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The resilient practice: Adaptability is key when facing a crisis

Aug. 1, 2020
To survive the pandemic and whatever the future may bring, your dental practice needs to agile and adaptive. The quicker your practice stops focusing on one aspect of reopening and embraces a holistic shift in mindset, the better.

In a time of transition, your starting point matters. Reopening is not a simple matter of checking things off a list, such as donning more PPE or taking patients’ temperatures. A change of mindset is in order—relying on previously successful tactics won’t be enough. The new normal demands a dramatic rethinking of both clinical and business protocols. It requires new investments and will likely result in additional operational costs that will challenge historical financial models.

Reopening vs. reestablishing

There is a difference between reopening and reestablishing your practice. To illustrate, let’s take a professional football team that set the goal of getting to the Super Bowl. The team makes it to the game, but their performance once there is abysmal. Why? Because they weren’t mentally prepared to win. Their goal should have been to win the Super Bowl.

Reopening is no different than getting to the Super Bowl. The organizational adrenaline of reopening won’t sustain long-term success. Reopening is just one of the markers on the journey to reestablishing your practice in the community. The real question is where to start.

A time of turmoil is actually an ideal time to reestablish a business. The convergence of dentistry and medicine is already creating a degree of upheaval, further amplified by COVID-19.1 Now is a great time to reposition your practice, featuring a broader scope of care and services. 

Reestablishing will necessitate a shift in overall mindset. Here I’ll explore a few key categories where a shift in mindset will serve your practice well during this unprecedented time. I’ll also highlight a few recommended tactics that will aid in the shift.

Create a safe harbor

Wellness has recently become a status symbol. According to marketing intelligence platform CB Insights, “Consumers are focused on preventive aging measures as more people view beauty as a reflection of overall health.”2 These trends create a unique opportunity to reposition your practice and focus on monetizing wellness. Here are a few ideas for how to go about it.

Focus on patient engagement

Use this emotional connection to gain patients’ active involvement in reaching their health-related goals with a focus on high-quality care in the fewest visits.

Think beyond the vermillion border

When I spoke with Bob Riggs of Oralogix in March of this year, he remarked, “Health and beauty are now perceived to be one and the same.” Become a beacon in your community for a healthy lifestyle, strengthening patients’ immune systems while promoting beautiful smiles. 

Avoid scare tactics

Stop marketing your business using the anxiety-inducing message of “enhanced infection control.” You can pass on the additional cost of infection control as a subtle way of informing the patient that the practice meets and exceeds the standard of care—just don’t make it the main message. Doing so is considered infection control theatrics, and it’s really no different than gloving up in front of the patient.

Reskill your team

Veterans of the dental field who can accept this new perspective will be able to acquire new skills. Unfortunately, it’s likely that some won’t make the transition. 

Expand your hiring criteria

Given the high unemployment rate, consider recruiting candidates who don’t have a background in dentistry, but who possess excellent customer service skills.3 Reskilling for them will be about learning the dental/medical profession.

Reexamine traditional roles and responsibilities

Dental hygienist

Gone are the days of passive employment and simply checking “yes” or “no” after “Do you snore?” Patient anxiety and increased cost will reduce demand; marginal offices will close, and unemployed dentists will be looking for positions. It now becomes a question of simple math: at what point is it more economical to hire a hygienist with a limited license over a dentist with a full license? To some, this may seem threatening and offensive, but others will see it as a real opportunity. I recently spoke with my colleague of 25 years, Janet Press, RDH. She said, “The changing face of wellness and the role of hygienists in treating patients to a new level of health should be viewed as inspiration. As we serve the public as essential members of their health-care delivery team, we need to use our hard-earned knowledge as investigative health-care professionals, ferret out patients’ medical risk profiles, and help them implement a path to wellness.”

Treatment coordinator

Traditional financial arrangements are too restrictive. It’s no longer just about collection ratios, accounts receivable, or insurance processing. In the current climate, it’s about using patient financing as a marketing tool. A practice will do well to produce more patient care in fewer appointments. This requires a reskill of your financial mindset with new options to meet new demands. 

The resilient practice that becomes a safe harbor in the eyes of patients and facilitates a reskill of its team will attract some of the best people in the community.

Boost your "credit-ability"

As consumers continue to pick up the tab, practices need to reevaluate what I’ve termed their “credit-ability,” or their ability to make quality care more affordable. It’s important to realize that care doesn’t necessarily need to be cheaper to be more affordable. Providing the most care in the fewest appointments is both a patient care issue and a cost of care issue. 

Today, standard payment options have new limitations. When it comes to major credit cards, dental offices pass on a convenience fee of credit card cost utilizing a program such as Merchant Preferred Zero. Health-care-specific credit cards are also available, but traditional credit scoring may limit acceptance rates. Cash and checks are always an option, but physical forms of payment are unpopular in our increasingly contactless economy. In light of these limitations, the following are some tactics to consider.

Medical billing

Given the accelerated convergence of dentistry and medicine, medical billing is now a necessity. Patients want more coverage, and practices are looking for fair compensation. There are many competent firms available to serve as dental billing consultants to your practice. 

Subprime patient financing

If credit scores drop as people deal with the COVID-19 crisis the best they can, many good patients may no longer qualify for traditional financing. A professionally managed subprime loan option can be an excellent tool for facilitating patient care and practice growth. 

Practice loyalty program

A well-designed loyalty program reflects a curated series of services, rewards, promotions, and educational information for both insured and uninsured patients. Potential benefits to consider include:4

  • Existing customers tend to spend around 31% more than new customers.
  • Around 83% of consumers are likely to stay with a practice that has a loyalty program.4

Be aware of the difference between a loyalty program and a membership plan. Most membership plans marketed in dentistry are just in-house discount plans directed only at the uninsured. A well-structured loyalty program attracts and retains value-driven patients, making it a necessity for successful practices.

VIP express checkout

In today’s contactless society, making financial arrangements fast, convenient, and safe is a must. Present this easy-to-use billing process as a new service, not as part of anxiety-provoking infection control, and eliminate the costly statements. The process should include:

  • Payment Card Industry-secured card numbers allowing single sales or recurring billing
  • Touchless hardware options (e.g., Apple Pay, Android Pay, or Europay, Mastercard, and Visa [EMV] chip)
  • Payment options on the website

The resilient practice should offer a wide range of financial options for their patients.

Take an omnichannel approach

The very nature of dental care will always make person-to-person contact paramount, but the dynamics have changed dramatically. Creating frictionless access for patients and prompt, personal responses will help your practice stand out from the rest. Managing the customer experience will generate different sources of revenue and allow the practice to better control cost. According to strategy and management consulting firm McKinsey & Company, “Organizations that can quickly reimagine their omnichannel approach to create a distinctive customer experience will recover faster from the pandemic.”5

Online scheduling

Increase patient access by providing the ability to request appointments 24/7. Preplan your schedule, leverage your team’s time, and reduce cost with prescheduled blocks.

Two-way text messaging

More consumers prefer text messaging. It’s quicker and more convenient for most, and texting has a higher open rate than email.6


The cost to patients for time off work and the increased cost of infection control makes teledentistry a great option. It’s a cost-effective convenience amounting to more than just a vehicle for prescreening or consultation.7

Mobile-friendly modules

Desktop internet use is falling rapidly;8 a practice must have a mobile-friendly website and/or a mobile app. Minimizing potential obstacles to communication is essential.


They’re your patients 24/7, and you’re their trusted source for oral health. Don’t send them to Walmart for home-care products; instead, establish an e-commerce section on your website. Undeniably, one of the biggest impacts—if not the biggest—on e-commerce trends in 2020 will be COVID-19.9

A shift in mindset

In her book, The Forever Transaction: How to Build a Subscription Model So Compelling, Your Customers Will Never Want to Leave, author Robbie Kellman Baxter states, “It’s not enough to get the sale—you need to optimize for engagement.”10 Engagement is about creating customer lifetime value. It’s time to temper efforts on new-patient acquisition with more emphasis on retention. With a broader scope of care and services, customer lifetime value will increase. It’s a win/win for the patient and the practice. The resilient practice can meet this challenge, and in return, patients searching for real value with integrity are sure to respond with their trust and loyalty.  


  1. Clements J. Billing dental procedures to medical insurance – key considerations. Outsource Strategies International. https://www.outsourcestrategies.com/blog/billing-dental-procedures-to-medical-insurance-key-considerations.html
  2. Beauty and self-care trends to watch in 2020. CB Insights. March 2020. https://www.cbinsights.com/research/report/nextt-beauty-trends-2020/
  3. State employment and unemployment - May 2020. Bureau of Labor Statistics; June 19, 2020. https://www.bls.gov/news.release/pdf/laus.pdf
  4. How to uplevel your customer loyalty program. Formation. March 2020. https://loyalty360.org/content-gallery/research-and-reports/how-to-uplevel-your-customer-loyalty-program
  5. Briedis H, Kronschnabl A, Rodriguez A, Ungerman K. Adapting to the next normal in retail: The customer experience imperative. McKinsey & Company. May 14, 2020. https://www.mckinsey.com/industries/retail/our-insights/adapting-to-the-next-normal-in-retail-the-customer-experience-imperative
  6. Windermere A. Texting vs. e-mail in business. Chron. https://work.chron.com/texting-vs-email-business-9217.html
  7. Dorfman G. The doctor is still in: Providing continuity of care through teledentistry. May 21, 2020. https://yapiapp.com/blog/teledentistry-101-free-ebook/
  8. Petrov C. 52 mobile vs. desktop usage statistics for 2020 [Mobile’s overtaking!] Tech Jury. June 15, 2020. https://techjury.net/blog/mobile-vs-desktop-usage/#gref
  9. Mohsin M. 10 ecommerce trends that you need to know in 2020. Oberlo. March 12, 2020. https://www.oberlo.com/blog/ecommerce-trends
  10. Baxter RK. The forever transaction: How to build a subscription model so compelling, your customers will never want to leave. 1st ed. McGraw-Hill Education; 2020. 
Robert H. Maccario, MBA, is president of Dental Management Sciences LLC. With over 40 years of experience in the dental profession, he codeveloped the Dental Concierge Club, a true loyalty program. He previously held a faculty position at University of Pacific Dental School. He currently manages four private practices. Contact him at [email protected] or (800) 332-0363 ext. 2.

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