Adding Evening Hours Without Killing Your Culture

Your practice feels maxed out, but you’re not ready to build more operatories or move locations. So what’s the lever most owners ignore? Hours. We talk through why adding evenings or Saturdays sparks instant fear in dental teams, and how to lead that change without breaking trust, creating burnout, or wrecking your culture.

We share the shift design that makes expanded hours feel fair: stop treating the day schedule as “normal,” rotate intentionally, and start small so the team can experience the upsides. We also dig into how to present the change so it lands as better patient access and more flexibility, not “work later and work more.” If you’ve ever worried that one resistant team member could derail the whole plan, we address that head-on with a practical leadership stance you can actually use.

Then we zoom out to the business side of dental practice growth. If you want to hire an associate in a smaller office, the math matters: hygiene capacity, production hours, and new patient flow. We unpack why simply sliding over a chair can make you less profitable, and why split shifts and expanded hours often create the room you need without adding square footage. We even share real-world results from high-performing small-op offices that prove the model can work.

If you found this helpful, subscribe for more practice owner strategies, share it with a dentist friend who’s stuck at capacity, and leave a review so more owners can find the show. What hours change would move the needle most for your practice right now?

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Transcript

Why Hours Changes Feel Scary

Paul Etchison 0:47

Now, I've been coaching with dentists for the past eight years now. And every single time I bring up with a client, the idea of adding evenings or Saturdays, I can see the fear immediately. People say, my team would never go for that. That would destroy our culture. We've never been like that. We've never had nights. We've never had weekends. Nobody wants to work them. I can barely keep my office staffed as it is. And I get it. It makes sense. Anytime you make a major change in your practice or change your hours, it can feel like this cultural shift is going to change everything. But here's the truth expanded hours don't wreck your culture. Poorly designed expanded hours can wreck your culture. And that's what we're going to be talking about today. So many doctors are in the position where they don't have enough operatories to run two doctors with four hygienists. So what are you to do if you want a DPH style practice in a smaller, less than eight operatory facility? What do you do? Well, you expand. And how do you expand without additional chairs? You expand your hours. And that's what we're going to be talking about today. Now you're listening to the Dental Practice Heroes Podcast, the podcast for practice owners who want to work fewer clinical days, increase their profits, and build a team-driven practice that runs without them being the bottleneck. I'm your host, Dr. Paul Etchison. I'm a dentist, I'm a coach, I'm an author, I'm the owner of a multi-doctor practice in the south suburbs of Chicago, beautifully called Nelson Ridge Family Dental. And today we are going to be talking about how you can add nights and Saturdays strategically without losing your team. We're going to make it easy for you and show you the possibility. Now let's talk about the reality of the reaction. When you first introduce the idea of evenings, the reality is always going to be negative. And why? Because it's change. And change will always feel to some extent feel threatening. But most of the resistance that you get from this, throwing this out there to your team, I promise you, it's not really about the hours. It's about the fact that it's change. So we need to look at how are we framing this? How are we presenting this to the team? Because if you present it like we need to work more, we need to work later, we need to stay here longer, you're going to get pushback. But if you present it in the proper frame, like, hey, we just really want to increase access for patients and create opportunity for our team, because that's literally what we're doing. That sounds a lot more noble. And the conversation can shift the way that your practice and your team members are reacting to this idea of expanding the hours. Which brings me to our first point. I want you to plan this shift. I want you to design it. I don't want you just to just throw it together and announce it. Plan how this is actually going to work in your practice. So I'll tell you how we do it in my practice and how I suggest it for most of my coaching clients is that evenings, they don't need to be mandatory across the board. It's not going to be one team is going to work the evenings, and one team is going to work the normal shift. And I want you to just erase that verbiage all completely. The day shift is not the normal shift. It is just that. The day shift. It is not the normal, and the night shift is the abnormal, the outlier, the unique one, the one that nobody wants. So these things should be rotated with your team. They should be intentionally staffed. And that takes some planning. Now think about this. I have an office open 7 a.m. to 8 p.m. We have two shifts. We have the morning shift and we have the night shift, okay? And you can do it all sorts of ways. I know Dr. Henry Ernst, he does 12-hour days where it's just one team works the whole day through. That's an easy way to do it too. If you did three 12-hour days, that's 36 hours. You can enjoy your four-day weekend. You know, that's kind of a benefit. You could frame it like that. If you have an office like mine that's open four nights a week, you can staff those evenings with just each person on your team working just one or two evenings a week. Now, what does this look like when they work in evening? Okay, you got to frame it in a certain way. Is that when they work in evening, they have all day to maybe till 1 p.m. Maybe they get their kids on the bus, it's eight o'clock. They have another five hours to do all sorts of stuff, catch up on errands, catch up on the housekeeping, to do doctor appointments, all these sort of things that you don't normally get to do when you're at work every day. So a lot of people, once they start doing this, they will realize that they really actually like having that one or two days a week. They get that late start. They can sleep in, and it really gives them a little more flexibility on what they're doing with their kids that day. So for me, I'm the leader of the practice. I'm not going to make my team do anything that I don't do. So you know I only work just a few days each month, but that my clinical day is Tuesday evenings. I work. I do work the evening shift. It's my only clinical day. And honestly, I prefer it like that. I am not an early riser. And even when I was an early riser, I did prefer to have my mornings for more focused work on things that I was growing and things I was doing. Like, such as in your case, if you're a solo practice owner, you can use that time to work on your business. So I prefer it. But would I want to do it every day? No. I have kids. I would never see them if I did it every day. But once a week, twice a week, I've always done it and it's always been that way. Now, if you have a startup practice and you lead with this, you make this part of your culture when you open your practice, which I would highly suggest if you're the solo dentist, you have that. You always have two nights a week that you're there because then your team will always be used to working two nights a week. But if you've always been a daytime office, don't just roll out five nights all at once. Here's what I want you to do. I want you to start small. You start with one evening. You try it, you let the team experience. You might even have to grovel a little bit. You might have to get down on your hand and knees and be like, guys, I just want to do this for the patients. I'm going to be here too. You know what? You could do anything you want in the morning. And we'll be here at night. We're just going to be here maybe two, three hours later than we usually are. It's not that big of a deal. Could we just try it for just like a month or two and just see how it goes? I promised you, when you try it, it's not going to be as bad as you think it is going to be. Your team is going to feel the same. So start with one evening, let the team experience it, normalize it. And over time, that thing that feels foreign, it's eventually going to feel normal. And here's something else I want you to really think about. And I've said this to so many different coaching clients is don't let one loud person with a negative attitude that is very resistant to change dictate your strategy, nor dictate the type of practice and the lifestyle that you want your practice to deliver for you. You cannot build the practice that you want if you are held hostage to one vocal team member. You went to school for a very long time, you risked a lot of things, you put a lot of money, you took out a lot of money in loans, you borrowed money to open this practice. You have done a lot to have the flexibility and freedom that comes from practice ownership. Don't let one person, someone, one nasty person, just dictate the whole thing and say you can't have evening hours. If you want them and they are part of you having a DPH style practice that gives you the freedom and flexibility that we all want, you've got to just grab it. You got to say, you know what? I will take everyone's feelings into account. I do care about them. But you know what? At the end of the day, it is my practice. And if that person is going to leave over that, so be it. You will find somebody that will come into this and will be fine with it. I can tell you, we're open four nights each week. When we hire a new person, they don't just like take the job and start griping and groaning about the fact that we're open four nights a week. It's just the way it is. So the only people you're gonna have griping and groaning about this is the people that go through this transition with you. And I promise you, 75% of them, they're gonna like it. They're not gonna really care. They just don't want to work four nights a week. They want to see their families just like you do. So once you start with that one evening a week and you get that and you get that rolling, that's when you're gonna start pushing a little bit further down the line. Maybe you're gonna add a second evening slowly, easily. It's easy change. And that puts you in a position. Now, if you're in a smaller practice that has less than eight operatories, that you can bring on an associate. Now you've got two nights that you can split shift. Now, what I mean by split shifting is you have a morning shift and an evening shift. You can clinically come in in the morning and have the associate work on that evening shift or vice versa. But what's nice about this change is that anybody that was originally on that evening shift, the only change they'll experience, they might shift into the morning shift. So it's a positive shift versus a lot of people, they bring on the associate, they jump into split shifting, and now all of a sudden you've got team members that are working two, three nights a week and they don't like it. It's a lot of change. It's too much too fast. Now, let's talk about Saturdays, because you know, a lot of us would really love to have Saturdays open. It's a very easy day for you to book because patients want to see that and they don't want to take off of work. So, what do you do with that? Now, this was a change that came later in my practice. We were always open four nights a week, but then eventually we added the Saturdays. Why do we do this? What really spawned this for me was that we were hiring an endodontist, and this endodonist could only work on Saturdays. So the only way I could have this endodontist in my practice is that if I opened up Saturdays. So it was something I pushed for. A lot of people complained, but I was able to ask enough people on my team, can you please just try this for me? So, what did we do? We were open two Saturdays a month. We rotated it. Nobody worked both Saturdays. And who were the people that worked these Saturdays that rotated? They were the newest hires. So when we would hire somebody, we would hire them on the basis that they're available for every other Saturday to work on the Saturdays. So that's my thing is like even if you don't have the people on your team, you can hire into them. Don't let that be a roadblock to you. So that's a lot of things to think about, but that gives you so much more flexibility as a practice owner to be able to see your patients and think about the thing it's doing for your community. I mean, you're being available late for every emergency. You are the place in your community where people don't have to take off work. There's a lot of people who can't really get off work two times a year to come in for their dental cleaning. So they look for an office that offers these evening hours. Now, what do they do when they come to your office when they're just blown away? They say, Oh my gosh, this is the most amazing experience I've ever had. They will turn around and they'll say, you know what? I'm gonna get the rest of my family in here. So, you know, I've talked to so many practice owners that have done startup practices where they've acquired a practice and they had just this exponential growth. And I can tell you, most of them were open evenings because it's such an easy way to generate growth. It's such an easy, marketable attribute that you can just throw out there and people like seek it. People like they look for it when they're Googling, like, I need a dentist tonight. They see that your hours that you are actually still open. Think about the opportunity it's gonna give you as a practice owner. So otherwise, your only other option is to expand your practice and get up to eight chairs. Because there's no way to have two doctors there at once if you don't have enough hygiene feeding it. Now, let me share something with you that I hear a lot of people do. Let's say, for example, five operatory practice, okay? Five operatory practice, and they say, I'm gonna bring on an associate. I'm not gonna cut any of my days, but I'm just gonna move myself over so that that associate can have one chair. I will continue to have my two chairs and I will have two chairs of hygiene running. And then they wonder why it just doesn't work because the math doesn't work. You need enough new patients coming through your practice and you need enough recall patients in your hygiene to feed that doctor. And what's gonna happen is you're going to back off and you're gonna give the doctor most of that production. But the thing that you now did is you just exchanged your production for that person's production. And then you wonder why when you brought on an associate, you started making less money and having a whole lot more headaches. When you bring on an associate, there needs to be some expansion of hours. There needs to be additional hygiene chairs, additional production hours. That is the only way that you can bring on an associate, make room for that associate, and continue to have more profitability and more money that you get to keep as the owner at the end of the year. So don't think just because you have those chairs, you can just slide over. You need to have the proper amount of hygiene going into it. Hygiene to hygienists per every doctor. You need it. And then here's another number for you. I find that it's 35 new patients per associate doctor. Now, if you are a more skilled dentist, super generalist, you're doing a lot of procedures, obviously, you're not gonna need as many patients coming through because you're gonna diagnose and treatment plan, you're going to keep more things in-house. You don't need 35 new patients. I don't think I personally need 35 new patients. I am a more comprehensive treatment planner who is going to put more things on a treatment plan typically than my associates will. But that is the number I have found my associates typically need. So part of growing your practice is this level of when you reach the solo GP, you've reached the capacity point. And now what do you do next? It's time to bring on an associate. If you have less than eight operatories, you're gonna need to split shift. Don't wait until then to start adding the nights. Add the night preemptively, add one night a week. And then maybe when you make that shift to bring on an associate, you can add that second evening. Or what I would suggest is eventually add that second evening before you even get to the point of having that associate. Think far ahead. It is gonna make your job so much easier. Now I can tell you, back in 2018, when we were five operatories, the most we did, I was three days a week. My associate was five days a week. We had four nights that we were open, three of which had a doctor. One was just three or four hygienists, just seeing patients without a doctor, no exams. We did and collected about 3.35 mil in 2018. So I don't know what that's worth like today's dollars, but I'm talking about the collectible dollars, adjusted production. That wasn't like before write-off and stuff. I just recently had somebody in my podcast that had a five or six op. I can't remember if it was five or six ops, but it was definitely it wasn't having two doctors there at the same time, sort of size office. And they were doing about five and a half million dollars out of that office. How in the world do most people get to like 1.5 million, maybe out of five ops? And they say, Oh, I need to expand. I need more chairs. I can't possibly get anything more out of this. I assure you, you can. And your practice, when you start utilizing it in that manner from morning till night, so many days a week, all one location, all out of the same small, maybe five, six ops, you start to become insanely profitable because you are just outpacing your fixed expenses insanely. So do not be scared to do that. Do plan for it in the future and make sure that you do it incrementally. Otherwise, it is bound to cause a ruckus in your practice. And we never want to ruckus in our practice because ruckus makes us stressed, right? Totally, yes. So reframe it cultural shift. The evenings, it is not we are working later, it's not we're working more. It's we are creating opportunity for our patients. We are creating an opportunity also for more revenue, more flexibility and schedules, more access to care for a lot of people, and more growth. It's going to the more people that come into your practice, the faster you're gonna grow as long as you are delivering a solid patient experience. So when you design this correctly, it will be a good thing for your practice. It will reduce the amount of pressure that you're dealing with a day-to-day financially because your income is going to outpace your expenses so much. So, closing, if you are thinking about someday you're gonna hire an associate, please reach out to us. We will help you take you through that transition. Go to dentalpracticeheroes.com slash strategy, set up a strategy call with me. But if you're thinking about hiring an associate or expanding your operatories and obviously growing your practice, you gotta ask yourself first before you do that. Have I fully utilized the current box that I am in? Expanded hours, it's not extreme. I mean, it's not so many people do it. So many people are working nights, so many people are working weekends. I mean, get yourself out of dentistry and look at all the other industries. People work on nights and weekends. It's not unusual, but be strategic about it. Design the way you want it, design the way the team's gonna work it, present it properly and roll them out intentionally. And lastly, such a big thing. Don't let fear dictate your growth. Don't let the fear of the unknown or the fear about the way your team is gonna react dictate the fact that you're not gonna have the practice you want. If you're sensing anyone on your team is upset, talk to them about it. When we get into trouble, is when we don't bring these things to light and we don't talk to the people about it. If you're sensing somebody's upset, call it out, have that conversation. I know you can do this. So many of my clients have done this. And if you want help doing this, I'm happy to take you through this transition. We do it all the time. We've done it so many times before. If you want that associate driven practice where it's not all relying on you, that is exactly what we know how to deliver with our seven phase omnipractice system. We would be happy to take you through that. Thank you so much for listening. I really appreciate you spending some time with me today, and we will talk to you next time.