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10 Steps to Dramatic Increase in Production

1. Set a realistic daily goal.

  • Determine what your average daily production has been for the past 3 to 6 months.  Add the production together and divide by the number of days worked.
  • A goal must be determined with involvement from all staff members.  Goals that are set only by the Doctor will not lead to group commitment.  Ownership is important in setting goals.
  • As a group, discuss and agree on an increase that is feasible but is challenging.
  • Count the number of days available to work in the month and multiply the new daily goal.  This is the new goal for the month.  Remember that you will be raising your fees every January and July to offset the cost of living (4-6%) each year.  We need to compensate or remember that your production would increase just from this fee increase if you did what you did last year.  A reasonable goal would be in the 15-20% range with no increase in staff or overhead in addition to the yearly fee increase.


2. Record the goal (without the $ sign) at the top of each appointment book page.

  • Your computer software may do this automatically – some do and some don’t.
  • This will be a reminder for the Appointment Secretary to keep a running total as the day fills by entering the fees for each appointment and to schedule keeping the goal in mind.
  • Included at the end of this article is a reproducible goal planning sheet along with instructions for its use.


3. Determine the number of Substantial cases needed to make the day and pre-block them in the appointment book.

  • A substantial case is about the fee of a single crown.  How many “substantial cases” (PVC or its equivalent) have you done lately to maintain your average production?
  • Approximately 60% of your daily goal should be in substantial cases.  It is impossible to make a reasonable goal with having this many substantial cases.
  • How many more “substantial cases” do you need to meet your new monthly goal on a daily basis?
  • Fill in around these with smaller procedures.  One way to prevent your schedule from becoming choked is to not preschedule seat appointments.  We only pre-scheduled seat appointments for large anterior cases.  Not single crowns, small bridges, or limited number of single seats.  The patient was told that the minute the crown or bridge came back, we would call and get them right in.  We would try to avoid giving them the option of coming in during peak demand times (7-9 AM and 3-6PM).  If you can’t seat a crown in about 5-10 minutes, you might be using the wrong lab. Substantial cases are our “bricks” that make up our schedule.  Everything else is the “mortar” that will fit around these substantial cases.


4. Determine the number of restorative hours and seat appointments         needed to meet your goal.  The remainder of the day will be filled with miscellaneous procedures.

  • Based upon how long your need for particular procedures.  Try to do as much as possible with the patient on each visit.  As you can see, clinical speed can hamper your ultimate productivity.  Be sure you have a 10 minute increment schedule, not 15 minute.  Just changing from 15 to 10 can net a 12% increase in productivity.  If a standard cleaning appointment is 60 minutes or a single crown prep is 60 minutes, try and cut it down by 10 minutes.  Your productivity per hour will dramatically increase.  Even more important: 10 minutes saved on several appointments may allow you to fit in one more procedure per day.  If it were a crown at $1000/crown, you would produce an extra $200,000 for the year.
  • In addition to not pre-appointing crown seats, don’t schedule too many each day.  If you average the same number of seats as preps, you’ll never get behind.


5. Purge your charts daily to help fill the appoint book and meet the Substantial Case requirements.

  • Find patients with outstanding diagnosed but as yet uncompleted and unscheduled treatment.
  • Each staff person will evaluate only “one” chart in the file per day.  Even the doctor and hygienist should do this.
  • Use a Purge Information Sheet attached to a clipboard which is placed in the files after the last patient chart “purged” to mark the point of progress.  Included at the end of this article is a reproducible “purge” sheet and a “call” sheet.  Copy them and start using them today.  Who better to call and reactivate than a previous patient who knows and trusts you.
  • Call all patients with incomplete treatment and schedule.
  • If necessary, invite patients in for a quick check at no charge.  Re-motivate when they are in the office.
  • Don’t forget about those patients who have missed their hygiene recall appointments while in the “purge” process.


6. Report the following during a brief morning meeting with all staff.  The morning “huddle”.

  • Did we meet our daily goal yesterday?
  • Production scheduled for today – will we meet our goal?
  • How many Substantial Cases are scheduled for the next five working days?
  • If you are below the number needed, everyone is responsible for looking.
  • Check for cancellations and use the Summit CA/NS system to correct any openings.


7. Create a sense of urgency to encourage the patient to schedule within a five day time frame.

  • Motivate the patient to set up an appointment as quickly as possible.
  • Never, never, never do insurance pre-authorizations.  Fact:  70% of patients who do not schedule and you send out a prauthorization will never come back.  Insurance companies count on the fact that the reason patients accept your recommendations is an emotional decision, and if you preauthorize the claim, 70% will not follow thru.  That is how they make money.  Don’t do it.


8. Identify the Potential Treatment each day by going through the day’s charts.  Pull from his source if you are behind goal and when cancellations occur.

  • It is necessary to have a comprehensive Treatment Plan in each patient’s chart with signed financial arrangements.
  • Be sure to consider patients on the days schedule for hygiene recall who my need other work completed.  We keep an up to the minute “needs” schedule in the sterilization room so every one is working on the hygiene and doctors schedule to have a full, productive day.  Remember:  I always want an extra operatory that I don’t have scheduled in order to fit in one more procedure a day and be able to offer same day service for productive cases or simple fillings.


9. Graph your production weekly for constant awareness.  Raise your daily goal when it is easily achieved.  I prefer that weekly production numbers be kept by hand.  Every producer, both doctors and hygienist keep their individual graphs and they are posted in the break room where every one will see them.  By doing this you will create an ownership and a healthy competitive spirit.

10. Celebrate when you succeed.


Call List

No. Name Telephone # Appt. Pref. Appt Notes


Purge Sheet

Name Responsible Party Last Appt Date Recall Status Treatment Status Financial Status Phone Number Comments