MY VIEW Look before you leap by PRABU RAMAN, DDS

As the landscape of health care is changing rapidly in our country, there are significant changes that have happened in the oral/dental care arena as well. More changes are predicted in the near, and distant, future as well. In this context, I would like to share some of my thoughts from my perspective as a dentist in private practice for 30 years.

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s a newly minted dentist from UMKC in 1983, I did not know much about the ‘business’ side of dentistry. I just

decided to open a practice in a strip mall in Kansas City North. The prime rate since 2008 to now is 3.2 percent. But it was a record 21.5 percent while I was in dental school contemplating my future. The prime was hovering around 11 percent when I gradu- ated. As you may know, the actual interest rate of a business loan is several percentage points over prime. The landlord told me to my face that he would not give any leasehold improvement allowance because he did not expect me to be in business for very long. After all, another dentist across the street from where I was locating had gone bankrupt recently. So I asked for and received a lower rate on a 5-year lease with a 5-year renewal option. If he did not expect me to be in business for long, the low rate would not really matter, would it? We outgrew that leased space and built a free-standing building in 1994, which is still our practice home.

Why am I giving this history? In 1983, there were experts that predicted that Dental HMO was the future of dentistry. New den- tists MUST sign up for as many DMO plans as possible to survive. For whatever reasons,

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I did not buy that or many other ‘expert’ pronouncements since that time. We have managed to survive, and even thrive, in the many economic and cultural climate changes,

would have pursued easier paths. So we don’t think like ‘business’ people, nor do we have the business education and training. Yet, if we don’t realize that a dental practice is also a small business that has to earn an income and remain profitable in order to pay its employees and suppliers, we won’t exist to be able to help people. Often, practice decisions are made without an objective analysis of data that impacts the bottom line, as any business per- son would do.

often, practice decisions are made without an objective analysis of data that impacts the bottom line, as any business person would do.

and even through the self-inflicted change into a full time TMD-focused practice. My hope is to share some of the business lessons I have learned along the way that may help my younger colleagues.

I sincerely believe that almost every dentist chose to be a dentist to help people. Having served on the admissions committee of the UMKC School of Dentistry for the last three years, I know that the candidates chosen have demonstrated commitment to community. If we just wanted to make a lot of money, we

Recently I was speaking to a dentist who was considering accepting a discount benefit plan as a provider. He felt that he had some open time on his schedule that could be filled with patients from this preferred provider plan. He would need to

accept a 30 percent discount as a contract provider, but it was ‘better than an empty chair’. In effect, this dentist is paying this benefit plan to ‘market’ his practice to their insured patients. Isn’t that what signing up for a PPO plan really is? The plan would mar- ket his practice to its clients. What are the chances that this same dentist is spending an amount equivalent to 30 percent of his pro- duction in ‘marketing’ budget? The national average is about 5 percent for a marketing budget. Could that amount be better used to do internal marketing to existing patients