Ep. 14: How Much Should a General Dentist Produce Per Day?
Curious how you measure up in terms of daily production? Want to know if you have room for improvement? This week we bring on special guest Chris Menkhaus, Senior Consultant at MGE, to discuss how much a general dentist should produce daily and ways to maximize your personal production.
Topics:
1:27 – How much should a GP produce with bread-and-butter dentistry?
3:30 – What if you’re doing high-dollar specialty procedures like full-mouth restorations?
5:00 – Reasons why you may be underproducing if you’re falling short of those numbers
8:56 – How many chairs should you be working out of?
12:44 – Utilizing your assistants properly
13:49 – How about associate doctors?
Links:
Learn more about MGE - https://www.mgeonline.com/
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Questions From This Episode
How much should a general dentist actually be producing per day?
For bread and butter dentistry, crown and bridge, composites, simple extractions, maybe light Invisalign or FastBraces, 3,000 to 7,000 dollars a day chairside is the range, with about 5,000 a reasonable midpoint in an average fee area. Doctors doing heavier specialty work like full arch implant cases can run 10,000 to 40,000 a day, though that pace usually comes with heavy specialty marketing behind it, not routine crown and bridge volume.
If I'm producing below average, what's the first thing to look at?
Whether you're actually selling the treatment you diagnose. Production follows sales almost exactly, if a patient only accepts two of six needed crowns because that's what insurance covers this year, you don't produce the other four, and often the patient assumes it was already done when you follow up next year. Getting comfortable presenting and closing full treatment plans is usually the single biggest lever for raising production.
How many chairs should a general dentist actually be working out of?
Two, in most cases. It's rare to see a general practitioner operate efficiently out of more than two chairs, doctors spread across three or four chairs are usually producing well under capacity and struggling to find time for hygiene checks, since the extra chairs tend to compensate for inefficient scheduling rather than genuine capacity needs. A dedicated day for a specific service like Invisalign is a reasonable exception.
What should a new associate be producing, and how fast should they get there?
In the first 90 days, the real metric isn't the associate's individual number, it's how much more the overall practice is collecting and producing because the associate is there, since the owner doctor is freed up to sell and treat more during that window. After 90 days, a typical associate should be producing at least 3,000 dollars a day, assuming a normal ramp up rather than someone already highly experienced.
Should a new associate be turned loose solo on day one?
No. A short integration period working directly alongside the owner doctor, assisting chairside for anywhere from a few days to, in some cases, close to three months for a new graduate, lets both doctors confirm clinical and chairside consistency before the associate works independently. It also doubles as a natural way to introduce the new doctor to patients with a built-in vote of confidence rather than a cold handoff.
Episode Transcript
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Jeff: If you're a general dentist, I have a question for you. How much did you produce on average per day, and how does that measure up? Are you underproducing, about average, or doing real well? To answer that, we first need to ask another question: how much should a general dentist be producing per day? That's what we're going to talk about in this week's episode of Dental Business Rx.
Jeff: My name is Jeff Blumberg, and I'm your host, and I'm joined this week by Chris Menkhaus. Chris is the Director of Practical Implementation at MGE. To give you an idea of his background, Chris is in charge of all the coaching at MGE, he manages our power client managers, and any coaching or implementation assistance you'd get as an MGE client runs through his department. Chris has also been in the dental industry for over 20 years and has run multiple multi-doctor offices, the first of which he built up to over 6 million dollars a year, to the point where the owner doctor didn't even need to be on site.
Jeff: Chris, are you all hooked up over there?
Chris: I'm all hooked up, yeah.
Jeff: Awesome, Chris, welcome, thank you for joining me today.
Chris: Thank you.
Jeff: All right, so that's the question. How much should a general dentist produce per day?
Chris: Bread and butter dentistry, I'd say between 3,000 and 7,000 dollars.
Jeff: When you say bread and butter dentistry, what do you mean?
Chris: No molar endo, not doing implants, your basic crown and bridge, composite, simple extractions, maybe a little ortho like Invisalign or FastBraces. Not the 40,000 or 50,000 dollar cases.
Jeff: Not doing all-on-fours or all-on-sixes or anything like that.
Chris: Right, those change the numbers dramatically.
Jeff: That 3,000 to 7,000 range, does that account for fee structure and things like that?
Chris: Yes, fee structure, the speed of the clinician, which insurances you're participating with, and certainly the doctor's own personal philosophy on what's best for the patient plays into it too.
Jeff: And when you say this is what they should be producing per day, you're talking about that doctor chairside, not the whole office.
Chris: That doctor chairside, exactly.
Jeff: So 3 to 7,000. And when you're talking to a client, you're looking at their specific circumstances to figure out whether they're under or over producing.
Chris: Absolutely. You look at what they can do versus what they're currently doing, their treatment plan opportunities, how many hygiene checks they're doing an hour if they have a hygienist, or whether they're doing their own hygiene, which happens more than people realize. Actually, yesterday I found out one of our clients in Southern California is paying 60 dollars an hour for a hygienist, and some candidates they interviewed wanted 65 to 70.
Jeff: There may be more people out there doing their own hygiene than you'd imagine, listening to this right now. Different podcast topic, but worth mentioning.
Chris: Definitely worth addressing.
Jeff: So let's say I'm one of those docs doing the more advanced procedures. How does that work out?
Chris: There's a lot of variability, but call it 10,000 to 40,000 a day.
Jeff: 10 to 40? That 40 is high.
Chris: Very high, but we do have clients who hit that on a fairly regular basis. If you're doing that, you're probably marketing your specialty very heavily, and it's usually all-on-fours or large full mouth cases, not high volume crown and bridge.
Jeff: That would be pretty intense. So let's say I'm out there listening. Before I ask the next question, are there other mitigating factors you'd add here? If I'm wondering whether I'm underproducing or below average, is there anything else I should account for?
Chris: The whole office is so interconnected that it's hard to say there's nothing else, but given proper administrative support and a reasonable schedule during normal business hours, I think you're in pretty good shape with those numbers.
Jeff: Let me play this forward with some math. You said 3 to 7,000, so the midpoint is around 5. Let's say I'm in an average fee area, not Manhattan or LA. I should be producing about 5,000 a day as the doctor. If I work 17 days a month, that's about 85,000 a month coming out of my chairs. Add hygiene on top, say 30,000, and we're at 110 to 115 a month, pretty solid and stable.
Chris: That's right.
Jeff: So say I'm listening right now and I'm doing 40 a month or less. I feel like I'm below average. What do I do about that?
Chris: First thing is to look at whether you're actually selling treatment. Sales is such a loaded word, you can call it educating, whatever you want, but at the end of the day, if you want to get people healthy, you have to be able to sell, it's non-negotiable. And generally, you don't produce it because you didn't sell it. That's pretty much where it starts and ends.
Jeff: And if I want to increase production, I also have to increase sales. I'm sure you'd agree, if I know what I'm doing in a sales conversation, that 25 minutes I spend presenting six crowns to a patient matters a lot. If I don't know what I'm doing, they accept two this year because that's what insurance covers, two next year, two the year after, and when I follow up next year they say, I thought we already did those. But if I know what I'm doing, that same 25 minutes can turn into all six crowns this year.
Chris: Which obviously has a huge impact on production.
Jeff: Any other points you'd flag if I wanted to raise this average?
Chris: The next thing, and it goes hand in hand with sales, is actually having time to present treatment. You said it yourself, having 25 minutes when necessary to sell a case. Beyond the sales skill itself, that's how you get the patient healthy in the first place. If I spread two crowns per visit across separate appointments, that's probably six visits minimum. If I do all six crowns at once where it's clinically feasible, that's two visits, it's a huge efficiency gain on top of the health outcome.
Chris: We see this constantly: a doctor says, I don't have time to sell. That's essentially saying I don't have time to get the patient healthy. Very few people go into dentistry because they love selling, but if you can't make time for it and give it real importance, put yourself in the patient's chair for a second. This is my health, it took me two years to work up the courage to come in, and you're too busy so you just tell me to come back next week for a consult. If you genuinely don't have time, fine, that's the right call in the moment, but build the time in so it happens less often. Having time to present is a big one.
Jeff: Then you get into the actual mechanics of production.
Chris: Right, you want an assistant, ideally one assistant per chair, brought up to speed on everything they're legally allowed to do in your city or state. And here's an interesting one: it's very rare that we see a general practitioner operate efficiently out of more than two chairs. When we see someone working three or four chairs, they're usually producing well under capacity and not finding time for hygiene checks. Stay efficient out of two chairs, and if you want a dedicated ortho day for Invisalign or FastBraces, great, have that separately. But in general, spreading across more chairs just becomes disorganized, it's compensating for inefficient scheduling, not an actual need for more chairs.
Jeff: Fair enough.
Chris: And you can absolutely do it out of one chair. We have clients doing remarkable numbers out of a single chair. We had a client with one doctor chair and one hygiene chair, not ideal, and he went through a lot of red tape trying to add a third. But working under a 40 hour week, he consistently did 130 to 140 thousand a month, and this was in an area most people would consider low income, not the Upper West Side of Manhattan.
Jeff: Wow.
Chris: Before working with us, he was a full Medicaid office. He achieved these numbers without taking Medicaid at all, just through extremely efficient scheduling.
Jeff: Got it.
Chris: The other thing you want in place is a scheduling system. What matters more than the specific system is that you have one, some agreed policy on how the day is structured. The more production you want, the tighter and more efficient that system has to be. It's funny, at the MGE sales seminars, I'm one of the main speakers and I like to survey the room. I'm always surprised how many doctors don't have any real system for running their schedule.
Jeff: I'll ask, how many of you put primary time in the mornings, and with newer clients, maybe 10 percent of hands go up. They're just putting cases wherever there's an opening, so they end up starting a four or five unit case at 6pm.
Chris: Yes.
Jeff: It seemed like more practices had a real system years back, and that's just less common now.
Chris: It really is. We put our clients on a system, obviously, but it's not nearly as prevalent industry wide as it used to be, and it's not a great trend. You end up with doctors who are, for lack of a better term, overworked and underpaid, and it becomes a worse patient experience too. With more insurance participation and corporate competition, doctors feel like they need to be high volume, even when that's not actually true, it's really a lack of a scheduling system, sales skill, or time to sell that's driving that feeling.
Jeff: And it's probably not great for the doctor, the office, or the patient in most cases.
Chris: Probably not.
Jeff: I'd imagine it doesn't feel great as a patient either. All right, so far we've got sales, a dedicated assistant, not operating out of more than two rooms, that's interesting, and a scheduling system. Any other points?
Chris: Just circling back to assistants, in a perfect world you'd have one assigned to each chair, brought up to do everything you need them to do so your own time stays efficient. If they're legally allowed to make temporaries in your state, they should be making temporaries. If they can't yet, that's fine, get them there, since dental assisting programs vary a lot in what they actually teach. You want every assistant maxed out to whatever your state's dental practice act allows.
Jeff: Got it. All right, so now we've established what average production should look like. What do I do to fix it if I'm underproducing, and how would this apply specifically to an associate relationship? I know the production doctor model is its own separate conversation, we actually covered how much to pay an associate a couple episodes back, including the different associate structures, traditional versus production doctor. Let's focus on the traditional model here. I'm an owner doctor getting busy, I bring in an associate to handle emergencies, pediatric patients, endo, and be on call, and they're going to help build the practice. What should this person actually be producing?
Chris: Great question, and my disclaimer up front is that you want a real integration period, just like you would with any new hire, they're not walking in day one and lighting it up. We'd strongly recommend the doctor actually work alongside them on patients for anywhere from a few days to a week or two, so you can both see how the other works and confirm you're going to be clinically and chairside consistent. It's actually a red flag if someone isn't willing to do that.
Jeff: Can I break that down a bit, since this is a newer idea for a lot of people? So I'm the owner doctor, I've hired this associate a year or two out of school. By the way, if anyone's hearing what sounds like a jet engine in the background, that's actually a jet engine going overhead, and also our AC running, we're in Florida, so bear with us on that. So I've brought in this doctor who's been out a year or two. You're saying I'd actually have them work directly with me, so if I'm prepping crowns on a patient, what is this associate doing while I work?
Chris: They're assisting you. It's almost an I drill, you fill dynamic, and then it flips.
Jeff: So let's clarify, since this is newer territory. We're working together on this one patient, there's no separate assistant in the room.
Chris: That's right, the associate is essentially acting as your assistant in that moment.
Jeff: Would we ever flip that, where the associate works and I assist them?
Chris: Absolutely. And in terms of how you frame it to the associate, it's not coming from a place of, I don't fully trust your dentistry so I want to watch you work, that's not a great icebreaker and it's not really where this comes from. It's more about being straightforward: it's important that the practice has consistent chairside manner and consistent clinical approach, so we're going to work together for a few days, you see how I work, I see how you work, and we make sure it's compatible. It's also a great way to introduce the new doctor to patients, instead of, hey this is Dr. Sue, she'll be working on you today, bye, it becomes, hey, this is Dr. Sue, have you met her, she's great, she's already worked on some of us, she's going to be working with me on you today, and good news, no extra charge for the second doctor.
Jeff: Wow.
Chris: And you take it on a gradient from there. Associates come in all different clinical skill levels, sometimes after a day or two you realize, this person really knows their stuff and has great chairside manner, and they're ready to go on their own. I've got a couple of associates still with practices who are giant producers now, one doing 150 thousand a month in production and sales, another around 200. One of those guys, as a new grad, worked directly alongside the owner for close to three months before going fully solo, occasionally turned loose on a composite here or there, but that was the integration process.
Jeff: Wow, that's great data, honestly. I've heard pieces of this before and talked to clients about it individually, but I haven't really heard it framed this clearly as an industry wide concept, even though we've had a lot of clients do it successfully.
Chris: Glad I could lay it out. And it's roughly a 90 day process. In those first 90 days, I'm honestly not that focused on the associate's individual production number, I'm more focused on how much more the overall practice is collecting and producing because the associate is present. If they're working alongside me on patients, I'm actually a bit more freed up, I can step out and spend more time selling a case, or move something over and start a major case sooner than I otherwise could have.
Chris: After that 90 day window, assuming this isn't someone already eight years out and placing implants left and right, we're talking about the average associate hire here, I'd want to see them producing at least 3,000 dollars a day.
Jeff: Got it, so now the expectation lines up almost exactly with where we started this conversation.
Chris: Right, and as the owner doctor, you're almost always going to be faster and better at sales than the associate, at least initially. And I'll add, if they're only doing two hygiene checks an hour on top of everything else, hitting that 3,000 dollar mark might genuinely be a tough ask, it's still very much an integration process. One of our most successful clients actually texted me today, they collected 100,000 dollars yesterday.
Jeff: Oh my gosh.
Chris: And most of their associates work out of a single chair, one treatment chair and one hygiene chair they run checks on. It might sound like overkill on paper, but it can absolutely be run efficiently, it just depends on your specific needs.
Jeff: That's actually a great topic for another episode, since we also run a whole scheduling seminar around this, because you'll see doctors spread across four or five chairs who, on paper, look busy, but it's just not showing up in the actual production numbers.
Chris: It's not, and they're wearing out a pair of rollerblades every week just going between chairs.
Jeff: That makes sense. All right, I think that pretty well answers it. This was awesome, and honestly, if you had a live audience, people would have follow up questions right now. If you do have questions for Chris, you can always email him directly, Chris M, C-H-R-I-S M, at mgeonline.com, we'll put his email link on the episode page. And if you want to learn more about MGE generally, find us online at mgeonline.com or call 800-640-1140. If you want more on the sales and communication seminars we referenced, we'll link that on the episode webpage too.
Jeff: Here's what I'd challenge you to do if you're listening: as Chris mentioned, there are a lot of variables here. If you're practicing in Biloxi, Mississippi, your fee schedule looks completely different than someone practicing in Tribeca. So you may not have a clear read on whether you're under or over producing, though realistically, nobody's really over producing. If you want an honest read on where you stand, I'd recommend emailing Chris directly, and he can give you a quick assessment, if that works for you, Chris.
Chris: I'd genuinely love to hear from them, yeah, absolutely.
Jeff: All right folks, have a great week. Chris, thanks again for joining us today, really appreciate it.
Chris: Thanks so much for having me, Jeff.
Jeff: Good stuff. Have a great week, everyone, and we'll see you at the next episode.