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Practice Management: Refining Dentistry – A Prescription for Success

March 1, 2002
by Ian Wexler, DMD


The Balance Myth

I have continually been amazed at how many dentists are unhappy and unfulfilled. Truthfully, I haven’t met a single dentist or anyone else who has achieved “a balance,” where every aspect of life harmonizes and falls into place for a sustainable period of time. When you think about it, life is too dynamic to maintain a proper balance point. My philosophy is that what is achievable and sustainable is a “balance zone.” Think of a graphic equalizer on a stereo receiver with the different bars of frequency jumping up and down within a certain musical range. If you could prevent any one bar from extending outside the zone, you can avoid certain extremes and stresses in your life. The happiest dentists I have met live within this zone.

The Forgotten Dentist

Why is it that you can have two practices with almost the exact same specifications, yet Dentist A makes $75,000 a year, after expenses, while Dentist B makes $300,000? I contend that the most overlooked and important variable for success within any dental practice is the dentist. It is the dentist who is single-handedly responsible for a practice’s success or failure. It’s easy to be told that all you need is the perfect location, an intra-oral camera, an efficient recall program, and the ideal practice team. These things, although helpful, do not guarantee higher revenue, lower overhead, or a higher bottom line. Ultimately it is the dentist’s ability to communicate, manage the practice, and perform quality dentistry in the most organized and efficient fashion that matters most.

Control is key

One of my favorite lines is that “you can’t run a million dollar business in an 8×12 room, with someone spitting on your fingers all day long.” In my journeys, I found one of the single greatest reasons for apathy and dissatisfaction among dentists is a loss of control.

I have found that the happiest and most successful dentists dedicate substantially more time to the “running” of their practice than average. They take a minimum of one-half day a week to hold staff meetings, develop practice business systems, review computer cancellation and production print-outs, and basically every other facet of “the business of dentistry.” In addition, many of these dentists realize their weakness in handling business affairs of the practice. To compensate, they hire a practice manager or practice management consultant to assist with these duties.

Interestingly enough, these same dentists make more money and work fewer hours than the average dentist; in the range of 30-32 billable hours per week.

How am I doing?

Success to one dentist is considered failure by another. It should be obvious that what matters most isn’t what you bill, but what you take home. How you are doing “income wise” is a function of a number of variables, including where you practice, the type of practice you have, the types of dentistry that you perform, as well as the stage your career is at. You should focus on who you are, your own practice, and your own needs. At the same time, never be complacent and always strive to improve your practice as well as your own abilities. Monetary success is a natural by-product of this.

Business is business

First, dental graduates are poorly trained as business owners and managers. Second, there are not enough articles, books, and courses on the business of dentistry. Third, most dentists do not run their practice at an optimum level of efficiency, organization, and productivity. Fourth, many dentists just aren’t the businesspeople they need to be.

Most dentists have no idea about things such as billings or overhead costs per hour. It’s the rare office that has a marketing program or advertising budget. As many accountants will attest, their dentist clients never know how they are doing financially until tax time each Spring.

What can you do to run a better business?

Read books on various business issues and subscribe to business magazines. You will learn what other businesses have done to achieve superior levels of success.

Meet more frequently with your accountant to get a better handle on your office finances.

Take general courses dealing with practice business issues.

Make sure you have the best set of financial advisors you can find who understand dental practices and your specific goals. They may be more costly in the short term, but will be worth it in the end.

Be careful of consultants and courses that are excessive in cost while only providing a band-aid fix. Although you and your staff may be enthused and motivated at first, without periodic follow ups and regular guidance, chances are that you will fall right back into your old ways. DPM

Dr. Wexler is an authority on insurance issues for dentists. He is the President of Protect-a-dent and Protect Insurance Agencies Inc., Toronto, which provides insurance products and consulting services to Dentists across Ontario.