EXCLUSIVE! 10 ways to stimulate practice growth in an unstable economy

Jan. 14, 2002
By Robert E. Hamric, DMD

Most of us have noticed a slowdown in our practices since the tragedies of Sept. 11. Although that moment in history has had a major impact on all of us, and will for years to come, I sensed an economic downturn in several practices prior to 9/11.

Over the 35 years I have been in practice, I have seen several recessions, and seen my retirement funds reduced, just like many of you. I have always seen the economy recover, and become evenbetter after the recovery ... and it will again this time. But, for the moment, let's consider 10 ways to stimulate practice growth in an unstable economy.

1. This is good time to conduct a complete chart audit of your active files, and purge those inactive files. You will be amazed when you discover the amount of unfinished dentistry that remains in your files. Before you begin calling at random, review each chart and plan, even script what you intend to say to the patient. I suggest you use the evenings from 6-8 to call. Speak with a positive approach, " what day would be best for you to get this completed?", "Do you prefer morning or afternoon?" "The doctor certainly doesn?t want to see you lose that tooth."

2. The re-care program will have a good number of patients that have, for various reasons, fallen through the cracks. Now is the time to get them in. If these patients have some form of dental insurance, preventive care is far less costly than neglect that leads expensive crisis care dentistry.

3. I am a strong advocate of quadrant dentistry, people may need to do less dentistry due to finances, so be flexible and do one or two crowns, instead of three or four. I had rather do less treatment and get paid properly, than do too much dentistry and not get any payment. Most restorative care is elective and people can pace their restorative needs. Do not drive them away from your office. However, do not fail to do a complete diagnosis, treatment plan and consultation, with a possibility of phase treatment, if necessary.

4. Good financial arrangements are a absolutely necessary. Hopefully, there are ways available in your practice for patients to pay without you issuing the credit, and carrying money on your books. However, I would loosen up on credit in certain cases and accommodate those patients that have been in the practice a long time, if they need some restorative care and have good credit with you. Some exceptions are going to be necessary.

5. Remember you are in the people business. You must accommodate people. Move your patient hours by starting early some days and working late on other days. Eat lunch at 1:00 instead of noon so someone can be seen on a lunch hour. I would consider working on Saturday. Some people are so concerned about their job, they are afraid to do anything that may lead to a lay off, therefore going to the dentist is easy to put off.

6. Normally, I suggest raising fees every six months. At this point in time, I would say, not to raise fees, if your fees are within the fee range of your area. Have you had a fee check up lately? I recently visited a practice where the doctor was not even charging what the best PPO in his practice was willing to pay. Get serious.

7. Offer some services as specials, such as tooth whitening. There are people who will take advantage of a "bargain". A $50.00 discount often times bring in new patients if marketed correctly to hair salons, spas, make up artists, ect. A service that has a large profit margin can still be a nice profit center, if marketed properly. Which would you rather do, 10 tooth whiteners at $300. or 20 at $250?

8. Now is the time for staff training sessions, to cover those areas in the practice that need refining and detailing. Take time to set goals and to plan for the next 12 months. One goal could be to increase the production in the practice $100,000 the next 12 months. That is only $500 per day for the next 200 work days. Outline ways to do that.

9. I was able to recession proof my practice by truly committing my practice toward excellence. I began each new patient with a personal interview in a dedicated conference room. I wanted to establish relationships and rapport before we looked in their mouth. Patients were given quick tours of the facility before being introduced to the assistant, who would begin their examination process in conjunction with the hygienist and me. We found that people who value their teeth, and health, were our best referral sources and slowdowns in the practice rarely happened.

10. One of the very best ways to increase production and recession proof your practice is to establish a soft tissue management program. I started a true STM program in the 80?s. I know most dentists? think they have a STM program, but in essence they really do not. To continue to do prophies with bleeding gums, not probe (even a PSR is better than nothing), to pick up a scaler and scrape away calculus for 45 minutes, then polish the teeth in 10 minutes, and charge for a prophy is not STM. To preach to the patient that they need to brush better and start flossing, will not modify behavior. STM requires periodontal probing ( ADA recommends annual probing as part of the dental record), co-diagnosis, behavior modification, proper verbal skills, and proper clinical training for the doctor and hygienist. It is precisely structured systematic approach to help patients control periodontal disease before it becomes too advanced to avoid surgery. STM is a practice builder. If the ADA states 80% of the American population have some form of gum disease, I would predict some of these people are in your practice. I found the Pro-Dentec company ( 1-800-228-5595) to have the material, equipment, medicaments and expertise to properly instruct my staff with this program. In my practice, prior to STM our average monthly production in hygiene was $8,000. After STM my average monthly production in hygiene tripled, using only one hygienist. I eventually needed two hygienists and a dedicated assistant for hygiene. I have consulted with practices with 3 hygienists using a hygiene assistant that produce $600,000. annually in hygiene by following this program. If somebody is already doing it, it must be possible. It will recession proof your practice. There will be no empty hygiene chairs if this program is properly established.

Patients who complete STM become very good patients. They are concerned about keeping their teeth, and are interested in doing restorative work, and cosmetic dentistry. Why would you want to do restorative or cosmetic procedures on an unhealthy foundation anyway? With the use of the intraoral camera, good consultation techniques, including financial arrangements, you will find there will be a constant flow of patients to your office. Hopefully these tips will help you through the present slowdown and recession proof your practice forever.