Dental Dow – First Half of 2014

statistics-in-dental-managementLooking at the data from the mature area practices sampled, we found that growth continues to be moderate with practice production up 3.2% and collections up 2.2%. The collections picture has improved a bit. The first quarter of this year collections were lagging at 83% and now they are up to 85% – I know this is nothing to brag about but, hey, it’s better than 83%! PPO write offs continue to dig into practice collections and profits.

Hygiene down time as a percentage of hygiene hours worked remained pretty consistent over the last three years at 12% of hours scheduled. That means that the average hygienist has about an hour open per day. So, every practice should have a discussion with their hygienists about what to do with that open time (Hint: It’s not just sharpening instruments and restocking rooms). We have a list of suggested Hygiene Downtime Priorities – just call if you’d like accopy.

New patients are up 7% with total patient flow up about 2.6%. To my surprise, there is not much happening with crown and bridge – it’s up just 1.7%. We have heard that more patients are saying “yes” as the economy peps up. We can’t prove it yet by the numbers though.

Production Collections 2014


(Advanced Practice Management’s Statistical Snapshot):

Our clients consistently tell us that one of the main things they rely on us for is our realistic frame of reference. So, below I have broken out Doctor and Hygiene production per hour by Outstate and Metro Area practices. The fee schedules are different and I’ve shown you a sample* of these just to help you have that frame of reference.

metro vs outstate stats

Statistics like this can be a little dangerous. If your hygienist’s production per hour is lower than average, don’t beat her over the head with the numbers! Through hard experience, I’ve found that you can’t appeal to your hygienist’s sense of statistics – for many of them, dollar amounts are an anathema to patient care. However, you can appeal to their sense of professionalism. Their production per hour is most determined by the range and depth of services they offer and provide. That’s why we are so big on examining and reasserting hygiene protocols once per year for everything from adult fluorides through perio to x-rays!

You can increase Doctor Production per Hour by addressing the following factors:

  1. Clinical Speed (usually not the most important)
  2. Staffing, Delegation and Teamwork
  3. Equipment, Technology and Facility
  4. Procedure Mix
  5. Scheduling/Appointment Book Control

It’s not enough to just post a goal on the wall and tell your staff to produce it. Work with them on the above factors to get more done each day. When it comes to your practice growth, there are three main approaches:

  1. Do more for the people you see.
  2. See more people.
  3. Do more per day!

Many Doctors hold off on equipment upgrades or facility expansions when usually they are very easy to cost benefit. Do you have a room that could be brought up to speed? Would it mean that you could see another operative visit or two per day? Then it’s almost certainly a better investment for you than anything in the stock market. So, take a little of your money out of the stock market and put it into your practice.

Then you can enjoy seeing your money put to work (and it will help you smooth out your days too).


Make sure that you are not duplicating efforts. Your staff is very capable of delivering pre- and post-operative instructions and doing co-diagnosis – delegate most everything that doesn’t require a Dental Degree!


Howard Farran’s famous line (to paraphrase) is, “Most Doctors are hung up on how far they are scheduled ahead. McDonald’s isn’t scheduled ahead very far and they do pretty good.” “Same Day Dentistry” is much discussed now in practice management circles.

I’ve never had an office say they didn’t do “Same-Day Dentistry.” But there is a difference between doing it and really doing it. We’ve seen this blossom best when the staff is incentivized and, otherwise, encouraged to “Git Er Done now.” This saves everyone a lot of work. Reappointing, reconfirming and so on.

Look at what you have scheduled for production at the beginning of the day. Challenge your staff – even after the inevitable cancellations and failures – that they end up with $500-$1,000 more done per day than was scheduled at the beginning of the day. It’s out there if you look for it! It’s easier to do if you have plenty of rooms and plenty of equipment. It also certainly helps if the hygienists can numb up patients and everyone is looking beyond their own column.

Even though I do not think daily goals should be worshipped, it certainly helps to have them. One of my favorite techniques is a “Weekly Review/Preview.” That is, having a set time each week where the Doctor and Assistants meet with the front desk staff (and whoever else is scheduling) and discuss what worked or didn’t work the previous week and then look ahead a week and make adjustments as necessary. Then you can really fine tune the schedule and scheduling in general). With the wisdom of hindsight, were there patients you could have treated last week if you were fully in the “Same-Day Dentistry” mode?

On average, another operative visit done per day means about $6,000 additional production per month – and most of that goes to your bottom line. So, it’s not how far you are booked out. It’s how much you do per day.