We recently attended a dental meeting where a presenter made a “big deal” over their office generating 70 new patients per month for the past several years. My back of the napkin calculations would indicate that this means they are generating 840 new clients per year. On the surface this might seem like really good news. We all know our attrition rate is about 10% per year so we need to have new clients just to stay even. But how many do we really need to be productive. Let’s step back and do some more in depth analysis to see how this would work out in an office that is practicing what we would term comprehensive care. That term means: through initial exam including necessary radiographs, photographs and periodontal charting, comprehensive diagnosis and treatment plan, personal consultation and financial plan before treatment. We will use information from out office as we do not have data from the presenter’s office.
In our office we are working 4 ½ days a week. That equates to 36 hours of available chair time per doctor. For an initial examination we allocate 30 minutes of doctor time and 90 minutes of chair time. We allocate diagnosis and treatment planning doctor time at 30 minutes. We try to use non-productive time during the day to treatment plan. Many cases will be very simple but some will require extensive time outside normal hours to consult with other colleagues, so this is an average. We allocate 30 minutes of doctor time for a consultation and case discussion during productive time. Our staff handles financial arrangements outside of that time. We allocate an average of 90 minutes of doctor time before we begin to be productive with a new client. Our presenter’s office had three doctors. So let’s run some numbers and see what all those new patients do to a schedule.
Our numbers say that the three doctor practice has 432 hours available per month to produce. If they use as much time as we do with new clients that eats up 105 hours leaving only 327 hours per month of production time. If we allocate 90 minutes per day for hygiene checks that is another 81 hours of production time gone leaving only 246 hours per month to produce. This assumes multiple hygienists with about 15 – 18 hygiene checks per day of only five minutes or about 9 checks per day at 10 minutes. By the way – your hygiene department is where clients are educated on self care, reminded of the next steps for their long-term restorative plan and where relationship development takes place. If your clients feel that the doctor is ‘rushed” in hygiene do you not think this is likely the perception of how the doctor is when doing restorative care?
So what are we trying to say? First, too many new clients in a mature restorative practice is not ideal. What is the proper number? You will have to do much more comprehensive analysis to determine what is right for you. The ideal mix is driven by your desire and ability to deliver comprehensive, behaviorally adept care and your personal understanding of work-life balance and desire for financial reward. Here are some questions to ask. What is your active patient base? Are you growing? What is your hygiene retention rate? You should have 85% or more of your patients actively appointed in hygiene with about 25% of that population in some sort of periodontal program. This is the pool of folks that will drive your restorative practice. What are you trying to produce per hour and per year. Doctor should produce 65% and hygiene should produce 35%. There is no one magic number but more is not always better. Do the numbers for yourself.