Survey says...

Jan. 1, 2004
Here's what you said about your practice-management software in our 2004 survey.

Here's what you said about your practice-management software in our 2004 survey.

Click Here to download a .pdf of the surveys.

Editor's Note: I asked two of the foremost experts of dental technology, Dr. Paul Feuerstein and.Dr. Lorne Lavine, to look at the results of this year's software survey and give Dental Equipment & Materials readers their interpretation of the data. Dr. Feuerstein offers his thoughts first, and Dr. Lavine begins his thoughts on page 19.

By Paul Feuerstein, DMD

Most journals have had an annual software issue for years. We are presented with information about features, costs, numbers of installations, and other information supplied by the companies. This year Dental Equipment & Materials took a different approach. We sent out questionnaires to dentists who were already using the software and asked them to fill out a survey on the software and also asked questions about its use. We found that 55 different programs were mentioned among the 297 responses, with the time owned averaging 5.5 years. We present here a recap of the survey results.

Most of the dentists purchased systems based on their own research and recommendations of other users. Before making a final decision, a few of the offices went to trade shows to do final research and comparisons, while most seemed content with in-office demos. A few reported that they were remiss in not asking questions about certain functions they assumed were present or performed in a particular way. Most companies supply the dentist with Q&A worksheets, which essentially guide them through the attributes of that particular system. It is important for the practitioners to break down their daily procedures into small steps, investigate how each system addresses them, and perhaps come up with his or her own Q&A. A couple of respondents reported they made up complex situations — for example, asking how the system could handle a divorced family with dual insurance, and children split among the custodial parents — to "challenge" the systems being considered.

At least 75 percent of respondents state they are still happy with their choice in general and feel that they will stay with their present company, but some have "issues" with their present companies. When further questioned, although a few were dissatisfied with the product, they did not want to face another conversion and training sequence. It was not uncommon to hear a respondent state that he or she just "gave up" on a particular problem or issue and accepted certain problems instead of pursuing solutions with the vendors. In fairness, the companies who provide support (not all do) become frustrated when a doctor leaves a problem unresolved and then registers a complaint in the media, Internet, or other public forum.

As we suspected, the systems, which have far-reaching capabilities, are underutilized for the most part. Many of the respondents felt the initial training was insufficient, while the ongoing support seemed to be acceptable. Additional training is available although many companies charge a fee, including added travel expenses, if the training is onsite. It can be debated as to how much training should be included in the initial purchase, and details must be discussed at the outset. The practitioner should question other users in this regard. Many of the systems have built-in tutorials, some more elaborate than others, as well as extensive manuals, embedded or online help, and periodic user-group meetings. In a couple of instances there are third parties (not necessarily endorsed by the practice-management companies) who can come in at a cost for additional training and troubleshooting. Some of these services are comprised of former trainers, developers, or experienced advanced users of the systems.

The appointment book and practice-management reports seemed to be the largest areas of contentment, while areas of integration with other programs seem to raise some eyebrows. There is a lot of confusion about "bridges" and software that links between the core products and other devices. Common questions were about integration with digital radiography, intraoral or digital cameras, and imaging systems. Some of these external products provide self-contained links with various practice-management systems while other require the practice-management company to supply the link. There are fees attached to these and, in many cases, the respondents felt they were excessive. There also was a frustration as some systems made it more attractive to integrate with one of their own company's products, in some cases seeming (wrongly) exclusive of other brands. There is always a method to cross-integrate products — some solutions might not be particularly smooth, and may require two sets of software or databases to run simultaneously, but the end results should be satisfactory. There also are third-party products and integrators who (at a fee) can make all of this work.

Both satisfaction and dissatisfaction was seen with the larger as well as the smaller companies. All of the companies referenced in the survey have stated that most problems come from unasked questions. There were certainly some comments about poor service, but these were often the same companies who were extolled by others. Customer service has to be in the forefront of any of the companies reviewed. It behooves the readers to respond to this survey's results with comments to our editor and writers, which can then be passed on to the proper channels.

On a daily basis, dentists work with a multitude of different systems. We all use numerous items, from impression materials and alloys to disposables and equipment. And, after striving constantly to find the best products for our practices, we develop a love-hate relationship with many of those products; we can be just as passionate about the products that we use every day as those that have failed us in the past. One of the areas that stimulates a strong amount of discussion among dentists is technology systems, and in particular, practice-management software. A vast majority of dentists use practice-management software (PMS) on a daily basis, and we have become very dependent on this software to run our practices. When it works, we hardly notice it, as we've come to expect the software to handle the burden of scheduling, insurance processing, and a host of other issues without incident. When the products fail to deliver, though, we begin to see the other areas that are important with software, service and support.

Recently, the editors of Dental Equipment & Materials surveyed their readers on their PMS programs, both their experience with the products and the companies themselves. Responding to the survey were 297 dentists, and this article will examine some of the interesting trends that were seen in the survey. While many of the results were expected, there were a number of surprises as well.

The players

One interesting finding was the number of different systems currently being used. In a similar study of PMS software just a few years ago, there were 208 different PMS programs in use. In 2003, this number has shrunk to 55. Many companies have discontinued their products or simply stopped producing updates to the programs. A number of others were purchased by PracticeWorks (which itself was bought by Kodak; more on this later). What was not surprising, though, were the major players. Dentrix leads the pack with 29 percent of the respondents, followed by Eaglesoft (13 percent), Softdent (13 percent), Easy Dental (7 percent), and PracticeWorks (7 percent). When asked why they originally purchased the software, the answers were spread out. Well over half (59 percent) did their research and felt that the purchase was a result of good research and their belief that the product was the best choice for them. About 15 percent took the recommendation of a friend or colleague as the main reason to get the software. Other, less popular reasons to purchase included good value for the money, being impressed with a demo at a dental meeting, the recommendations of a dental dealer, and from an ad in a journal.

Is everyone happy?

The average dentist has had their current software for more than five years. With so many people keeping their software for a long time, it would be logical to assume that the majority of people would be very happy with their PMS programs. The survey, however, seems to indicate some rumblings in the ranks.

The overall satisfaction with the software was relatively good. When asked to rank their overall satisfaction on a 10-point scale with 10 being the best, the average score was 7.52. Interestingly, while the overall score was at this level, none of the other scores for evaluating the software did this well. The score for integration with other programs was at 6.73, and dentists only gave the companies a 6.5 on their ability to provide proper training. Tech support was also middle-of-the-road at 7.18.

When asked to rate the importance of certain features, it would seem that dentists are using their software for less than what it is capable of doing. Practice analysis reports were clearly the most important feature of the programs; dentists rated this 8.37. Scheduling and appointment tracking were obviously also important factors; these were rated at 7.6 and 8.16, respectively. However, many other features scored below 5, and this included e-mail capability, HIPAA compliance, Web site access, lab tracking, and patient education.

Another finding that was surprising is that while many dentists stick with their software, many are not happy with the programs and/or the company. When given a choice, 45 percent claimed that they have complained about their software, rather than brag about it. What is most surprising, though, is the willingness of dentists to stick with their software. Over 88 percent said they have no intention of changing PMS programs.

The impression one gets from these scores is that dentists would rather fight than switch. Many realize that the other programs may be no better or worse that their current software. Additionally, the time and cost of changing programs can be very traumatic, especially on the staff, and these decisions are not taken lightly.

So…How did my software company do?

Again, there were a number of surprises. As expected, the companies at the top were rated very highly…with one major exception. It should be of no surprise that the top two products are owned by Schein and Patterson, the largest dental supply companies. While it can be argued that they have the largest sales force and can promote their software more easily, they also have the manpower to support and upgrade their products.

Dentrix, the software with the most installations, rated very well across the board. In the areas of overall satisfaction, integration, training, support, and ease of use, Dentrix scored no lower than 7.5 in any category and as high as 8.23 overall. Eaglesoft was a close second in all areas. Scores averaged between 6.5 and 7.5.

The scores for Softdent were the most surprising. Although Softdent is clearly in the top three programs as far as user base is concerned, their users are just as clearly unhappy with the program and its support. Softdent did not score above 4.8 in any category. Of the respondents, more than half had complained about the software instead of bragging about it. However, in keeping with the results with other PMS programs, more than 87 percent of the participants have no intention of changing to another program in the next year.

It is difficult to know the direction that Softdent will take in the future. While it started as an independent program, over the years it has been owned by Infosoft, Dentsply, Infocure, PracticeWorks, and now, Kodak. It is obvious that they have some work to do to win back the loyalty of their customers, as their scores were the lowest of the seven largest PMS programs.

Other interesting scores were seen with Daisy Dental. While a relatively unknown program with only 3 percent of the survey participants as users, their scores were extremely high. No score for Daisy were below 9.22. This simply illustrates what many of us in the dental technology field have known for a long time: You don't have to be a large company and well-known to produce well-designed and supported systems. Many of the users that have held on to their programs for many years have done so not because of inertia, but primarily because they find that no other programs on the market can offer the level of service and support that they desire.


Overall, the results of the survey seem to show a mixture of results. Most of the dentists feel that their software is an integral part of their practice and cannot function with out the features present in all modern dental PMS programs. Many, though, feel that their PMS companies can and should do more. Lack of support and training are still important areas and many companies did not score well in these fields. On a positive note, dentists are still willing to give the companies a chance to get it right. The vast majority spent considerable time and effort to choose the right software for their office, and they realize that other programs may not be an improvement over their current software.