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Making Dentistry Affordable

by Steven Mautner

Amazingly, I’ve been invited back by The Profitable Dentist to write another editorial. This one is a follow up to the last one which dealt with the absurdly high fees in dentistry we have today which have made many of our services unaffordable to the average consumer.

I’m often asked (well, maybe not often, occasionally) how can you provide dentistry at lower fees when each procedure has a certain amount of time required to do an adequate job. The answer is to reconsider the amount of time set aside (lower it), ignore the inevitable complaints that come from being “behind” and take walkin emergencies, at least in the morning or any time you prefer.

As an example let’s examine my scheduling “system”. I work out of four rooms and have three hygiene operatories manned by two and sometimes three hygienists as well as three assistants.

We schedule out of 7 columns on the Easy Dental (yes, Easy Dental) schedule template. Column 1 is for “major” procedures that I schedule an hour for, such as crowns, root canals, multiple extractions and insertion of immediate dentures, etc. Column 2 is for “minor” procedures, such as try-ins, crown deliveries, fillings and extractions. Columns 3 and 7 are for hygiene. Most cleanings are scheduled for 30 minutes but we throw in a few 15 minute appointments in column 3. Since we don’t confirm appointments, it’s usually not a problem as many (about 15 to 20%) don’t show. Columns 4 and 5 are for exams and an occasional child cleaning.

Most exams are given an hour, with an occasional half hour thrown in to accommodate someone that needs to get in. The reason that an hour is reserved for these appointments is just so they don’t overwhelm the schedule, not because I “need” an hour. The same goes for the major procedures, as the full hour for a crown, for example, takes into account assistant time.

With this type of schedule, it’s possible to provide $400 crowns because in any given hour I’m seeing another 4 to 5 patients generating additional revenue. Handling this requires focus and taking advantage of unavoidable pauses in all dental procedures, such as anesthesia waiting time (unless a PDL injection is used, which is another great way to speed things up) or material set times. It also requires alternately apologizing for being behind or just ignoring complaints. I know this is not for everyone but you did ask.

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