Buying into a Dental Practice: What to Expect

Most often, dentists going into private practice work alone. Buying an existing dental practice is a fairly straightforward process with a short transition period. Sometimes, though, the opportunity arises to join an existing dental practice with one or more dentists. This is more complex, as you will all be working and sharing equity together.

In many cases, a dentist buying into a dental practice will go through a slow testing process, where the new dentist and the existing dentists work alongside each other for a period of time before the buy in is completed. This is known as an associateship. The associateship to ownership process is typically divided into three phases.

Honeymoon Phase

The honeymoon phase allows everyone to get acquainted and see how they work together. The new dentist will sign an associate employment agreement that details the new dentist’s responsibilities and compensation. This is the time to explore each other’s philosophies, treatment methodologies, and business practices to determine if the partnership is the right fit.

This is also when all parties should discuss the parameters of a future buy in, as well as exit strategies. The goal here is to find a way for the new dentist to come into a full equity share without disrupting the business, and for either side to exit with minimal impacts to anyone.

Commitment Phase

A few months into the new arrangement, if things are working well, it is time to move into the commitment phase. As this point, a Letter of Intent is signed that details the terms of the buy in. This should also include a provision for the associate to move immediately to buy in should the senior dentist become disabled or pass away, ensuring that everyone’s interests are protected.

Other necessary paperwork includes an employment agreement revision and a practice management agreement. The goal for this phase is to spell everything out on paper so that the buy in is seamless and future hiccups are anticipated and provided for.

The commitment phase normally lasts 6 to 18 months, depending on the complexity of the existing practice and how long it takes to file all legal paperwork. If any current dentists are leaving the practice, arrangements must be made to transfer patient records and referral sources, which could extend the timeline.

Buy in Phase

The buy in phase is when the associate officially becomes a full partner. If the honeymoon phase and commitment phase were handled properly, the buy in phase should be smooth. The goal here is to allow the new partner to focus on becoming part of the team, and the team to focus on including the new partner, rather than drowning in forgotten or neglected paperwork.

Adding a new partner to an existing dental practice is a challenge for both the practice and the new dentist. However, slowing down and taking the process step by step can set up both sides for success. Clear communication, honesty, and a bit of patience will help to ensure that the transition is everything you hoped it would be.

Ascent Dental Solutions is a full-service agency dedicated to helping dentists build their practices and map out their careers. It is the brainchild of Dr. Kevin Coughlin, who earned his doctorate at Tufts University School of Dental Medicine and currently serves as a faculty member there. While Dr. Coughlin continues to practice dentistry as the principal owner of the 14-location Baystate Dental PC, he has a strong passion for helping fellow dentists maximize their success. If you are interested in learning how to take your dental practice to the next level, please contact Ascent Dental Solutions today at (800) 983-4126 to learn how Dr. Coughlin can help.

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.

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 www.ascent-dental-solutions.com. 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 www.ascent-dental-solutions.com. 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.

Patient fears and finances and how to address them

Twelve months is a long time to go between checkups.

When I haven’t seen a dental patient for over a year, I update their records, perhaps do new bitewing radiographs, and conduct a clinical exam and hygiene session.

Digging deeper, I always question why my patient hasn’t been in touch.

In most cases, the issues are fear, finances, or time.

When it comes to fear, I recommend offering a sedation option. There are many viable ones including oral, inhalation, intravenous, or general anesthesia. Having these as options in your practice not only allows your patients choices to make their visit a less stressful one, but also allows you to grow and expand your patient base.

If the patient has financial concerns, an evaluation of the plans your office accepts is in order. Although each has ramifications with regards to cost, time and financial factors to your organization, they should be reviewed with an eye towards the potential upside of being able to accept more clients. Methods of non-plan payment should also be evaluated ranging from credit cards to credit companies adept at handling dental payments.

If time is the issue and it prevents your patients from seeking care, then maybe it’s time to review your operating hours. The more you can do that allows for flexible service schedules such as evenings and weekends underscores your commitment to exceptional care and service.

To talk to me about how to turn your dental practice into a customer-focused dynamo, please get in touch.

A patient in distress is your opportunity to shine in customer care

Here’s the scenario: a new patient calls your office with an issue that needs attention.

If they’re calling because of an emergency, your staff should treat it like one. First of all appreciate they chose you over a competitor. Maybe it was your website, advertising, or word of mouth. But they chose you and it's your job to let them know it was a smart call on their part by delivering excellent service.

customer-service-and-dental-practicesOnce they’ve told you or your staff the issue as they see it, work to be both empathetic and clinical by asking them to quantify their pain on a scale from zero to ten.

Once your office  has an idea of how much discomfort they are in, they next goal is to get a location. This will help the front-desk coordinator estimate the time needed for an appointment and, perhaps, even the seriousness of the problem.

Is this an issue that has come on suddenly or has it progressively gotten worse over time? The answer to this question provides clues as to their current circumstances regarding income and benefit coverage.

Someone  with a pain level of ten that has endured for more than a few days has likely been holding off on care and treatment due to fear or finances.

This isn’t always the case. Extremely busy individuals will often put off care and treatment as long as possible because they believe treatment to be an inconvenience that will eat up valuable time.

Others have nothing but time, but lack the financial resources to obtain care. Still others are somewhere in the middle, wise enough to understand they require care and treatment but hope their issues will resolve on their own.

In all cases, I recommend you offer a patient either the option to come in immediately or sometime that day. This is an important concept to understand. I am well aware that you may not be able to accommodate Mr. or Ms. Smith on a particular day. However, experience has taught me that most people want to have their pain acknowledged and an offer to see them as soon as possible, while rarely accepted, is an important part of the customer experience.

Getting someone through your the door is for an initial assessment is different than fixing the problem immediately. In the most cases, having someone come in for evaluation of his or her chief complaint, taking a radiograph, and coming up with the diagnosis, treatment plan, and perhaps prescriptions are all that will be needed. The actual care can be done on another day.

If the chief complaint is severe, in most cases your well-trained staff should be able to temporarily alleviate discomfort by, if in the case of an abscess, opening the tooth and allowing for drainage. Your team should be able to extract the tooth or provide some type of temporary or long-lasting restoration. For offices that avoid specialty care, a prescription and referral often are all that is necessary to provide steller service.

I’m a firm believer that for a general dental practice, the more specialty care you deliver the better your overall service and care will be. Although most dentists feel that it’s simpler and less stressful to delegate specialty care out to specialists, it is my belief that most general dentists should be able to provide over 90 percent of all treatment as long as adequate effort and training are present.

The tremendous goodwill that you create by helping Mr. and Ms. Smith with a quick radiograph and referral slip cannot be overstated. In today’s environment, increased specialization has created an almost impossible scenario for patients to receive any kind of treatment from start to finish on the same day. While this lowers expectations of “quick fixes” it also results in inconvenience and increased costs to patients. If you can manage to “do more” you will see immediate service improvements and more profitability as your word-of-mouth referrals increase.

The goal of your dental practice should be to create what I refer to as “raving fans,” who support your practice and are so satisfied with your care and service that they cannot help but tell family, friends, and associates.

I would be happy to discuss how to turn your dental practice into a service dynamo. Please contact me for a quick chat about improving your bottom line and patient outcomes with excellent customer service.

I would be happy to discuss how to turn your dental practice into a service dynamo. Please contact me for a quick chat about improving your bottom line and patient outcomes with excellent customer service.

Dental Practices can’t just phone it in

Your front line team members are the first client/customer facing representatives anyone comes into contact with when they call or enter your dental practice. Hopefully you’ve trained them to be both empathetic and professional. Let’s say you’ve gone a step further and they are also well – versed on best practices surrounding customer care. That’s it, you’re done!

Not so fast.

What happens where they’re engaged with a real life customer and the phone rings? Is your answering system as good as your staff? If not, then you have a big hole that needs a filling.

First off, the phone should be answered within four rings. If staff are too busy to do so, let it go to the answering system. Nobody wants to hear, “this is Dr. Smith’s office. I’m going to have to put you on hold.”

If it isn’t possible for any member of your team to grab that phone call within four rings, your message has to be the next best thing to speaking to a real person.

First, the answering system should allow patients a choice. They should be allowed to leave their name and phone number along with a request or question.  Alternately, the caller should be able to opt to stay on the line and wait. But if they do so, it is vitally important they are reminded every 30 seconds that you haven’t forgotten about them and that someone will be with them shortly. If, after two minutes, they are still waiting, they should have an additional option to leave a message. Here is where you differentiate yourself by promising to return the call within 15 minutes. Why is this important? That 15 minutes buys your time before they call another practice to set up an appointment.

Still not convinced about the importance of this seemingly minor issue? I’ve got a simple test for you. Do you remember the last time you were put on hold for a long time? Did you call back? I would guess you might have moved onto another provider.

We are all busy. But that doesn’t mean you don’t have time for clients. How you treat someone when you are busy speaks volumes about how much you would value them as a customer.

If you want to talk about how I can transform your dental practice into a customer service dynamo, please get in touch.

Good profits or bad profits: good business or bad business?

There are good profits and there are bad profits in any business.  The business of Dentistry is no different.

Bad profits are those made in an unethical or unfair manner that ultimately lead to bad outcomes.  From my years of experience I’ve seen dentists chase the quick buck and I’ve seen the damage it causes to reputations and the bottom line. In fact chasing the bad profits is one of the most costly mistakes any business can make.

People lose what I call the BLT.

  • They no longer Believe you,
  • They no longer Like you, and most importantly
  • They no longer Trust you.

Good profits are when you make money and provide more value than what a customer or patient expects to get.

For example, the other day, an 80-something year old man came in his 80  year old wife. She needed some root canal treatment, the total cost was about $4,300. I looked them both in the eye and asked “Is it really necessary for you to make this investment? Don’t you think it would be much more cost-effective and perhaps better care and service to remove this infected tooth and avoid the trauma and expense?”

When I heard, “Dr. Coughlin, we can’t afford it.” I told them that my opinion they should consider saving the money and have the extraction. For me it wasn’t even  a question of affordability, it was about making the right clinical and ethical decision.  And in my opinion, although I make my income doing root canals and crowns, the less expensive extraction was the best option given the patient’s age and medical history.

When the procedure was completed, the patient hugged me and she said, “I don’t know if I’ve ever met a healthcare professional so honest.”

That made me think. Could I really be the exception? The dentists and physicians I know don’t roll out of bed each morning, look in the mirror and ask with an evil smile “how can I take advantage of my patients today?”

Instead I believe that the increasing monetization of health care adds to the pervasive narrative that it’s just a commodity. So procedures are not always performed based on patient need, but rather on what will help the balance sheet – even if there is a less expensive alternative.

As medical and dental professionals and for that matter all healthcare providers, it’s up to us to do what’s best for our patients. The best way to do that is not look at them like customers – but people. Find out what they need and deliver it based on the value to them rather than yourself.

What you’ll find is that with word of mouth marketing you get the best results with the most power return in investment than any advertisement is likely to bring.