Dentists can Prosper in a Recession with Dental Management Leadership Part 1

One of our dentists does mini implants and he has been going around to nursing homes promoting what he can do for them.

This is an excellent example of being pro-active. We can all sit back and wait for the phone to ring, but the question is what can YOU do to improve patient retention (get to know them as a person and all about what they do) or to improve case acceptance (using the camera, explaining the problems and the options they have, and also giving them SOME kind of reason to act now; using the benefits they have paid for, doing it before year end, or retirement or their 50^th anniversary).

Emergencies: In the last month I saw 2 patients who had been in to see another dentist in the office for emergency treatment and I saw them for minor complications with that treatment. What if found was that both of these patients had been treated, and then simply dismissed. No effort was made to bring them back for a complete exam. I know they were receptive to the idea because once I brought it up they both booked exams. In fact I have done 3 crowns and a root canal on one of them already. So what is the best way to get them to book? Simply what I said above. Get out the camera and show them a few other things going wrong with their teeth. If they want to keep their teeth they will want them fixed.

In fact even if the patient initially says they just want the tooth that is bothering them treated, once you have done an excellent job of diagnosing, outlining their options in a non pressuring manner and painlessly taking care of their problem, their opinion usually changes. At the start of the appointment they didn’t know you were a great dentist, but now they know you are. So that changes the answer to the question. If people find a dentist who treats them well, usually they will want to come back. So offer again!

Major vs Basic Treatment: Very often patients want to do the cheapest possible treatment. The best way to deal with this and improve your productivity is to explain the differences between basic and more complex treatment. I always talk in terms of Option A, B and C.

I tell them all the good and bad points about all the options, but I always emphasize the fact that Option A is what is best for them and their teeth for the long run, and if they choose option B or C, then invariably they will still need to do option A later. And since I have to go back in again to the same area it is more needles, more appointments, more cost and the tooth gets weaker every time I do it. I also usually tell them that I have Option A on my own teeth, which I do. I also talk in terms of filling a tooth now and crowning it later is really a wasted step. If it needs a crown, why bother to fill it. Better to wait till they can afford a crown and do it then. So doing it right actually IS the cheapest way in the long run if they can afford it.

After 28 years of practice and trying everything including gold inlays, Cerec crowns and inlays, gold crowns and onlays, PFM, Empress, veneers, etc, here is where I stand:

If you want great, strong, long lasting, trouble free teeth, get an excellent fitting full gold crown on your 7’s, PFM on your 6’s, 5’s and 4’s that are weak. For small fillings, I put gold best, ceramic next and composite last.

On anteriors on virgin teeth I lean toward no prep veneers. For broken down anterior teeth PFM or Procera type crown vs bonded Empress crowns which look nice but still have a higher fracture rate.

Since I really believe this is what is best for patients, I can sincerely promote this. People that go along with this, if it is done well, are going to have minimal trouble with their teeth.

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In the last post we talked about the importance of dental practices always remaining in touch with their patients – of making sure they are giving them what they want. These are tough and competitive times; people are struggling financially and so are businesses. Dental practices provide a service but they are also a business. And to look at it from that standpoint a dental practice needs to ensure that their business is being run properly. If patients are not receiving what they need or want then there is the danger of the practice ultimately failing – it’s that plain and simple.

Dental consultants are brought in on a regular basis by dental practices new and old. A dental consultant very often has worked in a practice or is even a dentist by trade. Their experience in the industry – as well as their ability to look at things objectively – are what gives dental consultants a leg up in helping dental practices find success. This is especially critical now when there is much competition in the marketplace and during an economy that has people questioning every dollar that they spend.

A dental consultant can offer insight into a practice’s operations and, more than that, offer a plan of action to adjust things where necessary; those components that may elevate a practice’s standing in the community, help them retain patients, and even attract new patients as well.

Some of the things that dental consultants may focus on in their examination of a practice include:

* Front office. Dental management begins when patients walk in the door. Dental consultants will look at how patients are greeted, the system by which they are checked in, and the first impression a patient receives. This will also include a dental practice’s appointment scheduling system.

* Back office. Billing and other administrative tasks are necessary for any business. But a dental practice has the added responsibility of dealing with insurance companies – a formidable task in this day and age.

* Patient experience. How long do patients wait in the waiting room? Is the equipment being used on them in good shape or could it stand some updating? Are they personally greeted by the dentist? Is there a treatment plan presented to them? These are considerations when it comes to making patients comfortable in their surroundings.

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It’s no secret that the economy is struggling right now; and along with it, countless families across the country. With the holidays in sight we are all looking at ways in which we can cut down and save our resources as best we can. While it does not make sense that people would skip going to the dentist just because the economy is bad, it does happen. Not everyone has comprehensive dental insurance that covers standard cleanings which means that such visits may have to come completely or at least partially out of pocket; an additional expenditure in an already trying time.

So what can dental practices do to make sure that they are reaching their community and keeping them informed about how important regular dental care is to their health? And how can they make sure that they are servicing their current patients in a way that will ensure that they remain with the practice? Oftentimes dental practices – like any other busy company that is working hard every day to make ends meet and remain viable – lose sight of the most important component in all of their hard work; to make sure that their clients – in this case, their patients – are getting what they want. With so much else to be accountable for – including salaries, equipment, the upkeep of the office, billing, and other administrative concerns, just to name a few – dental management teams are often pushed to the breaking point. And when that happens, things tend to start falling through the cracks.

It is important at all times – and during these times especially – that dental practices reconnect with who they are there to serve and to make sure that all of their efforts are focused in the right direction. Dental consultants can help and we’ll look at how in the next post.

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Going to dental school qualifies someone to practice dentistry – to care for patients and their oral health; it does not, however, necessarily prepare someone for the rigors of running a thriving dental practice. There is much more to such an undertaking than just setting up an examination chair and cleaning teeth. Rather, there are also the many things that go into running a successful business and without any of those important components in place, dentists are in danger of missing the mark in a great many ways.

Rather than wondering what it is that makes a successful dental practice and going about setting up operations that may or may not work, dentists who are uninitiated in the world of running a practice may be best served by bringing in a dental consultant to help implement dental management operations.

Dental consultants are often dentists themselves – those who have run practices and treated patients for much of their career but now help new practices make their way in the world based upon their experience and guided teachings. Dental consultants understand the many ways in which dental management can make or break a practice and they set about helping a practice get organized and make the most of the resources available to them.

Dental practices are reliant upon dental practice management; they are the front lines of the practice – often those who first deal with patients in terms of scheduling, billing, and other matters. Additionally, dental management teams are responsible for the nuts and bolts of the office – ordering of dental equipment, fostering of relationships with vendors, and the community outreach that comes with establishing a presence in a particular area.

Dental consultants can help dental management teams and dentists who are unfamiliar with the process of setting up a practice; walking them through one step at a time and allowing them to maximize their chances for success.

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In the last post we talked about the challenges that face anyone who is just starting a business; and this includes those who are building a new enterprise from the ground up and those who are taking over an existing business and infusing their operational systems into how the business is currently run. Making changes can be just as difficult as starting from scratch which is why many new ownership teams rely upon consultants to help them see things objectively and tackle their goals in a linear manner.

For dentists that are taking over an already established dental practice, there are just as many challenges as with any business. For this reason new dental ownership will often bring in a team of dental consultants who can reliably gage the current state of the practice and help ownership address any changes that should be made.

Dental consultants are invaluable to new dental practice ownership teams in just about any circumstance; but they are especially helpful when the dentist taking over the practice has already been practicing there. Dentists who are taking over an existing practice where they have been already seeing their patients for a number of years may be unable to objectively look at the business and see what changes or updates would most benefit it going forward. Dental consultants can provide an objective view and give insight into what may need to be updated or addressed in terms of making an office visit a better experience for patients.

Some of the areas that dental consultants may look at when helping new dental practice ownership teams define their upcoming goals include:

* Dental management – including administrative systems in terms of appointment scheduling, file storage and retrieval, billing/insurance issues, government compliancy, and community outreach.

* Equipment – including age and condition of existing office equipment including dental instruments, vendor relationships, and equipment expenditures.

* Office appearance – including the actual physical look of the office. Do you need a paintjob? New waiting room furniture? Overall updating?

* Patient care – this, of course, is the most important component of putting together a successful practice. Dental consultants will help dentists ensure there is no disconnect between the service they think they are providing their patients and the perception of the services received from the patients’ point of view.

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Sometimes patients they know they have a problem and intend to do something about it some day but there is no immediate urgency. They need another reason.

Here are some I use:

If it is close to year end, (which it is right now), and if you need something done, it is best to do it this calendar year. That way it goes through their 2008 coverage so that if something else crops up next year, this treatment has already been taken care of.

This also works during the middle of the year simply by explaining to them how to best utilize their dental benefits coverage: if they have several things that can be done but none are urgent, they can do one quad per year (or even one tooth per year!) so that they maximize the benefits they have paid for and are entitled to. They need to be told that dental benefits are a “use ‘em or lose ‘em” proposition. They have free money to spend each year; if they don’t spend it by year end it is gone.

Retirement. Let’s face it, most of us have lots of baby boomer patients thinking about retirement. I tell them that if they have large old amalgams, they are probably on their last legs. If they have a dental plan now, but do nothing and then retire, sometimes things start falling apart just when their coverage has been terminated and they have lost their income. I tell them I like my patients to go into retirement with their teeth in the best possible condition I can get them so that there is the least likelihood of dental problems. That usually means crowning the weak teeth and replacing the old restorations, (preferably with inlays instead of another filling).

Bleaching: I don’t find it that easy to convince people to whiten their teeth if they don’t ask me about it first. I do offer it, but the response is generally not that great. HOWEVER, if I am doing anything on their front teeth at all, I say that they have 2 choices. We can either match the new crown/filling/veneer to their other yellow teeth or whiten the other teeth and match the new treatment to the new whiter color.

I tell them that if we don’t whiten the teeth and match the new crown to the old color and they want to whiten them later, then we will have to redo the crown to make it whiter. I tell them that if they think they EVER might want to whiten them now is the time before we do the new work. Almost EVERYONE says yes to this offer. Remember I said they just need a reason. And this is certainly a real, time sensitive reason. In fact it would be negligent on our part not to mention it. We realize this but they don’t so we need to bring it to their attention. It is a service to inform them of this not a sales pitch.

Stay tuned for Part 3

Dr. Dave

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Starting a business is never an easy thing and when you come into a business that has been operational for some time, in the role of taking it over, it can be even more difficult. Not only do you have the general obstacles that come with starting a business but you have the additional burden of having operational systems that have been in place for years but that may not be effective anymore. Coming in to a company as a new owner oftentimes brings with it the responsibility of the “new broom sweeping clean;” sometimes the things that have been in place are just no longer beneficial for keeping the company operating successfully.

Dental practices often include a number of dentists and ownership may change hands over the years as older dentists retire and younger ones take the helm. There are many challenges that face those who take over a practice – whether they have been practicing there all along or are just now coming in for the first time. They will find that dental practice management is the first consideration when it comes to ensuring that operations are as smooth as possible and are among the first places where it will be identified whether changes or updating needs to be made.

To this end, many dental practices will bring in the expertise of a dental consultant in order to give them an objective vision of the viability of the dental practice and to make suggestions on any changes that may need to be made over the course of changing hands. The role of the dental consultant is to examine a dental practice from top to bottom – from the dental management team that handles administrative tasks and deals with vendors and patients to the actual care that the patient receives from the dentists and their assistants. More in the next post…

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When a dental practice isn’t functioning as desired or it’s taking up an inordinate amount of time to manage, chances are some improvements are in order. Unfortunately, for those working within a practice, spotting what needs to change can be difficult. This is where it can pay to rely on a professional dental consultant to assist.

Dental consultants that are able to authoritatively speak from both the practice and management sides of the coin can bring a wholly unique perspective to an office. When advice from a successful consultant is obtained, dentists often discover these benefits:

Increased patient retention – Customer service should be a top priority of dental office management. When it is not, even the best dentists in the field can see their practices suffer. Improving relations with patients requires not only the right bedside manner, but also an excellent office staff. From cleanings and examinations down to the fillings, everything must flow correctly to impress patients and keep them coming back for more.

Better hourly billing – The key to making the most of a dentist’s time involves being able to increase hourly patient billings. This doesn’t necessarily mean raising prices, but providing better service. When a dental consultant is called upon to help streamline a practice, hourly earnings can go up considerably.

Better staff morale – A well-run office is generally a pleasure to work in. When a dental management consultant helps tweak processes for the better, staff morale can go up. In turn, this can improve customer satisfaction, as well.

Improving a dental practice can be difficult from the inside out. When dental consultants are called upon to assist, however, the right ideas can be brought to the table. Even the best practices can often benefit from the skills and experience a knowledgeable dental consultant brings to the table.

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Dentists can Prosper in a Recession with Dental Management Leadership

Part 1

I don’t know about you, but the world wide market melt down has hit my home town pretty hard.

Real estate is dropping, jobs are being cut, and business is off in almost every industry including our office.

Here is what I told our dentists at our meeting last week:

Use your Downtime: If you are a little more slow than usual, use the extra time to talk to your patients. Talking about their lives builds long term relationships which keeps them coming back. You should know some personal information about EVERY patient and have it recorded in their records.

You can (and must) also talk about their dental options. Let’s face it, running over to the hygienist’s chair to do a recall exam in the middle of your bridge prep is not the best time to start discussing the pros and cons of amalgam vs gold or porcelain. But if you have a one hour opening, it sure is. It is amazing how much our patients forget, even about things we talked about last time. So don’t be afraid to bring it up.

And how is the best way to bring it up? Use the intra-oral camera. Personally I think you are crazy if you don’t have one. Showing the patients all the cracks and decay on their teeth immediately catapults their mindset from “yah, yah, blah blah” to “what is that black spot” or “what can be done about that”. There is no point talking about SOLUTIONS to their problems until they understand and believe there are PROBLEMS. But once they do, most people want them solved.

People need a reason to proceed with dental treatment. Sometimes the reason is simply realizing they have a problem which can be solved with the camera just by showing them.

Another place I use the camera is upon removal of their old restorations. Usually it looks awful under them and I like to show them that because it reinforces that they made the right decision about their current treatment which builds confidence in me and also gets them to realize the other old fillings are probably not as perfect as they thought either.

I also show them cracks under the old amalgam that did not show up before we got in there. It is not uncommon for me to show them that it is worse than I thought and to switch to doing a crown instead of a filling, or to finish the filling and bring them back for a crown.

But sometimes they know they have a problem and intend to do something about it some day but there is no immediate urgency. They need another reason.

Dental Management is not about some academic things you read in a book. It is doing what needs to be done right now.

In Part 2,  I describe some of the actual things I do to keep busy when demand drops.

All for now

Dr. Dave

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Dentistry, just like any other patient care field, should be a labor of love and a passion. When dental practice management becomes a burden, everyone involved will suffer. It is possible to turn things around and bring the joy of patient care back into an office. A dental consultant can help.

When the right dental consultant’s advice is called upon, dental office management can benefit greatly for a number of reasons. Some of the things a good dental consultant can help out with that can put joy back into the prospect include:

Focusing specialty – Dentists, like any other medical-related professionals, tend to do better when their jobs are focused on the areas they have a true passion for. A pediatric dentist who finds himself focusing almost solely on adult teeth will not likely be happy. A dental consultant can help dentists focus their efforts and build their practices in the directions they genuinely want to take.

Streamlining work flow – Dental management does demand some business savvy. Dentists, however, are not necessarily born with this. To improve the work flow and make sure dental office management is run properly, a good consultant can help streamline processes for the maximum efficiency.

Increase patient load – Marketing is an area that some dental management professionals fall short on. When there’s a need for new patients, taking the right steps to get the word out about a practice will prove imperative. A dental consultant can offer advice on this front.

Increased earnings – It doesn’t make sense to run a dental office without making a decent income for all parties involved. A dental consultant can show professionals how to increase per hour billings without necessarily raising fees. It often only calls for improving efficiency.

Putting the joy back into dental management is not an impossible task. When the right dental consultants are relied upon for advice, dental professionals can enjoy professional success in every regard.

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