Visit our website at
  05.19.05 Issue #167

Calculating ROI on Digital Radiography

Sally Mckenzie, CEO
The McKenzie Company

Printer Friendly Version

There are many reasons for dentists to convert from film to digital radiography, including improved diagnostic capability, greater patient acceptance of treatment recommendations, and increased efficiency. But one of the most important reasons, from a practice management point-of-view, lies in improved cash flow and return on investment. I'd like to compare the two technologies as far as their impact on your practice's finances is concerned.

First, as every dentist who's ever taken a film X-ray can tell you, there are significant out-of-pocket costs associated with film. As long as your practice remains film-based, you're going to be paying for film, chemicals, developer equipment service and maintenance, and mounts. Those costs amount to about $.50 per X-Ray, according to the ADA. In a practice that averages 50 X-ray images per day (or 200 images per four-day week), you can see that you're paying $400.00 or more per month just for consumable supplies. And you never get a return on your expenditures for consumable supplies.

Another thing you must consider is the fact that your team members spend a lot of time in the darkroom developing film during a work week. It takes, typically, five to seven minutes to process a single film X-ray. And while that's an accurate measure of how much time you're spending to develop a single X-ray - if that's all you're doing - the time for a single radiograph is reduced significantly if you're developing a batch of several X-rays. For example, it might take 12 to 16 minutes to process a typical full-mouth series, meaning that in this case the average time per X-ray is more like one minute.

To come up with a better measure of how much time is spent in the darkroom, it's more accurate to use an average figure of ten minutes per trip to the darkroom to make these calculations. So if you want an accurate measure of how much time your team members spend processing film X-Rays, just count the number of trips they make to the darkroom and multiply by ten minutes. You'll soon discover that for the 12 to 15 darkroom visits required to develop and mount 50 film X-Ray images in a given day, your practice is wasting two to two-and-a-half hours. If you multiply that times $20.00 per hour, you'll find it's costing you as much as $50.00 a day. That means you're paying $800.00 to $1,000.00 a month for staff time to develop film X-rays.

The typical lease cost for a digital radiography system is around $500.00 per month. If you subtract the $500 lease cost from $1,300.00 (the monthly cost of film supplies and staff time for taking 200 film X-rays a month), you'll see that your return on investment is $800.00 per month

But it's important also to look at this same model from a cash-flow standpoint, because you don't have to wait until you've amortized all of your film costs to realize the financial benefits of going digital. You will actually begin realizing positive cash flow from your investment in digital radiography within as short a time as one week.

Remember that we're using a cost of $500.00 per month to lease a digital radiography system, and we've determined that, if your practice takes an average of 50 X-Rays a day, it costs you about $100.00 daily - $50.00 for consumable supplies and $50.00 in wasted staff time. At that rate, you will have saved $500.00, the cost of one monthly lease payment, within five working days of installing digital radiography.

In other words, on day six you'll begin realizing your return on investment. That's one of the fastest returns you're ever likely to get for your money. And by the end of the first month, when you make your first lease payment, you'll hardly miss the money. That's because you'll already have realized at least $1,300.00 in savings. The ROI for digital radiography starts early and never goes away. It's one of the best financial moves you can make.

If you would like to know the cost saving of having digital radiography in your office email

If you have any questions or comments, please email Sally McKenzie at .

Interested in having Sally speak to your dental society or study club? Click here .

Forward this article to a friend.

"Help, I think I need to call Nanny 911 for my patients".
How To Manage Difficult and Demanding Patients

Belle M. DuCharme, RDA, CDPMA, Director
The Center for Dental Career Development

Printer Friendly Version

An Office Manager by the name of Louise (not her real name) came in recently for Advanced Business Training at The Center for Dental Career Development. She was a very warm and friendly person who was also articulate and very serious about the issues now taking place in her office. She came in for training to improve her efficiency and to learn how to put systems for managing patients in place. "The patients rule the practice". Louise said. Louise had managed the practice for five years and in that space of time the practice had grown to the point of taking on another dentist and more staff.

Louise's personality temperament type was an ESFJ, one of the most common temperaments seen in a dental employee. Before the practice got so busy, she had time to chitchat with the patients and became friendly with most of them on a personal "first name" basis. When scheduling the patient's next appointment, she would ask, "When would you like to come in for your next appointment?" instead of telling the patient when a time was available that fit the best times for the practice.

The practice had recently taken on an associate dentist and a new assistant. They had signed up for more PPO plans to give his practice a "jump start". The dynamics of the practice changed with the addition of the new doctor and staff. Utilizing the other operatories that used to be available for "overflow" meant more accurate scheduling and less flexibility to accommodate patients that got to "choose" the time to come in for an appointment.

"Belle, I am at my wit's end with some of our patients. I am afraid of upsetting them but several have gotten angry with me when I don't have time to see them. They think that if they pressure me I will give in and sometimes I do making a disastrous mess of the schedule for the doctor and the assistants. Some of my patients say, "I have been coming here for ten years, surely you can find a spot for me". When I do "work them in" and they have to wait, they come up to the desk and ask "When are you going to see me, I have been waiting for a half hour?".

The doctor and the assistants don't help much when they say, "This schedule is impossible!!".

Having an absence of policies for appointment control can contribute to chaos and high stress for the dental office environment despite good intentions. During the training we developed new policies and worked on the dialogue that we would use when communicating with the patients. With coaching, I helped her prevent patients from dictating office policy. Appointment times were to be offered that best suited the needs of the practice first. Special dialogue was developed to support the appointment times and to help the patient understand the necessity for the suggested times. Patients were to understand that effort was being made to also accommodate their requests within reason. "Because of the nature of this procedure, Dr. Brown has asked that your appointment be scheduled in the morning". Children and the elderly usually respond better to treatment in the morning when they are rested and fed. Saying "I will make every attempt to give you a time that is agreeable to your schedule and to that of the doctor. Due to the nature of the dental business it is not always possible to give you the time that you want. I know that Dr. Brown would be very happy if you would work with us on this matter. Thank you!".

Demanding patients remain that way because they have been rewarded for their inappropriate behavior in the past. Once they understand why you need to schedule for both them and the doctor, they are more compliant. Offering to put them on a "short call" list for times that they have requested is favorable and says that you are doing your best to accommodate their requests.

If you want more information on Business Training for Front Office, please email

Forward this article to a friend.

Attracting More Fee For Service Patients

By Howie Horrocks,
New Patients. Inc

Printer Friendly Version

In last week's issue May 12 I discussed winning ways to attract new patients through internal marketing. Let's continue now with internal and external.

Photos, photos everywhere. Before and after photos should line the walls of your reception area and operatories. When people see the difference between a mouthful of amalgams versus "white fillings" while they are waiting, they'll be more receptive once they're in the chair. A before and after shot of a good veneer case with the caption, "Porcelain veneers - done in two visits" will impress most anyone. Likewise with teeth whitening, a nice set of comparison photos make it much easier to sell this service. Also have photo albums of your best cases along with testimonials from the patients. They don't all have to be your patients either. You can describe veneers, whitening, inlays and bonding until you're blue in the face but it won't be half as effective as a good before and after photo.

Educate and motivate. A nice addition to your photo gallery is patient education on video, CD or DVD. A continuous loop video or a CD or DVD presentation on the benefits of modern cosmetic dentistry, running nonstop on your reception room, will not only distract a waiting patient but will also show them how good their smiles could look. The same presentations in the operatory will also raise dental IQ. You've essentially got a captive audience so whenever you need to leave the room, even for a couple of minutes, simply turn it on. Remember, this is the video age, people will watch anything that's on a TV screen, especially if there is nothing else to do and particularly if it's right in front of them.

Don't be afraid, just call them. You've heard this before and will hear it again, from me. Call everyone you numbed that day. This is a simple phone call made the evening after treatment. Ask them how they are doing, has the anesthesia worn off, do they have any questions, how does the bite feel and so on. You really want to know if anything is wrong so you can fix it right away - before they decide to go to another practice and bad mouth you. In fact I would take it a step further and call the new patient BEFORE the first appointment. Try this for a while and you'll see your blown appointments go way down and patient cooperation go way up. Some dentists think the patient will see these calls as an intrusion. This is simply not true. Patients, just like any human being, appreciate having attention paid to them.

In fact, you could say that the degree you give someone your attention is the degree they give you their admiration and money.

Your practice can hum along quite nicely for a long time on a referral only basis. However some external marketing usually needs to be done in order to make up for natural attrition.

Rather than go over old ground in regards to Yellow Pages or print ads, focus your attention on other ways to reach the people who need, want and can afford the dentistry you want to deliver.

Develop an effective mailer. Unless you're an experienced copywriter it would be wise to have an ad agency help you with this step. A mailing piece, professionally done, can be used for years. You don't have to have a high response rate for this to pay off. Even at less than one percent you can still be quite profitable. One good case will pay for the mailing, in some instances many times over.

To limit your risk and initial investment, first try an inexpensive postcard mailing. And don't be discouraged if it doesn't pull well right off the bat. You may have to try two or three different cards until you get one that brings you a decent response. If you ask an agency to design a mailing they will usually present you with three ideas. Ask them to produce the one you like the best, but in case it doesn't pull well get them to agree to let you use the other two ideas as tests. Test all three and settle on the one that yields the best response.

Target your mailings to areas near your practice, which are affluent enough to afford full care dentistry. You can also target people who have recently moved into your area. TRW has a great service called Redi Comps (800-345-7334), which will tell you about all the new homeowners in your area and the value of each property. This way you weed out the areas that are apartment heavy or are other wise undesirable. This assures that your mailings get to your target market. There are other firms specializing in new movers specifically for the health professions. Try Abstract Records Service, Inc., 105 Exchange Pl. Pomona, CA 91768, 800-879-9991 or your local mail list broker found under "Mailing Services" in the yellow pages.

Of course these items aren't the only things you can do to attract the kind of patient you want. But these are effective, relatively inexpensive and have proven themselves time and again. Use them well!

Howie Horrocks is the Author of More Unlimited New Patients . To order now click here

Forward this article to a friend.



How Personality Types Affect Practice Success and Please Understand Me. Problems in dental offices are caused by a breakdown in communications due to different personality styles. Understanding your employees' personality traits can help to better match your staff with the work they are likely to do best.

Based on the Myers Briggs Temperament Type, each job position in dentistry, business, clinical and hygiene is discussed teaching you what personality types are best suited to fill those positions. Dentists will learn how their personality affects their ability to successfully manage the business and its employees.

Included is the book Please Understand Me which provides the personality test and scoring form.

e-Newsletter special: $82*
*Valid until 5/27/05

Sally's Mail Bag

Printer Friendly Version

Dear Sally,

My wife and I (also a dentist and my business partner) are thinking about selling the practice and leaving the state.  It is my belief that we can make a whole lot more $$$ in a different state.

My question to you, because you have a better knowledge of the market, where is the best place to move? We will be looking to purchase an established state of the art practice in an area where the neighbor's house is not at arm's length, and the sky is not grey six months at a time.
Dr. Illinois

Dear Dr.
Well, I know the sky is not grey here in San Diego! But, in answer to your is hard to know where to steer your life and career. Obviously the answer will depend on a number of variables. We can provide a demographic study for you that will list the City, County and Zip Code that most closely matches your criteria in order of your intensity in matching the ideal. Areas such as: population growth over the last 10 years and next 5 years, number of households, population density, housing types, median age, educational achievement, number of employees and employment type. We then will provide you with a map that depicts each of the Ten Areas showing major transportation arteries, landmarks, zip code boundaries, etc. If you are interested, email

Missed Past Issues of Our e-Management Newsletter?

Want to Know More About The McKenzie Company?

This issue is sponsored
in part by:

The McKenzie Company Seminar & Exhibit Schedule
2005 Location Sponsor Information Topic Speaker
July 21-24 San Diego, CA
IA of Comprehensive Aesthe 702-341-7978 Peak Performer Sally McKenzie
August 13 Topeka, KS Delta Dental Plan of Kansas 800-733-5623 Breakdown Sally McKenzie
Sept. 9-11 San Francisco, CA California Dental Association* 916-443-0505 TBA Sally McKenzie
Sept. 22 El Paso, TX El Paso Dental Society 877-777-6151 TBA Sally McKenzie
Sept. 23-24 Griffin, GA Endo Magic Root Camp 877-478-9748 Top Issues Sally McKenzie
Oct. 14 Riverside, CA Riverside Implant Study Group 951-279-7847 TBA Sally McKenzie
Nov. 18-19 Griffin, GA Endo Magic Root Camp 877-478-9748 Top Issues Sally McKenzie
Dec. 1 Cincinnati, OH Cincinnati Dental Society 513-984-3443 Breakdown Sally McKenzie
Dec. 9 Minneapolis, MN Minneapolis District Dental 877-777-6151 TBA Sally McKenzie
* The McKenzie Company will be exhibiting at location

For more information, email
or call 1-877-777-6151

The McKenzie Company Newsletter Information:
To unsubscribe:
To discontinue receiving the Sally McKenzie eManagment newsletter,
click on the link at the very bottom of this page for instant removal,
To report technical problems with this newsletter or to request technical help,
please send a descriptive email to:
To request services, products or general inquires about The McKenzie Company activities
please send a descriptive email to:
If you would like to have any of your dental practice concerns answered personally by Sally McKenzie,
please send a descriptive email to her at:
Copyrights 1980-Present The McKenzie Company - All Rights Reserved.