Beyond Practice Management: In a down economy

I used to teach my team that people chose not to complete treatment because they didn't understand their needs and what was happening to their dental health.

We worked on communication and relationship skills, distinguishing ourselves from our fellow dentists in the way we cared for our clients, and developed systems and protocols that wowed them. Did their ability to pay for treatment matter? Sure it did! Even in the "good" times, some people just weren't able -- or willing -- to spend the money necessary to have good dental health.

How times have changed!

The No. 1 reason people are not proceeding with necessary care now IS money, whether we like it or not. We can complain all we want about that, but we can't change the economy. Or I suppose we could just quit, which is usually not an option, or retire ... assuming we can find someone to purchase our business.

It's time for a new plan.

Here's the challenge: How can we continue to provide quality care, pay our debts, and maintain a healthy business?

For what it's worth, I don't believe spending gobs of money on marketing is going to help matters -- and not spending a dime on marketing won't help, either. In my opinion, signing up for loads of discounted dental plans also isn't going to help matters.

So I'm going to give you my thoughts and experience of 25 years as a dentist and more than 10 years as a professional coach to dentists, having seen ups and downs in dentistry in a wide variety of practices, but none perhaps as widespread and ongoing as what we're experiencing now.

I'll start with the reality, as I see it: Clients are generally spending money on only those items they perceive as absolutely necessary. If it doesn't hurt, if it doesn't embarrass them when they smile, it gets put on hold. If insurance doesn't "cover it," then treatment gets put off – indefinitely. Even tooth decay, which used to be taken care of promptly, isn't being completed. Regular hygiene visits are being spread out longer and longer periods of time because "everything feels OK."

What's alarming is that these visits are being put off even if their insurance pays the total fee! "Pending treatment" lists in practices are growing by leaps and bounds -- higher than I can ever remember. The numbers of clients pursuing "comprehensive care" are few and far between, despite the fact that -- for the most part -- incomes have not declined. Yes, unemployment has risen (double-digit in some parts of the U.S.), and some people have taken jobs cuts, but fewer and fewer people are willing to complete the dental care that will improve their dental health and quality of life. Of course, you know what will someday happen to the person who doesn't complete necessary treatment: Their options for treatment are reduced, and generally treatment is more expensive and extensive at that point.

Now is the time for you to step in and take charge, not play victim, and pay closer attention to every detail of your practice than ever before. What does that mean? Let me give you a list of those things I believe you should take a long, hard look at in your own practice, and decide on a course of action.

1. Re-evaluate every protocol you have. If it's pointless, outdated, non productive, and/or labor-intensive without little return on investment, sideline it -- or at least change it.

2. Spend more time than you ever have fine-tuning your relationship and communication skills. People DO accept care from doctors they trust, and these days they certainly won't accept care from someone they don't trust. You have to be an expert listener and be willing to proceed with the care only they are willing to complete at this time. Don't run them off!

3. Critically review your budget every six months. Look for ways to reduce overhead costs. Get creative by considering alternatives for every budget item, such as using a material that may not be "name-brand" but will still give you the performance you need to produce quality dentistry. What are you spending for insurances? Is your lease renegotiable? (You don't and shouldn't wait until your lease is about to end to do that.) Every dollar counts these days; we can't afford to go on a spending spree.

4. Get your team behind you 100%. You hired your team to support you in providing dental care, so spend more time developing them professionally and personally, if you can. If you can't, get help. If you have too many employees or have a team member who is only marginally productive, consider reducing your team size.

5. Working five days a week or more? Most practices can do what they need to do in four days or less, reducing labor costs. Yes, it may take a change in the way you schedule clients, and there will be resistance from the team if you cut back work hours. Don't let your fears deter you from making the best choices for keeping your practice healthy, profitable, and solvent!

6. Negotiate reimbursement fees with insurance companies. Some insurance companies allow you to submit a dozen or so fees to them for approval at a higher reimbursement rate.

7. Stay in closer touch with your clients than ever before. Take their "pulse": what they need and want, what they understand about their oral health condition, and ask them how you can give them the best services and care possible. It's one thing to imagine what they're thinking; it's another to KNOW.

There's much more to look at to reduce overhead and increase production and profitability, so this article is by no means comprehensive. If there were ever a time for you to be more proactive in the management, leadership, involvement with employees, and development your relationship and communications skills, NOW'S THE TIME.

Those practices that are proactive at responding -- not reacting -- to the current state of affairs will be the ones that continue to be successful, despite whatever's thrown at them. Make your plan NOW, because there's likely more bumps in the road ahead.

Don Deems, DDS, FAGD, is known is The Dentist's Coach and is actively engaged in private dental and coaching practices. His latest book, The Dentist's Coach: Build a Vibrant Practice and the Life You Want, is available via his website, along with a book he co-authored with Stephen Covey and Ken Blanchard, Roadmaps to Success: America's Top Intellectual Minds Map Out Successful Business Strategies.