Category Archives: Dentistry

The Magic of Apple Employee Training

We often hear about how brilliant Steve Jobs was, and what a good job Apple does of marketing its products.  What I want to talk about is their employee training in retail stores, and how it can be applied to any small service business.  (And if you don’t think you’re in retail health care, take some time and read Chapter 3 of my book—it should convince you.)

As you may have noticed, Apple stores are the busiest stores in the mall.  For the statistic-minded, retail stores in malls average sales of $341 per square foot per year.  The top 20 retailers average $787.  Apple stores average $6,200!!  More than twice the next highest retailer, Tiffany & Co., which does $3,000 per square foot.*  And this is just what is sold in the Apple stores, not online.

So, now that I have your attention, here’s an acronym Apple uses in its employee training for the retail stores:

Approach customers with a warm, personalized greeting;

Probe politely to understand all the customer’s needs;

Present a solution for the customer to take home that day;

Listen for and resolve any issues or concerns;

End with a fond farewell and an invitation to return.

Do you see how these might apply to your practice?  I’m thinking they all do.  A warm, friendly greeting by everyone in the office who encounters the patient?  Check.  Probing politely to find out what their dental needs and desires are? Roger that.  Presenting a treatment solution that can be started and ideally completed that day?  Sounds ideal.  Listen for issues they may have, concerns about cost, treatment complexity, time involved, fears or misgivings they may have?  Pathway to success. And finally, ending with fond farewell AND an invitation to return or, better yet, an appointment already scheduled, and expressing how you’re looking forward to seeing them at that time.

In reality, it isn’t magic.  It’s just what we all want, and Apple is just smart enough to do it in a genuine and consistent way.

*Source: RetailSails Company Data 2012

Bring Online Reviews to Your Daily Huddle

I just had a great conversation with Anastasia Turchetta, who is a dental speaker and hygienist, (she’ll be speaking at TBSE this year) and I was showing her our new product, Reputation Monitor.  She immediately had a suggestion which I thought was great, which was to use it in the morning huddle and read the previous day’s reviews to the team.  This serves many purposes.  If there was as negative review, then the team can discuss what went wrong and how to correct it going forward. (It also should be someone’s job to respond to the negative review, but that’s not for the huddle.)  If you had positive reviews, this lets the team know that they are doing a great job and that people are noticing, and gets everyone excited about the day.

It also has the benefit of reminding team members that they are being reviewed, like it or not.  And so that should make them step up their game, and be conscientious, considerate and courteous throughout the day.  And it keeps the idea in mind that they should request that the patients do reviews for the practice, and that they can even do it in the office on their smartphone.  Or the patient could be encouraged to check in on Facebook and post a comment.

Reputation Monitor is a great tool for showing every comment that is being posted about the practice, whether it’s in social media like Facebook or an online review on Yelp or Google.  And this is a terrific way to take advantage of that information.  Thanks, Anastasia!

Dental Blogs: Why and How

In a webinar that I did yesterday, I mentioned the increasing importance of blogging for a dental practice.  For those of you who don’t know much about blogs (you’re reading one now, so you have some idea!) the word is short for “weblogs”, which were created as a form of online journal, essentially with articles that are written, usually by one person, and archived and searchable for anyone who wants to read them.

You can also subscribe to blogs, which means you could get them sent to your email whenever they are published.  If you wanted to do this with my blog, you would click on the button to the upper right that says, appropriately enough, “FOLLOW BLOG VIA EMAIL”, and then fill in your email address.  Now, onto your blogging career.

First, the “Why”.  Most dentists would say to me, “Who the heck is going to read a dentist’s blog?”  The answer is, no one. Your patients most likely won’t ever read it. On rare occasions a potential new patient might read it. But this is who will always read it:  Google, Yahoo and Bing.  In other words, the search engines.   So what you are doing is providing relevant content for Google, etc., to associate with your website.  Google is out there on the internet all day long looking at everything, and inter-relating it so that when someone does a Google search they can present what they deem is the best possible result, based on hundreds of criteria that they use (but won’t tell us about.)  So your blog is one element in what I call “The Google Matrix”.

This consists of your website, your Facebook Page, your Twitter posts, your LinkedIn profile, your videos, and, perhaps most important, reviews that are written about your practice on Google, Yelp, Angie’s List or other review sites.  See my previous blog about these.

Assuming you have good content across this matrix, your website will then have strong SEO, or search engine optimization, which should make it appear on the first or second page of Google search results (or Yahoo or Bing).

This is why you want steady content going onto your blog on a regular basis.

Now, the How.

Creating a blog is remarkably easy.  Go to either Wordpress.org, or Blogger.com and download the software.  It is free to run a blog through these sites.  And they will also host the blog, so you don’t even have to deal with that.  Follow these simple steps:

1. Pick a design. (They call it a theme.) Doesn’t really matter what you pick, so choose what you like.

2. Come up with a name for your blog.  Something with “dental” or “dentistry” in it.

3. Fill in all the relevant information, especially your website. This is how the search engines are going to associate your blog with your website. Create settings that will allow you to automatically publish to Twitter and LinkedIn. This gives you fresh content on those sites.

4. Write your first blog and publish it.  Be sure to preview it to see how it looks.  And spell check it, I beg you.

5. Categorize and tag the blogs.  ALWAYS do this.  Google is looking for this to know what the blog is about.  It should always have “dentistry” and “dental” as categories and tags. The rest you can create and add based on what’s in the blog.

Your blogs should be short and sweet. Two paragraphs, two sentences apiece is plenty.  This is where you write about dentistry (as opposed to your Facebook page, which is where you personalize your practice.)  Write about procedures, technology, cases (no patient names), or whatever else you want.  Add a picture occasionally.  And a video.  Remember, you’re not trying to create a beautiful, comprehensive blog like the ones people read all the time, so don’t get perfectionist about it.  You are just feeding the matrix.

If you want to increase the relevance of your blog, figure out how to use hyperlinks (the words that appear in blue and allow you to click to go to another website.)  Also, list your favorite websites and blogs on your page.  But don’t expect blogging to magically jack up your SEO overnight.  It takes months.  And you need to be feeding the matrix at the other points as well to get the optimum result.

How Often?

I recommend blogging once a week.  Ideally this should be someone else’s job in the office, not the dentist’s.  And you can write a dozen blogs all in one sitting, and then schedule them to publish on specific dates. On WordPress, for example, as you draft the blog, you’ll see on the right where it says, “Publish immediately” and “Edit” next to it. When you click on edit you can choose the exact date and time you want each blog to publish.

Welcome to the blogosphere!

Online Reviews: Witness the Rise of Yelp

The world of online reviews continues to heat up.  Yelp has now partnered with Bing, Microsoft’s search engine, to include their reviews when a business comes up in a search.

If you don’t know what Yelp is, you need to.  It is a site where people can review any business, including your dental practice, and you have no control over the content.  They went public this year and are currently worth $1.5 billion, so don’t expect them to go away any time soon.

You may be also thinking, “Bing?  Does anyone use Bing?”  Or even, “I’ve never heard of Bing.”  So you should know that there are three primary search engines at this point: Google, Bing and Yahoo. Google of course dominates with more than 65% of all searches, but Bing still gets 15%,  which is not nothing.  And Yelp is taking advantage of that.

Google is also the biggest player when it comes to reviews, but Yelp is a strong second. As I mentioned in an earlier blog, Google bought Zagat and is combining Zagat reviews with their own reviews.  Zagat is more than just travel and dining, by the way. It is now soliciting reviews on doctors and dentists, so those will start to show up.  In response to this, Yelp teamed up with Bing.  They also teamed up with Apple.  In October, Apple will be introducing its own mapping program and no longer using Google Maps on iPhones.  Yelp made a deal with Apple to include their reviews in local business search results.  This is big, as Apple controls almost a third of the smartphone business.

You should also be aware that if someone reviews you on Yelp, they can have it automatically posted to their Facebook wall for all their friends to see All of this will strengthen Yelp’s number 2 position.

Why should you care?  First, because 60-70% of dentists already have at least one review on Yelp. And even if you don’t have a review, you could very easily get one tomorrow.  Nothing Yelp does notifies you of this. (By the way, your practice is already listed there.) But you should really care because more people are reading online reviews all the time, and are coming to expect them. Many people don’t act until they can read a review, and if they can’t find a review about a business, they will move on to one that does have them.

How many people, you ask? According to a Nielsen report, for those people who are active users of social media, more than 65% will use social media, including Yelp, to seek reviews from their peers on products and services.  And more than 50% of them also actively post positive or negative reviews.  Those are huge percentages, considering the fact that more than 70% of baby boomers now have at least one social media account!  (Gen X and Y are of course even higher.)

So what should your plan be?

1.  You need to claim your business on Yelp in order to be able to comment or reply to reviews, and also because you can put a lot more information about your practice, like hours and services, photos and video. Do that here: biz.yelp.com.  Like, today.

2. Solicit Yelp reviews from your patients.  This blog tells you a great trick for getting them.

3. Monitor your reputation online.  Make this someone’s job in the office. And always comment on reviews.

I’ll be talking more about solutions for managing your reputation online in weeks to come.

Lastly, if you’re interested in an excellent in-depth look at online consumer behavior, check out this article by Brian Solis.

Facebook Now Lets You Schedule Posts

Facebook has now added a feature where you can schedule your posts, rather than have them post immediately.  This is a lot more convenient when your team member is doing her social media updates in the off-hours and you’d rather the post appear Tuesday or Friday (the best days).  The first time you do it, Facebook will ask you to put in the date when your page started—this is because you can actually backdate a post, though I’m not sure why you would want to.  It doesn’t have to be the exact date, just some time in the past.

When you begin to create a new status, there’s a little clock in the left hand corner, (where the arrow is pointing below), and when you click on it you can set up the date and time you want it to post. So far there is no way to find the post and edit it until it actually appears, so once it’s done, it’s going to post as is.

When you’re done click “Schedule.”  That’s it. A lovely new feature for those of us who do late night posting and don’t want them to disappear on people’s walls as the next day’s posts appear.

The Best Places for Patient Reviews

After a speaking engagement last week in Atlanta, a dentist asked me how I would rank the various places where patients can review his practice.  I thought my answer would be of general interest.

#1.  Google.  No surprise there.  80% of business search is done on or through Google or Google Maps.  And underneath the search results are the number of Google reviews that can be read. (These reviews have to be written by someone with a gmail address, by they way.)

I will again use my friend Dr. Craig Spodak’s results to show you.  See how he has 89 reviews?  Also note that someone can click next to that count and write their own review.  The more reviews you have, the better you will come up on Google in a natural (unpaid) search.

#2. Your Own Website. This is the next place people are likely to look for reviews (and Google will also be searching your site for them, which will boost your website’s SEO).  This means you have to have a website that is dynamic.  That word means something specific in the web world–that is, that you can add and change information yourself, rather than having to use your webmaster.  You need to be able to add photos, video, your blog (if you’re doing one) and especially patient reviews and testimonials.

This requires you to solicit those reviews from your patients, and then post them yourself. Or, much more simply, you could use a digital communication application like Patient Activator, that has as one of its features automatic patient surveys.  This application will email patients three days after their visit and ask them to respond to a short survey, and encourage them to write a review of the practice.  It is then posted to a microsite of your practice (more SEO for you), and you can also use the reviews you like on your own website, and also pop them onto your Facebook fan page.

#3. Yelp. The usage of this business review site varies widely city by city, but more and more people are posting reviews about everything, including dentists.  About 70% of US dentists have at least one review, I’ve been told.  You want to invite your patients to do this, ideally while in the office.  The best way is to get a few tablet computers for them to use, as I suggested in a previous blog.  One key point: Yelp gives preference to reviews that are written by frequent reviewers on their site.  This means that if a patient doesn’t normally review on Yelp, the review might not appear, or will not float to the top.  Yelp does not list your reviews chronologically, but by a combination of rating and some more mysterious elements.

#4. Facebook.  This is not technically a review site, but patients can now write “recommendations” on your Facebook fan page, and these are shown separately.  One glitch–if you have not properly categorized your dental practice there will not be a place for recommendations.  I also don’t feel like people use Facebook to see recommendations that much, but rather go to your fan page to see what people post about you, or what you and your team post about yourself.  You should use iPads to get patients do post here as well while they are in the office.

#5. Everywhere Else.  Angie’s List, LinkedIn, CitySearch, Dr. Oogle all have reviews.  Angie’s list is probably the next most important place, but reviews can only be read by subscribers, and only subscribers to the site can post reviews.  It narrows the audience considerably, and also the number of your patients who could review you there.  The site does a wide range of businesses, while Dr. Oogle is strictly health care, but the latter site gets significantly less traffic than all the others.

Reviews will matter more and more, so now is the time to focus on them, but make sure you are getting them in the most advantageous places.  And remember, you don’t need hundreds of reviews.  No one would read that many. But you need a steady stream of fresh ones. Even two a week will add up quickly, and help with your SEO, but I would aim for one a day, and you’ll be well on your way!

Google+Local: What It Means to Dentists

On May 30th, Google changed Google Places to Google+Local.  What does that mean to you as a dentist?  Hopefully, you understand what Google Places is/was, but let’s assume you don’t.  Google Places was a section of the search world where your business showed up in a Google search–either on a Google map, in a browser, or on mobile phone local search.  In that result will be information that Google gathered about your business: what type of business it is, the name, address and phone number. (You’re already there, if you know it or not.) But you as the business owner can add a great deal more information about your business: your hours, your services, promotions, photos, videos, your website address.  All very good stuff for people to find.   And you should have done it by now, but if you haven’t, it’s more important than ever with this new change.

You claim your business and add the information about your practice in the same place as the new Google+Local, which is www.google.com/places.  You find your business there starting by clicking at the button indicated below in red and following the instructions:

You MUST do this for your practice, and fill it with as much information as possible.  Here’s why:

1. It’s free.

2. It now boosts your SEO for your business and your website (which Google Places didn’t).

3. Reviews matter more than ever, and this is where they show up.

4. Search on mobile phones is exploding, meaning you need local listing with a lot of information.

5. Did I mention it’s free?

If you’ve already claimed your Google Places site, your practice will show now up in Google+Local, but looking very different. This is what my friend Craig Spodak’s site looks like.  Notice his fine use of photos.

So why the change?  Because Google wants to vastly expand two areas: local business advertising and social media.  Google+ is their social media equivalent to Facebook, but not a lot of people use it relative to Facebook’s daily activity.  But now, with Google+Local, Google is combining the search result information from Google Places and Google+, and indexing it for SEO purposes.  As I mentioned, this was not done previously, so doing Google Places did nothing for your own business SEO.  But it also means that now the more activity–social activity–that you have, the more your practice will come up in organic search as well.

So just as I recommend weekly activity on Facebook for your practice, you now need to have weekly activity and daily input and reviews from patients on Google+.  That’s the bad news.

The good news is the SEO, and the better look, and the fact that everything is happening in one place.  And no doubt you will be able to do promotions on this as well, for $, of course.  This will change and evolve over time, but Google wants into this space badly, so they are going to keep working it.

What’s different? These three areas:

RATINGS and REVIEWS

Before, there were star ratings from one to five stars.  Those are gone.  Now there is a score, and the score is a bit confusing.  The reason for the score is that last year Google bought Zagat, the travel review business, and it has now incorporated those Zagat reviews and ratings into Google+Local. This has nothing to do with dentistry, as we are not reviewed in Zagat, but the scoring shows up the same.  It is a scale from 1 to 30.  However, when someone reviews your practice on Google, they will rate it on a scale of 0 to 3, and then Google will multiply that by 10, and then average all the scores, just to make it uniform with all the Zagat scoring.  Weird, and it probably will change, but for now that’s how it works.

Your reviews will still show up, but it will be easier for people to write them, though they can still only write a review if they have a gmail address. But you need patient reviews!  This is ever-growing in importance, and Google only presents reviews done on your Google Local site, not any other reviews from anywhere else.

SOCIAL MEDIA INTEGRATION

In a search now, Google will now not only look at the rating and reviews for your business, they will look at both the frequency and content of the various postings and social activity on your Local Page.  Of course they are manipulating you to use Google+, but they are the big dogs, so we must play along.

WHERE IT SHOWS UP

Now this result will appear in several places: if someone searches on Google Maps, or if they simply do a Google search, and also now if they search within Google+, where there is now a “local” tab on the left, as you can see in my Google+ page, where the blue arrow is pointing.

If they search for anything in the top search box, they’ll get a result like this one for Dr. Craig Spodak:

The same results will occur on mobile phones for all three types of searches. (In June, Apple will launch its own mapping app  so it won’t show up on iPhones unless someone uses a Google Map app or a Google+ app on their iPhone.) In a previous blog on smartphones I talked about how prolific and accelerated the use of search will be on mobile phones.  This plays right into that.  Once they click on it, then it will go to your Google Local page.

So what should you do?

First, you need to get your Google Places claimed and fully filled with information.

Second, elicit Google reviews from your patients on a regular basis.

Third, have regular posting activity going on within your Local Page. Don’t spend a lot of time on this, but don’t spend none.

Remember, this is not going to suddenly flood your practice with new patients, but it is going to make you easier to find, and easier to find out about.  And that’s what millions of people will use it for.  So don’t wait another day.  You can add more photos and video as time goes on, but get started now.

By the way, if you are a Patient Activator customer, we’ll walk you through every step of this just to make sure it’s exactly right.

Further Thoughts on James Dwyer and Dental Insurance

Let’s start with what we know when it comes to dental insurance and patients.

First, the dental patient doesn’t really care if the dentist gets paid fairly or makes a different living. That’s the dentist’s problem, not theirs.

Second, dental insurance companies are out to make a profit.  And thus they benefit from under-utilization. Paying more for a treatment code, or for more patients being treated, doesn’t work. Neither does encouraging people to take care of their teeth.  All this either lowers profits or requires increased premiums. So what would seem to be the point of dental coverage––to get people to see a dentist and get treated––contradicts the business model it is managed through. But even when there is less utilization, these companies generally don’t lower premiums, but rather increase them every year.  That is, unless they do what Washington Dental Service did, which was cut payments to dentists so they could lower their premiums to businesses. These institutions are tax-exempt, but make no mistake, they are motivated by profit.  So dentists get to absorb the shock.

Third, for as long as I’ve worked in dentistry (since 1986), up until five years ago, the general trend, indeed the goal, was for dentists to gradually move their practices to full-fee-for-service, and not be a provider for any dental plan.  This came to a screeching halt in 2007, and has reversed itself continuously.  More and more practices are adding plans, for the simple reason that people are not spending money on their dental care like they used to.  The days when every month one or two patients would borrow against their home to do a full set of veneers or extensive implants are over.  Practices have had to adapt, accepting more plans, and in so doing have handed more power to the dental insurance companies.  And with this you get the arrogance exemplified in CEO James Dwyer’s remarks (see my previous blog on those, as well as Gary Takac’s call for Dwyer’s resignation.)

So the simple question is, do we want to go the way of general medicine, which is to say, let insurance companies call the tune?  For physicians, it is the insurance companies who determine the treatment, the fees and even the allowed medications.  If the doctor or the patient disagrees with that determination, then the patient has to pay out of his own pocket. And because 95% of physicians’ income comes from insurance, the average income for general physicians is now lower than that of general dentists. What’s more,  it is virtually impossible for a general physician to double or triple his income from the average level, while it is quite possible for most dentists to do so.  And everyone expects physicians’ income to continue to decline.  How’s that going to play out?

I think this problem needs attention right now, before control is fully surrendered to insurance companies, or before the government steps in to make sure that everyone in America has some sort of dental care, regardless of whether it provides a living income for a dentist who has a facility, leases, loans and employees to reckon with on a monthly basis.

And, as other people in this blog have mentioned, it’s not financially bearable for a dentist to drop the insurance provider when that company tries to cut their payments.  But in my mind that’s what your state dental society is for.  When Delta or any other company decides it’s time to do an across-the-board fee cut, then there ought to be an immediate call by the society for their entire constituency to drop that carrier the next month.  They don’t need everyone to comply; if 40% do, then the insurance company gets hit right where they care most–the profit end of their revenue.  It should be a swift, resounding and unequivocal response.  And my guess is after one or two states do it, and the results are proven, then an even greater number of dentists will join in the protest.  And the insurance companies will fall back into line.

Along with this response by the societies, there should also be a unified message sent out to each dentist’s patients as to why this is happening.  They should let all their patients know that the insurance company, in an effort to increase their profits, is paying less for the same services, and thus limiting care to the patients.  (In Washington, it was the insurance company who seized the opportunity, and communicated with the patients when a dentist stopped being a provider because of the fee cut, and recommended the patient move to a different dentist who accepted the plan, and even provided a list.  Outrageous behavior, unless of course you’re in business to make money, not provide dental care.)

This response by the society is only step one.  The next step is to take a hard look at how dental insurance is provided.  We live in a world where data can move instantaneously and simply between entities. Why do we even need a middle man to provide discounts on some dental services for a business’s employees?  In three months I could get five 20-year-olds to write a program that lets any business choose from a menu of services, calculate the premium, allow the employees to choose a dentist and get care, and subsequently the dental practice can file the claim and have the money in their account the next day.

Certainly there are regulations to follow, but does an enormous profit for an intermediary organization benefit anyone but that organization?  I don’t think so.  I say let them all work somewhere else where they don’t have a negative impact on the overall health of Americans.

One last point.  Dentistry in many ways is different from general medicine. There are millions of people in this country who will never be able to get high-end dentistry.  For example, we all know that implants are the ideal solution to missing teeth.  But this quite simply will never be insured, because eventually everyone will need them.  A quadruple bypass surgery is incredibly expensive, but not everyone is going to need one, so the cost gets spread over a thousand other people.  But as the population continues to live longer, most people are likely to lose some or most of their teeth. Either they can afford implants or they can wear dentures.  But it is not reasonable to imagine an insurance plan that provides virtually everyone with implants.  We need a wiser, more balanced solution that does not emulate health insurance.

Sometimes you can’t just modify business models.  They become antiquated, or fail to serve their original purpose, diverging from their mission to one that is more self-serving, (like Congress!) and we need to abandon them and start over.  Why not create a brilliant, modern solution that helps the greatest number of people, and is the envy of the entire world?

I’m open to your thoughts, and I will do my damnedest to get them in front of the right people.

 

Post Script: I have been told that the FTC views any such action by dental societies to be illegal boycotting, and precedent has been set.  Sounds like the wrong lobbyists got to the right ears (and pockets) to me, but if that really is the case, then dental societies are virtually powerless in this situation, until that precedent is challenged.  The Washington State Dental Association spent many hours and legal dollars trying to deal with this within the parameters of the FTC ruling, so other avenues may be more appropriate.  I’m not sure that the FTC could have much say about dentists using Twitter to say that they are personally dropping the insurance plan.  I’m not fond of laws or precedents that protect corporations to the detriment of individual citizens, and I can’t accept that boycotting of a company by anyone or any group can be considered illegal.  But I’m no lawyer, so the pathway through this is not clear to me.

Who Profits from Dental Non-Profits? Not you!

If you didn’t know the level of contempt that the dental insurance companies have for dentists, look no further than the actions and comments of Washington Dental Service and their CEO, James Dwyer.

Dwyer, in an interview with King5 TV station in Washington State this month, casually suggested that dentists “could start working five days a week” to make up for the 15% across-the-the board fee reimbursement cut WDS instituted in 2011.  Easy for him to say, as he makes $1.2 million a year.  He subsequently apologized, (which of course means nothing), saying also that his words were taken out of context.  So the TV station ran more of the video, where Dwyer says this not once but twice and also says, quite smugly, that dentists only work three and a half days a week.  “They certainly don’t work four days a week,” he adds, dripping with contempt.  I think this man believes that in saying this he will garner public support, that people don’t like dentists, and think that dentists make too much money already, and now he’s letting people know that they have short work weeks.  Excellent strategy, from an adversary.

And that’s my point. They are not in the dentists’ corner.  Washington Dental Services, part of Delta Dental, operates as a non-profit organization.   Of course, they are a non-profit in name only, and for one reason: to avoid paying taxes. WDS had a net income of $13.7 million in 2010, and paid no taxes on that.  On top of that, their executive compensation that year was $5.8 million (including Mr. Dwyer’s $1.2 million.)  Remarkably, the executive compensation of WDS has increased an average of 45% over the past five years, right through the recession.  How many dental practices grew 50% in the past five years? Only a few? Well, maybe they should work harder.  How many of your patients experienced that kind of salary growth? Maybe they should work harder too.

Why did they, and by “they” I mean Delta Dental, do an across-the-board cut?  They said to stay competitive.  Really?  They have 90% of the dentists in the market already.  They said they need to be able to lower their premiums to employers.  Why exactly should premiums go down?  Has the price of anything in dentistry gone down? I missed that.  Dwyer’s advice was “work harder”.  Work harder for less money is what he meant.  Making lots of money is for people like him, not for dentists.

Here’s the other reason why I think Delta did it.  They wanted to see  how the dentists and the societies would react, so that they could do it in other states.  To make more profit for their non-profit, and give bigger executive pay increases.  I mean, what better way to fulfill their stated mission, which is to promote oral health?

Yes, Mr. Dwyer actually stated, with no sense of irony, that the mission of WDS was to promote oral health.   How exactly are they doing that? The statement is ludicrous. Their clear purpose is to make money, crush the competition, pay no taxes, and pay themselves incredibly well.  You can’t do that and promote dental health, because that would result in more claims.  Which would hurt their profit.  I mean, their non-profit.

As I said, they are your adversaries.  Seldom are they so open about it, but Mr. Dwyer’s contempt is symbolic of an industry that is at crossed purposes to the health of Americans.  40 years ago in this country it was basically considered immoral and unethical to make a profit providing health insurance.  Now the opposite is true.  Now the  job is not to provide coverage and promote health, it is to be competitive, limit care, and pay extremely high salaries so you can attract better executives.  Recently, Blue Cross/Blue Shield of Massachusetts gave an $11 million severance package when they fired their CEO.  That would turn most businesses into a de facto non-profit, but BC/BS absorbed it nicely.  Because they don’t pay taxes.  It was chump change.

So what do I think the dental society should have done?  I think they should have recommended that their entire constituency drop WDS the next day–the old-fashioned American response to robber barons.  They didn’t do that, of course.  They sent a letter out recommending that dentists find cheaper dental suppliers. (Huh? How’s that going to offset 15% less in fees?)  And when an individual dentist did drop WDS, the company sent a letter out to all the dentist’s patients,  giving them a list of dentists who accepted their plan, and suggesting that their dentist simply wanted to make more money.

And there is that ridiculous statement: “They certainly don’t work four days a week.”  Really?  I personally know about 1,000 dentists, and virtually all of them work at least 4 days a week doing dentistry, and another day or more doing the business side of their practice or getting CE.  But Dwyer knows that.  He’s not an idiot. But he also knows how easy it is to turn public opinion against doctors and their incomes, which was exactly his intention.  So that WDS could maintain their fee cut, lower premiums and everyone still gets a raise next year.  Contemptible?  Reprehensible?  To be sure.  Does Dwyer care?  Not a bit.

So what is a dentist to do?  In the end, this is big business against the small businessperson.  So you work smarter, learn more procedures and techniques, and realize that some things are in your control, and some aren’t, and all your energy needs to go to those things that you can control, you can have an effect on.  And you’ll still have a great business.  And still change people’s lives for the better every day. The best revenge I think is doing good, and doing well.  I’d rather be you than Jim Dwyer any day.

Broadening the Dental Category

When VCR’s first came out, many people predicted it would be the demise of the cinema business.  It didn’t happen.  What did happen is that by 1988, video rentals and sales reached $4 billion annually, passing movie sales, which continued to grow.   (Oddly, when DVD’s came out, people predicted the same thing, yet in 2011, movie theater revenue was $10 billion.)  So what really occurred here is that the category broadened.  People assumed it was a zero sum game–people would either watch videos or go to the movies.  Instead, they did both.

Similar things have happened in dentistry. Cosmetics barely existed when I came into the dental field in 1986.  Now it is conservatively a $10 billion segment of dentistry.  When Invisalign came out, many thought it would erode the bracket side of orthodontics.  Instead, it broadened the category.  Literally millions of people, mostly adults, who would never have considered braces were excited about the idea of Invisalign, and as a result many more patients were treated, and the bracket business didn’t recede at all.  Most significantly, it broadened the category of orthodontics for the general dentist.

3D Cone beam imaging is now doing the same thing to implants.  Cases that were previously a near impossibility, or at the very least with a high risk of failure, are now done with pinpoint accuracy, much less surgery, faster healing times, and longer-lasting results.  And once again, the category is being broadened for the general dentist.

And yet, what I still see is a tendency by dentists to limit themselves to what they already know and do well.  It’s a natural tendency.  But thriving dentists are broadening their approach to the dental category.  They are adapting new technology, getting more training in new procedures, and offering a wider range of treatment to their patients.  As a result, their patients are accepting more comprehensive care, getting implants, trying Invisalign or Six Month Smiles, whitening their teeth every two years, eventually getting veneers (I finally did myself in January, and I love them!)   And most of all, having a lot of fun in their practice.

But most practices do not tell their patients all the options available to them.  This is a marketing misjudgment.  We often assume that when we tell people something once, they were actually listening.  People don’t listen until they care, and find it relevant to themselves.  The most basic tenet of marketing is to tell your customer (your patient) over and over what you do and why it’s good for them.  This means newsletters, in-office videos, email marketing to your patients, and most of all, your staff talking to patients about what is possible.  Waiting for people to ask assumes they know what to ask for.  They are looking to you for professional guidance.  Their goal will remain to do as little dental work as possible until you explain the benefits of new dentistry to them.

One my main goals is to broaden people’s appreciation of dentistry from simple teeth maintenance to a service that vastly enhances the quality of their life.  So I encourage you to take a look at your practice.  How can you broaden your approach to the dentistry you offer your patients?  (And don’ t they deserve it, after all?)  Think about new courses, new technologies, new services.  And then, most importantly, tell your patients about it.  The rewards await you!

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