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SDD for the DDS Joe Steven Jr., DDS

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There have been volumes written about increasing dental office production, and many dental speakers talk about that all the time. We’ve read or heard about doing quadrant dentistry instead of one tooth at a time numerous times. There’s no lack of information out there about improving case acceptance via better communication skills. And of course, I always recommend offering more services to our patients, which increases our busyness level and production.

For one reason or another, many dentists cannot or refuse to offer more services, yet they are still intent on increasing their daily production numbers. There is another way, which is actually quite simple for any dentist to do – more same day dentistry (SDD).

I recall a seminar I attended years ago where the speaker was advocating setting daily production target goals, which is always a good idea. But, he went a little too far I believe. He said at the end of a regular work day, the appointment secretary had to print out a schedule for the next day with the production numbers next to each patient’s name. If those numbers didn’t total up to their targeted goal, her work day was not over. She had to stay and rework the schedule by calling other patients and working them in or moving patients around if need be so that the numbers would total their goal. Boy, does that sound like a fun job!

I address that issue all the time at my seminars and regard that advice as being very misguided because we all know that at 8:15 the next morning, much of that schedule can change with unforeseen cancellations or rescheduling needs for various reasons. So, what would be the point of staying late the night before to put together the “ideal” schedule?

Taking care of the appointment schedule is the most difficult duty in any dental office, and we doctors really have no idea how difficult it is. I’ve had assistants help out up front when needed if we were short-handed up there, and they often come back and say that they could never do that job. It does take a very special individual who can balance many spinning plates at the same time. You have to know the patients and have a feel of how responsible individual patients are concerning their appointments. You have to understand dental procedures and know the time factors associated with them. You also need to know and calculate the doctor’s capabilities of handling a busy schedule. Some doctors don’t want a busy schedule, and that’s okay, but don’t complain when your numbers are not up where you would like them to be. I’ve heard from many offices that the doctor will not interrupt a regularly scheduled patient’s appointment time by working in an emergency patient. I understand that noble concept, but many times it is necessary and it usually results in increased production.

So, what is SDD all about? Simply put, it means doing dentistry the same day it is diagnosed whenever possible. If an emergency patient comes in with a terrible toothache and you make the diagnosis of a root canal, post, buildup and crown, if at all feasible, do as much as you can that day! That work is “icing on the cake,” adding production dollars to the daily schedule that weren’t there before.

The same thing happens when we take a patient from the hygiene exam room to the doctor’s treatment room after diagnosing a simple filling that needs to be done. We have done that for years when we are aware that we have an opening on the doctor’s side. And it’s not just the doctor being aware, the whole team needs to be on top of that and move these patients over and do same-day dentistry when possible. Most patients greatly appreciate that service because they avoid taking more time off from work.

Over the years, I’ve heard countless stories from patients who complained about how their previous dentist would only work on one tooth at a time, or they would have multiple consultation appointments prior to being treated, or their doctor kept referring them out for different procedures. People want to get things done and move on. SDD can be ideal for many of our patients and greatly appreciated while improving our profitability. Many doctors all around the country complain about how the economy has affected the busyness in their practices, resulting in openings in their schedule throughout the day. Many times SDD will solve that problem.

We have to address the big “elephant in the room” to really cover this topic properly, and I’m sure many of you reading this have already wondered about this concern: How do you do this if the doctor is only working out of one or two operatories? We can’t expand our offices over night, but with some creative flexibility, all of us can accommodate more patients on a daily basis.

Once again, a very astute person at the front desk has the best grasp of what is going on daily and needs to be offering guidance throughout the day. With the use of radio headsets in our office, the ladies up front always suggest possibilities to the clinical staff for doing SDD. They might call back with a message saying something like, “Mary can’t make it today, so you have time to do that emergency root canal on Bill right now.” Or, they might tell the assistants they can move Tom over to hygiene after their crown seat because there’s an opening in the hygiene room. Everyone has to be flexible and aware of what’s going on with the schedule every hour.

Another thing that I’ve capitalized on in the past, before we expanded our office to a total of nine treatment rooms five years ago, is the old “rotating game”! For nearly 30 years, we increased our daily production by rotating patients. Some might not consider this VIP treatment, but it certainly is for those emergency patients who we can care for on the same day. Actually, Linda Miles, one of our great consultants is the only other speaker I’m aware of who has recommended this same concept for increasing daily production while taking better care of more patients.

Here’s how it works. Let’s say an emergency patient comes in with a terrible toothache. Both of the doctor’s chairs are already filled with prescheduled patients. After giving anesthetic to one of those patients I would say to that patient, “Jim, we just had a patient come in with a terrible toothache. It’s going to take about 10 minutes for you to get real numb. Would you mind having a seat out front for a few minutes, and let me get that patient out of pain right away?” After he agrees, and they always do, then we seat the emergency patient, make the diagnosis, anesthetize, and then rotate again. The previous patient is now ready for treatment, and we have made the best use of our time.

I have to admit that I am not always politically correct when playing the rotating game, and we do pick and choose which patients we feel we can rotate. But, the majority of patients are great candidates for doing this, and actually regard us as being very compassionate and caring for all our patients. You will get comments such as, “I’ve been there before, so go ahead and take care of him!” Or they’ll say something like, “That’s great to know that if I ever come in with a toothache, that you’ll take care of me right away also, so go ahead!” It’s a win-win for everyone.

With our expanded office we seldom ever find the need to do that anymore, but occasionally we do. If I had not played the “rotating game” over all those years prior to our expansion, my net income would have suffered dramatically. When we work in more procedures like that, our office overhead has already been met, so this additional production represents a much higher profit per procedure. If you want to increase your profits immediately remember SDD for the DDS, and it works for DMDs also!

Author's Bio
Dr. Joe Steven graduated from Creighton Dental School in 1978 and has been in solo practice in Wichita, Kansas, up until June, 2007 at which time his daughter, Dr. Jasmin Rupp joined him. He is president of KISCO, a dental products marketing company, providing “new ideas for dentistry,” and is the editor of the KISCO Perspective Newsletter. Dr. Steven, along with Dr. Mark Troilo, presents the “Team Dynamics” seminar. Dr. Steven also presents four other seminars: “Efficient-dentistry,” “Efficient-prosthetics,” “Efficient-endo” and “Doctors Only.” Dr. Steven also provides the KISCO Select Consulting Program to dentists in the form of a monthly audio CD recording. He offers a coaching consulting program called the KISCO’s 21 Club. Contact info: jsteven@kiscodental.com, or call 800-325-8649; www.kiscodental.com.
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