Everything Dental Blog – August 2016

The Burden of Knowing

Do you debunk consensus and challenge the status quo for a greater purpose?

My son Jordan (21 years wise) and I recently had a serious man to man talk. He accused me of being a wimp because I didn’t speak up when a client spewed political nonsense at a recent business dinner. All of Jordan’s life, he has observed me enjoy vigorous debate and knows that I am extremely passionate about certain issues. I did my best to defend myself and gave a compelling argument for maintaining decorum, but Jordan wasn’t satisfied with my explanation.

Over the last few weeks I have given much thought regarding my conversation with Jordan. It’s true, I have suppressed my opinions and have opted out of many healthy debates over the years. As a sales professional I have never wanted to alienate a customer or interfere with the sales process. This is actually counter intuitive to my persona as described by family and industry leaders. Most would tell you that I am outspoken and consistently operate with purpose.

Twenty four years ago I had a few clients who insisted on making their own amalgam with alloy filings and mercury. The industry had already shifted to pre-made capsules but some clinicians insisted on making their own spills of amalgam balls on premises. This took place at a time when younger dentists pledged to never use amalgam and many older dentists were moving towards composite fillings. This was one of those moments in time when I had to decide if I was an instrument of change or not. Would I risk confrontation (challenge that customer) to make a greater point? Sadly, twenty four years ago I did not.

In the late eighties a French company called Trophy Radiologie S.A. ™ began a revolution. They were true pioneers in the digital intraoral radiography market. In the early nineties another company called Schick™ took the U.S. market by storm until the demand was slowed by a challenged infrastructure. About a decade later, the majority of dental offices were computerized and the capture, store and share challenges of the imaging software were resolved. At this juncture, the market place was poised for digital and a company called Dexis™ teamed up with Henry Schein Dental. In my opinion, that initiated a race amongst the manufacturers and dental distributors for digital dominance and market share. For me, that was the tipping point for accelerated conversion rates in my territory. Today the market place is nearly 90% digital with Dexis™, Schick™ and Carestream/Kodak™ leading the way.

Looking back, this was an exciting period in distribution history because the technology and convenience transformed the dental workplace. Another interesting phenomenon that came out of that era was the pattern of technology acquisition. The specialists and early adopters embraced the technology first, followed by the general dentist population. Dentists knew the technology was transformational and acquisition was an inevitability. It wasn’t a matter of would the dentist go digital? It was more about when they would go digital! During this period I was proactive and had the KOL’S on my side. I moved eighty nine of my one hundred and twenty clients to digital in less than five years! I think Jordan would have given me two thumbs up for advocating and executing on this digital movement.

In the mid-nineties, I was a distributor trainer for a unique product called Actisite®. Actisite® is a periodontal fiber (like retraction cord) impregnated with Tetracycline Hydrochloride that the clinician places subgingavally around the infected gum site. Back then, general dentists were resistant to providing any periodontal therapy in their offices. This was one of those times that I knew the trend, realized the need, understood the financial windfall but had to manage my level of advocacy. I met a great deal of resistance on this front so I developed a balanced game plan. I didn’t want to offend the periodontist, with whom I believed in and I didn’t want to ignore the opportunity for my GP’S either. Because of my direct but respectful advocacy for periodontal therapy back then, I have one of the largest dealer territories for Arestin™ today. I think Jordan would be respectful of my accomplishment but critical of my diluted effort and the two decades it took to arrive at this place.

In the mid-nineties rotary endodontics took off with the general dentist community. These earlier rotary endodontic systems were not sold through distribution and for many years the dealer rep ignored the endo business entirely. Prior to this endodontic revolution, GP’S who performed RCT used stainless steel hand files and referred the difficult cases to the Endodontist. While a significant segment of GP’S were embracing rotary endo, many dentists were uncomfortable with tapered, NiTi files and aggressive boring techniques. Back then, many dentists didn’t like to do endo and they didn’t need to. In simpler times, the GP referred everything out to the specialists and dental insurance was not nearly as invasive as it is today.

During the dark ages of this endodontic period, the distribution community was isolated and unengaged in the endo market. It was a disappointing moment in our history but a pivotal moment just the same. It has forever changed attitudes and continues to affect executive decisions regarding market share targets, product/service exclusivity and distribution rights in the U.S. and abroad.

It is difficult to assess my performance and leadership during this time. I remember those earlier days and still feel resentment towards those endodontic companies that chose to circumvent distribution. However, most of those patents have expired and I am regaining market share daily. Unfortunately, I was more of a spectator than instrument of change for almost two decadesL.

Today, Digital Impressioning and CadCam have the same momentum digital radiography had when it tipped. Doctors are excited to embrace and integrate digital impressioning and CadCam into their practices. Just like digital radiography, CadCam is transformative and improves clinical outcomes. It is estimated that over 40% of the dental offices in the U.S. will have a scanner or full CadCam system in their office within the next five years. Interestingly, the pattern of acquisition for this technology is different. This time around, the early adopters and dental groups have led the way and now the GP’s are onboarding. The windfall for offices who integrate CadCam is remarkable. We have evidence that CadCam offices attract more new patients, do more Implant Dentistry and identify a lot more same day dentistry in their offices.

If you work in dentistry than you know the status quo is under attack. If you are a consultant or coach than you are experiencing more interest in your services because dentists are trying to remain relevant while growing revenue in these changing times. If you are a dental dealer, group dentistry poses a huge opportunity and risk to your customer base and market share. If you are a dealer rep, the consolidation and movement towards group dentistry puts your career in jeopardy unless you possess unique business and/or clinical skills. If you are a dentist, the pressure to perform and execute has never been more daunting. Insurance dependency, regulatory mandates, the high cost of modernizing the facility and competing with the big boys are all significant challenges.

While I am not a prophet, I know what is happening to our dental community. Over the next three to five years 35-40% of dentists will become a group practice (two or more docs), will join/merge with a dental group or will acquire another practice. Those that do not expand and those that resist technology will slowly be marginalized or will have a tougher go at it.

As I travel my territory and analyze the numbers I can see which clients are up, which are down and who is growing. I am very fortunate to work with some of the best dental practices in America. I have clients that are 100% Fee for Service. I have several dozen that accept the better PPO’s and many that are on panel for PPO’s and DMO plans. In addition, I have a few Medicaid offices and three regional group accounts that I serve. These facilities provide me with a smattering of what works and what does not work in the real dental world.

While writing this month’s blog, I had a great deal of introspection. Jordan helped me see my role in a different light. I now realize that after two decades of helping my clients I have earned the right and have an obligation to tell them what’s going on around them. This is one of those moments in time that I will speak out without restraint. Here are three critical things my clients and all dentists should consider; (1). Know your numbers [schedule a demo of Dental Practice Pro with your offices data uploaded into the program – DentalPracticePro.com ]. (2). Embrace technology and focus on comprehensive patient care (grow your hourly production rate). (3). Improve your clinical and operational efficiencies [invest in a proven consulting organization and grow your over-all production by 20 – 30+ % over the next 18months!].

I hope you had a great summer.