Marketing Veterinary Dentistry in Your Practice. Heather L. Duncan DVM, DAVDC Diplomate of the American Veterinary Dental College

Transcription

1 Marketing Veterinary Dentistry in Your Practice Heather L. Duncan DVM, DAVDC Diplomate of the American Veterinary Dental College

2 Oral Disease is the most common problem in Veterinary Medicine Patients are quite painful despite the lack of clinical signs Oral disease causes significant localized and systemic medical problems

3 Education in Veterinary Dentistry Both the general public as well as the veterinary community lack adequate training This results in most patients being under treated Proper dental therapy is financially rewarding and good medicine

4 Loss of Revenue in Veterinary Medicine Over the past few years, there has been loss of traditional revenue streams due to many factors Vaccine revenue Flea & Heartworm Medications Spay and Neuter Clinics Owner reliance on the internet or other information decreases the client trips to the clinic Economy

5 How Can You Increase Your Dental Revenue? Increase the number of dental procedures performed Training, time efficiency, superior equipment Increase the per dental average This does not mean advanced procedures Improve pre-operative testing Bloodwork, urinalysis, thoracic/abdominal radiographs, etc Improve intra and post-operative care Give dental patients the proper attention and respect they deserve

6 1. Increase the number of dental procedures performed Most Important Place to Start: Staff Education Education for the Veterinary Staff Veterinarians, technicians, receptionists, managers Training & Education for Drs & Staff Veterinary Dental Forum ( Animal Dental Training Center in Baltimore ( American Veterinary Dental Society ( )

7 Team Approach Get the entire veterinary team on board: Receptionists, technicians, veterinarians

8 Team Building Strategies: Involve the staff in client education for home care (create home care kits) Perform oral care on staff member s pets and promote good oral care among the staff

9 Increase the number of dental procedures performed Most Important Place to Start: Client Education Client Education (Don t just say it, educate it)! Best performed by enlightening the population about dental disease Should come from the entire staff; not just the veterinarian Receptionists are very important to educate They give the estimates over the phone most of the time Educate clients on what a dental prophy includes (phone shoppers) Make sure everyone at the practice is on board

10 Team Approach Train staff members to identify traumatic occlusions, gingival inflammation, calculus, discolored and fractured teeth. Take photos of the pet s mouth (photos confirm there is a need for your services) Take the time to discuss oral needs with your clients, show them pictures, videos, etc of what is recommended

11 Team Approach Train Staff on how to identify Dental Disease and explain it to clients Dental models Pamphlets with pictures, other literature For example: If gingivitis is present the client should get a good explanation of gingivitis, periodontal disease, how this affects the pet, and what your cleaning includes. Client Handouts

12 Increase the number of dental procedures performed Superior, New Equipment Superior equipment will speed procedures A new drill, ultrasonic scaler, elevator, or curette can markedly cut down on surgical time & increase the number of procedures performed a day Burs last for ~10 seconds before becoming dull A loss of 1mm off the tip of an ultrasonic scaler reduces efficiency by 25%, and 2mm by 50% Digital radiographs are much faster than film

13 Minimum Needed: Equipment Needs Dental unit equipped with slow speed hand piece, high speed hand piece and water/air syringe (suction can be a luxury), these should all have a water flow/spray

14 Equipment Needs Ultrasonic Dental Scaler Periodontal Pack (including hand scaler & curette) Dental Charting

15 Dental Units

16 More Equipment Needs: Luxury for Ergonomic Care: Magnifying Loops Good table and dental chair Surgical light or light source

17 More Equipment Needs: Anesthesia: Anesthesia Monitor IV fluid pump (fluid pump warmer?) Warming blankets (bair hugger, etc) Circulating water pads

18 More Equipment Needs: Highspeed Handpiece Extraction Packs Light Curing Gun (if bonding/sealing)

19 Dental Radiology: If you don t have dental radiology..there is a cure for that By far the best way to improve income: The charge itself The additional needed treatments discovered

20 Equipment Needs Must Have!!! Dental Radiology: Digital vs. Film Skulls to practice with

21 Dental Radiography

22 Dental Film

23 Film Processing

24 Digital X-ray Sensors:

25 Phosphor Plate Systems: SCAN X VS. CR7 Systems Phosphor Storage Plates that are ultra-thin, wireless and flexible allowing for accurate positioning within the oral cavity. The plates are very inexpensive and can be used thousands of times.

26 Digital Radiograph Image

27 Dental Radiology Texts Authors: Gregg Dupont & Linda DeBowes Authors: DeForge & Colmery III Authors: Mulligan, Aller & Williams

28 Economics of Dental Radiographs: Dental X-ray Unit = $3725 $1/film = $ 300 Developer/Fixer = $ 75 Developing Tanks = $ 250? Hangers/Supplies = $ 100 Radiography Texts = $ 250 TOTAL INVESTMENT = $4700

29 Economics of Dental Radiographs: X-ray unit + supplies =$4700 Dedicated Computer = $2000 Digital Sensor = $4500-$12,000 TOTAL = $11,200 17,000

30 Return on Investment: Full Mouth X-rays = $60 to $175/ patient 85% of all pets >3yrs = Periodontal dz. Many other conditions require x-rays Pre-conditioned Clientele Aids in Diagnosis and Treatment Planning Find 50% more pathology when full mouth radiographs are performed

31 Return on Investment: See 10 pets/day Know 8 have some dental problem Convince 4 to have a dental prophy Even if 2 ok d $75 = $150 4 days/week = $ weeks/year = $30,000!

32 Return on Investment: 5 Dental prophys/day X-rays on 3 pets/day 5 days/week $75/patient x 15 pets/wk. $1125/wk. 50 wks/yr. = $56,250/yr.!

33 Return on Investment: Use science to determine treatment Eliminates guessing which tooth is diseased Protects you from liability Generates a lot of income Shows the client your practice is Cutting Edge Keeps you interested in practice FUN!!

34 Everyone Benefits from the Education and Equipment

35 Increase the Per Dental Procedure Charge: Increase the number of Treatment options for the client This does not mean doing Advanced Procedures like Root Canals, Jaw Fracture Repairs, and Major Oral Surgery What most DVM s charge for these is not efficient time usage More efficient way to do this is by offering superior basic care Dental Radiology Root Planing/doxirobe Oravet Nerve Blocks/Regional anesthesia Proper Pain Management Bonded Sealants Fluoride Therapies All of these will greatly increase income without a significant investment of time or money

36 Services to Provide: Identify the level of services you want to offer your clients with Veterinary Dentistry Professional ultrasonic dental cleanings, full mouth dental radiographs, charting Periodontal therapies: doxirobe for pocket reduction with closed root planing, open root planing with bone grafting Exodontia: Surgical and simple extractions

37 National Trends: Public expects excellent dental care for pets Seeking treatment besides extraction Concerned about anesthesia Assume we have the best anesthesia regimen and monitoring equipment for their pets Assume our staff is well trained in dentistry Assume we all take dental radiographs

38 Veterinarian s Role: Recognize Oral Pathology Prescribe, Perform or Refer for Treatment Utilize pain medications Quality equipment & anesthesia regimens Educate Clients about Preventative care Work in tandem with Support Staff Interpret Dental Radiographs

39 Technician s Role: Recognize Oral Pathology/Alert Veterinarian Perform Complete Dental Cleanings Assist Veterinarian with Procedures Monitor Anesthesia - induction and recovery Take quality Radiographs Take care of instruments & equipment Educate Clients on Homecare

40 Veterinary Dentistry Ignoring or overlooking the dental needs of our patients is an opportunity missed, to not only serve the client and their pet better, but a lost opportunity to improve profitability of the practice. You Already Have These Patients

41 American Veterinary Dental Society: AVDS ( Journal of Veterinary Dentistry ( Veterinary Dental Text Books:

42 Scheduling: Can be the most frustrating part of veterinary dentistry: Once you are looking for pathology you will find surprises you weren t expecting Schedule as a surgery day, etc so there is no rush Dentistry can be tedious and time consuming

43 Provide the Optimal Dental Care: Clients are already assuming you do this Safest Anesthesia and Monitoring Thorough Dental Cleanings Dental Radiographs on all patients Appropriate Dental Treatments and/or the Knowledge of procedures to Refer Long term follow up (yearly cleanings)

44 Thorough Oral Exam:

45 OraStrip

46 Preparing the Pet for a Dental Cleaning: Explain & Show Pathology to Client Complete Physical Exam Pre-operative Lab work, X-rays, EKG? OraStrip Prescribe Antibiotics (if appropriate) Prepare an Estimate Discuss Anesthesia with Client Discuss Probable Treatments Schedule Appointment for Dental Care

47 BUILDING THE BUSINESS Educate Clients on the Importance of Dentistry Discuss individual oral needs/treatments with the clients All patients need dental care, but focus on younger patients and home care Target clients who already understand the importance of dental services Use visual aids to identify the need for dental services Emphasize professional care tailored to the patient needs Provide estimates that market the value of your services Communicate with clients during dental procedures to engage them in treatment decisions, show the x-rays, pictures. Emphasize the necessity for home care (daily tooth brushing) Emphasize follow-up evaluation to determine the efficacy of home care Remind and reinforce the need for continued dental care Market your services to generate new clients

48 Marketing Veterinary Dentistry: Order Marketing Materials: Butler-Schein, Pfizer, Virbac, Hill s, Royal Canin Request educational materials, models, brochures Case of the Month on Clinic Website Quizes for the Staff (fun with prizes) Facebook Twitter

49 How to Increase Dental Revenue: Providing Superior Anesthetic Care: Pre-operative Testing Complete Blood Panel (renal, hepatic, CBC, T4) Urinalysis (especially cats) Chest Radiographs (if indicated) Ultrasound?

50 How to Increase Dental Revenue: Providing Superior Postoperative Care Pain Management Opiates NSAIDS Local Anesthetics Neuropathic Pain Analgesic (Gabapentin) Acupuncture Maxiguard, Oravet, Homecare kits Rechecks

51 Cases where you Can See an Increase of Income: Retained Deciduous Teeth Fractured Teeth with Pulp Exposure Worn Teeth Discolored (intrinsically stained) teeth Feline Tooth Resorption (formally FORLs) Periapical Abscess Caries Teeth with Enamel Hypoplasia Oral Masses Uncomplicated Crown Fractures Periodontal Disease

52 RETAINED DECIDUOUS TEETH No 2 teeth should be trying to occupy the same space!!

53 FRACTURED TEETH WITH PULP EXPOSURE

54 WORN TEETH Check for pulp exposure, tertiary dentin for repair? Treatment with sealing the dentin tubules

55 DISCOLORED (INTRINSICALLY STAINED) TEETH 92.2% of discolored teeth (pulpitis, etc) have been found to be non-vital, therefore requiring treatment

56 TOOTH RESORPTION

57 PERIAPICAL ABSCESS

58 CARIOUS LESIONS: Treatment: 1. Pulp Exposure: Root Canal vs. Extraction 2. No Pulp Exposure: Debridement & Restorations

59 ENAMEL HYPOPLASIA

60 ORAL MASSES Trust Your Pathologist! Antech: McLeod, Scanlon, Shokek, Krotec

61 UNCOMPLICATED CROWN FRACTURES

62 PERIODONTAL DISEASE

63 CONCLUSIONS Dogs: 80% have Periodontal Disease 10% have Fractured Teeth w/ Pulp Exposure 25% have Uncomplicated Crown 5% have other dental problems (neoplasia, orthodontic problems, cares, etc)

64 CONCLUSIONS Cats: 70% have periodontal disease 40% have Tooth Resorptive 10% have other problems (including fractures)

65 ANY QUESTIONS? Heather L. Duncan DVM, DAVDC Diplomate of the American Veterinary Dental College