Dental Practice Management

INTRODUCTION:

Successful practice is a result of proper management of resources, professional skills, and relationships with other health care providers and public in general. In India, commoners are largely dependent mainly on government health care delivery systems in which dental services are integrated with medical services, while the affluent get private services for a fee. In recent years, policies of the government have allowed the participation of individual and multinational groups in private health care systems. Dental requirements of the public in India are vast, varying and largely unmet

Patients, most commonly present themselves with painful tooth or bleeding gums to the dentist. The outcome is the relief provided for which the patient pays for the services, in full in private or partly in a government centre. The term ‘PRACTICE’ means arrangement or an agreement to provide certain services under a roof by an authorized person. ‘MANAGEMENT’ means the effective mode of provision of these services in a setting.

TYPES OF PRACTICE:

  • Solo practice– in this a dentist manages all types of cases according to his capacity
  • Group practice– here dentists trained in different specialties form a group and practice in the same office
  • Solo practice with visiting specialties– in this type of practice a single dentist manages the practice in his office but calls the specialists whenever required to carry out the specialty work

FACTORS ASSOCIATED WITH SUCCESSFUL PRACTICE:

Several factors are responsible for a successful dental practice, and are listed in the order of priority as:

  1. Location for Dental Practice
  2. Equipment and Materials
  3. Financial Resources
  4. Patients in Practice
  5. Fee for Service
  6. Personal Qualities required of the Dentist

1. LOCATION FOR DENTAL PRACTICE:

  • Is based on where the dentist would like to settle down
  • Established practice should not be shifted
  • Location may be classified as:
    1. Business area:
      • Advantage- being centrally located, most people can easily locate the dentist when they are in need
      • Disadvantage- one will encounter difficulty in acquiring the ideal place, floor area, can be very expensive with high rental or building value
    2. Professional area:
      • Advantage- Referral system is practices, specialists get to know each other by the practice of trade
      • Disadvantage- too many practitioners are concentrated at one place
    3. Residential area:
      • Advantage- good relations develop with the people in the area
      • Disadvantage- confined to having patients within one locality
    4. Floor plan must include-
      • Waiting hall
      • Consulting chambers
      • Private rooms
      • Operatory
      • X-Ray room
      • Recovery
      • Laboratory
      • Utility room
      • Rest room
    5. Furnishing must be pleasant
    6. Alterations in certain areas to accommodate patients with special needs are often necessary
    7. Timings of the practice vary according to the location
    8. The location should also be selected keeping safety in mind so that ladies also commute easily with no fear
    9. The building for practice should preferably be in the ground floor, if not, elevator service must be made available , atleast with the geriatric group in mind
    10. The building should preferably be a newly constructed one, so that it lasts for a longer time and has to be owned owing to advantages like:
      • No rent hike at regular intervals
      • No threat of evacuation
      • Building may be altered as per the wishes of the dentist without anyone’s consent
      • Convenient place may be chosen and suitable arrangements for parking may be made
    11. It is also possible to practice at home if some alterations are made. It is apt for teachers who are employed by colleges, want to have limited practice in the evenings or a lady dentist who has to manage her house, family and profession
    12. The design must be planned with the help of an architect, electrical connections are better concealed. Plumbing connections must be well planned. Design must be such that dust accumulation must be minimal and flooring must be easy to clean
    13. The compressor and generator should preferably be placed in the basement to reduce noise level
    14. All the required statutory licenses should be attained. It is better to have insurance coverage against fire, natural catastrophes, burglary and riots

2. EQUIPMENT AND MATERIALS:

  • Success also depends on right selection of equipments and instruments
  • The dentist should attend conferences, visit stalls during exhibitions to get familiarized with the latest equipments and gadgets
  • While selecting instruments, finance has to be suitably arranged. Prime importance should be given to the reputation, guarantee, warranty, time, cost of repair and availability of spare parts etc.,
  • Basic equipments which are essential include:
    • Dental chair
    • Dental unit
    • Light cure unit
    • Ultrasonic scaler with tip
    • X-Ray unit
    • X-Ray developer
    • Autoclave
    • Amalgamator
    • Ultrasonic cleaner etc.,

Disposable items are always preferred. Sterilized and preautoclaved materials should be preferred when one buys consumable materials like blades, suture materials, gloves, syringes, needles etc.,

3. FINANCIAL RESOURCES:

  • Financing a new practice is generally difficult
  • Appropriate sources e.g., banks, financiers, state financial corporations have to be identified
  • Care should be taken to be familiar with the rules, terms and conditions before availing financial assistance
  • Applicant who is of a good standing, having all documentation and a guarantee should be able to avail the grants and loans from institutions
  • Patient record with fees must be maintained
  • The help of a chartered accountant must be sought at the initial stage of setting up of the clinic

Tax planning and filing of tax returns must be kept in mind

4. PATIENTS IN PRACTICE:

  • Patients differ from their race, culture, religion, occupation, socioeconomic status, behaviors, and personalities. The dentist should be discreet and polite
  • Preference is to be given to those who value treatment to those who are ‘window shoppers’
  • Emergencies must be addressed immediately and sympathetically
  • Satisfied patients are a source of advertisement to the dentist
  • The dentist must maintain a high standard of honesty, work ethics and principles while he/ she is discharging his/ her duties

5. FEE FOR SERVICE:

  • There are neither fixed rate scales nor legal guidelines for charging fee.
  • Fee should ideally commensurate with the work done.
  • Pricing may vary between dentists in the same area or location.
  • Earning ‘target’ amount per day is unethical.
  • Profit at the end of the day is a welcome sign of growth.

6. PERSONAL QUALITIES REQUIRED OF THE DENTIST

  • Humane attitude-
    • Patient is a human being and has their own fears, frustration, ambitions and expectations
    • Individuality of the patient, his/ her humanity should not be forgotten
    • Dentists have to develop a friendly understanding, tender and loving approach while dealing with patients who are often scared, suffering with pain, depressed etc.,
    • Developing a humane attitude towards patients is very important

 

  • Confidence-
    • Most important quality to succeed in life
    • Unless the dentist has utmost confidence to provide the necessary, appropriate treatment resulting in uneventful success
  • Salesmanship-
    • There is no point in being sentimental about money collection and dentists have to make profits
    • This is based on how the dentist sells dentistry to his patients. This will happen only when you have convinced the patients the need for treatment and the ability of the dentist to communicate with the patient
  • Punctuality-
    • Receiving patients personally at the scheduled time and delivering the treatment at the exact time is important
    • Missed appointments affect both patients and dentist
    • Being punctual pays dividends in practice as it builds patients’ confidence on the dentist and serves a lot of time enabling time to b used in a more productive manner
  • Perseverance-
    • Striving for improvement is known as the pursuit of excellence
    • The maxim ‘Arise, Awake and persevere not until the goal is achieved” should be the motto in life
  • Personality-
    • Pleasing, soft spoken, with smile, well groomed with appropriate dress certainly along with skill, knowledge and confidence greatly contribute to success in dentistry
  • Politeness-
    • Being polite is the least a dentist could do to a patient if not serving them
    • The dentist has to be careful in observing and handling an array of patients of different age groups and sexes
  • Patience-
    • This is another unique quality dentists must have in abundance
    • Patience must be in not only in terms of getting patients but also in diagnosis and delivering quality service and collecting fee for service
    • It is the key word for a successful practice
  • Good health-
    • Dentist need to be physically, mentally & dentally fit without which the financial health cannot rewarding
    • Dentist’s dental condition is equally important as every patient looks forward to the dentist from whom they are seeking as a model

REFERENCES:

  • Essentials of Preventive and Community Dentistry- Soben Peter- 3rd Edition
  • Textbook of Preventive and Community Dentistry- S S Hiremath- 1st Edition
  • Essentials of Preventive and Community Dentistry- Soben Peter- 4th Edition