Monitor Your Practice’s “Vital Signs” to Ensure Growth

Dr. Bobby Haney


There are many indicators you can use to evaluate the health of your practice. These signs tell you where you are strong and healthy. They also, maybe more importantly, tell you where you need to make some improvements. You don’t want to wait until it hurts.

Just like your patients need to be diagnosed to determine their needs, so your practice needs the same. Your patients expect you to recognize what is right and wrong with their health and to prescribe proper treatment to heal the problem. To do that, you have to look at and evaluate their oral cavity and any other factor that affects it.

Again, the same is true in your practice. You must look at areas that drive your business function. Then, you must evaluate those areas against a healthy model to determine where to apply healing remedies and treatment.

There are numerous vital signs that can and should be checked. But some areas are more obvious and can give you a faster diagnosis than others. So, let me give you 7 that are key vital signs.

Treatment Acceptance Rate

Are your patients accepting recommended treatment? This number should be at least 85%. In my practice, we were dissatisfied with anything below 90% and would quickly evaluate any number below that.

If your rate is too low, you need to know why patients are refusing treatment. Are you educating them thoroughly (but not exhausting them)? Are you explaining the risk of not accepting treatment? Is your treatment coordinator closing the deal?


Are you getting paid your fees? This should be at least 98% of your production. Again, we expected better numbers in my practice and typically collected 99%. In a $1 million practice, that’s $10,000 per year. I could take a nice vacation on that amount!

Do you have a clear financial policy for both your patients and your team? Are your patients asked (firmly and politely) to pay at the time of treatment? (Doctors, you need to listen to what your team is saying to your patients!) Do you offer financing?

Number of active patients

We counted patients whom we had seen in the past 18 months as active. This number varies widely, but there are many reasons for it to be as high as possible. And what happened to those patients who have become inactive? Do you need a marketing plan for attracting new patients? If you are overwhelmed with new patients, do you need to expand your capacity by adding more hygienists, an associate dentist, or more hours?


You need no more than 30 to 45 minutes of open time per day for all producers, not each producer. Keep the book full. This is a challenging issue, but it must be relentlessly addressed. It can be easily excused as “that’s just the way it is” by your team as they enjoy an extended coffee break.

Do you have an appointment coordinator or someone assigned the task of keeping the schedule full? What is your confirmation policy, and is it being enforced?

Patient retention

Like active patients, this is a variable number. Some areas of the country have a more “mobile” population due to seasonal and economic reasons. But we always wanted to know why patients left our practice. We contacted them and asked them whenever possible via an exit interview. Are your patients coming in the front door and leaving out the back? If so, why is that happening? If you can, heal the problem!


What is your net collection (after expenses)? Overhead should not exceed 55% to 60% in an established practice. If you are over that amount, you need to determine why. There are standards of percentages for several overhead categories available from the ADA. The most common area where doctors are over the standard is personnel.

Hygiene Production

Is your hygiene department profitable? Again, this is variable depending on the type of practice you have, but hygiene should not be a loss leader. Hygienists should produce 3 times their salary.

You need to be sure your hygiene department is busy (see “Schedule” above.) Do you have a comprehensive periodontal program? Are your fees high enough? I doubt it!

What’s Next?

Are you having a problem with these areas or others? Then you need to address it. Again, you don’t want to wait until it hurts.

Dr. Bobby Haney recently retired from private dental practice in Waxahachie, Tex, after 32 years. He is the founder and leader of and president of 1Twenty2 Ministries, and he hones his “others-centric” skills with his family at their home in Bristol, Tex. He can be contacted via his website, by email at, or by phone at 469-843-0119.

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