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Michael C. DiTolla,
DDS, FAGD




Dr. Mike DiTolla, at age 30, has built a top 1% dental practice and is in the process of opening a second practice from scratch. As a fellow in the Academy of General Dentistry, Dr. DiTolla feels that the primary problem in dentistry today is getting patients to accept optimum care. He feels that high quality dentistry ultimately makes the patient happier, which in turn increases productivity and word-of-mouth referrals. In this way, everyone wins and the office flourishes.

This philosophy is echoed at Dr. DiTolla's practice-building seminar entitled "How to be a Fee-For-Service Tarzan in a Capitation Jungle". If your goal is to provide state-of-the-art dentistry to quality conscious patients, at the fees you choose, Dr. DiTolla's seminar is your road map to success. His seminar is also available on audio and video cassette. For information about Dr. DiTolla's seminars or tape series, call (714) 505- 4867.


Current Seminar Schedule

June 7
Denver, CO

June 14
Irvine, CA

June 21
Buffalo, NY

June 28
Santa Barbara, CA

July 26
San Jose, CA

August 9
Keystone, CO
The Profitable Dentist

September 12
Buffalo, NY

September 13
Binghamton, NY

September 20
San Luis Obispo, CA

September 27
San Fernando, CA

October 11
Las Vegas, NV
The Richard's Report




Compete With Capitation...
and Win!!



Perhaps nowhere in the country does capitation have such a strong foothold as it does in Southern California. Hardly a week goes by in which at least one of our patients doesn't bring in a letter from their employer explaining the new options to their dental plans, and a justification for why they can no longer see the provider of their choice. Years ago many offices chose to panic when the Los Angeles County Teachers Association (the largest teacher association in the nation) switched from a very generous Delta indemnity plan to CIGNA capitated plan. We simply saw it as a challenge to create an office atmosphere that our patients valued enough to spend on average an extra $500 annually to continue seeing us.

The most important thing I learned from that entire experience was that price and fees mattered less to these patients than I imagined, it just came down to a matter of value. One of the ways Webster's dictionary defines value is: "equivalent worth of services to payment." In other words, patients do not hesitate to pay more if they perceive they are receiving something more or something better than if they went somewhere else. I have found service to be the most tangible way for a patient to compare our practice to others. After crown cementation I never hand the patient an explorer and let them check their own crown margins to put their mind at rest that all the margins are closed. Patients, for the most part, assume quality unless you give them reason to think otherwise.

So rather than letting them check their margins, we provide superb post-crown service. The patient gets a call from me that night to make sure they aren't having any discomfort, and a week later gets a call from the assistant I worked with to make sure they can chew anything they want. Some offices call that night, but hardly any call a week later to make sure everything feels great. These calls are rarely an inconvenience, as they are made by the chair sides during normal business hours, as time allows. If an occlusal adjustment is needed, the patient will get a call one week after the adjustment to make sure it feels better.

The Big Fish

As a solo practitioner you are by nature a little fish. The capitation clinic with 5 doctors, 9 hygienists, and 43 staff (half of who never met each other) is obviously a big fish. In the ocean you'll notice that even though big fish eat little fish, there are still tons of little fish around. Little fish don't get eaten simply because they're little, it's always because they're in the wrong place at the wrong time. The smart ones survive, and dental practice is no different.

The point is that if you are a little fish, and most of us solo practitioners are, don't even think of trying to compete with the big fish on price. Even though the capitation clinic just did a mailing to a 10 mile radius for a $5 cleaning, exam and X-rays; you can't afford to drop your fees like that, even just as a promotion. Always remember these two things: anybody can give something away, it takes brains to sell it; and, a sale without a profit is a donation. Competing with the big fish comes in the form of service innovations that are much easier to implement in smaller offices than larger ones. When service is concerned, the small fish can swim rings around the big fish.

Making Time for Patients

There are some continuing trends in America that most dental offices need to start paying attention to if they wish to increase their service. By the year 2000, three-forth of all American families will be dual income, with both mother and father working. This means that 75% of the families will be making more than ever before. In 1995 the average American has about twice the buying power today as compared to the average family in 19521. The trade off for all of this prosperity, however, is lack, of time, specifically leisure time. In addition, in 1985 the average work week had already reached 49 hours, causing leisure time to decline almost one third in just over a decade.

So how do you appeal to patients with more spending power than ever before and not enough leisure time? You must offer them morning and evening hours to give them the time to come spend money in your office. I'm not suggesting your work 7 a.m. to 7 p.m. 7 days a week, but we work 7 a.m. - 3 p.m. two days a week, and 11 a.m. - 7 p.m. the other two days a week. In contrast to my first office, my new office is located in a heavy dual income family area. Morning and evening hours fill up first, whereas in my other practice in an older community, 9 a.m. - 4 p.m. was seen as normal business hours. Start keeping track of how many of your new patients are dual income families and I think you will be surprised. Don't force the families to choose a clinic with extended hours simply because you or your staff is too lazy to make this change in your office What your hours have been for the last 20 years has nothing to do with what they'll need to be for the next 20 years.

Are Crowns a Commodity?

Of course we know that most dentists crowns are about as similar as any two snowflakes, but our patients don't have the dental knowledge or experience to figure this out. And it is true that to a certain segment of the population that "A dentist is a dentist is a dentist..." To these people dentists are all alike and thus can be treated like commodity. These people need no service and simply want to compare price. It is much like the way I shop for toilet paper: I want it soft and cheap, and I don't need to pay for any service with it. For these non-service items, most of the growing American middle class is heading for discounters like Price Club, Costco and Sam's Club. I often chuckle as I count all the luxury cars in the parking lots of these discounted stores, but these are the same patients that don't think twice about doing those 3 Empress crowns.

My target market is intelligent enough to seek out commodities at their cheapest price, even if it means having to buy 17 six-packs of toilet paper shrink wrapped together. But they are also intelligent enough to realize that dentistry is not a commodity, and they are willing to spend premium dollars for a dental office that goes above and beyond the call of duty, both clinically and interpersonally. You should also be intelligent enough to realize that all the dollars that everyone is saving at the discounters are waiting to be dropped into someone else's lap, and my belief is that a cosmetic dental office is an even better choice than the beauty salon or jewelry store that would get it otherwise.



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