By: Bridget Burris

What does your ideal patient day look like? Have you ever considered that? Can you tell me, in detail, what makes a great day at work great? Most people cannot, though they fantasize about perfection and complain about their reality often. It doesn’t have to be that way! If you can imagine your perfect day then you can create it through scheduling. Assuming you have the new patient flow of course…

The future is now. People say this all the time, but what does that mean? Simple. It means that what we do today, right now, creates our future. Don’t you get it? Today is not the present, today is 8-10 weeks ago when we last saw these patients and filled up our template for today by appointing them. Crazy right? So what does that have to do with you and scheduling? EVERYTHING!

First you need to understand that even if you totally revamp your schedule template today, your reality will not change for 8-10 weeks (or whatever your appointment interval is). Next you need to know that there is little if anything you can do to change your current reality today. Finally you must understand that if you want change it will be in the future and real change will occur only if you make a detailed plan and implement the plan daily and ruthlessly. In that vein I will now go through the basic steps of creating YOUR schedule template.

1) Figure out how many active patients you have.

2) Do a chart audit and separate your overtime patients or those who will be overtime. You will want to see these patients more often and if you have more than 10 percent overtime or if you’re headed that way then you can’t really create your perfect practice schedule or have extended appointment intervals until that is under control.

3) Figure out how long your appointment interval is. I recommend you listen to Ben on this topic and adopt an 8-10 week interval for small wires and while having the patient wear elastics and a 6 week interval towards the end of treatment but it’s up to you.

4) Decide what appointment types you will have and what they are. Most orthodontic offices have way too many different types. You don’t need that many – it slows you down in a lot of ways. We only have 5 different appointment types in our offices.

5) Figure out how many different time slots you will have on your template (the slots that you can place appointment types into). There should be as few as possible. We have 3 on our template.

6) Use the number of active patients you have and your average appointment interval to figure out how many active appointments you will need each month.

7) Decide how many days a month you want to work and then divide the total number of active appointments needed each month by the days per month you want. Then divide that number by the number of chair+assistant parings you have (i.e. the number of chairs/columns you will schedule). That will give you the number of patients per chair per day and will tell you if you need to work more or less days. The industry average for patients per chair per day is 12-14. We see 22-24 patients per chair per day in our offices and I tell you this so that you can get an idea of what can be done (because if we can do it you can too). Anyway if you end up with too few patients per chair per day you might want to reduce the number of days you work per month – or you could grow your practice by starting more patients or by buying a local competitor and folding their patients into your office. If the number of patients per chair per day is exactly right then you’re golden (well almost, see below). If the number of patients per chair per day is too high you can open up more days… Or you and your staff can learn to go faster.

8) Before you get too excited about the results of #7, don’t forget that you’ve only accounted for active patient appointments and you still need to add in space for other appointments like bonds, debonds, appliance checks, retainer checks, emergencies, etc. It’s not that hard to do, you just need to look at the average number of these types of appointments you’ve done in the past and make space. You make space by adding chairs/columns to the schedule or by adding days. You’ll have to decide what time of day you see each of these types of appointments in your ideal day. This is also a good time to look at how many retainer appointments you do and also to reconsider bonding one arch at a time (i.e. needing two bond appointments per patient) because it all adds up.

9) Next you need to figure out how many observation/recall patients you’ll see each day and when. We like to see obs patients every six months for lots of reasons and this is not an area I would scrimp on in terms of the schedule. Obs is the lifeblood of your practice. Don’t cut your own throat by undervaluing them.

10) By now you should have a very solid grasp on how many days a month you’ll work. Once that’s settled you need to decide how many new patients you want to see each day. You can base this somewhat off of past performance but I would suggest, instead, that you figure out the number of new patient appointments by working backwards from your goal for your ideal practice. To do this, take the amount of production you want to do each year and divide it by the number of days you plan to work and divide that by your average case fee. This will tell you how many starts you need achieve your goal so divide that number by your conversion rate and that will tell you how many new patient appointment slots you need. If you only have a couple appointments per day then set your sights higher and up your marketing budget! If you don’t have enough room for all the slots you think you need then work on your conversion rate and check yourself to make sure you’re being realistic and if so then add another Treatment Coordinator and another new patient column!!

Creating an orthodontic schedule can seem complicated but it’s not. Use these logical steps to create YOUR perfect day. Don’t try and copy someone else – it rarely works. Good luck. You can do it! Let us know how it goes.

5 thoughts on “Orthodontic Scheduling- How To Create YOUR Schedule Template

  1. Great article. Now that the year is almost over it is time to go into the planning process for 2016. In my opinion we all spend too much time working and relatively little time thinking about how to improve our systems and take our practice to the level WE want.

  2. You’re not wrong, Bill! Here’s to a great new year.

  3. Thanks for the systematic plan! Would you share what your office’s appointment types and different time slots are? Any other recommended readings? Thanks!

  4. Camden our appointments are simple and are meant to hold space for the procedure and nothing more. Treatment notes are descriptions of what is being done.
    Active Adjustment 20 min
    Retainer check 10
    Flex appt 60
    New patient 30
    Observation 15

  5. I love this article. It’s so logical and wise. Thank you!

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