entrepreneur You’ve Got Your Diploma Now What?
3 Simple ways to
Build Powerful Leaders on Your Team
Things Every New Graduate Should Know!
CLASS OF 2012 | SPRING ISSUE
dental
Business Beyond the Classroom
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dental
entrepreneur Spring 2012 VOLUME 14, ISSUE 2
Welcome to Dental Entrepreneur
CLASS OF 2012 SPRING ISSUE
Editor & Publisher Anne M. Duffy RDH Assistant Editor Michael Duffy Brad Beauchamp Production/Accounting Kitty Beauchamp Director of Advertising Linda Hart Editorial Board Dr. Earl Douglas Dr. Gene Heller Scott Mahnken Allen Schiff, CPA Dr. Tom Snyder Dr. Harold B. Sturner Dr. Joe Rubino Layout and Design John O’Connor
Class of 2012 Contributors Dr. Tanya Brown Bruce Bryen, CPA Edward C. Challberg, CPA Derek Champagne Dr. Earl Douglas Leslie Franklin Peter Gopal, PhD Hema Gopal, MVA Dr. John H. Jameson Dr. Roger Levin
John McDonnell Brett S. Miller, CPA Brendan Morrissey, CEO Tammara Plankers Kathleen M. Roman Dr. Roy Shelbourne Dr. Tom Snyder Dr. Richard Weinman David Woods
Charter Sponsors Oral-B Laboratories Ultradent Products Inc. Proctor & Gamble Wm. Wrigley Jr. Corp. Glidewell Laboratories Benco Dental Co. Tess Corp. Dental Care Alliance
The Pride Institute The Snyder Group McKenzie Management Caesy Education Systems, Inc. Warner-Lambert Co. Phillips Health Care Oxyfresh Worldwide
Editorial Office 12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 ADuff2@aol.com Send materials to: Dental Entrepreneur 7422 Carmel Executive Park #107 Charlotte, NC 28226 704/846-7089 Fax 704/846-7304 Linkbeau@aol.com When you have finished enjoying this magazine pass it along to a friend and PLEASE RECYCLE Copyright 2012 Dental Entrepreneur, Charlotte, NC Material herein may not be reproduced, copied or reprinted without prior written consent of the publisher. Acceptance of advertising does not imply endorsement by the publisher.
2 Spring 2012 Dental Entrepreneur
By now you can probably see the light at the end of the tunnel. Not that dental school is a tunnel, but you do need focus and tunnel vision to complete your courses. It is somewhat ironic that you are entering a profession where you look into a deep, dark hole, mouth after mouth. So hold on to your lighted loupes and get ready for the ride! You may feel all sorts of emotions – excitement, triumph, distinction and quite possibly a little distress in what lies ahead as you embark on your career as a dentist. You are certainly clinically prepared, and you must trust that. But we are here to help you become entrepreneurially prepared. Recently, I took on a project to renovate our family’s Charlotte home. The question was, where do I start? The first thing I did was comb through magazines and websites to get a feel for my style. I reached out to experts referred to me by people that I admired and had a good track record. These experts helped me develop my game plan. After all, they do this kind of thing for a living. From those conversations and meetings my team was formed, the process begun and the realization of my dream was complete. Now it’s your turn to reach out. Where do you begin? What experts do you call on? What questions do you ask? This is where Dental Entrepreneur comes in. For the past 14 years, Dental Entrepreneur: Business Beyond the Classroom has been one of the top resources for future dentists just like you. We’ve worked with tons of experts in our diligent search for the answers to those questions, pulling together pros from finance, insurance, technology, team-building, continuing education and, yes, even dentistry. We hope we give you a place to start in this issue. Brett Miller answers the question, “How should young doctors manage their money?” Earl Douglas explains the different practice scenarios, laying the groundwork for you to make your decision on how you want to get started. Tammara Plankers of Wells Fargo Practice Finance shares how to create a compelling business plan that is unique to you. Dr. Tom Snyder knows about building strong relationships and he gives sound advise on creating a successful partnership agreement. An agreement that will affect you for a lifetime! Our insurance expert, Leslie Franklin begins with a simple quiz that will surely open your eyes, and she follows it with comprehensive information that will help you take a sigh of relief. Marketing ideas from Derek Champion and the Gopals will answer how to get butts in seats. Roy Shelburne tells one on himself and quite possibly will keep you from learning the hard way. And last and most important to me is Tanya Brown’s article on Leadership. I believe you must always strive to develop leadership qualities. Leadership supports success! Speaking of Leadership, my closing request is for all of you to take a strong look at the National Leadership Conference in Chicago this November, sponsored by ASDA. That is one skill that will keep you on the right track as you navigate through the many tunnels and many mouths throughout your dental career. All the best,
Anne M. Duffy Publisher
www.dentalentrepreneur.com
CLASS OF 2012 SPRING ISSUE VOLUME II
dental
entrepreneur’s Business Beyond the Classroom
Contents Prologue 4
Money 101: What Doctors Need to Know Before Graduating from Dental School Brett S. Miller, CPA, CFP
Getting Started 8
You’ve Got Your Diploma – Now What? By Earl Douglas DDS, MBA, BVAL
10
Plan To Succeed: Creating a Business Plan for Your Practice Tammara Plankers
28
Attract More New Patients with Low Cost Internal Marketing Peter Gopal, PhD and Hema Gopal, MVA, DMD
The Power To Succeed 34
3 Simple ways to Build Powerful Leaders on Your Team Dr. Tanya Brown
Business Fundamentals 14
Creating a Successful Partnership: What to Include in Your Partnership Agreement Tom Snyder DMD, MBA
16
Things Every New Graduate Should Know about Record Keeping! Dr. Roy Shelburne
18
Fact or Fiction? Quiz Yourself on Personal Insurance Myths & Misconceptions Leslie Franklin
Practice Builders 22
Unlock the Mystery of Effective Practice Marketing: Choosing the Right Identity, Message and Plan Derek Champagne
www.dentalentrepreneur.com
Dental Entrepreneur Spring 2012 3
Prologue BRETT S. MILLER, CPA, CF
Money 101: What Doctors Need To
Know Before Graduating From Dental School
I
had the privilege of attending the graduation ceremony for the University of North Carolina School of Dentistry in May of 2009. My brother, Dr. Chris Miller was lining up with his classmates, who were all eager to graduate and begin their dental careers. Like many graduating doctors, Chris was ready to transition from the life of dental student living on loans to a working professional earning an income! As Chris and I spoke about his plans following graduation, one common theme emerged in our discussions – how should young doctors manage their money? Most dental curriculums focus almost exclusively on the clinical side of dentistry, leaving a critical gap in what new doctors truly understand about managing their own money in Brett S. Miller, CPA, CF today’s complicated and ever changing economy. Below are a few money management tips that will allow young doctors to start their dental careers on the path to financial success. Always Have a Plan We find ourselves in difficult economic times. Over the past ten years, it’s been proven that dentistry is not recession proof and most doctors’ wealth has suffered. According to Dental Economics, only 5 percent of dentists can actually afford to retire at age 65 and maintain their current standard of living. Additionally, John K. McGill, editor of the McGill Advisory and principal of the
4 Spring 2012 Dental Entrepreneur
McGill & Hill Group, says the reason that most doctors struggle financially is not that they plan to fail, they simply fail to plan. No doctor works through dental school and perhaps a specialty to end up flat broke at the end of their career. However, many baby boom generation dentists find themselves in this position because they failed to implement a plan that would allow them to retire at the age of 65. The biggest mistake doctors make is not working with a dental spe-
cific financial planner as soon as they start their professional career. Developing a comprehensive financial game plan, in writing, is one of the most important financial decisions that a young doctor can make. Just remember, it’s much easier to pursue and attain a goal if it is clearly defined. Be Smart About Debt Like many dental professionals, Chris financed his education with debt. Many
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of today’s graduates use student loans to pay for dental school and others acquire even more debt to pay for their entire education. Additionally, many doctors have debts associated with a car, home, credit cards, etc. Regardless of the individual circumstances, “Should I pay down debt?” is one of the most common questions new doctors ask. The answer - it depends. Debt should be separated and classified into separate categories based on the interest rate and tax deductibility. Consumer related debts (credit cards, department store charge cards, cars, etc.) have the highest interest rates (typically above 7 percent), and the interest is not tax-deductible. We suggest paying these debts as quickly as possible to avoid the crippling interest costs. Loans secured by a doctor’s house (mortgage and home equity line of credit) are tax-deductible and the interest rates are typically between 3-7 percent. We understand that many dental students don’t yet own homes, but for doctors looking to purchase a home, we recommend they speak with a mortgage specialist to lock in a rate below 4 percent over a fixed time period (15 or 30 years). Education debt (student loans) typically has the lowest interest rates (below 4 percent) and should be the last debt young doctors should consider pre-paying. Being smart about debt is a very complicated practice and we recommend that new doctors speak with a dental specific financial planner before taking on additional debts. This will ensure that doctors are in the appropriate debt structures and financing terms, along with providing a great basis for discussion regarding prepayment of debt. Establish a Budget and Live Within Your Means Overspending is one of the key reasons that many doctors can’t afford to retire. The more a doctor spends, the more money they will need for retirement. Moreover, higher spending leaves less assets available to save. Recent studies indicate that most doctors don’t know how much they are actually spending.
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As a result, they fail to budget and live well above their means for a majority of their dental careers trying to keep up with the Joneses. Establishing a budget and sticking to it can alleviate this problem by allowing you to control your spending and ensure proper retirement savings. Additionally, it prevents doctors from accumulating consumer debts that have
The longer savings are allowed to grow and earn interest, the bigger the nest egg will become at retirement. high interest rates and kill monthly cash flow. The good news is that young doctors can choose to avoid this problem by establishing a budget to track their expenses now. Mint.com is a free personal finance website that allows users to develop a budget and monitor their cash flow. If young doctors get a handle on their spending now, it will lay a solid foundation for their dental careers. Save First, Save Often The No. 1 goal for all doctors is to be able to afford to retire and it’s never too early for doctors to start thinking about their future. In the book “Rich Dad, Poor Dad,” Robert Kiyosaki introduces the concept of “pay yourself first.” Most doctors make the mistake of making money, spending money and then trying to save. This is a poor money management technique, and the savings goal is very rarely achieved because the majority of money is already spent. We commonly refer to this as the “gone factor.” Instead, doctors should build savings goals into their budget and the first payment every pay period should be to savings. Doing so ensures doctors will save more money and prevents a savings failure.
Another important tip for new doctors is to begin saving as soon as possible. Compound interest and the time value of money are very important factors in determining retirement success. The longer savings are allowed to grow and earn interest, the bigger the nest egg will become at retirement. For example, assume that two doctors commit to saving $5,000 per year, at a growth rate of 8 percent per year, until retirement at age 70. The first doctor begins to save at 30 and the other waits until 40. At 70, the doctor who began saving at 30 will have accumulated $1,398,905 in savings while the second doctor will only have $611,729. That represents a difference of over $785,000! Why? Even though the difference in contribution was only $50,000, 10 years of procrastination resulted in the second doctor’s assets having less time to grow and compound! Prioritize Your Savings Once a doctor has committed to saving for retirement, it’s important to save in the proper order. Generally, the recommend savings order in the following order: 1) Retirement Plans, 2) Individual Retirement Accounts, 3) Education, and 4) Personal Savings and/or Pre-Payment of Debt. A doctor’s first priority should be to contribute the maximum to their company sponsored retirement plan (401k, 403b, Simple IRA, SEP IRA, etc.). If that is not possible, at a minimum, doctors should contribute up to the amount that the plan matches. After fully funding the retirement plan, a doctor should consider funding a Roth IRA. Roth IRA contributions are subject to an income threshold, and if a doctor’s adjusted gross income is higher than the contribution phase out range (Single - $110,000 to $125,000; Married - $173,000 to $183,000), doctors should fund a non-deductible IRA. For doctors with children, the next funding priority is to save for future education expenses. After fully funding these three items, doctors should consult with their advisor about investing the remaining money personally or look to pre-pay debt starting with the highest interest rates.
Dental Entrepreneur Spring 2012 5
Avoid High Cost Commission Based Investment and Insurance Products The final money management recommendation for new doctors is to protect their savings and invest in a prudent manner. The investment and insurance professions are very complex and have been further complicated by the extreme market volatility over the past several years. Many financial experts still recommend the tried and true theory of dollar cost averaging and I fully support this concept. When starting to invest, doctors should use a discount brokerage firm such as Vanguard, Charles Schwab, Fidelity, TD Ameritrade, etc., to set-up a balanced allocation of noload mutual funds containing both equities and fixed income that is appropriate for your risk tolerance. From an insurance perspective, we recommend doctors stay away from permanent life insurance and/ or annuity products. Doctors should seek to add term life insurance in an amount equal to their future earnings potential. A new doctor will need more term insurance to cover their higher load of debt and lack of retirement savings. As a doctor matures, their insurance needs should decline as they pay down debt and build retirement assets.
The final money management recommendation for new doctors is to protect their savings and invest in a prudent manner. Good Luck! As this article goes to press, a new generation of dentists will be entering their final semesters. I encourage each new doctor to make smart, informed decisions to better their financial future. There are many advisors who can help along the way, but ultimately it depends on each doctor’s level of commitment to his or her own financial success. Good luck! Q For more information, contact Brett Miller at bmiller@sconsulting.net or toll-free 866.727.6100
Please reach out to our authors and our advertisers. They care about you and keep us in print.
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Business Beyond the Classroom
entrepreneur If you have any questions, comments, or responses to
our magazine, please connect
Business Beyond the Classroom ADA Insurance Plans 888-463-4545 www.insurance.ada.org
ADS Transition Specialists (888) ADS-4237 www.ADStransitions.com
ADS Transition Specialists South 770-664-1982 www.adssouth.com
RESOURCE GUIDE
For loan collateral, debt protection, and financial security, dentists rely on the ADA Insurance Plans for best-in-class life and disability insurance, including free coverage for ASDA members during dental school. ADA members benefit from group rates that keep premiums low and hard to beat. Great-West Life & Annuity Insurance Company insures the ADA Insurance Plans, and protects more than 130,000 dentists, dental students, and their families every year. Please see our ad on the back cover. ADS is the nationwide leader in dental practice sales, associateships, buy-in/buy-outs, partnerships and appraisals. ADS is comprised of the industry’s most experienced professionals, including dentists, attorneys, and CPAs. We can help you with each step of your next transition. To view a complete list of practice opportunities available in your desired area, visit us at ADStransitions.com. Please see our ad on page 17.
with us on Dental Entrepreneur Magazine — our official Facebook page! Read us online www.dentalentrepreneur.com Send your questions or comments to aduff2@aol.com www.dentalentrepreneur.com
ADS South is the premier dental transition organization in the Southeast. We provide associateship placement, dental practice sales, appraisals, and expert testimony services. Our company was founded over 26 years ago by Earl M. Douglas, DDS, MBA, BVAL, and we continue to control the cutting edge of transition technology. Please see our ad on page 12.
6 Spring 2012 Dental Entrepreneur
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Serving part-time in the Air Force Reserve gives me experiences unavailable in my daily practice. It also provides additional benefits like paid CMEs and hands-ontraining. I learned dentists come in as officers and that the Air Force Reserve is offering generous signing bonuses. Best of all, I’m able to serve my country from where I live.
-%%"'*,"&'&' 6;GZhZgkZ#Xdb$=ZVai]Egd G U I D I N G A N D P RO T E C T I N G A M E R ICA JhZ V hbVgi e]dcZ l^i] V FG XdYZ hXVccZg Vee id aZVgc bdgZ VWdji 6;G cZlh VcY ZkZcih * * M e s s a g e a n d d a t a r a t e s m a y a p p l y. Te x t C H AT t o 7 1 2 1 2 t o i n i t i a t e a n S M S c o n v e r s a t i o n w i t h a n A i r F o r c e R e s e r v e a d v i s o r. Te x t S T O P t o 7 1 2 1 2 t o o p t o u t . Te x t H E L P t o 7 1 2 1 2 f o r m o r e i n f o r m a t i o n . T h i s p r o g r a m e m p l o y s o p e r a t o r s w h o a r e p a i d t o p a r t i c i p a t e i n c h a t . H o u r s o f o p e r a t i o n : M o n d a y t h r o u g h F r i d a y, 8 : 0 0 a m t o 1 1 : 0 0 p m E S T. S e e p r o g r a m t e r m s a n d c o n d i t i o n s a n d p r i v a c y p o l i c y a t h t t p : / / s m s . a f r e s e r v e . c o m .
Getting Started EARL DOUGLAS DDS, MBA, BVAL
You’ve Got Your Diploma Now What?
N
ow that the end of your formal dental education is finally in sight, you’re probably thinking about what’s next. As you search the horizon for options, you will probably discover that your new career will consist of one of the following - an associateship, a partnership, starting a new practice, or buying an existing practice. Each option comes with its own risks and rewards, and each option will contain the best and worst of opportunities. Your job is Earl Douglas DDS, to discover which MBA, BVAL option is best for you and discover the best opportunity that is available therein. First, let’s look at associateships. This option requires the least commitment. It doesn’t cost anything to get into one, and if one is careful, they can usually be terminated in 90 days or less. The best associateships with fee for service patients will generally involve a covenant not to compete and non-solicitation agreements as owners of such practices are not willing to allow an associate to leave with their patients. In managed care or Medicaid practices, owners are not as concerned about losing patients, as there is usually a very large supply. You should not expect to enter into restrictive agreements in those type practices. Don’t be surprised if associates are not given the best patients and the most rewarding treatment plans to work with. These will naturally be reserved for the owner. Also, if things slow down, the associate’s schedule will be the first one to be cut, as they are hired to work on a practice’s 8 Spring 2012 Dental Entrepreneur
overflow. If the overflow disappears, so will the associateship. Hopefully, you will find an associateship where you wish to practice that has an abundance of fee for service patients who have the need, demand, and ability to pay for top drawer services. In such a setting you can sharpen your skills, be productive and profitable. The next option is the partnership. I am more cautious about partnerships than any other option, having observed the experiences of dentists who have been hurt in these situations. Partnerships are like marriages in many ways. You may well spend more waking hours with your dental partner than you will with your spouse, but few partnerships have the luxury of a long engagement period in which the parties really get to know each other. And like a marriage, partnerships can get involved fairly easily and quickly, but can take years of litigation and large financial losses in order to extract oneself from them. Be sure you understand exactly what you are buying in a partnership – it is a 50 percent (or less) undivided interest in a practice, and it’s critical to know exactly what that means. It’s especially important to know what the rules are as to getting into it, working within it, and getting out of it before ever committing to a partnership. Another option is starting a new practice. Advantages include being able to set up close to where you want to practice and being able to design your office to your specs and choose your desired equipment. A new practice is most likely to be most successful in areas where there is the highest demand for a dentist. However, these are usually “undesirable” areas where most dentists choose not to practice – hence the demand for dentists. Dentists planning to locate in upscale suburban areas should
consider investing in a good demographic study before committing to such a venture. There are several excellent demographic study firms that can provide valuable input as to what to expect in a start up. As you might imagine, the most desirable areas for a dentist to locate in are areas that are already saturated and the patient/dentist ratio is very thin. A new practice with no patients faces a huge challenge in having to rapidly gain new patients when legacy practices in the area are losing active patients and revenues as a result of the economic decline. New graduates will require expertise in setting up their new practice. Office leases and build-outs or new buildings need to be in place, employees need to be hired and trained, computer systems need to be purchased and put into place, effective marketing initiatives need to be implemented, insurance plans need to be evaluated and signed onto, and a number of other business details need to be accomplished, most of which the dentist has no training or knowledge in. The economics of a new start are very daunting. An accurate understanding of practice economics is critical to anyone considering starting a new practice. They are simple but are unknown to most dentists. Here is how it works: Every practice has a break-even point, typically in the range of $150,000 per year. With high rent and high bank payments it will be more and for a practice with low rent and no debt, it will be less. To compute it, the dentist – with the help of a dentally experienced consultant – should calculate what the expenses and debt service would be for the first $125,000 of income, and for each successive $25,000 income increment until the break-even point is discovered. This is www.dentalentrepreneur.com
the point at which the expenses equal the income. The wrong assumption is to assume that practice overhead is around 60 percent and net income is around 40 percent of the gross revenues. This erroneous assumption could lead a dentist to believe that at a gross income of $150,000 there would be a practice net income of $60,000, when, in fact, there would be no net income at all. At practice gross revenues below the break-even point, the dentist will need to inject money into the practice in order to meet the overhead expenses and debt service. The good news is that the dentist will net approximately 75 percent of the amount of collections above the breakeven point, and this will be source of the practice net income. The next step is to carefully develop a budget of living expenses to see how much income the dentist will need for living expenses, and don’t forget to include an allowance for income taxes. If the total amount of living expenses is divided by .75, this will result in how much above the break-even point the practice would need to collect in gross revenues in order to support itself and the dentist’s living expenses. There should be a very realistic plan as to how that practice gross revenue figure will be attained, or else the dentist will be borrowing money to live on. The cost of starting a new practice needs to be considered – new technology, the build-out of office space, equipment, computerization, and so on – can add up to a figure of $300,000 to $450,000 for a new office. In addition, working capital will be required. That is the money needed to pay the overhead and live on until the practice hits the break-even point and reaches profitability for providing a net income. This option will involve sizable debt with potentially low income. The fourth option is the purchase of an existing practice. Practice purchases are the most predictable choice since they have a long informational track record. We can see what they have done for the past three years as opposed to a new start or associateship, in which we have no idea of what to expect. There is a great deal of documentation for practices for sale such as gross revenues, overhead by each category, net www.dentalentrepreneur.com
income, fee schedules, employee analysis, insurance plans accepted, census of active patients, new patients, services performed and referred out, productivity rates, and much more. An important advantage of purchasing a practice is that the projected net income of a practice is easily determined, and if it is not sufficient, the buyer can start looking for another practice that does have a successful net income. Another benefit of
this predictability is that financing is typically easier to obtain for a practice purchase since the risk is lower than for the other options. Lenders can review actual practice statistics and make a much better informed estimate of future financial outcomes and have better security for the future of their loan. Purchasers of practices are always pleased to see a book full of scheduled treatment to See “Diploma” on page 35
Grow your practice. Practice Image Builders does exactly what our name says: We build the image of your practice by providing you with a practice brand and identity, building your website, and providing you with all the marketing materials necessary to connect with your patient and referral community – at an affordable cost.
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Dental Entrepreneur Spring 2012 9
Getting Started TAMMARA PLANKERS
Plan to Succeed: Creating
a Business Plan for Your Practice
S
o you’ve decided to start your own dental practice after graduation. Congratulations! You are about to embark on an exciting project and fulfilling career. Your first step towards reaching your ownership goal is to develop a business plan for your practice that details the viability of your venture. A typical business plan outlines the business objectives, management and operational features, marketing plans and financial projections for your proposed practice. It is an indispensable tool for sharing your plans and solidifying support with your lender, contractor and vendors, and should be based on sound logic and careful research. A good business plan can take several months to prepare. To hit the ground running upon graduation, try to have your business plan Tammara Plankers completed before you leave dental school. Use the free business plan templates available from industry resources such as Wells Fargo Practice Finance to help organize your planning and research. (To download your template, visit wellsfargo.com/practicefinance and click on the New Dentists page.) Key Components of the Business Plan A business plan for a dental practice typically includes six components, each of which needs to be addressed in some detail. I. Executive Summary The Executive Summary serves as an introduction to you and your business
10 Spring 2012 Dental Entrepreneur
venture. It is often the first impression your readers receive of your project, so it is important that the Executive Summary be concise, complete, and compelling enough to persuade lenders that your practice startup plan is viable. The Executive Summary typically includes a Company Description, Mission Statement and Financing Requirements. In the Company Description, provide a brief overview of the type of practice you are developing and the services you will provide. Describe where your practice will be located and your target patient, and any specialties you will be offering. Your Mission Statement outlines your practice philosophy and rationale for building your practice, while the Financing Requirements section provides a summary of the capital you will need to get your practice up and running. After reviewing the Executive Summary, your reader should have a good idea of the “what, why and how” of your new practice.
of your business, your qualifications for managing the business, and your business resources. This section tells your lender that you have the personal know-how and professional means at hand to help ensure practice success. Elements of the Practice Description include your Practice History, which describes your professional experience to date such as where you went to dental school, when you graduated, and any professional experience you’ve gained; Management Team & Key Personnel, which identifies the principals ultimately responsible for financial performance of your practice, as well as key team members and their roles; your Professional
II. Practice Description The Practice Description goes into greater detail about the structure www.dentalentrepreneur.com
Advisors and how they will help you manage and grow your business; your Business Structure, including your legal entity (Sole Proprietorship, etc.) and health insurance mix; and the Business Insurance you plan to have. III. Market Research The Market Research section demonstrates that your future practice is based on a solid grasp of the local market and your potential for success. Your lender will look to see that you understand the community you are joining and have considered the competition in this area. Include a Market Description that describes who lives in the community you have selected for your practice, and what sort of growth is predicted for this area over the next 10 years. Outline your Target Customer by describing your ideal patient, including characteristics, needs, income level, education, gender and age. Provide a Competitive Environment & Analysis section that defines how many other dentists are practicing in the area and the range of services they provide. And finally, outline the Competitive Advantage your practice offers that your competitors do not. Tools for completing this type of research are available online, including a Market Data Report with detailed practice location information offered by Wells Fargo Practice Finance at https://practicefinance. wellsfargo.com/market-data-report/. The report is available for $75, or for free with your completed loan application. IV. Marketing Plan In this section you will describe the internal and external marketing activities you plan to use to announce your opening and grow your practice. How will you attract patients and keep them coming back? How will you set yourself apart from the competition? Approximately how much are you budgeting for marketing activities during the first year? What is your marketing mix – the balance between print advertising, promotions, referrals, email, and other elements of marketing? To ensure your marketing plan is realistic and effective, consider consulting with others who have successfully built a dental www.dentalentrepreneur.com
practice from ground up. Find a mentor who can advise you on marketing and promotion techniques that can help build awareness for a new practice and grow business on a monthly basis. V. Operations The Operations section of your business plan details the day-to-day needs and functions of your practice. It shows that, far more than just a dream or vision, your plan is a genuine blueprint for success based on well-thought-out ideas about how you intend to run your business. The first part of the Operations section outlines the Location & Premises of your new practice, including the exact location if available, why you chose it, and whether you will own or lease the space. Include the number of operatories in your practice and how many will be plumbed versus equipped. Outline the Days & Hours of Operation so your lender understands what your work week looks like. If you will be associating while growing your practice, include that information as well. Detail the Equipment & Supplies necessary now and in the future, and who your major suppliers will be. The Operations section also addresses Staffing, including your recruitment plans, staff roles, compensation and personnel
policies. You do not need to include job descriptions, but identify the resources you are using to create those job descriptions. VI. Financial Forecast The Financial Forecast is probably the most difficult section to complete, as well as the most important. The financing package you receive from your lender is based on the numbers in your forecast, so it is critical that you do your homework and make these calculations as accurate as possible. Turn to the resources available to you for guidance in completing your calculations, such as a dental CPA, practice lender, accountant and industry mentor. The forecast includes an Income & Cash Flow Projection for the first 12 months of practice operation. Your projected income is based on the number and type of procedures performed per week, and will likely grow over time. Your cash flow is the difference between your gross income minus operating expenses and overhead. The forecast outlines Capital & Operating Expenses as well, or the total funds needed to build and operate your new practice. Try to be as specific as possible, including categories such as contractor costs, loan payments, staff salaries, rent, utilities, lab fees, supplies and other minor expenses.
Business Beyond the Classroom
RESOURCE GUIDE
The Artist Evolution LLC Toll Free: 866-610-5334 www.theartistevolution. com
The Artist Evolution is a full service, strategic marketing and design firm with a passion for helping practices around the country to communicate effectively with their target patients, to develop an identifiable brand, and to meet their objectives in a cost-effective way. Please see our ad on page 9.
Aspen Dental 877-330-1349 www.AspenDentalJobs.com
At Aspen Dental we recognize that our success is a direct result of empowering and supporting ambitious dental professionals. We provide a professional, fast-paced, entrepreneurial work environment based on a mutual respect that keeps our interests aligned together, we build and develop successful, patient focused dental practices. Please see our ad on page 31.
Dental Entrepreneur Spring 2012 11
The Project Financing component of the forecast details how much you need in financing to build and launch your practice, and the terms you are looking for. Include here any personal funds or assets, if any, that you will be contributing to the project.
document gives your vendors a positive impression of your business skills as well as confidence that you can manage a project of this magnitude. t Do your research – don’t guess! Your financing package will be based on the financial projections included in your Tips for Completing Your Business plan. You don’t want to find yourself Plan unable to fulfill your vision simply t Be clear and thorough in creating your because you didn’t do your homework plan. Include a formal title page or thoroughly. cover for the plan and make sure your t Build a team of advisors who can help writing is grammatically correct and with plan and start-up details, including slang-free. Remember that your busia dental CPA, attorney, dental practice ness plan provides the first impression designer, contractor, and practice finance of you as a business person, so make it lender. A strong advisory team can help an accurate and professional representayou save considerable time and money in tion of your capabilities and objectives. implementing your practice vision. t If you lack writing skills, consider con- t Remember that your business plan is a tracting with a freelance writer to develliving document that should be updatADS.south209 1:42organized PM Page 1 ed periodically as circumstances change. op your plan.2/25/09 A well-written,
With a business plan for your practice in hand, you’ve got a jump-start on the competition – namely, new graduates who have not yet formulated their career plans. So if possible, get your business plan started now so you can begin planning your success for years to come. Q
Tammara Plankers, Assistant Vice President, Client Practice Services for Wells Fargo Practice Finance, helps doctors establish and grow their new practices. A Certified Executive Coach and practice consultant for over 15 years, Tammara assists practitioners in successfully transitioning to practice ownership through the use of proper due diligence, and guides them in developing the management and leadership skills necessary to successfully operate a practice. Tammara can be reached at 888.499.8871 or tammara.plankers@wellsfargo.com.
Practice Makes Perfect “Dr. Earl Douglas and the staff at ADS South have been real helpful in steering me in the right direction in the purchase of my first practice. Dr. Douglas’s experience, organization and detail-orientation, pointed out to me where improvement is needed and how to go about achieving it.” Elizabeth H. Guerrero, DDS Get off to the perfect start. Call your ADS transition specialist for AL, GA, LA, MS, NC, SC, TN and VA today.
ADS South (770) 664-1982 ADSsouth.com 12 Spring 2012 Dental Entrepreneur
www.dentalentrepreneur.com
The easiest Dental Exam you’ll ever take
DENTAL MALPRACTICE EXAM When selecting dental malpractice insurance, you should choose: The company with the strongest claims defense The most experienced company The dental malpractice company with the highest financial ratings Medical Protective is “All of the Above�
Before you see your first patient, you’re going to have to choose dental malpractice insurance coverage. Some new dentists give it little thought and automatically settle for the first insurer they hear about or use their employer’s company. But it’s your career on the line, and there are significant differences in the quality and value of companies and coverage available. Choose the company that more dentists have trusted since 1899 to protect their reputations, practices and assets. Choose the strongest malpractice insurer — Medical Protective.
Ask about our malpractice protection specifically designed for new graduates. dental@medpro.com www.medpro.com 800-4MEDPRO Š2011 The Medical Protective CompanyŽ.
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Business Fundamentals TOM SNYDER DMD, MBA
Creating a Successful Partnership: What to Include in Your Partnership Agreement
H
istorically, the goal of most dentists was to form a solo practice. In recent years, this trend has shifted with more partnerships being formed than in years’ past. Coupled with the fact that many recent graduates prefer not to practice alone, the opportunities for partnerships as a career choice are definitely on the rise. If you are planning to work as an associate and become a partner, you need to know some of the key Tom Snyder DMD, MBA ingredients that can lead to a successful partnership. In this article, we’ll address several of those key points you need to consider when contemplating forming or joining a partnership. Personality/Compatibility – It goes without saying that you have to like and respect the individual(s) that you will be spending more time with on a daily basis than with your spouse! Communication and openness are important ingredients for a successful relationship. You don’t have to be “best friends,” but there has to exist a mutual respect and trust that both parties are working toward the same goal of making the partnership successful. Clinical Philosophy – As a young dentist, you’ll spend years developing your “own” clinical philosophy. This is not influenced just by your experiences from dental school, but by the many hours after graduation that you will be investing in continuing education and professional associations. Having a clear understanding of your mutual philosophies of patient care is a 14 Spring 2012 Dental Entrepreneur
necessary dialogue you will need to have when forming your partnership. Will you be an Equal Partner?Oftentimes, the practice owner partner wishes to maintain control when forming a partnership with an associate, so a partnership arrangement with the senior partner desiring a 51-percent interest and the junior partner a 49-percent interest is not uncommon. However, in our opinion, that sends the wrong message to the new partner. The fear of loss of control is a common feeling solo practitioners share when they decide to make their associate a partner. You will need to determine whether or not you want another individual controlling your actions as a partner. Some young doctors may agree to this arrangement for the initial few years of the partnership, but do require that the partnership become a 50-50 arrangement at a future date. Income Division – Poorly conceived division of income has led to many partnership breakups. In the dental world, partners should be compensated based on a combination of personal clinical production and their respective ownership interest. As the senior partner begins to decrease his/her production in the later years, this approach will prevent the junior partner feeling that he or she is being taken advantage of, if income were shared equally. Most arguments over money occur when one party feels they are doing more of the work and not being compensated fairly. An income sharing formula whereby each partner is compensated based on their relative ratio of personal clinical production with direct expenses being allocated accordingly, is a fair way to compensate each partner for their production related portion of partner income.ly. Conversely,
if overhead is not shared properly that can lead to problems as well. For example, if one partner utilizes two assistants and one partner uses only one assistant, should those expenses be shared equally? Allocating those assistants directly as part of the compensation formula is only one example of how this concept works. Establishing Minimum Days/ Production Goals – As partners grow older, they may be unable to produce at the same performance level as they did in years past. Conversely, if a partner is financially secure, he/she may not desire to work as hard as they once did. So, establishing minimal production goals to maintain partnership status is not unrealistic criteria to include in your partnership agreement. Some agreements may also require the partners to practice an annual minimum number of days. Premature Retirement – One of the reasons you may want to become a partner is to maintain a long-term relationship with another doctor. In the event that one partner decides to leave prematurely, a penalty should be included that will discount the buy-out value of the departing partner. We prefer to use a sliding scale discounting factor, based on a preretirement age to calculate the departing partner’s decreased value, with the sooner they retire the greater the discount to value. Management Responsibilities – Not all partners share management responsibilities equally, and in fact, some partners have no interest in any aspects of the day to day management of the practice. They basically just want to perform only on a clinical level. In this case, the partner who is managing the practice and who probably spends many hours per week doing, so should be comwww.dentalentrepreneur.com
pensated accordingly. Negotiating either a fixed salary or a percentage of profit as additional compensation for a partner who is responsible for the day-to-day operations of the practice is a fair approach. This compensation should be considered an expense of the practice and have no relationship-toownership percentage or production-contribution levels. Death and Disability – Most partners purchase life insurance in the event of an untimely death. So it is an important habit for partners to develop by reviewing the amount of life insurance to ensure that the face amount of the policy keeps up with the changing value of the practice over time. In the case of partner’s long-term disability, we have seen many lawsuits occur due to insufficient definitions of disability, as well as poorly crafted valuation formulas and payment terms in the event of a disability. Therefore, you need to have clearly defined valuation formulae in your agreement that addresses the value of a partner’s interest in the event of death or disability. Mandatory Buy-Out – Too often, we’ve been retained to negotiate situations where the senior partner encounters difficulty in selling his remaining interest to the junior partner. We believe that the partnership transition model consists of two parts: a Buy-in and a Buy-out. A clearly defined intention of the junior partner’s expectation to purchase the senior partner’s remaining interest at a specified date is critical. This is especially true in markets where it is difficult to recruit associates, i.e. small towns and rural areas. A properly designed buy-out formula needs to be included in the agreement so all parties know what to expect beforehand. Finally, in the unlikely event that the junior partner decides not to honor the mandatory buy-out, a liquidated damages clause should be included as a financial penalty for not completing the purchase of the retiring partner’s interest. Partnership Valuation –Senior partners sometimes expect too much for their practice’s value at the end of their career. This especially becomes a problem if they have not been contributing significantly to the practice in their later years, and they expect 50 percent of the practice’s value. www.dentalentrepreneur.com
In the dental world, partners should be compensated based on a combination of personal clinical production and their respective ownership interest. We recommend that a buy-out formula be included in the partnership agreement that will reduce the senior partner value of his/her partnership interest if clinical production decreases over the last several years preceding retirement. This approach allows the junior partner to pay a fair price for the value of the senior partner’s interest. This discount, however, is applied only to the Intangible Asset (Goodwill) portion of the senior partner’s practice value. For example, if the retiring partner’s clinical production has decreased over the last three years – on average – by 20 per-
cent, the Intangible Asset Value would be reduced by 20 percent. The Tangible Assets (equipment, technology, etc.) should not be discounted, as these are assets having no bearing on the performance of the senior partner. So, for example if you have a 50-50 partnership, the Tangible Assets value for the retiring partner would be worth 50 percent of the appraised value at the time of sale. Properly designed Partnership/ Shareholder Agreements must be crafted in order to avoid unnecessary problems and legal costs to avoid failed partnerships. An “ounce of prevention” is worth a “pound of cure” and spending the time and money at the beginning of your relationship to have properly designed agreements will go a long way in solving any future problems. Q Dr. Tom Snyder is managing partner of The Snyder Group LLC. A transition services consulting firm that specializes in practice valuations, practice sales as well as designing associate and partner relationships. He can be reached at (800) 988-5674 or email: tsnyder@snydergroup.net. The firms’ website is www.snydergroup.net
Business Beyond the Classroom
RESOURCE GUIDE
Aspen Dental 877-330-1349 www.AspenDentalJobs. com/228
At Aspen Dental we recognize that our success is a direct result of empowering and supporting ambitious dental professionals. We provide a professional, fast-paced, entrepreneurial work environment based on a mutual respect that keeps our interests aligned. Together, we build and develop successful, patient focused dental practices. Please see our ad on page 31.
Bank of America Practice Solutions 1.800.491.3623 www.bankofamerica.com/ practicesolutions
Bank of America is endorsed by more dental associations than any other lending institution. We also have trusted relationships with industry leaders who seek our financial expertise and world-class service.*Subject to credit approval (Please see our ad on page 25.)
Henry Schein Professional Practice Transitions (PPT) 1-800-730-8883 ppt@henryschein.com www.henryschein.com/ppt
Henry Schein Professional Practice Transitions (PPT) is the practice sales division of Henry Schein, Inc. Our affiliation with the largest dental supply company in the country—intent on servicing the practice buyer’s future supply, equipment and service needs makes PPT the only company with a vested interest in the buyer and a careerlong trusted relationship with the seller. (Please see our ad on the inside back cover.)
Dental Entrepreneur Spring 2012 15
Business Fundamentals DR. ROY SHELBURNE
Things every new graduate should know about record keeping!
I
understand, as a dental student and soon to be dentist, record keeping may be the very last item on your priority list. Been there, done that and lost the t-shirt.... literally. You see, I not only lost my t-shirt, but almost everything I owned, except the love and concern of my family and friends, but that’s another story for another day. I have come to appreciate the fact that it is a wise man who learns from his mistakes, but a wiser man still who learns from another’s. I was found guilty of healthcare fraud, racketeering and structuring just as my son was graduating from dental school in the spring of 2008. I spent 19 months in federal prison and Dr. Roy Shelburne two months in a halfway house, forfeited $200,000 as a result of the racketeering and structuring convictions and paid back the $17,899.57 I received over the course of 6 ½ years from the Medicaid program that I was not entitled. I learned the hard way that if it’s not in your dental record: 1. It was not seen 2. It was not said 3. It was not heard 4. It didn’t need to be done 5. It wasn’t done 6. It doesn’t exist… from the legal perspective Your record can literally make the difference in a jury’s verdict, the dismissal of a malpractice claim, a review by the dental board that finds no grounds for action, or a “clean” insurance audit. I was accused of fraud, in part because my dental record did not justify the need for treatment. In fact,
16 Spring 2012 Dental Entrepreneur
I just finished another audit for a doctor who is in trouble with a regulatory agency, and the issues remain the same. “The documentation does not support the treatment provided.” This doctor faces significant financial loss. The entity is asking for repayment for the “unjustified” services and the demand is substantial. OUCH! If it’s not in your dental record, you didn’t see it, you didn’t say it, you didn’t do it, it didn’t need to be done and it doesn’t exist from a legal perspective. My plea to you is to be careful to document in such a way that there’s no question left unanswered, no service provided left to the imagination. The dental record should read like a story that has a beginning, middle and end where everything is recorded. I know, I know. There are only so many hours in a day, but ask this doctor who will most probably write a six-figure check. The time taken to document completely would have been very well spent and could have ultimately prevented this action. When you are tempted to cut corners in your recordkeeping, billing and coding systems weigh the consequences and choose wisely. Take it from me, defending yourself and your practice is priceless. What should the record contain? Comprehensive Medical and Dental History t Review the history thoroughly at the first visit and update at all subsequent visits t Revisit with a more comprehensive review as needed (the more compromised the patient’s health, the more often the medical history should be reviewed. Err on the side of caution). t Do a Rx review and run a drug interaction screen. Consider using epocrates or lexacon. http://www.epocrates.com or
http://www.lexi.com t Review histories before each visit thereafter, even if seen two times on the same day. t The histories must be reviewed, documented and any modifications of treatment necessary as a result of the Medical condition of the patient should be noted and followed. Documented Detailed Clinical Examination t Remember, an oral cancer screen is mandatory when reporting most examinations for reimbursement. Make note that the screening was conducted and the result. Hard and Soft Tissue Exam: t Soft tissues: lips, gingiva, buccal mucosa, tongue palate. t Periodontal evaluation/charting for every patient (establish your office’s protocol). t Hard tissues: bone and teeth. t The record should be complete and specify what information was evaluated to determine the treatment recommended/provided. Radiographs/Photograph t Record Normal Findings and Abnormal findings including: t Head and neck. t Soft tissues/photos. t Hard tissues/radiographs/photos. TMJ evaluation Caries Risk Assessment: CAMBRA Chief Complaint t Why is the patient in your office? t Establish the expectations from the patient. t If no problem is stated, record the reason for the visit. t Be aware that the chief complaint may change so note each visit. www.dentalentrepreneur.com
List a Definitive Diagnosis t Does stuff happen? t Treatment Plans should address all t Inform. abnormalities. t Deal with additional treatment/referrals. t Complete documentation includes the t Refusal of any kind or request to modify diagnostic tools used to arrive at that treatment. definitive diagnosis. Reason for Next Appointment t Diagnosis should list the location and t Treatment should be sequenced to extent of the pathology. address the condition of greatest concern. Informed Consent t Address the chief complaint. t Treatment needed. t Address the reason for the sequence. t Reason for treatment recommendations. t Get agreement from the patient for the t Material treatment risks. next appointment. t Benefits. Note Any Referrals t Clinically accepted alternatives. t Where was the patient referred? t Cost relative to treatment recommendat Reason for the referral. tions. t Lack of compliance. Treatment Rendered All Prescriptions Written t Anesthesia: amounts, types, and locat List prescriptions separately and include tions. number and strengths. t Numbness. t Indicate what the prescription is to treat. t Procedure. t Inform the patient of any possible side t Materials used. ADSNL_003 Half Page Ad REV2.qxd:Layout 1 effects. 2/14/09 6:36 PM Page 1 t Any negative outcomes. t What to do if they experience any
untoward effects from the medications. t (Check with your state regarding the Rx. database). All Phone Conversations t Conversations with business staff. t Conversations with clinical staff. t Conversation with the doctor. t Conversation with the referring doctor about that patient. Cancelled/Missed Appointments t Compliance can be very important to outcomes. Remember! Make your notations at the time of the visit, phone call, conversation If a correction or addition is needed, note when and why the correction was made. Subjective comments about the patient are not to be recorded in the treatment record! Be very careful with your choice of words. See “Record Keeping� on page 35
Make the perfect transition
Making that first transition into your career is the most important decision you will ever make. For more than 30 years, ADS and its local transition specialists have helped dental graduates like you make the perfect first transition. As the nationwide leaders in practice purchases, we know the best opportunities wherever it is that you want to be. We are dedicated to your success. Get off to the perfect start. Visit us online to find your local ADS representative.
ADStransitions.com/localrep www.dentalentrepreneur.com
Dental Entrepreneur Spring 2012 17
Business Fundamentals LESLIE FRANKLIN
Fact or Fiction? Quiz Yourself on
Personal Insurance Myths & Misconceptions 1. I don’t have a spouse or kids yet, so I don’t need life or disability insurance. 2. When insurance is cheap, the quality is cheap, too. 3. All disability policies are the same. 4. A fully loaded policy is always the best choice. 5. Locked-in premiums are better than premiums that change over time. 6. I’ll get the best service through a local insurance agent. 7. I’m young and healthy, so it will be easy for me to get insurance.
I
f the quiz above got your attention, that’s great! You’ve likely heard a lot of misleading, incomplete, and downright confusing information about life and disability insurance. Acting on misinformation can cost you hassles and money, or worse, it can lead to poor decisions that you may regret later but can’t undo. And not taking any action at all can create its own problems. So let’s dispel 7 common myths and misconceptions. 1. I don’t have a spouse or kids yet, so I don’t need life or disability insurance. Possibly. But you likely still have financial responsibilities. Think of your student loans, car payment, credit card debt, rent/ mortgage… How would such obligations be handled if you suddenly died or became disabled? This isn’t fun stuff to think about, but it’s very real. Young Leslie Franklin people die every day in accidents or unexpected events. And it’s widely known that dentists face an above-average risk of disability because of the physical demands of clinical practice. So don’t make the mistake of thinking, “It won’t happen to me.” The fact is, you likely do need life 18 Spring 2012 Dental Entrepreneur
and disability insurance protection even before you start a family. These products also play an important role in business, like providing collateral for a practice loan or funding a buy-sell agreement with a business partner, which are independent of your personal life. 2. When insurance is cheap, the quality is cheap, too. Maybe, but not always! You often hear, “You get what you pay for,” but exceptions do exist. For example, the American Dental Association is able to offer its members group insurance with highquality coverage features at surprisingly low rates. How? Volume buying power, low overhead, experience-based discounts, and an intimate understanding of dentists that results in focused (and thus efficient) underwriting and claims handling. Some ADA coverage is even free to student members because that’s how the ADA chooses to invest in its future membership. 3. All disability policies are the same. Definitely not true! Disability insurance is a complicated product, and there are lots of variations in quality and price. You have to take time to read the contract, compare features, and ask questions to make sure you know what you’re getting. One of the most important things to examine is how the policy defines disabil-
True
False
ity. An “own occupation” policy, preferred by most dentists, pays a benefit if an injury or sickness prevents you from working as a dentist even if you could hold down a different job. But own occupation policies are not all the same. A “true own occupation” policy will pay full benefits if you can’t work in your special area of dentistry—even if you could do other types of dentistry or could pursue another career like teaching— regardless of how much money you earn while disabled. Also consider the time period you could receive own occupation benefits: Some policies limit those benefits to just a few years, and then switch to a definition of disability that is harder to satisfy. Make sure you know how to spot these differences. 4. A fully loaded policy is always the best choice. False. It may be tempting to go for the deluxe model, but why pay extra for bells and whistles if you don’t need or want them? Budget-conscious dentists often look for a basic policy and then add only the options (also called riders) that fit their particular needs. For example, if you want to guarantee that you can increase your coverage without having to take another medical exam, it could be worth it to add a future increase option to your basic plan. On the www.dentalentrepreneur.com
other hand, a cost of living adjustment (COLA) option may not be the best use of your money when you could rely on other sources of income during a disability (spouse salary, product sales, etc.) to combat inflation. A souped-up policy that over-addresses your needs may be no “deal” after all. 5. Locked-in premiums are better than your rates can spike dramatically when premiums that change over time. you begin a new term (in which case, On the surface, this might seem true. It you’d be “locked in” with no alternative may feel comfortable knowing you’ll pay but to pay the higher rates or go without the same amount each year for the life of coverage). your policy. But if you look more closely In contrast, pay-as-you-go policies, at how these policies work, you’ll see that with premiums that gradually increase level premium policies charge more in the with your age and subsequent risk, can beginning than your relative risk of death give you more flexibility and control: You or disability at the time, in order to keep don’t have to determine up front how premiums the same as you grow older long you will need the insurance. Plus, and your risk increases. If you discontinue your insurance costs are lowest at the very your coverage before the term ends, you time when you’re starting out and money will have likely overpaid for the time you is tight. (In fact, most financial advisors were insured. And if you need to1keep the will5:51 recommend you 1pay as little as posP110369d_7_375x5_437:Layout 11/10/11 PM Page insurance longer than originally planned, sible and invest the rest on your own.) In
A souped-up policy that over-addresses your needs may be no “deal” after all.
rare instances, your premiums could even go down in some years, which has been a recurring and pleasant surprise for ADA plan participants throughout the past 10 years. In addition, policies with graded premiums generally do not make you go through another medical exam to continue coverage, so you know that you can keep your insurance into old age even if you are hit with health problems along the way. 6. I’ll get the best service through a local insurance agent. Not necessarily. Using an insurance agent or broker is a personal decision. Some people like face-to-face meetings with an agent. However, many dentists discover they can obtain sufficient information from a company’s website and/or call center to make an informed decision and avoid costly agent commissions. In fact, they often prefer doing business online or over the phone so they can get
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Dental Entrepreneur Spring 2012 19
information when and how they want it without having to endure time-consuming or uncomfortable sales pitches. What’s more important is to investigate the company or organization that stands behind the policy—its strength, stability, and reputation among your peers. For example, the ADA demands solid financial management and exemplary service from Great-West Life & Annuity Insurance Company, the company that underwrites and administers the ADA Insurance Plans. Many dentists like the idea of having their insurance selected by a professional association they know and respect. In the end, it may come down to trust—what company/policy/personnel you trust most to be there for you in a time of need. Everything may look rosy on the front end, but things could get ugly later if you make a poor choice. To confirm your instincts, solicit recommendations from colleagues and mentors, check independent rating services like A.M. Best, and ask the insurance company your most probing questions. How they handle your inquiries may help you predict how they’d handle more serious matters like a death or disability.
Do the smart thing by getting as much insurance as you need as soon as you can… because you will never be younger than you are today. 7. I’m young and healthy, so it will be easy for me to get insurance. That’s true—most of the time. But you might be surprised at the things that could affect your ability to get insurance coverage at the best rates or without any restrictions. Family history, an old injury, past illness, or the use of certain prescription medications could raise a red flag when the insurance company’s underwriter evaluates your risk of disability or death, and could affect the price you pay or the coverage features you’re offered. For example, a former back injury might
Business Beyond the Classroom Lightspeed Multimedia, Inc. Email: john@jumptolightspeed.com www.jumptolightspeed.com
MacPractice, Inc (402) 420-2430 MacPractice.com
Medical Protective 800-4MEDPRO www.medpro.com
RESOURCE GUIDE
Don’t settle for the same generic look as every other dental professional in the area! Stand out with a professionally designed image created for you and your practice.
MacPractice DDS is the leading practice management and clinical application for dentists who prefer to use a Mac, featuring electronic insurance submission, Mac native digital radiography and photos, charting, Electronic Dental Records, Kiosk, Web Interface, iPhone Interface, speech dictation, and Mac stability and ease of use. Please see our ad on page 27.
Since 1899 Medical Protective has been the nation’s leader in dental professional liability. As a member of the Berkshire Hathaway group of businesses, Medical Protective provides dentists and oral surgeons with four levels of unmatched protection - strength, defense, solutions, since 1899. For more information, visit www.medpro.com or call 800-4MEDPRO.” Please see our ad on page 13.
20 Spring 2012 Dental Entrepreneur
cause the company to exclude back problems from disability coverage but provide coverage for all other causes of disability. (Note: Most insurance companies use similar underwriting processes and information repositories; anything discovered by one carrier’s underwriter will likely be available to other insurers, too.) What else could affect your insurability? If you use tobacco in any form, your coverage will likely cost more. A driving record with multiple moving violations or DUIs also can raise your rates or even cause your application to be declined. Participating in extreme sports like hang gliding, car racing, or piloting private aircraft could make it more difficult or more costly to get insurance. Even your gender statistically influences the risk of death or disability and can result in higher premiums for some policies. These principles may not sound fair, but this is an area where statistics do rule. If you ever are considered less-thanperfect health-wise, it’s not the end of the world: You may be able to re-apply at some point in the future, and might qualify for lower rates or lifted restrictions if your situation changes. Also, watch for opportunities for guarantee issue insurance—coverage that does not require a medical exam—because you can’t be turned down. One final word to the wise: Do the smart thing by getting as much insurance as you need as soon as you can… because you will never be younger than you are today. Q Editor’s note: This article does not constitute legal, tax, or financial advice. Please seek professional input as appropriate to your situation. Leslie Franklin is Director of New Dentist Markets at Great-West Life & Annuity Insurance Company. She helps new dentists and dental students use insurance to attain their personal and professional goals. For more information about ADA-sponsored insurance costs, coverage, limitations, and terms for keeping coverage in force, call (888) 463-4545, e-mail ada@gwl.com, or visit www.insurance.ada.org.
www.dentalentrepreneur.com
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Don’t lose us a!er graduation. Go to
dentalcare.com and update your profile so we can stay in touch with news for your patients and your practice. And don’t forget to take advantage of student pricing while you still can—place your order at dentalcare.com today! Like facebook.com/professionalcrestoralb
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Practice Builders DEREK CHAMPAGNE
Unlock the Mystery of Effective Practice Marketing: Choosing the Right Identity, Message and Plan
Y
ou have opened the doors to your new practice. You have the perfect location with a nicely designed office space. Your technology is up-to-date, and you have hired a knowledgeable and friendly staff. You have a small core of reliable patients but start to notice that you are not experiencing steady growth. You know that it is time for some marketing and advertising. Maybe you are contemplating featuring a service on Groupon or another couponing site, having your staff post on social media every week, buying some Google adwords to help SEO presence, or even sending your hygienist to hand out brochures at local health fairs. Warning: During any given month, you and your staff will be solicited at least a dozen times by various print, TV, couponing sites, online ads and other advertising opportunities from sales vendors in the community. You can’t possibly participate in all of the advertising options presented to you. Which ones will get Derek Champagne you the best return and which ones will be a waste of your hard-earned money? You may decide to take a chance on a few advertising possibilities while crossing your fingers and hoping that one will work. I call this approach “blindfold marketing” – randomly selecting a variety of media with a variety of messages, hoping that one will hit something valuable. The problem with blindfold marketing is that it is generally not cost-effective, it confuses your audience, and it does not always build
22 Spring 2012 Dental Entrepreneur
measurable trust, value, or recognition to your brand or campaign. While there is some calculated risk in advertising – the blindfold approach is dangerous long term, since a significant portion of your growth is reliant on these marketing and advertising efforts. In assessments with numerous dental practices across the country, I have found four major problem areas that commonly hinder effective practice marketing: lack of identity and message strategy, lack of or improper marketing tools, and no organized plan/campaign. Addressing these four areas before you open your practice can save years of frustration, money, and guesswork. Identity Who are you? Know who you are so that
you can tell others and so that they will recognize your unique “signature” (your brand). Most simply, your “brand” is what people know and think about your practice. If they don’t know who you are or that you exist – you don’t really have a brand identity. A corporate identity builds trust and recognition. This is the visual part of your brand that should reflect your company in an honest way and should relate to your industry, your name and defining characteristics about your practice or the competitive advantage that you offer. Be unique and present yourself clearly and dynamically. It is very important that your identity is consistent, with marketing materials that have a similar look and feel. Each piece should contribute to your overall brand equity. These branded materials will also www.dentalentrepreneur.com
give your marketing efforts more “bang for your buck” and make your practice more recognizable. One way of achieving this consistency is by using brand standards. Brand standard are design rules focusing on your logo, graphics, colors, fonts and illustrative style. These rules work by creating awareness about your brand and differentiating your practice from your competition. When you’ve identified rules for the above areas, document them as a “standards guide” for use by employees, vendors and graphic designers. Message Consumers are exposed to thousands of brand messages each day (subtle and blatant), giving your practice only a few seconds to share your values, define what makes you different, and explain why the target patient should schedule their first appointment with you. A message strategy empowers you to intentionally tailor your communication with your target patients so that they quickly identify with the values and unique positioning of your practice and readily understand how engaging with your brand will enrich both their lives and their loved ones’ lives. Communication can only occur when you successfully break through the clutter with a relevant message that resonates with your target and motivates them to respond. In order to create a message
An effective message strategy frames up what makes you unique and reinforces the value of your service so patients and staff can readily share the unique values of your practice with others. that will resonate with them, you must first identify and understand your target. Narrow your target into specific segments to further identify what motivates them. Consider what their core needs are and how your service addresses those core needs. Next, you should research the profiles, patterns, preferences, and environment of your target. Like most practices, you will discover that you have a few targets on which you are focusing. Maybe you are seeking more cosmetic patients or restorative patients. These may be entirely different targets and each need a tailored message that is consistent and relevant to give it “sticking” power.
Having a message strategy also empowers your staff to properly represent your brand and empowers patients to refer you to others. Patients will appreciate your service but may be unsure why they should share you with others. An effective message strategy frames up what makes you unique and reinforces the value of your service so patients and staff can readily share the unique values of your practice with others. Exercise: Answering the following questions will help you create the framework of your own unique identity and message strategy: t For what do you want to be known? t Who are your ideal target patients? t Identify the core services that you will offer: How do they address the core needs of your target? t In relationship to your offerings, what services do your target patients need most? What motivates them? What are they most concerned about? And what will you deliver to address those needs? t How do you want to be perceived by your target patients and community? t What moods or emotions would you like associated with your practice? t What emotional connection can be made that will help your target better identify with your services? t What is the single most important
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Dental Entrepreneur Spring 2012 23
thing you want your target patients and community to associate with your practice? t Why will your target patients choose you over your competitor? What makes you unique? t What will be your promise? What are your Values? What is your Mission? After completing this exercise, frame your answers into a few well-crafted paragraphs. Practice sharing your newly-crafted message with staff, patients and your community and make adjustments until you can share comfortably. An Integrated Marketing Plan: This is not a typical business/marketing plan that includes the marketing mix, SWOTT analysis, and other details needed to get approved for a business loan. This is a new wave: a focused plan for you to use in executing an integrated marketing plan. This plan is focused on garnering new patients, keeping existing patients, and building goodwill with your community. My own hybrid definition of marketing is this: effective marketing is not one single action; it is a collaboration of several dedicated, strategic efforts that are executed holistically. Success results from sharing a cohesive and relevant brand message across multiple platforms, using appropri-
Success results from sharing a cohesive and relevant brand message across multiple platforms, using appropriate marketing tools and executing several strategies with frequency against prestated objectives. ate marketing tools and executing several strategies with frequency against pre-stated objectives. Disjointed efforts can work, but they are more difficult to build upon and they do not add as much value to brand recognition (equity), message and the overall value of the campaign. Creating a marketing plan is a balance of creativity and strategy. A good marketing plan contains specific tactics for reaching each of your target patients with sensitivity to your specific budget. The plan should
Business Beyond the Classroom
RESOURCE GUIDE
Oxyfresh Worldwide Inc. 800-333-7374 ref# R23037601 aduff2@aol.com
Since 1984 thousands of dental professionals have discovered Oxyfresh’s safe and effective oral health products for use in longterm care and maintenance of their patients. Retail sales, wholesale rebates and “free product” programs allow you to get paid appropriately for providing professional guidance and instruction to your patients. Ad on page 35.
PARAGON Dental Practice Transitions www.paragon.us.com 866-898-1867
Offices located Nationwide. PARAGON offers professional consultation and related services to healthcare professions with primary emphasis on the dental profession: comprehensive dental practice valuations (including a written valuation and analysis report); practice sales; pre-retirement sales; practice acquisitions; practice mergers; associateships; partnerships; practice consolidations and practice management. References available by request. Please see our ad on page 23.
Patterson Dental Supply Inc. 800-659-5977 http://www.cereconline.com
Patterson Dental Supply Inc. is a full-service distributor of a complete range of dental products and services to dentists, dental laboratories, institutions and other healthcare providers throughout North America. As one of the nation’s largest dental distributors, Patterson Dental sells consumable dental supplies, digital and other dental equipment and practice management software. Please see our advertisement on the inside of the front cover and page 1.
24 Spring 2012 Dental Entrepreneur
be executed against suggested timelines, frequencies and measures for success. It should also be designed specifically for you to reach your target clients in their unique environments. The end goal is to have a comprehensive plan with a cohesive message theme guiding patients towards a targeted action or place (such as your website) and positioned in venues and mediums where they are most likely to respond. Steps in building your integrated marketing campaign: Objectives t Clearly define your short and longterm objectives (Examples: To increase # of implant cases by x, increase # of quality cosmetic cases by x, etc.). Budget t Create a Budget - % of revenue allocated to marketing. t Build specific strategies into targeted campaigns to reach each patient segment. Your overall campaign should have multiple strategies for each target that you identified during your messaging development. External Marketing t Select two or so traditional core external drivers for driving awareness to your target patients. These may be radio, television, print, direct mail, or other advertising platforms, but the key is to share a consistent and concise message that stays the same across multiple advertising platforms. You should have a clear and measurable call to action and select the advertising platform based on where your target patients are most clustered – as identified in your message strategy t Set up a solid web and social media presence for search engine optimization (SEO) and conversion rate optimization (CRO. The goal is to increase the number of patients who schedule an appointment after visiting your website or social media outlets. t Set up other external platforms, such as a PR campaign that creates awareness about your practice each quarter. Adopt or start a community cause, www.dentalentrepreneur.com
Whether you are acquiring or starting a practice from scratch, Bank of America Practice Solutions can finance either type of transaction regardless of what side of the fence you are on!
At Bank of America Practice Solutions, you can rely on our industry leadership. We have performed thousands of each type of transaction, and understand the challenges that accompany them. Let us help you get the right financing. We encourage you to call the experts at Bank of America Practice Solutions to discuss. Today you decide what side is actually greener!
Practice Acquisition: ◆
Up to 100% financing for your practice — up to $5,000,000.
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12-month interest-only options for lower payments initially.
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Principal reduction and early payoff options.
Practice Start-up: ◆
Up to 100% financing for everything from architectural fees to construction, to equipment and cabinetry.
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Working capital to help you get started.
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Terms up to 15 years.
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Up to 36 months of graduated payments.
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Practice purchase and real estate combination loans.
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Up to 12-month rate lock through the project build-out phase.
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Working capital to help you with the transition.
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Terms up to 15 years.
Demographic Site Analysis to help you select the ideal location and attract the patient base you want.†
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Access to our complimentary Practice Heartbeat® program.♥
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Access to our complimentary Practice Heartbeat® program.♥
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Business debt consolidation† — Tired of having to process multiple payments all at different interest rates? Improve your cash flow with a debt consolidation loan.
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Commercial real estate*— Choose from a suite of comprehensive real estate loan options to buy, refinance, or relocate your practice. Why lease when you can buy?
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Equipment financing* — Choose from a variety of options and flexible terms tailored to meet your needs.
Want to know more? Call our Practice Specialists at 1.800.491.3623. Mention Priority Code ADDDEP12. You can also visit us online at www.bankofamerica.com/practicesolutions. * All programs subject to credit approval and loan amounts are subject to creditworthiness. Some restrictions may apply. Bank of America Practice Solutions may prohibit use of an account to pay off or pay down another Bank of America account. ♥ Bank of America Practice Solutions makes no express or implied warranties with respect to any aspect of the Practice Heartbeat® program, nor does it guaranty any success or promise any results, and hereby disclaims the same to the extent allowed by law. The opinions of Bank of America Practice Solutions are based upon prior experience, and it makes no promise or guaranty that you will achieve any particular measure of success or results by participating in the program. You are not bound by any recommendations provided under this program and retain full responsibility for the results achieved by your professional practice. † Bank of America Practice Solutions engages Scott McDonald & Associates, a national marketing firm specializing in demographic research, site analysis and profile reports for health care professionals to produce a demographic report to assist health care professionals in evaluating where to locate their professional practices. Scott McDonald & Associates charges a fee for this service, which is passed on to the customer. Bank of America is a trademark of Bank of America Corporation. Bank of America Practice Solutions is a division of Bank of America Corporation. ©2012 Bank of America Corporation
form a joint marketing partnership with other businesses who share a similar target for cross marketing and communicating to a larger base, attend key community events, and brainstorm other external marketing drivers for creating brand awareness and directing new patients to your practice.
Calendars/Frequencies/Timelines t Build out a marketing calendar that your staff can follow so that it becomes part of the fiber of your practice. The calendar will contain daily, weekly, monthly and quarterly action items to follow so that your campaign is properly managed.
Internal Marketing t An internal marketing campaign is as important, if not more important, than your external marketing. In fact, an effective external marketing campaign can be crippled by the lack of consistent internal marketing for your practice. The benefits are increased patient and staff satisfaction, loyalty and increased referrals. t Some effective internal marketing programs can include educating your patients about all the options available to them through a trained and motivated treatment coordinator, a referral program that rewards patients for referring friends and family, seasonal/ holiday and inviting décor in your office, recognizing patient birthdays and important achievements, identifying and participating in key community events, an effective patient recall system, capturing video and written testimonials from your patients for use on marketing materials, and more.
Measures for Success t Determine measures for success and track your results. Know where each new patient heard about your practice so that you can identify how well each advertising platform is performing. Utilize your practice management software to identify, track and generate reports that have tracked your marketing effectiveness. Continue to monitor and make adjustments each quarter. If the thought of developing your own identity, message, tools, and plan seems like a daunting task, you may consider incorporating the services of a dental marketing professional or firm. Many dentists prefer to focus on treating their patients and have a specialist assist in developing, executing and managing their branding and marketing.
Tools t Marketing Tools are everything that is necessary for ongoing communication with your target for your internal/ external marketing campaigns. These can include: A website, business cards, brochures, commercials, appointment cards, etc. t Marketing communication tools are effective when they communicate your message with your target; when they properly represent and build the equity of your message and brand; accomplish desired perception; and adequately meet short-term and longterm marketing campaign objectives. While this all may seem simple, it is often overlooked.
26 Spring 2012 Dental Entrepreneur
A few tips to consider when hiring a marketing specialist 1. They should specialize in dental branding and marketing. 2. They should have multiple dental client success case studies. 3. They should have multiple satisfied dental client testimonials. 4. Compare more than one dental marketing specialist and select the one with whom you are most comfortable and who best understands your vision. 5. Ensure they are able to provide the necessary attention for developing your practice marketing, and providing you with a competitive rate. Q Derek Champagne is the managing partner of Practice Image Builders, a company that specializes in developing medical brands, as well as building websites and social media platforms for practices nationwide. He can be reached at (866) 610-5334 or email: Derek@practiceimagebuilders.com.
Please reach out to our authors and our advertisers. They care about you and keep us in print.
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EDR (Electronic Dental Record) Orthodontic / Endodontic Charts
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Visit MacPractice.com for product information, trade shows, presentations, screenshots and a demo.
Practice Builders PETER GOPAL, PHD AND HEMA GOPAL, MBA, DMD
Attract More New Patients With Low Cost Internal Marketing
N
ew patients are the lifeblood of all dental practices. In a mature practice, 30-35 percent of production will originate from new patients. Newer practices are even more reliant on new patients for revenue. New patients may be acquired through external or internal marketing. External marketing is advertising outreach to your local community, while internal marketing seeks to acquire new patients from your pool of existing patients. Pros & Cons of External Marketing External marketing seeks to draw new patients from advertising and includes yellow pages, newspaper advertising, TV, radio, direct mail, Valpak, search engine optimization, Google Adwords, F a c e b o o k Advertising and others. All of these methods can work, but they are relatively Peter Gopal, PHD expensive and risky. An added difficulty is that marketing only works with repetition, which means the testing phase can be expensive. Furthermore, Hema Gopal, MBA, certain regions in DMD the United States are saturated with dentists and prospective patients are already being bombarded with 28 Spring 2012 Dental Entrepreneur
advertising messages from competing dental offices. Getting a marketing campaign to work under these circumstances can be challenging. Odds are you will need a mix of both external and internal marketing strategies to attract enough new patients to keep your schedule filled. However, it is prudent to focus initially on internal marketing before plowing money into external marketing. The Power of Internal Marketing Internal marketing is a safer, lower-cost way to increase new patient flow.
Effective internal marketing generates more referrals. The quality of patients generated through referrals tend to be better than those generated from external marketing. Internal marketing also improves patient retention and increases case acceptance, so you will need fewer new patients to achieve the same practice revenue. Word-of-mouth is still the most effective form of marketing. Most prospective patients are unable to evaluate the clinical competence of a dentist and know little about dental technology. Therefore, they will often consult a friend, coworker, or neighbor to make a decision. A friend or www.dentalentrepreneur.com
Wells Fargo Practice Finance
We’re here to help you take the next step
When you’re ready to purchase or start a practice, count on Wells Fargo Practice Finance to help you achieve your practice goals. · · · ·
Customized financing to help you acquire an existing practice or start one from scratch Competitive fixed rates with preferred pricing for ADA® members Expert project support by experienced practice financing specialists Complimentary business planning tools, educational resources and practice management consulting to help you successfully manage your transition to ownership
To get started, contact us at 1-888-937-2321 or visit wellsfargo.com/welcomedentists to request your free New Dentist planner.
Wells Fargo Practice Finance is the only practice lender endorsed by ADA Business ResourcesSM
ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. All practice financing is subject to credit approval © 2012 Wells Fargo Bank, N.A. All rights reserved.Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A.
coworker who shares a positive experience she had at your office helps persuade prospects to visit your office. The following are eight strategies to stimulate more referrals.
customer service situations. Your entire team has responsibility to deliver outstanding customer service, although the front desk staff may bear a higher burden.
1. Offer Superb Customer Service Nothing feeds referrals like excellent customer service. A happy patient is your most valuable resource in getting other new patients in the door. Much like your employees, they are ambassadors for your practice. Seat patients on time, know each patient by name and build a relationship with them, be courteous at all times, seek to eliminate financial and insurance misunderstandings, and minimize billing “surprises.” Make after-care calls to all patients who had major procedures done. The calls must be made with the genuine intention of making sure the patient is okay. Done consistently, this will increase patient loyalty and produce more referrals. Recruit staff with good interpersonal skills and a service orientation. Train your staff on customer service. Figure out how to deal with patients who don’t keep their appointments or don’t pay their bills. Learn from each experience and develop a plan and a script to deal with various
2. Ask Select Patients for Referrals Many offices are hesitant to ask for referrals, as they have introverted staff. Others find the entire process of asking for a referral somewhat awkward. Some offices work with scripts, most of which sound contrived, and doctors are concerned that the office will look needy. Eventually, asking for referrals gets dropped. Make the process of asking for referrals easy and natural for your team by waiting for the patient to say something nice about your office. Use that opportunity to ask them to refer friends or coworkers. Patients may comment on the office being clean, a particular staff member being nice, a cosmetic procedure that made them look good, or a root canal or extraction that wasn’t as painful as they anticipated. On any given day, you may have at least two or three such opportunities. You could spur these opportunities by asking the patient: How was your visit today? If she says something complimentary, that’s your cue to ask for a referral. The chance to ask for a referral might
Business Beyond the Classroom
RESOURCE GUIDE
Patterson Advantage (800) 328-5536 www.pattersondental.com
Patterson Dental, a leading distributor of dental products, equipment and technology in North America, is the largest business in the progressive, global Patterson Companies family of businesses. Dental professionals who partner with Patterson enjoy the convenience and assurance of relying on one trusted source for everything they need. Please see our ad on page 19.
P&G Oral Health 1-877-418-5559 (Option 1) www.dentalcare.com
P&G Oral Health markets a wide range of products to Dental Professionals, including Crest and Oral B brands. With our ProHealth system from Crest & Oral B, Professionals can now recommend a system that virtually eliminates plaque and helps prevent re-growth. To learn more visit www.virtuallyplaquefree.com. See our ad on page 21.
Sirona Dental Systems, LLC 800-659-5977 www.cereconline.com
CEREC AC from Sirona is the most advanced dental CAD/CAM system available. With its Bluecam, capturing fast, precise digital impressions and then creating high quality esthetic restorations is a reality. CEREC AC delivers access to efficient, precise, scalable and affordable solutions, including CEREC Connect. Call 1-800-6595977 or visit www.cereconline.com. Please see our ad on page 33.
30 Spring 2012 Dental Entrepreneur
present itself in the clinical area or at the front desk. For example, if after completing a procedure, your patient Mary says: “That was painless,” your assistant should respond with a smile and say: “Great, we’re pleased to help. Send us your friends or coworkers.” It is sincerity, body language and humor that make this natural and easy. To complete the process, at the front desk checkout counter, give Mary an office mug containing a couple of business cards and a practice brochure or DVD. Only ask good patients for referrals. 3. Open a Facebook Fan Page The office water cooler used to be the place where people gathered for casual conversation. That has now been replaced by Facebook. People spend an enormous amount of time on the computer and Facebook is a big part of it. Facebook has 600 million active users and the average user spends 50 minutes a day on Facebook. Word-of-mouth is stimulated on Facebook, as people heed the recommendations of their friends. If your office does not have a Facebook fan page, you are missing out on this huge development. Start a Facebook fan page for your practice. When patients are in your office, ask them to “like” your page. Make it convenient for them by making a computer available to them in the office. Connect with people on your fan page. Post status updates once every 2 weeks, more if time permits. Be sure the updates are well written. Spelling and punctuation errors may be acceptable among Facebook Friends, but will reflect poorly on you as a practice owner. Provide useful and interesting information regarding dentistry. Add personal updates about you and your staff as well. Include photos and images. Ideally, you want to prepare content in advance and have at least 6 months’ worth of content on hand. You can then release them at regular intervals. Facebook is really about connecting with people, so make sure you are not constantly talking about dentistry. Mix it up with other non-dental communications. Once you’ve established a relationship with your fan base, you will start to see referrals. www.dentalentrepreneur.com
Practice Made Perfect
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4. Gather and Post Patient Testimonials Patient testimonials give your office credibility. They make things believable. Ideally, you want to capture the testimonials on video with a camcorder and post them on your web site and on YouTube. YouTube is the second-largest search engine after Google. Posting videos on YouTube is free and will increase your visibility greatly. If you are not ready to shoot videos, ask patients for written testimonials and post them on your web site.
You can also include any special offers for new patients. Hand these out to existing patients when you ask them for a referral. Hire a professional videographer to film a video of the inside of your office. Put this on a DVD and distribute it to your patients, include the DVD in the welcome package you send to new patients, and post it on your web site.
5. Create Album of Before and After Pictures Create an album of before and after pictures and keep the album in your reception room. These should be real pictures of work that your office has completed on patients, not purchased photos.
7. Produce Print Newsletters Produce and mail a quarterly print newsletter to all your patients. Print newsletters allow you to educate and inform your patients about the services you offer and about dentistry in general. Include special offers, with a deadline. Newsletters keep your practice “top of mind.” It is one of the best investments you can make. E-newsletters are a lower cost alternative, but can’t reach as many patients and can’t be as detailed as print format.
6. Develop a Practice Brochure and Video Design an elegant brochure for your practice, which explains your services and how your practice is different from competitors. Describe important clinical capabilities and doctor CE, some of the main technologies available in your practice, and include your office hours and web site.
8. Start a Quarterly Patient Appreciation Day Pick one day per quarter and give out gifts to all patients who visit your office on that particular day. It is a random event and a pleasant surprise to those patients. These gifts should be valued at no more than $20.00 each. If you see 20 patients a day, this is only an investment of about
Business Beyond the Classroom
RESOURCE GUIDE
United States Air Force Reserve 800-289-6695 AFReserve.com/HQ
The Air Force Reserve offers dentists challenging part-time opportunities with lifelong rewards. Receive world-class specialized training with continuing education that will enhance your civilian opportunities. Gain valuable experience while caring for our nation’s finest. Special financial incentives available for some specialties. Discover where the rewards of service and healing take flight. Please see our ad on page 7.
Wells Fargo Practice Finance 1-888-937-2321 wellsfargo.com/dentists practicefinance@wellsfargo.com
Wells Fargo Practice Finance provides customized financing supported by experienced specialists and practical planning resources to help dentists acquire, start and expand their practices. The only practice lender selected especially for ADA® members and endorsed by ADA Business ResourcesSM, we understand the business of growing successful practices and are here to help you achieve your goals. Please see our ad on page 29.
32 Spring 2012 Dental Entrepreneur
$400.00 every 3 months. It could be movie tickets, flowers, novelty items, or inexpensive electronic gadgets. Practice growth can be accelerated with low cost internal marketing. When implemented correctly and consistently, the above eight strategies will create raving fans and fire up your referrals. Q Peter Gopal, PhD, is President of Visionary Management, a dental practice management consulting firm based in Pennsylvania. He is a graduate of the Wharton Management Program. Hema Gopal, MBA, DMD, is Vice President of Visionary Management. She maintains a private practice in New Jersey. Contact them by phone at (215) 295 6975, or visit www.visionary-management.com
Please reach out to our authors and our advertisers. They care about you and keep us in print!
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CEREC ® 3D Software powered by Biogeneric: Predicts perfect proposals with a single click. Natural form and function is now as easy as scan, click, mill. CEREC Biogeneric Software effectively reads the morphology of the patient’s own dentition to predict the right form and function for all restorations. Based on comprehensive morphological analysis of thousands of actual teeth instead of arbitrary “tooth libraries,” CEREC Biogeneric Software allows you to create inlays, onlays, crowns, veneers and temporary bridges with just a single click. Ideal form, function and occlusion— CEREC 3D Software powered by Biogeneric does it with ease. Simply scan, click, mill and admire. s #LINICALLY AND FUNCTIONALLY VALID PROPOSALS EVERY TIME s !UTOMATIC PROCESS A SINGLE CLICK PRODUCES THE NATURAL RESTORATION s 5NRIVALED EASE OF USE LETS YOU FOCUS ON YOUR PRACTICE AND NOT COMPLEX SOFTWARE MANIPULATION
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Power To Succeed DR. TANYA BROWN
3 Simple Ways to Build Powerful Leaders on Your Team
I
n a recent issue of the Proceedings of the National Academies, Nathan Mlot, a Mechanical Engineer at the Georgia Institute of Technology, published an article about fire ants. While a single fire ant struggles when exposed to water, a group of the same fire ants when working closely together can float effortlessly for days. The ants accomplish this by literally linking their bodies together. The fire ants actually create “waterproof rafts,” and as a whole the rafts are significantly more buoyant than an individual fire ant floating alone – much like a happy, productive dental team can outperform an unhappy Dr. Tanya Brown dental team any day of the week. So how are fire ants similar to dental team members? It’s all about synergy. The more efficiently everyone works together, the more productive and profitable the practice will be. The ultimate result will be superior customer service and high quality patient care compared to a disjointed group of people merely working in the same practice. There are three keys to strengthen a team and build powerful leaders: 1) Positive Attitude 2) Common Goals 3) Personal Growth/Leadership “Hire for Attitude & Train for Skill” provides insight to the first way to build a powerful team of leaders. If an individual has a positive attitude, they can easily be trained for skills. A group of people with positive attitudes are more likely to work well together, just like the fire ants. Patients especially appreciate friendliness and open-
34 Spring 2012 Dental Entrepreneur
ness as it helps them to connect on a deeper level and strengthen the patient relationship. After all, we are in the smile business! We must remember to have a smile on the inside and outside at all times. Unfortunately, dental team members may not receive the appropriate training for their positions, which creates a burden on the entire team. Training is critical because most teams are only as strong as their weakest link. Linda Miles has developed the concept of “Hire, Train, Trust, & Praise,” which describes an ideal dental practice management philosophy. Specific training could range from team meetings, hands-on coaching, lunch and learns, to continuing education programs. A highly-trained team of people with positive attitudes are also more likely to accomplish common goals. In dentistry, common goals could include expanding services provided to patients, producing a certain amount per month, or earning a continuing education trip. One way to promote teamwork and common goals is to create a practice bonus system based on net production and collections. This ensures that both the administrative and clinical team members must work together for the common benefit of the patients, the practice, and the team. At the end of the day, successful team oriented companies have “owner mentality” and NOT “unionized thinking.” The synergy and productivity is clearly evident when the entire team is happy and working together to accomplish common goals. It is a “WIN-WIN”! Finally, the third key to strengthening a dental team is to encourage each team member to develop personally. When each team member develops personally and becomes a more effective leader, the
entire practice grows and quality of patient care improves. The best-performing, leaststressed dental teams are often ones with “leaders at all levels,” which means that each person on the team takes ownership and responsibility for their area of the practice. Each leader presents the results of their efforts at the team meetings. This may include the number of collection calls made by the financial coordinator or the number of patients reactivated by the scheduling coordinator. The clinical team may report on their supply costs compared to the budget or numbers of a particular procedure completed for that month. The point is that each person is accountable to the team as a whole. Another personal development idea that has proven successful is a “book club,” where the team selects a particular book on leadership or personal growth. At a team meeting, each person should report on one or two things that they learned from the book and can apply to improve patient care and the practice. Dental practices that have strong team building processes throughout their organization have reaped the greatest personal and financial rewards. Remember the timeless adage of TEAM – “Together Everyone Achieves More.” Q
Dr. Tanya Brown, a leader in dentistry and dental management, founded and actively practices at The Center for Cosmetic & Restorative Dentistry. She is a member of the Speaking Consulting Network and is a senior consultant and speaker for Miles Global. Contact Tanya for a complimentary copy of her “Leadership at all Levels” tracking form or her book club suggestions. She can be reached at Tanya@ MilesGlobal.net or 757-285-2833.
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“Record Keeping” cont. from page 17 I hear your objections. Charting... ugh! ...the most tedious, time consuming, non productive waste of my time. That’s what I used to think. My opinion of charting, after having spent several months in Federal Prison, has been forever changed. I’ve learned that the chart is the single most important document in the event of an insurance audit, malpractice claim, legal action, or challenge of any kind. What is contained in the treatment record can exonerate you or condemn you, depending on what is there (or what is missing). The clinical record can speak volumes. Although just a document, it can “testify,” if you will, of your competence, your attention to detail, or your complete disregard for the treatment of the patient. We make a critical choice every day to take the time to construct a complete, concise and comprehensive record, or to “let it slide.” Believe me, it’s worth the time and effort to make the appropriate entries,
patient by patient, procedure by procedure, day by day! Start the charting system on the right foot and don’t ignore its importance. It will serve you and the patient well! Q Dr. Shelburne is a 1981 Honor Graduate from Virginia Commonwealth University’s School of Dentistry. After graduation, Dr. Shelburne opened his practice “back home” in his grandfather’s hardware store building and practiced there for 27 years. He has been a past president of the Southwest Virginia Dental Society and has volunteer at Virginia’s various MOM projects across the state. Dr. Shelburne has also been a short term missionary with the Baptist Medical Missions International to Honduras, CA. Most healthcare professionals live in fear of litigation but few worry about going to prison. Dr. Shelburne became aware that he was a target of an investigation when the FBI broke down the back door of his office and confiscated all his business and dental. Over the course of the
next 3 years no aspect of his life was left unexamined. Roy was found guilty of healthcare fraud, racketeering, and money laundering in March of 2008. He was sentenced to 24 months in Federal Prison and was ordered to pay fines and restitution. Roy is presently serving a 3 year period of supervised probation. During the investigation as well as in the preparation for and during the trial it became apparent that his records, billing, and coding systems were faulty. The Court stated that this decision was to send a message to the healthcare community and Dr. Shelburne has taken that statement literally. Dr. Shelburne has now focused his efforts toward the education of others to prevent the same from happening to them. His message is that it is possible to implement systems that can form a defensive systems approach. A speaker, consultant, and writer, Dr. Shelburne specializes in record keeping and business systems that protect and defend.
“Diploma” cont. from page 9 perform, a large number of active patients, experienced employees in place, equipment and systems in place and running – and a steady new patient growth from the first day forward. While a practice purchase is not likely to start out as one’s perfect practice, in time it can be molded to that perfect practice while earning a good income along the way. Also, in most cases the seller is available to provide expert support to the buyer in time of need. In review, the first step in your career process should be to look within yourself to determine which practice career option best suits you, then carefully assess each opportunity you uncover to discover the most successful alternative available. Good luck! Q Earl Douglas, DDS, MBA, BVAL, is the founding president of ADS, a company with independent practice brokers, appraisers, and consultants nationwide. His company, ADS South serves the Southeast and South Central US. He can be reached at 770-664-1982 or at douglas@adssouth.com. Visit the website at www.adssouth.com
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Dental Entrepreneur Spring 2012 35
Dental Trade Shows Hinman Dental Meeting March 22–24, 2012 Atlanta, GA 7th Annual Dental Student Orientation March 23, 2012 from 4 to 5 PM, Exhibit Hall Room #6 of the Georgia World Congress Center California Dental Association – Fall Session No meeting in 2012 San Francisco, CA American Dental Association October 18-21, 2012 San Francisco, CA Holiday Dental Conference TBA Charlotte, NC Greater NY Dental Meeting November 25-28, 2012 New York, NY
National Dental Student Lobby Day ASDA members can make a difference by lobbying for dental legislation. Attend National Dental Student Lobby Day in Washington, D.C., April 16-17. The event is co-hosted by the American Student Dental Association and the American Dental Education Association. Register by March 13 at www.ASDAnet.org.
ASDA’s National Leadership Conference The American Student Dental Association is hosting its first-ever National Leadership Conference, Nov. 2-4 in Chicago. The event will provide leadership training to dental students across all years. Other benefits of attending: t Experience training in people management, public speaking and presenting, personal finance, practice negotiations, mentoring others and more t Build leadership skills that will be beneficial throughout their dental careers t Increase the understanding of key issues in dentistry and dental education t Build relationships with exhibitors to fulfill current and post-graduation needs Online registration will open in May at www.ASDAnet.org.
Index of Advertisers ADA Insurance Plans ........................................................................................................Back cover ADS Transition Specialists…………………………………………………………… ............................... 17 ADS Transition Specialists South .................................................................................................. 12 Aspen Dental.............................................................................................................................. 31 Bank of America ......................................................................................................................... 25 The Artist Evolution LLC ................................................................................................................ 9 Henry Schein (PPT) .................................................................................................Inside back cover MacPractice ............................................................................................................................... 27 Medical Protective ...................................................................................................................... 13 Oxyfresh.................................................................................................................................... 35 Paragon ..................................................................................................................................... 23 Patterson Dental Supply .........................................................................Inside front cover and page 1 Patterson Dental ......................................................................................................................... 19 Procter & Gamble ....................................................................................................................... 21 Sirona ....................................................................................................................................... 33 US Air Force Reserve ..................................................................................................................... 7 Wells Fargo ................................................................................................................................ 29 36 Spring 2012 Dental Entrepreneur
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Are you fully prepared for your professional journey? Transitioning a career takes planning. Have you taken steps to ensure that you will make the right decision when retirement is at hand? Do you know what it takes to plan an exit strategy? Sell a practice? Hire an associate? Bring on a partner? It takes expert guidance from a team of people who have your best interests in mind. Henry Schein Professional Practice Transitions (HSPPT) provides a full range of nationwide dental practice brokerage, practice valuations and transition planning services to help dentists achieve their professional goals. HSPPT will support you with practical advice and customized strategies that will ensure your success.
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Speak with a Henry Schein Financial Services Specialist today!
1-800-730-8883 Henry Schein Financial Services is not a bank, does not represent itself as such, and does not conduct banking activities. Š 2012 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.
or e-mail: ppt@henryschein.com www.henryschein.com/ppt
The one advantage only certain dentists can have As a dentist, you have a lot of people counting on you: Your patients. Your colleagues. Your family. But if you’re an ADA member dentist, you have a better way of handling all that responsibility. Membership gives you access to ADA Insurance Plans—exclusive group insurance policies designed by your peers to meet the unique needs of dentists. From customizable coverage and exceptionally low rates to seasoned experts who work only with dentists, ADA Insurance Plans delivers the advantage you need. For more information, call 888-463-4545 or visit insurance.ada.org
©2012 Great-West Life & Annuity Insurance Company. The inverse boomerang logo is the trademark of Great-West Life & Annuity Insurance Company. All Rights Reserved. This ad is an outline only and not a contract. Benefits are provided under group policies issued to the American Dental Association, filed in the state of Illinois, and underwritten and administered by Great-West Life. All policies are subject to, governed by, and shall be construed in accordance with Illinois law. Eligible ADA and ASDA members residing in any U.S. state or territory may apply for coverage. NDAD12-DE
ADA Insurance Plans: Where dentists get their insurance