Massively increase efficiency

Efficiency in dentistry isn’t about moving faster. If that is your focus then it is a pretty certain road to burnout. Efficiency is about achieving your the work that needs to be done in minimum time with the least possible stress and effort. Truly efficient dentists don’t work hard at all yet complete prodigious amounts of dentistry.

Effortless efficiency comes down to four things working together: materials and equipment, team, the dentist, and systems. Get those four right and your productivity takes off.

The productivity paradox

Here’s a fact I still find strange: producing $8,000 in a day is less tiring than producing $1,500. Not the same. Less. The dentist grinding through a full book of fillings and adjustments at low fees goes home more exhausted than the one who did three crowns, a bridge and an implant placement. Effort and output aren’t related the way most dentists assume.

In an $8,000 a day practice everything is streamlined. In a $1,500 a day practice it is like trying to run through quicksand. I go deeper on that in this article.

A useful starting point to become more efficient is an honest self-assessment.

• Do you leave the practice every day feeling wrung out, even on days the appointment book wasn't that full?

• Do you eat lunch at your desk, or not at all?

• Is your production stuck at the same number it’s been for years, no matter how hard you push?

• Do you find yourself regularly apologising to patients for running late?

If any of that sounds familiar, the problem almost certainly isn’t your work ethic. It’s how your practice is organised.

I ran two very different practices across my career. One was a high-volume family clinic in Endeavour Hills, the other a state-of-the-art adult restorative practice in Canterbury. Both were highly productive and even though the business model for each was different, there were common factors about the operational methods.

The productivity method I utilised has four factors: Materials and equipment, Team, Dentist, and Systems. Every efficient day, and every exhausting one, can be traced back to how well those four are lined up.

Materials and equipment

Most inefficiency in a surgery starts with materials and equipment, long before the bur touches a tooth. Slow set up times are a killer. Having too many instruments is very common and creates clutter and confusion.

The same logic applies to burs. Dentists tend to accumulate them the way some people accumulate spanners in a shed, one for every situation that might arise. In practice, having too many burs slows you down because every extra option is a decision your hands have to make mid-procedure. Fewer choices, made in advance, beat more choices made on the fly.

So many dentists own a beautiful, expensive car yet old, worn-out equipment. They trade their time and clinical efficiency for a few dollars saved on their material bill.

Team

Nine out of ten practices I’ve visited were understaffed, and I think that’s a conservative estimate. Dentists convince themselves that adding a second nurse is an indulgence, another salary for not much return. I dismissed it myself once. I was wrong.

A dentist working with one under-trained or overstretched nurse ends up doing the nurse’s thinking as well as their own: fetching things, repeating instructions, carrying the cognitive load for two people while trying to concentrate on a margin.

Two nurses who are properly trained and know the sequence without being told change the entire rhythm of a day. The handpiece runs continuously instead of starting and stopping while someone finds the right instrument. You can hear efficiency in a surgery before you can see it. It sounds like a steady drone, not a stop-start hum.

Dentist

The fourth factor is the one dentists like least to hear about, because it’s them.

How you move around the surgery, how you sequence a procedure, how many small decisions you make per hour, all of it either adds friction or removes it. I can often tell how efficient a dentist is just from the sound of their handpiece: continuous means they know exactly what’s coming next, stop-start means they’re deciding as they go.

The best crown preparation I ever did took fourteen minutes, from when the patient sat down to when the patient sat up, and it wasn’t because I rushed. It was because there was nothing left in that sequence I hadn’t already thought through. Efficient dentists aren’t the ones who work fastest. They’re the ones who’ve pre-decided the most, so there’s nothing left to decide at the chair and they can move from one step to the next seamlessly.

Systems

Materials, team and dentist all rely on the fourth factor to hold them together: systems.

A practice manual that new staff can actually follow. A staff meeting structure that solves problems instead of just reporting them. A clear answer, written down somewhere, to what gets delegated and what doesn’t. Without systems, every one of the other three factors has to be rebuilt from scratch every time someone’s sick, someone’s new, or the day goes sideways.

I’ve watched dentists lose two hours a day to what I call time sucks: small, avoidable friction points that individually feel trivial and collectively wreck a schedule. None of them get fixed by trying harder in the moment. They get fixed once, in a system, and then they stay fixed.

Years ago I worked 5½ days a week. Pretty exhausting. To take the pressure off I cut 1½ days out of my schedule and rethought all my clinical systems around efficiency. My gross and net both increased even with the 12 hours less per working week.

Conclusion

Get materials, team, dentist and systems working together and something extraordinary happens. Your days get easier. Your stress level decreases. You earn more. I have an online course and also do in-office seminars.

The return is significant, not just financially, but in the quality of life you get to enjoy.

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