Non-Fungible Dentistry by Dr. John A. Wilde

Non-Fungible Dentistry 

How to make your dental practice irreplaceably important to patients

by Dr. John A. Wilde

Fungible has been defined as “able to be replaced by another identical item; mutually interchangeable.”

Recent years have starkly revealed the vulnerability of business entities that “just get by.” During my four decades in dentistry, I’ve practiced in the snow, rain, heat and gloom of night and never seen a time when it was safe or prudent to just get by, but current record inflation, the lingering pandemic and the menace of World War III have established a DEFCON 5 level of risk.

And to compound these worldwide threats, the proliferation of corporate dentistry indicates—and relentless fee repression by insurance companies verifies—that private practitioners are increasingly viewed as fungible, one being just as good as another. Every dentist knows this to be categorically untrue. Still, the perception grows unabated in a culture that discerns the price of everything and the value of nothing and casts all members of our profession in the unflattering monochromatic light of mediocracy.

To combat this belief, let’s consider how one may create a uniquely successful practice, then elevate it above the inevitable vicissitudes of the economy, making it impregnable to competition while transforming one’s life work into a pleasant, exciting, and rewarding journey toward mastery—even joy.

It starts with the dental team
We’ll begin our pursuit of this inspiring vision at the bedrock, because the underpinning of every outstanding dental practice is a dedicated, skilled and supportive team. (Please trust someone with 40 years of wet-fingered and -gloved experience because if you doubt this even a little, mediocrity is the most you can attain. No matter how hard you row, doctor, a one-person crew won’t win any race.)

The first step is identifying ideal individuals to join your team, because anything less will lead to a perpetually unhappy staff with high turnover. While hiring is an art that deserves a book of its own, let me offer a skeletal glimpse of my time-honed regimen.

  1. Create a dynamic ad that highlights the multitudinous benefits of your opportunity and post it on whatever recruiting venues have proven successful. You have much to offer because well-paying, Monday-through-Friday, 8-to-5 jobs that include generous benefits and take place in a pleasant, clean and comfortable environment are becoming unicorns.
  2. In your advertisement, insist that the aspirant personally deliver a written résumé to your office. Whoever greets the applicant engages them in conversation, then completes a standardized form recording her impressions. This construct allows a candid glimpse of people unaware they’re being evaluated, unlike the stilted formal interview setting where all are on their best behavior.
  3. After reviewing résumés and our first encounter forms, I’ll order phone interviews completed with my most promising prospects. Also employing a standard format, these are conducted by the head of the department (business office, chairside or hygiene) the candidate hopes to join.
  4. After reviewing our aggregate data, I select six to eight applicants and engage each in a 40-minute in-office interview. Perforce I must conduct these on evenings, days off or Saturdays, but hiring is far too important to rush or entrust to Zoom. I consistently follow a script of 24 questions, which keeps the process fair, and asking forces me to shut up, listen and take notes.
  5. The top two aspirants have lunch at the office’s expense with their potential department staff. Please don’t skimp here, because I’ve twice been informed, “You don’t need to know why, but not her.”
  6. My process deliberately engages numerous existing employees. When all these steps are complete, the entire staff meets and we hire only after reaching unanimity, so everyone has a vested interest in wanting “her choice” to excel.
  7. I call, offer the job, answer questions and settle details while observing enthusiasm. The lack of anything short of ebullience creates a large enough red flag to start the Indy 500.
  8. We send flowers to the second-place finisher with a handwritten note thanking them for their interest and advising we’ll keep their information on file. Hiring is an inexact science, and I once had to offer our second choice the job after less than a week.

We have detailed job descriptions for each position, and these narratives are the primary resources used to develop the standard forms on which we heavily rely. This information also helps generate our distinctive want ads. A training manual, specialized for each job, details our expectations for each day of early employment and assigns one existing team member as the new employee’s primary teaching resource.

At the very least, this concise protocol illustrates how important finding the ideal employee is to me. An outstanding team assembled and structured training begun, let’s consider how any dentist may differentiate their practice through personal and professional development, while remaining aware that none achieve excellence without a stupendous staff ’s ardent support.

Up next: expanding your knowledge
William James, the father of American psychology, claimed, “We can change our circumstances by changing our attitude.” Committing to becoming a lifetime student is choosing to be extraordinary. Yes, it requires additional effort, but you’ve labored before. And imagine the considerable rewards of becoming a master!

To achieve this worthy goal, I pick one topic annually and devote my winter to its study. A pragmatic way to determine a suitable subject is by evaluating what procedures you most often refer. I go to courses, read textbooks, concentrate on this issue clinically and visit appropriate specialists’ offices. (It’s hard to deny a referring dentist’s request. Time spent together enhances dentists’ relationships, possibly increasing cross-referrals, and I buy their staff lunch, so I’m remembered when I call, often asking a favor.)

Consider how a four-month intense focus on endodontics, oral surgery or removable prosthodontics could enhance one’s skills. Tasks at which one excels are usually enjoyable and quite profitable thanks to acquired efficiency. Not only will previously referred revenue be retained, but also patients are appreciative, because none like being banished to an unfamiliar office.

Consider starting these programs first
Understanding occlusion and treating TMD will profoundly change the quality of one’s dentistry while creating an additional profit center. While attaining a profound understanding of occlusion requires years of lucubration, simply adding NTI appliances to one’s arsenal allows the succoring of long-suffering facial pain patients while generating enthusiastic practice disciples. With the aid of skilled assistants, my chair time required to insert an NTI appliance is 20 minutes. Fees for an NTI, D7880, range from $300 to $1,000, but even at my modest $460 change, they proved more profitable than the vaunted single crown and a lot less hassle.

Six Month Smiles, my choice among available systems, has created a close-to-foolproof program to align the front teeth of adult patients, and trained auxiliaries perform most of the work. The system employs tooth-colored archwires and brackets, so the appliance is almost invisible, and fixed lingual retainers prevent relapse. Mastering the entire panoply of orthodontics is daunting, but most adults don’t care if they are Class II with an 8 mm overjet; they want an attractive smile, period. I contend they deserve that choice. I also performed conventional full-arch orthodontics and orthopedics, and this remodeling of bone in mixed dentition cases was the most valuable service I ever provided.

Removable prosthodontics is one of the easiest and most lucrative services I perform. However, I suspect this is a vanishing art, because of a lack of clinical competence and concomitant doctor confidence. As denturists can attest, it is a learned skill, and I can’t think of any procedure that more profoundly affects a patient’s life than restoring the edentulous to function, health and beauty. Two or more lower implants can prove life-changing—even life-saving—for debilitated souls who can now eat something besides pablum.

Many more opportunities exist than my space allows, yet some dentists spend careers self-limiting their scope of care to dental student procedures. A lifetime commitment to learning and growing makes our profession endlessly renewing, rewarding and exciting while establishing one as a master, unmindful of any competition, and offers bountiful financial awards.

Sophocles, that old nag, cautioned, “Heaven ne’er helps the men who will not act.” Or, as Dad often said, “The good Lord helps those who help themselves.” Let me leave you with the ringing words of James Allen: “In all human affairs, there are efforts and there are results. The strength of the effort is the measure of the result.” Becoming a dentist gives one a ticket to great things. Bestir yourself and punch it.

Author Bio
John Wilde After working through eight years of higher education, paying 100% of all costs, Dr. John A. Wilde spent his next two years in the U.S. Army Dental Corps before beginning a practice from scratch in Keokuk, Iowa. He was debt-free at 30 years old, owning his home and the practice he’d designed and built outright. He was financially able to retire at 40 and fully retired when he was 53. He has published six books and written more than 200 articles. Contact: 309-333-2865 or
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