Practice & Financial Management for Dentists - Pandemic Special

If your profession doesn’t allow you to do any of the above, I am afraid, either your habits are wrong or your chosen profession is wrong. Try changing either of the same. The former is cheap and easy, the latter not!

4. Costing In Practice Post Lockdown

Dentistry in future (Post-COVID-19 era) is never going to be the same as the Pre-COVID-19 era. Dentistry was already cited as one of the costliest professions in India, by Indian patients; believe me, this bar is all set to go higher! Now, let us talk of the present circumstances of Covid-19 and probably, the challenges of COSTING associated with it in the post Covid-19 era, whenever the working resumes. In the post Covid-19 era, improving personnel safety in healthcare environments through appropriate use of Personal Protective Equipment (PPE) would be most mandatory for every dentist all over the world. PPE like body cover-alls, gloves, gowns, goggles and face masks as well as diagnostic and surgical products would be needed by all of us in bulk. We will have to mandatorily provide appropriate PPE for ourselves and our employees / staff (whatever the GSM requirements finally get settled and approved) and ensure that PPE are either disposable or if reusable (highly unlikely for COVID-19) and are properly cleaned, laundered, autoclaved and stored (they are usually for other diseases). The compliance concerning PPE is often dependent on personal preferences. However, increased comfort (better fit, ergonomics, less allergies and body temperature regulation) is directly equitable to the cost in India for those being manufactured here. We are having PPE kits from INR 100 (IIT Kanpur) to INR 5000 (imported ones from Europe / American subcontinent) with about 10 options in this price range . An ideal or some sort of comfortable PPE kit is in the range of Rs. 800 (Indian make) which means minimum one for you and one for your assistant and if you are fond of 6-handed dentistry, two for your assistants. As per reports or studies coming in, the PPE kit has to be one for each patient and disposed of after that. Just assume a patient coming in for a restoration (filling) for which you earlier charged Rs. 1000 (suppose as an example). Add up the bare minimum cost of 2 PPE’s of you and your assistant to the procedure. Won’t the landing cost of one simple restoration zoom up to around Rs. 3000? Would it be feasible and practical? The costs of setting up a dental clinic is high as the exterior also needs to be done with along with the interior and of course, providing quality work which anyways is the prime requisite. Most of our medical colleagues have just got the bench and chairs in their clinic for the patients but when it comes to dentistry, patient expectations change quite a lot. Calculation and management of the costs and expenses relating to clinic (business) overheads, especially when done on a monthly basis is the one of the most important tools for success in any dental practice. The commonest business principle which is followed otherwise in business circles to decrease overhead is to increase the production by

• working more hours
• improving scheduling or
• increasing selling price (fees, in our case).

Sadly, the principle of working more hours defies logic as per the 80-20 Parreto principle. Let us presume a scenario, where we start promoting our clinic and are having an increased footfall. When we check more new patients generally, that would result in us; allocating and spending lesser time with each patient at their initial visit and by doing that, we are either not counselling them completely or overwhelming the new patient with rushed information. The most likely result in such a scenario is fewer turn-ups of the patients for actual treatment or poor conversion ratio. This is also known as the "roller-blading" method of dentistry which may temporarily result in higher production but does have the perennial side-effects of high overheads, fatigue, poor health and unhappiness in clinical practice life. Our running costs are going to grow manifold and the incoming cash collection won’t be coming at the same pace and volume as before due to the decreased purchase power of the patients. So, every such decision of investment in clinic; be it, the buying of a new equipment or an expensive material has now to be backed by a scientific logic, basic understanding of your figures and numbers and calculation of costs. The FOUR Most important aspects required will be:

1. Unity at one platform (in our hand)
2. Accepting and upgrading as per latest norms (in our hand)
3. Vaccine against COVID-19 (NOT in our hand)
4. Dental insurance - strong need of the hour (NOT in our hand)

Common sense says, if costs go up, Govt. services will be seeing a surge in OPD levels. But whosoever sees health as a priority, will avoid the same and prefer private setups (I am not saying Govt. setups won't upgrade – but the system is slow and takes much more time than us) This is thus, the opportune time for dental insurance in India which can take care of both of us (patient and dentist). Insurance brings so much parity all around and enhanced standardization in most clinics. The same can be set up as a PPP model (Public Private Partnership) for trial purpose. The models of western countries are before us, so not much of homework would be required But for that the representation and suggestion have to be made to the Govt. 72,000 (1/4th) members of IDA can't do that but 3 lac plus (total) dentists of India can surely do that by signing a petition on Change.org.

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