download_pdf_buttonBulletin, March 2011

The Latest in Area Economic and Technical Trends
Exclusively to Clients and Friends of Advanced Practice Management

2010 Wrap-Up

The Dental Dow: Comparing the statistics of the sampled mature practices from 2010 to 2009, we find that practice Production was up 1.4% and Collections were up .4%. New patients were down 8%, but total patient flow was down just 1%.
In 2009 practice Production and Collections were up about .5%. In 2008 Production and Collections growth were 3.5% and 3.0%. In 2007, 5.1% and 4.3%.

Other Trends: Back in 2007, about 38% of practices had websites. That has increased to 61% in our Fall 2010 survey. Digital Radiography has also shown big increases. In 2007, 37% of area offices had Digital Radiography. It’s now 59+%.

As noted in my previous bulletin, multi-location group practices are definitely on the upswing. Midwest Dental alone added about ten area practices to their collection in just the past year.

Please understand the whole point of that article was that you’re better off owning your own practice if you want to run your own practice. Why let a third party share in the profits and control? But you have to take control! I’m saying this because I think some Doctors thought I was “endorsing” selling out to big groups. I don’t consider the big groups an enemy and for some of our clients that might be the best path of transition, but I don’t endorse them unconditionally either. For most of my clients, they are the competition.

Good Things for You and Your Staff:

Take a Trip to The Big Easy to see Joe and Shelly: Dr. Joe Steven (of Kisco fame) and Shelly Ryan will be doing the “What Do You Say When?” seminar in New Orleans on April 1st. This seminar consistently gets rave reviews from the participants. It’s a great team outing and what could be a more fun place to take the team than New Orleans? Visit and make plans now!

The Virtues of Dentistry
Dr. Howard Farran on September 9, 2011

Howard’s insights and perspectives on the practice of Dentistry are second to none. He can occasionally outrage the audience members but no one is ever bored! You and your staff will hear scores and scores of mind-expanding concepts and you’ll have a great day to boot!

Call 952-921-3360 and register now!

Special client and group rates now apply:

Clients: The registration fee is $198 for the first person and $155 for each additional. We expect a sellout and as clients you get first dibs.

Non-Clients: The registration fee is $288 for the first person and $188 for each additional.

With early registration there is a $20 savings per person. We also offer you Special Group Rates.

We’re introducing group rates this year because this way you don’t have to determine every staff member who is coming or not. So, there is one flat fee for 6-10 attendees, 11-15 attendees, etc. This makes the registration a lot easier for you (and us!).

Statistical Snapshot—Front Desk Collections:






Front Desk Collections
as a % of Production




It’s not just about the money! Our client base averages 33% front desk collections. Collections at the time of service can reduce billing costs and of course eliminate completely the chance of not collecting! However, the real benefit in increasing front desk collections is in increasing patient commitment. Low front desk collections are a sign that conversations are not happening about treatment costs and insurance at the front desk.
In every office there are situations where the Doctor and hygienist recommend treatment and then are surprised to find out later on that the patient didn’t schedule or cancelled. “I thought they understood completely why they needed to get this stuff done now…” So sometimes the Doctors can feel that the front desk isn’t able to field the treatment they are sending their way.

Of course, the front desk isn’t the only possible culprit here. It’s a matter of getting the patients to the front desk with the right information at the right time so they can do their jobs. If your front desk collections are under 33%, they can be better. We can help! We coach teams on this all the time. As front desk collections go up, watch, your crown and bridge will too!

$25 Million per month in Perspective:
(from the APM Database)

Each month we collect data from offices all over the Upper Midwest. The collective productivity of these offices is over $25,000,000 per month. That’s a lot of data. How do we make it useful? We can look at Hygiene Production per Hour, Doctor Production per hour, Crown and Bridge, New Patients, Down Time, etc. All of these statistics give you a very real perspective on how much you can expect from you and your staff. What is possible and what is a stretch.

Here are some key statistics from the recently compiled 2010 data:

Metro Area
  Average 75%ile 95%ile
Dr. Production per hour $589 $665 $825
Hygienist Production per Visit $138 $148 $167
Collection Percentage 85% 87%  
Accounts Receivable Ratio 1.04 1.22  
Front Desk Collections 30% 35%  
Production per Active Patient per Year $677  
Outstate Area
  Average 75%ile 95%ile
Dr. Production per hour $453 $509 $681
Hygienist Prod. per Visit $117 $130 $138
Collection Percentage 91% 95%  
Accounts Receivable Ratio 1.1    
Front Desk Collections 36% 40%  
Production per Active Patient per Year $519


Obviously, if you increase your and your hygienists’ production per hour, all things being equal, you’ll make more!
You can increase your production per hour (capacity) by looking at the main factors that go into determining it such as:

1. Staffing, Delegation and Teamwork: Presumably, with more staff working together that you delegate more to, you can do more than with less staff not working well together that you don’t delegate to!

2. Treatment Plans and Procedure Mix: If you’re doing Quadrant Dentistry or higher end procedures, you’ll produce more than if you’re doing patchwork all day. If you went to CE for cosmetic, ortho, implants, etc., use the techniques.

3. Facility, Equipment and Technology: With more rooms, better equipment and more advanced technology, you can get more done than with fewer rooms, less equipment and less technology.

4. Clinical Speed: Not the biggest factor. The “time on tooth” for dental procedures between dentists isn’t all that different. There are exceptions though, for example, with Cerec. Some Dentists (through delegation, training and experience) can complete the whole procedure in 1 hour. Others need 2-1/2 hours.

5. Appointment Book Control/Scheduling: In most offices, the schedule is simply a list of patients coming in. Make your schedule a planning tool and you’ll profit accordingly. If you take care of each day, the months and years will take care of themselves!

This can involve setting a production per day goal. I’m sure that you’ve all heard of this many times. The goal has to be realistic though and really designed to leverage the resources you have. For example, often Doctors have two assistants but don’t make full use of them. For that second assistant, you have to comfortably see at least two more operative visits per day than you would if you only have one. If you don’t, your overhead is going to be above industry standards.

You don’t have to be booked out a long way to increase your hourly production. Good planning can make sure that every day is more productive. Plan your “Perfect Day” and block it out accordingly. Sure, you’ll rarely attain “perfect” but if you start putting together each day with a plan you’ll end up with more good days!

If you haven’t already worked with us to do so, it’s time to set your statistical targets for the year. Then we can work back to your and your hygienists’ production per day and hourly goals. Let’s give your staff a little direction on how to put those days together the way you want them.



Bill Rossi, Robyn Kain, Shelly Ryan and Matt Lahn
Bill Rossi , Robyn Kain, Shelly Ryan and Matt Lahn