Tier Dentistry

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(This is what the patient sees when they walk into my office,
read on to see why this is relevant)




Thank you for the comments.
A man needs to feel loved sometimes.
I am sensitive, what can say.

Anyways, we have been talking about why someone would pay $40 dollars for a steak or $400 a night for a room.
And how someone can come to appreciate a great filling (that cost more).

The Pankey Institute explained it to me as Tier Dentistry (that means if this sucks or you don't understand it, blame it on the institute).

All the offices can be broken down into 4 tiers.

Let me explain.

Tier I
Is what we would refer to as a clinic. High volume of patients all for bottom basement prices.
This is the McDonald's of dental offices.
On the McDonald's sign it reads Billions and Billions served.
They aren't saying, "we have great beef". They are not saying, "Come get great service"
People understand they are not getting USDA beef or exquisite service, they are coming to eat.
Plain and simple they are eating and it is not at home.
The Tier I office might be a full HMO office. They get their patients from THE LIST. You know the list. They are every insurance list. They get the patients that are told by their insurance where they are to go.
This is a no frills office. There is not alot of character in this office. There isn't alot of service in this office. There isn't alot of relationship building.
But the patient is able to get care maybe for the first time. They are getting in the dentistry door. They are being introduced to dentistry.
They for the first time are addressing things they may not of ever known they needed addressing.
I am not saying anything bad about this office. It is what it is. It is serving people. Now to me as a higher tier dentist I am glad these people are in the door (because soon enough they may want more out of their dental care).

Tier II
I compare this to a Denny's. It is getting a little better. People sit down to eat. There is a menu. There is service.
The dental office is getting a little better. There maybe some character in the office. There may be a dentist that owns the place. Maybe the office has relationships with some a good lab. But maybe using products are good but not great. They maybe serving steak but it is still not USDA.
Patients are getting better care but may still be looking for something more.

Tier III
This office is a TGIFridays. Maybe a Bennigans.
The office has some character. The office has personality. They care about the plant (the way the office/restaurant looks and feels). The dentist does a lot of CE. The dentist is using a lab that is good. They are using specialists that are good.
There is good service. The team spends time talking about how to make things better.
The food they are serving is good to great. The steak is now USDA.
They care.
The issue with this tier is, to me, an identity problem. The problem can be from the dentist wanting to be an exclusive kind of dentist and/or the patient want a $40 steak for $25.

Tier IV
Is like a Ruth's Chris.
This place serves steak and they wouldn't dare serve just USDA.
This office is real nice. This office spends a lot of time on CE.
I would say it has patients that know they are in a Tier IV place and have some expectations (this also can be a problem. Patients with unattainable expectation). Great service, great plant, character.
Alot of "It would be my pleasure, sir."
And the patient comes in expecting to pay $40 for a $40 steak.

Tier IV is where I thought I wanted to be.
Don't think there aren't problems with every tier. In tier IV there is an issue with maintaining. If you are going to do comprehensive dentistry on EVERYONE then this is a really small niche of patients.
This is hard to maintain.

Now me, I am a Tier III dentist and I have a Tier III practice.
I do dabble in Tier IV dentistry but my home is III.
I don't want to be exclusive. I don't want to only treat a certain type of clientele. I want my place to be for everyone. I want to see families. I want to see CEO's and I want him or her to tell me about the newest acquisition of the company. I want to see Little Susie and I want her to tell me how she lost her first tooth. I want to see the college kid going to UCF and tell me about the latest keg party. I want to see people from my church.
I want to see people that say, "It is okay if I pay for that $11,000 treatment plan before we get started (and whip out cash). And I want to see the patient that can't afford me that still comes in (and I give them a discount). I want my patients to expect great service. I want my staff to say, "It was my pleasure".


So how do I do this.

But this is hard to do. I try to be everything to everyone and this is deadly combination.
I have the education to do a full mouth reconstruction and I have the education to do a pulpotomy on #B.
I have a office that we just renovated. We have two different areas in the reception area. One with a couch and fancy chairs for the uppity folks (double click on the image and make it bigger) and the other side has a TV and some toys.
I have the ability to serve the Tier IV patient that likes the atmosphere in our office.

I don't have a problem with any tier. Just like I wouldn't have a problem going into a McDonald's or a Denny's. But I know what I am getting there.
I also know that my expectations change when I am getting a Ruth's Chris steak. I would say to myself that my water glass has been empty for about 5 minutes and I am noticing it.

I am rambling again. I am going to stop here.

Now that I have explained to you the tiers I want to explain to you my thoughts.
I think things have changed. The client has changed. Has the dentist changed?
I will try to get into it next week.

I did go to a study club yesterday that a years worth of blogs information came out of it.
I want to write about it soon because I will forget about it, so look for that.


Have a great weekend,
It was 93 degrees here today.
It has rained once in about 3 months here.
We have been doing a rain dances.
Lots of swimming and dead grass.
Peace out,
john