The opportunity for dentists to succeed has never been greater. However, according to the ADA Health Policy Institute, general dentist income has declined by approximately 17% over the past several years. Moreover, Levin Group Annual Practice Surveys corroborate this trend. As a result, dentists must evaluate how they will compensate for today’s challenges while recognizing that there are still many opportunities to increase practice income.
The current state of dentistry
Dr. Roger P. Levin.
The number of patient visits to dental practices has declined since 2018. Contributing factors include patients falling out of regular hygiene cycles due to the pandemic, national inflation, increased competition (such as dental service organizations), and rising staffing costs that have led to higher fees. These pressures have negatively affected practice income and, by extension, doctor income.
The good news is that nearly any dental practice has a 50% opportunity to increase production, which directly increases income.
Staffing challenges
Dental practices continue to experience a staffing crisis. During the pandemic, the dental industry saw significant losses in the following key roles:
- Dental hygienists. Many hygienists left the profession, and practices have struggled to recover due to lengthy education and licensing requirements. Levin Group estimates that reaching full hygiene capacity under current licensing regulations could take at least 10 years. While some states are exploring shorter educational pathways with modified regulations, meaningful change has not yet occurred.
- Dental assistants. The industry experienced an approximate 6% decline in dental assistants, though this has improved in recent years. Today’s challenge is that assistants must master increasingly complex technologies, setups, and clinical participation. As a result, it is more difficult to hire inexperienced individuals and train them quickly.
- Front-desk staff. While no definitive data exist, we believe there has been some loss of front-desk personnel. Unlike hygienists and assistants, there is a larger pool of candidates who can be trained for these roles. However, many prefer remote work. Technological advancements are beginning to replace certain front-desk functions, and this trend is expected to accelerate over the next few years.
Increased competition
Competition in dentistry continues to grow. It began with external marketing in the 1980s and has expanded steadily since then. Today, competition increasingly comes from new service delivery models such as DSOs, dentists who own multiple practices, and offices that accept all available insurance plans.
Competition is a normal part of business, but preparation is essential. Practices must implement strong patient-retention systems to maintain a higher percentage of existing patients while continuing to add new ones.
Insurance pressures
Dental insurance reimbursements are generally not increasing. While no comprehensive national data exist, Levin Group’s experience representing clients with hundreds of insurance plans shows that most insurers are holding reimbursements flat, and some are reducing them.
Each year, reimbursements fail to rise, and inflation erodes profitability. Over time, inflation steadily diminishes any fee structure that does not increase at the same pace.
How to improve practice performance
Despite these challenges, significant opportunities exist for practices to improve performance and income. Consider the following strategies:
- Effective scheduling. No dentist wants to hear that maintaining income may require seeing more patients, but it is often necessary. The key is achieving higher volume through efficiency so the team does not feel fatigued, rushed, or stressed. In fact, many practices report smoother, more controlled days once effective systems are implemented at higher volume.
- Procedural time studies. Most providers can save at least 10 minutes per hour by conducting procedural time studies, which is typically the first step in management consulting. These studies often reveal that less time is needed for many procedures, allowing schedules to be adjusted accordingly. When combined with appropriate delegation, team training, and improved patient flow, practices can significantly increase production and income.
- Team training. Team members should be trained to work independently, with a highly skilled office manager acting as the practice’s chief operating officer. This requires comprehensive training so every team member understands their responsibilities and performance expectations. Training should be positive, motivating, and ongoing. One simple measure of effectiveness is how often team members need to interrupt the dentist with questions during the day. Dentists should remain focused on patient care while the team and office manager handle administrative operations.
- Strong systems. Strong systems play a critical role in increasing production and income. These include scheduling new patients promptly, scheduling to daily production goals, reducing no-shows and last-minute cancellations, and improving case acceptance. Each of these areas can significantly enhance practice performance.
- New technologies. Emerging technologies, such as AI for diagnostics and insurance processing, can greatly improve efficiency and effectiveness. When implemented with a well-trained team and strong foundational systems, these technologies increase speed, accuracy, and productivity, helping practices overcome many of today’s challenges.
The state of dentistry is fundamentally strong, but like any industry, it faces real challenges that affect income and performance. Success requires operating a dental practice as a well-run business while continuing to deliver excellence in clinical care. With the right strategies, systems, and training, nearly any dental practice has the opportunity to grow by 50% or more within just a few years.
Dr. Roger P. Levin is CEO of Levin Group, a leading practice management and marketing consulting firm. To contact him or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit LevinGroup.com or email [email protected].
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
