Beyond the DOW: Recent Economic Survey of Dentists
I recently completed my fee, wage and economic surveys for the Upper Midwest. Over 300 practices responded.
33% of the Metro practices surveyed said they were up this year, 46% were down and 21% even. For Outstate offices (including the edges of North and South Dakota, Iowa and Wisconsin) the outlook was a little better. 41% of the practices said they were up, 28% down and 31% even.
17% of Metro Area practices felt the economy is not a factor at all but 73% felt the economy had a “moderately negative” effect. 27% of Outstate offices said the economy hasn’t affected them at all and 70% said “moderately negative”.
29% of Metro Area offices have given or plan to give raises this year and 41% said they won’t. In Outstate offices 54% have given or plan to give raises this year with 24% saying that they do not plan to give raises (the rest variable or not sure).
There is no question that the current economy is having an impact on practices. Just three years ago “5% growth” was more or less the rule.
I believe in management. Whenever we see Doctors take actual steps to improve, they do improve! Things just don’t come as easily as they might have in previous years.
Feel like talking about your situation? Got some ideas? I have a standing offer of a free 20 minute consultation that allows you and I to get to know each other and share information that will be beneficial to both of us. Call me at 952 921 3360.
’til next time...
Monday, November 9, 2009
Monday, October 12, 2009
From our newsletter back in July of 2006
Don’t Let Your Office Manager Retreat!
I thought this subject worth repeating...
At a certain point when the Doctor’s practice is large enough (or Doctors are practicing a group) there comes a time when they want a true office manager. They want someone to handle all the non-clinical aspects of the practice… especially staff hassles (scheduling vacation hours, interviewing, disciplining and generally calming the waters).
Yet, we see many office managers who have “retreated” (physically and figuratively to an area removed from the action). Perhaps they started at the front desk and were promoted to the office manager position. They get involved in the practice numbers (bookkeeping, payroll, insurance processing, credit follow up) and after a while are so busy managing numbers that they’re not managing people. Their front desk skills may have even gone dormant and they might be all but invisible to the treatment staff. Then, the staff hassles and other business matters end up back in the Doctor’s lap.
How does this happen? Often the Doctors are their own worst enemy in this regard. They set someone up to be an office manager but at the first unpopular decision (let’s say the manager did not grant your senior hygienist her preferred vacation time) the staff person does an end around and goes to the Doctor directly. It’s at that point you determine whether or not your office manager is going to be a true office manager or a bookkeeper. Do you stand behind your office manager… knowing there will be some flack but knowing that they will be empowered to do what you want them to do, or do you back down and try to be a “Nice Guy” and end up being a nice guy or gal with lots of management hassles you don’t want?
Often office managers do not take the cultivation of their supervisory skills as seriously as they do the numbers. They need to get to courses and read about leadership. They need to get out from behind the desk and walk around the office. This way they can listen to the staff’s problems and requests so they can grant resources as well as give direction. The office manager has to nail down Doctor decisions that need to be made and make sure those decisions are communicated throughout the office so that everyone feels they are in the loop.
Office managers focus on just getting through each day (like we all do). However a good office manager is future focused. Their job is not just to handle the day to day, it’s to help the practice reach its goals. Does your office manager know what your goals are? Do they have a strategy for reaching those goals? Are they reaching beyond the day to day duties each day to implement the gradual worthwhile changes that will help your practice excel? Are they actively looking for ways to cut your expenses? Are they totally familiar with computer software so you’re leveraging every application you can? Are they getting a reputation for making sure that decisions made at staff meetings are followed through and people responsible for the various systems are held accountable (and rewarded or not according to their performance)?
Comments or a story you'd like to share? Give me a call at 952 921 3360, email or post a comment. Visit our website for more.
’til next time...
Don’t Let Your Office Manager Retreat!
I thought this subject worth repeating...
At a certain point when the Doctor’s practice is large enough (or Doctors are practicing a group) there comes a time when they want a true office manager. They want someone to handle all the non-clinical aspects of the practice… especially staff hassles (scheduling vacation hours, interviewing, disciplining and generally calming the waters).
Yet, we see many office managers who have “retreated” (physically and figuratively to an area removed from the action). Perhaps they started at the front desk and were promoted to the office manager position. They get involved in the practice numbers (bookkeeping, payroll, insurance processing, credit follow up) and after a while are so busy managing numbers that they’re not managing people. Their front desk skills may have even gone dormant and they might be all but invisible to the treatment staff. Then, the staff hassles and other business matters end up back in the Doctor’s lap.
How does this happen? Often the Doctors are their own worst enemy in this regard. They set someone up to be an office manager but at the first unpopular decision (let’s say the manager did not grant your senior hygienist her preferred vacation time) the staff person does an end around and goes to the Doctor directly. It’s at that point you determine whether or not your office manager is going to be a true office manager or a bookkeeper. Do you stand behind your office manager… knowing there will be some flack but knowing that they will be empowered to do what you want them to do, or do you back down and try to be a “Nice Guy” and end up being a nice guy or gal with lots of management hassles you don’t want?
Often office managers do not take the cultivation of their supervisory skills as seriously as they do the numbers. They need to get to courses and read about leadership. They need to get out from behind the desk and walk around the office. This way they can listen to the staff’s problems and requests so they can grant resources as well as give direction. The office manager has to nail down Doctor decisions that need to be made and make sure those decisions are communicated throughout the office so that everyone feels they are in the loop.
Office managers focus on just getting through each day (like we all do). However a good office manager is future focused. Their job is not just to handle the day to day, it’s to help the practice reach its goals. Does your office manager know what your goals are? Do they have a strategy for reaching those goals? Are they reaching beyond the day to day duties each day to implement the gradual worthwhile changes that will help your practice excel? Are they actively looking for ways to cut your expenses? Are they totally familiar with computer software so you’re leveraging every application you can? Are they getting a reputation for making sure that decisions made at staff meetings are followed through and people responsible for the various systems are held accountable (and rewarded or not according to their performance)?
Comments or a story you'd like to share? Give me a call at 952 921 3360, email or post a comment. Visit our website for more.
’til next time...
Monday, September 14, 2009
Delta gets snout rapped in Rhode island
As reported in DrBicuspid.com on July 2nd, a new law in Rhode Island prohibits insurance companies from limiting the fees of dental procedures that they do not cover. Nationally, Delta Dental has been attempting to implement a new feature of its Premier and PPO provider organization contracts that require dentists to honor their contracted fees for services that are not covered by a subscriber's plan. This includes dental work performed by participating dentists even if not covered because the patient exhausted their annual maximum.For years now in Minnesota, Doctors have had to take Delta write offs even after the maximum was reached. Fees on non-covered services haven't been subjected (yet).
None of us like the idea that Delta limits fees for non-covered services (like veneers and bleaching). For one thing, how do you set a fee for such procedures when there can be such a wide range of materials and lab costs?
There are many other states where Doctors can get their full fee (not have to do Delta write offs) once the patient's maximum has been met. The idea is that the insurance helps cover the first $1,500 or so but after that the patient is responsible. When talking with other management consultants and hearing about their strategies with Doctors in other states, they have been more willing to accept PPO discounts because they can get their full fee once the insurance maximums are reached. I think all of you heard the argument that Delta and other insurance companies should have their maximums increased to $5,000 to have the equivalent coverage of what they had 20 years ago or so. In this context it's almost good that the maximum hasn't been moved up.
The Rhode Island legislature voted for this because they felt that it was unfair to patients who didn't have insurance coverage to in fact subsidize (indirectly) patients who had insurance with big write offs. Also, they felt that could affect access for patients. Rhode Island has neighboring states where the fee schedules are not as low and Delta write-offs are not as much. That gives incentive to new Dentists to not practice in Rhode Island.
Hopefully, this marks a turning point in Delta’s ability to continue to implement these policies nationwide. Maybe some day we can turn it back in Minnesota.
We have more news, free for the reading, on our website. If you have something on your mind, give me a call at 952 921 3360.
’til next time...
Monday, August 17, 2009
You Are Going to be Spending $50,000+
So Don’t Blow It!
According to our 2009 survey, as of this year more than 50% of dentists (54%) now have digital x-rays. Bringing computing to the operatories entails considerable expense. Usually as digital x- rays are added, other technologies are added or upgraded too such as intra-oral cameras, patient education software, and digital record keeping. Financially speaking, this often comes out to over $12,000 per treatment room.
The pace of bringing digital technology to the operatories is increasing. Many of you will be making these investments over the next three to four years.
Since we have and will have many clients who will be investing over $50,000, $100,000 and up in this technology, I have two main suggestions to get more bang for your buck:
That is, if you buy intra-oral cameras, you want to make sure they’re used. Half of intra-oral cameras are used less than five times per week.
Almost every office with intra-oral cameras struggles with getting them to be part of the hygienists’ routine (and the hygiene department is where they can have the greatest benefit in helping the patients understand their problems and value your solutions).
Lots of offices have the capability to do chartless record keeping but less than 10% are truly chart free. With this technology in the treatment rooms the hygienist (for example) can post charges, set their next appointment, use the intra-oral camera, enter the treatment plan and use the patient education software. However, usually only two or three out of these five things are routinely done. Most dentists have neither the inclination or the time to keep up on computer software and hardware. I have seen many installations where there was no competitive bidding whatsoever. Or, once the equipment was installed it was glitchy... the digital x-rays would go down in one room now and then, the intra-oral cameras wouldn't work well, there would be server problems, wires and cables in the way, poor monitor placement, etc. With technology the devil is in the details: video cards, cabling, monitors, monitor position, support, warranties, digital x-ray choices, etc.
There are reputable and competent technology installation firms out there, such as Erickson Technologies 651-452-6758 and Sunset Dental Technologies 612-326-8693. However, many clients have used the local “computer guy” or just bought the hardware from the software vendor or supply company.
I recommend you check out Ted Takahashi with T2 Consulting 952-891-5177. Ted does not sell anything and makes no commission or "finder fees" on any technology recommendations. What he does do is draw up the specs so you can get competitive apple to apple bids. He knows what works and he’ll help you pick the right stuff. And, furthermore, you'll be assured that the installation will be truly functional from day one. He has planned over 750 installations nationally, and he is based out of Eagan, Minnesota.
If you're about to make a $50,000+ purchase, I strongly recommend you talk to Ted and ask him directly this question: “Why should I hire you?” Anyone that is selling you equipment will tell you that Ted’s services aren’t necessary that they’ll make sure you get a good deal and the specs are right anyway. I’ve had clients save many thousands of dollars by making sure with a new facility or facility upgrade that they had competitive bidding. Don’t let the suppliers take your business for granted! There almost always is some bargaining room if you go through a bidding process. You need someone in your corner who knows the technology.
I've made a special partnership arrangement with T2 consulting for an 8% reduced fee for active APM clients. As always, we stand behind our work and guarantee you'll be satisfied. For more information, go to our website and see Mr. Takahashi’s article, “The Chicken or the Egg...which comes first?”
Read more at no charge at our website where you can also take advantage of my free, 20 minute consultation. This is a strictly professional offer without pressure to sign up for anything more. It’s chance for you and I to get to know each other and we both stand to benefit. Go to our site or call 952 921 3360.
’til next time...
The pace of bringing digital technology to the operatories is increasing. Many of you will be making these investments over the next three to four years.
Since we have and will have many clients who will be investing over $50,000, $100,000 and up in this technology, I have two main suggestions to get more bang for your buck:
- Get professional help in specs and get bids for the equipment— “cost control”
- Commit to additional training so you get “result control.”
That is, if you buy intra-oral cameras, you want to make sure they’re used. Half of intra-oral cameras are used less than five times per week.
Almost every office with intra-oral cameras struggles with getting them to be part of the hygienists’ routine (and the hygiene department is where they can have the greatest benefit in helping the patients understand their problems and value your solutions).
Lots of offices have the capability to do chartless record keeping but less than 10% are truly chart free. With this technology in the treatment rooms the hygienist (for example) can post charges, set their next appointment, use the intra-oral camera, enter the treatment plan and use the patient education software. However, usually only two or three out of these five things are routinely done. Most dentists have neither the inclination or the time to keep up on computer software and hardware. I have seen many installations where there was no competitive bidding whatsoever. Or, once the equipment was installed it was glitchy... the digital x-rays would go down in one room now and then, the intra-oral cameras wouldn't work well, there would be server problems, wires and cables in the way, poor monitor placement, etc. With technology the devil is in the details: video cards, cabling, monitors, monitor position, support, warranties, digital x-ray choices, etc.
There are reputable and competent technology installation firms out there, such as Erickson Technologies 651-452-6758 and Sunset Dental Technologies 612-326-8693. However, many clients have used the local “computer guy” or just bought the hardware from the software vendor or supply company.
I recommend you check out Ted Takahashi with T2 Consulting 952-891-5177. Ted does not sell anything and makes no commission or "finder fees" on any technology recommendations. What he does do is draw up the specs so you can get competitive apple to apple bids. He knows what works and he’ll help you pick the right stuff. And, furthermore, you'll be assured that the installation will be truly functional from day one. He has planned over 750 installations nationally, and he is based out of Eagan, Minnesota.
If you're about to make a $50,000+ purchase, I strongly recommend you talk to Ted and ask him directly this question: “Why should I hire you?” Anyone that is selling you equipment will tell you that Ted’s services aren’t necessary that they’ll make sure you get a good deal and the specs are right anyway. I’ve had clients save many thousands of dollars by making sure with a new facility or facility upgrade that they had competitive bidding. Don’t let the suppliers take your business for granted! There almost always is some bargaining room if you go through a bidding process. You need someone in your corner who knows the technology.
I've made a special partnership arrangement with T2 consulting for an 8% reduced fee for active APM clients. As always, we stand behind our work and guarantee you'll be satisfied. For more information, go to our website and see Mr. Takahashi’s article, “The Chicken or the Egg...which comes first?”
Read more at no charge at our website where you can also take advantage of my free, 20 minute consultation. This is a strictly professional offer without pressure to sign up for anything more. It’s chance for you and I to get to know each other and we both stand to benefit. Go to our site or call 952 921 3360.
’til next time...
Monday, August 3, 2009
Keeping you informed
When you are an Advanced Practice Management client you are automatically plugged into the data base and experiences of 250 Upper Midwest offices.
Our clients tell us the number one reason they hire us is "for an informed third party perspective" and we are very serious about keeping you well informed.
So, we continue to add to our website. On it we have data on Fee, Wage, Overhead and Technology surveys as well as our articles and seminars. We are soon going to add an area for "Resources" where we will list vendors that we know to be reliable.
’til next time...
Monday, July 6, 2009
Is Midwest Dental a viable transition option?Most often, when you think of multi-location group practices, “Metro” and “Park” come to mind. However, Metro and Park have now combined (as American Dental Partners affiliates) and have 57 practices. Midwest Dental, out of Mondovi, Wisconsin has 67 practices (42 in Wisconsin, 10 in Minnesota, 9 in Illinois, 4 in Iowa and 2 in Colorado).
I recently talked to Sean Epp, the Managing Director of Development* for Midwest. Midwest Dental’s business model is different than the other conglomerates because it’s based largely on one- and two-man practices. They see their model as a traditional practice.
For some dentists, Midwest Dental can be a viable transition option. They often employ the selling Doctor so it’s a possibility if you want to sell your practice but still would like to work for a while. Since the big merger a while back there hasn’t been a lot of news out of Park and Metro Dental. They still maintain separate websites. At one time I thought we’d see a diaspora of Doctors and patients but we haven’t seen that happen.
’til next time...
Contact Sean Epp at www.Midwest-Dental.com
I recently talked to Sean Epp, the Managing Director of Development* for Midwest. Midwest Dental’s business model is different than the other conglomerates because it’s based largely on one- and two-man practices. They see their model as a traditional practice.
For some dentists, Midwest Dental can be a viable transition option. They often employ the selling Doctor so it’s a possibility if you want to sell your practice but still would like to work for a while. Since the big merger a while back there hasn’t been a lot of news out of Park and Metro Dental. They still maintain separate websites. At one time I thought we’d see a diaspora of Doctors and patients but we haven’t seen that happen.
’til next time...
Contact Sean Epp at www.Midwest-Dental.com
Wednesday, June 10, 2009
The McGill Advisory quotes me extensively
This is a subscription-only newsletter, well respected in the dental field. Their June 2009 issue quoted me at length about participating in managed care.
What they said: “Almost all practices will benefit more through better management than by [participating in] managed care....”
I couldn’t have quoted myself better.
I can answer your questions about participating in managed care. A free 20-minute consultation is available by calling 952 921 3360.
And many of our newsletters cover the subject. They’re available, free for the reading, on our web site, advancedpracticemanagement.com.
Speaking of our newsletters, another issue is coming up in August. Check the site often for the latest news from the team.
’til next time...
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