Oral Health Group
Feature

Roundtable: The Future of Dentistry

June 1, 2002
by Dental Practice Management


2002 PARTICIPANTS:

ABELSoft

Ash Temple

Autopia

Baluke

DIAC

3M Espe Henry Shein/Arcona

Ivoclar Vivadent

The Shaw Group

Southern Dental

WHAT ARE THE BIGGEST CHALLENGES/ CHANGES FACING DENTISTRY OVER THE NEXT 3-5 YEARS?

3M Espe: The aging population along with increased disposable income and the increased demand for aesthetic treatments will place a tremendous demand on the dental industry. This increased demand coupled with the rapid change in technology and treatment planning will command major emphasis on continuing education by both the dentist and their auxillary staff.

ABELSoft: There are several: The large number of dentists retiring from the profession. The ever-increasing availability of technology and the implementation and co-ordination of same, and the speed with which things change/ advance/ improve. This in turn creates more difficulty in finding and retaining staff sufficiently trained to work in an increasingly technology-driven environment.

Ash Temple: A. Already somewhat of a factor, demographics will continue to be a major influence in the next 3 to 5 years. The “boomers” with the financial ability to purchase quality dentistry will continue to want to smile with confidence. The dental professional of this same generation has retirement in his/her future.

Parallel to this we have a decline in dental providers as schools are graduating fewer new dentists and the practicing population is represented by an increased number of female professionals. Statistically, the female dentist prefers a reduced work week to provide a balance between career and home and family. With fewer practitioner hours available it is likely the dental practice will move from a market-oriented climate to a more production-oriented environment.

B. A more educated dental patient. Clarification of treatment plans will be demanded and sometimes challenged.

C. Information overload for the practitioner. The ability to evaluate content and confirm relevance versus hype will remain a significant challenge as new products continue to be brought forward. These products will promise less aggressive, patient friendly properties. At the same time they will continue to offer productivity gains to the professional. The challenge will remain with the dental profession to confirm the evidence-based results.

Autopia: CHANGES: The internet — electronically sending images to insurance carriers and referring doctors. Web sites allowing on-line patient registration and also to check their next appointments, balances etc and make on-line payments at any time of the day.

CHALLENGES: Harnessing the technology that is available and getting staff properly trained and comfortable to optimize the capabilities offered.

There are many providers of technology services to dentistry (consultants, software, hardware, networking, internet). Coupled with the rapid changes in technogly itself, many of these providers of services do not convene or co-operate enough in the delivery of their specialized service, and the dentist is often stuck in the middle.

Patient service — more and more dentists in the Baby Boomer generation will be retiring, leaving fewer doctors to attend to more patients.

Baluke: New products and technology will create greater operating costs. Combining this with increased patient expectations regarding services and communication procedures plus an expectation for nicer looking physical premises will put increased stress on the average return-on-investment. Newer dentists will find this further compounded by the fact that there will tend to be an oversupply of dentists in large urban centres. As costs go up, the issue of adequate insurance to cover costs will become increasingly critical for the general population. Dentists will need to organize and lobby insurance companies for longer term solutions. Alternately, dental insurance benefits could become nil and strategies will need to be developed to cover this eventuality.

DIAC (Dental Industry Association of Canada): The ageing boomer population will place a greater demand for esthetic restorations/implants while the younger flouridated population will require more sophisticated preventative programs. As incomes and education attainments increase, we can look forward to a greater participation rate that will have to be matched by the dentist graduation rate and the continuing education/training needed to meet the demand.

Southern Dental: Fast-changing advances in technology and materials will increase the demand for access to information and ongoing education.

Ivoclar Vivadent: We have seen more change in dentistry in the last 10 years than we did in the previous 25. Change is all around us. We have seen changes in the products we use, the education we promote, the techniques we employ, the markets we serve, even the industry as a whole. This change is also causing further realignment of the roles and responsibilities of each of us who participate in this industry. What is causing this dramatic change at this time? The answer is the convergence of three basic conditions that have become strong catalysts of change throughout the industry. These catalysts are:

1. The advancement of new product technologies and techniques.

2. The Dentist’s desire for increased financial and creative satisfaction.

3. Patients becoming dental consumers and taking more control of the process.

Henry Schein/Arcona: The biggest change facing Dentistry over the next 3-5 years is the rapid advancement of technology in the dental practice. Intra oral cameras, laser technology, digital radiography and practice management software are things that patients will expect to see in their dentist’s office. The challenge for the dentist will be to integrate the proper systems into their practice so that they offer their patients the most up-to-date services at the most economical cost to the patient (insurance firms).

The Shaw Group: Demographics — “Aging Population” = potential increase in dental restorations. Will there be an adequate number of dentists and specifically dental technicians to take care of it? Also, keeping pace with the NEW technological advances!

HOW WILL THE ROLE OF DEALERS/MANUFACTUR-

ERS/LABS EVOLVE OVER THE NEXT 3-5 YEARS?

The Shaw Group: Dentistry in Canada at all levels of success is very much influenced by the RELATIONSHIP aspect — hopefully that will not change!

Also, increased need for support with respect to continuing education and financing alternatives.

Henry Schein/Arcona: The successful dealers of the future will become more consultive in nature, helping Dental practices to grow in revenues and become more profitable. The role of the sales consultant will be more focussed on helping practices run more efficiently by either using better products and equipment or by sharing their knowledge of what they believe to be “Best Practices.” Because there are so many manufacturers competing to get their product lines into the clinics, we will see a continued focus on making more technologically-advanced products. Also, the grey market that currently exists will be the focus of the manufacturers. They will continue to implement systems to cut off this illegal activity.

Southern Dental: Dealers and manufactures have always been, and should continue to be a valuable source of information. The industry will become more dependant on these resources to provide education and information.

3M Espe: Both the manufacturer and the dental distributor can no longer be simply sellers of product or “order takers” to the dental profession. They must work in tandum to continually add value to their customers in the form of auxillary training and continuing education as well other “non-product “related areas such as practice building.

DIAC: As manufacturers increase their direct contact with dentists through their salesforce and direct marketing, dentists will rely more on them for their product information. Product will still be delivered by dealers who will expand their offering in product and practice management. Newer technoligies, like CAD/CAM and the sophisticated products they will support, will require a more collabrative relationship with the dental lab.

Ash Temple: The manufacturer must continue to invest in research and development to bring new products forward. The dealer must ensure the customer contact personnel are provided training to be truly knowledgeable on the advanced offerings. The laboratory group must ensure they are completely informed of the product options specific to their science to continue to provide informed guidance to the dentist client.

Baluke: The need for increased cost efficiencies will drive change. Laboratories will either be large and full-service in nature and efficiency/systems orientated, or be very small botique type specialty ones. Laboratory conglomerates will prevail.

HOW IS TECHNOLOGY CHANGING DENTISTRY?

ABELSoft: Providing a more external focus to dentistry — technology provides the ability to communicate remotely with patients, specialists, labs, vendors and financial institutions, thereby changing the interaction between patient and dentist/staff. Technology is the driving force behind the major growth in aesthetic dentistry. Again, advancing technology use increases the skill requirement, and the value of, support staff.

Autopia:

1. Improved communication with patients — cameras, x-rays.

2. Web site — patient on-line registration etc.

3. Access to information (internet).

4. Service from suppliers.

5. Rapid access to patient information — provides for greater efficiency in practice management if used properly.

Ivoclar Vivadent: The continuous development and the release of new products is perhaps the most obvious and tangible change in dentistry. The introduction of dentin bonding materials opened a new avenue of restorative dentistry. By providing adhesion to dentin and enamel, these materials provided a foundation for the expansion and introduction of restorative materials for minimally invasive dentistry. New composite resin and cementation systems were introduced that expanded indications for chairside and laboratory fabricated restorations. Additionally, these new materials were stronger, more wear resistant, and longer lasting than any previous material. The new shades, new translucencies and new modifiers fortified the goal of esthetics in dentistry.

The Shaw Group: CONSTANTLY — materials and equipment.

Dentistry in general has been reluctant and late to get into the hi-tech arena — let the games begin! — there have, and will be, continued significant change and improvement in this area, whether we like it or not. We will have no choice but to get in the game! The “computer age” is not going away, it’s here to stay.

Baluke: Technology costs tend to be up front for smaller items, or amortized over longer periods for major investments, but there will be increased risk that new technology will come on-stream before the previous generation’s state-of-the-art equipment has been paid for. Either way, the R.O.I. is insufficient to warrant the increased costs.

Henry Schein/Arcona: The advancement of technology in the dental industry is allowing general dentists to do more procedures, faster and with a higher degree of accuracy in-office. Dentists are now able to involve patients a lot more in the diagnostic process as a result of intra oral cameras and digital radiography. Also, the appeal of painless dentistry is something the “technologically advanced” practices will be able to promote to their patients. Manufacturers are focused on introducing products that set faster, handle better, are more aseptic-friendly (unidoses) and easy-to-use.

DIAC: Product revolutions like the high speed handpiece are few and far between. Technology tends to develop more slowly in a sole-practioner environment that provides healthcare before marketing. However, I do foresee a greater use of the internet for collabrative training and consultation, especially with the restrictive finances available to dental faculties. The same technology will be used among dentists, and between dentists and their labs.

3M Espe: Digitization is a wave rolling over many aspects of life including dentistry. CAD-CAM dentistry has been around for years but major advances will occur at an ever increasing speed over the next several years that will effect the very fundamentals of dentistry as we know it today.

Today’s “computer savvy” dental school graduate has a comfort level with this technology that will command faster development of systems and their usage.

WHERE WILL DENTAL INVESTMENT GO OVER THE NEXT 3-5 YEARS? EQUIPMENT — LABS — SOFT-

WARE — MATERIALS — OTHER (please specify)

Ash Temple: We believe the behaviour is influenced directly by the nature of the practice.

Equipment will gain its fair share from those dentists looking to best position their existing, perhaps tired practice, for a transition. In addition to this, the new technologies will continue to demand a share of spending. This could be in both the areas of “hi-tech” or “practice management.”

In the area of new technologies, the cost of the decision to purchase is much different from that of the past. The resolve to adopt equipment that will provide improved clinical treatment within the practice also weighs very heavily on the economics of the practice. Technology upgrades that were once in the one to two thousand dollar range can today require a financial commitment 50 to 100 times that of the past.

The esthetic revolution will demand continued spending on new materials and laboratory services. The weight of spending will be dependent on the preference of the dental professional, ie: in-house provision of product versus a partner supported laboratory prosthesis.

ABELSoft: Equipment and Software

Baluke: Equipment, labs and CAD CAM will be very big in the future.

DIAC: Equipment, labs and software.

Henry Schein/Arcona: Equipment and software.

Shaw Group: Equipment, software, materials and high-tech advancements.

Southern Dental: Equipment, software and materials.

WHAT IS THE BIGGEST CHALLENGE IN GETTING NEW PRODUCTS TO MARKET AND GETTING CUSTOMERS TO PURCHASE?

ABELSoft: Attempting to provide up-to-date software in a marketplace where there is little IT planning, and hardware and operating systems are used long after their practical life.

Ash Temple: Credibility measures heavily in this equation. Establishing the product as an improved clinical alternative while providing the clinician with a reason to select a new alternative that could alter his/her familiar technique is indeed a challenge. The end result must prove superior time after time.

Autopia: It is vital to not only learn the customer’s needs but moreover to help the client to explicitly understand them themselves. Often the solution, or “product” is preceived, with regard to technology that is, as “complicated” or “confusing.” Simplifying the complexities of technology to a level of mutual appreciation is one of the biggest challenges.

It is equally important to maintain future focus — decrease the desirability to stay the same. Technology often represents change from the status quo, which to many is received as threatening.

Another challenge is that in many instances, the person using the technology is not the purchaser, and getting those aligned can often be difficult.

Baluke: Increased costs for new equipment and the fact that the dental/insurance industry is increasingly moving towards reduced benefits will challenge all. An increasingly knowledgable and skeptical general population will increasingly challenge some of the recommended treatment options. Communication and education strategies will need to be formulated and administered. Currently, dentists get no education regarding either marketing or business practices in dental school. These will need to be added to curriculums.

DIAC: There is a constant proliferation of new products in the market that can tend to overwhelm. Getting the right message to the right dentist is becoming a greater challenge. Look for greater use of CRM software by manufacturers and an expansion in product management training from both dealers and practice management consultants.

Southern Dental: The biggest challenge for a manufacturer is developing a product that is timely, tested and priced competetively. The demand for new and improved is great but the most important factor is ensuring the product has been thoroughly tested and is perfect before it hits the market.

Ivoclar Vivadent: It may help to think of our industry as a delicate chain of trust from researchers to educators to manufacturers, to dealers, to laboratories, to dentists, to patients. And like all chains, we are only as strong as our weakest link. So, as change occurs we must continue to build on and support the fundamentals that have always been part of dentistry; education, quality tested products and a genuine concern for the health and well being of our patients. The future will depend on how well we will be able to come together, alter and mature our roles, respect and rely on each other’s individual strengths and work toward our common goals.

3M Espe: Successful new product introductions in the dental industry are built on a foundation of sound research and development platforms, long term clinical data, established reputation and product differentiation. All new product introductions must be supported with account representative follow-up, continuing education and awareness programs.

The Shaw Group:

1. Research and development costs.

2. The ability to shorten cycle (research to purchase) without infringing on the quality.

3. Education and acceptance to purchase — establishing the required level of acceptance with respect to the performance of the product.

4. Adequate and cost effective marketing support.

Henry Schein/Arcona: Ironically, one of the biggest challenges in this area is there are so many new products being introduced that the dentist is being inundated from every side with another product. The biggest challenge for the dealer will be to get good clinicals on all new products and only promote the 5-star products.

WHAT IS THE BIGGEST CHALLENGE TO PROVIDING GREAT CUSTOMER SERVICE?

Baluke: Dentists tend to, almost by definition, be fine motor skills individuals with a generally under-developed skill set in the area of communication and persuasion. As patients demand more information and explanation, dentists will have to develop more advanced communication and empathy skills. Selling and marketing are becoming increasingly important attributes. Somehow, dentists must acquire these skills.

Southern Dental: Approachability! Customer satisfaction is number one at the manufacturers level. This is the foundation to ensuring confidence in the end user and the dealers that sell the products. Open lines of communication and followup are essential. Customers must feel they can openly discuss any situation or problem.

Autopia:

1. Shared values — aligning the company’s operating principles with the clients agenda.

2. Having knowledgable and compassionate staff available to respond to clients needs and issues

The Shaw Group:

1. Getting to know each customer as an individual.

2. Establishing — solidifying — maintaining — a high level of mutual trust — building that RELATIONSHIP!

Ash Temple: Education of the personnel to understand the customer’s environment and essential needs. The ability to provide the staff with information to satisfy client demands with practical and informed solutions.

DIAC: Great customer service is a function of both filling the customer’s needs and the manner in which they are filled. Understanding each dentist’s practice, how it currently functions, and the problems and opportunities that have to be addressed in order to help grow the practice are the greatest challenges facing suppliers.

Henry Schein/Arcona: The biggest challenge in providing great customer service is in finding the right balance between being able to offer exceptional service levels and being able to maintain profitability to sustain these service levels. Also, going forward there will be a major focus on using customer’s ordering data to help better analyze a customer so that the dealer can forecast customer’s needs more accurately. Like the dental industry, the distribution industry’s technology is advancing at a rapid rate.

ABELSoft: Focusing our service on our core strengths, software and business issues, in an increasingly integrated technical environment — we must become experts in all aspects of the available technology.

Ivoclar Vivadent: The industry’s aversion to self promotion has left us with at best a patch quilt of independent messages and at worst, the inability to create future value in the minds of the consumer. It is clear that dentistry provides services that everyone needs, but more than half of the population only utilizes its services under duress.

Today, however, the outcome can be dramatically different. Frequently, patients leave the dental office with a new view of dentistry; the clear benefits to appearance, self-esteem, as well as function, create a reward worth the cost. We see these outcomes published in the leading magazines and newspapers as well as on television. An informational and educational dynamic is taking place that is changing dentistry by changing dentistry’s guest — the patient. We are witnessing a change in the person from patient to consumer; and from now on, the rules of consumerism will apply.

3M Espe: The biggest challenge to providing great customer service is making sure that “Customer Service ” is your business primary goal . Each individual within your organization must believe in and be committed to providing solutions and customer service that exceed the customers expectations.

WHAT IS THE MOST EFFECTIVE WAY TO REACH YOUR CUSTOMERS/CLIENTS?

Baluke: The computer will become mandatory for most practices. Interactive web sites by practitioners will be expected. Manufacturers and laboratories will be required to maintain up-to-date sites and include on-line training modules and continuing education seminars in this format. Preliminary searches and investigations by all in the dental field will be frequently conducted via computer.

Ash Temple: One-on-one personal contact. This works best for the supplier and the provider. Manufacturer to end user, manufacturer to dealer, dealer representative to end user, service provider to end user. It’s a people to people business. Advanced communication technology can enhance the process. It cannot replace the one-on-one experience.

Autopia: It depends on the goal (shared values) — our goal is for a client to enjoy and optimize the functions available to them with regard to the usage of their technology. This is predominantly achieved through appropriate training.

To be most effective in providing exceptional service, if it requires an understanding of the technology available and developing business rules around their core values of what as a dental office they wish to accomplish, it must be through a co-discovery, where one on one we learn the needs of the dental office, the skill set within their team and develop an optimum approach to achieve results.

The best way to achieve immediate on-going service is electronically — dial in, internet, telephone (having a real live voice answer!)

The Shaw Group: Personal visits — face to face contact. Added value seminars.

Henry Schein/Arcona: The most effective way to reach our customers is through our sales consultants. Going forward, the internet and other electronic mediums will play a role in the dealer’s interaction with the customer, however, no medium will be as effective as the sales consultant’s role.

Southern: Dealer representatives are the most effective way! They are well educated on all products and can offer their customers options based on quality and price. Good advertising can also be effective in educating the patient, the dentist and the sales representative.

ABELSoft: We use mostly direct mail & regular newsletters for reaching our customers. Print ads, while designed primarily for generating new leads and prospects, are also seen by most of our clients, however they do not have the same impact as a direct piece.

AS FAR AS CURRICULUM GOES, WHAT| IMPROVEMENTS/CHANGES NEED TO BE MADE AT DENTAL SCHOOLS?

DIAC: I believe that dental faculties that are facing cash crunches will have to collaborate on classrooom instruction in order to preserve funds for their clinical and research programs.

Baluke: To keep costs down and to reduce the requirement for continually upgraded curriculum, some schools still teach older technology without really addressing the newer processes in sufficient detail. For example; Equipoise dentures. Others have concentrated more on theory and reduced hands-on learning so as to maintain current course workloads. This needs to be rethought and revamped.

ABELSoft: While we understand that a dental school’s main objective is to provide the professional and clinical training for new dentists, we suggest that they might strongly encourage that business courses make up some (or a greater) portion of the students’ elective courses.

Henry Schein/Arcona: I am not really in a position to comment on this. However, if I were to offer some advice I would say that more time on business courses such as marketing, finance, general management would be of value. Also including practise management software education would be benefical to the dentists.

The Shaw Group: Time needs to be spent on the actual business and marketing aspects of running a dental practice.

Clinical curriculum needs to be kept up to date on a consistant basis.

Challenge to professors to accept and understand new technologies.

Financial challenges to equip dental schools properly with up to date equipment and materials.

Autopia: Overwhelmingly Management — there is a tremendous lack of understanding or realistic expectations being imparted to graduating dental students in the running of a business. There are basic principles like staff policy manuals, accounting understanding, and clear understanding of the business issues facing them to determine the best work methods to accomplish explicit goals. In many instances, the most basic business principles are exempt. Though “dentistry” exists in the realm of healthcare, it can never be forgotten that at the end of the day, it is a business too. Fraud is rampant in the indulstry and often goes undetected.

Ash Temple: Our response here has been consistent for two decades. Incorporate business 101. The dentist is indeed a health care provider. He/she is not governmentally funded. Financial forecasting is essential to any business. Enhancing clinical expertise with the ability to build a viable business plan is a win — win situation!

WHAT ROLE DO YOU FEEL YOU/YOUR COMPANY CAN PLAY IN HELPING DENTISTS BUILD PRACTICE PRODUCTIVITY AND PROFITABILITY?

Ivoclar Vivadent: The formula for a dentist’s success is clear — combine the new materials and techniques (used in conjunction with quality, traditional materials) along with a new partnering relationship with a laboratory technician and communicate these options to the patient.

ABELSoft: We have a tremendous amount of experience and knowledge of many different types of practices through our customer base. We have designed our products based on the business requirements we see in many different areas, and can assist in productivity and profitability by providing the right tools to track, evaluate and analyze business practices, along with the proper training in their use.

Ash Temple: An informed, consultative role. The company is positioned to provide both the products and services the clinician requires to execute the business of the day and meet their personal and professional expectations for tomorrow.

Autopia: — Needs analysis (co-discovery) — learn what’s important (determine the client’s agenda), questionnaire to identify barriers and resisters, establish shared principles and operating values, gather background information,

The Shaw Group: Provide opportunities for the dentist to expand their current knowledge, both technically and operationally. Continue to offer and provide a high level of excellence in people, product and service.

DIAC: DIAC members are committed to the (continuing) education and business development programs that will give their employees the dental knowledge to recognize their customers’ needs, and the skills to fill them in an effective and professional manner.

Henry Schein/Arcona: Our responsibility is to provide the customer with the tools — effective sales consultants, electronic ordering systems, informative marketing pieces such as catalogues and flyers and the support of manufacturer representitives. These are the best things a dealer can offer a customer going forward.

Southern Dental: Our company has the ability to offer the dentists high quality products and very competative prices. We try to offer timely customer support and product information.

Baluke: Our company, being a major full-service laboratory, has taken the approach of offering all of the latest techniques and materials. We have combined this with continual upgrading programs for our technicians and constant evaluation of their work. We maintain a web site and carry a full schedule of continuing education seminars so as to constantly review and assess the latest products and the always relevent basics.


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