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5.12.06 Issue #218


Too Many Chiefs and Not Enough Arrows
A McKenzie Management Case Study

Nancy Caudill
McKenzie Management
Senior Consultant

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This case study is an illustration of a dental practice that may be similar to yours. The names have been change to protect the guilty!

Drs. Sarah and Bob Scott’s Story:
The phone call went something like this:
“My wife is graduating from dental school in a couple of months and we want to work together in my practice!”

My first thought was, “how sweet and romantic”.  My second thought was, “How great that he is busy enough to support 2 dentists” – WRONG!

Office Facts:

  • Dr. Bob Scott has a small office with 3 operatories.  He uses 2 and the hygienist uses 1.
  • His schedule is booked a little over a week in advance.
  • There are about 15 New Patients per month coming into the practice.

In-office Observations:
After my arrival at Dr. Scott’s office and reviewing the computer-generated reports, I questioned Dr. Scott during our lunch together.  “Dr. Scott, are you going to give your wife X of your patients and one of your chairs?”  His immediate response was, “Of course not.  Why would you ask that?”  Let me ask if you have thought about the following:

  • Where is she going to get her patients?
  • Where is she going to work in the office?
  • Does she need a paycheck?”

It was obvious that those issues never crossed his mind or hers.  He was going to add her name to the front door and “they would come”!

Immediate Recommendation:
The soon-to-be Dr. Sarah Scott should seek an associateship in another practice to allow her the opportunity to gain experience and have an income to help offset her dental school debt. 

In the meantime, Dr. Bob Scott can continue to grow his practice until he finds himself booked out 4-6 weeks on a regular basis and his New Patient base has increased to at least 30 patients per month.  At this point, he and Sarah can start planning to relocate to a larger space that would accommodate two dentists and the supporting hygienists and staff and live “happily ever after”.

Whether you are considering adding your spouse, your classmate and friend, your son or daughter or just an associate/partner, evaluate your needs and review these areas:

  1. Are your patients scheduled out more than 4-6 weeks and have been for several months?

The first indication of the need for another dentist in your practice is your schedule.  It is poor customer service to not be able to accommodate your existing active patients within 2-3 weeks for an appointment.  New Patients should be seen within 1 week.

  1. Do you have a marketing plan that includes the addition of another dentist?

You may have more than enough new patients now but do you have enough to allow you to continue to grow your own patient base as well as that of the additional dentist?  Let’s face it, you may be the greatest dentist in the area but you will lose at least 10% of your patient base each month simply through attrition.

  1. Do you have the operatories necessary without giving up yours or reducing your hygiene days?

You do not want to interrupt your own production or your hygienist’s in order to provide chair time for the new dentists, unless you are willing to take a reduction in your salary!

  1. Do you have reliable business systems in place to manage the growth and to avoid chaos?

Review your existing business systems to confirm that they are all in good working order, such as Patient Retention, Accounts Receivable, Scheduling, Overhead, Billing, Insurance, etc.  More dentists and more patients equal increased workload.  Without effective systems in place it will mean increased breakdown. 

  1. Do you have adequate staff or will you need to employ more?

You need specific Job Descriptions for your existing staff in order to handle the growth so the right hand knows exactly what the left hand is doing.  More patients do not always lend itself to more staff.  With proper job descriptions for your business staff, additional personnel may not be necessary.  You may be overstaffed now!

Congratulations on the mere fact that you are even considering inviting another dentist to join you!  You are obviously doing many things right.  Stay the course and plan wisely for your future growth. 

If you would like more information on how McKenzie’s Practice Enrichment Programs can help you, email

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