The Silver Bullet to Making Money in Dentistry | Part 2

The Silver Bullet to Making Money in Dentistry | Part 2

In part 1 of this series, I identify the silver bullet for a profitable dental practice: staff expenses. We recognize the frustration pexels-photothat accompanies a high staff expense because it pits our need for financial security against our desire to take care of our team. After a quick review of the staff expense percentage calculation, and confirming that Step #1 to increasing profitability was to track this ratio every month, now we’re on to talk about what a dentist can do to improve profitability.

Looking again at the equation for calculating staff expense, we see there are only two ways to improve: reducing the staff expenses or increasing collections. Just like with our personal finance, we can either spend less or make more. So, here are some ideas on both sides of this coin to help get you started:

Ideas to Reduce Staff Expenses

First, take a look at your timeclock reports. When does each member of your team clock in? If your first patient is at 8am and you run a quick 10 minute huddle before, but your team is clocking in at 7:15am – that’s an extra 15-20 minutes per person each morning in staff expense. Next, is your team clocking out for their full lunch hour every day? And, most offices have one person that’s “willing” to stay late – and that person will be clocked in for an extra hour at the end of the day.

Sit down with your team and set clear guidelines for clocking in/out. They can clock in 15 minutes before huddle, clock out their full lunch hour and clock out 15 minutes after their last patient. Then, your job is to periodically check the timeclock reports to make sure these guidelines are being followed.

Next, look at your schedule – are you leaving big holes in the 10am – 2pm hygiene columns? If so, it’s time to schedule from the top down on some days, and bottom up on others so that if the schedule isn’t full the clinical staff can come in later or leave earlier. It kills your staff expense % to have hygienists clocked in for an 8am patient just to “keep busy” when the next patient isn’t until 11am. Block your schedules, train your administrative team and keep an eye for holes in the schedule.

If the holes in hygiene are consistently a problem, count up the open hours each day. Let’s say you have a team of 3 hygienists and you’re counting 6-8 open hours in their schedules each day. It may make sense to let one hygienist go so you can condense your schedule and keep your other hygienists busy. Although letting staff go isn’t any fun, if you make one big change and that fixes your staff expense problem, that may feel better than making several smaller changes.


Ideas to Increase Collections

To increase collections, let’s start with production. If you’re standing at 37% staff compensation, it’s time to make bigger changes. Perhaps reduce the time of hygiene visits? Take your 1 hour recall visits down to 45 minutes or move your child prophies from 45 minutes to 30. By increasing the volume of appointments you can impact your staff expense without cutting team members.

Next, take a look at your broken appointments. If heavy no shows are causing open time in your schedules, then it’s time to re-evaluate your approach – update your policies and charge chronic no show patients a fee to pre-book. Or, if your office manager has strong verbal skills, you can schedule these patients in a side column and work them into your day.

Next, improve your approaches to filling the schedule. Print the recare and unscheduled treatment lists and assign these calls to team members. At the end of the week or month the team must turn in their lists to you with their results totaled. By filling schedules and holding your team accountable, you can improve the staff expense percentage.

Let’s say your production is strong, but the real problem is collections. Your staff expense ratio could be out of balance simply because your manager isn’t spending the time necessary to call insurance carriers on the insurance aging list. In Dentrix Ascend, you can easily run your Outstanding Claims report and copy/paste it into Excel where you can add columns and make notes of your collection efforts.


Sort your patient AR list from Dentrix Ascend

Beyond insurance, meet with your manager to review the collections process. Are you sending statements monthly? What efforts to collect are being made? What happens when a patient doesn’t pay? Again, Ascend allows you to run the Aged Receivables list and copy/paste it to Excel – now you can sort by dollar amount and tackle worst first. By increasing your collections, and not just a one time bump, but a maintained increase, you can offset your staff expense and improve your profits.

Right about now, you may be realizing there are dozens of aspects of your practice that you could be working on to improve your staff expense.

And, you’re right.

The key is to make changes. Don’t just accept that your staff expenses are too high and there’s nothing you can do. Decide that you’re going to run a profitable practice and then continue to make changes until you achieve the staff expense balance you need.



If your dental practice is not as profitable as it should be, you may be looking for the Silver Bullet solution. The good news is, there is one! Keeping staff expenses to benchmark is the silver bullet for profitability in dentistry.

To manage your staff expenses, first you have to track your percentage every month so you know how you’re doing. Next, when it’s high, you look for opportunities to either reduce the staff expense, starting with the low-hanging fruit of clocking in/out and moving to tighter schedule management so clinical staff are only being paid when their schedules are full.
To impact the collections, first look at production by improving several systems in your office such as handling broken appointments, re-evaluating the length of appointment times, making sure your team calls all patients due for unscheduled treatment and recare, etc.  Next, if production is strong, evaluate your aging for insurance and patient portion receivables.

Check out my Free Resources

If you’re managing a dental practice and want organized systems for easier dental staff training, then check out my Collections System and how to Set Up a Recall System. Once these internal systems are in place, you may want to focus on marketing with a system for New Patient Referral Tracking and handling patient complaints.

And, if you’re interested in a comprehensive approach to run your dental practice and train your team, visit Dental Staff Training Levels.

The key is to continue making changes until you achieve the staff expense ratio that allows your practice to run profitably.

AUTHOR: Jill Nesbitt
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