William G. Dickerson, DDS
Many dentists wonder how some of their colleagues have achieved so much success and why they themselves find it so difficult. Many blame the lack of success on their location and/or patient base. Many believe that, in today's world of dentistry, a successful insurance-independent practice is just an illusion. In an effort to inspire many not to give up hope and to try to achieve the success they have always wanted, I have been asked to do a series of interviews with successful individuals. The goal is to give some insight into the thinking of those who have persevered and find out how and why they are successful. Our first interview is with Dr. Bob Van Dyke of Green Bay, Wis.
Dr. Dickerson: You have developed a very successful practice. But how would you define success?
Dr. Van Dyke: Success is obtaining a predetermined goal, and performing to the best of your abilities the procedures necessary to secure that goal. Success is self-satisfaction. Success is not necessarily how much money one accumulates. It is not just how many patients we have in our practice, or how much "production" is done in one month. If we can provide services for our patients that are ethical, moral, and in their best interest, then the material signs of success - money, production, and patient flow - will follow. As I built my practice, the one question that always guided me was, "How well am I treating my patients?"
I never wanted to be embarrassed when another dentist looked at my work. I always wanted to learn as much as I could to achieve the goals that could bring me the success I was looking for.
Dr. Dickerson: I'm sure you always considered your practice to be dedicated to excellence and successful. In hindsight, knowing what you know now, what has been the most surprising thing about the last few years?
Dr. Van Dyke: I have been so surprised by the amount of fun I have had doing cosmetic dentistry. The rewards of changing people's lives create a relaxed atmosphere in the office that is unsurpassed by other forms of dentistry. As excellence grows, so does the comfort level.
Everyone realizes how confident we have become at producing a predictable result for our patients. There is no cloud of uncertainty hanging over our heads. The patients come to us knowing that we have a reputation for giving the best type of care and that they are going to be treated as comfortable guests in our office. That is extremely important when it comes to establishing a solid base of communication with our patients. As confidence grows, so does the level of care, and the word spreads in the community. The referrals we receive are from patients who are eager to tell their friends how friendly our office is. It is friendly because we are having fun!
The other thing that surprised me was the constant devotion to the building of excellence, as well as the consuming amount of time involved. There must be a mindset of making this a top priority in your business life. Please note that I said "business life." An excellent business can be built while still devoting the proper attention to your family. That is a must! All business decisions are made with the idea of always looking forward and not regressing.
In other words, we should establish our future goals and live our life as a means to those goals. This devotion is time-consuming. It means exhibiting leadership among your office team, taking time to attend continuing-education courses, making sure everyone in the office is educated in the same philosophy as you are, and continually fine-tuning and honing that philosophy.
But the rewards of all that hard work can be seen in the increasing numbers of cosmetic cases that are done. The philosophy must be firm. One cannot believe in the value of metal-free restorations and still place mercury fillings in patients. We must devote our entire thought process to bringing our practice to the level of excellence we set our goals for, which takes time. Operating this type of practice is not an 8 to 5 job. Like most executives, our time working in the practice involves evenings and weekends when we must find time to plan goals and tweak the systems already in place.
Dr. Dickerson: If you could attribute one thing to your success, what would it be?
Dr. Van Dyke: Three things come to my mind instantly - my wife, my devotion to excellence, and my office team. I couldn't have a great practice without the support of all three. My wife has been a great supporter of my desire to excel. She is my cheerleader and my number-one public relations person. She lifts me up when I am down and offers continual encouragement when things are going great.
My devotion to excellence has been my personal driving force. Without it, I would just be average. It has allowed me to set goals far outside my parameters and has forced me to reach for goals I previously thought were unattainable. Devotion is something that is internal; it can't be bought. One must set an internal goal to attempt to be one of the best, and then have the fortitude to seek excellence. One must reach a point of being unconsciously competent.
Without a good team, it is nearly impossible to achieve excellence. Everyone must be on board and totally supportive of the doctor's philosophy, and the doctor must be totally supportive of the team. We are executives. We must have a board of directors and department heads. Each team member is responsible for his or her department and must report to everyone in the office so all employees are thinking in the same direction. The boat must be paddled in the same direction by all of the oars.
Dr. Dickerson: If you could offer some advice to those dentists who think that a practice like yours is not possible in the location where they live, what would it be?
Dr. Van Dyke: This is easy, because I was there a few years ago. Green Bay is a very conservative community of about 100,000 and has a strong blue-collar influence. People are very concerned about how they spend their money on dental care, so I used to think that having a high-end cosmetic practice in my town was impossible. After all, no one was doing it. But a practice consultant showed me models of other practices that were establishing excellence in cosmetic dentistry. He led me to think in terms of what I wanted, not what others in my area were doing. I began to realize that this was my business, and I had every ability to make it into whatever I wanted. I explored my strengths, weaknesses, likes, and dislikes. It became very obvious to me that my true passion was to make people's teeth look like teeth, not teeth with black metal or purple tissue.
So it was all up to me. I have never given in to insurance-based dentistry. If the insurance didn't cover it, so what? Let's begin to think in terms of what the patient wants, not just what we think he or she may need. My best advice to others would be to establish a goal for the type of practice they want and find the models to copy to achieve that goal. Then just do it! Don't listen to criticism or condemnation. There will be plenty of people who want to see you fail because they are envious of the position you have achieved. There is so much good information out there. If I hadn't sought education, I know I wouldn't be where I am today. Dentists must realize that their destinies are in their hands, and it really is up to them to make their practices soar. Leadership is a key factor in all of this. If you can't lead yourself to success, how can you lead your team to rise above the ordinary?
It isn't easy in a small community, but perseverance will pay off. Your reputation will spread, and people will come from surrounding communities. The model has to be worked constantly, and it should not be insurance-dependent.
Dr. Dickerson: How do you educate your patients about cosmetic dentistry?
Dr. Van Dyke: First of all, I ask. I try to find out what patients want, and what they don't like about their teeth. I am always amazed at what people will offer when they are asked. It is such a simple thing to do that we often overlook its importance. Once I find out what they are interested in, then I can begin to direct my thoughts to help them achieve their goals. If they are uncertain, I have to be creative and help them realize what the possibilities are in cosmetic dentistry. I show them 8x10 photos of cases I have done. I have professional model photos in my reception room. All of my team members flash beautiful, white smiles to present the atmosphere of healthy teeth.
I really don't present a lot of high-tech information. I don't make use of the imaging system I have in the office. I do use the intraoral camera to show the present conditions. I take digital photos and enter them into the computer to use during my case presentations. I have CAESY running in my reception room, and that does plant some thoughts in the minds of our patients. I really believe that technology alone won't educate people. As providers, we must be the main source of information. Cosmetic dentistry education must be in an atmosphere that pervades everything that goes on in the office. I want my patients to know that I am interested in helping them achieve what they want for themselves, not just what I think they need. I recently received a letter from a lady thanking me for the cosmetic work I did for her. She said that she was so grateful to me for offering her choices, and that no other dentist had taken the time to do that before. That letter meant a lot to me because it summarized the feeling I want to convey to my patients. I know that my personal-touch communication methods are important to my patients.
Dr. Dickerson: How do you educate your patients on insurance coverage?
Dr. Van Dyke: I have no managed care in my practice, so the only insurance problem I have is getting people to understand that they do not have "insurance." They have a benefit, and that benefit hasn't increased in 40 years. I have found that if someone desires to have his or her smile improved, he or she won't rely on insurance coverage and will find a way to finance the care desired. So our insurance education is quite simple: We simply tell patients that they have no benefit coverage for cosmetic dental care, and that we can help them finance with an outside agency. I do not hesitate to tell patients that their benefits won't cover much, if anything at all. I want them to dislike the insurance companies as much as I do and not rely on them for all of their financial coverage. We try to be creative in offering financing solutions so that the lack of benefit coverage won't distract them from the work they need and want.
Dr. Dickerson: How many patients do you need to develop a high-end esthetic practice?
Dr. Van Dyke: For a practice with one dentist and one or two hygienists, 18 to 22 patients a month should be sufficient. But let me qualify that: This is assuming that full, comprehensive exams are being completed on each new patient who enters the practice. If a dentist is doing three-minute exams in the hygiene room for a new patient, then 18 to 22 patients won't be enough. When high-end esthetic dental treatment is provided, people get "dentally healthy" in a short period of time. Therefore, a constant influx of new patients is necessary.
Depending on the demographics of the area in which a dentist practices, the percentage of patients who will accept full cosmetic treatment will vary. For a boutique-type practice, maybe 18 patients is too many each month. If the practice were in a low- to middle-income area, possibly more than 22 new patients would be needed. I highly recommend having a demographic study completed and then learning to market to the type of population one desires to attract.
Dr. Dickerson: As far as you are concerned, what has been the most important dental advance for your practice?
Dr. Van Dyke: First of all, the knowledge I gained at the Las Vegas Institute for Advanced Dental Studies is the most important dental advance for me. There are plenty of great products out there developed by many great companies, but without the knowledge those products cannot be used to their full capacity. Proper knowledge is the basis for increased self-confidence. The more confidence I had, the easier it became to develop treatment plans for my cases.
Second, from a product standpoint, I really enjoy the new generation of bonding agents and porcelains. I currently use Optibond Solo Plus and have enjoyed great bonding strengths and a greatly reduced post insert sensitivity. The advent of pressed ceramics has allowed me to place restorations that are so lifelike and strong that I can complete a case confidently, knowing that the results will be very satisfying to me and the patient.
Dr. Dickerson: What do you think about the future and direction of dentistry?
Dr. Van Dyke: I have mixed feelings about dentistry's future. There are still far too many dentists who elect to participate in prepaid, insurance-based programs. If every dentist takes this route, the future of dentistry is not very bright. We all will be puppets for the insurance companies, with big business controlling the strings. Is this what we really want?
Personally, I didn't become a dentist to be controlled by someone else. I have seen far too many dentists who have a hard time making financial ends meet. They don't have enough money to attend continuing-education courses. They don't have enough money to purchase the best dental products. They can't do any charitable dentistry. They can't provide properly for their families. This is sad. I recently had a conversation with a dentist who repeated the scenario above. He was a very nice person, but his business sense was not in perspective, considering the amount of energy he put into becoming a dentist and operating a private practice.
On the other hand, I also can see a very bright future for those dentists who refuse to bow to the pressures of the insurance companies. There seems to be a resurgence of private practitioners who are willing to offer treatment options that are best for their patients, not best for the insurance company. Now isn't this why we went to school to become providers of dental care? If every dentist refused to participate in insurance plans, dentists would be working for their patients instead of working for the insurance companies.
Wouldn't it be great to be able to look forward to a bright future like that? All we have to do is look at physicians to see the direction we do not want to travel. I feel so passionately about every dentist being free from the controls of any outside source. It is entirely possible that this could be the future of dentistry. It is a goal that is well worth working for.
Dr. Dickerson: What are your goals for the future?
Dr. Van Dyke: I have been a dentist for 31 years. I enjoy treating patients more than ever because of the passion I have for esthetic dentistry, and I want to continue to provide that type of care as long as I am able. I also realize that my education never stops. There is so much to learn and so much to enjoy in treating patients properly. I want to continue to challenge myself to think beyond the parameters of ordinary care.
I have had so many great mentors in my career, and I have been fortunate to be helped by so many people, that I also want to be able to help others as a way of paying back all that has been offered to me. My goal is to help as many dentists obtain success and freedom in dentistry as I can.
My future outlook is very positive, and, at age 56, I am very fortunate to love going to work everyday!
