How to Survive in the Changing Dental Economy

Ten years ago, when I first started thinking about going back to business school, I asked many of my friends who were “in business” what they thought of the idea. Generally speaking, the advice I got from people who had not gone to business school (undergraduate or graduate level) was “You don’t need it. You’ve been running a business for so many years, you already know what you need to know.” Interestingly, the answer I received from friends who had advanced formal business training was very different: “You will love it—it will change the way you see everything.” That has been my experience exactly. I have also found that there are plenty of opportunities to acquire the tools and knowledge of business other than pursuing an MBA degree.

A referring general dentist once told me that when it comes to performing surgery, the main difference between a generalist and a specialist is that “the specialist has a bunch of tools that the GP does not own.” As I reflect on that comment today, many years later, I have a better understanding of what he meant. As a periodontist, the “tools” I have at my disposal are not only my instruments but also the focused knowledge, experience, and treatment plans I draw upon in caring for my patients. This concept applies to business as well: With a business education, you receive a set of business tools and frameworks to apply to specific business situations.

It seems there are as many business tools as there are dental instruments, and similarly there is a right one for most situations.

What Are These Tools?

Gaining access to these business tools does not require a formal business education, but it does require intentional education—that is, you won’t learn them through common sense. For example, a competitive analysis is a strategic management tool that brings your own particular strengths and weaknesses into focus relative to your competition. As dentists, we think of competitors as other dentists, or as corporate dentistry and DSOs. A few may even think in terms of the competition for dental dollars. However, a competitive analysis is a lens for understanding the important role power plays within these competitive relationships. Even more important is that you can then see the opportunity or risk that each of these competitors presents.

Porter’s Five Forces of Competitive Position Analysis. This theory is based on the concept that there are five forces that determine the competitive intensity and attractiveness of a market. Porter’s five forces help to identify where power lies in a business situation. It is often used to understand whether new products or services are potentially profitable. By understanding where power lies, the theory can also be used to identify areas of strength, to improve weaknesses, and to avoid mistakes. (Credit:

Porter’s Five Forces of Competitive Position Analysis were developed in 1979 by Michael E. Porter of Harvard Business School as a simple framework for assessing and evaluating the competitive strength and position of a business. Knowing how to use this tool can lead to opportunities for collaboration between business competitors to obtain mutually beneficial results. In the future, such “co-opetition” might be one of dentistry’s most attractive opportunities.

It seems there are as many business tools as there are dental instruments, and similarly there is a right one for most situations—the 7S Model, STP Marketing, VMOST, SOAR, Boston Matrix, root cause analysis, business life cycle, and SWOT, to name a few. The same truth holds with these models as with dentistry: If you know how to use them correctly you will get much more out of them. Sure, the SWOT Analysis can help you list your business’s strengths, weaknesses, opportunities, and threats, but it is much more than creating lists. When applied correctly, SWOT is a powerful decision-making tool.

Why Now?

Dentistry has always been unlike other industries. For as long as we can remember, a dentist would do fine simply opening an office. That, my friends, is changing. The private practice of dentistry will continue to be a great profession for those who create value by differentiating themselves. However, if a practice is “stuck in the middle” and the dentist makes no effort to move to differentiate himself or herself, then the future for that practice likely will not be as promising as the past.

The need to move out of the middle is not being driven solely by the proliferation of corporate dentistry players. While it is true that corporate dentistry will take up most of the space in the middle, that model is also creating opportunities for us private practitioners. We need to capitalize on what corporate dentistry has learned about the dental consumer. Ask yourself how many All-on-Four® types of cases you did before corporate dentistry educated our patients about what dentistry could do for them. Watch their television ads, listen to the radio, and study their social media posts. They have invested significant dollars and resources to learn what customers want, and you can learn from them if you know what you‘re looking for.

Consumerism is just as important a factor as corporate dentistry. Consumers are looking to see what makes a product/practice stand out. They also know how to comparison shop and have more information than ever before about you, your practice, and the organizations with which you are associated.

Where to Start?

You do not need an MBA—you need a business education. Many dental continuing education organizations are trying to integrate business programs into their dental curriculum; however, the key is to make sure these programs are business first, not dental. We do not need more tactics—we need strategy. Only then can we match our tactics to our differentiated strategy.

With a business education, you will learn that in a negotiation the best outcome is not just getting the best deal, but rather both parties getting more than either side expected (1 + 1 = 3). There are actually specific skills and tactics that can be incorporated to achieve these goals. You will learn that great communication does not just happen but is intentional, learned, and practiced. This extends well beyond your internal office communication to include your practice marketing and messaging. Is your message consistent with the individuals or segments you are trying to reach? Is your message creating value to the consumer?

You will learn that finance matters. Are you using company resources wisely? Cost-effective often does not mean cheapest. What about accounting as a tool—do your numbers help you run your business? I never realized that accounting is a qualitative subject and that marketing is quantitative.

My suggestion is to start developing a 5-year plan. Write down what you want your practice to look like in 5 years, but don’t stop at how much you want to earn or how little you want to work. If you know where you are heading, you can work to develop a road map to get there. I also believe in the value of dental consultants now more than ever.

Final Thoughts

We all know that the dental market is changing, whether from consumerism, cost of dental education, or corporate dentistry. We also know we are highly proficient at doing dentistry, and yet we continue to attend dental continuing education courses. In fact, the better we are at the fundamentals of dentistry, the more likely we are to recognize the value of advanced dental CE courses. In the new dental economy we must be fully aware that the way we run our businesses is just as important as our technical skills if we hope to continue delivering care at the quality we have been practicing for so many years. Most of us have had little if any exposure to the fundamentals of business, and even fewer seek formal business education. Rather than just complain about the changing market, I encourage you to acquire the business tools that will enable you to capitalize on the awesome potential that exists for the high-quality, differentiated practice.