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Focus Not Just on Growth, but Profitable Growth


Do you want to grow your practice? Or, do you want to grow your practice profitably? Be careful, because there is a difference.

“So many times you have a good doctor and good staff that do a very good job for their patients, and are well accepted and liked in the community. But just understanding what they can do better could be very beneficial.” - Dawn Renner, C.P. A., M.B.A.

There is some truth to the expression, “Work smarter, not harder.” If you or your staff are feeling like hamsters running on a wheel, or not nearly as much back from the practice as you’re putting into it, it may be time to take steps to ensure that your practice is growing profitably.

For example, imagine you decide to add certain procedures in order to attract more patients. Are you comfortable and proficient with those procedures? Is your staff? And do those procedures fit into your practice schedule in a way that maximizes earnings?

If not, says Dawn Renner, C.P. A., M.B.A., member of the National Society of Healthcare Business Consultants, then you might be “eating up extra time, or extra physical and mental energy that you could be spending on higher net reward cases.”


Renner says that one of the reasons dental practices don’t experience profitable growth relates to the reimbursement situation impacting those patients. It could be that you are not recouping the dollars you need to flow to your bottom line.

But, she adds, it also depends on where you are in your dental career. For example, if you’ve recently opened or are just beginning to expand your practice in a new location and have some blank openings in your schedule, it doesn’t make a difference whether you bring in patients who are high profitability or marginal profitability.

“If the scheduling is not full, any dollars coming in are probably better than no dollars come in,” Renner says.

All that changes, however, if you’re at the point of being so busy that you need more time for higher productivity items, such as possibly adding in cosmetic dentistry to your practice menu, or bringing in patients to have more profitable elective procedures done.

“Then you need to look at your overall reimbursement structure, and maybe not renew with a certain insurance provider because their fee schedule is too low,” she says.


Can investing in better, more high-end technology, including practice management systems, help spur profitable growth? Renner says most dentists already have the requisite software, and the reports available within that software, where they can closely scrutinize procedures and reimbursement. But more often than not, the dentists, their staff, or both are not comfortable with the software to dive deep into the numbers.

“They may just be looking at profit and loss, accounts receivable, and that’s about it,” Renner says. “Often times they just look at what’s left in their checkbook.”

That can be stressful, as can increasing workload, especially if the dentist and staff feel like hamsters running on a wheel. Renner recommends take time on a regular basis to sit down at the end of the day and write down what did or did not contribute to productivity at the practice. Is the staff interrupting you for a phone call in the middle of a procedure? Are you spending time playing telephone-tag with specialists or other oral health professionals? Or, do you have a tendency to run over the time that has been allotted for a particular procedure?

“You may ask the staff to schedule that procedure towards the end of the day where it won’t mess up the schedule too badly,” Renner says. “That’s less stressful, and there’s more efficiency.”


Renner agrees that increasing case acceptance can increase profitability, and while much of that can be accomplished by improving presentation skills, there’s also the factor of learning from others—which all too often dentists are uncomfortable with.

Consider two dentists in a practice who occasionally they have lunch together. They may discuss the office or staff issues, but they don’t converse with each other about a difficult patient who wouldn’t accept a case, and what they could have done or said differently.

“We don’t learn from each other best practices,” Renner says. “It's the same way with the front desk. If you have more than one person answering the phone, and one does certain things better than the other, why not set up an opportunity where they can learn from each other?”

Renner emphasizes that it’s not a question of dentists or their staff being unwilling to learn. It’s more a question of not knowing what phrases or questions to ask to obtain the information they need to get around the roadblock.

“So many times you have a good doctor and good staff that do a very good job for their patients, and are well accepted and liked in the community,” Renner says. “But just understanding what they can do better could be very beneficial.”

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