Practicing the Dream: PART 1 -Fleshing out the dream with real-life numbers

June 1, 2002
In the April through September 2001 issues of Dental Economics, we presented a series of articles chronicling the true story of a dentist in his year-long quest to improve his practice.

by James R. Pride, DDS; Amy Morgan; and Mary Lynn Wheaton

In the April through September 2001 issues of Dental Economics, we presented a series of articles chronicling the true story of a dentist in his year-long quest to improve his practice. Through precise application of practice-management concepts, his efforts resulted in a 20 percent ($100,000) increase in annual production.

Now, we have another extraordinary story to tell from the Pride Institute files. This story is of a young Midwestern dentist whom we'll call Mary Thompson.

Just three years out of school, Dr. Thompson bought and merged two practices to single-handedly produce more than her two predecessors combined. Her total annual production climbed from a modest $255,000 to $812,099, an astounding increase of 318 percent. In the process, she and her staff changed as dramatically as the practice. They exuded such enthusiasm, optimism, and self-confidence that patients noticed their personal transformation. And, most incredibly, Dr. Thompson and her staff achieved their meteoric success in just two years!

Practice management was the vehicle that sped the practice through its growth stage. It was what gave Dr. Thompson immediate control of her practice and radically shortened the learning curve. It was what enabled the transformation of a struggling new practice with no hygiene staff to a complete, fully staffed, quality dental office. It was practice management that unleashed the potential of an exceptional new dentist and an untrained, but dedicated staff to achieve phenomenal results.

Dr. Thompson's amazing story is the subject of this new series. The numbers are real; the names have been changed to preserve privacy.

We first met Dr. Thompson in September 1999. She had recently purchased her first practice. Disappointed at a decrease in production, she considered buying a second practice - the one next door - which was just put on the market. But how could a young dentist producing only $21,250 a month afford a second practice?

"Was it biting off more than I could chew?" she wondered. "I didn't know how to decide! At the time, I didn't even buy a new handpiece without first consulting my accountant, Brian Hufford. I didn't have any control over my business; no way to know what to do."

We helped Dr. Thompson formulate long-range goals and analyze her operating expenses. This analysis helped her determine whether the new practice was a proper fit for the kind of quality dentistry she was striving for. We believed she could afford to buy that second practice, and we showed her how to pay for it.

Dr. Thompson's dream was to buy the new practice and double her patient base of 1,200. Her annual plan was the indispensable blueprint for turning that vision into reality. The plan was formed from a thorough analysis of the projected practice expenses, combined with personal expenses and salary needs. To achieve her goals, the plan called for incremental monthly increases in production during the first year.

In the first quarter (October through December 1999), we projected a quarterly production goal of $78,232. We thought this initial increase over her previous quarterly production of approximately $64,000 was realistic, based on the power of efficient scheduling.

Pride Concepts

  • Turn dreams into reality by knowing the production needs to pay for your dream
  • Develop a challenging, yet achievable, annual plan to reach your goals
  • Implement production increases in incremental steps
  • If at first you fail to meet your goals, don't get discouraged!

Production can be improved significantly by using a formula for "preblocking" the schedule, which means setting aside a certain number of appointment slots for significant procedures equivalent to a crown fee or higher to achieve the production goals. Filling these preblocked appointment slots - two per day in Dr. Thompson's case - was essential to meet increased production goals. Preblocking is highly effective because there is almost always a substantial amount of diagnosed treatment in the charts that has not yet been performed. A focused effort by both doctor and staff brings patients into the office to obtain needed treatment. By filling the preblocked appointments, Dr. Thompson met her production goals.

Dr. Thompson planned to close for the holidays and remodel, with the new practice scheduled to open in January 2000. The two offices shared a reception area and entrance but had separate front desks, as well as other areas that needed to be consolidated. The renovation provided one front desk area, a consultation room, a break room, and five operatories.

In the fourth month, Dr. Thompson was scheduled to increase production by the continued preblocking of two appointment slots per day, hiring a hygienist, and from the influx of an additional 1,200 to 1,500 patients of record from the new practice. It was essential for Dr. Thompson to achieve these goals in order to cover her loan payments on the second practice and to meet her other expenses.

Although her staff was receptive to meeting the new goals, Dr. Thompson's schedule was not being preblocked consistently. The new practice was now open for business by the end of January, but newly implemented systems, such as the morning huddle, were failing; a hygienist had not yet been hired; and production and collections were down, with Dr. Thompson still taking care of hygiene appointments herself. The staff had regressed to old habits and a new staff had just come on board.

Dr. Thompson ended January 2000 with the newly acquired overhead of a second practice, but without the increase in production to pay the extra bills. She was in the process of merging two staffs and trying to find out who was staying, who was going, who was happy, and who was terrified - besides the doctor!

That month, the influx of patients from the new practice boosted monthly office production from the low $20,000s to $33,624, but the bar now had been raised to $39,603. She was still falling short by 13 percent. Had we overfilled Dr. Thompson's plate? Next time, we will see why it's important not to give up if goals aren't immediately met.

For information on education materials, seminars, and management programs, call Pride Institute at (800) 925-2600.

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