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How to Not Fail Miserably in Private Practice

Dr. Chris Salierno2004-05 president

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Fewer retiring dentists

More graduating

dentists

Higher student debt

Complex Business World

Disclosures

PulseThe Overhead MonsterThe Patient Experience

The Dream TeamGrowth

Daily

Monthly

Quarterly

Annually

Daily

Daily

Daily

Monthly

Monthly

Monthly

Monthly

Quarterly

Quarterly

Quarterly

Income Statement (P&L)

“How’d I do?”

Income – Expenses = Net Income

Balance Sheet

“What am I worth?”

Assets – Liabilities = Equity

Annually

PulseThe Overhead MonsterThe Patient Experience

The Dream TeamGrowth

Staff25%

Supplies5%

Lab10%

Rent5%

Your Piece of the Sweet, Sweet

Pie55%

Lab10.3%

Tier 3

Nobody – See You Next Month!

Tier 2

Bills with Finance Charges

Tier 1

Staff Loans Rent Lab Getting Shut Down

My Guide to Paying Bills

Preparation and Impression:Anesthetic: $0.52 ($25.98 per box of 50 of 2% lidocaine)Anesthetic syringe tip: $0.11Diamond burs: $1.80 ($45.40 for a 5 pack, assume 10 uses per bur, assume using two different diamond bur styles for prep)Retraction cord: $0.29Impression material: $10.83 ($108.29 per 4 cartridges, assume use of a heavy body and a medium body, assume 1/5 cartridge used of each per procedure)Impression material tips: $2.89 (a tip for heavy body, a tip for medium body, and a tip for the COE syringe)Triple tray: $0.90Total: $14.45

Provisional Fabrication:Bis-acryl for provisional: $9.60 ($192.53 for 76gm cartridge, assume 20 units per cartridge)Bis-acryl tip: $1.04Provisional cement: $2.00 ($80.25 for 2 cartridges, assume 20 units per cartridge)Provisional cement tip: $0.71Tray for matrix: $0.96 (47.95 for 50 pack)Matrix material: $ 4.38 ($210.00 for 12 pack, assume 1/4 cartridge used per procedure)Matrix material tip: $0.75Total: $19.44

Laboratory and Final Cementation:Laboratory costs: INSERT YOUR LAB FEE HEREPermanent cement: $5.46 (Rely-X Unicem is $218.30 per clicker dispenser, 40 units per clicker)Total: $5.46 + your lab fee

Miscellaneous Costs of Note:Assistant salary: $27.00 (assume $18 per hour)Front desk salary: $30.00 (assume $20 per hour)Rent: $10.27 (assume $5,000 per month, there are 730.48 hours in a month, so assume $6.84 per hour)Total: $67.27

GRAND TOTAL: $106.62 + your lab fee

Two surface composite RCT 1 canal RCT 3 canals Post and Core CD Crown

Materials 7.8 7.35 13 21.8 28.2 39.35

Assistant Time 9 18 36 4.5 18 27

Lab 0 0 0 0 354 110

Total Cost 17 25 49 26 400 176

Office Fee230 7.3%

750 3.3%

950 5.2%

362 7.2%

1600 25%

1250 14%

Metlife Fee121 14%

439 5.7%

715 6.9%

174 15%

916 44%

761 23%

EDP Fee88

19%279 8.9%

459 11%

150 17%

675 59%

635 28%

GHI Fee57

30%315 7.9%

470 10%

115 23%

580 69%

400 44%

PulseThe Overhead MonsterThe Patient Experience

The Dream TeamGrowth

Patient Needs

Beauty

FunctionPain Free

Really Expensiv

e Dentistry

General, Cosmetic, and Implant Dental Care

Treatment Date

14 days phone call

30 days billing

statement, friendly letter

45 days phone call

60 days billing

statement, stern letter

75 days phone call

90 days billing

statement, collections

letter

100 days collections

process started

PulseThe Overhead MonsterThe Patient Experience

The Dream TeamGrowth

Interview Initial Encounter

Ask Questions

Trial 0-6 months

Written Agreement

Brass Tacks

6 months – 1-2 years Contract

Structure

Salary

Percentage

Base with Bonus

Questions

Benefits?

Lab?

Patient Supply?

Collection Ratio?

Accounting?

There is no “I”

in “TEAM”

PulseThe Overhead MonsterThe Patient Experience

The Dream TeamGrowth

Maximum Starbucks Density

45th and Madison5 mile radius

Closest Distance Between Two Starbucks