Episode 120 – Requested Replay: The Secret to Productive Dental Scheduling

“Scheduling is the one thing that costs dental practices more in long-term revenue than anything else.” ~Dr. Bruce B. Baird

If you’re taught anything in dental school about scheduling, it’s about “perfect day” scheduling. Numerous consultants across the country teach it, but it’s just about the worst system you can use. It is totally non-productive. But you may not know how unproductive it is until you actually use it yourself on a daily basis. 

I’ve had a lot of doctors recently mentioning the stress scheduling is causing them. I have so much sympathy for you if you are one off them. I’ve been there…you’re working harder and faster and nothing is changing. I think this is so unfair. So I’m re-releasing one of my most popular episodes where I take a look at productive scheduling and the thought process I used in my dental practice that got me off the hamster wheel and onto a system that actually increased my productivity and lowered my and my team’s stress. 

The key here is productivity, we are working smarter, not harder. Listen in for more strategies to add consistency, lower stress, and bring predictability to your practice.

• looking at your hourly goal and booking procedures that allow you to meet that goal
• how to have your assistants take ownership of their patients
• the importance of communication between the assistants and the front office

Never miss an episode! Subscribe on iTunes & Spotify. Visit us at http://www.productivedentistpodcast.com

EPISODE TRANSCRIPT

Dr. Bruce Baird

This is Dr. Bruce Baird, scheduling is one of the most complicated of all the things that we teach at Productive Dentist Academy and it’s the one thing that I think costs, dental practices more in long-term revenue than anything else. What do I mean by that? Well, first of all, we teach and what I teach is scheduling for productivity, not time. Now, most of you are familiar with what it doesn’t matter really what kind of software you’re using. But in the years gone by I would ask a lot of dentists at programs, how many of you have computers in your treatment rooms? and very few would raise their hands now, almost everybody raises their hands. What’s important is for you to do your scheduling in the back and schedule for productivity, not time, and let me explain to you what that means.

When we start talking about scheduling for productivity and not time, what we’re talking about is setting up a schedule that has certain blocks, and many of you are familiar with block scheduling. As a matter of fact, Dentrix I know because I use Dentrix. But Dentrix has what’s called Perfect Day scheduling and for years, I would get upset in the office, I would say I can’t be in two places at one time. What’s the deal? You know, gay, you know, I can’t be in two places at one time.

Why are you scheduling it this way? As a matter of fact, years ago, you know, back when we had paper schedules, I would, I would be so frustrated by the way things were scheduled. I bought everybody in my entire office, a different colored pencil so that when they wrote in the chart, or I’m sorry, on the schedule, I would know who did it and I would say hey, you can’t do this and she goes, Well, I didn’t do that and I saw that your color and she said, Well, somebody stole my pencil. That’s how bad it got and I was stressed all the time. So perfect day scheduling, which is what’s taught in dental school if you’re taught anything about scheduling, and it’s one of the things that consultants across the country teach this concept of x’s and slashes x being Doctor time slashes being assistant time. It is totally non-productive to use that system. Totally not. It’s the worst system you can possibly use. Although 95% of all dentists in the country are using that system.

I went to a program I was lecturing up in Canada, this has been probably 1518 years ago, and a good buddy of mine. I was talking to him and I said what do you produce per hour? And this is back when we first started thinking about productivity per hour and he said I don’t know, let me think he says I do about 850 An hour and I said that’s got it. That’s crap. There’s no way in the world you’re doing 850 an hour because I’m doing 600 An hour and I’m not fiddling around. I’m getting in there working and I mean, I’m I don’t it doesn’t take me a long time to do certain things. I’m running around like a chicken with my head cut off. I’m, I’m literally seeing patients all day long, and I am doing 600 an hour. So 600 an hour. You know, that’s what 4800 A day and I’m killing myself. He said he’s doing 800 and I was like no way. So I was lecturing in Springfield, Missouri and I was with a practice analyst, a guy named Russell Knight, Russell could look at your numbers and know exactly what was going on in your practice, literally by the numbers that he was evaluating from new patient flow to, you know, productivity and so I asked him that question. I said, how can he do? How can this guy do 800 an hour?

And he was talking to me and we were driving from Springfield, Missouri to Chicago because there were thunderstorms and I was doing a program the next day in Chicago and I said how did it How does he do 800 He said it’s easy. He just books $800 An hour procedures and I was totally stunned. I was I did not say a word and for those of you who know me, that’s really hard to do is get me not to say a word but I didn’t say anything. For the next hour and a half, as we drove into Chicago, I was like, there is no way and I started thinking, Well, how do you do that? And so when I came back to my practice, I began to look at block scheduling, and I don’t care what you call it, whether it’s, oh, you can call it sand, rock, paper, scissors, whatever, you know, you hear out there from consultants, and most of us understand what block scheduling is, we’re gonna put, we need to have at least $2,000 in a three-hour spot. If our goal is, you know, 1000 an hour. Now, the average dentist in the US is doing $405 an hour. So let’s just say that’s, let’s just say we want to do 500 an hour. How long does it take you to do? Let’s just say you have blocks scheduled. So you have maybe an hour and a half in one chair, that’s a block and another chair, you have two hours, then you have in the afternoon, you have another two-hour block and another hour and a half block. So you’ve got this, these blocks for productive procedures.

And you put in your goals of 500 an hour, and you’ve got two crowns and two buildups to do well if your goal is 500 an hour? And how long does it take you to do two crowns into buildups and my programs I’ve had people say, Oh, it takes me five minutes. Takes me 10 takes me an hour, it takes me two hours, it doesn’t really matter. You just need to know, how long does it take me to do these procedures? Is that really what we’re looking for? Well, let me explain to you. If it takes you let’s just say it takes you one hour, and the total fee is $2,500. For two crowns and two buildups. How much time are you going to schedule? While everybody in the room says well, I’ll schedule an out. I’ll schedule an hour and a half. I’ll schedule 30 minutes, you know because what your schedule ends up being is ends up being jam-packed with all these procedures.

What I’m trying to do in my practice is if I look in my goal is 500 an hour, and I’ve got something that’s 2500 hours in treatment room number one or gaze treatment room, as we’ve talked about in the previous podcast. She is responsible for that chair and so I will actually book five hours to do two crowns and two buildups now people say that’s the stupidest thing I’ve ever heard of in my life. Bruce, why would you do that? Well, the reason I do that is that that’s my goal. If I set the goal, and I said 500, I have just even if I have three treatment rooms I’m using. I am actually just booked five hours, to my goal for that day, meaning I only have three hours left to reach my goal of 500 an hour, I wrote a series of articles for dental economics that was called the dental rollercoaster, most dentists have a great day, one day, a bad day, the next great day, one day, bad day, the next, what we try to teach and what we do in our own practice is we’re consistently producing whatever we set is our goal, whether it’s 500 an hour, 800 an hour, 1000 hour.

And I will tell you, I went back, I looked at every procedure I did, if I’m doing a root canal, for instance, and the root canal takes me two hours, and I’m searching for MB two, and it’s 1000 bucks to do on tooth number 14 and it takes me two hours to most I’m ever going to be able to produce this 500 an hour. But my goal is well above that. So how do I do that? We have to look at the overall I do that next to that same chair next to that chair that has five hours scheduled for you know, for those two crowns and two buildups. Why because I know it’s not going to take me two hours or it’s not gonna take me five hours to do it. What it’s going to do, it’s going to take me, you know, probably 30 to 40 minutes of doctor’s time, and that chair is open. Now, next to that, I’m doing Endo. I’m not rushed. I’m doing things on time.

Now if I would have only given myself an hour to do that and stuck endo right next to it with perfect day scheduling. What would end up happening is well, we would what happens if you’re doing those two crowns and to build apps, you have a perfect day scheduled based upon X’s and slashes and it turns into Endo. Well, what happens when you’re behind? Well, you’re not only behind but you’re behind. When do you catch up? I know when you’re going to catch up, you’re gonna catch up as you work through lunch. You’re going to work through lunch to try to catch up and you’re going to try to do same-day dentistry. You’re going to try to do those things. Well. The truth is most dentists around us are far behind. They never get a chance to do same-day dentistry. They actually ended up taking away production off their schedule just so they can catch up happens every single day in practice and so when I look at that, and I say, okay, when do I do other what I would call non-productive procedures, meaning a procedure like a composite resin that might be a four surface are five surfaces, which I don’t do a lot of them. But if I had that it’s going to take me 30 to 40 minutes to do.

I’m going to do that and next to a block. That is my goal. Does that make sense? I know it probably does. So. But if I’m looking at that, who runs behind if I’m doing my regular perfect day scheduling, and I’m already running behind who else is running behind? Oh, my hygiene checks. Well, they’re all standing outside the room waiting for me to get done. Now their patients are waiting. Now I have an entire waiting room of patients waiting for their hygienists waiting for me to go check the hygiene patients and my next patient is waiting. Now that’s pretty stressful. That’s pretty stressful. Now, I’ve been fortunate. This past year, I produced about 3400 an hour. Now how do you do that? Well, with implants and with different higher-end type procedures or service mix, I’m able to do that. So if you ask me, my goal is only 2300. Now, when I say 2300 an hour, that’s 18 $19,000 a day. Can that be done? Well, sure it can be if you’re doing the right kind of procedures, but I don’t care what you’re doing. I don’t care if you’re doing, you know, inlays or onlays with search. Whether you’re doing fillings when you’re doing restorations set your goals, and figure out what doctor time when you obviously when you have crowns to do that may be a huge block when you have three crowns or four crowns.

That’s what you’re looking for those longer procedures that you have no stress, you can pull that down. Let’s go back and look at it. Let’s say it’s those two crowns again with the two buildups now I have five hours and in gays chair, treatment chair one to do that. First thing in the morning, I’m going to go in and I’m going to anesthetize that patient. I have people ask me, Are you going to leave that chair? I mean, are you going to let the patient sit there for five hours I go, hell no, I’m not going to sit there for five hours, I’m going to walk in anesthetize the patient. First off with a buffered anesthetic. I’m going to prep that tea, and we’re going to scan and start making those crowns and in about an hour, hour and a half, or finished. I’m going in to seek those crowns. We have received mentation, X-ray, everything’s ready to go. So all I’m doing is, well what are you doing the rest of the time, I’m doing every non-productive procedure that I can do in the chair to ensure your three might be a filling might be incisal composites, it might be whatever it is taking impressions for a nightguard doing whatever it is, I’m doing that in, in, in the operatories, or the treatment rooms next to the operatory that I’ve already reached my goal for the day.

So I average an increase in my production by about 30% above what is actually on the schedule every day. Most dentists don’t do that. Most dentists actually start with 4000 on the books get behind and then end up having to take Well, Bob, we were going to do this upper and lower. Why don’t we just do this lower? today? Why don’t we just do this lower crown today? Does that sound familiar? Because that’s what happens and we run behind and then we’re, you know, we’re stressed and we’re looking at all the different things that cause stress in the dental practice and this is one that’s huge. It’s how do we schedule when someone calls the front desk, and we’re going to do several parts for doing the scheduling.

But they call the front desk and your your your team up their answers and they say Hi, this doctor, this is Bruce and I want to set up for that work that Dr. Baird said that I needed to get done. Well, they have to look it all up, they figure it out and they say okay, what we’re going to do is we’re going to, you need to have those two crowns done and then they look up at the schedule, and they just pick the next available spot. Boom. How about Tuesday? How about Wednesday, and that’s what happens. It’s not based upon productivity per hour. It’s not based upon scheduling for productivity is just the first available next available appointment, here you go. That’s why one day you ended up doing, you know, 7000 and the next day you ended up doing 3000 Your productivity per hour. We know that in the past even though you had a budget of 405 across the country. You’ve done 1000 Before you had a big cake so you did 1000 an hour.

Now what you want to do is you want to do more than $1,000 An hour days, that’s pretty obvious, but you tend to not be able to do that because you’re running behind all day. So this is just section one of scheduling and we may do four or five Have these scheduling sessions just to get you as much information as possible so you can make the right decisions and get off the dental rollercoaster so that you can actually produce dentistry at a much higher level and we’ll go from there we’ve talked about it in the past podcast but the way I schedule my assistants is each one of them has a production number which on Dentrix I don’t know how it is with Eagle soft but you know I actually have a production code which is BBB one, BBB two BBB three. So I have three treatment rooms that the Gay is in BBB one, Shannon’s and BBB two and summers and BBB three, and when I booked those who are responsible for that schedule we’ve talked about in the past, but they’re individually responsible for their own share and they do their own confirmations. They confirm their own appointments. Why? Well, if you look at it, I might see 15 people in a day 18 people in a day.

Less is better. As far as I’m concerned, I’d love to have a case where it is, say it’s three implants and that $6,000 and my goal, let’s just say is 2000, I am going to go ahead and book three hours to put those implants in, it’s not going to take me three hours to do it. But I want my team to be totally responsible for that schedule. Now I do not pit one assistant against the other on production, what I do is look at all three of them together and say together, we’re going to do a goal of 2300 an hour today, or whatever it is, maybe it’s 500 an hour for you. Maybe it’s 800. What I can tell you is that with Productive Dentist Academy, we grow productivity substantially based on scheduling for production. So when I’m looking at that schedule, I already know it’s going to be full to my goal. Why? Because I have three people working it. Now, what else does my team do? Well, gay summer in Shannon, when we see a new patient, the doctor sees him first. I see him first. Why? Because I know that we’re going to increase productivity by 27%.

If I see the patient first, instead of him going into hygiene first and people can argue the point yes, there are some successful practices out there that see new patients in hygiene. They are the one and done Crown of the year club type offices and they do very well they produce bam, bam, bam, my practice is a more comprehensive evaluation and treatment plan, which we’re going to talk at length about. But that’s the type of practice I have. I want to take care of a patient for life. I want to make sure that the dentistry I do has a chance of lasting a lifetime. So when we’re scheduling these patients, it’s the front office, maybe they get a call that says you know, hey, I need to get in for this appointment, as we talked about. It’s two crowns that Dr. Berry wants to do, they will then put that patient in. They’ll look at the schedule the best that they know how they’re not.

They’re not back there every day. They don’t know exactly what it is I do. So what I did is I put a system in place that would cover that and so what happens is they’ll say, Bob, what we’re going to do is I’m going to schedule you with Tuesday afternoon work at three. Bob says yes. She’s I’m going to put you down with Shannon or I’m going to put you down with summer. Why does that patient go with summer, because that Summers patient, every patient has a color? You know it’s either Shannon, it’s either they’re all my patients but it’s either BBB one color BBB two or BBB three. So they said I’m going to book you with Shannon or Bucky with summer, whoever it is, whoever their assistant is and we’ve got three o’clock on Tuesday and I’m going to talk to her to make sure that’s going to work. So if you hear from her, she may need more time, and is that okay? And the patients always say, Oh, sure, sure, that’s fine. But I want to get in and get it done as soon as possible. Now, she sends an instant message back to summer, saying, Hey, I just put Bobby in at three o’clock on Tuesday. Could you please evaluate that and make sure that’s going to be okay. That’s the front versus the back. It’s not one of these things where people are they just shove it in there.

What ends up happening is then summer goes well, I can’t believe they put him right here. Who’s responsible for that treatment room? Summer and the communication between the front office and summer have got to be solid. They send a little instant message. Now, I told you that Summer and Shannon, and Gay all confirm their own patients. Why? Because they have a long-term relationship with the patient. The patient wants to see them again. So now what If it’s noon, and they haven’t been able to call and confirm their own appointments for the next day, they’ll ask the front desk, I’ll send an instant message upfront and say, Hey, guys, we need help confirming my patients, could you guys help me, and they’ll do it. So that’s the way that we work our system as far as scheduling.

Now getting back into the scheduling for productivity, not time. Think about your goal. Think about your goal, let’s just say your goal is, if you’re doing 600 an hour, or $650, now you’re actually a million-dollar producer, you’re producing a million dollars if you’re working the average number of hours that a dentist works, which is 1600 hours a year. So let’s look at reaching having a goal of producing a million dollars in dentistry. Let’s just say that’s 600 600 an hour. So it’s $600 an hour. Look at every procedure that you do in your practice, figuring out how long does it take you to do it? This is kind of counterintuitive because I’m telling you to figure out how long it takes you to do it. Not so that you can schedule it that way.

It’s so that you know that you’re within your production numbers. Let me give you an example. I have a goal of 600 an hour and I like doing molar endo. Okay and I’m charging $900 or $1,000 for molar Endo and I’ve got this goal. Let’s go back to 600 an hour. Well, it takes me an hour to do that Endo. Does that fit within my 600 an hour? Well, yeah, it does. $900 In an hour, if you can do the molar Endo, you’re great that does fit within a productivity block that you have. But what if that endo takes you an hour and 45 minutes? What if it takes you two hours now all of a sudden, you’re at a different production per hour, you’re at 450 an hour. If it’s 900 and it takes you two hours? Do you follow what I’m saying? So I’m looking at the time based on how long it actually takes me to do a procedure. Now the truth is what if I do find if I’m doing two crowns with two buildups and I end up having to find endo or you know, there’s a pulp exposure and the decay goes in there. Well, if I’ve got four hours scheduled, I can do the Endo, I’ve got time to do the Endo, which in that chair anesthetize the patient, I’m doing it.

they’re already anesthetized. But I end up doing the endo on that, too. So it allows me an additional amount of time to do whatever procedures that I want to do. So I’m custom designing my schedule every day when I say I am. That’s partly about being a leader. I hold my team accountable for my schedule. So sometimes I’ll hear one of my team members go well, you know, I didn’t put that patient there. Well, what do I say? Well, I said, Yeah, but that really doesn’t matter to me. Remember, you’re in charge of that schedule, you’re in charge of that day. So let’s find out who put that in there and let’s go talk to him and let’s kind of guide them on why it wasn’t going to work in this spot. So it’s constantly this training opportunity that we’re working on, to help our productivity and to help patients because when patients right when you’re running behind, and trust me for my first 10 years in practice, the first introduction I had to every patient was Hi, my name is Dr. Baird, I’m sorry, you had to wait on me so long.

You know, that’s not a good way of being productive. Instead, I started out, when I came back, Russel Knight was in the car with me, I told you guys, I said, Okay, I want to do 800 an hour. So I started booking 800 An hour type procedures. All of a sudden, I was doing 900 and I was doing 1000 And I was doing 1250 You can play a game with it and I did. I decided I was working four days a week, four and a half days a week. I said for every half-day, I mean for every $250 that I increased my productivity. I’m going to take another half-day off. Now I had to do it for three months before I would trust that I could do it and so for the last 14 years, I’ve worked two days a week. Now how did that happen? Well, I started out, I started out at 600 an hour I ended up at 1250. Today I’m over 3000 I don’t see myself going to one day a week, because I still love dentistry. But having a schedule where you’re not running behind, and your team is being held accountable for that is the way to go and we’ve worked with 1000s of dentists over the last 15 years Productive Dentists. Once they get that concept down, which is again a little bit counterintuitive. It’s 180 degrees different than what you’ve been taught by any consultant out there. But what we do is we look at this and we say it’s all about productivity per hour and how do I do that? Well, it depends on how long it takes you, and rarely does productivity mean doing things faster? It really doesn’t mean that I will use an example. It depends on what you’re doing. But if you had

five teeth that needed to have crowns on that walked in the door, it was going to be $5,000. Well, how long is it gonna take you to do five crowns and five buildups, let’s just say it’s $6,000, your goal is 600 an hour? And you have $6,000 worth of treatment? How long? Are you going to book a treatment room? Well, you’re going to book that treatment room for all day. Now, how long? Is it really going to take you to do six grams? Well, what if it took you two hours and this is doctor’s time only? Great, no big deal, you got another six hours, you could do every other non-productive procedure. In the other ops, that junk up your schedule for Tuesday and Wednesday and Thursday, move everything you can into that day because what you’re doing is you’re eliminating all the other crap that gets you behind. So now you’ve set yourself up for productivity, you set yourself up to be massively successful, without being rushed, without running behind. So our goal is, to do bigger procedures and do longer procedures, if possible. If you’re the crown of the Month Club, it gets very difficult, it’s very difficult to you know, if every crown has a year club if every year you’re going, oh, let’s just do one crown. Bottom line, that’s gonna be very difficult to be productive that way and a lot of times, and we’ll talk about that in future podcasts, which is the financial strain that patients have that makes it very, very difficult for them to do more than one craft at a time and, and we’ll talk about that at length.

So if we’re looking at production, and we’re looking at productivity, it’s got to be it’s not about speed, it’s not about speed, it’s about scheduling it correctly. If you give the responsibility to your team, and you hold them accountable for that, what you’re going to find is what I found over the last 15 years, I show up at the office, and I’m ready to go to work. I know my schedule is going to be I have very few patients that miss their appointments, I have very few reschedules or cancellations, or no shows, it happens. So rare and the reason it happens rarely is that some are so one confirming her point, gaze, or one and confirming her appointment. So the person who’s really in charge is the one who’s working with them and if the patient has poor financial arrangements gays gonna know and she’s gonna say, I just don’t have the money right now. Well, let’s rework your financial arrangement. Try doing that with your front office trying to do that for you and now things you know, you start handing the ball off so many times that you fumble.

Well, I don’t like that, and remember, I was seeing 300 new patients a month and it was horrible. I mean, yes, we did a million dollars, but I only made 32,000. So bad overhead, bad everything I spent the next 1518 25 years trying to figure out how do I become productive, and make more money and take care of more people and do a better job of it and so, again, productivity is not about speed, you know, you can go to the one-minute root canal, you can go do that. That’s great. But most of us aren’t even doing the work on the patients we have, because of other reasons. So what I hope that you gain from this, from this information, is a new way of practicing one that gives you Gosh, gives you the ability to be able to enjoy dentistry and do it on your terms. I look at this as saying I’m helping gay, I’m helping summer I’m helping Shannon I’m helping Tamra, I’m helping Kelly, I’m helping everybody in my office because when the pace is great, stress is low.

People enjoy being at the practice. They’re not running around like a chicken with a head cut off and people oftentimes say when they come through and we do an over-the-shoulder course at my office because it’s not unusual that I’m doing 20,000 24,000 25,000 a day. But I don’t run behind and I’m not rushed. Truthfully it does have to do with the type of service mix. We may be doing eight or 10 Veneers we may be doing four implants. So I do those kinds of procedures and how do we get to do this? Well, that’s a whole nother conversation about marketing. How do we look at marketing and how do we take care of our patients? So I hope this has been valuable.

We’ll keep revisiting scheduling because I know that you have questions and I want you to go to send me an email at bruce@productivedentist.com and I will continue to answer these questions. I want this podcast to be something that’s interactive with people so that they can so I can help Have you in the future? Enjoy dentistry more, make more money, help more people, and have more time and if you can do those things, you’re going to absolutely just love dentistry. So that’s the end of Episode Six scheduling part two, but I know there’ll be more scheduling questions. So we’re going to continue with that in the future.

Hi, this is Dr. Bruce Baird here and I have a question for you. Do you feel like no matter how hard you try, you can’t get off the plateau and to the next level of your business. I get it. It can be incredibly frustrating to work harder and longer and not see any increase in your revenue. But I do have great news for you. Productive Dentist Academy is hosting a productivity workshop from September 22, through the 24th in Frisco, Texas, so you and your team can come to learn the tools and systems, you need to get your dental practice to the next level. We’ve been doing this for 18 years and it is a course that you really don’t want to miss, come learn for yourself what hundreds of other independent dentists have learned, you can get off the plateau.

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Thank you for joining me for this episode of the Productive Dentist podcast. If you found this episode helpful, make sure you subscribe and pass it along to a friend. Give us a like on iTunes and Spotify or drop me an email at podcast@productivedentist.com don’t forget to check out other podcasts from the Productive Dentist Academy at https://productivedentist.com/podcasts/ Join me again next week for another episode of the Productive Dentist Podcast