I don’t know about you, but I am getting so sick and tired of everything I’m reading about the imminent demise of dentistry as we know it. Corporate dental practices will be expanding into your neighborhood and will be stealing all of your patients. Your overhead is increasing because of higher technology costs and the steady upward pressure on staff wages and benefits. Then add to that the newer costs associated with the compliance to government mandates. We all know that dental insurance plans are continuing to aggressively deny treatment while at the same time decreasing benefits to pay for treatment. And how about your future–the huge debt load of recent dental school graduates is making it challenging for them to buy a dental practice.

The list goes on and on. My philosophy, however, has always been that it is wasted energy and totally unproductive to ever worry about what you can’t control. And in this instance, you shouldn’t either. The above list of problems is to some extent all true, and won’t be going away anytime soon. Here are my thoughts, suggestions, and solutions.

1. There will always be a place in every community for a well-managed, clinically excellent general practice, delivering exquisite customer service. This practice should include itinerant specialists to provide the opportunity for in-house referrals thereby offering easy one-stop shopping to your patients and increased revenue. I guarantee that such a practice will provide levels of care that cannot be approached or duplicated by corporate dentistry. A good proportion of dentists working in corporate dental settings have minimum experience, under developed diagnostic skills, and limited communication skills. Not where I would want to be treated.

2. You don’t want to be–and physically can’t be–all things to all people. Pick your niche–whether that be Ritz-Carlton or Motel Six. Just be terrific at what you do and you will continue to separate yourself from your competition. But whatever model you pursue, you absolutely need room to expand. In my experience, the greatest impediment to the growth and success of a practice is the lack of a proper facility.

3. New technology is expensive, but the return on investment, and the marketing WOW that it creates, will ultimately work in your favor.

4. Dentists must realize that staff costs, which are the biggest expense in any practice, have to be controlled. I am a strong believer in paying a fair and representative hourly wage and supplementing that wage with bonuses and incentives that are tied to increased practice revenue. I strongly believe that the dentists’ share of health insurance benefits must be capped. I just finished a very interesting book on controlling health care coststhat is a must read for every small business owner.

5. We fight with dental insurance companies every day. The message must be sent to your patients that dental insurance is merely a stipend. If you continue to belong to the “one crown every year” club, and let insurance companies dictate your treatment, then you indeed will be suffering and going in the wrong direction. If you can learn to effectively present comprehensive and elective dentistry, then welcome the fact that insurance is useful for getting patients in your door.

6. Nobody to buy your practice? I simply don’t find this to be true. I believe that we are still very much in a sellers market with more doctors looking to buy than looking to sell. Yes–recent graduates often have high debt loads. But I have helped countless young dentists with two or three years of associate experience and with education debt of 250K or more, obtain 100% bank financing on just their signature provided the collections of the practice they are buying supports the practice valuation.

In 2014, I worked as a consultant with 36 separate dental practices. Some were new relationships, but mostly were existing relationships. 25 of the 36 practices increased revenue and profitability in 2014 compared to 2013. Seven practices stayed constant, and four were slightly lower. I quote these numbers not to brag, but merely as proof of what I see on a daily basis. The sky is not falling!

If you work hard, pay attention to details, and continuously deliver a quality product and strive for always improving ways to maintain excellence, your future is bright. Nobody ever said this was easy. Every business has its own set of challenges. Dentistry is no different. So please stop listening to the gloom and doom predictions. These people are only trying to sell you something you probably don’t need to buy!

The beat goes on and the costs keep going up for dental providers. Costs in terms of time as well as money. OSHA training and recertification needs to happen every 18 months at an approximate cost of $900. HIPAA Compliance programs average $2500 to initiate and complete and around $1500-$2000 annually to stay current. And now, there is another cumbersome requirement that needs your attention.

By June 1, 2015, dentists who treat Medicare beneficiaries (any patient 65 or older) need to be enrolled with Medicare so that these patients can be reimbursed for their prescriptions that you write for them with Part D drug plans. You can’t just ignore this requirement. The law says you must make a choice and either opt in or opt out. And whatever choice you make is binding for two years.

There are two kinds of enrollment. Most of you should enroll strictly for the purpose of prescribing and referring. If, however, you treat obstructive sleep apnea and want Medicare to cover the cost of oral appliances, then you should consider enrolling as a billing provider for Medicare Part B.

Of course, anytime you are dealing with the Federal government, they don’t make things easy. The application process for something so essentially simple turns out to be extremely confusing, illogical, and cumbersome.You could try to do this yourself, but I think you’ll be opening a bottomless can of worms. Instead, I would suggest calling David Wester. He is the Director of Medicare Enrollment at StatDDS.  His direct line is 800-693-9076. StatDDS will simplify the process by gathering all of the pertinent information about your practice, fill out all of the paperwork, file all relevant material with insurance carriers, and keep up with the status of the application. The company charges a one time fee of $697.

I am strongly advising my clients to opt in. Patients over age 65 are an important demographic. Their dental needs are often extensive, they do lots more elective procedures, and they are usually more financially secure. I would not want any one of these people leaving my practice – and telling their friends – because they couldn’t get their Medicare prescriptions filled. No question that this new requirement by the government is another irritant and a big nuisance. But don’t be penny wise and pound foolish and try to enroll on your own. Take care of this today.