Just to go into more detail, root canals and crowns go hand in hand. The lightwalker laser makes root canals go faster and a lot more predictable. That hour long root canal can be shortened to 20 minutes or less. If you're focused primarily on the crown and bridgework, you need at least 2 cerec scanners, mills, and ovens. That gets rid of some bottlenecks associated with 1 cerec (i.e you can only scan one pt at a time, only mill one crown at a time, and bake only one at a time). I found the sweet spot is 6 systems and I calculated this from my crown productivity. If I have 6 patients lined up for an individual crown each, I can prep each one fairly quickly, get each one scanned, and each one sent to an individual mill, and by the next hour, start cementing/prepping for the next hour. Interweaving all these procedures is the key. I don't always maximize the productivity just because the work isn't always there. However, when the work is available, I can take down columns of procedures fairly quickly because I don't have the bottlenecks.
Mental organization and focus is extremely important while working in this state. If you are not focused, you will get overwhelmed quickly. If you are not organized, you will have people waiting. I don't always have the luxury of two assistants assisting me all the time due to the heavy workflow, so another thing is to be able to multitask while working on a patient. There are always downtimes within every procedure. For example, if you're using a 3s curing light, you have 3 seconds to do something. That's where you have to train your other hand to operate independently of your dominant hand. You might ask, what can I do in 3 seconds? You can ask your assistant to pull up the patient's next xrays for review upon the next 3 second curing interval. You can get the etchant, bonding agent, another compule of composite, you can grab the air water syringe, you can grab a hemostat or other instrument. It's all about making sure you are always doing something multiple steps ahead. I like to call out the steps to my assistant because it becomes second nature to them eventually as well.
In procedures that aren't linear, it is important to recognize if something is missing in the setup. An example is if I run out of composite and there's none in the room. I'll take over their job for a few seconds and expect the assistant to relay to another assistant to grab an extra composite. However, as much as I want them to anticipate these things, I find that I need to anticipate these things so that in the few steps before I run out of composite, I can already relay that information to my assistants to ensure no interruption in workflow. This tends to happen more in endo since sometimes I may need 31 or 21 mm files and I can lose valuable seconds with these interruptions. I also lose time when I have to change handpieces and burs, but I wonder if it's feasible to have 2-3 electric handpieces to reduce the need for bur/handpiece changes.
Anyway, I hope this gives you some insight on improving efficiency. Good luck on your endeavours!
