Cliff's Notes

The Business of Dentistry

The Master Craftsman’s Tools

A fine furnisher Master Craftsman, an artist, an athlete, a dentist always do their best work when they use the best tools. Your dental handpiece is your #1 tool. If your handpiece doesn’t preform you can’t work. So maybe it’s time to look at the function, maintenance, and power supply that can shut your practice down for hours or a full day. Not all handpiece are the same and the small price variation should have no bearing on what works best in your office.

In today’s dental trade market everyone is talking about impression scanners and I know you are too, but you need quality tools to get to the scanning process and in every case you will use your handpiece. A quality piece costs about the same as re-doing a crown that was under your practice warranty policy. Failure costs money.

Failure … Dental handpiece are very difficult to design and manufacture. To simplify it, they are miniature jet engines. Air driven turbines freewheel at 350k rpm to 450k rpm. Electric high speeds turn at 200k rpm, they need constant care and maintenance. If your quality high speed is being repaired more than once every 2 years I would assume there is a breakdown in maintenance protocol. Most often it involves the turn-over process.

Turn-over … When the clinical procedure is over a team member cleans the room. They clean the handpiece (with what?), lubricate it (how & with what), and sterilize it. Most offices clean the piece with a disinfectant wipe and that will breakdown the gaskets that secure the race (spinning part). Also, on lesser quality pieces the outer finish will be damaged. Clean a dental handpiece with water, they’re made to get wet. Then the handpiece has to be lubricated correctly with autoclavable lubricant that will protect the internal components from the heat of the sterilizer. Disinfectants will degrade the internal components.

The Internal Components … Outside factors greatly effect the internal function of a quality highspeed. The inside construction is very complex and designed to deliver the exact amount of air (32 psi) and a spray that is focused on the cutting point of a rotary instrument. They are built to work hard but garbage in, garbage out. Your air supply may be the most contaminated component in your office. When was the last time your dental compressor was serviced? When were the filters changed? Think about the inside of a dental compressor tank where it is moist and dark all the time. After several years what are you shooting through that quality handpiece? As handpieces got more presciently engineered biofilm became a factor with waterlines and spray. Equipment maintained routinely will extend the life of your handpieces. Electric Systems suffer similar abuse.

Electric Systems … Bad water passes through all the attachments and the system is controlled by an air actuated electric switch. All the same stuff.

Suggestion … contact the manufacturer of the handpieces you have and request they e-mail there maintenance guide. Have your mechanical equipment serviced annually and consider implementing an automatic handpiece maintenance system into office protocol.  Please feel free to contact me at any time with any questions or concerns.


August 26, 2018 Posted by | Uncategorized | Leave a comment

The Bus Is Leaving The Station


A lot of people that read this this week’s rant will have no idea who is in this picture but it is a seen from one of the most iconic TV shows ever. It’s Jackie Gleason & the Honeymooners. On October 5, 1951 the first episode aired and history was made in a time when more than one half of the country didn’t have a TV set but everyone wanted one. Ralph was pretty cheap and this episode was a classic.

In this seen Alice is complaining about not having a TV and Ralph didn’t want to spend the money so to justify his decision he yells out “I’m waiting for 3D TV”, that was in 1951. What are you waiting for.

Dental School … Do you have a digital radiography system? If there was a time that you used x-ray film you can appreciate the technology and think about all those years you didn’t have it. Today, most dentists under 40 don’t know how to use x-ray film and in the very near future (5 years) new dentists won’t know how to use impression material. Can you see where this is going? Dental impression scanners are NOT bells & whistles, they are the tools you will need to stay relevant.

Staying Relevant … Last week a well established dentist pulled me aside and told me that a new patient that came by way of referral was told that it was a great office but not to expect any bells & whistles. That was concerning to the doc and with good reason. What are your patients seeing and what are they thinking? Look around at what is evolving, technology is rolling like a freight train and if you don’t jump on-board you will be left behind. But just don’t jump!

Don’t Just Jump … So many offices spend a lot of money on dental impression scanners and don’t use them? The scanner your friend bought may work efficiently in their office but it may not fit the way you work. Step one is to consult with sellers that represent multiple brands this way you will be getting a more bi-partisan view. Step 2 is to demo several brands to see what feels best in your hands and integrates seamlessly with your current network. There is no “one size fits all”. Also, the industry landscape is changing with more dental labs accepting images and Invisalign’s patent on clear dental aligners expiring late in late 2017. And, be aware that Generation Z is on the way.

Generation Z … One fifth of today’s US population will change the way we see the world. The 20 year old that was in for a hygiene appointment is the front line of generation Z (born after 1996). Now,  you have to redefine your marketing program to relate to the mindset of this new patient base? Marketing 101, packaging is 95% of the sale. We all know Millennial’s look at things different than their parents did and their has been plenty of marketing research to guide organized programs. However, Generation Z is different. Their word is technology, virtual reality, instant information , and very soon artificial intelligence. What will your practice offer because today’s “WOW Factor” will be the expected standard tomorrow.

Tomorrow comes fast … Planning for the future of your dental practice is very scary. It requires dedication and a financial commitment, both of which are usually much more than a currently successful dental practice owner is willing to invest. But, as Albert Einstein simply stated “energy in motion tends to stay in motion, energy at rest tends to stay at rest”. The motion of your business must continue to move forward or it will stagnate and fade away. Maintain the quality of your investment.

Your investment … You are so afraid of spending money that you will justify the status quo. Ralph did, he wanted to wait for 3D TV. So many dentists tell me that they are waiting for the next upgrade but you know what, they will always be waiting. Your investment in school and business is too important to not be managed correctly. The bus left the station but you can still catch it if you want to be part of the future. The value of your practice depends on it. Please feel free to contact me at any time with any questions or concerns.


August 19, 2018 Posted by | Uncategorized | Leave a comment

Everyone Wants a Raise! What happens when a long time employee exceeds their market value?

Much of this week’s blog post is re-printed from a post on May 7, 2016. Not much has changed except quality team members are getting harder to find.

As a business owner or manager, there are some very difficult decisions that you will have to make through-out your career. Some of the hardest involve your team and their compensation vs production (value). In a different time an annual wage increase was standard business practice, but in today’s economy when operational cost are continually rising, there is not much left over to give to the team, and you will be expected to give again next year. How can you do it? You can’t keep giving. As an example, a good dental assistant (in northern NJ) will command an hourly wage of $18-$25 per hour. If that quality employee stays with you for 10 years that wage may run as high as $35 per hour and be far above market rates. How do you deal with a team member that has been with you since you bought the practice, is over paid, under produces, but the patient love them? Here comes that difficult decision.
Quality is the key to success and a quality team is one of the most important investments your practice can make. The question is how to compensate them, keep them happy, and help them “grow” with you and the practice?

There are many creative ways to compensate and retain quality team members. But first you need to up-date and complete your employee management program. Your employee manual must be reviewed annually and reflect any changes in policy. Team members will better understand their responsibilities when they are clearly defined in writing. Also, federal & state labor laws always favor the employee unless policies are formally and clearly presented. Your legal adviser can help you do it right and you can blame the changes on them (good cop/bad cop).

Some of the most successful practices I deal with offer “employee extra’s”. Everything from bonuses tied to production, medical benefits and 401K programs attract and help retain quality team members. If you establish realistic incentives as part of your compensation program you will see production increase. As a leader you need to constantly motivate your team and compliments only go so far. People go to work for mostly one reason, to make money. And if you want people to help you make money, you have to let them make money. Let them make extra money through production incentive programs.

Talk to your practice consultant and financial adviser about establishing a 401k program, one that requires several years for vesting. Matching funds can be tied to production goals. You may be surprised how this small investment will pay off. Now, every team member has something to lose if production is flat.

Your team is your greatest asset. Keep them educated, informed, and part of your future. Quality is hard to find, don’t be afraid to invest and expect a healthy ROI. Please feel free to contact me with any questions or concerns.

August 12, 2018 Posted by | Uncategorized | Leave a comment