Embrace Progress: Out Like a Lion by Dr. Daniel Grob

Dentaltown Magazine

by Dr. Daniel Grob, DDS, MS, editorial director, Orthotown Magazine


“Repurpose, retool and redeploy.” That was the advice from a recently featured consultant on one of the business channels giving his advice to small companies caught in this unprecedented pandemic. It’s no secret that all of us will need to do a little reinventing as well once we wade back into the daily grind of active patient care.

Less than one month ago, I had planned to remind readers to attend the AAO meeting and visit the various exhibits, lectures and, of course, friends. But everything changed. The meeting was canceled and replaced with a reschedule of virtual lectures and exhibits of sorts. Future meetings and conferences are on indefinite hold. Continuing education opportunities have been redefined. I’ve attended countless webinars and Zoom sessions over the past several weeks.

Uncertainty has increased and most of us were urged to shelter in place. When we’re given the all-clear sign, we’ll return to organized chaos as pent-up demand for adjustments, emergencies and exams will all need to be taken care of—and soon!

Taking a vacation or hiatus from the office—planned or unplanned—is rarely just “some time off” in the middle of an otherwise organized life. We worked hard before and we’ll work even harder when we return to meet deadlines, real or perceived, to get braces off by prom, graduation or bar mitzvahs.

Lots of things have changed and we probably haven’t had enough time to even think how we got here. My daughter’s New York City wedding—carefully planned for the end of April to coincide with cherry blossoms, a lack of tourists and, yes, a sizable discount to the May rate—had to be rescheduled for the end of July. (We have our fingers crossed.)

With so much unscheduled nonclinic time, I’m fortunate to be able to get things done that I’ve been putting off for years. (Yes, years.)

What have you done? What are you doing?

While it was difficult to mentally prepare for a shutdown of this magnitude and scope, a little bit of skepticism goes a long way. Raised by Depression-era parents, I was always often reminded of times like this, or worse, when people were selling pencils on the street, and saving the Sears catalog for essential home hygiene.

In this era with so many in debt to begin with, I’m not about to lecture on saving for disasters and the like. However, being prepared for a “black swan” event such as this has proven to be good for you, your family and your practice. In other words—and this can apply to everyone—living a notch below your capabilities is a beneficial learning experience.

What changes are you implementing? Just for starters, my team and I are:

  • Organizing our supply area with an updated inventory system.
  • Redoing our office binder system (actually a series of training manuals).
  • Creating new binders to detail every procedure in each department.
  • Getting all the new information stored digitally and in the cloud.
  • Gathering before-and-after photos for Instagram, the website and Orthotown message boards.

For a brief time, I offered hours and work projects to staffers who were willing to take a cut in hours. Some accepted, while others elected to take advantage of the expanded unemployment benefits.

We had an “all hands on deck” plan where phones were manned to reschedule patients for the return. Most patients were given extra time to accomplish their next appointment—we’re assuming that there will be plenty to do when we’re able to see them again, and I also want every visit to be as positive as possible, indicating to patients that we’re taking extra care to move their treatment along. Often, I set up appointments to rebracket teeth or add appliances.

Instead, we are just going to do it! This will mean long hours and lots of work, but the job needs to get done. The untimely and unscheduled delay presents a great opportunity to move patients from Phase?I to Phase II (assuming, of course, they are financially fit).

During this period, the delay in finishing Phase I treatment means that some patients are watching permanent teeth erupt ahead of their anticipated finish date. What a great time to extend the contract, reprice the treatment and create some goodwill by offering a special fee for continuing.

(I can already hear in the background those shouting, “That’s why you shouldn’t do Phase I!”)

But what about the future?

There’s no doubt that things are changing and will change forever. This generation will remember the sacrifices, new workflows and issues of the moment like never before, and will no doubt tell their children just like my parents told me.

It’s not enough to say “virtual consultations are here to stay,” because they were already taking place before the pandemic. Like other transformational times in our history, the crisis only accelerated what was already happening. Kind of like insurance reimbursement becoming standard, lower fees and the adaptation of 3D X-rays.

Office requirements and lease structures most probably will change to reflect the uncertainty of pandemics and other acts of God. With virtual consultations and other telemedicine, dentistry and orthodontics will probably need less of a footprint in society from the standpoint of square footage and number of dental chairs.

I’m told that a billionaire investor we’re all aware of has shorted the commercial real estate market by a sizable amount. With all the work from home and videoconferences going on, expansive offices will most probably be scaled down. How are $100-per-square-foot luxury offices buildings justified when on the turn of a dime, you tell your employees to just do their jobs from home?

Fees are anybody’s guess, but in the interest of access to care, I do think that there will be a justified downward pressure on fees. Staff will probably be reduced as practices scale up at a slower, measured pace. As much as we’d like business to be “as usual,” it’s safe to say that potential patients will tiptoe slowly back into the elective dentistry marketplace—all the more reason to be reasonable with fees, conversion from one phase to the next and re-treatment requests.

To those fresh out of school and feeling uncertain: The golden era is still here, just reinvented.

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