Answer the following questions and write them down. Just write down what you think the numbers are as they don’t need to be perfect.
How long is your average treatment time?
What percentage of your patients are overtime?
How many starts did you do in the last 24 months?
How many patients do you see a day?
What is your average appointment interval?
How many days do you see patients a month?
How many repairs do you do a day/what is broken bracket percentage?
Ok now that you’ve written these numbers down, let’s do some math.
First let’s figure out how many active patients you should see a day based on your numbers. For example if you say you started 230 patients a year for each of the last two years (these are pretty common numbers I hear) and you work 16 days a month (very common as well) and you assert your average treatment time is 24 months with an 8 week appointment interval then it’s very easy. In this example you should have 460 active patients (add up the number of starts over time and get rid of them at 24 months – the average treatment time – in this case they drop off as fast as you add them at the 24 month mark). Next with an 8 week appointment interval you should see half your patients every other month (assuming you schedule evenly – in this case 230 active patients per month). Next we divide the number of active patients a month by the number of days we work per month – in this case 230/16= 14.375 active patients per day. At this point orthodontists usually tell me they actually see 40-70 patients per day so we have to figure out why. There are many possibilities.
1. starts – in this case that’s 19 starts a month and 1.2 starts per day based on the days worked so that brings us or 15.6 patients per day.
2. Repairs – most Orthos claim very few repairs but often there are many more than you think. Let’s add 3 repair appointments per day here. That doesn’t sound like much but it’s more than 20% breakage every 8 weeks at that level and brings us to 18.6 patients per day.
3. Observations – I hear Orthos complain about not having time to see obs patients and needing to push them out a year all the time. If that’s the case then why are we starting so few cases per day??? We will add 2 obs bringing us to 20.6 patients per day.
4. New patients – if you’re only starting 1.2 patients per day you can’t have many NPs. We will put you down for 2 per day making it 22.6 patients per day. Of course that means your precious conversion rate is 1.2/4(obs+NP) so that ain’t too good…
5. Overtime patients – now we are getting somewhere. This is usually a huge issue in struggling offices. Take the damn braces off. Overtime pts account for a ton of the excess patients you see per day and your stress. 22.6 patients per day ++++++++
6. Retainer checks – another black hole that sucks the life and time out of your practice. Do one at most. None is good. By the way there is absolutely zero reason for using anything but suck down retainers. I used to hand make my own wrap around hawley retainers and I was good at it. It’s a waste. If essex works for everyone else then why do you think you need to spend all that money and time to do hawleys? Hubris, pure and simple. Stop. Please. 22.6+++++ plus retainer patients
7. Miscellaneous appts – hygiene checks, appliance checks, etc account for maybe 5 more appointments per day. This brings us to 27.6 patients per day plus retainer appts and overtime patients. Subtract this number from the number of patients you actually see per day to give you an idea of the mind and body sapping fluff work you do daily.
Now that you’re flustered go pull the real numbers from your software and check yourself. You’ll probably find that you erred in your favor in your initial estimates more often than not. The example I used is for a practice collecting 1.2-1.4 million with @ 5500 dollar fee so if you don’t want to do the math you can extrapolate using your collections if your fee is similar. Meaning that if you collect 2.4 million then you can basically double the numbers but it’s better to work through it yourself. Call or message me if you want to discuss it or we can discuss it here.
The big question coming out of this is why are you wasting so much time? You could see your obs patients more often, you could take Medicaid to drive new patients, you could do effective marketing and see more NPs, you could remove barriers like records fees and expensive financing and instead you could start more cases, make more people happy and make a shit ton more money. You could reduce your staff, reduce the days you work or grow like crazy…
Of course, as always, if you’re making all the money you want and getting the results you desire then ignore all of this and carry on as you have been.