Episode 47 - Increase Patient Referrals With Enhanced Technology & Communication: A Conversation With Bill Layman

April 28, 2023

Dr. Bill Layman, the owner of Straighten Up Orthodontics in Clearwater, Florida, is our guest on this episode of The Golden Age of Orthodontics. Dr. Layman talks about the advantages of using a 3-D Treatment Letter, demonstrating the potential outcomes of orthodontic treatment using virtual technology. This gives patients the assurance they require to move forward with treatment. Additionally, he discusses the advantages of remote monitoring and employing uLab for aligners. There’s never been a better time to be an orthodontist.


  • (00:57) Amy and Dr. Leon discuss what their marketing firm does and the frustrations Dr. Leon experienced as a practicing orthodontist. 
  • (03:47) Dr. Layman explains the benefit of a 3-D Treatment Letter. 
  • (07:58) What was the motivation for the creation of this digital technology? 
  • (11:06) The differences and benefits of Ulab for aligners. 
  • (13:22) Dr. Layman uses remote monitoring to the advantage of patients by acknowledging their busy schedules. 
  • (16:20) Dr. Layman responds to Dr. Strauss from Florida regarding virtual setups. 
  • (18:36) Three ways of creating 3D communication. 
  • (23:24) There is an increase in patient acceptance when they can see the result visually. 


  • An animated representation of a patient's teeth after correction instills motivation and confidence, encouraging them to undergo the necessary treatment
  • Teamwork between an Orthodontist and a GP assures patients they are working with the right professionals
  • Patients highly appreciate having remote check-ups as it saves significant time


People + Practice - Website
Dr. Bill Layman - Website
[email protected]


Raised in a small Virginia farm town, Dr. Bill Layman worked during high school as a farmhand, loaded dog feed, mowed church lawns, and was a full-service gas attendant. After graduating from The Citadel with a Bachelor of Science in biology, he served as a paratrooper with the Army’s 82nd Airborne. While in dental school at the Medical University of South Carolina, he was elected and served four years as class president while earning his Doctorate in Dental Medicine. He has lived and worked in Clearwater since opening Straighten Up Orthodontics in 2005. He and his wife Andrea have one son who is now attending Tulane University and majoring in Finance and Real Estate. Dr. Layman recently completed his Masters of Business Administration at the Wharton School, University of Pennsylvania, where he also received the Ben Franklin Award for leadership.


“Remote monitoring is one of the most patient-centric things you can do for someone.  It’s allowing them not to have to come into the office as often.  We make it clear we are here if you need us, but we acknowledge and respect that patients have other things to do.” - Dr. Bill Layman

“Now, with 3D printed models, we put the teeth in the position that we know we can get there as an orthodontist.  I’m not just arbitrarily moving teeth around. We know the mechanics, and we know how we’re going to get there. Before we meet the patient, we have their treatment plan.” Dr. Bill Layman

Achieving practice growth isn’t as simple as it used to be. But with groundbreaking technology and new communication channels to reach more patients, People + Practice is an orthodontic marketing agency that firmly believes that there’s never been a better time to be in practice. 


What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for watching the video.

Narrator: The future of orthodontics is evolving and changing every day, but although the way to achieve practice growth has changed, there's never been a better time to be an orthodontist. Let's get into the minds of industry leaders. Forward-thinking orthodontists and technology insiders to learn how they see the future of the orthodontic specialty.

How will digital orthodontics, artificial intelligence, clear aligner therapy, remote monitoring, in-house printing, and other innovations change the way you practice? Join your host, Dr. Leon Klempner and Amy Epstein each month as they bring you insights, tips, and guest interviews focused on helping you capitalize on the opportunities for practice.

And now welcome to the Golden Age of Orthodontics with the co-founders of People and practice, Dr. Leon Klempner and Amy Epstein.

Amy Epstein: Welcome to the Golden Age of Orthodontics, brought to you by people in practice. A marketing firm that my dad and I started together to help practices reach all the potential new patients that are looking for orthodontic treatment. And although much of our work is based in the business to consumer realm, attracting patients directly, general dentists still play a crucial role in the marketing equation.

So a comprehensive marketing strategy that takes both the business to consumer side and also the business to business side is the approach that we re. 

Dr. Leon Klempner: Yeah. You know, I, I practiced for 38 years and I have to say I had a, a love hate relationship with gps, Amy. Um, cuz on the one hand I definitely wanted their referrals, but particularly in the last 10 years of practice, uh, I also viewed them as competitors.

Because I was losing all of those easy cases, and it would drive me crazy when, um, a GP would come over and they'd have models or they'd ask me to look at their, um, you know, treatment plan and they were treating the case and some of them were easy cases within their realm. But some of them clearly were, were not.

And you know, and I, you know, I wanted to say, you know, what the f but, uh, you know, I would bite my tongue because clearly, uh, you know, I, I, I wanted to maintain that relationship. And truth be told, it's not a zero sum game. There's plenty out there for, for. So there's nothing wrong with buying bagels, um, and providing, you know, taking GPS out to dinner, but providing clear, effective communication about shared patients to strengthen the relationship.

And position yourself as a go-to tech forward expert, uh, to us appears to be a much more effective strategy, and nobody does it better than Dr. Bill Layman, who is our guest today. 

Amy Epstein: We are lucky to have Dr. Layman again on our show. He earned a d d S from the Medical University of South Carolina and completed his ortho training at Vanderbilt.

He also recently earned an M B A at up Penn's prestigious Wharton School of Business, where he received the Ben Franklin Award, which recognizes leadership contributions to a class. This is not surprising, uh, that Dr. Lehman earned such a, an award, so you also may not know about Dr. Lehman. Served as a paratrooper with the Army's 82nd Airborne Division.

His practice called Straighten Up Orthodontics is located in Clearwater, Florida. Dr. Layman, thank you so much for joining us today, 

Dr. Bill Layman: Amy. Thank you for having me. So 

Dr. Leon Klempner: Bill, um, first of all, uh, on behalf of all of our listeners, let me thank you for your service. 

Dr. Bill Layman: Thank you, Leon. 

Dr. Leon Klempner: Yep. So let, let's start with a, uh, a review of a, a conversation that we had before the podcast where you explain to me, uh, what you refer to as a 3d uh, treatment letter.

So if you, could you explain to our listeners exactly what you mean by a 3D treatment letter? 

Dr. Bill Layman: Well, a 3D treatment letter. What I found was working with the gps, like you talked about on some of the more complex cases, being able to explain to the GP and really lay out in written format what we were going to be able to accomplish for the case.

Sometimes didn't really, I didn't think, drew the entire picture and I found that out a year and a half, maybe two years later. Once the case comes to the end and we're looking at it, we're checking it out. Maybe there was a slight miscommunication, maybe there was a slight misunderstanding. And I, I really tried hard to avoid and eliminate those issues.

So what I decided to do is about seven, eight years ago, we started scanning all of our patients. We haven't taken a algin or PBS impression in eight years now, and the software and the ability to use software in our own office, you, I use a company called Ulab and the ability to actually create. Final positioning of the teeth immediately really helped.

What I found in some of these restorative cases is the dentist that may not have a lot of training, ortho may not have any at all, any exposure. That seems to be the joke that in dental school you don't get any and. The ability to show them a case when they're working on such a complex case and their mind is really in tune with that newer patient or that newer treatment plan they're working on.

To be able to show them what the case looks like. Now in 3d, 3D printed models, put the teeth in the position that as an orthodontist, we know we can get there. I'm not just arbitrarily moving teeth around, you know, we know the mechanics, we know how we're gonna get. And print that out. And within a week or two, maybe, maybe a week or less even sometimes I can either create a video for the dentist to show them where we're going and what the space is and maybe some of the limitations and some of the restorative goals, and have that conversation even before they meet with the patient for their treatment plan review.

And so having that communication, whether the patient starts treatment or not, the dentist that you're now working with, whether they're a little bit younger, a little bit older, really doesn't matter either way. They don't have to wait a year and a half, two years to see the case finish. They can understand it in very short cycle times.

So the ability for me to show the dentist that I'm working with maybe 10 or 12 cases a. Within a week or two has really improved their understanding of what we can do orthodontically, and it's also improved the comple, you know, essentially the acceptance rate because the dentist now, when they have the treatment plan with the patient and refer 'em to ortho.

The patient can even visualize like, yeah, that does make sense. That does look like a much more stable foundation for me to spend this 20, 30, 40 grand on new teeth to fill in these holes. So we found that that was working really well and um, we've been developing it, improving it, and uh, just wanted to be able to share it with everybody else what we're doing.

Amy Epstein: Yeah. To me it seems like, you know, we do a lot of brand positioning and solidifying value propositions for practices to be able to differentiate from their competitors in, in a given area. Mm-hmm. To me, this seems right in alignment with, um, you know, uh, tech forward approach. And, um, you know, the type of workflows that you may be providing to your patients that GPS would be looking for in a partner when they're serving their clients.

So was that at all in mind or has that been a benefit to taking this approach when working with 

Dr. Bill Layman: gps? Well, it depends on the hat I have on, you know, of course I mm-hmm. I like I was doing it anyway, so as I started looking at some of these more complex cases that I was using aligners, I thought to myself, why don't you share this with the dentist?

And so originally it was born out of the abil. I had it anyway. And then I have a study club that I work with and I brought a few cases in and showed 'em like, Hey, let's look at this before we even treat it. And that's what it was born out of. So yes, I took it into the study club to help them understand more about.

What orthodontics can do for their cases. Um, that's another place I learned. This was about, gosh, 10 years ago, maybe nine, nine years ago or so, for a few years, I taught with the Dawson Academy, the advanced treatment planning. And it was amazing because Glen DuPont, Whit Wilkerson and Dr. Dawson, after these courses would be in a huge ballroom and they would be at a table, and Dennis from all over would come by with their, um, typo dances, their articulators, not type it out, their articulators and their mounted teeth, and.

I would essentially float around the room saying, yes, ortho can do that. Yes, we can upright that tooth. And at that time, TADS, you know, we were really starting to see molar intrusions. We were starting to see a lot more mechanics with that, or, well, we were starting to introduce it to the community there.

Of advanced treatment, and it was amazing to be able to save root canals, crowns, all of that. So there was that entrenched understanding. There was al, there already was that pain point that I saw years ago. It's just it, it took me a little while to actually convert that to the digital concept of not just showing somebody, here's what your teeth are, here's what they could look like on a animat.

Virtual, you know, put some teeth in there. Like these are actually the patient's teeth that have moved to a better foundational position or a better aesthetic position. So, yeah. 

Amy Epstein: Mm-hmm. You know, when we talk about, uh, finding, uh, something about a practice or a doctor that makes them different, stronger, you know, their approach, it's, it's often born out of things.

You're already doing things that work for you, right? Things that make you who you are. That then you can shed light on whether you're talking to gps, like this is how I communicate with my partners when we treat patients, or this is how patient I communicate with your gp when we're working on a case together.

This is just who I am and how I do things, and that's what makes me different. So those are the best differentiators that we can promote about a doctor or practice are the ones that really come from within. Which it sounds like this type of approach was for you. You're just that type of person. So that's great.

Dr. Bill Layman: Thank you. 

Dr. Leon Klempner: So Bill, I, I couldn't help but, uh, notice that you mentioned Ulab, uh, as you're, as the aligner, uh, that you, that you use. So, uh, you know. Mm-hmm. Amy and I have been longtime big fans of Ulab. They're one of the sponsors of our podcast. But I'm curious, so, you know, there's a lot of aligner companies out there.

Why, why Ulab? 

Dr. Bill Layman: Ulab has an individual, uh, once again talking about how can. How as a practice can we find ways to differentiate ourselves? What can we do that's different than everybody else? Um, I remember doing a tour in Las Vegas and the Four Seasons was the only five star hotel, and the only reason they were, they didn't have a casino.

You know, that was their differentiator. Uh, to get that exclusive extra star in a city that is, has amazing hotels, Ulab, what they offered that I really don't see in any other marketplace. They offer the traditional aligner format where you can send your case to somebody, you can give them directions they present back a case that is set up that did what you wanted to.

Like many of the other aligner companies, where Ulab is different is one, I don't have to use somebody offsite. I can set up cases onsite at my office with our lab tech, with an assistant and do it. And I can either have trays sent to me from their manufacturing facility or depending on the turnaround time that I need for the trays.

Biggest example is college kids home for Thanksgiving. They come in on Monday, they've got a little relapse. We give 'em an attachment template if they need 'em in a couple trays Tuesday or Wednesday, they go back to school and then we, we monitor 'em. So I would never be able to do that with most aligner companies because of the turnaround time.

So that ecosystem provides such a broad spectrum of options for me as the doctor and as the business owner to accomplish many different goals. And that's, that's one of the reasons why I went with them and essentially exclusively with them. I don't really use any. Aligner companies, except that one.


Dr. Leon Klempner: great. So, so it's Amy, did you wanna say something? 

Amy Epstein: No, I was just going to, uh, just bring up the remote monitoring aspect as well and, uh, you know, you mentioned it a second ago, college kids coming home. Maybe talk a little bit about how, how that's benefited your practice as well as it relates to, uh, differentiation and being someone that stands out among lots of five star practices in perhaps in your area.

Dr. Bill Layman: So we started doing that last year, and that is, um, dental monitoring is the name of the company we use. It's a remote monitoring solution, and it's, it's a very, to me, it's one of the most patient-centric things you can do, uh, for, for somebody. It's giving them the opportunity to not have to come into the office as.

We make it clear we're here if you need us, and we're happy to see you. This is not trying to avoid you coming in. This is us realizing and acknowledging and respecting the fact that patients have kind of other stuff to do with their life and you know, for them to spend, you know, I have had a professor, we.

Talked about this quite a bit, that the average aligner check appointment, maybe 15 minutes in your office. And it's not unfortunately. And he and I, he kept saying, it's not 15 minutes. I went back, I measured it. I'm like, no, no, it's actually 14 minutes, 28 seconds. He's like, no, no, no, it's not right. And when I really dug into it, the average aligner check appointment for some patients can be upwards of 70, 75 minutes.

Cuz they have to leave the job, get in the car, come here, sit there, essentially look in, go, you look great. And then they leave. Uh, That's kind of infuriating if I think about it. Um, you know, if I was the patient and, and I now knew there was a way that not only is the doctor keeping a better track of me cuz I'm, they're looking, or there's a monitor of my case using AI and, you know, ai, human intelligence, people looking at it, you have the ability to really keep track of things and when mm-hmm.

A case maybe goes off a little. You make an adjustment there. You don't wait 10 to 12 weeks until they come back and be like, oh, it's not working. And they came back for an appointment That was kind of a waste of time. So, mm-hmm. All of that. Right now with just aligners as an example, we use it for braces also.

Uh, to me just made so much more sense. And it's not that I wanna lay anybody off. I don't have no desire to. Most of us in the orthodontic profession today, if you're in a position where you could lay somebody off, congratulations. Um, right. With unemployment right around three and a half percent. And wages skyrocketing.

You know, if you have great people, we wanna re maintain and develop and improve our culture. Mm-hmm. Uh, as much as we can. And, um, I may not have to hire that next person. Based on the way things are going and the trend that we have, we're able to handle our current demand set up for future increased demand.

Because of the chair time being such a valuable commodity, this remote monitoring allows us to not have to use as much chair. To accomplish. I wouldn't say the same goal. I'd say it's an improved goal because of the increased information you're getting about the case. 

Dr. Leon Klempner: Yep. So, so Bill, it's uh, uh, a tradition on the podcast that we take a caller.

Uh, so if you don't mind, we'll, we'll play the question and then you can respond 

Dr. Bill Layman: to it. Of course. Hi, this is Eric Strauss from Odessa, Florida. My question is, what is your response from referring doctors when it comes to working with them on these virtual setups? Uh, the response has been a little bit of disbelief, a little bit of skepticism on a couple people.

Um, you know, because it's just a lot to. It's, it's as if when I speak to an oral surgeon or or a periodontist and they go into the complete in-depth detail of this surgery, that can sound a little bit like, wow, really? And you know, sometimes that's what it can look like. You know, we set the case up and they might think, Well, I've never seen a tooth move like that.

I'm like, well, I, I can tell you this is how it's gonna happen. And so that level of education can create that, but it creates such an opportunity to discuss. That's what I'm looking for. Is if I'm in, if I have the ability to discuss with the gps what's actually happening, that's when you're in the good stuff.

I mean, the ability to actually talk about this. So the response has been great. Uh, especially younger. I mean, a lot of us, you know, are looking for maybe that younger generation, uh, maybe the generation that is maybe not in their own practice, but you still, there's. You know, wanting to create that type of dentistry that they really believe in, and the ability to educate those individuals and to piggyback on their genuine curiosity, uh, is kind of priceless. 

That does have a price. Mm-hmm. It's just not that high, you know, it's not an expensive marketing tool, so. Yep. 

Amy Epstein: Well, on that note, can you, it sounds like it, it's, It's an interesting thing for, uh, orthodontics to explore. And so we often talk about high level concepts. We'd like to dig in a little bit and see if we can ask you specifically can, how exactly do you create it?

Um, there's a, it's a movie file, uh, before and after. What do you use for screen capture? Can you take us through the process of creating one of these, um, 3D communications? 

Dr. Bill Layman: Of course there's. Two main ways I do it. First way is to print the initial model and then print the, essentially it'd be the retainer model on Ulab after I set everything up and then mail it to their office.

Or if I've fortunate enough to have time swing by the office, drop it off and talk about it the second way in a crunch. Either my crunch or their crunch and the patient has a treatment plan coming in or treatment plan review coming into their office is I. Second way is I hop on a Zoom call and just go pull up Ulab and go through the case, turning it around, showing 'em everything that's going on.

And the third way I do it is if there's just no way we can really synchronize our schedules. I'll use QuickTime Player on my Mac and just do a little screen record and then go through the case showing the upper and lower arch they're together. Move it around and then talk them through exactly what's happening right there, and then shoot that video off to 'em.

Either, probably. Usually, usually through a Dropbox, Gmail, G drive. Sometimes Google drives sometimes hard if they don't have a G Gmail account, you know, you probably all had that, you know, somebody shares something like request access. It's like, oh. So Dropbox is usually more predictable in that respect.

So we've, we've wanted to be able to create. Many, many channels for them to receive this information. Uh, something else that works out really well, very well actually, is now I'm starting to get doctors that they have scanners in their office. They'll just shoot the scan over to me and before I even see the patient, I'll get the notes from 'em.

I'll get any images they might have and the STLs, and sometimes I can set the case up before I even see the. And so that's to me is another patient-centric way of like, send me the models, let me see what I can do. Let me see what it would look like, send it back to them. Either mail the models or send the video how those three avenues, channels to get back to 'em.

And then when they meet with the patient and refer to ortho. They come in and it's, it's ready to start. So, and that's where we are now. I mean, there's a huge total adjustable market, like Leon said earlier, um, you know, the fact that so many more people are pursuing orthodontics because of the, cuz of the aligners, because of the direct to whoever, you know, it's, there's so many more people that are interested in it now that as we probably should, we're kind of rising to the level of more complex.

And being able to educate dentists on all of those more complex cases in their office that would benefit tremendously from orthodontic intervention, I think is a great place to be, to build that momentum. So we, we do have a pretty high, I haven't looked at it lately. I know we're above 50% when it comes to referral based starts versus uh, Google and all that stuff.

So I've also found that because of the size of our office, we're about 1400 square feet. I see patients about three days. And I just don't have a lot of room for 20 consults a week. We're only 10% convert from Google. So, or God forbid they need cleanings and fillings and all that. We, we actually have a format where we get a clearance form that the patient has, has a dentist of record, has seen the dentist within the past year had a cleaning and that the dentist says, yep, everything's great.

I mean, it's like going back to dental school. Cavities are done, perio is under control. You can treat 'em and. That just eliminates so many, so many headaches for us. So 

Dr. Leon Klempner: it, it seems like, uh, you know, particularly on the complex multidisciplinary cases, the GP is really the quarterback here. Uh, they have the primary relationship with the patient, and it, it sounds like what you're doing is you're really giving the GP the tools that, that effectively allow.

Him or her to present the case to the patient so that the patient understands the value of all the different players, in particular the orthodontics, which seems to, you know, would, would increase the, the patient acceptance. Do you find that? Uh, that, that you haven't improved because I, I know, you know, those are the toughest cases because they're big, big numbers, you know, and they're, and they're expensive for the patient to, to swallow, particularly if they're involved.

Pero, ortho, restorative, you know, you can get up into the, you know, 50 grand, 75 grand, depending on, you know, what's involved. So have you found or gotten any feedback in terms. The, uh, uh, increase in patient acceptance when you're, you're providing these visual tools?

Dr. Bill Layman: Yes. When we peel out patients that I am working with at this level and the doctors, and there's a team effect because of the ability to, one, pay for what we are doing over a long period of. You know, we give many options. I mean, we, you know, we, we will now extend, like if somebody's, uh, 12 months to get a few things done, we might go up to 18 months because we just haven't gotten burned.

You know? And you know, by doing that, you slightly raise your price, you know, maybe a 12 month, maybe you go up, you know, I'm not gonna give numbers, but you go up a percentage in your, in your region, in your area. You're hedging against the loss because we just, we don't have people stop paying because 98% of our patients are on auto pay.

So there's not this historical feeling of, I go to the office, I give a check like that, that's over. I think I heard Leon talk about that recently and Jersey just don't do that anymore. So we extend out the payments and God forbid, let's maybe, let's say 5%, if 5% of those people. Stop paying. After they finish a treatment, they go, haha, I'm done.

You're not getting any more money. Okay? One, they go to collections cuz you've already, that's easy. Let them take care of it. Two, if you've raised your price a little bit, you can easily find the math that helps you hedge against that five even. Even if you wanna say, oh my area's horrible. Hedge against 10%.

So the people that keep paying more than cover up that potential loss that you're scared of. Yeah, we haven't, we haven't had, we have about a 90% acceptance rate when it comes to these types of setups and cases. Cuz people are like, by the time they come to me, it's a predisposed market. I mean, the, they already are curious, you know?

You know they, if they came to me, The dentist that I'm working with, the type of case they have, they're like, okay, I, I need to go hear this. And it is on us. It's on us to communicate the team effect, to communicate the foundational effect of what they're doing to communicate the, you've got time to pay this over and also save up for the next phase.

So, yeah. Mm-hmm. We've had good success with that. 

Amy Epstein: So, Dr. Layman, thank you so much for joining us today. If any of our listeners have questions for you, would they be able to reach out to you to ask them? 

Dr. Bill Layman: Of course, yeah. My, my number 7 2 7 4 4 6 8,005. I'm in Clearwater, Florida, and if you wanna email me, happy to go.

Um, Dr. Bell, d r b i l l at s. U ortho.com. Straighten up ortho.com so that s and u and then ortho.com. Happy to answer. You can always find me on Facebook, LinkedIn. Those places are pretty easy too. So yeah, anytime. 

Amy Epstein: Thank you so much. Yeah, you're an accessible guy in all ways, so we appreciate you being here today and uh, look forward to having you back next time.

Dr. Bill Layman: Thanks. Appreciate it. Y'all have a wonderful day. 

Amy Epstein: You too. This episode is powered by both Ulab systems and Dental monitoring. And as you heard from Dr. Layman, the combination of those two technologies can really provide significant benefits, not only to patients, but also to the partners that you're working with, the gps, um, you know, as well.

So we're pleased to be working closely with both companies. They're both leaders in orthodontic technology and you know, But we're always, um, we're happy to partner with companies that provide orthodontists with tools to offer profitable treatment options and also a better patient experience. You can subscribe or download other episodes of our podcast on Apple Podcast, Spotify, SoundCloud, YouTube, or wherever you get your podcasts.

And if you enjoyed it, we'd appreciate you telling a colleague. And for more information about us or about our company, which is People in Practice, visit [email protected]

Dr. Leon Klempner: Yep. Thanks for listening or watching. Um, I hope that you found value. You know, there are many ways to grow a practice and we don't wanna forget about the gps.

So, you know, we, we counsel our, our clients all the time that, you know, we don't wanna throw the baby out with the bath water. So, um, thank you again. If you'd like to contact me with any questions. You can reach me [email protected] and remember for Forward Thinking Orthos. There's never been a better time to be an orthodontist, so we are in the golden age and we want to take advantage of it, so, Bye for now.

Narrator: Thank you for tuning in to the Golden Age of Orthodontics. Subscribe now on Apple Podcasts, Spotify, or visit our website at the golden age of orthodontics.com for direct links to both the audio and video versions of this episode.


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