Going with Digital Radiography will be your best move ever!
by Howard Farran DDS MBA MAGD
W
e all get lucky with a purchase
now and then, but the majority
of us also all have a dental
museum in the back of the practice with all
the crap we bought and never used. Labor
Day weekend 2000, we closed down our
Today’s Dental family practice in Phoenix
and installed Trophy in all eight treatment
rooms. We knew it was something we had
to do on our journey to going paperless.
Now, a year after we took the plunge, I can
honestly tell you it was one of the best
decisions we’ve ever made. It has
significantly affected our practice’s
bottom line.
Before digital radiography
Efficient operations and logistics are crucial
to the successful operation of any business.
My dad, an extremely successful
entrepreneur, would probably use an
analogy of a train to describe our operations
before and after going digital. Each train car
is a procedure. If any part of the train broke
down, the entire train would come to a
screeching halt.
With that in mind, let’s run through the
steps of a patient calling with a broken tooth
for an emergency appointment. The patient
calls and the front office finds a free hour
and schedules an appointment. The patient
arrives at the office. The dental assistant
takes approximately five minutes (one train
car) to set up the operatory and another five
minutes to seat the patient. Another five
minutes are used to take a periapical and
bitewing radiograph of the broken tooth.
Now, the assistant has to leave the patient
alone, and develop the x-rays on our old and
trusty AT-2000 developer. If no one else is
using the developer, it will take another ten
minutes (5 minutes to develop, 5 minutes to
mount, identify and date the slides) before
the assistant can return to the operatory
with the radiographs. Now, 20-25 minutes
later, the assistant finally has everything
ready for you, the dentist, to begin.
You review the x-rays, go to the operatory
(another five minutes) and explain to the
patient that tooth #3 needs a build-up and
3 DentalTown Magazine
crown. The patient immediately asks, “How
much is this all going to cost?” The dental
assistant begins entering the treatment plan
into the chart and heads to the front office
to find one of those rare people that can
actually talk and collect money. After
explaining everything to the patient and
checking insurance coverage, the front office
person says to the dental assistant, “If they
want to have it fixed today, do you have
time?” The dental assistant promptly says,
“No, sorry.” Because it’s already taken over
35 minutes to get to this point and the open
time slot was only an hour. And you say you
can’t afford digital radiography? In the old
world of film, the staff immediately starts
thinking with their brakes on. Slow down,
reschedule, we’ll run out of time! By simply
switching out the old film and developer
process with digital, here’s how that same
procedure plays out.
The efficiency of digital x-rays
The patient is seated and the dental assistant
begins taking digital x-rays. The image
immediately comes up on the flat-screen
monitor, right next to the patient. No
guessing if the shot was good. Now, with the
digital images on the screen, the dental
assistant beeps me using our Director light
system by Comlite that the patient is ready.
I go into the operatory, make my diagnosis,
explain the problem to the patient, who sees
clear magnified images on the monitor. The
entire process, including fees and approval
takes about 15 minutes. With 45 minutes
left, I immediately start the build-up and
crown. Now, let’s go back to the analogy of
the train. Do you see how the addition of
digital radiography has enabled the entire
train to move much faster? You must
increase your efficiency if you want to
increase your bottom line. Just because you
always do a root canal in two, one-hour
appointments, doesn’t mean you can’t do it
in just one.
Other time savers
Try making the temporary with the dental
assistant before you take the impression.
Faster! No more reduction copings––you
figured out the clearance issue with the
temporary. Every time the dental assistant
has to leave the treatment room to get
something, stop and write it down. Later go
back and order gobs of whatever the
assistant is only storing in one place, and
store whatever it is in every operatory. Move
to a self-etching bonding agent like Clearfil,
manufactured by Kuraray and available
through J. Morita, and eliminate the acid
etch step. Switch to Rembrandt’s Sapphire
light and cure five millimeters of light shade
composite in nine seconds. Time is money
and operations and logistics rule everywhere
from Wal-Mart to Southwest Airlines.
My dad always said, “The only secret to
lower prices is to know your costs.” So, the
only secret to more profit is to know your
costs. But, do you really know your costs?
The greatest curse in healthcare is that 80%
of our costs are variable costs. Variable Costs
(VC) are the costs that go up and down in
direct relationship to how much dental
activity goes on. This is labor, lab bills and
supplies. Fixed Costs (FC) are the
remaining 20% of our costs. Fixed costs are
the bills you pay each month whether you
see one patient or a hundred. They include
rent/mortgage, equipment, build-out,
computer updates, professional dues,
continuing education, insurance, utilities
and phone bills. Our staff labor is 25%. We
pay our dentists (including myself ) 25% of
production, straight off the top. (I don’t
deduct my salary from the bottom line
profit zone.) Our equipment costs usually
roll in at about 3%. So, if our labor alone is
50% and our equipment is 3%, we should
be buying every piece of equipment known
to man to make our staff just a little
more efficient.
So, if you’re thinking you simply can’t afford
the initial costs of implementing digital
radiography into your practice, think again.
I honestly can’t see how you can afford
not to! DT
December 2001