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Talking to dentists is a great spring break

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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

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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

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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

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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.

My spring break: going to ‘Excellent’ and talking profitabilty

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Even dentists need a spring break. But I’m going to be working during mine!

It’s a good kind of work though: I’ll be talking at the Excellence In Dentistry Spring Break Seminar taking place April 27 to 29 in Destin, Florida.

Even better I’ll be speaking about one of my favorite topics: Process and Procedures to Improve Profitability.

When it comes to building a more profitable dental practice, cutting corners is a short-sighted strategy. Better to invest in processes and procedures that drive the growth of your practice.

Over the course of my 90-minute talk, I’ll outline how I did exactly that in my 14 practices and outline the simple but crucial changes you can implement to make your practice S.P.E.C.I.A.L.

These include:

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

C collections improvements that will show you how to reach a 98% success rate.

I internal controls to help you manage your practice

A Associates and accounts receivables as a tool for growth

L liability and asset management to protect yourself and your business

So please join me on April 27th at 1:30pm at Destin for my talk and make certain to reach out to talk while there or in advance about how to improve your practice.

See you there!

Every member of your practice team is in the sales and service dept.

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E10:Podcast: Training and educating your dental team

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Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

My name is Dr. Kevin Coughlin. Welcome to this week’s podcast which specializes in organization, development and training and education for your dental team or health care unit. The name of my website is www.ascent-dental-solutions.com. I can be reached by email at drkevin@ascent-dental-solutions.com. I hope you enjoy this podcast.

I’ll start by stating that in almost all of the information that I share for the last 33 years of practicing dentistry and continue to practice dentistry, unfortunately, almost nothing I say is original and this particular podcast is no different. I have been fortunate to take thousands and thousands of hours of continuing education and listened to many great thought leaders, not only in the dental profession but in the business profession and I have modified or addressed many of their comments to suit the needs of what I feel would be an ideal dental practice.

The following acronym will help you develop a special dental practice. Special spelled S-P-E-C-I-A-L. I would ask you to remember the word special and start with the letter S, which stands for Scheduling. If your dental practice does not have control of the schedule, your life will be miserable and your results will be just as bad. The most important concept is the time value of money. And over 33 plus years the single largest mistake I see in practice over practice in the 14 practices that I own are mistakes with the schedule, either scheduled too lightly or too heavily.

I cannot emphasize the amount of training and time that is necessary to inform your front desk managers, receptionist, team members how to schedule appropriately. There is an art to this and that art starts with the ability to profile the patient and their problem. I would strongly recommend that the individuals answering the phone should know whether the patient is a new patient or existing patient.

They should be able to determine whether they have a problem or no problem at all. If they have a problem is it top, bottom, right, left, front or back, the duration of the problem and the intensity of the problem simply by asking the following, “Mr. or Mrs. Smith, on a pain level scale of zero to ten — zero no pain, ten the most severe pain — how would you rate this?” Then you want to know the duration of the problem as you’re gathering this information which usually will take no more than three minutes on the phone.

The next issue is to be able to profile the patient with either a CareCredit check, a Wells Fargo check or some type of preliminary check for dental insurance and finance reasons to determine if it is most likely Mr. or Mrs. Smith are going to stay and want a root canal build up in crown, an implant or they’re simply going to want a prescription and deal with the problem later on or simply go for a lower type of production procedure such as an extraction because they are not interested in the time or investment in saving their teeth. This profiling and screening of the patient will dramatically improve your schedule and dramatically improve your bottom line, but perhaps most importantly make your life much more enjoyable.

The second letter in developing a special practice is P for Production. Obviously we know production is important but keep in mind what you really want to concentrate is net production. This simply means that in many types of the software what I’ll see is the office production but not net production. This means that the dental insurance has one fee and your office has another fee. For example, you may charge $1,500 for a PFM or Porcelain-fused high noble crown but your insurance company may only allow you to charge $950. Understanding net production and what you’re writing off with insurance companies, government plans, etcetera, is critical to have a profitable end of the day and end of the month bottom line.

The next letter is E for Education. If I could emphasize one thing, training, education and communication should never end. It starts with a morning meeting, it continues with a pickup in the afternoon and it should end with an ending meeting. If you feel that you can communicate without really communicating, trust me your practice has problems. This ongoing training and education should be built on proven successful processes and procedures and those processes and procedures should be written, explained and understood.

Next in the word special is C and C stands for Collection. At the end of the day if the dollars are not collected for the procedures done, your practice will be a failure. You will not have enough profit to expand and improve your staff and your business. Collection is the gasoline for the engine and you must understand that the goal is to collect 100 percent of what’s being produced. Failure to obtain that goal or have the proper processes and procedures to obtain that goal is shame on you and the results will have long term negative effects.

Next in the word special is I, and it stands for Insurance. You, your team, your managed service organization have to clearly understand the type of insurance plans and most importantly your front desk personnel because different insurance plans have different reimbursements.

As a general rule, evening hours and Saturday appointments, Sunday appointments, early morning appointments, lunch time appointments should be saved for the highest producing and production type patients possible. This means that you are dedicating your time and effort, taking away from your family and friends, you should be rewarded with the highest financial gains. This starts by fully understanding each patient, their type of insurance and what the reimbursement is going to be for that insurance and almost more importantly, your front desk understanding what is covered, what is not covered and what your patient will be expected to provide for finance in fees.

Next in the word special is the letter A, and A stands for Accounts receivable. Over and over again I find that the staff is completely disconnected on what healthy accounts receivable should be. I use the rule of 45 days. That simply means what your net production is, your accounts receivable should be 45 days of that. 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. If they’re far below that, you may want to take a hard look that your financial policies may be so strict that you’re losing opportunities to provide additional care and services.

Lastly, the L stands for Liability. In all businesses, you want to reduce your liability or risk. 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 patient in writing. Failure to get these signed, scanned written treatment plans that provide the risks, benefits, options, costs is a mistake that will cost you time, money, stress and aggravation.

I hope you’ve enjoyed the podcast. There’s no reason in the world you cannot also have a very special practice providing you focus on scheduling, production, education, collection, insurance, accounts receivable and liability. If you need help with the processes and procedures in these specific areas, don’t hesitate to contact me at drkevin@ascent-dental-solutions.com or at www.ascent-dental-solutions.com and visit my website which focuses on knowledge, development, training and consultation. I hope you’ve enjoyed the following podcast and thanks so much for listening. My name is Dr. Kevin Coughlin.