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The business of dentistry: It's academic (finally!)

March 1, 2008
Picture yourself as a first-year dental student at a major university. You are overwhelmed by the rudiments of gross anatomy, biochemistry, and physiology...
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by Garrett Ludwig

Picture yourself as a first-year dental student at a major university. You are overwhelmed by the rudiments of gross anatomy, biochemistry, and physiology, and realize that you are at least a year away from any hands-on clinical interaction ... and then, opportunity knocks. You’re invited to participate in a concentrated, interactive program that teaches the essential skills needed to operate a dental office — a veritable boot camp for the dental entrepreneur, and a chance to be involved in shaping your career as a professional. Sound far-fetched or futuristic? Not really. The program is now in its third year at the University of Connecticut School of Dental Medicine in Farmington, Conn.

The workshop, which is formally known as “The Dental Office as a Company for the Delivery of Oral Health Care,” is a crash course in the business of dentistry or (to many) “the missing link” in dental education. This keenly structured and intensive program runs on a business schedule — 9 a.m. to 5 p.m. — five days a week for the month of July, and encompasses the principles of business based on the Kaizen philosophy, the objective of which is to create a manufacturing or production facility that imbues energy and vitality and respects its employees — inspiring in them the desire to work, and thereby enhancing their feelings of self-worth.

The integration of these business principles is truly insightful, since they have been used successfully by many leading businesses worldwide. This cognitive sensibility resonates throughout the core curriculum.

The program’s founder, Ed Rossomando, DDS, PhD, MS, is an unassuming academic whose extensive resume belies his underlying enterprising and entrepreneurial spirit. Dr. Rossomando is a professor in the craniofacial sciences in the School of Dental Medicine at the University of Connecticut. He has concurrently taught and carried out research in the dental school since 1972. In 1973, he created and introduced Biodontics® into the undergraduate dental school curriculum.

Additionally, he has taught molecular, cellular, and developmental biology to undergraduate dental and medical students, graduate dental students, and dental residents. In 1998, he was appointed coordinator of the National Institute of Dental and Craniofacial Research (NIDCR) in their program on new products and technologies, through which he received the NIDCR’s Exemplary Service Award for his work in developing the Institute’s Commercialism Program in 2000. Now, with the creation of this innovative course, he has earned notable distinction as a modest business savant. In plain terms, the program which he originated is simply brilliant because it is brilliantly simple.

How the program works

Divorcing itself temporarily from the piety of clinical care, the premise of the program is to equate the dental office to a manufacturing facility. Inherent to any manufacturing industry, each “department” represents a “profit center.” Therefore, every room or area in the dental office is identified with a value — even if the defined area functions interdependently with another — as is the case with the reception, business, and consultation areas. In the same metaphorical context, each member of the dental team assumes a new identity for his or her respective role in the office: the dentist, CEO (Chief Executive Officer); the administrator, COO and HRO (Chief Operations Officer and Human Resources Officer); and the bookkeeper, CFO (Chief Financial Officer).

Of course, no corporation would be complete without department heads and production personnel. The clinical staff at large was entrusted with the responsibility to manage their respective departments as well as perform their licensed/certified skills.

Those of us who serve the dental industry have relied allegorically on these simple formularies for many years, in an effort to establish fiscal efficacy and project feasibility. It’s refreshing to see these principles applied to academic premise. Evidentially, this course of study represents the paradigm for the much needed business training in mainstream dental education.

It is long overdue, and the University of Connecticut School of Dental Medicine deserves commendation for recognizing the need as well as respecting the intuition of its originator — whom I might add also had the foresight to expand the program beyond the confines of the University of Connecticut campus. To date, the attendees include students from NYU, Howard, Marquette, USC, Meharry, and of course, UConn.

The educator in Ed Rossomando has a clear understanding of the impact that hands-on experience has on the retention of doctrinal instruction. As a result, this multitalented professor has aptly ingrained the instructional precepts of his business theories with tours of hand-selected local companies.

Following the informative didactic sessions, the students were invited to observe the business operations of various manufacturing facilities firsthand — three of which are Connecticut-based firms that produce dental products: Pentron of Wallingford; Centrix of Shelton, which produces restorative and endodontic materials; and Ultimate Wireforms of Bristol, which manufactures orthodontic arch and ligature wires. These tours afforded the students the opportunity to witness the manufacturing process with products to which they can relate.

In an effort to bring the concepts of production full circle to its optimal productivity, the students were also familiarized with the equipment that is essential to the practice of dentistry. Although they already maintained a common knowledge about many of the components, such as the dynamic instrument delivery system, they were introduced to many of the more sophisticated clinical adjuncts as well. Among them were presentations on a dental laser and a CAD/CAM system, which were provided by Benco Dental and Patterson Dental respectively.

With those factors effectively addressed, the profit-based “dental manufacturing company” was then operationally ready for business, leaving one piece of the puzzle to be added — “customers.” As the saying goes, “You’ve got to meet them before you can treat them.” With the need for marketing clearly etched in their minds, the students were enlightened about the multitude of marketing techniques that can be employed to grow their fledgling dental manufacturing business.

Presentations were provided by two marketing specialists, Joseph Sakaduski and Mark Judge. The content of their individual review ranged from the subtleties of internal marketing to the various media formats that are commonly used to promote professional services. The visualization of the extensive impact that an effective marketing program can have on a business generated a distinct energy and enthusiasm among the student body.

With the business network neatly structured and defined, the team was then prepared to utilize this collective data in the exploration for and development of a physical plant. Having taught office design to the Family Dentistry Residents at UConn since 1987, I was given the honor and privilege to fill this fundamental segment of the curriculum.

Over time, I have attempted various formats to inspire interest when reviewing the mundane details associated with defining the needs of a dental practice. It has been equally challenging to maintain concernment when reviewing the intangible and sleep-inducing volume of acronyms associated with regulatory issues that profoundly impact design — HIPAA, OSHA, ADA, NFPA, EPA — to name a few. As a result, I resorted to a hands-on, interactive format.

At the encouragement of Dr. Rossomando, I provided each student with a drafting kit, a drawing of a “raw” space outlining the perimeter of an office that my company had planned for a former client, a list of rooms and sizes that comprised that space, and the assignment to design the space as they saw fit.

Enthusiastic student participation

Throughout the morning session, I was flooded with insightfully relevant questions about every topic of my presentation, including ergonomics, function and flow, code compliance, and the integration of technologies. This enthusiastic interplay persisted throughout the afternoon session, during which we toured three local offices that my company had previously designed. The most gratifying elucidation regarding their interrogatory was the fact that they clearly understood the ultimate objective of the course — superior patient care. They drew precise, illustrative corollaries to the entire course curriculum. As such, they cognitively articulated the benefits that would be derived by their patients as a result of the global optimization of their dental “business.”

Armed with the knowledge imparted to them through Dr. Rossomando’s curriculum, and motivated by the challenge of creating their own office, the students responded with remarkable enthusiasm. When I returned to the university a week later to review their design concepts, a palpable energy permeated the room. Most were eager to show what they had accomplished, and took great pride in the much deserved positive feedback from their peers as well as the faculty.

To my further amazement, many of the students bypassed the archaic drawing tools and downloaded design software from the Internet, which resulted in amazingly professional-looking floor plans. A few of the designs were inordinately impressive. These students’ designs had met all professional and legal requirements and expressed a functionality that would satisfy the most discerning, seasoned dental professional. Dr. Rossomando has awakened a sleeping giant and ignited a spirit in a group of future dentists who will, without a doubt, soon be providing cutting-edge dentistry that is both professionally gratifying and financially rewarding. Although several of the students submitted testimonials extolling the benefits of the program, none said it better than Leigh Mae Cabral. “Everything presented to us should be [included] in every dental curriculum.”

It was this contagious enthusiasm that inspired the concept of repackaging the Biodontics program for introduction into the “mainstream” dental school curriculum. With the practice of dentistry as the program’s premise and overall objective, it made the most sense to replicate a physical plant in which the graduating dentists would ultimately dispense their professional services.

The spawning of the Innovation Center®

In short, the focused objective is to construct a professionally staffed, fully-functioning dental office within the University of Connecticut campus. The intent is to cycle all fourth-year dental students through this facility and prepare them for the administration of all aspects of business and clinical operations.

In true business fashion, it was necessary to create a business plan. That task was accomplished by the CRETE (Center for Research and Education in Technology Evaluation) Industry Advisory Council, which is comprised of dental professionals and leading dental manufacturers. The development of the prototype was further supplemented by data imparted by allied business advisors, including a technology expert and a seasoned fundraising/marketing specialist. With the aid of the latter, it is intended that the project will be funded by UCSDM alumni, as well as local practicing dental professionals and dental industry product manufacturers. Thus far, the project has been met with praise, enthusiasm, and pledged support.

Since the Innovation Center will essentially function autonomously, most of the operational expenses will be offset by dental fees, which will be processed, tracked, and organized with a preferred practice management software program. Additional revenues will be generated by the lease of the Innovation Center dental suite and the respective networked lecture halls. Ultimately, all net revenue will remain in the university coffers.

The Innovation Center is a win, win, win venture

WIN — As noted, the fourth-year dental students will be plying their skills as they would in a private sector setting. The facility will be fully staffed with a paid receptionist, office administrator, chairside assistants, and a dental hygienist. In addition to their monitored performance as clinicians, the students will be trained in managing treatment plans, scheduling, handling personnel, and general practice operations. In addition to learning the comprehensive skills in the business of dentistry, the students will have an opportunity to train with and utilize the latest dental technologies, including dental lasers, digital radiography, and CAD/CAM technologies.

The Innovation Center will also have the capability to broadcast advanced training sessions live to selected lecture halls via digital videography to enhance training in advanced treatment modalities.

WIN —The dental manufacturers will be afforded a showcase for their state-of-the-art equipment. As such, students will be trained to use equipment that would otherwise not be available to them until later in their professional careers. With the exception of the practice management software, each manufacturer’s components will be presented for implementation on a rotational basis, thereby allowing each to demonstrate the benefits of their respective products.

The Innovation Center will also be available for lease by the dental manufacturers in a fashion of private enterprise, i.e., the manufacturers will pay to utilize the dental suite and lecture halls to train practicing dentists in the use of their products. The manufacturers will have a venue that far surpasses the constrained carnival-like atmosphere of an exhibit hall or the confines of a treatment room in a private practice. The revenues generated will further offset operational costs, as well as allow for additional enhancements to the physical plant.

WIN — The Innovation Center and lecture halls will also be available to practicing dentists as a vehicle for continuing education, and will be open to all dental generalists and specialists. The Biodontics program and the Innovation Center represent landmark growth in dental education and the advancement of dental care. I am thrilled to have played a small role in this remarkable program.

Anyone interested in participating in the development and operations of the Innovation Center may contact Garrett Ludwig, President of Diversified Design Technologies, Inc., at 800-622-5563, or [email protected]. Please reference the Innovation Center in the subject line.

Garrett Ludwig founded Diversified Design Technologies Inc. in 1971. The company has specialized in the design and construction of private-practice, health-care facilities since 1975. During that time, he has designed more than 300,000 square feet of professional office space. He has a U.S. patent on his emergency services “crash cart” design. Ludwig has shared his experience in dental office design in numerous trade publications, and continues to lecture on the subject throughout the United States. He can be reached at (800) 622-5563 and [email protected]. Visit his Web site at

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