Running a dental practice like a real business

Aug. 1, 1999
You know the drill: Don`t answer the phone, charge extra for nothing, and blame it on the hard drive.

You know the drill: Don`t answer the phone, charge extra for nothing, and blame it on the hard drive.

Harriet Seldin, DMD

What would it be like to be able to get away with running my dental practice like a "real" business? I mean a real business like a big HMO, a bank, the phone company, or an automobile body shop.

What if I ran my patient- records system like one well-known HMO? This HMO is one of the largest in California, and although the millennium bug hasn`t bit, the company has an out-of-control computer system. It`s efficient at terminating coverage, even though the patient`s premiums have been paid. Apparently, this HMO doesn`t consider such behavior to be patient abandonment. To retain coverage, the patient must submit canceled checks ... which brings me to banks.

Obtaining canceled checks from the bank may require you to actually communicate with a human at the bank by phone. Sometimes, the only phone number is an 800 number that doesn`t work due to technical difficulties. If your account doesn`t give you canceled checks, you may wait months for copies of your checks. Then you`ll pay for the privilege of seeing your own checks, on top of paying for the privilege of speaking to someone at the bank.!

Sometimes, banks can be sweet and actually do things for us. One credit-card merchant statement included this interesting language: "Your merchant account will be assessed a one-time fee of $40 for year-2000 compliance efforts completed on your behalf." Sounds great!

Now, how do I pass along such an assessment on my patients` "behalf" without their approval? To be fair, I should mention my recent dealings with another large bank. To its credit, bank personnel were easily available by phone. To its discredit, one of the bank`s employees posted my $11,000 payment incorrectly as $1,000, and then charged me $188 of interest for their mistake! I was, however, able to resolve the issue over the phone ... and was not charged for the phone call!

However, many financial institutions charge customers for phone calls and using tellers. Now, could we charge our patients for the privilege of speaking with them over the phone? That brings me to the phone company. These days, there are many phone companies, some of which we`ve never heard of and hope to never encounter!

My last phone bill at my office included a charge for a call I had never made from a carrier that I had never contracted with. After several attempts, I actually got through to someone at my local phone company who assured me the situation could be resolved painlessly. Unfortunately, soon afterwards, I received a notice of what appeared to be two, new monthly 59 cent charges from that phone company related to that "painless" resolution.

My local telephone company is very difficult to reach by phone. It would be a violation of the Dental Practice Act to treat our patients the way this company treats its customers: endless voice mails and high-tech disconnects.

For example, I was charged for a white pages listing in the city where I live. This would have been fine, except the listing wasn`t in the phone book this year! However, the charge for the listing appeared every month, cleverly buried with other charges. It took a call to the Public Utilities Commission (PUC) to get a phone number to reach the appropriate human at my local phone company. This situation with my phone listing would be like charging a patient for treatment I didn`t perform and continuing to charge for it every month. Such behavior would be fraud if a dentist did it. For my local phone company, it was business as usual. Of course, the PUC allows phone companies to network together, while the FTC doesn`t allow dentists to talk about fees. But, that`s another story.

Which brings me to the last business I would like to emulate - the auto-body shop. My car was rear-ended driving home from the California Dental Association House of Delegates Meeting, and I found an auto-body shop that handles accounts the way I wish I could. This body shop has a very flexible payment plan. Pay the full charge in advance, or pay a surcharge if payment is made upon completion of the work with a credit card. Now, why can`t I do that?

To recap: Blame the computer, take the money, don`t provide the service, don`t be available on the phone, continue charging. As I said at the beginning of this article, why can`t we get away with running our dental practices like a real business?