The Most Important Measure of Dentist Efficiency

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1 This thread comes from the s of Dentaltown.com. Log on today to participate in this discussion and thousands more. The Most Important Measure of Dentist Efficiency Dentists have so many different practice styles and staff sizes. What is the best metric for comparison? Post: 1 of 105 Often here, we have discussion about different practice styles. Low overhead. High grossing. Complex procedures. Bread and butter. One dentist, three hygienists. One dentist, one hygienist. But from a business point of view, your bottom line is all that really matters. So how can you compare all these different practice styles? What is a common way to compare the efficiency of different styles of practice? Kevin Tighe Post: 3 of 105 Take your average monthly production or collections and divide that number by the number of staff you have. That will give you a baseline to start from. Then implement an effective staff training program. The baseline should steadily increase. You can apply this to any practice model. Post: 5 of 105 That s not a bad method. How do you compare a single dentist niche practice that only does short-term ortho with a large hygiene practice? Even though the niche practice might be much more efficient per staff member, the take-home pay might be less for the same hours worked. So in effect, the dentist in the hygiene-based practice might be using all those staff to make himself personally more efficient. Broken Dentist Post: 10 of 105 Production per hour depends on your fees and your insurance participation. So even if you can do efficient dentistry, production per hour can be low if your fees are low. Post: 15 of 105 I probably wouldn t care what practice type (GP everyday work vs. implant, etc.) or about much else, as long as I am able to net in the same hourly timeframe, in that $500K area. After that, it just wouldn t matter. browndawg Post: 16 of 105 I bet most Townies would change their style to net in the $550K area. This can t be the norm or I really missed the boat on this tooth fixing stuff. continued on page 28 26

2 TM practice management continued from page 26 Post: 18 of 105 I really didn t mean for that to be the point. The only point I was trying to make was who really cares how they do it whatever it is. If they do care, they need to make a change. If they don t, fine. There are all kinds out there, doing pretty much the same on a financial level. You will have extremes in just about everything. That doesn t mean anyone or everyone could or should be doing things in that same way. skuzma2dds Post: 19 of 105 From what I can tell... there are many practices with one full-time dentist, two assistants, two to three full-time hygienists and two full-time front desk staff that do $1-1.2 million with percent overhead ($500K range). This type seems to be the most predictable method for a dentist to net $ K. There s a handful of dentists on here who do more than $2 million with 55 percent overhead or so... netting about $1 million. Not many, but a few. Post: 23 of 105 If there is a procedure or a patient I really don t want to take on I don t do it. I m a single tooth kind of guy. I don t like the stress I feel when doing the full mouth or the big cosmetic cases. On the right person, with the right circumstances I might do the case, but I refer far more than I complete myself. The odd thing is by doing this; neither my production efficiency/overhead efficiency nor net efficiency has ever suffered. continued on page 30 Over 5,000 dental professionals trained from 46 states and 28 countries! BOTOX & DERMAL FILLER THERAPY For Every Dental Practice AMERICAN ACADEMY of FACIAL ESTHETICS TM Join today and save an extra $200 on tuition Featuring: Dr. Louis Malcmacher, Dr. Peter Harnois, and the faculty of the American Academy of Facial Esthetics Limited Attendance! Sign up before November 1 - save up to $500 plus bring a team member for free! Upcoming Courses: Oct Oct. 26 Oct. 28 Oct Nov. 4-5 Nov Nov Nov Dec. 2-3 Dec. 7-8 Dec AGD PACE CE Credits Orlando, FL Atlanta, GA (Botox Therapy) Phoenix, AZ (Botox Therapy) Philadelphia, PA Newark, NJ Detroit, MI Houston, TX Seattle, WA (Level I & II) Columbus, OH New York, NY (Level I & III) Ft. Lauderdale, FL 2012 dates can be found on our website! Save an additional $50 in tuition by using promo code dtown50 Call Today! or visit: FacialEsthetics.org OUR #1 SELLING BOTOX AND DERMAL FILLER THERAPY DVD S NEW 3 VOLUME SET! These over the shoulder treatment DVD s will give you a solid foundation of facial esthetic techniques. Two hours of AGD PACE CE credit for each DVD! Limited time offer - order before Nov. 1 and save up to $150! 28

3 continued from page 28 Some of these people just don t have enough money, in my opinion. In fact, I would say that is a big component for my efficiency. I ve learned when to hold em and when to fold em, as the saying goes. I think the stress factor becomes a larger and larger multiple as time goes on. I am blessed to have a family practice with family that opened in My father worked unbeut-bill Post: 25 of 105 Funny, I remember an article that Mike DiTolla wrote on this. He made a point that the most profitable were three or less units on a fixed case. After this, the cases became more complicated and the actual net profit was lower. Of course he backed it up with more numbers, but that was the gist of the article. rscrawfo Post: 26 of 105 Good thread,! Predictability is also important. It s always nice to have a predictable monthly income rather than a feast or famine type practice. Many hygiene-based practices seem to have a very steady production level, and downturns in the economy seem to affect them less. They will never have the extreme high months, but they also never get the low months. The more hygiene patients you see, the more stable production seems to be. I think profit per hour worked is an excellent measure, but you must include all hours worked, including lab work, paying bills, etc. Many of the small efficient offices have low overhead because the dentist is doing all the extracurricular work (lab work, paying bills, ordering supplies, repairing equipment, doing up deposits, keeping the books, etc.). This could double the hours spent working. Many of the larger hygiene-based practices might have higher overhead, but the dentist spends much less time working. Personally, I do very little in my practice and the extra overhead it costs me is money well spent. Sandy Pardue, My answer to your question would Post: 27 of 105 be hourly production average for the dentist. We keep this on hygienists as well. It is amazing to watch a practice with two or three hygienists, once we start measuring this on Dental Dashboard. All of them increase and it really keeps them on their toes. It s a great stat. Remember you better collect what you produce! I m not impressed by high production without the collections being right there with it. It also gets interesting with two or more dentists in the same practice. browndawg Post: 31 of 105 continued on page 32 30

4 continued from page 30 Check out these other Dentaltown.com message boards for ways dentists can become more efficient. Overhead Percentages 2011 Search: Overhead Percentages 2011 My Production Stinks Today but My Schedule is Full Search: My Production Stinks lievably hard through the 80s and 90s. Now we have massive competition and bad economic times and the game has changed. Fees are so much higher than they were. I can read in our charts where Dad was taking out all four impacted thirds for $375. Crowns were $250. Occlusals $40 and he managed to earn $200K a year at those fees. He came home, crashed on the couch and woke up to eat dinner. Rarely ate lunch. I do much better than he did working a lot less with less stress simply due to implementing systems, adding implant therapy and controlling costs. We have three docs now. Some months I feel rather pathetic doing four crowns with open holes in the schedule and producing $30K. Crowns are now $1,050 here. The key that I have noticed over time is that our overhead is much lower and we are doing so much less dentistry. Most of this must be due to fee increases over the years. But since we built the practice based on hygiene, it not only out produces, but out collects each of the individual doctors. I can t imagine having it any other way. Working on four to six patients a day and collecting half of my net from hygiene profits with the phone rarely ringing on a weekend and having the time with the wife and kids. This has become a blessing we never knew what we were blindly creating. And as Greg says, who cares how you get it if it is low stress and you enjoy the ride. continued on page 34 Practice Made Perfect 32

5 continued from page 32 Posted: 8/11/2011 Post: 42 of 105 Generally when I take on a new procedure, I use the following method to get proficient. 1. Accept that it won t be a money maker for a year or more. 2. Do some free cases to get going. Usually I make this a charity thing as well, so I get marketing mileage out of it. 3. Accept that my first few cases will not be as good as those I do in 10 years time. This is a big problem. I don t advocate being a hack. However I do understand that a lecturer who has done 1,000 sinus lifts over five years is probably going to be better than me. You cannot be good without practice, and you cannot do any practice if you expect to be perfect your first time. The difficulty is that there are a lot of armchair experts on Dentaltown who will criticize the tiniest imperfection of other people s cases, but then when they show their own, they will explain why it was appropriate to cut a few corners (normally because the patient was informed and declined. Don t let armchair perfectionism cripple your attempts at new procedures. 4. I begin marketing new procedures as soon as, or shortly after I m trained in them so that I get enough to be proficient. 5. Yes, taking more CE is great, but no amount of CE will make you proficient. Only practice will do that. 6. You will get failures. Suck it up and learn from them. I had my first sea-o-pus implant the other day. What I meant by the statement that you shouldn t do procedures that you don t do often enough is that sometimes people learn a new procedure and for whatever reason, they don t do it often. Like implants there are a lot of dentists out there that only do 10 a year. The first implants you do, you don t know which drill to use and you drill slowly and tentatively. It takes forever. If you are doing one a month, it s like you are always doing your first implant. I didn t make much out of rehabs when I first started them. Now they are very profitable because they proceed smoothly and efficiently, and prepping 10 crowns is always more profitable than one. I also get very few fractures now, although I did get a lot in my earlier days. Hope that helps. CoachDDS Posted: 8/18/2011 Post: 84 of 105 This is something I ve really learned first-hand in the last few months of owning a practice. There s a counterpart of efficiency that a lot of practice management experts don t seem to grasp. There comes a time when one is so efficient that your head starts to spin... you make more mistakes, you get burnt out faster and your long-term overall efficiency is lower. My favorite days are with a nice easy flow. A crown in the morning, some fillings here and there, eight or nine hygiene patients in between and maybe an emergency or two. All adds up to a $3-4K day and I get to leave the office without feeling drained. Granted I can do those rollerskate $10K days just fine but they tax me. Doing that day in and day out would kill me and I m young. I say the biggest measure of efficiency is how much your practice allows you to live the life you want to live. Find it online at Dentist Efficiency 34