Size matters

July 1, 2007
Dentistry is a lot like the fishing stories we tell. When we talk to other dentists, we remember the largest number we ever produced...

by Bill Blatchford, DDS

Dentistry is a lot like the fishing stories we tell. When we talk to other dentists, we remember the largest number we ever produced and round it off to the nearest hundred. But do we ever mention net or numbers that really count? As a rookie dentist, I remember hearing those boastful conversations and being frustrated because I thought they were true, and I also thought gross mattered. No one ever mentioned net.

Within the artistry of dentistry, attention to details and numbers affects the end result. The same applies to the business of dentistry. Size matters. Numbers make a difference, and it is not all about being big. The doctor with the largest gross is not the winner if the net return is 20 percent. Why do you choose to work so hard for so little return?

Paying attention to practice numbers ensures an excellent outcome, just as in your technical work. Ignoring this aspect is a choice that can result in those numbers moving in the opposite direction rather than having a good result. Slipping, sliding, and guessing are not so good when size matters.

A million-dollar practice should net $400,000. Why would you work hard to produce a large gross and take home less? Which would you rather have - a practice grossing $800,000 with a net of $350,000, or a practice grossing $1 million with a take-home pay of $200,000? These are choices we make about size.

Let’s examine more “sizes.” Not only is there a choice about gross and net, but there is also a choice about numbers of new patients and case acceptance. Some dentists are crying for more new patients, yet they lack the skills they need to build relationships, discover dreams, and determine wants. New patients are wasted in this type of environment. With current sales training, you can do well with one quality new patient each day.

Instead of large new-patient numbers, it takes focused sales skills where conversations with patients are about what they want and not about the pressure to purchase. Relax. Find out who your patients are, what they want, and how you can help them. Every team member needs to be on board with good personal skills.

Another place where size matters is the percentage spent on staff salaries. A general practice should make it a goal to spend 20 percent of its production on team salaries, taxes, and benefits. We have seen practices spend as much as 39 percent on the team. Now that is a big number, but not one of which to be proud. A dentist would be working hard to support the team at that rate. How does that percentage get to be so big? There are many reasons, but basically it occurs because of an absence of real leadership and planning. A better question is, “How can I get my staff costs in line?” Even a million-dollar practice can operate with three team members plus the doctor. Yes, they must be the right team members. So keep looking until you find the right ones instead of hiring three to do the job of one.

Size matters regarding the doctor, too. If you are a seasoned veteran who takes more than 60 minutes to routinely prepare a crown, you have a case of the “slows.” Combine that with a team of six and you will find yourself working hard, very hard. The solution? Take more classes and develop efficiency skills in the treatment room. Work from a laminated checklist and avoid being a “diddler.”

Size matters in scheduling treatment. If you do not know your overhead per hour, how can you expect to cover it each hour? A big overhead and little income is not a pretty thing. Combine an 80 percent overhead with a team of six to eight, all involved in the Crown of the Year Club, and dentistry will not be so fun. An average overhead is about $250 to $300 an hour. Do you have a goal of covering your overhead per hour? Consider, too, that just reaching your overhead per hour is a tie game.

Size matters in the relationship of your lab bill to production. It is very difficult to make a good living in the Crown of the Year Club. Your lab percentage should be in the 9 to 11 percent range for a general practice, which means you are diagnosing beyond the magic insurance maximums. If this is the case in your practice, congratulations! You are just the right size.

Size matters. Strive for a higher lab bill, a lower team percentage, a bigger net vs. gross, and a higher case acceptance from fewer quality patients. Set your goals for the right numbers to be large and some to be small, all the while remembering that size does matter!

Dr. Bill Blatchford is a leading dental business coach who has worked with more than 2,000 offices to help dentists achieve more time off, more net, and more enjoyment. Become a member of Blatchford FILES, Dr. Blatchford’s monthly CD on winning at dental business. The first two months are free. Call (541) 389-9088 or visit for more information.

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