by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

When the average person hears “dentist,” the word “activism” doesn’t usually come to mind. However, there are many dentists who stand up for the changes they want to see. For instance, dentists changed oral health forever when they rallied to fluoridate water. They took action and won, case by case, community by community. We need that same kind of dedication for a different matter now: oral cancer.

In the United States, a person dies every hour from oral cancer, and many of those people could have been saved if they’d had a screening or an earlier screening for oral cancer.1 Let’s face it—actually getting reimbursed for a screening would help. We have 150,000 dentists in this country and we don’t even get paid by the largest dental insurance companies in the world for an oral-cancer exam?

Another lifesaver: the vaccine for human papillomavirus (HPV). If more people got the HPV vaccine, fewer people would get oral cancer. It’s that simple, but dentists aren’t even allowed to administer the vaccine.

It’s worse than that, though: most of us don’t give HPV advice or talk about HPV at all. How many people have to die before the physicians of the mouth start asking parents, “Has your child been vaccinated for HPV?” The fact that HPV is linked to cervical cancer is becoming well known, but the average person is not aware that HPV is also linked to oral cancers.

Dentists could be an amazing ally in spreading this information, and I believe we should be able to give the vaccine. I would like to, but as a dentist I’m not allowed to, and even if I did give it, I wouldn’t get reimbursed for it. A registered nurse can give the vaccine, but I can’t.

After almost a decade of advanced education I don’t have the legal right to give a vaccine, yet I go to Walgreens or CVS and I can get a flu shot.

Dentists, we have to take our ground back.

All the data I see says that the average American sees a dentist twice for every time he or she sees a physician. This frequency of visit gives us tremendous power, and that power is not being used adequately. Dentistry is a sleeping giant in terms of overall health. We do a lot, but we could do more, and we should be reimbursed for it. Should we screen patients for lung cancer or brain tumors? No. But preventing oral cancer is a cause we should take up.

There has long been a resistance to helping people regarding oral cancer and I think it has to do with past prejudice. When I got out of school in 1987, a lot of clinicians weren’t much into oral-cancer screening, and it’s probably because they were judgmental. Public perception was that everyone who had oral cancer did “bad” things such as drinking and smoking, and brought the illness on themselves. Some people still may have those beliefs regarding oral cancer and HPV, when sexual activity plays a role.

We’ve had some brave famous people go public about their oral cancer (such as actor Michael Douglas, who was diagnosed with throat cancer) and this is helping to remove the stigma. There’s a lot more that can be done to educate the public, though, and we are just the people to take the lead. We’ve taken the lead before…

I am very proud of our efforts for community fluoridation, which started in the 1940s in Grand Rapids, Michigan. Right now about 74 percent of Americans drink fluoridated water, and the research shows that we have about a 40-percent reduction in decay in those communities. But why stop there? One in four Americans still doesn’t have water fluoridation. Maybe it’s time for the American Dental Association (ADA) to get involved. The ADA has an amazing president, Dr. Maxine Feinberg, whom I love and adore, and the president-elect is Dr. Carol Summerhays, whom I also very much admire. Maybe if we start talking with these two legendary dentists and the ADA about this topic, water fluoridation can become a piece of national legislation. By the way, check out the podcast I did with Maxine Feinberg and Carol Summerhays at Dentaltown.com/ADApodcast. You can also find it in the blogs/podcasts section.

We have national legislation to put vitamin D in milk; we have national legislation to put chlorine in water. We don’t let every community decide if they put vitamin D in milk, or chlorine in the water to prevent cholera, or iodine in the salt to prevent goiter. Can you imagine if one in four communities didn’t have iodine in the salt and people had goiters? Or if communities didn’t have vitamin D in their milk and had rickets? This is crazy. It’s time to close the water-fluoridation deal and have one piece of national legislation.

I’d like to go farther than that, though, and take on oral cancer. I want to see legislation for this and I want people to accept that dentists have eight years of college and are doctors. They should be able to do anything in any state that a pharmacist at Walgreens and CVS can do, such as give a flu shot if they want to, and they sure should be able to give an HPV vaccine.

Legislation or not, we all need to start talking to patients about HPV and oral cancer, because someone is dying of oral cancer every hour.

You’re a doctor and your patients are counting on you. Man up. Woman up. Let’s band together to standardize fluoridation nationwide and to reduce oral-cancer deaths.

Oral Cancer Facts
Nearly 45,750 Americans will be diagnosed with oral or pharyngeal cancer this year.
It will cause more than 8,650 deaths, killing roughly one person per hour, 24 hours per day.
Historically, the death rate associated with this cancer is particularly high not because the cancer is hard to discover or diagnose, but because the cancer is routinely discovered late in its development.
Of those 45,750 newly diagnosed individuals, only slightly more than half—approximately 57 percent—will be alive in five years.
One of the real dangers of this cancer is that in its early stages, it can go unnoticed. The good news is that in many cases, a physician or dentist can see or feel the precursor tissue changes, or the actual cancer while it is still very small or in its earliest stages.
Worldwide the problem is much greater, with more than 450,000 new cases diagnosed each year. Note that the world incidence numbers from the World Health Organization, while the best available, are estimates that users should consider with caveats.
The human papilloma virus (HPV) is now confirmed to cause oral cancer in a younger age group. Transmitted via sexual contact, HPV (particularly version 16) is conclusively implicated in the increasing incidence of young, non-smoking oral-cancer patients. This is the same virus that—along with its other versions—causes more than 90 percent of all cervical cancers in women. The foundation believes, based on recent peer-reviewed published data, that HPV16 may be replacing tobacco as the primary causative agent in the initiation of the disease process in people under the age of 50.
Information from Oralcancerfoundation.org – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=393&aid=5412#sthash.ahl8vFaJ.dpuf

by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine You have the best technology. You went to a top dental school. You do excellent clinical work. All of that is important, and none of it is why your most loyal patients come to your practice. They go to your practice because of relationships with you and your staff, and the more you do to nurture those relationships, the better your business will be. The patients who have been coming to see you for years are a core part of your practice. I suggest that you and your staff members consciously cater to keeping these long-time patients (as long as they’re not crazy … I suppose we’ve all had a patient or two we wouldn’t mind losing). Most loyal relationships took years to build and need to be sustained. However, save energy for your new patients. They are the future of your practice and you must form relationships with them, too. How do you do that? Step one: “Get in their heads.” Understand them. They want convenience and to come in as seldom as possible. They’re leaving from work or are making arrangements for their kids, and they’re probably stressed. They want to get as much done in one visit as they can. This person is probably nervous and might even be scared. You can address all this by having a smooth, upbeat office, and by having a staff of skilled, pleasant people. Yes, a clean, comfortable office helps. So do televisions, good reading materials, and play areas for kids. Your new patients notice things that your staff may have stopped noticing a long time ago, such as clutter, dust or grouchiness. Address those issues and your new patients will become your long-time patients. Your loyal patients were new patients at one time. What did you do to retain them? I bet you had a friendly staff, were respectful of patient schedules by keeping appointments on time, and that you did great dentistry. All of this is important. I don’t mean in any way to underestimate great clinical skills, but keep in mind that it’s personal, human connections that make loyal patients. If your new patient likes your office manager, guess what? This person is more likely to come back. If this person likes your whole staff, this person is more likely to come back. Most important though is how the patient feels about his or her hygienist, and how patients feel about you. If patients like their hygienist, and they like you, those patients will come back. Those relationships are the cornerstone of your business; they’re the heart of your practice. So how do we retain patients? Let’s say that a new or fairly new patient doesn’t show up for an appointment. You may have received advice that if a patient doesn’t show up, that’s not the kind of patient you want in your practice anyway. I disagree. There may be a good reason why the person didn’t show up. Have your staff call the patient to find out. Perhaps the patient was running behind and just needed a reminder. Or, maybe something terrible happened to him or her. This is an opportunity to show that your office cares. Less dire—perhaps the patient couldn’t find your office. If you’ve received that feedback from other people, this experience may show you that your website map needs to be updated. Another possibility is that the patient called your office several times and never received a response. If the patient felt ignored, that could be why he or she didn’t show up. This scenario gives you the chance to find out whether your staff is fast enough about returning calls. At my office we contact as many “no shows” as we can, especially if the patient is new. This helps us cultivate a relationship. It shows we care. We all know that life can get stressful for our front-office staff and that it’s impossible to give perfect attention to every patient. However, ask your staff to be as warm as possible, even when conditions are tense. Efficiency is vital, but if your staff members are coming across as too robotic, that attitude may turn new patients away. People are still looking for a family environment and positive customer-service experience at the dentist. Frequently, the front-office staff faces necessary conversations about finances, payment collections and arrangements. When this happens, sometimes our treatment of the patient can become mechanical and impersonal. And when the visit becomes impersonal, the patient’s relationship with the doctor and the practice is compromised. When patients check in, make sure the emphasis is not on the day’s payment arrangement—instead, make it about a warm greeting, treating the patient with respect, and focusing on the procedures that need to be completed. If financial questions or details need attention, use a consult room to provide privacy. Established patients may tolerate more impersonal behavior because they have an established relationship with the practice, but new patients will move on because they sense the financial aspect is more important to the practice than the relationship. Be mindful of your patient’s time—particularly how long he or she has been waiting. Don’t escort patients to the back if you cannot see them in a timely fashion. It is better to keep them informed as they wait in the lobby. Convenience is everything. New patients want to been seen as few times as possible. If it’s been two years since they’ve seen a dentist, you may want to schedule an exam in the doctor’s chair first, to diagnose and determine cleaning needs. If they regularly see a dentist, start them in the hygiene chair; every new patient wants to get his or her teeth cleaned on the first visit, if possible. If the flow in the office between the doctor and hygienist is not good, patients wait. Waiting creates anxiety, a rushed exam and little time to build relationships. When patients wait, they become reluctant to return to your practice. Those dreaded three words, “I’ll call you,” become common when relationships and flow are not in sync. Dentistry is not a product. It is a service. Most patients don’t know if the root canal you did was good or bad or if you screwed up that onlay—they just recognize if they feel safe and respected at your practice. You know you do great dentistry, but the patients just know if they like you. Referrals are based on, “God I love that dentist!” The referrals aren’t, “Guess what amazing dental school my dentist went to?!” All the years I’ve been in dentistry have shown me that half of dentistry is sold on price and half is sold on relationships. It’s a relationship deal. It comes down to how you and your staff make that patient feel. This part of dentistry will never change, and never should.

– See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=390&aid=5351#sthash.Cp3E37Tq.dpuf

by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

In most dental practices, the average staff member has been there three years, but when you go into the dental offices where they’re just crushing it (the dentistry is great, the revenue is high, the word-of-mouth referrals are high, the net income is high), you start finding that if you want to be a dentist who makes $200,000 a year, your average staff member has to be with you five to six years or more. Every dentist I know who’s making $250,000 to $300,000 a year has staff members who have been there 10 years or more.

To keep staff members that long, you have to reduce burnout and increase hope. They need to have hope that their jobs will either stay great or have hope that if their jobs aren’t great, the situation will get better.

There’s a business reason for reducing turnover. When patients walk into a dental office and the dentist says, “You need a root canal,” some patients will trust the dentist no matter what, but other patients will need more assurance that the dentist is trustworthy. Your team can offer that assurance. See, if the patient knows that the dentist has been able to keep his or her receptionist, hygienist and assistant there for 10 years, it increases trust. The patient thinks, “I like those people—I know they wouldn’t work here with a lying sociopath. If you were telling me I needed a root canal when I didn’t, I don’t think those employees would keep working for you. I think they’d quit and turn you into the board.”

When we plot highest net income with all the variables that can be associated with it, we don’t find it related to where you went to school or what institute you did some training at; we find it linked to longevity of the average staff member.

So what keeps turnover high? What keeps staff members from staying with an employer long term?

Toxic people and loss of hope. They’re sometimes related. Let’s start with toxic people.

I pay a lot of attention to teams and I’ve seen that the No. 1 destroyer of good teams is that the owner doesn’t get rid of toxic people. Sure, you want employees long term, but not if they’re toxic. The most dangerous type is the moody person. You know who they are. They come in one day and they’re adorable and the next day they’re mad at the world. You have to get rid of toxic people. It goes back to the playground. Are we all going to have fun in the sandbox? I don’t care how good your dentistry is, if you’re toxic and you’re throwing instruments, or you’re tolerating toxic people, it’s a morale destroyer. Then you have staff turnover and then people aren’t trusting treatment plans, and your business stops growing.

Think of how valuable it is when you have your staff take an online dental course from Dentaltown and they learn something great, and then stay on your team for the next 15 years implementing what they learned. That value is long term. I see a lot of business owners who aren’t reaching their top and it’s because they’re holding on to toxic people. You want the kind of person, where, every time you see them, it’s the same person you first met. They should be allowed to be upset about specific situations, but not just be grouchy for the sake of being grouchy. Your staff will start to wonder why you keep that person, that employee who is nice to you but mean to others, who refuses change and who drags people down. All this, and other mismanagement, will lead to your team losing hope.

You have these staff meetings and employees tell you what’s wrong and initially they have hope that there’s light at the end of the tunnel and that you’re going to make changes. You acknowledge that it’s not good today but it’s going to be better someday. Well, 30, 60, 90 days go by and nothing changes. The same toxic people get protection and favoritism, and the same people don’t pull their weight but act like they work harder than everyone else.

Then what happens? No one’s playing to win; they all start looking for a better job. They don’t give you insight, they don’t take risks, they don’t care anymore.

Here’s another scenario I see all the time. The first person out the door is the dentist and then one assistant follows him out the door. Then the other, more caring, dental assistant wants to make sure everything is done, so she’s cleaning everything up. She gets everything ready for the next day and realizes the next day there’s a bridge scheduled that is coming back from the lab and it’s not in, so she’s freaking out calling the lab and then the lab says, “I didn’t know that was scheduled. Do you want to reschedule the appointment?” And the assistant is sitting there like, “It’s hours after the dentist left. The other staff left too. That toxic person who doesn’t work hard left as soon as the boss left. Why am I being paid salary, working my butt off, going long, doing everything right when no one even cares?”

This person might keep thinking, “I don’t think the doctor is ever going to notice it. He never says anything. I’m not going to make any more money. I don’t care anymore. I’ve lost hope that I’m going to be recognized, that I am going to see my effort rewarded in any way. Why am I going to tell my boss what’s wrong with this place and what we need to do when it’s all talk, no walk and nothing ever gets done? I’ve lost hope. I’m not going to share with my team what needs to be done around here. I’m going to quit going to CE. I’m going to quit trying to improve this place.”

Invest in your staff. For instance, at conferences and shows, the dentists who don’t bring their staff because of cost are losing out the most. They end up going back to the practice and try to cram an eight-hour seminar into a five-minute meeting and no one learns and nothing gets implemented. Then you have doctors who only take a few staff and the rare doctors who bring the whole staff. The dentist who sends his whole staff to seminars and stays home makes the most money. That staff is the staff that’s crushing it, doing $2 million a year and the newest girl on the team has been there six years. That’s an office that’s fired up. If you give people hope, growth and abundance, you’re going to crush the future.

Your team loses hope when they see all talk and no walk, and see you protecting toxic, manipulative people. To notice this, you’ve got to be all over the practice and you have to ask people what’s going on. Get involved. Don’t just take one or two people’s opinions. Get a cross section of input and then act on that input. Don’t let your team lose hope. It hurts your employees, creates turnover and hurts your bottom line. There’s a better way. – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=388&aid=5305#sthash.MJzbki91.dpuf

by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

The documentary “20 Feet from Stardom” was absolutely the best movie I’ve seen in a long time. It features some music I love and the film relates extraordinarily well to business and creativity. More on that later. For now, a summary: 20 Feet From Stardom is the true story of back-up singers who worked with famous groups.

There’s a lot we can learn from one particular singer from the film, Lisa Fischer, who has a gospel background and a huge voice. Think of the Rolling Stones song “Gimme Shelter.” You hear two singers: Mick Jagger, and a woman. Who’s the woman? That’s Lisa Fischer, and without her voice on the track it’s a totally different song, and not nearly as powerful or dynamic. In the refrain to “Gimme Shelter” you don’t even think about Mick Jagger—Fischer steals the whole song and what she does is amazing. What’s also amazing is that Jagger lets her steal the song. He gives up control, but not every star would do that.

The backup singers interviewed tell us that insecure stars micromanage backup singers and make them follow every detail of sheet music. When backup singers start veering off, insecure artists tell them, “Ya know, you’re kind of loud, and you’re not singing the words exactly as they’re on your sheet, and if you could just tone it down a little bit …”

However, the more secure, confident performers, such as Mick Jagger, let these singers follow their instincts and do what they were born to do. The combination is crazy good; it’s a completely new level. Sometimes Mick Jagger and other stars (David Bowie, for instance) see these girls are on a roll and they actually back away from the microphone; they just let them rip. They unleash them from the sheet music and say “Let it out.”

Real stars aren’t afraid of being upstaged, and as a business person and a leader, you shouldn’t be afraid of being upstaged either.

Business is about managing three things: people, time and money. Those three factors aren’t equally important though; about 80 percent of it is people. If you get the right people everything falls in place.

For instance, if I have the right people in place and I tell them that, for example, we’re going from Phoenix to Los Angeles, I just tell them the vision from 30,000 feet. I don’t care if we’re going to drive, rent a bus or fly. I’m not worried if we rent cars and one of them breaks down; my team will change a tire, and if they don’t have a tire, they’ll figure something out, because they’re smart and determined. There are a thousand dental examples of how talented team members are even better when they’re not micromanaged. When you have stars on your team your practice runs smoothly and is a fun place to be. It’s all about finding the right people and then giving them the freedom to do the jobs you hired them to do. It’s not just about the leader—it’s about the people the leader hires.

Think of Sam Walton, the founder of Wal-Mart. He’s six feet under and yet the company opens dozens of new stores a month. Sam Walton put the right people in charge of his business. The successful businessperson delegates. Granted, it’s not always easy. The reptilian cortex is always trying to turn us into the 400-pound gorilla trying to control everybody. That controlling mentality makes your assistant have a horrible job of just suctioning spit when there’s so much more he or she could be doing. At my practice the assistants are very involved in every CEREC case from start to finish. My assistants love their jobs because they’re doing so much more than the basics. They’re not just singing sheet music.

I have three hygienists and I don’t involve myself in what products they’re going to use. When they’re cleaning teeth eight hours a day, sitting there grumbling and thinking, “I wish I had this certain product, but dumb Howard makes me use this cheap stuff,” what good does that do for anyone? I don’t want them frustrated and mad at me all day. I let them order their own hygiene supplies and now they’re empowered and they’re on Dentaltown.com looking at the Townie Choice Awards and making their own product decisions. They’re happier, and when they’re happier, I’m happier, and patients probably end up more satisfied too from being around all these happy people.

Here’s an example of giving up control—let’s say a dentist buys a CAD/CAM machine but the dentist can’t delegate so he does the whole CAD/CAM process himself. Essentially he’s paid $150,000 to get a job as a lab tech who makes $50,000 a year. So you just paid $150,000 to have your income demoted. When I got my CEREC I told my assistants, “I’m not going to learn how to use this thing.” Dentists ask me questions all the time about how my CEREC machine works and I say, “Ask Jan.” Jan’s been working with me for 27 years. Many of my employees have been with me long term, and one of the reasons they love their jobs is because I let them abandon their sheet music. I don’t tell them how to sing the script, and if they just want to start screaming “Gimme Shelter,” I say go for it.

Dentists ask me, “How do you do it? You have a dental office, you have four kids, you have magazines and websites. Seriously, how do you do it?” I do it because I don’t do all of it. I have 50 backup singers who can sing what they want to sing and how they want to sing it, as long as they get the job done right and are being nice people. Dental friends, back away from the mic and see what your team can do. – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=385&aid=5246#sthash.BvUQNkgE.dpuf

by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

We’re all trained to think that reading makes you smart. Well, information makes you smart and you don’t necessarily have to read to get information.

Podcasts, my friends.

Reading is great, but let’s save our eyes. We can do that with podcasts. Dentaltown.com is making podcasts with some of the most knowledgeable, innovative people in the industry. Huge names. We’re talking everyone from Gordon Christensen to Mike DiTolla. You have to hear these people!

So what is a podcast? It’s an audio recording. It’s like listening to a radio show, but from a computer or smart phone. Plus it’s “on demand” which means you can listen to it whenever you want. Podcasts are online. You pretty much just click a link.

So let’s say you want to listen to a podcast on Dentaltown.com. Put “Dentaltown.com” in your browser. This will take you to the Dentaltown.com homepage. Find the tab that says, “blogs/podcasts.” Click it!

Now, choose either “most recent podcasts” or “most popular podcasts.” Now you’ll see podcasts you can choose from. Click on the title that looks the most interesting to you. Press play.

You are now listening to a podcast. It’s that easy. On Dentaltown.com you can also upload your own podcast. Through our magazine and online offerings, we’re connected to 300,000 dentists around the globe. That can be your audience. Use it! We’re sharing the space. There’s no charge to include your podcasts on our site, and there’s no charge for audience members to listen to them. Next month, our Dentaltown podcast director Richard Low will be writing a column about how you can make your own podcast.

So what’s so great about podcasts anyway? They allow you to multitask! You can listen while commuting, when you’re on the treadmill, or mowing the lawn. You can’t say that for seminars. At a seminar, what can you really get done for your practice or your personal life while you’re listening to a lecture? Not much.

Women seem to like podcasts even more than most men do. About 10 female dentists have sent me pretty much the same email. They say, “Howard, I’m not a male, married dentist like my colleagues. I don’t have someone who can sit at home and watch the kids on the weekend while I go to a seminar.” They say, “I’m a divorced mom with kids, and I work full-time Monday through Friday, and Saturday I do about four hours of laundry and dishes and household chores. And I love your Howard Speaks podcasts because I feel like I’m at a dental seminar while I clean my garage and watch my kid’s soccer game. I’m there in the bleachers waving to my kids, rocking out to a Howard Speaks podcast.”

Anytime you want to break from a podcast (like to cheer for your kid), you just press pause. So easy! Every time a podcast is over, I can’t believe it’s already done. It’s the fastest hour of my life. Podcasts are also perfect if you get bored easily and don’t want to sit in a chair and read a black-and-white book for two hours. I love reading and I bet you do too, but if you’re a dentist, you’ve probably already read half a library.

You crushed it in calculus, physics, chemistry and biology. And people who could get A’s in those four classes got into dental school, which means you’re wickedly smart. Well, people who crush it in the sciences, they’re readers. I’m sorry to say but a lot of us were readers because we were nerds. For three years of undergrad, every night I heard the same voice over the intercom: “Ding. The library will be closing in 10 minutes.”

And the first word out of my mouth was, well, I guess I can’t put that word in the magazine. But after that word I’d start thinking, “How come I’m paying $6,000 a year for this stupid library to close at midnight? Why can’t it stay open all night? I remember going to the dean of Creighton University and chewing him out about closing the library at midnight.

He got up from behind his desk and he walked over and he put his arm around me and real sweetly, he said, “Maybe at midnight you should just go to bed.”

We were losers. Yes, former dental students, losers.

Then there were the students who at midnight were coming home drunk with dates hanging on them and making out in the elevators. And we were looking at them like they were some vile person, making a mockery out of a higher institution of learning.

Well, they didn’t want to read. Maybe you still want to read. Guess what? You can read a podcast. That’s right: we transcribe every podcast we have on Dentaltown.com. That’s because I don’t want my readers to have to stop and write down the name of a speaker or website or anything. It’s all there for you.

Dentists aren’t exactly known for being high tech. But really guys, get in on this podcast thing early anyway. It sounds weird: “podcast,” but remember, it’s just a free recording you get off the Internet. Simple stuff. Remember apps, how they seemed sketchy five years ago? I mean, what were those? Well now pretty much everyone has at least one. That’s how podcasts will be: they’re not too common now, but in five years almost everyone will be listening to them. That’s how it worked with our message board. When I started Dentaltown, the first four people posting were:

• Me
• Another dentist
• My ex-wife
• My ex-mother-in-law

Now we have up to 2,000 posts a day and I make fewer than 10 of those posts. Podcasts: listen to one today, and look out for that March article by Richard Low about how to make your own. We want to hear you. – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=384&aid=5240#sthash.3n37wQKC.dpuf

by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

It’s a new year, but I’m ringing it in with an old message, one that I’ve hammered on from time to time, and one that keeps needing to be hammered until we all finally get it.

Everyone who focuses on practice management (I’m talking about consultants, business gurus, office managers and even practice-management software providers) says dentists who own their own practices spend way too much time on clinical dentistry and that they don’t spend enough time on the business of their practice.

>Is that you? See if you can answer any of the following questions (without asking someone in your office): What was last year’s return on asset? What was last year’s return on equity? How many incoming calls did you have? What percentage of your calls went straight to voicemail? What percentage of your calls were answered in the first few rings? What percentage of cavities you diagnosed last month were scheduled to be done? How many got done?

Ask a dentist any of those questions or any question pertaining to the business of his or her practice and you know what? Most of the time they have absolutely no idea. These are questions you need to know the answers to!

You got As in calculus, physics, chemistry and biology and you consider yourself to be a good dentist. But I could stroll into your practice, jump on whatever practice-management software you may or may not be using to its full potential, run a report and find out something like: for every 100 fillings this practice diagnoses, it’s only doing 38 of them. Would a fireman be considered a great fireman if he only put out one in three fi res? Would the sheriff of your town be considered great if he only caught one in three criminals? Despite missed fillings you still might be a great dentist, but how great are you in business?

Some people are amazing at the business of our profession. After all, dentistry has its own billionaire. His name is Rick Workman. He’s the man behind Heartland Dental and he does everything you may not feel like doing. Rick has 600 offices, employs 1,000 dentists and 2,000 hygienists, and he hasn’t seen a patient or done clinical dentistry in more than 25 years. This is an example of corporate dentistry. Do you like corporate dentistry? Maybe not. Is corporate dentistry a threat to small practices? Sometimes, yes. Are corporate dentistry leaders paying a lot of attention to their businesses? Yes, and so should we.

On that note, take a look at Stephen Thorne from Pacific Dental Services. Steve spent so much time focusing on the time and money factors of running a dental practice that he didn’t even spend time going to dental school to learn how to practice dentistry. He thought it was easier to hire a dentist than become one. These men are success stories in the dental profession and they only focus on the business of a dental practice. I’m not saying that you should do everything the way they do it or that you shouldn’t care about being a super dentist— I’m saying you should be a strong business person too.

I’m a dentist and I’d rather pull four wisdom teeth than play golf any day of the week. I’d rather do a molar root canal than go water skiing. I love clinical dentistry. But, I don’t spend all my time doing clinical dentistry. What I often see in the profession is all the continuing education you take and that most hours of your day are spent focusing on clinical. And then you recite the same old story that, “Friday I’m only going to do a half-day and then Friday afternoon I’m going to do the business side of things, run reports, have a staff meeting and all that stuff.” But every single Friday at noon, what do you say? “I’m trashed, I’m exhausted, I had a rough week, I’m going to go hit some golf balls and I’m going to go to happy hour, and I’m going to go to lunch with my spouse.” Is that you?

You know what the definition of insanity is? Doing the same thing over and over and expecting a different result. Why not make the business the first four hours on Monday? Think differently. Treat your practice differently. There are several leaders in dentistry who follow through on the business side of dentistry and have done things differently and are ultimate success stories.

My consultant friends all concur that half of the incoming calls coming into a dental practice come in when you’re not even open, and half the calls that come in when you’re open go straight to voicemail, and if you’re lucky, one in 10 leave a message. I don’t know too many dentists who track this stuff. Every consultant I know (even the consultants who work for practice management systems), tell me that when they visit an office, 85 percent of the reports have never been run. But even after you read this, you’re going to sign up for a course on doing root canals, and then you’re going to go on Dentaltown.com to find the ultimate bonding agent. That’s important, and I understand those motivations. After all, everyone knows what they’re good at.

However, it’s the truly successful people who can focus on the things they’re not so good at. The only reason you’re not good at something is because you’re not interested or you don’t spend enough time on it. Everybody knows that when you go to a concert and you watch a professional violinist perform, that person wasn’t born with a different brain—he or she probably just chose to play the violin four hours a day since childhood. And when you leave the concert that night, you don’t wake up the next morning and decide you’ll play the violin four hours a day. But you can decide to devote more time to your practice. If you’re not interested in the business, go find a support team, an office manager, someone who can focus on the business 24/7 so you can go back to doing what you love: clinical dentistry.

If you’re not interested in the business of your practice, you’re not going to work on it and you’re never going to be good at it. Doing things you’re not interested in for money usually leads to dysfunction, depression, disease, drinking or something else horrible. You should not get up every day and do something you don’t want to do all day long for money. That’s just a really bad idea. So if you truly don’t like this stuff, you need a right-hand man or woman and that’s going to be your office manager. And if you are interested in this stuff, then let’s move some clinical time over to the business time.

You know what, gang? It’s a new year, time to really turn over a new leaf and start focusing on the business of your practice in 2015. If you’re not going to focus on it yourself, at least hire help to make sure the doors to your office stay open a very long time. – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=382&aid=5191#sthash.1d6Ax0T6.dpuf

by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

If you were to ask practice-owning dentists around the country what their biggest business concern is, many of them will simply say overhead. I can’t stand it when people in the dental profession generalize overhead percentages for the entirety of the United States, because every state and every market is different. A dentist in North Dakota will always face different overhead costs than a dentist practicing in Manhattan. The economic and market variables that practices face in big cities differ greatly from those faced in rural areas, so to generalize and say a dental practice’s overhead should only be X percent isn’t fair.

t’s also frustrating to me when certain entities completely negate the cost of the dentist in overhead equations. When I practice dentistry I pay myself 25 percent, which makes up a lot of my practice’s labor costs. The rest of which is — of course — split up amongst my staff. This includes receptionists, office managers, hygienists and assistants. In large markets, that remaining labor cost makes up 25 to 28 percent of total overhead. In rural areas it’s about 20 percent. Regardless, it doesn’t matter who you speak to about their overhead, because no matter if your practice is in rural Kansas or a big city, we’re alltrying to bring our overhead percentage down.

When you’re looking at between 50 to 60 percent in labor costs (including what the dentist makes), the best way to bring your overhead cost down is you need to find every single advantage you can to ensure your practice is working as efficiently as possible. One of those ways is through magnification.

I know a lot of younger dentists who look at magnification as something used by old, fat, bald guys whose best days of practicing dentistry were 20 years ago. But even though you might say, “Dr. Farran certainly falls into that category,” that generalization simply isn’t true. Anybody who can see something four times larger than you is going to see things you can’t, see more than you can, and do a much better, quicker, more thorough job than you.

I really don’t understand the professors in dental school who tell their students not to invest in loupes because “they’ll rely on them too much” and “they’ll always have to work with that level of magnification.” Are you kidding me? Um, hey professor, that’s not a bad thing. Loupes are not a crutch — they’re an advantage. Loupes should be the first tool a dental school should hand their students. Practicing without them is like the difference between doing a filling with the lights on and doing a filling blindfolded in the dark. In my practice, loupes are mandatory for every person who works clinically. My entire staff tells me they would not and could not perform the high level of dental care they provide without them — they just can’t!

I’m on the message boards of Dentaltown.com every day since 1999, and I recall a dentist who once said he is so tired of going in to check the patient after a cleaning and he ends up clearing away a big chunk of calculus. The thing is, he’s wearing loupes so he can see this piece of calculus, but his hygienist isn’t wearing loupes and cannot see what he sees. This difference really puts the hygienist at a disadvantage. And of course, the doctor gets upset with her because she missed this obvious piece of calculus… well, obvious to him because he can see it. This clinician has the same kind of professional blinders on as the dentist who goes to a dental convention or seminar and doesn’t take his team with him. Sure it’s great the doctor is learning a lot and getting energized and excited about dentistry, but his staff isn’t. Then he wonders why his team isn’t as pumped as he is. I know this is getting a little off track, but doctor, you have to invest in your staff! You need to get them loupes so they can see what you’re seeing. You have to get them to CE courses so they can get as excited about practicing dentistry as you are. I digress…

Not only do loupes help your vision, but think of the ergonomic benefits! You can sit straight up while you work on your patients, and you don’t have to crane your neck around in someone’s mouth to see what’s going on. Over time, loupes will help you practice dentistry longer than the dentist who has a constant kink in her neck from trying to get a better look at her patients’ chompers.

Loupes are great, but let’s take this a little further. You can even improve upon what you’re seeing in your patients’ mouth with proper lighting. Overhead lamps and LED lights that attach to your loupes are a true godsend in this profession, but when I really want every single thing illuminated in my patient’s mouth, I’m going to turn to my trusty Isolite every time. I mean, take a look at this photo, I’m using an Isolite in this patient’s mouth, and his mouth is so illuminated, I can see everything — especially when I’ve paired the lighting with my loupes. I almost need sunglasses his mouth is so bright!

Not only am I thrilled about having such bright light in my patients’ mouths, but it frees up my assistant’s hands from continually adjusting the overhead light. Jan, my assistant, swears using the Isolite is like giving her another set of arms. Since we’re talking about making sure your practice is working as efficiently as possible, when I’m using an Isolite, I almost don’t need Jan in the room while I’m working on a patient. Instead of babysitting an overhead light for me, Jan can be setting up other things for the procedure or setting up another operatory for my next patient. In fact, it is so handy, I’ve heard from other colleagues that their assistants feel a little threatened by it. While it certainly doesn’t replace the entire functionality of an assistant working in your practice, having the Isolite is really like having a free dental assistant work in your office all while you’re getting the best light possible in your patient’s mouth

That’s the beauty here! It has to be the most boring job in the world for your assistant to sit there and suck spit all day while you’re working on a patient, when you could just get an Isolite to do that task for you, freeing up your assistant to take care of other more important tasks.

I recently met with a bunch of office managers in Nashville, Tennessee, and I had a conversation with some of them about how frustrating it is now that the practice has purchased a CAD/CAM milling unit because the doctor is spending three hours of his time making a crown. That’s crazy! Before he purchased the CAD/CAM milling unit did he do his own lab work to make the crown? No, he sent it to the lab. So, now he went from being a doctor to a lab-tech. Congratulations, you just spent $100,000 to spend your time doing lab work.

Doctors, you need to start investing in your team and delegating things like making a same-day crown to them. It’s time to free up on the reins a little bit, doc! Let your staff soar! You need to invest in your team. Allow them to see what you’re seeing with your loupes. Start using other helpful instruments so you can free up your assistant from sucking spit, allowing her to take on other more important tasks. And for heaven’s sake, start bringing your team with you to dental conventions and seminars and get them on the same excitement level you’re on. – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=375&aid=5125#sthash.7K8kKc1Y.dpuf