I recently read an email from the Ontario Dental Association that shared that a proposal from the Ontario government includes a public consultation on expanding the scope of practice of denturists and hygienists. That expanded scope includes the ordering of radiographs and administration of local anesthetic for hygienists, and for denturists it includes taking radiographs.
It can feel like we are in a race to the bottom with corners always being cut: There is a saturation of dentists, patient demands are increasing, the cost to providing care is up, the challenges with staffing still lack sustainable solutions, and margins keep shrinking (profit margins, not restorative ones), and our scope of practice is threatened with dilution.
A few years ago my wife and I saw Jerry Seinfeld perform. I recall him saying, “Marriage is like a game of chess where the board is made of water and the pieces are made of smoke”. That’s how it can feel to run a business in healthcare these days, particularly in dentistry.
The million dollar question is, “What needs to happen for you not to be in that race to the bottom?”
My son is studying evolution in biology right now. He is fascinated by the studies and observations Darwin made on the Galapagos associated with finches. In times of drought, finches with deeper, larger beaks survived with their ability to crack open seeds while those with unfavorable phenotypes in this regard, perished.
When it comes to the environmental pressures imposed upon dentistry, how can one ensure they are on the winning side in the survival of the fittest?
Some ideas include,
- Niche your practice. Creating a unique value proposition in a saturated market makes for a different patient experience that doesn’t have to compete, but instead markets with a story targeting unique patients you like to work with.
- Be efficient. Two and three operatory facilities can be remarkably efficient in the current climate. If you’re thinking of buying or building and being a hands on owner, the small, lean practices can be real powerhouses today that can weather these storms well.
- Maximize your capacity. Never has downtime mattered more. Evening hours, weekend hours and revenue per square foot analyses are crucial parts of your business strategy.
- Increase the provision of services in house with in house specialists.
- Consolidate your practice with other practices as a cost share arrangement. Consolidating the non-revenue generating parts of your practice (reception and waiting areas, steri-centres, panorex bays, and administrative offices, along with team members that can be shared) offer efficiency without partnership.
- Further on the theme of consolidation, when it comes to selling, consider the combination of your practice with others ready to sell to increase the EBITDA of the combined entity. Leveraging other practices in a consolidated sale model can offer benefit based on higher multiples associated with higher total earnings.
- When it comes to sale, minority partnerships with a clear delineation of roles and expectations offer some owners a staged exit reduction in management responsibilities with the RIGHT FIT.
These are not exhaustive ideas and some won’t align or apply to you, but hopefully it gets the wheels turning.
If they’re turning but not producing solutions, let’s connect to devise a strategy that keeps you on the right side of dentistry’s evolution.
