Organizational Structures to Manage a Dental Practice

Real World Insights from AADOM Authors - Veronica La Chapelle

A great organizational structure for a dental practice determines how the dentist and staff manage the activities to meet the goals of the business. The eight types of organizational structures in managing a dental practice are: team, matrix, divisional, horizontal, hierarchical, network, project, and functional. Most dental practices are managed with a combination of these designs.

Team structure

Most dental practices use a form of team structure, especially in processing clinical duties between a dentist and a dental assistant. The dental staff works as a team to ensure the patient’s needs are met in conjunction with front and back-office dental staff.

Matrix structure

A matrix organization is a work structure where team members report to multiple leaders. An example of a matrix structure in a dental practice includes a hygienist performing prophylactic care on patients. The hygienist is the most qualified staff member to perform this procedure. Another example of the matrix structure is the registered dental assistant (regulated by their state’s laws and supervised by a licensed dentist) to perform coronal polishing. Registered dental assistants work under the direct supervision of a licensed dentist and have at least two years of experience. This allows the registered dental assistant to use skills outside of their primary role of assisting the dentist.

Divisional structure

A divisional structure is when dental office operations are divided up according to budgets and profit margins. In this system, the practice assesses the profitability of a department by its allocated costs and profits earned.  This assists the dentist and office manager or consultant in deciding if changes should be incorporated. One example of change would be adding accelerated hygiene to increase patient volume in the hygiene department. The hygienist has their own dental assistant to schedule hygiene appointments, set up their room, clean instruments, take X-rays, and perform coronal polishing (if applicable to your state laws.)

Horizontal structure

An example of horizontal structure in a dental practice is cross-training your staff. This is how some practices managed overstaffing issues during COVID-19 to compensate for patients not wanting to come back to the dental office. Employees were trained to pitch in to complete tasks that might otherwise be designated to other departments. Some registered dental assistants were taught expanded functions supervised by the dentists to reduce overhead in an otherwise challenging economic environment.

Hierarchical structure

A hierarchy establishes a distinct chain of command between the dentist and every employee. In a dental office, the dentist is in charge of all decisions that affect the company. This organizational structure of reporting will have the front desk employees reporting to the office manager and the office manager to the dentist. A registered dental assistant my report to the hygienist who then reports directly to the dentist.

Network structure

A network organizational structure is one in which the practice groups certain types of employees together based around a common specialization. Network structures in a dental practice utilize a vast number of partners in the dental industry. A dental practice works with dental supply companies to purchase inventory and equipment for maintaining the dental practice on a daily basis. A dental practice may also use a third party for hiring, payroll, career development, developing policies, and handling work-related issues. Dentists will also partner with professional organizations such as the ADA or AADOM to remain current on rules and regulations and continue education to maintain dental licenses. Other networks include insurance companies, attorneys, certified public accountants, information technology, website designers, or third-party dental consultants to assist in managing and increasing productivity or profit margins in the ever-changing dental environment.

Project structure

Project structure in a dental practice involves working on a patient’s dental treatment from start to finish and then completing their case. For example, the front office schedules the initial dental appointment, noting patient’s dental concerns, and verifying dental insurance. Once treatment is charted and explained to the patient, the financial treatment plan is conveyed to the patient and appointments are set. Preparatory work includes checklists for necessary supplies obtained for the appointment. The project is completed once services are rendered, including any follow up appointments necessary to complete the case. The front office has a responsibility to the financial commitment completed by the patient and any insurance company contracted with the dental practice.

Functional structure

In a functional structure, a dental practice requires all employees to be completely proficient in the functions listed under their job description. The clinical team is continuously improving their training whether it’s on the job or utilizing outside sources to expand their skills. Front office staff learns on the job and through outside sources such as AADOM to improve upon their skillset and keep abreast of current rules and regulations in the industry.

Using all eight organizational structures in a dental practice

The goal of any dental practice is to be the very best they can be on all levels. A dental practice has to be the most efficient, delivering the best quality care at every appointment for every person that the dentist treats. Resources made available to the dentist and their staff whether that is through team, matrix, divisional, horizontal, hierarchical, network, project, and functional, should be the goal of each and every member of that dental practice.

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About the Author

Headshot of Veronica La Chapelle

Veronica La Chapelle, MAADOM, began her career in dentistry after retiring from a municipal government position she held for 27 years. Today, she is the assistant manager for Advanced Premier Dental and Implant Dentistry in The Woodlands, TX. Veronica has been an AADOM member since 2009, received her Fellowship (FAADOM) in 2013, and received her AADOM Masters (MAADOM) in September 2022.

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