Area Economic News

Insurance and PPO Participation


This was the second most frequent issue mentioned by respondents. Participation in major PPO’s in our area has remained much the same this past year. About 30% of area practices participate with Delta PPO and 17% Met Life (down slightly from 19% last year). About 30% of practices participate with the Premier Group and 19% with Cigna.

This year, 7% of practices said they dropped a PPO and another 7% said they plan to drop a PPO. 7% had joined a PPO in the last year (which would account for the statistics staying pretty much the same) and only 1% plan to join a PPO.

If you’re participating with Delta PPO or Met Life, there’s a better than even chance that you do not need to suffer the large write offs. Although these plans have their place, many offices continue participation much longer than they benefit by doing so. Often these plans have a 30% or more discount from Dentists’ normal fees meaning those providers are treating every third patient for free. Ouch!

Ironically, some of the practitioners who are in the best position to leave their PPO are the most “addicted” to them. We can help you look at this rationally. There are serious risks and rewards involved.

Technology

61% of area dentists now have websites, up from 41% last year. 59% of offices now have digital radiography. 65% have intra-oral cameras (but getting them used regularly can still be a challenge). 45% of offices have laser caries detection (e.g. Diagnodent from KAVO).

Wages and Fees

An unweighted comparison indicated Metro fees were up just 1%. Outstate fees were up 3.1%. Wage increases were low to non-existent.

See the complete surveys and more on our Fee Survey page.

We put wages and benefits in the “Members Only” area, so if you’re a retainer client and don’t know how to find that, just call our office and we’ll give you the secret path.

If you haven’t already been there, our website is chock full of information. We have past bulletins that cover a wide variety of subjects, articles I’ve written, detailed surveys on area economic trends plus a very good survey of Dental Office Overhead by the firm KDV.

When I ask our clients what the major thing they want from us is, the answer is “An informed third-party perspective.” Our goal is to provide just that. We work hard to make sure that our website has relevant information to give you the perspective you want and need.

The All-Time Top 10 Outrageous Cancellation Excuses

Speaking of downtime, a few years ago we surveyed offices for their patients’ most outrageous cancellation and failure excuses.

10.) “Tooth hurts really bad but have to go hunting.”

9.) “The cat turned the alarm off.”

8.) “My mother passed away.” (3rd time in 10 years).

7.) “Too many bears. I’m not leaving the house.” (Duluth patient)

6.) “My teeth look fine. I’ll call you when they aren’t white any longer.”

5.) “Eclipse might hurt my baby. I won’t go outside.”

4.) “Did I make that appointment…really?”

3.) “I found a dead squirrel on the road on the way to my appointment and needed to bring it to the police department so they could properly bury it.”

2.) “My dog ate the reminder card that was on my refrigerator.”

1.) “I thought my appointment was yesterday.”

Health Care Reform and your free consultation

How Health Care Reform Will Impact Your Practice in 2010

The Patient Protection and Affordable Care Act (PPACA) will impact you and your employees beginning this fall.

There are still major aspects of the bill that are open for interpretation and are subject to change. However, it is important you know how this bill will affect you and your employees in 2010.

When is a free consultation really free?

When you give me a call for a brief discussion. We can talk for 15 to 20 minutes about what’s on your mind.

Before you call, check out the testimonials on our web site from dentists who called me and are glad they did. Real dentists, real practices, real names and photographs. I'm sure you'll recognize at least a couple of fellow dentists. 952 921 3360

Profitability and Overhead Control

Another Word about Profitability and Overhead Control

Want to make sure your net is good?

1. Overhead Control really consists of: Confrontation: Often, reducing overhead comes down to confrontation such as:

• Bargaining with your lab guys.
• Holding your staff accountable for results (given the correct direction and training— that’s our job to help).
• Terminating staff members who are not performing well.
• Making sure you are price shopping and bargaining when making any significant investments in technology, facility, anything.
• Enforcing work place rules (time clock, reasonable vacation time and coordination).

1. Result Control: Making sure that for whatever technology, equipment, facility or advertising you invest in you get a good “bang for your buck.” Please see the “Result Control “articles I’ve written regarding this on my website (under Articles) AdvancedPracticeManagement.com
2. Keeping an eye on the numbers. You can’t manage what you don’t measure and many dental offices have Profit and Loss reports that don’t clearly show the bottom line and don’t organize the expenses into rational groups that make it easy to compare to industry standards.
3. Wise selection (or de-selection) of PPO participation to limit discounts.
4. Increasing practice productivity through seeing more patients or doing more for the patients you see.

Online comments and reviews

Protect Your Reputation.
Keep an Eye Online!

As you probably read in the recent Northwest Dentistry, given the pervasiveness of The Web, every Dentist is vulnerable to receive a derogatory review online.

I’ve seen several occasions in the last few weeks where Dentists didn’t even know that there were negative reviews online. Do a Google search for your area...for example, “Maple Grove Dentist.”

First of all, see if you come up under Google Maps within the first page or two. If not, get after your web guys. Also, make sure there is a link to your website. We’re surprised how often there isn’t.

Then read the reviews. The only defense against a negative review is to have it diluted by a preponderance of positive reviews. Get patients who you are especially close with to write positive reviews ASAP.

When you’re looking for vacation places or searching online, you read reviews, don’t you? As you know, in many places (but not all, yet), The Web is replacing Yellow Pages as a source of new patients. And despite years of controversy, I personally have seen Yellow Page and online advertising work, so it’s worth staying on top of this. A bunch of good reviews can make a difference in your new patient flow.

Your Practice Area Demographics

Are Demographics Destiny?

If you listen to anyone on the lecture circuit and most consultants, they’ll tell you that it doesn’t matter where you practice…it matters how you practice.

True, mostly.

I have certainly seen the substantial difference good management can make wherever you’re practicing,

However, after 30 years of doing this I have come to think that even the most virtuous, capable dentist with a well-managed office can be hurt by crummy demographics.

The toughest demographic—a low population to dentist ratio.

Many dentists locate with the income of the population in mind and little attention to much else. That’s why there’s very high dentist to population ratios in affluent areas such as Wayzata, Edina and North Oaks.

It’s been my experience that these are some of the toughest, most competitive places in the state to practice. The high per capita income does not overcome the high dentist population ratio.

Dentists have an easier time of it if they’re located in a place with a lower dentist population ratio even if the population’s income is not in the top tiers.

On the other hand, there’s a point where the population’s income can be so low that no matter if you have a low dentist to population ratio (e.g. lots of patients) it isn’t worth it because you find yourself doing less and less on more and more people—a version of dental hell.

You can see more info, stats, even charts in our May news letter on the Advanced Practice Management web site.

Dying for Dentistry — and — Little Things result in Big Gains

Dying for Dentistry

Our man, Matt, heroically tried to make his consulting appointment on January 7th and got caught in a snowstorm in Southwestern Minnesota.

At 10:30 in the morning, he was told by the Highway Patrol they probably wouldn’t get to him until late at night or even the next day.

However, miraculously, his wife rescued him from 160 miles away. It was a Google rescue. Go to our About Us page to watch the story that aired on Fox 9 News on February 10th.

Little Things = Big Gains

When we take a close look at practices that are experiencing good growth, we sometimes find that growth is generated by or can be explained by significant big events such as: adding an associate, a new facility or extensive remodeling, a significant Continuing Education event, or change for the better in personnel.

These dramatic events can change the chemistry or capacity of a practice, the motivation of the Doctor and/or the team and result in growth.

Staff wages are the major overhead item, so it certainly makes sense to go slow with raises if your practice isn’t growing. I’ve often said that the staff’s compensation should be linked to how the practice does, not just to the economy or the consumer price index (which by the way was up 1.8% in 2009).

However, we find that most of the time growth comes from a number of small improvements that cumulatively have a large effect. This is what management is all about...catching every little bit of wind you can in your sails.

I've provided a number of examples in our latest newsletter, our February Bulletin.

’til next time...

Leadership and Staff Raises

Leadership and Staff Raises

In our recent economic survey we asked area Dentists if they plan to give staff raises in 2009. 41% of Metro Area and 24% of Outstate offices said, “No.” Only 30% of Metro and 54% of Outstate dentists will give raises in 2009.

Staff wages are the major overhead item, so it certainly makes sense to go slow with raises if your practice isn’t growing. I’ve often said that the staff’s compensation should be linked to how the practice does, not just to the economy or the consumer price index (which by the way was up 1.8% in 2009).

Even if you’re not giving raises, you should at least give your staff recognition, direction and hope. That’s leadership.

“Look, we’ve had a flat year but I want to let you know that I do appreciate your efforts (giving specific recognition to each staff person). And, I do need your help in the coming year because despite the economy we intend to press on and make the practice better all the time. Once we’ve gotten a string of 4 to 6 months that shows growth then we’ll revisit the wage situation and consider raises at that time.”

Wage increases should be based on these three major factors:

The market rates for wages. (See the Advanced Practice Management Surveys).

How the practice is doing (practice growth and profitability).

Individual merit.

Smart Wage Decisions:

I believe it’s best to take a look at staff wages as a percentage of collections at least once per year for the sake of determining how much will be available for wages and raises.

If your total gross wages were running at about 25% of collections, for example, last year and they are 23.5% now (because your collections grew) then you are in a position to give raises.

If staff salaries have crept up to 26% or 27%, then it’s time to hold off until your practice revenue catches up.

Using this very simple method, you can keep the biggest chunk of your overhead (staff wages) under control.

Incentives:

About one third of dental practices have team incentives. When they work they can work beautifully. They can really pull a team together and lead to greater production. Some of you have been burned by incentives or are jaded about them. The key thing is that if you have set up an incentive with the staff for practice growth you have to have a plan for growth.

You, as the leader of the practice, have to quarterback that plan. Incentives are not indicated and will fail if the staff is at each other’s throats, there is no realistic plan to grow the practice and the Doctor doesn’t do his/her part to lead by example.

Agree? Disagree? How do you handle leadership and staff raises?

Post your comments!

Then give me a call at 952 921 3360 to discuss these or other issues in your practice. Please call with confidence. I consider this a professional-level discussion.

Check out what your colleagues are saying about us.

’til next time...