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
Why Your Office Manager Isn’t Growing Your Practice (And How to Change That Fast)
Most dental offices don’t have an office manager problem—they have a role definition problem. We promoted the best front desk performer, gave them a title, and then left them buried in tasks with no roadmap for leadership. In this conversation, I share the exact KPI-based bonus system that transforms a “super admin” into a true leader who aligns team behavior with the practice’s goals and delivers measurable growth.
Ready to align behavior with results and build a practice that runs without you? Subscribe, share this episode with a fellow practice owner, and leave a review to tell us which KPI you’re prioritizing next.
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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.
There's a huge difference between a regular employee and a manager. And in dentistry, most office managers are not managing the practice. They're just really good at front desk and admin work. They're basically the senior receptionist at your practice. And they become that person, like the go-to person, the person that everybody goes to because they always have those answers. And they're valuable to your team in that regard, but not because they're creating systems and not because they're creating an environment at your practice where other people can thrive. They're often the person that a well-intentioned practice owner gave a promotion and a title to, but never really expressed what they wanted the office manager to truly do. And here's the tragedy these so-called office managers, they are working hard. They are hardworking employees, but they're not doing anything to move the practice forward. Now, I work with so many offices where I hear the owner say, Yeah, my office manager, they're busy as hell, but they don't really manage. They just do front desk work all day. And the reason is simple is that your office manager, they can be busy all day and they can stay busy without even touching anything that grows the practice, without ever managing, without ever leading, without ever creating anything, any systems, anything like that. And just like you, as the practice owner, they get sucked into doing the business of dentistry instead of working on the business. They do the tasks, they do everything that needs to get done, but they don't ever make any investment in the future of the practice or scaling. And often this can be due to a number of factors, one of which being that there's not a method or system for onboarding and training. So your quote, office manager is the only one who knows how to do everything. But that is a dangerous and vulnerable place to be in as a practice owner. Because if you lose that person, you're gonna be in big trouble. So today, I'm gonna show you how to transform your office manager from a task doer into a real leader by using a simple KPI-based bonus system that aligns their daily behaviors with the big picture of the practice. Now you are listening to the Dental Practice Heroes podcast. I am your host, Dr. Paul Etchison. I'm the author of two books on dental practice management, a dental coach, and the owner of a large five-doctor practice in the south suburbs of Chicago. If you want a practice and a life that allows you to make more profit while taking an insane amount of time off with your family, you've come to the right place. All right, let's dive in. So today we're talking about why so many offices have an office manager that is not truly an office manager. We typically call them the glorified front desk employee. They're the super admin. So why don't these office managers actually manage, even if they want to? Well, the fact of the matter is they are amazing at tasks. They know every insurance rule. They are the go-to problem solver on the team. They run around, they put out fires, they deal with upset patients, and they feel valuable personally as a team member when they're busy. But the thing is, is they will never rise to the level of leadership because when we look at it, they were promoted because they were like maybe the longest tenured front desk employee, or they were the only front desk employee that knew how to do everything. But the fact of the matter is, is they're drowning in tasks and they're reactive, they're not being proactive, and most of the time they don't even know what leading even looks like. These office managers, they want to lead, but they've never been given the roadmap. So if your office manager's value is based on the number of tasks that they can do, they will spend their whole career buried in the tasks and they will think that they're doing a great job and that they're so valuable to the team. And I'm not saying that they're not, they are, but that's not what you want out of your office manager. So let's talk about creating a bonus system that is not only something where it's win-win for the owner and it's win-win for the office manager, but it's also a leadership tool. Okay, it's not a money tool. It's not about making more money, it's about giving them a way to lead the team. You see, most doctors they think that bonuses are the motivation. No, that's wrong. The bonuses, they need to be about alignment. They need to teach your office manager what to focus on, and they set the boundaries of what things and what behaviors at the practice really move the needle. And then they also give the office manager a tangible and real metrics that they can evaluate their performance on. So let's talk about what is a great office manager bonus. What does it look like? All right, the first thing, it has to be based on KPIs, key performance indicators. It has to be based on KPIs that they can influence. If they can't affect it, if they have no control over that KPI, it doesn't work. You have to explain and teach them how they can influence every KPI that you're tracking, and you let them know directly that you want them to come up with and implement systems and new protocols that's going to help affect these KPIs positively. And number two, the bonus needs to be simple enough to track monthly. Complication kills consistency. It needs to be simple, it needs to be something that you can pull up, like your divergent dental, your practice by numbers, or just run your reports in your practice management system and you can see what is the performance. And the third thing is that the bonus needs a reward behavior that both grows the practice and is beneficial for patients and how they experience the practice. So it's not, it's not just revenue, it's not just like busy work, it's not just being helpful. They've got to be those things that reflect the health of the practice and further down the line affects the revenue and the profitability. So, what are the KPIs that we're gonna track for this bonus that we want the office manager to focus on? Now remember, what's our goal? We want to turn our office manager into a leader at the practice. So we've got to design this bonus system carefully. All right, I'm gonna give you a list of different KPIs. I will tell you what I do in my practice, but this is something that's fluid. You can come back to it, you can change what the KPIs are depending on what you're working on at the practice, but you want to make sure that these are things that reflect the health of the practice. So, KPI number one that I really like is collections. I mean, we all know that we need to collect the dollars that we produce on, right? So we've got to collect no less than 98% of what our adjusted production is. So, why is this good as a KPI for an office manager? Well, it forces leadership. And this is what I really want you to see with all these KPIs is that there's a lot of elements that go into affecting them. So let's talk about collections. It requires training at the front desk, it requires enforcing same-day payment so that we collect on the patient portion. It requires better financial conversations, it requires accurate insurance breakdowns and verifications so that we don't mess up the breakdown and mess up the estimate, and then the patient's all pissed off that they have to pay us or that you know, now we have to send a bill because we misestimated. So this requires training for the front desk. It requires enforcement of the protocols. And by making this one of the KPIs that your office manager is going to track, it kind of keeps all those things in check. Now, this is collections. We're talking about a monthly bonus, but you can't look at collections on a monthly time interval. You've got to go a little bit larger. You got to go like three to six months, like a trailing three or a trailing six months. Because you know, you'll have a big production month and your collections are never going to be 100% then. Because you know, even when you're growing and your practice is doing more revenue than it's used to doing, it takes a few months for that collections to catch up because we're waiting for insurance payments and such. So I recommend you do this on a trailing three to six months. So you're always looking back three to six months. What is the collection percentage? And you want it to be greater than 98%. All right, KPI number two. I love this one. The accounts receivable over 60 days. You want this to be less than 12%. So we're talking about balances that are over 60 days. This KPI, this is gonna force the office manager to hold the team accountable and follow up frequently on what is the status of the AR. This is gonna make them focus and build systems that prevent aging, not just cleaning up old balances, not just collecting up front. We want to do everything we can to prevent aging balances. So it's encouraging them to follow up on the balances, to check on the AR, to follow up on insurance claims that maybe got denied or they asked for more information, things like that. It gives the office manager opportunities to train the team on how to better collect money, how to better discuss and have conversations around money. And this is something that is showing, it's like a barometer that's showing what is the health of the collection systems at the practice. So ultimately, with this one, we're talking about consistency. The first one is saying, what is our collections? Are we collecting our adjusted production? But this one's showing, you know, how consistent are our systems here in the collections department. This ties into collections as a whole. It makes sure that we're not allowing balances to go unpaid. It makes sure those insurance claims are getting followed up on, and it also ensures that we're collecting when we're supposed to, when we decided as a team, this is when we collect. These are our policies. All right, KPI number three, provider and hygiene utilization. So I'm gonna give you some targets for this. What this means is we're looking at a schedule and we're seeing how much of that schedule as a percentage had appointments booked on it. So we're making sure that we're efficient and that we don't have a lot of openings and gaps. Now, for doctor schedule, I want this greater than 90%. Okay. For hygiene schedule, I want this greater than 85%. So when we're looking at this, this KPI allows your office manager to lead in this way. It holds them accountable for the cancellations at the office. It holds them accountable for pre-collecting balances if that's your policy on the doctor side. Because if you pre-collect to schedule the appointment on the doctor side, you're not gonna get cancellations and you're not gonna get holes in your schedule. It requires team communication. It requires case acceptance training, it requires daily huddle discipline, meaning that we've we're gonna look at the day at the beginning of the day. We're gonna be strategic about where the opportunities are, and we're gonna make sure that we capitalize on those opportunities. It requires that we're managing our confirmation policies, that we're confirming patients. And if they're not confirmed, we're following up and either trying to get them to let us know if they're coming or not, or we're getting them off the schedule and we're filling it with something else. It requires managing the short notice list, our ASAP list. It manages our recare, getting people in that are overdue, all our reactivation programs, calling the people that have been in our office for years and trying to get them back into our hygiene program. And it's also a reflection of what is the efficiency in our scheduling. Are we scheduling in a manner that we're staying busy all day and we're minimizing the lost time? Now, another version of this KPI is to track monthly visits. Essentially, it's doing the same thing. We're making sure that we're seeing enough visits, just like we're making sure our schedule is full, but the tracking visits is a little bit less focused on the schedule being full. It's more about what is the amount of visits. So the KPI of schedule utilization is really about the health of the schedule. Think how much more efficiency we could have if we never ever had an opening in our schedule. I mean, this is a huge number. I have seen offices that I work with gain 20 to 30% in revenue just by focusing on schedule utilization. Because think about it. If you can keep that hygiene schedule full, the doctor's schedule tends to stay full too because they're seeing more patients, they're diagnosing more. It just helps keep the doctor's schedule full as well. So there are a lot of trickle-down things that happen from making sure our schedules stay full. All right, KPI number four, Google reviews. I love tracking Google reviews because this is something showing what is the patient experience. And it's also doing something else. It's making sure that we handle upset patients. So I like to say 15 five-star reviews per month, and no more than a single bad review. And for me, a bad review is three stars or less. Now, you may decide to do this bonus in your office with just saying, you know what, no bad reviews. But with the amount of volume that comes through my office, I don't expect to get a bad review every month. But sometimes there's nothing you can do and it's out of our control. So I would really hate to crush the office manager bonus if they're doing everything right just because we get one silly patient that gets upset about something. But this does force leadership in training the front desk on how to handle and deal with upset patients. This is probably one of my most favorite masterclasses that I've created that we provide for all of our DPH clients. Nothing makes upset patients easier to deal with and less stressful than having a system for easily diffusing the emotional component of the upset patient and really helping them feel that we're on their side. We're searching for a solution with them. We're not here to get defensive and tell them that they're wrong, but we're trying to find a solution that everybody's happy with so that nobody is upset anymore. So it's one of those things that you can train your front desk on, or if you're a DPH client, you get that training included. Now we're also training the front desk on how to more accurately present finances and do more accurate insurance estimates. Because if we're trying to have less upset patients, less one-star reviews, these are typically financial conversations. They're financial issues that we run into. And where do we piss patients off financially? Well, when we tell them they're going to pay us one thing, and then after the claim close, we say, oh, sorry, we made a mistake. You actually owe us this. We missed this clause in your insurance. We didn't realize that you were out of benefits, things like that. So by tracking this, you're also making sure that that's under control. Now we're talking more about how to prevent negative reviews, but what about the 15 positive reviews? This is that making sure that our team is asking for these reviews, but we're also setting a standard for patient experience, staying on time, being attentive to the patient needs. We're responding to patient inquiries, the emails, the texts. We're making sure that we're responding to people and getting back to people if we tell them that we're going to get back to them. We're making sure that we have good patient flow, that we're staying on schedule, and that our scheduling systems are getting tweaked and adjusted so that if they need some adjustments, maybe we're running behind a lot. So it doesn't just happen every day. We're changing things and making these adjustments so that we can remain an on-time practice for our patients. So by looking at how many reviews we're getting, we're making sure our online reputation is improving and we're making sure we're taking good care of our patients. All right, KPI number five. This is one that I do with my office manager bonus. New patients per doctor. I have a target of 35 plus new patients per doctor. Now, if you are a well-trained doctor who has taken a lot of CE, you can typically get away with less. But what I find, I've had lots of associates over the past 13 years, is that my associates need typically 35 plus new patients every single month. So I want to make sure that not one associate's getting all the new patients and the other ones are getting kind of shafted. I want to make sure that each of them see at least 35 new patients per month. So, what does this do for the office manager? Now they're this is forcing them to lead the team in lead conversion, new patient conversion. How do we do that? Make sure we're answering the phone, make sure that we have phone skills training, that someone's following up and listening to phone calls and working with the team to give them more training so that they can convert more new patients. It's making sure that we're following all our systems for getting, generating more new patients from our existing patients. They're following up on the online booking that makes it easy for the patients. We're making sure that the new patients actually show up. So if we start seeing some new patients that schedule, but they don't show up for their appointment, I want the office manager to say, okay, what can we do to get more new patients to show up? Now in dental practice heroes training, we have our new patient booster system. And that gives our clients seven easy ways to increase new patients. And new patients are fundamental to having a profitable and growing office. I mean, let's face it, if we don't have new patients, we're dead in the water. We need to have enough new patients so that we have enough demand so that we can DPH block schedule and everything else stems off of that. Now, also in the realm of new patients, this ties into block scheduling and ensuring that we prioritize new patients over existing patients when we're talking about hygiene. Because we want to handle our capacity issues at a DPH office by expanding our hours and expanding our providers. That's what's going to ensure our practice continues to grow versus prioritizing recall patients and choking off new patient flow. Now, this happens when we don't block out for new patients. We are always booking six months ahead for our recall patients. When we get six months into the future, we realize we don't have any room for new patients. And then our doctor's production gets choked off because we're not seeing enough new patients. So if we have our office manager following this KPI, they are checking on all of those things. So I just gave you those five KPIs: collection percentage, AR over 60 days, provider and hygiene utilization, Google reviews, and new patients per doctor. And those are the five that I use at my office. Now let's talk about how we are going to utilize this in our bonus system. So every single KPI is going to have a dollar value attached to it. In my office, it's $200. Now I have a big office. You can decide what's okay for your office. There's no right, there's no wrong. But in my office, it is $200. And if my office manager hits every single KPI, they get an additional bonus. There's some dollar amount that's like a bonus on top of the bonus because they hit all the KPIs. Now, why does this work so well? Because it removes that all or nothing thing. When we have all or nothing bonuses, we don't want the office manager to look at say, okay, I'm definitely not going to hit that KPI this month. So I don't get any bonus. So I'm not going to try for any of the other KPIs. They're independent of each other. So they can still get a bonus if they hit certain KPIs, but they don't hit the other KPIs. But then also, if you think about it, we've got that additional bonus that if they hit all of them. So if they're hitting just four of them, it makes that fifth one so much more valuable because that's going to allow them to get the extra bonus. And I really love having this office manager bonus because it encourages leadership. It's not like heroics. It's not the office manager doing all these things themselves. They can't hit all these KPIs by themselves. They need to enlist the help of the team. So it encourages them to look at the team as a whole, look at providing training, look at revamping some systems. And I think it's really important for us as practice owners. We got to show that office manager how it's more important for them to focus on things that scale, such as training and leading, rather than just doing everything themselves, because that is a tendency of a lot of people in that position. So this can be the foundation of creating accountability across your entire team because the OM, the office manager now, has to start holding the team accountable. So you can see how this works into creating a practice that runs without you. So I want you to choose these KPIs. Strategically, every single KPI forces your office manager to lead a different part of the practice, not just do the tasks like most office managers are doing. But that's why it's important for us as owners. We have to make these connections for our office manager. We have to make sure that they understand what kind of things affect the KPIs. We got to show the KPIs and we got to put them on the scoreboard and explain to the office manager what kind of things they can be doing to improve those KPIs. All right, so here are your tactical takeaways from this episode. I want you to pick maybe four, maybe six KPIs that your office manager can directly influence. Don't bonus them on the things that depend on you. Bonus them on the things that depend on the team. And I want you to attach a dollar amount to every single KPI, and then you add an additional bonus should they hit all of their KPI goals. And then I want you to meet with the office manager monthly. You're gonna look at these KPIs together monthly, and you're gonna be speaking in systems with them. You're gonna say, okay, not you're not asked talking about tasks. You're not saying, hey, can you remember to do this? Did I did this? Did this get done? You're saying, what are you doing to change this? What new systems are you creating to keep this from happening or to improve in this? What kind of trainings are you doing? What solutions are you coming up with? Because ultimately we want to shift the office manager's identity. Remember, they were just a front desk employee at one time. And they probably, in a lot of offices, the office manager still is. So we want to shift that identity from someone who is a tasker that does everything to a leader that leads the team to do everything. And just like every other position in your office, when things are going well, celebrate the wins, celebrate that consistency. The great office managers, they always perform their best when they know what matters most to us as owners. So we have to vocalize that. We need to discuss that, we need to be talking about what's important. So your office manager can be the engine of the practice. But you got to remember, engines only work when they're aligned, when they're tuned up, and when they're fed the proper fuel. And that's what you need to do as the practice owner. The moment that you start to get your office manager on focusing on the right KPIs, the ones that are tied to leadership instead of task doing, everything changes. They stop being that senior receptionist and they start being the glue of the practice, the leader, the driver of growth. And your entire practice is gonna feel that difference. Everything's gonna change. So this week, pick your office manager KPIs, build the scorecard that you want to use and show your office manager exactly what success looks like. And then watch that person rise to the level that they've always been capable of. And if you want help building this bonus system or any other sort of systems in your practice, perhaps you want help training your office manager into being a real leader, please check out our coaching options. Go to dentalpracticeheroes.com/slash strategy so that you can set up a strategy call with me. I will get on the phone with you. I'll talk about your specific practice situation. I'll let you know if our coaching options can help. And at the bare minimum, you will walk away that call with a few action items so that you know what to do for your next steps to grow your practice into a practice that runs without you, that's highly profitable and brings so much peace into your life because it doesn't require you for every little thing. Trust us, we do this every day. We are true dentists, we run large teams, we know how to change your practice. Thank you so much for spending some time with me today. I really appreciate it. I want you to have an awesome day. Thank you so much for listening.
