Before considering an associate, make sure you have enough patients. Measure the number of truly “active” patients. Start with key computer reports, including the past due recall report, the missed appointments report, and the unscheduled treatment report.

1. Generate a report of patients due for recall from today’s date to one year from today. Indicate that you are seeking to identify all patients with and without appointments on the report.

2. Tally the number of patient records in the computer system and divide that by the number of patients in the recall system. For example, if there are 4,759 patient records on file and 1,737 patients in the recall system, patient retention would be at 36%.

3. Now subtract the number of active patients from the number of total patient records in the system. Using the example above that number would be 3,022.

4. Divide that number by the number of months the records represent. For example, if you believe that active charts represent the period from 11/09 through 2/13 that would be 39 months. In this scenario, the practice is losing 78 patients per month.

Obviously the patient base is shrinking. Now what? For starters, don’t hire a full-time associate. Instead, implement a patient retention program and look carefully at clinical efficiencies. When it comes to clinical efficiency it can never be compromised, but it can almost always be enhanced.

Experiencing a few growing pains these days? The schedule is maxed out. The team is stressed out. And it seems that no matter how much you work the money’s always out. While the practice may appear to be booming, in reality it is on the brink of a bust. Take steps to turn things around, starting with the time.

It’s time to make the schedule your servant and not your master, which means scheduling to meet daily production goals, NOT scheduling just to keep the doctor and team busy. Establish a realistic financial goal for your practice; let’s say $700,000 in clinical production. This calculates to $14,583 per week (taking four weeks out for vacation). Working forty hours per week means you’ll need to produce about $364 per hour. If you want to work fewer hours, obviously per hour production will need to be higher.

Use the formula below to determine the rate of hourly production:

1. The assistant logs the amount of time it takes to perform specific procedures. If a procedure takes the doctor three appointments, she/he should record the time needed for all three appointments.

2. Next record the total fee for the procedure.

3. Determine the procedure value per hourly goal. To do this, take the cost of the procedure, for example $900 for a crown; divide it by the total time to perform the procedure, 120 minutes. That will give you your production per minute value – $7.50. Multiply that by 60 minutes – $450.

4. Compare that amount to the doctor’s hourly production goal. It must equal or exceed the identified goal.

5. Start scheduling to meet that goal every hour of every day.

Eighty percent of practices are losing more patients than they are gaining new patients. It’s easy to assume that patients you’ve had for years will continue to return, and it’s also easy to fall into the trap of thinking that those patients will raise questions and inquire about treatment options without your prompting. What happens far too often is teams fall into the “Transaction Mindset.” The patient is coming in for a routine oral hygiene appointment and exam. Everyone clicks into autopilot, after all this is merely a routine transaction. Wait! Wake up! This is one of only two contacts your office will have with that patient in the next 12 months. This isn’t a mere transaction. It’s your brief opportunity to strengthen your relationship with this patient.

In many cases, the six-month visit is the only time the dentist is going to have the opportunity to sit down with the patient and assess not only his/her their oral health condition, but also the individual’s oral health concerns and interests. What do you do during every routine visit to WOW the patients, further educate them on the importance of oral healthcare, and inform them of the services that your practice provides? Anything? In about eight months, you might be wondering why you haven’t seen this or that patient in your practice for a while. Can you figure it out? Maybe they were tired of being treated as simply just another “routine transaction.”

Consider the unspoken messages you and your team convey to patients, starting with the obvious: your smiles. Every time a patient comes into your practice, they are examining your smile. What does yours say about your dentistry, your team, and your philosophy of care? Case in point: A young orthodontist I know is building his practice alongside two very well established doctors in a mid- size city. He is a nice young man, but I can’t help wondering what impact his own crooked smile has on his patients’ decision to proceed or delay treatment – particularly his adult patients. How often are patients second guessing their decision to pursue $6,000, $8,000, $10,000 in adult orthodontic treatment when they sit down and have a conversation with “Dr. Allen.” After all, even “Dr. Allen,” the orthodontist, doesn’t have perfect teeth – and if anyone can afford straight teeth, they reason, it’s an orthodontist.

You and your team advertise your dentistry. If you’re selling smiles, everyone on your team, including you, doctor, should wear the beautiful smiles that excellent dentistry can create.

If you’ve found that production numbers for 2012 left you with little joy to your world, consider what you can do throughout the next 12 months to ensure that production in 2013 has you singing the Hallelujah Chorus next Holiday Season.

Take a few practical steps to improve the bottom line and put the dental team on a high performance track they can stay on. Prescribe treatment plans for patients that include everything that needs to be done – appointments necessary, the cost of treatment, an estimated length of treatment time, and any treatment options. Implement an interceptive periodontal therapy program. Designate a treatment coordinator who is responsible for presenting treatment plans to patients and is expected to secure at least 85% case acceptance. Hold the scheduling coordinator accountable for daily monitoring and following up with patients that have unscheduled treatment.

Market your services to existing patients. Provide superior customer service that will encourage patients to refer friends and family. Implement a recall system that ensures full schedules and minimizes no shows and cancellations.

Each month run the year-to-date Practice Analysis Report and compare it to the same period last year. Do that every, single month. Do not wait until the bell tolls midnight on December 31 to find out how your practice has done for the year.