My Practice My Business: The Clinical Business of Dentistry

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Dentists play a crucial role in ensuring the oral health of individuals. However, many dentists are hesitant to speak out about dental insurance companies and the American Dental Association (ADA) when it comes to policies that negatively affect patient care. This podcast aims to discuss the reasons why dentists may be afraid to speak out about these organizations.

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One of the books that Tracy makes a required read for the Advanced OM/FO Business Training talks about “bottlenecks” in a manufacturing plant. It was an amazing business read, and I quickly understood why she requires it for all our attendees. The similarities to what dental practices experience became strikingly similar.
Just like the bottlenecks in a manufacturing plant that can cause inefficiencies and lost revenues, I want to identify six bottlenecks commonly seen in a dental practice.

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We’ve trained hundreds of practices here at MPMB, both in state and out of state, and I would say roughly forty percent or more of them are not members of the ADA and their state associations. When I ask them why they chose not to be members, the answers have a common ground. 
Another problem I believe is contributing to the decrease in ADA and State dental membership is the fragmentation of efforts protecting dentists from state to state. If there is one thing that has become clear to Tracy and I as we have passed legislation and defended dentists against dental insurance company’s unethical policies, it’s the simple fact that the ADA picks their battles, and the state associations don’t know what battles to pick. 

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Shouldn't it be licensed dentists who determine generally accepted practice standards? Dental Insurance companies are trying to fill that role and need to be stopped.Tracy and I attempted this one topic for legislation, which reads:

“Generally accepted practice standards for dentistry, are to be determined by the majority of professionally licensed dentists in Utah and managed by the state dental association.” 

Our talking point was this: Our proposal would prevent unlicensed dental plan executives from setting dental standards of care. Sounds simple…right?  The pushback was unbelievable...

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How often do we hear dental thought leaders tell us to drop dental plans, or at least the worst ones? Inevitably, someone will ask the question, “which ones are the worst ones?” Or better yet, they ask, “please define what is meant by the ‘worst’ ones, aren’t they all bad?”

Then there are the grumblings from all of us on how bad the reimbursement rates are, and how impossible it is to provide quality dentistry on a patient who is covered by a PPO plan you are a provider for. 

Last but not least is our front office team members who have to deal with the dental insurance plans, their reps, and the deceptive EOBs, not to mention the patients who love to complain about their insurance coverage, or lack thereof. I sometimes don’t understand why the majority of front office team members are not in group therapy in every state.

I want to talk about the importance of fighting on principle, not on a platitude when protecting dentists and the patients we serve.

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So many thought leaders in our profession despise this very topic. They cringe at the thought someone like me would even suggest to you that your mission is to make money. But it’s called reality. The mission of any business should be to achieve success, and that success is accomplished by being profitable on all, or as many procedures as possible, which leads us to the term “vision.”

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In this discussion, I ask them some very important questions. Please allow me to just jump to their answers for now, I’m sure you can figure out the questions, and here are their answers:

1-We are maintaining infection, not eliminating it. This just doesn’t make sense…

2-I’ve always felt that periodontal disease can be eliminated, but not with our current treatment protocols, and especially not with my office treating it to insurance limitations.

3-I have no idea why we don’t use antibiotics. It doesn’t make sense.

4-All of our patients bleed in almost all the areas of needed SRP at the six-week exam. And all of them continue to have forever periodontal disease if I’m being honest…

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It seems like every week I see an advertisement from a dental consultant advocating the need to drop dental insurance and build a strictly fee-for-service (FFS) practice. Many of these dental consultants teach their clients what I call a very deceptive tactic, one that loses the patient’s trust right from the beginning every time, and we begin our podcast right there.

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Why do so many solo dentists take the stink bait offers of DSOs without investigating what they are really giving up when swallowing hook, line, and sinker to these predators? The main reason dentists give up their autonomy and business opportunities are because they don’t know what they don’t know. We are going to tell you what the corporate predators are not telling you, that you need to know. We begin right here!

There are so many places to begin this topic on that I almost do not know where to start. So, I think I’ll begin with our own experiences here at MPMB.

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I read a statement from a dentist on one of the dental networking groups that caught my eye. The comment, for some reason, made me feel bad for that dentist, and my heart really ached for him. That may sound a bit cheesy, but I care about all of you, and your teams. Tracy and I learned so much about the inner workings of dental insurance companies when we got our Utah Dental Law passed. Some of it good, and some really bad, but grateful for the educational experience we had with the Network Leasing, Down-coding, and Bundling Protections Law. Back to this dentist’s comments, his deductive logic and reasoning to his statement simply lacked intuitive business skills and accurate definitions in regards to state laws, which is something Tracy and I specialize in here at MPMB. This is a very important topic all dentists need to understand, and we begin our podcast right there…

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