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I received an email a few months ago. Great question, but there may be a little wrong thinking going on. See what you think.

Hello Michael,

I have a question for you. My practice is growing. I bought it from a retired dentist three years ago. I have started to place implants and I know the more I focus on this the better things will be. Some experts say I should buy a CO2 laser and a cone beam and just go for it. My intention is to use an imaging center for CT’s, hold off on a laser, and start slow. What would you do? The end of the year is approaching and I’m wondering if I should make an investment. I also still have film X-rays. My intuition says to be cheap. But being cheap can cut yourself short. I’m ready for the next level.

Thanks for your time. Have a great day.

These are great questions, but there is not enough information to really know what the right answer might be. Every question hinges on the numbers: New patients, production per op, production per employee, overhead, direct referrals, hygiene production, this year compared to last year, etc. Since we don’t know those numbers, let’s assume everything is doing well and just take the questions on face value.

He has started placing implants and he prefaces this with the statement that “the more I focus on this the better things will be”. Not so fast. Every dentist should be placing implants, doing Invisalign or Six Month Smiles, providing Sleep Apnea treatment, etc. The problem occurs when they are not producing around $25,000 per Op per month, having hygiene producing about 33% of the total practice income, having at least a 50% referral rate from existing patients, maintaining an overhead between 50-60%, and have decided that these pseudo-specialty services will completely turn around their practices. These types of services are not practice builders or a solution to a poor practice; rather they add fuel to an already good practice by multiplying the already great results you have. They are more of an accelerator for a practice moving in the right direction. Implants are great and fun to do, but oftentimes doctors fixate on a particular service to pull them off of a plateau or out of a slump. This can be a huge mistake. I have spoken to hundreds of doctors that have taken courses for implants, sleep apnea, TMJ, and various areas of cosmetic dentistry only to find a year later that the increase in business just has not materialized.

Niche dental services sometimes overlook that fact that consumers don’t choose a practice based on one service, but on the overall level or perception that you as a doctor and staff exceed their expectations. We know that about 47% of all organic searches done on the Internet for anything dental is a “Dentist in a Location”. Not till you get down to the last three things that consumers ever look for on the Internet do you ever see an inquiry about implants, sedation, or cosmetic dentistry. Those searches for implants, sedation, and cosmetic dentistry represent only 3-4% of any search Dentally related, and only represent 1% of the searchers. Knowing this should help you understand that to grow a practice you must be found through reputation management and general services when someone types in “Dentist in a Location”. The neat thing is that those 47% of people looking for a dentist will still need cosmetics, implants, and sedation. They are just not doing searches for them.

I believe that you should add a new service every year or two for your entire career. In this instance you are correct by not jumping into purchasing hundreds of thousands of dollars of equipment and supplies until you find that there is a demand for that service. I found it a little interesting and funny that the so-called experts suggesting you buy a CO2 laser and cone beam are the speakers paid to say this or the companies that directly benefit from its sale. The use of the word “investment” in your question is also great. Investments provide a return on what you spend. Not so with just an ordinary purchase. Section 179 of the IRS Code does offer accelerated depreciation of certain improvements and equipment purchases but nothing will help you profit if your practice does not have the demand for these services.

My suggestion is you take a little time and look at the basics: Overhead, production, staffing issues, new patient numbers, and referral rates to make sure they are in line before stepping up to purchase equipment that may or may not help you grow your practice. That is how you Summit.

Mike Abernathy, DDS
[email protected]
972-523-4660 cell

PS — In this case, if this doctor would simply go to he could save over $20,000 in just the purchase of a laser and cone beam from BEST’s alliance partner Archer Dental Equipment. If you have not already joined, and there is no charge to become a member, be sure you stand up and be counted as one of the hundreds of offices that are already saving tens of thousands of dollars on services and products through using BEST partners while standing with us to preserve the independent practice of Dentistry.