By Paul Koshgerian, DMD, MD
Since the opening of The Oral Surgery & Dental Implant Specialists in San Diego, California, we have been at a disadvantage. It’s a highly competitive market. Other practices have enjoyed the benefit of long tenures with great name recognition and reputations in the community.
But we, coming straight out of residency from the University of Louisville, were outsiders. My partner, Dr. Jonathan Shelton, and I knew we would be fighting an uphill battle.
So, instead of focusing on our competitors, we looked inward: how can we make our practice as productive and efficient as possible?
Practice optimization starts with developing and implementing a practice philosophy—including how the dentists and patients in your community visualize your brand—and culminates with the internal workflow and players inside the practice.
Our practice philosophy starts with (and centers around) the patient. We spend time with our patients during our consultation visits. We really try to educate them regarding their options. Although we would all love our referring partners to send us patients with tight treatment plans, we don’t always get what we want.
Ambiguity in the treatment planning process has the potential to confuse patients, so we often find ourselves doing basic treatment planning. Although this is arduous, see it as an opportunity: if patients haven’t been given this level of education, and if others haven’t taken the time to explain their options, your patients will respect you by taking the time to do so.
The decisions patients make are difficult, have long-term consequences, and are expensive. Giving them the flexibility to put the options through their own filter should be encouraged. Creating an environment where the patient doesn’t feel as though they are being “sold” something is of paramount importance. As surgical subspecialists, we loathe the feeling that someone may feel they are being pressured. Instead, we deserve to feel pride in every interaction we have. By taking the time, explaining options, and allowing the patient some freedom to understand their situation, we have found that patients appreciate and value our role in their process before we ever render treatment. Providing good care and keeping the patient’s best interests at heart takes a lot of the stress away from the consultation and planning appointments, both for the patient and for the surgeon.
Another surgeon-specific mentality is the complexity surrounding complications of surgical techniques and how to communicate these to patients. Albeit low, there are failure rates with dental implants. Let’s face it: there are patients who develop temporary paresthesias, infections, and other rarities after surgery, and these zebra complications often occur in patients who you wouldn’t have necessarily seen as high risk. Learning to prepare patients for their post-operative course honestly and openly will (contrary to most of our natural thoughts) strengthen a patient’s trust in you.
It’s also important to separate the surgical complication from the surgeon. More often than not, these complications do not represent personal failures. Instead, they are inherent to the surgical procedure itself. Learning to communicate openly and clearly about the possible complications of the procedures and plans we offer makes patient interaction easier and complication management much less arduous.
Next, we knew that positioning our practice in the San Diego market required assistance. Dr. Shelton and I had faith in ourselves as surgeons and as leaders of a practice. We had faith in how we could structure our practice, develop our practice philosophy, and engage with patients and referrals. What we needed was a loudspeaker.
We needed a team of professionals to help us organize our outreach and share our practice and our philosophy with the dentists and citizens of San Diego. Partnering with Jock Putney and his team at Nuvolum allowed us to formalize our brand, create beautifully branded paper and online content, and most importantly, create a rock-solid online presence. By forming this partnership, we’ve been able to grow in two ways: we’ve been able to grow more traditionally as most solid practices can through organic patient referrals from folks that have had great experiences inside of our practice, and we have been able to engage referring dentists and specialists inside our community through traditional outreach.
In my mind, the keystone of our growth has been our strong online presence. This online presence brings in patients who are “unreferred;” however, the real power is that anyone who has been referred to us or is finding us independently online sees a consistent message.
Dentists traditionally referred patients, and patients who found us independently are seeing educationally rich content, branded messaging, and hearing from patients in their community about how well they have been taken care of at our practice. Dr. Shelton and I are very grateful and proud to call Nuvolum a partner in our practice. They have, without a doubt, helped us streamline our processes and be more efficient and productive.
Finally, continuing to optimize our practice is an everyday grind. Let me be clear: we are not the optimal practice, but we put effort into making ourselves better every day. As the surgeons and leaders of our practice, everything is our responsibility. That being said, managing all of that responsibility is impossible for any surgeon. We take our hiring processes seriously because creating a team which shares the values of the surgeon(s) is critical. Therefore, recruiting good people is a must.
Nearly two years ago, we made the decision to hire two upper-level administrators for the practices: one as a clinical supervisor and the other as a business supervisor. These roles were created to oversee the operations of our practices, to create further accountability amongst the employees, to allow the surgeons in our practice to focus more on the surgery and patient care, and, frankly, to do a better job than what we had been doing up to that point standardizing policies and procedures, creating financial reports, and performing practice analyses. At the time, we were concerned because we knew these higher-level administrators were going to demand higher compensation than what we were used to. We certainly saw their potential value, but (like most surgeons) we didn’t love the idea of spending money. More accurately: we were concerned that we would be creating more expenses without seeing much benefit.
I’m glad to say we were wrong. Since their hiring, our practice’s growth has accelerated, our office staff is magnitudes more organized, our collection and expense reports are well organized, and Dr. Shelton and I can rely upon these leaders to help us create a healthy environment to work within. The tangible monetary benefit they’ve provided has been substantial, but the real value they have provided us is the peace of mind in knowing we have partners who can address the daily tasks and unforeseen issues we formerly had to step away from patient care to address.
Optimizing our practice has been, and will continue to be, challenging. It takes consistency and effort. Very few if any Oral and Maxillofacial Surgeons want to settle for mediocrity. Pushing ourselves as surgeons and expanding our education comes naturally to us and should be celebrated and continued. What may not come so naturally is thinking of our practices as the businesses they are.
Put the time in, surround yourself with good people, and as our mentor Dr. Brian Alpert said, “treat people well and do the right thing, and there’s always going to be a place for you regardless of the city or town.”
Paul Koshgerian, DMD, MD
The Oral Surgery & Dental Implant Specialists of San Diego
Dr. Koshgerian is a board-certified oral and maxillofacial surgeon, completing his residency at the University of Louisville. He now practices the full scope of surgery with his partner, Dr. Jonathan Shelton, at his private practice in San Diego, CA.