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Mastering The Business of Dentistry – Increase Production Every Year

Hello Readers,

I am incredibly excited to provide a new column for the Resnik Implant Institute newsletter. I have great respect for the educational importance of the Institute, and I hope that I will be able to contribute ideas on the business of dentistry and increase practice production that will benefit all students and alumni. My career as CEO of Levin Group began with one question that I am still asking 38 years later: How do you increase production in a dental practice while reducing stress? Based on this career-defining question, I look forward to providing relevant information that includes practical recommendations that can be implemented quickly to benefit all your practices. So, here we go.

All the best, Roger

FOUR WAYS TO INCREASE PRACTICE PRODUCTION

Dentistry is a business, and as a general dentist who practiced ten years full-time and then kept a hand in clinical dentistry for many years after that, I found that one of the biggest challenges for dentists is balancing clinical education and skill set enhancement while mastering many of the essential business skills that determine their career paths and the long-term performance of their practices. Dentistry is a complex small business. Like much larger businesses, it must deal with various operational areas, including financial management, human resources, customer service, inventory, overhead control, and recruiting and hiring. The difference in dental practices is that all these things must happen while the dentist also spends most of their time with patients focused on clinical excellence. The key to success is implementing documented, proven business systems that allow the team to operate at the highest and most efficient level. I will focus on one essential concept throughout these columns: increasing practice production. In any business, one measurement or metric is more important than any other in understanding the business and making strategic decisions. For dental practices, this number is production. Looking at production alone and as a ratio with many other factors, such as overhead as a percentage of production, production per patient, production per hour, production per implant patient, and other ratios, will give more insight into practice performance and where the strengths and weaknesses exist more than any other single measurement. For this column, it is essential to understand that production will be the number one factor in determining a practice’s short-term and long-term success, and the good news is that production is healthy. The ratios are in line, which indicates that your practice is healthy and performing well.

  1. INCREASE THE NUMBER OF IMPLANT CASES.
    Many or all of you have had the opportunity to receive advanced implant education through the Misch Resnik Implant Institute. Adding a new service to a practice is always a beneficial strategy for increasing practice production. Some of you are already involved in implant dentistry and others are learning it from the beginning. Your clinical education was comprehensive and created a wonderful opportunity to develop the confidence to be involved in implant dentistry. But there is another side…The other side is the business side of dentistry and dental implants. In many cases, even with advanced clinical education, dentists tend to simply add the new service and identify patients on a random basis for treatment. This is a reactive approach which means that the practice has not developed a plan to drive dental implants to a higher level. If you want to increase the number of implant cases, then it is essential to design a strategic plan and specific goals around the implant component of the practice. There are a number of areas to be addressed, and, again, we will focus on many of these in future columns. For example, educating every patient on the fact that implant dentistry is available as a service, starting with the first new patient phone call, is a great starting point. Levin Group further recommends that you have a recurring email that reaches patients every 30 days and includes at least one update on implant cases and the benefits of implant dentistry. It could be advancements in the field, types of patients that qualify, new information, or just an overall reminder of the key benefits. Another example is the power of the dental hygienist in educating every patient in the practice through a scripted overview about implant dentistry. While most patients won’t need implant dentistry at that moment, they may know others who would benefit. Keep in mind that any time you add a new service to the practice there should be a strategic implementation plan and then a long-term communications plan developed to continue to advance the number of cases each year.
  2. SET SPECIFIC GOALS.
    Goal setting is one of the most powerful activities that a dentist can engage in. This is because goal setting opens your mind to possibilities. You learned a great deal about dental implants in your education and your mind was open to the possibilities of offering and growing the number of implant cases. However, without setting a goal to increase the number of implant cases every year, your mind won’t be open to the possibilities of how you might achieve that goal. Levin Group recommends that you set a goal for the number of implant cases you will perform in any given year and that they grow by at least 10 to 20 percent annually. The fact that you may not know exactly how you’re going to make that happen when you set a goal is not important. What is important is having the goal. By setting the goal you are now opening your mind to the possibilities of how you will achieve it. It may be by adding additional clinical knowledge, enhancing the internal marketing program, adding an implant treatment coordinator at least part time in the practice, offering the right spectrum of financial options, or inviting new patients or family members of patients for no-cost implant exams. These and other strategies become the beginning of achieving the goal of increasing implant cases each year by 10 to 20 percent.
  3. REACTIVATE ALL OVERDUE PATIENTS.
    Levin Group is currently conducting a study on prioritizing practice production strategies. In our initial findings, there are 244 ways to increase practice production by 1% or more, with some of them achieving a 10 to 20 percent increase. The objective of the research project is to work through a process of ranking these production growth strategies in priority order. Because of the pandemic, we believe that the number one way to increase practice production is to reactivate all patients who don’t have a next appointment scheduled. The approach we are now teaching practices is that any patient who is one day overdue for their appointment will be contacted that day by phone or voicemail using positive and energizing scripting. We then recommend a nine-week follow-up process that starts with three text messages (one per week) followed by three phone calls (one per week) with voicemail messages left and followed by three emails (one per week). We often hear from dentists that this may be perceived as overwhelming or even harassing by patients; however, we find that the average response time for this process is about 4 weeks. Why is it so important to reactivate overdue patients? The answer is simply that the more patients you have, the more candidates you will have for implant dentistry.

Additionally, reactivating patients increases practice production significantly. One of your goals is to increase implant dentistry by 10 to 20 percent each year and these reactivated patients will likely have other dental needs to add to practice production. In another study that has been conducted by Levin Group, we focused on revenue losses over a 36-year career from areas not addressed by the practice over time. We estimate that the lost revenue to an average practice from patients that are simply off-cycle in their visits could be as high as $2 million over 36 years. This does not include patients who do not have their next appointment and never end up coming back to the practice. That lost revenue would be considerably higher. Therefore, it makes sense to have a rigorously followed system regarding reactivation of overdue patients.

  1. INCREASE PRACTICE PRODUCTION EVERY YEAR.
    The single most important objective of each practice is to increase production on an annual basis. Certainly, there may be a few years over a career where practice production does not grow, but you want to always be working in that direction. Dentistry is a business and as a business it will face new changes and challenges on a regular basis. These can be overcome by focusing on having at least three new strategies each year to propel the practice forward. For example, one practice we know set these three goals:
  • Perform 25 more implant cases than the previous year.
  • Reduce no-shows to under 2% (currently at 6%).
  • Add one new assistant and select an assistant to be trained to educate patients interested in implant dentistry before the patient meets the doctor.

Each practice must determine what goals are in their best interest. For example, a different practice may identify weaknesses in staff training and set a goal of enhancing the skill set of all dental assistants in a specific set of clinical areas, including assisting with implant dentistry. SUMMARY Dental practices are businesses and dental implants, as and expanding service, represent one of the best ways to increase practice production. However, increasing the number of implant cases is only one strategy amongst many that will allow practices to increase production and practice performance. Understanding the key drivers of practice production will ultimately allow a practice to achieve the essential objective of increasing production yearly.

ROGER P. LEVIN, DDS Roger P. Levin, DDS, is the CEO and Founder of Levin Group. This leading practice management consulting firm has worked with over 30,000 practices to increase production. A recognized dental practice management and marketing expert, he has written 67 books and over 4,000 articles and regularly presents seminars in the U.S. and worldwide. To contact Dr. Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit www.levingroup.com or email rlevin@levingroup.com.

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