Where are you going?

by Kevin Coughlin

These may seem like simple questions however they are extremely important when considering your overall financial, physical and spiritual wellbeing.

Dentistry, as we know it, is changing right before our eye. However the more things change the more they really seem to stay the same. Each of us as individual practicing dentist will be making decisions that will impact the type of care and perhaps more importantly the way we provide are care and services over the next few years. Change is always occurring, however, the change we are witnessing now will make the influence of dental insurance on our profession seem like nothing!

The data is clear, fewer dentists are practicing as solo practioners and more of us are moving toward group practice careers. The reasons are many and varied, however, the biggest reasons are perhaps a better work life balance. With ever increasing regulations, and increase education debt and the high cost of dental technology and ever increasing influence from third party payers, have put enormous stress on the solo practioner to wear more and different hats. You are expected to be an excellent healthcare provides leader, businessman or businesswoman, attorney, accountant, CEO, CFO, CIO, marketing expert, community leader and family person. Is this even possible?

For many of us the answer is clearly no. As we look to the future we can only guess at the outcome but we should clearly recognize the changes and opportunities that exist before us providing we take the correct steps, institute the right processes and procedures and position ourselves and our practice to take advantage of what lies in front of us.

The following opinion piece is based on over 30 years of practicing general dentistry full time along with owning and running 14 dental practices with over 100 employees. Dealing with the trials and tribulations that we all deal with every day. My experience with DSO’s and MSO’s, teaching practice management or what I prefer to say teaching the business of dentistry at Tufts School of Dental Medicine. My point is, that although some of the following is my opinion, it came with much research and a very strong background in the business of dentistry, specifically in how to increase your rate of success (which is good for you, our profession, and perhaps most importantly, our patients and employees).

Perhaps the greatest threat, or depending on your outlook, the greatest opportunity presented to our profession is corporate dentistry. In the truest since, most of us have a corporation and/or operate within our dental corporation. More specifically I am referring to DSO’s and or MSO’s (Dental Service or Support Organization or Managed Service or Support Organization), which have specific difference from your ordinary mom and pop solo dental corporation. That difference, in many cases the MSO’s are backed by equity partners with millions of dollars to support their groups with marketing, education, expansion and support. Another big difference and perhaps even more important is that these groups are only in the game for a short period of time 3-7 years and in most cases the investment arm takes their money and profit and moves on to another investment and another group will move in with perhaps better or worse ideas and new team members. This can cause disruption and lack of continuity and discourse within the organization. On the positive side process and procedures will be put in place that could perhaps reduce waste, control some cost but perhaps increase other cost by additional layers of management and a greater need for profits and less focus on long-term growth and more emphasis on the short-term to reduce cost increase profit for short-term gain and perhaps long-term failure.

The question we should be asking ourselves is not whether we agree or disagree but how must we adapt and modify our practices and prepare are team members and the public for changes that are already upon us.

I suggest you consider that there may be room for both types of business models and the hope is that each model will force the other model to become better not just in care but in service as well.

Ask yourself the following question… do you think the public yearns for the years past when you could go to a mom and pop pharmacy to pick up your prescriptions (and in most cases the pharmacist was the owner)… I think not. With CVS, Walgreens, Rite Aid you would be hard press to find a solo pharmacist today and the ones out there find it difficult, if not impossible to compete.

The difference between dentistry and pharmacy is that, although we both provide services and products, we as dentisst, offer something more personal… something much more difficult to commoditize… we offer a specialized type of care and treatment with an artistic element and skill that vary tremendously between different practitioners. Perhaps this is the area that those of you who don’t want to give up your autonomy may have to recognize and improve on.

Most likely the market will have room for both business models. Patients will be attracted to both models bases on their needs, finances and education. The vast majority will be moved by slick marketing, convenient hours and locations. Other patients will be looking for continuity of care, specialized services, and what I like to say is BLT… The patient will be looking for an office they Believe in, Like and Trust.

No model is all bad or all good. For those that want to carve their own course, take what is good and working from the MSO’s and implement it into your private practice with an emphases on standing out from your peers and/ or competitors. Focus on developing your team to provide outstanding care and service or, as I like to say, be so good at what you do that patients cannot help but refer family and friend to your office. Keep in mind that quality care and service over the long-term are no accident. It takes enormous time and effort to make sure each process and procedure is not just good but great. Your goal is to have your patients have an outstanding experience.

For those of you choosing the other route keep an open mind, help educate the mostly non-dentist leaders of the corporate world that not everything is dollar and cents. Help them realize that even when their game plan may have a short-term horizon, great processes and procedures make good business sense and will lead to less turnover, better outcomes, happier team members and a higher quality of care and service.

For those of you swimming upstream and really interested in creating a SPECIAL dental practice start with improving your scheduling, production, education, collection, insurance, accounts receivables and liabilities.

Looking for more information on these subjects and others look no further in Destin Florida in the Spring of 2017 sponsored by Excellence in Dentistry and The Profitable Dentist sign up now!

Dr. Kevin Coughlin is with Ascent-Dental Solutions. For insight into each of these areas presented in this article, go to AscentDental-Solutions.com or call t 1-800-983-4126 and sign up for my free webinar.

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