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Achieving same-practice growth: A 3-pronged plan

Sept. 22, 2016
Alex Sharifian, DDS, and Mark Dean share what has helped achieve success in the dental offices they've helped grow over the years by looking at these three aspects: patient flow, PPO dental insurance plan acceptance, and patient retention.

Alex Sharifian, DDS, and Mark Dean

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Recently, a fellow dental school alumnus was discussing the limitations he was facing in trying to expand his practice. He was contemplating the possibility of no longer accepting PPO plans. He thought he could increase profitability by focusing on patients whose services resulted in higher fees for the practice. But he wasn't considering how this could affect the patient flow in his office and possibly reduce profitability.

Many practice owners experience similar struggles in trying to grow their practices. According to data provided by the National Center for Health Statistics, the number of dental visits for patients ages 18 to 64 has been flat from 1997 to 2014.1 Additionally, research from the ADA Health Policy Institute (HPI) showed that the average retirement age of dentists increased from 64.8 in 2001 to 68.7 in 2013 due to a lack of growth in the dental economy.2 With these trends, it is more important than ever to take intentional steps to achieve practice growth.

READ MORE |Do PPO 'insurance inches' matter?

We considered what has helped achieve success in the dental offices we've helped grow over the years. It is critical to start with a strong business plan that outlines a strategy for year-over-year growth. The plan should include detailed strategies for impacting three aspects of the practice: patient flow, PPO plan acceptance, and patient retention.

Patient flow

Creating a strategy to increase patient flow is one of the best ways to increase profitability in a dental office. Several different tactics can accomplish this.

• Add more providers-Hiring additional clinicians allows us to leverage the existing space in our practices to maximize productivity. Some practice owners are hesitant to bring on another clinician based on the level of responsibility required to coach and oversee the associate, and they may be reluctant to give up control over the treatment of patients. Consider this as a great opportunity to seek out like-minded clinicians. Supporting the growth of a fellow clinician through mentorship can be truly rewarding for any practice owner. In turn, this additional clinician can support the desired practice growth.

For example, one of my practices had an operatory with an orthodontic bay that was used only four days per month by the orthodontist. I hired another hygienist who did not mind using this operatory to treat patients. By expanding hygiene services in an operatory that was often empty, the practice saw a noticeable increase in productivity.

• Expand office hours-Expanding office hours offers greater accessibility for patients. According to the Dental Economics/Levin Group 7th Annual Practice Research Report, the majority of dentists (65.4%) work four days or less per week.3 Only 15.8% of dentists surveyed reported working five or more days per week.

With dental visits for working-age adults ages 18 to 64 remaining flat, flexibility with work schedules is extremely important. In a 2013 survey conducted by 1-800-DENTIST, 57% of patients said they look for practices with extended hours on weekdays, and nearly 50% look for practices open on Saturdays.⁴

Dentists are responding to these trends. A 2014 study conducted by the Brighter Practice showed that more than 50% of dental practices are open after 5:00 p.m. on Mondays through Thursdays, and approximately 39% are open on Saturdays.⁵ By offering expanded hours, we can attract more patients to our practices and avoid losing them to our competition.

READ MORE | There's a hole in your hygiene: How reappointment rates dramatically affect dental practice growth

• Improve efficiency and visibility-It may seem simple, but creating an efficient schedule for each provider can optimize patient flow and help deliver better customer service. Determine ideal but realistic scheduling, and work with the entire team to ensure everyone can execute this new schedule effectively. When the practice runs efficiently, your entire team will experience less stress, work together in harmony, and provide better customer service. When patients enjoy a friendly, on-time visit, they will leave happy and be more apt to refer friends and family to the practice.

Increasing our visibility in the community also helps maintain a healthy patient flow. Hosting events for the community and supporting local charities and community service projects helps us create awareness and a positive brand image for our practices. The local residents will appreciate the support and remember us when they choose a dental provider.

PPO plan acceptance

There has been a significant shift in the dental marketplace moving toward PPO plans over the past decade. Data shows that PPO plans now account for almost 80% of all commercial dental benefits.⁶ In addition, a research brief from the ADA HPI indicated that people are more than twice as likely to have a dental exam at least once per year when they have private insurance.⁷

Accepting more PPO plans can help us gain additional patients who wouldn't otherwise visit the practice if their insurance were not accepted. Since these patients are more likely to visit annually, it is a great way to help grow the practice.

Patient retention

New patients are important for the practice, but retaining patients is even more critical to achieving long-term growth. When patients continue to visit the practice, we can build stronger relationships, promote case acceptance, and generate organic referrals.

Gaining patient loyalty not only requires great dentistry, but also great customer experiences. A report from Deloitte showed that only 22% of people are content with their current health-care providers.⁸ If patients aren't content with their dental providers, it is easier to lose them to the competition.

The best way to build patient loyalty is to take time to understand our patients' wants and needs. By making the effort to listen and get to know our patients, we begin building a foundation of trust. We have to be consistent and create exceptional experiences for patients at every visit and touchpoint. This might include on-time service, friendly staff, doctor consultation prior to the exam, and follow-up phone calls from the office.

Many practice owners experience struggles similar to my dental school colleagues in achieving additional growth for their dental offices. But by outlining an intentional plan with strategies to optimize patient flow, PPO plan acceptance, and patient retention, we can foster the growth we desire for our practices.


1. Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. US Department of Health and Human Services. Centers for Disease Control and Prevention website. National Center for Health Statistics. cdc.gov/nchs/data/hus/hus15.pdf#078. Published May 2016. Accessed July 14, 2016.

2. Munson B, Vujicic M. Supply of dentists in the United States is likely to grow. Health Policy Institute Research Brief. American Dental Association. Published October 2014. Accessed July 14, 2016. Available from: ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_1.ashx.

3. Dental Economics/Levin Group 7th Annual Practice Research Report. Levin Group, Inc. website. levingroup.com/pdf/desurvey/2013/Nov_DE_LGsurvey2.pdf. Published November 2013. Accessed July 14, 2016.

4. Henry K. Convenience, honesty, and online reviews ... some of the things your dental patients want. DentistryIQ website. dentistryiq.com/articles/2013/05/convenience--honesty--and-online-reviews-----some-of-the-things-.html. Published May 2013. Accessed July 14, 2016.

5. Extending Office Hours to Benefit Your Practice. The Brighter Practice. practice.brighter.com/2014/10/extending-office-hours-to-benefit-your-dental-practice.html. Published October 30, 2014. Accessed July 12, 2016.

6. 2015 NADP/DDPA Joint Dental Benefits Report: Enrollment. National Association of Dental Plans website. knowledge.nadp.org/products/2015-nadpddpa-joint-dental-benefits-report-enrollment. Published August 2014. Accessed July 14, 2016.

7. Nasseh K, Vujicic M. Dental benefits expanded for children, young adults in 2012. Health Policy Institute Research Brief. American Dental Association. Published October 2014. Accessed July 14, 2016. Available from: ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_5.ashx.

Alex Sharifian, DDS, is a graduate of the University of Southern California School of Dentistry. He also earned a master's degree in physiology from Georgetown University. Dr. Sharifian is a multiple-office owner dentist supported by Pacific Dental Services® and also serves as chair of owner dentist development for the PDS Institute®.

Mark Dean is the director of DeNovos and strategic analysis for Pacific Dental Services.

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