-effective Gems at your fingertips to help you help patients… asymptomatic patients... perceive the immediate need for care. Accept recommended care. Site map GG12 Monthly Team Training Toolkit: “058 & 059 Worn Enamel Recognize and Treat Pathologic Occlusion, Add $50,000 to $100,000 Per Year, Part I & II” These two episodes offer you a gold mine of opportunity. My longtime friend and colleague, Dr. Buddy Mopper, InsidersCircle.com | 1-888-880-GEMS (4367) 1 Continued on page 2...

It’s time we REJECT “usual and customary” dentistry as “good enough.” The state of care in our profession is deteriorating because we’ve allowed it to be contingent upon (our perception of) our patients’ financial capabilities. Insurance companies set what they deem “usual, customary, and reasonable (UCR) fees” based on some FICTICIOUS number they pick out of a hat and then tell our patients it’s the norm in your zip code. Employers choose to pay for dental insurance plans with maximum limits capable of covering next to nothing. Meanwhile, we have real patients with real problems. It’s our obligation to rise above the usual and customary and deliver the extraordinary. We can only do that if we stop approaching dentistry from a reactive position and re- establish a doctor-patient relationship that fosters the level of trust necessary to help patients achieve optimal health. OBSTACLES TO RENDERING BEST-OPTION CARE What are some of the most common reasons patients don’t accept (reject) recommendations for care? Lack of money, insufficient time, fear of treatment. The absence of symptoms, and of course… the insurance quagmire. But what if insurance considerations, time, money, and fear were magically removed from the equation? What would be the best possible care for your patients’ long- term health? While this sounds great in theory, putting this into practice is more difficult in the real world. Many dentists are still delivering “one-tooth dentistry”… in the face of the (perceived) stranglehold of “Doc, just do what my insurance covers.” When a patient comes in for a checkup or cleaning, it’s much easier for them to accept that one tooth is a problem because insurance usually only covers $1,000–$1,500 a year. No one wants to hear that they

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2 InsidersCircle.com | 1-888-880-GEMS (4367) THE NEW PATIENT CASE PLANNING PARADOX If one-tooth dentistry doesn’t address the patient’s actual needs and telling the new patient about everything they need just scares them out the back door… then what can we do to RETAIN and actually HELP patients achieve the best possible long-term health? shared some of the very best Gems on this topic at “GICW 057 Mopper How to Perform and Get Paid for More Cosmetic Dentistry” and “GICW 095 Mopper How to Prep and Place Invisible Long-Lasting Cervical Restorations.” Pankey, Dawson, Kois, and Spear, all highly respected clinicians, taught us superior clinical methodologies that changed the course of dentistry. They addressed rehabilitative care in great depth. But a funny (not so much) thing happened between taking those courses and trying to get our patients to accept such high-level care. WHY NEW PATIENTS RUN OUT OUR BACK DOORS After completing some of the top rehabilitative continuum in our profession, I introduced a far more extensive new patient exam than I’d ever performed. Every new adult patient was scheduled for 90 minutes. I performed a TMJ ultrasound, not one but three DeLar bites, impressions, casts mounted in centric relation, Centri-Check to confirm centric on a Denar Articulator… a TMJ exam, measurements, muscle palpations, pterygoids check… Every single step of what the continuum told us to do, I did it. And at the end of the new patient exam, I’d ask them to come back in a week and to bring a spouse or loved one because (we were coached to tell them that). “Four ears are better than two.” If they came back, I presented them with recommended care for their whole mouth. More often than not, their response was often shock, disbelief, and something to the effect of, “My last doctor said I only need a filling, not $20,000 worth of work done.” One day, my office manager, Izabel, came to me with what I initially thought was a compliment. “Doc, since taking all these advanced continuums, you’ve become a much better clinical dentist.” This was a classic case of a woman speaking and the man having absolutely no clue what she actually said! I thanked her, to which she replied, “Not so fast. Look at this.” She handed me a piece of paper. On it was quite a long list of names. Izabel asked me, “How many of these names do you recognize?” Truth be told, some were familiar, but I didn’t recognize most of them. She continued, “This is a list of our new patients over the last year. Almost all of them have left the practice!” The continuums were terrific (clinically), but if you weren’t one of the superhuman doctors who taught them, deploying their suggested method of new patient exam and case presentation often caused patients to run out the back door. Of course, if you’re in the 1 percent who have the communication gift to consistently convince BRAND NEW ASYMPTOMATIC PATIENTS to get a full-mouth reconstruction (the moment you meet them)… then ignore everything from here on out. The other 99 percent should keep reading.

This conundrum reminds me of a time I was in the Midwest speaking at a seminar. That year, Reader’s Digest ran a scathing article about modern dentistry on their front page. The cover said “RIP OFF” in big, bold letters. The article cast a long, dark shadow on dentists, stating that we were routinely overtreating patients, by recommending and performing unnecessary care. They essentially secret shopped dozens of dentists across the country. Pretending to have just moved into the area, the writer asked each doctor to perform an exam and recommend a plan of treatment. Unbeknownst to these dentists, the writer says that his dentist at home told him he only needed two teeth treated. Meanwhile he got treatment plans across the country ranging from a few thousand up to $40,000. “60 Minutes” performed a similar hack job on our profession. I happened to have mentioned this during the seminar. During the lunch break, one of the attendees approached me and said, “Tom, about the Reader’s Digest story... I am that dentist featured in the article! I was the writer’s dentist.” I asked the doc what he had really diagnosed. “The whole thing is a lie,” he told me. “Sure, at his most recent exam, I told the writer he only needed one crown and a filling. But for the longest time, I told him he was going to lose teeth. What he really needed was a full-mouth reconstruction. He had refused treatment for years. The minimal treatment he said was the plan recommended by his real dentist was nothing more than emergency recommendations to put out the worst couple of fires.” HOW TO KEEP THE NEW PATIENT AND DELIVER BEST- OPTION CARE You may have heard me speak about the Mercedes study. Mercedes-Benz wanted to know how many positive interactions with a new client, customer, or patient it takes before they are ready to hand over a significant amount of money. The result? They found it takes 5–7 positive interactions with a new client, customer, or patient for them to consider a big purchase. The bottom line? When meeting most new patients, especially those who haven’t experienced symptoms and have NO CLUE regarding their true dental needs… it’s JUST TOO SOON to tell them all about what they need. During most asymptomatic new patients’ first few visits to your practice, there is INSUFFICIENT RELATIONSHIP AND TRUST for you to consistently achieve high levels of acceptance of high-dollar recommendations for care. IS IT ETHICAL (EVEN CREDIBLE?) TO NOT TELL THEMWHAT WE SEE? This is truly a (multi) million-dollar question. In our next issue of “New Frontiers in Dental Practice Success,” in Part II of this article, I’ll not only answer this question… I’ll also reveal in explicit detail exactly how you can RETAIN the highest possible number of new patients and achieve consistently high acceptance of your very best possible recommendations for care.

“Together we are dedicated to improving the health and longevity of 3,000,000 people, one smile at a time.”

Minimally Invasive Maximum Profit Dentistry

The Artful Genius of Dr. Buddy Mopper

Imagine being so adept at what you do and loving it so much that after 50 years at it… you’re still practicing! Dr. Buddy Mopper is one of the most gifted, talented, hard-working clinicians and mentors in our profession. I had the good fortune of meeting Buddy nearly 30 years ago through the American Academy of Cosmetic Dentistry. Buddy was one of the founding members of the AACD and one of the earliest members to achieve AACD accreditation. As one of my first mentors in esthetic dentistry, Buddy played a large part in inspiring me to devote more than two years to becoming accredited by the AACD, and to subsequently devote six years as an accreditation examiner. Dr. Buddy Mopper doesn’t need to be practicing dentistry into his 80s. In addition to being one of the most successful esthetic and restorative dentists in the world, Buddy co-founded Cosmedent Corporation. Buddy continues to see patients and mentor us through webinars and seminars solely because of his passion for his artful deployment of our science. 50 YEARS OF EXPERIENCE EXTENDING THE LIFE AND BEAUTY OF DENTITIONS One of the most commonly overlooked (neglected), insidious problems contributing to the demise of patients’ dentitions is pathologic enamel wear secondary to diminished or lost anterior guidance. The problem with which this patient presents in Buddy’s case below is all too common. The patient’s mandibular incisors have worn through the incisal enamel, exposing dentin. The remaining incisal enamel, “cupped” and unsupported, is subject to ever rapidly increasing deterioration. Left untreated, this patient would potentially be facing root canals and most likely four anterior mandibular crowns. As Buddy says, nobody wants to prep a mandibular incisor for a crown!

Before and after photos and dentistry by Dr. Buddy Mopper

Put yourself in the place of this patient. If these were your teeth, which of the following would you want your doctor to do?

A. Wait and do nothing until the only alternative is massively more expensive, extensive, and destructive

B. Remove all the labial enamel and a couple millimeters of the incisal enamel… prepping for and placing porcelain veneers; or… C. Minimally invasively remove as little remaining tooth structure as possible, and then prep, etch, and rebuild the incisal edges with direct resin bonding (as shown in the photos) The answer is obvious, and yet cases just like this — some not quite as advanced, others far worse — present to dental practices every day, often leaving the visit with no recommendations for care. We (here on Planet Gems!) can and should take a stand. It’s not happening at our practices on our watch. Show these photos to your entire team and alert them to the fact that this is NOT NORMAL — when enamel wears like this, it’s the sign of a PATHOLOGICAL OCCLUSION. We need to restore the worn enamel and rebuild the anterior guidance in order to protect the patient from further loss. Remember our mission: “Together we are dedicated to improving the health and longevity of 3,000,000 people, one smile at a time!” EXACTLY HOW SHOULD YOU RESTORE THIS CASE? As members of our Gems Family, you and your team have the opportunity to watch Buddy restore this case. You’ll get to listen to Buddy as he talks about the rationale for treatment,

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FROM LEAD MAGNET TO CONVERSION If online marketing is your vehicle for new patients, then your website is the garage. A patient’s journey with your practice starts and ends with your website. Even with this understanding, many dental practitioners can’t tell you anything regarding their web presence. They don’t know their demographic, how many leads they are getting from it, or how to use it for marketing. Which brings us to our first Gem. Hiring someone to manage your website is a great place to start if you feel intimidated by the mechanics or time investment required. From there, you can have that team member set up what we call a lead magnet. I like to start with a free giveaway, such as an e-book, brochure, checklist, or cheat sheet — some marketing material that adds value to their lives. For example, when a potential patient logs on to your website, you can have a “10 Things You Should Know Before Implant Treatments” article. From that article, you can capture that person’s email address and add them to your database. That lead magnet — the article — helps you gather the necessary information to market and place them into what’s called a funnel. If you use online ads, these funnels can be explicitly targeted to what patients are searching for on the internet. NOT JUST ANY PATIENT Blindly taking shots in the dark to try to generate leads is no way to approach your practice. Our second Gem is to use Google Ads to target your ideal patient. By setting up an AdWords account, you can develop strategies to collect leads and place them into specific marketing channels based on their search criteria. For example, if a client is searching “dental implants” on Google and your ad comes up, you’ll know that’s precisely what they are looking for. From there, you can target your marketing directly to that patient. But AdWords is more than just a way to target your services. You can also target specific demographics that fit the mold of what you are looking for in a lead. THERE’S A SYSTEM FOR THAT Slick marketing tricks are always fun to talk about, but while everyone loves to talk about unique ways to find new patients, no one wants to focus on the system needed to make these tactics successful. Just as with every Gem we present, online marketing needs an efficient system to make sure it’s successful. I recommend starting with a good CRM tool. For those on a budget, HubSpot offers a free service you can use that will help you with the basics. These Gems are just the beginning. SEO, social media, text messaging, email marketing, and newsletters are all ways you can expand the reach of your practice. Set up a call with your Gems Concierge today and see how you can start using the wide world of digital marketing.

Digital Marketing Is a Gold Mine Full of Untapped Gems

By Jeff Anzalone, Certified GG12 Coach

Online marketing isn’t a subject they teach you in dental school, but there may be no better way to grow your practice than by utilizing this Gem. Every practice has a revenue-generating machine at their fingertips, but they don’t know how to use it. I came across a practice a while back that was losing patients to another dental office over 100 miles away. When we broke down the reasons people were leaving, the rationale was maddening. Patients were going to the other practice to receive a specific treatment with the misunderstanding that the dentists I was working with didn’t offer it. Why? One practice marketed online, and the other didn’t.

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GG12 Office Hours: Twice each month, my office door is open for your visits. This is an optional opportunity for GG12 doctors and teams to reach me directly with questions about dental practice management. Gems Insiders’ Circle™ Quarterly Q&A Webinars: Four times each year, I’m available in the evening for up to 90 minutes to answer your questions about any dental practice management topics of your choice. GG12 and Insiders’ Circle™ Members’ Spring and Fall Retreats: Doctors and team members often tell us they have never experienced anything like our retreats in all their years attending dental continuing education. Experience it for yourself and form a lifelong bond with other GG12 and GIC family members. Register now!

SAVE THE DATES! The Gems Family Members’ Spring 2019 Retreat and Mastermind sessions will be held in Atlanta, GA, March 14 to 16, 2019. Registration will be open shortly! For the latest up-to-date information about what’s happening on Planet Gems, go to InsidersCircle.com and click on “Calendar” (menu bar, top left of homepage). If you have questions, please contact your Personal Gems Concierge or call 1-888-880-GEMS (4367).

October 11: 11:00 a.m. to 12:00 p.m. EDT — GG12 Office Hours

October 24: 11:00 a.m. to 12:30 p.m. EDT — GG12 90-Minute Team Training Webinar

90-Minute GG12 Team Training Webinars: GG12

October 24: 8:30 p.m. to 10:00 p.m. EDT — GG12 and Gold PLUS Global Mastermind Webinar

Team Training Toolkit Dental Practice Transformation members, please block out this monthly program. These occur just once each month, but they could easily be the most important 90 minutes you and your entire team will invest.

October 26: 11:00 a.m. to 12:00 p.m. EDT — GG12 Office Hours

Dr. Dennis Rinaldi Dr. Edward Smith Dr. Chris Sortman Dr. Patrick Weimer Dr. Behnaz Nonahal Dr. Jae Shim

Dr. Martina Ettinger (Austria) Dr. Duncan Scorgie (UK) Dr. Tom Miller Dr. Ira Biderman Dr. Laura Gramse Dr. Vincent Huang (Australia)

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It’s Time for a Little Promotion

The Deadline: Nothing happens without a deadline. You need to make sure that someone has a reason to take action NOW! Otherwise, they’re likely going to put it off. For example, you could say something like:

Most practices struggle with promotions. Things slip through the cracks. That stops now with this surefire way to create your promotions. As we’re already into October, it might be too late to really get something going this month, but November is just around the corner. There are two federal holidays in November you could choose between (Thanksgiving and Veterans Day). Given the noise that comes from Black Friday and Cyber Monday, for this example, we’ll use Veterans Day.

Submissions must be in by (X date), for example: Friday, Nov. 9.

The Prizes: You need two prizes… the big “grand prize” and THREE second-place prizes.

There are five things you need to make sure any contest/ promotion is effective:

Grand prize: Free dental procedure for a veteran

THREE second-place prizes: $500 off any service booked by Thanksgiving Day (ALWAYS use a deadline). The idea is to make it attractive enough so that it gets used and creates a patient for life. Be sure to include a second-place prize message: “Although you didn’t win the grand prize, because you’ve served us/ nominated someone, we’d like to serve you!” By making THREE second-place prizes — the $500 gift card for any treatment or service in your practice — you will maximize the number of new patients and ultimately the amount of revenue and PROFIT you enjoy from this strategy. And who better than our veterans with whom to share such a prize? Of course, you send the second-place prize notice to EVERY VETERAN (other than the grand prize winner) who entered!

The prizes: 1 grand prize and a lot of second-place prices (for everyone else)

The story

The medium

The deadline

• The selection method The Story: Tell people why you’re doing the promotion. In this example, you’re telling the story about why you’ve picked Veterans Day. After putting life and limb on the line, our country’s veterans come home to an occasional “thank you” from well-meaning civilians, but often they find neglect. If you know of a veteran who needs ANY type of dental care our practice offers (a basic filling, braces, or even a mouth-full of implants), we want to help them. This Veterans Day, (PRACTICE NAME) is going to give one veteran in need the dental care they truly deserve. We’re going to cover 100 percent of their treatment… even if they’re not currently our patient. If you know someone who has served our great country, please go to (PRACTICE WEBSITE, FB PAGE, OUR OFFICE), and share their story. That’s why this Veterans Day, we’re asking for your help to serve those who have served us.

The Selection Method: This is how you’re going to select and share the great news with the winner.

You can use a random drawing or the story with the most likes/ comments/views/votes.

Announce the winner on Nov. 12 via email/Facebook/radio/ practice website.

As with any (all) marketing, always check with your attorney prior to deploying to be sure you are complying with local, state, and federal laws. That’s a quick sample of how to create and run a promotion to help attract new patients (and do a lot of good in the community). To get more details on this, or to see several real- life examples of what other Gems Family members have done for Veterans Day celebrations, go to our Gems Family website, InsidersCircle.com SITE MAP Advanced Marketing Brain Trust Scroll to section 038 where you will find EIGHT additional resources to help you help our veterans and build your practice! As always, your Personal Gems Concierge is always happy to assist you in locating any resources or answer any questions you have. To your success!

This Veteran’s Day, our goal is to serve someone who so bravely served you, me, and the rest of our nation.

Please help us help a veteran get the care they need and deserve.

The Medium: These are a few of the many places where you need to make sure you’re sharing your story and telling people how to enter the contest and nominate someone.

Practice website Practice Facebook page

Practice Instagram/Snapchat account Local radio, TV, and newspaper

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then walks you step-by-step through the SIMPLE PROCESS of RESTORING this patient’s dentition.

Go to InsidersCircle.com SITE MAP GEMS INSIDERS’ CIRCLE WEBINARS GICW 052 MOPPER THE ULTIMATE TECHNIQUE AND STRATEGY FOR MINIMALLY INVASIVE MAXIMALLY PROFITABLE DENTISTRY In addition to being some of the most patient-pleasing, professionally rewarding dentistry you’ll ever perform… Minimally Invasive Dentistry can be wildly profitable as well!

No lab fee, no anesthesia, minimal prep time, and significant fees make this not only professionally rewarding, but financially as well.

Create Content Prospective Patients Are Searching For With Help from AnswerThePublic

first page of Google is paramount, and tailoring your content to common search queries is the best way to do that. Of course, your content still has to be killer, but AnswerThePublic will help you ensure that killer content doesn’t get lost in the shuffle. Content marketing is a great way to catch the attention of your desired audience. AnswerThePublic helps laser-focus your content marketing based on reams of data and millions of searches. And it’s totally free! If you’re not using AnswerThePublic, it’s time to start. You’ll be shocked at how quickly it starts reaping benefits for your SEO, and the increase in engagement with your audience will be well-worth the extra effort.

We’ve all heard it said over and over and over again: Content is king. While there’s no denying the truth of that statement, it’s equally true to say that not all content is created equal. You could create all the content in the world — articles, videos, podcasts, etc. — but it’s useless if nobody wants to engage with it. How do you know if the content you’re producing is relevant to your audience? AnswerThePublic, a revolutionary keyword tool for SEO, can be a huge help. In the past, you probably relied on keywords to generate topic ideas. While that’s not a bad starting point, very few people input a string of keywords when they use a search engine. AnswerThePublic lets you know what people are actually searching for. When you input a term into AnswerThePublic, it will generate web-like visualizations of the most common searches based on three categories: questions, prepositions, and comparisons. Basically, it aggregates Google autocomplete responses in a matter of seconds. To help illustrate how AnswerThePublic works, let’s use the example of searching for “newsletters.” The first web, questions, is divided by terms like “how,” “are,” can,” and “why.” Around those major terms you’ll find results like “How do newsletters make money,” “Why send newsletters,” and “Are newsletters worth it.” The same goes for the other two webs. These are phrases that are searched the most frequently, giving you direct access to the most-sought-after content topics. Using these results, you can reverse engineer content tailored precisely to what people are searching. Instead of titling your article “The Value of Newsletters,” you can opt for “Why Newsletters Are Worth It.” The importance of landing on the

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Gems Inside

4. Digital Marketing Gems to Jump-Start Your Practice

1. Your Patients Deserve More Than ‘Usual and Customary’ Dentistry!

6. It’s Time for a Little Promotion

3. Recently Unearthed on Planet Gems

7. A Killer Idea Starter for Your Content

Dr. Ken Rasbornik Shares the Mother of All Gems

By Dr. Ken Rasbornik

My practice is coming up on our fourth year using Gems, and I have to tell you, I don’t use the word “outstanding” lightly, but my experience has been precisely that — especially the retreat this year. I thoroughly enjoyed the time I was able to spend with my fellow Gems family members, especially with Hurricane Florence hitting so close to home. But what goes on at the retreats is only a small fraction of the benefits our practice has seen since joining the Gems family. Making that decision so many years ago was the best decision I’ve ever made, and that all starts with our 90-minute weekly meetings. I know Dr. Wolt discussed how important the 90-minute weekly meeting was to her practice last month, but I wanted to elaborate on some specifics of how it has impacted our office. Our team certainly exemplifies her points on implementation and growing closer together, and hearing that other practices have seen the same results we have is exciting. But our practice has witnessed a lot of changes over the past four years, and I believe our perspective can help everyone in the Gems family understand how these meetings develop over time. Before we started with Gems, staff meetings consisted of discussions about technical elements of dentistry. I used to attend seminars as a way to put the paddles on the heart of our practice. The education I received at these courses focused on how to be a better practitioner, so I’d come back and talk about the exciting opportunities these skills presented. But we never had a compelling reason to change, so after six weeks, we usually fell back into the same slump and started performing what Tom refers to in the cover as “usual and customary dentistry.” When we first started meetings using the Gems method, it took a lot of conversations with my Concierge to understand where our focus should be. He helped us home in on specific Gems in webinars that directly related to our practice. At first, we asked for every team member’s input, and that taught us volumes about which employees felt invested in the process and which didn’t. It was clear we had to cull the herd and have some difficult conversations. “If you don’t want to be here, other offices will have you” was not an uncommon phrase

at the time. Once we got to a point where buy-in was not an issue, we started having discussions about how the Gem we were going over that week pertained to our practice. You can’t apply concepts that will change your practice by simply listening or observing. It requires relating the Gems to everyday life, and that meant action became the center of every meeting. Fast-forward to today and Gems provides us with a platform to have a perfectly executed meeting every time. My office manager, Crystal, leads the topics, and we all collaborate to find the best way to plug specific Gems into our practice. We’re more consistent on every aspect, and that provides stability and expectations that everyone can follow. Our team is more motivated and on the same page, which translates directly to our bottom line. Since starting with Gems and implementing the 90-minute weekly team meetings, our practice has grown by more than $500,000. We’ve seen a $61,550 yearly profit on our biannual implant seminars. A billboard we placed near the office turned out $155,000 in direct referrals in one year. Our total revenue increased from $954,000 in 2014 to $1.4 million in 2017. Projections indicate that 2018 will surpass those totals, and we couldn’t be more thrilled. All of that starts with our weekly meetings. It’s one Gem you cannot ignore in your practice, no matter what.

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