It’s office autopsy time! Kiera shares the story of a practice that recently discovered $2.5 million going unnoticed. She talks about the doctors and their (very) busy schedules, the need for an additional hygienist, and what the cold, hard numbers told this practice about next steps.
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Transcript:
Kiera Dent (00:01)
Hello, Dental A Team listeners. This is Kiera. And today I am excited. I was just in a practice and we were going through a lot of really fun things. And whenever I come from an office, I get so excited to come back and chat with our podcast family of things that you and your practice should and could be doing. I was told when I was in this office, this is the Dental A Team magic where we physically fly to your practice. We work with your teams. We work with you as a doctor. We uncover hidden pieces that maybe you didn't even know to bring to a call.
I think it's so magical to be able to do this for practices. And so today is a little office autopsy of finding $2.5 million left behind on the table in ways that you would never expect. Sound interesting? Well, I hope you're ready because I wanna take you through and uncover hidden little cashflow pits that you might not even be looking at. So number one, we decided to go through...
because this doctor is so busy. So many of you tell me I'm so busy, Kiera, my schedule is jam-packed, and I say congratulations, but what is the cost of that? So for example, if you have your hygiene department, you should be looking at your active patient base. So an active patient base for a general dentist should be 1,500 patients as an active patient for one doctor. High end, like where you can kind of get by is 1,900, but beyond that, that's very high. And we're talking 12 months and 18 months. So take a look at both of those numbers.
and just look to see where are you at. So this practice, they have about 4,500 active patients with two full-time doctors. They're at capacity. So what's happening is we have options. We can add more hygiene, but then that's going to have our doctor to hygiene, AKA our exams at the wrong amount. What's happening is they're dropping periopatients because they don't have space for their...
Regular prophy patients, then they're diagnosing SRPs, but they have nowhere to put them for six months. They're pushing new patients out for four to five months. So we did a little bit of fun math and we didn't even, this is just gonna be some hypotheticals, but I think for you just to hear like, what are some of the things that actually can hurt your practice and how much are you leaving on the table when we do things like this? So for this practice, when we went through and we looked at it, we thought, all right, let's take an average prophy and whatever it is for you.
Maybe it's 150 up to 200 for an average prophy. We're talking prophy, x-rays, cleanings, or just even prophy and an exam. How much is that for you and your practice? Now, look to see how many active patients you have. If we've got 4,500, well guess what? You get a double that because those patients are coming in two times a year. So have fun with those numbers. We divide that by 12. We look at how many patients we're seeing per day. Now that doesn't necessarily mean how many you are, but that's how many you're going to need to see.
Then we look to see how much hygiene we have right now today to see, we actually have enough hygiene spaces for it? But let's not forget that we also have to add new patients because in addition to our active base, we are constantly adding more patients. Yes, we are losing some patients, but my hope is that you at least are adding more than we're losing. So we've got to look at those two together and see how much time we actually have in a week, in a month that we need to be seeing patients. This is gonna then show you your gap. So for this practice, they had over 200 appointments
that they were short every single month. That's at a minimum. So clearly they're ready to bring on another hygienist. This was great numbers to see, do I bring on a hygienist? Do I not bring on a hygienist? But the problem is they're already at five hygienists with two doctors. You can start to do the math. So it's like, well, great. Well, we're not diagnosing perio either. So options are we could bring on a sixth hygienist and that hygienist would just do SRP. That doesn't mean just that person, but we'd have eight hours of SRP in a given day.
spread across all the hygienists. That means we don't increase our exam numbers, but we do increase our number of perio. We do increase our number of hygiene spots. That's going to help in some instances. But even if we fix that problem, remember we still have all these patients that we're not seeing. So this practice right now, they told me, hey, Kiera, we're pushing our patients out about eight months is where we've got to put them. We can't see them on the six month mark. We've got to push them to the eight month. So I did the math and I was like, okay, average pro fee is going to be about $150 per patient.
but you gotta take all those patients that would be seen in one month and we times that by 150. Now, I understand this is very loose math, but it gives a good idea because think about it, those patients, if we saw them every six months, that's money from insurance and also from seeing them on a regular schedule, plus not just that, but patient care. We see them on the six month interval, but these ones we're not seeing every six months, we're seeing them every eight months. So that means there's two months that we're missing out on opportunities to see them.
So when we did the math, it averaged out to about $450,000 with this patient base annually, just of miss hygiene. And that was only on one month. If you want to do it on two months, which is realistically what it would be, that's almost a million dollars worth of revenue, just in hygiene miss opportunity. That's fascinating to me. This is why I think a consultant is so powerful because we come in and we do crazy numbers like this and we look at your numbers and we look at where you're at. And it really gives you the confidence to know, can I bring on an associate? Can I bring on more hygiene?
I feel like this, what does the number and the data suggest? So just looking at that, I was like, a simple fix is bring a hygienist in, let's have our perio go up. And then also we need to bring a doctor in for whether it's full time or not. So we ran scenarios of if we brought a doctor in, if we added more hygiene, if we had our doctors do this, what do we need to do? How do we keep our doctor to hygiene ratio running all these scenarios to then say, my gosh, this really would help our practice out.
And when I think about this and I think about practices for us, are you looking at numbers and metrics like this? Are you calculating the cost of missed appointments or not scheduling our hygiene patients back? Not to mention that we're certainly not doing 30 % of our patient base as perio. What these hygienists are doing is they're seeing that they need perio, but they don't have space to put them. So they don't want to have the conversation. This is no knock to a hygiene team. Several hygienists do it because I'm going to tell you, you've got this awful disease.
but then I'm not actually going to be able to get you in for X number of days, weeks, months. That feels really, really, really hard to try and convince a patient of this. So what do we do? We clean it out and we say, you know what, we're just gonna get it next time. But next time then fumbles and then we gotta have these conversations. Then we don't wanna have these conversations. We're constantly looking at like, we're just punting the ball down the line. So what do we need to do on this? What are the scenarios in this option? How much money is being left behind, but also how much patient? And this is great.
Other options that we considered are, we cut insurances? Because, hey, if we've got this many patients, what if we cut out our lowest producing insurance that pays us? And the doctor said, no, my mission and vision for this practice is that we care for the average patient, that we are here to take care of them and support them. And that's what this doctor wants to do. So it's like, great. They have an incredible building. They've got more space to build out. Fantastic. Let's bring in the other doctors. Let's bring in more hygiene. Let's serve these patients because instantly if we brought on one or two more hygienists,
Guess what? We could backfill very quickly with all those patients. Plus we need to hold space for new patients and perio that would be ideal based on the number of perio. So then you look at your patient base, you figure out 30 % of that. That's going to tell you how much SRP spaces you need to hold every single month in the practice. Don't forget, once you have SRP, you also need to have perio maintenance is in there. So this you can see is like this amazing web of data, of knowledge, of fun.
to figure out how much is your practice actually leaving on the table unintentionally. And when I looked at that, the doctor, he was like, well, Kiera, number one, you're always worth your weight in gold. You come in and you find little things. You guys, that is one small change that's worth 450 to $900,000 just in the amount of pro fees. That's nothing else, nothing. Like that's all we did. And to be able to uncover little opportunities like this and so,
for you to look at your practice, this is why I wanted to give you this scenario of this practice. There were several others that we looked at that we found that we were able to just quickly identify. But I think so often people are looking for big moves. They're looking for these all on X cases. They're looking for what could I do here? How could I do this? What could we change this for? And what I wanna highlight to you is I promise you there are little gold nuggets in your practice of true solid gold that's serving patients at a higher level.
or you have to do nothing else in this practice. And all you need to do is just shift one or two things and instantly your practice is going to grow 10, 20, 30, 40, 50%. Small little tweaks and changes, small little gaps, small little pieces. So it's let's look to see our hygiene patients coming in on time, like on the six month interval. Do we have the correct active patient base for the number of doctors that we have? Do we have enough hygiene to doctor ratio? What's our perio percentage?
How many perio maintenance are we doing? Are we solid on those pieces with our patient base? And then if we are on those, let's look at our x-rays. Are we doing our FMXs and our comp exams on regular frequencies? Are we doing perio, excuse me, are we doing fluoride therapy on all of our patients if you believe in that? These little tiny opportunities just in hygiene I've highlighted for you, not to mention all the other spaces that we could go after, but just hygiene alone. Are we collecting before patients walk out the door?
Are we using our block schedules and getting enough block time in our schedules for our new patients, for our perio? Do we have those blocked in there? Because if we don't, guess what? Like I don't even do the math for you on how much SRP patients are, but you wanna tack that on with the number of patients that we're missing out on. That's for sure a $1.2 million mistake with no extra effort. So I just want you today, it's a quick fast episode. It's a down and dirty of one, I think this is a huge.
A-ha of what a consultant can do for your practice. Number two, I think it's a quick a-ha for you to look at your practice and say, hey, during my CEO time, let me go walk through my practice and let me see these little gaps and cashflow gaps in my practice and let's see how we can close those up. And number three, I really hope you realize so many people think they need to expand, go get another practice, all these different things to grow their business. And I will tell you that 99, maybe I'll say 90 % of the time, we can find growth, we can find opportunities.
right underneath your roof with no extra effort, no extra energy, just to do a small change. Perfect block scheduling. Usually can add $1 million plus to a practice if we do it correctly. No extra hours, no extra time, no extra team members, just being more strategic with it. Increasing your case acceptance, small little change, small little tweak, way more revenue to your practice. So my question to you is, what's it worth? What's your hour, two hours, three hours of admin time worth to you if it could show that you could create this?
What's it worth not to call a consultant to just come check your practice and see what are maybe the hidden gaps? You guys, this practice is doing amazing. Their overhead's great, their team's great, all of that. You would think on paper that this person doesn't need a consultant. They're not stressed, they're not cashflow poor, they're none of those things. What they are is they are looking for the hidden opportunities that a consultant who's been in practices hundreds of times can come and find for them. They're looking for, what am I not thinking about that you're gonna think about? I want you to come in and find that.
And I love it. I feel like I get to go in as a sleuth. I'm not looking for systems or operations. This practice, like I said, on paper, this practice looks like they would never need to call a consultant. But what I want to highlight for you is we found in a less than day and a half, over a million, and I just told you one part of this story, over a million dollars worth of opportunity for this practice. Would that be worth your time? Something to consider.
Something to think about. And I hope today you take this and you don't just think about it, but you go do action because I promise you there is just this same, if not bigger cashflow leak in your practice or hit an opportunity that you're not thinking about that would radically change your practice, your patients, your team, your life. So go find it. And if you don't know how to do it, reach out, or if you're like, Hey, I'd love you just to come see like come sleuth. Let's do this together. Reach out. Hello@TheDentalATeam.com your practice, your team, your life is worth it.
and you deserve all the happiness in the world. And I'm happy that you chose to listen today. I'm happy to hear you hung out. And if you thought this was a fascinating podcast, share it with a friend because I think all of us could think a little bit differently, find these little opportunities. Again, no extra diagnosis, no extra work, just changing it up a little bit, doing things a little differently and their practice is going to exponentially grow. Yes, they need to bring a doctor. Yes, they need to find a hygienist. Yes, they're strategic, but we talked about all the different scenarios, ran all the different numbers and hey, here's all the options. Now pick which one you want to do.
There's so many ways to do it, but look at the awesome opportunities that they could do. And I hope that you do the same. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.