The Single Most Impactful Business Strategy for Dental Practices – Work Smarter…Not Harder

By Kathy Edwards, RDH, Practice Consultant, Burkhart Practice Support Team


It sounds so simple, yet practices continue to undercharge for their services. Other service industries do not run into this dilemma—in large part due to competition in the marketplace and transparency of fees. Your neighborhood gas station owner and his or her consumers, as an example, can readily see a competitor’s prices by simply looking across the street at a giant sign revealing the current rate for gasoline. While dentistry is competitive in most urban areas, and increasingly more in rural areas, fees are not transparent to the public or dentists.

Set Fees That Are Fair & Represent Quality of Care
The Federal Trade Commission’s anti-trust laws prevent dentists from discussing fees that could potentially result in setting fees that could ultimately hurt consumers. They do not prevent dentists from setting fees that are fair for their geographical area and represent their quality of care. It does not prevent the circulation of fee surveys that help dentists strategically set fees. Adjusting fees should be a business decision based on published data, rather than an emotional decision.

Emotional Struggles Prevent Raising of Fees
In speaking with hundreds of dentists through our unique PracticeView offering, we have heard the concerns dentists express when the topic of raising fees comes up. If you have similar concerns, please read the rationale following each type of emotional struggle that is preventing you from raising your fees:

1. Fear of losing patients.

The cash-sensitive segment of a patient base are generally those without access to dental benefits. Offer them a private pay discount. Note this is not a “cash discount”; it is a “private pay discount” only available to those without dental benefits. Keep the patient loss in perspective—losing ten patients due to a fee increase in a 1,000 patient base practice is only 1%. Your overall fee increase will more than account for the potential production loss.

If your state allows, consider an in-house dental savings plan to reduce the impact of fee increases for the private pay patient base. Enjoy the opportunity to enter a market with less cash-sensitive patients. Understand the fact that your patient base with dental benefits pays a monthly premium for access to those benefits. Your cash patient base does not. Although the cash does not flow through your practice, do not lose sight of this fact.

2. It will not matter; I am a PPO office and cannot raise those fees anyway.

According to a 2015 Bureau of Labor and Statistics report, in 60.6% of married-couple families with children, both spouses worked. That’s a lot of dual insurance claims. Often the secondary insurance pays up to the full office fee. In addition, higher fees provide leverage to renegotiate PPO contracts in the future. Many plans allow renegotiation every two years.

3. I raised most of my fees last year by 3%.

A 3% increase is only effective if your fees were balanced. If your fees are out of balance (some fees in the 40th percentile and some in the 90th) you will need to balance first. Plan to utilize published data as your basis for setting fees such as the NDAS fee optimizer. The website can also provide zip code-specific fees on a more limited basis.

Maintaining Branding as You Grow is the Challenge
When dental practices form, a brand is created that represents the experience patients will learn to consistently expect during their care. This type of branding represents the entire patient experience—from being greeted by name as they enter, the type of conversation regarding treatment options presented to them, the technology utilized, to the “high touch” they receive throughout their visit. The doctor’s vision generally dictates the branding that is created. Creating the branding is not the challenge—maintaining that branding as you grow and add more staff is the challenge.

Proper Fees Help Maintain Critical Branding
Fees set in the proper percentile and updated annually, allow the business the leeway to provide ongoing training through staff meetings and mentoring to maintain that critical branding. Additional cash flow further enhances the business branding and patient experience by providing the opportunity to purchase newer technology and equipment. Fee increases are not just about increasing profit, they also provide resources to maintain your branding and enhance your practice. Your patients benefit when you keep your fees in the proper percentile. You are worth it. Your team is worth it. Your patients are worth it.

Additional key business benefits realized when fees are reviewed and updated annually:

  • PPO contracted fee negotiations are possible
  • Future practice transition opportunities for adding an associate or selling the practice can be realized
  • Keeping up with inflation becomes possible
  • Opportunities to reward your staff and maintain healthy staff overhead are available
  • Additional equipment, software and technology opportunities are within reach



PracticeView is a unique, complimentary offering to Burkhart Clients. A practice management consultant will review your fees and percentiles as well as numerous other business systems and offer recommendations for your continued business success. Reach out to your Burkhart Account Manager for further details. 

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