By John C. Cranham DDS
Although the number of continuing education (CE) options for the general dentist is ever expanding, choosing the best option for the growth of your practice continues to be a challenge. Knowing whether you should attend a one-day lecture, a weekend hands-on course, a live patient experience, or do your expanded training via the worldwide Web, is a difficult decision. The price of dental CE courses is not getting any cheaper—and the real cost is the time away from the practice. Learning to align the best educational experience with your particular practice dynamic is critical if you want to experience an optimum return on investment.
A plan for CE implementation in a practice has to begin with finding the best possible content for what you are trying to accomplish, align it with your schedule, and then create a budget over time that is affordable. Be very clear about what the desired outcome for what the additional training will do for the practice. Training should accomplish one of three goals:
1. Add additional professional services to the practice.
Last month we described the process of implementing surgical implant procedures into a general practice. This additional training comes at a considerable expense, but there is a direct return on the investment that is measurable. At the Dawson Academy, we train dentists on how to predictably do more complex restorative and interdisciplinary cases. Again, training with us should create a measurable increase in the productivity of the practice.
2. Increase the efficiency of current procedures.
Good CE should not only train the team on expanding the number of services a practice provides, but also how to do the procedures efficiently. This goes way beyond what the dentist has to do. Getting the front desk to work with the dental assistants to schedule appropriately and making sure the treatment room has everything ready for the procedure is critical. Efficiency is also easy to measure, as more procedures will be completed during the course of a day.
3. Increasing the quality and predictability of current procedures.
What is more difficult to measure is CE that increases the quality and predictability of the procedures you are currently doing. This will increase profitability over time with a decrease in remakes and fewer unnecessary emergencies. It will also increase your own personal satisfaction for the services you provide and allow you to realize a higher net income with fewer hours worked. This has been a cornerstone in the teachings of Dr. Peter Dawson for the last 30 years.
The Problem With CE in Most Dental Practices
In the vast majority of dental practices, continuing education is an afterthought. A time and financial budget is never created, so CE is considered whenever it is convenient. When a brochure comes across the front desk, if it seems interesting, and the day is open, the course gets scheduled. The problem is that there is a guaranteed lack of congruency from one course to another. Some may actually contradict one another. This leaves the dental team confused, with a great deal of difficulty implementing what they have learned.
Continuing education needs to be an extension of a practice’s big picture. The leader first needs to decide the niche of the practice, get the team aboard, and look for courses that will expand their services, increase efficiency, and increase quality/predictability. It is also strongly recommended to find an approach to dentistry that suits the practice—and stick with it. This leads to a clear approach that can be understood and easily implemented by the team.
The Best Way to Implement CE
One of the greatest challenges in a dental practice is the implementation of high-tech equipment into the practice. This requires a thorough understanding of the equipment as well as necessary training that will be required to perform the procedures. All too often, the technology is purchased without a clear-cut plan for where it will fit in the practice. A great example of this is the implementation of a chairside CAD/CAM system into a general practice. We have been involved with the E4D® system since its inception. I can tell you from experience that the more complicated the technology, the more important a well-defined plan will be to the practice. If the parameters of your practice are not clearly defined prior to the purchase, the impact of an exciting new purchase can quickly throw the practice into chaos. It is far better to clarify who you are; get the team to understand how the new technology fits into the practice; get everyone trained accordingly—then hit the ground running. The following is a five-step implementation strategy for any dental practice. We will continue using the E4D example.
1. Begin With a Sound, Specific Practice Philosophy –
Having a clear understanding of the population you serve and a specific idea of the kind of dentistry you want to practice will help you choose the appropriate technologies. Our practice is an adult restorative practice that focuses on solving complex functional/esthetic problems. Because we do a lot of inlays, onlays, crowns, and veneers, chairside CAD/CAM was a logical choice. By controlling a percentage of the lab-fabricated restorations, we could add an additional service to the practice (same-day restorations), increase the efficiency of current procedures as well as decrease our laboratory expense. Although these were all great reasons to get involved with chairside CAD/CAM, we also knew that we would continue to use the dental laboratory for the majority of our multiunit cases. In our reality, this purchase was for our cases that involved 1–2 units, with the occasional quadrant. Once the decision was made, the first step was to assemble the team, and make sure everyone was clear on the role of the new purchase within the vision of the practice. Key point—never let a technology define your practice. Technologies are simply there to make your practice better.
2. Align your Leadership/Management Principles With Your Practice Philosophy –
The second step is to make sure you align the technology specifically with your management principles. With E4D, the first thing to preplan is how you are going to schedule these restorations. For traditional crown & bridge, we prep, pack cord, take an impression, and place a provisional restoration. With E4D, we prep, pack cord, take a digital impression, design the restoration, mill it then fire it in an oven.
What had to be discussed is how we were going to schedule this. What part of this procedure could be delegated and still end up with an optimum restorative result? What cases were appropriate for E4D in our philosophy, and when would we need to utilize the services of the dental lab? The point is, these decisions have to made before the technology arrives. Preplanning will allow the practice to stay true to their vision, and allow for the best possible transition into the new reality.
3. Scientific Understanding of Technology and Materials –
Once philosophical and managerial principles have been clarified, it is time to immerse the team into the nuances of the chosen technology. With E4D, this was relatively easy. The purchase came with 2 days of training along with an unbelievably good support line. If a practice desires to do larger cases or smile design with E4D, training is also available. Check out www.e4dsky.com/university/courses.php for a detailed list of training possibilities. Nothing can take the place having access to great information/training when it comes to the use of a complex new technology. Keep in mind that it is the practice’s responsibility to determine where this technology best fits (refer to steps 1 and 2). We utilized our relationship with E4D to completely understand the intricacies of technology, porcelains, and cements. Team dedication to becoming an expert on the chosen path is imperative.
4. Attain Procedure Mastery –
Procedural mastery comes with experience. Taking the time to creating a philosophy, a managerial plan, and a scientific understanding of the technology will prepare you for mastery. Then and only then can you focus on individual procedures. By having the managerial discussions well in advance, the schedule will be structured to allow the clinical team to do their best and be productive and efficient. Nothing is more stressful than doing a new procedure for the first time without enough time or a properly trained team. We can all remember when we have been in that position. Preplanning and proper training is the key to success.
5. Create Standard Operating Procedures and Checklists –
The last step in the process is to take the time to create Standard Operating Procedures (SOPs) and checklists. It may seem mundane, but the more we learn to do things the same way over and over, the more predictable it becomes. SOPs and checklists are tremendously important to make sure that each team member sets up a room and assists the Doctor in the same way, every time. The more complex the technology, the more important SOPs and checklists become to the practice.
Practice growth is directly related to practice improvement. We improve by expanding our services, increasing the efficiency of what we are doing, or increasing the predictability/quality of our services. For the past 25 years, The Dawson Academy has been working with thousands of students to help them create a sound practice vision and learn the procedures necessary to perform restorative procedures at a very high level. As we evolve, we are expanding our lectures and hands-on training to include Web-based learning opportunities (Dawson TV). Our goal is to have educational opportunities at all five levels on the above grid, within the context of one congruent philosophy. Regardless of where you decide on training, make a point to plan your CE choices a year in advance. If you do, you will experience a healthier practice financially—and one that is far more enjoyable.