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Everything Dental – January 2012

Happy New Year!

 I often talk about our personal, social and business responsibility when I consult dental practices. As business owners we have a burden and responsibility to our staff, associates and patients to set the tone for an ethical and customer service oriented entity. Additionally, we must operate efficiently and turn a profit for a healthy business to survive.

Dentists should be aware that their reputation goes far beyond their local community. The internet has shrunk the world and information about us (both good and bad) can be uploaded and read online. Like it or not, information about you can wind up on someone’s Facebook newsfeed or on a YouTube video. Old flames and friends from dental school or even your childhood may be checking up on you. Communities of people can be talking about you and uploading images of you without your permission or knowledge. Patient on-line reviews are gaining popularity and can help or hurt your practice. Do you know what your patients are saying about you and your practice?

Everyone has a reputation but most people are not actively developing or managing it. Reputation management and brand building requires a degree of active engagement for all people and businesses if they wish to build and protect a favorable brand. This is true if you are a stock clerk, teacher, C.E.O., dentist, sales rep or a corporation. Good reputations are generally built over time and your community involvement, philanthropy and good deeds go a long way to securing a wonderful reputation and brand. Google yourself and your practice to see how well optimized you are. You may be super popular or may have to narrow the search a bit to find yourself. Google yourself under images and see what pops up. Many clients of mine have been quite happy with their results and many others have been disappointed by what they see or the lack thereof. Remember, whether you like it or not “Your online reputation is your reputation” – Abe Kasbo.

Don’t surf the Web / Don’t use Social media / Don’t like Texting or E-mail / Like things the way they are?


We are in the midst of the greatest technological period in the history of the world and we have no choice but to embrace change. I have coined this phrase to that end – We must be able to identify a fad, recognize a trend and join the movements!”  The movements represent change in the making. Whether you are starting a new practice from scratch or are working on your exit strategy, you must be aware of the trends and join the movements if you want to do well in the future.

“Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.” Mark Twain

The Groups

Private dental practices should take note of what the big medical groups are doing operationally. While they operate in a different environment, many of the things they are doing are worthy of review and can potentially improve the bottom line of your practice. I am not advocating or judging these business practices, I am merely stating observations I have made this year.

For many of us these changes will go unnoticed but for those of us with pre-disposed conditions, these changes can be quite profound. The most dramatic change, will be the adoption of a more productive and profitable scheduling regimen. These groups realize that auxiliaries, technicians, registered nurses and nurse practitioners are qualified to augment the wellness model embraced by the group, thus freeing up valuable doctor/patient opportunities. Consequently, you will only see your physician every other or every three visits while the care giving team will arrange for your lab work, annual vaccines and record your vital signs periodically as required based on your age, weight, family history, pre – conditions and other factors.

It is a numbers game with emphasis on prevention. See as many patients as possible (generally thousands per provider), deliver procedures and prescribe tests to manage the patients health, reduce the doctors and groups liability from legal and compliance matters while keeping many procedures in-house that were once farmed out.

These groups have acquired most of the independent private care facilities in the bigger cities and suburbs over the last ten years. It is difficult to find an independent private care physician anymore.

Today, the larger groups are concentrating on integrating practice management software and various protocols throughout their network. They are focused on applying universal procedures and a standard of care model that reflects the group’s mission. Additionally, they have allocated a great deal of resources towards expanded clinical services, operational competencies and branding. These medical groups are focused on market dominance in the areas they serve. Their size and geographical dominance allows them to negotiate better fees from the insurance community. I expect these groups to grow over time. They will continue to expand their geographic reach and will identify other healthcare services to integrate for the sole purpose of adding revenue to their overall bottom line. Could optical, chiropractics, physical therapy, dental and alternative medicine be next?

What are the medical groups doing?

  • More services under one roof or within the medical group
  • Strategic relationships with specialists/specialty groups
  • Hundreds of  physicians representing 40 different medical specialties
  • Convenient locations in urban, rural and remote geographical areas (leveraging size and market penetration for better insurance fee reimbursement).
  • Strategic locations (blocking others from invading their marketing area)
  • Centralized billing
  • Laboratory services – many groups have strategic alliances with national laboratories
  • Infusion therapy/home care
  • Shared reception for multiple practitioners
  • Radiology services in-house, spurs immediate care recommendations and referrals
  • Expanded duties for auxiliaries- RN, Physician assistant, patient technicians
  • Patients do not see the doctor on every appointment in these organizations.
  • Extensive utilization of various practice management systems including billing modules, electronic claims modules, digital records, and patient communication and confirmation services.
  • Paperless offices – scanners are in use for insurance cards and prescriptions are sent digitally to the pharmacy.

Dentistry provides the patient with a better experience and more personalized care than our medical counterparts. Most dental facilities see their patients twice a year and are in a better position to identify a change in someone’s oral and physical well being. Your dental team will know more about your patients and their family members than the typical medical office will! This is quite significant and powerful if you think about it.

This coming year, let’s raise the bar on dentistry


The oral cavity is the gateway to the body and we must communicate the oral and systemic connection to our patients. Below are some ideas to consider regarding a wellness program for your office. Identify one or two from the list below and begin the transition to a more relevant doctor/patient relationship. I know change is difficult and I am aware that several of these recommendations will affect scheduling, training and patient education.

This is a movement and process that will take many years to administer but it will protect and expand dentistry’s relevance and importance to society!

  • Market the oral and systemic connection with regards to Periodontal disease, Oral cancer, HPV, Sleep disorders, Heart disease and Diabetes.
  • Emphasize oral hygiene and its effects on children, adults, geriatric patients and pregnancy.
  • Take courses on pharmacology. Know the popular drugs for the 40 plus generation and their side effects. The baby boomers represent the largest group of patients we serve!
  • Provide assisted Cancer screening in your office – look into Velscope™ and Identifi™ (the two most respected products on the market)
  • Consider taking blood pressure on hygiene patients
  • Consider taking your patients weight at hygiene appointments (a significant change in weight during the six month period can be a warning sign that something is wrong)
  • Provide Saliva testing on HPV, Perio and other key health markers. This reinforces that the mouth is the gateway to the body!
  • Implement a Sleep apnea and snoring program
  • Provide a Smoking cessation program
  • Have a formalized education program for your dental team so they can clearly communicate your dental services and discuss the mouth/body relationship


Last year 70% of all employer insurance programs were PPO’s and that trend is expected to continue. This will limit the practitioner’s ability to raise fees if they participate. If you continue to do dentistry the same way you always have, chances are that you will see a profit reduction. The only way to keep or grow your profitability is to increase efficiency and embrace technology. Of course, you can adapt some of the above recommendations and make yourself and your practice more appealing to the fee for service patient!

High Hopes for 2012

2011 tested our resilience and challenged our business models like no other year in memory. Business as usual was unusual in 2011 because most of us had to change. Some of the adjustments were needed and many were necessary because of technological advancements and economy. Competition was fierce and everyone had to step up their game.

In the long run, this instability forced us to reinvent ourselves and improve our efficiencies. Change was in vogue in 2011 and many of us crossed the bridge safely, some crossed it reluctantly and others stayed backed hoping things would return to the way they were.

I am very excited about 2012 because many of the social and political issues that have been unaddressed due to partisan politics will become priority after the 2012 presidential election. Most economic indicators suggest America’s trajectory is pointing in the correct direction and I believe most Americans want to regain and re-establish America’s superiority across the globe. As a parent with a seventeen year old son and twenty one year old daughter, I am quite aware of the challenges they will face when they enter the job market. The competition is global, the talent pool is formidable and many of the better paying jobs have been eliminated or have gone abroad. We are at a critical time and place in American history and many of our children do not have the education, skills or talent that many of our corporations seek today.

I am currently reading a wonderful book by Tom Friedman and Michael Mandelbaum that speaks about these and other global issues we are faced with today. The book is called; That Used to Be Us. I recommend this book because it explains the enormous obstacles America faces with clarity and a touch of optimism. In the book, Tom Friedman dedicates a chapter to the position that – Average Is Over. He acknowledges Tony Wagner – author of The Global Achievement Gap by sharing his teaching of the “The Three C’s – Creative Creators/Servers, Communication and Collaboration. Many of the job candidates from competing countries like China and India may have wonderful grades and SAT scores but may fall short in their ability to innovate, communicate and collaborate because their upbringing and culture did not cultivate those leadership skills.


Best wishes to you and your family for a happy, healthy and prosperous new year!

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