It is common knowledge that I am, and have always been, a strong proponent of the fee for service (no managed care), private practice of dentistry/orthodontics. During my 35 year consulting career I have believed so strongly in this that Zuelke & Associates has always declined to work with “corporate” type practices and has declined to work with private practices that accepted PPO’s and the other forms of managed care except for those practices working to get off of the PPO’s.
Obviously there are other points of view on this subject. For instance, some years ago I discontinued support for one of my orthodontic clients due to his having signed up with a couple of PPO’s. In the years since then his practice has grown substantially into a high grossing, multi-doctor, multi-office orthodontic business that casts off, I assume, a substantial net income. We continue to be hunting and fishing partners and so from time to time we have conversations, sometimes arguments, with the basic argument on his side being that I should not be critical of his style of practice because it is so profitable, and the argument on my side being that while the managed care and retail/corporate models can be highly profitable for some doctors, that profitability always comes at the cost of a reduced quality of life within the practice.
For many business models a low profit per item sold but a high volume of items sold in order to create a high level of profitability, makes all sorts of sense if the ability to sell a lot is available. However, in the health care profession the high volume of patients and low profit per patient model results in significant declines in the quality of service to the patients, sometimes even in the quality of the clinical result, and always results in declines in the quality of life within the practice.
In my world, “quality of life” in a health care office cannot be measured by the degree of profitability. In my world, a high degree of profitability cannot compensate for high percentages of failed/cancelled appointments, greater instances of poor clinical cooperation, low quantities of new patients referred by existing patients, generally terrible rates of case acceptance, and greater administrative and clinical staffing requirements.
My point is simply that there is no right or wrong in the two models of practice I am discussing. If my friend and past client is tolerant of the patient related problems that exist with his model and can handle the stresses and related issues of such high volume patient flow without going home at night and beating his children, then that model is right for him. I simply think there is another model that is more satisfying, less stressful, and also highly profitable, that is right for the majority of the profession.
On another but still somewhat related subject, I am receiving increasing numbers of calls from clients asking my opinion of OrthoFi. I do not know a lot about OrthoFi’s full business model but what I do know sounds to me to be potentially terribly damaging to the well-being of practices/doctors who believe in our vision of the orthodontic world. In my February 27, 2015 article I spoke about third party financing and the fact that history has proven that the vast majority of “A” category patients instantly reject any form of “outside” or third-party financing. Treatment Coordinators everywhere in the country re-learn that every day when they present the option of using CareCredit or any of the other dozen or so companies currently offering financing to orthodontic and dental patients and get an instantaneous “No” from most of their patients/parents. OrthoFi is a new and much more comprehensive version of a third party financing company with a few interesting (and I believe potentially very dangerous) twists. I will write more about this new company in the future. Right now though I will caution our clients to recall the hype and promotion surrounding the MSO’s (OrthoAlliance, New Image, etc.) some years back. Back then a Management Service Organization was the newest thing on the orthodontic scene and was touted as the perfect business model and the future of the profession. Of course, those who were promoting the MSO’s were mostly the doctors who had invested in the MSO’s and a few non-investor doctors who were among the “misery loves company” crowd who promoted participation in an MSO in order to validate their own decision. The MSO business model failed, in most cases within a very few years. I strongly urge my clients to stay away from any new business model until that business model has been time-tested for years and has been proven to be an intelligent way to conduct the business operation of an orthodontic practice.
The Zuelke Automated Credit Coach (ZACC)
What is it worth to your practice to know, for certain, that the patient you are speaking with is stable and has an outstanding credit history? What is it worth to your practice to know, for certain, that the patient you are speaking with is not credit worthy and does not keep promises regarding money? With the Zuelke Automated Credit Coach (ZACC) you can know the financial risk presented by your patients and tailor financial arrangements that help you earn more case acceptance.
Many patients – even those that are a low credit risk – do not have the financial means to pay in full, or to make huge down payments for medical or dental treatment. While outside patient financing is an option for some, most patients reject the thought of financing their care at a bank or finance company. Don’t allow your practice to lose a $6000 case, even temporarily, because the patient just had to repair the transmission in his car. ZACC evaluates a patient’s maturity, stability, and credit report and returns a letter grade with a payment plan recommendation in seconds, allowing you to offer flexible financial arrangements to fit your patients’ budgets and financial situations.
To learn more about ZACC, please visit www.getzacc.com or contact OrthoBanc at 888.758.0585.
