<a href="http://www.linkedin.com/pub/dr-donald-lurie/1a/297/82?rel=author">Dr. Donald Lurie</a> is retired from a highly successful oral and maxillofacial surgery practice in Maryland. Dr. Lurie's insight and perspective after 50 years of practice are “spot-on” and we are happy to share his work with you. Additional articles by Dr. Lurie can be found at http://dentalcpas.blogspot.com/ donald.lurie@att.net

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Why Become a Dentist. My Thoughts, Then and Now

become-dentist

It seems to me that goals and aspirations upon entering dentistry have changed drastically over the years. A few weeks ago, I was attending a conference and the subject arose as to “Why did you become a dentist?” I thought this was a really easy question until I tried to write down the reasons that I entered this wonderful profession 50 years ago.

As I reflected upon the question, I realized that the dynamic had changed so dramatically over the years that it was now, for me, a most difficult question to answer. I listed the reasons that started me on this journey: to heal and to cure the sick, to maintain independence and be my “own boss”, to have the ability to make a substantial income, to provide for my family, to obtain respect in the community. But now the dynamic has changed so much that I am not sure that I could compare those thoughts to a new student with aspirations. You would have to interpret the ability to be “your own boss”. I am not sure that, in these times, that is as possible as in the “old” days.

The time of solo practice appears to be over. I remember going to the bank and asking for a loan to open my own office. The banker, a classmate from college, advised me as to what he thought it would take, shook my hand, and said there would be some paperwork to fill out. He suggested that I go and find my location, lease the property, and prepare to renovate the space for my needs. He also suggested that I bring the information back to him so he could advise me. Thus, with the help of my accountant who was already on my team—-before I even had an office—the Team of Retirement, which I have discussed in earlier articles, was started. This is actually a philosophical term of practice management that has served me well. Can you imagine being able to do that in today’s financial world? And would you have the fortitude to do it? In those early days, this was the norm.

The desire to heal the sick and to make people well and return them to function has never dissipated. This is still a goal that has been with me my entire life and even in retirement I continue to give and to donate effort to this ideal. However, I wonder if the freedom to exercise this is as easy as it was in my beginning. There is so much litigation, so much inspection, so many bureaus to satisfy, that I wonder if I would have the courage to try some of the new techniques and projections that I did in those days. If a doctor had an idea, he would suggest it to a patient and many times, it was accepted and tried. Now I am not talking about moribund procedures, but rather a new technique or variation on a theme mixed with good common sense and based on good surgical knowledge and experience. Today, if the “experiment” went wrong, social media would crucify me and the good that I had done over the course of my years in practice might disintegrate quickly. These are just thoughts but it gives me pause as I look back on reasons why I became a Dentist and Oral Surgeon.

I think that the opportunity to make a good income and to provide for one’s family is still viable but I am not sure that it is as attractive as it once was. The tax laws are so different and the age of insurance and government interference have also changed the dynamic. The large groups are doing quite well and are able to diversify but the small solo practitioner may be another story. I have to yield to the accountants for introspection on this, but it is something that I have heard many times recently.

I mentioned above about the respect of the community and I think that is still true. The doctors of today are TALL and WELL REGARDED. I think that this has always been so and it is a tribute to the schools and to the profession that has nurtured us on our journey. We feel discomfort when one of our group is challenged or if a bad report hits the news since we feel it reflects on all of us. It is part of our heritage that we want to “do no harm.” I also feel that, especially in these times, our brothers and sisters do a fantastic job of carrying on the respect of the professions.

And so I think that you can understand how difficult it was to list and compare the reasons that started me in this profession of dentistry and surgery. The years of training were many, but they are even longer now. I would challenge you to sit and reflect on your career and for the reasons that you are where you are at this time. Reflect, meditate, and make it better while you can. And may this wonderful career bring peace and joy to you and to those you serve.

We are all here to help one another. Please do not hesitate to send me you thoughts, questions, or comments. It would be an honor to help.

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Dental Mentoring Equals Dental Outreach

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It seems to me that part of the continuing attempt to refresh and recharge our enjoyment of practice is the chance to be a mentor. In these times, there is an obvious decrease in the ability to sit back and enjoy the practice of dentistry and medicine. Interference from many sources, stress of compliance, making the numbers work are so problematic that the doctor can lose focus on one of the things that brought him into private practice in the first place. These are indeed difficult times. The solo practitioner is almost extinct and the mega practices have their own set of problems.

One of the areas that I found to be energizing and helpful was mentoring. It started with teaching of residents in the early years of practice. This was a great way to relate and to also keep current. As all teachers know, you learn more from teaching than as a student. Not only is it challenging, but it is a great reward to bring the missing link to the “new doc” – experience. To be in a group and acknowledge an “ah ha” moment is so rewarding. For those who are fortunate enough to be in a university city with medical and dental students, there is ample opportunity to give (and to relate). You will find that the student is greatly appreciative that you took the time to help and point the way. You will also find that you return to the office or to your home with an exhilarating feeling yourself – remember, “it is better to give than receive.” From another view, these contacts become friends, referral sources, and associates that may lead to other projects and outreach possibilities. This is just another example of a means to refresh and recharge.

Knowing how good the feeling is to give a gift to someone, I also had a grand time in mentoring patients of mine. Actually, my staff also enjoyed it and related to the mission. There were numerous opportunities where a young patient, entering college, had no idea of his major or area of interest. This was an opportunity to chat and just become a friend and counselor. We would actually make an appointment in a off time (lunch etc.) to meet and advise. Did it happen every day? No, but often enough that we were invited to many graduations (and even some weddings). I am convinced that we know more than just how to be a good doctor and this ability can be a wonderful way to have that “feel good” day or moment. So you want to talk about marketing. This, if done from the heart, is number one in my mind.

So, it seems to me that you can make some fun out of your practice and have it actually become a source of an outreach program.

I would love to hear from you and share your ideas and experiences.

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The Dental Specialist and Referrals

Tips to Obtain Referrals for the Dental Specialists

It seems to me that the dynamic of a specialist obtaining referrals has changed. As we have all noted, private solo practice in the specialties has greatly decreased. I have heard estimates of less than 7%. As a retired Oral and Maxillofacial Surgeon, I have personally noted the change in referral patterns and, I think, understand what must be done to encourage referrals. This wisdom comes from fifty years of practice. No longer is it enough to take a generalist to lunch, or to have an annual Christmas party. I think that the whole picture has to be viewed and rearranged.

Firstly, the specialist has to be extremely well trained. He has to be able to get the “word out” about how well trained he is. I would suggest a curriculum vitae be sent with the announcement of the opening of his practice. This is important and should be of the highest standards befitting the degree of their excellent training. While it is important to let folks know where you are located, phone, email etc…, it is paramount to let them understand your qualifications. This should be updated periodically as new honors and leadership positions occur. Obviously, with social networking as keen as it is, it is imperative to have the correct team to help in this initial matter. I have discussed the team concept in one of my previous articles (The Team of Retirement). This is the first impact that you will have on your referring base.

It is to be assumed that most specialists will be joining an existing practice. I would still recommend that this initial information (CV and other marketing) get out there so that the new “person” is not relying on the reputation of the existing practice. Obviously, if the doctor is solo, then it speaks for itself.

Incidentally, most of these ideas would apply to a generalist starting practice with the obvious difference being that his target marketing prospects would be different.

In the beginning of the practice, personal visits to the referral base is mandatory. Now the doctor can place the name with the face. I would also suggest that care be taken to find a convenient time to visit the doctor—-check with his front desk and get to know them well. Lunch is always good if it is possible but a coffee break at an off-time can usually be arranged. You might want to stop in unannounced just to meet the front office, introduce yourself and make the appointment with them in person. These first months will require a great deal of leg work and it is wise to plan this out so that you still have proper time to cover your new office and schedule (keep in mind the new IRS standard mileage rates as well – note all of your travel in a journal regularly). It will be also mandatory that your new staff be well versed in what you are doing so that things run smoothly while you are out and about. Again, the proper team will be helpful in putting that staff together. Nobody said it would be easy.

As time progresses, I would suggest a series of “Munch and Learn” sessions in your office. This now completes the circle of announcement, face to face, and seeing your office location. There should be a wall that displays your credentials—–do not make it obnoxiously obvious, but it is a must. These sessions should be an hour or less and eventually may lead to further interactions (study clubs, etc…) which I will discuss in another article. Keep them low-key with simple refreshments. You might want to invite a speaker, present yourself, or even have one of the detail persons from a company at these gatherings. It does not always have to be about your specialty per se, but could be a practice management tidbit, accounting novelty, equipment demonstration etc.

I invented a little item that was a big hit and I will share it with you. After a patient was seen, treated and eventually discharged, I sent them a thank-you note. What?!? A thank-you note from a surgeon to a patient. At the same time, a reminder note went to the generalist so that his patient could be kept in his system for recall and follow-up. Too often, these patients were late in there general check-up because the referring office thought the patient was still under treatment. Just a little tidbit but it was effective for me. The marketing angle is to engage the patients to refer to you directly. Obviously, you then have an opportunity to reciprocate with your referral base if the patient is not “attached” to a GP. Always, always, always, try to market with your patients.

I think that the specialist should take a look at the reports that he sends to the referring doctor so that they are sent in good time and are relevant. I had a personal, handwritten quick note that went out the same day the patient was treated so that the doctor knew that treatment was on-going and active. If it was a major case, this was followed by a complete operative note etc. so that it could be filed in the patient’s permanent chart. This is just another means to get your name in front of the generalist and to establish good lines of communication. This obviously can be done by email, fax etc. The important thing is to document the treatment clearly and always ask for his feedback if necessary.

These are just a few ideas about getting started and I hope they are of help. Please do not hesitate to send me you thoughts or questions. It would be my honor to be of help.

More Mistakes Made and Lessons Learned next time.

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