The fundamental differences relate to a commitment, or lack of commitment, to four core principles, which are the cornerstones of The Intelligent Practice: Standard of Care, Standard of Business, Standard of Teamwork, Standard of Leadership

Having analyzed thousands of dental practice statistics from every state in the county, I can easily say that the Standard of Care principle is the principle most often compromised. At first glance this may seem hard to believe, but once you recognize the poor decisions that erode this principle, you can understand how make more intelligent choices that will support your Standard of Care. It is essential for every business owner to lay the proper foundation from which all other “standards” will emerge. The intelligent practice owner defines and commits to operation policies and strategies that represent the values of the owner. Every business attracts the customer that reflects the values of the business. Make certain you have given this the proper attention it deserves. Only then can you develop your Standards of Business, Teamwork, and Leadership.

The answer is hidden in a fundamental flaw in their Standard of Care. Your Standard of Care begins with a treatment planning philosophy that leads your patients onto a path of wellness, defined by you and explained to your patients by you and your team. So fundamental is this commitment that as basic as it seems, over 70% of the dentists I meet compromise their Standard of Business because of flaws in their Standard of Care. The compromise manifests itself in unused and unequipped treatment rooms, with patients being abandoned by your hygiene department.

“Why do so many dental practice owners begin with a vision of more treatment rooms than they ended up equipping and using?”

Did you know that a majority of dentists have only one full-time hygienist equivalent when their patient base needs at least two full-time hygienists? Many dentists today are learning how to connect with their patients in a way that transforms their mission into results with up to three fulltime hygienists.

With a commitment to taking care of your patients in your continuing care program, the economics generated from a second fulltime hygienist are almost as rewarding as the smiles you get from a larger pool of grateful patients.

Let’s go into detail about just how many patients a hygienist can manage. Assuming that 50% of your patients need to be in your nonsurgical periodontal therapy program (which is less than ADA estimates), one patient with two quadrants of Scaling and Root Planning, one child prophy with fluoride, two adult six-month prophies, and four periodontal maintenance prophies, I have outlined what your schedule might look like in a day … without suggesting any sequence of procedures, instead I am outlining the number of each procedures required each day in order to fulfill your Standard of Care.

To calculate the economic opportunity within the hygiene department of your practice you need to gather and analyze the following information:

  • What percentage of your patient base is periodontally healthy?____%
  • How many unappointed patients do you have today?____#
  • How many openings in hygiene do you have per month for the next six months?____#
  • How many new patients are you getting per month?____

I’m confident that the results of this exercise will demonstrate that you have more patients in your practice than you are treating. Imagine what will happen to your schedule when you develop a proactive relationship with your patients through hygiene. Do you think your schedule will be full? With an abundance of patients in hygiene, you create powerful choices for you and your practice. You may find yourself no longer willing to treat patients with bad values, poor track records, and unpleasant behaviors.

Let’s visit why adding a second hygienist works for the benefit of the patients, your Standard of Care principle:


  • More patients will complete needed periodontal therapy treatment
  • More patients will complete needed restorative dentistry
  • More patients will complete desired cosmetic dentistry

Now let’s evaluate the economic benefit to the practice, your Standard of Business principle:


  • Hygiene revenue (200 days/year @ $1,360/day) $272,000
  • Expenses (labor @ $90,000/year plus $10K/supplies) $100,000
    • Gross margin – hygiene department $172,000
  • Extra dentistry on 500 “active” hygiene patients/year $200,000
  • Expenses (lab, supplies, and office supplies @ 20%) $ 40,000
    • Gross margin – dental department $160,000
    • Estimated increase in annual profitability $332,000

It all begins with the intelligent decisions you make regarding your facility, team, patient base, and the economic components that come together to support your mission.

We recommend the following standards for facility and equipment for the solo practitioner in order for the team to perform at maximum potential. It includes, but is not limited to:

  • A minimum of four fully equipped operatories per doctor: two for the dentist and two for hygiene. (Please note that our current template for the sole practitioner provides for seven operatories: three for the dentist, three for three full-time hygienists and one backup operatory.
  • Intraoral cameras in every operatory, not one to take from room to room, but one ready to use at all times in every operatory. Why make it so hard on your team to “talk” to your patients? Each picture is worth a 1,000 words. Your patients have decay and disease, and you are there to help them solve their problems. Don’t make it your problem by failing to educate and inform them in a meaningful way.
  • Digitize or Vaporize” is our motto when it comes to information … today’s dental office needs data processed and retrieved quickly so that you and your team can work in an efficient and effective way. This includes computers chairside as well as digital radiography, the current standard in dentistry.
  • Brand enhancement pieces of equipment like lasers are distinguishing practices from one another.

In order to attract intelligent patients your practice must be equipped and designed in an intelligent manner, have intelligent operating policies, offer intelligent strategies for treating disease, based on intelligent principles. In order to attract intelligent staff you must be intelligent, emotionally as well as clinically. The Intelligent Practice performs at a higher level than other practices, and it elevates everyone associated with it.