It’s a common and frustrating reality: collections are high, the schedule looks packed, yet there’s barely enough left over for the owner at the end of the month. If you’ve ever looked at your practice numbers and asked, “Where is all the money going?”, you’re not alone.
We’ve walked hundreds of practices through what we call the Office Autopsy, and it almost always reveals the real reasons why a successful practice still feels broke.
Here’s what to assess if you’re ready to tighten up operations and build a stronger financial foundation for 2026.
1. Follow the Money: Is Your Overhead in Check?
High collections don’t automatically equal high profit. Overhead is often the silent killer of take-home pay. We’ve seen doctors collecting $2M+ yet taking home less than $250K. If this sounds familiar, your first move is to break down the core areas:
- Payroll: Should be 25–30% of collections (including taxes and benefits)
- Supplies + Labs: Aim for 5–8%
- Facility Costs (Rent/Utilities): Target 4–6%
- Marketing: Usually around 3–5%
If any one of these is bloated, your net will take a hit, fast.
2. Block Schedule Breakdown
The second place we look is the doctor’s schedule. Is it production-focused or full of reactive “just fit them in” blocks? A healthy schedule includes:
- Morning and afternoon anchor blocks for high-production cases
- Limited (and strategic) same-day appointments
- Systems for assistant-driven efficiency during procedures
If your schedule is reactive, your stress and overhead will climb while collections stay flat. Intentional block scheduling can reclaim both production and peace.
3. Uncollected Treatment Plans
A shocking number of offices are leaving treatment on the table. When we run treatment plan audits, we often find $100K–$500K in unscheduled dentistry sitting idle in the software.
Ask yourself:
- Are your case presentations happening same day?
- Do you follow up on unscheduled treatment weekly?
- Does your team know how to present payment options clearly?
Often, fixing the how of case presentation, not just the clinical work, releases massive production gains.
4. Clean Up the Insurance and AR Pipeline
Many dentists don’t realize how much money they’ve already earned but haven’t collected. Our Office Autopsies often expose:
- Claims that were never submitted
- Old insurance AR sitting beyond 60 days
- Patient balances not being followed up
You might have $80K+ sitting in the AR pipeline. That’s not a future goal, it’s your money now.
5. Too Many “Hats” at the Top
Finally, we often see doctors trying to be the CEO, the lead producer, the team therapist, and the practice manager all in one. It’s not sustainable.
Growth stalls when there’s no accountability partner or outside advisor giving honest feedback. Sometimes it takes a second set of eyes to show you that you’re working too hard for too little.
Ready for a Real Review?
You don’t need to do this alone. If you want a real Office Autopsy to figure out where the money is going, how to tighten operations, and how to take home more in 2026, that’s what we do best.
We work with practices collecting $800K to $10M+ and bring clarity to owners through systems, scheduling, accountability, and profitability strategies.
Let's take a look at your practice. Schedule A Free Call today!
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Last updated: August 2025
Written by Jacintha Ham, Dental A Team