Ep. 38: Organizing Your Front Office to Maximize Efficiency
Poor organization in your front office doesn’t just create stress—it also costs you a ton of lost revenue! And it’s extremely common in many dental practices. So in this episode, Sabri Blumberg joins Jeff to discuss front office structure and how to become more efficient.
Topics:
1:58 – The three most common dental offices get it wrong
8:57 – Creating structure and division of duties
23:46 – Using statistics and tracking performance
Links:
Team training video courses - https://ddssuccess.com
Learn more about MGE - https://www.mgeonline.com
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Questions From This Episode
What are the three common front desk setups Sabri sees in new client practices, and why do they cause problems?
The first is a front desk manager with a couple of generalist helpers, where one person controls everything and it simply doesn't scale. The second, and most common, is everyone doing a little of everything, answering phones, scheduling, reactivation, with no one truly accountable, which tends to produce strong volume but poor profit margins since so much business quietly walks out the door. The third is a check-in and check-out split, more organized but still ineffective, since core functions like scheduling end up divided across two people, making it impossible to track anyone's actual production.
What roles should a front desk actually be split into as a practice grows?
At minimum, a receptionist responsible for all incoming and outgoing patient contact, a scheduler responsible for keeping the schedule efficiently full and following up on incomplete treatment, and a financial or treatment coordinator role, often handled initially by the office manager, responsible for collections and closing treatment plans. As volume grows, financial coordination and treatment coordination typically need to split into separate, dedicated roles.
Why is it a mistake to think you're paying staff for their time rather than their production?
Because time itself isn't actually what you're buying. If you hire a scheduler, you're not paying them simply to be present, you're paying for an efficiently filled schedule that maximizes production. Without a clear production statistic tied to that role, there's no way to know whether you're actually getting what you're paying for, regardless of how busy or present the person appears to be.
What statistic should a scheduler be given, and why does it matter that they own it rather than just track it?
Overall office production, since the scheduler directly controls how efficiently every provider's time is used and how many future sales opportunities get placed on the schedule. Owning the statistic means understanding that its movement reflects their own influence and effort, not just a number they report. Some staff quietly slip into treating a statistic as something they simply record for someone else, with no more weight than tidying the waiting room, which defeats the entire purpose of tracking it in the first place.
What should you do with a staff member who isn't suited to their current front desk role?
Look honestly at their actual strengths and consider reassigning them rather than assuming they're simply a weak employee. Someone quiet or uncomfortable discussing money may be a poor fit for treatment presentation but genuinely excel with detail-oriented insurance work, while a more outgoing person in insurance might thrive as a scheduler instead. The one exception is a staff member with a proven, demonstrated track record in a role, actual performance should always outweigh a general impression about who seems suited to what.
Episode Transcript
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Jeff: The average dental practice has anywhere from one to three or four staff working the front desk. And what do we actually call them? Unlike most positions in society, a welder welds, a drill press operator runs a drill press, a host hosts, but front desk staff are named after the area they work in, not what they actually do.
Jeff: What does a conventional front desk staff member do? A little bit of everything: scheduling, filing, insurance, patient checkout, benefit verification, and so on. When several people are all doing a little of everything, with no one truly responsible for anything specific, what happens when something goes wrong? Say there's a big opening on the schedule, who do you talk to? Who actually owns fixing that? I ask this at seminars all the time: if everyone is responsible for everything, who's actually responsible? The answer I get every time is nobody.
Jeff: To maximize productivity and efficiency anywhere in a business, you need to divide labor and responsibility clearly. People need a genuine zone they control and are accountable for. So how do you actually do this with a dental front desk? That's what I want to cover this week. My name is Jeff Blumberg, and I'm your host, joined this week by Sabri Blumberg, our Deputy Chief Operating Officer.
Jeff: If you've listened to this podcast for any length of time, you already know Sabri, she oversees all technical delivery here at MGE and has worked directly with thousands of dentists. Sabri, you're all set?
Sabri: All set.
Jeff: Let's jump right in. Since you meet with most new clients directly, at least once, how would you typically organize the front desk when a new client comes in?
Sabri: It really depends on their existing setup, and there are usually three common patterns I see. It depends on practice size and how much attention the doctor has historically paid to the front desk. The first pattern is having someone called the office manager, though not in the sense MGE actually defines that role, an executive responsible for practice profitability, running the business on the doctor's behalf. What I mean here is more often just a highly competent, trusted longtime staff member who ends up at the front, with a couple of helpers supporting them.
Jeff: So they're functioning more like office manager assistants, doing pieces of everything the office manager is technically responsible for.
Sabri: Right, filing, answering phones, insurance verification, little slices of everything that person oversees. The obvious problem is one person controlling everything, which is inefficient and simply doesn't scale.
Jeff: And just to be clear, none of these three setups are ones you're actually recommending, these are just what you commonly encounter.
Sabri: Correct, none of them are ideal, though some are better than others. The worst version is what you described at the start, everyone helping with everything. And it's genuinely shocking how common that is, sometimes even in practices producing really strong numbers financially.
Jeff: So a practice can look successful on paper with this setup?
Sabri: It can, everyone answers phones, everyone schedules, everyone handles reactivation, usually with just one person dedicated to accounts receivable or insurance filing. What that structure hides is exactly how much business is quietly walking out the door. That's usually why practices like this have strong revenue but a poor profit margin, high volume, genuinely talented doctors, but a practice doing 400,000 that should be doing 800,000 or 900,000, with a profit margin nowhere near where it should be. That's often exactly why they come to us, working extremely hard, often long hours, for far less income than they'd expect given the effort.
Jeff: And the third pattern, the check-in, check-out split?
Sabri: That's typically the most organized of the three, since responsibilities are at least divided, which creates some efficiency. But the real problem is that core job functions end up split across two different people, which makes it essentially impossible to track anyone's actual production. You lose any real way to measure whether a given person is accomplishing what you're actually paying them for.
Jeff: Which gets at something I want to dig into. There's a common assumption, and honestly this extends well beyond dentistry, that when you pay someone, you're paying for their time. I'm here, whether the outcome is good or not is beside the point, you're paying for my presence.
Sabri: Right, and to be clear, you do have to pay your staff regardless. But you're not actually paying for their time, you're paying for the result of that time, specifically what you hired them to produce. There's a reason you hired and paid them in the first place, you were buying something specific.
Jeff: So if I hire a scheduler, I'm not just hiring someone to schedule patients, I'm hiring someone to deliver a fully, efficiently booked schedule. That's what I'm actually paying for.
Sabri: Exactly, you're buying a specific amount of production.
Jeff: So how do you actually know whether you're getting that?
Sabri: You need a tracked statistic. Production is literally the scheduler's stat. Without tracking it, there's no way to know. And critically, the person in that role needs to genuinely understand that this is what you're buying from them, not just a duty they complete.
Jeff: Let's walk through a concrete scenario. Say I'm a new client, I have a front desk manager and two helpers, and the practice is doing 140,000 dollars a month. How would you organize that?
Sabri: At that volume, the minimum staffing I'd want is a receptionist, a scheduler, and either a treatment coordinator or financial coordinator, often combined into one role at that size, especially since the doctor is likely still presenting treatment personally.
Jeff: And in a lot of cases the existing office manager becomes that treatment coordinator initially.
Sabri: Correct, if their workload genuinely allows it. But you also have to look honestly at how much opportunity and revenue is currently walking out the door, since that's usually where most of a practice's actual profit is being lost. They're covering overhead fine, staff, marketing, a nice facility, good materials and labs, all of that gets paid. What's disappearing is the profit above that, because they're already meeting expenses with what they currently collect.
Jeff: Let's clarify terms here, since receptionist and scheduler might sound interchangeable to a lot of listeners who aren't MGE clients.
Sabri: They're genuinely distinct roles. A receptionist is responsible for the organization's flow lines, making sure all incoming traffic, patients, phone calls, is handled and routed correctly. They're also responsible for outgoing contact with the patient base, which is a less familiar concept in dentistry specifically but a totally standard one in business generally. We've never once had our own receptionist here at MGE schedule clients for a seminar, that's an entirely separate role.
Jeff: And most dental receptionists are pleasant and friendly on incoming calls, but genuinely underdeveloped on the outgoing side, proactive contact with existing patients, which is really its own topic. We actually did a full episode on that specifically.
Sabri: Right, reception is absolutely not an entry-level position in any business, dental or otherwise. They're usually quite competent on incoming traffic, but rarely realize they're also responsible for outbound contact that actually drives revenue.
Jeff: So in our scenario, we've turned the front desk manager into a genuine office manager, and we're assigning the two remaining staff as scheduler and receptionist. Would you ever combine receptionist and scheduler into one person?
Sabri: I could, it depends on the practice, insurance mix, and patient volume. Sometimes I combine them initially and split them out later as things get busier. In a smaller practice, people naturally wear multiple hats. But in a practice already doing 140,000 dollars a month, given the incomplete treatment sitting there and the patients being lost to poor follow-up, I'd be pushing hard to separate those roles given how much revenue is likely at stake.
Jeff: It's interesting, a practice doing 140,000 a month used to look fairly similar 15 or 20 years ago. Now that number can represent completely different situations.
Sabri: Exactly, a fully private, fee-for-service practice with no insurance write-offs at that number looks nothing like one carrying heavy HMO or PPO participation, where reimbursement is often poor. If a practice hasn't gotten out of PPOs yet, retention and conversion matter even more, since they're often already spending close to 40 percent of their income on PPO write-offs functioning as an extremely expensive form of marketing.
Jeff: Which is why, if you're still in PPOs, it's worth putting together an actual exit plan, something we keep coming back to on this podcast.
Sabri: Consistently, yes.
Jeff: So back to our scenario, office manager plus two staff. How do you decide who becomes the receptionist versus the scheduler?
Sabri: Largely based on individual skill and personality, or existing familiarity if someone's already been scheduling successfully for a while. If someone has a genuine track record, I'm not pulling them off that role just because their personality isn't the textbook fit, performance matters more than a generic idea of who should be doing what.
Jeff: So walk me through actually implementing this. Say you've told me my front desk manager becomes my office manager, handling financial and treatment coordination duties, and my two staff become receptionist and scheduler. What do I actually do when I go home to make that real?
Sabri: You need absolute clarity on which functions belong to which role, otherwise you just confuse your own staff. Reception covers answering the phone, filing, all outbound communication, reactivation letters, recall reminders, and asking for family referrals, is there anyone else in your household who doesn't currently see a dentist. The scheduler follows up on incomplete treatment by booking consultation appointments, ensures adequate production is scheduled each day, and manages the hygiene recall schedule specifically, though usually not full reactivation, since there generally isn't time for both. The office manager oversees overall collections, accounts receivable, over-the-counter collections, and supports the doctor in presenting and closing treatment plans.
Jeff: Now say the practice gets busier as this structure starts working, collections climb 40 to 50 thousand dollars a month, volume increases, more marketing is running. At what point does the office manager need to hand off either the financial coordinator or treatment coordinator role entirely, so they can actually function as a manager?
Sabri: That threshold shows up in a couple of ways. One is simply capability, if they genuinely can't manage the full scope, there's no real coordination happening between front and back of the practice, and no one is watching upcoming statistics closely enough to take the action needed to protect next month's numbers, since they're too buried in today's tasks.
Jeff: And what if it's more a matter of volume, say they hire a financial coordinator, production keeps climbing, but now the office manager is spending three or four hours a day directly in treatment consultations?
Sabri: That's absolutely a real problem. At that point, you no longer really have an office manager, you have a treatment coordinator or salesperson wearing an office manager title. Often that person is genuinely skilled at it, which is exactly why they end up doing it, but treatment coordination is a substantial role in its own right, they're effectively the practice's primary salesperson, directly responsible for its income. We actually have a full episode and course specifically on that role.
Jeff: So realistically, once volume grows enough, treatment coordination needs to become its own dedicated hire, separate from the office manager role entirely.
Sabri: Right, otherwise you're losing real income by having one person try to hold both jobs at once.
Jeff: Let's go back to the scheduler and statistics. Once someone is assigned that role, when do you actually give them their statistic?
Sabri: Immediately, you want them thinking from day one that they're not just here to complete tasks, these actions are driving toward something specific. You have to trust people's own capability here, if you clearly show someone where you want the numbers to go and they genuinely understand their role, they'll generally figure out the most efficient path to get there.
Jeff: And what statistic specifically goes to the scheduler?
Sabri: Overall office production. The scheduler does two things: they control how efficiently every provider's time gets used, and they control how many future sales opportunities are actually placed on the schedule.
Jeff: So say production is down one month. What happens next?
Sabri: There's an entire body of management training around exactly that. But simply put, if someone genuinely owns that statistic and is personally invested in the role, the most direct approach is asking them: what are you going to do so this doesn't happen again? Hand the problem back to them and let them own the solution.
Jeff: You've talked about this idea of truly owning a statistic versus simply keeping track of one. Can you say more about that distinction?
Sabri: This became really clear to me visiting a number of client offices directly over the years, established clients already doing well, tracking statistics, seemingly following everything correctly. But more often than I was comfortable with, I'd find staff who were keeping a statistic without ever realizing it was actually their statistic to influence. To them it carried roughly the same weight as tidying the waiting room, just another task, rather than understanding, this number directly reflects my value here, my job security, my compensation, because this is specifically why I'm employed and paid.
Jeff: So they were functioning more like a scorekeeper than an actual player in the game.
Sabri: Exactly, I keep the production number updated for the office manager, rather than I own this number and it's my job to move it. That's the entire difference, reporting a stat versus actually influencing it.
Jeff: And these were genuinely strong clients, some in the top tier of practices in the country.
Sabri: Right, which just goes to show there's always room to improve, even in excellent practices. A bit more structure and clarity consistently takes things even further.
Jeff: Last question on this specific topic. Back to our original scenario, office manager plus two staff, say one of them just isn't well suited to their assigned role, an introverted person placed in reception, for instance.
Sabri: It depends on what other roles are actually open. This comes up often, someone genuinely introverted or uncomfortable discussing money ends up presenting treatment plans, or someone who simply dislikes sales gets placed in a sales-adjacent role. There's nothing inherently wrong with that person, it's simply not their natural skill set. It would be equally absurd to make me your dental assistant, I faint at the sight of blood, that's a complete misuse of whatever I'm actually good at.
Jeff: So you'd look at reassigning based on genuine strengths, maybe someone who's great with detail and numbers moves into insurance, while someone more naturally outgoing in insurance moves into scheduling instead.
Sabri: Exactly, matching people to roles based on real aptitude. The one clear exception is someone with a demonstrated, proven track record in a role, even if they don't seem like the obvious personality fit on paper. If the performance is genuinely there, that outweighs any assumption about who should be doing what. Actual performance should always outrank opinion about suitability.
Jeff: Given how different every practice's specific situation actually is, what would you recommend for someone listening who wants to dig deeper into their own setup?
Sabri: A few things. We have a much more thorough resource called the Practice Jumpstart, essentially the full interview process we walk every new client through, available on our online training platform, DDS Success, link in the description, free demo available if you're not already a subscriber. And if anyone has a specific question about their own situation, they're always welcome to email me directly.
Jeff: One thing worth highlighting again: the hardest part of all this to actually notice is exactly what you pointed out, the money that isn't there. Nobody clearly registers a loss that never visibly happened. When you meet with a new client over those first few hours, how much of that time typically goes specifically toward calculating what they're actually losing?
Sabri: Usually at least an hour. Overhead in these practices is often already stretched thin, and yet they've frequently spent real money acquiring patients and family members who simply aren't coming back in, sometimes people who've never had regular care scheduled at all. I look closely at hygiene production specifically too, your hygienist isn't an expensive toothbrush, they're a genuine part of the healthcare team, and it matters enormously that they understand exactly how to be successful in that specific role within your practice.
Jeff: Sabri, thank you so much for joining me again this week.
Sabri: Always happy to, there's genuinely so much more we could cover on this topic alone.
Jeff: We'll definitely have you back. Folks, thank you for listening, I hope this was helpful. If you have a moment, please follow or subscribe wherever you're listening, it genuinely helps and keeps you notified whenever new episodes come out. If you have questions about MGE, find us online at mgeonline.com or call 800-640-1140. We'll see you at the next episode.