Oral Health Group

REBUILD: Is Your Practice Pandemic-Proof?

September 3, 2020
by Lisa Philp, RDH

We are approaching the last quarter of one of the most challenging years in history. Dentistry has finally reopened its doors for non-essential and elective care, while adapting the new operational standards. This new normal includes changes to the facility, training for team members, modifications to scheduling and the implementation of the COVID-19 contactless patient experience. Now is the time to rebuild and show that your dental practice is pandemic-proof.

What defines the components of a “pandemic-proof” dental practice? Our family at Transitions Group has prepared the ideal adaptations with tips on how you can rebuild your practice.


An ideal pandemic-proof practice requires a variety of criteria. To begin, all team members would be provided with The New Normal: Practice Playbook E-Book, trained on the COVID-19 Cycle of Care and sign off on their learnings. The practice leader should check in each week to debrief on how the team is managing. It’s important that the leader supports their team’s ideas to tweak or modify the processes in place along with the standards from public health, occupational safety and the dental colleges.

The dental team is aware and comfortable with how their leader has invested in their safety and is grateful that they were chosen for the new normal. The team is open to change and follows the playbook guidelines for workplace social distancing, daily screening and disinfection protocols.

The administrative team is managing increased tasks due to public health mandates for COVID-19. The administrative team has defined roles and has allocated all shared responsibilities. They know who is responsible for the team screenings and temperature checks before every shift with time clock entry and exit tracked. They have been trained with the COVID-19 Cycle of Care and modified many systems of confirmation, reminders, and engineering of the schedule for procedures and providers. They have assigned operatories for AGP and obtained COVID-19 screening preparation prior to arrival at the practice either manually or electronically.

The restorative and hygiene clinical team has adapted to the changes with focus on access to PPE and mastered the donning and doffing process to infection control standards. They are aware of operative air flow and how AGP (aerosol generated procedures) will be handled with a time schedule. They know how to manage hygiene exams frequency and limitations while always following the COVID19 contactless patient experience. They complete all posting and pre-scheduling in the clinical area with hygiene billing matching the time of visit.

The patients of a “pandemic-proof” practice were communicated with throughout isolation and informed about all the changes and enhancements with a welcome back letter. Over 50% are grateful to book a dentist or hygiene appointment and are aware of the contactless patient experience as well as what they need to do before they arrive.

They are confident about their safety when they see all the extra measures and pandemic protections. They will leave reviews and tell their friends!

The process of calling back patients is happening in 3 stages.

Stage 1: Utilizing electronic contacts to bring back all those who had cancelled appointments due to the shutdown.

Stage 2: Recalling all overdue hygiene patients to fill in any gaps between the existing and pre-scheduled appointments.

Stage 3: Reaching out to all active patients who have not been in since the practice’s reopening. This is to try and secure patients to begin treatment planning and case acceptance using virtual presentation aids.

At the onset of the pandemic, production was believed to be delayed or postponed since no one knew how long the shutdown would last. As the days and weeks turned into several months, it became apparent that the revenue was more than just delayed. Revenue was in jeopardy of being lost forever with serious implications to cash flow, profitability and a significant reduction in the overall practice value.

You can pandemic-proof your practice for production by beginning with setting a goal to reach your pre-shutdown monthly average by October, 2020 or earlier. If you can show you reopened and were back to your pre COVID-19 top line within 3-4 months after phase 3 of reopening, your lost revenue will be accepted as a pandemic shutdown delay in production.

Once the goal is set, the key is figuring out how you can achieve it and what it will take to produce like you did before January 2020.

Below is a list of best practices from members of our Transitions Family – who by the time this article is published, would have EXCEEDED their pre-shutdown production.

Some tips for production include:

Engineer and plan the schedule with blocks. Format each day to gross a production goal based on the monthly average before COVID-19. For example: Dr. Smith produced pre-COVID $50,000 and he worked 16 days. The daily goal would be $3,125 per day.

Identify the operatory schedule for AGP procedures with agreed upon fallow time if applicable.

(NOTE: Operatories that are closed and have air purification after much controversy, sent confusing messages and provided a mis-interpretation of science. The maximum suggested fallow time has been reduced to 15 minutes between AGP treatment rooms and procedures.)

Stagger the start time of providers, especially hygiene so patients are not in need of exams at the same time or exit all at once.

Implement an annual exam in hygiene that includes updated perio charting, x-rays, and restorative exams. The dentist will confirm all needs in the oral health treatment plan.

Detail the schedule daysheet with the exact names of each procedure, tooth numbers and codes for all to see.

Block emergency time in the middle of day and make sure those appointments qualify as a true emergency since there are currently no walk-ins.

Hygiene should not expand their appointments since they’ve learned donning and doffing. The clinical visit remains the same with billing codes matching time and procedure.

Perform annual hygiene exams or recall exams at the beginning of AGP procedures.

• If a patient needs an extensive treatment plan, bring them back to a non AGP room with no PPE and use visual tools to present their findings and solutions.

Collection at the time of service is more crucial than ever before. This will not only save hours and months of statements, but insurance as well as copays. Collections will help to cover the increased costs of reopening, PPE and overhead as we move forward.

Collection at the time of service is easy nowadays since there is so much available technology for automation of payments. Some options include Google pay, Apple pay, online banking and e-transfers.

For collections of copays and deductibles, most insurance companies offer an online portal for the patient to see their dental insurance benefits. For the practices that take assignment, there will always be a need to follow up and make sure the insurance claims have been paid daily and weekly.

Collections of accounts receivable can be added to the total collections for outstanding money owed from past dental care. This will take a professional and focused effort to contact each patient by name via the accounts receivable report. You will need to arrange how and when they will pay their outstanding balance.

• Work on cash flow to break even with your Transitions Team Coach and plan for upcoming deferrals.

• Clinical case presentation is a must by providers.

• Go back to the recall program and fill hygiene to 90% capacity.

• Watch for antibody tests as they will revolutionize dentistry.

The new normal of dentistry operations doesn’t have to be a block in your growth if handled proactively with leadership. A synergistic team can transfer confidence and safety assurance to your patients who will drive the production, collections and case acceptance in your rebuild process. We are still all in this together.

Transitions Group’s COVID-19 Survival Guide, which started in March 2020, has been supporting dentistry through shutdown shock, unknown isolation, cabin fever and conflicting guidelines and mandates. All while providing all the tools to reopen and rebuild with specialized and adapted post COVID19 e-learning courses, virtual town halls and on-site coaching modules – so you can be back on top!

We are committed to continuing to support dentistry with our expertise. Together we will transition into the new normal of dentistry while helping the practice owners to succeed and advance.

Please feel free to join our Transition family for all the latest post-shutdown tools and resources.

About the Author

Lisa Philp RDH, is the Chief Visionary Officer and founder of TGNA: Transitions Group North America; a fullservice coaching company for dentistry. Her career began in clinical hygiene, however she quickly transitioned into a world class coach; creating a periodontal disease management program, in which she coached thousands of dental professionals. Lisa is an industry leader, author, consultant, coach and speaker. Through Lisa’s leadership, TGNA has developed into one of dentistry’s premier full-service practice development companies.