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Improving efficiency and increasing profits in implant dentistry

Dec. 4, 2009
Establishing a successful dental implant practice requires most dentists to modify their business model. Dr. Kanyon Keeney discusses the three core factors to building a successful practice around implant dentistry: managing the cost of delivering care, reducing the number of office visits, and improving collaboration and communication between your staff and the referring doctors.
By Kanyon R. Keeney, DDSIn the 20 years I have been involved with implant dentistry, I have learned that establishing a successful dental implant practice requires most dentists to modify their business model. I have concentrated on implant placement in my oral and maxillary surgery practice and have placed several thousand implants over the past 10 years. I have come to understand that there are three core factors to building a successful practice around implant dentistry: managing the cost of delivering care, reducing the number of office visits, and improving collaboration and communication between your staff and the referring doctors.Before deciding to build my implant surgery practice, I visited other implant specialists to get a firsthand look at how their practices operated. I quickly realized that patient satisfaction and profitability required reducing complications and improving the patient’s experience. Fewer complications mean a better experience for the patient and fewer office visits. For both practitioner and patient, this is the ultimate win-win.Strategic scheduling and patient flowOne of the ways I became successful improving my workflow was through block scheduling. We average between 10 and 20 new-patient consults per week in addition to my postoperative visits and surgeries. Therefore, I consolidated my new-patient consults and postoperative visits into a day-and-a-half each week, and I leave the rest of the week open for implant surgery. This scheduling tactic allows my practice to run more efficiently. In addition, reducing the number of postoperative visits my patients require means more time is available for patient consults.When patients are referred to my office for consultation, they first speak with one of my implant coordinators. The implant coordinator gets to know the patients, assesses their expectations, and shows an educational video, providing them with a basic overview of the procedure and process. When the patients are informed and educated up front, there is less likelihood for miscommunication and confusion during the process.Before speaking with the patient, it is critical that the referring doctor has a basic understanding of the case from the patient’s point of view and knows what the patient expects. The implant coordinator then briefs me on the patient. During my initial consult, I explain the surgical experience and outline my recommendations based on the treatment plan designed by the restoring doctor. I also use consultation software programs to provide images of the treatment and present handheld implant models that enable the patient to better visualize the process. The patient will then meet again with the implant coordinator to arrange the procedure and discuss payment options.Finally, a letter is dictated to the referring doctor outlining the surgical treatment plan, often with photographs and cone beam images if necessary. This is a critical step in the communication process. The letter and images can be sent electronically or by traditional mail. If the dentist does not have a clear understanding of where the implants can be placed, which implants will be used, and other surgical considerations, he or she will not have all the information needed to properly restore the implant. More importantly, without this letter, the dentist may find that the surgical treatment is not what was expected. When there is a communication breakdown between the general practitioner and the surgeon, the success of the case and the patient’s satisfaction is at risk.Choose your partners wiselyGaps in the flow of treatment planning between the surgeon and the referring dentists translate to repeat visits for patients. Today, I receive patient referrals from more than 100 dentists. We have worked hard at my practice to establish an efficient process of communication with referral offices. I understand what the referring physicians’ requirements are, and I work hard to let them know I understand that the delivery of dental implants must be profitable for both practices, as well as clinically beneficial for the patient.Your implant provider can also play an important role in streamlining communication between the surgical and restorative practices. They become an important partner in treatment. The best companies have well-educated sales representatives who can support both practices with technical knowledge and the support they need. Having the “right” representative available to the restoring doctor is invaluable, especially when the doctor is new or less experienced in implant dentistry. I have found that choosing an implant system based on cost alone is a mistake. While the price of an individual implant does affect the bottom line, not having the proper support or poor implant and abutment quality affects the total cost of the procedure significantly. Remember, you get what you pay for. You may save a few dollars on a generic implant or abutment today, but if the component fails or you do not have support from the sales representative, you will spend more time and money fixing the problem later. I need an implant sales representative who can be in a restoring doctor’s office on short notice if necessary, and I have found that many of the “discount” implant providers are not able to do this.As previously stated, one way to reduce the number of office visits is by reducing or eliminating complications. To avoid complications, an implant needs to work reliably in a combined procedure such as simultaneous graft and placement. It needs to have a high success rate even in patients with compromised healing capacities, such as smokers or diabetics. Selecting a dental implant system with a surface treatment and thread design that integrates quickly with the surrounding tissues, demonstrates excellent soft-tissue characteristics, and supports precision prosthetics is one way to avoid extra office visits. I also use implants that are backed by a warranty. Remember, when patients have a bad experience, they tell their family and friends about it. The number one complaint from patients regarding dental implant treatment is the frequency and number of visits required to complete their treatment, not the cost. Multiple office visits are inconvenient for patients and have a direct impact on your bottom line. If you have an implant system and technique resulting in a 4% complication rate, that means that for every 1,000 patients, there will be 40 complications. Those 40 complications will increase the number of office visits by a factor of four or more, which could translate to as many as 160 additional visits. On the other hand, if you find an implant system with a complication rate of less than 1% during the surgical phase, this significantly reduces the number of office visits, thus opening your schedule for more procedures and more patients, which will enhance your bottom line.Marketing your expertiseIn order to be successful, you need patients. Establish yourself as a leader and the “go to” doctor for implant dentistry. Techniques for branding yourself as an expert, such as lectures, articles, and even advertising can be very effective. In developing relationships with referring doctors, personal contact is important, but providing an excellent surgical outcome is even more important.Once you have improved your efficiency in placing dental implants, you need to let your referral base know about it. Be proactive in communicating with general dentists, making it clear that you understand the needs of their practice. Recognize that for implant dentistry to be profitable for the referring dentist, patients must return to their office with dental implants that have been placed properly, are easy to restore, provide excellent support, and offer superior long-term results. The ideal implant system will provide excellent long term crestal support of the bone and soft tissues and result in fewer complications.In dentistry, like any business, the best marketing tool is a satisfied customer. When the general dentist and specialist work together to improve efficiency, we can treat more patients, deliver better care, and establish a business that is right even in today’s challenging economy.
Kanyon R. Keeney, DDS, is a partner in a private oral and maxillofacial surgery practice with a concentration in implant surgery located in Richmond, Va. He is a diplomate in the American Board of Oral and Maxillofacial Surgery, a fellow in the American Association of Oral Surgeons and American Society of Dental Anesthesia, and a diplomate in the International Congress of Oral Implantology.