How to Maintain a Profitable Practice If Your Doctor Has a Big Heart

“How much would you like to pay today?”

This was a question I overheard a staff member ask a patient who was checking out at the front desk of my husband’s dental office.

Alarms went off in my head, and chills went up to my spine! So many questions raced through my mind.

Is this patient a member of the family I have not met?

Do they ask every patient this question, and if so, is Dr. Brad, my husband, able to pay his bills? As it turned out, soft collection language like this happened all the time.

The soft collection language I kept hearing

I witnessed even more patient check-out contacts like, “Did you want to pay anything today” “Don’t worry about it, I’ll just send you a statement,” “Let us just wait to pay after we see what the insurance is going to do.”

The best description of my immediate gut response is both panic and concern.

That evening over dinner, I asked my husband if the practice was good financially. To my relief, he assured me that the bills were getting paid. I shared the conversation I heard that day as patients checked out with him.

I felt that my background as a business owner for over 25 years could be helpful to his practice because, after all, business is business; maybe I could offer my services for a few months.

I proposed the idea to my husband, and he was more than thrilled to take me up on my offer. Those few months have now turned into six years.

Vastly different goals. Since my background is business, my priority is making the practice more profitable.

My husband’s priority is to practice dentistry to the best of his ability. He was accustomed to discussing finances with his patients, AKA making deals.

The first thing we had to agree on if it was to work out with me in the OM position, was that going forward, all financial discussions with the patients would happen at the front desk by one of the business staff or me, never him, his hygienist, or assistants.

Taking this out of his hands would free him up to do what he loved: dentistry. And it relieved him of awkward financial conversations.

The days of trading dentistry for horses, pigs, and goats were over.

Barters and deals were of no interest to me! We decided that when a patient asks about fees or deals, his response would be, “I will give our business office staff your treatment plan, and they will discuss the total investment and financing options we have available.

I feel confident they will be able to find a financial option that will work for you.” Dr. Cathy Jameson’s book “Collect What You Produce” was an invaluable resource for our practice.

Maintaining a healthy, profitable practice

Our next step to make the office more profitable was to review our office fees.

The fees had not been increased in many years. Auditing and adjusting fees regularly are essential.

However, just the suggestion of raising fees made my husband very uneasy and the business staff uncomfortable.

My thoughts were, “What is wrong with this bunch? Don’t they understand that raising fees is the only way to keep up with the cost of living increases, inflation, maximizing insurance fee schedules, increases in operating costs and salaries, not to mention creating profit that allows for pay raises!” “This is all basic business 101!”

Then I realized none of these team members are businesspeople.

None of them have business degrees, nor have they owned and operated businesses. They all have come into the practice with backgrounds in the clinical side of dentistry.

Even my office staff are all former dental assistants.

Like my husband, they all have big hearts and share Brad’s love of dentistry. The reality is, he would do the work for free! Just for the joy of it. Consequently, it would be my job as the OM to fix this issue, even if I had to drag them kicking and screaming, back into a healthy state of solvency!

After much persuasion and a few battles, I found myself pouring over the National Dental Advisory Service (NDAS) Comprehensive Fee Report book, and a new fee schedule percentile increase was agreed upon and implemented.

Next, we trained the business staff on how to answer questions or respond to comments regarding the fee increase.

Thank you again for your patient encounter scripts, Dr. Jameson! Presenting treatment plan options to the patients after every appointment and securing firm financial commitments before making return appointments was a game-changer.

But acclimating the staff to our new process was only half the job.

Retraining our patients

Teaching patients a new way of conducting business when they have been accustomed to the old way was challenging.

Even today, we must work very hard to help the patients understand their treatment options and their financial responsibility to create a seamless check-out that builds patient confidence in our business practices.

In the long run, the patients appreciate that we help them make sound financial decisions about treatment that protects them, their pocketbook, and their credit rating, allowing them to continue receiving excellent care in our office.

Distilling all this down, we made just two overarching adjustments that impacted our entire practice in an incredibly positive way.

First was taking all the financial discussions off the clinic floor, away from the clinical team, and moving it into the business office, placing full responsibility for finance squarely on the shoulders of the office management team.

Second, we started regularly auditing and adjusting our fees, which created a significant increase in our bottom line.

But as often is the business case, this increase in profit started a host of wonderful things to happen for our practice, such as new equipment purchases, continuing education for the whole team, remodeling our facility, raising salaries, more marketing, etc.

All of that led to a stronger practice and ultimately enabled us to provide a better, higher-quality dental experience for all.

Meet the Author

Teresa Berry Williams, MAADOM is a lifetime AADOM member, receiving her Fellowship designation in 2018 and most recently was inducted as an AADOM Master, (MAADOM) in 2021.

She’s the current office manager for Williams Dental & Orthodontics… This text opens a new tab to the Williams Dental & Orthodontics website….

She has been leading the business management team at Williams GP Orthodontic Seminars for the last 5 years and holds degrees in Business Administration & Commercial Art.

Teresa and her late husband managed multiple businesses in Oklahoma, where The Journal Record named her Woman of the Year “50 Making a Difference”.

Teresa married Dr. Brad Williams in 2012 and began to use her business experience in managing his practice. With his encouragement, Teresa developed Managing Orthodontics, a one-day training management seminar for fellow dental professionals.