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7101 York Avenue South, Suite 300 Edina, Minnesota 55435-4407
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February 2010

Bulletin, February 2010

The Latest in Area Economic and Technical Trends
Exclusively to Clients and Friends of Advanced Practice Management

The Dental Dow 2009 wrap up— Running in Place

By year end the 36 mature area practices sampled showed little statistical change compared to 2008. Production was up .5% and Collections down about .4%. Total patient flow was up about 1% although new patients were down about 2.8% for the year.

Crown and bridge was also down 2.8%. Hygiene downtime remained the same. Doctor downtime was up about 6%. As we saw throughout the year, hygiene schedules maintained. Total patient flow didn’t go up much but it didn’t decrease either. However, most Doctors felt that they personally experienced more lightness in their schedules. The decrease of about 3% in crown and bridge fits many conversations I’ve had with Doctors that have felt more resistance on the part of patients in accepting treatment.

About half the practices sampled had a slightly down year and the other half had a slightly up year. Based on contacts I’ve made with my colleagues around the country, dentists are doing pretty well to break even. Moreover, in situations where the Doctors and staff are truly motivated to grow, we still see growth! It generally happens in direct proportion to the degree in which they follow through on our recommendations. More about that below.

DELTA Says It Isn’t Going to Give You a Raise This Year:

The last few years, Delta Dental of Minnesota has given increases of 1.5%-3.5% each year. Their Board of Directors meets in the first quarter and decides what fee increases they’ll allow for Doctors in their Premier program. This year they told us they are not planning on giving any increases.
If your overhead is up you may want to write Delta and let them know. If they don’t hear from you and your colleagues they’ll be happy to stand pat.

Practically Dying for Dentistry! (Neither rain nor snow will stop Matt… usually):

Our man, Matt, heroically tried to make his consulting appointment on January 7th and got caught in a snowstorm in Southwestern Minnesota. At 10:30 in the morning, he was told by the Highway Patrol they probably wouldn’t get to him until late at night or even the next day. However, miraculously, his wife rescued him from 160 miles away. It was a Google rescue. Go to the About Us page to watch the story that aired on Fox 9 News on February 10th.

Little Things = Big Gains:

When we take a close look at practices that are experiencing good growth, we sometimes find that growth is generated by or can be explained by significant big events such as: adding an associate, a new facility or extensive remodeling, a significant Continuing Education event, or change for the better in personnel. These dramatic events can change the chemistry or capacity of a practice, the motivation of the Doctor and/or the team and result in growth.

However, we find that most of the time growth comes from a number of small improvements that cumulatively have a large effect. This is what management is all about…catching every little bit of wind you can in your sails.

Example: Metro Area client increased his practice collections by $8,400/month ($100,788 for the year) by:

  • Gaining acceptance of appointments of one more crown per week.
  • One point increase in the collections percentage.
  • One more operative visit per day scheduled

Example: A two Doctor client increased collections by $26,419/ month ($317,000 for the year) by:

  • Filling a little bit more than one more day of hygiene per week.
  • Increasing the hygienists’ production per visit by $10.
  • Scheduling 1.5 more operative visits per day.
  • Collection percentage up four points (through dropping a PPO).

After working with a Doctor in Western Minnesota for over 8 years,he asked us, “How do I take my practice to the next level? The things you tell us to do are great however they seem to slip away a few weeks after you leave, only to come back for a few weeks after your next visit.”

Shelly and the Doctor agreed to intensify the consulting visits (two visits per month) in order to support onsite coaching and accountability.

As a result the practice increased their collections by $14,000 per month, recall exams by 30+ per month, the hygiene production increased by $10 per visit and the Doctor completed an additional 6 units of crown and bridge per month.

A Southern Metro practice had moved into a new facility a year prior to our discussion with them in regard to getting result control on the technology that came along with the new facility. Over a six month period of time with extra support from us, the practice increased collections by $17,000 per month, completed an additional 9 units of crown and bridge per month, and increased recall visits per month by 17+.

They did this through:

  • Clinical calibration. Clarify office’s recommended treatment protocols.
  • Increased use and awareness of verbal skills and effective semantics when presenting care and helping patients move forward.
  • Incorporated consistent use of the intra-oral cameras.
  • Onsite coaching and accountability.
  • Discussions with patients regarding fees and finances.
  • Focusing on the details and consistency of the patient flow
  • from the clinical area to the front desk.
  • Focusing on recall contact tactics and language.

I could cite far more dramatic examples of client practice growth but the above cases indicate how you can get solid gains through good management and incremental improvements.

I believe in Management like you believe in flossing. Just like flossing, it’s not that hard to do, but it does have to be done regularly. It’s also not that expensive (our fees typically come to less than 1% or 2% of our clients’ practices’ gross). By helping our clients keep focused on the simple steps above, they get good outcomes. We’ve seen it over and over again.

We never recommend anything that we haven’t seen work. If it’s experimental, we’ll let you know. If it’s not experimental and we recommend it, then do it! You’ll have a better year.

How Do Things Stack Up for You?

Statistical Snapshots:

As you probably know, each month we monitor over $17 million dollars of dental activity in over 250 offices. The #1 thing our clients ask from us is, “To provide an informed third party perspective.” So here are some important statistical reference points for you.

Metro and Rochester Areas
  AVG 75%ile 95%ile LOW HIGH
Dr. Production per hour worked $565 $662 $772 $322 $1,224
Hygienist Production per hour worked $133 $140 $164 $88 $188
Production per Hygienist Visit $129 $139 $156 $82 $166
Production per Patient Examined $484 $535 $701 $310 $959
Outstate Areas
  AVG 75%ile 95%ile LOW HIGH
Dr. Production per hour worked $452 $501 $709 $217 $916
Hygienist Production per hour worked $120 $133 $146 $82 $156
Production per Hygienist Visit $114 $126 $141 $78 $149
Production per Patient Examined $406 $456 $141 $78 $149

Statistics are a reflection of reality, not reality. However, as your reality changes, the reflection from that reality changes. Simply put, if you’re seeing more people or doing more for the people you see, and getting more done per day, your production per hour will be higher than someone who is seeing fewer people, doing less per person and getting less done! As you and your team organize your time and talents, the numbers will reflect that. If the numbers aren’t changing, you aren’t changing! Unless they are clients, most Doctors don’t even know their stats and are truly flying blind.
Fortunately, you don’t have to change a lot—as I’ve said before, just incremental efforts can have huge outcomes. To me, that’s the magic of management. Just as you have heard how the accumulation of interest over time can have astounding power, likewise, the accumulation of efforts over time can too.

Get the Biggest Bang for the Buck!:

Despite the economy, many offices are now investing more in office technology. Over 50% of offices now have digital and the others are putting technology in their operatories fast. This can easily come to over $12,000 per operatory.

Do not spend over $50,000 without checking with us on this. Your supply guys are an important part of your team but you need someone in your corner when it comes to making these major purchases. You can end up saving considerable money by being well prepared and negotiating. You need someone who knows the ropes to help you with that. We will help you plan your project and Ted Takahashi will make sure you buy the right stuff, get the right price and it all works right too! Call Ted at APM or 952-891-5177.

It’s Cookie Time!

Be sure to stop by our booth and invite your staff as well. We usually give over a 100 dozen cookies away at each convention.

Also, if you have friends that want to take their practice to the next level, please tell them to talk to us. We get more results for more offices in our area than all other consulting outfits combined. I’ll put my crew up against any outfit from California, Arizona, Texas or anywhere else. The Upper Midwest —practice management-wise— is a bit of a jungle and no one knows the ropes (vines?) better than us. We appreciate and depend on your referrals.

See you at the convention!

Yours truly,

BillBlueSig

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