Upen J. Patel, DDS, discusses the advantages of transitioning to a fee-for-service practice for both you and your patients.
Q: Is there only one way to practice dentistry in 2024?
A: There is no one way to practice dentistry, which explains why we have so many different models of practice. Some superb business-minded dentists focus on multiple office locations and excel in operations and management. Others focus on joining every insurance plan offered to maximize patient acquisition but could spend much of their careers regretting what could have been due to insurance handcuffs. There are some who choose to be free from insurance limitations and focus their energy on being an out-of-network, fee-for-service (OON, FFS) dentist in an independent model of practice.
Q: Whose patients are these, anyway, yours or the insurance companies’?
A: For me, excellence in clinical dentistry is the most important aspect of dentistry, and I want it to be on my terms, not terms dictated by an insurance company. For some time, I felt I was working too hard; seeing too many patients; and, at the end of the day, not being properly rewarded for routine procedures. I came to realize I had fallen into the commodity model of dental delivery, with me being the commodity. When comparing professional services, none of us are the same. Insurance companies have successfully convinced patients that dentists are commodities, and therefore, you can pick a dentist based on price.
Q: What is the future of dental insurance reimbursement?
A: I foresee lower and lower PPO and HMO contracts and dentists becoming increasingly disheartened over a potential 40-year career. Overhead costs continue to increase, especially staff salaries, business insurance policies, and supplies. The quality of care could be compromised by using cheaper materials and spending less time with more patients, which may be seen as “breaking even” in the dental practice. You cannot be everything to everyone. Attempting this will lead to frustration and conflict. It is physically and mentally draining to attempt to be in multiple rooms at once. I recommend slowing down and increasing the time spent and the quality of the experience for your patient. Transitioning your practice from PPO/HMO to OON/FFS dentistry allows you to control your own destiny. If you wait until later, “when the time is right,” to go OON, you may be waiting forever. Perhaps hold off on that luxury purchase and focus on rebuilding the foundation of your dream practice so that you can work and live the way you want for the rest of your life without regrets.
Q: What are the challenges of going OON?
A: Most of us fear losing patients and going back to the idea of a survival mode mindset vs the comfort of current practice life. While fear has a sound evolutionary basis, it can keep us from reaching our full potential in life. Challenges include new financial arrangements such as collecting at the time of service; communicating with patients about their benefit plans; and knowing how they can still come to your practice if we drop insurance plans, especially those we really love to treat.
Q: What are the steps to mitigate patient concerns over time, money, fear, and trust issues?
A: Education is a vital key to success. The power of consistent discipline, work ethic, focus, and compassion will always outperform talent in the long run. First, get better; then get paid better. Take as much CE as possible and become an expert in the procedures you love to do. Never underestimate the power of word-of-mouth referrals. Embrace change, find mastermind groups, and take CE on the business and psychology of dentistry. Work with a mentor/coach to help guide you and your team on this new practice model. Choose 10 things you want to do at the highest level, then do them repeatedly. This leads to mastery and less stress. Educating patients to build trust and great dentist-patient-RDH rapport is imperative. Patients want to know that you are dependable, capable, trustworthy, and compassionate. Patients who trust us realize that we are acting in their best interests and putting their well-being first.
Q: What is in the engine that drives your practice to peak efficiency?
A: Systems and your team. Hire the best people with loyalty, character, and the same enthusiasm for your vision of practice. Cross-train all staff members and be emotionally present for your patients and staff. Have a marketing plan to establish brand awareness online and find your own niche. Gone are the days of yellow pages; Google reviews and engaging Instagram pages are the new forms of advertising. Patients feel more connected, and options for virtual consultations are an idea.
In conclusion, take risks early on and follow your dreams. Mistakes are not mistakes if you learn from these experiences. Learn to delegate; you are the foundation and leader of your business. Luck is when preparation meets opportunity. The opportunity is there. Are you feeling lucky?
ABOUT THE AUTHOR
Dr. Patel has 20 years of experience in dentistry. He is a Kois graduate, completed an AEGD program at and received a DDS degree from the University of the Pacific (Pacific), and is a restorative part-time professor at Pacific. He is also a podcast speaker on The Fee for Service Dentist Podcast and Dental Leaders Podcast, a former professional squash player, and a US level 2 squash coach. He can be reached at upenpateldds@gmail.com or at the Instagram handle @doctorupenpatel.
FEATURED IMAGE CREDIT: Constantin Stanciu/Shutterstock.com.
