Berlin Same Day

Today, not next Thursday

May 19, 2014
In many cases, dentists feel the need to diagnose problems today but put off treatment until a later date … let's say next Thursday.

By Marvin Berlin, DDS

In many cases, dentists feel the need to diagnose problems today but put off treatment until a later date … let's say next Thursday. Unfortunately, as you all know, when next Thursday comes along, inevitably "life" happens. The patient's water heater goes out, the kids get sick, or meetings come up. You name it; we've heard it. We complain about hearing excuse after excuse, but it's not our patients' fault. Life does happen. I've had to cancel my own doctor appointments from time to time. So what can be done to avoid these inevitable obstacles to treatment?

Same-day dentistry

At the end of 2005, my outlook on dentistry went through a complete transformation — a paradigm shift like no other. Within a 45-day period, my existing four-doctor practice became a three-doctor practice when two senior dentists suddenly left and were replaced by my best friend, Dr. Jeff Lynch. Jeff joined me and Dr. Matthew Markham, and although the facility and practice had been there for years, it was time for a change … a major change. Our first order of business was a simple (yet powerful) name change. The three of us established When we sat down and created our vision for this "new" practice, we were constantly coming back to the idea: "Make every day count and seriously stay focused on today and specifically, same-day dentistry." With this new focus, even with one fewer doctor, we nearly doubled our production in two years from $4.5 million to $8 million a year. Interestingly enough, it wasn't that we changed how we prepped or added any new procedures. Instead, we invested in ourselves and created "real" same-day dentistry.

"Would you like to take care of that today?"

We have committed ourselves to saying, "Right now. Today, not tomorrow." The phrase, "McKinney will do it today" has even become a well-known saying in our town. People know we are willing to do whatever it takes for their immediate well-being. In our office, the phrases, "We can take care of that for you today" and "Would you like to take care of that today?" have become automatic. We also offer our patients the option of using our outside financing partner, CareCredit. Bottom line — we do what's best for every patient right away. This has been a staple of our office early on and something we're encouraged to focus on even more since we affiliated with Heartland Dental.

You must treat people like people want to be treated. If you've ever been sick or if your kids have been sick, you want to get better immediately. One day, my six-year-old daughter was miserably sick. We took her to the pediatrician and it was amazing. They saw her immediately, did an efficient exam, and completed labs right there on the spot. Within 10 minutes, she was 100% diagnosed with strep throat. She received an injection of antibiotics and her prescriptions were already called in and ready to be picked up. By the time she got home, she was already feeling better. That's how efficient we need to be and every dental office needs to be.

When a patient calls with any emergency, we always say, "How soon can you get here?" If they say, "I'm on my way," you and your team will know this a true dental emergency. If they say, "I can be there late this afternoon," it is most likely not an emergency. We still want the patient in the office, but we know it is not urgent. When a patient arrives, if you don't have an operatory available, have your hygienist visit with the patient until you can get him or her diagnosed. Even if you have to bring the patient back into a consultation room to talk, he or she will appreciate that. Find any room that's available.

A same-day scenario

Imagine this. You review your schedule in your morning huddle. Your first column is full of productive cases; your second column has some crown seats, some occlusal adjustments, and a few fillings. Your third (emergency) column has a few emergency patients. If everyone comes as scheduled, you will meet your goal for the day. But as we all know, rarely does a schedule end up exactly as it starts out. In McKinney, "life happens." Some patients are going to reschedule and some are going to unexpectedly call in. Let's discuss the latter. You look up at your schedule, and there's a new patient (broken tooth) that's just been added. Your team takes all the necessary radiographs, and you diagnose a root canal, buildup, and crown. It's decision time.

You could write the patient some prescriptions and hope he or she comes back for the follow-up appointment. Or you could take care of it right now. I know that sounds very simple, but for some reason, we are programmed to reschedule the patient. As you know, when you reschedule a patient, that person has so many opportunities to change his or her mind; to find something or someone else to spend money on. Don't miss the chance to help your patient now!

But how? You are already busy. And why today? You don't need any more to make your goal. Sometimes working treatment like this into your day is hard. If it were easy, everyone would do it. Here is something you should ALWAYS remember — if you miss opportunity the first time, it doesn't always knock again. Making the most out of every opportunity is a key to maximizing your production.

It's a matter of attitude

When implementing same-day service, the right attitude is a necessity. We all have the clinical training and knowledge to provide same-day service. It's a question of having the right mindset — the willingness to put in the time and effort. I've heard many doctors say, "I want to work smarter, not harder." This is simply not possible. You always have to work harder. Does it mean I may have to work through lunch? Yes. Does it mean I can't go check my Facebook status? Yes. Does it mean I can't return texts? Yes. Does it mean I need to avoid chatting on dental forums? Yes. Work is work and sometimes … we need to roll up our sleeves. Actually, all the time.

Here are some questions to ask yourself to help determine what your attitude is:

  • Do you have a daily goal for production? Is it a challenge to surpass, or is it easy?
  • Do you hope that you exceed it, or do you expect to exceed it?
  • What do you do every day to make sure you surpass it?
  • Do you work outside of your comfort zone?
  • Does your staff know the answers to these questions?

Setting a daily goal gives us a target for each day. It should take hard work to reach and give you a sense of accomplishment. Your attitude should be one of expectation, not hope. Control your results by controlling your attitude. Because our team is completely in tune with our expectations, they do what is needed every day. They never ask us if we want to work something in. They tell us we are. They don't ask me if we want to work a case in over lunch. They tell us we are. And we always oblige. To do otherwise would be contrary to the "do it today" mindset we have instilled in them. As a sidebar, if we do work through lunch, I always offer to buy lunch.

If you're like me, you have probably spent tens of thousands if not hundreds of thousands of dollars on various new equipment, products, and continuing education to increase efficiency and profitability. We are constantly looking for the best ways to hone our skills and deliver the best care. Sometimes this can be a new procedure or perhaps a new piece of equipment. The problem is, more often than not, these new toys are eventually tossed in a closet. Again, this goes back to clinical training vs. attitude. Even with the latest techniques and tools, you have to have the "want to." New skills or equipment are only worthwhile if you're actually using them to their fullest advantage.

Think about these things. Take a look at your goals and what it takes to exceed them. Go from hoping to expecting. Let your team know what you expect, and do what it takes every day. Saying YES to a patient is easy when your day falls apart and you have a big opening. Do it every day when things are tight. Be known in the community for handling your dentistry today and when presenting to your patients, remember to say …

"It's never going to be more convenient or less expensive to do this treatment than right now."


More by Dr. Marvin Berlin:


Marvin Berlin, DDS, is senior dentist at and has one of the most productive and profitable dental offices in America. Dr. Berlin is also an affiliated dentist and clinical director of Heartland Dental, and is on the board of the Academy of Comprehensive Esthetics (ACE). He lectures nationwide on marketing and management of dental practices, as well as clinical aspects, including a half-day endodontic program. You may contact him at [email protected].

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