• Sedation Dentistry: Too Good To Be True?

• The Risk of Spinal Cord Injuries to Dental Patients

• Regulating Sedation Dentistry: Is it Political?

• Meeting the Needs of Elderly Dental Patients

• Increasing the Value to Your Patient/Guest

• Discounting Your Fees Is NOT the Answer

• Time to Celebrate the Future

• Do You Know your Teams’ Compatibility Quotient?

• Can There Be Healthcare Reform Without a Public Option?

• Should General Practitioners Treat Children?

Sedation Dentistry: Too Good To Be True?

While I was growing up, my mother often repeated to me a warning that many mothers repeat to their children: "If something sounds too good to be true, it probably is."

Like most of my mother’s warnings, I put this one to the test at every opportunity; and like most of my mother’s warnings, I regretted every time that I did.

Today, dental patients are being offered a proposition that surely must sound too good to be true for them: pain-free dental treatment. This comes in the form of sedation dentistry, the latest craze to sweep the dental industry.

Through the use of various sedatives, administered either orally or intravenously (or a combination of both), sedation dentistry has the potential to end the anxiety and discomfort traditionally suffered by patients while receiving dental treatment.

However, it also has the potential to end a patient’s life.

A number of children have died from complications resulting from sedation dentistry. Consequently, proponents of the technique have recommended that its use be reserved only for adult patients. Beginning in 2007, however, sedation dentistry began claiming adult victims as well, often resulting in costly litigation.

The threat posed by sedation dentistry can be attributed to the combinations of drugs used in sedating a patient. Previously, such drugs were traditionally reserved only for use during the most pain-inducing of surgical procedures – not routine treatments. There is always an inherent risk, even if a relatively small one, associated with sedating a patient, and so doing so has generally been considered a last resort option. Using sedation techniques so much more liberally only unnecessarily exposes more patients to this underlying risk. Different bodies absorb different drugs at different rates, making the effects of drugs on a particular patient’s body difficult to predict, monitor, or address. For this reason, the ADA remains wary of endorsing sedation dentistry. As ADA spokesperson Joel Weaver explained, "Because there is such a wide variable in how rapidly or how slowly patients absorb drugs by the oral route, the ADA believes there is increasing potential for sedating patients to a level that is deeper than the dentist intended."

Furthermore, there remains the question of whether general dental practitioners can ever truly be fully equipped and prepared to handle what complications may occur from sedating patients. Hospitals have large staffs and the latest in state-of-the-art equipment on hand to treat a patient should complications arise from sedation. While a dentist may acquire basic training with regard to sedation practices, he or she simply will not be as capable of responding to complications as a well-equipped and extensively trained hospital staff would be. As Dr. Lee Winter, chief anesthesiologist at New York Downtown Hospital, put it, “There is no safety net when using sedation in an office.”

For dentists as well as patients, sedation dentistry is a prospect seemingly too good to be true. A practitioner that offers sedation dentistry has the potential to substantially increase the profitability of his or her business – not only by attracting new customers that might otherwise be too wary of the expected pain and anxiety to visit the dentist, but also by charging those customers sizable fees for this additional service. But at what costs could these profits come at? What hidden risks are being taken for the sake of them?

The Risk of Spinal Cord Injuries to Dental Patients

The following story should serve as a warning to all dentists, though particularly those that treat elderly patients.

Earlier this year, a 79-year-old Chicago woman visited a local periodontist to have an implant placed. The procedure required that a particular tooth be extracted from the women’s mouth. As this was being done, the woman alleges that the specialist positioned her head at a particularly awkward and uncomfortable angle, and an exceptional amount of strain was placed on her neck. Initially, the woman felt no ill effects in the aftermath of the procedure, and she was able to leave the office under her own power. For the remainder of the day, she went about her usual business – i.e.: shopping at stores, watching television – before retiring to bed that night. When she awoke the next morning, however, she received a horrific surprise: she was paralyzed from the neck down.

The woman’s husband quickly contacted emergency services and an ambulance rushed her to a nearby hospital. There, she was diagnosed with Central Cord Syndrome (CCS), a form of spinal cord injury most commonly occurring in elderly adults. CCS usually results from hyperextension injuries to the neck area, which can occur when the neck has been either flexed forward or extended backward to an exceptional degree, causing the spinal cord to become pinched between the front of the cervical vertebrae and the ligament on the back it. CCS can reduce or extinguish motor ability in all four limbs, but usually afflicts the arms more than the legs. After many months of physical therapy, the woman eventually managed to recover the ability to use her legs and left arm; however, as of this writing, she still has not regained the use of her right arm – and doctors believe she likely never will. Not surprisingly, the woman has since filed a malpractice suit against her periodontist, citing the unusually rough treatment she received from him as the cause of her injuries.

This story serves to illustrate the sort of unique but severe risks associated with the treatment of elderly dental patients. When treating an elderly patient, a dentist must remain mindful at all times of the patient’s potentially delicate physical condition. The dentist should make every effort to ensure that the patient’s neck is not hyperflexed or hyperextended in the course of treatment. The dentist should also inquire beforehand as to whether or not the patient has a history of neck or back troubles and, if possible, even request that tests be done to uncover any hidden risk factors.

Regulating Sedation Dentistry: Is it Political?

In recent years, oral conscious sedation (OCS) has taken the dental industry by storm. That this has happened should come as no surprise, as OCS offers dental patients their long sought-after equivalent of the Holy Grail: the prospect of pain-free dental treatment.

Over time, OCS has become increasingly more popular, safe, and efficient. Yet paradoxically, it has also become more regulated, scrutinized, and criticized.

Many among OCS’s increasingly more vocal collection of critics have derided it as "sleep dentistry" – a flagrantly deceptive label, as patients generally remain conscious while receiving this treatment. In implying that patients are put to sleep during OCS, the term not only fails to acknowledge the complexity of the procedure, but also fiendishly suggests that the patients are being placed in a potentially unsafe situation.

Initially, the ADA looked favorably on the proliferation of sedation dentistry, even praising its "remarkable record of safety." However, there since appears to have been a sudden and inexplicable turnaround in the association’s outlook on the matter, as it has spent the last two years overhauling its regulations to increase the extent of training required in order for a dentist to be considered qualified to practice OCS. A number of state dental boards have followed suit, likewise toughening their restrictions on OCS practitioners. The result of these actions has been to reduce the number of dentists able and willing to offer OCS to patients.

This apparent crackdown on sedation dentistry is being done under the guise of public safety concerns. However, despite an array of speculative criticisms, studies show that OCS actually poses less risk to a patient’s well-being than the typical anesthetic treatment one would receive in a hospital. Furthermore, it offers a wealth of benefits to both patients and practitioners alike. Patients that might otherwise be deterred by the traditionally accompanying pain and discomfort will be far less reluctant to visit the dentist and receive necessary and perhaps overdue treatment; meanwhile, the influx of such new and willing patients has the potential to substantially increase the profitability of a dentist’s business.

Given thus, the question then arises: what is the real driving force behind the suppression of sedation dentistry? In answering that question, many dentists claim there is a sinister ulterior motive at work: politics.

Since its inception, sedation dentistry has threatened the practices of such industry specialists as anesthesiologists and oral surgeons. These specialists’ businesses thrive on their ability to offer exclusive services at lofty prices. Sedation dentistry, however, enables general practitioners to offer many of those same services, such as tooth extractions, and at more affordable prices, thus forcing the specialists to either lower their own prices in order to compete with those of OCS practitioners or face the possibility of being driven out of business by them. In response, these specialists have lobbied the ADA and state dental boards hard to ensure that the growth of sedation dentistry is stemmed by the implementation of unnecessary and overbearing regulations.

The advocacy group Trust for Equal Access Medicine (TEAM) 1500 blasted the efforts to suppress sedation dentistry, claiming that they unfairly discriminate against underprivileged patients by depriving them of a very desirable, beneficial, and economical form of dental treatment.

"Team 1500 believes that these unjustified regulations disproportionately impact the poor and minorities and raise the cost of quality medical and dental care for everyone," read a statement issued by the group. "By imposing unnecessary regulatory hurdles on the general practitioner, the ADA and the state dental boards that rely upon the ADA to help establish their regulations, are making it more difficult for members of the public at large to have access to safe, affordable, quality oral healthcare."

Recent polls show that a majority of dentists either already offer OCS or have a desire to do so. That sedation dentistry is becoming increasingly difficult, and in some cases impossible for them to practice is a source of much anger and frustration for many of them.

"The recent rule changes advocated by the ADA are ridiculous," one anonymous dentist declared in a website blog, echoing a sentiment shared by many of his colleagues.

"We need regulations," another dentist acknowledged, "but not the knee-jerk, specialist-protectionist, overreaction that is being fabricated by the ADA."

"Oral surgeons and others are increasingly obstructive in their efforts to block sedation in any form by non specialists," wrote yet another dentist. "They ignore the safety record established by general practitioners who have provided many thousands of sedations over the last 12 years."

One dentist even attempted to rally his fellow practitioners with a figurative call to arms: "Currently OCS is surrounded by an entanglement of special interest groups. It is time we as dentists who have been certified be able to provide this safe and time-proven technique of patient care!"

Dental consultant Jim Du Molin succinctly summed up the views of many dentists on the matter. "Oral conscious sedation may be the most controversial topic in dentistry right now," he said. "It hurts me to think of how many patients won’t get dental care if the ADA’s new guidelines – engineered by the surgeons – go into effect. Is it really in patients’ best interest to limit their dental options?"

Meeting the Needs of Elderly Dental Patients

It has been estimated that roughly three decades from now, senior citizens will comprise more than 20% of the US population. As the number of senior citizens in the country continues to rise, dentists are likely to see a correlating increase in the number of elderly patients seeking dental treatment. Consequently, dentists must be thoroughly prepared to meet the specific needs of these patients.

To provide an elderly patient with the most efficient treatment possible, a dentist must be cognizant of the inherent differences between an elderly patient and a younger one and the potential challenges an elderly patient poses. For example, an estimated 85% of senior citizens are afflicted with at least one chronic illness, while as many as 30% have three or more. Such ailments often have a direct impact on oral health, and vice versa. When treating an elderly patient, a dentist must be aware of such underlying health conditions and the potential correlation between them and the patient’s oral health. If a dentist can identify issues beyond the mouth that are affecting the patient’s oral health, then that dentist can more effectively treat the problems inside the mouth. Likewise, as a dentist treats an elderly patient, he or she should keep a constant lookout for problems inside the mouth than can potentially lead to other health-related issues.

"We see things in the mouth that could be related to other systemic problems," explained John C. Chandler, DDS, MAGD, of the Academy of General Dentistry (AGD). "If we identify those, we encourage patients to talk to their physicians about it."

Elderly patients generally have weaker immune systems than young ones, and their mouths produce less saliva. Such factors make the older patients more susceptible to dental diseases and the diseases potentially more difficult to control. Furthermore, with senior citizens taking an estimated average of six to ten different medications at once, there is a strong likelihood that an elderly patient is taking some form of medication, which can also impact oral health and further complicate treatment. A dentist must carefully review a patient’s medical history and should request to be provided with a list of any medications that a patient is currently taking.

Dentists should also strive to educate elderly patients on the importance of maintaining oral health and its potential impact on other aspects of their health. For example, many denture-wearers are under the false impression that their lack of real teeth removes the necessity of habitual dental visits – a notion that could not be farther from the truth. Dentists must be both patient and persistent when discussing such critical matters with elderly patients, who may sometimes have difficulty understanding or hearing their explanations. Dentists should also take careful note of even the most mundane of comments and complaints made by elderly patients, as they can often bear relevance to more significant issues. For example, a reference to dry mouth may actually indicate a side effect of medication.

Dentists must also pay heed to the often delicate physical state of elderly patients when treating them. Putting such patients in positions that place too much strain on their back or neck can potentially result in surprisingly serious injuries – and surprisingly large malpractice suits! A dentist should inquire before treating an elderly patient as to whether or not he or she has a history of back or neck problems.

As AGD spokesperson James W. Little, DMD, put it, "The reality is, there are going to be more and more older patients. It’s a matter of dentists getting used to older patients."

Increasing the Value to Your Patient/Guest

As a progressive cosmetic dentist, you apply proven dental principles to your patient care for consistent, high-quality results. The same applies to how you manage your practice: you need to apply sound business principles to achieve sustained success. This is particularly important as a cosmetic practice, since you are competing in a highly competitive marketplace—the one for discretionary spending. In the discretionary spending marketplace, you have different competitors than the average general practice, and your patients/guests have different buying criteria. To compete in this environment, your standards of practice operations need to be higher. You are now competing with other businesses—and they have years of marketing experience, in which they have tuned their message and honed their guest services. In this marketplace, your buyers have more sophisticated needs and demands. Fortunately, there is good news: because discretionary spending deals with wants rather than needs, you can price to the value—not to the cost. What does a laminate veneer, including chair time, actually cost? What is the value of a healthy, beautiful smile to a highly motivated patient/guest?

Understanding Value
All businesses exhibit two components to quality: conformance quality and perceived quality. Conformance quality is the technical aspect of the business. In the computer field, it would be chip speed, screen resolution, etc. In dentistry, conformance quality includes the margins, occlusion, etc. Perceived quality involves the perceptions of your customer, client, or patient/guest. In the restaurant business, the ambience of the facility, how the servers treat the guest, etc. all affect the patrons’ perceptions. In your practice, what is the ambience of the reception area? How are your patients/guests greeted—if at all?

Why is this important to understand? In the dental office, the dentist and dental team are the experts on conformance quality. But the experts on perceived quality are your patients/guests. If the dental team is the expert on conformance quality and the patient/guest is the expert on perceived quality, how do you think the patient/guest determines if they are in the right practice? You got it: by the perceived quality. You build your practice on conformance quality—clinical excellence—but you market perceived quality.

The combination of conformance quality and perceived quality determines overall quality. Once your patient/guest looks at your qualities and your fees, he or she can now make a determination as to the value you provide. Quality relative to price determines value. If your price is too high relative to your quality, you will have a low value. Understand that your fees and pricing are part of your marketing: if your price is too low, you may actually detract from your value and be perceived as poor quality.

So how can you increase the value perceived by your patient/guest? This very term, patient/guest, is a perfect example of creating more value. Imagine an individual walks into your practice and you refer to them as your next “patient”. What is their response? Probably there’s no response—you’re no different than any other dentist he or she has visited. Now imagine if instead, you referred to that patient as your next “guest”. What is the difference in reaction?

Think of the difference in these terms: what do you think when I say the word “patient”? At most, it’s an indifferent term, though in many cases it can be pretty negative, particularly in the medical field. But what do you think about the word “guest”—doesn’t this person suddenly sound important? When you invite a guest to your home, typically (unless an in-law) a guest is someone special, someone you are looking forward to seeing and welcoming. The same applies to your patients: start thinking of them as guests, and a subtle change in both your and your team’s behavior will send a completely different message to your guests—and your guests will perceive the difference. Yes, you are in the health care business, and yes, they are still patients, but that doesn’t mean you can’t treat them as your guests. But just changing a word means nothing if you haven’t set up systems that reinforce the intended meaning.

Quality: A Series of Events
Assuming you already have a commitment to clinical excellence, or conformance quality, how do you raise the perceived value of your practice? There are systems that can easily be set into your practice so patients/guests have the ride of their life—or at least their best ever in a dental office.

Have you ever been on the jungle cruise in a Disney park? You step onto a boat that slowly takes you into the jungle. The cruise is rehearsed—planned, not canned; perfectly scripted and timed. Every time the boat goes around this one corner, a mechanical hippo raises its head and the Disney guide shoots the gun to scare it off—every time, all the time. Your practice needs to be structured the same way. In the Dental Concierge® program we call the concept of the jungle cruise a “cycle of care.” You want to “jungle cruise” your practice. Your practice can have several cycles of care; cosmetic cycle of care, dental implants cycle of care, etc. As the guests move through the practice—as on the boat—everything happens exactly on cue, every time, at each step of the way, in each cycle of care. How is the telephone answered? Who greets the guest, with what words, the moment they walk in? What happens during the first appointment? All of these issues and more must be planned and choreographed.

Your team must also know what cycle of care/jungle cruise your guest is on. Why is this important? Because the jungle cruise is so well choreographed, a Disney executive can stand on the pier as a boat lands, and as the guests disembark, he knows exactly what they have experienced. He can ask them how they liked the spray of water from the bathing elephant, or the scary alligators—he can talk to any of the guests with total confidence about what they’ve just experienced. It should work the same in your practice. Your entire team should know what has happened to your guest on the cruise/cycle of care he or she has just experienced in your practice. The administrative team knows exactly what took place in the clinical area; the clinical team knows what the guest can expect from the administrative part of the team. The ability of your team to talk with confidence to any of your guests has a huge impact. You must create a seamless chain of positive events to raise their perception of quality, thereby increasing your value in the eyes of your guests.

People vs. Process
Once established, how do you maintain consistent high value? First and foremost, it has to do with people—the right people. When it comes to long-term success, the practice with the best people wins. And the best people, the right people for your practice, are individuals who know how to play on a team. The stellar practices have long ago outgrown the concept of one or even two people as all-stars, with the rest of the team as supporting cast. If you are to create a seamless chain of events, each critical step needs to be handled with expertise and skill. So how do we get a team of all-stars to work at an optimum level day in, day out? The second step is putting those people in the right working environment.

There are two types of companies: process companies and people companies. Process companies are like McDonald’s, where every step is set up as a simple process to ensure consistent quality. All of McDonald’s processes provide service just above the customer’s expectations. When you buy a medium cup of soda, the server picks up a medium cup, fills it with ice, and hits the medium button on the machine. The cup is filled with the appropriate amount of soda so the guest gets his or her money’s worth, but the soda doesn’t run over and make a mess. The buzzer for fries goes off so they are always cooked consistently. As you may have figured out, it doesn’t take a lot of brain power from the server to assure consistent quality—the process assures the quality.

In direct contrast are people companies, like real estate companies. In real estate, 20 percent of the agents sell 80 percent of the properties. They are all-stars, and as all-stars they become very busy. Many times these agents get so busy they become overwhelmed, and thus they burn out and the quality of service is lost.

Best of Both Worlds
In your practice you want to combine the two concepts—people and process. Work with a team of all-stars, but put in processes/systems that stop the quality of care from ever going below the expectations of your guests. This will ensure your guest always experiences consistent high quality, while saving you and your team from suffering burnout. During the jungle cruise, not every passenger knows the boat is being pulled by a chain through the river, or that the guide is pretending to steer the boat. In this case, steering the boat can be reduced to a process. It is a given route through a timed sequence of events. This allows the guides, who know the script by heart, to focus their attention on entertaining the guests. By combining process and people skills, they consistently get the best result.

To apply this winning combination to cosmetic practices, consider financial arrangements. Many historical practices are typically people companies, with the all-star treatment coordinator working far too hard to get a signed financial arrangement. They think obtaining a financial arrangement is stressful, or even requires a special skill or magic. In most cases, it should be as easy as checking out at the supermarket. The mechanics of financial arrangements prior to care can be reduced to a few simple steps, so it becomes a process. When a financial arrangement is incorporated correctly into a cycle of care, it should allow your treatment coordinator to focus his or her people skills on the guest, not the process—just like the jungle cruise. Save those all-star skills for better things—don’t waste them on simple redundant processes that will lead to burnout.

You compete in a tough market for discretionary spending: it’s hard now, and it’s going to become even more competitive. To ensure long-term success, you need to build a strong team and set up systems in your practice to maximize everyone’s performance. This way, you create exceptional value for your guests without wasting anyone’s time or skills. You need to manage your practice at the same high level you perform dentistry.

Discounting Your Fees Is NOT the Answer

Yes, these economic times are unique. Practice growth and profitability goals can seem difficult to reach. Making sure your current patients/guests accept care and/or actually show up for appointments can be a challenge. And attracting new patients/guests can be expensive and daunting.

How is a practice to thrive in these times? Some dentists assume that scaling back—discounting fees and cutting cost is the answer. But beware: these tactics have serious ramifications. Not only can they negatively impact your commitment to clinical excellence, but they can also damage your practice’s reputation in the community. You have invested considerable time, effort and money to develop your skills and your brand/image. Don’t devalue this investment with shortsighted tactics.

Discounting Your Fees –Impacting Your Brand
First of all let’s establish a very basic definition of “Brand”. A Brand is your identity, distinguishing you from all the other options available to consumers. More than just a logo, which is the graphic representation of your business, a brand communicates everything about you. A brand characterizes your business, encompassing what you do and how you do it. Everything you do must reinforce your brand. In his article Discounting Prices Discounts your Brand in MarketingProfs, (http://www.mpdailyfix.com/2008/08/thinking_about_discounting_ret.html), Paul Williams states “The problem with discounts is that customers don't see the price drop the same way you do. As a business person, you clearly understand you are temporarily cutting into your own profit to give a little more to the customer and keep their business. As customers we see it different. The moment you discount, it re-calibrates the perceived value of your products/services. Selling something for $200 today and discounting for $150 tells us you are making more money on the $200 version... And you're still making money on the $150 version... so the $200 version was over-priced. The new perceived value is $150. As a consumer buying something, we get this. As a marketer selling something, we tend to ignore this fact."

Another downside to discounting; it is the easiest competitive move to counter. It is just as easy for your competitor, be it another dentist or any other consumer product, to lower price as it is for you. Therefore, if your practice is based on quality, you will probably never be the lowest cost. The anticipated increase in production from discounting will probably never materialize- you’ll just end up doing the same care at a lower fee and dramatically lower profit.

Differentiation VS Discounting
Businesses with a consistent track record of success, competing in the quality/service marketplace (rather than low cost producer marketplace) understand they need to continually enhance their Brand by providing more value. By providing more value they differentiate themselves from their competitors in the marketplace.

Raising the Value of Your Brand
In the consumers eyes quality relative to price determines value (Q/P = V). If your price is too high relative to quality you will have a low value. If your price is too low, you may actually detract from your value and be perceived as poor quality. Your fees (pricing) are part of your Branding. This is where discounting can negatively impact your Brand.

Understanding Quality
In every business quality is comprised of two components, conformance quality and perceived quality. Conformance quality is the technical aspect, in dentistry it would be the margins, occlusion etc. Perceived quality has to do with the “perceptions” of your patient/guest; the ambience of the reception area, were they seen on time, etc. You are the expert on conformance quality and in the consumers eyes the mere fact you have a dental license implies some acceptable degree conformance quality. Perceived quality is based on the opinions and experiences of your patient/guest. The patient/guest is the expert on perceived quality, therefore perceived quality becomes the significant determining factor in their buying decisions.

Boosting Perceived Quality
You build your practice on conformance quality (clinical excellence) but you market the perceived quality; listening, caring and a variety of services beyond just “doing a crown”. This important concept dramatically influences treatment acceptance and practice growth. To be successful in today’s competitive environment, a practice must offer state-of-the-art services consistent with their quality of clinical care. Together, the entire package creates a higher value to the consumer.

Grow Your Practice.
How do you increase the value of your Brand and motivate your current patient/guest to keep appointments, reactivate the ones that are overdue, attract new patients- and get them all to accept treatment? How do you avoid discounting your fees and possibly being forced into using a cut-rate lab, switching to cheaper materials or lying off a key employee?

Tactics Consistent With Long-Term Success
The key is value added services- make it easy for guests to communicate with your practice and make them feel appreciated. Many progressive practices find the Dental Concierge® turn your patients into guests system with the Loyal Patients Rewards Program consistent with their values of clinical excellence, exceptional guests services and effective cost control. It is the integration of some the very best components of two proven programs: The Dental Concierge® turn your patients into guests- a marketing, management and customer service training program and Loyal Patient™ Rewards- the first and only program to provide dental practices a turnkey, patent-pending, technology-driven patient rewards system. All wrapped into one easy to use system that will enhance your practice’s Brand and increase your bottom line.

Automated Guests Services
Most practice have been using healthcare credit cards with their easy to use technology for many years, and more recently over the last few years automated patient communications with their technology have made significant inroads into practices. The two have become the “standard of care” for most well run practices. The Loyal Patients Rewards program is just the natural evolution of automated guest services. It automates the communication process with your guests; confirmations of appointments, reactivation of guests, birthday wishes, their practice anniversary, monthly ongoing communications, guests’ surveys, and practice newsletters AND Rewards them for behaviors consistent with their well being. It is the most complete and cost effective, web-based service offered today.

Rewards That Really Do Motivate
Rewards programs have been proven to influence purchasing decisions and engender loyalty. The Loyal Patients Rewards program is derived from a similar program many Fortune 500 companies have used successfully for years; it automatically promotes tracks and delivers valuable rewards. These rewards are earned for behaviors consistent with guests well being and in appreciation for their loyalty to the practice.

The Rewards program is more than just a reminder or promotional communication. This “Value Added” service presents a more compelling reason for patients/guests to read your communications and to return for care, it offers rewards. With the buying power of major companies behind them, a practice can now reward clients $1000‘s in rewards - all for a fraction of the actual cost. These rewards can be used instantly - no waiting to accumulate points!

Quality Care Is the Focus, and Profitability Is the Result
Most progressive practices never take their focus off the pursuit of clinical excellence, and implementing the Rewards program is a consistent step in the evolution of a well-run practice. Learning from the experience of other advanced organizations, dental practices can now utilize programs like these not just for the good of their valued guests, but also for their own benefit, by cutting costs while efficiently utilizing their team.

Four Simple Steps in Proven Business Tactics
With a conservative approach to the practice’s financial performance, let’s take a step-by-step approach to increasing the value to your guests by implementing this new service.

Practice Profile

• One dentist working 184 days per year (4 days per week × 46 weeks per year) at $3500 per day = $644,000 or $438 per hour.
• Two hygienists, both working 184 days each, $1000 per day at $125 per hour = $368,000.
• Total annual production = $1,012,000 per year, or $84,333 per month with a 35% net income.

1.Reduce no-shows/cancellations in general practice.
Focus: Current patients, New Patients.
Implementation: Enroll current patients into the Rewards program for their convenience, using rewards to reduce cancellations or no-show appointments. Offer Rewards program to new patients prior to their appointment to decrease no-show rate.

Eliminating two missed appointments, one hour each, per week would result in an annual increase in production of $40,296 ($438 per hour × 2 appointments × 46 weeks = $40,296). This estimate does not include the lost potential of additional treatment or lost referrals.

2.Reduce no-shows/cancellations in hygiene department.
Focus: Current patients, New Patients.
Implementation: Enroll current patients into the Rewards program for their convenience, using rewards to reduce cancellations or no-show appointments. Offer Rewards program to new patients prior to their appointment to decrease no-show rate

Eliminating two missed appointments, one hour each, per week, per hygienist would result in an annual increase in production of $23,000 ($125 per hour × 2 hygienists × 2 appointments × 46 weeks = $23,000). This estimate does not include the lost potential of additional treatment or lost referrals.

3.Reactivation of current patients/guests.
Focus: Current patients.
Implementation: Re-enroll inactive patients back into the practice utilizing the Rewards program.

Average new patient value ranges from $1200 to over $4500 depending on the practice. If we estimate an inactive patient has at least $2500 of needed care and we only reactivated one additional patient per month, it would still result in an additional $30,000 in increased production (1 reactivated patient = $2500 × 12 months = $30,000). This could also yield more referrals to the practice.

4. Increase new patients.
Focus: Current patients
Implementation: Consistently and automatically reward patients/guests enrolled into the Rewards program for recommending the practice to family and friends.

We have persuaded our current active patients to keep appointments and utilized the system to reactivate patients/guests. Now is the time to gently and consistently encourage them to regularly recommend the practice for more new patients. If a new patient is worth $2500, and referrals yielded 2 more new patients a month, that’s an additional $60,000 in production per year (2 new patients × 12 months × $2500 = $60,000).

These four simple steps, which utilize proven business tactics applied to a dental practice, can have a total potential impact of:

1. Reducing no-shows/cancellations in general practice = increased production of $40,269
2. Reducing no-shows/cancellations in hygiene department = increased production of $23,000
3. Reactivation of current patients/guests = increased production of $30,000
4. Increasing new patient referrals = increased production of $60,000

Total increase = $153,269
Total increase in net profit from steps 1– 4 = $53,644

Since this is an increase in production, the current profitability percentage of 35% would result in an increase in profits of (35% of $153,269 = $53,644).*

*(If all fixed costs were met prior to this increase, only the variable cost would be incurred on this increased production— i.e. lab, supplies. Therefore a higher percentage of profit may actually drop to the bottom-line.)

These calculations on profit are intentionally conservative. Just in case you think the numbers were overestimated, cut them in half. Now you’ve got a potential net profit increase of $26,822.

How much would a practice be willing to invest to earn another $26,822 in profit?

How much would a practice have to grow to see this potential increase in net with discounted fees?

Would you invest $289.00 per month for a $26,822 increase net?

For more details on the Reward program and the rewards available contact;
maccario@ dental-mba.com  or  http://www.loyalpatientsinc.com/

Time to Celebrate the Future

The dental profession has a long tradition of discipline, motivation and personal sacrifice. When it comes to the pursuit of clinical excellence and public concern, no one would ever consider questioning the commitment of the vast majority of dentists. The same holds true for the business of dentistry as a whole. Most practices have focused their efforts and entrepreneurial energy on doing the right thing.

As the continual commitment to clinical excellence and the blossoming of business entrepreneurship continue to meld, a question now arises: Are the current drivers of ethics and values clear and still on course for the profession, industry and individual?

Reappraising the path that our profession and industry are now following doesn’t have to include condemnations of those who’ve been at the forefront of the current direction. Nor does any one organization or individual have all the answers. Careful evaluation and considered criticism of the direction itself, however, can be constructive. It can lead all of us to make whatever course corrections we see are needed—and we can do so before any possible missteps might be taken that would impact dentistry for many years to come.
 
Many general practitioners maintain that treating children has the potential to substantially increase the profitability of one’s business.  The main reason, they say, is that it can significantly expand a dentist’s patient-base – not only through the addition of those children as patients but also their family members as well.

Leadership: Setting the Standards
Many dental professionals contemplate the real meaning of the hustle and bustle they experience in their careers. They realize there must be more to life, but they don’t know what that missing “something” is. What will fill that void? It’s hard to know for sure, but they are certain about this:

• They want to connect with others who share the same values and interests as they do.
• They desire to be around those who demonstrate the expertise and eagerness to learn new skills and gain new knowledge that will bring them to higher levels of proficiency.
• They want to feel such a sense of mastery in their work and business that they can say, “I now possess it confidently and feel competent.”
• They want to share this newly gained knowledge and experience to perpetuate the cycle of abundance with and for others.
• They are looking to make a new “home,” an industry where the leadership walks the talk and provides inspiration by demonstrating positive attributes, free of petty politics.

If these are the goals, we need to ask ourselves a number of questions. Let’s start with whether leaders and those who aspire to leadership ought to maintain the highest standard of values and ethics. And what is the responsibility for everyone else? Shouldn’t everyone in the industry insist on fair treatment, respect, and honorable, honest dealings?

It’s a given that no one should be used as a stepping stone for someone else’s self-serving, personal gain. Yet our industry hasn’t been exempt from this problem. Many people have been caught by this with the lure of being part of something bigger. From now on, though, can’t we avoid this trap, both by encouraging leaders to sidestep it and by reminding ourselves not to fall for it?

It’s also reasonable to expect that no one should be reviled simply for having a dissenting opinion. Throughout history, fanatic followers have subverted their passion for gaining truth and knowledge by attacking people with differing points of view. Santayana’s definition of fanatic —“redoubling your efforts when you have forgotten your aim”—could apply to some of our contemporaries. Can we rise above this? What might be the benefits of abandoning polarizing points of view and opening the lines of communication? What could happen if we supported each other and continually reminded ourselves of the bigger picture, which is the pursuit of knowledge, and the real prize: long-term healthy relationships?

We are fortunate to live in a society where we can be heard. We can “vote with our feet” by refraining from support of programs and venues that do not reflect a standard of honesty and values that are congruent with a spirit and best interest of the entire profession and industry. As members of the dental community, isn’t it our responsibility to hold all organizations, teaching institutions, their faculty, and their alumni to the highest standards?

Many organizations have allocated valuable resources to bring many outstanding programs to the marketplace, and without them, we would not have had access to the information that’s brought us to this point. We owe a debt of gratitude to many of these individuals who have sacrificed their personal and family time to present state-of-the-art education, for sharing their insights, for taking the time to develop new skills and concepts as well as communicate the ideas that have impacted our lives.

Likewise, those who have been students and participants in these programs have made sacrifices of their own: personal time, family time, and efforts and energy studying. They’ve parted with their hard-earned dollars to pay tuition for this opportunity.

Everyone who participated by either teaching or learning has contributed to creating the current climate and culture of dentistry. It has been a fair exchange, and we’re all the better for it. So the question before us today is: How will we use where we are now as a springboard for the future?

A New Era
The sun is rising on a new time for dentistry. There’s a unique opportunity for established leaders to recommit to the traditional values and the upright virtues of the profession and industry. There’s also the opportunity for new leadership to emerge.

Who might be the leaders of this new era? What if they could …

• Act as the catalyst to strengthen others, to empower them with similar passion and enthusiasm for their life’s journey?
• Show by example what it means to become a servant leader?
• Emit a buzz of enthusiasm and inspiration among colleagues, friends and co-workers, who would then also share this newfound enthusiasm of direction and mission?

As full participants in the profession, we could not only enjoy the emergence of such leaders, but we could also expect our leaders to communicate a renewed vision to the entire industry, not just in word, but with their actions, too. Would anything less really count as leadership? We need to ask ourselves, What are the acceptable standards for leadership? What role must ethics and integrity play? To what degree will we allow commercialism, self-interest, or a lack of substance?

One thing’s clear: New leadership should make it safe for all voices to be heard. A wealth of goodness is encoded in our professional DNA, and it is transferred from one generation to another in dentistry, just as it is in families. New leaders can indeed perpetuate positive virtues and values. They can purposely create an environment for critical thinking and opportunities for others to safely challenge “what is” with “what might be.” These new leaders can understand that for the profession and industry to continue to move forward, there must always be room for differing perspectives.

Time to Celebrate the Future
Positive changes are afoot. Many in our profession feel empowered to confront confidently the challenges they face and to reorder their steps as they move into a new time for the entire industry. They follow something new: not a trend, but an inner voice that lets them know what’s best for them personally and professionally.

Perhaps they realize that this inner consciousness, if neglected, is what leads to those weighty feelings of burden, distress, unfulfillment, discouragement, anxiety, worry, fear, strife, anger, jealousy, doubt, self-pity, and resentment—all of which affect thoughts, judgment, words, and actions.

What happens when people follow that inner voice? Might it lead to a new perspective, one that allows them to rise to their greatest potential, operating from the position of abundance? Such a perspective most likely includes the values of generosity, friendship, love, compassion, humility, excellence, honesty, passion, discipline, mental toughness, and more. From these values, many other positive character attributes could spring, among them creativity, enthusiasm, kindness, respect, reverence, dedication, integrity, wisdom, sensitivity, fearlessness, peace, calm and discernment.

With these characteristics, what sort of atmosphere would you expect to result? Most likely, we’d all enjoy greater levels of success economically, socially, professionally and even spiritually.

Clearly, these values transcend being just a dentist, a dental assistant, a technician or a salesperson.

Indeed, what might happen if our new leaders operated from this position of abundance and confidence? Might they repair broken professional relationships for the betterment of the whole? Could their commitment to a pioneering spirit of advancement extend the boundaries and regain territory that was once lost to petty turf wars? Picture our profession and industry as a single community that resonates together in health and vibrancy, abundance and confidence, unity and respect. In the bright light of this kind of community, even a shadow of negativity would be dissipated.

Perhaps this is how the journey is meant to be. Perhaps it’s within reach right now. To find out, it’s time to honor and appreciate the past, let it go, and then start celebrating the future. Each of us must step up and behave as leaders to be a part of this new era.

Do You Know your Teams’ Compatibility Quotient?

The WorkTraits Assessment

• Want to know how to better communicate with your team and reduce stress?
• Want to help your team better communicate with each other and increase productivity?
• Want to better communicate with your patients and increase treatment acceptance?

Now you can- and it’s easy!  The WorkTraits Assessment is the answer! This simple to use on-line survey takes about 15 minutes, results come back immediately. It will give you insights and specific tools for doctor to team communication, team to team communication and increase communication to all of your patients. It will even guide you on potential new team members - before you hire.

Your Package Included:
Personal Fit Assessment - Your Organizational Fit.
Your Behavioral Style Profile will provide insight into a team members’ optimal role within the practice and basic strategy for executing that role. You get four reports as a result (more than one person must take the survey). You get a profile of yourself, a profile on compatibility with each team member, a profile on handling conflict with each team member and Your Core Convictions Profile. These profiles will provide insight into the type of work environment which best suits your values and a basic strategy for effectiveness in that environment.

Company Fit Assessment – Team Compatibility Quotient.
The Compatibility Quotient is a measurement of the potential for employees to work alongside one another without conflict based on their Core Convictions. It is measured on a scale similar to "IQ“, a score of 100 being standard or average. This unique Company Fit Assessment is an interactive online system for improving compatibility & communication among existing staff and resolving office conflict. It will help discover the best role for every employee in the practice, strengthen team cooperation and reduce employee turnover.

Set up fee and 1.5 hours of consultation: $ 229. 00
Surveys @ $49.95 per team member  x _________ # of surveys = $ 229. 00

TOTAL:  $__________

Can There Be Healthcare Reform Without a Public Option?

As the battle over healthcare reform rages on, from town halls all the way to the houses of Congress, some self-proclaimed supporters of reform – including the president himself – have suggested that they are willing to abandon the pursuit of a government-run public option in an effort to compromise with those who are either opposed to or wary of reform.

Should the formation of a public option be eliminated from reform plans, it would be a grave injustice to the American people.  A public option is a necessity in any meaningful healthcare reform.  It is comparable to the engine that starts a car, the ink that fills a pen, or the bulb that lights a lamp.  Without it, there might as well be no reform at all.

Opponents of the public option have assailed the idea from many different angles.  They have denounced it as “socialist”; they have dismissed it as being too costly; they have claimed it will prevent patients from seeing the doctors of their choice and relegate them to lengthy waiting lists for essential treatments; they have suggested it will be misused to provide insurance to illegal immigrants; and soon.

However, those who criticize the public option do so for one reason and one reason only: they are afraid it will work.

A public option has the potential to provide viable healthcare access to all American citizens, even the very poorest of them.  Whatever downsides or shortcomings such an institution might have, they surely will pale in comparison to the notoriously high costs and labyrinthine red tape that customers of private insurance companies have long had to contend with.  At the very least, the existence of a public option will force those companies to lower their rates and provide better service in order to compete with the government-run alternative; at most, it will drive those companies out of business.  Of course, the average, honest, hard-working American justifiably couldn’t care less about the greedy, heartless pigs that held the insurance industry in their cold, vice-like grip for far too long.  Unfortunately, many of our Congressmen do: they have long been taking bribes – or should I say, “donations” – from those very companies.  As a result, they are firmly entrenched in the pockets of insurance executives.

In addition, those politicians that have long been lobbying against the expansion of government as part of their political platform fear that a working public option will spell the end of their ideology – and with it their careers.  Sadly, they would rather sacrifice the best interests of the American people – the very thing they were elected to preserve – than confess to their own misapprehensions.

Opponents of the public option will propose an “alternative” plan, one that provides no real threat to insurance companies – but simultaneously, no real services to American citizens.  If the government elects to pursue such a plan, it will likely result in millions, if not billions of dollars wasted on a merry-go-round charade intended to appease supporters of healthcare reform but without actually satisfying them.

Americans have waited far too long to see genuine healthcare reform in their country.  Supporters of reform must remain steadfastly focused on their goal and what is absolutely necessary to achieve it.  There is a time to compromise and a time to fight: this is not a time for the former.

There can be no healthcare reform without a public option.
For all intents and purposes, a public option IS healthcare reform.

Should General Practitioners Treat Children?

The question of whether or not to work with pediatric patients is a divisive one among general dentists.  Some will readily treat children, while others simply want nothing to do with them.
 
Many general practitioners maintain that treating children has the potential to substantially increase the profitability of one’s business.  The main reason, they say, is that it can significantly expand a dentist’s patient-base – not only through the addition of those children as patients but also their family members as well.

“If you treat children like gold, you’ll see their mothers, fathers, aunts, uncles, and grandparents as well!” declares one anonymous dentist on a website blog.

Also, as another dentist points out, while adults may have reservations about spending money on expensive dental treatments for themselves, they often will “readily spend money on their kids.”

Besides the obvious profit motive, many general practitioners say they are willing to treat children for the simple sake of promoting oral health awareness among patients from the earliest age possible.

“General dentists need to start seeing more children including infants and toddlers,” says one practitioner.  “Every child should have a dental home by age 1.”

Recent polls show that the majority of general dentists say they will accept patients as young as 12-years-old, and at least half of those polled will treat children under the age of 6. 

But is treating pediatric patients really a responsibility that simply any practitioner can or should accept?  Many say it is not.

“They will have a better dental life if they start with a pediatric office,” one dentist says of children.  Those who recommend referring children to pediatric dentists claim that general practitioners lack the sort of extensive training and experience necessary to enable them to provide children with the optimum care.

“Pediatric dentists are specially trained to handle problems particular to children, such as dental developmental difficulties and root canals on adult teeth that have not fully formed,” reads a statement on the Academy of General Dentistry’s website.

Another factor to consider in this issue is the level of comfort a particular dentist has with working with children.  Many practitioners will admit they find the task of treating pediatric patients to be a daunting one.

“I break out in hives when I treat anyone under 18,” declares one dentist. 

“I don’t enjoy restorative on very small children,” another dentist says.  “It’s not profitable, and it’s stressful.”

“Pedodontists make their money the old fashioned way,” says yet another practitioner, “they earn it.”

If a dentist is generally unnerved by working with children, it can reflect on any sessions he or she has with one.

“If you do not enjoy treating them, then don’t!” warns one practitioner.  “They know you do not like it and they get traumatized.”

Those dentists who are willing to treat pediatric patients might do well to be selective with regard to which patients they work with and under what conditions. 

“If they can be reasoned with and kept calm with nitrous, I’ll treat them,” says one practitioner.  “I don’t treat anyone that is screaming and crying, and I don’t care how old they are!  Be calm, or take drugs!”

Other complications can arise out of treating children that dentists must be prepared to face as well.

“Either the child or the parent may be problematic,” notes one dentist.

Ultimately, every practitioner must carefully consider his or her own capabilities and limitations with regard to treating children before choosing to do so.  Only those that are both mentally and physically prepared to undertake such a responsibility should do so.

“Children are the dental patients of the future – and the present, too,” acknowledges Jim Du Molin of The Wealthy Dentist.  However, he says, “But if treating kids will cost a dentist his or her sanity, then there’s no sense in offering pediatric dental care!”