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Taming High-Tech Purchases—Planning for Life on the Cutting Edge
Rand T. Mattson, DDS
There is a good possibility that as the year ended, you found yourself under a full siege of year-end activities. Along with a packed holiday schedule and the daily tasks of dentistry, special year-end circumstances such as using tax benefits for equipment purchases were on your mind. Not wanting to lose out on any tax benefit, you may have purchased some cutting-edge equipment, rationalizing that you would work out how it integrates with the rest of the office later in the year.
If this sounds familiar, you are not alone. It is a vicious cycle that attacks even the most progressive dentists because of a lack of purchase planning and implementing new technologies.
Today’s modern practices are high tech. Ninety percent of practices have computers at the front desk but only 44% have them in the operatories. Twenty-eight percent of practices have intraoral digital radiography, but only 13% use digital pans. Twenty-nine percent of practices use low-speed electric handpieces, but only 22% use high-speed electric handpieces.
Although the list is extensive, the important point is that the number of offices adopting high-tech environments continues to increase each year. So ask yourself:
- Do I want to be competitive?
- Do I want to offer my patients the latest investments in dental technology?
High tech is expensive. Yet Section 179, the US government’s way of helping with the purchase of high tech (or any legitimate equipment purchase), provides a set of special tax rules that allows for the purchase of $108,000 of qualified equipment to be treated as an expense rather than a capital expenditure. Consult with your tax advisor to be sure these rules apply to you. In short, this law encourages a December push to purchase to gain advantage of a tax benefit, but new technology is often wasted because it is not integrated strategically in the practice.
The first step is commitment on 2 levels. The first commitment is to a high-tech practice and the second is to a mid-year plan. The most important aspect in incorporating advanced technology is to focus less on shiny gadgets and more on systems that emphasize the foundations of technology. The plan should include an office design, new or in your existing facility, that will allow for the incorporation of new systems. High tech requires space and a place, it needs to be ergonomic and easy to use, some high-tech equipment needs to be connected to other systems in the office, and most require power. Office design makes the difference between people friendly, integrated, easy-to-use systems throughout the office versus new gadgets pasted in every available spot. In the end, office design has little to do with the value of a new technology, yet it is often a significant factor in technology’s value to the practice. Take a look at your space and find a place for each item.
Once high tech has your commitment and a place in the practice, attention should turn to infrastructure. Plan now to avoid costly upgrades in the form of reengineering your office to accommodate technology. Every office space that could incorporate high tech needs access. This is step two. This implies appropriate wiring and power for current and future uses. Your access can masquerade as “runs,” which are empty conduits incorporated in floors, walls, and ceilings, allowing power or cables to be taken wherever needed.
Access and space intersect with location, location, location. High tech’s location is critical to its successful use. Computers must be easy to use wherever they are located. Keyboards and mice must be convenient for users in their regular setting. Monitors should be visible to all users yet placed with patient confidentiality in mind. Patient monitors should be large and viewable. The location of equipment mixed correctly with the human interface creates easy-to-use systems.
Practice Management Systems, Hardware, and Service
The third blueprint is practice management systems, hardware, and service. These constitute the critical mass of any potential high-tech purchase. When this combination works well, everything functions smoothly; if there are problems, the practice is mortally wounded. Irrespective of the importance of the aforementioned issues, these 3 areas are where most practices start their cutting-edge journey, specifically with front office systems. Practice management software drives the entire technology solution. Strong consideration should be given to both front and back office aspects of practice management software because the clear trend today is toward total use throughout the office. Remember also that wherever a software program is needed, hardware is required.
Many offices purchase retail computers that are not maintained by the practice management supplier. In this situation, software compatibility and service issues are always a concern. In short, hardware must be up to the task of today’s high tech with memory, storage, network services, and back-up systems constituting just a few considerations in a complete solution. Technology often feeds on computer resources in an ever-increasing demand for more power. Hardware requirements for offices that only use front office features are vastly different from those that integrate in-operatory high-tech systems. These needs should be carefully planned in conjunction with the practice management software provider as well as other high-tech systems that require computer resources. The best advice is to over-plan computer hardware as well as a total service package with an eye on future developments.
When hardware is straightened out, our blueprint guides us to service, which is the linchpin of the hardware/software question. When setting up the computer system in my practice, I purchased retail computer hardware to use with my practice management software. The inevitable problems that occurred caused much finger pointing and a slow resolution, which was a constant source of frustration. To avoid these pitfalls, service of hardware and software should be a primary, if not the most significant, consideration in any high-tech office. There are single-source solutions that provide complete service, which eliminates many concerns that accompany modern systems and allows the dentist to perform dentistry while a technician takes care of the computers. Hardware and software service, by someone other than the dentist, should be a top consideration when implementing high tech. The fact is, most dentists are far better dentists than service technicians. So find a one-source provider (eg, Patterson EagleSoft [St. Paul, MN]) and let them support you and your practice. For most, letting a technician perform the high-tech service while we do dentistry is the best, most profitable service solution.
Now that all of your systems are purchased, in place, and serviced according to a plan, you’ve got to use them. This reveals that dentists adore toys, and love to have the latest and greatest, only to let the technology sit underused or not used at all. There are ways to use high tech to help catapult your practice to the cutting edge.
- Move the practice management system into the operatory.
- Use chairside charting.
- Enter treatment notes in the operatory.
- Simplify billing functions. A summary of services can be prepared addressing payment and insurance issues before the patient returns to the front office.
- Use digital radiography. This is an easy step if you have a computer in every operatory.
- Go paperless by entering all patient information and transactions in the computer record.
Before the end of the year, take time to plan for the orderly adoption of high-tech devices. Avoid the pitfall of purchasing high tech for tax benefits instead of purchasing to complement your overall plan and receive a tax benefit. Following a pressure-free, pre-December plan will help you achieve an eye-popping, cutting-edge practice.