Overcoming the dental industry's core challenges to remain competitive: Pacific Dental Services'® Drs. Brad Guyton and Charles Rodgers share thoughts


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Pacific Dental Services'® Vice President of Clinician Development and Dean of the PDS Institute® Brad Guyton, DDS, MBA, MPH and Vice President of Clinical Quality and Chair of the PDS Institute® Charles Rodgers, DDS, delved into the major changes unfolding in the dentistry field and where dental professionals should focus their efforts to remain competitive moving forward.

Note: The following responses have been slightly edited for style and clarity.

Question: What are three major factors that have changed the way dentists practice?

Dr. Brad Guyton: The landscape in dentistry has changed significantly in the last two decades. But the solutions to these challenges remain the same.
• First, dentists are collaborating more now than ever before. The largest growth sector in dentistry over the past 15 years has been in group practice. This is not to say that niche solo practice is dying; it isn't. But, solo practice is feeling the pressure of more competition in urban and suburban locations and there are more preferred provider organizations and discount fee plans than ever before. That means dentists have two choices — they either constantly evolve to improve their business systems in their solo practices or they look to a larger group practice or dental support organization (DSO) to help them stay competitive.
• Second, student debt plays a part in the ways new dentists are choosing to practice. Many students lack the capital to start their own practices. Therefore, almost all general practitioner graduates are starting out as associates and either delaying a practice purchase longer or partnering with a group.
• Third, we have finally accepted that the head is indeed attached to the body. Dentists and physicians are finally starting to communicate about the patient's overall health. The link of periodontal disease to chronic systemic disease, the evolution of simple and cost effective diagnostic tests and greater awareness of other conditions like obstructive sleep apnea are accelerating this trend of enhanced collaboration. This is true advancement in serving patients.

While the landscape has changed, the solutions from two decades ago that allowed us to win remain the same today. Keep a close eye on your business, constantly innovate, be better — not cheaper, and prioritize patients over revenue and revenue over cost.

Dr. Charles Rodgers: While Dr. Guyton's assessment is correct, my choices for the three most significant factors in how dentists practice are all tied to digital changes:
• Number one from my view without doubt is CAD/CAM dentistry. Benefits include:
o The increased speed to provide a restoration, often same day;
o The access to preferred, historically lab-related materials such as lithium disilicate and zirconia;
o The ability to restore implants in a complete digitally-guided process;
o The improved accuracy available with digital magnification for margins and visualizing prep design;
o The ability to store and transfer clinically rendered procedures across networks, office to office, office to insurance plans and office to lab.
• Digital radiographs allow the magnification and storage of patient radiographic records. Radiographs are created that can help educate the patient regarding their needs. These records can also be sent directly to insurance or benefit-related inquiries for payment. [Digital radiographs can do] all of this while reducing patient radiation exposure 90 percent!
• Digital charting allows more accurate and legible record keeping for patients. These too can be transferred and stored by the office for the insurance companies, regulatory agencies or even for the patients themselves. This also creates more physical space in the actual office that can be used for other purposes.

Q: What is the top challenge dentists face today and what challenges are coming down the pipeline?

BG: While competition, insurance trends and regulation play a part in some of today's challenges, patient connection continues to be the top challenge for dentists today. [To be successful], dentists should be able to look a patient in the eye and honestly and confidently tell them that "you are going to be okay. We understand you and you are in good hands. We are going to do everything in our power to make this visit as comfortable and affordable as possible, and we will exceed your expectations." New dentists must commit to lifelong learning and become students of not only clinical disciplines but also of human interaction.

CR: In my view, the top challenge is insurance companies trying to dictate how dentists provide care by tugging on strings that affect the insurance company balance sheets. Some even try to dictate what dentists are allowed to do beyond what is actually covered. [Another challenge is] regulatory agencies and politicians trying to dictate how dentists practice, often with little actual knowledge of what is best for the industry, the dentist or the patient.

Q: How can dentists remain competitive moving forward?

CR: Some of these strategies are already happening.
• Dentists are learning skills beyond what they did in the past so they can provide more comprehensive care for their patients, placing implants, CAD/CAM dentistry, etc.
• Independent dentists are pairing up, or forming small groups, to create leveraged buying power and economies of scale, mini-DSOs if you will.
• Dentists are pushing back against some of the insurance and regulatory decisions that are negatively impacting the dental industry.

To be truly successful in this field, we need to know not only where we are currently, but especially important is where we are headed, and over what timeframe this journey will take. This means being continuously aware by tracking impactful decisions and changes beyond the four walls of our practice, and sometimes beyond the lines of the state in which we choose to practice.

BG: Dr. Rodgers makes a good point; I would add that we can always move to a rural market where there aren't very many other dentists. In this type of location we can practice like dentists did in the 1980s and 1990s, setting our own fees and just focusing on patients. However, that isn't an option for most dentists. As more and more of us want to live in the same areas, competition is something we must take seriously if we really want to win.
• We must have a mission and vision for our practice.
• We must know what we are good at and when we need to refer.
• We must always be getting better clinically and in our business.
• We need to have a business that is always growing at least three percent — otherwise we are going backwards.
• We must become leaders, not managers, of our team and dedicate ourselves to the growth of others.
• We must keep an eye on the landscape — it is always changing. We should invest in ourselves in the economic downturns.
• We need to avoid overspending. We must live within our means and start saving for retirement day one out of dental school.
• We must stop thinking about retirement and start thinking about financial security and reinvention. The goal isn't to stop practicing dentistry early — it is to be able to do what we love about dentistry on our own terms.

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