My spring break: going to ‘Excellent’ and talking profitabilty

Even dentists need a spring break. But I’m going to be working during mine!

It’s a good kind of work though: I’ll be talking at the Excellence In Dentistry Spring Break Seminar taking place April 27 to 29 in Destin, Florida.

Even better I’ll be speaking about one of my favorite topics: Process and Procedures to Improve Profitability.

When it comes to building a more profitable dental practice, cutting corners is a short-sighted strategy. Better to invest in processes and procedures that drive the growth of your practice.

Over the course of my 90-minute talk, I’ll outline how I did exactly that in my 14 practices and outline the simple but crucial changes you can implement to make your practice S.P.E.C.I.A.L.

These include:

S scheduling tips that make a big difference to profitability by increasing efficiency.

P production improvements to provide better care and service to patients.

E employee or team member management that drives everyone to want to deliver better results and perform at higher levels.

C collections improvements that will show you how to reach a 98% success rate.

I internal controls to help you manage your practice

A Associates and accounts receivables as a tool for growth

L liability and asset management to protect yourself and your business

So please join me on April 27th at 1:30pm at Destin for my talk and make certain to reach out to talk while there or in advance about how to improve your practice.

See you there!

Managing periodontal care can be a challenge

Let’s keep it simple: almost all patients have some type of periodontal disease.

Gingivitis, where inflammation is confined to the soft tissue, involves no bone loss. Periodontitis, on the other hand, means bone loss.

Whenever you have periodontitis, you also have gingivitis, but just because you have gingivitis does not mean you have periodontitis. Sound a bit confusing? It’s really not.

Consider this:

The diseases can be classified as follows:

∙ Type one: gingivitis-inflamed tissue, no bone loss

∙ Type two: early periodontitis with mild bone loss but without furcation involvement

∙ Type three: moderate periodontitis with moderate bone loss and early furcation involvement

∙ Type four: periodontitis or advanced periodontitis, which involves severe bone loss and extensive furcation invasion

The cause is, unsurprisingly, bacteria, mostly Gram-negative, combined with cell walls that have a lipopolysaccharide base or endotoxin that causes inflammation. The bacteria are anaerobic and can be motile or nonmotile.

So you’ve a patient with periodontal disease. The key to finding the causes has to do with the patient themselves.

First, when was the patient’s last visit and why? The answer gives you the patient’s dental IQ.

Dealing with a patient who does not go to the dentist makes it more difficult to treat periodontal disease. If you see in the patient history that your subject smokes a half pack of cigarettes a day or consumes a good deal of alcohol, it will be an uphill battle for both of you.

Also consider the patient’s hygiene: is it good, fair, or bad? If bad, then once again, it’s not going to be easy. Consider this  your unofficial dental risk assessment. The higher the risk, the poorer the outcome you can expect.

To quantify such a risk, look at the number of missing teeth, decayed teeth, and teeth with restorations. Any patient with more than ten—excluding wisdom teeth and missing premolars due to orthodontic care—is a red flag. You will have an uphill battle resolving your patient’s periodontal disease.

I have always looked at periodontal disease as similar to weight problems. The majority of patients with weight issues will diet, but very few stick to the diet and even fewer keep the weight off in the long term. In my experience, what I often see in periodontal disease is short-term success and long-term failure.

But that, of course, can change depending on how you coach  your patients before, during and after treatment. Getting them on to a program that is successful with result in better outcomes for them and more business for you as they come in more regularly and refer you to friends and family.

Your success can be their success.

Cover your assets with a dental non-compliance form

At some point every dentist will have to tackle a tooth restoration. Of all the types of restoration, the most challenging is doing a composite restoration that looks good, functions well, has nice interproximal contacts, and isn’t sensitive.

It’s generally not the first recommended treatment in your care arsenal. But often it’s what the patient wants. 

Just be certain to let them know to expect sensitvity during it and that the process will need a root canal and crown to finish.

But a restoration can create more clinical problems than anything else we do in our day to day practice. In most cases, a better treatment plan might include an inlay, onlay, or crown rather than a very large and complex composite restoration.

When the patient refuses the most appropriate treatment plan, always have them sign a non compliance form. Such forms are signed by both the doctor and patient, stating what was recommended for treatment and what your patient has elected to do.

Let me be candid: performing a treatment you do not agree with should be avoided. However, in the real world, often you will have make compromises. And in such cases it’s important to protect yourself and your practice.

A non compliance form decreases the chances of a patient requesting that a failed treatment be conducted at no charge or even taking legal actions against you or your company for the results.

I recommend informing all patients considering large restorations that there will be very probably be sensitivity issues that may require a root-canal treatment, and most likely a crown to fix.

This disclosure should always be made before you perform the procedure, as it shows you to be an astute clinician; when done afterward, you only appear to be making an excuse.

If you’d like to learn more about the best practices for your dental operation, please contact me for a consultation.

Comprehensive dental records invaluable as tool and insurance

I’m always a bit perplexed when I hear someone question the need to build and maintain a  comprehensive record for all patients.

To be clear, I insist on it for some very pragmatic reasons.

If a patient complains about your work on a particular problem, it’s good to have records on hand. In most cases, records gathered at the time they became a patient can determine if the problem existed before they began treatment at your practice.

If a patient registers a complaint against a dentist or the dental office, comprehensive records can provide a solid defence in litigation.

A dental record should consist of a Panorex survey, four to seven vertical and/or horizontal bitewings, and, when indicated, a full-mouth series.

When a patient has a history of periodontal disease, a full series of radiographs will be necessary as well as intra- and extraoral photographs. Such photographs should provide: a full face view; a profile view on both right and left sides; a smile view; a view of the upper six to eight front teeth; views of the right and left cuspid; and upper and lower occlusal views.

The record should also contain the worst intraoral condition for the patient (this particular photo should be put into the treatment plan letter for educational and motivational reasons); upper and lower impressions with centric occlusion bite and, if indicated, a centric relation bite; complete and comprehensive periodontal charting; and an overall assessment of the patient’s chief complaint and dental IQ.

Sound like a lot of work? Consider it an ounce of prevention in comparison to the amount of work you’ll need to do if a complaint arises and you have an attorney looking for answers.

I’ve been doing this for 30 years and I’m happy to share my experiences through my dental practice consulting services.  

Every member of your practice team is in the sales and service dept.

When you have a great dental team, all members play an important role in making the business successful.

Let’s look at the role of hygienists and the contribution they make to your operation. They are definitely specialists with a very specific technical skillset. However, when they are freed from this silo, they become so much more.

These are some of the expectations one would have for a hygienist:

∙ take diagnostic photos, impressions, and all types of radiographs (such as Panorex, full-mouth series, vertical and horizontal bitewings, and cephalometric and TMJ radiographs)

∙ re-cement temporaries

∙ place IRM

∙ discuss and review all risks, benefits, and any alternatives to care and treatment

But if you want to maximize their interactions with your clients/patients they should also be able to:

∙ provide information about fees

∙ schedule appointments

∙ provide fluoride and local anesthesia

∙ place sealants

∙ review home-care instructions

∙ remove sutures

∙ place medicaments such as Atridox and Arestin

∙ perhaps most important, communicate with, educate, and inform patients before you perform in order to improve their dental health

Too often, hygiene teams lock into a 30, 40, 50 or 60 minute schedule, whether patients need that full allotment of time or not. This is valuable time where you have the patients undivided attention, so it is an opportunity to educate patients about different options available through your clinic.

Simple tricks like this can show an immediate improvement to your practice’s bottom line. And all it takes is raising the expectations and providing some additional training. Remember every member of your staff is a part of your sales and service team. It’s your job to provide the leadership, vision and set the expectations for them to deliver. 

To learn more about how I can turn your organisation into a dental team dynamo, please get in touch.

Payment policies key to success of your practice

So you’ve got a new patient coming for some dental work. Great. You’ve even set up a treatment plan for them and booked a number of appointments to get the work done.

But there’s a crucial bit of business you still have to take care of. You need to make sure they fully understand your payment policies.

An office’s financial policies should be written down and thoroughly understood by all employees, team members, and, in particular, your front-desk coordinator.

One key person in this process is the patient themselves. They may have some idea of the payment options open to them but it’s important that you educate them as to the specifics to head off any awkward misunderstandings.  

I’ve found that a best practice is to get payment in full before a procedure is started, or a retainer of 50 percent down with the balance paid upon completion of care  – for patients with approved credit and credit history.

Your practice should provide financial options such as Care Credit, Wells Fargo, Visa, MasterCard, American Express, or Discover.

Of course all of those payment options have a cost to your organization with fees ranging from 2 to 21 percent. So offer as many options as you can but keep an eye on the costs to your practice.

Given the fluctuating costs attached to offering credit, it might seem that cash should be your preferred method of payment. Except that it’s really not. Accepting cash for payment brings with it another set of problems. Given the prevalence of credit, debit and epayment options most practices don’t have the procedures set up to process cash transactions, which means large sums of money are left unsecured for hours at a time.

Although you and your team should do a daily balance of  payments, cash is impossible to track and very difficult to account for going from day to day. Over time, you will be confronted with issues surrounding missing cash: was it stolen, misplaced, or accounted for incorrectly? All these issues can create doubt and tension in your office. So if possible, try to avoid cash payments.

If you would like to talk to me about turning your dental practice in a model of professionalism, please contact me.

Efficiency and Effective Treatment go hand in hand

At this point in my career, little gives me more satisfaction than mentoring and advising my contemporaries in the dental profession.

Conferences like the upcoming Excellence In Dentistry conference taking place April 27-29 in Destin, Florida are a great opportunity for me to talk to and engage with dental professionals from across the country.

In Florida one of my talks will focus on ways dental practices can better focus their resources wit the aim of providing greater patient satisfaction.

The talk, titled Efficient and Effective Treatment Planning for Your Dental Patients will look at the following:

  1. Why not do in one visit what normally would take 3-4 visits?

Most patients don’t mind taking time off of work to visit the dentist. But repeat visits for an issue that can be resolved in one is a waste to time for everyone.

  1. What systems can you put in place to become more efficient?

Advances in both technology and planning methods go a long way to making  your practice more efficient and profitable. I’ll talk about how simple changes can dramatically increase your efficiency.

  1. It’s not how long you work but what you do while you’re working.

This also speaks to efficiency. Are you and your team maximising your time while working? There are many ways to work smarter with benefits both professional and personal.

The mistake some dentists make is setting their methods stone at the outset of their business and never review them again. I can promise this: you will make mistakes. The point is to make each one a learning experience then use it to improve your practice.

I look forward to discussing this in more detail with my colleagues at the Excellence In Dentistry conference. If you haven’t already registered I encourage you to do so by clicking here.

If you can’t make it and would like to talk about this topic and how it specifically applies to your practice, book me for a coaching session.

Finding Excellence in Dentistry

Dental-consultant-Kevin-CoughlinMuch of my professional life these days involves working with dental practices on how to deliver superior customer service while increasing profits.

It’s engaging and invigorating work. But It’s good to recharge the batteries and meet with my professional contemporaries in an environment where my core message can reach many people at once.

The Excellence In Dentistry conference taking place April 27-29 in Destin, Florida is an excellent example. It’s a way for dental professionals of all stripes to make presentations on their areas of expertise. For my part, I’ll be speaking on Practical Systems For Same Day Dentistry at the conference.

Others will delve into a wide range of topics including:

  • ​Sleep Apnea
  • Oral Surgery
  • Removables
  • Overhead Control
  • ​Hygiene/Productivity
  • ​Implants
  • Marketing
  • PPO Negotiations
  • Back Pain/Neck Relief
  • Staff Mgmt/Hiring
  • ​Endo
  • Hygiene/Perio
  • Practice Management
  • ​Efficiency
  • ​Financial Planning

As a dental speaker, it’s an honor to have my experience and successes showcased to others in the profession who might be struggling with where to take their practices in this increasingly competitive landscape.

In any business, it’s easy to get stuck in your own systematic method of addressing problems. Pulling on different levels of expertise from across the country can shake the figurative cobwebs and open eyes to new ways of doing things. So the best part about this conference, for me, will be the opportunities I get to discuss issues in the dental industry with contemporaries with a wide variety of viewpoints.

If you haven’t already registered I encourage you to do so by clicking here.

Podcast: Designing a Winning Customer Strategy

In this episode Dr. Coughlin discusses how to design a winning customer strategy.

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

kevin-transparentWelcome to the following podcast. My name is Dr. Kevin Coughlin, owner and creator of Please visit my website and listen to additional podcasts, but today’s podcast is on designing a winning customer strategy.

So let’s get started. First, there’s a difference between believers and achievers. Data indicates that about 92 percent of CEOs believe they are providing excellent customer satisfaction. The reality, however, is only about eight percent really achieve it. The goal is to be that eight percent. How to become that eight percent and bring you from a believer to an achiever is to focus on what I refer to as the 3Ds. You must first design then develop and then deliver.

Design simply means the appropriate segmentation of your patient or customer base to complete customer experience in each of the segments involved in your valuable final product. Develop simply means you must reinvent and renew your customer experience over and over. Change is good but change must be for the better.

Lastly and perhaps most importantly, is the action step of delivering. Every department, every team member must be pulling in the same direction. Failure to achieve this last action step will put you in the 92 percenters of believers rather than achievers. The alternatives of not becoming an achiever is simply more money on advertising, more sales people, more acquisitions, more products, more gimmicks, more waste of time and money. Simply stated, you must delight your patient or customer base in all aspects.

It’s common knowledge that managers tend to feel more accountable for improving profits. Most managers do not feel they are accountable for improving patient or customer relationships or the quality of that relationship. What truly creates the difference between an average manager and an outstanding manager are those managers who focus on the accountability of improving customer relationships or the quality of that relationship.

In general we’ve talked in past podcasts about promoters versus detractors. Promoters should be the core of your business. They are the best group to invest in. They create high margins, they love to do business with us, they constantly refer additional business to us and they should drive our strategic priorities.

Detractors do not like doing business with us. They spread negative word of mouth and they defect at the first opportunity to another company or business. You constantly should try to convert your detractors to promoters and if not possible, eliminate these detractors from your business plan.

The vast majority of your customer base will be passive customers. They can be easily lured into the detractor group if you do not focus constantly on improving relationships, products and service. The goal is to take the passive group and move them into the promoter group. Constantly you should be on the lookout for finding additional promoters for your business.

As a golden rule, what is ever good for your patient or customer base and team members will generally be good for your company. You need to look at your business in totality. You need to look at your phone system, your appointment systems, your orientation and treatments, the ability to discharge, evaluation of charts if you are in the medical or dental profession, financial arrangements should be clear, concise, honest and upfront.

You must take a look at every aspect of your business, including your reception room or office, your restrooms, your operatories, your magazines, the appearance, the communication skills. In order to achieve this, most focus in on the 3Ds which is design, develop and deliver.

For additional information about this podcast and other podcasts, please visit Thanks for listening and we look forward to spending more time in the future on additional business topics to help your medical and dental practice grow along with your overall business. Thanks for listening. My name is Dr. Kevin Coughlin.

Meet your front desk receptionist: the most important person in your Practice…

In many offices the front desk reception staff rarely get the respect they deserve.  But if you run a dental practice they are the most important component of your customer service experience.

Having a clinically trained person answer calls that require complex answers is absolutely essential.

Imagine a patient calling about implants, extractions, or upper or lower fixed or removable prostheses. How would you feel, as an existing or new patient, if you were told, “I am so sorry; I cannot answer those questions. I am not sure whether we provide that level of care and service.”

Your front-desk coordinator has to be able to answer a full array questions. These can include:

∙ Radiographs (how and when they are performed)

∙ Extractions (what can be expected regarding postoperative discomfort, how long they take, and how much they cost)

∙ Implants (their advantages, when they should be recommended, and cost)

∙ Periodontal or gum infections and periodontal care (what is entailed, potential pain, and cost)

∙ Headaches, jaw pain, limited range of motion, or simply TMJ treatment (when is treatment performed, what is involved, and cost)

The list can go on, but you get the point. Speaking strictly from a business and sales perspective, the front-desk coordinator has to have knowledge and information about all the clinical procedures your office provides.

The front-desk coordinator is an educator and sales person—make no mistake about it. Once the “sale” is made they then have to get patients into the office for the correct amount of time and allocate an appropriate slot in your appointment schedule.  

If you already have a good front desk receptionist, that’s fine. Just take some time to get them trained properly for their role as the most important representative of your practice.

To learn how to turn your practice into a dental dynamo, please get in touch.