GDP growth in the United States was 1.6% last year. Wages in the U.S. were up 2.6%.

Dental Office Wages in Outstate Minnesota were up about 4% for experienced staff in all positions. However, wages for the Metro Area (experienced staff of 8+ years) were virtually flat. Although starting wages for CRDAs were up 7%.

Metro Area fees were up 3.3%. Outstate Area fees were up 5%. The gap between Metro and Outstate fees is gradually closing.

Dentists’ major concern by far is “PPO/Insurance Discounts and Involvement” yet only 5% had dropped a PPO in the last year and only 4% plan on dropping a PPO in the coming year. To me, that doesn’t add up.

51% of Metro Area practices reported being up with 30% being down. 67% of Outstate Minnesota practices were up with 15% being down.

42% of Metro Area practices and 55% of Outstate practices said their new patient numbers were up.

60% of Dentists still charge at the prep despite Delta’s push to have crowns charged at the seating.

Nationally, households are carrying low debt levels relative to their incomes. Household debt is at its lowest point in 50 years, proportionally.

50% of area practices use Digital Communication Software with Lighthouse, RevenueWell and Solution Reach being the leaders.

50% of respondents said they are or have used a Management Consultant. Advanced Practice Management had the highest satisfaction rate (8.7 out of 10) and a greater market share than all other cited firms combined. We are proud of that!

Pre-Election Effect?

I had more than one client tell me that their October was less busy than usual. In fact, one client told me that he looked at the election data going back three Presidential elections and in each of those cases, the fall schedule was lighter but the winter was busy. We’ll see!


The first half of 2016 was off to a brisk start with a nearly 6% increase in production. The second half wasn’t as strong. For the year, the Production was up 4.1% and Collections were up 3.3%. There was a 2.3% increase in patient traffic. New patients were up just .9%.

Production Increase Percentages

Collection Increase Percentages




If you are confused, you are not alone!

This is a flow chart that Shelly Ryan and Heidi Benson put together to help us and our clients understand the plethora of state-related plans. Call or email if you’d like the more legible “Full sized” version.


Area Economic Dental Trends:

“Knowledge is Power” and we are on a mission to make sure you survive and thrive in a marketplace increasingly encroached upon by insurance/PPOs and large scale competition.

Our recent survey shows that PPOs are once again at the top of the list as far as issues you and your colleagues are facing. Yet in the last year, fewer than 5% of area offices actually dropped a PPO.

We are not purists. We feel that every office should have the right balance of PPOs for their area. We often see, though, that doctors are much deeper into PPO participation than they need to be. If you haven’t negotiated with your PPOs, you may be leaving money on the table. If you’re collecting less than 80%, you should seriously look into peeling back PPO participation. We can show you how you can lose the discounts and keep the patients!

Other Trends:

  • Metro Wages remain pretty much the same this year compared to last year. Outstate Wages are up 4%.
  • Digital Communications are now in 50% of the marketplace practices. We’ve seen this to be very handy. Patients like text confirmations. Email blasts help get the word out about the services you provide and help you keep on top of seasonal opportunities (back-to-school, yearend insurance/flex plan notices, etc.).

    The leaders in our area are (in descending order of market share): Lighthouse (33%), RevenueWell (21%) and Solution Reach (12%).

  • Despite the fact that Delta pushes hard on dentists charging at the seat, not the prep appointment, 59% of dentists in our area charge at the prep, 41% at the seat.


Save Money! Run Smoothly!

When Heidi does her “Administrative Tools” check-up, she’ll look into things like:

  • Claims Processing (typically saving practices $150 – $300/mo.).
  • Credit Card Expenses: Many offices are spending more than they should on bank charges – banks make it complicated so you can’t really see what they are costing you.
  • Third Party Financing: Some options are better than others. Kinder to the patients and less expensive to you – think alternatives to Care Credit.
  • Answering Services. This is an old idea that is coming back again. We think it will help bring in more new patients.
  • Everything and every way to make your administrative staff’s job easier and save (or make) you money.

Just call (952-921-3360) Heidi to “Get it done!”


Right now, we can utilize regular prophies as a preventive procedure and codes 4341 and 4342 for more therapeutic procedures. A new code (D4346) potentially can close that gap and allow clinicians to report a therapeutic treatment of patients with generalized, moderate to severe gingival inflammation but without exhibiting pockets and bone loss. A “Difficult Prophy” code if you will.

Code D4346: Scaling in the presence of generalized moderate or severe gingival inflammation/full-mouth after oral evaluation. The exact description is the removal of plaque, calculus and stains from the supra and subgingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis. It is indicated for patients who have swollen, inflamed gingiva, generalized supra bony pockets and moderate to severe bleeding on probing should not be reported in conjunction with prophylaxis, scaling and root planing or debridement procedures.

It sounds like the code will be effective January 1, 2017. Suggested fee: $230 Metro/$190 Outstate.

It is possible this code could close a CDT gap that presently exists. Stay tuned to see what insurance reimbursements are.


For Secure Communications Outside* the office and Effective Communications Inside the Office Intra-office communication is the most undervalued way to increase production and elevate quality of care.

Patients’ lives are busier than ever. Therefore, patients are looking for efficiency in their treatments. Practices which have incorporated “same day dentistry” – the concept of having extra capacity and doing what it takes to get treatment done the same day – have been shown to have an increase in office production of more than 30%.

To illustrate this workflow and how it successfully incorporates “same day dentistry,” imagine a patient, Doug, in for his routine prophylaxis. Doug broke tooth #3 a week ago and requires a crown for predictable restoration. Mary, the hygienist of 25 years, clearly recognizes this will most likely be the recommended treatment plan. Mary can, in one single message:

  1. Obtain necessary financial arrangements from the front desk.
  2. Inform the dentist that pulp testing and a crown is likely going to be their recommendation.
  3. Inform the team the patient would like to stay if there is an opening in the schedule.
  4. Alert an assistant to get a room ready for the same day crown.

The simple messaging continues with other members of the team, as:

  1. The dentist, who is currently in a meeting, can
    respond to the team immediately.
  2. The dentist can then page the assistant whom they
    would like to assist them in the procedure.

Communicating an anticipated treatment checklist by auxiliaries to the dentist prior to them engaging the patient can act like rocket fuel to “same day dentistry” and case acceptance. By having immediate and organized communication, staff can control the flow within the practice and increase the patient’s value of our services. Using custom checklist messaging, the practitioner can receive vital, pertinent information in a consistent order every time they are preparing to see a patient. Therefore, the dentist can enter the room already having a solution to the patient’s problem.

It sounds like a simple change because it really is that simple. But the impact on treatment planning and case acceptance is phenomenal.

Patients are happier because their needs are met immediately and concisely; Staff are happier because they are able to work without interruption, messaging only when ready and needed; Dentists are happier because they know everything happening in the office without having to check on people. For more about OperaDDS go to

* “Opera Chorus” has fully HIPAA compliant email


We believe that Independent Private Practice is the best way to deliver dentistry. It is best for the patients, the Doctors and the staff.

Private practices can be more selective with their continuing education and technology. They can also be more adaptable and efficient.

Most importantly, the people who make decisions about patients’ dental care are the ones in direct contact with them.

We also believe that professional management support helps good practices be better and thrive in a competitive environment.

The outcomes your patients receive are a function of your Clinical, Behavioral and Managerial skills. It is nearly impossible for a private practitioner to keep up with all the advancements in clinical education and technology plus practice management. Good management leverages the time and talents of the Doctor and staff to get the best possible outcomes for the patients and production for the office.


As you may recall, through June of this year practice production was up 5.7% and collections were up 5.2% compared to the first half of 2015. This was the second year of pretty good growth since the great recession.

Through September, practice production is up 4.1% and collections are up 3.4% compared to the previous year’s averages, which reduced the year’s positive trends.

Total Patient Flow is up 2.3% but new patients are down slightly (about 2%). Dr. and Hygiene Hourly Productivity is up about 2%, Exams are up 2%, but Doctor hours canceled are up about 6%.

Keep in mind that December, January and February are the best “Crown & Bridge” months of the year. Get ready to make hay when the sun shines (and the snow flies)!

Let’s make this last quarter a good one!