The Solo Dental Practice: Is It Dying?

Dentistry, along with many other things in life, are vastly changing: from technology and its direct impact on how we do dentistry to the amount of dentists in the marketplace to how dental insurance plans impact our practices to the overall economy. I think we can all agree that change is here to stay. 

In this article, I’m not going to focus on the wonderful options we have available in technology that can and will impact our practices going forward. I am going to focus, however, on a few things that as a solo practitioner you should think about when it comes to you and your practice.

The rise of group dental practices

When I first started practicing dentistry over 16 years ago, general dental practices were primarily solo practitioners with the occasional group practices in the mix. Most patients had dental insurance, and many dental practices didn’t advertise other than a simple listing in the telephone book. Many others didn’t even participate in dental insurance plans. 

Sixteen years later, however, I have started to see that many practices are beginning to merge into larger group practices that advertise heavily and participate in all insurance plans. We also have seen the advent of widespread corporate dentistry.

Google searches, webpage design, search engine optimization, social media, Facebook page and likes, Twitter followers, mobile friendly websites, etc., are now mainstream discussions among dentists and are important to the vitality of your practice in this digitally driven world. We have gone from focusing on dental procedures that have been around for a long time to now looking at implants, grafting, guided surgeries and a variety of other procedures that have become mainstream and predictable.

Not only that, the economy and the overall patient perception of dentistry has changed. To a degree, dental practices are being marketed and advertised as a commodity and not a service by dental professionals, corporate dentistry or dental insurance companies. As dental patients and consumers are bombarded by so much marketing and advertising, they lose the ability to differentiate between dental offices.

It leads us to the question: will you continue to be a solo practitioner doing the same dentistry that you have always done, doing it the same way you always have or do you …? If you think that by sticking your head in the sand and hunkering down, continuing to do what you are doing, that this will all pass and you will end up on the other side intact, I don’t believe that will be the case. It’s a difficult question to ask, but as things continue to change and evolve at an even faster pace, we must change or suffer the consequences. 

So, this begs the question: how do you change or what should you do differently? Where do you start? Do you jump ship from a solo practice and join a group practice? Do you join all insurance plans? Do you start to advertise heavily? Do you create a new website or update an existing one? The list goes on and on. There are so many things that can have a direct and indirect impact on your practice today.

Defining your practice's values

First and foremost, you have to decide and define what your values are and “why” your practice exists.  Is it to serve as many patients that you can or to treat fewer patients comprehensively? Is it to work six days a week or only work three and a half?

There are a lot of questions to consider and think about. An important thing that happened to me was when I was exposed to Simon Sinek, a “visionary thinker,” a few years back. He has a great Ted Talk video about defining your why that I encourage all of you to view. I think it’ll make you think about your practice and even your life.

When our practice is different from our why, it creates a lot of stress and burnout. Remember, you can’t serve two masters. For example, you can’t see 50 patients a day by yourself and spend a lot of time to get to know your patients. You should take a look at your practice to see who you believe you are and what your practice is about. Then, you and your team can create and set goals to support your mission.

Setting prices

Here’s something to think about: As a solo practitioner, owner and operator, I believe that if you are considering offering low prices, accepting all insurance plans and competing with corporate dentistry or large, multi-doctor practices in your area that are doing the same thing, it can be challenging to do in today’s current market successfully.

It’s only going to get worse. Why? Well, it’s simple math. Corporations can purchase larger volumes and get bigger discounts. They may have a person dedicated to marketing and can spend a lot of money on marketing and advertising along with a lot of other things. A simple example: Wal-Mart versus the local store that sells the same item. The local store can’t compete on price and volume alone. The same thing has happened in medicine. Many of the solo practitioners in medicine have either quit, joined a hospital group or sold out and are now employees of hospital or larger groups.

“ ... as things continue to change and evolve at an even faster pace, we must change or suffer the consequences.”

What happened to medicine?

As we look deeper at medicine, we have seen it go from when I grew up, where we went to a family doctor who knew each of my family members individually and treated us appropriately. Now, we’ve moved on to family doctors who are the “gatekeepers,” the ones that refer you to the next specialist to manage or treat your disease/sickness.

Because of the time constraints that are placed on our medical friends from the years of insurance influence on medicine, they only have time to find out what the problem is, develop a diagnosis and refer for tests or a specialist to manage or diagnose.

For many years, we sat back and watched medicine change and for the most part, dentistry learned some of the pitfalls and avoided them for many years.

But as the pressure continues to build from economic changes from the Great Recession, soaring student loan debt and insurance companies ever-changing reimbursement rates and schedules for payments that drive corporate profit, dentistry is starting to go down the same road as medicine. This road goes from relationships and individualized care to one that sees us quickly diagnosing the disease/problem and then onto the next patient.  

Dental - and personal - continuing education

One thing that never goes out of style or changes, and in my opinion may be more important than ever in today’s dental world, is to keep ourselves up-to-date through continual improvement personally and professionally.

We need to develop relationships with our patients and ultimately, become facilitators of health. When we apply what we learn, our continual personal improvement and especially professionally can have a direct impact on our abilities to help our patients and the care we deliver to them. 

It is one that focuses on quality and what many of us refer to as relationship-based practices. We are human beings before dental patients, and hence, I believe that relationships are important in all that we do. There will always be patients that will seek this out. Patients and people who desire to be treated as a person, and not a number or tooth number, will look for this relationship with their provider. 

A word on advertising

One last thing going forward: No matter what path you choose, you will need new patients to keep your practice alive and thriving. Asking for referrals and word-of-mouth referrals is still the best way.  However, many potential patients nowadays get names from current patients, but they verify and validate you online by Googling you and your practice.

You could be the best clinical dentist in your area, have the best staff and patients and receive many word-of-mouth referrals, but if you don’t have a well-placed website on Google or other search engines as well as good online reviews, many patients won’t be able to find you or come to you. Make it easy for them to find you and your practice to get those great online reviews. 

So, is the solo practice dying? No, but it will if you let it. It is changing faster than ever, and you must change as well to be successful. 

(Click this link for more dentistry articles by Dr. Jeff Lineberry.)

Jeff Lineberry, D.D.S., F.A.G.D., Spear Visiting Faculty and Contributing Author - http://www.jefflineberrydds.com