My Practice My Business: The Clinical Business of Dentistry

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Titles and profits channel, or front-line advocacy channel? It’s time for the rose-colored glasses to come off, and either hold your state and national associations accountable to reality, or stop wasting your money on annual dues. May I suggest all of us stop taking a back seat, and put some pressure, a lot of pressure, on the ADA and your state dental association executives. Tell them to stop feeding us with platitudes of topics that have little action on what we do as dentists each day, and focus on legislation that protects us from the evil designs of third-party payers, like we did here in Utah. 
Tracy and I were doing some research on the ADA, looking for some statistical data, and just happened to find a very interesting article by Dr. Mike Barr, the content of which I have echoed many times, and deserves new coverage and commentary by Tracy and I. 

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A few weeks ago, I had a fellow colleague ask us to run an analysis on his practice to see how much revenue he was losing each year. We do this for offices who are interested in our Team Training here at MPMB. After showing him the hundreds of thousands of dollars our training would bring to his practice, he asked the worst question possible.

“Rob, this number is amazing. I’ve talked with other docs who have gone through your training courses, and they are extremely happy. But the question I have is this: how much of that new revenue your MPMB training brings to my practice WILL THE PATIENT HAVE TO PAY?”

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In dentistry, dental team meetings can become unproductive, and ideas may not be conveyed effectively. This podcast aims to explore the reasons why individuals may choose not to speak up in meetings, the implications of this behavior, and possible solutions to overcome it.

In today’s world, meetings have become an essential aspect of organizational communication. Meetings are a platform for employees to express their opinions, ideas, and concerns about a project or task at hand. However, there are times when everyone in the meeting is thinking the same thing, but no one wants to speak out. 

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Dentistry is a field that requires not only clinical expertise but also strong managerial skills to run a successful dental practice. While many dentists excel in providing quality oral healthcare, there are so many instances, that Tracy and I have witnessed first-hand, where the Doc does not actively take charge of managing their dental office. I am going to explore some reasons why dentists may not fully embrace the role of leadership and management within their practice. Listen up my friends, its time gain insights in to the challenges we face as dentists and identify potential solutions to empower your practice management endeavors.

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As I was gathering my thoughts on this topic, my mind was racing in many directions as to where I should start with this one. Let me first begin by saying, contrary to what we read from our dental association leadership, it is definitely not your fault doc, by you signing up with PPO plans, that third-party payers have such low reimbursement rates. It actually has everything to do with the dental insurance market, and the perceived ideologies that dental consultants have propagated for years when it comes to how we can bill the PPO patient.

Dental insurance companies use sophisticated software to calculate the needed premiums required to pay us the reimbursement rates they set, while acquiring a 24%-32% corporate profit margin. This software, which Tracy and I have seen, and navigated intimately first hand, has unbelievable information on all of us docs, average billings we send in, and average payouts their clients have in our dental offices. Once again, nowhere in their calculations on contractual reimbursement rates does sending in our fee-for-service fees affect this process in determining what their reimbursement fees are per our contracts. Honestly people, stop lies from so many out there who teach such stupid things.

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Dental leaders play an essential role in the dental industry, as they provide guidance and direction to dentists and other dental professionals. However, in recent years, some dental leaders have been answering questions that no dentist is asking, causing confusion and frustration among dental professionals. This report aims to explore why dental leaders are answering questions that no dentist is asking and the impact of this trend on the dental industry.

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Let me be very clear from the start. Dental Insurance Companies, commonly called “third-party” payers, DO NOT SET THEIR REIMBURSEMENT FEES BASED UPON YOUR FEE-FOR-SERVICE FEES. For the ADA to imply this false statement is factual is unbelievable to me. They should know better. It’s articles like this that drive membership downward, because those of us in PPO driven states know this article to be anything but true. My goodness ADA, they set those reimbursement fees based upon their profit and loss of their company. How much comes in via premiums, and how much is paid out, guarding their set profit margins. 
Insurance companies are lowering negotiated fees to LESS than what was agreed to as a financial business strategy that is rarely caught by front office teams.  How would you catch this if you billed your FFS fee?  We caught TWO insurance companies doing this last year and when we called them out on it, they stated there was a “Bug” in the system, and they would fix it and send us another check to account for the percentage they should have paid.  How many offices are unnecessarily writing off or reducing services because they are billing their fee-for-service fees, and not seeing this little insurance tactic? You would almost never catch this little bait-and-switch tactic dental insurance companies do if you were sending in your full fees. Chew on that one little accounting problem if you don’t send in your contracted fees. 

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The American Dental Association (ADA) owns and licenses the use of Current Dental Terminology (CDT) codes, which are a standardized set of codes used to describe dental procedures and services provided to patients. The CDT codes are used by dental insurance companies to process claims and reimburse dentists for services provided to patients. If the ADA leases those codes to third-party payers, and the ADA receives a butt load of money from the insurance companies for the use of their codes, is that not a conflict of interest, speaking as a dentist who is a member of the ADA?

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Dentistry is an essential component of healthcare, and the dental industry is a significant contributor to the economy. In recent years, however, the economy has had a profound impact on the dental industry, particularly on the revenue of dental practices. This podcast aims to explore how the economy is affecting dentists in terms of their income, patient volume, and business operations.

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Running a dental practice with critical business thinking vs. “how does this make me feel” strategies is something that Tracy and I deal with constantly. It’s where dentists and front office team members, and sometimes every team member, fail the business test. It’s what separates the average practice from the great practices. Here we go…

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