From a higher-end business perspective, Feldsien adds that DSOs have demonstrated their abilities to use their scale for negotiating excellent pricing on supplies and equipment, as well as driving down benefit costs for their employees. Likewise, their financial stability facilitates acquiring the most attractive lease rates at the best real estate sites.
“If dentists weren’t being successful in the DSO model, the concept would have died long ago,” Feldsien says. “Supported autonomy is real and it works.”
Feldsien acknowledges that for dentists who want to remain in an unsupported environment and oversee all practice aspects—including those areas they may not have been trained in—those opportunities certainly remain. Not every dental practice business model is right for every dentist, whether a new dentist, an associate in an existing practice, or a solo practitioner.
“When dentists are considering whether the DSO model is right for them, the key is in the questions (Table 3) they ask and the answers they are looking for,” Feldsien advises. “They need to think about and articulate in writing what is most important to them, and author questions that they believe will best elicit answers that confirm fit or demonstrate the lack of fit.”
Dentists who are intentional in this process will realize a great fit and a foundation for development and growth. Dentists who take a casual approach will likely end up with a less appealing outcome, Feldsien cautions.
Every industry, everywhere, is going digital. It’s no longer a matter of “if”; rather, it’s a question of “when?” Despite some challenges with adopting technological processes (eg, integration, equipment compatibility, learning curve, team member buy-in, financial investment), there are systematic benefits for dental practices and their patients when digital technology replaces conventional processes. Additionally, at a time when dental practices face increasing pressures to remain competitive, profitable, and relevant to patients, investing in technology can be the solution.
“Investing in equipment and technology can lower a practice’s overhead,” explains Keith Dryer, vice president of Henry Schein Financial Services. “If you look at the abundance of easy-to-obtain, long-term, and relatively inexpensive financing, acquiring technology and equipment with affordable monthly payments is an economic enhancer to the practice that outweighs the costs.”
One example Dryer readily points to is the use of in-office dental computer-aided design/computer-aided manufacturing (CAD/CAM) that can be used for everything from treatment planning to digital impression taking, and from restoration design to restoration fabrication. Examining how many crowns are needed each month, as well as the chairtime, staff time, and materials involved with conventional procedures (ie, analog impressions, stone models, temporaries, laboratory fabrication) typically demonstrates that the break-even point is very achievable, Dryer says.
“Dentists also enhance the practice’s value proposition by being able to diagnose and propose complete treatment plans more efficiently, and expand the services that a practice can offer today,” Dryer explains. “There’s always a cost/benefit analysis involved, but the benefits to patients, staff, the practice, and the doctor usually win out.”
Realizing and maximizing the return on investment, however, requires consideration of the technology from the customer’s point of view. In this case, Dryer notes that dental practices, like all business, should consider the staff as their customers.
“Having dental team members who are happy at work and satisfied with their jobs affects production, and that ultimately benefits the patient experience,” Dryer says. “Therefore, consider whether the equipment or technology will help the dental team do a better job, be more productive, and/or work in a better environment. If the answer is yes, then the time is right to invest in technology.”
“I’ve never purchased equipment necessarily to ensure I make a great return on my investment, one being a CBCT, which was really more of an investment for better diagnostics, not necessarily to make more money,” says Margeas. “I do think it’s prudent to do that, but there are times when you invest in technology to make your life better and easier—such as with an electric handpiece, and hopefully the return on investment is good.”
Interestingly, because acquiring equipment and technology is good for the long-term success of the practice and quality of patient care, the decision about “when” shouldn’t be dependent on a financially good or bad month. Any time of the year is the right time to seize opportunities for technology integration that can help a practice become more efficient, effective, and more profitable, Dryer emphasizes. Regardless of what month they’re in, if it makes sense for a practice, it makes sense to acquire the equipment.
Yet, there are caveats to the timing technology investments. Current attractive low-rate financing rates are not guaranteed to be available in the future, but practice owners should feel confident locking in a good rate, with affordable monthly payments, for 3- or 5-year terms. Additionally, although the Section 179 benefit of $500,000—which enables practitioners to lower their taxable income each year—is now permanent, it is a use-it-or-lose-it benefit. However, with year-end incentives offered by manufacturers being much better, dentists can receive the same tax benefit, regardless of whether they acquire equipment later in the year rather than earlier.
“Because every situation is unique, dentists and practice owners should check with their own financial and tax advisors,” Dryer advises. “For the overwhelming majority, investing in technology is really a win-win situation that increases the practice’s standard of care and benefits the practice owner by lowering their taxable income.”