In business management, dentists seem to have a commonality; they are reactive in their management style. This reactive approach occurs because dentists must focus the majority of their energy on treating patients rather than concentrating on running a business.

While consulting with and lecturing to countless dental offices across the United States since 1983, I have found a similarity between all; dentists tend to be reactive in their management style.

For instance, if the checkbook is low on funds, dentists wonder why collections haven't been keeping up with production. The battle cry then becomes: "Susan, why aren't you collecting more money?!? Get after those patients and make them pay their bills!" Or, "Why didn't the parent pay for their child's emergency treatment?!?", "How long have we been waiting for them to pay? That long? Send 'em to collections!"

If there are few patients scheduled in the appointment book, panic sets in. Followed by the edict: "I wonder why parents aren't scheduling their children for treatment? We send a pre-determination to the insurance company so treatment coverage is known. Why aren't they interested when we call five weeks later? Maybe the solution is to get a bigger ad in the Yellow Pages. I'd rather pay more for an ad than to take a cut in my fee by joining a reduced-fee insurance program, just to get new patients."

More often than not, the supposition to why people don't pursue treatment is that they can't afford it. Typically, parents indicate to the dental team in some way that they don't have the money to move ahead with treatment. Unfortunately, the reactive approach is, "We need the production; let's just do the treatment now, we'll worry about the money later!"

Another catalyst for reactive behavior in a dentist occurs when employees of the office cause stress in the workplace. Imagine the perception given to the other team members when the marching order from the dentist is: "I won't put up with this. You're Fired!"

Rather than having to deal with the events described here, dentists and their team can prevent negative occurrences from happening by developing systems and coaching employees to create a more proactive approach to dental practice management. The results are worthwhile!

There are many different ways to accomplish proactive approaches to dental office issues, and in the following paragraphs, I will entertain a few ideas on how business systems can be restructured. The end result will ward off problems before they occur.

The first example is handling patients who are in need of emergency treatment. In my experience, dentists create accounts receivable problems in these instances because they begin treatment before a discussion about finances occurs. According to popular rationale, payment arrangements are best created in a private place away from the front desk and the operatory. But in this situation, an exception to the rule by asking for payment during the treatment process would be in the best interest of the patient and the practice.

Here's one solution that works very well. Once the dentist has exercised pain control and the patient is now comfortable, call a brief "time out" and have a key member of the staff present the fee for treatment and make payment arrangements before any long lasting treatment is rendered.

This proactive solution makes sense because patients are informed and have agreed to how they will handle payment before treatment begins. The end result is that patients follow through on their payment arrangements because the expectation for payment was created from the beginning.

The second example entails how to deal with sustaining practice growth by attracting an appropriate number of new patients. Through continuing education and practice, dentists become knowledgeable and skilled in the healing arts, but dedicate much less time to learn how to market their services. Without a well thought out and executed marketing plan, new patient flow is unpredictable and may be too low to sustain practice growth.

In order to create a consistent flow of new patients, proactively market the practice by following these simple guidelines:

  1. Set Goals. Clearly define the number of new patients you wish to acquire each month. Dental practices across the country lose 20% of their patient base annually. Patients move, change jobs, pass on, or elect to seek services from another dentist. Set your practice goals first to replace the 20% attrition, and decide how much of an increase in the patient base you desire. As an example, if the practice has 2000 active patients and seeks to grow 10%, it must acquire 600 new patients. Mathematically: 2000 multiplied by 20% equals 400 (for attrition), plus 2000 multiplied by 10% equals 200 (for growth).
  2. Create a Mission or Vision statement. Articulate the direction of the practice in a few sentences. Utilize the office's team members' input to create a sense of unity.
  3. Create a Budget. Practices which desire accelerated growth may wish to designate 5% of the previous year's revenue to marketing; mature practices who wish to only maintain current patient flow may allocate up to 2% of the previous year's revenue.
  4. Decide on Methodology. Determine what appropriate marketing tactics will be used that fall in line with the practice's vision statement. Internal and external means of marketing may provide a suitable mix. Ensure these methods are within the budget and can be measured.
  5. Delineate Limitations. Some dentists are steadfastly opposed to certain forms of marketing. This element of the plan entails deciding what the practice will not do to market.
  6. Implement Tracking Mechanisms. Make sure you follow the business axiom, "When performance is measured, performance improves. When performance is reported back, the rate of improvement accelerates." Track the results of the program and meet regularly to discuss your findings.

The third and final example deals with the attitude children today have towards orthodontics. In contrast, a generation ago children with braces were viewed as anomalies; labeled as "tin-grin", they were routinely made fun of by their classmates for reflecting brightly from the flash bulb in the class picture. Not to mention the headgear worn by some that seemed so foreign, it was easy to tease.

As with eyeglasses, orthodontics seem to be an easier sell to kids lately compared to twenty-five years ago. Kids these days seem to have everything. For instance, they have a plastic bin full of Matchbox cars instead of a collection of ten to twenty. Instead of one Barbie and one Ken, the playroom is now a small city of dolls. The mentality of children today is that they want everything, including "the cool things" others in their age group have today: braces. It's not uncommon for kids to even play guessing games via e-mail for what color braces they will choose, "Wait until you see me tomorrow."

And, as precocious as some children are today, they will notice adults with crooked teeth. They are becoming more and more exposed to and aware of advertisements and television shows with people (models, actors) who exhibit beautiful white, healthy smiles. They observe adults' teeth that aren't straight, almost in horror and may not even fear to comment, "How come you never got braces before?"

The continued challenge, it seems, is to be proactive and sell the parents.

In order to address this element of business management, offices must remain keen to what drives the family's desires and strive to connect it with the quality of services offices deliver.

Certainly people today are more educated about health and well-being, but the fact remains that dental offices today must hone communication skills so that parents are provided information on services in such a way that they choose what is right for themselves and their children.

And, lest we forget, financial obstacles exist today in some parents' minds because of the fee for orthodontics. Parents may not be aware of the variety of payment methods available to them. Offering discounts for payment in advance, budgeted payment arrangements locked into a contract over time, and outside financing are part and parcel of a great payment system that won't get in the way of case acceptance, and won't cause the practice financial problems down the road due to non-payment.

Bear in mind, these are just three examples of issues confronting dental offices today, and ways in which to become proactive in their approach to achieving a practice's goals. Each system within a dental practice can be refined in order to ward off problems before they occur. A proactively managed practice will deliver many benefits to patients and the community will be well served. Dentists, and their team members, will be rewarded with a more profitable and gratifying workplace.