Evaluating the Industry

Assessing what dentists are accomplishing, what they want and how Heartland Dental compares

Assessing the Industry

Dentistry is not what it used to be. Twenty-five years ago, dental offices were run without the aid of email and internet, and tools like the dental laser, modern dental composites and Invisalign had yet to be created. One can only imagine the changes that will take place in the next twenty-five years. Progress is in the very nature of the industry. As technology races forward and techniques develop, dentists have the capability to provide remarkable, cutting-edge patient care. In this exciting, ever-changing industry, dentists also face the constant challenge of staying current.

Overhead Costs

As innovations change the way dentists practice, dentists are changing too. To discover what dentists want and what they achieved in 2013, Dental Economics and Levin Group, the leading dental consulting firm, completed their seventh annual practice research report. A sample group of general dentists were surveyed on six specific areas: practice overview, practice production, collections and billings, procedure mix, overhead and doctor satisfaction.

"Levin Group's mission is to improve the lives of dentists. As part of that commitment, the Levin Group Data Center has become one of the largest aggregators and analysts of data in dentistry today. For the past seven years, Levin Group has partnered with Dental Economics to survey thousands of dentists and publish a comprehensive report on the state of the profession," explained Roger P. Levin, DDS, Chairman and Chief Executive Officer of Levin Group, Inc. "I am pleased that this information enables dentists and other dental professionals to see where they stand among their peers and identify the trends that are reshaping the future of dentistry."

Perhaps most noteworthy were four key changes revealed in the 2013 report: many dentists are seeking improved systems to improve practice efficiency, financial burdens are increasing with rising overhead costs and collection issues, dentists are working longer and retiring later, and dentists are searching for outside support.

As a dental support organization, or DSO, Heartland Dental has particular interest in understanding and assisting with these areas. With Heartland Dental’s assistance, many dentists who once struggled with the challenges of increased overhead, decreased time for patients and keeping up with industry advances are now finding resolve. On top of that, newer dentists who affiliate can start their careers out without worrying about these struggles at all.

New Patients Per Month

The following sections detail the specific findings of the DE/Levin Group report. In comparison, these sections also highlight how Heartland Dental affiliated dentists match up in those same categories, pinpointing what areas in which they are enjoying relief, success and ideal careers.

Systems for Success

Although patient care is and should be the most important responsibility of a dentist, the fact remains that a dental office must remain viable from a business standpoint. Like any other business, certain tasks must be managed and certain systems must be implemented in order for it to thrive. However, the DE/Levin Group research indicates that offices just aren’t finding the systems they need. According to the report, two-thirds of those surveyed are ready for an improved business model. One-third of those dentists said that inefficient practice systems are significant barriers to their success.

In addition, the report revealed interesting statistics regarding collections and overhead costs:

  • Collections were down to 91.3%, the lowest rate registered in seven years.
  • Overhead costs continued to rise (from 60.8% the previous year to 61.2% in 2013).

Decreased collections and increased overhead are two reasons that right systems are a necessity in today's industry. Otherwise, as the report suggests, offices do not function at their full potential, negatively affecting doctors, teams and patients. Heartland Dental's mission is to support affiliated dentists in applying proven systems that work for their specific needs. With this support, affiliated dentists can boost the overall efficiency of their offices and find success in areas where so many solo practitioners are struggling.

"Supporting affiliated dentists in applying the right systems has always been a staple of Heartland Dental from the start. Without a set system of organized groundwork of an office maintaining efficiency and consistency will be difficult."

Patrick Bauer

Patrick Bauer
President and Chief Operations Officer at Heartland Dental

"Dentistry is valued in our population and will always be valued. Despite that, profitability is a struggle for more and more solo practitioners. With Heartland Dental's strong business model, affiliated dentists have the proven systems and support they need to face the challenges posed by today's market," said Dr. Rick Workman, Founder and Chief Executive Officer at Heartland Dental."

This information is helpful in assessing the climate for today's dentists. Because Heartland Dental concerns itself with so many of these issues, it conducted its own survey of Heartland Dental affiliates. Compared to averages from the DE/Levin Group report, Heartland Dental affiliated dentists:

In comparison to the doctors surveyed in the DE/Levin Group report, Heartland Dental affiliated dentists:

  • Spent less on overhead (at 56.7 percent of revenues) compared to the industry average of 61.2 percent
  • Generated an average of $1,570,924 in annual practice revenue (a 3 percent increase), compared to $1,180,022 a year reported in the DE/Levin Group report (no increase)

One of the major points mentioned above is reduced overhead costs. It is a fact that an average DSO can establish more effective, cost-saving relationships with vendors than solo practitioners can. Specifically, Heartland Dental has:

  • Buying power for cost-effective purchasing of both dental and office supplies
  • Buying power for cost-effective purchasing of small equipment and technology
  • Reduced credit card fees for affiliated offices

"With these advantages, affiliated dentists save significant amounts on overhead expenses," said Patrick Bauer, President and Chief Operations Officer at Heartland Dental. "With industry costs continuing to rise, the position DSOs have with cost management is and will continue to be invaluable."

In addition to reduced overhead costs, affiliated dentists have the ability to purchase Heartland Dental stock. Currently, over 200 affiliated dentist have ownership in the company. For those who affiliated in 2002, they saw a 1,415% return on their investment in 2012.

"Supporting affiliated dentists in applying the right systems has been a staple of Heartland Dental from the start. Without a set system and organized approach within the groundwork of an office, maintaining efficiency and consistency will be difficult. This could contribute to why many dentists are experiencing overhead cost and collection issues," explained Bauer. "Our systems are tested and proven, and we always welcome feedback from affiliated dentists on the level of impact the systems are making. In 2012, we completed a survey of our own―we asked affiliated dentists about their overall satisfaction with Heartland Dental and our business support model. Of the affiliated dentists surveyed, 84 percent are satisfied or extremely satisfied, 87 percent would recommend Heartland Dental to other dentists and 59 percent say Heartland Dental has continually improved over the past five years."

The Demands of Dentistry

In the modern dental office, dentists and their teams must adapt to the needs of their offices and patients. More often than not, this translates into handling more administrative tasks in less time. Dentists must build their teams, manage their accounting, execute effective marketing strategies and the list goes on. For dentists, demands are at an all-time high. With this growing list of duties, treating patients, taking care of the administrative side and finding life-work balance all at once can seem impossible. But with Heartland Dental’s support, many of those non-clinical demands can be met, including:

  • Management of office payroll, human resources and information technology needs
  • Property support with office development, leases and maintenance
  • Procurement of cost-effective, preferred supplies and equipment
  • Implementation of effective, cutting-edge marketing techniques
  • Overall office support from field and Home Office administrative teams

"Today's non-clinical aspects of practicing are much more complex than when I graduated and will undoubtedly become more complex in the future. This is the primary reason that DSOs exist―to support dentists in these extra non-clinical areas" said Dr. Workman. "It is in a dentist’s best interest, whether affiliated with a DSO or not, to understand how these responsibilities affect his or her office. Nowadays, it has become a requirement for clinicians to have at least some understanding of these areas."

Dentists Who Work Five Days Per Week

Some of the challenges dentists face are directly reflected in the DE/Levin Group report as well. Simply put, more dentists are working more, and for longer; 15.8 percent of them work five days or more per week to manage all aspects of their offices effectively (an increase of 12.9 percent from 2012). Average retirement age is up too. The DE/Levin Group reported an average response of 65.5 years old. Lower than the American Dental Association’s most recent calculation, 68.3, this figure is still an increase from past DE/Levin Group reports.

Dentists are also working harder: surveyed dentists now treat an average of 27.9 new patients each month. While this is excellent news, it also means more responsibility, more time needed, and more support needed. All of this takes its toll, often in the form of stress. In fact, 28.7 percent of surveyed dentists reported experiencing high levels of stress in practicing dentistry. The demands of successfully managing a dental office are causing many modern dentists to work long hours, take on more stress and retire later in life.

"Heartland Dental has studied the practice patterns of thousands of affiliated and non affiliated dentists for 15 years. When the collected data is shared with dentists, they can determine how their individual and practice results compare with thousands or other dentists."

Justin Wendling

Justin Wendling
Director of Affiliations at Heartland Dental

Heartland Dental can offer the support dentists need to achieve balance. Heartland Dental's large team specializes in a variety of administrative fields, like accounting, human resources, marketing, information technology, payroll and supply procurement; tasks that often overwhelm today’s dentists. With this support, affiliated dentists are equipped to handle many of the challenges expressed in the DE/Levin Group report. Only 7 percent of Heartland Dental affiliated dentists work 40 hours a week or more, compared to the 15.8 percent industry average. Because of the non-clinical support, affiliated dentists actually average 62.2 new patients per month, more than double the 27.9 other dentists are averaging. With their non-clinical duties taken care of, Heartland Dental-affiliated dentists have more time to treat more patients and can still maintain a work-life balance.

"When I speak with Heartland Dental affiliates, I hear more and more how our support is helping them rejuvenate their careers and passion for dentistry, as well as reclaim their personal lives outside of the office," explained Justin Wendling, Director of Affiliations at Heartland Dental. "Our company not only implements proven administrative systems to streamline office workflow and efficiency, but we benchmark our results with competitors and industry standards. We understand the importance of measuring our systems, models and initiatives in order to ensure they are making a positive impact for our affiliated offices. Heartland Dental has studied the practice patterns of thousands of affiliated and non affiliated dentists for 20 years. When the collected data is shared with dentists, they can determine how their individual and practice results compare with those thousands of other dentists."

In the 2012 survey given to Heartland Dental affiliated dentists, they identified some of the major benefits of affiliating with Heartland Dental, including growth opportunities, career security, support with overhead expenses, clinical autonomy, relocation opportunities and ideal exit strategies. Almost half of the respondents said the most common barrier keeping other dentists from affiliating with Heartland Dental is a lack of knowledge and understanding on how Heartland Dental and other DSOs function. "For affiliating dentists, Heartland Dental seeks to make their transition as seamless as possible," said Wendling.

"We support affiliated dentists in bringing in the right associates, maintaining stable careers for their team members and relieving their administrative burdens. Then, affiliated dentists can choose to stay on or transition out of the office on their own terms. Dentists affiliate with Heartland Dental for a number of reasons. Perhaps they have difficulty finding an associate to transition their office to, maybe they seek stability for themselves and their team members, or they might need relief from increased costs and demands," Wendling added.

A Coach and Consultant

Stock Return

In today's industry, it is becoming more and more difficult for solo practitioners to find success completely on their own. Modern dentists are encountering a multitude of difficulties, including keeping up with technology, increased costs, government regulation, legal issues, third party payment changes, student loans and other debt, and more. Because of this, many dentists are seeking outside parties for support and counsel, whether coaches, consultants or DSOs. In the DE/Levin Group report, more than one out of every three dentists are seeking advice from some form of coach or consultant to help grow and restructure their offices.

"With the entire weight of office tasks falling on their shoulders, dentists should not have to carry that alone. They should have a system of support or an advisor to turn to, and that’s what many of today’s dentists are currently searching for," said Bauer. "Heartland Dental is an ideal choice for this. Heartland Dental helps affiliated dentists grow personally and professionally through leadership, communication and clinical training opportunities. We have established Heartland Dental as a trusted source of guidance that supports affiliated dentists in becoming the best possible clinicians they can be."

Heartland Dental places great importance on continuing education. Affiliated dentists and team members have access to world-class, nationwide continuing education opportunities on many valuable topics. The Institute at Heartland Dental, located at the company’s Home Office in Effingham, Illinois, features a variety of courses from the industry's top clinicians and other prominent speakers, including the Bell Leadership Institute and the Dr. Leadership series. With these opportunities, affiliated dentists and team members can learn successful practice management techniques. Courses also emphasize leadership skills, so dentists can balance clinical skills, develop effective communication strategies, inspire their teams and ultimately advance their level of care. Educational opportunities include:

  • Dr. Leadership series - As an update in 2014, the Dr. Leadership series will be broken into regional study clubs for a more localized, hands-on experience for dentists
  • Bell Leadership Institute - Considered life-changing by many, the Bell Leadership course provided through the Bell Leadership Institute is one of the most recognized and successful seminars on personal development
  • Access to DentalXP - A growing education website, DentalXP connects dental communities around the globe and facilitates the distribution of content that encourages training beyond dentists' formal education
"The economic problems we've seen in the country have established a new reality in our industry - many dentists are unable to sell or share their offices with associate dentists, and young dentists with amount of student loans can't finance a new office or startup on their own. This has led to a continual increase in the number of quality dentists searching for a means to succeed. Heartland Dental can offer this means."

Rick Workman, DMD

Rick Workman, DMD
Founder and Chief Executive Officer of Heartland Dental

Another point of emphasis is mentorship. The mentorship and networking opportunities present at Heartland Dental are invaluable. Having a seasoned mentor who has grown familiar with the business of dentistry and optimal patient care can be very helpful, especially for dental professionals with less experience. There is no reason it should take dentists years to learn how to be successful on their own when they can build upon the successes and failures of others right now.

"One of the greatest things about Heartland Dental is the camaraderie shared between our affiliated dentists. If a dentist has a question or is seeking assistance, they have a network of over 800 colleagues to turn to. That level of teamwork won’t be found anywhere else in the dental industry," explained Wendling. "This group mindset is a huge reason Heartland Dental has seen a great amount of success. Establishing an open, collective atmosphere where everyone works together towards the same goal has been a huge contribution to our team’s achievement."

Looking to the Future

As the dental industry continues to evolve, several key trends have been identified in the DE/Levin Group report: dentists are searching for improved business models and systems, dentists are putting in more time to stay ahead of the curve and to achieve the highest levels of success and dentists must continually adapt to an ever-changing market. Heartland Dental and other DSOs are poised to handle these conditions.

"Heartland Dental is responding to a marketplace where dentists want out of debt, want work/life balance and freedom to relocate. Most dentists don’t really want to deal with business responsibilities. The economic problems we've seen in the country have established a new reality in our industry – many dentists are unable to sell or share their offices with associate dentists, and young dentists with a large amount of student loans can't finance a new office or startup on their own. This has led to a continual increase in the number of quality dentists searching for a means to succeed. Heartland Dental can offer this means," explained Dr. Workman. "We are able to support dentists from all career levels in advancing themselves and overcoming industry challenges. New dentists are offered the chance to start their careers on the right foot. Experienced dentists can achieve a work-life balance and control their career on their terms. This is why I believe Heartland Dental and other DSOs will continue to see significant growth as our industry progresses."