Gilbert M. Amthor, DDS

Dr. Amthor’s cosmetic practice, The Center for Smile Enhancement, is located in Palm Desert, California. You may contact Dr. Amthor by e-mail at ddsgil@aol.com.

It doesn’t matter what type of practice you would like to own or develop, it must be profitable or it’s a worthless endeavor. I learned that lesson the hard way back in 1993 when I really thought I was "tearing it up" as they say. I produced almost $700,000 with moderate level fees and a lot of hard work. I was tired, my staff was tired, and even my wife was tired of hearing I was so tired. But the biggest problem came when my CPA and I looked at the end of the year bottom-line numbers. I thought I was going to shoot myself, my CPA, and my wife (she writes the checks for the office). Our net profit for the year was $208,500. I worked that hard for $208,500? Well, that’s when I decided to change my philosophy on "practicing dentistry."

Over the Christmas holiday I worked day and night, crunching numbers to figure it out. The first major problem I found was that our hourly production was only $347.50. That would be great if you were open 24 hours per day, but I wanted a Nordstrom-type practice not a Wal-mart. (If you want to be Wal-mart that’s okay, and it can be profitable. But that wasn’t the direction I wanted to go.) It was costing me $243.25 per hour to run my office, so we realized we needed to push up the hourly production. After looking very closely at what my days of production were like, we realized that some procedures I didn’t like to do were taking too long for me to finish. Things like endo, extractions, and amalgams. (Now I know what you’re thinking! Just double up the patients. Well, that is not my philosophy. How would you like to walk into Nordstrom and have the salesperson help you and another customer at the same time? Doesn’t make you feel very special, does it?) So I decided to stop doing those procedures.

Next I decided to reduce the hours I worked, since I was so exhausted. In January 1994 I cut back to three and a half days per week from the previous 40+ hours I had been practicing. Then I started having the staff schedule by production. I knew we had to stay at $500 per hour to reach our goal. Now, where were we going to come up with $150 more production dollars per hour? My staff and I talked about this for two days. We argued some too! This would represent a 42% jump in production per hour. We found the answer in four different areas: hygiene, scheduling, raising our fees, and bringing in better quality patients.

Hygiene had not been productive enough. We had been doing very little soft tissue management (STM). We found that hygiene was a great place to sell bleaching and night guards, and we also started a fresh breath center. With these changes, we were able to raise our hygiene production to $150 per hour. That was $50 of the additional $150 we needed to meet our goal.

Next, and probably the most important, was scheduling. Everyone has to be tuned-in with the hourly production goal. We are all constantly working on the schedule to maintain production, whether it is selling a night guard through hygiene, or diagnosing and doing two inlays to fill a cancellation.

The third change was to increase our fees by 20 percent! We learned from a study done by the Eastman Kodak company in the mid-80's that by increasing our fees 20%, we could lose 45% of our practice and still make the same profit. (A 10% increase and we could have lost 30% of our practice to make the same profit.) I thought we would lose some patients, but we didn’t!

The fourth and final thing we did was bring in a higher quality patient. We turned to 1-800-DENTIST® for this. We had tried Val-pac, newspaper ads, and even a direct mail piece. None of which did better than a 2 - 1 return on investment. I feel that a good marketing investment must be at least a 4 - 1 return on investment to be profitable. We found that with 1-800-DENTIST® and my dynamic staff we were converting at an 80% rate and were producing an average of $785 per patient. That added up to a 5 - 1 return on investment. I don’t know of a better way to invest my money than that. (I am now on the waiting list for a second 1-800-DENTIST® listing).

What did all this mean for us? In our first year of doing the dentistry I really enjoyed, we kept production at $500 per hour, working 30 hours per week. I took four weeks off that year as well. That equaled a production total of $707,000 and our overhead only went up to $257 per hour. That gave us a net profit of $336,920. I was a happy man at the end of 1994!

Since that time I sold that practice and started a cosmetic practice in Palm Desert, California called The Center for Smile Enhancement. I have developed a boutique style practice built around four major principles:

1) high quality

2) high service

3) high fees

4) high quality of patients.

High quality is the most important principle! And guess what? It has nothing to do with the quality of dentistry. You must market your service, not just your product, and it is the patient that defines quality. Patients judge the quality of your office four ways: 1) The physical appearance of your office. It must look nice and new! 2) The "wow" factor. Does your patient walk out of your office and say, "Wow! I have never had a great dental experience like that before!"? 3) Advanced technology. High tech equals high quality to the patient. 4) The overall positive experience—from phone to financial arrangements. Did you keep the patient feeling really special?

My new practice is so fun! I have cut back my time there. (My golf swing is getting really good -- I shot a 66 the other day!) I work 24 - 25 hours a week with an hourly production goal of $600. We continue to work on the basic goals of hygiene, scheduling, quality of patients and fees. We have added some new business laws that I learned from my mentor, Dr. Roger Levin. Those are:

1) You must assemble a great team and then keep them.

2) Cut costs (overhead control is a constant battle). We reduce about 6 - 8% off overhead when we start focusing on this.

3) Pay attention to "core business." This means understanding who your clients are and what they want.

4) Most important is to write a marketing plan. If you don’t write it down, it won’t get done.

I’d like to leave you with a few quick sayings you can put up in your back office or use at your next staff meeting:

· What makes us different?

· It’s about service not product!

· Everything we say or do for our patients is done as a benefit.

· The three most important words we can learn are value, value, and value.

1-800-DENTIST® is a registered service mark of Applied Anagramics, Inc. operated under license by Futuredontics, Inc. in the U.S.