Practice Management Insights

CDA member surveys and focus groups indicate that the greatest concerns facing dentists today have little to do with clinical dentistry and everything to do with managing a dental practice.

As dental students, we learn how margins affect our crown and bridge work, and in life after dental school we must learn how margins affect our ability to sustain a business and service our educational and practice debt. Likewise, in dental school, we are focused on tracking our grades so we can make sure we graduate, and in practice, we must track and manage our key performance indicators if we expect to be able to keep the lights on and pay our staff.

Staffing shortages have been one of the most challenging aspects of managing a dental practice, and the pandemic has exacerbated that trend. U.S. Labor and Statistics data indicate a decline in younger adults participating in the workforce in general in the past two decades, a trend that is expected to continue.

The operational costs associated with hiring and maintaining great employees are on the rise as the cost of living increases. Dental supply costs and the push to keep up with and invest in rapidly evolving technology are also driving up the cost of delivering dental care. Consolidation of dental practices seeks to share expenses and scale capacity but introduces a whole other level of complexity, often at additional expense.

All of these expenses are rapidly increasing, while at the same time dental benefit plans’ reimbursement rates have remained flat or have decreased. Some dentists are reconsidering their contractual agreements with dental benefit plans. In some cases, reimbursement rates that do not cover overhead expenses can shift the economic burden to uninsured patients with practices having to increase fee-for-service rates, see more patients at an increased speed, or shift their focus to the promotion of elective dental care.

In this journal collection of practice management insights, five authors share their knowledge and expertise. First, Debbie Castagna walks us through the annual planning process, which is a critical first step in assuring a practice remains viable and meets its goals.

Author Dr. Paul Etchison then presents readers with a discussion on dental practice culture and the dentist’s role in creating a workplace that will help attract and retain an outstanding dental team, which is critical to practice success.

Dental hygienists are a crucial partner in not only delivering clinical care and educating patients about dental disease prevention but they play an important and collaborative role in patient acceptance of the dentist’s restorative treatment recommendations. Rachel Wall shares her expertise on the dental hygiene department’s often overlooked and underappreciated role in the overall success of a practice.

Dr. Michael Perry explores the impact of dental benefit contracts on the practice of dentistry. He provides case study examples of dentists who have made different decisions regarding their relationships with dental benefit plans based on thorough evaluation of their practices.

Finally, Gene St. Louis educates us about practice valuation during practice transitions as some dentists contemplate the sale or acquisition of a practice.

Dental education does not end the day we graduate from dental school. Lifelong learning must include practice management insights such as these in order to succeed in dentistry today. With a better understanding of practice management concepts such as those presented in this collection, running an efficient, financially sustainable practice, with a great team, happy patients and a fulfilled dentist, can still be fully realized.

Additional information

Notes on contributors

Natasha A. Lee

Natasha A. Lee, DDS, is an assistant professor at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco, California. She is the director of the dental practice management and jurisprudence curriculum.