Dental services
at the Dental Clinic
low prices":
Among the various areas of medical business, one of the oldest and most profitable is dental practice. Which is not surprising. The demand for the services of dental hospitals is quite high and at the same time constant, independent of fashion and season, since human teeth are constantly exposed to various negative impact leading to various types of diseases. It should be noted that in the human body, teeth are the only ones in which constant surgical intervention is allowed without any harm to the general health of a person.
The success of the dental business around the world is also due to the phenomenon that most people are afraid of visiting. As a rule, patients go to the dental hospital only when the problem is no longer solved by available means in the form of painkillers, etc. At the same time, the more often a person turns a blind eye to the need for periodic preventive examinations at the dentist, the more expensive it costs him to visit a dental hospital if necessary, regardless of whether it is private or public and in what price segment it operates.
Today, most of the commercial dental hospitals (about 70% of all operating institutions) are single; the rest of the dental services market is occupied by network and branch dental hospitals. Among them, the most common model of a clinic providing dental services is a center working in two directions: therapy and.
Any commercial dental hospital exists in conditions of fierce competition: only those who managed to find their market segment and fully demonstrate their competitive advantages survive. The dental services market is divided into segments by type of patients, by types of services and their cost, and by the size of the dental hospital itself.
There are three main formats for dental business: dental hospital, focused on mass customer service, delivered on stream. As a rule, these institutions provide economy-class dental services and are equipped with a large number of chairs with round-the-clock operation.
The second area in which dental hospitals specialize is servicing corporate clients within the framework of voluntary health insurance.
The third group of dental hospitals unites institutions specializing in VIP-class services. The main thing in their work is an individual approach to each client.
Based on the business strategy of the institution, a pricing policy is built, which is determined by two main factors: the level of service chosen by the dental hospital for its positioning in the market and the minimum costs of establishing work in the selected segment.
Dental hospital will become successful if you remember two main features of the dental business. Firstly, the client, when preparing to go to the hospital, is tuned in to pain and discomfort, so most people feel dejected and depressed. This is exactly what you can play on by using one marketing move - changing the client’s negative mood to a positive one, thereby relieving psychological stress.
Secondly, the quality of the services provided is assessed at the level of “it hurts - it doesn’t hurt”, “it interferes - it doesn’t interfere”. Few patients can give an objective assessment of the dentist’s work, so the success of a dental hospital in terms of economic results is only possible if such concepts as “to be” and “to appear” are identified.
INTRODUCTION 4
1. THEORETICAL PART. 7
1.1.Features of the development of dental activities in the Russian Federation.. 7
1.2. Specifics of creating a new enterprise in this type of activity. 7
1.3. Features of demand. 10
1.4. Characteristic material base of this type of activity. 13
1.5. Specifics of organizing the work of a new enterprise in this type of activity 14
2. ANALYTICAL PART. 20
2.1. Analysis of industry development factors over the last 3-5 years. 20
2.2.Analysis of external factors in the development of a new enterprise. 21
2.2.1. Choosing a location for a new enterprise. 21
2.3.Marketing research of the market and services in the selected area. 27
2.3.1.Development of a questionnaire and organization of potential consumers of these services 27
2.3.2. Calculation of the production program for opening dentistry. 29
2.4.Analytical assessment of competitors' activities. 34
2.5.Analysis of suppliers. 36
2.6. Conclusions on the analytical part. 40
3. DESIGN PART. 42
3.1.Measures for creating a new enterprise. 42
3.1.1.Formation of the material base.. 42
3.1.2.Formation statutory documents. 42
3.1.3.Registration of a new enterprise. 42
3.1.4. Registration of a license. 44
3.2.1.Selection organizational structure and management structure of the new enterprise. 47
3.2.3.Office equipment. 49
3.2.4. Product development. 51
3.2.5. Organization of sales activities and responsibility. 53
3.2.6. Participation in exhibitions. 54
3.3. Information support for the project. 56
3.4. Legal support of the project. 57
CONCLUSION. 60
BIBLIOGRAPHICAL LIST... 62
INTRODUCTION
There is a misconception that in order to open a clinic you need to be a dentist and understand the medical aspects of the treatment process. Practice shows that, on the contrary, dentists rarely make good clinic managers, and they certainly have to leave practice and retrain as managers. The most famous and quite successful dental clinics, which have now become network clinics - such as Masterdent, Denta-Vita, Dento El and others, were not created by doctors. Although, of course, it is the dentists who manage the treatment process. But it’s a healing process, not a business.
IN last years The dental business is experiencing rapid development. In 2003, prices for dental services increased by almost 40-60%, at a slower pace, but they continued to grow in 2004-2005. Every year dozens of new dental clinics open in Moscow. It would seem that there are fewer and fewer open niches for entrepreneurship in this area, but investments in this business are still considered one of the most promising types of investment. Of course, the dental business is one of the most closed types of business. A potential investor has to collect information about him literally bit by bit. We will try to lift the veil of secrecy by introducing you to economic indicators, the current state of the dental services market and trends in its development.
There are several most difficult and important stages in building a private dental business - choosing a business model for a dental clinic, finding the “highlights” in the types of services, building customer service, and developing a promotion program. A huge selection of dental equipment and materials also creates certain difficulties for the clinic owner - should he trust the advice of practicing dentists or listen to the opinion of specialist technologists? Serious requirements of supervisory authorities impose special responsibility on the design of a dental clinic - common sense and economic calculation, requiring that everyone square meter brought in as much revenue as possible, the requirements of the SES intervene, forcing the allocation of auxiliary areas that do not generate income - a sterilization room, a staff rest room, additional bathrooms, etc.
The process of creating and promoting a dental clinic is the most difficult and responsible period, which often becomes not only a joyful event for the owner, but is also accompanied by a huge number of questions and problems. It is at the first stage that most mistakes are made, which subsequently hurt the investor’s wallet. How to choose the right premises, how to design a clinic so that every meter of space generates income, how to choose those services that are in demand by patients and the prices that bring maximum profit, how to select a professional team, how to go through the grindstone of obtaining permits, how to promote a clinic - with Every beginner faces these and many other questions when creating a dental business.
Life shows that a profitable dental institution can be created only with the preliminary detailed and professional development of its project, with the calculation of a business plan, finding highlights in the range of services, with the competent selection of equipment, with the construction of a business model that is as independent as possible from personnel, with the creation special emotional atmosphere customer-oriented service that could not be copied.
We have collected here a lot of information on how to create a dental clinic and how to promote it. Familiarization with the proposed materials provides answers to general questions about creating a dental business. But at the same time, you should not consider what you read as a tutorial on how to create your own private dentistry - the medical services market is changing, it is developing rapidly. Some information becomes outdated - with at different speeds for each region. Conditions are changing, the number of clinics created by talented entrepreneurs and newcomers is growing, bringing something new to this business. More and more new “flavors” are appearing - in the types of services, in providing them to clients, new types of materials and equipment are appearing, management procedures are being improved, and requirements for the organization of customer service are growing. Few people talk about their findings, new solutions and moves, releasing information into the public domain. Therefore, be soberly aware that when reading information about the dental business today, you are getting acquainted with the yesterday of this business, and today and, most importantly, tomorrow always remains behind the scenes. Creating your clinic according to the model of yesterday is the same as being half a step behind the start line in a hundred-meter race. You can catch up, but only if you run faster than others, and most importantly, in the right direction.
1 THEORETICAL PART
1.1 Features of the development of dental activities in the Russian Federation
Dental practice is historically one of the oldest areas of medical business. The dental business is based on a very stable demand - a person has many teeth, and when at least one of them hurts, anyone is ready to give everything they have to get rid of the misfortune. But after treatment, any of us forgets to take care of our teeth, and the story of toothache repeats itself again and again. And - a paradox! The longer a person endures pain and postpones going to the dentist, the more expensive treatment costs him. It’s cynical, but it’s true: the ostrich policy, namely the fear of going for treatment until everything is running, has enriched more than one generation of dentists.
Is the dental business profitable? To find out the answer to this question, don’t be too lazy to go to the exhibition “Dental Expo” or “Dental Salon”, look at the luxurious two-story pavilions of exhibitors, at the top-class cars parked in the parking lot - you will see that the level of income of participants in the dental market is much higher than from other representatives of Russian business. By the way, in the West, the dental business is also far from in last place in terms of attractiveness. To be honest, it requires more initial investment than a restaurant or salon. But it is not subject to fashion, sustainable, stable and all-season.
1.2 Specifics of creating a new enterprise in this type of activity
The creation of each clinic takes into account the best domestic and foreign experience in building a medical business, using the so-called “technology of success.” This means not only equipping the clinic with proven equipment, techniques and personnel, but also using effective management, marketing and quality assurance techniques (this means not only the doctor’s compliance with technology, but also the quality of communication with the patient in the clinic, as well as the entire a set of services with which every visitor should be surrounded), in other words, building a dental clinic not only as a health care institution, but, above all, as a successful client-oriented business in the field of medicine.
The concept of any dental business is based on the following chain of actions:
1. The client base and competitive environment in the area where our clinic is located are examined. Conclusions are drawn about the level of the future clinic and the range and ratio of various services that are different from competitors and adjusted to local needs - in demand and capable of bringing commercial success in the area.
2. Positioning is formulated and patients’ perception of the clinic is formed.
3. A legend, corporate identity and design of the clinic are being developed.
4. Competitive differences and advantages for services are determined.
5. Competitive differences and advantages in customer service are determined.
6. For the selected level of the clinic and set of services, a room layout is developed and technologies for performing services are selected, as well as recommended prices with which you can enter the market. Competitive differentiation is being created in terms of technologies and prices used.
7. Equipment and consumables that have the necessary and sufficient parameters to ensure the required level of quality of treatment are selected for the technology. Calculations of economic indicators are made.
8. A design, requirements for personnel qualifications, and internal documentation are developed for the selected level and equipment of the dental clinic.
9. A program for promoting a new clinic is being developed.
It is this procedure that makes it possible to implement the project conceived by the clinic owner, to make it sustainable, down-to-earth, and not soaring in the air. Who are our customers? Most often, entrepreneurs often turn to us who are concerned about the decrease in the profitability of their own business, which is far from dentistry. They want to find, with our help, where to transfer their capital. Money is being withdrawn from industries where competition is particularly high and profits are declining. This usually happens in waves. Three years ago, a whole group of entrepreneurs came from the printing business, a little later from the trade in mobile phones and household appliances, and recently businessmen from wholesale trade and some industries. Search for fast growing and profitable business bring many of them into the service sector. It was this direction that was particularly lagging behind in Soviet times. With the rise in the standard of living of the population, it is here that the number of newly opened enterprises is rapidly growing. The number of restaurants, beauty salons, and various entertainment centers. The medical business still scares off many with its apparent complexity, but it is completely in vain. Here you can still stake out a plot for yourself and pan for gold. Not as much as before, but still a business with a profitability of about 30% is now a rarity. The competitive environment is very diverse in each district of the city. In some places it’s not worth opening up, but in others it’s very possible. However, in the medical business one has to fight not with competitors, but with government supervisory authorities.
Alas, we most often see that new entrepreneurs are looking for a doctor as an assistant, who is completely trusted with the creation of a clinic, the selection of equipment, personnel, and, worst of all, the development of a price list. As a result, no matter how good the doctor may be, the clinic is initially built primarily as a medical institution, and not as a business. To avoid such a distortion, it is better for an entrepreneur to set up a business and manage it himself, trusting doctors only with the treatment process.
Taxation. Having the form of ownership of an LLC or individual entrepreneur, you can be a payer under the simplified taxation system (STS).
Obtaining a license is the most difficult stage when opening a dental office: it is necessary to carry out everything flawlessly SES requirements. It is necessary to have certificates for the installed equipment, personal medical records of workers, copies of documents on their education and qualifications. Everything in the office should be arranged in accordance with the BTI plan.
A license allows you to engage in a certain type of medical activity. Therapy, surgery, orthodontics and other types of services are declared separately. The licensing authority makes a decision to grant a license within a period not exceeding 45 days from the date of receipt of the application, and does not have the right to require documents other than those specified in the Federal Law “On licensing of certain types of activities.
1.3 Features of demand
In Moscow alone, according to various sources, there are from one and a half to two and a half thousand dental clinics and offices, although the market capacity, according to experts, is almost twice as large. And the point is not even that the population has more dental problems due to poor ecology, increased consumption of sweets and natural laziness of Russians, manifested in irregular teeth brushing. Rather, with the growth of the middle stratum of Russians, whose standard of living is approaching Western standards, patients’ demands for the quality of treatment and service are growing. Traditionally, going to the dentist is associated with terrible pain, so today's patients prefer to pay more to be greeted friendly, reassured, given a cup of coffee or a glass of juice in a cozy atmosphere, asked about life, and only then get down to business. And of course, for pain relief they used not outdated anesthetics of the novocaine group, but modern articaine drugs that completely block pain. The modern patient is more educated and often asks the doctor a proactive question: “What are you actually going to do in my mouth?” Knows that there are modern “soft” impression materials. Such a patient, upon seeing a dentist mixing plaster, can easily turn around and leave. Many patients already know what a visiograph is, and do not want to be irradiated in the old-fashioned way with X-ray machines from ancient times. The same applies to equipment - after lying in a comfortable Castellini chair once, the patient is unlikely to want anything else.
Here, as Raikin once noted: “If you haven’t seen Italian shoes, then you’ve seen ours!” Barefoot childhood is over, and those people who moved from five-story buildings to monolithic houses and cottages became pickier and more demanding. Although clinics with outdated equipment and lack of service, they charge less for treatment, but patients vote with their wallets for more expensive, but high-quality care, so the average cost of a filling in Moscow has almost doubled over the past five years. The growth in the number of dental clinics and the cost of services is also facilitated by the fact that in society it has become indecent to “wear” crooked teeth, have tobacco or coffee stains, and even more so show gaping gaps in the smile. In addition, Russians are now trying not to remove teeth, but to treat them, especially since modern technologies and materials make it possible to fight for the preservation of teeth in the most advanced cases. In addition, patients understand that the effectiveness of teeth whitening, for example, at home cannot be compared with clinical procedures.
From Soviet times we inherited many municipal and departmental clinics, although the private sector, represented by both large clinics and single offices, already occupies almost half of the Moscow market and continues to expand.
It seems that the public sector is still staying afloat only because doctors earn extra money in such clinics unofficially, “for their own pockets.” In such clinics they work on outdated, worn-out equipment, which no one is going to update. The quality of such services can only be tolerated by those hardened by times of scarcity.
Large clinics (sometimes with a branch network), where, no matter how you hide them, the costs of the flow system still appear, such as interest rates, the struggle of doctors for patients, and high turnover of personnel. As a result of the impersonality of the appointment, the patient sometimes does not even remember the doctor’s last name, but the consequences of errors and flaws in treatment or service are easily spread to the entire clinic.
Mini and micro clinics, or rather dental offices, where the owner himself works. Here patients go not to the brand, but to the name of the doctor who is responsible for everything. The quality of services here is higher, because if you make a mistake you will be left without a clientele. But, alas, such mini-salons, on the one hand, are very vulnerable (sometimes they operate without proper documentation, which is time-consuming and expensive to collect), and besides, they offer patients a very limited range of services - such offices cannot afford a variety of equipment, and there is nowhere to put it.
The fastest growing system is of small private clinics with three or four chairs. This is perhaps the most promising direction, since in such a clinic, on the one hand, there is an individual approach to the client, and on the other, the range of services and profitability are higher than those of private offices. It is not for nothing, apparently, that the system of such small dental clinics dominates throughout the entire civilized world.
1.4 Characteristics of the material base of this type of activity
Let’s take, for example, a medium-sized clinic with three dental units. Such a clinic usually requires an area of about 100 square meters. meters.
Table 1. Cost of equipping the clinic
Depending on the choice of supplier level, the total cost of equipment costs can range between 70 to 130 thousand dollars. The exact cost amounts will be determined during the selection of process equipment. Repairs are another difficult to predict investment cost parameter. It all depends on the condition of the room. The item “other expenses of the start-up period” mainly includes payment of personnel during the period when revenue will not cover current expenses. If the premises are rented, and it was not possible to agree on a “vacation” for the period of repair work, then add here rent payments for several months, while the dental clinic is still being created. If you need the services of professional consultants when creating a dental business, add another 10% to the estimate. However, almost all expenses for assistance in creating a clinic will come back to you with discounts on equipment, time savings and risk reduction
1.5 Specifics of organizing the work of a new enterprise in this type of activity
Today, the dental services market is in a state of relative stability. The increase in prices in all previous years was due to an increase in the country's cash supply and the strengthening of the ruble. Increased costs (due to the growth of the euro, since the main suppliers Supplies- European companies) clinics passed on prices to buyers of services. As a result, the growth in effective demand was offset by rising prices for dental services, which led to the “fixation” of the market at a different, higher price level with unchanged volumes. At the same time, rising prices have changed the price/quality ratio of dental services. Being forced to pay increased prices for treatment, consumers began to pay more attention to the range (breadth) of services offered and the level of service. The one who solves these two strategic tasks today when building a dental business will win the competitive competition for the consumer. This circumstance will determine the direction of development of the dental market in the near future, and it is this that imposes on newcomers the task of approaching the creation of a new generation of dental business - different from most of today's dentistry. Cleanliness, tidiness, modern equipment, and the presence of qualified personnel alone are not enough to build a successful dental business. What's the point if you perfect the treatment process with an A, if only one and a half diggers will come to vote with their wallets for your efforts? That is why, when approaching the creation of a clinic, we first of all consider it not as a place where they help people get rid of dental diseases, but as an organizational structure designed to make money. Such a cynical monetarist approach can cure any newcomer from naive desires to invest everything without a trace in “the best clinic in the city, where the best doctors in the city work.” In any science there is a rule of necessary and sufficient conditions. Building a decent treatment process is a necessary condition for creating a modern dental business. But not enough. Compliance with SES standards during design is the same necessary condition, but also insufficient. We call sufficient only those conditions that are directly related to the generation of financial flows and profit.
Here are some of the main conditions for financial success when creating a clinic:
1. Carefully select the location of the clinic - are there clients in the area? What are they like, are they able to pay for our treatment?
2. Analysis of the closest competitors - how strong are they? Will we be able to enter the market and pull the blanket over ourselves, taking away some of today’s patients, and therefore part of their income?
3. Legend, corporate identity, design, marketing program. How will we position ourselves in the market, how will we shape the perception of our clinic among future patients, advertising our services, attracting clients and turning primary patients into regular ones?
4. Accounting, cash desk, management. How will accounting and management be organized, what sources of income will replenish our cash register?
5. Business plan. How much will it cost us to create a clinic, promote it, what will be the current expenses and expected income?
Please note that in this list of sufficient conditions there is nothing related to the healing process. This does not mean that attention is not paid to this when creating a clinic. But we deliberately push the construction of supporting elements (the treatment process, personnel work, etc.) into the background, and put the main elements inherent in business at the forefront. Let's leave it to the doctors to do what they can do well without us - treat people. Let’s think better about the perishable things - payback, profitability, financial “exhaust” from every meter of area. But still, we note that in the treatment process there are eight main types of services, which it is advisable to all accommodate under the roof of the clinic:
1. reception and consultations; functional diagnostics;
2. therapeutic dentistry (treatment of caries, pulpitis, periodontitis, diseases of the oral mucosa),
3. therapeutic periodontology and conservative treatment of periodontitis and chronic periodontal disease;
4. surgical dentistry (tooth extraction, treatment of purulent-inflammatory diseases of the oral cavity, surgical methods for the treatment of periodontal tissue diseases, excision of benign tumors, etc.); physiotherapy; anesthesia;
5. teeth whitening, removing tartar, smoker’s plaque, etc.
6. orthopedic treatment of dental defects, preparation for prosthetics, implantology, patient preparation for implantation;
7. orthodontics (treatment of dental anomalies), treatment of congenital defects of the maxillofacial area, including defects acquired as a result of injuries or early diseases;
8. pediatric dentistry;
Today, only every fifth clinic provides its clients with all of the listed types of dental services. And market development trends and marketing surveys of patients indicate that a good clinic provides a full range of services and good customer service.
1.6 Legislative framework for the activities of a new enterprise
When inspecting a dental clinic, it is required to present documents confirming the legality of the provision of medical services in this clinic, subject to medical licensing, not only a license, but also many other documents - from ownership of the premises or lease agreements, to diplomas received by the staff medical education. In this case, the following violations may be identified, which may lead to unpleasant consequences for the dental business:
The dental clinic does not have appropriate premises owned by it by right of ownership or on any other legal basis (for example, lease)
Lack of appropriate organizational and technical conditions and material and technical equipment, including equipment, tools, transport and documentation, ensuring the use of medical technologies approved for use by the Ministry of Health of the Russian Federation
Lack or malfunction of fire protection equipment
The absence of employees (doctors, paramedical personnel, engineering and technical workers, etc.) with higher or secondary specialized, additional education and special training that meet the requirements and nature of the work performed and services provided, as well as the absence of the head of the enterprise and ( or) a person authorized by him with higher specialized education and work experience in licensed activities (for specific types of work and services) of 5 years or more
An individual entrepreneur carrying out medical activities does not have a higher or secondary medical education, additional education and special training that meet the requirements and nature of the work performed and services provided, and work experience in licensed activities for 2 or more years
Failure to comply with requirements for advanced training of employees of a legal entity engaged in medical activities, as well as individual entrepreneurs
Listed here are only the main violations that are primarily paid attention to when inspecting a dental clinic. Even dental business consulting specialists cannot compile a complete list of violations due to the fact that officials of supervisory authorities are very creative in interpreting regulatory documents.
Regulatory documents for the creation of dental clinics:
1. Hygienic requirements for the design and operation of x-ray rooms, devices and the conduct of x-ray examinations. SanPiN 2.6.1.1192-03
2. Hygienic requirements for natural, artificial and combined lighting of residential and public buildings. SanPiN 2.2.1/2.1.1.1278-03
3. Sanitary rules devices, equipment, operation of outpatient dental institutions dated December 28, 1983 N 2956a-83
4. Requirements for the placement, organization of work and equipment of the X-ray room
5. Ensuring radiation safety during X-ray dental examinations
6. Requirements for the X-ray room upon acceptance into operation, appendix number 7 to SanPiN 2.6.1.1192-03
7. MANUAL FOR DESIGNING HEALTHCARE INSTITUTIONS (to SNiP 2.08.02-89) Section I - GENERAL PROVISIONS. ENGINEERING EQUIPMENT
8. MANUAL FOR DESIGNING HEALTHCARE INSTITUTIONS (to SNiP 2.08.02-89) Section II - HOSPITALS
9. MANUAL FOR DESIGNING HEALTHCARE INSTITUTIONS (to SNiP 2.08.02-89) SECTION III - SPECIALIZED, AUXILIARY DIVISIONS AND SERVICE - HOUSEHOLD PREMISES
10. MANUAL FOR DESIGNING HEALTHCARE INSTITUTIONS (to SNiP 2.0802-89) Section IV - OUTPATIENT - POLYCLINIC INSTITUTIONS
11. MANUAL FOR DESIGNING HEALTHCARE INSTITUTIONS (to SNIP 2.08.02-89) Section V - AMBULANCE AND EMERGENCY MEDICAL CARE STATION, BLOOD TRANSFUSION STATION WITH VIVARIUM, DAIRY KITCHENS, DISPENSING POINTS, PHARMACIES, CONTROL BUT - ANALYTICAL LABORATORIES
12. Regulations on the organization and implementation of reconstruction, repair and maintenance of buildings, communal and socio-cultural facilities. Order of the State Committee for Architecture of the Russian Federation under the USSR State Construction Committee dated November 23, 1988 N 312
13. INSTRUCTIONS FOR DESIGNING BUILDINGS AND STRUCTURES ADAPTED FOR HEALTHCARE INSTITUTIONS - BUILDING STANDARDS SN 515-79 dated January 1, 1980
2 ANALYTICAL PART
2.1 Analysis of industry development factors over the last 3-5 years
In recent years, the dental business has experienced rapid development.
In 2003, prices for dental services increased by almost 40-60%, at a slower pace, but they continued to grow in 2004-2005.
Every year dozens of new dental clinics open in Moscow. It would seem that there are fewer and fewer open niches for entrepreneurship in this area, but investments in this business are still considered one of the most promising types of investment. Of course, the dental business is one of the most closed types of business. A potential investor has to collect information about him literally bit by bit.
Over the almost fifteen-year history of the development of a market economy in Russia, the private medical sector has not received much development, primarily due to the presence large number state and departmental medical institutions that act as quasi-market entities, that is, entities that offer paid services on the market and are simultaneously subsidized by the state or departments. At the same time, some of the services are provided by doctors themselves, who act as independent market participants using the infrastructure created at the expense of the state - premises, equipment. The only branch of medicine in which the private sector has taken a significant share in the volume of services provided is dentistry (see Expert Magazine No. 17, 2002, article “White Coats”). For example, today there are about 800 private dental clinics in Moscow, the features of which are:
1. Small size (the staff of 95% of companies does not exceed 25-30 people, 4.5% - no more than 120 people).
2. In 95% of companies, the owners themselves manage the companies.
3. In 40% of companies, the owners are both managers and attending physicians.
4. Most companies, with the exception of 5-10% of the most expensive ones, as well as those focused on providing services under contracts with insurance companies, focus on providing services to clients living in the area where the company is located.
The situation in the Moscow dental services market is characterized by a high level of competition, which is indicated by a downward trend in the growth rate of the number of dental firms. So, for example, if in 1997 the number of firms increased by 91% compared to the previous year, then in 1999-2001. the annual increase in the number of clinics was 7%, 6% and 5%, respectively. Increasing competition is forcing clinic managers to pay more attention to management efficiency issues. An indicator of the presence of this trend is the appearance in 1998-1999. two highly specialized consulting companies that specialize in consulting on the management of dental firms.
2.2 Analysis of external factors for the development of a new enterprise
2.2.1. Choosing a location for a new enterprise
All necessary information about the requirements imposed by supervisory authorities can be found in Rospotrebnadzor.
You should not be careless if you immediately like the room. First, you must take all its dimensions. If the ceiling height is less than three meters, then problems are likely to arise. Secondly, when we're talking about about a residential building, you need to know who lives above. This is very important if you have an X-ray room. No one will allow the radiation source to be located under the bathroom. Naturally, the radiation from the radiovisiograph is weak, and the room where the X-ray unit is located is lined with lead sheets: there is no danger to the residents. However, if they complain, consumer law will be on their side and they could lose their license.
It is also necessary to find out about the amount of electricity supplied to the facility. Typically for domestic premises this figure is 5-10 kW, and for a clinic even three chairs require 15 kW, unless, of course, you are planning to create a prosthetics laboratory. In any case, electricity will have to be purchased. Let’s say, a clinic with 4-5 chairs with powerful receivers will need another 10 kW, and each additional kW now costs more than 50 thousand rubles. That is, the question may arise about amounts that are very burdensome for the business plan, and this must be anticipated.
A very serious issue is related to ventilation. The clinic can be “collapsed” when it turns out that there is nowhere to remove the ventilation shaft - there are 20-30 floors of a residential building above you. Because of this problem, such premises are often simply not considered. Perhaps in vain, since an elegant solution can be found here too. For example, for the clinic in Golden Keys we used products from a Russian company that produces biological filters with a very high degree of purification. As a result, instead of one and a half million rubles, which we expected to spend on the ventilation system, we ended up with 400 thousand.
In general, it must be said that, in principle, there are no insurmountable obstacles. There are, for example, certain standards for lighting, and it is desirable that the windows be located on the sunny side. But you took the risk of allocating a semi-basement room for the clinic. It turns out that this is possible. True, you need to “translate” it to the first floor: the most important thing for this is that the floor is flush with the ground. One of our clients bought a semi-basement property and wanted to turn it into a clinic at all costs. To do this, it was necessary not only to widen the window openings, but also to open a trench along the entire house with an excavator, creating a beautiful lawn with a negative angle of inclination. People are cunning when it comes to inventions.
Each room where a dental unit is located must have an area of at least 14 square meters. m after the repairs have been made, and not when the plan is drawn. Because, as a rule, after repairs 0.5-1 square meters are lost. m. If the office is adjacent, then the second installation will require another 10 sq. m. m. The X-ray installation will take 11 square meters. m, and if it is film, then another 5-6 sq. m is allocated for the darkroom. All these standards are not secret; they must be followed. It would be even more correct to first invite the SES commission, which would give permission to open a dental clinic in this premises, and only then carry out any work.
Of course, someone will say that any permit can now be purchased. However, God forbid, some kind of litigation begins with the patient, and then any deviation from the regulations will work against you. Losing your license will be a serious blow to your business. A dental clinic is not a garment factory, where to make a profit it is enough to install equipment and start producing products. It begins to generate income in one and a half to two years, when the client flow is formed. When you hear that you can open a dental clinic anywhere, know that this is coming from someone who is not entirely competent in these matters. That’s why we explain to our clients so carefully what and how to do when choosing a room: the law is like a guiding star for us.
And yet, which option would be optimal? In ten years of practice, I have not come across a renovated room that was already suitable for the healing process. But it is quite possible to avoid serious redevelopment with the right choice. Don't forget that construction work is the most burdensome part of your budget.
Any room with certain load-bearing walls is to some extent damaged from the start. Because of this, it is impossible to implement all modern trends in the construction of medical institutions there. If you want to make something worthwhile, you need to build from the ground up. That is, get a mono-volume space without ceilings for rent. Then it will be possible to bring to life the most elegant project.
If we talk about sizes, then there is a set of premises determined by production technology. Sterilization room (not required in every clinic) – unless the clinic has three or more chairs. It is advisable to install vacuum equipment in a separate, soundproofed room. Somewhere there must be an accountant, doctors undressing, patients waiting. At the very minimum you will need 120 sq. m, the ideal option is 150-170. Moreover, you need to make a reserve for growth when in a couple of years you “unwind”.
It is welcome if your premises have an emergency exit. In this case, you can implement zoning, and you will be able to separate the flow of patients and doctors. They will “intersect” only in the chair. It seems that this is not so important. But the patient is preparing for a not very pleasant procedure; any fuss bothers him. In addition, an emergency exit is necessary in case of emergency. It is simply a must for children's clinics.
The answer to the question of where is the best place to locate a clinic is not so obvious. We had a client who really wanted to open a clinic in the area of Povarskaya and Nikitskaya streets. One of the options is a house on Khlebny Lane. However, there had to be asphalt resurfaced five times over the course of a year. The house sank so much that it was necessary to fill in some of the window openings so that the window sills would not be level with the ground. Naturally, this premises had to be abandoned immediately. Therefore, when you are planning to make a prestigious and visually attractive house in old Moscow the site of the clinic, keep your eyes peeled. The state of communications is terrible, the basements are damp, parking cannot be organized. Don’t buy a pig in a poke; renovating such a room can be golden. And what are the wooden floors worth? Insurance will cost you a pretty penny: when you buy real estate, you pay an insurance premium, the amount of which depends on the condition of the building. In addition, such houses have very difficult residents. They do not accept neighbors in the form of any medical institutions: “I will buy your first floor myself and make a garage there!” There is no point in suing such a public.
And in a residential area you can settle down at the best possible level. Peripheral clinics pay much more attention to landscaping than capital ones: they will paint the house, lay out the lawn, install benches or a fountain
Is there a chance to minimize costs when choosing premises? Yes. You can save on rental payments (with smart trading) or by increasing the period of your rental holiday (this will allow you to slightly defer monthly payments). You need to bargain for any reason, and in the end you can get a room for rent not for one and a half thousand, but for a thousand. for 1 sq. m. Also, as a tenant, you should not buy kilowatts of electricity: if you leave after three years, then simply donate them to the landlord.
In general, it is better to purchase the premises immediately. After all, when you rent for five years, you will be feeding strangers. In addition, rental payments tend to increase, and contract renewals occur in rare cases. It is deadly for a clinic when its location changes: some of the clients immediately “dissolve.” On the other hand, when the owner of the clinic understands that the dental clinic is his life’s work, he will not be afraid of a mortgage loan for 10-15 years (our company has found such options and proved their worth). Payments in this case are fixed, and no inflation processes, no additional payments will be scary to you. Try it, I think it will be very effective. In addition, you will become a happy owner.
So, we talked about the main stages of choosing a room. Of course, only specialists know more subtle nuances. But you shouldn’t skimp on specialists. It is ideal to hire a group of project launch managers who will be involved in the selection of premises, technological control of construction work, selection of equipment, and advertising. There is so much information to digest, so many questions to resolve: a practicing physician simply does not have enough time to do all this. A dentist who does not lose practice will receive funds during this time, which he will usefully invest in himself.
Regulations
for the creation of dental clinics
Hygienic requirements for natural, artificial and combined lighting of residential and public buildings. SanPiN 2.2.1/2.1.1.1278-03;
Sanitary rules for the design, equipment, and operation of outpatient dental clinics dated December 28, 1983, paragraph 2956a-83;
Requirements for the placement, organization of work and equipment of the X-ray room;
Ensuring radiation safety during X-ray dental examinations;
Requirements for the X-ray room upon commissioning. Appendix No. 7 to SanPiN 2.6.1.1192-03;
A manual for the design of healthcare institutions (to SNiP 2.08.02-89). Section I. General provisions. Engineering equipment;
A manual for the design of healthcare institutions (to SNiP 2.08.02-89). Section II. Hospitals;
A manual for the design of healthcare institutions (to SNiP 2.08.02-89). Section III. Specialized, auxiliary units and service premises;
A manual for the design of healthcare institutions (to SNiP 2.0802-89). Section IV. Outpatient clinics;
A manual for the design of healthcare institutions (to SNiP 2.08.02-89). Section V. Ambulance and emergency medical care station, blood transfusion station with vivarium, dairy kitchens, distribution points, pharmacies, control and analytical laboratories;
Regulations on the organization and implementation of reconstruction, repair and maintenance of buildings, communal and socio-cultural facilities. Order of the State Committee for Architecture of the Russian Federation under the State Construction Committee of the USSR dated November 23, 1988, paragraph 312;
Instructions for the design of buildings and structures adapted for medical institutions. Building codes SN 515-79 dated January 1, 1980
2.3 Marketing research of the market and services in the selected area
2.3.1.Development of a questionnaire and organization of potential consumers of these services
To understand what is necessary and priority for consumers of dental services, we have compiled a questionnaire:
1.Location of the dental institution:
A) Availability of other dental institutions in the area
B) Heavy pedestrian traffic near the dental facility
B) Ease of parking
D) The presence of nearby residential areas, large shopping centers and industrial enterprises
D) Proximity of the dental facility to public transport stops
E) Availability of a well-developed public transport network for the dental institution
2. Range of services
A) A wide selection of dental services in accordance with the income level of the population served
C) Preservation of traditional technologies that are in demand among the population
3. Price of services
A) Pricing strategy (affordable prices)
B) General pricing policy in comparison with average prices in the dental services market
B) Solvency of the population
4. Promotion of services
A) Operating mode
B) Image of a dental institution: signboard, external and internal design
C) Organization of services provided
D) Material and technical equipment of the dental institution
D) Quality of work and warranty periods
E) Medical ethics and deontology
G) Setting goals
H) Development of a corporate trademark
M) Choice of service consumer
H) Definition of success/failure
2.3.2 Calculation of the production program for opening dentistry
The initial data of the enterprise's work necessary to solve the problem.
Table 2. Costs of manufacturing products in the 1st quarter.
Table 2. Prices for material resources.
Table 4 Fixed assets of the enterprise.
Table 5 Enterprise performance indicators.
1. Draw up cost estimates for production and sales of products.
We will calculate the amount of costs for raw materials, auxiliary materials, and electricity.
It is equal to the product of the total consumption of raw materials (auxiliary materials, electricity) for the quarter and the cost of 1 ton of raw materials (Auxiliary materials) 1 kW of electricity, respectively.
Amount of costs for raw materials: 250*1450=362500 rub.
Amount of costs for auxiliary materials: 980*10=9800 rub.
Amount of electricity costs: 2390*0.35=836.5
Salary costs equal to the product of the number of working people and the average monthly salary. one worker multiplied by 3 months (i.e. quarter)
170*1700*3=867000 rub.
Contributions to extra-budgetary funds are equal to 38.5% of salary costs.
867000*38.5/100=333795 rub.
Depreciation of objects is carried out depending on the cost of the object, the depreciation rate and the number of months in the billing period (3 months)
Depreciation of buildings is equal to: 2500000*2*3/100=150000 rub.
Depreciation of structures is equal to: 4000000*2*3/100=240000 rub.
Depreciation of machines is equal to: 1000000*12*3/100=360000 rub.
Depreciation of equipment is equal to: 1000000*12*3/100=360000 rub.
Depreciation of vehicles is equal to: 1000000*9*3/100=270000 rub.
Other expenses are: 2200 rub.
Table 6.
| Cost elements | Amount of costs, rub. |
| 1 Raw materials | 362500 |
| 2 Supporting materials | 9800 |
| 3 Electricity | 836.5 |
| 4 Salary | 867000 |
| 5 contributions to extra-budgetary funds | 333795 |
| 6 cushioning: | |
| - buildings | 150000 |
| - structures | 240000 |
| - cars | 360000 |
| - equipment | 360000 |
| - Vehicle | 270000 |
| - other funds | - |
| other expenses | 2200 |
| Total costs | 2956131.5 |
2. Let’s create a calculated cost of production.
The first, second and third calculation items are taken from previous calculations. The salary of production workers is determined as the product of the piece rate per unit of production to the total volume of products produced: 80 * 1000 = 80,000 rubles.
Deductions from wages are equal to 38.5% = 80,000 * 38.5/100 = 30,800 rubles.
Variable expenses are equal to the sum of expenses of points 1,2,3,4,5 of this table: 362500+9800+836.5+80000+30800=483936.5 rubles.
Conditionally fixed costs are equal to the difference between the total amount of costs according to the production cost estimate and the value of variable costs:
2956131.5-483936.5=2472195 rub.
The total cost is: 483936.5+2472195=2956131.5
Table 7
3.1. Enterprise pricing.
1 Determination of the wholesale price of the enterprise (TsO):
Tso=(1+P/100)*C (1)
where P is the profitability of the product, %,
C - cost per unit of production, rub./unit.
С=2953931.5/1000=2953.93
P=30% (from table No. 1)
Tso=(1+30/100)*2953.93=3840.11 rub.
2 Determination of the selling price of the enterprise
Tsotp=(1+ VAT rate/100)*Tsot (2)
where the VAT rate is the value added tax rate.
Tsotp=(1+20/100)*3840.11=4608.13 rub.
3. Sales volume in wholesale prices (Ор):
where Q is sales volume in physical terms
Or=3840.11*1000=3840110 rub.
4. Formation of enterprise profit
1 Calculation of gross profit Pv
Pv=Pr+Pvrd (4)
where Pr is profit from sales;
Pvrd - profit from non-operating activities;
2 Pr=Pp+Pk (5)
where Pp is the profit from the main production activities(product sales)
Pk - profit from commercial activities (sale of property)
3 Profit from core activities (PP)
Pp=Or-Svyp (6)
Where Svyp is the total cost of production (production)
4 Profit from commercial activities (Pk)
Pk=(Tsprod-Tspok)/(1+VAT rate/100)*Qn (7)
Where Tsprod, Tspok are the selling price and purchase price of goods (raw materials);
Qн - sales volume in physical terms.
5 Profit from non-operating activities (Pvrd);
Pvrd=Pa+Pd, (8)
Where Pa is the profit from the leased property;
Pd - dividends on securities.
Calculation formulas:
PC=(1650-1450)/(1+20/100)*1000=166666.66 rub.
Pp=3840110-2956131.5=883978.5 rub.
Pr=166666.66+883978.5=1050645.16 rub.
Pvrd=35000*3+65000=170000 rub.
Pv=170000+1050645.16=1220645.16 rub.
5 Profit distribution
1 Taxable profit (Mon)
Mon=Mv-Nv (9)
Where Нв - taxes received from gross profit (9000 for all options)
Mon=1220645.16-9000=1211645.16 rub.
2 Tax on income on securities (Nb)
Nb=D*tax rate/100 (10)
Where is the tax rate - the tax rate on securities
D - income from securities
Nb=65000*10/100=6500 rub.
3 Naog on profit from core activities and from the rental of property (Npr);
Npr=(Monday)*28/100 (11)
Npr=(1211645.16-65000)*28/100=321060.64
4 Profit remaining at the disposal of the enterprise (Prasp)
Prasp=Mon-Nb-Npr (12)
Prasp=1211645.16-6500-321060.64=884084.52 rub.
5 Net profit (Pr)
Pch = Prasp - economic sanctions (RUB 55,000) (13)
Pch=884084.52-55000=829084.52 rub.
6 Capital investments in production development (CI):
KV=A+Pch*0.3 (14)
Where 30% is the percentage of profits allocated to production development.
A - depreciation of all funds = 1,380,000 rubles.
Figure 1. Organizational structure of a dental clinic
Table 8.
3.2.2 Determination of staffing, organization of personnel selection
How many employees should one dental chair serve? According to standards, one dentist can work 6 hours a day. Usually there are two shifts. If you want the clinic to function around the clock, then you will have to hire four doctors to work on one installation. Every doctor should have a nurse working with them. Here, of course, you can save money and offer the nurse to work for two doctors at once, but in this case, disruptions in work are likely. After all, both of them may need her help at the same time. If the room is large, then a nurse is also required, whose responsibilities include maintaining order. Salaries in private clinics for nurses usually start from 3,000 rubles, for nurses - from 6,000 rubles.
Rice. 2. Personnel management structure
Paying a doctor is a separate, very delicate issue. Recent practice is as follows: every doctor officially receives a minimum salary. Today this is at least two and a half minimum wages. Further, the specialist’s income is directly related to his work, since the doctor, by and large, lives on interest from the cost of what he did. Typically this figure ranges from 10 to 30%. He will receive more or less depends on his relationship with the owner of the clinic, on how interested he is in him. And, of course, from the level of the specialist.
3.2.3 Office equipment
Let's make a calculation for a small dental clinic that has:
Patient reception area (hall), which also serves as a mini-store selling home care products - 20 square meters
Four therapy rooms with one chair each - 14x4=56 sq. meters
Implantology room - 15 sq.m. meters
Office of orthodontics and orthopedics – 15 sq.m. meters
Surgery room – 15 sq.m. meters
Pediatric dentist's office – 15 sq.m. meters
X-ray room - 12 sq. meters
Dental laboratory – 15 sq.m. meters
Auxiliary premises (sterilization room, warehouse, director's office, staff rest room, toilets, corridors) - 42 sq. meters
TOTAL: 200 sq. meters!
Why such large offices and auxiliary areas, you ask? Look at the SES standards! For one dental unit - at least 14 sq. m. If you plan to place two dental chairs in one office, then you need to add another 7 square meters to this number. m. And so on - seven for each new workplace. But neither doctors nor patients these days want to huddle in shared offices where several chairs are installed at once. They prefer comfort and privacy, so it is better to make the offices separate.
The choice of equipment is large, it is enough to visit any dental exhibition to make sure that there are several suppliers for each position, but it’s difficult for a beginner to figure it out - each seller will praise his equipment. This requires a specialist who is well versed in dentistry and professional technology. That is, a consultant who will help and advise you on how to organize this business for you. His services are usually estimated at 10–15% of all purchased equipment. This is exactly the amount that the equipment seller, as a rule, returns back to the buyer as a kind of discount.
I don’t think you would want to buy an antediluvian Soviet-era dental chair for next to nothing, in which the instrument is driven by a foot drive, like in your grandmother’s Singer sewing machine. Cheap equipment sometimes looks like a rotten tooth in a Hollywood smile in a clinic.
The price level in good clinics depends on the equipment, so it is better to purchase reliable brands, for example, dental units from Castellini, Sirona, Kavo, Trophy diagnostics, and use materials from 3M, Dentsply, Kerr, Degudent.
Table 9. As an example, we give prices for standard mid-level equipment.
If you are committed to serious business, and not to seasonal cutting of coupons, then you need to approach the purchase of equipment carefully. After all, the clinic has been working on it for more than one year. Besides equipment must have all the functions that allow it to provide the most modern dental services. Therefore, the central figure of your office - the dental unit - should have at least 4 sleeves: for a water-air gun, for a micromotor, for a turbine, which bears the greatest load, and for an ultrasonic scaler for removing dental plaque. Of course, you need to have a reserve. What if the tip breaks? Or is it time to sterilize him? An additional set of replacement tips is required. Add another $1,500. You should stock up on a set of consumables: filling materials, other chemicals, various hygiene products. This will cost at least $1,500. This is the initial kit needed to get started. It will have to be replenished monthly. Prepare another $1,000 for tools. You also need to purchase technical support in the form of solar-curing lamps, which cost from $300 to $1,000. An additional apex locator - up to $1,000.
The clinic needs an X-ray machine; it is also advisable to purchase a radiovisiograph (this is an X-ray machine with a low degree of radiation, which allows you to view the image on a computer). Pregnant women, for example, will look for a clinic only with a radiovisiograph. Depending on the configuration, this equipment will cost from $3,000 to $12,000. Another mandatory item in your purchasing marathon is an autoclave. It is necessary for antibacterial treatment of instruments. Cost from $1,500 to $5,000. Don't forget about a refrigerator for medicines and sterilizers. They will cost another $1,000. And, of course, all kinds of cabinets, chairs and other furniture. Throw in another $1,000.
3.2.4 Product development
A dental clinic begins with choosing the procedures you are going to offer to patients. Here are the possible directions in your future clinic:
therapeutic dentistry (treatment
caries, pulpitis, periodontitis),
· therapeutic periodontology (treatment of periodontitis and periodontal disease),
· surgery (tooth extraction, treatment of purulent-inflammatory diseases of the oral cavity, surgical methods for the treatment of periodontal tissue diseases, excision of benign tumors, etc.),
· orthopedic treatment of dental defects, preparation for prosthetics, implantology,
· orthodontics (treatment of dental anomalies), treatment of congenital defects of the maxillofacial area, including defects acquired as a result of injuries or early diseases;
· children's dentistry
· aesthetic dentistry (teeth whitening, removal of tartar, smoker’s plaque, etc.)
In Soviet times, clinics focused mainly on therapy and surgery, that is, on solving the immediate problems of patients who, fearing toothache to death, usually delayed the start of treatment. Number of patients with acute pain in those days exceeded all conceivable standards. Since tooth extraction was a common practice, and the question “should we remove?” patients easily answered “yes,” but by the middle of life, for many Russians, their mouths gaping with emptiness required the installation of dentures. That is, the next most popular procedures were procedures for installing all kinds of removable or non-removable structures (“bridges”). That is, there was a need to restore the visual appeal of clients. Since in Soviet time Prosthetics were quite an expensive occupation, so only a select few could boast of teeth made of pure gold. Perestroika gave this same socially secure layer of the population metal-ceramics. Modern technologies They have gone even further - now, to install artificial teeth, it is often no longer necessary to grind down adjacent healthy teeth; implantology has come to the rescue.
3.2.5 Organization of sales activities and responsibilities
Table 10. Prices for dental services
Table 11. Responsibility for activities
| Chief Accountant | Head of the organizational and methodological department | Administrator | Attending doctor |
| Patient registration | X | ||
| Patient examination | X | ||
| Drawing up a contract and paying for services | X | ||
| Preparation of documents and reporting | X | ||
| Entry into the medical record of dental services performed | X | ||
| Filling out reporting form 37 | X | ||
| Filling out feeding reports 39 | X | ||
| Analysis of compliance of the volume of services provided with payment | X | ||
| Filling out the warranty card | X | ||
| Formation of an expense cash order for the return of funds to the client | X | ||
| Formation of a cash receipt order for additional payment by the client for work performed | X |
3.2.6 Participation in exhibitions
For the convenience of visitors and ease of perception, our exhibition will be located in five halls:
1. In the first hall, dental equipment is exhibited - in a broad sense, these are all conceivable devices and apparatus, dental units, furniture - in general, everything moving, rotating, equipped with microcircuits, motors, or vice versa, silent, but large and massive, for example - dental furniture and so on.
2. In the second hall, dental instruments are demonstrated - in all their diversity, everything that dentists hold in their hands while working, and that patients consider an indispensable attribute of a torture chamber, is presented.
3. In the third hall there are dental materials - at our exhibition this is everything that is not equipment or instruments.
4. In the fourth hall there is a real “reading hut”, or congress hall for reading reports; articles for dentists are published here.
5. In the fifth hall there is a business center, where managers and owners of clinics can get acquainted with publications on the dental business, and beginners and future investors can get information on how to open a dental clinic.
3.2.7 Organization of advertising activities
Some tips for creating dental advertising:
1. Recommendations from friends. The main way dentists get new patients is through referrals. People will go to doctors recommended by their friends. Everyone knows this, but few draw practical conclusions. But it’s really simple - here, for example, is the most obvious move.
Give each patient who completes your treatment a business card, on the back of which place a coupon entitling them to a free examination or a discount on teeth cleaning. Explain that this coupon can be transferred to other people - and the chances that you will have a new patient for an examination will be greater. Surely such an inspection will reveal problems that you will fix, but for money.
2. Reminders. Patients are busy and forgetful people - almost everything and almost always. In addition, many subconsciously simply force themselves to forget about the dentist - few people have pleasant associations with dental treatment. Therefore, remind yourself. Ensure that all patients are sent a postcard 6 months after their last visit reminding them of the need for preventive screening. If they don't respond to the card, you can call them on the phone to remind them to take care of their teeth, but this requires a "specialist" who can do this tactfully and unobtrusively.
3. Identification. Main mistake What leads to advertising failure is that clinics do not research the market of potential patients before making the advertisement. Before you spend money on advertising, take the time to try to understand who your patients are and what they want from you. Although this is quite simple, special skills are still needed - it is better if you attend a seminar on how to conduct testing without wasting money on unsuccessful advertising.
4. Advertising design. It is very important how the advertisement is designed, what illustrations are used in it, what overall design. But it is also necessary to pay attention to the selection of words and expressions. Do not frighten the patient with caries and other adversities. Your main message should be “Save your teeth.” This, and not a description of the procedures available in your clinic, should “hook” the potential patient. Here, for example, is a successful slogan: “Don’t wait until they get sick.” This should be followed by an offer to call and make an appointment.
3.3 Project information support
Information support for the creation of a dental clinic should be accompanied by marketing advertising activities in the media, radio, television, billboards and other billboards, and resort to the help of hired workers in distributing leaflets.
It is necessary to conduct advanced training courses for the clinic staff every six months and send them to trainings.
Table 12. Planned technical and economic indicators
Index |
|||||||
1st quarter |
2nd quarter |
3rd quarter |
4th quarter |
||||
| income from sales of goods | 173577,85 | 35876,45 | 40807,35 | 46152,84 | 50741,21 | 189917,1 | 206945,8 |
| variables|changeable| expenses | 125027,35 | 17997,6 | 31770,35 | 35868,1 | 39391,3 | 147652,4 | 160789,1 |
| gross income | 38549,9 | 7878,85 | 9037 | 10284,74 | 11349,31 | 42264,7 | 46156,7 |
| fixed costs | 10500 | 2850 | 2650 | 2350 | 2650 | 10500 | 10500 |
| net profit payable for taxes | 28052,9 | 5028,85 | 6387 | 7937,74 | 8699,31 | 31764,7 | 35656,7 |
| tax payments | 2400 | 600 | 600 | 600 | 600 | 2400 | 2400 |
| net profit after taxes | 25652,9 | 4428,85 | 5787 | 7337,74 | 8099,31 | 29364,7 | 33256,7 |
| profitability | 17,415% | 14,35% | 16,81% | 19,2% | 19,3% | 18,56% | 19,41% |
Table 13. Activities and expected results
3.4 Legal support of the project
To begin with, the future head of a private dental clinic needs to decide in what organizational and legal form his enterprise will exist. In operation civil law All legal entities, depending on the nature of their activities, are divided primarily into commercial and non-profit organizations.
Commercial organizations include organizations that have profit as the main goal of their activities (Clause 1, Article 50 of the Civil Code of the Russian Federation). They subsequently distribute the resulting profit in one way or another among their participants (founders). These are business partnerships and societies, production cooperatives, state and municipal unitary enterprises. Commercial organizations cannot be created in any other organizational and legal forms other than those mentioned (clause 2 of Article 50 of the Civil Code of the Russian Federation). Practice shows that for a private dental clinic the most acceptable type of capital combination is a limited liability company.
This organizational and legal form is a business company, characterized, firstly, by the authorized capital divided into shares of participants and, secondly, by the absence of personal (property) liability of participants for the debts of the company they created (Clause 1, Article 87 of the Civil Code of the Russian Federation; p. .1 Article 2 of the Law on Limited Liability Companies). The procedure for creating a Company includes two stages - the actual establishment of the Society and its state registration. The decision to create the Company, made by several founders, is formalized in the form of a constituent agreement. The same decision made by one person must be formalized by a charter approved by this person. If the sole founder is a legal entity, then the decision to establish the Company is made by the body of the legal entity authorized by law and the constituent documents.
A legal entity is subject to mandatory state registration with the justice authorities and is considered created from the moment of such registration. Registration of legal entities in Moscow occurs in accordance with the Moscow Government Decree No. 97 dated September 17, 1991, which approved the Regulations on the procedure for registering enterprises and organizations in Moscow. To register an enterprise, it is necessary to submit the following documents to the Moscow Registration Chamber (branch of the administrative district): an application with an attachment in the established form; the constituent agreement in 2 copies or the decision to create a company, if there is only one founder; charter approved by the founders, in 2 copies; document confirming the fact of payment of 50% authorized capital; document. confirming payment of state duty and registration fee; a certificate confirming the uniqueness of the Company’s name in the Moscow Registration Register; copies of the registration certificate (decisions) for each legal entity that is the founder of the Company; registration card of the established form (registration information) in 2 copies; letter of guarantee confirming the location of the company.
After the creation of a Limited Liability Company, the next stage is obtaining a license to engage in medical activities, since medical activities in accordance with the FEDERAL LAW “On Licensing of Certain Types of Activities” adopted by the State Duma on September 16, 1998, require special permission from the state. When organizing a private dental clinic, you should also not forget that the clinic rests on the authority of the doctors working in it.
CONCLUSION
Owners who develop their business in an extensive way constantly feel the disadvantage of their business. Because there are clinics nearby, where, in the absence of external advertising, which requires constant significant costs, there is a constant influx of patients. It so happens that the assessment of the quality of dental treatment in our country is entrusted to patients, and they try to find clinics with the best price-quality ratio. In clinics that provide bona fide medical services, the owners, as a rule, are doctors. These clinics have the most friendly and comfortable psychological atmosphere, because... Doctors and service personnel do not have stress associated with low wages, lack of materials or equipment, or unjustified demands from the owner to increase work intensity. In these clinics, doctors have days off and work without overexertion. A doctor’s working day can start at 10 am or even later, and end at 6 or 8 pm. As a rule, in such clinics there is no staff turnover among both doctors and assistants, because everyone gets a decent salary. In clinics with an intensive type of development, the quality is constantly improving and the range of services is expanding, which creates in patients a feeling of the need and usefulness of treatment at a constantly high level.
The development of the domestic economy in the post-perestroika period shows that our society is not yet ready for reforms that would transfer the economy to an intensive path of development. At the same time, the extensive development of state dentistry has led it to a dead end, because Dental treatment itself has become a risk factor for the patient’s health. Reforms are overdue, but they will only happen when people who received higher (including economic) education after 1991 come to management (not only at the highest level, but mainly at the local level). From about this time, universities began to teach economic theory based on the work of foreign economists, and not on Marxist-Leninist teaching. In addition, over time, the social activity of the population will increase, and reforms will become necessary for dentists themselves. The command-administrative management system and the denial of the principle of election became the cause of the “orange” revolutions in the CIS countries. The development of society and civilization cannot be stopped - you can only lie down under the wheel of history.
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Annex 1
Dental equipment suppliers:
A-DEC – A-DEC INTERNATIONAL ING.
AVANTA INVEST – AVANTA INVEST
AVERON-SPb
AI SI MED
ACADEMY OF SCIENTIFIC BEAUTY
ACTEON GROUP
ACTIVE GROUP
AKURATA G+K MANHARDT DENTAL E.K.
ALADENT/BREDENT
Alternative
Alpha Bio Ltd
Alpha Bio-ru
Alfred Becht
Amicodent
Amphodent
Anas medical
Anise-dent
Apex-dent
April-m,ooo
Arnika, JSC
Art-line nv
Artis-trade plus
Astrodent
Bingo Grand
Biosan technical service
Biopharmaholding
Bona-dent
Boston Institute of Cosmetic Dentistry
Baging retourning swans technologies
V&H dentalwerk
Waldmann
Vallex m
Viva-dent
Wieland dental + technician
Wilman & Pein GmbH
Vita-med mcc
Vita-pool medical company, LLC
Vital evv
Vladimir-reg-snab, JSC
Vladmiva, trading house
WORLD DENTAL GROUP
WORLD DENTAL FEDERATION
HERMAN DENTAL GROUP
GERMAN OFFICIAL REPRESENTATION
GLAXOSMITHKLEIN HEALTHCARE
DeguDent
DELTAMED, LLC
DENTAL-IST
DENTAL-SPA
DENTAL-EVADA
DENTAL AB
DENTAL GROUP
DENTAL IMPORT
DENTAL COMPLEX, JSC
DENTAL SNAB
DENTAL FILM
DENTAL BUSINESS CENTER
DENTAURUM
DENTO-NELLA
DENTSPLY RUSSIA LIMITED
CHILDREN'S TOY
CHILDREN'S DENTISTRY №1
GS HOLDING
DIAMED, JSC
DIARSI center
DIV-MEDSERVICE
DISKUS DENTAL EAST
DUBNA BIOPHARM
DEM AND COMPANY
DÜRR DENTAL
ZHEJIANG MINMETALS
INSTRUMENT BEARINGS PLANT
Health
Dental architecture
Ivoclar-vivadent
Implaza Hecht GBMH
Inter-Med
Intermedapatite
Kavitron, LLC
Kavo dental russland, llc
Kazan Medical Instrument Plant, JSC
Carolina group of companies
Ceramics center 3
Kettenbach gmbh
Colgate-Palmolive
Ring, ooh
Coltain\valedent
Com-dental
Alan Depot Company
Intermedservice company
Hey Sea Dental Company
Consort Millennium
Kostroma medical equipment
Craftway dental depot
Crosstek diamond
Xingxing
Lyco-stomy
Logostom
Lotte KF Rus
Max-pharma
Maxi dent
MD Simulation
Megadenta
Megadenta
Megastom
Honey and Tex
Medimport St. Petersburg
Medinfodent company
Medina Company
Medstilservice
Medtek-implant
Medical equipment
Medtorg 21-dentarus
Medtronic TKF
Medexim r
International dental company
Mid-Unix
Mk-1 dental attachments
Momentum
Moscow pharmaceutical factory
Mt equipment
Natusana
German Dental Center
Neonica m
Nissin dental product
Nobel biocare
Nordin s.a
Normed plus
NPK vitaform
NGO screen
R&D technologies
NSK Nakanishi
NTFF polysan
New-dental-XX1
Ok-Loza, OJSC
Omega-dent
Oraltronics
Ortolyushion
Pastelli
Polident
Polycardent
Polist
Polist
Proclinic International
Procter and Gamble
Promedtech
Promethene
Prommedservice
Radio factory
Rick, oooh
Rokada honey
Rossa-med enterprises
Rosslyn Medical
Rus-Atlant and co
Relma-start
Sae-rübeling-dental
Sayang microtech
Satellite group
Sia Orthodontics Manufacturer
Simcoe trading
Symphony of Rest
Sirona dental systems foshan
Sirona dental systems
NPOOO system
Sky dental
Smart delta systems
Sonis NPF
Sonodent
Soredex
Spark-don
Specialized dental pharmacy
Special electrode
Sportmedimport
Stildent
Dental medical supply
Stoma prime
Stoma-dental
Stoma service
Stomadent
Stomax-eurodent
Stomalit
Dental technology
Dentistry
Stomakhim
Stomclub
Stomex plus
schpk-diva
Typhoon honey
Takara Belmont Corporation
Tbi stoma
TD dentistry
Technodent
Technosystems, LLC
Titaniumfix
TKD tekne dental
Tokuyama dental
Tornado-dent
Trekhgornaya manufactory
Tutogen Medical GmbH
Sky dental
Tuttnauer
WIDM Corporation
Ulyka firm, LLC
Uralquadromed
Pharmadent
Pharmadental
Pharmadentmedical
Pharmasoft
Pharmgeocom-pro
Elfa Pharmaceutical Plant A.O.
Firm circle ltd
Hammacher Omnimed GmbH
Hariko denta honey, LLC
Heka dental
Hirana ist
Hirana medical
Hiratrade
Hexagon
Celite, Trading House
Chicago Center for Advanced Dentistry
Scheftner GmbH
Chic Technologies
Shoy-dental
Straumann ag
Ewe Ernst Wetter GmbH
Edenta ag
Ex dentis
Exhibitor
Erkast XXI
Es ti i dent
Estaid-servicegroup
Eur-med dentaldepo
Yunist-ag
Yamagachi dental mfg., co.
3M ESPE, USA-Germany -3M ESPE, USA- GERMANY
3 DENTA, LLC -3 DENTA LTD.
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1 Allow for protection of vehicles and aircraft Head of department. Markhasin A.B. BACHELOR'S GRADUATE THESIS Informatization of business processes of a dental clinic Explanatory note Student Chumakov A.V. // Faculty of IVT Group IA-231 Head Lapova S.G. /.. / Novosibirsk 2016 1
2 Federal Communications Agency Federal State Budgetary educational institution higher education"Siberian State University of Telecommunications and Informatics" (SibGUTI) DEPARTMENT OF TELECOMMUNICATION NETWORKS AND COMPUTING FACILITIES ASSIGNMENT FOR THE GRADUATE THESIS OF BACHELOR STUDENT Chumakov A.V. GROUPS IA-231 APPROVED “2016 Head. department / A.B. Markhasin / Novosibirsk 2016 2
3 1. The topic of the bachelor’s final qualifying work: Informatization of business processes of a dental clinic was approved by order of SibGUTI dated February 20, 2016 4 (159o-16) 2. The deadline for the student to submit the completed work is June 22, 2016 3. Initial data for work 1 Special literature 2 Internet materials 4. Contents of the explanatory note (list of questions to be developed) Deadlines for completion by section Date of issue of the task February 20, 2016 Supervisor signature Accepted the task for execution February 20, 2016 Student signature 3
4 ABSTRACT Final qualifying work Chumakov A.V. (Last name, I.O.) on the topic “Informatization of business processes of a dental clinic” Volume of work - _33 pages, on which _17_drawings are placed. When writing the work, _6 sources were used. Keywords: business process, information structure, IDEIF0 standard, Database, BPWin, ERWin Work performed at the Department of TSiVS (name of enterprise, division) Tasks to be solved 1. Development of Internet technologies and expansion of the scope of use of Internet applications 2. Analysis of business processes in dental clinic 3. Justification for choosing a standard for modeling the business process of the subject area under consideration Development of your own structure. 4. Database design Main results 1. Description of the LAN architecture of the dental clinic. 2. Software implementation and debugging *This section should reflect the main results of the study 4
5 Federal Communications Agency Federal State Budgetary Educational Institution of Higher Education “Siberian State University of Telecommunications and Informatics” (SibGUTI) REVIEW on the final qualifying work of student Chumakov A.V. on the topic “Informatization of business processes of a dental clinic” Chumakov A.’s final qualifying work is dedicated to current topic building a working model of business processes of a dental clinic using functional modeling methodology. The work formulates the purpose and objectives of the research, provides short description object of study, characteristics of the BPWin software package chosen as a tool for analysis and model building. However, it should be noted that the work has significant drawbacks: the subject area has not been sufficiently studied; the list of functions and the list of data for constructing functional diagrams of business processes have not been defined; an infological data model for the subject area under consideration has not been built; the choice of software for database development is not justified; program text is missing. Thus, A. Chumakov did not solve the problem in full. The final qualifying work of Chumakov A., with appropriate protection, deserves the grade “SATISFACTORY”, and Chumakov A. is awarded the qualification “Bachelor”. 5
6 Competencies General cultural OK-1 has a culture of thinking, is capable of generalizing, analyzing, perceiving information, setting a goal and choosing ways to achieve it OK-2 is able to logically correctly, reasonedly and clearly build oral and written speech OK-10 uses basic laws naturally scientific disciplines V professional activity, applies methods of mathematical analysis and modeling, theoretical and experimental research Professional PC-2 master methods of using software to solve practical problems PC-5 develop components of software systems and databases, use modern tools and programming technologies PC-7 prepare presentations, scientific and technical reports on the results of work performed, document research results in in the form of articles and reports at scientific and technical conferences The level of competence development is high average Low The work has practical value The work has been implemented I recommend the work for implementation I recommend the work for publication The work was completed using a computer The topic was proposed by the enterprise The topic was proposed by the student The topic is fundamental I recommend the student for master's degree I recommend the student for graduate school Checking using the Anti-Plagiarism program showed 78% of the originality of the text. Position of the head signature Lapova S.G 6
7 Contents INTRODUCTION NEED FOR ONLINE SERVICES DEVELOPMENT INFORMATION SYSTEM OF AN ORGANIZATION Concept of an information system Description of the goals and objectives of the organization Information structure of the clinic Classification of business processes SOFTWARE IMPLEMENTATION OF INFORMATION FOR BUSINESS PROCESSES IN A DENTAL CLINIC Methodologies for analyzing business processes Rationale for choosing a modeling standard Description of business processes in Healthcare facilities MODELING AND DEVELOPMENT OF A DB FOR THE PATIENT ACCOUNTING SYSTEM Creation of a logical model of a dental clinic Software implementation CONCLUSION REFERENCES USED
8 INTRODUCTION To run a successful business, it is necessary to constantly study the needs of the market and improve the range of services of an enterprise or company. To better understand ways to improve system functioning processes, business process modeling is increasingly being used. Modeling allows you to identify relationships between business processes, identify the most important areas and eliminate duplication. Models can display the entire system or include only a description of part of the business processes; they can be designed in “width” or “depth”, i.e. processes can have varying degrees of detail. In this case, the purpose and objectives of the modeling must be clearly defined, the answer to which will allow the construction of the model to be considered complete. Currently, the description and analysis of enterprise business processes is based on the use of computer technology. Modern software tools support various modeling methodologies. Platinum BPWin is currently rightfully recognized as the most popular software package due to its functionality. It is this package that was chosen as a tool for modeling the process of organizing the activities of a private dental clinic for the purpose of this qualifying work. It is no longer possible to imagine the organization of treatment and preventive processes without the introduction of information technology. Most information systems for dental clinics are focused on automating services, mainly supporting specific functions, such as maintaining an electronic database, scheduling patient appointments, accounting for services provided, settlements with insurance companies, financial and statistical reports, etc. This functionality is the basis for any similar systems, useful and in demand by customers. The purpose of my work is to develop a model of business processes in a dental clinic based on CASE technologies. 8
9 In connection with this goal, the following main tasks are being solved: 1. Familiarization with BPWin methodologies. 2. Analysis of existing structural solutions. 3. Development of the proposed structure of health care facilities. 4. Creation of an infological data model. The object of the study is the document flow for recording services provided in a dental clinic. Purpose of the work: studying existing approaches to modeling business processes, conducting a structural analysis of the service delivery system, building an informational data model for accounting for the services provided. Scope of application: the developed model should be designed for use in small dental clinics to automate the accounting of services and draw up work schedules for employees. 9
10 1 NEEDS FOR ONLINE SERVICES DEVELOPMENT Now it is impossible to imagine a world without online services. Online services make life easier for all humanity. Today you can easily go to the website of an online store and buy something; this is the first benefit of this example; and then you can track where your product is online, no need to sit and wait for the unknown. We don't have to stand all day in a stuffy room in huge queue to get a coveted doctor’s certificate, register a car, get a passport, get a driver’s license and many more possible services in human activities. You can simply go to the website, submit an application, select the date and time when it is convenient for you to arrive, click your computer mouse a couple of times and now you are at the dentist, at a time convenient for you. And you didn’t waste two hours of your valuable time just making an appointment with a doctor. You need a clinic website where you can check opening hours, location, phone number, and you can even consult a doctor online. You don’t need to keep a big yellow book with phone numbers, you just go to the search, type in the name of the clinic and now you’re on the website, where there is all the information you need. What if my contact details change? Your friends may also have outdated information. We went to the website, and everything had already changed. Faster than any other source. In the near future, there will be a general patient database where you can go in and see when and what you were treated for, and what actions the doctor performed. 10
11 2 INFORMATION SYSTEM OF AN ORGANIZATION 2.1 Concept of an information system An information system of an organization is an interconnected set of information, technical, software, mathematical, organizational, legal, ergonomic, linguistic, technological and other means, as well as personnel, designed for collecting, processing, storing and issuing economic information and management decision making. The constituent elements of the system: Computer Computer network People Information support Software The purpose of this system is to produce professional information. Information system processes: Entering information from external and internal sources Processing information Storing information Outputting information in an accessible form 2.2 Description of the goals and objectives of the organization The goal of the organization is to obtain maximum profit. The activities of the dental clinic are related to the provision of highly qualified services for dental treatment and prosthetics. The main services include 11
12 1. Therapeutic treatment. Cosmetic treatment; Installation of modern dental fillings; Root canal treatment; Teeth whitening; Professional teeth cleaning; Treatment of caries using an intraoral camera. 2. Surgical treatment. 3. Prosthetics. Installation of bridges; removable dentures; dental inlays; crowns; veneers; Properly organized work of the registry, the main function of which is recording patients and maintaining a file cabinet, is of no small importance for the effective functioning of health care facilities. For this section of the IS, an analysis will be carried out in the future and a diagram of the interrelationships of work will be constructed. Most often, in dental clinics, patient records are kept manually. That is, the outpatient card is filled out by hand, all information is entered into an Excel document, where patients are counted using various formulas. With such an accounting system, the following main problems arise: Large volume of card indexes, inconvenient for searching. Why do you need a large archive room? Difficulties in searching for patient outpatient records and the associated time costs; Time spent filling out patient records; 12
13 Loss of data (patient records); A large share of routine work of workers and the associated share of personnel engaged in data processing and not related to the main activities of the clinic. The goal of automating business processes is to eliminate all of the listed shortcomings. The use of patient databases largely solves the problems of accounting for services, searching and integrity of information. An important role is played by modern Web technologies, which offer patients new opportunities for making appointments, online consultations, etc. 2.3 Information structure of the clinic The structure of the clinic is shown in Figure 1. Figure 1 information structure of the clinic 13
14 2.4 Classification of business processes The main business processes of a dental clinic are: Management Treatment Providing After identifying the main groups of business processes, you can begin to create models. To create models, I decided to use a simple and accessible method, the structural analysis method (SADT - Structured Analysis and Design Technique), a family of the IDEF0 standard. The standard diagram of this method is a diagram in which on the left is the input, on the right is the output, on top is the control, and on the bottom is the mechanism. Figure 2 shows a simple diagram of the IDEF0 standard. Figure 2 IDEF0 diagram A distinction is made between main and auxiliary processes. Core processes are those that add quality. In our case, these are the processes of providing quality medical care (quality medical services) to the patient. Auxiliary processes form the infrastructure of the organization; in a medical institution they create conditions for performing the diagnostic and treatment process. 14
15 The medical information system is designed to provide information support for both the main and auxiliary business processes of a medical institution. Therefore, the first stage of its design is a formalized description of these business processes, i.e. building an informational model of the enterprise. As will be demonstrated below, this model is not equivalent to the structural-functional model of the enterprise. 15
16 3 SOFTWARE IMPLEMENTATION OF INFORMATIZATION OF BUSINESS PROCESSES IN A DENTAL CLINIC 3.1 Methodologies for analyzing business processes Formalization and description of business processes of any enterprise is carried out on the basis of the IDEF methodology. Its distinctive feature is the emphasis on the subordination of objects. In the IDEF0 standard, the system under study appears to developers and analysts as a set of interrelated functions (functional blocks in IDEF0 terms). The IDEF1 standard is a methodology for modeling information flows within a system, allowing you to display and analyze their structure and relationships. The result of applying IDEF0 to a system is a model of that system consisting of a hierarchically ordered set of diagrams, documentation text, and vocabularies that are cross-referenced together. The two most important components that make up IDEF0 diagrams are the business functions or activities (represented as box diagrams) and the data and objects (represented as arrows) that connect the activities. In this case, the arrows, depending on which face of the work block they enter or from which face they exit, are divided into five types: Entry arrows (entering the left face of the block) depict data or objects that change during the execution of the work. Control arrows (included in the upper edge of the block) depict the rules and restrictions according to which the work is performed. Output arrows (extending from the right edge of the block) represent data or objects that appear as a result of the work being done. 16
17 Mechanism arrows (entering the bottom edge of the block) depict resources necessary to perform the work, but do not change during the work process (for example, equipment, human resources, etc.) Call arrows (exiting the bottom edge of the block) indicate access to the block included into another part of this model or another model. 3.2 Justification for choosing the BPWin and ERWin modeling standard from Computer Associates. Computer Associates International, Inc. (CA) is one of the five leading software manufacturers, offering tools for modeling, backup, enterprise infrastructure management (networks, servers, etc.), information security, business intelligence, etc. The BPWin package is based on the IDEF methodology and is intended for functional modeling and analysis of enterprise activities. The IDEF methodology, which is an official US federal standard, is a set of methods, rules and procedures designed to build a functional model of an object in a particular subject area. The IDEF functional model displays the functional structure of an object, i.e. the actions it performs and the connections between these actions. BPwin features: supports three standard notations at once - IDEF0 (functional modeling), DFD (data flow modeling) and IDEF3 (work flow modeling). These three main perspectives allow us to describe subject area most comprehensive; allows you to optimize procedures in the company; Fully supports volumetric costing methods economic activity(functional cost analysis, ABC); 17
18 facilitates certification to ISO9000 quality standards; integrated with ERwin (for database modeling), Paradigm Plus (for modeling software components), etc.; integrated with Arena simulation tool; contains its own report generator; allows you to effectively manipulate models - merge and split them; has a wide range of tools for documenting models and projects. The advantages of this software package are: Completeness of description of business processes Ease of documenting processes Complexity in decomposition (migration and tunneling of arrows) Possibility of aggregation and detailing of data and information flows (division and merging of arrows) Availability of strict requirements of the methodology, ensuring the receipt of process models of a standard form Compliance of the approach to the description of processes in IDEF0 standards ISO 9000:2005 The listed advantages justify the choice of Bpwin for modeling business processes in health care facilities. 18
19 3.3 Description of business processes in health care facilities Let's consider an example of using the IDEF0 methodology to analyze business processes and build a functional model of a hospital-type medical institution. Figure 3 shows a generalized model of his work: hospital staff (the resource necessary to perform the work) treats the patient (an object that changes during the work), the results of which are a discharged patient and an invoice register for the medical services provided to this patient. Figure 3 - Generalized IDEF0-description of the work of the hospital After completing the medical history, work with the patient in the admission department continues (Figure 4): he is examined, a diagnosis is made upon admission, if there are indications, a conclusion on hospitalization is taken and he is directed to a specific healing branch of the hospital, or provide the necessary outpatient care and direct them to the necessary medical institution. 19
20 Figure 4 - IDEF0 description of work performed in reception department. In the medical department (Figure 5), the patient is examined, the diagnosis is clarified, an examination and treatment plan is drawn up, prescriptions are made and carried out, etc. until his discharge. Figure 5 - IDEF0 description of patient treatment in the hospital department. The stage of discharge or closing the medical history itself (Figure 6) includes the doctor making a decision on discharge, drawing up a discharge summary and, if necessary, a sick leave certificate, as well as issuing 20
21 recommendations for further treatment, lifestyle, etc. Based on the results of the patient’s stay in the hospital and on the basis of the total calculation of the cost of medical services provided to him (including the cost of medications and medical products consumed during treatment), an invoice register for the medical care provided is generated, presented by the medical institution to the insurance medical organization. Figure 6 - IDEF0 description of the process of closing a medical history. Another standard of the IDEF family is the IDEF1 methodology, which allows you to model information flows occurring within the system, display and analyze their structure and relationships. The result of its application is an information model that represents the structure of the information necessary to support the functions of the production system or environment (Figure 7). 21
22 Figure 7 - Scheme of hospital information flows 22
23 4 MODELING AND DEVELOPMENT OF A DB FOR THE PATIENT ACCOUNTING SYSTEM 4.1 Creating a logical model of a dental clinic To create a business process model, we use the CA ERWIN process modeller r7.3 program. The key business process of the designed system is the process of automating the registration of a dental clinic. The subject of the business process is “Registration of a dental clinic.” The appropriate data is received as input: a database of applications. DB of the duty doctor's work schedule. DB of clinic services and prices. Picture with code (to protect against automatic access) The control is: DB Server The mechanisms for executing the process are: System Client The output is: Application number Price list Updated DB Based on this model, the main diagram IDEF0 is presented in Figure 8. 23
24 Figure 8 Diagram IDEF0 “Informatization of the registry in a dental clinic.” The leading business functions of the process of “Automation of the registration of a dental clinic” will be. 1. Make an appointment. 2. Application editor. 3. Withdrawal of the application. 4. Table of prices and services. 5. Entering data into the database. A more complete diagram of IDEF0 “Informatization of the registry in a dental clinic” is presented in Figure 9. 24
25 Figure 9 Complete diagram IDEF0 “Informatization of the dental registry.” In turn, these business functions, such as “Making an appointment”, “Editing an application” and “Entering data into the database” are decomposed even higher. A diagram with a decomposition of the business functions “Make an appointment”, “Edit an application”, “Entering data into the database” is presented in Figures 10, 11, 12, respectively. Figure 10 Making an appointment 25
26 Figure 11 Edit application Figure 12 Enter database 26
27 4.2 Software implementation The patient can perform certain actions in relation to the information system: “Make an appointment”, “Edit an application”, “Submit an application”, “Price list”. The main window of the program is shown in Figure 13. Figure 13 The main window of the program “Registration of a dental clinic” Window “Make an Appointment” In the “Make an Appointment” window, the registrar sends a request to the database server. When the registrar presses the “Make an Appointment” button, the following algorithm occurs: 1. The system opens the “Make an Appointment” window. 2. The registrar enters the name. 3. The registrar enters the name. 4. The registrar enters the passport number. 5. The registrar selects the appointment date from the drop-down list. 6. The registrar selects the reception time from the drop-down list. 7. The registrar clicks on the “Done” button. 27
28 8. The system enters information about the patient into the database. 9. The system returns the application number. The “Make an appointment” window is shown on the screen in Figure 14 Figure 14. window of the “Make an appointment” program If everything is entered, the system will send the application number. Option for selecting the “Edit application” window In this window, the registrar can change the date and time of the appointment with the doctor. When the registrar clicks on the “Edit Application” button in the main program window, the following algorithm begins to execute: 1. The system opens the “Edit Application” window. 2. The registrar enters the application number. 3. The registrar enters the passport number. 4. The registrar selects a new appointment date from the drop-down list. 5. The registrar selects a new appointment time from the drop-down list. 6. The registrar presses the “Done” button. 28
29 7. The system updates the database 8. The system closes the “Edit request” window and goes to the main window. If, when entering your data, the registrar entered an incorrect passport number, the system will display an error. On the screen, the “Edit Application” window is shown in Figure 15. Figure 15. - “Editing Application” window Selecting the “Withdraw Application” window. This is where the doctor's appointment is deleted. After clicking on the “Withdraw application” button, the following algorithm occurs. 1. The system opens the “Request Withdrawal” window. 2. The registrar enters the application number. 3. The registrar enters the passport number. 4. The registrar presses the “Done” button. 29
30 5. The system saves changes to the database. 6. The system closes the “Request Withdrawal” window and goes to the main window. The system will generate an error if the registrar enters an incorrect application number or an incorrect passport number. If everything is done correctly, the system will display a message with the text “the application has been deleted, the changes have been saved.” On the screen, the “Request Withdrawal” window is shown in Figure 16 Figure 16. “Application Withdrawal” window Selecting the “Price List” button The price list window displays information about services and their prices in the dental clinic. Algorithm for performing the action of the “Price List” button: 1. The system opens the “Clinic Price List” window. 2. The system displays a list of services and their prices. On the screen of the “Clinic Price List” window is shown in the figure
31 Figure 17. Price list 31
32 CONCLUSION As a result of this final qualifying work, an information system for a dental clinic was designed. 32
33 REFERENCES 1. Sheer A.V. Business processes. Basic concepts. Theory. Methods / August-Wilhelm Scheer; lane from English Mikhailova N.A.; edited by Kamenova M.S., Gromov A.I. M.: VestMetaTechnology, p. 2. Berseneva E.A. Introduction of a comprehensive automated information system implemented using Workflow technology as an integral stage in the development of a medical institution / Berseneva E.A., Golukhov G.N. // Doctor and information technology S Vozny A.V. Prospects for improving orthopedic dental care for the population of the region / Vozny A.V., Dolgintsev V.I., Semenyuk V.M. Tyumen: Mandr i K, p. 4. Quality management [Electronic resource] - MODELING OF BUSINESS PROCESSES: - Cap. from the screen. language rus 5. Reengineering [Electronic resource] - Analysis of modern business process modeling tools: - Cap. from the screen. language rus 6. Welling L., Thomson L. Development of Web applications using PHP and MySQL, 3rd ed.: Per. from English M.: “Williams”, p. 33
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ORGANIZATION OF WORK OF A SURGICAL DENTAL HOSPITAL
In accordance with the adopted structure of treatment and preventive institutions, dental inpatient departments are organized in republican, regional, regional hospitals with an average of 0.3 beds per 10,000 population with a capacity of up to 30-50 beds. In cities of republican subordination, industrial centers and cities with regional divisions, up to 10 beds are allocated in a surgical hospital at one of the city hospitals for the hospitalization of surgical dental patients. In cities that are regional centers, 5 beds are allocated in central regional hospitals for inpatient treatment of dental patients.
In surgical dental hospitals (regional hospital), about 20% of all patients are children and about 20% are residents of rural areas. Up to 30% of the total composition are patients with inflammatory diseases, up to 25% - with facial trauma, up to 17% - with tumors of the maxillofacial region, 6% - with congenital facial clefts. About 8% of patients require various reconstructive surgeries related to the correction of various deformities of the face and jaws.
The population of maxillofacial patients is diverse, and surgical interventions are specific features. Along with plastic surgeries that require special asepsis, extensive interventions are performed for malignant neoplasms. The opening of phlegmon and purulent leaks leads to contamination with highly virulent microorganisms. All this creates certain requirements for planning the surgical block.
The operating and dressing unit in hospitals with 40 beds includes a complex of premises for planned aseptic operations in relation to a standard design of a surgical (burn) department with 40 beds.
The specificity of patients being treated in a dental hospital and the unique nature of surgical interventions require an operating and dressing unit for purulent operations: a small operating room for purulent operations (extensive jaw cysts, sequestrectomies, maxillary sinusotomies, operations in the oral cavity, etc.) on the same table with the preoperative and sterilization.
The dressing room for purulent dressings must have a separate entrance outside the operating unit; it is designed for one table and a dental chair.
In the operating room of a surgical dental hospital, in addition to the usual equipment, anesthesia and other equipment necessary for any operating room, there must be special equipment and instruments for operations in the maxillofacial area.
Special equipment and instruments for operations
I. Apparatuses and devices
1. Apparatus for extraoral fixation of fragments of the lower jaw.
2. Electric drill for inserting metal spokes into the jaw bone CO-2.
3. Surgical dental drill BPHS-1.
4. Surgical suction device with electric drive for voltage 220 V (OX-2).
5. “Electronic knife” device (EN-57) with oncology, ENT and cosmetic sets.
6. Apparatus for cutting skin grafts (dermatome).
7. Apparatus for extraoral reposition, fixation of fragments of the lower and upper jaws (according to Zbarzh).
II. Operating room instruments
1. Set of instruments for biopsy of the oral mucosa.
2. A set of instruments for radical uranoplasty.
3. Set of instruments for tracheotomy.
4. A set of instruments for the study and treatment of the ducts of the salivary glands.
5. A set of tools for removing teeth in children.
6. Protective heads for circular saws and separating discs with sliding sectors (No. 1, 2).
7. Circular saws (5 sizes) for the drill.
8. Hook for realigning the zygomatic arch.
9. Extraoral fixator for mandibular fragments for children.
10. Forceps for realigning the zygomatic bone.
11. Single-prong bone hook.
12. Forceps for removing teeth on the upper and lower jaw (for adults).
13. Nasal corrector for fractures and displacements.
14. Fluted, flat chisels (sets).
15. Language guides for adults and children.
16. Vojacek's chisel.
17. Raspators of different sizes, straight and curved.
18. Sharp spoons of different sizes (set).
19. Mosquito-type hemostatic clamps, straight and curved.
20. Mouth retractor.
21. Saw Jigli.
22. Sequestral forceps, straight and curved.
23. Bone forceps-nippers with round jaws, straight and curved.
24. Kostechka or Kerger needles.
In addition, there must be a sufficient number of tools provided for in the report card.
In the operating room, an “Operational Journal” is kept, which is the main document reflecting the work of the surgical dressing unit. Based on it, annual reports are drawn up, scientific development is carried out, etc. The journal is filled out in the form: serial number, date of admission of the patient, last name, first name, patronymic, age, diagnosis, date of operation and its name, brief description, biopsy data, discharge date and outcome, signatures of the surgeon and assistant. Cleaning the room is very important in operating rooms. Small wet cleaning is carried out daily and large cleaning (mechanical and chemical) is carried out once a month. During work, the staff monitors the sanitary condition of the operating room and dressing room and cleans it as it gets dirty.
In dressing rooms, in addition to a dental chair, a table for dressings and non-special surgical equipment, it is advisable to provide a portable anesthesia machine of the Autonarcon S-1 type for pain relief during some painful dressings and minor operations. In the dressing room for aseptic dressings, they also provide emergency care in case of injury, perform primary surgical treatment of fresh wounds, treatment of facial burns, splinting for jaw fractures, etc. To do this, on a special table covered with sterile material, the necessary instruments and materials are selected (aluminum wire, crampon tongs, etc.). In the dressing room for purulent dressings, emergency care is provided for inflammatory diseases (opening of phlegmons), for asphyxia - tracheotomy, etc.
In the hospital's dental office with an area of 14 m2, equipped with a dental chair and a UNIT unit, the oral cavity is sanitized before surgery, splints, obturators or temporary orthopedic devices are made (depending on the nature of the upcoming operation). After the operation, patients are made with prosthetics or devices to fill or replace defects in the maxillofacial area, etc. To perform dental work, you can use the laboratory of a regional or city dental clinic, which has 1-2 dental technician positions at the expense of the hospital staff. Depending on the setting, the dental laboratory may be located in a hospital that houses an inpatient unit. A dental hospital should have an irrigation room for oral care, since most hospital patients need systematic rinsing of the oral cavity. It consists of special boxed rooms equipped with washbasins, separated for men and women. This procedure is performed by the patient himself. It uses a 0.1% solution of potassium permanganate, which is supplied through a flexible hose with a sterile tip from a special reservoir.
An important objective document in the treatment of dental patients with surgical diseases are photographs of the face before and after surgery, as well as at the stages of treatment. In this regard, in addition to the indicated units, the department organizes photo laboratories and a museum where photographs, dummies, preparations, albums, etc. are stored.
In dental surgical hospitals, where patients of different ages and the nature of the disease are treated, the profiling of wards becomes important. Wards for children should be organized separately from adults. It is advisable to have wards for trauma, oncology patients and patients admitted for reconstructive operations, as well as wards for patients with acute inflammatory processes.
As in every surgical hospital, it is necessary to allocate wards for severe postoperative patients, wards for intensive care (resuscitation rooms), if the hospital does not have an intensive care unit.
The head of the surgical dental hospital systematically analyzes the performance indicators of the department, conducts advisory work in the hospital-polyclinic association, takes part in the improvement and advanced training of surgeons, traumatologists, and local hospital doctors on emergency dental care, early diagnosis precancerous conditions and tumors of the maxillofacial area, etc.
Slide 2
PLAN:
1. Features of modern business models dental clinics. 2. Modern features of the demand for dental services. 3. Specifics of organizing the work of a new dental enterprise. 2
Slide 3
1.Features of modern business models
There are several most difficult and important stages in building a private dental business - choosing a business model for a dental clinic, finding the “highlights” in the types of services, building customer service, and developing a promotion program. A huge selection of dental equipment and materials also creates certain difficulties for the clinic owner - should he trust the advice of practicing dentists or listen to the opinion of specialist technologists? 3
Slide 4
Serious requirements of supervisory authorities impose special responsibility on the design of a dental clinic - common sense and economic calculations, which require that every square meter generate as much revenue as possible, interfere with the requirements of the SES, forcing the allocation of auxiliary areas that do not generate income - a sterilization room, a staff rest room, additional bathrooms, etc. 4
Slide 5
The process of creating and promoting a dental clinic is the most difficult and responsible period, which often becomes not only a joyful event for the owner, but is also accompanied by a huge number of questions and problems. It is at the first stage that most mistakes are made, which subsequently hurt the investor’s wallet. How to choose the right premises, how to design a clinic so that every meter of space generates income, how to choose those services that are in demand by patients and the prices that bring maximum profit, how to select a professional team, how to go through the grindstone of obtaining permits, how to promote a clinic - with Every beginner faces these and many other questions when creating a dental business. 5
Slide 6
6 A profitable dental institution can be created only with the preliminary detailed and professional development of its project, with the calculation of a business plan, finding highlights in the range of services, with the competent selection of equipment, with the construction of a business model that is as independent as possible from the staff, with the creation of a special emotional atmosphere customer-oriented service that could not be copied.
Slide 7
How to create a dental clinic and how to promote it? Familiarization with the proposed materials provides answers to general questions about creating a dental business. But conditions are changing, the number of clinics created by talented entrepreneurs and newcomers is growing, bringing something new to this business. More and more new “flavors” are appearing - in the types of services, in providing them to clients, new types of materials and equipment are appearing, management procedures are being improved, and requirements for the organization of customer service are growing.
Slide 8
Dental practice is historically one of the oldest areas of medical business. The dental business is based on a very stable demand - a person has many teeth, and when at least one of them hurts, anyone is ready to give everything they have to get rid of the misfortune. 8
Slide 9
The creation of each clinic takes into account the best domestic and foreign experience in building a medical business, using the so-called “technology of success.” This is not only equipping the clinic with proven equipment, techniques and personnel, but also using effective management, marketing and quality assurance techniques, i.e. building a dental clinic not only as a health care institution, but above all, as a successful client-oriented business in the field of medicine. 9
Slide 10
10 The concept of any dental business is based on the following chain of actions: 1. The client base and competitive environment in the area where our clinic is located are studied. Conclusions are drawn about the level of the future clinic and the range and ratio of various services that are different from competitors and adjusted to local needs - in demand and capable of bringing commercial success in the area. 2. Positioning is formulated and patients’ perception of the clinic is formed. 3. A legend, corporate identity and design of the clinic are being developed. 4. Competitive differences and advantages for services are determined. 5. Competitive differences and advantages in customer service are determined.
Slide 11
11 6. For the selected level of the clinic and set of services, a room layout is developed and technologies for performing services are selected, as well as recommended prices with which you can enter the market. Competitive differentiation is being created in terms of technologies and prices used. 7. Equipment and consumables that have the necessary and sufficient parameters to ensure the required level of quality of treatment are selected for the technology. Calculations of economic indicators are made. 8. A design, requirements for personnel qualifications, and internal documentation are developed for the selected level and equipment of the dental clinic.
Slide 12
12 Practice has shown that newbie entrepreneurs are looking for a doctor as an assistant, who is completely trusted with the creation of a clinic, the selection of equipment, personnel, and, worst of all, the development of a price list. As a result, no matter how good the doctor may be, the clinic is initially built primarily as a medical institution, and not as a business. To avoid such a distortion, it is better for an entrepreneur to set up a business and manage it himself, trusting doctors only with the treatment process.
Slide 13
13 Taxation. Having the form of ownership of an LLC or individual entrepreneur, you can be a payer under the simplified taxation system (STS). Obtaining a license is the most difficult stage when opening a dental office: impeccable fulfillment of all SES requirements is necessary. It is necessary to have certificates for the installed equipment, personal medical records of workers, copies of documents on their education and qualifications. Everything in the office should be arranged according to the BTI plan. compliance
Slide 14
A license allows you to engage in a certain type of medical activity. Therapy, surgery, orthodontics and other types of services are declared separately. The licensing authority makes a decision to grant a license within a period not exceeding 45 days from the date of receipt of the application, and does not have the right to require documents other than those specified in the Federal Law “On Licensing of Certain Types of Activities”. 14
Slide 15
2. MODERN FEATURES OF DEMAND FOR DENTAL SERVICES Dental problems among the population have increased due to poor ecology, increased consumption of sweets and natural laziness of Russians, manifested in irregular teeth brushing. Rather, with the growth of the middle stratum of Russians, whose standard of living is approaching Western standards, patients’ demands for the quality of treatment and service are growing. Traditionally, going to the dentist is associated with terrible pain, so today's patients prefer to pay more to be greeted friendly, reassured, given a cup of coffee or a glass of juice in a cozy atmosphere, asked about life, and only then get down to business. 15
Slide 16
The modern patient is more educated and often asks the doctor a proactive question: “What are you actually going to do in my mouth?” Knows that there are modern “soft” impression materials. Such a patient, upon seeing a dentist mixing plaster, can easily turn around and leave. Many patients already know what a visiograph is, and do not want to be irradiated in the old-fashioned way with X-ray machines from ancient times. The same applies to equipment - after lying in a comfortable Castellini chair once, the patient is unlikely to want anything else. 16
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The public sector is still staying afloat only because doctors earn extra money in such clinics unofficially, “for their own pockets.” In such clinics they work on outdated, worn-out equipment, which no one is going to update. The quality of such services can only be tolerated by those hardened by times of scarcity. 17
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The private sector is represented by three categories: Large clinics (sometimes with a branch network), where, no matter how you hide them, the costs of the flow system still appear, such as interest rates, doctors’ struggle for patients, and high turnover of staff. As a result of the impersonality of the appointment, the patient sometimes does not even remember the doctor’s last name, but the consequences of errors and flaws in treatment or service are easily spread to the entire clinic. Mini and micro clinics, or rather dental offices, where the owner himself works. Here patients go not to the brand, but to the name of the doctor who is responsible for everything. The quality of services here is higher, because if you make a mistake you will be left without a clientele. But, alas, such mini-salons, on the one hand, are very vulnerable (sometimes they operate without proper documentation, which is time-consuming and expensive to collect), and besides, they offer patients a very limited range of services - such offices cannot afford a variety of equipment, and there is nowhere to put it. The fastest growing system is of small private clinics with three or four chairs. This is the most promising direction, since in such a clinic, on the one hand, there is an individual approach to the client, and on the other, the range of services and profitability are higher than that of private offices. It is not for nothing, apparently, that the system of such small dental clinics dominates throughout the entire civilized world. 18
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3. Specifics of organizing the work of a new dental enterprise
19 The medical services market, according to experts, is growing at least 20% per year. On average, one city dweller spends one thousand rubles a year on dental health. Whereas, according to the calculations of insurance companies, one patient needs approximately 100 euros for rehabilitation, or complete treatment. This means that the market is still at the stage of growth and saturation. Change will be required to grow the market legislative framework, in particular in the field of health insurance. It is difficult to say today whether they will be implemented.
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Today, the dental services market is in a state of relative stability. The increase in prices in all previous years was due to an increase in the country's cash supply and the strengthening of the ruble. The clinics passed on rising costs (due to the growth of the euro, since the main suppliers of consumables are European companies) to the buyers of services. As a result, the growth in effective demand was offset by rising prices for dental services, which led to the “fixation” of the market at a different, higher price level with unchanged volumes. 20
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Rising prices have changed the price/quality ratio of dental services. Being forced to pay increased prices for treatment, consumers began to pay more attention to the range (breadth) of services offered and the level of service. The one who solves these two strategic tasks today when building a dental business will win the competitive competition for the consumer. This circumstance will determine the direction of development of the dental market in the near future, and it is this that imposes on newcomers the task of approaching the creation of a new generation of dental business - different from most of today's dentistry 21
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Cleanliness, tidiness, modern equipment, and the presence of qualified personnel alone are not enough to build a successful dental business. What's the point if you perfect the treatment process with an A, if only one and a half diggers will come to vote with their wallets for your efforts? When approaching the creation of a clinic, it is primarily viewed today not as a place where they help people get rid of dental diseases, but as an organizational structure designed to make money. Such a cynical monetarist approach can cure any newcomer from naive desires to invest everything without a trace in “the best clinic in the city, where the best doctors in the city work.” In any science there is a rule of necessary and sufficient conditions. 22
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Building a decent treatment process is a necessary condition for creating a modern dental business. But not enough. Compliance with SES standards during design is the same necessary condition, but also insufficient. We call sufficient only those conditions that are directly related to the generation of financial flows and profit. 23
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7. Contract management subsystem. Maintaining a register of external organizations. Preparation, coordination and maintenance of contracts. Planning and control of work execution under contracts. Maintaining reports on contracts. 8. Personnel management subsystem. Maintaining the organizational structure of the CO, personnel data (according to form T2) about employees, doctors and medical personnel. Maintain information about employee training, experience and competencies. Management of training and retraining of personnel. Maintaining personnel records. To calculate salaries, an interface with common external systems is used. 9. Intellectual capital management subsystem. Structuring, assessment and monitoring of intellectual capital in joint ventures. Planning for the development of intellectual capital. Accumulation and use of knowledge (best practices) in information science. Analysis and acquisition competitive advantages from the use of intellectual capital. 10. Financial management subsystem. An interface with common external accounting and management accounting and calculation systems is used wages etc. 25
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In the treatment process, there are eight main types of services, which it is advisable to all accommodate under the roof of the clinic: 1. reception and consultations; functional diagnostics; 2. therapeutic dentistry (treatment of caries, pulpitis, periodontitis, diseases of the oral mucosa), 3. therapeutic periodontology and conservative treatment of periodontitis and chronic periodontal disease; 4. surgical dentistry (tooth extraction, treatment of purulent-inflammatory diseases of the oral cavity, surgical methods for the treatment of periodontal tissue diseases, excision of benign tumors, etc.); physiotherapy; anesthesia; 5. teeth whitening, removal of tartar, smoker’s plaque, etc. 6. orthopedic treatment of dental defects, preparation for prosthetics, implantology, patient preparation for implantation; 7. orthodontics (treatment of dental anomalies), treatment of congenital defects of the maxillofacial area, including defects acquired as a result of injuries or early diseases; 8. pediatric dentistry; 26
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Today, only every fifth clinic provides its clients with all of the listed types of dental services. And market development trends and marketing surveys of patients indicate that a good clinic provides a full range of services and good customer service. One of the main trends in the dental services market is the consolidation of formats. There are quite a lot of offices in the city with only one equipped dentist position. In such medical institutions there is no possibility of even X-ray diagnostics, not to mention some more complex medical procedures. A promising direction for dental clinics will be not narrow specialization, but expansion of the range of services and universalization. 27
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There is a tendency to create conglomerates - bringing together diverse participants to create a single offer. For example, consolidation of dental and general medical clinics, cooperation of diagnostic centers and clinics providing services, say, in the field of reproductive health. It is assumed that with the development of this process, it is possible to create multi-brand platforms where the client can receive a full range of health services. 28
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29 Why multi-brand platforms and not multi-disciplinary medical centers? Because it is difficult to cover all medical services under one roof and equally successfully organize work in different industries medicine. Because in the end, the issue of quality will inevitably arise; one way or another, there will be a division into priority areas and related ones. But the client does not want to receive some service; he needs each product to meet a certain, fairly high level.
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30 What can be called the locomotive in our field? In dentistry, dental implantation has the greatest potential. This service will soon take a leading position in demand among patients. And although today many people view this service with some caution, in my opinion, the demand for it will actively grow. According to statistics, the majority of the adult population requires restoration of one or more teeth. Today, implantation is the most natural way to replace lost teeth.
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31 How is the balance of power in the market changing? What are the reasons for this? The experience of the clinics shows that no new major players have appeared in the dental services market. The composition of companies actively participating in the promotion remains the same. The battle for market shares will continue in this sector. The attractiveness of the market for new companies has decreased somewhat. The reasons for this are the high entrance fee (costs of equipment, premises, personnel search), difficult market conditions and personnel costs. In general, human resources have become more expensive, costs for medical specialists amount to an average of 50%, which is a lot.
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32 Organizational difficulties are increasing: the procedure for licensing activities has changed, licensing of quality assessment in dentistry and new labor protection rules are being introduced. Today, companies are recommended to follow the path of service standardization. The organization must have a quality and standardization service, and internal and external training for doctors and contact staff must be regularly conducted. Companies must set a goal: providing the full cycle of outpatient dental care, and move towards achieving it. In the near future, the range of services will be complemented by the possibility of placement in a hospital, and in the first half, patients of the clinics will be able to undergo dental treatment under general anesthesia.
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THANK YOU FOR YOUR ATTENTION 33
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