Ep. 49: Designing the Ideal Schedule for Your Dental Practice, Part 1
Scheduling is important in any business, but in dentistry it is absolutely crucial. The office schedule is the heartbeat of the practice. It is no fun running hectically from room to room all day and working through lunch just to find out you only produced half of your daily production goal. So, in this episode, Jeff begins a series on how to structure and manage your schedule efficiently so you are consistently productive without being stressed or overworked.
Topics:
:11 – Using a scheduling system that works for your practice
7:41 – Setting production goals
12:29 – Structuring and fine-tuning your schedule
Links:
Scheduling for Production Seminar - https://www.mgeonline.com/the-scheduling-for-production-seminar/
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 four basic requirements any scheduling system needs to actually work?
It needs properly allocated time for specific categories of procedures, enough elasticity to absorb the unexpected without falling apart, dedicated time to actually sell treatment, and a single person clearly accountable for the schedule itself. Skipping any one of these tends to cause the whole system to break down the first time something goes even slightly off plan.
How do you break a monthly production goal down into an actionable daily target?
Divide the monthly goal by the number of working days in the month to get a daily production target, then subtract a conservative, dependable estimate of hygiene production to determine what the doctor specifically needs to produce each day. Reviewing progress against that daily number every morning makes it possible to catch and correct a slow start well before the month is already lost.
What are the three classes of procedures used for scheduling purposes?
Primary procedures are high dollar value work like crowns, implants, veneers, or endo, regardless of how long they take. Secondary procedures are medium to low value work like basic restorations, bleaching, or new patient exams. Tertiary procedures carry no charge at all, things like crown deliveries, adjustments, or consults, even though consults specifically carry real long-term value from a sales standpoint.
Why shouldn't a non-charge delivery appointment get bumped for a productive procedure?
Because the delivery appointment, seeing the final crown or veneer in place, is genuinely the moment the patient has been looking forward to the whole time, even though it shows up as no-charge production-wise. Bumping it for a same-day emergency or another billable procedure is a real customer service failure, and a properly structured schedule shouldn't need to make that tradeoff in the first place.
Why recommend scheduling primary, high dollar procedures in the morning?
Mornings typically have less competing traffic and interruption, and hitting the daily production goal before lunch removes the stress of watching the numbers fall behind later in the day. When a scheduler struggles to get patients into morning slots, the fix is usually training and a clear office policy, not abandoning morning scheduling altogether, since a doctor personally mentioning that a specific procedure is only done in the morning carries real weight with patients.
Episode Transcript
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Productive and efficient. These are the two words we hear most often when a dentist describes their ideal schedule, and it makes sense. Nobody wants to work a ten hour day out of three or four chairs, bouncing room to room and patient to patient while running 20 to 30 minutes behind most of the day, only to find at the end that you've produced roughly half of your daily goal. It's frustrating, demoralizing, and genuinely stressful.
Dentistry runs on tighter intervals than most businesses, ten to fifteen minutes at a time. The schedule itself is essentially the heartbeat of the practice, it touches nearly every function, determines your productivity and revenue, and when handled poorly, becomes a major source of stress.
So how do you build a schedule that runs on time, lets you actually eat lunch, gets you out of the office when you're supposed to leave, and stays consistently productive? That's what I want to cover this week and next week, a two part series on assembling the ideal schedule for your practice. My name is Jeff Blumberg, and I'm your host.
I've wanted to do this episode for a while, my hesitation was really about scope and how to explain something this visual through audio alone. We run a full two day seminar on this exact subject, Scheduling for Production, and about seven hours of related training on our online platform, DDS Success, covering both team-wide scheduling and around four hours specifically for the schedule coordinator role. It's genuinely a lot of material, so the challenge was fitting something usable into a podcast format. I've decided to go all in rather than offer a scattered tip or two, since the pieces of this system really only make sense together. I'll use visual aids where it helps, and you can let me know how it landed.
Across these two episodes, we'll cover how to structure the whole system: what your scheduling system needs to actually accomplish, how to set weekly and monthly goals, how to classify different types of procedures for scheduling purposes and determine how long they actually take, how your dental assistant fits into all of this, how to productively double book, how to fit emergencies into the day without wrecking it, and how all these pieces come together into a working system.
Let's start with the first point: what should a scheduling system actually be able to do? There are four basic requirements.
First, it needs properly allocated time, meaning specific blocks set aside for specific categories of procedures, which I'll get into shortly. Alongside that, it needs real elasticity to absorb the unexpected, since things don't always go as planned in dentistry. A patient shows up 15 to 20 minutes late, a tooth breaks during an extraction, someone doesn't get numb properly. Whatever system you build has to absorb these without collapsing entirely, otherwise even a beautifully designed schedule falls apart the moment one thing shifts by ten minutes.
Second, the system needs to allow for genuine expansion. If your current system already produces exactly what you want at the hours you want to work, you don't need to change anything. But if you're making a change, it's because you want to grow, whether that's higher volume, better efficiency, or eventually bringing on additional providers, and the system needs room to support that.
Third, the system needs dedicated time to actually sell treatment. If your goal is 8,000 dollars a day in production, you need to sell at least 8,000 dollars a day in accepted treatment, and that requires time built specifically for presenting cases, something I've touched on in episode 27 and episode one. Without that time, very little gets sold.
Worth noting here too: scheduling connects directly to cancellations and no-shows. Patients who make some form of real commitment, a deposit on a larger treatment plan, or prepayment, are meaningfully more likely to actually show up than patients who've committed nothing. If I present a 7,000 dollar treatment plan and you tell me you'll bring a check on the day of your appointment versus leaving something with me beforehand, you're statistically less likely to show if you've committed nothing in advance. Proper financial arrangements, tied into your scheduling process, genuinely reduce cancellations and no-shows on the doctor's own schedule.
Fourth, and this one matters enormously: someone, one specific person, has to be ultimately accountable for the schedule. That doesn't mean nobody else helps when the day runs behind, everyone should pitch in to get things back on track. But when it comes to actually booking patients, filling openings, and keeping the schedule productive, one person needs to own that responsibility.
In a lot of practices, you'll see the traditional setup, two or three people at the front desk all doing a bit of everything. That doesn't work for scheduling specifically. If everyone shares the job equally, nobody actually owns it, and when there's a gap in the schedule, everyone just looks at each other. If your practice currently has that generalist front desk setup, designate one person, ideally whoever's naturally strongest at it, as the schedule coordinator specifically. Someone has to be accountable.
Those are the four basic requirements. Now let's look at setting monthly goals. A goal should obviously be realistic, if you produced 105,000 dollars last month and want to hit 120,000 next month, that's a reasonable stretch. Jumping from 105,000 to a million isn't. Generally, don't set next month's goal lower than last month's, barring a genuine mitigating factor like being out of the office for part of it.
I actually challenged a client with this idea back in 1999. He was planning to be out of the office for two weeks and worried about paying his hourly staff for time he wouldn't be working. So we made it into a challenge: if the team hit their normal monthly production and collections goal within those first two weeks, they could work from home for the remaining two weeks, just answering phones and routing emergencies, and still get paid their normal wages. He presented it to the team, and they were in. He was doing about 65,000 dollars a month at the time, and they hit 65,000 dollars for the full month despite him being out two of the four weeks. He told me afterward he'd never worked harder in his life, but it was genuinely fun, and his team kept him running room to room to make it happen.
Once your monthly goal is set, say 100,000 dollars, break it down further so you can track progress in real time. Divide that by your working days for the month, say 17, and you get roughly 5,882 dollars a day, I'd round that to 5,900 for simplicity. The office manager should do this calculation once the monthly goal is set with the doctor, ideally before the month even starts.
From there, subtract a conservative, dependable estimate of hygiene production, not an optimistic best-case number, but what you can confidently expect on an average day. Say hygiene reliably produces 1,500 dollars a day. Subtract that from the 5,900 dollar daily target, and the doctor specifically needs to produce 4,400 dollars a day.
Get your team genuinely involved in this, not purely from a dollar perspective, but understanding that production and collections largely reflect how many patients are actually getting the treatment they need. During your morning huddle, review where the month stands so far. If day one comes in at 4,900 dollars against a 5,900 dollar target, that gap needs to be made up the next day, or you need to identify why and adjust. Checking this in real time, rather than discovering on the 20th that you're hopelessly behind with no time left to fix it, is the entire point of breaking the goal down this way.
Now let's talk about how to actually classify procedures for scheduling purposes. We use three basic classes.
The first is a primary procedure, meaning a high dollar value procedure, regardless of how much time or how many visits it takes to complete. Obvious examples include crowns, implants, veneers, endo, dentures, partials, or clear aligner cases, but the classification is really about total value, not the procedure type itself. Twelve composites done in a single visit could functionally be a primary procedure too, even though a single composite normally wouldn't be.
The second class is a secondary procedure, medium to low value work regardless of time or visit count, basic restorations, bleaching, night guards, a new patient exam on the doctor's schedule, or an emergency patient, even though an emergency could theoretically turn into something higher value once you actually see them, we classify it as secondary going in since we simply don't know yet.
The third class is a tertiary procedure, meaning no charge at all: crown deliveries, adjustments, consults. Worth flagging specifically: a consult where you're actually presenting treatment carries zero direct production value, but it's extremely important from a sales standpoint, since that's exactly where your future production comes from. Keep that in mind as you schedule these.
One important note on tertiary procedures specifically. I've seen practices fall short of a daily production goal and respond by bumping a scheduled no-charge appointment, say a veneer delivery, to slot in a same-day productive emergency instead. I'm not a fan of this, and here's a different way to think about it.
Production, technically, happens the moment you charge out a procedure. When you prep a crown, that's production, you've charged for it even if insurance hasn't been submitted yet. When the patient comes back for the actual crown delivery, that's a no-charge appointment, production-wise you've gone from a primary procedure down to a tertiary one.
But look at it from the patient's perspective for a second. Getting prepped, numbed, and drilled on isn't the appointment they're excited about, even though it's necessary. The moment they're genuinely looking forward to is the delivery, seeing the finished crown or veneer actually in place, that's the real reveal, that's why they're doing this in the first place.
So personally, once someone is on the book, I believe in honoring that appointment regardless, barring something truly unavoidable like the doctor being out sick. Bumping a non-billable but genuinely important appointment in favor of a billable one is a real customer service failure. With proper structure, you shouldn't have to make that tradeoff at all, but it's worth remembering that the delivery appointment matters enormously to the patient even when it shows up as zero production on paper.
So now that you have your three procedure classes, primary, secondary, tertiary, the next question is how to actually structure the schedule around them. My longstanding recommendation, not a new idea, but one that persists because it genuinely works, is scheduling primary procedures in the morning.
Here's why. Say you work eight to five, four days a week, with your first primary procedure starting around 8:30 or 8:40 after any early consults. If primary time runs from then until lunch around 12:30, and your schedule is built correctly, you've likely already hit your daily production goal before lunch even starts. The rest of the day proceeds without that background stress of watching the numbers fall behind. This isn't a mandatory approach, but I've had plenty of clients structure their week this way successfully, primary time in the mornings Monday through Thursday, secondary and tertiary procedures filling the afternoons, with the daily goal typically met by lunchtime.
Where this tends to break down is in one of two places. First, you might genuinely have a large enough segment of your patient base working second or third shift that morning appointments simply aren't realistic for them. In that case, you might run primary time in the mornings three days a week and flip it to afternoons on the fourth day, or lean more heavily toward afternoon primary time overall if that better fits your specific patient demographics.
The second, more common issue is inconsistency at the scheduling position itself. Say your scheduler is told to book primary procedures only in the mornings, but a patient says they absolutely can't miss work and needs a 5pm slot instead. If that happens two or three times in a day and the scheduler simply accommodates each request, you end up with a patient needing a major prep pushed out four weeks because they can only come in at 5pm. As the doctor or office manager, this can create the false impression that morning-only scheduling simply doesn't work for your patient base, when the real issue is scheduling execution, not the underlying policy. I've genuinely seen this play out where one scheduler struggles to fill mornings while a second scheduler, talking to the exact same patient population, has no trouble at all.
There are a few things that help make morning primary time actually work. As the doctor, once a patient has agreed to a treatment plan and fees are settled, you can mention directly that you only perform that specific procedure in the mornings, and even ask your treatment coordinator right there, in front of the patient, when your next available slot is. That plants the expectation early, and patients are generally far more responsive to something coming directly from the doctor than from anyone else in the practice.
On the scheduler's side, this needs to be treated as a clear office policy, not a personal judgment call. If a patient insists they can never come in during the morning, the answer isn't to simply accommodate them into an evening slot on your own authority, that's not the scheduler's call to make unilaterally. Either loop in the office manager to make an exception, or hold the line using the policy itself: this is the only time the doctor performs this specific procedure, it's our office policy.
I'd specifically avoid the old excuse that the doctor is freshest in the morning, that framing tends to backfire, since a patient scheduled for an evening slot instead might reasonably start wondering if the doctor is somehow less capable by five o'clock. Framing it simply as established office policy works better: patients generally assume there's a sound reason behind a stated policy, even if the real reason is about morning traffic and overall office efficiency rather than anything about the doctor personally. And there's genuinely not much a patient can argue against a stated policy, in my experience, this resolves the situation smoothly around 70 to 80 percent of the time on its own.
If you've tried morning primary scheduling before and assumed it just doesn't work for your practice, it's worth revisiting with this framing, plenty of our clients run it successfully every day.
The next major step in building this system is determining actual procedure duration, and one specific recommendation here: operate your schedule on ten minute intervals rather than fifteen. In our experience, about 80 percent of practices already use ten minute intervals, the remaining 20 percent use fifteen. I'm not a fan of fifteen minute intervals specifically because a genuinely 50 minute appointment can't be represented accurately, it either gets rounded up to a full hour, wasting time, or forced into an awkward fit.
With ten minute intervals established, the real work is determining how long procedures actually take, measured from the moment the patient is seated to the moment they're dismissed to the front desk. This means the timing needs to be realistic and reasonably uniform, and you'll want to build in a bit of extra buffer time to absorb the unexpected once you start constructing the actual schedule around these numbers.
Take a crown prep as an example. If you track this, or simply have a good working sense of it already, say the full visit from seating to dismissal runs about an hour, even though the doctor isn't in the room the entire time. Repeat this for the procedures you perform most often, basic restorations, endo, crowns, implant placement or restoration if applicable, adjusting for variations like multiple procedures in a single visit. Two crown preps, even in the same quadrant, won't simply double to two hours, more realistically it adds perhaps 20 to 30 minutes beyond the single-procedure time, which is exactly where operating on ten minute intervals becomes genuinely useful.
Focus this exercise on the procedures you perform most frequently rather than trying to time every possible CDT code, that's an unnecessary rabbit hole. Include no-charge appointments in this exercise too, delivering a single crown takes a certain amount of time, two crowns takes a bit longer, an onlay delivery has its own timing, and so on. If your own sense of these numbers is fuzzy, pull a report from your practice software showing procedure volume over a given period, and consider actually timing a few real appointments directly if needed.
I want to keep these episodes to roughly 30 minutes, so I'll wrap up here, next week's episode is likely going to run longer. We'll cover how your dental assistant factors into all of this, how to determine assistant time within these procedures, productive double booking, and how to structure emergencies into the day without derailing everything else.
In the meantime, I'd genuinely recommend starting to track how long procedures actually take in your own practice, from seating to dismissal, focusing on whatever you perform most commonly, crowns, implant placement, whatever fits your practice. We'll be using this data directly as we build out the rest of the system next week.
If you want to get ahead of this, check out the Art of Scheduling Productively course and the Schedule Coordinator training on DDS Success, link in the description, or join us for the Scheduling for Production seminar here at MGE, also linked. If you have questions before next week's episode, email me directly at jeffb@mgeonline.com, visit us online at mgeonline.com, or call 800-640-1140. I hope this was helpful, let me know how it landed, and I'll see you at the next episode.