How to lower overhead and increase productivity with optimized scheduling blocks

October 10, 2017
Bruce B. Baird, DDS
Bruce B. Baird, DDS

Bruce B. Baird, DDS, one of America’s most productive dentists and leading productivity expert, practices comprehensive treatment planning and full-mouth restorative care in the Dallas/Fort Worth area in Texas. In 1990, he established the Texas Centers for Implant Dentistry, a mobile practice that allowed him to work with more than 25 doctors in the region. Recognizing his ability to help other dentists achieve the same success, in 2004 Dr. Baird founded Productive Dentist Academy and partnered with Vicki McManus, RDH, in 2005. He is also the founder of Comprehensive Finance.

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Vicki McManus Peterson, RDH
Vicki McManus Peterson, RDH

Vicki McManus Peterson, RDH, is the co-founder of Productive Dentist Academy, a public speaker and owner of a dental practice in Wisconsin. She is the collaborative author of “FUNdamentals of Outstanding Dental Teams” and recently published her latest book, “Frustration: The Breakfast of Champions”. Vicki is an expert in the industry regarding leadership communication, rock-solid hygiene strategies and effective dental practice marketing.

Switching up how you schedule appointments can have a big impact on your practice.

You’ve run the numbers, and you just can’t make them work. You’re sure that you can’t increase productivity any further without expanding your practice and increasing overhead. But you’re not sure that’s a step that you’re ready to take. Are you really in a place where you can hire more staff, add bays and procedures, and buy new equipment? Do you want to take on more debt at this point in your career?

If you’re feeling the tug toward expansion but you want to reduce risk, it’s time to look for ways to increase productivity and lower overhead in the short-term so that you can expand in the long-term.  One of the most efficient ways to increase your hourly productivity while reducing or holding steady on overhead is to change how you schedule appointments in your practice.

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How to know when it’s time for a schedule retool

Practices grow and change over time. Your patient mix develops, you become locally known for certain procedures, and your days develop a rhythm. As your staff becomes accustomed to your needs and the routines, it’s easy for everyone to go into autopilot mode. You keep doing the same things in the same way, not because they’re efficient or productive, but because they’re what you’ve been doing for a while.  When was the last time you took a step back, looked at the whole picture, and made sure your schedule and production goals fit your current needs?  Since your last scheduling retool, have you:

  • Hired new staff members to either replace retirees or expand your practice?

  • Added new services?

  • Adjusted your hours?

  • Rearranged your bays and cabinets?

  • Added chairs?

  • Grown your patient base?

  • Used the current scheduling system for more than a year?

If your situation has changed but your scheduling hasn’t, you’re probably missing out on productivity gains. When you schedule efficiently for hourly productivity, your practice runs more efficiently, staff are engaged and happy, and you don’t have wasted overhead costs.

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Why hourly productivity?

Scheduling for daily or weekly productivity leads to the temptation to reach your production goals through a high volume of low production procedures rather than a reasonable volume of high production procedures.

However, just as in the old joke, ‘making it up on volume’ is a myth. What happens when you try to cram low production procedures into your schedule? Your staff feels rushed. They’re always running behind schedule. As a result, the patients are cranky and stressed out. Your office feels chaotic, and people don’t trust you with high production procedures because there’s a sense that you can barely handle run-of-the-mill cleanings and minor restorations.

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When you schedule for hourly production, you can’t fool yourself into compensating with a higher volume of patients. You don’t have enough time to imagine that you can squeeze extra people in, and you don’t have the chairs to add appointments. You have to take a good, hard look at your goals for the practice and schedule accordingly.

Hourly production goals also ensure that doctor time is being used efficiently. If you’re standing around in the hall waiting for hygienists to call you in at the end of a cleaning, you’re wasting your time. If you want your practice to be productive, schedule high production procedures for yourself. You’ll be happier, busier and less stressed because you’ll be doing the kind of highly skilled, interesting work that you went to dental school for.

Finally, hourly production goals can jumpstart a cycle of practice growth. The sort of high production procedures that help you meet your hourly goals also create enthusiastic patients. People like you when you give them their smiles back. They’re enthusiastic when you provide them with excellent care - care that they couldn’t get at just any practice. The patients you book in you major procedure blocks are the people who will bring their families and friends to see you and who will ultimately help you grow your practice.

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Concrete goals for your practice

How do hourly production goals work in practice? Here are a few pointers to get you started:

  • To find your hourly goal, start with your monthly goal. Divide that by four (for the four weeks in most months) and then by the number of hours your practice is open each week.

  • Meet your hourly goal with major procedure blocks. Each major block should be one-and-a-half to two hours long.

  • Once you’ve blocked out the space for major procedures, you can fill in the other chairs with your less productive services like cleanings, simple fillings and orthodontia adjustments. All of the production from these appointments will be in excess of your hourly goals.

  • Do not violate the blocks. Once you allow a violation of a block, violations become the norm and you lose your blocks. At that point, you need to start over from scratch on the schedule.

  • Diagnose, diagnose, diagnose. In the past, you may have been unwilling to diagnose emergent issues because you didn’t have openings in the schedule to deal with them. You have the time now. You can get the patients in quickly, so don’t be afraid to diagnose. 

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Notice that with this method you are doing major procedures every day that you’re open, not just on certain days of the week. At first, you may wonder if you can fill three or four major procedure blocks every working day. The answer is yes! One benefit to these blocks is that when you have patients who need major work, you can often schedule them within the week. Patients appreciate it when you take their needs seriously and help them get care quickly. Even if a dental situation isn’t an emergency from a clinical perspective, it often feels like an emergency to the patient. When you offer those blocks, patients will fill them.

If your block is still empty 24 hours in advance, you can fill it with patients from your ‘sudden opening’ list or use the time to do same-day procedures for patients diagnosed during their cleanings. However, once you’ve been using this method for a month or so, you’ll find that if you have the blocks, you’ll have the patients to fill them.

Track metrics so the whole staff can see

Once you implement block schedules, track your hourly production and get your whole staff involved in meeting goals for production, on time appointments and diagnostic rates. If you’re concerned about your overhead, look for places where you can reduce waste and track your progress toward eliminating wasted supplies or utilities. No one can meet fuzzy goals like “improve efficiency.” Give your team concrete benchmarks tied to real rewards, and they will exceed your expectations.

A productive, well-run practice benefits you, your team and your patients. Take the time to implement block scheduling, and you’ll be able to do more good for your community with less stress for yourself.