Blue Light Special

Do you ever feel like you’re working the layaway line at Kmart?!

To those of you who have a patient clientele without financial issues, who always pay in cold, hard cash, who willingly put down large deposits to save appointments, and who agree to office fees without negotiation or discussion, I raise a glass of this red wine to you.

Cheers!

For everyone else — this one’s for you! We do some awesome dentistry for a lot of patients, yet sometimes, it is such a battle to get compensation and reimbursement. It’s mind-boggling, really. My dad always said something when patients gave front desk staff a hard time about paying: “Do you walk out of the store without paying for your groceries?!”

But really, what’s the difference? We provide a service with a high overhead and ever-so-thin profit margins. What gives patients the right, or the expectation, to think they don’t have to pay?

Sometimes, it has to do with us: the dentist/owner. Most of us have big hearts. We see some patients in dire situations with no means to afford dental care. We do free, donated, and deeply discounted dentistry all the time. Heck, often on a daily or weekly basis. We also have a tendency to “give away the house.”

Early on in my career, I wanted to wear all of the hats. Treatment planning and presenting were what I enjoyed, but I noticed myself all too often giving away serious discounts without much pressure from the patient. Bottom line, I used to think: If you’re in my chair, I might as well do some dentistry.

That’s certainly true, but it makes more sense to have standardized, clear, and accountable financial policies. And they can’t just be on paper. Staff must understand and follow the financial guidelines, and patients have to be held accountable as well. This is the only way to take “us” out as being part of the problem. Staff should be trained on treatment presentation and financial discussion skills. We’re here to do dentistry, and we need our teammates to feed us the assist on these other matters.

The flip side of the coin is the patient. I recently did a same-day crown on a patient I kindly worked into my schedule. Ninety minutes later, she walked up front to check out. I was happy; the crown looked great, the patient was excited she wouldn’t have to return for a second visit, and my schedule was still on track. And then it happened. The patient said: “Well, actually, I don’t have any money today.”

Wait, what?!

Why would you expect my 90 minutes of dental work to be done at no cost to you? (Again, do you pay for your groceries?) We worked out an automated recurring billing arrangement but still. It was unacceptable from my front desk staff down to the patient. Financial arrangements need to be outlined, cleared up, signed on, taken care of before I sit down and devote those precious minutes to prepping, designing, and spending my practice money on the patient.

I can’t place the blame on any single person, but I certainly need to work on my leadership when it comes to this side of my practice. I hope (assume) I’m not the only one who is working on this.

In the meantime, you better believe I’m going to try that trick with my groceries. I’ll pack my cart up and walk right out the front door. Look for me on the news. Maybe I’ll be in jail. #bluelightspecial

Donald Murry III, DMD