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Becoming a patient-centric practice: Your most lucrative pivot

Sept. 19, 2022
Learn why Jay Geier says your most lucrative move is to start making every decision about how you run the office with patients in mind.
Jay Geier, Founder, Scheduling Institute

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Most dentists go into private practice with the misguided notion that really good clinical skills will bring success—that the practice will automatically attract patients, grow, and be forever profitable. Throughout their careers they continuously invest time, effort, and money in CE credits well beyond what is required, and they learn new techniques that they think will impress patients. They also habitually overspend on new equipment and gadgets, believing the sales spiel about it being a great investment that will bring a profitable return.

None of the above is true. When was the last time a patient asked to see your credentials or your CE certificates or got excited about the equipment you used? Never; they just assume you’re good. But if that’s the game you want to play—the game that’s more about you becoming a better clinician versus the game of building a patient-centric practice—then you really ought to go to work for someone else instead of being a practice owner. Then you can focus entirely on your skills without having to worry about business matters or growing the practice.

Of course, that means you’ll need to be OK with your income maxing out at a certain level no matter how much you keep learning. Why? Because you personally can only see so many patients in a week, which means your earnings have a definitive ceiling. It’s basic math; you can only drive the average purchase up so far, and then you’re maxed out.

Another unavoidable fact of life is that dentistry is hard on the human body. The longer you’ve been practicing and the older you get, the fewer hours you’ll be able to work week after week.

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The same scenario applies if, as an independent practice owner, you refuse to have associates. Your business and personal income will max out and are destined to decrease over the years as you find it necessary to cut back on the hours you’re willing and able to work.

Given that fact, why do so many practice owners continue to play the game of insisting on being the only provider and focusing heavily on clinical skills instead of patient-focused, business-building strategies?

Reasons . . . or excuses?

These are the two most often admitted reasons dentists give for being the sole provider in a practice:

They can’t afford associates. That’s an oxymoron because the whole point of hiring associates is to profitably raise the production and net income of the practice through clinical duplication. If your investment in an associate doesn’t bring a net positive return, you have a poorly structured contract, or your associate is underperforming in accordance with the agreement and needs to either improve or be replaced. Get coaching on how to correctly implement the strategy, and learn why you can’t afford not to have associates if you expect to remain a viable practice in the long term.

They don’t want to deal with the problems that go with having associates. Maybe you’ve had a bad experience hiring or managing an associate or have heard others talk about their difficulties. Again, it’s a matter of doing it right by learning from others who know what works and what doesn’t. Don’t give up on an excellent business-building strategy just because you lack the training on how to implement it well.

Those are really just excuses when the underlying reason often is actually egotism. Many doctors simply cannot accept that anyone else could care for their patients as well as they do, so they refuse to allow another provider into the practice. That’s nonsense. If you got hit by a bus tomorrow, do you really believe absolutely no one else could care for your patients? No matter how much you may love your own GP doctor or chiropractor or trainer, do you really believe there is no one else in your community who could possibly take good care of you? Of course there is.

Pivot, shoot, score!

You worked hard to earn your credentials and gain your experience, but so did many others. Once you accept that fact, you can start playing a different game—one that’s patient-centric instead of clinician-centric—and learn to pivot in ways that position your practice to score bigger by making better shots, especially these:

1. Clinical duplication. Learn how to grow the practice with associates by connecting with a community of colleagues who have done it and are willing to share their experiences so you’re not having to reinvent the wheel or learn the hard way. Their bottom lines are benefiting from higher production, and the business earns even when they’re not there. This allows them greater freedom of time and a more balanced life, and also positions the practice to remain viable and thriving over the long term as they age.

2. Maximizing ROI on your space and equipment. Obviously, no office sees patients 24/7, but when you consider how much more ROI you could be getting on your investments in space and equipment, you’ll see the value in pivoting to score with more patients across more hours.

Let’s say your office is open 8:00 a.m. to 4:00 p.m. four days a week and closed an hour for lunch. That’s 28 hours of seeing patients per week, which is a mere 17% of the time you’re paying rent on all your space and making lease payments on equipment. Associates make it possible for your practice—not you personally—to offer extended hours, stagger staff lunches so you don’t have to close, and even offer Saturday hours so you’re getting a much higher return on your S&E investments.

3. Being patient-centric. The most lucrative pivot you can make is to begin making every decision about how you run the office with the patient in mind:

  • Put patient convenience ahead of yours by offering extended hours and being open six days a week (with the help of associates, of course), so patients can be seen when they want to be seen.
  • Answer the phones when patients want to call, not just when it’s convenient for the staff.
  • Take the phones off the front desk altogether so potential new patients calling in get undivided attention at the same time as your valued patients in the office.
  • Train the team on how to capture new patients and deliver an excellent experience, which leads to patient retention, referrals, and a reputation that attracts new patients—practice growth and profitability.
  • Provide growth and development opportunities that attract and retain talent to a growing business.

What game are you playing?

Is your game about you—your clinical skills, your convenience, and your team’s convenience? Or is your game about the patient—their convenience and overall end-to-end experience?

If you’re a young practice owner, the sooner you start playing the right game in the right way, the better. But you’re never too old to start playing a different game and learn to pivot in ways that position your practice to score big.

Editor's note: This article appeared in the September 2022 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.

About the Author

Jay Geier | Founder, Scheduling Institute

Jay Geier is a world authority on growing independent practices. He is the founder and CEO of Scheduling Institute, a firm that specializes in training and development and coaching doctors on how to transform their private practices into thriving businesses they can keep for a lifetime of revenue or sell for maximum dollar. To hear more, subscribe to Jay’s Private Practice Playbook podcast at

Updated February 15, 2023

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