Talkin’ Bout a Revolution

Back in the old days, circa 2010, the conventional wisdom told us that technology was the main driver of change in the dental profession. Digital technology was advancing apace, and new materials were continually being introduced. The comforting underpinning was that the fundamentals of dental practices would remain unchanged—at least that’s what we thought.

The reality is the dental profession is evolving so quickly we cannot clearly predict where it is going. The best we can do is be aware of current trends and seize opportunities while they last.

Here are five ways dentistry is changing on an almost daily basis, with recommendations on how to join the revolution or run the risk of being left behind.

1. Whose practice is it, anyway?

Traditional dental practice models are disappearing. One school of thought predicts dentist-owned practices will continue to exist as a percentage of the total market alongside corporate dentistry. Some argue DSO expansion will taper off; independent practices will occupy a niche market for those who still desire to be entrepreneur dentists. There are others who posit that the traditional dental model will go the way of independent pharmacies and be subsumed by large corporate entities.

There is agreement on one key point: solo practices are disappearing. Doctors will either practice in independent group settings (some as small as two-clinician practices), or they will work for a DSO. The solo, independent model is not sustainable in light of increasing overhead and consolidation pressure.

A winning strategy now is to get the most production possible out of each office location. Too many dental offices are open only four days per week, or they fail to offer expanded evening and weekend hours. The owner can hire dentists who want to work part-time as employees to cover the additional hours. Filling these hours will not be very difficult—as practices re-open in the wake of the COVID lockdown, there is pent-up demand for dental care and practices are getting booked out many weeks in advance. By increasing production, the owner is a much stronger position to sell to either a DSO or bring in associates who will buy in.

2. Gig economy.

Fewer employees these days want to work for you full-time, forever. There is a trend toward working fewer hours and enjoying more leisure time. Once the province of the unemployed or the occasional freelancer, the part-time, on-demand worker is now a staple of the workforce. The gig economy has gone mainstream. (See Paul Estes, The Gig Mindset, 2020.)

There are talented individuals who will work on an intermittent project basis or long-term on tasks such as bookkeeping or insurance claims.

Employees no longer have to be physically present to contribute to your practice, a trend that the COVID crisis has accelerated. Untethering the worker from geographical limitations opens up a tremendous supply of talent. I have seen quality, part-time employees who are based hundreds of miles away from the dental office. They perform tasks such as setting up continuing education courses or helping answer phones.

There are also part-time employees who only want to work certain hours. Just as some practices hire multiple, part-time hygienists to cover the week, doctors need to be open to job sharing arrangements for part-time administrative staff. One important advantage of this type of arrangement is flexibility: when demand increases, you can go to the bench to bring in another player; when someone calls in sick you can call in another team member with a proven track record to help.

3. Micromarketing.

We are riding a demographic wave. Baby Boomers are now between the ages of 56 and 74, their peak dental treatment years—a confluence of dental need and the financial ability to pay for care. In ten years, those Boomers will be 66 to 84, and almost half have no retirement savings or woefully inadequate retirement accounts. They are followed by Generation X, a much smaller cohort that promises to be not the sandwich generation but what I call the “panini generation.” Pressed on all sides, many will be caring for aging parents, their children, and themselves.

The exceptionally good news is that there are more opportunities than ever to refine your niche using micromarketing, sometimes referred to by the less current term “target marketing.” Small businesses, including private dental practices, no longer have to lament their inability to compete with the sizeable advertising budgets of major companies. Internet marketing has leveled the playing field. Now is the time to get into this game and learn it. You will need to outsource these efforts, but the resources required are rather reasonable and the potential return on investment is impressive. It is all part of what Dr Peter Diamandis, who has been a featured speaker at Seattle Study Club symposia, calls the “demonetization” of certain services. (See Peter Diamandis and Steven Kotler: The Future is Faster than You Think, 2020.)

4. Knowledge explosion.

The term “Renaissance Man” was coined to describe individuals who centuries ago had a command of many subjects, including art, science and music. Today, even the most learned men and women cannot keep up with the information explosion. Feras A. Bataresh of the London School of Economics explains that up to the year 1900, information was doubling once a century. By the year 2000, it was doubling every year. Now, the total sum of human knowledge/information almost doubles every day. Much of this information is not relevant to the practice of dentistry, but the overwhelming volume makes it impossible to process, much less sift and sort, to find relevant nuggets.

This onslaught of information pushes everyone to collaborate. While you should always be looking for ways to grow your study club and increase participation, you should cultivate working relationships with a small group of colleagues. This group may one day come together under one roof in a multi-disciplinary practice, or it may remain a tightly knit network of independent professionals who share their expertise. As the Seattle Study Club has so presciently preached for years, excellence in patient care springs from group collaboration across disciplines. The need for clinicians to share information and work together has never been greater and it continues to grow. Find a group within your club or create one, and by all means take advantage of video conferencing services to hold virtual meetings.  Learn together by using the Seattle Study Club’s digital resources, and treatment plan together. Your combined knowledge is a tremendous benefit to patients that also gives you a competitive advantage.

5. Train and retrain.

Even as technology propels dental practices forward, there are countervailing pressures that keep the business side of practices years behind the curve. In many practices, there are talented and dedicated team members who have not been trained to excel in the current business climate. For example, more patients than ever are finding practices through Internet searches. Substantial numbers are also responding to social media advertisements. When these individuals contact a dental practice, the team needs a new skill set for 2020 and beyond.

Because ingrained behaviors are hard to change, training must be focused and ongoing. When I train administrative staff in the office, the emphasis is on role-playing. It’s not about understanding a concept; it’s about learning a new behavior through repetition and refinement. I also train team members through video conferencing sessions. Sometimes even the best students will fall back on their old ways of doing things, even though they have the script I provided in front of them. However, through positive reinforcement of good behavior and attention to detail, team members learn the skills needed to succeed. They are always grateful to have new-found verbal skills, because the alternative can be a certain awkwardness in dealing with incoming calls from potential patients, which results in a low call-to-appointment ratio.

As an example, I explain that Internet patients are going to ask one important question very early in the call: “How much will it cost?” The person answering the phone should give a range of fees and explain that the doctor will give them options and more information when they come to the office. However, it is also important to engage the patient in conversation. The phone answerer is instructed to ask the potential patient a series of questions to learn more about them, their needs, and their motivation. The goal is to avoid having someone call, ask about the fee, and then hang up as soon as they hear a fee so they can continue to price shop. When the person in the dental office skillfully starts a conversation and starts to build trust with the caller, odds go up that the individual will feel comfortable making an appointment.

Team training must be a high priority. Investing in marketing to attract leads without training the team is like trying to fill a tub by turning on the faucet and not closing the drain. To capture the leads you pay for, be sure to continually update your team’s skills.

Training is not reserved only for team members.  Doctors are also using teledentistry for many purposes, including virtual consults with potential patients who respond to advertisements.  When a person who has a dental question or problem gets immediate feedback from a dentist via teledentistry, that individual is much more likely to start to develop trust and book an appointment in the office. The dental practice revolution has started. The forces of change have breached the barricades. Great opportunities still abound for you amid the upheaval; but as the song says, “you better run, run, run. . . .” [1]

[1] “Talkin’ Bout a Revolution,” Tracy Chapman Lyrics, 1988.