OPINION: Dear New York Times: The answer isn't more dentists
October 23, 2007 -- In all the heated debate about the New York Times' recent controversial piece, "Boom Times for U.S. Dentists, But Not for Americans' Teeth," some basic history and economic realities have been ignored.
The boom in the number of dentists in the 1970s (my generation) didn't result in more people getting dental care. Back then, the federal government said we didn't have enough dentists. The result was a glut of dentists and less business for dentists all the way around. It took years to work off the oversupply.
Now the government is saying the same thing. But if we've learned anything, increased availability of a service doesn't necessarily increase utilization. If people can't pay for a service, they won't use it. And if people don't want to pay for a service, they won't value it, either.
The real problem is that federal and state medical assistance programs aimed at helping the underprivileged (and even the lower-middle class) don't come close to covering a dentist's overhead. Are dentists expected to provide medical care at a loss, to essentially subsidize dental care for those who can't afford it? I can't help but agree with Dr. Terry D. Dickinson, the executive director of the Virginia Dental Association, when he said, "Charity is not a healthcare system."
If dental care is truly important (and I wouldn't be a dentist if I didn't think it was), then we all need to step up to the plate -- Congress, state legislatures, and yes, taxpayers. Everyone should contribute to making dental healthcare available to the people most in need. Like attorneys, dentists do plenty of pro bono work. But ultimately, they have to make a living, too.
In Wisconsin, where I practice, the Marshfield Clinic is working with the Family Health Center to set up rural dental clinics to provide care to underserved patients.The only downside? The group doesn't cover Medford, where I practice. (More than 9% of the local population lives below the poverty line, including nearly 13% under the age of 18.) What makes this program possible? Federal grants, higher Medicare and Medicaid compensation, state grants, and more. If the government appropriately reimbursed dentists for their services, there'd be plenty of access to dental care for Americans of all economic stripes. There wouldn't be a need for dental "therapists."
Dentists are healers -- compassionate, civic-minded men and women who are dedicated to helping their fellow citizens. But we're not doormats. It's up to our elected representatives -- who, to date, have shown little backbone -- to tackle the inequities in American healthcare, and to come up with the bucks to make it happen.
Kim Gowey, D.D.S., practices in Medford, WI. He is a past president of the American Academy of Implant Dentistry. He was on the continuing education faculty of Howard University School of Dentistry's Implant Maxicourse, and Baylor College of Dentistry.
Related dental links: Bunsen Burner Dental Loupes Vacuum Forming Machine
OPINION:,Dear,New,York,Times:,The,answer,isn't,more,dentists
Tuesday, 8 January 2013
The battle of the power toothbrushes
The battle of the power toothbrushes
October 22, 2007 -- Ultreo, Inc., makers of Ultreo, a power toothbrush based on ultrasound waveguide technology, filed a counter suit against Procter & Gamble in the United States District Court for the Southern District of New York last week.
P&G, which makes the Oral-B power toothbrush, filed a suit against Ultreo in September for allegedly misleading consumers and dental professionals through false advertising. According to P&G, Ultreo's claim that their product's ultrasound waveguide technology creates bubbles that fight plaque--that bristle action alone leaves behind--is false. P&G further claimed that one of its studies proved the Ultreo toothbrush was more effective at removing plaque with its ultrasound waveguide technology switched off.
"Ultreo has provided no clinical proof that the ultrasound makes any difference in plaque removal in the mouth. We're taking this action to prevent consumers from being misled and to protect our business," said Dr. Paul Warren, Vice President of Global Oral Care Scientific and Professional Relations for P&G in a press release.
Ultreo has denied these claims in full, and in its countersuit says that P&G is misleading consumers and dental professionals by falsely disparaging Ultreo. Ultreo claims considerable scientific evidence proves its product's advantages, notably a 95 percent reduction of plaque within the first minute of brushing.
"Our marketing focuses on the strong scientific evidence behind Ultreo and the proven consumer preference for the incredible feeling of clean Ultreo provides," said Ultreo CEO and President Jack Gallagher in a press release. "It’s obvious that this is the real source of concern for P&G. The fact that a $76 billion market leader is attacking and disparaging a $3 million startup offering a technological innovation simply validates Ultreo’s acceptance by the marketplace."
Related dental links: Dental Loupes Vacuum Forming Machine root canal
The,battle,of,the,power,toothbrushes
Work less, earn more? One dentist explains how
Work less, earn more? One dentist explains how
October 22, 2007 -- William Blatchford, D.D.S., had a successful practice but he wasn't truly happy. He worked five days a week, never had time for vacations, and always felt a cloud of stress hanging over him. One night while eating leftovers from yet another office dinner, his wife and fellow dentist, Carolyn, said, "We're eating the leftovers of the practice's revenues every month." One night, Blatchford had a realization: He needed to change the entire way he ran his business.
Once he did, Blatchford claims he eventually climbed to the top 1 percent of highest-grossing dentists nationwide. Then he founded Blatchford Solutions and became a coach and consultant to 2,500 dental practices. His selling point: Life is too short, so develop a practice that allows you the lifestyle you desire. When he is not flying planes; skiing near his Bend, Oregon home; or sailing in Puget Sound; Blatchford spreads the word about his theory.
Dr. William Blatchford
His "Show Me the Money" session at the recent ADA conference in San Francisco was a few years in coming. "Two years ago, the ADA told me not to talk about profit or use the 'S-word' at the conference." (We're assuming he meant "sell".) "This year, they actually requested I do this program. It shows how far the dental business has come."
One of his seemingly contrary discoveries: Customer service demands that you focus on income. "People want to go to a dentist who is profitable. They don't want a dentist working on their teeth who is preoccupied with paying the rent."
Cut back on overhead
What keeps dentists from boosting profits? They're bad at estimating what to expect to gross every month, says Blatchford. "A dentist has one month that's shockingly big and assumes it will always be like that and spends money on more staff and equipment. The next month, business goes back to normal and he's worrying about paying expenses. What did the dentist do to make that one month so big? Chances are, they don't know.
"Your 'range of predictability' shouldn't go up and down. It should become narrower."
In Blatchford's case, he scrutinized his staffing. He had 16 employees, five solely for hygiene. ("What does one dentist need 16 employees for?") He laid off three hygienists ("The worst day of my career"), then later cut his total staff to eight. A year later, he grossed slightly more than the prior year, even with half his staff.
Blatchford boasts that his clients gross between $2 to $3 million annually, even when working with staffs of five or fewer. More telling? His dentists work 3.5 days a week and take eight to 10 weeks vacation a year. All of them have cut their overhead and reduced their staff to a handful. "It's not about time spent or efforts made, or even how much you work. It's about results."
Getting there means cutting the small stuff, focusing on high-end treatments, and developing specialized niches. One of Blatchford's clients moved his dental practice to Florida and focused on cosmetic dentures and implants for the abundant population of well-heeled seniors. The dentist charges $6,000 to $10,000 a pop. The results: He went from grossing $800,000 a year to $2 million, with half his previous overhead (a team of five employees), and a four-day workweek.
Another client only works three mornings a week, but she focuses on dentures and implant-supported dentures in a Polish neighborhood in Chicago. "She doesn't do fillings or see kids," says Blatchford. "But she earns so much in her specialty that she throws in a spare set of dentures for free." She likewise trimmed staff, cutting overhead from 63 percent to 37 percent, and grosses $1 million annually.
Typically, 30 percent of a dentist's overhead is staff. Blatchford says it should be 12 to 20 percent. But pay those staffers you keep well--double their salaries. "I once hired someone incompetent and then had to hire a trainer to help her. That's stupid." Hire the most competent staff, give them incentives of higher pay and a reduced workweek, and they'll give you hard work and loyalty in return.
Focus on your top clientele
Blatchford is a firm believer that the top 20 percent of patients generate 80 percent of your income--and that the bottom 20 percent can actually be an income drain. "It's ludicrous to treat all patients the same when some are actually costing you money."
He suggests you create a spreadsheet of all your patients and how much they spend, then list them in descending order of expenditures. "When the descending total hits 80 percent of total income, study those people in that range. Look at their age, gender, and treatments needed -- that's your target market. Get rid of the bottom 20 percent."
Raise fees, lower receivables
Don't be afraid to raise fees, either. Blatchford actually recommends doubling them. "People go to my Chicago-based client because her dentures cost twice as much. They perceive it as quality."
If you're hesitant to double, add the bill cost to your current fee. "Then you can send work to the best lab around, because the patient is paying for it directly."
Accounts receivables are poison in his book. Say you have $100,000 in A/R on Jan.1. Over the course of a year, you'll lose $6,000 through inflation, $10,000 from money you could have invested (if you had it), $36,000 in the costs of trying to get patients to pay, and $24,000 in write-off of bad debts. By year's end, you will have lost $76,000.
"That's why my clients do not carry account receivables," says Blatchford. "It's check, cash or credit card upfront at the desk."
Make treatments affordable by offering financing options from outside sources. Why not?, says Blatchford. "That's how they pay for their car and big-screen TV."
Ply them with services
Consultants often tell dentists to focus on getting more hygiene patients, but Blackford says forget that. "You'll only break even. It will never be a profit center."
Instead, focus on doing more Class II and Class III procedures. "If you do two units of a crown or bridge, your net profit per hour triples." He also recommends offering additional services, such as denture implants, cosmetic dentures, and veneers.
How can you get patients to accept these offerings? "McDonald's made millions by asking, 'Do you want fries with your burger?'" says Blatchford. "Say to your patient during a procedure, 'I notice you'll need an additional crown here soon. We can get both done while you're still numb and save you two extra appointments.'"
Instead of trying to educate patients about treatments' benefits, appeal to their emotions. "People don't want dentures or veneers, they want their teeth to look good, feel good and last a long time. Instead of trying to sell the process, you should be selling the results."
Moneymaking aside, Blatchford emphasizes that all dentists should balance business and pleasure, and ensure that they can incorporate both into their practice. "Life is too short. Make a commitment to be happy. You should say, 'Thank God it's Monday!' Focus only on the things you want to do and enjoy them, both in work and life."
Related dental links: Vacuum Forming Machine root canal Wax Pot
Work,less,,earn,more?,One,dentist,explains,how
October 22, 2007 -- William Blatchford, D.D.S., had a successful practice but he wasn't truly happy. He worked five days a week, never had time for vacations, and always felt a cloud of stress hanging over him. One night while eating leftovers from yet another office dinner, his wife and fellow dentist, Carolyn, said, "We're eating the leftovers of the practice's revenues every month." One night, Blatchford had a realization: He needed to change the entire way he ran his business.
Once he did, Blatchford claims he eventually climbed to the top 1 percent of highest-grossing dentists nationwide. Then he founded Blatchford Solutions and became a coach and consultant to 2,500 dental practices. His selling point: Life is too short, so develop a practice that allows you the lifestyle you desire. When he is not flying planes; skiing near his Bend, Oregon home; or sailing in Puget Sound; Blatchford spreads the word about his theory.
Dr. William Blatchford
His "Show Me the Money" session at the recent ADA conference in San Francisco was a few years in coming. "Two years ago, the ADA told me not to talk about profit or use the 'S-word' at the conference." (We're assuming he meant "sell".) "This year, they actually requested I do this program. It shows how far the dental business has come."
One of his seemingly contrary discoveries: Customer service demands that you focus on income. "People want to go to a dentist who is profitable. They don't want a dentist working on their teeth who is preoccupied with paying the rent."
Cut back on overhead
What keeps dentists from boosting profits? They're bad at estimating what to expect to gross every month, says Blatchford. "A dentist has one month that's shockingly big and assumes it will always be like that and spends money on more staff and equipment. The next month, business goes back to normal and he's worrying about paying expenses. What did the dentist do to make that one month so big? Chances are, they don't know.
"Your 'range of predictability' shouldn't go up and down. It should become narrower."
In Blatchford's case, he scrutinized his staffing. He had 16 employees, five solely for hygiene. ("What does one dentist need 16 employees for?") He laid off three hygienists ("The worst day of my career"), then later cut his total staff to eight. A year later, he grossed slightly more than the prior year, even with half his staff.
Blatchford boasts that his clients gross between $2 to $3 million annually, even when working with staffs of five or fewer. More telling? His dentists work 3.5 days a week and take eight to 10 weeks vacation a year. All of them have cut their overhead and reduced their staff to a handful. "It's not about time spent or efforts made, or even how much you work. It's about results."
Getting there means cutting the small stuff, focusing on high-end treatments, and developing specialized niches. One of Blatchford's clients moved his dental practice to Florida and focused on cosmetic dentures and implants for the abundant population of well-heeled seniors. The dentist charges $6,000 to $10,000 a pop. The results: He went from grossing $800,000 a year to $2 million, with half his previous overhead (a team of five employees), and a four-day workweek.
Another client only works three mornings a week, but she focuses on dentures and implant-supported dentures in a Polish neighborhood in Chicago. "She doesn't do fillings or see kids," says Blatchford. "But she earns so much in her specialty that she throws in a spare set of dentures for free." She likewise trimmed staff, cutting overhead from 63 percent to 37 percent, and grosses $1 million annually.
Typically, 30 percent of a dentist's overhead is staff. Blatchford says it should be 12 to 20 percent. But pay those staffers you keep well--double their salaries. "I once hired someone incompetent and then had to hire a trainer to help her. That's stupid." Hire the most competent staff, give them incentives of higher pay and a reduced workweek, and they'll give you hard work and loyalty in return.
Focus on your top clientele
Blatchford is a firm believer that the top 20 percent of patients generate 80 percent of your income--and that the bottom 20 percent can actually be an income drain. "It's ludicrous to treat all patients the same when some are actually costing you money."
He suggests you create a spreadsheet of all your patients and how much they spend, then list them in descending order of expenditures. "When the descending total hits 80 percent of total income, study those people in that range. Look at their age, gender, and treatments needed -- that's your target market. Get rid of the bottom 20 percent."
Raise fees, lower receivables
Don't be afraid to raise fees, either. Blatchford actually recommends doubling them. "People go to my Chicago-based client because her dentures cost twice as much. They perceive it as quality."
If you're hesitant to double, add the bill cost to your current fee. "Then you can send work to the best lab around, because the patient is paying for it directly."
Accounts receivables are poison in his book. Say you have $100,000 in A/R on Jan.1. Over the course of a year, you'll lose $6,000 through inflation, $10,000 from money you could have invested (if you had it), $36,000 in the costs of trying to get patients to pay, and $24,000 in write-off of bad debts. By year's end, you will have lost $76,000.
"That's why my clients do not carry account receivables," says Blatchford. "It's check, cash or credit card upfront at the desk."
Make treatments affordable by offering financing options from outside sources. Why not?, says Blatchford. "That's how they pay for their car and big-screen TV."
Ply them with services
Consultants often tell dentists to focus on getting more hygiene patients, but Blackford says forget that. "You'll only break even. It will never be a profit center."
Instead, focus on doing more Class II and Class III procedures. "If you do two units of a crown or bridge, your net profit per hour triples." He also recommends offering additional services, such as denture implants, cosmetic dentures, and veneers.
How can you get patients to accept these offerings? "McDonald's made millions by asking, 'Do you want fries with your burger?'" says Blatchford. "Say to your patient during a procedure, 'I notice you'll need an additional crown here soon. We can get both done while you're still numb and save you two extra appointments.'"
Instead of trying to educate patients about treatments' benefits, appeal to their emotions. "People don't want dentures or veneers, they want their teeth to look good, feel good and last a long time. Instead of trying to sell the process, you should be selling the results."
Moneymaking aside, Blatchford emphasizes that all dentists should balance business and pleasure, and ensure that they can incorporate both into their practice. "Life is too short. Make a commitment to be happy. You should say, 'Thank God it's Monday!' Focus only on the things you want to do and enjoy them, both in work and life."
Related dental links: Vacuum Forming Machine root canal Wax Pot
Work,less,,earn,more?,One,dentist,explains,how
New drug can 'revolutionize' oral and maxillofacial surgery
New drug can 'revolutionize' oral and maxillofacial surgery
October 22, 2007 -- Infuse Bone Graft -- a drug used in orthopedic procedures that stimulates stem cells to form bone -- has recently been approved by the FDA for dental use.
The drug consists of two parts: a solution containing rhBMP-2 (recombinant human bone morphogenetic protein 2) and the ACS (absorbable collagen sponge). It can be highly useful in oral and maxillofacial procedures. Surgeons at the School of Dentistry, Loma Linda University have successfully used Infuse to do reconstruction surgery on gunshot and trauma victims, as well as patients with cleft palates and oral cancer.
Until recently, surgeons harvested bone needed for reconstruction surgery from the patient's own hip or ribs. "This is painful, and requires a second surgery site [on the patient]," said Philip Boyne, D.M.D., M.S., D.Sc., professor emeritus of oral and maxillofacial surgery at Loma Linda, in a press release. Infuse can eliminate this entire process from oral and maxillofacial reconstruction surgery.
"The cleft palate cases are particularly rewarding," Dr. Boyne said. "This new drug makes a second surgery unnecessary and the bone generated from the patient's own stem cells forms bone that beautifully completes the natural arch. And the sponge doesn't have to be removed -- it is eventually absorbed by the body."
Infuse can be used in many areas of dentistry and will save patients considerable time and money. For example, cleft palate cases can be an outpatient procedure, saving insurers as much as $15,000, according to Dr. Boyne.
Related dental links:root canalWax PotElectric Toothbrush
New,drug,can,'revolutionize',oral,and,maxillofacial,surgery
Something to smile about
Something to smile about
October 22, 2007 -- October is National Domestic Violence Awareness Month and according to the American Academy of Cosmetic Dentistry (AACD) five million people are victims of domestic violence in the U.S. every year.
The American Academy of Cosmetic Dentistry Charitable Foundation's (AACDCF) Give Back A Smile (GBAS) program provides free dental care to victims of domestic abuse. They restore broken and damaged teeth at no cost to the victim. To date the foundation has treated 600 cases at a total cost of nearly $5 million.
"After suffering abuse, it is difficult for survivors to find something to smile about, and it's even harder when they don't have a smile to show. Time after time we have witnessed AACD members assist survivors of domestic violence by treating their dental injuries, restoring their smiles, their self-esteem and their lives," said AACD Foundation Director Erin Roberts in a press release.
If one of your patients is a victim in need of help, have them call GBAS at (800) 773-4227 and complete the application process. The AACD will connect eligible applicants with a local GBAS volunteer for treatment.
Related dental links: Wax Pot Electric Toothbrush oral b electric toothbrush
Something,to,smile,about
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