A common conversation in the aisles of this year’s Veterinary Dental Forum (VDF) held in Orlando, Fla., centered on the opportunity to improve dental care at the general practice level. Indeed, veterinary practices face unprecedented competition from alternate channels for traditional business and revenue sources, whether it is Amazon or Chewy, Walmart or PetSmart, or low-cost vaccine clinics and shelters. By contrast, a comprehensive oral and radiograph evaluation (CORE) dental procedure is one service that cannot be duplicated by these competitors.
Ask any practice owner or manager how they are doing in the dentistry department and the usual response is they have a healthy case load and busy appointment schedule. Some may even say they are “booked out” for weeks. Yet, how do they really know how well they’re doing when it comes to their dental business? Here are some specifics to consider regarding your own practice:
- How many patients have you seen over the last 12 months?
- Exactly how many dental procedures did you perform in the last year?
- What was your total dental revenue last year?
- How does this figure compare to practice revenue?
It’s likely most practice owners and managers would be hard-pressed to answer these questions in the moment simply because they are not truly measuring or tracking their dentistry performance.
The size of the prize
Studies by the American Veterinary Medical Association (AVMA) suggest 70 to 80 percent of cats and dogs over the age of three have periodontal disease. In the average small animal veterinary practice, this mean about half the patients seen every day would benefit from a CORE procedure to assess and treat oral disease.
Based on general estimates, in an average practice comprising 3,000 active patients, there are approximately 1,500 cats and dogs suffering with periodontal disease. Yet, it is likely that less than one in 10 are receiving the care they need. According to the American Animal Hospital Association (AAHA), the average dental case before oral surgery is just over $500, which translates to more than $600,000 in annual dental opportunity.
To realize the full potential of your dentistry business, you first need to develop a comprehensive baseline so you know exactly where you stand. This also allows you and your team to set realistic goals for improvement and growth. Knowing how many of your existing patients may be suffering the pain and discomfort of periodontal disease is a real eye-opener and motivator for change. With modest investments in proper equipment and team training, some would argue it is possible to double the dentistry a practice is performing in a matter of months. For those nearing retirement, such an endeavor could mean adding hundreds of thousands (or more) to your practice’s value.
What should be included in dental revenue?
The most popular benchmarking publications in the industry include AAHA’s Financial & Productivity Pulse Points and The Veterinary Fee Reference, as well as Benchmarks: A Study of Well-Managed Practices. The approach of all three makes sense: track all the revenue associated with dentistry (i.e. income that would not have been earned without the dental procedure). In most cases, that means tracking down the dental invoice and including not only the charges for “dental scaling and polishing” (or the 100 other titles given to just teeth-cleaning itself), but also the blood work, anesthesia, fluids, monitoring, dental X-rays, surgical extractions, hospitalization, antibiotics, pain meds, etc. Not only that, but dental-related home care product revenue also should be tracked. Some experts suggest 70 percent of a pet’s oral health is managed at home.
And lastly, once a practice has committed to offering a comprehensive dentistry program, it usually will carry a variety of dental products (e.g. toothbrushes, dental diets, chews, rinses, water additives). Tracking this helps gauge how well your client education and home care messages are being delivered (and received) and allows you to set goals and measure compliance.
Even when all these revenue sources are tracked, it is often the case that owners or managers will have difficulty extracting and summarizing this information from their practice management software. This is partly because they haven’t done it before and need more training or experience navigating the software’s reporting function. It also may be a hospital has not adopted a uniform system of dental codes, so it is difficult for staff to separate anesthesia revenue that is attributed to dental cases, for instance. Consider creating unique billing codes for dental charges, especially for anesthesia, or a dental billing group if possible. Some software packages are better than others in this department, so a call to technical support may help.
The other challenge is that non-dental charges often appear on the same invoice, including vaccines, ear swabs, nail clips, mass removals, and other miscellaneous items that accrued during a particular visit. In addition, the associated lab work may be done days or weeks before, so getting a clear picture on the revenue a practice is generating from dentistry can be very challenging. The first time the baselining is done for a hospital may take a significant amount of time to produce a full year of data, but it is worth it. Going forward, it may take no more than an hour to produce the report, even when compiled manually, so long as it is done on a regular monthly basis.
What comes next?
Once you and your team have the baseline and an idea of how many of your current patients may be suffering from untreated oral disease, you can set goals for improvement. One survey of pet owners once asked why they didn’t get their pet’s teeth cleaned. The number one reason offered was that it was never recommended. Build dentistry into the client experience from the very beginning when pets are puppies and kittens. Checking on the progression from deciduous to adult teeth can start a regular conversation about oral health, one that repeats at every visit routinely. So how do we ensure the message is getting across confidently and pervasively? Stay tuned for our next two installments where we will discuss how training your entire team and a client education makeover are necessary and vital ingredients to support your oral health-care recommendation.
Andrew W. Schultz, Jr., is director of business development and clinical services for Midmark and serves on the board of directors of the Foundation for Veterinary Dentistry (FVD). Schultz also served as director of “Project Milkbone,” a study into the dental performance of companion animal practices and presenter of Double Your Dentistry” at the Veterinary Dental Forum (VDF).
Danielle Heberle, CVT, VTSH (dentistry), is clinical services manager for Midmark, and leads Midmark Academy where she oversees a network of more than 50 dental and anesthesia experts who train in over 500 veterinary hospitals a year from a course menu totaling 100-plus hours of related continuing education. She was awarded the American Veterinary Dental College Presidential Medal for Stewardship in 2018.
This is part one of an exclusive three-part series on how to grow your practice through dental services. To read part two, click here.