The 4 P’s of Your Dental Practice: Performance, Productivity, Profitability, and Patients
All dentists want a practice with high performance, productivity, and profitability. These three P’s represent the standard by which successful dental practices are measured. There is, however, another “P” that many dentists forget, which is arguably the most important – Patients.
Happy patients lead to positive outcomes and accelerate the other Ps. Enhancing customer service and public relations are vital to running a thriving dental practice. To accomplish this requires dentists to devote more time to patients and provide them with what they need to complete their treatment recommendations. By incorporating current, proven, safe, and secure technology into the dental practice, staff can focus more on patient care.
Performance indicators The recall program is the performance enhancement engine of most dental practices. When patients commit to and show up for regular recall appointments, dentists can diagnose potential issues early. These appointments allow time for patients to express their concerns and discuss what needs to be addressed with their teeth. In order to have an effective recall program, the practice needs a good hygiene program to encourage patients to return at six-month intervals. This means the practice has enough staff to see both recall patients and those coming in for more time-consuming dental treatment.
If the one-on-one time with the staff decreases, performance may suffer, and patients may become uneasy about accepting the recommended treatment that was not effectively explained to them. Enhancing patient communication internally and externally during this pandemic time will help to ease patient fears and build trust with being treated at the practice.
Productivity indicators A full patient schedule, along with healthy collections, is indicative of high productivity. In fact, according to the ADA’s Practical Guide to Expert Business Strategies, “Controlling the schedule requires constant vigilance, commitment, and training. It is the foundation for the success of the entire practice. (Ref 1) It takes valuable staff time to maintain this schedule and work with patients and insurance companies to collect payment. When staff is concentrating on reminding patients about appointments, preparing monthly invoices, and communicating with insurance companies, they are not focused on patient treatment and business-building tasks.
Here are several signs that the practice is busy, but not productive:
- The main objective is to keep the schedule full rather than focused on patient care.
- Both the hygiene and dentist schedules are booked for weeks or even months, forcing patients to wait long periods of time for even routine procedures.
- There is no consistency in the procedure schedule—patients are booked for 30, 60, or even 90 minutes.
- Staff skips lunch breaks to catch up.
- There is low patient retention.
- Revenues are flat. (Ref 1)
Using or adding technology can help staff maintain a full patient schedule through automated email, text, mail, and phone call reminders to help patients with their appointments. These software programs also provide practices with essential statistics, such as appointed and completed versus missed appointments, to increase productivity.
Another productivity indicator is the number of patient referrals. Satisfied patients refer others to the practice. Happy patients believe the staff truly cares about their dental care and goes the extra mile explaining treatment options. Happy patients = more referrals! (Ref 1)
Poor performing dental practices experience a myriad of problems. For instance, there may be staff issues that lead to high turnover. High turnover results in reduced efficiencies within the practice since dentists spend more time training new employees and less time with their patients. Patients notice the constant staff changes and increased waiting time.
To have a high performing, productive, and profitable dental practice, focus on the fourth “P”—patients. The solution is having your staff focus on practice building work and less time on busywork that can be automated.
Omni Practice Group has been helping dentists for over 15 years to maximize the value of the practice and provide smooth transitions for dentists as they retire.
References 1. American Dental Association (ADA). The ADA Practical Guide to Expert Business Strategies: Advice from Top Dental Consultants. 2014.
Read MoreEffectively Managing and Maximizing the Value of your Practice
By Kevin Brady, OMNI Practice Group
Dental Practice owners know, there’s a lot more to running the business than treating patients.
Owners are responsible for hiring and managing staff, billing patients and insurance companies, handling accounts payable and receivable, and becoming proficient on dental software to operate the practice.
All these duties have a negative impact on both the time dentists are available to their patients and the profitability of the practice.
Practice Demands
It’s no secret that dentists face increasing constraints on their time. This means providing high-quality care for their patients, which entails creating treatment plans and participating in continuing education to keep abreast of the latest innovations in dentistry.
At the same time, the dentist needs to be CEOs of their practice. In this capacity, they are tasked with:
-Hiring, training, firing, and managing staff
-Marketing the practice
-Understanding insurance changes and HIPAA regulations
-Managing the billing, collections, and account payables/receivable processes
-Ensuring the office is running smoothly
-Maintaining and enhancing office technology
-Dealing with economic conditions affecting the bottom line of the practice
A lot of dentists come out of school dreaming about doing dentistry and they become disillusioned after a short time learning that not only do they perform dentistry, they have to run a business. When a dentist is overwhelmed with the business aspects of their practice, it is time to seek help.
Outsourcing
Employing third parties to help with the daily business aspects can allow dentists to focus more on their core competencies to enrich patient care. Dentists have many choices when seeking advice and outsourcing partners. Most major software companies have additional services to help with outsourcing patient billing and insurance billing, which allows the office to go paperless. Enhancing the Billing/Collections and freeing up doctor and staff time allows the practice to be more productive and profitable.
Marketing
Developing a Marketing plan is important in building a sustainable practice over time. The ADA says a good rule of thumb when budgeting for marketing expenses is to allow 3-6% of a new practice’s expenses; 2-3% for mature practices; and about 4% for practices that are in the middle. A start-up practice should plan to spend about $40,000 on marketing during the first year, with those costs incorporated into the overall practice financing.
Internal marketing is the least expensive way to build and maintain existing patients and generate new patients. Practices that successfully connect with patients have the best marketing vehicle available – positive word of mouth that current patients share with families, friends, and coworkers that generate new patients for little or no cost.
Having a website that connects the practice with your ideal patient is critical to keeping existing patients and generating new patients. Once you have a branded site, make sure you continue to enhance it with Search Engine Optimization – (SEO). Keeping up with SEO will increase the quality and increase the visibility of the website to internet search engines.
Making sure you have the right branding and marketing strategies designed to endure the current market conditions and changes are critical for the practice to compete with larger corporate dentistry groups.
Practice Transitions – Buying or Selling a Practice
Just as dentistry is a profession that is highly trained and practiced, so are the professional services recommended for selling and buying a practice. A dentist that is looking to sell or buy a practice should seek professional help. Selling or buying a practice can have very complex processes and numerous legal, financial, and tax implications.
OMNI Practice Group is one of the experts in the industry helping dentists with developing plans for adding associates, developing transitions plans, and selling or buying a dental practice and real estate.
Omni provides:
-Practice Appraisals
-Web Practice Listing Services
-Marketing and Listing services
-Practice Real Estate and Lease services
-Banking Referral Options
Being a Dentist/CEO can present a lot of challenges with operating a dental practice in today’s market. Using the right partners can help improve efficiencies, generate new patients, and increase the value of the practice.
Contact us today for a no-obligation consultation with one of our expert Practice Transition Advisors.
Click here to connect with Kevin on LinkedIn!
Read MoreBiggest Decisions Dentists Will Have to Make
As a dentist, you worked hard to build a successful dental practice. This has often meant putting in long hours, dealing with staff turnover, insurance hassles, ongoing CE requirements, and economic issues. Everything about the practice has been on your shoulders, along with having a good life balance outside the practice. Then comes that day when you want to transition the practice and retire.
Transitioning the practice is probably one of the biggest decisions a dentist will make in their career. Deciding on whether to transition the practice to a partner, associate, a new dentist, or corporate dentistry, you will need expert help to make the right decision.
Developing a plan
Having a plan that is 6-8 years out from transitioning the practice will allow you to maximize the fruits of your labor. Most dentists should consult experienced and reputable practice transition advisors who specialize in dental practice transactions. Having the practice transition consultant explain the practice valuation process can show you your practice’s true worth. This will allow you to develop a plan that meets with your goals of when you want to transition the practice and what you want the practice to be worth. This will allow the practice transition consultant to advise you on possible strategies to maintain or increase the value of the practice, ensuring that your practice is ready to transition when you are. Many dentists wait “too long” to develop a plan and make decisions to slow down as they get closer to a retirement date or they may add new overhead or make other business decisions that could have a huge negative impact on the value of the practice.
Consider all possible options
Developing a plan early will allow you to compare different possible options to transition the practice. Explore all the different options with your practice transition advisor and pick the one that is right for you and your professional reputation and legacy.
Finding the right buyer
Finding the right buyer that is financially qualified to buy the practice is the most important process of the transition process. Working with your practice transition advisor and their banking partners will allow you to identify the most qualified candidates to negotiate a final deal. Using an expert practice transition advisor will help to maximize the value of your practice and make for a smooth transition.
Finalizing the deal
Once you have a qualified buyer and an offer for the practice, the offer must be reviewed with your attorney and accountant before you accept to make sure that you are protected and know the tax implication of the sale. This will provide you with expert guidance that all your personal financial affairs are in order and you are sufficiently funded for your retirement.
Transitioning of the practice
Developing a transition plan with your transition practice advisor and the new buyer is critical for a smooth transition. A plan must be in place to ensure patients and staff retention. Most dental practice transitions require a transition time commitment from the seller. Make sure you work with your transition practice advisor to identify a time commitment that fits with your exit time frames. This transition time frame is an essential process in providing the buyer with a comprehensive understanding of the day to day operations of your practice.
Practice Transitions Buying or Selling a practice
If you are thinking about transitioning your practice now or within 8 years, you should seek professional help. Selling or buying a practice can have complex processes and numerous legal, financial, and tax implications.
OMNI Practice Group is one of the experts in the industry helping dentists for over 15 years, with developing plans for adding associates, developing transition plans, and selling or buying a dental practice and real estate.
Omni provides:
- Practice Appraisals
- Web Practice Listing Services
- Marketing and Listing services
- Practice Real Estate and Lease services
- Banking Referral Options
Patients seek out their dentist professionals for help when they need it, dentists should also seek out the use of experts in assisting them with all their transitioning needs.
Contact us today for a no-obligation consultation with one of our expert Practice Transition Advisors.
Click here to connect with Kevin on LinkedIn!
Read MoreGoodwill in Dental Practice Value – For Sellers
By Megan Urban, OMNI Practice Group
As many of you know, in the sale of dental practices, typically the biggest contributor in determining the purchase price is “Goodwill”. Are you aware of the aspects that make up goodwill? Of course, it includes your patients and business reputation, but it’s also based on patient retention, which is your hygiene program or Recare.
Savvy buyers understand that the repeat or retained patients are critical to on-going success. It is also important to lenders working with buyers. If you have a bulk of your patients coming in for large cases and your collections are high, that is commendable, however, a new buyer will be concerned that your patients have completed all treatment leaving them nothing to do and eliminates the chance for the buyer to meet and keep your patients.
All dentists focus on getting enough New Patients, as they should, but what happened to all the New Patients you treated over the years? Consider this example:
Let’s say you averaged 15 NPs per month for 10 years and you saw each on an average of twice per year in hygiene or Recare, you would need approximately 514 days of hygiene if you see an average of 7 per day. Some of you may see more patients in hygiene, but some may be SRP and perio patients may be coming every 3-4 months. You may work around 180-195 days per year so you would need approximately 2.75 hygienists. So that means if you retain at least 85% of those patients, you will need more and more hygiene days each year. Is this happening in your practice?
How many years have you been practicing and how many hygienists do you have? You may feel it’s impossible to fill more hygiene schedules. That tells me you may need revised scripting and a strategy for talking with your patients and educating them about their dental maintenance.
I have analyzed hundreds of practices and found that the average potential for increased collections from goodwill or patient retention is $30,000 to $150,000, depending on the size of the practice. I know it’s usually a high priority in any practice but needs a little tweaking that can bring big increases. And this doesn’t include potential increased collections from diagnosed treatment from all those periodic exams!
I encourage you to look at your own practice statistics. How many patients did you see in Recare in 2019? Run a procedure frequency report for codes 1110, 0120 and see if your numbers make sense based on your number of patients.
Do yourself a favor and increase your collections now and increase the value of your practice for the day you sell. This is my area of expertise and something I enjoy helping my clients achieve. Please contact me if you would like to further discuss and make a plan for your practice.
Read More5 Points to Ponder About a Transition in the New Year
We have been involved in practice transitions since the mid-1990s. Our company has sold over 500 practices in 10 different states. Doctors have sold their practices for numerous reasons ranging from just being tired of owning and managing a practice to severe health issues forcing them to sell. In all these years and transactions we have performed, not one doctor has come up to us after the sale and said, “I wish I wouldn’t have sold my practice so soon”, or, “I wish I still owned my practice.” In fact, most doctors whom we talk with months, or even years after a transition, say, “Selling my practice was one of the smartest decisions I made. I wish I would have sold much earlier.” So, how do you know when is a good time to sell? Here are a few things to consider:
- The Current Sales Market – Is it a buyer’s or a seller’s market? A buyer’s market is when there are a lot of practices for sale, interest rates are average-to-high and there is low-demand. Currently, as of December 2019, we are in a seller’s market. Interest rates are quite low. The economy is doing well. The demand for practices is high. The demand for practices producing over $700,000 per year is ridiculously high. We can usually sell those in 3 to 6 months. This high-demand and low-interest rates are causing an increase in practice values. In a few years, this will change – and we will probably never see these high values again in our lifetime. You want to sell your practice in a seller’s market that is this hot.
- Being Forced to Sell – There are certain things that are inevitable in life. Getting older is one of them, and that includes all the aches, pains and other health issues that go along with it. Every year, we have seen several doctors sell their practice because of back, neck, hand, or eye site issues, to name a few. We have also seen more serious health issues that forced a doctor to sell. Cancer in all its’ forms, and other diseases, can happen when you least expect it. There have been several doctors who often tell me they are ready to sell, and yet, they don’t put their practice on the market when they’re still healthy. Only when they were diagnosed with cancer did they decide to sell. One of them sold their practice and then passed away the next day. We have story after story of doctors who sold their practice expecting to enjoy retirement with their family only to report back that they or their spouse got sick, or worse yet, passed away. Enjoying retirement and life is something we should all have the opportunity to do. Selling when it’s the right time ensures us of this.
- Harvesting the Equity in Your Practice – This is one of our favorite strategies in selling a practice. And, this hot market with high practice prices makes it even a smarter decision. When you started or bought your practice, you probably took out a loan with the bank. As you’ve been practicing, you have paid your loan down and have built up your practice. The difference between the potential sales price of your practice and any debt you may have on your practice is called equity. Many doctors may have hundreds of thousands of dollars, if not millions of dollars, in equity. This equity doesn’t do anything for you. You can’t do anything with it unless you harvest the equity. You do this by selling your practice. You put the hundreds of thousands, or million dollars into the bank, invest it, or pay off your house. Whatever you’d like to do. You can then work back in the practice you just sold, or work in another practice. Or, you can even go buy a new practice, build it up and harvest even more equity. It’s a beautiful thing.
- And now for Something Completely Different – (This heading is for the Monty Python fans out there!) We all get tired of doing the same old thing, day in and day out. We are just tired of the monotony, tired of staff, tired of the patients and just ready to do something completely different. We have doctors who are ready to change course completely. We have had doctors sell and tell me they want to be a real estate agent, a barista, or they are going to run a surf shop in Hawaii. If you’ve reached that point and are tired of the same old routine, remember – Life is Short, it’s time to take action and do something different. You can always come back years later if you decide you have had a long enough break and are ready to return to practice.
- Annual Production is Decreasing – Just for fun, go back and look at your last five years of profit and loss statements or tax returns. Have your annual revenues gone down year after year after year? How’s your income – has it also gone done year after year? We frequently see this as practice owners start to get a bit tired towards the end of their careers. They slow down their production, but the overhead stays the same, so their income goes down even faster. They then decide to sell and think that the price should be based on what the practice used to do before the slide in production. It doesn’t work that way. A practice’s value is what it’s doing today, not five years ago when it was double. Using the Equity Harvesting strategy (in number 3, above) would have given these doctors hundreds of thousands of additional dollars.
We are imparting this knowledge to you not to get you to sell your practice as soon as possible. We are simply giving you some things to think about and passing on some wisdom from prior experiences of other doctors. Thinking about these five things, in addition to taking action, may provide you more time with your family if you sell a few years earlier. It may also give you more money to have a happy retirement. Look at each one of the five items above and ask yourself, “Do I want to sell your practice when I have to, or when I want to?”
Peace, out.
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