Ep. 43: Management Time: The Key to Practice Growth
One of the most difficult parts of owning a dental practice is finding the time to manage it. And if you don’t put focus on management consistently, things just pile up or don’t get done. So, in this episode, Jeff discusses ways to organize your time and practice intelligently so you don’t have to try to squeeze things in between patients or stay late every night to catch up.
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Questions From This Episode
Why does a new initiative in a dental practice usually fizzle out after a few weeks?
Because anything new isn't yet part of the regular business process, so it needs continuous, regular reinforcement, weekly conversations and daily reminders, until it genuinely becomes routine. A referral program announced once in a staff meeting and never mentioned again predictably stops happening within a month or two, not because the idea was bad, but because it was never reinforced consistently enough to actually take hold.
Why isn't monthly management frequent enough to actually run a practice?
A month is simply too long a stretch to catch problems early. A practice that only checks its numbers around the 20th of the month might discover it's $50,000 short of a $180,000 goal with only a few production days left, when catching that same shortfall in the first week would have left plenty of time to fix it.
How should a practice actually define its week for management purposes?
Base it on the practice's actual closed day rather than the calendar week, ending the week on the last working day before that closure and starting the new week the following morning, even if that morning happens to fall on a closed day, since that's still when incoming money like insurance checks needs to get logged. A practice closed Fridays would end its week Thursday night and start the new week Friday morning, leaving a built-in buffer to actually plan before the next week begins.
What are the three weekly meetings this structure actually requires?
A doctor and office manager meeting to review statistics, personnel, and marketing and set direction for the week, a weekly financial review so spending problems get caught in days rather than the month or more it takes for a P&L to arrive from an accountant, and a staff meeting to get the whole team looking at the same numbers and the same priorities for the week ahead.
Does this management structure alone guarantee better results, or does something else still matter?
It alone won't replace genuine management skill in areas like handling an underperforming employee or truly managing finances, but simply giving the practice regular, adequately timed opportunities to catch and correct problems produces real improvement on its own, the same way giving an average salesperson enough time to properly present a case, even without additional training, results in more closed cases than giving them no real opportunity at all.
Episode Transcript
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If you want something done in a dental practice, it has to be scheduled. And this doesn't just apply to clinical procedures. As we discussed back in episode 27, it's also important to build time into your schedule for sales, since you're not going to do any treatment a patient hasn't first accepted.
So where does this leave us with management? Do you have time built into your schedule to manage your practice, to make sure it's growing and to keep your team on the same page? If you're like most dentists, you probably don't, and if you do, it's likely not happening on a regular basis, it only happens when there's already a problem and you have no choice. Handling things this way robs you of real expansion potential, increases your own stress, and quietly prevents your team from ever actually being on the same page. That's what I want to talk about in this week's episode: how to build management time into your practice. My name is Jeff Blumberg, and I'm your host.
Let's start by looking at what we actually mean by management. Essentially, it's the ability to control something, direct it, plan for it, and implement things. You manage your office schedule, you control when patients will be there, you provide direction on when they'll be seen, you plan when to do productive procedures, that's management. Patients manage, or fail to manage, their own dental health, some do it well, some poorly. We manage our finances, we control them, direct them, plan them. Even driving your car is a form of management, making sure it's maintained, the tires aren't bald, it has gas, it isn't overheating, and then managing it while it's actually on the road.
Now imagine applying an I'll get to it whenever I can attitude to any of these. With your finances, you pay bills late, you ruin your credit, things go badly. With your car, you run out of gas or a tire blows out. It simply doesn't work. So don't be puzzled if you're struggling with managing your practice or its growth, it's not necessarily that you're bad at it. You certainly need real management knowledge too, which is its own separate issue, but in a lot of cases, you're not even at square one yet, there's no actual management time built into your schedule to control the business in the first place.
Management in dentistry usually runs into two problems: it's done irregularly, and it's done too infrequently. Let's look at irregularity first. Say you want to implement a new referral program. You hold a meeting, brief your staff, everyone's excited and wants to get started, and that's the end of it. Maybe they do it for the first week or two, and six weeks later you notice it's not being done at all. I've heard that story constantly over the course of my career. What went wrong? Anything new in your business isn't yet part of the normal business process, so it has to be continuously and regularly reinforced, talked about weekly, reminded about daily, until it eventually becomes part of how the business actually runs.
Take a morning meeting as an example. Say you decide to hold it at 8:30, with your first patient at 9:00. Monday morning, you hold it right on time. Tuesday, also at 8:30. Wednesday, someone's late, so it starts at 8:40. Thursday, something comes up, so you skip it entirely. By the following Monday, staff are asking whether you're even still doing that meeting, and if you don't have it that day either, you're basically starting over from scratch trying to re-implement it. Compare that to holding your morning meeting at 8:30 every single morning for a full year, that's now a genuine part of your business process, done regularly. In that scenario, if you decided one day to move the meeting to 9:00 and texted everyone about the change, you'd still see people showing up at 8:30 out of habit, since it's simply become part of their routine. If you want something to become routine, it has to be done regularly and reinforced continuously.
So that's the irregularity issue. Now the frequency issue. Dental practices are typically managed on a monthly basis. Say you want to collect $180,000 in a given month, and to keep the math simple, let's say it's an 18 day production month, that's $10,000 a day the office needs to produce and collect. You set that goal on the first of the month, and since there's no structure built in to actually check on it, your days pass one after another. Then around the 20th or 23rd, you finally ask the front desk how things are looking, and hear you're at $50,000 with 14 production days already gone and only four left. You're not going to hit $180,000. What happened is that the follow up was too infrequent to actually manage the practice.
It's a lot like watering a plant that needs attention every two or three days. When you actually water it, you look at it first, are the leaves too yellow, maybe it's getting too much water, are they browning, maybe it needs more water or more frequent watering. That's managing the plant, helping it grow. Now imagine managing that same plant only once a month instead. First month, you water it. Second month, you go back to water it again, and it's already dead. Too infrequent. That's essentially what happens in a lot of dental practices, the management activity that is built in simply isn't frequent enough to actually manage the business.
So what do we actually teach clients? Manage weekly, and monitor productivity daily. Sure, you still set monthly goals, but a month is a long stretch, anywhere from 28 to 31 days, and a lot can happen in that time. Break that month down into smaller, bite sized pieces, and you have a much better shot at actually hitting it, instead of discovering on the 23rd that you're nowhere close.
In this episode I want to get into the how, setting this structure up in your business along with the specific meetings involved. I won't get as deeply into the why here, that's a longer conversation, and just as important, which we cover thoroughly in the MGE Power Program, I'll put a link on the episode webpage if you want to explore that further.
So say you want to monitor productivity daily and manage the practice weekly, how do you actually set that up? First, you need to define a week ending. That might sound obvious, everyone knows a calendar week runs Monday through Sunday, but from a production management standpoint, it works a little differently. When you're building a business week specifically for tracking statistics, ideally the end of that week leaves a bit of buffer time afterward for planning.
So what do we typically tell clients? A lot of dental practices are closed on Fridays, or sometimes Wednesdays, that's traditionally been the common day off in the US, though Friday has become more common in recent years. If you're closed Friday, end your week on Thursday, with the new week starting Friday morning. You might think, but we're closed Friday, why would the new week start then? Because that's when you'd start logging statistics for the new week. You might still be in the office briefly Friday morning, and if a direct deposit from an insurance company shows up, or you check the mailbox and find insurance checks waiting, that money belongs to the new week that started Friday, not the prior week that ended Thursday. If you're instead closed Wednesdays, you'd end your week Tuesday, with the new week beginning Wednesday morning. You'll want to look at what genuinely fits your own practice, the goal is simply leaving enough time to properly plan the new week before you're actually in the middle of it.
So what kind of planning and meetings does this actually involve? On a daily basis, you're holding a morning production meeting. I covered this in episode 34, which includes a downloadable guide for running one. The purpose of that meeting is figuring out how to actually increase treatment acceptance, looking at which patients are coming in that day, what treatment they need, and making sure it gets properly presented and genuinely understood so they accept it. It's also central to increasing overall practice productivity, and it happens daily. Before the meeting itself, you're looking at how the week's statistics are trending, and where you stand relative to the month. Checking this daily means no big surprises, if you're only at $4,000 on the 4th of the month against a $180,000 goal, you'll know there's a problem immediately rather than discovering it on the 23rd. Checking regularly means catching problems while the leaves are just a little yellow or a little brown, not after the plant has already died, giving you real time to actually do something about it.
So that covers the daily morning production meeting. What happens weekly? Three separate things: a doctor and office manager meeting, which I covered the procedure for back in episode 21, a financial review, where the doctor is paying bills and reviewing finances on a weekly basis, and a staff meeting.
Let's walk through an example office, open Monday through Thursday, closed Friday, and closed most Saturdays and Sundays except maybe one Saturday half day a month during the summer. That week ends at the close of Thursday and starts at the beginning of Friday. Your morning production meeting only really happens on days patients are actually there, so Monday through Thursday, not Friday, Saturday, or Sunday, aside from that occasional half day.
As for the weekly meetings, Thursday night your team turns in their statistics to the office manager before heading out for the weekend, or Friday morning if some team members come in briefly for paperwork. At that point they'll look ahead at the coming week, and honestly, sometimes the week after too, since schedules take time to build. Say I'm the schedule coordinator responsible for $180,000 a month, roughly $45,000 a week, I'd want to see where next week's schedule already stands relative to that $45,000 target. If I see it's only at $35,000, I know I need to find another $10,000 somehow, and I'm identifying that on Thursday, before the week even starts, not in the middle of it. Any scheduler will tell you a same-day cancellation at 4 PM tomorrow is far easier to fill than one at 8 AM tomorrow morning, the more lead time you have, the easier it is to fill a gap. Catching a shortfall a full week ahead gives you real room to work with.
So that's what your team is doing Thursday night or Friday morning before heading out. Then Friday itself: since everyone already turned in their statistics Thursday, the doctor and office manager hold their meeting, the specifics of which I covered in episode 21. Here you're reviewing statistics, personnel issues, whether anyone needs to be hired, and reevaluating marketing, is it working, does anything need to change. Out of this meeting come real decisions and directives, what's actually going to happen in the coming week. You might also check in briefly, five minutes, on a daily basis afterward to track progress against whatever was decided Friday, quick Monday morning check-in on what's getting done today, Tuesday morning on how yesterday went and what's next, and so on.
Management isn't about sitting in a room talking, it's active, you're out there actually doing things, but you have to plan what you're doing first, and that's exactly what these meetings are for, planning and coordinating, not meetings for their own sake. I'm not a fan of meetings that drag on pointlessly, I like them quick and efficient, straight through what needs covering, but you should walk out having made real decisions about what's getting done that week.
So Friday morning might start with the doctor and office manager meeting, say you're in the office from 9 to noon that day. After that meeting comes the financial review. There's a lot to this specifically, which we cover in depth in the Financial Planning and Profitability seminar within the MGE Power Program, but the same core principle applies here as with statistics generally: if you're managing your finances purely off a P&L, you're always going to be too late, especially if that P&L is arriving from your accountant with a full month's delay. Say someone's overspending on dental supplies in May, and you don't get May's P&L until June 22nd. By the time you actually act on it a few days later, you've likely got two full months of overspending stacked up, since whoever's ordering supplies probably kept doing the same thing through June too. I'm a much bigger fan of managing finances closer to real time, sitting down weekly to check collections, expenses, and so on. Even just reviewing the numbers weekly beats doing nothing, since it gives you a chance to catch a spike, a supply bill running unusually high, and act on it that following Monday rather than discovering an entire month of overspending after the fact.
So Friday covers the doctor and office manager meeting, then the financial review. That leaves the staff meeting. Using our same example office, closed Friday and most weekends, you'd most likely hold the staff meeting Monday morning, since that's the next time the full team is actually present after the doctor and office manager have already met, reviewed statistics, personnel, and marketing, and landed on a list of priorities for the week.
If your first patient Monday is at 9:00 and your morning production meeting is at 8:30, hold the staff meeting at 7:30 or 7:45, depending on how long it runs. Honestly, if you're holding a weekly staff meeting consistently, it shouldn't take very long. At MGE, with over 70 employees, our staff meeting runs about half an hour a week, with a slightly longer one roughly quarterly to review the quarter overall. Quarterly and annual meetings are worth having too, annual ones especially useful for planning the year ahead, we don't personally run monthly meetings since we're not a dental practice ourselves, but if a monthly meeting genuinely works for your goal-setting process, absolutely keep doing it. A longer meeting once a quarter is fine, but a consistent weekly meeting should generally move fast.
What actually happens in that weekly staff meeting deserves its own full episode, and I'll cover the complete format in a future one, but at minimum, you're showing your team how the office is doing statistically, how last week went, where things stand relative to the month, and reviewing whatever priorities came out of the doctor and office manager meeting. Since it's first thing Monday morning, you might have everyone come in a little early with coffee, bagels, or donuts available, informal but organized, people can eat while you go through it. The point is getting everyone genuinely on the same page, since your team is the one actually generating those statistics day to day, they should know exactly how things are going and what you're collectively working toward.
So that's the basic infrastructure. Run this consistently, and one of the real advantages of a daily morning production meeting specifically is that you're not just looking at today, you're looking ahead at tomorrow and the rest of the week too. The thread running through all of this is handling things with advance notice, so a small problem gets caught while it's still small and manageable, rather than growing into something far more severe by the time you finally notice it. It also lets you set real direction and actually confirm you're following through on it.
To be clear, this doesn't cover every skill involved in properly managing finances, statistics, or an underperforming employee, those are genuinely separate management skills in their own right. But here's the thing worth remembering, and it connects to something I've said before about making real time for sales: if I give a mediocre salesperson adequate time to properly present a treatment plan, answer every question, and make sure the patient genuinely understands it, even someone closing only 30 or 40 percent of cases, which isn't great, will close more overall if given enough genuine opportunities with adequate time than if given no real opportunity at all. The same logic applies here. Simply putting this structure in place and running it consistently will produce real improvement on its own. You can turbocharge that improvement further if you're also a genuinely excellent manager, which is its own separate subject we get deeply into in the MGE Power Program, link again on the episode webpage. But even just getting this basic structure going puts real attention on the issues that can make or break your expansion, which is ultimately what we're all after in the first place.
I hope this helps, and I hope you see real benefit from putting it into practice. Let me know how it goes, you can email me directly at jeffb@mgeonline.com, or leave feedback on the episode webpage at dentalbusinessrx.com. And if you need any help with your practice, you can always reach us at MGE, at mgeonline.com, or call us at (800) 640-1140. Folks, that's everything I have for you this week. Thanks so much for listening, I genuinely appreciate it, and we'll see you at the next episode.