by Roger P. Levin, DDS, MBA
Scheduling is the single most important production factor in dentistry — and the most misunderstood. Doctors generally design their schedules early in their careers and seldom change them. Rather than adjusting their techniques to meet the changing needs of the practice, the schedule is simply tweaked over time using a "bandaid" management approach.
Eventually, one of two things happen. Practices appear to reach production capacity, even though they may actually be performing below potential. Or, doctors become stressed to the point of misery.
The truth is that schedule design is mathematical and time-controlled. Where do you begin? Not by simply buying new software or giving up, but by evaluating exactly what you want your schedule to be and assessing whether or not it is realistic. Can you produce $3,000 or $5,000 per day? Do you want to work six or eight hours? Do you need two or four assistants? These and about 80 other questions all determine how your schedule should be designed.
Here are a few scheduling basics that never change, regardless of what type of system you use.
Do the most productive things first. Most practices take a "fill in the holes" approach to scheduling. One of the key principles of effective scheduling is to do the most productive things first. Block off a segment of time every day for productive procedures. We recommend the morning, when 60 percent or more of daily production occurs. This could be in one to three-hour time blocks allocated for certain fee level cases.
Establish the ideal day and ideal production. Practices should apply a mathematical formula to their daily production. Achieving a desired annual production requires an average daily production level. For example, if you want to produce $500,000 in 200 days, your production must average $2,500 per day.
Schedule the dentist and clinical team on a per chair basis. When evaluating the schedule, look at each of the available dental chairs as an opportunity. For example, a general dentist should use at least two main chairs and effectively rotate between patients. This can increase production by 30 to 40 percent — without adding stress.
At the same time, general dentists and all specialists should have at least one additional chair that will produce at 50 to 60 percent of the first two chairs. Not only will this significantly enhance practice production, but it will also allow for flexibility in emergency scheduling, minor procedures, delays, late patients, and other unexpected scenarios.
The number of chairs varies per specialty. As a rule, general dentists should utilize a minimum of three chairs; specialists should utilize even more, depending on the specialty.
Schedule auxiliaries separately from the doctor. Dental assistants customarily work directly with dentists. This means that many of them spend 30 percent or more of their time waiting for or watching doctors. Instead, these individuals could be more effectively engaged in productive diagnostic or treatment-related activities. This will help an individual patient's progress move forward and takes a great deal of burden off the dentist.
The schedule controls almost every aspect of practice activity; therefore, all change originates from the schedule. Unfortunately, many dentists are scheduling a higher volume and building much more hectic and stressful practices. The physical and mental fatigue is wearing, and the stress takes the fun out of dentistry.
Simply applying some of the above recommendations can revolutionize both your production and your enjoyment of dentistry.
Roger P. Levin, DDS, MBA, president and CEO of The Levin Group and the Levin Advanced Learning Institute, provides worldwide leadership in dental management for general dentists and specialists. Contact The Levin Group at (410) 654-1234.