Tuesday, December 16, 2014


The Break-even point (BEP) is the minimum amount of money needed to pay overhead, compensate the doctor(s), service debt, and provide a profit (Return on Investment, ROI).  Production and collection goals and the annual budget can be projected once the BEP Is determined.  Remember, if a BEP is based on production rather than on collections, it must be adjusted to the collection rate for the practice if the rate is less than 100%.

An example of the calculation follows:

FORMULA:  BEP = Total Fixed Costs / 1 - % variable costs are of gross collections

Fixed Costs include office overhead (staff salaries and benefits, occupancy costs, administrative costs, taxes, insurance, etc.), the dentist’s compensation, and debt service.

Variable Costs are considered to be laboratory fees and clinical supplies (those costs which vary according to patient load) and are, typically, 15% to 20% of collections in general practice; 8% to 12% in pediatric and orthodontic practices;         

If total Fixed Costs are $625,000 and Variable Costs are 10%:

            BEP = $625,000 / 1.0 - .10 = $625,000 / .9 = $694,500 BEP (Collection goal)

Tuesday, December 9, 2014


As dentistry is changing and evolving, so are the ways some practitioners prefer to practice.  I’ve recently read of one manifestation of the various changes in practice, the mobile dental implant practitioner.  These dentists work in a number of offices, often 12 to 15 different locations, bringing with them their dental assistant, instruments, equipment, medicaments, and materials.  The traveling dentist must be well organized and flexible in order to transport safely all items necessary to work in a different dental office every day.  Further, the resident dentist and the mobile dentist must be comfortable and trusting with one another’s treatment modalities and interactions with patients.

The mobile implant practitioner is not a specialty because currently no such designation exists.  If a dentist practicing in a single office location were to choose limitation of his or her practice to implant services, lack of referrals would make that nearly impossible.  If however, that dentist is willing to be mobile, he or she can stay fully scheduled because many GPs and specialists now prefer to keep all care in-house.  Additionally, most patients prefer to be treated in the office with which they are familiar, and the coordination of treatment planning and execution of procedures is smoother between the implant practitioner and the referring dentist when they are both in the same office.

While the idea of bringing a mobile practitioner into your office to treat your patients may not appeal to you, be aware that the services of mobile practitioners are increasing.  At some point you may find that bringing a mobile practitioner into your office is both cost effective and stress reducing.  

Tuesday, December 2, 2014


There are two ways to increase profitability in your office:  earn more and spend less.  Many dental practice management consultants, advisors, speakers, writers, and instructors focus on the “earn more” part of the equation.  Time and energy focused on the “spend less” concepts are equally productive.

Saving money in your practice is possible, and those savings flow directly to the bottom line to become increased profit.  Many tools should be utilized as part of your “spend less” efforts, including (1) annual budgeting, (2) comparative shopping, (3) advance planning for capital expenditures, and (4) staff involvement.

An effective way to get your team members to buy in to savings projects is to ASK their opinion and advice about savings, and then implement all feasible ideas so that staff members feel valued and contributory.  A word of advice:  unless you, the Dentist, intend to use their ideas that are practical and possible to implement in your office, do not seek their input.

If you choose to involve staff, assign team members the challenge of listing at least three ideas for saving money in the office.  A list of more than three ideas is encouraged; three is minimal.  Correlate the individual lists into one master inventory of creative possibilities.  Then distribute copies to the entire team for discussion, evaluation, and planning at the next Staff Meeting or at a lengthier Practice Retreat.

A client who recently used this method received a wealth of ideas that, when implemented, generated significant savings for his practice.  Staff suggestions covered the entire practice---from basics such as lights off in every unoccupied space to ideas for using less material during procedures to improvements in time and motion during   clinical procedures to efficiencies at the business desk.  That office improved efficiency while better serving patients and saved a great deal of time and money in the process.  And remember, in a busy dental office, TIME = MONEY!

Sunday, November 30, 2014


We know that the majority of new patients find a prospective dental home through the internet.  Marketing gurus tell us between 65%-70% of Americans in the 30 to 50 age range now search for health information, including finding a practice that will meet their family’s needs, online.

However, once a patient decides which dental office to call to schedule an initial  appointment, the telephone is the front door, the first person-to-person contact, the all-important first impression.  Chances are that non-clinical staff members answer the telephone in your office.  These business team members must be well trained, not simply expected to handle all phone calls by the proverbial “seat of their pants”.  Calls must be answered promptly, by the third ring at the latest, with a pleasant voice and manner.  Answers to frequently asked questions should be part of all telephone greeters’ training.  The type of questions to be answered by each team member should be specified; for example, business staff may handle scheduling, billing/insurance, fee, and similar questions.  Questions about treatment plans, home care, follow-up directions or concerns following treatment, and similar clinical questions should be referred to trained clinical staff.  Calls about urgent care needs, an emergency following treatment, or a dissatisfied patient too upset to respond to an experienced staff member should be referred to the dentist.  Suggestion: use staff meeting time with team member in-put to assess the telephone protocols in your office.  If they are less than stellar, make fixing them a priority.

Telephone protocols for an office should be established by the dentist and clearly understood by all team members.  Remember the old axiom, “One has only one chance to make a good first impression.” is true of a dental office as well as an individual.  Make the first impression your office gives an excellent one with well-organized, consistently-used telephone protocols.

Monday, November 24, 2014


OSA (obstructive sleep apnea), called a “ubiquitous and insidious malady” by experts in the field, is increasingly the bailiwick of dentists.  Oral appliances have proven to be effective OSA therapy, and most patients prefer oral therapy to the longer, more complicated, and uncomfortable treatment their physician can provide.

Briefly, OSA can be described as the tongue rolling dorsally, blocking the patient’s airway as he or she sleeps.  The blockage may affect OSA sufferers between 10 and 100 times per hour, varying each time in length between 10 and 90 seconds.  The deprivation of oxygen results in mild, moderate, or severe hypoxia, the condition of reduced levels of oxygen reaching cells that should be regenerating during sleep if sufficient oxygen is present.

Studies by the National Sleep Foundation show that approximately 50% of American adults suffer from some type of OSa.  Additionally, juvenile obstructive sleep apnea (JOSA) is on the increase.

OSA often manifests itself as snoring, an annoyance to anyone within earshot of the sleeper.  However, OSA is well beyond an annoyance; it is, in fact, dangerous to the sufferer’s health.  Research dating to the 1930s, work of a Nobel prize winner, Otto Warburg, MD, substantiates the claim that many diseases are negatively affected by insufficient levels of oxygen in the body.  Cancer cells, harmful bacteria, and viruses cannot survive in a high-oxygen atmosphere; hence, the vital importance of successfully treating OSA to assure sufficient disease-fighting levels of oxygen in the body.

If you have not yet added this treatment modality to your scope of services, consider its feasibility.  Research the variety of oral appliances meant to treat OSA; understand the positives and negatives of the various types; and attend credible CE courses on the subject.  Experts predict that within the near future, patients will expect their dentist to be able to provide OSA therapy.  Since most insurance companies and Medicare administrators are now allowing reimbursement for oral appliance OSA treatment, demand for therapy will increase.  Be prepared to meet your patients’ requests.

Tuesday, November 18, 2014


PLEASE!  Don’t skip reading this blog, thinking, “I don’t need encouraging.” or “Nothing you say can make me feel better right now.”  Please stick with me as I share a personal story with you.

This summer, July 2014 to be precise, I had a battle with a life-threatening disease.  My surgeon and I were victorious with the help of prayers from family and friends.  During my recovery, I received many messages from well-wishers.  One card in particular begs to be shared with others.  It came from a long-term dentist/client/friend.  The message of encouragement was written as a poem, and my friend added his own words that buoyed me as I read it initially and re-read it on long difficult days.  Perhaps you or someone you know can use just such a message now:
            “A mighty wind blew night and day.  It stole the oak tree’s leaves away.  Then snapped its boughs and pulled its bark until the oak was tired and stark.  But still the oak tree held its ground while other trees fell all around.  The weary wind gave up and spoke, ‘How can you still be standing, Oak?’  The oak tree said, ‘I know that you can break each branch of mine in two, carry every leaf away, shake my limbs, and make me sway.  But I have roots stretched in the earth, growing stronger since my birth.  You’ll never touch them, for you see, they are the deepest part of me.  Until today, I wasn’t sure of just how much I could endure.  But now I’ve found, with thanks to you, I’m stronger than I ever knew.’” 

The Hallmark card listed no author.  I thank my friend who chose to encourage me at such a time, and I thank the author, whoever he or she may be.

Friday, November 14, 2014


What reputation does your practice carry in your community?  How visible is your practice to patients and potential patients in your area?  How is your practice different from other dental practices in your city?  Would you agree that branding (establishing a distinct identity for a business or organization) is not just for the “big guys” (big business), but is vitally important for a small business (your dental practice) as well?

Pew Internet Research, a respected source of opinion polls and surveys, says that 72% of Internet users look online for health information, and 93% of Americans ages 30 to 49 use the Internet.  That is a significant audience to reach.

Branding, the identity you establish for your practice, can be assured by a consistent online presence beginning with your Website.  Suggestion:  if no one on your staff has the skill or time to keep your online communications up to date, hire a reputable professional designer to coordinate your online efforts such as your Website, Blog, and Social Media postings.  Make certain your Website links to your Blog postings as well as your Social Media sites.  Conversely, create a link from your Blog and Social Media outlets to your Website.  Make certain either a knowledgeable staff member or the outsourced professional keep your Blog and Social Media sites up to date with fresh ideas and information.

The branding coordinator, whether an outsourced professional or a dental team member, should also assure your practice profile is active and accurate on Patient Review sites such as Google + and Healthgrades.com.  Further, your branding coordinator should optimize your Website’s visibility through search engines, monitoring results of patient searches, and linking your Website through all relevant-to-dentistry sites.

Make certain all references to your practice, whether print media, signage, or online, use the same name.  If your practice name differs from your own name (John H. Doe, DDS vs Doe Family Dentistry), use the practice name rather than your own in all cases of branding/marketing.  This assures that the identity of your practice is consistent across all online and offline marketing efforts.

Think of an example of big business branding---think of TARGET, the giant retailer.  The red color and the concentric-circle target make all TARGET ads distinctive and memorable whether seen online or received offline via print media.  Transfer that type of instant recognition to your practice with creative ideas generated during some brain storming sessions with your dental team.  While your own branding efforts may be more subtle that those of TARGET, you get the idea.  Go with it!