Expanding profitability through new services

May 1, 2000
Any business begins to need new services as other services begin to decline. Dentistry is no exception to this rule!

Any business begins to need new services as other services begin to decline. Dentistry is no exception to this rule!

Roger P. Levin, DDS, MBA

Dental practices are always seeking out ways to increase profitability with high-quality patient care. For most dentists, this involves working harder to increase profitability through a higher volume of patients.

The reason dentists try to increase patient volume is because insurance reimbursements generally have declined. As a result, insurance-based practices only can maintain or increase profitability by seeing more patients.

Just as there are many ways to redirect the influence of insurance companies on dental practices, other methods also exist for increasing practice profitability. These methods should be strongly considered and routinely analyzed.

New services

Adding new services is a lifeline to the future for any business. One law of business success states: "Whatever you sell today will begin to run out tomorrow."

Look at some of the changes that have taken place in dentistry and medicine:

* Babies are delivered and mothers go home the next morning.

* A double-hernia operation is considered an outpatient procedure.

* Dental implants replace missing teeth.

* Fluoride has decreased the number of cavities per patient.

* Human organs can be transplanted into other humans to save lives.

This is a very small list of the many incredible advances that have occurred in dentistry and medicine. If, 20 years before the advent of these new procedures, you had asked dentists and physicians if they would ever have been possible, their answer would have been a resounding no! However, dentistry and medicine will keep evolving, and new services will continue to emerge, replacing or eliminating older services.

Improving techniques

A big difference exists between an improved technique and a new service. Porcelain laminate veneers, posterior tooth-colored restorations, dental implants, tooth- whitening, and antibiotic periodontal therapy all represent new services. New technologies like intra-oral cameras or digital radiography may add a wonderful dimension to practices, but they do not represent new services. They are simply a newly improved way of doing something.

In today`s fast-paced, changing world, it is essential that every dental practice evaluate the potential for new services. While we must provide the highest quality care to every patient, it is interesting to note that more than 80 percent of all dental procedures represent "one-tooth" appointments. This statistic has not changed in the last 15 years to any degree. Yet, we have many new services and techniques.

Increasing profitability

Dental practices, like other businesses, should consider new services for several reasons. Any business begins to need new services as other services begin to decline. Whether we realize it or not, the demographic need for dental treatment is changing. While the amount of purely elective treatment currently being provided is at relatively low levels, the demographics indicate that many adults are from the generation of children that had a far reduced number of cavities. Many of these adults represent patients who care about their oral health and who can afford treatment. However, many of these potential patients don`t need any specific services in the traditional sense.

Declining need for the basics

As I previously mentioned, one natural law of business success states: "Whatever you sell today will begin to run out tomorrow." Dentistry has not been faced with this particular concept in the past. We have had many years of treating decay, fractured teeth, and other basic problems. Up until now, there was certainly more than enough restorative dentistry to build a highly profitable practice.

However, even some practices that still are heavily based in one-tooth traditional dentistry are finding that the insurance reimbursements are not increasing (and, in some cases, are decreasing). These are the practices that now feel they must see a much higher volume of patients to maintain profitability. My concern is that this pace of daily practice will eventually lead to physical fatigue, physical disability, or psychologically negative factors for the doctor.

What many of us may not realize is that adding new services often increases case acceptance for other services. For example, once patients have experienced the beauty of a whiter smile through tooth-whitening, it often leads them to consider other levels of cosmetic dentistry. In some cases, it is not the whitening that has been the most profitable treatment. The results of tooth-whitening have pleased the patient so much that it has influenced him or her to consider other services.

The referral process

Some of the newer services also allow us to expand dramatically in fields that have not been traditional strong points of practices. Some new services have even improved the referral process between general dentists and specialists.

For example, whether a patient begins with periodontal treatment or cosmetic treatment often depends on what that patient is willing to consider. A patient who would truly benefit from periodontal treatment first - and would never have considered it in the past - now may do so. The patient accepts the periodontal treatment because he or she understands the restorative/cosmetic treatment available following the proper alignment or positioning of teeth. This fits in extremely well with the interdisciplinary philosophies outlined by Dr. Rick Roblee in his book, Interdisciplinary Dentofacial Therapy: A Comprehensive Approach to Optimal Patient Care, which every dentist should read.

A new philosophy

Dr. Roblee`s philosophy of interdisciplinary care is that many patients should receive workups from the general dentist and multiple specialists to best assess a total treatment plan. This concept works far better when patients are open to certain types of care through which they will receive the end result that they are seeking. A number of dentists using this approach are increasing their practice profitability by 15-20 percent. They are doing it by providing services that typically have not been accepted by large numbers of patients in the past.

These services include periodontal services such as Atridox® (the new doxycycline antibiotic gel), bone regeneration, rotary endodontics, faster whitening products, fluoride dental floss, single-tooth implants, and a host of other new services and improved products.

We have to be able to integrate new services into our practice, even if the practice is doing well today. The definition of doing well often keeps dentists from thinking more than a few days down the road. What we should be doing is thinking about six months to three years from now!

For more information about this article, contact the author by phone at (410) 654-1234. A biography of the author appears on page 10.

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