Dentistry in Today's Private Practice

Practical Wisdom From the Trenches

Eric Hall DMD, FAGD

“We don't rise to the level of our expectations, we fall to the level of our training.”

― Archilochos

Hall Comprehensive Dentistry

-Grad UGA '05 (Biology)

-Grad Medical College of Georgia '09

-AEGD Resident '10

-Macon, Georgia

-Fee for Service

Hall Comprehensive Dentistry

-13 Team Members

-Two Dentists

-Five Hygienists

-Three Assistants

-Three receptionists

The Competition

Treatment Plan Coordinator

For every 100 diagnosed cavities, 38 actually get filled (38% case acceptance)  


Provide detailed treatment plans for patient showing patient portion and insurance portion


Remind them that this is an ESTIMATE and they are responsible for anything insurance doesn't pay

Warranty Everything for 5 Years

"Root canals don't work"

We'll warranty it!

Who's the Boss?

Healthcare and education are female dominated arenas and industries

Economics are mainly women

In America, 2 out of 3 dollars are spent by women

Differences between Men and Women

The majority of females will take their cars to the dealer for repairs

Men typically choose the cheapest auto place to get it fixed

Women are more driven by trust and loyalty

92% of appointments are made by women

Differences between Men and Women

Women tend to spend 3x more when they have trust

Men: 2000 Words/Day

Women: 7000 Words/Day

Majority of referrals are from women

Avg Amazon Prime Member: $1500/year

Avg Non-member: $400/yr

Must have trust for success

Quick Overhead Review

Marketing: 3-6%

Payroll: 25-30%


Dental Supplies: 5-7%

Office Supplies: 1.5-2.0%

Lab Expenses: 8-10%

Total Overhead: 50-64%

Source: "Multi-Million Dollar Dental Practice" by Dr. Michael Kesner

How much $$$ does it cost to sit a patient in the chair?


Employees $40

Facility $11

Business Expense $12

Materials $15

Discretionary Expense $4

Need to know cost analysis of treatment

Usually lose money on prophy

Before you sell something, know how much you bought it for

Which Implant Do You Use?

Nobel Biocare

Implants Direct



Oral Surgery

 Zoll Luxators


3.0 Plain Gut

NuOss Bone Graft

BioMend Collagen Membrane

Which Endo System Do You Use?

Brasseler Endo Sequence

BC Sealer



Always Use RD


Howard Farran





Morning Huddle

15-30 Min 

Discuss previous day 
Post-op calls
Treatment Scheduled

Discuss upcoming day

Unfinished tx plan

Potential STM

Soft Tissue Therapy

#1 reason dentist are sued= Lack of diagnosis of Perio

3 out of 4 Adults have some form of Perio

Soft Tissue Therapy




5% Fluoride Varnish




Soft Tissue Therapy

Case Type I- Gingivitis-$550-700

Case Type II- Early Perio 4-6mm- $900-1300

Case Type III- Late Perio 7+mm- $1000-1800

Oral Cancer Screening

#2 reason dentist are sued= Lack of diagnosis of Oral Cancer



Toluidine Blue

D0431- Oral Cancer screening

Oral Cancer Screening

47% Increase in Oral Cancer

Mainly due to HPV

75-80% Survival Rate when found in early stage


Great in-office service for mild ortho

All the work is done by aligners

Lab fee $1599

Patient fee $4500

Choose cases carefully for compliance

Location, Location, Location

Research the economics


-Median Income?

-Growth/decline past 5-10 years

Remember, business is supply and demand

Hire the Right People

Always hire on attitude and train for skills

Quality equals consistency



Already internally motivated

Fire the right people

Time Well Spent

Outliers author Malcolm Gladwell states most successful people spend 10,000 hrs before they master success

Avg person takes ten years to reach 10,000 hrs

Time Well Spent

Crown prep- 1 hour

Bridge prep- 2 hrs

Implant placement- 1 hr

Seat crown- 30 min

One filling-30 min

Two fillings- 40 min

Ext 1,16,17,32- 1.5 Hrs

Practice Acquisition is the Name of the Game


Associate: 35% of production/collection

Buy-out: 60-65% previous three years avg collection

Establish good working relationship w attorney and commercial banker and labs

Practice Valuation

# Active Patients

# New patients

Gross and Net Collection/Production

Other factors: PPO?



Practice Philosophy

Do Your Research

Why are they selling?

How long will they practice?

Non-Compete Clause


How long have staff been around?

Buying in is a marriage

Suggested Reading

A Philosophy of the Practice of Dentistry- L.D. Pankey

Suggested Reading

The 4-Hour Workweek- Tim Ferriss

*Has a great podcast as well

Suggested Reading

"They Call Me Coach"
- John Wooden

*Also learn about the Pyramid of Success

Suggested Reading

"Ego Is The Enemy"

"The Obstacle is the Way"

-Ryan Holiday

Suggested Reading

"Meditations"-Marcus Aurelius

"Letter from a Stoic"- Seneca

Rise Above the B.S.

Tell yourself: The people I deal with today will be meddling, arrogant, dishonest, jealous, and surly. They are like this because they can’t tell good from evil. But I have seen the beauty of good, and the ugliness of evil, and have recognized that the wrongdoer has a nature related to my own—not of the same blood or birth, but the same mind, and possessing a share of the divine. And so none of them can hurt me. No one can implicate me in ugliness. Nor can I feel angry at my relative, or hate him. We were born to work to together… To obstruct each other is unnatural. To feel anger at someone, to turn your back on him: these are obstructions.

Choose not to be harmed—and you won’t feel harmed. Don’t feel harmed—and you haven’t been.

-Marcus Aurelius- "Meditations"

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Public - 10/5/16, 6:17 PM