Bulletin, August 2007

Exclusively to Clients and Friends
of Advanced Practice Management

The Dental Dow Jones, January through June:

Practice production is up 6.2% and collections are up 6% compared to 2006 averages. Comparing the first six months of this year to the first six months of 2006, we find that practice production is up 3.9% and 3.6%, respectively.

You may recall, in 2006 average production increase was 3.3% and collections 1.6% so we’re showing a little bit better growth this year in collections.

There has been a mild uptick in new patients and recall exams (about 1.3% each). Hygiene downtime is up a bit and Doctor downtime has decreased a bit (In our sample practices, downtime decreased from an average of 13.5 Doctor hours per month in 2006 and 10.7 hours per month this year).

The great majority of practices have some slow months. Some of these are seasonal fluctuations and some are just plain random. They come and go. It’s safe to say that there is no evidence here of local Dental depression but it’s not a boom market either. As you’ve heard me say many times, you have far more control over your practice than the economy does. If you have positive expectations you’ll do better than if you have negative expectations because you’ll make better decisions. Why not plan on succeeding?

Most practices generally do well in direct proportion to the degree in which they follow through on our recommendations.

Statistical Snapshot/Working the Edges—
A More Detailed Look At Hygiene Productivity.

Take a look at these statistics (which are not unusual to find in a multiple hygienist practice):

Hygiene Case History
  Ann Bertha Carla Total Revenue
Production/Hour $123 $110 $105  
Production/Visit 120 100 105  
Hours Worked 130 120 50  
Production/Month $15,990 $13,200 $5,250  
Increased revenue impact if hygienists increase to $120/Hour.
  $1,200   $750 $1,950/Month

In this example you can see that one hygienist is out-producing the others. She’s producing $123 per hour which is about the current Twin Cities’ average. The other two hygienists are producing $110 per hour and $105 per hour.

Let’s assume all the hygienists are equally pleasant and hardworking. They are all equally busy yet one hygienist is out-producing the others. Here’s the key point. If the other two hygienists were just to bring their production per hour up to $120… practice revenues will increase by $1,950 per month and most of this would be net (less x-ray film, prophy cups, bibs, etc.).

The main factor in the hygienist production per hour is what they do per patient. That means coverage of perio, x-rays, sealants, and fluorides.

I’m often asked by Doctors about overhead control but often overhead control isn’t a matter of squeezing down expenses as it is making sure you get good result control. It often comes down to confrontation. Whether it is confronting supply guys and getting two bids so they are competitive, confronting your “friendly” local banker about giving you a lower interest rate, or confronting staff members who may be hardworking and well-meaning but not performing as well as they could.

In larger practices with more than two hygienists, we recommend doing an individual breakout of hygiene production per hour from time to time. As you can see, it can be quite worthwhile. We can do this for you. Just ask.

Dentist Sued for $125,000 for Showing Before and After Photos:

In a recent Minnesota case, a patient sued their dental office for using her “before” and “after” pictures in a newspaper ad. The ad showed the patient’s mouth area only and did not identify her. The patient signed a release, but it did not specifically speak to “Promotional Purposes.”
I think we’d agree that it seems like quite a stretch that $125,000 worth of damage was done to a person for having a picture of her mouth (only) in the paper. And, she did sign a release. According to the Dentist’s attorneys, Barb Zurek and Marshall Lichty, the jury eventually found the Dentist had adequate permission and that the patient did not suffer any damages— but only after four days of trial!

Are you using “before” and “after” pictures of your patients or have promotional materials on your website? Please make sure you have the appropriate releases. Call us if you’d like an example.

The Unemployment Cost of Terminating an Employee?

When a Doctor is contemplating terminating an employee we often get asked, “How much will this cost me?” Unfortunately, given the complex system states use, it’s hard to be very specific but I can give you some guidelines.
For example, in the State of Minnesota, if an employee is making $20 per hour, his or her weekly benefit amount would be $400 and he/she is eligible for benefits up to 26 weeks ($10,400). However, of course, not everyone uses the full 26 weeks. The State of Minnesota says for all employees at all kinds of pay rates the average unemployment cost is about $4,566.

From an employee standpoint, someone who makes $20 per hour would be earning about $3,466 per month. On unemployment they would receive about $1,733 per month. So, of course, most employees have incentive to move on and get another job.

As you know, most Dentists wait too long to terminate someone. I’ve said this before but, in over 25 years of advising Doctors, I’ve never seen a Dentist regret terminating an employee that they wanted to terminate. They always wish they had done it sooner. And, in fact, your unemployment liability is often less if you do it sooner.

We don’t want to be capricious with peoples’ careers but when someone either can’t or won’t perform to expectations or has a bad attitude, it costs you, your patients and the other staff members a lot in lost productivity and morale.

The ‘Collections Made Comfortable Seminar’

for the Entire Team:

We had so much positive feedback on the seminar that we continue to run it every fall. This used to be just for administrative staff but the most frequent comment we got was, “Why don’t you have everyone come?” Moreover, we found that the entire team enjoys the seminar and, of course, everyone contributes to the management of patients, money and insurance. Shelly’s Collections Seminar is not just about proven tactics to get you the money you want… it’s about the whole attitude of using money and insurance coverage to move people to and through treatment instead of it being a barrier to treatment.

As a Client, You Get First Dibs and 20% off but Please Register Now. Call 952-921-3360:

We will soon be mailing non-clients and we want to make sure you get your seat first.

This year’s seminar is being held on October 5 from 9:00-2:00 at the Embassy Suites at 2800 American Blvd. in Bloomington.

See you there!

Make Hay When the Sun Shines!:

August is the peak hygiene month for most general practitioners. Your patients don’t plan in advance for the back-to-school rush so you must. Make sure you load up on extra hygiene time, particularly for the last couple of weeks of August. That means lining up extra CRDA time, doing Family Check-Up Days, or just simply adding hygiene time where you can.
And then be aware that there is almost always a September slowdown. Hey, that’s a good time for you to finally take that vacation to Europe that you’ve been putting off!

Yours truly,