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Howard Speaks Howard Farran, DDS, MBA, MAGD; Publisher, Dentaltown Magazine

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Tough Times Call for Tough Actions

Howard Farran, DDS
MBA, MAGD
Publisher,
Dentaltown Magazine
 We talk a lot about tightening our belts in this current economy by cutting expenses along with increasing marketing to promote new patients. What about the current patients in your practice? Do you know what your current outstanding treatment number is? What about the number of unscheduled hygiene patients? You don’t? Why not? Take a look, and you might be shocked – and not in a good way – by the grand total number on the outstanding treatment plan report. Patients can get lost in the black hole at your front desk if systems are not in place to follow up with them on a regular basis.

Get ‘em Scheduled!
Starting this month you should be sending out letters to all of your patients with outstanding unscheduled treatment and unused insurance benefits. Seriously. Generate these letters now! If you need help with this, consult your practice management software as most have the capability to generate a list of patients and merge them to a letter. If you wish to offer a discount incentive you’ve got to be careful – the last thing you need to face is insurance fraud.

Follow-up is the key element for your treatment coordinator. There needs to be a systematic process of generating reminders to call patients back. Don’t be afraid to communicate with your patients after they leave your office. So many offices are afraid they are badgering their patients like a used car salesman. The reality is patients get busy with life and, let’s face it, we are rarely on their “to do” list! Let’s say Mr. Brown needs a crown but doesn’t schedule the appointment at check out because he needs to check his schedule. This is the time to generate a memo (preferably on your computer but manual if no option on the computer is available) to follow up with Mr. Brown at a later date. There are many other scenarios at check out which require follow-up to keep that patent out of the black hole of your practice. I’m sure your staff has heard them all! Even if the reason for not scheduling is financial, a follow-up phone call to see how things are going lets your patients know you have not forgotten about them.

Calling patients when their pre-authorization comes in is another great way of keeping in touch with patients who need treatment. Even though they receive a copy in the mail, it is always good to call them and explain the benefit breakdown for the procedure and then of course to get them scheduled! You’ve got to keep track of pre-authorizations that are being sent out because they have a tendency to fall through the cracks. Follow up with the insurance company for a pre-authorization the same way you do for outstanding insurance claims.

Filling the Gaps
When you have a cancellation in your practice whether it is in your schedule or the hygiene schedule don’t just sit there and wish for someone to fill the spot. Keep handy a running log of patients who are scheduled but would like to come in sooner or who are not scheduled but are available to come in on short notice. When scheduling you should always ask your patients if they would like to be notified if something becomes available sooner. You will find patients appreciate the effort and it is a fast way to fill a hole in your schedule!

A tickler file is a list of patient’s who have cancelled but haven’t rescheduled. This is another tool to utilize for filling the schedule. The key here is to keep track of those precious patients at all times! Make progress notes not only on their treatment but on the status of why they have not scheduled and when the next communication will be made.

What else can you do to run a more efficient and profitable dental practice?
Howard Live

Howard Farran, DDS, MBA, MAGD, is an international speaker who has written dozens of published articles. To schedule Howard to speak to your next national, state or local dental meeting, email colleen@farranmedia.com.

Dr. Farran’s next speaking engagement is December 4, 2009, at the Mid-Valley Dental Meeting in Salem, OR. For more information, please call Colleen at 480-718-9914.

Seminars 2009/2010
December 4 • Salem, OR
Mid-Valley Dental Meeting
www.salemdentalmeeting.com
melody@jerryjonesdirect.com

January 22 • Vail, CO
Aesthetics in the Alpines
Linc Harris or Gail Reynolds
+61 419592951
www.harriscallaway.com
gayle@harriscallway.com

February 5 • Jonesboro, AR
Northeast Arkansas District
Dental Society
Renee Aspinwall
870-932-0015

February 12 • Carterville, IL
Southern Illinois Dental Society
Wayne Hawkins
618-357-9333

March 12 • Sarasota, FL
Sarasota County Dental Society
Kim Feathers: 941-953-6235
sarasotacountydentalassociation.com

March 19 • Aspen, CO
The Dentist’s Wife
Liz Pryor: 727-667-6945
liz@thedentistswife.com

April 8 • Hong Kong, China
Modern Dental Laboratory USA
Liv Fode: 877-711-8778
info@moderndentalusa.com

Location, Location, Location!
You are renting in a crappy location and real estate is at a 25 year low! Ever think of moving to a better location? A dentist friend of mine just bought an old bank on a four-lane intersection for $400,000 when a year ago the land was selling for $500,000 and the 4,000 square foot building cost another $350,000! Can you believe this? What an investment! His previous location got no walk-ins because they were buried in the second floor of a medical dental building. Now they are getting two walk-ins per day! That is 40 new patients per month without trying!

Move it or Lose it
Why can’t you do dentistry any faster? The biggest misconception is “fee for service.” Guys, it’s “production per hour” that matters. You have Dr. A who charges $1,200 per crown and takes an hour and a half to do it. Then you have Dr. B who accepts PPOs for $750 a crown, which only takes him 45 minutes. Dr. A is getting $1,200 per hour and a half and Dr. B gets $1,500 per hour and a half and has twice as many patients because he joined a PPO!

I’ve said this before and I’ll keep saying this until the day I die: faster is directly related to higher quality. Pop quiz: who do you think does a root canal better? An endodontist who can do a molar in 45 minutes; or a general dentist who takes two one-and-a-half hour appointments? It is a known fact that dentists who go faster do so because they know exactly what they are doing. The dentists who go slowly are doing so because they don’t know what to do next. You know who I’m talking about. This is the dentist who drills a little bit then rinses, dries and examines. Then the dentist drills a little more and then rinses, dries and examines. Dentists who know what they are doing simply put the bur to the tooth and knock it all out in one swoop! This genius concept was brought to dentistry by the famous dentist Omer Reed, DDS, who, it just so happens, practices up the street from me.

What about posterior all porcelain crowns? When you have to bond on a crown it takes 30 minutes. You have to anesthetize the tooth! You have to pack cord! You have to place a rubber dam! Why take the time to do this in the posterior? You could just cement the crown in 15 minutes with 3M ESPE Rely-x Luting Cement if you used a PFM crown, a Captek crown, or a Procera crown by Nobel Biocare at 500mPA, or a ZrO2 crown at 1450mPA, and cut your crown cementation overhead in half!

Bonding Time
Finally, why are you numbing the tooth with lidocaine and then going back to your office for 15 minutes sipping coffee and talking on the phone when you could numb up the tooth with Septocaine and set a timer for four minutes and then be ready to work. And what should you be doing with those four minutes? First of all you pride yourself in word-of-mouth referrals so stay in the operatory and bond with the patient! You can’t be flying in and out of the dental operatory and expect to have an overwhelming positive chairside manner. Stay in the room and bond not to the tooth but to the patient.
Dentaltown Magazine
September 2025
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