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to charge $17,000? How do I, as a practitioner
and as a leader, signal to the marketplace
– my patients, my team – that we’re
worth it?” Because the difference between
the $10,000 and the $17,000 reconstruction,
when it’s done well, is huge. You can’t be
doing reconstructions half-assed, because it
will come back to haunt you. So the higher-fee
cases are more difficult to sell. Case
acceptance for the high-fee case is something
that I have focused on for the last 20
years of my life.
MD: Now, in those 20 years that you’ve been
focusing on high-fee case acceptance, is there
a huge difference between case acceptance for
a $10,000 case and a $17,000 case? Don’t they
both sound relatively expensive to the patient?
100%
Case
Acceptance
0%
$1,000 $5,000 $10,000
Figure 5
PH: Absolutely, yes. You know there’s a case
acceptance curve, where case acceptance is
real high when the case is real low (Fig. 5).
But as you cross that $5,000 to $6,000 mark,
that’s where I see case acceptance drop
down. Is case acceptance that different between
the $10,000 and $17,000 level? Not
really, but enough psychologically for the
dentist. Not so much in the patient’s mind,
but it is in the dentist’s mind. So factoring
in proper case acceptance dialogues and essential
conversations that you have, those
conversations need to be entirely different
at the $10,000 level up than at the $5,000 level down. And
that’s been the topic of some of our other articles.
MD: Yes, we’ve talked about that before. So a dentist who’s
reading this or listening to this and realizes, wow, I bought
this practice 13 years ago and I just took over at whatever
Delta-approved fees the previous dentists had and we’ve tried
to make increases every year based on our ZIP code as time
went on. Maybe I should take a closer look at my fee schedule
before I get too much farther into this to see if my fees are
in the right place and make sure that when I’m operating
at the sweet spot, I am making the net profit per hour that I
deserve.
PH: I’d contact Ken at Dental Practice Advisors. For
years I did the fees and analysis, but they are far quicker
at it and more complete. What they’ll have you do
is submit two or three of the large cases you’ve done,
your fee schedule and your profit and loss
statement. And they’ll look at it comprehensively.
They’ll look at how much money
you need to live; that’s where they’ll start. How
many days do you want to work? How much
money do you need to live? This will create the
profit per hour that you need to make. Then
they’ll look at your practice overhead and your
fee schedule. They’ll adjust your individual fee
schedule such that the fees are balanced up
to that 3-unit level. Then they’ll look at your
complex-care cases to help you look at and
see, what is the profit you have? And what’s
amazing, when you come back from a profitability
analysis or a fee analysis like that, you
come back with some hard data on a piece of
paper. Now you can sit down with your team
and say: Listen, when we did Mrs. Smith, that
case where we all pulled our hair out, we made
less on a per-hour basis than when we’re just
fixing individual teeth. When you can see it in
black and white, Mike, that becomes a great
leadership tool. It becomes more real to everyone.
And now, I can sit down with my dental assistants
and say: You know, you’ve been asking for a raise the last
several months. See this profit point that we have right
here? In order for me to give you a raise, we’re going to
need to move that profit point up. A lot of that has to
do with time. So let’s think together: How can we shave
an hour or two off of these longer procedures without
reducing quality. How can we do that? When the team is
engaged – engagement means they’re thinking on their
own without my direct influence – they’ll help create the
solution, they’ll support the solution.
MD: Sure. And now she is responsible for her own raise. The
doctor says, I want to give you a raise. I think you deserve
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