A Successful Solo Dental Practice Really Isn’t Solo at All
Louis Kaufman, DDS, MBA
Henry Ford said, "Surround yourself with successful people and you will succeed." The relationship clinicians have with their dental team is arguably the most important aspect to making their practice run smoothly, as it helps allow the clinician to thrive and provide the highest level of patient care and service. The dental team is a conglomerate of those both in the physical office as well as outside. The solo dental practice will thrive by recreating itself on a regular basis and using outside practice consultants and organizations.
Dental school does not prepare dentists for buying a practice, controlling costs, reducing overhead, developing marketing strategies, assessing artificial intelligence (AI) (which is increasingly being used in radiology and caries detection), dealing with corporate dental competition, or eventually selling a dental practice. A number of strategies involving others can be used to create a successful dental practice.
A Team Effort
The dental team is crucial to the solo practitioner, as there are many facets of a dental practice that extend well beyond the provision of good dentistry. Some of these include:
Friendly office team-The front office team must be friendly. When answering the phones, team members should be cheerful and efficient. There are many practice consultants and educational centers to help a practice properly handle the dental consumer in an efficient manner. Some patients will choose to schedule strictly online, and there is now the availability of AI to accomplish this.1
Cleanliness-My entire dental team sets aside 1 to 2 hours per month to go through the office and thoroughly clean the physical facility. This exercise is not only smart for the practice, but it also can serve as an effective means of team building.
Insurance-If a practice takes insurance, then it must be exceptionally good at processing it. If it is not, outside resources can be brought in to help service patients.2 Today, numerous companies are available to provide this service. Three years ago, I brought in an outside company and since then have reduced my insurance dependence.
When I graduated dental school in 1995 the solo dental practice was thriving. Connecting to the Internet was done with a dial-up modem. Today the solo dental practice is on a decline; however, I believe it is evolving and being reinvented. As in any industry, a product has a life cycle. This life cycle can be viewed as evolving or, as Darwin said, "survival of the fittest." To compete in today's high-demand, fast-paced society the solo practice must not only provide the best service every minute of every day, but it may need to augment what it is doing and offer its clientele much more.
A solo dentist simply cannot be excellent in all aspects of dental care. A few years ago I brought a periodontist in to the office, which created the ability to offer more services, thereby reducing overhead. We split expenses of materials and the collections 50/50. This alone can help cover rent/mortgage, which, in return, decreases cost. This certainly does not mean dentists should end relationships with other periodontists/specialists in their community, as it is important to recognize different skill sets and leverage them. This also maintains continuity of existing patient care and referrals from these providers to your practice.
Multi-doctor practices are not a new concept. As a sole owner, it is beneficial to bring on an associate who can perform procedures that support full-service dental offices. This helps meet all the needs of a patient base.
A private practice must be proficient in areas such as finances, marketing, continuing education (CE), vendor partner relationships, and competitive lab pricing. I joined an organization (Smile Source®, smilesource.com) that has had a huge impact on my dental practice. It is a dental group that allows the practitioner to remain completely independent from a corporate structure. It offers excellent access to supply pricing, marketing, equipment, and CE, to name just a few areas. The value of high-quality education is a plus, and being part of a group can help lower the cost of CE, which is a foundation to a successful, fulfilling career in dentistry.
Organizations such as this enable clinicians to share best practices and not feel like they are competing against each other but, rather, helping one another thrive. Meetings are held locally at least four times per year, with a national meeting once a year. This organization facilitates access to quality CE and networking with other like-minded dentists from across the country. Local meetings include masterminding sessions in which peers assist each other in critical time-sensitive decision-making in a safe, non-judgmental environment.3 The group also utilizes geospatial market analysis.
Geospatial analysis examines the congregation, management, and view of GPS, satellite, and historical data sets. This analysis is accurately transcribed in the relationships of geographic coordinates in a tactical manner using street addresses, postal codes, traffic patterns, and more.4 It lets dental practices know who to target and how to target them based on age, buying power, and the type of media they use to communicate.
Having the backing of a supportive organization is vital, especially when dealing with a dental manufacturer. As just one office, it is hard to be heard; but together 600-plus offices can make a loud voice and garner much more favorable treatment. This goes for working with dental laboratories as well, enabling competitive pricing with some of the best labs in the dental industry.
The Consumer's Perspective
I spent a number of years in the restaurant business, which taught me how to see things from the consumer's eyes.5 People return to a favorite store or restaurant because of their experience. For patients, dentistry is an experience. The dental practice's brand-who we are, what we encompass, and what we deliver daily-must continually be improved upon. In any business "quality control" is critical. For example, in the fast-food restaurant business we had secret shoppers who would go through the drive-through. They would time how long it took to place and receive an order and assess how hot the food was and whether the soda was properly iced and carbonated. The objective was delivery of high-quality product on a consistent basis in all areas of the business.
In my dental practice we ensure the technology is current, creating a thorough process while continuing to provide the highest standard of care. We brought in digital workflow so that we could provide faster and better service. The clinician must be willing to put in the time to master the technology. I first brought CBCT into the practice 8 years ago. I learned how to place implants freehand and then using guided surgery.
The end game of dental practice ownership is selling to another dentist, associate, or corporate entity.6 Before the time comes to sell, though, it is important to have an exit strategy in place. Such a strategy needs to begin the day one becomes a practice owner. The owner must invest wisely in the practice and make sure it is continuing to grow rather than be in a declining life cycle.
A simple question to ask is, "When do I want to retire, and will I have the financial ability to do so?" Just as dentists plan with the end in mind for a full-mouth rehabilitation prosthetically driven with implants, they need to envision their end game with regard to career. Speaking to dental practice evaluators and dental consultants can help in planning for the end game. The time is now. The dental team and the relationship you create with it is priority one.
About the Author
Louis Kaufman, DDS, MBA
Kaufman and Kaufman Smile Design Studio LLC, Chicago, Illinois; Fellow, Academy of General Dentistry
1. Bucki J. Pros and Cons of Outsourcing. The Balance Small Business website. Updated January 11, 2019. https://www.thebalancesmb.com/top-6-outsourcing-disadvantages-2533780. Accessed April 29, 2019.
2. Gupta S. The future of artificial intelligence in dentistry. Healthcare in America website. August 20, 2018. https://healthcareinamerica.us/the-future-of-artificial-intelligence-in-dentistry-114e04fc4e8f?gi=3a97135aeef. Accessed April 29, 2019.
3. Hofstrand D. Product life cycle. Iowa State University Extension and Outreach website. Ag Decision Maker. Updated October 2017. https://www.extension.iastate.edu/agdm/wholefarm/html/c5-211.html. Accessed April 29, 2019.
4. Geospatial analysis. Encyclopedia.com. https://www.encyclopedia.com/environment/energy-government-and-defense-magazines/geospatial-analysis. Copyright 2009. Accessed April 29, 2019.
5. Kelso A. How mystery shoppers provide a "micro view" of restaurant operations. QSRWEB website. April 22, 2014. https://www.qsrweb.com/articles/how-mystery-shoppers-provide-a-micro-view-of-restaurant-operations/. Accessed April 29, 2019.
6. Burns S. 7 reasons to join a mastermind group. Forbes website. October 21, 2013. https://www.forbes.com/sites/chicceo/2013/10/21/7-reasons-to-join-a-mastermind-group/#41fdae675deb. Accessed April 29, 2019.