#252 3 Core Steps to Solve Your Capacity Crisis (Without Hiring More Hygienists)

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Learn how a rapidly growing dental practice solved a major capacity problem without immediately hiring more staff. In this episode, Gary Bird and Dr. Shane break down practical dental practice growth strategies, including improving new patient flow, increasing case acceptance, optimizing hygiene scheduling, and scaling a dental office while controlling overhead. Discover real-world insights on dental practice management, new patient systems, team workflow optimization, and how to sustainably grow a dental practice.

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Website: https://carolinapinesdentistry.com/

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Dental Marketing Goat, the go-to podcast for dentists who want to grow faster, market smarter and build practices that thrive in today’s competitive landscape. Hosted by Gary Bird, the Dental Marketing Goat himself and founder of SMC National - recently named Best Dental Marketing Agency by over 60,000 dental professionals. Each episode unpacks the real strategies, marketing frameworks and operational shifts that high-performing practices use to attract more patients and increase production. Whether you're a solo practitioner or scaling a DSO, you’ll learn how to align your marketing, team and systems to drive predictable growth.

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Transcript

SPEAKER_00 0:00

You're seeing a ton of new patients. Your collections are growing. Like everything's going in the right direction. But then now you started to run into a capacity issue.

SPEAKER_01 0:07

We had a great new patient flow. We were growing, we're growing. We had three hygienists that were well with our new patient blocks were blocked out. We were having to push out new patient hygiene visits for, you know, three, four weeks at a time. And our goal in our practice is to get them in within a week or two, or they're going to go find, you know, someone else down the road. Do we hire someone? And we all know like hygienist hiring right now is kind of like finding that unicorn in our current market. We realize, okay, we hit capacity again. Let's add it again. So then we had to go through the pain of that. Like we didn't have the spot to do it. And I couldn't necessarily give up four days of my time to make this happen.

SPEAKER_00 0:44

Hey, welcome back to another episode of Dental Marketing Go. I'm your host, Gary Bird. Today we have a special guest, one of our clients, Dr. Shane. In the last episode, he shared how his practice grew from two to three million dollars in collections, and he is on a path to four million dollars. He's gonna dive into what is holding him back as an office, which was capacity and how he solved it. This is one of the biggest issues that we see is that new patients just can't make it into the dental office fast enough. And then that prevents offices from growing. So in this episode, he's gonna dive deep into that, how he solved it, and how he made sure that everybody's happy, his doctors, his hygienists, and his whole team. This is a great episode. You gotta listen to this all the way through if you want to make sure that you have the capacity that you need to grow. Stay tuned. All right. So you were just explaining something really cool to me, Dr. Shane, and your practice has been growing like crazy. And when you grow, a lot of times everybody wants to grow, right? But there's things that come along with growth that you don't necessarily, there's no way to plan for them. There's no way to know. It doesn't matter how many masterminds you're in, all those kind of things. And then you just have to solve them. And you you were really growing, you're seeing a ton of new patients, your your collections are growing, like everything's going in the right direction. But then now you started to run into a capacity issue. And so obviously you can always hire, but hiring's very expensive and you don't want to hire too soon. So could you walk me through what you did to solve the capacity issue? Because I think a lot of people have this problem.

SPEAKER_01 2:18

Yeah. So we actually have two capacity issues, one that I'm currently in and one we were in like six months ago when we started this process. So we'll back up and kind of paint the picture six months ago is you know, we were we had a great new patient flow. We were growing, we're growing. We had three hygienists that were well with our new patient blocks or blocked out. We were having to push out new patient hygiene visits for you know three, four weeks at a time. And our goal in our practice is to get them in within a week or two, or they're gonna go find, you know, someone else down the road. So we ran into that issue. It was like, well, how do we, you know, how do we grow that? Do we do we hire someone? And we all know like hygienist hiring right now is kind of like finding that unicorn in our in our current market. And some doctors kind of turn their nose up as what it's gonna cost them to add that in and increase overhead and how's that gonna be sustainable in that in that situation. So we actually got kind of creative with it, and it's worked really well for us the past six, seven months and created another capacity issue. But I knew I wanted to grow our new patients more, but we didn't have the spot for it. So what I did in that situation was like, well, who do I have on my team that can help me currently and how can we shift some things around to do that? Personally, for me, I was kind of a gas pedal full throttle, right? Like I didn't have time as a CEO or admin or whatever you want to call it for designated time to work on my business. And what I mean by that is, you know, auditing our systems, doing regular check-ins, doing coaching time, exploring marketing ideas, like how can we grow with those things. I didn't have the visionary time that I needed to keep us going. So I I paused and we started out with just kind of two days a month that I would designate a whole day where that would kind of be my focus on that. But what I did was now that I had an empty chair that's just sitting there, not producing, I took my assistant and made her what we called the new patient coordinator in our office for that day. Um, along with that, she worked with one of our hygienists that we would what we would do is basically kind of stagger a new patient in my chair in the hygienist column. And in our office, we do a two-hour visit for a new patient. We do photos, extra oral photos of the DSR camera, we do X-rays, 3D, intro scanning, all that stuff. We do a very thorough, comprehensive exam for the patient. So we take our time on that. But what we did was we staggered that. So it would start every 30 minutes or so and go out through the day. And the assistant would basically introduce the patient to the practice, get them seated, take their records, say, Hey, I'm the new new patient coordinator for the day. I'm gonna walk you through this process, get all the diagnostics, usually do the exam with the doctor if the time permitted right for the schedule. And the hygienist would come in and just clean teeth, do her thing, and then and we would do that shift all day long, right? It works really, really well because we could build a treatment plan, pass that off to our treatment coordinator while the hygienist was cleaning teeth and it was ready to present, ready to roll. It was like this nice little flow. Now, there were some kinks at first to work out, like the team was a little confused and there were some struggles. So I'm not gonna say that it was all rainbows and unicorns when we first did that because it was a very, very And what month did you start this in? I want to say we started sometime around like August, September-ish. Um, I believe that's when we started started doing that.

SPEAKER_00 5:49

Yeah, so let's talk through some of the problems. Like what, like the first thing that I can think of that would be a problem is uh like people are like, Wait, wait, that was my job. Why are you giving away my job to somebody else who's not, you know, and there's not that you can't solve it. I've seen people solve all those kind of things, but that would be the first thing that I could think of.

SPEAKER_01 6:06

It was really just like the the flow, like who's responsible who's responsible for what part of the appointment? Like, is the assistant responsible for getting all the diagnostics here? Are they responsible here for that? Who's responsible for that? So it's really we like consistently every week we after our huddle, we would huddle again with just them two and kind of be like, okay, here's our process for the day, right? And then, you know, there's some Swiss cheese built in there as you stagger the schedule. Like it's not, there's there's definitely some gray area just in case like a patient's gonna show up late, or maybe that patient needs SRP and we can start a quad that day or something like that. Like we would work that production in the schedule, right? So we gave definitely some some fluff in there, but really it was just kind of the clarity on like who is responsible for what for each patient between the assistant and the hygienist. And you're right, like our hygienists are incredible, they do a lot of things. They talk about the photos of the patient, they bring up awareness, they talk about permission of choice and all these things on how to talk about the photos and get them prepped and primed if they want to do treatment. But it's almost like, hey, you need to turn your brain off from that. I'm gonna put you back into just being the tooth cleaner. You've got to go back and just focus on cleaning teeth, right? Like we're like I'll lead with the assistant, the new patient coordinator on the treatment and all that stuff. So that was a little bit, a little bit of a shift and change. Like the hygienists had to had to kind of reel it back a little bit on those days. Some are very motivated by tracking their production as well. We don't pay on production in my office, but that was like a thing because if they weren't taking the x-rays and stuff, like it was making their numbers look, you know, kind of down. But in reality, it wasn't, it was actually better. Like if you added everything up, like when you saw nine new patients in a day, it was it was a pretty good day for for that hygienist, um, especially if they threw in a quad of SRP or you know, gingivitis cleaning or whatever you whatever you call it in that situation. That was kind of the biggest struggle. Some of the team pushback I got too was like, well, it's gonna look kind of weird them seeing two different people, two different team members in the same visit. And and honestly, that was just kind of like it really ended up not being that big of a deal.

SPEAKER_00 8:16

I as a patient, I'm a patient and I have no idea what's going on when I go to the dentist, like no clue. Right.

SPEAKER_01 8:21

Yeah, it's just like whatever you're explaining to me, if you explain it to me, I'm like, okay, like that's it was it was totally fine because they see you know, they see three, they see four or three, four people at a time. They see the front desk, right? Then they saw the the new patient coordinator, then they saw the hygienist, then they saw the treatment coordinator. You know, and and honestly, you get these handoffs, and that's the biggest thing is like we didn't want a patient to go without a handoff. They had to be touching someone at some point all the time. So that was we were super clear with that, just no like awkward waiting as best we could. But those are those are really kind of the kinks, just just clarity, honestly, on who's responsible for for what. Once we found our groove with it, though, it was just like sky cracking. Boom, boom, boom. Um, it was great.

SPEAKER_00 8:59

Yeah, it looks like it you've you're you're on pace to hit 80 new patients this month. So that which would be a record, you're on pace for a record new patient month.

SPEAKER_01 9:07

Yeah, so now we've ramped it up to doing it basically every Monday. So we're doing that until we get our other high, we actually do have four hygienists now, but we have some maternity leaves that we're kind of going through. So it's worked really, really well for us to add capacity to add those eight, nine new patients, you know, a month for us instantly. I knew I wanted to kind of invest in more marketing, but if you do that and you're spending dollars, you want to make sure you've got somewhere to put those people. And it was it allowed me not to have to hire another hygienist. I already used who I had. Some overhead for my team didn't instantly kind of pop up and I had this worry of like, how am I going to account for this and and going through that? And it worked out, it worked out good. Honestly, for me too, as a doctor, like it was a good change of pace. Being able to focus on like administrative things in between the new patient exams, I kind of stacked those to where I could go downstairs and knock both of them out and come back up and then re-refocus. It allowed me to work on the business a lot more to get some of that free time back. Yeah, I I lost like two days of like me potentially working, but guess what I did? I have other associates, so it changed my my schedule for my other days when I was in the chair, right? So I didn't my production actually went up.

SPEAKER_00 10:19

Wow. And so and your associates' production went up too?

SPEAKER_01 10:23

Yeah. Oh yeah.

SPEAKER_00 10:23

So everybody's production, so everybody ate, everybody won. No one took a everybody won.

SPEAKER_01 10:27

Nobody took a hit.

SPEAKER_00 10:29

So if the new patients are getting in faster, they're getting more treatment done, your team is running smoother, and your doctors are all doing more dentistry, like there really isn't a loot. Like, those are the kind of situations you want to create.

SPEAKER_01 10:41

Yeah. The biggest hurdle of Gary to get started with this, though, is like and we did this now when we added it to four days, four days a month instead of two, is like you're our schedule's so booked, how do we even build this in? Right. So that that's hard. A doctor may have to go out, you know, plan for the six months out from now and start it and start it then rather than trying to do it all all right now, especially if you don't have current blocks in your hygiene schedule as it is.

SPEAKER_00 11:08

Yeah. So so what were some other unintended consequences of doing this? Because I know uh you you checked all the boxes of the right things, right? So that's good, but I already know it caused other problems that you had to solve down downstream.

SPEAKER_01 11:21

Yeah, so that's where that's kind of where we're at now is like we realized, okay, we hit capacity again, let's add it again. So then we had to go through the pain of that. Like we didn't have this, we didn't have the spot to do it. And I couldn't necessarily give up four days of my time to make this happen. So I had to change my schedule again, which led to changing my blocks again. And it was just kind of this cycle of how do we how do we play this jigsaw puzzle? But now that we have it figured out, like it took us a few months throughout this year to get it, we're we're gonna start rolling again. But it built the backlog of patients that I obviously didn't expect or have the foresight to see six months from now, like we're booked so we're we're seven almost eight months out for a recall exam. So if we have someone fall off the schedule now for recall or perimaintenance or whatever it may be, like, sorry, we'll put you on an ASAP list, but we're gonna have to see you, you know, out in whatever it is now, like November or something, like something crazy, right? And that's not good. People don't want to, you know, if they're sick for the day, they don't want to feel like they're being penalized for you know being sick and not being able to get back into your hygiene schedule for another six or seven months. So that's where we're at now. That's what we're tackling. Just kind of added a new chair in the office and a consult room to allow me to continue to work and then open up that other spot. Um, like I mentioned, we do have another hygienist on. We we had eventually we had to hire because what we did essentially is we we ramped up hygiene, we ramped up the capacity to justify the fact that hey, now we need a hygienist to to sustain this and we and we can sustain it. So rather than hiring that person off the start and then trying to ramp up, we ramped up first and now we can hire that person and just go and just go at it.

SPEAKER_00 13:04

Yeah. And you can keep doing that over and over and over again. So it's like you like it, it's much easier to do that. I and I think a lot of dentists do get stuck on the you know, the chicken and the egg or the horse in the cart, like which one goes first because it is confusing. So that's cool that you figured it figured that out. How how long are your new patient appointments?

SPEAKER_01 13:22

Two hours.

SPEAKER_00 13:23

Two hours. Okay.

SPEAKER_01 13:24

Yeah, we ran a two-hour new patient.

SPEAKER_00 13:25

Okay, and patients are pretty good with that.

SPEAKER_01 13:27

Yeah, again, we set the expectations on the phone. We've done phone training, phone scripting on that. Like, hey, yeah, the first visit's a longer visit. It's because we we do XYZ, we do photos, a doctor wants to spend time with you, you know, all these to introduce you to our practice. Moving forward, it will be your normal like one hour visit that you normally have.

SPEAKER_00 13:46

And that includes the cleaning or no?

SPEAKER_01 13:48

It does, yeah. Yeah, it includes the cleaning.

SPEAKER_00 13:50

Yeah, that makes sense. Okay. And then what were some of the things that you had to work on with your doctors from a scripting standpoint to kind of make this work? Because I feel like it's almost you're playing more of a game of Tetris, more so than a I don't even know what it would like what you were doing before, but like how I describe it. But it's like Tetris, where it's like, hey, we're kind of doing this on the fly. So what were some things I know you're really good with patients? So what how what'd you work with with your associates?

SPEAKER_01 14:15

Well, I think a lot of the times the the associates, what we did on the new patient day was like, hey, you guys, I want you guys focused on your your craft and your clinical skill. I'll handle the new patients in that situation.

SPEAKER_00 14:26

Oh, okay.

SPEAKER_01 14:27

So, and then I've again live in this minded mindset of of abundance, like it's not because I want to see how the new patients and cherry pick all this work, because I'm honestly cutting back clinical time, right? So I don't have the time to do it. But what I will do is I will build a rapport of the patient, gain the trust of the patient, tee up the treatment, get them ready, and they'll go back on, they'll go back on you.

SPEAKER_00 14:47

Yeah. And I think that that opens you up to more opportunities because you can bring in younger associates, you can bring in people who aren't as skilled maybe with the person side, but they're skilled on the like there's lots of dentists that are like extremely skilled clinically, but they're not as great on the you know communication side. And you know, you it it gets it can get rough when you're just bleeding new patients through an associate. So you see on those days, you're seeing all the new patients, you're setting them up for your associates, and they're happy because they're doing all the treatment. And and I I can already hear a doctor is like, Whoa, wait, wait, wait. So the doctor, how do you get the patients not to want to stay with you, Dr. Shane, the owner? Like, so you're you're are you hyping up the other associate in a certain way?

SPEAKER_01 15:32

Yeah, I mean you you you kind of have to. It's it's one of those things where you you have to understand that it you live kind of in your in your niche. And whenever I bring it up in conversation, I don't we we had to work with the team a little bit. Like it is an option, but it's not an option. And and what I mean by that is like I know my youngest associate, bread and butter, great clinician, is awesome dentistry. That's that's his wheelhouse. So if I have someone who comes in who needs quadrant, you know, posterior crowns or something at a time, like that case is gonna go to him. And I'm already thinking, like, okay, when I say this to the patient, like, hey, you know what? You're gonna see Dr. Nick, his or associate. This is what he loves to do. He's the best at this, he handles all these cases in our practice. And it's kind of like I I already have that conversation or tee that up with the patient to let them know like they're not gonna see me. If they want to see me, like those are things that you've got to look at your menu of services and be willing as a doctor to take things off your menu and being okay to say no. And honestly, I haven't got that much pushback from from a lot of patients on that. If you just have that conversation, like, this is what they do every day, this is how they this is how they serve this pot, this, these people in our in our practice. They're gonna take amazing care of you. I've let them work on me. Like saying things, yeah, saying things like that is just like go ahead and have that expectation set for them before they get to the treatment coordinator. So that way the treatment coordinator is not the one having to like break the news and try to convince them and stumble. Like if they're hearing it from the the doctor, the owner already, uh, you know, it's less of the less of a barrier.

SPEAKER_00 17:12

What do you foresee as like like what how do you foresee this rolling out in the future, right? So let's say right now you're gonna you have a record new patient months, you're gonna see 80 new patients. You're gonna continue to have to grow your new patients to get to your goals and your long, which we talked about on the last episode. If people want to talk, go check that out. But uh to continue to do that, you you know, let's just say you're gonna get to 120 new patients or 140 or whatever it may be. How how will you deal with that at that point? Will you train one of the other dentists to come in and do some of the things you're doing up front, or will you retool or evaluate at that at that time?

SPEAKER_01 17:44

Yeah, that's kind of what we're talking about in the practice now, is that even now with my leadership style this year, things are still evolving and changing, and I'm pulling myself out even more and more in the practice because I want to get to the point to where the practice like wants me but doesn't need me. So I'm trying to kind of replace myself in the sense that maybe we can level up one of our other associates to handle these new patient days or these new patient conversations to where they're getting they're getting people on board and they're okay with offloading and giving it. And we have that. I think an associate has to have like almost an ownership mentality to do that, and that's hard, that may be really hard to find. But I think if you understand, and mine's been with me for a while, like we're all gonna kind of scratch each other's back here. It's not like a which you kill type of thing, like we're all gonna spread that around because we each have our niche. Um, but that's that's the goal, and that's the kind of the conversations we're having now is to is to work on the soft skills, the communication part of it, and that stuff to get patients down that pipeline.

SPEAKER_00 18:46

That's awesome. This is really good stuff. So these are the kind of things that you have to continue to work through. And I I think a lot of times uh people just have this preconceived notion of like just give me more new patients and then I'll be good. And it's like, it's never that easy. Business, if it wasn't that easy, everybody would just do it. You know what I mean? And we'd all but gone are the days where you just kind of hang your shingle and just things just happen. You you have to really be intentional. And I love how much thought you put into this and you're willing to try different things and convincing your team to try different things. That's big. Getting them on board with that. And and then everybody wins.

SPEAKER_01 19:20

Yeah, we made you know some of these decisions to you. Like, I'm I try to be better as a business owner of like not making emotional decisions. What we've what we saw, the reason that I pulled pulled out some of my time and got back into hygiene or new patients is because once we ran the numbers on when I how many new patient exams I did in a month and the production from following the month versus when it was lower and then that production, it was clear that you know I was better at getting patients to say yes to treatment, whether that's through honestly, I think it's just relationship building. Like I just I genuinely like talking to people in those new patient days. Like my hygienist was like, You're kind of like a different person on those days. And I was like, Yeah, because it's it's fun for me. It's like a it's like a new challenge. Like, how much can I, and not unethically, but how much can I treatment plan on this patient and see how I can get them to do it, you know? And and it was all for their benefit. I don't want to do anything wrong, but no, no, no. It was just it was just fun to try to put that puzzle together for me.

SPEAKER_00 20:15

Yeah, there's there's a uh rule that I learned about it's called 100% case acceptance. And I know people hear that and they go, what is that? And it's like, you you will, if a new patient comes in and they schedule more treatment or schedule their next hygiene appointment and come to it, either one of those, you will get 100% of all the treatment from that patient for their entire life, plus patient referrals, which you guys are doing great on your patient referrals. However, the opposite is true too. So when you were bleeding some new patients where they were coming in and then bouncing and not getting anything, you get 0% of all of their treatment. Someone that treatment goes to another office, and you lose all those referrals as well. So just by changing top, we call it top of funnel, right? So like in my company, I touch dentists 10 to 20 times before they get to our sales team because I want them indoctrinated and like, here's how we think, here's how the right way to do things. This is I don't want them coming in cold turkey and being like telling us, hey, do it this way, you know, I've been burnt by dent, you know, dental marketing companies before or whatever. And so I interject myself in the conversation. Now we're digital, so I can use videos and cool things like that. But you that's what you did is you interjected yourself at the top of the funnel, and then now you're reaping the benefits down at the bottom of it.

SPEAKER_01 21:30

Right. Yeah.

SPEAKER_00 21:31

Awesome stuff, man. That was really good. Any other comments or thoughts? Any any questions that you would if a dentist was listening to this that they would ask about this?

SPEAKER_01 21:40

I mean, they can always reach out to me and I can always share some more struggles because like I said, it wasn't, it's it's not always like great and grand. There's definitely some things that we had to to work through initially and then a little bit on the way. But you know, we did catch fire on it, and then then it created a new problem. And that's kind of I'm kind of, you know, let's create a problem then. Let's find a solution. Let's not worry about stuff until it kind of gets here and we'll we'll kind of figure it out from there. But if you do that, if you do it correctly, just expect there's going to be some more issues that pop up later on. Uh, but enjoy enjoy the ride and enjoy it.

SPEAKER_00 22:15

That's that's one thing in business, and I'll I'll let you go. But one thing that I've learned is I I used to be hyper focused on a destination, and I'd get there, and it was like I was already bored with that destination because I've been working two years to get there. I'm like, whatever. I'm more and I already moved on to my next destination, and that really burnt my team out around me because I was they're like, We did it! And I'm like, dude, I we should have hit that like six months ago. I'm already on to this next thing. And I once I started learning how to like, no, no, no, no, the the destination, it's great, whatever. I'm just gonna set new ones all the time. And it's kind of arbitrary, to be honest with you. Like, it's this big or this many customers or whatever. I'm just a random number that I'm picking bigger than the one that I have now. But it's learning how to enjoy the journey. So as I learned to enjoy the journey, and the the journey was like, and it sounds cheesy, but it's like that's the exciting part. It's like I'm gonna learn something new through this process that I didn't know before, and it's gonna help, and I'm gonna help my team figure it out and all those kind of things. And business, if you can learn to do that, business is so much easier. It just makes it less stressful.

SPEAKER_01 23:18

Yeah, it's just more fulfilling. I mean, again, I I think a lot of fulfillment in life is just the relationship you build, and you're gonna build some going through some hard stuff. So you're gonna build it with your team, you're gonna build some with your patients, and that's where that's kind of where the fulfillment comes in.

SPEAKER_00 23:31

That's awesome. Well, thanks so much for coming on, and I appreciate you uh sharing this. And I know it's gonna be a big help to people.

SPEAKER_01 23:36

Yeah, man. I appreciate it. Thank you. All right, peace.