We received over 470 responses to our online member survey on practice reopening strategies. Thanks for this excellent response! Of these, 57% were from general dentists, 22% were from orthodontists, 6% were from pediatric dentists, 6% were from oral surgeons, 4% were from periodontists, 3% were from endodontists, and 2% were from prosthodontists.

Practice Reopening

Virtually all (99.79%) practices have reopened to provide non-emergency procedures during the pandemic. 48% of practices resumed non-emergency procedures between May 1-15, while another 27% did so between May 16-31. Another 18% reopened between June 1-15, with the remaining practices opening shortly thereafter.

Current Busyness Levels

We also asked about your current level of busyness compared to pre-COVID-19 levels.

The chart above illustrates an astonishing 31% of practices are back to full (100%) capacity, while another 28% are operating at 90-99%, and 25% are operating at 80-89%. Only 12% are operating at 70-79% of pre-COVID-19 busyness levels, and just 4% are below that.

In order to restore their pre-pandemic production, most practices called the vast majority of their staff back from furlough. 71% are now back to full (100%) staffing, while another 16% are staffed at 90-99% of full levels. 9% are operating with staffing at 80-89% of full levels, while only 4% are staffed below that.

Fee Adjustments

Only 28% of practices reported increasing practice fees since they reopened, while 72% left fees unchanged. Of those increasing fees, 82% followed our recommendation for a general (overall) fee increase, while only 18% were imposing a separate PPE surcharge. Raising fees overall makes more sense now than ever, since the Maryland Attorney General has recommended that patients seeing a PPE surcharge request the dentist drop it, and to contact your State Attorney General’s office if the dentist does not comply. It’s not worth fighting the battle, if you can accomplish the same result through a simple across-the-board fee increase.

Fortunately, 90% of practices are now able to obtain all the PPE required to safely operate, and PPE costs are declining as the supply increases.

Practice Recovery Loans and Grants

We were pleased to see 96% of practices had applied for and received a Paycheck Protection Program (PPP) loan that’s eligible for forgiveness. We’ll continue to provide updates on the loan forgiveness rules, application process, and associated tax implications as they become available.

An astonishing 72% of practices had followed our advice to apply for Provider Relief Fund payments through the Department of Health and Human Services (DHHS). These payments are not loans, and thus do not need to be repaid, as long as they are used in accordance with the program requirements.

Another 55% of practices indicated they had received an Economic Injury Disaster Loan (EIDL) grant or loan. EIDL grants of up to $10,000 do not need to be repaid, although they do count against the amount of PPP loan forgiveness. While EIDL loans must be repaid, the interest rate (3.75%) and repayment term (30 years) are very favorable.

Top Practice Reopening Ideas

We also asked doctors for their best practice reopening idea. The following is a summary of the responses:

1. Staff involvement and commitment – We had our entire team involved in planning the reopening process, communicating via Zoom and a Facebook group. This allowed each staff member to have input, assured they all “bought in” to the new protocols, and made everyone feel safe returning to the office.
    
2. Increased patient communication and education – Communicating our new COVID-19 protocols to patients through letters, calls, texts, emails, and mailers was critically important. It made patients feel safe, encouraging them to return for new appointments.
    
3. Publicizing COVID-19 safety protocols – We published a walk-through video on social media (YouTube) and our website showing our new COVID-19 protocols and precautions implemented to make patients safe. This turned out to be a great marketing tool bringing in new patients who loved our organized approach to providing high-quality patient care in a safe environment.
    
4. Boosting referrals – We sent our safety protocol video to our referring doctors, along with a letter offering to support and help them through the reopening process. We found that making our referring doctors more successful translated into increased referrals for our specialty practice.
    
5. Benefits of a virtual reception area – We reduced transmission risk and increased our efficiency with a virtual reception area. We ask our patients to text when they arrive in the parking lot so a staff member can meet them at the door to update their health history and COVID-19 questionnaire. No additional family members are allowed to accompany them. Other practices are using the TextNow app so assistants can text from their chairside computers to have patients enter the office from their car. Others are using third-party software that notifies the practice when the patient has arrived in our parking lot and sends them the COVID-19 questionnaire and then moves them into our “welcome station,” all through texting without tying up any phone time.
    
6. Technology to reduce front desk labor – Sparked by the pandemic, more practices have gone digital for all patient consent forms, procedure forms, and new patient forms, using YAPI or Google Docs. Others are collecting health history screenings and COVID-19 questionnaires online when scheduling appointments to minimize front desk labor.
    
7. Going virtual – More practices (particularly orthodontists) are going virtual with consultations, exams, and virtual fee presentations. Leveraging teledentistry with new technology has also extended to Invisalign appointments, routine progress checks, and retainer checks. This not only increases staff labor efficiency, but patients and their parents love this option!
    
8. Increasing hygiene department production – We educated our patients (by Facebook and on our website) that missed hygiene appointments could cause tooth decay leading to root canals and periodontal disease resulting in tooth loss and increased risk of heart attack and stroke. This allowed us to increase our soft-tissue management periodontal program to fill hygiene holes. Furthermore, when we educated patients about our limited supply of hygiene appointments, it made them less likely to cancel or no-show.
    
9. Increased doctor production – With our new protocols in place, patient visits take longer so there are fewer each day. As a result, each visit is more important. Through strict scheduling and confirmation (by phone or text including requiring the patient to text back to confirm), we have reduced broken appointments and cancellations. We are producing more same-day dentistry using block scheduling and maximizing our production-per-visit to reduce the number of visits required.
    
10. Dedicated hours for high-risk patients – We have extended our hours and some of these are dedicated solely to high-risk patients, so they can feel comfortable coming to our office for needed dentistry which is substantial for our older patients.
     
11. Recalibrated our practice – We used the downtime to re-examine our practice, raising fees, dropping PPOs, and brought back fewer staff when we returned. As a result, we are now more productive and profitable.
     
12. Reducing costs – We’re using washable gowns instead of disposable ones to cut waste and costs. We have installed a washer and dryer to launder on-site and have employed our children to take care of these duties at an increased tax-deductible salary!
     
13. Showing compassion and care – We have reached out to our patients to let them know we’re doing everything possible to keep them safe and showing empathy and care for their situation. This has translated into reduced broken appointments and cancellations and higher treatment acceptance rates.
     
14. Reducing risk from aerosols – We are switching to end-of-day bracket removal to reduce aerosols and are using HEPA filters, advanced vacuum/suction devices, UV lights, and advanced sterilization techniques to keep our office clean and patients and staff members safe.