survive thrive 2020 Dr Larry Stanleigh blog

Survive, Revive, Thrive

This truly is a memorable period of time, but, for most of us, for all the wrong reasons. Most of us had our practices shut down for an extended period and are now back. What do we do now, and how do we get there?

Kenneth Wong, MBA, a distinguished professor of marketing at Queens University, was recently quoted while discussing the three phases that businesses will undergo due to COVID-19. Those phases are survive, revive and thrive.


When calculating disability insurance, the Canadian Dental Services Plan Incorporated determined that the average dentist is approximately three months away from bankruptcy if their ability to earn an income drops to zero. In my case, we were closed for eight weeks. Thankfully, in Canada there were robust federal government programs for rent relief, wage subsidies and loan programs that would reduce the vulnerability for small businesses, including dentistry. Additionally, some dentists had practice interruption insurance, and, in my province, when dentistry was declared a nonessential service, it triggered the disaster relief portion of these insurance policies. Nevertheless, the financial consequences have been huge, and no one has been spared.


Now we are back in our practices, but at a reduced capacity. Our reception areas have been changed to reduce the number of people congregating in a potentially infective indoor situation. It takes longer to process claims and payments. Additional procedures for infection prevention and control require more time to turn over our operatories, especially after aerosol-generating procedures (AGPs) such as the use of ultrasonic units in hygiene and drilling procedures in operative dentistry. Donning and doffing the extra personal protective equipment (PPE) adds additional time and costs. And, once we start a procedure that requires enhanced PPE, we cannot leave the room in the middle of that procedure to see another patient for an exam or noninvasive procedure without having to remove all of the extra PPE and replace it with fresh gear.

What about our patients? They are still wary of COVID-19 and unwilling to take risks, particularly if other waves of infection strike. The economic shutdown is a reset button. Our long-term patients will be viewing us with new pairs of eyes. They will be watching what we do and how we do it to decide whether we still deserve to be their oral healthcare provider.

So how do we negotiate this reset? For extroverted patients, when they first come back to our practice, we need to allow them time to tell their story. They have a story to share and a need to share it. Schedule extra time to let them tell their story, but be prepared to redirect them to why they are in your office. Firm, compassionate limits and kindness will go far with them. Although introverted patients will have a story to tell, they are more interested in your story. You and your team should have a good elevator speech for them — something positive that can be explained in 30–45 seconds.

Your patients who are healthcare workers have been working through this period, and they will be exhausted, stressed, anxious and probably not taking good care of themselves. They are not interested in comprehensive reconstructive dentistry right now. They want basic oral healthcare now — the proverbial oil and filter change — while we all get through this.

There is also a group of people for whom the COVID-19 isolation was not a noteworthy experience. They have already fashioned their lives around working from home or remotely, spending most of their day interacting with machines instead of people. I am referring to computer programmers, gamers, accountants, some engineers, researchers, etc. For them, nothing changed, and they may even accept more comprehensive dentistry now if they feel safe and that the recommendation is logical.


When our practices shut down, we were not alone. Where I live, there was upwards of 20% unemployment, and there remains a 50% unemployment rate for those under age 25.

So we must go slow. We will be lucky to achieve 80% of our pre-COVID-19 production numbers for the near future. Focus not on the money but rather on maintaining the relationships with existing patients. If you do the ‘revive’ process well (and it may take between 6 and 12 months to complete), the ‘thrive’ phase will have you ready to soar. During this recent period of reopening, our patients have been looking at us critically, and we have shone in how we are dealing with them, leading to huge numbers of people calling our office to become new patients in our practice family. It is important that we all recognize this reset button and implement changes to ensure we survive, revive and thrive.

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