Few dental school graduates these days open their own practices. Saddled with debt, they typically join established offices as associates. Yet as every clinician knows, education doesn’t end with that diploma. Young dentists need to continue learning about their profession, from new clinical techniques and technologies to the principles of practice management.
While many practices institute informal training and mentorship programs, Greenberg Dental & Orthodontics in Florida has a pipeline that shepherds dentists from their undergraduate years to associate positions and, potentially, practice ownership. And it all begins with an exhaustive statewide outreach to college campuses, regular meetings with the doctors with in Greenberg Dental, and chairside mentoring individual doctors.
“Upon graduation, probably 30% of all dental students are currently joining some type of group practice, and I think that trend is only going to increase. The level of debt the students undertake makes opening their own office very difficult. With such high debt levels, it is more important than ever for young dentists to develop their skills sooner,” said chief clinical director and senior partner Steve Barrett, DDS.
“Within our group structure, which is completely owned by dentists, we believe we understand how important this is to get right. After many years of refining our mentorship approach, we have formally named it the Greenberg Vision First Approach,” said Barrett.
“In a short period of time, we help young doctors to predictably work through relatively complex dental diagnoses. This is done in combination with their mentor doctors and in-house specialty support. The Vision First Approach is accomplished by applying our clinical protocols, which we call the Barrett Protocols,” said Barrett.
“Why did we make such a great effort to create our own highly structured mentoring approach? After personally visiting dental schools over the last 20 years, I ask the students each time what the most important thing is to them when they graduate. Is it pay? Is it location? Is it mentoring? Mentoring is always the number one thing the students say they are looking for,” said Barrett.
Barrett joined Greenberg Dental and Orthodontics in 1991 after serving three years as a dental officer in the United States Navy. Since 1988, the privately owned multi-specialty group practice has grown to 92 offices throughout Florida. Its dentists in each office have autonomy over their clinical decisions and run their day-to-day operations.
“When our doctors have a question or they need something, they’re contacting one of the owners. There’s no middle management layers that we require our doctors to go through,” Barrett said.
“We believe growth comes when doctors take ownership of their clinical responsibilities and developing their minds eye to see what is possible through the mentorship of others. Having a ‘vision’ for what is possible is fundamental. Couple this with affordable fees, we give dentists the chance to do more dentistry and gain more experience,” Barrett said
“My message to students at dental schools speaks to the great potential of restorative and aesthetic dentistry done well and predictably. Typically, we have an hour to an hour and a half presentation, with plenty of time for questions. Whether it is lunch and learn, an American Student Dental Association chapter, or an Academy of General Dentistry meeting, I speak about income potential and what to look for in contracts, but the majority of time is spent on discussing cases and walking students through procedures step by step,” Barrett said.
Barrett wants young dentists to develop a vision for how they see teeth and how teeth fit into the face, as well as develop a passion for dentistry. This is the students’ first exposure to his Vision First Philosophy.
“The students are really excited about seeing dentistry. They want to understand what they can do and what’s possible for them once they graduate,” said Barrett. “What excites them is when they see before and after pictures of cases our young dentists are restoring. We complement our case documentation with videos of actual patients talking with and without their restored smiles so they can see dynamically what dentistry done well can do to change someone’s life.”
Barrett wants them to realize that each one of them can develop the skills and the talent needed to achieve these results. They can, according to Barrett, in a short period of time after graduation, have the ability to affect the lives of their patients in a very positive way.
In the Office
When these students graduate from dental school, many of them find work at one of Greenburg Dental’s offices. New employees begin with a two-day orientation process, with eight hours each day spent on topics such as case presentation, digital photography, and dental insurance.
“After orientation, they begin working with their mentor doctor. There’s really no pressure for anyone right out of school to produce. There’s no quota. We want them to take the time to learn our procedures, gain clinical confidence, learn how the office runs, learn how to work with specialty care, learn our materials and the deeper whys behind our thought process,” Barrett said.
Barrett himself conducts what he named the Accelerated Learning Program (ALP).
“In small group case review sessions, which are live monthly meetings in each region, we discuss issues such as the initial patient dialogue, coordination of care with inhouse specialists, treatment planning, sequence of treatment, custom BioTemp Provisionals, and final restoration material choices. We expect them to make conscious decisions and be fully engaged in their own learning. This is how we get them to their next levels faster,” Barrett said.
“These ALP meetings are really to get them to step away from the normal daily pressures of dentistry and develop their vision to see their role as dentists and leaders,” said Barrett.
“Their exposure in dental school is typically one patient in the morning and one patient in the afternoon. Now we’re putting them in an environment where they’re seeing 10 or 15 patients a day,” Barrett said.
“They just have not had enough patient exposure, enough patient care, to really be efficient at this process. Part of these meetings is really to get them to develop their mind’s eye, expand their vision, see what is possible, and learn to communicate that vision to the patient,” Barrett said.
Barrett further notes that this approach is part of the advantage of working for owners who are dentists, since they understand all of the factors that may affect a doctor’s productivity.
“Another advantage is the integrated specialty care within Greenberg Dental. Young dentists have plenty of opportunity for consultation,” said Barrett.
“I talk with them a lot about the multidisciplinary cases and the advantage of having an orthodontist or a periodontist in the office who can help you,” said Barrett. “It’s almost like a dental school setting where they could just walk down the hallway and have a consult. We do consults with our specialists at no charge to our patients.”
Barrett provides further reinforcement via the company’s monthly newsletter, The Perspective, and by travelling every day to different offices. Barrett usually works chairside with more than 50 doctors each year.
“When a mentor doctor or I work chairside with a doctor, we do the case together from start to finish—the diagnosis, the treatment plan, and the finances. We complete the case with them and take final photographs,” said Barrett.
“When a doctor receives mentoring, that doctor still gets paid for the work completed. We try to eliminate any roadblocks that would prevent a doctor from asking for help. And I don’t think there’s any group in the country that offers chairside mentoring to that extent,” Barrett said.
This intense one-on-one mentoring has led to better care for patients, Barrett said, noting that he gets about 20 emails and texts a day from doctors who are looking for advice on cases. Doctors also can schedule time for Barrett to visit their office for additional guidance.
“Certainly, our mentorship process is not easy. It takes an incredible amount of time and focus. I shouldn’t be working this much after all these years. But I know that’s still how dentistry is taught. It’s still a one-on-one relationship.”
In addition, Barrett and his team set up a variety of hands-on workshops at their educational training facility in Lake Mary, Florida, each year. Recent courses have focused on veneers, overdentures, and socket preservation techniques.
“We also host smaller educational events in each region with our vendor partners like 3M, Kerr, Astra, Implant Direct, Orascoptic, Ultradent, and Glidewell, as well as some of the great companies that support specialists like Ormco and Gieshlich,” Barrett said.
“There is a need to continue where dental schools leave off and build upon that base of knowledge. We are trying to address this need in a highly structured and meaningful way,” Barrett said.
“Young dentists need to get up to speed faster, not only for themselves to overcome the huge debt burden, but more importantly to help more patients experience the full potential of clinically excellent dentistry,” Barrett said. “Our mentorship philosophy was developed to help them through this process.”