Goal Setting

“How many days do you want to work each month?”
                             “How much do you want to make each month?”

These questions aren’t about mission statements or philosophical goals. If an orthodontist determines how many days a month he or she is willing to see patients and what net income is desired, it is simple mathematics to calculate everything else.

For example, let us say that our doctor wants to net $60,000 a month from her primarily full treatment practice (a Phase I/Phase II practice is calculated a little differently). We’ll assume the full treatment fee is $4850 and the overhead is running about 55% a month. Of course, one can always play with the fee and work on lowering the overhead, but for simplicity’s sake, we’ll take those as given.
Generally, we create a situation where the practice (unless it is new or growing quickly) produces (charges out) 15% more than anticipated in collections. This formula doesn’t work immediately but should kick in after about six months following a major change in production.

If overhead is 55%, the gross collections must be approximately $134,000 a month. Because production should be 10-15% higher than collections to generate this collection figure, a schedule must be built to produce $154,000. If the treatment fee is $4850, one must start 32 full cases a month.
Let us also assume that our doctor wants to see patients 16 days a month. That’s a little high (the average for Hummingbird practices is 14 days a month), but for our example, that means two starts a day. Allowing for no shows but anticipating a 75% conversion rate on exams, the practice should schedule 4 exams a day, totaling an average of 64 exams a month.

 So, to meet the goal, one needs to achieve the right number of exams a month and keep the right number of full start slots available to feed the goal. Scheduling templates with the necessary number of exams and starts can be created in the ViewPoint Grid Scheduler Template Editor and loaded on the patient days with the Template Calendar.

If the rotation is 8 weeks, the practice will see about 120 patients a day. From this information, one can determine that this practice, when correctly scheduled 16 days a month, will need two scheduling coordinators, one treatment coordinator, five clinicians, one financial coordinator, and possibly a records tech who helps with sterilization. The choice of having in-house lab staff is up to the doctor. The number of clinicians will be determined by how the orthodontist practices — rotation between visits, extent of expanded duties, percentage of patients beyond their estimated completion date, number of emergencies per day, etc.

One of the practice goals should be to complete patients during their estimated treatment time. An estimated completion date creates a goal by which the patient should move into the retention portion of treatment. When patients languish in active treatment past the estimated completion date, the schedule fills with non-paying patients; patients become impatient that they are still in treatment; and goals are compromised. To identify these patients, be sure to enter accurate expected and actual appliance removal dates in patient folders and then print the Exceeds Length of Treatment report on a regular basis.