How Do You Attract Practitioners to Under-Served Areas?

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Luring hygienists to a practice in rural Maine has proved challenging. Though there’s been a lot of interest in the ads they’ve posted, very few candidates are actually interested in the “downeast lifestyle” that Machias, Maine, offers.

Recruiting Hygienists from Across the State

So the Sparagas decided to try another hygienist recruitment strategy - and it’s proven to be surprisingly controversial. For $35, the State Bureau of Records gave them a mailing list of all licensed health care providers in the state of Maine.

Interestingly, roughly a third of the listed RDHs used their current office as their personal mailing address. As a result, the Sparagas received a few irate letters from dentists questioning the moral and ethical appropriateness of soliciting their hygienists. As one doctor wrote,

I feel compelled to write you today with a serious concern we have regarding a mailing each of our hygienists received from you (at our office address no less!) inviting them to join your team at Machias Dental.

Our reaction to this solicitation initially was to laugh at it, though as I thought more about it, my feelings went from amusement to outrage to bewilderment. This is not the way we “do things” in Maine, so where was this coming from? I know your reputation and the reputation of your practice is outstanding, so I’m confused as to why this type of mailing would make its way to our office. I can only assume this was an oversight mistake on your part. I suppose this can happen. But did hygienists at other dental offices in the state also receive this letter? I certainly hope not!

Please either respond to this email or call me to discuss this matter further. I would like to put my mind at ease that the collegial culture Maine dentists have traditionally enjoyed is not on the decline! I look forward to hearing from you soon.

The Doctor Defends His Strategy

Dr. Sparaga’s response was both diplomatic and sympathetic.

Thank you for your concerns about our recent mailing to all the hygienists in the state in our quest for a new hire. I’m sorry if you have taken this personally and it has offended you.

As we all know, it is most difficult to attract qualified personnel to live here, and we’ve resorted to a mass mailing to Maine RDH’s seeking someone looking for a change not only in jobs, but in lifestyle. With a practice in an underserved rural area, we do not have the luxury of putting an ad in the local paper, hoping to attract a provider, someone looking for a change.

The state considers the lists of practitioners, medical and dental, as public information, rather than personal. With the dental manpower shortage in the rural areas, the state bureau of records is most willing to give out the list of all their medical and dental personnel especially if it helps remedy the maldistribution of manpower toward these areas. I would suppose when considering the current access to care issue, it might be considered unethical to restrict such information. For whatever reason, it would appear that many of the RDH’s listed their dental office of employ as their contact address, instead of their personal residence. We could not tell whether these addresses were of their home or office. And of course, I assume that these healthcare professionals will judge for themselves whether our offer of new horizons is offensive to them. I would propose that the offer might mean more to them than a concern for collegiality amongst us dentists.

Thank you for understanding that a mass mailing was the only way we could reach out to Maine’s RDH’s and supply more healthcare manpower to this underserved area.

But in addition to the angry letters, they also received several excellent replies from remarkable candidates. The Sparagas are happily interviewing those RDHs now.

Jim Du Molin’s Two Cents

I am squarely on Dr. Sparaga’s side. There’s nothing wrong with a doctor who is looking to hire hygienist taking a state mailing list and sending out a letter. It is clear to me that there are no ethical issues here. The state mailing list is public information, and I’m not going to fault Dr. Sparaga for using all the resources available to him.

Registered dental hygienists are a scare resource. Given the realities of supply and demand, that means there will be competition for RDHs. If you’re a dentist and you need a hygienists, you will do whatever you can and pay whatever you need to in order to find a hygienist. It’s easier for dentists to raise their prices than function without a hygienist.

In addition, there are lots of reasons why RDHs (or anyone) might switch jobs. No matter how great a job is, sometimes people need a change of scenery. People are going to do what’s in their own self-interest. If you want loyalty, get a dog!

So to the doctor who complained, I would say, “If you’re taking care of your hygienists, then you have nothing to worry about.”

What do you think? Post your comments!

Introducing Botox in Your Dental Practice
By Catherine Maley, MBA

More and more dental practices are offering Botox and other aesthetic services to their patients. But introducing Botox demands more than just clinical training; it also requires some marketing know-how.

I’ve made a career of examining the unique needs and desires of aesthetic patients. Offering Botox is not the same as offering root canals, and you shouldn’t approach the two in the same way!

This week, I’ll tell you how to prepare your staff and prepare your office. Next week, we’ll talk about how to reach patients with easy marketing strategies.

Prepare Your Staff: Turn Them into Rock Stars!

Be sure your staff is on board and committed to your success with this new addition to your practice. They can make or break the success of this venture, so you need their 100% support.

Meeting with Your Team

• Let your staff know what your vision is and where they fit into it.
• Get their commitment to help you make this successful.

Your staff will perform better when they have quantifiable numbers to strive for. It’s important these be individual goals with numbers and time lines attached to them so the staff person knows what is expected of them and when. The more specific the goal, the better able they will be to obtain it.

Examples of Goals

• Book 10 Botox appointments per week
• Sell $5,000 of aesthetic services per week

It’s human nature to perform better when there is a “carrot” at the end of the stick. The easiest way to get your staff to be at their best when they are on the job is to reward them for a job well done and then reward them even more for going the extra mile.

• Incentives keep your staff motivated and on top of their game.
• Offer them free Botox or Botox at cost so they will be your front line walking/talking testimonials.
• They could wear lapel pins that say “Ask Me About Botox.”

And be sure your staff knows you appreciate them. Thank them often. Hold regular staff meetings. Discuss what’s going on and what’s new. Get your staff’s input on what’s working and what needs to change so they feel they are part of the team. They will be more receptive to helping you reach your goals when they feel respected and valued by you.

Prepare Your Office: Signage Is a Beautiful Thing

Will someone who walks by or steps into your office know what sort of services you offer? In-house signage helps spread the word and will ensure that every single patient who walks through your door knows you now offer Botox.

Make Patients Aware of the Services You Offer

• Clear signage
• Digital photo albums in reception area and exam room
• Framed eye-catching posters in restrooms and strategic places on the wall

Overwhelmed Yet?

Don’t be! In addition to being rewarding and profitable, it also doesn’t have to be that hard! I’ll be back next week to discuss strategies for attracting cosmetic patients.

Catherine Maley, MBA, is the author of Your Aesthetic Practice: A Complete Guide: What Your Patients Are Saying. As a speaker and consultant, she helps doctors market themselves to cosmetic patients.

For free tips, resources and strategies, visit CosmeticImageMarketing.com or give Catherine a call at (877) 339-8833.

Dentists Dropping Dental Insurances

Dentists are sick and tired of dental insurance companies dictating fees and treatments. Just over half of the dentists in this survey said that they had mostly or completely stopped accepting dental insurances.

“We still work with hundreds of insurance companies by filing the paperwork, etc,” said an Ohio dentist. “But by not being ‘in-network’ on any plan, we get paid for what we do.”

Dropping insurance can raise a dental practice’s bottom line, but it can also cost them patients. One-third of respondents felt that dropping insurances was not a financially realistic option for them.

Here are some more thoughts from dentists:

• “Insurance has ruined medicine.” (New Jersey dentist)
• “I have a brand new office and a lot of debt. Being a preferred provider for insurance companies is not ideal long-term, but it is necessary now to get people in the door.” (Indiana dentist)
• “If I dropped insurance, I’d be cutting ties to 85% of my patient base!” (Endodontist)
• “Those who can’t be bothered with insurance are self-serving people who have lost sight of the service part of being a professional.” (California dentist)
• “If all dentists dropped all insurances, then ALL dentists could collect their fees in full from everyone.” (Virginia dentist)
• “Dental insurance is a joke.” (Alaska dentist)
• “Some of the contracted insurance patients are the most demanding and unappreciative.” (Minnesota dentist)
• “We have no contract with any insurance companies. It is a great benefit to have control of our fee structure.” (General dentist)
• “I have dropped all insurance plans, and patients pay us first. However, we will fill out paperwork and fight for the patient to get the benefits they are owed.” (Washington dentist)
• “Free At Last!!” (Minnesota dentist)

Post your own thoughts on dental insurance, or check out the full survey results to read stories of dentists who have successfully dropped insurances.

Dentist Ruffles Feathers with Mailing List Strategy

Dr. Jim Sparaga is constructing a new dental facility in rural Maine. He’s going to need some dental hygienists for his expanded practice, but finding them has proven more difficult than expected. He came up with a great recruiting strategy - but a few Maine dentists were less than thrilled.

Learn more by watching the video below. Or, if you prefer the written word, you can read Jim’s editorial about the difficulty of recruiting dental hygienists.

Discipline Problems Down, Test Scores Up

A U.K. principal’s unusual plan to motivate students may have raised the wrath of the British Dental Association, but it seems to be working.

Three years ago, Andrew Sheppard grew frustrated with discipline problems at Norfolk’s Recastle Furze Primary School. He decided that the school’s 240 pupils would be rewarded for good behavior with chocolate bars.

The school hasn’t had a single suspension in the past three years. In addition, test scores have gotten higher. The rewards program has been expanded to include a Christmas dance, Easter eggs, and barbecues.

“I feel vindicated,” said Dr. Sheppard. “A 40-pence bar of chocolate is not going to make children obese or rot their teeth. It is providing them with an incentive that they value. Some people said that I should give them a carrot instead, but they are not donkeys.”

Read more

Dentists’ Hands Might Be Dirtier Than You’d Expect

A study of New York dental practitioners found that most are not following the hand-cleaning recommendations of the CDC.

Published in July's Journal of the ADA, it found that 19% of dentist respondents don't wash or disinfect their hands between patients. Even more surprising, some 20% reported that they don't wear gloves at all.

The good news? When it comes to keeping their hands clean, dentists don't seem to be doing any worse than their physician colleagues.

With hand hygiene like this it's enough to make you wonder which century we're in!

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Government Dental Plan Soliciting Bids from Offshore Labs

The US government employs several million individuals. As their employer, it’s the government’s job to provide health care coverage to all of these people: soldiers and politicians, maintenance workers and administrators.

Health care benefits for federal employees are managed through the U.S. Office of Personnel Management (OPM). There are seven insurance carriers that provide supplemental dental and vision benefits under the Federal Employees Dental and Vision Insurance Program (FEDVIP). Four of these are nationwide plans, and the other three provide coverage in certain regions.

• Aetna Life Insurance Company
• Government Employees Health Association, Inc. (GEHA)
• MetLife Inc.
• United Concordia Companies, Inc.
• Group Health, Inc. (New York state area)
• CompBenefits (Southeastern US)
• Triple-S, Inc. (Puerto Rico)

I have heard that one of these dental insurance companies has been soliciting bids from offshore dental laboratories. They’re looking to provide a low-cost product option to their network of providers, and it’s nearly impossible to compete with the prices offered by some foreign labs. ($29 dental crowns from China, anyone?)

There are any number of reasons why this might be cause for concern, but chief among them is the Buy American Act. Passed in 1933, this legislation states that the US government should preferentially purchase American products over foreign-made goods. Though exceptions can be made for price or quality issues, the basic principle is that America’s government should patronize American businesses whenever possible.

With reports surfacing that some dental crowns and bridges may be contaminated with lead, there are also health concerns about outsourcing dental restorations. The FDA doesn’t directly regulate overseas labs, and the National Association of Dental Labs warns that there are significant holes in the FDA’s oversight of dental lab manufacturing.

And yet we have GEHA shopping for cut-rate bids from foreign dental labs… Am I the only one who sees a problem here?

Post your own comments

Dentists Agree: It’s Better To Be Your Own Boss

Three-quarters of dentists in our most recent poll said they would rather be their own boss than work for someone else. But with freedom comes responsibility, and some associate dentists prefer focusing more on practicing dentistry and less on practice management.

Specialists were unanimous: being your own boss is better. Not a single dental specialist responding to this survey said they would prefer to be an associate. On the other hand, 28% of general dentists think associateship is an excellent plan.

What do dentists think?

• “I didn’t go to dental school for four years to be somebody’s employee!” (Oregon dentist)
• “I would rather have the headaches of an owner than to be subject to the whims of an employer.” (California dentist)
• “Initially it is good to get some experience as an associate.” (Arizona dentist)
• “At some point, I want to change my role and be an employee without the worries of the business.” (Tennessee dentist)

Read the complete dental associate dilemma survey results, or post your thoughts about being your own boss

Can Braces Be Both Effective and Attractive?

A new survey reveals a sad truth: the most effective orthodontic braces are also considered the ugliest.

Traditional metal braces were seen as the least attractive, and those with no visible metal were rated as most aesthetically pleasing. Unfortunately, the more attractive options tend to be harder for dentists to work with and/or move patients’ teeth less effectively.

Read more

Move-in Date Looms for Machias Dental

Machias Dental’s new facility [click to enlarge]

It’s full speed ahead for Jim and Kathy Sparaga as they put the finishing touches on their brand-new dental practice facility in Machias, Maine.

At times, there are ten men working on the building’s interior at once. The basement is a maze of pipes and wires. The sheetrocking stormtroopers are making everyone nervous; will they close up the walls before the equipment gets installed? Inevitably, there will be a number of wall panels coming off to get the details installed before the process is over. Despite a well-reputed dental architectural firm and a good local architect, there have been many omissions and undiscovered conflicts of materials and placements.

Making sense of 33,800 feet of cable [click to enlarge]

“It takes 4 hours every day for Kathy to unravel the issues and do the research required by the general contractor,” sighs Jim. “I just do the dentistry.”

The move-in date looms. Several new hires are joining the practice. Their new associate is about to arrive. They’re wrestling with wallpaper and furniture. Their resident computer whiz is connecting 33,800 feet of cable. (Yes, that’s over six miles of cable.) And the Sparagas couldn’t be more excited.

Catch up on the dental practice construction story in Machias, Maine, and check back for further updates.