Mega Dental Practices the New Dentist Reality?

Dentist Plans “Disneyland of Dentistry”

Dr. Derek Thompson, a 37-year-old Washington state dentist, has set his sights on building the biggest dental practice he possibly can. In fact, he’s gone so far as to call the new facility (which will cover a whopping 25,000 square feet) “the Disneyland of dentistry.”

And what would Disneyland be without entertainment? Thompson plans to delight children with games and an aquarium – oh, and with giant sculptures of prehistoric animals as well. Adults will be able to enjoy free internet access and deluxe coffee drinks.

Dr. Thompson started his career with a more traditional dental practice. Apple Valley Dental found success by targeting the same patients that many other practices try to avoid: those with Medicaid coupons. He and the practice’s three other dentists have a support staff of 30. The practice has expanded rapidly, doing some $1.4 million worth of Medicaid business in 2006.

Thompson’s business model focuses on treating lots of patients (many of them low-income) with lots of tooth decay. And Washington’s Yakima county has no shortage of such patients.

Creekside Dental serves the same population. One of the practice’s doctors, Dr. Shane Smith, explains that the clinic treats 200 patients a day, spread between five dentists and 22 treatment rooms. To handle such a high volume of patients, much of the prep work is performed by dental hygienist and assistants. (In fact, the state legislature recently introduced a new class of dental professionals, expanded function dental auxiliaries, whose responsibilities will be just below those of hygienists.)

Currently, some 85% of dental work is performed by a traditional dentist with his or her own practice. However, as economic realities change, more and more practices will have to examine ways to decrease expenses and increase profitability.

Dr. Thompson is confident he’ll be ahead of the curve. His new 25,000-square-foot facility will have 28 patient rooms, though he’s only planning to use 15 of them in the beginning.

Many dentists are critical of high-volume dental practices, calling them “dental mills” or “assembly lines.” However, Thompson shrugs off this criticism. “Is it a mill because we’ll accept children who need help?” he asks rhetorically.

Being the vanguard of a new era in dentistry is not without its risks. However, Thompson’s competitors were diplomatic when asked about his strategies. “Derek Thompson is a promoter, and you need promoters,” said one. “He’s doing a completely different thing,” offered another.

Thompson himself was less conciliatory. “We’ve destroyed every other clinic in town on services,” he boasts. “This is competitive annihilation. You’re seeing a changing of the guard.”

In total, what does this all mean? Mega practices are nothing new. Las Vegas has been running 24-hour practices for casino and hotel employees for at least ten years. Entertainment for kids has always been big in the pediatric dentistry market. Giant dinosaurs are just the next step. The only thing I’m unsure of is highly-caffeinated patients from the deluxe coffee drinks… That could be a problem in the making!

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Patients’ Funniest Excuses

Classic Patient Excuses for Missing Dentist Appointments

We did a survey asking dentists about the funniest excuses they’ve heard from patients for missing appointments. The clear winner was the toothache defense: “My tooth hurts too bad to get out of bed.”

Other highlights include, “My windshield wipers aren’t working and it might rain,” “I had to go shopping for my daughter’s bat mitzvah dress,” and “I went a movie instead.”

Here were a few more classics from dentists:

  • “A model doing a photo shoot said she was bitten by a lion. A cop was involved in a shoot out.” (New York endodontist)
  • “The patient was in jail!” (Virginia dental office worker)
  • “One patient wanted to know if his insurance would cover the broken appointment fee!” (General dentist)
  • “We always document patients’ excuses when missing an appointment. Sometimes the same grandparent passes away unexpectedly two or three times in the same year!!” (Texas dentist)
  • “‘I have a hangnail.’ Also, ‘My dog has diarrhea.'” (North Carolina dentist)
  • “‘The goats got loose!'” (Maryland pediatric dentist)
  • “‘My dog ate my appointment card.'” (Arizona dentist)

Have more excuses to share? Post them here! Plus, check out the full results

Dental Management & Marketing: Fun – or No?

Dental management & marketing - responsibilities and enjoymentDentists are split over dental marketing and management — almost half hate those responsibilities, but just as many say they sometimes enjoy them.

“I hate the management, but like the marketing,” said one dentist.

In this survey, 43% said they sometimes enjoy dental management and dental practice marketing, 16% say it’s not the best and not the worst, and 41% absolutely hate it.

  • “I like patient education and motivation.” (Endodontist)
  • “I like the dental surveys and hearing what other dentists are thinking.” (New York dentist)
  • “I enjoy bringing out the best in the team and coming up with a marketing plan that works!” (California dental professional)
  • “I love the marketing; it is fun and profitable. Dental websites are essential, and I have many.” (Illinois sleep apnea & TMJ dentist)
  • Internal dental marketing, where my patients tell their friends about the appointment they had at our office, is what I prefer most.” (Wisconsin dentist)
  • “I don’t like that we have to advertise, but the general public has been so brainwashed to accept marketing that we are almost forced to do some form of marketing in order to stay competitive.” (Florida dentist)
  • “I wish I could have someone buy my practice and do the management! I have been told often that I am an excellent manager, but it is not my favorite part of practice ownership. I never seem to get a total break.” (Alabama dentist)

Read more: Enjoying Dental Marketing & Management Dentist Responsibilities

Periodontal Examinations: Dentists Recommend More Than 1 a Year

periodontal disease Dentists perform periodontal examinations once a year, we found in our recent survey, with some dentists preferring to do this procedure twice a year or more.

In fact, 14 percent of the dentists we surveyed are likely to recommend periodontal exams every three months.

“It should be done every time the patient comes in even if they see the dentist,” advised one dentist, “Generally, the patient should be seen 4 times a year.”

The respondents to this survey tended to perform periodontal examinations at least once a year.

43% recommend periodontal examinations once a year
33% recommended periodontal examinations at least twice a year
14% recommend periodontal examinations four times a year
9% recommended periodontal exam frequency on the need of their patients

Here are some comments from dentists:

“For periodontal maintenance complete charting should be done every three months.” (Florida periodontist)

“We probe at each cleaning visit, so the frequency varies based on the needs of the patient, ie: either 4x, 3x, or 2x per year.” (Arizona dentist)

“I recommend 3 to 4 times per year depending on the patient that I have diagnosed with having a case type III or higher.” (Illinois dentist)

“For the average healthy patient – once a year. For the patient with active periodontitis – every appointment.- For the patient with perio who has been been controlled for at least a year – annual full probes, and spot probes at other appointments.” (General Dentist)

“This all depends on the patient’s periodontal health. We do periodontal probings at each new patient exam and all recall/recare appointments with the RDH.” (Kentucky dentist)

“A four-month recall for adults is best!” (Virginia dentist)

“If a patient has aggressive periodontitis, we probe more frequently, and have the periodontist check the patient annually as well.” (Texas dentist)

“My hygienists probe at each hygiene appointment –every 3-4 months for perio patients.” (General dentist)

Read more: Periodontal Exams Should Be Done Every Time A Patient Sees The Dentist.

Dentists Turn to Central Call Centers To Market New Dental Patients

Dentists Turn to Central Call CentersWhen it comes to assisting new dental patients, some dentists have turned to dental call centers to improve their exposure in the patient community.

It used to be that when a dentist opened a new dental office, his or her ability to market new patients over the phone was limited to a receptionist and an answering machine after hours. Needless to say this was not a very effective way to market new dental patients.

The Wealthy Dentist conducted a survey to ask dentists what they think about utilizing a highly trained central call center to answer new patient phone calls or to talk with patients when the office is closed.

47% of the dentists surveyed were excited about the idea of a central call center. Another 21% were interested in the idea for when their office is closed. 7% liked the idea for new patients only, while 25% didn’t like the idea at all.

As usual, our dentists had a variety of responses to the idea of a central call center. Several dental practices are already using them. Below is what they had to say.

Love the idea –

“An excellent idea! I hope someone offers this service. It would be ideal if the service could connect with the office’s PMS, (practice management system), so appointments could actually be scheduled.” (Florida dentist)

“Already using Ultimate Phone Consierge. Excellent results 140+ phone calls per month 15-31 patients scheduled.” (Pennsylvania dentist)

Depends on the service –

“I have 4 practices and am ready to do it myself, but if it can be done better… I am all over that!” (Ohio dentist)

“I would have to be convinced for the new patient calls.” (Texas dentist)

Depends on the training –

“If they are highly trained I would support it, but I doubt seriously you are going to find ‘highly trained” in dental field working in a call center . . . something is wrong if they are.” (General dentist)

“Who trains? Where will they be located? Is it National?” (Minnesota dentist)

“They would need to be able to make appointments. “ (New Jersey dentist)

Depends on the cost –

“It must be comparable in fees with regular services except better for new patients.” (California dentist)

“Possibly interested. Obviously would depend upon the cost involved.” (Illinois dentist)

Depends on size of the dental practice –

“I think it is great for large offices, but for small single doctor practices probably not cost efficient.” (Rural Tennessee dentist)

“We are in a very small town; people expect to speak to someone they know. I do hate missing calls when we are closed.” (Rural Texas dentist)

Absolutely not –

“No way. Anything less than a direct contact with me or my staff would be inappropriate and delay treatment. I provide a phone line for emergencies and a sub when needed.” (Indiana dentist)

“I think it is worse to call somewhere and just be told that they are only an answering service and can’t help you vs. leaving a message if the office is closed. If new patients are calling our office during business hours, we better be answering the phones ourselves! ” (Michigan front-office employee)

“In this day and age with instant access via e-mail, cell phone or pager, why would anyone want to do this? The call center would probably have to get in touch with the doctor via e-mail, cell phone or pager so why even have it?” (Illinois dentist)

“I would rather pay to have my staff trained and then let patients be able to put a face with a name and a voice when they come to my office. An answering service is valuable for when the office is closed and no one is here to take calls.” (Kansas dentist)

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