Thank you to Anne Linesch Duffy and Dental Entrepreneur for the opportunity to share my story with their readers. It is my hope that it will inspire others to find their own path to achieve their dreams and personal definition of success. The rewards and benefits bestowed upon me by those with whom I’ve had the honor and privilege to work and serve over the past four decades are beyond what many people define as success.
Some have said that there is no upward mobility for auxiliaries in the dental profession. I disagree with that statement because opportunity exists for anyone who considers dentistry their career, not just a job. I’m living proof of that possibility.
After graduating early from high school, I entered university, barely 17 years old. With my limited life experience, I was focused on a career in what I knew—teaching or journalism. Whatever my path, I wanted to make a difference in people’s lives. After only a year, I became disillusioned by the political environment in the Arts program. Time to explore another avenue!
Searching for a job was, in some ways, simpler in 1975. Scouring the classified ads in the newspaper, I found something that interested me—a dentist was looking for someone to train as a dental assistant in his practice. I always liked (even loved) my visits to the dentist and admired the profession. Learning something new would be an adventure! How fortunate that I answered that ad. What started as a job was the beginning of a career that has allow me to give back in meaningful ways to practitioners and the public in ways that could not have been imagined.
The opportunity to commence learning was like my brain and heart were sponges soaking up as much knowledge about dentistry as I could. It was inspiring to watch my boss diagnose and design treatment plans for our patients. I loved chatting with them between procedures. The collaboration with other dental teams and their patients was energizing, as we learned and discovered ways to help our patients enjoy better dental health. I found another way that I could make a difference in the lives of others!
In those days and in that practice, dentists and assistants didn’t sit. We stood. We didn’t wear masks, gloves, or protective eyewear. We mixed amalgam by mixing alloy and mercury in squeeze cloths. Our slow-speed handpiece was powered by a series of cables. No saliva ejector—patients spit into the cuspidor. Our “high-tech” office was the envy of many other practices. We used the latest impression system available—hydrocolloid—even though we lacked the recommended water-cooling system recommended by the manufacturer. Instead, we used gravity-fed cool water flowing from a bucket held over my head through the tubes to the collection bucket placed strategically under the patient’s chair.
The scope of involvement as a dental assistant in those days was quite limited, so administration (a.k.a. “reception”) was beckoning . No automated systems to create efficiencies in managing patient accounts, let alone scheduling. No, we did it by the book. One-write ledgers to record and balance AR were as simple as balancing your checkbook. That is unless the person managing the accounts can’t add or subtract! In my first administrative role, the one-write ledger hadn’t balanced in over two years! My new boss didn’t care, but I did. So, I searched the ledger sheets until I found the sheet that did balance. Every night I would take home a packet of sheets to work on. After six months, the ledger sheets finally balanced. Feeling accomplished, I showed my boss. He was amazed that I had made the effort on my own time and even more impressed with the results. Could I do more to help my employer manage his practice more effectively? Yes. That became possible with more training in business administration and marketing that I studied in the evenings and applied to managing our dental practice and every practice throughout my career.
My involvement with dentists and their teams has changed dramatically since the 1980s. Technology allowed dentistry to be delivered more efficiently and safely, as both clinical and administrative departments were given better tools. Using those tools promised increased production sufficient to mitigate the capital cost to acquire them. Sadly, in my observation, one of the consequences of this was a shift away from relationship-based dentistry to simple revenue and profit goals.
Thus, the behavioral side of dentistry gradually evaporated during the ‘90s, and managing expectations of dentists and the public became more challenging. Dentists began to view their colleagues as competitors; collecting “patients” like chips in a game of poker.
During the ‘90s, costs of operating had escalated, and dentists began to struggle to meet their financial obligations. The solution embraced by many was developing relationships with third-party payers (primarily insurance companies) to make access to dentistry more affordable for the public. Besides adding to the financial burden on practitioners, that shift from fee-for-service to third-party payer system, had another impact on dentistry. Insurance companies became the defacto authority in the patient-doctor relationship, usurping that role from the practitioners and further eroding the right for patients to make informed decisions about their own oral health.
At the same time, investors found opportunity to capture a previously untapped source of income. With the industry showing growth exceeding many others in the stock market, especially following the collapse in 2008, equity investor groups believed that the profession held little risk and great reward.
In 2002, I learned a lesson about the corporate world. Accepting a role as Professional Services Manager for a major, well-established dental supplier, dentists sought my advice and assistance in resolving practice management issues. My employer saw this involvement as an opportunity to sell more supplies, materials and equipment. What I quickly learned was that these dentists didn’t need to buy any more stuff! They needed to develop skills that would help them to utilize the tools more effectively to build a strong team that shared a clear vision and mission for creating more satisfied patients. Dentists and their teams needed to feel empowered and supported to achieve their goals.
In 2004, I founded my own company which is solely dedicated to empowering and supporting independent practitioners through education and provision of services to the dentists and their teams customized to their unique practice culture and model. Merging behavioral and business allows them the balanced approach needed for sustainable, manageable growth.
Escalating cost of a dental degree has also been challenging to those entering private practice. Couple the $250,000 to $400,000 in student debt and fewer opportunities to join thriving private practices, career transition has become very challenging for many young dentists. My work with dental students helps them to prepare for life after dental school. On the other end of the career spectrum, I coach established dentists for succession of ownership in their practice.
In the broader professional environment, my mission is to provide a viable alternative to corporately-controlled operating models because a thriving independent practice model that includes being a strong advocate of the public’s right to choose is in the best interest of the dental profession.
It is my good fortune, and I am deeply grateful for the continued opportunity to serve my clients, and bear witness to their success.
Nadean Burkett, Founder & President of My Practice Matters