Troublemaker on Your Team?
As dentists transition towards a modern dental practice, many of them realize the value and benefits of placing computers in the operatory. A recent study seems to indicate that most offices have computers in the treatment room, and many practices are moving in this direction over the next 12-18 months. One of the issues that has created resistance is the confusion over proper positioning of the monitors. In this article, we will examine the decisions that must be made in positioning monitors for maximum benefit.
One Scoop or Two?
While the concept of having more than one monitor in the operatory was a foreign thought a few years ago, this is becoming more and more common today. The main benefit of two monitors is the ability to pick and choose what the patient sees and what they do not see. Most practices want the patient to be able to view intraoral camera images, digital camera images, digital radiography, patient education, and DVD or TV. However, in many cases, there is more HIPAA-sensitive information that is best not seen by the patient, such as the day’s schedule, financial statements, and other private information. In these situations, a dual monitor set up is ideal.
It’s important to differentiate between two monitors and a dual monitor display. Many offices already use two screens, such as a TV and a computer monitor. However, the TV is not connected to the computer and these are really two separate systems. In a dual-monitor display, both screens are connected to the computer. This requires the use of a dual-display video card. These cards can have outputs for both monitors (VGA or DVI) and TV (RCA or S-Video). By setting up the monitors in Windows, they are basically treated as two halves of one monitor: drag an image to the edge of one screen, and as you continue to drag, it appears on the leading edge of the other screen. Through this system, you can pick and choose what appears on each monitor.
For the monitor being viewed by the patient, there are a number of options that are available. Many offices currently have TV monitors that are positioned in the upper left or right corner where the wall meets the ceiling. While adequate for watching TV, this position is not ideal for viewing digital images. The monitor should be positioned about 18” from the patient’s face, and this corner position is simply too far away. So, this narrows down the options to three: the ceiling, the wall, or the light pole.
For maximum flexibility, the ceiling is the best location. When connected to an articulating arm, such as those from ICW (www.icwdental.com) or Ergotron (www.ergotron.com), it allows the monitor to be viewed from both a sitting as well as a reclined position. Since many offices have drop ceilings, it is also easier to run the necessary cables (video, audio, and power) from the monitor back to the computer.
If viewing the monitor while the patient is reclined is important, then a pole mount is also a good option to consider. Many dental chairs have built-in options for a Radius-style monitor mount. The one limitation is the issue of the cables. If the floor is concrete slab and there are no conduits in place, then there is no easy way to run the cables from the monitor to the computer. Also, it makes sense to position the monitor as high as possible on the light pole, as the higher the monitor is positioned, the easier it is to view while reclined.
If viewing the monitor from a reclined position is not crucial, then a wall mount can be considered. These mounts come in many shapes and sizes. Dentists will have to decide if they need the monitor to extend out across the patient or just to the side, whether up-down motion is required, and whether they want a keyboard tray to be mounted to the monitor.
As practices add new technology systems, it is important for dentists to evaluate the different options available for positioning monitors. There are ergonomic and esthetic issues that must be considered, but with proper planning, the ideal result can be achieved.
Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provides dentists a full range of services relating to the implementation of technology.
Hear Dr. Lavine’s FREE podcasts at The Dentist’s Network - HERE
The access to care problem in both medicine and dentistry has risen dramatically in the last ten years. In our dental profession, the number of Dental Health Shortage Areas (as defined as one dentist per 3,000 people) has grown from 1,853 shortage areas to 4,230 shortage areas in 2009. This is a 128% increase! So why are these areas growing so rapidly? From our experience, we have found that dentists who established their practices in small town or rural areas are having an increasingly difficult time finding associates or purchasers to buy their practices. Why so? The primary reason is that the majority of today’s dental graduates want to practice in urban or suburban areas. Granted these areas may provide more social and cultural opportunities than smaller towns or rural areas, but from a professional point of view, it may make good business sense for a young dentist to reconsider their strategy. Here are some points to consider:
It goes without saying that many young graduates are having a harder time finding associate buy-in opportunities in this tough economy in the suburban and urban areas. As many doctors have deferred their retirement plans for several years due to the economy, the opportunities in these areas for practice purchases has diminished, thus frustrating more and more associates who want to own their own practice. However, this is not the case in small towns and rural areas. Most dentists in these areas are doing quite well economically, as many communities do not have enough dentists, and consequently, patient demand is quite high. So less competition means more economic opportunity!
Accelerated Loan Forgiveness
Because of the dental shortage crisis, certain states are offering loan forgiveness programs based on the number of years a doctor practices in a shortage area. Practicing in these locales can accelerate your ability to retire your student loans. Moreover, if you decide to purchase a practice in a small town or rural area, chances are you will be able to purchase an excellent practice at a very attractive price due to the lack of demand of purchasers. Consequently, you’ll get a better return on investment in these areas than purchasing a comparable practice in an urban/suburban area.
High Net Profit
When valuing rural practices, we find that most practices rarely have overhead exceeding 50-55%. This is true for two primary reasons; cost of labor in small towns and rural areas is certainly a lot less than in urban and suburban areas. Secondly, so are the occupancy costs. Therefore, purchasing a professional building in these locales can be a tremendous financial investment for a doctor wishing to purchase a practice with the real estate. Even if you decide to rent instead, your facility expenses ratio will be significantly lower as well. So higher net profit can build your wealth more rapidly by having the cash flow to save more and retire debt more aggressively than your classmates will be able to do in urban and suburban areas.
Practice Start-Up or Practice Purchase?
In rural areas you’re faced with a worthwhile dilemma. You can move to a small town and either purchase a practice with a low multiple of gross receipts, or conversely, you may elect to start your own practice in the same area and be quite busy from the outset! We find that in many small towns and rural areas, practices are selling between 40-50% of last year’s gross and in some cases even lower than that. So, it is possible to buy an extremely successful dental practice for a relatively low price.
Life Style Changes
I have talked to some dentists who are tired of the “rat race,” competition and tough economy in the urban areas, and yearn to simplify their lives. So, for someone in practice who wishes to slow down the pace, increase income, and reduce stress, relocating to a small town or rural area may be the best solution.
Now for the few of you who understand the points we have just made in this article, think long and hard about considering a small town or rural area as the place to begin or end your career!
If you would like additional help, email Dr. Snyder at email@example.com.
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