Many jurisdictions throughout the country have loosened restrictions on dental practices, while others plan to soon. The question then becomes: how prepared are you to be successful in the new reality you are heading into, and to ramp up that success swiftly?

One thing we know for sure is that it won't simply be a matter of flicking a switch and resuming “business as usual.” Things will be different, there will be adjustments to make, and it's going to take some concerted energy at first to rev up your economic engine again.

But there is every reason to believe that if you take charge of your destiny now, if you have complete clarity for your plan and relentlessly pursue the right path, if you have the right energy and focus and can inspire the right alignment and teamwork, you will not only come back strong, you will set your practice up for even greater success down the road.

There is a great analogy from my favorite business book, “Good to Great” by Jim Collins, that illustrates this well. He says to imagine a large flywheel, 30 feet in diameter and weighing about 5,000 pounds. Naturally, the effort required to get that flywheel moving is going to be substantial — for the first couple of revolutions. After that, however, you don't have to push quite as hard to keep it going and pretty soon momentum takes over and the flywheel is producing energy reliably and fairly easily.

Your ramp-up process is going to involve some concentrated effort at the beginning. And it's not going to be about applying effort in just one area — there is no one thing that's going to provide a magic breakthrough. Rather, you're going to need a balanced “flywheel” where you exert your energies in a number of areas simultaneously.

‘RAMP UP’ WITH SPEAR ONLINE: Members can take Imtiaz Manji's “How Will I Ramp Up When I Get Back” Part 1 (1.25 CE credits) and Part 2 (1.25 CE credits) courses to go into greater depth on this subject. Part 1 includes a sample Practice Safety Checklist.

Here's an example of what your balanced wheel could look like:

Balanced Wheel Chart

You'll notice that in the center of this wheel we have communication, because that's a feature that is universal to what you will be doing in all the other areas identified. I have broken down those areas into six categories that require specialized attention.

In this article, we'll look at what goes into the three categories at the top of the wheel. I'll address the other three categories in Part 2 of this two-part series.


This is obviously going to be a big concern, for patients and for the team, as well as for yourself, as your schedule starts to pick up.

There are a number of measures to look at: new cleaning and sterilization protocols for the office (including reception area), improved personal protection, new filtering systems, and UV light sterilization, among others. Also, you will probably be looking at new protocols for scheduling and for reception area seating, to maintain adequate social distancing.

Naturally, you will be following the mandates of the ADA and other regional governing bodies in determining what needs to be done.

You also have to follow your own self-imposed standards. You have to ask yourself: knowing that I have to come home to my family, am I confident in the safety measures we are taking in the practice? Is the team confident? Because until that happens you can't begin to communicate about safety to your patients.

But don't let yourself get carried away. Remember that the dental industry has already had a head start when it comes to safe interpersonal interactions. You have always seen only one patient at a time in any given operatory. You have always maintained stringent standards for sterilization, and for using personal protection gear.

Unlike other industries that are starting from scratch in coming to terms with these kinds of considerations, your task in this area, as a practice, is to elevate your existing skills and standards to meet the needs of the moment. By all means you must meet those mandated new standards, and you must meet your own standards. But don't get to a point where you are chasing after every new safety measure you hear about in an attempt to achieve perfection. Trust your judgement about what's necessary.

Once that is established, the most important thing you can do in terms of safety, as it relates to your ramping up process, is to communicate what you are doing. Make sure the team is engaged in the process and understands that you are taking everyone's health and safety seriously as staff members return to work, so you can all serve patients feeling safe and confident. Speak with your interdisciplinary colleagues to share best practices regarding new protocols and to help create alignment on safety for patients that move between practices for treatment.

Most of all, make sure your patients know that you are taking extra steps to ensure their safety when they return for their next appointment. This can happen during the care calls you make to reconnect with patients (which we will get to shortly), and it can also be documented in a resource you can post on your website, or email to patients, or print out and laminate selected pages of for patients to refer to in the office.

The point is patients need to be reassured that you are addressing their concerns.

VIRTUAL SEMINARS: The new virtual Spear Seminar format allows you to refine your clinical skills and interact with faculty following the same CE-eligible coursework that you would at the Spear Campus in Scottsdale — but from anywhere, as a safe online alternative to large-attendance campus events.


Any plan for a return to business should include a schedule that is adequately filled for four weeks out. “Adequately filled” means we're taking into account ongoing restrictions on the number of patients you might have in the practice at any one time, so it's important to have the right ratio of higher-value cases to optimize your time and patient care.

Where do you find those cases? You no doubt have a reservoir sitting in your charts right now. To begin with, every practice — whether you're a general practitioner or specialist — will have a backlog of appointments that you had to cancel when things shut down, that you now have to get back into the schedule, including the backlog in hygiene (for periodontists and restorative practices).

There will be patients who cancelled just before the shutdown who still need to be rescheduled. There will be emergency cases you saw recently where you identified a need for further treatment. And there will be those complex cases where treatment has been interrupted or never started. Go through your records right now, identify those patients, and start making calls to get them appointed.

I would suggest putting significant energy into the complex cases — especially interdisciplinary cases, as they give you an opportunity to optimize the value of your time, and help you create a future pipeline by reconnecting with colleagues and developing those relationships in a time when you need each other more than ever.

If you are a specialist, you undoubtedly have a significant reservoir of your own: patients who were referred to you but have never been in contact with your office because of the outbreak and lockdown.

Now is the time to have someone on the team get in touch with each referring practice to find out who those patients are and to get in touch with them to reassure them that your practice is taking every precaution to ensure their safety and you are still looking forward to seeing them.

Again, most practices have a deep reservoir of unscheduled treatment. Take advantage of the time you have now to draw on that reservoir and make reopening really count.


Commenter's Profile Image Doug S.
June 8th, 2020
Thanks Imtiaz, these are very helpful tips! I have noticed this week being back fully open that the floodgates have opened. There really is a reservoir of patients that can't wait to get in. Thank Goodness!