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Building a dental practice that sparks joy

March 1, 2021
No one wants to hate going into work, or dread any patients on the schedule. There are ways to create a dental practice that brings you and your team joy.

In the wake of the pandemic, my perpetually optimistic outlook eagerly searched for a silver lining. How do we turn the strain and stress that has affected our mental and physical health into something that allows us to emerge stronger, happier, and more financially stable? How do we turn all of this into something that sparks joy?

The term “spark joy” was coined by Marie Kondo, a tidying expert, best-selling author, and star of a Netflix show. She has made a career out of helping people convert their homes into spaces of inspiration and serenity. Kondo based her KonMari Method on six simple rules.1 Could we take a page from Marie Kondo and transform our practices by imagining what our ideal practices should look like and getting rid of anything that doesn’t fit that vision?

Here’s what I suggest:

Fire unreliable and rude patients.
Drop the lowest-paying PPOs.
Let go of ineffective or toxic employees.
Eliminate unnecessary processes.
Get rid of clutter.

Let’s take a closer look!

Fire unreliable and rude patients

The adage “the customer is always right” is no longer relevant. Customers are not always right, and not every patient is right for you. Patients are the lifeblood of any practice, but they must be the right patients—the kind who appreciate your care and refer others.

Look at your patient base and you’ll find that the Pareto principle applies here2—20% of patients cause 80% of the problems. These patients make unreasonable demands, expect more for less, forget how to swallow saliva when they sit in your chair, miss their appointments, show up late, and treat your team with disrespect. You know who these patients are. 

It’s hard to let go, but there is a good reason why you should—these people might be costing you tens of thousands of dollars every year. They take up too much of your time and are detrimental to your team’s morale. With a typical overhead of 65%, a patient who misses a single cleaning appointment would need to keep two hygiene appointments to make up for the lost time.

If you decide to part ways with someone, make this transition as smooth as possible to reduce bad feelings. Also, check the Dental Practice Act in your state to ensure you’re being compliant. Once you rid your practice of these bad apples, keep them away. Also, keep an eye out for early warning signs when taking on new patients and avoid scheduling the bad ones in the first place.

Drop your lowest-paying insurance plans

The landscape of insurance participation has changed. An insurance-free practice is no longer considered the norm, but not all dental plans are equal. Look at the 10 most common procedures: How well does each plan pay for them? Do frequent denials and down-coding cause patients to question your billing methods? Are you working harder than you expected you would when you signed up? How many patients will leave if you end participation?

Once you decide to go out of network with a company, have a plan of action. Find out if the PPO uses shared or leased networks with better fee schedules. Prepare a well-written letter to explain that you cannot provide the care your patients expect under the company’s PPO terms. Implement an in-house membership plan to offer patients an alternative.

Also, mind your online reputation. In the past, patients chose a dentist from a list of participating providers. Now, patients check Google reviews before they call a practice. Online reviews are insanely influential because patients trust them as much as personal referrals. Part of your marketing strategy should be getting five-star reviews online that will help you replenish patients who leave your practice for an in-network dentist.

Get rid of ineffective and toxic employees

Toxic employees are often productive, but they are a poor cultural fit for your practice. They care about results to the extent that it makes them look good. 

You can easily spot those toxic employees. They are the drama queen, the one-man show, Debbie Downer, the slacker, the “it’s not my job” person, the victim, and the gossip. It may be a prima donna assistant who is good with patients but doesn’t get along with the team. It may be your office manager who knows his job but loves to gossip. These employees cause us to worry because we convince ourselves that they are not bad enough to fire. We fear that we won’t find a competent replacement. We dread having this conversation and decide to wait three months to see if things improve. Yet, while we avoid a stressful situation, we allow this negative employee to continue to drag down the team.

In an experiment conducted at the University of New South Wales, Australia, researchers hired an actor to infiltrate different teams as a “bad apple” to see how his behavior would affect their performances. In every group, productivity diminished by 30% to 40%. Research shows that toxic employees also cause other employees to leave, which leads to huge turnover and training costs.3 

These employees might appear irreplaceable, but while you spend your time trying to motivate and manage them, they cost you a lot of money and aggravation. But when you hire motivated people whose values align with your values, you don’t need to micromanage your employees. 

Eliminate unnecessary processes

Consultant and educator Peter Drucker said, “There is surely nothing quite so useless as doing with great efficiency what should not be done at all.”4

You’ve been working the same way for a long time. It’s not easy to distinguish which processes are essential and which steps have “always been done this way” to accommodate your old systems. Evaluate your workflows and ask, why do we do it this way? What is the purpose of this activity? Who should be responsible for these tasks and where should they be done?

Look for ways to simplify, eliminate, and automate. Can you eliminate any processes that are no longer necessary? Which systems can you simplify to lead to the desired results? Can you automate any steps leveraging technology? How should job descriptions change if you automate or eliminate some steps?

Whenever possible, seek to automate manual processes. A typical office spends nearly 1,200 hours per year on printing, scanning, shredding, confirming appointments, and following up on unscheduled recalls. Implementing software to automate these redundant tasks can significantly reduce the time your team spends on these activities. Going paperless with digital forms will save time and eliminate printing, scanning, shredding, and data entry. Your team will be more motivated and happier having extra time to attend to patients. You can even automate some patient interactions, such as appointment reminders, online review acquisition, and recall. Other technology, such as patient portals and online scheduling, will save time and create an exceptional experience for your patients.

Declutter your space

It’s not easy to let go of things, but is all the stuff you’re holding on to still relevant to you and your vision for the practice? Or does it sit around your office and make you feel that you need to do something about it? Do you still have copies of old publications that you plan to read one day? How about that old mill collecting dust in your closet? What should you do with the box of expired cement you have stashed away?

Storing old dental equipment makes it difficult to keep track of supplies. Have you ever asked your assistant for something only to find out that you’ve run out? It’s simple to blame the person closest to the problem—your assistant—but the real issue might be a lack of organization.

Speaking of decluttering, are you still using paper charts? Did you invest in a robust computer system, but your scheduling coordinator si still retyping patient information from a handwritten form into your practice management software as patients wait to be seated? It’s time to go paperless. A clean space means a clean mental state. Decluttering your office will help declutter your mind, reduce stress, and increase productivity. 

This last year was the opportunity for many of us to reevaluate and rethink our work and life. Also, a new season is the time for new resolutions and new goals. With spring in full swing and many months of extraordinary challenges behind us, hopefully this year will be different for many reasons. Few spring traditions are more satisfying than an annual deep cleaning. This year let’s take it up a notch; let’s turn our practices into places that spark joy.


1. Kondo M. 6 rules of tidying. Rule 6: Ask yourself if it sparks joy. https://konmari.com/marie-kondo-rules-of-tidying-sparks-joy/
2. Tardi C. 80-20 rule. Investopedia. Updated May 25, 2020. https://www.investopedia.com/terms/1/80-20-rule.asp
3. Felps W, Mitchell TR, Byington E. How, when, and why bad apples spoil the barrel: negative group members and dysfunctional groups. 2006. https://s3-us-west-2.amazonaws.com/oww-files-public/a/a5/Final_BA_ROB.pdf
4. Quote Investigator. https://quoteinvestigator.com/2017/02/09/efficient/

GINA DORFMAN, DDS, graduated from the University of Southern California in 2000. She is a practicing dentist and the founder of Dentistry for Kids and Adults, a busy family practice just north of Los Angeles, California. She is also a cofounder and the CEO of the paperless dental software company, Yapi. Contact her at [email protected].

About the Author

Gina Dorfman, DDS

Gina Dorfman, DDS, graduated from the University of Southern California in 2000. She is a practicing dentist and the founder of Dentistry for Kids and Adults, a busy family practice just north of Los Angeles, California. She is also a cofounder and the CEO of the paperless dental software company, Yapi. Contact her at [email protected] and learn more yapiapp.com.

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