Fees, Enhance Care
If you sat down and thought
about the last time you raised your fees, could you actually remember
that far back? Too many dentists are reluctant to adjust their fees.
They box themselves into providing discount dentistry year after
year. Consequently, the practice is idling. The
doctor and team are burning energy and getting no where. Worse yet,
it’s not just the practice that is suffering. Read on.
are a statement of the quality of the work provided. What message
does it send patients
the charges for service never change? More importantly, what message
does it send patients when the old equipment is never updated; when
that dinosaur of a computer system continues to limp along; when
new diagnostic technologies and services aren’t offered year
after year? Doctors agonize over how patients might respond to fee
increases, but they give little or no thought to what they are denying
patients in the way of enhanced and expanded services.
Ultimately, practices that do not increase fees on a regular schedule
are compromising both the practice and the patients.
a matter of routine, fees should be increased 5% annually or 2%
and 3% twice a year. If you’re finding yourself quaking at
the mere mention of any increase, it’s time for a shift in
your fee paradigm: Fee increases ultimately benefit
the patient. As revenue increases there is far more opportunity
to expand and enhance services, to improve equipment, to implement
diagnostic technologies. When financial pressures are reduced the
team is more cohesive, therefore there is less staff turnover. And,
most importantly, the doctor’s stress is reduced significantly.
what you would like to do to improve patient care if you only had
the money, then take these 10 steps to establish a fair and reasonable
Increase income even before you increase fees. Overlap patients
during the first and last 10 minutes of each appointment.
the time required for each procedure, the fixed
expenses necessary to run the office, variable expenses including
supplies and lab fees, income required per hour to compensate
you, the dentist.
at where your expenses are as compared to where they should be.
Examine gross income and establish a goal to rein in expenses
so they line up according to the following benchmarks: Laboratory
expenses – 10%, dental supplies – 7%, Rent 5%, Employees’
salaries – 19-22%, payroll taxes and benefits – 3-5%.
how much you would like to work per week and how much you want
to earn per year. Determine the number of days
per week you will see patients and the number of hours you will
spend on treatment. If your annual production goal is $350,000,
you work 48 weeks a year, 36 hours per week, your hourly production
goal is $203.
a solid fee for each service and no waffling.
The receptionist’s second cousin Bob does not get a break
based on bloodline!
your neighbors. Study the fees of other dentists in your area
as well as the income demographics of your patients.
your fees on the quality of your work
and the overall quality of your team, which may be far different
than the skills and quality of the practice down the street.
your fees on a consistent schedule
payment options. Establish a relationship with a patient financing
company, such as CareCredit™.
Panic. When Mrs. Cartwright calls you up and chews you out because
you had the audacity to actually adjust your fees. She probably
doesn’t pay her bills on time, and if she is representative
of the very few who will actually leave your practice, you just
might consider that a welcome departure.
use a little fee psychology. Consumers/patients are more accepting
of fees that end with the following: $1, $2, $3, $4, $6, $7, and
$8. Remember, improve your practice’s financial health
and you improve care for your patients.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
PRACTICE START-UP PROGRAM
Don’t Give Your Valuable Services Away”
Belle M. DuCharme
RDA, CDPMA, Director
The Center for
Dental Career Development
the Director of Training for The Center for Dental Career Development
here in beautiful La Jolla, California, it has been my pleasure
to have had as students some of the best people I have ever met
in my life. The Center offers an advanced Business Administrator
Course, Treatment Coordinator Course, and Scheduling and Financial
Coordinator Courses but of all the courses we offer, my favorite
is the Practice Start-up Course. This is an empowering
course for the new dentist about to open the doors for the first
time or the transitional dentist going solo from a partnership or
associate relationship. I
as a guide through rough waters. As a mentor who has worked in the
dental environment for the last thirty-four years my sole purpose
is setting the foundation for a successful and
joining me for the Start-Up Program I ask that the doctor bring
a list of items with him or her for the training. One of the items
I ask the doctor to bring is a vision of the future
practice. This vision must be in line with the demographics
of the neighborhood where the practice will be located. If the practice
is in a middle to low income area perhaps the vision of full mouth
Empress crowns on the schedule routinely may be an unrealistic expectation.
A demographic survey showing the average age of the populace, the
average income, location of schools, businesses, retirement communities,
housing tracts and projected growth of the community will be helpful
in determining marketing strategies for the type
of dentistry desired in the area. What kind of an “image”
do you want to create for yourself? This is often referred to as
“your niche.” In other words, how will you set yourself
apart from all of the other dentists in the area? Bringing in samples
of your advertising, brochures, welcome letters, business cards,
signs and logo for examination is recommended. If the dentist hasn’t
designed these items yet then we can “brainstorm” together.
I had the pleasure of training a very bright and enthusiastic dentist
and her office administrator. One of her ideas for attracting new
patients was to offer free initial examinations.
She wanted to print this offer on her brochures. I advised against
it and explained my reasons. Never give away a specific service,
especially examinations. You devalue the service and give the impression
that it should be “free” anyway. The initial exam and
any examination to follow is the key procedure to solidifying a
patient to your practice. The examination is where you use the skills
that you have honed as a diagnostician. The examination is where
you define who you are both as a professional service provider and
as a caring person. If you must offer a get acquainted incentive,
then offer a one time voucher for $50.00 off of any service. Never
print this offer on a permanent piece such as a brochure or welcome
letter. Print it as a voucher so that you can discontinue it latter
without having to reprint thousands of brochures or letters.
the Practice Start-up Program, we cover a tremendous amount of material
including complete business systems training backed by books, workbooks
and CDs covering all of the systems in detail.
more information please call THE CENTER FOR DENTAL CAREER
DEVELOPMENT at 877-777-6151.
M. DuCharme, RDA, CDPMA
DOES YOUR OVERHEAD
Fluoride Benefit Adults?
Dr. Allan Monack
Hygiene Clinical Director
that we are living longer how can we protect our teeth for a lifetime?
The beneficial effects of fluoride were noted in the early 1700’s.
However it had a major side effect of mottling and discoloration.
In 1936, Lt. Trently Dean, D.D.S. of the U.S. Public Health Service,
discovered that 1.0 ppm in drinking water could give the maximum
protection in reducing the incidence of tooth decay without the
side effects. The first community water supply that was
fluoridated began in Grand Rapids, Michigan in 1945.
DOES FLUORIDE WORK
It reduces the solubility of enamel in the presence of acid.
It exerts an effect on bacterial plaque by reducing their ability
to produce acid.
It promotes remineralization of tooth enamel.
FLUORIDATION FOR ADULTS
fluoride is ingested throughout life it is incorporated in enamel
and dentin as it is formed. In communities that do not have fluoridation,
the population relies on fluoride tablets during tooth development.
Unfortunately, fluoride daily intake is usually discontinued by
age 10. This is the age pediatricians and dentists feel the crowns
of the 2nd molars have formed. The roots do not get adequate fluoride
incorporated in the dentin matrix. There is a constant ebb and flow
between demineralization and remineralization of exposed teeth.
Fluoride improves the remineralization and prevents the loss of
tooth structure from the effects of the acid produced by the bacterial
topical fluoride directly to the erupted teeth allows the penetration
of fluoride into the enamel and exposed dentin. It provides localized
protection of teeth not treated with ingested fluoride and replaces
fluoride leaching out of the tooth surface. Topical fluorides include
toothpastes, mouth rinses, and professionally applied fluoride solutions
1998 study by the U.S. Department of Health and Human Services has
shown a dramatic increase in tooth loss among adults age 35-44.
The study shows that 78% of adults 35-44 have at least one tooth
lost because of tooth decay. 84.7% over the age of 18 have at least
one area of tooth decay per year. Data from the 1988-1991 National
Health and Nutrition Examination Survey showed that 6.9% of 18-24
adults and 56% of all adults over the age of 75 have root decay.
As we age, there is a decreased salivary flow, exposed root surfaces,
and poorer home care. This greatly increases our risk for root decay.
There is data that shows individuals who have consumed fluoridated
water continuously from birth have a 31% reduction in tooth compared
to adults with no exposure to water fluoridation.
should have fluoride treatments! The dental profession should lobby
the insurance industry to include fluoride treatments for adults
in their preventive benefits. You should encourage your adult patients
to have fluoride treatments at their recall appointment. As our
adult population continues to live longer active lives, we need
to help them maintain their teeth for a lifetime.
you have any questions concerning your hygiene program submit them
to me at allan@
mckenziemgmt.com and I will answer them in future articles.
in having Dr. Allan Monack speak to your dental society or study
YOU LIKE TO IMPROVE YOUR HYGIENE DEPARTMENT?
Clinical Practice Enrichment Program is
designed to improve Hygiene Clinical Skills and develop
and implement a step-by-step Interceptive Periodontal Therapy
Program that will immediately bring greater productivity,
with enhanced patient care. For more information...GO
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I’d like some advice on scheduling new patients to bring up
at my monthly meeting. Can you help?
Never underestimate the expectations of prospective new patients.
From the first phone call a new patient makes to a practice, they
are sizing up the professionalism of the doctor and the staff. Consciously
or subconsciously, they are determining whether this practice deserves
their ongoing business. Patients expect to be treated with respect
and professionalism. They expect their concerns and needs to be
addressed expeditiously. And they expect doctor and staff to have
their acts together. Like it or not, the quality of the doctor is
judged by the quality of his or her staff.
the new patient’s expectations through excellent phone communication
and even better written information. Make sure that the first point
of contact a patient has with your office –the phone call-
is not their last. Develop a script for the scheduling coordinator
to use when handling a new patient phone call. Her voice should
convey warmth, understanding, and good judgment. She should come
across as unhurried and cheerful. Patients calling the office for
the first time will be either discouraged or encouraged to make
an appointment, depending on how well the call is handled. If the
receptionist answers the phone with a curt, hurried, or exasperated
tone, the caller is immediately put off. If the receptionist is
sincere and empathetic, the caller responds accordingly.
patients are calling because they want your services now, not next
month. Be prepared to handle the demand. First, determine how much
time you need to allocate in the schedule to accommodate new patients.
Look at new patient activity over the last six months. If you saw
60 new patients, that would be 10 per month and 2.5 per week. Reserve
at least that much time in your schedule to handle immediate new
patient demand. Second, monitor new patient activity each week while
you are marketing externally. If demand increases, block additional
new patient time in your schedule, even if it means extending hours
for a period. Third, new patient slots should be reserved during
prime time. Those are the hours in which your practice experiences
the greatest demand for appointments, and, typically, they are in
the late afternoons, evenings, and on Saturdays.
US TRAIN YOUR
Center for Dental Career Development
Business Education for Dental Professionals
737 Pearl Street,
La Jolla, CA 92037
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