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Everything Dental Blog “Special Edition” – February 2014


An Interview with Linda Miles

EDB: Can you update us on what Linda Miles is up to for 2014?

LM: Even though I sold Linda Miles and Associates in 2007 and the Speaking Consulting Network in 2010, I stay very busy with OCC (www.oralcancercause.org) which Robin Morrison and I founded in 2012. OCC is a nonprofit that will provide financial assistance to the families or oral cancer patients during their medical treatment phase. The diagnoses is traumatic enough without worrying about monthly financials to feed the family, pay insurance premiums, car payments, utilities, rent or mortgage if the primary breadwinner’s ability to work is compromised.

EDB: Why is this foundation so important to you?

LM: I wanted to start something like this in 2009 when my best friend Lee Tarvin’s son David was diagnosed with stage 4 cancer of the tonsil. Finding the time to do this was an issue. At a dental meeting that Robin and I both attended, she told me her brother had just recently passed away with oral cancer. My sister in law Charlotte had been given months to live after having not been diagnosed early enough to save her life. As Robin and I talked, we realized that with our combined 80 plus years in dentistry and our family connection to the disease that year, it was meant to be that we team up and start OCC. Robin’s marketing savvy and web design experience was a huge plus to this endeavor.

EDB: How do you see OCC improving the clinical and business side of dentistry?

LM: By starting at the grassroots level providing education and awareness to patients of the need for oral cancer screenings…and how serious this disease is, patients will now be  ASKING for a screening versus saying “no thanks” if the dentist or team ask them if they wish to have one. We want every OCC practice to become the “go to” dental office as word spreads from current patients to those who will become new patients based on the fact their current dentist doesn’t mention this important screening or how oral cancer is on the rise. Increasing new patient numbers is always a great boost to practice productivity. We see oral cancer screenings becoming the next cosmetic whitening of dentistry, demand wise. Every person knows someone stricken with oral cancer. Whether the practice charges for the screenings or uses it as a marketing tool to let patients know how thorough and concerned they are, it is a huge benefit to every practice.

EDB: How do you see the Fee for Service business model in 2015 and beyond?

LM: It is becoming more difficult to maintain a FFS practice as patients view their benefit plan as just that…a benefit. I work with a few FFS practices and keep hoping as the percentage of FFS practices continue to decline each year (since 2005), that there will be more FFS patients to keep the diehard FFS practices busy….Educating the teams in those practices has become one of my major asked for services with AskLindaMiles.com. It takes positive verbal skills to help patients understand that the office is happy to see them regardless of what plan they are on…the only difference is the way in which you handle their account. They pay you and are reimbursed (if it is an indemnity or PPO plan). Some patients are happy to do this. When they see the low reimbursement they will understand why your office isn’t participating in the plan. Practices that take insurance plans and do write offs must be twice as proficient with well-trained team members as the only way insurance works effectively is more patients per provider hour and total efficiency. On the horizon with Obamacare I feel many employers in communities will drop dental as a benefit. If that is true, then the FFS practice will remain as it is or even grow in the years to come. No one really knows how all that will pan out. Not even those who came up with the plan. In light of that statement, I feel there will be more independent Discount Dental Plans in the future.

EDB: What direction would you take if you were opening a practice from scratch today – insurance model? – No insurance/FFS model? –  Hybrid model?  DMO/Medicaid model?

LM: It depends on the area in which I would start my practice. I’d begin with a demographic study to discover the ten biggest employers within a ten mile radius of the office. I’d be a hybrid model if I’m in a highly concentrated insurance neighborhood. I’d take the top 3 insurance plans with the largest number of employees but hope for noninsured patients as well. If on the other hand I opened in a retirement village area surrounded by wealthy people who love to look and feel twenty years younger I’d go the FFS route as the majority of my patients would not be insured. I’d concentrate on preventive and perio, basic and complete restorative, plus cosmetics. And I’d market heavily my Age Defying Dentistry.

EDB: Are Fee for Service practices extinct?

LM: Not yet…but declining. Some dentists would rather hang up their hand pieces and retire or find another profession than to take insurance of any kind.

EDB: What role will hygienists play in the future?

LM: I see the dental therapist and mid-level provider coming on the horizon…with expanded duties especially in the underserved areas of the country. I don’t see independent practices for hygienists. If they knew the risks involved in having their own business, hiring and training their teams and the ugly word “overhead” in running a business, they will gladly work as they work today as an employee and part of the team. I hope in the future hygienists start getting more respect from their dentists. If the dentist resents what they pay the hygienists (and some do), it causes the rest of the team to treat the RDHs poorly. It is such a pleasure to have worked with clients over the years who have a true team and respect going back and forth among everyone there.

EDB: Do you believe in expanded duties and mid-level care givers?

LM: See above….I also feel there will be more Expanded Function Dental Assistants. They are eager to learn and do more.

EDB: What percentage of the dental practice population will be corporate dentistry in 5 years?

LM: I see corporate dentistry continuing to slowly grow. New grads have such high debt upon graduation that the fulltime guarantee of a salary plus benefits sounds good to them. Some will become disenchanted if the ethics, training nor future opportunities are not there….so they will move on. In the next ten years I see FFS being 15%; solo doctor practices 25%; groups 2-6 doctors 30% and larger corps 30%. Some corps that were not well designed have created a negative about corporate dentistry. The cream will rise to the top and the successful will become more so while the non successful will drop out, creating less growth than some predict.

EDB: What do you think will happen to specialists as more offices are engaged in multi-specialty services?

LM: I have concern for the specialists more than the GPs. Again the successful group or solo specialty practices will continue to succeed as long as their referral sources stay strong. Many specialists will jump ship and join the corporations to avoid the higher marketing costs to compete. Some will have no office and work 3 to 5 days per week (one day in each) as a traveling specialist in several practices.

EDB: Are there any specialists that you think will thrive in the future?

LM: It will be tough. More GPs are doing RCT, implants, surgical extractions, perio and seeing more children.

EDB:  Are there any good programs for Drs. who seek to open a second or third office? (that 800K to 2.4 K office)?

LM: Some dentists are buying up declining practices. Many of them bought a gold mine of perio and incomplete dentistry. I don’t know many dentists who enjoy the business side of dentistry and the staffing issues enough to want more than one office to deal with….Entrepreneurial dentists will surely be interested but I don’t know of any programs that specialize in how to expand from one to several. Perhaps someone should start one?

EDB: What do you think about dentists doing facial fillers and other cosmetic services that are not in the oral cavity?

LM: I’m sure some enjoy that but as a patient I would seek a cosmetic facial surgeons practice for anything to do with facial cosmetics, fillers etc.

EDB: Please tell me why the consultants at SCN provide value for any doctor growing their business and relevance?

LM: Most SCNers are seasoned professionals with 5 or more years in the business…some twenty plus. They offer a variety of services and often collaborate and refer to one another as we know what each person specializes in. No one consultant has it all. We know our strengths and weaknesses…and we know WHO can fix the parts of that practice better than anyone in the profession.

EDB: Do you have one pearl to share with the dental community (practicing dentists)?

LM: Your team makes or breaks your practice. Take care of your people and they will take care of you and your patients! HIRE, TRAIN, TRUST AND PRAISE them. They will then have “owner mentality” versus “unionized thinking”.

Jack: Thank You

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