Oral Health Group
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Crystal Ball 2004: 2004 Predictions

December 1, 2003
by Lisa Philp


The beginning of the New Year always seems to bring with it a sense of promise and potential. Well, for those of you too anxious to wait, here are a few trends I believe will affect how you will deliver dentistry in 2004 and beyond.

Trends in technology — Internet

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Technology is not new to the world or to dentistry. And, I’m not here to announce anything as significant as the invention of the personal computer or the creation of the World Wide Web. But a trend that will affect how today’s dental offices operate is using technology to be more connected — within your practice and with your patients.

Every day, thousands of Canadians will use the Internet as their preferred way to find out more about your dental services and what you offer. Why? Because it is a quick, easy and convenient method of seeking information. Marketing your practice with a well-done Website will be a popular way to increase new patient flow because it appeals to people’s visual emotions. The practice Website shows dynamic depiction of a practice, its team and culture, and the services it provides. The CD business card will replace practice marketing printed materials, including practice brochures, newsletters and other patient information. They are less expensive to produce and much more effective in informing current patients of new procedures and generating new patient referrals.

Paperless charts

We have heard for years of the trend toward a paperless chart, and we are definitely going to see this materialize in 2004. Dental software programs continue to evolve with electronic signatures, voice-activated charting and online medical histories that patients can complete in the privacy of their own home and e-mail to the practice prior to their visit.

E-mail confirmations

Another way the Internet can be used is for patient correspondence is the use of e-mail appointment confirmations. I’ve often said that no one harasses the home of a Canadian family by telephone more than a dental practice. Instead of making up to five calls to make sure patients are going to show up for the appointment, we will begin using bulk e-mail confirmations and “read replies” to confirm patients have received and read the email and consider that the appointment confirmation. Instead of the patient receiving a volume of telephone calls that can quickly become annoying, with e-mail, they receive a professional confirmation of their appointment they can read at their convenience. E-mail confirmations not only save time, they also saves money by eliminating long-distance phone costs and postage. A verbal confirmation left on the answering machine of a busy professional is not usually considered a confirmation. But soon you’ll be able to confirm even your busiest patients’ dental appointments by sending an e-mail to their laptop, desktop, or BlackBerry, or even by text messaging their cell phone.

In addition, I’d like to mention two other technology trends for 2004. The first is integrated clinical and management computerized system, which is a networked computer system in every operatory. The clinical team members will need to be computer literate to function in tomorrow’s dental world. Clinicians will be posting all completed treatment, enter all planned treatment and schedule future appointments before the patient leaves the operatory. There will be a reduction in stand-up patient checkout traffic at the front desk and practices will continue to develop the treatment coordinator role. The second is digitization through digital radiography, digital photography and storage and retrieval of images with an effective integration of image management software programs. The intraoral camera is still a trend for 2004 as 57 percent of dental practices currently do not own one. It has a consistent return on investment in dentistry and is an integral contribution to increased case acceptance.

These are the main thrust of trends in technology and we need to embrace the progression of the technology revolution. Research has shown that 95 percent of Canadian dentists have Internet access in their home or practice, yet less then 33 percent use it for any type of patient contact or correspondence. It is no longer a question of “if” the practice will plan for technology, it is a case of “when and how” can a budget within the overhead be created.

Trends in delivery of patient service — never treat a stranger!

There is absolutely no question that the delivery of dentistry has and will be changing as Baby Boomers continue to age. In Canada, Baby Boomers are defined as individuals born between 1947 and 1964, and today account for one-third of our country’s population. Due to the sheer number of Canadians in this age demographic, they have been driving market trends in government, business and healthcare for decades now, including dentistry.

Baby Boomers want to look younger and they want to feel better, so smile design and functional enhancements with implants will be the services that dental offices must be able to provide to meet patient demand. In fact, implants and veneers are the top two growing procedures in practices today.

Not only do practices need to be comfortable with the ability to diagnose these cases, but also gain the technical training and confidence of how to perform these procedures. In 2004 we will see a significant increase in enrollment in hands-on courses and the need for organized, strategic budgeting and goal setting for continuing education for the entire dental team. We will also see an increase in enrollment for training in case presentation, because the communication skills used in the past to gain acceptance to “tooth” dentistry within the confines of an insurance annual maximum are very different than the skills needed to present modern comprehensive plans. The future skills involve the entire dental team providing eloquent case presentations based on their ability to listen to patient’s wants and find creative ways to help the patient fit dentistry into their lifestyle and financial budgets.

Baby Boomers want premier service. They want to know how you are going to serve them, cater to their every wish and prove why they should choose you for their dental goals. The secret to providing service to Baby Boomers will be about relationship and trust on a behavioral level.

Trends in practice management

Dentists are realizing that they need to surround themselves with experienced and competent companies and coaches to provide outsourced services in areas of the practice the dentist has not been trained. The modern day dental practice encompasses so much more than mastering and delivering dental services and trying to maintain or create profit.

Today, the dentist must wear three hats: the technical provider; the manager; and the leader. As the technical provider the dentist is the main practice revenue producer. As the manager, they must be able to comfortably delegate and use a facilitative style of leadership. The facilitative leadership style is a “people come first” style where there is natural relationship building and a clear path to the vision, which creates a sense of belonging and fulfillment for all dental team members. When this leadership style is executed well, team members can believe in, promote, and plant the seed for solutions of smile and implant dentistry.

With all the demands on the dentist, including the need to maintain their technical skills, evolve their management skills and improve their own patient relationship skills, it will be much more practical and beneficial for them to outsource the daily operations and the organizational systems approach to the management of the practice. One area of outsourcing is human resources, including recruiting, hiring and interviewing. In Canada, there is a shortage of experienced dental administrative persons. So dentists will need to partner with employment experts who are creative and can go out of dental industry and attract successful, effective team members. These team members will first and foremost need to be comfortable
with money, be curious about patients’ dental outcomes and understand the philosophy that dentistry is part of a person’s overall wellness, not just a place where people come to get their teeth fixed.

Trends in practice financial health

Annual patient revenue

The law of money clearly states that if you put the patient first, then the revenue will follow to buy the things you need to continue to deliver quality dentistry. From a revenue perspective, the trend for 2004 is for dentists to increase their annual revenue per patient (ARP). Today, the average Canadian dentist produces between $250 and $350 per patient per year. Over the next few years, they are going to need to increase that annual revenue per patient to be able to keep up with modern technology and marketing services. This will be accomplished by organized systems and operations combined with a high performing dental hygiene department and ability to effectively move the dentistry out of the charts and into the mouths. I often refer to dentists as “cabinet millionaires,” because the average dentist has $500,000 to $700,000 of undone dentistry sitting in their charts without gaining another new patient.

Practices will need to evaluate the amount of unaccepted dentistry and begin to nurture their practice from within.

Fee-for-service

Another big trend worth mentioning is the movement towards fee-for service and moving away from the “just bill me “attitude. It will become even harder to access policy information for the patients due to the privacy act. There will be an ever-increasing understanding that Canadian insurance policies were designed by employers based on cost concerns with insurance companies whose number one priority is profit. The patient is the policyholder and the practice is a third party in the relationship that will electronically file claims as a courtesy. Insurance is a minimum financial assistance for preventive and basic restorative needs. It will never be designed as a “pay all” for optimum dentistry.

Financial partner

Another trend is a significant increase in the number of practices aligning themselves with a financial partner who offers a patient financing program. The alliance will take the dental practice out of the banking business and make dentistry affordable for Baby Boomers that are used to credit with ‘no interest’ payment options. Today, 17 percent of Canadian dentists are using some form of third party financing and more than 22 percent are currently considering this option or planning on it for 2004.

One final trend that is important to a dentist’s future is the need for them to have a clear transition strategy. They are going to need to prepare their practice and determine how they are going to leverage the potential and the value to a more educated group of potential buyers. New dentists are much more educated on what a good buying decision involves as far as active patient counts, incomplete dentistry and transfer of goodwill risk. There will be a lot more competition when selling a practice, because the availability of practices will out number the buyers.

Lisa Philp RDH, CMC, is president, Transitions Group.


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