What Dentists Should Be Doing Now

by Jeremy Ueno, DMD

It was the end of February and I was looking ahead at my schedule in March. I noticed that we had our highest producing month scheduled! I had a long weekend planned toward the end of March since I was sponsoring an autism awareness night at the Shark Tank and had family flying in from all across the country to support it. I also had the first week of April off since my kids were on Spring break. The work-life balance that we all strive for was really falling into place perfectly for me. I was even looking to find extra days to take off. 

At my office, we had just done a full day of training with our consultant on February 24, and there was no mention of COVID-19 affecting our practice. I then proceeded and made a couple of large purchases in early March, which included hundreds of implants, new computers for the office and a 3D printer. We hired three new employees and were gearing up for our best production year yet!

At my office, we have weekly team training meetings and, in the last month, those trainings all became discussions on COVID-19. Luckily, we had already implemented COVID-19 precautions at our office since the beginning of the year. We sent email blasts to our patients asking them to reschedule if they had traveled to high-risk countries or had any flu-like symptoms. We pre-screened our patients with questionnaires. We screened our own team as well, and we had one employee stay home for 14 days after she returned from visiting family in China. We felt confident that we were taking the proper precautions, but we had no idea of what was to come.

On March 9th, I turned 41 and my team threw me a mini-celebration at the office. At this time, all everyone was talking about was COVID-19. Some team members voiced their safety concerns and we started discussing how we could increase the protection of our team and patients, but there was never any discussion of shutting down. Little did we all know that life and business as we knew it would be forever changed the following week.

On Friday, March 13th, we started hearing that we may have to shut down for a certain amount of time due to the pandemic and the fact that California was a new COVID-19 breeding ground. My kids had been off from school since March 12th, so we knew businesses may be next. I had conversations with my associates and office manager over the weekend about how they felt about the situation, and some of them felt uncomfortable going back to work. We then got word that the city may get shut down with a “shelter-in-place” order and our decision to shut down our normal operations was made. On Monday, March 16th, we went along with business as usual. I had drafted a letter the night before and we held a team meeting at lunch. 

When I gave the letter to everyone, there were so many uncertainties and I had no idea what the future of the business or the world would be. I was in tears when I told my team that we were shutting down and that they should all apply for unemployment. At this point, the shelter-in-place was to be lifted on April 7th and I let them know that we would be back to work on this date. Or so we thought.

Now, like most offices, we had a knee-jerk reaction and rescheduled every single patient immediately. As a periodontics office, it was critical that we see our post-op patients and address our patients who were in pain or had infections. Some of the patients we rescheduled were not happy because they wanted to be seen. We were unclear about whether we could see certain patients until the CDA and ADA came out with their guidelines. Once we had more clarity and direction, we decided to open for certain hours of the week to see our post-op and emergency patients.

Like all dentists and business owners, I was scared. I did not know what to expect. I did not know what the future of my business and employees would be. We heard of all of these bills being passed and there was so much misinformation on the internet. I felt down on myself the first few days of the “shelter-in-place,” but then a switch went off in my brain. As a referral office, we have a network of hundreds of doctors who refer to us. Why not use my connections to connect everyone in a safe environment where we can share information with local peers?

I decided to start a Facebook group called “Silicon Valley Dentists and COVID-19.” I initially invited about 40 local dentists to join the group and I shared information regarding the bills that were being passed and started hosting webinars regarding what I knew. 

I am part of what is called the “Think Tank” for Spear Education. This is where roughly 20 specialists across the country come together and discuss issues. Since COVID-19 hit, we were meeting almost daily via webinars. From the information I received from the Think Tank meetings, I was able to demystify and find more clarity in the laws that were being passed. The other specialists in this group were also starting Facebook groups and hosting webinars on the pandemic, which enabled us to share the best information out there. This, in turn, helped me host quality webinars. We had 100-200 attendees at each one!

So now we are weeks into the California “shelter-in-place.” Where are we now? What are we going to do? What is the future?

For now, we are recommending that all dentists defer all loans as far back as possible. Some of my lenders have given me a 180-day deferral. Contact your credit card companies, your insurance companies, auto leases, rent, etc. Defer as much as you can so you can keep cash on hand. In times like this, we say “Cash is King.” I was on a webinar that was broadcast in New Orleans and they compared this time to Katrina and said that “Cash was oxygen.” That definitely gave me some perspective on the situation.

Once everything is deferred, what are you going to do with your team now that you aren’t bringing in any production? Well, that all depends on what you think your future is going to be. When it comes to all of the bills (and by the time this article is published everything may be different), I recommend doing what you think is best for your practice and THEN decide how government funding can help you.

If you think that you will be at full capacity once we are allowed to be running again, then the CARES loan is a great option.

If you think that you only want to keep a core few people, then not taking the CARES loan and focusing on tax credits may be the best option.

So it all depends on what you think is best for your practice. We are all different and we can’t do something just because the guy next door is doing it. Speak to your advisors and make the best decision for yourself.

And what do we expect from life after the crisis? Will patients still want to get treatment done? 

For me, I believe that the oral-systemic link is the key to the future of our practices. Help people understand that a healthier mouth can lead to a healthier body. If we have infections in our mouth, it can affect our immune system, and a compromised immune system is the worst thing that we would want during a pandemic. 

Also, we must hope to break even in 2020. All of the goals that were set at the beginning of the year have to be reset and re-evaluated. Make game plans with the assumption that your production is down 50%. Make another game plan if your production is down 25%. Know what you have to do before you open your doors if the patient flow is not the same. This is the time to start planning. If you do it on the fly and make knee-jerk reactions, then the wrong decisions can sometimes be made.

Also, know that we are not in the worst position. There are many other businesses that are in much worse shape than dentistry. Our businesses will bounce back. We just need to make the correct decision for our businesses right now. Also, we have to realize that there is a business and a human side to all decisions. We want to do right by our employees, but we cannot jeopardize the health of the business to make everyone happy.

During times of crisis, tough decisions have to be made. Those that put in the work now will make it out ahead once the dust settles. This is not the time to sit at home and watch Netflix. This is the time to really focus on your business. What are the things that you wished you always had time to do but never had the time? It could be updating your employee handbook, or updating your website and patient forms. Maybe you want to learn more about 3D printing. This is the time to learn and put the focus on your practices. Hopefully, you will never have this much time again! 

For me, I am working more now than I ever have. I am trying to get as much information as possible to make the best decision for my practice. The decisions we make affect a lot of people. They affect your employees, their families, your family, your patients and the list goes on. 

By the time you read this, I hope we are all working and in a great place. I hope our offices are busy and we are back to normal. If we are not, then I hope you are using your time wisely. Training your staff, learning new skills to implement into your practice, upgrading your forms. Whatever it may be, use this time wisely. 

My mentor once told me, “You can’t write a check for yesterday.” So make sure you don’t regret the way you spend this time that you have now. Many people are counting on you!

 

Board-certified periodontist, Dr. Jeremy Ueno, is a Bay Area native and founder and owner of Ueno Center Dental Specialists in Campbell, California. From an early age, Dr. Ueno demonstrated a passion for medicine and technology. After graduating as a biology major from the University of California, San Diego (UCSD), that passion for technology was apparent as he completed his internship and, later, served as an employee in the IT department at Genentech in South San Francisco. This helped form the basis of his appreciation for the intersection of technology and medicine that continues today. 

 

 

 

 

 

 

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