Practice Value

Now ‘n’ later: Preparing your office for the future through technology

Now ‘n’ later: Preparing your office for the future through technology

I started my career in the U.S. Army Dental Corps, repaying the four-year commitment I owed for attending college as an undergraduate on an ROTC scholarship. Military practice is an excellent learning environment for a young dentist. There is an unlimited pool of patients in a group practice setting in which you interact with colleagues of varying experience levels daily. You learn to diagnose and treat emergencies, develop speed, and have the benefit of exchanging ideas with other general dentists and specialists. It also fosters versatility and flexibility because you have to learn to treat patients with whatever instruments and supplies are available at the various clinics at which you are assigned. We never became hooked on “pet” instruments because we moved around frequently. This work style has made me a versatile dentist; one who never has become stuck in his ways.

Upon leaving the Army, I chose to join a busy private practice in Virginia as an associate, feeling confident at the time in my clinical abilities, but uncertain about the business side of civilian dentistry. For a variety of reasons, the associateship lasted just one year. With my wife’s encouragement, I began planning to take the leap and open my own practice. So, in 1992, I opened an office in what has become one of this country’s fastest-growing counties - Stafford County, Virginia.

At the time, I wasn’t thinking about preparing my office for the future because I had basically jumped on a moving train, and found myself just trying to hang on and take care of my patients to the best of my ability. I initially equipped two rooms, but soon came to realize that - given the growth in the area - purchasing new equipment would be a good investment. At that time, my purchases were low-tech - chairs, lights, and X-ray machines. I didn’t do much planning or return-on-investment analysis. It was simply a matter of keeping up with the ever-increasing patient numbers.

My first high-technology purchase was a Schick digital X-ray unit, which served two hygiene rooms. It saved a lot of darkroom time, but we still printed hard copies for the chart and stored the images on a separate computer. Eventually, my practice evolved into a fairly modern one with a solid patient base. The family practice had five operatories, as well as two computers at the front desk that were used for billing, scheduling and insurance. At the time, I thought I was as high-tech as I wanted to be. The next three years showed me how wrong I was.

Living in the here and now

For me, the light bulb went on when I was listening to a Richards Report monthly tape series interview with Dr. Joe Blaes on new technology in dentistry. Dr. Blaes’ “Pearls For Your Practice®” column had long been a favorite of mine, so his opinions held a lot of credibility for me. Dr. Blaes grabbed my attention when he said the time had arrived for general dentists to consider the benefits of CAD/CAM technology in their restorative practices. Specifically, he said that the new 3D software developed by CEREC had made the process useful to dentists. The only negative was that the machine cost $90,000.

At about the same time, my local Patterson representative offered to present a CEREC demonstration in my office. For me, it was love at first sight. I saw instantly the benefit of one-visit dentistry for my patients. After I did some simple number-crunching, comparing lab costs versus the number of restorations per month I could convert to CEREC, I ordered the machine. I attended the initial CEREC training, and stubbornly struggled through the learning process until I reached the point that I was convinced I had made the most enjoyable and profitable purchase of my career.

An unexpected bonus after my introduction to the world of CAD/CAM dentistry was gaining exposure to dental colleagues who had embraced technology of all kinds in their practices. These were dentists who were excited about their jobs, and saw technology not as a cost, but as an investment. Their enthusiasm was contagious. So I began to consider what additional steps I needed to take to push my practice forward.

After listening to the advice of these new high-tech role models, I decided to invest in intraoral cameras and a patient education system (CAESY). While this sounded fairly simple at first, soon I realized that I would need to computerize my operatories and create a network in my office. This resulted in more money, more complications, more anxiety, and more resistance to change from staff. But I now had a vision of the kind of practice I was going to have, and I was not going to be deterred. The positive impact of CAESY and the intraoral imaging was immediate.

But once the network was operational, it became apparent that my current practice management software was inadequate to completely integrate all the digital information I was trying to utilize. It was frustrating. I felt like I had spent all this money, and was still only 80 percent of the way to a seamless system. My management software didn’t work effortlessly with my Schick images.

When I told staff members that we were going to change the practice management software, they were not exactly thrilled. The conversion was as painful as the staff predicted it would be. When I would tell them how wonderful it would become - as soon as we were comfortable with the new system and worked out all the bugs - staff members would scowl at me and say how great the old software was. Slowly, almost imperceptibly, things became better. There was no specific point in time when the staff agreed the conversion was worth the trauma everyone had endured, but now staff members are so used to the current program (Patterson Eaglesoft) that we can’t imagine returning to life before the conversion. I liken it to the patient whose tooth becomes sensitive after you restore it. Eventually, the sensitivity goes away, but the patient may not remember that it used to bother him or her until you ask about it six months later.

Why now? For later!

Another motivation for embracing high-tech dentistry is making my practice attractive to a potential buyer in the future. Given current demographic trends within our profession, it’s obvious that only the most advanced practices will be attractive to an ever-shrinking pool of dental graduates. I am planning to build an office with a much higher capacity to treat patients in a county that gains 30 new residents a day. There are numerous successful practice models available in dentistry today. But, looking forward, those practices with a strong foundation in technology will stand out in a competitive market.

Between now and later

Between now and later

Now, more than a year since the conversion, not one day goes by without patients in my practice mentioning how impressive the technology is. Patients say how much they appreciate being treated by the state-of-the-art equipment. Surprisingly, they never talk about the cost. As the practice moves forward, the staff is doing more with digital photography. We even have started scanning charts into a digital database in an effort to move toward a paperless practice. I never would have predicted proceeding in this direction. I knew I could perform excellent dentistry without the expense of computers and space-age gadgetry. It’s just that the time arrived when I could see the benefits of technology, and I wanted more of what the technology could do for me and my patients. The enjoyment I get from my work and the positive feedback from my patients keeps me open to the next wave of innovations, which are no doubt on the horizon.

Timothy Hughes, DDS, has been practicing dentistry for 22 years. A graduate of the University of Missouri-Kansas City School of Dentistry, Dr. Hughes is actively involved in the Northern Virginia Dental Society. He is also a member of the Academy of Computerized Dentistry and Seattle Study Club. Dr. Hughes resides in Fredericksburg, Va., where he enjoys cycling and spending time with his wife and two children. Dr. Hughes can be contacted by phone at (540) 720-2627, or via e-mail at

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