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January 26, 2015

Stop With the Gloom and Doom

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 12:33 am

I don’t know about you, but I am getting so sick and tired of everything I’m reading about the imminent demise of dentistry as we know it. Corporate dental practices will be expanding into your neighborhood and will be stealing all of your patients. Your overhead is increasing because of higher technology costs and the steady upward pressure on staff wages and benefits. Then add to that the newer costs associated with the compliance to government mandates. We all know that dental insurance plans are continuing to aggressively deny treatment while at the same time decreasing benefits to pay for treatment. And how about your future–the huge debt load of recent dental school graduates is making it challenging for them to buy a dental practice.

The list goes on and on. My philosophy, however, has always been that it is wasted energy and totally unproductive to ever worry about what you can’t control. And in this instance, you shouldn’t either. The above list of problems is to some extent all true, and won’t be going away anytime soon. Here are my thoughts, suggestions, and solutions.

1. There will always be a place in every community for a well-managed, clinically excellent general practice, delivering exquisite customer service. This practice should include itinerant specialists to provide the opportunity for in-house referrals thereby offering easy one-stop shopping to your patients and increased revenue. I guarantee that such a practice will provide levels of care that cannot be approached or duplicated by corporate dentistry. A good proportion of dentists working in corporate dental settings have minimum experience, under developed diagnostic skills, and limited communication skills. Not where I would want to be treated.

2. You don’t want to be–and physically can’t be–all things to all people. Pick your niche–whether that be Ritz-Carlton or Motel Six. Just be terrific at what you do and you will continue to separate yourself from your competition. But whatever model you pursue, you absolutely need room to expand. In my experience, the greatest impediment to the growth and success of a practice is the lack of a proper facility.

3. New technology is expensive, but the return on investment, and the marketing WOW that it creates, will ultimately work in your favor.

4. Dentists must realize that staff costs, which are the biggest expense in any practice, have to be controlled. I am a strong believer in paying a fair and representative hourly wage and supplementing that wage with bonuses and incentives that are tied to increased practice revenue. I strongly believe that the dentists’ share of health insurance benefits must be capped. I just finished a very interesting book on controlling health care coststhat is a must read for every small business owner.

5. We fight with dental insurance companies every day. The message must be sent to your patients that dental insurance is merely a stipend. If you continue to belong to the “one crown every year” club, and let insurance companies dictate your treatment, then you indeed will be suffering and going in the wrong direction. If you can learn to effectively present comprehensive and elective dentistry, then welcome the fact that insurance is useful for getting patients in your door.

6. Nobody to buy your practice? I simply don’t find this to be true. I believe that we are still very much in a sellers market with more doctors looking to buy than looking to sell. Yes–recent graduates often have high debt loads. But I have helped countless young dentists with two or three years of associate experience and with education debt of 250K or more, obtain 100% bank financing on just their signature provided the collections of the practice they are buying supports the practice valuation.

In 2014, I worked as a consultant with 36 separate dental practices. Some were new relationships, but mostly were existing relationships. 25 of the 36 practices increased revenue and profitability in 2014 compared to 2013. Seven practices stayed constant, and four were slightly lower. I quote these numbers not to brag, but merely as proof of what I see on a daily basis. The sky is not falling!

If you work hard, pay attention to details, and continuously deliver a quality product and strive for always improving ways to maintain excellence, your future is bright. Nobody ever said this was easy. Every business has its own set of challenges. Dentistry is no different. So please stop listening to the gloom and doom predictions. These people are only trying to sell you something you probably don’t need to buy!


January 14, 2015

Another Compliance Issue to Consider

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 9:52 pm

Screen shot 2015-01-14 at 10.23.45 AMThe beat goes on and the costs keep going up for dental providers. Costs in terms of time as well as money. OSHA training and recertification needs to happen every 18 months at an approximate cost of $900. HIPAA Compliance programs average $2500 to initiate and complete and around $1500-$2000 annually to stay current. And now, there is another cumbersome requirement that needs your attention.

By June 1, 2015, dentists who treat Medicare beneficiaries (any patient 65 or older) need to be enrolled with Medicare so that these patients can be reimbursed for their prescriptions that you write for them with Part D drug plans. You can’t just ignore this requirement. The law says you must make a choice and either opt in or opt out. And whatever choice you make is binding for two years.

There are two kinds of enrollment. Most of you should enroll strictly for the purpose of prescribing and referring. If, however, you treat obstructive sleep apnea and want Medicare to cover the cost of oral appliances, then you should consider enrolling as a billing provider for Medicare Part B.

Of course, anytime you are dealing with the Federal government, they don’t make things easy. The application process for something so essentially simple turns out to be extremely confusing, illogical, and cumbersome.You could try to do this yourself, but I think you’ll be opening a bottomless can of worms. Instead, I would suggest calling David Wester. He is the Director of Medicare Enrollment at StatDDS.  His direct line is 800-693-9076. StatDDS will simplify the process by gathering all of the pertinent information about your practice, fill out all of the paperwork, file all relevant material with insurance carriers, and keep up with the status of the application. The company charges a one time fee of $697.

I am strongly advising my clients to opt in. Patients over age 65 are an important demographic. Their dental needs are often extensive, they do lots more elective procedures, and they are usually more financially secure. I would not want any one of these people leaving my practice – and telling their friends – because they couldn’t get their Medicare prescriptions filled. No question that this new requirement by the government is another irritant and a big nuisance. But don’t be penny wise and pound foolish and try to enroll on your own. Take care of this today.


December 30, 2014

The Year is Changing – Will You?

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 9:32 pm

Screen Shot 2014-12-29 at 8.50.42 PMAnother year is about to wind down. 2014 is a few days away from being history. Hopefully it was a good one for you and your dental practice. If it wasn’t, what do you plan to do about it? This is the time of year for making resolutions–promising ourselves that we will in fact have the strength, the willpower, and perhaps the courage to make positive changes.

My job as a coach and advisor to dentists is to strategize with them about their practice and support and facilitate the changes we have  identified. These changes are critical and necessary to help them fulfill resolutions made with the greatest of intent. Two years ago, I offered comments on this very topic. One year ago,  I began a 10 part series of posts where I identified the reasons–in my experience–that separated eminently successful dentists from the majority of their peers. All of those posts are archived on the Blog Page of my website.

So here we are again. A fresh start awaits you. But as I have said so often and truly believe, “Hope and prayer is not a strategy”.  One of my most influential mentors and motivators is Seth Godin. Earlier this month, he penned the most prophetic statement: “If you hesitate to map out your future, to make a big plan or to set a goal, you’ve just gone ahead and mapped your future anyway.” That is flat out brilliant!

Change is hard and change is rarely easy to accomplish. John Wooden, the legendary basketball coach of UCLA, whose teams amazingly won 10 NCAA championships between 1964 and 1975, realized the difficulty of change. When asked the reason for his success, he said it was his ability to get his players to do what they didn’t want to do in order to get the results they wanted.

I would imagine that all of you desire to improve. So my message today is not a sermon or a lecture, but rather a gentle reminder and a challenge to actually make that plan to reach the potential you deserve and of which you are capable. Every one of us can identify three or four areas where we can improve. Take the time–it may take hours or it may take days–but force yourself to sit down and write down your goals. That often is the most difficult part – identifying the goals. But once the goals have been articulated, figuring out how to reach them  becomes infinitely easier.

Good luck! I wish all of my loyal readers a healthy and happy and prosperous New Year.


December 15, 2014

Instant Gratification

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 9:24 am

Those of you who read my blog posts know that I am a big fan of using the iPad as an extremely effective tool for presenting dentistry to your patients. A few weeks ago, I suggested downloading the DDS GP app to your iPad in order to take advantage of the beautifully designed drawings and graphics that illustrate dental problems and the solutions to those problems.

Another great enhancement for your iPad is Shuttersnitch. Shuttersnitch is an app (the cost is a mere $19.99) that receives and displays pictures wirelessly on an iPad moments after they are shot. Instead of taking digital photos and then plugging the memory card into a laptop in order to upload the photos, there now is a much simpler and less cumbersome way to accomplish the task.

As long as you are using a digital SLR wi-fi enabled camera to take your photos, Shuttersnitch is the perfect partner for the wireless image transfer system in your camera. It takes in the photos and almost instantly displays them on the iPad’s 9.7 inch screen. Shuttersnitch has specific support of wireless SD memory cards from Eye-Fi, but can also accept pictures from any camera transmitter that is capable of an FTP transfer. Shuttersnitch provides a detailed set up guide, and I am told that you don’t have to be a computer whiz to figure this all out.

I firmly believe that high tech equals high reward. Once you take the time to get comfortable with the mechanics, your case acceptance should skyrocket.


December 1, 2014

A Must for Every Dental Practice

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 8:20 pm

Screen shot 2014-11-26 at 4.24.10 PMI have long been an advocate of the iPad as the principal and most effective way for a dentist to present dental treatment to a patient. The intimacy of sitting right next to your patient, the phenomenal vibrancy of the photos or images,  the ability to manipulate these images – allowing the patient to touch the screen – these are all great advantages compared to showing X-rays or drawing squiggly lines on bracket table covers.  Or what I really hate is having a patient sit alone in a room watching  a video with voice over.

That is why I am so excited about DDS GP. It is an app that you can download to your iPad. It was invented by Dr. Robert Marcus, a practicing California general dentist. DDS GP is presented as a series of beautifully designed drawings or graphics that illustrate dental problems and the solutions to those problems. The library of drawings is very complete,  literally everything you could ever imagine.

The dentist sits with the patient and has a personal conversation – your words at your pace. Just below the main demonstration area of each screen is a bar with a round handle called the slider. Moving the slider portrays the increasing severity of a condition or the treatment steps to resolve the problem. I especially like the presentations for a fractured tooth and for cracked tooth syndrome. The app also does a great job illustrating periodontal disease and root canal treatment.

I don’t think the graphics and drawings are especially effective for presenting cosmetic dentistry. For that, you absolutely want to have the before and after photos of your nice cases downloaded into the iPad. You can also easily import the digital photographs of your patient’s smile. The DDS GP app allows you to add these photos. Coordinating all of this information  into one tablet will, in my opinion, definitely lead to greater case acceptance.

A very cool feature is the ability to incorporate the drawings you showed to the patient into a custom designed treatment plan that can be handed or e-mailed to a patient.

The technology is very intuitive and easy to learn. You can even draw with your finger right over the graphics if you feel that it will help illustrate a point you are trying to make. I have been told that the app is continuously being improved and updated and that the customer service support is good.

The cost for the app is a one time fee of $400.  There are no subscriptions or annual fees. You can find out more at the company website.

November 17, 2014

Change Your Luck

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 11:15 am

Screen shot 2014-11-16 at 6.34.44 PMHopefully you have been fortunate over the years to surround yourself with trusted advisors or mentors who have been influential in your growth and development–both personally and professionally. Often the advice they give comes in the form of words or phrases that stick in your head and resonate. One of my favorites is “the harder I work the luckier I seem to get.” I so totally believe that!

Consider the doctor who attracts 40 new patients a month. Did these patients just fall out of the sky? I don’t believe so. That doctor has spent money and time to develop a great website. He also employs an energetic and social media savvy staff member who has been given the opportunity to spend one hour a day maintaining an active Facebook Page, publishing posts and engaging and responding to followers. That is work–not luck!

Consider the doctor who started two large veneer cases this month. Does that happen by chance? I don’t think so. That doctor has spent countless hours on continuing education courses with the best of the best. That doctor spends the time and money to fly to Scottsdale a few times every year to improve clinical skills hanging out with the likes of Dr. Frank Spears. That takes effort and dedication and commitment and work.

Consider the doctor who actually loves going to work every day because she has made the effort to surround herself with a fabulous staff. She has built and maintained a great team of talented customer service oriented people. She has created a wonderful atmosphere where staff truly want to work, and patients love to visit and refer others.  Can this all happen because she is lucky? This is the result of a lot of hard work.

It is my opinion, after interacting with 600+ practices over the past 19 years, that probably 85% of dentists significantly under-achieve their true potential. They don’t do this intentionally. They may often feel successful on some fronts. But they simply are just not aware of the upside.

On a personal level and as a way of illustrating my point, I want to tell you that for years I have been consistently going to the gym and putting in the time. This past January, I decided to hire a trainer. I have lost 14 pounds and am in the best shape of my life. I now realize that what I thought was a workout at the gym was the equivalent to a walk in the park!

So the sooner you stop waiting to hit the lottery with your dental practice, the better off you will be. Lady luck is unlikely to pay you a visit. There is no substitute for setting goals and then working really hard – harder than you ever thought possible – in order to achieve them. Then – and only then – will you feel lucky.

November 3, 2014

Are You Hiding?

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 7:29 am

In February 2012, I was excited to publish a blog post announcing a new look to my website. That post discussed a re-design or re-skin of my original website that had been created in 2008. You can read that post to learn the benefits of such a project. Ten months later–in December of 2012–I was still trying to stay ahead of the curve, and I asked TNT (my long time website developer) to reformat the site with a new technology called responsive design.

Responsive design was important then, and it is particularly important today, considering the continuing trend of expanding screens (Galaxy Note, Kindle Fire, iPhones, iPads, etc.). An issue that serves as an immediate turnoff for nearly half the population is a website’s failure to display correctly on a mobile device. As far as these visitors are concerned, if it doesn’t fit or load correctly on the screen of your phone or tablet, it may as well not even exist. A mobile responsive site, on the other hand, automatically adjusts to the size of the screen on which it is being viewed.

Time goes by quickly when you are having a good time! So just a few weeks ago, I had TNT to do another re-skin for me. Here’s what my site used to look like. Here is the newer version. And here they are side by side. I decided to go with a brighter and cleaner look–a bit more open space to make things look less cluttered and easier to navigate–more youthful colors, and a slightly larger and more modern font. I also made the page somewhat wider and increased the  space between the lines of content for ease in reading.

What you don’t see is the underlying code structure behind the site. The re-skin alters this code in order to improve the way that SEO spiders crawl the site and index it, promoting better search results. A re-skin is substantially more cost-effective than building a new site from scratch, thus it offers a relatively inexpensive and time efficient opportunity for your web developer to review and improve the functionality of the site’s backend.

Here is how I look at external marketing. When you use direct mail or radio spots or TV ads, or subliminal Facebook ads to attract new patients, you are essentially hoping to get your message noticed by someone who wasn’t really thinking about going to the dentist. You have to bombard this potential audience over and over – spending LOTS of money – hoping someone will eventually respond. On the other hand, when someone goes to Google and does a search for a dentist or a dental procedure, they have taken the initiative and are truly motivated to find what they are searching for. Totally different!!

The Internet is HOT.  Studies show that people read and believe Google reviews. If people are searching for neurosurgeons on the web, they certainly are searching for dentists. Conclusion – it is absolutely imperative that your website be easily found on a search from any device.

October 20, 2014

Cut Down Your Hedgerows!

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 7:28 am

u_s_army_in_world_war_ii_photograph_of_gis_moving_cautiously_between_hedgerows_in_normandy A few weeks ago, my wife and I went on a “bucket list” trip to Berlin and Normandy. We traveled to Berlin to view the transformation of the city from the horrific times of Hitler and Natzi Germany to the welcoming and passionately transparent atmosphere that exists today. Beautifully designed memorials to the Holocaust, built in the most prominent areas of the city, insure that the sins of the past will never be forgotten. We traveled to Normandy to see the D-Day beaches and the American cemetery. When you actually view the 80 foot cliffs above the beaches that were heavily fortified by the entrenched German soldiers,  it is hard to believe how these brave Americans – part of the “greatest generation” as described by Tom Brokaw – were able to advance.

What we didn’t know about were the hedgerows. A hedgerow is a fence or barrier formed by a row of closely planted shrubs or bushes. In Normandy, these hedgerows separated one small farm from another. Many of these shrubs were very think and dense and often 20 to 30 feet in height. The American war machine was ill-suited to this maze of tiny enclosed fields and sunken lanes. The Germans turned the hedgerow complexes into deathtraps by covering every road and trail with machine gun, mortar, and anti-tank artillery fire. Eventually the allied forces prevailed, but the hedgerows were a major impediment to the eventual success of the invasion.

For some reason, as I was viewing all of this, it occurred to me that,metaphorically speaking, we as dentists create our own hedgerows, our own obstacles,  that prevent or certainly interfere with our ability to grow and prosper. Five examples immediately come to mind.

1. Patient unfriendly hours of operation – 8:30 to 5 Monday through Thursday is what I see more often than not. You will exponentially increase your income by offering some early and some late options for appointments. The needs of the patients need to be balanced with your own personal life. It is not a one way street.

2. Limited payment options – people love and understand budgets. That is how they live their lives. The need is more necessary than ever to employ a dedicated, talented, and compassionate staff member who can sit down with a patient and navigate the intricacies of out-sourced financing while coordinating payments with sequenced treatment plans.

3. Failure to delegate – doctors are always complaining to me that they “don’t have enough time”. I realize that there are only so many hours in a day. In my experience, the most successful doctors are the ones who have figured out how to absolutely delegate EVERYTHING possible in order to have the time to pursue what only they can do. You may have to leave your comfort zone on this.

4. Consistently running behind schedule – a favorite topic of mine. You have to figure this out. There is no compromise position. It is not an acceptable level of customer service to keep patients waiting.

5. Weak or zero Internet presence – In this day and age, successful practices attract 30-35% of new patients from Google or Facebook. It must be a top priority to create or upgrade your website so that it positions prominently in your geographic area, is current, informative, and conveys the distinctive personality of the practice.

As you can see, none of these five suggestions requires changing or enhancing your clinical expertise. There is no need in this case for expensive continuing education courses. These are basic principles that apply to any business. So cut down your hedgerows! Eliminate these easy- to -overcome obstacles that are unwittingly preventing your practice from  reaching the next level of productivity and profitability.


October 1, 2014

Throw Away Your Megaphone!

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 8:37 am

Screen shot 2014-09-30 at 10.12.23 PMFor as long as I can remember, solving the inherent conflict between the front of the office and the back of the office is a monumental challenge. The larger and busier the practice–the more treatment rooms and providers–the more complex the solution. The goal, of course, is to create a consistent, smooth flowing on time schedule where nobody has to wait.

Sprinting up and down corridors to deliver messages is good cardiovascular exercise but not very efficient. There are other options. Physical hardwired light panel communications systems were a good start, but these systems are quite expensive and pretty basic. Many offices decided to wear headsets or walkie-talkies or earbuds, but all of these are very clunky and intrusive. The major dental management software companies decided to get their hat in the ring by incorporating instant messaging via computer as an add-on service. But this also is very basic–has privacy concerns–and I have heard from many doctors that the Dentrix messenger–called Dentalink–is quite fragile and inconsistent.

Enter BlueNote Communicator. Based in Lewisville, Texas, BlueNote is a small independent software developer that has been in business since 2004. Their focus is on providing innovative intra-office communication products for dental and medical offices. Armed with a simple mouse and the power of BlueNote Communicator, you can create the perfect intra-office communication system for your practice. BlueNote runs over your own network – no server or Internet connection is required –  and it is simple to download and install. You can customize up to 60 lights that can be activated with a single click. Popup Alerts and Tones are used to alert each computer that a Light has been activated or has changed. These visual and audible cues can be controlled at each computer to create the perfect balance of form and function. Each user has complete control over the notifications for each light. Another great feature is that BlueNote uses the latest industry standard encryption algorithms to secure all data transmitted and stored by BlueNote Communicator Lights.

The cost of $795 to purchase their latest product called Blue Communicator Lights is amazingly inexpensive. There are no monthly fees, per doctor fees, setup charges or per computer license fees. You can also try the full version of the software free of charge for 30 days to evaluate the program and see how it works. That purchase price includes setup assistance, along with software upgrades, phone support, and e-mail support for one year.

You can go to their website and read the many positive comments from satisfied offices. You can also call Shelly Salinas, the customer service rep at BlueNote, at 469-648-0172 for more information. I personally have a number of clients using this product, and they all give it rave reviews.

September 15, 2014

The View from Where I Sit

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 5:02 pm

A significant part of my work week is spent assisting and advising dentists who are buying or selling a dental practice. I would like to share my current observations.

• By and large, it remains a seller’s market. There are definitely more dentists looking to purchase a practice than dentists wishing to sell a practice.
• Because of that supply/demand ratio, I see practice valuations continuing to increase.
• Financing for practice transitions has never been easier. 100% financing of documented practice valuation is the norm. Banks have realized that very few dental practices ever fail, and so they are lining up to compete aggressively for your business. And we all know that when banks compete–you win.
• The Federal Reserve has been your friend. Monetary policy that has kept interest rates at historically low levels has stimulated acquisition activity by making borrowing costs so cheap.
• Prior to this low interest rate environment, it was often difficult for a buyer to be able to afford and take on the debt of both the dental practice AND an office condo or stand-alone office building. Sellers would usually be required to offer a lease to the buyer, and become the landlord. Now, it is almost cheaper to buy than to rent, so buyers actually want to own the physical location and build their own equity.
• There is still a premium to a seller if he or she has stayed current with new technology. Upgraded practice management software and advanced computer networking also guarantee a practice valuation at the higher range of the spectrum.
• There are numerous interesting and innovative ways to enable a win/win transition.

My message to buyers is that you should be prepared to pay a little more than you thought in order to buy a quality practice. That increased cost is easily offset by the availability of ten to fifteen year amortization schedules with low fixed rate financing that still allows a great return on your investment. My message to sellers is to get your house in order if you want to receive top dollar for your practice.

As always, I welcome your comments and thoughts.

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