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6.9.06 Issue #222

Grrrrrowing or Groooaning?
A McKenzie Management Case Study

Nancy Caudill
Senior Consultant
McKenzie Management

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

Dr. Steve Martin’s Story:

The phone call went like this:
“My production has leveled off and the practice just doesn’t seem to be growing.  Obviously, something is wrong but I just don’t know what it is!  Can you help me?”

If “misery loves company” is true, many dentists out there have lots of company.  This scenario is heard at our office daily – lack of growth.  I would like to propose that it isn’t a matter of stunted growth but rather a matter of patient retention.

What is your definition of practice growth?

  • Increasing the number of New Patients
  • Increasing production or collections
  • Increasing the number of days you are working or the hours you work

How about this definition:  “Practice growth is when you are adding more hygiene days in order to serve your patient base.” what does this mean to you?  Let’s look at this from a purely statistical aspect.

Office Facts:

  • 20-year old practice
  • Dr. Martin works 4 days a week
  • 1 hygienist working 3 days a week
  • 20 Comprehensive Exam New Patients per month average

Grab your calculator and let’s do some simple math.  Let’s assume the following:

20 pts/month x 12 months x 20 years = 4,800 patients
Each of the 4,800 patients are seen 2x/yr = 9,600 appts
His hygienist sees 9 patients/day x 3 days/wk x 48 wks/yr = 1,296 appts per year at 2 visits per year = 648 patients
This means that 4,152 patients are NOT being seen!!!

OK…now you see that in a 20-year old practice, it is impossible for 1 hygienist working 3 days a week to see the entire patient base of 4,800 patients.  Who is seeing the other 4,152 patients?…another hygienist in another dental office…NOT Dr. Martin!  His practice has lost 4,152 patients over the past 20 years and is currently only maintaining an active patient base of about 600 patients or less.

In other words, Dr. Martin’s practice stopped growing after the first two years and simply has been exchanging the 240 new patients/yr with the previous 240 patients, keeping some and losing some.

“So what?”, you say.  I only want 3 days of hygiene.”  50% of your production comes from your new patients and 50% comes from treatment diagnosed during the hygiene exam.  Imagine how much more productive Dr. Martin would be if he looked in 4800 mouths instead of 600.  I would also venture to say that he would need an associate or partner to share the success with as well.

And what about the increased production from the hygiene department?  Let’s make up a number and say that the average hygiene appointment (not including periodontal therapy) is $130 x 9,600 appointments = $1,248,000! I know…reality sets in.  No office can keep 100% of their patients and I understand that but this was just for illustrative purposes.  However, with a strong recall system, Dr. Martin and you can retain 80-90% of your hygiene patients.


Stop spending thousands of dollars a year in mining for new patients and start buying fertilizer!  GRRROW your business with the patients that are currently in your practice by  having your systems analyzed and improving your patient retention. 

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

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