Office Visit: The Mad Doctor Is In by Kyle Patton, associate editor, Dentaltown magazine

Why did you choose to pursue dentistry as your career?
Completely by accident—I was in my last year of college and went for a cleaning with my family dentist, whom I’d seen since I was a little kid. He asked me what I was going to do after college and I told him grad school.

He said that I should go to dental school, and I thought that might be a really odd choice, but I spent a few days observing him and the other doctors in his practice and decided that what they were doing was interesting and appealed to me. I took the DAT and applied to dental school and that’s how it all started for me. Before that encounter with my family dentist, that career path wasn’t even on my radar. It never would have occurred to me.

What is your practice’s philosophy, and how does it extend to the culture in your office?
Improving and enhancing our patients’ health and well-being. Our office philosophy is that, to achieve that goal, we strive to make the maximum impact on our patients’ lives by building strong, enduring relationships, and by encouraging patients to stay with us for life, to refer friends and family, and to follow through with recommendations.

These ideals extend into our everyday relationships with our patients. Every facet of what we do is geared toward improving our patients’ lives and their overall health. My team and I work hard at becoming well-acquainted with our patients, for two reasons. One, our patients feel more comfortable if they know the people performing the treatment. And two, I feel more comfortable if I feel that I know the patients; I really don’t want to work on strangers.

Having a culture like this decreases burnout and improves the team’s sense of professional satisfaction—and makes coming to work feel less like work.

How do you market your practice and bring in new patients?
We do very limited external marketing. We’re very picky about what we do and closely track our incoming patients and referral sources. My market is saturated with dental advertisements and it’s very difficult to get our message out effectively. It’s also prohibitively expensive. With a saturated market such as ours, returns diminish and ROI tends to be low.

We get between 40 and 60 percent of our new patients from internal marketing and word-of-mouth referrals. Beyond that, web-based searches for specific topics or our Google reviews. Our limited external marketing and people who drive by and notice our office bring in roughly the same number of patients. And then lastly, those brought in by insurance searches make up the smallest portion of new patients.

What does your schedule look like on a typical day in your practice?
You probably guessed that our practice doesn’t rely on volume. We don’t have a large, busy practice and I like it that way. I’d rather spend time with our patients and get to know them, so I typically see between four and 10 patients a day, depending on the type of treatment we are doing. If I have a patient with an involved treatment plan or a sedation, then it may be only one or two patients. My hygienists will usually see between five and eight patients a day.

How do you manage emergency patients?
We have an unscheduled operatory for overflow and we plan for emergency patients by building the time into our schedule. We take care of people; it’s what we do. So the last thing I want to have happen is sending a new or existing patient home in pain because we can’t accommodate them.

What’s your favorite procedure to perform?
Any procedure that improves a person’s self-esteem. Those are the big, life-changing events that will have a lasting impact for people who haven’t been able to eat or talk comfortably, or have been hiding away from interacting with others. They also bring the most professional satisfaction. We do implants, dentures, ortho and all kinds of cosmetic procedures, and they all have their moments.

The bread-and-butter restorative procedures don’t make that kind of impact. It’s part of what we do and it’s important, but will never be what gives you “the feels” like when a patient’s 5-year-old daughter says, “Look, Mommy, Daddy’s smiling,” because she’s never seen her father smile.

What is the single product or piece of technology that has the biggest “wow” factor for your patients?
We’ve been involved in CAD/CAM for a long time and that really impresses patients. Our patients aren’t wealthy and most have difficulty taking the time off work to come in for dentistry. They really appreciate the fact that we can utilize CAD/CAM to complete a crown or onlay in one visit. It makes their lives much easier. Plus, they think it’s cool when my assistants show them a scan or design.

CBCT is also a “wow” factor bit of technology that our patients appreciate. It’s amazing what you can find with CBCT that just doesn’t show up on conventional radiography.

Tell us about the integration of of digital imaging and CAD/CAM in your practice, and how it has affected you and your patients.
We had a plan before we started and we adjusted it along the way. We started out with an E4D system, which has grown and evolved into the PlanScan FIT system. Initially we went to a training session where we learned the very basics of the system. Then we had an in-office training, during which we made sure to have back-to-back patients who knew we were training.

We had the next few weeks pre-blocked with “ideal” patients so that the team could learn what they needed to. Next we had another in-office training to help make our processes better. Over the next few years, my assistants and I attended PlanScan’s educational continuum. Support was fantastic and upgrades were handled very well and very fairly. Patients love having crowns and onlays completed in one visit, and the system really pays for itself and has improved our office cash flow.

What is your approach to integrating new technologies into your practice?
I want to have our technology serve a purpose and I want to be clear about that purpose before purchasing the technology. To help me get clear about why I want a particular technology, I try to categorize it. In my mind, there are three things that technology can do:

• It can be fun. This isn’t just frivolous, because making work fun improves office morale and customer service. This is important also.
• It can help you provide a higher quality of care.
• It can generate revenue.

Some technology will be able to do all three. I’ve found that CAD/CAM is one of those technologies. My assistants enjoy using it. Patients appreciate how it simplifies their lives. I like it because I feel that we can do better, more accurate and more efficient work for our patients. From a business point of view, simply scanning instead of taking impressions pays for itself. You can actually see an improvement in cash flow, depending on how many impressions you were taking.

Tell us about your team. Who are they, what are their jobs and what do they add to your practice?
My team knows how to bring it every day. They are on stage and they know how to perform. Taking care of our patients and changing lives is what we do. So we all take it seriously.

It’s more than just a restorative and hygiene practice because our patients are more than just teeth and gums. We get to know people, and in doing so we can learn how best to treat them the way they want. Everyone in my office is cross-trained to some extent. They are accountable and responsible for their own jobs, but they can help out in other areas if needed.

Trish, my wife, runs the show. She is a hygienist by training and has been running the practice since 2009. She is just great and I couldn’t do it without her.

Mel is our newest front office member and she has really taken ownership of her new position. We rely on her to help patients figure out how they can afford the treatment they need or want.

Morgan is an assistant who has been with us for a number of years and she loves organizing. She is great at it. She jumped into CAD/CAM right from the beginning and earned CDD certification through Planmeca’s educational program. Patients love her confidence and how she explains what she’s doing.

Kortney is an assistant with ninja-sharp assisting skills. Patients love her personality and she has almost completed her CDD. She has a level head and stays calm throughout any crisis.

Kim is one of our dedicated hygienists who has a passion for helping people improve their health and live life to the fullest. Her knowledge of biology is unsurpassed in the dental field. Working with Kim is what I imagine it would be like to have Tony Robbins come to your office every day.

Teresa (aka T-Bone) is a skilled hygienist who brings levity to the office and gets everyone on fun office kicks like the TV show The Biggest Loser. She is attending school to become a physician’s assistant.

Sheryl is a hygiene trainer who travels the country helping offices set up a dental hygiene program. When she isn’t out doing consulting, she helps us with everything from insurance and front-office tasks to seeing patients in hygiene. She is a fantastic person to have in the office.

What do you think is the best secret in cultivating a great staff?
Life is too short! Hire for a good personality and attitude, even if they have no experience. I feel confident in my team and it helps me sleep comfortably at night knowing that they can handle anything.

What is the dental practice competition like? What do you do to differentiate yourself from the other dental practices in your area?
Madison is a great town. Consequently, there are a lot of dentists here. It’s a highly saturated market. On top of that, the market is highly penetrated by dental insurance. There are several large local dental groups, and in the past few years, large national chains have moved in. That said, I don’t feel as if it’s a cutthroat area; for the most part, the local dentists get along well. We also have some great specialty groups that I feel confident sending my patients to when needed.

Since you began your career as a dentist, what’s the biggest change you’ve seen in the profession?
When I first started working as a dentist, the “restorative” style of practice that I grew up with, where you go get your teeth cleaned and maybe get a filling or a crown, was being replaced by the “cosmetic revolution,” where almost every office now advertises cosmetic dentistry.

The cosmetic revolution was in full swing. The economy was booming, people had plenty of money or easy access to it, and some of the most popular shows on TV featured dentists doing cosmetic makeovers. People wanted expensive, elaborate procedures and were willing to pay for it. Then 9/11 happened, followed by the housing mortgage crisis, then the banking crisis. We went very quickly to what I call the “new dental economy.” People stopped going to the dentist.

I read somewhere that visits to private dental practices dropped by 9–15 percent. Those numbers have not recovered. That, stagnant insurance fees and the fact that many businesses dropped dental insurance as a benefit during the economic downturn, have led to a decrease in the dentists’ take-home pay, to the tune of about $4,000 a year.

However, that doesn’t mean that there isn’t opportunity. Spending the past 15 years away from preventive dental care means that many people need our help for reconstruction, implants and dentures. The “sweet spot” has moved.—it’s no longer cosmetics, it’s reconstruction. We have to be able and ready to help our patients.

What’s the biggest problem dentists face today?
Dental practice management software is horrendous and, in my opinion, hinders dentists from being able to easily run a practice and make sensible business decisions.

Recently, everyone—the insurance company, my fellow dentists, employees, accountant, etc.—was advising me to take a certain insurance plan. “You’ll get a ton of patients from it,” they said. I downloaded a third-party software to help me analyze the plan’s impact on my practice, and guess what? I would have had to generate $160,000 from new patients on this insurance to make up for the write-offs. And that would be just to get back to my regular production.

There’s no way it would have made sense for me to participate in that plan … but I would have been working about 30 percent harder for the same money—or probably less! That type of business decision should be something you can easily use your practice management software for. How can you make decisions about a business without your financial data? It’s an incredible pain to try to merge information from dental software with your accounting software. I think most dentists don’t even try, and end up relying on gut feelings instead. This is one reason insurance companies can manipulate dental practices so easily.

What is the most rewarding experience you’ve had as a dentist?
Hearing patients tell you how your practice has improved their lives feels great. I enjoy going to work and seeing the people I work with, and getting to know the people coming to us.

How has Dentaltown affected you and your practice?
I don’t think there’s anything in this life that’s new or unique. Everything has been done before by someone, and Dentaltown helps cut through the trial and error of having to figure things out for yourself. I found my implant mentor on Dentaltown. He introduced me to my ortho mentor. I’ve taken fantastic courses from people I otherwise never would have known about.

When you aren’t practicing, what do you like to do with your time? What gives your life balance?
I have a young family, so I really like spending time with my kids. They give my life balance because I don’t want to miss out on any part of their growing up.