A practice is like a three-legged stool

Here’s a new way to look at your dental practice. I hope you find it useful.

Any practice — and I don’t care if it’s the ultimate high-end practice or a slowing-down practice where the dentist is nearing retirement — does just three things.

When you boil it all down here’s what us dentists do

Firstly, the practice attracts patients and in business language that’s called marketing. Marketing covers a wide range of activities all the way from just being

nice to patients to elaborate Facebook and SEO schemes. Marketing takes in things such as your fee level, your external advertising (if any), your internal advertising (if any) and your “recall” system. Marketing delivers the lifeblood of your practice because without patients to care for, your clinic will go out of business.

Secondly, you need to get agreement from patients about the treatment to be done. This is case acceptance. As with marketing case acceptance covers a wide range. The basic level is “Here’s a hole — let’s fill it” all the way up to developing comprehensive treatment plans for patients where they make informed choices from among complex treatment options.

Thirdly, and finally, the practice must deliver the dental care. Once again, the range of ways this is done is huge. At the low end of the efficiency scale you have one dentist with one nurse (who doubles as receptionist) working out of one operatory. Ergonomics is poor and set-up times are

long. At the other end of the scale you have a dentist working out of two or more ergonomically- efficient operatories with two or three dedicated nurses and complete front desk support.

Let’s look at these three legs of the stool.

If you don’t have a patient in the chair you’re dead

Most dental practice don’t have a marketing plan. It’s pretty hit and miss and usually runs like this. The dentist looks at the appointment book and notices gaps. He/she panics. He/she calls in the receptionist and tells her to put an ad in the local local newspaper. He/she also starts being extra nice to patients. In a few weeks the cycle turns, the appointment book looks normal again and all is forgotten. Until the next time when the cycle repeats.

A proper marketing plan is thought out carefully and planned in advance. It is consistent and purposeful. It has goals, measures results and based on those results it evolves. It is innovative and looks for opportunities. It differentiates the practice. When every one else zigs it zags.

It’s not just what you say, but how you say it

With respect to case acceptance so many practices follow a version of benign paternalism. “I’m a doctor. You have a problem. Here’s what we do to fix it.” This model is not only well past its use- by date but also not really fair on the patient. It denies the patient the opportunity of being an active decision maker in their health.

A proper case acceptance regimen lets the patient know their situation in terms that they readily understand. It then gives them choice between the relevant treatment options being aware of the advantages, disadvantages and cost of each. Proper case acceptance turns passive patients into active decision makers in their dental care. Proper case acceptance also uncovers hidden demand — treatment that patients would have if only they knew about it.

Life is meant to be easy

Finally, getting the work done. In a poorly set up practice it can be totally exhausting for the dentist to produce even a modest daily output. The experience is like trying to run through quick sand — although, if you have been doing that for your entire career, you may not realise that

better is possible. Every set-up and procedure takes far longer than it should. Ergonomics is poor so that the dentist must constantly stop work and look away to find things.

A properly staffed, properly equipped, ergonomically correct practice is a delight by comparison. Even though the dentist may produce three or four times more work per hour it is actually easier for him/her. This is because the focus is never broken and the dentists delegates everything that is legally possible giving him/her the ability to just concentrate on doing dentistry.

How does your practice stack up in all this?

Look at your marketing, look at your case acceptance and look at your work flows. In particular, if you want your practice to advance find the weak link out of those three and fix it. Then you will find your practice will jump forward. Then find the next weak link and fix that. Keep doing this over and over and your practice will keep evolving and improving regardless of how the economy is travelling or the number of dentists in your area.