Tips for a Start-Up Practice
I began my career in dentistry in 2012 when my sister and brother-in-law approached me about an opportunity to work with them as an office manager in their new start-up practice.
We had a very small team that included two part-time dentists (general and pediatric), one full-time assistant, one part-time assistant, and an office manager.
My closest experience in the dental industry was during high school. I shadowed my sister in dental school during spring break and a few times when she began working as a dentist.
The clinical side of dentistry never interested me; however, I was intrigued by the business aspect.
Looking back at the past 11 years, I realize that I learned a lot through trial and error.
I do share my mistakes with others since it helps my colleagues when they are training in their new roles. At the present time, I make business decisions with better strategy and execution.
Here are some words of wisdom…
Don’t Add Every Insurance
When we started our practice, it was a two-operatory office with the possibility of adding four more dental chairs. Seeing that our schedule was completely open, we decided to enroll in several dental insurances.
None of us had dental insurance knowledge, and the 3rd party we worked with didn’t coach us or give us any insight into the plans we were signing up with at that time.
When we started seeing the EOBs and checks coming in for the procedures we completed, we noticed checks with a minimal monetary amount. We realized we were losing money from seeing patients with those dental plans. I immediately started removing several plans that we credentialed with at that time.
If you don’t know this, adding and removing a provider network is a big hassle.
When someone submits to cancel participation with a plan, you can magically re-appear on the provider network. It kept happening for years!
I know every office is different in the plans they take, but I removed all DHMO and HMO plans from our network. I am currently working with a third party to drop direct networks and be in-network with plans that use umbrella networks.
It is very confusing if you don’t know what insurance is attached to what fee schedule.
What I do recommend, even for a start-up, is to look at the large companies in your area. Research their insurance and see if those fee schedules make financial sense.
If you do hire a third party to help, ask a lot of questions. You’re paying them for their knowledge. It is a learning process.
Don’t Just Fill the Schedule
For years I focused on ensuring the schedule was full no matter what procedure we booked. We focused so much on the quantity and not the quality of the appointment.
My sister did work for a corporation at the beginning of her career, and she suggested we follow rock, sand, and water when making a template. After watching some dental videos on productive scheduling, I began to understand what template scheduling really meant.
We created types of appointments based on price points, timed our procedures, put a template on our schedule with colors, and made sure everyone followed the template.
We did get pushback from the team, and sometimes team members would make mistakes on the templates. We decided to create a template guideline sheet, and some of our staff meetings consisted of explaining the new guidelines. Once they started seeing the template in action, the team understood it worked, and it benefited all of us.
The biggest challenge is getting team members to focus on building the schedule based on their office needs. We can’t bend over backward for the patients.
For example, if we schedule two CEREC procedures in the morning, we need an appointment at 8 am and another at 10 am. So, if a patient requests 9 am, that is not available on our schedule.
If you notice a lot of mistakes in your schedule, have your team keep a log of the appointments they schedule during the week. You can do an audit and talk one-on-one with the team members that made the scheduling mistakes.
Don’t Start a New Team Member Without Proper Training
Before 2019, I hardly had to hire a new team member.
Once COVID hit, things changed, and they changed fast.
I became a full-time recruiter and HR specialist overnight. We also opened a new building in November 2020, and I needed to increase my team from 12 to 30.
I realized that training was 100% easier in our smaller office.
Our training consisted of, “You watch me, I watch you, and go!”
That obviously didn’t work, and we had many team members who felt that they were not a good fit for our office.
We decided we needed to remodel how we trained our new team members. We currently have a new hire orientation where we assign a designated trainer for the new team member. We have the new hire shadow, and then their trainer shadows them, but it’s a longer process.
For example, dental assistants start with mastering sterilization, flipping rooms, bringing patients to the operatory, and bringing patients to checkout. No matter what your prior experience is, we start everyone on the same point since each dental office works differently. We also have a PowerPoint presentation covering their roles in the dental office.
It’s still a work in progress, but our training has vastly improved in the past few years.
A Note to Hiring Dentists
If this is your first time starting a dental practice, look for your dream manager. Your manager may or may not have dental experience, but make sure they are willing to learn and have a passion for leading.
You need someone who understands your goals and can solve new problems that will arise throughout the process.
I also encourage you to invest in education courses and have them join AADOM.
A Note to Office Managers (or Future Office Managers)
Don’t get discouraged.
There are many resources out there that can help you learn the ins and outs of running a dental practice.
If you find yourself needing advice or encouragement, find your local AADOM group or reach out to other office managers.
Find a dentist that wants you and the practice to succeed!
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- 1 webinar recording
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