Good for the environment and the bottom line
By Bradley Dykstra, DDS, MBA
Going green is much more than the ethically, morally, or politically correct thing to do; it is also beneficial to the bottom line of the practice. It is our responsibility as health-care professionals and citizens of this planet to do our part in preserving our natural resources and minimizing the waste we produce. At the major dental shows there are now exhibits and seminars promoting "going green" in the dental office. If we take time to reflect, we realize the average dental office produces a tremendous amount of waste each year.
Many of the going green suggestions are good, but the implementation may seem daunting and complicated, or the payback marginal at best. The biggest benefit to the environment and getting the biggest bang for the buck comes from implementing just a few time-tested and logical technologies in the office. In addition to doing our part in saving the planet, implementing these technologies has the added benefits of saving time and money, improving diagnostic ability, and increasing the safety of patient records.
The supply of fresh water on earth is not endless. It is a natural resource to be respected and used wisely. Water is not free; there is a cost for the water we use, both in buying the water and in processing the wastewater in a sewage treatment plant. The amount of waste produced has increased over the years because the use of disposables has been amplified to comply with OSHA mandates, and they are convenient.
This waste must be disposed of in landfills; therefore, reducing the amount of waste we produce is a responsible thing to do. Most of the energy we use is still produced from fossil fuels that are continuing to be depleted. Any means we can employ to reduce the amount of energy used in the office is beneficial.
The first and most obvious decision is transitioning to digital imaging in radiography and photography. The majority of dentists have made the transition on the photographic side. It allows the viewing and deleting of photographs that are not considered necessary without having to print them. Printing only the pictures desired saves ink, paper, time, and most of all, money.
The same benefits apply in the radiographic arena to an even greater extent. With digital radiography (KDI, Dexis, and Schick, among others), there are very few reasons to ever print a radiograph and no grounds to ever have to duplicate one.
The average film processor, which uses about $66 worth of processing chemicals a month in addition to processor cleaning chemicals, is no longer needed. These processors also consume 30 gallons of water per hour they run, guzzle electricity, and generate heat and odors.
These chemicals and wastewater no longer have to be processed in wastewater treatment plants. The natural resources used to make the film, developer, and fixer are also eliminated.
The cost savings of digital radiography in time and materials as well as the increased diagnostic ability is confirmed by those who have made the switch. If you are not using digital radiography and photography in the office, making the switch will benefit the office and environment.
A second rather obvious and related way to go green is in totally implementing the EMRs (electronic patient records by PracticeWorks, Dentrix, or Eaglesoft) or the digital dental patient record. Although it may not be possible to be completely paperless, the use of EMRs greatly reduces paper use in the dental office.
Electronic claims submissions, and transmitting radiographs, photographs, and other documents digitally saves reams of paper, postage - and most of all - valuable time.
The cost of sending a quarterly newsletter to a patient approximates $1.50 in material, postage, and time. For a patient base of 2,000, it would cost $3,000 to send a newsletter, whereas sending a digital newsletter is virtually free.
Patient reminders sent via e-mail or text messaging, rather than through the mail, provide similar savings. An additional benefit of the digital patient record is the security of knowing that all of your financial and patient data is protected, even if the office is destroyed by fire, flood, tornado, or earthquake.
The third way to go green is the use of digital impression scanners, such as the Cadent iTero or 3M COS scanner, for acquiring dental impressions for crown and bridge, veneers, bite splints, orthodontia, and study models. Digitizing the impression process eliminates the need for disposable plastic trays and impression material.
Yet again, we save money by not buying the impression materials and are able to keep that much more out of our landfills. In addition, in-office milling systems such as the E4D or CEREC eliminate the need to even construct a working model.
The fourth and least obvious way, at least until now, is using a waterless and variable speed oral evacuation system such as the Midmark PowerVac G.
The annual cost of operating and maintaining a vacuum system is made up of three variables - the amount of water used, the amount of electricity used, and replacing the filters as needed. This may seem a bit complicated, but the following explanation should help clarify the benefits.
Most wet-ring vacuum systems use between 60,000 and 90,000 gallons of water per year. At the average U.S. cost of sewer and water of .0071 per gallon, the annual cost is between $426 and $639 per year. Adding a water recycler to the vacuum reduces the water consumption by approximately two-thirds to 20,000 to 30,000 gallons.
Besides not having to pay for this water, we do not have to pay the sewer fee to process this water. Adding an amalgam separator, which now is mandated in many areas, keeps most of the toxic amalgam waste out of the water treatment plants.
In most offices, the vacuum system is turned on first thing in the morning and runs full speed until the end of the workday. The average system in a five operatory office consumes more than $300 worth of electricity per year. Wet-ring systems also require frequent filter changes, at an annual cost of more than $500.
At a minimum, the total annual cost of operation is between $1,000 and $1,500 per year, depending on if a water recycler is used or not. A dry vacuum uses no water so there is no cost for water or sewer with this one. There is also no need to change any filters. It does, however, produce much heat and consumes twice the amount of electricity as a wet-ring vacuum system. The extra heat may require additional cooling systems, especially if the vacuum system is in a confined area.
The annual cost of this technology is between $500 and $600 for electricity, plus any costs associated with the increased heat production.
The newest system being introduced by Midmark, which will eventually be followed by other ystems, is the PowerVac G system. This is a variable speed unit that increases and decreases the speed/volume of the vacuum system as needed.
This eliminates the vacuum system running at full speed all day, every day. The savings in energy costs is substantial and minimizes the use of fossil fuels. The annual cost of this system should normally be less than $200.
There are many more things we can embrace in our attempt to do our part in being environmentally responsible. The four ideas presented here are a start in the right direction. The long-term payoff is not only a benefit to future generations, but also to the bottom line of the practice.
Bradley Dykstra is a general dentist in private practice in Hudsonville, Mich. A graduate of the University of Michigan dental school, he earned his MBA from Grand Valley State University. He speaks on integrating technology into dentistry, and consults via his company, Anchor Dental Consulting. Reach Dr. Dykstra at [email protected] or (616) 669-6600.
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