Insights from a Super GP
Michael R. Sesemann, DDS, FAACD | September 8, 2015
Since the end of the Great Recession in 2009, many dentists are kept up at night weighing strategies to recapture their lost income and encourage practice growth. While there is not one answer that suits all practices, Inside Dentistry’s (ID) September cover story explores a growing trend that deserves consideration—becoming a Super GP.
ID: Can you tell us briefly how your practice evolved to include all the services of a “Super GP?”
Michael R. Sesemann, DDS (MS): It began right out of dental school when I started a practice from scratch in the early 80s. To survive those initial slow days, I did anything I had been trained to do in my dental education. Thankfully, my alma mater, the University of Nebraska Medical Center College of Dentistry, had an excellent curriculum for preparing someone to be a “wet-fingered” dentist. I took my surgical, endodontic, and periodontic rounds very seriously and stayed on Friday afternoons to join surgeries or do additional root canals whenever possible. The periodontal department allowed students who had demonstrated an aptitude for surgery to perform soft tissue grafting. Those were great skills to take into practice.
My first 6 years out of dental school, I set up and worked the dental department at the county correctional center for 1 day a week. That experience turned out to be a surgical residency, where my main charge was to alleviate pain and stabilize patients. Within that population there were a number of people who had inundated worsening oral pathology with drug and alcohol abuse, allowing them to cope with pain beyond what someone not using those substances could have endured. Upon being incarcerated, separation from those substances and the resulting stress caused these pathological conditions to literally “blow up,” requiring immediate resolution. I became comfortable with treating conditions that were more extreme than anything I would end up seeing in private practice, and I became very familiar with human oral anatomy and surgical techniques.
I had no idea at the time that these experiences would be such a positive move for my career but they ultimately gave me the tools to add a number of services to my practice. Over the years, my staff and I subsequently added implant prosthodontics, comprehensive esthetics, periodontal surgery, endodontic surgery, occlusal treatments, Invisalign, implant placement, and injectable esthetic treatments like Botox and fillers to our skillset.
ID: What are the benefits for you and your patients of providing additional services beyond standard restorative dentistry?
MS: All of those additions were well received by our patients and they stabilized our production much like a diversified portfolio reduces risk in investing. Being able to offer a lot of different services allows us to stabilize our production and ensure our own security.
Providing a dental facility that offers comprehensive services for my patients has always been our goal. Out of our six current staff members and one who retired, we have purchased four 25-year commemorative watches, with another one to purchase next year. I say this because without my staff’s complete encouragement, commitment, and help, we would never be able to do all of the things we do. Introducing new services, especially when they are complex treatment modalities, requires a team approach and a committed focus from all of us to make it work. When dialoging with younger practitioners, I constantly stress the importance of finding those key people who want to make a career in dentistry. If a dentist finds that kind of person, one who wants to make their daily work a career and not just a job, it behooves the dentist to work hard to keep them. It ultimately pays exponential dividends. Also, an important component to retaining them is providing work that is challenging, satisfying, invigorating, and stable. Learning new things is one of the essential elements to accomplishing that objective.
For me personally, and I believe for my staff as well, we receive tremendous internal satisfaction from doing a lot of different things in dentistry. In providing such diverse services, every day is fresh and exciting because it is not the same day in and day out. Even though we’ve been in practice for a number of years, we still find our work stimulating and satisfying, and part of that is due to the variety of things we do. Our patients also really appreciate being able to have everything done at our office by the team of health providers they’ve come to know. When it makes sense clinically, if we eliminate the need to go to a different office, meet new people to trust, fill out another set of patient forms, and have more appointments, it helps people with their schedules in this hectic world we live in.
ID: How much continuing education is required per year for you to feel up-to-date in each area of your practice?
MS: A lot! At the heart of the matter, there needs to be a passionate drive to learn everything possible about one’s chosen craft. With that inspiration and motivation, it then becomes a commitment to put two important resources toward that objective: time and money. That is not easy to do, because it is initially in direct competition with personal time off and salary compensation.
Once the commitment is there, it becomes very important to have clear objectives for post-graduate continuing education and what it is going to achieve for the dentist, staff, patients, and practice. As Jim Collin’s book Good to Great documented, it is not the acquiring of leading edge technology that makes success certain, it’s the pioneering application of carefully selected technologies at the right time. This not only applies to technology itself, but also the education and acquisition of the skillset that needs to accompany it.
Continuing education decisions need to be strategic and focused. To that end, more often than not, the education needed is more curriculum-oriented in structure as opposed to a one-day course taken locally. This type of dental continuing education is usually a more expensive proposition. In addition, you have to account for the cost of travel and the probability of loss of production due to closing the office while the practitioner and/or staff is away. For those reasons, it is extremely important to make the decisions about what courses to pursue as calculated as possible.
ID: If a colleague were going to move into a “Super GP” practice model, what advice would you have for him or her?
MS: I love what my staff and I do and recommend it to anyone who wishes to immerse oneself in dentistry. I believe it to be at the heart of our love for our profession, patients, and practice. However, I am sure that type of obligation is not for everyone. If someone does not feel capable or willing to commit resources to pursuing and obtaining the necessary education to provide these services, dentistry can still be a wonderful profession.
ID: Do you still refer out difficult clinical cases?
MS: We have tremendous specialists in our community of all dental disciplines with whom we are grateful to have associations. We need those relationships, because although we do a lot of procedures in our office, we do have patients who present with conditions that are best treated by a specialist or by an interdisciplinary approach that only a diverse dental team can provide. Despite the fact that we do a lot of procedures, it does not eliminate the necessity for assembling an interdisciplinary team when appropriate.
My obligation is to make sure I direct our patients to where they can obtain optimal care. That brings us to an extremely important point: If a GP dentist is placing a patient on the schedule for a procedure, the practitioner needs to be confident that he or she can provide the same level of care as what the patient would obtain at a specialist’s office. If that assurance cannot be given, it is better to refer the patient for treatment with one of our talented specialist colleagues.
