The bottom line for sustainability

Aug. 1, 2011
I must be the happiest dentist in the world. I love the practice of dentistry, but I hate practice management.

William Strupp, DDS

For more on this topic, go to and search using the following key words: sustainability, system analysis, business principles, better dentistry, Dr. William Strupp.

I must be the happiest dentist in the world. I love the practice of dentistry, but I hate practice management. I believe many dentists feel the same way. Loads of information about how to build a practice exists from virtually every conceivable source.

Certainly it is necessary to operate on sound business principles and have systems in place, coupled with system analysis, in order to run the business side of the practice. This business model must be flexible so that corrections can be made, as necessary, to be successful from a business perspective. However, this model is not the solution to a successful dental practice.

An analogy can be made to the mechanics involved in playing golf. The mechanics of the golf swing are not the totality of a great round of golf, but without sound mechanics, the game will most likely be torture instead of fun.

I started my practice with the basic concept that running a successful practice required more than just having a good business model. It also had to integrate my philosophy about the quality of dentistry I wanted to provide. In order to reach my goals I had to define, quantify, and qualify what I wanted to do.

Fortunately, there were many other dentists at the time who had already achieved the type of dental practice I wanted, so it was very easy to model my practice after theirs. My mentors were ethical dentists with excellent clinical skills. They had created highly successful private practices and influenced large numbers of dentists.

Back to the golf analogy. My mentors (Pankey, Dawson, and Barkley) understood the idea of the game. Sure, they had business models driving their practice decisions (the mechanics of the swing).

More importantly, however, they understood the global concept of what they wanted to achieve in their practices (to shoot a good score without cheating). They taught me that cheating was not the right path to achieve a good score, nor was it the way to find happiness in my dental practice.

There is a hollow emptiness that rings loudly in those golfers that cheat. The score has no value if it is not earned honestly. Similarly, if a dentist is more concerned about the bottom line (the score) than providing better care for the patients, the success achieved is self-limiting.

Practicing better dentistry has done more for me in terms of building my practice than any other approach I could have taken in my 42 years of clinical practice. I never believed the practice management gurus when they analyzed my practice. I never followed the herd mentality.

I chose to simply do the best dentistry that I knew how to do and let the chips fall where they may. As it turned out, bigger was not better, faster was not better, insurance rankling was not better, more technology was not better, leaping onto the next best product was not better ... better was better.

Better also made me happier. I could not have imagined in my wildest dreams what a wonderful life I would have in dentistry. Better enabled me to retain my staff longer. Five of my eight current employees have been part of my team for 32, 29, 27, 25, and 14 years, respectively. I had two employees who retired after 25 years. Better improved my financial status. The net income of the practice is higher than most dental practices gross.

Better helped me attract and retain patients who not only wanted the type of dentistry that I could provide, but who could also afford to pay for it. My patients include celebrities, hundreds of dentists from all over the country, as well as individuals in the upper echelons of the financial and social registers in my community. Better improved the quality of life for my patients and made my dental practice a place where I want to be — it is fun!

There was a price to pay for better, but it was insignificant compared to the emotional and financial rewards afforded from the choice I made. The inspiration to pay that price came from L. D. Pankey quoting a famous phrase from literature: “Oh, ye disenchanted young man, see what you want, step up, pay the price, and take it.”

In future articles I will cover some of the required parameters that will lead to better dentistry.

Dr. Bill Strupp is a practicing clinician and inspirational speaker, acclaimed for his practical and predictable presentation, “Simplifying Complex Cosmetic and Restorative Dentistry.” He is an accredited fellow and founding speaker of the AACD. He is a member of the AAFP, AOD, APS, AES, AAIP, IASD, AAOSH, FACD (president and founding speaker), and other organizations. Contact him by phone at (800) 235-2515, by email at [email protected], or visit

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