Setting up your dream practice

We are witnessing an unprecedented time in the evolution of dentistry. It is more possible than ever before for the dentist who is committed to a higher standard of care to attain a more fulfilling practice environment. Your practice environment and the quality of care are a by-product of your systems.

You are about to make a commitment to improve treatments, patient care and services in your practice. The ensuing result? Greater job satisfaction and greater profitability. This is not something that can be accomplished without the help and support of your dental team, as they will play very important roles in the implementation of the new dental system and making sure you reach your ultimate goal.

Change is good but it can be uncomfortable. Staff and patients typically react hesitantly when they are faced with the unfamiliarity of a transitional practice. There will always be patients who accept changes without question.

However, in consideration of those who don’t, it is important to prepare them for the evolving improvements in your practice.

Creating the vision

Vision can be vast. Realistically, though, it must be contained first within the context of your practice philosophy. In my practice, the concepts of comprehensive care, continuing education and patient communication are the foundation of this philosophy and therefore constitute the

vision that our practice shares.

Ask yourself:

• What kind of dentistry do I want to practise?

• Do I have enough education/experience to carry out the level of dentistry that I want to practise? If not, what level of commitment is required to gain this?

• Are my staff motivated and knowledgeable enough to make this journey with me and what must I do to make it happen?

• Do I need a hygienist?

• How do I want my practice to appear?

• Do I have the right equipment and if not, am I willing to invest in it?

• What am I willing to do to promote my practice?

• Do I need a website?

The list could go on, but what has been detailed above constitutes some of the main points to be considered in helping to establish a practice philosophy.

Comprehensive care

It is a known fact that the best type of care for a patient is comprehensive care; this means treatment of the patient from every aspect, starting from their education through to treatment in periodontal health, occlusion, functionality, aesthetics and restorative dentistry. The mouth is examined as a total functioning system rather than just treatment of individual teeth. Prevention of dental disease is the ultimate goal.

The merits of comprehensive care are evident in the overall health of people in countries such as the United States where this philosophy has long been practised. It is imperative that this be the case for all people wherever it is possible and certainly in Ireland. Most importantly, it is the right of the patient to expect nothing less than the optimum level of care and it is the dentist’s obligation as part of his or her code of ethics to provide it.


For yourself

Making a commitment to continuing education is the most valuable thing that you can do for yourself, your staff and your patients.

Further education brings about greater knowledge and equips you with the tools to perform dentistry at the highest level. It will be ongoing because there are always new techniques and materials to learn about. There are so many great minds in the field of dentistry; it would be a shame not to have learnt from them. Going to lectures and hands-on programmes opens doors to many other areas of dentistry, areas that you may want to learn about and improve in.

There is a financial aspect to consider when embarking on postgraduate education. Just like you plan to invest time, energy and money in your practice, it is equally important to do the same for yourself. Many of the courses and lecture programmes can seem expensive but the return on investment will be tangible through the added services and procedures you provide to your patients.

Your support staff

Education of your staff is paramount. They form your support network and will be fundamental in your success. Without proper training, your practice will not grow as much as you may expect and will also cause frustrations and inefficiency. Everybody that works for you must see value in what you are doing. If not, patients will pick up on it.

First impressions are very important and your staff are a reflection of you and your practice. Each member of staff should be competent at what they do so that you can concentrate on practising dentistry. If trained properly, they will decisively contribute to the evolution of your practice to the highest level.

Your hygienist

Education of your hygienist is also key to the success of your practice. Hygienists who are unwilling to explore new protocols for treatment will slow the evolution of your practice. Your practice will not progress in the way that you would like and it could set a bad example for the rest of your staff members. Low staff morale is always an obstacle to growth.

The ideal hygienist is someone who you can work well with, someone who shares the same philosophy as you and someone who is committed to constantly improving the service they provide. This type of hygienist will be a great help in the education of the patients, rendering them more amenable to the concept of comprehensive care and better health.

Your patients

Education of your patients is vital. They need to understand the reasons for the changes that you are making. This involves you, your staff and your hygienist. Everybody at the practice needs to give the same message and this requires planning.

Any change will cause some of your patients to be anxious and they may need a lot of clarification; others will accept the changes readily.

Patients should be informed as soon as possible to give them time to get used to the new ideas. Some may not see the value in what you are trying to achieve and may subsequently choose to attend a dental practice that better suits their needs. Don’t be disheartened if this happens. You want to retain the patients that value what you do and understand that your aim is to give them more comprehensive dental care.

Informing your patients of changes

Where possible, it is best to inform patients in person. It is easy to do this at a re-care appointment. Let the patient know that there will be changes taking place over the next few months.

If, for example, the length and cost of re-care has increased because you combine the appointment with a hygiene visit, it helps to let the patient experience the new form of treatment at a reduced price. Inform the patient that this is an initial courtesy fee so that they will see the value of the changes for themselves. Most people enjoy good service and the feeling that they have really been taken care of.

By spending time with patients to give explanations and allowing them to see the value of a longer appointment at a reduced fee, you have accomplished three things:

1. Gained a little more trust from the patient by being open and honest with them

2. Allowed them to realise that the changes are to benefit them and are not just to increase profit

3. They may have a more pleasant experience and are more likely to tell other people about it and accept this change.

I have found all these things to be true from my own experience. However, with all the will in the world, it is impossible to inform all patients in person. Letters can then be sent to ensure all patients who attend your practice are fully informed of all changes.

Changing fees will always create a response from your patient pool. Your fees must accurately reflect the quality of treatment you provide and the level of service you deliver. Any inconsistency between the two will most often initiate adverse reaction. Dentistry is a business as well as a care-giving profession and we have to take into account all aspects of running the business when we set our fees. The patient should be informed of the following points:

• When the changes are going to take place – give your patients between three to six months’ notice

• Why the changes are taking place:

– You want to offer more comprehensive care

– You want to spend longer with your patients

– You want to be able to offer different treatments

– You want to place more emphasis on hygiene treatments

– You want to offer treatments that you have been trained to do, i.e. implants, aesthetic restorative dentistry, etc

– You don’t want your treatment to be dictated by the schemes that you are currently on

• Any changes in appointment lengths/changes in your fee schedule:

– Be very open about this and don’t apologise

– Services that you offer may change

– Longer appointments

– You may start using a better laboratory to produce

your work

– Your skill levels have improved

– You’ve invested more in the practice, your education, that of your staff

– You may have bought new equipment, e.g. a CEREC machine.

These are just some of the first steps to take when implementing change. This will result in giving you more job satisfaction and success.


It was Bobby Unser who said: ‘Success is where preparation and opportunity meet’.

Preparation for us in the transition process is being technically apt, educationally sound and aspiring toward a higher level of communication.

Opportunity is the moment we realise that our dreams have evolved into tangible goals now within our reach.

The opportunities to elevate our practices have never been greater. If our preparation is proper, we can expect the vision of a three-day working week, 50% overhead, supportive staff, 100% collection rate, and discretionary (non-insurance or scheme-related) dentistry to be our reality.

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