When I work with other dentists to implement technology successfully into their practices, several common objections or barriers seem to arise. While it is true that there are specific challenges along the voyage to the digital practice, with proper guidance they are all easily navigated to arrive at your desired destination. Following is a list of the most commonly identified misconceptions and challenges and the reality of the situation.
(1) My staff is not computer literate. They will never be able to learn the new systems and be productive. It will take too much time away from production to install, learn, and implement the new technologies.
Computers and programs today are user-friendly and are continually getting easier to learn and use. It takes some specific training for many of the new programs and technologies, but excellent training is usually available from the vendors. Your best investment is paying for the proper training. Most of the installation and training can be done during non-patient-scheduled hours, and consequently, production is not severely impacted. The effect on staff members is that they will become more efficient, more valuable, and more fulfilled in their everyday tasks. Work becomes more productive and interesting when boring, repetitive tasks are automated.
(2) The technology is not good enough yet. It will be better later, so I will just wait.
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| Photo Illustration by Nathan Zak |
The quality is here now. The diagnostic quality of digital x-rays currently is equal or superior to the traditional film method. Add to this the fact that because the image shows up on a computer monitor, it is large enough for the patient to see, and they actually comprehend what the issues are. The resolution and color correctness of digital cameras are also now equal or superior to the traditional film method. These digital pictures can be electronically stored in the patients’ clinical records, printed and given to the patient for review, or e-mailed to specialists for consultations or insurance companies for claim review.
(3) The technology costs too much.
The cost of the necessary computers, monitors, printers, scanners, etc, has fallen to very reasonable price points, and the amount of technology purchased per dollar continues to escalate. Interest rates are at near historic lows, and lease plans are available that allow for monthly payment schedules that will not break the office budget. The increase in production will more than cover these payments. Moreover, the government is continuing in 2006 to encourage business investments with tax incentives, so you can purchase technology at a great savings—about 34% on average. If you can purchase all of the hardware and software at about a 34% discount, it is unlikely to ever get better than this. The time savings for staff will more than pay for the digital upgrade by allowing them to be more productive by seeing more patients in a day. The need to add additional staff as the practice blossoms is also avoided. Technology integration will be one of the best return-on-investment decisions a dentist can make.
(4) It is just a fad. Only a few offices will ever do it…just the computer nerds. It will never catch on in mainstream clinical practice.
This is not a fad; technology and digital records have reached the tipping point and are here to stay until they are replaced by something not even thought of yet. Computerization at the front desk has reached about 95% penetration, digital radiography is believed to be approaching 30%, and complete digital practices are in the 4% to 6% range. Some may remember the days before office computers existed—even at the front desk—and the pegboard system was considered to be state-of-the art. Now most offices at least have computers at the front desk for patient billing and processing insurance claims. The day may well come soon when you will be forced to file all insurance claims electronically in the same way that payroll taxes have to be done.
(5) Digital radiographs are not safe for the patient.
In reality, digital x-rays are safer for the patient. Radiation exposure to the patients, the staff, and yourself is usually greatly reduced. It is safer for the environment because no chemicals pollute the air and water. Most municipal sewer authorities are really cracking down on this type of discharge, and with digital radiographs, this is no longer an issue. If there is a way to get radiographs that have more diagnostic capabilities, cause less harm to the environment, and especially expose the patient to less radiation, is it morally or ethically acceptable to continue to practice dentistry with traditional film?
(6) Digital records are not safe or secure.
In reality, digital records are safer than paper records. Backup copies always exist out of the office. Where would you be if your office was destroyed by fire, flood, tornado, or hurricane? Dentists in various places have lost their offices to one of the above. They are truly forced to start over. With totally digital records, you may have lost the office, but all of the patient records, including charting, radiographs, photographs, and accounts receivable, are still completely intact. As far as liability control is concerned, everything is time and date stamped. Insurance companies now prefer them because they are legible and more complete. There is never a lost chart or x-ray. Also, an audit trail can give you a copy of every transaction, including every change made to appointments, charges, and payments. Consequently, it makes it much more difficult for anyone to embezzle from you.
(7) I do not need all of those bells and whistles to be a quality dentist; I can do great dentistry without them.
No one will argue that you need digital technologies to perform excellent dentistry. A book can be written with a pen and paper, but the process can be accelerated and less tedious when it is done on a typewriter, and it becomes even easier using a computer, especially when you want to edit and make additions or changes. Consider the fact that better technology leads to better diagnostics, and consequently better treatment. The whole concept of minimally invasive dentistry comes alive in the digital age using such technologies as digital radiographs, intraoral cameras, microscopes, digital caries detectors, and lasers. Additionally, with digital dentistry, when the patients can actually see what you see as their dentist, they finally understand their dental problem, which leads to increased treatment acceptance. Once you start using the new technology, you no longer want to practice without it.
(8) The learning curve looks too hard for me.
Learn and institute one piece at a time. A person can accomplish almost anything if it is tackled in manageable chunks. The staff will do most of the hands-on part with the digital technology. When any software is purchased, make sure staff members are able to get appropriate training on how to use it effectively. They will embrace the technology when the dentist does, and once they understand how much it will help them in their day-to-day repetitive tasks, they will be eager to learn whatever they need to. Ultimately, they will never want to go back to the old way or leave for an office that is not “up-to-date.” You do not have to be proficient with each program yourself; you merely need to understand what is happening and why. This is a team effort!
(9) Fear of the transition process—I am afraid to change! (This is where the rubber really meets the road.)
Everyone has apprehensions about the unknown. It is easier to tolerate the status quo even if you know a different way is better for you and/or your patients. It is really the process of change, not the change itself, you may fear. Go and see the technology in action so you have a clear vision of the outcome you desire, and focus on that outcome, not the process. It may be helpful to read the book Building the Bridge as You Walk on It, by Robert E. Quinn, for the encouragement and insights you may possibly need along the voyage. Become more purpose- centered and less comfort- centered while you ask yourself what you want to create. Finally, talk to someone who has already done it; hire a consultant who has been through the process himself or herself.
(10) I will be retiring soon, so I don’t want to bother with the hassle, the expense, or the learning curve; I will just let the buyer of the practice do it.
With modern technology incorporated into your practice, it will be a more valuable asset to sell. The value added to the practice will be much more than the cost of the technology. A young buyer is more apt to buy a practice with newer technology because he can ill-afford to pay for the new technology at the same time as purchasing the practice. The new digital technology will be much more readily accepted if it is implemented by the older doctor. The patients will want to stay with the practice because they believe that the doctor, even on approaching retirement years, is progressive and wants to keep current, so the patients know they continue to receive the best care possible.
CONCLUSION
The only crucial barrier to using digital technologies is in the present mindset of the practice owner. If change is viewed with fear and trepidation, then you can find a hundred-and-one reasons to rationalize staying with the status quo. The choice is to be either proactive or reactive to the changes that continue to challenge you. When you are proactive, you are much more in charge of your future destiny. Let the wind blow you wherever it is going, or trim your sails and use it to get where you want to go. Abandon the anchors that are holding you back and move forward through the storm of change with confidence. The old adage “if you think you can, or can’t, you are probably right” certainly applies here. If you are willing to have a vision of the future and have a clearly defined goal of joining the 21st century, there is a charted path to get you there safely and affordably. Once you are on the voyage, you will enjoy it and never look back.
Dr. Dykstra started his solo dental practice in 1978 in Hudsonville, a small town in western Michigan. His original office was expanded 3 times, and in 1994 he built his dream office with just more than 3,800 square feet of working room. Dr. Dykstra’s practice is in the top tier of production and collection of dental practices in the United States. He went paperless in the fall of 2002 and has successfully incorporated total electronic records with digital clinical charting, digital radiography, digital intraoral and extraoral photography, and digital imaging. He added a laser to his practice in 2003. In addition to working full time in his practice, he does speaking and consulting work through Anchor Dental Consulting, which he founded to help dentists successfully integrate technology into the dental office. He can be reached at info@anchordentalconsulting.com.
