Assessing the Dental Practice

In the previous chapter of my life, I spent 14 years on the school board and 37 years as an adjunct faculty member at Virginia Commonwealth University-School of Dentistry.
 
Assessment is a popular mantra in the field of educational at all levels. 

The Standards of Learning (SOL’s) were introduced in the 90's, established and measured to provide objective evidence that students were learning and tax payer dollars were being used effectively.  Dental students are required to complete numerous assessments to assure high standards, which include very specific metrics, to evaluate their performance.  It is important for the student to learn self-assessment technical skills in preparing a tooth for a crown, to instrumenting and obturating a tooth for an endodontic procedure. The vast majority of dental education is occupied in teaching and acquiring technical skills.  Along with the intense technical training there is the delivery of a wide field of knowledge to develop critical thinking and judgment coupled with their technical skills.
 
Development of self-assessment skills in the application of this newly acquired knowledge and technical skills is essential; as no one will be looking over their shoulder as they deliver care to their patients after graduation. An ever changing knowledge base after graduation requires all health care professionals to regularly apply a method of self-assessment and ask the difficult question, "Am I current with state of the art knowledge and techniques in my profession?" 
 
As I currently work in the field of practice transitions and development I have realized that upon graduation we enter the world of private practice and often don't transfer those technical self-assessment skills learned in dental school to all phases of our practice and business. Government, insurance and corporate forces are all having an impact on our profession and how we function and continue to be successful as professionals and business entities.  I am experiencing a wide range practice models throughout Virginia that have stimulated me to raise the flag for an objective assessment process to evaluate the health of your practice BEFORE you enter into any action plan for change, development or growth.
 
Often, assessment is based upon a ‘feeling’ or ‘I think’ instead of well-defined standards, factual data or criteria. The reality of any business is it has three components: cost, quality, and service.  As owners of dental practices we would do well to build a template that allows for an objective assessment of these three areas. This can be a major undertaking and may require outside resources where your knowledge and skill level may not allow you to complete a comprehensive office assessment. One of the greatest limitations of practices reaching their full potential is the failure to block out time throughout the year to plan, assess and develop strategies around finances, service and quality. 
 
Understanding the financial aspects of your practice beyond,  ‘Do I have enough to cover the operations in my checking account?’ may require the expertise of setting up your books that allows you to tract your revenue and expense streams to monitor your trends.
 
An accurate set of trends can guide you in making intelligent strategies and follow the outcomes to see if your implemented strategy was effective instead of concluding ‘I feel it was a good idea’ or ‘I am comfortable’ which is not always a good metric!  A prime example is the participation in multiple insurance contracts, without a clear understanding of the trend taking place in decreasing reimbursement for procedures performed. The benefit of being a provider needs to be carefully analyzed with objective facts not feelings.
 
Expanding the concept of assessment can be applied in the area of service that patients receive and can further the ability of a practice/business in reaching its full potential. Having a written series of standards and training on how the phone is answered that creates the highest percentage of bringing people into the office is a major source of growth.  Exit surveys of patients and staff leaving your practice can provide an enlightening perspective to the service people experience from your team.
 
As owner and leader your ability to develop your team is often over looked. Pursuing self-assessment of your own leadership skills which will have a major impact on your professional career is largely ignored in medical and dental education. There are many opportunities to pursue personal growth as we wear the dual hat of professional and business entity. This can be a good starting point which can equip you to develop an assessment of the multiple areas of your practice and a process to move forward.
 
Properly executed this can put you, the business owner and professional in the driver’s seat. Today I emphasized the importance of objective assessments to determine where you stand today. With that tool in your hand you are able to plan where you want to be next year at this time.

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