Learning Practice Management


The best way to learn practice-management skills is to buy a good practice.

Each time I sell a practice, it is my sincere wish to see the purchasing dentist become very successful. Most young dentists have the necessary dental skills to do well. Dental schools, residency programs, and associateships do a sound job of preparing young dentists as clinicians.

On the other hand, graduating dentists have been taught very little about the business side of dentistry.  Dental schools are turning out dentists who have practically no training in accounting, marketing, or management. Most senior dentists are reluctant to teach associates about the business side of the practice. It is up to the associate to pay close attention and ask lots of questions.

Continuing education is another way to learn practice management. CE courses are provided by dental societies or at-large dental meetings. State dental boards regulate CE and have mandated that a certain number of CE hours each year are required to maintain a dental license. The irony is that these same state boards have asserted that most business courses are not eligible for CE credit.

Dental schools are not business schools and don’t have the time or money to properly educate dentists about the business side of the practice. Dental graduates are left to learn the business part of their education on their own. In an associateship, chances are slim that anyone will teach the associate the business side of the practice. When you take a CE course, you are limited because most business seminars are not eligible for CE credit.

So, what is a young dentist to do? The answer is obvious: buy a good practice! The majority of assets purchased in a dental practice consists of “goodwill.” One key component of goodwill is a well-trained and experienced staff. It is from this staff and the multiple systems incorporated within any good practice that most young dentists learn dental practice management. In other words, most dentists learn how to successfully manage their practice on the job!

A hygienist who has been in the practice 12 years explains the importance of a well-organized recall system.  The receptionist demonstrates the value of preappointing all patients with six-month recare appointment before they leave the office. The patients address their own reminder post-cards. The hygienist also explains that all patients receive a call the day before their scheduled appointments to reconfirm. He or she shows the young dentist how to fill a slot quickly in case a patient cancels at the last minute. The hygienist understands the importance of a preventive-maintenance system and why it is the backbone of any good dental practice.

Working with the office manager and CPA, the young dentist learns about the practice’s finances and accounting, including overhead, managing accounts receivable, and documenting financial arrangements made with patients.  The office manager explains what a reasonable practice overhead is and how the overhead is affected at different production levels.

Working with the receptionist, the purchasing dentist learns about production scheduling. The receptionist schedules by operatory and arranges appointments so that, at a glance, each day can be seen separately for greater control. The scheduling system allows for emergencies.  Because the office has expanded-duty assistants, the receptionist shows how expanded duties have enabled more efficient scheduling of the dentist’s time. The staff teaches the dentist the charting system. The charts are readable and easy to follow; it is important to keep them that way. The charts must be complete and protected against misfiling.

The insurance coordinator shows the purchasing dentist how she files claims electronically the same day of a patient’s office visit. The insurance coordinator explains what percentage of patients have insurance and how those without insurance pay for their services. The dentist learns the office has primarily indemnity insurance, but also accepts three decent-paying PPO programs. The insurance coordinator carefully reviews the fee schedules of the three PPOs with the purchasing dentist so he or she understands why these particular PPO plans were accepted. The insurance coordinator also goes over examples of other PPOs and why the selling dentist declined those plans. There is a great deal to learn about dental insurance.

It is from the experienced staff and the many systems within the practice that the young dentist ultimately learns how to effectively manage his or her practice.

Guy B. Jaffe, MBA,

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