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On Monday morning, I found myself on a video conference call with Andy and Tom scheming and plotting about matters which were Academy based.

I wasn’t in the best shape.

Training had been going really well on the bike and I had done an epic ride the Friday previous with coach Simon and came back feeling like I could take on the world.

It was Saturday afternoon when the flu like symptoms hit and knocked me flat on my back for the rest of the weekend which continued into Monday; I only managed to surface to do the 2-hour conference call which we had all previously agreed to get together to do.

Did I feel like doing this? Did I not!

In these situations though, sometimes the greatest things happen. The meeting was fantastic (Tom is the master at organising and meeting planning). We were chatting about sinus grafting and the barrier that exist to block dentist’s paths into more complex procedures in implant dentistry.

So, as what tends to happen in these meetings (and Tom is there to keep Andy and I under control) we went off on a tangent to talk about this and how we could help people expand the practice in circumstances that are difficult.

In turns out (we believe) that indemnity in sinus grafting procedures is a massive barrier and for some people to take on sinus grafting indemnity will double their indemnity costs.

So, the guys who consider doing this count how many sinus grafts they’re going to do throughout the year (as an estimate) and add up the fees that they will get for them and see how it works against the increased indemnity costs.

This of course is a crazy approach to planning your implant education and service.

Incidentally it’s a crazy approach for indemnity companies to charge on as well.

Sinus grafting is a complex procedure in implant dentistry, that is well enough defined. Anterior implants are an advanced procedure, that too is pretty clearly defined.

Why not charge people based on whether they do straight forward, advanced or complex cases, surely the risks increase based on the complexity of the case?

Why not factor into that the number of implants people have placed?

From an individual’s point of view though, why not understand that the increase in the indemnity increases with the complex of the case.

When you’re good enough to provide sinus grafting for a case then you’re good enough to provide full arches and good enough to take on the more complex of cases which of course attract the greater fees, the higher turnover and the greater ability to pay a larger indemnity fee.

It also attracts greater risk, so that is fair.

Time and time again we speak to guys who say “it’s not worth my while paying for sinus grafting”, which is to say it’s not worth my while doing complex implant dentistry. Here is another approach that you might think about trying…

Why not set your fees at an appropriate level (using a sensible method for setting your fees)? 

Why not ignore anything that anybody else is charging and run your own business, why not do the work and see what happens?

Anybody who has done this in the past has done well.

Indemnity for sinus grafting is a business cost.  

Blog post number: 1560