1) What management software do you use for what?
2) Do you have centralized management or is each office run by itself?
3) Do you find any problem with associate turnover in each office? What is the incentive for staying in (what is their pay structure?)?
4) How many associates do you have per office and how many days a week do they work on average?
5) What are your office hours? (My current office is looking to expand to 7a-7p and open 7 days a week, not sure if this is a good move from 4.5 days, we are definitely busy enough for the expansion)
6) Do you find yourself in better leverage to negotiate your fee schedule with Delta with more offices? I assume your started with more than just Delta PPO, when did you start dropping insurances?
7) What lab do you use for your cases or is it all/some of it in-house? Are you using traditional impressions for crowns or is everything scan and mill?
8) How far booked out are you for hygiene and new patients?
1) Dentrix
2) House of brands with central control of things like bills, ordering, payroll, bookkeeping.
3) Associates are hired guns - they come and go. Good ones go fast, band ones you can't wait to get rid of. My strategy is to have partners instead of associates. Either a buy-in for one of my existing offices, or, more often, a partnership where a less experienced doc buys a practice and exchanges 20-30% of ownership for my consulting/optimization/leverage positions. Leverage in this case means STEEP discounts for variable expenses (lab costs, supplies, marketing, etc). This way, they can buy an office that producing 700K and end up with a 1.4 mil in REVENUE in 18 months.
4) See above
5) ranges from 7-9am start and 5-6pm finish. Things for you to check would be (a) labor law in your state (some states consider anything above 8 hrs/day at overtime), as you may need to stagger employee shifts; (b) will your patients and STAFF be willing to be in the office at those hours; (c) is this better than being open an extra day; (d) if it's recall/hyg issue, why not add another hygienist and run a double or triple hygiene in the same day and expand another operatory, if possible; (e) if it's issue of you not being able to see more patients, consider working a little faster/smarter, double booking, or adding another RDA/DA for faster turnover. I very often see offices get in trouble by expanding without any optimization, which just results in minor revenue increase and major overhead gain. PM me if you want more specific advice
6) I don't negotiate with terrorists (or, in case of Delta, terrorists don't negotiate with you, regardless of how big you are). And no, always looked for offices to buy that were not insurance heavy.
7) Hardly no in-house lab work, though we are equipped for it in case of clutch situations. I am full digital flow (Trios) in all my offices and my lab picks up the tab on the cost of my Trios's. That's one of my leverage positions. It's a California-based lab that services all of US. PM me if you are interested in using them.
8) months and months, but of course, there are openings here and there. Combined, my offices have something like 22 days of hygiene/week.