Your Dental Practice Doesn't Need Another January: September Already Has the Receipts

3 days ago

10 min read

By Sarah Beth Herman, MBA, Founder & CEO, Dentistry Support®

As the year begins to move toward its final quarter, many businesses start shifting unresolved issues into the category of “next year.” The schedule will be addressed in January. Accounts receivable will be reviewed after the holidays. A difficult employee conversation will happen in the new year. Expenses will be evaluated during the next budgeting cycle. Operational improvements will begin when things slow down.

But January is not a business strategy.

A new calendar can provide a fresh starting point, but it cannot resolve a problem that already exists. If your practice has aging insurance claims today, those claims will still be aging on January 1. If your front office is overwhelmed because too many responsibilities have accumulated in one role, a new year will not redesign that position. If you are paying for software or services no one actively uses, those expenses will continue unless someone makes a decision.

And if the same operational problem has appeared repeatedly throughout the year, another planning meeting alone is unlikely to solve it.

Before you begin creating goals for 2027, consider a more important question:

What are you calling a 2027 goal that is actually a 2026 problem?

That is the focus of this week’s Dentistry Support® FREE TRAINING.

The Challenge Is Often Not a Lack of Ideas

Most dental practice owners are not short on ideas.

You may already know that case acceptance could improve. Insurance follow-up could be more consistent. Scheduling systems could operate more efficiently. Team responsibilities could be clearer. Expenses could be reviewed more carefully.

You may also have a list of systems you want to implement, positions you want to add, services you want to grow, and financial goals you want to achieve.

The challenge is often not identifying what should improve. The challenge is execution.

Harvard Business Review reported on research involving nearly 700 executives in which only 8% of leaders were rated very effective at both strategy and execution. This does not suggest that most leaders lack intelligence, ambition, or vision. It highlights an important distinction: knowing what should happen and consistently making it happen are two very different responsibilities.

This is where business improvement can become unnecessarily complicated. You do not always need another extensive strategic plan before addressing an issue that is already costing your practice time, money, efficiency, or team capacity.

Sometimes the most productive first step is simply to examine what is happening right now.

THE FIVE-AREA PRACTICE AUDIT

Take out a piece of paper, open a document, or use the Notes app on your phone. Write down five areas:

Revenue. Expenses. People. Operations. Leadership.

Under each category, identify one thing you need to stop, fix, finish, or build before carrying it into another year.

Not ten things.

One.

The purpose of this exercise is not to solve every challenge in your practice in a single afternoon. The purpose is to identify issues you already understand and begin converting them into decisions rather than future intentions.

1. REVENUE: LOOK BEYOND THE TOP LINE

Begin with the number most businesses naturally focus on: revenue.

How much revenue has your practice generated this year? How does that compare with the same period last year?

Then ask the next question:

What did it cost the practice to generate that revenue?

A practice can increase revenue while simultaneously experiencing greater financial pressure. Production may increase while payroll, supplies, marketing, software, write-offs, and administrative expenses increase at an even faster rate. Collections may appear strong while aging insurance balances continue accumulating in accounts receivable.

A service may also look impressive on a production report while requiring significant chair time, team resources, administrative follow-up, or overhead.

Revenue tells you what came in. It does not, by itself, tell you whether the underlying business is financially healthy.

FOLLOW THE MONEY ALL THE WAY THROUGH

Select one area of the practice that appears successful from a top-line perspective. It might be a procedure category, a provider, a marketing channel, a membership plan, or a specific area of the schedule.

Then examine the complete financial picture.

Ask yourself: What was actually collected? What did it cost to deliver the service? How much team time was required? Were there remakes, adjustments, refunds, or write-offs? How much administrative follow-up did it create? How long did it take to collect the revenue? What remained after the work was completed?

You may discover that the area is every bit as healthy as you believed.

Or you may discover that something you have been trying to grow deserves closer analysis before assuming that more volume will automatically create a better result.

2. EXPENSES: WOULD YOU PURCHASE IT AGAIN TODAY?

Businesses naturally accumulate expenses over time. At some point, nearly every recurring expense probably had a legitimate reason for being added. A software platform solved a problem. An employee needed a particular tool. A service supported a specific initiative.

Then the business changes.

A newer platform begins performing the same function. An employee leaves. A project ends. A subscription renews automatically. A small monthly charge does not seem significant enough to investigate, so it remains.

Individually, a $79 expense may appear insignificant. However, multiple $49, $79, $129, $299, and $499 charges spread across several accounts can quietly become a meaningful expense category.

Instead of asking only, “Can we cut this?” ask:

“If we did not already have this expense, would we purchase it today?”

If the answer is yes, keep it intentionally.

If the answer is no, determine what is required to eliminate it.

A decision that made sense two years ago does not automatically need to remain a permanent business expense. Good financial management requires businesses to regularly reevaluate previous decisions using current information.

3. PEOPLE: REVIEW THE ROLE BEFORE ADDING ANOTHER PERSON

This issue is particularly important in dental practices because the front office can gradually become responsible for nearly every administrative task that does not have another clear owner.

Phones. Check-in. Check-out. Insurance verification. Treatment follow-up. Claims. Patient balances. Scheduling. Records. Patient questions. Referral coordination. Administrative projects.

And everything else that needs attention during the day.

Eventually, the team feels overwhelmed and the immediate conclusion becomes:

We need another employee.

That may be correct.

But before adding another person to payroll, remove the names from your organizational chart and examine the responsibilities assigned to each role.

Then ask:

If we were designing this practice today, would we create these positions exactly the same way?

Jobs change gradually. Someone leaves, so another employee temporarily takes on additional responsibilities. The practice grows, so more work is added. A strong employee becomes the person everyone relies on, which means even more responsibilities accumulate.

The temporary arrangement eventually becomes permanent.

Three years later, leadership may be frustrated because one employee is struggling to perform twelve unrelated responsibilities at the same level.

That may not be an employee performance problem.

It may be a job-design problem.

REDESIGN THE ROLE BEFORE YOU REPLACE THE PERSON

Choose the role in your practice that currently feels the most overloaded and list every recurring responsibility assigned to that position.

Then categorize each responsibility:

KEEP — This responsibility clearly belongs in the role.

MOVE — This responsibility should be owned by someone else.

REMOVE — This task is no longer necessary.

SUPPORT — The responsibility should remain, but the employee needs a stronger system, additional training, better technology, or outside administrative support.

Complete this exercise before automatically concluding that another full-time employee is necessary.

Sometimes the practice genuinely needs another person.

Sometimes the practice needs the work itself to be redesigned.

Confusing those two problems can become very expensive.

4. OPERATIONS: RECURRING PROBLEMS REQUIRE SYSTEMIC SOLUTIONS

Think about the operational issue your team has discussed repeatedly.

The same insurance verification error.

The same missed handoff.

The same scheduling issue.

The same incomplete patient follow-up.

The same aging claim.

The same confusion about who owns the next step.

If the same problem occurred in January, March, May, July, and September, you are probably not dealing with five unrelated incidents.

Something within the system is allowing the problem to continue.

Perhaps no one owns the process from beginning to end. Perhaps expectations are unclear. The technology may no longer support the workflow effectively. The team may have created so many workarounds that the original process is no longer recognizable.

Or everyone may understand what is supposed to happen, but leadership has not consistently reinforced the expectation.

McKinsey reported that 61% of respondents in a survey of more than 1,200 managers said at least half of the time they spent making decisions was ineffective.

Consider how easily this can happen inside a dental practice. A team can repeatedly discuss the same problem, collect more opinions, add another step, and talk about accountability while still leaving the meeting without a clear decision or owner.

At some point, additional discussion is no longer providing useful information.

It is postponing a decision.

DO NOT HOLD THE SAME MEETING AGAIN

Select one recurring operational problem and answer four questions:

What exactly continues to happen?

Who owns the process from beginning to end?

What needs to be different the next time this situation occurs?

How will we measure whether the change worked?

If you cannot clearly identify who owns the process, that is valuable information.

And if several meetings have already been held about the same issue, another meeting with the same agenda is unlikely to create a different outcome.

The next step should be a decision, an owner, and a measurable action.

5. LEADERSHIP: YOUR CALENDAR REVEALS YOUR ACTUAL PRIORITIES

Open your calendar and review the previous two weeks.

Do not evaluate what you intended to prioritize.

Examine where your time actually went.

How much time was spent making decisions only you can make? How much time was spent reviewing the financial health of the practice? How much time was devoted to developing leaders? How much of your week was consumed by work someone else could appropriately own? How much uninterrupted time did you have to think about the practice rather than simply react to it?

Owners often evaluate delegation only by comparing the cost of their time with the cost of someone else completing a task.

For example, if a task requires five hours and could appropriately be completed by someone earning $25 per hour, the visible labor cost is $125.

But that is not necessarily the true cost to the business.

The more important question is:

What did the owner not accomplish during those five hours?

Did you postpone a conversation with a potential partner? Did you fail to closely review a department that is consistently underperforming? Did you lose an opportunity to develop the leader responsible for managing the team? Were you so occupied with routine activity that you never had sufficient time to identify an important issue before it became a larger problem?

Being extremely busy can create the feeling that you are indispensable.

Sometimes, however, it simply means your role has not evolved as the business has grown.

PEOPLE STILL MATTER WHEN YOU START TALKING ABOUT NUMBERS

None of this means a dental practice should be managed like a spreadsheet.

People matter tremendously.

Gallup’s Q12 research, involving more than 183,000 business and work units, found that teams in the top quartile of employee engagement had 23% higher profitability than teams in the bottom quartile, along with stronger outcomes related to productivity, turnover, absenteeism, and other performance measures.

That matters because operational accountability and human-centered leadership are not opposites.

Strong employees should not spend their careers compensating for problems leadership refuses to address. They should not continually absorb another employee’s responsibilities because a role was poorly designed. They should not be required to work around a broken process for years simply because the organization has become accustomed to it.

And employees should not receive multiple competing priorities and then be told they have a time-management problem.

A financially responsible practice can care deeply about its people.

A compassionate leader can maintain clear expectations and accountability.

A healthy business must learn to do both.

THE 24-HOUR DECISION

Return to the five areas:

Revenue. Expenses. People. Operations. Leadership.

Write one decision beside each category.

Not a general goal.

A specific decision.

For revenue, that might be: I am reviewing our aging accounts receivable report and identifying what is realistically collectible.

For expenses: I am reviewing every recurring software charge before the next billing cycle.

For people: I am evaluating the responsibilities assigned to our overloaded front-office role before approving another hire.

For operations: I am assigning one person clear ownership of the insurance verification process.

For leadership: I am removing three recurring tasks from my calendar that someone else can appropriately own.

Then choose one of those five decisions and take action within the next 24 hours.

Pull the report. Review the expense. Schedule the conversation. Assign the owner. Adjust the calendar. Ask the question. Finish the task that has already been started.

You do not need enough information to know every step that will follow.

You need enough information to make the next responsible decision.

That decision creates new information. New information allows you to make the next decision.

That is how meaningful business improvement happens.

BEFORE YOU START PLANNING 2027

There is nothing wrong with preparing for a new year.

Set goals. Build the budget. Create the plan. Decide what you want your practice to become.

But do not use the next calendar year as a place to store problems you already understand.

Before you finalize your 2027 goals, consider these two questions:

If I built this practice today, knowing everything I know now, what would I refuse to rebuild exactly the same way?

And:

What am I calling a 2027 goal that is actually a 2026 problem?

Do not stop with the answer.

Choose one issue and move it forward.

Your practice does not need January to give you permission to make a better business decision.

September already has the receipts.

References

Leinwand, P., Mainardi, C., & Kleiner, A. (2015, December 30). Only 8% of Leaders Are Good at Both Strategy and Execution. Harvard Business Review.

Aminov, I., De Smet, A., & Lovallo, D. (2019, May). Good Decisions Don’t Have to Be Slow Ones. McKinsey Quarterly.

Gallup. (2024). The Relationship Between Engagement at Work and Organizational Outcomes: Q12 Meta-Analysis, 11th Edition.

Disclaimer:

To learn more about Sarah Beth Herman, the author of all free training content you can read her bio here. These materials are intended to provide helpful information to dentists and dental team members. They are in no way a substitute for actual professional advice based on your unique facts and circumstances. This content is not intended or offered, nor should it be taken, as legal or other professional advice. You should always consult with your own professional advisors (e.g. attorney, accountant, or insurance carrier). To the extent, Dentistry Support ®has included links to any third-party website (s), Dentistry Support ® intends no endorsement of their content and implies no affiliation with the organizations that provide their content. Further, Dentistry Support ® makes no representations or warranties about the information provided on those sites. You can view our privacy policy and terms and conditions by clicking those pages in the footer of our website