How Often Should You Raise Your Fees?

Over time, you may find that you need to modify your fees based upon patient feedback, equipment and supply prices or overhead costs. Routinely raising fees by 3-5% every 10 months has many advantages. When implementing this adjustment, raising every fee by the same percentage across the board is beneficial. I would suggest not wasting time and energy attempting to adjust each fee separately, perceiving possible negative reactions from patients and insurance companies. These perceptions are usually much worse than reality. The adjustments typically go unnoticed by patients, but serve to add significantly to your bottom line.
 
Raising your fees every 10 months gives you an additional fee increase every five years above what a typical yearly increase would provide. Set a reminder on your scheduling software when your next fee increase should occur. Since it is very difficult to institute large fee increases to make up for lost time, doctors who do not raise their fees annually commit themselves to greater overhead percentage and lower profits for the remainder of their careers.
 
It is commonly recommended to raise your fees 5% across the board in order to keep pace with inflation. This fee increase helps defray the costs of investing in new technology for your office and rising payroll expenses. On average, operating costs for the typical practice are advancing at a rate of 3-4% annually. In order to maintain or improve profitability, practice fees must be raised above that level.
 
Being mindful of the economy at large, go easy on fee increases in times of economic downturn. A 3% increase will normally keep pace with inflation during these periods, as overall growth and spending will wane. Though some practitioners will continue to operate with apparent immunity to any recession, most will find practice volume to slow in accordance. The goal is to take the patients along for the long haul, so absorb some of the recessionary pain with them while striving to keep them in your operatories.
 
If you practice in a state which allows resubmission of your fee schedule to Delta on a yearly basis, by all means take advantage of this. I have my office manager keep a note in the software alerting her to the day in which we are able to do this each year. Therefore, every twelve months to the day we submit our fee schedule to Delta reflecting the new, higher fees for the codes we use in our practice. Although Delta does not regularly grant us the full value of the increases we appeal, Delta is required to enter our new fees into its database as those of a provider in our zip code. This ultimately raises the level of approved fees in our area, as Delta bases its fee schedule on a percentile of the overall fees submitted for each zip code.
 
In determining your fees, do not underestimate the value of the efforts you have made to create a unique dental environment for your patients. They value that, and therefore, so should you. You are taking pains to provide high quality care and a comfortable encounter. It takes time to provide exceptional clinical care and service. Low fees and high volume encroach upon that time. Being rewarded for your efforts will allow you and your business to continue to satisfy your patients’ desires and expectations for the best dental experience available.

Treatment Planning for Dental Nightguards

I Don’t Need a Nightguard!

This scenario presented itself in my office just yesterday.  I had a patient who admittedly grinds her teeth and shows moderate to advanced wear on all her teeth.  I have recently lowered my dental nightguard fee in an effort to get more of the patient population in need to schedule this treatment.  Her excuse was that if she had the money sitting around somewhere, she would do it.  I shot a quick glance at her Louis Vuitton handbag resting in the chair and the BlackBerry smartphone she couldn’t resist but to answer and had to wonder.  When she finally revealed that she would be taking a two week vacation to Florida next week, my suspicions were confirmed.  It wasn’t that she did not have the money.  It was that I apparently did not do a sufficient job in convincing her of the value of the nightguard and of her real need for it.
So this begs the question: What do you do in your practice to gain treatment acceptance for occlusal guards?

What Should a Dentist Tweet About?

My dental office has been participating on Twitter for a few months now.  It has become easier to think of tweet ideas, but we are always working to keep a good mix of dental health tips, local events, office news, helpful resources and personal highlights.  I just came across a great article on Rizzo Tee’s blog entitled “The Top 50 Tweets That Businesses Should Be Doing.”  It was a good reminder that people soon tire of hearing about your dental office or their teeth.  While tweets about these subjects must be included, it’s important to engage with your followers. The entire experience will be more enjoyable for you and for those following you.

How to Hire the Right Employee the First Time

In attempt to avoid the need to fire an employee and begin the hiring process all over again, one must make every effort to hire “right” the first time.  With the “two weeks’ notice” standard, we are often left with too little time to hire a new employee.  Rushed interviews and reference checks can lead to poor decision making and settling for an employee candidate who is less than ideal.  Nonetheless, striving to hire right the first time can eliminate headaches down the road. Business coach Eric Herrenkohl speaks to this in his book “How To Hire A-Players.”

Recently, I was given two weeks to hire a new dental assistant when my current dental assistant changed careers unexpectedly.  With the economy and unemployment being what it is currently, I was afforded the opportunity to consider more candidates for this new hire.  Within the first 24 hours of posting a free Craigslist job ad, I had received multiple resumes from qualified individuals.  In order to avoid having to sift through countless resumes from unqualified applicants or applicants who would not be able to satisfy the timing requirements that I needed, I drafted a detailed ad.

In the midst of a busy day of dentistry and practice management, it is tempting to settle for the first warm body to present herself somewhat positively in an interview.  Having read Eric Herrenkohl’s book and knowing from past experience where “settling” had gotten me, I decided to interview several additional candidates even after meeting one that might have been adequate.  In this employment market, we do not have to settle for adequate.

Implementing the right interview protocol and background checks on potential staff members is imperative in the hiring process.  Coming soon to our website is a Resource CD which contains 17 Questions to Ask in an Interview as well as a dozen questions to ask references when a potential hire shows promise.  Please check back to www.dentistrysbusinesssecrets.com for the impending release of this Resource CD and my new book, ”Dentistry’s Business Secrets: Proven Growth Strategies for Your New or Existing Practice.

How Do We Treatment Plan the “Baby Boomer”?

The “longevity” factor of our patients cannot be overemphasized when it comes to our treatment planning.  We would be remiss in our examination process if we were determined to diagnose the pocketbook and not what the patient (read, Baby Boomer) might want.  Calculations for retirement plans are now being performed based upon the expectation that the retiree will live to be 100 years old!  Baby Boomers know this and are trying to plan for the welcomed eventuality that this occurs.  Therefore, they are valuing their teeth for a lifetime and not opting for the extraction as often as I have witnessed in my practice life.  I am reminded of a quote from history,

“Every tooth in a man’s head is more valuable than a diamond.”

Miguel deCervantes, Don Quixote, 1605

Getting to “Yes” for Esthetic Dentistry Treatment

Even though we may want to drive the sale of cosmetic dentistry to our patients, it is generally more profitable to allow the patient to take the wheel in this process.  The idea is to balance the notion of investigating what the patient really wants without “selling” the patient something she does not want. Fleshing out true desires is an art.  I have been disappointed at times when the desire for esthetic improvement was primarily my own and not the patient’s.  When this is the case, the patient tends to be even more critical of the work and more difficult to please.  Tread lightly with the patient who was actually “sold” cosmetic dentistry, I would caution.  Be sure to present all available cosmetic improvement options you can provide and then let the patient “buy” the treatment from you.

Should You Require a Credit Card to Secure New Patient Appointments

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At first glance, the idea of requiring a credit card on file in order for a new patient to schedule an appointment may seem preposterous.  In my new book, “Dentistry’s Business Secrets, Proven Growth Strategies for Your New or Existing Practice” I discuss the importance of providing Five-Star Customer Service to your patients.  Following this principle, it might appear even more outlandish to demand credit card information during the new patient phone call.  The unfortunate truth, however, is that even though you may be committed to offering top-quality customer service, this in no way assures that your new patient will be so kind as to supply Five-Star Doctor Service.  This is to say that while most people are honest and attempt to live their word, many will disrespect the initial appointment time when anything more appealing presents.  We all understand that most things fall within this category when they are compared with going to the dentist.

When a new patient calls our office and requests an appointment, we are diligent about helping to first establish a warm rapport and help to answer any questions or concerns that  the patient might have.  We then walk through insurance information to obtain data which will allow us to arrive at a reasonably accurate co-payment estimate for treatment on the first visit.  We do all we can to make the patient feel comfortable and welcome in our practice before broaching the topic of securing the appointment with a credit card.  This is presented almost as an afterthought, something so standard in the industry that it must stand to reason.

Though many dentists approach this subject with some trepidation, the process holds a dual purpose for the profitable dental practice.  Not only does it ensure against losing money when a patient fails an appointment, it also establishes the appointment in the patient’s mind as valuable.  We have found that the number of new patient failures and cancellations has been significantly reduced when employing this protocol.  We have also been pleased to find that the resistance to such a request has been much milder than originally anticipated.

Halloween Candy Buy Back Program

My office has decided to participate in the Halloween Candy Buy Back Program this year.  The program assists dentists in collecting extra Halloween candy to be sent to American troops overseas through a project called Operation Gratitude.  On the afternoon and early evening of November 2nd, we will offer $1/pound of donated Halloween candy to local children.  Children can choose the candy that they want to keep at home and bring in the rest of the candy to donate.  The children will be given the opportunity to decorate a card to be sent along with the candy.

This will be our first year participating in the program.  We are beginning to lay the groundwork by contacting local businesses and restaurants to see if they would like to partner with us by providing items or coupons for a goodie bag giveaway.  We are contacting local media outlets with press releases as well.

Has your dental office participated in the Halloween Buy Back Program?  If so, do you have any advice as we plan for our first event.  Has your office attempted any other similar promotions?

Avoiding Slow Times in Dentistry

September and October can be a slow time in the dental office schedule.  After a summer filled with child check-ups, everyone returns to school and the schedule lightens.  The combination of hectic back to school schedules and the expense of school supplies, clothes and fall sports leave many families without time or financial resources to visit the dentist.  Summer is an expensive time with increased child care costs and vacation expenses for many families.  The credit card bills from that vacation in July are now due which squeezes the budget even more for many families.

My practice experiences this slowdown every year so we take steps ahead of time to combat this tendency. It can be difficult in the busy months of summer to find time for additional marketing, but a few simple steps have helped us to avoid too much of a decline in the early fall months.  In August, we check through our overdue recall and outstanding treatment plan reports.  Patients with an overdue recall are sent a postcard which is followed up by a phone call a couple weeks later.  Patients with an outstanding treatment plan are offered a discount if they schedule during the month of September or October.

These months also afford an opportunity to highlight a special promotion such as free whitening.  Online advertising and social media are great outlets for getting the word out about a new promotion or special.  Google Places allows status updates which can run for 30 days to highlight a new product or promotion.  Twitter and Facebook provide easy updates to current patients and potential new patients, but you must remember to use location specific keywords in these updates.  Blogs provide easy content updates to highlight special events as well.

I have found these fall months to be a great time to take a vacation.  Popular vacation spots are less crowded and more affordable, as families have headed back to school.  Closing the office for a week or two provides the added benefit of creating a more efficient schedule in the weeks surrounding the vacation.  This is also an effective means by which to control payroll overhead if your staff is paid on an hourly basis.

What steps does your office take to avoid slow production times?

Clinician’s Report – Dental Product Guidance

With so many competing dental product suppliers and material choices, how do we determine what to buy and from whom to buy these items?  One highly effective method is to research dental equipment and materials by attending a lecture sponsored by CR Foundation, available via www.cliniciansreport.org.  One such seminar supplied me the reference guide, Cutting-Edge Products for Clinical Excellence, outlining hundreds of product choices and contact information for the particular company manufacturing or supplying each product.  I consulted this list for many of my initial material choices in my current dental practice and continue to revisit it from time to time.  This outline simplifies the initial ordering process by centralizing a vast network of dental manufacturer contact information in one source.  It also serves to reinforce all the materials you will need to complete every dental procedure you will be offering in your practice.  The least beneficial time to discover that you need a dual-cure cement on hand is when the post is ready to be cemented.

Gordon J. Christensen Clinicians Report, formerly CRA Newsletter, is a periodical edited by Dr. Gordon Christensen, a pioneer in dental industry research.  Clinicians Report offers an online subscription option with full search and cross referencing capabilities of the past 30 years of CR test results.  This provides dentists the ability to search specifically for any product they are considering and consult issues related to its testing.  When opening my current dental office, I ordered two years of back issues of CRA Newsletter and made purchasing decisions based on my research.  This is a very practical tool as it eliminates manufacturer bias and reports only those findings of our professional peers.