Louis Malcmacher, DDS
One of the keys to controlling overhead is procedure efficiency. We all know the saying, Time is money. That statement, however, means different things in different situations. Various professions use the saying as it suits their purposes. For example, when you say to a lawyer that time is money, it typically means that the longer the attorney can spend on a case, the more money he will make. Lawyers charge by the hour, so they are more productive when negotiations or research take longer to do.
To dentists, time is money means the exact opposite. You receive the same fee whether it takes you one hour or two. With the kind of procedures we do, the more efficient we can be in accomplishing them, the more profitable those procedures become. The faster we work (only with equal or better quality), the more we can lower our overhead efficiently and dramatically.
Clinical Research Associates estimates that the dentist's time is worth approximately $10 per minute in overhead. If it takes you 20 minutes to seat a crown, then that's another $200 of overhead you have invested in that procedure. I would venture to say that for most dental offices where this is the case, they have lost money on that crown — unless their crown fee is very high. Over the next few months in this column, I will talk about specific ways you can reduce your overhead through more efficient procedures.
Here are some concrete ways you can increase your efficiency and reduce the time it takes to seat a crown:
1 Delegate as much of this procedure to your assistant as your state allows. Most states allow assistants to remove a temporary crown, clean off residual temporary cement from the tooth, try in the crown, and make adjustments as necessary. The dentist then comes in for the final cementation, at which point the crown should fit perfectly. The patient has already agreed to the shade and shape of the crown.
2 Work on your impression technique with your laboratory so your crowns literally fall into place with minimal adjustment. I know this is easier said than done. It may take a few weeks of intensive work with your lab, but it will pay off in the long run. Sit down with your lab technician and go through your techniques for creating a crown. This communication is invaluable; it will help your crowns fit better and lessen the time it takes you to seat the final crown.
3 Use a fast-setting, resin-reinforced, glass ionomer cement that releases fluoride, desensitizes the teeth, and is very strong. These cements are wonderful. The entire cementation can take five minutes or less, which includes seating and cleanup. Some examples of these fine cements include Infinity® by Den-Mat Corporation, RelyX™ by 3M™ ESPE™, and Fuji PLUS by GC America.
Time is money in the dental office — it directly relates to your profitability and overhead. Time is not money if it means that you reduce the quality of your work. Low quality will eventually cost you more in time, money, and unhappy patients. But even a simple procedure such as seating crowns can actually help lower your overhead if done in a time-efficient manner.
Dr. Louis Malcmacher is an international lecturer and author, known for hiscomprehensive and entertaining style.An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired his audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988.For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via email at [email protected].
