Why do dentists switch laboratories? Inconsistent quality and technical problems say dentist-respondents to a joint survey conducted by LMT and Dental Economics (see Survey Demographics below). "When quality is lacking--such as inaccurate crowns, artificial-looking shades, shy flanges or the prescription hasn't been read carefully--that's when I consider a switch," writes a dentist from Harrisburg, Pennsylvania, one of the 61% of respondents who have switched laboratories at least once in the past 10 years. For details, see charts, Top 10 Reasons Dentists Switch Laboratories and Number of Times Dentists Have Switched in the Past 10 Years.
By far, the most common technical problem that dentists experience with both fixed and removable restorations coming back from the laboratory is poor occlusion. About a third of the respondents also noted problems with incorrect shades, failure to follow the prescription and restorations that fit the model but not the mouth. "If I receive good-looking dental work that fits the first time, it saves me time and money in the long run. I'm looking for work that keeps my chairtime to a minimum," writes a Birmingham, Alabama dentist.
Poor communication is another reason that prompts dentists to make a change. Repeatedly, the message from our survey respondents is that effective communication and easy interpersonal interactions are essential to a long-term dentist-lab relationship. "Once I'm happy with the work and experiencing good, open communication with the laboratory, I don't shop around," says a respondent from Marina Del Rey, California.
The vast majority of our survey respondents describe their labs as valued members of the dental team and welcome their input on technical issues. For instance, more than 80% of respondents want their labs to call them when an impression is inadequate so they can correct the error up-front. "I appreciate a technician who is not afraid to let me know how I can improve what I give him so he can give me his best," notes a dentist from San Diego, California.
The price factor
Less than 10% of the respondents say that price was a consideration the last time they switched to a new laboratory. In fact, almost half the respondents say their laboratories charge reasonable rates and that they expect an increase every year. In addition, one-quarter say they are willing to pay their laboratory's higher-than-average fees for its top-quality work.
Given the number of complaints about price-shopping dentists that we hear from LMT readers, these statistics seem at odds with laboratory owners' real-life experiences. So we asked dentist-respondents to comment on this disparity.
Their responses ran the gamut. For instance, some dentists acknowledge that they shop around for lower prices because they feel lab fees are too high. Others view being fee conscious as a smart business practice and a way to reduce expenses and increase profits. Several respondents say they are offended when their patients price shop and therefore won't do it themselves. Many commented that "you get what you pay for" and insist that price alone is not a factor when choosing a lab and rank the most important features they look for as follows (respondents were asked to choose the three most important features so percentages don't total 100):
- High quality work--97%
- Good communication--69%
- Reasonable prices--32%
- Fast turnaround time--25%
- Easy interpersonal relationship--24%
- Proximity to the office--16%
- Range of services--7%
- Lab's reputation--6%
- Specializes in a certain restoration--6%
- Offers cutting-edge technology--5%
- Simple fee schedule--3%
- Laboratory size--1%
So why the discrepancy between what dentists say about themselves and laboratory owners' feelings? Are dentists--consciously or unconsciously--not wanting to admit to the importance of price? Or is it a result of a misperception? Perhaps what laboratory owners perceive as shopping for price, dentists view as shopping for the best value for their dollar. "No matter what fee a laboratory charges, the product has to have value. A piece of junk, even if it's free, has no value to me," writes a dentist-respondent from Shreveport, Louisiana.
The best way to let dentists know about the value of your products and services is via their peers. Eighty-six percent of our respondents say that when choosing a new laboratory, a referral from another dentist has the most influence on their decision, a finding consistent with our previous surveys of dentists. Face-to-face marketing strategies--such as personal sales visits, seeing samples of the lab's work, attending lab-sponsored seminars and meeting a laboratory representative at a continuing education program--are also effective ways to attract the attention of our survey respondents. See chart: Marketing Strategies that Attract the Dentists' Attention.
However, what's not compelling is technician and laboratory certification. Only 24% of the survey respondents are familiar with both of the NBC's certification programs. Also, there has been a marked decrease in certification awareness in the past decade, according to a comparison of our 2003 and 1994 surveys. In 1994, 64% of the respondents were cognizant of the CDT and CDL programs, meaning that awareness has dropped by 40%!
Laboratories that offer mail order services may be interested to know that one-quarter of our survey respondents feel it's necessary to look outside their local area to find a laboratory that satisfies their needs. Although some of these dentists practice in rural areas without any laboratories, others are looking for a level of quality and esthetics or specialty restorations that they can't find nearby.
"There are all types of shoppers; some shop for price, some for value, some for convenience, etc.," writes a dentist-respondent from New England. "All labs can't be all things to all dentists." This is an important message. It's not realistic for a laboratory to try to meet the needs of every dentist. To effectively market your services and work with the type of dentist-clients you want to work with, you should define who you are and position your laboratory accordingly.
Of the 2,500 surveys mailed to Dental Economics readers nationwide, we received 283 surveys (an 11% response). Following are the demographics of our respondents:
Type of Practice (All are GPs)
Solo Practitioner: 79%
Group Practice: 11%
Years in Practice
Less Than Five: 5%
5to 10: 8%
11 to 20: 22%
Over 30: 23%
New England (ME, NH, VT, MA, CT, RI): 2%
Middle Atlantic (NY, NJ, PA): 19%
East North Central (OH, IN, IL, MI, WI): 15%
West North Central (MN, IA, MO, ND, SD, NE, KS): 9%
South Atlantic (DE, MD, DC, VA, WV, NC, SC, GA, FL): 18%
East South Central (KY, TN, AL, MS): 4%
West South Central (AR, LA, OK, TX): 10%
Mountain (MT, ID, WY, CO, NM, AZ, UT, NV): 7%
Pacific (AK, WA, OR, CA, HI): 16%