The What?

What does digital case presentation (DCP) mean? DCP is a way of combining great verbal skills with digital tools to support the message. This includes using digital extra-oral photos as well as PowerPoint and, in some cases, cosmetic imaging. The result is a beautiful PowerPoint presentation filled with the patient’s concerns, doctor’s diagnosis, treatment considerations, photos and, for cosmetic patients, a digital rendering of what he or she could look like with cosmetic dentistry.

The Why?

Why do digital case presentations (DCP) encourage the exclamation point and quite often secure a "yes" when otherwise it would have been a "no"? The answer is multifold. In an information age, people want – you guessed it – INFORMATION! First, they desire to see photographs that support the diagnosis. In fact, they expect it. The more the patient sees the areas of concern that need treatment, the more they value it and want it. It builds TRUST; trust between you and your patient.

It also builds strong patient RAPPORT. The patient is hearing their own concerns relayed back to them. They know you are hearing them because you are showing them the photos of the area with which they were concerned. You are showing them the diagnosis and treatments for that concern. They can visually see that you get it. In addition, they know you have taken time to put all this information together. It builds value in the additional appointment to go over your findings. All of this results in a stronger relationship.

DCP acts as a DOOR OPENER to a wider variety of treatment. For patients who express some concern regarding the appearance of their teeth, cosmetic imaging is a great way to sell the case. You read that right – sell. Cosmetic imaging is digitally altering a photograph to render potential results from cosmetic dentistry. It gives the patient an idea of what he or she could look like with porcelain veneers, for example. By showing them this image, they can imagine how they would look without that ugly gap in the middle of the two front teeth - or - how much more youthful the patient could look with lighter teeth. The result? Taking the guessing out of the game and creating a patient who WANTS the treatment!

The door opener is not just for cosmetic dentistry; this applies to general and advanced restorative dentistry as well. Jane Doe may have come to you because she is experiencing pain in the upper right portion of her mouth. Upon a thorough evaluation, you discover several other areas that are in distress, which will eventually cause her more pain. Presenting her with radiographs and a diagnosis, may not convince Jane. However, if you show her a presentation with clear photos to which she can relate, she will be more likely to say "yes".

It eliminates buyer’s remorse. When scheduling larger cases, patients will often times say "yes" and book the appointment. Then when they leave, their spouse or other influencers will tell them that it isn’t worth the money. With the DCP burned onto a CD, the patient can show friends and family members what she learned in the consultation. More often than not, it will result in an outpouring of support for the desired treatment. In addition, when the patient reflects on the consultation, if she has questions, she can simply pull out the CD and be reminded of why she made a GREAT decision.

Involve other decision makers by incorporating DCP. Too often, the spouse or other decision maker cannot be available for the consultation. As a result, the patient leaves without making a commitment. We are asking our patients who have very little knowledge of dentistry to go home and sell the dentistry. You already have a challenge doing that one-on-one with your patient. Now we want our patient to do that for us. The CD with DCP is meant to recreate that appointment as best as possible so that proper information in laymen’s terms with photos can be relayed to other decision makers.

Increase your new patient flow. YES! It increases new patient flow. That is a phenomenon that we did not even anticipate until our practices started to tell us about it. Because patients want the support of those closest to them, they share the CD. When others see the level of detail and effort that went into the CD, they are blown away prompting them to find out more about this fabulous dentist! You are essentially equipping your patient with the tools to talk about YOU!

Finally, it is motivational for the team. Teams love to be challenged and to take on new endeavors. DCP is no exception. The practices with whom we have worked get excited about learning new technology. The enthusiasm carries over to the patient consultation. The team member is excited to show the patient what can be done and is proud of the format. Patients feel the excitement and energy, realizing it is genuine and is motivated to say "YES!"

The How?

Now that you are convinced, let’s talk about how you put together a Digital Case Presentation. You need five things to make this happen: digital photos, PowerPoint 2003 or 2007, cosmetic imaging software (OPTIONAL), a CD burner and a willing TEAM!

You start a digital case presentation by taking quality, consistent images with a professional digital SLR camera. There are many great cameras on the market. We recommend the latest Nikon digital SLR (i.e. Nikon D90) or the latest Canon digital SLR (i.e. 40D). Clear photos that are properly framed will yield you the best results. Patients need to know that you pay attention to the details. Clear photos also help to showcase the teeth more appropriately. To take great photos, you need to allocate approximately 5-10 minutes, based on team’s skill level and the photos you wish to take. With advances in technology, downloading the photos should only take 1-2 minutes.

Does your patient want cosmetic dentistry? If yes, then cosmetic imaging is a great add-on to your digital case presentation. Simply image the photos using software such as Adobe Photoshop, Dentrix DDO or Envision-A-Smile. There are several different types of software; these are a few that our clients like. When imaging smile, you can invest 5 minutes, 10 minutes 1 hour, or 24 hours into it. Note that the smile looks just as good at 5-10 minutes as it does at 24 hours! Remember earlier we stated that this is a sales tool – not a diagnostic tool. It is not and should not be used to show the patient EXACTLY what she will look like. Instead, it is meant to give a patient an idea of what is possible.

PowerPoint is the software to use to create a presentation. By using a pre-made template with your logo and color scheme, you can simply insert photos and text. Once you are finished, save the presentation. By going into presentation mode (full screen), the computer screen will be filled with the presentation only. It neatly displays your pictures and includes objects pointing out concerns. Follow up the photo with treatment recommendations. Remember that you are showing this to patients; people without dental degrees. So always use laymen text. That way the patient can comprehend it even if you are not there to translate. With the template, you need to budget approximately 5-10 minutes.

Once the presentation is created, burn it to a CD. This allows the patient to take it home to share with important decision makers and influencers. This greatly increases the "YES!", reduces broken appointments and no shows and increases word of mouth referrals.

With a willing team, you can incorporate DCP into your routine for general dentistry, advanced restorative or cosmetic treatment. The total amount of time (on the high side) that you need to create a winning DCP is 35 minutes. Like anything, practice is perfect. The more you do, the more efficient your team will become. Is this worth it for a $10k, $5k or even a $2,500k case? You bet it is!

Implement DCP today. Start by taking small pieces at a time such as taking digital photographs. Then move into working on PowerPoint. Finally, add cosmetic digital imaging. Once you have those pieces in place, simply burn onto a CD. Print a label with your logo and contact information. Then adhere it to the CD. Voila! You’re done. Remember, you should invest approximately 35 minutes into each DCP.

Need help implementing DCP? Call Jameson to get it going in your practice today! You can choose from in-office implementation & training or for a smaller investment, choose a customized DCP package that includes the manual and PowerPoint template. Call us today at 877.369.5558.

Most practices can double from within! Upon careful analysis, most practices have more dentistry sitting in the charts waiting to be done than they have ever provided! Getting the dentistry out of the charts and into the mouths is critical for practice growth. In addition, it costs less to nurture an existing client than it does to access a new one. So, combine those two pieces of information. Develop a business plan that accomplishes the following: (1) doubles the practice by nurturing your own patient family, and (2) does this in a cost effective manner.

Treatment Acceptance: The Goals

Developing an effective protocol for your treatment presentations accomplishes the following goals:

• The patient outlines the goals they want to accomplish.
• Patients are educated about the need for and the benefits of the dental treatments that you are recommending.
• Patients become motivated to accept those particular recommendations.

The purpose of your program is to make it possible for a patient to say "yes" to the dental treatment you are recommending.

Everyone on the dental team has specific responsibilities. The case acceptance protocol is not just one person's responsibility. It is not the responsibility of the doctor only. Everyone is critical. Know that each person on the team has a "moment of truth", and that each person on the team can make or break a person's willingness to proceed with treatment.

The Steps of Case Presentation

Step One: Build the Relationship. Before a person will say "yes" to your recommendations, you must first build a relationship of confidence and trust. Without this level of confidence or trust, you will not get to the point at which you can provide necessary treatment. Remember that the oral cavity is an intimate zone of the human body and deserves the ultimate respect. This is why that establishment of trust is so critical.

Most of the time, the initial contact is made on the telephone. The telephone may be the single most powerful marketing tool in your practice. People calling your dental office make a subconscious decision about the dental treatment they will receive by the treatment they receive on the telephone. In fact, they often make a decision about whether they will come to you or go to someone else based on their first impression on the telephone. It is very important that the person answering the telephone be enthusiastic, warm and knowledgeable. They must concentrate when answering that telephone, and focus on the business at hand: the person on the other end of the line.

The New Patient

Upon answering the telephone, if you determine it is a new patient calling, immediately locate a new patient telephone communication slip and begin recording information about this newcomer. You begin gathering information so that you can be totally prepared for the patient's arrival and so that you will know something about them before they arrive.

Welcome Packet

Send a packet of information to this new patient before their scheduled appointment. Why? To prepare for their arrival and to get them acquainted with you and your practice. Begin the bonding process in advance. (This will offset some of those new patient broken appointments and no shows!)

In this "Welcome Packet," include your latest promotional materials, packaged with consistent branding messages that accurately reflect you and what your practice offers. Include a patient information sheet/health history form, a confirmation card for the appointment, a practice brochure or welcome letter, a patient education newsletter that's relevant for what you know about that patient and include a self-addressed, stamped envelope for them to use when returning the form.

Tell the patient that you will be sending information about the office. Ask that they complete the patient information sheet/health history, and mail it back to you in the enclosed envelope. Tell them that by returning this information prior to their appointment, you can be better prepared for their visit and will be able to seat them more quickly. Sell the benefits of this request to the patient, and they will respond positively by sending the information back to you.

By enclosing a brochure about your office-one that outlines the positive aspects of your practice-you can offset last minute "cold feet", and, in addition, you can build a person's confidence in you before they step a foot inside your door. Don't just list the services you provide. Think of the brochure as a marketing piece for and about your practice.

A patient education newsletter sets you apart from the average. It outlines the available services you offer, and it illustrates your commitment to total, long term care.

FACE-to-FACE CONTACT

Building the relationship continues as the patient is received in the office. The person greeting the patient should stop what he/she is doing, stand up, and make a conscious effort to greet the patient by name. An introduction is desirable.

For Example: "Mrs. Smith? I'm Cathy. I spoke with you on the telephone. Welcome to our practice! We're glad you are here. Thank you for returning your information to me. We have all of the necessary information, so the doctor will be right with you. Make yourself comfortable for just a moment, and I will let the team know that you are here. By the way, I notice that John Jones referred you to our practice. He's great. We really appreciate him telling you about us."

Usually the next person that a patient meets is the clinical assistant. I encourage the clinical assistant to address the person in this way:

"Mrs. Jones, I'm Jan, Dr. Jameson's clinical assistant, and I will be working with you today. You may come with me."

Then the clinical assistant escorts the person to the clinical area, or in some offices, to the consultation area. The assistant spends a few minutes in personal conversation with the patient to put them at ease. Then, she reviews the health history, making sure that it is completed, asking some pertinent questions, letting the person know that she wants to get to know them as an individual and that she notices anything about them that might affect their treatment. Tell the patient a summary of the practice philosophy, and inform the patient what treatment will be provided that day. It is very important for a person to know what is going to happen before it happens. The clinical assistant can go through the scenario of the initial examination, making sure that the person is informed and comfortable.

Upon the entrance of the doctor, the clinical assistant can introduce him or her. Apply to the dental office the same etiquette that you use in your own home:

"Mr. Smith, this is Dr. Jameson. Dr. Jameson, I'd like to introduce you to Sam Smith."

The clinical assistant should then provide the doctor with the appropriate information for him or her to comfortably begin the conversation. The referral source is a good starting point.

While the patient is still sitting up, the doctor moves his or her chair into a position that easily establishes eye contact with the patient. Following appropriate social graces, the doctor moves into Step #2 of the treatment acceptance scenario.

Step Two: Establishing the Need. Have questions listed on your patient information sheets that the patient can answer about their attitude toward their dental health or toward the appearance of their smile. Patient questionnaires or surveys can give you valuable information about your entire patient family, and, certainly, about individual concerns.

If you do ask written questions of your patients, be sure to respond to their answers. Doing so will open doors for possible treatment modalities. It will also let the patients know that you are sincerely interested in meeting their needs. Giving patients a sense of control over their own situation is critical for "empowerment". By asking questions and listening, you can gain valuable information and insight. You can gain control of a conversation by asking questions, but, at the same time, you give the patient that needed sense of control.

Opening questions that achieve this desired result include the following:

• Mr. Smith, tell me, how can I help you?"
• Mr. Smith, tell me, what are your goals for your teeth, your mouth, and your smile?"
• Mr. Smith, tell me what do you like most about your teeth. What do you like least about your teeth?"
• Mr. Smith, if there were anything you could change about your smile, what would it be?"

Once you ask a question, it is very important that you stop and listen. Reflect back to the person what you think you heard them say, ensuring that you are, indeed, hearing them clearly and accurately. Be careful not to put your own value system on them.

Once the initial interview is completed and you are clear about the patient's goals, begin the clinical examination.

The comprehensive examination becomes the worksheet for your treatment plan. At the conclusion of this initial appointment, you will have established both the patient's perceived need and the clinical need.

After the necessary data and information have been gathered and the comprehensive examination has been concluded, invite the patient back to your practice for a consultation appointment. Find out who the decision-maker of the household is, and invite this person to the consultation appointment, as well.

For Example: "Mr. Smith, I need to evaluate the information I have gathered today so that I can develop a treatment plan specifically to meet your needs. I'd like to invite you back to the practice in about a week for a consultation appointment so that we can sit down together-one on one-and discuss your particular situation along with my treatment recommendations. Is there anyone besides yourself who will be involved in making the decision to proceed with treatment? No? Then, let's go ahead and schedule a consultation appointment. Would that be acceptable to you?"

Step Three: Instill the Desire. At this stage of the process, you will educate and motivate the patient to accept the recommended treatment. As dental care providers, you are educators of dentistry. People usually don't come to the dental office with very much dental knowledge. In fact, the number one reason people don't come to the dentist or do not say "yes" to the recommended treatment is that there is no perceived need or lack of dental education. Thus, education is your biggest commission.

As educators, you must access the best methods of teaching. Approximately 83% of a person's education or learning takes place visually. Understanding that this is the main mode of learning for most people, it makes sense to access excellent visual aids to show a person the end results and the benefits of treatment that you are recommending.

You want patients to know the following things:

What they have now.

What procedures you are recommending to restore their mouth to health again or to create the beautiful smile of their dreams.

What the advantages or benefits are of proceeding with treatment.

What the disadvantages are of not proceeding with treatment.

What the financial responsibility is.

Visual aids are vital if you want to effectively communicate those messages. We use intra-oral imaging in our practice to visually educate patients. A disk recorder allows us to store images of other cases or situations that are similar. However, before and after photo albums, slide presentations, books and brochures can also be effective if used properly.

At your initial interview, you established the person's emotional "hot button", or main motivator: (1) appearance, (2) comfort, (3) function, (4) keeping the teeth for a lifetime, (5) time or (6) money. Knowing this vital piece of information allows you to gear your presentation toward the patient's perceived need.

A person will buy what they want long before they will buy what they need. So, get on their side. You will get a great deal further with treatment acceptance if both you and the patient are after the same thing. People want to know, "How is this going to affect me? What is in this for me? How is this going to affect my health, my looks, my pocketbook or my schedule?" Determine their main motivator. Direct your comments and your presentation toward that motivator.

For Example: During the initial examination, you have asked the question: "Mr. Smith, tell me, if there were anything that you could change about your smile, what would that be?"

Patient: "Well, I just hate my teeth. They have stains all over them, and I'm embarrassed to open my mouth. I usually just cover my mouth when I smile or laugh, and I am really ready to change that."

Doctor: "So you are uncomfortable with the discoloration of your teeth, and you are interested in getting a whiter, brighter smile. Is that right?"

Patient: "YES!"

You know that this person's main motivational factor is appearance. When he comes back to the office for consultation, have your visual aids: appropriate books, brochures or images on your intra-oral imager readily available. Your presentation should be simple, direct and geared toward the answering of that patient's "perceived need".

FOR EXAMPLE:

Doctor:"Mr. Smith, last week when you were here for your initial examination, you indicated a concern about the color of your teeth. Let me show you an image of a person who had a situation similar to yours. He had stained teeth also. Can you see the similarity?"

Patient: "Yes."

Doctor:"Once he completed his treatment he looked like this. (switch to the after) What do you think?"

Patient: "That's great."

Doctor:"Well, Mr. Smith, I feel comfortable in telling you that once we complete your treatment that your smile will look similar to this. Would this be something that would be of interest to you?"

And he will probably say "yes". Then, go into some detail about the treatment recommendation, but don't go into incredible detail on the technique itself. Often times we, as dental professionals, get so involved with the technique that we totally lose the patients. We forget that they haven't had as much dental experience as we have. We confuse them, and a confused person can not make a decision. Keep the technical aspects simple. Let the person know what the end results and the benefits are going to be. That is really what matters to them.

After you have completed explaining your treatment recommendations and after you have shown him the end results and benefits of the treatment, then go to Step Four.

STEP Four is ASKING FOR THE COMMITMENT. Dental teams often times fall short here. We are a little bit uncomfortable asking for a commitment -- or "CLOSING"!!! Get comfortable with this aspect of case presentation by practicing or role playing various situations as a team. Unless you ask for a commitment, you will have a lot of people walking out the door not knowing if they are going ahead with treatment or not. So it is appropriate to ask for a commitment from the patient.

FOR EXAMPLE:

Doctor: "Mr. Smith, have I explained the treatment so that you are comfortable with my explanation?"

Patient: "Yes, I'm clear on what needs to be done."

Doctor: "Then do you have any further questions?"

Patient: "Well, no I guess not."

Doctor: "Then is there any reason why we shouldn't go ahead and schedule an appointment to begin your treatment?"

Patient: "I see no problems. Let's go ahead."

Doctor: "Okay, then I am going to have Pam, my treatment coordinator, discuss the financial responsibilities, and then she will schedule your first appointment. I will look forward to working with you."

By asking the question "is there any reason why we shouldn't go ahead and schedule an appointment to begin your treatment?", you are trying to discern any barriers to treatment acceptance. A good management principle is this, "A problem is only a problem until it becomes defined. Once it becomes defined it becomes manageable". Unless you find out what the barriers to treatment acceptance are, you don't have a chance to clear the way. Find out what is getting in the way of a person saying "yes" to treatment. Then, you have an opportunity to do something about it. You may or may not be able to clear the way, but at least you have a chance to defuse the barrier. The only way to define the barriers to acceptance is to ask questions.

Once the closing question has been asked and, if there are no more clinical questions, the doctor excuses him or herself and the treatment coordinator or business manager takes over.

The business manager makes FINANCIAL ARRANGEMENTS, STEP Five and then SCHEDULES THE APPOINTMENT, STEP Six. There is no exception to this order. Financial arrangements always precede the scheduling of an appointment.

SPECIAL NOTE: In our own practice, our treatment coordinator joins the doctor while he is planning and presenting the case. She is then able to give necessary back up support for the doctor and is able to answer questions that the patient may ask her but doesn't feel comfortable asking the doctor. She is clear about the financial responsibilities and is prepared to discuss appropriate financial options with the patient prior to the scheduling of the first appointment.

Careful planning by all team members prior to the consultation moves us toward greater case acceptance.

IN SUMMARY

So, there are the Six Steps of case presentation/treatment acceptance:

Build the relationship

Establish the need

Instill the desire

Ask for a commitment

Make financial arrangements

Schedule an appointment

Follow this proven six step process and you will find that your acceptance rate will increase. The key to this is building the relationship, helping the person feel involved in the decision making process.

"Tell me and I will forget. Show me and I might remember. Involve me and I will understand."

Involve a person in case presentation by asking questions and finding out what he/she wants or needs and by responding to those wants and needs. Use visual aids to more successfully educate. Ask for the commitment. Ask questions to find out what the barriers to acceptance might be. The patient has a chance to tell you barriers that are getting in the way. You have a chance to clear them.

This method of case presentation is a two way communication between you, the providers, and the patient. Both parties benefit -- the patient receives wanted and needed dental treatment, and your team gets the opportunity to perform great dentistry. Everyone wins! That's DENTAL TEAMWORK!!

1. Technology (obviously!)

Many of Jameson coaches remember our early days of computerizing practices. We would take the pegboards and appointment books out of the office. They couldn't stand to give up their ledgers. We had to set a date to take their paper away and help them go live with their computerized system.

My husband, Dr. John H. Jameson, was such an early proponent of technology. He was the fourth United States dentist to have a digital radiography unit! It had just been approved by the FDA after it had come to the U.S. from France. We had intraoral cameras in the 80s when they first came out. So, we were on the leading edge of technology in our practice, but we have seen this huge advancement in technology continue throughout the industry.

Now more dentists have digital radiography and are fully computerized than ever before. We computerized John's practice in 1982. In 1990, there approximately 10-15% of dentists who were computerized. Now the question is "which software system are you on?" - not "do you have a computer?"

The integration of technology and how that interacts with every patient from intraoral camera, lasers and beyond - these were not the big practice management issues in 1990. The few people who had that mentality were the exception to the rule. From CAD CAM to lasers to hand pieces, dentistry is now in a realm almost unimaginable 20 years ago. Clearly, technology is a very different aspect of dentistry today than 20 years ago.

Clinical work stations - terminals at the chair with a monitor for patient education and another for patient entry - are still evolving into the practices but they're becoming much more commonplace than rare. John had terminals at the chair 10-15 years ago but most dentists did not yet have clinical work stations. I'm sure we'll see a lot more of that - it's not going to just be computers at the business office. That's happening at a fast rate right now.

2. Marketing

In 1970, it was just becoming legal to market the practice at all. There were days when you couldn't even do a newsletter. Now, dentists are able to educate their communities and help people understand the value of dental care through various marketing strategies. So, people are looking at marketing their practice in a different way than prior generations who felt that promoting the practice was shameful, wrong or even illegal. Now, it's just a requirement to have a strong practice and help patients get what they need.

What started as newsletters or ads in a telephone directory grew to local sports sponsorships and speaking engagements. Then other ads, bolder signage and direct mail campaigns full of incentives and direct calls to action became the norm. Now the digital age dominates marketing budgets through enhanced Web sites, email newsletters and social media campaigns. Marketing not only landed on the map but has accelerated into the industry quite rapidly.

3. Financial arrangements

Gone are the days when dentists believe they have to carry accounts on their own books, striking a comfortable financial arrangement with every member of their community. Now practices have business-like procedures for a few well defined options and then engage with patient financing partners who can help patients proceed with the treatment they want and need.

In 1983, John and I were the 18th practice in the world to have patient financing in the practice. It was a third party financier called DentaMed. That's actually how I started my dental coaching life outside of working in John's practice - by teaching people how to computerize their practice, coaching and training people on how to use this patient financing we'd discovered. The very first program was a tough sell because doctors couldn't imagine having their patients finance their dentistry outside the practice. There were many pioneers of this evolution and we'd like to consider ourselves part of that moment. We found it made a huge difference in our practice during the oil crisis of the 1980s. We started using the program the day we signed up and we never looked back. It became a huge basis of the beginning of Jameson, foundational content for the Collect What You Produce book that followed and beyond.

Throughout the 1990s when I used to ask people in audiences how many were using patient financing, I'd see no hands raise or a few hands raise. Over the years, I've seen more and more hands raise and I know more practices are using patient financing than ever before. In fact, there are now about 16 active patient financing programs in the market so millions of patients are receiving care that couldn't otherwise do so. Practices are more productive because they're able to do the kind of dentistry they want to do/believe in doing. That's what I've been saying about patient financing since I first heard of it. It opens doors - big time - and it's opened a whole new dimension of dentistry.

4. Gender

There is a clear rise in the number of female dentists today, as compared to 20 years ago. I believe this started changing in the 1970s when schools were mandated to integrate more minorities into the classroom. Females being considered a minority in dentistry at the time, the dental schools started graduating an occasional woman dentist. Now, 50% of graduates are female. In my opinion, it's been delightful to see women dentists become a major part of the industry. I think the industry has a long way to go in terms of seeing women dentists in clinical lecturing and other leadership roles, but am proud to see so many strong men AND women making a difference in the lives of their patients and in the lives of one another. The "glass ceiling" is lifting.

5. Consultants

In the early 1990s, there weren't that many people who'd heard of dental consultants. There were firms that were doing great things and individual coaches who were stirring positive results in certain regions, but most practices didn't have a partnership with a coach. That's really changing. Dentists are parallel with many industries across the nation who are incorporating coaches into their lives to help with clinical, financing, technology, management, legal, human resources, communication and countless other niche needs. They're seeing that they can't be all things to all people and they're reaching out to those they believe can be an asset to the practice. That's been a healthy development. I believe in coaches not only because I am one, but because I know I need them. At Jameson, we regularly seek advice on issues and help our executives and coaches continue to learn and grow. It makes all the difference. Dentists aren't the only ones accepting the fact that coaches count.

6. Continuing education

Dental CE has always been an interest, but it's changed over the years in terms of method. Historically people would go to local study clubs and dental meetings. Over time, larger meetings have grown. People started traveling more to go to courses. People have embraced the idea that dentistry is complex so they're more willing to go to long-term, in-depth, hands-on training and education. While that's been around for decades, it's increasing.

There's so much to learn and it's impossible to learn it in four years. While in-depth, longer, multiple level hands-on courses will always need to be part of the dental CE picture, the change that's happening now and will continue to happen in ways we can't even foresee at this point is the digital world of webinars and podcasts. No, this isn't necessarily new in concept but it's just catching on more quickly now than ever. In 1990 I was doing a newsletter where people were reading the newsletter and completing a test to get CE, so the concept of distance learning or on-your-own learning is not new. However, over the last decades, people are accessing training at any time on any day. The industry is recognizing that online training is important as we bridge generational gaps and keep opportunity for enhancement within reach of any dental professional. Digital and distance learning is here.

7. Implant & Cosmetic Dentistry

Two areas that have blossomed in the last two decades are implant and cosmetic dentistry. There's always been dentistry that's aesthetic. All dentistry should be aesthetic. My first lecture was in 1987 alongside two dentists talking about composite veneers. The world of porcelain laminate veneers was starting. We created a video on marketing cosmetic dentistry in 1990. However, the whole world of adding a cosmetic dimension to a practice has skyrocketed. From internet searches bridging the patient education gap to popular main stream television shows highlighting various options, cosmetic dentistry is booming.

The techniques and materials have changed. The educational curriculum has changed. The schools are updating themselves. Many aren't teaching anything cosmetic until graduate or resident programs. Some are ahead of others, but the whole world is revolutionizing at its own rate.

Implants still have a long way to go. Many young doctors aren't as afraid of implants as doctors may have been in the past. For example, at the Oklahoma University Dental School, implants are a huge part of the AEGD program so those students come out ready and prepared. There's still a world crying out trying to learn how to do it. Baby boomers want to look good and be healthy as long as possible. Patients are well educated enough to know that a positive appearance plays a huge role in health and well being. Conservative, long lasting restorations that look good are desirable.

Now that curriculum is changing, dentists are more knowledgeable and confident right out of school, so I believe with less fear of implant and cosmetic dentistry coupled with the continued evolution of training, we'll see more of this type of dentistry in the future.

8. Managed care

In the 1990s, managed care programs took a huge surge. It was a subject of every convention and among most dentists. "What happens if I don't take this insurance and the major company in my town is on it" vs. "If I compromise my fees as a business person, can I afford to do that?" These thoughts were pressing, so managed care became pretty huge, albeit in some parts of the countries more so than others.

Managed care overtook medicine. Dentistry stood up and stayed fee-for-service more so than other medical fields. Managed care hasn't been consuming to most practices. Learning how to manage the managed care has been possible and accomplished by many.

9. Leadership

Over the last two decades, I'm seeing more of a change in management style from old-school hierarchical mentality to leaders making a more concerted effort to be horizontal, engaging and communicative in their management. Situations where the doctor is dictating down to the rest of the team and everyone bowing to that, having no say and being almost in a subservient role - rare today. People in the workplace today won't tolerate that. If they're not fulfilled, then they'll simply move on to the next best job. The millennial and the gen-x generations don't stick around without engaging challenges and appreciation. Good leaders are finding that practices must include a healthier management style where individuals are respected and listened to; where creativity is encouraged and valued; where the team is respected and the practice is thriving.

Hygienists are trained with finite, valuable skills in the dental industry, but we see many going into pharmaceutical sales. Clinical assistants are moving over to medicine. Business team members hone people skills or organization - they pick up and go elsewhere, too, if their practice or the dental industry norm is not meeting their expectation. Ninety percent of the management principles are the same in any industry. It's the last 10% where we customize for a particular genre.

Select people who are a good fit with your team and then enable them to be productive. The impact of training on transformational leadership makes a profound difference in the productivity of the dental practice.

10. Group

There are some group and corporate dental organizations these days with really awesome people involved. I think we're going to see more of that evolving. There are some generational mentalities coming into the work force today including many young doctors who don't want to go out and start a practice or even buy into a practice. So they're going in as an employee of a practice where they show up, do good dentistry and someone else is managing the personnel, cutting the checks, making it all flow, etc. They don't have to run the business.

Michael Gerber wrote the book 'E-myth'. He explains that, often a specialist - like a dentist - runs a business but doesn't khave that type of education so they get themselves into a bind. Gerber says we need to get a proforma: start a business, get it running well, have it running exquisitely and then pick it up and place it someplace new. That's what the group practices do. They need to follow the E-Myth/Gerber strategy. Get the systems and structures working well - then pick it up and mirror that elsewhere. I believe this will be a growing part of what we will continue to see.

Predictions for the future

Besides the unavoidable predictions within my reminiscing, I'd say the future prediction summarizes into two issues and four words: (1) generational shift and (2) healthcare reform.

Traditionalists born before 1945 are mostly retired. The baby boomers are now starting to retire, while others will be working longer than we thought due to economic shifts, etc. Many are still in the prime of the practice, which is not surprising since there are some 78 million baby boomers living today. Many doctors over the age of 55 have already included an associate in the practice or are moving into a partnership for sale (or they will in the near future).

Dental professionals need to be aware of the generational differences. I believe this is going to be crucial to the future of our industry. So, I encourage doctors of all generations to learn about the generations and communicate responsibly. It's everyone's responsibility. Baby boomers started these practices from scratch, built them up, earned a reputation, wrote manuals, carved out systems. Millennials are wise to respect that and meet them where they are, doing well but appreciating what they've been given if they have an opportunity to buy or join such an affiliation.

All of this is happening amidst national healthcare reform. None of us know what it's going to look like; most say they can't figure it out or agree; most don't feel confident saying how it is going to affect dentistry. We'll have blog postings to help people sort through the confusion if possible, but I'm hopeful that the doors are opening for some bipartisan discussion and a strong enough presence from the medical and dental world among the legislators to help us make this right. We have the finest healthcare program in the world and I hope it's handled with care as it alters.