Office Visit By Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

Welcome to the fifth installment of Office Visit, where we visit a Townie’s office and profile their equipment, design or unique practice philosophy. If you would like to participate or nominate a colleague, please send me an e-mail at tom@dentaltown.com. This month, we visited Dr. Dennis J. “Dennie” Jenkins’ practice, Designing Smiles in Sellersburg, Indiana. Dr. Jenkins discusses marketing his practice, insurance, aesthetics, how he staffs his office, technology and even the benefits of Dentaltown.

Office Highlights Computer System 14 stations networked Internet access for patient use if needed and also for media sources DVD patient entertainment package Software Image F/X Softdent Caesy patient ed program Gendex Dentoptix digital radiography Gendex Intraoral camera systems Concept IV Tech Scan Occlusal analysis JVA from Bioresearch to verify joint condition PowerPoint for patient case presentation

Lasers Premier Diode laser Hoya ConBio Delight Erbium laser Camera Canon 10D digital camera Magnification Designs for Visions 3.5x loupes Miscellaneous BriteSmile light assisted tooth bleaching system Diagnodent Piezo sonic scaler The Wand from Compudent XM satellite sound system Second-floor conference room with fully equiped audio/visual system for small capacity meetings.

How do you balance a practice population of patients from the farming communities to the north and higher-end patients from East Louisville?

When I entered the practice in 1988 it was an older practice with more of a small-town flavor, which was really nice as that provided stability and great goodwill. Our area has changed dramatically over the last 20 years and our practice has evolved as well. We have changed our name and the focus of what we provide to allow myself and my team to tune in on the aspects of dentistry that we really enjoy. With the change of our practice name to Designing Smiles in 1998, we began to market ourselves in an effort to create a brand that people in the surrounding area would come to connect with excellence in all that we do. I would note that changing ones name in this way can be a concern as we occasionally will suffer from the stigma that some will assume we are strictly a high-end aesthetic practice. It is up to our marketing and our everyday approach to relax that concern.

How do you market your practice as a general family practice and an aesthetic practice? Do you advertise differently in different venues? Discuss your approach to marketing both within and outside of the practice.

The term, “practice within a practice,” is very true for us as we certainly thrive on bread-and-butter type of dentistry. I enjoy posterior dentistry and find it every bit as rewarding to follow the progress of my patient base as they become healthier from a restorative perspective. It is the aesthetic aspect of our practice that has placed us on the map as a place to improve people’s smiles. Everyone is treated as if they are the focus of our entire day.

Internal marketing has always come easy as we really make an attempt to make an impression on people. Knowing our patients’ names and using them as we greet them in the office, as well as servicing them with amenities like heated neck rolls and paraffin dips, allows them to feel relaxed and special. We might send them to an Indiana basketball game or dinner at a local restaurant if we feel that we fell short on a given appointment. All of these little things build the relationship that binds patients to the practice.

One of the most powerful internal marketing options that we have is that of simply asking our current patient base for their referrals. So many of them do not realize that we are always taking new patients and they are many times looking for permission to send people our way.

Marketing our practice was essentially 100-percent internal for many years as we had so much dentistry to be done within the existing patient base. As that base became healthy and restored, the need for a stronger new patient flow became apparent as we do not have patients driven to us through insurance plans, etc. With that in mind, our first real external venture was via the new 16-screen movie theatre located a few miles from our office in a new high-growth area. I am a firm believer that any marketing must be done in a first-class manner in order to present our office in that light. We run a nice 30-second ad at the theatres to run on a loop between movies, which is seen by thousands of people weekly.

We have utilized some direct mail pieces to balance our marketing and have focused on three areas. We have separate mailers for demographics related to cosmetics, general dentistry and one for reactivation of existing patients. This approach has been fairly successful in making the phone ring and turning those calls into treatment opportunities.

Using the same type of approach, we have run ads on local television in the Louisville market and have experienced some nice feedback from patients as well. It too has enhanced that effect of branding our office. They all seem to work as a network; each referring to and supporting the other.

It is a fine line between trying to be everything to everyone and narrowing your scope to certain types of patients but the practice in a practice concept has allowed for us to market both with success. The key is to get folks in our door and then let the people who are “designing smiles” take over.

Did/do you participate with any dental insurance plans? If you did, and no longer participate, how did you make the change? What is your advice for dentists considering a move to an insurance free practice?

We do not participate with any plans simply because we decided many years ago that we wanted to be the driving force in our patient’s treatment decisions and not have insurance as the determining factor both with the treatment and the fees.

Many years ago we had gotten involved in a few plans and were concerned with losing those patients if we dropped the plans. When the change was made we were empathetic to our patients and made every attempt to assist them and educate them. Some will leave the practice and many will return. It is indeed all about your vision and staying the course even when it may seem a little scary. Certainly everyone’s situation is different and I am not here to say that every office should run out and drop all of their plans, but it made sense for us.

Do you accept assignment of benefits? Do you process insurance claims for patients? Describe your approach to insurance in your communications with patients.

We do process claims for our patients with traditional or out-of-network plans. I feel it helps them to reach their goals. I do understand that money is tight for many of our patients, and if we can help them in using their insurance benefits, then I see that as a service for them. The biggest problem we all face is that when we become involved in this way, there becomes a major dependence over time and they begin to include us in the triangle of insurance/patient/dentist. I simply sit with all of my new patients and explain my philosophy on their treatment and my approach to helping them reach their goals.

What are your tips for picking the great members of your team? How do you screen potential candidates and what is your interview process?

I learned a long time ago that I am not a very good interviewer as I tend to be a very positive person to excess. With that in mind, I would always see only the potential good in people and not necessarily the attributes that might be a drawback. I began to have my team take part in the process and this has worked out much better for our practice. Since they played a role in that selection they must take ownership and work at building the new relationship.

• Click Here to See Dennie's Top Five

Describe your approach to team development with your existing team.

My approach to my team is simple. I treat them essentially as equals trying not to shadow them but to give them much responsibility and allow them to share in most of the decisions that we make. I refer to them as our board of directors and they realize that ultimately I will make the final decision but they had a role in the process. Implementation of any change is much easier if they have played a role in the decisions that led to it.

Two of my team members have been with me since day one and the remaining five have all been together for many years now. Several years ago we worked with Jameson Consulting in order to fine-tune our practice. One of the most compelling parts of our program was communication. It was and will always be I think the most difficult and challenging part of any team.

What are some of the physical ways your office is different than most?

There are so many really nice offices across the country today that it is hard to compare many times from strictly a physical aspect. I remodeled an existing bank building 11 years ago and probably the most unique quality as you enter is the large stainless vault door, which we still use today. This room is part of my front desk area and allows us to lock down charts and financials when we leave the building.

We have made a real effort to have any and all wall art, counter cards, marketing pieces and brochures as our own patients professionally photographed and selected to become a part of the décor. I know patients appreciate and are intrigued by the look of this approach.

What dental equipment do most patients notice immediately?

Obviously not every patient gets to experience all of the technologies but they are all exposed to our digital world including many photos and images for them to experience on the flat screen Samsung monitors both chair side and in front of the patient. Patients find the vast availability to images in Image F/X to be very interesting. This is also the manner in which we present and show the patients digital photos taken with the Canon 10D. I find that patients really respond best to the full arch photos making the IOC somewhat less useful at this point.

Lasers are of course another area of interest for patients as I think they find the concept very cool. Often times, patients may inquire about the Delight/Versa Wave laser.

How do you use computers in your office?

We have 14 computer stations in the office all networked together and they allow us to communicate, diagnose, educate, and present with patients and one another. I spend a great deal of time daily communicating with specialist and colleagues on several internet forums extending my support system way beyond my four walls with the computer. The computer system is the hub of all that we do today.

What is your new-patient process? Do you bring patients back for a second visit to present their treatment plan?

I am a firm believer in giving the patient what it is that brought them to me if I can do so without some major compromise. I will introduce new patients to the practice in one of three ways. The patient may call and request a consultation to explore the possibilities. This patient usually comes from our marketing and would be scheduled with my patient care coordinator for photos and possible radiographs. She would spend as much time as needed with the patient determining the level of commitment, etc… and then I would meet and spend a few minutes with that patient to wrap things up. This would then be followed with a more detailed evaluation and consultation if the patient so desires.

The second scenario would be the new patient coming in as an emergency and we would deal with the problem as time allows. They would then have the opportunity to return as a new patient for full evaluation. Lastly is the new patient who comes in through our hygiene department for a comprehensive exam and subsequent suggested therapy depending on the case.

As far as case presentation, there are several protocols that we follow. The first would be a smaller treatment plan perhaps coming out of hygiene. This information would be formulated and presented in the consultation room that day. I find treatment acceptance is much higher when presented in this manner as opposed to the treatment room.

The larger case treatment plans will usually get scheduled for a full consultation appointment with my patient care coordinator in a very short period of time. I want to maintain any enthusiasm that has been built. When she meets with patients and presents their customized treatment plan she will present case fees, not per tooth fees as I feel this promotes more of a comprehensive acceptance. Phasing of treatment can then take place as needed.

What is your approach to aesthetic dentistry? Do you believe this is something that should be requested by the patient first, or is it necessary to let the patient know what is possible before they will be interested?

We do all that we can to provide an environment that promotes what we love to do. In the office however it is not my intent to ever have the patient feel as though we are shoving aesthetic dentistry down their throat. I have continuously looped PowerPoint slide shows that run in all ops as screen savers allowing the patients to a variety of dentistry and beautiful smiles. Included in the slide show are an equal number of non-dental photos such as sunsets and family photos. It helps to create a feeling of sharing ourselves with our patients and further building that relationship.

I find that exploring aesthetic dentistry with patients can occur in any number of avenues. Often times the patient will express an interest and sometimes that may come from photos they have seen or some message that we delivered in the office. I will approach patients on an individual basis, case dependent, if I feel that we may have something that can help them is some way. I certainly would prefer that they are the ones to open the dialogue.

You use special equipment to evaluate TMJ and occlusion, do you perform many full mouth reconstructions? What is your occlusal philosophy? Tell us how you got started with full mouth cases.

My occlusal philosophy is certainly more traditional and stems from my background with the Hornbrook Group. It is based on the concept of Apex of Force which some would recognize as their CR position. It has many of Bob Lee’s principles as well as those of Pete Dawson. The beauty of this approach is that it is something that can be broken down and incorporated into ones practice with relative ease.

As I have progressed with my occlusal knowledge I have incorporated some more advanced technologies in my practice that allow me to treat more complex cases and finish them more predictably. The Tech Scan and the JVA have been instrumental in tackling these more difficult cases. They are impressive to the patient and allow me to take my dentistry to another level.

How has Dentaltown impacted your practice? Give examples of something that you now do differently because of Dentaltown.

I have found Dentaltown to be a really neat online source of friends, colleagues and sources of feedback to what I do every day. I have been active on Dentaltown for less than a year and already feel like I know a number of dentists quite well. It is a way to reach out of the four walls that we all find ourselves trapped in from time to time and share with those with which we have so much in common. I think the thing that has separated Dentaltown from all of the other online communities is the format in which case presentation is set up. It makes everything so easy to access and respond.

The feedback that I receive from my case presentations will many times influence the way I might approach the same procedure that next time.

What changes do you expect to see in our profession over the next five years?

I hope to see a greater influence of continuing education on the whole of our profession. I think this will continue the trend of dentistry taking on a much different feel both publicly and within our profession.

Clinically we will see CAD type technologies take a more prominent role in everyday dentistry in many forms. I think the day is not far off when we will take very few impressions as digital images will be passed on to labs for fabrication of restorations. Certainly in-office CAD systems will continue to thrive and improve as competition will move this technology forward.