How often are dentists the victims of embezzlement?

More than two thirds of dentists are destined to become victims of embezzlement at some point in their career. According to David Harris, the founder of Prosperident, the world’s largest dental embezzlement firm that number might even be low!

“Those numbers are probably understated a little bit simply because some embezzlement goes on and is never detected and other embezzlement happens and nobody reports it,” says Harris.

“So my own number, which is of course unprovable, is that there’s probably an 80 percent chance that you’ll get hit at some point in your career.”

David’s vast investigative experience in this field has helped Prosperident grow to more than a dozen specialized investigators consulting on hundreds of embezzlement matters annually.

When we think about embezzlement the assumption is that it always involves some sort of cash. But according to Harris this type of theft can manifest itself in all sorts of ways.

“Typically we see staff stealing from their doctors. In most cases it’s money. But it could also be something like someone ordering hand pieces and they order an extra one to sell on eBay.”

Embezzlement is something that can happen to anyone. In fact it’s happened to me. Three times! Each time was not only emotionally disturbing, it also rattled my confidence.

Over his 25 years in the business Harris has seen just how this can happen – even to people who think they have the proper safeguards in place.

“You can’t underestimate the embezzler or assume that your superior education will give you some kind of upper hand in this battle,” he says.

“The second thing is there is absolutely nothing you can do that will prevent embezzlement. If I work for you and I get the idea that I am somehow more entitled to the money that your practice makes than you are, I’m going to get away with it – at least for a while.”

If somebody steals from you once and gets caught, I view that as a success not a failure. Somebody who gets away with it for three years and gets $275,000, that’s a failure.”

So what can a dentist to make sure that thefts are caught quickly?

“One of the pieces of advice that I give doctors is that the only reports they look at the end of each day and at the end of each month be ones that they printed themselves. Otherwise you can’t be confident that the reports are 100% accurate.”

If you are concerned at all about your practice after reading this and you would like to contact David Harris directly or you would like to have his company help you minimize your risk exposure to embezzlement he can be reached at david@dentalembezzlement.com.

Why should dentists join the ADA

Dentistry is a business. And you need to treat it as such if you want to maximize the return on all your hard work and skills development.

A big part of being successful in business is the support you get from being a part of an association.

Recently I spoke to Dr. David Preble of the American Dental Association about how the ADA helps dentists at every stage of their career journey.

Currently the ADA counts about 63 percent of working dentists in it’s membership, representing more than 161,000 men and women from across the country.

That may seem like a lot. But with boomers retiring and selling their practices and millenials making up almost 50 percent of dentists the challenge is to find a real value proposition that speaks to dentists wherever they are in their career.

The ADA provides a broad range of services from legislative and regulatory advocacy, practice-based advocacy with third-party payers and governmental agencies, continuing education, peer review, scientific research, the development of dentistry policies and standards, as well as, practice management tools and resources.

I’ve been a member since 1983. Over the years I’ve had both agreements and disagreements on policy. However in the end the mission statement is to represent the dental profession and dentists and I think it generally does a great job.

With increasing competition, financial risks and educational debt having a greater impact on individuals than ever before it’s good to have an group to advocate on our behalf.

For new dentists the ADA is a tremendous source of information and knowledge to help guide those new graduates through some of the trials and tribulations of either starting a practice, joining a practice, and other areas related to getting a career started on the right foot.

“A new dentist can really benefit from the services like our Career Center,” says Dr. Preble, “which we are building to be even better and better. That really helps dentists make more informed and better decisions about where they want to practice, and how they want to practice.”

“We also provide networking opportunities through local and state dental societies, which are an integral part of the ADA, along with practice development resources, and even licensure guidance and loan refinancing options.”

It’s not just new dentists. For dentists who have been practicing for between 8 to 20 years and are dealing with the practice management issues, where perhaps their practice isn’t growing and doing as well as they’d hoped for a variety of reasons the ADA has an enormous amount of information to help.

Again Dr. Preble says “for those dentists in that mid-career part, they can have ADA tools and resources to answer these third-party payer and other business related questions, along with access to online scientific resources, etc.”

Finally, the last group are those individuals more in the twilight of their career. Are they in a position to retire financially? Is their clinical practice in a position to pass on to another individual or group? Again, the ADA is there with knowledge, information and expertise.

“When dentists get into the later part of their career, “ says Preble, “The ADA has practice transition information, along with answers to financial questions and then lots of opportunities for mentoring new dentists”

If you are a new dentist a membership in the ADA is a critical to becoming part of the greater community of peers and will provide you with knowledge and networking that will help you throughout your whole career. If you’ve let your membership lapse then maybe it’s time to re-think and re-engage with this important organisation.

Additional resources

www.ada.org.

Center for Professional Success
www.success.ada.org.

Successful dental careers require more than clinical skills

If you’re just coming out of dental school it’s safe to say that you probably have the requisite clinical skills to do your job.

Unfortunately clinical skills are not the only thing you need to have a successful career.

Dentistry is a business. If you don’t treat it like a business, then you are setting a ceiling on your own financial security.
I learned very young one of the most important skills they don’t teach you in dental school is how to choose the proper career path.

Most new dentists graduate with a lot of debt. That means the dream of opening your own practice right away is out of reach for most of us early in our careers.

The reality is that you’ll probably be working as an associate for a few years while you get your own financial house in order.

Depending on where your see your career taking you, you may consider joining an independent practice or one that is connected to a Dental Service Organization or Managed Service Organization.

Deciding on which route you want to take boils down to one question – do you have the entrepreneurial drive to one day own your own practice, or are you content to be an employee?

There is no right answer. However it’s a decision that you will have to make early and it will determine the path of your career going forward.

Whatever path you choose it’s important that you not only burnish your clinical skills, but also pay attention to how the practice is run. In essence you have two jobs – improving your skills and learning the business.

I’ve been a “wet-finger” dentist for over 35 years. When I graduated it was a different environment for dentists. When I started I had the luxury of time to figure things out. I made mistakes and I learned hard lessons. Eventually I was able to put in place processes and procedures that not only worked – but were also easy to replicate.

Today, the commoditization of dentistry has accelerated the learning curve considerably. So if you don’t get everything going right from day one then you will struggle.

I started consulting with new dentists because, through my work at Tufts, I saw that dental schools are very good at clinical, and often ignore the business and career development part of dentistry.

I didn’t see enough emphasis on accounting, legal, sales, marketing and other aspects of the business that can make or break a career.

Getting these skills, along with putting in place the proper processes and procedures that make a practice efficient at every level is the best way to ensure sustained growth and position you to achieve the maximum return on your investment when you eventually go to sell.

If you are a new dentist, or simply struggling with the business part of your dental practice, then I encourage you to book some time with me to talk about your current situation. It’s up to you how you want your career to play out. Talking to someone who knows what they’re doing with a solid track record of success is the best place to start.

When should a dentist open a second or third practice

If you are successful running one practice, it is almost impossible not to consider the potential financial windfall that might come from opening a second or even third practice.

I’ve been a practicing dentist for over 35 years and I have 14 offices. So what have I learned? The first thing is that before you make any decision you need to think long and hard about what your end game is.  

Are you building additional practices to sell to a DSO or MSO? If that’s the case then you must think about how you can get the highest return on your investment down the road. Maybe you’re growing because you’re business is booming and the only way to effectively grow your business is to expand to another location.

The reality is that even if you aren’t thinking about selling now, at some point you will. When that day comes you’ll want to get the biggest return on your investment.

If one practice is successful and the second practice is just as successful, the investment and the return on your investment will be significantly better than just selling one solo practice. That’s just math.

So the more successful practices you have,  and the better the processes and procedures you have in place to run them, the more valuable this entity will eventually be to a potential purchaser.

Depending on the number of practices you accumulate and run successfully, your value will go up, but the number of individuals interested in that practice will go down. If you grow your business to include three, four, five, ten or fifteen practices they will be valuable – but the market for them when you go to sell will be severely restricted.  

Let’s face it, a single dentist will not be purchasing 10 practices at once. So in most cases, you will ultimately be leaning towards a DSO or Dental Service Organization or an MSO, Managed Service Organizations.

That being you should never expand into another location, unless your first location has excellent processes and procedures. That means infrastructure is in place, you have great team members at your front desk, adequate chair side assistance, adequate dental hygienists and – let me emphasize this – hardware and software controls.

Another consideration is age. Where are you in your career? You can afford to lose almost everything in your 20s and 30s and still have plenty of time to rebound and be very successful financially.  When you start this type of aggressive expansion mid to late  in your career, the money, time and effort may not give you the best return because your investment will not be recouped quickly.

This last point is very important to dentists in their 50s or late 50s. You need to fully understand the financial and the emotional time commitment of opening up additional practices and what you can expect for your return on investment prior to selling. Unless you’re an incredible superstar and you can get that practice up and running, profitable, with an EBITA of at least $300,000 to $400,000 within 12 to 18 months, you may find that your return on investment may not benefit when you consider the risk and effort involved.

What Do You See When You Look In the Mirror?

I’ll tell you what I see. I see opportunity!

Dentistry is a great profession. As sure as people will always need a haircut, they will always need to have their teeth looked after by professionals like us. But that doesn’t mean there aren’t challenges ahead. Like every industry, we too are facing many changes. Some of them are amazing and let us work more efficiently and become more profitable, while others take us down unproductive paths.

For many years now Lasers have been a part of dentistry. We use lasers for intra oral tissue removal, tissue re-contouring, tooth whitening, caries removal, disinfection of periodontal pockets, improvements in the healing of aphous lesions and the list goes on and on…it’s amazing technology.

Most practicing dentists quickly develop a myopic view of the patient care. We tend to see only the oral cavity because that is where we are most comfortable and where we have been trained to diagnosis and treat. But what if there is more? What if there was a way to utilize the skills and equipment you already have to offer additional value-added services to your patients? Would you be willing to think outside the box and take action?

Recently I have been considering additional lasers for my 14 dental offices. As part of the decision-making process I took a week’s course though the National Laser Institute to evaluate different laser companies and experience firsthand what would work best in my practices.

Let me say that my experience with the National Laser Institute could not have been better. Their team was professional and knowledgeable and I had a very enjoyable experience. But even more importantI saw opportunity. When it comes to laser treatments there is an almost limitless supply of patients clamoring for this type of treatment option.

I have had, and used, lasers in my dental offices on and off for many years. But I’d never considered their use for other forms of care and treatment.

Consider the following-

  • Hair removal and or reduction
  • Brown and Red spot removal
  • Tattoo removal
  • Facial Rejuvenation and Radiofrequency Care and Treatment
  • IPL Treatments or Intense Pulsed Light Photo facials
  • Wrinkle Reduction and Fractional Laser treatments
  • Body Contouring That Targets Adipose and Cellulite Problem Areas
  • Vein Reduction
  • Micro-needling

The above list just scratches the surface of treatment options we could all be offering. This is an opportunity just waiting for dentists to embrace.

There is a seemingly never ending list of challenges that face us day in and day out – with dental insurers constantly reducing fees and placing more rules and regulations between us and the care we provide, not to mention the growing competition from DSO’s and MSO’s. Perhaps now is the time to look into the mirror and see the enormous opportunities that are still there if we choose to learn and apply new skills to service alternative markets outside the gumline.

Did you know that almost 30 million people in the US alone have tattoos and almost 80% want them removed! With the right laser and techniques in 4-10 visits this can be done!

Did you know that most women have terminal and vellus hair on their face that they would like to see removed and or reduced!

Did you know in recent surveys most men and women want to see a reduction of age and sun damaged spots on the face along with reduction of wrinkles and fine lines!

What I have learned over the last 35 years in my professional and business career is that we are health care professionals and the care and service we provide is paramount. But we are also small business owners who need to adjust to market forces to grow our practices.

Clearly esthetic treatments are in great demand and will become even more popular as our population ages. What I see is an opportunity to add value, a growing patient base, an unmet need and a reduced barrier to provide care and treatment. That’s right – this is a “no-insurance” business. Patients pay for what they want and need.

If you are still on the fence about adding this kind of service option to your practice consider this, when a crown is done it usually doesn’t require additional treatment for many years, however facial esthetics treatments are ongoing. We may never stop aging, but we clients will sure as heck pay to hold the signs of aging back for as long as possible.

With the correct lasers and training a tremendous opportunity lays right in front of us all. We need embrace it and learn to provide these additional services to patients.

 

Kevin Coughlin DMD, MBA, MAGD

Owner of Ascent-Dental-Solutions with a focus on Knowledge, Development, Training and Consultation

Author, Educator and Lecturer

Dr. Coughlin started Baystate Dental in 1983 with 14 practices and 150 employees and continues to practice full time all aspects of General Dentistry.

He can be reached at 1-800-983-4126 or 1-413-634-4459 or DrKevin@Ascent-Dental-Solutions.com

 

 

You already have a sales team: your staff!

Look around your practice. What is the biggest investment you’ve made? You’ve got modern technology: that ensures that customers return, knowing that they’re getting the best care. That is a good investment.

But consider your most important investment: your team. You upgrade your technology, certainly. But are you doing the same with your team?

Here’s something I can offer from my years of experience with multiple practices and teams. If you don’t have a successful team, you don’t have a successful business or practice.

Intuitively, all dentists understand that they’re the leaders of their organization. But unfortunately, most of us are not trained in leadership, management, and many times, we just don’t know how to coach our team members.

Individual team members share a goal and are there to support your patient base, your business, and improve the quality of care and service for patients.

Here’s quick overview of how to make your team stronger…

They need to be trained in basic dental procedures, whether that’s periodontics, endodontics, oral maxillofacial surgery, implant dentistry, temporomandibular joint or temporomandibular disorders, cosmetic procedures, sedation options, pediatrics, dental radiology, public health: the list is really extraordinary.

It’s about education, yes, but also about value to the customer. If your team knows the value of these procedures, they can educate patients about them when they ask about them. They become part of your marketing and sales department. That’s value to your practice.

I think there isn’t a dentist or a dental personnel out there that doesn’t realize that some individuals are just innately better at sales. In general, the medical and dental profession generally frown upon the word sales. Sales sounds unprofessional. We’re above the fray: we shouldn’t be selling anything. We provide care and treatment.

In the world that I live in, sales are a positive thing. When you can educate, inform and motivate patients in a certain direction for a specific treatment, providing that treatment is the correct treatment and best for your patient, then sales are critically important because they motivate your patient to do what you think is best for them.

In short, your team can boost your practice’s success rate and how patients accept  the treatment plans.

So how’s your (sales) team? Have you given them the training and motivation you need?

You upgrade your technology so upgrade your team now and often. It’s the best investment you’ll ever make in your practice.

Checklist for Buying a Dental Practice

Whether you are newly out of dental school or have been running your own practice for years, buying a dental practice is a huge commitment. It is absolutely essential to do your homework, ensuring that the practice you select will truly serve your needs. In addition, the paperwork requirements are significant, requiring a great deal of time and effort. With so much going on, it is easy to overlook some very important steps. Here is a checklist to keep you on track when buying a dental practice.

Research Phase

The first step is to research available practices in the area you would like to serve. Make appointments to go see each practice and speak with those in charge. Examine the existing equipment and make note of anything you would like to upgrade or change. Talk to the staff. Find out how many regular patients are currently on the books. Learn as much as you can about the practice’s current financials.

Build a Team

Once you have narrowed down your list to the ideal practice for you, it is time to build your team. At a minimum, you will need to retain a CPA and an attorney. You might also choose to add a business coach, a partner, and other professionals who can help make your transition as smooth as possible.

Apply for Financing

Although some dentists wait until their offer is accepted to find financing, it is far better to obtain pre-approval for a loan. Presenting a letter of pre-approval reassures the seller that you are serious and minimizes the risk of the deal falling through, which can help move yours ahead of offers from other dentists without pre-approval.

Make an Offer

Remember that you are not buying an inanimate object. You are purchasing another dentist’s life’s work. He or she has worked very hard to build the practice and form relationships with both the staff and the patients. Therefore, a lowball offer, like you might make for real estate, is inappropriate. While you certainly want to leave room to negotiate, and to get the best deal, consider the full package when preparing your offer. A fair offer shows respect and will be seriously considered, while a lowball offer may cause the dentist to move on to the next offer without negotiating.

Also include your letter of pre-approval, as well as your resume or CV and letters of reference. These documents show the dentist that if he or she accepts your offer, the practice will be in good hands.

Review the Sales Contract

With your lawyer, go through the sales contract with a fine-tooth comb. Ask for clarification on any clauses that you don’t understand. Make sure all blanks are filled in, and that all terms are as expected.

Manage All Other Documents

If you are assuming equipment leases, contact the lease companies for the proper assumption documents. Review the accounts receivable if they are part of the purchase. Assess the practice’s regulatory compliance status. Also speak with the property owner to set up either a lease assignment or a new lease on the physical location.

File Business Documentation

The exact documents that you need to file vary widely by location. Your attorney can help you determine what documentation you need. In general, expect to file paperwork with the state board, the IRS and state tax commission, any dental societies to which you belong or plan to join, and the unemployment office. You will also need the appropriate licenses and permits to operate a dental practice in your state and city. In addition, you will need to set up a business bank account if you do not already have one.

Get Insurance

Depending on your state and local laws, as well as the requirements of your bank, you may need several different types of insurance. Speak with an insurance agent in your area who is familiar with dental practices to ensure that you get everything you need.

Set Up Your Practice

Although you are buying an existing practice, it is important to adjust it to your needs and goals. Set your fee schedule. Decide which dental insurance carriers you will accept, and file the appropriate forms. Choose an employee benefits package. Set up your accounting system. Decide how payroll will be handled. Organize your billing and insurance filing systems either internally or through an outside company. Order business cards, prescription pads, stationery, and other branded products. Select a dental lab. Order new equipment if needed.

Smooth the Transition

Immediately after signing the sales contract, determine how long you will need to get the office reopened. Review the appointment book and contact any patients whose appointments need to be changed. Send out a letter of introduction to all existing patients, and plan an open house. Meet with the employees to explain how the transfer will affect them. If desired, present a letter from the seller to the patients, employees, or both, to help them understand why the previous dentist left. Send a letter to your own existing patient list, if applicable, to let them know of your new location.

Buying a dental practice is complicated, but the rewards can be significant. Do your homework, assemble an experienced team, and take the time to help smooth the transition for both patients and staff. This will minimize disruptions and help your new practice start off on the right foot.

Ascent Dental Solutions is dedicated to helping dentists build their practices. If you are interested in learning how to take your dental practice to the next level, please contact us today at (800) 983-4126.

How you brand your practice is crucial to its success

How you brand your business is key to how you’ll be perceived by existing clients and those looking for a new dentist.

How do I know this? Because I used to be bad at it!

I’ve learned, of course, and have leaned on the wisdom and services of branding and marketing professionals ever since.

But back in 1983, I made a blunder. Although I was marketing in many mediums at the time, I thought a humorous TV spot might be a useful strategy.

The commercial featured an absurd image of a dentist brandishing a carpenter’s drill about to start work on someone’s choppers. The idea was to apply a comedic twist to people’s fear of the dentist’s drill.

It didn’t work. Let me put it another way: people hated it!

So there I was, a successful dentist and I almost lost it due to a sixty second commercial.

The way you present yourself online, in print through marketing of any kind, is very important.

You want to consider the type of audience you have and the customer base you want to have. Look at the reviews you’re getting online to see what people are saying. Do a close review of your competitors and see why they’re getting their business to the level it’s at or even getting more business than you are. And use marketing and use the internet and social media and design to get your business to where you want it to be.

The lesson here is that you are an expert at dentistry and there are other professionals skilled at making you shine in the marketplace.

Pro-tip: if your marketing consultant suggests the carpenter’s drill idea, find another one!

Marketing Your Dental Practice: 4 Keys to Success

Marketing is an enormous part of any business, and your dental practice is no exception. Yet most dentists’ skills run more toward actual dentistry than dental marketing. Yet just 4 simple keys can dramatically boost your marketing success.

Identify Your Target Market

Your target market is a fancy way of describing your ideal patients. Perhaps you want to focus on older patients, young families, or children. Maybe you don’t like dealing with insurance companies, and prefer patients who can self-fund up front and wait for insurance reimbursement. Whatever your target market is, make sure your marketing appeals to that group. Also keep it female-friendly, as women make a stunning 90% of dental buying decisions, and they are highly informed consumers seeking solid information before they buy.

Define Your Practice

It’s not enough to define yourself as a dentist. To market effectively, you need to perform a SWOT analysis of your practice:

Strengths: Your strengths are those things that you do better than the competition. These could be clinical strengths, such as an in-house dental lab or advanced training in the latest dental implant techniques. But they could also be process based. Maybe you offer Saturday hours or online paperwork filing. Make a list of every single thing you do better than the other dentists in your area.

Weaknesses: No one likes to admit their weaknesses, but an honest assessment is key to both a solid marketing plan and a strong business plan. What do your existing patients complain about? What is the corporate dental office across town doing that you wish you could do? An honest assessment lets you predict and plan for the obstacles you will face.

Opportunities: What could you do differently, either now or in the future, to drive practice growth? What about external factors? Is your community growing? Are young families moving in? Are insurance coverage rates going up? Are costs going down? Make a complete list of your opportunities for both short-term and long-term practice growth.

Threats: What forces are working against your practice? Is your community shrinking? Are local insurers raising premiums and lowering benefits? Did a huge corporate dental office just open down the street? Is your partner retiring? Identifying the threats to your practice lets you prepare a plan to guard against a decline in your patient list and revenue.

Engage Patients, Staff, and the Community

Your existing patients and staff can be strong brand ambassadors for your practice. However, they do not know nearly as much about the overall picture as you do. Hold regular staff training sessions to teach them the benefits of your practice. Hold them accountable for familiarizing themselves with all emails, flyers, and other marketing materials you send out. The more informed they are, the more they can stay on-message when speaking to current and potential patients.

Your patients already like you, so leverage those relationships to bring in new patients. Institute a referral program with incentives. Ask them to write reviews. Encourage them to follow you on social media and share your posts with their friends.

The local community is your source for new patients, but they have to know you exist. Hold open houses now and then, with fun activities for the family. Participate in local festivals, volunteer for a local charity, or sponsor a local kids’ sports team. Build your reputation as a strong, friendly, trustworthy member of the community, and new patients will be more likely to give you a chance.

Leverage Both Digital and Print Marketing

From a website to a social media presence to email communications, digital marketing is absolutely essential in the modern world. Start an email newsletter. Post helpful tips on your social media sites. Add a blog to your website. Whatever you do, follow two key rules: 1) Update no less frequently than once per month and 2) End each and every item with a Call to Action (CTA). A CTA tells readers what you want them to do—in this case, call for an appointment. Sweeten the deal by offering an incentive, such as a free consultation.

Print marketing may seem to have gone the way of the dinosaur, but it still plays a key role in attracting local business. Hand out business cards to your patients, preferably with a handwritten note of thanks on the back. Send branded merchandise such as notepads and pens to your regular customers now and then. Snail mail birthday cards, annual checkup reminders, and other occasional communications. In a digital world, print materials can really set you apart.

Ascent Dental Solutions is dedicated to helping dentists build their practices. If you are interested in learning how to take your dental practice to the next level, please contact us today at (800) 983-4126.

Your website is only as good as your SEO

If you’re a dentist then you probably have a website. It might even be an awesome site. But here’s the thing, it doesn’t matter how much blood, sweat and money you’ve sunk into, if prospective clients can’t easily find your site then it’s not really doing you any good.

So how do you get them there? Try typing ‘dental office’ into Google right now along with your town or city and see what comes up. Is your website there or is it someone else’s?

To ensure your site is near the top of the Google search rankings (the goal in local search is #1), you need to work on your SEO. Search Engine Optimization is the method web experts use to make sites appear at the top of search results and get your business found by potential patients.

Given the number of practices competing for new customers local search is becoming a big deal and it’s only a matter of time before every practice starts to optimize their sites for maximum exposure.

I recently spoke to a guy named Mike Pederson about it. Mike is the CEO of Dental Boost, a cutting-edge dental SEO company for both solo and group practices.

He told me it all comes down to coming up with the right ‘buyer-intent’ keyphrases that people use on Google to find dental practices.

Typically, most dental practice’s keyword phrases number about 20. Mike Pedersen’s company has developed around 500 such phrases. However it’s about more than numbers. The better your phrases and search terms are, the more chance your practice has of rising up through the rankings.

Of course if that’s all it took then everyone’s practice would be at the top of the searches! There’s more and you should look into a company like Mike’s to give you some guidance. .

So is it worth it? Every penny!

Outside of word-of-mouth, web searches are the best way for people to find a new dentist.

Although a good marketing campaign also helps, making sure your business name is tops in web searches is a basic necessity, the digital equivalent of having a lighted sign in front of your practice.