How to operate a practice right out of dental school – Dental Practice Solutions CEO explains various career paths, resources

Coming out of dental school with loans to pay and little management experience makes it challenging for dentists to open their own private practice. Dental service organizations are making it possible for dentists to have a steady income, own a private practice and gain management knowledge.

In a recent interview with Becker's Dental + DSO Review, Dental Practice Solutions CEO and Founder Debbie Seidel-Bittke, RDH, BS, explained the hardships dentists face out of school and the resources DSOs provide these dentists.

Question: Do you see trends in dentists and hygienists choosing practice management groups over private practice?

Debbie Seidel-Bittke: When I look at trends in dental practice management and private practice, I see three groups of dentists.

1. The young and hungry: I see a trend where dental students are coming out of school with $500,000 plus in student loans. Owing this much money alone is quite stressful, and if a dentist wants to buy a dental practice, many banks won't give them a loan until they have experience practicing as a dentist for two years. Starting up your own dental practice is another very stressful situation if you have recently graduated dental school with a lot of student loans and no business knowledge. Dentists then look for dental service organizations and support organizations because it guarantees them a paycheck to pay back their loans.

2. Non-entrepreneur: Most dentists do not go to dental school to be a business owner and they don’t have the experience of operating a business. Dentists choosing private practice must understand financial reports and the day-to-day operations of running a business. A typical dental school curriculum will have four courses for the students to learn treatment planning for their patients. When a dentist first begins their career as a dentist it can be difficult to organize and properly sequence treatment plans and communicate with patients, so they want to schedule and pay for necessary treatment. There is this big boulder that gets in the patient’s way for accepting treatment they need. This is boulder is called “insurance.”

It takes a lot of time working with patients and discussing a lot of treatment plans with patients, maybe to become proficient at case acceptance. When a dentist wants to enroll patients into high-end treatment upwards of $10,000 it is tough and takes a lot of skill: not only psychology of understanding different people but learning how to elegantly communicate so patients do want to accept your treatment, schedule and pay. On top of all that you need to understand how to keep these patients returning to your dental office when they have so many choices of dental offices to go to.

Most dentists who are seeking entrepreneurship do not have the knowledge about organizing a productive patient schedule especially if they want to enroll patients into these big treatment plans.

For a dentist who understands they do not have business acumen and does have a desire to be a business owner the dental service organization is a great choice for their career.

3. Dental hygienists: In my experience working with dentists, clients and their team, I have seen a high turnover rate with their employees. Many of the hygienists we speak to about employment opportunities are looking to work for a dental service organization because they want a good salary with a benefit package.

When the dental hygienist has student loans to pay and the private practice dentist can’t support higher wages, benefit packages, etc., it’s scary and they are looking for security in their place of employment. Most private practice employers do not include when hiring a dental hygienist, so a dental service organization is a good career choice.

Q. What separates a dental hygiene practice management group from a dental service organization?

DS: Dental Practice Solutions believes the dental service organization industry is the way of the future. We believe that we are different from many other practice management groups because we take a holistic and integrative approach with the practice owner and the entire team.

We customize systems and processes for a dental practice/dental service organization around the vision of the dental business owner. For example, we may begin working with a dental service organization defining their culture. We want to know 'why' they exist as a business. We want to know 'what' they are doing for their patients, so their patients choose to return to this dental office indefinitely. From this point forward, we can create all systems and processes around the vision and culture of this particular dental practice/dental service organization.

Q: What is your first step when affiliated with a dental office?

DS: One thing I feel that sets us apart, is we don't have a one sizes fits all [approach] when working with clients. What we do is assess the dental office's needs and begin here to create an appropriate plan of action. For example, we are currently working with a dentist in an affluent area; however, he chooses not to work with the people who consider themselves “affluent” in the community. It may seem like an odd choice for his business, but this is what he wants, and we are here to support his vision and the culture he wants for his dental practice. Dental Practice Solutions takes a thorough look at the practice to recognize the specific areas of low-hanging fruit. Think of this as someone standing 30,000 feet above your practice and looking down on it. Someone else looking from the outside can see more clearly exactly what is going on in the inside. Looking from afar we can see areas which will bring immediate cash-flow into that dental practice or dental service organization. It’s the low-hanging fruit that will multiply your profits in the practice. This is where we will begin. It brings immediate cash-flow when you work on these specific areas.

Q: How has the dental practice management industry evolved in the past 10 years?

DS: In the 1980s a dental student would have a maximum student loan amount of about $150,000. In today’s world of dentistry, we have new graduates, dentists, who are hungry to pay off their multiple six-figure, student loans.

The problem for these dentists owning a dental practice in today’s world of dentistry is that they do not have a lot of experience operating a dental office. Practice management and business acumen are not a big part of any dental school curriculum. It’s tough in today’s world to survive as a young dentist with a new dental practice: start-up or a new purchase.

Second, as you read the statistics, many years ago we had 40 dentists for every 100,000 people in the U.S. and now there are 70 per 100,000 people. As you can see the competition is stiff to own a dental practice in the 21st century.

Dentists in today’s world know how tough it is to be profitable as a dental practice owner. In the 1970s and earlier, you could set up a dental practice, put up a sign and patients knocked at your door. Profitability as a dental practice owner has never been tougher to sustain than it is today.

Dentists are looking to be a part of dental support organizations, so they have a guaranteed salary, a consistent paycheck, benefits with a 401k and possibly an opportunity to buy into the dental service organization.

The other thing I see is [the emergence of the] multi-specialty practice. For example: seven different dentists of multispecialty are all under one roof. When together under one roof, a multi-specialty practice, will order the supplies and build out their new office at affordable costs, just as if they are a dental service organization. This type of dental practice will receive lower pricing on supplies, equipment, etc., because they have more quantity when they make a purchase. More quantity the better the prices on supplies and equipment. More dental sales companies will fight to have their business. I see this type of business model as a shift in how dentistry has evolved over the last 10 years.

Additionally, we have this large population of baby boomers retiring; selling their dental practices. Today and for probably the next ten years, there will be a lot of opportunities for dentists to buy and own their own dental practice. With all these baby boomer dentists selling their practice, it leaves the door open for dental service organizations to buy these offices and add to their business portfolio.

As difficult as this may sound to own a dental practice, abundance is in our future. The population in this world is growing and there will be more opportunities to buy a dental practice. With the economic climate of 2018, people are spending money and we as dental professionals must find a way to be the very best we can be, so our dental business will not survive but thrive.

It is important for dentists to have an open-mind and an attitude of constant and never-ending learning. This is a must to sustain the business of dentistry. More dental experts and dental courses are available than 10 years ago which means dentists can thrive.

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