TBU #029 Stop Refering Out Your Patients

 New Issue of The Biomimetic Uprising

Read Time: 4.5 min

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One of the popular complaints I hear with biomimetics is the potential for loss revenue.  I say that's not the case.  I have completely changed my practice from how it was when I originally purchased it to how it is know.  Sure it had a similar flow and feel, but the office is different.  

Dental offices can lose about 10% of the their patient base in a given year.  Its recommended to grow at about 15% to compensate for the loss.  These are general averages. Its also recommended to see to have at least one new patient per work day. 

I purchased my office in April of 2019 and have grown every year that I have owned the place.  I have increased production about 10-15% every year.  I have added around $100k in production each year and am now topping a million.  I am a solo dentist practice that works 4 days a week and sees patients 8:00am to 4:00pm.  We also have 9 hygiene days per two week cycle. We see on average 12-18 new patients per month.  We get good google reviews.  And we have people traveling from a good distance to see us. 

So how have I done this? 

I keep what I WANT to do in the practice, and then refer out what I DON'T WANT to do. (Oh and I send out almost all extractions, all endo, and all implants)

Wait, I thought this newsletter is about not referring out? 

Here's a possible three procedures that a biomimetic dentist can do where they otherwise might have referred out. 

1. Deep Margin Elevation instead of crown lengthening
2. Biomimetic caries cleanout (and a subsequent onlay) instead of Endo therapy
3. Invisalign to adjust alignment and occlusion

Deep Margin Elevations (DME) have been shown to have a high success rate.  There has been a growing amount of research on the subject and the general consensus is that it is an accessible treatment choice in avoiding a crown lengthening surgery.  Ceramic onlays have shown a greater survival rate compared to composite indirect onlays.  Typically these procedures are well tolerated by the periodontium.  There is no recreation of the attachment of the normal tissue but rather a different biological width, mainly composed of long junctional epithelium and a slight connective attachment on the dentin below the material. If you would like, you can charge a separate fee for these.  For me, I build in this fee into my onlay fees.  I dont like having tons of smaller codes and charges, but would rather just have one.  Some offices might want the opposite however.

Biomimetic Caries Cleanout cases are a daily occurrence.  Whenever there is that much to cleanout, an  onlay is typically needed with them.  These are cases that I love doing.  This is really what we have become know for.  People will often say that with biomimetics there is potential for loss revenue by not doing Endo, but this is where that is wrong.  A typical Endo and crown can be $2500-$4000 give or take some and takes 2-3 hours of chair time.  An onlay in my office is typically around $2200 and takes about 90min of chair time.  So for me, this is a wash and has about the same chair time to production ratio.  I    also have a high success rate where I'm not retreating these or seeing repeated follow up exams. 

Invisalign, or clear aligners, is actually an easy treatment to add into your daily workflow.  Instead of referring out ortho, try getting trained in a clear aligner if you haven't been doing it already.  The learning curve isn't that high and its been a good resource for my patients.  I love Invisalign as the core concepts of alignment fit well with biomimetics and preventing larger issues. I'll write more about Invisalign in my office at a later date.  But needless to say its help with production and revenue.

These treatments have definitely helped me grow. As I have mentioned tons of times before, these are practice and reputation builders.

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Whenever you're ready, here are the ways I can help you:

1.  If you're looking for better application in your practice, take a look at our online courses and guides 
   1. The Foundations Of Biomimetic Dentistry
   2. How To Do Biomimetic Posterior Direct Composites.
   3. Get our 53 page biomimetic protocols guide for posterior direct restorations. 
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