When evaluating our practices, it’s easy to get lost in the small details and overlook the broader picture. Taking time to assess the Five Pillars of your Practice Foundation: Production, Cash Flow Metrics, Schedule Success, Patient Retention, and Growth & Treatment Planning, can shift your perspective and help clarify your next steps.
Production is often the first metric we focus on. Compare your historical production with your current levels to determine where you need to go next. If your production has remained unchanged for more than two years, your practice is likely stagnating and losing ground financially, as expenses such as wages, supplies, and rent have probably increased. Relying solely on annual fee guide increases isn’t enough to offset these rising costs. It’s essential to make strategic decisions that position your practice to meet the production goals required to keep it healthy.
A strong Cash Flow pillar is equally essential; without it, stress inevitably spills into every part of your life. Know the monthly production required to cover all expenses, including your personal draw and any lease payments, your accountant can calculate this annually. Aim for accounts receivable to sit at least at 98% of monthly production, with no more than 15% of outstanding accounts past 90 days. Keep flexible expenses aligned with industry benchmarks: sundries at approximately 6.5% and wages between 25% and 28% of production. At the same time, remember that insufficient staffing can limit your ability to increase production.
Schedule Success is vital for all practices. Ideally, dentists should have no more than 5% open time and hygienists no more than 10%. Achieving these targets requires the right balance of hygiene hours based on your patients’ perio interval needs. Offering too many hygiene hours can create scattered openings that disrupt both patient flow and team efficiency, while offering too few can delay patient care and negatively affect long-term perio health. For the dentist’s schedule, full hygiene chairs are essential for generating diagnostic opportunities and supporting treatment acceptance. If basic treatment acceptance falls below 90%, or major restorative acceptance below 80%, openings will inevitably appear in the dentist’s schedule.
For Patient Retention, the benchmark is 80% participation in your hygiene program. It’s important to track patients who leave the practice and why. Keeping inactive patients on your lists for years inflates your numbers and creates a false sense of practice size. New patient growth should outpace patient loss, but attracting new patients only matters if you can retain them. Internal referrals and a strong social media presence are effective sources of growth, track them and use the data to guide your strategy.
Although some assume Treatment Planning falls under production, it deserves its own pillar. Every team member should be equipped with strong patient education skills, enabling them to clearly explain the benefits and consequences of recommended treatment. Dentists may vary in their planning philosophies, from addressing immediate needs to creating comprehensive long-term plans, but regardless of approach, all diagnosed treatment must be accurately entered into reliable software so nothing slips through the cracks.
This is a high-level overview of the Five Pillars of a Dental Practice, but monitoring each one consistently helps prevent cracks in your foundation. Even if you don’t feel them right away, those cracks can hinder your growth over time. With solid systems supporting each pillar, you can move forward confidently, knowing your practice is structured for continuous success.
