Introduction

Managing the Patient-Centered Practice

In our fast-paced, high-tech world where information by the gigabyte, rapid communication, and mass marketing of the latest dental technology du jour all clamor for our attention and resources, it is easy to lose sight of the real reason we went into dentistry -- to care for and interact with people. The patient is the common thread that binds all aspects of our profession, from research and education, to our professional organizations, to the individual dentists who deliver care on a daily basis. While the notion of a "patient-centered" practice is undoubtedly appealing to all dentists, it can be challenging to maintain that focus in today’s environment. We are all too aware of the numerous forces that conspire to divert the dentist’s focus from placing the well-being of the patient above all else. Mastering the art of practice management can allow us to rise above these challenges and place the patient first again.

There are two important benefits of implementing sound practice-management principles that create a patient-centered atmosphere. One is the personal satisfaction achieved by the dentist, and the other is the delivery of the highest quality care from individual dentists and the profession as a whole. These benefits are, of course, intimately woven together. For many of us, satisfying ourselves in our dental practice means satisfying our patients and delivering care to the best of our ability. Both of these goals can be met by providing dentistry that looks good, feels good to the patient, and lasts a long time. This type of dentistry comes at a high price. It cannot be rushed, nor can corners be cut to achieve it. Fundamental practice management skills allow the dentist to secure the time and resources necessary to provide dentistry at such a high level.

In addition to personal satisfaction, dentists want to see a high level of quality maintained in our profession. Preserving the standard of care is a fight that demands countless hours of volunteer effort from some of the brightest minds in the dental profession. As the backbone of the profession and the group directly responsible for delivering patient care, full-time practicing dentists must do their part. They must not compromise quality in favor of a quick and easy way to earn a desirable income. At no other time in the profession has this been more difficult than right now. For proof, one need look no further than recent dental school graduates. Dental educational debt has approached and, for some, crossed the $200,000 barrier. Quality associate positions, which provide adequate income and sound professional mentorship to new dentists, are scarce. In spite of cost-of-living increases, salaries for beginning associates have not risen appreciably in the past 20 years. Young dentists feel this pressure and many are forced to take jobs where they must compromise quality to put food on the table and pay the bills. It is a problem that cannot continue. Practice management skills are a way for both young and experienced dentists to find the skills and confidence they need to practice dentistry at the highest level of clinical and ethical standards. Just like placing a composite or fabricating a fixed partial denture, practice management is a series of steps and skills that must be learned and sharpened through education and experience.

I would like to point out some of the challenges faced in presenting the topic of practice management in a scientific, peer-reviewed publication such as Journal of the California Dental Association. Because dentistry is a profession grounded in science, most new information in the discipline is obtained through research using principles based on the scientific method. This, of course, lends validity to the conclusions that are drawn. On the contrary, most practice management principles are an amalgamation of knowledge based on communication with dentists, their staffs, and other professionals experienced in the business of dentistry. Practice management experts distill this information from their experience working directly with practices to provide dentists with current management techniques they can apply. The result is highly individualized philosophies, all of which may allow dentists to arrive at the desired result in their individual practices. Whereas opinions are discouraged on the scientific side of dentistry, they are encouraged and, in fact, embraced within the area of practice management. These opinions are what lead to progress and better ways of managing the dental practice.

Because the changes in the evolving dental care marketplace are dynamic and rapid, it is not always possible to validate the experience of experts in the field of dental management with studies in the literature. While opinion may be suspect in scientific matters, when carefully considered, it may prove useful to the serious student of practice management.

With this in mind, the mission for this issue of CDA Journal is to raise the reader’s knowledge and skill level in managing a practice that is truly patient-centered.

We are fortunate to have some of the foremost authorities on practice management contribute to this issue. Linda Miles, CSP, CMC, has written an introduction on fundamental characteristics of the patient-centered practice. She has gained extensive experience working with numerous dental practices throughout the country and is currently contributing her expertise to the Practice Management Department at Harvard School of Dental Medicine. I am honored to have Roger Levin, DDS, give us his insight into business systems in the dental office and how to successfully manage them. Dr. Levin is founder of The Levin Group and many readers will no doubt recognize his contributions as a leading authority in the field of dental practice management. At the core of every successful practice is a talented, well-functioning team, so for an informative article on the development of the dental team, I went straight to Andrea Clasen. With 33 years of experience in dentistry, her insight should prove most valuable to those dentists seeking to take their practices to the highest level of success. Because the hygiene department is so critical to comprehensive patient care, I sought out one of the leading authorities in hygiene management, Peggy Sprague, RDH. She is co-founder of JP Consultants Institute and has worked with more than 1,000 dental practices in establishing state-of-the-art soft tissue management programs. Finally, we want to know where dentistry is today and where it is going as we charge into the new century. When it comes to the current and future state of practice management, the person with his finger on the pulse of the profession is William Blatchford, DDS, and we are pleased to include his commentary.

John Cotton Dana said, "Who dares to teach must never cease to learn." All of our authors are great teachers because they are also eternal students of practice management. May you and your patients benefit from the wisdom of our panel of experts.

Contributing Editor

Steven A. Gold, DDS, is the editor of the WestViews, the newsletter of the Western Los Angeles Dental Society. He is in private practice in Santa Monica, Calif.