Profit Centers

Jan. 1, 2000
Additional sources of profit from the hygiene operatory can be `passive income,` where the burden of additional chairside time is minimal.

Additional sources of profit from the hygiene operatory can be `passive income,` where the burden of additional chairside time is minimal.

Anthony Stefanou, DMD

One of the keys to success in dentistry today is creating more income without spending more time chairside. The last decade has offered us many new technological advances that allow the practice to be viewed as "cutting edge." It is no secret, however, that the initial burden and extensive training necessary to implement these advances can cause extraordinary stress.

What if the practice were able to immediately institute new programs that:

- Require only basic training.

- Increase staff motivation via profit sharing.

- Don`t involve any "invasive" dentistry.

- Greatly improve "health and wellness" of patients.

- Can be incorporated into the existing patient base or marketed successfully to generate a steady stream of new patients.

Guess what? All of you already offer similar programs in your practices. All you need is more of them! For example, most offices charge a set fee for a cosmetic service such as tooth whitening ($200 per arch, for example) that is "all inclusive." You provide that patient with a consultation and examination, construct a splint or tray, dispense the kit that includes the gel, and offer follow-up and support until the case is complete. Simple. The practice gets what is sought with the service - a nice profit and a satisfied patient. The patients get what they want - an improved appearance. Please note here that you are not "selling whitening gel," but rather providing a cosmetic service and getting paid for your expertise, instruction, and guidance. The bottom line is that this concept works because everyone wins. Let`s take a look at some other programs that provide all of the same benefits.

Soft-tissue management program

Many of you may be saying, "I already have a STMP in my office." That may be true, but let`s examine this more closely before dismissing it. You probably have a "structured" office philosophy about periodontics and treatment plan for active cases with specific procedures (quadrant root planing and scaling). In some cases, a prescription is written for a therapeutic agent. You may even "hand out" a kit that includes several of the following: toothbrush, paste, floss, rinse, disclosing tablets, etc.

Let`s stop here for a moment and ask a few questions. How much is it costing monthly to just give away these products? You`d be surprised at the numbers! Remember, toothbrushes usually need to be bought by offices and are not given as free samples from dental companies. How much income are you providing drug stores and drug companies annually? Some surveys estimate $150,000 to $200,000 for an average office!

How many of you (as dental professionals) would personally use or have your family use the products you`re handing out or prescribing? Think about this for a moment! How many patients actually fill the prescriptions or purchase the products you recommend? Chances are only a small percentage. They`ll either get what`s "on sale" or consider the trip to the store to be such an inconvenience that they`ll continue using what they have been using. How does this support the perio therapy you`re providing them?

How many patients who receive these free gifts actually get the safest, most effective programs for their particular condition? Or, are they being dispensed "the inventory of the week" in your office? If this is the case, how is this serving their long-term needs?

Let us now examine the missing piece to a powerful, all-around beneficial STMP. What if, without changing the office philosophy, a fee was presented that was all inclusive (sound familiar?) for chairside therapeutic procedures and a complete home care maintenance program? For example, let`s say the quadrant fee is $125. Instead of charging $500 for four quads, writing prescriptions for rinses and handing out a "free brush, paste, and floss," and hoping patients do what they are supposed to do, why not present a case fee of $660 ($165 per quad). The case and fee would include a customized, complete, and safe home care program that includes some or all of the following products: brush, toothpaste, mouthrinse, tongue cleaner, irrigator, conditioning gel, floss, etc. They get proper professional instruction and support from a system that you and your staff use personally and have witnessed excellent clinical results. The patients don`t have to make any additional stops to pick up products and rely on others for instruction. They have the peace of mind knowing they are getting "insurance" for the money they are spending on treatment.

Why aren`t we doing more of this? How about a few more points while we`re on the subject? In the original scenario (the one in which we hand out the goodies), just what kind of message or value are we passing along to patients? If you`re handed something different every time you go to an office, aren`t you just saying, "All home care products are the same?" When you`re handed something for free, does that necessarily mean you`ll use it (even if it`s a good product)?

When you go to a dental trade show and are given lots of free samples, do you immediately go home and use them? Conversely, if you spend $50 on an item (on any product, not just in the dental arena) haven`t you made a commitment to it and usually opt to use it immediately? When you pay for something, it makes sense to get the most out of it.

From a business point of view, you`ve now created a modest additional profit without any additional chairtime. If this same type of service also is offered to all recare patients, the perio and preventive departments in a practice can easily and conservatively add several thousands of dollars per month in additional income!

Guess what? It doesn`t stop here. These home care programs should be introduced to all cosmetic, orthodontic, prosthetic, and surgical patients as well. Don`t they deserve the highest quality in dental home care? The truth of the matter is that most of the patients in our offices are in need of, and very receptive to, guidance when it comes to home care. If left to decide on their own, they may very well end up using a system that is not only ineffective for their needs, but maybe harmful as well.

While we`re on the topic of home care products, a few points should be addressed. As dental professionals, when we select a brand or particular program to recommend in our offices, we should offer the best. That is to say, a system that passes your personal tests, one that you would and do use yourself at home. It also should offer versatility and choices so that it can be customized for any needs the patient has. For example, I strongly believe and recommend avoiding alcohol-based products in our dental offices completely. In my opinion, many alternative ingredients are available that are safer. My practice does not offer products found on the store shelves that contain additives, colorings, and/or preservatives (not to mention alcohol!). I want to offer what I believe to be the finest in quality and safety. I want excellent products that maintain patients` treatments.

When patients use the home care system you recommend, they view your practice as a "caring" one. It sets the practice apart. People will talk about these programs with their friends, families, neighbors, etc. Guess what happens next? You get referrals. This minor revision to your STMP can generate several new patients per month. If you`re concerned about becoming a "dental drug store" and what to do about "refills" or carrying a huge inventory within the practice, many companies offer a "retail direct program."

Fresh breath program

These profitable and highly rewarding programs have become incredibly popular and successful within the last few years (and rightly so!). You greatly improve the daily, personal, and professional lifestyles of patients and boost their self-confidence with this program. Unfortunately, most dental professionals receive little or no training in dental school about the etiology, diagnosis, and treatment of halitosis, which afflicts millions of Americans on a chronic basis. Recent advances in diagnostic tools and products have changed all of this.

Ninety-five percent of chronic halitosis cases originate in the oral cavity, so dental professionals are responsible for assisting in treatment. In most cases, VSCs (volatile sulphur compounds), which are the byproducts of the degradation of bacterial and epithelial cells, are the main culprits and accumulate and compound in the soft tissues of the oral cavity (particularly the tongue). We can now detect the presence and levels of the VSCs with new diagnostic equipment and have safe products that can completely neutralize and eliminate the odor.

These anti-halitosis programs have been so effective that several national media broadcasts have recently reported the positive success rates. In addition, the major dental journals have featured fresh breath programs within the last two years. My guess is that, within another year or two, almost all offices in the United States will offer some form of anti-halitosis treatment. Why not get started now?

A structured fresh breath program is simple to implement. Most patients that seek your services are highly motivated because of the effects halitosis has placed on their daily lives. They will usually spend whatever it takes to combat it, providing you offer them a safe, effective system and offer it with confidence. Most programs, once you receive some basic training, will boast a 90 percent-plus success rate within two weeks of implementation. The best part of it all is that they will stay on these home care systems for the long term and most become regular patients in your dental office. You have eliminated what they thought was a lifetime of doom using mints, sprays, and gums that worked only for a few minutes at a time.

Training is certainly needed here, since some serious systemic problems can be contributing to breath problems. However, there is excellent information available. Manuals, audios, videos, seminars, and ongoing support by dental professionals can be obtained from various sources. Once you are trained and order the diagnostic equipment and home care systems, your "structured" fresh breath profit center is ready to go. A hygienist can run the whole program -consultation, examination, diagnostic tests (gas analysis and microbiological), home care kit and instructions, follow-up, and support. Again, there`s very little chairtime, no invasive procedures, it`s profitable, and it`s very rewarding. You earn income through product refills and other general treatment planning once the patient becomes a regular.

Nutritional therapy

Your initial response to this may be that you`re not qualified to do this or it`s not within the scope of dentistry. I say you are and it is. I`m not suggesting that we become counselors, experts, or get into complex programs concerning nutritional needs on a systemic level. What I am suggesting is that nutritional considerations play a much larger role in dentistry than we often choose to admit. Think about it. Decay. Periodontal disease. Halitosis. Isn`t it true that what we eat and how our body functions affects the condition of the oral cavity to a great extent? If you agree with this, several types of high quality, natural supplements assist in supporting and maintaining the tissues of the oral cavity. Specifically, your periodontal, surgical, and endodontic patients could greatly benefit from antioxidant supplements. They contain combinations of ingredients ? grape seed extracts, B vitamins, CoQ10 (and others). They are dispensed seven days before treatment and assist in boosting the body?s immune system, scavenge free radicals that can cause tissue destruction, decrease post-op discomfort and speed the healing process.

Dr. Anthony Stefanou maintains a private practice in the New York City area. He lectures nationally on soft-tissue management and halitosis treatment. He can be reached at (800) 999-9551, extension 352, for more information.