When I opened my office in 2010 I had more than one operatory to work out of and barely any idea how to do that efficiently. I thought I was doing well because we would see a patient in one room and then see the next patient in the other room. That treatment flow shaved off a few minutes of breakdown, disinfection, and set up and allowed the next patient to be seen on time. My assistant would go back and prepare the first room while patient # 2 was getting numb. If there was an emergency we would just squeeze them in somewhere. Here’s what my schedule would typically look like:
Average 3 operatory schedule
My hygiene room is nicely booked with 1 hour appointments, shown in green. At 9 and 10 AM I have crown appointments, marked in orange, each taking one hour. You can see an emergency in red stuck in at 10:30. Then at noon I have a crown insert, shown in peach, for a half hour. Then a half-hour operative appointment in blue at 12:30.
We were working out of two operatories but the schedule didn’t reflect that very well. We just put the main appointments back to back and stuck in anything extra in OP-2 as it came up. This kind of scheduling is inefficient. You know how I could tell? Because I had plenty of extra time to browse Facebook or Reddit throughout the day. That annoys me. I want to be treating patients, not looking at stupid cat videos.
So let’s look at when we have free time during an appointment, say, for a crown. I book an hour. I have to wait a few minutes after anesthesia, so there’s an opportunity right there. I have trained my assistant to make temporaries, so there’s a good five minutes there. I also don’t just sit and watch impression material set, so I have about five minutes right there. In fact, when you think about it, after I place the impression tray in the patient’s mouth I’m basically free for the rest of that appointment except for checking the temp and impression. So let’s view the crown appointment and mark green areas where I am free to see patients in the other room:
Green shows the times I can see a patient in another room
I could have my front desk book another patient in OP-2 during those green times. During that first green spot while the patient is getting numb, I could do a quick insert. During the impression setting and temp fabrication steps, I can at least start anesthetizing another patient for operative, another crown, do an insert, and so on. Once you start looking at your free time you can create a more optimized schedule that looks like this:
An optimized schedule
I am being a heck of a lot more efficient with my two operatories and treating more patients. The best way to reduce overhead is to produce more in the time you have. The largest chunk of your overhead is what you pay your staff. My team gets paid by the hour, so the more I can produce in that hour, the lower my overhead.
Making a schedule like this work does not require two assistants but it does mean that you have to train him/her how to do expanded duties, like fabricate temps. Check your State practice act to see what duties can be delegated. My office implemented this strategy a few months ago and here’s the good news: (1) our production went up, and (2) patients didn’t have to wait as long to get an appointment. The trickiest part is keeping in touch with your front desk about how much time you need for procedures. Without proper planning, you can get behind and create a mess. Fortunately this is a perfect conversation for your morning huddles.