By: Dr. Talar Kiladjian
One truth that nearly every dentist realizes in their early years of practice is that dental school doesn’t prepare us for the business side of dentistry.
We spend four-plus years in school with “dental blinders” on, absorbing as much clinical and academic information as possible to perfect our craft. Upon graduating, we apply this knowledge as perfectly as possible to each patient. With repetition, we become more efficient, improve our time, and grow more confident in treatment planning and executing complex clinical cases. While top-quality clinical care is crucial, its delivery would not be possible without the strategic control and understanding of several business-related variables.
The Business Gap in Dental Education
Dental schools have recognized this lack of business competence amongst graduates and incorporated relevant seminars into their curriculum to address this barrier. My experience included worksheets on calculating total overhead and lectures on topics such as types of compensation, investment funds, student loan management, and contract negotiations. Our repeated review of the differences between production versus collections and lab fees “off the top” versus “off the bottom” will forever be ingrained in my brain. While a step in the right direction, this introductory course merely scratches the surface of what it takes to run a dental practice.
The days of small, quaint family dental offices are nearly behind us as larger multi-specialty practices take their place. While an important transition—promoting collaboration between providers under one roof to ensure seamless comprehensive care—this comes with the management of a much bigger staff and the need for a larger variety of materials and equipment.
Building an Effective Team Structure
As an associate in a multispecialty office, I’ve observed that a successful business requires teamwork. A team with good chemistry and organization leads to returning patients and referrals, driving continued growth. How can a practice encourage growth while maintaining a comfortable and supportive work environment? The key is an organized business model with checks and balances, starting with strong leaders and delegated roles for each team member.
A dental office can most simply be organized into two teams:
Clinical Team: Typically led by a senior assistant or hygienist. In larger practices, both roles may have separate leaders to ensure smooth operations.
Administrative Team: Led by an office manager, who oversees front-desk staff and ensures efficient scheduling and patient communication.
At my multi-specialty office, we have eight doctors—including specialists in periodontics, endodontics, and prosthodontics. While every assistant can work with any doctor when necessary, generally each is specifically assigned to one or two. This allows for close monitoring and communication regarding the specific needs of each doctor. Without this, one can imagine how the productivity of a large practice can quickly decline.
Our administrative staff follow a similar structure, with our office manager assigned the role of team leader. The remaining front desk staff share the roles of answering phone calls and patient checkout but are also each assigned to specific doctors for scheduling. This allows staff to focus on the unique needs of their assigned provider, to curate a productive and seamless schedule flow. The goal: establish an office that can run itself.
My understanding and appreciation for this structured model stems from personal experience. At times of breakdown—due to reduced staff, increased turnover, and disharmony between team members—I’ve noticed a plummet in my scheduled production and increased stress directly affecting my work and my patients’ experiences. The converse effect occurs when this model is being implemented at full capacity.
The Role of Workplace Culture in Business Success
Undoubtedly, a smooth workflow supports an amicable work environment. How, then, can we make sure things stay this way? A second key lies in creating a work environment that encourages relationships, motivates and prioritizes open communication.
In practice, I make a daily effort to thank my assistant for a range of tasks, from as simple as handing instruments, to more generous and involved gestures, such as completing intermediary steps for in-office crowns while I attend to hygiene and side books. When a procedure runs over into lunch, I take over flipping the operatory to respect my assistant’s much deserved break. These mutual efforts build trust and good work chemistry, which leads to efficiency, quality work, and patient comfort. It also promotes constructive communication, to ensure what is working well is recognized, and what needs improvement can be addressed before spiraling into a bigger issue.
These same types of relationships are just as important amongst colleagues of different levels of hierarchy. To foster this, every member–from practice owner(s), to doctors, to team leaders, to supporting staff–must equally commit to being approachable and considerate. Consistent office meetings provide formal opportunities for check-ins, while office parties encourage bonding and office morale in a more relaxed setting. Staff that feel heard and supported are motivated to excel, and (similarly) feel committed to resolving disruption. This loyalty establishes the backbone for this model, supporting its longevity. Without it, the office would continuously exhaust itself to re-establish harmony.
With a self-sufficient practice model in place, efforts can be dedicated towards new avenues of growth.
Leveraging Technology
No discussion on the business of dentistry is complete without addressing technology’s growing role. The right technology improves treatment acceptance, patient comfort, efficiency, and documentation accuracy. At the most basic level, incorporating the use of an intraoral scanner supports many of these benefits.
At our office, every new patient visit starts with a full mouth scan, which is left open for the patient to peek at throughout their cleaning. This unique three dimensional visual of their dentition prompts patients to self-diagnose and question details about their scan before a formal review by their clinician, ultimately leading to treatment acceptance. This is further supported by combining AI assisted radiographic review. Patients are prepped with unbiased third-party diagnoses, which helps earn patients trust with clinicians’ ultimate diagnoses. An additional benefit of intraoral scanners is their digital impression feature. They require fewer supplies, have an easier cleanup, are more comfortable for patients, and allow prompt electronic case submission.
For more technologically seasoned practices, CEREC is a tremendous asset. As each appointment means additional time off for the patient, there’s immense value in being able to deliver same-day treatment. This convenience sets the practice apart from competitors offering traditional treatment. Financially, by bypassing exorbitant laboratory fees, the office can net more production.
Dental technology is unquestionably a significant time and financial commitment, with the greatest barrier being the upfront cost of equipment. Through avoiding lab fees and increased patient treatment acceptance, the potential net earning benefits are promising. To manage this successfully requires strategic planning. Thorough research must be done to ensure equipment purchased will have longevity. While tempting to splurge on the latest equipment, thoughtfully paced purchases and proper training will help ensure smooth implementation into practice in a way that maximizes equipment’s value.
Lifelong Education
The business of dentistry is layered and complex. While I still have years of learning ahead of me, it is already clear that knowledge acquired over time combined with a commitment to learning and keeping up with modern changes are integral for growth in dental business acumen.
