Know yourself

Jan. 1, 2004
I am always amazed at the attention aesthetic dentistry lectures get at dental meetings. I know that whenever I am speaking at a major dental meeting, if one of my topics is aesthetic dentistry, I can be assured that the interest level will be high.

Louis Malcmacher, DDS

I am always amazed at the attention aesthetic dentistry lectures get at dental meetings. I know that whenever I am speaking at a major dental meeting, if one of my topics is aesthetic dentistry, I can be assured that the interest level will be high. Aesthetic dentistry is very exciting, both to the dental profession and to patients. These are procedures that we could never before imagine doing, and the opportunities they present to patients are truly amazing.

Many dentists, however, make the mistake by thinking that a high-end — either aesthetic or crown-and-bridge — practice is what they want to achieve exclusively for their dental careers. I have seen some dentists go so exclusively into cosmetic dentistry that they refer out simple operative procedures, endodontics, periodontal services, and just about everything else. A very few actually succeed at doing this, but I have personally spoken to a significant number of dentists over the last couple of years who have nearly gone bankrupt trying to establish themselves as premier cosmetic dentists. I remember consulting with one dentist who chose this direction for his practice. Upon faxing me the advertisements he routinely runs in local magazines, I was struck by all of the dental spa services listed right along with "Medicaid accepted." This dentist wanted the high-end patients, but had become so desperate financially that he was willing to do anything to get patients into the practice once again.

Where do cosmetic procedures fit into your practice? Do you want your practice to become an all-cosmetic-all-the-time dental office? Or should cosmetic procedures be another integrated part of the many procedures you provide? These are decisions you need to make. I have seen too many dentists make a rash decision that they are going to become a "boutique" practice overnight without consideration of the kind of patients they presently serve. This needs to be a thoughtful decision that involves input from your staff members as well as from your legal and professional advisers. The marketing statements from some of the cosmetic dental institutes claiming that "You can create a boutique aesthetic dental practice anywhere in the world" is just nonsense.

You plan to fail when you fail to plan. This is true of any major decision that you would like to make in your office, whether it is going insurance-free, changing your office to a boutique office, or simply deciding that you won't provide standard services to your patients. There are a few things you can do to measure where your practice is now so you can plan the direction in which you would like to go.

First, you need to know how many cosmetic procedures you are performing every month, as well as what you have done in the last two years. This would include all whitening procedures, whether take home or one-hour, veneer cases, crown-and-bridge cases done for aesthetic reasons, and resin restorations. Has the number of procedures gone up, gone down, or stayed the same? Generally, if you have seen an increase of about 10 percent a year, then you are headed in the right direction for becoming an aesthetically inclined dental practice.

Next, you need to know the demographics in a five-mile radius around your office. I am always amazed at how many dentists do not know this simple but very important piece of information about their practices. Generally, you can obtain this information from any commercial realtor in your area. If the average family has 4.3 people and an income is $40,000, I wouldn't recommend discontinuing operative dentistry. You will still be able to provide aesthetic dentistry, but probably not exclusively. If your five-mile demographics show an annual average income of $80,000, then you need to make sure you have developed the proper skills to offer aesthetic dental services and to market them appropriately.

Get to know yourself and your practice. Know what services you have been providing and to whom. Spend time every few months to analyze where you have been and where you are going.

Dr. Louis Malcmacher is an international lecturer and author known for hiscomprehensive and entertaining style.An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired his audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988.For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via email at [email protected].

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