Practice Management: Too Many Patients?

by Timothy A. Brown

A large percentage of Canada’s ‘middle-age’ dentists are about to reach a point in their career where they desire to reduce their working hours. This is a direct result of the aging baby boomer population. The need to work fewer hours as we age is a natural process that most self-employed professionals experience. I believe this trend should be encouraged, to prolong our lifespan and career span.

Evidence of this trend among dentists is found in the discussions I have with clients. Many report that they have too many patients in the practice and they lack the energy to treat their increasing needs. Effectively, they have too many patient demands yet they want to reduce their hours. This dilemma occurs most often with solo dentists. It’s an unfortunate side-affect of being successful and choosing to operate as a sole proprietor. I predict that every solo dentist will experience this at one stage in his or her career.

What should you do when this happens to you?

Relax. This is a common symptom of the maturation of your practice. Having too many patients is a luxury and an opportunity to modify both your dental practice and your practice philosophy.

Let’s consider the basic economic principle of supply and demand for a moment. It states that supply has an impact upon demand and vice-versa. It also proves that price changes with a rise or fall in either variable.

Now let’s consider the dental practice that has too many patients. This suggests a greater demand than supply. The result should be a higher price. Another resultant could be a limiting of the supply, which would support the increased price, while allowing for less work to be performed at higher fees.

Essentially, this is the work less/make more objective that most professionals strive towards as they develop their unique expertise. The limiting of the supply of a service can also be related to the principle of scarcity. Scarcity suggests that when the service is in very short supply, it may demand a very high price. Specialists are a good example.

Can general dentists implement scarcity in practice?

Yes. I believe that general dentists, at various stages of their careers, can test this theory.

This is how you test this theory for yourself. Schedule a month or two of limited hours within your practice. You must plan it purposely and resist the temptation to open up more than 10 or 20 hours each week in your schedule. After the test period is over, return to your regular schedule for a few months then repeat the process again. Then judge the results for yourself, both personally and financially.

You should discover that your scarcity (limited supply) immediately supports the increase in demand for your service. At first this appears to be an obvious effect due to your reduced hours. However, the unique side effect, which is often overlooked, is that you will be able to increase your fees. Some patients will have difficulty adapting to the new fees and hours, and others will seek out a new dentist, thus creating a net patient loss for your practice.

This may seem bizarre to some of you, but I know of dentists who are budgeting for a net patient decrease figure, not the more typical new patient increase figure. The resultant they are seeking is that fees will increase and hours will decrease. Most professionals can take advantage of this phenomenon, assuming they are fully booked. This test is not advisable to those who are servicing large debts or family obligations. And furthermore, there are individual circumstances to consider.

The principle of supply and demand is at the core of most every capitalistic venture. If, after trying this experiment you have not found relief, you may want to consider your other options, such as contracting a permanent, part-time Locum dentist to assist with your patient load. Whatever your patient load is today, it can be modified to suit your personal needs. If you have too many patients, and desire to work less/make more, this test may prove to be one of the greatest you have ever undertaken.

Timothy A. Brown is president & C.E.O. of ROI Corporation, a company specializing in dental practice appraisals, brokerage and consulting across Canada.

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