Monday, September 28, 2015


The art of patient retention begins with your practice is structure.  A few basic rules:
Hire pleasant, enthusiastic, caring team members.
            Train team members well, and appreciate them openly.
            Make sure the office itself is attractive, modern, impeccably clean, in good repair                     including chair coverings in both reception and clinic areas, has visible,
                    noteworthy signage---in short, a place that feels and looks good.
             Market your practice constantly and memorably, making full use of social media                                        as well as print media and community activities.
            Deliver top quality care to make you and your staff proud and patients delighted.
            Adhere to sound fiscal management including an annual budget put into writing                                           and into practice.
            Strive to show patients how much you and your staff care for each one as an                                                 individual, not simply a “crown prep in chair III.”
            Delegate meaningful responsibilities to team members and then avoid micro-                                               managing.
            Share your vision of what your excellent practice will look and feel like, and then                                         depend on your team to set the ambiance and culture of the office so that                                               each patient has an excellent experience at every appointment.  

Notice that the bare-bones list above begins and ends focused on team members.  Patients are persuaded to remain in your practice by evidence of the genuine, unshakable, enthusiastic commitment of your team, you included, to their care, comfort, and long term health.  One of your most significant responsibilities as Team Leader is to convince every team member that she/he is THE KEY to keeping patients for life.

Make an honest evaluation here.  Just between you and me…is your team lacking sincere passion for patient service and real concern for patient retention?  If the answer is “Yes.”, reproduce the piece below, making a copy for each team member.  Discuss the concept in several team meetings, brainstorming ways each person can enrich patients’ experiences in your office.  Encourage team members to take this piece home to re-read and to take to heart.

You Arx a Kxy Pxrson

Xvxn though my computxr  is an old modxl, it works vxry wxll---xxcxpt for onx kxy.  You would think that with all thx othxr kxys functioning propxrly, onx kxy not working would hardly bx noticed; but just onx kxy out of whack sxxms to ruin thx wholx xffort.

You may say to yoursxlf---“Wxll, I’m only onx pxrson.  No onx will noticx if I don’t do my bxst. Patixnts won’t noticx if I’m cross as a bxar today.”  But it doxs makx a diffxrxncx bxcausx to bx xffxctivx, an organization nxxds activx participation by xvxry onx to the best of his or hxr ability.

So thx nxxt timx you think you arx not important to how our patixnts fxxl whxn thxy arx hxrx and how long thxy will choosx to rxmain our patixnts, rxmxmbxr my old computxr.  YOU are a kxy pxrson!   

Monday, September 21, 2015


Several factors have worked together the past five to ten years to create a perfect storm that has buffeted the dental profession:  the economy has declined so that fewer consumers are seeking regular dental care, participation in managed care has increased thereby reducing practice income, and overhead has continued to require an ever-greater percentage of gross income.  Such factors mean most dentists, no matter how much they would like to do so, can no longer afford to give annual raises.  Bonus plans have gained favor as an alternate way to increase staff compensation so that the increase is fair for staff members and the practice as well.

The plan described below is based on the premise that staff compensation including wages, payroll taxes, and benefits is a set percentage of gross collections.  Note it is based on collections, not production---the office operates only on fees collected.

A survey of 2014 costs and profit by a dental practice management company I respect and depend upon to have true current data shows that staff compensation varied almost 10 percentage points--28.2% in General Practice; 27.7% in Pediatric Dentistry; 25.5% in Periodontics; 21.9% in orthodontics; 20.4% in Oral Surgery; and 19.2% in Orthodontics with no figures available for Prosthodontics.  For ease of calculation, I’ll use 22% of collections allotted for staff compensation in the following example.

                        April                           $75,000                                 
                        May                              69,350                
                        June                              72,800               
                                                         $217,150 total collections ÷ 3 months = $72,383/month
                                                                                    average collection

            Staff Compensation compared to Collections:
                        Actual staff compensation/month
                                    Dannie           $4,167
                                    Heidi                2,917
                                    Laura               2,500
                                    Melanie           3,125
                                    Khloe              2,333

                        $15,042/month staff compensation for previous 3 months                                                                  Average collections/month for previous 3 months = $72,383
                        $15,042 ÷ $72,383 = 20.8% = actual staff compensation : collections        
                        Staff allotted compensation = 22% of collections
            Bonus Calculation:

                        $72,383 x .22 = $15,924 for staff compensation

                                 $15,924 = 22% of collections = designated staff percentage
                                 -15,042 = actual staff compensation percentage
                                      $882   to be shared as monthly bonus

                         The incentive money may be divided among staff based on the number of                                   hours each works per month:

                        Dannie           154 hours
                        Heidi              138 hours
                        Laura              138 hours
                        Melanie          154 hours
                        Khloe               86 hours
                                               670 hours total
            $882 total money to be shared    =   $1.32 per hour worked
             670 total staff hours worked 

                        Dannie            154 hours x $1.32 = $203.28
                        Heidi               138 hours x $1.32 = $182.16
                        Laura              138 hours x $1.32 = $182.16
                        Melani            154 hours x $1.32 = $203.28
                        Khloe                  86 hours x 1.32 = $113.52

Include all staff members in the incentive plan; new staff members may participate upon completion of their training period.  Base calculations on collections, not production.  As production and collections increase, keep the percentage allotted for staff compensation constant until a new analysis of practice overhead percentages proves the percentage should be changed.  Pay bonuses with separate checks, apart from regular paychecks, so that the extra pay stands out, seems like a true bonus.

When to give raises? 
Increases to base salaries may be made periodically in order to stay commensurate with similar jobs in your community.  Since the bonus is a group reward for increased-production-and-therefore-increased-collections, recognition of an individual’s improved  job performance can be reflected through an increase in her/his base salary.  If no raises at all are given to base salaries year after year, staff members may feel unappreciated even if bonus dollars have been paid monthly.  Many dentists now evaluate base salaries every two to three years, varying dates of raises to individual staff members in order to avoid “blanket raises”.  “Blanket raises” given to all staff members at once seem automatic and, therefore, lose the value of expressing appreciation to an individual  team member for a job well done.     

Monday, September 14, 2015


Flying Doctors of America (FDA) is celebrating its 25th anniversary this year.  In its 25 year history, FDA has completed over 220 missions and treated more than 200,000 people in developing countries or in countries in crisis with free dental and medical care.

Earlier this year a group of dentists, physicians, and nurses treated 1500 Syrian refugees in a refugee camp in Jordan.  One participating dentist described the camp: “Out in the desert, with brutally hot temperatures, are rows and rows of tents.  The devastation, the despair, the look on children’s and adults’ faces---these people have been taken from their homes and have been abused at all different levels.  They have no place to go and nobody wants them.”

He goes on to describe an 8 year old girl from whose face he picked shrapnel.  She was inexpressive, non-communicative, and visibly traumatized.  She’d seen her parents and brother killed, a horror we cannot fathom.  Years of service by this practitioner and scores of others working through the FDA in countries around the globe has taught these professionals that they must remember those they did treat, those they did save rather than ruminating over the thousands they could not see and care for.

Several flying dentists I have known acclaim the work of the FDA.  They feel privileged to help provide health care for the poorest of the poor, disaster victims, and refugees around the world.  These professionals serve with no thought of compensation or of politics.  Their aim is to give in the best way they can to fellow human beings who need their care.  To a person, upon returning home from a mission trip, these Flying Dentists are already eagerly anticipating their next opportunity to help those in need.

For information about Flying Doctors of America, visit their website,    

Monday, September 7, 2015


The average dental student graduating in 2014 had $241,097 in student debt, and it was not unusual for students completing a residency program to graduate with close to $600,000 loan debt according to figures released by the ASDA (American Student Dental Association).  What a burden these young dentists carry when beginning practice!

Corporate dentistry is growing rapidly with the four largest dental management companies adding 902 practice locations in the past four years, an 85% growth rate.  With the offer of immediate remuneration, these companies are attracting, according to some experts, a majority of recent graduates 

Dental management companies typically pay a producer 25% of production, well under what an owner, partner, or associate in a busy private practice would earn.  In spite of such a limit to their income, many recent dental school graduates are choosing to go to work in corporate dentistry rather than in private practice or in academia.  Their choice is heavily influenced by the over-whelming loan debt they carry which prevents their securing another loan to buy into or buy out an established private practice.  Further, most newly-minted dentists feel an urgency to hit the ground running with a full patient load and no worries about managing a practice---that sounds good after years of “round-the-clock, 24/7” work getting through dental school and, perhaps, a residency program.  Simply eager to begin treating patients, these young dentists do not want to take time to research, negotiate, obtain financing, and decide on a private practice opportunity.  At that point in their careers, they do not realize how such a choice may well limit their future earnings and their pride in being an entrepreneurial health care provider.

Experts in dental practice management are emphasizing the importance of educating  dental students more intensely about the advantages of private practice, such as much greater lifetime earning power; independence to manage your practice as you choose, including such seemingly-minor points as taking your vacation or C.E. days or any time off when you wish rather than when the management company dictates you may be away from the office; and ownership of a very valuable asset to be sold at retirement.  

Through repeated emphasis in lectures and classes on practice management while in dental school and with mentoring by private practitioners, young dentists can be persuaded to go into private practice vs becoming an employee in a large corporation where they are simply a producer with little to no say over their own career and life work.  When hungry to begin practice, a new graduate may give little thought to the negatives of working an entire career under a corporation that is more interested in producing a profit for its stock holders than in care for its patients.  A challenge facing the profession---those of you who love the practice of dentistry in a private setting where the dentist manages her/his own destiny should consider ways to educate and recruit more graduating dentists to follow your example.

Monday, August 31, 2015


Today I drove a friend to work.  She’s without a car, works at a family buffet restaurant, often pulls double shifts, and depends on tips to make enough money to pay her bills.  She works very hard as a server, has an always-positive attitude, and enjoys many regular customers who request seating in her section of the large restaurant.  Because she is friendly and fun, quick and efficient, always smiling and showing genuine care for her customers, they reward her with generous tips.  Daily, in fact, she averages over twice the amount in tips as her co-workers.

On the way to work this morning, she told me she often receives a question from co-workers:  “How do you manage to get so much more in tips than I do?”  She said she gives a candid answer to the questioner---“Because I like my customers; I enjoy being nice to them; I tell them I appreciate their coming to eat with me and their generosity with tips; and I always invite them to come back to see me soon.”  If the co-worker questions her further, Jennifer will again be candid:  “I’ve seen you act like you think the customer is a bother; you act annoyed if a customer asks for something; you don’t smile very much; and it seems you’d rather be anyplace else but here serving a customer.”

Now---contrast the buffet restaurant employee’s attitude which my friend described to attitudes among your own dental team members.  Could the very direct, plain-spoken answer my friend gave to her co-worker describe the attitude of any of your team members?  If so, perhaps sharing the following quotation with your team will provide a springboard for discussion among the group about proper appreciation of patients.

A Patient

A patient is the most important person ever in this office, either in person or otherwise.
A patient is not dependent on us.  We are dependent on her/him.
A patient is NOT an interruption of our work, but the purpose of it.

We are not doing the patient a favor by providing dental care; she/he is doing us a favor by giving us the opportunity to do so.

A patient is at the center of our practice; NOT on the outside.

A patient is NOT someone to argue with---nobody ever won an argument with a patient.

A patient is a person who brings us her/his needs and values.  It is our job to satisfy them with tender loving care and to do so profitably to the patient and to ourselves.

                                                                                 Author unknown