Few things deflate a day faster than a hole in the schedule at 10 a.m. The hygienist is ready, the room is set, and the patient simply does not come. Or they call at 7:45 that morning with a vague reason and no plan to reschedule.

Every practice deals with this. The good news is that no-shows and last-minute cancellations are not just bad luck. They are largely a systems problem, and systems can be improved. Here is how we help offices reduce dental no-shows and protect their schedules.

Start by Measuring the Problem

Before you change anything, find out how big the problem really is. For the last three months, track:

• How many appointments were broken (no-show or same-day or next-day cancellation)
• Which providers and which days were affected most
• Which patients broke more than one appointment
• How many of those broken appointments were rescheduled

You may find that a handful of patients account for a large share of the holes. Or you may find that one day of the week is the problem. Either way, you will know where to focus.

Why Patients Do Not Show Up

Most broken appointments come down to a few root causes:

• The patient does not understand why the visit matters
• The appointment was made far in advance and life got in the way
• They are worried about cost and did not want to have that conversation
• They are anxious about the treatment itself
• The practice made it easy to cancel and hard to keep the appointment

Notice that most of these start long before the confirmation call. That is where the real fix lives.

Value Starts in the Chair

The single biggest factor is whether the patient understands why the appointment matters. "We'll see you in six months" sounds optional. "Let's get you back in six months so we can keep an eye on that area by your lower molar" sounds important.

Train your clinical team to end every visit by connecting the next appointment to something specific for that patient. When the hygienist or assistant explains why, and then walks the patient up front, the appointment carries weight.

The same goes for restorative treatment. If a patient leaves without understanding what happens if they wait, that appointment is the first thing to go when their week gets busy.

Make the Appointment Itself a Commitment

How your front desk schedules sets the tone. A few practical habits help:

1. Let the patient choose the time. People keep appointments they picked themselves.
2. Ask, "Is there anything that might get in the way of this time?" It surfaces problems now instead of the morning of.
3. Clearly explain your cancellation policy in a friendly, matter-of-fact way at the time of scheduling, not just on a form.
4. Discuss financial arrangements before the appointment day, so cost is not a hidden reason to cancel.
5. Hand the patient a card or send a confirmation right away with the date, time and reason for the visit.

Build a Confirmation System That Works

Automated text and email reminders are helpful, but they should not be the whole system. A good confirmation process usually includes:

• An automated reminder a few days ahead and again the day before
• A personal call for new patients, large treatment appointments, and anyone with a history of broken appointments
• A clear ask for a reply, rather than a reminder that only informs
• A follow-up call to anyone who has not confirmed by a set time the day before

Teach your team to confirm, not just remind. "We have you scheduled for tomorrow at 10. We are looking forward to seeing you. Can you confirm that still works?" invites a yes. A good phone script makes a big difference here, and our post on phone skills in your dental practice has more on how to sound warm and confident.

Handling the Cancellation Call

When a patient calls to cancel, the goal is to keep the appointment if you can and reschedule it immediately if you cannot. Avoid saying "no problem" as your first response. It tells the patient the appointment did not matter.

Instead, try something like: "I'm sorry to hear that. The doctor set aside that time specifically for your crown. Is there any way we can make it work?" If not, offer two specific new times before ending the call. Never let a cancellation end with "we'll call you."

Fill the Holes You Cannot Prevent

Even with great systems, some openings will happen. Be ready for them:

• Keep an active short-notice list of patients who want to come in sooner
• Flag patients with unscheduled treatment who live or work nearby
• Review openings at the morning huddle and assign someone to fill them
• Have a quick text ready to send to your short-notice list when a spot opens

Patients Who Break Appointments Repeatedly

For patients with a pattern, have a written policy so the team is not making it up on the spot. Some offices only schedule those patients for same-day or short-notice openings. Others require a confirmation call from the patient. Whatever you choose, apply it consistently and kindly. If you are considering fees or dismissing patients, check with your own advisor first so your policy is handled appropriately for your state and your contracts.

Bring It Together

Reducing no-shows is not one big fix. It is a handful of small habits done every day by the whole team. Pick two or three changes from this list, train on them this month, and track your broken appointment numbers to see what moves. If you would like help training your front office on scheduling and confirmation conversations, take a look at our phone and front office training.

Tired of watching your schedule fall apart the day before? Schedule a free Practice Growth Call with AMP, and we will help you find where your appointments are slipping and what to change first.

Most practice management software can produce dozens of reports. Most doctors look at one or two of them, usually production, and maybe only when something feels wrong.

The problem is not a lack of data. It is knowing which numbers matter and building the habit of looking at them on purpose. In this post, we will walk through seven dental practice KPIs we believe every owner should review monthly, what each one tells you, and how to turn that review into action.

Why Monthly Is the Right Rhythm

Daily numbers belong in the morning huddle. Yearly numbers belong in your planning session. Monthly is where trends show up clearly enough to act on, but early enough to fix before they become a real problem.

One month is a snapshot. Three months is a trend. Get in the habit of comparing each number to the same month last year and to your rolling three-month average, not just to last month. Seasonal swings are real in dentistry, and comparing December to November can tell you very little.

The 7 Dental Practice KPIs to Review Every Month

1. Production

Production is the value of the dentistry you completed. Look at it in total, and also broken out by provider, so you can see doctor and hygiene separately. If you can, compare scheduled production to actual production. A big gap between the two often points to cancellations, no-shows or treatment that changed chairside.

2. Collections

Production is what you earned on paper. Collections is what actually came in the door. Track your collection percentage, meaning collections divided by adjusted production. If that number is drifting down, look at insurance claims that are aging, patient balances, and whether your team is collecting estimated patient portions at the time of service. Our post on the dental patient revenue cycle goes deeper on how money flows through the office.

3. New Patients

Count new patients each month, and if you can, note where they came from. A practice can look busy while slowly shrinking if new patients are not replacing those who move away or drift off. Watch the trend, and pay attention to how many new patients actually complete their first hygiene visit and get reappointed.

4. Case Acceptance

How much of the treatment you diagnose is actually scheduled and completed? Measure it in dollars, not just cases. A practice with strong diagnosis and weak acceptance has a communication or financial-arrangement problem, not a clinical one. If you want a quick way to see what a small improvement could mean in your office, try our case acceptance calculator.

5. Hygiene Reappointment Rate

Of the patients seen in hygiene this month, how many left with their next visit already on the books? This is one of the simplest numbers to track and one of the most powerful. Patients who leave without an appointment are much easier to lose. Many practices aim for nearly every hygiene patient to be reappointed before leaving the chair. Measure where you are today, then set a goal to improve on it.

6. Unscheduled Treatment

This is the total value of treatment that has been diagnosed but not scheduled. Look at how big that number is and whether it is growing or shrinking. A growing balance usually means patients are leaving without a clear next step. It is also one of the best places to find production you have already earned the right to do.

7. Overhead

Review your major expense categories as a percentage of collections: team wages and benefits, dental supplies, lab, facility and marketing. You do not need to be an accountant to spot a category that has jumped. When something moves, ask why, and talk with your CPA about what makes sense for your specific situation.

How to Run a Monthly KPI Review

Knowing the numbers is step one. Using them is where things change. Here is a simple format that works for most offices:

1. Have your office manager pull the same reports, the same way, every month. Consistency matters more than perfection.
2. Put them on one page. A single dashboard beats a stack of printouts.
3. Meet for 30 to 45 minutes with the doctor and office manager. Look for the one or two numbers that moved the most.
4. Ask "why" before "what." Understand what caused the change before deciding on a fix.
5. Pick one or two actions for the coming month, with an owner and a deadline.
6. Share the key numbers with the team in a way they can understand, and celebrate wins.

That last step matters. When the team understands what the numbers mean and how their work affects them, they start solving problems you did not even know about.

Common Mistakes to Avoid

• Looking only at production and ignoring collections
• Changing how a report is run from month to month, so the numbers are not comparable
• Reacting to a single bad month instead of watching the trend
• Reviewing numbers without deciding on any action
• Keeping the numbers locked in the doctor's office so the team has no idea how the practice is doing

Start Simple

If you are not tracking any of these yet, do not try to build a perfect system this week. Start with production, collections and new patients. Add hygiene reappointment and unscheduled treatment next month. Within a quarter you will have a clear, honest picture of how your practice is running, and you will be making decisions based on facts instead of feelings.

Want help building a monthly dashboard your team will actually use? Schedule a free Practice Growth Call with AMP and we will walk through your numbers together and help you decide where to focus first.

Sooner or later, most practice owners hit a wall. The schedule is full but the numbers feel flat. The team is working hard but something keeps slipping. You know you need outside help, and then you start searching and find two words used almost interchangeably: consultant and coach.

They are not the same thing. Both can be valuable, but they solve different problems. Picking the wrong one can cost you time, money and a lot of team goodwill. At AMP we do both, so we get asked this question often. Here is how we explain the difference.

What a Dental Practice Consultant Does

A dental practice consultant looks at how your practice runs and tells you what to change. Think of it as a diagnosis and a treatment plan for the business side of the office.

A good consultant will usually:

• Review your numbers, such as production, collections, overhead, new patients and hygiene performance
• Observe or map your systems, from the phone call to the checkout
• Identify the bottlenecks that are holding production or profit back
• Recommend specific changes to scheduling, fees, staffing, insurance mix or workflow
• Help you prioritize, so you are not trying to fix everything at once

Consulting tends to be project-based. You bring someone in because there is a specific problem or a specific goal: a new location, a stalled practice, a transition between doctors, an overhead number that keeps creeping up. Our dental practice consulting work is built around that kind of focused, structured review.

What a Dental Coach Does

A dental coach works with you and your team over time to build the habits that make those changes stick. Where the consultant answers "what should we change," the coach helps with "how do we actually do this every day."

Coaching usually looks like:

• Regular sessions with the doctor, the office manager or the whole team
• Accountability on goals you set together
• Skill building, such as case presentation, scheduling conversations and leadership
• Working through people issues, communication breakdowns and resistance to change
• Adjusting the plan as you learn what works in your office

Coaching is a longer relationship. It is less about one big report and more about steady progress. If you have ever made a great plan at a seminar and watched it fade in three weeks, that is the gap coaching fills. You can read more about how we approach dental coaching on our coaching page.

Signs You Need a Consultant

You may need a consultant first if:

• You do not have a clear picture of your numbers, or you have reports but do not know what they mean
• Something specific is broken and you cannot pinpoint why
• You are facing a big decision, such as adding a hygienist, changing hours, dropping a plan or opening a second office
• Your overhead feels too high, but you are not sure where it is going
• You have tried fixing things internally and keep going in circles

In short, if the question is "what is wrong and what should we do about it," start with consulting.

Signs You Need a Coach

You may need a coach first if:

• You already know what needs to change, but it is not happening
• Your team agrees in meetings and then goes back to the old way
• You feel like the only person pushing the practice forward
• Your office manager is capable but has never been trained to lead
• Communication between doctor and team, or front and back, is strained

If the question is "why can't we make this stick," coaching is usually the better fit.

Do You Need Both?

Many practices do. A common pattern is a consulting phase to assess and set priorities, followed by coaching to carry out the plan. The two work best when they are connected. A beautiful recommendations binder that nobody follows does not help your patients or your bottom line, and coaching without a clear direction can turn into pleasant conversations that never move the numbers.

Ask yourself honestly: is our problem knowing what to do, or doing what we know? Your answer points you in the right direction.

Questions to Ask Before You Hire Anyone

Whether you are interviewing a consultant, a coach or a firm that offers both, these questions will tell you a lot:

1. What does your process look like in the first 30, 60 and 90 days?
2. Who will I actually be working with, and how often?
3. How do you measure progress, and what numbers will we track together?
4. How do you involve the team, not just the doctor?
5. What happens if something is not working? How do we adjust?
6. What is the commitment, and how do we end the engagement if it is not a fit?
7. What will you need from me and my team to make this successful?

Listen for specifics. A strong answer sounds like a plan. A weak answer sounds like a pitch. Be cautious with anyone who promises a particular dollar result before they have seen your numbers. Every practice is different, and nobody can honestly guarantee an outcome without understanding where you are starting from.

How to Prepare So Outside Help Actually Works

Whoever you hire, you will get more out of it if you do a little homework first:

• Pull your last 12 months of production, collections and new patient numbers
• Write down the three problems that frustrate you most right now
• Decide what success would look like a year from today
• Tell your team why you are bringing in help, before the first visit, so it does not feel like a threat
• Block real time on the calendar for the work. Help that only happens "when we have a minute" rarely happens.

The doctor's commitment sets the tone. If you treat the engagement as a priority, your team will too.

The Bottom Line

A consultant helps you see clearly and decide what to change. A coach helps you and your team change it and keep it changed. Neither one replaces your leadership, but either one can make that leadership a lot easier.

If you are not sure which you need, that is completely normal. The right first step is a conversation about where your practice is today and where you want it to go.

Not sure whether consulting, coaching or both is the right fit? Schedule a free Practice Growth Call with our team at AMP. We will talk through your goals and your biggest challenges, and help you figure out the next best step for your practice.

What is the first thing that comes to mind when you read "habitude"? Is it a habit, is it attitude or is it something else?

Habit hab·it/ˈhabət/
noun
1. a settled or regular tendency or practice, especially one that is hard to give up.

Definitions from Oxford Languages

Now, start spitting out all of your habits. Think you don't have any? How about-

• Getting up in the morning on the same side of the bed?
• Brushing your teeth the same way every day
• Putting your pants on your right leg first
• Stopping for coffee
• Getting in your car, the same way every time

Created habits are usually kept. Until someone somewhere introduces something done in a new way. Tried anew the first time seems awkward, off-kilter, and possibly uncomfortable. Some master this to success, most give up.

When was the last time you tried something new?

How long did you persevere when you did try that new thing? Did the newness feel strange?

Attitude at·ti·tude/ˈadəˌt(y)o͞od/
noun
1. a settled way of thinking or feeling about someone or something, typically one that is reflected in a person's behavior.

Definitions from Oxford Languages

What constitutes a good attitude? You know those people. They see the glass half full, offer solutions to challenges, they don't get too ruffled when things go south. They lead with empowerment. How do these folks do this? They are usually spotted in a crowd or office environment quickly. Here are some attributes of a great attitude-

• A well-rested individual
• One who is willing to try change, and maybe, persevere through it until mattered
• A self-creative
• A well-balanced performer
• Someone you want on your team!

How many employers out there wish you had employees with great attitudes, habits, and habitudes? They are out there, you just have to be willing to lead and guide them. At Accelerate My Practice, our coaches unveil many diamonds in the rough and polish up the moderate performers to great habituders. Most times, it is adding leadership and direction to one's plate.

Boundaries and accountability happen next. So often we hear doctors and business owners say they just want to "drill teeth" and not bother with all this other stuff.

Turn your team into a team full of habitude, by shining up those diamonds in the rough.

UNTIL the Dental Patient Knows How Much You Care!

Recently one of our coaches was in an office listening to the doctor present a case to a very backed-up individual. Shockingly, the patient did not accept treatment.

Here is the story.

A snowbird dental patient visiting the warm weathered community called this office for an appointment with this, “I am calling to make an appointment. My periodontist said I need three fillings.” The appointment was made. This patient entered the office disturbed, taking her sharp comments to the front desk person. This person made an immediate negative opinion and translated this to the back.

The clinical person began the radiograph process. After taking image #15, the patient said, “that was 15 x-rays, how many more are you going to take?” The dental assistant replied, just three more. Both the front office person and the dental assistant relayed a negative opinion to the doctor just before his diagnosis.

This negativism imbeds in the doctor immediately as his blood pressure raised. He proceeded to provide his diagnosis through a twenty-minute long, very dental, clinical word-driven diagnosis while the patient was cross-armed and not listening.

This diagnosis disallowed the patient’s involvement as only the doctor spoke. If you are the doctor, what are you thinking right now?

1. Maybe, I would have done the same.
2. I probably would have kicked the chair, the desk, yelled out curse words, then saw the patient?
3. I would have tabled my diagnosis, asking the dental patient directional questions.

Were you between 1 and 2? Most are. As humans, we tend to react with a READY FIRE AIM attitude. When, if we master the art and skill of understanding people, the people we treat, and the why of their behavior, we will succeed in keeping a friendly two-way didactic and productive conversation with the patient. And, we may have the ability to turn around a very unhappy patient to an accepted treatment plan.

Here is what the AMP coach provided.

1. Ask questions before any treatment discussion.
2. The more topical the question, the more topical the answer, dig.
3. Be curious. This is the easiest, yet one of the hardest skills to master.

Dentists are highly trained scientists, mostly wanting to share what they know so the patient will understand. NOT. Patients want to know first how much you care NOT how much you know. Once they have a sense of your caring attitude, doors open wide to treatment acceptance. Ask questions!

This is the first task. Use your skill to calm the patient to begin to understand. Steven Covey said it beautifully, seek first to understand, then be understood. The second task is to share this skill and technique with your team.

Need help with this? We master this teaching. Contact us!

The cold, rainy, snowy, ugly dreary dental months happen every year. The days are shorter, the nights are longer and many of us just yearn for this to reverse. We're waiting for that daylight savings day.

How many of you feel like your dental practice lives in these dreary months year-round?

Dentists are highly trained scientists, performing the standard of care of dental medicine to patients using a variety of methods allowing flexibility in the process, however, clinging tightly to a code of morals and ethics. Seems so simple to the outsider looking in, doesn't it? Is this your reality? Or are you the insider looking out? Is there chaos, do you choose tolerance over confrontation, do you long for a well-oiled dental machine in your day to do?

Believe it or not, there is an answer to the chaos. Here's how to tame the chaos;

• Admit the challenges you are unwilling to address
• Believe this can be changed
• Reach out for help
• Try something new, perhaps something you have always wanted to try but didn't know how to start.

If you find yourself to be in a cycle of; failed, try to change, change, retreat to old habits, this is normal UNTIL you hire a company that holds your hand, guides you as an owner on the how-to in dealing with your team, and finishing the race (your day to day) feeling accomplished.

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Overcome the dental dreary months.

The video here is of a doctor in Spokane, WA who was visited on the fly a year after coaching with us.

How can we help you overcome the challenges and leave you like this and many more of our doctors?

These months come and go, but it is your decision on how long they last.

Reach out to us, we're here to listen, plan and overcome.

Let's talk insurance and tools to use to get past the general feeling about it. Here is an exercise that I do with dental offices all around the country. We sit in a group, and we play a word association game.  I will say a word, and then you immediately say the first word that comes to mind.  Let’s try it.

I have no idea what you said for the first few words, but I’ll bet I can predict what you said for INSURANCE. You probably said something like “sucks” or “write off” or “thieves” or another negative word.  Was I right?  If so, read on.

This is what I call the Insurance Paradox.  Many of us as dentists have decided to voluntarily join up with certain PPO insurance plans. We are aware in advance that this will involve a contract with very specific terms. Primarily, we will have to abide by a fee that is often significantly lower than our standard fee. Will have to be aware of maximums, frequencies, waiting periods, and many other contractual obligations.   We enter these contracts with our eyes open, knowing the negatives, and understanding the positives. And then we turn around and moan and groan and complain about it while voluntarily re-signing that contract every year.

My first suggestion, of course, is to grow your practice to a point where you can reduce or even eliminate your dependency on network Insurance. However, many dentists live in areas or have practices where they are simply unable to do that. In San Diego there were several huge employers, all of whom seem to carry Delta PPO.

This is where my thinking seems to diverge from many dentists. I decided long ago not to be Mister negative about insurance. Not to constantly complain about it. And certainly not to transmit to patients that insurance was bad, evil, sucks, etc. Instead, I came with a positive view of insurance. The fact that it could significantly reduce patients costs was a good thing for me because I like my patients. I was their cheerleader in this.

There is a video in our library where we talk all about how to see and portray Insurance in a positive light. You will be shocked how this simple mindset change can increase your production.

If you find that being an in-network provider for dental insurance is increasing your blood pressure and decreasing your bottom line, I'd love to chat with you.  Let’s fix it!

At AMP, one of our primary roles is to identify areas of opportunity at dental practices. It's no secret that in most practices there is a lot of treatment that is recommended but goes undone. Sometimes, the amount of this is shocking. I have seen practices with literally millions of dollars of treatment that was recommended and never done.  

But the word “treatment” can encompass many things. It could be an x-ray, a cleaning, or a crown. Or something bigger. I'll bet that your case acceptance rate on cleanings is pretty high.  It's those bigger treatment plans that most often go undone.   A dental implant is a good example of this.  When a patient has a missing tooth and is asymptomatic, an implant just doesn't seem to be that important.   Until the patient realizes the importance of replacing that missing tooth or teeth, he or she will be very price sensitive. And it's not comparing your fees to other dentists’… It's comparing your fee to items they want more, like that new flat-screen TV or iPhone.

One of my primary functions as a coach is to help doctors and their staff explain things better to help build value to the patient. We never recommend aggressive treatment plans or over-treating. We help you to better address those items that you normally would treatment plan. And we don't recommend a hard sell or special techniques and tricks to bully the patients.   Instead, we work on honest narratives that the doctor can have with the patient to gain understanding, build value, and therefore increase case acceptance.

When a treatment plan consists of, for example, three fillings and a dental implant, it is common to hear the patient say “I'll do the three fillings, but I need to think about the implant.”  Do you hear this a lot? To do more of the implants you recommend, we have to figure out how to get past this barrier.

If you need help with your narratives, please let me know. You might find that some simple changes can do two great things: help your patients return their mouths to a state of dental health, and help your business grow. Isn't it wonderful when you can do both at the same time?  That is a true win-win situation.

AMP is often in offices coaching team members that are consistently ‘too busy.’ These folks are usually too busy to get ordering done properly. Too busy to get things done on time, to do their clinical notes while the patient is still seated in the chair, to call unscheduled treatments. They are just too busy!

How busy are you?

Do you leave your day ‘undone?’ Does your ‘busy’ never go away? Perhaps a call to us. We can help you un-busy yourself and your team and return to a fulfilled day!

Someone said to me once, if you tell me you are too busy, you just took the time telling me you are too busy and could have taken that time to get the task done! Think about that. How many times in an office is a question asked only by the last word of the sentence did the asker answer their own inquiry? Talk about wasted time. Or, how about the confirmed crown delivery patient that must be cancelled because ‘we didn’t have time to order the proper cement.’

Here are some things to try to undo some of that busyness!

• Make reminder calls to your patients at least TWO days out. This minimizes stress, giving the caller 24+ hours to fill the schedule.
• Ask the patient to call back to confirm the time they blocked for their appointment. If they don’t, fill the spot with someone else!
• Enter all clinical notes while ‘the butt is still in the chair.’ When the patient leaves, you are done! The patient does not mind sitting there while you do this.
• Ask for all patient portions before the treatment is done. This eliminates chasing the patient for payment, and one more thing to eliminate in your day to day.

These are just a few things we do onsite while coaching a dental team. One of our biggest goals is to create team empowerment by ‘un-busying’ the day to day. It works! Give us a shout! Be glad to get you and your team from too busy to fulfillment!