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Lean in Dental - Part Three



How Dental Can Start Thinking “Lean”: Part 3


Lean Dental Practice Management

In the final article in this series, we will take a closer look into lean application in practice management. It’s no secret the dental industry is evolving right now, as are the expectations of patients. And to stay in stride with these changes, dentists are having to put more focus on the business side of their practice, thus making effective practice management more important than ever.

Below are the six main areas where lean principles can be applied to improve dental practice management. Some are more tactical in nature and can be implemented in the short term, while others will require a strategic, longer term approach.

Practice Leadership

Among today’s dental practice management consultants, there are varying ideas, philosophies, methods, and processes. However, most would probably agree on the general qualities that make a practice owner a good leader:

  • Involvement in the business
  • Empowerment of the team
  • Continuously striving to improve
  • Responsibility for the overall office culture

These elements also match up to leadership principles within lean. First, lean leaders know that to make the best-informed decisions and see opportunities for improvement, they must be involved in the “ground floor” operations and stay in continual communication with their employees. It also helps reduce the likelihood of being blindsided by problems or issues that might have been building for a long time but didn’t reach management until a breaking point.

Additionally, lean leaders also know it’s their responsibility to actively set the tone and build the culture of the business. This includes empowering and motivating their employees to take ownership of their work and results. They realize that people are a huge part of the process and that they cannot achieve success on their own. Lastly, lean leaders are continually striving to find better ways of doing things and encouraging their employees to do the same.

Patient Communications

There’s typically a lot of opportunity to reduce waste, streamline processes, and deliver more value when it comes to medical offices communicating with their patients. Everything from reducing no-shows, to saving front desk staff time, ensuring HIPPA compliance, and delivering messages via the channels that patients prefer.

Plus, there’s plenty of technology available to help automate many of these processes, such as texts and email for recall. This also includes paperless forms, which helps streamline the patient intake process for everyone involved by saving time and helping to avoid issues with regulatory or consent compliance.

There’s even software that allows patients to self-schedule appointments via a web interface, making it easy and efficient for them to match their availability with that of the practice’s. 

Supplies and Equipment

In lean, excess inventory is seen as one of the seven main areas where waste can show up. That’s because financial resources are being tied up in something that is not producing value to either the office or the patient. But this is not to say that you should keep the bare minimum of supplies in stock. Rather, evaluate and refine your supply procurement process to ensure your inventory levels of certain items accurately reflect their use. If you looked in your supply closet, you’d probably find more than what you need of at least a few items which, for example, could have been over-purchased simply because a bulk discount was available. However, the advantage of the extra stock probably does not outweigh the money and space that is being tied from storing it. Plus remember, nowadays most dental product suppliers have quick delivery, within a day or so, giving more reason not to overstock unless necessary.

For equipment, lean stresses total productive maintenance (TPM) which is making sure it’s properly and proactively maintained to avoid breakdowns. A dentist who’s ever had a compressor or vacuum pump go down knows how painful this can be, as production halts. Employees should know the proper maintenance protocols for all your equipment, for example, cleaning the evacuation lines and lubricating handpieces. In addition, they should also be preemptive in identifying possible signs of breakdown, such as a loose wire on a digital X-ray sensor.

Intraoffice Communications

Lean stresses effective communication within an organization to create efficient workflow as well as to help mistake-proof processes (poka-yoke in lean terminology). For a dental office, this can mean cutting down on procedure times by allowing doctors and team members to walk in to the operatory better prepared. It can also help avoid mistakes, as miscommunication is one of the main reasons for error in health care.

There are plenty of solutions available to improve intraoffice communication. For example, OperaDDS Chat allows team members to instant message each other through a computer, mobile device, or Apple Watch. This is opposed to traditional light systems, headsets, or simply trying to flag someone down.

But as efficient as technology can be, it should also be noted intraoffice communication can be implemented through basic visual devices. For instance, in lean manufacturing, Kanban refers to the process of placing cards in parts or supply containers to signal when its time to refill. This same concept would work in dental offices as a way for team members to notify each other when an item needs to be reordered. Or maybe to even signal when items still need to be processed through sterilization.

Patient Experience

It’s been established that the overarching goal of lean is to find out what your customers’ needs and wants are, and then tailor your systems and processes to deliver on them. And for dental practices that means finding creative ways to deliver beyond just a superior clinical experience because today’s patients expect more. Here’s a scenario to consider. Research has shown there are many adult patients today that don’t receive dental care simply out of fear of going to the dentist. So, to help mitigate those fears and anxieties, some dentists are trying different methods such as drug-free sedation. One example of this is OperaVR, which leverages Involuntary Mindfulness to reduce patient anxiety, increase case acceptance, quality of care, and time savings for the office.

Office Layout

For many dental practices, applying lean to the layout of your office will be more of a long-term, “big picture” strategy since it’s a significant undertaking in terms of time and money. But for those doctors who are considering office renovations or a new build, be sure to keep in mind the flow and designs that will allow you and your team to perform your tasks as efficiently as possible. Perhaps you’ll go with a “U” shaped office so processing areas are centrally located, and foot traffic is free-flowing. But whatever you choose, lean principles would have you focus on reducing wasted motions, travel, and touches.


To implement many of these changes will most likely require a small to large culture shift in your practice. But remember, nothing with any real lasting power happens overnight. As with any of the lean applications discussed in this series – clinical, practice management, and now people, it’s a gradual process that that needs continual commitment to evaluating, revising, and polishing. But at this point, lean has established a track record of success across many types of industries, especially healthcare, so there’s no reason to believe it can’t bear the same fruit for dental practices.


About the Author

Alex Sadusky currently serves as the Chief Executive Officer of Dental Card Services Alliance, LLC (, an organization he co-founded in 2009.  Dental Card Services Alliance is the exclusive credit card processing services provider of the AGD Exclusive Benefits program and has numerous other endorsements, alliances, and associations.

Prior to resuming the role as the CEO of Dental Card Services, Mr. Sadusky was Vice President Office of the CEO for Dentsply Sirona, the world’s largest dental consumable and equipment provider.  In his previous roles with Dentsply Sirona, Mr. Sadusky was responsible for corporate strategy and business development, specialty markets, and strategic projects.

Prior to joining legacy Sirona Dental, Mr. Sadusky spent over 15 years of experience in investment banking, venture capital, private equity, management consulting and corporate business development.

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