What is the industry standat of ceramic production?

[odchamp]

RKM, charming comments! I am only stating that if the prices were fixed you are only competing on service and quality, it's not what I am advocating just stating a fact.
Before you start accusing me of lowering my prices and standards please can you point out where i said this? I will be carrying on as i am because i can afford to, but some technicians may not be so lucky and have mouths to feed, and mortgages to pay, and why do you assume standards will fall if a tech lowers their prices, i have always done the best work i can do regardless of price, and just cannot do bad work because of the price i may have been charging.
As far as raising the bar goes, i am all the time looking for ways to improve the service and new technological advancements to my clients, nothing to do with price.
I am not a Communist, just a realist!

 

[rkm rdt]

I'm not accusing you of lowering your prices.I'm accusing you of wanting to lower my prices!

I'm not accusing you of being a communist,I'm accusing you of thinking like a socialist!

 

[dmonwaxa]

I'm not accusing you of lowering your prices.I'm accusing you of wanting to lower my prices!

I'm not accusing you of being a communist,I'm accusing you of thinking like a socialist!

Very funny

 

[odchamp]

rkm, beore you start a linking me to Lenin,Trotsky, and the socialist workers party, please look up the meaning of advocate.

yours

K, Marx

 

[Mark Jackson]

I feel for my American counterparts here.I think I am benefitting from a separation of the lab fees from the dentist fees to the patient
I think if you could somehow lobby the insurance companies to demand separate billing you would be in a better position.

So then the patient can shop around for the cheapest lab, and then the dentist is required to put in crap work, or lose the patient as a customer? Or a patient wants a really high quality crown, so they call around and find the most expensive lab (who may actually send to China?).

I don't think the patient is a qualified buyer, and I think the restoration should be for sale only to a licensed dentist. If the dentist is actually controlling everything, and the patient is simply being asked to make TWO credit card transactions to pay for a service that should only require ONE transaction, it is simply buearucratic red tape and a nusiance to everyone.

All I see is a point of contention and conflict between the dentist and the patient and an opportunity for meddling and time wasted explaining to patients the nuances of dental technology.

Oh, and 15 units a day is perfectly acceptable to make a high quality restoration the old fashioned stacking way. With pressables even more.

 

[rkm rdt]

Why would there be 2 transactions?

Are your 59 dollar crowns crap? They certainly are cheap.

Why do you have such disrgard for the patient?

 

[Mark Jackson]

Why would there be 2 transactions?

Are your 59 dollar crowns crap? They certainly are cheap.

Why do you have such disrgard for the patient?

You said the patient is invoiced seperately for the crown. If you simply mean that the dentist must itemize the cost of the drown, you need to be more clear, and I highly doubt they would show the real price. Ever stay at the hospital? Do you really think they paid $85 for an aspirin?

I don't sell crowns for $59, except as part of a coupon promotion. I lose money on every one I do at the price.

My business practices reflect the utmost concern for quality, consistency and patient safety. I am a firm believer that we must operate in as efficient a manner possible, and while I believe the patient is the end user, I don't think the price the dentist paid is as important as knowing WHAT they bought, and WHERE it came from.

 

[Hal2a]

In a system where the lab fee is separate, the dentist is still the one who decides where the cases go. Also the dentist can't mark up the lab fee. Having said that, we still have labs that want to give there work away for nothing and it can make it a challenge to maintain a fair fee schedule.

 

[paulg100]

sorry to disagree mark but 15 quality crowns a day from metal/ceramic frame to finish is rubbish.

we were up to a 25 man lab at one point and i am now running a high end satellite site for the company at my brothers practice so i have experience from both a production lab and high end bespoke, and you cannot put out a clinically sound crown at that production rate.

Even with our guys producing 12 units a day, i constantly have to patch up margins and contacts and adjust occlusion, when i get stuff from the Larger site.

I'm fully aware of what i was putting out myself when doing those numbers and to be frank it was shocking.

I guess it depends what your definition of quality is.

Edit: That sort of output is what gives credibility to the argument that CEREC units put out better restorations than dental labs!

 

[rkm rdt]

Well said Hal2a,

I apologize for not explaining it as well.

If the dentist wants to show an inflated lab price I would imagine he runs the risk of insurance fraud.

We pay for our other health care costs(ie hospital stays) thru our taxes.

By the way I don't think your work is crap.

 

[Al.]

sorry to disagree mark but 15 quality crowns a day from metal/ceramic frame to finish is rubbish.

we were up to a 25 man lab at one point and i am now running a high end satellite site for the company at my brothers practice so i have experience from both a production lab and high end bespoke, and you cannot put out a clinically sound crown at that production rate.

Even with our guys producing 12 units a day, i constantly have to patch up margins and contacts and adjust occlusion, when i get stuff from the Larger site.

I'm fully aware of what i was putting out myself when doing those numbers and to be frank it was shocking.

I guess it depends what your definition of quality is.

Edit: That sort of output is what gives credibility to the argument that CEREC units put out better restorations than dental labs!

15 units a day of pfms is alot of work.

If I had to opaque, do a few porc shoulders, build, grind in, 2nd bakes, slick up, glaze, put on solid models, its overtime for me.

If I had to match any pics, then forget it.

If somebody else opaqued, did the shoulders when needed, and glazed, that would help.

 

[Mark Jackson]

15 units a day of pfms is alot of work.
If somebody else opaqued, did the shoulders when needed, and glazed, that would help.

The context of this coversation was build and grind. Opaque, shoulders and S&G are done seperately.

I think it's a reasonable amount of work, and I see the quality we put out, and since our prices are above the national average, I can only attribute our growth to exceeding customer expectations.

Not every technician can match those numbers, and I don't want the ones who can't. They are paid extremely well, have great benefits and a pleasant work environment. Sometimes I have to bring them from out of state, but if that's what it takes to find productive people who can do the kind of work I expect, it's no big deal. You can't always build a dream team from the local farm league.

BTW, they are given the same amount of time to do a PFG with a metal occlusal, so there is a cushion built in for more complicated cases. I'm not in business to build up little monuments to my ego. I'm in business to make money, otherwise I'd go work for the Peace Corps.

I'm sure you can all understand that.

 

[Al.]

The context of this coversation was build and grind. Opaque, shoulders and S&G are done seperately.

I think it's a reasonable amount of work, and I see the quality we put out, and since our prices are above the national average, I can only attribute our growth to exceeding customer expectations.

Not every technician can match those numbers, and I don't want the ones who can't. They are paid extremely well, have great benefits and a pleasant work environment. Sometimes I have to bring them from out of state, but if that's what it takes to find productive people who can do the kind of work I expect, it's no big deal. You can't always build a dream team from the local farm league.

BTW, they are given the same amount of time to do a PFG with a metal occlusal, so there is a cushion built in for more complicated cases. I'm not in business to build up little monuments to my ego. I'm in business to make money, otherwise I'd go work for the Peace Corps.

I'm sure you can all understand that.

Opaquing, porc shoulders, staing and polishing bands and sandblasting the inside of crowns is time consuming.

Small talk and interruptions really cut into time.

If a person can come in and take 20 min to organize cases by shade, mix all
the powders in a large wet tray, you can have everyting built and fired by 11.

You can have all the contacts ground in by 11:30 and the occ by noon or lunch break.

After lunch I think 1 1/2 hour to 2 max for addons that inludes 3 bakes for bridges.

That leaves 2 hours to contour, and if your contours are done in your build up its simple.

Thats a busy day but not particularly stressfull.

It requires few interuptions, no chit chat and no technique problems like bubbles and cracks.

 

[Mark Jackson]

Opaquing, porc shoulders, staing and polishing bands and sandblasting the inside of crowns is time consuming.

Small talk and interruptions really cut into time.

If a person can come in and take 20 min to organize cases by shade, mix all
the powders in a large wet tray, you can have everyting built and fired by 11.

You can have all the contacts ground in by 11:30 and the occ by noon or lunch break.

After lunch I think 1 1/2 hour to 2 max for addons that inludes 3 bakes for bridges.

That leaves 2 hours to contour, and if your contours are done in your build up its simple.

Thats a busy day but not particularly stressfull.

It requires few interuptions, no chit chat and no technique problems like bubbles and cracks.

EXACTLY AL!

That's what always cracks me up about lab owners who are so full of themselves, and say they only do six units a day, therefore, my technicians must produce crap.

They cannot compare running a small business, with all the inherent interuptions, phone calls, other tasks and busy work, with someone, who comes in, already has the work sitting on their desk opaqued and the coffee pot steaming. Most of them sit down, put on some headphones and get to work. My lab is as quiet as a library most of the time.

FDA GMP's, not mixing and matching materials, having equipment that is properly maintained and calibrated, and materials that are fresh, clean and dispensed daily mean we have very few complications. Manufacturing that runs like a Swiss watch.

If you cannot measure, you cannot manage. Every job has a time limit.

 

[paulg100]

"The context of this coversation was build and grind."

Well thats somewhat more realistic.

Still, if you want "High Quality work" then my personal opinion is that the tech does each case from start to finish all the way through. Sadly this is not a cost effect method of working and theres only a few percentage of Dr's that are willing to pay for it.

 

[Al.]

Mark I had a real eye opening when I spent time at Mike McCanns lab in Fl.

I went from spending the day running the business and trying to produce crowns on the side, to producing.

I saw his waxers do 40 and 50 units a day without killing themselves.

But all they did was wax, no die prep. Their dip pot was already on for them before they came to work.

He had 2 vietnamese (SP) girls that built only, they would build 40 to 50 units per day and add on for the grinders.

They were little machines. They built blocks though and refused to change their build up technique because they were on peice work.

An opaquer came in the evening and washed the dies and opaqued.

But I took their techniques of doing everyting in groups and working by the week rather than the day and doubled to tripled my production.

The great thing is now I deliver or mail everything on Mon. All the Drs get their weeks seats on Mon. (local) or Tues (mailer Drs).
My phone quit ringing, because 60% of my calls used to be sec's looking for tomorrows seats.

My wife does model work through out the week and has all the dies ready for me to trim by Fri. for next weeks work.

IMO if a 1 or 2 man operation is trying to produce X number of units per day their production is way below what it could be and their stress levels will be very high vs working by the week. Ive been there and done that.

 

[Mark Jackson]

Mark I had a real eye opening when I spent time at Mike McCanns lab in Fl.

I went from spending the day running the business and trying to produce crowns on the side, to producing.

I saw his waxers do 40 and 50 units a day without killing themselves.

But all they did was wax, no die prep. Their dip pot was already on for them before they came to work.

He had 2 vietnamese (SP) girls that built only, they would build 40 to 50 units per day and add on for the grinders.

They were little machines. They built blocks though and refused to change their build up technique because they were on peice work.

An opaquer came in the evening and washed the dies and opaqued.

But I took their techniques of doing everyting in groups and working by the week rather than the day and doubled to tripled my production.

The great thing is now I deliver or mail everything on Mon. All the Drs get their weeks seats on Mon. (local) or Tues (mailer Drs).
My phone quit ringing, because 60% of my calls used to be sec's looking for tomorrows seats.

My wife does model work through out the week and has all the dies ready for me to trim by Fri. for next weeks work.

IMO if a 1 or 2 man operation is trying to produce X number of units per day their production is way below what it could be and their stress levels will be very high vs working by the week. Ive been there and done that.

There is more than one way to skin a cat, and to believe that OUR way is the ONLY way, is a death sentence to any small business. I love visiting other labs, and I'm always changing and tweaking the money machine to squeeze out more productivity.

Have you seen Glidewells sprocket caster? That is a perfect example, of grabbing people from outside the industry and letting them solve problems.

 

[Al.]

"The context of this coversation was build and grind."

Well thats somewhat more realistic.

Still, if you want "High Quality work" then my personal opinion is that the tech does each case from start to finish all the way through. Sadly this is not a cost effect method of working and theres only a few percentage of Dr's that are willing to pay for it.

Yeah but your are talking about $250 + crowns. Photo quality crowns.

Ive been raising my prices for new Drs into the $250 + range and the work is coming in but its all anteriors and large cases.

Every Dr will get a couple of 10+ unit cases a year. Some get 3 or 4 a year.
And for these cases they are willing to pay 3 to 4 grand to have it done right the first time. They will send their gravy to cheaper labs.

Its hard to find these guys and it takes 10 or 12 of them to have the larger cases come in on a regular basis, But the $ add up pretty quick if 2 or 3 of them come in a month.

 

[JohnWilson]

Yeah but your are talking about $250 + crowns. Photo quality crowns.

Ive been raising my prices for new Drs into the $250 + range and the work is coming in but its all anteriors and large cases.

Every Dr will get a couple of 10+ unit cases a year. Some get 3 or 4 a year.
And for these cases they are willing to pay 3 to 4 grand to have it done right the first time. They will send their gravy to cheaper labs.
Its hard to find these guys and it takes 10 or 12 of them to have the larger cases come in on a regular basis, But the $ add up pretty quick if 2 or 3 of them come in a month.

These two statements are so true AL, my lab has always worked on this model but it was the "Gravy" work that filled the holes in the big case schedule. Now as single unit prices plummet its time to rethink where our profit center is. We all like to be the hero's that take FMR cases and hit home runs and be appreciated for it. The compensation for those complicated cases has actually increased not decreased. The problem is the sheer number of these cases seem to be diminishing. As I have stated in the past Implants and fixed removable cases are the future for me, I just do not see a way to stay competitive in the quadrant dentistry market.

 

[rkm rdt]

John, why do you think single crown prices are plumetting and who do you think is responsible for that?