Show me the money!
Like most young dentists, my initial, wobbly steps after graduating in 1977 challenged my ability to put it all together.
by Jerry Woolf, DDS
Like most young dentists, my initial, wobbly steps after graduating in 1977 challenged my ability to put it all together. I had to learn how to handle patients, a new staff, and the not-so-perfect physical plant, as well as my clinical efforts. This was done while trying to make enough money to keep the practice and my family afloat. Now, years later, I see how my diagnostic and clinical skill development contributed to my personal, professional, and financial growth. In addition, my Accreditation in the American Academy of Cosmetic Dentistry marked a major turning point in the process. It is now clear to me that, when I knew less, I proposed less. This produced less revenue and generated less income, resulting in less profit. While this is a simple and reasonable progression of thinking, it is not always apparent in the moment. Hindsight has given me a perspective I wish I had some 30 years ago.
Better diagnostic skills
While I thought I was a cosmetic dentist 15 years before I earned my AACD Accreditation, I didn’t know what I had not learned until I studied with the masters and challenged myself to undertake the Accreditation process. Improved diagnostic skills enabled me to see things I previously missed. A more sophisticated diagnostic ability dramatically altered my approach to cases. I am more comprehensive and complete than ever. I approach each case with the big picture in mind rather than a single tooth or multiple-unit mindset. I have a much better sense of the causal factors that contribute to breakdown, deterioration, and disease. I understand related variables such as wear, discoloration, malocclusion, and other forms of disease. Ten years after completing Accreditation, my diagnostic mindset is broad and deep. My ability to identify clinical opportunities and options has increased dramatically. In my mind, there is no question this is the first step in creating a more productive and profitable practice.
Better clinical skills
Once I was able to identify more clinical opportunities, I was faced with the challenge of performing the dentistry. Fortunately, my AACD mentors and the Accreditation process helped me develop clinical skills as I became more diagnostically accomplished. The AACD’s Accreditation process requires the completion of only five clinical cases, yet I worked on dozens trying to perfect my clinical and diagnostic skills. I was proud of the cases I presented to the Accreditation board. But upon reflection, all of my clinical casework took a dramatic turn for the better.
During the Accreditation journey, I carefully chose continuing education to support my learning. I registered for each AACD Scientific Session and selected from among the many hands-on courses offered. Each year I learned something new, and my clinical skills reflected that learning. I heard from the masters at lectures and presentation courses and chose to pursue further training with a few of those who I thought were the best. I believe we develop an internal clinical standard. My standard was honed and sharpened as I saw the work of others and then integrated the clinical ideas I learned from my peers.
How does clinical excellence translate into a more financially sound practice? While it may seem obvious, there is no question that better clinical skills result in more predictable results, fewer redos, and less time wasted. This is in addition to larger cases that command higher fees. The opportunity to provide clinical service is reward in itself, yet greater financial returns are a welcome addition.
Better photographic and documentation skills
As I followed the documentation guidelines for Accreditation, I began documenting the rest of my cases, too. With additional practice, my photographic skills showed a dramatic improvement. Before I knew it, I had assembled a fabulous portfolio to show patients the possibilities that esthetic dentistry could offer. What an advantage that was for patients and me! Patients who view photos that were reminiscent of their needs could envision looking better and being transformed. My case acceptance began to rise dramatically, and more patients asked for additional dentistry than ever. We know cosmetics are largely driven by a patient’s subjective impression of his or her self-image.The ability to envision a different time with a different appearance is empowering for patients. Our documentation has helped more patients take that leap with the assurance that we could meet their expectations.
More skilled support
When I compare the staff and professional clinical support I had prior to Accreditation versus what I have assembled today, the difference is remarkable. I now have the privilege of working with team members who are professional, mature, and skilled to carry a substantial portion of the clinical care under my direction and guidance (Fig. 1). They are happier being used more fully, and I am delighted to relinquish many steps to these skilled and competent professionals. Being freed to tend to other patients and issues has increased my productivity substantially. My ability to work with the best specialists and ceramists in the industry has contributed to the quality and predictability of my results, too. I continue to work with and learn from the best. My practice’s bottom line is a reflection of this reality.
Better fees and financial arrangements
Of course, more highly discretionary services command a more significant fee, and the profit from these services is greater than from more basic dentistry. Moreover, cosmetic services are generally unencumbered by patients’ expectations from their dental insurance. Like many Accredited dentists, I make financial arrangements independent of insurance reimbursement. Fees are collected in advance or at the beginning of treatment, eliminating expensive accounts receivable. Having more patients pay in advance with fewer collections problems translates into a financial advantage.
The AACD credential differentiates me from other dentists, and the public is becoming more aware of the distinction that comes with Accreditation. With this distinction, I now am well-positioned in the community and more confident in my ability to propose and execute cosmetic care.
Through the years, I have taken courses that offered a smattering of useful information, and others that have helped me move to long-term achievement. The Accreditation process has set a new standard in my expectations, as well as what I expect to provide to patients. I am reminded of the story of the admiral who burned his ships, and told his soldiers the only way home was straight ahead. I often think of my journey through Accreditation in this way. It is a focus and commitment that accepts no substitutes. This helps keep me from returning to my old ways and enables me to proceed forward, advancing to a new level of dentistry.
Since becoming Accredited, my practice has grown four-fold. My AACD friends report similar success. Much of that growth can be attributed to the skills I have learned and recognition I have received. Yet each of the factors discussed have played a part in the productivity and profitability I am now experiencing. I invite you to consider how my story could be yours. The AACD and its Accreditation process are open to everyone. I invite you to explore each. We will welcome you with open arms.
Jerry Woolf earned his DDS from the University of Southern California. He has served as president of his local component, an instructor at UCLA and Esthetic Professionals, an examiner for AACD, and a director for AACD and the American Board of Cosmetic Dentistry. An avid pilot, Dr. Woolf commutes in a twin-engine airplane between two dental practices he owns. He can be reached at email@example.com.