by Michael B. Rogers, DDS

An orthodontist streamlines his practice using cutting-edge products

In my 30-plus years practicing orthodontics, I have seen many gadgets come and go. The technologies that have stood the test of time and have been worth a large initial investment have been those that have brought value to me and to my patients. Through the years, we have developed criteria for evaluating orthodontic products and have learned to implement technology without sacrificing our patient relationships.

Before I consider investing in any technology, I make sure that it will stand the test of time. It has to be more than just a gimmick—it must improve the practice’s workflow, offer convenience to my patients, and offer a good return on investment.

The Web Site
Every business has a Web site these days, and orthodontists can spend anywhere from a couple hundred to several thousands dollars on developing, implementing, and maintaining a Web site. I decided early on that if I was going to invest in a Web site, I wanted it to be more than just a glorified office brochure. I wanted it to be interactive, and I wanted patients to use it all the time.

When developing our Web site ( in 2002, we chose a company that specialized in orthodontic Web sites. This made it easy to establish a Web site with all of the information patients need about orthodontic appliances, oral hygiene, and emergency information. Our developer created more than just an informational Web site by adding interactive features such as video feeds, video games, Flash applications, and animation.

Our next step in making our Web site a truly useful tool was to educate our patients about its features and functions. A Web site is valuable only if people use it, so we did—and still do—everything possible to drive our patients to our Web site over and over again. All new patients who call our office log on to our Web site before coming to their new-patient exam. To encourage participation, we placed our new-patient form on our Web site. Our patients download and complete the form, and then they e-mail the completed form back to us before coming to their first appointment. For patients without Internet access, we send a CD-ROM with our Web site on it so that they can learn about our practice and procedures prior to their first visit.

During the new-patient exam, our patients sit down in front of the computer with our treatment coordinator and click through the Web site so that they can learn where to find the necessary information about our practice. We have several computers throughout our office, including one at each chairside in the treatment bay, all of which house our Web site on a CD-ROM so that patients can repeatedly familiarize themselves with our site. We added video games to the Web site to encourage our young patients to visit. While they are there, they learn about braces, oral hygiene, and our office procedures.

In 2003, we added a feature—an online communications gateway—to our Web site that gives patients 24/7 secure online access to their information, including appointments and financial information. This helps us better serve them while saving us time, freeing our phone lines, streamlining our office operations, and minimizing no-shows. We also are able to e-mail appointment reminders, and patients can make secure payments online. We can remotely access daily appointment schedules, send online practice newsletters, receive online referrals, and collaborate with other specialists, all through our Web site.

Incorporating the Web site into our practice has benefited us in several ways. First, it educates our patients about their treatment. While our patients are on the Web site, they can find a picture of someone with a similar case to theirs to gain a better understanding of issues such as spacing, crowding, or open bite. Second, it has reduced the number of emergency calls that we receive. Patients can log on to the site and find out how to troubleshoot problems such as a loose bracket or wire irritations. They also can learn proper brushing techniques and oral-hygiene tips. Third, our Web site has reduced our accounts receivable by allowing patients to make secure payments online. Patients can print a ledger with our logo on it and turn it in to their insurance company or submit it to their flexible spending account. Fourth, it has cut down on the number of calls to our office, because almost every question about appointments or payments can be answered online.

The biggest benefit of our Web site, however, is the time savings during our new-patient exams and consultations. By placing our new-patient form online and having patients download, complete, and e-mail it back to us prior to the first appointment, we have all of the health history and insurance information before they walk in the door. We are able to verify insurance benefits before the patient arrives, which cuts down on waiting time for the patient. Additionally, all the information we need to explain a patient’s case is on our Web site. Instead of searching for models of a Class III patient, we can show a similar case online. We have photos and explanations of all of our appliances at our fingertips. There have also been times when patients cannot make it in for both a new-patient exam and a consultation, so we have even been able to offer a phone consultation. I can explain their treatment plan over the phone, and we can go through the Web site together to help them learn about their case.

The Practice-Management System
After our Web site, our practice-management system has been our next-greatest investment. Four years ago, we converted from an antiquated UNIX-based system to a completely integrated, easy-to-use practice-management system that helps manage clinical information, process financial data, schedule effectively, and communicate professionally and efficiently. Moving to a more sophisticated system was a big step financially, but we recouped our investment right away.

Our software’s robust reporting capabilities make the information we need readily available. The financial modules make it easy to process patient accounts and insurance, giving our patients the financial flexibility they need while helping us manage our accounts receivable. Scheduling capabilities allow us to maximize the time we spend with patients. Scheduling is totally integrated with other areas of our software, including patient flow, treatment card, word processing, and financials. State-of-the-art communication features help us automate the process of communicating with patients, their families, referral sources, and our community. We can also merge patient information, photographs, and x-rays automatically into documents. On the clinical side, chairside tools easily integrate patient workflow, treatment card, and imaging systems to bring our clinic to a new level of efficiency. The most helpful feature is our system’s financial module, which enables us to see which patients are past due, which patients are 30 days overdue, or which patients do not have contracts. Another great option is the ability to back up our data online every day. This feature alone saved us hundreds of dollars and days of headaches when our system crashed and our backup tape failed—but our data was online waiting for us.

A year ago, we added a feature to our practice-management system that automatically generates credit-card payments and eliminates manual processing. The device, an electronic credit card swiper that connects to our monitor, has reduced accounts receivable and improved our practice efficiency so that we can focus on patient care.

The Digital Imaging System
Our practice-management system is seamlessly integrated with one of our other favorite technologies—our digital imaging system. We have two digital cameras and a digital x-ray machine that instantly send images to each computer in our office. My staff members and I can bring up any photograph while we are at the chair or at a consultation. If a parent has a question about what the child’s bite used to look like, we can access those records immediately, print the initial photos, and compare them with current images. We’ve been using digital imaging for 15 years, and we have since turned our darkroom into a storage area.

Another technology that proved to offer a quick return on investment was our automated messaging system, also known as appointment-reminder software. This system delivers personalized messages to patients including name, date, time, office location, or any other variables that we designate. We set the appointment reminders to call our patients 3 days ahead of their appointment so that we have plenty of time to fill any cancellations. Our productivity has increased ever since we implemented this system 10 years ago, and we have cut our no-show rate down to nearly nothing.

The decision to invest thousands of dollars in new technology is not something to be taken lightly. Before we implement anything new, we make sure that it not only will save us time and money but that it also will improve the lives of our staff and our patients. In a world of e-mail, voice mail, and Web sites, it is easy to lose your personal touch. We have made it a point to use new technology to enhance, not replace, our communications systems. Because we maintain a high level of personal customer service while offering top-of-the-line technology, our patients know that ours is a forward-thinking practice with old-school values.

Michael B. Rogers, DDS, has been in private orthodontic practice for more than 30 years. He has been a speaker at the past three AAO Annual Sessions. Rogers is a member of the Omicron Kappa Upsilon Dental Honor Society, a diplomate of the American Board of Orthodontics, an honorable fellow of the Georgia Dental Association, president-elect of the Georgia Dental Association, and a trustee to the American Association of Orthodontists. He has received numerous honors throughout his career, including the Army Commendation Medal; and he has been elected a fellow of the American College of Dentists, the International College of Dentists, and the Pierre Fauchard Academy. He can be reached at [email protected].