Ep. 97: Six Reasons You’re Not Making Your Production Goals
So you’ve done the math: in order to meet your goal for the month, you need to produce X amount per day. Wouldn’t it be nice if you could just get that production lined up consistently every day and meet your goals like clockwork? That is possible with good planning! And if it’s not happening in your office, the culprit is most likely one (or more) of the six reasons Jeff covers in this week’s episode.
Links:
Morning Production Meeting - https://mgeonline.com/morning-production-meeting-download
Free Consultation - https://www.mgeonline.com/free-practice-analysis
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Questions From This Episode
What's the most common reason practices don't hit their daily production goals?
No defined areas of responsibility. Titles like front desk person don't come with a clear job description or an owned outcome, so when something goes wrong, nobody is actually accountable for fixing it. Every position, scheduler, receptionist, financial coordinator, needs its own defined responsibility and a statistic that person owns, good or bad.
What does no targets assigned actually mean if the team already has a plan for the day?
It means the practice came up with action steps to salvage a shortfall, like moving up a patient or discussing outstanding treatment, but never assigned a specific person to actually own and execute each step. Ideas without an owner rarely get done. Each target should go to whoever's job it naturally belongs to: a scheduling target to the scheduler, a financial target to the financial coordinator, and so on.
Why isn't it enough to just assign targets in the morning meeting?
Because things go wrong during the day, a treatment coordinator gets backed up, a patient takes longer than expected, an idea to salvage the day falls through. Someone has to actively drive, push, and troubleshoot those targets as the day unfolds, not just hand them out at 8am and hope. That's the office manager's job: making sure targets set that morning actually get done by closing time.
What happens if there's no real consequence when someone doesn't follow through on their target?
The behavior continues, and it tends to spread. If one team member sees another get away with consistently not doing their job, whether it's chronic lateness or an empty schedule that never gets addressed, it quietly gives everyone else license to do the same. Non-performance has to lead to something: retraining, a direct conversation, or eventually replacement.
How do I know if a missed goal is a policy problem or a person problem?
Ask whether what you asked the person to do was actually reasonable, something you yourself could see working. If it was reasonable and it still isn't getting done, the problem is the person, not the policy. If the policy itself is genuinely unworkable, that's different, but most of the time practices give up on a perfectly reasonable policy and quietly stop pushing for it, which is really an accountability problem wearing a policy costume.
Episode Transcript
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Let me give you a scenario. Your dental practice has a daily production goal of 5,000 dollars. It's Monday morning. You start the day with your morning huddle and find out there's only 3,000 dollars on the schedule. Your team looks at the schedule and suggests a few scenarios to make up that 2,000 dollar difference and hit your goal.
For example, they might call Mr. Smith to come in today instead of tomorrow to start those two crowns, or talk with Mrs. Jones, who's already in for a hygiene cleaning, about the three inlays diagnosed last visit, since you happen to have some open time around her hygiene appointment. After discussing a few possible scenarios that could save the day, satisfied you have a plan, you and your team jump into today's schedule and get to work.
At the morning huddle on Tuesday, you ask how the office ended up on Monday, and find out nothing really changed. You produced the 3,000 dollars that was originally on the schedule and nothing more. Disappointed, but not sure what else to do, you run through the same motions for Tuesday's huddle. Same 5,000 dollar goal, maybe already scheduled, maybe not, the team brainstorms again, and the day plays out, hitting or missing the goal much like the day before.
Does any of this sound familiar? If you're anything like the hundreds of new clients we onboard every year, you're either not meeting your daily goals regularly, not sure what to do when you don't, or worse, you're not consistently setting goals in the first place, daily, weekly, monthly, quarterly, however you'd lay them out.
If you're not setting goals for things like production, collections, or new patients, maybe it's time to start, you don't hit a goal you never set. But if you are setting goals and just not making them consistently, this episode is for you. We're going to walk through the six most common reasons you might not be meeting your daily goals, and more importantly, what to do about each one. My name is Jeff Blumberg, and I'm your host.
Reason number one, and if you've been a regular listener, you may have heard pieces of this before, is no defined areas of responsibility in the practice. I'll say it again anyway, because it's important and not enough practices actually implement it.
In a traditional dental practice, you typically have one or more people at the front. What do we call them? Front desk people, which really isn't a job description at all. A hygienist has an actual job description, they're the dental hygienist. A front desk person is essentially named after furniture, no real defined role.
The problem with having three people at the front and no clear division of responsibility is that when something goes wrong, who do you actually talk to? You've got three people, a three hour opening on the schedule nobody caught, and when you ask what happened, everyone shakes their head, genuinely willing to help, but nobody is ultimately accountable for it. It's like fielding a baseball team where nobody has an assigned position, everyone's just out on the field. That doesn't work. Everyone needs a defined area of responsibility.
I've heard the counterargument, since there are plenty of different ways to organize a practice, that everyone should know how to do everything in case someone's out sick, the whole cross-training idea. I'm fine with that. Training your financial or treatment coordinator to answer phones if the receptionist is out, no problem. But it still has to be the receptionist's job ultimately. You need a clear division of labor.
As an example, with three people up front, you might have one dedicated receptionist, one schedule coordinator, and one financial coordinator, with one of them possibly also serving as office manager. Or you might have a scheduler and receptionist combined into one role. The reason I distinguish these roles at all is that people default to treating scheduler and receptionist as the same job, which is really just another version of the generic front desk person label.
A true receptionist role, especially as an office gets busier, is the person answering the phone, routing communication in and out of the practice, greeting patients, making sure they get back on time, and managing the reception area. In a smaller office, that's not a full time job on its own. In a larger office fielding hundreds of calls a day and seeing 20 to 60 patients daily, it very much is.
Scheduling is a genuinely different function. The schedule coordinator owns the scheduling book and is responsible for overall office production, a meaningfully different job than simply answering the phone. In a smaller practice, sure, one person can wear both hats. But as the practice grows, those roles eventually have to split, otherwise the person managing the schedule gets so consumed answering calls that they have no time left to actually fill a last-minute opening.
The same logic applies in reverse as a practice scales. Say you start with one doctor, two hygienists, and one person tracking the schedule. Add an associate and another hygienist, then eventually three associates and five or six hygienists, and at some point one person simply can't keep every provider's schedule full effectively on their own. That's when you might bring in a hygiene coordinator who manages the hygiene schedule specifically and reports to the scheduler, while the scheduler still owns overall office production. Clear divisions of responsibility, even as the org chart grows more complex.
Each of these roles should come with an expected outcome. What would I expect from a scheduler? My schedule built correctly, especially around any structure I've set, larger primary procedures in the morning, deliveries in the afternoon, consults at specific times, scheduled efficiently, and scheduled productively. How do I measure that outcome? With a statistic, and for a scheduler, that's typically production.
Same idea with a financial coordinator. What would you expect? Minimal uncollected accounts receivable, and financial arrangements handled properly and consistently with office policy. Every role has a division of labor, an expected outcome, and a statistic that person owns, not just reports on as a bystander.
If a schedule coordinator's statistic is production, they shouldn't be relaying it to you like a spectator, oh, we did 5,000 yesterday, as if they had nothing to do with it. They have everything to do with it, they're the one creating that number. If it's up, that's great, and they should be able to see how they contributed. If it's down, that's a genuine problem, and here's something interesting: once you start tracking statistics regularly, people are generally quick to take credit when a number is up, but tend to struggle owning it when a number is down, even when there are real external factors, weather, no-shows, whatever it might be. That's fairly natural, but they still have to own both the good and the bad.
If someone consistently isn't producing their expected outcome, the fix might be more training, working alongside them, especially if you're handing off a role to someone newer. But if underperformance is a long-term, ongoing pattern, it may be time to consider replacing that person. The point is, this decision is grounded in hard numbers, not opinion or how you happen to feel that day.
So assuming you've got defined responsibility in place, what's reason number two? Irregular or nonexistent coordination. Coordination means organizing people so they actually work together harmoniously, and it doesn't happen automatically just because everyone sits near each other. The financial coordinator, the scheduler, and the assistant in the back aren't necessarily talking regularly about what each of them is working on unless there's a structure for it, which is exactly what your morning huddle should be for.
As an example, if I'm the schedule coordinator and I learn during the meeting from the financial coordinator that a patient coming in on recall has a large outstanding balance, I make sure that when I schedule them, they see the financial coordinator before they leave to handle it. Small coordination points like this, multiplied across the day, keep things from falling through the cracks.
Here at MGE, we don't call it a morning huddle, we call it a morning production meeting, and I have a handout available on how to run one effectively, I'll put it on the episode webpage if you want to download it. It's a guide for running that meeting in a way that actually maximizes coordination.
So you've got defined roles and regular coordination in place. What's reason number three? No targets assigned. Going back to the earlier scenario, say your team worked out a plan in the morning meeting to turn a 3,000 dollar day into a 5,000 dollar day, including talking to Mrs. Jones about her outstanding inlays. She might say yes, she might say no, she might say yes but not today, in which case you schedule it for tomorrow instead. Fine either way. But who's actually responsible for making sure that conversation happens at all?
There are usually several people on the hook for a single target like this. The hygienist might need to do some initial education, reminding Mrs. Jones about the inlays and why they matter. The assistant needs to know the doctor is going to step into that room specifically to have that conversation, even outside a normal exam flow. The treatment coordinator needs to be aware Mrs. Jones might be coming to them afterward to discuss financial arrangements. Hygienist, doctor, assistant, and treatment coordinator all need to be aligned on that one target.
Or take the idea of moving a patient up from tomorrow to fill today's opening. Whose job is that? The schedule coordinator's. But if you just have generic front desk people with no defined roles, who's actually assigned that target? Nobody, and if everyone is theoretically responsible for everything, in practice nobody is responsible for anything.
This is where plans tend to fall apart: you generate good ideas and action steps in the meeting, but nobody is explicitly assigned as the owner of each step. That's what I mean by targets not being assigned, someone needs to own each step and be accountable for actually executing it. Ideally, you assign each target to whoever's role it naturally belongs to: a scheduling target to the scheduler, a financial target to the financial coordinator, a sales-related target to the treatment coordinator.
And circling back briefly to coordination: meetings need to happen routinely, not occasionally. Your team should be so used to the morning meeting that skipping it feels strange, not the other way around. Sure, there might be a legitimate reason to skip one, an ice storm keeping everyone out until 10am, for example, but consistency is what makes coordination actually stick over time.
Assuming you've got defined roles, regular meetings, and assigned targets, what's reason number four? And a quick aside first: I wouldn't set an isolated daily goal in a vacuum, I'd tie it to a monthly goal, and ideally a quarterly one too, so there's a bigger target it's actually contributing to. Going back to our example, if that practice is working 17 days that month at a 5,000 dollar daily goal, that's an 85,000 dollar monthly goal, possibly more once hygiene is factored in. A 3,000 dollar day puts you behind, and you want to start closing that gap early rather than realizing two days before month end that you're at 40,000 dollars with no time left to recover.
So, reason four: no one is driving, pushing, or actively handling those assigned targets throughout the day. Nobody is following up to confirm that what got assigned in the morning meeting actually happened. You might think, why would I need someone doing that, my staff is competent. It doesn't matter how competent your team is, if nobody is functioning as the executive making sure things actually get done, some things simply won't happen. What happens when your three ideas to save the day all fall through by 10am and you need new ones? What happens when your treatment coordinator gets stuck in a room longer than expected while the next patient waits, and the whole schedule starts backing up? Someone has to be actively ironing that out in real time.
That's ultimately the office manager's role. In a smaller practice, the office manager likely wears other hats too, that's fine, and as the practice grows and the manager does their job well, they'll eventually be able to hand some of those other duties to someone else. Throughout the day, alongside whatever else is on their plate, the office manager should be actively confirming that the targets and action items set that morning, or even for the week, are actually getting done, and when they're not, finding another way to still hit the underlying objective. If the original three ideas to salvage the day fall apart, the office manager is the one finding a fourth and fifth idea, stepping in directly if needed, grabbing the next patient themselves, covering for someone who had to leave sick, whatever it takes to keep targets on track.
I covered the office manager role in much more depth in an earlier episode, somewhere in the first 20 or 30 I recorded, there's a lot of confusion around what this role actually is. But the short version: the office manager is the senior executive running the practice day to day, not just the front desk supervisor, that's only one piece of the job. They're responsible for overall practice productivity, because the owner doctor genuinely cannot manage the practice effectively while also being chairside. You can't run the business while your full attention is on a one inch by one inch space for an hour during a root canal. Someone needs to be actively running the practice throughout the day.
So, assuming you've got defined roles, regular meetings, assigned targets, and an office manager driving all of it, what's reason five? No accountability or consequences. Say the scheduler was supposed to call five patients to rearrange the day and salvage production, and simply didn't. What actually happens? If the answer is nothing beyond maybe a mild talking-to, that's not much of a deterrent. Or maybe it shows up more subtly, a schedule with growing gaps, a hygiene schedule quietly emptying out with no clear explanation, this applies to any role in the practice, scheduling is just the example here.
Without real accountability or consequences, that behavior simply continues, and worse, it tends to spread to the rest of the team. If I'm the financial coordinator and I notice the receptionist is chronically late with no consequence, that quietly gives me a kind of unspoken permission to be late too, whether or not I actually take it. Then the scheduler notices the same pattern and decides it's fine to act sulky or disrespectful toward the office manager, since the assistant gets away with it. It spreads through a team almost like an infection. Non-performance without consequence is a real problem, and something has to happen in response, whether that's more training, a direct conversation, or eventually a decision to replace that person.
Which brings us to reason six, and this one is about you, the doctor. Do you actually care about hitting these goals, or have you become apathetic about it? Maybe you've had enough days falling short that you've quietly concluded the goal just isn't realistic.
Here's an example, not strictly a daily production example, but a policy point that illustrates it well. Say you decide you only want to do your higher dollar, primary procedures in the morning, when the office is calmer and you're in the best position to focus. Completely reasonable in your mind, so you make it office policy, and then your scheduler can't get anyone to book morning slots, leaving that part of your schedule empty. You ask why, and hear that patients just can't come in the morning because they're working.
At that point you have a choice. First, evaluate honestly whether what you asked for was actually reasonable, something you yourself could picture working. I'd never ask a team member to do something I couldn't imagine doing myself, that would be strange. Scheduling people for morning appointments is entirely reasonable, plenty of people go to doctor's appointments in the morning, why not a dental appointment? If the ask is reasonable and it's still not happening, the problem isn't the policy, it's the person. I'll say that again: the problem is not the policy, the problem is the person.
Now, if you'd set a genuinely unworkable policy, say, requiring patients to prepay two weeks before every appointment including routine cleanings, and staff start hearing, what is this, no other dentist does this, that's a different story, that's a policy problem. But when what you're asking is reasonable and it's still not happening, most people don't do the honest evaluation I just described. Instead they conclude, guess mornings just don't work, and quietly give up, rescheduling everything for the afternoon instead. This is the same pattern that shows up with PPOs: you convince yourself patients only want in-network providers, so you never actually drop any plans, and you keep working for half of what you should be earning.
As the owner doctor, you set the tone for the entire team. If you're visibly apathetic about getting things done, that attitude spreads. What example does that set for your staff, or for your office manager, who is genuinely your partner in growing the practice? That's not something to just let slide, it needs to be addressed directly.
My suggestion for handling it: get trained as an executive. Just like your clinical role has an expected outcome, a healthy patient, and your sales role as the doctor has an expected outcome, a closed case, your role as an owner is also an executive role, whether you think of it that way or not, and an executive has an expected outcome too: an expanding, profitable organization. If you're not getting that outcome, the issue is your executive skill set, not some inherent deficiency, more likely you simply never received formal training in it. You can't walk around apathetic while also expecting your team to believe something is achievable.
Those are the six main reasons I consistently see, especially with newer clients, for not hitting practice goals: no defined responsibility, irregular coordination, no targets assigned, no one driving those targets throughout the day, no accountability or consequences, and doctor apathy toward the goal itself.
You've put in a lot of time becoming a doctor, make it worth it. Careers have an expiration date, and if you want to genuinely love yours, it may mean learning a few things you haven't yet so the practice actually runs the way you want it to.
I hope this helps. If you have questions about MGE or want more information, find us online at mgeonline.com or call 800-640-1140. I've got the morning production meeting download on the episode webpage if you'd like it. See you at the next episode, have a great week.