THE FIRST FIVE
How to prioritize your equipment and technology purchases – and the five investments you need to
make first
Imtiaz Manji
Outfitting a new dental practice is like buying a home. You have the exhilarating sense of excitement and promise that comes with seeing your aspirations take shape, combined with a sobering sense of anxiety and responsibility that can keep you up at night. You’re entering the world of dentistry at time of unprecedented opportunities, but you’re also likely carrying unprecedented levels of personal debt, making it absolutely crucial that you get that initial investment equation right.
If you’re in a position to be making early investment decisions, rather than transitioning into an established practice as an associate, it’s for one of two reasons. Either you enjoy the idea of building a business from the ground up and are determined to start your career in your practice, or you’ve found exactly the practice you want to buy, and now you need to refresh the facility to bring into the next phase of its evolution.
Either way, you’re going to be faced with difficult decisions about significant financial commitments at a time when you’re still determining how strong the current is going to be in your cash flow. It’s all about minimizing risk while maximizing opportunities.
Ask Yourself the Right Questions
So what are the must-haves and what can wait? Before I get into specific recommendations, let’s examine how you need to make re-investment decisions, at any stage of your career. To get the right answers, you have to start by asking yourself the right questions. Specifically, you should evaluate each purchase by asking the following:
Is it right clinically? A strong ethic for ideal patient care is the driving force of a successful practice. Scrutinize any potential purchase through the lens of your vision and philosophy, and make sure its advantages support your standards of clinical excellence and client value.
Does it help the practice grow? Especially in these crucial early years you need technology that is going to contribute to growth—and that can be measured in a number of ways, including an increase in clinical speed, case acceptance, patient retention, or new patients.
Does it provide a good return on investment? This sounds obvious, especially with technologies such as digital radiography, which gives you a precise break-even number to work with. The return on something such as your management software system may be harder to pin down, but the economic benefits are real, and should be factored in to your deliberations.
Does it fit into my short-term future? Other than your chairs, most technology you buy today will be replaced over three- to eight-year cycles, so what you choose to begin with needs to be what you will use to begin with. But be aware of where the trends are taking dentistry and don’t buy into technologies that are on the road to obsolescence.
The First Five
Ok, you’ve got your philosophical priorities straight, you have a budget and an appointment with an equipment rep. Where do you start? Here are my top fivenominees for your consideration:
1. An integrated and expandable delivery system. An effective dental facility is built from the chair out—that’s where your clinical capabilities and the patient’s experience converge—so your plan starts here. You don’t want the heart of your clinical environment patched together in an ad-hoc way, so start with a top quality unit featuring a delivery system module that integrates all the basics—air, suction, handpieces, and curing light—in a neat, efficient, ergonomically-friendly way. Most importantly, get a system that allows you to easily add and upgrade as you grow.
2. Electric handpieces. Dentistry is as much a craft as a profession, and as any master craftsman will tell you, the right tools make all the difference. For a dentist, that’s especially true of handpieces, which are to you what brushes are to a painter. The new generation of electric handpieces offers unparalleled accuracy and control, and precision should be the goal of any serious clinician. In fact, it’s worth noting that most of the leading practitioners in the profession—dentists such as Dr. Frank Spear and Dr. Gordon Christensen, who are renowned for their exacting standards—have long since embraced electric handpieces because of their clinical advantages. If you intend to join the ranks of the masters, you need to get comfortable with this technology from the start.
And while we’re at it, don’t forget a simple low-cost, low-tech way to make the most of the precisely detailed work these handpieces let you do. Dental magnifying loupes may look old-school, but they can help you produce higher quality dentistry and increase your delivery speed, not to mention helping you avoid posture-related muscle pains.
3. Intra-oral camera. This is not just a great diagnostic tool, but it is also one of the biggest breakthroughs in value creation that dentistry has ever seen. Tell a patient that you have detected a crack in a tooth and they may or may not be motivated to act. Show them—up close and in real time—exactly what you’re seeing and you’ve dramatically raised the impact of your diagnosis.
But as revolutionary and effective as the intra-oral camera is, remember that it is designed primarily for tooth by tooth and quadrant scrutiny. Ideally, it should be used together with a digital SLR camera—another fairly modest investment, and one that is critical for providing the full-mouth images you’ll need for truly comprehensive diagnosis and communication.
4. Chairside Practice Management Software. Believe it or not, the most costly part of many dental facilities is a hallway. By the time patients come out the other end and face the receptionist, that “yes” they gave you in the chair has dissolved into “maybe some time” and they walk out uncommitted.
This is why having practice management software at chairside is so important. It keeps the discussion of things like fees and appointments tied to the value experience you have just worked so hard to create, so you’re able to capture those “yeses” immediately and finalize the process on the spot, before the patient takes a walk down that hall. Not only that, but this system is central to many critical functions you are—and will be—performing. Records, images, treatment plans, insurance, scheduling—they all tie into your software system (or will eventually), making it the pulse of the practice, so you need to make sure the system you choose now is up for the job.
5. Digital Radiography. It almost seems absurd to include this on the list. It’s kind of like advising someone to buy a DVD or Blu-Ray player rather than a VCR—a no-brainer, right? But the fact is there are still a lot of wet film x-ray systems in use by many reputable practitioners, and new units continue to sell. Film is, in its own way, dependable and accurate. But can anyone deny that the future belongs to digital? And since the future is where you intend to practice, it makes sense to “go digital” right now.
6. CAD/CAM. Yes, I know this was supposed to be a list of the top five investments; consider this one a bonus. Because if there is one technology that you may not be opening with, but that you need to factor into your plans, it’s CAD/CAM—specifically CEREC, which was the pioneer in this technology and, for my money, still the front-runner because of its track record, support network, and expandability. This is one investment that starts paying for itself very quickly, so monitor the number of CEREC-worthy units you are doing, and as soon as the numbers justify it, make the bold CAD/CAM leap. Trust me, one day this technology will be standard equipment in all dental offices. Don’t wait for the future to come to you. Get out there and meet it on your terms.
Putting It All Together
A few final thoughts to keep in mind before finalizing your choices: First of all, integration and compatibility. The best way to develop a well-equipped practice is to plan for it, so make sure your facility is designed to allow the right space for proper installations (including wiring and CPUs), that the systems you buy today work smoothly together, and that they allow you to add new “plug and play” modules as you grow.
Secondly, even though technology can be complex, owning and maintaining your systems shouldn’t be complicated. You can do yourself a huge favor and simplify things considerably just by choosing your vendors carefully. Look for suppliers who you can go to for most of your needs, suppliers who offer full support and can help you develop a coherent plan to integrate everything. That “one call solution” peace of mind is worth a fortune in itself.
Finally, remember that having the best technology in the world doesn’t mean much if you’re not prepared to learn to use it to your best advantage. Dental school does a great job of providing foundational learning so you can open your doors and get to work. And the ever-evolving world of high-tech dentistry is always inventing exciting ways to enhance and supplement those foundations. If you really want to be a part of the forefront in this industry, get out there among the leaders in the field—and the leaders among your peers—and discover how the best minds are using the best technology for the best results. After all, the most important, most adaptable, unit of sophisticated circuitry in your practice is the one between your ears. ■
For 25 years, Imtiaz Manji has been one of dentistry’s most sought-out leaders for his unique view point and practical advice. Past CEO of Mercer and current CEO of The Scottsdale Center for Dentistry, Imtiaz is dedicated to helping doctors achieve clinical excellence, leading-edge technology and ideal patient and practice success.