The View From Inside

An “insider’s view” is supposed to be valuable.  However, “you can’t read the label from inside the jar,” as the wise saying goes.

The pandemic has placed us all in the jar, so to speak.  We yearn for perspective, but we don’t know what we don’t know.  Through it all, we have marvelously adapted.  There are countless new protocols in dental offices, and patients have, for the most part, admirably adjusted. 

The Covid crisis is the most significant disruption to daily life and security since World War II.  The very act of coping causes us stress.  One day, we will look back and gain perspective on how our world of certainty was thrown off its axis but still managed to right itself.  For now, we soldier on.

For years we tried to educate those patients who had only sporadic contact with the dental profession.  We wanted to bring them in, show them all that modern dentistry has to offer, and turn them into high dental IQ patients who take responsibility for their oral health and consequently also garner general health benefits.

It turns out that there was a larger cohort, those loyal patients of record who would not be denied dental care.  They could not wait for offices to re-open; schedules filled quickly as patients rushed back to dental offices.

As dental practices work through the backlog of pent-up demand, the time is now to plan for the future.  The post-pandemic dental practice needs to rebrand itself.  Patients now have a better understanding of dentistry as an overall healthcare service.  Practices need to build on that understanding and redouble marketing and education efforts.

The future of dentistry is bright, but it will not write itself.  It’s time to think about emerging from the jar, surveying the landscape, and planning for success throughout the rest of this year and into the next.

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United We Stand

The dental professional is waging a ferocious war against COVID-19, the invisible enemy.  To prepare for battle, dental professionals have Zoomed, webinared, phoned, e-mailed, texted, talked, reflected, discussed, shared, learned, and shopped. To reopen, dental practices have masked, barriered, digitized, cleaned, covered, sprayed, wiped, sanitized, decontaminated, autoclaved, air purified, suctioned, UVed, and fogged. 

Patients are held in their cars or hallways, the wonderfully euphemistic “virtual waiting room,” until those other potential virus-carrying patients are gone, then ushered in to be greeted by the administrative team through plexiglass and/or masks and face shields to be temperature checked and health questioned.  Patients are asked to wash their hands, and in some cases also instructed to rinse their mouths and don disposable protective gear just for them. 

In treatment rooms patients encounter a clinical team in full COVID-19 PPE regalia who look like Neil and Buzz on the surface of the moon, triumphant in a hostile environment.

For years we talked about educating patients and explaining treatment.  The pandemic has reminded us that there is a cohort of patients who are committed to optimal oral health.  They demand dental care; they hold dental professionals in high regard; and they appreciate all the extraordinary measures taken to keep them safe.

Given the dental profession’s outstanding track record of protecting patients, their team and themselves from cross contamination due to H1N1, HIV/AIDS, SARS, MERS, and other pathogens, the public can rest assured that dentists will never be satisfied in their quest to provide quality care in the safest possible environment.  When dentists cannot jam one more piece of anti-viral equipment into a treatment room, they still ask, “Are we doing enough?” 

The virus is a formidable enemy, but it does not stand a chance of getting between dental professionals and their patients.

COVID’S Big Impact on Dentistry: Teledentistry

Have you been on Zoom lately? Last year Zoom was averaging about 10 million participants per day. Now they are getting 200 million participants per day.

There was a survey recently about telemedicine that asked if people would use telemedicine for any reason to access the healthcare system.  Two-thirds said “yes.”

We now have a wonderful confluence of people who are used to video chatting and people who say that this video medium is a good way to access the healthcare system.

Enter teledentistry. Prior to this COVID crisis, I thought teledentistry was somewhere between a gimmick and a novelty. Now it’s a game changer. Many people don’t access the dental care system because of barriers, such as cost, time, fear of the dentist, or something else. Some people don’t think about dentistry until late at night when they are brushing their teeth. If they have a question or a problem, they do not always call you and leave a message. With teledentistry, they can make a quick video, upload photos, and send you a message 24/7.  The next day you can respond with a video chat to build rapport with them. If it’s an emergency, of course, you’ll get notified right away and you’ll advise them.

In terms of rapport building, marketing, and being able to break down barriers, teledentistry is absolutely amazing. It’s also very powerful in terms of case acceptance. By definition, a new patient comes to the office for the first time and they have to meet you and comfortable with the office.  With teledentistry, they have already met you (virtually). You have already established trust with this patient.  When they come to the office after a teledentistry consult, it’s not all new and intimidating.  In addition, some doctors are using that first actual appointment in the office for diagnosis and treatment, because they already have a relationship with the patient.

What platform should you use? I don’t have an interest in any company doing teledentistry and I know that doctors choose whatever platform suits their needs.

I am focusing on creating teledentistry protocols.  How’s it going to work? What are the mechanics? What are the expectations for you, for the patient, your staff? How do you capture information? What about administrative details such as insurance, whether you take insurance or not? How do you make this technology a timesaver for you and make sure that people are not wasting your time? These are all great questions and we have to work on these protocols.

I am gathering information and I want to learn from you and share information that I hear from other doctors. Contact me through my website,  Let’s start a dialogue and bring others into the conversation. The goal is to pull together the best ideas and protocols, because teledentistry is a real game changer. It’s probably the biggest change in dental practice management since computers were introduced into dental offices a generation ago.

Teledentistry is a great opportunity, and if we all work together and figure out how to use it to full advantage to benefit patients, it’s going to be one of the best things that came out of this terrible COVID crisis.

Reopening the Office: A Tale of Two Cities

St. Louis and New Orleans, two cities with fairly comparable populations, have a huge disparity in the number of coronavirus cases.

Coronavirus Cases, March 26, 2020, 8:30 a.m. Central Time:

St. Louis (population 319,000) 69 cases.

New Orleans (population 391,000) 997 cases.

These statistics are for the respective cities only, not the surrounding areas. Similar differences in coronavirus cases appear across the country.

When will you be able to fully reopen your dental office?

Three factors will determine the answer to that question:

1. Where are you located? Hot spots such as New York will be locked down longer than many other areas.

2. Statewide versus county-by-county approach. Some states, such as California, have closed all non-essential businesses statewide; other states, such as Florida, are taking a more localized approach. The decisions made by your governor make a difference.

3. Availability of Personal Protection Equipment (PPE). Even if you are in an area that has been impacted less severely by the coronavirus, government officials will be reluctant to allow dental offices to open for business as usual as long as PPE is in scarce supply in some parts of the country.

In the coming weeks, look for a mixture of good and bad news: surging cases in hot spots, a push to reopen areas of the country with relatively few cases, and (possibly) an easing of the shortage of PPE.

Stay safe!

2020 Foresight: Three Ways to Increase Profitability

The year 2020 is not only a new year but a new decade.  Here are three ways to increase profitability in your dental practice.

  1. Commit to larger cases.  Demographic trends portend more older patients with increasing dental needs.  There is also a growing market for orthodontics—for both children and adults.  A restorative dentist told me recently that he has shifted his focus to larger cases.  Although he has always had a commitment to comprehensive treatment planning, he is now explaining the benefits of treatment in more detail to patients.  By changing the mix of services in his practice, he is now increasing revenue by spending more time on larger cases, which are inherently more profitable and more cost effective in term of hourly production.  
  • Train the Team.  Practice often underestimate the synergistic effect of good team training.  When team members are not sure how to proceed or what to say to patients in certain situations, patients may take the off ramp and park their decision-making process.  Effective team training is focused and involves sufficient repetition and practice to make the new behaviors standard operating procedure.  
  • Follow Up.  There are many patients who are not ready to commit to treatment on the spot.  They need to be followed up in a low-key but methodical manner.  Two ways to ensure proper follow up are to a) ask for permission, and b) establish a texting relationship with the patient.  You ask for permission by using a script: “Would it be o.k. if we followed up with you?”  Most patients grant this permission.  When a team member calls, the script to use is as follows: “I am calling like we promised.”  The call is not an intrusion, but the fulfillment of good customer service.  Another way to reach out is with a text message: “It was great to see you.  What questions do you have?”  If you can establish a texting relationship with the patient, you break down barriers.  The patient knows that if they have a question, all they have to do is send a text, and someone will respond.

There are so many patients who need your services.  Make a commitment in 2020 to serve those patients and at the same time increase practice profitability.

Be sure to visit my website for information about new and updated seminars.

The Rise of Corporate Dentistry—and the Demise of the Solo Practice

The corporate dentistry asteroid has hit the earth.  The skies are darkening.  Solo dental practices are declining at a rate of 7% per year.  Independent solo practices may not become extinct—they are always a few contrarians who soldier on—but they are becoming an endangered species.  The 7% rate of decline may not be fixed; it is likely to accelerate.

The consolidation of practices is being driven by the DSO model, an acronym for “Dental Service Organization” or “Dental Support Organization”—the terms are used interchangeably.  DSO’s are relentless in their pursuit of efficiency as driven by technology.

There are 168 hours in a week.  The average solo practice in the United States is open 35 hours per week.  In those 35 hours, the practice has to pay all overhead expenses and generate a profit.  If we focus for the moment only on fixed overhead, the solo practice is strikingly inefficient.  For 133 hours per week, the office is dark.  The fixed overhead meter runs like clockwork, week after week, month after month; but the production needed to offset fixed overhead only occurs during those precious 35 hours when the doors are open to patients.

The average DSO office is open 45 hours per week.  DSO offices usually have more than one dentist working at a time.  If there are just two dentists in a DSO office, and each dentist works 35 hours per week, the DSO office has double the production of the solo office.

With that kind of production power, the DSO can afford to buy the latest technology.  There are nimble solo dentists who make every minute count.  They post impressive production numbers and they also buy up-to-date equipment.  Ultimately, though, the hamster wheel can only spin so fast.  With expanded hours and more dentists, DSO’s have a built-in advantage.

Next blog:  Challenges that DSO’s face.

Take advantage of the sale on my Team Training Video Series.

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Capturing Great Dental Patient Testimonials

Great video testimonials are powerful because they engender trust.  All advertising about is claims: we’ve got the best car repair place, we’ve got the best jewelry store, we’ve got the best dental practice; but is that true? If they can see you, if they can see you on video ahead of time, the credibility factor goes up tremendously.

Here is a list of some really good tips to capture those patient testimonials.

  1. Use a video camera, not your phone. It’s very tempting to use your phone. Cameras are made for this purpose and they do a much better job for you, and video cameras have dropped in price considerably.
  2. Use a tripod. You don’t have to spend a lot of money; you’re not trying to capture the wildebeest going across the plains of Africa.  You just do not want the camera moving around–you want it to be fixed when you’re talking to that patient.
  3. Use an unobtrusive background. I’ve seen so many homemade videos where plants or plaques were growing out of people’s heads. It’s distracting.  The best background for video testimonials is the one you never notice.
  4. The patient should be talking to an off-camera interviewer. If patients are told to look at the camera, they won’t do it. They not professionals, they’re not used to it, they start looking around, they look over here, they look over there. We had one lady whose eyes were darting all over the place.  I call it the ferret video. She didn’t look trustworthy. Have the patient look at you, not the camera.
  5. The next tip is good lighting. Lighting is the hardest part of video, if you’ve got a spot in your office and you have figured out that you can put some lights there and make it a well-lit scene then always use it. Be careful also not to mix temperatures of light. Sunlight, fluorescent light, incandescent light—they all have different temperatures and they do not mix well.  You want to have some consistent lighting to make the video look good.
  6. You want to have clear sound. I cannot tell you how many patient homemade testimonial videos I have watched that were hard to hear.  There’s talking in the background, doors are slamming, you hear sounds of a high-speed, sounds of suction—and it’s all so distracting.   The audio is what we call “muddy;” it’s hard to decipher. Making the audio crystal clear will really help your video.
  7. Edit the video. I don’t care how good you are, your raw footage needs editing. You don’t have to buy expensive video editing software. Just Google video editing software. There are many options and much of it is very inexpensive. And if you don’t want to do it yourself, ask any teenager because teenagers all make video projects in school and they know how to do it.  You do not need Steven Spielberg.  You’re just trying to say take this segment out, put this segment here–just to make it flow.

Video testimonials are so important to capture, and I’ve given you advice on how to do it. I go out to offices and we do welcome to the practice videos and patient testimonial videos.  Click here for more information and samples.  Call me if you want to know more; but if you want to do it yourself, these are great tips for you.

A video explaining how to create videos is available by clicking here.