The Surprising Cost of 'Slippage'

Case success is a linear process that you can think of as a chain of events. There can be a lot of links in that chain, but for the purposes of this article, let's look at six key links, starting when the patient first sits down in the operatory and ending when you collect payment for treatment. The links are: diagnose, present, accept, appoint, bill and collect.

Working backwards, we see that the effectiveness of each step in this chain depends on the step before it. You can only collect what you bill, you can only bill what you appoint, you can only appoint what the patient accepts, the patient can only accept what you present, and you can only present what you diagnose.

This interdependency also becomes clear when we start to rate efficiency at each step. If there is less than 100 percent efficiency anywhere in the chain, it can have a profound effect on the final result. For instance, let's look at a sample report card:

• Diagnosis (how often you diagnose comprehensively): 100 percent
• Presentation (how often you present everything you see): 95 percent
• Acceptance (how often patients accept significant treatment): 95 percent
• Appointments (How often patients keep their appointments): 95 percent
• Billing (how consistently you bill your full fee): 95 percent
• Collections (how consistently you collect your full fee): 95 percent

This may look impressive at first: the doctor is diagnosing completely all the time, and 95 percent efficiency sounds pretty good for those other links in the chain. But when you multiply those percentages to get an overall efficiency rating it comes out to 77 percent. That means this practice is leaving 23 percent of its potential on the table. In many practices, that would be enough to double the dentist's take-home.

This gap widens as the percentages decrease. Just a slight decline from 95 percent to 90 percent in the last five areas means 41 percent in lost potential. Reduce those figures to 80 percent, and the total lost potential is even more striking: 68 percent!

This is why it is not enough as a dentist to be great at diagnosis, or treatment presentation and clinical delivery. The goal has to be absolute excellence in all areas of practice performance. All the links in the chain must be just as strong, because when slippage like this occurs, the losses don't just add up – they multiply.