Dental Practice Heroes
Where dentists learn how to cut clinical days while increasing profits - without sacrificing patient care, cutting corners, or cranking volume. We teach you how to grow a scalable practice through communication, leadership, and effective management.
Hosted by Dr. Paul Etchison, author of two books on dental practice management, dental coach, and owner of a $6M collections group practice in the south suburbs of Chicago, we provide actionable advice for practice owners who want to intentionally create more time to enjoy their families, wealth, and deep personal fulfillment.
If you want to build a scalable practice framework that no longer stresses, drains, or relies on you for every little thing, we will teach you how and share stories of other dentists who have done it!
Dental Practice Heroes
Full Schedule, Empty Wallet: The Hidden Cost of Busyness
A crowded calendar can look like success, but what if it’s hiding slow service, low-yield work, and profit slipping through the cracks? We pull back the curtain on the “packed restaurant” illusion and share a clearer measure of health: dollar-per-hour production. By focusing on adjusted production per hour, you can design days that hit your goals on purpose, not by accident, and reclaim time without sacrificing revenue.
We get specific about how to shift from busy to profitable. You’ll hear the simple math that compares an eight-hour day of fillings to a four-hour block of crowns—and why the latter can be four times more profitable in half the time. We dive into DPH block scheduling, setting minimum dollar values for key slots, and limiting low-dollar procedures so your schedule tells the truth. We also tackle the hidden cost of cancellations: the empty operatory that quietly halves profitability. From pre-collecting and firm policies to waitlists and same-day rescue protocols, we show how to protect high-value time and stabilize your week.
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Take Control of Your Practice and Your Life
We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.
Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.
Now, I want to paint a hypothetical picture in your mind right now. Let's picture a restaurant. Okay. It looks great. It's a beautiful place. You step inside there and it is packed. There is so many people waiting to eat there. There's so many people already in there. And you're just like, oh my gosh, why is this place so popular? Oh my God, I have to eat here. So you get on the waiting list. They tell you it's going to be four hours. You're like, oh my God, what is this? It must be worth it. So you wait four hours and then you finally sit down on your table. And after you have your meal, you realize that it actually takes about three hours to get your food. It takes 40 minutes to even get a drink at this place. The service is incredibly slow. And the reason that they're so backed up is because instead of a normal dinner taking maybe an hour for people, people have to stay for four hours just to even get their food. Now, you might have looked at that restaurant before and you said, man, this place is popping. But now you look at it and you say, This place is horribly inefficient. I want you to think about does your practice ever give you that impression? Are you one of those docs that's like, I'm booked out for three weeks? I must be doing really well. Is your schedule maybe lying to you? Because we can have a full schedule in our dental practice. But I assure you, that is not the barometer that's going to show us how efficient we are and how well we're doing. The great equalizer, I'm going to tell you what it is today, and I'm going to give you some ideas of how to make it better so that you can make more money in less time. Now, you are listening to the Dental Practice Heroes podcast. I am your host, Dr. Paul Etchison. I'm an author of two books on dental practice management, a dental coach, and the owner of a large five-dock practice in the south suburbs of Chicago. I want to teach you how to run your practice in a way that gives you mega profits, mega time off, that gives you so much peace of mind that every day when that head hits the pillow, you feel accomplished and you're looking forward to the next day. So if you want to create a highly efficient practice that runs without you and allows you to take a ton of time off, you are in the right place. All right, let's talk about this full restaurant analogy. Now, like I said before, full, it doesn't mean profitable. A lot of owners, we equate having a packed schedule with success. But if it's packed with low yield procedures or we have a lot of cancellations, it can be a totally false signal. I remember I had this one client who I started working with. She started talking about her numbers, and her numbers weren't very good at all. And I was actually really surprised because then she followed up and told me that she was booked out like over a month. And I'm thinking, with these numbers, how could you possibly be booked out over a month? So we started looking deeper into it and we realized that the dollar per hour production isn't there. The scheduling methods, horribly inefficient. The delivery of care, horribly inefficient. And then along with that, there was a mega cancellation rate. So even when we looked at the schedule the night before and we said, this looks great, by the end of the next day, it looked like Swiss cheese. So full does not mean profitable. This is why the great equalizer, it's dollar per hour production. You take what your production is, adjust it production after the write-offs and all that stuff, and then you divide it by the amount of hours that it took you to produce that. That is the great equalizer. Now there is, I'm gonna give you some numbers that I think you should follow. All of my associates in my practice are able to do greater than $650 per hour production, adjusted. That is not a stellar number. I don't think that's what you should strive for as a dental owner. I think we can do much better, but I'm telling you, that is the bare minimum for my associates. And I've never had an associate not hit it. So people say, How do you get your associates to produce? It's within the block system, it's within the way that we set up our practice. This is what we teach you to do in our coaching. Now, what do I think you should be hitting as a dental owner? I think you should be hitting about $1,000 an hour. I know people doing $2,400 an hour. And I can tell you in my heyday, in my prime, when I was just grinding like hell, I was doing about $1,200 an hour. This is almost 10 years ago. And that's back like mess, probably six years ago now. So it's I don't even know what that's worth now, but that's what I used to consistently do. Now, could I have done more? Possibly, but that was the number I felt comfortable with. And it wasn't too much, it wasn't too little, it was really efficient. So I want to give you an example of two different schedules. Okay. These are gonna be very simplified. Let's say you have a schedule in which it's an eight-hour schedule and you do eight fillings. I know you're saying, I don't need eight hours to do eight fillings. I know you probably don't. If you do, call me. We got to figure this out. But that's $250 each for each filling. So that's gonna be a $2,000 schedule in eight hours. Okay. That's a $250 an hour. Now let's take this other schedule. This is gonna be three crowns, and we're gonna do it in half the time in four hours. We're gonna say each crown is $1,500. So as opposed to that $2,000 eight-hour day, now we have a $4,500 four-hour day, and we're producing at a level of $1,125 per hour. Day, the second example is literally four times more profitable in half of the time. So, what I want to show you is that a full day of low dollar work can make such a big difference in the profitability of your schedule. So, this is why. Why don't we control that? How do we control that? Through DPH block scheduling. We're holding time for big dollar procedures, we're limiting the amount of low dollar procedures that we will do in a single day. I remember there was one day, man, dude, I did like 30 fillings in one day. And as you can imagine, you look at your numbers at the end of that day, and it does not feel like it represents how hard you worked. It will not, you're like, holy cow, like that was the worst day ever. I can't believe we got through it, what I get paid. And then you want to barf because you're like, wow, that is a full day of low profit procedures. Stay away from that. All right, for this next point, I want to ask you a question. What is the most expensive room at a hotel? Now, I've asked this before when I've been speaking. People raise their hand, they say, uh, it's like that penthouse suite. It's the the king's suite, the executive suite, this and that. No, the most expensive room in the hotel is the empty one. And it's just like that in our dental practices. We need to understand the hidden loss that comes from cancellations and gaps in our schedule. These holes, they matter. All right, let's talk about a hygienist that's doing about $150 an hour. Now, when somebody cancels on them and they have an opening, what happens there? Well, that appointment now required twice as much time. So it becomes half as profitable. So maybe that Profi and the exam and everything was gonna be $150, but now they had to secure another time to do it. So now it took you two hours to make $150. We see this so often in practices with big procedures. They're not pre-collecting the schedule. So they might take like a $2,000 procedure and somebody cancels it. Now that $2,000 was be really profitable for that day. But when they cancel an hour before their appointment or they don't show up because they don't have the money and they call back to do it again, now you just book twice as much time. So now it's like it's half as profitable. So we need to preserve our schedule and do everything we can to make sure that patients are showing up. You need to have a cancellation policy that is buttoned up and that your team can enforce. So it's not always about how fast you or efficient you can move through the procedures, but how consistently can you keep them on the schedule so that we don't lose time to the empty hotel room, to the empty chair. So we talked about how a full schedule doesn't always mean we're profitable and how dollar per hour is the great equalizer. How do we make the schedule tell the truth? Well, we set up a block schedule. We protect the high value production, we make sure that we have blocks with dollar values in it. We make sure that if you're gonna put an appointment here, it is of a certain dollar value. So nothing lower than a dollar value can go there. And that's how we assure at the end of the day, if we fill all of our blocks, it will always hit our production goal because we designed the schedule to hit that production goal. Now, I want to give you another example of dollar per hour. So we're gonna take the average dental office in the United States. And I don't remember where the stat was. Don't quote me on the study. It was around $700,000. That was the average production and collections in a dental office. Now, let's say this is 48 weeks a year. So you're this doctor in the office is gonna take off four weeks each year. So what does this mean? If we're doing eight-hour days, that means that this office, the doctor and the two hygienists are producing at a total of $455 per hour. I mean, that might be each hygienist doing $75 an hour and the doctor is maybe doing $300 per hour. So at the end of 48 weeks, four days a week, they're gonna be at $700,000 a year. Okay. So that was 32 hours a week. Now let's go back to what me and my hygienist, and I don't, this is not a flex. I just want to show you something, is that I was producing at a level of $1,200 per hour. All of my hygienists produce at a base level of $150 per hour. So if myself at $1,200 per hour and each of my hygienists are producing at $150 per hour each, how many hours each week with a 48-week schedule in a year would we have to practice to reach that average $700,000? Okay. Me and my two hygienists and my team, we would have to show up a total of 9.7 hours each week to make $700,000. So think about that. If you can get your production up to $1,200 an hour, if you can get your hygienist to $150 per hour, you can have an average dental practice in just 9.7 hours per week. So when you're focusing on getting new patients, when you're focusing on adding just one more crown and all these things that are short-term thinking, look at what can be done if we start from the foundation and we build the systems and the efficiencies and we bake them into the office so that we can enjoy the fruits of our labor and all of our hard work. Now, I would never just show up to practice 9.7 hours a week and say we're good. I mean, that would be crazy. But the thing is, this is how you, as the owner doc, can get your production up and you can easily practice one or two days a week, have associates to do the other stuff, and you can enjoy the rest of your time off. So here are your tactical takeaways for this episode. Do the math, figure out what your dollar per hour is for your schedule. All you got to do is take your production and divide it by the hours it took to produce that. You can do this for your hygienist, you can do this for yourself, you can do it for an office. Then, number two, I want you to audit your procedure mix. Really get a feel for what kind of days. Go back and look at some high production days and then go and look at that schedule. What was on these days? What made these such high-producing days? I guarantee it, it was the procedure mix. So start figuring out a way that you can control that procedure mix so that you don't have a schedule full of those low profit procedures. Three, find out a way to ensure that you're gonna see a certain amount of high value time slots each day. I tell people when they're dipping their toes into block scheduling, all you got to do is just hold a space for two crowns a day. Here it is. Here are where the two crowns each day are gonna go. Don't book anything else there. That will give you a taste of what's possible as you get more intentional with your schedule. Number four, track your cancellations and do everything possible to reduce those. Realize how costly they are for your practice and the kind of ROI you would get from setting up a cancellation system and setting up protocols and enforcing them with your team and holding them accountable to hold your patients accountable. It's not only about holding your patients accountable, it's also about doing the things that make them show up too. So it's a little bit more complicated than just make your patients show up. But nonetheless, it's something you can do. And number five, shift your focus. Stop celebrating how far you're booked out, stop celebrating the full days, celebrate profitable days, celebrate the days in which you hit your production goal. And this is what I love about block scheduling is if you can figure out what your dollar per hour goal is, you can then reverse engineer how many weeks you can take off each year. Say, you know what? I want to produce $1.5 million. Cool. What's it gonna take if you do it $1,200 an hour production? How many weeks off could you take? And then just be happy with it. We hit 1.5. I took off all out of time. It was great. That's the whole idea behind the lifestyle practice. Now, I love the lifestyle practice. I love Justin Short, I love Derek. I mean, they're great dudes. But the thing is, I like the DPH practice, which is a lot like a lifestyle practice for the owner, but the owner gets to take more time off and let the team run the practice. You can have the lifestyle, but you set up the systems to make them way more profitable than a lifestyle practice. So, in closing, a full schedule has the ability to lie to you. The truth is in dollar per hour, not on how busy the schedule looks. So I want you to ask yourself if you looked at last week's schedule, do you see true profitability and true efficiency, or do you just see busyness? And if you want someone to help you and plan with you and guide you through it, reach out to us at dentalpracticeheroes.com and set up a free strategy call with me. I would love to give you some ideas and talk to you about what's possible. Thank you so much for taking time out of your day to spend it with me. I really appreciate it. And we will talk to you next time.
