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7 questions about comprehensive dentistry

Oct. 1, 2006
George Horton, a practice development manager from CareCredit®, recently attended a seminar for general dentists that I presented in Miami, Fla.

George Horton, a practice development manager from CareCredit®, recently attended a seminar for general dentists that I presented in Miami, Fla. Horton was an active participant in the program. Later, he sent me several thought-provoking questions about practice management. Those questions and the subsequent answers may shed some light on several areas of interest for dentists seeking to better understand how to grow their practices.

1)How many new patient exams should be performed each month and how many of those new patients should be presented with a comprehensive treatment plan?

Over the years, I have observed that the number of new patient exams performed each month varies in every office. Some offices conduct 50 or more exams per month, while others perform only 10. In some cases, the practices with only 10 such exams can outproduce those practices that have quadruple the number of new patients a month.

How can that be possible? In this instance, the key performance indicator (KPI) that practices need to evaluate is average production per new patient. The average production per new patient should rise in a practice gradually over time, indicating an expanded service mix, an improved examination process, and enhanced case presentation skills. Levin Group recommends presenting a comprehensive treatment plan to all patients, so that they have a better understanding of optimal oral health, including elective and cosmetic dentistry options.

2) Of these patients, how many do not schedule or move forward with treatment?

Once again, this varies in every office. However, case acceptance is never 100 percent. If the office is recommending a few restorations, the likelihood of case acceptance is much greater than a practice that is recommending six maxillary porcelain-laminate veneers. In our general observations, simple restorative dentistry has an 85 to 95 percent case-acceptance rate, minor-level prosthetics range between 60 percent and 80 percent, and major prosthetics run 20 to 30 percent. Cosmetic dentistry case acceptance can vary greatly depending on the practice.

3) What is the average cost of these treatment plans to the patient?

To the best of my knowledge, there is no average cost of a treatment plan. However, there are many factors that contribute to treatment cost, including types of services, insurance participation, patient volume, geographical location, competition, etc. Treatment plan presentations can differ significantly from practice to practice. However, practices that typically see patients for an exam - and then a separate treatment presentation appointment - often have a higher average production per new patient or average production per patient.

4) Of the patients who do schedule or move forward with treatment, how many start, but do not complete the treatment plan?

In most cases, patients who schedule treatment move forward. Currently, Levin Group is noticing a slightly higher dropout rate for scheduled patients, probably due to the burden placed on family budgets by rising energy prices. However, one solution to this problem is for practices to request a small deposit to schedule the appointment. Offer the patient a variety of financial options to pay the deposit (see next question). This approach can significantly reduce the no-show and last-minute cancellation rates to almost zero.

5) How many patients accept “less than” optimal treatment?

In my estimation, many patients throughout the country do not accept ideal treatment. The first reason is that ideal treatment - which encompasses periodontal, restorative, prosthetic, cosmetic, implant and occlusal analyses - is rarely presented to patients. Secondly, when these cases are presented, they are typically higher-dollar cases requiring a greater time commitment by the patient and a willingness to undergo the procedures.

6) On average, how many short-notice cancellations does a practice experience in a typical month?

I think it would be illuminating to look at this question from an annual perspective, instead of a monthly one. Levin Group has consulted with many offices that have between a 4 to 5 percent no-show, last-minute cancellation rate. At 5 percent, this means that the practice loses the equivalent of one entire year of production for every 20 years in practice. To make this point more dramatically, how would it feel if, for one year, nobody came in? We recommend that the no-show, cancellation rate be reduced to approximately 1 percent or less through training, scripting, and improved scheduling, including removing habitual no-show offenders from the practice.

7 How much in treatment fees goes uncollected in a typical month?

Most new Levin Group clients initially report a collection rate of 98 percent or better. Unfortunately, this percentage often includes overdue accounts that are truly uncollectible, but have not yet been identified as such. Based on this, when Levin Group recasts financial information for many clients, we find that they are actually collecting between 95 and 96 percent rather than 98 percent or better. This analysis provides an excellent motivation to improve collections, because 1 percent in increased collections represents $1,000 on every $100,000 of gross revenue. In some cases, this can mean as much as an additional $36,000 to $50,000 to a practice’s bottom line (and profitability) when collections are improved and uncollectible debt is no longer masking the realities of a less-than-optimal collection rate.

Better position your practice for case acceptance

These were excellent questions being asked by an inquisitive representative in our profession, and I am delighted he took the time to send them. I hope that my responses will encourage practices to take another look at their case-presentation processes. As you know, increasing case acceptance for comprehensive dentistry is a challenge faced by most practices. By examining the reasons why patients say “yes” or “no” to recommended treatment, you can better position your practice for case-acceptance success.

Roger P. Levin, DDS, is founder and CEO of Levin Group, a leading dental management consulting firm that is dedicated to improving the lives of dentists through a diverse portfolio of lifetime services and solutions. Since the company’s inception in 1985, Dr. Levin has worked to bring the business world to dentistry. Levin Group may be reached at (888) 973-0000, or at www.levingroup.com.

Offer Financial OptionsOffering a variety of financial options can make treatment more affordable for patients and can significantly increase case acceptance. Levin Group recommends these four options:
  • 5 percent courtesy for full payment prior to treatment
  • Acceptance of major credit cards
  • 50 percent down prior to treatment, the balance to be paid before treatment is completed
  • Acceptance of third-party financing
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