Your practice, your leadership: A few things to consider as a new dental practice owner

    By Greg Grillo, DDS

    Owning our own dental practice (or practices) is one of the most exciting and fulfilling challenges we’ll ever see, as dentists. Without competent guidance or mentoring, however, it’s easy to make common mistakes that can impact your future production, staff, and even how efficiently your business operates from day one.

    Fortunately, you can hit the ground running when you know what common mistakes and pitfalls to avoid, as well as who to turn to for guidance. That being said, there are always some decisions that you’ll have to make for yourself.

    Here are just a few examples:

    Insurance Choices and Commitments

    Most practices choose to process insurance for their patients, but a few decide to sidestep relationships with insurers. Eliminating insurance from a practice requires a clear philosophy, message, and systems. It can be done, but solid groundwork needs to be in place.

    Assuming your practice will process insurance for patients, you need to decide whether to establish preferred provider relationships and which insurers to be in-network with. As insurance reimbursements remain stagnant (and even continue to fall), it becomes more challenging to earn a profit on everyday procedures that make up the bread and butter of your practice. Some providers are choosing to opt for in-house “savings” or “membership” plans rather than opt into a network that places strict barriers on production.

    Take for instance the recent assault that dentists have withstood from Delta Dental in several states. This includes rigorous new requirements for in-network dental providers, and slashed fee schedules that have been frozen for several years.

    Decide early on what your office financial policies will be, and then stick to them. Each patient should sign one, and your staff should implement them properly. Otherwise, you’ll be stuck with collection issues, treatment delays, and unhappy patients. One way to do this is to outsource insurance duties to professionals who can assist you in confirming benefits and filing claims. That way you can spend your time actually treating patients.

    Outsourcing and Hiring

    You may need extra personnel in your new practice, but you may not be ready to hire full-time. Finding the right employee is challenging enough. It’s even more of a struggle when you aren’t sure if you can afford the best team member or the ongoing cost of a full-time position. At that point, it’s easy to lose quality team members who would otherwise be one of the biggest assets to your business. After all, they need a regular paycheck too!

    Fortunately, there are 3rd party networks, such as Cloud Dentistry, which allow local specialists, dentists, and dental staff to book help as needed. There are no middle-man temp agencies involved, and dentists (or potential staff) can find a great match on the days that one is required. Better yet, sources such as Cloud Dentistry handle all of the legal documentation for you. And you can schedule specialists to provide treatment in-house, as opposed to outsourcing procedures and losing production. It’s more affordable for everyone.

    As your practice grows into a full-time business with predictable cash flow, you can transfer temporary or as-needed staff into permanent roles that fit everyone’s needs.

    Investments in Technology

    The right equipment can help your practice run smoother, faster, and reduce the physical strain on you and your staff. Simply buying the right tools isn’t enough: You also need to invest in training to make sure that it’s being used properly…not just for you, but for your entire team.

    In many cases, there are often “hidden gems” built into a product’s design that you might not otherwise know about. It’s not worth it to just buy a new piece of equipment if you aren’t going to be using its capabilities to their full extent.

    Our patients deserve the best care possible, and smart equipment and technology purchases should pay dividends. Consider how CBCT conebeam machines have revolutionized dental implant placement, or digital radiography has reduced the length of your hygiene block scheduling. These investments aren’t just for the dentist; they’re also for the better oral health of the patients that we serve.

    Take for instance your patient management software. Cloud-based dentistry allows dentists to easily access patient records, photographs, and make appointments even if they aren’t in the office. Plus, appropriate programs are HIPAA approved, making it easier to bridge from a part-time employee role in another practice to an independent practice owner in your own time.

    Creating Positive Morale

    When you walk into a place of business, you can tell by the staff whether or not it’s a “fun” place to be. How often have you been bluntly greeted by a receptionist or spent five minutes with a doctor who didn’t even know your name? That’s why it’s vital to make a choice on day one to create a positive environment that harbors both healthy relationships among staff and your patients.

    Encourage a comfortable, friendly tone where people get to know one another. You might keep notes in the patient charts to remember personal things about your patients, to ask them about later on at their next appointment.

    Make it a policy to smile when you’re talking to patients…even if it’s over the phone. Your prospective “customers” can tell! Consider the business model of other companies that have succeeded in customer satisfaction, and make notes about some of those practices that you can take and use on a daily basis. Not only will it help your patients want to return, but it also facilitates a healthy work environment among your staff.

    Balancing Your Role

    You wear many hats: dentist, business owner, and entrepreneur. And if you’re new to opening a practice, you may also be an insurance coordinator and sterilization tech. In your new roles, it’s easy to get overwhelmed both physically and mentally.

    In The E-Myth, author Michael Gerber explains the need for developing a managerial and entrepreneurial role. Many small business owners, such as dentists, lack training in these vital areas. Without evolving these skills, dentists may be running in circles when they should already be halfway through a marathon.

    Understanding how to delegate, entrust, and train the proper staff encompasses just one key element of running your business. You cannot do everything yourself (nor should you!) Making smart hiring and training choices early will facilitate your own professional business development.

    Perhaps there are certain cases where you feel in over your head. Your patient needs the attention of a specialist, but you don’t want to risk the lost revenue. Consider delegating out certain services to a local specialist that can come into your facility for the procedure, as opposed to making your patient go elsewhere.

    Once you’ve mastered the skill of delegation, you’ll find your stress level plummets without negatively impacting your overhead. It just frees you up to do what you’re meant to do…treat patients!

    These are just a few examples of the challenges that a new dental business owner will experience. Thankfully with technology, it’s easier to partner with supportive networks and mentors who know what works and can help you avoid the pitfalls of many dentists before you. Find a mentor or guide to help you feel confident about overcoming common start-up mistakes and discover the rewards of building your dream practice.


    Dr. Greg Grillo is a 1995 University of Washington School of Dentistry graduate practicing in North Central Washington. He balances clinical practice with a role as the Content Director for Legwork, a rapidly-growing dental software company. Dr. Grillo purchased his current practice in 2001 after four years as a U.S. Navy Dental Officer and proceeded to triple the practice by every productive measure. He’s now the senior partner of Grillo Robeck Dental, an innovative practice blending technology with exceptional staffing to provide relationship-based healthcare.

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