Thanks for the great insight Dr Jeff. Would you agree with me then that if one dentist attempts to see too many patients comprehensive treatment gets put off and production decreases (my dentist actually tries to see around 6000 active patients and whenever I go for a checkup he appears to be running around his office). A friend of mine went for a checkup last month and was told he needed braces, multiple fillings, and laser treatment for his gums. Diagnosis and treatment options were not presented at all; he only accepted the fillings (he is on Medicaid). Large practices have the potential to produce large profits... If managed correctly.
I think that it's doable to have a very large number of patients and be quite profitable, and NOT have it seem like one is just running around all day trying to play "catch up"
IF YOU HAVE CONTROL OF YOUR SCHEDULE!!
Plain and simple, not every patient you see in your practice, be them a brand new patient or a 20+ year patient of yours, is going to need some work, let alone some "big ticket" work (endo/crown/implant/etc) no mater what any practice consultant or online dental personality tells you, that's just not the "real world" (or atleast the real world that i've seen in my 13+yrs of private practice).
So the reality then becomes, and I think that most active GP's will tell you that they'll always want a few more patients coming through the office on a daily basis (via either hygiene vists or vists with the dentist themselves) than a few less, since the more mouths that walk through the front door every day, the more chances are for production. The key though for me atleast is to take control of my schedule, even before a single patient is in the schedule!! What I mean by that is by having both a staff who handles my scheduling (and in my office tat can be done by my front desk staff, my assistants and my hygienists) aware of MY scheduling goals for my day, and that includes a production goal, some set time for larger procedures, a certain maximum number of pedo patients per day (usually a mentally draining patient visit for me), a certain maximum number of "non billing" procedures per day (cement crown visits, denture adjustments, etc), some time to put a few emergency patients in the schedule when and if they call that day, and also awareness of certain other things such as if my business partner may be out that day, thus giving me extra hygiene checks per hour, if the lab tech that I use for my crown and bridge work is coming for a chairside custom stain of a crown, etc. The more I actively take control of my schedule, the more patients that I can see in an efficient and profitable and mentally sane way.
This may mean that some of my patients who I see on a hygiene check and need some simple filling work on non symptomatic teeth might be scheduled 6 to 8 weeks out to accomodate my scheduling template, but it lets me function efficiently!
When my schedule is working as I planned it to, my days while from just lookng at the schedule on the computer monitors in my office would seem to be super crazy, it actually flows for me very easy. Simple things like being aware of when my hygienists are more than likely going to be coming to find me for a hygiene check and have myself aware of that so I know that say at :45 after the hour I'm going to be needing to get up from my chair and check the hygenists, so that's also a good time to say have my next patient scheduled to arrive so I can have one of my assistants get them seated so that while I'm up checking hygiene, I can get that next patient numb, then go back to my 1st patient and finish up on them (after having giving them a few mintes to close and rest their mouth after having asked thm to keep it open for the previous 30 minutes or so). I finish up my 1s patient, and then my 2nd patient is numb and ready to go, and more than likely I then have a 35-40 minute window where I'm going to have limited and/or no interruptions from my hygienists for checks. When it goes as planned, its great! When it gets out of sync, such as when a bunch of "quick" hygiene patients are in the schedule (kids, adults with less than 12 teeth, etc) or if a patient shows up late and/or that unexpected patient who takes a while to get numb,etc then my schedule can get very "choppy" and inefficient where it can seem like every 5 minutes or so I'm getting called to get up and check a hygiene patient, so my hygienists can get their next patient in, but at the same time taking away from my time to work on my patients
😱 As much as one tries to plan for a smooth day and forsee as many possible problems ahead of time and take steps to alieviate them, sometimes things just happen and my schedule goes from"smooth on the screen" to chaos in the office. Some docs, because of lack of control over ther schedle have "chaos in the office" every day, andon the outside seem like they're running around with their heads cut off all day every day - and that can hapen reguardles of how many or how few patients the practice has.
For me it was, and still is, a trial and error process about how to manage my schedule. For me atleast I'd much rather day in and day out be trying to figure out and adapt my schedule to fit in more patients than less, since I make my $$ when i'm sitting in my chair with my foot on the reostat and a bur spinning away, not when i'm sitting at my desk in my office. And the more patients that I see, the better the chances are that for more of my day the bur is spinning rather than not spinning!
