|Dr. Doug Carlsen interviews Dr. Hall* to learn the secrets of his high-tech
practice that maintains near 50 percent overhead.
|* Doctor’s name has been changed. Also, few details are given regarding Dr. Hall’s identity. He is a real practicing dentist,
as verified by Dentaltown Magazine. He wishes to maintain a certain degree of anonimity.
Many dentists love tech “toys,” yet pay the price of
high overhead, often well over 70 percent and occasionally
over 90 percent. I’m pleased to interview Dr. Hall,
59, who practices in the suburbs of a Midwestern city.
Hall has fully embraced high-tech throughout his career,
following in the footsteps of his dad, a dentist “gadget
freak” even back in the 1950s.
Hall has been able to incorporate many of the technologies
we all wish to have while keeping his overhead
in the low 50 percent range.
Carlsen: You talked of your dad’s tech influence on
your practice. Please elaborate.
Hall: I was fortunate to practice with my father for
more than 25 years, joining him in 1980. Being a
depression baby, he imparted a very sound financial
basis to our practice. He was a cash kind of guy, yet did
borrow on occasion, feeling the best thing was to invest
in our practice. We knew more about it than anyone
and certainly more than we did in the stock market.
My father was always very interested in gadgets and
technology. He was an early adopter of stereo gear, color
TVs, cordless phones and video. When I joined the practice
and suggested we get a PC and a dot matrix printer to
print out insurance statements he was all-in. It was 1981-
82 when we got our first PC. We paid over $2,500 for a
machine less powerful than an iPhone is today.
As much as I am interested in technology I am not
naive enough to think that machines will solve all of our problems. If you don’t have the right people with the
right skills, most of that equipment will end up sitting
in a corner somewhere.
You still need a receptionist who has great people
skills who can engage new and existing patients, a dental
assistant who can make people feel at ease, and
hygienists who can make patients want to come back. I
have often heard that technology makes for a cold
atmosphere. I see it differently. If you can avoid having
your staff ’s time taken up with repetitive tasks, which
computers handle so well, it gives them time to do the
things you want them to do: engage your patients, ask
them about their families, ask them about where they
are going on vacation, etc. If you have to spend your
time filling out forms, you miss the important stuff.
Carlsen: Let’s go through the list of tech devices
you use in your practice and how they assist you.
Hall: Video Conferencing: I use GoToMeeting
extensively with both patients and specialists. After my
initial examination I always have the patient return for
a consultation appointment. I
decided to see if patients were
interested in doing this remotely.
GotoMeeting allows the patient
to log in and we review their
radiographs, photos and chart
online. It saves the patient the
time and cost to visit the office.
This has been received extremely
well. I’ve also found the patient
seems to be more focused on what we have to say to
each other, possibly because they are in a very comfortable
environment. Also, if I have a complex case I can
often meet with a specialist to hash things out. In a
much shorter period of time we can review records
Digital Radiography: This is a no-brainer, being
easier, quicker and more diagnostic than film. I don’t
know a reason why anyone would still be using film.
Cone Beam: It is certainly expensive but it makes
you such a better dentist through better diagnostics. You
and the patient receive more information and it leads to
better dentistry. It opens discussions and patients accept
Shade Taker: We use Shade Wave. The virtual tryins
save me a great deal of time and deliver a more predictable
Digital Impressions: With our 3M camera, crowns
fit better and we can deliver in less time.
Digital Phone System: We are now trying out new
IP phones and telephone service by a company called Broadview. The really cool thing about their product is
their software integrates with my Dentrix software.
When the phone rings a screen populates information
about that patient in a very convenient format. We see
existing appointments, balances and treatment needed.
It puts a lot of information at the fingertips for whoever
answers the phone.
Carlsen: Let’s go to your website. You’ve told me
that one’s website is crucial to a practice’s success, while
I’ve heard stories of untold time spent and wasted dollars.
Please describe your way of building a website that
Hall: When I started developing our web site, I
came across a statistic that said the page that was most
referenced on dental sites was “Meet the Staff.” That
told me that people have and will always be interested in
relationships. My website made it easy for relationships
to be made and to grow.
I see sites with a lot of verbiage and photos of
before-and-after treatment. I don’t think people want to read or look at all of the technical stuff. People want to
be able to interact with you and the staff as easily as possible.
My site has a few large buttons that allow new and
existing patients to have a portal to view what they wish
to view: make appointments, update their information,
pay their bill and ask a question. Construct your website
to be as easy to interact with as possible. I have photos,
videos and written descriptions, but they are not
the focus of my website.
Dentrix allows us to make and use true online registration—not the kind of form that the patient has to
print, fill out and return to our office. This saves time
1. My office staff doesn’t have to manually enter all
the information—it imports automatically. If
your receptionist isn’t spending time entering
information, she can talk to the new patient and
start developing that important relationship.
2. I can review the patient information when I have
the time, before they are in my office. I often will
Google their employer and get up to speed on what their company does. It is very impressive to
a patient when you understand their work—yet
another way to develop a relationship. And relationships
are what allow people to feel comfortable
with you as their dentist.
Carlsen: How do you keep your overhead low, even
with all the technology?
Hall: Net profit is a function of how much you produce
minus how much you spend. I think much of an
office’s production has to do with relationships. The
stronger they are the more likely your patients will seek you
out and accept treatment, thereby increasing production.
In addition, when you institute the right technologies,
you will be able to employ more productive people
who are consistent in their tasks, creating a consistent
product that has less cost. Increased production (treatment)
with a more consistent product (less cost) lowers
Here is an example for a single unit anterior crown.
We used to take digital photos and send them to the lab.
We would get the crown back, try it in and often have
to send it back to the lab to adjust the shade. Now we
use digital shade mapping software (Shade Wave). It
allows a virtual try-in that greatly improves our success
rate. We also use digital impressions (3M True
Definition). Crowns consistently fit better, with far
fewer remakes and shorter appointments. More accurate
fits with fewer shade changes definitely improves the
Carlsen: Return on investment seems so important
today for high-tech equipment. What has been your
return on investment with your technological devices
Hall: When I was thinking about buying a cone
beam system, the sales people talked incessantly about
return of investment in terms of how many scans I would
need to take to cover my monthly loan amount.
What I found out was that the equipment made me a
better dentist. I provided superior diagnosis and implementation,
allowing me to expand the conversation I was
having with my patients about their dental health and
needs. I stopped thinking about how many scans I needed
to take a month and did the more important thing of concentrating
on what is the best for the patient.
Those expanded conversations have led to a lot
more dental treatment and the revenue associated with
it than scan fees alone would ever produce. Return on
investment has not been an issue in my practice.
Carlsen: What is the main thing you’ve done right
Hall: Most dental offices are similar, with a single
dentist, a couple of dental assistants, some front office
people and a hygienist or two. Being interested in technology
and then dropping it in the laps of your staff is not
enough. Implementation has to come from the top down.
You as the dentist have to be willing to spend the time to
learn the products and stand behind your staff when they
need help. If you throw it in their court and walk away, it
will never work.
You also must invest in an IT service. I have my IT
service on retainer and it is one of the best investments
I have made.
Carlsen: What suggestions would you give for both
a new grad and an older dentist near retirement?
Hall: Technology is and will continue to be a part
of dentistry. Do your homework, subscribe to dental
blogs and listen to what they are saying, good and bad.
Develop relationships with dental manufacturers and be
willing to help them improve their products. Don’t be
too disappointed when some products don’t work. Trust
me, all do not do what they claim. Even if you are near
retirement, don’t be afraid to upgrade. When you wish
to sell your practice it will be that much more attractive
to a young dentist wanting to buy.