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Lean dental service organizations

June 17, 2020
Just what is a "lean" DSO, and why is it a good thing? Dr. Chris Salierno explains that lean means management supports the organization while reducing waste. That's a win-win for everyone.
Chris Salierno, DDS, Chief Editor, Dental Economics

With all due respect to my dental colleagues, we often think more like assembly line workers than CEOs. Small private practices with minimal (or no) layers of management have the dentist wearing many hats, and the clinical work can take the majority of the dentist’s attention. I’m guilty of this as well. After a busy day of interacting with patients and providing care, I don’t often have much time or energy to devote to tuning up my practice’s engine.

One of the great advantages of owning multiple practices is that there can be additional layers of management who will pay attention to the practice’s strengths, weaknesses, and opportunities. Whether the dentist-owner trades some clinical time for administrative time, or hires managers to oversee aspects of operations, multipractice enterprises can evolve more quickly than their solo counterparts. If you’re looking to better define management roles, you should research the concept of “lean.” How does management help the business provide more value while reducing waste?

First, if you’re new to the jargon behind lean, or if you just need a refresher, I wrote this article in Dental Economics on kaizen, Six Sigma, and lean manufacturing for dental practices. It provides a brief overview of how these concepts were forged on Toyota assembly lines and how dentists can adapt it to managing a practice.

When you’re ready for a deeper dive, might I suggest Kaizen: The Key to Japan’s Competitive Success by Maasaki Imai. You can find a lot of books about kaizen, but this was one of the first and most influential. This book forever changed my mindset on how we make improvements to our systems. If you’re a C-level executive at a large group practice or DSO, then this should be required reading.

My next recommendation is The Lean Startup by Eric Ries. This book was written for entrepreneurs who are launching their new ventures, but the lessons also apply to legacy institutions who are in need of innovation. If your group practice or DSO feels sluggish and unable to adapt, Eric Ries’s work will help you become nimble and start iterating. If you’re a small group practice looking to accelerate your growth, then this is definitely for you.

Reducing waste is about a lot more than just cutting overhead. Increasing value is about a lot more than just lower fees. Group practices and DSOs have an opportunity to apply lean concepts to their practices in ways that solos cannot.  

Chris Salierno, DDS, is the chief editor of Dental Economics and the editorial director of the Principles of Practice Management and Group Practice and DSO Digest e-newsletters. He is also a contributing author for DentistryIQ and Perio-Implant Advisory. He lectures and writes about practice management and clinical dentistry. Additional content is available on his blog for dentists at thecuriousdentist.com. Dr. Salierno maintains a private general practice in Melville, New York. You may contact him by e-mail at [email protected].