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Your diary can be fully booked and your practice can still be quietly losing ground. We recorded this live at the Business of Dentistry Conference in Birmingham with Dr. Chetan Mathias, a seven figure dentist and practice owner who has spent years helping UK dentists install simple systems that improve profitability without compromising care.
We get practical about KPIs for dental practices and why so many principals and associates avoid them: no training, fear of what you’ll find, and the worry that tracking turns patients into revenue units. Chetan flips that on its head and argues that the right numbers actually protect ethics, because they stop you making desperate choices when cash gets tight.
You’ll hear the six “vital signs” he uses to understand practice health with minimal effort: new patient numbers and where they come from, case acceptance rate, production per hour, overhead percentage, patient retention, and team engagement through employee NPS. Along the way we dig into real examples, from wasted Google ad spend that should have been redirected into referrals, to small consultation tweaks that lift conversion, to diary restructuring that restores hourly output, and overhead leaks like clinical waste costs that quietly balloon.
———————————————————————
Disclaimer: All content on this channel is for education purposes only and does not constitute an investment recommendation or individual financial advice. For that, you should speak to a regulated, independent professional. The value of investments and the income from them can go down as well as up, so you may get back less than you invest. The views expressed on this channel may no longer be current. The information provided is not a personal recommendation for any particular investment. Tax treatment depends on individual circumstances and all tax rules may change in the future. If you are unsure about the suitability of an investment, you should speak to a regulated, independent professional. Investment figures quoted refer to simulated past performance and that past performance is not a reliable indicator of future results/performance.
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Episode Transcript
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Dr James (01:15):
This episode of the Dentists Who Invest Podcast will
be a little bit differentbecause we are broadcasting live
for the first time ever one ofthe rooms that was held at the
recent Business of DentistryConference in Birmingham.
The next conference will be tobe held in the next few months.
That will be on the 7th ofNovember in London.
We are going to be focusing onentrepreneurship and dentistry
(01:36):
with a special dragon's dancesegment.
This content that we're you'reabout to hear is from none other
than Dr.
Chetan Mathias.
Dr.
Chetan Mathias is known asbeing a 7th figure dentist in
that he will grow over sevenfigures across the surgeries and
down practice.
He shares the best piece ofwisdom through this journey with
us today so that we can benefitand understand how you achieve
(01:58):
this momentous accomplishmentwhilst also being ethical and
doing a great job for itskitchen.
As ever, you can claim your CPDfor this episode within the
official Dentists Who InvestSmart Money Members Club.
Smart Money Members Club alsoincludes multiple mini courses
and webinar series on financefor dentists, including how to
become as tax fitent aspossible, as well as
understanding investing.
(02:19):
All of this content counts asverifiable CPD, and you can
download your certificates thereand then upon completion of
each lesson.
In addition to this, we alsoinclude a whopping 10% discount
on your dental indemnity and a5% discount on lab bills for
dental principals, amongst otherperks and discounts for
members.
Please use the link in thedescription to claim your
(02:39):
verifiable CPD for this episode.
Dr Chetan (02:46):
Today we're going to speak about KPIs.
Everyone here aware of KPIs?
Right?
What does KPI stand for?
Simple, right?
And working with practices,that's what I've been doing over
the last three years, workingwith different practice owners.
Implement systems in theirpractices, implement processes
(03:07):
in their practices.
Sometimes they have issues andproblems.
We're trying to find solutionsfor them in their practices.
And one thing that terrifiesmost, not all, but most practice
owners, is numbers.
The minute you say numbers,they switch off.
They're great at clinicaldentistry, but the minute you
say numbers, then they switchoff.
The practice is busy, they'refully booked most days.
(03:30):
The team's working flat out.
Right?
And this is what I get on aweekly basis, practice owners
asking me, like, what the hellis happening?
Right?
They're busy, very busy, butthey're not profitable.
Great turnovers, right?
(03:51):
You all heard that saying, soI'm not going to go through that
again.
But it's not about turnoveranymore.
It was never about turnover.
And it's it's more importantnow, right?
So this practice owner, I'mgoing to give you some examples
as we go ahead.
So this practice that I'mworking with at the moment, they
spoke to me six months back.
(04:12):
They had an 18% drop inproduction per hour.
Overheads, this is a commontrend in most practices, going
up 65%.
With this practice, it was 65to 78%.
But this is a trend across theindustry.
Case acceptance rates.
(04:32):
For treatments, over a thousandpounds dropped from 62% to 41%.
They were busier than ever.
They were working harder, butthere was just no money in the
bank.
There was just no money in theaccount.
Right.
Now, this practice owner had noidea what was going wrong.
He just kept working harder.
(04:53):
He'd been running his practicefor the last 15-20 years.
He was not a new practiceowner.
He's been running his practicefor the last 15-20 years.
Now, it might seem obvious toyou, right?
Like, okay, fine.
But the but the issue was therewas no tracking.
He just didn't track anything.
And the problem I find withmost people is this, right?
(05:15):
Wipe-based management.
That's that's the biggestissue.
You've you run your practices,most people run their practices
just because of their with thegut with their gut feeling, just
to see how they feel about thepractice.
The schedule looks full, sothings must be great.
The practice is busy, so thingsmust be great.
The team seems happy.
(05:36):
No one's complaining.
Does that actually mean theteam's happy?
Patients keep coming in throughthe door, so things must be
great.
And this is the biggest one.
They're too busy to think aboutit because they're so busy
putting out fires.
Right?
And this is very important,right?
(05:59):
So busy, your practice beingbusy does not mean it's
profitable.
Full doesn't mean efficient,and fine does not mean that your
practice is thriving.
So question.
Why do dentists avoid numbers?
And this is across the boardthat we've seen, right?
(06:23):
The first thing is we aren'ttrained for this.
Five years in dental school,how many hours on business?
Not in my school.
Right?
This is the biggest issue we'rehaving.
You have a clinical course, andthis was me as well, right?
Been doing dentistry for thelast 19 years.
This was me as well.
We run to the first clinicalcourse that's there, restorative
(06:48):
course, composite course,implant course.
But how many of us have spenttime learning on the business of
dentistry?
Right?
Numbers.
No.
So this is the problem, andthat's why we there are lots of
practices there who arestruggling.
Second, numbers feel unethical.
(07:09):
We need to stop thinking likethis.
We all run, especially practiceowners out there, we run
sizable businesses.
On an average, half a millionturnover, right?
You have a responsibility toyour team, to your staff.
It's very important that youstop thinking that numbers feel
unethical, right?
Tracking KPIs feel likereducing patients to revenue
(07:32):
units.
And this is a big one, right?
We are afraid of what we'llfind.
Right?
I know we need to track ournumbers, but we're just worried
about what we're gonna find.
I've poured my heart into thispractice, but it's actually
failing.
Nowadays you've got lots ofsoftwares that give you numbers.
But the problem is not gettingthe numbers, it's understanding
(07:56):
what you do with those numbers.
Right?
You have softwares that keepthrowing numbers at you.
Right?
You can open spreadsheets withnumbers, numbers, numbers, but
what do you do with them?
That's important.
Right?
And this, I relate to this.
Did five years of dental schoolnot to look at spreadsheets.
(08:17):
Right?
So this is what we're gonna do.
So we're gonna do this oneexercise, right?
To start off with, I want youguys to play full on on this.
You don't have to share thiswith me.
So, my team, I'm gonna sharesome sheets with you.
What I need you to do is scoreyourself, okay?
(08:38):
This is your honest self-audit.
So you've got to score betweenone to five, right?
Now, one means that's not me atall, right?
(09:00):
And five means I relate tothis, right?
So one means that's not me atall, and five means I relate to
this.
Ah, you'll need pens, right?
So share a pen if you'll haveone.
(09:24):
You'll all got a sheet?
We're gonna have a fewexercises like this, so get used
to it.
We're gonna do a few in thenext forty-five minutes.
Yep.
(09:50):
There are some pens here.
Once you finish writing, justshare that, yeah.
Did everyone get?
It's not an exam, should takeyou a couple of minutes to
finish.
I'm coming to your talk later.
(10:11):
Yeah.
Interesting.
Yeah.
Has had a chat with Barry.
That's what I told Barry we needto have a chat.
Yeah.
Good.
Some still filling.
Don't worry, you just gotta behonest with yourself when you do
(10:37):
this.
I'm not going to ask you toshare this.
This is for you to take backhome with you.
Right?
We're gonna have a few exerciseslike this.
The more you play into it, themore you get into it.
Right, all done.
Oh, thanks.
(10:59):
Is there a mic?
Yeah, that's fine.
Okay, so show of hands, howmany of you have scored between
zero to ten?
That's fine.
(11:21):
How many of you have scoredbetween eleven to fifteen?
And how many of you have scoredbetween sixteen to twenty?
Fairly equal number.
And twenty to twenty-five?
Cool.
Right.
(11:41):
So this is normal, right?
And this is exactly how thesenext twenty-five minutes are
gonna go.
What I want you to do is speakto the person next to you and
share with them that one numberwhere you scored a five on.
(12:04):
Right?
And what and what number inthere has the biggest, I mean,
the biggest problem you havewith?
Right?
So speak to the person next toyou.
So anyone brave enough to sharewhat happened?
(13:51):
Do you want to share?
Do you want to share what whatyou discussed?
Which one?
So you feel time is you feelit's too time consuming.
Sorry, what's your name?
Simon?
Simon.
You gotta practice?
You wanna practice?
Okay, fine.
Thank you, I'll catch up onthat.
(14:20):
Right.
Good, good, good, good, good,good, good, good, good, good,
good, good.
Do you want to share?
What's the biggest problem?
You have no idea.
(14:40):
Because you're not trained,right?
To the clinical dentist.
Good.
All right, should we continue?
Guys, we've got thirty minutesleft.
(15:04):
Right, should we continue?
Fab.
So anyone here wanting toshare?
No?
Should I ask?
Dev, which part do you thinkyou struggled with?
So where were you a five on?
Speaker 3 (15:26):
I was I'm not five on and I mean I wasn't trained.
This could be five.
Dr Chetan (15:31):
Yes.
But the rest, I think becominga practice owner changes you.
Which is very important.
We know each other for such along time.
And the biggest problem most ofus face is we weren't trained.
Everyone agrees with me onthat?
Yeah?
That's the biggest problem wehave, right?
And that's why I said Ireluctantly became a practice
(15:51):
owner.
I didn't know that you had tobe trained to run the business
side of things.
I knew I was good at dentistry,but it's a whole different
ballgame once you're a practiceowner.
Fab.
So let's go ahead.
Next.
So KPIs, right?
(16:13):
Now on the left we have KPIs.
So before when you go to yourdoctor, your doctor sees you,
what does the doctor do?
The doctor measures your bloodpressure, heart rate, oxygen
saturation, temperature,respiratory rate, and then he
helps you arrive at a diagnosis,right?
He checks all your vital signs,right?
(16:36):
KPIs just to make sure thateverything's fine.
If we as doctors, dentists inthe medical profession do KPIs,
uh, we have, I mean, look atpatients' vital signs to
understand exactly what'shappening, we need to look at
the vital signs of our businessas well.
(16:57):
All right, very important.
So I've kept it simple, right?
Over the years, I startedlooking at different metrics,
different numbers to see whatworks, what doesn't work.
And then I realized that withtime, we don't need to look at
40 or 50 different metrics.
Sorry, 40 or 50 differentmetrics.
(17:18):
We just need to look at five ormaybe six metrics.
That's it.
We don't have to spend hoursevery week looking at
spreadsheets and numbers, right?
Leave that to the accountantsto do, right?
But you need to know a few keynumbers, something that helps
(17:41):
you keep your pulse on thebusiness.
Right?
So, for a practice, having anidea of your new patient
numbers, case acceptance rates,production per hour, overhead
percentage, and patientretention.
Right?
(18:01):
A doctor wouldn't treat apatient without checking their
vital signs.
Yeah?
So being a practice owner, it'sso important you know your
vital signs.
And what I find that happensmost of the time is your gut
feelings.
How's your practice doing?
(18:23):
I think it's doing well.
I think it's great.
Why?
Everyone's happy, no one'scomplaining, the books are full.
I think they're cool.
There is some money left overin the account at the end once
it's all done.
Right?
So having some vital signs foryour practice is very important.
So let's look at the six mainKPIs that I think we need to
(18:47):
look at.
So let's go there.
Yeah.
So this should give you 80% ofthe insight you need in your
practice.
Not 100%, but 80% of theinsight you need in your
practice.
So the first one, new patientnumbers.
(19:08):
Not only the number of newpatients coming into your
practice, right?
Not only the number of newpatients coming in, but where
are these patients coming from?
Simple.
Right?
What's your case acceptancerate?
You're a practice owner.
What is the case acceptancerate of your associates?
What's the case acceptance ratefor general dentistry, for
(19:31):
complex and for specialist levelservices?
What's your production perhour?
If you're an associate, greatmetric to look at.
If you're not an associate,it's important, I mean, as a
practice owner, to see what yourassociates are doing.
Overhead percentage, this hasbecome more common now than it
(19:54):
used to be, just because of theincrease in costs these days.
Right?
Silent killer of mostpractices, overhead percentage,
patient retention, very easy tocalculate and very important as
well.
And finally, team management.
Now, what I'm going to do inthe next 15-20 minutes is I'm
(20:17):
going to go deep on three ofthese.
Yeah.
Now, these three are going tomake the biggest financial
impact in your practices.
I'll touch up a little bit onthe others as well, but three
that I'm going to go slightlydeeper into.
And if you implement thesethree, it'll really help your
practice.
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of this podcast.
Dr Chetan (22:27):
So let's first look at new patient numbers, right?
So it's not only important tocheck how many new patients come
to your practice, but what'smore important is to check how
many new patients came to yourpractice and where did they come
from.
So, on an average across thecountry, what I've seen is
(22:49):
anything between 30 to 50 newpatients, again, depending on
your type of practice, 30 to 50new patients per full-time
dentist.
So uh I have it's a goodexample.
I had a practice that cameacross, they spoke to me, they
said we're spending X amount onmarketing, we keep throwing
(23:12):
money on marketing month onmonth.
On month, we keep spending alot of money on marketing, but
we're not getting the resultsthat we need.
We're not getting the resultsthat we want.
So I told them one metric.
This look at this one metricthat you need to measure, right?
Look at the number of newpatients you have last month,
the month before, and for thelast few months.
(23:33):
Track and see where they camefrom.
And you know what?
It was interesting.
They spent close to 2,000pounds on Google.
And look at the number of newpatients they had from there.
Whereas they had 22 patientsfrom word of mouth and from
referrals.
Right?
What does that say?
(23:55):
Anybody?
You're doing well?
Good quality practice.
Good quality practice.
Great care.
Right?
It shows that you're doing agood job with your patients.
Great care.
Patients like what you'redoing.
Yes, they trust you.
So they're referring morepatients to you.
(24:16):
So if you know that you'regoing to get more patients
through that, where are yougoing to double down on?
You're going to double down onthat service.
There's no point you'rethrowing X amount on marketing,
getting one marketing agency andthen the next marketing agency
and expecting a differentresult.
It's not the marketing agency'sfault.
The problem is you're doing agreat job looking after your
patients.
So we redirected their budgetinto a referral program.
(24:39):
Right?
We doubled down on it.
Right.
And the only reason, simplereason, right?
The only reason they knew aboutthis was the change because of
tracking.
Right?
Something as simple as that.
So and this metric is notdifficult to calculate.
(25:00):
You don't need a software tocalculate this.
Right.
Fab.
Next, case acceptance rate.
Okay?
Another important KPI.
And personally, I feel this isone of the biggest predict
(25:23):
predictors for your associatesmainly.
Right?
What I find is between 70 to 80percent routine care should be
like a norm.
Routine channel dentistry.
There's a reason why they'vecome to your practice.
40 to 60 percent for majortreatment, anything over a
thousand pounds, implant work,orthodontic work.
(25:45):
On an average, you should havebetween 55 to 65 percent.
Okay.
Again, this is a real lifeexample of a practice that came
to us.
They discovered their accepted,I mean, they never measured
anything in the first place.
Then we said, okay, what's yournew patient numbers?
They got their new patientnumbers.
(26:06):
Then we went further down deep.
I said, Okay, these are yournew patient numbers, you're
spending so much on marketing,you're getting patients coming
in through the door.
What are your associates doingwith those patients that are
coming in through the door?
I don't know.
All right, so let's measure it.
And when we measured it, wefound 31%.
Right?
(26:27):
So all that money you'respending on marketing, you're
getting the patients in, butyour conversion rate is only
31%.
So we started going deep downinto their consultation process.
We started identifying whattheir consultation process is
like, right?
What are they doing right?
What are they not doing right?
And small changes, just puttingvisual aids in, spending more
(26:48):
time, listening to patients.
It's not rocket science, right?
That itself increased it to54%.
Right?
And look at the difference itdid.
80,000 in anwater production.
Right?
Small metrics, just smallmetrics, just small changes can
(27:11):
make such a big difference.
Right?
Again, you don't need asoftware to measure it.
It's pretty straightforward.
Right?
Start measuring it becauselet's think about it, right?
You'll spend on Monday, youmight go in and say, no, I need
to increase my marketing budgetbecause I need more patients
coming in through the door.
Right?
You don't need more patients.
(27:33):
Look at what you already haveand do small tweaks.
Fine.
Let's move to point numberthree.
Production per hour.
Right?
Now a lot of people talk aboutproduction per hour.
Anyone knows their productionper hour here?
You?
(27:55):
You okay, great.
More than the norm.
But generally, no one measurestheir production per hour,
right?
And this is very important.
We spend a lot of time talkingabout production per hour
because this goes down intozoning of your diaries and
everything.
I don't have the time to speakabout that at the moment, but I
just need you guys to be awareof these topics, right?
(28:15):
So as a general dentist or asan associate in your practice,
roughly you look at around 200to 300 quid an hour.
If you're doing advancedtreatment, 300 to 400 an hour,
specialist treatment 400 to 500,400 to 600 an hour.
Right?
Now, in this practice that weworked with, their production
(28:38):
per hour dropped from 285 to214.
So they were stupidly busy.
Right?
That was the problem.
Right?
Anyone came in, okay.
You squeeze them in, squeezethem in, squeeze them in.
But the problem was bysqueezing, squeezing, squeezing
everybody in, their hourly ratestarted dropping.
Right?
(29:00):
And this can happen like over ayear.
It's one patient, two patients,if you don't set strict rules
to your appointment books orappointment diaries.
We went in, we saw this, and asmall change again.
Restructured their schedule,looked at their diaries, saw
(29:20):
exactly what needs to be done,spoke to the reception team,
spoke to the booking team, andwe changed it.
Right?
And that one small change, justa few pounds, right?
Increase, changed everything.
Right?
And now obviously you've got tomultiply it if you have a
bigger practice, five surgery,six surgery, seven surgery, it
(29:43):
just multiplies.
Fab.
Now let's look at point numberfour.
Right?
Like I said previously, this isthe silent practice killer, and
this is a big reason a lot ofdental practices these days are
struggling, especially the bigmixed practices.
(30:05):
In fact, I'm seeing it more nowin private practices as well,
practices that have been therefor a long time because they've
just been doing things howthey've been doing things and
they expect a different result,right?
So, what do I mean by this?
So these are differentpercentages.
What do I mean by 60 to 65percent excellence?
So for every hundred pounds orsay for every pound that your
(30:30):
practice earns, 60p is gone, soyou get to keep 40p for the
rest.
Right?
So if you have that kind ofratio, you're great.
But at 80% overhead, then it'sa problem.
And trust me, that can changesoon.
(30:53):
Right?
That can change soon.
For those of you who havepractice owner, who are practice
owners, you know, remember thetime when we didn't have
clinical waste bags.
Now we have, sorry, yeah, goahead.
Yes.
Yeah, definitely.
Yeah.
Yeah, yeah, yeah.
So for those of you, I'll giveyou a simple example.
A practice that we were workingwith, clinical waste, right?
(31:14):
Big practice, they were justchucking the clinical waste in
the bin, everything was fine.
All of a sudden, the practiceowner never checked the bills on
his clinical waste because theteam was paying for it,
everything was fine.
It was a process that washappening.
But what he didn't realize isin the surgery, there was only
(31:35):
one bin, and that was theclinical waste bin.
So they took out wrappers,clinical waste bin, everything
in the clinical waste bin.
What happened?
Clinical waste bin.
You know how you get chargedwith clinical waste, right?
It's per bags.
What also happened was at theend of the day, there were
people who were coming in for acouple of hours, three, four
hours, just doing a short shiftclinical waste in the bin.
(31:55):
You were charged per bag.
And they didn't realize justclinical waste alone increased
by 60%.
Right?
Something as small as that.
Right?
But I'm talking about multiplelevels, right?
The price of running apractice, electricity, gas, all
these things have gone up.
These are like basic stuff.
(32:16):
Forget about material cost andeverything.
I don't believe you've got tocompromise on your material, but
it's very important you look atyour overheads.
Now, we know year on year, forsome reason, staff expect a pay
hike.
It's like a birthright, right?
They expect uh a pay rise everyApril.
(32:38):
And if you don't, they eitherleave uh or you end up in a
tribunal.
Right?
So again, how do you justifygiving a pay hike, right?
So say I think this year it was5%.
Where do you get the extra 5%in your business from?
If you don't have an extra 5%in your business, how are you
(32:59):
going to pay your staff extra?
You can't just increase your 5%and expect it to happen.
It doesn't magically happen.
But over the years, every year,year on year, for those of you
who have had practices for quitesome time now, every year we've
had this increase.
But has the practice grownsimilarly?
Right?
So things like this creep upslowly and they start eating
away on your overheads.
(33:21):
Right?
Smaller practice, it's great,you have more control, you have
bigger practices, then it's anissue.
New equipment, we all love ourtoys in one form or the other.
Um you buy them withoutunderstanding the impact that
(33:41):
it's causing on your revenue, itmakes a big, it makes a big um,
it can be a big problem.
Right?
Your staff come and tell youyou're just giving us too much
work, there's just so much work,constantly you're throwing work
at us.
All right, let's hire some morestaff.
Right?
But it's not as simple as that.
So just from 78% to 63%, right?
(34:05):
From a struggling practice to athriving practice.
Small, just a small difference,right?
But again, it depends on yourturnovers.
Like I said, most practices onan average are a half a million
turnover to whatever numbers,right?
So they can make a difference.
Fab, let's move to number five.
(34:27):
Number five is patientretention, right?
And I tell this all the time: there's no point spending on (34:31):
undefined
marketing if you have holes inyour bucket at the moment.
You're losing patienceconstantly.
There's no point spendinganything on marketing, right?
You could spend and spend andspend, but if you're losing
patience on the other end, it'snot good, right?
And this is important, right?
It takes it costs a lot more toattract a new patient than to
(34:54):
retain an existing one.
A lot more, right?
Plus, it's a new patient who'scoming in.
You've got to build trust withthis patient, plus you're
spending on marketing, right?
So I call this the leaky bucketproblem.
So again, a practice who I wasworking with before we started
(35:16):
tracking, so we did the trackingretrospectively, they were
getting 14 new patients a month.
It was great.
So the first metric that Ispoke to you about, new patient
numbers, great, 14 new patientsa month, right?
But what's the point having 40new patients if you're losing 35
patients a month?
Right?
And then so the net growth wasfive.
They increased their retentionrate.
(35:37):
You can use this on differentmetrics: your hygiene, your
general dentistry, and othertreatments.
But if you lose, if yourretention rate's low, your
growth's low.
So they sorted their retentionrate out, say marketing budget,
they managed to increase theirnumbers.
Okay, again, it's notcomplicated, it's simple.
You don't need to do it aspractice owners.
(35:59):
Get someone in your team to doit.
It's simple, just delegate it.
Delegate it to somebody in yourteam and just tell your team,
tell them that this is what Iwant.
Can you do this for me and giveit to me in a week's time?
It throws a lot of information.
Finally, team engagement,right?
Now, this is an interestingKPI.
(36:20):
This is not a financial KPI.
This is not a financial KPI.
Anyone here knows what the NPSis?
Except those people who came onthe DPN.
Sorry.
Yeah, what is NPS?
Net NS.
(36:41):
That's correct.
Anybody else for the PNS?
Brilliant.
Net promoter score, right?
Lots of big companies, theyhave an NPS scoring system.
An NPS scoring system tells howlikely you are to refer that
business or company to somebodyelse and how loyal you are to
that business.
Okay, question here.
(37:01):
What's an E NPS?
No.
ENPS.
Anybody?
No.
Employee net promoter score,right?
It's how likely your employeesare to refer your business as to
somebody else as a great placeto work.
Right?
That's an E NPS scoring.
(37:22):
There's a system behind it.
You can Google it, don'tovercomplicate it.
But ask them one simplequestion.
Right?
On a scale of 0 to 10, howlikely are they to recommend our
practice as a good place towork?
Keep it anonymous.
Right?
And be ready to face criticism.
(37:45):
But like it's better of thedevil you know, right?
Then you don't know.
So again, a big problem in alot of practices, high staff
turnover.
Right?
It's more expensive, it costsyou more to get a new staff
member than to retain your oldstaff member.
(38:07):
It's not that one poundincrement, right?
You've got to take into factoruh into consideration the time,
the training, right?
Yeah.
So team engagement, this isgreat.
I mean, so important if youhave to build a big team, right?
And a good team.
At the moment, I have 132 staffmembers who work with me and 36
(38:33):
dentists.
This was one of the mostimportant things that helped
change, create the switch for mein my practices.
Right?
And we regularly do this.
We regularly do this.
Right.
Ready for the next exercise?
Now, again, I'm going todistribute some worksheets with
(38:56):
you.
Now, on these worksheets, whatI would like you to do is you've
got three minutes.
Just three minutes.
For each of you to write yoursix KPIs.
Right?
Listen, it doesn't have to beperfect.
Again, I'm not going to ask youto share it with me.
But this is for you guys,right?
For you guys to keep.
(39:17):
Write down your best guess,your best guess at your own
number right now.
If you genuinely don't knowone, just put a question mark
next to it.
Right?
(39:44):
The whole idea of this exerciseis not to know your numbers,
but it's to know those questionmarks on it.
Right?
Are those percentages all fromyour practice or are they from
your own?
It's from no, it's from my notmy practices.
So I work with lots ofpractices.
So I've been 164 practicesacross the country.
So those are because industrynumbers can be skewed.
(40:10):
Yeah.
So I prefer to use my data.
Right.
So we got three minutes.
We're almost there, we shouldbe done in the next ten minutes.
You might as well put aquestion mark on it.
(40:51):
Right, hands up if you have onequestion mark.
(41:38):
One question mark, hands up.
Two question marks?
Great.
Three question marks.
Four.
So most of you all know yournumbers well.
Fine.
But the reason for thisexercise is like I said, I'm not
(42:03):
going to ask you to share yournumbers with me.
But the whole idea is you needto understand these six metrics.
Right?
There's no point you doing itif you know, running a practice
if you're not aware of thesenumbers.
Fine.
So this is what I propose toyou guys, right?
Just keep it simple.
You don't it, it doesn't haveto be too complicated.
Just have on your practicedashboard one page, six numbers,
(42:27):
and update it monthly.
It doesn't take you long.
Five minutes weekly, twentyminutes monthly, and thirty
minutes quarterly.
That's all it does.
There's six numbers.
And listen, you don't have tosit down with the spreadsheets
and write the numbers.
Delegate to it to your team andexpect your team to do it for
you, right?
Decide on a date and a timewhen you want them.
This is less time thanscrolling social media, right?
(42:53):
It's quick.
And what's the benefit, right?
You get complete clarity onyour practice health.
You know exactly what'shappening, at least 80% of
what's happening, right?
Look at the risk to rewardratio, right?
Fab.
(43:15):
This is one thing I want totouch up on quickly, and this is
what a lot of people think,right?
Knowing data corrupts yourethics.
It doesn't.
It protects them.
Again, if you don't track, whatI see happen most of the time
is people trying to over-treatto boost production, they start
(43:36):
pushing unnecessary procedures,procedures that they don't need
to do.
Cut corners and materials, rushappointments, reduce staff
regardless of care impact.
But once you start trackingyour numbers, remember what I
said in the beginning.
It's alright to know yournumbers, but you need to
understand what you're going todo with those numbers.
Right?
And this is what I've seen withpractices that we've worked
(43:58):
with, right?
Time and time again.
They improve how they presenttheir treatment.
They start scheduling theirbooks more efficiently, they
start zoning their diaries moreefficiently.
They invest in better systemsand the price fairly for value
delivered.
Now, without data, you makedesperate decisions in crisis
(44:21):
mode, and that's usually when Iget a phone call.
When people are in crisis mode,right?
And common trend, no data.
Now I'm not asking you for datathat the MPC, for those of you
who have exactly, that throwsout, right?
Again, you need right data, youneed correct data, right?
Because your your decisions areonly as good as the data you
get.
(44:41):
Right?
With data, you can makeprincipal decisions every time.
Listen, it doesn't have to becomplicated.
This practice that we workedwith, we we spoke on all those
six metrics.
We changed their overhead costfrom 78%, we reduced it to 63%.
(45:04):
We increased their productionper hour by 28%.
Case acceptance increased, andtheir ENTS scoring increased as
well.
But look at the difference itcost, right?
But it was not by workingharder, but by making better
decisions.
Right?
Six KPIs, better decisions, jobdone.
This episode of the Dentists Who Invest Podcast will
be a little bit differentbecause we are broadcasting live
for the first time ever one ofthe rooms that was held at the
recent Business of DentistryConference in Birmingham.
The next conference will be tobe held in the next few months.
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As ever, you can claim your CPDfor this episode within the
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Dr Chetan (02:46):
Today we're going to speak about KPIs.
Everyone here aware of KPIs?
Right?
What does KPI stand for?
Simple, right?
And working with practices,that's what I've been doing over
the last three years, workingwith different practice owners.
Implement systems in theirpractices, implement processes
(03:07):
in their practices.
Sometimes they have issues andproblems.
We're trying to find solutionsfor them in their practices.
And one thing that terrifiesmost, not all, but most practice
owners, is numbers.
The minute you say numbers,they switch off.
They're great at clinicaldentistry, but the minute you
say numbers, then they switchoff.
The practice is busy, they'refully booked most days.
(03:30):
The team's working flat out.
Right?
And this is what I get on aweekly basis, practice owners
asking me, like, what the hellis happening?
Right?
They're busy, very busy, butthey're not profitable.
Great turnovers, right?
(03:51):
You all heard that saying, soI'm not going to go through that
again.
But it's not about turnoveranymore.
It was never about turnover.
And it's it's more importantnow, right?
So this practice owner, I'mgoing to give you some examples
as we go ahead.
So this practice that I'mworking with at the moment, they
spoke to me six months back.
(04:12):
They had an 18% drop inproduction per hour.
Overheads, this is a commontrend in most practices, going
up 65%.
With this practice, it was 65to 78%.
But this is a trend across theindustry.
Case acceptance rates.
(04:32):
For treatments, over a thousandpounds dropped from 62% to 41%.
They were busier than ever.
They were working harder, butthere was just no money in the
bank.
There was just no money in theaccount.
Right.
Now, this practice owner had noidea what was going wrong.
He just kept working harder.
(04:53):
He'd been running his practicefor the last 15-20 years.
He was not a new practiceowner.
He's been running his practicefor the last 15-20 years.
Now, it might seem obvious toyou, right?
Like, okay, fine.
But the but the issue was therewas no tracking.
He just didn't track anything.
And the problem I find withmost people is this, right?
(05:15):
Wipe-based management.
That's that's the biggestissue.
You've you run your practices,most people run their practices
just because of their with thegut with their gut feeling, just
to see how they feel about thepractice.
The schedule looks full, sothings must be great.
The practice is busy, so thingsmust be great.
The team seems happy.
(05:36):
No one's complaining.
Does that actually mean theteam's happy?
Patients keep coming in throughthe door, so things must be
great.
And this is the biggest one.
They're too busy to think aboutit because they're so busy
putting out fires.
Right?
And this is very important,right?
(05:59):
So busy, your practice beingbusy does not mean it's
profitable.
Full doesn't mean efficient,and fine does not mean that your
practice is thriving.
So question.
Why do dentists avoid numbers?
And this is across the boardthat we've seen, right?
(06:23):
The first thing is we aren'ttrained for this.
Five years in dental school,how many hours on business?
Not in my school.
Right?
This is the biggest issue we'rehaving.
You have a clinical course, andthis was me as well, right?
Been doing dentistry for thelast 19 years.
This was me as well.
We run to the first clinicalcourse that's there, restorative
(06:48):
course, composite course,implant course.
But how many of us have spenttime learning on the business of
dentistry?
Right?
Numbers.
No.
So this is the problem, andthat's why we there are lots of
practices there who arestruggling.
Second, numbers feel unethical.
(07:09):
We need to stop thinking likethis.
We all run, especially practiceowners out there, we run
sizable businesses.
On an average, half a millionturnover, right?
You have a responsibility toyour team, to your staff.
It's very important that youstop thinking that numbers feel
unethical, right?
Tracking KPIs feel likereducing patients to revenue
(07:32):
units.
And this is a big one, right?
We are afraid of what we'llfind.
Right?
I know we need to track ournumbers, but we're just worried
about what we're gonna find.
I've poured my heart into thispractice, but it's actually
failing.
Nowadays you've got lots ofsoftwares that give you numbers.
But the problem is not gettingthe numbers, it's understanding
(07:56):
what you do with those numbers.
Right?
You have softwares that keepthrowing numbers at you.
Right?
You can open spreadsheets withnumbers, numbers, numbers, but
what do you do with them?
That's important.
Right?
And this, I relate to this.
Did five years of dental schoolnot to look at spreadsheets.
(08:17):
Right?
So this is what we're gonna do.
So we're gonna do this oneexercise, right?
To start off with, I want youguys to play full on on this.
You don't have to share thiswith me.
So, my team, I'm gonna sharesome sheets with you.
What I need you to do is scoreyourself, okay?
(08:38):
This is your honest self-audit.
So you've got to score betweenone to five, right?
Now, one means that's not me atall, right?
(09:00):
And five means I relate tothis, right?
So one means that's not me atall, and five means I relate to
this.
Ah, you'll need pens, right?
So share a pen if you'll haveone.
(09:24):
You'll all got a sheet?
We're gonna have a fewexercises like this, so get used
to it.
We're gonna do a few in thenext forty-five minutes.
Yep.
(09:50):
There are some pens here.
Once you finish writing, justshare that, yeah.
Did everyone get?
It's not an exam, should takeyou a couple of minutes to
finish.
I'm coming to your talk later.
(10:11):
Yeah.
Interesting.
Yeah.
Has had a chat with Barry.
That's what I told Barry we needto have a chat.
Yeah.
Good.
Some still filling.
Don't worry, you just gotta behonest with yourself when you do
(10:37):
this.
I'm not going to ask you toshare this.
This is for you to take backhome with you.
Right?
We're gonna have a few exerciseslike this.
The more you play into it, themore you get into it.
Right, all done.
Oh, thanks.
(10:59):
Is there a mic?
Yeah, that's fine.
Okay, so show of hands, howmany of you have scored between
zero to ten?
That's fine.
(11:21):
How many of you have scoredbetween eleven to fifteen?
And how many of you have scoredbetween sixteen to twenty?
Fairly equal number.
And twenty to twenty-five?
Cool.
Right.
(11:41):
So this is normal, right?
And this is exactly how thesenext twenty-five minutes are
gonna go.
What I want you to do is speakto the person next to you and
share with them that one numberwhere you scored a five on.
(12:04):
Right?
And what and what number inthere has the biggest, I mean,
the biggest problem you havewith?
Right?
So speak to the person next toyou.
So anyone brave enough to sharewhat happened?
(13:51):
Do you want to share?
Do you want to share what whatyou discussed?
Which one?
So you feel time is you feelit's too time consuming.
Sorry, what's your name?
Simon?
Simon.
You gotta practice?
You wanna practice?
Okay, fine.
Thank you, I'll catch up onthat.
(14:20):
Right.
Good, good, good, good, good,good, good, good, good, good,
good, good.
Do you want to share?
What's the biggest problem?
You have no idea.
(14:40):
Because you're not trained,right?
To the clinical dentist.
Good.
All right, should we continue?
Guys, we've got thirty minutesleft.
(15:04):
Right, should we continue?
Fab.
So anyone here wanting toshare?
No?
Should I ask?
Dev, which part do you thinkyou struggled with?
So where were you a five on?
Speaker 3 (15:26):
I was I'm not five on and I mean I wasn't trained.
This could be five.
Dr Chetan (15:31):
Yes.
But the rest, I think becominga practice owner changes you.
Which is very important.
We know each other for such along time.
And the biggest problem most ofus face is we weren't trained.
Everyone agrees with me onthat?
Yeah?
That's the biggest problem wehave, right?
And that's why I said Ireluctantly became a practice
(15:51):
owner.
I didn't know that you had tobe trained to run the business
side of things.
I knew I was good at dentistry,but it's a whole different
ballgame once you're a practiceowner.
Fab.
So let's go ahead.
Next.
So KPIs, right?
(16:13):
Now on the left we have KPIs.
So before when you go to yourdoctor, your doctor sees you,
what does the doctor do?
The doctor measures your bloodpressure, heart rate, oxygen
saturation, temperature,respiratory rate, and then he
helps you arrive at a diagnosis,right?
He checks all your vital signs,right?
(16:36):
KPIs just to make sure thateverything's fine.
If we as doctors, dentists inthe medical profession do KPIs,
uh, we have, I mean, look atpatients' vital signs to
understand exactly what'shappening, we need to look at
the vital signs of our businessas well.
(16:57):
All right, very important.
So I've kept it simple, right?
Over the years, I startedlooking at different metrics,
different numbers to see whatworks, what doesn't work.
And then I realized that withtime, we don't need to look at
40 or 50 different metrics.
Sorry, 40 or 50 differentmetrics.
(17:18):
We just need to look at five ormaybe six metrics.
That's it.
We don't have to spend hoursevery week looking at
spreadsheets and numbers, right?
Leave that to the accountantsto do, right?
But you need to know a few keynumbers, something that helps
(17:41):
you keep your pulse on thebusiness.
Right?
So, for a practice, having anidea of your new patient
numbers, case acceptance rates,production per hour, overhead
percentage, and patientretention.
Right?
(18:01):
A doctor wouldn't treat apatient without checking their
vital signs.
Yeah?
So being a practice owner, it'sso important you know your
vital signs.
And what I find that happensmost of the time is your gut
feelings.
How's your practice doing?
(18:23):
I think it's doing well.
I think it's great.
Why?
Everyone's happy, no one'scomplaining, the books are full.
I think they're cool.
There is some money left overin the account at the end once
it's all done.
Right?
So having some vital signs foryour practice is very important.
So let's look at the six mainKPIs that I think we need to
(18:47):
look at.
So let's go there.
Yeah.
So this should give you 80% ofthe insight you need in your
practice.
Not 100%, but 80% of theinsight you need in your
practice.
So the first one, new patientnumbers.
(19:08):
Not only the number of newpatients coming into your
practice, right?
Not only the number of newpatients coming in, but where
are these patients coming from?
Simple.
Right?
What's your case acceptancerate?
You're a practice owner.
What is the case acceptancerate of your associates?
What's the case acceptance ratefor general dentistry, for
(19:31):
complex and for specialist levelservices?
What's your production perhour?
If you're an associate, greatmetric to look at.
If you're not an associate,it's important, I mean, as a
practice owner, to see what yourassociates are doing.
Overhead percentage, this hasbecome more common now than it
(19:54):
used to be, just because of theincrease in costs these days.
Right?
Silent killer of mostpractices, overhead percentage,
patient retention, very easy tocalculate and very important as
well.
And finally, team management.
Now, what I'm going to do inthe next 15-20 minutes is I'm
(20:17):
going to go deep on three ofthese.
Yeah.
Now, these three are going tomake the biggest financial
impact in your practices.
I'll touch up a little bit onthe others as well, but three
that I'm going to go slightlydeeper into.
And if you implement thesethree, it'll really help your
practice.
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Dr Chetan (22:27):
So let's first look at new patient numbers, right?
So it's not only important tocheck how many new patients come
to your practice, but what'smore important is to check how
many new patients came to yourpractice and where did they come
from.
So, on an average across thecountry, what I've seen is
(22:49):
anything between 30 to 50 newpatients, again, depending on
your type of practice, 30 to 50new patients per full-time
dentist.
So uh I have it's a goodexample.
I had a practice that cameacross, they spoke to me, they
said we're spending X amount onmarketing, we keep throwing
(23:12):
money on marketing month onmonth.
On month, we keep spending alot of money on marketing, but
we're not getting the resultsthat we need.
We're not getting the resultsthat we want.
So I told them one metric.
This look at this one metricthat you need to measure, right?
Look at the number of newpatients you have last month,
the month before, and for thelast few months.
(23:33):
Track and see where they camefrom.
And you know what?
It was interesting.
They spent close to 2,000pounds on Google.
And look at the number of newpatients they had from there.
Whereas they had 22 patientsfrom word of mouth and from
referrals.
Right?
What does that say?
(23:55):
Anybody?
You're doing well?
Good quality practice.
Good quality practice.
Great care.
Right?
It shows that you're doing agood job with your patients.
Great care.
Patients like what you'redoing.
Yes, they trust you.
So they're referring morepatients to you.
(24:16):
So if you know that you'regoing to get more patients
through that, where are yougoing to double down on?
You're going to double down onthat service.
There's no point you'rethrowing X amount on marketing,
getting one marketing agency andthen the next marketing agency
and expecting a differentresult.
It's not the marketing agency'sfault.
The problem is you're doing agreat job looking after your
patients.
So we redirected their budgetinto a referral program.
(24:39):
Right?
We doubled down on it.
Right.
And the only reason, simplereason, right?
The only reason they knew aboutthis was the change because of
tracking.
Right?
Something as simple as that.
So and this metric is notdifficult to calculate.
(25:00):
You don't need a software tocalculate this.
Right.
Fab.
Next, case acceptance rate.
Okay?
Another important KPI.
And personally, I feel this isone of the biggest predict
(25:23):
predictors for your associatesmainly.
Right?
What I find is between 70 to 80percent routine care should be
like a norm.
Routine channel dentistry.
There's a reason why they'vecome to your practice.
40 to 60 percent for majortreatment, anything over a
thousand pounds, implant work,orthodontic work.
(25:45):
On an average, you should havebetween 55 to 65 percent.
Okay.
Again, this is a real lifeexample of a practice that came
to us.
They discovered their accepted,I mean, they never measured
anything in the first place.
Then we said, okay, what's yournew patient numbers?
They got their new patientnumbers.
(26:06):
Then we went further down deep.
I said, Okay, these are yournew patient numbers, you're
spending so much on marketing,you're getting patients coming
in through the door.
What are your associates doingwith those patients that are
coming in through the door?
I don't know.
All right, so let's measure it.
And when we measured it, wefound 31%.
Right?
(26:27):
So all that money you'respending on marketing, you're
getting the patients in, butyour conversion rate is only
31%.
So we started going deep downinto their consultation process.
We started identifying whattheir consultation process is
like, right?
What are they doing right?
What are they not doing right?
And small changes, just puttingvisual aids in, spending more
(26:48):
time, listening to patients.
It's not rocket science, right?
That itself increased it to54%.
Right?
And look at the difference itdid.
80,000 in anwater production.
Right?
Small metrics, just smallmetrics, just small changes can
(27:11):
make such a big difference.
Right?
Again, you don't need asoftware to measure it.
It's pretty straightforward.
Right?
Start measuring it becauselet's think about it, right?
You'll spend on Monday, youmight go in and say, no, I need
to increase my marketing budgetbecause I need more patients
coming in through the door.
Right?
You don't need more patients.
(27:33):
Look at what you already haveand do small tweaks.
Fine.
Let's move to point numberthree.
Production per hour.
Right?
Now a lot of people talk aboutproduction per hour.
Anyone knows their productionper hour here?
You?
(27:55):
You okay, great.
More than the norm.
But generally, no one measurestheir production per hour,
right?
And this is very important.
We spend a lot of time talkingabout production per hour
because this goes down intozoning of your diaries and
everything.
I don't have the time to speakabout that at the moment, but I
just need you guys to be awareof these topics, right?
(28:15):
So as a general dentist or asan associate in your practice,
roughly you look at around 200to 300 quid an hour.
If you're doing advancedtreatment, 300 to 400 an hour,
specialist treatment 400 to 500,400 to 600 an hour.
Right?
Now, in this practice that weworked with, their production
(28:38):
per hour dropped from 285 to214.
So they were stupidly busy.
Right?
That was the problem.
Right?
Anyone came in, okay.
You squeeze them in, squeezethem in, squeeze them in.
But the problem was bysqueezing, squeezing, squeezing
everybody in, their hourly ratestarted dropping.
Right?
(29:00):
And this can happen like over ayear.
It's one patient, two patients,if you don't set strict rules
to your appointment books orappointment diaries.
We went in, we saw this, and asmall change again.
Restructured their schedule,looked at their diaries, saw
(29:20):
exactly what needs to be done,spoke to the reception team,
spoke to the booking team, andwe changed it.
Right?
And that one small change, justa few pounds, right?
Increase, changed everything.
Right?
And now obviously you've got tomultiply it if you have a
bigger practice, five surgery,six surgery, seven surgery, it
(29:43):
just multiplies.
Fab.
Now let's look at point numberfour.
Right?
Like I said previously, this isthe silent practice killer, and
this is a big reason a lot ofdental practices these days are
struggling, especially the bigmixed practices.
(30:05):
In fact, I'm seeing it more nowin private practices as well,
practices that have been therefor a long time because they've
just been doing things howthey've been doing things and
they expect a different result,right?
So, what do I mean by this?
So these are differentpercentages.
What do I mean by 60 to 65percent excellence?
So for every hundred pounds orsay for every pound that your
(30:30):
practice earns, 60p is gone, soyou get to keep 40p for the
rest.
Right?
So if you have that kind ofratio, you're great.
But at 80% overhead, then it'sa problem.
And trust me, that can changesoon.
(30:53):
Right?
That can change soon.
For those of you who havepractice owner, who are practice
owners, you know, remember thetime when we didn't have
clinical waste bags.
Now we have, sorry, yeah, goahead.
Yes.
Yeah, definitely.
Yeah.
Yeah, yeah, yeah.
So for those of you, I'll giveyou a simple example.
A practice that we were workingwith, clinical waste, right?
(31:14):
Big practice, they were justchucking the clinical waste in
the bin, everything was fine.
All of a sudden, the practiceowner never checked the bills on
his clinical waste because theteam was paying for it,
everything was fine.
It was a process that washappening.
But what he didn't realize isin the surgery, there was only
(31:35):
one bin, and that was theclinical waste bin.
So they took out wrappers,clinical waste bin, everything
in the clinical waste bin.
What happened?
Clinical waste bin.
You know how you get chargedwith clinical waste, right?
It's per bags.
What also happened was at theend of the day, there were
people who were coming in for acouple of hours, three, four
hours, just doing a short shiftclinical waste in the bin.
(31:55):
You were charged per bag.
And they didn't realize justclinical waste alone increased
by 60%.
Right?
Something as small as that.
Right?
But I'm talking about multiplelevels, right?
The price of running apractice, electricity, gas, all
these things have gone up.
These are like basic stuff.
(32:16):
Forget about material cost andeverything.
I don't believe you've got tocompromise on your material, but
it's very important you look atyour overheads.
Now, we know year on year, forsome reason, staff expect a pay
hike.
It's like a birthright, right?
They expect uh a pay rise everyApril.
(32:38):
And if you don't, they eitherleave uh or you end up in a
tribunal.
Right?
So again, how do you justifygiving a pay hike, right?
So say I think this year it was5%.
Where do you get the extra 5%in your business from?
If you don't have an extra 5%in your business, how are you
(32:59):
going to pay your staff extra?
You can't just increase your 5%and expect it to happen.
It doesn't magically happen.
But over the years, every year,year on year, for those of you
who have had practices for quitesome time now, every year we've
had this increase.
But has the practice grownsimilarly?
Right?
So things like this creep upslowly and they start eating
away on your overheads.
(33:21):
Right?
Smaller practice, it's great,you have more control, you have
bigger practices, then it's anissue.
New equipment, we all love ourtoys in one form or the other.
Um you buy them withoutunderstanding the impact that
(33:41):
it's causing on your revenue, itmakes a big, it makes a big um,
it can be a big problem.
Right?
Your staff come and tell youyou're just giving us too much
work, there's just so much work,constantly you're throwing work
at us.
All right, let's hire some morestaff.
Right?
But it's not as simple as that.
So just from 78% to 63%, right?
(34:05):
From a struggling practice to athriving practice.
Small, just a small difference,right?
But again, it depends on yourturnovers.
Like I said, most practices onan average are a half a million
turnover to whatever numbers,right?
So they can make a difference.
Fab, let's move to number five.
(34:27):
Number five is patientretention, right?
And I tell this all the time: there's no point spending on (34:31):
undefined
marketing if you have holes inyour bucket at the moment.
You're losing patienceconstantly.
There's no point spendinganything on marketing, right?
You could spend and spend andspend, but if you're losing
patience on the other end, it'snot good, right?
And this is important, right?
It takes it costs a lot more toattract a new patient than to
(34:54):
retain an existing one.
A lot more, right?
Plus, it's a new patient who'scoming in.
You've got to build trust withthis patient, plus you're
spending on marketing, right?
So I call this the leaky bucketproblem.
So again, a practice who I wasworking with before we started
(35:16):
tracking, so we did the trackingretrospectively, they were
getting 14 new patients a month.
It was great.
So the first metric that Ispoke to you about, new patient
numbers, great, 14 new patientsa month, right?
But what's the point having 40new patients if you're losing 35
patients a month?
Right?
And then so the net growth wasfive.
They increased their retentionrate.
(35:37):
You can use this on differentmetrics: your hygiene, your
general dentistry, and othertreatments.
But if you lose, if yourretention rate's low, your
growth's low.
So they sorted their retentionrate out, say marketing budget,
they managed to increase theirnumbers.
Okay, again, it's notcomplicated, it's simple.
You don't need to do it aspractice owners.
(35:59):
Get someone in your team to doit.
It's simple, just delegate it.
Delegate it to somebody in yourteam and just tell your team,
tell them that this is what Iwant.
Can you do this for me and giveit to me in a week's time?
It throws a lot of information.
Finally, team engagement,right?
Now, this is an interestingKPI.
(36:20):
This is not a financial KPI.
This is not a financial KPI.
Anyone here knows what the NPSis?
Except those people who came onthe DPN.
Sorry.
Yeah, what is NPS?
Net NS.
(36:41):
That's correct.
Anybody else for the PNS?
Brilliant.
Net promoter score, right?
Lots of big companies, theyhave an NPS scoring system.
An NPS scoring system tells howlikely you are to refer that
business or company to somebodyelse and how loyal you are to
that business.
Okay, question here.
(37:01):
What's an E NPS?
No.
ENPS.
Anybody?
No.
Employee net promoter score,right?
It's how likely your employeesare to refer your business as to
somebody else as a great placeto work.
Right?
That's an E NPS scoring.
(37:22):
There's a system behind it.
You can Google it, don'tovercomplicate it.
But ask them one simplequestion.
Right?
On a scale of 0 to 10, howlikely are they to recommend our
practice as a good place towork?
Keep it anonymous.
Right?
And be ready to face criticism.
(37:45):
But like it's better of thedevil you know, right?
Then you don't know.
So again, a big problem in alot of practices, high staff
turnover.
Right?
It's more expensive, it costsyou more to get a new staff
member than to retain your oldstaff member.
(38:07):
It's not that one poundincrement, right?
You've got to take into factoruh into consideration the time,
the training, right?
Yeah.
So team engagement, this isgreat.
I mean, so important if youhave to build a big team, right?
And a good team.
At the moment, I have 132 staffmembers who work with me and 36
(38:33):
dentists.
This was one of the mostimportant things that helped
change, create the switch for mein my practices.
Right?
And we regularly do this.
We regularly do this.
Right.
Ready for the next exercise?
Now, again, I'm going todistribute some worksheets with
(38:56):
you.
Now, on these worksheets, whatI would like you to do is you've
got three minutes.
Just three minutes.
For each of you to write yoursix KPIs.
Right?
Listen, it doesn't have to beperfect.
Again, I'm not going to ask youto share it with me.
But this is for you guys,right?
For you guys to keep.
(39:17):
Write down your best guess,your best guess at your own
number right now.
If you genuinely don't knowone, just put a question mark
next to it.
Right?
(39:44):
The whole idea of this exerciseis not to know your numbers,
but it's to know those questionmarks on it.
Right?
Are those percentages all fromyour practice or are they from
your own?
It's from no, it's from my notmy practices.
So I work with lots ofpractices.
So I've been 164 practicesacross the country.
So those are because industrynumbers can be skewed.
(40:10):
Yeah.
So I prefer to use my data.
Right.
So we got three minutes.
We're almost there, we shouldbe done in the next ten minutes.
You might as well put aquestion mark on it.
(40:51):
Right, hands up if you have onequestion mark.
(41:38):
One question mark, hands up.
Two question marks?
Great.
Three question marks.
Four.
So most of you all know yournumbers well.
Fine.
But the reason for thisexercise is like I said, I'm not
(42:03):
going to ask you to share yournumbers with me.
But the whole idea is you needto understand these six metrics.
Right?
There's no point you doing itif you know, running a practice
if you're not aware of thesenumbers.
Fine.
So this is what I propose toyou guys, right?
Just keep it simple.
You don't it, it doesn't haveto be too complicated.
Just have on your practicedashboard one page, six numbers,
(42:27):
and update it monthly.
It doesn't take you long.
Five minutes weekly, twentyminutes monthly, and thirty
minutes quarterly.
That's all it does.
There's six numbers.
And listen, you don't have tosit down with the spreadsheets
and write the numbers.
Delegate to it to your team andexpect your team to do it for
you, right?
Decide on a date and a timewhen you want them.
This is less time thanscrolling social media, right?
(42:53):
It's quick.
And what's the benefit, right?
You get complete clarity onyour practice health.
You know exactly what'shappening, at least 80% of
what's happening, right?
Look at the risk to rewardratio, right?
Fab.
(43:15):
This is one thing I want totouch up on quickly, and this is
what a lot of people think,right?
Knowing data corrupts yourethics.
It doesn't.
It protects them.
Again, if you don't track, whatI see happen most of the time
is people trying to over-treatto boost production, they start
(43:36):
pushing unnecessary procedures,procedures that they don't need
to do.
Cut corners and materials, rushappointments, reduce staff
regardless of care impact.
But once you start trackingyour numbers, remember what I
said in the beginning.
It's alright to know yournumbers, but you need to
understand what you're going todo with those numbers.
Right?
And this is what I've seen withpractices that we've worked
(43:58):
with, right?
Time and time again.
They improve how they presenttheir treatment.
They start scheduling theirbooks more efficiently, they
start zoning their diaries moreefficiently.
They invest in better systemsand the price fairly for value
delivered.
Now, without data, you makedesperate decisions in crisis
(44:21):
mode, and that's usually when Iget a phone call.
When people are in crisis mode,right?
And common trend, no data.
Now I'm not asking you for datathat the MPC, for those of you
who have exactly, that throwsout, right?
Again, you need right data, youneed correct data, right?
Because your your decisions areonly as good as the data you
get.
(44:41):
Right?
With data, you can makeprincipal decisions every time.
Listen, it doesn't have to becomplicated.
This practice that we workedwith, we we spoke on all those
six metrics.
We changed their overhead costfrom 78%, we reduced it to 63%.
(45:04):
We increased their productionper hour by 28%.
Case acceptance increased, andtheir ENTS scoring increased as
well.
But look at the difference itcost, right?
But it was not by workingharder, but by making better
decisions.
Right?
Six KPIs, better decisions, jobdone.
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