New Dentists: independent or corporate practice a personal choice

Congrats. You’ve finished school and graduation was a blast. However after you’ve taken off the cap and gown, you have dentistry degree certificate and a lot of decisions to make. Life happens fast and you don’t have a lot of time before you have to begin your career.

You’re at the proverbial fork in the road. And you really have two options: corporate dentistry (Managed Service Organizations or Dental Support Organizations) or starting your own practice.

Corporate dentistry is definitely an easier road and a lot of grads are tempted by the allure of a steady, predictable income. I come from a different world. I know how great it is to have your own practice, set your own rules, define your own standards for performance, and even set your own hours of operation.

I’m not here to judge. What works for one dentist won’t work for another. Corporate dentistry isn’t going anywhere and both private practice and corporate work each have pros and cons to consider.

One of the objections I’ve heard when speaking to new dentists who are considering opening their own practice is, what they see, as a lack of experience in clinical skills and complete absence of any practical business knowledge.

To these dentist corporate dentistry looks pretty good: more skill experiences, a built-in primer on running a business and the piece of mind that comes with knowing everything else is the corporation’s problem.

But here’s the thing. I’ve talked to many practicing dentists who have taken this path only to find out that the above scenario isn’t necessarily true.

Experienced dentists today say 50 or 60 percent of the stress in their practice, is not related to their clinical focus but rather, caused by staff and patients.

These are stresses that will happen whether you’re the captain of your boat or a hired hand on someone else’s.

For me, being independent and in control of both the clinical and business aspects is very important. Not only do you control every factor in your professional life, it also pushes you to get the training on the clinical skills you need and upgrade your management skills.

It really comes down to the kind of person you are. Do you just want to do A, B and C? Then explore a corporate dentistry opportunity.

Just don’t do it because you’re lacking clinical skills and business savvy. You can learn those while developing your own practice. And this is something I help new dentists do through my private coaching programs.

So ask yourself: what kind of a person am I? Are you happy being the employee, or would you rather develop the skills to create something special? The answer to that will ensure you make the right decision: your right decision.

Formula for a great dental practice: S.P.E.C.I.A.L.

I have one word to help you build a great practice.

It’s special. Well actually, it’s S-P-E-C-I-A-L, bold letters and period too.

It’s no ordinary special. It’s a special special.

Confused? Sure you are. Let me explain.

The letter S stands for scheduling.

Having firm control of your schedule is essential to delivering great service. The single biggest mistake I see in many practices - including the 14 I own - are issues about either being scheduled too lightly or too heavily.

The second letter is P for Production.

It’s about understanding net production and what you’re writing off with insurance companies, government plans and such. In the end, it’s critical to have a profitable end-of-day and end-of-month bottom line.

E is for Education. Training, education and communication should never end. It starts with a morning meeting, continues with a pickup in the afternoon and the day should end with a meeting. This ongoing training and education should be built on proven successful processes and procedures.

C is about Collection. If the dollars are not collected for procedures done, your practice will fail. You have to ensure you have enough profit to expand and improve your staff and business. Collection is the gasoline for the engine, and you must understand that the goal is to collect 100 percent of what’s owed to you.

I stands for Insurance. You, your team, your managed service organization and especially your front desk personnel must clearly understand the differences between insurance plans because different plans have different reimbursements.

A stands for Accounts Receivable. I use the rule of 45 days meaning that if your net production is,45 days, your accounts receivable should ensure payments are made within 45 days.

So if your net production is $100,000 a month, then your accounts receivable should be approximately $150,000. If the accounts receivable are in excess of that, your policies and procedures are not working or they’re not being implemented.

Lastly, L stands for Liability. My personal opinion is there is no better way to reduce your liability than having written treatment plans that are signed and agreed to by your patients. Failure to get signed treatment plans that clearly state risks, benefits, options, and costs is a mistake that will cost you time, money, stress and aggravation.

So that is S-P-E-C-I-A-L. I can assure you it will be special to you if you follow each letter, day after day.

If you want to learn how to be special and more, don’t hesitate to contact me at drkevin@ascent-dental-solutions.com or at www.ascent-dental-solutions.com.

Investing in dental tech good for patients and your team

We’ve all seen the articles in dentistry trade magazines and skimmed the ads targeted specifically at dentists with some money to spend. Shiny, exciting new technologies that promise of increased productivity and higher profitability. What’s not to like? Sign me up!

But let’s take a step back and ask the fundamental question - is it really worth it to invest in new technology when what you have already does an adequate job?

Well there are two answers and the both start with an emphatic “yes.” The first yes, is that any investment in new technology is great for both patients and your team members. When it comes to choosing and referring your dental practice to others having a reputation as  a dynamic organization is on the cutting edge with new strategies and tools instills confidence and pride in your customers/patients.

Now what about the tech itself?

Let’s not beat around the bush. Some of the technology that is out there would have been science fiction just a few decades ago. In a recent podcast with Kevin McGonigal we discussed a software-driven product that creates a 3D image of dental procedures. For example you can show a patient the exact method you are going to use to execute a dental implant.

This kind of technology also engages and excites your team as they learn more about these procedures, giving them on-site training. And let’s not forget that a practice that’s tech heavy is an enticement to potential employees. After all, who wouldn't love to work in a practice that looks forward on a constant basis?

In general employees who know what they are talking about and patients who understand procedures increases  the education component for patients and in doing so, speeds up the process of getting a procedure done. For those sitting on the fence about getting a procedure, the 3D can help push the decision from a maybe to yes and that will have a definite impact on your bottom line.

There really is no downside to investing in good, useful new technology. Because if you’re not, your competitor up the street will and that will leave your practice looking a little dusty and unattractive to new patients.

Setting up a good dental practice same as setting up a good business

“So how do I set up a good dental practice?”

When I meet colleagues or new dentists, it’s the first real question that gets put to me, after the hellos and “that’s-a-nice-shirt-you’re-wearing” chit chat.

It’s a great question. But sometimes the answer I give isn’t exactly what they expect.

The answer, or at least my version of it, is that setting up a good dental practice is exactly like setting up a good business.

My colleague Steve Parker is responsible for that observation and he’s absolutely correct.

So how do you set up a good business that just happens to be a dental practice?

It comes down to focusing on five areas:

  • Leadership
  • TeamBuilding
  • Money (finance)
  • Metrics (measurement for the business and systems)  

Whether you be setting up a sole practitioner office or one in a DSO or MSO, the principles are the same. A DSO will provide the measurement systems and some of the team building tools.  But in the end it’s up to you to provide inspired and inspiring leadership.

But here’s the rub. Most dental school graduates emerge from the hallowed halls of their academe wielding a dental drill like a champion but with a limited business acumen that borders on financial illiteracy.

It may explain why some find the allure of DSOs and MSOs enticing. Much of the marketing and business growth is left to the corporate head offices.

But let’s go back to those factors again, one by one…

Leadership: It’s about the buck stopping with you. It’s about standing behind your team members so they know you have their back. Remember, how you behave sets the tone and atmosphere of your entire practice.

Team Building: Your team can build you up if you build them up. Get them to understand that training is a lifelong pursuit. If one of them learns something in any given day, ask them to share it with the others. Encourage sharing of lessons learned and how they were learned them. In essence, you are their coach, showing them how to do the work, push them when needed and cheer them when they do a superb job.

Money (finance): This one is important if only to ensure a smooth flow of finances to keep the doors open.

Metrics (measurement for the business and systems): This is about where you steer your Good Ship Dental and why you’re doing it. If you decide to focus on getting new children patients, then that is where you’ll point your metrics and determine your success.

Is it really that easy? Well yes and no. Within each of the four areas noted above there are multiple areas for discussion and exploration.

But those four factors are the foundation of setting up a good Dental / Business practice.

If you want more direction on setting up a new dental practice, please give me a call.

The direction of your dental career starts on Day 1

In any career, the earliest decisions are always the most crucial.

Decisions made at the outset of any endeavor directly determine the path you're on and at least in rough terms, where you will end up.

And yes, when you walk out the doors of dental academe, the choices begin.

Today, the new dentist is faced with an important fork in the career road that really didn’t exist when I started out some 34 years ago.

To go the corporate dentistry route or not is a decision that would have vexed Hamlet and it’s the same for new dentists.

Corporate dentistry (Dental Service Organizations or Managed Service Organizations) is a very viable route for new dentists. But the decision to go that route has everything to do with the kind of life you want to live and the kind of person you are.

Here’s a few questions to mull over.

Do you want to set up your own service standards or subscribe to ones set up by the chain’s management?

Do you want to grow your own practice through your own marketing or using DSO chain-wide advertising?

Are you comfortable with the change in ownership that can happen with a DSO or MSO and the new standards of performance and profit sharing that can result?

These are all very important questions with many spin-off issues from each.

Exploring these issues with new dentists is the most rewarding part of my career as a dental coach. If I can help guide them to the decision that’s right for their lives, it means success for them and me.

And after all, we all want success on our terms. How one goes forward with their career is directly reflected with how they want to live their life.

Early decisions in a dental career are the most crucial

New dentists don’t often think of themselves as business people. But that’s exactly what they are. Whether you are starting your own practice, buying into a practice or joining an established team as an employee, your decisions are all primarily business decisions.

And the choices you make at the beginning of your career are some of the most important you’ll ever have to make.

When you leave dental school you are ready for patient care. But what about career care? What business prep have you received?  I can tell you that when I left school it was very little and that hasn’t changed much.

I was out on the street with a DDS and not much else.

Thirty-four years later, I have 14 dental offices, 23 dental associates and over 150 employees.

I learned a few things over those years. Today I coach young dentists, so they don’t have to figure out the toughest part of the job  – the business part.

I still practice dentistry day after day. Oral surgery, implant surgery, TMJ, orthodontics, endodontics, periodontics, fixed and removable prosthesis: I do it all. I can do this because I learned how to implement processes and procedures that make the business part work efficiently.

I talk to new dentists all the time and I get the same questions over and over again.

“Do I open my own practice?”

“Should I take over a practice from another dentist or join a corporate practice?”
“What should I consider before signing a contract?”

“How can I research a practice and learn more about it’s potential for growth?”

These are all great questions and I wish a simple FAQ would do the trick. But every dentist’s situation is different. While some are more entrepreneurial, others might prefer to clock in and clock out in time to hit the golf course a couple of times a week.

Defining your goals and then mapping out a career plan to reach them is something I enjoy doing.

If you’re interested in this specialized career guidance, take a look at my dental coaching program and I will help you match your plan to your goals.

Talking to dentists is a great spring break

Last month I had a great spring break at Destin 2017. No, there wasn’t a lot of swimming, or reading by the beach. It was a different kind of break: one where I was connecting with fellow dentists and sharing best practices to make our businesses more profitable.

At these types of events the one-on-ones are great. But I was fortunate enough to have been invited as a speaker – thereby allowing me to share my practical experiences with more people dentists than I could ever have reached simply walking the halls.

With 34 years in the industry building up 14 dental practices, I played to my strengths and talked about building profitable dental operations.

Specifically I spoke about the reality that cutting corners often costs a practice more than one might think. Instead I am an advocate for investing in the processes and procedures that really drive business growth.

It comes down to what I call the SPECIAL approach:

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 make everyone want to deliver better results and perform at higher levels.

C collections improvements that will show you how to reach 98%

I internal controls to help you manage your practice

A associates and accounts receivables as a tool for growth

L liabilities and asset management to protect yourself and your business

The talk went over very well, given that in the days afterward, I was fielding questions about the SPECIAL factors from many in attendance.

If you weren’t able to make it to the conference – or even if you did – I pulled together a resource page with the slide deck of my presentation, and related materials.

If you want to talk to me about how to make your practice SPECIAL, please send me note and we can schedule a private coaching/consulting session that will help you make your dental practice more profitable going forward.

Denture solutions as varied as the patients themselves

If a patient wants or needs a prosthesis solution, there are a few good options available.

Although many would prefer a non removable denture solution, sometimes medical history, time and / or clinical conditions and of course expense can work against that option.

When patients consider a denture solution, it is usually with limited information as to the hows and whys of such a procedure.

For example most consider a denture solution to be a one-time mattter which is not true. A removable prosthesis must be relined periodically, which can mean they will have to live without it while this is being done.

Prior to treatment planning, you need a complete review of dental records and the patient’s medical history to date.

The design of your removable prosthesis will start with which type of material should be used, such as acrylic resin, vulcanite, polystyrene, metal, or flexible material. The guide planes and the height of contour of abutment teeth are other important factors.

Whether it is a full or partial denture, the goal is to reduce or eliminate lateral forces and attempt to transmit forces parallel to the long axis of teeth. When designing your prosthesis, consider the necessary support, retention, stability, and esthetic requirements.

When creating treatment plans for full dentures, please make sure you review with your patients the fact that they will need denture adhesive for a more secure fit. The advantage here is if they do not need it, you look good. If they do, they will not be surprised.

I recommend informing patients that ideally, they would benefit from two to six implants on the upper or lower arch or both arches for the best and most secure fit. Mention that the placement of implants reduces the need for relines and in many cases reduces the bone loss caused by resorption due to disuse atrophy.

This is an important concept for your patients to understand: in the time without dental implants, they will have more and more bone loss causing their dentures to fit poorly, causing many problems as well as discomfort.

A word of caution regarding patients who come to you and only want a reline: once you do a reline on a patient who has had dentures for a long time, you will be irreversibly changing his or her denture, which can cause problems.

I strongly recommend that you consider a new prosthesis first so you never touch his or her original denture. I find that patients who have had dentures for a long time develop a feel for them, much like an old pair of blue jeans.

To learn more about helping customers transition to prosthetics and more customer-focussed approaches to dental care, please contact me.

Dental implants good but only in specific situations

Dental implants have grown in use over the years and for good reason. In an ideal scenario, an implant can replace a problem tooth quite well.

But that doesn’t mean it’s the ideal procedure for all patients. There are many mitigating factors to consider before recommending an implant.

First, check the condition of the teeth next to the implant area. If they’re good, then I would recommend proceeding. If not, I would think a conventional crown and bridge treatment would be better.

Here are some common questions and answers that arise during treatment planning:

  • How long will the implant last?
    • Typically ten years or longer.
  • Does implant surgery hurt?
    • In most cases, implant surgery is less painful than having a tooth removed. 
  • How long does implant surgery take?
    • Most of the time, placement of a single implant will take less than fifty minutes.
  • Do dental implants fail?
    • Yes, about 10 percent fail on the lower arch and 20 percent on the upper arch.

Many factors increase the failure rate, but the most common are smoking, diabetes that is not under control, and poor patient home care.

A dental implant cannot get a cavity but it can develop periodontal disease. Other failure factors include poor quality and quantity of bone and putting the implant into function too soon.

Can you place the dental implant immediately after you extract a tooth? Yes, but you have to be able to remove the tooth with as little trauma as possible to provide the implant with the best bone available.

If the dental extraction is completed with little to no damage to the surrounding bone, than in many cases, the implant can be placed immediately.

When discussing the cost of a dental implant with your patient, make certain they understand that at least three different fees may apply.

  • The first fee is the surgical placement of the implant.
  • The second is for the implant abutment.
  • The third covers the placement of the implant crown.

Your patient should be aware of the total cost before treatment.

An implant is a good way to handle a problem tooth in the right circumstances. But a truly successful implant experience includes involving your patient in the entire process, from rates of success to the cost.

This is just one of the best practices I talk about when coaching other dentists. If you want to talk to me about coaching your practice, please contact me.

Being a coach to your patients the best dental strategy

When working with my patients, I’ve come to see that aside from fixing their teeth, I’m also a consultant and at best, a coach to them.

If all I did was fix their chompers, that would get old rather quickly. Helping them change their habits and become proactive in their own care is a very fulfilling process for both them and myself.

As a dentist, I’m looking to establish a relationship with my patients much like a medical doctor.

Your physician talks to you about your health and what you can do to improve it. Same with dentists.

Short term thinking would have it that a dentist should allow poor patient habit to continue in order to profit off of their bad decisions.

But most of us are in the long game as dentists. We want our roles in their lives to be meaningful. We want them to change their bad habits and learn better dental hygiene.

Here’s the odd twist. Despite the seeming financial benefits of letting a patient worsen in their habits, it’s not at all true. If a patient’s dental health deteriorates one of two things will happen. They will either stop going to a dentist or only show up when they need a tooth pulled. Eventually dentures will enter the picture, another one-time solution to dental care. In short, they won’t be a patient of you – or any dentist – for long.

Keeping a patient by coaching them to better personal care will result in a fulfilling long-term relationship, one that, circumstances permitting, will see them as your patient for many years.

So if you want to bring greater purpose to your role as a dentist, become a coach to your patient. It will bring dividends both personally and financially for that matter.

If you want to learn how to be a better dental coach please get in touch. I can be your coach too.