Friday, September 21, 2012

Times Are Still Tough



There are a couple of things that went on I wanted to tell you about from the Florida Academy of Cosmetic Dentists meeting I went to. This was my forth meeting.

I get a lot of emails from them telling me what is going on in the group. They are very professional and not overbearing. There are guys two guy who are always there. They are both past presidents and they are always in magazines. They are like the faces of the group.

Taking a step back here, I think this economy has hit cosmetic dentists the hardest. They do one thing: high-end, cosmetic, elective dentistry. Of course, when the economy is tough, this is the first type of dentistry that is going to be put off. I know this. And for this reason, I am glad I am a jack of all dental trades. I think I am pretty good at a lot of things. I do root canals.

I do anterior esthetics, composites, porcelain veneers.

I work on kids. I do removables (as little as possible). I do posterior composites pretty well. I do full-mouth reconstructions. I restore implants. My father does the Invisalign in the office. We do a lot of things. So when the cosmetic stuff decreases, you know what increases? Root canals. Because people ignore that hole in their tooth until it starts to hurt. When it hurts, I am their man. And when the cosmetic stuff comes back and they are ready to change their smile, again, I am their man.

I am not saying that I don't understand why someone would move their practice toward doing one thing well. I do. I just like a variety in my life. I like all those aspects of general dentistry (except for the removable part).

Now, back to the guys I was talking about. Some of us were talking about work and whatnot. Of course, the conversation got to how busy we are or are not. It was all about how slow we all are. We were not complaining; the overarching theme to our conversation was how blessed we all are to have this awesome job. One guy did, however, talk about how he was considering taking plans. "Yeah, you know Dr. X and Dr. Y over there? I practice near them and their office started taking plans."

I don't know. I think this does two things. It justifies how we are doing. If the guys writing magazine articles are slow, then I guess it makes me feel a little better that I am less than packed. And if they are taking plans then I guess it might not be such a terrible thing. It gives us confidence to maybe call up the representative.

The guy I was talking to said that he is getting so slow during the summer months that he has had the insurance representatives in the office. He said there are people you can hire to be an advocate for you. They will call the insurance people and either negotiate a fee or they will find what is in your wheelhouse and find the insurance plan that fits you and your office the best so you don’t take such a hit.

A couple of months ago, our office called in a representative of what we thought was the most used and best insurance plan in our town. We had a discussion with her. We almost bit the bullet until we found out that it was not just the new people we would have to honor the plan’s fees for but that our existing patients would have to pay more to see us. The dollars lost because of that was enough to run the rep right out of the office. For an established office like ours, getting plans is a tough sell. Have any of you started taking plans? I would like to hear about it.

There was another thing that I found interesting in the lecture. This was a high-end lecture. This guy does very high-end Pankey/Dawson type dentistry. You know, full-mouth reconstruction, multiple discipline treatment plans. I have seen many of these practitioners; he is the first one that said that you don't have to do this type of dentistry on all of your patients.

I am a very big fan of Pankey, so I am not knocking them under the bus. But I have always had a beef with the Pankey system: if you are going to workup everyone that walks in your office, you are going to scare a lot of people and watch them walk out. This dentist said that if you are only going to restore one tooth, just do it. You have nothing to worry about. You don't need to know about the VDI or the CR or the MCO. I have always felt a little inadequate when I broke the Pankey mold, but he is saying it is okay. Good, because I have about 400 single-unit crowns out there.

I feel like being slow is the norm around our offices. I am happy when I am busy, but I am not all that sad when I am not. Look, I get to write blogs and articles and whatnot. I am not feeling inadequate. The overwhelming feeling I get when I think about all this gratitude. You know, blessed.

Hey, if the president of the FACD is taking plans and the Pankey/Dawson guy is saying it is okay to do a crown, things are definitely changing.

Have a great weekend,

john

P.S. I write about these things because I know how easy it is to feel small. I have been there. I have read the magazines and seen all the dentists talking about how awesome their practices are. They are producing $2,000,000 and not even breaking a sweat. They only had to do X and it changed their lives. I hope this helps. You’ve got a great practice with great patients. Feel blessed.

5 comments:

Anonymous said...

I dunno. America still boggles me. I'm Canadian and although lots of money exists here no one is going to drop money on Pankey Dawson or Kois dentistry that is so well plied in the US. Many dentists here want to take their practice to "the next level" as a result of taking too many courses and it never works. It backfires into the overcharging guy who melts down his practice. It never ever works but it keeps the CE machine going. PT Barnum once said "there's a sucker born every minute". So just stop it already.

Dentistry to me as you're finding, and as it should to every dentist, is about treating people's needs, whatever that may be. On a per service fee you get paid decently so just leave it there. There is no pie in the sky money maker case. Its a tough grind in every case. I'm rated one of the best in my city as it happens I think because I tell people what they need but also if they ask I tell them what they could have. I'm happy doing molar endo, wisdom teeth and aesthetics and IV sedation. It's what I was taught to do. Nineteen years on I'm happy with that. I would stop chasing the moon - your destiny, as you're finding, is just where you are. G in BC

M. Benson DDS said...

I disagree just a bit; I am a younger dentist that "does it all." I do composites, root canals, dentures, and place implants. Just about anyone out of dental school can do these procedures, but can they do them well? That philosophy is more in line with what Dawson and Kois teach. You are slightly mis-informed because not every patient gets a "dawson" workup. My health history and patient information form dictate what level of dentistry they are looking for, which is how Dawson teaches. I have found that people are willing to do more dentistry if you know how to present what can happen if they don't address certain issues. The difference is, today, that instead of doing 10 (+) crowns in 1 visit, you maybe doing 2-3 every 6 months or so to get them where they want to be not only cosmetically, but functionally and financially. The workup is still the same and you better know how to make the teeth work with the muscles and joints or else they will be back in your office with no money because they are having to redo work constantly. It is all about comprehensive dentistry not cosmetic dentistry. Just because one person needs a filling or 1-2 crowns and another needs 7-8, one is neither more comprehensive than the other. The treatment plan needs to fit the needs of the patient to insure their long term dental health and function.

Anonymous said...

After 23 years, I still love going to work every day! Although Dentistry is difficult and patients can be trying, the payoff is that at the end of the day, you have helped someone- often many! IN New Jersey, things have been slow for a while, but we do a little bit of everything and help patients work out payment plans like we used to do years ago. Many patients have lost their jobs, but we still want to take care of them, so we work it out. I think people do appreciate your commitment to them- even in difficult times. Believe me we are busy enough.. yes, it could be better, but we are just fine. Happy in NJ- Dr. Teresa

hrifai said...

I agree with the second comment. I am fortunate enough to work in a hospital setting where I get paid a salary regardless of how many patients I see or how much I produce. I find that as a recent grad I am a jack of all trades, but I do want to do more procedures and do them better. That is what drives me to CE, not the sales pitch. Working along side of more experienced dentists I constantly get their feedback on large cases and they point out things I may not have considered. That's a real benefit to continuing ed.

HR

hrifai said...

I agree with the second comment. I am fortunate enough to work in a hospital setting where I get paid a salary regardless of how many patients I see or how much I produce. I find that as a recent grad I am a jack of all trades, but I do want to do more procedures and do them better. That is what drives me to CE, not the sales pitch. Working along side of more experienced dentists I constantly get their feedback on large cases and they point out things I may not have considered. That's a real benefit to continuing ed.

HR

Disclaimer

PLEASE NOTE: When commenting on this blog, you are affirming that any and all statements, and parts thereof, that you post on “The Daily Grind” (the blog) are your own.


The statements expressed on this blog to include the bloggers postings do not necessarily reflect the opinions of the Academy of General Dentistry (AGD), nor do they imply endorsement by the AGD.